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Higher antibiotics use may raise Parkinson’s disease risk

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Antibiotic Resistance

London, Nov 23 : Excessive use of certain commonly used antibiotics is linked to an increased risk of Parkinson’s disease, a progressive nervous system disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination, says a study.

This connection may be explained by their disruptive effects on the gut microbial ecosystem, said the study published in the journal Movement Disorders.

The strongest associations were found for broad spectrum antibiotics and those that act against against anaerobic bacteria and fungi.

“The link between antibiotic exposure and Parkinson’s disease fits the current view that in a significant proportion of patients the pathology of Parkinson’s may originate in the gut, possibly related to microbial changes, years before the onset of typical Parkinson motor symptoms such as slowness, muscle stiffness and shaking of the extremities,” said research team leader Filip Scheperjans from Helsinki University Hospital, Finland.

“It was known that the bacterial composition of the intestine in Parkinson’s patients is abnormal, but the cause is unclear. Our results suggest that some commonly used antibiotics, which are known to strongly influence the gut microbiota, could be a predisposing factor,” Scheperjans said.

In the gut, pathological changes typical of Parkinson’s disease have been observed up to 20 years before diagnosis.

Constipation, irritable bowel syndrome and inflammatory bowel disease have been associated with a higher risk of developing Parkinson’s disease.

Exposure to antibiotics has been shown to cause changes in the gut microbiome and their use is associated with an increased risk of several diseases, such as psychiatric disorders and Crohn’s disease.

However, these diseases or increased susceptibility to infection do not explain the now observed relationship between antibiotics and Parkinson’s.

The study compared antibiotic exposure during the years 1998-2014 in 13,976 Parkinson’s disease patients and compared it with 40,697 non-affected persons matched for the age, sex and place of residence.

Antibiotic exposure was examined over three different time periods: 1-5, 5-10, and 10-15 years prior to the index date, based on oral antibiotic purchase data.

Exposure was classified based on number of purchased courses. Exposure was also examined by classifying antibiotics according to their chemical structure, antimicrobial spectrum, and mechanism of action.

“The discovery may also have implications for antibiotic prescribing practices in the future. In addition to the problem of antibiotic resistance, antimicrobial prescribing should also take into account their potentially long-lasting effects on the gut microbiome and the development of certain diseases,” Scheperjans said.

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No benefit from arthritis drug for severe Covid patients: Study

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Contrary to a few studies that earlier suggested benefits from an arthritis drug for patients with severe or critical Covid-19 infection, a new study indicates that it is not better than standard care alone.

According to the researchers, including Regis G Rosa from Hospital Moinhos de Vento in Brazil, there was an increased number of deaths at 15 days in patients receiving an arthritis drug — tocilizumab — that resulted in the trial being stopped early.

These results contradict earlier observational studies suggesting benefit from tocilizumab. However, observational effects are limited by a high risk that they may be due to other unknown (confounding) factors — and some studies have not yet been peer reviewed or published in a medical journal, the researchers said in a paper published in The BMJ journal.

Tocilizumab blocks a specific part of the immune system (interleukin 6) that can go into overdrive in some patients with Covid-19.

According to the team, doctors think this might help lessen the body’s inflammatory response to the virus and avert some of the more dire consequences of the disease, but its effects are not well defined.

To test this theory, researchers conducted a randomised controlled trial involving 129 Covid-19 patients with an average age of 57 years and compared tocilizumab plus standard care with standard care alone.

Patients were receiving supplemental oxygen or mechanical ventilation and had abnormal levels of at least two chemicals linked to inflammation in their blood.

The study participants were randomly divided into two groups — 65 received tocilizumab plus standard care and 64 received standard care alone. All patients were monitored for 15 days.

By day 15, 18 (28 per cent) patients in the tocilizumab group and 13 (20 per cent) in the standard care group were receiving mechanical ventilation or had died.

Death at 15 days occurred in 11 (17 per cent) patients in the tocilizumab group compared with 2 (3 per cent) in the standard care group.

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Male sex hormones may help treat breast cancer: Study

While endocrine therapy is standard-of-care for estrogen receptor positive breast cancer, resistance to these drugs is the major cause of breast cancer mortality.

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Sydney : Researchers have found new evidence about the positive role of androgens, commonly thought of as male sex hormones but also found at lower levels in women, in breast cancer treatment.

In normal breast development, estrogen stimulates and androgen inhibits growth at puberty and throughout adult life.

Abnormal estrogen activity is responsible for the majority of breast cancers, but the role of androgen activity in this disease has been controversial.

The new research published in the journal Nature Medicine showed that androgens have potential for treatment of estrogen receptor positive breast cancer.

A cancer is called estrogen receptor positive if it has receptors for estrogen, according to Breastcancer.org.

