Electric Sleep: The Gadgetry Tracking and Hacking The Way We Rest

As activity tracking goes mainstream, an arsenal of consumer technology is rolling out for sleep. But how much do these interventions help?

At 2.16am, I stumble to the bathroom. I catch a glimpse of myself. The light from the red bulb is flattering – I’ve been told to eliminate all blue light on my nocturnal trek – but the sleep-tracker headband, currently emitting the sound of gently lapping waves, kills any woke-up-like-this vibe. I adjust its double straps and feel my way back to bed.

The next time I wake is at 6.30am – after fractured dreams in which the Dreem 2 headband makes many cameos – to birdsong, also from the headband. When I check the app, I see I have slept six-and-a-half hours of my anticipated eight. Anxious to remedy this, I head out for my first coffee. In his new book Blueprint: Build a Bulletproof Body for Extreme Adventure in 365 Days, athlete Ross Edgley warns that this sort of overriding behaviour can bring about “biochemical bankruptcy”. Not now, Ross.

Health influencers like Edgley are all over sleep lately, and no wonder, when so many of us obsess over it. A 2021 report released by the Sleep Health Foundation estimates around one in 10 Australians have a sleep disorder, while a report from 2019 found that more than half are suffering from at least one chronic sleep symptom. Studies have suggested that sleep deficiency can lead to weight gain and a weakened immune system and that poor sleep patterns may contribute to later dementia risk.

In recent years, sleep-fretting has intersected with fitness-tracking, with the latest bio-hacks regularly featured on the podcasts of personal-development heavyweights such as Joe Rogan, whose Whoop Strap – worn around the wrist – told him he was getting four or five hours a night, not the seven or eight he’d thought; and Aubrey Marcus, whose Oura ring measures various biomarkers overnight and gives him a total score in the morning. “If I can get close to 80%, I’m golden for the day,” Marcus told the authors of My Morning Routine.

Wearables, such as watches, rings and headbands, appeal to those of us who enjoy geeking out on our stats, but could they also be cultivating anxiety and feeding into insomnia? Associate Prof Darren Mansfield, a sleep disorders and respiratory physician who is also deputy chair of the Sleep Health Foundation, thinks some balance is needed.

“These devices in general can be a good thing,” he says. “They’re not as accurate as a laboratory-based sleep study, but they are progressing in that direction, and technology enables the person to be engaged in their health. Where it can become problematic is people can become a bit enslaved by the data, which can lead to anxiety or rumination over the results and significance. That might escalate any problems, or even start creating problems.”

As a clinician, Mansfield thinks that the most useful role of these devices is monitoring routine, not obsessing over the hours of good-quality sleep. “There will be some error margin, but nonetheless when we’re looking for diagnostic information, like timing of sleep and duration of sleep, they can capture that,” he says.

Since Mansfield admits his sleep doesn’t need much hacking, I seek out an insomniac-turned-human guinea pig. Mike Toner runs the dance music agency Thick as Thieves, and has been on a mission for five years to fix the sleep issues earned from a decade of late nights in Melbourne clubs and reaching for his phone to answer international emails at 3am.

“I tried everything,” he says. “Magnesium capsules and spray, melatonin and herbal sleep aids. I even signed up for treatment at a sleep centre. You sleep in this room with all these wires connected to you, things coming out of your nose, cameras trained on you. Ironically, I slept better that night than I have any other night.”

He decided to start monitoring his body in earnest, learning about the latest devices from the Huberman Lab Podcast and The Quantified Scientist. Sleep-monitoring wearables have progressed from having an accelerometer to track movements which are fed through an algorithm to predict when a person is asleep, to being able to track sleep latency; sleep efficacy; heart-rate variability; light, deep and REM sleep and sleeping positions.

Toner’s accumulated a few as the technology becomes more sophisticated. He estimates having spent around $1,500 on them, and a further $3,500 for the sleep-centre treatment.

Then there are the cooling devices. Toner beds down on a Chilipad as soon as the weather gets warmer – a hydro-powered cooling mattress.

The idea is that lying down in a cool room – perhaps after taking a warm shower – tricks the body into slumber, since our body temperature drops when we’re asleep.

Non-techy strategies include having hands and feet out from under the covers, or using a fan. Lifestyle guru and entrepreneur Tim Ferriss recommends a short ice bath before bed. Be warned, though: Dave Asprey – founder of Bulletproof, which sells high-performance products – once tried putting ice packs on his body right before bed. As he told MensHealth.com: “I ended up getting ice burns on about 15% of my body.”

Mansfield says that ensuring you’re cooler in the evenings may help with sleep. “Generally, a lower-level temperature is better tolerated at night … 25C can make a beautiful, comfortable day, but can be unbearably hot at night when our own core temperature drops, so 18C or 19C is more tolerable.

“Then in the last two hours before getting up, your temperature rises again – you might have thrown off the blanket in the night and then might wake up at 5am feeling freezing cold.”

And what about the new frontiers of technology? According to neuroscientist Matthew Walker, in his influential book Why We Sleep, in the future, we can expect the marriage of tracking devices with in-home networked devices such as thermostats and lighting.

“Using common machine-learning algorithms applied over time, we should be able to intelligently teach the home thermostat what the thermal sweet spot is of each occupant in each bedroom, based on the biophysiology calculated by their sleep-tracking device,” Walker says. “Better still, we could program a natural circadian lull and rise in temperature across the night that is in harmony with each body’s expectations.”

Mansfield thinks this kind of integration is feasible, and that a thermostat linked to a device measuring circadian rhythms offers plausible benefits in preparing people’s sleep, but he predicts that automated control of room lighting will wind up being manually overridden, because technology can’t necessarily gauge when we’re in the middle of reading a book or having a conversation. “It’s liable to just irritate people,” he says. He’s more interested in technology that will track conditions like sleep apnoea.

As Toner has concluded, no device is a silver bullet. Ultimately, it was a $70 online cognitive behavioural therapy (CBT) course that his GP referred him to that fixed his sleep over three months of strict adherence. Now he just uses technology to make sure he’s not drifting off track.

The key lessons? Only use your bedroom for sleep and sex. Set your alarm for the same time, no matter how late you get to bed. Screens off early. No day-napping. Alcohol is a bad idea. All of these things are easily monitored yourself using a good old notebook, and they don’t cost a cent. They just take persistence.

With those good habits in place, Toner is now mindful of how he will put the CBT pointers he’s learned during lockdowns into practice once his life picks up its pace again.

“I used to put this obligation on myself to be there all the time with my artists, but interestingly, coming out of this pandemic, a lot of the artists are having the same train of thought as I am, wanting to avoid late nights,” Toner says.

He’s even coaching some of them for a charity run – quite the lifestyle change for many. “I’ve spent so long fixing this that one of the things I’ve realized, when we eventually go back to work routines, is I’m going to be fiercely protective of my sleep.

By:

Source: Electric sleep: the gadgetry tracking and hacking the way we rest | Sleep | The Guardian

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Scientists Must Speak Out Against Misinformation About Immune Boosting Supplements

The COVID-19 pandemic saw huge increases in searches for immunity boosters, including for things like supplements claiming to improve immune function. But even before COVID-19 scared people into their nearest supermarket aisle, “wellness” through supplements was a multi-billion dollar industry.

Celebrities and influencers across social media platforms regularly advertise and promote a myriad of supplements to improve health and the immune system. However, there are some major problems with these claims — namely, vitamin companies are not regulated by the Food and Drug Administration (FDA) as drugs, and many supplements don’t work as claimed.

Unlike pharmaceuticals, which must undergo clinical trials that are reviewed by the FDA for the product’s safety and efficacy, dietary supplements have a less stringent path to market shelves. Even though they are most often found in or next to the store pharmacy, dietary supplements are regulated as food, not as drugs. This means that they have not been evaluated or proven effective.

Furthermore, while the manufacturer must prove the ingredients are “reasonably safe”, none of these products are formally “approved” by the FDA. But these supplements are not always inherently harmless options for people trying to live a healthy lifestyle. A 2015 study concluded adverse effects from dietary supplements caused an “estimated 23,000 emergency department visits in the United States every year.”misperception

Despite these risks, there has been an unfortunate absence of expert voices contesting supplement company claims with real data. “There needs to be a more robust response from the science community in the face of pseudoscience and misinformation,” says Tim Caulfield, a professor of health law at the University of Alberta, who has worked on studies and books examining ads and posts claiming to support the immune system on social media.

He explains that supplement marketing often builds on the common misperception that if the right amount of a vitamin is good for you, more is better. “That’s not the case at all,” he says. On the topic of supplement misinformation, Pieter Cohen, an associate professor of medicine at Harvard Medical School and a general internist at Cambridge Health Alliance, says, “The main problem is that the law permits companies to promote supplements as if they have important benefits for health even if there has never been a single study in humans to study the product’s efficacy or safety.”

