Secret mint herb may stop breast cancer patients’ hot flushes and night sweats

Researchers at the University of Manchester are testing a secret herb in a bid to stop the severe hot flushes that besiege breast cancer patients on hormone treatment.Professor Alex Molassiotis, of the School of Nursing, Midwifery and Social Work, says the herb – one of the mint family, found in any kitchen – is thought to stop the hot flushes and night sweats which can be so bad that some women have to change their clothes three or four times a night.

It is traditionally used by Mediterranean women undergoing the menopause, but Professor Molassiotis cannot name it as he and his team are carrying out a double blind trial (neither the patient nor the doctor is allowed to know whether they are in the group taking the herb or a placebo).

The women are taking hormone treatment to lower oestrogen and progesterone levels as these affect the growth of some breast cancer cells. This can lead to early or revisiting menopause with symptoms such as anxiety, dry skin, bone thinning and hot flushes, with some women having up to 30 flushes a day. It is too risky for them to take Hormone Replacement Therapy (HRT) as this will increase the hormone levels again. Instead they are advised to cut out tea, coffee and nicotine, try alternative remedies or a certain type of anti-depressant.

Professor Molassiotis said: “It is hoped that the herbal remedy will be simpler and cheaper to take, as well as more effective, thus improving the lives of women who need all their energy to fight the disease.”

He and his team are now recruiting 170 volunteers for the randomized trial, half of whom will take the phytooestrogen herb in the form of a pill and half of whom will take a placebo, from Greater Manchester and Cheshire. Only breast cancer patients who have or are receiving hormone treatments for their cancer are allowed to take part, and only if they experience at least one hot flush a day of moderate and above severity for at least a month. The treatment will be for a total of three months, taking one pill a day. The team will assess the volunteers’ hot flushes four times over six months from starting the trial with questionnaires and a blood sample.

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Article adapted by MD Only Weblog from original press release.
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Contact: Mikaela Sitford
University of Manchester

Valuable Vitamin D report bridges gap in bone health benefits

A new evidence report on vitamin D and bone health reviews the current scientific evidence and identifies its strengths and weaknesses. This report is a valuable resource that examines a range of scientific perspectives related to vitamin D and bone health across the lifecycle.

“This independent, systematic review is timely because there are mixed messages and recommendations to consumers regarding the benefits and harms of vitamin D intake” said NIH Office of Dietary Supplements (ODS) Director, Paul M. Coates, Ph.D. He added, “The evidence report in combination with the conference presentations and discussions, newly available methodological tools, and newer information on the vitamin D status of the US population will provide an invaluable and very timely update for the research and public health communities of what we know and what we need to know for this key nutrient.”

Researchers have long known that vitamin D had an impact on bone health but there is uncertainty about how much vitamin D is needed to achieve optimal bone health and whether there are differences in the relationship of vitamin D status to bone health across age and life stage groups. This report highlights the fact that the largest amount of evidence for bone health benefits is in postmenopausal women and older men (the majority over 60 years of age) taking vitamin D supplements. This report also confirms that vitamin D from ultraviolet-B (sunlight) exposure, fortified foods, or dietary supplements are all effective in raising the level of circulating vitamin D. Of concern, there were only sparse data on other subgroups cited as being at high risk for the consequences of low vitamin D, such as dark-skinned individuals and pregnant and lactating women.

The report found it difficult to define specific blood levels of markers for vitamin D status that indicate optimal levels for bone health. One reason for this is that current methods, which measure serum-25-hydroxy vitamin D as the marker for vitamin D status, yield highly inconsistent results. As part of its broader vitamin D initiative, ODS is working with laboratory testing facilities to standardize the quantification of vitamin D status.

The report investigators were not able to separate the impact of vitamin D from that of calcium, as most trials studied the effect of vitamin D plus calcium. The combination of vitamin D3 (daily dose 700 to 800 IU) and calcium (daily dose 500 to1200 mg) decreased the risk of falls, fractures and bone loss in the elderly (ages ranged from 62 to 85 years). The current recommended intake is 400 IU/day for people 51-70 years of age, and 600 IU/day for people over 70 years of age. Based on the combined data of two trials, the decreased risk of fractures was seen primarily in the subgroup of elderly women (average age 85 years) living in nursing homes.

Vitamin D intake above current recommended levels was not reported to be associated with an increased risk of harms. However, most trials using higher doses of vitamin D were not adequately designed to assess potential harms.

