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Caffeic Acid Inhibits Colitis In A Mouse Model
Researchers at Iowa State University have found that increased expression of a form of cytochrome P-450 (CYP4B1) is a key marker of inhibition of colitis in mice by caffeic acid, an anti-inflammatory antioxidant compound widely distributed in foods. The results, which appear in the June 2009 issue of Experimental Biology and Medicine, implicate CYP4B1, a form of cytochrome P450 previously found to be associated with resolution of allergic inflammation in another model. The normalization of CYP4B1 by caffeic acid treatment was associated with significant lessening of colitic damage, assessed by examining colon histopathology. In comparison with rutin, an anti-inflammatory flavonoid and hypoxoside extract, a botanical known as African potato previously shown to protect against colitis, all three compounds had anti-inflammatory effects, suppressing myeloperoxidase, IL-17 and iNOS and increasing IL-4, known factors associated with inflammation responses. But only caffeic acid protected against the dextran sulfate sodium induced colitis. Its novel mechanism related to CYP4B1 is being studied further. The research team, Zhong Ye, a graduate student in Toxicology, along with Microbiology graduate students Zhiping Liu and Abigail Henderson, Visiting Scientist Kwangwon Lee, Korea University, Dr. Michael Wannemuehler, Veterinary Microbiology, Dr. Jesse Hostetter, a veterinary pathologist, and Dr. Suzanne Hendrich, Toxicologist and Nutritionist, performed studies in 8 week old mice fed the various dietary components and then exposed to dextran sulfate sodium in a mildly irritating dose to induce colitis. Dr. Hendrich noted that "this study of caffeic acid will help us to advance studies of botanicals and plant foods with respect to their ability and mechanisms of inhibiting colitis, and perhaps colon cancer, because colitis increases risk for this disease".
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Study Shows Decreased Risk Of Death From Opportunistic Infections With Earlier Antiretroviral Treatment
HIV-positive people with opportunistic infections who receive earlier antiretroviral treatment lower their risk of death compared with people who delay treatment, according to a new study conducted by the Stanford University School of Medicine and published in PLoS One, the San Jose Mercury News reports. The findings could lead to changes in recommendations for antiretroviral treatment protocol, specifically for patients diagnosed with HIV at an advanced stage, the Mercury News reports. The study included 262 HIV-positive participants at 39 health care sites across the U.S., and 20 participants in South Africa. During the yearlong study, the researchers found that among the participants who were treated promptly after developing an opportunistic infection, 14% died or developed another infection. The researchers also found that 24% of participants who deferred treatment for an average of 45 days died or had a decrease in health outcomes. According to the Mercury News, the question of when to start HIV-positive people on antiretroviral treatment remains unclear because of issues such as the high cost of medicines, side effects, and drug interactions or resistance. Andrew Zolopa, head of Stanford University School of Medicine"s division of infectious diseases and lead investigator of the study, said that physicians often treat HIV-positive people for an "acute crisis, then follow up later with treatment for HIV." He continues, "But that answer is wrong. The study shows very clearly that there is no safety downside to doing this -- and the benefit is quite substantial, reducing death by 50%." "Even in San Francisco, one of the first epicenters of HIV in the United States, we still find that many people present late in the course of their illness with an opportunistic infection," Mitch Katz, director of San Francisco"s Department of Health who was not involved in the study, said. He added, "This study shows that it is lifesaving to treat those persons with antiretroviral drugs while they are still in the hospital." Katz said that the results could lead to changes in HIV/AIDS practices worldwide. The International AIDS Society, CDC and the British AIDS Society have developed guidelines recommending that early antiretroviral treatment be considered in patients with opportunistic infections, Zolopa said. In addition, NIH is considering an international study to examine earlier initiation of antiretroviral treatment involving more than 9,000 people from both developed and developing countries (Krieger, San Jose Mercury News, 5/15).
News of the day
BioElectronics Is Filing For 510(k) Clearance With FDA For Its AllayTM Product
BioElectronics Corp. (PINKSHEETS: BIEL), the maker of inexpensive, disposable drug-free anti-inflammatory devices, announced it is filing an application with the U.S. Food and Drug Administration (FDA) for 510(k) clearance to market its Allay™ Menstrual Pain Relief Patch product. The filing follows a very successful double blinded, placebo controlled clinical trial in which 71% of women in the active group reported either complete elimination or a reduction in their typical menstrual pain symptoms, with 49% showing at least a 50% reduction in pain associated with dysmenorrhea.
Diagnostics

Study Examines Trends In Gallbladder Cancer Over Four Decades

Overall prognosis for gallbladder cancer appears to be improving, although many patients still have incurable disease and poor survival rates, according to a report in the May issue ofArchives of Surgery, one of the JAMA/Archives journals. An estimated 9,520 new cases of gallbladder or bile duct cancer were diagnosed in the United States in 2008, and approximately 3,340 of these patients will die of their disease, according to background information in the article. The disease affects women more frequently than men and surgical removal of diseased portions of the organ (resection) is the only curative treatment. However, many patients present to the clinician with advanced-stage disease and are not candidates for this procedure. "Gallbladder cancer is characterized by locally aggressive behavior, with early spread to regional lymph nodes and distant dissemination," the authors write. "In addition, it recurs rapidly even after presumed curative resection." Ioannis T. Konstantinidis, M.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues identified 402 patients with gallbladder cancer at one university-affiliated tertiary care center between 1962 and 2008. Of these, 260 underwent surgical exploration at the same institution and were included in the data analysis. They were diagnosed during three periods: period A (1962 to 1979, 83 patients), period B (1980 to 1997, 105 patients) and period C (1998 to 2008, 72 patients). Overall median (midpoint) survival improved from 3.5 months in period A to 6.5 months in period B and 12 months in period C. "The stage of disease at presentation affected the survival in all time periods (stage I, median survival not reached; stage II, 10.3 months; stage III, 4.7 months and stage IV, four months)," the authors write. "The survival of patients who presented with advanced-stage disease and who underwent palliative [treating symptoms only] procedures remained poor in all periods (A, 1.9 months; B, 3.9 months; and C, 3.6 months)." Of the 260 cancer patients who had surgery to explore the extent of their disease, 151 (58.1 percent) underwent resection. Unresectable disease was found in eight patients and became less common over time (44.4 percent in periods A and B, 17.3 percent in period C). Between January 1994 and March 2008, 6,881 laparoscopic cholecystectomies (procedures to remove gallstones) were performed at the same facility; 17 cases of gallbladder cancer were discovered incidentally during these procedures. "When gallbladder cancer is found incidentally during or after a cholecystectomy, aggressive resection should be performed either during the present operation or during a second operation," the authors write. "In our series, 56 percent of patients who underwent re-exploration [a second surgery] were found to have residual disease. Patients underwent re-exploration at a median of 41 days, similar to other series. Increased T stage at cholecystectomy correlated with a higher frequency of residual disease." "Patients with gallbladder cancer continue to have a poor prognosis because many of the patients present with advanced disease," the authors write. "Earlier detection coupled with an aggressive surgical approach leads to better outcomes. A better understanding of the molecular pathways contributing to the development of gallbladder cancer is needed to develop improved adjuvant therapies to increase overall survival." Arch Surg. 2009;144[5]:441-447. Archives of Surgery


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