Ebola is a subject that’s been on everyone’s minds for weeks
and, as such, has received a lot of media attention. I’ve covered the Zaire
and even discussed the heroism
of those responsible for treating victims and disposing of the bodies, but the
situation in West Africa has recently expanded to the US. An article
from the New York Times detailed the
journey of a man who took a trip to visit family and ended up in isolation at a
Texas hospital, as well as the precautions being taken both by the facility and
the US government.
“We have had a plan in place for some time now for a patient
presenting with possible Ebola,” explained Edward Goodman, MD, an
epidemiologist at Texas Health Presbyterian Hospital in Dallas, Tx., where the
unidentified patient is currently being treated. “Ironically, we had a meeting
the week before of all the stakeholders who might be involved. We were well
prepared to care for this patient. ”
Passengers attempting to board a plane out of areas of West
Africa are being screened for Ebola symptoms prior to take off, but as his
symptoms hadn’t yet presented, the infected passenger was able to board his
flight to visit family in the US. After a few days, he started to get sick,
sought medical attention and was treated. According to the NY Times article, however, the early symptoms of the disease like
fever and nausea can be easily mistaken for any number of diseases – even
despite the heightened alert concerning patients with recent travel histories
in Guinea, Liberia or Sierra Leone.
After his symptoms started to worsen, the passenger went to
the hospital and was put in isolation while they awaited his test results, which
came back positive for Ebola. His family, as well as anyone he came into
contact with during the infectious period of his stay, has also been brought
into isolation. This is the first instance of Ebola in the US and the first
time it’s been diagnosed outside of West Africa. Upon confirming the test, the
CDC sent out a team to handle the situation in Texas while the Obama
administration began a massive social media campaign to calm and educate the
“You cannot get Ebola through the air, water or food in the
US,” said a post on the White House’s official Twitter account according to the
NY Times article. “Ebola can only
spread from contact with the blood or body of fluids of a person or animal who
is sick with or has died from the disease.”
The appearance of the disease in the US is unprecedented,
but healthcare facilities not unprepared. The NY Times article noted, “Many health experts said it would only be
a matter of time before it reached the United States,” and there has been a lot
of preparation across the country for such an event. Additionally, the
isolation protocols established by the CDC were described in the article, in the
words of Thomas R Frieden, MD, MPH, CDC director, as “tried and true.” He went
on, commenting, “I have no doubt that we’ll stop this in its tracks in the [US].”
It’s no big secret that clinical laboratories have been
subjected a series of strict budget and reimbursement cuts over the past few
years. Rather than easing in the coming year, these cuts are predicted to remain
equally rigid, if not more so. A recent news
briefing from Dark Daily pointed out the unprecedented nature of
cost-cutting measures in laboratories across the United States compared to any
other time in recent history.
“Labs today face a stark reality: not only are they getting
less money today from their parent organizations and health insurance plans,
but they are entering a multi-year period that will see equally dramatic
reductions in lab test reimbursement and lab revenue,” commented Robert Michel,
editor-in-chief of the Dark Daily Report and Dark Daily.
Specifically, the release noted that the current fiscal
situation in clinical laboratory is harsher than it has been in the last 25
years, and there’s no end in sight. For healthcare facilities facing reduced
funding, the Dark Daily story also discussed the impact and importance of
implementing methods like LEAN, Six Sigma and “process improvement methods with
consistent success.” According to the article, laboratories that utilize these
approaches tend to remain successful despite the new restrictions.
“Two big challenges confront the nation’s clinical
laboratories and pathology groups,” continued Michel. “One is the need to cut
costs aggressively in the face of shrinking lab budgets and failing lab
revenue. The second is how to increase the value of lab testing services the
lab delivers to physicians, patients, payers.”
These cuts are certainly not new and are predicted to continue.
As healthcare facilities stretch both funds and personnel to cover for the
increased financial pressure to continue providing the same level of care --
essentially doing more with less – managers and administrators who can roll
with the punches on cost-cutting measures to adapt are going to be the most
successful. Similarly, medical personnel are increasingly well-versed in multiple areas of
I’ve discussed the spread of the Zaire ebolavirus before,
but as it continues to overwhelm countries in West Africa, scientists have been
able to track the virus in real time. A recent article
from NPR followed a team of researchers as they collected and analyzed data on
the genetic structure of the virus from its victims in Sierra Leone. As the
researchers monitored the ebola
spread, they noticed that it was rapidly mutating, “about twice as quickly as
it did while circulating among animals in the past decade or so.”
