Posted on autoimmune conditions, Cardiovascular disease, Lupus

“Tiny Killers: How Autoantibodies Attack the Heart in Lupus Patients”

Hand-drawn: Autoantibodies attacking the heart in lupus patients

Autoantibodies attacking the heart in lupus patients Credit Hand-drawn image by Xiaokan Zhang/Vunkak-Novakovic Lab

Cardiovascular disease is the primary cause of death in individuals with lupus, an autoimmune disease that occurs when the immune system attacks the body’s own tissues and organs, including the heart, blood, lungs, joints, brain, and skin. Lupus myocarditis, inflammation of the heart muscle, can be extremely serious as it can disrupt the normal rhythm and strength of the heartbeat. However, understanding the mechanisms of this complex disease is challenging and studying it is difficult.

A long-standing question about lupus is why some patients develop myocarditis while others remain unaffected, and why the clinical manifestations of affected patients range so dramatically, from no symptoms at all to severe heart failure. Lupus is characterized by a large number of autoantibodies, which are immune proteins that mistakenly target a person’s own tissues or organs, with different specificities for various molecules. These autoantibodies, similar to our genes, may explain why different individuals experience different symptoms.

Researchers have long suspected that certain autoantibody signatures may be the key to understanding the varied clinical presentations seen in lupus patients. Identifying the specific autoantibodies responsible for heart damage has been very difficult due to the lack of experimental models that accurately mimic the cardiac disease in lupus patients. The animal models currently used have limitations due to differences in cardiac physiology, and human cell cultures are unable to fully replicate the complexity and function of the human heart.

New study shows that autoantibodies can directly affect heart disease in lupus patient

The researchers created small cardiac tissues from healthy adult human stem cells, and then they matured the tissues using metabolic and electromechanical signals. Afterward, they exposed the tissues to the autoantibodies present in the blood of lupus patients who had myocarditis and those who did not. The team found that the way the patients’ autoantibodies attached to the heart tissue depended on the type and severity of their myocardial damage. Some patients with severe myocarditis had unique autoantibodies that mainly targeted dying cardiac cells, while those with weakened heart pump function had autoantibodies that mostly focused on the surface of live cells. Interestingly, the team also found that the autoantibodies binding to live cardiac cells could have powerful biological effects on the tissues without the presence of immune cells, potentially revealing new mechanisms that could lead to heart failure in lupus patients.

The study also identified four autoantibodies that may directly affect the heart muscle. These findings could assist in identifying lupus patients with the highest risk of developing heart disease, informing the development of new therapeutic strategies, and potentially extending to other autoimmune diseases.

“This study is the first to show that autoantibodies can directly cause injury to the heart in this complicated autoimmune disease,” said Gordana Vunjak-Novakovic, the leader of the team. She is the University Professor and the Mikati Foundation Professor of Biomedical Engineering, Medical Sciences, and Dental Medicine at Columbia. “It’s astonishing that the miniature heart tissues we’ve created using human stem cells and ‘organs-on-chip’ technology can replicate organ-level functions in a way that is specific to each patient, particularly for such a complex disease. We are now in an era where we can examine the progression and treatment of diseases using seemingly simple yet highly controllable and predictive models of human organs. It feels like we are living in the future.”

Posted on Diabetes, Obesity

Over a decade, there was an almost 20% increase in the prevalence of type 2 diabetes.

Age, race, income level, obesity, physical inactivity all factor in risk of diabetes diagnosis
The risk of being diagnosed with diabetes is influenced by factors such as age, race, income level, obesity, and physical inactivity.

Type 2 diabetes increased by nearly 20% from 2012 to 2022, as per a recent study from the University of Georgia.

The researchers discovered an increase in diabetes across all sociodemographic groups. However, non-Hispanic Black individuals were particularly affected by the disease, with just under 16% of Black study participants reporting a diagnosis of Type 2 diabetes.

“More than one in five individuals aged 65 or older had the condition. In the same age group, the likelihood of being diagnosed with diabetes was more than 10 times higher than for people in the 18-to-24-year age bracket. Those between the ages of 45 and 64 were over five times more likely to receive the diagnosis.”

The research also revealed that individuals with lower incomes had a notably higher prevalence of diabetes compared to those with higher incomes. People with higher incomes had a 41% lower likelihood of being diagnosed with the disease, while individuals with a college education were 24% less likely to receive a diabetes diagnosis.

