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Published10 minutes agoShareclose panelShare pageCopy linkAbout sharingBy Megan LawtonBBC NewsbeatPainful periods, fatigue and infertility are just three of the symptoms of endometriosis.It affects one in 10 women in the UK and takes on average eight years to get a diagnosis – figures that haven’t changed for a decadeThere is no known cause or cure, and treatment can range from pain relief drugs to hormonal treatments to surgery.The crippling pain caused by the condition can also affect day-to-day life, making it difficult to work, socialise and exercise.That’s something personal trainer Stef Williams knows only too well.She tells BBC Newsbeat having endometriosis is “awful” and says on a bad day she experiences “stabbing, crippling pains”.”I didn’t even know what the condition was, so I felt a lot of shame because I’d never heard of other women suffering with it,” she says.’Such a battle’Exercise has always been important to the fitness influencer, who’s known as Stef Fit to her 2.2 million Instagram followers.So learning how to keep moving her body throughout flare-ups was a priority when she was diagnosed.Like many who have the condition, she had surgery which initially left her unable to lift weights and do cardio – her usual forms of exercise.Stef knew she wanted to keep moving for her mental health but when she looked online for help, she found it was limited and often conflicting.”It was frustrating, the online advice was a maze and the advice from doctors was vague too,” she says.”The fact we have to do so much research ourselves is frustrating and such a battle for women, but after 10 years of being in daily pain I knew I needed to.”Image source, Rebecca SpencerDr Sharon Dixon, a GP and researcher at the University of Oxford who looks into women’s health, agrees with Stef.”There isn’t a huge amount of evidence about which types of exercise help endometriosis,” she tells Newsbeat.”That doesn’t mean there aren’t benefits, it just means it’s an area where we need to develop more science.”So how do you exercise with endo?For Stef, on a day when she’s in pain a simple stroll is a good starting place.”Hot girl walks are a trend now, but seven years ago I felt like I was a 90-year-old grandma going on walks,” she says.”But it’s amazing for my body. On the days I feel exhausted a 10-minute walk is enough.”Stef, who has her own activewear brand and workout app, has also discovered softer forms of exercise like Pilates and yoga.She says you don’t need to go to expensive gyms or studios to do them either, and wants to help women learn to do them from home.”You can’t lift weights after your operation for around six to eight weeks, but Pilates still gives your muscles a burn.”Bindi Irwin reveals endometriosis struggle’I am a voice for Asian women with endometriosis’New test could speed up endometriosis diagnosisDr Dixon says you can draw parallels between endometriosis and women suffering with menstrual pain.”Looking at period pain, exercise does seem to help and that includes low intensity exercises like yoga or Pilates,” she says.”We know from people living with other pain conditions that exercise can be really helpful in reducing pain intensity.”Despite her diagnosis, Stef has managed to continue doing impact and strength training too.But her advice her women suffering from endometriosis who want to do that type of exercise is to be patient.”It can be so frustrating but you will get there, you just have to find your flow,” she says.”Yes, there are tough days but also better days too.”What is endometriosis?It’s where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubesIt can affect women of any age, including teenagersSymptoms can include pain in your lower tummy or back, period pain that stops you doing your normal activities, and pain during or after sexSome women experience no symptoms but for many others the pain can be debilitating, and the condition can lead to infertilitySource: NHSFollow Newsbeat on Twitter and YouTube.Listen to Newsbeat live at 12:45 and 17:45 weekdays – or listen back here.More on this storyEndometriosis: ‘Doctors would tell me it’s in my head’Published30 March 2022Mum’s ‘disgusting’ wait for endometriosis surgeryPublished10 August’I am a voice for Asian women with endometriosis’Published9 AugustNew test could speed up endometriosis diagnosisPublished14 JulyBindi Irwin reveals endometriosis strugglePublished8 March’Wellness tracker helps me manage endometriosis’Published6 FebruaryEndometriosis: ‘There’s a fire inside my uterus’Published26 March 2022

