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Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January. Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”. The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate. <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”. Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively. <h2>What is cancer?</h2> Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one. We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide. However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced. In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell. <h2>What exactly are mutations?</h2> Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix. <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions. These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>. Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required. <h2>How is cancer treated?</h2> Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy. Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically. <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence). Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally. Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients. Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history. <h2>What you should do</h2> Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to: <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.

Caring

"I’m not going to be cured". How breast cancer awareness and support sidelines people with metastatic disease

<a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> There have been incredible <a href="https://www.cancer.gov/types/breast/research">advances</a> in breast cancer diagnosis and treatment in recent years. And stories about celebrities who have “beaten” breast cancer continue to be a source of inspiration for many people. However, this emphasis on fighting, beating and surviving cancer shuts out the voices of those who will not survive. That is, the many people diagnosed with incurable, life-limiting metastatic breast cancer, <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">which kills nine Australians every day</a> or nearly <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">3,300 people</a> a year. Yet an <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">estimated 10,000</a> Australians are living with the diagnosis. Being diagnosed with metastatic breast cancer, as one of the authors has been, means ongoing treatment to live as long, and as well, as possible. It also means an ongoing need for emotional and practical support. However, society, health-care professionals, cancer advocacy organisations, even a patient’s closest family and friends, can struggle to understand what it is like to live with an incurable and life-limiting cancer and how best to provide support. <h2>Why is there so little awareness?</h2> <a href="https://www.breastcancer.org/types/metastatic">Metastatic breast cancer</a>, also called stage four breast cancer, is the most serious form of breast cancer. Unlike early breast cancer that is contained within the breast or nearby lymph nodes, metastatic breast cancer has spread to other parts of the body, most often the bones, lungs, liver, or brain. There is no cure for metastatic breast cancer despite decades of advocacy, funding and research. Treatment continues for as long as it helps to control the cancer and is tolerated by the patient. Median survival is <a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.51687">two to three years</a>, although newer, novel treatments mean some patients are living much longer. As a society, we can be uncomfortable <a href="https://theconversation.com/before-you-go-are-you-in-denial-about-death-34056">talking about and facing death</a>. When it comes to cancer, we usually prefer focusing on good news stories. These narratives are often perceived to be better for fundraising and are reassuring for people newly diagnosed. But they fail to <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">represent</a> the diversity and reality of cancer experiences. Despite considerable research into people with non-metastatic breast cancer, <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">relatively little</a> is known about Australians with metastatic breast cancer. <h2>Feeling silenced and unsupported</h2> Through our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">research</a> we wanted to better understand people’s experiences of metastatic breast cancer. We interviewed 38 participants from around Australia with diverse experiences of metastatic breast cancer. Participants were recruited through breast cancer and community organisations. We found messages and public campaigns about cancer survivorship, which emphasise hope and positivity, drowned out the voices of those with metastatic breast cancer. The focus on “success stories” about surviving breast cancer made some people feel like it was their responsibility to “beat” cancer. If they didn’t, it was their own fault. As one interviewee told us: "I react quite badly to all the, ‘we’ve had breast cancer and we beat it and we’ve survived. Aren’t we fantastic.’ There’s almost a feeling if you haven’t beaten your breast cancer you haven’t tried hard enough." Silence around metastatic breast cancer was common in research participants’ experiences. It prevented many from connecting with others and to the support they needed. It even affected relationships with those closest to them leaving them feeling misunderstood: "They don’t realise I’ve got to be on treatment forever. I’m not going to be cured. I think society thinks everything can be fixed; metastatic breast cancer actually can’t be fixed." Sharing deep fears and worries about their life expectancy can leave people with metastatic breast cancer feeling drained rather than supported. Many participants reported having to support and shield family, friends, acquaintances and work colleagues from the reality of their terminal diagnosis. "You hide how you feel because you don’t want to be avoided […] You put on that big, happy face. But like an onion if you peeled the layers away, you’d find out what’s going on." While many participants wanted to join a community of people with metastatic breast cancer, they struggled to know how to find one. Those who did, emphasised how invaluable it had been: "Being able to identify with and know that these people really get me is a huge relief and it reduces the isolation." These findings echo <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">previous research</a> demonstrating people with metastatic breast cancer have higher support needs than those with non-metastatic breast cancer. And these needs are <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">less likely to be met</a> by <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08269-8">health care, support services</a>, family or friends. <h2>A new path</h2> Being diagnosed with metastatic breast cancer can be terrifying, lonely and create significant support needs. It is essential people with metastatic breast cancer have their <a href="https://ascopubs.org/doi/10.1200/OP.20.00183">voices listened to</a> and their needs met. Next steps should include: <ul> <li> <a href="https://bcna-dxp.azureedge.net/media/d32bhdzf/bcna_making-metastatic-breast-cancer-count_2022.pdf">improving data collection by cancer registries</a> so we know exactly how many people in Australia have metastatic breast cancer </li> <li> increasing representation of people with metastatic breast cancer in advocacy, support organisations and research </li> <li> nationwide access to peer-to-peer programs and professionally led metastatic breast cancer support groups. </li> </ul> We must ensure people with metastatic breast cancer are the ones to speak to their experience and needs. As a colleague with metastatic breast cancer said: "I read an article written by an early-stage breast cancer ‘survivor’. It felt like someone describing winter when they had only ever experienced autumn." If you or someone you know has metastatic breast cancer, these organisations may be able to support you or connect you with others with the same diagnosis: <ul> <li> <a href="https://www.bcna.org.au">Breast Cancer Network Australia</a> for information and support </li> <li> <a href="https://www.mcgrathfoundation.com.au/">McGrath Foundation</a> for information about access to metastatic breast care nurses. </li> </ul> <hr /> The authors would like to thank the members of Breast Cancer Network Australia’s Metastatic Breast Cancer Lived Experience Reference Group for their review of this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215458/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, Senior Lecturer, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, Research fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-not-going-to-be-cured-how-breast-cancer-awareness-and-support-sidelines-people-with-metastatic-disease-215458">original article</a>.

Caring

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

<a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies. While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low. But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections. <h2>What diseases can pets carry?</h2> Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people. Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs. Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water. Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms. Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva. Dogs also commonly carry Capnocytophaga bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>. Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray. Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium Bartonella henselae. Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium Staphylococcus aureus</a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission. <h2>Birds, turtles and fish can also transmit disease</h2> But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to Salmonella infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis. Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink. Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to Pasteurella multicoda infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats. Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets. Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed. For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>. <h2>What should I do if I’m worried about catching a disease from my pet?</h2> There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include: <ul> <li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li> <li>not allowing your pets to lick your face or open wounds</li> <li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li> <li>wearing gloves when changing litter trays or cleaning aquariums</li> <li>wetting bird cage surfaces when cleaning to minimise aerosols</li> <li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)</li> <li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments</li> <li>seeking veterinary care if you think your pet is unwell.</li> </ul> It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, Lecturer in environmental health, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-okay-to-kiss-your-pet-the-risk-of-animal-borne-diseases-is-small-but-real-210898">original article</a>.

Family & Pets

Why understanding how spiders spin silk may hold clues for treating Alzheimer’s disease

