March 25, 2011
NIH Podcast Episode #0130
Balintfy: Welcome to the 130th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health—the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode understanding the seriousness of type-2 diabetes—we’ll have both a report and interview; news about a drug that shows promise for inner-city children and youth suffering from asthma; and details on a study looking into the health effects on volunteers and workers who helped clean up the gulf oil spill. But first, this news update. Here’s Craig Fritz.
Fritz: Scientists at the National Cancer Institute have found that a gene suppresses activation of cells related to immunity and leads to a reduced immune response against a growing cancer. The study was conducted on prostate tumors from mice and humans. One of the main problems in treating cancer by vaccine or immunotherapy is that tumors often evade the body’s immune response. One of their tricks is to create an environment where immunity is inhibited or suppressed. By identifying a gene that makes immune cells suppressive, the researchers may have found a new target for enhancing immune responses to cancer tumor cells. The cells isolated and examined normally initiate an immune response to disease by presenting a foreign body in a way that it is recognized by an invader-killing t cell. However, in the tumor-associated cells, this stimulating immune response is often suppressed. This suppression caused the killer t cells to become tolerant of tumor cells, to lose their ability to target and kill tumor cells, and even to suppress the activity of other t cells. Researchers believe that targeting or turning off this gene in tumors may help boost the body’s response to tumors and prevent immune suppression.
Researchers funded by the National Heart, Lung and Blood Institute have found a link between high blood pressure and a greater drop in average walking speeds in older adults. The drop seems to occur even in study participants whose high blood pressure is successfully treated. The study examined the role of brain, heart, and kidney function in changes in seniors' walking speeds over 14 years. The researchers measured how long it took participants to walk a 15-foot course, starting from a standing position. At the beginning of the study, the average walking speed was 2.2 miles per hour. While everyone who participated in the follow-up period walked slower, speeds decreased more steeply among all groups with high blood pressure by about 10 percent. Scientists note that an acceptable walking speed is important for seniors to maintain their independence, and a declining walking speed can be an indicator of other health problems and can help predict who will develop dementia or disabilities. More research is needed to better understand the link between high blood pressure and a steep decline in walking speeds.
The National Institutes Of Health, in partnership with several federal agencies, unveiled a new high-speed robot screening system that will test 10,000 different chemicals for potential toxicity. The system is part of an ongoing collaboration, known as tox21, that is working to protect human health by improving how chemicals are tested in the united states. The chemicals screened by the robot system include compounds found in industrial and consumer products, food additives, and drugs. Scientists say the new system will allow them to quickly provide information about potentially dangerous substances to health and regulatory decision makers, so they can make informed decisions to protect public health.
For this nih news update—i’m craig fritz
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up adding an asthma drug for inner-city kids; studying possible health effects of the Deepwater Horizon oil spill on clean-up volunteers and workers; plus are you at risk for diabetes? That’s next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Find out if you could be at risk for type 2 diabetes on Diabetes Alert Day
Balintfy: We’re coming up on the end of World Kidney Month—the month of March—and this past Tuesday, March 22nd was Diabetes Alert Day. If you missed it, it’s not too late to hear the wake-up call about the seriousness of diabetes. Britt Ehrhardt reports on how the campaign encourages everyone to know their risk of diabetes by taking a diabetes risk test.
Ehrhardt: Diabetes Alert Day encourages people to know their risk of diabetes.
Rodgers: Diabetes Alert Day is an annual reminder to find out if you—or someone you love—could be at risk for type 2 diabetes.
Ehrhardt: Dr. Griffin Rodgers directs the National Institute of Diabetes and Digestive and Kidney Diseases. He is also a leader of the National Diabetes Education Program, or NDEP, a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention.
Rodgers: In observance of Diabetes Alert Day, the National Diabetes Education Program is encouraging everyone to know their risk for type 2 diabetes by taking the diabetes risk test.
Ehrhardt: The diabetes risk test asks seven simple questions about family history, weight, age, and lifestyle—all potential risk factors for type 2 diabetes.