When Jessica Albright returned with her family to their home in East Palestine, Ohio, last month after four months away, she opened the car door and took a deep breath — then stopped and thought: Maybe not too deep. Hauling suitcases up the steps, she tried to discern whether the acrid scent in the air had lessened.Listen to This ArticleFor more audio journalism and storytelling,

Published2 hours agoShareclose panelShare pageCopy linkAbout sharingBy James CookScotland editorScotland has the highest drugs death rate in Europe, with narcotics claiming more than 100 lives on average every month.The Scottish government is proposing to decriminalise the possession of drugs for personal use to “help and support people rather than criminalise and stigmatise them”.But the UK government, which controls drugs policy, has rejected the plan as dangerous and says it has no intention of giving the Scottish Parliament the power to enact the new policy.So what is decriminalisation – and would it work?In setting out their proposals, Scottish National Party (SNP) ministers cited Portugal, which relaxed its drug laws in 2001, as a potential model.Despite having almost double the population of Scotland – 10.3 million compared with 5.5 million – Portugal has far fewer drug deaths. There were just 74 in 2021 compared with 1,330 in Scotland, where the figures for 2022 are set to be published on Tuesday.The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) makes comparisons using drug deaths of people aged 15-64 years-old. On that measure, National Records of Scotland says Scotland had 327 deaths per million people in 2020, the most recent year for which the breakdown is available, while the EMCDDA says Portugal had nine deaths per million.This video can not be playedTo play this video you need to enable JavaScript in your browser.Statisticians say there are some methodological differences between the two nations but the figures are broadly comparable.Portugal’s architect of decriminalisation, João Goulão, argues that adopting a similar policy in Scotland could save lives.”We are dealing with a health condition, with a disease, and we do not criminalise other diseases,” he tells BBC News.We meet Dr Goulão in the Portuguese capital, Lisbon, at the General Directorate for Intervention on Addictive Behaviours and Dependencies, where he oversees national drugs policy.Globally, many advocates of drug liberalisation praise the framework which the former GP helped to design.In Portugal, drug trafficking and dealing remain criminal offences. Possession of up to 10 days’ supply for personal use of any drug, including heroin and cocaine, is not criminal – but it is not legal either and is dealt with as an administrative matter.If a user is detained, and if there is no evidence that they are supplying narcotics, the police can confiscate their drugs and refer them to a Commission for the Dissuasion of Drug Use. This is a panel usually made up of a legal expert, a health professional and a social worker.Image source, Getty ImagesThere is one commission for each of the country’s 18 districts. Overseen by Portugal’s health, rather than justice, ministry, they try to establish if a drug user is an occasional recreational consumer or someone struggling with addiction.The panels have a variety of options available to them, including referring the user for treatment or counselling; levying fines for repeat appearances; imposing sanctions such as revoking a driving licence, a gun licence, or the right to practise in a licensed profession; and applying restrictions on visiting certain places or associating with certain people.However, in around four out of five cases, after a discussion with the user about their drug use, no action is taken.In the last year for which figures are available, nine out of ten participants were male and 45% were aged between 16 and 24.The number of people appearing before the commissions rose from 4,850 in 2002 to 11,995 in 2017 before falling back to 6,628 in 2021.The head of the commissions, Nuno Capaz, says that reflects the changing rate at which police referred users, rather than a shift in drug use.Dr Goulão says there have been challenges with funding and recruitment of staff in recent years which have made the job of the panels more difficult, but he insists Portugal is in a much better place than it was before decriminalisation.Then, he says, the nation was in the grip of heroin and HIV epidemics, with drugs deaths running at around 350 per year.At one point, one per cent of the entire population — some 100,000 people — had used heroin, estimates Dr Goulão.”It was difficult to find a Portuguese family that had no problems related to drugs,” he adds.Illicit drug use had exploded after the overthrow, on 25 April 1974, of the right-wing Estado Novo (New State) dictatorship, in a peaceful coup which became known as the Carnation Revolution. The restoration of democracy saw a