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Month: July 2023

MS severity: Genetic markers may lead to better treatment.

MS severity: Genetic markers may lead to better treatment.

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Globally, 2.8 million people will have Multiple Sclerosis (MS) in 2020. The symptoms of MS can worsen over time and result in chronic problems, and the condition presently has no known cure.

The first genetic indicator of MS severity and progression has been identified by researchers at the University of California, San Francisco.

This discovery, according to scientists, may help in the creation of new medications that can delay the advancement of the illness.

Multiple sclerosis (MS), a condition of the central nervous system that affects mobility and vision, will impact roughly 2.8 million individuals worldwide by the year 2020.

MS presently has no known cure. Each person is uniquely affected by the illness, both in terms of when symptoms initially appear and how severe they are.

The severity of the illness can worsen as the body experiences a cycle of symptom flare-ups and remissions, resulting in persistent mobility problems, visual loss, and even partial or complete paralysis.

The first genetic signature connected to MS severity and progression has now been identified by researchers from the University of California, San Francisco.

This discovery, according to scientists, may help in the creation of new medications that can delay the advancement of the illness.

Research targets MS progression

The University of California, San Francisco’s Dr. Sergio Baranzini, professor of neurology and co-senior author of the study, explained that they chose to look for a genetic variation associated with faster MS progression because the disease develops differently in each patient after diagnosis.

“Neurological progression is a common feature in persons with MS, which is inexorable and independent of whether relapses are controlled or not,” he said.

“Some people have a very aggressive disease that can impact their mobility and neurological function in a few years, while others experience a much more benign course,” he said. We already knew that genetics has a significant influence on risk, but the wide range of outcomes revealed that genetics may also affect severity.

Data from The MultipleMS Consortium and The International Multiple Sclerosis Genetics Consortium (IMSGC), two sizable MS research consortiums, were used by Dr. Baranzini and his team.

For a genome-wide association study (GWAS), data from both groups were pooled to represent more than 12,500 MS patients.

From there, researchers combed through more than 7.5 million genetic variants before discovering one linked to accelerated disease progression in MS patients.

This particular mutation is situated between two genes named DYSF and ZNF638 that had no known association with MS. ZNF638 aids in the control of viral infections whereas DYSF aids in the restoration of damaged cells.

Possibility of new treatments for MS

Since there is currently no treatment for MS, doctors employ a variety of drugs to treat the symptoms, delay the disease’s course, and help avoid relapses.

The results of this study, according to Dr. Baranzini, will open the door for a new class of medicines that will treat progression and probably target the central nervous system.

Dr. Baranzini made the point that genetic information considerably reduces the risks associated with drug development because developing medicines represents a considerable risk for the pharmaceutical business, where only a tiny percentage of drugs reach the market.

“This discovery will set up several development programs that will target the unmet need of disease progression in MS,” he said.

“All relapse-controlling medications are immunomodulatory, which is consistent with the genetics of the more than 200 MS risk variations. The central nervous system should be the target of this new class of therapies, according to the genetics of illness severity.”

Dr. Baranzini explained that since it has been proven that genetics contribute to the severity of an illness, the IMSGC is currently preparing for a new genetic study including even more participants.

The researcher continued, “Our prior experience with disease susceptibility suggests that a larger study translates into more findings, and we are pleased to uncover new genetic variants that could aid in the development of more efficient treatments for MS.”

How is MS being treated right now?

The capacity to move, think, talk, and see clearly can all be significantly impacted by MS since it affects the brain and nerve system.

The majority of scientists concur that MS is caused by the body’s immune system wrongly attacking the central nervous system, even though the exact origin of MS is still unknown.

The myelin that wraps the nerve fibres in the brain and spinal cord is damaged by this onslaught. When myelin is destroyed, it is unable to protect the exposed nerve fibre, which prevents messages from travelling from the nerves to the brain.

Additional MS risk factors include:

  • age – between the ages of 20 and 50, most persons acquire a diagnosis
  • MS is more prevalent in women than in men.
  • an MS family history
  • smoking
  • a lack of vitamin B12 or vitamin D
  • exposure to specific viral illnesses, such as mononucleosis or the Epstein-Barr virus

Why the recent study is beneficial?

