February 10, 2012
NIH Podcast Episode #0152
Balintfy: Welcome to episode 152 of NIH Research Radio. NIH Research Radio bringing you news and information about the ongoing medical research at the National Institutes of Health – NIH . . . Turning Discovery Into Health®. I'm your host Joe Balintfy, and coming up in this episode, new understanding about resveratrol, that compound found in red wine; the very commonly consumed caffeine and how it charges up the brain; details on Sjögren’s syndrome, an autoimmune disorder commonly associated with dry eye and dry mouth; and for Black History Month and American Heart Month, we talk about heart health for African Americans. But first, a news update. Here’s Craig Fritz.
Fritz: Higher blood levels of cadmium in females, and higher blood levels of lead in males, delayed pregnancy in couples trying to become pregnant, according to a study by researchers at NIH. Researchers calculated a measure to estimate couples' likelihood of pregnancy each cycle, by their blood concentration of metals. They found that high cadmium concentrations in women showed the likelihood of pregnancy was reduced by 22 percent with each increase in the level of the metal. Males’ lead exposure showed about a 15 percent reduction in the likelihood of pregnancy for each increase in the level of lead concentrations. Scientists note that these findings highlight the importance of assessing couples' exposure jointly, in a single, combined measure. Cigarette smoke is the most common source of exposure to cadmium, and smokers are estimated to have twice the levels of cadmium as non-smokers. Common sources of lead exposure in the United States include lead-based paint in older homes, lead-glazed pottery, contaminated soil, and contaminated drinking water. Exposure to these metals is known to have a number of effects on human health, but the effects on human fertility have not been extensively studied.
A new NIH study shows that a medication approved for the treatment of rheumatoid arthritis, is effective in stopping the progression of organ damage in people with neonatal-onset multisystem inflammatory disease. This rare and debilitating genetic disorder causes persistent inflammation and ongoing tissue damage and effects about 100 people worldwide. Up to 20 percent of children with this disease do not live to adulthood. The drug works by blocking the activity of a protein made by cells of the immune system. This protein is overproduced in patients with the disorder, leading to damaging inflammation. For example, inflammation in the inner ear was found to be responsible for hearing loss and thinning of the optic nerve caused by inflammation-related pressure in the brain has been identified as a cause of vision loss. Researchers note that without this drug, patients are at risk of progressive organ damage that results in hearing and vision loss, cognitive impairment and, in many cases, early death.
NIH has created a new website, NIH Clinical Research Trials and You, to help people learn more about clinical trials, why they matter, and how to participate. From the first cure of a solid tumor with chemotherapy to the use of nitroglycerin in response to heart attacks, clinical research trials have played a vital role in improving health and quality of life for people around the globe. Clinical trials are essential for identifying and understanding ways to prevent, diagnose, and treat disease. Research has shown that many trials struggle to recruit volunteers due to the lack of general knowledge about what trials involve, where they are carried out, and who may participate. Learn more about clinical research trials by visiting clinicalresearchtrials.nih.gov.
For this NIH news update – I’m Craig Fritz.
Balintfy: Speaking of clinical trials, be sure to keep tuning in through the spring and summer to hear in-depth and detailed coverage of a clinical trial – I’ve signed up to be a healthy volunteer and will be recording my experience to share. Again that website Craig mentioned is clinicalresearch.nih.gov. News updates are compiled from information at www.nih.gov/news. Coming up, caffeine in the brain, understanding Sjogren's syndrome, a heart health interview, and resveratrol news, that’s next on NIH Research Radio.
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NIH study uncovers mechanism underlying resveratrol activity
Balintfy: You may have heard of resveratrol, it’s a chemical found in red wine and other plant products like grapes and nuts. It’s been studied a lot, mostly in mice because of health and longevity that’s been associated with it. Now researchers are finding that the effects of resveratrol seem to be more complicated than originally thought. Dr. Jay H. Chung, a senior investigator at NIH, says research published over the past few years has shown that feeding resveratrol to obese mice protected them against diet-induced obesity, as well as some of its consequences.
