- A Promising Alzheimer’s Drug Doesn’t Work After All
- Thanksgiving: 4 Easy Ways to Become More Grateful
- You Asked: Can People Be Allergic to Semen?
- The Freak City-Wide Outbreak of Asthma That Overwhelmed Melbourne ‘Could Have Been Predicted’
Posted: 23 Nov 2016 06:35 AM PST
The third try wasn’t the charm for Eli Lilly’s Alzheimer’s drug solanezumab. In EXPEDITION3, the third test of the drug since it was developed in 2006, the compound failed once again to show significant benefit for people with mild forms of the disease.
“The outcome was not what we hoped for, and that is disappointing for the millions of people waiting for a potential disease-modifying treatment for Alzheimer’s disease,” Dr. Eric Siemers, medical director of the Alzheimer’s Disease Team at Lilly said during a teleconference. The company will not continue to pursue approval of the drug for treatment of mild Alzheimer’s.
Solanezumab is among the first of a new group of treatments that are designed to address the brain disorder at its root cause, rather than just relieve symptoms. Had it been successful, it would have been the first so-called disease-modifying treatment, or therapy that slowed progression of Alzheimer’s. The compound sticks to the free-floating forms of the protein amyloid, which build up into damaging plaques in the brain. Lilly scientists had hoped that their agent, an amyloid antibody, would soak up enough of the circulating amyloid so that there weren’t enough fragments around to aggregate into the toxic plaques. “By increasing the rate of clearance of amyloid with solanezumab, we are making the brain younger in a sense,” Siemers told TIME earlier while describing the compound.
In the study, 2,100 people with mild dementia and evidence of amyloid in the brain confirmed by PET scans were randomly assigned to solanezumab or placebo. After 18 months, there was no significant difference between them on measures of cognitive decline.
“It’s clearly disappointing for all of us [in the Alzheimer’s field],” says Dr. Dennis Selkoe, co-director of the center for neurology at Brigham and Women’s Hospital. Selkoe was not involved in the study but has patients who are enrolled in it.
The company came under fire over the summer when it changed the endpoint of the trial. Originally, Lilly was going to determine the success of solanezumab by looking at two measures: how it affected thinking skills such as memory and reasoning, and whether it changed a person’s ability to function independently and perform daily activities such as dressing, bathing and feeding. But just before the final data on the last patient was collected in October, Lilly changed the outcomes so that the drug’s success would rest solely on the cognitive changes, with the functional ones as a secondary measure of success. Critics pointed out that functional changes tend to be more challenging to show and that the company made the change to maximize the chances of a positive outcome.
The company maintains that the shift simply reflected better understanding of how Alzheimer’s affects the brain; cognitive declines happen before functional ones, so detecting the latter would take a longer, more expensive study than an 18-month trial.
EXPEDITION3 was Lilly’s third chance to show that solanezumab was worth approving. In the previous two studies, people with either mild or moderate Alzheimer’s participated and the results were similarly negative. As knowledge about the disease improved, researchers learned that amyloid starts to build up years, perhaps even decades, before the first symptoms of memory and cognitive problems start. In response, Lilly launched EXPEDITION3, limiting the participants to people with mild forms of the disease. The company also took advantage of better imaging techniques that could document the presence of amyloid in the brain; in the previous two studies, anywhere from 20% to 30% of the volunteers did not actually have amyloid. (At the time, doctors were diagnosing people based only on their symptoms and performance on cognitive tests.)
The fact that the trial did not show benefit even among people with mild Alzheimer’s doesn’t necessarily spell the end of anti-amyloid approaches. It could simply mean that the drug treatment wasn’t started early enough in the disease to make a difference. Other anti-amyloid compounds, including one developed by Biogen, for example, have recently shown encouraging results in reducing amyloid plaques as well as improving cognitive skills. That agent, aducanumab, is designed to bind preferentially to the early clumps of amyloid as they form plaques, and therefore may be more useful in mild or moderate patients who are already showing signs of memory loss and other cognitive problems. “I don’t think we will abandon attempts to slow down Alzheimer’s with amyloid-lowering,” says Selkoe. “We’ve always known that solanezumab is a weak antibody, which is why it also doesn’t have many side effects. There is a balance between efficacy and safety, and while solanezumab was not that powerful, the idea was that the Food and Drug Administration, in approving the first disease-modifying Alzheimer’s treatment, needs to have a drug that can be used safely, and first do no harm.”
