CDC Report Finds Increase In Reports Of Respiratory Illness In Children After Hurricane Katrina; New Orleans Mayor Pushes For City Residents To Leave

The number of children in the Gulf Coast region after Hurricane Katrina who complained of symptoms of bronchitis, pneumonia and other lower respiratory illnesses rose in the years after the storm, according to a 49-page CDC report released on Thursday, the Washington Post reports. CDC researchers developed the report based on an analysis of medical charts and interviews with 144 children ages two to 12 in Mississippi’s Hancock County who received treatment between August 2004 and August 2007 at the Hancock Medical Center and four physician clinics.

The report found the proportion of physician visits by children who displayed cold-like symptoms declined from 63% to 52%, while the rate of complaints of bronchitis-like symptoms rose from 22% to 31%. The report also found there were 414 total visits by the children to the five facilities in 2007 compared to 411 visits in 2004.

The study did not report data from 2006, the year after the storm, because there were severe community disruptions and damage to medical facilities in the state. A summary of the report stated, “Basic medical information systems in Hancock County were severely compromised … creating a particularly challenging environment for performing a retrospective investigation,” adding, “The nature and … effects resulting from these issues are unmeasured and remain unknown.”

The researchers noted that they could not determine the reasons or full validity of the study’s results due to several factors. Researchers did not know how many children lived in the county prior to the hurricane. In addition, the study included only children who experienced health problems before Katrina. Researchers also were unsure if the number of physician visits was affected by the announcement in February that travel trailers provided by the federal government to families who had been displaced by the hurricane had toxic levels of formaldehyde, which can cause respiratory and other health problems.

‘Broader Concerns’
According to the Post, the study’s “limited conclusions did not resolve broader concerns raised by health officials and pediatricians, who previously reported heightened complaints of breathing problems among children on the Gulf Coast after Katrina.”

Michael McGeehin, director of the CDC unit that developed the report, said the results of the study do not apply to children living in travel trailers and homes along the Gulf Coast region. He said, “I don’t want this study generalized,” adding, “The numbers were very small.” Ed Thompson, a Mississippi state health officer, said, “The issue of what, if any, effects did the hurricane — and the changes that occurred in its aftermath — have on the children of the Gulf Coast is one that we remain very much interested in.” Thompson also noted, “People whose children were not part of the study can’t draw any conclusions, positive or negative, from it,” adding, “It did not answer whether exposure to indoor air contaminants, including formaldehyde, has any effect on health” (Hsu, Washington Post, 5/9).

Trailer Move-Out
In related news, New Orleans Mayor Ray Nagin last week urged residents living in the nearly 5,700 federally issued temporary travel trailers in the city to move out of them amid concerns for their health and the approaching hurricane season, the AP/Kansas City Star reports. Nagin said, “We need to get everybody out,” adding, “We need to find out if anybody’s health has been harmed and how do we deal with that, and find the housing that’s necessary so these people can get their lives together.”

Andrew Thomas, a spokesperson for the Federal Emergency Management Agency, which provided the trailers, on Wednesday said that the agency will cooperate with parish officials and residents to determine their “long-term housing plan” and move people out of the trailers. However, Thomas said the agency is “not just going to take the trailer away because of a date on the calendar, if they’re making progress in getting back into their home” (Bohrer, AP/Kansas City Star, 5/7).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Asthma Through The Eyes Of A Medical Anthropologist

Asthma affects an estimated 8 percent of Americans, and about 300 million people around the world, but varying practices in diagnosis and treatment have global implications in understanding a widespread, chronic condition, says Van Sickle, who applies an anthropological approach to medicine.

“Since the major way to learn how many people have asthma is to ask them, external factors that alter those estimates have a major impact on our understanding of how widespread asthma is,” he says. “Yet local culture and conditions make these estimates subject to a great deal of error.”

Van Sickle, who joined an AAAS panel discussing the role of anthropology in medicine, researched asthma diagnosis and treatment in India for several years. In one project, he had doctors watch videos showing classic asthma symptoms wheezing, shortness of breath, waking up and coughing in the night.

“I asked, ‘If you saw this in the clinic, how would you describe it?’ and found very few of them used the term ‘asthma.’ Instead, many applied a label that was less stigmatized, more friendly, like ‘wheezy bronchitis.’”

