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Thursday, January 24, 2019

Slim people have a genetic advantage in maintaining their weight


In the largest study of its kind to date, Cambridge researchers have looked at why some people manage to stay thin while others gain weight easily. They have found that the genetic dice are loaded in favour of thin people and against those at the obese end of the spectrum.
More than six in ten adults in the UK are overweight, and one in four adults is obese. By age five, almost one in four children is either overweight or obese. Excess weight increases the risk of related health problems including type 2 diabetes and heart disease.
While it is well known that changes in our environment, such as easy access to high calorie foods and sedentary lifestyles, have driven the rise in obesity in recent years, there is considerable individual variation in weight within a population that shares the same environment. Some people seem able to eat what they like and remain thin. This has led some people to characterise overweight people as lazy or lacking willpower.
With support from Wellcome and the European Research Council, a team led by Professor Sadaf Farooqi at the Wellcome-MRC Institute of Metabolic Science, University of Cambridge, established the Study Into Lean and Thin Subjects — STILTS — to examine why and how some people find it easier to stay thin than others. Studies of twins have shown that variation in body weight is largely influenced by our genes. To date studies have overwhelmingly focused on people who are overweight. Hundreds of genes have been found that increase the chance of a person being overweight and in some people faulty genes can cause severe obesity from a young age.
Professor Sadaf Farooqi’s team were able to recruit 2,000 people who were thin (defined as a body mass index (BMI) of less than 18 kg/m2) but healthy, with no medical conditions or eating disorders. They worked with general practices across the UK, taking saliva samples to enable DNA analysis and asking participants to answer questions about their general health and lifestyles. It is thought to be the only cohort of its kind in the world and the researchers say that the UK’s National Institute for Health Research — the National Health Service’s research infrastructure — strongly enabled and supported their research.
In a study published today in the journal PLOS Genetics, Professor Farooqi’s team collaborated with Dr Inês Barroso’s team at the Wellcome Sanger Institute to compare the DNA of some 14,000 people -1,622 thin volunteers from the STILTS cohort, 1,985 severely obese people and a further 10,433 normal weight controls.
Our DNA comprises of a sequence of molecules known as base pairs, represented by the letters A, C, G and T. Strings of these base pairs form genetic regions (which include or make up our genes). Our genes provide the code for how our body functions and changes in the spelling — for example, a C in place of an A — can have subtle or sometimes dramatic changes on features such as hair colour and eye colour but also on a person’s weight.
The team found several common genetic variants already identified as playing a role in obesity. In addition, they found new genetic regions involved in severe obesity and some involved in healthy thinness.
To see what impact these genes had on an individual’s weight, the researchers added up the contribution of the different genetic variants to calculate a genetic risk score.
“As anticipated, we found that obese people had a higher genetic risk score than normal weight people, which contributes to their risk of being overweight. The genetic dice are loaded against them,” explains Dr Barroso.
Importantly, the team also showed that thin people, had a much lower genetic risk score — they had fewer genetic variants that we know increase a person’s chances of being overweight.
“This research shows for the first time that healthy thin people are generally thin because they have a lower burden of genes that increase a person’s chances of being overweight and not because they are morally superior, as some people like to suggest,” says Professor Farooqi. “It’s easy to rush to judgement and criticise people for their weight, but the science shows that things are far more complex. We have far less control over our weight than we might wish to think.”
Three out of four people (74%) in the STILTS cohort had a family history of being thin and healthy and the team found some genetic changes that were significantly more common in thin people, which they say may allow them to pinpoint new genes and biological mechanisms that help people stay thin.
“We already know that people can be thin for different reasons” says Professor Farooqi. “Some people are just not that interested in food whereas others can eat what they like, but never put on weight. If we can find the genes that prevent them from putting on weight, we may be able to target those genes to find new weight loss strategies and help people who do not have this advantage.”
Story Source:
Materials provided by University of Cambridge. The original story is licensed under a Creative Commons LicenseNote: Content may be edited for style and length.

Journal Reference:
  1. Fernando Riveros-McKay, Vanisha Mistry, Rebecca Bounds, Audrey Hendricks, Julia M. Keogh, Hannah Thomas, Elana Henning, Laura J. Corbin, Stephen O’Rahilly, Eleftheria Zeggini, Eleanor Wheeler, Inês Barroso, I. Sadaf Farooqi. Genetic architecture of human thinness compared to severe obesityPLOS Genetics, 2019; 15 (1): e1007603 DOI: 10.1371/journal.pgen.1007603

