Increased use of antibiotics may predispose to Parkinson’s disease

Higher exposure to commonly used oral antibiotics is linked to an increased risk of Parkinson’s disease according to a recently published study by researchers form the Helsinki University Hospital, Finland.

The strongest associations were found for broad spectrum antibiotics and those that act against against anaerobic bacteria and fungi. The timing of antibiotic exposure also seemed to matter.

The study suggests that excessive use of certain antibiotics can predispose to Parkinson’s disease with a delay of up to 10 to 15 years. This connection may be explained by their disruptive effects on the gut microbial ecosystem.

“The link between antibiotic exposure and Parkinson’s disease fits the current view that in a significant proportion of patients the pathology of Parkinson’s may originate in the gut, possibly related to microbial changes, years before the onset of typical Parkinson motor symptoms such as slowness, muscle stiffness and shaking of the extremities. It was known that the bacterial composition of the intestine in Parkinson’s patients is abnormal, but the cause is unclear. Our results suggest that some commonly used antibiotics, which are known to strongly influence the gut microbiota, could be a predisposing factor,” says research team leader, neurologist Filip Scheperjans MD, PhD from the Department of Neurology of Helsinki University Hospital.

In the gut, pathological changes typical of Parkinson’s disease have been observed up to 20 years before diagnosis. Constipation, irritable bowel syndrome and inflammatory bowel disease have been associated with a higher risk of developing Parkinson’s disease. Exposure to antibiotics has been shown to cause changes in the gut microbiome and their use is associated with an increased risk of several diseases, such as psychiatric disorders and Crohn’s disease. However, these diseases or increased susceptibility to infection do not explain the now observed relationship between antibiotics and Parkinson’s.

“The discovery may also have implications for antibiotic prescribing practices in the future. In addition to the problem of antibiotic resistance, antimicrobial prescribing should also take into account their potentially long-lasting effects on the gut microbiome and the development of certain diseases,” says Scheperjans.

The possible association of antibiotic exposure with Parkinson’s disease was investigated in a case-control study using data extracted from national registries. The study compared antibiotic exposure during the years 1998-2014 in 13,976 Parkinson’s disease patients and compared it with 40,697 non-affected persons matched for the age, sex and place of residence.

Antibiotic exposure was examined over three different time periods: 1-5, 5-10, and 10-15 years prior to the index date, based on oral antibiotic purchase data. Exposure was classified based on number of purchased courses. Exposure was also examined by classifying antibiotics according to their chemical structure, antimicrobial spectrum, and mechanism of action.

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Materials provided by University of Helsinki. Original written by Comms-Meilahti. Note: Content may be edited for style and length.

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Filaments that structure DNA

They play a leading role not only in muscle cells. Actin filaments are one of the most abundant proteins in all mammalian cells. The filigree structures form an important part of the cytoskeleton and locomotor system. Cell biologists at the University of Freiburg are now using cell cultures to show how receptor proteins in the plasma membrane of these cells transmit signals from the outside to actin molecules inside the nucleus, which then form threads. In a new study, the team led by pharmacologist Professor Robert Grosse uses physiological messengers to control the assembly and disassembly of actin filaments in the cell nucleus and shows, which signaling molecules control the process. The results of their study have been published in the latest Nature Communications.

“It was previously unknown just how a hormone or agent induces the cell to begin filament formation in the intact cell nucleus,” Grosse says. Back in 2013, he discovered that actin threads were formed in the nucleus when he exposed cells to serum components. In the nucleus, actin usually occurs as a single protein. It only forms filaments when a signal is given. Actin filaments resemble a double chain of beads and create possible anchor points or pathways for the structures in the cell nucleus. They give the DNA structure — for example, determining how densely packed the chromosomes in the form of chromatin are. This influences the readability of the genetic material. “What we have here is a generally valid mechanism that shows how external, physiological signals can control the cytoskeleton in the nucleus and reorganize the genome in a very short time,” Grosse explains.

