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Improved Stomach Cancer Chemotherapy

By MICHAEL SMITH, UPI.

Stomach cancer, long one of the most difficult cancers to treat, is yielding to new combination therapies, a new studyshows. "For most of the past century really," the only treatment for the disease was surgery, physician John Macdonald said Monday, and only about one in five patients was cured. But a new nine-year study of about 600 patients shows that a combination of surgery, radiation and chemotherapy increases survival by almost one-third, he told a plenary session of the American Society for Clinical Oncology here.
"We think we have a treatment that will cure significant numbers of patients with gastric cancer who would not otherwise be cured," he said in an interview. Macdonald, of Saint Vincent's Cancer Center in New York City, said his study offers the first progress "in a disease we didn't have good options for." In the study, half the patients, chosen at random, had standard treatment-- surgery to remove their cancer -- but no other therapy. The rest were given radiation and chemotherapy after surgery.
Macdonald said the chemoradiation group had "very significant benefits":
The time without disease increased on average to 30 months from 19 months and overall survival increased to 35 months from 26 month. In 1999, 21,900 new cases of stomach cancer were diagnosed and 13,500 people died of the disease, "so it's a significant health problem," Macdonald said. The stomach cancer study was among three other major reports presented here that should lead to improved treatment for prostate, kidney and breast cancer, their authors said. Suppressing male hormones for up to two years after radiation therapy ignificantly improves the outlook for men suffering from prostate cancer, even among high-risk groups, said physician Gerald Hanks of the Fox ChaseCancer Center in Philadelphia. Hanks said in an interview the five-year study of more than 1,500 patients means that long-term hormone suppression should be "the standard of care....This is the best current treatment for the problem." In the study, half the patients, chosen at random, had only radiation therapy, combined with four months of treatment with drugs that both suppress production of testosterone and prevent its from functioning.
The other patients were given an additional two years of a drug to prevent production of testosterone. Patients on long-term hormone suppression had increased time without a recurrence of the disease, reduced spread of the cancer and fewer deaths, Hanks said. It's too early to say what the overall survival rates will be, he said, but those will probably be improved as well. The treatment has serious side-effects, he said, including hot flashes, impotence, and loss of energy. "That's why it's important to have a real benefit or impact on the disease," he said.
In other reports: --Researchers from the Southwest Oncology Group said that removing a cancerous kidney and delivering an immune system booster, called interferon alpha 2b, increases survival time of 50 percent, compared with the immune therapy alone. In the largest study of its kind, 123 patients treated with the new approach live an average of 12 months, compared to an average of eight months for immune therapy alone. Lead researcher Robert Flanigan of Loyola University's Stritch School of Medicine said Monday there should be a shift toward the combined therapy for patients with advanced renal cancer.
--In early stage breast cancer, three months of a chemotherapy regime known as AC works as well as a six-month course of another widely-used treatment, according to a study from the National Surgical Adjuvant Breast and Bowel Project.
In the largest head-to-head study of the two therapies, researchers found that five-year disease-free survival and overall survival were about the same, no matter which treatment was used. The AC therapy uses two drugs, adriamycin and cyclophosphamide; the competing treatment uses the drugs
cyclophosphamide, methotrexate and flurouracil.
That means, lead author Bernard Fisher of the NSABP said Sunday, there should be a shift toward the AC treament, because it can save women three months of treatment.

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Lung Cancer Survival rates Improved
By MICHAEL SMITH, UPI

A drug derived from the needles of the European yew tree has helped to increase lung cancer survival rates five fold in a small study, researchers said Monday at a major cancer meeting.
Adding the drug docetaxel to a chemotherapy regimen increased survival rates to almost 50 percent from less than 10 percent, said David Gandara of the University of California at Davis.
"A two-year survival rate of 50 percent has never been achieved before," he told a press conference at the annual meeting of the American Society for Clinical Oncology in New Orleans.
Another study presented at the meeting showed that four of the newest chemotherapy approaches to lung cancer are roughly the same in terms of increasing patient survival, but all are better than drugs used a decade ago. "There are no clear winners" among the different approaches, which typically combine two anti-cancer drugs, said physician Joan Schiller of the University of Wisconsin. The study of more than 1,100 patients was the first to rigorously compare the various treatments, she said. The studies are important because lung cancer is "one of the most difficult cancers to successfully treat," said physician Frank Haluska of Harvard Medical School, who moderated the press conference on new approaches to the disease. Lung cancer kills about 160,000 Americans every year -- the leading cancer
killer -- even though it is third on the list of most common cancers, after prostate and breast.
Haluska said lung cancer is also important because it shares characteristics with many other types of cancer. "Strategies that we work out with lung cancer can be applied to other (cancers)," he said. In the docetaxel study, the researchers examined patients with a late-stage cancer, who were not considered good candidates for surgery because their disease had begun to spread. The current best treatment, he said, is radiation combined with the drugs cisplatin and etoposide. As a follow-up, patients are given two additional cycles of the drugs. The researchers substituted docetaxel for the additional cycles of cisplatin and etoposide, he said. The reasoning, he said, was that radiation therapy and the two other drugs require a gene in the tumor known as p53 to be normal in order to have an effect, while docetaxel does not. P53 is abnormal in more than half of all cancers. Gandara said the study, conducted by the Southwest Oncology Group and financed by the National Cancer Institute, is preliminary. It involved only 81 patients, all of who received the therapy, and there was no control group.
"We need to be cautious about being overly optimistic about these results,"Gandara said. But he added the current study is "well-matched" to an earlier study by his group of the standard therapy. That study showed a two-year survival rate of 34 percent.