closed, conservative and Catholic country rapidly opening up to the world.It also led to the return of tens of thousands of Portuguese soldiers who had been fighting to retain colonies in Angola, Guinea-Bissau and Mozambique.Luis Miguel Pereira recalls how, as the troops came home, drugs flooded into the country.He started using at the age of 14, he says. Nearly four decades later, he is HIV-positive and remains hooked on cocaine and heroin.”I need it,” he says, simply.As a child, Mr Pereira says, he had a good life, studying and playing football, “but when I start to take drugs, everything changes.””It’s like a prison,” he says. “You are locked inside of the drugs. You wake up thinking drugs. You lay down thinking drugs. It’s the only thought that you think in your mind.”By the late 1990s the left-wing government of António Guterres – who is now Secretary-General of the United Nations – had begun to take steps towards liberalisation. In November 2000, it passed law number 30/2000, which enacted decriminalisation from 1 July 2001.”The initial impact was amazing,” says Rui Moreira, who was running a nightclub at the time but is now the independent mayor of Porto. “It was great.””It was very influential. We were giving them methadone. We were supplying them with medical help. We started controlling HIV. We started distributing free syringes through pharmacies.”These days the most obvious embodiment of this ‘harm reduction’ approach are Portugal’s two drug consumption rooms, one in Porto which opened exactly one year ago, the other in Lisbon, which has been running since 2021.In the Porto centre, co-ordinator Diana Castro explains that nurses, a psychologist, a social worker and a doctor are on hand to assist and advise users.In just nine months, she says, it has helped 1,600 people.”Every day we are saving lives,” she added.The mayor of Porto supports the facility and remains in favour of decriminalisation, but he tells us that he also has concerns.Time, says Mr Moreira, has revealed some nasty side effects of law 30/2000.First, he argues, it normalised dangerous drug use among young people, entrenching criminal behaviour by those desperate to feed their addiction and supporting profits for drug dealers.And as hard drugs began to lose their stigma, users could even be seen shooting up outside schools – where it was forbidden to advertise ice cream or sweets, he adds.These side effects are not everywhere, by any means. Many parts of this industrial powerhouse turned tourist hotspot on the Douro estuary are bright, clean and bustling with visitors.But look for evidence of drug taking in Portugal’s second city, and you can certainly find it.Outside São Bento railway station, in the historic centre of this Unesco World Heritage site, syringes lie discarded on the cobbles.A short drive away, a group of drug users, stripped to the waist, huddle in the shade under a public stairway.And in Porto’s noisy margins, under the flight path of Francisco Sá Carneiro airport, the atmosphere outside the drug consumption room in the neighbourhood of Pasteleira is edgy, as Tony prepares to smoke crack cocaine.”I’m here every day,” he tells me, in his native Portuguese.Tony’s aquiline features and grey curls lend him the air of a senator in Ancient Rome.But given that Tony, 61, says he has been taking drugs for 40 years, perhaps his most remarkable feature is a beating heart.”I only do coke,” he says but then adds: “I take methadone. And I only take heroin when I run out of methadone.””Even if the law decriminalises consumption… the police are very aggressive with us,” adds Tony.”We’re treated like garbage. It’s not fair.”Not long after chatting to Tony outside the facility, our guide tells us abruptly that we must leave.A look-out has apparently summoned a more senior member of a drug trafficking gang and Pasteleira is no longer considered safe for us or for those with us.We return to the area a few hours later, accompanied by Porto’s municipal police chief, Superintendent Antonio da Silva. He takes us to a rabbit warren of a housing scheme, its high walls crisscrossed by shaded alleyways.A few months ago, says Mr da Silva, standing here would not have been possible.”This was a stronghold of drug dealing in Porto,” he explains, describing it as a “complete nightmare” full of dealers and users.Faced with angry residents who felt trapped in their own homes, the national police moved in and cleared out the criminals.Drug trafficking is a “big problem” in Portugal says Commander Rui Mendes, head of Porto CID at the national police force, which carried out the operation.”The traffic dealers are very well organised,” he adds.”You can make 500 arrests but sometimes I feel you can do a thousand and it would be the same because the profits are