<a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> Really, we should envy spiders. Imagine being able to make silk like they do, flinging it around to get from place to place, always having a <a href="https://pubs.acs.org/doi/10.1021/acsmacrolett.8b00678">strong-as-steel safety line</a> or spinning a comfy hammock whenever they need a rest. The fascinating properties of spider silk make it no wonder that scientists have been trying to unravel its secrets for decades. If we could understand and recreate the spinning process, we could produce artificial spider silk for a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0141813021021292">range of medical applications</a>. For example, artificial silk can help <a href="https://doi.org/10.1016/j.biomaterials.2021.120692">regenerate the nerves that connect our brain and limbs</a>, and can shuttle <a href="https://doi.org/10.1021/acs.biomac.0c01138">drug molecules directly into the cells where they are needed</a>. <figure><iframe src="https://www.youtube.com/embed/zNtSAQHNONo?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Spider silk is made of <a href="https://www.sciencedirect.com/topics/engineering/spidroins">proteins called spidroins</a>, which the spider stores in a silk gland in its abdomen. There are several types of spidroin for spinning different sorts of silk. Spiders <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673682/">store them as a liquid</a> that resembles oil droplets. But one of the questions that has eluded scientists so far is how spiders turn these liquid droplets into silk. We decided to investigate why the spidroins form droplets, to get us closer to replicating a spider’s spinning process. <h2>Weaving a web</h2> The trick that spiders use to speed up their spinning process can be used to spin better artificial silk, or even develop new spinning processes. In 2017, we learned to <a href="https://www.nature.com/articles/ncomms15504">make synthetic silk fibres</a> by emulating the silk gland, but we did not know how things work inside the spider. Now we know that forming droplets first <a href="https://pubmed.ncbi.nlm.nih.gov/37084706/">speeds up the conversion to these fibres</a>. An important clue to how the droplets and fibres are related came from an unexpected area of our research – on <a href="https://pubmed.ncbi.nlm.nih.gov/23013511/">Alzheimer’s and Parkinson’s diseases</a>. Proteins that are involved in these diseases, called <a href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/alpha-synuclein#:%7E:text=%CE%B1%2DSynuclein%20is%20a%20highly,linked%20to%20familial%20Parkinson%20disease.">alpha-synuclein</a> and <a href="https://www.alz.org/media/Documents/alzheimers-dementia-tau-ts.pdf">tau</a>, can assemble into tiny, oil-like droplets in human cells. Tau is a protein that helps stabilise the internal skeleton of nerve cells (neurons) in the brain. This internal skeleton has a tube-like shape through which nutrients and other essential substances travel to reach different parts of the neuron. In Alzheimer’s disease, an abnormal form of tau builds up and clings to the normal tau proteins, creating “tau tangles”. Alpha-synuclein is found in large quantities in <a href="https://www.webmd.com/mental-health/what-is-dopamine">dopamine-producing nerve cells</a>. Abnormal forms of this protein are linked to Parkinson’s disease. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Beautiful spider web with water drops close-up" /></a><figcaption>The trick spiders use to speed up their spinning process can be used to spin better artificial silk. <a class="source" href="https://www.shutterstock.com/image-photo/beautiful-spider-web-water-drops-close-155560781">Aastels/Shutterstock</a></figcaption></figure> Oil droplets of either one of these proteins form in humans when they become entangled, like boiled spaghetti on a plate. At first, the proteins are flexible and elastic, much like spidroin oil droplets. But if the proteins remain entangled, they get stuck together which alters their shape, changing them into rigid fibres. These can be toxic to human cells – for example, in neurodegenerative conditions such as Alzheimer’s. However, <a href="https://pubmed.ncbi.nlm.nih.gov/33148640/">spidroins can form droplets</a> too. This left us wondering if the same mechanism that causes neurodegeneration in humans could help the spider to convert liquid spidroins into rigid silk fibres. To find out, we used a <a href="https://www.nature.com/articles/nchembio.2269">synthetic spidroin called NT2RepCT</a>, which can be produced by bacteria. Under the microscope, we could see that this synthetic spidroin formed liquid droplets when it was dissolved in phosphate buffer, a type of salt found in the spider’s silk gland. This allowed us to replicate spider silk spinning conditions in the lab. <h2>Silky science</h2> Next, we studied how the spidroin proteins act when they form droplets. To answer this question, we turned to an analysis technique <a href="https://www.britannica.com/science/mass-spectrometry">called mass spectrometry</a>, to measure how the weight of the proteins changed when they formed droplets. To our surprise, we saw that the spidroin proteins, which normally form pairs, instead split into single molecules. We needed to do more work to find out how these protein droplets help spiders spin silk. Previous research has shown spidroins have different parts, called domains, with separate functions. The end part of the spidroin, called c-terminal domain, makes it form pairs. The c-terminal also starts <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1001921">fibre formation when it comes into contact with acid</a>. So, we made a spidroin which contained only the c-terminal domain and tested its ability to form fibres. When we used phosphate buffer to entangle the proteins into droplets, they turned into rigid fibre instantly. When we added acid without first making droplets, fibre formation took much longer. This makes sense since the spidroin molecules must find each other when forming a fibre. Entangling the spidroins like spaghetti helps them rapidly assemble into silk. This finding tells us how the spider can instantly convert its spidroins into a solid thread. It also uncovered how nature uses the same mechanism that can make brain proteins toxic to create some of its most amazing structures. The surprising parallel between spider silk spinning and fibres toxic to humans could one day lead to new clues about how to fight neurodegenerative disorders. Scientists may use spider silk research, including what we have learned about the spider silk domains, to keep human proteins from sticking together – to stop them from becoming toxic. If spiders can learn how to keep their sticky proteins in check, perhaps so can we.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, Researcher, Department of Microbiology, Tumor and Cell Biology, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, Researcher in Veterinary medicine biochemistry, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-understanding-how-spiders-spin-silk-may-hold-clues-for-treating-alzheimers-disease-205857">original article</a>. Images: Getty

Body

Here’s how a new AI tool may predict early signs of Parkinson’s disease

In 1991, the world was shocked to learn actor <a href="https://www.theguardian.com/film/2023/jan/31/still-a-michael-j-fox-movie-parkinsons-back-to-the-future">Michael J. Fox</a> had been diagnosed with Parkinson’s disease. He was just 29 years old and at the height of Hollywood fame, a year after the release of the blockbuster Back to the Future III. This week, documentary <a href="https://www.imdb.com/title/tt19853258/">Still: A Michael J. Fox Movie</a> will be released. It features interviews with Fox, his friends, family and experts. Parkinson’s is a debilitating neurological disease characterised by <a href="https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055">motor symptoms</a> including slow movement, body tremors, muscle stiffness, and reduced balance. Fox has already <a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">broken</a> his arms, elbows, face and hand from multiple falls. It is not genetic, has no specific test and cannot be accurately diagnosed before motor symptoms appear. Its cause is still <a href="https://www.apdaparkinson.org/what-is-parkinsons/causes/">unknown</a>, although Fox is among those who thinks <a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">chemical exposure may play a central role</a>, speculating that “genetics loads the gun and environment pulls the trigger”. In research published today in <a href="https://pubs.acs.org/doi/10.1021/acscentsci.2c01468">ACS Central Science</a>, we built an artificial intelligence (AI) tool that can predict Parkinson’s disease with up to 96% accuracy and up to 15 years before a clinical diagnosis based on the analysis of chemicals in blood. While this AI tool showed promise for accurate early diagnosis, it also revealed chemicals that were strongly linked to a correct prediction. <h2>More common than ever</h2> Parkinson’s is the world’s <a href="https://www.who.int/news-room/fact-sheets/detail/parkinson-disease">fastest growing neurological disease</a> with <a href="https://shakeitup.org.au/understanding-parkinsons/">38 Australians</a>diagnosed every day. For people over 50, the chance of developing Parkinson’s is <a href="https://www.parkinsonsact.org.au/statistics-about-parkinsons/">higher than many cancers</a> including breast, colorectal, ovarian and pancreatic cancer. Symptoms such as <a href="https://www.apdaparkinson.org/what-is-parkinsons/symptoms/#nonmotor">depression, loss of smell and sleep problems</a> can predate clinical movement or cognitive symptoms by decades. However, the prevalence of such symptoms in many other medical conditions means early signs of Parkinson’s disease can be overlooked and the condition may be mismanaged, contributing to increased hospitalisation rates and ineffective treatment strategies. <h2>Our research</h2> At UNSW we collaborated with experts from Boston University to build an AI tool that can analyse mass spectrometry datasets (a <a href="https://www.sciencedirect.com/topics/neuroscience/mass-spectrometry">technique</a> that detects chemicals) from blood samples. For this study, we looked at the Spanish <a href="https://epic.iarc.fr/">European Prospective Investigation into Cancer and Nutrition</a> (EPIC) study which involved over 41,000 participants. About 90 of them developed Parkinson’s within 15 years. To train the AI model we used a <a href="https://www.nature.com/articles/s41531-021-00216-4">subset of data</a> consisting of a random selection of 39 participants who later developed Parkinson’s. They were matched to 39 control participants who did not. The AI tool was given blood data from participants, all of whom were healthy at the time of blood donation. This meant the blood could provide early signs of the disease. Drawing on blood data from the EPIC study, the AI tool was then used to conduct 100 “experiments” and we assessed the accuracy of 100 different models for predicting Parkinson’s. Overall, AI could detect Parkinson’s disease with up to 96% accuracy. The AI tool was also used to help us identify which chemicals or metabolites were likely linked to those who later developed the disease. <h2>Key metabolites</h2> Metabolites are chemicals produced or used as the body digests and breaks down things like food, drugs, and other substances from environmental exposure. Our bodies can contain thousands of metabolites and their concentrations can differ significantly between healthy people and those affected by disease. Our research identified a chemical, likely a triterpenoid, as a key metabolite that could prevent Parkinson’s disease. It was found the abundance of triterpenoid was lower in the blood of those who developed Parkinson’s compared to those who did not. Triterpenoids are known <a href="https://www.sciencedirect.com/topics/neuroscience/neuroprotection">neuroprotectants</a> that can regulate <a href="https://onlinelibrary.wiley.com/doi/10.1002/ana.10483">oxidative stress</a> – a leading factor implicated in Parkinson’s disease – and prevent cell death in the brain. Many foods such as <a href="https://link.springer.com/article/10.1007/s11101-012-9241-9#Sec3">apples and tomatoes</a> are rich sources of triterpenoids. A synthetic chemical (a <a href="https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html">polyfluorinated alkyl substance</a>) was also linked as something that might increase the risk of the disease. This chemical was found in higher abundances in those who later developed Parkinson’s. More research using different methods and looking at larger populations is needed to further validate these results. <h2>A high financial and personal burden</h2> Every year in Australia, the average person with Parkinson’s spends over <a href="https://www.hindawi.com/journals/pd/2017/5932675/">A$14,000</a>in out-of-pocket medical costs. The burden of living with the disease can be intolerable. Fox acknowledges the disease can be a “nightmare” and a “living hell”, but he has also found that “<a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">with gratitude, optimism is sustainable</a>”. As researchers, we find hope in the potential use of AI technologies to improve patient quality of life and reduce health-care costs by accurately detecting diseases early. We are excited for the research community to try our AI tool, which is <a href="https://github.com/CRANK-MS/CRANK-MS">publicly available</a>. This research was performed with Mr Chonghua Xue and A/Prof Vijaya Kolachalama (Boston University). Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/heres-how-a-new-ai-tool-may-predict-early-signs-of-parkinsons-disease-205221" target="_blank" rel="noopener">The Conversation</a>.