When Van Sickle repeated the experiment in Wisconsin, “The physicians were much more likely to identify the signs and symptoms of asthma, and they applied a very different set of terms to describe the video scenes,” he says.

The difference in diagnostic practices may reflect different motivations. In India, Van Sickle says, “People resist being diagnosed with asthma for fear of being stigmatized. A diagnosis of chronic disease can impair a woman’s marital chances, and a physician is unlikely to make an unpopular diagnosis because one can always go down the street and get a different doctor. It’s a private medical marketplace, with many competing systems that include traditional medicine, which often market products for chronic diseases that western medicine cannot cure, but has little incentive for accuracy. The patient pays out-of-pocket, and there’s pressure on physicians to make the patient a satisfied customer.”

Physicians in high-income countries appear more likely to use the label of asthma for a variety of reasons, ranging from differences in the overall burden of respiratory disease to the structure of the health care system.

When Van Sickle looked at asthma management on Navajo reservations in Arizona and New Mexico, he found that extremely young children were expected to take preventive medications by themselves.

“In United States, the dominant approach to asthma is self-management,” he says. “People are expected to monitor and take care of asthma largely on their own. But in Navajo country, due to cultural ideas about individual autonomy, self-management means giving very young kids primary responsibility for managing the disease, and parents play a lesser role.”

Although that decision reflects Navajo traditions, Van Sickle says, “If kids are getting this responsibility, they need more training and education. But in the clinic, most doctors focus on the parent, not the child.”

Van Sickle says that rates of asthma reflect both the diagnostic habits of physicians and the differences in the actual frequency of disease. The origins of asthma have been tied to a host of risk factors, ranging from genes, allergy, viral infections and environmental conditions such as smoky fires. “It’s considered a ‘multifactorial’ disease, but I think that’s another way of saying we can’t fully explain the prevalence patterns or time trends,” he says.

A better understanding of the causes of the disease should emerge from better data about those with asthma and on under circumstances they develop asthma, Van Sickle says.

“Important differences in the incidence of asthma are built into different ways of life such as diet, environmental exposures and clinical practices and anthropology should be able to help us understand how to prevent and treat this disease,” he says. “I hope that my work can help make sense of the origins of asthma and the sizable differences in the rates of asthma across populations. Behavior and culture play major roles in the causation and treatment of many diseases, and anthropology is the study of culture and behavior.”

Source: University of Wisconsin-Madison

Future Climate Change Likely To Cause More Respiratory Problems In Young Children

More children will end up hospitalized over the next decade because of respiratory problems as a result of projected climate change, according to a new study from Mount Sinai School of Medicine. The abstract was presented on Sunday, May 3, 2009 at the Pediatric Academic Societies Annual Meeting in Baltimore, Maryland. The lead author of this research is Perry Elizabeth Sheffield, MD, Pediatric Environmental Health Fellow in the Department of Community and Preventive Medicine and the Department of Pediatrics at Mount Sinai School of Medicine. Mount Sinai worked with Natural Resources Defense Council and the Columbia University Mailman School of Public Health on this eye-opening research that finds a direct connection between air pollution and the health of children.

Ozone has many known negative respiratory health effects to which children are particularly vulnerable. An important projected consequence of climate change is the increase in ground-level ozone. Urban areas such as the New York City metropolitan area are at a higher risk of increasing temperature compared to rural areas. However, while more ozone is formed in higher temperatures, the downwind suburban areas are predicted in some of the models to experience higher ozone levels.

For this study, Dr. Sheffield and her colleagues created a model describing future projected rates of respiratory hospitalizations for children less than two years of age using baseline NYC metropolitan area hospitalization rates from publicly available corresponding state Department of Health databases. These hospitalization rates were then compared to a previously developed dose-response relationship between ozone levels and pediatric respiratory hospitalizations, and the expected New York City eight-hour daily maximum ozone levels for the 2020s, as projected by a regional climate model created by the NY Climate and Health Project, supported by a grant from the US Environmental Protection Agency. Two separate future scenarios were used. The two scenarios differed by the amount of projected ozone precursor emissions (chemicals that are converted to ozone by light and heat).

