Health – IdeasXChange

New study finds controversial “liberation therapy” fails to treat Multiple Sclerosis

Azadeh Kojouri on March 10, 2017

According to a study led by the University of British Columbia and Vancouver Coastal Health, opening up narrowed veins from the brain and spinal cord is not effective in treating multiple sclerosis.

The conclusions derived from the so-called “liberation therapy,” which thousands of MS patients have undergone since 2009, debunk the claim that MS patients could achieve huge improvements from a one-time medical procedure.

“We hope these findings, coming from a carefully controlled, ‘gold standard’ study, will persuade people with MS not to pursue liberation therapy, an invasive procedure that carries the risk of complications, as well as significant financial cost,” said Dr. Anthony Traboulsee, a UBC associate professor of neurology and director of the MS Clinic at the Djavad Mowafaghian Centre for Brain Health. Traboulsee pointed out that luckily there is a wide range of drug treatments available for MS patients. He also added that these treatments have been proven to be safe and effective at slowing disease progression through extensive studies.

The findings from the $5.4-million study was jointly funded by the Canadian Institutes of health Research, the MS Society of Canada, and the provinces of British Columbia, Manitoba and Quebec. The findings were presented at the Society for Interventional Radiology’s annual scientific meeting in Washington, DC.

Dr. Paolo Zamboni of Italy introduced the use of venoplasty to treat MS. Zamboni demonstrated that narrowing of the veins in the neck could result in iron accumulating in the brain and spinal chord, triggering an autoimmune response. He named his theory chronic cerebrospinal venous insufficiency (CCSVI). He cited several dozen patients who improved after undergoing venoplasty performed by him.

Upon learning of those anecdotal results through the news media, many patients in canada and Europe asked for imaging of their veins and subsequent venoplasty. However, almost all Canadian physicians declined performing the treatment, due to the lack of supporting evidence. As a result, some patients sought treatment in the US, Latin America and Eatern Europe.

This is the second study led by UBC and Vancouver Coastal health team along with other researchers from across Canada. The goal of the study was to find more evidence on the CCSVI theory. The first study was supported by the MS Society of Canada, and was aimed at finding whether narrowed veins were a distinct feature of MS. The study found that the narrowing was just as common in people without the disease.

“Despite the negative findings of that diagnostic study, many patients wanted to know if the venous dilation procedure could help,” said Dr. Lindsay Machan, a UBC associate professor of radiology who presented the findings at today’s interventional radiology conference. “We were committed to meticulously evaluating this treatment with robust methods and patient-focused outcomes.”

MS is an autoimmune disease, leading to the body’s own defences attacking the protective coating of brain cells, or neurons. The attack degrades the insulation of the cells slowing the neurons’ ability to conduct electrical signals causing problems with movement, sensation and cognitive function. The causes of the disease are unknown, however, scientists have implicated genetic variation and environmental factors, including a lack of Vitamin D.

Nation wide coverage for essential medications would improve access, save billions

Azadeh Kojouri on March 3, 2017

By publicly funding essential medicines and covering the cost of nearly half of all prescriptions in Canada, $3 billion per year will be saved while removing financial barriers for Canadians.

“Universal pharmacare has been long-promised but undelivered in Canada, in part because of concerns about where to start,” said Steve Morgan, a professor in the school of population and public health. “We show that adding universal public coverage of essential medicines to the existing system of drug coverage in Canada is a significant and feasible step in the right direction.”

Steve Morgan (Photo courtesy of: UBC)

A list of 117 essential medicines were identified by researchers including, antibiotics, insulin, heart medication, anti-depressants, oral contraceptives and more. They found that the list accounted for 44 percent of all prescriptions written in 2015 and up to 77 per cent of all prescriptions when therapeutically similar medications were considered.

According to The World Health Organization (WHO) these essential medicines should be provided to everyone who needs them. Dr. Persaud, a family physician, leading the team developing the essential medicines list, said the WHO’s list has been adapted based on clinical practice in Canada.

