Medical Bulletin 23/ August/ 2024
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Here are the top medical news for the day:
Rheumatoid Arthritis and Its Influence on Atherogenic Lipid Disruptions
A recent study published in the journal Gene Expression indicates that Rheumatoid Arthritis, a systemic autoimmune disorder can contribute to the progression of atherosclerosis.
Rheumatoid arthritis, an inflammatory autoimmune disorder, leads to the production of inflammatory cytokines due to the immune response, which significantly disrupts lipid and lipoprotein metabolism.
There are certain inflammatory mediators responsible for the progression of rheumatoid arthritis like Inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) which influence lipid and lipoprotein profiles by modulating gene expression and metabolic pathways.
Other inflammatory mediators such as C reactive protein modify the behaviour of low-density lipoprotein(LDL) which ultimately leads to the development of atherosclerotic plaques.
Myeloperoxidase (MPO), an additional inflammatory mediator, generates reactive oxygen species (ROS) that compromise the effectiveness of high-density lipoprotein (HDL). As a result, high-density lipoprotein becomes less efficient at transporting surplus cholesterol away from cells. This impairment in high-density lipoprotein function contributes to the progression of atherosclerosis, a condition characterized by the accumulation of cholesterol and other substances in arterial walls.
In patients with rheumatoid arthritis (RA), triglyceride, total cholesterol, and LDL-cholesterol (LDL-C) levels are generally higher, while HDL-cholesterol (HDL-C) levels are typically lower. Despite these general patterns, there is considerable variation among individuals with RA. This variability indicates that lipid profiles specific to inflammatory conditions may offer useful insights for monitoring the disease and assessing risk.
Small, dense low-density lipoprotein particles pose a greater risk for atherosclerosis compared to larger low-density lipoprotein particles, as these altered low-density lipoprotein particles accumulate within the walls of blood vessels, they contribute to the development of atherosclerosis.
Researchers reveal that exploring the underlying mechanisms and clinical outcomes of these disturbances can help identify new approaches for preventing and managing cardiovascular disease in this high-risk group.
Reference: Gerasimova, E. V., Popkova, T. V., Shalygina, M. V., & Gerasimova, D. A. (2024). Proatherogenic disorders of blood lipid and lipoprotein metabolism in patients with rheumatoid arthritis. Gene Expression, 24(2), 123-134. https://doi.org/10.14218/GE.2024.00036
Long COVID Symptoms in Children and Teens: Study Finds
In a new study published in the the Journal of the American Medical Association elucidates the team’s newly developed index identifies children and adolescents who are at the greatest risk of developing long COVID.
The team’s newly developed index identifies children and adolescents most likely to develop Long COVID. This research tool is based on long-term symptoms that are more frequently observed in children with a history of COVID-19 infection compared to those without such a history.
Children and teenagers were observed to experience persistent symptoms affecting nearly every organ system following infection with SARS-CoV-2, the virus responsible for COVID-19, with fatigue and pain being the most common.
School-age children exhibited a specific pattern of symptoms including neuropsychological effects such as memory or concentration issues, sleep disturbances, and gastrointestinal problems. In contrast, adolescents showed a unique cluster of symptoms involving changes in or loss of taste or smell, which was not present in younger children.
In the RECOVER Pediatric Observational Cohort Study (RECOVER-Pediatrics), the current research involved 751 school-age children infected with SARS-CoV-2 and 147 uninfected school-age children, as well as 3,109 infected adolescents and 1,369 uninfected adolescents, across over 60 healthcare institutions.
The post-acute sequelae of SARS-COV-2 infection include trouble with memory or focusing, back or neck pain, stomach pain, headache, fear of specific things (phobias), refusing to go to school, itchy skin or rash, trouble sleeping, nausea or vomiting, and feeling lightheaded or dizzy. In adolescents, the most predictive symptoms were change in or loss of smell and/or taste, body, muscle, or joint pain, daytime tiredness, tiredness after walking, back or neck pain, trouble with memory or focusing, headache, and feeling lightheaded or dizzy.
