People have long used different methods to attempt to lighten or tan their skin. The 1920’s made beautiful, bronzed skin the latest fad, a trend that has persisted to this day in many parts of the world. Achieving that perfect sun-kissed look, however, has not always been safe. (more…)
Category: Health
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How Modern Technology is Improving Health Care (Genome and Algorithms)
Genome Testing
According to an article that rates this year’s medical advances according to their importance, at the top of the list is a new Ebola vaccine that is expected to be available later this year. Genome-based testing, which has the potential to increase the speed and flexibility of clinical trials for life-saving experimental treatments, ranked at number two.
Within the field of genome testing, one of the most important recent discoveries in medicine is CRISPR, which scientists have learned to use as a genome editing tool. CRISPR, an acronym for clustered regularly interspaced short palindromic repeats, is a natural defense mechanism found in bacteria. In the 1980s, scientists began observing patterns of bacterial genomes and now understand more about how the process of preventing viruses from replicating works.
A viral microbe copies the genetic material in each spacer into an RNA molecule. Cas9 enzymes cradle the RNA molecule, and in combination, they explore a cell. If they find genetic material that matches the CRISPR RNA, the viral RNA attaches to it. The Cas9 enzymes cut the DNA in half, preventing it from multiplying. Scientists believe that CRISPR has the potential to revolutionize biology because it can identify and remove bad genes from a DNA strand at very little economic cost.
Health Algorithms
According to a recent study, a new computer-based test can help predict the likelihood of developing dementia. The test utilizes a complex algorithm based on information such as a person’s age, weight, gender, social habits and previous medical history. Those whose test results showed them to be at higher risk could then take additional preventive measures by increasing activities that have been proven to improve memory. The focus of this technology is prevention.
Researchers used the test to assess the medical records of over 226,000 people over the age of 60. The algorithm proved to be so accurate that the developers decided to share it freely with other researchers. Their goal is that it become available to the public and an important element of a national healthcare database. They predict that it may take a few years to reach those goals.
Integrated Health Care Software
Another technological advance in medicine are software services that enable those in the medical profession to deliver a higher level of care. From a patient’s perspective, that higher level of care is manifested at every level of the health care system. Doctors are able to develop superior treatment plans by quickly and securely sharing medical information with specialists. All the time saved by not having to make physical appointments and drive to them can be used to increase communication between doctors and their patients. Automated scheduling capabilities also give other medical staff more time to communicate with the patient, which results in providing the doctor with more useful information.
One of the most common complaints of health care professionals in the last decade is the growing amount of paperwork they are required to complete. Health care professionals choose their careers based on a desire to spend their time having human interactions that result in people feeling better, not learning complex insurance billing procedures. Clinical trials have shown that one of the benefits for health care providers is the simplification and automation of some of the most time and energy consuming billing processes.
The Future
Scientists and health care professionals predict that the next thing that will revolutionize health care is the concept of precision medicine. Rather than offering every patient the same treatment for the same illness or condition, this concept focuses on developing individual treatment plans based on a number of genetic and environmental factors. Research in the field of epigenetics has demonstrated that genes are not, as was once believed, fixed, but are in fact affected by the environment.
The Precision Medicine Initiative, which is currently being developed and is expected to be launched later this year, promises to change the way medical professionals are trained by incorporating many of the newest scientific discoveries. This will allow doctors to more easily develop and implement valuable new techniques into their practices. Scientific advancements in genetics, computer technology, and medicine are making the future of health care look very bright indeed.
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Nanotechnology in Dentistry Creates Stronger Fillings
Breakthroughs in nanotechnology don’t just limit their effect to the electronics industry. Recent advancements in the industry have allowed dentists to severely cut down on their workload in a way you may not have expected.
Dentists use dental composites to restore teeth to their original hardness and rigidity, making them essential in dental repairs such as restoration fillings. They are typically made of amalgams such as composites made of silica, plastic compounds or ceramic, or of mixtures of silver, mercury or tin.
The problem is that these can be prone to breakages and suffer from a short life span. In fact, it is thought that replacement fillings make up 75% of dentist’s work. The use of nanotechnology in dentistry has allowed engineers to come up with a viable solution to this problem.
