Ankle Blood Flow Test Helps Identify Stroke Survivors Most At Risk For Future Strokes, Heart Attacks And Death

Posted by | Posted in Medical | Posted on 29-08-2009

A simple test that measures blood flow through the ankle helps identify people with peripheral artery disease (PAD) before they start showing symptoms, a study led by University of North Carolina at Chapel Hill researchers has found.

The study shows that the test, called an ankle brachial index (ABI), may be useful in screening people who have already suffered a stroke or transient ischemic attack (TIA), said Souvik Sen, M.D., director of the UNC Stroke Center and the study’s principal investigator.

“Stroke and TIA survivors are already at risk of suffering another stroke, TIA, heart attack or death,” Sen said. “Our study found that 26 percent of survivors also had PAD without showing any symptoms, and this group suffered three times more subsequent strokes, heart attacks and deaths than survivors without PAD.

“When we find PAD early, we can treat it and the patient has a much better chance of avoiding future adverse events,” Sen said.

The study was published online Thursday, August 27 by the journal Stroke, which is published by the American Heart Association.

PAD occurs when arteries in the lower legs become obstructed by plaque. Symptoms include leg pain, cramping, weakness and limping. However, surveys show that up to one-third of patients never report such symptoms to their doctors and less than half of general physicians routinely ask.

The ABI test uses a device similar to a blood pressure cuff to measure blood flow in the ankle and compares that to blood flow in the arm. Reduced blood flow in the ankle is considered to be an indicator of PAD.

“The test can be easily performed in 15 minutes in a doctor’s office or at the bedside of hospitalized patients,” Sen said.

Source: University of North Carolina

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UAB’s Dr. Whitley Chosen To Serve On President’s H1N1 Swine Flu Working Group

Posted by | Posted in Medical | Posted on 29-08-2009

University of Alabama at Birmingham (UAB) Director of Pediatric Infectious Diseases Richard Whitley, M.D., has been tapped to serve on the 2009-H1N1 influenza working group of the President’s Council of Advisors on Science and Technology (PCAST).

The group is providing recommendations to U.S. President Barack Obama, through PCAST, on federal activities needed to respond to H1N1, or swine flu. Issues examined by the group include infection data collection, vaccine production, drug stockpile, preparedness plans and other public-health concerns, Whitley said.

Whitley is co-director of UAB’s Center for Emerging Infections and Emergency Preparedness and a renowned researcher on the antiviral therapies designed to fight infections in children and adults. A UAB professor of pediatrics, microbiology, medicine and neurosurgery, he also serves as vice-chair of the Department of Pediatrics.

Whitley is president elect of the Infectious Diseases Society of America (IDSA) and serves on the Advisory Council for the National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health.

PCAST, which is administered by the Office of Science and Technology Policy, and its working groups include the nation’s leading scientists, doctors and engineers who directly advise the president and the Executive Office of the President on prevention, planning, best practices, resource allocation and other responsibilities.

Source: University of Alabama at Birmingham

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ASN Committed To Managing Conflicts Of Interest

Posted by | Posted in Medical | Posted on 29-08-2009

Twenty-six million Americans suffer from kidney disease, and for decades nephrologists in academia, practice, and industry have enhanced their quality of care. To ensure that partnerships between the American Society of Nephrology (ASN) and industry continue to improve kidney health, ASN leaders convened the Committee on Corporate Relations in 2008. Publications resulting from this committee’s efforts set will help guide medical societies and industry in their efforts to advance patient care, research, and education.

In an upcoming issue of the Journal of the American Society of Nephrology (JASN), ASN publishes the “ASN Policy on Managing Conflicts of Interest” and presents 10 recommendations that guide best practices on how to “design, monitor, and enforce regulations that insure appropriate Society’s interactions with industry.” Drawn from ASN’s long history of responsible partnerships with industry as well as extensive research and self-assessment, this article provides compelling guidelines for ethical approaches to these important partnerships.

