tag:theconversation.com,2011:/us/topics/biomarkers-4112/articlesBiomarkers – The Conversation2024-03-14T12:43:02Ztag:theconversation.com,2011:article/2229442024-03-14T12:43:02Z2024-03-14T12:43:02ZProteins in milk and blood could one day let doctors detect breast cancer earlier – and save lives<figure><img src="https://images.theconversation.com/files/581419/original/file-20240312-28-8qcsls.jpg?ixlib=rb-1.1.0&rect=18%2C91%2C5398%2C3982&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">What if a simple blood test could diagnose otherwise undetected breast cancer?</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/vascular-testing-in-research-laboratories-royalty-free-image/1443155227">Srinophan69/Moment via Getty Images</a></span></figcaption></figure><p>Doctors may someday be able to use bodily fluids to noninvasively detect breast cancer in patients earlier than is possible now.</p>
<p>Breast cancer is the <a href="https://doi.org/10.3322/caac.21763">most commonly diagnosed cancer among women</a> in the U.S. and is currently one of the leading <a href="https://www.cancer.org/cancer/risk-prevention/understanding-cancer-risk/cancer-facts/cancer-facts-for-women.html">causes of cancer deaths</a>. Earlier diagnosis and treatment <a href="https://doi.org/10.1002/cncr.32887">lead to better prognoses</a> for breast cancer patients. But mammograms have proved to be <a href="https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms/limitations-of-mammograms.html">less effective for those under age 40</a>, as their breast tissue is denser and screening and biopsies can be unpleasant to endure.</p>
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<p>In breast milk and blood serum, researchers, including <a href="https://people.clarkson.edu/%7Ecdarie/">those in my lab group</a>, have identified proteins that are involved in tumor development. Eventually, biochemists like my colleagues <a href="https://scholar.google.com/citations?user=GH2M7ZEAAAAJ&hl=en">and I</a> hope we can use these cancer-related proteins to create a <a href="https://doi.org/10.3390/proteomes10040036">biomarker panel</a> that physicians can use to detect breast cancer earlier, therefore aiding in diagnosis and treatment.</p>
<h2>Proteins as biomarkers for what’s happening</h2>
<p>Researchers can analyze the proteins present in a variety of tissues, from biopsies of tumors to biological fluids including blood, saliva, urine, tears or breast milk. This technique is an example of studying a sample’s proteome – all the proteins in a particular cell, organism or species. The field is called <a href="https://doi.org/10.4331/wjbc.v12.i5.57">proteomics</a>. </p>
<p><a href="https://doi.org/10.1016/S1672-0229(07)60018-7">Proteomics can be a powerful tool</a> when researchers compare the proteomes of individuals from different groups, such as in blood from healthy people versus those with breast cancer. This kind of case-control comparison can identify a single protein or a group of proteins and their variants that are specific to one condition.</p>
<p>That’s what my colleagues and I are looking for: proteins that are present only in the samples from people who have breast cancer. Scientists call them <a href="https://www.britannica.com/science/biomarker">biomarkers</a> because they signal that a patient has a particular condition. Once our candidates are verified by large-scale clinical trials that include many patients, we hope that particular proteins can then be used to assess someone’s future risk of developing the disease.</p>
<p>Doctors can currently use <a href="https://doi.org/10.5493/wjem.v2.i5.86">biomarkers for breast cancer</a> to gauge a patient’s response to treatment. For instance, the molecules cancer antigen 15-3 (CA 15-3) and carcinoemybronic antigen (CEA) are elevated in breast cancer patients, so monitoring their levels can let physicians know whether treatment is working. </p>
<p>Inherited variants of the BRCA1/2 genes can increase the likelihood of developing cancer; they can act as biomarkers in screening for cancer risk. </p>
<p>None of these biomarkers aid in diagnosis of breast cancer, though.</p>
<p>Researchers prefer proteins as cancer biomarkers over the genetic materials DNA and RNA because proteins provide a snapshot of what is happening in a patient’s body at the time a sample is collected. DNA and RNA can tell you whether a certain gene is turned on or off, but not the active form of the protein it codes for or the relative abundance of <a href="https://doi.org/10.1016/j.heliyon.2023.e13323">proteins</a>. Protein analysis can also reveal changes the protein has undergone and <a href="https://doi.org/10.1016/S1672-0229(07)60018-7">protein-protein interactions</a> that can alter the way a protein functions.</p>
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<a href="https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="diagram showing nursing mother and breast milk bag, and a blood draw and test tube" src="https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=368&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=368&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=368&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=463&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=463&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581402/original/file-20240312-18-og1u88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=463&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Looking for biomarker proteins in breast milk or blood serum could detect the presence or absence of cancer.</span>
<span class="attribution"><span class="source">Danielle Whitham</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>Benefits of milk and serum biomarkers</h2>
<p>Breast milk and blood serum are two bodily fluids that can be collected noninvasively and that give information about what is happening in the body when collected.</p>
<p><a href="https://doi.org/10.1002/elps.201700123">Breast milk contains</a> secreted proteins, immune cells and sloughed cells of the milk ducts. During lactation, the breast is actively working to create milk to feed an infant. Any abnormalities in the breast milk reflect the current situation in the body. Some proteins in breast milk also circulate throughout the body and can be found in blood serum as well.</p>
<p>Serum is the <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/serum">liquid part of the blood</a> after red blood cells have been removed. It contains all the same proteins found in the blood, minus the clotting factors, therefore allowing circulating protein levels to be monitored. Narrowing in on a serum-based biomarker would mean it could be used to screen every woman, not just one who is currently lactating.</p>
<p><a href="https://doi.org/10.3390/proteomes10040036">The proteins we’ve found</a> <a href="https://doi.org/10.3390/proteomes10040036">in breast milk and identified as being</a> <a href="https://doi.org/10.1002/elps.202300040">out of whack in breast cancer</a> are involved in the cancer cells’ ability to divide, multiply and spread throughout the body. They all promote disease progression.</p>
<p>My colleagues and I currently consider these breast milk proteins to be <a href="https://doi.org/10.1080/14789450.2024.2320158">a draft biomarker for breast cancer</a>. Our group is currently working on using blood serum to identify proteins that could be involved with breast cancer. Moving from breast milk to blood serum would allow people of any age and reproductive status to be screened for the disease, rather than just those who are lactating.</p><img src="https://counter.theconversation.com/content/222944/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The Biochemistry and Proteomics Laboratories at Clarkson University receives funding from National Cancer Institute of the National Institutes of Health under Award Number R15CA260126.</span></em></p>Identifying proteins that are only present in bodily fluids when a patient has breast cancer could provide a way to screen healthy people for the disease.Danielle Whitham, Ph.D. Candidate in Chemistry and Biochemistry, Clarkson UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2168532024-02-05T13:30:30Z2024-02-05T13:30:30ZStudying lake deposits in Idaho could give scientists insight into ancient traces of life on Mars<figure><img src="https://images.theconversation.com/files/568753/original/file-20240110-30-i5trcc.JPG?ixlib=rb-1.1.0&rect=23%2C398%2C3128%2C1343&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Scientists have been studying the Clarkia site for nearly five decades.</span> <span class="attribution"><span class="source">Robert Patalano</span></span></figcaption></figure><p>Does life exist elsewhere in the universe? If so, how do scientists search for and identify it? Finding life beyond Earth is extremely difficult, partly because other planets are so far away and partly because we are not sure what to look for.</p>
<p>Yet, astrobiologists have learned a lot about <a href="https://science.nasa.gov/astrobiology/">how to find life</a> in extraterrestrial environments, mainly by studying how and when the early Earth became livable.</p>
<p>While research teams at NASA are <a href="https://mars.nasa.gov/mars2020/mission/overview/">directly combing</a> the surface of Mars for signs of life, our <a href="https://news.bryant.edu/there-life-red-planet-faculty-earns-funding-explore-theory-earth">interdisciplinary research group</a> is <a href="https://news.bryant.edu/mars-mind-bryant-students-earn-funding-nasa-ri-space-grant-consortium">using a site here on Earth</a> to approximate ancient environmental conditions on Mars. </p>
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<a href="https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A rock face with several blocky layers of rock, in different stripes of color. The top layers are a darker clay, while the bottom layers are a lighter volcanic ash." src="https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568752/original/file-20240110-18-1v7yda.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A close-up view of the Clarkia site where you can see lacustrine clay and volcanic ash layers. This site represents Mars in our work.</span>
<span class="attribution"><span class="source">Taylor Vahey</span></span>
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</figure>
<p>Contained within northern Idaho’s <a href="https://doi.org/10.1130/G48901.1">Clarkia Middle Miocene Fossil Site</a> are sediments that preserve some of Earth’s most diverse biological marker molecules, or <a href="https://doi.org/10.1016/j.epsl.2008.07.012">biomarkers</a>. These are remains of past life that offer glimpses into Earth’s history.</p>
<h2>An ancient lake</h2>
<p>About 16 million years ago, a lava flow in what would one day become Clarkia, Idaho, dammed a local drainage system and created a deep lake in a <a href="https://archive.org/details/latecenozoichist0000unse/page/424/mode/2up">narrow, steep-sided valley</a>. Although the lake has since dried up, weathering, erosion and <a href="https://www.facebook.com/p/Fossil-Bowl-100063724775941/">human activity</a> have exposed sediments of the former lake bed.</p>
<p>For nearly five decades, research teams like ours – being led by <a href="https://www.radcliffe.harvard.edu/people/hong-yang">Dr. Hong Yang</a> and <a href="https://www.bryant.edu/academics/faculty/leng-qin">Dr. Qin Leng</a> – have used <a href="https://doi.org/10.7717/peerj.4880">fossil remains</a> and <a href="https://doi.org/10.1016/0146-6380(95)80001-8">biogeochemistry</a> to reconstruct past environments of the Clarkia Miocene Lake region. </p>
<p>The lake’s depth created the <a href="https://www.jstor.org/stable/1303276">perfect conditions</a> for protecting microbial, plant and animal remains that fell to the lake’s bottom. In fact, the sediments are so well preserved that some of the fossilized leaves still show their autumn colors from when they sank into the water millions of years ago.</p>
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<a href="https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A reddish brown long, thin leaf shown embedded on a piece of smooth sediment." src="https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568751/original/file-20240110-15-2y3q3p.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A fossil magnolia leaf showing fall (reddish) colors. This leaf likely fell off a tree in the fall once the trees paused photosynthesis for the winter and sank to the bottom of the lake, where it was buried. The leaf retained its fall coloring for 16 million years, though once being dug up and exposed to air, it quickly oxidized and lost its color.</span>
<span class="attribution"><span class="source">Robert Patalano</span></span>
</figcaption>
</figure>
<p>Today, ancient lake beds on Earth are becoming <a href="https://doi.org/10.1146/annurev-earth-053018-060332">important settings</a> for learning about habitable environments on other planets. </p>
<h2>Biological marker molecules</h2>
<p>Clarkia’s lake sediments <a href="https://doi.org/10.1016/0146-6380(94)90045-0">contain a suite</a> of ancient biomarkers. These compounds, or classes of compounds, can reveal how organisms and their <a href="https://doi.org/10.1016/j.quascirev.2011.07.009">environments functioned</a> in the past.</p>
<p>Since the discovery of the <a href="https://www.idahogeology.org/pub/Information_Circulars/IC-33.pdf">Clarkia fossil site in 1972</a>, multiple research teams have used various <a href="https://doi.org/10.1016/S0146-6380(02)00212-7">cutting-edge technologies to analyze</a> different biomarkers. </p>
<p>Some of those found at Clarkia <a href="https://doi.org/10.1073/pnas.90.6.2246">include lignin</a>, which is the structural support tissue of plants, <a href="https://doi.org/10.1016/S0146-6380(00)00107-8">lipids like fats and waxes</a>, and possibly <a href="https://doi.org/10.1038/344656a0">DNA and amino acids</a>.</p>
<p>Understanding the origins, history and environmental factors that have allowed these biosignatures to stay so well preserved at Clarkia may also allow our team to predict the potential of organic matter preservation in ancient lake deposits on Mars.</p>
<h2>Studying life signatures on Mars</h2>
<p>In 2021, the <a href="https://mars.nasa.gov/mars2020/">Mars Perseverance Rover</a> landed on top of lake deposits in Mars’ <a href="https://doi.org/10.1126/science.abl4051">Jezero Crater</a>. Jezero is a meteorite impact crater believed to have once been flooded with water and home to an ancient river delta. Microbial life may have lived in Jezero’s crater lake, and their biomarkers might be found in lake bed sediments today. Perseverance has been drilling into the crater’s surface to collect samples that could contain ancient signs of life, with the intent of <a href="https://mars.nasa.gov/msr/#Facts">returning the samples to Earth in 2033</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&rect=14%2C7%2C4977%2C2799&q=45&auto=format&w=1000&fit=clip"><img alt="An artist's rendition of the Perseverence rover, made of metal with six small wheels, a camera and a robotic arm." src="https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&rect=14%2C7%2C4977%2C2799&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/547616/original/file-20230911-26-nc2bk5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">The Perseverance Rover is collecting samples to learn more about Mars’ environment.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/MarsLanding/c835b14b3e6645d7a0cd46558745752b/photo?Query=mars%20rover&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=530&currentItemNo=11&vs=true">NASA/JPL-Caltech via AP</a></span>
</figcaption>
</figure>
<p>Clarkia has many similarities to the Jezero Crater. Both Clarkia and Jezero Crater have ancient <a href="https://doi.org/10.1006/icar.2000.6530">lake deposits</a> derived from silica-rich, <a href="https://doi.org/10.1029/2017JE005478">basaltic rock</a> that formed under <a href="https://doi.org/10.1016/j.gloplacha.2022.103737">a climate with</a> higher temperatures, high humidity and a carbon dioxide-rich atmosphere. </p>
<p>At Clarkia, these conditions preserved microbial biomarkers in the ancient lake. Similar settings could have <a href="https://doi.org/10.1029/2012JE004115">formed lakes</a> on the surface of Mars. </p>
<p>The samples <a href="https://mars.nasa.gov/mars-rock-samples/#23">Perseverance is collecting</a> contain the geologic and climate history of the Jezero Crater landing site and may even contain preserved biomarkers of ancient life.</p>
<p>While Perseverance continues its mission, our group is <a href="https://agu.confex.com/agu/fm23/meetingapp.cgi/Paper/1367388">establishing criteria</a> for biomolecular authentication. That means we are developing ways to figure out whether ancient biomarkers from Earth, and hopefully Mars, are true echoes of life – rather than recent contamination or molecules from nonliving sources.</p>
<p>To do so, we are studying biomarkers from Clarkia’s fossil leaves and sediments and developing laboratory experiments using <a href="https://spaceresourcetech.com/collections/regolith-simulants">Martian simulants</a>. This material simulates the chemical and physical properties of Jezero Crater’s lake sediments.</p>
<p>By deciphering the sources, history and preservation of biomarkers connected with Clarkia’s ancient lake deposits, we hope to develop new strategies for studying the Perseverance Rover samples once they are back on Earth.</p><img src="https://counter.theconversation.com/content/216853/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robert Patalano receives funding from the NASA Rhode Island Space Grant Program. </span></em></p>While NASA rovers on the surface of Mars look for hints of life, researchers back on Earth are studying ‘echoes of life’ from ancient basins – hoping that the two sites might be similar.Robert Patalano, Lecturer of Biological and Biomedical Sciences, Bryant UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2163412024-02-05T13:30:15Z2024-02-05T13:30:15ZWhat do your blood test results mean? A toxicologist explains the basics of how to interpret them<figure><img src="https://images.theconversation.com/files/570974/original/file-20240123-19-h34bd4.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2120%2C1414&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">From CBC to CMP and beyond, blood test panels provide essential information to health practitioners.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/workplace-of-laboratory-with-blood-tubes-samples-royalty-free-image/1389684965">angelp/iStock via Getty Images Plus</a></span></figcaption></figure><p>Your blood <a href="https://www.ncbi.nlm.nih.gov/books/NBK279392/">serves numerous roles</a> to maintain your health. To carry out these functions, blood contains a multitude of components, including red blood cells that transport oxygen, nutrients and hormones; white blood cells that remove waste products and support the immune system; plasma that regulates temperature; and platelets that help with clotting.</p>
<p>Within the blood are also numerous molecules formed as byproducts of normal biochemical functions. When these molecules indicate how your cells are responding to disease, injury or stress, scientists often refer to them as <a href="https://doi.org/10.1097/COH.0b013e32833ed177">biological markers, or biomarkers</a>. Thus, biomarkers in a blood sample can represent a snapshot of the current biochemical state of your body, and analyzing them can provide information about various aspects of your health.</p>
<p><a href="https://www.researchgate.net/profile/Brad-Reisfeld">As a toxicologist</a>, I study the effects of drugs and environmental contaminants on human health. As part of my work, I rely on various health-related biomarkers, many of which are measured using conventional blood tests.</p>
<p>Understanding what <a href="https://www.nhlbi.nih.gov/health/blood-tests">common blood tests</a> are intended to measure can help you better interpret the results. If you have results from a recent blood test handy, please follow along.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/4nYHPM7BHIM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Blood samples go through several processing steps after they’re drawn.</span></figcaption>
</figure>
<h2>Normal blood test ranges</h2>
<p><a href="https://theconversation.com/how-do-blood-tests-work-medical-laboratory-scientists-explain-the-pathway-from-blood-draw-to-diagnosis-and-treatment-196874">Depending on the lab</a> that analyzed your sample, the results from your blood test may be broken down into individual tests or collections of <a href="https://www.testing.com/tests/chemistry-panels/">related tests called panels</a>. Results from these panels can allow a health care professional to recommend preventive care, detect potential diseases and monitor ongoing health conditions.</p>
<p>For each of the tests listed in your report, there will typically be a number corresponding to your test result and a <a href="https://www.testing.com/articles/laboratory-test-reference-ranges/">reference range or interval</a>. This range is essentially the upper and lower limits within which most healthy people’s test results are expected to fall.</p>
<p>Sometimes called a normal range, a reference interval is based on <a href="https://webstore.ansi.org/preview-pages/CLSI/preview_CLSI+C28-A3.pdf">statistical analyses</a> of tests from a large number of patients in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975205/">reference population</a>. Normal levels of some biomarkers are expected to vary across a group of people, depending on their age, sex, ethnicity and other attributes. </p>
<p>So, separate reference populations are often created from people with a particular attribute. For example, a reference population could comprise all women or all children. A patient’s test value can then be appropriately compared with results from the reference population that fits them best.</p>
<p>Reference intervals <a href="https://doi.org/10.1001/archinternmed.2007.131">vary from lab to lab</a> because each may use different testing methods or reference populations. This means you might not be able to compare your results with reference intervals from other labs. To determine how your test results compare with the normal range, you need to check the reference interval listed on your lab report.</p>
<p>If you have results for a given test from different labs, your clinician will likely focus on test trends relative to their reference intervals and not the numerical results themselves.</p>
<h2>Interpreting your blood test results</h2>
<p>There are <a href="https://kidshealth.org/en/parents/blood-test-types.html">numerous blood panels</a> intended to test specific aspects of your health. These include panels that look at the cellular components of your blood, biomarkers of kidney and liver function, and many more.</p>
<p>Rather than describe each panel, let’s look at a hypothetical case study that requires using several panels to diagnose a disease.</p>
<p>In this situation, a patient visits their health care provider for fatigue that has lasted several months. <a href="https://www.merckmanuals.com/professional/special-subjects/nonspecific-symptoms/fatigue">Numerous factors and disorders</a> can result in prolonged or chronic fatigue.</p>
<p>Based on a physical examination, other symptoms and medical history, the health practitioner suspects that the patient could be suffering from any of the following: anemia, an underactive thyroid or diabetes.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Close-up of a person holding gauze against the crook of their arm while another person holds up two heparin tubes of blood" src="https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570977/original/file-20240123-21-rfgobx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Blood tests provide clinicians with more information to guide diagnoses and treatment decisions.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/female-nurse-holding-blood-collection-tubes-royalty-free-image/1463489972">FluxFactory/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>Blood tests would help further narrow down the cause of fatigue.</p>
<p><a href="https://www.nhlbi.nih.gov/health/anemia">Anemia</a> is a condition involving reduced blood capacity to transport oxygen. This results from either lower than normal levels of red blood cells or a decrease in the quantity or quality of <a href="https://theconversation.com/why-do-we-bleed-a-hematologist-explains-how-the-body-prevents-blood-loss-after-injury-174581">hemoglobin</a>, the protein that allows these cells to transport oxygen. </p>
<p>A <a href="https://medlineplus.gov/lab-tests/complete-blood-count-cbc/">complete blood count panel</a> measures various components of the blood to provide a comprehensive overview of the cells that make it up. <a href="https://www.nhlbi.nih.gov/health/anemia/diagnosis">Low values</a> of red blood cell count, or RBC, hemoglobin, or Hb, and hematocrit, or HCT, would indicate that the patient is suffering from anemia.</p>
<p><a href="https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism">Hypothyroidism</a> is a disorder in which the thyroid gland does not produce enough thyroid hormones. These include thyroid-stimulating hormone, or TSH, which stimulates the thyroid gland to release two other hormones: triiodothyronine, or T3, and thyroxine, or T4. The <a href="https://medlineplus.gov/thyroidtests.html">thyroid function panel</a> measures the levels of these hormones to assess thyroid-related health.</p>
<p><a href="https://www.cdc.gov/diabetes/basics/diabetes.html">Diabetes</a> is a disease that occurs when blood sugar levels are too high. Excessive glucose molecules in the bloodstream can bind to hemoglobin and form what’s called glycated hemoglobin, or HbA1c. A <a href="https://doi.org/10.4137/BMI.S38440">hemoglobin A1c test</a> measures the percentage of HbA1c present relative to the total amount of hemoglobin. This provides a history of glucose levels in the bloodstream over a period of about three months prior to the test.</p>
<p>Providing additional information is the <a href="https://medlineplus.gov/lab-tests/basic-metabolic-panel-bmp/">basic metabolic panel, or BMP</a>, which measures the amount various substances in your blood. These include:</p>
<ul>
<li>Glucose, a type of sugar that provides energy for your body and brain. Relevant to diabetes, the BMP measures the blood glucose levels at the time of the test.</li>
<li>Calcium, a mineral essential for proper functioning of your nerves, muscles and heart.</li>
<li>Creatinine, a byproduct of muscle activity.</li>
<li>Blood urea nitrogen, or BUN, the amount of the waste product urea your kidneys help remove from your blood. These indicate the status of a person’s metabolism, kidney health and electrolyte balance.</li>
</ul>
<p>With results from each of these panels, the health professional would assess the patient’s values relative to their reference intervals and determine which condition they most likely have.</p>
<p>Understanding the purpose of blood tests and how to interpret them can help patients partner with their health care providers and become more informed about their health.</p><img src="https://counter.theconversation.com/content/216341/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Brad Reisfeld does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Your blood contains a wealth of information about the state of your health. Analyzing the levels of each component is an important part of diagnosis.Brad Reisfeld, Professor of Chemical and Biological Engineering, Biomedical Engineering, and Public Health, Colorado State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2174042023-11-17T17:18:16Z2023-11-17T17:18:16ZNew blood tests for dementia announced, but what can they tell us and who will benefit?<figure><img src="https://images.theconversation.com/files/559949/original/file-20231116-28-b88a0l.jpg?ixlib=rb-1.1.0&rect=27%2C18%2C6104%2C4063&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/lab-assistant-medical-scientist-chemistry-researcher-2248148893">Pickadook/Shutterstock</a></span></figcaption></figure><p>A five-year, £5 million initiative has just been launched to investigate the feasibility of using new blood tests in the diagnosis of Alzheimer’s disease. Alzheimer’s Research UK and the Alzheimer’s Society are working with the National Institute for Health and Care Research to <a href="https://www.alzheimersresearchuk.org/a-five-year-project-to-bring-alzheimers-blood-tests-to-the-nhs/">use these blood tests in the NHS</a>.</p>
<p>This funding, hot on the heels of <a href="https://theconversation.com/experimental-alzheimers-drug-shows-promise-but-there-are-many-hurdles-still-to-overcome-195383">recent drug trials</a> for Alzheimer’s disease, continues a wave of breathless excitement in a field that has traditionally found good news stories hard to come by. </p>
<p>Of those seen by specialists in memory services, the vast majority are <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/dementia-diagnosis/dementia-tests">given a diagnosis</a> of dementia based on their symptoms alongside cognitive tests, blood tests to rule out other explanations (such as hormone imbalances), and sometimes an MRI brain scan. </p>
<p>A small percentage, particularly those who are younger or who have more complex symptoms, may be offered a more detailed investigation to look for some proteins (amyloid and tau) that can build up in the brain. </p>