Copyright 2000 by United Press International.
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Human DNA revelation draws nearer
LONDON, May 24 (UPI)

Scientists are nearing completion of the first draft of the human blueprint with work on assembling an estimated 3 billion letters that encode the instructions for human life, officials from two
research institutions said Wednesday.
"We are working toward achieving about 90 percent of the work by mid-June," Dr Wean Birney, a lead researcher at the European Bio-informatics Institute in Cambridge, England, told United Press International. Dr. Don Powell from the adjoining Sanger Centre, the UK's participant in the international Human Genome Project, told UPI that all the data would be made freely available immediately to start working on disease control worldwide.
"Our projection is that the nine sequencing centres will have passed the 90 percent mark by mid-June.
All the data is going to be there, as at present, freely available and working for people." Scientists said the publicly funded project was accelerated to match private and commercial work on the DNA code amid concerns that business interests were seeking to profit from the research.
The Human Genome Project is a publicly and charity-funded international project to write out all the letters in human DNA code, which would allow scientists to get a copy of all human genes. Results obtained by the scientists are published daily on the Internet, allowing medical researchers worldwide to have almost immediate free and unrestricted access to the DNA sequences.
This flow of information is seen as vital to advances in medical science, officials said.
Britain is contributing about a third of the global project, but about 60 percent of the work is under way at the Whitehead Institute, Mass., and other U.S. institutions. The remainder is carried out in France, Germany, Japan and China.
The Sanger Center is a part of the Wellcome Trust Genome Campus, which includes EBI, an outstation of the European Molecular Biology Laboratory and the UK Human Genome Mapping Project Resource Center. Main competition to the public project has come from a private company, Calera Genomics, which claims it has read all the letters in the code and is in the final stages of assembling them into the correct order.
Scientists said an announcement from the company could come any day. Both Barney and Powell refused comment on private sector motives for the DNA work, but industry sources said the research opened prospects for huge profits for participating companies.
"A number of companies have been making money from sequencing," Barney said. He said the research would enable medical scientists worldwide to react to individual patients. "It gives us the ability to find genes which indicate how a certain individual responds to certain drugs, such as in heart disease."
"Previously it would have been a lottery," he said. Genetic tests will highlight disease risk factors, allowing preventative action. Drugs will be individually tailored, drastically reducing side effects. And it may be possible to overwrite faulty genes, using gene therapy, short-circuiting many diseases at source.

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Pill-like camera view colon
SAN FRANCISCO (UPI)

