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Type 2 Diabetes Linked with Reduced Cognitive Function

Researchers have revealed that over just 2 years, the ability of people with type 2 diabetes to regulate their blood flow is reduced, impairing the cognitive and executive skills.

Older lady tests her blood sugar level with a pen device.
The study focused on older adults, assessing participants with an average age of 66.
When blood flow is regulated normally, the brain can redistribute blood to areas that become more active during specific tasks.

“People with type 2 diabetes have impaired blood flow regulation,” explains study author Dr. Vera Novak, from Harvard Medical School in Boston, MA. “Our results suggest that diabetes and high blood sugar impose a chronic negative effect on cognitive and decision-making skills.”

Type 2 diabetes has previously been established as an independent risk for the development of both cognitive impairment and dementia. In their study, published in Neurology, the researchers wanted to investigate how inflammation, blood flow regulation in the brain and cognitive decline were related in people with the metabolic disorder.

The researchers examined a small cohort of 40 people – 19 with type 2 diabetes and 21 without diabetes. The average age of the participants was 66. The participants that had type 2 diabetes had all been treated for the disease for more than 5 years, receiving an average of 13 years of treatment.

For the study, the researchers conducted an array of tests on the participants. They assessed their cognitive and memory functions while also taking magnetic resonance imaging (MRI) scans and blood tests to measure brain volume, blood flow and inflammation. After 2 years, the researchers repeated the tests.

They found that the participants with type 2 diabetes experienced a reduction in their capacity to regulate the blood flow in their brains. These participants also performed worse in the cognitive and memory function tests.

Participants whose blood flow regulation was poorest at the start of the study experienced the greatest declines in their ability to perform basic routine tasks such as bathing and cooking, defined as decline in executive function.

Additionally, the researchers found that the participants who experienced the highest levels of inflammation also had the greatest decreases in blood flow regulation, regardless of whether their diabetes and blood pressure were well controlled or not.

Blood flow regulation monitoring could help predict cognitive changes
Over the 2 years of the study, there was a marked difference in the learning and memory skills of the participants with type 2 diabetes compared with those without the disease. Average test scores fell by 12%, from 46 to 41, among those with type 2 diabetes while the scores of those without diabetes remained steady at 55 points.

Among the participants with type 2 diabetes, the researchers found that blood flow regulation decreased by around 65% overall.

“Early detection and monitoring of blood flow regulation may be an important predictor of accelerated changes in cognitive and decision-making skills,” Dr. Novak suggests.

Only conducting the tests on the participants twice, at the start of the study and 2 years later, means that the study does not reveal much about how cognitive and executive function in people with type 2 diabetes alters over time.

The authors partially acknowledge this limitation, stating another study involving a larger sample size and longer duration is required to shed further light on the time sequence of the relationship between blood flow regulation and the disease.

Other limitations of the study are that the researchers did not measure for other factors that could have contributed to cognitive impairment among the participants and that younger participants were not involved in the study.

Despite these, the authors believe that their research provides clinical evidence regarding the mechanisms of the long-term effects of type 2 diabetes on the brain, with implications for health care and future treatment for older people with the disease.

– via MedicalNewsToday

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Cancer Patients Treated in World-First Clinical Trial of Canadian Viral Therapy

Canadian researchers have launched the world’s first clinical trial of a novel investigational therapy that uses a combination of two viruses to attack and kill cancer cells, and stimulate an anti-cancer immune response. Previous research by this team and others worldwide suggests that this approach could be very powerful, and could have fewer side effects than conventional chemotherapy and radiation, although it will take years to rigorously test through this trial and others.