too high for them,” says Mr Mendes.Mr da Silva supports decriminalisation but he agrees that the fight is never ending. Asked if the operation in Pasteleira simply pushed the problem elsewhere, he replies: “Definitely.””We can make arrests,” he adds, but “the police will not solve the social problem of drug addiction.”The drug consumption room in Lisbon, like its counterpart in Porto, is also under a noisy flight path on the margins of the city, with drug users sheltering from the blazing sun beside a dual carriageway, barely visible in shadows cast by concrete and steel.Roberta Reis, who runs it, agrees with Mr da Silva that decriminalisation has worked. “A history of success,” is how she describes the policy.Ms Reis says harm reduction has led to a fall in cases of hepatitis B and C, tuberculosis, and HIV.”You can educate people to use [drugs] in a safer way,” she adds.This is a common view here. Decriminalisation feels settled in Portugal. There is no mainstream call for the policy to be reversed.The mayor of Porto, Rui Moreira, does want changes though. As well as improving housing, cleaning up public spaces, and offering more opportunities for young people, he is calling for criminalisation of drug use in certain areas, such as near schools and civic centres.There are limits to the comparisons between Portugal and Scotland. No two countries are the same. Scotland has a particularly acute problem with benzodiazepines.The outgoing chief constable of Police Scotland, Sir Iain Livingstone, recently told Today on BBC Radio 4, that officers had, in effect, been operating a de facto decriminalisation policy.”For many years now, those that use drugs and addicts have not been subject to criminal sanctions,” he said.”My greater concern,” added Sir Iain, “rather than the decriminalisation of drugs, is actually making sure there’s enough support services.”On that point at least there appears to be some agreement.Antonio da Silva recalls being “absolutely shocked” by Scotland’s death rate.”Scotland is by far the worst… It’s something that should make us think about what is going wrong there,” he says.”Must do something,” agrees João Goulão, although he has a word of caution for policymakers in Edinburgh and London.”Decriminalisation by itself gives you nothing,” he warns, “but all the health responses — treatment, harm reduction — are much more efficient within a decriminalised environment than they were before.”More on this storyMy daughter wouldn’t have died if drugs were legalPublished11 MayIncrease in suspected drugs deaths across ScotlandPublished24 JanuaryScotland’s first rehab clinic for parents opensPublished21 November 2022

Three people died from infections caused by bacteria that health officials tied to ice cream machines at a Frugals restaurant that they said had not been properly cleaned.A listeria outbreak that led to the deaths of three people has been linked to milkshakes sold by the burger chain Frugals at its restaurant in Tacoma, Wash., according to the state’s health department.In a news release on Friday, officials said that outbreak had been caused by the food-borne listeria, a type of bacteria that can cause serious sickness or death in people 65 or older and miscarriages and premature births in pregnant women. At least three other people were hospitalized as a result of the outbreak from Feb. 27 to July 22.The same strain of the bacteria was found in ice cream machines at the restaurant, about 10 miles south of downtown Tacoma, that had not been properly cleaned, the health department said. The restaurant stopped using the ice cream machines after they were tested on Aug. 8, but listeria can sicken people several days after consuming the bacteria, health officials said. None of the other Frugals restaurants in Washington or Montana are believed to have been affected, they added.In a statement posted on Instagram over the weekend, Frugals said, “We are heartbroken and deeply regret any harm our actions could have caused.” The Tacoma Frugals has stopped selling milkshakes and has sent the milkshake equipment to be cleaned and retested, it said.Frugals did not immediately respond to requests for additional comment on Monday evening.Investigators said that all of the six people hospitalized, including those who died, were immunocompromised, and that genetic fingerprinting of the bacteria had showed the same food was likely responsible for making them sick.Two of those who were sickened and survived told investigators they had drunk milkshakes from the restaurant.Past listeria outbreaks caused by ice cream and milkshakes prompted the Tacoma-Pierce County Health Department to take samples from the restaurant on Aug. 8, state health officials said. Ten days later, they confirmed that all of the restaurant’s milkshake flavors had been contaminated with the same strain of listeria that caused the outbreak.While most people who eat food contaminated with listeria do not develop serious illness, state health officials have advised anyone who is pregnant, age 65 and older or immunocompromised and drank a milkshake at the restaurant from May 29 to Aug. 7 to contact their health provider.