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Death rate also increasing with cases this time: Dr Guleria

Covid-appropriate behaviour and vaccines are the two weapons needed to fight the war against the novel coronavirus, says AIIMS director Dr Randeep Guleria.

Shalini Bhardwaj

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In an exclusive interview with The Sunday Guardian, Dr Randeep Guleria, Director of the All India Institute of Medical Sciences (AIIMS), explained the reasons behind the recent record surge in Covid-19 cases, the susceptibility of youngsters and people with comorbidities, and how the infection can be tackled by a combination of isolating and treating patients and vaccinating others.

An artist makes a mural of Monalisa wearing a face mask to spread awareness for the prevention of the coronavirus in Mumbai on Thursday. (ANI Photo)

Q: Why is the second wave of Covid-19 in India progressing so quickly and why is it targeting so many people?

A: One of the two main reasons for this is that when cases started decreasing and the vaccines started rolling out in January and February, people thought that Covid has ended and ignored Covid-appropriate behaviour like wearing masks and socially distancing. As a result, the virus got another chance to spread. Secondly, the mutant viruses, especially the UK mutant, are more infectious and spreading faster than the previous one. We can see that the spike is very steep and cases are increasing at a very fast pace as we have now crossed an average of 1.5 lakh cases per day.

Q: When talking about specific mutants, like the UK variant, why are they spreading more in metropolitan cities?

A: The coronavirus is a respiratory virus that spreads through droplet infections. Wherever the population density is greater, like in metropolitan areas, urban slums or metro stations, the virus spreads faster. An asymptomatic person can also cause infections when present in a crowd. Moreover, in rural areas, the air is fresh and people tend to stay outdoors and maintain social distancing due to which the virus cannot survive for long in the environment.

Q: Keeping in mind the pace of the spread of the virus, do you think we need to make some changes in the guidelines?

A: We don’t need to change the guidelines, but need to follow them strictly. We have been testing, tracking, treating and isolating. If there is a Covid-positive case in the family, we need to isolate the patient. If they cannot be isolated, admit them to a Covid care centre so they don’t spread infections in their area. We have to see where the most cases are being reported from and divide areas into red, orange and green zones, just like we did before. The more the cases, the more the people will fall ill and need ICUs and hospital beds.

Q: More youngsters are getting affected by the infection this time. What should we do in this situation?

A: This time, cases in the younger age group are comparatively higher. This is because we saved children from the infection last time but just as we became more casual and ignored Covid-appropriate behaviour later, they got exposed to the virus immediately. Secondly, the younger age group thinks that the disease is not as severe in their age group and so they need not worry due to which they have started partying and clubbing again. However, if they are infected and unaware about it, they may spread the infection to more friends and colleagues.

Q: How can we protect kids?

A: Since the vaccine has still not been approved for kids, we need to take precautions just as we did before. Avoid crowds and non-essential activities, wash hands properly and wear masks when going out. We have started behaving casually and the virus has grown more infectious, due to which entire families are getting infected together.

Q: What is the reason for the increased mortality rate this time?

A: Last time we assumed, and the figures also showed, that the death rate is low. This time, as the cases increase, the death rate is also increasing. When a person gets infected, they go home and infect their family as well. In case any of them has a comorbidity, it may get more serious and hence chances of mortality are greater. Many people are not taking the infection seriously and visiting hospitals only when it gets serious. This is causing a delay in treatment and getting medicines, hence increasing the risk of death.

Q: Do you think a second lockdown is a solution?

A: Weekend lockdowns are okay but we need to take aggressive action. We have to contain the areas reporting the most number of Covid cases and test and treat the people in those areas. Also, we need to keep a check on travel because people travelling from red to green zones can spread infections.

Q: People, including many doctors, are getting infected after taking the second dose of the vaccine. What is the reason behind this?

A: First of all, we need to understand the purpose of the vaccine. After we receive the vaccine, we will not catch the disease even after getting the infection. Catching an infection means coming in contact with a Covid-positive person, when the virus may enter our nostrils and throat. But since we are vaccinated, the antibodies in our body will not allow the virus to spread further in our body. Therefore, we need to follow Covid-appropriate behaviour as the vaccines may save us from serious illness, but we are still able to spread the infection among others who are not vaccinated.

