BreakThrough Digest Medical News |
- Can hormone help treat multiple sclerosis long-term?
- A new drug reduces heart damage
- Anti-aging drug breakthrough
- Biological tooth replacement — a step closer
| Can hormone help treat multiple sclerosis long-term? Posted: 09 Mar 2013 09:00 PM PST A new study suggests that treatment with adrenocorticotropic hormone (ACTH) may be helpful for people whose multiple sclerosis (MS) is not well-controlled through their regular treatment. The study was released today and will be presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego, March 16 to 23, 2013.
The study involved 23 people with MS who were taking beta-interferon treatment and had at least one relapse or brain scan showing new disease activity within the previous year. They were considered to have “breakthrough” MS, which means that their treatment that had been working previously stopped being effective, leading to worsening disability and more frequent relapses, as well as increased evidence of disease activity on brain scans. The study participants were given either ACTH or methylprednisolone as pulse therapy monthly in addition to their regular treatment for one year. The people with MS knew which treatment they were receiving, but the researchers examining them did not. The participants were tested every three months for 15 months. Over that time, those receiving ACTH had fewer relapses, or 0.08 cumulative relapses per patient compared to 0.8 relapses per patient for those receiving methylprednisolone. Those taking ACTH also had no cases of psychiatric side effects, while those taking methylprednisolone had a cumulative number of 0.55 psychiatric episodes per patient. “These results are of interest because few treatments are available for people with breakthrough MS,” said study author Regina Berkovich, MD, PhD, of Keck Medical Center of USC in Los Angeles. “Further studies, including randomized controlled trials, are needed to validate these preliminary findings, but the results suggest a potential benefit of ACTH pulse therapy in breakthrough MS.” While ACTH has been approved for use in MS relapses for many years, its cost has limited its use to only those patients who are in need of a relapse treatment alternative to corticosteroids. This is believed to be the first study to have been done on its use as a chronic treatment for MS. ACTH is not FDA-approved for use as chronic treatment for MS. ### The study was supported by a research grant from Questcor Pharmaceuticals, Inc., maker of ACTH. Learn more about multiple sclerosis at http://www.aan.com/patients. The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy. For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube. Media Contacts: Contact: Rachel Seroka |
| A new drug reduces heart damage Posted: 09 Mar 2013 09:00 PM PST A single dose of an investigational anti-inflammatory drug called inclacumab considerably reduces damage to heart muscle during angioplasty (the opening of a blocked artery), according to a recent international clinical trial spearheaded by Dr. Jean-Claude Tardif, Director of the Research Centre at the Montreal Heart Institute, affiliated with the University of Montreal. Presented today in San Francisco at the prestigious American cardiology conference, these findings show great promise.
“Inclacumab could indeed become an integral part of the therapeutic arsenal of modern cardiology if we can reproduce these results in subsequent studies. We could use the drug for a broader patient population, or for all patients who present with a heart attack, but this will require further study,” explained Dr. Tardif, lead investigator of the study and also professor of Medicine at the University of Montreal. Reducing the risk of complications after angioplasty to treat heart attack Each year, approximately 35,000 coronary artery angioplasty procedures are conducted in Canada and more than 1 million are conducted in the United States to treat atherosclerosis. This condition occurs when the arteries are obstructed with deposits of fat (cholesterol), calcium and cellular waste. Over time, the arteries lose their elasticity and narrow, which slows down or blocks blood flow. Because of the resulting complications (angina, heart attack, stroke, etc.), patients may ultimately need an angioplasty, which is a percutaneous intervention that dilates the narrowed artery to re-establish blood flow. However, heart tissue can become damaged during an angioplasty, and an inflammatory cascade can lead to other complications. A single dose may provide benefits For this clinical study, Dr. Tardif and his team compared the effects of a single dose of this new anti-inflammatory drug with placebo. Inclacumab is an antibody that blocks P-selectin, a molecule that drives inflammation and plays an important role in vascular disease. To study the effects of the drug, Dr. Tardif and his team administered a single dose of inclacumab and then measured the subjects’ levels of troponin I, which is a marker used clinically to diagnose heart attack. They found that inclacumab reduced troponin l levels by 24 %. “It is very exciting to discover that a single dose of inclacumab can provide benefits,” stressed Dr. Tardif. The trial involved 530 patients with myocardial infarction whose median age was 61 and 78.9 % of whom were men. Patients were randomized to receive an infusion of inclacumab at 20 mg/kg, inclacumab at 5 mg/kg, or placebo 1 to 24 hours before angioplasty. Markers for heart damage were then measured at 8, 16 and 24 hours after angioplasty. On Sunday March 10, Dr. Tardif will present the results of the SELECT-ACS, supported by Roche, or “Effects of the P-Selectin Antagonist Inclacumab in the Select-Acute Coronary Syndromes Trial” at the 62nd Annual Scientific Session of the American College of Cardiology. ACC.13 is the premier cardiovascular medical meeting in the United States that brings together cardiologists and cardiovascular specialists to further advances in cardiovascular medicine. ### The University of Montreal is officially known as Université de Montréal. Contact: William Raillant-Clark |
| Posted: 07 Mar 2013 09:00 PM PST Drugs that combat ageing may be available within five years, following landmark work led by an Australian researcher. The work, published in the March 8 issue of Science, finally proves that a single anti-ageing enzyme in the body can be targeted, with the potential to prevent age-related diseases and extend lifespans.