Using cell-line and patient-derived models, the global team, including researchers at the University of Adelaide and the Garvan Institute of Medical Research in Australia, demonstrated that androgen receptor activation by natural androgen or a new androgenic drug had potent anti-tumour activity in all estrogen receptor positive breast cancers, even those resistant to current standard-of-care treatments.

In contrast, androgen receptor inhibitors had no effect.

“This work has immediate implications for women with metastatic estrogen receptor positive breast cancer, including those resistant to current forms of endocrine therapy,” said lead researcher Theresa Hickey, Associate Professor at the University of Adelaide.

“We provide compelling new experimental evidence that androgen receptor stimulating drugs can be more effective than existing (e.g. Tamoxifen) or new (e.g. Palbociclib) standard-of-care treatments and, in the case of the latter, can be combined to enhance growth inhibition,” said Wayne Tilley, Director of the Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical School, University of Adelaide.

Androgens were historically used to treat breast cancer, but knowledge of hormone receptors in breast tissue was rudimentary at the time and the treatment’s efficacy misunderstood.

Androgen therapy was discontinued due to virilising side effects and the advent of anti-estrogenic endocrine therapies.

While endocrine therapy is standard-of-care for estrogen receptor positive breast cancer, resistance to these drugs is the major cause of breast cancer mortality.

“The new insights from this study should clarify the widespread confusion over the role of the androgen receptor in estrogen receptor driven breast cancer,” said Elgene Lim, a breast oncologist and Head of the Connie Johnson Breast Cancer Research Lab at the Garvan Institute.

“Given the efficacy of this treatment strategy at multiple stages of disease in our study, we hope to translate these findings into clinical trials as a new class of endocrine therapy for breast cancer.”

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Expert panel recommends Phase 1 trial of nasal Covid-19 vaccine

According to the firm, an intranasal vaccine stimulates a broad immune response at the site of infection, in the nasal mucosa, which is essential for blocking both infection and transmission of Covid-19.

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New Delhi, Jan 20: The Subject Expert Committee (SEC) of the Central Drugs Standard Control Organisation (CDSCO) on Tuesday recommended Bharat Biotech’s intranasal vaccine for coronavirus for phase 1 clinical trials. The final call will now be taken by the Drugs Controller General of India.

Days after getting the Drugs Controller General of India’s nod for restricted emergency use of India’s first indigenously-made coronavirus vaccine, Bharat Biotech had applied to the drug regulator for permission to start the clinical trials of their nasal coronavirus vaccine.

The nasal vaccine is different from the intramuscular vaccine which recently got approval, as it is non-invasive, needle-free, doesn’t require trained healthcare workers, eliminates needle-associated risks, suits children and adults and has scalable manufacturing.

Earlier on Tuesday, Dr VK Paul, Member, NITI (National Institution for Transforming India) Aayog had said, “A nasal vaccine candidate has been identified. It has come for consideration for phase 1 and phase 2 trials. If it works then it could be a game-changer.”

“Phase 1 has been recommended,” top government sources told IANS. Clinical trials of Bharat Biotech’s ‘BBV154’ — a novel adenovirus vectored, and intranasal vaccine for coronavirus — will be conducted at various locations. The vaccine will be single-dosed.

According to the firm, an intranasal vaccine stimulates a broad immune response at the site of infection, in the nasal mucosa, which is essential for blocking both infection and transmission of Covid-19.

The vaccine has demonstrated protective efficacy in mice and hamsters. Mice and hamsters immunized with its single-dose conferred superior protection against the SARS-CoV-2 challenge, “more so than one or two intramuscular immunizations of the same vaccine and dose.”

“Thus, intranasal immunization of ChAd-SARS-CoV-2-S can create an immune response in the nose, which is the point of entry for the virus, thereby protecting against disease, infection and transmission,” Bharat Biotech said in a statement.

On January 3, two intramuscular vaccines – Bharat Biotech’s Covaxin and Oxford-AstraZeneca’s Covishield manufactured by the Serum Institute of India were approved for restricted emergency use and have been administered to over four lakh people till now. Both are two-dose vaccines.

While the full efficacy of Covaxin is yet to be determined, it was given the go-ahead by the DCGI citing ‘public interest’. Covaxin is an indigenously developed vaccine by Bharat Biotech, in collaboration with the Indian Council of Medical Research (ICMR).

Public health experts believe that intranasal vaccines for coronavirus, administered through the nose rather than muscles, can be a potential game-changer in India’s fight against the coronavirus pandemic.

Last month, Pune-based Serum Institute of India and Codagenix Inc had announced that they have received regulatory approval in the United Kingdom to begin an early-stage trial of their single-dose, intranasal coronavirus vaccine.

(Aakanksha Khajuria can be contacted at [email protected])

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