Q: We talked to a lot of professionals about the lack of antibodies in many people, even after vaccination. What is the reason for this?

A: Nowadays, we test upon G-antibodies, whereas we need to look for neutralizing antibodies. Cell-mediated immunity is long-lasting immunity created by the vaccine. There is another cell called the T-cell, that is also called a memory cell, which starts creating antibodies once exposed to the virus. Looking for antibody creation after vaccination is one thing but there are a lot of things apart from it like cell-mediated immunity and T-cell immunity. Research is being conducted for a booster dose vaccine which might be needed after 1.5 years.

Q: If someone receives Covishield, can the person receive Covaxin or other vaccine?

A: Right now, that is not possible due to a lack of stock of vaccines, but once everyone gets all the doses of the vaccines, we will see if we can inoculate people with a third dose as well. Some studies are being conducted upon the mixing of the vaccines and whether that will create more immunity. Until now, only a single dose was being administered during the vaccine trials.

Q: Do you think we should reduce the age limit for inoculation in view of the increasing Covid cases?

A: When talking about the vaccine, the first criterion is to reduce the mortality rate. Thus, we started by vaccinating people above 60 years of age as they are at the highest risk. Then we came down to people 45 years of age with comorbidities and covered healthcare workers and frontline workers, also to ensure that the healthcare system remains efficient. After this we have to vaccinate people who are of lower priority. But if we open vaccinations for all, we won’t be able to cover everybody because we will need a minimum of 2 billion doses to vaccinate a population of over 1 billion in our country. And if we inoculate people in the age group of 25-45 years and have no doses for people above 60, it will increase the risk factor for the country. Thus, we need to balance out the vaccine doses among the population.

Q: A lot of states are reporting a lack of vaccine doses. Many people could not get the second dose. How can we deal with this?

A: This issue is arising due to a supply-demand issue and it is not a matter of a lack of doses. Also take into account the eligibility of the people taking the doses. If at a centre, 50-75 people are visiting, we keep a record of those people and maintain the chain. But if 500 people arrive suddenly at the same centre on a given day, the chain cannot be scaled. At first, there was vaccine hesitancy but due to the sudden spike in cases, people started crowding immediately at the centres. It can so happen that if there is vaccine hesitancy at some place, we can move the surplus vaccines from there to a place with higher demand.

Q: How can vaccine wastage be controlled?

A: Vaccine is supplied in vials. A vial contains 10-20 doses. This means that we need to use all the doses when a vial is opened. Each vaccination centre needs to make a strategy and check if there are people waiting for doses before opening a vial.

Q: Do you think people need to get some tests done before receiving the first dose of the vaccine?

A: Many people tend to get their blood tests done, take Crocin and anti-allergy medicines, which are not at all needed. No tests need to be done before getting inoculated. Even if you get any side-effects after the vaccines, they can be treated. The side-effects are not major and are usually treatable.

Q: How can people with cardiac disease, high blood pressure, diabetes or any such issues take care of themselves?

A: 80% of such people are above the age of 45 and should get vaccinated quickly as these people may get severe Covid. Also, they should follow Covid-appropriate behaviour and avoid crowded places. Also, they should take proper precautions at home like maintaining hygiene and maintaining distance from people with possible symptoms of Covid.

 Q: When will the curve flatten? What would you say about the future possibilities of the disease?

A: The curve may not flatten in the upcoming days and it is difficult to say anything about the future. It completely depends upon us. If we follow Covid-appropriate behaviour, work from home and avoid going to public places, cases may reduce. 80% of people in India are still susceptible to the infection. The fight against Covid can only be won with the active participation of people. If we stop the droplet infection by maintaining social distancing, wearing masks, sanitising and washing hands, we can stop cases from increasing. Thus, everyone must take precautions.

Q: When is the Remdesivir injection needed and how does it work?

A: The timing of a drug is very necessary to be taken care of. Remdesivir is anti-viral but has not shown reduced mortality rates till now. It does reduce hospital admission. It only works when you have a moderate illness and your oxygen saturation is reducing, fever is high or there is a patch in the X-ray or CT Scan. In later stages, Remdesivir does not work. A treatment strategy needs to be implemented.

Q: As hospitals do not have enough beds, how can one treat Covid at home?