Teaching human cells to clean house to delay aging and fight neurodegeneration


Monash researchers have unlocked a key process in all human cells that contributes to diseases like cancer and neurodegenerative diseases as well as ageing. The discovery reveals how cells efficiently get rid of cellular junk, which when it accumulates, can trigger death and the health problems associated with getting older.
Autophagy is the ‘clean-up crew’ of the cell — used by cells to break-down debris like broken proteins, bits of cell membrane, viruses or bacteria. To capture this trash, cells use specialised membranes to trap the cargo for recycling into new parts and energy. Without efficient autophagy cells become choked by their own damaged components, which can contribute to the development of a range of diseases, including diabetes, muscular dystrophy, Parkinson’s and Alzheimer’s disease.
Dr Michael Lazarou’s laboratory from the Monash Biomedicine Discovery Institute have today published data in Nature Communications that debunks previously held beliefs about how cells target their trash. Cells target different types of cargo by using ‘autophagy receptors’, which can bind the cargo as well as the ensnaring membranes. Until recently these autophagy receptors were thought to recruit the membranes to the cargo, but research led by Dr Benjamin Padman from the Lazarou lab now shows that this is not the case.
Dr Padman removed the ability of autophagy receptors to bind the membranes — and found that this did not halt the autophagy process. In collaboration with Dr Lan Nguyen, head of the Monash BDI Computational Network Modelling Laboratory, the researchers have instead discovered how cells amplify the rate of autophagy.
“It totally flipped the way I used to think about it,” Dr Padman said.
“The autophagy receptors weren’t recruiting the membranes, the membranes were recruiting more autophagy receptors to speed things up,” he said.
According to Dr Padman, there are a number of treatments and therapies currently under development globally which aim to control the activity of these proteins, “which according to our findings, don’t function the way we previously thought.”
“The clean-up crew of autophagy is always hard at work in our cells, but it can sometimes have trouble keeping up. If we can find drugs that target this amplification mechanism, we could help neuronal cells deal with the build-up of protein trash linked to Huntington’s and Alzheimer’s,” Dr Padman said.
Story Source:
Materials provided by Monash UniversityNote: Content may be edited for style and length.

Journal Reference:
  1. Benjamin Scott Padman, Thanh Ngoc Nguyen, Louise Uoselis, Marvin Skulsuppaisarn, Lan K. Nguyen, Michael Lazarou. LC3/GABARAPs drive ubiquitin-independent recruitment of Optineurin and NDP52 to amplify mitophagyNature Communications, 2019; 10 (1) DOI: 10.1038/s41467-019-08335-6

Hyperbaric oxygen therapy for Alzheimer’s disease


Dr. Paul Harch, Clinical Professor and Director of Hyperbaric Medicine at LSU Health New Orleans School of Medicine, and Dr. Edward Fogarty, Chairman of Radiology at the University of North Dakota School of Medicine, report the first PET scan-documented case of improvement in brain metabolism in Alzheimer’s disease in a patient treated with hyperbaric oxygen therapy (HBOT).
The authors report the case of a 58-year-old female who had experienced five years of cognitive decline, which began accelerating rapidly. Single photon emission computed tomography (SPECT) suggested Alzheimer’s disease. The diagnosis was confirmed by 18Fluorodeoxyglucose (18FDG) positron emission tomography (PET) brain imaging, which revealed global and typical metabolic deficits in Alzheimer’s.
The patient underwent a total of 40 HBOT treatments — five days a week over 66 days. Each treatment consisted of 1.15 atmosphere absolute/50 minutes total treatment time. After 21 treatments, the patient reported increased energy and level of activity, better mood and ability to perform daily living activities as well as work crossword puzzles. After 40 treatments, she reported increased memory and concentration, sleep, conversation, appetite, ability to use the computer, more good days (5/7) than bad days, resolved anxiety, and decreased disorientation and frustration. Tremor, deep knee bend, tandem gain, and motor speed were also improved. Repeat 18FDG PET imaging one month post-HBOT showed global 6.5-38% improvement in brain metabolism.
“We demonstrated the largest improvement in brain metabolism of any therapy for Alzheimer’s disease,” notes Dr. Harch. “HBOT in this patient may be the first treatment not only to halt, but temporarily reverse disease progression in Alzheimer’s disease.”
The report also contains video imaging, including unique rotating PET 3D Surface Reconstructions, which allow the lay person to easily see the improvements in brain function.
“PET imaging is used around the world as a biomarker in oncology and cardiology to assay responses to therapy,” says Dr. Fogarty. “We now have an irrefutable biomarker system that this intervention has promise where no other real hope for recovery of dementia has ever existed before.”
The physicians report that two months post-HBOT, the patient felt a recurrence in her symptoms. She was retreated over the next 20 months with 56 HBOTs (total 96) at the same dose, supplemental oxygen, and medications with stability of her symptoms and Folstein Mini-Mental Status exam.
According to the National Institutes of Health, “Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It is the most common cause of dementia in older adults. Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.”
The authors note that four pathological processes have been identified and primary treatment is with acetylcholinesterase inhibitors or the N-methyl-D-aspartate receptor antagonist memantine, which have been shown to have a positive impact on Alzheimer’s disease progression with no significant disease-modifying effects.
HBOT is an epigenetic modulation of gene expression and suppression to treat wounds and disease pathophysiology, particularly inflammation. HBOT targets all four of the pathological processes of AD by affecting the microcirculation; mitochondrial dysfunction, and biogenesis; reducing amyloid burden and tau phosphorylation; controlling oxidative stress; and reducing inflammation.
The first successful HBOT-treated case of Alzheimer’s disease was published in 2001. The present case report is the first patient in a series of 11 HBOT-treated patients with Alzheimer’s disease whose symptomatic improvement is documented with 18fluorodeoxyglucose positron emission tomography (18FDG PET). “Our results suggest the possibility of treating Alzheimer’s disease long-term with HBOT and pharmacotherapy,” concludes Harch.
Story Source:
Materials provided by Louisiana State University Health Sciences CenterNote: Content may be edited for style and length.