Grosse is familiar with the signaling pathway that reaches into the nucleus, known as the G-protein-coupled receptor pathway. Agents, hormones, or signal transmitters bind these receptor types at the cell membrane, which is a target for a large number of clinical drugs. The receptor initiates a calcium release in the cell via a signaling cascade. The team then shows that intracellular calcium causes filaments to be formed on the inner membrane of the cell nucleus. In the study, they used fluorescence microscopy and genetic engineering methods to show how actin filaments appeared in the nucleus after physiological messengers such as thrombin and LPA bound to G-protein-coupled receptors.

In the research project within the University of Freiburg excellence cluster CIBSS — Centre for Integrative Biological Signalling Studies, Grosse is now investigating the more exact processes in the cell nucleus. “My team in Freiburg wants to find out in detail how filament formation influences the readability of the genetic material and what role the inner cell nucleus membrane plays in this process.”

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Materials provided by University of Freiburg. Note: Content may be edited for style and length.

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Dangerous bacteria communicate to avoid antibiotics

A bacterial infection is not just an unpleasant experience — it can also be a major health problem. Some bacteria develop resistance to otherwise effective treatment with antibiotics. Therefore, researchers are trying to develop new types of antibiotics that can fight the bacteria, and at the same time trying to make the current treatment with antibiotics more effective.

Researchers are now getting closer to this goal with a type of bacteria called Pseudomonas aeruginosa, which is notorious for infecting patients with the lung disease cystic fibrosis. In a new study, researchers found that the bacteria send out warning signals to their conspecifics when attacked by antibiotics or the viruses called bacteriophages which kill bacteria.

‘We can see in the laboratory that the bacteria simply swim around the ‘dangerous area’ with antibiotics or bacteriophages. When they receive the warning signal from their conspecifics, you can see in the microscope that they are moving in a neat circle around. It is a smart survival mechanism for the bacteria. If it turns out that the bacteria use the same evasive manoeuvre when infecting humans, it may help explain why some bacterial infections cannot be effectively treated with antibiotics’, says researcher Nina Molin Høyland-Kroghsbo, Assistant Professor at the Department of Veterinary and Animal Sciences and part of the research talent programme UCPH-Forward.

One United Organism

In the study, which is a collaboration between the University of Copenhagen and the University of California Irvine, researchers have studied the growth and distribution of bacteria in petri dishes. Here, they have created environments that resemble the surface of the mucous membranes where an infection can occur — as is the case with the lungs of a person with cystic fibrosis.

In this environment, researchers can see both how bacteria usually behave and how they behave when they are affected by antibiotics and bacteriophages.

‘It is quite fascinating for us to see how the bacteria communicate and change behaviour in order for the entire bacterial population to survive. You can almost say that they act as one united organism’, says Nina Molin Høyland-Kroghsbo.

Possibility of Blocking

The Pseudomonas aeruginosa bacteria are such a big problem that they are found in the top category ‘critical’ in the World Health Organization’s list of bacteria, where new types of antibiotics are most urgently needed. Therefore, the researchers are excited to make new discoveries about the ways in which this type of bacteria behaves and survives.

‘Infections with this type of bacteria are a major problem worldwide with many hospitalisations and deaths. That is why we are really pleased to be able to contribute new knowledge that can potentially be used to fight these bacteria’, says Nina Molin Høyland-Kroghsbo.

However, she emphasises that it will still take a long time for the new knowledge to result in better treatment. The next step is to research how to affect the bacteria’s communication and warning signals.

‘This clears the way for the use of drugs in an attempt to prevent that the warning signal is sent out in the first place. Alternatively, you could design substances that may block the signal from being received by the other bacteria, and this could potentially make treatment with antibiotics or bacteriophage viruses more effective’, concludes Nina Molin Høyland-Kroghsbo.

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Health24.com | Could omega-3 be a remedy for some kids with ADHD?