<p>At the moment, this would involve a lumbar puncture (placing a needle into the spine and removing some of the fluid) or a specialist brain scan called a PET scan. If simple blood tests can tell us the same information, with enough accuracy, then this will be preferable for this small group of people.</p>
<p>So far, so good. But what about those people who don’t need a lumbar puncture or PET scan? Will they see meaningful benefits from these new blood tests? It is far from certain. </p>
<p>Some argue that more “precision” in the diagnosis will help people understand what the coming years will entail. But this assumes that we can confidently place all people with dementia into the <a href="https://www.alzheimers.org.uk/about-dementia/types-dementia">various disease categories</a> (such as Alzheimer’s, vascular dementia, Lewy body dementia, frontotemporal dementia) based on the pathologies we find in their brains, and that we can then accurately predict how things will unfold for that person. </p>
<p>Unfortunately, we can’t. Instead, data show that many pathologies (disease-causing abnormalities such as protein build-up or damage to blood vessels) are linked to dementia, and most people with dementia have <a href="https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(23)00019-3/fulltext#seccestitle140">more than one</a>. This mixed disease is a big part of what makes researching the syndrome of dementia so complex. </p>
<p>The other suggested benefit is that the tests will tell us if the patient is eligible for the new drugs approved in the US (and currently being considered by UK and European regulators). But beyond the headlines, the current crop of new drugs <a href="https://theconversation.com/new-alzheimers-drugs-dont-deserve-the-hype-heres-why-211842">don’t stand up to scrutiny</a>.</p>
<h2>Beyond the amyloid theory</h2>
<p>The theory on which they are based (that the build-up of the amyloid protein is the trigger for everything that comes after) is increasingly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997141/#:%7E:text=Taken%20together%2C%20the%20evidence%20is,initiation%20and%20progression%20of%20dementia">challenged</a> by <a href="https://academic.oup.com/brain/article-abstract/146/10/3969/7162122?redirectedFrom=fulltext&login=false">experts</a>. We need to better understand the complex biology of dementia. </p>
<p>In the past, this has been heavily focused on amyloid even though evidence has told us to <a href="https://mitpress.mit.edu/9780262546010/how-not-to-study-a-disease/#:%7E:text=Herrup%20presents%20a%20new%20and,of%20the%20Alzheimer%27s%20disease%20research">also look elsewhere</a>. </p>
<p>The ultimate frontier that many seek is screening people who have no symptoms but who would, if tested, be found to have raised protein levels. They hope that by detecting people at this stage, drugs could not just slow down the disease but prevent it altogether. </p>
<figure class="align-center ">
<img alt="Person receiving a lumbar puncture." src="https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/559961/original/file-20231116-19-knacv6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Person receiving a lumbar puncture.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/demonstration-simulator-lumbar-puncture-epidural-anesthesia-1946628973">Kittipong Somklang/Shutterstock</a></span>
</figcaption>
</figure>
<p>A recent trial tested this, in which people with raised amyloid but no symptoms took the amyloid-clearing drug <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2305032">solazenumab</a> for more than four years. It had no effect on cognitive function compared with a placebo, confirming that this ambition is, sadly, not close. </p>
<p>It may not ever be realised for such a complex disease. The most significant problem is that many of those who have raised brain amyloid but no symptoms <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2018.03.005">will die without developing dementia</a>. Therefore, most symptom-free people with a positive blood test have nothing to gain and can only experience harm – from anxiety, further tests, or treatments. Importantly, the focus of this new initiative is not people without symptoms. </p>
<h2>New initiative</h2>
<p>Several studies of new blood tests have been carried out already in people with dementia symptoms, showing they are almost as good as PET scans or lumbar punctures at detecting protein levels. But the people in these studies were typically younger (in their 60s and 70s), with minimal brain pathologies (except amyloid) and other disorders, and minimal ethnic and socioeconomic diversity. </p>
<p><a href="https://www.alzheimersresearchuk.org/wp-content/uploads/2023/05/Blood-Biomarker-Challenge-Request-for-Application.pdf">This initiative</a> will test how well these emerging blood tests perform for those with suspected dementia in the NHS. Most people in the UK who develop dementia are <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61570-6/fulltext">in their 80s</a>, have mixed brain pathologies, commonly have other diseases (for example, kidney disease, which may <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800717#:%7E:text=Kidney%20function%20might%20influence%20the,of%20the%20disease%20are%20multifactorial.">affect the accuracy of the blood tests</a>, and rates are higher among poorer groups and those <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12774">from some minority ethnic backgrounds</a>. </p>
<p>The results of this new initiative will tell us how well the new blood tests perform in these older, more complex people. The most important question, though, will be: do the results of protein tests change the way we look after people with dementia, resulting in a better quality of life?</p><img src="https://counter.theconversation.com/content/217404/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sebastian Walsh receives funding from the NIHR</span></em></p><p class="fine-print"><em><span>Edo Richard receives funding from The Netherlands Organisation for Health Research and Development (ZonMW) - public funding </span></em></p><p class="fine-print"><em><span>Carol Brayne does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The NHS will trial a new blood test for dementia, which could be widely available in five years.Sebastian Walsh, NIHR Doctoral Fellow in Public Health, University of CambridgeCarol Brayne, Professor of Public Health Medicine, University of CambridgeEdo Richard, Professor of Neurology, Radboud UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2170252023-11-13T21:44:00Z2023-11-13T21:44:00ZGulf of St. Lawrence: Analyzing fish blood can show us how healthy they are<figure><img src="https://images.theconversation.com/files/557461/original/file-20231003-21-bibw4p.jpeg?ixlib=rb-1.1.0&rect=30%2C12%2C3995%2C3005&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The industrialization of the fishing industry and changes in the environment have raised many issues about the management of our fisheries.</span> <span class="attribution"><span class="source">(Fanny Fronton)</span>, <span class="license">Fourni par l'auteur</span></span></figcaption></figure><p>The Gulf of St. Lawrence is an invaluable resource for Canada. Fish and shellfish fisheries that date to the 16th century have remained an essential source of income for many communities, including those on the North Shore and Gaspésie or the Îles-de-la-Madeleine.</p>
<p>For example, in <a href="https://publications.gc.ca/collections/collection_2019/mpo-dfo/Fs124-10-2018-eng.pdf">Îles-de-la-Madeleine</a>, nearly 1,800 jobs (for a total of 12,500 inhabitants) were linked to fishing in 2015.</p>
<p>But the industrialization of fishing, and changes in the environment, have brought about many new problems in the management of our fisheries. The abundance of different fish species in the Gulf has fluctuated greatly over the last 20 years.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/469058/original/file-20220615-9549-jj1phn.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>This article is part of our series, <a href="https://theconversation.com/ca-fr/topics/fleuve-saint-laurent-116908">The St. Lawrence River: In depth</a>.
Don’t miss new articles on this mythical river of remarkable beauty. Our experts look at its fauna, flora and history, and the issues it faces. This series is brought to you by <a href="https://theconversation.com/ca-fr">La Conversation</a>.</em></p>
<hr>
<p>A case in point: the number of Greenland halibut has declined drastically. This year, <a href="https://www.hi.no/hi/nettrapporter/imr-pinro-en-2023-6">landings</a> are six times lower for fishermen compared to last year.</p>
<p>But other species are benefiting from the situation. This is the case for the population of Atlantic halibut, which is at record levels today.</p>
<p>What is causing these changes? And can we predict further changes?</p>
<p>As a doctoral student in biology at the Institut national de la recherche scientifique (INRS), I am trying to find possible answers to these questions as part of my research work.</p>
<h2>A new health monitoring technique</h2>
<p>The means available for studying the health of fish at the individual level are limited. On the one hand, we can calculate indicators from the weight and height of individual fish. But these measurements are too vague and don’t tell us much.</p>
<p>The logistics of performing biopsies on the tissue of fish — which requires taking samples from their muscle or organs — are complex. To carry them out, researchers must have to travel to the ocean, physically collect samples and bring them back to a laboratory. And then there are ethical considerations, since obviously fish must be sacrificed to achieve this.</p>
<p>Even so, these methods are not very effective for detecting stress induced by environmental changes, and are not effective for detecting stress at early stages, before the physical effects can become manifest.</p>
<p>Yet in a context where the abundance of certain fish species is in rapid decline, an analysis of their overall health is necessary. Fortunately, a new tool is being developed: the <a href="https://www.nature.com/articles/s41598-023-32690-6">circulating microbiome</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="viruses in the blood" src="https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=343&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=343&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=343&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=431&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=431&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551779/original/file-20231003-15-6ou9xh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=431&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">It is often wrongly believed that blood is sterile.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>A little-known practice</h2>
<p>The circulating microbiome is a biomarker, an alarm signal that can be detected in fish even before their health begins to deteriorate. A good biomarker is sensitive, easy to sample, and inexpensive.</p>
<p>The analysis of the circulating microbiome, made up of the DNA of bacteria found in the blood, is directly inspired by <a href="https://theconversation.com/ladn-%20circulating-a-new-simple-and-rapid-weapon-in-the-diagnosis-and-monitoring-of-cancers-206786">similar analyses performed on humans</a>, which provide a great deal of information.</p>
<p>In particular, these analyses make it possible to detect anomalies resulting from the effect of a stress factor on the body, or the development of a disease.</p>
<p>Changes in the environment can also be detected from studying the circulating microbiome. But a major problem emerges here: a fish is not a human. Humans are studied in such detail that knowledge about their health can then be used for an infinite amount of further research. However, sampling fish blood is not a common practice. So there is a great deal that needs to be done before we can properly evaluate the health of fish.</p>
<p>Since the analysis of the circulating microbiome in fish has never been studied before, a lot of work needs to be done to develop the technique.</p>
<h2>Traces of bacteria in the blood?</h2>
<p>As blood circulates throughout the body, it comes into contact specifically with bacteria that make up the other microbiomes (intestinal, oral, dermal). Both in fish and humans, these bacteria are essential for good health.</p>
<p>When we analyze bacterial DNA in the blood, it is therefore possible to find bacteria from the intestine, mouth, or skin. But the hypothesis that these are bacteria specific to the blood cannot be completely ruled out either.</p>
<p>While some continue to believe that blood is sterile, and therefore does not contain any bacteria, we have known since the 1970s that this hypothesis is false — it was confirmed <a href="https://doi.org/10.1128/jcm.39.5.1956-1959.2001">in the 2000s by genomic studies</a>. It’s possible that in 1674, the Dutch microbiologist Antonie Van Leeuwenhoek may even have observed bacteria in salmon blood <a href="https://doi.org/10.3389/fcimb.2019.00148">under a microscope</a>.</p>
<p>Today, we can analyze these bacteria in detail by targeting a very specific bacterial gene, the 16S ribosomal RNA gene. Present in all bacteria around the world, this gene varies slightly from one species to another. That makes it possible to identify and analyze the biodiversity of the microbiome.</p>
<h2>I eat, therefore I am</h2>
<p>Our recent work has made it possible to characterize, for the first time, the <a href="https://www.nature.com/articles/s41598-023-32690-6">circulating microbiomes of turbot and halibut</a>. We have demonstrated that the two fish species have circulating microbiomes dominated by the presence of the species <em>Pseudoalteromonas</em> and <em>Psychrobacter</em>. These bacteria are known to colonize cold environments, for example the bottom of the Gulf of St. Lawrence, which is around 5°C. They are also known to produce bioactive compounds (antibacterials and antifungals). They are more tenacious than other bacteria.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="person with blue gloves holds a fish" src="https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551768/original/file-20231003-29-qhulgz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Greenland halibut.</span>
<span class="attribution"><span class="source">(Fanny Fronton)</span>, <span class="license">Fourni par l'auteur</span></span>
</figcaption>
</figure>
<p>However, differences can be observed between the two species. Turbot has more bacteria called <em>Vibrio</em>, some of which metabolize chitin, a molecule that makes up the shells of the invertebrates on which it feeds. Atlantic halibut, for its part, presents more <em>Acinetobacter</em> bacteria, typical of piscivorous (fish-eating) diets in the intestinal microbiomes. The circulating microbiome in these two fish species therefore seems to be influenced by intestinal bacteria, as is the case in humans. We could therefore potentially link a blood microbiome to the fish’s diet, which is often difficult to estimate.</p>
<h2>An embryonic, but promising technique</h2>
<p>So this first bacterial mapping of the blood of these two species probably reflects their respective intestinal microbiome. From this characterization, detection of a variation in the composition of bacteria could be linked to stress, a change in the environment or a physiological change in the animal.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="comic strip" src="https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=907&fit=crop&dpr=1 600w, https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=907&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=907&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/540859/original/file-20230802-23891-ctgz3u.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Comic strip illustrating the principle of analyzing the circulating microbiome.</span>
<span class="attribution"><span class="source">(Fanny Fronton)</span>, <span class="license">Fourni par l'auteur</span></span>
</figcaption>
</figure>
<p>For example, we know that in humans, the loss of <em>Actinobacteria</em> in the circulating microbiome is associated with severe acute <a href="https://doi.org/10.3389/fcimb.2018.00005">pancreatitis</a>. And there are dozens of examples like this in humans.</p>
<p>This study, the result of a collaboration between university researchers from INRS, the University of Québec at Rimouski and the Department of Fisheries and Oceans Canada, provides a small overview of the informative potential offered by the blood microbiomes of fish from the Gulf of St. Lawrence.</p>
<p>Further research will make it possible to estimate their health and better predict the evolution of their population. The dramatic collapse of the cod stock in the late 1980s had a major impact on fishermen. Several of them even fear that this situation will happen again with another species. As turbot remains a species at risk, it is essential to ensure better management of St. Lawrence species.</p>
<p>Only by refining our analysis techniques and deepening our scientific knowledge can we prevent this type of collapse from happening again in the future.</p><img src="https://counter.theconversation.com/content/217025/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Fanny Fronton received a grant from the Fondation Armand Frappier.</span></em></p>Blood isn’t sterile, and analyzing the bacteria in it could help assess the health of fish and prevent the collapse of their populations.Fanny Fronton, Doctorante en Écologie halieutique et biologie moléculaire, Institut national de la recherche scientifique (INRS)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2156112023-11-06T10:30:24Z2023-11-06T10:30:24ZYour biological age predicts dementia and stroke regardless of your actual age – new study<figure><img src="https://images.theconversation.com/files/557607/original/file-20231105-27-bb4wsv.jpg?ixlib=rb-1.1.0&rect=10%2C31%2C6939%2C4594&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/concept-image-on-age-characters-young-2274077339">tomertu/Shutterstock</a></span></figcaption></figure><p>As we journey through life, the risk of developing chronic diseases, including cancer, heart disease and neurological disorders, increases significantly. However, while we all grow older chronologically at the same pace, biologically, our clocks can tick <a href="https://doi.org/10.1038/s41591-023-02296-6">faster or slower</a>. Relying solely on chronological age – the number of years since birth – is inadequate to measure the body’s internal biological age.</p>
<p>This discrepancy has prompted scientists to find ways to determine a person’s <a href="https://doi.org/10.1016/j.cell.2023.08.003">biological age</a>. One way is to look at “<a href="https://www.nature.com/articles/d41586-022-00077-8">epigenetic clocks</a>” which consider chemical changes that occur in our DNA as we age. Another approach uses <a href="https://doi.org/10.1007/s11357-021-00480-5">information from medical tests</a>, such as blood pressure, cholesterol levels and other physiological measurements.</p>
<p>By using these “biomarkers”, researchers have discovered that when a person’s biological age surpasses their chronological age, it often signifies <a href="https://doi.org/10.1038/s43587-021-00044-4">accelerated cell ageing</a> and a higher susceptibility to age-related diseases. </p>
<p>Our new research suggests your biological age, more than the years you’ve lived, may predict your risk of dementia and stroke in the future. </p>
<p><a href="https://doi.org/10.1093/brain/awad252">Previous studies</a> have shed light on this association but they were often limited in scale. This has left gaps in our understanding of how biological ageing relates to various neurological disorders, including Parkinson’s disease and motor neuron disease.</p>
<p>To bridge this gap, our study, <a href="https://doi.org/10.1136/jnnp-2023-331917">published in the Journal of Neurology, Neurosurgery and Psychiatry</a>, examined over 325,000 middle-aged and older British adults. We investigated whether advanced biological age increases the future risks of developing neurological diseases, including dementia, stroke, Parkinson’s disease and motor neuron disease.</p>
<p>To assess biological age, we analysed 18 biomarkers collected during medical checkups conducted between 2006 and 2010. These included blood pressure, blood glucose, cholesterol levels, inflammation markers, waist circumference and lung capacity. </p>
<figure class="align-center ">
<img alt="A man reading his own blood pressure." src="https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557608/original/file-20231105-21-98b0vn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A number of biomarkers were measured, including blood pressure.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hypertension-older-age-senior-black-man-2066841269">Pro-stock Studio/Shutterstock</a></span>
</figcaption>
</figure>
<p>We then followed participants for nine years to see who developed neurological diseases. Those with older biological ages at the study’s start had significantly higher risks of dementia and stroke over the next decade – even after considering differences in genetics, sex, income and lifestyle.</p>
<p>Imagine two 60-year-olds enrolled in our study. One had a biological age of 65, the other 60. The one with the more accelerated biological age had a 20% higher risk of dementia and a 40% higher risk of stroke.</p>
<h2>Strong association</h2>
<p>It is worth noting that while advanced biological age showed a strong association with dementia and stroke, we saw a weaker link with motor neuron disease and even an opposite direction for Parkinson’s disease.</p>
<p>Parkinson’s disease often exhibits unique characteristics. For instance, although smoking typically <a href="https://doi.org/10.7554/eLife.59479">accelerates ageing</a>, it paradoxically exerts a <a href="https://doi.org/10.1212/WNL.0000000000009437">protective effect</a> against Parkinson’s disease.</p>
<p>Our findings show that biological ageing processes probably contribute substantially to dementia and stroke later in life. Together with our previous research showing a significant association between <a href="https://doi.org/10.1038/s41416-023-02288-w">advanced biological age and cancer risks</a>, these results suggest that slowing the body’s internal decline may be key to preventing chronic diseases in late life.</p>
<p>Assessing biological age from routine blood samples could someday become standard practice. Those with accelerated ageing could be identified decades before dementia symptoms arise. While currently incurable, early detection provides opportunities for preventive lifestyle changes and close monitoring.</p>
<p>For example, research starts to suggest that biological age may be slowed down or even reversed by <a href="https://doi.org/10.18632/aging.202913">lifestyle intervention</a> including exercise, sleep, diet and nutritional supplements.</p>
<p>Replicating our results in diverse groups of people is next step. We also hope to unravel connections between genetic background, biological ageing and other major diseases, such as diabetes and heart diseases.</p>
<p>For now, monitoring internal ageing processes could empower people to delay cognitive decline, providing hope for a healthier and more fulfilling life in later years.</p><img src="https://counter.theconversation.com/content/215611/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sara Hägg receives funding from the Swedish Research Council, the Swedish Cancer Society, the National Institute on Aging.</span></em></p><p class="fine-print"><em><span>Jonathan Ka Long Mak does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Why we should all try to be biologically younger.Jonathan Ka Long Mak, PhD Candidate, Karolinska InstitutetSara Hägg, Associate Professor, Molecular Epidemiology, Karolinska InstitutetLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2151662023-10-09T12:17:28Z2023-10-09T12:17:28ZCentenarian blood tests give hints of the secrets to longevity<figure><img src="https://images.theconversation.com/files/552718/original/file-20231009-28-ftpqy8.jpg?ixlib=rb-1.1.0&rect=103%2C17%2C3725%2C2132&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-hundred-years-old-woman-centenarian-1022974105">Dan Negureanu/Shutterstock</a></span></figcaption></figure><p>Centenarians, once considered rare, have become commonplace. Indeed, they are the <a href="https://www.weforum.org/agenda/2021/02/living-to-one-hundred-life-expectancy/">fastest-growing demographic group</a> of the world’s population, with numbers roughly doubling every ten years since the 1970s.</p>
<p>How long humans can live, and what determines a long and healthy life, have been of interest for as long as we know. Plato and Aristotle discussed and <a href="https://pubmed.ncbi.nlm.nih.gov/12092789/">wrote about the ageing process</a> over 2,300 years ago. </p>
<p>The pursuit of understanding the secrets behind exceptional longevity isn’t easy, however. It involves <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105197/">unravelling the complex interplay</a> of genetic predisposition and lifestyle factors and how they interact throughout a person’s life. Now our recent study, <a href="https://link.springer.com/article/10.1007/s11357-023-00936-w">published in GeroScience</a>, has unveiled some common biomarkers, including levels of cholesterol and glucose, in people who live past 90.</p>
<p>Nonagenarians and centenarians have long been of intense interest to scientists as they may help us understand how to live longer, and perhaps also how to age in better health. So far, studies of centenarians have often been small scale and focused on a selected group, for example, excluding centenarians who live in care homes. </p>
<h2>Huge dataset</h2>
<p>Ours is the largest study comparing biomarker profiles measured throughout life among exceptionally long-lived people and their shorter-lived peers to date. </p>
<p>We compared the biomarker profiles of people who went on to live past the age of 100, and their shorter-lived peers, and investigated the link between the profiles and the chance of becoming a centenarian. </p>
<p>Our research included data from 44,000 Swedes who underwent health assessments at ages 64-99 - they were a sample of <a href="https://pubmed.ncbi.nlm.nih.gov/28158674/">the so-called Amoris cohort</a>. These participants were then followed through Swedish register data for up to 35 years. Of these people, 1,224, or 2.7%, lived to be 100 years old. The vast majority (85%) of the centenarians were female. </p>
<p>Twelve blood-based biomarkers related to inflammation, metabolism, liver and kidney function, as well as potential malnutrition and anaemia, were included. All of these <a href="https://www.nature.com/articles/s41591-019-0719-5">have been associated</a> with ageing or mortality in previous studies.</p>
<p>The biomarker related to inflammation was uric acid – a waste product in the body caused by the digestion of certain foods. We also looked at markers linked to metabolic status and function including total cholesterol and glucose, and ones related to liver function, such as alanine aminotransferase (Alat), aspartate aminotransferase (Asat), albumin, gamma-glutamyl transferase (GGT), alkaline phosphatase (Alp) and lactate dehydrogenase (LD). </p>
<p>We also looked at creatinine, which is linked to kidney function, and iron and total iron-binding capacity (TIBC), which is linked to anaemia. Finally, we also investigated albumin, a biomarker associated with nutrition. </p>
<h2>Findings</h2>
<p>We found that, on the whole, those who made it to their hundredth birthday tended to have lower levels of glucose, creatinine and uric acid from their sixties onwards. Although the median values didn’t differ significantly between centenarians and non-centenarians for most biomarkers, centenarians seldom displayed extremely high or low values.</p>
<p>For example, very few of the centenarians had a glucose level above 6.5 earlier in life, or a creatinine level above 125.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Image of Villagrande Strisaili in the Ogliastra Province of Sardinia, Italy, which has the world's highest population of centenarian men." src="https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/552719/original/file-20231009-27-cn0vqz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Villagrande Strisaili in the Ogliastra Province of Sardinia, Italy, has the world’s highest population of centenarian men.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/villagrande-strisaili-italy-october-2019-scenic-1543489556">Sabino Parente/Shutterstock</a></span>
</figcaption>
</figure>
<p>For many of the biomarkers, both centenarians and non-centenarians had values outside of the range considered normal in clinical guidelines. This is probably because these guidelines are set based on a younger and healthier population. </p>
<p>When exploring which biomarkers were linked to the likelihood of reaching 100, we found that all but two (alat and albumin) of the 12 biomarkers showed a connection to the likelihood of turning 100. This was even after accounting for age, sex and disease burden. </p>
<p>The people in the lowest out of five groups for levels of total cholesterol and iron had a lower chance of reaching 100 years as compared to those with higher levels. Meanwhile, people with higher levels of glucose, creatinine, uric acid and markers for liver function also decreased the chance of becoming a centenarian. </p>