These recommendations “are based on the premise that societies can develop beneficial partnerships with commercial interests as long as the Society’s leaders, staff, and members appropriately and responsibly manage their relationships with these entities.” The ASN Council unanimously approved all 10 of the committee’s recommendations.

In coordination with the online release of the article and an accompanying editorial entitled, “Managing Conflicts of Interest: The Road Ahead,” ASN will launch a webpage on August 27 that provides information about managing conflicts of interest on the Society’s website that includes:

1. Links to the above mentioned JASN article and the “Final Report of the ASN Committee on Conflict of Interest”;

2. A timeline that includes links to important resources on conflicts and bias; and

3. Information about congressional legislation related to conflicts and bias.

ASN will also address this topic during its upcoming annual educational meeting, Renal Week 2009, which will take place from October 27-November 1 in San Diego, CA. Bernard Lo, MD, who chaired the IOM panel that produced “Conflicts of Interest in Medical Research, Education, and Practice,” will present the Christopher R. Blagg Endowed Lectureship on “Conflicts of Interest in Medicine” on October 29 during the Public Policy Forum from 1:30 p.m. – 3:30 p.m.

In the conclusion of “ASN Policy on Managing Conflicts of Interest,” ASN invites other medical societies to “join together to articulate national standards for managing relationships with commercial interests.” The Society continues to lead the fight against kidney disease by attempting to address complex areas of significance, such as the management of conflicts of interest.

Source: American Society of Nephrology (ASN)

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New Metabolic Safeguards Against Tumor Cells Revealed By Study

Posted by | Posted in Medical | Posted on 20-08-2009

Cells don’t like to be alone. In the early stages of tumor formation, a
cell might be pushed out of its normal home environment due to
excessive growth. But a cell normally responds to this homeless state
by dismantling its nucleus, packing up its DNA, and offering itself to
be eaten by immune system cells. Simply put, the homeless cell kills
itself. This process, known as apoptosis, typically stops potential
cancer cells before they have a chance to proliferate.

Now, researchers from the lab of Harvard Medical School
professor of cell biology Joan Brugge have uncovered another mechanism
that kills these precancerous, homeless cells. By studying two
different types of human breast epithelial cells, the researchers found
that when separated from their natural environment, these cells lose
their ability to harvest energy from their surroundings. Eventually,
they starve.

“We originally thought that in order for cells to survive
outside their normal environment, they would simply need to suppress
apoptosis,” says Brugge, senior author on the paper, which appeared
August 19 online in Nature.
“But our studies indicate that this activity is not sufficient to
prevent the demise of homeless cells. Even if they escape apoptosis,
these cells can’t transport enough glucose to sustain an energy
supply.”

Surprisingly, metabolic function is restored if antioxidant
activity is increased inside the cells, allowing the cells to use
energy pathways that don’t rely on glucose.

“It raises the interesting idea that antioxidants, which are
typically thought to be protective because they prevent genomic damage,
might be allowing these potentially dangerous cells to survive,” says
first author Zachary Schafer, assistant professor at the University of
Notre Dame and a former postdoc in Professor Brugge’s lab.

The authors caution against extrapolating too far from their
data, which were based on experiments in laboratory cell culture. They
also emphasize that the experiments were not designed to mimic the
effect of dietary antioxidants in the body. The researchers used two
specific antioxidant compounds – which are chemically distinct from
those found in food and supplements – only in order to understand how
oxidants contributed to the metabolic defects.

“We think that genes with antioxidant activity play a much
bigger role than antioxidant compounds administered from outside the
body,” says Brugge. “What happens with dietary antioxidants is much
more complicated and not what we were trying to study.”


Beyond cell suicide

The researchers had previously reported that when cells were
endowed with a cancer-causing gene that prevents them from committing
suicide, they still died when cut off from their extracellular
environment. This puzzled researchers, who have long thought that
apoptosis was the only way the cells could die.