Using Nanotechnology
The short lifespan of current dental composites have led engineers to look into the concept of using nanotechnology in dentistry, with fillings that could last longer than the conventional kind. The benefit of using nanomaterial is that when a material becomes smaller, it reduces the chance of it containing a defect, thus increasing the strength of that material.
The Development of NovaPro Flow
Hao Li, a professor at the University of Missouri’s college of engineering has developed a “flowable
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FDA Approved an Injection That Will Eliminate Your Double Chin
For many of us, trying to hide our double chin – perhaps under a scarf or turtleneck – is a daily battle. It’s a major cause of embarrassment for thousands of affected Australians, and is usually caused by obesity or other natural effects of aging. A double chin is actually just an extra layer of submental fat that forms around the neck and can sometimes sag, creating the impression of a second chin. Up until now, surgery was the only way to remove it.
However, there is now a surgery-free way to remove the dreaded double chin thanks to a recently FDA-approved drug called Kybella (or deoxycholic acid). Approved as a treatment for adults with moderate-to-severe submental fat below the chin, Kybella is an injectable drug that works by helping the body absorb fatty tissue. In essence, the drug dissolves the submental fat under the chin by destroying the fat cell’s membrane, causing it to burst. The remains of the cell are then reabsorbed by the body’s normal metabolic pathways.
According to the results of numerous clinical trials, injecting Kybella into the affected area can produce a noticeable reduction in submental fat in just 6 months. Patients can receive up to 50 injections in a single treatment (which usually lasts around 5 minutes), and sessions must be spaced at least 1 month apart for best results. No bandages are required, and recovery time is between 2 and 3 days.
There are some side-effects, however, that patients need to be made aware of before embarking on this journey. The most common side-effects reported in clinical trials were swelling, bruising, pain, numbness, redness and areas of hardness around the treatment area. However, most of these should disappear within a few days after treatment.
It’s important to understand that Kybella can also cause far more serious side-effects, such as possible nerve damage in the jaw. Although these side-effects are much less common, some patients have reported uneven smiles, weak facial muscles, and even trouble swallowing after receiving treatment. Indeed, according to Amy G. Egan of the FDA’s Center for Drug Evaluation and Research, “Treatment with Kybella should only be provided by a licensed health care professional, and patients should fully understand the risks associated with use of the drug before considering treatment.
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Are synthetics overcoming the natural materials?
In 1935, Percy L. Julian (1899-1975) synthesized physostigmine, the compound that was only available in its natural source, the Calabar bean, now used in the treatment of glaucoma. This pioneering research opened a door to widespread usage of chemical materials; however, it also started a “synthetic versus natural
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Efficiency and Benefits of Massage Therapy
When health is absent…Wisdom cannot reveal itself
Art cannot become manifest
Strength cannot be exerted
Wealth is useless and reason is powerless.
HeraphiliesThe advancements in medicine have provided numerous cures and treatments for diseases that were terminal just a hundred years ago. And while there is a pill that can solve many problems, there isn’t one that can give you what a simple old-fashioned massage can – a total relaxation. But, there is more to it.
Massage is so simple: it is natural, there are no chemicals involved and the person receiving the treatment needs to do absolutely nothing in order to feel the full effect. It has become a part of various aspects of everyday life, from free time to medicine, sports and even beauty treatments.
Illness is the most heeded of doctors:
to goodness and wisdom we only make promises;
pain we obey.
Marcel ProustAs one of the main alternative treatments, massage therapy is recommended and used for different problems, from coping with pain, cancer, fibromyalgia, HIV/AIDS and infant care to other conditions. Massage styles mostly performed today are Swedish, Deep tissue, Sports massage, Trigger point massage, Esalen, Pre-Natal, Acupressure, Shiatsu, Counterstrain, Ortho Bionomy, Reflexology and others.
