Tuesday, 31 May 2016

Control of immune response relies on a key protein, study finds

Scientists have identified a protein that appears to play a key role in controlling immune response. By testing how the protein works in mice, they found possible explanations for why immune T cells sometimes fail to eliminate tumors and chronic infections. They suggest the discovery may lead to new treatments for many diseases, including cancer, autoimmune diseases, and infections.



The study, led by Sanford Burnham Prebys Medical Discovery Institute (SBP) in La Jolla, CA, is published in the journal Immunity.

Senior author Linda Bradley, a professor in SBP's Immunity and Pathogenesis Program, says:

"We discovered that a protein on the surface of T cells, P-selectin glycoprotein ligand-1 (PSGL-1), acts as a negative regulator of T cell function. PSGL-1 has the broad capacity to dampen T cell signals and promote the exhaustion of T cells in viral and tumor mouse models."

The researchers were interested in studying T cells because there is evidence many diseases - including infections and cancer - may arise because of problems with T-cell response.

T cells recognize and destroy specific invaders, including infectious bacteria and viruses from outside the body and rogue cells from inside the body that can trigger tumors.

T-cell activity is highly sensitive to control signals from other immune cells. These adjust T-cell response according to the nature of the "invasion." However, sometimes the response fails - for example, chronic viruses and cancers are able to escape attack by the immune system by disrupting T-cell response.

'Crucial for limiting immune responses'
One reason the T-cell response fails is because the cancer cells or viruses are able to use "checkpoints" on the T cells that turn down their activity - effectively exploiting a natural brake on the T cells. The checkpoints are normally controlled by patrolling immune cells and ensure T cells do not overreact and attack healthy tissue.

New drugs called "checkpoint inhibitors" - because they remove the brakes on the T cells - are beginning to show promise in treating some cancers. These drugs could potentially extend survival by years in the case of lung cancer and melanoma, note the authors.

From tests on mice, Prof. Bradley and colleagues found PSGL-1 plays a key role in inhibiting T-cell activity. It is needed to increase levels of checkpoints.

In mice bred to lack the protein, T cells remained active for longer than normal and completely eradicated lymphocytic choriomeningitis virus (LCMV) infections, which normally last months.

"Total clearance of LCMV is rare," Prof. Bradley notes. "When we saw that, we knew PSGL-1 was crucial for limiting immune responses."

When they injected the same mice with melanoma cells, the researchers found the resulting tumors grew more slowly than normal, suggesting PSGL-1 regulates T-cell responses in general.

Prof. Bradley suggests blocking the protein could boost the immune response to cancer and chronic viral infections like hepatitis. Alternatively, increasing the protein could inhibit immune response, an approach that could be useful for treating autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, psoriasis, and lupus.

"PSGL-1 inhibitors could provide another tool in the arsenal against cancer, and benefit the many patients who don't respond to the currently available checkpoint inhibitors."

Prof. Linda Bradley

The team at SBP is now looking at how the protein target might work with other anti-cancer drugs. T-cells do not reach all tumor cells, so an immunotherapy based on PSGL-1 could be more effective when combined with drugs that kill cancer more directly - and vice versa.

Alzheimer's disease: Could a leaky blood-brain barrier be involved?

A study found that the blood-brain barrier was leakier in a group of people with Alzheimer's disease than their healthy counterparts. The researchers suggest this means increased brain-barrier permeability may be a key contributor to the early stages of the disease.



The team, including Walter H. Backes, a professor in medical physics at Maastricht University Medical Center in the Netherlands, reports the study in the journal Radiology.

Prof. Backes says:

"Blood-brain barrier leakage means that the brain has lost its protective means, the stability of brain cells is disrupted and the environment in which nerve cells interact becomes ill-conditioned. These mechanisms could eventually lead to dysfunction in the brain."

The blood-brain barrier (BBB) separates the brain from circulating blood to keep brain tissue healthy. It is a collection of specialized cells and cellular components that line the walls of blood vessels in the brain and the rest of the central nervous system.

The BBB controls the delivery of important nutrients, blocks substances that can harm the brain, and removes waste from the brain.

Alzheimer's disease is the most common form of dementia, an illness that disrupts memory, thinking and behavior. Symptoms usually come on slowly and worsen over time, eventually preventing people from living independently. The disease accounts for 60-80 percent of dementia cases.

