Fasting: what are the health benefits and risks?

Fasting is commonly associated with the month of Ramadan. As you read this, billions of Muslims around the world are engaging in this declaration of faith that involves abstaining from food and drink from dawn until dusk. While fasting for Ramadan is down to spiritual beliefs, many of us choose to fast with the belief that it benefits our health. But does it?

A number of studies have suggested intermittent fasting has numerous health benefits, including weight loss, lower blood pressure and reduced cholesterol.

In recent years, numerous studies have suggested that intermittent fasting - abstaining or reducing food and drink intake periodically - can be good for us, making it one of the most popular diet trends worldwide.

One of the most well-known intermittent fasting diets is the 5:2 Fast Diet - a plan that involves eating the recommended calorie intake for 5 days a week but reducing calorie intake to 25% for the remaining 2 days - to 500 calories a day for women and 600 a day for men.

According to Dr. Michael Mosley - author of The Fast Diet books - this eating plan can not only help people lose weight, but it offers an array of other health benefits.

"Studies of intermittent fasting show that not only do people see improvements in blood pressure and their cholesterol levels, but also in their insulin sensitivity," he adds.

In June 2014, for example, Medical News Today reported on a study suggesting periodic fasting - defined in the study as 1 day of water-only fasting a week - may reduce the risk of diabetes among people at high risk for the condition.

Another study, conducted by Dr. Valter Longo and colleagues from the University of Southern California (USC) in Los Angeles, found longer periods of fasting - 2-4 days - may even "reboot" the immune system, clearing out old immune cells and regenerating new ones - a process they say could protect against cell damage caused by factors such as aging and chemotherapy.

But what are the mechanisms underlying the suggested health benefits of fasting?

The potential benefits of intermittent fasting

Since the body is unable to get its energy from food during fasting, it dips into glucose that is stored in the liver and muscles. This begins around 8 hours after the last meal is consumed.

When the stored glucose has been used up, the body then begins to burn fat as a source of energy, which can result in weight loss.

As well as aiding weight loss, Dr. Razeen Mahroof, of the University of Oxford in the UK, explains that the use of fat for energy can help preserve muscle and reduce cholesterol levels.

When the body has used up glucose stores during fasting, it burns fat for energy, resulting in weight loss.

"A detoxification process also occurs, because any toxins stored in the body's fat are dissolved and removed from the body," he adds, noting that after a few days of fasting, higher levels of endorphins - "feel-good" hormones - are produced in the blood, which can have a positive impact on mental well-being.

As mentioned previously, the study by Dr. Longo and colleagues suggests prolonged fasting may also be effective for regenerating immune cells.

"When you starve, the system tries to save energy, and one of the things it can do to save energy is to recycle a lot of the immune cells that are not needed, especially those that may be damaged," Dr. Longo explains.

In their study, published in the journal Cell Stem Cell, the team found that repeated cycles of 2-4 days without food over a 6-month period destroyed the old and damaged immune cells in mice and generated new ones.

What is more, the team found that cancer patients who fasted for 3 days prior to chemotherapy were protected against immune system damage that can be caused by the treatment, which they attribute to immune cell regeneration.

"The good news is that the body got rid of the parts of the system that might be damaged or old, the inefficient parts, during the fasting," says Dr. Longo. "Now, if you start with a system heavily damaged by chemotherapy or aging, fasting cycles can generate, literally, a new immune system."

With the potential health benefits of fasting widely hailed by nutritionists worldwide, it is no wonder many of us are putting our love of food to one side in order to give it a try.

But intermittent fasting isn't all bells and whistles, according to some researchers and health care professionals, and there are some people who should avoid the diet altogether.

The health risks

According to the UK's National Health Service (NHS), there are numerous health risks associated with intermittent fasting.

People who fast commonly experience dehydration, largely because their body is not getting any fluid from food. As such, it is recommended that during Ramadan, Muslims consume plenty of water prior to fasting periods. Other individuals following fasting diets should ensure they are properly hydrated during fasting periods.