Indeed, dietary supplements are not required to be reviewed by the FDA before they are distributed because they are not considered medications. Vitamins say right on the bottle that their claims “have not been reviewed by the FDA.” Instead, they are predominantly regulated by the Federal Trade Commission, or FTC, which monitors the claims the labels make; however, this is limited to ensuring that the supplement makers are not explicitly claiming the product can be used as a treatment.

The FTC does allow companies to suggest a range of benefits their products provide, which may be why up to 70 percent of adults in the United States take at least one dietary supplement daily, with the most common reason being to try to maintain or improve their health. While some individuals with specific vitamin deficiencies may benefit from these products (under a doctor’s supervision), most of us do not. However, those marketed as “immune boosters” or “immune boosting” are more problematic.

Despite suggestive labels, there is no way to “boost” the immune system. The immune system is a complicated and dynamic network of cells, proteins, hormones, and other biological components. Even if it were possible to ratchet up such a complex system, you wouldn’t necessarily want to, because the immune system operates primarily by inducing inflammation. This alerts various immune cells to mobilize and fend off danger.

In moderation, this is perfectly healthy, and the system has a braking mechanism all its own. But if a product were to truly “boost” the immune system, this mechanism would be amplified. We know what too much inflammation looks like: autoimmune disorders, inflammatory disease, and allergies.

Ironically, in some cases, products heralded to improve immune function can actually suppress it. Take vitamin D, touted for its ability to enhance “immunity.” While it may increase the inflammatory response, it has been shown to actually reduce the activity of other cell types—namely T cells, which are critical in forming long-term memory. The same is true of many other popular supplements, such as zinc, when a person takes substantially more than the recommended daily amount.

Supplements can be actively harmful in other ways too. Since supplements aren’t regulated by the FDA, they aren’t evaluated for safety in the same way as pharmaceuticals. Of course, the manufacturers cannot knowingly use or include compounds that are known health hazards — legislation from 1994 dictates that ingredients used in supplement products must not have been shown to cause harm.

But that doesn’t mean these products aren’t without yet unrecognized risks. “I think one of the biggest things that gets overlooked is the potential for a drug-drug interaction,” says Dr. Kathryn Nelson, a medicinal chemist at University of Minnesota. Physicians need patients to disclose what supplements they are using, including multivitamins, because they might interact with prescribed medications.

From inactivating a pharmaceutical prescription, to dangerously exacerbating its effects, these products can have significant consequences. Yet many patients do not disclose or discuss their supplement use with their healthcare providers, due to their misguided perception that vitamins are safe or not worth mentioning.

Additionally, the active ingredient in vitamins must be either be purified from a natural source or synthesized in a lab, and both methods have the potential for carry-over from compounds used in these methods. Such contamination is called “residual complexity,” Nelson says.

This is particularly concerning when heavy metals are used and possibly present in the final product. In pharmaceutical drugs, these compounds would usually go to clinical trials, and any potential introductions of heavy metals removed in what’s called “process chemistry” to gain FDA approval. But the purification process of supplements are not reviewed by the FDA. This has opened the door for potential contaminants-heavy metals as well as other drugs and even pathogens-into these products.

Given all of this negative and even contradictory information about these products, why is the supplement market a multi-billion dollar industry? Much of the answer lies in its advertising. Companies often collaborate with social media influencers, who talk up how great the product is. And despite thousands of scientists across the country with expertise in nutrition and immunology, experts rarely publicly contradict these statements.

Science communication is an important part in the scientific process. However, more often than not, important conversations happen only with other scientists at scientific conferences, or in journals behind paywalls. As a result, the larger non-expert community is left in the dark. Daniel Pham, the associate director of the Milken Institute’s Center for Strategic Philanthropy, wrote an essay in 2016 which detailed the lack of support for science outreach by scientists, and an absence of communication training.

Almost five years later, he says, “The same issues have resonated with me even more in the times of COVID. I feel like there’s a bigger sense of the need for improved communication of science to the public. But the tools we’re using are just woefully inadequate.” The evidence of his statement can be seen in a recent study by Arizona State University, which showed the majority of scientists believe that it is important to inform and engage the general public about science topics.

However, when asked about their personal interest or intentions of doing this, the answers are less enthusiastic. Often scientists are not encouraged or even rewarded for public outreach, which doesn’t aid securing funding, publishing, or gaining tenure. One possible solution might be to reform the funding and promotion institutions so they reward researchers for this kind of public service.

However, scientists should also not anticipate their feedback will be immediately accepted based on their resumes. As Nelson points out, the first step in improving the public’s access to verified information is building trust with experts. That includes breaking down the stigmas surrounding what it means to be a scientist, and making expertise more accessible.

A recent example is the initiative Science on Tap, where a scientist describes their research in general terms to patrons at a local bar or venue. Pham has also started a similar effort at Johns Hopkins University, called Project Bridge, bringing small, introductory science demonstrations to public spaces such as farmer’s markets. Specific tactics to counter supplement marketers could also include partnering with influencers who are willing to share verified research, as well as lobbying for legislative reform.

The supplement industry is a prime example of the dangers of misinformation, which is damaging to both science and the public at large. Cohen notes that the next steps are to urge the FDA and FTC to enforce existing laws prohibiting the promotion of products with disease claims, in an attempt to get them off the shelves. In the long-term, he notes the existing law on these products needs to be reformed so that “all products [are] registered with the FDA.”

Scientists and researchers have the expertise to get information to the public and enact policy change. But it will require getting creative. “A lot of the misinformation really has become a social media story,” Tim Caulfield says, “so we need to go to where the misinformation resides.” Scientists, he adds, “need to find their own voice.

By Shelby Bradford

Source: Scientists must speak out against misinformation about “immune-boosting” supplements | Salon.com

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U.S. Set To Recommend Booster Covid-19 Vaccine Dose For Most People, Reports Say

U.S health officials are expected to recommend Covid-19 vaccine booster doses for Americans across all eligible age groups eight months after they received their second vaccine dose, to ensure lasting protection against the coronavirus as the more infectious delta variant spreads across the country partially blunting the efficacy of existing vaccine regimens.

According to the Associated Press, health officials could announce the booster recommendation as soon as this week, just a few days after an additional vaccine dose was recommended for people with weakened immune systems.

The Biden administration could then begin rolling out the third shots as early as mid-to-late September, the New York Times reported, citing unnamed officials.

The first booster shots will likely be administered to nursing home residents, health care workers and elderly Americans who were among the first people in the country to be inoculated.

The Associated Press notes that the formal deployment of the booster doses can only take place after the vaccines have been fully approved by the Food and Drug Administration—an action that is expected for the Pfizer jab in the next few weeks.

The Food and Drug Administration is expected to fully approve the Pfizer vaccine in the coming weeks which will formally open the door for it to be offered as a booster to millions of Americans who have already received two vaccine doses.

Big Number

59.4%. That’s the percentage of the eligible U.S. popuplation (12 years of age and older) that has been fully vaccinated against Covid-19, with 70% receiving at least one dose, according to the CDC’s tracker.

Surprising Fact

An estimated 1.1 million people have already received an unauthorized booster dose of the Moderna or Pfizer vaccine, ABC News reported last week, citing an internal CDC document reviewed by the broadcaster. The number is likely an undercount as it only accounts for people who received a third dose of an mRNA vaccine but does not count those who may have received a dose of the one-shot Johnson & Johnson vaccine and then received a second dose of either the Moderna or Pfizer vaccines.

Key Background

Last week, the U.S. Food and Drug Administration approved a booster dose of the Covid-19 vaccines made by Pfizer and Moderna for people with compromised immune systems. The targeted move was aimed at providing better protection for people who have undergone solid organ transplants or those diagnosed with conditions that are considered to be immunocompromised.

Unlike the eight-month gap being proposed for booster doses for the general population, immunocompromised patients can receive their third dose as early as 28 days after their second shot. The FDA’s decision followed similar moves undertaken by Israel, France and Germany who began administering an additional dose to vulnerable populations amid the threat of the more infectious delta variant of the virus.

Contra

As the more infectious delta variant of the coronavirus takes hold across the U.S. questions about the effectiveness or even the necessity of a booster dose remain unanswered. While some vaccines are slightly less effective against the variant, it is still unclear if protection against more severe disease and hospitalizations have been impacted significantly as well.