“The milkshake machines will be kept out of service until the Tacoma-Pierce County Health Department determines they are free of Listeria contamination and no longer pose a danger to the public,” the Washington State Department of Health said.Last year, a multistate listeria outbreak was linked to contaminated deli meat and cheeses. Other recent outbreaks have been caused by contaminated store-bought ice cream and leafy greens.Listeriosis typically manifests within two weeks of consuming contaminated food and can cause flulike symptoms including fever, muscle aches and fatigue, according to the Centers for Disease Control and Prevention. In pregnant people, severe cases can lead to miscarriage and other complications.From 2009 to 2021, the latest year for which data is available, Washington State logged 18 listeria outbreaks that resulted in 238 hospitalizations and 47 deaths. The state records around 10 to 25 cases of the infection each year, according to the Tacoma-Pierce County Health Department.

For many, the threat of the COVID-19 pandemic seems over. However, for patients whose immune systems are compromised by cancer or by cancer therapies, fear of COVID-19 infection and severe disease remains very real.
Currently, CDC guidance recommends that immunocompromised patients receive COVID-19 booster shots “as needed.” While this flexibility is useful for patients with complex medical conditions, more specific guidance is lacking as to when additional COVID-19 boosting would be most effective.
New research led by scientists at Yale University and the University of North Carolina at Charlotte provides this critically needed information. The rate at which additional COVID-19 boosters are needed for cancer patients, the researchers say, depends on the treatment they are receiving.
The study, published Aug. 21 in the Journal of the National Cancer Institute, quantifies the long-term likelihood of future infection among cancer patients undergoing various common therapies after they received updated Pfizer vaccine booster shots.
According to the research, increased boosting among cancer patients provides benefits similar to those obtained by non-cancer patients. The study predicts that one out of every three people who forgo boosting will be infected within two years. In contrast, boosting every six months reduces that risk to 1 in 20.
“It turns out that most cancer patients are protected nearly as well as the non-cancer population by COVID-19 boosting,” said Yale School of Public Health Professor Jeffrey Townsend, the study’s lead author. “But there is a big exception.”
“Some cancer therapies directly attack immune cells,” said the study’s co-leader Alex Dornburg, an assistant professor at the University of North Carolina at Charlotte. “This is great for battling blood cancers such as some lymphomas, but the death of immune cells also opens a window not only for COVID-19 infection, but for severe infection.”
For those cancer patients whose therapies directly impact the immune response, a much higher frequency of boosting could be very beneficial, the researchers said. With annual boosting, one out of every three patients on these therapies would still be vulnerable to contracting COVID-19 within two years without other interventions. Boosting every three months cuts this risk almost in half, the study said.

The world needs greener ways to make chemicals. In a new study, University of Wisconsin-Madison researchers demonstrate one potential path toward this goal by adapting hydrogen fuel cell technologies. These technologies are already used to power some electric vehicles, laptops and cell phones.
“The chemical industry is a massive energy consumer, and there is a big push to decarbonize the industry,” says Shannon Stahl, a professor in the UW-Madison Department of Chemistry who guided much of the research. “Renewable electricity can provide energy to produce chemicals with a much lower carbon footprint than burning fossil fuels.”
The conventional process uses large quantities of zinc metal as the source of electrons, but handling zinc is complicated and generates large amounts of environmentally unfriendly waste. Working with scientists at the pharmaceutical maker Merck & Co. Inc., UW-Madison chemists and engineers sought to develop a more sustainable method to manufacture ingredients needed to make many types of drugs.