Rodgers: First, it’s important to find out whether you are at risk for type 2 diabetes. Take the NDEP diabetes risk test by visiting www.YourDiabetesInfo.org.
Ehrhardt: Dr. Rodgers says that encouraging people to identify their risk of type 2 diabetes is a critical step. He explains that this helps people prevent the disease, and it promotes early diagnosis and treatment.
Rodgers: If left undiagnosed or untreated, diabetes can lead to serious health problems such as heart disease, stroke, blindness, kidney disease, amputations, and even death. The good news is that with early diagnosis and treatment, people with diabetes can delay or prevent the development of these health problems.
Ehrhardt: Millions of Americans have diabetes, and many do not know it.
Rodgers: Diabetes is a serious disease that affects nearly 26 million Americans. Diabetes is called a “silent killer” because 1 out of 4 people with diabetes has the disease and doesn’t know that they have it.
Ehrhardt: Even more Americans are at risk of diabetes.
Rodgers: Most people with diabetes don’t know that they have symptoms. But if they do, some of the symptoms can include being very thirsty, urinating often, losing weight without trying, feeling very hungry or tired, having blurry vision, and losing the feeling in your feet or having a tingling sensation in your feet.
Ehrhardt: For more information on diabetes, the diabetes risk test, and Diabetes Alert Day, visit www.YourDiabetesInfo.org. This is Britt Ehrhardt at the National Institutes of Health, Bethesda, Maryland.
NIH study finds omalizumab relieves seasonal asthma attacks in youth
Balintfy: We’ll hear more from Dr. Rodgers later in the program. Now, to asthma. A study of the drug omalizumab, sold under the brand name Xolair, has been conducted in eight U.S. cities: Boston, Chicago, Cleveland, Dallas, Denver, New York City, Tucson, Ariz. and Washington, D.C. The findings, which appear in the March 17 issue of the New England Journal of Medicine, show it nearly eliminated seasonal increases in asthma attacks and decreased asthma symptoms among young people living in inner city environments. In the United States, asthma affects approximately 18 million adults and 7 million children under the age of 18. Symptoms include wheezing, coughing, chest tightness and shortness of breath. And experts note that many patients require visits to emergency rooms and hospitalizations because of an asthma attack or exacerbation.
Dr. Togias: It’s an asthma attack that lasts much longer than a day.
Balintfy: Dr. Alkis Togias is with Division of Allergy, Immunology and Transplantation at the National Institute of Allergy and Infectious Diseases. He says an exacerbation is a worsening of asthma that can go on for a number of days and can require the patient to be placed on oral steroids.
Dr. Togias: It is not your everyday worsening of asthma where you use a few more puffs of your inhaler and it goes away. It is something more than that.
Balintfy: One aim of a recent study has been to find out if the addition of the drug omalizumab could reduce the number of exacerbations in inner-city children and youth age 6 to 20. And it does: Those who received omalizumab had a 75 percent reduction in hospitalizations.
Dr. Togias: For us, this study was not only a proof of concept that allergy is a very important factor in asthma in this particular group of children, but it opened up a path of developing perhaps new strategies of using this medication.
Balintfy: The study was conducted by the Inner City Asthma Consortium, a nationwide clinical trials network supported by the NIH. Dr. Togias notes there were three major findings in the study.
Dr. Togias: The first one was that despite the fact that these children were being treated by the consortium, by the actual doctors that were performing the study with state-of-the-art, guidelines-based treatment for asthma, despite that, this medication given on top of everything else, had a very significant effect in reducing symptoms, in reducing overall asthma exacerbations, in reducing hospitalizations but also in reducing the need for some of these other medications.
Balintfy: The second finding shows the reduction in asthma exacerbations, including an almost complete elimination of surges during peak asthma seasons, the fall and spring.
Dr. Togias: And the third finding was that we identified a sub-population of these children that appeared extremely responsive to this medication. And that was a population of children who were allergic to cockroach, but were also exposed to high levels of cockroach in their homes.
