Tuesday, 11 September 2012

increasing vitamin intake


'Super soup' test in asthma trial

Asthma inhaler dispensing a dose of medicationThere are more than five million people in the UK who suffer from asthma

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Scientists are to begin clinical trials to determine if eating more foods rich in vitamin E during pregnancy prevents childhood asthma.
Women will eat soups naturally high in the vitamin, which it is believed may promote lung growth in the developing foetus.
Children born with good lung function are less likely to develop asthma.
Details of the trial were outlined at the British Science Festival being held in Aberdeen.
Asthma is highly prevalent - in the UK, 10-15% of children and 5-10% of adults have been diagnosed with the disease.
The majority of children with asthma will carry the illness into adulthood.
The disease is managed by preventing and relieving the major symptoms - breathlessness, wheezing and coughing - using inhalers and, in extreme cases, with steroid tablets.
There has been a recent increase in the prevalence of asthma in children.
To try to understand why, a team of researchers from the University of Aberdeen established a cohort of approximately 2,000 women and measured the impact of diet on the incidence of asthma in children up to the age of five.
Prof Graham Deveraux, who led the study, said: "We were able to show, for the first time, that children born to mums with a lower vitamin E intake during pregnancy were more likely to develop asthma by the age of five and have poor lung function."
These early findings were then confirmed in studies carried out in Japan and the US.
The next challenge for the researchers was to show that altering nutrition during pregnancy could positively impact on a child's susceptibility to asthma.
Avoiding potions and pills
Prof Deveraux considered that a trial using vitamin supplements lacked credibility - trials of vitamins to treat various conditions had so-often failed.
He said the key may be intake in food.
"People have never actually eaten vitamin E tablets; normally most people get their vitamin E from food.
"I wondered whether it might be the other nutrients that go with vitamin E in food that may be responsible for the effect. There may be interactions between vitamin E and the other nutrients.
"So, I was very keen to do a dietary intervention rather than a pill or a potion."
With the help of a team of dietitians, he performed a small study on pregnant women to see if he could manipulate their diet to increase their vitamin E intake up to the recommended levels and, he says, "it worked a treat".
But vitamin E was not the only thing that altered, as Prof Deveraux observed: "Lots of other things changed, like the fatty acids changed, the zinc changed, the selenium, the vitamin D - and all these are nutrients which we know have been associated during pregnancy with childhood asthma."
Whilst the results vindicated their overall approach, the dietary interventions were too complex and would not be readily accessible to a wide range of society. Also it was difficult to standardise and control.
Super soups
To overcome these problems, the team approached a commercial soup manufacturer to develop a range of enhanced soups. Each one is naturally rich in vitamin E - and other potentially important minerals - and for each there is a similarly tasting "normal" soup that could be used for the control group of pregnant women.
By judicious tweaking of ingredients - for example, substituting normal tomatoes found in cream of tomato soup with their super-nutritious sun-dried counterparts - they were able to develop three new varieties of "super-soups".
The team now plan to test the soups in a small pilot study involving 50 women. They will be enrolled during early pregnancy and asked to eat either enriched or normal soup three times a week.
The study will show whether the new dietary intervention is well tolerated by the women and - by carrying out blood measurements - if it has the desired effect on vitamin intake.
They might also get an early indication that the approach could prevent asthma. "If we're really lucky we might show that the children [born to women] receiving vitamin E enhancement may actually have better lung function," Prof Deveraux commented.
The overall approach has support from both nutritionists and asthma experts.
Prof Maijaliisa Erkkola, from the University of Helsinki, told BBC News: "Appropriate food-based strategies that could contribute to reducing low maternal intakes of vitamin E to prevent asthma in offspring and to improve health of children are welcome."
Whilst Prof Ian Hall, from the University of Nottingham and an expert on asthma, told us: "In general these studies [using diet supplement tablets] have been disappointing in that they have failed to show reductions in the risk of developing asthma in the treated subjects.
"The current study adopts a novel approach by using natural supplementation in soup rather than a tablet based approach: it will be interesting to see if this proves more successful".
If the pilot study is successful in its primary aim - increasing vitamin intake - then Prof Deveraux and his team plan to carry out a much larger trial in over 1,000 women.

