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Diabetes research: A new hormone to spur insulin production?
In a potentially significant advance against diabetes, researchers have found a new hormone in the liver and in fat that seems to cause insulin-generating cells in the pancreas to reproduce at unprecedented rates. The discovery could ultimately lead to new ways to fight the disease.
Beta cells (pictured above in green) reproduced at unprecedented rates when exposed to betatrophin.
The Harvard University scientists behind the study call the new hormone “betatrophin.” In mice, the hormone stimulates insulin-producing beta cells in the pancreas to reproduce at rates three to 12 times faster than beta cells in a control group. The researchers reported their results April 25 online in the journal Cell.
Although much more research is needed before this discovery can be translated into a therapy to be tested in humans, the finding is drawing considerable attention. Stimulating the production of, or otherwise targeting, this previously unknown hormone could become a weapon against diabetes, a growing health epidemic. The disease currently affects about 347 million people worldwide. Continue reading “Diabetes research: A new hormone to spur insulin production?” »
HIV vaccine failure fuels researchers’ determination
Yet another experimental HIV vaccine may have taken a fall, but researchers – including those at City of Hope – aren’t giving up.
Yet another HIV vaccine trial has failed, but researchers aren’t giving up.
The trial halted this week by the National Institutes of Health is but the latest failure in the realm of would-be HIV vaccines. The study, known as HVTN 505, was testing a two-vaccine “prime-boost” strategy; the first vaccine was designed to prime the immune system, the second was intended to boost the immune response, explained the National Institute of Allergy and Infectious Diseases (NIAID).
In this case, the strategy didn’t appear to work. And on Thursday, the government called off the trial, effective immediately. Not only did the vaccine not prevent HIV infection, it didn’t even reduce viral load among those recipients who became infected with HIV. Continue reading “HIV vaccine failure fuels researchers’ determination” »
Drugs for HER2-linked breast cancer may work against lung cancer
The HER2 protein is most well-known for its link to breast cancer, but it’s tied to a small portion of lung cancers as well. Now researchers have found that drugs that fight HER2-linked breast cancers may be effective against HER2-sensitive lung cancers as well.
Screening for and targeting HER2 (colored in beige in the above rendering and bound to Herceptin, in blue), a protein traditionally identified with breast cancers, may be beneficial for lung cancer patients, a new study says.
The study, published ahead of print on April 22 in the Journal of Clinical Oncology, involved 16 patients diagnosed with Stage IV HER2-mutated nonsmall cell lung cancer. After conventional chemotherapy, the patients were given HER2-targeted drugs — including Herceptin — and were monitored for disease progression. Drugs that target HER2 work by shutting down production of the cancer-promoting protein, which can hit overdrive due to a gene mutation.
The scientists reported that patients on either the HER2-targeted drug afatinib or on Herceptin-based combinations exhibited a disease control rate — either stabilization or partial remission of the disease — of 100 and 93 percent, respectively. Furthermore, those on the HER2-targeted drugs had a median progression-free survival of over five months.
Karen Reckamp, M.D., M.S., co-chair of City of Hope’s Lung Cancer and Thoracic Oncology Program, told MedPageToday that, although only 2 percent of patients with nonsmall cell lung cancer are positive for HER2 mutations, the numbers add up. As she pointed out, more than 200,000 Americans are diagnosed with lung cancer each year. Continue reading “Drugs for HER2-linked breast cancer may work against lung cancer” »
Cord blood transplants: Using a rare mutation to fight HIV
Even as University of Minnesota physicians attempt the first cord blood transplant designed specifically to cure a pediatric patient of HIV and leukemia, City of Hope researchers have devised a program that could make such transplants more readily available.
As a boy undergoes a cord blood transplant that doctors hope will cure his HIV and leukemia, researchers at City of Hope and elsewhere are pushing for better identification of blood that carries a rare genetic mutation that protects against HIV.
The cord blood being used in the Minnesota transplant, which took place Tuesday, has a rare mutation shown to protect against HIV, and researchers at City of Hope have been working with cord blood banks and other institutions to identify blood with this mutation. Doing so could make the blood more readily available to those who could benefit.
The boy undergoing the treatment Tuesday was born with HIV, the virus that causes AIDS, and several months ago developed a rare form of leukemia, according to the Minneapolis Star Tribune.
