Review article calls for measures to enable safe design of nanomaterials

The recent explosion in the development of nanomaterials with enhanced performance characteristics for use in commercial and medical applications has increased the likelihood of people coming into direct contact with these materials.

There are currently more than 800 products on the market “” including clothes, skin lotions and cleaning products “” claiming to have at least one nanocomponent, and therapeutic nanocarriers have been designed for targeted drug delivery inside the human body. Human exposure to nanomaterials, which are smaller than one one-thousandth the diameter of a human hair, raises some important questions, including whether these “nano-bio” interactions could have adverse health effects.

Now, researchers at UCLA and the California NanoSystems Institute (CNSI), along with colleagues in academia and industry, have taken a proactive role in examining the current understanding of the nano-bio interface to identify the potential risks of engineered nanomaterials and to explore design methods that will lead to safer and more effective nanoparticles for use in a variety of treatments and products.

In a research review published in the July issue of the journal Nature Materials (and currently available online), the team provides a comprehensive overview of current knowledge on the physical and chemical properties of nanomaterials that allow them to undergo interactions with biological molecules and bioprocesses.

“What we have established here is a blueprint that will serve to educate the first generation of nanobiologists,” said Dr. Andre Nel, leader of the team and chief of the division of nanomedicine at the David Geffen School of Medicine at UCLA and the California NanoSystems Institute.

Despite remarkable advances in nanoscience, relatively little is known about the intracellular activity and function of engineered nanomaterials, an area of study particularly important for the development of effective and safe nanoparticle drug-delivery systems. Much of the current knowledge derives from the study of tagged or labeled nanoparticles and their effects on cells after cellular uptake “” without any detailed understanding of what these interactions may lead to, good or bad.

The review article examines the variety of ways in which nanomaterials interface with biological systems and presents a roadmap of the physical and chemical properties of the materials that could lead to potentially hazardous or advantageous interactions at the nano-bio interface. A better understanding of the biological impact, combined with appropriate stewardship, will allow for more informed decisions about design features for the safe use of nanotechnology.

In addition to Nel, the team included Tian Xia, a researcher in UCLA’s nanomedicine division, UCLA associate professor of civil and environmental engineering Eric Hoek, Lutz Mädler of the University of Bremen, Darrell Velegol of Penn State University, Ponisseril Somasundaran of Columbia University, Fred Klessig of Pennsylvania Bio Systems, Vince Castranova of the National Institute for Occupational Safety and Health, and Mike Thompson of FEI Co.

“We are committed to ensuring that nanotechnology is introduced and implemented in a responsible and safe manner,” said Nel, who also directs the Center for Environmental Implications of Nanotechnology, which is funded by the National Science Foundation and the Environmental Protection Agency and is headquartered at the CNSI.

“Based on our rapidly improving understanding of nano-bio interactions, we have done a thorough examination of the literature and our own research progress to identify measures that could be taken for safe design of nanomaterials,” he said. “Not only will this improve the implementation and acceptance of this technology, but it will also provide the cornerstone of developing new and improved nanoscale therapeutic devices, such as drug-delivering nanoparticles.”

The review article spotlighted several important research advancements:

* A classification of the interactions when nanomaterials contact and bind to biological systems will help scientists understand how man-made materials may react when exposed to cells, tissues and various life forms in different natural environmental contexts.

* When nanomaterials enter a biological fluid “” for example, blood, plasma or interstitial fluid “” the materials’ surface may be coated with proteins. Understanding how these protein layers change the properties of the nanomaterials and the ways in which they interact in the body can provide valuable information on how to alter the protein coatings to allow for targeted delivery of nanomaterials to specific tissues, such as in cancer treatments.

* Physicochemical properties such as size, charge, shape and other characteristics could greatly affect the ability of nanomaterials to enter a cell; this could determine whether a material can be useful in nanomedicine applications or could cause harm if taken in by life forms in an ecosystem or food chain.

* Nanoparticles can elicit a wide range of intracellular responses, depending on their properties, concentrations and interactions with biological molecules. These properties and their relationships to cellular function can induce cellular damage or induce advantageous cellular responses, such as increased energy production and growth.

Based on the link between certain nanomaterial properties and potential toxic effects, the team asserts that scientists can reengineer specific nanomaterial properties that are hazardous while maintaining catalytically useful function for industrial use.

As an example of a safe design feature, some nanoparticles now receive a surface coating designed to improve safety by preventing bioreactivity. Nanoparticles in cosmetic formulations such as suntan lotions, for instance, may be coated with a water-repelling polymer to reduce direct contact with human skin. An extension of this principle uses polymers and detergents to decrease cellular uptake. However, there is the potential that when the coating wears off, the material may become hazardous. It is therefore important to consider improving the stability of coating substances. Coating nanoparticles with protective shells is also an effective means of preventing the breakup of materials that could release toxic substances upon dissolution.

“Instead of waiting for knowledge to unfold randomly, we can already begin to view the events at nano-bio interface as a discoverable scientific platform that can be used for setting up a deliberate inorganic-organic roadmap to new, better and safer products,” Nel said. “What we can identify by understanding the rules that shape the nano-bio interface will have a massive impact on the ability to develop safe nanomaterials in the future.”

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On the Net:

• University of California – Los Angeles
• California NanoSystems Institute
• Nature Materials
• Center for Environmental Implications of Nanotechnology

The heath risks of obesity have always been something that experts knew about, but a new Japanese study notes that those considered very skinny are even more at risk, and that slightly overweight people have longer lives.

People who are rotund at age 40 have six to seven years longer to live than extremely thin people, whose life expectancy is about five years less than people who were obese, the study noted.

“We found skinny people run the highest risk,” stated Shinichi Kuriyama, an associate professor at Tohoku University’s Graduate School of Medicine to AFP.

“We had expected thin people would show the shortest life expectancy but didn’t expect the difference to be this large,” he added.

The study was conducted by a health team led by Tohoku University professor Ichiro Tsuji and surveyed 50,000 people between 40 and 79 in a 12-year research project in the northern Japanese area of Miyagi.

“There had been an argument that thin people’s lives are short because many of them are sick or smoke. But the difference was almost unchanged even when we eliminated these factors,” Kuriyama said.

A few reasons for the briefer life spans include their increased susceptibility to diseases like pneumonia and the delicate nature of their blood vessels, he noted.

However, Kuriyama stated explicitly that he was in no way encouraging people to overeat in any way.

“It’s better that thin people try to gain normal weight, but we doubt it’s good for people of normal physique to put on more fat,” he said.

