Wednesday, June 17, 2020

Celiac disease shares many genetic factors with T1Diabetes


NIDDK study continues to look at possible factors that lead to the development of the diseases in children.

 New results and information surrounding potential "triggers" of the autoimmune process leading to type 1 diabetes (T1D) and how they interact with genetic factors in children at-risk for developing the disease were highlighted in the "Update from the TEDDY Study" symposium today at the American Diabetes Association's® (ADA's) 80th Virtual Scientific Sessions. Similar evidence for celiac disease is also being accumulated through the large international study program. The data The Environmental Determinants of Diabetes in the Young (TEDDY) study has collected prospectively since 2004 will be utilized in new clinical trials to prevent these autoimmune diseases that jointly affect more than 3% of the general population.

TEDDY is an international multi-center trial researching the potential causes T1D in children. The study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). T1D occurs when the beta cells of the pancreas that normally make insulin are destroyed by the body's own immune system. When the beta cells are destroyed, the body cannot make insulin and maintain normal blood sugar levels.

Children who have T1D have certain types of genes, but not all children who have those genes develop diabetes. Something from the environment "triggers" the immune destruction of the beta cells. TEDDY is aiming to discover viruses and nutritional factors that interact with genes to "trigger" immune destruction of the beta cells, marked by the appearance of islet autoantibodies. The study enrolls infants identified as "at-risk" for developing T1D and follows them for 15 years to look for the appearance of various beta-cell autoantibodies and diabetes. TEDDY has also studied biomarkers that can predict faster or slower progression to diabetes after the autoimmune destruction has begun.

"An interesting finding from TEDDY has been how early the autoimmune destruction of insulin-producing cells begins – often in the initial two years of life," said study TEDDY co-chair Marian Rewers, MD, PhD, a professor of pediatrics and medicine and executive director of the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine. "There appear to be two subtypes of T1D that differ by genetic factors and immune phenotypes. Metabolomic biomarkers may offer clues to the subtypes and whether a child develops T1D. Interestingly, HbA1c has very different predictive characteristics for progression to clinical diabetes in children with islet autoantibodies, compared to adults with risk factors for type 1 diabetes."

 Additional key updates from the study group include:

 Persistent presence of enterovirus B species in a child's stool predicts development of islet autoimmunity, especially the earlier subtype characterized by the presence of autoantibodies to insulin. 

There are also subtle differences in the composition and function of gut microbiome in children who develop islet autoantibodies, compared to controls. Early use of probiotics may decrease the risk, while use of antibiotics was not related to islet or celiac autoimmunity. 

TEDDY has also found potentially beneficial effects of vitamin D, vitamin C, or a diet rich in polyunsaturated fatty acids, though these observations need to be confirmed in randomized clinical trials. 

Celiac disease, another autoimmune condition, shares many genetic factors with T1D, noted Dr. Rewers. TEDDY investigators follow study participants for both T1D and celiac disease in an attempt to determine why some children with high-risk genes develop T1D or celiac disease, while most remain disease-free. This information will be used to try to prevent both diabetes and celiac disease in children. Recently reported TEDDY research showed an association between gluten consumption in the early years of childhood and an increased risk of celiac disease among genetically predisposed children.

 "While T1D and celiac disease share a lot of genetic 

characteristics, there are intriguing differences in the ways these 

diseases develop and progress," added Dr. Rewers. "TEDDY is 

contributing exciting clues for design of future trials to prevent 

both T1D and celiac disease."




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Monday, May 04, 2020

AI helps spot early signs of glaucoma progression to blindness

Using Artificial Intelligence (AI), researchers have developed a quick test to identify which people with glaucoma are at risk of rapid progression to blindness.

A new test can detect glaucoma progression 18 months earlier than the current gold standard method, said the study published in the journal Expert Review of Molecular Diagnostics.

Glaucoma, the leading global cause of irreversible blindness, affects over 60 million people, which is predicted to double by 2040 as the global population ages.

Loss of sight in glaucoma is caused by the death of cells in the retina, at the back of the eye.

“Being able to diagnose glaucoma at an earlier stage, and predict its course of progression, could help people to maintain their sight, as treatment is most successful if provided at an early stage of the disease,” said study first author Eduardo Normando from Imperial College London.

The test, called DARC (Detection of Apoptosing Retinal Cells), involves injecting into the bloodstream (via the arm) a fluorescent dye that attaches to retinal cells, and illuminates those that are in the process of apoptosis, a form of programmed cell death.

The damaged cells appear bright white when viewed in eye examinations — the more damaged cells detected, the higher the DARC count.

One challenge with evaluating eye diseases is that specialists often disagree when viewing the same scans, so the researchers have incorporated an AI algorithm into their method.

In the Phase II clinical trial of DARC, the AI was used to assess 60 of the study participants — 20 with glaucoma and 40 healthy control subjects.

The AI was initially trained by analysing the retinal scans (after injection of the dye) of the healthy control participants.

The AI was then tested on the glaucoma patients.

Those taking part in the AI study were followed up 18 months after the main trial period to see whether their eye health had deteriorated.

The researchers were able to accurately predict progressive glaucomatous damage 18 months before that seen with the current gold standard OCT retinal imaging technology, as every patient with a DARC count over a certain threshold was found to have progressive glaucoma at follow-up.

“These results are very promising as they show DARC could be used as a biomarker when combined with the AI-aided algorithm,” said lead researcher Francesca Cordeiro from University College London (UCL) Institute of Ophthalmology.


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Thursday, March 12, 2020

Regular use of aspirin bad for uterine cancer patients

Regular use of over-the-counter non-steroidal inflammatory drugs (NSAIDs) such as aspirin and ibuprofen is associated with an increased risk of dying in patients diagnosed with a type of uterine cancer.

"There is a increasing evidence that chronic inflammation is involved in endometrial cancer and progression and recent data suggests that inhibition of inflammation through NSAID use plays a role," said co-lead author of the study Theodore Brasky from Ohio State University in the US.

"Our finding was surprising because it goes against previous studies that suggest NSAIDs can be used to reduce inflammation and reduce the risk of developing or dying from certain cancers, like colorectal cancer," Brasky said.

In the study involving more than 4,000 patients, the researchers found that regular NSAID use was associated with a 66 per cent increased risk of dying from endometrial cancer among women with Type-1 endometrial cancers, a typically less-aggressive form of the disease.
The association was statistically significant among patients who reported past or current NSAID use at the time of diagnosis, but it was strongest among patients who had used them for more than 10 years in the past but had ceased use prior to diagnosis.

Use of NSAIDs was not associated with mortality from typically more aggressive form of the cancer, according to the study published in the Journal of the National Cancer Institute.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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