If you are used to having breakfast, lunch, dinner and snacks in between, fasting periods can be a major challenge. As such, fasting can increase stress levels and disrupt sleep. Dehydration, hunger or lack of sleep during a fasting period can also lead to headaches.

Fasting can also cause heartburn; lack of food leads to a reduction in stomach acid, which digests food and destroys bacteria. But smelling food or even thinking about it during fasting periods can trigger the brain into telling the stomach to produce more acid, leading to heartburn.

While many nutritionists claim intermittent fasting is a good way to lose weight, some health professionals believe such a diet is ineffective for long-term weight loss.

"The appeal is that [fasting] is quick, but it is quick fluid loss, not substantial weight loss," says Madelyn Fernstrom, PhD, of the University of Pittsburgh Medical Center's Weight Loss Management Center. "If it's easy off, it will come back quickly - as soon as you start eating normally again."

"My experience has been that [this] way of eating does not produce weight loss even in the short term," dietitian and author ofDiet Simple Katherine Tallmadge told ABC News in 2013.

Some health professionals believe intermittent fasting may steer people away from healthy eating recommendations, such as eating five portions of fruits and vegetables a day. Many fear fasting may also trigger eating disorders or binge eating.

In a blog for The Huffington Post last year, fitness and nutrition expert JJ Virgin wrote:

"The 'anything goes' mentality some experts permit during the feeding state could lead someone to overeat, creating guilt, shame, and other problems that only become worse over time. For someone with emotional or psychological eating disorders, intermittent fasting could become a convenient crutch to amplify these issues."

While Dr. Mosely says there is no evidence to suggest the 5:2 Fast Diet is associated with eating disorders, he stresses people who have eating disorders should not engage in intermittent fasting.

Other people who should not follow this diet include people who are underweight, individuals under the age of 18, pregnant women, people with type 1 diabetes and individuals recovering from surgery.

Could we reap the benefits of fasting without fasting?

While intermittent fasting may have health risks, nutritionists claim it can be good for us if individuals consult with their doctors before adopting such a diet and adhere to it correctly.

But could there be a way to reap the potential health benefits of fasting without actually having to fast? Dr. Longo believes so.

Researchers say a fasting-mimicking diet could simulate the effect of fasting without the food deprivation and side effects.

Earlier this week, Dr. Longo and colleagues from USC published a study in the journal Cell Metabolism revealing how a fasting-mimicking diet (FMD) triggered immune cell regeneration and extended the lifespan of mice.

What is more, on testing the diet in humans - who adhered to it for only 5 days a month for 3 months - they found it reduced a number of risk factors associated with aging, cardiovascular disease (CVD), diabetes and cancer.

The FMD is low in protein, low in unhealthy fats and high in healthy fats, according to the researchers. It stimulates markers linked to fasting, such as low glucose levels and high levels of ketone bodies, in order to mimic the effects of prolonged fasting.

Dr. Longo and colleagues say their diet could promote immune cell regeneration and longevity associated with fasting without the need for food restriction and the potential adverse effects that come with it.

"Although the clinical results will require confirmation by a larger randomized trial," they add, "the effects of FMD cycles on biomarkers/risk factors for aging, cancer, diabetes, and CVD, coupled with the very high compliance to the diet and its safety, indicate that this periodic dietary strategy has high potential to be effective in promoting human healthspan."

The team hopes that clinicians will one day have the ability to prescribe this diet to patients. "This is arguably the first non-chronic preclinically and clinically tested anti-aging and healthspan-promoting intervention shown to work and to be very feasible as a doctor or dietitian-supervised intervention," says Dr. Longo.

It may be a while before the FMD receives approval from the US Food and Drug Administration (FDA) for clinical use. First, the team needs to put the diet through a rigorous testing process.

Further research is required to gain a better understanding of the exact benefits and risks the FMD poses, and this appears to be the case with existing fasting diets. One thing is clear, however; talk to your doctor before engaging in any form of fasting.

