A grape-like structure in the brain called the choroid plexus becomes enlarged and shows increased accumulation of abnormal inflammatory molecular signaling in people with Alzheimer's disease, according to a new study published in the journalAlzheimer's & Dementia.
An international team of researchers, including scientists from the Translational Genomics Research Institute (TGen), part of City of Hope, show that these changes appear to be a more extreme or perturbed version of changes seen in thechoroid plexus—part of the blood-brain barrier—during normal aging.
The choroid plexus increases in volume with age and Alzheimer's disease. One striking finding from the study was that "the larger the choroid plexus, the poorer the cognitive performance in those Alzheimer's patients," said Gorazd B. Stokin, M.D., Ph.D., principal investigator at the International Clinical Research Center of St. Ann's University Hospital Brno, Czech Republic, and senior author of the study.
The choroid plexus is a network of blood vessels and cells that produces cerebrospinal fluid (CSF) and creates a barrier between CSF and blood circulating throughout the body. Through the production of CSF, the choroid plexus helps maintain the brain's immune system activation.
The scientists compared the CSF choroid plexus in healthy individuals and people with Alzheimer's, as well as patients with other neurological diseases such as acute Lyme disease and amyotrophic lateral sclerosis or ALS. They analyzed inflammatory signaling in the CSF, as well as structure and volume changes in the choroid plexus in postmortem brains and in patients using MRI.
Following up on studies that show the choroid plexus can be damaged in aging and Alzheimer's, Dr. Stokin and his colleagues wanted to focus more deeply on the role that this tissue may play in neuroinflammation in the disease.
The researchers found protein abnormalities and "an aberrant signaling of immune molecules" in the CSF and choroid plexus of people with Alzheimer's," said study author Patrick Pirrotte, Ph.D., Director of TGen's Collaborative Center for Translational Mass Spectrometry.
While these biological changes are also found in normal aging, he noted, they are different from those seen in other neurological disorders examined in the study.
The changes seen in aging and Alzheimer's patients were most pronounced in the 66–75 years old age group, the researchers found.
"The changes in choroid plexus volume in this group could be related to the recruitment of more inflammatory cells," said Mária Čarná, Ph.D., of St. Ann's University Hospital Brno, and the papers first author. "With the help of cognitive performance tests taken by some patients, the team also showed that increased choroid plexus volume was correlated with poorer cognitive performance."
The researchers cautioned that more work needs to be done to determine whether these changes in the choroid plexus and CSF are causing Alzheimer's, or whether they reflect the disease state.
Dr. Pirrotte continues to work on potential external risk factors that might exacerbate these changes, "and could accelerate the development of Alzheimer's Disease," he said. Last year, for instance, he and his colleagues published a study on how the herbicide glyphosate can increase pro-inflammatory molecules in the brain that may be related to neurodegeneration.
More information: Maria Čarna et al, Pathogenesis of Alzheimer's disease: Involvement of the choroid plexus, Alzheimer's & Dementia (2023). DOI: 10.1002/alz.12970
Age-related macular degeneration (AMD) is one the most prevalent eye diseases. In the late stage of the disease, newly formed vessels in the retina alter its structure, which leads to blurry and distorted vision. This condition is called wet AMD and if left untreated, it can lead to severe and irreversible vision loss. Among the elderly, wet AMD is a leading cause of vision loss.
How do we detect wet AMD?
The change in vision can be subtle in the beginning with slow, gradual worsening of symptoms. Realizing that one needs an eye examination is not always easy. But timely diagnosis and treatment of wet AMD is crucial to saving vision.
Eyes at risk of wet AMD have features characterized as early AMD or dry AMD. These can progress to wet AMD, but many patients live their lives without ever experiencing a progression to wet AMD.
Health professionals widely recommend the use of the Amsler grid test as a method of self-test for wet AMD.
The Amsler grid test in theory
The Amsler grid was developed by Swiss ophthalmologist Marc Amsler in 1940s. This is a grid with vertical and horizontal lines and a dot in the center. The observer looks at the grid with each eye separately, and focuses on the dot in the center. This method allows detection of a distorted visual experience in one eye, which otherwise can be difficult to observe.
The Amsler grid is, at least in theory, a great test. It is easy to use and has an extremely low cost, as it only requires a piece of paper. Therefore, it is widely recommended as a self-test for early detection of wet AMD.