The data was collected onsite as soon as possible and,
according to the article, resulted in the death of five scientists who
contracted the virus. Despite this, the tremendous effort led to the gathering
of 99 ebola genomes for analysis.
While the virus’ genome contains only seven genes (relatively small in
comparison to the human genome’s 20,000), the article noted that the
researchers have already, “found over 250 mutations that are changing in real
time as we’re watching” -- a figure with significant implications for current treatments, which are experimental and rely on the known genetic makeup of the virus.
Meanwhile, men and women serving in healthcare facilities,
clinics or in collaboration with Doctors Without Borders are consistently
putting themselves at risk for the dangerous infection. These are nurses,
doctors and laboratorians alike -- both local and international. One particularly
brave group of workers heroes was highlighted in another NPR story,
which followed the people responsible for collecting and disposing of the
bodies of ebola victims in Liberia.
According to the story, the virus has already been
responsible for 700 deaths and over 1,300 cases. The corpses remain highly
contagious and can add to the already devastating rate of infection in
Monrovia. These crews of “body collectors” must gather the bodies to dispose of
them safely -- a task that carries unbelievable risks -- and prevent the
further spread of the virus. In order to prepare, each collector wears
protective gear, including surgical scrubs, rubber boots, white plastic
jumpsuits, face masks and goggles -- and they all pray for luck together before
Whether it’s the scientists working to analyze the virus in
the search for a cure or the hands-on professionals working with ebola on a day-to-day basis, their role is crucial. They are all
Lately, I find myself becoming a little jealous of bears.
That’s right, bears – but not for the reasons you might think. Sure, it’d be
great to hang out in creeks during the summer months, eating nothing but fresh
salmon and berries all day, every day. I guess it’d also be pretty fantastic to
be able to hibernate and sleep away the winter too, but a recent
blog post from NPR discussed some surprising physiological advantages of bears --
specifically in terms of their body’s response to their diet.
According to NPR blog, “Grizzly bears can easily double
their body fat in the months leading up to hibernation.” This kind of rapid
weight gain in humans can lead to any number of dangerous conditions, but the
post highlighted the development of insulin resistance leading to the
occurrence of type 2 diabetes. Insulin resistance occurs when the body is
forced to “produce more and more insulin to control blood sugar,” turning it
into fat. Eventually, the body becomes resistant. Type 2 diabetes is the result
of the pancreas shutting down insulin production as a result.
So, why doesn’t this happen to grizzlies? In the blog post,
a research team from Amgen Inc., led by Kevin Corbit, PhD, discovered that the
bears become more and less sensitive to insulin before, during and after
periods of hibernation. Kara Manke, the NPR blogger, wrote, “assuming that,
like humans, bears became less sensitive to insulin when they gained weight,”
the researchers subjected each of the six bears being monitored to a relatively
small (human) dose of insulin just before they were supposed to enter
hibernation. The results were almost catastrophic.
As it turns out, unlike humans, “the bears were actually most sensitive to insulin just before
hibernation, when they were at their largest.” So, the insulin nearly killed
them due to overdose. The researchers then hypothesized
on the changing nature of the bears’ insulin resistance. In the article, Corbit
noted that figuring out what allows the bears to regulate their insulin
sensitivity could also benefit people. The impact of this could have enormous
potential for patients with type 2 diabetes.
“I think giving insulin is making people much sicker,” said Corbit in the NPR
blog. “I’m hoping that whatever we find is going to ramp up the insulin
sensitivity enough that we don’t have to supplement with insulin at all.”
The Zaire ebolavirus
and the increasingly dire situation in West Africa have been all over the news
in recent weeks. Airports and hospitals in the United States are on high alert
for suspicious cases coming out of the region to prevent the potential spread
into a new country. According to a recent Perspective
article from the New England Journal of Medicine (NEJM), there are five
known species of ebolavirus. Each of the African strains vary in severity, with
the risk of fatality ranging from 40 percent to 70-90 percent (as is currently
the case with the Zaire ebolavirus)
in the African strains.