Currently, Canadians depend on a mix of private and public coverage leaving millions facing high out-of-pocket costs for drugs.

Research shows that due to the high out-of-pocket costs which many Canadians cannot afford, many do not take medication as prescribed.

“Access to medicines can be the difference between life and death,” said Dr. Nav Persaud. “There are treatments for HIV and heart disease that save lives but only when they are in the hands of people who need them.”

Morgan and Dr. Persaud propose governments purchase these essential medicines in bulk for all of Canada. They believe this approach will save patients and private drug plans $4.3 billion per year while costing government only an additional $1.2 billion per year. This would lead to a total net savings of $3.1 billion per year for Canadians.

“A program of this kind is a feasible way of improving the overall health of Canadians while dramatically lowering drug costs,” said Morgan. “Other countries that do similar things pay 40 to 80 per cent less for these essential medicines.”

Dr. Persaud is leading a clinical trial with patients in four Family health Teams in Ontario. Through these trials he will compare the health outcomes and health-care use of people receiving the free essential medicines and those who did not.

Tiny magnetic implant enables new drug delivery method

Azadeh Kojouri on February 17, 2017

UBC researchers have developed a new method of drug delivery, the first of its kind in Canada. The new method makes use a magnetic drug implant, offering an alternative for patients struggling with various pills or intravenous injections.

Size of the magnetic implant compared to the Canadian one-dollar coin. (Photo courtesy of: UBC)

The device measures just six millimetres in diameter and is made of a silicone sponge with magnetic carbonyl iron particles encapsulated in a round polymer layer.

The drug is delivered into the device and then surgically implanted in the area being treated.

A magnet is passed over the patient’s skin activating the device by deforming the sponge and resulting in the release of the drug into the surrounding tissue through a tiny opening.

“Drug implants can be safe and effective for treating many conditions, and magnetically controlled implants are particularly interesting because you can adjust the dose after implantation by using different magnet strengths. Many other implants lack that feature,” said study author Ali Shademani, a PhD student in the biomedical engineering program at UBC.

Ali Shademani and co-author Hongbin Zhang. (Photo courtesy of: UBC)

Co-author John K. Jackson, a research scientist at UBC’s faculty of pharmaceutical sciences said actively controlling drug delivery plays a significant role for patients suffering from diabetes where the required timing and dosage of insulin varies from patient to patient.

“This device lets you release the actual dose that the patient needs when they need it, and it’s sufficiently easy to use that patients could administer their own medication one day without having to go to a hospital,” said Jackson.

Researchers used the prostate cancer drug docetaxel to test their device on animal tissue in the lab. They found the technique was effective in administering the drug on demand even after repeated use. The effect of the drug on cancer cells was comparable to that of freshly delivered docetaxel, proving that the drugs stored in the device stay effective.

Mu Chiao, Shademani’s supervisor and a professor of mechanical engineering at UBC, said the team is working on refining the device and narrowing down the conditions for its use.

“This could one day be used for administering painkillers, hormones, chemotherapy drugs and other treatments for a wide range of health conditions. In the next few years we hope to be able to test it for long-term use and for viability in living models,” said Chiao.

“Active regulation of on-demand drug delivery by magnetically triggerable microspouters” was recently published online in the journal Advanced Functional Materials. Click here to download a copy.

Same brain chemistry involved in sex, drugs and rock & roll

Azadeh Kojouri on February 10, 2017

According to a study by McGill University researchers published in the Nature journal Scientific Reports, the same brain-chemical system involved in the feelings of pleasure from sex, recreational drugs, food were also responsible in experiencing musical pleasure. McGill scientists revealed brain’s own opioids are involved in musical pleasure

“This is the first demonstration that the brain’s own opioids are directly involved in musical pleasure,” says cognitive psychologist Daniel Levitin, senior author of the paper.

