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A new University of Colorado Boulder study shows that a small amount of physical exercise could profoundly protect the elderly from long-term memory loss that can happen suddenly following infection, illnesses or injury in old age.
In the study, CU-Boulder Research Associate Ruth Barrientos and her colleagues showed that aging rats that ran just over half a kilometer each week were protected against infection-induced memory loss.
"Our research shows that a small amount of physical exercise by late middle-aged rats profoundly protects against exaggerated inflammation in the brain and long-lasting memory impairments that follow a serious bacterial infection," said Barrientos of the psychology and neuroscience department.
The results of the study appears in the Aug. 10 edition of The Journal of Neuroscience.
"Strikingly, this small amount of running was sufficient to confer robust benefits for those that ran over those that did not run," Barrientos said. "This is an important finding because those of advanced age are more vulnerable to memory impairments following immune challenges such as bacterial infections or surgery. With baby boomers currently at retirement age, the risk of diminished memory function in this population is of great concern. Thus, effective noninvasive therapies are of substantial clinical value."
Past research has shown that exercise in humans protects against declines in cognitive function associated with aging and protects against dementia. Researchers also have shown that dementia is often preceded by bacterial infections, such as pneumonia, or other immune challenges.
"To the best of our knowledge, this is the first study to show that voluntary exercise in rats reduces aging-induced susceptibility to the cognitive impairments that follow a bacterial infection, and the processes thought to underlie these impairments," Barrientos said.
In the study, the researchers found that rats infected with E. coli bacteria experienced detrimental effects on the hippocampus, an area of the brain that mediates learning and memory.
Previous research has shown that immune cells of the brain, called microglia, become more reactive with age. When the older rats in the study encountered a bacterial infection, these immune cells released inflammatory molecules called cytokines in an exaggerated and prolonged manner.
"In the current study we found that small amounts of voluntary exercise prevented the priming of microglia, the exaggerated inflammation in the brain, and the decrease of growth factors," Barrientos said.
The next step of this research is to examine the role that stress hormones may play in sensitizing microglia, and whether physical exercise slows these hormones in older rats, she said.
Barrientos co-authored the paper with CU-Boulder professors of psychology and neuroscience Steven Maier, Linda Watkins, Serge Campeau, Heidi Day and Susan Patterson; and CU-Boulder psychology research assistants Timothy Chapman, Matthew Frank, Nicole Crysdale and Jared Ahrendsen.
The research was funded by the National Institute on Aging, which is part of the National Institutes of Health.
Source: University of Colorado at Boulder, August 11, 2011
More and more, patients show up to appointments with hypertension expert John Bisognano, M.D., Ph.D. carrying bags full of "natural" products that they hope will help lower their blood pressure. And like most physicians, Bisognano doesn't always know if these products will do any good, or if they will cause any harm.
"Right now we're seeing a cultural shift where an increasing number of people want to avoid standard pharmaceuticals," said Bisognano, professor of Medicine and director of Outpatient Cardiology at the University of Rochester Medical Center. "We're also seeing a growing number of patients who require a large number of drugs to control their blood pressure and are looking for something else to help manage it."
In an effort to better educate health care professionals and patients, Bisognano and Kevin Woolf, M.D., a cardiology fellow at the Medical Center, conducted the most comprehensive review to date of the evidence behind a wide range of non-drug interventions for the treatment of high blood pressure. The review is featured in the September issue of the Journal of Clinical Hypertension.
Woolf said there is not enough data to recommend any of these alternative options on a routine basis, but on an individual basis he thinks they are useful. "Patients have different backgrounds and different approaches to living their lives," said Woolf. "This is where the art of medicine comes in; getting to know patients and what they will and will not embrace can help physicians identify different therapies that suit their patients' habits and that will hopefully make a difference for them."
Woolf and Bisognano, who is a member of the editorial board of the Journal of Clinical Hypertension, emphasize that all patients with hypertension should adhere to the low-salt DASH diet, which is high in fiber, low in fats and incorporates lots of fruits and vegetables, and follow an exercise and weight loss regimen - lifestyle modifications recommended by the American Heart Association. Any alternative options should be considered for use in addition to these lifestyle changes.
When it comes to safety, Bisognano adds, "These alternative options are usually harmless, except when they keep patients from taking medications they need to take. If a patient is taking a supplement instead of something that we know is useful, that could be a problem."
The shining star among supplements is coenzyme Q10, an enzyme involved in energy production that also acts as an antioxidant. Patients with hypertension tend to have lower levels of the enzyme, and a meta-analysis - an overarching analysis of past studies - found that treatment with coenzyme Q10 supplements significantly reduced blood pressure.
Woolf noted that "Coenzyme Q10 has a pretty profound effect on blood pressure, but whenever research is based on a collection of other data you have to have some skepticism." Woolf said he still thinks the compound is promising.
