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Posts Tagged ‘Medical research’

HIV ‘missing link’ found in ill chimps

July 22nd, 2009 | No Comments

A virus that is killing chimpanzees in the wild may be an intermediate stage in the evolution of the deadly human strain

Scientists believe they have found a “missing link” in the evolution of the virus that causes Aids. It bridges the gap between an infection that does no harm to most non-human primates and one that kills millions of people.

The suspected link is a virus that is killing chimpanzees in the wild at a disturbingly high rate, according to a study in tomorrow’s issue of the journal Nature. Chimpanzees are the first primate shown to get sick in the wild in significant numbers from a virus related to HIV. They are also humans’ closest relative among primates.

The discovery of the disease killing chimps may help doctors to come up with better treatments or a workable vaccine for humans, experts said.

The primate version of the virus that causes AIDS is called simian immunodeficiency virus (SIV), but most apes and monkeys that are infected with it show no symptoms of illness. “If we could figure out why the monkeys don’t get sick, perhaps we could apply that to people,” said study lead author Beatrice Hahn, a professor of medicine at the University of Alabama in Birmingham.

The nine-year study of chimps in their natural habitat at Gombe National Park in Tanzania found chimps infected with SIV had a death rate 10 to 16 times as high as uninfected chimps. And postmortems of infected chimps showed unusually low T cell counts that are just like the levels found in humans with AIDS, said Hahn.

And when scientists looked at the strain infecting the chimps, they found that it was a close relative of the virus that first infected humans.

“From an evolutionary and epidemiological point of view, these data can be regarded as a ‘missing link’ in the history of the HIV pandemic,” said Aids researcher Dr Daniel Douek of the National Institute of Allergy and Infectious Diseases, who was not involved in the Nature study.

Monkeys and apes other than chimps seem to have an evolutionary adaptation, probably at the level of their cell receptors, that allows them to survive the virus, Douek said. The infection in chimps is more recent so they haven’t adapted.

Hahn said chimps and people probably caught the virus the same way, by eating infected monkeys. And they both spread it the same way, through sexual activity.

Chimps are already endangered in the wild. Many factors are causing Africa’s chimp population to dwindle, said study co-author Michael Wilson, a professor of anthropology at the University of Minnesota and former director of field research at the Jane Goodall Institute in Tanzania.

Hunting, loss of habitat and disease are decreasing chimp numbers and it’s hard to figure out how much of a factor SIV is, he said.

“It is a concern,” Wilson said. “The last thing these chimps need is another source of mortality.”

Wilson, who spent years observing chimps in Tanzania as part of the study, said that when researchers realised the virus was fatal and they knew which chimps were infected, it became hard to watch some of their activities in the wild.

He recalled wanting to warn one female chimp: “Don’t mate with those guys … But of course I can’t do that.”

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UK medical tests on animals rise 14%

July 21st, 2009 | No Comments

Animal rights campaigners round on government as expansion in biomedical research triggers ‘biggest increase’ in medical tests

The number of medical experiments involving animals has shown its largest rise since modern records began, the latest government figures reveal.

Nearly 3.7m experiments were performed on animals last year, a rise of 454,000 or 14% on the previous year, the Home Office said. The increase marks the greatest leap in animal use in medical research since 1986, when the government introduced new auditing procedures.

The growth in animal experiments reflects an expansion in biomedical research in Britain and is driven by advances in genetics and the development of new drugs that must be tested rigorously in monkeys before they are allowed to be given to humans. The experiments range from small procedures such as taking blood and tissue samples to invasive brain surgery and inducing incurable diseases such as Parkinson’s and cancer. Substantial numbers of animals are used to test the safety of new drugs before they are allowed to be used in human trials.

Animal rights campaigners deplored the latest rise, which coincides with the 50th anniversary of landmark proposals to find alternatives to animals in medical research.

Judy MacArthur Clark, chief inspector of the Home Office animals scientific procedures inspectorate, said the rise reflected an increase in “ethically justified research” in Britain. “If the research is ethically justified and has funding, it’s not our role to say you can’t do it, we’ve used too many mice this year,” she said.