We discussed the significance of the study with Dr. Krupa Pandey, director of clinical research at the Neurosciences Institute in New Jersey, director of the Hackensack University Medical Centre MS Centre, and associate professor of neurology at the Hackensack Meridian School of Medicine who was not involved in the current investigation.

She said, “There are a few ways in which this study is helpful. Finding a connection between genes and the potential severity of a disease is a positive step.”

“It is also beneficial since it offers more proof that environmental variables, like smoking, truly do assist people with genetically susceptible diseases to get sicker. This is a fantastic illustration of how a disease may be affected by both nature and upbringing, said Dr. Pandey.

The expert went on to say that similar discoveries “may lead to future findings that can help us counsel patients on how to tailor not just medication regimens but modify lifestyle-related factors.”

“It is also helpful for companies looking at MS therapies [to] enroll patients with higher risks for progression to see if the drug is effective,” she said.

REFERENCES:

For Nerve damage medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=30

Coffee: Is it energy booster or just a placebo?

Coffee: Is it energy booster or just a placebo?

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The neurological effects of caffeine and coffee consumption were compared by researchers. They discovered that drinking coffee, but not caffeine, enhances brain activity associated with higher-order cognitive function and visual processing.

Could the effects of coffee on enhancing focus and performance be a placebo effect? A recent study comparing the impact of drinking coffee vs only caffeine suggests that might be the case.

Coffee is frequently consumed first thing in the morning to combat fatigue, maintain alertness, and perform well. Approximately 49% of Americans who are 20 years of age and older and who drink coffee do it daily.

Several distinct chemicals in coffee have diverse effects on the brain. The most well-known of these substances, caffeine, is known to stimulate dopamine circuits that improve memory.

Coffee’s neurochemical effects on the brain are well established, but its psychological consequences are less well understood.

For instance, some study indicates that while coffee consumption may have an impact on cognitive function in non-regular drinkers, it has less of an impact on habitual drinkers due to tolerance development.

According to the same research, a significant portion of caffeine’s and coffee’s stimulating effects may be accounted for by the alleviation of withdrawal symptoms following brief abstinence.

It may be easier to comprehend why individuals consume coffee with the help of more research into how coffee affects the brain.

They discovered that the effects of caffeine and coffee on brain function altered “the connectivity of the default mode network.” This shows that caffeine or coffee consumption facilitated the shift from resting to working on tasks, according to a news release.

Active ingredients in coffee

Numerous bioactive substances found in coffee contribute to its potential for substantial health effects.

Many of these substances are antioxidants, which protect your cells from injury from dangerous free radicals.

The key components of coffee are listed below:

  • Caffeine. Caffeine, which is coffee’s primary active component, activates the central nervous system.
  • Acids chlorogenic. Some biological pathways, including blood sugar metabolism and high blood pressure, may benefit from these polyphenol antioxidants.
  • Cahweol and cafestol. These substances are abundant in unfiltered coffee and are present in the natural oil of coffee.
  • Trigonelline. Since this alkaloid molecule is unstable at high temperatures, it transforms into nicotinic acid, or niacin (vitamin B3), during roasting.

However, the concentrations of these ingredients in a cup of coffee can differ.

Effects of drinking coffee as opposed to only caffeine

47 participants who consumed at least one cup of coffee daily were chosen by the researchers for the study. 31 of them were female, and they were all around the age of 30.

Before taking part in the trial, each participant was instructed to refrain from consuming any caffeinated food or beverages for at least three hours.

The subjects were subjected to two fMRI scans in the lab: one before and one 30 minutes after ingesting caffeine or drinking a cup of coffee. Participants were instructed to unwind and allow their thoughts wander throughout the fMRI scans.

In the end, the researchers discovered that in the default mode network (DMN), both coffee and caffeine decreased functional connectivity.

According to the authors, “self-referential processes when participants are at rest” are connected to the DMN. Reduced DMN, according to the researchers, suggests a higher level of readiness to shift from resting to task-context processing.

They also observed that consumption of coffee, but not caffeine, markedly reduced brain connection between somatosensory and motor networks. This may help to explain why people report having better psychomotor function after consuming caffeinated coffee, according to the researchers.