Woolf also found that potassium helps lower blood pressure, and there is evidence that increasing the amount of potassium we get through the foods we eat could carry some of the same mild benefits as taking supplements.
The potential herbal remedies Woolf identified include mistletoe extract, used in traditional Chinese medicine to treat hypertension. Mistletoe extract reduced blood pressure in animal studies, but Woolf cautions that it may be toxic at high doses. The extract from Hawthorn, a type of tree, is also used, but provides only a slight reduction in blood pressure. Conversely, Woolf uncovered a handful of herbal remedies - St. John's wort, ephedra/ma huang, yohimbine and licorice - that may increase blood pressure.
Woolf and Bisognano stress that the Food and Drug Administration does not regulate dietary and herbal supplements the way they regulate traditional pharmaceuticals. They say health care providers and patients need to be aware that the safety of these products is not always rigorously established and that formulations can vary.
Research on both practices is mixed - the types of patients included, the methods used, and the results, which vary from study to study. While there is no conclusive evidence that either lowers blood pressure, researchers found that acupuncture reduces blood pressure compared to placebo in patients also taking anti-hypertensive medications, while in a meta-analysis, transcendental meditation appeared to lower blood pressure. Other techniques that may provide some benefit include Zen Buddhist meditation and Qi Gong.
Some devices developed in recent years involve a medical procedure, while others use technology that requires patients to participate in various exercises.
Those that involve a procedure include the implantable Rheos® device, which regulates blood pressure much like a pacemaker regulates heart rhythm, and the Symplicity® catheter system, which ablates or destroys nerves around the kidneys that send inappropriate signals to the brain to increase blood pressure. Both are designed for patients with difficult-to-treat hypertension and led to significant drops in blood pressure in clinical trials. They are only available to research participants at this time.
Two devices that patients can use in the comfort of their own homes are the RESPeRATE breathing device and the Zona Plus hand drip device. The RESPeRATE system uses a breath sensor and gives patients feedback through headphones to help them slow their breathing, which research suggests benefits blood pressure. If used 15 minutes a day, studies show RESPeRATE leads to a modest decrease in hypertension.
The Zona Plus is a device that patients grip in either hand and perform multiple sets of squeezing at different levels in response to electronic cues. Bisognano says there is no good explanation as to why this works, but studies found the device decreased hypertension in patients using it three days a week for at least eight weeks. Patients can buy both devices for between $300 and $400, and Bisognano suggests them to interested patients.
Source: University of Rochester Medical Center, September 1, 2011
Scientists at Yale University have developed the first practical method to create a compound called huperzine A in the lab. The compound, which occurs naturally in a species of moss found in China, is an enzyme inhibitor that has been used to treat Alzheimer's disease in China since the late 1990s and is sold in the U.S. as a dietary supplement to help maintain memory. Scientists believe it could also potentially combat the effects of chemical warfare agents.
Until now, researchers have only been able to derive small amounts of the compound directly from the Huperzia serrata plant, or had to resort to lengthy and cumbersome methods to synthesize it in the lab.
Now researchers at Yale have developed a practical and cost-effective method to synthesize huperzine A in the lab. The process requires just eight steps and produces a yield of 40 percent. Previously, the best synthetic techniques had required twice as many steps and achieved yields of only two percent.
"Being able to synthesize large amounts of huperzine A in the lab is crucial because the plant itself, which has been used in Chinese folk medicine for centuries, takes decades to grow and is nearing extinction due to overharvesting," said Seth Herzon, the Yale chemist who led the research, which is described in the Aug. 25 issue of the journal Chemical Science.
In some places, huperzine A can cost up to $1,000 per milligram. Herzon and his team produced several grams of the compound in their lab and are capable of creating much more. They believe they will be able to drive the cost down to just 50 cents per milligram (a projected typical dose is about one milligram per day), and have partnered with an industrial firm to help produce it on larger scales.
The firm plans to comprehensively evaluate the therapeutic potential of huperzine A by conducting clinical trials for several different neurological disorders in the U.S. In addition, the Herzon lab and the firm are working with the U.S. Army, which is interested in huperzine A's potential in blocking the effects of chemical warfare agents, he said. The compound has been shown to protect primates against chemical warfare agents, without side effects.
Other Alzheimer's treatments based on enzyme inhibitors are currently prescribed in the U.S., but huperzine A binds better, is more easily absorbed by the body and last longer in the body than other treatments, Herzon said.
"We believe huperzine A has the potential to treat a range of neurologic disorders more effectively than the current options available," Herzon said. "And we now have a route to huperzine A that rivals nature's pathway."
Other authors of the paper include Maung Kyaw Moe Tun and Daniel-Joachim Wüstmann, both of Yale.
Source: Yale University, August 26, 2011
A new saliva test can measure the amount of potential carcinogens stuck to a person's DNA interfering with the action of genes involved in health and disease and could lead to a commercial test to help determine risks for cancer and other diseases, scientists reported here today during the 242nd National Meeting & Exposition of the American Chemical Society (ACS).
