Marijuana Relieves Chronic Pain, Research Shows


Three Puffs a Day Helped People With Nerve Pain, Study Finds
cannabis sativa leaves

Aug. 30, 2010 — Three puffs a day of cannabis, better known as marijuana, helps people with chronic nerve pain due to injury or surgery feel less pain and sleep better, a Canadian team has found.

”It’s been known anecdotally,” says researcher Mark Ware, MD, assistant professor of anesthesia and family medicine at McGill University in Montreal. “About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain [control] strategy,” he tells WebMD.

But Ware’s study is more scientific — a clinical trial in which his team compared placebo with three different doses of cannabis. The research is published in CMAJ, the Canadian Medical Association Journal.

The new study ”adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present,” Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study.

Marijuana for Pain Relief: Study Details

Ware evaluated 21 men and women, average age 45, who had chronic nerve pain (also called neuropathic pain). A typical example, Ware tells WebMD, is a patient who had knee surgery and during the course of the operation the surgeon may have had no choice but to cut a nerve, leading to chronic pain after the surgery.

Ware’s team tried three different potencies of marijuana, with the highest a concentration at 9.4% tetrahydrocannabinol (THC) herbal cannabis. He also tested 2.5% and 6% THC.

”Each person was in the study for two months, and used all four strengths [including placebo],” Ware says. He rotated them through the four strengths in different orders, and they didn’t know which they were using.

The cannabis was put into gelatin capsules, then put into the bowl of a pipe. Each person was told to inhale for five seconds while the cannabis was lit, hold the smoke in their lungs for 10 seconds, and then exhale.

They did this single puff three times a day for five days for each of the doses and the placebo. The participants were allowed to continue on their routine pain medications.

After each of the five-day trials, participants rated their pain on a scale of zero to 10, with 10 being the worst.

The highest dose, 9.4%, provided relief, Ware says. “They reduced their pain down to 5.4,” Ware says. “Those on placebo were at 6.1.”

Although that difference may seem modest, ”any reduction in pain is important,” Ware says.

The concentration of 9.4%, Ware says, is lower than that found in marijuana on the street. “On the street, it’s 10% to 15% THC, more or less,” he says.

“We’ve shown again that cannabis is analgesic,” Ware says. “Clearly, it has medical value.”

Side effects were reported, including headache, dry eyes, numbness, cough, and a burning sensation in the area with pain.

The cannabis relieves pain, Ware says, by ”changing the way the nerves function.”

Marijuana for Pain Relief: Second Opinion

Marijuana’s pain-relieving potential is worth investigating, McQuay says in his commentary.

He points out the average daily pain relief was lower, ”but not hugely so,” for people taking the highest concentration of marijuana.

The cannabis, he tells WebMD in an email interview, “may help some patients who have limited relief from other remedies, but current cannabis formulations are unlikely to replace existing treatments.”

Among McQuay’s disclosures are serving as an advisory board member for Pfizer’s Data Safety and Monitoring Board, as a consultant for Sanofi and other companies, and receiving royalties for a textbook on pain.

bleeding in hemophilia


In people with haemophilia, therapeutic clotting agents might be recognised as a foreign protein and induce anti-FVIII antibodies, known as `inhibitors`. Drugs insensitive to such antibodies, either recombinant or plasma-derived, are called factor VIII “by-passing“ agents and used for treatment of bleeding in people with inhibitors.
OBJECTIVES: To determine the clinical effectiveness of recombinant FVIIa concentrate in comparison to plasma-derived concentrates for the treatment of acute bleeding episodes in people with haemophilia and inhibitors.
SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Coagulopathies Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of the most recent search of the Group`s Trials Register: 07 July 2010.
SELECTION CRITERIA: Randomised (RCTs) and quasi-randomised controlled clinical trials comparing recombinant FVIIa concentrate (rFVIIa) to human plasma-derived concentrates (high-dose human or recombinant FVIII or FIX concentrate; prothrombin complex concentrates (PCCs); activated prothrombin complex concentrate (aPCC)) in persons with haemophilia. Comparisons with animal derived products were excluded.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials (eligibility and risk of bias) and extracted data. No meta-analysis was performed due to unavailability of outcomes and comparisons common to the included studies.
MAIN RESULTS: A total of ten trials were identified, two of which (total of 69 participants) were eligible for analysis. Both trials showed methodological flaws and did not show superiority of one treatment over the other. Both the treatments showed that (rFVIIa and aPCC appeared to have a similar haemostatic effect in both studies, without increasing thromboembolic risk.
AUTHORS’ CONCLUSIONS: Although the main conclusion should be the need for further randomised controlled trials, we conclude that both rFVIIa and aPCC can be used to treat bleeding in haemophiliacs with inhibitors.

