Asthma and obesity genetic link is established

Researchers from the University of Buffalo say two related studies they have conducted demonstrate that chronic inflammation in asthma is more prominent in people who are overweight or obese.

“Our findings point the way to the management of asthma in the obese through simple weight reduction,” said first author Paresh Dandona, MD, PhD, SUNY Distinguished Professor and Chief of Endocrinology, Diabetes and Metabolism at the University at Buffalo.

The findings were published online in the 26 June edition of journal Obesity and involved a study contrasting people in a normal weight range against people classified as obese; in addition to analysis of if/how biological indicators – such as the behaviour of asthma-linked genes – were altered following obese patients receiving weight loss surgery (a gastric bypass).

Assessed were 22 patients of normal weights, 23 obese patients (11 with Type 2 diabetes, 12 without) and 15 morbidly obese patients with Type 2 diabetes.

The Scientists involved with the research discovered in the comparative study that the four genes linked to chronic inflammation in asthma were more active in obese and morbidly obese people, as much as 100% in some cases.

This increased gene expression matters as it can result in mononuclear cells (white blood cells) to generate significantly more inflammatory factors such as interleukin 4, LIGHT and lymphotoxinβ receptor. These help to induce allergic inflammation and other abnormalities in the bronchial passages in asthma.

MMP-9, a contributor to inflammation, and nitric oxide metabolites (NOM), an indicator of oxidative stress, are both asthma-related compounds which were found in higher concentrations within the plasma of both obese and morbidly obese patients.

Interestingly, concentrations of MMP-9 and NOM decreased in morbidly obese diabetics after they had received gastric bypass surgery, together with the expression of six asthma-related genes including the key factors, interleukin 4, LIGHT, lymphotoxinβ and interleukin 33.

The study could hold some weight behind it as none of the participants actually suffered from asthma, meaning any findings or correlations were not a direct result of the lung condition.

“Ours is the first study to provide a mechanistic link between obesity and asthma through biological/immunological mechanisms,” Dandona said. “There has been, until now, no biological, mechanistic explanation other than the fact that obesity may raise the diaphragm and thus reduce lung volumes.”

According to Dandona, the next stage of research into asthma and obesity will involve clinical studies to find information about if or how weight loss can be beneficial for obese asthma patients. “We are embarking on this project now,” he said.

Exercise pill is possible claim scientists

Exercise pill…Exercise in a pill? This may sound like a premise too good to be true, and something that will have government officials and personal trainers shaking their heads in despair. However, the results of two connected studies published in Nature Medicine suggest that we may be able to soon receive the health benefits from exercising – without having to move a muscle or break a sweat!

Researchers at the Scripps Research Institute in Florida formulated a compound in 2012 which once injected into obese mice, actually amplified activation of ‘REV-ERB’ – a protein which can help to control animals’ circadian rhythms and internal biological clocks. These mice were found to lose weight and improve cholesterol levels despite being on a high fat diet.

To their amazement, the researchers discovered that the mice injected with the compound started to use up more oxygen on a daily basis and expend roughly 5% more energy than the untreated mice, even though they were less active than the untreated mice. Generally, the treated mice had actually become lazier than pre-injection and it seemed the compound was providing them with exercise without any effort being input.

Working with researchers from the Pasteur Institute in France, Scripps scientists decided to conduct further test to try and find out more information about how the compound worked inside of muscles to generate this invisible exercise. It was clear the drug was boosting potency of the REV-ERB protein, but scientists were puzzled as to what role REV-ERB had inside the muscles.

Therefore, a strain of mice were analysed – all of whom were unable to express much REV-ERB in their muscle cells, being referred to as ‘anti-athletes’. A common indicator of regular aerobic exercise is the fact that there is usually a better vigour and quantity of the mitochondria. These are cellular structures aiding the production of energy whilst oxygen is consumed. The anti-athlete animals’ muscles had a staggeringly low number of mitochondria.

This means they became exhausted way before other mice, with poor endurance and a maximal oxygen capacity of approximately 60% less than what would be considered normal. However, in another part of the experiment, the scientists added their compound to isolated muscle cells from these particular mice.  The cells started to generate significantly more REV-ERB and thus began to generate new mitochondria in addition to improving/strengthening the ones already present.

Then it was sedentary mice that were given the compound to test them with a higher amount of REV-ERB than what could be considered normal. After being set free onto small treadmills, these mice ran “significantly longer both in time and distance” than the untreated animals, the authors wrote, despite no previous training.

Co-author Dr Thomas Burris, chairman of the department of pharmacological and physiological science at St Louis University School of Medicine says there is a possibility in the future that this ‘exercise pill’ might be able to especially help the disabled or can’t otherwise exercise, to enjoy the health benefits of endurance without the exertion.