More experiments on rodents and fish account for the vast majority of the rise and make up 97% of all experiments on animals. Of 197,000 more experiments on mice last year, most involve breeding genetically modified rodents to help scientists understand the role of individual genes in development and disease.

The figures reveal large falls in experiments on rats, domestic fowl, guinea pigs, rabbits and beagles, which together decreased by more than 40,000.

Britain has a longstanding policy that bans the use of great apes such as chimpanzees and gorillas in medical research, but the use of macaques and marmosets rose by more than 600 experiments, up 16%. This masks a reduction of more than half in experiments on marmosets and other new world primates, but the use of old world macaques in 1,000 more experiments, a 33% rise. Macaques have similar immune systems and physiology to humans and are increasingly being used to test advanced antibody-based drugs that target diseases with far more precision than older drugs.

Testing in monkeys has become more extensive after the disastrous clinical trial of an antibody drug at Northwick Park hospital in north London in 2006. The drug, which had been tested in primates, triggered a catastrophic immune reaction in the six trial participants which led to widespread organ failure.

Home Office inspectors investigated 45 cases where scientists had infringed their licences to do animal research. The most minor cases involved poor record keeping and retaining animals after licences had expired. Of the more serious cases, the worst occurred when mice in one study unexpectedly developed gangrene in their legs, causing greater suffering than the licence permitted. Two researchers involved in the study surrendered their licence before the inspectors’ investigation was completed.

The figures were met with dismay by animal rights campaigners who rounded on the government and called for a concerted effort to reduce the number of animals used in medical research.

“With the scientific expertise this country has to offer we should have seen far greater progress to replace animals with more advanced techniques,” said Dr Sebastien Farnaud of the Dr Hadwen Trust for Humane Research. The organisation called on political parties to agree to a “roadmap to replacement” to drive the use of animals in research down.

The animal rights group, People for the Ethical Treatment of Animals (PETA), said it was “profoundly disappointed” at the statistics and called on the government to be open about the fate of every animal used in experiments. “We have seen increases year on year in contradiction to public sentiment, but the numbers in this year’s statistics are shocking by any standards,” a spokesperson said.

The science minister, Lord Drayson, defended the figures and said the government was committed to reducing the use of animals in research where possible. “Britain has a high reputation for its standards of regulating research which uses animals. This work, described in today’s report from the Home Office, is critical to the development of new medicines and increasing the level of understanding of diseases,” he said.

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Third of breast cancer diagnoses ‘harmless’

July 10th, 2009 | No Comments

BMJ study finds that one third of women identified as having breast cancer may be treated unnecessarily

One in three breast cancer patients identified in public screening programmes may be treated unnecessarily, a new study has found.

Karsten Jorgensen and Peter Gotzsche of the Nordic Cochrane Centre in Copenhagen analysed breast cancer trends at least seven years before and after government-run screening programmes for breast cancer started in parts of Australia, Britain, Canada, Norway and Sweden.

The research, published today in the BMJ, formerly known as the British Medical Journal, found that once screening programmes began, more cases of breast cancer were inevitably picked up.

If a screening programme is working, there should be a drop in the number of advanced cancer cases detected in older women, since their cancers should theoretically have been caught earlier when they were screened.

However, Jorgensen and Gotzsche found the national screening systems, which usually test women aged between 50 and 69, simply reported thousands more cases than previously identified.

Overall, Jorgensen and Gotzsche found that one third of the women identified as having breast cancer didn’t actually need to be treated.

Some cancers never cause symptoms or death, and can grow too slowly to ever affect patients. As it is impossible to distinguish between those and deadly cancers, any identified cancer is treated. But the treatments can have harmful side-effects and be psychologically scarring.

“This information needs to get to women so they can make an informed choice,” Jorgensen said. “There is a significant harm in making women cancer patients without good reason.”

Jorgensen said that for years women were urged to undergo breast cancer screening without being informed of the risks involved, such as having to endure unnecessary treatment if a cancer was identified, even if it might never threaten their health.

“Mammography is one of medicine’s ‘close calls’, … where different people in the same situation might reasonably make different choices,” wrote H Gilbert Welch of the Dartmouth Institute for Health Policy and Research in an accompanying editorial in the BMJ. “Mammography undoubtedly helps some women but hurts others.”