Metformin: Taking Away the Candy for Cancer?


Metformin is widely used in the treatment of diabetes mellitus type 2 where it reduces insulin resistance and diabetes-related morbidity and mortality. Population-based studies show that metformin treatment is associated with a dose-dependent reduction in cancer risk. The metformin treatment also increases complete pathological tumour response rates following neoadjuvant chemotherapy for breast cancer, suggesting a potential role as an anti-cancer drug. Diabetes mellitus type 2 is associated with insulin resistance, elevated insulin levels and an increased risk of cancer and cancer-related mortality. This increased risk may be explained by activation of the insulin- and insulin-like growth factor (IGF) signaling pathways and increased signalling through the oestrogen receptor. Reversal of these processes through reduction of insulin resistance by the oral anti-diabetic drug metformin is an attractive anti-cancer strategy. Metformin is an activator of AMP-activated protein kinase (AMPK) which inhibits protein synthesis and gluconeogenesis during cellular stress. The main downstream effect of AMPK activation is the inhibition of mammalian target of rapamycin (mTOR), a downstream effector of growth factor signalling. mTOR is frequently activated in malignant cells and is associated with resistance to anticancer drugs. Furthermore, metformin can induce cell cycle arrest and apoptosis and can reduce growth factor signalling. This review discusses the role of diabetes mellitus type 2 and insulin resistance in carcinogenesis, the preclinical rationale and potential mechanisms of metformin’s anti-cancer effect and the current and future clinical developments of metformin as a novel anti-cancer drug.

Apple DNA code is cracked by geneticists


Golden Delicious apples The discovery could leader to better looking and tasting apples

A team of 86 global scientists have sequenced the genetic code of the Golden Delicious apple for the first time.

The DNA breakthrough could result in new and improved apple varieties which are more resistant to disease.

Scientists from 20 institutions took two years to unravel the code – the largest plant genome uncovered to date.

The findings are published in the leading journal Nature Genetics.

‘Competitive advantage’

Professor Riccardo Velasco at the Edmund Mach Foundation in Italy, who led the research team, said that sequencing the genome “would have huge implications for applied breeding”.

“This breakthrough will help us to develop high quality traits and bring new things to the apple market,” he told BBC News.

Kate Evans from Washington State University’s Tree Fruit Research and Extension Centre said the discovery would help the “long-term sustainable production” of apples.

Scientists hope improvements to the popular Golden Delicious variety – which originated in West Virginia, US, more than a century ago – could enhance the taste, look, and crunchiness of the fruit.

The researchers were also able to trace the apple’s ancestry, and found the domestic fruit’s wild ancestor Malus sieversii originally grew in the mountains of southern Kazakhstan. There are more than 7,500 varieties of apple known today.

The researchers also discovered that the huge size of the apple genome originated when it got accidentally duplicated far back in its evolutionary history.

A large number of genes can give plants a competitive advantage, providing more in-built defences against disease.

Will GM mosquitoes end dengue and malaria?


Anopheles-stephensi-mosquitoes-vg-glow-in-the-dark140_AnthonyJames.jpgA gene in the mosquitoes causes them to fluoresce under ultraviolet light

Anthony James

While great advances have been made in the lab, malaria-resistant mosquitoes are still a long way from being airborne, reports Katherine Nightingale.

When researchers first genetically modified an Anopheline mosquito — the type that spreads malaria — it was hailed as a major step towards creating armies of malaria-resistant mosquitoes that could take over populations, leaving them unable to transmit the disease.