In both scenarios, ozone levels rise by 2020. The study found that by 2020, respiratory hospitalizations are projected to rise between four and seven percent for children under two years old because of projected air pollution (ozone) increases. The scenario with increased ozone precursors showed less of an overall increase in hospital admissions because of a paradoxical reduction in ozone due to the effects of air pollutant interactions, sometimes referred to as the scavenger molecule effect. These are likely conservative estimates because population was held constant, a single dose response function was used for the entire area, and most counties were not weighted by race and ethnicity. “These significant changes in children’s hospitalizations from respiratory illnesses would be a direct result of projected climate-change effects on ground-level ozone concentrations,” said Dr. Sheffield. “This research is important because it shows that we as a country need to implement policies that both improve air quality and also prevent climate change because this could improve health in the present and prevent worsening respiratory illness in the future.”

“Our study supports the necessity of improving air pollution around the world. We need to begin to make these improvements through industry emission controls, traffic reduction policies, and increased enforcement of traffic regulations,” said study co-author Dr. Philip Landrigan, Professor and Chair of Community and Preventive Medicine, and Director of the Children’s Environmental Health Center, at Mount Sinai School of Medicine.

About The Mount Sinai Medical Center

The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. The Mount Sinai Hospital is one of the nation’s oldest, largest and most-respected voluntary hospitals. Founded in 1852, Mount Sinai today is a 1,171-bed tertiary-care teaching facility that is internationally acclaimed for excellence in clinical care. Last year, nearly 50,000 people were treated at Mount Sinai as inpatients, and there were nearly 450,000 outpatient visits to the Medical Center.

Mount Sinai School of Medicine is internationally recognized as a leader in groundbreaking clinical and basic science research, as well as having an innovative approach to medical education. With a faculty of more than 3,400 in 38 clinical and basic science departments and centers, Mount Sinai ranks among the top 20 medical schools in receipt of National Institute of Health (NIH) grants.

Source: Mount Sinai Medical Center

Rice Researcher Sees Link To Cardiovascular Disease, Osteoporosis

A research project at Rice University has brought scientists to the brink of comprehending a long-standing medical mystery that may link cardiovascular disease, osteoporosis and perhaps even Alzheimer’s disease.

And for that, we can thank the rat.

The recent paper in Artery Research by Rice evolutionary biologist Michael Kohn and his team reports they have found that common rats with a genetic mutation have developed a resistance to rat poison, aka warfarin. That’s good news for the rats, but it comes at a price. The mutation also leaves them susceptible to arterial calcification and, potentially, osteoporosis.

The discovery is certainly good news for humans.

In the mutated gene, the researchers found what could be the link that solves the calcification paradox, the puzzling association between metabolic bone disease and vascular calcification that has eluded researchers for years. Kohn, an assistant professor of ecology and evolutionary biology, collaborated with Roger Price of the Baylor College of Medicine and Hans-Joachim Pelz of the Julius Kuehn Institute in Germany.

Kohn said a good part of the answer lies in the vitamin K cycle, which is known to regulate the coagulation of blood – clotting. It’s also suspected of helping keep calcium out of the body’s vessels and in its bones, which has particular ramifications for postmenopausal women for whom loss of bone density is a nagging issue.

Warfarin has long served humans as a medicine called coumadin, because it interferes with the vitamin K cycle. In regulated doses, it thins the blood by reducing its ability to clot, helping prevent heart attacks, stroke and blood clots.

In bigger doses, it once excelled as rat poison; rats that ingested the poison would simply bleed to death. But a mutation in the gene Vkorc1 effectively blocks that interference.

“I have a feeling the mutation predated the introduction of warfarin,” said Kohn. “But it was rare, because it causes side effects. It’s not an advantageous mutation unless it’s exposed to warfarin.”

Poisoning rats without the mutation killed them, while those with the mutation multiplied. “And these rats, in the absence of poison, suffer from cardiovascular disease — just like we do,” said Kohn, adding that the kidneys of rats in the study were “calcified to an extent that is shocking.”

His hope is that the equivalent gene in humans turns out to be the key to a number of ills.

“As you look at humans, this calcification of arteries is, I suspect, a very important precondition to thrombosis and stroke. So to find such a strong effect was shocking to us. We had a tough time publishing the paper because people might have thought it was too good to be true, that you can explain the effect to such a degree by looking at just one gene.”

Kohn and his colleagues have begun a study on osteoporosis in rats that have the mutation, and early results are promising. “The prediction is the mutant rats have a lower bone density. And I think if we complete and confirm that as well, it would be a major “breakthrough. That means one gene, one mutation, explains the so-called calcification paradox.”