The therapy was jointly discovered and is being developed by Dr. David Stojdl (Children’s Hospital of Eastern Ontario, University of Ottawa), Dr. Brian Lichty (McMaster University) and Dr. John Bell (The Ottawa Hospital, University of Ottawa), and their respective research teams and colleagues. The clinical trial, which is funded by the Ontario Institute for Cancer Research and coordinated by the NCIC Clinical Trials Group, is expected to enroll up to 79 patients at four hospitals across Canada. Up to 24 patients will receive one of the viruses and the rest will receive both, two weeks apart.
Christina Monker, 75, a former nurse from Rockland, Ontario, is one of the first patients treated in the trial. She was diagnosed with cancer in 2012 and, despite six weeks of radiation therapy and two rounds of chemotherapy, the cancer spread to both her lungs. After completing another 30 rounds of chemotherapy, she enrolled in the trial at The Ottawa Hospital and was treated on June 2, 2015.
“The nausea of chemotherapy was worse than I ever could have imagined, but with the viral therapy I just felt like I had the flu for a couple of days, and the symptoms were easily managed,” said Ms. Monker. “It is too soon to know if I may have benefited from this therapy, but I’m very glad to contribute to this important research that could improve care for others.”
The idea of using viruses to treat cancer has been around for more than a century, with sporadic reports of cancer patients experiencing remarkable recoveries after viral infections. However, it is only in recent years that viral therapy has begun to be developed and tested in a rigorous way. Drs. Bell, Lichty and Stojdl began investigating viral therapies for cancer nearly 15 years ago when they worked together at The Ottawa Hospital.
“We found that when normal cells become cancerous, it’s like they are making a deal with the devil,” explained Dr. Bell, a senior scientist at The Ottawa Hospital and professor at the University of Ottawa. “They acquire genetic mutations that allow them to grow very quickly, but these same mutations also make them more susceptible to viruses.”
The two viruses being tested in this clinical trial are called MG1MA3 and AdMA3. MG1MA3 is derived from a virus called Maraba, which was first isolated from Brazilian sandflies, while AdMA3 is derived from a common cold virus called Adenovirus. Both of these viruses have been engineered to stimulate an immune response against cancer cells that express a protein called MAGE-A3, but the Maraba virus also achieves an extra layer of anti-cancer activity by replicating inside many kinds of cancer cells and killing them directly. These viruses are manufactured in specialized facilities at The Ottawa Hospital and McMaster University.
“The idea behind this trial is to use the Adenovirus to prime the patient’s immune system to recognize their cancer, and then use the Maraba virus to directly kill their cancer and further stimulate their immune system to prevent the cancer coming back,” said Dr. Brian Lichty, associate professor at McMaster University. “We’re enthusiastic about the potential of this unique therapy.”
“We’re very excited about this first clinical trial,” said Dr. Stojdl, senior scientist at the Children’s Hospital of Eastern Ontario and associate professor at the University of Ottawa. “We’re continuing to push very hard to develop a suite of biological therapies with the goal of launching similar trials tailored to other types of tumours, including brain cancer and several devastating childhood cancers.”
Viral therapies are one component of a growing field of cancer research that seeks to use biological materials (including cells, genes, antibodies and viruses) to attack cancer cells and stimulate an anti-cancer immune response. This field of research has been called biotherapy or immunotherapy. Dr. Bell and his colleagues recently launched the $60M BioCanRx network to advance this area of research.
The Maraba virus is an important part of a broad biotherapeutics clinical trial development program in Canada that is combining viruses and vaccines with standard and emerging therapies to treat different types of tumours. Drs. Lichty, Bell and Stojdl and their institutions, in cooperation with the Fight Against Cancer Innovation Trust, have formed Turnstone Biologics in order to engage the private sector and to help fund further clinical trials.
“Immunotherapy is a very exciting field of cancer research, with antibody-based therapies showing the most promise in clinical trials so far,” said Dr. Derek Jonker, the overall lead for the clinical trial, a medical oncologist at The Ottawa Hospital and a professor at the University of Ottawa. “Viral therapies have also shown promise in laboratory studies, but it is too soon to know what impact they may have on patients. This clinical trial will help us find out and we’re very grateful to the patients who have participated.”
“Ontario is pleased to support innovative research through the Ontario Institute for Cancer Research,” said Reza Moridi, Ontario Minister of Research and Innovation. “Our investments have enabled our researchers to be at the forefront of this new therapy. Immunotherapy has the potential to vastly improve the way cancer is treated, and is another example of how research investment brings tangible benefits to Ontarians and people around the world.”
“The NCIC Clinical Trials Group is very pleased to conduct this trial, which offers a potential new therapeutic approach for cancer patients that has been developed by Canadian researchers,” said Dr. Janet Dancey, director, NCIC Clinical Trials Group and professor at Queen’s University in Kingston.
“Our Government is committed to investing in research that will accelerate efforts to find a cure for cancer, a disease that kills thousands of Canadians each year. The clinical trial announced today represents an innovative approach to treating cancer. We are proud to have contributed to the development of this therapy and wish the researchers and clinicians every success as they carry out this important study,” said the Honourable Rona Ambrose, Canada’s Minister of Health.
In addition to The Ottawa Hospital, the clinical trial is also taking place at the Juravinski Cancer Centre of Hamilton Health Sciences (under the leadership of Dr. Sebastien Hotte), Princess Margaret Cancer Centre of the University Health Network in Toronto (under the leadership of Dr. Albiruni R A Razak) and the Vancouver Centre of the BC Cancer Agency (under the leadership of Dr. Daniel Renouf). The trial was approved by Health Canada, the Ontario Cancer Research Ethics Board and the BC Cancer Agency Research Ethics Board. Further details about the trial are available at clinicaltrials.gov. Patients wishing to participate in the trial should speak with their own oncologist and ask for a referral to one of the participating hospitals. Further details for patients at The Ottawa Hospital are available online.