The study separated people into four groups according to their body mass index, or BMI, which is determined by dividing weight in by their squared height.

A normal BMI is in the 18.5 to 25 range, while those with a BMI under 18.5 is considered thin.

A BMI of 25 to 30 was considered mildly overweight and an index higher that 30 is considered obese.

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On the Net:

• Tohoku University Graduate School of Medicine

A Dutch sociologist says there is a growing trend for overtime to be less a matter of choice despite inefficiency associated with working long hours.

The study, published in the journal Gender & Society, says choice is turning into expectation at most companies built upon the team work model — with pressures coming from project teams, responsibility for meeting profit or production targets, imposed deadlines and employees left to manage their own careers.

Patricia van Echtelt of the Institute for Social Research in The Hague, Netherlands, and colleagues found 69 percent of men and 42 percent of women worked overtime. Van Echtelt says there is a growing body of evidence that heightened competition in the workplace, combined with modern business practices, are resulting in near-unprecedented levels of overtime — and exhaustion.

Moreover, a growing body of literature shows that working long hours does not automatically lead to greater productivity and effectiveness, she said, and thus (does not necessarily contribute) to employers’ needs but potentially harms the well-being of employees.

For example, a separate study at a software engineering firm determined that interdependent work patterns, a crisis mentality and a reward system based on individual heroics led to inefficient work processes and long working hours, Van Echtelt added.

Suffering a stroke can have a profound effect on relationships and lead to significant changes in how couples relate to each other on a physical, psychological, social and emotional level, according a study in the June issue of the Journal of Clinical Nursing.

Researchers from Northern Ireland have come up with four key recommendations for clinical practice after speaking to 16 married stroke survivors, nine males and seven females, aged between 33 and 78.

They found that sexual relationships were significantly affected after a stroke, gender roles became blurred and feelings like anger and frustration were confounded by a lack of independence and ongoing fatigue.

“All the participants perceived stroke as a life-changing event” says Hilary Thompson, who is based at Mullinure Hospital, Armagh, and carried out the research with Dr Assumpta Ryan from the School of Nursing and Institute of Nursing Research at the University of Ulster.

“They faced a continuous daily struggle to achieve some sense of normality and that required huge amounts of physical and mental effort” adds Hilary, a nurse specialist, who earlier this month won the Patient’s Choice Award at the RCN Northern Ireland Nurse of the Year 2009 for the support she provided to the family of a stroke survivor.

Key findings included:

• Sexual relationships changed. A 35 year-old female stroke survivor summed up the general feeling well. “It’s not a husband and wife role anymore” she said. “It’s a carer and a patient and it’s not very pleasant and it’s not fair.”
• All but one of the respondents reported a reduction or total loss of sexual desire after their stroke. Some felt that this was down to medication and fear of another stroke. As one 61 year-old male told the researchers “I want her there now as a friend but not really as my wife.”
• Most of the females lost interest in their appearance, regardless of their age. “No interest in clothes, no interest in make-up, no interest in hair. Weeks go by that I don’t even wash my hair” said one 57 year-old female.
• All the respondents said they had changed since their stroke and irritability, anger, agitation and intolerance were frequently mentioned. “I’m normally easy going, but now the slightest little thing sets off the temper” said one 53 year-old male, adding that his wife would “probably say I’ve turned into a miserable pig.”
• A number said they felt unable to prevent outbursts and this compounded their feelings of guilt, low-esteem and despair. As one 62 year-old female said: “I’d sit back and think why did I do that? But if doesn’t make any difference, I keep doing it.”
• A lot of the respondents said their outbursts reflected their frustration at not being able to perform routine daily activities, such as making a cup of tea. One 67 year-old male said that that his wife was a “reasonably healthy person” and asked “why should she be lumbered with me?”.
• Over-protective spouses appeared to increase anger and feelings of frustration. One 78 year-old female explained that her husband wouldn’t give her time to do the things she could still do because “he’s afraid of me falling”.
• Being discouraged from doing things they could do before their stroke made survivors feel demoralised and affected their confidence. One 72 year-old male said he was keen to “do the hedges, want to tidy the place up” but if he tried to do anything heavy his wife had a go at him.
• Over-protective spouses also demotivated survivors and made them even more dependant. As one 66 year-old female said “I don’t have to so I don’t bother”.
• Some survivors said that they were unable to continue their traditional male or female role after their stroke and that this challenged their self-perception and identity. “You’re not as much a husband as you were before” said one 67 year-old male, while a 66 year-old wife said that her husband didn’t do the washing right “but he is only trying to help so I let it pass”.
• Survivors said they felt safe and comfortable at home but were reluctant to resume social activities with their spouse because of swallowing problems, anxiety and fatigue. Some came to agreements whereby their spouse would go out alone. “I would be asked enough times but won’t go” said a 46 year-old male.
• Fatigue was a real issue for survivors and this was often associated with reduced independence and guilt. It made it difficult to plan ahead because they didn’t know how they would feel from day to day. Younger survivors also said it made it difficult for them to return to work. “You plan nothing” said a 46 year-old male survivor.
• “There is no doubt that strokes have a profound effect on relationships and our research showed many of the physical, psychological, social and emotional issues a stroke can raise” says co-author Dr Ryan. “It is important to point out that stroke can happen at any age and many of the survivors who took part in our study were relatively young.”

Four were aged between 33 and 43, two between 44 and 54, six between 55 and 65 and four between 66 and 78. The time since their stroke ranged from two months to four years, with an average of 18 months.

As a result of the study the researchers have come up with four key recommendations for clinical practice.

These recommendations are:

• Nurse education should focus on both the physical and psychosocial effects of stroke so that nurses can provide holistic care to stroke survivors and their spouses.
• Health care professionals and service providers must recognise and be sensitive to the profound impact of stroke on sexuality and sexual function.
• Statutory counselling services should be available to people with stroke and their spouses on both an acute and long-term basis to help them cope with the complex issues described.
• Evidence-based guidance is needed to demonstrate how nurses can address the psychosocial needs of stroke survivors most effectively.

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On The Net:

Wiley-Blackwell

On Tuesday, Health and Human Services Secretary Kathleen Sebelius said she is urging school superintendents around the country to spend the summer preparing for the possibility of turning schools into swine flu vaccine clinics this fall.

“If you think about vaccinating kids, schools are the logical place,” Sebelius told The Associated Press.

Last week the World Health Organization formally declared the swine flu a pandemic, meaning it is now spreading throughout the world unchecked.  

The U.S. has not made a formal decision on how to vaccinate millions of Americans against the flu, although money is being poured into developing a vaccine for the strain.