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Missing link found between brain, immune system; major disease implications

In a stunning discovery that overturns decades of textbook teaching, researchers have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. The discovery could have profound implications for diseases from autism to Alzheimer's to multiple sclerosis.

Maps of the lymphatic system: old (left) and updated to reflect UVA's discovery.

Credit: University of Virginia Health System

In a stunning discovery that overturns decades of textbook teaching, researchers at the University of Virginia School of Medicine have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. That such vessels could have escaped detection when the lymphatic system has been so thoroughly mapped throughout the body is surprising on its own, but the true significance of the discovery lies in the effects it could have on the study and treatment of neurological diseases ranging from autism to Alzheimer's disease to multiple sclerosis.

"Instead of asking, 'How do we study the immune response of the brain?' 'Why do multiple sclerosis patients have the immune attacks?' now we can approach this mechanistically. Because the brain is like every other tissue connected to the peripheral immune system through meningeal lymphatic vessels," said Jonathan Kipnis, PhD, professor in the UVA Department of Neuroscience and director of UVA's Center for Brain Immunology and Glia (BIG). "It changes entirely the way we perceive the neuro-immune interaction. We always perceived it before as something esoteric that can't be studied. But now we can ask mechanistic questions."

"We believe that for every neurological disease that has an immune component to it, these vessels may play a major role," Kipnis said. "Hard to imagine that these vessels would not be involved in a [neurological] disease with an immune component."

New Discovery in Human Body

Kevin Lee, PhD, chairman of the UVA Department of Neuroscience, described his reaction to the discovery by Kipnis' lab: "The first time these guys showed me the basic result, I just said one sentence: 'They'll have to change the textbooks.' There has never been a lymphatic system for the central nervous system, and it was very clear from that first singular observation -- and they've done many studies since then to bolster the finding -- that it will fundamentally change the way people look at the central nervous system's relationship with the immune system."

Even Kipnis was skeptical initially. "I really did not believe there are structures in the body that we are not aware of. I thought the body was mapped," he said. "I thought that these discoveries ended somewhere around the middle of the last century. But apparently they have not."

'Very Well Hidden'

The discovery was made possible by the work of Antoine Louveau, PhD, a postdoctoral fellow in Kipnis' lab. The vessels were detected after Louveau developed a method to mount a mouse's meninges -- the membranes covering the brain -- on a single slide so that they could be examined as a whole. "It was fairly easy, actually," he said. "There was one trick: We fixed the meninges within the skullcap, so that the tissue is secured in its physiological condition, and then we dissected it. If we had done it the other way around, it wouldn't have worked."

After noticing vessel-like patterns in the distribution of immune cells on his slides, he tested for lymphatic vessels and there they were. The impossible existed. The soft-spoken Louveau recalled the moment: "I called Jony [Kipnis] to the microscope and I said, 'I think we have something.'"

As to how the brain's lymphatic vessels managed to escape notice all this time, Kipnis described them as "very well hidden" and noted that they follow a major blood vessel down into the sinuses, an area difficult to image. "It's so close to the blood vessel, you just miss it," he said. "If you don't know what you're after, you just miss it."

"Live imaging of these vessels was crucial to demonstrate their function, and it would not be possible without collaboration with Tajie Harris," Kipnis noted. Harris, a PhD, is an assistant professor of neuroscience and a member of the BIG center. Kipnis also saluted the "phenomenal" surgical skills of Igor Smirnov, a research associate in the Kipnis lab whose work was critical to the imaging success of the study.

Alzheimer's, Autism, MS and Beyond

The unexpected presence of the lymphatic vessels raises a tremendous number of questions that now need answers, both about the workings of the brain and the diseases that plague it. For example, take Alzheimer's disease. "In Alzheimer's, there are accumulations of big protein chunks in the brain," Kipnis said. "We think they may be accumulating in the brain because they're not being efficiently removed by these vessels." He noted that the vessels look different with age, so the role they play in aging is another avenue to explore. And there's an enormous array of other neurological diseases, from autism to multiple sclerosis, that must be reconsidered in light of the presence of something science insisted did not exist.