Balintfy: At the end of the study, the investigators found that, overall, children and adolescents who received omalizumab had a 25 percent reduction in days with symptoms and a 30 percent reduction in asthma attacks. Dr. Togias emphasizes that this study answers a key question:
Dr. Togias: How important is allergy in children with asthma in inner-city.
Balintfy: He adds that the consortium is about to begin a new study to test this medication during peak asthma seasons.
Dr. Togias: So what we’re thinking is perhaps this medication may act very well if it’s given only during the seasons when these exacerbations occur.
Balintfy: Omalizumab is currently approved in the United States for patients age 12 and older with moderate to severe, persistent allergic asthma. Patients who are interested in adding this drug to their current asthma treatment should speak with their health care professional. For more information on the Inner City Asthma Consortium and these study results, visit www.niaid.nih.gov. The NIH Guidelines for the Diagnosis and Management of Asthma can be viewed or downloaded at www.nhlbi.nih.gov/guidelines/asthma.
NIH launches largest oil spill health study
Balintfy: A new study has begun that will look at possible health effects of the Gulf of Mexico's Deepwater Horizon oil spill. The study is the largest health study of its kind ever conducted among cleanup workers and volunteers. It is just one component of a comprehensive federal response to the spill. Wally Akinso reports on how cleanup workers and volunteers across Louisiana, Mississippi, Alabama, and Florida can get involved in the “Gulf Long-term Follow-up” or GuLF Study.
Akinso: The National Institute of Environmental Health Sciences has launched The GuLF STUDY.
Sandler: The GuLF Study is the largest study that’s ever been conducted on the health effects of oil spills.
Akinso: Dr. Dale Sandler is the principal investigator of the GuLF Study.
Sandler: The study is specifically for people who helped clean-up the Deep Water Horizons Gulf oil spill or had something to do related to that effort.
Akinso: The GuLF Study will reach out to some of the 100,000 people who took the cleanup worker safety training and to others who were involved in some aspect of the oil spill cleanup. The goal is to enroll 55,000 people in the study, but they must fit certain criteria.
Sandler: To be eligible for the Gulf study people had to have some connection to the Gulf oil spill clean up. Be it, by actually doing something that was potentially hazardous, like standing over the oil or working in a support capacity. There is no upper age limit. The younger age limit is 21. There is also no limit for where you live. Most of the people live in the four Gulf States.
Akinso: Dr. Sandler explains that about 20,000 of the people who enroll in this study will participate in a home visit.
Sandler: And that home visit will involve a very brief clinical exam, where we will measure lung function and blood pressure, height and weight and collect some biological samples. And we will be following up these 20,000 people who do the home visits with more actively by asking them to complete telephone interviews ever couple of years.
Akinso: The study has been developed to make participation as easy and convenient as possible. Dr. Sandler says the study will keep all personal information private.
Sandler: We are working under the privacy act. And information on individuals is of course kept private and confidential but the data we generate we will be sharing. We will actually make raw data available for others to use as part of our goals for doing this study in the open and having as many people as possible take advantage of the information we’re collecting.
Akinso: Over time, the GuLF STUDY will generate important data that may help inform policy decisions on health care and health services in the region. Findings may also influence responses to other oil spills in the future. For more information, call the GuLF Study toll-free number at 1-855-644-4853 or visit www.niehs.nih.gov/GuLFSTUDY. This is Wally Akinso at the National Institutes of Health, Bethesda, Maryland.
Balintfy: Coming up next, more on diabetes—the details on risk factors. This is NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Diabetes Alert Day
Balintfy: At the start of this episode we heard a report from Britt Ehrhardt featuring Dr. Griffin Rodgers about Diabetes Alert Day. He mentioned in that report that 26-million Americans have the disease. But...
Dr. Rodgers: Another 79 million adults have pre-diabetes, which places them at increased risk for developing type 2 diabetes.