Children with attention-deficit/hyperactivity disorder (ADHD) and low blood levels of omega-3 fatty acids might benefit from supplements, new research suggests.

Fish oil supplements appeared to boost attention in these kids, British researchers report.

Early, but promising results

The effect seemed limited to youngsters who weren’t already getting enough omega-3 in their diets, however.

Prior research by the same team of investigators found that children with omega-3 deficiency are more likely to have more severe ADHD.

“Our results suggest that fish oil supplements are at least as effective as conventional pharmacological treatments among those children with ADHD who have omega-3 deficiency,” said co-lead researcher Jane Chang. She’s at the Institute of Psychiatry, Psychology & Neuroscience, at King’s College London.

One ADHD specialist working in the United States said the work is early, but promising.

“Omega-3 fatty acids have been studied to determine their efficacy in this population in the past, and the results have been equivocal,” said Dr Victor Fornari, vice-chair of child & adolescent psychiatry at the Zucker Hillside Hospital in Glen Oaks, New York.

A ‘preferable option’

Although “further work needs to be done,” Fornari said, “this may be a promising treatment for a subset of youth with ADHD.”

The British study included 92 children with ADHD, aged 6 to 18, who were given high doses of the omega-3 fatty acid EPA (eicosapentaenoic acid) or a placebo for 12 weeks.

Those with the lowest blood levels of EPA before the study had improvements in focused attention and vigilance after taking the supplements, but these improvements didn’t occur in children with normal or high blood levels of EPA.

According to senior researcher Carmine Pariante, also at King’s College London, “The omega-3 supplements only worked in children that had lower levels of EPA in their blood, as if the intervention was replenishing a lack of this important nutrient. For those children with omega-3 deficiency, fish oil supplements could be a preferable option to standard stimulant treatments,” she said in a school news release.

But the researchers cautioned that children with high blood levels of EPA before the study actually had a worsening of impulsivity symptoms after taking the supplements.

That’s why parents should consult with medical professionals before giving their children high-dose fish oil, Chang said.

Lower than average EPA

“It is possible to have too much of a good thing, and parents should always consult with their children’s psychiatrists since our study suggests there could be negative effects for some children,” Chang added.

The researchers also stressed that their study looked at data from children in Taiwan, where diets tend to be higher in fish than in Western nations.

Most studies of children with ADHD have been conducted largely in Western countries, and have found average blood levels of EPA that are lower than in this new study.

Co-lead researcher Kuan-Pin Su, of China Medical University in Taichung, Taiwan, said that “it is possible that EPA deficiency is more common among children with ADHD in countries with less fish consumption, such as in North America and many countries in Europe, and that fish oil supplementation could therefore have more widespread benefits for treating the condition than in our study.”

The study was published online in Translational Psychiatry.

Image credit: iStock

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Health24.com | Doctors spot a new, severe lung illness tied to vaping

Canadian researchers have reported a new twist on the spate of deaths and lung damage from vaping in the United States.

A 17-year-old boy may well be the first case of a novel type of lung injury from vaping. The condition is similar to “popcorn lung”, which is seen in workers exposed to the chemical flavouring diacetyl, an ingredient used to produce microwave popcorn, researchers said.

Several toxic compounds

When inhaled, the chemical causes inflammation and obstruction of the small airways in the lungs.

“The type of lung injury our patient suffered is different from the pattern of injury seen in the outbreak of cases in the US, meaning that there is more than one way vaping can harm the lungs,” said lead researcher Dr Karen Bosma, an associate scientist at the Lawson Health Research Institute in London, Ontario.

“We don’t know for certain what chemical or ingredient is causing the problem, but we do know that several compounds found in e-liquids can be toxic when inhaled, so no vaping products can be considered free of risk,” she said.

In this Canadian case, the teen came down with a life-threatening case of bronchiolitis after a week of persistent coughing. The boy was hospitalised and put on life support.