"The test measures the amount of damaged DNA in a person's body," said Professor Hauh-Jyun Candy Chen, Ph.D., who led the research team. "This is very important because such damaged DNA we call this 'DNA adducts' is a biomarker that may help doctors diagnose diseases, monitor how effective a treatment is and also recommend things high-risk patients can do to reduce the chances of actually getting a disease," said Chen. The research team is at National Chung Cheng University (NCCU) in Taiwan. "We tried urine and blood and found these adducts. Then we turned our attention to saliva. It's much more convenient to collect a sample of saliva."
A DNA adduct forms when a potentially cancer-causing substance is chemically attached to a strand of DNA, which makes up genes. People come into contact with such substances in the environment, certain workplaces and through everyday activities. Cigarette smoke, for instance, contains at least 20 known cancer-causing substances. When such a substance binds to DNA, it changes the DNA so that genes may not work normally. Our body has a built-in repair system that can naturally clear up such damage. If that system fails, however, a DNA adduct could lead to mutations or genetic changes that, in turn, could lead to cancer. DNA adducts also accumulate with aging and have been linked to other health problems, including inflammatory diseases and chronic brain disorders like Alzheimer's disease.
The new test measures the levels of five key DNA adducts, including some that form as a result of cigarette smoking. Traditionally, DNA for such tests had to be obtained by taking a blood sample and processing the white blood cells, which contain large amounts of the genetic material. More recently, however, scientists found that DNA samples could be obtained more conveniently from saliva. The DNA is present in white blood cells found naturally in saliva and from cells shed from the lining of the mouth. Chen uses a very sensitive laboratory instrument called a mass spectrometer to analyze for DNA adducts.
Chen envisions several uses for any potential commercial version of the test, which she said would probably cost several hundred dollars. One, for example, might be health promotion among people exposed to carcinogens due to lifestyle, occupation or other factors. Detection of high levels of DNA adducts in cigarette smokers, for instance, could encourage them to stop. Follow-up tests showing a decline in DNA adducts could reinforce their healthier lifestyle.
Source: American Chemical Society, September 1, 2011
Can changing a single word on a sign motivate doctors and nurses to wash their hands?
Campaigns about hand-washing in hospitals usually try to scare doctors and nurses about personal illness, says Adam Grant, a psychological scientist at The Wharton School, University of Pennsylvania. "Most safety messages are about personal consequences," Grant says. "They tell you to wash your hands so you don't get sick." But his new study, which will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science, finds that this is the wrong kind of warning.
Hand-washing is an eternal problem for hospitals. Healthcare professionals know it's the best way to prevent the spread of germs and diseases. But, on average, they only wash their hands about a third to a half of the time they come into contact with patients and germs.
Grant had done research in hospitals before, on topics like getting nurses to speak up about safety and reducing burnout among doctors. But when his first daughter was born, Grant's attention was drawn to the hospital's signs about hand-washing. "I noticed a real disconnect between what the signs were emphasizing and what I knew as a psychologist," he says.
As a psychologist, Grant knew about "the illusion of invulnerability" - that most people think they aren't at risk of getting sick. His own research had also shown that people aren't motivated only by avoiding dangers for themselves; they also go to work because they want to protect and promote the well-being of others. The problem was, the signs warned about personal risks. These messages should fall on deaf ears among healthcare professionals, who are frequently exposed to germs but rarely get sick. "If I don't wash my hands, I'll be okay. But patients are a vulnerable group," he says.
To test that, Grant and his coauthor, David Hofmann of the University of North Carolina at Chapel Hill, came up with two signs to post over dispensers for soap and hand sanitizer. One said "Hand hygiene prevents you from catching diseases." The other said "Hand hygiene prevents patients from catching diseases." They posted these signs above different dispensers in a hospital and recorded how often people washed, measuring how much soap and gel was used― and having trained observers spy on their colleagues.
The sign about patients was the winner. Healthcare professionals were much more likely to wash their hands if they were reminded that they were keeping patients safe. The patient sign increased soap and gel use by 33% per dispenser, and healthcare professionals were 10% more likely to wash their hands. The sign about personal risks did no good.
"Our findings challenge prevailing wisdom in the healthcare professions," Grant says, "that the best way to get people to wash their hands is to scare them about their own health. Instead, his research demonstrates, you should remind them that hand-washing helps others.
A lot of interventions work well in the beginning, then drop off, and these studies only lasted two weeks. Grant suggests that future studies should test whether these signs would continue to work in the long term. It might be possible keep the message fresh by changing the signs frequently to mention different patients, or to use different slogans, like "Did you wash your hands? What if your mother was the next patient you saw?" Grant says. The punch line here is that it's not all about me. To motivate people to engage in safety behaviors, we should highlight the consequences for others - not only themselves.
Source: Association for Psychological Science, September 1, 2011
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