Michael Harper for redOrbit.com – Your Universe Online

The New York City Council has raised the legal smoking age from 18 to 21. Adults must now be of legal drinking age before they can buy cigarettes, electronic cigarettes or any tobacco products. New York City is the largest city to increase the smoking age from 18 to 21. In an additional measure, the city also increased the minimum cost of a pack of cigarettes to $10.50 and banned the discounting of tobacco products.

This is the latest of several attempts by Mayor Michael Bloomberg to put tight restrictions on smoking in the city. Previously he has worked to kick cigarettes out of bars and restaurants and even raise tobacco taxes on packs of cigarettes and other smokeables sold in the city. In an interesting twist, Bloomberg’s measure did not cover the sale of bongs or pipes used to smoke marijuana.

“By increasing the smoking age to 21 we will help prevent another generation from the ill health and shorter life expectancy that comes with smoking,” said Bloomberg. “It’s critical that we stop young people from smoking before they ever start.”

Bloomberg now has 30 days to sign the bill into law. After which, the law will go into effect after 180 days.

Though Bloomberg’s office praises the prior attempts to squash smoking in the city, many people – smokers and non-smokers alike – view these efforts as yet another step taken towards a Nanny State. Bloomberg’s previous attempt to ban large soda containers was quite controversial and even brought non-New Yorkers into the fray to oppose the measure.

According to City Hall, the number of smokers in New York fell from 21.5 percent to 14.8 percent between 2002 and 2011. Bloomberg’s office is expecting similar results from this measure, saying they expect the number of 18-20 year-old smokers to drop by more than half. Their previous measures have already worked to reduce the number of high school smokers by 8.5 percent between 2001 and 2011.

Those who disagree with the new measure – most notably cigarette manufacturers – say it will only drive young adults to find their smokes on the black market and create even more problems for the city.

“New York City already has the highest cigarette tax rate and the highest cigarette smuggling rate in the country,” said Bryan D. Hatchell , a spokesman for R.J. Reynolds Tobacco Company in a statement to ABC News. “Those go hand in hand and this new law will only make the problem worse.”

As noted by the New York Post, there’s some discrepancy in the legal tobacco smoking age and at what age young adults can buy marijuana paraphernalia. Though it’s illegal to sell pipes, water bongs and other smoking accessories that can be used with marijuana, shops are able to sell these goods if they claim they’re for tobacco use only. This means an 18 year-old New Yorker is now able to legally buy a pipe to smoke marijuana but cannot buy a cigar.

Bloomberg’s proposed ban on sugary sodas was also met with some criticism and was ultimately struck down by New York’s Supreme Court. Justice Milton Tingling said the measure was “fraught with arbitrary and capricious consequences.”

Brett Smith for redOrbit.com – Your Universe Online

Since we weren’t able to talk during the first couple years of our lives, we had to learn how to make simple movements by watching our parents and imitating them. New research from Temple University and the University of Washington published in the journal PLOS ONE has revealed some of the neural mechanisms behind how babies learn through imitation.

“Babies are exquisitely careful people-watchers, and they’re primed to learn from others,” said study author Andrew Meltzoff, co-director of the UW Institute for Learning & Brain Sciences. “And now we see that when babies watch someone else, it activates their own brains. This study is a first step in understanding the neuroscience of how babies learn through imitation.”

In the study, the researchers found that babies’ brains showed specific activity patterns when an adult touched a toy with different parts of her body. When the 14-month-old babies watched a researcher’s hand touch a toy, the hand region of the child’s brain became active. When another group of infants saw a researcher touch the same toy with her foot, the foot area of the child’s brain lit up.

Because each body part has an identifiable section of neural ‘real estate’ in the brain, the scientists were able to clearly correlate brain activity to specific limbs. Previous research has found that a corresponding part of the adult brain activates while watching someone else use a specific body part, and the study team wondered if the same would be true for babies.

For the study, 70 infants were outfitted with electroencephalogram (EEG) caps, which have embedded sensors that detect brain activity in the various motor regions of the brain. While seated on a parent’s lap, each child observed an experimenter touching a toy on a low table. When the researcher pressed the toy’s clear plastic dome with her hand or foot, music sounded and confetti in the dome spun around. The researcher repeated the actions until the baby lost interest.

“Our findings show that when babies see others produce actions with a particular body part, their brains are activated in a corresponding way,” said Joni Saby, a psychology graduate student at Temple University in Philadelphia. “This mapping may facilitate imitation and could play a role in the baby’s ability to then produce the same actions themselves.”

To copy what they see adults do, babies must first know which body part is needed to replicate an observed behavior. The new study indicated that babies’ brains are organized in a way that helps crack that code.

“The reason this is exciting is that it gives insight into a crucial aspect of imitation,” said study author Peter Marshall, an associate psychology professor at Temple University. “To imitate the action of another person, babies first need to register what body part the other person used. Our findings suggest that babies do this in a particular way by mapping the actions of the other person onto their own body.”