Experts said overtreatment occurs wherever there is widespread cancer screening. The NHS recently ditched its pamphlet inviting women to get screened for breast cancer after critics complained it did not explain the overtreatment problem.

Laura Bell of Cancer Research UK said Britain’s breast cancer screening programme was partly responsible for the country’s reduced breast cancer cases.

“We still urge women to go for screening when invited,” she said, though she acknowledged it was crucial for women to be informed of the potential benefits and harms of screening.

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Scientists claim sperm breakthrough

July 8th, 2009 | No Comments

Scientists claim to have created human sperm for the first time, in a breakthrough they say could lead to new treatment for male infertility.

The sperm was grown in a laboratory in Newcastle from embryonic stem cells. Led by Professor Karim Nayernia, researchers developed a method of growing early-stage sperm from human embryonic stem cells by using retinoic acid, a vitamin A derivative.

They found that about 20% of the cells produced early-stage sperm cells or spermatagonia and, after further culture, they could see a number of cells continue to split and divide.

The breakthrough came when some cells continued to grow, elongating and growing a tail which caused them to move, and forming recognisable sperm cells.

Nayernia, of Newcastle University and the North East England Stem Cell Institute (Nesci), described the cells as “fully mature, functional” sperm, which he called In Vitro Derived (IVD) sperm.

He said: “This is an important development as it will allow researchers to study in detail how sperm forms and lead to a better understanding of infertility in men – why it happens and what is causing it.

“This understanding could help us develop new ways to help couples suffering infertility so they can have a child which is genetically their own.

“It will also allow scientists to study how cells involved in reproduction are affected by toxins, for example why young boys with leukaemia who undergo chemotherapy can become infertile for life – and possibly lead us to a solution.”

The scientist, who created mice sperm six years ago using similar techniques, said that he used four criteria to determine whether the cells he produced were sperm. They were: the presence of proteins specific to sperm, one of which is located in the tail and very important for activating egg division; chromosome analysis, which showed that the sperm produced contained 23 chromosomes or half of the chromosome set – this is specific to sperm cells; the shape of the sperm, which has a tail and a head; and finally the movement of the sperm – “we could clearly see the movement of the sperm using the tail”.

But his findings, published in the academic journal Stem Cells and Development, were met by a barrage of criticism by other scientists, who said further research was needed to determine the authenticity of his claims.

Dr Allan Pacey, from the University of Sheffield, said: “As a sperm biologist of 20 years’ experience, I am unconvinced from the data presented in this paper that the cells … produced by Professor Nayernia’s group can be accurately called ‘spermatozoa’.” After watching a video clip of the cells, he said that while they possessed “some of the distinctive genetic features and molecular markers seen in sperm”, there were other characteristics of human sperm that were not described in the paper, while the footage “did not have sufficient resolution” for him to properly assess how the sperm was moving, another indicative factor of sperm behaviour.

Professor Azim Surani, a specialist in physiology and reproduction at the University of Cambridge, said the cells should be tested to find out how they develop inside an animal egg and added: “These sperm-like cells made in a dish from embryonic stem cells are a long way from being authentic sperm cells.”

Professor Robin Lovell Badge, from the Medical Research Council Institute of Medical Research, also questioned the findings, saying that “they need much better evidence that such in-vitro derived sperm are normal” but added that any progress by the team “will be very important for research” and “ultimately, although definitely not yet, fertility treatments”.

Nayernia responded by saying that his research paper was clearly labelled a “proof of principle” which concludes that it is in its early stages and further research is needed. He said: “We are not claiming this research is complete but we are saying that we have found human sperm.”

Nayernia added that his findings would not lead to human beings being produced “in a dish”, but were rather “a way of investigating why some people are infertile and the reasons behind it.

“If we have a better understanding of what’s going on it could lead to new ways of treating infertility.”