A: First, we need to check if the person has a home isolation facility or not. If not, they should be sent to a Covid care centre. Next, see the condition of the patient. Does the person need hospitalization, what are his/her symptoms, and do they have any comorbidities? The government has demonstrated the process of home isolation already. 85%-90% people catch mild symptoms of Covid and can be treated at home. Only 10%-15% of people need to get hospitalised and out of them, only 5% need to get admitted to the ICU. Thus, many can treat themselves at home.

Q: What last message do you want to give?

A: The fight against Covid is not yet over and we have to fight it together. Covid-appropriate behaviour is very necessary in this pandemic. The vaccine is a great weapon against this virus and it will assist us in this fight. If we use both these weapons together, we will get rid of this pandemic quickly.

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SUGARY BEVERAGE LINKED TO INCREASED RISK OF COLORECTAL CANCER IN WOMEN UNDER 50: STUDY

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If you are obsessed with sugar-sweetened drinks then you need to think twice before having them regularly.

A new study led by Washington University School of Medicine has found a link between drinking sugar-sweetened beverages and an increased risk of developing colorectal cancer in women under age 50. The findings suggest that heavy consumption of sugary drinks during adolescence (ages 13 to 18) and adulthood can increase the disease risk. The study, published in the journal Gut, provides more support for public health efforts that encourage people to reduce the amount of sugar they consume.

“Colorectal cancer in younger adults remains relatively rare, but the fact that the rates have been increasing over the past three decades — and we don’t understand why — is a major public health concern and a priority in cancer prevention,” said senior author Yin Cao, ScD, an associate professor of surgery and of medicine in the Division of Public Health Sciences at Washington University.

“Due to the increase in colorectal cancer at younger ages, the average age of colorectal cancer diagnosis has gone down from 72 years to 66 years. These cancers are more advanced at diagnosis and have different characteristics compared with cancers from older populations.

“Our lab is funded by the National Cancer Institute (NCI) and the National Comprehensive Cancer Network to identify risk factors, the molecular landscapes, and precision screening strategies for these cancers so that they can be detected earlier and even prevented,” said Cao, who also has a master’s of public health.

“In past work, we have shown that poor diet quality was associated with increased risk of early-onset colorectal cancer precursors, but we have not previously examined specific nutrients or foods.”

Compared with women who drank less than one 8-ounce serving per week of sugar-sweetened beverages, those who drank two or more servings per day had just over twice the risk of developing early-onset colorectal cancer, meaning it was diagnosed before age 50.

The researchers calculated a 16 per cent increase in risk for each 8-ounce serving per day. And from ages 13 to 18, an important time for growth and development, each daily serving was linked to a 32 per cent increased risk of eventually developing colorectal cancer before age 50.

Sugar-sweetened drink consumption has been linked to metabolic health problems, such as type 2 diabetes and obesity, including in children. But less is known about whether such high-sugar beverages could have a role in the increasing incidence of colorectal cancer in younger people. Like early-onset colorectal cancer rates, consumption of such drinks has increased over the past 20 years, with the highest consumption level found among adolescents and young adults ages 20 to 34.

The researchers analyzed data from the Nurses’ Health Study II, a large population study that tracked the health of nearly 116,500 female nurses from 1991 to 2015. Every four years, participants answered surveys that included questions about diet, including the types and estimated amounts of beverages they drank.

Of the total participants, over 41,000 also were asked to recall their beverage habits during their adolescence.

The researchers identified 109 diagnoses of early-onset colorectal cancer among the nearly 116,500 participants.

“Despite the small number of cases, there is still a strong signal to suggest that sugar intake, especially in early life, is playing a role down the road in increasing adulthood colorectal cancer risk before age 50,” said Cao, also a research member of Siteman Cancer Center.

“This study, combined with our past work linking obesity and metabolic conditions to a higher risk of early-onset colorectal cancer, suggests that metabolic problems, such as insulin resistance, may play an important role in the development of this cancer in younger adults.”

With the increasing rates in mind, the American Cancer Society has recently lowered the recommended age for a first screening colonoscopy to 45, down from the previously recommended age 50 for people at average risk. Those with additional risk factors, such as a family history of the disease, should start even earlier, according to the guidelines.