“The neural system of babies directly connects them to other people, which jump-starts imitation and social-emotional connectedness and bonding,” Meltzoff added. “Babies look at you and see themselves.”

redOrbit Staff & Wire Reports – Your Universe Online

A fat recycling system contained within pancreatic beta cells helps regulate the amount of insulin they secrete, making them a potential target for new and novel ways to treat diabetes, according to new research appearing online in the journal Diabetologia.

The pancreas is the organ that produces the precise amount of insulin needed by our bodies when we eat, but when a person develops diabetes, the production of the hormone begins to slow down, the study authors explain.

A small structure inside the pancreatic beta cells, known as the lysosome, helps break down unwanted fats and proteins so that they can be re-used. The study authors call it “an intracellular recycling unit,” but when lysosomes are prevented from breaking down fat, the beta cells actually secreted more insulin.

According to study authors Gemma Pearson and Trevor Biden of the Garvan Institute of Medical Research in Australia, their work is in its earliest stages. However, thus far, the results appear promising, and could provide the medical community with a new approach for treating diabetes.

“There are many different ways fats can be used within the beta cell – so if you stop them being recycled, you force them to be used in a different way,” Pearson, a doctoral student, said in a statement Tuesday. “When you shift fats from the lysosome, you store them in other parts of the cell, and they become available to participate in various signaling pathways. One of these pathways clearly increases insulin secretion.”

“Fat molecules… can bind to proteins and activate them, causing a range of downstream events to occur,” she added. “The good thing about this particular pathway is that it is only stimulated by glucose. That limits the beta cell to producing excess insulin only to deal with food, rather than around the clock. Too much insulin circulating in the blood, or hyperinsulinaemia, can be very detrimental to health in many respects”.

Should a drug ultimately be developed in order to block fat degradation from occurring in the lysosome, Pearson explained that it would have to be fine-tuned so that it only had an effect on beta cells.

Earlier this month, researchers from the Tufts Medical Center announced that they had received a $40 million grant from the National Institutes of Health (NIH) in order to settle the ongoing debate as to whether or not vitamin D can be beneficial in treating diabetes.

According to Dr. Anastassios Pittas, who is leading the new study, there is currently little clinical evidence suggesting that the supplement could help prevent or delay type 2 diabetes. He hopes that his study, which will span several years’ time and feature 2,500 participants, will finally put an end to the debate.

“Past observational studies have suggested that higher levels of vitamin D may be beneficial in preventing type 2 diabetes, but until this large, randomized and controlled clinical trial is complete, we won’t know if taking vitamin D supplements lowers the risk of diabetes,” Dr. Pittas said in a statement.

[ Watch the Video: Human Rhinovirus C15 Model Suggests Novel Topography ]

redOrbit Staff & Wire Reports – Your Universe Online

Thanks to the genetic sequencing of the so-called “missing link” cold virus, researchers have created a three-dimensional model of the pathogen that sheds new light on why there is currently no cure for the common cold.

Writing in Monday’s edition of the journal Virology, University of Wisconsin-Madison biochemistry professor Ann Palmenberg and her colleagues created a topographical model of the protein shell (or capsid) of rhinovirus C, a type of cold virus that was unknown to the medical community until seven years ago.

According to the study authors, rhinovirus C is believed to be responsible for as many as half of all colds among children, and is also considered to be a serious complicating factor for asthma and other respiratory ailments. Rhinovirus C, along with the A and B versions of the same pathogen, are reportedly the cause of millions of illnesses each year, with an annual cost topping $40 billion dollars in the US alone.

The research is described as important, as it creates an exceptionally detailed structural model of the cold virus and demonstrates that it has a different protein shell than other strains of cold viruses. Palmenberg said that the discovery “explains most of the previous failures of drug trials against rhinovirus.”

“The A and B families of cold virus, including their three-dimensional structures, have long been known to science as they can easily be grown and studied in the lab,” the university explained in a statement. “Rhinovirus C, on the other hand, resists culturing and escaped notice entirely until 2006 when ‘gene chips’ and advanced gene sequencing revealed the virus had long been lurking in human cells alongside the more observable A and B virus strains.”

The new cold virus model was constructed using a computer simulation, and took advantage of both advanced bioinformatics and the genetic sequences of 500 rhinovirus C genomes – the latter of which provided the three-dimensional coordinates of the viral capsid, the investigators said.

Previously, pharmaceutical firms attempting to design drugs to combat the common cold had little to work with due to the lack of a 3D rhinovirus C model. Palmenberg, who was a member of the team that first mapped the genomes of all known common cold viruses in 2009, called it a “very high-resolution model” that “fits the data.”

“With a structure in hand, the likelihood that drugs can be designed to effectively thwart colds may be in the offing,” the university said. “Drugs that work well against the A and B strains of cold virus have been developed and advanced to clinical trials. However, their efficacy was blunted because they were built to take advantage of the surface features of the better known strains, whose structures were resolved years ago through X-ray crystallography, a well-established technique for obtaining the structures of critical molecules.”