A camera tiny enough to be swallowed may offer doctors a diagnostic view of the small bowel and colon, researchers report.
The pill-sized "capsule endoscope" transmits images from inside as it travels through the patient's body, a more pleasant prospect than the current method, called endoscopy, which entails insertion of tubular optical probing instruments into the patient's back passage, the investigators said.
The minuscule device, which may provide a less uncomfortable alternative, measures just 11 millimeters by 30 millimeters and comprises a video camera, light source and radio transmitter that sends pictures to a recorder carried by the patient, said Paul Swain of the Royal London Hospital in England, lead author of the study that will be published Thursday in the British journal Nature.
Once they swallow it, patients are oblivious to the presence of the capsule, which takes some 24 hours to make its way through the body before being discharged in stool, the scientists said.
The capsule's journey is recorded in transmitted images, its position calculated from the strength of its signal, the researchers said.
Clinical trials of the device will begin within the next two months in the United States, England and Israel and, if all goes well, the researchers hope to get regulatory approval from the Food and Drug Administration in the next year or so.
"Initially, it will be mainly used to examine the small bowel, especially in patients with bleeding," Swain told United Press International. "We hope that it may eventually replace a good many diagnostic endoscopy procedures which require large tube conventional endoscopes."
When approved, the technique would not replace therapeutic endoscopy, such as the removal of polyps and gallstones, which require the conventional method, at least for now, the scientists said.
While its cost has not yet been determined, the new disposable device could be kept in the inexpensive range if it were mass produced, scientists said.
The pill-sized video-camera incorporates a small light source and a tiny television transmitter and aerial. The radio-waves transmitted from the capsule inside the patient are beamed to an aerial on a belt fitted around the tummy and recorded on a device that resembles a portable stereo.
After six hours, the patient removes the belt and recorder, returning them to the doctor who downloads the images onto a computer work station and examines the movie in search of abnormalities. The images can be viewed in "real time" as the capsule makes its journey through the body or examined at
the work station at the end of the examination.
"They are moving images, but each frame is a still picture," Swain said. "The video camera, light source and radio transmitter are tiny and have been designed to fit into the capsule as well as the small silver-oxide batteries which power the device."
In the preliminary study of 10 volunteers, the device produced no side effects, could not be felt by the patients after it was swallowed and was found to be safe and as "easy and painless as swallowing an aspirin," the investigators said.
The researchers are now working to further refine the device, which, at this point, does not take biopsies and cannot be moved remotely or controlled once swallowed.

By LIDIA WASOWICZ
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STUDY SHOWS CANCER TARGET

Researchers have found a potential target for cancer therapy. It lies in a region in the telomerase enzyme, which can replenish the tips of chromosomes, called telomeres. These telomeres lose their ends with each cycle of cell division. The enzyme can replenish these lost pieces. Telomeres regulate a cell's lifespan. As they continue to shorten with each cell cycle, they finally reach a stage when they signal the cell to stop dividing. The cell then dies. In the new study, the scientists report in the journal Science that they found a small structure within the RNA molecule of yeast telomerase controls the precision with which the enzyme carries out this key function. This knowledge could one day be used to kill cancer cells, said senior study author Elizabeth Blackburn, professor of microbiology and immunology and biochemistry and biophysics at the University of California, San Francisco.
LIDIA WASOWICZ - UPI
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DRUG EASES OVERACTIVE BLADDER

Researchers report a capsule a day can keep bladder problems away. The results come from a large study of the investigational compound Detrol, which has been available in a twice-daily formulation. The trial shows the new once-a-day version of the drug reduced all major symptoms of overactive bladder, the scientists said at the 95th Annual Meeting of the American Urological Association in Atlanta. Overactive bladder affects 17 million Americans. Its symptoms include frequent urination and urgency to urinate. Since many people consider the condition an inescapable part of aging, only 5 percent to 10 percent of individuals with overactive bladder receive treatment. The study of 1,500 patients at 167 centers in North America, Europe and Australia showed the once-a-day capsule reduced incontinence and the urge to urinate, said Dr. Michael Chancellor, associate professor of urology at the University of Pittsburgh School of Medicine.
LIDIA WASOWICZ - UPI
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PILL TURNS 40


The "pill" is 40 and more popular than ever. The contraceptive, introduced May 9, 1960, is used by more than 100 million women. It is the most popular contraceptive method in 78 of 150 surveyed countries. The figures come from a report from the Johns Hopkins School of Public Health in Baltimore, Md. The report says the pill is used by some 12 percent of married women. "Taken regularly, the pill prevents pregnancy almost without fail. Pill users benefit in other ways, too, such as less anemia and protection from certain cancers," said lead study author Richard Blackburn. The current pill is safer than the original higher-dose contraceptive, which had been associated with increased risk of certain circulatory system diseases, the scientists said.
LIDIA WASOWICZ - UPI
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RESEARCHERS REVEAL STRUCTURE OF REOVIRUS


Researchers have determined the three-dimensional architecture of the core structure of the reovirus. This is a double-st randed RNA virus similar to the rotavirus that causes potentially lethal diarrhea in infants. The feat was achieved with a special technique called X-ray crystallography by a team at Children's Hospital in Boston and Harvard University. "This work will provide much insight," said Aaron Shatkin, director of the Center for Advanced Biotechnology and Medicine at Rutgers University in New Brunswick, N.J. The structure could serve as a model for related viruses found in nature. Understanding the mechanisms, such as how the microbes enter and infect cells, could lead to ways to stop the troublemakers dead in their tracks, researchers said.
LIDIA WASOWICZ - UPI
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Prostate Therapy Maintains Quality of Life