Currently the swine flu doesn’t appear to be any more harmful than regular flu, which kills 36,000 Americans each year, although scientists do fear that the strain has the potential to develop into a much more serious flu.

According to the WHO, nearly half of the 160 people who have died from swine flu have been young and healthy.

That could mean school-age children would be the first priority to receive vaccinations, said Sebelius.

Schools have teamed up with health officials in the past to provide flu vaccinations, although the event is rare.

Last fall, 140 schools scheduled flu vaccinations for students, and some offered them to entire families.

According to Sebelius, meeting President Barack Obama’s top healthcare priority of covering the uninsured could take until 2012 to implement, even if it Congress passes legislation this fall.

Implementing the new programs is estimated to cost over $1 trillion over 10 years.

The administration also plans to eliminate health disparities between minority groups and whites.

According to Sebelius, the most severe disparities are found among American Indians.  

She pledged to reverse this “a historic failure of the government,” saying the U.S. must provide free health care on reservations, and give the Indian Health Service the funds it needs.

Sebelius faces the question of whether to push forward with swine flu vaccinations this fall in edition to the annual winter flu vaccination.  Communication on who needs which, or both, vaccines will be a key challenge.

She will soon call together state governors to see that the summer is used to prepare for the possibility of a severe flu season, instead of being “used as vacation months.”

“We can always sort of back off” if the new flu fades away, she said, “but we can’t wait til October hits and say, ‘Oh my heavens, what are we going to do?'”

In 1976, a mass vaccination against a different swine flu occurred, but was spoiled by reports of paralyzing vaccine side effects.

The Food and Drug Administration will thoroughly test for swine flu vaccine safety, Sebelius said.

“The worst of all worlds is to have the vaccine cause more damage than the flu potential,” she added.

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On The Net:

WHO

FDA

New research from Cincinnati Children’s Hospital Medical Center highlights the critical role a certain gene and its protein play during early embryonic development on formation of a normal heart and skull.

In a study posted online June 15 by the Proceedings of the National Academy of Sciences, a research team at Cincinnati Children’s reports that too little of the gene/protein SHP2 interferes with the normal developmental activity of what are called neural crest cells. These cells, which occur very early in embryonic development, migrate to specific regions of the embryo. While doing so, the cells are supposed to differentiate and give rise to certain nerve tissues, craniofacial bones or smooth muscle tissue of the heart.

“Our findings show that a deficiency of SHP2 in neural crest cells results in a failure of cell differentiation at diverse sites in the developing embryo,” said Jeffrey Robbins, Ph.D., co-director of the Heart Institute at Cincinnati Children’s and senior investigator of the study. “This leads to anatomical and functional deficits so severe that it precludes viability of the developing fetus.”

SHP2 is a tyrosine phosphatase ““ an enzyme that helps trigger a cascade of biochemical reactions in cells as they specify to form certain tissues.

Although the study was conducted using mouse embryos, the findings are significant in efforts to understand congenital malformations of the heart and craniofacial region in people. Especially relevant, the researchers said, is the insight gained into early molecular events during embryonic development that might help explain such birth defects.

Dr. Robbins said the findings from this study can be used to develop specific drugs that could target the affected pathway, leading to treatment of heart and craniofacial malformations. About 4 percent of human infants are born with congenital malformations. Abnormal heart development is the most common human birth defect, affecting about 1 percent of newborns. The researcher team also wants to explore the exact alterations in neural crest cell migration, expansion and differentiation that contribute to birth defects of other organ systems.

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On The Net:

Cincinnati Children’s Hospital Medical Center

Taking precautionary measures to protect your eyes during the summer can help prevent long-term damage to eyesight, said a Baylor College of Medicine (www.bcm.edu) ophthalmologist.

“Ultraviolet light, or UV exposure, among many other factors, has certainly been linked to the development of macular degeneration, cataracts and other vision-loss problems,” said Dr. Elizabeth Baze (http://www.bcm.edu/eye/index.cfm?PMID=7921), assistant professor of ophthalmology at BCM and deputy executive of the Eye Care Line at the Michael E. DeBakey Veterans Affairs Medical Center.

“While exposure may not pose harm to your eyes immediately, it could cause long-term damage.”

Baze offered tips you can practice to help protect your eyes from sun damage this summer. And, “when it comes to picking sunglasses, the bigger the better,” said Baze. “The more they wrap around and shield your eye and the skin around the eye, the more full protection you have.”

Also be sure to check the sunglass label for UV ray protection, Baze said.  

“Sunglasses do not have to be expensive or prescribed by a doctor,” said Baze. “They just need to provide 99 to 100 percent UV protection.”

Sunblock is a must for your whole body, said Baze, including the skin around the eye.

“This area is very sensitive and can become irritated if sunburned,” she said. “Also, sun exposure to the eyelids increases risk of skin cancers in these areas.”

Wearing broad-brimmed hats can add extra protection, Baze said.  

If you already have an existing eye condition like macular degeneration or cataracts, protecting your eyes from the sun should be a top priority during the summer, she said.

“It’s important to enjoy the summer with friends and family,” said Baze. “Practicing these measures, along with many other safety tips, can ensure for healthy fun in the sun.”

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On The Net:

BCM

Evidence exists that people who lived or worked at Camp Lejeune Marine Base in North Carolina between the 1950s and 1985 were exposed to the industrial solvents tricholorethylene (TCE) or perchloroethylene (PCE) in their water supply, but strong scientific evidence is not available to determine whether health problems among those exposed are due to the contaminants, says a new report from the National Research Council.  The report adds that further research will unlikely provide definitive information on whether exposure resulted in adverse health effects in most cases.  Therefore, policy changes or administrative actions to address and resolve the concerns associated with the exposures should not be deferred pending new or potential health studies.
 
“Even with scientific advances, the complex nature of the Camp Lejeune contamination and the limited data on the concentrations in water supplies allow for only crude estimates of exposure,” said David Savitz, chair of the committee that wrote the report and professor in the department of community and preventive medicine at Mount Sinai School of Medicine, New York City.  “Therefore, the committee could not determine reliably whether diseases and disorders experienced by former residents and workers at Camp Lejeune are associated with their exposure to the contaminated water supply.”
 
In the early 1980s, two water-supply systems, Tarawa Terrace and Hadnot Point, on Camp Lejeune were found to be contaminated with various toxic industrial solvents, including PCE — which entered the groundwater as a result of spills and improper disposal practices by an off-base dry cleaner — and TCE from on-base spills and leaks from underground storage equipment.  Considerable public controversy grew over the potential health consequences, such as various cancers, for former residents.  To supplement the few studies that have been performed and to help inform decisions about addressing health claims, Congress asked the Research Council to examine whether adverse health effects are associated with past contamination of the water supply at Camp Lejeune.  
 
