A study led by the University of Eastern Finland has discovered that patients with relapsing-remitting multiple sclerosis (RRMS) experience lower levels of fatigue when they are in better physical condition and engage in higher daily activity. The study also revealed that lower disability rates were linked to reduced fatigue. These findings were published in the esteemed journal Multiple Sclerosis and Related Disorders.
Fatigue is a prevalent symptom in multiple sclerosis (MS) patients, but evaluating its impact on patients’ daily lives can be difficult. The study aimed to explore the connection between fatigue in patients with relapsing-remitting MS (RRMS) and their physical activity levels measured by accelerometers, as well as their level of disability.
The study utilized various measurement methods, including an accelerometer to measure physical activity, two different meters (MFIS and FSS) to measure fatigue, and two methods (EDSS and MSFC) to assess disability. Additionally, the study involved various physical performance tests.
Patients with a disability level of 0–2.5, considered moderately low, had higher fatigue levels than healthy controls, but lower fatigue levels than patients with a higher disability level (EDSS 3-5.5). There was a significant relationship found between fatigue and disability, as well as between daily physical activity and fatigue. A lower disability level, better physical condition, and higher daily activity were predictive of lower fatigue levels.
Fatigue plays a significant role in MS and has a strong impact on, for example, patients’ ability to work and premature retirement. This is of great importance socially.
“The findings are interesting and support previous studies very well,” says Doctoral Researcher Marko Luostarinen of the University of Eastern Finland. “Patients with MS should find a suitable form of exercise, taking into account their disability, which maintains their functional capacity and reduces fatigue.”
“This study is unique because it was large and used modern methods. However, more detailed research into patients’ disability and actual physical activity levels is needed,” points out Luostarinen.
Brigham researchers are developing a new method to target autoimmune reactions in the brain using designer bacteria, aiming to make treatments safer and more effective.
Researchers from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, have developed a probiotic to suppress autoimmunity in the brain. This occurs when the immune system attacks the cells of the central nervous system and is at the core of several diseases, including multiple sclerosis. In a new study, researchers demonstrated the treatment’s potential using preclinical models of these diseases. They found that the technique offers a more precise way to target brain inflammation with reduced negative side effects compared to standard therapies. T
“Engineered probiotics could revolutionize the way we treat chronic diseases,” said lead author Francisco Quintana, PhD, of the Ann Romney Center for Neurologic Diseases at Brigham and Women’s Hospital. “When a drug is taken, its concentration in the bloodstream peaks after the initial dose, but then its levels go down. However, suppose we can use living microbes to produce medicine from within the body. In that case, they can keep producing the active compound as it’s needed, which is essential when we consider lifelong diseases that require constant treatment.”
Autoimmune diseases impact around 5-8% of the U.S. population. Despite being widespread, there are limited treatment options for most of these diseases. Diseases like MS that affect the brain are especially difficult to treat because many medications can’t effectively reach the brain due to the blood-brain barrier, which acts as a protective barrier between the brain and the circulatory system.
In their search for new treatments for autoimmune diseases, researchers focused on dendritic cells, a type of immune cell found in high numbers in the gastrointestinal tract and around the brain. While these cells regulate the immune system, their specific involvement in autoimmune diseases is not yet fully understood. Through their study of dendritic cells in the central nervous system of mice, the researchers identified a biochemical pathway that these cells use to inhibit other immune cells from attacking the body.
“The mechanism we discovered acts like a brake for the immune system,” explained Quintana. “In most people, it is activated. However, in individuals with autoimmune diseases, there are issues with this braking system, which means the body lacks a way to defend itself from its own immune system.”
The researchers discovered that this biochemical brake can be activated with lactate, a molecule involved in numerous metabolic processes. Then, they successfully genetically engineered probiotic bacteria to produce lactate.
“Probiotics are not new – we have all seen them sold as supplements and marketed as a way to promote health,” said Quintana. “Using synthetic biology to get probiotic bacteria to produce specific compounds relevant to diseases, we can enhance the benefits of probiotics to the maximum.” They tested their probiotic in mice with a disease closely resembling MS and found that, even though the bacteria live in the gut, they could reduce the disease’s effects in the brain. They did not find the bacteria in the bloodstream of the mice, suggesting that the observed effect resulted from biochemical signalling between cells in the gut and in the brain.
“We have discovered in recent years that the microorganisms in the gut have a significant impact on the central nervous system,” said Quintana. “We focused on multiple sclerosis in this study to see if we can use this effect to treat autoimmune diseases of the brain. The results indicate that we can.” Although the current study only looked at the effect of the probiotic in mice, the researchers are optimistic that the approach could be easily adapted for human use because the strain of bacteria used to create the probiotic has already been tested in humans. The researchers are also working to adjust their approach for autoimmune diseases that affect other parts of the body, especially gastrointestinal diseases like inflammatory bowel syndrome.