This makes any decision to authorize booster doses remains a controversial one in the global context as critics decry the fact that developed nations are administering an additional dose at a time when several poorer nations have limited access to vaccines. Earlier this month, the World Health Organization (WHO) called for a moratorium on Covid-19 vaccine booster shots until at least the end of September.

Further Reading

U.S. to Advise Boosters for Most Americans 8 Months After Vaccination (New York Times)

US to recommend COVID vaccine boosters at 8 months (Associated Press)

More Than 1 Million Have Received Unauthorized Third Dose (WebMD)

FDA Authorizes Extra Covid-19 Vaccine Dose For Those With Weakened Immune Systems (Forbes)

How Good Are Covid-19 Vaccines At Protecting Against The Delta Variant? (Forbes)

I am a Breaking News Reporter at Forbes, with a focus on covering important tech policy and business news. Graduated from Columbia University with an MA in Business and Economics Journalism in 2019. Worked as a journalist in New Delhi, India from 2014 to 2018. Have a news tip? DMs are open on Twitter @SiladityaRay or drop me an email at siladitya@protonmail.com.

Source: U.S. Set To Recommend Booster Covid-19 Vaccine Dose For Most People, Reports Say

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More Contents:

COVID-19 Did Not Affect Mental Health the Way You Think

You’ve probably heard that the coronavirus pandemic triggered a worldwide mental-health crisis. This narrative took hold almost as quickly as the virus itself. In the spring of 2020, article after article—even an op-ed by one of us—warned of a looming psychological epidemic.

As clinical scientists and research psychologists have pointed out, the coronavirus pandemic has created many conditions that might lead to psychological distress: sudden, widespread disruptions to people’s livelihoods and social connections; millions bereaved; and the most vulnerable subjected to long-lasting hardship. A global collapse in well-being has seemed inevitable.

We joined a mental-health task force, commissioned by The Lancet, in order to quantify the pandemic’s psychological effects. When we reviewed the best available data, we saw that some groups—including people facing financial stress—have experienced substantial, life-changing suffering. However, looking at the global population on the whole, we were surprised not to find the prolonged misery we had expected.

We combed through close to 1,000 studies that examined hundreds of thousands of people from nearly 100 countries. This research measured many variables related to mental health—including anxiety, depression, and deaths by suicide—as well as life satisfaction. We focused on two complementary types of evidence:

Surveys that examined comparable groups of people before and during the pandemic and studies tracking the same individuals over time. Neither type of study is perfect, but when the same conclusions emerged from both sets of evidence, we gained confidence that we were seeing something real.

Early in the pandemic, our team observed in these studies what the media was reporting: Average levels of anxiety and depression—as well as broader psychological distress—climbed dramatically, as did the number of people experiencing clinically significant forms of these conditions.

For example, in both the U.S. and Norway, reports of depression rose three-fold during March and April of 2020 compared with averages collected in previous years. And in a study of more than 50,000 people across the United Kingdom, 27 percent showed clinically significant levels of distress early in the pandemic, compared with 19 percent before the pandemic.

But as spring turned to summer, something remarkable happened: Average levels of depression, anxiety, and distress began to fall. Some data sets even suggested that overall psychological distress returned to near-pre-pandemic levels by early summer 2020. We share what we learned in a paper that is forthcoming in Perspective on Psychological Science.

We kept digging into the data to account for any anomalies. For example, some of the data sets came disproportionately from wealthy countries, so we expanded our geographic lens. We also considered that even if the pandemic didn’t produce intense, long-term distress, it might have undercut people’s overall life satisfaction. So, members from our team examined the largest data set available on that topic, from the Gallup World Poll.

This survey asks people to evaluate their life on a 10-point scale, with 10 being the best possible life and zero being the worst. Representative samples of people from most of the world’s countries answer this question every year, allowing us to compare results from 2020 with preceding years. Looking at the world as a whole, we saw no trace of a decline in life satisfaction: People in 2020 rated their lives at 5.75 on average, identical to the average in previous years.

We also wondered if the surveys weren’t reaching the people who were struggling the most. If you’re barely holding things together, you might not answer calls from a researcher. However, real-time data from official government sources in 21 countries showed no detectable increase in instances of suicide from April to July 2020, relative to previous years; in fact, suicide rates actually declined slightly within some countries, including the U.S. For example, California expected to see 1,429 deaths by suicide during this period, based on data from prior years; instead, 1,280 occurred.

We were surprised by how well many people weathered the pandemic’s psychological challenges. In order to make sense of these patterns, we looked back to a classic psychology finding: People are more resilient than they themselves realize. We imagine that negative life events—losing a job or a romantic partner—will be devastating for months or years. When people actually experience these losses, however, their misery tends to fade far faster than they imagined it would.

The capacity to withstand difficult events also applies to traumas such as living through war or sustaining serious injury. These incidents can produce considerable anguish, and we don’t want to minimize the pain that so many suffer. But study after study demonstrates that a majority of survivors either bounce back quickly or never show a substantial decline in mental health.

Human beings possess what some researchers call a psychological immune system, a host of cognitive abilities that enable us to make the best of even the worst situation. For example, after breaking up with a romantic partner, people may focus on the ex’s annoying habits or relish their newfound free time.

The pandemic has been a test of the global psychological immune system, which appears more robust than we would have guessed. When familiar sources of enjoyment evaporated in the spring of 2020, people got creative. They participated in drive-by birthday parties, mutual-assistance groups, virtual cocktail evenings with old friends, and nightly cheers for health-care workers.

Some people got really good at baking. Many found a way to reweave their social tapestry. Indeed, across multiple large data sets, levels of loneliness showed only a modest increase, with 13.8 percent of adults in the U.S. reporting always or often feeling lonely in April 2020, compared with 11 percent in spring 2018.

But these broad trends and averages shouldn’t erase the real struggles—immense pain, overwhelming loss, financial hardships—that so many people have faced over the past 17 months. For example, that 2.8 percent increase in the number of Americans reporting loneliness last spring represents 7 million people. Like so many aspects of the pandemic, the coronavirus’s mental-health toll was not distributed evenly.

Early on, some segments of the population—including women and parents of young children—exhibited an especially pronounced increase in overall psychological distress. As the pandemic progressed, lasting mental-health challenges disproportionately affected people who were facing financial issues, individuals who got sick with COVID-19, and those who had been struggling with physical and mental-health disorders prior to the pandemic.

The resilience of the population as a whole does not relieve leaders of their responsibility to provide tangible support and access to mental-health services to those people who have endured the most intense distress and who are at the greatest ongoing risk.

But the astonishing resilience that most people have exhibited in the face of the sudden changes brought on by the pandemic holds its own lessons. We learned that people can handle temporary changes to their lifestyle—such as working from home, giving up travel, or even going into isolation—better than some policy makers seemed to assume.

As we look ahead to the world’s next great challenges—including a future pandemic—we need to remember this hard-won lesson: Human beings are not passive victims of change but active stewards of our own well-being. This knowledge should empower us to make the disruptive changes our societies may require, even as we support the individuals and communities that have been hit hardest.

By: Lara Aknin, Jamil Zaki, and Elizabeth Dunn

Lara Aknin is a psychology professor at Simon Fraser University and the chair of the Mental Health and Wellbeing Task Force for The Lancet’s COVID-19 Commission. Jamil Zaki is a professor of psychology at Stanford University and the director of the Stanford Social Neuroscience Laboratory. He is the author of The War For Kindness: Building Empathy in a Fractured World. Elizabeth Dunn is a psychology professor at the University of British Columbia and a co-author of Happy Money: The Science of Happier Spending.

Source: COVID-19 Did Not Affect Mental Health the Way You Think – The Atlantic

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Critics:

The COVID-19 pandemic has impacted the mental health of people around the world. Similar to the past respiratory viral epidemics, such as the SARS-CoV, MERS-CoV, and the influenza epidemics, the COVID-19 pandemic has caused anxiety, depression, and post-traumatic stress disorder symptoms in different population groups, including the healthcare workers, general public, and the patients and quarantined individuals.

The Guidelines on Mental Health and Psychosocial Support of the Inter-Agency Standing Committee of the United Nations recommends that the core principles of mental health support during an emergency are “do no harm, promote human rights and equality, use participatory approaches, build on existing resources and capacities, adopt multi-layered interventions and work with integrated support systems.”COVID-19 is affecting people’s social connectedness, their trust in people and institutions, their jobs and incomes, as well as imposing a huge toll in terms of anxiety and worry.

COVID-19 also adds to the complexity of substance use disorders (SUDs) as it disproportionately affects people with SUD due to accumulated social, economic, and health inequities. The health consequences of SUDs (for example, cardiovascular diseases, respiratory diseases, type 2 diabetes, immunosuppression and central nervous system depression, and psychiatric disorders) and the associated environmental challenges (e.g., housing instability, unemployment, and criminal justice involvement) increase risk for COVID-19.