Since all three cold virus strains contribute to the illness, potential medicines developed to combat the common cold failed. This is because drug makers did not fully understand the surface features which allowed rhinovirus C to dock with host cells and avoid a person’s immune system .

Those features are different in rhinovirus C than they are in A and B, and none of the drugs tested by the research team were found to be effective. For that reason, the authors have concluded that pharmaceutical firms will need to develop a substance that specifically targets rhinovirus C – a feat which should now be possible, thanks to the 3D rhinovirus C model produced through their efforts.

Image 2 (below): Two faces of the common cold. The protein coat of the “missing link” cold virus, Rhinovirus C (right), has significant differences from the more observable and better studied Rhinovirus A. Those differences explain why no effective drugs have yet been devised to thwart the common cold.

In the biggest international study ever conducted on Alzheimer’s disease, the International Genomics Alzheimer’s Project (I-GAP) consortium has found eleven new regions of the genome involved in the onset of the neurodegenerative disorder.
The project involved searching the DNA of over 74,000 volunteers for new genetic risk factors linked to late-onset Alzheimer’s disease, the most frequently seen form of the disease. I-GAP, made up of four research consortia in the United States and Europe, made the discovery possible via thousands of DNA samples and shared datasets
“Collaboration among researchers is key to discerning the genetic factors contributing to the risk of developing Alzheimer’s disease,” said Dr. Richard J. Hodes, director of the National Institute on Aging (NIA) . “We are tremendously encouraged by the speed and scientific rigor with which IGAP and other genetic consortia are advancing our understanding.”
One of the biggest finds was the HLA-DRB5/DRB1 region, which plays a role in the body’s immune system and inflammatory response. This region of genome has been connected with multiple sclerosis (MS) and Parkinson’s disease, indicating that the diseases where irregular proteins build up in the brain may have a common system involved, and possibly a common target for treatment.
“The discovery of novel pathways is very encouraging considering the limited success of Alzheimer’s disease drugs tested so far,” said Dr. Margaret Pericak-Vance, Director of the Miami Institute of Human Genomics. “Our findings bring us closer toward identifying new drug targets for Alzheimer’s and other neurodegenerative diseases.”
The study also reported another 13 genetic variants that should be analyzed further.
“Interestingly, we found that several of these newly identified genes are implicated in a number of pathways,” said Gerard Schellenberg, from the University of Pennsylvania School of Medicine. “Alzheimer’s is a complex disorder, and more study is needed to determine the relative role each of these genetic factors may play. I look forward to our continued collaboration to find out more about these—and perhaps other—genes.”
“This study clearly demonstrates that there really is strength in numbers to identify genes that individually have a small effect on risk of Alzheimer’s,” said Lindsay A. Farrer, Chief of Biomedical Genetics at Boston University Medical Center.”But it’s not the magnitude of the odds ratio that’s really important.”
“Each gene we implicate in the disease process adds new knowledge to our understanding of disease mechanism and provides insight into developing new therapeutic approaches, and ultimately these approaches may be more effective in halting the disease since genes are expressed long before clinical symptoms appear and brain damage occurs,” he added.
“This landmark international effort has uncovered new pathways and new genes in old pathways that are definitely associated with Alzheimer dementia, but we need to do much work to better understand how exactly these genes work in health and disease, and to perhaps make drugs from these genes and molecules,” said Dr. Sudha Seshadri, professor of neurology at Boston University School of Medicine.
“We will continue to mine these results for new insights, even as we include more patients and use new technologies like whole genome sequencing to find more new pathways and genes.”

redOrbit Staff & Wire Reports – Your Universe Online

Despite California state regulations mandating their use, only 11 percent of Los Angeles County children treated for bike-related injuries between 2006 and 2011 were wearing helmets, according to research presented Saturday at the American Academy of Pediatrics (AAP) National Conference and Exhibition.

Specifically, the analysis of 1,248 bicycle-related accidents found that children over the age of 12, low-income and minority children were less likely to wear the potentially life-saving headgear, study author Dr. Veronica F. Sullins of the University of California, Los Angeles (UCLA) and the Harbor-UCLA Medical Center said at the Orlando conference.

Dr. Sullins and her colleagues reviewed the records of pediatric patients involved in bike accidents from the Los Angeles County database from 2006 to 2011. The data reviewed included helmet use, age, gender, insurance status and race/ethnicity before checking to see if there was a link between helmet use and the need for emergency medical attention, morbidity, mortality and/or length of hospitalization, the AAP said in a statement.

The median age of the children was 13, and 64 percent of them were male, the researchers discovered. A total of 11.3 percent of patients wore helmets, including 35.2 percent of white children, seven percent of Asian children, six percent of black children, and four percent of Hispanic children.

In terms of insurance coverage, 15.2 percent of children with private insurance wore helmets at the time of injury, compared to 7.6 percent with public insurance. Children over age 12 were less likely to wear a helmet. A total of nine patients died, eight of whom were not wearing a helmet, while 5.9 percent of those injured required emergency surgery. A total of 34.1 percent of the children returned to their pre-injury capacity.