One year after 31 prostate-cancer patients underwent implantation of radioactive iodine, their
quality of life averaged the same or even slightly better than before the treatment. Wake Forest University researchers reported their findings, the first on the brachytherapy technique, at the American Urological Society meeting in Atlanta. Study leader Dr. Jeffrey Martin says brachytherapy, an outpatient procedure that places a radioactive source in or near a tumor, now appears to convey better quality of life than the two other common treatments-prostate removal and standard radiation-for early prostate cancer. His team used a quality-of-life questionnaire before implantation, then one, three, six and 12 months after. Scores on physical, functional, social, and emotional well-being dipped in the first month but gradually rose to meet or slightly exceed pre-brachytherapy scores.

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Most Ex-Football Players Report Having Concussions


If you are a professional football player there is likely to be a concussion in your future-or your past. In the first scientific survey of the health of retired National Football League players, researchers say that 60 percent of the 1,090 players surveyed said they had suffered at least one concussion, and 26 percent more than one. Dr. Barry Jordan, director of the Brain Injury Program at Burke Rehabilitation Hospital, White Plains, N.Y., says that among those who had suffered concussions, there were twice as many incidents of problems with memory and concentration, confusion, speech or hearing difficulties, headaches, numbness or tingling in hands or feet. While preliminary, scientists hope Jordan's findings may point the way toward understanding why some people who suffer head injury go on to develop neurological injuries and others do not. Jordan reported his study at an American Academy of Neurology meeting in San Diego.

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Drug Combats Common Pain in Diabetics

An experimental drug shows promise in treating painful diabetic neuropathy, a condition that severely impacts the quality of life for about 5 million people in the United States, researchers report at the annual meeting of the American Academy of Neurology. In the largest study of its kind, doctors say 44 percent of the 200 patients taking the drug memantine reported a reduction in pain associated with diabetes by 50 percent. Twenty-nine percent of 200 patients who took a placebo, or sugar pill, reported similar relief. Chief investigator Dr. Richard Pellegrino says about 40 to 50 percent of diabetics develop the neuropathy, which some describe as a sensation like sandpaper or burning-so intense that it can prevent sleep. Pellegrino, president of Central Arkansas Research Inc., Hot Springs, says few drugs can currently treat the condition. Memantine has been used in Europe for treatment of dementia and other degenerative diseases.