In the recent study, Schafer and colleagues took a closer
look, measuring the levels of proteins and molecules associated with
metabolic activity in the displaced, but apoptosis-resistant, cells.
They found that the cells had become incapable of taking up glucose,
their primary energy source. Under the microscope, the cells also
displayed telltale signs of oxidative stress, a harmful accumulation of
oxygen-derived molecules called reactive oxygen species (ROS). The end
result was a halt in the production of ATP, the molecular lifeblood
that transports energy in the cells. The unmoored cells were literally
starving to death.

“The idea that a lack of extracellular matrix can prevent
cells from accessing nutrients hasn’t been shown conclusively before,”
says Schafer. “Loss of glucose transport, decreased ATP production,
increased oxidative stress – all those things turn out to be
interrelated.”

To figure out what was wrong, the researchers took a
straightforward approach – they tried to fix it. Schafer engineered the
homeless cells to express high levels of a gene, HER2, known to be
hyperactive in many breast tumors. He also treated the cells with
antioxidants in an attempt to relieve oxidative stress and help the
cells survive.

Both strategies worked. The cells with the breast cancer gene
regained glucose transport, preventing ROS accumulation, and recovered
their ATP levels. The antioxidant-treated cells also survived, but by
using fatty acids instead of glucose as an energy source.

“Our results raise the possibility that antioxidant activity
might allow early-stage tumor cells to survive where they otherwise
would die from these metabolic defects,” says Schafer.

The researchers are currently planning to test the effects of
antioxidant genes, some of which are abnormally regulated in human
tumors, and a wider range of antioxidants in animal models. They also
plan on characterizing the metabolic consequences of matrix detachment
in more detail.

“Ultimately,” Brugge says, “we want to understand enough about
the metabolism of tumor cells so that new types of drugs can be
designed to target them.”

Notes:
This research was funded by the National Cancer Institute and the National Institutes of Health.

Written by Jue Wang

“Antioxidant and oncogene rescue of metabolic defects caused by loss of matrix attachment”

Zachary T. Schafer(1,†), Alexandra R. Grassian(1,*), Loling
Song(1,*), Zhenyang Jiang(1), Zachary Gerhart-Hines(2,3), Hanna Y.
Irie(1), Sizhen Gao(1), Pere Puigserver(1,2), & Joan S. Brugge(1)

1-Department of Cell Biology, Harvard Medical School, Boston, MA
2-Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA
3-Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD
*These authors contributed equally to this work.
†Present address: Department of Biological Sciences, University of Notre Dame, Notre Dame, IN

Source:
David Cameron

Harvard Medical School

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Codeine Use After Tonsillectomy Warning

Posted by | Posted in Medical | Posted on 20-08-2009

A report out of The University of Western Ontario, published in the New England Journal of Medicine, warns the use of codeine to treat pain following a tonsillectomy could prove fatal for some children. Dr. Gideon Koren, who holds the Ivey Chair in Molecular Toxicology at Western, zeroed in on the danger after investigating the death of a two year old boy following a relatively easy operation to remove his tonsils.

Koren is a pediatrics professor at both Western and the University of Toronto, and the Director of the Motherisk program at the Hospital for Sick Children in Toronto. Enlarged tonsils are usually treated with antibiotics, but Koren says tonsillectomies are still performed in the case of sleep apnea, where the child stops breathing while asleep.

In this particular case, the toddler had a history of snoring and sleep-study-confirmed sleep apnea. He was taken to an outpatient clinic, had the operation, and was taken home. The mother was given syrup of codeine and instructed how to administer it to her child for pain relief. On the second night after surgery, the child developed a fever and wheezing, and was found dead the next morning. Tests later showed the mother had given the proper dosage, and yet the child’s body was found to have high levels of morphine. The coroner asked Koren to look at the case.