Since the study only included female nurses, most of whom were white, more work is needed to examine this link in people of more diverse races, ethnicities and genders.

While sugar-sweetened beverages were linked to an increased risk of early-onset colorectal cancer, some other drinks — including milk and coffee — were associated with a decreased risk.

This observational study can’t demonstrate that drinking sugary beverages causes this type of cancer or that drinking milk or coffee is protective, but the researchers said that replacing sweetened beverages with unsweetened drinks, such as milk and coffee, is a better choice for long-term health.

“Given this data, we recommend that people avoid sugar-sweetened beverages and instead choose drinks like milk and coffee without sweeteners,” Cao said.

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ORGAN TRANSPLANT RECIPIENTS REMAIN VULNERABLE TO COVID-19 EVEN AFTER SECOND VACCINE DOSE

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Researchers at Johns Hopkins have found that two doses of a vaccine against SARS-CoV-2 — the virus that causes COVID-19 — confers some protection for people who have received solid organ transplants, it’s still not enough to enable them to dispense with COVID safety measures including masks and physical distancing.

The findings that were published in the Journal of the American Medical Association (JAMA). This is a follow-up study to an earlier one published in March in JAMA, in which the researchers reported that only 17 per cent of the participating transplant recipients produced sufficient antibodies after just one dose of a two-dose COVID-19 vaccine regimen.

“While there was an increase in those with detectable antibodies — 54 per cent overall — after the second shot, the number of transplant recipients in our second study whose antibody levels reached high enough levels to ward off a SARS-CoV-2 infection was still well below what’s typically seen in people with healthy immune systems,” says study lead author Brian Boyarsky, M.D., a surgery resident at the Johns Hopkins University School of Medicine.

“Based on our findings, we recommend that transplant recipients and other immunocompromised patients continue to practice strict COVID-19 safety precautions, even after vaccination,” Boyarsky says.

People who receive solid organ transplants (such as hearts, lungs and kidneys) often must take drugs to suppress their immune systems and prevent rejection. Such regimens may interfere with a transplant recipient’s ability to make antibodies to foreign substances, including the protective ones produced in response to vaccines.

The new study evaluated this immunogenic response following the second dose of either of the two messenger RNA (mRNA) vaccines — made by Moderna and Pfizer-BioNTech — for 658 transplant recipients, none of whom had a prior diagnosis of COVID-19. The participants completed their two-dose regimen between Dec. 16, 2020, and March 13, 2021.

In the most recent study, the researchers found that only 98 of the 658 study participants — 15 per cent — had detectable antibodies to SARS-CoV-2 at 21 days after the first vaccine dose. This was comparable to the 17 per cent reported in the March study looking at the immune response after only one vaccine dose.

At 29 days following the second dose, the number of participants with detectable antibodies rose to 357 out of 658 — 54 per cent. After both vaccine doses were administered, 301 out of 658 participants — 46 per cent — had no detectable antibody at all while 259 — 39 per cent — only produced antibodies after the second shot.

The researchers also found that among the participants, the most likely to develop an antibody response were younger, did not take immunosuppressive regimens including anti-metabolite drugs and received the Moderna vaccine. These were similar to the associations seen in the March single-dose study.

“Given these observations, transplant recipients should not assume that two vaccine doses guarantee sufficient immunity against SARS-CoV-2 any more than it did after just one dose,” says study co-author Dorry Segev, M.D., PhD, the Marjory K. and Thomas Pozefsky Professor of Surgery and Epidemiology and director of the Epidemiology Research Group in Organ Transplantation at the Johns Hopkins University School of Medicine.

Segev says that future studies should seek to improve COVID-19 vaccine responses in this population, including additional booster doses or modulating the use of immunosuppressive medications so that sufficient antibody levels are achieved.

In addition to Boyarsky and Segev, the Johns Hopkins Medicine research team includes William Werbel, Robin Avery, Aaron Tobian, Allan Massie and Jacqueline Garonzik-Wang.

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New research analyzes more palatable alternatives to control SARS-CoV-2 spread

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At the beginning of the COVID-19 pandemic, intense social distancing and lockdown measures were the primary weapon in the fight against the spread of SARS-CoV-2, but they came with a monumental societal burden. New research from the Center for the Ecology of Infectious Diseases and the College of Public Health at the University of Georgia explores if there could have been a better way.

