Medical Bulletin 08/ January/ 2025
Here are the top medical news for the day:
Advanced Imaging Reveals Undetected Metastases in High-Risk Prostate Cancer Patients: Study Finds
A new study published in JAMA Network Open, found that nearly half of high-risk prostate cancer patients previously classified as nonmetastatic by conventional imaging actually have metastatic disease when evaluated with advanced prostate-specific membrane antigen–positron emission tomography (PSMA-PET) imaging, suggesting that traditional imaging may underestimate how far the cancer has spread in many cases. The findings are published in JAMA Network Open.
To better understand the advantages of PSMA-PET over conventional imaging, researchers conducted a post hoc, retrospective cross-sectional study using data from 182 patients with high-risk recurrent prostate cancers who were thought to have disease limited to the prostate and were eligible for the EMBARK trial.
This clinical trial previously demonstrated that adding enzalutamide, a type of hormone therapy, to androgen deprivation therapy significantly improves metastasis-free survival. However, the trial relied on conventional imaging to classify patients, which researchers believe might have underestimated the disease's extent in some cases.
The researchers found PSMA-PET detected cancer metastases in 46% of patients, even though traditional imaging had suggested no evidence of cancer spread. Based on PSMA-PET, 24% of the patients even showed 5 or more lesions that had been missed by conventional imaging.
This advanced imaging technology plays a critical role in redefining how prostate cancer is staged. PSMA-PET imaging uses tiny amounts of radioactive “tracers,” called radiotracers, that binds to prostate cancer cells, making them visible on PET scans.
Reference: Holzgreve A, Armstrong WR, Clark KJ, et al. PSMA-PET/CT Findings in Patients With High-Risk Biochemically Recurrent Prostate Cancer With No Metastatic Disease by Conventional Imaging. JAMA Netw Open. 2025;8(1):e2452971. doi:10.1001/jamanetworkopen.2024.52971
Study Unveils Link Between Loneliness and Higher Risk of Heart Disease, Stroke
A new research found that interactions with friends and family may keep us healthy because they boost our immune system and reduce our risk of diseases such as heart disease, stroke and type 2 diabetes. Their findings are published in the journal Nature Human Behaviour.
A team led by scientists examined the ‘proteomes’ – the suite of proteins – in blood samples donated by over 42,000 adults aged 40-69 years who are taking part in the UK Biobank. This allowed them to see which proteins were present in higher levels among people who were socially isolated or lonely, and how these proteins were connected to poorer health.
The team calculated social isolation and loneliness scores for individuals.
When they analysed the proteomes and adjusted for factors such as age, sex and socioeconomic background, the team found 175 proteins associated with social isolation and 26 proteins associated with loneliness (though there was substantial overlap, with approximately 85% of the proteins associated with loneliness being shared with social isolation). Many of these proteins are produced in response to inflammation, viral infection and as part of our immune responses, as well as having been linked to cardiovascular disease, type 2 diabetes, stroke, and early death.
They also identified five proteins whose abundance was caused by loneliness.
One of the proteins produced in higher levels as a result of loneliness was ADM. The team found a strong association between ADM and the volume of the insula, a brain hub for interoception, our ability to sense what's happening inside our body. In addition, higher levels of ADM were linked to increased risk of early death.
Another of the proteins, ASGR1, is associated with higher cholesterol and an increased risk of cardiovascular disease, while other identified proteins play roles in the development of insulin resistance, atherosclerosis (‘furring’ of the arteries) and cancer progression, for example.
Dr Chun Shen from the Department of Clinical Neurosciences at the University of Cambridge and the Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, said: “We know that social isolation and loneliness are linked to poorer health, but we’ve never understood why. Our work has highlighted a number of proteins that appear to play a key role in this relationship, with levels of some proteins in particular increasing as a direct consequence of loneliness.