Finally, he noted, Alzheimer’s patients tend to be vitamin K-deficient, which opens up avenues for further study. “Could there be one mutation that explains osteoporosis, arteriosclerosis and Alzheimer’s? That would be huge,” said Kohn.

“I think the pathway of the vitamin K cycle is underrated in terms of its importance to some of these diseases. Gas6 is a vitamin K protein expressed in the brain, and there are many more vitamin K-dependent proteins we don’t know about. The question is, if the recycling capability of the vitamin-K cycle is reduced, how many of these proteins can’t do what they’re supposed to do?

“I think we have some surprises in store.”

Kohn said it’s gratifying to know that evolutionary biology can help pave the path to personalized medicine. He credits the now-published findings with helping him land a recent grant of $900,000 from the National Institute of Heart Lung Blood disease at the National Institutes of Health. Kohn will now use mutant and normal rats to find additional genes that respond to warfarin, with two purposes: first, to see if rats have recruited additional genes to battle poisons that are more potent, and second, to attain the ultimate goal of fine-tuning doses of coumadin for humans.

Kohn’s paper is available here.

Source: Mike Williams

Rice University

View drug information on Warfarin Sodium tablets.

Anavex Life Sciences Corp. Will Present New Findings At The International Conference On Alzheimer’s Disease 2008 (July 26-31, 2008, Chicago, USA)

Anavex Life Sciences Corp. (“ANAVEX”) (OTCBB: AVXL) announces its participation at the International Conference on Alzheimer’s Disease 2008 (July 26-31, 2008, Chicago, USA), where it will present results obtained with ANAVEX 1-41 demonstrating a protective effect against the neurotoxicity of amyloid (beta)25-35 peptide (A(beta)25-35) in mice. This peptide is used to mimic the neurodegenerative processes found in Alzheimer’s disease (AD) and help identify the neuroprotective effects of the ANAVEX compound in order to establish its potential for further development.

The two outstanding aspects of the results to be presented are:

1) The very low doses of ANAVEX 1-41 (30-100 micrograms/kg, ip) at which
we attain neuroprotective results, indicating significantly greater
potency than other pharmacological agents. The neuroprotection was
specifically assessed in the hippocampus, an area highly implicated in
Alzheimer’s disease. This very significant neuroprotective activity of
ANAVEX 1-41 was found to be related to its combined sigma-1 and
muscarinic effects.

2) The novel anti-apoptotic mechanism of ANAVEX 1-41 that was attained at
extremely low doses of ANAVEX 1-41 (100-fold below the threshold for
unwanted muscarinic effects). Apoptosis is the predominant
pathophysiological aspect of the brain degeneration in AD, and protection
against this process could be an important therapeutic strategy. In
particular, the inositol triphosphate receptors calcium channels (IP3R)
upregulation and endoplasmic reticulum (ER) stress sensors modulation
maintained the ER and the mitochondrion in the unfolded protein response
(UPR) adaptative status and protected against the triggering of apoptotic

Unlike the challenge of pro-amyloid and anti-amyloid theories of AD, Anavex Life Sciences’ SIGMACEPTOR™ Discovery Platform sigma-1 activator molecules target neuron structures (ER, mitochondrion) with the goal of preventing the neurodegenerative action of the disturbed biochemical pathways and channels (UPR, IP3R, Bcl-2, apoptosis), which recently emerged as putative crucial factors in AD as well as many other neurodegenerative diseases.

“We are pleased by our continued progress in the development of ANAVEX 1-41, and are excited to be presenting data regarding its potent neuroprotective and anti-apoptotic properties at such low doses at ICAD,” said Dr. Vamvakides, Chief Scientific Officer of ANAVEX. “Based on our pre-clinical studies to date, we continue to believe that ANAVEX 1-41 may offer disease-modifying options that reverse memory and learning deficits and protect nerve cells from death.”

The above-mentioned findings further support ANAVEX to progress ANAVEX 1-41 towards Phase 1 human clinical trials.

The International Conference on Alzheimer’s Disease is being held July 26-31, 2008 in Chicago, USA. Additional information is available on the conference web site at alz/icad/overview.asp. The ANAVEX abstract can be viewed by visiting alz/icad/abstract.asp and doing a search for “Anavex” using the Online Program Planner.