“Our study highlights the need to target minority groups, older children, and those with lower socioeconomic status when implementing bicycle safety programs in Los Angeles County,” Dr. Sullins said, noting that the study emphasizes the need to reinforce bicycle safety, especially in low-income and minority youngsters.

“Children and adolescents have the highest rate of unintentional injury and therefore should be a high priority target population for injury-prevention programs,” she added. Regional research, such as this one, can help identify at-risk populations in specific communities, allowing regions to use their safety-related resources more effectively.

According to the US Centers for Disease Control and Prevention (CDC), nearly 1,000 people die from injuries related to bicycle crashes each year, and another 550,000 men and women receive emergency care for these types of injuries annually. Furthermore, head injuries account for approximately 62 percent of bicycle-related deaths, 33-percent of bicycle-related emergency department visits, and 67-percent of bicycle-related hospital admissions.

redOrbit Staff & Wire Reports – Your Universe Online

The role of caregivers in supporting those who have suffered a stroke, as well as myths and misconceptions surrounding the disease will be highlighted on Tuesday, October 29 as the global healthcare community marks World Stroke Day.

A stroke attacks someone, regardless of age or gender, every two seconds, the European Society of Cardiology (ESC) said in a statement Friday. Six million people die as a result of a stroke every year, and another nine million suffer from the condition, which occurs when a lack of oxygen suddenly kills brain cells.

Approximately 30 million people worldwide have experienced a stroke, and many of those have residual disabilities, the society added. Furthermore, a study published last week by the British medical journal The Lancet reported a 25 percent increase in the number of stroke cases among 20-to-64-year-olds worldwide. Furthermore, the percentage of people in this age group accounting for all stroke cases increased from 25 percent before 1990 to 31 percent currently.

The slogan for this year’s World Stroke Day – “Because I care…” – is the same as that featured in 2012. According to the World Stroke Organization, the phrase was selected because “it can easily be adapted to all cultures and in any setting… the slogan attempts to address prevailing misinformation about the disease, e.g., stroke only happens later in life.”

“Moreover, caregivers and the role of family and close friends – as those in the frontlines providing the supportive care – will play an essential role in the campaign,” the organization added. “The campaign will celebrate their important contributions. Care givers are the conduits between the stroke community and the general public in correcting misinformation as they know first-hand what the reality is around stroke.”

The American Stroke Association is using the occasion to try to educate the public about the warning signs of a person suffering from a stroke. The organization uses the acronym “F.A.S.T.” to describe what to look for: “Face Drooping, Arm Weakness, Speech Difficulty, Time To Call 911.” They will also be hosting a Google Hangout on Monday and an education event in Washington DC on Tuesday to mark the occasion.

The ESC is emphasizing the steps that young, obese women can take in order to reduce the risk that they will experience a stroke during their lifetimes. Research presented during ESC Congress 2013 demonstrated that young, overweight females who do not suffer from high blood pressure, high cholesterol or other metabolic disorders do not have an increased risk of stroke compared to normal weight women without metabolic disorders.

However, those who did suffer from metabolic disorders and were overweight or obese were 3.5 times more likely of having a stroke. As the authors of that study pointed out, obesity can increase the risk that a young woman will develop diabetes, high blood pressure or high cholesterol, which in turn increases the likelihood that they will suffer a stroke or heart attack. Those women can protect themselves from those conditions by losing weight, they said.

“Overall women get more strokes than men each year, mainly because stroke occurs more frequently at older ages and women generally live longer than men,” ESC spokesperson Professor Gregory Lip said in a statement. “Thus, approximately 55 000 more women than men have strokes each year. Awareness of important risk factors, such as atrial fibrillation (an irregularity of the heart rhythm) and high blood pressure, is crucial. Of note, women are twice more likely to die from a stroke than breast cancer each year.”

“Women are at the same risk of stroke as men, and the level of risk is completely steered by the underlying risk factor pattern they have. The majority of people who have a stroke are disabled for the rest of their lives and may be paralyzed or lose their ability to speak. The devastating consequences of this disease for patients and their loved ones make prevention even more important,” added ESC spokesperson Professor Joep Perk.

Brett Smith for redOrbit.com – Your Universe Online

On Thursday, the Food and Drug Administration (FDA) suggested tighter controls on how doctors prescribe common, widely-use narcotic painkillers containing the narcotic hydrocodone, making them controlled as strictly as powerful painkillers such as OxyContin.

In announcing its recommendations, the FDA said it had become “increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States.”

Janet Woodcock, who heads the FDA’s center for drug evaluation and research, said that the agency expects to submit its formal recommendation later this year that reclassify painkillers containing hydrocodone as “Schedule II” medications, an upgrade from their current “Schedule III” classification.

“We are announcing the agency’s intent to recommend to HHS (Health and Human Services) that hydrocodone combination products should be reclassified to a different and more restrictive schedule,” she said in a statement.

“This determination comes after a thorough and careful analysis of extensive scientific literature, review of hundreds of public comments on the issue and several public meetings, during which we received input from a wide range of stakeholders, including patients, health care providers, outside experts and other government entities.”