Endocrine System. It is scientifically proven that massage regulates and stimulates hormone levels in the organism. Hormones such as serotonin, dopamine, epinephrine, oxytocin, cortisol and growth hormone are released into the organism during a massage session and they affect metabolism, mood, body temperature, the pituitary, thyroid, parathyroid, adrenal, pancreas, reproductive glands, as well as kidneys, liver, heart and gonads. For example, high cortisol levels, associated with depression, are reduced while serotonin levels increase. More than 12 studies, mentioned in the Journal of Clinical Psychiatry in 2010, indicate that massage reduces anxiety levels, as well as symptoms of depression, up to 50%.
Immune system. Massage enhances lymphocyte production, resulting in heightened immune response. Researchers in Cedars-Sinai’s Department of Psychiatry and Behavioral Neuroscience carried out a study with 29 participants. The results showed that a 45-minute session of deep-tissue Swedish massage decreases cortisol levels, while it increases white blood cells.
Muscles. Another research, published in “Science Translational Medicine
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Common Myths and Truths About Food
It seems that a new study or experiment comes out on a weekly basis, claiming to expose a common food ingredient or simply to support a new fad diet. How do you if the claims are true, or if you’re being fed myths?
It all comes down to due diligence. When you hear the latest claim, check out the scientific basis of the study and who was behind it. If McDonald’s comes out with a study that proves eating burgers all day is good for you, you may want to approach with a little caution.
The following claims are some of the most common, with some having just hit the scene while others have been around for what seems like centuries. Each can either be debunked or proven with just a little bit of research – check out the results below.
Claim: Carrots Improve Your Eyesight
Reality: Myth (At Least in the Way You Think)This is probably one of the most widely believed myths out there. It’s rare to find a child who wasn’t encouraged to eat their carrots while at the dinner table, with improved vision as the promise. Sadly, the dream of developing x-ray vision just like Superman simply never came true.
It’s easy to see why this myth has endured. Carrots are packed with beta carotene (aka Vitamin A), which is known to improve overall eye health. However, having healthy eyes doesn’t translate to 20/20 vision.
Carrots will improve your vision if you’re highly deficient of Vitamin A. And carrots aren’t the only vegetable that can help you boost your intake – broccoli, pumpkin, and most leafy greens can do the job equally well.
Claim: Peanut Butter Makes You Fat
Reality: MythDieters these days are so obsessed with numbers that they don’t look at ingredients. This has unfairly lumped peanut butters in the ‘it makes you fat’ camp. While it’s true that peanut butter contains fat, it’s also the case that it comes packed with the good kind of fat. Monounsaturated fat will actually help keep your heart healthy, as illustrated by Harvard Medical School.
Not only that, peanut butter also delivers a range of other benefits. For instance, you can protect yourself from developing benign breast disease. You’re also less likely to develop type-2 diabetes. Just make sure you get the good kind– avoid added fat or sugar if you can.
Claim: Aspartame Causes Cancer
Reality: MythAspartame and other artificial sweeteners are found in most diet drinks – it’s likely that if you don’t for the full-sugar version, you’re ingesting a hefty dosage of aspartame instead. The debate on whether it causes healthy problems is one of the most controversial.
The fact is that there is no conclusive evidence. Most studies conducted thus far have not shown any links between cancer and the artificial sweetener. Studies that purportedly do establish causation simply do not have a large enough data set or have other inconsistencies.
So should we discard the warnings and continue drinking diet sodas? We wouldn’t advise it, especially if you’re consuming soft drinks in large quantities – overdoing anything is never a good thing.
Claim: Eat Fish to Boost Your Brain
Reality: TruthCan fish really boost your brainpower? Yes, This is particularly applicable in those of us who are getting a bit long in the tooth. This study from Chicago’s Rush University Medical Center highlights the abundance of links between cognitive performance and the regular consumption of fish, including a 60% risk reduction of developing Alzheimer’s disease.
So if you’re suspecting your brain of feeling the knocks of old age, try and add fish to your diet. Once a week is enough to make a difference. Considering the overall benefits of fish anyway, there’s no reason not to include it in your menu.
Research Your Food
Before you take our claims and run with them, do your own research and verify the studies yourself. It’s all about knowing what you’re adding to your diet and being aware of the benefits and downsides of a particular food item. Don’t believe hype or unfounded claims – always look for the numbers and the scientific proof before buying into the next fad.
