Medical Bulletin 26/ August/ 2024

Here are the top medical news for the day:

High-Risk HPV Affects Male Reproductive Health

A new study published in Frontiers in Cellular and Infection Microbiology indicates that high-risk HR-HPV-positive men had a higher percentage of dead sperm leading to infertility in men.

Cervical cancer, the fourth most prevalent cancer among women, results in around 350,000 deaths annually, predominantly in middle- and low-income countries. Human papillomavirus (HPV) infection is responsible for 95% of these cases. Public health officials in 37 countries are currently administering vaccines to girls aged nine to 14.

HPV is known to raise the risk of genital warts and cancers of the genitals, anus, mouth, and throat in infected men, which is why the WHO and the US Centers for Disease Control and Prevention (CDC) recommend routine vaccination for boys as well. Nevertheless, the complete range of HPV's effects in men and boys is not yet fully understood.

For the study, researchers recruited men tested positive for HPV and they were surprised to discover that men with high-risk HPV (HR-HPV) had significantly fewer CD45+ white blood cells (leukocytes) in their semen. Additionally, they found that sperm from HR-HPV positive men might experience frequent damage from oxidative stress, as indicated by increased production of reactive oxygen species (ROS).

While low ROS levels are normal for sperm function, elevated ROS can cause cell membrane rupture, DNA breaks, and uncontrolled cell death. The researchers also observed that HR-HPV positive men had a higher percentage of dead sperm.

Reference: Olivera, C., Paira, D. A., Olmedo, A., Olmedo, J. J., Tissera, A. D., Molina, R. I., Motrich, R. D., Cuffini, C. G., & Rivero, V. E. (2024). Impact of high-risk and low-risk human papillomavirus infections on the male genital tract: Effects on semen inflammation and sperm quality. Frontiers in Cellular and Infection Microbiology, 14, 1420307. https://doi.org/10.3389/fcimb.2024.1420307

Weight Loss Drug’s Cardiovascular Benefits for Heart Failure Patient

The new study, published in The Lancet, found that the anti-obesity drug semaglutide might aid in preventing heart attacks and other significant cardiac events in overweight individuals with cardiovascular disease, regardless of whether they also have heart failure.

This study discovered that a subgroup of participants diagnosed with heart failure (i.e., those with impaired heart function) experienced similar cardiovascular benefits from the treatment. This diagnosis was made by a clinician at the beginning of the trial.

The researchers analyzed data from 4,286 participants out of the 17,605 in the significant Semaglutide and Cardiovascular Outcomes (SELECT) trial, who were randomly assigned to receive either semaglutide or a placebo. These individuals were monitored for an average of over three years.

They discovered that semaglutide was associated with a 28% decrease in major adverse cardiac events (with 12.3% of the placebo group experiencing such events compared to 9.1% in the semaglutide group). Additionally, it was linked to a 24% reduction in cardiovascular disease-related deaths and a 19% reduction in deaths from any cause among those with pre-existing heart failure.

Semaglutide, a GLP-1 receptor agonist, mimics the action of the body’s natural incretin hormones, which help reduce blood sugar levels after eating. Initially, it was prescribed for adults with type 2 diabetes.

While the precise mechanism behind semaglutide's cardiovascular benefits is not fully understood, it may involve its beneficial effects on blood sugar, blood pressure, and inflammation, as well as potential direct impacts on the heart muscle and blood vessels.

Reference: Deanfield, J., Verma, S., Scirica, B. M., Kahn, S. E., Emerson, S. S., Ryan, D., Lingvay, I., Colhoun, H. M., Plutzky, J., Kosiborod, M. N., Hovingh, G. K., Hardt-Lindberg, S., Frenkel, O., Weeke, P. E., Rasmussen, S., Goudev, A., Lang, C. C., Urina-Triana, M., Pietilä, M., & Lincoff, A. M. (2024). Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: A prespecified analysis of the SELECT trial. The Lancet. https://doi.org/10.1016/S0140-6736(24)00123-7

Gut Microbiome essential for managing Type 2 Diabetes: Study Finds

A paper published in the journal Cell Host & Microbe examined the influence of the gut microbiome on the onset and management of type 2 diabetes. The review highlighted how the gut microbiome plays a critical role in the disease's development and its treatment strategies.