The change would come after the Drug Enforcement Administration (DEA) requested just such a move in 2009. According to federal data, doctors wrote over 130 million prescriptions for hydrocodone-containing drugs for about 47 million patients in 2011.

Created in a collaboration between the FDA and the DEA, the scheduling system ranks drugs according to their medical use, potential for abuse and international agreements, among other factors.

If hydrocodone-containing drugs were to become Schedule II substances, they would officially be considered having one of the highest potentials for abuse and addiction of all legally prescribed medications. Other Schedule II substances include morphine, the attention-deficit hyperactivity disorder (ADHD) medications Adderall and Ritalin and cocaine – when used as a topical anesthetic to treat cancer.

Prescription drugs are responsible for about 75 percent of all drug overdose deaths in the US. According to federal statistics, the number of deaths from prescription narcotic painkillers has quadrupled since 1999. With drugs containing hydrocodone representing about 70 percent of all opioid prescriptions, and their current status as a Schedule III substance, abuse has skyrocketed, experts have said.

In an interview with The New York Times, Woodcock said FDA officials have considered how the new rules might affect patients. However, she said that the effect on public health caused by the abuse of these drugs has created a watershed moment.

“These are very difficult trade-offs that our society has to make,” she said. “The reason we approve these drugs is for people in pain. But we can’t ignore the epidemic on the other side.”

The new regulations would cut the supply of the drug a person receives without a new prescription in half to 90 days. Under current regulation, a patient can refill a prescription for hydrocodone-containing drugs five times over a six-month period before needing a new prescription. Previous research has found that most patients use such medications for only 14 days.

[ Watch the Video: KSR2 Mutations are Associated With Obesity ]

Michael Harper for redOrbit.com – Your Universe Online

Researchers from the University of Cambridge say they’ve discovered a possible genetic origin for obesity which could slow the metabolism and drive a person to eat fatty foods. Though they say this genetic condition affects less than one in one hundred people, they were able to observe similar conditions in mice with the same genetic switches flipped.

Those who are affected by faulty genetics, however, are likely to be severely obese by the time they reach early childhood. Dr. I. Sadaf Farooqi of Cambridge University and team say the main suspect in their research is the gene KSR2 (Kinase Suppressor of Ras 2). When this gene is flipped off, it may trigger longer bouts of eating and slower metabolism, thereby leading to obesity. For study, Farooqi and team sequenced the DNA from over 2,000 severely obese patients, finding several variations of a KSR2 mutation. Their results are now published in the journal Cell.

“You would be hungry and wanting to eat a lot, you would not want to move because of a slower metabolism and would probably also develop type 2 diabetes at a young age,” explained Farooqi in an interview with the BBC. “It slows the ability to burn calories and that’s important as it’s a new explanation for obesity.”

Farooqi is quick to admit, however, that their studies show this mutation is rare and likely only affects young children who already show signs of obesity. All told, the research suggests that less than one percent of the population is affected by the gene, but two percent of young children who are already obese likely have a KSR2 mutation.

Doctors and researchers are often quick to dismiss the idea that being born with a slow metabolism could be to blame for severe cases of obesity. Those who do have a slower metabolism are usually found to have an underactive thyroid gland. Yet when Farooqi and team began sequencing the DNA from 2,101 severely obese patients, they found their thyroid glands were behaving normally. It’s also been suggested that some people simply burn calories more slowly than others, a hypothesis which may be supported by Farooqi’s research.

“Up until now, the genes we have identified that control body weight have largely affected appetite. However, KSR2 is different in that it also plays a role in regulating how energy is used in the body. In the future, modulation of KSR2 may represent a useful therapeutic strategy for obesity and type 2 diabetes.”

With this new study, Farooqi says there may be good cause to look into creating a drug to flip the KSR2 switch back into normal operating mode to prevent a lifetime of obesity and health problems in children.

This isn’t the first time medical science has sought a drug to rid the developed world of obesity, however. Previously researchers claimed they found a hormone responsible for giving some people to have larger appetites than others. The biochemical is technically known as ghrelin but is commonly referred to as the ‘hunger hormone.’ It had been assumed that if a drug could repress this hormone, it could help those who struggle with their weight to stop overeating.

Recent research has shown that while ghrelin may be responsible for triggering hunger, it’s also know to be triggered during long bouts of stress. This means drugs created to inhibit ghrelin may also one day be used to help those with post-traumatic stress disorder (PTSD).

[ Watch The Video: Barrier To HIV Cure Bigger Than Previously Thought ]

redOrbit Staff & Wire Reports – Your Universe Online

Although current treatments for human immunodeficiency virus (HIV) can keep the disease at bay, a larger-than-expected amount of hidden virus may complicate efforts to find a cure, according to the most detailed and comprehensive analysis to date of the latent reservoir of HIV proviruses.

The three-year study, published Thursday in the journal Cell, deals a painful blow to researchers working hard to find a cure for HIV/AIDS, a disease that kills nearly two million people per year according to the World Health Organization (WHO).

