nicole-ostrow

Kidney Donors Don’t Shorten Their Lives by Giving Up Organ, Research Shows

by on March 9, 2010

By Nicole Ostrow March 9 (Bloomberg) — People who donate a kidney in the U.S. don’t die any faster than nondonors long term, according to a large study that looked at donors over 15 years. Within the first 90 days after surgery to donate a kidney, their death rate was slightly higher at 3 per 10,000, compared with less than 1 per 10,000 in healthy nondonors, according to research from Johns Hopkins University. Over 15 years, there was no difference in deaths of donors compared with others matched by age, health status, gender and race, said the study in today’s Journal of the American Medical Association . Kidney transplants have almost doubled over the past 15 years in the U.S. as more older people became eligible and higher rates of diabetes led to kidney disease and increased demand, said Dorry Segev , lead author of the study. The need for kidneys far outpaces the organs available each year, with more than 83,000 on a U.S. waiting list and 15,402 transplants performed from January through November last year, according to the Organ Procurement and Transplantation Network . “Over the last 15 years, live kidney donation remains a very safe operation,” said Segev, an associate professor of surgery and epidemiology at Johns Hopkins University in Baltimore, in a March 5 telephone interview. “There is no evidence that living with one kidney rather than living with two kidneys after donating a kidney is associated with any increased risk of dying prematurely.” Earlier Evidence Previous studies that found kidney donation was safe have been much smaller and often lacked well-matched comparison groups, according to the study authors. The research analyzed data from a national registry of 80,347 living kidney donors in the U.S. who gave their organ from April 1994 to March 2009. They were compared with 9,364 people who were part of a national health survey . Over those 15 years, 25 people died in the first 90 days after surgery, making their risk of dying from surgery 3.1 per 10,000 cases. That compared with 0.4 per 10,000 people for similarly healthy people who participated in the health survey. That makes the short-term risk of death after kidney donation surgery six times lower than from dying after gallbladder removal , when patients are sent home the same day as their surgery, the authors said. Donating a kidney is “one of the safest operations you could ever undergo, although the risk is not zero,” Segev said. One Year Later A year following the surgery, the risk of dying for those who donated a kidney was similar to the nondonors who participated in the health survey, the study found. Men and black people had a slightly higher risk of dying following the procedure, but their overall risk was still small, the researchers said. The need for U.S. kidney donations has increased as rates of diabetes and obesity have risen. Diabetes can lead to kidney disease over 20 to 30 years, eventually requiring treatment by dialysis or a transplant, according to the International Diabetes Federation. In the U.S., the number of people with diabetes awaiting a kidney transplant has almost tripled e over the past decade to almost 25,000 from about 9,600, according to data from the Organ Procurement and Transplantation Network. Most kidney donations from the living go to families and friends, Segev said. About 100 people every year will donate a kidney without a specific person in mind. The study was funded by the Organ Procurement and Transplantation Network, supported by a federal agency. To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Kidney Donors Don’t Shorten Their Lives by Giving Up Organ, Research Shows