“The sudden death of a healthy child was quite sobering because tonsillectomies are done every day, all over North America,” says Koren. “And more and more of them are done on an outpatient basis, with the child going home the same day.” The child was found to have the ultra-rapid metabolism genotype which causes the body to metabolize codeine at a faster rate, producing significantly higher amounts of morphine.

Last year Koren published research showing how mothers who are given codeine for pain following childbirth, can pass toxic levels of morphine to their babies though their breastmilk, if they carry this genotype. It’s estimated just over one per-cent of Caucasians carry this gene, but the incidence could be as high as 30% in those of African origin.

Koren has another concern about giving codeine to children following a tonsillectomy for sleep apnea. “If the apnea doesn’t go away, codeine will also suppress the child’s breathing. This demonstrates the need to keep children in hospital under surveillance for at least 24 hours to see if the apnea persists.”

Western graduate student Catherine Ciszkowski co-authored the paper with Koren. The Ivey Chair in Molecular Toxicology studies why drugs can be safe for most people, and yet life-threatening to some, and tries to find ways to predict those situations.

Source:
Kathy Wallis
University of Western Ontario

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New Report: Employer-Sponsored Health Insurance Premiums Increase 119 Percent From 1999-2008; Projected To Double Again By 2020

Posted by | Posted in Medical | Posted on 20-08-2009

Nationally, family premiums for employer-sponsored health insurance increased 119 percent between 1999 and 2008, and could increase another 94 percent to an average $23,842 per family by 2020 if cost growth continues on its current course, according to a new Commonwealth Fund report.

The report, Paying the Price: How Health Insurance Premiums Are Eating Up Middle Class Incomes, State Health Insurance Premium Trends And The Potential Of National Reforms, finds that national reforms that slow health care cost increases by 1 to 1.5 percent per year would yield substantial savings for families and businesses across the country. By 2020, slowing the annual rate of growth by 1 percent would yield more than $2,500 in reduced premiums for family coverage, and slowing growth by 1.5 percent would yield more than $3,700 in premium savings compared to projected trends.

“With health spending projected to double if we stay on our current path, middle and lower income families are at high risk of losing their coverage or facing long-term stagnant incomes,” said report lead-author and Commonwealth Fund Senior Vice President Cathy Schoen. “Employers and employees share premium costs but we know that take home pay and retirement savings are being sacrificed to maintain health benefits. Reforms that slow the growth of health care costs could go a long way toward health and financial stability for working families.”

According to the report’s state-by-state analysis, the five-year increase (2003 to 2008) in employer-based premiums for family coverage averaged 33 percent, ranging from a high of 45 percent in Indiana and North Carolina to an average low of 25 percent in Michigan, Texas, and Ohio. Most states saw increases of 30 percent to 40 percent. By 2008, average family premium costs were highest in Indiana, Massachusetts, Minnesota, and New Hampshire-topping out at more than $13,500. Idaho, Iowa, and Hawaii had the lowest average family premiums, around $11,000.

“These rapid premium increases aren’t sustainable for families or employers,” said Commonwealth Fund President Karen Davis. “If we craft patient-centered reform that focuses on improving quality and efficiency and bending the cost curve, the insured in every state stand to benefit. We could assure coverage and, over time, make more money available for wages, retirement, and other family needs.”

The report found that insurance premiums have been rising much faster than income across states. As a result, by 2008 total premiums-including employee and employer shares-equaled or exceeded 18 percent of the average household income for the working age population in 18 states, compared to just three states in 2003. In three states-Mississippi, Tennessee and West Virginia-family premiums averaged 20 percent or more of middle household incomes for the state’s under-65 population. The stress on businesses and families is particularly acute in Southern and South-central states, where premiums are often high, yet incomes are lower than national averages. In addition, employees are often paying more for less, because as costs rise employers have increased patient cost-sharing while limiting benefits.