Potential key mechanism in early Alzheimer's
For their study, the team used contrast-enhanced magnetic resonance imaging (MRI) to identify leakages in the BBB of patients with early Alzheimer's.

Contrast-enhanced MRI allows researchers to identify more clearly the different fluids in the brain. Prof. Backes says it helps to spot tiny changes in blood vessels - even in cases where no directly visible cerebrovascular abnormalities can be seen.

The team compared the MRI scans of 16 patients with early Alzheimer's disease with those of 17 healthy people of the same age (the controls). They measured BBB leakage rate and made a histogram map that showed how much brain tissue was affected.

The results showed that the BBB leakage rate was higher in the Alzheimer's disease group than the controls.

From the histogram maps, the researchers say they could see that the leakage was distributed throughout the cerebrum - the largest part of the brain.

The Alzheimer's disease group had a significantly higher proportion of gray matter brain tissue affected by BBB leakage than the controls. The affected gray matter included the cortex, the outer layer of the brain.

From other research, scientists know that two features of Alzheimer's disease - the plaques and tangles of faulty protein that clog up the brain - tend to spread through the cortex as the disease progresses.

On closer inspection of the histogram data, the team also found evidence of very subtle BBB impairment in the white matter of the brain.

The researchers also found a link between the extent of BBB impairment and reduction in cognitive performance.

They suggest the findings point to impairments in BBB as a potential key mechanism in the early stages of Alzheimer's disease.

When they added diabetes and other non-cerebral circulation diseases to their analysis, the researchers found they did not affect the results, strengthening the case for a direct link between BBB impairment and Alzheimer's disease.

"For Alzheimer's research, this means that a novel tool has become available to study the contribution of blood-brain barrier impairment in the brain to disease onset and progression in early stages or pre-stages of dementia."

Prof. Walter H Backes

Opioids might worsen chronic pain, study finds

Anew study has questioned the benefits of opioid painkillers, after finding the drugs might worsen chronic pain rather than ease it.



Study co-leader Prof. Peter Grace, of the University of Colorado at Boulder (CU-Boulder), and colleagues recently published their findings in the Proceedings of the National Academy of Sciences.

Opioids are among the most commonly used painkillers in the United States; almost 250 million opioid prescriptions were written in 2013 - the equivalent to one bottle of pills for every American adult.

Previous studies have suggested opioids - such as codeine, oxycodone, morphine, and fentanyl - are effective pain relievers. They bind to proteins in the brain, spinal cord, and gastrointestinal tract called opioid receptors, reducing pain perception.

Increasing use and abuse of opioids, however, has become a major public health concern in the U.S.; opioid overdoses are responsible for 78 deaths in the country every day.

Now, Prof. Grace and colleagues have questioned whether opioids really work for pain relief, after finding the opioid morphine worsened chronic pain in rats.

Just 5 days of morphine treatment increased chronic pain in rats
According to Prof. Grace, previous studies assessing morphine use have focused on how the drug affects pain in the short term.

With this in mind, the researchers set out to investigate the longer-term effects of morphine use for chronic pain.

For their study, the team assessed two groups of rats with chronic nerve pain. One group was treated with morphine, while the other was not.

Compared with the non-treatment group, the team found that the chronic pain of the morphine group worsened with just 5 days of treatment. What is more, this effect persisted for several months.

"We are showing for the first time that even a brief exposure to opioids can have long-term negative effects on pain," says Prof. Grace. "We found the treatment was contributing to the problem."

Another 'ugly side' to opioids
According to the authors, the combination of morphine and nerve injury triggered a "cascade" of glial cell signaling, which increased chronic pain.

Glial cells are the "immune cells" of the central nervous system, which support and insulate nerve cells and aid nerve injury recovery.

They found that this cascade activated signaling from a protein called interleukin-1beta (IL-1b), which led to overactivity of nerve cells in the brain and spinal cord that respond to pain. This process can increase and prolong pain.

The researchers say their findings have important implications for individuals with chronic pain - a condition that is estimated to affect around 100 million Americans.

"The implications for people taking opioids like morphine, oxycodone and methadone are great, since we show the short-term decision to take such opioids can have devastating consequences of making pain worse and longer lasting. This is a very ugly side to opioids that had not been recognized before."