But ten years since it was created, there are still no GM mosquitoes buzzing around the plains of Africa. Malaria-resistant mosquitoes have yet to even leave the laboratory.

Their production is taking much longer than first envisaged — and other ways of manipulating mosquitoes to stem disease transmission are overtaking them.

Survival of the fittest

After the 1998 genetic modification of Aedes aegypti, which transmits dengue virus, yellow fever and chikungunya virus, came the creation of the first GM anopheline mosquito in 2000. Two years later, scientists created the first malaria-resistant GM mosquito.

Marcelo Jacobs-Lorena leads the laboratory that produced this mosquito, which worked by producing an antimalarial substance when it fed on blood.

But GM mosquitoes are not necessarily fitter than their wild counterparts. Mechanisms are needed to ensure that the antimalarial genes are ‘driven’ through populations instead of dying out. This has proved to be a major challenge.

“Up to now — almost ten years later — no one has really found out how to do that,” saysJacobs-Lorena, a professor at the Johns Hopkins Malaria Institute, United States.

One approach has been the ‘selfish genes’ — or ‘Medea’ — approach. These genes have been shown, in fruit flies, to ensure their carriers’ survival.

But scientists have not yet managed to combine Medea genes with malaria resistance genes in fruit flies, which they use as models. Nor have they successfully transferred the Medea effect into mosquitoes. This should be possible within 2–3 years, says Anthony James, a professor of microbiology and molecular genetics at the University of California at Irvine, United States.

GM bacteria: a new way forward?

Instead of waiting for genetic drive systems to be perfected, Jacobs-Lorena has switched to genetically modifying a different organism: bacteria that live in mosquitoes.

His team has shown that when the bug Escherichia coli is modified so that it produces the same malaria-inhibiting molecule that first made mosquitoes resistant, the mosquito itself displays a lower level of malaria infection.

“The question is similar to the one we had with the transgenic mosquitoes — how do you introduce a GM bacteria into mosquitoes in the field? That is a challenge which we think we have a handle on.”

Jacobs-Lorena’s team is collaborating with an Italian laboratory to work with types of bacteria called Asaia that occur naturally in mosquitoes. Asaia is passed from female mosquitoes to their offspring.

Jacobs-Lorena hopes to one day produce a ‘cocktail’ of bacteria, each secreting a different antimalarial molecule, to ward off resistance in a way similar to combining antimalarial drugs. Creating the bacteria and testing their spread through populations should take about 8–10 years, he says.

Dengue hope

That he sees 8–10 years as a shortcut gives an indication of just how far from the field disease-resistant GM mosquitoes are. Another GM strategy, however, is much closer to fruition.

Instead of using genetic engineering to create resistance, researchers at biotech company Oxitec a spin-off from Oxford University, United Kingdom are using GM to reduce A. aegypti mosquito populations.

The method targets dengue fever, a disease which infects up to 100 million people each year and for which there is no treatment or vaccine.

The Oxitec team uses a system known as RIDL (release of insects carrying a dominant lethal) to genetically sterilise mosquitoes. Their strategy is based on releasing male GM mosquitoes that can’t produce viable offspring.

One benefit of using Wolbachia is the bacteria’s ability to spread through mosquito populations

Flickr/AJC1

In one example, offspring all die at the larval or pupal stage and, in the other, female offspring cannot fly or feed and therefore cannot mate.

“It’s a self-limiting system, you release sterile males, they mate with wild females and the progeny die before they can bite and transmit disease. If you release them for long enough the wild population will decline and collapse,” says Luke Alphey, research director of Oxitec.

The first strategy was tested in successful contained trials in a purpose-built house in Malaysia during 2007–2008. The second strategy, developed by a large consortium funded by the Gates Foundation’s Grand Challenges in Global Health programme, is being tested in outdoor cages in Mexico. Open field trials of both strategies are being planned.

Oxitec is concentrating on this kind of ‘population suppression’ strategy rather than disease resistance because it should have an impact sooner, says Alphey.