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The Health Risks of Energy Drinks
The slim-lined cans promise an energy hit that will have you flying through your day of study, work or play. Energy drinks are now a popular choice for teenagers and young adults as opposed to a good old cup of coffee. One study found energy drinks are consumed by 30-50% of adolescents and young adults (Seifert SM, Schaechter JL, Hershorin ER and Lipshultz SE). But do these fizzy, sugary and caffeine-loaded “supplements
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Changing Time Zones: The Health Effects of Jet Lag
As a human race, we have only been able to cross such large distances and multiple time zones in the past century. Before commercial flights were a common way of travelling overseas, we would have been able to cope with changing time zones better during a lengthy voyage by sea.
Besides the lack of hydration, uncomfortable seating position and questionable food we are subjected to during an economy flight, the main reason why jetlag catches up on us is to do with our circadian rhythm being desynchronised. Until we evolve to adapt to frequent travel between time zones, this cannot be ignored.
Time Zones A lot of our body’s physiology is regulated by neurotransmitters that can be classified as amino acids, peptides and monoamines. One example of a monoamine is melatonin, which is affected by sunlight over a 24-hour period (circadian rhythm). A disruption in this circadian rhythm can profoundly affect body temperature, digestion, heart rate, blood pressure, hormones and state of mind (source –The State Government of Victoria).
Naturally corresponding with the amount of hours in the day, there 24 time zones around the world. It has been documented that travelling over two time zones will have a marginal effect to a person’s circadian rhtyhm but travelling over any more than three can cause desynchronisation to a substantial degree (source – Reilly T).
The Effects
Travelling west will also make jetlag easier to recover from due to the circadian rhythm being temporarily prolonged to about 27 hours, making it easier for the body to adapt (Reilly T). When experiencing a shift of any more than 12 time zones however, travelling east or west does not make a difference. That would be the equivalent of flying from Adelaide to Sao Paulo, Brazil. It would be hard not to pull up a bit rough after a marathon flight such as that.
After travelling east, it is also common for people to have trouble getting out of bed at a normal time in the morning while flying back from the west will result in waking up before dawn (Libassi L, Emad YA).
Suffering from jet lag may be inconvenient for someone coming back from a holiday or the occasional business trip but it can have further implications for those travelling more regularly as a part of their day-to-day lifestyle.
According to Centers for Disease Control and Prevention (CDCP), the amount of days jet lag could last for can be calculated.
In the United States, where sporting teams could experience up to four different time zone changes on a flight to an away game, the overall effect of disrupted circadian rhythms to the whole team can impact results and change the course of a season.
A three-year study on 19 North American Major League Baseball (MLB) teams found the home team could expect to score 1.24 more rune than usual when the visitor had just completed eastward travel. Home teams also scored 0.62 more runs during the day than the night (source – Recht LD, Lew RA, Schwartz WJ).
A more recent 10-year study found MLB teams that travelled through three time zones have as much as a 60% chance of losing their first game upon arrival (Winter WC, Hammond WR, Green NH, Zhang Z, Bliwise DL).
Jet lag can no doubt take its toll for sporting teams and businessmen who must travel as part of their job but there usually is a period of rest for the body to recover from crossing multiple time zones. Cabin crew members on international flights regularly do this more than anyone with as little as two days break before their next flight.
A study on 62 experienced female cabin crew members found increased secretion of the stress hormone, cortisol, and impaired nonverbal cognitive processing for cabin crew members who travelled on more transmeridian flights with less days off. The results showed the body could not even adapt to the stress of jet lag with some participants having as much as four years experience in the field (Cho K, Ennaceur A, Cole JC, Suh CK).
Another study on 45 female flight attendants and 26 teachers confirmed the variability in melatonin production as high as 25% was twice as likely to be associated with flight attendants (Blosser F).
The Treatment
As mentioned previously, melatonin is a key factor for regulating sleep. It also promotes the release of antioxidant enzymes and can act as a defense against free radicals (Rodriguez C, Mayo JC, Sainz RM, Antolín I, Herrera F, Martín V, Reiter RJ).
Available as a 2mg prescription tablet in Australia, melatonin can help combat jet lag easily and with minimal side-effects. Although, the Therapeutic Goods Administration does not advise taking melatonin in combination with alcohol, Thioridazine and Imipramine, and benzodiazepine or other hypnotics.
