False Claims Act

Skin cancer ‘able to fight off body’s immune system’.

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A deadly form of skin cancer is able to fend off the body’s immune system, UK researchers have found.

Analysis of tumour and blood samples shows that melanoma knocks out the body’s best immune defence.

A potential test could work out which patients are likely to respond to treatment, the Journal of Clinical Investigation reports.

Cancer Research UK said the body’s response was a “complex puzzle”.

Previous work from the team at King’s College London showed that while patients with melanoma produced antibodies that could attack tumour cells, the immune system often seemed powerless to stop the cancer progressing.

But in the latest research they discovered that the subtype of antibody attracted by the melanoma cells was the most ineffective at mounting the right sort of response.

In samples from 80 melanoma patients they say that the conditions created by the tumour attract IgG4 antibodies, which mount the weakest response and in turn interfere with any “strong” IgG1 antibodies that might be present.

By mimicking the conditions created by melanomas, they showed that in the presence of tumour cells, the immune system sent out IgG4 antibodies, but when faced with healthy cells it functioned as expected with IgG1 circulating.

They also confirmed that IgG4 was ineffective in launching an immune attack against cancer cells.

Potential test

In additional tests in 33 patients, they found that those with higher levels of the weak antibody IgG4 had a less favourable prognosis compared with those with levels nearer to normal.

Study author Dr Sophie Karagiannis said: “This work bears important implications for future therapies since not only are IgG4 antibodies ineffective in activating immune cells to kill tumours but they also work by blocking antibodies from killing tumour cells.”

She said not only was IgG4 stopping the patient’s more powerful antibodies from eradicating cancer, but it could also explain why some treatments based on boosting the immune response may be less effective in some patients.

Co-author Prof Frank Nestle said more work was needed on developing IgG4 as a potential test to improve patient care by helping to identify patients most likely to respond to treatments.

“This study can also inform the rational design of novel strategies to counteract IgG4 actions,” he added.

Dr Kat Arney, science communications manager at Cancer Research UK, said: “There’s a lot we don’t yet understand about how our immune system recognises and responds to cancer, so we’re pleased to have supported this new research that’s helping to solve such a complex puzzle.

“This work is still at an early stage, but it’s a step towards developing more effective treatments for skin cancer and potentially other types of cancer in the future.”

Source: BBC

US HIV baby ‘cured’ by early drug treatment.

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A baby girl in the US born with HIV appears to have been cured after very early treatment with standard drug therapy, doctors say.

The Mississippi child is now two-and-a-half years old and has been off medication for about a year with no signs of infection.

More testing needs to be done to see if the treatment – given within hours of birth – would work for others.

If the girl stays healthy, it would be the world’s second reported ‘cure’.

Dr Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, presented the findings at the Conference on Retroviruses and Opportunistic Infections in Atlanta.

“This is a proof of concept that HIV can be potentially curable in infants,” she said.

Cocktail of drugs

In 2007, Timothy Ray Brown became the first person in the world believed to have recovered from HIV.

His infection was eradicated through an elaborate treatment for leukaemia that involved the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection.

In contrast, the case of the Mississippi baby involved a cocktail of widely available drugs, known as antiretroviral therapy, already used to treat HIV infection in infants.

It suggests the swift treatment wiped out HIV before it could form hideouts in the body.

These so-called reservoirs of dormant cells usually rapidly reinfect anyone who stops medication, said Dr Persaud.

The baby was born in a rural hospital where the mother had only just tested positive for HIV infection.

Because the mother had not been given any prenatal HIV treatment, doctors knew the baby was at high risk of being infected.

Researchers said the baby was then transferred to the University of Mississippi Medical Center in Jackson.

Once there, paediatric HIV specialist Dr Hannah Gay put the infant on a cocktail of three standard HIV-fighting drugs at just 30 hours old, even before laboratory tests came back confirming the infection.

“I just felt like this baby was at higher-than-normal risk and deserved our best shot,” Dr Gay said.

The treatment was continued for 18 months, at which point the child disappeared from the medical system. Five months later the mother and child turned up again but had stopped the treatment in this interim.