“The vitamin D and bone health evidence report provides valuable insights because it is based on an independent and rigorous examination of the totality of evidence across all age groups and during pregnancy and lactation,” said Agency for Healthcare Research and Quality (AHRQ) Director Carolyn Clancy, M.D. “It Is important that health care decisions are made using a review of all available evidence and not solely on the results of individual study reports.”

This report served as the framework for a conference, Vitamin D and Health in the 21st Century: An Update. The ODS-sponsored report was produced by the University of Ottawa Evidence-based Practice Center, and is available at:
http://www.ahrq.gov/clinic/tp/vitadtp.htm.

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Article adapted by MD Only Weblog from original press release.
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Contact:
Lisa Ahramjian
National Institute of Health

The mission of ODS is to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, stimulating and supporting research, disseminating research results, and educating the public to foster an enhanced quality of life and health for the U.S. population.

Smart Bone Cells May Add or Remove 3% Bone Mass Per Month

Liyun Wang, UD assistant professor of mechanical engineering, views osteocytes (bone cells) in her lab, as graduate students Wen Li and Xiaozhou Zhou examine the magnified images in the background.  Click here for more information.

Ten million people in the United States are estimated to already have bone diseases, and almost 34 million more are estimated to have low bone mass, putting them at increased risk for osteoporosis, according to the National Osteoporosis Foundation.

Liyun Wang, assistant professor of mechanical engineering at the University of Delaware, knows the serious consequences of osteoporosis.

Two of Wang’s aunts have suffered from the insidious bone-thinning disease, and one aunt died within a year after falling and fracturing her hip.

Wang is now leading research that will shed light on how osteocytes–the cells encased inside your bones–sense external stimuli and communicate with cells on the surface, signaling them to either build more bone or remove existing bone.

The five-year, $1.6 million project, ranked in the top 5 percent of research proposals recommended for funding by the National Institutes of Health (NIH) this year, holds promise in unveiling the mysteries of bone and joint diseases afflicting people worldwide.

The results may not only help scientists home in on the cause of osteoporosis and arthritis, but also develop more effective drug therapies to treat the debilitating bone and joint diseases.

The project will involve an interdisciplinary team of investigators at UD, including Prof. Mary C. Farach-Carson and Associate Prof. Randall Duncan, who hold primary appointments in biological sciences with joint appointments in mechanical engineering, and John Novotny, assistant professor of mechanical engineering.

“Bone and joint disorders affect almost half of all people over 50 years old, at a cost of $250 billion annually in the United States,” Wang said. “A third of the people who suffer a fracture due to bone loss end up dying within a year.”

The embedded bone cells, or osteocytes, that Wang is studying, act like the bone’s “brain.”

“The osteocytes are very smart,” Wang says. “They can tell whether a person is using his or her bones or not. If the person is physically active, the osteocytes tell cells on the surface that it’s okay to put on more bone. Otherwise, they signal the surface cells to remove bone at a rate that can be as high as 3 percent bone mass per month, which is the case for patients confined to long-term bed rest and for astronauts,” she notes.

The osteocytes lie in tiny pits or holes, called lacunae, within the bone. These living cells have many long arms that connect them to surface bone cells and the bone’s vascular system. The narrow channels housing the osteocyte’s arms (canaliculi) and the lacunae form a network through which a mixture of water, nutrients and other bioactive molecules flows.

“Although it is hard as cement, bone is actually like a stiff sponge,” Wang says. “It’s porous and has water inside. When we have mechanical loading, when you run, for example, a part of the leg bone is compressed, and water is pushed through gaps, less than a micrometer in size, between the osteocytes and the bone cement that surrounds them.”

This powerful wave of fluid keeps the osteocytes happy and functioning well, Wang says, delivering nutrients to them from nearby blood vessels and quickly dispersing signaling molecules, such as calcium ions, from one cell to its neighbors.

Using a novel microscopic imaging method that Wang developed, which is based on fluorescence recovery after photobleaching (FRAP), the research team hopes to do what no one has done before: see inside living bone and determine how rapidly these signaling and nutrient molecules are transferred between the cells when a bone is at rest and when it is at work.

A high-powered laser-scanning microscope will be used to assess the movement of molecules in the tibia of an anesthetized mouse. A harmless green fluorescent dye, tagged to various-sized proteins, signaling molecules and cell nutrients, will be injected into the animal’s bloodstream.