Reference: Shen, C., Zhang, R., Yu, J. et al. Plasma proteomic signatures of social isolation and loneliness associated with morbidity and mortality. Nat Hum Behav (2025). https://doi.org/10.1038/s41562-024-02078-1
Researchers Identify 6 Biomarkers of Kidney Injury for Improved Patient Outcomes
Researchers have identified six new biomarkers that could detect kidney injury faster and with more sensitivity, advancing safer drug development and improving health outcomes for patients.
The findings were published recently in Clinical Pharmacology & Therapeutics.
The research team examined urinary levels of protein biomarkers in healthy volunteers and patients undergoing treatment for mesothelioma with a chemotherapy drug that is known to have toxic effects on the kidneys.
The six biomarkers identified by the team are mostly made in the kidneys themselves in response to injury or inflammation. This enables detection of kidney injury more quickly than current blood tests, like serum creatinine, which can sometimes take several days to reach abnormal levels.
Earlier detection of kidney damage could allow clinicians to intervene sooner, reducing the risk of long-term damage and improving patient outcomes across all settings. "These biomarkers have the potential to make a real difference in how we monitor kidney health and manage patients at risk for kidney damage," says Sushrut Waikar, MD, MPH, first author on the paper, who is also the Norman G. Levinsky Professor of Medicine at Boston University Chobanian & Avedisian School of Medicine. "We are hopeful that these findings will contribute to better strategies for preserving kidney function and improving patient care, as well as advancing safer drug development."
Reference: Waikar, S.S., Mogg, R., Baker, A.F., Frendl, G., Topper, M., Adler, S., Sultana, S., Zhao, R., King, N.M.P., Piccoli, S.P., Sauer, J.-M., Hoffmann, S., Nunes, I. and Sistare, F.D. (2025), Urinary Kidney Injury Biomarker Profiles in Healthy Individuals and After Nephrotoxic and Ischemic Injury. Clin Pharmacol Ther. https://doi.org/10.1002/cpt.3531
New Nasal Swab May Detect Specific Asthma Subtype in Children
Researchers at the University of Pittsburgh have developed a nasal swab test for kids that diagnoses specific asthma subtype, or endotype. The findings are published in JAMA
Traditionally, asthma has been classified into endotypes known as T2-high or T2-low based on the amount of T helper 2 inflammation present. More recently, T2-low has been split into two endotypes: T17-high, which has less T helper 2 inflammation and more T helper 17 inflammation, and low-low, which has low levels of both types of inflammation.
Precise diagnosis of endotype usually involves genetic analysis of a lung tissue sample taken by a procedure called a bronchoscopy, which is done under general anesthesia. For children, especially those with milder disease, it’s not feasible or ethical to perform this invasive procedure, so clinicians have had to rely on imperfect tools, including immune markers in the blood, lung function and whether or not they have allergies.
Researchers collected nasal samples from 459 youth across three different studies. Then they analyzed the expression of eight T2 and T17 signature genes.
As expected, analysis of nasal swab samples revealed a patient’s endotype. Across studies, 23% to 29% of participants had T2 high, 35% to 47% had T17-high and 30% to 38% had low-low endotype.
For treating severe T2-high asthma, there is a powerful new class of drugs called biologics, which target the immune cells that drive disease. However, no available asthma biologics directly target T17-high and low-low endotypes.
“We have better treatments for T2-high disease, in part, because better markers have propelled research on this endotype,” said senior author Juan Celedón, M.D., Dr.P.H., professor of pediatrics at Pitt and chief of pulmonary medicine at UPMC Children’s Hospital of Pittsburgh.. “But now that we have a simple nasal swab test to detect other endotypes, we can start to move the needle on developing biologics for T17-high and low-low disease.”
Reference: Yue M, Gaietto K, Han YY, et al. Transcriptomic Profiles in Nasal Epithelium and Asthma Endotypes in Youth. JAMA. Published online January 02, 2025. doi:10.1001/jama.2024.22684
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