But that is theory. In practice, individuals at risk of wet AMD already have certain changes in their retina. Although they may not experience it themselves, there may already be blurry and distorted vision because of these so-called early AMD features.
The Amsler grid test in practice
In a recent meta-analysis study published in JAMA Ophthalmology, we evaluated how well the Amsler grid test actually detected wet AMD.
We collected data from 10 studies with data from a total of 425 eyes with wet AMD and 1,262 eyes at risk of wet AMD (early/dry AMD).
When performed under supervision and in the best possible conditions, the Amsler grid was positive in 2 of 3 cases with wet AMD. In patients at risk of wet AMD (early/dry AMD), the Amsler grid was positive in 1 of 3.
In other words, this was far from being a perfect tool as it misses some cases of wet AMD and wrongly suggests wet AMD in others.
We recommend to health care professionals that if they prescribe the Amsler grid for patients, they should also allocate 5–10 minutes to ensure that it is used correctly. Patients should also be made aware of vision irregularities and seek an eye examination upon any visual decline regardless of the Amsler grid.
More information: Jakob Bjerager et al, Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration, JAMA Ophthalmology (2023). DOI: 10.1001/jamaophthalmol.2022.6396
Vaping cannabidiol (CBD), a compound found in marijuana, leads to more severe lung damage than vaping nicotine, according to a study by researchers at Roswell Park Comprehensive Cancer Center. Until now, research on the health effects of vaping, or using e-cigarettes, has focused almost exclusively on vaping nicotine as opposed to CBD. Previous research has documented the effects of smoking cannabis, but the effects of vaping cannabinoids such as CBD were not previously known.
Led by Yasmin Thanavala, Ph.D., of the Department of Immunology, the Roswell Park team has conducted the first study comparing the pulmonary effects of acute inhalation of vaporized CBD andnicotine. The results are shared in a new research paper, "Not all vaping is the same: differential pulmonary effects of vaping cannabidiol versus nicotine," published in the journalThorax.
Vaping involves using a device that heats a liquid containing nicotine or other substances, such as CBD, to create an aerosol that can be inhaled. For this study, the team compared two commercial vaping products: a CBD product containing 50 mg/mL of CBD (natural flavoring), dissolved in a solution of medium chain triglycerides—fats derived from coconut or palm oils; and a nicotine product containing 5.0% nicotine (Virginia Tobacco flavor) dissolved in a solution of propylene glycol, a synthetic food additive, and vegetable glycerin, made from plant-based oils.
The preclinical study involved both in vivo models and in vitro cultures of human cells, which were exposed to filtered air, nicotine aerosols or CBD aerosols for two weeks. "We believe this is the first-ever report on what happens to various immune cell types and markers of damage and inflammation measured in the lung following in vivo inhalation exposure," says Dr. Thanavala.
Among other results, the researchers found:
The number and severity of focal lesions—areas of tissue damage—in the lung were greater after inhalation of CBD aerosols than nicotine aerosols.
Myeloperoxidase (MPO) activity was significantly greater following exposure to CBD aerosol vs. nicotine aerosol. MPO, an enzyme, promotes inflammation and damage to lung cells.
Inhalation of CBD aerosols resulted in greater inflammatory changes and higher oxidative stress in the lung.
Exposure to CBD aerosols killed purified human neutrophils at a higher rate than nicotine aerosols (44.5% vs. 21%). Neutrophils in the lungs protect against bacteria, viruses and fungi.
CBD aerosols were more toxic to cultures of human small airway epithelial cells and disrupted the integrity of the lung epithelial barrier.
Inhalation of CBD aerosols resulted in significantly lower numbers of pulmonary interstitial macrophages compared with inhalation of nicotine aerosols (11,460 cells in CBD-vape vs. 27,727 cells in nicotine vape). Among other roles, pulmonary interstitial macrophages are responsible for reducing inflammation and protecting against infection.
This work underscores how important it is forhealthcare providersto zero in on the specifics of a patient's smoking history, Dr. Thanavala notes, keeping in mind that for many people, the word "smoking" applies exclusively to smoking combustible cigarettes.
"Our findings suggest that vaping cannabis may not only cause significant lung injury, but can also increase susceptibility to respiratory infections, lead to poor responses to prophylactic vaccinations or cause worsening of symptoms in patients with underlying pulmonary inflammatory disease. So it's not enough for care providers to ask people, 'Do you smoke?' The next step is, 'Do you vape?' If the answer is yes, you need to ask, 'Do you vape nicotine or do you vape cannabis?'"