Quintana and his colleagues are collaborating with Mass General Brigham Ventures to establish a new company. Mass General Brigham is renowned for its leadership in research and innovation, which has led to the formation of numerous companies driving scientific advancement and economic growth locally and globally. These companies allow patients worldwide to benefit from the discoveries made at Mass General Brigham. Quintana stated, “Using living cells as a form of medicine within the body holds great potential for creating more personalized and precise therapies. If the microbes in the gut can impact brain inflammation, we believe we can harness their power for other applications.”
UCLA Health researchers have published the largest-ever study of families with at least two children with autism, uncovering new risk genes and providing new insights into how genetics influence the development of autism.
The new study, published on July 28 in the Proceedings of the National Academy of Sciences, also provides genetic evidence that language delay and dysfunction should be reconsidered as a core component of autism.
The majority of genetic studies on autism have concentrated on families with a single affected child, often excluding families with multiple affected children. Consequently, very few studies have explored the impact of rare inherited genetic variations or their interaction with the collective effect of multiple common genetic variations that contribute to the risk of developing autism.
“Study design is critical, and not enough attention has been paid to studying families with more than one affected child,” said lead study author Dr. Daniel Geschwind, the Gordon and Virginia MacDonald Distinguished Professor of Human Genetics, Neurology, and Psychiatry at UCLA.
“Autism is highly heritable. It is estimated that at least 50% of the genetic risk is attributed to common genetic variations, while another 15-20% is due to spontaneous mutations or predictable inheritance patterns. The remaining genetic risk is still not completely understood.”
For this study, researchers conducted whole-genome sequencing on 4,551 individuals from 1,004 families, including 1,836 children with autism and 418 without.
The researchers found seven potential genes linked to autism: PLEKHA8, PRR25, FBXL13, VPS54, SLFN5, SNCAIP, and TGM1. This is notable because previous studies needed larger cohorts to find a similar number of new risk genes. Most of the new genes were supported by rare inherited DNA variations passed from parents to children with autism.
The researchers also looked into polygenic risk, which involves a combination of commonly found genetic variations that can increase the likelihood of developing autism. They discovered that children who inherit rare mutations from unaffected parents, combined with polygenic risk, are more likely to have autism. This helps to explain why parents who have a single rare mutation may not display signs of autism, even if their children do. It also supports the liability threshold model, a concept in behavioral genetics that suggests there is an additive effect of genes influencing the probability of developing a certain trait.
Children who experienced language delay were more likely to inherit a polygenic score linked to autism, compared to children without language delays. This association was specific to autism and was not observed for other traits such as educational attainment, schizophrenia, or bipolar disorder. This suggests a connection between the genetic predisposition for autism and language delay.
The most recent edition of the professional guidebook used by mental health providers to diagnose disorders, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), does not consider language delay a core symptom of autism. This is due to the variability in language ability among people with autism.
“This association of general risk for autism that was strongest in those with language delay suggests that language is actually a core component of autism. This finding needs to be replicated in larger cohorts, especially those recruited more recently under DSM-5,” Geschwind said.
Research by Professor Neda Akhavan in UNLV’s Department of Kinesiology and Nutrition Sciences indicates that the health benefits of potatoes are often misunderstood. Credit: Becca Schwartz/UNLV
Nutrition sciences professor Neda Akhavan’s recent study suggests spuds as a potential superfood for those with Type 2 diabetes
The potato is small enough to fit inside a person’s hand, yet it contains enough nutrients to help whittle waistlines and lower blood sugar in adults with Type 2 diabetes. Despite the fact that potatoes, particularly the skins, are packed with health-boosting nutrients, they routinely get a bad rap among dieters.
There may soon be a change, thanks to new research conducted by Neda Akhavan, an assistant professor in the Department of Kinesiology and Nutrition Sciences within UNLV’s School of Integrated Health Sciences. Akhavan recently presented her findings on the cardiovascular benefits of potatoes for individuals living with Type 2 diabetes to the Alliance for Potato Research and Education. “I enjoy researching food items that are often stigmatized in the field of nutrition,” she stated. “Many people think of potatoes as something that is usually fried or high in fat, and we wanted to highlight how a potato, when prepared properly, can be both functional and healthy.”
Putting Potatoes to the Test
Akhavan enlisted 24 participants for the study, all of whom had Type 2 diabetes that was well controlled with medication. Funded by the Alliance for Potato Research and Education, this is believed to be the first study of its kind to scientifically measure the cardiovascular benefits of potatoes for adults with diabetes.
Participants in the study group were each given a pre-prepared baked potato with the skin measured to 100g, with only 20 grams of carbohydrates, roughly enough to fit in one hand to incorporate as a snack or side with meals daily. The control group was given a similar potion of white rice with the same number of calories and carbohydrates. The study ran daily for 12 weeks, which is considered the minimum time needed to see changes in indices of glycemic control and cardiometabolic health.