In their search for an alternative process, the researchers took inspiration from hydrogen fuel cells, which use hydrogen gas as the source of electrons to generate electricity.
“The process we are working with needs a green source of electrons,” says Stahl. “We realized that fuel cell technology could be modified to make chemicals rather than electricity,”
Hydrogen gas is an ideal choice in many ways, according to Stahl. It can be generated from renewable electricity, and it creates very little waste. Developing a hydrogen-based way to make pharmaceuticals aligns with renewed interest in a “hydrogen economy.”
“This work is connected to a broader effort to create a hydrogen infrastructure that goes beyond fuel cells and energy production,” says Mathew Johnson, a postdoctoral researcher in the chemistry department who led the study. “This work shows that hydrogen can be combined with electricity to make new drugs.”
The researchers developed a system that uses a type of organic compound called a quinone to pull electrons away from hydrogen. An important feature of this process is that it works well in the absence of water. Fuel cells typically need water to operate effectively, but water can interfere with steps used to make the drug ingredients.

Markers that indicate the presence of Parkinson’s disease in patients on average seven years before clinical presentation have been identified by a UCL and Moorfields Eye Hospital research team.
This is the first time anyone has shown these findings several years before diagnosis, and these results were made possible by the largest study to date on retinal imaging in Parkinson’s disease.
The study, published today in Neurology®, the medical journal of the American Academy of Neurology, identified markers of Parkinson’s in eye scans with the help of artificial intelligence (AI). Its analysis of the AlzEye dataset was repeated using the wider UK Biobank database (healthy volunteers), which replicated the discoveries. The use of these two large, powerful datasets has enabled the team to identify these subtle markers, even though Parkinson’s disease has a relatively low prevalence (0.1-0.2% of the population). Generation of the AlzEye dataset was enabled by INSIGHT, the world’s largest database of retinal images and associated clinical data.
The use of data from eye scans has previously revealed signs of other neurodegenerative conditions, including Alzheimer’s, multiple sclerosis and, most recently, schizophrenia, in an emerging and exciting field of research referred to as “oculomics”.
Eye scans and eye data have also been able to reveal a propensity to high blood pressure; cardiovascular disease including strokes; and diabetes.
Doctors have known for a long time that the eye can act as a ‘window’ to the rest of the body, giving a direct insight into many aspects of our health. High-resolution images of the retina are now a routine part of eye care – in particular, a type of 3D scan known as ‘optical coherence tomography’ (OCT), which is widely used in eye clinics and high-street opticians. In less than a minute, an OCT scan produces a cross-section of the retina (the back of the eye) in incredible detail – down to a thousandth of a millimetre.
These images are extremely useful for monitoring eye health, but their value goes much further, as a scan of the retina is the only non-intrusive way to view layers of cells below the skin’s surface. In recent years, researchers have started to use powerful computers to accurately analyse large numbers of OCTs and other eye images, in a fraction of the time it would take a human. Using a type of AI known as ‘machine learning’, computers are now able to uncover hidden information about the whole body from these images alone. Harnessing this new potential is what oculomics is about.

One of the hallmarks of Alzheimer’s disease is disruption to the body’s circadian rhythm, the internal biological clock that regulates many of our physiological processes. Nearly 80% of people with Alzheimer’s experience these issues, including difficulty sleeping and worsening cognitive function at night. However, there are no existing treatments for Alzheimer’s that target this aspect of the disease.
A new study from researchers at University of California San Diego School of Medicine has shown in mice that it is possible to correct the circadian disruptions seen in Alzheimer’s disease with time-restricted feeding, a type of intermittent fasting focused on limiting the daily eating window without limiting the amount of food consumed.
In the study, published August 21, 2023 in Cell Metabolism, mice that were fed on a time-restricted schedule showed improvements in memory and reduced accumulation of amyloid proteins in the brain. The authors say the findings will likely result in a human clinical trial.