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Cloning makes cells younger


WASHINGTON, April 27 (UPI)
Cloning appears to turn back the clock for aging cells, and may increase the life span of cloned creatures, say Massachusetts researchers.
Their work contradicts findings by the Scottish pioneers who opened the cloning era with a sheep called Dolly. About two years ago, they made the disappointing discovery that their woolly celebrity had cells that appeared to be older than her years.
Scientists don't have a solid explanation for the difference between the two clones, but they think it may have something to do with slight variations in technique used by the Massachusetts team to clone six calves. It may also be a simple difference in the way species react to being cloned, other scientists say.
"If this increased life span at the cellular level extends to the whole animal, they could be extremely long-lived," says research leader Robert Lanza of Advanced Cell Technology (ACT), a biotechnology company in Worcester, Mass., referring to the calves in his study.
Human clones, he estimates, could live for two centuries, with chronic diseases not starting until 150. Childbearing could wait until middle-age or beyond, without the help of high-tech in vitro fertilization.
But he says the practical, immediate -- and most exciting -- impact of the work will be felt by researchers attempting to use cloning to create replacement tissues and organs for people whose bodies are sick or just old and worn out.
Any method to create replacement parts would rely on use of the patient's own cells to grow patches and perhaps whole replacement organs, he says.
This creates a problem. Since scientists are starting with cells as old as the patient, by the time these cells were grown into the needed part, it would be a like getting graft from a grandmother.
But, Lanza says his new study shows that cloning actually makes cells younger and lengthens their lifespan. So tissues made of cloned cells would be younger than the recipient.
Reporting in Friday's issue of the journal Science, the investigators say they created calf clones starting from very old cow cells, which were at the end of their life span. They had about one or two cell divisions left before they were to enter the twilight state known as cell senescence.
To their amazement, the scientists found that cells in their clones were seemed younger than those of newborn calves, even at about a year old, says Lanza. In the laboratory, cells from these animals lived twice as long as normal.
One sign of aging, a DNA structure at the tip of chromosomes known as a telomere, was actually 50 percent longer than in a normal animal, Michael West, president and CEO of ACT, told UPI.
Telomeres are DNA tags at the end of the chromosomes that function as a sort of cellular clock, getting shorter each time cells divide. When they become very short, the cell's machinery starts to break down, and the cells become bloated, sluggish and enter cell senescence, when they can no longer divide.
In another part of the experiment, the scientists took cells from cloned and normal fetal calves. On average, West says, the normal cow cells divided about 60 times, but the cloned cells divided about 90 times. Second generation cloned cells had even more staying power, dividing about 110 times, West said.
West says it will take at least five years to see if these lengthened telomeres translate a slower aging process, with fewer signs of old age cropping up, like loss of skin elasticity. It will take even long to prove that it all adds up to a doubled or tripled life span.
"We have to wait for these animals to grow old. It's like watching a candle burn," he said. Scientists have predicted that one problem with cloning would be that the cells of the replicas will be at least as old as the age of the mother organism, an idea that was supported by research on famed Scottish sheep Dolly.
Scientists examining her cells found clear signs of age beyond her years, most notably abnormally short telomeres. But, that does not mean that Dolly herself is old, says Thomas Okarma, president of Geron, which bought the company known as Roslin BioMed, the Scottish firm formed to commercialize the Dolly technology. Dolly has successfully given birth to normal lambs, suggesting that telomere length doesn't have a bearing on the animal's age. "We have no idea if, in our case, short sheep telomeres or, in their case, long cow telomeres have any impact on longevity," says Okarma. "I doubt they do."
Lanza believes the difference between the cells might be in the method of cloning that was used. In the Dolly experiment, he said that cells were starved to force them into a resting state thought to improve the process. Lanza's group did not force the cells into this state, and that may be the difference. Also Lanza's group used different kinds of cells than the Dolly cloners. Nevertheless, Lanza says he cannot say for sure what made the difference.
Other groups using the Dolly method have found shorter telomeres in cloned offspring, Lanza says. But a team of researchers in Hawaii, the first to successfully clone mice, also have seen longer telomeres in the offspring, says Lanza. This group used an approach similar to the Massachusetts work.
Lanza says his team is the first to report on the lengthened telomeres, but he expects see published support for his finding soon. Okarma, however, says the difference may just be related to species, sheep may react one way to cloning, while cows react another way. And, as far as humans are concerned, he says "There's no scientific rationale to take our sheep data or their cow data and apply it to humans." While he applauds the study itself, Okarma was critical of what some of the scientists were making of it. "I think the extensions and speculations that accompany the paper just aren't warranted."
Lanza was unwilling to speculate about the implications of the work in the area of pet cloning, already in the commercial realm with companies actively storing cells of beloved animals and millions of dollars invested into a project to duplicate a very special canine pal named Missy. A scientist with a Louisiana based start-up pet cloning company called Lazaron BioTechnologies says the research will eliminate one of the concerns expressed by his customers -- that their brand new cloned pet will start out old.
"They say, 'Yeah, we heard that Dolly was aging too fast because of her telomeres,'" says reproductive physiologist Brett Reggio, executive vice president and science director of the year-old firm, which offers cryopreservation of pet cells in anticipation of the day when cat and dog cloning becomes routine.
"That's great news," he said, referring to the study. "I guess you can teach an old dog cell a new trick." He said he doubted the research would one day translate into 50-year old pet dogs, but he added, "We never use the word 'impossible' anymore." --

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Key piece to lupus puzzle found

   

 SAN FRANCISCO, May 1 (UPI)

Researchers have been able to slow the progression of lupus in laboratory mice, a feat they say could pave the way

to novel treatments for a variety of autoimmune diseases in humans.

  The scientists found they could curtail symptoms and prolong life in mice

with the incurable disorder for which the cause and risk factors remain

unknown. They hope their work will one day lead to similarly successful

results in humans with lupus, rheumatoid arthritis, multiple sclerosis,

psoriasis, myasthenia gravis and perhaps even certain types of lymphatic

cancers.

  The advance "is a significant new piece of the puzzle that helps us

understand how the immune system is regulated and how it may go awry in a

way that contributes to autoimmune-like diseases," said Carl Ware, head of

the Division of Molecular Immunology at the La Jolla Institute for Allergy

and Immunology and professor of biology at the University of California, San

Diego.

  "This is a step forward in understanding lupus, but not a cure."

  Systemic lupus erythematosus affects more than 1 million Americans,

according to the Lupus Foundation of America. Some 200,000 of them progress

to a severe form of the disease that threatens organs, including the

kidneys, which can prove fatal in 10 percent to 20 percent of the cases.