However, don’t cancel your gym membership just yet. Dr Burris stresses the core aim of his and other similar research is to help those who are unable to exercise, for whatever reason, not those who simply cannot be bothered. He says: “Exercise has so many health benefits” and “no drug can” recreate all of them. Activities such as swimming and lifting weights will never be fully reduced to tablet form, and exercising helps to release endorphins – the body’s natural feel-good chemical , and decreases stress hormones such as cortisol.

Statins help to cut heart attack deaths by half

Firstly, Medical Specialists Pharmacy would like to wish everybody a slightly belated Merry Christmas and we hope everyone has had a fantastic few days with their family, friends and loved ones.

Secondly, we have already touched upon one group of people who may be vulnerable at Christmas time; asthmatics. However, those at risk of high cholesterol and heart problems need to be particularly cautious as well over the festive period.

Yesterday (Dec 26) is a day notorious for a high number of cardiac-related health problems such as heart attacks, heart failure and arrhythmias. A 2004 study conducted by researchers at the University of California, San Diego and Tufts University discovered that heart-related deaths go up by almost 5% during the Christmas holidays.

Some of the increased deaths can be attributed to a number of causes such as alcohol abuse as people already at risk of heart problems ignore the warnings and consume alcohol in excess, and some of the tragic fatalities are down to a build-up of Cholesterol – an important component of the blood stream that works at repairing body cells. However if excess cholesterol is not efficiently removed from the blood stream, it can pose a serious problem and cause deadly health issues such as stroke, heart attack and coronary heart disease.

As everybody is aware, stress levels for the majority of the UK and indeed around the world are at their peak over Christmas time as we frantically rush around for presents, planning time to see family and friends, and sorting last minute arrangements. Unfortunately stress and cholesterol are closely linked and when our stress levels increase, the production of two hormones – cortisol and adrenaline also increase.

Cortisol is known as the ‘stress hormone’ and it raises the sugars (glucose) in the bloodstream. Prolonged levels of cortisol have been shown to be connected to increased abdominal fat – linked to higher levels of ‘bad’ cholesterol (LDL) and lower levels of ‘good’ cholesterol (HDL), which can lead to all kinds of heart problems.

Cholesterol lowering medicines known as ‘Statins’ have been in the news throughout 2012 as health experts uncover more exciting findings about their capabilities. As stress and over indulgence of fatty foods increase our cholesterol over Christmas, it may come as good news to learn that British Heart Foundation statistics show that deaths from heart attacks have been cut by half, saving the lives of millions of people and this has been largely down to ‘wonder drug’ statins such as Crestor and Lipitor.

According to figures released by the British Heart Foundation, between the years 2002 and 2010 the death rate in men dropped from 78.7 deaths per 100,000 men to just 39.2 deaths per 100,000 men. Over the same 8 year block there was also a decrease in the death rate for females, 37.3 deaths per 100,000 women in 2002 fell to 17.7 deaths per 100,000 women in 2010.

The higher use of statin medication and blood thinning medication in conjunction with such lifestyle factors as fewer people now smoking have resulted in the decrease in heart attacks and other related problems. In addition, more advanced treatment than previous years means that those who do suffer from a heart attack, have a much better chance of surviving.

Professor Peter Weissburg, medical director of the foundation, said: “The last decade has seen excellent progress in heart attack prevention, treatment and care which has resulted in a dramatic reduction in the number of people dying from heart disease. Statins are an important part of that success story. They have undoubtedly changed the face of heart disease treatment for the better and there can be little doubt that there are thousands of people alive and well today because of statins. Whilst some people do experience irritating side effects, they are very rarely life threatening and the benefits far outweigh any risks. The progress we have witnessed over the last 10 years is something to celebrate but coronary heart disease is far from beaten and is still the single biggest killer in the UK. We must tackle the problem of inequalities which place an unfair burden of heart disease on our poorest communities. By dealing with the root causes of heart and circulatory disease – diet, smoking and lack of exercise – we should continue to see a decline in the numbers dying from a heart attack.”

Prescriptions for statins are now an incredible 15 times higher than 20 years ago, with estimates showing that approximately eight million people in the UK take statins every day. They work out to cost around just 40p per day and their benefits have led for calls for even more ‘healthy’ adults to be prescribed them too.

Thankfully, Medical Specialists Pharmacy provides private and confidential online consultations for statins, and for suitable patients our in-house doctors can prescribe statin medication such as Lipitor and Crestor, and our in-house pharmacists can dispense to patients within just 24 hours. We also dispense statins for patients who can provide a private prescription. If all that wasn’t enough, we also have the legally available generic Atorvastatin at much lower prices for suitable patients.