To date, only one patient in the world has been cured of HIV/AIDS by transplantation. Timothy Brown, known as the Berlin patient, was treated with bone marrow from a donor with a specific mutation in a cell surface protein. This mutation protects against HIV by preventing the virus from entering the T cells, ultimately preventing it from destroying the immune system. Continue reading “Cord blood transplants: Using a rare mutation to fight HIV” »
Mammogram rates not falling for women 40 to 49, despite U.S. advice
Since 2009, the U.S. Preventive Services Task Force (USPSTF) has recommended routine mammograms only for women age 50 and older. But a study published in Cancer on April 19 found that despite those recommendations, screening rates among women age 40 to 49 have not fallen.
Mammogram rates among women ages 40 to 49 have not changed, despite recommendations against them from the US Preventive Services Task Force in 2009.
In fact, between 2008 and 2011, the screening rate for that age group has risen slightly, from 46.1 percent to 47.5 percent.
Looking at this data, the study’s authors speculated that the rate may have stayed stagnant due to conflicting screening guidelines from other professional organizations.
The American Cancer Society and the National Comprehensive Cancer Network both recommend annual mammograms for women starting at age 40. But the USPSTF suggested that women between 40 and 49 talk with their doctors about the benefits and risks of mammograms, and personal risk factors — such as a genetic mutation or a family history of breast cancer — that may warrant earlier, more frequent screenings.
In making its recomendation, the USPSTF evaluated breast cancer screening, incidence and mortality data. The task force considered the lower incidence of breast cancer in young women and the negative impact of earlier, more frequent screenings, particularly “false positives” that can result in unnecessary costs, additional tests and emotional burden. Continue reading “Mammogram rates not falling for women 40 to 49, despite U.S. advice” »
‘My cancer diagnosis: What I wish I’d known’ – James Neustice
One in a series of stories asking former patients to reflect upon their experience …
James Neustice fought bone cancer with everything he had and came out the other side a survivor. (Credit: James Neustice)
For James Neustice, what began as severe back pain at the age of 23 quickly spun into a whirlwind of blood tests and doctors’ visits — and ultimately led to a life-threatening diagnosis: a kind of bone cancer known as chondroblastic osteogenic sarcoma. That diagnosis was the beginning of seven hard-fought years of treatment.
Good thing he had City of Hope on his side. Now cancer-free more than a decade after his diagnosis, Neustice wants to share what he learned with others who must confront cancer. He has his own records from the time to draw upon.
“Through it all, I have made lists, lists upon lists and even more lists,” he said. “Lists about what to eat, what to drink, what I will stand up for, what I am doing after this chemo treatment, what I am doing during that chemo treatment.”
We asked Neustice to look back at the time of his diagnosis and to ask himself what he knows now that he wishes he’d known then. What wisdom, soothing words, practical tips or just old-fashioned advice would he give his newly diagnosed self?
Continue reading “‘My cancer diagnosis: What I wish I’d known’ – James Neustice” »
Breast cancer: Task force may recommend drugs for high-risk women
Currently, the official guidelines to reduce breast cancer risk are primarily a set of lifestyle habits such as eating a healthier diet, exercising regularly and getting the recommended screenings. But what if the prescription to prevent breast cancer included actual drugs?
Women at an elevated risk of developing breast cancer should be offered drugs such as tamoxifen or raloxifene to reduce that risk, the U.S. Preventive Services Task Force suggests.
That just might be the case for some women, specifically those at an elevated risk of breast cancer, according to a draft recommendation made by the United States Preventive Services Task Force (USPSTF).
The report, which is still being developed and open for public comment until May 13, recommends: “For women who are at increased risk for breast cancer and at low risk for adverse medication effects, clinicians should offer to prescribe risk-reducing medications such as tamoxifen or raloxifene.”
Both drugs work by blocking estrogen’s effect on breast tissue, and approximately 75 percent of breast cancers are fueled by estrogen.
However, these drugs also have serious side effects, such as increasing the risk of blood clots, strokes and, for tamoxifen, cataracts and endometrial cancers. Thus, the USPSTF report also notes that “women who are not at increased risk for breast cancer should not use tamoxifen or raloxifene to reduce their risk for breast cancer.” Continue reading “Breast cancer: Task force may recommend drugs for high-risk women” »
Gestational diabetes: Take action to reduce disparities
Gestational diabetes may not receive as much attention as the type 1 and type 2 variants, but it can have equally serious consequences for both mother and child. Worse, its prevalence is growing in the United States.
Gestational diabetes is easily manageable once diagnosed, but that’s only one step in combating the condition. Researchers and clinicians hope to get funding to further study gestational diabetes so they can not only reduce disparities in its incidence but ultimately prevent it altogether.