Dr. Thanavala and colleagues note, "While cannabis has proven health benefits in pain management, sleep, relieving the symptoms of chemotherapy-induced nausea/vomiting in cancer patients, and in patients experiencing seizures, there is simply a lack of robust evidence about cannabis safety when delivered from vaping products."
They add that further research is needed—first, to investigate the long-term effects in people who regularly vape CBD and nicotine, and second, to evaluate the effects of vaping products that contain other types of cannabinoids, including tetrahydrocannabinol (THC), the psychoactive component of cannabis.
Tariq Bhat, Ph.D., Department of Immunology, served as first author of the paper. Other contributors include Suresh Kalathil, Ph.D., Department of Immunology; Maciej Goniewicz, Ph.D., Department of Health Behavior; and Alan Hutson, Ph.D., Department of Biostatistics.
Dr. Thanavala has been at the forefront of research on the health effects of vaping cannabinoids. In 2020 she led a team of researchers from Roswell Park and the National Center for Environmental Health at the Centers for Disease Control, who were first to report (in The New England Journal of Medicine) that a potentially fatal condition called EVALI—E-cigarette or Vaping use-Associated Lung Injury—was associated with vitamin E acetate, frequently used as a cutting agent in e-cigarette liquids containing THC, the psychoactive agent in cannabis.
More information: Tariq A Bhat et al, Not all vaping is the same: differential pulmonary effects of vaping cannabidiol versus nicotine, Thorax (2023). DOI: 10.1136/thorax-2022-218743
Maternal obesity alters the structure of the placenta (a vital organ that nourishes the baby during pregnancy) more than gestational diabetes mellitus (GDM; a condition characterized by poor glucose control in pregnancy).
The new insight, published inThe Journal of Physiology, enhances understanding about the mechanisms underlying poorpregnancyoutcomes and the subsequent greater risk of poor neonatal and offspring health. The identification of specific changes in the placenta could lead to the potential development of future placenta-targeted treatments or screening tests that may improve the health outcomes of the mother and offspring, particularly in low-middle income countries.
The research conducted by scientists in South Africa in alliance with those in England is the first study to investigate the effects of maternal obesity and GDM simultaneously and to be carried out in a low-middle income country, where obesity and GDM during pregnancy have a substantial health and economic impact. Previous studies have investigated obesity and GDM separately and have only been carried out in high-income countries.
The rates of obesity and GDM, the development of poor glucose handling during pregnancy, are increasing worldwide. Both are linked to multiple maternal and fetal complications, such as increased risk of fetal death, stillbirth, infant death and higher infant birth weight. It is not known how these complications arise.
The researchers found that maternal obesity, more than GDM, reduced the formation of the placenta, its blood vessel density and surface area, and its capacity to exchange nutrients between the mother and developing child. Both obesity and GDM impact placental hormone production and inflammation markers, suggesting that the placenta is indeed functioning abnormally.
The study looked at 71 women who were black or of mixed ancestry. Of those, 52 were obese and 38 had developed GDM. The researchers conducted the study using clinical profiling, deep structural examination and molecular analysis of the placenta, and biochemical measurements of maternal and infant cord blood to examine the effect of obesity and GDM in this group of expectant women.
Lead author Professor Amanda Sferruzzi-Perri of the University of Cambridge said, "For the first time we have looked at the effects of both obesity and GDM on the placenta in black and mixed-ancestry woman, who are an understudied group, and what effect that these conditions might have on them and their children. It was important to discover that obesity has more of an influence than GDM on pregnancy outcomes for both the mother and the child."
The study limitation is that with a small sample size of 71 women, it was not possible to determine what impact the sex of the fetus has on these placental changes. The non-obese group of women also included women who would be termed overweight. The researchers would like to carry out further research in obese, overweight and lean women with and without GDM, and explore the impact of the sex of the fetus. They would then like to study how obesity, GDM and treatments, like metformin a drug that lowers blood glucose levels, interact to determine pregnancy outcomes and the long-term health of the child.