Levitin’s lab and others had previously used neuroimaging to map areas of the brain which are active during musical pleasure, however, scientists were only able to guess the involvement of the opioid system.

Daniel levitin’s lab (Photo courtesy of McGill University).

In this new study, Levitin’s team at McGill temporarily and selectively blocked opioids in the brain using naltrexone, a popular drug used in treating addiction disorders.

After this procedure participant’s response to music was measured, the results showed that even the participant’s favourite songs no longer resulted in feelings of pleasure.

“The findings, themselves, were what we hypothesized,” Levitin says. “But the anecdotes — the impressions our participants shared with us after the experiment — were fascinating. One said: ‘I know this is my favourite song but it doesn’t feel like it usually does.’ Another: ‘It sounds pretty, but it’s not doing anything for me.’”

Many things people enjoy can lead to addictive behaviour that can harm lives and relationships such as alcohol, sex and a friendly poker game to name a few. As a result, understanding the neurochemical roots of pleasure has been a key factor of neuroscience research for decades. However, scientists have only recently been able to do such research in humans.

Still, this study proved to be “the most involved, difficult and Sisyphean task our lab has undertaken in 20 years of research,” Levitin says. “Anytime you give prescription drugs to college students who don’t need them for health reasons, you have to be very careful to ensure against any possible ill effects.” To ensure there are no potential side effects , all 17 participants were required to take a blood test within a year following the experiment, in order to make sure they didn’t have any conditions that would be made worse by the drug.

Music’s ability to deeply effects emotions and its universality suggest an evolutionary origin, and the new findings “add to the growing body of evidence for the evolutionary biological substrates of music,” the researchers wrote.

Older Canadians forgo meds due to costs, compromising their health

Azadeh Kojouri on February 4, 2017

According to new UBC research one in 12 Canadians aged 55 and older skipped their prescriptions due to cost in 2014. This number was the second highest rate among comparable countries.

“When patients stop filling their prescriptions, their conditions get worse and they often end up in hospital requiring more care which in the long run costs us more money,” said Steve Morgan, senior author of the study and professor in UBC’s school of population and public health.

Steve Morgan (Photo courtesy of: UBC)

The research used the 2014 commonwealth fund International health Policy Survey of Older Adults (people aged 55 years or older) in 11 high income countries. The countries in the study included: Australia, Canada, France, Germany, the Netherlands, the United Kingdom, and the United States. Canada is the only country without coverage for prescription medications among countries with publicly funded health-care systems.

In a separate analysis of the Canadian survey responses, researchers revealed Canadians aged 55 to 64 were the ones subject to the greatest barriers to filling their prescriptions. Among them one in eight reported not filling their prescriptions due to costs in 2014. However, this was in comparison to Canadians aged 65 and older out of which one in 20 filled their prescription. This gap was due to the eligibility of older Canadians for comprehensive public drug coverage in many provinces.

Morgan says this gap in drug coverage among Canadians imposes a problem. He said unlike the universal public health care in other countries, public drug plans in Canada cover only a select group. This group consists of social assistance recipients, and people over the age of 65. Other canadians may have drug coverage from private insurance through their workplaces or none at all.

The survey revealed Canadians without insurance were twice as likely to not fill prescriptions due to the cost. It also showed low-income Canadians were three times more likely than high income respondents to not fill prescription medicine due to financial barriers.

Morgan said the 2014 findings were the same as were a decade ago. This consistency shows that affordability of prescription drugs is still a public health issue in Canada.

“Our problem hasn’t gone away. Financial barriers to prescription drugs are still high, both in absolute terms and relative to our peer countries.”

(Photo courtesy of: UBC)

New drug resulting breakthrough in MS treatment

Azadeh Kojouri on January 13, 2017

A drug called ocrelizumab has been shown to not only reduce new symptom progression in primary progressive multiple sclerosis (MS) but also reduce new attacks in patients with relapsing remitting MS.