  The disorder results when the body's disease-fighting immune system

mistakenly attacks its own healthy tissue, including the skin, joints,

lungs, blood, blood vessels, heart, kidneys, liver, brain and the nervous

system.

  Treatment, which has not fundamentally changed since the 1970s, includes

nonsteroidal anti-inflammatory drugs, such as ibuprofen; corticosteroids,

such as cortisone; anti-malarial drugs, such as Plaquenil, and

immunosuppressants or chemotherapy in the most severe cases, which may

produce debilitating side effects.

  Lupus is difficult to diagnose because it imitates numerous other

conditions, such as rheumatoid arthritis, scleroderma, mononucleosis,

malaria and autoimmune liver disease; affects many systems and organs;

develops slowly with symptoms coming and going over months or years, and has

no single test for positive identification.

  A new piece to the puzzle fell into place with the recent discovery of a

protein called BAFF, which leads to lupus-like symptoms in mice by causing

hyperactivity in the immune system's B cells. These cells produce antibodies

that attach to foreign matter and initiate the body's attack on the

potential troublemakers.

  In the latest advance, Jane Gross and colleagues of ZymoGenetics, Inc. in

Seattle, Wash., developed a specific antagonist for BAFF, called soluble

TACI receptor. In studies with autoimmune mice, they found their agent could

slow the progression of certain features of lupus. In mice treated with

TACI, the proportion of B cells declined, and the rodents suffered less

severe symptoms and lived longer than their untreated counterparts.

  "We have established an important relationship between TACI and SLE in

mice," said Gross, lead author of the study published in the British journal

Nature. "We can now examine the utility of the soluble TACI receptor as a

therapeutic for other autoimmune diseases."

  Since more than 50 different diseases appear to be associated with

overactive B cells, "it is reasonable to speculate that our soluble receptor

could have an effect on other autoimmune diseases and certain other diseases

involving B cell abnormalities, such as B cell lymphomas," Gross told United

Press International.

  "Our discovery that the soluble TACI receptor inhibits symptoms of

autoimmune disease provides further validation of our strategy, which

combines expertise in genomics and biology to turn novel proteins into

therapeutic candidates," said Bruce Carter, president and chief executive

officer of ZymoGenetics.

  It is too early to predict when, or if, the findings could lead to a

successful drug for humans, cautioned Gross and Charles Hart, senior

director of business development and strategic planning at ZymoGenetics.

  Further research is still needed to validate the initial results, the

scientists said.

  "This means more preclinical animal work that we hope will lead to

clinical trials in humans," Gross said. "Our ultimate goal would be to make

and sell a protein-based drug that will treat patients with a variety of

autoimmune diseases, but we have to obtain more experimental evidence before

we can say which patient populations would most benefit and whether the drug

is safe and effective."

  While the specially designed rodents used in the study do not mimic the

course of disease in humans perfectly, "the autoimmune diseases of rodents

provide good models for the same immunological processes that are involved

in human autoimmune diseases," Gross told UPI. "Our findings in this model

-- which has several features that emulate the development of spontaneous

autoimmune disease in humans -- are promising, and we will continue to

investigate the possible use of this treatment for human disease."  How

likely is it that a specific antagonist for the protein that leads to the

lupus-like syndrome in mice could potentially slow the progression of the

debilitating autoimmune disease in humans?

  "This is the question that biomedical researchers can now begin to answer,

but there is still quite a lot of basic research that needs to be done,"

said Ware, who wrote the accompanying News and Views article. "For instance,

are the levels of the cytokine BAFF high in patients with lupus? Is it the

same in all patients or do levels vary? The results in mice are promising

but far from definitive."

By Lidia Wasowicz,
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Preventing lung cancer in smokers