Nine out of ten randomised trials on airline passengers, airline staff and military personnel crossing five or more time zones saw decreased jet lag symptoms in subjects when melatonin was taken one hour before the destination bedtime (10pm to midnight). Doses of melatonin closer to 5mg were seen to be significantly more effective than a slow-release 2mg dose (Herxheimer A, Petrie KJ).
Adjusting to a new time zone before arrival, known as preentrainment, can be another way of dealing with jet lag. This is to do with our chronosense, a biological response to light generated by the suprachiasmatic nucleus that can be active even in blind newborn babies (Sernagor E).
Circadian rhythm labeled A study on 28 participants trialled a three-day treatment of exposing differing amounts of light in the first 3.5 hours of waking, advancing normal wake time by one hour each day. Participants who received the greatest amount of bright light over the three days experienced a phase shift of nearly two hours, which can be particularly helpful for those travelling east and arriving in the morning (Burgess HJ, Crowley SJ, Gazda CJ, Fogg LF, Eastman CI)
The disadvantage of this treatment is the inconvenience of being exposed to bright light and still carrying out normal morning duties.
Another study from the same research team combined morning bright light exposure with afternoon doses of melatonin over three days before a flight. Participants experienced a phase advancement of nearly 2.5 hours and no jet lag symptoms with a 0.5mg dose of melatonin and alternating exposure of bright and dim light for 30 minutes (Revell VL, Eastman CI).
Previously, the typical method of dealing with jet lag would be drinking yourself to sleep on the flight followed by a stupendous amount of coffee consumed on arrival. The health implications of these methods are obviously detrimental. Until we make genetic advances to cope with jet lag however, the other options available today are safe and effective for returning back to your regular time zone.
Images courtesy of visual.dichotomy, Will Fisher and Wikimedia. -
Alternative therapies – the facts
People have been using alternative therapies for thousands of years, long before scientific-based medicine became the norm. Defined as any form of medical treatment not covered by top medical school courses, alternative therapies come under many guises, from acupuncture and chiropractic to homeopathy and naturopathy.
Many people will only use alternative therapies whereas others believe in a complementary approach, whereby elements of conventional and alternative therapies are used to get the desired result.
Are alternative therapies a safe and effective choice? Here are the facts.
Types of alternative therapies
There are dozens of types of alternative therapies, which range from practitioner-based to therapies that can be completed in the home. Many of these therapies are closely aligned with each other, whereas others have very different thoughts and methods of diagnosis and treatment.
Some of the more common types of therapies used in the developed world, as listed by the National Centre for Complementary and Alternative Medicines, include acupuncture, hypnosis, diet-based therapies (e.g. Atkins diet, South Beach diet), massage, meditation, naturopathy, yoga, chiropractic and energy healing therapy.
Alternative therapies today
In an American study, the 2007 National Health Interview Survey, it was found that 38 per cent of adults and 12 per cent of children had used some form of complementary or alternative therapy in the 12 months prior to the survey.
Additionally, the survey found that Americans had spent $33.9 billion on alternative therapy services and products. As an increasing amount of funding is put into researching the benefits of alternative therapies, more people, including medical doctors, are taking it seriously.
As an example of the effects that research can have on the uptake of an alternative medicine in the general public, in 2002 the most commonly used natural product was echinacea. By 2007, echinacea had dropped to third place and omega 3 fish oil use had drastically increased. This came after several positive studies proved the benefits of fish oil and the mainstream media jumped on it (NCCAM, 2008).
What can alternative therapies help with
Alternative therapies can offer relief from a wide range of health problems, and can also assist in the prevention of illness. While many of the types of alternative therapies can offer a very broad spectrum of health benefits (e.g. naturopathy), others are much more specific (e.g. chiropractic for spine-related pain relief)
The most commonly used alternative therapies are used to treat back and neck pain, largely through the use of a chiropractor. Arthritis, anxiety, insomnia and head or chest colds are also on the list of commonly treated illnesses. (NCCAM, 2008).