The executive control and visual networks associated with visual processing and higher-level cognitive function, such as working memory, cognitive control, and goal-directed behaviour, were more active after coffee consumption but not caffeine.

Coffee consumption is a sensory experience.

The researchers hypothesised that the sensory experience of drinking coffee may be the cause of the different effects of ingesting caffeine and drinking coffee.

The additional effects of drinking coffee may be explained by the placebo effect, according to Armargo Couture, a registered dietitian nutritionist at Staten Island University Hospital in New York who was not involved in the study:

Because drinking a cup of coffee in the morning is the social custom in this culture, the placebo effect may be effective in this situation. In essence, many people connect their “morning coffee” with “waking up” and getting ready for the day.

“Many people regularly take their morning cup of coffee after getting out of bed before beginning the day, which naturally comes to be connected with being successful. The idiom “don’t talk to me until I’ve had my morning coffee” was coined because preparing for the day with a daily cup of coffee is a shared experience and the social norm, she continued.

However, Couture pointed out that other substances in coffee may potentially be the source of its additional effects.

“Coffee’s terpenes, cafestol and kahweol, and polyphenols, including chlorogenic acids, interact with different brain receptors to boost energy, elevate mood, and instill a motivational attitude. According to a study, coffee’s terpenes and polyphenols contain anti-inflammatory and antioxidant effects that have also been linked to a lower incidence of depression.

Study limitations for evaluating the effects of coffee

Dr. Teixeira pointed out that the study’s significant shortcomings include the absence of non-drinker or decaf-drinker groups as well as the absence of task-related fMRI data or cognitive tests.

“Rather of directly measuring cognitive function, the researchers used fMRI to examine brain connections. The lay media frequently misinterprets things like this, he said.

“It is also unclear how matched the coffee and caffeine groups were regarding sociodemographic and coffee and/or other caffeinated beverage consumption,” he continued.

We also received the following information from Dr. Gregory S. Carter, Ph.D., Associate Professor of Neurology and Head of the Sleep Medicine Section for the Department of Neurology at the University of Texas (UT) Southwestern Medical Centre.

The length of time between consuming coffee or other caffeinated beverages and the fMRI’s operation is the main restriction. The caffeine that has been dissolved takes 50–60 minutes to reach its peak blood concentration. The authors tested after 30 minutes, which is a little early especially when the blood-brain barrier’s relatively swift transit is taken into account.

The results are further constrained, according to Dr. Michael J. McGrath, Medical Director at the Ohana Luxury Alcohol Rehab and a board-certified psychiatrist who was not involved in the study, because the researchers did not examine whether the advantages coffee drinkers enjoy are caused by the alleviation of withdrawal symptoms.

Benefits of coffee consumption

According to Couture, “coffee may benefit your mindset towards goals while improving your working memory and cognition. It increased subjects’ executive control.”

She continued, “Those who struggle with executive dysfunction may find that consuming coffee helps by boosting motivation and working memory.

Dr. McGrath added that the findings demonstrate that some advantages of drinking coffee derive from sources other than caffeine. He pointed out that this suggests that consuming decaffeinated coffee in the morning may help increase alertness and focus.

REFERENCES:

For Energy booster medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=83

Is Mirikizumab useful for ulcerative colitis as per study?

Is Mirikizumab useful for ulcerative colitis as per study?

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In a recent clinical trial, a novel drug being developed to treat ulcerative colitis showed promise.

Researchers found that those receiving the medication lebrikizumab experienced remission from ulcerative colitis twice as frequently as those taking a placebo.

The results, according to experts, are encouraging; nonetheless, more clinical trials are required because the medicine has not yet received approval from federal regulators.

Research in the New England Journal of Medicine found that people receiving the medication lebrikizumab experienced remission from ulcerative colitis almost twice as frequently as those taking a placebo.

Researchers examined the effectiveness and safety of lebrikizumab, a novel injectable drug being created to treat ulcerative colitis. The use of lebrikizumab in the US has not yet received approval from the Food and Drug Administration.

In comparison to those who took a placebo, participants reported having a better clinical response, endoscopic remission, and reduced urgency in bowel movements.