<p>In absolute terms, the differences were rather small for some of the biomarkers, while for others the differences were somewhat more substantial.</p>
<p>For uric acid, for instance, the absolute difference was 2.5 percentage points. This means that people in the group with the lowest uric acid had a 4% chance of turning 100 while in the group with the highest uric acid levels only 1.5% made it to age 100.</p>
<p>Even if the differences we discovered were overall rather small, they suggest a potential link between metabolic health, nutrition and exceptional longevity. </p>
<p>The study, however, does not allow any conclusions about which lifestyle factors or genes are responsible for the biomarker values. However, it is reasonable to think that factors such as nutrition and alcohol intake play a role. Keeping track of your kidney and liver values, as well as glucose and uric acid as you get older, is probably not a bad idea.</p>
<p>That said, chance probably plays a role at some point in reaching an exceptional age. But the fact that differences in biomarkers could be observed a long time before death suggests that genes and lifestyle may also play a role.</p><img src="https://counter.theconversation.com/content/215166/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karin Modig receives funding from The Swedish Research Council and Swedish Research Council for Health, Working Life, and Welfare.</span></em></p>Centenarians tend to have lower levels of glucose, creatinine and uric acid from their sixties onwards.Karin Modig, Associate Professor, Epidemiology, Karolinska InstitutetLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2059102023-05-22T15:12:55Z2023-05-22T15:12:55ZChronic pain can be objectively measured using brain signals – new research<figure><img src="https://images.theconversation.com/files/527287/original/file-20230519-19-eir5ap.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2040%2C1465&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Researchers are working on untangling the neural circuitry of chronic and acute pain.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/migraine-conceptual-illustration-royalty-free-illustration/1161025033">Victor Habbick Visions/Science Photo Library via Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>Using a <a href="https://doi.org/10.1109/TNSRE.2012.2183617">brain implant</a> that can record neural signals over many months, my <a href="https://shirvalkarlab.ucsf.edu">research team</a> <a href="https://scholar.google.com/citations?user=yE7ikcUAAAAJ&hl=en">and I</a> have discovered <a href="https://www.nature.com/articles/s41593-023-01338-z">objective biomarkers of chronic pain severity</a> in four patients with chronic pain as they went about their daily lives.</p>
<p>Pain is one of the most <a href="https://theconversation.com/how-do-painkillers-actually-kill-pain-from-ibuprofen-to-fentanyl-its-about-meeting-the-pain-where-its-at-173804">important and basic subjective experiences</a> a person can have. While there is plenty of evidence that perception of pain <a href="https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/pain-brain-connection">takes place in the brain</a>, there is also a major knowledge gap regarding where and how pain signals are processed in the brain. Even though pain is universal, there has not been a way to objectively measure its intensity. </p>
<p>Most prior studies on the brain signals responsible for pain have relied on <a href="http://dx.doi.org/10.1056/NEJMoa1204471">laboratory experiments in artificial environments</a>. Until now, most research on chronic pain has used indirect measures of brain activity such as <a href="https://www.radiologyinfo.org/en/info/fmribrain">functional magnetic resonance imaging</a> or <a href="https://www.youtube.com/watch?v=tZcKT4l_JZk">electroencephalography</a>. Furthermore, although doctors widely recognize that chronic pain is not just an extension of acute pain – like stubbing your toe – it remains unknown how the brain circuits behind acute and chronic pain relate to each other.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person sitting on couch, holding head in hands." src="https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/527288/original/file-20230519-25-21qk7w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Chronic pain can be debilitating.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/african-american-woman-holds-head-in-hands-on-couch-royalty-free-image/1208951217">Catherine McQueen/Moment via Getty Images</a></span>
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<p>Our study was part of a <a href="https://clinicaltrials.gov/ct2/show/NCT03029884">larger clinical trial</a> aimed at developing a new brain stimulation therapy to treat severe chronic pain. My team surgically implanted electrodes in the brains of four patients with post-stroke pain and <a href="https://www.ncbi.nlm.nih.gov/books/NBK448188/">phantom limb pain</a> to record neural signals in their <a href="https://doi.org/10.1016/j.pneurobio.2004.03.006">orbitofrontal cortex</a>, an area of the brain associated with planning and expectation, and <a href="http://doi.org/10.3171/jns.1962.19.2.0089">cingulate cortex</a>, an area associated with emotion.</p>
<p>We asked the patients about their pain severity levels several times a day for up to six months. We then built machine learning models to try to match and predict each patient’s self-reported pain intensity scores with snapshots of their brain activity signals. These brain signals consisted of electrical waves that could be decomposed into different frequencies, similar to how a <a href="https://doi.org/10.5642/jhummath.201401.05">musical chord can be broken down</a> into individual sounds of different pitches. From these models, we found that <a href="https://www.nature.com/articles/s41593-023-01338-z">low frequencies in the orbitofrontal cortex</a> corresponded with each of the patients’ subjective pain intensities, providing an objective measure of chronic pain. The larger the shift in low-frequency activity we measured, the more likely the patient was experiencing intense pain.</p>
<p>Next, we wanted to compare the relationship between chronic pain and acute pain. We examined how the brain responded to short-term, intense pain caused by applying heat to the patients’ bodies. Based on data from two participants, we found that the anterior cingulate cortex was more involved in <a href="https://www.nature.com/articles/s41593-023-01338-z">processing acute pain</a> than chronic pain. This experiment provides the first direct evidence that chronic pain involves information-processing areas of brain distinct from those involved in acute pain.</p>
<h2>Why it matters</h2>
<p>Chronic pain, defined as pain lasting more than three months, affects <a href="https://doi.org/10.1001/jamanetworkopen.2023.13563">up to 1 in 5 people in the U.S.</a> In 2019, the incidence of chronic pain was more common than that of diabetes, high blood pressure or depression. </p>
<p>Neuropathic pain resulting from damage to the nervous system, such as stroke and phantom limb pain, often doesn’t respond to available treatments and can significantly impair physical and emotional function and quality of life. Better understanding how to measure brain activity to track pain could improve the diagnosis of chronic pain conditions and help develop new treatments such as <a href="https://doi.org/10.3389/fncom.2018.00018">deep brain stimulation</a>. </p>
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<figcaption><span class="caption">Deep brain stimulation has been used to treat severe depression.</span></figcaption>
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<h2>What still isn’t known</h2>
<p>Although our study provides a proof of concept that signals from specific brain regions can serve as an objective measure of chronic pain, it is more likely that pain signals are <a href="http://doi.org/DOI:%2010.1038/srep34853">distributed over a wide brain network</a>. </p>
<p>We still don’t know what other brain regions may harbor important pain signals that may more accurately reflect subjective pain. It is also unclear whether the signals we found would apply to patients with other pain conditions.</p>
<h2>What’s next</h2>
<p>We hope to use these newly discovered neural biomarkers to develop <a href="https://theconversation.com/brain-stimulation-can-rewire-and-heal-damaged-neural-connections-but-it-isnt-clear-how-research-suggests-personalization-may-be-key-to-more-effective-therapies-182491">personalized brain stimulation</a> as a way to treat chronic pain disorders. This approach involves incorporating signals into tailored algorithms that would govern the timing and location of brain stimulation on demand, similar to how a thermostat operates.</p><img src="https://counter.theconversation.com/content/205910/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Prasad Shirvalkar receives funding from the National Institutes of Health BRAIN Initiative and HEAL Initiative, UCSF Weill Neurosciences Institute, and the George and Judy Marcus Fund. He is leading clinical trials for which Medtronic Inc. has donated devices but no direct funding.</span></em></p>Pain has long been subjectively measured, leading to frustrations for patients and doctors alike. Identifying neural biomarkers of pain could improve diagnosis and lead to better treatments of chronic pain conditions.Prasad Shirvalkar, Associate Professor of Anesthesia, University of California, San FranciscoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1988492023-03-15T12:21:15Z2023-03-15T12:21:15ZAre you a rapid ager? Biological age is a better health indicator than the number of years you’ve lived, but it’s tricky to measure<figure><img src="https://images.theconversation.com/files/514749/original/file-20230310-2079-5uhxpf.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2122%2C1410&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Healthspan measures incorporate quality of life in ways that lifespan does not.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/female-babyboomer-jumping-into-lake-royalty-free-image/92930493">Ira T. Nicolai/The Image Bank via Getty Images</a></span></figcaption></figure><p>Do you ever wake up some days and think, “When I was younger, I could survive on just four hours of sleep, but now it seems like I need 10”? Or have you ever walked out of the gym and “felt” your knees?</p>
<p>Almost everyone experiences these kinds of signs of aging. But there are some people who seem to defy their age. The late U.S. Supreme Court Justice <a href="https://www.cbsnews.com/news/remembering-rbg-justice-ruth-bader-ginsburg-a-woman-who-lived-a-life-defying-expectations/">Ruth Bader Ginsberg</a> stayed on the bench until her death at age 87. The “Great British Bake Off” judge <a href="https://www.bbc.com/news/entertainment-arts-58982697">Mary Berry</a>, now in her 80s, continues to inspire people all over the world to bake and enjoy life. And actor <a href="https://www.washingtonpost.com/arts-entertainment/2021/11/10/paul-rudd-sexiest-man-alive-people/">Paul Rudd</a> was named People magazine’s “Sexiest Man Alive” in 2021 at age 52 while still looking like he’s in his 30s. Is age just a number then? </p>
<p>Researchers have focused a lot of attention on understanding the causes and risk factors of age-related diseases like Alzheimer’s, dementia, osteoporosis and cancer. But many ignore the major risk factor for all of these diseases: aging itself. More than any individual risk factor such as smoking or lack of exercise, the number of years you’ve lived predicts onset of disease. Indeed, aging increases the risk of multiple chronic diseases <a href="https://doi.org/10.1016/j.cub.2012.07.024">by up to a thousandfold</a>. </p>
<p>However, <a href="https://doi.org/10.1038/s41586-018-0457-8">no two people age the same</a>. Although age is the principal risk factor for several chronic diseases, it is an unreliable indicator of how quickly your body will decline or how susceptible you are to age-related disease. This is because there is a difference between your chronological age, or the number of years you’ve been alive, and your biological age – your physical and functional ability.</p>
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<figcaption><span class="caption">As the author notes in her TED Talk, aging is not just a number.</span></figcaption>
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<p>I am a <a href="https://scholar.google.com/citations?user=tqI8C_UAAAAJ&hl=en">scientist interested in redefining “age.”</a> Instead of benchmarking chronological age, my lab is invested in <a href="http://agresearchlab.com">measuring biological age</a>. Biological age is a <a href="https://doi.org/10.1016/j.jacc.2019.11.062">more accurate measure of healthspan</a>, or years lived in good health, than chronological age, and doesn’t directly correlate with wrinkles and gray hairs. Rapid agers experience a faster rate of functional deterioration relative to their chronological age. </p>
<p>My grandmother, who lived to be 83 but was bedridden and could not remember who I was for the last few years of her life, was a rapid ager. My grandfather, on the other hand, also lived until he was 83, but he was active, functional and even did my homework with me until he passed away – he was a healthy ager.</p>
<p>With the unprecedented <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">growth of the world’s aging population</a>, I believe that figuring out ways to measure biological age and how to maintain or delay its advance is critical not only for individual health, but also for the social, political and economic health of our society. Detecting rapid agers early on presents an opportunity to delay, change or even reverse the trajectory of biological aging. </p>
<h2>Genetics and biological age</h2>
<p>Biological aging is multifaceted. It arises from a complex mix of genetic traits and is <a href="https://doi.org/10.1016/j.jacc.2019.11.062">influenced by factors</a> like microbiome composition, environment, lifestyle, stress, diet and exercise.</p>
<p>Genetics were once thought to have no influence on aging or longevity. However, in the early 1990s, researchers reported the first studies identifying <a href="https://doi.org/10.1098/rstb.2010.0276">genes that were able to extend the lifespan</a> of a small roundworm. Since then, multiple observations support the influence of genetics on aging.</p>
<p>For example, children of long-lived parents and even those with long-lived siblings <a href="https://doi.org/10.1038/ejhg.2011.40">tend to live longer</a>. Researchers have also <a href="https://doi.org/10.1038/s41576-019-0183-6">identified multiple genes</a> that influence longevity and play a role in resilience and protection from stress. These include genes that repair DNA, protect cells from free radicals and regulate fat levels.</p>
<p>However, it is clear from studies in identical twins – who share the same genes but not the same exact lifespans – that genes are not the only factor that influences aging. In fact, genes probably account for only <a href="https://www.scientificamerican.com/article/genetic-factors-associated-with-increased-longevity-identified/">20% to 30% of biological age</a>. This suggests that other parameters can strongly influence biological aging.</p>
<h2>Environmental and lifestyle effects</h2>
<p>Researchers have found that environmental and lifestyle factors heavily influence biological age, including social connectedness, <a href="https://doi.org/10.1001/jamanetworkopen.2021.24387">sleeping habits</a>, <a href="https://www.cnn.com/2023/01/02/health/hydration-disease-aging-death-risk-study-wellness/index.html">water consumption</a>, exercise and diet. </p>
<p><a href="https://doi.org/10.1016/j.alcr.2019.02.002">Social connectedness</a> is essential for well-being throughout life. But social connections can be challenging to maintain over time due to loss of family and friends, depression, chronic illness or other factors. Several studies have reported a <a href="https://doi.org/10.1073/pnas.1219686110">strong link</a> between social isolation and increased stress, morbidity and mortality.</p>
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<a href="https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three women dancing together in a park" src="https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/514754/original/file-20230310-449-nugrkx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Social connectedness and physical activity are linked to well-being throughout life.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/three-ladies-listening-to-music-and-dancing-royalty-free-image/1152656857">Filippo Bacci/E+ via Getty Images</a></span>
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<p>Similarly, diet and exercise are strong influencers of biological age. <a href="https://doi.org/10.1177/1559827616637066">Blue zones</a>, which are areas around the world where people live long lives, attribute their successful aging to diet, exercise and social connectedness. Mostly plant-based meals and spurts of activity throughout the day are well-known “secrets” of healthspan and longevity. Although newer studies on the effects of diet interventions such as intermittent fasting and time-restricted feeding on longevity have not been rigorously tested, they do show multiple health benefits, including <a href="https://doi.org/10.1007/s00125-022-05752-z">better glucose</a> and <a href="https://doi.org/10.1186/s12986-021-00613-9">insulin regulation</a> </p>
<p>While genetics is difficult to control, diet and exercise can be modified to delay biological aging.</p>
<h2>How to measure biological age</h2>
<p>Currently, there is no effective test to predict an individual’s health trajectory early enough in life in order to intervene and improve quality of life with age. Scientists are interested in identifying a molecule that is sensitive and specific enough to serve as a <a href="https://doi.org/10.1038/s41576-022-00511-7">unique fingerprint for biological age</a>. </p>
<p>Considering the health and resilience of the individual instead of focusing solely on disease state is important in discussions on biological age. Resilience is the state of <a href="https://doi.org/10.1093%2Fgeroni%2Figab046.621">adapting and bouncing back</a> from a health challenge and is often more predictive of functional health. A molecular aging fingerprint may provide a tool to help identify people who are less resilient and require more aggressive monitoring and early intervention to preserve their health and help <a href="https://doi.org/10.1038%2Fs43587-021-00044-4">reduce gender, racial and ethnic health disparities</a>.</p>
<p>There are several promising molecular markers that may serve as biological age fingerprints.</p>
<p>One of these markers are epigenetic clocks. <a href="https://www.cdc.gov/genomics/disease/epigenetics.htm">Epigenetics</a> are chemical modifications of DNA that control gene function. Several scientists have found that DNA can get “marked” by methyl groups in a pattern that changes with age and could potentially act as a <a href="https://theconversation.com/epigenetic-and-social-factors-both-predict-aging-and-health-but-new-research-suggests-one-might-be-stronger-200153">readout for aging</a>.</p>
<p>It is important to note, however, that while epigenetic clocks have been valuable in predicting chronological age, they do not equate to biological age. In addition, it is unclear how these epigenetic marks work or how they contribute to aging.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Older adult holding gold balloons of the number 70 in a backyard" src="https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/514752/original/file-20230310-140-5j83gz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Age is so much more than a number.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/happy-man-with-number-70-helium-balloons-in-royalty-free-image/1187298370">Klaus Vedfelt/DigitalVision via Getty Images</a></span>
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<p>Another well-regarded marker of biological age is the build-up of dysfunctional cells called senescent or <a href="https://theconversation.com/cells-become-zombies-when-the-ends-of-their-chromosomes-are-damaged-a-tactic-both-helpful-and-harmful-for-health-186445">zombie cells</a>. Cells become senescent when they experience multiple types of stress and become so damaged that they cannot divide anymore, releasing molecules that cause chronic low-grade inflammation and disease.</p>
<p><a href="https://doi.org/10.1111/acel.12344">Animal studies</a> have shown that getting rid of these cells can improve healthspan. However, what clearly defines senescent cells in humans is still unknown, making them challenging to track as a measure of biological age.</p>
<p>Lastly, the body <a href="https://doi.org/10.1126/sciadv.add6155">releases unique metabolites</a>, or chemical fingerprints, as byproducts of normal metabolism. These metabolites play a dynamic and direct role in physiological regulation and can inform functional health. My lab and others are figuring out the exact makeup of these chemicals in order to figure out which can best measure biological age. A lot of work still remains on not only identifying these metabolites, but also understanding how they affect biological age.</p>
<p>People have long sought a fountain of youth. Whether such an elixir exists is still unknown. <a href="https://doi.org/10.1038/s43587-022-00278-w">But research</a> <a href="https://doi.org/10.1038/ncomms3192">is starting</a> <a href="https://doi.org/10.1073/pnas.2107621118">to show</a> that delaying biological age may be one way to live healthier, fuller lives.</p><img src="https://counter.theconversation.com/content/198849/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aditi Gurkar receives funding from National Institute on Health, Richard King Mellon Foundation, AFAR/Hevolution. </span></em></p>Aging is a major risk factor for many chronic diseases. Figuring out what influences longevity and how to identify rapid agers could lead to healthier and longer lives for more people.Aditi Gurkar, Assistant Professor of Geriatric Medicine, University of PittsburghLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2001532023-02-20T20:11:51Z2023-02-20T20:11:51ZEpigenetic and social factors both predict aging and health – but new research suggests one might be stronger<figure><img src="https://images.theconversation.com/files/510905/original/file-20230217-22-uooeg7.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3295%2C2549&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Epigenetics is but one of many factors that influence aging, health and disease.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/clock-and-dna-royalty-free-image/1094434840">bestdesigns/iStock via Getty Images</a></span></figcaption></figure><p>Can we objectively tell how fast we are aging? With a good measure, scientists might be able to change our rate of aging to live longer and healthier lives. Researchers know that some people age faster than others and have been trying to concisely measure the internal physiological changes that lead to deteriorating health with age.</p>
<p>For years, researchers have been using <a href="https://doi.org/10.1093/gerona/gls233">clinical factors</a> normally collected at physicals, like hypertension, cholesterol and weight, as indicators to predict aging. The idea was that these measures could determine whether someone is a fast or slow ager at any point in their life cycle. But more recently, researchers have theorized that there are other biological markers that reflect aging at the <a href="https://doi.org/10.1016%2Fj.cell.2013.05.039">molecular and cellular level</a>. This includes modifications to a person’s genetic material itself, or epigenetics.</p>
<p>While each person has a genetic makeup that largely does not change over their lifetime, chemical changes to their genetic material that occur throughout life can change which genes are turned on or off and lead to more rapid aging. These changes typically involve the addition of methyl groups to DNA and are <a href="https://doi.org/10.1016/j.ssmph.2022.101071">influenced by social</a> and <a href="https://doi.org/10.1186/s13148-022-01286-8">environmental exposures</a>, such as adverse childhood experiences, smoking, pollution and depression.</p>
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<figcaption><span class="caption">The body undergoes many changes as it ages.</span></figcaption>
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<p>But how well do epigenetic markers predict the important health changes that happen with aging? We are <a href="https://scholar.google.com/citations?hl=en&user=xcXH8QcAAAAJ">social</a> <a href="https://scholar.google.com/citations?user=0aj9ZoEAAAAJ&hl=en">scientists</a> who study how social factors predict aging. Our <a href="https://doi.org/10.1016/j.arr.2020.101136">previous research</a> has shown that factors like education, poverty, race, access to medical care and certain health behaviors can influence aging rates. We are incorporating biological measures like epigenetic age in large population studies to understand how social factors get “under the skin” and affect aging. In our <a href="https://www.pnas.org/cgi/doi/10.1073/pnas.2215840120">recently published study</a>, we found that while epigenetic age does predict certain health outcomes later in life, it does little to explain important differences related to social factors.</p>
<h2>What is epigenetic aging?</h2>
<p>In 2013, geneticist and biostatistician <a href="https://scholar.google.com/citations?user=mEM8q5cAAAAJ&hl=en">Steve Horvath</a> introduced the idea that a person’s rate of aging would be captured by the <a href="https://doi.org/10.1186/gb-2013-14-10-r115">level of methylation</a> in their genome. He also developed ways to measure epigenetic age in terms of years and compare this age to one’s chronological age.</p>
<p>Researchers have since developed <a href="https://doi.org/10.18632/aging.101684">several measures</a> that can more reliably predict health outcomes based on epigenetics. Some have suggested that DNA methylation could potentially be used to summarize the amount and rate of aging with a <a href="https://doi.org/10.7554/eLife.54870">few drops of blood</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Diagram of DNA methylation" src="https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=408&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=408&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=408&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=513&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=513&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=513&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Epigenetics can influence health in a number of ways.</span>
<span class="attribution"><a class="source" href="http://commonfund.nih.gov/epigenomics/figure">National Institutes of Health</a></span>
</figcaption>
</figure>
<h2>Comparing epigenetic and social factors</h2>
<p>It has been unclear how well epigenetic age predicts health outcomes compared to other nongenetic factors like demographics and socioeconomic status. We wanted to see whether epigenetic age, measured by DNA methylation levels in the blood, predicted four aging-related health outcomes: death, chronic disease, physical disability and cognitive dysfunction.</p>
<p>Using data from the <a href="https://hrs.isr.umich.edu/about">Health and Retirement Study</a>, a large, nationally representative sample of Americans over the age of 56, we found that epigenetic age <a href="https://www.pnas.org/cgi/doi/10.1073/pnas.2215840120">predicted all of the health outcomes we examined</a>. Epigentic age most strongly predicted death and morbidity later in life. So overall, people with a higher epigenetic age experienced poorer health.</p>
<p>On the other hand, epigenetic age did not explain why people with certain demographics – such as having less education, smoking, being Black or Hispanic, being obese or having a more difficult childhood – experienced worse health outcomes earlier or more frequently. These social factors were able to predict mortality and morbidity just as well as epigenetics and substantially predicted physical and cognitive functioning better than epigentic age.</p>
<p>Our findings suggest that while DNA methylation is a useful addition to the toolbox to predict health outcomes later in life, other factors such as demographics, socioeconomic status, mental health and health behaviors remain equally, if not more robust, predictors of health.</p>
<h2>Better predicting aging and health</h2>
<p>Epigenetic aging processes like DNA methylation show promise in explaining aging. But there is still a long way to go before researchers fully understand the molecular and cellular mechanisms underlying aging.</p>
<p>Improving our ability to measure both the lifetime social experiences that affect biology and the biological mechanisms that underlie aging could lead not only to better measurements of aging, but to better treatments and disease prevention for those who need it the most.</p><img src="https://counter.theconversation.com/content/200153/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eileen Crimmins receives funding from the National Institute on Aging .