“Diabetes is on the rise in the U.S. and is projected to continue increasing in the future,” stated Sulakshan Neupane, the lead author of the study and a doctoral student in UGA’s College of Agricultural and Environmental Sciences. “The annual cost of diabetes is approximately $412 billion, encompassing medical expenses and indirect costs such as loss of productivity. This substantial amount is expected to grow as more individuals are diagnosed with the disease.”

South, Midwest particularly vulnerable to diabetes

The researchers utilized data from the nationally representative Behavioral Risk Factor Surveillance System, an ongoing health survey of over 400,000 individuals.

They used the same dataset for a paper that was published by the American Journal of Preventive Medicine in April. The paper highlighted the economic impact of Type 2 diabetes and the increased prevalence of the condition over the same study period as the current paper.

The researchers found regional differences in diabetes prevalence, with the South and Midwest experiencing large increases in Type 2 diabetes cases. Arkansas, Kentucky, and Nebraska reported the highest increases between 2012 and 2022. Over the decade-long study period, ten states saw increases of 25% or more: Arkansas, Kentucky, Nebraska, Texas, Alabama, Minnesota, Illinois, West Virginia, Delaware, and Massachusetts. “In these areas, people are at a higher risk of developing diabetes, so policymakers and public health officials need to focus on these regions,” Neupane said.

Overweight, obese individuals more likely to have diabetes

Obese and overweight individuals had a higher likelihood of being diagnosed with Type 2 diabetes. In 2022, 1 in 5 obese individuals reported having the disease, while 1 in 10 overweight participants reported the condition.

Physically active individuals had a prevalence of under 10% for diabetes, while inactive people experienced a rate closer to 19%.

“It is crucial to identify these risk factors and take steps to mitigate them,” Neupane emphasized. “Being more physically active and paying greater attention to your physical health is essential. While certain risk factors such as age and race are beyond our control, some measures can be taken to reduce the risk of diabetes, such as adopting a healthy diet, maintaining an active lifestyle, and managing weight.”

Leave a comment Posted on Multiple Sclerosis

Ataxia – find out more about this symptom of multiple sclerosis

Multiple sclerosis awareness

Multiple sclerosis awareness

[Original article on NHS Choices website]

Ataxia is a term for a group of disorders that affect coordination, balance and speech.

Any part of the body can be affected, but people with ataxia often have difficulties with:

balance and walking

speaking

swallowing

tasks that require a high degree of control, such as writing and eating

vision

The exact symptoms and their severity vary depending on the type of ataxia a person has.

Types of ataxia

There are various types of ataxia, which can be categorized into three main groups:

1. Acquired ataxia: Symptoms develop as a result of trauma, stroke, multiple sclerosis (MS), brain tumor, nutritional deficiencies, or other conditions that damage the brain or nervous system.

2. Hereditary ataxia: Symptoms develop gradually over many years and are caused by genetic mutations inherited from parents. The most common type is Friedreich’s ataxia.

3. Idiopathic late-onset cerebellar ataxia (ILOCA): The brain is progressively damaged over time for reasons that are unclear.

What causes ataxia?

Ataxia usually results from damage to a part of the brain called the cerebellum, but it can also be caused by damage to other parts of the nervous system. This damage can be part of an underlying condition such as multiple sclerosis (MS), or it can be caused by a head injury, lack of oxygen to the brain, or long-term, excessive alcohol consumption. Hereditary ataxia is caused by a faulty gene passed on by family members, who may or may not be affected.

Read more about the causes of ataxia.

How ataxia is treated

In many cases, there is no cure for ataxia, so supportive treatment to manage the symptoms is essential. This may involve:

– Speech and language therapy to address speech and swallowing difficulties

– Physiotherapy to assist with movement issues

– Occupational therapy to help manage daily challenges

– Medication to regulate muscle, bladder, heart, and eye issues

In a few cases, treating the underlying cause can improve ataxia or prevent its worsening.

Read more about treating ataxia.

Outlook

The outlook for ataxia can vary significantly and largely depends on the specific type of ataxia. Some types may remain stable or even improve over time, but most will worsen progressively over many years.

People with hereditary ataxia generally have a shorter life expectancy than normal; however, some individuals can live into their 50s, 60s, or beyond. In more severe cases, the condition can be fatal in childhood or early adulthood.

For acquired ataxia, the outlook depends on the underlying cause. Some cases may improve or remain stable, while others may worsen over time and reduce life expectancy.