Scientific evidence
The main problem that has always inhibited the large-scale uptake of alternative therapies is the lack and quality of scientific evidence. Instead, a lot of the claims made by providers of services and products are anecdotal.
The popularity of alternative therapies in recent years has demanded for a more serious, scientific look into their benefits. In a positive move for the industry, the National Centre for Contemporary and Alternative Medicines (NCCAM) was established in 1999 to help fund detailed scientific-based research into the safety and efficacy of alternative and complementary therapies.
Since then, a range of therapies have been endorsed and scientifically proven. For example, several studies into the benefits of chiropractic therapy found that spinal manipulation could provide mild-to-moderate relief from low-back pain and was proven to be as effective as conventional medical treatments (Rubinstein et al, 2011).
Additionally, women are turning to acupuncture as a fertility and miscarriage prevention treatment, even more so now after scientific evidence has proven it helpful. Manheimer et al (2008) found that women who are using IVF treatment could benefit from the use of specialist fertility acupuncture.
5 Quick facts about alternative therapies
- Between 60 and 80 per cent of the world’s population rely on alternative therapies as their primary choice of health care (World Health Organization, 2005)
- Almost 20 per cent of Fortune 500 companies offer alternative therapies as part of their health care packages for employees
- The National Institute of Health (NIH) currently invests about $40 million per year in complementary and alternative medicine related research (NCBI, 2012)
- Studies have shown that regular yoga practice can improve a variety of health problems including back pain, headaches and stress, as well as improve quality of life (Lipton, 2008)
- Omega 3 is the most commonly used natural product among adults in the United States, followed by glucosamine and echinacea (NCCAM, 2008)
Additional Sources:
http://www.sciencebasedmedicine.org/the-facts-of-the-alternative-medicine-industry/http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=85
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Advances in health technologies: Saunas
For many, saunas are the epitome of health and wellbeing luxury. Originating in Scandinavia, they are now a staple in day spas and gyms around the world.
However, new health technologies are coming out all the time, many offering similar health benefits to saunas but often at inflated prices. The question is, are we better off sticking to the tried and tested benefits of saunas or should we be seeking out more advanced technologies? Here are the facts.
Health benefits of saunas
With a sauna’s dry heat reaching temperatures of around 80C, pushing skin temperature up to 40C within minutes, are these warm, cosy rooms actually good for you?
Studies by naturopathic physician, Dr Walter Crinnion, showed that sauna-induced sweating can help to lower blood pressure and assist with a range of chronic and acute health problems.
Sauna therapy for chronic heart failure
Several researchers and health practitioners praise the benefits of sauna therapy for a range of health problems.
A study by Takashi Ohori (2011) and colleagues found that repeated sauna use could help patients with chronic heart failure. Heart failure occurs when the heart can’t pump enough blood around the body, resulting in fatigue and shortness of breath. Saunas help to increase the heart’s ability to pump blood.
Common cold prevention
A study by Ernst et al (1990) found that regular sauna use could probably help reduce the prevalence of the common cold. Although the authors concluded that more research was necessary, it was a good step forward in potentially preventing the thousands of deaths that occur each year from the common cold, most of which are elderly patients.
Weight loss
There are varying opinions on the benefits of saunas for weight loss. Most people will lose approximately one pint of sweat during an average sauna session, which can give the illusion of almost immediate weight loss. However, this weight will go back on as soon as you consume any food or fluids (JAMA, 1981).
However, it can cause weight loss in another way. When the body is exposed to high heats, it causes the pulse rate to increase by 30 per cent or more. This causes an increase in metabolism, resulting in more calories being burned per minute than if you were sitting in front of the television, for example (Harvard University, 2005).
Your increased metabolic rate will also continue after the sauna should you then exercise, meaning a better result from a workout.
Muscle pain relief
When put in a warm environment, a body’s blood circulation is increased causing strained muscles to relax. After a workout, the heat of a sauna can help relax muscles and prevent the buildup of lactic acid and potential strains.
Flushes toxins
Toxins can build up in our bodies over time and one of the best ways to remove them is through deep sweating. While normal sweating will contain almost only water, deep sweating, which can be achieved in a sauna, may allow the release of chemicals such as lead, copper, zinc, nickel and mercury. These toxins get into the skin just by being surrounded by our everyday environment.