“There is currently no licensed prophylaxis or treatment for
any ebolavirus or marburgvirus infection; therefore, treatment is merely
supportive,” wrote Heinz Feldmann, MD, in the NEJM article.
In discussing the treatment of the Zaire ebolavirus, Feldmann pointed out several promising options
being considered, including antibody treatment, modulatory RNA, the
introduction of a synthetic molecule called BCX4430 and recombinant
technology-based vaccines. With no confirmed treatment available yet, however,
the primary focus has been on diagnostics for surveillance and confirmatory
testing. Antigen detection for more immediate diagnosis, antibody detection for
confirmatory results and molecular techniques like reverse-transcriptase-PCR allow
health and safety professionals to get control of a potentially dangerous
situation quickly. Like many other outbreak scenarios, Feldmann also noted the
importance of real-time information sharing for public health.
“The latest outbreak
of Zaire ebolavirus in West Africa
has shown the limited ability of our public health systems to respond to rare,
highly virulent communicable diseases,” continued Feldmann in the article. “The
medical and public health sectors urgently need to improve education and
The article went on to discuss the importance of rapid
diagnostic capabilities, “so that local public health systems do not have to
rely on distant reference laboratories.” In order to prepare before the occurrence
of any future outbreaks, Feldmann concluded that the need to approve a
treatment method is vital to “practice cutting-edge medicine, rather than
simply outbreak control.”
We’ve discussed mobile
medicine and hand-held
technology before, but a recent partnership
between drug manufacturer Novartis and internet juggernaut Google takes the
theory to a whole new level. The two companies announced their collaboration to
develop a smart contact lens to monitor blood sugar. Apart from the obvious
implications of a “smart” piece of technology as small as a contact lens, the
impact of results and information available “almost in real-time” could change
the way diabetic patients monitor their blood sugar.
“It’s not going to happen overnight,” said Joe Jimenez, CEO
at Novartis, in the New York Times
article. “This will take a few years, as opposed to a few months.”
As a manufacturer, Novartis would understand the challenges of
the development process better than most. The company had unsuccessfully
attempted to produce glucose-monitoring contacts before. The new smart lens, based
on Google’s prototype, utilizes “miniature sensors and a radio antenna thinner
than a human hair to track glucose levels.” Additionally, Jimenez pointed out that
the partnership with Google gave the project the technological step-ahead it
needed in order to develop a more effective prototype.
“One of the biggest hurdles was miniaturization, and that’s
one of the biggest benefits that Google X brings,” he continued. “This is a set
of engineers that are really doing incredible things with technology.”
While the “smart” contact lenses remain in early stages of
development, they represent a trend in healthcare towards personalized medicine
and interactive testing. According to the NY Times story, as the general
population continues to have a greater understand and, subsequently, take more
control over their health, the healthcare and pharmaceutical industries are
seeing an increased demand for improved medical technology. As of this year,
both Apple and Samsung also offer individual health-monitoring technologies.
In public comments presented to the CMS today, the American Clinical Laboratory Association (ACLA) provided input on various aspects of implementing relevant provisions of the Protecting Access to Medicare Act of 2014 ("PAMA"), which modifies the Medicare reimbursement rate methodology for lab services.
"ACLA supports a measured and thoughtful analysis as well as robust stakeholder engagement in order to guarantee the new fee schedule continues to ensure adequate access to lab services for Medicare beneficiaries," said Alan Mertz, ACLA president.
ACLA's comments primarily focus on the need for CMS to develop or clarify definitions of several key terms, determine when private payor rates must be reported and for what timeframe, build a technology platform capable of accepting millions of discrete pieces of data, and establish coding processes for certain new tests.
A key definition identified by ACLA in its comments was "applicable laboratory" and ensuring that this encompasses the true private market. ACLA pointed out that the text of the statute, as well as Congress' intent, reflects that all major sectors of the laboratory market should be represented in reporting private payor rates, including independent laboratories and hospital outreach laboratories.
