Health

neoantigen-dna-vaccine-shows-promising-results-against-triple-negative-breast-cancer

Wed Nov 20 12:24:27 IST 2024

An alarming 10 to 15 per cent of all breast cancer incidents are categorised as triple-negative breast cancer—one of the most aggressive forms of breast cancer. A newly developed neoantigen DNA vaccine may be able to help patients fight the recurrences of such cancer, according to a recently concluded study.

Triple-negative breast cancer (TNBC) tends to grow and spread more quickly than other types of breast cancer and is often diagnosed at a more advanced stage, contributing to its aggressive reputation.

TNBC is more commonly found in younger women, particularly those under 40, and those patients with TNBC have a higher likelihood of recurrence, particularly within the first three years following treatment.

Approximately 40 per cent of individuals with stage-one to stage-three TNBC may experience a recurrence.

It is called “triple-negative” breast cancer as it is characterised by the absence of three key receptors: estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2). This means that this type of breast cancer does not respond to hormone therapies or targeted treatments that are effective for other breast cancer types. As a result, chemotherapy has been typically the primary treatment option so far.

ALSO READ | Ray of hope for rare disease patients as Centre launch Rs 900 crore initiative to procure high-value drugs

Now, according to a new study published in Genome Medicine, a new vaccine that targets cancer “neoantigens” in TNBC could become a new force of defence against TNBC recurrence.

Cancer neoantigens in triple-negative breast cancer are like special “badges” that appear on the surface of cancer cells. These badges are created when the cancer cells change or mutate, which can happen when they grow and divide.

Patients with persistent TNBC following neoadjuvant chemotherapy were the participants in the study. As part of it, 18 consented patients received a neoantigen DNA vaccine. All subjects were vaccinated with 4 mg of neoantigen DNA vaccine on day 1, day 29 ± 7, and day 57 ± 7.

Vaccines were monitored by the researchers for safety and immune responses using technologies like ELISpot, intracellular cytokine production via flow cytometry, and TCR sequencing.

It was observed that the vaccinations were well tolerated with relatively few adverse events and induced highly specific antitumor immune responses with minimal risk of autoimmunity in 14 out of 18 patients. At a median follow-up of 36 months, it was observed that 87.5 per cent of the vaccinated patients experienced recurrence-free survival.

ray-of-hope-for-rare-disease-patients-as-centre-launch-rs-900-crore-initiative-to-procure-high-value-drugs

Tue Nov 19 23:25:38 IST 2024

In what will come as a major relief for thousands of patients of rare diseases in India, the central government's Ministry of Health and Family Welfare has earmarked a Rs 900 crore for a mega initiative to procure high-value drugs in bulk for certain life-threatening and chronic rare diseases and medicines for their treatment which are highly prohibitive.

This was devised following a nudge by the Delhi High Court, so that patients of rare diseases aren't denied treatment just because of monetary reasons and can effectively reap the benefits of the Centre’s National Policy for Rare Diseases, 2021.

ALSO READ | How Indian pharma uses AI to develop faster and cheaper medicines to treat rare diseases

Cure SMA Foundation of India, a parent-led patient advocacy organisation for Spinal Muscular Atrophy (SMA) in India is now urging the government to take necessary steps to initiate the procurement process as directed by the court within 45 days and pledges its support to help the government agencies in fastening the process.

SMA is a severe, progressive, genetic neuromuscular disease that robs individuals of essential physical abilities, such as walking, eating, and breathing. It is the leading genetic cause of death among children worldwide as well.

While globally approved treatments—Spinraza (Nusinersen), Zolgensma and Risdiplam have transformed the outlook for SMA patients, accessibility in India remained an unfulfilled promise until the approval of Risdiplam by the Drug Controller General of India (DCGI) in 2020. This gave the SMA community in India hope, and today many Indian SMA patients have benefited from this life-saving drug.

“In India, approximately 4,000 children are born with Spinal Muscular Atrophy (SMA) every year, making it a critical, albeit rare, health challenge. This genetic disorder, caused by a mutation in the SMN1 gene, leads to severe muscle weakness, impacting essential functions like movement, swallowing, and even breathing,” said CureSMA's Alpana Sharma.

“Among the three globally available treatments, Zolgensma, Spinraza (Nusinersen), and Evrysdi (Risdiplam)—only Risdiplam is approved for use in the country. We are thankful that this life-saving drug is available in the country, and is giving a new lease of life to SMA patients. All stakeholders including the government, pharma industry and patient groups need to work together to build a sustainable access network so that the treatment reaches more patients in the country. We are very hopeful that a sustainable solution is in sight,” she added.

In a recently held press conference, experts highlighted the measures taken by the state of Kerala in addressing the issues surrounding rare diseases and the challenge of accessing treatments for them.