The paper shows all of the 117 drugs tested work on the single enzyme through a common mechanism. This means that a whole new class of anti-ageing drugs is now viable, which could ultimately prevent cancer, Alzheimer’s disease and type 2 diabetes. “Ultimately, these drugs would treat one disease, but unlike drugs of today, they would prevent 20 others,” says the lead author of the paper, Professor David Sinclair, from UNSW Medicine, who is based at Harvard University. “In effect, they would slow ageing.” The target enzyme, SIRT1, is switched on naturally by calorie restriction and exercise, but it can also be enhanced through activators. The most common naturally-occurring activator is resveratrol, which is found in small quantities in red wine, but synthetic activators with much stronger activity are already being developed. Although research surrounding resveratrol has been going for a decade, until now the basic science had been contested. Despite this, there have already been promising results in some trials with implications for cancer, cardiovascular disease and cardiac failure, type 2 diabetes, Alzheimer’s and Parkinson’s diseases, fatty liver disease, cataracts, osteoporosis, muscle wasting, sleep disorders and inflammatory diseases such as psoriasis, arthritis and colitis (inflammatory bowel disease). “In the history of pharmaceuticals, there has never been a drug that tweaks an enzyme to make it run faster,” says Professor Sinclair, a geneticist with the Department of Pharmacology at UNSW. The technology was sold to pharmaceutical giant GlaxoSmithKline in 2008[i]. Four thousand synthetic activators, which are 100 times as potent as a single glass of red wine, have been developed ? the best three are in human trials. “Our drugs can mimic the benefits of diet and exercise, but there is no impact on weight,” says Professor Sinclair, who suggests the first therapeutic to be marketed will be for diabetes. There have been limited trials in people with type 2 diabetes and the skin inflammatory disease, psoriasis. There were benefits to the metabolism in the first group and a reduction in skin redness in the second. The drugs can be administered orally, or topically. So far, there have been no drugs developed targeting ageing skin, but one major skin care range has developed a crème with resveratrol in it. While any drug would be strictly prescribed for certain conditions, Professor Sinclair suggests that one day, they could be taken orally as a preventative. This would be in much the same way as statin drugs are commonly prescribed to prevent, instead of simply treating, cardiovascular disease. In animal models, overweight mice given synthetic resveratrol were able to run twice as far as slim mice and they lived 15 per cent longer. “Now we are looking at whether there are benefits for those who are already healthy. Things there are also looking promising,” says Professor Sinclair, who also heads the Lowy Cancer Research Centre’s Laboratory for Ageing Research at UNSW. “We’re finding that ageing isn’t the irreversible affliction that we thought it was,” he says. “Some of us could live to 150, but we won’t get there without more research.” ### [i] Professor Sinclair formed a started up company Sirtris to develop the anti-ageing technology. This was subsequently sold to GlaxoSmithKline (GSK). Professor Sinclair is now a scientific advisor to GSK. Several other authors on the paper work for GSK or an affiliated company. Contact: Susi Hamilton |
| Biological tooth replacement — a step closer Posted: 07 Mar 2013 09:00 PM PST Scientists have developed a new method of replacing missing teeth with a bioengineered material generated from a person’s own gum cells. Current implant-based methods of whole tooth replacement fail to reproduce a natural root structure and as a consequence of the friction from eating and other jaw movement, loss of jaw bone can occur around the implant. The research is led by Professor Paul Sharpe, an expert in craniofacial development and stem cell biology at King’s College London and published in the Journal of Dental Research.
Research towards achieving the aim of producing bioengineered teeth ? bioteeth ? has largely focussed on the generation of immature teeth (teeth primordia) that mimic those in the embryo that can be transplanted as small cell ‘pellets’ into the adult jaw to develop into functional teeth. Remarkably, despite the very different environments, embryonic teeth primordia can develop normally in the adult mouth and thus if suitable cells can be identified that can be combined in such a way to produce an immature tooth, there is a realistic prospect bioteeth can become a clinical reality. Subsequent studies have largely focussed on the use of embryonic cells and although it is clear that embryonic tooth primordia cells can readily form immature teeth following dissociation into single cell populations and subsequent recombination, such cell sources are impractical to use in a general therapy. Professor Sharpe says: ‘What is required is the identification of adult sources of human epithelial and mesenchymal cells that can be obtained in sufficient numbers to make biotooth formation a viable alternative to dental implants.’ In this new work, the researchers isolated adult human gum tissue from patients at the Dental Institute at King’s College London, grew more of it in the lab, and then combined it with the cells of mice that form teeth. By transplanting this combination of cells into mice the researchers were able to grow hybrid human/mouse teeth containing dentine and enamel, as well as viable roots. Professor Sharpe concludes: ‘Epithelial cells derived from adult human gum tissue are capable of responding to tooth inducing signals from embryonic tooth mesenchyme in an appropriate way to contribute to tooth crown and root formation and give rise to relevant differentiated cell types, following in vitro culture. ‘These easily accessible epithelial cells are thus a realistic source for consideration in human biotooth formation. The next major challenge is to identify a way to culture adult human mesenchymal cells to be tooth-inducing, as at the moment we can only make embryonic mesenchymal cells do this.’ ### CONTACT Katherine Barnes NOTES TO EDITORS The research was funded by the UK National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, UK. Adult Human Gingival Epithelial Cells as a Source for Whole-tooth Bioengineering Journal of Dental Research 2013 Copy of the paper available on request About King’s College London (http://www.kcl.ac.uk) King’s College London is one of the top 30 universities in the world (2011/12 QS World University Rankings), and the fourth oldest in England. A research-led university based in the heart of London, King’s has more than 25,000 students (of whom more than 10,000 are graduate students) from nearly 140 countries, and some 6,500 employees. King’s is in the second phase of a £1 billion redevelopment programme which is transforming its estate. King’s has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million. King’s has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres. About the National Institute for Health Research (http://www.nihr.ac.uk) The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. The views expressed in this news release are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Contact: Katherine Barnes |
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