References

The Cancer Custodians Hidden Truths

woman-with-headscarf-getting-chemo-treatment-article

Part of Dennis Plenker’s daily job is growing cancer. And a variety of different ones, too. Depending on the day and the project, different tumors may burgeon in the petri dishes stocked in the Cold Spring Harbor Laboratory where Plenker works as a research investigator. They might be aggressive breast cancers.

They might be glioblastomas, one of the deadliest brain tumors that rob patients of their ability to speak or read as they crowd out normal cells. Or they might be pancreatic cancers, the fast and vicious slayers that can overtake a healthy person within weeks or even days.

These tiny tumor chunks are transparent and bland—they look like little droplets of hair gel that accidentally plopped into a plastic dish and took hold. But their unassuming appearance is deceptive. If they were still in the human bodies they came from, they would be sucking up nutrients, rapidly growing and dodging the immune system defenses.

But in Plenker’s hands—or rather in the CSHL’s unique facility—these notorious killers don’t kill anyone. Instead, scientists let them grow to devise the most potent ways to kill them. These tumor chunks are called organoids. They are three-dimensional assemblages of malignant growths used to study cancer behavior and vulnerability to chemotherapy and the so-called “targeted drugs”—the next generation therapies.

Scientists used to study tumors at a single-cell level, but because tumors grow as cell clusters in the body, it proved to be inefficient. The three-dimensional structures make a difference. For example, chemo might destroy the tumor’s outer cell layer, but the inner ones can develop resistance, so where single cells may die, a 3D mass will bounce back. Organoids can provide a window into these little-known mechanisms of drug resistance.

They can reveal how normal tissues turn malignant and where the cellular machinery goes off-track to allow that to happen. As their name suggests, organoids are scientists’ windows into organs, whether healthy or stricken with disease. You need to know your enemy to beat it, Plenker says, and cancer organoids offer that opportunity.

Taken from patients currently undergoing cancer treatments, these tumor chunks will reveal their weaknesses so scientists can find the cancers’ Achilles’ heel and devise personalized treatments. “Organoids are essentially patients in a dish,” Plenker says. Only unlike real patients, the organoids can be subjected to all sorts of harsh experiments to zero in on the precise chemo cocktails that destroy them in the best possible way.

And they will likely provide a more realistic scenario than drug tests in mice or rats, as animal models aren’t perfect proxies for humans.

These notorious killers don’t kill anyone. Instead, scientists devise the most potent ways to kill them.

The way that cancer proliferates in the body is hard to reproduce in the lab. Stem-cell research made it possible. After scientists spent a decade understanding how various cells multiply and differentiate into other cell types based on molecular cues and nourishment, they were able to make cells grow and fuse into tissues.

To stick together like bricks in a nicely laid wall, cells need a biological scaffold that scientists call an extracellular matrix or ECM, which in the body is made from collagen and other materials. Today, the same collagen scaffolds can be mimicked with a gooey substance called Matrigel—and then seeded with specific cells, which take root and begin to multiply.

Some tissue types were easy to grow—Columbia University scientists grew viable bones as early as 2010.1 Others, like kidney cells, were trickier. They would grow into immature tissues incapable of performing their job of cleaning and filtering blood. It took scientists time to realize that these cells wanted more than scaffolding and food—they needed to “feel at home,” or be in their natural habitat. Kidney cells needed the feeling of liquid being washed over them, the Harvard University group found, when they first managed to grow functioning kidney tissue in 2018.2

Cancers have their own growth requirements. In the body, they manage to co-opt the organism’s resources, but keeping them happy in a dish means catering to their dietary preferences. Different cancers need different types of molecular chow—growth factors, hormones, oxygen and pH levels, and other nutrients. Pancreatic adenocarcinoma thrives in low-oxygen conditions with poor nutrients.3 Glioblastomas feed on fatty acids.4 These nutrients are delivered to organoids via a specific solution called growth medium, which the lab personnel regularly doles out into the dishes.

Plenker is charged with keeping this murderous menagerie alive and well. He is the one who designs the cancers’ dietary menu, a specific protocol for each type. And while his official title is facility manager and research investigator who works closely with David Tuveson, director of the CSHL’s Cancer Center, he is essentially a cancer custodian, a curator of a unique collection that aims to change the paradigm of cancer treatment.

Plenker’s research area is pancreatic cancer—one of the most notorious killers known. Often diagnosed late and resistant to treatment, it is essentially a death sentence—only 8 to 10 percent of patients remain alive five years after diagnosis. The chemo drugs used to treat it haven’t changed in 40 years, Plenker says. In the past decade, physicians tried combining multiple drugs together with relative success. Identifying winning combos can save lives, or at least prolong them—and that’s what the organoids will help clinicians do better.

In a groundbreaking clinical trial called PASS-01 (for Pancreatic Adenocarcinoma Signature Stratification for Treatment), Plenker’s team collaborates with other American and Canadian colleagues to identify the most effective chemo cocktails and to understand the individual patients’ tumor behaviors, which would lead to more personalized treatments.5

Scientists know the same cancer types behave differently in different patients. Typically, all malignancies have the so-called “driver mutation”— the cancer’s main trigger caused by a mutated gene. But tumors also often have “passenger mutations” that happen in nearby genes. These additional mutated genes can generate various proteins, which may interfere with treatment.

Or not. Scientists call these mutated gene combinations tumor mutational signatures, which can vary from one patient to the next. With some cancers, doctors already know what mutations signatures they may have, but with pancreatic cancer they don’t have good tale-telling signs, or biomarkers. “There aren’t many biomarkers to help clinicians decide which chemo may be better for which patient,” explains oncologist Grainne O’Kane, who treats pancreatic cancer patients at the Princess Margaret Hospital in Toronto, Canada.

That’s the reason O’Kane participates in the PASS-01 trial—it will give doctors a better view into the exact specifics of their patients’ malignancies. As they take their patients’ biopsies, they are sending little cancer snippets to the CSHL to be grown into organoids, which will be subjected to chemo cocktails of various combinations to design more personalized regiments for them.

The hospital treats all patients with the so-called standard of care chemotherapy, which is more of a one-size-fits-all approach. Some patients will respond to it but others won’t, so the goal is to define the second line of chemo defense in a more personalized fashion. “That’s where the biopsies we send to Tuveson’s lab might be useful,” O’Kane says. “They can help us find something to benefit patients after the first line of chemo stopped working.”

Organoids are patients in a dish. Unlike real patients, organoids can be subjected to experiments.

Scientists can try all kinds of combos on the tumorous organoids, which they can’t do in living people. “You can treat 100 organoids with 100 different compounds and see which one works, or which compound does a good job and which ones don’t work at all,” Plenker says. That would also allow scientists to define the precise amount of chemo, so doctors wouldn’t have to over-treat patients with harsh drugs that create sickening side effects. Ultimately, organoids should take a lot of guesswork out of the process.

With about 150 patients’ adenocarcinomas already collected, the team hopes to come up with some answers. O’Kane says her team already has three patients for which they were able to design the more personalized second line of defense chemo, based on what their organoids revealed. They haven’t yet tried it, because the trial has only started recently, but this would be the next step.

“Being able to piece all this information together in real time as patients are moving through their therapies can really improve the outcomes,” O’Kane says. And while they may not be able to save all of those who graciously donated their biopsy snippets to science, it will help build better treatments in the future. “Even if we won’t be able to help these specific patients we’re hoping to use this info in the future clinical trials,” O’Kane says.

Organoids can also help understand how cancer develops. This is particularly true for breast cancers, says Camilla dos Santos, associate professor and a member of the CSHL Cancer Center. She studies the inner life of human mammary glands, more commonly referred to as breasts, and is also part of the cancer custodian crew. The hormonal changes that women go through during pregnancy subsequently modify breast cancer risk, sometimes lowering it and sometimes increasing—a complex interplay of the body’s chemicals.

“We know that women who get pregnant for the first time before they turn 25 years old, have a 30 percent decrease in breast cancer incidents later in life,” dos Santos says. “When they turn 60 or 70, 30 percent of them will not develop cancer.” On the contrary, those who are pregnant past 38 have a 30 to 50 percent increase in developing aggressive breast cancer types. Clearly, some molecular switches are involved, but they are very hard to study within the body. That’s where organoids can provide a window into the surreptitious process.

Using breast organoids, scientists can model the complex life of mammary glands at various stages of a woman’s life. And while most women wouldn’t want their breasts poked and pierced when they are pregnant or breastfeeding, many donate their tissues after breast reduction surgery or prophylactic mastectomy due to high-risk mutations like the BRCA gene.