Clinical studies for a new medication for ulcerative colitis

52 weeks of treatment were spread across two phase 3 double-blind, placebo-controlled trials. 1,281 adults with ulcerative colitis who had moderate to severe inflammation participated in the experiment.

LUCENT-1, the first, ran for 12 weeks. Three participants received 300 mg of lebrikizumab for each one who received a placebo. 294 patients received a placebo, whereas 868 patients received lebrikizumab.

The maintenance phase, LUCENT-2, was continued with the participants who were deemed receptive. Rectal haemorrhage and stool frequency were measured by the researchers.

At the conclusion of the 12-week period, 179 placebo patients and 365 mirikizumab users both reported responsiveness.

Participants were given a 200 mg dose of mirikizumab or a placebo during the second stage, which is known as the maintenance phase.

Nearly 50% of those who got mirikizumab and 25% of those who received a placebo experienced remission by week 40 of the maintenance phase (or by week 52 of both phases combined).

Eli Lilly, a pharmaceutical corporation, supported the research.

Expert response to medication research for ulcerative colitis

Longer trials are being conducted to evaluate the safety and efficacy of mirikizumab over longer periods of time.

“This study shows that we have another tool for people with ulcerative colitis and that this might help those who do not respond to other medications,” said Dr. Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Centre in California who was not involved in the study. However, I’m not giddy with excitement over the figures.

And before we can get this to the patients, it will be a while. The phase 4 trial comes first. We have the insurance companies to get through if that advances us to the next round, Farhadi said.

“These medicines are outrageously expensive, and insurance companies frequently need us to pass hurdles before receiving clearance. For instance, they might advise the patient to try several other medications first,” he continued.

“In general, I believe having additional tools is a good thing. However, the numbers do not now make this my top pick, said Farhadi.

Ulcerative colitis: What is it?

A chronic inflammatory bowel illness is ulcerative colitis.

It is regarded as an autoimmune condition that affects the lining of the colon and rectum and results in sores and ulcers.

The signs consist of:

  • Diarrhea
  • stool with blood in it
  • Continent pain

The condition ulcerative colitis cannot be cured. The Crohn’s & Colitis Foundation lists the following as treatments:

  • drugs that reduce inflammation
  • biologics
  • immunomodulators
  • a variety of drugs taken together
  • surgery

During a flare, doctors also advise sticking to a diet of soft, bland foods. They could advise cutting back on hot and high-fiber foods as well.

How drugs can treat ulcerative colitis?

According to the American Academy of Family Physicians, when ulcerative colitis patients take medication, remission occurs in about two-thirds of cases. 80 percent of them will continue to be in remission.

Dr. Arun Swaminath, chief of gastroenterology and director of the Inflammatory Bowel Programme at Northwell Lenox Hill Hospital in New York, who was not involved in the study, said, “This is very difficult to understand.” “Response rates for other autoimmune diseases, like rheumatoid arthritis, range from 80 to 90 percent. But because of ulcerative colitis, we cannot travel there. It’s possible that the reason why inflammatory bowel diseases (IBD) have such a high burden of inflammation.

The release of a new IBD drug always excites medical specialists. According to Swaminath, the mechanism of action for mirikizumab is distinct. Its physiological effects will be different from those of other drugs.

“There are some positives, such as the fact that this study enrolled many people in the severe category,” he continued. “It is challenging to determine how much the medication works when studies mostly include people in the moderate category. I was quite inspired to learn that participants with advanced illnesses still experienced success.

What’s coming up in medication research for ulcerative colitis?

A phase 3 experiment was the current investigation. According to the National Cancer Institute, phase 3 trials examine a new drug’s safety as well as how well it performs over a longer time frame than in earlier trials.

A phase 4 clinical trial would presumably follow the FDA’s approval of mirikizumab. Thousands of participants frequently participate in phase 4 trials.

The next phase “might answer some lingering questions” because so many more people will be involved, according to Swaminath. “For instance, while I read the paper, I pondered the situation of those who had previously taken Stelara. Does the fact that they were rejected from phase 3 indicate that they won’t be suitable candidates for this medication? In addition, there were two cases of induction-phase cancer and two cases of maintenance-phase cancer. Were those cancers prevalent at the time? To learn what transpires when the drug is administered to a big population, we must monitor the subsequent phase.