But whether the technique is sustainable in the long term is doubtful, says James, who is principal investigator of the Gates-funded consortium. The very property that could make these mosquitoes more acceptable to regulators and the public — that the transgene dies out with the mosquito — means that the mosquitoes have to be released continually.

“You have to have the political will … It’s a public health paradox: if you spend a whole lot of money releasing mosquitoes you don’t have a problem, but if you stop doing it, then you do,” says James.

Amongst the objections to using GM mosquitoes is the issue of the ’empty niche’, in which other — perhaps more dangerous — insects might move into the ecological niche vacated by the mosquitoes.

But Alphey says the issue is not unique to GM mosquitoes and he is confident that there are few insects that would replace A. aegypti, particularly given that it isn’t a native species in most of the areas where it spreads dengue fever.

“We’ve done extensive environmental analysis and it’s very hard to see any significant, tangible risk from releasing these insects.”

Non-GM solutions

Closer still to field trials is a non-GM approach. A team of researchers led by Scott O’Neill from the University of Queensland, Australia, will start field trials of its dengue-resistant mosquitoes — which contain a bacterium called Wolbachia — in about six months, he says.

The researchers originally found that a strain of Wolbachia cuts the lifespan of mosquitoes so much that they cannot pass on the dengue virus.

But more recently they have discovered that many Wolbachia strains also make the mosquitoes resistant to the virus — though they do not yet know how.

The researchers have tested the mosquitoes in a large ‘greenhouse’ in Australia complete with mock-ups of houses — and volunteers for the mosquitoes to feed on.

“When we introduce Wolbachia mosquitoes into a wild population, they quickly invade,” says O’Neill.

Initial field trials in Australia — for which the team is awaiting government approval after an extensive risk analysis — will check safety, followed by larger trials assessing whether the method cuts dengue transmission in Vietnam next year. The whole process should take around three years, says O’Neill.

One benefit of using Wolbachia is the bacterium’s ability to spread through populations. It is transmitted only by the female mosquito, via its eggs, to its offspring. Unusually, if a male infected with Wolbachia mates with a female that is not, her eggs die.

“That makes it interesting from a bio-control perspective because [the bacterium] can spread very effectively yet is quite specific so we don’t have to worry so much about secondary environmental effects,” says O’Neill.

Wolbachia already lives in around two-thirds of insects, including some mosquitoes that bite humans, so the risk to human health is tiny, says O’Neill. And because the bacteria are spread only from female to offspring there is little chance of them infecting other insects.

But it’s unlikely to be a permanent solution. Resistance could emerge eventually, says O’Neill, so he is working on different Wolbachia strains that could be deployed one after another to prolong effectiveness — like changing from one insecticide to another.

Political hurdles

Despite progress in O’Neill’s non-GM approach, he acknowledges that it is likely to be the elusive, disease-resistant mosquito that has the most potential in the long term.

James, who works on both resistant and sterile GM mosquitoes, agrees. “[Disease-resistant mosquitoes] are envisioned to be able to achieve not only control and elimination but also target the more ambitious goal of eradication,” says James.

There is strong support for O’Neill’s non-GM approach from Australia and Vietnam

O’Neill/McGraw Lab, University of Queensland

But public attitudes and regulatory processes may prove to be the biggest barrier.

O’Neill’s field trials are going ahead because of strong community support for the idea in both Australia and Vietnam. But GM technology is controversial in many countries and campaigning groups such as Greenpeace are against GM science, whatever its aims.

“The political/social side of GM is a major hurdle,” says Andrew Read, professor of biology and entomology at Penn State University in the United States.

“The first GM vector product will be critical it needs to work really well and alleviate suffering right away.”

Jacobs-Lorena says that the public might be more accepting of GM insects and bacteria than of crops because the insects have the potential to save lives, rather than produce cheaper food.

But a 2001 Zogby International poll found that just 39 per cent of Americans surveyed agreed with genetically modifying insects to fight disease.

The insects may prove more popular in developing countries where people see first-hand the devastation of malaria and dengue fever.