Study participants were permitted to add herbs or spices to the potatoes, or up to ½ tbsp of butter, but they were advised not to fry their potato.
Key Takeaways and Recommendations
A slight reduction in fasting blood glucose levels was observed in study participants who consumed potatoes. Additionally, improvements in body composition and waist circumference, as well as a decrease in resting heart rate, were noted.
“The results from our study provide evidence that white potatoes can be healthfully incorporated in the diet of individuals with Type 2 diabetes when substituted for other foods with a high glycemic load, such as long-grain white rice,” Akhavan said. “Additionally, there were no harmful effects on measured health outcomes, and some cardiometabolic health benefits were shown, which aligned with what we expected to see. Therefore, diabetics should not shy away from potatoes.”
Akhavan says that just like all foods, moderation – and preparation methods – are key.
“Potatoes are a versatile food and can be eaten with most types of cuisines. However, it’s important to incorporate them into a well-rounded diet,” she said. “For those short on time, consider making a large batch of baked or roasted potatoes and meal prepping to last you a while. I don’t oppose boiling potatoes, but you want to keep as much of the potassium from the skin as possible, and you lose some of that when you boil them.”
Making the Case for Potatoes
Potatoes are the richest source of dietary potassium in Western diets, and high potassium diets have been shown to prevent high blood pressure and Type 2 diabetes development. Additionally, potato skins contain a certain type of fiber called “resistance starch,” which have been shown to improve glucose control, lipid profiles, and satiety. Because of these added health benefits, Akhavan recommends eating potatoes with the skin.
So, the next time you want to reach for a banana, she added, reach for that potato instead.
“A lot of people are shocked to learn that a potato has a higher level of potassium than a banana,” she said. “Believe it or not, a baked potato is one of the most satiating foods consumed within the western diet. And, when it is consumed baked, it increases our ability to feel fuller throughout the day.”
Akhavan intends to expand the study in the coming months to include a larger and more diverse participant population, and incorporation of potatoes within a Mediterranean dietary pattern. She also plans to explore the role of potato consumption and its effects on dietary patterns and related health benefits.
A quarter (24%) of autistic doctors have attempted suicide, and more than three-quarters (77%) have considered it, according to a new study by Brighton and Sussex Medical School (BSMS), Thomas Jefferson University and Autistic Doctors international (ADI) – published in Frontiers in Psychiatry. Nearly half (49%) had also engaged in self harm.
Lead author Dr Sebastian Shaw, Lecturer in Medical Education at BSMS and the Research Lead of ADI, said: “Whilst it is deeply concerning to see the extent to which my fellow autistic doctors have struggled with their mental health, it is perhaps not surprising when we consider the many barriers and challenges faced by autistic people working in the healthcare sector.
“We also discovered that individuals who viewed autism as a ‘disorder’ instead of a difference or disability were more likely to have attempted suicide. This could suggest that they have internalized feelings of shame from being taught to perceive autism as a disorder during their medical training. This finding supports the idea of embracing neurodiversity when it comes to autism. Promoting greater acceptance of autism as a difference could potentially enhance the well-being of both autistic healthcare professionals and patients.”
The study also found that many doctors with autism did not disclose their diagnosis in the workplace. 29% had not told anyone at work, 32% had disclosed their autism to their supervisor, and 30% had disclosed it to their colleagues. This secrecy seems to contribute to a feeling of isolation. Although four-fifths reported having worked with another doctor they suspected was autistic, only one-fifth reported having worked with another doctor they knew was autistic. Those who had never worked with any suspected autistic colleagues were also more likely to have considered suicide.
As awareness and diagnosis of autism increase, more medical students and doctors are identifying themselves as autistic. A study found that on average, they were diagnosed at the age of 36. Some were diagnosed due to difficulties in stressful clinical environments or demanding career paths. They also found that support from employers was inconsistent, with some colleagues refusing to believe that a qualified doctor could be autistic.
Dr. Shaw emphasized the importance of improving the experience of autistic doctors by promoting a positive view of neurodiversity. Workplaces should offer better support and raise awareness about autistic healthcare professionals. By employing a well-supported and diverse medical workforce, the public’s diversity will be reflected in their medical providers, likely leading to improved experiences and outcomes for neurodivergent patients.
Despite these striking findings, three-quarters of doctors (74%) generally enjoyed their work, and a similar percentage (73%) felt that being autistic was beneficial in their role as doctors.
Dr. Mary Doherty, senior author and founder of ADI, commented, “Autistic doctors are a hidden minority in the medical workforce, and the specialties in ADI challenge autistic stereotypes, with general practitioners being the largest subgroup followed by psychiatrists.”
Dr Wendy Ross, Director of the Jefferson Center for Autism and Neurodiversity, added: “This study is a call to action for the entire medical field to meet the needs of autistic medical talent as well as patients.”
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