In Lilly’s case, the effectiveness wasn’t enough. But other ways of treating the disease, including targeting the other protein called tau that damages nerve cells, may prove important as well. Ultimately, it’s likely that the most effective treatment won’t be one drug but a combination of them, each of which addresses a different part of the disease process. It may be the end of solanezumab, but not the end of amyloid antibodies. There isn’t a drug to treat Alzheimer’s yet, but there’s hope that one, and possibly more, are coming.
Posted: 23 Nov 2016 05:30 AM PST
Thanksgiving is the official season of gratitude: that old-fashioned, warm and fuzzy out-loud appreciation of our fellow humans. Most of us count our blessings for a day, then dust off the list a year from now.
But a ream of research makes the case that gratitude shouldn’t just be a seasonal affair. It’s stellar for your health; practicing gratitude is linked to better immunity and blood pressure and less loneliness, which comes with its own host of health detriments. It improves sleep and self-esteem. People who are grateful are more likely to exercise more and visit the doctor less. And even in our modern-day tech trap of social judging apps, they’re less likely to compare themselves to others.
Gratitude is the very stuff that makes social relationships possible and pleasurable. But like anything else that’s good for you, gratitude takes work and doesn’t always come naturally. Here are four science-backed ways to get more grateful.
Make sure it’s something you can do, not own. You probably already knew that experiences—things like vacations, concert tickets or nice meals out—make you happier than material purchases like gadgets or jewelry. But a series of new studies published in the journal Emotion finds that they make you more grateful, too. When people thought about past experiences they’d paid for, they used more thankful language than when they reflected on possessions. And in an economic game used in one study, they were also more likely to behave more generously and give more to others than those who reflected on possessions they’d bought.
The best part is that everyone benefits. “When people reflect on their experiential pursuits, they end up feeling grateful, but not necessarily grateful to a particular entity,” says study co-author Amit Kumar, a post-doctoral research fellow at the University of Chicago. People feel fortunate, and because it’s a “diffuse, untargeted type of gratitude, they’re motivated to give back to people in general.”
One scientifically reliable way to nudge people toward gratitude is to have them write a grateful letter to someone else. Researchers recently had a group of therapy patients do this, while another group wrote deeply and expressively on their stressful experiences.
A month after the experiment ended, people who wrote grateful letters reported significantly better mental health than those who wrote expressively. The effect stuck around when researchers measured again after three months.
Writing a gratitude letter only takes about 15 minutes, according to the Greater Good Science Center at the University of California, Berkeley. Use specific, concrete terms to describe what the person did, why you’re grateful and how your life has changed as a result. No need to write more than a page, but make sure to deliver it in person if you can and read it out loud.
It’s good to be grateful—but don’t forget who deserves the credit. In a recent study, researchers watched while couples expressed gratitude to each other, taking careful note of the language they used. The compliments were either other-praising—phrases that keep positive attention on the person, like “you go out of your way” and “I feel like you’re really good at that”—or self-beneficial, meaning the speaker framed the compliment in terms of how she benefited, such as “it let me relax” and “it makes me happy.”
The first kind was better by far. Those who received this kind of gratitude felt happier and more loving toward their partner.
Even though gratitude is an evolutionary tool to help people feel more connected, it can feel awkward to express. And won’t the targets of your gratitude feel kind of weird when you tell them how exactly much they mean to you?
That’s a common but unfounded fear, Kumar is finding in forthcoming research. “People tend to overestimate the awkwardness and underestimate how good the recipient of gratitude will feel,” he says. But the response to gratitude is “almost universally positive, even though we don’t always anticipate that it’s going to be beforehand.”
Posted: 23 Nov 2016 05:00 AM PST
It sounds like a bawdy joke. But semen allergies are a thing—and may be a much more common thing than most people realize. Up to 40,000 women in the U.S. alone might have a hypersensitivity to one or more of the protein components in human semen, according to a review study from the University of Cincinnati.