Journal Reference:
  1. PaulG Harch, EdwardF Fogarty. Hyperbaric oxygen therapy for Alzheimer’s dementia with positron emission tomography imaging: A case reportMedical Gas Research, 2018; 8 (4): 181 DOI: 10.4103/2045-9912.248271

Health insurers, IBM partner on blockchain project


A group of health insurers is partnering with IBM Corp. to use blockchain technology to improve how industry stakeholders exchange health information and ultimately create a better patient experience.
Aetna, Anthem, and Health Care Service Corp. along with PNC Bank and IBM said Thursday they want to create a blockchain network that will allow the companies to build, share and deploy transformative solutions.
They plan to use blockchain to solve some age-old industry problems, such as enabling health information exchanges, maintaining accurate provider directors and processing claims and payments more efficiently. The group said they are still figuring out what they will focus on first, and plan to add more healthcare and tech companies to the collaborative in the coming months.
“We are committed to improving the healthcare consumer experience and making our healthcare system work more effectively,” Claus Jensen, chief technology officer at Aetna, said in the announcement. “Through the application of blockchain technology, we’ll work to improve data accuracy for providers, regulators, and other stakeholders, and give our members more control over their own data.”
In the simplest terms, blockchain is a shared record of transactions. Instead of the record being located on a single, hackable computer, it is maintained across multiple computers. Any changes made to the shared record must be agreed on by all users. Changes are tracked and time-stamped.
In recent years, healthcare companies have become interested in leveraging blockchain technology to address various problems, largely those that involve sharing data. But the technology is still nascent, though it has immense potential. Most healthcare companies are still testing the blockchain waters through experiments and pilot projects.
“Blockchain’s unique attributes make it suitable for large networks of members to quickly exchange sensitive data in a permissioned, controlled, and transparent way,” Lori Steele, general manager for healthcare and life sciences for IBM, said in the announcement. “The fact that these major healthcare players have come together to collaborate indicates the value they see in working together to explore new models that we think could drive more efficiency in the healthcare system and ultimately improve the patient experience.”
The IBM-led group is not the only collaborative testing blockchain in healthcare. The Synaptic Health Alliance is another group formed by Aetna, Ascension, Humana, Multiplan, Optum, UnitedHealthcare and Quest Diagnostics to first find out how blockchain could improve healthcare provider directories. Early results of their pilot project, first launched in April 2018, are slated to be released next month during the HIMSS annual conference..
In another example, companies including WellCare Health Plans and Spectrum Health, among others, are working with the Hashed Health-backed Professional Credentials Exchange to leverage blockchain technology to speed up the process of verifying physician credentials.

Merck KGaA signs China digital health deal with Tencent


Germany’s Merck KGaA has signed a collaboration with Tencent to develop digital healthcare services in China.
Darmstadt-based Merck’s strategic tie-up with the China-based multinational tech company will initially focus on increasing public disease awareness and providing more accessible health services via digital platforms.
China is of huge interest to big pharma as its healthcare system develops, after a period of economic expansion during a transition to a more capitalist economy over the last few decades.
AstraZeneca is one of the companies that is aiming to build its presence in Chinathrough digital health-based initiatives, while Novo Nordisk and rival Sanofi see it as a lucrative market for diabetes medicines.
German Merck said it plans to combine its scientific expertise with Tencent’s technology in the fields of internet and artificial intelligence.
The collaboration, based around “intelligent digital health services” will also provide patients with more convenient and smarter medical services, helping to better manage chronic diseases.
Focus areas include treatment areas of Merck KGaA’s China healthcare business – in allergies the companies will aim to increase awareness of symptoms and encourage adherence to treatments.
In infertility, the collaboration will work to inform patients of their treatment options and help patients shorten the period of medical treatment.
They will also focus on diabetes, thyroid disorders and cardiovascular diseases, as well as oncology including metastatic colorectal cancer.
In the future the firms will continue to extend the scope of collaboration to other areas such as exploring the use of innovative medical service models based on “A.I. doctors” to provide more comprehensive disease awareness education and treatment services for mCRC and other diseases.
In an interview with CNBC at this week’s Davos World Economic Forum, Merck KGaA’s CEO Stefan Oschman said that he is “absolutely certain” that a pharma company ranked among the 50 largest in the world will arise in China.
He said that improved intellectual property protection, and reforms from the country’s drugs regulator to make it faster at approving new medicines, will drive development of the country’s pharma industry.
Oschman said: “This is a mixed blessing. On the one hand, it means more competition, on the other hand, there’s a lot of business opportunity for us.”