Balintfy: So we’re talking more with Dr. Rodgers from NIDDK about diabetes awareness. And why?
Dr. Rodgers: Encouraging people to find out if they are at risk for type 2 diabetes is a critical step in helping people prevent the disease and promote early diagnosis and treatment.
Balintfy: So Dr. Rodgers, what are some potential risk factors for developing type 2 diabetes?
Dr. Rodgers: Your risk for diabetes goes up as you get older, become overweight, or if you do not stay active. Diabetes also is more common in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders. Risk factors for diabetes also include having a family history of diabetes—such as a mother, father, brother or sister with diabetes; having diabetes during pregnancy, or having a baby weighing more than nine pounds at birth; having high blood pressure and high cholesterol are also important.
Balintfy: Are there steps people can take to prevent or delay the onset of type 2 diabetes, especially if they are at risk or concerned about being at risk?
Dr. Rodgers: While there are some risk factors that you can’t change, such as your family history and age, there are risk factors associated with your lifestyle that you CAN change, such as being physically active and maintaining a healthy weight.
If you are a woman who’s had gestational diabetes when you were pregnant, it’s important to know that you are also at future risk for diabetes, so make sure you get tested for diabetes six to 12 weeks after your baby is born, and at least every three years there after. Your child from that pregnancy may also be at risk for obesity and type 2 diabetes, so share your history of gestational diabetes with your child’s doctor.
If you are at risk for diabetes, perhaps because you have a family history of diabetes or a history of gestational diabetes, you can prevent or delay type 2 diabetes by making important changes, such as losing a small amount of weight—5 or 7 percent which for a person who weigh 200 pounds translates to 10 to 14 pounds—and being more physically active.
Make a plan that includes healthy lifestyle changes, such as making healthy food choices such as fruits and vegetables, fish, lean meats, poultry without skin, dry beans or peas, whole grains, and low-fat or skim milk and cheese; choosing water instead of sugar-sweetened drinks; and eating smaller portions. Make half your plate vegetables and/or fruit; one-fourth a whole grain, such as brown rice, one-fourth a protein food, such as lean meat, poultry or fish, or dried beans. And being active at least 30 minutes, 5 days per week to help burn calories and lose weight. You don’t have to get all that physical activity at one time. Try getting some physical activity during the day in 10 minute sessions, 3 times a day. And choose something you enjoy. Ask family members to be active with you, as a way to stay on course.
Balintfy: And what is the diabetes risk test?
Dr. Rodgers: Well the diabetes risk test asks seven simple questions about family history, weight, age, and lifestyle—all potential risk factors for type 2 diabetes. People scoring 10 points or more are at a high risk for diabetes and are encouraged to talk with their doctor about diabetes. A blood test to check your blood glucose (or blood sugar) levels will show you if you have pre-diabetes or diabetes.
Balintfy: In addition to the diabetes risk test, are there other resources that can help?
Dr. Rodgers: Well NDEP has free resources to help you learn more about your risk for developing type 2 diabetes as well as ways to lower your risk. You can call 1-888-693-NDEP that’s 1-888-693-6337) or visit a website www.YourDiabetesInfo.org for more information on how to prevent or delay type 2 diabetes. Ask for Your GAME PLAN to Prevent Type 2 Diabetes, a tip sheet called It’s Never Too Early to Prevent Diabetes, a tip sheet for children at risk called Lower Your Risk for Type 2 Diabetes, which are available both in English or Spanish.
Balintfy: Thank you very much Dr. Griffin Rodgers. Again that website is www.YourDiabetesInfo.org. And that’s it for this episode of NIH Research Radio. Please join us again on Friday, April 8th when our next edition will be available. We’ll have lots of brain-related stories for you: brain activity and dyslexia, brain patters and anxiety, and mini-strokes. Be sure to tune in then. In the mean time, if you have any questions or comments about this program, or have story suggestions for a future episode, please let me know. Best to reach me by email—my address is firstname.lastname@example.org. I'm your host, Joe Balintfy. Thanks for listening.
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