The dyed molecules will be subjected to a flash of intense light, temporarily photobleaching them black, leaving a distinct black sector surrounded by green. Thus, if the molecules diffuse into one another’s territories, they can easily be tracked by color.

Using similar techniques, Wang is investigating the communication between bone and cartilage in the development and progression of osteoarthritis, one of five projects in an $11 million NIH grant led by Thomas Buchanan, professor and chairperson of the UD Department of Mechanical Engineering. The UD effort includes a unique mentoring program for women scientists.

Wang says she is grateful for the mentoring and support she has received from her colleagues at UD since she joined the faculty in 2005, as well as from her doctoral advisers at the City College of New York, including Profs. Susannah Fritton, Steve Cowin, and Sheldon Weinbaum; and Dr. Mitchell Schaffler, with whom she worked as a postdoctoral researcher at the Mt. Sinai School of Medicine.

Currently, Wang’s laboratory group includes Wen Li, a graduate student in biomechanics and movement science, Xiaozhou Zhou, a graduate student in mechanical engineering, and undergraduate students Ben Keller and Laura Schultz, who are both working on degrees in mechanical engineering, and Samantha Nigro, who is pursuing her degree in biological sciences. Research associate Jun Pan will join the group at the end of this year.

“My students have been excellent,” Wang says, smiling. “They are well-organized and eager to learn how to do research. They are very motivated, and that is important. We have exciting work ahead of us!”

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Article adapted by MD Only Weblog from original press release.
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Contact: Tracey Bryant
tbryant@udel.edu
302-831-8185
University of Delaware

Wang is seeking two additional doctoral students and one postdoctoral researcher in the areas of biomechanics, orthopedic biology or mechanical engineering to join her research team. For more information, contact Wang at [lywang@udel.edu].

Stanford/Packard scientists discovery way to speed bone healing

Blocking a naturally occurring inhibitor of bone formation accelerates healing of skull defects in mice, say researchers at the Stanford University School of Medicine and Lucile Packard Children’s Hospital. The finding advances the understanding of how the skeleton develops and opens new therapeutic avenues for many of the disorders that are expected to afflict aging baby boomers.

“This could potentially lead to much more effective therapies for how we replace bone or promote bone healing,” said Michael Longaker, MD, professor of plastic and reconstructive surgery. “Let’s say I’m an 80-year-old with a fractured hip. It would be invaluable to be able to heal more quickly and regain mobility and strength.”

The study will be published in the Sept. 7 issue of the Journal of Biological Chemistry.
Scientists have known for some time about a class of proteins called bone morphogenetic proteins, or BMPs, which stimulate bone formation. In fact, some current therapies for stimulating bone formation, such as spinal fusions, use recombinant BMPs to help healing. But Longaker’s new study of a protein called Noggin, which blocks bone growth, suggests there might be another, more efficient approach.

Noggin was first identified in 1992 by one of Longaker’s collaborators, Richard Harland, PhD, now a faculty member at the University of California-Berkeley, as a protein that guides tissue fate in developing frog embryos. In 2003, the researchers found that Noggin prevents the premature fusion of bones in the skull during infancy by blocking the actions of BMPs.

Longaker and the first author of the new study, Derrick Wan, MD, a postdoctoral scholar at Stanford, wondered whether interfering with Noggin expression could speed bone growth.In the new study, they initially found through work with tissue cultures that using small pieces of RNA to block Noggin expression in bone-forming cells increased the activity of the cells’ BMPs and nudged them further down the bone-producing path. Furthermore, bone-forming cells in which Noggin expression was suppressed were able to heal large skull defects in mice significantly more quickly than Noggin-expressing cells.

“Basically we just took away the natural brake and let the accelerator go to town,” said Longaker, who is also a pediatric craniofacial surgeon at Packard Children’s Hospital.

Despite the accelerated rate of healing seen in the mice treated with the Noggin-challenged cells, bone formation didn’t run rampant in these animals. After eight weeks, the healed skulls of the two groups of mice looked similar. This is important because over-enthusiastic bone formation could exacerbate rather than solve musculo-skeletal problems.

“The bone that was formed looked very normal,” said Longaker. “It’s not as if these mice grew horns or anything.”

In addition to the obvious therapeutic implications, the discovery of the interplay between Noggin and BMPs also sheds light on a perplexing developmental mystery: What guides skeletal formation during embryogenesis, when BMPs are expressed in many cells not destined to become bone? Now it appears that Noggin, along with other potent BMP inhibitors, keeps the BMPs in check throughout most of the body. This type of yin-yang relationship keeps the body primed to respond quickly to damage like fractures.