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Carbon emissions linked to Europe's hay fever rise


Carbon emissions linked to Europe's hay fever rise

Pollen from catkinsThe pollen season is getting longer in Europe, partly influenced by climate change

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Carbon dioxide emissions may be raising pollen counts in European cities, according to a continent-wide study.
Researchers from 13 EU nations analysed pollen levels for more than 20 species of tree and plant.
They found that many, including several that cause allergies such as hay fever, correlated with rising CO2 levels.
Presenting their study at the European Geosciences Union (EGU) annual meeting, scientists said city planners might need to review which trees they plant.
Hay fever and other allergies appear to be rising across Europe.
In the UK, GP diagnoses of allergic rhinitis, which includes hay fever, rose by a third between 2001 and 2005.
It has been suggested that higher temperatures might be causing plants to produce more pollen.
But by comparing pollen counts during relatively hotter and relatively cooler years, this latest study found temperature was not the cause.
Annette Menzel from the Technical University of Munich said other possible factors were eliminated as well.
"We thought the increase in the amount of pollen could be related to land use changes, but we don't observe this," she told BBC News.
"We tried to link it to temperature, but that's not possible.
"So the only effect that's left would be a CO2 effect; and we know from experiments in the real world and in climate chambers that CO2 does promote the amount of pollen [that trees produce]."
Urban conundrum

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The season of suffering for people with hay fever is getting more serious”
Annette MenzelTechnical University of Munich
Data in the study came from pollen monitoring stations in the 13 nations, supplemented by tree cover information from the UN Food and Agriculture Organization and weather data.
Not all the 25 species studied show the same trend - pollen counts from some have actually gone down.
But 60% of species have seen an increase in pollen production across the decades of the study period, including nine species known to produce allergenic pollen.
There were also differences between trends in different countries, with pollen counts falling in a few.
Perhaps the most intriguing finding was that pollen counts have generally increased with CO2 inside cities, but not outside.
The researchers suggest this could be down to the longer lifetime of ozone molecules outside urban areas.
Pollen grains under a microscopePollen causes inflammation of the air passages by stimulating the immune system
The gas is known to disrupt plant growth.
Although more research remains to be done, Professor Menzel's team suggests further rises in pollen counts probably lie ahead, given that CO2 concentrations are rising.
The increasing length of pollen seasons in Europe is linked to the introduction of plants and trees from other continents, in addition to any impact of CO2.
"In Germany, it is now only in November that we do not see allergenic pollen - so the season of suffering for people with hay fever is getting more serious," she said.
"On a local scale, planners should be more aware of what sort of problems may arise from the urban trees they're planting.
"Often they use birch trees, for example, because of their nice silver colour, not aware that they leave allergenic problems behind."
Many of the researchers on this project are involved in wider efforts to plot climate impacts on the timing of natural events such as plant flowering, egg laying and bird migration across Europe - the field of phenology.
The hay fever research presented at EGU will shortly be written up for formal scientific publication.

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Hay fever vaccine


Hay fever vaccine: New method could be 'cheaper and better'


Sneezing through summer with a runny nose could become a thing of the past if researchers in London are successful at developing a new hay fever vaccine.
The researchers, at Imperial College London and King's College London, say their "targeted" approach could lead to a cheaper and more effective vaccine.
In tests, they have injected into a layer of skin on patients they think is a "hotline" to the immune system.
Allergy UK said it was a very exciting development.
Treatment for hay fever is largely through drugs such as antihistamines or steroids. In very severe cases, tablets or injections of pollen under the skin can be given. The doses are gradually increased over three years to boost tolerance to pollen. However, the treatment is expensive.
The research team are trying much shallower injections into a part of the skin packed with white blood cells, part of the immune system. They argue their targeted approach means they can use tiny amounts of pollen - their dose is 2,000 times smaller than current injections - and also need fewer injections.
"It is a totally different route," Dr Stephen Till told the BBC. "The injections are very, very superficial almost flat against the skin."
Improvement
The results of early tests on 30 patients, published in Journal of Allergy and Clinical Immunology, suggested the allergic reaction to grass pollen decreased with the vaccine.
A third of the patients were given six injections a fortnight apart. Initially the injection resulted in a large lump on the skin, but over time the size of the lump decreased.
The researchers said this suggested the allergic reaction to grass pollen was being switched off.
They are now starting a clinical trial with 90 patients to see if the vaccine can also reduce other symptoms such as sneezing.

Dr Till said: "If this approach proves to be effective it would define a new scientific and clinical principle that could also be applied to other allergic diseases such as asthma and food allergies.
"This could be a pivotal study in immunological research."
Maureen Jenkins, the director of clinical services at the charity Allergy UK, said this was a "very exciting development" which "offers hope for sufferers".
She added: "The proposed vaccine, if successful, is much quicker and more straightforward than current immunotherapy treatment for hay fever, which takes years. It also has the potential to offer cost savings.
"If this series of injections proves effective in combating hay fever, it will be a wonderful step forward in tackling this common, but often underestimated allergy."
A separate vaccine would have to be developed to help people with allergies to tree pollen.