The findings were discovered through three separate studies conducted by an international team of researchers, including Amit Bar-Or and Douglas Arnold from the Montreal Neurological Institute and Hospital of McGill University.

Canada has one of the highest rates of MS in the world- about 1,100 new cases are found each year. Around 50,000 Canadians have MS with more than one-in-five of them found in Quebec. (Photo courtesy of: www.freeimages.com)

In one study , 732 patients with primary progressive MS were randomized on a 2:1 ratio to receive either ocrelizumab, a humanized monoclonal antibody that depletes CD20+ B cells, or a placebo.

With the placebo, the proportion of patients with 12-week confirmed disability progression was 39.3 percent while it was 32.9 percent with ocrelizumab.

After 24 weeks, the confirmed disability progression proportion was 35.7 percent with placebo versus 29.6 percent with ocrelizumab. By week 120, timed 25-foot walk was seen to worsen by 55.1 percent for placebo versus 38.9 percent for ocrelizumab.

It was also found that patients given ocrelizumab were found to have fewer or less brain lesions and less brain volume loss compared to those given the placebo.

“The results in patients with relapsing remitting MS not only demonstrate very high efficacy against relapses, but also underscore the important emerging role of B cells of the immune system in the development of relapses,” says Bar-Or. “While the results in patients with primary progressive MS are more modest, they nonetheless represent the very first successful trial in such patients, a breakthrough as primary progressive MS now transitions from a previously untreatable condition to one that can be impacted by therapy. It is an important step forward in the field.”

Canada has one of the highest rates of MS in the world- about 1,100 new cases are found each year. Around 50,000 Canadians have MS with more than one-in-five of them found in Quebec.

Among young Canadians MS is one of the most common neurological diseases. Children as young as two are diagnosed with the disease. MS typically attacks people in their prime years, between the ages of 15 and 40. Women are twice as vulnerable as men in getting the disease.

UBC discovery may lead to new treatment for problem gamblers

Azadeh Kojouri on January 6, 2017

A new UBC study shows problem gamblers experience increased activity in their brain after looking at slot machines and roulette.

This area is the same part of the brain that lights up when drug addicts have cravings.

The findings published in Translational Psychiatry, suggest this part of the brain, known as the insula, is also involved in behavioural addictions. In addition, the study finds that treatments aimed at the insula could also treat people with gambling problems.

“This mysterious and poorly understood part of the brain has been identified as a key hub for craving in past research. For example, smokers who have sustained brain injuries affecting their insula have been found to be more likely to quit smoking,” said lead author Eve Limbrick-Oldfield, postdoctoral research fellow at the UBC department of psychology and Centre for Gambling Research. “Our study builds on those findings, showing that the insula is also involved in behavioural addictions like problem gambling.”

19 people with gambling disorder, a psychiatric term for serious gambling problems, were shown a series of gambling-related photos and neutral photos. The same photos were shown to a control group of 19 healthy volunteers. MRI brain scans were completed to assess their brain activities.

After the participants rated their craving level, the problem gamblers’ brain response to the gambling photos was compared with their brain response to the neutral photos. Researchers noted a higher level of craving after the gambling photos were shown.

Gambling cues also increased brain activity in parts of the frontal cortex and insula in problem gamblers. These areas are linked to craving and self-control in drug addiction.

Study co-author Luke Clark, psychology professor and director of the Centre for Gambling Research at UBC, said the findings show cues play a major role in triggering cravings for problem gamblers.

“Everything from the lights and the sounds of the slot machines to the smell of the casino are cues that, even after years of abstinence from gambling, can trigger a craving,” said Clark. “Being able to control one’s response to these cues is a crucial part of avoiding relapse.”

Clark said the findings shed light on the potential for treating gambling disorder by targeting the insula and testing new treatments which could tone down the brain’s responses.

The researchers are examining the effectiveness of naltrexone, a medication used to treat alcohol and heroin addiction. These medications are used to change the brain responses in problem gamblers.