The WHO is developing guidelines for countries to use as the basis for developing their own regulations for the field testing and release of GM insects. Draft guidelines should be ready by October this year, Yeya Touré, leader of the Innovative Vector Control Interventions programme at the WHO, told SciDev.Net.

He is confident that GM mosquitoes will have a role to play in future malaria and dengue control and says that the Cayman Islands, Malaysia and Mexico are interested in using GM sterile mosquitoes to tackle dengue.

As for the armies of disease-resistant GM mosquitoes, they may not be a pie in the sky anymore, but they’re not airborne either — and seem unlikely to be anytime soon.

Quantum Physicists Dream Up Smallest Possible Refrigerator


ou may have a $10,000 Sub-Zero fridge in your kitchen, but this is cooler. Theoretical physicists have dreamed up a scheme to make a refrigerator out of a pair of quantum particles such as ions or atoms, or even a single particle. The fridges may be the smallest ones possible. “It’s very elegant and innovative,” says Nicolas Gisin, a theorist at the University of Geneva in Switzerland. Theo Nieuwenhuizen, a theorist at the University of Amsterdam, says “I don’t see any error, so probably this would work.”

The challenge is to make a few quantum particles act like a so-called thermal machine, the theory of which was set out by French engineer Sadi Carnot in 1824. Carnot imagined a piston filled with gas that could be compressed or expanded. The piston could make contact with either of two large bodies (say, massive steel blocks) at different temperatures, which could serve as the “hot bath” and the “cold bath.”

Carnot put the imaginary piston through a cycle of motions, including one in which the gas expands while in contact with the hot bath and another in which it is compressed while in contact with the cold bath. During the cycle, the piston does work while absorbing heat from the hot bath and releasing heat into the cold one, making it a “heat engine.” Reverse the cycle and, in response to work done on it, the piston acts as a refrigerator, absorbing heat from the cold bath and releasing it into the hot one.

Now, Noah Linden, Sandu Popescu, and Paul Skrzypczyk of the University of Bristol in the United Kingdom report that, at least in principle, they can make a refrigerator out of a few quantum particles called “qubits.” Each qubit has only two possible quantum states: a zero-energy ground state and a fixed-energy excited state. The theorists have found a way to siphon energy out of one qubit by making it interact with just two others.

The theorists arrange things so that each qubit has a different excited-state energy but the trio of qubits has two configurations with the same total energy. One is the configuration in which only the first and third qubits are in their excited states—denoted (101). The other is the configuration in which only the second qubit is in its excited state—denoted (010). If all three qubits were at the same temperature, then the system would flip with equal probability back and forth between these two configurations.

But the researchers skew that flipping, as they explain in a paper in press at Physical Review Letters. The trick is to put the first two qubits in contact with a cold bath and the third one in contact with a hot bath. The higher temperature makes it more likely that the third qubit will be in its excited state—and thus that the trio will be in the (101) state instead of the (010) state. But that means the system is more likely to flip out of (101) and into (010) than the other way around. So on average the flipping takes the first qubit from its excited state to its ground state and draws energy out of the first qubit. After a flip, the qubits essentially reset by interacting with the baths, allowing the cycle to start again.

The theorists measure the fridge’s size in terms of the number of its quantum states, and the three qubits have a total of eight possible states. That number can be clipped to six, if they replace the second and third qubits with a single “qutrit,” a particle with a ground state and two excited states—although those two states have to be in contact with different baths. “We believe that’s probably the smallest number of states you can get away with,” Linden says.

In theory, such a fridge can get arbitrarily close to absolute zero, and Popescu says that it might be possible to make one using trapped ions for the qubits and streams of laser light as the baths. Some researchers hope to use such qubits as the guts for a quantum computer, and Popescu says the refrigerator scheme might allow researchers to cool some set of qubits with a few others. David Wineland, an experimental physicist with the U.S. National Institute of Standards and Technology in Boulder, Colorado, says he believes such schemes can indeed be implemented in trapped ions.