Genetic Tests No Help Predicting Heart Disease Risks in Women, Study Says

by on February 16, 2010

By Nicole Ostrow Feb. 16 (Bloomberg) — Genetic screening didn’t help doctors predict which women would develop heart disease in the first study assessing the effectiveness of the current gene markers for the disease, researchers said. Instead cholesterol levels, blood pressure and family history were better indicators for determining who is at risk for having a heart attack, stroke or dying from heart disease, research today in the Journal of the American Medical Association showed. More than 316,000 women died in the U.S. in 2006 from heart disease, the leading cause of death for American women, according to the Atlanta-based Centers for Disease Control and Prevention. About 8 million women are currently living with heart disease , according to the Women’s Heart Foundation, a nonprofit group based in Trenton, New Jersey. As more heart disease genes are discovered, they may eventually play a role in determining who might develop the disease, lead study author Nina Paynter said. “These findings were a checking in to see if we know enough yet about genetics for our risk prediction tool kit. We don’t have a good enough picture,” Paynter, an instructor in medicine at Brigham and Women’s Hospital in Boston, said today in a telephone interview. “It’s definitely possible that at some point when we get a better sense of everything, we’d be able to have some sort of genetic score or a panel that will help us actually identify people at higher risk.” First Study Today’s study is the first to look at genetic markers available for heart disease to see if they may help more effectively predict who is at risk for developing the condition, Paynter said. The results apply only to women. The researchers included 19,313 white women in the Women’s Genome Health Study who were followed for more than 12 years. Researchers developed two genetic risk scores. One was based on 12 markers known to be linked to heart disease. The second was based on the 12 markers plus 89 more linked to risk factors such as blood pressure and cholesterol levels . Just using the genetic risk factors alone was the equivalent of a “coin flip” in classifying who has a higher risk of heart disease, Paynter said. Blood pressure, cholesterol levels, age, smoking status and family history were more helpful, the authors said. Helpful Predictor “Family history of heart disease was a useful predictor. There is this implication that at some point we may be able to tease out the genetic part of that since some of that is shared genes and get a genetic predictor that is a good risk stratification tool,” she said. Unlike diseases that are more directly related to genes, heart disease is “complicated” and can develop many different ways, Paynter said. Genetic testing seems to help indicate who may be at risk for certain breast cancers and cystic fibrosis, she said. “Understanding genetics and its role in chronic disease remains absolutely vital for developing new therapies and new approaches to treatment,” said study author Paul Ridker , director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, in a statement. “Our data in no way undermine those efforts. However, it is sobering to find that the current body of genetic data adds little to our ability to predict cardiovascular disease.” The National Institutes of Health and the National Cancer Institute are among the organizations that fund the Women’s Genome Health Study. Genotyping for the Women’s Genome Health Study was supported by Thousand Oaks, California-based Amgen Inc. To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Genetic Tests No Help Predicting Heart Disease Risks in Women, Study Says

Thirdhand Smoke Forms Cancer-Causing Indoor Residue That Lasts, Study Says

February 8, 2010

By Nicole Ostrow Feb. 8 (Bloomberg) — Tobacco smoke contamination lingering on furniture, clothes and other surfaces, dubbed thirdhand smoke, may react with indoor air chemicals to form potential cancer-causing substances, a study found. After exposing a piece of paper to smoke, researchers found the sheet had levels of newly formed carcinogens that were 10 times higher after three hours in the presence of an indoor air chemical called nitrous acid commonly emitted by household appliances or cigarette smoke. That means people may face a risk from indoor tobacco smoke in a way that’s never been recognized before, said one of the study’s authors, Lara Gundel . Previous research has shown that secondhand smoke, which is inhaled by nonsmokers exposed to fumes from cigarettes, raises the risk of cancer and heart disease. More research is needed to identify the potential health hazards of thirdhand smoke, Gundel said. Overall, tobacco use causes 20 percent of all cancer deaths, according to the study published in today’s Proceedings of the National Academy of Sciences . “We have considered that nicotine on surfaces has been pretty benign up to this point. It turns out we shouldn’t say that now,” said Gundel, a staff scientist at Lawrence Berkeley National Laboratory in Berkeley, California, in a Feb. 5 telephone interview. “People can be exposed to toxins in tobacco smoke in a way that’s never been recognized before.” Residue Found A spokesman for Philip Morris USA, a unit of Altria Group Inc. , did not return a telephone call for comment. Spokesmen for Reynolds American Inc. and Lorillard Inc. did not respond to telephone calls for comment. A previous study, published in the journal Pediatrics in January 2009, found residual tobacco smoke is deposited on furniture, carpeting and clothing and coined the phrase “thirdhand smoke.” Today’s study found that when the residue from tobacco smoke settled on indoor surfaces, it mixed with indoor air pollutants to form tobacco-specific nitrosamines, or TSNAs, which are potent cancer-causing substances found in unburned tobacco and tobacco smoke. The researchers checked for nitrosamine levels by exposing paper to smoke and then to nitrous acid, which is produced by gas ovens and burners that aren’t properly vented and by cars. They also tested the surfaces on the inside of a truck of a heavy smoker. In both cases they found the reaction between the nicotine in thirdhand smoke and the nitrous acid produced two known and potent nitrosamines. They also found a tobacco-specific nitrosamine that is absent in freshly emitted tobacco smoke. Children Exposed People, particularly infants and toddlers, are most likely exposed to these carcinogens by either inhaling dust or by skin contact, the authors said. Using fans and opening a window doesn’t help eliminate the hazards because most of the nicotine and other substances from burning cigarettes aren’t found in the air, but are absorbed by surfaces, Gundel said. “Buildings, rooms, public places should be 100 percent smoke free,” she said. “Replace nicotine-laden furniture, carpets and curtains. Nicotine absorbs into these materials. The stuff that’s imbedded can continue to come to the surface.” The researchers are trying to determine how long these nitrosamines may last as a result of the interaction of thirdhand smoke and the indoor air pollutant, nitrous acid. They are also looking to develop ways to track exposure to nitrosamines. “We know that these residual levels of nicotine may build up over time after several smoking cycles, and we know that through the process of aging, thirdhand smoke can become more toxic over time,” said study co-author Hugo Destaillats , a chemist with the Indoor Environment Department of the Berkeley national lab’s Environmental Energy Technologies Division, in a statement. “Our work highlights the importance of thirdhand smoke reactions at indoor interfaces, particularly the production of nitrosamines with potential health impacts.” The study was sponsored by the University of California’s Tobacco-Related Disease Research Program . To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Novel Nanosphere Test Detected Prostate Cancer Recurrence Early in Study