Diabetes warning for people of Asian


Diabetes warning for people of Asian, African and Caribbean descent

Blood sugar testScientists are trying to find out why some ethnic groups much more likely to develop diabetes

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British people of South Asian, African or African Caribbean descent are significantly more likely to develop Type 2 diabetes than their European counterparts, researchers have warned.
Half had developed the disease by the age of 80 in a study of 4,200 people living in London - approximately twice the figure for Europeans.
The researchers said the rates were "astonishingly high".
The findings were published in the journal Diabetes Care.
Losing control of blood sugar levels increases the risk of heart disease, stroke, kidney failure, blindness and amputations. Type 2 diabetes is often linked to lifestyle and diet.
Some ethnic groups are already known to have a higher risk of Type 2 diabetes. However, one of the researchers at Imperial College London, Dr Therese Tillin, said it may be down to them simply getting the disease earlier in their lives and the figures would even out over time.
But the study showed: "The rates don't slow down as you get older. The astonishing difference continues," Dr Tillin said.

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People from these communities should be screened earlier than the general population - from the age of 25 rather than 40”
Dr Iain FrameDiabetes UK
She warned this could be a sign of things to come with the potential for soaring levels of diabetes around the world as more people lived in cities and enjoyed a calorie-rich diet.
Mystery
The scientists involved said that fat, particularly around the waist, could explain some, but not all of the difference, between the ethnicities.
Fellow researcher, Dr Nish Chaturvedi, said genetics could not explain the difference either as there were similar levels of "risky genes" across all groups.
She said: "There is something else that puts them at higher risk and we're not sure what that is."
Dr Mike Knapton, from the British Heart Foundation and a GP, said: "Awareness is really low considering the magnitude of the problem, even I'm surprised by the figures."
He also warned that failing to deal with diabetes would have huge financial consequences for the NHS.
The director of research at Diabetes UK, Dr Iain Frame, said it was "even more important" for people at high risk to manage their weight.
He said: "People from these communities should be screened earlier than the general population - from the age of 25 rather than 40.
"People need to know their risk of developing Type 2 diabetes and get diagnosed as early as possible. We know that people from South Asian backgrounds can often be living with the condition for around 10 years before they are diagnosed, which increases the risk of complications such as heart disease, stroke, kidney failure, blindness and amputation.

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Monday, 10 September 2012

Crippling viral infections 'cause asthma'


Crippling viral infections 'cause asthma'

They say their findings, published in the journal Nature Medicine, will help develop ways of preventing asthma.Viral infections in newborns "cripple" part of the immune system and increase the risk of asthma later in life, US researchers studying mice have said.
They showed infections by respiratory syncytial virus (RSV) stripped immune cells of their ability to calm down inflammation in the lung's airways.
The charity Asthma UK said the study had "really exciting" potential.
When something irritates the airways of a patient with asthma, the airways become tightened, inflamed and produce too much sticky mucus. All of this can make breathing difficult.
Child using asthma inhalerPrevious studies have shown a link between repeated lung infections with RSV and developing asthma later in life.
One Swedish study showed showed 39% of infants taken to hospital with RSV had asthma when they were 18. However, only 9% of infants who were not ill developed asthma.
How the virus might be able to do this was, however, unknown. Now a team of researchers at the University of Pittsburgh School of Medicine believe they have an explanation.
Their experiments on mice showed the virus impaired the ability of a specific part of the immune system, called regulatory T cells, to calm inflammation.
Infection with RSV led to a "complete loss of suppressive function" of the regulatory T cells, after which the mice developed asthma-like symptoms," researchers Prof Anuradha Ray and Prof Prabir Ray told the BBC.
Early window
They said there might be a window in early life when the cells were vulnerable to being "crippled".
They think the finding could help scientists devise treatments which prevent some people developing asthma.
"We feel that both prophylactic and therapeutic approaches can be developed.
"This is especially desirable in infants who have a strong family history of asthma."
Malayka Rahman, from Asthma UK, said: "This research provides vital information on how viruses interact with our immune cells and why this might lead to an increased risk of asthma.
"What's really exciting is the potential of these findings to translate into new treatments for asthma in the future."