Although the concept needs to be tested in humans, the researchers envision a day when many disorders could benefit by tweaking Noggin levels up or down.

“Think of the way we treat arthritis,” said Longaker. “Right now, we cut off the diseased part of the joint and glue in a metal implant. Imagine if we could instead use a biodegradable replacement seeded with a compound that could knock down Noggin expression in the area and slowly secrete BMPs. Over two or three years, the implant would dissolve, to be replaced by the individual’s own healthy bone. This is a first step toward the concept of personalized bone tissue engineering.”

In addition to Wan, Longaker’s Stanford collaborators include Jason Pomerantz, MD, postdoctoral scholar; Jae-Beom Kim, PhD, research associate; and Helen Blau, PhD, the Donald E. and Delia B. Baxter Professor of Pharmacology. Longaker also collaborated with researchers at UCLA.

The research was funded by the National Institutes of Health, the Oak Foundation, a Ruth L. Kirschstein National Research Service Award, and an Ethicon-Society of University Surgeons Research Fellowship.

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Article adapted by MD Only Weblog from original press release.
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Contact: Krista Conger
Stanford University School of Medicine

Nearly 50% of young women unaware Osteoporosis risk!

Many young women are unaware of the dangers of osteoporosis, leaving them vulnerable to crippling bone disease.

Mark J. Kasper, Ed.D., FACSM was the lead researcher for a survey of 302 college females enrolled in an elective physical activity course. While almost all (97.7 percent) had heard of osteoporosis, only 52.9 percent were able to correctly identify eight or more out of 14 risk factors listed and only 30.8 percent named all three major risk factors: low calcium intake, a sedentary lifestyle, and infrequent menstruation. The National Osteoporosis Foundation defines osteoporosis as “a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine and wrist.”

Kasper pointed out that 39.7 percent of respondents believed they were unlikely to develop osteoporosis. “Despite a similar lifetime risk of developing osteoporosis, heart disease or breast cancer, there is a lack of knowledge and a high degree of complacency concerning osteoporosis in young women,” said Kasper. “This data mirrors our previous research suggesting that educational interventions targeting young women either have not been implemented or have been ineffective.”

The coeds in Kasper’s study that osteoporosis is a serious illness, but less serious than heart disease or breast cancer. Blacks were less likely than whites to identify risk factors and to believe that they would develop osteoporosis. Respondents ranged from 18 to 21 years of age.

Exercise Aids Bone HealthPhysical activity is the only known intervention that can potentially increase bone mass and strength in the early years of life and reduce the risk of falling in older populations, according to a Position Stand from the American College of Sports Medicine (ACSM). The official ACSM pronouncement, published in the November 2004 issue of Medicine & Science in Sports & Exercise®, encourages the adoption of specific exercise prescriptions designed for various ages to best capitalize on the chances to accrue and preserve bone throughout the various stages of life.

The paper cites worldwide predictions that the number of hip fractures will double by the year 2025, with a mortality rate of 15 to 20 percent within the first year following such a fracture for elderly individuals, as reasons to encourage a better understanding of the types, durations and frequencies of physical activities that help build and maintain bone. These include high-intensity, high-impact activities for children to build bone and moderate-to-high intensity weight-bearing activities for adults to maintain bone mass.

For adults, experts have established these recommendations to help preserve bone:

Mode – weight-bearing endurance activities such as tennis and jogging, activities that involve jumping, and resistance exercise (weight lifting)
Intensity – moderate to high
Frequency – weight-bearing activities 3 to 5 times per week, resistance exercise 2 to 3 times per week
Duration – 30 to 60 minutes a day combined

For children, especially in the years surrounding the onset of puberty, experts recommend the following activities to help build bone:

Mode – impact activities such as gymnastics and jumping activities combined with moderate resistance training
Intensity – high, but with appropriate weights for resistance training (no more than 60 percent of the maximum amount a person can lift one time)
Frequency – at least three days per week
Duration – 10 to 20 minutes with multiple sessions within the same day potentially being more effective

The Position Stand also explicitly mentions the importance of bone health for men, noting that the predicted increase in osteoporotic falls and fractures in men in the coming decades is even greater than in women. The authors also encourage weight-bearing physical activities for even the most frail and elderly, provided they can still perform them safely.

The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine.

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Article adapted by MD Only Weblog from original press release.
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Contact: Communications and Public Information
American College of Sports Medicine