The committee reviewed an extensive water modeling effort of the contamination of Tarawa Terrace, and for Hadnot Point they examined information on chemical contamination from records and disposal practices.  PCE was the primary contaminant of the Tarawa Terrace water supply, but the water models could not overcome data gaps to provide accurate estimates of the concentrations of the contaminants.  The committee concluded that in the Hadnot Point area, exposures to TCE and PCE occurred, and exposures to several other contaminants through the drinking water distribution system were likely.  The ability to determine the levels of exposure at Camp Lejeune was complex, because people could have been exposed at home, school, daycare, or work.
 
In addition to reviewing the studies focusing specifically on Camp Lejeune, the committee examined data on exposures and available scientific research on associations between these chemicals and adverse health effects to determine which health problems might be associated with the Camp Lejeune contaminant exposure.  The committee looked at data from two types of studies: epidemiologic and toxicologic.  Epidemiologic studies examine whether a group of people with more exposure to particular chemicals have greater frequency of disease than people with lesser or no exposure.  Toxicologic studies conduct tests on animals to observe the health effects caused by exposure to chemicals.
 
The epidemiologic studies of TCE and PCE, primarily conducted in workplace settings, contained insufficient evidence to justify causal inference for any health effects.  However, the committee found “limited or suggestive evidence of an association” between chronic exposure to TCE, PCE, or a mixture of solvents, and some diseases and disorders, including cancers of the breast, bladder, kidneys, esophagus, and lungs.  This categorization means these epidemiologic studies give some reason to be concerned that sufficiently high levels of TCE or PCE may have an adverse effect, but the studies do not provide strong evidence that they actually do.
 
The majority of the health outcomes reviewed in the epidemiologic studies was placed in the category of “inadequate or insufficient evidence,” meaning that evidence was of insufficient quantity, quality, or inconclusive in results to make an informed assessment, but that an association between exposure to a specific agent and a health outcome cannot be ruled out.  A summary of the conclusions drawn from the epidemiologic studies related to solvent exposure can be found in Box 2 on page 8 of the report.  Some health outcomes reported by former residents of the base — such as male breast cancer and second-generation effects — are not cited because those specific outcomes were not investigated or the studies were too small or of insufficient quality.
 
The committee also compared information from epidemiologic studies with that from toxicologic studies and found similar health effects in both humans and animals for kidney cancer.  Similar noncancerous diseases and disorders included adverse effects on the liver, kidneys, and nervous and immune systems.  The findings are in Table 1 on page 10.  The absence of other diseases and disorders from Table 1 indicate that the findings were inconsistent between the epidemiologic and toxicologic evidence or were not addressed in the available studies.
 
Studies specifically on the Camp Lejeune population have addressed only reproductive health outcomes, but the limited quality of exposure information restricts their value.  The inability to study exposure and health outcomes accurately is a serious limitation in any future research.  Thus, the committee concluded that the U.S. Department of the Navy, under which the Marine Corps operates, should not wait for the results of more research before making decisions about how to follow up on the evident contaminant exposures and their possible health consequences.  They should undertake appropriate action in light of the available sparse information that indicate exposure to toxic contaminants occurred and may have affected the health of the exposed population.

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On The Net:

National Academy Of Sciences
 

Those stubborn grey hairs that come with age really are signs of stress, albeit of the cellular kind, according to a new Japanese study.

Genotoxic stress, which is anything that damages our DNA, sets off a chain reaction in which specialized cells known as melanocyte stem cells (MSCs) become damaged, ultimately resulting in a malfunction of the cells responsible for hair color.

Scientists discovered that the type of genotoxic stress that damages DNA depletes the MSCs in hair follicles that make pigment-producing melanocytes.   When exposed to the stress, these MSCs differentiate into mature melanocytes themselves, rather than dying off.  Therefore, anything that can limit genotoxic stress might also stop the graying from taking place, the researchers said.

“The DNA in cells is under constant attack by exogenously- and endogenously-arising DNA-damaging agents such as mutagenic chemicals, ultraviolet light and ionizing radiation,” said Emi Nishimura of Tokyo Medical and Dental University.
 
“It is estimated that a single cell in mammals can encounter approximately 100,000 DNA damaging events per day,” she added.

However, cells have sophisticated ways to repair damaged DNA and prevent the damage being passed on to their daughter cells.

“Once stem cells are damaged irreversibly, the damaged stem cells need to be eliminated to maintain the quality of the stem cell pools,” Nishimura explained.

“We found that excessive genotoxic stress triggers differentiation of melanocyte stem cells,” she said, adding that differentiation might be a more sophisticated way to eliminate those cells instead of fostering  their death.

Nishimura’s team had previously traced the loss of hair color to the gradual dying off of the stem cells that maintain a continuous supply of new melanocytes, which give hair its youthful color. It turns out that those specialized stem cells are not only lost, they also differentiate into fully committed pigment cells, and in the wrong place.

The current study, which used mice, found that irreparable DNA damage, in this case that caused by ionizing radiation, is responsible.  

Furthermore, the “caretaker gene” known as ATM (ataxia telangiectasia) serves as a stemness checkpoint that protects against MSCs differentiation, the researchers found.  That’s why people with Ataxia-telangiectasia, an aging syndrome caused by an ATM gene mutation, will gray prematurely.

The study supports to the idea that genome instability is a significant factor in aging.   It also supports the “stem cell aging hypothesis”, which says that DNA damage to long-lived stem cells can be a major driver for many of the conditions that come with age.

In addition to the aging-associated stem cell depletion typically seen in MSCs, quantitative and qualitative alterations to blood stem cells, cardiac muscle, and skeletal muscle have also been reported, the researchers said.  Stresses on stem cell pools and genome maintenance failures are also thought responsible for the decline of tissue renewal capacity and the accelerated appearance of aging-related characteristics.

“In this study, we discovered that hair graying, the most obvious aging phenotype, can be caused by the genomic damage response through stem cell differentiation, which suggests that physiological hair graying can be triggered by the accumulation of unavoidable DNA damage and DNA-damage response associated with aging through MSC differentiation,” the researchers wrote.

A separate study recently reported by European scientists found that going grey was caused by a build up of hydrogen peroxide due to normal wear and tear of the hair follicles.  The hydrogen peroxide blocked the normal production of melanin, the scientists wrote in the report, which was published by the Federation of the American Societies for Experimental Biology.