“For many years, we assumed that the circadian disruptions seen in people with Alzheimer’s are a result of neurodegeneration, but we’re now learning it may be the other way around — circadian disruption may be one of the main drivers of Alzheimer’s pathology,” said senior study author Paula Desplats, PhD, professor in the Department of Neurosciences at UC San Diego School of Medicine. “This makes circadian disruptions a promising target for new Alzheimer’s treatments, and our findings provide the proof-of-concept for an easy and accessible way to correct these disruptions.”
Alzheimer’s disease affects more than 6 million Americans, and it is considered by many to be the biggest forthcoming health challenge in the United States. People with Alzheimer’s experience a variety of disruptions to their circadian rhythms, including changes to their sleep/wake cycle, increased cognitive impairment and confusion in the evenings, and difficulty falling and staying asleep.
“Circadian disruptions in Alzheimer’s are the leading cause of nursing home placement,” said Desplats. “Anything we can do to help patients restore their circadian rhythm will make a huge difference in how we manage Alzheimer’s in the clinic and how caregivers help patients manage the disease at home.”
Boosting the circadian clock is an emerging approach to improving health outcomes, and one way to accomplish this is by controlling the daily cycle of feeding and fasting. The researchers tested this strategy in a mouse model of Alzheimer’s disease, feeding the mice on a time-restricted schedule where they were only allowed to eat within a six-hour window each day. For humans, this would translate to about 14 hours of fasting each day.

A simple blood test may predict the risk of progressive heart and kidney disease in people with Type 2 diabetes and kidney disease, according to new research published today in the American Heart Association’s flagship journal Circulation.
“High levels of certain biomarkers are indicators of heart and kidney complications and may help predict future risk of disease progression,” said lead author James Januzzi, M.D., the Hutter Family Professor of Medicine at Harvard Medical School, a cardiologist at the Massachusetts General Hospital and the director of heart failure and biomarker trials at the Baim Institute for Clinical Research in Boston. “Treatment with canagliflozin, a sodium glucose co-transporter 2 inhibitor, lowered biomarker levels and reduced the risk of hospitalization for heart failure and other heart complications in people at the highest risk.”
Health professionals regularly measure biomarkers to screen, diagnose or treat specific conditions. Previous research has shown that concentrations of some biomarkers may predict the onset and progression of chronic kidney disease as well as cardiovascular events in people with Type 2 diabetes.
The researchers analyzed biomarker data from the blood samples of 2,627 people who participated in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial to assess the effects of canagliflozin on concentrations of the four biomarkers from the study start, the one-year mark and the three-year mark. They also examined the prognostic value of each biomarker on various levels of kidney problems, and risk of death due to kidney disease or cardiovascular disease. Patients were separated into low, medium and high risk categories. People at highest risk showed dramatically higher rates of progressive kidney failure and cardiovascular complications throughout the three-year study period.
The analysis found: High concentrations of each biomarker at the beginning of the study were strongly predictive of the severity of the participant’s heart and kidney issues. The concentrations of each of the four biomarkers in people taking canagliflozin were lower after one year and three years compared to those taking the placebo. After one year, the levels of all biomarkers in participants who took canagliflozin rose 3% to 10%, compared to an increase of 6% to 29% in the those who took the placebo.”It was reassuring to discover that canagliflozin helped reduce risks the most in people with the highest chances for complications. Future studies are needed to better understand how Type 2 diabetes in conjunction with kidney disease develops and progresses so that we may initiate life-saving therapies earlier, before symptoms of heart and kidney disease have occurred.” Januzzi said. “Given that the American Heart Association/American College of Cardiology and the American Diabetes Association now all recommend measurement of biomarkers to enhance ability to predict risk in persons with Type 2 diabetes, these results may considerably extend the reach of biomarker-based testing, refining accuracy even further.”
The study was limited in that not all study participants in the CREDENCE trial had available samples for biomarker measurement, and the participants with biomarker measurement may not be representative of the study’s entire population. Additionally, biomarker data over time were not complete, and some study participants had missing values during the study follow-up period. While prognostic thresholds for predicting the risk of kidney and heart complications in people with Type 2 diabetes have been identified for two of the biomarkers, prognostic thresholds remain exploratory for the other two.