The authors note that a health industry coalition recently has pledged to slow the rate of cost growth by 1.5 percent annually. Further, estimates indicate that payment and system reforms, including the choice of a public insurance plan to compete with private plans, could reduce projected spending by $2 trillion to $3 trillion between 2010 and 2020–a reduction of 1 to 1.5 percent in annual growth rates. Authors conclude that if current trends continue, middle and lower income families could end up priced out of the health insurance market. In contrast, national reforms present an opportunity to put families on a path to rising incomes and health security.

Methodology

Data for single and family premiums for 2003 and 2008 by state are from the Medical Expenditure Panel Survey-Insurance Component, which is representative by state. State median incomes are from the Census, Current Population Survey. The analysis estimated average premiums from 2008 to 2020 for each state, applying the same growth rate to all states. The estimates for 2010 used the average growth rate in single and family premiums over the 2006-08 period from the Kaiser/HRET Survey of Employer-Sponsored Health Benefits. Estimates for potential premiums from 2011 through 2020 used the projected average annual growth rate in health spending per capita in the Centers for Medicare & Medicaid Services. The analysis applies the same inflation rate and the same alternative slower rates to all states for each year through 2020, to illustrate potential reductions in premiums compared to projected trends.

Source
The Commowealth Fund

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Labor Induction Need Not Increase Cesarean Risk, UCSF/Stanford Team Findings

Posted by | Posted in Medical | Posted on 18-08-2009

Contrary to a belief widely held by obstetricians, inducing labor need not increase a woman’s risk for cesarean section delivery in childbirth, scientists at the University of California, San Francisco and the Stanford University School of Medicine have found.

The research was conducted by a team affiliated with the Stanford-UCSF Evidence-based Practice Center, which focuses on furthering the practice and translation of evidence-based medicine to improve health outcomes for populations and individuals. Findings of the study will appear in the August 18 edition of Annals of Internal Medicine.”

“It appears there is misunderstanding regarding the association of increased cesarean deliveries with elective induction of labor, a procedure which has been rising in frequency,” said Aaron Caughey, MD, PhD, lead author of the paper and a UCSF associate professor of obstetrics, gynecology and reproductive sciences. “However, our findings need to be tempered with women’s and physicians’ expectations of choosing to induce labor.”

“Elective induction can be done in such a way as to avoid raising c-section rates – it’s possible,” said Douglas Owens, MD, director of the Stanford-UCSF Evidence-based Practice Center, and an author of the study. Owens is a senior investigator with the Veterans Affairs Palo Alto Health Care System and a professor of medicine at Stanford.

The scientists reviewed existing research that examined elective induction of labor, in which women have labor induced by choice rather than for medical reasons. Of note, the majority of the research findings were limited to women who were about one week past their due date. Although the rate of elective inductions has more than doubled since 1990, the practice has been poorly studied, and physicians have worried these inductions exposed women to higher risk for cesarean and the medical complications that can follow a surgical delivery, according to the research team.

But physicians’ concerns may be unfounded. The confusion arises in part from a flaw in the observational studies that link elective induction to higher cesarean risk, Owens said. Observational studies usually compare electively induced labor at a particular gestational age with spontaneous labor at the same time in pregnancy.

“That comparison is misleading because it doesn’t reflect the clinical decision that women and their physicians must make,” Owens said. Women and their doctors can’t decide to start spontaneous labor on a particular date; they can induce labor or wait. The risks of induction must be weighed against the risks of staying pregnant. Near the end of gestation, as the fetus gets bigger, staying pregnant increases a woman’s chance of needing a cesarean. And past the full gestational period of 40 weeks, the placenta may transmit oxygen to the fetus less efficiently. Thus, in labor, there may be an increased need to deliver via cesarean to prevent fetal distress.