Chung: Resveratrol has been associated with a number of different helpful effects such as extending the lifespan in lower animals as well as protecting against aging-related metabolic diseases such as Type 2 diabetes.
Balintfy: The chemical has received significant interest from pharmaceutical companies for its potential to combat diabetes, inflammation, and cancer. But Dr. Chung says before researchers can transform resveratrol into a safe and effective medicine, they need to know exactly how it works on a cellular level.
Chung: It's possible that plant-based foods or chemicals can affect cells and physiology by a number of different ways.
Balintfy: Resveratrol was originally thought to directly activate a particular protein called SIRT1, which is associated with aging. Dr. Chung explains that it actually affects enzymes that help regulate energy.
Chung: So our new study shows that resveratrol can activate another group of proteins called phosphodiesterases, which degrade a chemical called cyclic AMP, and in doing so, it activated SIRT1 and also reproduced the health benefits of resveratrol.
Balintfy: Dr. Chung notes that resveratrol in its natural form interacts with many proteins, and may cause not-yet-known toxicities as a medicine, particularly with long-term use.
Chung: Resveratrol has a number of other targets that may or may not be good for you and no long-term studies have been done with humans.
Balintfy: He adds that the levels of resveratrol found in wine or foods are likely not high enough to produce significant health benefits or problems.
Chung: Studies that have shown effects in humans usually required about a gram of resveratrol, pure resveratrol. So you probably won't get that kind of effect drinking red wine.
Balintfy: Convincing clinical studies in humans have used about 1 gram of resveratrol per day, roughly equal to the amount found in 667 bottles of red wine.
Chung: The question is how about supplements? It's not clear how pure these supplements are. They could say 150 milligrams but it's not clear whether it's pure 150 milligrams of resveratrol.
Balintfy: Researchers emphasize that there is a clear need for additional careful and well-controlled studies to show how resveratrol operates. This latest study in mice appears in the journal Cell. For more information on the findings, visit www.nhlbi.nih.gov.
Caffeine charges up a part of the brain
Balintfy: A couple glasses of wine may not have a significant does of resveratrol, but a couple cups of coffee have enough caffeine to show an effect. Wally Akins reports that an NIH study in rats has shown that caffeine stimulates a particular region of the brain which affects learning and memory.
Akinso: When drinking coffee, many coffee lovers feel mentally refreshed or stimulated, and now according to an NIH study in rats, that stimulation happens in a particular part of the brain.
Dudek: Caffeine, in concentrations that are comparable to a large cup of coffee, can strengthen connections in a part of the brain called the hippocampus, in the part of the hippocampus called CA2.
Akinso: Dr. Serena Dudek is the senior author of this NIH Study.
Dudek: The hippocampus is a part of the brain. It’s a structure that’s known to be important for learning and memory. And the CA2 is a little part of the hippocampus that really hasn’t been studied much.
Akinso: Once the rats were given caffeine, researchers measured the strength of nerve cells’ electrical messages in brain tissue.
Dudek: The caffeine caused an enhancement of the synaptic responses and - almost immediately in the case of the brain slices. We then characterized the cellular mechanism of this enhancement.
Akinso: According to Dr. Dudek, the study showed that the higher the caffeine dose, the stronger the effect in the CA2 region of the brain.
Dudek: Caffeine enhances synaptic connections in this one particular part of the brain at concentrations that really don’t do anything elsewhere. So we think that this is where caffeine is working.
Akinso: Dr. Dudek adds that the CA2 region is likely to be a key site where cognitive function is modulated by the time of day. For more information, visit www.niehs.nih.gov. For NIH Radio, this is Wally Akinso.
Balintfy: A Swedish physician named Henrik Sjögren is credited as the first to describe a group of women who had chronic arthritis that was accompanied by dry eyes and dry mouth. That was back in the early 1900’s. A lot more is known now Sjögren’s syndrome, but its cause and cure are still for the most part, a mystery. Lesley Earl reports on this disease that affects the glands that make moisture.