</span></em></p><p class="fine-print"><em><span>Jessica Faul receives funding from the National Institute on Aging.</span></em></p>People don’t all age at the same rate. Untangling the factors that influence health and disease – such as epigenetics, demographics and behavior – could lead to better care for those who need it most.Eileen Crimmins, Professor of Gerontology, University of Southern CaliforniaJessica Faul, Research Associate Professor of Epidemiology, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1944282022-11-16T13:31:31Z2022-11-16T13:31:31ZAgeing: hormone could help predict men’s long-term health years in advance – new study<figure><img src="https://images.theconversation.com/files/495612/original/file-20221116-20-s91scs.jpg?ixlib=rb-1.1.0&rect=0%2C11%2C7935%2C5020&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Who is likely to develop age-related disease could be predicted years in advance by looking at INSL3.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fulllength-photo-happy-senior-man-headphones-2040514991">Evgeny Atamanenko/ Shutterstock</a></span></figcaption></figure><p>We all age, but we don’t all age the same way. For some people, ageing means an increased risk of developing illnesses such as diabetes, cardiovascular disease, weak bones and cognitive decline.</p>
<p>It would be ideal if we could predict in early adulthood, while a person is still healthy, whether or not they are at risk of becoming ill or needing medical support when they are older. By then taking preventative measures, this would mean fewer people with health issues, fewer people in care, and considerably lower costs for the health system.</p>
<p>Our <a href="https://www.frontiersin.org/articles/10.3389/fendo.2022.1016107/full">latest study</a> suggests that predicting long-term health outcomes may be possible. We have found a novel insulin-like hormone in the blood, called insulin-like peptide 3 (INSL3), that may be able to predict long-term health, and whether a person is likely to develop age-related diseases – at least for men. </p>
<p>To conduct our study, we looked at data from one of the largest cohorts of ageing men, the <a href="https://academic.oup.com/ije/article/42/2/391/733095">European Male Ageing Study</a>. This had recruited 3,369 men between the ages of 40 and 79 from across Europe, including the UK, and followed them for four-to-five years. It was designed in part to assess whether the incidence of age-related disease in men can be explained by the decline of anabolic hormones such as testosterone, which is important for growth and development in the body. </p>
<p>Using data from the European Male Ageing Study, we looked for significant associations between INSL3 levels in stored blood samples that were taken at the beginning and end of the study, and the incidence of self-reported age-related illness. INSL3 was measured using a new testing method developed in our laboratory. We compared these results with the effects of other hormones such as testosterone, and also adjusted them for age, smoking status, and clinical parameters like obesity.</p>
<h2>Strong associations</h2>
<p>We were able to show that INSL3 levels can vary markedly from one person to another, and they were strongly associated with the incidence of illnesses such as cardiovascular disease, diabetes, loss of sexual function and bone weakness.</p>
<p>Men who had high INSL3 had lower risk of later becoming ill, while men with low INSL3 had a higher risk of developing age-related disease. Importantly, by looking at blood samples taken at both the beginning and end of the study, we showed that this relationship could be predicted several years in advance. </p>
<p>Although INSL3 is made in men exclusively by the same cells in the testes that make testosterone, the latter is highly variable. Testosterone levels can change markedly from hour to hour and day to day. This high variation makes it difficult to find statistically significant associations with other factors such as disease incidence. </p>
<p>Unlike testosterone, INSL3 levels remain amazingly consistent in a man’s bloodstream over long periods of time. This makes it possible to obtain similar values even when measured weeks, months or years apart. This allowed us to determine that low INSL3 was significantly linked with higher risk of age-related illness. </p>
<figure class="align-center ">
<img alt="Three young men walking together on a beach." src="https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=517&fit=crop&dpr=1 754w, https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=517&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/495614/original/file-20221116-14-5bwen0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=517&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Differences in INSL3 levels appear to emerge in men as young as 18.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/summer-holidays-vacation-happy-people-concept-192589262">Ground Picture/ Shutterstock</a></span>
</figcaption>
</figure>
<p>In fact, <a href="https://doi.org/10.1111/andr.13001">previous research</a> from our group has shown that person-to-person variations in INSL3 levels can be seen in apparently healthy men as young as 18. Based on our findings, it seems that INSL3 levels remain similar throughout a man’s life. This means that we may be able to look at a man’s INSL3 levels when they are young and predict how likely they are to develop certain diseases when they get older.</p>
<p>It’s likely that INSL3 has functions in its own right, acting on different organs in the body. This will need to be confirmed by further research. What is clear is that the consistency of INSL3 throughout life makes it a much easier biomarker to observe when predicting age-related disease in men.</p>
<h2><strong>What’s behind these variations?</strong></h2>
<p>Our group in Nottingham is now focused on finding out what factors influence INSL3 levels in young men, and hence their capacity to make testosterone that could affect their later health.</p>
<p>Preliminary work from animal studies suggests that early-life nutrition may play a role, but many other factors including genetics or exposure to certain environmental factors (such as smoking) may also be involved. We need to confirm the predictive ability of INSL3 by studying men over a much longer period of time.</p>
<p>Of course, this work only relates to ageing men whose testes can function consistently into old age, only gradually declining in terms of sperm and hormone production. A woman’s physiology is much more radically modulated by ovarian function, which changes dramatically after the menopause. Hence we do not yet know of an equivalent to INSL3 for women when it comes to predicting ageing and disease.</p><img src="https://counter.theconversation.com/content/194428/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ravinder Anand-Ivell received funding from University of Nottingham and DFG.</span></em></p><p class="fine-print"><em><span>Richard Ivell received funding for part of this study from the German Research Council (DFG) .</span></em></p>Our study found that low levels of INSL3 hormone were associated with greater risk of cardiovascular disease, diabetes and frailty in men.Ravinder Anand-Ivell, Associate Professor of Endocrinology and Reproductive Physiology, University of NottinghamRichard Ivell, Professor of Molecular Biology and Endocrinology, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1907632022-10-19T15:04:39Z2022-10-19T15:04:39ZWhat exactly are chemicals doing to our bodies? European scientists team up to find out<p>As the production of chemicals continues to boom, how exactly are they impacting our health? To answer this question, new tools have been developed to identify and monitor hazardous substances. Recent surveys have shown that 90% of Europeans are concerned about the impact of chemicals on the environment, while <a href="https://barometre.irsn.fr/chemical-safety/">84% worry about their potential risks to health</a>.</p>
<p>Despite this, global chemical production is expected <a href="https://www.unep.org/news-and-stories/press-release/un-report-urgent-action-needed-tackle-chemical-pollution-global">to double by 2030</a>, reflecting a rapid increase in use in nearly every sector of the economy. The European Commission has also <a href="https://www.euronews.com/green/2022/10/17/profit-more-important-than-europeans-eu-blasted-for-proposed-delay-in-cleaning-up-toxic-ch">shelved its plans</a> to tighten its restrictions on harmful substances - reforms to the so-called <a href="https://echa.europa.eu/regulations/reach/understanding-reach">REACH legislation</a> - to late 2023.</p>
<p>Awaiting this, current European law requires that chemicals employed in manufacturing processes be assessed for potential consumer risks before being placed on the market. Others present in the environment can also be harmful, whether they are of natural origin (eg. micro-organisms, toxin-producing fungi, soil metals, etc.) or synthetic (PCBs, chlordecone or metals).</p>
<p>By <em>chemical</em>, we refer to several substances mixed together to obtain specific properties for an intended product. They’re then categorised as cosmetics, paints, cleaning products, and so forth.</p>
<h2>Assessing the damage</h2>
<p>The modern era has increasingly exposed us to environmental pollutants. Whether it be in the air we breathe, the water or food we take in, the items we touch, or the products we apply to our skin, all go on to accumulate within our bodies.</p>
<p>This level of internal exposure then determines how seriously hazardous substances can affect us. But how can we measure it, amid the hundreds of thousands of chemicals that now pervade the planet? In the area of human health, the practice of <a href="https://www.sciencedirect.com/topics/earth-and-planetary-sciences/biomonitoring">biomonitoring</a> shows some promise.</p>
<p>By measuring certain biomarkers added to blood, urine, hair, or breast milk samples, biomonitoring aims to measure the precise amount of chemical contaminants that our bodies can safely withstand. The science also has the advantage of taking into account individual differences related to physiology (for example, breathing, metabolism, and age) and behaviour (e.g., general hygiene and consumer product use).</p>
<h2>Comparing previously incomparable European chemicals</h2>
<p>With this in mind, European scientists have dedicated more than five of the past years to the <a href="https://www.hbm4eu.eu/">HBM4EU initiative</a>, a continent-wide project aiming to measure Europeans’ chemical exposure and its associated health risks. One of the priorities of this large-scale programme has been to build a network of efficient laboratories, and to standardise and monitor their analytical methods, such as in survey design.</p>
<p>In recent decades, human biomonitoring has been used as a tool in a wide array of research projects and national programmes, generating a <a href="https://pubmed.ncbi.nlm.nih.gov/34297934/">vast quantity of data across Europe</a>. However, this information is often fragmented and not easily comparable.</p>
<p>Recent technical and methodological progress has effectively multiplied the number of analysable chemical substances, but no standard reference method has been set up. Contrary to other fields, such as chemical food safety, there is currently no formal European framework for biomonitoring. A number of countries have set up national programmes in this domain, but each in isolation, limiting the potential for comparing results.</p>
<p>Set up as part of the <a href="https://pubmed.ncbi.nlm.nih.gov/33774419/">HBM4EU project</a>, our European network of <a href="https://www.hbm4eu.eu/wp-content/uploads/2022/01/The-European-HBM-Laboratory-Network-research-brief.pdf">166 laboratories</a> across 28 member states could fill this gap. Out of these laboratories, 74 have been certified for quality and comparability, 34 of which have gone on to complete <a href="https://www.sciencedirect.com/science/article/pii/S1438463921000249">more than 43,000 analyses</a>.</p>
<h2>Wanted chemicals list</h2>
<p>To set out which chemicals to monitor, researchers prioritised substances on the basis of their toxicity, prevalence in humans or in the environment, and controversy among the public. Moreover, available knowledge about substances was also taken into account, with more-researched molecules likelier to generate quicker responses. This, in turn, helped to determine how the results could be used to improve substance management and, where appropriate, limit exposure.</p>
<p>In all, 24 countries have joined forces to gather data on their respective populations’ exposure to certain priority chemicals known for their negative health impacts, including cancerogenic, hormone and immune-disrupting effects. Key compounds measured were:</p>
<ul>
<li><p>Phthalates and their substitute, <a href="https://www.hbm4eu.eu/hbm4eu-substances/phthalates-and-hexamoll-dinch/">DINCH</a>. They’re used in the manufacture of plastics to make them soft and flexible, and in personal care products.</p></li>
<li><p>Per – and polyfluoroalkyl substances (<a href="https://www.anses.fr/en/content/pfass-chemicals-spotlight">PFASs</a>), which are coveted for their non-stick, waterproof and heat-resistant properties.</p></li>
<li><p><a href="https://theconversation.com/what-is-bpa-and-why-is-it-in-so-many-plastic-products-185272">Bisphenols</a>, used to make clear, hard plastic.</p></li>
<li><p>Cadmium, used to protect critical components of aeroplanes and oil platforms.</p></li>
<li><p>Arsenic, which is found in pharmaceuticals, wood preservatives and agricultural chemicals. It also has applications in the mining, metallurgical, glassmaking, and semiconductor industries.</p></li>
<li><p>Acrylamide, present in contact lenses, permanent-press fabrics, toiletries, and soil stabilisers.</p></li>
<li><p>Sunscreens</p></li>
<li><p>Pesticides</p></li>
</ul>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cohortes par tranches d’âge pour les études de biosurveillance en Europe" src="https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=325&fit=crop&dpr=1 600w, https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=325&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=325&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=409&fit=crop&dpr=1 754w, https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=409&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/487114/original/file-20220928-16-87qoey.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=409&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Age groups monitored and chemicals researched in the Europe-wide studies.</span>
<span class="attribution"><span class="source">HBM4EU</span></span>
</figcaption>
</figure>
<h2>Properly interpreting future results</h2>
<p>Until now, scientists have determined safe exposure thresholds on the basis of chemical concentrations in foods or in the air. To find out whether the concentrations measured in blood or urine exceeded them, we had to set up safety thresholds, known as <a href="https://doi.org/10.1016/j.ijheh.2020.113622">guidance values</a>. <a href="https://www.hbm4eu.eu/work-packages/deliverable-5-2-1st-substance-group-specific-derivation-of-eu-wide-health-based-guidance-values/">Some 15 substances</a> have been measured in the general or working population.</p>
<p>In the case of bisphenol S, there was a concentration of 1 µg per litre of urine among the general population and 3 µg per litre among workers. These concentrations vary because individuals coming in contact with bisphenol in their work are exposed through their skin, in addition to their (regular) diet, and across various scenarios. The figure here is calculated on the basis of their working time.</p>
<p>For other substances, the research went beyond simple determination of guidance values. For example, an estimate was made of the number of people in France, Spain, and Belgium at risk of osteoporosis due to heightened exposure to cadmium.</p>
<h2>Workers are especially exposed</h2>
<p>We attempted to monitor health in the workplace and refine our understanding of the hazards facing workers.</p>
<p>The programme has investigated exposure types specific to different sectors. For example, electronic waste management alone is exposed to carcinogens (eg. aniline and chromium VI) and sensitizers (eg. substances that sensitise the skin on first contact so that subsequent contact causes inflammation, such as <a href="https://www.sciencedirect.com/topics/chemistry/diisocyanate">diisocyanates</a>). Our research will enable us to judge the efficiency of existing management methods or suggest new ones.</p>
<p>The HBM4EU project has helped develop new tools (surveys, participatory science, data analysis, etc.) for gathering the necessary data, which may lead to the establishment of recommendations for reducing the most hazardous exposure types.</p>
<p>Models correlating internal and external exposures have also been developed. All of this work could help identify primary sources of contamination to determine safety thresholds in the workplace.</p>
<p>Within five and a half years, the project has helped strengthen the network of European entities involved in biomonitoring or chemical risk assessment. This partnership will bring new data, methods, and tools to risk assessors and managers studying chemical hazards to human health. This will, in turn, help develop the scientific expertise required to tackle current and future challenges in chemical safety.</p>
<hr>
<p><em>Translated from the French by Enda Boorman for <a href="http://www.fastforword.fr/en">Fast ForWord</a>.</em></p><img src="https://counter.theconversation.com/content/190763/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christophe Rousselle works for Anses, a partner in the human biomonitoring for Europe initiative (HBM4EU)</span></em></p>Chemicals are omnipresent in our lives and production is booming, yet we know little about their impacts on human health. To fill the gap, the EU has launched a series of biomonitoring initiatives.Christophe Rousselle, European Project Manager, Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1846452022-06-13T20:04:08Z2022-06-13T20:04:08ZWe know heatwaves kill animals. But new research shows the survivors don’t get off scot-free<figure><img src="https://images.theconversation.com/files/467926/original/file-20220609-20-8dwfo0.jpeg?ixlib=rb-1.1.0&rect=0%2C4%2C2693%2C1621&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Niki Teunissen/AWC</span>, <span class="license">Author provided</span></span></figcaption></figure><p>Extreme heat waves can cause <a href="https://royalsocietypublishing.org/doi/full/10.1098/rsbl.2009.0702">birds</a> and <a href="https://theconversation.com/killer-climate-tens-of-thousands-of-flying-foxes-dead-in-a-day-23227">mammals</a> to die en masse. But it’s more common for an animal to experience relatively mild heat stress that doesn’t kill it. Our new findings suggest that unfortunately, these individuals can suffer long-term health damage.</p>
<p>Our <a href="https://www.pnas.org/cgi/doi/10.1073/pnas.2122944119">study</a>, published today, describes how exposure to hot and dry conditions can damage the DNA of nestling birds in their first few days of life. This can mean they age earlier, die younger and produce less offspring. </p>
<p>We focused on a population of <a href="https://www.australianwildlife.org/15-years-of-research-reveals-secrets-of-rare-purple-crowned-fairywrens/">purple-crowned fairy-wrens</a> – a small endangered songbird from Northern Australia.</p>
<p>The findings suggest unless the wrens can adapt rapidly to climate warming, their populations may struggle to survive as global temperatures rise. It’s vital we consider such subtle and otherwise hidden impacts when predicting how biodiversity will fare in a warmer world.</p>
<figure class="align-center ">
<img alt="birds drink and shelter in shade" src="https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468144/original/file-20220610-15-7pytul.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Hot weather can kill birds and leave others with shorter lives.</span>
<span class="attribution"><span class="source">WA Department of Environment and Conservation</span></span>
</figcaption>
</figure>
<h2>The cost of growing up in the heat</h2>
<p>Nestlings are particularly sensitive to hot temperatures due to their immobility, rapid growth and immature physiology. And the consequences of heat stress are potentially amplified in young birds because damage may persist into <a href="https://doi.org/10.1016/S0169-5347(01)02124-3">adulthood</a>. </p>
<p>We intensively monitored a population of individually-marked purple-crowned fairy-wrens at the Australian Wildlife Conservancy’s Mornington Wildlife Sanctuary in Western Australia’s Kimberley region, as part of our long-term ecological study. </p>
<p>These insect-eating birds form small social groups centred around a breeding pair. The birds we monitored spend their lives in dense vegetation beside their particular spot along a riverbank, which they enthusiastically defend from interlopers. </p>
<p>Breeding can occur all year but peaks in the monsoonal wet season. Nests contain between one to four nestlings. During our study they experienced maximum air temperatures between 31-45°C.</p>
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Read more:
<a href="https://theconversation.com/fly-infertility-shows-were-underestimating-how-badly-climate-change-harms-animals-161410">Fly infertility shows we're underestimating how badly climate change harms animals</a>
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<p>Our investigation focused on week-old nestlings, and the relationship between temperature and a section of the birds’ DNA known as “telomeres”. </p>
<p>Telomeres are DNA caps on the end of chromosomes which, among other functions, act as a buffer to protect cells from the byproducts of energy production and stress.