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Story Source:

The above post is reprinted from materials provided by University of Virginia Health System. Note: Materials may be edited for content and length.

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Journal Reference:

1. Antoine Louveau, Igor Smirnov, Timothy J. Keyes, Jacob D. Eccles, Sherin J. Rouhani, J. David Peske, Noel C. Derecki, David Castle, James W. Mandell, Kevin S. Lee, Tajie H. Harris, Jonathan Kipnis. Structural and functional features of central nervous system lymphatic vessels. Nature, 2015; DOI: 10.1038/nature14432

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Missing link found between brain, immune system; major disease implications

In a stunning discovery that overturns decades of textbook teaching, researchers have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. The discovery could have profound implications for diseases from autism to Alzheimer's to multiple sclerosis.

Maps of the lymphatic system: old (left) and updated to reflect UVA's discovery.

Credit: University of Virginia Health System

In a stunning discovery that overturns decades of textbook teaching, researchers at the University of Virginia School of Medicine have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. That such vessels could have escaped detection when the lymphatic system has been so thoroughly mapped throughout the body is surprising on its own, but the true significance of the discovery lies in the effects it could have on the study and treatment of neurological diseases ranging from autism to Alzheimer's disease to multiple sclerosis.

"Instead of asking, 'How do we study the immune response of the brain?' 'Why do multiple sclerosis patients have the immune attacks?' now we can approach this mechanistically. Because the brain is like every other tissue connected to the peripheral immune system through meningeal lymphatic vessels," said Jonathan Kipnis, PhD, professor in the UVA Department of Neuroscience and director of UVA's Center for Brain Immunology and Glia (BIG). "It changes entirely the way we perceive the neuro-immune interaction. We always perceived it before as something esoteric that can't be studied. But now we can ask mechanistic questions."

"We believe that for every neurological disease that has an immune component to it, these vessels may play a major role," Kipnis said. "Hard to imagine that these vessels would not be involved in a [neurological] disease with an immune component."

New Discovery in Human Body

Kevin Lee, PhD, chairman of the UVA Department of Neuroscience, described his reaction to the discovery by Kipnis' lab: "The first time these guys showed me the basic result, I just said one sentence: 'They'll have to change the textbooks.' There has never been a lymphatic system for the central nervous system, and it was very clear from that first singular observation -- and they've done many studies since then to bolster the finding -- that it will fundamentally change the way people look at the central nervous system's relationship with the immune system."

Even Kipnis was skeptical initially. "I really did not believe there are structures in the body that we are not aware of. I thought the body was mapped," he said. "I thought that these discoveries ended somewhere around the middle of the last century. But apparently they have not."

'Very Well Hidden'

The discovery was made possible by the work of Antoine Louveau, PhD, a postdoctoral fellow in Kipnis' lab. The vessels were detected after Louveau developed a method to mount a mouse's meninges -- the membranes covering the brain -- on a single slide so that they could be examined as a whole. "It was fairly easy, actually," he said. "There was one trick: We fixed the meninges within the skullcap, so that the tissue is secured in its physiological condition, and then we dissected it. If we had done it the other way around, it wouldn't have worked."

After noticing vessel-like patterns in the distribution of immune cells on his slides, he tested for lymphatic vessels and there they were. The impossible existed. The soft-spoken Louveau recalled the moment: "I called Jony [Kipnis] to the microscope and I said, 'I think we have something.'"

As to how the brain's lymphatic vessels managed to escape notice all this time, Kipnis described them as "very well hidden" and noted that they follow a major blood vessel down into the sinuses, an area difficult to image. "It's so close to the blood vessel, you just miss it," he said. "If you don't know what you're after, you just miss it."