Mind

Mediterranean diet associated with big reduction in the risk of heart disease and dementia

Further scientific evidence of the benefits of a “Mediterranean diet” on health have been published this week, extolling the virtues of fruit, veggies, nuts and even a little wine. <div class="copy"> In one Australian-led <a href="https://doi.org/10.1136/%20heartjnl-2022-321930" target="_blank" rel="noreferrer noopener">review</a> researchers found women who closely followed a Mediterranean diet were associated with up to 24% lower risk of cardiovascular disease and up to 23% lower risk of death from any cause. This is the first study to examine the association between the Mediterranean diet, cardiovascular disease, and mortality in women specifically, and is published in the journal Heart. A <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02772-3" target="_blank" rel="noreferrer noopener">UK study</a> in BMC Medicine has also found that men and women with a strict Mediterranean diet had up to 23% lower risk for developing dementia in comparison with those with the lowest level of adherence to the diet. The Mediterranean diet is rich in fruits, vegetables, legumes, nuts, seeds, wholegrains, and olive oil; moderate in fish and shellfish; low to moderate in wine; and low in red meat and processed meats, dairy products, animal fat, and processed foods. Cardiovascular disease is an umbrella term that includes heart, stroke, and blood vessel diseases, and was the <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/about" target="_blank" rel="noreferrer noopener">underlying cause</a> of one in four deaths in Australia in 2019. “The Mediterranean diet is known for its health benefits, especially for heart health, but most studies and research into diet and heart disease are done primarily in men,” says Anushriya Pant, University of Sydney PhD candidate at the Westmead Applied Research Centre (WARC) and first author of the Heart paper. The study analysed pooled data from 16 studies published between 2006 and 2021, involving over 722,000 female participants aged 18 and above who followed the Mediterranean diet and whose cardiovascular health was monitored for an average of 12.5 years. The researchers found that the reduced risk of cardiovascular disease and death applied to women of all ethnicities.. “Now we have confirmed that similar benefits apply for women’s dietary guidelines, and this reflects the strength of the Mediterranean diet for good heart health,” adds Pant. “In medical research, there are sex disparities in how clinical trials are designed. This creates large gaps in clinical data, which can potentially impact the development of health advice. Our work is a step towards addressing this gap.” The researchers acknowledge some limitations to their findings. All studies analysed were observational – so could only establish an association, not causation, between the Mediterranean diet and lowered risk of cardiovascular disease and death – and relied on self-reported food frequency questionnaires. Adjustments for potentially influencing factors also varied across the studies. The second study into dementia is equally supportive of the diet guidelines. UK scientists analysed data from 60,298 individuals from the <a href="https://www.ukbiobank.ac.uk/" target="_blank" rel="noreferrer noopener">UK Biobank</a> – a large-scale biomedical database containing genetic and health information from half a million UK participants – who completed a dietary assessment. Participants were followed for nine years, during which there were 882 cases of dementia. The researchers scored individuals based on how closely their diet matched the key features of a Mediterranean one, while taking into account their genetic risk for dementia. The authors say the findings indicate that, even for those with a higher genetic risk for dementia, having a better diet could reduce the likelihood of developing the condition. “Dementia impacts the lives of millions of individuals throughout the world, and there are currently limited options for treating this condition,” says Dr Oliver Shannon, a lecturer in Human Nutrition and Ageing at Newcastle University, and first author of the study. “Finding ways to reduce our risk of developing dementia is, therefore, a major priority for researchers and clinicians. “Our study suggests that eating a more Mediterranean-like diet could be one strategy to help individuals lower their risk of dementia.” The authors caution that there are limitations to this study, including that their analysis is limited to individuals who self-reported their ethnic background as white, British, or Irish, as only genetic data based on European ancestry was available. Further research is needed in a range of populations to determine the potential benefit for all people. In 2022, it was estimated that there were 401,300 <a href="https://www.aihw.gov.au/reports/dementia/dementia-in-aus/contents/summary" target="_blank" rel="noreferrer noopener">Australians living with dementia</a>. With an ageing and growing population this number is predicted to more than double to 849,300 people by 2058. <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=239397&title=Mediterranean+diet+associated+with+big+reduction+in+the+risk+of+heart+disease+and+dementia" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div id="contributors"> <a href="https://cosmosmagazine.com/health/mediterranean-diet-heart-dementia/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto">Imma Perfetto</a>. Image credit: Shutterstock </div>

Body

What is myrtle rust and why has this disease closed Lord Howe Island to visitors?

Some 70% of the World Heritage-listed Lord Howe Island has been <a href="https://www.theguardian.com/australia-news/2023/mar/17/most-of-lord-howe-island-closed-to-visitors-after-outbreak-of-plant-fungus">closed to non-essential visitors</a> in response to a recurrence of the plant disease myrtle rust. Myrtle rust, native to South America, was <a href="https://www.dcceew.gov.au/environment/invasive-species/diseases-fungi-and-parasites/myrtle-rust">first detected</a> in Australia on the Central Coast of NSW in April 2010. It is caused by a fungus that belongs to a group of plant pathogens known as the rusts. Rusts are among the most feared of all plant pathogens. They spread rapidly over thousands of kilometres on wind currents and can cause huge losses in plant production. For example, wheat rust research over the past 100 years at the University of Sydney has shown clear evidence of wind-borne rust spores travelling from central Africa to Australia. Wheat production losses due to rust have at times totalled <a href="https://www.agriculture.gov.au/abares/research-topics/biosecurity/biosecurity-economics/potential-impact-wheat-stem-rust">hundreds of millions of dollars</a>. Myrtle rust rapidly invaded the entire east coast of Australia in the years after it was first detected. It has caused the near extinction of at least three rainforest species, including the native guava (<a href="https://www.environment.gov.au/cgi-bin/sprat/public/publicspecies.pl?taxon_id=19162">Rhodomyrtus psidioides</a>) and the scrub turpentine (<a href="https://www.environment.gov.au/cgi-bin/sprat/public/publicspecies.pl?taxon_id=15763">Rhodamnia rubescens</a>). The disease was detected at Lord Howe Island <a href="https://islandarks.com.au/files/2017/12/I-think-we-dodged-a-bullet-Implementing-a-Rapid-Response-Plan-for-a-Myrtle-Rust-incursion-on-Lord-Howe-Island-in-October-2016.pdf">in 2016, and eradicated</a>. Now it has managed to spread there once again. There are concerns if the disease is left unchecked, it could seriously alter the unique ecology of the island. Lord Howe is home to some 240 native plant species, of which more than 100 are not found anywhere else. <h2>How can the disease be controlled?</h2> Rust diseases in agriculture are controlled by the cultivation of genetically <a href="https://csiropedia.csiro.au/rust-resistance-in-plants/">resistant plants</a>, or by use of fungicides. These fungicides can kill existing recent infections and provide protection for up to four weeks. In other situations, such as horticulture and native plant communities, fungicides are used together with removal and destruction of infected plants. The 2010 detection of myrtle rust in Australia followed its detection in Hawaii in 2005 and China in 2009. It was later found in New Caledonia (2013) and New Zealand (2017). <a href="https://espace.library.uq.edu.au/view/UQ:13b49a4">Research</a> has shown the same strain – known as the “pandemic strain” – has appeared in all of these countries. Several other strains occur in South America. It is likely the fungus spread to Lord Howe Island from eastern Australia on wind currents. The especially wet conditions along the east coast of much of Australia in 2022 led to an increase in the disease there. This, in turn, increased rust spore load and hence the chance of long-distance spore dispersal. In addition to being spread on the wind, the rusty coloured spores produced by these fungal pathogens stick readily to clothing. These spores remain viable for at least two weeks under ambient conditions. Several wheat rusts of exotic origin are believed to have been accidentally brought in to Australia on travellers’ clothing from North America and Europe. The chance of inadvertent spread of myrtle rust on contaminated clothing is why access to Lord Howe island has been restricted since last week. The second incursion into the island clearly shows how incredibly difficult rust diseases are to manage once they reach a new region. It points to possible recurrences of the disease there in years to come even should current efforts to eradicate it succeed. On top of the ability of rust diseases to spread rapidly over large distances, a further complication in controlling myrtle rust is it infects a wide range of native plants. Some of these species hold great cultural significance and/or are endangered. Endemic species of the myrtle plant family <a href="https://www.britannica.com/plant/Myrtaceae">Myrtaceae</a> that are dominant in many of the plant communities on Lord Howe Island are highly vulnerable to myrtle rust infection. Of critical concern are two species that occur only on the island: the mountain rose (Meterosideros nervulosa) and the rainforest tree scalybark (Syzigium fullagarri). The rust infects young leaves and also flowers, where it causes sterility. <h2>Australia brings expertise to the battle</h2> Australia has some of the best plant pathologists in the world and has long been a leader in controlling rust diseases in agriculture. This expertise, combined with world-leading scientists in the ecology of Australian native plants, has enabled solid progress in understanding myrtle rust in the Australian environment. Australian scientists have joined hands with New Zealand scientists to boost efforts to control the pathogen in both countries. Research is also under way at the University of Sydney and Australian National University to develop new DNA-based diagnostics to allow rapid identification of the different strains of the pathogen. These tests are especially important given only one strain of myrtle rust occurs in the Asia-Pacific and Oceania regions. The success of managing the impact of myrtle rust on the region’s iconic flora against a backdrop of climate change will rely heavily on undertaking the research needed to gain a much better understanding of this damaging plant pathogen. Recognising this, staff at the University of Sydney have convened a conference for June 21-23 this year. It will bring together myrtle rust experts to exchange their latest research findings and identify priority areas for research. This article originally appeared on <a href="https://theconversation.com/what-is-myrtle-rust-and-why-has-this-disease-closed-lord-howe-island-to-visitors-202045" target="_blank" rel="noopener">The Conversation</a>. Images: Getty