To ensure that their research evaluated the choices women and physicians must make, the team reviewed randomized controlled trials that assigned women to an elective induction group or an “expectant management of pregnancy” (waiting) group at a particular time in late pregnancy. These studies indicated that elective induction of labor at or after 41 weeks’ gestation lowered cesarean risk by 22 percent compared to waiting. (Too little research had been done on elective induction earlier in pregnancy to draw conclusions about it.) The researchers also observed that women whose labor was electively induced were half as likely to have meconium-stained amniotic fluid, a sign of fetal intrauterine stress. Both findings suggest elective inductions may be safer than continuing pregnancy past 41 weeks.

There’s an important caveat to these results, however. Obstetricians need to be patient enough to see if the induction is working before deciding to try a cesarean, the research team noted.

“We’re concerned that our findings may not translate to many hospital settings in the United States,” said Caughey. Most of the studies reviewed were done at academic medical centers, and many were conducted in other countries, he said, noting physicians in different settings may allow different amounts of time for an induction to work. Prior research has indicated that doctors often tend to proceed from starting an induction to cesarean fairly quickly.

But the take-away message for pregnant women, said Owens, is still that induction can be done without increasing cesarean risk if obstetricians are willing to give induction of labor sufficient time to work. “Women should talk with their physician about how they would handle induction and what their approach to the procedure would be,” he said.

Further analysis of elective induction of labor in a variety of settings is badly needed, Caughey added. In addition to assessment of the risks of elective induction, researchers need to explore whether the procedure is cost-effective, since each induction adds about $3,000 to $5,000 to the cost of birth.

“It’s pretty surprising that something obstetricians do all the time hasn’t been studied all that well,” he said. “If you’re dealing with pregnant women, you don’t want to take any unnecessary risks.”

Co-authors of the paper are Anjali J. Kaimal, MD; Yvonne Cheng, MD, MPH; and Brian L. Shaffer, MD, all from the UCSF department of obstetrics, gynecology and reproductive sciences; Vandana Sundaram, MPH; Kathryn McDonald, MM; Dena Bravata, MD, all from the Center for Primary Care and Outcomes Research at the Stanford University School of Medicine; and Allison Gienger, BA, of the Stanford-UCSF Evidence-based Practice Center.

The research was funded by a contract from the Agency for Healthcare Research and Quality awarded to the Stanford-UCSF Evidence-based Practice Center. Two of the researchers were partially supported by the Health Services Research and Development Service, Department of Veterans Affairs.

Source:
Karin Rush-Monroe
University of California – San Francisco


Article URL: www.medicalnewstoday.com/articles/160979.php

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Post Traumatic Stress Symptoms Common After Heart Attack

Posted by | Posted in Medical | Posted on 18-08-2009

Many people experience symptoms of post-traumatic stress following a heart attack, and anxiety, depression and social withdrawal are also commonplace. These are the findings of a study by Susan Ayers of the University of Sussex and colleagues Claire Copland and Emma Dunmore, published recently, in the British Journal of Health Psychology.

Seventy four people who had experienced a heart attack in the previous 12 weeks and who were attending cardiac rehabilitation programmes took part in the study. The sample was predominantly male (76 per cent) with an average age of 62 years. Participants completed questionnaires assessing post traumatic stress disorder (PTSD) symptoms, as well as perceptions of the severity of their heart attack and the extent to which they believed their lives were in danger. Physical health, anxiety, depression and impairment of social activities were also measured, as were dysfunctional coping strategies such as denial and avoidance.

Of the participants, 16 per cent met clinical criteria for acute PTSD and a further 18 per cent reported moderate to severe symptoms. Those with PTSD symptoms were more likely to have poorer psychological health and social impairments. Findings revealed that people who tended to use denial and avoidance coping strategies were more likely to develop PTSD symptoms – this was a more powerful predictor of symptoms than patients’ perceptions of the severity of the heart attack and the threat to life.

Dr Ayers said: “Around 150,000 people in the UK survive the acute stage of a heart attack each year. Feelings of fear, anxiety and depression are common after such an event. The findings of this study suggest that a high proportion experience very severe distress – this has the potential to impair recovery, quality of life and threaten future health. It is therefore vital that cardiac patients are screened for psychological distress, such as anxiety, depression and PTSD, and offered appropriate treatment if necessary.”