October 19, 2009

By Nicole Ostrow Oct. 19 (Bloomberg) — Nanosphere Inc. ’s novel technology using gold nanoparticles may predict the recurrence of prostate cancer earlier than current blood tests, a pilot study found. In an 18-patient study, the new method detected a protein specific to prostate cancer in 86 percent of blood samples compared with 25 percent for conventional tests, according to research published online today in the Proceedings of the National Academy of Sciences . The company attaches antibodies to the gold, producing what Nanosphere calls probes for “ultrasensitive” detection of proteins that may otherwise go undiscovered. About 70,000 men a year undergo surgery to remove diseased prostates and 40 percent will have their cancer return, according to C. Shad Thaxton , the lead author. If the test works in larger studies, doctors may be able to diagnose recurrence of the disease several years earlier than what now is the norm, the researchers said. “It gives them a whole new tool to help people who have just undergone radical surgery for a potentially lethal disease,” Chad Mirkin , a study author and a professor of chemistry at Northwestern University in Evanston, Illinois, said in a telephone interview on Oct. 16. “It gives them the ability to figure out if the patient is in good shape sooner than the commercial tools do, so you can take the weight of the world off their shoulders.” Mirkin, Thaxton and Norm Smith, also an author of the study, are Nanosphere shareholders, according to a statement from Northwestern. Mirkin was a founder of the company and provides it with research and development services, according to a Nanosphere regulatory filing. The research was sponsored by the National Cancer Institute , based in Bethesda, Maryland. Cause of Death Prostate cancer is the most common malignancy other than skin cancer to occur in U.S. men, and is the second-leading cause of cancer death, behind lung tumors, according to the Atlanta-based American Cancer Society. This year, more than 190,000 men will develop prostate cancer and more than 27,000 will die from the disease, according to the nonprofit group. The new test, developed by Northwestern and licensed by Northbrook, Illinois-based Nanosphere, finds previously undetectable levels of a protein in the blood called prostate- specific antigen, or PSA, a marker to determine cancer. After surgery to remove the prostate gland , patients typically have PSA levels too low to be seen using conventional tests. The prostate is a walnut-sized gland, part of the male reproductive system. It is located below the bladder, where urine is stored, and surrounds the urethra, where urine passes from the body. Glands Removed The pilot study looked at blood samples collected over a number of years from 18 men who had their prostates removed as part of their treatment. The researchers found PSA in 102 of 118 blood samples using the new analysis compared with 30 of the samples using tests currently available. In the study, nine men remained cancer free, while the other nine had their cancer return, said Thaxton, an assistant professor of urology at Northwestern. For seven of the nine whose cancer was in remission, the nanoparticle test found their PSA levels were low and not rising, while the conventional test didn’t detect the protein, he said. It also picked up when the PSA levels for the other two men started climbing. Of those whose cancer returned, the nanoparticle analysis spotted rising PSA levels in two of the men about a year earlier than conventional tests, Thaxton said. “We’ve taken this test and shown that almost everyone has a PSA level” after surgery, Mirkin said. “We’ve created a new zero. Then we can follow these people and see if it’s staying the same or if it’s rising.” Nanoparticle Probes The technology is based on gold nanoparticle probes, which have DNA and antibodies that can recognize and bind to PSA in the blood. Nanosphere also is developing genetic tests using the technology to diagnose illnesses such as heart disease and herpes. The company markets tests for influenza A and B and respiratory syncytial virus , for gene disorders linked to blood clots and to detect a possible side effect from the blood thinner warfarin, according to Nanosphere’s Web site. Nanotechnology is the use of materials with dimensions of 1 to 100 nanometers, according to the U.S. government’s National Nanotechnology Initiative , based in Arlington, Virginia. A nanometer is one-billionth of a meter. A sheet of paper is about 100,000 nanometers thick. Nanotechnology is used in products that add strength to lightweight tennis rackets and make eyeglasses harder to scratch, according to the initiative’s Web site. The scientists are conducting a similar study in 260 patients to determine how much earlier the Nanosphere test detects PSA levels. “The broader implication of this work is that greater sensitivity for these types of biomarkers enables much earlier detection of disease when presumably you can treat it much more successfully,” said William Moffitt III , president and chief executive officer of Nanosphere, in a telephone interview on Oct. 16. To contact the reporter on this story: Nicole Ostrow in New York at Nostrow1@bloomberg.net