Infectious disease experts at John Hopkins found that the amount of potentially active, dormant forms of HIV hiding in infected immune T cells may actually be 60 times greater than previously thought.

This hidden HIV is part of the so-called latent reservoir of functional proviruses that remains long after antiretroviral drug therapy has successfully brought viral replication to a standstill. If antiretroviral therapy is stopped or interrupted, some proviruses can reactivate, allowing HIV to make copies of itself and resume infection of other immune cells, the researchers said.

Senior study investigator Robert Siliciano, M.D., Ph.D., who in 1995 first showed that reservoirs of dormant HIV were present in immune cells, said that while the current study’s results show most proviruses in the latent reservoir are defective, curing the disease will depend on finding a way to target all proviruses with the potential to restart the infection.

“These results indicate an increased barrier to cure, as all intact noninduced proviruses need to be eradicated,” Siliciano said. “Although cure of HIV infection may be achievable in special situations, the elimination of the latent reservoir is a major problem, and it is unclear how long it will take to find a way to do this.”

The study’s results showed that among 213 HIV proviruses that were isolated from the reservoirs of eight patients and that were initially unresponsive to highly potent biological stimuli, some 12 percent could later still become active and capable of replicating their genetic material and transmitting infection to other cells. All of these non-induced proviruses had previously been thought to be defective, with no possible role in resumption of the disease, said Siliciano, a professor at the Johns Hopkins University School of Medicine and a Howard Hughes Medical Institute investigator.

These disappointing findings pose a serious problem to prevailing hopes for the so-called “shock and kill” approach to curing HIV, he said. That approach refers to forcing dormant proviruses to “turn back on,” making them “visible” and vulnerable to the immune system’s cytolytic “killer” T cells, and then eliminating infected cells from the body while antiretroviral drugs prevent any new cells from becoming infected.

Siliciano said this new discovery could enhance support for alternative approaches to a cure, including renewed efforts to develop a therapeutic vaccine to stimulate immune system cells that attack and kill all HIV.

Lead study investigator and Johns Hopkins postdoctoral fellow Ya-Chi Ho, M.D., Ph.D., said the team’s investigation of “the true size” of the latent reservoir was prompted by a large discrepancy between the two established techniques for measuring how much provirus is in immune system cells.

The team’s original method of calculating only reactivated proviruses yielded numbers that were 300-fold lower than a DNA-based technique used to gauge how many total proviral copies, both dormant and reactivated, are present.

“If medical researchers are ever going to lure out and reactivate latent HIV, then we need to better understand exactly how much of it is really there,” Ho said.

In the current study, the researchers sequenced, or spelled out, the entire genetic code of HIV proviruses that reactivated and those that could not be induced to do so. Twenty-five of the 213 non-induced isolates, when sequenced, had fully intact genomes when compared to those that did reactivate. Analysis of the remaining 88 percent of non-induced proviruses showed that all were defective, possessing genetic deletions and mutations that would forestall viral replication.

Additional experiments on the cloned proviruses showed that the intact, non-induced proviruses could be reconstructed to produce active virus, which in turn could replicate in human immune cells.

The researchers also found that cloned proviral DNA lacked a latency-inducing chemical methyl group. When researchers looked at where non-induced proviral DNA showed up in infected human immune cells, they found some 92 percent of the non-induced proviral DNA was located in actively transcribed regions of the human cell DNA. This finding suggests that non-induced proviral DNA is not permanently hidden in some inaccessible regions of the host chromosomes, but instead lies in regions where it could become reactivated, the researchers said.

Statistical modeling later revealed that these figures equated to a 60-fold increase in the potential size of the latent reservoir when compared to the team’s original method for counting only reactivated viruses.

Additional experiments showed that repeated chemical stimuli could reactivate proviruses that failed to respond to initial attempts at reactivation.

Ho says the study results, although disheartening, will galvanize experts to refine and improve methods for detecting proviruses capable of reactivation. Siliciano is currently working to organize the “What Will it Take to Achieve an AIDS-free World?” conference, which will take place November 3-5 in San Francisco.

Lawrence LeBlond for redOrbit.com – Your Universe Online

An HIV case first documented in a Mississippi baby 18 months ago is still proving that an antiviral treatment early on is effective in not only treating the virus that causes AIDS, but also curing it.

Earlier this year, researchers from Johns Hopkins University (JHU) reported that a child born with HIV and treated with a series of antiviral drugs showed signs of remission within days of initial treatment. The child was administered antiretroviral therapy (ART) for the next 18 months before ultimately being taken off the drugs.

The researchers, led by Deborah Persaud, MD, of JHU, conducted a follow-up in late 2012 when the child was 23 months of age and found that, after conducting a battery of tests, the infant was in full remission with no visible signs of HIV in the body. They presented their findings at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta, Georgia.

REMISSION CONTINUES

Now, more than 6 months later, the same researchers have conducted another follow-up and are happy to report that the child, now 3 years old, is still free of active infection 18 months after all treatment ceased. A new report on the case has been published in the Oct. 23 issue of the New England Journal of Medicine (NEJM).