Study co-leader Prof. Linda Watkins, CU-Boulder

It is not all bad news, however. The researchers found they were able to reverse morphine's pain-increasing effect using a technique called "designer receptor exclusively activated by designer drugs" (DREADD), which involves the use of a targeted drug that stops glial cell receptors from recognizing opioids.

"Importantly, we've also been able to block the two main receptors involved in this immune response, including Toll-Like receptor 4 (TLR4) and another one called P2X7R, which have both been separately implicated in chronic pain before," notes Prof. Grace.

"By blocking these receptors, we're preventing the immune response from kicking in, enabling the painkilling benefits of morphine to be delivered without resulting in further chronic pain."

He adds that drugs that can block such receptors are currently in development, but it is likely to be at least another 5 years before they are available for clinical use.

How I Trained For A Hot Summer Bod

Dana James is a triple-board-certified nutritionist, Charlotte’s Book advisor, and founder of Food Coach NYC. She has a multi-disciplinary approach to nutrition therapy and fitness—here’s how she struggled to find the right work out, and eventually figured out the key to a beautiful toned, hot bod.



Almost every woman I know wants a lean body with sculpted muscles. She doesn’t want to bulk up. She wants a feminine body with curves from nicely rounded muscles. Yet, when we ask how to achieve this, the exercise experts give us conflicting information.

The buff trainers advise us to lift heavy weights to see muscle tone, while the Tracy Anderson-style trainers advise us to use light weights with lots of repetition. Who’s right? Is there some middle ground?

An Inadvertent Experiment

Over the past 18 months, I inadvertently conducted an experiment on my own body. For 15 years, I’d worked out with trainers and always requested the same thing—give me leaner legs and get rid of that fat above my knee (I have leg issues). My legs didn’t change much, but then, under the advice of my trainer-at-the-time, we increased the weights to tighten the muscle around my knee. The objective was to make it smaller. It didn’t work: it bulked it up.

After that, I was done—I went on a trainer hiatus for 12 months. There were enough boutique studios popping up in New York that I opted for group classes instead. I ran, took spin classes, yoga classes and, when I was on-form, did Tracy Anderson’s leg workout (this didn’t happen often). The only weights I used were in the spin classes for my upper body.

The Results? Not Exactly Perfect

Did my legs change? No. Did my body change? Yes, but not in the direction I wanted it to. The sculpted arms I was proud of the year before were no longer there. I felt dumpy and pudgy.

Was it time to go back to the heavy weights? I felt like one of my detox-retox-detox clients. It wasn’t time to do that. I needed an alternative strategy.

Experiment #2 (Spoiler Alert, This One Worked)

I replaced my cardio-skewed exercise program with a muscle sculpting program. I took Barry’s bootcamp 2-3x per week and used medium weights. I continued with yoga, and started with a movement specialist, Erik Hansen, who also trains Eva Mendes and Bruce Willis. Erik taught me the importance of postural alignment, working on small muscle groups, and using a combination of weights to improve my body shape. I’m happy to report that my arms are back and I’ll be wearing shorts this summer!

Tips From Erik, Movement Specialist

According to Erik, “most women prefer to avoid muscle hypertrophy.” Couldn’t agree more! His workouts address any postural imbalances, mobility or stability issues and improve overall strength and conditioning.

I choose carefully when and which muscles to place under significant load, sometimes only using body weight exercises.
I utilize full body and functional movements and movements inspired by yoga and pilates.
I tend to steer clear of heavy lifting with presses, pulldowns and rows, using them at a lower intensity instead, to support good posture rather than going after big strength gains.
I’ve also found that the smaller muscles—the biceps, triceps and deltoids—can be pushed harder strength-wise without adding size.
When training the lower body, I choose compound movements in which the muscles of the posterior chain (lower back, hamstring, glutes) are the primary movers, with variations of deadlifts, squats and lunges, in an attempt not to overload the quadriceps muscles, as they can tend to hypertrophy as well.
Perfect Legs: Tips From Chris Heron At Shaping Change

As I’ve been in search of the perfect legs for the past 20 years, I’ve asked many experts along the way. Chris Heron from Shaping Change in London, added this to the solution:

Sprint: this has better fat loss effects in half the time of steady state cardiovascular exercise. Studies have shown that near maximal efforts (90% + of max effort) for 15 repeats of 30 second sprints helped participants lose more fat in 6 weeks than people who spent more than double the time daily doing steady state cardio exercise.
Lift moderate weights but at very high volume: women should lift a little lighter weights, but lift them lots of times! Try a set of exercises that hits muscles in order of size, starting with legs, then back, chest and finish with shoulders and arms. With each exercise do 20-25 reps and go through the entire set 3 times.
At Last: The Dana James Plan

Spend 15 minutes doing sprint intervals, followed by Chris’ program, then do another round of 15 minute sprint intervals. This mimics the Barry’s bootcamp program I do in New York.
In terms of diet, eat clean. Mostly plants. A small amount of protein. An even smaller amount of carbs.
If you find yourself rationalizing your food choices with “I’ll run it off tomorrow” then you’ve just taken a step backwards. Use exercise to change the shape of your muscles and diet to burn fat.

FIND BEAUTY AND WELLNESS EXPERTS

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Smoothies Are a Lie



Smoothies, in theory, are pretty brilliant. You can stuff two cups' worth of spinach in there, along with strawberries, bananas, blueberries, chia seeds, and voila, that's already half of your daily recommended dose of fruits and veggies in just one drink. Getting lots of nutrients in one easy to consume drink is great. But it doesn't necessarily mean that smoothies are healthy. .

A recent New York Times story reports that you are likely consuming more calories and sugar when drinking a smoothie than when eating whole fruits and vegetables. According to dietitian and nutritionist Sarah Krieger, people often overdo it by drinking 20- or 24-fluid-ounce smoothies–that's the size of a Venti Starbucks–especially if you're buying from a store that adds loads of sweeteners and calorie-adding nut butters.

Even if you make smoothies at home, Krieger says the way we drink smoothies in just a few minutes as opposed to taking our time eating whole fruits leads to overconsumption. She explains the fiber in whole fruit "acts as a net" to slow down the body's process in converting sugar from food into blood sugar. Smoothies don't eliminate fiber, but they are shredded to bits in the blender and, thus, less effective. "You're likely to feel hungrier again sooner after drinking the smoothie than you would have had you eaten the same fruits and vegetables whole," the report reads.

Krieger insists "there's a fine line between a smoothie and a milkshake." Bottom line: whole fruits > blended fruits. Also, if you were thinking of getting a smoothie anyway...just go all the way and treat 'yo self with a milkshake, won't you?

Eating Breakfast Isn't as Important as You Think



You’ve heard it all before: Breakfast is “the most important meal of the day” and skipping it can lead to weight gain, a sluggish metabolism, or stress. According to a new piece in The New York Times however, our beliefs about breakfast are all based on “misinterpreted research and biased studies"–propaganda, basically.

Author Aaron E. Carroll notes that almost all breakfast studies suffer from a "publication bias.” There are flaws in reporting of studies that skew findings to link skipping breakfast with causing obesity. Carroll writes:

The [reports] improperly used causal language to describe their results. They misleadingly cited others’ results. And they also improperly used causal language in citing others’ results. People believe, and want you to believe, that skipping breakfast is bad.
Additionally, there are usually conflicts of interest behind the studies, considering most of them are funded by the food industry. The Quaker Oats Center of Excellence, for instance, paid for a trial that concluded eating oatmeal or frosted cornflakes reduces weight and cholesterol. Go figure.

We’re conditioned from a young age to believe that breakfast is essential to performance. It turns out that’s because most of the research geared toward kids is meant to evaluate the impact of school breakfast programs. They don’t take into consideration that 15 million children in the U.S. go hungry at home–of course they would do better in school if they eat. “That isn’t the same, though, as testing whether children who are already well nourished and don’t want breakfast should be forced to eat it,” Carroll writes.

Overall, you should just go with your gut. If you’re hungry in the morning, eat. If you’re not, don’t think you’re sinning by skipping it. Finally, approach all studies skeptically–Carroll put it best: “Breakfast has no mystical powers.”

How to Protect Your Eyes From Getting Sunburned



You wear sunscreen year-round, even on cloudy days, but what are you doing to safeguard your eyes? (And no, sorry, those $7 sunglasses you use as a permanent headband don’t count as a legit form of protection.)