"Live imaging of these vessels was crucial to demonstrate their function, and it would not be possible without collaboration with Tajie Harris," Kipnis noted. Harris, a PhD, is an assistant professor of neuroscience and a member of the BIG center. Kipnis also saluted the "phenomenal" surgical skills of Igor Smirnov, a research associate in the Kipnis lab whose work was critical to the imaging success of the study.

Alzheimer's, Autism, MS and Beyond

The unexpected presence of the lymphatic vessels raises a tremendous number of questions that now need answers, both about the workings of the brain and the diseases that plague it. For example, take Alzheimer's disease. "In Alzheimer's, there are accumulations of big protein chunks in the brain," Kipnis said. "We think they may be accumulating in the brain because they're not being efficiently removed by these vessels." He noted that the vessels look different with age, so the role they play in aging is another avenue to explore. And there's an enormous array of other neurological diseases, from autism to multiple sclerosis, that must be reconsidered in light of the presence of something science insisted did not exist.

---

Story Source:

The above story is based on materials provided by University of Virginia Health System. Note: Materials may be edited for content and length.

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A Lifetime of Viruses

Scientists devise an antibody-based test that can generate a person’s complete “viral history” with just one drop of blood.

FLICKR, ALDEN CHADWICK

Last summer, infectious disease specialist Gregory Poland saw a patient at the Mayo Clinic in Rochester, Minnesota, who had a fever, a rash, kidney failure, and—despite seeing several doctors—no diagnosis. Only after talking with the patient for hours and digging into her medical and travel history could Poland generate a potential diagnosis. To test his theory, he had to send a serum sample to researchers at the US Centers for Disease Control and Prevention in Atlanta, who confirmed that his patient had chikungunya.

Situations like this, explained Poland, are not uncommon. “I can’t tell you how many times we don’t know what’s going on,” he said. When tests for all of the usual suspects come back negative, it’s difficult to know what to try next. On top of that, he added, some disease-causing agents are rare. “There are viruses that I know the name of, but I’ve never seen the disease.”

Thanks to a method described today (June 4) in Science, it may be soon be possible to test patients for previous exposures to all human-tropic viruses at once. Virologist Stephen Elledge of Harvard Medical School and the Brigham and Women’s Hospital in Boston and his colleagues have built such a test, called “VirScan,” from a bacteriophage-based display system they developed in 2011. The scientists programmed each phage to expresses a unique viral peptide, collectively producing about 100 peptides from each of the 206 known human-tropic viral species.

The team combined the phage with serum collected from 569 donors in the U.S., Thailand, Peru, and South Africa, allowing antibodies in each sample to bind their target peptides. The researchers then isolated the antibody-peptide-phage complexes, and harvested and sequenced the DNA inside each. The sequences, which can be read millions at a time, represent peptides recognized by the antibodies, revealing which viruses a given donor’s immune system had previously seen.

“This is far beyond anything we’ve had before regarding the human antibody response to viruses,” said Kristine Wylie, a microbiologist at Washington University in St. Louis who was not involved in the work.

Scientists like Wylie have been cataloging viruses living in and on humans for years, typically by searching for viral DNA and RNA sequences in blood and tissues. “Healthy people carry a lot of viruses, asymptomatically,” she said. Knowledge of prior viral exposures can improve health care. For example, it’s good to know whether a patient about to start chemotherapy carries a latent virus that could resurge during treatment.

Detecting a virus by the presence of its genes, however, depends on the virus being present at high enough levels and in easily accessed fluids or tissues. Measuring antibodies produced in response to viruses makes it possible to detect an infection weeks or decades later using only blood serum. But this approach is typically limited to testing for antibodies against one virus at a time. According to Poland, testing for many viruses at once is currently too expensive and requires too much blood to be routinely feasible.

VirScan requires just one drop of blood and, for about $25, screens for antibodies against 206 viruses, covering 1,000 strains. Using the technique, Elledge’s team identified high rates of exposure to common viruses like Epstein–Barr virus (found in 87 percent of adult donors screened) and rhinovirus (found in around 70 percent), many of which Wylie said are consistent with the rates she and others have seen in asymptomatic adults.