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Body’s Own Antioxidant May Slow Parkinson’s Patients’ Decline, Study Says

October 12, 2009

By Nicole Ostrow Oct. 12 (Bloomberg) — Higher concentrations of a natural antioxidant in the body may slow the progression of Parkinson’s disease in patients with early stages of the illness, a study from Harvard researchers found. Those in the study with the highest amounts of antioxidant urate in their blood were 36 percent less likely to need treatment within two years for early Parkinson’s symptoms than those with the lowest levels, research online today in the Archives of Neurology showed. Raising the amount of urate is one of the “more promising” strategies in development, said senior study author Michael Schwarzschild . About one million Americans have Parkinson’s, which starts with trembling and stiffness that can eventually hamper walking and talking, according to the National Parkinson Foundation. Today’s study “suggests a new approach in slowing down the rate of the disease,” said Schwarzschild, an associate professor of neurology at Harvard Medical School, in an Oct. 9 telephone interview. “People live with Parkinson’s disease for decades. We want to make those decades much more manageable and keep people much more mobile.” Urate occurs naturally in the blood. Schwarzschild cautioned that people shouldn’t try to raise levels of the antioxidant on their own through diet or supplements because high amounts can lead to gout and kidney stones and may also contribute to heart disease. Testing Safety A trial testing the safety of raising urate in patients who were recently diagnosed with Parkinson’s is under way at 10 centers around the country, he said. Researchers are using the dietary supplement inosine, a precursor to urate, in the study. Antioxidants can protect against some cell damage that may contribute to the impairment or death of nerve cells that occur in Parkinson’s disease, according to the authors. In the U.S., about 60,000 new cases of Parkinson’s are diagnosed each year, according to the National Parkinson Foundation. Most of the time, the disease develops after age 65. Symptoms include shaking, slowness of movement, stiffness and difficulty with balance. The researchers, from the MassGeneral Institute for Neurodegenerative Disease and Harvard School of Public Health, first turned up evidence of urate’s potential of slowing down the progression of Parkinson’s in a study last year of 800 people that showed similar results. Older Data The researchers then looked at data on urate levels from early Parkinson’s patients who had been part of a two-year trial in the late 1980s. Blood urate levels were available on 774 patients and the scientists also were able to analyze the antioxidant levels in frozen spinal fluid from 713 patients. Overall, 369 people, or almost 48 percent of the 774 patients, had their disease progress enough to require drug therapy, the study said. The chance of needing medication decreased the higher their blood urate levels were, the authors said. Similar findings were seen for urate levels in spinal fluid. “These results were critically important,” said Alberto Ascherio , the study’s lead author and a professor at the Harvard School of Public Health, in a statement. “Only now we can be reasonably sure that the slower rate of progression in patients with higher concentrations of urate is real and not a chance occurrence.” In the study, 162 people, or 39 men and 123 women, were in the lowest blood urate level group, while 158 people, or 138 men and 20 women, were in the highest blood urate level group. Other Factor Schwarzschild said the researchers are unsure if it’s the urate itself or some other factor that helps slow the progression of Parkinson’s disease. The study also found unexpectedly that higher urate levels didn’t slow the progression of Parkinson’s in study participants who were receiving vitamin E, another powerful antioxidant. Researchers said it wasn’t clear whether vitamin E at high doses might have a “pro-oxidant” rather than antioxidant effect. The study was sponsored by the National Institutes of Health, the Department of Defense, the Parkinson Disease Foundation and the Parkinson Study Group and others. To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Diet Rich in High-Fructose Foods Raises Blood Pressure in Middle-Aged Men