Once this buffer erodes, the cell shuts down. As the number of these inactive cells builds up over time, the ageing process accelerates. </p>
<p>Nestlings exposed to hot, dry conditions during their first days of life had shorter telomeres. This suggests surviving heat stress may shorten their protective DNA buffer and make the birds age more quickly. Indeed, our previous <a href="https://doi.org/10.1111/mec.15002">research</a> demonstrated nestlings with shorter telomeres tend to die younger, and subsequently have fewer offspring.</p>
<p>Interestingly, nestlings appeared to tolerate heat better when it coincided with rain, although we’re not sure why.</p>
<figure class="align-center ">
<img alt="chicks with open mouth in nest with greenery" src="https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=590&fit=crop&dpr=1 600w, https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=590&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=590&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=741&fit=crop&dpr=1 754w, https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=741&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/467931/original/file-20220609-20-fwa0vz.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=741&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Purple-crowned fairy-wren chicks are sensitive to hot, dry conditions.</span>
<span class="attribution"><span class="source">Niki Teunissen/AWC.</span></span>
</figcaption>
</figure>
<h2>What this means under climate warming</h2>
<p>Hot, dry conditions are predicted to become more frequent in Australia under climate change. So we built a mathematical model to simulate whether their effects on nestling telomere length may depress reproduction enough to cause population decline.</p>
<p>We found even under relatively mild rates of warming, the population could decline solely as a consequence of nestling telomere shortening. The maths also revealed two potential “escape” measures that might maintain population viability.</p>
<p>First, the population could evolve longer telomeres, and thereby a larger buffer to prevent early ageing. However, this is entirely speculative as we do not understand how telomeres evolve or whether their evolution could keep pace with climate change. </p>
<p>Alternatively, the birds could adjust when they breed, so nestlings experience wet conditions more often. However, this seems unlikely because the number of rain days in the region is forecast to decline, and the birds already try to maximise breeding when it <a href="https://doi.org/10.1111/1365-2656.13068">rains</a>. </p>
<p>Importantly, if global warming continues to accelerate, the success of any countermeasures becomes increasingly unlikely. </p>
<p>Concealed and delayed costs of heat exposure, such as those identified in our study, can be subtle and difficult to detect. But they’re crucial when considering how climate warming might affect biodiversity. </p>
<p>Given that developing animals are generally <a href="https://www.frontiersin.org/articles/10.3389/fphys.2020.00419/full">more sensitive to heat</a>, and telomeres function in similar way across species, our results could extend to many other birds and mammals. More research is needed to confirm this. </p>
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<strong>
Read more:
<a href="https://theconversation.com/new-research-reveals-animals-are-changing-their-body-shapes-to-cope-with-climate-change-166267">New research reveals animals are changing their body shapes to cope with climate change</a>
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<figure class="align-center ">
<img alt="small bird at nest with food in mouth" src="https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=314&fit=crop&dpr=1 600w, https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=314&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=314&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=395&fit=crop&dpr=1 754w, https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=395&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/468142/original/file-20220610-17-sukdd0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=395&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Male purple-crowned fairy-wren arrives at the nest to feed his young. Unless the birds can adapt to climate change, their populations may decline further.</span>
<span class="attribution"><span class="source">Niki Teunissen/AWC</span></span>
</figcaption>
</figure>
<h2>What’s next?</h2>
<p>Keeping cool is also costly for parent birds. Like us, birds often seek out shade and become less active in extreme heat. Instead of sweating, they open their beaks to pant and spread their wings to cool off. </p>
<p>But these behaviours <a href="https://esajournals.onlinelibrary.wiley.com/doi/10.1002/fee.2324">leave</a> a parent bird with less time to forage, defend the nest or feed offspring – activities required for the population to survive. We are investigating whether this exacerbates the effects of telomere shortening.</p>
<p>Next, we plan to expand our research by measuring temperatures in and around the nest. We’ll also study whether females are able to select cooler microsites to help their young better withstand climate warming, and investigate how this relates to habitat quality, management and threats.</p>
<p>Ultimately, we hope our research will inform the design of conservation strategies to climate-proof the future of this iconic Australian bird and others like it. </p>
<p><em>Acknowledgements: we thank the Australian Wildlife Conservancy, the Australian Research Council and our colleagues: Tim Connallon, Kaspar Delhey, Michelle L. Hall, Niki Teunissen, Sjouke A. Kingma, Ariana M. La Porte, and Simon Verhulst.</em></p><img src="https://counter.theconversation.com/content/184645/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anne Peters receives funding from: Australian Research Council Discovery Program; Australian Wildlife Conservancy; Monash University.</span></em></p><p class="fine-print"><em><span>Justin Eastwood does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Exposure to hot and dry conditions can damage the DNA of nestling birds in their first few days of life – meaning they age earlier and produce less offspring.Justin Eastwood, Postdoctoral research fellow in ecology, Monash UniversityAnne Peters, Professor in Behaviour, Ecology and Conservation, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1811382022-04-15T18:01:27Z2022-04-15T18:01:27ZWhat is that rash? Genetic fingerprints can help doctors diagnose and treat skin conditions more effectively<figure><img src="https://images.theconversation.com/files/458016/original/file-20220413-23-kvcimv.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Skin conditions like psoriasis and eczema can have rashes that are difficult to distinguish by eye.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/dermatitis-eczema-texture-of-ill-human-skin-royalty-free-image/1270950737">tylim/iStock via Getty Images Plus</a></span></figcaption></figure><p>Rashes can be thought of as a dysfunctional community of skin cells. Your skin harbors <a href="https://dermnetnz.org/topics/the-structure-of-normal-skin">dozens of distinct cell types</a>, including those that form blood vessels, nerves and the local immune system of the skin. For decades, clinicians have largely been <a href="https://doi.org/10.1097/01.pcr.0000117274.16187.de">diagnosing rashes by eye</a>. While examining the physical appearance of a skin sample under a microscope may work for more obvious skin conditions, many rashes can be difficult to distinguish from one another.</p>
<p>At the molecular level, however, the differences between rashes become more clear. </p>
<p>Scientists have long known that <a href="https://doi.org/10.1038/jid.2009.71">molecular abnormalities</a> in skin cells cause the redness and scaliness seen in conditions like psoriasis and eczema. While almost all the various cell types in your skin can release chemicals that worsen inflammation, which ones leads to rash formation remains a mystery and may <a href="https://doi.org/10.1016/j.immuni.2018.05.012">vary from patient to patient</a>.</p>
<p>But molecular testing of skin rashes isn’t a common practice because of technological limitations. Using a new approach, my colleagues and I were able to analyze the <a href="https://www.science.org/doi/10.1126/sciimmunol.abl9165">genetic profiles of skin rashes</a> and quantitatively diagnose their root causes.</p>
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<figcaption><span class="caption">Skin is a complex organ that performs a wide variety of functions.</span></figcaption>
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<h2>High-res skin profiles</h2>
<p>Traditional genetic analyses work by averaging out the activity of <a href="https://doi.org/10.1038/jid.2014.28">thousands of genes across millions of cells</a>.</p>
<p>Genetically testing tissue samples is standard practice for conditions like cancer. Clinicians collect and analyze tumor biopsies from patients to determine a particular cancer’s unique molecular characteristics. This genetic fingerprint helps oncologists <a href="https://doi.org/10.1016/j.semcancer.2017.08.010">predict whether a cancer will spread or which treatments might work best</a>. Cancer cells lend themselves to this form of testing because they often grow into recognizable masses that make them easy to <a href="https://www.cancer.gov/about-cancer/treatment/types/biomarker-testing-cancer-treatment">isolate and analyze</a>.</p>
<p>But skin is a complex mixture of cells. Collapsing these unique cell communities into a single group may obscure genetic signatures essential to diagnosis.</p>
<p>Recent technological advances called <a href="https://doi.org/10.1016/j.jdin.2020.08.001?">single-cell RNA sequencing</a>, however, have enabled scientists to preserve the identity of each type of cell that lives in the skin. Instead of averaging the genetic signatures across all cell types in bulk, single-cell RNA sequencing analyses allow each cell to preserve its unique characteristics.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/k9VFNLLQP8c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Single-cell RNA sequencing is used to analyze samples where many different types of cells are present.</span></figcaption>
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<p>Using this approach, my colleagues and I isolated over 158,000 immune cells from the skin samples of 31 patients. We measured the activity of about 1,000 genes from each of those cells to create detailed molecular fingerprints for each patient. By analyzing these fingerprints, we were able to pinpoint the genetic abnormalities unique to the immune cells residing in each rash type. This allowed us to quantitatively diagnose otherwise visually ambiguous rashes. </p>
<p>We also observed that some patients had treatment responses consistent with what we expected with our predicted diagnoses. This suggests that our concept could viably be expanded for further testing.</p>
<p>To make our approach available to clinicians and scientists, we developed an open source web database called <a href="https://rashx.ucsf.edu/">RashX</a> that contains the genetic fingerprints of different rashes. This database will allow clinicians to compare the genetic profile of their patients’ rashes to similar profiles in our database. A closely matching genetic fingerprint might yield clues as to what caused their patient’s rash and lead to potential treatment avenues.</p>
<h2>Open source diagnostics</h2>
<p>The <a href="https://www.scientificamerican.com/article/biologics-the-pricey-drugs-transforming-medicine/">rapid development of drugs that target the immune system</a> in recent years has inundated doctors with difficult treatment decisions for individual patients. For example, while certain drugs that act on the immune system are known to work well for conditions like psoriasis or eczema, many patients have atypical rashes that can’t be precisely diagnosed. </p>
<p>An <a href="https://rashx.ucsf.edu/">open source database</a> like ours could help enable clinicians to profile and diagnose these rashes, providing a stepping stone to choose a suitable treatment. </p>
<p>Furthermore, <a href="https://doi.org/10.1126/science.abf3041">chronic inflammatory diseases</a> that affect organs other than the skin share similar genetic abnormalities. Lab tests that can illuminate the root causes of skin diseases can likely be expanded to many other conditions.</p>
<p>Our <a href="https://rashx.ucsf.edu/">RashX</a> project initially focused on just two very common types of rashes, psoriasis and eczema. It is unknown whether <a href="https://www.aad.org/public/diseases/a-z">other types of rashes</a> will have similar genetic profiles to psoriasis and eczema or instead have their own unique fingerprints. It is also unclear which parts of the fingerprint would best predict drug response.</p>
<p>But <a href="https://rashx.ucsf.edu/">RashX</a> is a living web resource that will grow more useful as more scientists collaborate and contribute new data. Our lab is also working to simplify the process of developing genetic profiles of rashes to make participating in this area of research more accessible for clinics around the world. With more data, we believe that projects like RashX will make precision testing for rashes an essential next step in diagnosis and treatment.</p>
<p>[<em>Understand new developments in science, health and technology, each week.</em> <a href="https://memberservices.theconversation.com/newsletters/?nl=science&source=inline-science-understand">Subscribe to The Conversation’s science newsletter</a>.]</p><img src="https://counter.theconversation.com/content/181138/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Raymond J. Cho, MD, PhD receives funding from the LEO Foundation, the National Psoriasis Foundation, the National Eczema Assocation, Sun Pharmaceutical Industries, Sanofi, and Pfizer. </span></em></p>Many doctors currently diagnose skin conditions by eye. Advances in molecular testing could lead to more precise and accurate diagnoses for ambiguous rashes and skin lesions.Raymond J. Cho, Associate Professor of Dermatology, University of California, San FranciscoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1806772022-04-06T20:00:23Z2022-04-06T20:00:23ZWe found a genetic link between routine blood test results and mental health disorders<figure><img src="https://images.theconversation.com/files/456489/original/file-20220406-23-6k8f42.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C7000%2C3489&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/dna-helix-3d-illustration-mutations-under-1841082199">Shutterstock</a></span></figcaption></figure><p>Mental health disorders including depression, schizophrenia, and anorexia show links to biological markers detected in routine blood tests, according to <a href="http://www.science.org/doi/10.1126/sciadv.abj8969">our new study</a> of genetic, biochemical and psychiatric data from almost a million people.</p>
<p>The research will increase our understanding of what causes mental illness and may help to identify new treatments. </p>
<h2>Healthy body, healthy mind</h2>
<p>People often consider mental health as separate from the health of the rest of the body. This is far from true: there is clear evidence many biochemical substances involved in diseases such as <a href="https://www.cdc.gov/diabetes/managing/mental-health.html">diabetes</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797267/">autoimmune conditions</a> directly impact the function of our brain.</p>
<p>Many studies have tried to address this by focusing on substances called biomarkers that can be readily measured in blood. </p>
<p>A biomarker is simply something in the body that is a sign of a particular disease or process. These often relate to the kind of things reported in a blood test ordered by your doctor, such as cholesterol, blood sugar, liver enzymes, vitamins, or markers of inflammation. </p>
<p>Biomarkers found in routine blood tests are useful as they are often affected by diet and lifestyle, or by treatment with a drug. </p>
<h2>The complex role of genetics in mental health</h2>
<p>It’s often difficult to study the role of these blood biomarkers in mental health conditions. Many studies in this area are often not large enough to make strong conclusions. </p>
<p>One solution is to look at genetic influences on both mental illness and substances measured in blood. Genetics is useful as we now have data from millions of individuals who have volunteered in research studies. </p>
<p>Both mental illnesses and blood biomarkers are what geneticists call “<a href="https://www.uptodate.com/contents/principles-of-complex-trait-genetics">complex traits</a>”. In complex traits, many genes are involved and environmental factors also contribute. </p>
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Read more:
<a href="https://theconversation.com/genetics-helps-estimate-the-risk-of-disease-but-how-much-does-it-really-tell-us-175077">Genetics helps estimate the risk of disease – but how much does it really tell us?</a>
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<p>The widespread availability of genetic data has allowed us to investigate how huge numbers of tiny changes in the DNA sequence (or “variants”) are related to the risk of mental illness. These same variants can then also be linked to the measured levels of a biomarker in blood. </p>
<p>For example, a variant in a particular gene may increase the risk of developing schizophrenia and also be linked to a decrease in the levels of a vitamin circulating in the blood. Most of these variants are individually associated with very small changes in something like risk of a mental illness, but they may add together to produce larger effects.</p>
<h2>How are blood biomarkers related to mental illness?</h2>
<p>Our recent study sought to use genetics to investigate the relationship between nine mental health disorders and 50 factors measured in routine blood tests, such as cholesterol, vitamins, enzymes, and indicators of inflammation. We used data from very large studies conducted by other people, with data from almost a million volunteers included in total. </p>
<p>Our study first confirmed the existence of what is called <em>genetic correlation</em> between blood biomarkers and mental illness, which was more widespread than has previously been shown. Genetic correlation means the effect of DNA sequence changes on the risk of a mental illness and the levels of a given biomarker were more similar to each other than what would occur by chance alone. </p>
<figure class="align-center ">
<img alt="A gloved hand placing a vial of blood into a rack on a laboratory bench filled with other vials of blood." src="https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/456491/original/file-20220406-3361-5nnjzo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Common blood tests can pick up biomarkers linked to mental disorders.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/medical-equipment-blood-test-327930536">Shutterstock</a></span>
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<p>To take one example, there was a positive genetic correlation in our study between white blood cell count and depression. This could indicate some process in our body influences both depression and white blood cells. </p>
<p>If we could identify what this shared process is, it could lead to a better understanding of what causes depression and this could be targeted for treatment. </p>
<h2>Correlation verses causality</h2>
<p>Our study showed there was <em>correlation</em> between the genetics of mental illness and factors in the blood, but this does not tell us whether blood biomarkers are involved in what <em>causes</em> mental illness. </p>
<p>To distinguish correlation from causation in medicine, the gold standard approach is to conduct clinical trials where patients randomly receive a treatment or a placebo. However, these trials are expensive and difficult to conduct. </p>
<p>We did the next best thing: using DNA variants linked to changes in blood biomarkers to act as a <a href="https://edhub.ama-assn.org/jn-learning/audio-player/14933400">natural clinical trial</a>. This process takes advantage of the fact we randomly inherit DNA variants from our parents, in much the same way that participants in a clinical trial randomly receive a treatment or a placebo. </p>
<p>It’s a complex method and the results need careful interpretation. </p>
<p>We found evidence some substances measured in blood may actually be involved in the cause of some mental illnesses. Proteins related to the immune system, for example, may be involved in depression, schizophrenia, and anorexia. </p>
<p>Further work is now needed to identify how these blood measures are precisely involved in these disorders, and to find out if they can be targeted for treatment. </p>
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<strong>
Read more:
<a href="https://theconversation.com/blame-it-on-biology-how-explanations-of-mental-illness-influence-treatment-48578">Blame it on biology: how explanations of mental illness influence treatment</a>
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<img src="https://counter.theconversation.com/content/180677/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>William Reay receives salary funding from grants from the National Health and Medical Research Council and the Medical Research Future Fund.</span></em></p>A new study shows connections between genetics, biomarkers in the blood, and mental disorders - opening new avenues to understand the causes of mental illness and find new treatments.William Reay, Postdoctoral Research Fellow, School of Biomedical Sciences and Pharmacy, The University of Newcastle, Newcastle, NSW, Australia, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1690122022-02-09T13:20:23Z2022-02-09T13:20:23ZDogs can be trained to sniff out COVID-19 – a team of forensic researchers explain the science<figure><img src="https://images.theconversation.com/files/429406/original/file-20211029-27-2s0efb.jpg?ixlib=rb-1.1.0&rect=13%2C0%2C2982%2C1994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Researchers at Florida International University successfully trained One Betta, a Dutch Shepard, and three other dogs to detect COVID-19 on face masks. The dogs got it right 96% to 99% of the time.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/one-betta-a-dutch-shepard-sniffs-a-mask-for-the-scent-of-news-photo/1339133710?adppopup=true"> Joe Raedle/Staff/Getty Images North America</a></span></figcaption></figure><p>With up to 300 million scent receptors, dogs are among the <a href="https://www.pbs.org/wgbh/nova/article/dogs-sense-of-smell/">best smell detectors</a> in the animal world. The human nose, by comparison, contains only around 6 million scent receptors. Dog brains also devote <a href="https://www.pbs.org/wgbh/nova/article/dogs-sense-of-smell/">40% more brain space</a> than humans to analyzing odors.</p>
<p>That’s why people train dogs to search for diverse targets via smell, from <a href="https://www.nationalgeographic.com/animals/article/detection-dogs-learning-to-pass-the-sniff-test">illegal drugs</a> and <a href="https://doi.org/10.21273/HORTTECH03791-17">agricultural pests</a> to <a href="https://theconversation.com/for-sniffing-out-crime-and-missing-persons-science-backs-blood-detection-dogs-82213">missing persons</a>, <a href="https://www.smithsonianmag.com/smart-news/meet-ernie-and-betty-white-two-conservation-dogs-sniffing-out-invasive-species-wisconsin-180976764/">endangered wildlife species</a> and more. Dogs accomplish this by successfully recognizing the odors of substances called <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/volatile-organic-compound">volatile organic compounds</a> that are specifically associated with these targets. Not only can trained dogs detect these volatile organic compounds, but oftentimes they can do it with <a href="https://doi.org/10.1016/j.forc.2020.100230">greater sensitivity than</a> analytical instruments. </p>
<p>Volatile organic compounds can be produced by living organisms as well as by natural or synthetic materials. In humans, they are produced by the body’s metabolic activity, then enter the bloodstream and are finally released into the air through blood, urine, feces, skin or breath. </p>
<p>Scientists have found that dogs can be trained to successfully recognize unique volatile organic compounds, called “biomarkers,” in the <a href="https://doi.org/10.1016/j.ebiom.2020.103154">exhaled breath of patients</a> with certain diseases or chronic medical conditions, including <a href="https://doi.org/10.1177/1534735405285096">cancer</a> and <a href="https://doi.org/10.1089/acm.2008.0288">diabetes</a>, as well as for <a href="https://doi.org/10.1016/j.yebeh.2020.107690">pre-seizure detection</a> in epileptic individuals.</p>
<p>Our team of canine scent scientists at Florida International University wanted to figure out whether COVID-19 is among the diseases that trained dogs can detect. <a href="https://doi.org/10.1016/j.fsisyn.2021.100155">Our recent study</a>, which we carried out with our colleague, <a href="https://case.fiu.edu/about/directory/profiles/mills-deetta.html">forensic biologist DeEtta Mills</a>, confirms that it is. </p>
<p>We believe that dogs hold great promise as a rapid screening method that, used with other measures <a href="https://theconversation.com/free-rapid-antigen-tests-makes-economic-sense-for-governments-our-analysis-shows-174342">such as rapid tests</a>, can help stop COVID-19 spread and end the pandemic. Some of the dogs trained during our research have already proved their abilities <a href="https://www.washingtonpost.com/nation/2021/09/09/covid-sniffer-dogs/">at airports</a> and public events.</p>
<h2>Training dogs to detect COVID-19</h2>
<p>For several decades, Florida International University’s <a href="https://ifri.fiu.edu/">International Forensic Research Institute</a> has been a global institution for <a href="https://gfjc.fiu.edu/research/detector-dogs/index.html#tab-N10728-3">research on detector dogs</a>. The majority of this research has focused on identifying the specific volatile organic compounds that natural or synthetic materials and living organisms produce and which dogs can be trained to detect. </p>
<p>In <a href="https://doi.org/10.1016/j.fsisyn.2021.100155">our recent research</a>, we hypothesized that people infected with COVID-19 would release specific volatile organic compounds, and that a well-trained odor detection dog would be able to tell these biomarkers apart from other volatile organic compounds. </p>
<p>So in collaboration with Baptist Health South Florida, a nonprofit health care organization, we obtained face masks from hospitalized patients with confirmed COVID-19 diagnoses, as well as from those who tested negative for COVID-19.</p>
<p>We then trained four dogs to respond to COVID-19 positive masks, while ignoring COVID-19 negative masks and unused masks. In the process, the dogs learned to tell the difference between biomarkers originating from COVID-19 breath and from non-COVID-19 breath.</p>
<p>One of the training tools we used was a scent detection wheel. We placed both COVID-19 positive and COVID-19 negative masks in cans with small holes in the lids, which were attached to the ends of the wheel’s arms. The dogs then walked around the wheel sniffing the volatile organic compounds coming out of these holes.</p>
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<img alt="A large black and tan dog walking around a scent detection training wheel." src="https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/427975/original/file-20211022-21-1l67hu8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Cobra, a Belgian Malinois, undergoes training with a scent detection wheel to identify COVID-19 biomarkers on face masks.</span>
<span class="attribution"><span class="source">Julian Mendel/Florida State University</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>After 40 double-blind trials – meaning that the people training the dogs didn’t know which masks were which –
<a href="https://doi.org/10.1016/j.fsisyn.2021.100155">we found that</a> each of the four dogs in this study accurately detected COVID-19 positive masks more than 90% of the time.</p>
<p>Mac, a Terrier mix, got it right in 96.2% of attempts. Cobra, a Belgian Malinois, was correct 99.4% of the time. One Betta, a Dutch Shepherd, got it right in 98.1% of attempts, and Hubble, a Border Collie mix, 96.3% of the time. </p>
<p>After the study, Cobra and One Betta went to work at <a href="https://www.wtsp.com/article/news/health/coronavirus/florida-university-trains-dogs-to-detect-covid-19/67-10687ffa-3a6e-4038-90e3-2a10326e67e4">the State Emergency Operation Command Center</a>, in Tallahassee, Florida, screening for COVID-19 on surfaces. In May 2021, both dogs also put their COVID-19 detection skills to work <a href="https://www.msnbc.com/hallie-jackson/watch/covid-sniffing-dogs-screening-guests-at-miami-festival-112761413511">at the annual Food and Wine Festival</a> in Miami. </p>
<p>In September 2021, Cobra and One Betta worked for two separate <a href="https://www.internationalairportreview.com/news/163866/mia-partners-fiu-covid-19-k9-pilot-programme/">30-day pilot studies</a> at Miami International Airport, screening individuals for COVID-19. </p>