The way in which CMS defines the parameters, participants, methods, and timeframes for lab services payment rate and volume reporting, ACLA notes, will have a substantial impact on the rates that the Medicare program pays for clinical laboratory tests. It also has the potential to impact other payors' rates, as many private payors and state Medicaid programs base their reimbursement levels on Medicare rates. ACLA asserts that Medicare rates for lab services are best determined when payment and volume data reflect true market rates for clinical lab testing.
"Modifying the Medicare payment system for clinical laboratory services is a complex undertaking and ACLA is committed to ensuring the end result works for clinical labs, CMS, and Medicare beneficiaries," said Mertz. "Decisions made during this process will have a major impact on the clinical laboratory industry and the patients we serve, and it is important that those decisions work to promote ongoing diagnostic innovations and protect access to critical lab testing for Medicare beneficiaries."
To view ACLA's comments in their entirety, click here.
Researchers from the Icahn School of Medicine at Mount Sinai
and Harvard Medical School recently discovered a connection between a form of
liver cancer and two mutations in the IDH gene. Intrahepatic cholangiocarinoma
(iCCA) is the second most common form of liver cancer. Although there had
previously been evidence of IDH mutations in patients with iCCA, this study
marks the first time the exact genes, IDH1 and IDH2, have been targeted and
identified specifically as a direct link. An story from Newswise
detailed the study and subsequent findings.
“Our findings provide novel insights into the development of
iCCA and offers a possible treatment option for patients suffering from this
fatal disease,” said Josep Maria Llovet, MD, director of the liver cancer
program at Mount Sinai’s Icahn School of Medicine, in the article.
The study demonstrated the effect of mutated IDH genes using
mice, showing a decrease in the liver’s ability to health itself and an
increase in “the number of cells to form a tumor. The gene mutations also
resulted in a relationship with the KRAS gene, which is known to be linked to
the development of cancer. The combination of these factors leads to formations
of malignant legions in a liver with weakened defenses and, eventually, iCCA. According
to the story, targeting IDH1 and IDH2 as pathways for iCCA has already resulted
in new clinical trials to determine their impact on iCCA patients.
“iCCA is resistant to standard treatments like chemotherapy
and radiation,” explained Llovet. “Understanding the molecular mechanism of the
disease is the key to finding a treatment that works.”
Although the article pointed out, “there is no first-line,
standard of care and no successful therapies” for patients with iCCA, the study
has provided a necessary first step in the development of a treatment for the
disease. The discovery has opened the door for further investigation into a
relatively mysterious cancer and could potentially lead not only towards a
broader understanding, but also a successful therapy.
The emergence of whole genome sequencing has certainly had an impact on both scientific research and clinical medicine, but there are still a few remaining hurdles preventing widespread use of the technology. While the ability to interpret the raw data provided by genetic testing relies on the computing power of laboratory instruments, few laboratories have the analytical equipment capable of that kind of speed. A recent news briefing from Dark Daily noted on recent study in which researchers at the University of Chicago, using software available to the public, successfully incorporated the “Beagle” Cray XE6 supercomputer in their genetic testing.
“Whole genome analysis requires the alignment and comparison of raw sequence data,” said Elizabeth McNally, MD, PHD, professor of medicine and human genetics and director of the cardiovascular genetics clinic at the University of Chicago’s School of Medicine, in the Dark Daily briefing. “[This] results in a computational bottleneck because of the limited ability to analyze multiple genomes simultaneously.”
According to the release, the research team was able to analyze 240 whole genomes simultaneously. Using the “Beagle,” for their study, titled “Supercomputing for the parallelization of whole genome analysis,” they looked at sequencing information from 61 patients -- which took less than 50 hours and only 25 percent of its total capacity. To put this into perspective, the Dark Daily briefing pointed out that, for a 2.1 GHz CPU, it would take “roughly 47 years to analyze the same data.” Because of this, most current laboratory practices simply analyze the human exome, which is comprised of only about 2 percent of the human genome responsible for protein coding. Although the briefing noted that this is considered to be the basis of 85 percent of “disease-causing mutations,” the ideal method for research would include the whole genome -- an approach that isn’t currently feasible for consistent use.