The doctors carried out tests to see if the virus had returned and were astonished to find that it had not.

Dr Rowena Johnston, of the Foundation for Aids Research, said it appeared that the early intervention that started immediately after birth worked.

“I actually do believe this is very exciting.

“This certainly is the first documented case that we can truly believe from all the testing that has been done.

“Many doctors in six different laboratories all applied different, very sophisticated tests trying to find HIV in this infant and no body was able to find any.

“And so we really can quite confidently conclude at this point that the child does very much appear to be cured.”

A spokeswoman for the HIV/Aids charity the Terrence Higgins Trust said: “This is interesting, but the patient will need careful ongoing follow-up for us to understand the long-term implications for her and any potential for other babies born with HIV.”

Source: BBC

Skin patches ‘tackle prostate cancer’.

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Skin patches which deliver oestrogen into the blood may be a cheaper and safer treatment for prostate cancer than current therapies, a study says.

The main treatment is injections of a chemical to cut levels of testosterone – the driving force of many prostate cancers – but it causes side effects.

The Imperial College London study in the Lancet Oncology compared patches and injections in 254 patients.

It found patches were safe and should avoid menopause-like side effects.

‘Effective treatments’

Using oestrogen to treat prostate cancer is an old treatment.

Both oestrogen and testosterone are very similar chemically, so ramping up the levels of oestrogen in the body can reduce the amount of testosterone produced – and slow prostate cancer growth.

However, taking oral oestrogen pills caused significant health problems by overdosing the liver. The organ then produced chemicals which caused blood clots, heart attacks and strokes.

The preferred treatment is injections of a drug, LHRHa, which reduces the production of both oestrogen and testosterone. However, this has side effects similar to the menopause in women – resulting in poor bone health and diabetes.

Prof Paul Abel, from Imperial College London, said: “We’re not claiming this is equivalent to current therapies yet, but it does look like we are getting castration levels of testosterone.”

However, the researchers need to follow patients for longer.

“The next step is to test if the oestrogen patches are as effective at stopping the growth of prostate cancer as the current hormone treatments, we’re now testing this in over 600 patients.”

Kate Law, from the charity Cancer Research UK which part funded the study, said: “More men than ever are surviving prostate cancer thanks to advances in research, but we still urgently need to find more effective treatments and reduce side effects.

“This trial is an important step towards better and kinder treatments that could bring big benefits to men with prostate cancer in the future.”

Dr Iain Frame, director of research at Prostate Cancer UK, said: “It is unclear as yet if hormone patches could be an effective alternative to hormone injections, but we await with anticipation the results of the further trials planned which could in time offer men hope for the future.”

Source: BBC

Coronary Artery Calcification Helps Predict Stroke Risk.

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Coronary artery calcification (CAC) independently predicts future stroke risk in people considered to be at low and intermediate risk, according to a study in Stroke.

In a population-based cohort of 4180 people aged 45 to 75, some 90 people experienced a stroke over 8 years’ follow-up. After adjusting for Framingham risk factors, people with a CAC score of 400 or higher had three times the risk for stroke, relative to those with a score of zero. CAC was effective in predicting stroke risk in people under age 65 (but not older), independent of atrial fibrillation or sex.

Source: Stroke

Secondary and Tertiary Vaccinia Transmission from a Vaccine.

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A case of secondhand — leading to thirdhand — vaccinia infection is reported in MMWR.

One man received smallpox vaccine through the U.S. Department of Defense, without complications, but he did not cover the vaccine site as instructed. After intercourse with the vaccinee, a second man was hospitalized for painful perianal rash and upper-lip sore, as well as fever and emesis; he reported having had contact with “moisture” on the vaccinee’s arm. The second man then had intercourse with a third, who was also hospitalized with genital and arm lesions.

Both hospitalized patients tested positive for nonvariola Orthopoxvirus by PCR. Tests for sexually transmitted diseases were negative in both, and neither had received smallpox vaccination. The patients had histories of eczema, a risk factor for smallpox vaccine reactions. They were treated successfully with intravenous vaccinia immunoglobulin.

Source:MMRV