However, some argue that although you sweat a lot in a sauna, the toxins stay in the body. Professor Donald Smith from the University of California said that almost all toxins are excreted through urine and feces, and only 1 per cent through sweat (LA Times, 2008).
Neck and head pain reduction
New Zealand researchers found that saunas could help ease neck and head pain in chronic sufferers. The study, led by Dr Giresh Kanji, concluded that not only could sauna sessions minimise the intensity of a headache, but could shorten its duration too.
In his analysis, Dr Kanji said that saunas could be more effective than painkillers as they helped to treat the cause of the pain rather than mask it.
Additional Sources:
http://www.finnleo.com/pages/health-and-wellness.aspx#q4
http://www.globalhealingcenter.com/natural-health/7-dangers-of-the-sauna/
http://informahealthcare.com/doi/abs/10.3109/07853899009148930
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Hopeful results in latest HIV vaccine trial, but many hurdles to overcome yet
A HIV vaccine, known as SAV001-H has shown promising results in an early clinical trial, with no adverse effects reported and importantly, a significant increase reported in HIV specific antibodies in participants who received the vaccine. In this trial, 33 HIV positive participants were randomly allocated to one of two groups: half into a treatment group receiving the vaccine and half into a placebo group who did not receive the vaccine. The participants were followed up at regular periods, testing safety of the vaccine and antibody response over a one year period. The vaccine has been developed by Dr C. Yong Chan and his team at the University of Western Ontario and has been licensed for commercialisation by the biotechology company Sumagen.
This is welcome news for a disease which killed an estimated 1.7 million people in 2011 (WHO, 2013). Furthermore, there are an estimated 34 million people around the world living with HIV/AIDS, and the disease continues to have a devastating impact in Sub-Saharan Africa where up to a quarter of the population in countries such as Botswana, Lesotho and Swaziland are infected (WHO 2013; UNAIDS 2013). While great strides in treatment of HIV; via the development of antiretroviral (ART) medications, have been made by extending the time it takes for HIV to develop to AIDS, ART treatment is not yet available to all, particularly in the poorest nations; and of course, treatment is much less optimal then prevention of HIV in the first place.
Worldwide adult HIV Prevalence (Click for larger) The long road to effective HIV vaccines
However development of successful HIV vaccines has proven to be highly elusive, due in part to the rapid mutation rate of HIV, these mutations generating a diverse population of quasi-species of HIV over the length of the infection period – the immune system, itself the target of HIV, is simply not able to keep up (Ackerman and Alter, 2013). This immense genetic diversity of HIV has meant that targeting HIV with effective, universal vaccines has been particularly difficult.
This leads to a cautionary note that must be taken regarding SAV001-H; this was a small, very early trial of this particular HIV vaccine. These early trials are referred to as Phase 1 trials, meaning that its primary focus was on assessing the safety of vaccine, with efficacy or effectiveness assessed only as a secondary objective (see graphic, below). Phase 2 and 3 trials are planned next and it is these trials which are particularly focused on assessing the effectiveness of the vaccine to prevent HIV infection in large numbers of HIV negative participants at high risk of contracting HIV. Furthermore, other promising HIV vaccines have passed through early Phase 1 trials, only to show in later trials no significant efficacy. An example of this was a highly anticipated STEP trial, which was a large Phase 2 trial enrolling 3,000 high risk individuals randomised into a vaccine or placebo group. The vector based vaccine used in this trial failed to show any effect on reducing risk of infection and indeed those receiving the vaccine appeared to be at greater risk of contracting HIV (HTNV, 2013).
Clinical trial phases Thus some of the early media reports for SAV001-H which have been mentioning ‘eradication’ are very premature and paying scant heed to the long (and sometimes disappointing) road that this vaccine must pass through with its coming Phase 2 and 3 trials, as demonstrated above with the example of the STEP HIV vaccine trial. These promising early results from this latest HIV vaccine trial must be tempered by the historical difficulties in conducting successful HIV vaccine trials.