Others suggest that such tiny quantum refrigerators might already be humming along in nature. It’s possible that one part of a biomolecule might work to cool another in such a fashion, says Hans Briegel, a theorist at the University of Innsbruck in Austria. “I don’t expect that you will have a mechanism exactly like this,” Briegel says, “but it gives you a framework valuable for telling what to search for.”

No word yet on when physicists might unveil the smallest possible beer.

calcuim supplementaion and CVD


OBJECTIVE: To investigate whether calcium supplements increase the risk of cardiovascular events. DESIGN: Patient level and trial level meta-analyses.
DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1966-March 2010), reference lists of meta-analyses of calcium supplements, and two clinical trial registries. Initial searches were carried out in November 2007, with electronic database searches repeated in March 2010.
STUDY SELECTION: Eligible studies were randomised, placebo controlled trials of calcium supplements (>or=500 mg/day), with 100 or more participants of mean age more than 40 years and study duration more than one year. The lead authors of eligible trials supplied data. Cardiovascular outcomes were obtained from self reports, hospital admissions, and death certificates.
RESULTS: 15 trials were eligible for inclusion, five with patient level data (8151 participants, median follow-up 3.6 years, interquartile range 2.7-4.3 years) and 11 with trial level data (11 921 participants, mean duration 4.0 years). In the five studies contributing patient level data, 143 people allocated to calcium had a myocardial infarction compared with 111 allocated to placebo (hazard ratio 1.31, 95% confidence interval 1.02 to 1.67, P=0.035). Non-significant increases occurred in the incidence of stroke (1.20, 0.96 to 1.50, P=0.11), the composite end point of myocardial infarction, stroke, or sudden death (1.18, 1.00 to 1.39, P=0.057), and death (1.09, 0.96 to 1.23, P=0.18). The meta-analysis of trial level data showed similar results: 296 people had a myocardial infarction (166 allocated to calcium, 130 to placebo), with an increased incidence of myocardial infarction in those allocated to calcium (pooled relative risk 1.27, 95% confidence interval 1.01 to 1.59, P=0.038).
CONCLUSIONS: Calcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.

Rheumatoid Arthritis Protein Reduces Alzheimer’s Plaques In Mouse Model


A signaling protein released during rheumatoid arthritis dramatically reduced Alzheimer’s disease pathology and reversed the memory impairment of mice bred to develop symptoms of the neurodegenerative disease, a new study by the University of South Florida reports. Researchers found that the protein, GM-CSF, likely stimulates the body’s natural scavenger cells to attack and remove Alzheimer’s amyloid deposits in the brain.

People with rheumatoid arthritis, a chronic disease leading to inflammation of joints and surrounding tissue, are less likely than those without arthritis to develop Alzheimer’s. While it was commonly assumed that non-steroidal anti-inflammatory drugs may help prevent onset and progression of Alzheimer’s disease, recent NSAID clinical trials proved unsuccessful for patients with Alzheimer’s.

The USF researchers are among the first to look at what effect innate immunity gone awry in rheumatoid arthritis may play in protecting against Alzheimer’s disease.

“Our findings provide a compelling explanation for why rheumatoid arthritis is a negative risk factor for Alzheimer’s disease,” said principal investigator Huntington Potter, Ph.D., Eric Pfeiffer Professor at the USF Health Byrd Alzheimer’s Institute and director of the Florida Alzheimer’s Disease Research Center.

“Moreover, the recombinant human form of GM-CSF (Leukine®) is already approved by the FDA and has been used for years to treat certain cancer patients who need to generate more immune cells,” Dr. Potter said. “Our study, along with the drug’s track record for safety, suggests Leukine should be tested in humans as a potential treatment for Alzheimer’s disease.

The researchers analyzed three rheumatoid arthritis growth factors in mouse models and identified the signaling protein GM-CSF as the most promising for potential protective benefit against Alzheimer’s disease. Then, they peripherally injected GM-CSF into two groups of mice – those genetically altered to develop memory problems mimicking Alzheimer’s disease and normal, aged mice. Behavioral tests confirmed the Alzheimer’s mice were exhibiting signs of memory impairment at age 12 months. Another two control groups of mice—the Alzheimer’s mice and normal mice—were administered saline (placebo).