September 23, 2009

By Nicole Ostrow Sept. 23 (Bloomberg) — A diet high in foods with large amounts of fructose sugar such as sweetened soft drinks increased blood pressure in men, according to a study presented today that also found that a drug for gout blocked the effect. Men in the study who ate a high-fructose diet had their blood pressure rise about 5 percent after two weeks, while those who also were given a gout treatment increased less than 1 percent, study author Richard Johnson said. Eating great amounts of fructose without the treatment also raised the risk of developing metabolic syndrome, a group of risk factors associated with the development of heart disease and diabetes. The study is one of the first to show that consuming foods high in fructose raises blood pressure in people, Johnson said. The gout treatment lowered the body’s uric acid that is linked at elevated levels to high blood pressure, diabetes and heart disease. “Reduce your sugar intake,” Johnson, a professor of medicine at the University of Colorado, Denver in Aurora, said yesterday in a telephone interview. “This data would suggest that too much sugar and high fructose corn syrup may not be a good thing.” Johnson said larger trials were needed to confirm the findings, particularly before treating people with any drugs including the gout medicine, allopurinol. ‘Exciting Data’ “We’re not ready to lower uric acid as a means to lower blood pressure,” said Johnson, who worked with Santos Perez- Pozo, a kidney specialist and lead author of the research in Minorca, Spain. “It is exciting data that suggests uric acid may have a role in hypertension.” The study, which was funded by the National Institutes of Health, will be presented today at the American Heart Association’s annual conference on high blood pressure in Chicago. Fructose is one of several sugars in food and makes up about half of all the sugar molecules in table sugar and in high-fructose corn syrup , according to background information from the American Heart Association . The syrup often is used as a sweetener in packaged food products. Fructose is the only common sugar known to increase uric acid levels, the heart association said. The study examined 74 adult men in Spain with an average age of 51. The men were given 200 grams (7.05 ounces) a day of fructose in addition to their regular diet. In the U.S., most adults consume about 50 grams to 70 grams of fructose a day. Blood Pressure Half of the men in the study were assigned to receive the generic gout drug allopurinol , while the other half were given a placebo. After two weeks, those in the fructose-placebo group had an increase of 6 mm Hg in their systolic blood pressure and a 3-mm Hg rise in their diastolic blood pressure, the researchers found. Systolic refers to the top number in the blood-pressure ratio and shows the pressure when the heart beats, while diastolic is the lower number that measures the pressure between the heart beats. The men with elevated blood pressure saw their levels return to normal within two months of the study’s end when they went back to their usual diets, the researchers said. Those getting the high-fructose diet who also were given allopurinol didn’t show significant increases in their systolic or diastolic blood pressures, the study showed. Metabolic Syndrome The incidence of metabolic syndrome as defined in the U.S. more than doubled to 44 percent of the group getting the high- fructose intake without allopurinol. The syndrome is defined as having at least three of five risk factors including increased waist circumference, high blood pressure and high fasting-blood sugar. Those in the group receiving allopurinol didn’t experience a rise in metabolic syndrome incidence, possibly because the gout drug stopped their blood pressure from rising, the authors said. Most sugar consumption in the U.S. comes from sweetened drinks and foods high in sugar or high fructose corn syrup, Johnson said. The research results suggest it’s possible that lowering uric acid levels could become a routine practice in the future, much like lowering cholesterol. “This could become a risk factor that is modifiable and that lowering it could be of considerable benefit,” Johnson said. “However we still need more studies to prove it.” To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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