The current study was published in the June 12 issue of the journal Cell.

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On the Net:

• Tokyo Medical and Dental University
• Cell: Genotoxic Stress Abrogates Renewal of Melanocyte Stem Cells by Triggering Their Differentiation

Scientists have now revealed how nanoparticles can cause lung damage. In the same research, they reported successfully being able to block the cancer-causing mechanism.

Nanotechnology is a growing sector of research that involves the control of atoms and molecules to create new materials, including many that could have medical applications. Nanotechnology, as an industry, is expected to gain an annual market of about $1 trillion by 2015, researchers said in the June 11 issue of the Journal of Molecular Cell Biology.

Nanoparticles have unusual physical, chemical, and biological properties which scientists hope will be able to improve the effectiveness of drugs and gene therapy.

However, there are concerns that the science has underlying toxicity, including lung damage. Although nanotechnology had been traced to lung damage, scientists had been unsure as to how it causes it.

Chinese researchers discovered that ployamidoamine dendrimers (PAMAMs) ““ a class of nanoparticles being used in medicine ““ can result in lung damage by turning on the process of autophagic cell death.

Researchers found that by using an autophagy inhibitor, the cell death was counteracted in mice.

“This provides us with a promising lead for developing strategies to prevent lung damage caused by nanoparticles,” said the study’s leader, Dr. Chengyu Jiang, a molecular biologist at the Chinese Academy of Medical Sciences in Beijing, China.

“Nanomedicine holds extraordinary promise, particularly for diseases such as cancer and viral infections, but safety concerns have recently attracted great attention and with the technology evolving rapidly, we need to start finding ways now to protect workers and consumers from any toxic effects that might come with it.”

“The idea is that, to increase the safety of nanomedicine, compounds could be developed that could either be incorporated into the nano product to protect against lung damage, or patients could be given pills to counteract the effects.”

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On the Net:

• Journal of Molecular Cell Biology

New research shows that muscle atrophy is a much more ordered and deliberate process than previously thought.

During atrophy, which can occur when the body is weak from a disease such as cancer or AIDS, the body cannibalizes itself and breaks down muscle proteins to liberate amino acids. According to a new study, scientists have learned that a specific enzyme selectively degrades the thick filaments in the muscle but leaves the thin filaments alone. This allows muscles to remain muscles and still function, the researchers said.

Prior to this study, scientists knew that muscles were disassembled during atrophy but they didn’t know exactly how it was accomplished. It was also thought that the muscle just got smaller. They said they now know that the enzyme MuRF1 demolishes various components of the muscle’s thick filament in a specific order as part of a well-regulated process of degradation and disassembly.

The researchers said their findings have given them a better plan to halt or reverse atrophy with medication.

SOURCE: Journal of Cell Biology, June 15, 2009

New research published in the June issue of the Journal of the American College of Surgeons reveals that in counties with the highest levels of segregation, an increase in the African-American or Hispanic population was associated with a decrease in the availability and use of surgical services and an increase in the number of emergency room visits. This research supports prior studies that have shown that minority groups in the United States have comparatively poorer access to a range of health care services, often resulting in late diagnosis of illness and delayed treatment.

African Americans are the most segregated racial group in the U.S. Studies have shown that segregated African-American communities have higher infant mortality rates, decreased access to appropriate cancer care and worse outcomes from organ transplantation than other racial groups experience. Both African Americans and Hispanics living in counties with a higher proportion of African-American population report that they experience difficulty obtaining health care as compared with African Americans living in counties with a smaller African-American population. Through the National Institutes of Health and Healthy People 2010, the federal government has set forth goals to explore, account for and minimize these disparities. However, despite these goals, improving access to health care continues to pose a considerable challenge to health policy makers in their attempts to establish equity in the provision of care.

“In the most segregated counties, we found that an increase as small as one percent in the African-American or Hispanic population was associated with a significant decrease in the availability and utilization of surgical services, a difference that was not present in counties with the least segregation,” said Awori J. Hayanga, MD, MPH, Administrative Chief Resident, Department of General Surgery, University of Michigan Health System. “We hope this report will guide budgetary decisions and incentives by health policy makers in their bid to close the racial health disparity gap and increase access to surgical health care across racial lines, particularly in the most segregated areas.”

A cross-sectional analysis was performed on data from the 2004 U.S. Department of Health and Human Services Area Resource File, a nationwide record of health care, economic and demographic data. Each of the 3,219 U.S. counties was categorized into one of three levels ““ most, moderately or least segregated ““ using the Isolation Index, a measure of the probability that a member of one minority group will come into contact with members of the same racial group. Multivariable linear regression analysis was performed to examine the association between access to surgical services and proportion of minority population with varying levels of segregation, adjusting for socioeconomic and health characteristics.

Results showed that in the most segregated counties, each percentage point increase in Hispanic or African-American population was associated with a statistically significant decrease in outpatient surgery volume (p< 0.0001), ambulatory surgical facilities (p< 0.0001) and number of general surgeons (p< 0.0001). In the least segregated counties, small population increases were not associated with significant decreases in surgical resources. A significant increase in the volume of emergency medical visits was associated with increasing proportions of African-American and Hispanic populations within the most segregated counties (p< 0.0001).

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Weber Shandwick Worldwide

Cecal volvulus is axial twisting that occurs involving the cecum, terminal ileum, and ascending colon. Rarely, it may take the form of upward and anterior folding of the ascending colon (“cecal bascule”).

The research team led by Prof. Hiroshi Suzuki from Toyama Hospital reported a case of caecal voluvuls seen in a 78-year-old woman and reviewed of Japanese literature. This will be published in May 28, 2009 in the World Journal of Gastroenterology addresses this issue.

A 78-year-old woman presented with fever, severe abdominal pain, and distension. She had been institutionalized for depression and senile dementia. Laboratory examinations disclosed a leucocytosis (WBC: 12500/ÃŽ¼L) and elevated levels of serum C-reactive protein (2.8 mEq/L). Diagnosis of acute cecal volvulus was made from a “coffee bean sign” on an abdominal computed tomography and a “beak sign” on a gastrographin enema. An emergent laparotomy confirmed the diagnosis and an ileo-colectomy with primary anastomosis was carried out. The patient recovered after intensive respiratory care and fluid therapy, and then returned to her former institution. A review of Japanese literature disclosed that: (1) a marked increase of aged patients with mental disability presenting with cecal volvulus, (2) adoption of ileo-colectomy as the standard surgical procedure, and (3) improved survival of the patients, were observed in the last decade.