Travel Trouble

“Cruel disease”: Bruce Willis given heartbreaking new diagnosis

In a devastating statement on Instagram, Bruce Willis’ family have shared an update on his health, announcing that the actor has been diagnosed with frontotemporal dementia. Bruce’s wife, Emma Heming Willis, shared a picture of Bruce smiling on a beach, with a caption that provided their supporters news of the development in his health battle, and explained that his condition has gotten worse since his aphasia diagnosis in 2022. The same post was shared by Bruce’s ex-wife, Demi Moore, and daughter Rumer. On behalf of herself and the “Ladies of Willis/Moore”, Emma wrote, “our family wanted to start by expressing our deepest gratitude for the incredible outpouring of love, support and wonderful stories we have all received since sharing Bruce’s original diagnosis. “In the spirit of that, we wanted to give you an update about our beloved husband, father and friend since we now have a deeper understanding of what he is experiencing. “Since we announced Bruce’s diagnosis of aphasia in spring 2022, Bruce’s condition has progressed and we now have a more specific diagnosis: frontotemporal dementia (known as FTD). Unfortunately, challenges with communication are just one symptom of the disease Bruce faces. While this is painful, it is a relief to finally have a clear diagnosis.” In their full statement, the family explained that FTD is a “cruel disease” that is largely unheard of, although it is the most common form of dementia for individuals under the age of 60. Symptoms, which can worsen over time, include a loss of motor skills - from having trouble walking to muscle spasms. “Today there are no treatments for the disease,” the family wrote, “a reality that we hope can change in the years ahead. As Bruce’s condition advances, we hope that any media attention can be focused on shining a light on this disease that needs far more awareness and research.” “Bruce always believed in using his voice in the world to help others, and to raise awareness about important issues both publicly and privately. We know in our hearts that – if he could today -- he would want to respond by bringing global attention and a connectedness with those who are also dealing with this debilitating disease and how it impacts so many individuals and their families.” The statement - from the hearts of Bruce’s wife, ex-wife, and five daughters - concluded with a plea for fans to go out and educate themselves on the disease, and to support the mission to help others, whether or not they had any experience with FTD themselves. “Bruce has always found joy in life – and has helped everyone he knows to do the same,” they finished. “It has meant the world to see that sense of care echoed back to him and to all of us. We have been so moved by the love you have all shared for our dear husband, father, and friend during this difficult time. Your continued compassion, understanding, and respect will enable us to help Bruce live as full a life as possible.” In response to the news, fans and fellow Hollywood stars came to share their love and support for the actor, as well as his loved ones as they all come to terms with the new diagnosis. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Cou_gFCPvjB/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Cou_gFCPvjB/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Emma Heming Willis (@emmahemingwillis)</a> </div> </blockquote> “Thank you for sharing this with us. Sending Bruce and all the families love,” wrote American actress Rita Wilson. “I do understand, I lost my father from this disease,” a supporter shared. “I have to say- we kept finding gifts in the darkness and came out his death with a deeper love and an abundance of appreciation for life because though dementia is awful, we didn’t let it define him or us. We met him where he was hour by hour, minutes by minutes and learned so much him and ourselves. Sending all our love and light.” Surprisingly, a fuzzy cat even dropped by to send its love to the family, telling them “I send you all my love Bruce, Emma, Demi, Rumer, Scout, Tallulah, Mabel, and Evelyn.” And as one fan on Twitter said, “Thanks to the Willis family for sharing his diagnosis, it helps raise awareness of FTD. To his and other families with a loved one with FTD, stay strong. Keep fighting. We are all here for each other.” Image: Instagram

Caring

13 things neurologists do to help prevent Alzheimer’s disease

Understand Alzheimer's disease Alzheimer’s disease is the leading cause of dementia. But all dementia is not Alzheimer’s, says Dr David Knopman, a neurologist at the Mayo Clinic in Minnesota. Dementia is a general term used to describe a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. Alzheimer’s is a physical disease that targets the brain, causing problems with memory, thinking and behaviour. It is also age-related (symptoms usually start at age 65) and progressive, as symptoms usually worsen over time. Research shows that plaques and tangles two proteins that build up and block connections between nerve cells and eventually kill nerve cells in the brain, cause Alzheimer’s symptoms. Get enough sleep When you toss and turn all night, levels of brain-damaging proteins in the cerebrospinal fluid can rise: A 2017 study in Brain suggests that those with chronic sleep problems during middle age may increase their risk of Alzheimer’s later in life. “You have to commit to the importance of sleep,” says neurologist Dr Gayatri Devi. “I prioritise sleep as one of the most important activities I do – I will leave a party early in order to get a good night’s sleep.” Stay socially active Say yes to those social invitations! A 2019 study published in PLOS Medicine found that social activity with friends in your 60s could lower your risk of dementia by 12%. “There is something intrinsically valuable about social engagement,” says Dr Knopman. “It makes sense that those who are more engaged, especially socially, will think more positively and have a better outlook on life.” Keep learning People with advanced degrees have a lower risk of Alzheimer’s, according to 2017 research published in the BMJ. Education seems to build a ‘cognitive reserve’, which enables the brain to better resist neurological damage. “Higher education has a powerful effect,” says Dr Knopman. It’s never too late, check out the continuing education courses offered online or near you. Learn a second language Speaking more than one language can protect against Alzheimer’s disease and other types of dementia, according to 2017 research published in Clinical Interventions in Aging. While no one is sure why a second language helps so much, Dr Knopman theorises that the effort to communicate bilingually is like a workout for the brain, helping preserve grey matter and neurons. Do it yourself Challenging your brain in new ways can enhance memory as you age. Dr Devi has her own take on this: “If there is a problem with the phone or the plumbing, I will try to fix it,” she says. “If I try to figure out how to fix this on my own, it is good for my brain.” Right now she’s designing and building a window seat. “It is a way to keep different parts of my brain thriving.” Stay active Exercise is crucial to your wellness and your brain. Research published in Cureus in 2020, found that people who exercise regularly can slow cognitive decline. According to the Alzheimer’s Society, the combined results of 11 studies indicate that regular exercise can reduce the risk of developing dementia by about 30%; it drops the risk of Alzheimer’s by 45%. “When you are physically active, you burn more calories and you’re less likely to be obese,” explains Dr Knopman. “You’ll have better cardiovascular health because you are pushing your heart rate.” Take care of your heart “What is good for the heart is good for the brain,” says Dr Devi. Conditions such as high blood pressure, diabetes and high cholesterol, which increase the risk of cardiovascular disease, may also increase the risk of developing Alzheimer’s, and a 2017 study in JAMA found that middle-aged people with risk factors for heart attacks and stroke are also more likely to develop changes in the brain that can lead to the disease. “Anything that keeps the heart healthy is directly related to brain health,” Dr Devi says. It also reduces the risk of stroke, which can cause its own kind of dementia – vascular dementia. Lower your stress levels Persistent stress can take a toll on the brain, and 2018 research published in Neurobiology of Stress indicates that chronic stress can accelerate Alzheimer’s disease. When you’re stressed, your body releases cortisol, a hormone linked to memory trouble. In addition, experts have found that stress can lead to conditions such as depression and anxiety, which also increases the risk for dementia, according to research in Current Opinion in Psychiatry. “Eliminating stress helps reduce the amount of cortisol and optimises glucose utilisation, which your brain needs for food,” says Dr Devi. Try the MIND diet A combination of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, the MIND diet is designed specifically for brain health. (MIND is short for Mediterranean-DASH Diet Intervention for Neurodegenerative Delay.) The diet is pretty pleasant: you eat at least three servings of whole grains a day, two portions of vegetables (one of which must be a leafy green), snack on nuts, eat lean proteins like chicken and fish, berries, and have a glass of wine a day. According to research in Alzheimer’s & Dementia, those who adhered to the diet rigorously were able to lower their risk of cognitive decline later in life. You can’t trust all diets, warns Dr Knopman, but he likes this approach: “I tell my patients that if you follow a reasonable diet with lots of fresh fruits and vegetable that balances different food groups, and avoid obesity, you will be okay.” Get your snoring checked out Another way to wreck your sleep without realising it is with sleep apnea. According to the US National Institutes of Health, sleep apnoea occurs when a person’s upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow. Many factors – from obesity to large tonsils to neuromuscular disorders – can cause sleep apnoea. Sleep apnoea not only prevents restful sleep, but untreated it can increase the risk of developing certain health conditions. “If left untreated, sleep apnoea has significant cardiovascular consequences and consequences of mental function,” says Dr Knopman. Protect your head According to the Alzheimer’s Association, there is a strong link between serious head trauma and developing Alzheimer’s later in life, especially if the injury involves loss of consciousness. A 2017 review of research in PLOS One suggests head injuries that require medical attention may increase the risk of dementia and Alzheimer’s disease. Wear a helmet while cycling, make your home fall-proof, and always use a seat belt to help protect your noggin. Drink a cup of tea Green tea has loads of health benefits – including some for your brain. A 2019 systematic review in Nutrients found that green tea might reduce the risk of dementia. And research in the Journal of the American Chemical Society found that it’s a compound in the beverage that can disrupt the formation of toxic plaques that contribute to Alzheimer’s disease. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/conditions/13-things-neurologists-do-to-help-prevent-alzheimers-disease?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