Through the findings, published in the journal Proceedings of the Royal Society B, the researchers analyzed more palatable alternatives to the kind of social distancing mandates that threw a wrench at how businesses, schools and even family gatherings work. The alternatives — widespread testing, contact tracing, quarantines, certification for non-infected people and other public health policy measures — can slow the spread when combined together, but only with significant investments and broad public compliance.

“I understand why government leaders quickly enacted strict social distancing mandates as the COVID-19 pandemic was rapidly spreading in 2020,” said lead author John Drake, director of the Center for the Ecology of Infectious Diseases and Distinguished Research Professor in the Odum School of Ecology.

“This was the best that we could do at the time. However, school and workplace closures, gathering limits and shelter-in-place orders have had extreme economic consequences. These are harsh, and we really need to find alternative solutions,” John added.

Drake worked with other researchers to develop two models. One targeted how to find infected people to limit transmission through active case finding (through testing of at-risk individuals), thorough contact tracing when cases arise, and quarantines for people infected and their traced contacts.

The second model focused on a strategy of limiting exposure by certifying healthy individuals.

“Each model was tested independently and in combination with general non-pharmaceutical interventions (NPIs),” said co-author Kyle Dahlin, a postdoctoral associate with the centre.

For this study, those interventions were defined as behavioural or generalized interventions that can be broadly adopted, such as wearing a face mask, hand washing, enhanced sick leave, micro distancing and contactless transactions.

“When we ran the model to evaluate the effectiveness of only using social distancing measures, like workplace closures, after the onset of the first wave, approximately half of the population eventually became infected,” said study co-author Andreas Handel, associate professor of biostatistics and epidemiology in UGA’s College of Public Health who helped design the models.

“When we combined social distancing with general interventions, SARS-CoV-2 transmission was slowed, but not enough for complete suppression.”

When they tested the model that actively looked for infection, they found that active case-finding had to identify approximately 95 per cent of infected persons to stop the viral spread.

When combined with NPIs, like face masks, the fraction of active cases that needed to be located dropped to 80 per cent. Considering that during the first wave of the pandemic in 2020, only 1 per cent to 10 per cent of positive cases were found, such an approach by itself wouldn’t work.

The researchers also determined that adding contact tracing and quarantine to active case finding and general NPIs did not drastically change the model’s success.

The model that targeted healthy people to limit exposure determined that to successfully control viral spread, SARS-CoV-2 test validity had to occur within a very narrow window of seven to 10 days with a waiting time of three days or less, and NPIs had to be strictly adopted. Otherwise, a large outbreak would occur.

Pej Rohani, Regents’ and Georgia Athletic Association Professor of Ecology and Infectious Diseases in the Odum School and College of Veterinary Medicine, said that the models’ conclusions indicated the need for continued research.

“These models are important because infectious disease ecologists and epidemiologists need to understand how SARS-CoV-2 transmission can be reduced using measures that do not have extreme societal consequences,” he said.

The CEID’s research highlighted the importance of a robust and widespread testing program, the general adoption of NPIs like face masks, and targeted measures to globally control the ongoing pandemic. These approaches are still extremely important as vaccines continue to be distributed.

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Benefits of deworming for expectant mothers to their infants

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Researchers from Syracuse University, the World Health Organization, and SUNY Upstate (The State University of New York Upstate Medical University) measured the impact of deworming medicine during pregnancy on the subsequent risk of neonatal mortality and low birthweight.

The study has been conducted on 95 Demographic Health Survey data collected on more than 800,000 births and the results are published in the current issue of the journal PLoS Neglected Tropical Diseases.

More than 25% of the world’s population (greater than 1.5 billion people) face the burden of soil-transmitted helminth (STH) infections, a species of an intestinal parasite whose eggs develop in the soil before finding a new host.

The main cause of this high infection rate is lack of access to adequate sanitation facilities (toilets) and the consequent contamination of the environment with human faeces. While universal access to adequate sanitation is one of the sustainable development goals, parasite burdens are still causing harm. Fortunately, deworming medicines are highly effective and safe.