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Wake up to 20/20 vision

July 7th, 2009 | No Comments

Patrick Barkham was amazed to hear about new contact lenses that correct your vision while you sleep, leaving you lens-free all day. So he decided to give them a go

Ewwwcrrsssh! The screech of metal against wood was the moment I began to question the efficacy of miraculous-sounding contact lenses that correct impaired vision while you sleep. I was not asleep, in fact I was reversing my car, but my vision was definitely still impaired because I had just reversed into a telegraph pole. Perhaps I should have blamed my foolish decision to reverse down a dark country lane but I decided to berate my new i-GO contact lenses (“sleep, see, go”). One week into my trial and, by evening, everything was a bit of a blur.

If you have ever worn contact lenses, the idea of wearing them to sleep in is not just revolutionary, it is repulsive. Ask any contact-lens wearer who has woken from a boozy night out to find their eyelids gummed up and lenses screaming to be removed from bloodshot eyes.

But i-GO lenses are deliberately popped in at night, and removed in the morning. A new generation of gas-permeable lens, they allow oxygen into your eyes during wear, preventing your eyes from becoming dry and sore. Crucially, however, they encourage movement of cells in the epithelium, the top level of your cornea, from the centre of your eye to the periphery. These cells are gently shifted by the fluid – the tear film – between contact lens and cornea, temporarily creating a new structure to the eye.

This “overnight vision correction” treatment is called orthokeratology and the lenses are now available in ordinary opticians in major cities across England. It sounds amazing, and means you can see during the day without the need for glasses, contact lenses or laser surgery.

When I meet Kieran Minshull, my optician for the trial, at LK Leon in central London, I wonder why he’s wearing glasses. Minshull, it transpires, has even worse sight than me and i-GO lenses cannot correct short-sightedness worse than -5.0 (Mine hovers at -4.0). And these lenses do not correct serious astigmatism. Are they dangerous? “No more than with normal contact lenses,” says Minshull. “Hygiene is important but there aren’t any side effects.” Unlike laser surgery, there are no permanent changes. If you don’t keep wearing the lenses at night, your eyes readjust and your vision returns to how it was within a few days.

Minshull has treated 18 people since the i-GO lenses were launched in the UK but in the US, 50,000 people are using this technology. The lenses cost from £200 for the initial appointments and fittings and £40 per month for lenses, checkups and solutions.

I begin with a sight test, then Minshull takes a topography of my eye, photographing the curvature of my cornea to obtain the measurements needed to make the lenses.

A week later, Minshull shows me how to put in and remove the lenses – easy if you are familiar with contact lenses. And he tells me that I need to sleep regularly, for six hours, and wear them every night. I have some solution to clean and store them in, and lubricant should they become stuck in my eyes (urgh) and that’s it. Or so I thought.

These lenses, I am told, do not usually work instantly. “We should achieve something like a 70% change within the first night of wear,” says Minshull. In the early days, most users find their eyesight deteriorates by the end of the day. “You may notice a little bit of ghosting in the evening,” he says. I am supplied with some -1.50 daily disposable contact lenses in case my eyesight becomes less than perfect.

After the first night, I wake up and visit the opticians again, for a checkup, with the i-GO lenses still in my eyes. Everything is blurred and very uncomfortable because I am unused to these hard, plastic gas-permeable lenses. It turns out my vision is about 70% better and I return to work wearing soft contact lenses to correct my improving vision. Things are still rather blurry. I accidentally blank people I know. I am not enjoying blurred vision. It makes you appreciate the miracle of sight.

After two nights in the lenses, I wake up and – hosanna! – I can see. Without lenses. Almost perfectly. The problem is at night: when it gets dark, I realise that while I can read car numberplates at a distance, my sight is distorted by electric lights, which are almost as blurry as if I had my normal vision. Street lights and car headlights are fuzzy.

At my weekly checkup, Minshull explains that this “ghosting” or halo effect occurs because, while the lenses have corrected the centre of my pupils, they have not yet altered the periphery. This means that in low light, when my pupils widen, I am seeing with the corrected zone and with a small uncorrected area. With most clients, this passes in time. After my very minor crash, though, I decide to wear my i-GO lenses when I am driving at night. They are not as comfortable as my old soft contact lenses but are tolerable and I can see pin-sharply with them in.