That’s where organoids shine because scientists can not only grow them, but also give them the pregnancy hormonal cues, which will make cells generate milk, stop lactating, or do it again—and study the complex cellular interactions that take place in real life.

There’s a lot to study. At birth, mammary glands are similar in both genders—just little patches of the mammary epithelium tissue. But when puberty hits, the female glands fill up with the so-called mammary tree—a system of ducts for future milk production, which fully “blooms” in pregnancy.

“When a woman becomes pregnant, the duct tree expands, growing two types of cells—luminal and myoepithelial ones,” explains Zuzana Koledova, assistant professor of Masaryk University in Czech Republic who also uses organoids in her work. When the baby is born, the luminal cells, which line the inside of the ducts, produce the proteins that comprise milk.

The myoepithelial cells reside outside the ducts and work as muscles that squeeze the ducts to push milk out. Dos Santos likens this pregnancy mammary gland growth to the changes of the seasons. The images of sprouting ducts look like blossoming trees in the spring while later they shrivel like plants do in the fall.

The body governs these processes via the molecular machinery of hormones, which stimulate breast cells growth during pregnancy, and later cause them to die out. The two pregnancy-related hormones, prolactin and oxytocin, are responsible for milk production. Prolactin induces the luminal cells to make milk while oxytocin makes the myoepithelial cells contract. Once the baby is weaned, the levels of these hormones drop, causing cells to shrink back to their non-pregnant state.

With organoids scientists can observe these cellular dynamics at work. Koledova’s team had watched breast organoids secrete milk based on biological cues. They even recorded movies of cells pumping tiny milk droplets in the dish they were growing in. Using tiny snippets of donated breast tissue, the team grew the organoids inside the Matrigel matrix in the growth media and then added the two pregnancy hormones into the mix, explains Jakub Sumbal, a mammary gland researcher in Koledova’s group.

As they began to secret proteins that compose milk, the organoids, which looked like little domes inside the dish, changed from translucent to opaque. “At first, you can see through them, but then as they produce these proteins, they kind of darken,” Sumbal says. “And you can see them pushing out these little droplets.”

Cancer patients would no longer have to undergo chemotherapy by trial and error.

Dos Santos’s team, who also did similar work, outlined molecular changes that follow such dish-based hormonal cues in their recent study.6 In response to hormonal messages, cells produce proteins, which they display on their surfaces, like status symbols. During pregnancy the burgeoning cells prepping for milk production display the “proteins flags” that make them look important, attracting nourishment. When it’s time to die, they commit a cellular suicide.

They signal to the bypassing macrophages—immune system cleanup crew—to devour them. “They essentially say ‘come eat me!’ to the macrophages,” dos Santos says. “Because I’m no longer needed.”

The ability to mimic these processes in a dish, allows scientists to study the molecular switches that trigger breast cancer development—or minimize it. Scientists know that cancerous cells can hide from the immune system and even co-opt it into protecting themselves. They do it by displaying their own “do not eat me” protein flags on the surface and avoid destruction.

“Sometimes cancer cells can recruit specific types of immune cells to protect them,” dos Santos says. “They can not only say ‘do not eat me,’ but say ‘come hang out with me’ to the macrophages, and the macrophages will send suppressive signals to the B-cells or T-cells, the body defenders.” It is as if the cancer requests protection—a crew of guardians around it to defend against other cells that would otherwise wipe it out.

Scientists can’t telescope into the body to peek at these interactions, but they now can watch these stealth battles unfolding in a dish. “Right now we are looking at the proteins that are secreted by the organoids—the proteins that go on the surface of the organoids’ cells and what they would communicate to the immune system,” dos Santos says.

“Even when there’s no immune system surrounding them, they would still be doing that.” There’s a way to mimic the immune system, too. Scientists can add B-cells, T-cells, macrophages, and other players into the growth medium and watch the full-blown cellular warfare in action. “That’s the next step in our research,” dos Santos says.

Understanding what hormonal fluxes trigger breast cancer, and how it recruits other cells for safekeeping, can give scientists ideas for pharmaceutical intervention. “We can find drugs that pharmacologically turn off the switches that trigger cancer or interrupt its signaling for protection,” dos Santos says. “That opens novel ways to treat people.”

Can organoid research lead to a new standard of care for cancer patients? That’s the ultimate goal, researchers say. That’s why Plenker works at keeping his collection of cancer glops alive and well and thriving—he calls it a living biobank. And he keeps a stash in the cryogenic freezer, too.

He is also developing protocols that would allow commercial companies to grow organoids the same way chemical industries make reagents or mice suppliers grow rodents for research. A benefit of organoid experiments is they don’t involve animals at all.

Hospitals may one day start growing organoids from their patients’ biopsies to design and test personalized chemo cocktails for them. Once science crosses over to that reality, the entire treatment paradigm will change. Cancer patients won’t have to undergo chemotherapy by trial and error.

Instead their cancer organoids will be subjected to this process—knocked out by a gamut of drug combinations to find the winning one to use in the actual treatment. Plenker notes that once enough data is gathered about the tumors’ mutational signatures, scientists may create a database of tumor “mugshots” matching them to the chemo cocktails that beat them best.

And then just sequencing a biopsy sample would immediately inform oncologists what drug combo the patient needs. “We may be about 10 years away from that,” Plenker says, but for now there’s a lot more research to do. And a lot more cancers to grow.

By: Lina Zeldovich

Lina Zeldovich grew up in a family of Russian scientists, listening to bedtime stories about volcanoes, black holes, and intrepid explorers. She has written for The New York Times, Scientific American, Reader’s Digest, and Audubon Magazine, among other publications, and won four awards for covering the science of poop. Her book, The Other Dark Matter: The Science and Business of Turning Waste into Wealth, will be released in October 2021 by Chicago University Press. You can find her at LinaZeldovich.com and @LinaZeldovich.

Source: The Cancer Custodians – Issue 102: Hidden Truths – Nautilus

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Critics:

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans.

Tobacco use is the cause of about 22% of cancer deaths. Another 10% are due to obesity, poor diet, lack of physical activity or excessive drinking of alcohol. Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants. In the developing world, 15% of cancers are due to infections such as Helicobacter pylori, hepatitis B, hepatitis C, human papillomavirus infection, Epstein–Barr virus and human immunodeficiency virus (HIV).

These factors act, at least partly, by changing the genes of a cell. Typically, many genetic changes are required before cancer develops. Approximately 5–10% of cancers are due to inherited genetic defects. Cancer can be detected by certain signs and symptoms or screening tests. It is then typically further investigated by medical imaging and confirmed by biopsy.

Most cancers are initially recognized either because of the appearance of signs or symptoms or through screening. Neither of these leads to a definitive diagnosis, which requires the examination of a tissue sample by a pathologist. People with suspected cancer are investigated with medical tests. These commonly include blood tests, X-rays, (contrast) CT scans and endoscopy.

The tissue diagnosis from the biopsy indicates the type of cell that is proliferating, its histological grade, genetic abnormalities and other features. Together, this information is useful to evaluate the prognosis and to choose the best treatment.

Further reading

Show Your Immune System Some Love

If the immune system ran its own version of The Bachelor, antibodies would, hands down, get this season’s final rose. These Y-shaped molecules have acquired some star-caliber celebrity in the past year, due in no small part to COVID-19. For months, their potentially protective powers have made headlines around the globe; we test for them with abandon, and anxiously await the results.

Many people have come to equate antibodies, perhaps not entirely accurately, with near imperviousness to the coronavirus and its effects. Antibodies are, in many ways, the heartthrobs of the immune system—and some 15 months deep into immunological infatuation, the world is still swooning hard. Frankly, it’s all getting to be a little too much.

Don’t get me wrong: Antibodies have served me well, and thanks to my recent dalliance with the Pfizer vaccine, the anti-coronavirus variety will be receiving an extra dose of my admiration for a good while yet. I am, above all else, eager for the rest of the global population to nab the safeguards they offer, ideally for keeps.

But antibodies are simply not the only immune-system singles worthy of our love. A multitude of cells and molecules are crucial to building a protective immune response against this virus and many others. It’s time we took a break from antibodies, and embarked on a brief Rumspringa with the rest of the body’s great defenders.

What follows isn’t even close to a comprehensive overview of the immune system, because I am not a masochist, and because no one wants to read a 75,000-word story. Instead, I asked a few immunologists to chat with me about some of their favorite immune cells and molecules, and imagine what these disease fighters might be like if they truly were single and ready to mingle. As it were, everyone needs someone to be their starter bae.