About Alzheimer’s disease

Alzheimer’s disease is the most common cause of dementia and is characterized by the progressive degeneration of cognition as a result of the destruction of nerve cells in the brain. In March 2007, the Alzheimer’s Association reported that 5.1 million people in the United States (4.9 million of whom are aged 65 and older) are living with Alzheimer’s disease. This represents an increase of at least 10% from the previous prevalence estimate of 4.5 million. By 2015, there could be as many as 16.8 million people with Alzheimer’s disease in the major seven pharmaceutical markets unless novel drug treatment therapies are discovered.

Medications currently available to treat Alzheimer’s disease include acetylcholinesterase inhibitors and N-methyl-D aspartate receptor antagonists. Both types of medications only treat symptoms of the disease — they do not stop the onset and progression of Alzheimer’s disease.

In conclusion, there are very real and unmet medical requirements for drug therapies to treat Alzheimer’s disease. The impressive market size leaves no doubt for the business opportunity presented by treatments for Alzheimer’s disease.

Drugs able to act on the underlying disease pathology and modify disease onset and progression, demonstrating neuroprotective, anti-amnesic and preventive properties combined with excellent safety and low toxicity, have the potential for blockbuster sales.

About Sigma Receptors

Sigma receptors are a unique family of proteins, present mainly in the Central Nervous System (CNS) but also in various peripheral tissues. The receptors are classified in two subtypes: the sigma-1 and sigma-2. These subtypes are distinguishable pharmacologically, functionally and by molecular size. Sigma-1 receptors have been cloned and shown to be distinct from any known receptor class.

In the CNS, they are involved in the modulation of neurotransmitter receptor function, neurotransmitter release and response, as well as memory and learning processes, demonstrating potential neuroprotective and anti-amnesic properties. The modulatory action and the implication of numerous cellular and biochemical signaling pathways suggest possible sigma receptor involvement in many neuronal processes, as well as in the pathophysiology of certain psychiatric disorders including depression, schizophrenia, motor disturbances, neuropathic pain, drug addiction, and attention deficit disorders.


Anavex Life Sciences Corp. is an emerging biopharmaceutical company engaged in the discovery and development of novel drug targets for the treatment of cancer and neurological diseases. The company’s proprietary SIGMACEPTOR™ Discovery Platform involves the rational drug design of compounds that fulfill specific criteria based on unmet market needs and new scientific advances. Selected drug candidates demonstrate high, non-exclusive affinity for sigma receptors, which are involved in the modulation of multiple cellular biochemical signalling pathways.

ANAVEX’s SIGMACEPTOR™-N program involves the development of novel and original drug candidates, targeting neurological and neurodegenerative diseases (Alzheimer’s disease, epilepsy, depression). The company’s lead drug candidates exhibit high affinity and selectivity to sigma receptors and also synergetic action with other receptors, such as Muscarinic, NMDA and ion channels, with strong evidence of anti-amnesic, neuroprotective and anxiolytic properties.

ANAVEX’s SIGMACEPTOR™-C program involves the discovery and development of novel and original drug candidates targeting cancer. The company’s lead drug candidates exhibit high, non-exclusive affinity to sigma receptors with strong evidence for selective apoptosis of cancerous cells without affecting healthy cells, as well as anti-metastatic and low toxicity properties in various types of solid tumors such as colon, breast, prostate and melanoma.

Forward-Looking Statements

This press release contains forward-looking statements for Anavex Life Sciences Corp. that involves a number of risks and uncertainties. Actual events or results may differ materially from those projected in any of such statements due to various factors. Among other things, there can be no assurance that any of the Company’s development efforts relating to its product candidate, ANAVEX 1-41, will be successful, or such product candidate will be successfully commercialized or that ANAVEX 1-41 will have the potential to treat Alzheimer’s disease or other types of neurodegenerative diseases or that ANAVEX 1-41 will provide clinically relevant advantages over other competitive compounds in development. Other risks that affect forward-looking information contained in this press release include the high degree of risk associated with drug development, results of further research and development, the impact of competition and of technological advances and other risks detailed to ANAVEX’s SEC filings. Other than as required by federal securities laws, we undertake no obligation to publicly update or revise any of our forward-looking statements, whether as a result of changed circumstances, new information, future events, or for any other reason occurring after the date of this news release.