<p>Other agencies are beginning to adopt FIU’s methods for training dogs to detect COVID-19. Recently, with FIU’s assistance, the Bristol County Sheriff’s Office in Massachusetts <a href="https://boston.cbslocal.com/2022/01/04/covid-sniffing-k9s-dogs-bristol-county/">started putting two young labradors</a> named Duke and Huntah to work detecting COVID-19. These two dogs are <a href="https://www.cnn.com/2022/01/08/us/covid-detection-dogs-help-ma-schools/index.html">also sniffing for COVID-19</a> at facilities in the nearby Freetown-Lakeville Regional School District.</p>
<h2>Next steps in COVID-19 detection</h2>
<p>Now that we know dogs can be trained to sniff out COVID-19, our team hopes to identify the exact volatile organic compounds – the biomarkers – that they’re detecting. To accomplish this, we are continuing to analyze both COVID-19 positive masks and COVID-19 negative masks in the laboratory.</p>
<figure class="align-center ">
<img alt="A large black and tan dog sitting and looking at his handler outside at a Florida beach resort." src="https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/427976/original/file-20211022-17-sisf1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Cobra, one of the dogs trained in a Florida International University study to detect COVID-19 biomarkers, prepares to screen guests prior to the Food and Wine Festival in Miami in May 2021.</span>
<span class="attribution"><span class="source">Julian Mendel/Florida International University</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>Pinning down which biomarkers are linked to COVID-19 will help in developing materials and training aids for teaching other dogs how to detect the disease. </p>
<p>[<em>Over 140,000 readers rely on The Conversation’s newsletters to understand the world.</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-140ksignup">Sign up today</a>.]</p>
<p>It may also contribute to developing COVID-19 sensors for use in odor-detecting devices – which might then join rapid testing and sniffer dogs like One Betta, Hubble, Mac and Cobra in helping get the pandemic under control.</p><img src="https://counter.theconversation.com/content/169012/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kenneth G. Furton receives funding from the National Institutes of Health (NIH). </span></em></p><p class="fine-print"><em><span>Julian Mendel and Kelvin J. Frank Jr. do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Dogs have such sensitive noses that they can be trained to detect the odors of crop pests, endangered species, illegal drugs – and diseases like COVID-19.Kenneth G. Furton, Professor of Chemistry and Biochemistry, Florida International UniversityJulian Mendel, Research Assistant Professor in Forensic Research, Florida International UniversityKelvin J. Frank Jr., Forensic Science Professor / Postdoctoral Research Associate, Florida International UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1732102022-01-28T13:27:13Z2022-01-28T13:27:13ZNew insights from biology can help overcome siloed thinking in cancer clinical trials and treatment<figure><img src="https://images.theconversation.com/files/441611/original/file-20220119-25-164wpa0.jpeg?ixlib=rb-1.1.0&rect=0%2C0%2C537%2C420&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Metabolic conditions like obesity and diabetes can influence how cancer develops and responds to treatment.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/chemo-therapy-royalty-free-image/1134307405?adppopup=true">Eric Kitayama/iStock via Getty Images Plus</a></span></figcaption></figure><p>Rarely does an oncologist closely question a breast cancer patient about their blood glucose, body weight, lipid profile, or medications for diabetes and cardiovascular disease. Instead, these issues are usually the concern of the patient’s primary care provider. </p>
<p>Medical experts have <a href="https://doi.org/10.1152/physrev.00030.2014">recognized that obesity</a>, defined as a body mass index of 30 or greater, increases the <a href="https://doi.org/10.1016/j.canep.2016.01.003">risk of several cancers</a>. They include cancers of the breast, esophagus, kidney, gallbladder, liver, colon and several other organs. We have been aware of this relationship for <a href="https://doi.org/10.1038/sj.onc.1207751">about 20 years</a>. Despite this awareness, medicine is still missing a holistic view of people with cancer.</p>
<p>When testing new cancer drugs, clinical trials traditionally exclude patients with a history of heart disease, kidney disease, diabetes or similar chronic conditions related to obesity. The purpose is to make <a href="https://doi.org/10.1001/jamaoncol.2019.1187">study results easier to interpret</a>. But this practice leaves cancer researchers with a weak understanding of how patients could be monitored and treated for <a href="https://doi.org/10.1038/nrc1550">obesity-driven cancers</a>. One way it limits their knowledge is by leaving out significant numbers of patients. Among them are patients of color, who are already underrepresented in <a href="https://doi.org/10.3233/SHTI190369">scientific studies</a> generally and <a href="https://doi.org/10.1002/cncr.23157">cancer treatment treatment trials</a> in particular.</p>
<p>As a <a href="https://profiles.bu.edu/Gerald.Denis">molecular oncologist</a> at Boston Medical Center, I explore how metabolic conditions like <a href="https://scholar.google.com/citations?user=2f8xa-oAAAAJ&hl=en">obesity and diabetes</a> can influence whether someone develops cancer. I look closely at how these conditions can affect how the cancer grows, spreads or responds to treatment.</p>
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<img alt="Blue-gloved hand holding clear vial of blood." src="https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/441767/original/file-20220120-8584-1uztb33.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Less invasive cancer detection and treatment is one potential benefit of better communication between endocrinologists and cancer specialists.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/blood-sample-for-lipid-profile-testing-medical-royalty-free-image/1354714222?adppopup=true">Juan Ruiz Parmo/iStock via Getty Images Plus</a></span>
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<p>Our teams at Boston Medical Center’s Cancer Center have have identified how obesity and diabetes may provoke cancer to spread in potentially deadly ways. In particular, <a href="https://doi.org/10.1016/S0026-0495(78)80007-9">insulin-resistant fat cells</a> are likely to play a critical role in provoking breast cancer cells to move from the original tumor to distant organs like the lungs, liver, bones or brain. These distant metastases commonly define the end stage before someone with breast cancer dies.</p>
<p>Our results show that in the <a href="https://doi.org/10.1126/scisignal.abj2807">microscopic neighborhood inside or near a tumor</a>, cancer cells and noncancerous fat cells sit right next to each other, like neighbors on a park bench. Our research has shown that these two cell types engage in active “cross-talk.” This communication may inhibit or promote a tumor’s ability to grow and spread. How that happens is not well understood, partly because oncologists – whether studying cancer or treating it – generally don’t take nearby fat cells into consideration. </p>
<h2>Strategic diagnosis and treatment</h2>
<p>Acknowledging the relationship between fat cells and cancer cells offers opportunities to find and treat cancer less invasively. With molecules isolated from just a teaspoon or less of a patient’s blood, specialists can learn the risk that the cancer might be growing and spreading. These molecules, <a href="https://doi.org/10.1016/j.molonc.2012.01.010">called biomarkers</a>, can also show which patients are in the greatest danger of treatment failure. Taking occasional blood samples is less invasive than repeated biopsies, which involves getting samples of breast or other tissue. </p>
<p>When endocrinologists and oncologists consult with one another, they can consider obesity and metabolism alongside the current standard of care for patients with cancer. This combination would likely benefit populations, like <a href="https://doi.org/10.1200/JCO.2003.08.010">older adults</a>, in which both obesity and metabolic disease are more prevalent. </p>
<p>Furthermore, the cancer patient population may soon include more <a href="https://doi.org/10.1038/s41571-020-00445-1">young people</a>. A 2019 study found that people age 50 or younger have a <a href="https://doi.org/10.1016/S2468-2667(18)30267-6">disproportionately elevated risk</a> for certain obesity-driven cancers, including obesity-associated colorectal cancer. The relationship between fat cells and cancer cells could explain some of these trends.</p>
<h2>Closing gaps in care</h2>
<p>And already, more young African American adults are developing <a href="https://doi.org/10.1097/MEG.0000000000001205">aggressive colorectal cancers</a> than young adults of <a href="https://doi.org/10.3322/caac.21555">other races</a>. This fact came to the nation’s attention in 2020, when actor <a href="https://doi.org/10.2196/29387">Chadwick Boseman died</a> from an <a href="https://doi.org/10.1002/cncr.33919">aggressive colon cancer</a> at age 43. </p>
<p>Although Boseman was not overweight, his death brought attention to the community of African American adults who experience higher risks not only <a href="https://doi.org/10.1007/s10549-015-3353-z">for obesity</a> and <a href="https://doi.org/10.2105/ajph.92.4.543">diabetes</a> but also for several cancers including <a href="https://doi.org/10.1007/s11934-017-0724-5">prostate</a>, <a href="https://doi.org/10.1158/1055-9965.EPI-07-0336">breast</a> and <a href="https://doi.org/10.1053/j.gastro.2019.10.029">colorectal</a>. And despite their higher risks, Black patients are often not effectively counseled <a href="https://doi.org/10.1093/jnci/djab073">by physicians</a> regarding cancer risk and treatment.</p>
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<p>At Boston Medical Center, 50% of our patients have diagnoses of obesity and 30% have Type 2 diabetes. We see similar numbers and patterns in our cancer patient population. One potential reason is that Boston Medical Center is a <a href="https://doi.org/10.1177/1077558708315440">safety-net hospital</a>, providing essential and excellent care to a very diverse range of patients regardless of insurance, immigration status or medical literacy. Such hospitals are often located in neighborhoods with high rates of <a href="https://doi.org/10.1001/archinternmed.2011.287">obesity and diabetes</a>.</p>
<p>Black and Latino adults with cancer tend to be overrepresented in <a href="https://doi.org/10.1007/BF02345673">safety-net hospital systems</a>. They receive cancer screenings <a href="https://doi.org/10.1016/j.athoracsur.2019.11.052">less often</a>. They also experience
<a href="https://doi.org/10.1080/03630242.2010.530928">longer wait times</a>, first for diagnosis and then for treatment. These factors contribute to <a href="https://doi.org/10.1016/j.canep.2017.05.003">worse survival rates</a> among Black and Latino cancer patients. Some of these worse outcomes may be a result of cancer and diabetes <a href="https://doi.org/10.1530/ERC-16-0222">interacting in these patients</a>.</p>
<p>Addressing disparities like these would be a natural benefit of bringing together previously disconnected clinical specialties. Research on the linkage among obesity, diabetes and cancer is revealing new pathways and molecules that tie these different diseases together. These new insights could improve outcomes for patients who are at greatest risk, and prompt more holistic assessments and treatments for all patients.</p><img src="https://counter.theconversation.com/content/173210/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gerald Denis receives funding from the National Cancer Institute.</span></em></p>Fat cells and cancer cells talk to each other. Specialists in both systems can do the same.Gerald Denis, Professor of Medicine and Pharmacology, Boston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1663932021-09-28T11:56:22Z2021-09-28T11:56:22ZCan healthy people who eat right and exercise skip the COVID-19 vaccine? A research scientist and fitness enthusiast explains why the answer is no<figure><img src="https://images.theconversation.com/files/422695/original/file-20210922-25-11lek97.jpg?ixlib=rb-1.1.0&rect=16%2C24%2C5439%2C3612&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Several thousand protestors opposed to the COVID-19 vaccine march through the streets of midtown Manhattan in New York on Sept. 18, 2021. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/several-thousand-protestors-opposed-to-the-covid-19-vaccine-news-photo/1341164693?adppopup=true">Andrew Lichtenstein/Corbis News via Getty Images</a></span></figcaption></figure><p>I’m a fitness enthusiast. I also adhere to a nutrient-dense, “clean” eating program, which means I minimize my sugar intake and eat a lot of whole foods for the purpose of optimizing my health. </p>
<p>You might wonder how effective such a diet and exercise plan would be in the fight against COVID-19, since some <a href="https://www.washingtonpost.com/technology/2021/09/12/wellness-influencers-vaccine-misinformation/">have suggested</a> – without supporting evidence – that vaccination may be unnecessary if a detailed wellness lifestyle is closely followed. </p>
<p>As a <a href="https://scholar.google.com/scholar?hl=en&as_sdt=0%2C43&q=Bloomer+and+memphis&btnG=">research scientist</a> who has studied nutrition for close to 20 years, I have watched the wellness community’s response to the COVID-19 vaccines with great interest. While eating right can <a href="https://doi.org/10.3390/nu12061562">favorably impact the immune system</a>, it is not reasonable to expect that nutrition alone will defend against a potentially life-threatening virus. </p>
<h2>My experience with nutrition science</h2>
<p>My lab group at the <a href="https://www.memphis.edu/healthsciences/">University of Memphis</a> studies the effect of food and isolated nutrients on human health. In January 2009, we conducted an initial study of a stringent vegan diet. We enrolled 43 men and women who were allowed to eat as much plant-based food as desired, but drank only water, for 21 days. </p>
<p>The results demonstrated improvements <a href="https://doi.org/10.1186/1476-511X-9-94">in many variables</a> related to cardio-metabolic health, such as blood cholesterol, blood pressure, insulin and C-reactive protein – a protein that increases in response to inflammation. We have <a href="https://pubmed.ncbi.nlm.nih.gov/?term=bloomer+and+daniel+fast">since completed</a> multiple human and animal nutrition studies using this dietary program. </p>
<figure class="align-center ">
<img alt="A woman eating a healthy salad." src="https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/422240/original/file-20210920-19-log1mt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Diet improvements may reduce or eliminate the need for some medications, but a clean diet cannot completely protect you from COVID-19.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/woman-eating-salad-royalty-free-image/912617718?adppopup=true">Tara Moore via Getty Images</a></span>
</figcaption>
</figure>
<p>My lab’s research has resulted in some 200 peer-reviewed scientific manuscripts and book chapters specific to <a href="https://umwa.memphis.edu/fcv/viewprofile.php?uuid=rbloomer">nutrients and exercise</a>, and the interaction between these two variables. The results of our work, as well as that of other scientists, clearly demonstrate the power of food to favorably impact health.</p>
<p>For many individuals, a positive change in eating habits results in such an improvement in clinically relevant measures like <a href="https://doi.org/10.1186/1476-511X-9-94">blood cholesterol</a> <a href="https://doi.org/10.3390/ijerph17072557">and glucose</a> that doctors can sometimes reduce or eliminate certain medications used to treat high cholesterol and diabetes. In other cases, these measures improve but the patient still requires the use of medications to control their disease. This tells us that in some situations, a great nutrition program is simply not enough to overcome the body’s challenges.</p>
<h2>Nutrition and other wellness approaches do matter</h2>
<p>Although certain <a href="https://doi.org/10.3389/fphar.2020.01189">natural products</a> have been discussed as treatments for COVID-19, little emphasis has been placed on whole food nutrition as a protective measure. I think this is unfortunate, and I believe strengthening our immune system with the goal of battling COVID-19 and other viral infections is of great importance. And the <a href="https://theconversation.com/good-nutrition-can-contribute-to-keeping-covid-19-and-other-diseases-away-145086">evidence tells us</a> that a <a href="https://doi.org/10.3390/nu12061562">nutrient dense diet</a>, <a href="http://dx.doi.org/10.1136/bjsports-2021-104080">regular exercise</a> and <a href="https://doi.org/10.1007/s00424-011-1044-0">adequate sleep</a> can all contribute to optimal immune function. </p>
<p>Regarding nutritional intake, a <a href="https://doi.org/10.1136/bmjnph-2021-000272">recently published study</a> using a sample of health care workers who contracted COVID-19 noted that those who followed a plant-based or pescatarian diet had 73% and 59% lower odds of moderate to severe COVID-19, respectively, compared to those who did not follow those diets. Although interesting, it’s important to remember that these findings represent an association rather than a causal effect. </p>
<p>While people can use nutrition to help shore up their immune system against COVID-19, diet is only one important consideration. Other <a href="https://doi.org/10.3945/an.115.010207">variables matter</a> a great deal too, including <a href="https://pubmed.ncbi.nlm.nih.gov/29306937/">stress management</a>, <a href="https://doi.org/10.3389/fimmu.2020.570122">nutritional supplements</a> and <a href="https://doi.org/10.1016/S0140-6736(20)31142-9">physical distancing and mask-wearing</a>.</p>
<p>But to be clear, all of those elements should be considered tools in the toolbox to help combat COVID-19 – not a replacement for potentially life-saving vaccines. </p>
<figure class="align-center ">
<img alt="A teenage boy at a clinic getting a COVID-19 shot." src="https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/422243/original/file-20210920-25-4sj241.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Charles Muro, age 13, receives a COVID-19 shot at a mass vaccination center in Hartford, Connecticut. Without the vaccine, even young people in good health are not fully protected from the virus.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/charles-muro-age-13-is-inoculated-by-nurse-karen-pagliaro-news-photo/1232871480?adppopup=true">Joseph Prezioso/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Vaccines are not perfect, but they save lives</h2>
<p>I find it interesting that nearly all parents understand the importance of having their kids <a href="https://abcnews.go.com/US/vaccine-mandates-place-attend-school-us/story?id=80046650">vaccinated against serious illnesses</a> like mumps, measles and varicella. They do not expect that certain foods, or a nurturing environment, will do the job of a vaccine. </p>
<p>Yet, when it comes to COVID-19, this thought process is abandoned by <a href="https://www.washingtonpost.com/technology/2021/09/12/wellness-influencers-vaccine-misinformation/">some who believe</a> that a healthy lifestyle will substitute for the vaccine, without seriously considering <a href="https://theconversation.com/what-happens-when-the-covid-19-vaccines-enter-the-body-a-road-map-for-kids-and-grown-ups-164624">what the vaccine actually does to provide protection</a> against the virus – something that a healthy lifestyle alone simply cannot do. </p>
<p>When contemplating whether to receive the COVID-19 vaccine, consider the following: All medications have risks, including things as <a href="https://www.huffingtonpost.co.uk/entry/daily-aspirin-causes-more-than-3000-deaths-per-year-scientists-warn_uk_593fb481e4b0b13f2c6daa10">seemingly benign as aspirin</a>. <a href="https://doi.org/10.1177/0024363918816683">Hormonal contraception</a> – something used by millions of women every month – is thought to cause an estimated 300-400 deaths annually in the U.S. The same is true for <a href="https://www.huffpost.com/entry/what-would-wendy-davis-do_b_3672484">cosmetic surgery</a>, <a href="https://doi.org/10.1007/s00266-020-02027-z">Botox injections</a> and other elective procedures. </p>
<p>Many people are willing to accept the low risks in those cases, but not with those involving <a href="https://theconversation.com/what-does-full-fda-approval-of-a-vaccine-do-if-its-already-authorized-for-emergency-use-165654">the COVID-19 vaccines</a> – despite the fact that the risk of <a href="https://www.theguardian.com/world/2021/aug/27/blood-clot-risk-greater-after-covid-infection-than-after-vaccination">serious complications or death from COVID-19</a> far outweighs the low risk of serious <a href="https://theconversation.com/new-covid-19-vaccine-warnings-dont-mean-its-unsafe-they-mean-the-system-to-report-side-effects-is-working-164455">adverse events</a> from the vaccines. </p>
<p>No lifestyle approach, including strict adherence to a holistic, nutrient-dense diet – vegan, plant-forward or otherwise – will confer total protection against COVID-19. The vaccines <a href="https://theconversation.com/medicine-is-an-imperfect-science-but-you-can-still-trust-its-process-166811">aren’t perfect</a> either; <a href="https://theconversation.com/what-is-a-breakthrough-infection-6-questions-answered-about-catching-covid-19-after-vaccination-164909">breakthrough infections</a> do occur in some cases, though the vaccines <a href="https://www.wsj.com/articles/breakthrough-cases-covid-19-delta-variant-11627596643">continue to provide robust protection</a> against <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e1.htm?s_cid=mm7037e1_w#T1_down">severe illness and death</a>. </p>
<p>I encourage people to do all they can to improve the health and functioning of their immune system, naturally. Then, seriously consider what additional protection would be gained from vaccination against COVID-19. When people make decisions based on the latest science – which is always evolving – rather than on emotions and misinformation, the decision should become much clearer.</p><img src="https://counter.theconversation.com/content/166393/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Richard J. Bloomer has received research support and has served as a consultant to a variety of dietary ingredient and supplement companies over the past 20 years. </span></em></p>A growing body of research shows that nutrition, sleep, exercise and a host of other lifestyle choices can help optimize the immune system. But they are no substitute for life-saving vaccines.Richard Bloomer, Dean of the College of Health Sciences, University of MemphisLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1636872021-07-14T13:53:51Z2021-07-14T13:53:51ZChocolate – a new way to make sure your favourite bar is an ethical treat<figure><img src="https://images.theconversation.com/files/410596/original/file-20210709-17-gm8g2l.jpg?ixlib=rb-1.1.0&rect=239%2C89%2C3754%2C2568&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/composition-bars-pieces-different-milk-dark-1721265295">Shutterstock/ivan_kislitsin</a></span></figcaption></figure><p>Chocolate has a special place in many of our lives. It is widely seen as an affordable and essentially harmless treat – a food of comfort, celebration and joy. But those bars, cakes and Easter eggs are also part of a <a href="https://www.icco.org/chocolate-industry/">£61 billion</a> a year global industry with a troubling history of social and environmental harm.</p>
<p>For example, there are now an estimated <a href="https://www.confectionerynews.com/Article/2020/05/07/New-report-reveals-child-labor-on-West-African-cocoa-farms-has-increased-in-past-10-years">two million child labourers</a> working on cocoa farms in west Africa. Some are <a href="https://laborrights.org/sites/default/files/publications-and-resources/cocoakit1_2.pdf">tricked or sold into slavery</a> on those farms where <a href="https://www.du.edu/korbel/hrhw/researchdigest/slavery/africa.pdf">they are forced</a> to carry heavy loads of cocoa, use harmful pesticides, and handle machetes. </p>
<p><a href="http://www.takepart.com/article/2015/07/31/cocoa-child-labor-report/">Reports suggest</a> the problem is getting worse, despite <a href="https://www.nestle.com/sites/default/files/asset-library/documents/creating-shared-value/responsible-sourcing/nestle-cocoa-plan-child-labour-2017-report.pdf">promises</a> from large chocolate producers. Multinational chocolate firm executives have admitted that the cocoa supply chain is “<a href="https://uk.reuters.com/article/us-cocoa-mars-sustainability/mars-aims-to-tackle-broken-cocoa-model-with-new-sustainability-scheme-idUKKCN1LZ1DZ">broken</a>”.</p>
<p>The high demand for chocolate products and volatile price of cocoa means that some traders seek to buy cheaper beans from deforested regions and lower quality plants. This affects the prices and practices of legitimate farmers, <a href="https://www.voicenetwork.eu/wp-content/uploads/2019/08/Raising-Farm-Gate-Prices-Cocoa-Barometer-Consultation-Paper-170419.pdf">reducing sustainability gains</a> that have been made, such as improved land management.</p>
<p>At the heart of this complex issue is the difficulty of tracing cocoa from farms to the end product. The majority of the world’s crop – <a href="https://chocolatephayanak.com/unkategorisiert/where-is-cocoa-grown-around-the-world/">around 70%</a> – is grown on small farms in remote areas of Ghana and Ivory Coast. </p>
<p>From those farms it is collected by small-scale traders and taken to larger facilities, where vast quantities are traded on international markets. With many different parties mixing crops early in the supply chain, tracing beans back to their farms of origin becomes extremely difficult. </p>
<p>So far, certification schemes such as Fairtrade, which aim to encourage responsible sourcing, appear to have <a href="http://www.msi-integrity.org/not-fit-for-purpose/">failed</a>. Some well-known chocolate brands <a href="https://www.theguardian.com/business/2020/jun/23/profoundly-disappointing-kitkat-cuts-ties-with-fairtrade">such as KitKat</a> have <a href="https://www.cips.org/supply-management/news/2020/june/kitkat-ends-partnership-with-fairtrade/">dropped ethical labels</a> and <a href="https://www.confectionerynews.com/Article/2019/04/30/Mondelez-adds-more-brands-to-its-Cocoa-Life-Program-as-new-report-shows-it-s-on-track-to-deliver-100-sustainability-by-2025">self-certification</a> has become increasingly popular, with the likes of the company which owns Cadbury Dairy Milk. </p>
<p>But <a href="https://doi.org/10.1108/SCM-11-2020-0583">our research</a> suggests a solution could now be within reach, with a reliable system that tracks the journey from cocoa trees to the chocolate in your fridge. </p>
<p>The system uses something called “biomarkers”, which are like biochemical fingerprints or bar codes extracted from the plant’s DNA. These provide a unique identifier of a plant that is also observed in its beans. The biomarkers in cocoa beans are so hardy they can even survive the industrial processes used in chocolate making. </p>
<h2>Test and trace</h2>
<p>This allows for the identification of an individual farm’s beans from a mixture of beans of different origins in the final product. The method has now been successfully tested in <a href="https://doi.org/10.1108/SCM-11-2020-0583">a study of cocoa supply chains</a>, tracing specific plants on individual farms through to chocolate products. </p>
<p>If a database was created with sufficient samples, chocolate bought anywhere in the world could be traced back to the farm where the cocoa was originally sourced. Chocolate producers and customers would know precisely where the raw material of their chocolate has come from. </p>
<p>While the solution has proved to be effective in our small pilot study, if the method can be scaled up effectively, there can be no excuses for continued abuses within chocolate supply chains. Claims that farms are too widespread or remote, or the cocoa supply chain too complex, become empty. </p>
<p>Such a biomarker database identifying the origin of cocoa products could be built by firms or done independently at an estimated cost of around £5 per farm – the cost of a box of chocolates. The industry’s serious challenges of child labour, modern slavery, and environmental degradation could then be addressed, with targeted audits of specific farms where chocolate producers source their cocoa. </p>
<p>The chocolate industry and governments need to face this ethical challenge. We have developed an effective tool for them to make progress – and drastically improve a trade that is rife with environmental destruction and human misery.</p><img src="https://counter.theconversation.com/content/163687/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Rogerson receives funding from the Economic and Social Research Council (grant reference ES/P000630/1).</span></em></p><p class="fine-print"><em><span>Glenn Parry receives funding from the Engineering and Physical Sciences Research Council (UK) via the