Researchers are reporting progress in developing a substance that might
prevent lung tumors in smokers.
Two substances fed to mice exposed to heavy cigarette smoke prevented lung
tumors when given in combination over an extended period of time, according
to a new study. When given together, myoinositol, which comes from cereal
bran, and dexamethasone, a steroid drug, were successful in protecting the
mice from developing cancerous lung tumors.
Unlike previous experiments, the research team from the University of
California in Davis, led by Hanspeter Witschi, exposed their male mice to
"whole" cigarette smoke rather than individual components -- such as
benzopyrene, or tar - which are believed to be carcinogenic.
Witschi said he envisions that myoinositol and perhaps inhaled steroids
might be key ingredients in "chemoprevention kits," to reduce smokers' risk
of lung cancer, much as people with asthma use inhalers. It is known that
smokers' risk of lung cancer continues for a while after they quit.
The team's experiment provides the first true animal model for testing
agents that could prove to be protective against lung cancer caused by
cigarette smoke, Witschi said. Previous experiments did not recreate a true
smoking situation in animals, he said, and results were ambiguous.
The results of the current experiment led Witschi and colleagues to
conclude that "whole" cigarette smoke contains carcinogenic elements in
addition to those identified as such. The study was published in the journal
Carcinogenesis, and supported by a grant from the National Institute of
Environmental Health Sciences at the NIH in Bethesda, Md.
Witschi's team exposed mice to tobacco smoke for five months, gave them
one of nine agents -- including aspirin and green tea -- to test their
ability to prevent lung cancer, and discovered that of nine, only the two in
combination were effective in preventing tumors. The mice had a five-month
rest period following exposure to the smoke.
Animals who lived in a smoke-filled environment had a lung tumor
incidence of 89 percent, and an average of 2.4 tumors per animal, which
dropped to 62 percent and one tumor per animal in those who then received
the myoinositol-dexamethasone therapy. The lower rates were almost identical
to those in animals never exposed to smoke.
Some other substances like green tea had been shown to prevent lung cancer
caused by one or more chemicals in tobacco smoke, but not against the
effects of whole tobacco, said Witschi.
"These results are very encouraging that a similar preventive regimen
could work in other mammals, including humans," said George Malindzak,
program director at the National Institute of Environmental Health Sciences
in Research Triangle Park, N.C. "There is no doubt that human clinical
trials will be done based on this work," he added. Malindzak hypothesized
that the two substances worked to reduce genetic mutations caused by smoke
that lead to the tumors.
By VICKIE BROWER, UPI

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Treat MS early, aggressively

SAN DIEGO, May 1 (UPI)
Treat multiple sclerosis early, and treat it with higher doses of medication.
That's the message of studies in which treatment of the progressive disease was delayed -- and maybe prevented -- with early use of drugs which have become mainstays of treatment.
In one major study presented at the annual meeting of the American Academy
of Neurology, Dr. Lawrence Jacobs, professor of neurology at the University
at Buffalo, New York, said treating patients at the first sign of multiple
sclerosis with the interferon beta-1a (Avonex, manufactured by Biogen,
Cambridge, Mass.) reduced by 43 percent the risk that the disease would
progress in these patients for at least three years.
The study was halted by the safety and monitoring committee in February
when it became apparent that people receiving treatment were faring better
in their disease than those receiving placebo.
Not only did the treatment reduce the risk that the disease would
progress, but Jacobs said, "There was a rapid onset of action that persisted
over the course of the study." He also said that the treatment of these
early patients seemed to be safe and well tolerated. Patients were selected
for the trial if they suffered a common symptom of multiple sclerosis,
usually vision problems. These patients then underwent magnetic resonance
brain imaging. If the MRI found evidence of brain abnormalities, the
patients were assigned to receive interferon or placebo. Jacobs and
colleagues at 50 medical centers in nine countries enrolled 383 patients in
the study.
Jacobs said he doesn't know if the people treated early will remain free
of disease progression further down the road, but he said a substantial
number of patients with early treatment remain free of further exacerbations
of MS for at least three years. MS affects 350,000 people in the United
States and more than 1 million people around the world.
In another study, Dr. Mark Freedman of Ottawa General Hospital reported
that treating patients with high doses of interferon beta-1a (Rebif,
manufactured by Ares-Serono) results in better outcomes than treating
patients with lower amounts of the drug.
"We can now see the superiority of high doses of interferon beta-1a in
slowing disease progression," Freedman said. The study reported at the
meeting was an extension of an earlier trial that suggested the higher dose
of the drug imparted greater benefit to patients. Freedman said the two-year
continuation of that trial showed that higher doses held off progression of
the disease. Although the same compound, Avonex, interferon beta 1a in an
intramuscular injection, is available in the United States; Rebif, which is
administered subcutaneously, is available in Canada and Europe.
In a third study, Dr. Donald Goodkin, medical director of the University
of California, San Francisco/Mt. Zion MS Center, reported results from a
940-patient trial in which interferon beta-1b (Betaseron, Berlex
Laboratories) was used to attempt to slow progression of disease in patients
with advanced MS.
Goodkin said that while the patients seemed to do better in most of the
clinical aspects of the study, there seemed to be no difference in slowing
the rate of progression. That seemed to differ from a similar study in
Europe in which use of interferon had an impact in slowing disease
progression.
Dr. Henry McFarland, chief of the neuroimmunology branch at the National
Institute of Neurological Disorders and Stroke, Bethesda, Md., said that in
analyzing the two studies it became apparent that patients in Europe tended
to be in an earlier stage of disease than those treated in the North
American study.
"Interferon may only have an effect on MS in patients in which there is
still active inflammation," he said. In advanced MS, inflammatory bouts of
the disease are diminished, although deterioration continues. McFarland said
that overall, the studies indicated that treating MS patients with the
interferon drugs earlier in the course of the MS seemed to be the right
direction.
By ED SUSMAN