Earl: Sjögren’s syndrome is a condition that affects between 1 and 4 million Americans. It usually occurs in women after menopause, but it can occasionally occur in younger women, in men and in children.
Illei: Sjögren's syndrome is a systemic autoimmune disease.
Earl: Dr. Gabor Illei is the head of the Sjögren’s Syndrome Clinic at the National Institute of Dental and Craniofacial Research at NIH. He explains that exocrine glands like the salivary gland that produces saliva and the lacrimal gland that makes tears are involved in this autoimmune disease.
Illei: In an autoimmune disease, one’s own immune system that is there to protect us from viruses, bacteria, cancers and so on turns against our own body and they attack different organs. This is what is happening in Sjögren's.
Earl: Sjögren's can cause dry eyes or dry mouth, but also is associated with rheumatoid arthritis, a painful type of arthritis that causes swelling and stiffness.
Illei: There are various forms of Sjögren's syndrome and for most patients the most bothersome syndromes are related to the dryness as well as fatigue. But there is a minority of patients who get more severe systemic involvement like involvement of the lungs, the nervous system, and those people really need more aggressive treatment whereas the majority of the Sjögren's patients receive mainly symptomatic treatment.
Earl: Because tears and saliva are protective, the dryness in Sjögren’s can lead to infections and other problems.
Illei: We recommend to have plenty of water and Sjögren's syndrome patients usually have water at their hand all the time, to use certain physical measures to increase saliva production like the use of sugar-free gums or candies.
Earl: Cavities, he notes, are another risk of dry mouth.
Illei: In the eyes, we use artificial tears that can be bought over-the-counter; when it's more severe, then certain glasses that can protect the eye from drying out. But there are also some medications that we can use in more severe cases.
Earl: But how do you know if you have Sjögren’s syndrome? Dr. Illei says that diagnosing Sjögren’s syndrome is a multi-step process, and can take a long time.
Illei: One problem with Sjögren's syndrome is that the average time to diagnose Sjögren's is about seven years from the first symptoms because the symptoms can be very subtle.
Earl: Physicians have to show objective evidence of eye and mouth dryness, and that the immune system is attacking the body. Inflammation of the salivary glands and autoantibodies—antibodies that recognize the body’s own tissues—are markers of autoimmunity.
Illei: We can measure tear production fairly easily; we can measure saliva production fairly easily. Autoantibodies can be measured in blood tests and we can do biopsies of the minor salivary glands which are small glands in the inner side of the lip and take them out and then look under the microscope if there is inflammation.
Earl: Because Sjögren’s syndrome can involve so many different parts of the body, including the eyes, mouth, lungs, and joints, patients with the condition often need to see many specialists.
Illei: In general, I think that especially if someone has systemic involvement, the rheumatologist should be involved who can manage and coordinate the care. I think it is very useful to have an ophthalmologist, an eye doctor involved who can really focus on the optimal management of the eye as well as an oral disease specialist or a dentist who has experience with dry mouth to prevent or correct the effect of dry mouth on the teeth and other structures in the mouth.
Earl: As head of the Sjögren’s Clinic at NIH, Dr. Illei explains the clinics role of improving our understanding of how Sjögren’s works, and developing new, more effective therapies.
Illei: So we are very patient oriented. We do clinical studies. Some of them are just observational so we follow the disease over time and do certain investigations periodically. Some are interventional; for example, trying out a new treatment or addressing a specific problem of Sjögren's syndrome in more detail. We also include close collaboration with more basic scientists with the goal to find out more about the details of the underlying causes of Sjögren's syndrome.
Earl: Dr. Illei adds there are clinical trials on Sjögren’s syndrome currently recruiting. To find out more about a clinical trial near you, visit www.clinicaltrials.gov. To learn more about Sjögren’s syndrome and the Sjögren’s clinic, visit www.nidcr.nih.gov. For NIH Radio, this is Lesley Earl.