Dynamic, Real time, On-demand Personalisation for Scaling (DROPS) EP/R033374/1, and the Next Stage
Digital Economy Centre in the Decentralised Digital Economy (DECaDE) EP/T022485/1. </span></em></p><p class="fine-print"><em><span>Pedro Lafargue received funding for this research from the University of the West of England, Bristol, and would like to thank Tree of Wisdom Chocolate for its assistance in this research.</span></em></p>DNA testing for cocoa beans could fight slavery and child labour.Michael Rogerson, PhD Candidate, University of BathGlenn Parry, Professor of Digital Transformation, University of SurreyPedro Lafargue, Research Fellow, University of the West of EnglandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1433132020-11-17T13:22:58Z2020-11-17T13:22:58ZRacial discrimination ages Black Americans faster, according to a 25-year-long study of families<figure><img src="https://images.theconversation.com/files/366512/original/file-20201029-21-aenhdo.jpg?ixlib=rb-1.1.0&rect=0%2C11%2C4000%2C2646&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Anti-racism protest, 2020.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/woman-wearing-a-protective-face-mask-reading-i-cant-breathe-news-photo/1218209395">Fabrice Coffrini/AFP via Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>I’m part of a <a href="https://cfr.uga.edu/fachs/">research team</a> that has been following more than 800 Black American families for almost 25 years. We found that people who had reported experiencing high levels of racial discrimination when they were young teenagers <a href="https://doi.org/10.1037/hea0000788">had significantly higher levels of depression in their 20s</a> than those who hadn’t. This elevated depression, in turn, showed up in their blood samples, which revealed accelerated aging on a cellular level. </p>
<p>Our research is not the first to show <a href="https://doi.org/10.1146/annurev-publhealth-040218-043750">Black Americans live sicker lives and die younger</a> than other racial or ethnic groups. The experience of constant and accumulating stress due to racism throughout an individual’s lifetime can wear and tear down the body – literally “getting under the skin” to affect health.</p>
<p>These findings highlight how stress from racism, particularly experienced early in life, can affect the mental and physical health disparities seen among Black Americans. </p>
<h2>Why it matters</h2>
<p>As news stories of Black American women, men and children being killed due to racial injustice persist, our research on the effects of racism continue to have significant implications.</p>
<p>COVID-19 has been <a href="https://www.washingtonpost.com/opinions/2020/05/13/stress-was-already-killing-black-americans-covid-19-is-making-it-worse/">labeled a “stress pandemic” for Black populations</a> that are <a href="https://theconversation.com/covid-19-is-hitting-black-and-poor-communities-the-hardest-underscoring-fault-lines-in-access-and-care-for-those-on-margins-135615">disproportionately affected</a> due to factors like poverty, unemployment and lack of access to health care. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&rect=30%2C20%2C6679%2C4446&q=45&auto=format&w=1000&fit=clip"><img alt="Young black mother comforting sad school age daughter at home." src="https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&rect=30%2C20%2C6679%2C4446&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/365258/original/file-20201023-19-1eyt63q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Racism has a far-reaching impact on children’s health.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-black-mother-taking-care-of-her-sad-little-royalty-free-image/1143896999">skynesher/E+ via Getty Images</a></span>
</figcaption>
</figure>
<p>In 2019, the <a href="https://doi.org/10.1542/peds.2019-1765">American Academy of Pediatrics identified racism</a> as having a profound impact on the health of children, adolescents, emerging adults and their families. Our findings support this conclusion – and show the need for society to truly reflect on the lifelong impact racism can have on a Black child’s ability to prosper in the U.S.</p>
<h2>How we do the work</h2>
<p>The <a href="https://cfr.uga.edu/fachs/">Family and Community Health Study</a>, established in 1996 at Iowa State University and the University of Georgia, is looking at how stress, neighborhood characteristics and other factors affect Black American parents and their children over a lifetime. Participants were recruited from rural, suburban and metropolitan communities. Funded by the National Institutes of Health, this research is the largest study of African American families in the U.S., with <a href="https://cfr.uga.edu/fachs/">800 families participating</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Black man concentrates while completing a form." src="https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=903&fit=crop&dpr=1 600w, https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=903&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=903&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1135&fit=crop&dpr=1 754w, https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1135&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/365260/original/file-20201023-18-1mcm3we.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1135&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Early experiences of racism can have long-term physical effects.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/attractive-young-african-american-man-writing-royalty-free-image/181864094">PamelaJoeMcFarlane/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>Researchers collected data – including self-reported questionnaires on experiences of racial discrimination and depressive symptoms – every two to three years. In 2015, the team started taking blood samples, too, to assess participants’ risks for heart disease and diabetes, as well as test for biomarkers that predict the early onset of these diseases. </p>
<p>We utilized a <a href="https://doi.org/10.1038/ncomms9570">technique that examines how old a person is at a cellular level</a> compared with their chronological age. We found that some young people were older at a cellular level than would have been expected based on their chronological age. Racial discrimination accounted for much of this variation, suggesting that <a href="https://doi.org/10.1037/hea0000788">such experiences were accelerating aging</a>. </p>
<p>Our study shows how vital it is to think about how mental and physical health difficulties are interconnected. </p>
<h2>What’s next</h2>
<p>Some of the next steps for our work include focusing more closely on the accelerated aging process. We also will look at resiliency and early life interventions that could possibly offset and prevent health decline among Black Americans.</p>
<p>Due to COVID-19, the next scheduled blood sample collection has been delayed until at least spring 2021. The original children from this study will be in their mid- to late 30s and might possibly be experiencing chronic illnesses at this age due, in part, to accelerated aging. </p>
<p>With continued research, my colleagues and I hope to identify ways to interrupt the harmful effects of racism so that Black lives matter and are able to thrive.</p><img src="https://counter.theconversation.com/content/143313/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This research was supported by the National Institute of Child Health and Human Development
(R01HD080749), the National Heart, Lung, Blood Institute (R01HL118045), the National
Institute of Drug Abuse (R01DA021898). In addition, support for this study was provided by the
Center for Translational and Prevention Science (P30DA02782) funded by the National Institute
on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily
represent the official views of the National Institutes of Health.</span></em></p>A study of 800 Black American families shows early experiences of racism have long-term consequences for physical and mental health.Sierra Carter, Assistant Professor of Psychology, Georgia State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1464322020-09-24T09:46:35Z2020-09-24T09:46:35ZParkinson’s disease can affect the eyes – here’s what we know so far<figure><img src="https://images.theconversation.com/files/359768/original/file-20200924-24-27yh42.jpg?ixlib=rb-1.1.0&rect=13%2C0%2C8661%2C5787&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Parkinson's is a motor disease which can affect eye movement.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/senior-looks-instrument-checking-eyes-ophthalmologist-372743563">Lucky Business/ Shutterstock</a></span></figcaption></figure><p>Parkinson’s disease is the <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30295-3/fulltext">second most common</a> neurodegenerative disease, affecting over <a href="https://www.parkinson.org/Understanding-Parkinsons/Statistics#:%7E:text=More%20than%2010%20million%20people,have%20Parkinson's%20disease%20than%20women.">10 million people worldwide</a>. It’s characterised by changes in movement, including tremors, and slower and more rigid movements. But researchers are also beginning to investigate other symptoms of <a href="https://theconversation.com/uk/topics/parkinsons-disease-30547">Parkinson’s disease</a> – including <a href="https://www.parkinson.org/Understanding-Parkinsons/Symptoms/Non-Movement-Symptoms/Vision-Changes">those involving the eye</a>. </p>
<p>Parkinson’s results from the degeneration of dopamine neurons in the brain’s basal ganglia – an area involved in voluntary movement. Though no cure exists for Parkinson’s, symptoms can be managed with drugs that replace dopamine.</p>
<p><a href="https://www.parkinson.org/Understanding-Parkinsons/Diagnosis">No single diagnostic test</a> exists for Parkinson’s as the blood-brain barrier (which protects the brain from pathogens roaming the bloodstream) and skull make it hard to assess the brain. As a result <a href="https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/how-parkinson-disease-is-diagnosed">subjective assessments of symptoms</a> are used to diagnose patients. </p>
<p>Given Parkinson’s is known to affect the body’s motor system, it’s perhaps not surprising it has been shown to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684125/">disrupt eye movements</a>. Promisingly, Parkinson’s may be diagnosed using technologies that already exist by showing subtle changes in eye movements and the thinning of specific layers in the retina. This may help measure the effectiveness of treatments and determine the progression of the disease. </p>
<h2>Changes in movement</h2>
<p>Studies investigating the effect of Parkinson’s on eye movements have focused on the rapid, ballistic movements of our eyes towards a stimulus (known as <a href="https://pubmed.ncbi.nlm.nih.gov/24113556/">saccades</a>). The opposite, <a href="https://www.sciencedirect.com/science/article/pii/S0042698913000357?via%3Dihub">antisaccades</a>, are voluntary movements of our eyes moving away from a stimulus. <a href="https://pubmed.ncbi.nlm.nih.gov/25600361/">Early studies</a> showed errors in antisaccades – whereby participants failed to look away from a light stimulus – are higher in those with Parkinson’s.</p>
<p><a href="https://www.jneurosci.org/content/35/38/13043">Another study</a>, which used <a href="https://www.michaeljfox.org/news/deep-brain-stimulation">deep brain stimulation</a>, found targeting the globus pallidus interna – the brain area partially responsible for conscious movement – reduced the number of antisaccade errors. Deep brain stimulation is the only surgical treatment for Parkinson’s disease. It works by directing electricity to precise regions of the brain. Stimulation targeting the subthalamic nucleus, an adjacent region, had no effect. Recently, <a href="https://www.nature.com/articles/s41598-020-61572-4">researchers found</a> stimulating the subthalamic nucleus increased antisaccade errors and delay both away from and towards a stimulus. </p>
<p>Though evidence from the small number of stimulation studies conflict, they highlight how Parkinson’s disease could <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005881/">influence eyes movements</a>. </p>
<p><a href="https://n.neurology.org/content/94/15_Supplement/2174">A study from earlier this year</a> describes 85% of recently diagnosed Parkinson’s patients displaying rhythmic eyelid fluttering upon closing their eyes. These small changes in movement can be measured using webcams, virtually. However, larger studies are needed to investigate the potential of eyelid fluttering as a diagnostic tool.</p>
<h2>Retinal thinning</h2>
<p>Researchers have identified the abnormal accumulation of the protein <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281589/">alpha-synuclein</a> in areas of the brain involved with voluntary movement in patients with Parkinson’s disease. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122110/">Alpha-synuclein</a> is found throughout the brain, although its function is not yet well defined. It is thought to regulate the synthesis of dopamine, which in turn helps regulate movement.</p>
<p>Interestingly, a <a href="https://link.springer.com/article/10.1007/s00401-018-01956-z#Sec6">handful of recent studies</a> have found an accumulation of alpha-synuclein in the retinal tissue of Parkinson’s patients compared to healthy samples. The <a href="https://pubmed.ncbi.nlm.nih.gov/29737566/">amount of alpha-synuclein</a> found may even correlate with the severity of disease – though this potential disease indicator can only be detected using post-mortem tissue samples.</p>
<p>Optical coherence tomography (OCT) scans, which take cross-sectional images of the retina’s ten distinct layers, may allow researchers to detect retinal changes in living patients. These scans are fast, non-invasive, relatively cheap and easy to use.</p>
<p>A <a href="https://n.neurology.org/content/86/16_Supplement/P5.177">number</a> of OCT studies have so far shown retinal thinning in patients with Parkinson’s. Not only are dopamine neurons found in <a href="https://academic.oup.com/brain/article/132/5/1128/357681">specific regions of the retina</a>, the layers of the retina neighbouring these regions were <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591751/">found to harbour alpha-synuclein</a>. <a href="https://www.nature.com/articles/s41598-019-48388-7">Studies show</a> retinal thinning does selectivity occur in these layers of the retina, potentially indicating the onset of early Parkinson’s disease.</p>
<figure class="align-center ">
<img alt="Man has his eyes tested using an OCT machine." src="https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/359769/original/file-20200924-23-iix4ij.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">OCT scans can show thinning of the retinal layers.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/slit-lamp-eye-oculist-doctor-control-1246634854">Parilov/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Alongside diagnosing Parkinson’s, eye tests could also help track disease progression. <a href="https://cp.neurology.org/content/10/1/29">A study</a> involving 126 participants looked to see if OCT scans and simple visual chart tests in patients with Parkinson’s disease correlated with the risk of dementia (an algorithm was used to <a href="https://pubmed.ncbi.nlm.nih.gov/28629879/">calculate risk</a>). </p>
<p>Those with Parkinson’s disease who were calculated to have the highest risk of dementia fared worse on the sight tests. These patients also were found to have greater retinal thinning. These findings were not replicated in participants who had a similarly high dementia risk, but no Parkinson’s diagnosis.</p>
<p>However, this type of study has limitations. The number of patients involved and other factors – such as the medication they take – can affect the findings. Eye tests are also harder to perform on patients with the most severe symptoms.</p>
<h2>Big data</h2>
<p>As more patients are studied, more can be learned about Parkinson’s disease. Big data studies can be advantageous because Parkinson’s disease is <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30295-3/fulltext">relatively common</a> and eye scans are becoming increasingly routine. This allows researchers to analyse large numbers of OCT scans and retinal images already captured on patients with, and without, Parkinson’s.</p>
<p>Databases such as this exist, the largest being the <a href="https://www.moorfields.nhs.uk/news/moorfields-announced-new-health-data-research-hub">INSIGHT Data Hub for Eye Health</a>, which consist of <a href="https://www.insight.hdrhub.org/">millions of eye scans</a> alongside anonymised medical histories from over 250,000 patients. Population-based approaches, coupled with the use of machine learning (a type of artificial intelligence) and <a href="https://www.nature.com/articles/s41591-018-0107-6">deep learning</a> (a subset of machine learning), can sift through large databases, uncovering patterns. Researchers can use several eye scans from the same patient to <a href="https://link.springer.com/chapter/10.1007/978-981-10-4361-1_138">help investigate disease progression</a>.</p>
<p>An increasing body of evidence suggests that changes in eye movements and retinal structure result from the degeneration of dopamine, which is characteristic of Parkinson’s disease. Other <a href="https://pubmed.ncbi.nlm.nih.gov/27412389/">visual disturbances</a>, such as changes in rapid eye movement during sleep, motion perception, and colour vision, are also under investigation. Importantly, these changes can be detected non-invasively.</p><img src="https://counter.theconversation.com/content/146432/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Chrystalina Antoniades receives funding from NIHR, Wellcome Trust, UCB- Oxford Collaboration grant, Merck Industry funding.</span></em></p><p class="fine-print"><em><span>Siegfried Wagner is funded by the Medical Research Council through a Clinical Research Training Fellowship. He also holds project grant funding from Fight for Sight and Alzheimer's Research UK. </span></em></p><p class="fine-print"><em><span>Pearse Keane and Salil Patel do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Parkinson’s disease may be diagnosed by looking for subtle changes in eye movements and thinning of retina layers.Salil Patel, NIHR academic clinical fellow and incoming PhD student, University of OxfordChrystalina Antoniades, Associate Professor of Neuroscience, University of OxfordPearse Keane, Professor of Ophthalmology, UCLSiegfried Wagner, Research Fellow, Ophthalmology, UCLLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1433882020-08-07T12:35:59Z2020-08-07T12:35:59ZWearable fitness devices deliver early warning of possible COVID-19 infection<figure><img src="https://images.theconversation.com/files/350944/original/file-20200803-24-1x9uoce.jpg?ixlib=rb-1.1.0&rect=0%2C16%2C5615%2C3715&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fitness information from wearable devices can reveal when the body is fighting an infection.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/runner-in-the-park-using-smart-watch-royalty-free-image/636251614?adppopup=true">Nico De Pasquale Photography/Stone via Getty Images</a></span></figcaption></figure><p>The difficulty many people have getting tested for SARS-CoV-2 and delays in receiving test results make early warning of possible COVID-19 infections all the more important, and <a href="https://advances.sciencemag.org/content/early/2020/06/30/sciadv.abd4794.full">data from wearable health and fitness devices shows promise</a> for identifying who might have COVID-19. </p>
<p>Today’s wearable device gather data about physical activity, heart rate, body temperature and quality of sleep. This data is typically used to help people track general well-being. Smartwatches are the most common type of wearable. There are also smart wrist bands, finger rings and earbuds. Smart clothing, shoes and eyeglasses can also be considered “wearables.” Popular brands include Fitbits, Apple Watches and Garmin watches.</p>
<p>Several studies are <a href="https://med.stanford.edu/snyderlab/news/20202-covid-19-research.html">testing algorithms</a> that <a href="https://wvumedicine.org/news/article/wvu-rockefeller-neuroscience-institute-announces-capability-to-predict-covid-19-related-symptoms-up-/">assess data</a> from wearable devices to detect COVID-19. Results to date show that the concept is sound. However, wearables can be expensive and sometimes challenging to use. Addressing these issues is important to allow as many people as possible to benefit from them.</p>
<h2>Detecting flu-like illness</h2>
<p>Because wearables are excellent tools for monitoring general health conditions, researchers began studying ways of using them to detect illness before the COVID-19 pandemic. For example, researchers used Fitbit data <a href="https://doi.org/10.1016/S2589-7500(19)30222-5">to identify people who could have an influenza-like illness</a> from their resting heart rate and daily activity patterns. An elevated resting heart rate can be related to an infection. </p>
<figure class="align-right ">
<img alt="Fitbit fitness tracker" src="https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=775&fit=crop&dpr=1 600w, https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=775&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=775&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=974&fit=crop&dpr=1 754w, https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=974&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/350946/original/file-20200803-24-t4cbmc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=974&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fitness trackers like this Fitbit monitor heart rate, activity and quality of sleep. Elevated resting heart rate is a sign of infection.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/185603127@N05/49111707501/">Krystal Peterson/Flickr</a></span>
</figcaption>
</figure>
<p>Most Fitbit models measure and record heart rate, so the devices can be used to spot periods of increased resting heart rate. They also measure and record activity, so they can identify reduced levels of daily activity. Combining these two measures allowed the researchers to better predict who had an influenza-like illness. </p>
<p>It’s not possible to determine if a smart device wearer has a particular illness from just these data measures. But seeing a sudden change in these conditions can prompt people to isolate themselves and get diagnostic tests, which can reduce the spread of communicable diseases like COVID-19.</p>
<h2>Body temperature</h2>
<p>Fever and persistent cough are the <a href="https://doi.org/10.1371/journal.pone.0234765">most common symptoms of COVID-19</a>. This has sparked widespread screening using thermometers, most commonly contactless infrared thermometers. </p>
<p>Despite the ubiquity of thermometers, temperature sensors in wearables are uncommon. This is due in part to <a href="https://dx.doi.org/10.3390%2Fs18061714">how complicated it is</a> to obtain true body temperature from skin-based measurements. Skin temperature varies depending on environmental conditions and stress levels, sweat evaporation can lower skin temperature, and temperature sensors sometimes have less-than-ideal contact with the skin.</p>
<p>There are wearable temperature patches that communicate with smart devices and record temperature continuously. But body temperature isn’t 100% predictive of illness, and it’s impossible to diagnose a particular infection, such as COVID-19, using body temperature alone. Nonetheless, a fever alert could lead to earlier intervention.</p>
<h2>Sweat and tears</h2>
<p>Research into sensing technology continues to expand the possibilities for wearables as health monitoring and diagnosis devices. The COVID-19 outbreak is likely to influence the direction of this research as well as accelerate it. </p>
<figure class="align-right ">
<img alt="backside of Garmin smartwatch" src="https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/350948/original/file-20200803-14-1c653hn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The backside of this Garmin smartwatch shows the sensors that use light to illuminate blood vessels in order to measure heart rate.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/185627742@N03/49108710981/">Tina Arnold/Flickr</a></span>
</figcaption>
</figure>
<p>One approach is to create sensors that <a href="https://doi.org/10.1002/elan.201800677">detect compounds in sweat</a> from the skin. These compounds can provide a lot of information about a person’s health. pH, sodium ions, glucose and alcohol content are just some of the things that emerging sweat sensors can detect. Tears also contain compounds from the body, so researchers are investigating <a href="https://doi.org/10.1039/C9LC01039D">chemical sensing using contact lenses and smart lenses</a>. </p>
<p>Sweat rate can also be measured, which can be used as an indicator of temperature, so these sensors are being examined for use in <a href="https://spectrum.ieee.org/view-from-the-valley/the-institute/ieee-member-news/sweat-sensing-patch-aimed-athletes-takes-covid19">helping detect COVID-19</a>. </p>
<h2>Toward detecting viruses</h2>
<p>The drawback of many existing wearable sensors is that they can’t actually detect the presence of a virus such at SARS-CoV-2. To do this, they would have to detect virus-specific RNA. </p>
<p>RNA detection typically involves several steps, including extracting RNA from a sample, making many copies of the RNA and identifying the RNA. Although there has been a lot of progress in miniaturizing RNA detection equipment for use in rapid, point-of-care testing, there’s still a ways to go before it can fit in wearable devices.</p>
<p>Much of the ongoing research on developing rapid, point-of-care pathogen detection uses “lab-on-a-chip” technology. Lab-on-a-chip refers to the goal of shrinking laboratory tests that once required many large pieces of equipment to the size of a computer chip or microscope slide. </p>
<p>An example is a <a href="https://www.engineering.com/DesignerEdge/DesignerEdgeArticles/ArticleID/20451/Lab-on-a-Chip-LoC-COVID-19-Test-Advances-to-Clinical-Trials.aspx">COVID-19 diagnostic test</a> undergoing clinical trials. The test’s sensor is a specialized <a href="https://ieeexplore.ieee.org/document/6189704">ion-sensitive field-effect transistor</a> (ISFET) that is designed to respond to the presence of the virus RNA. The device can perform a test in less than one hour, but requires a sample collected by nasal swab. </p>
<p>While this technology is not wearable, it could become the launching point for future virus-detecting wearables because these can be made small and use little power. A wearable device that continuously monitors a person and indicates that they’ve contracted or been exposed to the virus would allow the person to seek treatment and isolate themselves to prevent further spread.</p>
<h2>Sonic screwdrivers and tricorders</h2>
<p>Fans of Dr. Who know the <a href="https://en.wikipedia.org/wiki/Sonic_screwdriver">sonic screwdriver</a>, and Star Trek followers know the <a href="https://en.wikipedia.org/wiki/Tricorder">tricorder</a>. The ideal wearable of the future would be similar to these wondrous fictional devices. It would be able to detect the presence of the virus in the environment around the wearer, providing the opportunity to leave before becoming exposed. </p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<p>But airborne virus detection requires significant equipment to <a href="https://dx.doi.org/10.1371%2Fjournal.pone.0174314">collect air samples and analyze them</a>. Other methods, such as the <a href="https://doi.org/10.1021/acsnano.0c02439">plasmonic photothermal biosensor</a>, provide promising results, but still require the user to perform the analysis. It will be some time before a smartwatch will be able to alert its wearer to the presence of a dangerous virus.</p>
<h2>Wearable and accessible</h2>
<p>For all the promise of wearables as tools to tackle the COVID-19 pandemic, and future pandemics, there are barriers to widespread use of the devices. Most wearables are expensive, can be difficult to learn to use by non-native English speakers, or are developed without data from a broad population base. There’s a risk that <a href="https://doi.org/10.2196/mhealth.6494">many people won’t accept the technology</a>. </p>
<p>Continued development of broadly accepted health-based wearables should include community input, as outlined in a <a href="https://doi.org/10.17226/23439">National Academies Workshop Summary</a>. By ensuring that everyone has access to wearables, and accepts them, the devices can help keep people healthy in the midst of a global pandemic. Ongoing research should result in improved technology that, with care, will benefit all of society.</p><img src="https://counter.theconversation.com/content/143388/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Albert H. Titus has received research funding from the National Science Foundation, the National Institutes of Health, and the Department of Defense. He has also received funding for research in this area from Garwood Medical Devices.