Kerala’s exemplary model in supporting SMA patients

Kerala, they said, has set an exemplary model in supporting Spinal Muscular Atrophy (SMA) patients through innovative funding solutions and comprehensive care. By leveraging state-level programs like the NPRD fund, Kerala has successfully provided access to life-saving therapies and multidisciplinary care for over 100 SMA patients, including adult patients—a first in India.

The state’s initiatives, such as the KARE program (Kerala United Against Rare Diseases), demonstrate how targeted funding and dedicated care can transform lives, offering hope to families and significantly improving patient outcomes. These impactful measures highlight the potential of national-level programs like the NRDP fund, which, if implemented swiftly, could replicate such successes across the country, ensuring timely access to treatment and care for all rare disease patients.

baby-mhd-hussain-becomes-the-youngest-in-the-country-to-get-cochlear-implant-for-hearing

Mon Nov 18 18:55:28 IST 2024

Rehmat Khan, 32, and wife Shaheeda Praveen, 24, were blessed with a baby boy in January this year. Like any other couple, they were thrilled and the boy was named as Mhd Hussain.

But soon Rehmat and Shaheeda found their son was not responding to claps and cheering or any other sound in his surroundings. Rehmat Khan has history of hearing loss but could not bear to see his little baby suffer.

The family decided to visit the local hospital for immediate advice. Mhd Hussain’s grandfather Shambhu Khan took the kid to Sarvodaya Health Care in Haryana’s Faridabad.

The baby was examined by a team of doctors. After conducting the necessary tests and scans, Dr Ravi Bhatia, head of the ENT, decided to operate the child to place a Cochlear implant inside his ear.

The Cochlear implant functions by bypassing damaged parts of the ear to directly stimulate the auditory nerve, explains Dr Bhatia. The device consists of two components— an internal device surgically implanted inside the ear and a second device which is an external equipment which includes a speech processor and transmitting coil and microphone. The internal device then stimulates the auditory nerve allowing sound signals to reach the brain enabling the person to hear.

In most cases, the outcome is optimistic, especially when deafness is detected early. Even better if the deafness is known as soon as child is born, say experts.

Baby Mhd Husssain’s surgery cost was borne by Hans Foundation, an NGO which works closely with Sarvodaya Health Care. Normally Cochlear implant costs around Rs 12 lakhs but the parents of Mhd Hussain did not have to spend any money as the expenses were taken care of by the foundation.

A Cochlear implant lives the life of the patient. Five months have passed since the surgery and Shaheeda and Rehmat are happy to see their son’s progress.

Mhd Hussain is the youngest in the country with a Cochlear implant at the age of four-and-a-half months. The claps and cheering are back in the family as Hussain responds to all sounds and makes necessary eye contact in the direction of the sound.

climate-change-drives-19-per-cent-increase-in-dengue-transmission-finds-study

Mon Nov 18 15:45:58 IST 2024

Climate change has exacerbated the spread of dengue fever, one of the most prevalent mosquito-borne diseases globally. Rising temperatures, altered precipitation patterns, and increased humidity create ideal breeding conditions for Aedes mosquitoes.

According to a new study presented at the Annual Meeting of the American Society of Tropical Medicine and Hygiene, climate change has a massive impact on dengue transmission, accounting for 19 per cent of the current dengue burden.

The study also added that it has the potential to spark an additional 40 percent-60 per cent spike by 2050.

Warmer temperatures also accelerate the mosquito's life cycle and viral replication, increasing the potential transmission. Furthermore, changing weather patterns and extreme weather events, such as floods and droughts, disrupt ecosystems and human settlements, facilitating the spread of mosquitoes.

The findings are from researchers at Stanford and Harvard Universities.

In 2024, countries in the Americas recorded almost 12 million cases, compared to the 4.6 million in 2023.

"We looked at data on dengue incidence and climate variation across 21 countries in Asia and the Americas and found that there is a clear and direct relationship between rising temperatures and rising infections," said Erin Mordecai, an infectious disease ecologist at Stanford's Wood Institute for the Environment.

She added that it's evidence that climate change already has become a significant threat to human health.

The study finds that amid dengue’s growing threat, moderating global warming by reducing emissions would also moderate climate impacts on dengue infections.

The WHO estimates that climate change will increase the risk of dengue transmission by 50 per cent by 2050, underscoring the urgent need for integrated climate and public health strategies to mitigate the growing threat.

Mordecai's team looked at 21 dengue-endemic countries, including Brazil, Peru, Mexico, Colombia, Vietnam and Cambodia, which regularly collect data on infection rates.