Some good candidates might be found among the members of the innate immune system, a fast-acting fleet of cells that are the first to contend with an infection. (Antibodies belong to another branch, called the adaptive immune system; more on that later.) They’re a lot like adolescent lovers: dogged and earnest, but impulsive and, on occasion, woefully imprecise. Unlike antibodies, which can zero in on specific pathogens, innate immune cells are built to clobber just about anything that doesn’t resemble their human host. Perhaps it’s no surprise that these underdog cells are often forgotten or outright snubbed in conversations about immune protection.

But the all-purpose approach of innate immune cells has its charms. They’ll try anything at least once, and they’re admirably selfless. When pathogens come knocking, innate cells are the first to volunteer to fight, and often the first to die (RIP, neutrophils). Some ambush invading microbes directly, snarfing them down or bathing them with deadly toxins, while others blow up infected cells—tactics reminiscent of guerrilla warfare. Although antibodies take many days to appear, innate cells will immediately be “by your side when you have a problem,” Ashton Trotman-Grant, an immunologist at the University of Toronto, told me.

These acts of martyrdom buy the rest of the immune system time to prepare a more targeted attack. And in many cases, innate immune cells act so quickly and decisively that they can subdue an invasive microbe on their own—a level of self-sufficiency that most other defenders can’t match.

Some innate immune cells are also just plain adorable. Among the fan favorites are macrophages (“big eaters” in Greek), aptly named for their round-boi physique and insatiable appetite. Their goal in life is to chow down for the greater good. “They’ll never make you feel like you’re eating too much, and they’re open to trying new foods,” Juliet Morrison, a virologist and immunologist at UC Riverside, told me. They’re also endearingly unselfish: If a microbe crosses their path, they’ll gobble it up, then belch up bits to wave at adaptive immune cells as a warning of potential danger. It’s a great gift-giving strategy, Morrison said, especially if weird microscopic puke is what makes your heart go pitter-patter.

Dendritic cells have a similar modus operandi. Like macrophages, they specialize in regurgitating gunk for other immune cells. But they are much more social than macrophages, which prefer to gorge and digest in solitude. Dendritic cells are sentinels and gregarious gossips; their primary imperative is to “talk and hang out with other cells,” and they’ll flit from tissue to tissue to do it, David Martinez, an immunologist at the University of North Carolina at Chapel Hill, told me. If you’ve recently caught word of a new and dangerous infection, you probably heard about it from a dendritic cell.

A few weeks ago, Trotman-Grant put together a March Madness–style bracket to choose the “best” immune cell; after a couple of grueling weeks of voting, dendritic cells won. They’re almost certainly the cells you’d want to take to prom. But Trotman-Grant warned that their social-butterfly tendencies could be a double-edged sword: Dendritic cells just aren’t the type to settle down. Innate immune cells might be convenient dates, for a time. But while they’re great at first impressions, they can also be commitment-phobes, as likely to ghost you as they are to come on strong. (Besides, who wants to date someone who’s always arriving on the early side?)

The real keepers belong to the adaptive branch of the immune system: B cells—the makers of antibodies—and T cells, which, among many other tasks, kill virus-infected cells. Adaptives are slow-moving specialists. They take down microbial invaders that innate cells can’t handle on their own, relying heavily on intel from macrophages, dendritic cells, and other early defenders. They won’t be the first to make a move, but they’re sharp and sophisticated, capable of singling out individual pathogens and zapping them with precision.

B and T cells are self-assured enough to know what they want. Unlike innate cells, they’re also capable of remembering the things they’ve encountered before, ensuring that most pathogens can’t trouble the same person twice; that capacity is the conceptual basis of vaccines. “They do a great job at committing things to memory,” Ryan McNamara, a virologist at UNC Chapel Hill, told me. That also means no missed birthdays or anniversaries—and no chance they’ll ever forget that time you were wrong.

If you’re a fan of antibodies, you have B cells to thank: They are the glorious wellsprings whence these molecules hail. (On Mother’s Day, antibodies call their B cells.) Unfortunately, B cells are often overlooked; as living, dividing cells that hide away in tissues, they’re harder to isolate and study than the proteins they produce. But the antibodies they deploy can be powerful enough to quash microbes before they break into cells, potentially halting infections in their tracks. And even after antibodies disappear, B cells persist, ready to produce more.

Martinez stans the B cells he studies. But he’s wary of their romantic potential. B cells, he said, are almost too good at their job, and will compete aggressively among themselves. Their crime-fighting careers consume them, leaving little room for a fulfilling personal life. “I would say B cells are selfish,” he told me. In the cold light of morning, it turns out a lot of them are just self-involved snobs.

T cells play a far more subtle game. Their career choices range from demolishing virus-killed cells to corralling and coordinating other immune cells. As several researchers have pointed out, T cells might be some of the most underappreciated cells in the war against COVID-19, especially when it comes to vaccines. Some evidence even suggests that, in the absence of decent antibodies, T cells can clean up the coronavirus mostly on their own.

Certain T cells are killers. As their name suggests, they operate with devilish flair: When they happen upon virus-infected cells, they force them to self-destruct. Killers’ excellent memories also give them a predilection for grudges—enemies that trouble them twice should expect to be trounced with extra gusto. Thrill seekers might be drawn to killers, but Avery August, an immunologist at Cornell University, points out that these cells, also called cytotoxic T cells, might be all take and no give. Scientifically, they’re full of intrigue; romantically, he told me, “not so much”—at least for him.

Then there are the helpers—the benign Jekyll to the killers’ bellicose Hyde. Helper Ts are some of the most loyal partners you’ll find in the immune system, nurturing almost to a fault and versatile to boot. They coax B cells into maturing into antibody factories. They cheer killers along their murderous paths. They even goad innate immune cells into becoming the most ferocious fighters (and feeders) they can be. Effectively, helpers are “badass multitaskers that coordinate every level of immunity,” Marion Pepper, an immunologist at the University of Washington, told me. They’re about as supportive as they come—as long as you don’t mind being micromanaged from time to time.

It’s easy to see the appeal of antibodies. They’re among the few immune-system soldiers that can annihilate viruses before they enter cells, and they’re thought to be crucial to most vaccines. They can also be team players, throwing up red flags around microbes in order to alert other defenders to their presence. Transferred from animal to animal, or human to human, antibodies can confer protection against COVID-19; synthetic versions of the molecules are also relatively straightforward to manufacture en masse. Scoring a date with an antibody is a bit like finally getting together with the most popular person in school.

But counting on antibodies, and only antibodies, for protection is like shacking up with the first eligible suitor you meet—a risky and perhaps close-minded gamble. In the same way that our immune systems can guard against multiple pathogens at once, we could stand to be a bit less monogamous with our affections.

Besides, the choice might not ultimately be ours to make. Love is a two-way street, and antibodies are incorrigibly picky. Their sole mission is to glom on to a very specific microbe and cling to it, ignoring everything else along the way; it’s largely them doing the picking and choosing. And if you’re not the soul mate they imagined, there’s little you can do to change their minds—they’re proteins, and they don’t have one. Really, it’s not them. It’s you.

By: Katherine J. Wu

Source: Show Your Immune System Some Love – The Atlantic

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More Contents:

India Is What Happens When Rich People Do Nothing

The Tyranny of the Female-Orgasm Industrial Complex

Control of Genes Could Explain Why Females Suffer Worse Virus Infection

A university study could explain why females may suffer worse outcomes of virus infection such as Covid-19. Researchers from the University of Dundee’s School of Life Sciences found the control of genes on X chromosomes in females can cause much wider effects on cells than previously realised.

The X chromosome – of which females have two and men have only one – contains more than 1,000 genes that are vital for cell development. However, a double dose of such gene products can be lethal, meaning one of the two chromosomes in female cells shuts down in a process known as X chromosome inactivation (XCI).

The team found that issues with the XCI process in female cells can cause major changes in protein levels. Proteins are the main targets of almost every drug and differences in the levels of a cell are frequently responsible for many different types of disease, including cancer.

Alejandro Brenes, an analytics developer at the university school, said: “This study has revealed major consequences for the female cells if the XCI mechanism is defective. “By analyzing a collection of human stem cells from both healthy male and female donors, we found that a defective XCI increased the levels of thousands of proteins from all chromosomes, many of which are known markers of disease.

“The data can help to explain why some people may be more likely to develop specific types of disease, suffer worse outcomes of virus infection, such as Covid-19, or vary in how they respond to treatments and therapy. “The results could also be important for the safe development of stem cell therapies.

COVID-19, has been said to affect men and women differently, with men thought to be more likely to become severely ill and die from the disease.To find out more about sex differences in COVID-19, we spoke to Professor Sabra Klein, from the Johns Hopkins Bloomberg School of Public Health.