Approximately 65 million people globally are affected by Long COVID, and its effects on global health are anticipated to persist for decades. The NIH’s Researching COVID to Enhance Recovery (RECOVER) Initiative seeks to address these gaps through an extensive study of the condition.
Reference: Gross RS, Thaweethai T, Kleinman LC, et al. Characterizing Long COVID in Children and Adolescents. JAMA. Published online August 21, 2024. doi:10.1001/jama.2024.12747
Role of a Ketogenic Diet in Preventing Pancreatic Cancer
In a recent study published in the journal Nature reveals that a ketogenic diet may work in conjunction with specific cancer treatments to prevent the onset of pancreatic cancer.
Researchers have observed that a high-fat diet, when combined with cancer therapy, disrupted fat metabolism in mice, depriving tumours of the essential nutrients they required for continued growth. As long as the mice were maintained on the ketogenic diet, tumour growth ceased.
The findings arose from the researchers' initial objective of understanding how the body sustains itself during fasting, a process influenced by a protein called eukaryotic translation initiation factor (eIF4E). This protein triggers fat consumption during fasting, a mechanism also activated by a ketogenic diet.
The researchers found that eFT508, a new cancer drug in clinical trials, inhibits eIF4E and the ketogenic pathway, thereby stopping the body's fat metabolism. When eFT508 was used in conjunction with a ketogenic diet in an animal model of pancreatic cancer, it effectively starved the cancer cells, resulting in tumour shrinkage.
These findings reveal a novel signalling pathway induced by fatty acids that activates selective translation, driving ketogenesis and offering a targeted dietary intervention for cancer. This approach shows potential for treating other cancers through a combination of diet and medication. While experts are optimistic about the promise of this diet-drug combination, they emphasize that further research in humans is necessary to fully explore its efficacy.
Reference: Yang, H., Zingaro, V. A., Lincoff, J., Tom, H., Oikawa, S., Oses-Prieto, J. A., Edmondson, Q., Seiple, I., Shah, H., Kajimura, S., Burlingame, A. L., Grabe, M., & Ruggero, D. (2024). Remodelling of the translatome controls diet and its impact on tumorigenesis. Nature. https://doi.org/10.1038/s41586-024-00000-0
Relationship Between Heart Disease and Alzheimer’s Disease
A study published in the International Journal of Molecular Science has found an association between Alzheimer’s disease and cardiovascular disease.
Researchers have identified a possible genetic link between Alzheimer’s disease and various disorders related to coronary artery disease, as well as lipids like cholesterol.
Previous research has associated cardiovascular issues such as high blood pressure, dyslipidemia, coronary artery disease, and atrial fibrillation with a higher risk of developing Alzheimer’s disease and other types of dementia.
For the study researchers focused on seven traits of coronary artery disease, which occurs when plaque builds up inside the arteries supplying blood to the heart like angina pectoris, cardiac dysrhythmias, coronary atherosclerosis, ischemic heart disease, myocardial infarction, coronary artery disease and non-specific chest pain.
Scientists also examined 13 distinct lipids linked to coronary artery disease, such as lipoproteins, triglycerides, and cholesterol.
At the end of the study, researchers identified a significant genetic relationship among all seven traits related to coronary artery disease that were evaluated, as well as with triglyceride levels.
Furthermore, the scientists found a genetic connection between Alzheimer’s disease and three additional lipid measurements—high-density lipoproteins (HDLs), low-density lipoproteins (LDLs), and total cholesterol. They also identified genes with significant associations across Alzheimer’s disease, various lipid levels, and traits related to coronary artery disease.
The researcher noted that these findings can enhance our understanding of the fundamental biological mechanisms and the genetic connections between Alzheimer’s disease, specific lipids, and traits associated with coronary artery disease.
Reference: Kirby A, Porter T, Adewuyi EO, Laws SM. Investigating Genetic Overlap between Alzheimer’s Disease, Lipids, and Coronary Artery Disease: A Large-Scale Genome-Wide Cross Trait Analysis. International Journal of Molecular Sciences. 2024; 25(16):8814. https://doi.org/10.3390/ijms25168814
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