“By paying close attention to family members with genes that place then[m] at increased risk, but who do not yet show signs of disease, we can investigate early phases of the disorder,” continued McNally. “In this setting, each patient is a big-data problem.”
New screening technologies are continuing to improve the accuracy of testing technologies, but the laboratory’s ability to breakdown and investigate the results of those tests quickly and accurately is every bit as important. By successfully utilizing the “Beagle” supercomputer in the analysis of raw genetic data, the researchers at the University of Chicago have opened the door to improved options for understanding sequenced information. The potential of quicker interpretation capabilities in whole genome sequencing could lead to more standard genetic tests with faster turnaround times and, subsequently, a more cost-effective laboratory model.
A mouse is a mouse is a mouse is a mouse – or so the
research community had thought. As it
turns out, a major component has been missing from the majority of animal testing
for clinical drug production: more female animals. In a recent article
from the New York Times, experts in
the field discussed the importance of incorporating more female subjects into
clinical testing and the subsequent impacts of current, male-dominated models
on women in terms of side-effects after production.
“One of the underlying assumptions has been that females are
simply a variation on a theme, that it isn’t a fundamentally different
mechanism, that if you’ve learned about the male you’ve learned enough to with
both males and females,” said Jill Becker, PhD, a senior research scientist at
the University of Michigan, in the article. “We’ve discovered that’s not always
The use of male animals as the primary subjects in clinical
testing has resulted in some particularly harsh and often serious consequences
for women once a drug has already been in production due to different
physiological responses to a variety of treatments. An example of this is the
FDA’s recent warning for women to cut Ambien pills in half because the female
metabolic process in slower in processing the active ingredient. According to
the NY Times Piece, the NIH has new policies regarding male and female testing
scheduled to be introduced in October, with exceptions most likely to be made
for gender-specific ailments like prostate and ovarian cancers.
“Every cell has a sex,” explained Janine A. Clayton, MD,
director of the NIH office of research on women’s health, in the story. “Each
cell is either male or female, and that genetic difference results in different
biochemical processes within those cells.”
The article also predicted some resistance among scientists
in the research community due to additional strains the new regulations might
place on experiments as the inclusion of animals of both sexes could
potentially double the number of subjects needed to deliver the necessary
results. Additionally, the article noted scientists' concerns regarding the need
for more extensive calculations made to factor in changes in hormones and the
reproductive cycle. On the other hand, the long-term decrease in serious, potentially
harmful side effects of drugs incorrectly calibrated for women stands to
drastically improve the effectiveness of clinical medications.
Imagine adding letters to the alphabet. Suddenly after
centuries of working with 26 letters, there are just whole new possibilities
for different words and phrases that had never been explored before. How would
we use the new letters? As it turns out, research scientists at the Scripps
Research institute in La Jolla, CA have been asking themselves the same
question, but with a very different alphabet. According a recent article
from NPR, Floyd Romesberg, PhD, along with the rest of the researchers in the
department of chemistry, managed to introduce two new letters to the genetic
“This is the first time that people have integrated a truly
synthetic, manmade thing into the machinery -- in this case the most
fundamental aspect of the machinery, the DNA -- and used it do something that
system does, in this case store information,” said Romesberg in the NPR story. “And
obviously we can now store more information than we could before
Romesberg and the research team created two synthetic
letters in addition to A, C, T and G (adenine, cytosine, thymine, and guanine).
Not only were the new codes successfully introduced into the DNA of a strain of
E. coli, but they were duplicated as the cells multiplied, implying that the
codes could be passed down. Of course, the findings remain in the preliminary
stages of testing, but the prospect of new genetic combinations is especially
exciting in terms of its impact down the road.
“Maybe you get three consonants and one vowel. Maybe there
are some words you can write and you can string them together to make, sort of,
primitive stories,” continued Romesberg. “But if you could have a couple extra
letters, there’s more that you could write. Having the ability to store
increased information would allow you to write more interesting words, bigger
words, more complicated words, more nuanced words, better stories.”
While the team’s goal was simply to create fully integrated
coding for the storage of genetic information, the new letters were
intentionally left unreadable to the cells. According to the article, the next
step for researchers will be to use the manmade letters to “use it to do something
that a cell wouldn’t normally do -- like make a new kind of protein.” Along
with the potential for a more advanced ability to engineer functions at the
genetics level, the research could also provide additional insight on biology
and even “how life got started in the first place.”