The study also found that areas already on the high end of the temperature range, like southern Vietnam, will experience little additional climate impact.

Overall, the analysis revealed that there are at least 257 million people now living in places where climate warming could cause dengue incidence to double in the next 25 years.

brushing-and-flossing-can-keep-away-head-neck-cancer

Mon Nov 18 14:23:35 IST 2024

Bacteria that cause gum disease can also increase a person’s risk of head and neck squamous cell cancer, according to a US study published in the journal JAMA Oncology. Researchers analysed data from three ongoing studies that tracked 1,59,840 adults to see how diet, lifestyle, medical history and other factors affect cancer risk.

They collected saliva samples from the participants to examine the number and types of bacteria in their mouths and followed them for 10 to 15 years. The study found that 236 patients, mean age 60.9, and 24.6 per cent women, were diagnosed with head and neck cancer during follow up. The DNA of their oral microbes were then compared with that of 485 participants who remained cancer free.

As many as 13 bacterial species were shown to affect cancer risk. Overall, this group was linked to a 30 per cent greater likelihood of developing cancer. When combined with five other species often seen in gum disease, the overall risk for head and neck cancer increased by 50 per cent.

“Our results offer yet another reason to keep up good oral hygiene habits,”the study said. “Brushing your teeth and flossing may not only help prevent periodontal disease, but also may protect against head and neck cancer.”

vitamin-d-supplements-found-to-lower-blood-pressure-in-older-adults-with-obesity

Sun Nov 17 22:29:51 IST 2024

A recent study published in the Journal of the Endocrine Society suggests that vitamin D supplements can help reduce blood pressure in older adults with obesity. The study, funded by the National Institutes of Health (NIH) and other organisations, found that taking more than the recommended daily dose of vitamin D provides no additional health benefits.

The study involved 221 adults aged 65 and older with BMIs over 25, indicating overweight or obesity. Participants had insufficient vitamin D levels (10-30 ng/mL) and received 250mg of calcium citrate daily. They were divided into two groups: one taking 600 IU/day (recommended dose) and the other taking 3,750 IU/day (high dose).

After one year, researchers observed:

- Average 3.5 mm Hg reduction in systolic blood pressure (SBP)

- Modest 2.8 mm Hg reduction in diastolic blood pressure (DBP)

- No statistically significant difference between low and high-dose groups

- Greater benefits for participants with obesity and low vitamin D levels

Previous studies have linked vitamin D deficiency to increased risks of falls in old adults, autoimmune diseases (multiple sclerosis, type 1 diabetes) and cardiovascular diseases (hypertension, heart disease). Low vitamin D intake has also been linked to high blood pressure later in life.

The key findings of the study

1. Vitamin D supplements help lower blood pressure in older adults with obesity

2. Taking more than recommended doses provides no additional benefits

3. Obesity and low vitamin D levels benefit most from supplemental vitamin D

Meanwhile, the NIH recommends 600 IU (15 mcg) daily for adults 51-70 years and 800 IU (20 mcg) daily for adults over 70 years.

This study supports vitamin D's role in maintaining circulatory and metabolic health, emphasizing the importance of adequate intake without exceeding recommended doses.

kerala-hospital-conducts-rare-surgery-remove-9cm-tumour-from-the-liver-of-infant

Sat Nov 16 22:49:45 IST 2024

A team of doctors at a Kerala hospital has successfully operated on a five-month-old baby and removed a 9cm complex tumour from the baby’s liver. Authorities at the KIMSHealth hospital, Thiruvananthapuram said the infant recovered well after the surgery and has been discharged.

A medical team at KIMSHealth hospital in Thiruvananthapuram conducted a 12-hour-long rare, complex surgery to remove hepatoblastoma, a rare cancer that forms in the tissues of the liver. A release from the hospital said the tumour was initially detected during an ultrasound scan, when the mother was 33 weeks pregnant, and the infant was delivered via elective C-section at 37 weeks of gestation.

“A subsequent biopsy confirmed the presence of hepatoblastoma, a rare cancer that forms in the tissues of the liver. This condition is predominantly seen in children but rarely occurs in neonates,” it said.

A medical team, led by Dr Naveen Jain, senior consultant, department of neonatology at the hospital decided on a multi-disciplinary treatment for the child and took measures to shrink the tumour prior to surgery. The treatment methodology included chemotherapy and doctors said it was extremely challenging to administer the procedure to an infant.

Dr. Shabeerali T.U, chief coordinator and senior consultant, department of hepatobiliary, pancreatic and liver transplant surgery said their objective was to reduce the tumour size to make surgical intervention possible. “Despite the challenges of administering chemotherapy to such a young child, the medical team successfully reduced the size of the tumour,” a release said. The hospital had also identified the infant’s mother as a potential donor and advised her mother to undergo lifestyle changes if in case a liver transplant was necessary.