Background: The CREDENCE trial (2014-2018) compared the effectiveness of a placebo to 100 mg of canagliflozin, which is used to treat Type 2 diabetes. It works in the kidneys to prevent the absorption of glucose. People enrolled in the phase 3 clinical trial had Type 2 diabetes and chronic kidney disease; the trial concluded canagliflozin was more effective than placebo in reducing cardiovascular disease and kidney failure in the participants. The four biomarkers analyzed in the study were: N-terminal pro-B-type natriuretic peptide; high-sensitivity cardiac troponin T; growth differentiation factor-15; and insulin-like growth factor binding protein 7.

A research team at the Wyss Institute at Harvard University, MIT, and Brigham and Women’s Hospital in Boston has developed a new approach that integrates a minimally invasive, painless microneedle platform capable of absorbing the cell-surrounding, biomarker-containing fluid from deeper layers of the skin with an ultra-sensitive, single-molecule detection method (Simoa) that detects often rare, yet relevant biomarkers with higher sensitivity than conventional methods.
Patients with melanoma, the most concerning form of skin cancer in which pigment-producing cells start to grow out of control, can benefit from existing immunotherapies, but by far not all of them do. More than 50% of patients do not respond to current immunotherapy drugs and among those that initially respond, many become resistant to the drugs’ effects. Thus, besides developing more effective immunotherapies, doctors need to be able to determine which patients respond well at the start of treatments and, which ones keep or stop responding in order to make the best treatment decisions.
Because cancerous skin lesions of melanoma patients are easily accessible, an effective way to eradicate them could be to apply immunotherapies locally, instead of systemically infusing them into the blood circulation. Also, monitoring the immune system’s reaction to the therapy right at the tumor site, by sensitively and continuously measuring different biomarkers that signal the intended immune cell activation and a desirable inflammatory response, could enable better and more personalized patient care.
Now, a research team at the Wyss Institute at Harvard University, MIT, and Brigham and Women’s Hospital in Boston has developed a new approach that integrates a minimally invasive, painless microneedle platform capable of absorbing the cell-surrounding, biomarker-containing fluid from deeper layers of the skin with an ultra-sensitive, single-molecule detection method (Simoa) that detects often rare, yet relevant biomarkers with higher sensitivity than conventional methods. The researchers provided proof-of-concept for their approach in a mouse melanoma model in which they treated cancerous lesions with a novel therapy. The therapy acts locally on tumor lesions in that it combines non-invasive focused ultrasound (FUS), which generates heat at the tumor site to instantly kill tumor cells, with the delivery of a previously developed nanoparticle-bound activator of an inflammation-inducing protein known as stimulator of interferon genes (STING). The findings are reported in Advanced Functional Materials.
“Rapid readout of the responses to melanoma therapy using microneedles may enable effective drug screening and patient stratification to maximize therapeutic benefits,” said Wyss Associate Faculty member Natalie Artzi, Ph.D., who led the study. Artzi is also an Associate Professor of Medicine at Harvard Medical School (HMS) and a Principal Research Scientist at the Institute for Medical Engineering and Science at MIT.
Immunotherapy made local
Artzi and her group first developed a locally applied immunotherapy for melanoma that leveraged some of their previously pioneered methods and expertise. In a recent publication, which built on the known fact that activation of the inflammation-inducing STING protein contributes to tumor cell killing, they reported a significantly more effective way to activate the protein in immune cells. Natural activators (agonists) of STING are not sufficiently stable in the body and need to be given in high doses that also can produce side effects. The group’s solution was to deliver multiple copies of a synthetic STING agonist, called a synthetic cyclic dinucleotide (CDN), via nanoparticles (NP) that easily traverse the plasma membrane and, with the help of an engineered enzymatic reaction, release their cargo inside cells. This CDN-NP therapeutic can be directly injected in or close to cancerous skin lesions to additionally increase the drug concentration in tumors.