It’s pretty widely agreed that stress can be unhealthy.
Whether it comes down to high blood pressure, muscle tension or simply having
trouble sleeping, the physical implications of stress can have physical
implications on an otherwise healthy lifestyle. In a recent press
release from Stem Cells Translational Magazine, researchers from both the
UC-Davis Institute for Regenerative Cures and California State University
examined the impact of stress in the healing process for chronic injuries and
afflictions in a study led by Roslyn Isseroff, MD, and Mohan R. Dasu, PhD.
“The precise process that prevents their healing is unclear
except for two constants: a prolonged inflammatory response and the bacterial
colonization of the wound bed,” said Isseroff. “These two interrelated factors
are thought to contribute to the wound’s chronic state.”
According to the release, the presence of a protein called
epinephrine (adrenaline) functions to start the process of healing by
increasing activity to TLR2. This allows inflation to occur and, as a result,
promotes healing. The presence of bacteria, however, can cause “crosstalk,”
disrupting the signals to epinephrine. In their study, the research team examined
how increased epinephrine and TLR2 as a result of elevated stress levels could
impact the stem cells and keratinocytes altered to help heal the wound, and
found that the crosstalk produced by the increase led to the impaired healing
of the injury.
“These findings have implications for understanding the
mechanism controlling the differing susceptibility to infections and immune/inflammatory-related
conditions in wounds,” commented Anthony Atala, MD, director of the Wake forest
Institute for Regenerative Medicine and editor of Stem Cells Translational
Medicine, in the release.
It’s important to remember to take a deep breath and relax
sometimes, otherwise those annoying injuries that just won’t seem to go away
might end up sticking around even longer. Not only is stress a mental strain,
but the physiological impact can be detrimental to the healing process. The “crosstalk”
seen in cell signals from increased stress can throw a wrench into the body’s
natural ability to heal itself.
Not only does Medical Laboratory Professional’s Week (MLPW)
celebrate the services provided by laboratorians throughout the year, but now
it provides a platform from which to educate the public about the roles of
these professionals and the potential for employment within the industry.
Originally part of the “COLA Cares” initiative, “Give Back Days” began during
MLPW 2011. In a recent interview with James Liggins, Chief Marketing Officer at
COLA, he described the intended purpose of the “Give Back Days,” as well as the
effect they have had on the industry overall.
“The reality is that, while job growth in this sector is
faster than average, clinical laboratories across the nation have reported
difficulties in recruiting new staff,” said Liggins. “This program is COLA’s
way of helping to alleviate that worker shortage in the future.”
After the initial success of the MLPW 2011 Give Back Day in
Baltimore, Md., COLA has continued the program annually, expanding to include
local high schools, community colleges, universities and other venues. As the
program has expanded, COLA staff members give presentations describing a day in
the life of the typical medical laboratory professional, demonstrate simple
laboratory tests and conduct fun experiments with participants.
“Our program now includes additional career presentations at
schools, science expos and other venues; mentoring opportunities for interested
students; and expanded scholarship support aid for students interested in
medical laboratory careers,” explained Liggins.
COLA’s Give Back Days feature a number of campaigns to
increase awareness of the laboratory’s role in the healthcare industry and
promote it as a viable career option. In addition to the outreach and
continuing education programs offered during Give Back Day, COLA also offers
scholarships to aspiring laboratorians and endowments to education programs
catering towards future medical laboratory technologists.
“We are also
launching a course for allied health professionals, emphasizing the components
of good clinical laboratory practices,” continued Liggins. “Designed for nurses
and other healthcare personnel who work in hospitals, clinics and physician’s
offices, the course will provide non-laboratorians with a basic knowledge of
quality laboratory testing procedures in healthcare settings.”
The course, “Fundamentals of Clinical Laboratory Testing,”
will be offered through Howard Community College’s continuing education
program. COLA hopes to expand the
program elsewhere throughout the U.S. in the future.