Lead co-author Professor Mushi Matjila of the University of Cape Town said, "South Africa is burdened by a quadruple disease burden of communicable and non-communicable disease, along with high maternal and child morbidity and mortality, and deaths related to violence and injuries. Additionally, we have one of the highest rates of female obesity globally, which undoubtedly fuels the non-communicable disease burden and contributes to maternal, neonatal and child morbidity. As obesity and GDM often coexist, the study highlights the importance of obesity over GDM in modulating placental structure and function, and begins to piece together how these placental changes may explain observed complications (e.g., intrauterine death and stillbirths) and increased future non-communicable disease risk for both mother and baby."
More information: Obesity and gestational diabetes independently and collectively induce specific effects on placental structure, inflammation and endocrine function in a cohort of South African women, The Journal of Physiology (2023). DOI: 10.1113/JP284139
Many people use fitness trackers, such as smartwatches, as part of achieving a healthy lifestyle — but some cardiac patients should be aware of the risks.
Some smart scales, smart rings and wearable fitness devices that use “bioimpedance,” a sensing technology that emits a tiny unnoticeable electrical current into the body, may interfere with cardiac implantable electronic devices (CIEDs), like pacemakers and defibrillators, according to a new study.
The research was published on Feb. 21 in Heart Rhythm.
“We found bioimpedance sensing technology available in certain consumer devices such as smart scales, smartwatches, and smart rings could interfere with the correct functioning of CIEDs,” lead author Dr. Benjamin Sanchez Terrones of Utah told Fox News Digital.
He’s an assistant professor in the department of electrical and computer engineering and member of the Huntsman Cancer Institute, University of Utah in Salt Lake City.
CIEDs include pacemakers and implantable cardioverter defibrillators (ICDs), according to the American Heart Association.
The study noted the U.S. Food and Drug Administration (FDA) has not cleared any consumer bioimpedance device for patients with cardiac implantable electronic devices because of the potential electrical interference.
Yet not all the commercially available trackers have bioimpedance sensing technology, he added.
Cardiac patients should be aware that using fitness trackers can have a negative impact.Shutterstock
“The FDA published a study in 2021 in the same journal as we did where they found that both the Apple iPhones and the Apple smartwatches create a magnetic interference to CIEDs when closer than 6 inches,” Sanchez Terrones noted.
“As indicated by the manufacturers of these devices and the recommendation by the American Heart Association for other devices that may also interfere, the safest [step] is not to use them by this population [who have CIEDs].”
He added that for any questions about these devices, patients should always talk to their health care providers.
Bioimpedance sensing: What is it?
“Bioimpedance sensing is a technology [in which] a tiny, painless, alternating electrical current is applied to the body by the smartwatch, smart ring, or smart scale, and used by the device to measure the body’s response,” Sanchez Terrones said.
An application of this technology is measuring body composition, “where this electrical current is used to measure hydration level and fat mass content,” he said.
Wearable fitness trackers use this sensing technology to record the level of stress or vital signs, such as heart rate or the number of steps taken every day, per the study’s press release.
Smart scales and rings
Some smart scales and rings also use bioimpedance sensing, Sanchez Terrones said.
“When the person is barefoot on the scale, then the scale — in addition to measuring weight — uses bioimpedance sensing to apply an electrical current from one foot to the other in some cases, sometimes from the foot to the hand if the smart scale also has a handle bar with sensors in it, to then measure segmental body composition,” Sanchez Terrones added.
The devices could interfere with CIEDS.Shutterstock
The scale can measure fat mass in the legs, arms and trunk separately for more accuracy, he added.
Electromagnetic risk well known
The electromagnetic waves on metal detectors and certain devices, such as cell phones, headphones and radios, can keep a cardiac defibrillator or pacemaker from functioning properly, the American Heart Association warns.
“This sort of interference had been previously described with smartphones, but a possible risk with smartwatches had not been fully appreciated,” Dr. Deepak L. Bhatt, director of Mount Sinai Heart and a professor of cardiovascular medicine at Icahn School of Medicine at Mount Sinai in New York City, told Fox News Digital.
The association advises patients with an implantable defibrillator or pacemaker to use their cell phone at least six inches from their implantable device (by keeping it at the ear opposite where their device was implanted).
It also reminds them not to keep their cell phone in their front chest pocket.
What exactly are CIEDs?
Normally the heart beats on its own through its natural pacemaker known as the sinus node.
“Your heart’s electrical system controls your heartbeat, beginning in a group of cells at the top of the heart (sinus node) and spreading to the bottom, causing it to contract and pump blood,” according to the Mayo Clinic’s website.