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Breath test indicates safety of Cancer


UPI 26 April
By ELIZABETH MANNING,
A simple breath test can tell how safe an anti-cancer drug will be for a given patient, researchers say. The test for the drug docetaxel takes about 20 minutes, and accurately predicts how patients will react to the drug, according to a study released in the journal Clinical Cancer Research. Drugs used for chemotherapy are often highly toxic, says liver specialist Paul Watkins of the University of North Carolina at Chapel Hill, the inventor of the breath test and one of the authors of the study. He explains, "The amount of chemotherapy you need to give for maximum benefit yet not to get life-threatening toxicity variesfrom patient to patient." The key factor is not size or weight, but how quickly a particular patient's liver clears the drug from the system.
Watkins's test measures the amount of a docetaxel breakdown product, expelled as carbon dioxide in a chemotherapy patient's breath. He compares that value to that of a control dose, a harmless antibiotic that happens to use the same breakdown pathway. The published study concluded the breath test "was the best predictor" of clearing docetaxel in 21 patients.
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MAPS Accommodate Color-Blind


UPI 26 April
By ELIZABETH MANNING,
Color-coded maps can be a treasure trove of information, but not if you're among the 9 million Americans with some form of color blindness. Very few people actually see only in shades of gray --but 8 percent of men, for example, have trouble distinguishing red and green or blue and yellow. So Penn State geography professor Cynthia Brewer has developed color schemes that mapmakers can use to convey their same information without confusing the color-blind. Instead of blue, magenta, green, red-orange and yellow, she says, try a combination like blue, light green, greenish white, gray magenta and dark green. That's a scheme that either eliminates problem colors or clearly separates them with light and dark shades. Brewer explains that red-green color blindness, the most common form, is more than just confusing red and green. Related shades can be indistinguishable as well, and unpredictably: blue-green and purple, for example, or olive and rust. Brewer recently helped develop epidemiological
maps for the National Center for Health Statistics.
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Healthy food cuts Women's death risk

UPI 26 April
By ELIZABETH MANNING,
Women who eat lots of fruits, vegetables and grains and watch the sugar and fats may cut their risk of death from all causes by nearly a third. Data from more than 42,000 women were gathered by a research team led by Ashima K. Kant, of Queens College of the City University of New York, and Dr. Arthur Schatzkin, of the National Cancer Institute. The diet survey, published in the Journal of the American Medical Association, is the first to examine total eating patterns in a large number of women over a long period of time. Schatzkin says it is important because it shows how different nutrients appear to interact to produce good health, rather than focusing on a single diet factor, such as fiber. The list of 23 healthy foods included apples, cantaloupe, grapefruit, dried beans, tomatoes, spinach, mustard greens, sweet potatoes, lean-cooked chicken and fish, dark breads, and low-fat milk. Schatzkin does add that diet may not be the only factor for a long life, however. The women with better diets tended to be more educated and wealthier, meaning they might exercise more or have better access to medical care.
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Tender skin gives Migraine clue

UPI 26 April
By ELIZABETH MANNING,
A study of 42 migraine patients finds that 79 percent of them suffer extreme skin sensitivity during their pounding headache attacks. Lead investigator Rami Burstein says the discovery is the first human confirmation of an animal-based theory to explain ineffectiveness of current medications and to point to new targets for drug therapy. While hypersensitive skin -- too tender to tolerate hairbrushing, shaving or even the brush of a bed sheet -- probably sounds familiar to many migraine patients, the symptom has never been scientifically documented before, says Burstein. It suggests that pain signals sensitize fundamental spinal cord nerves as well as those around blood vessels in the head. Burstein, a pain researcher at Boston's Beth Israel Deaconess Medical Center, explains that current migraine drugs don't
act at the level of the spinal cord. He recommends patients take medication at the first signs of migraine, before spinal cord neurons become sensitized. The study is published in the Annals of Neurology.
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Updated 29 August 2005
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