A protein made in a man’s prostate gland may be the prime culprit. “However, given the myriad proteins and other biomolecules in semen, there may be more than one allergen responsible,” says Michael Carroll, a senior lecturer in reproductive and clinical science at Manchester Metropolitan University in the UK.
A guy’s diet may even play a role. Carroll cites one case study in which a woman who was allergic to nuts had a bad reaction to her boyfriend’s semen after he ate a Brazil nut. So it’s possible people who aren’t typically allergic to semen may experience a reaction, depending on what their partner has been eating.
In 2011, Carroll coauthored a study on “hypersensitivity to human semen” (HHS), the medical name for a semen allergy. He says symptoms include itching, redness, burning and swelling in the vagina and vulva area, as well as classic systemic allergy symptoms like hives, breathing problems and eczema. “It’s thought to be a type-1 allergic reaction: the same type of reaction that one gets from pollen or cat dander,” he says.
Women who experience HHS tend to have symptoms emerge right after unprotected sex or contact with semen. Those symptoms can last more than 24 hours. But in many cases, doctors may misdiagnose the condition as an infection or chronic vaginitis.
How can you tell if you have a semen allergy? The first (and most obvious) predictor is if you have some of the above symptoms after unprotected sex, but not when your partner wears a condom. Carroll says skin prick tests and blood antibody profiles can confirm a semen allergy.
Condom use is an effective solution, although that won’t help couples trying to get pregnant. The good news is that Carroll’s research has shown sperm “washed” of seminal fluid do not cause allergic reactions. Also, having HHS doesn’t seem to harm a woman’s ability to conceive, he says.
If you have a semen allergy and you’re trying to have a baby, your doctor can prescribe prophylactic antihistamines, which you would take 30 to 60 minutes before sex, Carroll says. Anti-inflammatory drugs can help knock down your allergic reaction, too, before it gets going.
Posted: 22 Nov 2016 07:35 PM PST
Authorities could have predicted the deadly, city-wide outbreak of asthma and respiratory problems that took place during a thunderstorm in the Australian city of Melbourne on Monday evening local time, according to the researcher who first coined the phrase “thunderstorm asthma.”
Associate professor Cenk Suphioglu, an environmental allergist from Deakin University, told a local newspaper that a “perfect storm” of conditions triggered what one senior health official described as a “state disaster.”
Two young people died during the storm as a result of asthma triggered by the extreme weather, while ambulance services were overwhelmed by a massive spike in calls as thousands of residents struggled to breathe and hundreds were rushed to local hospitals.
“We’ve had a lot of rain, which means there’s a lot of grass, which means there’s a lot of pollen, Prof. Suphioglu told the Geelong Advertiser. The rain, he explained, broke up the pollen, releasing an abnormally high concentration of microscopic particles into the wind.
The size of the particles made it easy for them to enter airways and lungs, triggering adverse reactions in many people who had never experienced them before.
Professor George Braitberg, director of emergency services at Royal Melbourne Hospital, told another local paper, the Herald-Sun, that “Most people I saw weren’t asthmatics or hadn’t had it for 25 years. It was an extraordinary situation; the worse I’ve experienced in 30 years in the job.”
Around 1,900 calls were made to ambulance services during a five hour period and, at one point, calls were being received every few seconds. Several hospitals enacted disaster management plans.
Nearly 500 children were brought to the Royal Children’s Hospital, with scores admitted. The state premier’s two sons suffered serious attacks.
The Herald-Sun reported the two fatalities as 18-year-old Omar Moujalled, who was just days away from his high school graduation, and 20-year-old Hope Carnevali, a law student who died on her front lawn while waiting for an ambulance to arrive.
According to the Age newspaper, dozens remain in intensive care and more deaths are likely.
Prof. Suphioglu said resources were needed to set up an alert system and prevent a recurrence of the tragedy. How seriously the authorities “take those alerts will be up to them,” he told the Herald-Sun.
State health minister Jill Hennessy said that a “full review” would launched.
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