After the 10th day of injections, all the mice began a series of behavioral testing. At the end of the 20-day study, the cognitively impaired mice treated with GM-CSF performed substantially better on tests measuring their working memory and learning. In fact, their memories were similar to normal aged mice without dementia. Even the normal mice treated with GM-CSF performed slightly better than their untreated peers. The Alzheimer’s mice administered saline continued to do poorly on the tests.

“We were pretty amazed that the treatment completely reversed cognitive impairment in 20 days,” said Tim Boyd, Ph.D., who, together with Steven Bennett, Ph.D., is a study lead author.

In addition, the brains of GM-CSF-treated Alzheimer’s mice showed more than a 50-percent decrease in beta amyloid, a substance forming the sticky clumps of plaques that are a hallmark of Alzheimer’s disease. This reduction in Alzheimer’s plaques and associated restoration of memory was accompanied by more immune cells known as microglia in the brain. Microglia are like the body’s natural garbage collection cells that rush to damaged or inflamed areas to get rid of toxic substances.

The researchers suggest that GM-CSF boosted during the immune system overdrive of rheumatoid arthritis helps harness the beneficial properties of inflammation in the brain. The protein may do this by recruiting more microglia from the peripheral blood into the brain to remove Alzheimer’s plaques, Dr. Potter said. An apparent increase in neural cell connections in the brains of the GM-CSF-treated mice may also help explain GM-CSF’s association with improving memory decline in Alzheimer’s disease, the researchers said.

The USF Health Byrd Alzheimer’s Institute plans to begin a pilot clinical trial this year investigating GM-CSF (Leukine) in patients with mild or moderate Alzheimer’s disease.

The study appears in the Journal of Alzheimer’s Disease.

Vitamin D Deficiency Linked to Autoimmune Diseases


Study Also Shows Lack of Vitamin D May Also Be Linked to Some Cancers

Aug. 23, 2010 — There is now biologic evidence to back up the belief that vitamin D may protect against autoimmune diseases and certain cancers.

A new genetic analysis lends support to the idea that the vitamin interacts with genes specific for colorectal cancer, multiple sclerosis, type 1 diabetes, and other diseases, says Oxford University genetic researcher Sreeram Ramagopalan.

The study is published in Genome Research.

When Ramagopalan and colleagues analyzed the binding of vitamin D receptors to gene regions previously identified with different diseases, they found evidence of increased binding for multiple sclerosis, Crohn’s disease, lupus, rheumatoid arthritis, colorectal cancer, and chronic lymphocytic leukemia (CLL).

“Genes involved in autoimmune disease and cancer were regulated by vitamin D,” Ramagopalan tells WebMD. “The next step is understanding how this interaction could lead to disease.”

Role of Vitamin D Supplementation

The role of vitamin D supplementation in preventing these diseases is also not well understood.

Exposure to sunlight is an efficient way to raise blood levels of vitamin D hormone, and food sources of the nutrient include oily fish like salmon, fortified milk, and other fortified foods.

But most people would have a hard time getting the vitamin D they need from food, and the increased use of sunscreen has reduced sun exposures.

By one recent estimate, as many as half of adults and children in the U.S. were deficient in the vitamin.

Current recommended daily vitamin D intake is 200 IU (international units) for those up to age 50; 400 IU for people 51 to70; and 600 IU for those over 70. Most experts say that these doses are too low.

Many experts, including Ramagopalan, say 2,000 IU of the vitamin may be optimal for preventing disease.

Blood levels of the vitamin are measured as 25-hydroxyvitamin D. Levels below 20 nanograms per milliliter are generally considered deficient.

Harvard School of Public Health nutrition researcher Edward Giovannucci, MD, says blood 25-hydroxyvitamin D levels of between 30 and 40 nanograms per milliliter may be about right for reducing the risk of autoimmune diseases and certain cancers.

While he says some people can reach these levels without supplementation, many others would need to take 1,000 to 2,000 IU of the vitamin a day.

“Based on what we know, I think it is reasonable to recommend that people maintain blood levels of around 30 nanograms per milliliter,” he says.