Type 2 diabetes is a multifaceted disorder, and scientists continue to investigate its underlying causes. There is growing interest in exploring how the gut microbiome influences the development of type 2 diabetes.

Type 2 diabetes frequently features insulin resistance, a condition where the body's cells do not effectively respond to insulin, a hormone produced by the beta cells in the pancreas.

The gut microbiome consists of microorganisms, including bacteria and viruses, present in the digestive tract. It plays a role in various systemic metabolic processes, and researchers are increasingly investigating how it contributes to the development of metabolic diseases.

Recent studies suggest that beta cell dysfunction involves several pathways, with the gut microbiome potentially playing a role in this process. The authors highlight that this insight has contributed to a more intricate understanding of the mechanisms behind diabetes.

The paper observes that the loss of many ancestral bacterial species over time has contributed to issues like metabolic diseases. This decline in gut microbiome diversity, likely linked to medication use and Western lifestyle, is hypothesized to be associated with the rise in type 2 diabetes.

Previous research has highlighted changes in the gut microbiome of individuals with type 2 diabetes, such as shifts in bacterial proportions and reduced species diversity. Factors like body responses, medications, and Western dietary habits can influence the gut microbiome, with oral antidiabetic drugs also impacting gut microbiota.

Additionally, the gut microbiome produces metabolic byproducts that influence various bodily functions, including immune responses and gut barrier integrity. For example, bile acids, which are metabolic products of the gut microbiome, are altered in individuals with type 2 diabetes.

Reference: Baars, D. P., Fondevila, M. F., Meijnikman, A. S., & Nieuwdorp, M. (2024). The central role of the gut microbiota in the pathophysiology and management of type 2 diabetes. Cell Host & Microbe. https://doi.org/10.1016/j.chom.2024.07.017

Predictive Power of Blood Tests for Chronic Age-Related Conditions

Recent research featured in Nature Medicine highlights a study by researchers who have created a blood test that analyses more than 200 proteins to determine a person’s biological age.

The research indicates that the test, which was developed using machine learning techniques, can forecast an individual’s risk of developing 18 major age-related diseases and their likelihood of premature death from any cause. This study enhances the understanding of the biological processes underlying various age-related conditions and sheds light on how genetics and environmental factors impact the aging process.

The proteome encompasses all the proteins produced by an organism. The research aimed to develop a "proteomic aging clock" to predict the risk of prevalent age-related diseases.

By utilizing proteomics data, scientists can more precisely evaluate ageing by comparing an individual’s biological functions to their chronological age. Unlike most biological ageing clocks that depend on DNA methylation, analyzing protein levels could provide more immediate insight into ageing mechanisms, particularly since proteins are central to drug development.

Researchers analyzed data from 45,441 participants aged 40 to 70 and identified 204 proteins that can accurately predict chronological age. From this larger model, they determined a subset of 20 age-related proteins that maintained 91% of the accuracy in age prediction.

Their findings revealed that proteomic aging assessments are associated with the onset of 18 major chronic diseases, including heart, liver, kidney, and lung diseases, diabetes, neurodegenerative disorders like Alzheimer’s, cancer, as well as multimorbidity and overall mortality risk. Furthermore, proteomic aging was found to correlate with various age-related biological, physical, and cognitive indicators, such as telomere length, frailty index, and performance on cognitive tests.

Reference: Argentieri, M.A., Xiao, S., Bennett, D. et al. Proteomic aging clock predicts mortality and risk of common age-related diseases in diverse populations. Nat Med (2024). https://doi.org/10.1038/s41591-024-03164-7.