MLPW is a time to celebrate the work of laboratories across
the country, but why not use the spotlight to promote the profession among the
rest of the industry and potential co-workers? In addition to their Give Back
Days, COLA is also in the process of implementing “COLA Giving Back 365 Days a
Year,” which will expand on areas already covered and include a new disaster
relief program. AS Part of MLPW, COLA encourages laboratories everywhere to
take part in COLA’s Give Back program with a free kit offered on their website
Type 2 diabetes has been a growing concern in the United
States for several years. While the established research has pointed to two
specific hormones, glucagon and insulin, as the primary factors leading to the
development of the disorder in patients, researchers have discovered a third
key player in a recent news
release from Johns Hopkins. The Johns Hopkins scientists discovered that
Kisspeptin 1 (K1), a hormone typically associated with puberty and fertility,
directly influences and interferes with the production of insulin in the
“Glucagon and insulin alone never really made complete
sense,” said Mehboob Hussain, MD, lead investigator, endocrinologist and
metabolism expert at the Johns Hopkins Children’s Center. “There was always
something missing and, we feel, kisspeptin 1 is a very good candidate to be
that missing part. All of our findings point in this direction.”
According to the release, the general opinion prior to the
discovered impact of K1 was that the slow build-up of blood sugar due to
elevated levels of glucagon eventually tired out the pancreatic beta cells
responsible for insulin secretion. Instead, it seems that, rather than the
cells slowly wearing out, high glucagon triggers the production of K1, which
targets the cells and suppresses the secretion of insulin, leading to the high
blood sugar and low insulin levels associated with the disorder. In experiments
with human blood and liver cells and eventually mice, once the Johns Hopkins
researchers rendered their livers incapable of producing K1, the levels of
insulin and blood sugar returned to normal.
“Our findings suggest that glucagon issues the command, but
K1 carries out the orders,” explained Hussain. “And, in [doing so,] it appears
to be the very cause of the declining insulin secretion seen in type 2
Additionally, Hussain and his colleagues speculated that the
evolution of K1 arose from the need to prevent dramatic decreases in blood
sugar during fight-or-flight situations. This research, while still in its
preliminary stages, has offered a third key component in the assessment of type
2 diabetes and the possibility of a new method of treatment for the disorder. Rather
than treating as needed with the injection of insulin, the disorder could
potentially be cured by limiting and even eliminating the production of K1.
Regenerative medicine is a field that seems like something
right out of the pages of science fiction. In a recent study from the
University of Pittsburgh Medical Center (UPMC), researchers studied the effect
-- and subsequent success -- of stem cells derived from human muscle tissue in
repairing nerve damage in mice. A UPMC press
release detailed the study and speculated on the potential impacts to the
healthcare industry given the results of the experiment.
“This study indicates that placing adult, human
muscle-derived stem cells at the site of peripheral nerve injury can help heal
the lesion,” said Johnny Huard, PHD, senior author and professor of orthopedic
surgery, UPMC School of Medicine. “The stem cells were able to make
non-neuronal support cells to promote regeneration of damaged nerve fiber.”
According to the release, the study involved creating a
quarter-inch defect in the sciatic nerve of test mice and then treating with
“cultured human muscle-derived stem/progenitor cells” injected into the damaged
nerve. It noted that treatments for peripheral nerve damage have had limited
success so far, so the introduction of a successful treatment utilizing
regenerative medicine techniques is a promising start -- even if it was only in
the preliminary stages of testing. Not only did the treated mice experience
full regeneration in the nerve, but the study also found that the mice
eventually experienced a restored gait.
“Even 12 weeks after the injury, the regenerated sciatic
nerve looked and behaved like a normal nerve,” commented Mitra Lavasani, PHD,
assistant professor of orthopedic surgery at the UPMC School of Medicine and
author of the study. “This approach has great potential for not only acute
nerve injury, but also conditions of chronic damage, such as diabetic
neuropathy and multiple sclerosis.”
The ability to heal living organisms simply by using their
own biological materials puts modern science in view of fictional pipedreams. The
early success of tests incorporating regenerative medicine could potentially
make room for uses in healthcare for humans. The press release specified injury
repair and the developments of “delivery systems, such as gels,” and a
prospective next step in healing larger areas.