Global Database Needed To Guarantee Identification Of Victims In Mass Disasters

An expert in forensic anthropology argues that the database should include computer records of citizens such as anthropological data, physiognomic characteristics, medical information, radiographic files, dental records and numbers of different identity documents. Tzipi Kahana believes that radiographic techniques, together with information from this database, are a reliable mechanism for identifying bodies after natural disasters or attacks.

Forensic Anthropology, as an independent discipline within the field of forensic science, has evolved since the early twentieth century in tandem with technological developments of the scientific world. One of its best tools has been the implementation of radiological techniques for positive identification of human remains.

A research conducted at the University of Granada warns of the need to create “immediately” a database of citizens, from all countries of the world, that include computer records of citizens such as anthropological data, physiognomic characteristics, medical information, radiographic files, dental records and numbers of different identity documents.

This work has been performed by Tzipi Kahana (former student at the Hebrew University of Jerusalem) at the Department of Physical Anthropology of the University of Granada, and directed by professors Miguel C. Botella L??pez and Immaculada Alem??n Aguilera. Its author argues that the creation of this database “is crucial to the proper thanatological management following natural disasters or attacks”, in order to guarantee an accurate diagnosis of the data of death and to enable the identification of victims.

Tsunami in Thailand

Kahana worked with the Israel Police in the task of identifying bodies after the tsunami that hit Phuket (Thailand) in December 2004. They were the first to reach the area after the disaster and, along with other teams that arrived successively (Italy, Switzerland, Japan, Canada and Portugal), identified more than 600 corpses. She was also active in identifying victims of the terrorist attack on the Asociaci??n Mutual Israelita Argentina (AMIA) which took place in Buenos Aires, in 1994.

In this work, the scientist has analyzed how new radiographic technologies comply with legal requirements of the forensic field, studying the progressive development of Forensic Radiology as a new discipline through its symbiotic relationship with Forensic Anthropology. Tzipi Kahana has based her research on her own experience in the field of forensic anthropology for 20 years and, for the first time, her work meets the new legal requirements, the magnitude of major catastrophes of 19th and 20th centuries, and technological advances of the modern world.

From her point of view, “it is essential” to carry out a radiographic examination of all human remains in the field of forensic identification, as this examination not only provides documentation of the recovered material, but it is useful both in the identification of skeletal trauma and in the location of teeth hidden in the tissues.

A crucial role

Tzipi Kahana stresses that radiological investigation, as part of the thanatological examination, “is very useful in cases of traffic accidents, gunshot injuries and identification of corpses.” Furthermore, radiographic examination plays a crucial role in the positive identification of human remains on Forensic Anthropology and Odontology.

The effectiveness and usefulness of any identification technique depends on the speed at which ante mortem data are available. In Israel, the U.S. and UK, countries where there are no fingerprint records of all people, an average of 10% of all medico-legal cases are individuals or human remains whose identity is unknown. Of these, 80% were identified through radiographic comparisons during the 90s.

The UGR researcher points out that some of the degenerative changes of the spine “are excellent radiological features, useful for the identification of corpses and human remains”, since, in general, “the radiographs of the spine contain a large number of individualizing features”.

Useful vertebral features for necroidentification include conditions such as evidence of healed trauma, degenerative and infectious processes, congenital malformations and normal anatomic variations of the spinal structures.

Part of the results of this research has been published in scientific journals such as British Journal of Radiology, Journal of Forensic Identification, American Journal of Forensic Medicine and Pathology, Journal of Clinical Forensic Medicine and Forensic Pathology Reviews, among others.

Tzipi Kahana. Department of Physical Anthropology, University of Granada. Prof. Miguel Botella L??pez
Director of the Forensic Anthropology Laboratory, University of Granada

Tzipi Kahana
University of Granada

C-Section-Linked Allergies And Asthma: Possible Biological Explanation Found

Scientists believe they may have identified a biological explanation for the link between cesarean-section delivery and risk of allergy and asthma in childhood. They will presented their findings at the American Thoracic Society’s 2008 International Conference in Toronto.

Several studies have shown immunological differences between children with and without allergy at the time of birth. For example, increased cord blood levels of IL-13, a Th2 type cytokine, have been positively associated with allergy among children with a family history of allergy

Regulatory T cells are a subgroup of T lymphocytes with immune suppressive properties on effector T cells, which in turn regulate cytokine secretion and the development and function of the immune system. Evidence suggests that CD4+CD25+ T regulatory (Treg) cells in those with asthma or allergy may be functionally impaired.