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World Journal of Gastroenterology

Older women who take hormone therapy to relieve menopausal symptoms may get the added benefit of reduced body fat if they are physically active, according to a new study. The results were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

The study provides new information on the health benefits of any type of physical activity, not just exercise, said the presenting author Poli Mara Spritzer, MD, PhD, a professor at the Federal University of Rio Grande do Sul in Porto Alegre, Brazil, and chief of the Gynecological Endocrinology Unit at the university’s Hospital de Clinicas de Porto Alegre.

After menopause, a woman’s percentage of body fat tends to increase and redistribute to the abdomen, Spritzer said. Excess belly fat is a risk factor for diabetes and heart disease. Postmenopausal women who exercise have a lower percentage of body fat than sedentary women, past research shows. However, Spritzer said less is known about the influence on body fat composition of physical activity in women receiving hormone replacement therapy, or HRT. Some data suggest that estrogen treatment may add to the effect of exercise in reducing fat.

Spritzer and her colleagues studied 34 healthy women who had an average age of 51 years, had experienced menopause for less than 3 years and sought HRT to relieve hot flashes, night sweats and vaginal dryness. They evaluated the women’s cholesterol levels, body mass index (BMI), waist circumference (a measure of abdominal fat) and percentage of body fat before and after 4 months of HRT. The women received estrogen plus progesterone therapy in either non-oral (nasal and vaginal) or low-dose oral preparations. For 6 consecutive days before starting HRT and 6 days at the end of HRT, women wore a pedometer to estimate their level of physical activity. The device measured the steps they took, including walking, working, and doing house chores and leisure activities. They were instructed to not change their usual activities. Most of the women did not play sports or do any structured physical exercise, according to Spritzer.

Results showed that 24 of the women were physically active””defined as taking 6,000 steps or more per day””and 10 were inactive (less than 6,000 steps a day). For a woman who has a step, or stride, length of 2 feet (60 cm), 6,000 steps would be around 2.25 miles (3.6 km), Spritzer estimated. For active women, the higher the number of steps they took, the lower was their waist measurement and the better their level of “good” (high-density-lipoprotein, or HDL) cholesterol, the authors reported. The inactive women did not have any changes in body fat or cholesterol. However, when all 34 women were considered in the analysis, body fat still declined significantly after HRT.

“Data from our study suggest that active women could benefit from hormone therapy beyond the relief of menopausal symptoms””by preserving a good body fat percentage and distribution,” Spritzer said. “Further studies with a larger number of subjects are needed in order to answer whether a specific physical activity is better than others.”

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The Endocrine Society

Nearly 1 in 10 patients with obstructive sleep apnea also experience “parasomnia” symptoms such as sleepwalking, hallucinations and acting out their dreams, a Loyola University Chicago Stritch School of Medicine study has found.

Researchers examined records of 537 adult sleep apnea patients who were evaluated at the Loyola Center for Sleep Disorders in Maywood and Oak Brook Terrace. Fifty-one patients, or 9.5 percent of the total, reported one or more types of parasomnia symptoms.

Parasomnia complaints included sleep paralysis (21 patients), sleep-related hallucinations (16 patients), acting out dreams (11 patients), sleepwalking (5 patients) and eating while asleep (one patient).

Results were reported at Sleep 2009, the annual meeting of the Associated Professional Sleep Societies, held this year in Seattle.

Obstructive sleep apnea is caused by a partial or complete blockage of the airway. Each time this happens, the brain becomes aroused, in order to resume breathing. This is disruptive to sleep, and the patient can feel chronically tired during the day.

Earlier studies found that obstructive sleep apnea is associated with a higher risk of high blood pressure, heart attacks, stroke, obesity, diabetes, heart failure and irregular heartbeats. The new study suggests that apnea also is linked to increased parasomnia symptoms.

Parasomnia disorders include sleep paralysis (brief episodes of being unable to move), hallucinations during the state between waking and sleeping, acting-out dreams (punching, kicking, crying out, etc.) and walking, eating or even driving while asleep.

Because it interrupts sleep, apnea can set a person up for parasomnia, said Dr. Nidhi S. Undevia, principal investigator of the study. “If you have a predisposition to parasomnia, apnea could make it worse,” Undevia said. Undevia is medical director of the Loyola Center for Sleep Disorders and an assistant professor in the Department of Critical Care Medicine at Loyola University Chicago Stritch School of Medicine.

Undevia said doctors should ask apnea patients if they have parasomnia symptoms. “We need to start asking, because we might be missing potentially dangerous or harmful behaviors,” she said.

Other co-authors are Loyola sleep specialist Dr. Sunita Kumar, an assistant professor in the Department of Critical Care Medicine at Stritch School of Medicine and lead author Dr. Mari Viola-Saltzman, a sleep medicine fellow at the University of Washington. During the course of the study, Viola-Saltzman was a neurology resident at Loyola University Hospital.

Viola-Saltzman said that, in addition to screening patients for snoring, apneic spells, disrupted sleep and daytime somnolence, physicians “may also consider asking about parasomnia symptoms as another tool to indicate whether the patient may be suffering from obstructive sleep apnea.”

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Loyola University Health System

Alternative medicine is growing increasingly more mainstream, and is now accepted by most doctors, insurers and hospitals.

People use unconventional methods and herbal therapy for many reasons. Often they do not trust big drug companies or the government, and they have more faith in the natural remedies.

Dietary supplements do not have to pass any safety tests before being sold. Some contain lead and arsenic, and some obstruct other medicines from working, like birth control pills.

“Herbals are medicines,” and have both good and bad effects, noted Bruce Silverglade from the consumer group Center for Science in the Public Interest.

The Associated Press evaluated dozens of studies and interviews of 100 different sources and discovered that an entire underground medical system existed, with an entirely different standard to follow than the rest of the medical industry.

Fifteen years ago, Congress started allowing dietary and herbal supplements go to market without federal Food and Drug Administration consent. In these 15 years, the amount of products available has increased ten-fold, from 4,000 to 40,000.

Around this time, Congress formed a federal agency to review herbal supplements and unconventional treatments. However, after spending $2.5 billion on research, nothing monumental has been discovered, aside from the use of acupuncture and ginger for chemotherapy-associated nausea. Nevertheless, these unconventional therapies are being used more and more.

Several hospitals offer alternative methods of recovery, like meditation, yoga and massages. Other hospitals make profits from offering acupuncture, which insurance does not pay for if the reason is not explicitly stated.

Some medical schools have alternative medicine classes, sometimes paid for with federal grants. A University of Minnesota program allows the study of nontraditional healing therapies in Hawaii.