Unanswered Questions

But vitamin D researcher JoAnn E. Manson, MD, says it is way too soon to recommend taking much larger doses of vitamin D than are recommended.

Manson chairs the preventive medicine department at Brigham and Women’s Hospital in Boston and is principle investigator of a large U.S. study on vitamin D.

Still in the recruitment stage, the five-year, 20,000-person study will explore the impact of 2,000 IU of vitamin D on the risks for a wide range of health conditions, including cancer, heart disease, diabetes, hypertension, and depression. The study will also examine the effects of the fatty acid omega-3.

“I think it is important that we not leap ahead of the evidence in recommending high doses of vitamin D,” she says. “We will soon have a better understanding of the optimal doses of vitamin D and the optimal blood levels associated with the best balance of benefits and risks. But right now there are many unanswered questions.”

Virus Linked to Chronic Fatigue Syndrome


Murine leukemia viruses (MLV), a family of retroviruses known to cause cancer in mice, may be linked to chronic fatigue syndrome (CFS), a study shows.

The full name of the virus is xenotropic murine leukemia virus-related virus. It is part of a family of viruses known as murine leukemia viruses (MLV), which is a type of retrovirus known to cause cancer in mice.

The new study, published in the Proceedings of the National Academy of Sciences, conflicts with some earlier studies. Several U.S. studies, including a recent report from the CDC and research done in the U.K. and the Netherlands, found no evidence of MLV in the blood of people with CFS. One recent study, however, found evidence of an MLV-related virus called XMRV in blood cells of patients with CFS.

The new study shows that 86.5% of 37 people with CFS had evidence of murine leukemia virus in their blood, as did 6.8% healthy blood donors.

“There is a dramatic association with CFS, [but] we have not determined causality for this agent,” said Harvey Alter, MD, chief of clinical studies and associate director for research in the department of transfusion medicine at the National Institutes of Health (NIH) Clinical Center in Bethesda, Md., at a news conference. “Other labs have not found this virus, so a dilemma at present is how to reconcile that some labs find the association and others do not.”

“We think it is in the patient populations, not the lab testing [contamination causing a false-positive lab result], but the latter has not been completely ruled out,” he says.

More Questions Than Answers?

Steve Monroe, PhD, director of the division of high-consequence pathogens and pathology at the CDC, tells WebMD that the new study “raises as many questions as it answers and there are still a lot of things about this virus that we don’t know.”

Andrew L. Mason, an associate professor of medicine at the University of Alberta in Edmonton, Alberta, Canada, says it’s time to act, not point fingers.

There have been several studies showing the presence of this virus in the blood of people with chronic fatigue syndrome and prostate cancer, but other studies have not found it.

“We don’t know why that is,” he says. “It is baffling, and we need to sort it out rather than ignore it. It’s there. Does it cause disease? We don’t know, but it’s there and that needs to be investigated.”

“There is only one way to prove or disprove XMRV’s role and that is to do a proper study with antiviral drugs,” Mason says. In an editorial accompanying the new study, he suggests studies that compare antiviral drugs with placebo or dummy pills on viral load and CFS symptoms in affected individuals are now feasible.

Such drugs are used to treat HIV, the virus that causes AIDS, and can cause several side effects.

“The drugs are well-tolerated, and we would be justified ethically to see if they work,” he tells WebMD. He likens this situation to the now Nobel-prize-winning research that first tested antibiotics to determine if some ulcers are caused by the bacterium H. pylori.

“We didn’t know that H. pylori was causative until they tried using medicine and it worked,” says Donnica Moore, MD, a women’s health expert and president of Sapphire Women’s Health Group in Far Hills. N.J.

The issue is a personal one for Moore, whose son was diagnosed with CFS about six years ago. As a result, she has become an outspoken advocate for research into the cause and cures for CFS. Moore is also a spokeswoman for the Whitemore Peterson Institute for Neuro-Immune Disease, the group that published a previous report linking XMRV and CFS.

“I hope this study puts to rest any question about the validity of the [findings] and will allow science to move on toward diagnostic, treatments, and causality studies,” she says.