When women receive deworming medicine during pregnancy, we find two specific benefits for the baby: first, the risk of neonatal mortality (a baby’s death within the first 4 weeks of life) decreases by an estimated 14%; second, the odds of low birthweight are an estimated 11% lower in countries with the lower transmission of soil-transmitted helminths. These results vary somewhat by transmission rate across different countries.

Given the low cost of deworming medicine and fundamental health advantages, these findings call for an increased global effort toward the widescale distribution of deworming medicine for pregnant women. Global effort toward reducing STH infections is affordable, and the benefits far outweigh the program costs.

A recent study has found that mothers receiving deworming treatment during pregnancy reduce by 14% the risk of their child dying within the first four weeks after birth. Another benefit is that treating pregnant women with anthelminthic medicines can avoid low birth weight.

The study, conducted on 95 Demographic Health Survey datasets and collected on more than 800 000 births, utilised birth histories to measure the impact of routine deworming medicine during antenatal care on subsequent neonatal mortality and low birth weight for births between 1998 and 2018 in 56 lower-income countries.

“Pregnant women who received deworming medication were associated with a 14% reduction in risk for neonatal mortality, with no difference between high and low transmission countries,” said Bhavneet Walia of the Department of Public Health, Syracuse University, New York, USA.

“We also found that in countries with low transmission of soil-transmitted helminths, the deworming treatment decreased the odds of low birth weight by 11%, although these somewhat varied in relation to transmission rates across different countries,” Bhavneet added.

Routine deworming during antenatal care decreases the risk of neonatal mortality and low birth weight: a retrospective cohort of survey data (to hyperlink) authored by Syracuse University, the World Health Organization (WHO) and SUNY Upstate is published in the journal, PLoS Neglected Tropical Diseases.

The researchers matched births on the probability of receiving deworming during pregnancy. They then modelled birth outcomes with the matched group to estimate the effect of deworming during antenatal care after accounting for various risk factors. They also tested for effect modification of soil-transmitted helminth prevalence on the impact of deworming during antenatal care.

“Intestinal worms impact the health of women and girls of reproductive age and this study supports the fact that treating pregnant women can be beneficial,” said Dr Antonio Montresor, Medical Officer, WHO Department of Control of Neglected Tropical Diseases.

He said, “WHO has long recommended the deworming women of reproductive age after their first trimester of pregnancy and in areas where the prevalence of worm infections is 20% or higher.”

Soil-transmitted helminths2 is transmitted by ingesting microscopic eggs that are passed in the faeces of infected people and disperse in the environment. Adult worms live in the intestines where they produce thousands of eggs each day. In areas that lack adequate sanitation, these eggs contaminate the soil.

More than 1.5 billion people, or 24% of the world’s population, are infected with soil-transmitted helminths. Infections are widely distributed in tropical and subtropical areas, with the greatest numbers occurring in sub-Saharan Africa, the Americas, China and East Asia.

Approximately 688 million girls and adult women of reproductive age live in areas that are endemic for intestinal worms, in more than 100 countries. The greatest number is found in sub-Saharan Africa, the Americas and Asia where reinfection is frequent in areas of high transmission.

WHO coordinates shipment of donated medicines to countries requesting them. They are then distributed freely by national disease control programs during mass treatment campaigns.

Periodic deworming should be available to children and to all pregnant women in endemic countries.

Deworming is not the only answer, however. A permanent solution can only be obtained by a substantial improvement in access to sanitation – a process that is normally slow and expensive.

With ANI inputs

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CHANGES IN PROTEINS PLAY CRUCIAL ROLE IN AGEING KIDNEYS: STUDY

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Studying protein changes in the kidneys as we age, as well as the transcription of genes into proteins, helps provide a full picture of the age-related processes that take place in these organs, says a recent study published in eLife.

Ageing causes many changes in the body and in essential organs such as the kidneys, which function less efficiently later in life. Age-related changes in the kidneys have mostly been reported by looking at the transcription of genes the process by which a segment of DNA is copied into RNA.

 The current study suggests that this approach, combined with studying changes in proteins, gives us a better understanding of age-related changes in the kidney and may point to new approaches for treating age-related kidney dysfunction.