Although often temporary, gestational diabetes is linked to a variety of complications, especially if left unmanaged. These include pre-eclampsia, a greater likelihood of Caesarean section delivery, urinary tract infections in mothers and infants, and higher perinatal morbidity and mortality. Gestational diabetes also increases the likelihood of developing type 2 diabetes for both mother and child.
Further, because the condition disproportionately affects minority populations, better research, treatment and advocacy are needed, according to a paper in the Spring 2013 issue of Clinical Diabetes.
The paper was co-written by Raynald Samoa, M.D., assistant professor in City of Hope’s Department of Clinical Diabetes, Endocrinology & Metabolism, Wilfred Fujimoto, M.D., from the University of Washington in Seattle and Amy Wotring, the American Diabetes Association’s associate director of federal government affairs.
“Asian-American, Native Hawaiian, Pacific Islander, Hispanic, and African-American women are at a disparately higher risk for GDM [gestational diabetes mellitus] or its long-term effects than non-Hispanic white women … therefore, diagnostic testing and prevention measures should be undertaken during postnatal follow-up,” they wrote. Continue reading “Gestational diabetes: Take action to reduce disparities” »
Genetic counseling: City of Hope helps patients worldwide
Genetic screening is gaining prevalence — and impact — worldwide. Through such tests, patients can better understand their risk of developing cancer, or a recurrence if they’ve already been diagnosed, and then act to limit that risk. Further, research continues to unveil new genetic clues that could help assess a person’s likelihood of developing several cancers. And two companies, Genomic Health and Myriad Genetics, have even developed genetic tests that can help gauge how aggressive a patient’s prostate cancer is.
City of Hope’s genetic counseling training is helping families worldwide cope with cancer risk. (Photo by Jack Hollingsworth)
But in some parts of the world, people lack access to clinicians capable of understanding the results of these genetic tests; as a result, their ability to make informed decisions suffers. A one-of-a-kind course on cancer genetics, taught by City of Hope researchers, is helping to change that.
For more than a decade, City of Hope’s Division of Clinical Cancer Genetics, headed by Jeffrey Weitzel, M.D., has offered courses and resources to train clinicians in clinical cancer genetics best practices — and people around the nation, and the world, are now benefiting. One of the most far-reaching offerings is the Community Cancer Genetics and Research Intensive Course. Continue reading “Genetic counseling: City of Hope helps patients worldwide” »
Circumcision and HIV risk: Bacteria may play key role, study finds
Circumcision reduces a man’s risk of HIV infection, scientists have said, although they didn’t exactly understand the “why” behind the link. Now researchers think they know.
Reducing the bacteria on the surface of the penis appears to reduce the likelihood that HIV, shown here in the bloodstream, will take hold, researchers find.
It comes down to microbes. Specifically, removing the foreskin leads to a dramatic reduction in overall bacteria, including anaerobic bacteria, on the penis. Such bacteria can prevent so-called Langerhans cells in the foreskin from fighting off viruses, also leading to inflammation that prompts the body’s immune system to send T4 cells to the scene. These cells can then become infected with HIV.
The findings, published April 16 in the journal mBio, amount to an “aha” moment.
“The bacterial changes identified in this study may play an important role in the HIV risk reduction conferred by male circumcision. Decreasing the load of specific anaerobes could reduce HIV target cell recruitment to the foreskin,” the authors wrote.
Their research on the so-called penis microbiome has led the researchers to make broader ecological comparisons.
“From an ecological perspective, it’s like rolling back a rock and seeing the ecosystem change. You remove the foreskin and you’re increasing the amount of oxygen, decreasing the moisture – we’re changing the ecosystem,” said corresponding author Lance Price in a press release from the American Society of for Microbiology, which publishes mBio.
The study’s first author, pathologist Cindy Liu at Translational Genomics Research Institute in Flagstaff, Ariz., summed up her findings this way to the L.A. Times: “It’s the same as if you clear-cut a forest. … The community of animals that once lived in that forest is going to change.”
As for clinicians, they appear to welcome the findings.
Alexandra Levine, M.D. M.A.C.P., chief medical officer at City of Hope, said the study’s authors make a strong case. “This is an important paper in beginning to document what the reason might be,” Levine, a nationally recognized expert on blood diseases and HIV/AIDS-related malignancies, told the L.A. Times. ”Their data are convincing to me.”
But scientific discovery doesn’t stop with an “aha” moment. As the authors themselves noted in their paper, more research is needed.
“Understanding the mechanisms that underlie the benefits of male circumcision could help to identify new intervention strategies for decreasing HIV transmission, applicable to populations with high HIV prevalence where male circumcision is culturally less acceptable.”
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