Bosma’s team suspected that the problem was related to flavoured e-cigarettes. Indeed, the family said their son had regularly used flavoured e-liquids including those that contained THC, the active ingredient in marijuana.

The boy’s condition was so serious that his doctors referred him to a lung transplant centre.

A warning to others

Although the teen avoided needing a lung transplant, his lungs were permanently damaged. He continues to recover and has sworn off e-cigarettes, marijuana and tobacco, the researchers said.

Vaping has health risks and the potential short and long-term effects of vaping remain unknown, Bosma said. Non-smokers, pregnant women and young people should not vape, she cautioned.

“The patient, his family and his health care team want to use his case as a warning to others,” Bosma said. “What happened to our patient could happen to anyone.”

The report was published in the journal CMAJ.

In the United States, the number of those stricken with a severe lung illness tied to vaping has reached 2 172, according to the US Centers for Disease Control and Prevention.

Cases have now been reported in every state except Alaska, the agency noted.

In September, President Donald Trump pledged to ban sale of most flavoured e-cigarettes in the United States. But the New York Times reported this week that under pressure from lobbyists and political advisers, Trump has not yet taken action, saying only that he wants to study the issue.

Unregulated products

Meanwhile, the US death toll from vaping-related lung illness stands at 42, spread across 24 states and the District of Columbia. Deaths have involved patients ranging from the ages of 17 to 75, with a median age of 52.

The CDC noted that more than 85% of cases involved products that contained THC.

Experts said an oily chemical known as vitamin E acetate appears to be involved, which is used in a variety of products, but when heated and inhaled it can cause severe lung damage.

“These are products that are not regulated with regards to the substances being inhaled,” explained Dr Albert Rizzo, chief medical officer of the American Lung Association.

While these compounds may be safe to swallow, they can become toxic and cause lung damage when they’re heated and inhaled as a vapour, he said.

People shouldn’t vape, Rizzo said. “If they don’t, they shouldn’t start. If they are vaping, they should stop because these products have not been evaluated by any regulatory agency in this country and there’s no evidence as to their safety or efficacy,” he said.

Image credit: iStock

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Cancer: One in five cancer diagnoses ‘in Emergency Departments’

Research shows that a quarter of bowel cancers and a third of lung cancer are diagnosed in this way.

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Health24.com | Would you reconsider your usual order if calorie counts were added to menus?

Calorie labels in fast-food restaurants appear to help customer trim purchases, but only up to a point, a new study says.

Customers ate slightly fewer calories after a fast-food chain started including calories on its menus, but the impact weakened over time, researchers found.

Mandatory calorie labelling

“Our findings suggest that calorie labelling may be most effective as a short-term strategy for reducing calorie purchases, but that other nutrition interventions may be necessary for long-term positive dietary changes in these settings,” said study lead author Joshua Petimar. He’s a research fellow at the Harvard Pilgrim Health Care Institute and Harvard Medical School.

In May 2018, calorie labelling on menus became mandatory for chains with 20 or more outlets in the United States. The goal was to help customers make healthier food choices.

However, effectiveness of this approach is unclear. Some studies have found associations between calorie labelling and calorie consumption, but most have been too small to identify differences before and after the introduction of calorie labelling on menus.

This new study is one of the largest to examine the issue, according to the researchers.

They assessed the impact of calorie labelling on food purchases by analysing three years of sales data from a franchise of fast-food restaurants in the southern United States.

A slight weekly increase

The franchise began providing calorie information on its menus in 2017. The researchers examined data from 2015–2018, ending up with information on nearly 50 million sales in the two years before and one year after the introduction of calorie labelling.

There was an initial decrease of 60 calories per sale (about 4%) after calorie labelling began, but that was followed by a slight weekly increase over the next year, according to the study.

“We recommend future research to estimate the effects of calorie labelling over a longer period, particularly once restaurants have had time to reformulate their menus,” Petimar said in an institute news release.

The study results are in the BMJ.

Image credit: unsplash.com

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