According to data from around the world, including preliminary data from the UK, an equal number of males and females contract the disease, but do we see the same symptoms?Where we are seeing real differences, in terms of larger magnitude of a male-female difference is in severity of disease.

When the virus enters our body, it needs to enter our cells in order to replicate. Successfully making it into the cell, the virus tries to replicate itself. Estrogen in women is thought to make this harder, meaning that the virus can’t make as many copies of itself in women.

Once the immune system realizes the virus has infiltrated its cells, it launches an attack to try and clear out the infection from its cells.

Generally speaking, women tend to mount more robust immune responses that can be beneficial for initially recognizing and initiating the clearance of a virus. So that can be beneficial. Where it can be detrimental is if long-term responses are not properly regulated, so you can get excessive immune responses that can contribute to long-term inflammation and that in and of itself can cause some tissue damage.

In addition to these sex differences in physiology, there are also important behavioral differences. Men are less likely to go to hospital until later in their disease. However, as healthcare workers are often women, we may still see a shift away from the male bias of the disease as the pandemic progresses.

“It also highlights the importance of sex-specific studies, as there are still many uncharacterized differences between females and males that need to be better understood in order to advance precision medicine.” The study, Erosion of human X chromosome inactivation causes major remodeling of the iPSC proteome, is published in Cell Reports and can be found online.

By: Douglas Barrie

Source: Control of genes could explain why females suffer worse virus infection – study

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How The COVID Vaccine and Regular Exercise May Increase Effectiveness

And while we’re still waiting for similar studies with COVID-19 vaccines, there’s good reason to believe the same effects would apply, says University of Sydney associate professor of exercise science Kate Edwards, who has extensively researched the links between vaccines and exercise.

Exercise and your immune system

First, it’s important to understand the profound effects of exercise on the immune system. One, Edwards says, is that it puts more immune cells – which kill infected cells and produce antibodies to destroy viral and bacterial antigens – on patrol in the body’s blood circulation. Also, when you work out, your muscles release signalling molecules, called myokines, that help put our body’s defences on high alert. Over the long-term, regular exercise means having a stronger, more responsive immune system.

And this has had repercussions during the pandemic. A US study, published this week in the British Journal of Sports Medicine, examined almost 50,000 patients and concluded that aside from old age or a past organ transplant, physical inactivity was the biggest risk factor for severe symptoms. People who didn’t exercise were more than twice as likely to be hospitalised compared to those who clocked up at least 150 minutes of activity every week. They were also 2.5 times more likely to die of the infection.

The effects of exercise on vaccines

Given all this, it’s perhaps unsurprising that exercise has been shown to improve the efficacy of vaccines. “We see that regular exercise over the course of weeks or months makes vaccine responses stronger and that likely then means you are more protected from the disease,” Edwards says.

A study published last year found that elite athletes had significantly more anti-influenza immune cells after a flu shot compared to other healthy adults. This echoed a 2019 study finding that older adults who trained regularly had a much higher antibody response to healthy adults who didn’t exercise. Consistent exercise after a vaccine is also thought to prolong enhanced protection.

“Vaccination does cause an immune response but because we have more of these immune cells [when we exercise], it’s a much more powerful response,” says Rob Newton, professor of exercise medicine at Edith Cowan University.

Interestingly, exercising on the day of a vaccine has also shown benefits. There’s less evidence for this, Edwards says, but her research suggests it may lead to a stronger immune response, particularly from doing arm movements in the hours before injection.

“You are likely to get more immune cells moving to pick up the vaccine … but also by exercising the muscles where you’ll get the vaccine means you release those immune signals and so it may draw the cells to that location as well.”

“The key is that exercise has no downsides. It gives benefits regardless and the evidence is so strong in a range of other vaccines.”

Professor Rob Newton

What’s even more startling is that being active close to the time of a vaccination – such as flu or HPV – has been found to reduce the risk of suffering from adverse reactions to the jab. Edwards says the effects were observed simply with 15 minutes of moderate resistance band exercise, probably because the immune system was primed and ready for a challenge.

“I would expect exercise in the hour before vaccination and the short period after would have the same effect,” Edwards says. This may be particularly valuable for people who are compromised through age or illness, Newton says.

Preparing for your COVID-19 vaccine

Of course, while this is all compelling evidence, Newton says we can’t be sure the same will apply to COVID-19 vaccines, particularly those that use new mRNA technology, such as Pfizer. “But those pathways still require the involvement of the immune system and the activation of immune cells,” Newton says. “[And] exercise distributes immune factors through the body.”

Newton is frank when he explains how he’ll approach his own COVID-19 vaccine: “I’m already exercising regularly and when it’s my turn to get a vaccination I can tell you I’ll be exercising before I head off to the medical clinic.” He suggests people follow his lead: “The key is that exercise has no downsides. It gives benefits regardless and the evidence is so strong in a range of other vaccines.”

“If you’re particularly worried about a vaccine working well, then exercise is a really good thing to do, but remember it’s important for … all sorts of things.”

Associate Professor Kate Edwards

Edwards agrees: “Certainly what we’ve never seen is exercise making anything worse: immune response or side-effects.” Edwards says because researchers are still exploring why some people are experiencing COVID-19 vaccine side-effects, she recommends not drastically changing your exercise routine on the day of your shot. But if you typically go for a run or do yoga, go for it.

She says it may help to do some light arm exercises close to the time of injection – for example a few sets of wall push-ups, shoulder presses and bicep curls. “Then you might want to consider having a rest day the day after the vaccination because reactions are sometimes being seen 24-48 hours after.”

And while you wait for the rollout to reach you, it’s worth ensuring you have a training routine in place. Australia’s physical activity guidelines for adults aged 18-64 are to have at least 150 minutes of moderate exercise each week, and two resistance training sessions – the latter of which Edwards particularly recommends for promoting immune function.

The bottom line, though, is working out is good for everybody, for myriad reasons. “If you’re particularly worried about a vaccine working well, then exercise is a really good thing to do, but remember it’s important for chronic disease, mental health, socialisation, all sorts of things,” Edwards says.

Newton says people shouldn’t worry that vigorous exercise will stress their bodies. “Unless you’re an elite athlete it’s very difficult to exercise to excess and compromise your immune system.” He recommends older Australians or people with chronic illness set up an exercise program with the guidance of an accredited exercise physiologist.

Sophie Aubrey

 

By: Sophie Aubrey

Source: How the COVID vaccine and regular exercise may increase effectiveness

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Related Links:

Common Ground: a pandemic influenza simulation exercise for the European Union, 23-24 November 2005

R Kaiser, M Ciotti, G Thinus… – Weekly releases (1997 …, 2005 – eurosurveillance.org
… the Commission, ECDC, WHO and the member states in his interview following the exercise.
More exercises at European and national levels will help to apply lessons learned … communication
mechanisms to aid preparations for an emergency such as an influenza pandemic …

Exercising in isolation? The role of telehealth in exercise oncology during the COVID-19 pandemic and beyond

KA Bland, A Bigaran, KL Campbell… – Physical …, 2020 – academic.oup.com
… Navigation. Exercising in Isolation? The Role of Telehealth in Exercise Oncology During
the COVID-19 Pandemic and Beyond. Kelcey … pandemic. Exercise Support Throughout
the COVID-19 Pandemic: Is Telehealth the Answer? Identifying …

Combating physical inactivity during the COVID-19 pandemic

AJ Pinto, DW Dunstan, N Owen, E Bonfá… – Nature Reviews …, 2020 – nature.com
… with systemic lupus erythematosus 9 . Of relevance in the context of the COVID-19 pandemic,
home-based exercise programmes are feasible and can be effective in promoting health benefits
for patients with rheumatic diseases without causing any important adverse events 2,3 …

Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic

M Leonardi, AW Horne, K Vincent… – Human …, 2020 – academic.oup.com
… The strategies discussed are not exclusively restricted to consideration during the COVID-19
pandemic … that aim to directly target the problem of endometriosis-related pain are improving
sleep hygiene, low-intensity physical activity (including pelvic exercises, yoga), dietary …

The impact of the COVID-19 pandemic on Parkinson’s disease: hidden sorrows and emerging opportunities

RC Helmich, BR Bloem – Journal of Parkinson’s disease, 2020 – ncbi.nlm.nih.gov
… Nevertheless, a loss of aerobic exercise during the COVID-19 pandemic may well … Furthermore,
reduced physical exercise may contribute to increased psychological stress, thereby further …
Promoting home-based and adequately dosed exercises, such as cycling on a stationary …

Loneliness and social isolation in older adults during the Covid-19 pandemic: Implications for gerontological social work