“Aging, heart muscle damage from a heart attack, some medications and certain genetic conditions can cause an irregular heart rhythm,” the website added.
Fitness trackers record stress levels and vital signs every day.Shutterstock
When this natural pacemaker stops working properly, the heart can beat too fast or too slowly — so a small, artificial and battery-operated pacemaker can be placed to allow the heart to beat in a regular rhythm, per the American Heart Association.
An ICD, or implantable defibrillator, is a small battery-powered device that’s placed to prevent sudden death. It would shock the patient if he or she experiences life-threatening cardiac rhythms known as ventricular tachycardia and ventricular fibrillation, according to Mayo Clinic’s website.
When these rhythms occur, the heart can beat so fast that it stops pumping blood out to the rest of the body.
FDA sets standard of electromagnetic compatibility
The researchers evaluated the electrical safety of measuring bioimpedance sensing technology using technical specifications that are established by the FDA.
The researchers first evaluated implantable cardiac devices from three different manufacturers — Medtronic, Boston Scientific and Abbott — in benchtop testing, which is done to have a perfectly controlled testing environment.
“The advantage of this approach is that it facilitates the testing of different manufacturers of CIEDs in a reproducible and repeatable fashion,” said the lead author. “However, it does not account for the fact people are not made of cables.”
Because it is not possible to study thebioimpedance interferenceinside actual human beings, the study included computer modeling.
“We simulated with modeling the level of bioimpedance interference using a smartwatch, smart scale, and smart ring form factor on a male and a female human computer model with a CIED,” Sanchez Terrones said.
“Bioimpedance sensing generated an electrical interference that exceeded Food and Drug Administration-accepted guidelines and interfered with proper CIED functioning,” added Sanchez Terrones in the press release.
Researchers noted that the level of electrical current sometimes “confused” the implantable devices, although the level and the “confusion effect” differed among the three different manufacturers.
“This is a clever study that suggests there may be a potential for wearable devices, such as smartwatches, to interfere with medical devices, such as pacemakers and implantable defibrillators,” said Bhatt, who was not part of the study.
Study’s limitations
Although the study’s computer models are more accurate in terms of human anatomy than plain cables, it did not account for all the biological variability between people, Sanchez Terrones admitted.
He recommends further clinical studies on patients to make sure the scientific and medical community get the most complete information possible to make an informed decision.
“It will be important to see how regulators and manufacturers respond to these results to provide concrete guidance to patients,” Bhatt added.
Health-clinic operator Acadia Healthcare Co. Inc. (ACHC) on Monday offered up sales results and forecasts that beat estimates, but a weaker showing for profits. The company, which runs mental-health and addiction-treatment facilities, reported fourth-quarter net income of $63.1 million, or 67 cents a share, compared with $71.5 million, or 77 cents a share, in the same quarter in 2021. Revenue came in at $675.3 million, compared with $593.5 million in the prior-year quarter. Excluding income from a provider relief fund, Acadia earned 70 cents a share, compared with 67 cents a share in the fourth quarter of 2021. Analysts polled by FactSet expected adjusted earnings per share of 75 cents, on revenue of $660.4 million. Acadia updated its 2023 outlook, saying it expected $2.82 billion to $2.88 billion in sales, compared with FactSet forecasts for $2.83 billion, with adjusted earnings per share of $3.10 to $3.40, compared with FactSet forecasts for $3.31 a share. For the first quarter, the company said it expected sales of $690 million to $700 million and adjusted earnings per share of 70 cents to 74 cents, compared with FactSet forecasts for sales of $674 million and 73 cents a share. Shares fell 1.2%.
European low-cost carrier Wizz Air is suspending all its flights to the Moldovan capital of Chisinau starting on March 14 due to some “recent developments” in the country, the airline said.
"As a result of recent developments in Moldova and the high, but not imminent, risk in the country's airspace, Wizz Air has taken the difficult but responsible decision to suspend all flights to Chisinau starting on March 14,” it said in a statement on Monday.
The company didn’t specify the recent developments it was referring to.
Tensions have been mounting in Moldova, as the country's President Maia Sandu has accused Russia of using “saboteurs” to stoke unrest amid a period of political instability, echoing similar warnings from Ukrainian President Volodymyr Zelensky.