The silver lining to all these statistics is that very few herbal supplements can actually be bad to your health. However, a large number do not accomplish what their labels say they will, and have could have lead in them, or are tainted in other ways.

“In testing, one out of four supplements has a problem,” said Dr. Tod Cooperman, head of ConsumerLab.com.

Even when the ingredients are healthy and safe, spending money on merchandise that has no proven advantage is risky when the economy is in poor shape and people cannot pay for health insurance.

It should be noted that mainstream medicines have issues, too. Drugs like Vioxx and Bextra were discontinued after deadly side effects emerged after they were on the market. The difference is that at least these medicines have rules, guidelines and watchdog groups that follow their usage.

Alternative medicines do not have that kind of safety net. People who accredit them are usually self-policing, with private schools and unknown accreditation groups.

Still, millions of Americans use supplements, like vitamins, minerals and herbs, said Steven Mister, president of the Council for Responsible Nutrition.

“We bristle when people talk about us as if we’re just fringe,” he said. Supplements remain “an insurance policy” for a lot of people.

In actuality, doctors recommend a few: prenatal vitamins, calcium, and fish oil specifically. Several studies imply that vitamin deficiencies can increase the chance of disease. However, it is not proven that taking vitamins will change that, and research has touched on some harm, said Dr. Jeffrey White, alternative medicine chief at the National Cancer Institute.

White sees alternative medicine as “an area of opportunity” that should be studied more. Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine, agrees.
“Most patients are not treated very satisfactorily,” Briggs said. “If we had highly effective, satisfactory conventional treatment we probably wouldn’t have as much need for these other strategies and as much public interest in them.”

Even those who oppose the use of alternative medicines understand their allure.

“They give you a lot of time. They treat you like someone special,” said R. Barker Bausell, a University of Maryland biostatistician.

This is the reason why Dr. Mitchell Gaynor, a cancer authority at the Weill-Cornell Medical Center in New York, includes nutritional review, therapy, and meditation techniques in his cancer treatment, although he admits that some of his patients disagree.

“You do have people who will say ‘chemotherapy is just poison,'” said Gaynor, who disagrees. “Cancer takes decades to develop, so you’re not going to be able to think that all of a sudden you’re going to change your diet or do meditation (and cure it). You need to treat it medically. You can still do things to make your diet better. You can still do meditation to reduce your stress.”

The majority of his patients “will do the right thing, do everything they can to save their life,” Gaynor told the AP.

The Dietary Supplement and Health Education Act of 1994 excused these herbal medicines from requiring FDA approval before they went on the market.

“That has resulted in consumers wasting billions of dollars on products of either no or dubious benefit,” noted Silverglade.

Many want President Barack Obama’s administration to take a closer look at the debate. In the meantime the industry has increased self-policing, and the Council for Responsible Nutrition hired an attorney to work with the Council of Better Business Bureaus.

“We certainly don’t think this is a huge problem in the industry,” Mister stated, but did admit seeing infomercials “that promise the world.”

“The outliers were making the public feel that this entire industry was just snake oil and that there weren’t any legitimate products,” said Andrea Levine, ad division chief for the business bureaus.
People need to retain skepticism about the marketing term “natural,” said Kathy Allen, a dietitian at Moffitt Cancer Center in Tampa, Fla.

The bottom line is that natural medicines usually lack proof of safety or assistance. When asked to take an herb knowing this, “most of us would say ‘no,'” Allen said. “When it says ‘natural,’ the perception is there is no harm. And that is just not true.”

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CSPI

FDA

People once thought of as disabled will come together in Miami with scientists working on devices to help them overcome physical limitations.

The No Barriers Festival is scheduled for this weekend, The Miami Herald reports.

One of those in attendance will be Erik Weihenmayer of Colorado, president of No Barriers USA, who has been blind since he was 13. Weihenmayer is using one of three prototype BrainPorts, which gives him enough vision to make out letters and to see his 8-year-old daughter, although so far only in black and white.

”I can’t tell you how amazing and surreal it has been,” Weihenmayer said of the BrainPort. ”This sort of technology is not just ahead of the curve, it’s miles ahead of anything we’ve seen before.”

The festival will feature other high-tech devices, like global positioning systems for the blind and prosthetic limbs that respond to brain signals. But Weihenmayer and others say changing attitudes is as important as technology.

There was a time not that long ago when most people might see someone like me — a paraplegic in a wheelchair — and automatically assume ‘disabled,’ said Harry Horgan.

Horgan founded Shake-a-Leg Miami, a center for sailing and aquatic sports and the host of the festival.

A drug derived from the hydrangea root, used for centuries in traditional Chinese medicine, shows promise in treating autoimmune disorders, report researchers from the Program in Cellular and Molecular Medicine and the Immune Disease Institute at Children’s Hospital Boston (PCMM/IDI), along with the Harvard School of Dental Medicine. In the June 5 edition of Science, they show that a small-molecule compound known as halofuginone inhibits the development of Th17 cells, immune cells recently recognized as important players in autoimmune disease, without altering other kinds of T cells involved in normal immune function. They further demonstrate that halofuginone reduces disease pathology in a mouse model of autoimmunity.

Currently there is no good treatment for autoimmune disorders; the challenge has been suppressing inflammatory attacks by the immune system on body tissues without generally suppressing immune function (thereby increasing risk of infections). The main treatment is antibodies that neutralize cytokines, chemical messengers produced by T cells that regulate immune function and inflammatory responses. However, antibodies are expensive, must be given intravenously and don’t address the root cause of disease, simply sopping up cytokines rather than stopping their production; patients must therefore receive frequent intravenous infusions to keep inflammation in check. Powerful immune-suppressing drugs are sometimes used as a last resort, but patients are left at risk for life-threatening infections and other serious side effects.

Through a series of experiments, the researchers show that halofuginone prevents the development of Th17 cells in both mice and humans, halts the disease process they trigger, and is selective in its effects. It also has the potential to be taken orally. “This is really the first description of a small molecule that interferes with autoimmune pathology but is not a general immune suppressant,” says Mark Sundrud, PhD, of the PCMM/IDI, the study’s first author.

Recognized only since 2006, Th17 cells have been implicated in a variety of autoimmune disorders including inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, type 1 diabetes, eczema and psoriasis. They are genetically distinct from the other major categories of T-cells (Th1, Th2 and T-regulatory cells).

Th17 cells normally differentiate from “naïve” CD4+ T cells, but when Sundrud and colleagues cultured mouse CD4+ T-cells along with cytokines that normally induce Th17 development, there was a pronounced decrease in Th17 cells ““ but not in Th1, Th2 or T regulatory cells ““ when halofuginone was added. Similarly, in cultured human CD4+ T-cells, halofuginone selectively suppressed production of IL-17, the principal cytokine made by Th17 cells.