At the end of the four-week trial, my eyesight only declines very slightly during the day but in the dark, bright lights are still distorted. I return for my final checkup ready to give up the lenses but Minshull shows me the progress on reshaping my eye, and says that in some cases it can take longer than four weeks. We continue for two more weeks but the i-GO lenses still leave me with blurred vision at night. Minshull believes they have not worked because I have unusually large pupils.

Sean O’Sullivan, 44, a business manager for a software company, has been using the lenses for three weeks. His prescription (-3.75) is similar to mine and yet his right eye was perfect after one night and his vision in both eyes was perfectly corrected after two nights. He, too, experienced blurry lights after dark but this has steadily lessened. He can still see late at night and, if he has to travel to America, into the next day as well. “It’s an amazing thing to think that by putting a plastic lens in your eye at night you can see for a day and a half,” he says. “I’m surprised more people aren’t trying it. It is very liberating. It feels like a miracle cure. If it works, it’s a great alternative to laser surgery.”

So far, only one other of Minshull’s patients has experienced a similar problem to mine and they loved days without lenses so much they persevered. And I can see the attraction: it was wonderful to hurl myself into the ocean and not worry about contact lenses, do away with the dryness and red eyes from wearing ordinary contact lenses all day, and nice not to worry about treading on, or losing, my glasses again. But I am letting my eyes return to their old prescription because of the blurring at night. I could wear my i-GO lenses after dark, when I am awake, but that that seems little more convenient than using standard contact lenses.

I feel sorry for Minshull, who looks crushed when I tell him they are not working for me. He has taken me through the trial with reassuring thoroughness and admirable patience. But I’ve had it with newfangled contact lenses. On the way out of LK Leon, one of their swish pairs of frames catches my eye and I try them on: I can definitely see myself wearing glasses again.

igolenses.com, 0844 7362579.

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Vegetarians ‘less likely to get cancer’

July 1st, 2009 | No Comments

• Striking difference found in risk of disease in blood
• Scientists acknowledge more research still needed

For years, they have boasted of the health benefits of their leafy diets, but now vegetarians have the proof that has so far eluded them: when it comes to cancer risks, they have the edge on carnivores.

Fresh evidence from the largest study to date to investigate dietary habits and cancer has concluded that vegetarians are 45% less likely to develop cancer of the blood than meat eaters and are 12% less likely to develop cancer overall.

Scientists said that while links between stomach cancer and eating meat had already been reported, they had uncovered a “striking difference” in the risk of blood cancers including leukaemia, multiple myeloma and non-Hodgkin lymphoma between the groups. The study looked at vegetarians, fish eaters and people who ate meat.

Co-author Naomi Allen, from the Cancer Research UK epidemiology unit at Oxford University, said: “Previous research has found that processed meat may increase the risk of stomach cancer, so our findings that vegetarians and fish eaters are at lower risk is plausible. But we do not know why cancer of the blood is lower in vegetarians.”

She said the differences in cancer risks were independent of other lifestyle factors including smoking, alcohol intake and obesity.

However, Allen urged caution over the interpretation of the findings. “It is a significant difference, but we should be a bit cautious since it is the first study showing that the risk of cancer of the blood is lower in vegetarians. We need to know what aspect of a fish and vegetarian diet is protecting against cancer. Is it the higher fibre intake, higher intake of fruit and vegetables, is it just meat per se?”

The study also reported that the total cancer incidence was significantly lower among both the fish eaters and the vegetarians compared with meat eaters.

The study, published in the British Journal of Cancer, is part of a long-term international study, the European prospective investigation into cancer and nutrition (Epic).

Today’s findings were based on a study of 61,000 people who scientists followed over 12 years. During this time, 3,350 participants were diagnosed with cancer. Of those, 68% (2,204) were meat eaters, 24% (800) were vegetarians and 9.5% (300) ate fish but no meat.

They found that 180 meat eaters developed blood cancers, while 49 vegetarians developed the diseases and 28 fish eaters. They found the risk of being diagnosed with cancers of the stomach, bladder and blood was significantly lower in vegetarians than in meat eaters but, in contrast to earlier work, they found the rate of bowel cancer was slightly higher among vegetarians than meat eaters.