“Our research looked at the effect of cesarean-section versus vaginal delivery in newborns to determine whether cesarean-section was associated with reduced regulatory T-cell function,” said lead researcher Ngoc Ly, M.D., M.P.H., who is assistant professor of pediatrics at the University of California, San Francisco.

In a previous study Dr. Ly and colleagues demonstrated an association between cesarean section and increased neonatal secretion of IL-13. In this latest study, the researchers measured the expression and function of specific regulatory T-cells in the cord blood of 50 newborns born by cesarean section, and 68 delivered vaginally, all of whose have at least one parent with allergies and/or asthma. They found that babies born by cesarean section showed a reduction in the suppressive function of their regulatory T-cells. There was a trend for lower level of TGF-fO, a cytokine secreted by tregs, and higher level of IL-4 and IL-13 among children born by c-section as compared to children born by vaginal delivery.

“This finding is exciting because it suggests that the mode of delivery may be an important factor influencing immune system development in the neonate,” said Dr. Ly, who postulated that the stress and process of labor itself or exposure to specific microbes through the birth canal in vaginal as compared to c-section delivery may influence neonatal immune responses.

“These findings are preliminary and further work is needed to explore potential mechanisms for the association between mode of delivery and neonatal immune responses,” she/he” explained. “However, this finding provided a potential immunologic basis for previous reports of the association among cesarean section, elevated IL-13 and allergy and asthma.”

Source: Keely Savoie

American Thoracic Society

Possible Link Between Vitamin D Deficiency, Alzheimer’s Disease And Vascular Dementia

There are several risk factors for the development of Alzheimer’s disease and vascular dementia. Based on an increasing number of studies linking these risk factors with Vitamin D deficiency, an article in the current issue of the Journal of Alzheimer’s Disease (May 2009) by William B. Grant, PhD of the Sunlight, Nutrition, and Health Research Center (SUNARC) suggests that further investigation of possible direct or indirect linkages between Vitamin D and these dementias is needed.

Low serum levels of 25-hydroxyvitamin D [25(OH)D] have been associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, all of which are either considered risk factors for dementia or have preceded incidence of dementia. In 2008, a number of studies reported that those with higher serum 25(OH)D levels had greatly reduced risk of incidence or death from cardiovascular diseases.

Several studies have correlated tooth loss with development of cognitive impairment and Alzheimer’s disease or vascular dementia. There are two primary ways that people lose teeth: dental caries and periodontal disease. Both conditions are linked to low vitamin D levels, with induction of human cathelicidin by 1,25-dihydroxyvitamin D being the mechanism.

There is also laboratory evidence for the role of vitamin D in neuroprotection and reducing inflammation, and ample biological evidence to suggest an important role for vitamin D in brain development and function.

Given these supportive lines of evidence, Dr. Grant suggests that studies of incidence of dementia with respect to prediagnostic serum 25(OH)D or vitamin D supplementation are warranted. In addition, since the elderly are generally vitamin D deficient and since vitamin D has so many health benefits, those over the age of 60 years should consider having their serum 25(OH)D tested, looking for a level of at least 30 ng/mL but preferably over 40 ng/mL, and supplementing with 1000-2000 IU/day of vitamin D3 or increased time in the sun spring, summer, and fall if below those values.

Writing in the article, Dr. Grant states, “There are established criteria for causality in a biological system. The important criteria include strength of association, consistency of findings, determination of the dose-response relation, an understanding of the mechanisms, and experimental verification. To date, the evidence includes observational studies supporting a beneficial role of vitamin D in reducing the risk of diseases linked to dementia such as vascular and metabolic diseases, as well as an understanding of the role of vitamin D in reducing the risk of several mechanisms that lead to dementia.”

The article is “Does Vitamin D Reduce the Risk of Dementia?” by William B. Grant, Ph.D. It is published in the Journal of Alzheimer’s Disease 17:1 (May 2009).

Astrid Engelen

IOS Press

Rising Attacks On Food Convoys Undermining WFP Work In Darfur

The United Nations World Food Programme (WFP)
condemned the dramatic escalation in attacks on humanitarian staff
and food convoys in Darfur, which are hampering WFP’s ability to
deliver assistance to millions of hungry people in the strife-torn
region of Sudan.