Some viruses showed up at lower frequencies than expected. Influenza, for example, appeared to affect only 53 percent of the donors, and chickenpox, just 24 percent. Elledge noted that these apparently low rates may be the result of a potential limitation of the test: the 56 amino acid peptides used for VirScan may have been too short to attract antibodies that only bind longer spans of folded-up peptides called conformational epitopes. Despite this, the team detected antibody responses against 4,406 unique epitopes, most of which had not been recorded in the Immune Epitope Database.

Unexpectedly, each person sampled showed a strong response to just three or fewer peptides per virus, making those peptides immunodominant. Although immunodominant peptides don’t always make the best vaccines, Elledge noted they might still be useful for vaccine design. “You might be able to piggyback on pre-existing immune responses and use that to your advantage,” he said.

Improvements to VirScan—such as the inclusion of conformational epitopes and a reduction in cross-reactivity between viruses with similar proteins—are in the works, said Elledge. Going forward, the team would like to extend its approach to screen for other pathogens, like bacteria, and to use VirScan to look for correlations between viral infections and chronic conditions, such as autoimmune diseases.

Down the line, Poland sees a place for VirScan in the clinic. “They’ve made real progress in what could have been seen as a pipe dream,” he said. “If they can perfect this and move this forward, this changes everything.”

G.J. Xu, et al. “Comprehensive serological profiling of human populations using a synthetic human virome,” Science, 348:1106-1114, 2015.

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Immunotherapy heralds 'new era' for cancer treatment

A "whole new era" for cancer treatment is upon us, according to experts. Two new studies published in the New England Journal of Medicine provide further evidence that immunotherapy - the use of drugs to stimulate immune response - is highly effective against the disease.

Immunotherapy involves the use of drugs to boost patients' immune system response, increasing the attack on cancer cells.

Recently presented at the 2015 American Society for Clinical Oncology annual meeting, one study revealed that a drug combination of ipilimumab and nivolumab (an immune therapy drug) reduced tumor size in almost 60% of individuals with advanced melanoma - the deadliest form of skin cancer - compared with ipilimumab alone, while another study found nivolumab reduced the risk of lung cancer death by more than 40%.

Nivolumab is a drug already approved by the Food and Drug Administration (FDA) for the treatment of metastatic melanoma in patients who have not responded to ipilimumab or other medications. It is also approved for the treatment of non-small cell lung cancer (NSCLC) that has metastasized during or after chemotherapy.

According to cancer experts, however, the results of these latest studies indicate that nivolumab and other immune therapy drugs could one day become standard treatment for cancer, replacing chemotherapy.

Prof. Roy Herbst, chief of medical oncology at Yale Cancer Center in New Haven, CT, believes this could happen in the next 5 years. "I think we are seeing a paradigm shift in the way oncology is being treated," he told The Guardian. "The potential for long-term survival, effective cure, is definitely there."

Nivolumab plus ipilimumab reduced tumor size by at least a third for almost 1 year

Nivolumab belongs to a class of drugs known as "checkpoint inhibitors." It works by blocking the activation of PD-L1 and PD-1 - proteins that help cancer cells hide from immune cells, avoiding attack.

In a phase 3 trial, Dr. Rene Gonzalez, of the University of Colorado Cancer Center, and colleagues tested the effectiveness of nivolumab combined with ipilimumab - a drug that stimulates immune cells to help fight cancer - or ipilimumab alone in 945 patients with advanced melanoma (stage III or stage IV) who had received no prior treatment.

While 19% of patients who received ipilimumab alone experienced a reduction in tumor size for a period of 2.5 months, the tumors of 58% of patients who received nivolumab plus ipilimumab reduced by at least a third for almost a year.

Commenting on these findings, study co-leader Dr. James Larkin, of the Royal Marsden Hospital in the UK, told BBC News:

"By giving these drugs together you are effectively taking two brakes off the immune system rather than one, so the immune system is able to recognize tumors it wasn't previously recognizing and react to that and destroy them.