Brain ‘organoids’, a futuristic innovation inspired by traditional Japanese art

Azadeh Kojouri on December 9, 2016

Researchers have been inspired by the ancient Japanese art of flower arranging for a groundbreaking technique to develop tiny “artificial brains”. These brains could be used to create personalized cancer treatments.

The organoids, which are clusters of thousands of human brains, will not be able to perform basic brain functions, let alone generate thought. However, they impart a far more authentic model — the first of its kind — for studying how brain tumours grow and how they can be stopped.

“This puts the tumour within the context of a brain, instead of a flat plastic dish,” said Christian Naus, a professor in the department of cellular and physiological sciences, who developed the project while collaborating with a Japanese company that specializes in bioprinting. Naus shared details about the technique at November’s annual Society for Neuroscience conference in San Diego. “When cells grow in three dimensions instead of two, adhering only to each other and not to plastic, an entirely different set of genes are activated.”

Christian Naus (Photo courtesy of UBC).

His area of study is glioblastoma, an especially aggressive brain cancer, originating deep inside the brain which easily spreads. The standard care is surgery followed by radiation and/or chemotherapy. However, gliomas, almost always return as a few malignant cells are able to leave the tumour and invade surrounding brain tissue. Average survival from the time of diagnosis is one year.

The idea for developing a more authentic model of glioblastoma came after Naus partnered with a Japanese biotechnology company, Cyfuse. This company has created a particular technique for printing human tissues based on the Japanese art of flower arranging known as ikebana. In ikebana, artists use a heavy plate with brass needles sticking up, upon which the stems of flowers are affixed. In Cyfuse’s bioprinting technique a much smaller plate covered with microneedles is used.

In ikebana, artists use a heavy plate with brass needles sticking up, upon which the stems of flowers are affixed. In Cyfuse’s bioprinting technique a much smaller plate covered with microneedles is used. (Photo courtesy of UBC).

“The cells make their own environment,” said Naus, Canada Research Chair in Gap Junctions and Neurological Disorders. “We’re not doing anything except printing them, and then they self-assemble.”

The team then placed cancerous cells inside the organoids. Naus noted the gliomas spread into the surrounding normal cells.

Having shown that the tumour attacks the surrounding tissue, Naus anticipates that such a technique could be used with a patient’s own cells – including both their normal and cancerous cells – in order to grow a personalized organoid with a glioma at its core. This enables researchers to test a variety of possible drugs or combinations of treatment to find out if any of them stop the cancer growing and invading surrounding tissues.

“With this method, we can easily and authentically replicate a model of the patient’s brain, or at least some of the conditions under which a tumour grows in that brain,” said Naus. “Then we could feasibly test hundreds of different chemical combinations on that patient’s cells to identify a drug combination that shows the most promising result, offering a personalized therapy for brain cancer patients.”

New method discovered to test for antioxidants in chocolate

Azadeh Kojouri on December 2, 2016

UBC food scientists have come up with a cheaper and faster way to measure the levels of antioxidants in chocolate. They are planning on using this method to recognize when antioxidant levels rise and fall during the manufacturing process, from raw cocoa beans to chocolate bars.

“Our method predicts the antioxidant levels in chocolate in under a minute, compared to the industry standard that can take several hours or even days,” said Xiaonan Lu, an assistant professor in food, nutrition and health in the faculty of land and food systems, who developed the method alongside PhD student Yaxi Hu. “It’s not a substitute for the traditional method used at the moment, but it does show a strong correlation for being just as reliable.”

Antioxidants are beneficial to human health and help contribute to the prevention of cancers, vision loss and heart diseases. They are usually found in foods like pecans, blueberries and chocolate. (Photo courtesy of: www.freeimages.com).

The UBC procedure uses infrared spectroscopy, a technology which illuminates infrared light onto chocolate samples. The infrared spectra record the chemical composition of each sample, including the levels of polyphenols, micronutrients with high antioxidant properties. The conventional method depends on biochemical tests to read absorbance values which are expensive and time consuming.