Diabetes cholesterol risk warning


Diabetes cholesterol risk warning


Cholesterol testA simple test can show if cholesterol levels are too high

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The majority of people with diabetes are not controlling cholesterol levels effectively - putting them at increased risk of heart disease, a charity warns.
Diabetes UK says 90% of people with the disease are having annual checks which will show up problems.
But it says the most recent national diabetes audit found many are not then addressing high cholesterol.
Chief executive Barbara Young said it meant the health of thousands was being put at unnecessary risk.
'Easy to control'
About 3.7 million people in the UK have diabetes. The majority - about 90% - have Type 2 diabetes, where the body makes too little insulin or where it fails to make it properly. In those with Type 1 diabetes, the body cannot produce any insulin at all.
The audit includes data on 1.9 million people in England with diabetes.

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It is an issue that is putting the health of hundreds of thousands of people at risk. ”
Barbara YoungDiabetes UK
People with both types of the condition have a higher risk of heart disease than the rest of the population.
Cardiovascular disease is linked to 44% of deaths in people with Type 1 and 52% with Type 2.
Diabetes UK says that because of the existence of statins - cholesterol-lowering drugs - it is relatively easy to control high cholesterol.
People with Type 2 diabetes also have twice the risk of stroke within the first five years of diagnosis compared with the general population.
Barbara Young said the findings were worrying, adding: "It is not clear why the high number of people having their annual cholesterol check is not translating into better cholesterol control, but it is an issue that is putting the health of hundreds of thousands of people at risk.
"It will often be appropriate to prescribe medication such as statins, but it is no good doing this without explaining the importance of taking the medication regularly and the potentially devastating consequences of not doing so.
"Other ways people can help improve their cholesterol levels include losing weight, exercising daily, reducing alcohol consumption, stopping smoking and eating a healthy diet, low in fat."

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Saturday, 8 September 2012

Viral Special Pathogens Branch


Viral Special Pathogens Branch (VSPB)

The Viral Special Pathogens Branch is involved in activities that address more than 35 highly infectious viruses across five different viral families, many of which cause hemorrhagic fevers and other deadly diseases.
Some of these viruses are rare, whereas others are quite common and cause frequently debilitating or fatal disease in many thousands of people. While a portion of the virus types are found in relatively small geographic areas, others are distributed over continents.
VSPB diseases include:
Activities include:
  • Monitoring of hemorrhagic fevers and other infectious diseases
  • Operation of Biosafety Level 4 labs for safe containment of viruses
  • Responding to outbreaks and conducting epidemiological fieldwork
  • Assisting with disease detection and control measures
  • Conducting ecological investigations of emerging zoonotic viruses

Dame Jo Williams: Care regulator chair to resign


Dame Jo Williams: Care regulator chair to resign

She said it had been a "privilege" to work at the Care Quality Commission, but it was now "time to step aside".
The CQC came under attack last year over the exposure of abuse of residents at the Winterbourne View care home.
Jo Williams
The Department of Health said she was "tireless and dedicated" to her role.
She will step down once a replacement has been found.
Last year scathing reports by the health select committee of MPs and the National Audit Office suggested the organisation was struggling to cope.
Her own position has come under close scrutiny after she tried, and failed, to have a board colleague sacked over criticism of the CQC's leadership.
Kay Sheldon had given evidence to the public inquiry into failings at the Mid Staffordshire trust which is due to deliver its report to the government in mid October. The recommendations from the inquiry could have far reaching implications for the regulation of healthcare.
'A privilege'
In a statement Dame Jo said: "I am proud of the progress we have made.
"It has been a demanding and complex role, and there have undoubtedly been challenges as we registered 40,000 providers and brought the entire health and social care system under one set of standards.
"But there is now clear evidence that our regulation is beginning to have an impact on the care that people receive, and it feels as if the organisation is moving into the next stage of its development.
"It has been a privilege to hold this important role but I now believe it is time to step aside and for a new Chair to lead CQC into the next stage."
She will still give evidence as planned to the Health Select Committee on Tuesday. The committee has previously criticised the CQC for taking on too many responsibilities and failing to concentrate on its core role of ensuring minimum standards.
Earlier in the year Cynthia Bower resigned as chief executive of the organisation.
Una O'Brien, permanent secretary at the Department of Health, said: "I would like to thank Jo for her tireless and dedicated service in leading the CQC as Chair since 2010, and before that as a Non-Executive Director from its inception in 2008.
"Jo has shown sustained loyalty and commitment to the organisation, and to the patients and the public its serves. She is leaving the CQC well prepared for the next phase of its development

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