A spokesman for BPEX, the British pig executive, questioned the methodology of the study: “We are unable to take a view on this because there is mixed evidence based on the compounding factors to do with lifestyle that come into it.”

Richard Lowe, the chief executive of Eblex, the English beef and lamb executive, said: “We think that the link between diet and cancer is complex and as scientists themselves say, more research is needed to see how big a part diet plays.”

The Oxford research is the latest in a series of reports to discourage too much meat in the diet. Last year, Dr Rajendra Pachauri, chair of the UN Intergovernmental Panel on Climate Change – which last year earned a share of the Nobel peace prize – urged giving up meat at least once a week as a way of combating global warming. The UN’s Food and Agriculture Organisation has estimated that meat production accounts for nearly a fifth of global greenhouse gas emissions.

Two years ago, the World Cancer Research Fund found a link between red and processed meat and bowel cancer and recommended that the average amount of meat eaten should be no more than 300g a week. In Britain, the current meat intake is about 970g a week for men and about 550g a week for women.

In 2005, the Epic study, funded by the Medical Research Council, Cancer Research UK and the International Agency for Research on Cancer, concluded that eating just two portions of red meat a day – the equivalent of a bacon sandwich and a fillet steak – increased the risk of bowel cancer by 35%. It found that eating fibre, in the form of vegetables, fruit and wholegrain cereals, lessened the risk of cancer and that fish, eaten at least every other day, was also protective.

Annette Pinner, chief executive of the Vegetarian Society, said: “It is widely recognised that a third of cancers are directly related to diet and what’s interesting in this study is the findings on blood cancers. We wouldn’t claim vegetarianism is a panacea for cancer but it is a step in the right direction.”

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Miscarriages raise premature births

June 29th, 2009 | No Comments

The findings of international experts should make it easier to predict which women may need special care during pregnancy

Women who have a miscarriage are more likely to give birth prematurely in their next pregnancy, doctors have found.

The findings of an international group of experts, to be presented at the annual conference today of the European Society of Human Reproduction and Embryology (ESHRE) in Amsterdam, Netherlands, should make it easier for doctors to predict which women may need special care and attention during pregnancy.

Premature babies can survive from as early as 22 weeks’ gestation, but they are on the border of viability. Every extra week of life in the womb increases chances of survival and improves prospects of long-term health without significant disability.

Dr Robbert van Oppenraaij from the department of obstetrics and gynaecology at Erasmus University medical centre in Rotterdam, Netherlands, and colleagues from the UK, Denmark and Spain reviewed 75 studies carried out between 1980 and 2008, looking at the impact of complications in early pregnancy.

They found that women who experienced complications either early in their current pregnancy or who had had a miscarriage or other problem in a previous pregnancy were more at risk of going into labour prematurely or experiencing other difficulties in later weeks.

Women who had experienced one or more miscarriages had nearly double the risk in their next pregnancy of giving birth prematurely. Those who had suffered three or more miscarriages were at even greater risk.

Termination of a previous pregnancy, for any reason, also increased the risk of premature birth in a subsequent pregnancy.

A whole range of problems in the first three months of a pregnancy were predictive of later complications:

• Vaginal bleeding increased the risk of pre-eclampsia or dangerously high blood pressure in the woman, as well as raising the chances that the baby would be born prematurely and under-weight.

• The survivor of a vanishing twin pregnancy (where one twin miscarries very early on) was more likely to be born prematurely, had three times the normal risk of very low birth weight and was more than three times more likely to die around the time of birth.

• Women who suffered from extreme early morning sickness were three times more likely to give birth prematurely and the baby was nearly three times more likely to be of low weight.

Identifying these women as at high risk of problem births would help to ensure their babies have the best chance of survival through careful monitoring of the baby’s development, said Van Oppenraaij. More studies are needed to confirm the findings, he said.

Events and complications in early pregnancy can be extremely distressing for women, Van Oppenraaij said. For the clinician it is important to interpret the symptoms and to understand not only the short-term consequences, but also the long-term consequences of these early pregnancy complications. This is especially important for reassuring and supporting the couple at a difficult time.

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