Cautious optimism
Despite the very real need for caution at this early stage, there are several reasons why many in the health community are particularly optimistic about SAV001-H. This optimism is largely due to the fact that SAV001-H takes a new approach to HIV vaccine design as it uses whole killed HIV viruses. Previous HIV vaccine strategies have used other strategies such as subunit vaccines which basically introduce important proteins (called antigens) to the body to induce a specific immune response, or vector based vaccines to introduce genetic material from the HIV virus via another ‘carrier’ virus; both approaches proving disappointing so far (Sumagen, 2013).
HIV structure: gp120 and gp41 are essential in fusion to immune cells and subsequent invasion For SAV001-H, the HIV-1 virus is genetically engineered by deleting the activity of specific genes involved in the disease causing process (pathogenicity) and then chemically treated and bombarded with gamma radiation to disable its ability to multiply within human cells (virulence) (Sumagen, 2013). This way, the immune system will still detect and mount a response against the invading virus, but the virus is no longer able to cause disease. The early data from the Phase 1 trial are particularly encouraging as it has been reported that vaccination with SAV001-H produced large increases in two particular antibodies specific for the p24 envelop antigen and gp120 surface antigens of HIV-1 (Western News, 2013).
While gaining plenty of attention, SAV001-H is only one of multiple vaccines in development; a major focus of several other research efforts, are vaccines designed to induce potent antibodies, known as broadly neutralizing antibodies (bNAbs), that are able to potentially block HIV infection (Korber and Gnanakaran, 2011). Promising early research into vaccines that may be able to effectively induce these bNAbs and provide effective immunity against HIV infection have provided another boost to HIV vaccine development efforts. So there is certainly reason to be hopeful about SAV001-H, but we need to mix this hope with a healthy dose of caution at this stage. Also, it is worth noting that any effective HIV vaccines will likely be just one, albeit very important, part in a multitude of preventative strategies, including sex education, male circumcision, microbiocide gels and prophylactic antiretroviral therapies which will result in the effective prevention of HIV infections worldwide.
Sources:
1. World Health Organisation. HIV Data and Statistics [Online]. Available at: http://www.who.int/hiv/data/en/
2. United Nations AIDS (UNAIDS). AIDS Information by country [Online]. Available at: http://www.unaids.org/en/dataanalysis/datatools/aidsinfo/
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All images sourced from public domain (Wikimedia)
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Pacific plant could be good news for anxiety sufferers
A clinical study on kava, a Pacific plant, has found that it has properties which could be extremely useful in treating the symptoms of anxiety. The plant has been used recreationally in Pacific societies, in places like Polynesia and Hawaii, for a long time but this is apparently the first proper clinical study of the plant.
Now, I must admit, I’m writing this story because I have some anecdotal experience with kava (piper methysticum) myself. Simply, I’ve been an insomniac on and off for most of my adult life. It can be an inconvenience, but I mostly have it under control. Of course, I’ve tried numerous different things to ease the insomnia, with varying degrees of success – but kava was always one of the best. That is, before it became unavailable to buy here in the UK.
This latest study, led by researchers at the University of Melbourne certainly seems to support the plant’s apparent calming ability. It may prove to be very useful to the significant numbers of people, both in Australia and worldwide, who suffer from anxiety disorders.
Anxiety is a more common problem than many people may think. In particular, generalised anxiety disorder (GAD) is a blight to millions of people around the world; in Australia, 3% of people suffer from GAD, and the numbers are similar in North America and parts of Europe, with estimates in the UK being as high as one in 20. Over the past decade, I’ve known a huge number of people who suffer from anxiety, and unfortunately, treatments for this type of disorders are far from straightforward.
“Based on previous work we have recognised that plant based medicines may be a viable treatment for patients with chronic anxiety,” explained lead researcher Jerome Sarris at the University of Melbourne’s Department of Psychiatry, who believes that new an more effective options are needed for patients with anxiety, instead of the existing medications. Sarris stressed the complexity of GAD and the way it can significantly affect the daily lives of those who suffer from it, continuing to add that, “In this study we’ve been able to show that Kava offers a potential natural alternative for the treatment of chronic clinical anxiety. Unlike some other options it has less risk of dependency and less potential for side effects.