And in mice with experimental autoimmune encephalitis (EAE), an artificially-induced immune disease resembling multiple sclerosis in humans, and marked by infiltration of Th17 cells into the central nervous system, low-dose halofuginone treatment significantly reduced both the development of EAE and its severity. (In mice with another form of EAE that doesn’t involve Th17 cells, halofuginone had no effect.)

Wondering how halofuginone works, the researchers did microarray studies of the halofuginone-treated cells to examine patterns of gene expression in response to the drug. Unexpectedly, many genes involved in stress responses were turned on. Eventually, they found that halofuginone acts by activating a biochemical pathway known as the “amino acid starvation response,” or AAR, which typically protects cells when amino acids, essential building blocks of proteins, are in short supply. When excess amino acids were added to cultured T-cells exposed to halofuginone, the AAR didn’t switch on, and Th17 cells were able to develop. Conversely, the researchers were able to inhibit Th17 differentiation simply by depleting amino acids, thereby inducing the AAR.

Why would the AAR prevent Th17 cells from forming? The researchers propose that the AAR has an energy-saving function, slowing down a cell’s building activities to conserve amino acids. “When a cell senses amino acid deprivation, it tries to conserve amino acids by preventing specific types of responses that are energetically expensive,” says Sundrud. “In inflamed tissues, a lot of cells are producing a lot of protein, so it would make sense that a cell with amino acid deprivation would want to block signals that promote inflammation.”

Halofuginine is one of the 50 fundamental herbs of traditional Chinese medicine, and has been used as an antimalarial agent. Decades ago, the U.S. Army tried to improve upon its antimalarial properties, without success. It has been in clinical trials for scleroderma, but because it is now in the public domain, the pharmaceutical industry has not shown interest in further developing it therapeutically.

But halofuginone, or some yet-to-be developed derivative compound, could potentially be used to address any autoimmune or inflammatory disease related to Th17 cells by activating the AAR, the researchers say.

“Remarkably, halofuginone evokes the AAR in all cells but selectively inhibits T-cell inflammatory responses,” says Anjana Rao, PhD, of the PCMM/IDI, a senior investigator on the study. “This recalls the actions of cyclosporin A and FK506, two other immunosuppressive drugs that block the activity of calcineurin. Calcineurin is present in all cells, but selectively prevents the rejection of heart, lung, liver and bone marrow transplants when given to patients. These drugs revolutionized transplant medicine when they were introduced over 20 years ago, and halofuginone may herald a revolution in the treatment of certain types of autoimmune/inflammatory diseases.”

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Children’s Hospital Boston

 The cause of Parkinson’s disease (PD), the second most frequent neurodegenerative disease after Alzheimer’s disease, is unknown, but in most cases it is believed to involve a combination of environmental risk factors and genetic susceptibility. Laboratory studies in rats have shown that injecting the insecticide rotenone leads to an animal model of PD and several epidemiological studies have shown an association between pesticides and PD, but most have not identified specific pesticides or studied the amount of exposure relating to the association.

A new epidemiological study involving the exposure of French farm workers to pesticides found that professional exposure is associated with PD, especially for organochlorine insecticides. The study is published in Annals of Neurology, the official journal of the American Neurological Association.

Led by Alexis Elbaz M.D., Ph.D., of Inserm, the national French institute for health research in Paris, and University Pierre et Marie Curie (UPMC, Paris 6), the study involved individuals affiliated with the French health insurance organization for agricultural workers who were frequently exposed to pesticides in the course of their work. Occupational health physicians constructed a detailed lifetime exposure history to pesticides by interviewing participants, visiting farms, and collecting a large amount of data on pesticide exposure. These included farm size, type of crops, animal breeding, which pesticides were used, time period of use, frequency and duration of exposure per year, and spraying method.

The study found that PD patients had been exposed to pesticides through their work more frequently and for a greater number of years/hours than those without PD. Among the three main classes of pesticides (insecticides, herbicides, fungicides), researchers found the largest difference for insecticides: men who had used insecticides had a two-fold increase in the risk of PD.

“Our findings support the hypothesis that environmental risk factors such as professional pesticide exposure may lead to neurodegeneration,” notes Dr. Elbaz.

The study highlights the need to educate workers applying pesticides as to how these products should be used and the importance of promoting and encouraging the use of protective devices. In addition to the significance of the study for those with a high level of exposure to pesticides, it also raises the question about the role of lower-level environmental exposure through air, water and food, and additional studies are needed to address this question.

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Wiley-Blackwell

According to research presented at the American College of Sports Medicine’s annual meeting in Seattle, the physical challenges and demands of participating in a competitive high school marching band are similar to those experienced by athletes.

Study presenter Gary Granata told Reuters Health that marching bands do not just march in precision formation. 

“In the past 20 years, marching bands have gone to these highly choreographed visual shows, where performers are literally running around the field at very high velocities with heavy instruments while playing very difficult passages.”

“At the top levels of marching band and drum corps, you get a level of competition and athleticism that is equal to a division I athletic program,” added Granata, an exercise physiologist, registered dietitian and owner of the New Orleans-based company PerformWell.

The researchers studied a 172 member marching band from Avon High School in Indiana, which were the Grand National Champions at the 2008 Bands of America competition.  The members completed an anonymous questionnaire on the physical demands, challenges and injuries associated with participating in a marching band.

Band members commonly reported fatigue, muscle soreness, and injuries.

Over 95 percent of surveyed band members reported muscle soreness and stiffness after practice.  Also, nearly half said that they were “frequently tired” after band practice, along with nearly a quarter saying they felt faint or sick to their stomach after marching band participation.  Over half of the members experienced heat-related illness.

Also, over 38 percent said that they had suffered an injury as a direct result of participating in a marching event.

Research conducted on traditional sports has led to guidelines that help ensure the safety of participants and proper methods to enhance training regimens, Granata noted. “Yet, there is essentially no research on marching bands,” he told Reuters Health, “a sport where kids participate in the heat at very high intensity levels that are incurring injuries.”

He concluded that safety guidelines and effective training regimens are needed for marching bands and drum corps because it has a “strenuous physical activity that has rates of both participation and injury similar to competitive sports.”

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Image Caption: The Avon High School Marching Black and Gold, a large marching band, is classified as an AAA band in the BOA circuit. Courtesy Wikipedia

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On the Net:

• American College of Sports Medicine
• PerformWell