Source
British Psychological Society


Article URL: www.medicalnewstoday.com/articles/160980.php

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Cellular Crosstalk Linked To Lung Disease

Posted by | Posted in Medical | Posted on 18-08-2009

Crosstalk between cells lining the lung (epithelial cells) and airway smooth muscle cells is important in lung development. However, it has also been shown to contribute to several lung diseases, including asthma and pulmonary hypertension. A team of researchers, at the University of Pennsylvania, Philadelphia, has now molecularly characterized one crosstalk pathway in mice, providing potential new therapeutic targets for treating individuals with lung diseases, such as asthma and pulmonary hypertension, which are caused, at least in part, by affects on airway smooth muscle cells.

The team, led by Edward Morrisey and Ethan David Cohen, used numerous in vivo gain- and loss-of-function approaches to demonstrate that a Wnt7b/Tnc/Pdgfr crosstalk pathway was important for mouse smooth muscle development, with Wnt7b being exclusively expressed by lung epithelial cells and Pdgfr being expressed by the developing airway smooth muscle cells. Importantly, expression of the components of this crosstalk pathway was upregulated in a mouse model of asthma and humans with pulmonary hypertension, thereby indentifying the Wnt/Tnc/Pdgfr crosstalk pathway as important in both lung development and adult lung disease.

TITLE: Wnt signaling regulates smooth muscle precursor development in the mouse lung via a tenascin C/PDGFR pathway https://www.the-jci.org/article.php?id=38079

Source:
Karen Honey
Journal of Clinical Investigation


Article URL: www.medicalnewstoday.com/articles/160982.php

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To Contract Or Not To Contract: Decision Controlled By 2 MicroRNAs

Posted by | Posted in Medical | Posted on 18-08-2009

The walls of blood vessels contain muscle cells known as vascular smooth muscle cells (VSMCs). These cells contract and relax to modulate blood pressure and distribute blood to the areas of the body that need it most. However, some environmental signals, many of which are associated with human disease, cause VSMCs to switch from being contractile in nature to being dividing cells that produce large amounts of the proteins that form tissue matrix. Despite the fact that this switch has been associated with a number of human blood vessel diseases, the mechanisms that control it have not been well defined. However, a team of researchers at the Max-Planck-Institut für Herz- und Lungenforschung, Germany, has now identified two small RNA molecules (microRNAs) known miR-143 and miR-145 that regulate acquisition and/or maintenance of the contractile nature of VSMCs in mice.

The team, led by Thomas Braun and Thomas Boettger, generated mice lacking both miR-143 and miR-145 and found that they had dramatically reduced numbers of contractile VSMCs and increased numbers of tissue matrix-producing VSMCs in their large arterial blood vessels. Further analysis revealed that these two small RNA molecules were required for normal contractility of arteries in vitro and maintenance of normal blood pressure in vivo. As their absence led to signs of blood vessel disease in mice, the authors suggest that miR-143/145 might provide new therapeutic targets to enhance blood vessel repair and attenuate blood vessel disease.

In an accompanying commentary, Michael Parmacek, at the University of Pennsylvania School of Medicine, Philadelphia, discusses the importance of this study and highlights the fact that miR-143 and miR-145 were found to alter the expression of differing sets of genes, meaning that future studies will need to determine precisely how they alter control of blood pressure and disease development.

TITLE: Acquisition of the contractile phenotype by murine arterial smooth muscle cells depends on the Mir143/145 gene cluster https://www.the-jci.org/article.php?id=38864

ACCOMPANYING COMMENTARY
TITLE: MicroRNA-modulated targeting of vascular smooth muscle cells https://www.the-jci.org/article.php?id=40503

Source:
Karen Honey
Journal of Clinical Investigation


Article URL: www.medicalnewstoday.com/articles/160983.php

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