Hu said testing antioxidant levels will help chocolatiers select better beans, and also to improve their processing parameters.

Chocolate is manufactured through various processing stages from drying, to roasting and to fermentation, from chocolate beans.

UBC food scientists are starting to use their method to measure cocoa beans from different countries in each stage to pin point when antioxidants are at their highest and lowest levels.

“If we identify drying as the step that significantly lowers the bean’s antioxidant properties, for example, we will want to develop a strategy to reduce the drying time, or drying temperature,” said Lu.

Finding the antioxidant level could be valuable information for chocolate companies wanting to make products high in antioxidants, appealing more to health conscious consumers.

Antioxidants are beneficial to human health and help contribute to the prevention of cancers, vision loss and heart diseases. They are usually found in foods like pecans, blueberries and chocolate.

The research is in its early stages as the scientists test hundreds of samples. This new method used to quantify antioxidant levels was funded by a local chocolatier in Metro Vancouver, the Natural Sciences and Engineering Research Council (NSERC) and by the non-profit MITACS.

The UBC food scientists are hoping to receive more funding, specially from a major chocolate company, to advance their studies.

Six Canadian universities partner on game-changing health promotion movement

Azadeh Kojouri on November 3, 2016

Canadian universities are initiating an international effort in creating campuses, which will emphasize on health improvement and the well-being of students, faculty and staff.

The first universities to formally adopt the Okanagan Charter – An International Charter for Health Promoting Universities and Colleges – are the University of British Columbia, Simon Fraser University, Memorial University, Mount Royal University, the University of Calgary and the University of Lethbridge.

“We are committing an additional $1 million to support well-being initiatives because people who study, work and live in environments that make healthy living a priority are happier, more successful and better equipped to handle challenges,” said UBC President Prof. Santa Ono. “I am proud of UBC and our partner universities for taking steps to strengthen our communities, both on and off campus.”

UBC and SFU were the two universities leading the development of the charter along with international partners from post-secondary institutions, the Pan American Health Organization and the United Nations Educational, Scientific and Cultural Organization (UNESCO).

In order to inspire other universities, six Canadian universities adopted the charter and highlighted the fact that universities and colleges can set an example for other communities to promote health.

“The Okanagan Charter places well-being at the forefront of a wide range of programs and initiatives to support our university community,” said SFU President Andrew Petter. “SFU is proud to be a leader in the development of the Okanagan Charter, realizing our vision of being Canada’s most engaged university.”

Research shows that well-being is important to retention, productivity, learning, satisfaction and establishing a sense of community.

Universities and colleges are unique in their position in that they can promote well-being through research, education, practices and policies which can be developed on campuses.

The Okanagan Charter provides common framework for colleges and universities to lead this significant mission.

Each institution has made commitment to enact the Okanagan Charter on their campuses in different ways from campus spaces supporting connection and community to campus-wide mental health strategies.

UBC will invest an additional $1 million to promote well-being on its Vancouver and Okanagan campus as part of its commitment to the charter.

The funding will go towards efforts already underway such as increasing mental health literacy through routine mental first aid courses for staff members and faculty.

It will also go to initiatives to support well-being in classrooms and workspaces as well as supporting active lifestyles with a stationary bike study space at UBC’s okanagan campus library and movement breaks during lectures.

SFU’s Healthy Campus Community initiative will also be advanced with the help of the charter. SFU has been a leader in designing more supportive campus communities by building new spaces and re-designing courses focusing on well-being. SFU is also offering a new resilience program helping students take ownership over their emotional and social well-being.

The week of oct. 31 Presidents from the six universities will undertake the Okanagon Charter.

UBC will sign the charter during Thrive, a week-long series of events focusing on promoting mental health. Thrive originated at UBC in 2009, and is celebrated at various campuses across Canada.