While not as common as sunburned skin, photokeratitis - aka sunburned eyes - can occur when unprotected or under-protected eyes are exposed to sunlight reflecting off water, sand, ice, and snow, as well as those high-intensity UV lamps found in tanning beds. This kind of burn damages the thin surface layer of the cornea, and symptoms range from pain, redness, and swelling to watery eyes, sensitivity to bright light, blurriness of vision, and even temporary vision loss. Eek.

But don’t worry: Janelle Routhier, MD, licensed optometrist, fellow at the American Academy of Optometry and the British Contact Lens Association, and senior director of customer development at Essilor, has some easy ways to help you avoid sunburning your eyes.

1. Always wear the right kind of sunglasses, which might mean splurging a little.

Dropping $100+ on a pair of shades might sound like an indulgence, but it’s actually a smart health investment that can save you money and grief down the road. If you choose wisely, that is.

Dr. Routhier suggests selecting a pair that promises to block at least 98 percent of UVA and UVB. But even those lenses that boast a max amount of UV protection likely won’t shield you from all the ambient light hitting the back of your lens and reflecting into your eyes.

“It’s important to realize that most sunglasses only block light coming at us from straight ahead. Unless they are very tight around your face - in what we call a ‘wrap style’ - sunglasses let a lot of light in around the sides,” Routhier says.

Ask your eye doc about sunglasses that reduce the reflection off the back of the lens into your eye. Also, make sure to go for polarized lenses. While they don’t protect you from the sun’s rays, they do reduce glare and help you see more sharply.

So splurge a little on a pair of high-quality shades (the larger the better) and wear 'em as often as you can - on cloudy and sunny days alike - to not only prevent photokeratitis, but also decrease your risk of getting cataracts, which can develop after years of cumulative sun exposure. For maximum protection and style, pair shades with a floppy, wide-brimmed hat.

2. Refuse to part with those cute-looking cheapies? You don’t have to.

Head over to your optometrist and ask to swap out your lenses for a pair that will actually protect your precious peepers. They’re armed with the lenses you need to better protect your eyes from the sun, so you can upgrade your shades but still keep the fun frames. (Health and fashion crisis averted!)

And listen up, eyeglass wearers: Did you know you can order whatever sun lenses you want in your prescription? That means you can actually see the road in front of you while driving on a sunny day! Score.

3. Don’t forget the kids.

Kudos to the parents who diligently coat their children with gobs of sunscreen, but they’re probably still overlooking one critical area: the eyes. Kids need eye protection even more than adults do.

“The most damage occurs when we’re little because that’s when our pupils are the largest. It’s also when we’re outside the most and when we have both phones and devices [close to] our faces,” Routhier says. “Kids are exposing themselves to all sorts of UV, high energy, and blue violet lights.”

We get it - who wants to spend a wad of cash on a pair of sunglasses for a six-year-old who will lose or rip them off in a matter of minutes? If you don’t think eyewear is the way to go, at least put a wide-brimmed hat on your child’s head.

4. Fair folk, take heed.

Anyone who doesn’t protect their eyes properly can develop photokeratitis, but people with fair skin and light eyes are more susceptible thanks to the lower levels of pigment found in their skin. Lighter-eyed folks also tend to have slightly larger pupils than their darker-eyed friends, resulting in an extra light-sensitive iris and retina.

Blue-eyed journalist Anderson Cooper experienced firsthand what can happen when you don’t wear sunglasses. He reportedly burned his eyes during a 2012 trip to Portugal after spending a few hours boating without any protective eye gear. The result? About 36 hours of blindness and the feeling that his eyeballs were on fire. (Ouch!)

5. Don’t swap contact lenses for sunglasses.

Wear contact lenses? You’re also more prone to sunburned eyes.

“Generally, having anything in your eye - like a contact - is going to make your eyes more sensitive,” Routhier says. “A common misconception is that all contact lenses are UV-blocking, which they aren’t. A lot of people think, 'Well, I’ve got a contact lens on my eye so it’s blocking something; it’s protecting me.’”

Even those contacts that promise to block UV rays only cover a small portion of your eye and not the surrounding areas. That’s why you need sunglasses, regardless of what you wear for vision correction purposes. They help protect the delicate skin around your eyes prone to sunburn, as well as early signs of aging.