“Physiological changes in kidney function during ageing are well documented, but little is known about the underlying molecular processes that drive this loss of function,” explains first author Yuka Takemon, who was a research assistant at the Jackson Laboratory in Bar Harbor, Maine, US, when the study was carried out and is now a PhD student at the Michael Smith Genome Sciences Centre, University of British Columbia, Canada.

 “Many previous studies of these physiological changes have looked at the transcription of genes into proteins by measuring messenger RNA (mRNA), but we wanted to see if we could gather more insights by combining this approach with studying protein levels in the kidney.”

In their study, Takemon and colleagues looked at age-related changes in kidney function in about 600 genetically diverse mice. They also measured changes in mRNA and proteins in kidney samples from about one-third of the animals.

They discovered an age-related pattern of changes in both mRNA and proteins in the mice that suggests the animals have increasing numbers of immune cells and inflammation in their kidneys, as well as decreased function in their mitochondria, which produce energy for the cells.

However, not all of the changes in proteins corresponded with changes in the mRNA, suggesting that some of the protein changes occur after the transcription of genes into RNA.

 This could mean that older kidneys become less efficient at building new proteins, or that proteins are broken down more quickly in older kidneys. If further studies confirm this, it could mean that therapies or interventions that promote protein building or slow protein breakdown may be beneficial for treating kidney diseases associated with ageing.

“Our study suggests that mRNA measurements alone provide an incomplete picture of molecular changes caused by ageing in the kidney,” concludes senior author Ron Korstanje, Associate Professor at the Jackson Laboratory. “Studying changes in proteins is also essential to understanding these ageing-related processes, and for designing possible new approaches for treating age-related diseases.” 

With ANI inputs

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AIR POLLUTION LINKED TO HIGH BP, HEART DISEASES IN CHILDREN

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A meta-analysis of 14 air pollution studies from around the world found that exposure to high levels of air pollutants during childhood increases the likelihood of high blood pressure in children and adolescents, and their risk for high blood pressure as adults, a new study finds. The findings are published in a special issue on air pollution in the Journal of the American Heart Association, an open-access journal of the American Heart Association.

 Other studies look at: the effects of diesel exhaust on the muscle sympathetic nerve; the impact of pollutants on high blood pressure; rates of hospital readmission for heart failure among those exposed to high levels of ambient air pollution; and risk of stroke and heart attack after long-term exposure to high levels of particulate matter. The studies include health outcomes of people who were exposed to pollutants in the United States, China and Europe.

 High blood pressure during childhood and adolescence is a risk factor for hypertension and heart disease in adulthood. Studies on air pollution and blood pressure in adolescents and children, however, have produced inconsistent conclusions.

  This systematic review and meta-analysis pooled information from 14 studies focused on the association between air pollution and blood pressure in youth. The large analysis included data for more than 350,000 children and adolescents (mean ages 5.4 to 12.7 years of age).

  “Our analysis is the first to closely examine previous research to assess both the quality and magnitude of the associations between air pollution and blood pressure values among children and adolescents,” said lead study author Yao Lu, M.D., PhD, professor of the Clinical Research Center at the Third Xiangya Hospital at Central South University in Changsha, China, and professor in the department of life science and medicine at King’s College London.

  “The findings provide evidence of a positive association between short- and long-term exposure to certain environmental air pollutants and blood pressure in children and adolescents.”

 The meta-analysis concluded:

 1. Short-term exposure to PM10 was significantly associated with elevated systolic blood pressure in youth (the top number on a blood pressure reading).

  2. Periods of long-term exposure to PM2.5, PM10 and nitrogen dioxide were also associated with elevated systolic blood pressure levels.

3. Higher diastolic blood pressure levels (the bottom number on a blood pressure reading) were associated with long-term exposure to PM2.5 and PM10.

  “To reduce the impact of environmental pollution on blood pressure in children and adolescents, efforts should be made to reduce their exposure to environmental pollutants,” said Lu. “Additionally, it is also very important to routinely measure blood pressure in children and adolescents, which can help us identify individuals with elevated blood pressure early.”

  The results of the analysis are limited to the studies included, and they did not include data on possible interactions between different pollutants, therefore, the results are not generalisable to all populations. Additionally, the analysis included the most common and more widely studied pollutants vs. air pollutants confirmed to have a heart health impact, of which there are fewer studies. 

With ANI inputs

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