FDA approves consumer colorectal cancer test


The FDA will allow consumer DNA testing company 23andMe to give customers reports on their risk of hereditary colorectal cancer.
The California-based company, which allows customers to test their own DNA via mail, will now be able to tell its users whether they have the two most common genetic variants influencing MUTYH-associated polyposis, a hereditary colorectal cancer syndrome.
If left unchecked, carrying both of these variants or having two copies of one increases the risk of developing colorectal cancer to between 43-100%. The risk for those who have just one variant is uncertain; however, some studies suggest that the colorectal cancer risk may be slightly increased, particularly for those with a family history of colorectal cancer.
23andMe received a similar approval last March for reports on the BRCA1/BRCA2 genes, which are associated with increased risk of breast cancer.
These two reports are the only direct-to-consumer genetic health risk reports for inherited cancers that have been authorised or cleared by the FDA for use without prescription.
Like with other 23andMe Genetic Health Risk reports, this one will also include an education module to ensure customers are informed on what they can learn from this report and how to interpret the results, as well as its limitations.
In a statement 23andMe pointed out that hereditary colorectal cancers only account for about 5% of all colorectal cancer cases.
Additionally, the report does not look at variants associated with Lynch syndrome, which is the most common form of inherited colorectal cancer. The two variants included account for around 80-90% of MUTYH variants in people of Northern European descent. However, more than 100 variants in the MUTYH gene are known to be linked to MUTYH-associated polyposis.
23andMe said that the approval followed an “extensive” FDA review process in which the company submitted studies and evidence demonstrating that the report is scientifically valid and understandable for consumers, and that the results are analytically reliable.
Nevertheless, direct-to-consumer cancer tests remain controversial, as they are done without the guidance of a doctor.
This hasn’t stopped 23andMe seeing enormous success and attracting interest from big players in the industry, though. Last year the company signed a $300 million R&D deal with GSK, giving the British pharma firm access to four million customers’ DNA information.

Mass cloning for R&D? Chinese scientists report birth of five gene-edited monkeys


Remember when Chinese researchers announced the birth of the first monkeys created by somatic cell nuclear transfer? Exactly a year later, the same team is reporting a second breakthrough — cloning five gene-edited monkeys in an effort to overcome previous concerns about the costs and efficiency in using cloned monkeys for medical research.
“It can be said that this research means the technology for cloning gene-edited monkeys has made the leap from theory to practice,” scientists from the Chinese Academy of Sciences Institute of Neuroscience in Shanghai write in a blogpost for Chinese media Sina.
Carrying a genetic alteration that predisposes them to dysregulation of the circadian rhythm, the five monkeys are expected to shed light on disease mechanisms and offer therapeutic testing ground for neurodegeneration. In diseases such as Alzheimer’s and Parkinson’s, mice models have proven woefully inadequate in terms of predicting human reactions to drugs, creating a big hurdle in preclinical experiments for new therapies.
Like Zhong Zhong and Hua Hua, the identical long-tailed macaques in the spotlight last January, the new monkeys — now three to six months old — were cloned in a process that involves taking the nucleus of a differentiated cell from one animal and infusing it into an empty egg cell from another. An electric current triggers the egg to develop into an early embryo and the resulting fetus, grown in a surrogate, would be a replica of the animal that donated the nucleus.
In their case, the donor was an aborted monkey fetus. While adult cells were also tested in a separate cohort of the trial, both babies born in that group were short-lived and one had abnormal body development.
This time around, researchers think they have cracked the code for “batch producing” identical monkeys that all possess a desired trait, state-owned Xinhua reported, citing a paper from Chinese journal National Science Review. Specifically, they knocked out BMAL1, a “clock gene” responsible for producing a “clock protein,” in the donor monkey.
Notably, the success rate of cloning is still the same as in earlier experiments at around 1% — a positive sign, the scientists say, considering the added complexities of using adult cells and tweaking DNA.
Researchers have observed signs of sleep disorders, anxiety and behaviors in these monkeys that are suggestive of schizophrenia, they added in the blogpost.
They also told Xinhua that the program “adhered to international ethics standards and recognition,” with support and supervision from the institute’s ethics panel.