REFERENCES:

For Ulcerative colitis medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=69

Important signs to consider to avoid Colorectal cancer.

Important signs to consider to avoid Colorectal cancer.

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The incidence of colorectal cancer, which ranks third among all cancers in the globe, is on the decline in older people and is largely avoidable. However, the prevalence of colorectal cancer among younger people is rising.

Seven risk factors that raise the likelihood of colorectal cancer in younger males have been found in a recent study. Men under 45 who are at increased risk should get screened for colorectal cancer, according to the authors.

Colorectal cancer is the third most prevalent cancer in the world, behind breast and lung cancer. Only lung cancer accounts for more fatalities. It is estimated that each year, more than 150,000 people in the United States alone receive a colorectal cancer diagnosis.

The median age of diagnosis for colorectal cancer is 66, and persons over the age of 45 are most likely to develop it. According to the American Cancer Society, widespread screening of adults over 50 and the removal of pre-cancerous growths known as polyps are contributing to a decline in colorectal cancer occurrences and deaths in older people.

Those under 45 have a low chance of developing colorectal cancer, the number of cases and fatalities in this age group has been rising since the 1990s.

Currently, a research of American veterans has identified certain elements that are linked to a higher risk of early-onset colorectal cancer in males. The authors contend that in some situations, targeted screening may aid in case prevention.

What exactly is colorectal cancer?

Cancer that starts in the colon or rectum is called colorectal cancer. These cancers may also be known as colon cancer or rectal cancer depending on where they first appear.

The majority of colorectal malignancies begin as polyps, which are growths on the colon’s inner lining. Even though not all polyps develop into cancer, some of them can over time.

In the United States, colorectal cancer ranks third among all cancers, excluding skin cancer, according to the American Cancer Society.

Causes of colorectal cancer risk

The researchers located 956 men between the ages of 35 and 49 who had received a non-hereditary colorectal cancer diagnosis between 2008 and 2015 from the National Veterans Affairs database in the United States. 600 of them satisfied the requirements for study inclusion.

These were then matched with 1,200 controls who underwent colonoscopies but did not develop colorectal cancer and 1,200 controls who had not.

For both cases and controls, the researchers examined sociodemographic and lifestyle characteristics, family and personal medical histories, physical measurements, vital signs, medications, and laboratory results. For people with colorectal cancer, data from the six to eighteen months before diagnosis were utilized to identify characteristics that might vary with the development of the disease.

Age, cohabitation, employment, BMI, malignancies in first- or second-degree relatives, comorbidities, alcohol use, hyperlipidemia, and usage of statins, non-steroidal anti-inflammatory medications (NSAIDs), or multivitamins were all examined to find risk variables.

From this, scientists discovered 15 variables that were each independently linked to a higher chance of developing colorectal cancer at an early stage. They singled out seven of these that offered equivalent precision and whose data are easily obtainable:

  • elder age (between the ages of 35 and 49)
  • NSAIDs (such as aspirin or ibuprofen) should not be regularly used.
  • no consistent statin use
  • usage of alcohol today
  • relatives in the first or second degree who have colorectal cancer
  • a greater burden of sickness

According to corresponding author Dr. Thomas F. Imperiale, a research scientist at the Regenstrief Institute, several characteristics raised risk more than others:

It was more significant to have a first- or second-degree family who had colorectal cancer. Non-steroidal anti-inflammatory drug use and statin use were two additional factors with a stronger impact.

Risk of colorectal cancer and lifestyle

The risk of colorectal cancer may be increased by a number of lifestyle variables, according to the Centres for Disease Control and Prevention (CDC). These consist of:

The study’s author, Dr. Bilchik, who was not involved in it, emphasized the importance of lifestyle factors:

According to this study, lifestyle choices have a significant impact on the development of colorectal cancer. For instance, taking statins is connected to elevated cholesterol, and food and alcohol have also been linked to a number of different cancers.

Screening for high-risk individuals

The researchers pointed out that although their study only included men, men are still twice as likely to develop colorectal cancer as women of any age. However, they are currently conducting research along these lines on female risk factors.