“Our findings suggest that this child’s remission is not a mere fluke but the likely result of aggressive and very early therapy that may have prevented the virus from taking a hold in the child’s immune cells,” says Dr. Persaud, a virologist and pediatric HIV expert at Johns Hopkins Children’s Center (JHCC), who has been handling the case since the child was born.

Persaud has worked on this case with immunologist Katherine Luzuriaga, MD, of the University of Massachusetts Medical School, and pediatrician Hannah Gay, MD, of the University of Mississippi Medical Center, who identified and treated the baby and continues to see the child.

“We’re thrilled that the child remains off medication and has no detectable virus replicating,” Gay says. “We’ve continued to follow the child, obviously, and she continues to do very well. There is no sign of the return of HIV, and we will continue to follow her for the long term.”

The child was born to an HIV-infected mother and was administered ART within 30 hours of birth. A series of tests in the subsequent days and weeks showed the ART was continuing to diminish the overall presence of the virus in the child’s blood, until it reached undetectable levels 29 days after birth. At 18 months of age, the child was lost to follow-up for nearly five months, and ART stopped; but when checked after another five months, testing could still not detect virus in the bloodstream.

Persaud and colleagues say this one child’s experience provides “compelling evidence” that infants infected with HIV can achieve remission when ART begins within hours or days of birth or whenever infection begins. Based on the information from this case, a federally-funded study is set to begin in 2014 to test early-treatment ART to determine whether the approach is feasible for all HIV-infected newborns.

Persaud and colleagues maintain that swift intervention likely led to the child’s remission because it halted the formation of hard-to-treat viral reservoirs – dormant HIV hiding in immune cells that can reignite in  patients within weeks of halting drug therapy.

“Prompt antiviral therapy in newborns that begins within hours or days of exposure may help infants clear the virus and achieve long-term remission without the need for lifelong treatment by preventing such viral hideouts from forming in the first place,” Persaud says.

BERLIN PATIENT

As previously reported by redOrbit, as well as other media sources, this is not the first case of remission of HIV in a person.

Timothy Brown, widely known as the “Berlin patient,” is the only other known person to be effectively cured of HIV. However, unlike with the Mississippi child, who was administered 18 months of ART, Brown was cured through a different means altogether.

In 2006, while receiving treatments for his HIV infection, Brown was diagnosed with leukemia. His cancer was subsequently treated with a stem-cell transplant from a person who was born with a genetic mutation causing immunity to HIV infection. Following that transplant, Brown was able to halt all HIV treatments without experiencing a return of HIV infection.

However, Brown’s case was unique and it is unlikely such procedures would be feasible for the general public of HIV patients due to the cost of such treatments. Also, a stem-cell transplant is typically viewed as necessary in a cancer scenario where often times the only other possible outcome is death, whereas HIV can usually be treated through antiviral therapy, allowing patients to lead otherwise normal lives.

In the Mississippi child, continuing tests for HIV-specific antibodies remain negative to date, as do tests to detect the presence of cytotoxic (killer) cells that the body deploys to destroy viral invaders and whose presence indicates active infection. Highly sensitive tests designed to hunt down trace amounts of the virus have detected intermittent viral footprints in the child’s system, says Persaud. However, these footprints appear incapable of forming new viral infections.

Furthermore, the child also exhibits none of the immune characteristics seen in the so-called “elite controllers,” a tiny percentage of HIV-infected people whose immune systems allow them to naturally keep the virus in check without treatment. Such people have immune systems that are revved up to suppress viral replication. So it is clear that early ART, rather than natural immune mechanisms, led to the child’s remission, the authors report.

PREEMPTIVE MEASURES

Currently, newborns who have a high-risk of HIV infection, either due to poorly controlled infections seen in the mother or in mothers who are diagnosed with HIV at time of delivery, are administered a preemptive combination of antivirals to prevent an infection. ART treatment does not start until an actual infection is confirmed. While a prophylactic approach is significant in preventing at-risk infants from acquiring HIV, it does nothing for those who are already infected with the virus. These infants would likely stand to benefit highly from prompt ART, as did the Mississippi baby.

“This case highlights the potential of prompt therapy to lead to long-term remission in those already infected by blocking the formation of the very viral reservoirs responsible for rekindling infection once treatment ceases,” says Luzuriaga, senior author of the NEJM report. “This may be particularly true in infants, whose developing immune systems may be less amenable to the formation of long-lived virus-infected immune cells.”

“Indeed, recent studies in HIV-infected infants have shown a marked reduction in the numbers of circulating virus-infected cells when babies are treated during the first few weeks of infection. Research has also shown that many hard-to-eradicate viral reservoirs begin to form very early, within weeks of infection. Taken together, these findings mean that the window of opportunity to achieve remission may close very quickly,” according to a JHCC statement.

Persaud and her colleagues maintain that despite the significance of treating HIV-infected newborns early on, preventing mother-to-child transmission remains the primary public health goal. The report authors caution that the approach is still considered preliminary and more research is needed to confirm the efficacy of such treatments. Also, they advise that children with confirmed HIV infection should not be taken off antiviral treatment.