For immunotherapies, we've never seen tumor shrinkage rates over 50% so that's very significant to see. This is a treatment modality that I think is going to have a big future for the treatment of cancer."

Dr. Gonzalez and colleagues also demonstrated the effectiveness of another immune therapy drug called pembrolizumab in patients with advanced melanoma.

While 16% of 179 patients treated with chemotherapy alone experienced no disease progression after 6 months, the team found that disease progression was halted for 36% of 361 patients treated with pembrolizumab after 6 months.

Dr. Gonzalez notes that while a combination of nivolumab and ipilimumab shows greater efficacy against advanced melanoma than pembrolizumab, it also presents greater toxicity. Around 55% of patients treated with nivolumab plus ipilimumab had severe side effects, such as fatigue and colitis, with around 36% of these patients discontinuing treatment.

Dr. Gonzalez says such treatment may be better for patients whose cancer does not involve overexpression of the PD-L1 protein.

"Maybe PDL1-negative patients will benefit most from the combination, whereas PDL1-positive patients could use a drug targeting that protein with equal efficacy and less toxicity," he adds. "In metastatic melanoma, all patients and not just those who are PD-L1-positive may benefit from pembrolizumab."

Nivolumab almost doubled patient survival from NSCLC

In another study, Dr. Julie Brahmer, director of the Thoracic Oncology Program at the Johns Hopkins Kimmel Cancer Center, and colleagues tested the effectiveness of nivolumab against standard chemotherapy with the drug docetaxel among 260 patients with NSCLC.

All patients had been treated for the disease previously, but the cancer had returned and spread.

The team found that patients who received nivolumab had longer overall survival than those treated with standard chemotherapy, at 9.2 months versus 6 months.

At 1 year after treatment, the researchers found nivolumab almost doubled patient survival. Around 42% of patients who received nivolumab were alive after 1 year, compared with only 24% of patients who received chemotherapy.

The study results also demonstrated a longer period of halted disease progression for patients who received nivolumab compared with those who had chemotherapy, at 3.5 months versus 2.8 months.

Overall, the researchers estimated that, compared with patients who received chemotherapy, those who received nivolumab were at 41% lower risk of death from NSCLC.

Commenting on these findings, Dr. Brahmer says:

"This solidifies immunotherapy as a treatment option in lung cancer. In the 20 years that I've been in practice, I consider this a major milestone."

While both studies show promise for the use of immunotherapy in cancer treatment, experts note that such treatment would be expensive. The use of nivolumab plus ipilimumab for the treatment of advanced melanoma, for example, would cost at least $200,000 per patient.

As such, researchers say it is important that future research determines which cancer patients would be most likely to benefit from immunotherapy.

Medical News Today recently reported on a study conducted by investigators from Cancer Research UK, which reveals a class of drugs called AKT inhibitors may boost the effect of radiotherapy against various cancers, including breast, kidney, melanoma and brain cancers.

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'Taste for sugar' could be HIV's major weakness

It turns out that having a sweet tooth is not just the downfall of many of us humans. According to a new study, a taste for sugar could also be HIV's major weakness and a target for future treatment.

The study, published in PLOS Pathogens, suggests that if the virus is unable to access sugar and other nutrients after invading a cell, it is unable to replicate itself and, therefore, unable to grow and spread.

Researchers from Northwestern Medicine, IL, and Vanderbilt University, TN, were able to utilize an experimental new compound to shut down the sugar and nutrient pipeline in immune cells and starve HIV to death.

"This compound can be the precursor for something that can be used in the future as part of a cocktail to treat HIV that improves on the effective medicines we have today," says Harry Taylor, research assistant professor in medicine at Northwestern University Feinberg School of Medicine.

HIV grows in specific types of immune cells called CD4+ T cells. When these cells are active, responding to pathogens in the blood, their supplies of sugar and other nutrients necessary for growth are increased. The virus purposefully seeks out activated T cells and hijacks their glucose supplies.