They emphasised that not all younger men should have colorectal cancer screenings, but those who are at higher risk may benefit.

“Only high-risk men between the ages of 35 and 44 should be screened. Guidelines now recommend colorectal cancer screening for men between the ages of 45 and 49 but do not specify how (i.e., which test),” Thomas F. Imperiale, M.D.

“The risk factors may be helpful in deciding whether noninvasive testing (with the faecal immunochemical test or with the multi-target stool DNA test) or a colonoscopy is more appropriate,” Dr. Imperiale said to us.

Additionally, he hoped that highlighting these risk factors will prompt males between the ages of 45 and 49 who are already eligible for screening to request testing.

The findings indicating that colorectal cancer screening is advised starting at age 45 are particularly pertinent to male veterans under the age of 35. Dr. Imperiale continued, “However, the results may also be valuable for persuading 45-49 year old male veterans that they should be examined.

How is colon cancer identified?

Your doctor would advise exams and testing to determine the cause if you have colorectal cancer symptoms or if a screening test result was abnormal.

The American College of Physicians advises colorectal cancer screening using one of the following methods for those with a typical risk of developing the disease:

  • a colonoscopy every ten years
  • every two years, a high sensitivity guaiac-based faecal occult blood test (gFOBT) or faecal immunochemical test (FIT)
  • FIT every two years in addition to flexible sigmoidoscopy every ten years.

People who have a higher risk of developing colorectal cancer should discuss the type and frequency of screening that is most appropriate for them with their doctor.

To determine your personal risk level, use this risk calculator. Additional testing is necessary to stage colorectal cancer and determine the best course of therapy if it is discovered.

Physical examination and medical history

To ascertain whether you have any risk factors, such as a family history of colorectal cancer, your doctor will inquire about your medical history. Additionally, the duration of your symptoms will be questioned of you.

During a physical examination, your abdomen will be felt for lumps or enlarged organs, and a digital rectal exam (DRE) may be performed.

A gloved finger is inserted into your rectum by the doctor during a DRE to look for any anomalies.

Stool tests

Tests to look for blood in your stool may be advised by your doctor. To the naked eye, blood in the faeces is not always obvious. These examinations aid in finding blood that cannot be seen.

These tests, such as a FOBT or FIT, are carried out at home with the aid of a kit that is provided. You can use the kit to gather one to three stool samples for testing.

A blood test

Blood tests may be required to look for colorectal cancer symptoms include anaemia, which is a condition when there are not enough red blood cells in the body.

Additionally, your doctor can request tests for liver function and tumour markers such carcinoembryonic antigen (CEA) and CA 19-9. Colorectal cancer cannot be identified by blood testing alone.

Signoidoscopy

Your doctor can view the interior of your sigmoid colon via a sigmoidoscopy, also known as a flexible sigmoidoscopy. If a colonoscopy is not possible for any reason, this less intrusive technique could be suggested instead.

Colonoscopy

A diagnostic colonoscopy is carried out as a result of symptoms you are experiencing or an anomaly discovered during a screening test. The test is performed to observe your colon and rectum in their entirety.

A colonoscope, which is put into the body through the anus, is used to perform it because it is a small, flexible tube with a camera on the end.

The colonoscope can be used to insert specialised tools that can be used to remove polyps and collect tissue samples for biopsies.

Proctoscopy

During a proctoscopy, the anus is used to introduce a proctoscope. To observe the interior of the rectum, a proctoscope is a short, rigid tube with a camera at one end. It is used to examine the rectum for cancer.

Biopsy

A biopsy is a lab test that looks at a tissue sample. Polyps or questionable spots are typically removed during a colonoscopy, but if necessary, they can also be removed surgically.

The tissue is delivered to a lab where a microscope is used to examine it. The samples might also be examined for gene alterations if cancer is discovered. To help categorise the malignancy, more lab tests could be carried out.

Imaging exams

Imaging examinations can:

  • view potential cancerous regions that are suspicious
  • determine the extent of the cancer’s spread
  • test the efficacy of the treatment

REFERENCES:

For Cancer disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10