M Berg-Weger, JE Morley – 2020 – Springer
… Having had to quickly respond during the pandemic necessitated the use of technology … delivery
option, traditional interventions can similarly be offered (eg, exercise, dementia care … eg, interactive
photo sharing, support and learning assistants, online-based websites for pairing …

General practice and pandemic influenza: a framework for planning and comparison of plans in five countries

MS Patel, CB Phillips, C Pearce, M Kljakovic… – PloS one, 2008 – journals.plos.org
… Tools [54], [55] and desktop simulation exercises [19] are available to help GPs plan … This aspect
of preparedness was enhanced after the Exercise Winter Willow simulation in … or impede effective
functioning of general practice services during a pandemic, including adaptation of …

Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

P Hanvoravongchai, W Adisasmito… – BMC public …, 2010 – bmcpublichealth.biomedcentral.com
… Open Access; Published: 08 June 2010. Pandemic influenza preparedness and health
systems challenges in Asia: results from rapid analyses in 6 Asian countries … PDR in
2006. Pandemic preparedness programme. All countries in …

Have a heart during the COVID-19 crisis: Making the case for cardiac rehabilitation in the face of an ongoing pandemic

TJ Yeo, YTL Wang, TT Low – European journal of preventive …, 2020 – academic.oup.com
… to their mobile devices more than ever, scrutinising social media, news websites and messaging …
Table 1), to ensure that patients keep themselves healthy during the pandemic and do … With
bespoke smartphone applications and wearable activity trackers, exercise can even be …

Enhancing the legitimacy of local government pandemic influenza planning through transparency and public engagement

PE French – Public Administration Review, 2011 – Wiley Online Library
… opportunities for the inclusion of all stakeholders in decision making, mock community‐wide
exercises and drills … communications, Assess readiness to meet communications needs in
preparation for an influenza pandemic, including regular review, exercise, and update …

Regeneron Says Antibody Therapy Prevents COVID-19 Infections

Regeneron Pharmaceuticals is planning to ask the Food and Drug Administration (FDA) to allow its antibody cocktail to be used as a preventive treatment for COVID-19, the company said Monday.

New results from a clinical trial conducted with the National Institute of Allergy and Infectious Diseases found the drug reduced the risk of symptomatic infection by 81 percent in people who were not infected at the start of the trial, Regeneron said.

The company has already received emergency use authorization from the FDA to use its antibody drugs to treat adults with mild to moderate COVID-19 and pediatric patients at least 12 years old who have tested positive for the virus and are at high risk of severe disease but are not yet hospitalized.

The trial enrolled 1,505 people who were not infected with the virus but lived in the same household as someone who recently tested positive. The patients were randomized to receive either one dose of the antibody therapy or a placebo administered as injections.

After 29 days, 11 people out of the 753 who received a single 1,200 mg dose of the treatment developed symptomatic COVID-19; 59 people who received a placebo out of 752 participants developed symptomatic COVID-19.

The drug provided 72 percent protection against symptomatic infections in the first week and 93 percent protection in subsequent weeks, Regeneron said. The data has not yet been peer reviewed or published.

Regeneron also said the trial found individuals treated with the therapy who experienced a symptomatic infection resolved their symptoms in one week, compared to three weeks with placebo. Infected individuals also cleared the virus faster with the therapy, the company said.

Adverse events occurred in 20 percent of patients who received the antibody drug and 29 percent of those who received a placebo, Regeneron said, but nobody withdrew from the trial because of them.

None of the participants who received the therapy were hospitalized or went to the ER because of COVID-19 over the course of 29 days; four in the placebo group did so. There were four deaths in the trial — two in the therapy group and two in the placebo group — but none were reported due to COVID-19 or the drug.

“With more than 60,000 Americans continuing to be diagnosed with COVID-19 every day, the REGEN-COV antibody cocktail may help provide immediate protection to unvaccinated people who are exposed to the virus, and we are also working to understand its potential to provide ongoing protection for immunocompromised patients who may not respond well to vaccines,” George Yancopoulos, president and chief scientific officer at Regeneron, said in a statement.

The trial tested the antibody treatment for use as a “passive vaccine,” which involves directly injecting antibodies into the body. Traditional vaccines rely on a person’s immune system to activate and develop its own antibodies.

That means the treatment may provide immediate benefits, in contrast to active vaccines, which take weeks to provide protection. In addition, using injections rather than an infusion could make administering it more convenient than the currently authorized use for antibody drugs.

While much of the attention has been focused on vaccines, experts say therapeutic treatments are just as important to ending the pandemic, which has killed more than 562,000 Americans.

Source: Regeneron says antibody therapy prevents COVID-19 infections | TheHill

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Histamine Intolerance: Causes, Symptoms, and Diagnosis

Histamine intolerance is not a sensitivity to histamine, but an indication that you’ve developed too much of it. Histamine is a chemical responsible for a few major functions:

  • communicates messages to your brain
  • triggers release of stomach acid to help digestion
  • releases after injury or allergic reaction as part of your immune response

When histamine levels get too high or when it can’t break down properly, it can affect your normal bodily functions. Histamine is associated with common allergic responses and symptoms. Many of these are similar to those from a histamine intolerance.

While they may vary, some common reactions associated with this intolerance include:

In more severe cases of histamine intolerance, you may experience:

What causes high histamine levels?

You naturally produce histamine along with the enzyme diamine oxidase (DAO). DAO is responsible for breaking down histamine that you take in from foods.

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SEVEN Causes of Histamine Intolerance For access to blog, article, podcast, shareable quotes: advancednaturopathic.com/SEVEN-Causes-of-Histamine-Intolerance/ Get Dr. Roberts’ new book: http://advancednaturopathic.com/build… Join Us on Facebook: https://www.facebook.com/AdvancedNatu… Follow Us on Twitter: https://twitter.com/drmelinaroberts ——————– ABOUT DR. MELINA ROBERTS ——————-
Dr. Melina Roberts is a Naturopathic Doctor, Author of Building a Healthy Child, Founder and Clinic Director of Advanced Naturopathic Medical Centre in Calgary. She is a leading authority in the field of naturopathic medicine specializing in European Biological Medicine effectively treating digestive issues, chronic disease and cancer.
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If you develop a DAO deficiency and are unable to break down histamine, you could develop an intolerance. Some reasons your DAO enzyme levels could be affected include:

  • medications that block DAO functions or prevent production
  • gastrointestinal disorders, such as leaky gut syndrome and inflammatory bowel disease
  • histamine-rich foods that cause DAO enzymes to function improperly
  • foods that block DAO enzymes or trigger histamine release

Bacterial overgrowth is another contributing factor for developing a histamine intolerance. Bacteria grows when food isn’t digested properly, causing histamine overproduction. Normal levels of DAO enzymes can’t break down the increased levels of histamine in your body, causing a reaction.

Controlling histamine levels with diet

Foods to avoid

A healthy diet contains moderate levels of histamine. However, there are some foods high in histamine that can trigger inflammatory reactions and other negative symptoms.

Histamine-rich foods are:

There are also a number of foods that trigger histamine release in the body, such as:

Foods that block DAO production include:

Foods to eat

If you have a histamine intolerance, incorporating low-histamine foods into your diet can help reduce symptoms. There’s no such thing as a histamine-free diet. Consult with a dietician before you eliminate foods from your diet.

Some foods low in histamine include:

Diagnosing histamine intolerance

Before reaching a diagnosis, your doctor will eliminate other possible disorders or allergies that cause similar symptoms. Doctors may also suggest following an elimination diet for 14 to 30 days. This diet requires you to remove any foods high in histamine or histamine triggers, and slowly reintroduce them to watch for new reactions.

Your doctor might also take a blood sample to analyze if you have a DAO deficiency. Another way to diagnose histamine intolerance is through a prick test. A 2011 studyTrusted Source examined the effectiveness of a prick test to diagnose histamine intolerance. Researchers pricked the skin of 156 people and applied a 1 percent histamine solution.

For those with suspected histamine intolerance, the prick test was positive for 79 percent, revealing a small red, itchy bump on the tested area that didn’t resolve within 50 minutes. Histamine intolerance can cause uncomfortable symptoms, but it can be treated with a low-histamine diet.

Histamine intolerance shouldn’t be self-diagnosed since symptoms are similar to other allergens, disorders, or infections. If you think you might have an intolerance or are experiencing irregular symptoms, talk with your doctor.

Medically reviewed by Daniel Murrell, M.D. — Written by Kiara Anthony

Source: Histamine Intolerance: Causes, Symptoms, and Diagnosis

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More Content:

ns. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
Medically reviewed by Daniel Murrell, M.D. — Written by Kiara Anthony — Updated on March 7, 2019

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