“In the last two weeks, nine food convoys have been attacked by
gunmen across Darfur,” said Kenro Oshidari, WFP Sudan
Representative. “WFP staff and contractors are being stopped at
gunpoint, dragged out of their vehicles and robbed with alarming

Oshidari called on all parties to the conflict in Darfur to
guarantee the safety of humanitarian workers so that the UN food
agency and other aid organizations can continue with their
life-saving work.

“These abhorrent attacks, which target the very people who are
trying to help the most vulnerable in Darfur, must be brought under
control,” he added.

So far this year, 18 WFP food convoys have been attacked by gunmen
and four of WFP’s light vehicles carjacked. Six WFP vehicles,
including trucks and light vehicles, have been stolen and 10 staff,
including contractors, have been either detained or abducted.

The Darfur operation is WFP’s biggest, employing some 790 staff who
feed more than two million people every month. WFP also contracts
commercial truck companies to haul food into the region. This year
the agency plans to distribute up to 450,000 metric tons of food in
Darfur at a cost of about half a billion dollars.

Due to a lack of security, WFP was not able to reach 170,000 people
in June, a sizeable increase from the lowest point last March when
60,000 could not be reached. As a result of convoy attacks in recent
weeks, the road between Nyala, the capital of South Darfur state,
and the town of Kass, has been declared a “no-go” area for UN staff.
In North Darfur, food dispatches to the town of Kabkabiya have been

UN security personnel say attacks on vehicles are now the number one
security concern for the aid community in Darfur. A recent and
deeply troubling trend is that staff are being abducted when their
vehicles are stolen, giving robbers time to get away before the
alarm is raised. To date, all WFP staff have been released, although
some were injured and hospitalized.

WFP is the world’s largest humanitarian agency: on average, each
year, we give food to 90 million poor people to meet their
nutritional needs, including 58 million hungry children, in 80 of
the world’s poorest countries. WFP – We Feed People.


Erratic lymphatics contribute to asthma

Excessive accumulation of fluid, known as edema, occurs in asthma and other inflammatory diseases when fluid drainage
through lymphatic vessels is overwhelmed by the amount of plasma leaking from blood vessels. It is unclear to what extent new
lymph vessels are able to grow from pre-existing ones – a process known as lymphangiogenesis – in order to compensate for
this overload.

Donald McDonald and fellow researchers from University of California, San Francisco, examined mice infected with Mycoplasma
pulmonis or in which a viral vector had been used to deliver to the mice the potential pro-lymphangiogenic factors known as
VEGF-A, -C, or -D.

The authors found extensive growth of new lymphatic vessels associated with airway inflammation after delivery of VEGF-C and
-D. Surprisingly, while antibiotic therapy caused bronchial inflammation and blood vessels to regress, these new lymphatic
vessels persisted.

The study also showed that impaired growth of new lymphatics during airway inflammation may lead
to bronchial lymphedema, which worsens the airway swelling, obstruction, and resultant wheezing that asthmatics, for example,
experience. Correction of defective lymphangiogenesis may benefit the treatment of asthma and other inflammatory airway

The study will appear online on January 20 in advance of print publication in the February 1 edition of the Journal of
Clinical Investigation.

TITLE: Pathogenesis of persistent lymphatic vessel hyperplasia in chronic airway inflammation.

AUTHOR CONTACT: Donald M. McDonald
Department of Anatomy, University of California, San Francisco, California, USA.

View the PDF of this article at: https://the-jci/press/22037.pdf

From 5:00PM USA EST Thursday January 20, 2005 a PDF of this article will be available at
: jci/papbyrecent.shtml
JCI table of contents, January 20 2005
Molecule predicts colon cancer patient survival
Antibody treatment partially reverses nerve damage in Alzheimer disease
T cells target HIV in a relationship on the rebound
T cell escape from thymic Alcatraz
Researchers identify pathway that jumpstarts the autoimmune response in lupus
Erratic lymphatics contribute to asthma
An IL-6 sense balances pro- and anti-inflammatory effects during asthma
With a little help from its friends, RANKL drives bone loss
Slain brain cells cause mental retardation syndrome

Brooke Grindlinger
Journal of Clinical Investigation