According to background information in the study, nearly 3.3 million children around the world live with HIV infection. More than 260,000 acquire the virus from their mothers during delivery despite advances in preventing mother-to-child infection.

redOrbit Staff & Wire Reports – Your Universe Online

Individuals who have blood sugar at the lower end of the normal range perform better on memory tests than non-diabetics with higher glucose levels, according to new research published online Wednesday in the peer-reviewed medical journal Neurology.

Lead author Agnes Flöel of Charite University Medicine in Berlin and her colleagues recruited 141 individuals with an average age of 63, according to Nanci Hellmich of USA Today. None of those men and women had type 2 diabetes or prediabetes, and none of them had demonstrated any signs of cognitive or memory-related impairments.

“The study participants took a series of memory tests and had their blood sugar tested. They also had brain scans to measure the size of the hippocampus area, which plays an important role in memory,” Hellmich said. “The findings showed that chronically higher blood glucose levels exert a negative influence on memory.”

Specifically, the subjects were asked to review a list of 15 words, and then recall them 30 minutes later, according to Los Angeles Times reporter Mary MacVean. The ability to recall fewer words was associated with higher blood sugar levels, she said, and those individuals also were found to have less volume in the hippocampus – a region of the brain associated with both short- and long-term memory.

“Flöel says the findings suggest that even for people within the normal range of blood sugar, lowering their levels might be a possible way to prevent memory problems as they age,” Hellmich said. “She points out that the study is relatively small and doesn’t prove cause and effect. There’s a need for large clinical trials to test whether lowering glucose will help with the prevention of dementia.”

“Earlier research has shown ‘deleterious effects of diabetic glucose levels on brain structure, particularly the hippocampus,’ the researchers wrote,” according to MacVean. She added that they also explained that “impaired glucose tolerance and Type 2 diabetes also have been associated with lower cognitive function and a higher incidence of dementia, including Alzheimer’s disease.”

Robert Ratner, the chief scientific and medical officer with the American Diabetes Association, told USA Today that the results of the study only show an association between glucose levels and memory, not necessarily a causal relationship.

He explained that they have not shown that memory loss is caused by higher glucose levels, or that reducing blood sugar would improve recall. Even so, Ratner noted that it was “not surprising that glucose levels can potentially have these kinds of negative impacts. The risk of dementia is higher in people with diabetes. It has been well established that elevated glucose impacts brain function and recovery in people following a stroke.”

Michael Harper for redOrbit.com – Your Universe Online

A new study conducted at Columbia University in New York finds five-year-old children who have been spanked are more likely to be aggressive and get into even more trouble. This research echoes prior studies which have found spanking to have quite the opposite intended effect on children.

Used as a disciplinary tool for many generations, spanking has only recently been questioned as an effective means of punishment. The Columbia study analyzed data from a long-term study which followed children born in one of 20 US cities between 1998 and 2000.

According to their research, children who were spanked at age five were more likely to become rule breakers in school and act aggressively towards their teachers and peers. The data revealed, however, that parents were more likely to spank their children when they were three years old rather than when they were five. Researchers also noted a difference in the child’s behavior depending on which parent was administering the spanking. The paper is now published in the journal Pediatrics.

“Most kids experience spanking at least some point in time,” explained lead author Michael MacKenzie with Columbia University in an interview with Reuters‘ Genevra Pittman.

After examining the data collected from nearly 2,000 children, MacKenzie and team say 57 percent of mothers and 40 percent of fathers spanked their child when they were three years old. This number dropped slightly by the time the child had grown to five years old; 52 percent of mothers and 33 percent of fathers spanked their kid at this age. Though there had been an average decrease in spankings, the behavior problems in these children were more pronounced when they were spanked at age five. Researchers did not find a direct link between behavioral problems and spanking at age three. Furthermore, these children were even more likely to act out if they had been spanked by their mother, even if it was only occasionally.

According to the research, mothers who spanked their children at least twice a week increased their child’s problem behaviors by two percent. This kind of behavior was measured on a 70-point scale and took family lifestyle and past behaviors into account.

Kids who were regularly spanked at age five by their fathers were also more likely to score lower in vocabulary tests, says MacKenzie’s research. The average vocabulary test score of nine-year-old children is 93. When the child was regularly spanked by their father at age five, however, these scores went down an average of four points. MacKenzie admits this decrease could be due to chance instead of a direct link to spanking.

Parents often spank their children as a way to get their attention and change their behavior quickly in the moment. While this is often effective in the short-term, MacKenzie says parents don’t think of the long-term ramifications of spanking.

“The techniques that are designed to promote positive behaviors … oftentimes take more effort and time to put into place,” said MacKenzie.

A 2005 study found that children who had been spanked, particularly children who lived in a culture where spanking was not widely embraced, were more likely to act out aggressively and display signs of anxiety. This aggression was not observed in children who were spanked in a culture that embraces the punishment.