Mind

Air travel spreads infections globally, but health advice from inflight magazines can limit that

“Travel safe, travel far, travel wide, and travel often,” <a href="https://thoughtcatalog.com/matthew-kepnes/2014/01/53-travel-quotes-to-inspire-you-to-see-the-world/">says</a> <a href="https://www.nomadicmatt.com/">Nomadic Matt</a>, the American who quit his job to travel the world, write about it and coach others to do the same. But there’s a downside to all this travel, with its unprecedented volume of passengers moving from one side of the world to the other, largely by plane. There’s the risk of those passengers spreading infectious diseases and microorganisms resistant to multiple drugs (superbugs) around the world. Yet, our recently published <a href="https://www.sciencedirect.com/science/article/pii/S1477893919301218">research</a> into health advice provided by inflight magazines shows plane passengers are given practically no advice on how to limit the spread of infectious diseases. Should we be worried about the part air travel plays in spreading infectious diseases? And what can we do about it? How big is the risk? Low airfares and a series of social and economic factors have made global air travel more common than ever. According to the Australian government department of infrastructure, transport, cities and regional development the <a href="https://www.bitre.gov.au/publications/ongoing/files/International_airline_activity_CY2018.pdf">number of passengers taking international scheduled flights in 2018 was 41.575 million</a>. But the International Air Transport Association projects passenger demand will <a href="https://www.iata.org/pressroom/pr/Pages/2019-02-27-02.aspx">reach 8.2 billion by 2037</a>. There are many examples of infectious diseases spread via international flying. The World Health Organization documented <a href="https://www.who.int/ith/mode_of_travel/tcd_aircraft/en/">transmission of tuberculosis</a> (TB) on board commercial aircraft during long-haul flights during the 1980s. Research published in 2011 documents the <a href="https://wwwnc.cdc.gov/eid/article/17/7/10-1135_article">transmission of influenza</a> on two transcontinental international flights in May 2009. More recently, the current <a href="https://theconversation.com/why-people-born-between-1966-and-1994-are-at-greater-risk-of-measles-and-what-to-do-about-it-110167">global outbreak of measles</a> in many countries, including the Philippines and the United States, gave rise to the risk of transmission during international travel. In a recent case a <a href="https://www.health.nsw.gov.au/Infectious/alerts/Pages/measles-alert-january.aspx">baby</a> too young to be vaccinated who had <a href="https://www.smh.com.au/national/nsw/measles-alert-after-infectious-baby-flew-from-manila-went-to-central-coast-20190603-p51tzs.html">measles</a> returned from Manilla in the Philippines to Sydney, exposing travellers on that flight to infection. Then there is the risk of transmitting antimicrobial-resistant organisms that cause disease, such as <a href="https://theconversation.com/explainer-what-is-tb-and-am-i-at-risk-of-getting-it-in-australia-75290">multi-drug resistant TB</a>. Recently, patients in Victoria and New South Wales were identified as carrying the drug-resistant fungus <a href="https://www2.health.vic.gov.au/about/news-and-events/healthalerts/candida-auris-case-detected-in-victoria">Candida auris</a>, which they acquired overseas. <a href="https://www.ncbi.nlm.nih.gov/pubmed/27890665">One study</a> estimates that over 300 million travellers visit high-risk areas, such as the western Pacific, Southeast Asia and Eastern Mediterranean, each year worldwide, and more than 20% return as new carriers of resistant organisms. These popular destinations, as well as the Middle East, have high rates of drug resistant organisms. How is this happening? Aircraft move large volumes of people around the world swiftly. But what sets them apart from buses and trains is that passengers are close together, in confined spaces, for a long time. This increases the risk of transmitting infections. Passengers interact with high-touch surfaces, such as tray tables, headsets, seats and handles. We cough, sneeze and touch multiple surfaces multiple times during a flight, with limited opportunities to clean our hands with soap and water. Many infections, such as gastroenteritis and diarrhoea, are spread and contracted by touch and contact. What can we do about it? Providing plane travellers with relevant health advice is one way to limit the spread of infectious diseases via air travel. This would include information and advice on routine hand washing with soap and water, or using alcohol-based hand rubs, and other basic measures including cough etiquette, such as coughing into your elbow and covering your nose and face. <a href="https://academic.oup.com/jtm/article/4/2/102/1847252">Researchers</a> have looked at the role commercial websites and travel agencies might play in providing that advice. And since the 1990s, airline magazines have been <a href="https://academic.oup.com/jtm/article/4/2/102/1847252">highlighted</a> as an underused source of traveller health advice. More than 20 years on, we discovered little has changed. In our recent study, published in the journal <a href="https://www.sciencedirect.com/science/article/pii/S1477893919301218">Travel Medicine and Infectious Disease</a>, we looked at the content of inflight magazines from 103 airlines issued during January 2019. Of the 47 available online, only a quarter (11) included an official section on passengers’ general health and well-being, of which only two contained information related to infection control and the preventing infectious diseases. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Inflight magazines have a potential audience of billions. So why not include advice on hand hygiene and coughing etiquette? <a class="source" href="https://www.shutterstock.com/download/confirm/1424594042?src=vUDfEziJwFDV7GZr5OYMRA-1-2&studio=1&size=medium_jpg">from www.shutterstock.com</a></figcaption></figure> The first magazine, from a UAE-based airline, had an official section on passenger health and well-being that included very limited relevant content. It advised passengers “with blood diseases or ear, nose and sinus infections should seek medical advice before flying”. There was no further explanation or information, nor were there any strategies to prevent these or other infections. The second magazine, from a USA-based airline, contained general travel health advice, but none specifically about infectious diseases. However there was a full-page, colour advertisement next to the health section. This contained images of many disease causing microorganisms on passengers’ tray tables and advocated the use of a disinfectant wipe for hands and other inflight surfaces. The slogan “because germs are frequent fliers” was displayed across the tray table. This was accompanied by information about the use and effectiveness of disinfectant wipes for hand hygiene and disinfecting surfaces during air travel, public transport use, and in hotels and restaurants. Inflight magazines are valuable assets for airlines and are the source of considerable advertising revenue. They are read by potentially billions of passengers every year. The results of this study show that they are a greatly underused source of information about infection control and measures to prevent the spread of infectious diseases. Airlines should also provide health advice to passengers in other media, in particular video screens, about infection prevention and basic control measures such as hand hygiene, cough etiquette and personal hygiene. Such advice should be provided before, during and after the flight. It could also include destination-related advice for particularly risky travel routes and destinations. More information for passengers Airlines providing health advice to passengers is just one way to limit the spread of infectious diseases and antimicrobial-resistant organisms around the world via air travel. This would need to sit alongside other measures, such as <a href="https://wwwnc.cdc.gov/travel/page/travel-industry-information-center">information and guidelines</a> provided to those who travel via the sea. The simple, low-cost measures highlighted in our research could go a long way to help passengers stay healthy and avoid illness from infectious diseases. At the same time, these measures could reduce the impact of outbreaks of infectious diseases for airlines and society as a whole.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/120283/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Ramon Zenel Shaban and Cristina Sotomayor-Castillo. Republished with permission from <a href="https://theconversation.com/air-travel-spreads-infections-globally-but-health-advice-from-inflight-magazines-can-limit-that-120283" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

International Travel

Urine sample test: new way to detect and screen for early stages of Alzheimer’s disease