“The twelve-hour long surgery involved the removal of a major portion of the liver, including the vena cava and the main blood vessel supplying blood to the tumour. The child regained health following the surgery and was discharged a month later,” it said.

falls-may-increase-risk-of-dementia

Fri Nov 15 16:37:10 IST 2024

Falls are the leading cause of injury in older adults and can lead to life changing consequences, including loss of independence or risk of death. According to a US study published in JAMA Network Open, it could also be a precursor to cognitive decline, Alzheimer’s disease and related dementias.

Researchers analysed data for more than 2.4 million older adult patients who suffered a traumatic injury. Patients who suffered these injuries from falls were significantly more likely to be diagnosed with dementia within a year compared with those with other types of injuries. As many as 10.6 per cent of patients who experienced a fall were later diagnosed with dementia. Falls increased the risk of a future dementia diagnosis by 21 per cent compared with other types of injuries.

“The relationship between falls and dementia appears to be a two-way street,”said the senior author. “Cognitive decline can increase the likelihood of falls, but trauma from those falls may also accelerate dementia's progression and make a diagnosis more likely down the line.”

Since falls could be an early sign of cognitive decline or undiagnosed dementia, researchers recommend cognitive screening for seniors who experience a fall. Screenings could help identify seniors who are at risk for mental decline, start them on treatment sooner and improve outcomes.

india-has-more-cases-of-untreated-diabetes-than-china-says-study

Fri Nov 15 14:54:21 IST 2024

Around 30 per cent of the 445 million people with untreated diabetes in 2022 were in India, according to a new Lancet report. India’s count was 133 million, at least 50 per cent higher than that of China—the next largest population of people with untreated diabetes at 78 million for the year.

The report revealed that 445 million adults aged 30 or older with diabetes have not been treated with oral hypoglycemic drugs or insulin, with the 2022 number being 3.5 times the 129 million cases reported in 1990.

Since 1990, the most significant increase in diabetes prevalence was observed in low-income and middle-income countries, while the greatest improvements in treatment occurred in high-income, industrialized nations and certain emerging economies, particularly in Latin America.

These findings indicated a widening global gap in diabetes prevalence and treatment, with an increasing share of untreated diabetes cases occurring in low-income and middle-income countries, according to the study titled "Worldwide trends in diabetes prevalence and treatment from 1990 to 2022".

The research paper identified eight super-regions for diabetes prevalence. Between 1990 and 2022, the number of people with untreated diabetes rose in every super-region. In each of these regions, between 84 per cent and 97 per cent of individuals with untreated diabetes remained undiagnosed. Between 2006 and 2021, 97 per cent of women and 95.1 per cent of men in South Asia with untreated diabetes went undiagnosed.

Notably, in sub-Saharan Africa and South Asia, more than 94 per cent of untreated diabetes cases were undiagnosed.

The study recommended that “expansion of health insurance and primary health care should be accompanied by diabetes programs that realign and resource health services to enhance early detection and effective treatment of diabetes.”

malaria-treatment-crisis-in-africa-new-study-finds-resistance-to-key-drug

Thu Nov 14 20:40:36 IST 2024

A disturbing trend has emerged in Africa, where a lifesaving malaria treatment is losing effectiveness. Researchers discovered that 11 out of 100 children treated for severe malaria in Uganda showed partial resistance to artemisinin, a crucial component of the standard treatment. This marks the first documented instance of artemisinin resistance in African children with severe malaria.

What are the key findings?

Resistance Rate: 1 in 10 patients exhibited signs of resistance.

Recurring Infections: 10 children experienced repeated attacks within a month.

Genetic Mutations: All resistant patients had malaria parasites with genetic mutations linked to artemisinin resistance.

The study, presented at the American Society of Tropical Medicine & Hygiene conference, highlights the growing concern of antimicrobial resistance, projected to claim over 39 million lives by 2050. Children under the age of five are disproportionately affected, with 4,50,000 annual deaths in sub-Saharan Africa.

Artemisinin resistance initially emerged in Southeast Asia, leading to increased treatment failure rates. Experts fear a similar scenario unfolding in Africa.

According to Dr Chandy John of Indiana University, who co-wrote the study, “This is the first study from Africa showing that children with malaria and clear signs of severe disease are experiencing at least partial resistance of artemisinin.”

Enhanced surveillance including monitoring of resistance patterns, exploring new medications and ensuring quality diagnosis and treatment are some of the ways suggested by experts to combat resistance.

The World Health Organization (WHO) stresses the urgency of addressing antimicrobial resistance, citing alarming resistance rates among bacterial pathogens.