He is a Senior Member of the IEEE, a member of BMES, ASEE, and is a member of the BME Council of Chairs.</span></em></p>Fitness information like resting heart rate collected by wearable devices can’t diagnose diseases, but it can signal when something is wrong. That can be enough to prompt a COVID-19 test.Albert H. Titus, Professor of Biomedical Engineering, University at BuffaloLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1222492019-08-23T12:20:46Z2019-08-23T12:20:46ZNew blood screening may detect ovarian cancer two years before other methods<figure><img src="https://images.theconversation.com/files/289071/original/file-20190822-170956-zstdsq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/real-female-hairless-fight-against-cancer-243554755?src=QqPUzHwuo1ierIyyU9MAMQ-1-2">fototip/Shutterstock</a></span></figcaption></figure><p>Ovarian cancer has a high mortality risk because it is so often diagnosed at <a href="https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21456">a very late stage</a>. In a <a href="https://www.nature.com/articles/s41416-019-0544-0">new study</a>, our team has shown that detection rates can be significantly improved by screening for a specific set of proteins in the bloodstream. This could mean detection of ovarian cancer up to two years before current screenings allow.</p>
<p>Cancer tests walk a harsh line between missing cancer and misdiagnosing healthy people. If you make your test too strict, you will fail to detect traces of real cancers that are present. If it is too lenient you will falsely detect cancer where it doesn’t exist.</p>
<p>While it might seem obvious we should tip the scales in favour of catching every cancer, the burden this places on the health system <a href="https://theconversation.com/medical-researchers-raise-alarm-on-overdiagnosis-12471">can be unsustainable</a>. Not to mention the stress and potentially dangerous treatment it can mean for healthy people.</p>
<p>Our group is working to improve this balancing act in the diagnosis of ovarian cancer, the statistics for which speak for themselves. In 2016, 4,227 women <a href="https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ovarian-cancer">died from ovarian cancer</a>. The overall five year survival for stage III & IV ovarian cancer (late stage) is only 22%, making this the <a href="https://www.ncbi.nlm.nih.gov/pubmed/22237781">most lethal</a> female reproductive cancer. When ovarian cancer is detected early, the patient’s prospects are much better, with approximately 90% of women diagnosed at stage I (early stage) <a href="https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ovarian-cancer">surviving five years or more</a>.</p>
<h1>Red herrings in current cancer detection</h1>
<p>Unfortunately, ovarian cancers are often not caught early enough. Almost six in ten ovarian cancer cases are <a href="https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ovarian-cancer">diagnosed at a late stage</a> in England and Northern Ireland today, resulting in a <a href="https://www.ncbi.nlm.nih.gov/pubmed/27903971">high death rate</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289072/original/file-20190822-170946-1kcsan7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?u=http%3A%2F%2Fdownload.shutterstock.com%2Fgatekeeper%2FW3siZSI6MTU2NjUwMzg4OCwiYyI6Il9waG90b19zZXNzaW9uX2lkIiwiZGMiOiJpZGxfMTM3NzQ1ODUwNCIsImsiOiJwaG90by8xMzc3NDU4NTA0L2h1Z2UuanBnIiwibSI6MSwiZCI6InNodXR0ZXJzdG9jay1tZWRpYSJ9LCJsUXhjL0dwbjhwZk5VZHNzb1dxYUNyN2NmUjAiXQ%2Fshutterstock_1377458504.jpg&ir=true&pi=33421636&m=1377458504&src=y6qv_ROL2M0fAm5GPdCpcQ-1-7">Iconic Bestiary/Shutterstock</a></span>
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<p>Late detection of ovarian cancers is mostly due to the “non-specific” nature of its symptoms. Currently most blood tests measure the levels of a <a href="https://en.wikipedia.org/wiki/CA-125">protein CA125</a>. But using this as a marker for cancer in the blood <a href="https://theconversation.com/why-single-blood-markers-for-disease-will-become-a-thing-of-the-past-41636">is not reliable</a> as it can also be elevated in pregnancy, during a woman’s period, and other non fatal conditions (such as <a href="https://www.nhs.uk/conditions/endometriosis/">endometriosis</a>). Additionally, not all cancer patients show this marker. Studies have shown it is <a href="https://www.ncbi.nlm.nih.gov/pubmed/2651469">only elevated in around 50%</a> of early stage cancers.</p>
<p>For this reason, our research team has been working with an international group of experts from the universities of New South Wales, Milan and Manchester, to develop a combination of proteins we can use to identify cancer earlier than is currently possible.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/28664912">Our previous work</a> lead to the identification of four <a href="https://www.ncbi.nlm.nih.gov/pubmed/26815306">possible markers</a> we could look for in the blood to maximise the power of our tests (protein CA125, phosphatidylcholine-sterol acyltransferase, vitamin K-dependent protein Z, and C-reactive protein).</p>
<h1>A time capsule of blood samples</h1>
<p>Armed with our panel of blood markers, the next stage was to test for effectiveness in a large group of women. Part of the success of our study came from the <a href="https://www.ncbi.nlm.nih.gov/pubmed/31388184">incredible dataset</a> we had access to thanks to the United Kingdom Collaborative Trial for Ovarian Cancer Screening (<a href="https://gtr.ukri.org/projects?ref=G0801228">UKCTOCS</a>). From the 200,000 women registered in this database, we were able to select 80 women (49 ovarian cancer cases, and 31 healthy people). Blood samples from these women had been taken every year for seven years before the ovarian cancer patients were diagnosed with the disease.</p>
<p>This provided us with a very powerful tool. With this time capsule of samples we were able to observe how levels of our four target proteins changed over time between patients and healthy individuals. In essence, it allowed us to see directly if the proteins differed between patients and the healthy people over time. Because the samples were taken over such a long period, we could track back over the seven years to see when the first time the proteins would allow us to detect the disease.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=262&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=262&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=262&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=329&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=329&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289074/original/file-20190822-170922-ksv1jh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=329&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">shutterstock time.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/pixel-flat-people-run-over-clocks-1427233007?src=rZUwIjIjoUMvNj22KHqosg-1-0">New Design Illustrations/ Shutterstock</a></span>
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<p>We then developed a computerised tool that assessed changes in protein levels to determine the “predicted risk” of ovarian cancer for each person (cancer patients and healthy people). The tool was asked to grade the risk of ovarian cancer for each person at each point along the seven year timeline (rating them severe, elevated, intermediate, or normal).</p>
<p>This initial work demonstrated that the screening tool has the potential to diagnose ovarian cancer one to two years earlier than current diagnosis. Our results also suggest it could identify 60% of the most aggressive ovarian cancers around one year before currently possible.</p>
<h1>The future - digital biological maps</h1>
<p>The results of this study are encouraging but this research is still at an early stage. We are now setting up a study to verify our results in a large group, which will provide us with around 1,000 blood samples. By using a technique called <a href="https://www.atascientific.com.au/spectrometry/">SWATH mass spectrometry</a>, we can create a digital map of all the proteins in a person’s system at that time.</p>
<p>This means we do not have to rely on physical blood samples, which can get used up or expire. If future research suggests a new protein is important, we can come back in the future to look at these samples again and can share them easily with other research groups. We hope this study will provide the data we need to advocate for an ovarian cancer screening programme.</p>
<p>By optimising these methods we also hope we can move towards a stage where ovarian cancer is diagnosed in stages I and II in most women, when treatment can really make a difference.</p><img src="https://counter.theconversation.com/content/122249/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This research was funded by the CRUK and the eve appeal . </span></em></p><p class="fine-print"><em><span>Ciaren Graham receives funding unrelated to the current study</span></em></p>We need to change diagnosis of ovarian cancer from late stage to early - scientists make stepsBobby Graham, Reader in the School of Biological Sciences, Queen's University BelfastCiaren Graham, Senior Lecturer in the School of Biological Sciences, Queen's University BelfastLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1156972019-05-14T22:50:22Z2019-05-14T22:50:22ZKetamine: The illicit party psychedelic that promises to heal depression<figure><img src="https://images.theconversation.com/files/273668/original/file-20190509-183077-1whnt10.jpg?ixlib=rb-1.1.0&rect=83%2C330%2C2483%2C1521&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Ketamine is effective for those who do not respond to traditional anti-depressants. It also shows promise for the treatment of PTSD and bipolar disorder. </span> <span class="attribution"><span class="source">(Unsplash/Kal Visuals)</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>It’s been 50 years in the making, but the anaesthetic and illicit party drug ketamine is now having a clinical comeback. New studies show that this commonly used anaesthetic can provide quick relief of core symptoms associated with severe depression, including <a href="https://www.cbc.ca/radio/april-13-2019-black-hole-imaged-a-new-tiny-human-rebuilding-coral-reefs-and-more-1.5093713/ketamine-works-its-magic-on-depression-by-stabilizing-the-brain-in-a-well-state-1.5093729">suicidal ideation</a>. </p>
<p>Amazingly, ketamine works within hours and its <a href="https://doi.org/10.1001/archpsyc.63.8.856">effects are maintained for at least one week</a>. Most strikingly, ketamine is effective in those patients who are <a href="https://doi.org/10.1176/appi.ajp.2013.13030392">resistant to ordinary antidepressants</a>, and they make up around <a href="https://doi.org/10.3310/hta18310">30 to 50 per cent of the depressed population</a>.</p>
<p>Now, efforts in <a href="https://doi.org/10.1111/pcn.12675">Mexico</a>, <a href="https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12616001096448">Australia</a>, <a href="https://doi.org/10.1016/j.psychres.2015.10.032">France</a>, <a href="https://doi.org/10.1016/j.biopsych.2018.02.1052">Canada</a> and the <a href="https://doi.org/10.1016/j.biopsych.2009.04.029">United States</a>, among others, are focusing on understanding exactly how ketamine does this, and to what extent it is safe and effective in a clinical setting. Together, these studies will increase our understanding of depression around the world and perhaps expand ketamine’s potential to treat other forms of mental illness as well.</p>
<p>The focus of <a href="https://www.uoguelph.ca/psychology/users/francesco-leri">our lab at the University of Guelph</a> is to understand how specific drugs, such as ketamine, work in the brain and influence behaviour. </p>
<p>My doctoral research, specifically, looks at <a href="https://www.researchgate.net/profile/Brett_Melanson2">the link between stress, inflammation and behaviour</a>. I am studying how ketamine influences behaviour and can reduce the effects of stress, and what this means for mood disorders, such as major depression.</p>
<h2>The first dissociative anaesthetic</h2>
<p>Initially, ketamine was developed as an alternative to the well-known, illegal party drug, phencyclidine (PCP). In the late 1950s, PCP was the focus of Parke-Davis pharmaceuticals for its use as an anesthetic. However, the drug came with <a href="https://doi.org/10.1097/ALN.0b013e3181ed09a2">uncomfortable side effects</a> such as delirium and a loss of feeling in the limbs, which lasted for several hours after the drug was taken.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/273394/original/file-20190508-183083-i63nor.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ketamine is known as the party drug Special K.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>To fix this issue, Cal Bratton of Parke-Davis encouraged scientists to look into possible ways to modify PCP, with a primary goal of reducing side effects. In 1962, the organic chemist, Calvin Stevens, made a PCP-like compound which he said had similar anaesthetic properties, with shorter acting psychoactive effects than PCP. </p>
<p>This compound, <a href="https://doi.org/10.1097/ALN.0b013e3181ed09a2">originally known as CI-581</a>, was eventually named <a href="https://doi.org/10.1097/EJA.0000000000000638">ketamine</a> based on the ketone and amine group that formed its chemical structure.</p>
<p>Followings its discovery, ketamine was then used in the first human trials in the mid-1960s which included testing on <a href="https://doi.org/10.1111/j.1365-2044.1990.tb14287.x">volunteer inmates of Jackson Prison</a> in Michigan, United States. </p>
<p>After consistent reports of feeling “disconnected” from the environment when given ketamine, it was classified as the first <a href="https://doi.org/10.1097/ALN.0b013e3181ed09a2">dissociative anesthetic</a>. </p>
<p>In the years after its initial testing, the effects of ketamine rapidly gained popularity around the globe, and the approval as a human anaesthetic was passed by the U.S. Food and Drug Administration (FDA) in 1970 — <a href="https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm">to be sold as Ketalar</a>.</p>
<h2>Unique antidepressant effect</h2>
<p>Recent studies describing ketamine’s antidepressant properties have led to a dramatic shift in how we view the drug and treat mental illness.</p>
<p>Typical antidepressants work by controlling levels of neurotransmitters in the brain known as monoamines, such as serotonin and norepinephrine. Ketamine’s antidepressant effect is unique, as it <a href="https://doi.org/10.1016/j.psychres.2014.10.028">modifies the activity of glutamate</a>, which is the main excitatory neurotransmitter in the brain and is not a monoamine.</p>
<p>One of the fascinating findings about ketamine is that it can rapidly reduce depressive symptoms in <a href="https://www.ncbi.nlm.nih.gov/books/NBK487457/pdf/Bookshelf_NBK487457.pdf">patients who do not respond to typical monoamine antidepressants</a>. This suggests the role of glutamate in depression.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/273667/original/file-20190509-183112-e1i9bo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The study of ketamine is opening new doors for treating mental illness.</span>
<span class="attribution"><span class="source">(Unsplash/Candice Picard)</span></span>
</figcaption>
</figure>
<p>In fact, studies have related ketamine’s antidepressant effect with its ability to maintain connections between neurons (or nerve cells) in the brain. These connections are known to continuously change in response to our environment, which is a process known as <em>plasticity</em>. Interestingly, the ability of these neurons to change connections highly relies on normal glutamate activity. </p>
<p>A combination of human and animal studies suggest that ketamine’s antidepressant effect may involve regulating glutamate levels to <a href="https://doi.org/10.4103/1673-5374.230288">strengthen these connections</a> and/or restore them <a href="https://www.bbrfoundation.org/event/brain-plasticity-effects-antidepressants-major-depression">back to a pre-stressed state</a>.</p>
<p>Further study of ketamine’s ability to restore these neural connections and how glutamate relates to mood disorders will surely open new doors for understanding mental illness.</p>
<h2>Nasal sprays and biomarkers</h2>
<p>Current research has shown positive effects of ketamine for other forms of mental illness as well, such as <a href="https://doi.org/10.4088/JCP.17m11634">post-traumatic stress disorder (PTSD)</a> and <a href="https://doi.org/10.9740/mhc.2017.01.016">bipolar disorder</a>. Though the results seem quite positive, more studies are required to validate their use beyond depression. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=404&fit=crop&dpr=1 600w, https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=404&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=404&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=507&fit=crop&dpr=1 754w, https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=507&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/273395/original/file-20190508-183103-1t9fg1i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=507&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A vial of ketamine.</span>
<span class="attribution"><span class="source">(AP Photo/Teresa Crawford)</span></span>
</figcaption>
</figure>
<p>Other studies using a <a href="https://doi.org/10.1176/appi.ajp.2018.18070834">repeated treatment method over several weeks</a> showed that ketamine can produce long-term reductions in symptoms of treatment-resistant depression, lending potential to its safety and effectiveness over longer periods of treatment.</p>
<p>Recently, the FDA has approved esketamine (ketamine’s “close cousin”) in the U.S., sold as <a href="https://www.cnn.com/2019/03/05/health/esketamine-depression-nasal-spray-fda-bn/index.html">Spravato</a> in the form of a nasal spray. Importantly, the spray is only prescribed to treatment-resistant patients who continue to take an oral antidepressant and can only be used under the supervision of a health-care provider.</p>
<p>Finally, studies are also looking into <a href="https://www.mayoclinic.org/medical-professionals/psychiatry-psychology/news/ketamine-research-focuses-on-mechanisms-of-action-and-biomarker-development/mac-20430311">biological markers that can predict response to treatment, also known as biomarkers</a>. If successful, this research would allow for more accurate and effective treatment delivery in the form of <a href="https://www.canbind.ca/research/why-and-how-we-study-depression/">personalised treatment plans</a>.</p>
<p>Increasing accessibility to ketamine treatment for depression will be the next major milestone for this drug. It is sure to provide effective relief for those who continue to experience treatment-resistant and severe depression.</p>
<p><br>
<br></p>
<p><em>The promise of ketamine for treating mood disorders only applies in a carefully monitored clinical setting. The street drug <a href="https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/ketamine">Special K can be addictive, put users at high risk and cause long-term psychological harm</a>.</em></p><img src="https://counter.theconversation.com/content/115697/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Brett Melanson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Research shows that ketamine can produce long-term reductions in symptoms of treatment-resistant depression.Brett Melanson, PhD Student in Neuroscience and Applied Cognitive Science, University of GuelphLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1103342019-01-28T12:29:00Z2019-01-28T12:29:00ZHow renting could affect your health<figure><img src="https://images.theconversation.com/files/255363/original/file-20190124-135151-1u819lm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/house-key-on-yellow-background-minimal-1014728863?src=10WOo7YZCl4xbwljjLEKgg-1-2">Nednapa/Shutterstock.com</a></span></figcaption></figure><p>Our homes play a number of vital roles in our lives. They are where we rest, spend time with friends and family, and can be most ourselves. Given this central role it is not surprising that researchers have found a number of important relationships between the homes we live in and our health. </p>
<p>A lot of this evidence uses subjective measures, where people are asked in surveys to rate their health, usually on a scale from poor to excellent. Our <a href="https://jech.bmj.com/content/early/2019/01/05/jech-2018-211431">recent paper</a> added to this evidence by exploring the association between housing and health using an objective <a href="https://www.understandingsociety.ac.uk/documentation/health-assessment">indicator</a>: C-reactive protein (CRP) level. CRP is a marker found in the blood that is associated with infection and stress, and at high levels with increased risk of cardiovascular disease. </p>
<p>We found that private renters have higher levels of CRP, indicating worse health, than owner occupiers. People who lived in detached houses had lower CRP compared to people living in other types of housing, such as flats or semi-detached homes. Surprisingly, we found that people paying high proportions of their income on housing costs had lower CRP levels, although only if they were renting. These findings have important implications for current housing debates, particularly in England.</p>
<h2>Home quality</h2>
<p>The poorer health of private renters in our study may reflect the average <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/705821/2016-17_EHS_Headline_Report.pdf">lower</a> quality of homes in the sector. Private rented homes, for example, are more likely to have damp than social rented or owner occupied homes, and less likely to have central heating. </p>
<p>Efforts to improve home quality in UK rented sectors have tended to <a href="https://fullfact.org/economy/did-mps-vote-against-homes-having-be-made-fit-live-in/">struggle</a> in parliament, raising questions about conflict of interest for MPs who are <a href="https://www.independent.co.uk/news/uk/politics/tories-vote-down-law-requiring-landlords-make-their-homes-fit-for-human-habitation-a6809691.html">also landlords</a>. Despite this, from March this year UK landlords <a href="https://services.parliament.uk/bills/2017-19/homesfitnessforhumanhabitation.html">will be required</a> to maintain the condition of their properties throughout the tenancy to a habitable standard, with new routes of <a href="https://www.insidehousing.co.uk/news/news/bill-giving-tenants-power-to-take-action-against-landlords-becomes-law-59593">redress</a> for tenants where these standards are not met. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/255366/original/file-20190124-135154-11wc6a8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Privately rented homes are more likely to be damp than owned or social housing homes.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mold-corner-window-516787591?src=T7x60f76Ww-LFYMM9AJ_rA-1-19">Burdun Iliya/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>That our analysis did not find a similarly negative health association for tenants in social housing, where a statutory minimum standard for housing (the <a href="https://england.shelter.org.uk/housing_advice/repairs/what_counts_as_a_decent_home">Decent Homes Standard</a>) is already in place, suggests that these new protections may improve the health of private tenants.</p>
<h2>Affordability</h2>
<p>We also found that paying high proportions of income on housing costs was positively associated with renters’ health. This was a surprising finding given the substantial evidence linking more <a href="https://academic.oup.com/aje/article/184/6/421/2576058">affordable</a> <a href="https://academic.oup.com/eurpub/article/26/5/788/2197597">housing</a> with better <a href="https://academic.oup.com/aje/article/174/7/753/115870">health</a>, but likely further emphasises a link with housing quality. </p>
<p>Renters seem to have to place themselves under financial strain to access decent quality housing and avoid the negative health impacts of poor housing. This finding supports efforts to improve housing affordability, challenging the move from social to more <a href="https://www.z2k.org/about-us/latest/an-end-to-affordable-rents/">expensive</a> “<a href="https://blog.shelter.org.uk/2015/08/what-is-affordable-housing/">affordable</a> <a href="http://researchbriefings.files.parliament.uk/documents/CBP-7747/CBP-7747.pdf">rent</a>” <a href="https://www.insidehousing.co.uk/comment/comment/lets-stop-converting-social-rented-homes-to-affordable-rent-54922">homes</a>, and <a href="https://academic.oup.com/aje/article/184/6/421/2576058">reductions</a> to <a href="https://academic.oup.com/jpubhealth/article/38/2/197/1752995">housing benefit</a>.</p>
<h2>Social housing</h2>
<p>In support of this, the charity <a href="https://england.shelter.org.uk/support_us/campaigns/a_vision_for_social_housing">Shelter</a> recently argued for significantly more social housing to be built. Although expensive, at £10.7 billion per year, the savings from reduced housing benefit expenditure (currently costing the UK government around £21 billion per year) and increased productivity mean the building of 3.1m homes is estimated to pay for itself within 40 years. </p>
<p>Our results suggest further potential savings due to improved health. Additionally, increased building could tackle the significant lack of housing suitable for <a href="https://www.equalityhumanrights.com/sites/default/files/housing-and-disabled-people-britains-hidden-crisis-main-report_0.pdf">disabled people</a>, with implications for health, well-being and employment. </p>
<p>Of course, as the <a href="https://theconversation.com/uk/topics/grenfell-tower-39675">Grenfell fire</a> starkly demonstrated, social housing is not without its flaws, but the regulation and enforcement suggested in the report, alongside improvements due to the Homes (Fitness for Human Habitation) Act, should make significant improvements.</p>
<h2>Right to buy</h2>
<p>Meanwhile, a <a href="https://tomcopley.com/wp-content/uploads/2014/01/Tom-Copley-AM-Right-to-Buy-Wrong-for-London-report-January-2019.pdf">recent report</a> found that over 40% of homes in London sold through the <a href="https://righttobuy.gov.uk/">Right to Buy</a> scheme are now in the private rented sector. This level is similar to <a href="https://publications.parliament.uk/pa/cm201516/cmselect/cmcomloc/370/370.pdf">previous findings</a>. </p>
<p>As well as the important implications for social housing stock and government spending, our results indicate that this shift may well be having a significant impact on health, and provides additional support for <a href="https://labour.org.uk/press/communities-losing-conservatives-right-buy-john-healey/">calls</a> to <a href="http://www.cih.org/resources/PDF/Policy%20free%20download%20pdfs/Final%20Rethinking%20social%20housing%20report.pdf">suspend</a> or <a href="https://theconversation.com/renting-rights-what-england-can-learn-from-fairer-systems-around-the-world-103779">end</a> Right to Buy in England, rather than <a href="http://researchbriefings.files.parliament.uk/documents/CBP-7224/CBP-7224.pdf">extend</a> it, as the government currently plans (Right to Buy has already been suspended in Scotland and Wales).</p>
<h2>Security</h2>
<p>Housing quality is not the only way in which which housing affects health. The poorer health associated with private renting and better health associated with detached homes points to previous evidence linking housing security, <a href="https://www.tandfonline.com/doi/abs/10.1080/14036090120617">autonomy</a>, and <a href="https://www.tandfonline.com/doi/abs/10.1080/02673037.2011.559724">control</a> with health. </p>
<p>Tenants in the private rented sector are typically living in homes with tenancies of only six to 12 months, and can be evicted without having done anything wrong (“Section 21” evictions), undermining their sense of security and control. Section 21 evictions are sometimes used for “<a href="https://www.citizensadvice.org.uk/about-us/how-citizens-advice-works/media/press-releases/complain-and-youre-out-research-confirms-link-between-tenant-complaints-and-revenge-eviction/">revenge evictions</a>”, leading to tenants living in substandard homes <a href="https://theconversation.com/private-tenants-are-putting-up-with-dangerously-cold-homes-scared-of-eviction-if-they-complain-72438">scared</a> to ask for improvements. Given these conditions, it is unsurprising that private renters are less likely to feel that where they live is their <a href="https://england.shelter.org.uk/support_us/campaigns/a_vision_for_social_housing">home</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=417&fit=crop&dpr=1 600w, https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=417&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=417&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=524&fit=crop&dpr=1 754w, https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=524&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/255367/original/file-20190124-135163-h3g2u2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=524&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Surprise!</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-vacant-house-eviction-notice-on-387715486?src=54WLtEWO_Pu1J5Smt45Ltw-1-3">Zimmytws/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Section 21 evictions are now the <a href="https://www.nao.org.uk/wp-content/uploads/2017/09/Homelessness.pdf">most common</a> reason cited by households seeking homelessness assistance in England. Private renters can end up moving so often that some have suggested that they have been forced to become <a href="https://journals.sagepub.com/doi/10.5153/sro.3491">nomadic</a>. Ending Section 21 evictions would improve private renters’ sense of security and control – and potentially health. </p>
<p>Similarly, organisations such as Shelter have <a href="https://england.shelter.org.uk/support_us/campaigns/longer_tenancies">campaigned</a> for a switch to landlords providing longer tenancies as standard as one way to improve security for private renters. This idea appears to be gaining some ground: the UK government <a href="https://www.gov.uk/government/consultations/overcoming-the-barriers-to-longer-tenancies-in-the-private-rented-sector">consulted</a> on introducing three-year tenancies last year. </p>
<p>Together our findings, alongside those from previous research, highlight the importance of thinking about housing policy holistically. Policy should recognise the diverse and important roles housing plays in people’s lives, and prioritise its function as home, rather than asset.</p><img src="https://counter.theconversation.com/content/110334/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Clair is supported by funding from the Economic and Social Research Council (grant number ES/L009153/1). The data used in our analysis covered Great Britain in 2010-12. Since this time, a number of changes have been made to housing policies by the devolved governments of Wales and Scotland, for instance ending Right to Buy and, in Scotland, introducing new tenancies that do not permit no fault evictions unless certain grounds are met. For this reason our discussion here is primarily focused on England.</span></em></p><p class="fine-print"><em><span>Amanda Hughes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Housing policy needs to prioritise housing’s function as a home, rather than an asset.Amy Clair, Research Fellow in Social Policy, University of EssexAmanda Hughes, Senior Research Associate in Epidemiology, University of BristolLicensed as Creative Commons – attribution, no derivatives.