When it comes to <a href="https://cosmosmagazine.com/science/alzheimers-peer-review/" target="_blank" rel="noreferrer noopener">Alzheimer’s disease</a>, an early diagnosis – one made well before signs of irreversible dementia are apparent – is key to providing effective intervention and treatment. Now early detection might be as simple as a urine test, allowing for wide-scale and early screening across large populations of the elderly. A collaboration of researchers in China investigated urine samples for biomarkers from a large group of patients with varying severity of Alzheimer’s disease, comparing them with healthy controls. A compound known as <a href="https://www.acs.org/content/acs/en/molecule-of-the-week/archive/f/formic-acid.html?cid=home_motw" target="_blank" rel="noreferrer noopener">formic acid</a> (which is also produced by some ant and bee species) was a particularly sensitive marker for cognitive decline associated with Alzheimer’s disease. Significant increases in urinary formic acid levels were found in all samples from Alzheimer’s sufferers (including those with only early-stage subjective cognitive decline) as compared with those from the healthy controls. “Alzheimer’s disease is a continuous and concealed chronic disease, meaning that it can develop and last for many years before obvious cognitive impairment emerges,” say the authors. “The early stages of the disease occur before the irreversible dementia stage, and this is the golden window for intervention and treatment.” When blood samples of the participants were analysed for Alzheimer’s biomarkers in combination with the urinary formic acid level, the researchers were able to predict to what stage of the disease the patient had progressed. Their report is in <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2022.1046066/full" target="_blank" rel="noreferrer noopener">Frontiers in Ageing</a>. Other methods currently used to diagnose Alzheimer’s disease, such as positron emission tomography brain scans, <a href="https://cosmosmagazine.com/health/medicine/alzheimers-blood-test-developed/" target="_blank" rel="noreferrer noopener">invasive blood draws</a> and lumbar punctures, tend to be costly and invasive. Although other urinary biomarkers for Alzheimer’s disease have been found, none have been able to detect the disease at its earliest stages. The links between urinary formic acid and Alzheimer’s disease are still not fully understood, but this research is an important step towards developing tools to diagnose and treat this debilitating condition amongst a vulnerable group in society. “Urinary formic acid showed an excellent sensitivity for early Alzheimer’s screening,” said the authors. “The detection of urine biomarkers of Alzheimer’s is convenient and cost-effective, and it should be performed during routine physical examinations of the elderly.” <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=227116&title=Urine+sample+test%3A+new+way+to+detect+and+screen+for+early+stages+of+Alzheimer%E2%80%99s+disease" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /> <div id="contributors"> <a href="https://cosmosmagazine.com/health/urine-new-way-detect-alzheimers-disease/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Clare Kenyon. Image: Getty Images </div>

Mind

Drugs – 4 essential reads on how they’re made, how they work and how context can make poison a medicine

Pandemics and disease outbreaks put a spotlight on the hurdles researchers face to get a drug on the shelves. From finding prospective drug candidates to balancing time and financial pressures with ensuring safety and efficacy, there are many aspects of drug development that determine whether a treatment ever makes it out of the lab. Broadening the definition of “medicine” and where it can be found, however, could help expand the therapeutic options available for both researchers and patients. Here are four facets of how drugs are developed and how they work in the body, drawn from stories in The Conversation’s archive. <h2>1. Matching drug to target</h2> The most effective drugs are, in a sense, the product of good matchmaking – they bind to a specific disease-causing receptor in the body, elicit a desired effect and ideally ignore healthy parts of the body. Drugs <a href="https://theconversation.com/how-do-drugs-know-where-to-go-in-the-body-a-pharmaceutical-scientist-explains-why-some-medications-are-swallowed-while-others-are-injected-182488" target="_blank" rel="noopener">travel through the bloodstream</a> to reach their targets. Because of this, most drugs circulate throughout the body and can bind to unintended sites, potentially causing undesired side effects. Researchers can increase the precision and effectiveness of a drug by designing different ways to take it. An inhaler, for example, delivers a drug directly to the lungs without its having to travel through the rest of the body to get there. Whether patients take drugs as prescribed is also essential to ensuring the right dose gets to where it needs to be often enough to have a desired effect. “Even with all the science that goes into understanding a disease well enough to develop an effective drug, it is often up to the patient to make it all work as designed,” writes pharmaceutical scientist <a href="https://www.researchgate.net/profile/Thomas-Anchordoquy" target="_blank" rel="noopener">Tom Anchordoquy</a> of the University of Colorado Anschutz. <h2>2. Searching for drug candidates</h2> Researchers have discovered a number of drugs by chance, including <a href="https://www.pbs.org/newshour/health/the-real-story-behind-the-worlds-first-antibiotic" target="_blank" rel="noopener">penicillin</a> for bacterial infections, <a href="https://www.bbc.com/future/article/20200928-how-the-first-vaccine-was-born" target="_blank" rel="noopener">vaccines for smallpox</a> and <a href="https://doi.org/10.1038/nrcardio.2017.172" target="_blank" rel="noopener">warfarin</a> for blood clots. While serendipity still plays a role in modern drug discovery, most drug developers take a systematic approach. Scientists typically start by identifying a particular molecular target, usually receptors that trigger a specific response in the body. Then, they look for chemical compounds that react with that target. Technology called <a href="https://theconversation.com/discovering-new-drugs-is-a-long-and-expensive-process-chemical-compounds-that-dupe-screening-tools-make-it-even-harder-175972" target="_blank" rel="noopener">high-throughput screening</a> allows researchers to quickly test thousands of potential drug candidates at once. Compounds that match screening criteria advance to further development and refinement. Once optimized for their intended use, compounds go on to safety and efficacy testing in animals and people. One way to ease the search for optimal drug candidates is to work with compounds that are already optimized to work in living beings. <a href="https://theconversation.com/nature-is-the-worlds-original-pharmacy-returning-to-medicines-roots-could-help-fill-drug-discovery-gaps-176963" target="_blank" rel="noopener">Natural products</a>, derived from organisms like microbes, fungi, plants and animals, share similar structures and functions across species. Though not without their own development challenges, they could aid the search for related compounds that work in people. “There are thousands of microorganisms in the ocean left to explore as potential sources of drug candidates, not to mention all the ones on land,” writes medical chemist <a href="https://scholar.google.com/citations?user=8_T1ueYAAAAJ&hl=en" target="_blank" rel="noopener">Ashu Tripathi</a> of the University of Michigan. “In the search for new drugs to combat antibiotic resistance, natural products may still be the way to go.” <h2>3. A drug by any other name may be just as effective</h2> Existing drugs can find a second (or third, fourth and fifth) life through repurposing. Most drugs <a href="https://theconversation.com/many-medications-affect-more-than-one-target-in-the-body-some-drug-designers-are-embracing-the-side-effects-that-had-been-seen-as-a-drawback-184922" target="_blank" rel="noopener">have many functions</a> beyond what researchers originally designed them to do. While this multifunctionality is often the cause of unwanted side effects, sometimes these results are exactly what’s needed to treat a completely unrelated condition. Sildenafil, for example, failed to treat severe chest pain from coronary artery disease, but proved to be potent at inducing erections as Viagra. Similarly, thalidomide, a compound that caused birth defects in thousands of infants around the world as a morning sickness drug, found redemption as a cancer treatment. Because drugs inherently have more than one function in the body, <a href="https://theconversation.com/repurposing-generic-drugs-can-reduce-time-and-cost-to-develop-new-treatments-but-low-profitability-remains-a-barrier-174874" target="_blank" rel="noopener">repurposing existing drugs</a> can help fill a gap where pharmaceutical companies and other developers cannot or will not. <a href="https://scholar.google.com/citations?user=iDKZaA4AAAAJ&hl=en" target="_blank" rel="noopener">Gregory Way</a>, a researcher at the University of Colorado Anschutz, uses artificial intelligence to predict the various effects a drug can have and believes that this lack of specificity is something to explore rather than eliminate. Instead of trying to home in on one specific target, he suggests that scientists “embrace the complexity of biology and try to leverage the multifaceted effects drugs can offer.” <h2>4. Poison as medicine</h2> If so many drugs can have toxic effects in the body, be it through side effects or taking the wrong dose or for the wrong condition, what determines whether a drug is a “medicine” or a “poison”? Biomedical scientists evaluate drugs based on their active ingredient, or a specific compound that has a specific effect in the body. But reducing medicines to just a single molecule ignores another important factor that determines whether a drug is therapeutic – the context in which it is used. Opioids treat intractable pain but can lead to debilitating and lethal addiction when improperly administered. Chemotherapy kills tumors but causes collateral damage to healthy tissues in the process. Another pharmaceutical paradigm, <a href="https://theconversation.com/poison-or-cure-traditional-chinese-medicine-shows-that-context-can-make-all-the-difference-163337" target="_blank" rel="noopener">traditional Chinese medicine</a>, has historically acknowledged the malleability of drugs through the use of poisons as therapeutics. <a href="https://scholar.google.com/citations?user=4q0hYSwAAAAJ&hl=en" target="_blank" rel="noopener">Yan Liu</a>, a medical historian at University of Buffalo who studies this practice, notes that ancient texts did not distinguish between poisons and nonpoisons – rather, Chinese doctors examined drugs based on a continuum of potency, or ability to harm and heal. They used different processing and administration techniques to adjust the potency of poisons. They also took a personalized approach to treatment, aware that each drug works differently based on a number of different individual factors. “The paradox of healing with poisons in traditional Chinese medicine reveals a key message: There is no essential, absolute or unchanging core that characterizes a medicine,” Liu writes. “Instead, the effect of any given drug is always relational – it is contingent on how the drug is used, how it interacts with a particular body and its intended effects.” This article originally appeared on <a href="https://theconversation.com/drugs-4-essential-reads-on-how-theyre-made-how-they-work-and-how-context-can-make-poison-a-medicine-192590" target="_blank" rel="noopener">The Conversation</a> and is a roundup of of articles from The Conversation’s archives. Image: Shutterstock