Balintfy: When NIH Research Radio continues, heart health for February.
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Heart health during Black History Month
Balintfy: February is Black History Month and American Heart Month. So we’re talking with Dr. Griffin Rodgers an institute director here at NIH about ways to make taking care of you heart a new tradition this month. First Dr. Rodgers, why is it especially important for African Americans with diabetes or kidney disease to know about their risk for heart disease?
Rodgers: People with diabetes and kidney disease need to know that having diabetes and kidney disease can also increase their chances of having a heart attack or stroke. For instance, 2 out of 3 people with diabetes die from heart disease or stroke. And having kidney disease also increases a person’s chances of having heart disease. Compared to the general public, African Americans are disproportionately affected by type 2 diabetes and kidney disease – which increases their chances of having heart disease.
Balintfy: What can African Americans with diabetes and kidney disease do to lower their chances of developing heart disease?
Rodgers: As we celebrate Black History Month and American Heart Month this February, let’s also take some time to learn how to lower our risk for heart disease and reach out to family members who may be able to offer insight into our own family’s health history.
Knowing your family’s medical history will allow you to alert your doctor if type 2 diabetes, kidney disease, obesity, high blood pressure, high cholesterol and/or heart disease runs in your family. This is important information to share so that your health care team can keep an eye on your health status and work with you to make any lifestyle changes to keep you healthy.
It’s very important that you take action to manage your diabetes and kidney disease to help prevent a heart attack or stroke.
If you smoke, get help to stop smoking. Smoking is one of the major risk factors associated with heart attack and stroke. Ask your health care provider for help to quit. If you have diabetes and kidney disease, a key to preventing heart attack and stroke is to control the ABCs of diabetes: A is for the A1C test, a test that measures your average blood glucose (blood sugar) over three months; B is for blood pressure; and C is for cholesterol.
Balintfy: Dr. Rodgers, what are some lifestyle changes to make if you have diabetes, kidney disease or want to stay at a healthy weight?
Rodgers: It’s important to be physically active every day. Playing sports, dancing, walking, or even doing household chores may help you manage weight and lower your blood pressure. Aim to get at least 60 minutes of physical activity, most days of the week. Eat foods with less fat, salt and added sugars. Instead of reaching for the salty fries, choose a side salad. Add more fiber to your diet by choosing whole grains, vegetables, and beans. Limit portion sizes and choose healthy foods to stay at a healthy weight. Being overweight or obese is a risk factor for heart attack and stroke. Take your medicines as prescribed. Ask for help. A little encouragement and a support go a long way. Ask your family and friends to help you stay on the right track.
Balintfy: And where can people get more information about staying healthy not just during February, but year round?
Rodgers: To learn more, visit www.niddk.nih.gov for more information on diabetes, kidney disease and weight control.
Balintfy: Thank you very much Dr. Griffin Rodgers. Again that website is www.niddk.nih.gov. There’s also more information about diabetes at www.ndep.nih.gov. And speaking of Black History Month, if you’re part of our NIH community: The Office of Equal Opportunity and Diversity Management is holding its 2012 African American History Month Observance on February 16, from 11:00 am to 12:00 noon in the Ruth L. Kirschstein Auditorium of the Natcher Building. This year’s theme is “Black Women in American Culture and History.” The keynote speaker is Dr. JC Hayward, an award winning news anchor and Vice President of Media Outreach for WUSA Channel 9. Dr. Francis Collins will provide the welcome remarks for this NIH-employee program.
Balintfy: And that’s it for this episode of NIH Research Radio. Please join us again on Friday, February 24th when our next edition will be available, including details on an e-book about Dr. Ruth Kirschstein.
“Because of her work, hundreds of thousands of people have been spared from an incredibly debilitating disease.”
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. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter @NIHRadio, or on Facebook. Until next time, I'm your host, Joe Balintfy. Thanks for listening.
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