While this trial is primarily funded by the Government of Ontario through the Ontario Institute for Cancer Research, many other funding organizations have also supported the research of Drs. Bell, Lichty and Stojdl, including The Ottawa Hospital Foundation, CHEO Foundation, Canadian Cancer Society, Terry Fox Research Institute, Canadian Institutes of Health Research, Ontario Ministry of Research and Innovation, Canada Foundation for Innovation, Ottawa Regional Cancer Foundation, Hair Donation Ottawa, Angels of Hope, BioCanRx, Pancreatic Cancer Canada, NAV Canada and several philanthropic donors.

– via NewsWise

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Does cigarette smoking contribute to schizophrenia?

A meta-analysis published in the journal Lancet Psychiatry reports that people who smoke are more than three times more likely to suffer from psychosis, compared with nonsmokers.

Researchers previously thought people with psychosis are more likely to smoke because they may find that smoking counteracts side effects from schizophrenia medication.
Previous studies have reported a link between smoking cigarettes and psychosis. However, few studies investigated cigarettes as a direct driver of this association.

Instead, researchers had hypothesized that people with psychosis are more likely to smoke because they may find that smoking counteracts side effects from schizophrenia medication or negative schizophrenia symptoms.

One problem with this hypothesis, however, is that rates of smoking would only increase after someone has developed psychosis for this to be the case.

The new meta-analysis, conducted by researchers at King’s College London in the UK, assessed evidence from 61 observational studies, which involved 15,000 tobacco users and 273,000 nonusers overall.

The analysis shows that 57% of people presenting with a first episode of psychosis were smokers – this means they were three times more likely to be smokers than healthy, nonsmoking study participants.

Daily smokers were also found to develop psychotic illness around 1 year earlier on average than nonsmokers.

These findings shed doubt on the theory that an association between smoking and psychosis exists because people with psychosis use cigarettes to self-medicate, claim the authors.

“While it is always hard to determine the direction of causality,” says Dr. James MacCabe, clinical senior lecturer in Psychosis Studies at the King’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN), “our findings indicate that smoking should be taken seriously as a possible risk factor for developing psychosis, and not dismissed simply as a consequence of the illness.”

Because very few of the studies in the meta-analysis took into account consumption of substances other than tobacco, it was difficult for the King’s team to rule out other factors that may contribute to the association between smoking and psychosis.

Nicotine, psychosis and dopamine
The researchers do, however, propose another hypothesis that could explain the association. Sir Robin Murray, professor of Psychiatric Research at the IoPPN, points to the brain’s dopamine system:

“Excess dopamine is the best biological explanation we have for psychotic illnesses such as schizophrenia. It is possible that nicotine exposure, by increasing the release of dopamine, causes psychosis to develop.”

“Longer-term studies are required to investigate the relationship between daily smoking, sporadic smoking, nicotine dependence and the development of psychotic disorders,” says IoPPN research fellow Dr. Sameer Jauhar.

“In view of the clear benefits of smoking cessation programs in this population every effort should be made to implement change in smoking habits in this group of patients.”

A 2014 study conducted by researchers from the Washington University School of Medicine in St. Louis, MO, found that people with severe mental illness such as schizophrenia or bipolar disorder have a higher risk for substance abuse – especially cigarette smoking.

In that study, people with severe mental illness were:

4 times more likely to be heavy alcohol users (four or more drinks per day)
3.5 times more likely to use marijuana regularly (21 times per year)
4.6 times more likely to use other drugs at least 10 times in their lives
5.1 times more likely to be daily smokers.

– via MedicalNewsToday

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