Books

Michael Klim shares hopes for his incurable disease

Australian swimming legend Michael Klim has shared an update on how his neurological disorder has changed his day-to-day life and his hopes for raising awareness and finding a cure. In a recent interview with Sunrise, the Olympic gold medallist said it has “definitely been a very up and down three years” since <a href="https://www.oversixty.com.au/health/caring/it-s-not-easy-michael-klim-shares-health-update">he was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)</a>, which has caused him to lose “pretty much all muscle and sensation” in his legs. “There was a grieving process for the first couple of years, trying to come to terms with a completely different lifestyle and a different mindset, really,” he told the program. “I’ve stabilised but my mobility is still very much compromised, most of the time I use a walking stick around the pool deck.” “I plan simple things, when I’m going to the shops I have to plan how far I have to walk ... to get my groceries.” Having established himself in Bali with his partner Michelle, where they run one of the swim schools in his franchise Klim Swim, the 44-year-old still returns to Sydney for specialist treatment - though he doesn’t visit Australia as much as he used to. “I don’t get back to Australia as much as I used to, mainly just for treatment, but I’ve had an enormous amount of support from the Australian public and my swimming community just to get through this, so I’ll keep fighting and hopefully we can find a cure one day,” he said. Klim revealed that doctors still don’t know the cause of his CIDP, but said it’s easy to question whether the physical demands of his athletic career may have contributed. “They (doctors) don’t know the cause of CIDP. It can be genetic but in my case it’s not,” he said. “We used to pride ourselves on our physicality (as Olympians), our ability to take on anything that was thrown at us, especially during our training. “I used to love overtraining, that was my way of being ready and making sure mentally I was ready. “It used to give me toughness and mental strength, and now I think sometimes, ‘did I overdo it? Are the last three or four decades (of training) catching up with me?’” According to <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-inflammatory-demyelinating-polyradiculoneuropathy#:~:text=Chronic%20inflammatory%20demyelinating%20polyradiculoneuropathy%20(CIDP)%20is%20a%20slowly%20developing%20autoimmune,in%20the%20arms%20or%20legs." target="_blank" rel="noopener">John Hopkins Medicine</a>, CIDP is thought to be the chronic or long-term version of the disease Guillain-Barre syndrome, and occurs when the immune system attacks myelin, the fatty sheath around the nerve that acts as insulation and allows electrical impulses to travel along the nerve to stimulate muscles and transmit information to skin and joints. While the triggers of CIDP are still unknown, it doesn’t seem to have a link to genetics or occur after an infection, unlike Guillain-Barre syndrome. The <a href="https://www.gbs-cidp.org/cidp/" target="_blank" rel="noopener">GBS/CIDP Foundation International website</a> says that current theories are that CIDP is thought to start when the immune system perceives myelin as foreign and attacks it, causing damage to the myelin or removing it entirely. This damage or absence of myelin results in the electrical impulses being slowed down or lost, meaning that messages sent from the brain to move muscles don’t make it to their final destination. Despite the unknowns about his condition, Klim said he is optimistic that talking about his diagnosis will help to raise awareness and find a cure. “Hopefully we can put all our heads together, maybe there are certain treatments outside the realm we’re thinking of,” he said. “Maybe there’s future treatments that we can implement and…. we can knock it off.” Image: @michaelklim1 (Instagram)

Caring

COVID-19 has similar effect on brain as Parkinson’s disease

A new study from the University of Queensland has found that being infected with COVID-19 can trigger a similar reaction in the brain to Parkinson’s disease - and they have identified a possible treatment to stop Covid’s impact on the brain in its tracks. A growing number of reports have found that Covid affects more than just our lungs, with several studies finding up to 85 percent of people with Covid, including severe, mild and asymptomatic infections, have neurological complications from being infected with the virus. This can show up in a variety of symptoms, such as headaches, dizziness, confusion, seizures, and change in mood, including depression and anxiety. The team of scientists has discovered that the virus can cause inflammation in the brain, which could make people more vulnerable to developing Parkinson's and other similar conditions. “We studied the effect of the virus on the brain’s immune cells, ‘microglia’ which are the key cells involved in the progression of brain diseases like Parkinson’s and Alzheimer’s,” Professor Woodruff said. “Our team grew human microglia in the laboratory and infected the cells with SARS-CoV-2, the virus that causes COVID-19. “We found the cells effectively became ‘angry’, activating the same pathway that Parkinson’s and Alzheimer’s proteins can activate in disease, the inflammasomes.” Inflammasomes are a kind of complex of proteins that activate inflammatory responses in the body. Dr Albornoz Balmaceda, another of the 33 authors of the study published in <a href="https://doi.org/10.1038/s41380-022-01831-0" target="_blank" rel="noopener">Molecular Psychiatry</a>, said that triggering this pathway can spark a “fire” in the brain that silently kills neurons over time in a similar way to Parkinson's and Alzheimer’s. “It’s kind of a silent killer, because you don’t see any outward symptoms for many years,” he said. “It may explain why some people who’ve had COVID-19 are more vulnerable to developing neurological symptoms similar to Parkinson’s disease.” They also found that the triggering of the inflammasome pathway was exacerbated in people who were already predisposed to developing Parkinson’s. “So if someone is already predisposed to Parkinson’s, having COVID-19 could be like pouring more fuel on that ‘fire’ in the brain,” Professor Woodruff said. “The same would apply for a predisposition for Alzheimer’s and other dementias that have been linked to inflammasomes.” While the findings are concerning, the team has also found a potential treatment that could stop the inflammation and put out the “fire” in the brain. Using inhibitory drugs developed at the University of Queensland currently being trialled with Parkinson’s patients, they found that inflammasome activation was reduced in comparison to no treatment at all. “We found it successfully blocked the inflammatory pathway activated by COVID-19, essentially putting out the fire,” Dr Balmaceda said. “The drug reduced inflammation in both COVID-19-infected mice and the microglia cells from humans, suggesting a possible treatment approach to prevent neurodegeneration in the future.” As a result, Professor Woodruff said that it means that potential treatments for Covid’s impact on the brain already exist. “Further research is needed, but this is potentially a new approach to treating a virus that could otherwise have untold long-term health ramifications,” he said. Image: Getty Images

Body

Your eyes could predict your risk of heart disease

As well as being windows to the soul, <a href="https://www.oversixty.com.au/health/body/could-an-eye-test-predict-your-risk-of-heart-disease" target="_blank" rel="noopener">your eyes</a> could indicate your risk of developing heart disease according to new research. Scientists have developed imaging powered by Artificial Intelligence (AI) that can predict cardiovascular disease and death just by looking at the network of veins and arteries in your retina. Their findings could pave the way for a non-invasive and highly effective test that could replace the blood tests and blood pressure measurements currently used. With previous studies finding that the width of the tiny veins and arteries in the retina may be an accurate, early indicator for circulatory diseases including heart disease, cardiovascular disease, stroke, and heart failure. But, it was unclear whether these findings apply to both men and women, prompting the researchers to develop an AI-enabled algorithm called QUARTZ (QUantitative Analysis of Retinal vessels Topology and siZe) to develop models for assessing whether combining imaging of the retina with known risk factors could predict vascular health and death. They then applied models the algorithm created to retinal images of 88,052 people that are stored in the UK’s BioBank, as well as 7411 participants in the European Prospective Investigation into Cancer (EPIC)-Norfolk study, which tracked the health of participants for seven to nine years. The predictive model used known risk factors, including smoking, medical history, and age and was able to identify two-thirds of the participants who later died of circulatory disease who were most at risk. With retinal imaging already being common practice in the UK and US, the researchers argue that using changes to the retina and AI has the potential to reach a greater portion of the population than current testing methods. “[Retinal vasculature]is a microvascular marker, hence offers better prediction for circulatory mortality and stroke compared with [heart attack] which is more macrovascular, except perhaps in women,” they write. “In the general population it could be used as a non-contact form of systemic vascular health check, to triage those at medium-high risk of circulatory mortality for further clinical risk assessment and appropriate intervention.” Drs Ify Mordi and Emanuele Trucco of Scotland’s University of Dundee wrote in <a href="https://bjo.bmj.com/content/early/2022/09/12/bjo-2022-322517" target="_blank" rel="noopener">a separate editorial</a> that using changes to the retina to inform overall cardiovascular risk is “certainly attractive and intuitive” but is yet to form part of clinical practice. “Using retinal screening in this way would presumably require a significant increase in the number of ophthalmologists or otherwise trained assessors,” they write. “What is now needed is for ophthalmologists, cardiologists, primary care physicians and computer scientists to work together to design studies to determine whether using this information improves clinical outcome, and, if so, to work with regulatory bodies, scientific societies and healthcare systems to optimise clinical workflows and enable practical implementation in routine practice.” The study was published in the <a href="https://bjo.bmj.com/content/early/2022/08/23/bjo-2022-321842" target="_blank" rel="noopener">British Journal of Ophthalmology</a>. Image: Getty Images

Caring

The “unlikely culprit” worsening lung disease unequally

Bronchiectasis (bron-kee-ek-tah-sis) is a chronic lung disease caused by widening of the airways in the lungs. As well as making breathing more difficult and coughing more common, it can lead to repeated flare-ups of lung infections. An international team of researchers based in Singapore has identified a bacteria, previously thought harmless in the lungs, that can be responsible for bronchiectasis flare-ups. According to their paper in Cell Host & Microbe, Neisseria bacteria, and specifically the species Neisseria subflava, worsens bronchiectasis. Neisseria are known to cause meningitis and gonorrhoea, but while they’d been found in lungs, they’ve previously not been thought to cause infections. “This discovery is significant because it can change how we treat our bronchiectasis patients with this bacterium,” says senior author Professor Sanjay Chotirmall, a researcher from the Lee Kong Chian School of Medicine at Nanyang Technical University, Singapore. “Doctors will now need to think about Neisseria as a potential ‘culprit’ in patients who are worsening despite treatment, and to conduct tests to identify those who may be harbouring this type of bacteria in their lungs.” While it affects people of every age and ethnicity, bronchiectasis prevalence increases as age does, and it’s up to four times more common among Asian people than white or black people. “We hope that early identification will lead to personalised therapy, and consequently, better disease outcomes for Asian patients with this devastating disease,” Chotirmall says. The researchers examined the lung microbiomes of 225 bronchiectasis patients from Singapore, Kuala Lumpur, and Dundee, in Scotland. They found that Neisseria subflava “dominated” the microbiome of Asian patients with worsening conditions. They then tested this bacteria in cell cultures and mice, showing that it caused cell disruption and thus inflammation and immune disfunction in lungs. “It is encouraging to see that we have made headway in identifying the Neisseria bacteria species as the cause of worsening bronchiectasis, the unlikely culprit that was originally not considered to be a threat,” says co-author Professor Wang De Yun, from the National University of Singapore’s Yong Loo Lin School of Medicine. “This comes as a strong reminder that we should not be too complacent when it comes to doing research and exercise more proactiveness in exploring various possibilities, as every seemingly innocent element could be a source of threat to our bodies and overall health.” This article originally appeared on <a href="https://cosmosmagazine.com/health/bronchiectasis-lung-disease-bacteria/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Image: Shutterstock

Body

"Dramatic result": New drug shows hope for slowing down Alzheimer's disease

A trial drug has shown "significant" results in slowing down Alzheimer's disease, with Australian healthcare experts hopeful in where this breakthrough can take their research. The drug, known as Lecanemab, has been proven to reduce cognitive decline by 27 per cent compared to placebo, according to an overseas study. More than 1,700 patients with mild cognitive impairment were enrolled in the study and the results were collected over 18 months. "Functionally and cognitively, it seems they did better and so that is a dramatic result," Dr Lawrence Honig, one of the study investigators from Columbia University Medical Centre, said. The drug works by removing the build-up of amyloid plaques in the brain which is one of the hallmarks of the disease, which featured in the scans of each study participant. Australian experts are excited about the findings, and how this can further their research. "This is the first time we've seen a drug like this have these kinds of effects," Professor Sharon Naismith, Clinical Neuropsychologist & NHMRC Dementia Leadership Fellow at the University of Sydney, said. "The results of this trial have massive implications for our resourcing." Naismith warns there's a need to spend more money on better diagnosing patients with mild cognitive impairment. "In the past there has been a lot of reluctance from healthcare physicians to diagnose or ask about cognitive impairment, even in primary care," she said. She said being able to access a drug that can slow cognitive decline will change the paradigm and conversation around Alzheimer's disease. "I do think we're going to get a real avalanche of people coming to GPs and coming to memory clinics for that reason," she said. Professor Kathryn Goozee, Director of KaRa Minds at Macquarie Park said the study showed using an antibody to target amyloid in the brain can help with cognition. "To date there has been no disease-modifying medication so we want to be offering studies that can potentially change that trajectory," Goozee said. The full details of the results will be presented at an international conference of experts in the US in late November. Image credits: 9News

Mind

Could Alzheimer’s be an autoimmune disease?

Searching for an Alzheimer’s cure is among the world’s most pressing needs. Researchers in Canada have a new theory. Alzheimer’s is a degenerative brain disease with no cure and no effective therapeutic treatments to stop or slow its progression. It impacts an estimated <a href="https://cosmosmagazine.com/health/dementias-rising-pressure/" target="_blank" rel="noreferrer noopener">50 million people around the world</a>, and for those afflicted, invariably results in <a href="https://www.dementia.org.au/" target="_blank" rel="noreferrer noopener">dementia</a> and death. <a href="https://www.healthdirect.gov.au/alzheimers-disease" target="_blank" rel="noreferrer noopener">In Australia Alzheimer’s affects up to 1 in 10 Australians over 65 years of age, and up to 3 in 10 over 85. It is not a normal part of ageing.</a> One prevailing theory suggests that a sticky protein called beta-amyloid builds up in the brain forming clumps known as plaques, which then acts to kill brain cells, directly causing Alzheimer’s disease. However, 30 years of research into the development of medical treatments designed to target these plaques have led to failure after failure. Now, scientists at the Krembil Brain Institute, which is part of the University Health Network in Ontario, Canada suggest that new thinking around the disease is desperately needed. They are asking: “Could Alzheimer’s be an <a href="https://cosmosmagazine.com/health/medicine/autoimmune-disease-on-the-rise/" target="_blank" rel="noreferrer noopener">autoimmune disease</a>?” <div class="newsletter-box"> <div id="wpcf7-f6-p215071-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> </div> </div> “Yes,” says Dr. Donald Weaver, co-Director of the Krembil Brain Institute and author of <a href="https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12789" target="_blank" rel="noreferrer noopener">new research</a> published in the peer-reviewed journal, Alzheimer’s & Dementia. “We don’t think of Alzheimer’s as fundamentally a disease of the brain. We think of it as a disease of the immune system within the brain.” The role of beta-amyloid in the brain is as an ‘immunopeptide’ – a messenger within the immune system which is involved in repairing the brain. “If we have head trauma, beta-amyloid repairs it. If a virus or a bacteria comes along, beta-amyloid is there to fight it,” explains Weaver. But unfortunately, beta-amyloid can become confused. “Beta-amyloid gets confused and can’t tell the difference between a bacteria and a brain cell,” says Weaver. “And so, it inadvertently attacks our own brain cells. This, then, becomes what we call an autoimmune disease.” To test these ideas, the team surveyed the disease and patient literature to develop a detailed model describing the cause and effect relationship of Alzheimer’s disease (known as a <a href="https://royalsocietypublishing.org/doi/10.1098/rsbl.2017.0660" target="_blank" rel="noreferrer noopener">mechanistic model</a>). This approach allowed them to step back and take a more holistic review of the workings of the disease at several different levels within the biological system — such as Alzheimer’s progression and effect on different sections of the brain’s nerve cells, and the larger immune disease response — and also to consider novel causes and inputs into the disease. Tangible rethinking about Alzheimer’s disease as an autoimmune disease, and beta-amyloid as a normal part of our immune system, opens the door to new avenues and approaches to develop innovative new therapies, says Dr. Weaver, who hopes that this new conceptual framework could eventually present a new way to combat this insidious and devastating disease. <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=215071&title=Could+Alzheimer%E2%80%99s+be+an+autoimmune+disease%3F" width="1" height="1" /> <div id="contributors"> <a href="https://cosmosmagazine.com/news/could-alzheimers-be-an-autoimmune-disease/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/clare-kenyon" target="_blank" rel="noopener">Clare Kenyon</a>. Clare Kenyon is a science journalist for Cosmos. An ex-high school teacher, she is currently wrangling the death throes of her PhD in astrophysics, has a Masters in astronomy and another in education. Clare also has diplomas in music and criminology and a graduate certificate of leadership and learning. Image: Getty Images </div>

Mind

Son's first dance with mum suffering from motor neurone disease

An emotional wedding video of a wheelchair-bound mother severely affected by motor neurone disease (MND) dancing with her eldest son on his big day has gone viral, with people describing the moment as both heart-breaking and heart-warming at the same time. Kathy Poirer was watching her eldest son Zak get married in a moving ceremony in their native Florida. Despite being unable to walk, Kathy, with the help of her other two children, was able to dance with her eldest child on his big day. The moment was captured on video and has since gone viral, as Kathy said the dance was a dream come true. “I just really wanted that moment with my son,” Poirer told Sunrise. “There are so many milestones in their life and you look forward to them and I was afraid I wouldn’t have that opportunity." “It truly is an expression of a mother and her son and their love for each other.” Kathy was diagnosed with MND more than three years ago, and has bravely fought the diagnosis and challenged the odds against her ever since. “I prayed every day that I would make it long enough to dance with him, and I fight every day for my life,” she said. Motor neurone disease is a condition that affects the body’s brain and the nerve cells called motor neurones. According to <a href="https://www.mndaustralia.org.au/mnd-connect/what-is-mnd/what-is-motor-neurone-disease-mnd" target="_blank" rel="noopener" data-link-type="article-inline">MND Australia:</a> “Motor neurones normally carry messages from the brain to the muscles via the spinal cord. The messages allow people to make voluntary movements like walking, swallowing, talking and breathing." There is currently no cure for MND, and the condition is known to drastically reduce life expectancy. Kathy is devoting the rest of her life to bringing awareness to this devastating disease, while encouraging people not to take life for granted. “What I wanted to do was make people aware that this can happen to you in a heartbeat and just live every moment to the fullest - you never know when it’s gonna get taken away,” she said. Image credits: Sunrise

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News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

"I’m not going to be cured". How breast cancer awareness and support sidelines people with metastatic disease

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

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Mediterranean diet associated with big reduction in the risk of heart disease and dementia

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COVID-19 has similar effect on brain as Parkinson’s disease

Your eyes could predict your risk of heart disease

The “unlikely culprit” worsening lung disease unequally

"Dramatic result": New drug shows hope for slowing down Alzheimer's disease

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Son's first dance with mum suffering from motor neurone disease

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