The researchers discovered that turning on a cell component called phospholipase D1 (PLD1) signaled for activated T cells to increase their supplies of sugar and the vital nutrients. By blocking this component, the researchers were able to in turn block the sugar pipeline, depriving the invading HIV of the building blocks required for it to grow.

A previous attempt to prevent the virus from stealing immune cells' sugar and nutrients using drugs was carried out in the 1990s, but the drugs led to serious side effects in patients with HIV and sometimes ended up killing healthy cells.

Blocking sugar supplies could also prevent premature organ damage

The new approach appears to not only be safer but has the additional effect of slowing the spread of abnormally activated immune cells. HIV triggers the excess activation and growth of T cells which can lead to inflammation in the body, causing premature organ damage in patients with HIV even when the virus is suppressed by medicine.

"Perhaps this new approach, which slows the growth of the immune cells, could reduce the dangerous inflammation and thwart the life-long persistence of HIV," Prof. Taylor speculates.

Before joining Northwestern University, Prof. Taylor was on the faculty at Vanderbilt, where we knew that researchers had managed to identify a compound that could stop breast cancer cells from spreading by blocking PLD1.

The researchers speculated whether blocking this same cell component in CD4+ T cells would have the same effect in slowing the spread of HIV by blocking the supply of glucose and nutrients. They tested their theory in vitro and, sure enough, HIV was unable to access enough resources to reproduce.

Dr. Richard D'Aquila, director of Northwestern's HIV Translational Research Center, believes that the study's findings could hopefully lead on to future breakthroughs.

"This discovery opens new avenues for further research to solve today's persisting problems in treating HIV infection: avoiding virus resistance to medicines, decreasing the inflammation that leads to premature aging, and maybe even one day being able to cure HIV infection," he states.

Prof. Taylor hopes to identify additional compounds with the potential for development into medicines that could starve HIV in this way without harming cells. This discovery could also have application in the treatment of other diseases such as cancer that similarly rely on access to sugar and other nutrients found in cells to grow and spread.

Last month, Medical News Today reported on a study that identified a "can opener" molecule that renders HIV vulnerable to antibodies that could kill off infected cells.

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Seasonal allergies: tips and remedies

While this time of year usually brings cheerful weather and the growth of beautiful plants, millions of people will be gearing up once again to do battle with a problem that recurs every year. Itchy eyes, repetitive sneezing, a permanently runny nose - the symptoms of seasonal allergies.

In the US, around 7.8% of people aged 18 and above are estimated to have hay fever.

For many people, the emergence of marauding ticks at this time of year is the least of their worries. The real struggle for these people is with seasonal allergies, also referred to as hay fever or allergic rhinitis.

If these common symptoms seem to develop for weeks and months on end at the same time each year, it is likely that you could be affected by seasonal allergies. The condition affects many in the US; in 2010, around 11.1 million visits to physicians' offices led to a primary diagnosis of hay fever.

Thankfully, despite how infuriating and disruptive seasonal allergies can be, there are many steps that can be taken to lessen their impact. In this Spotlight, we take a look at what seasonal allergies are and what the best strategies are for handling them.

What causes such allergies?

People develop allergies when their body's immune system reacts to a substance as though it is a threat like an infection, producing antibodies to fight it. These substances are referred to as allergens.

The next time that the body encounters the allergen, it produces more antibodies in anticipation, releasing histamine and chemical mediators in the body that lead to an allergic reaction. It is these chemicals that typically cause symptoms in the nose, throat, eyes and other areas of the body.

Jan Batten, a British Lung Foundation (BLF) Helpline nurse, explained to Medical News Today that as the summer months approach, certain allergies begin to cause more problems, such as allergies to flower pollen, grass pollen, tree molds and fungi. The drier days around this time of year help the allergens to remain in the atmosphere for longer.

"Summer allergies start to pick up around May and those affected will usually get itchy and runny eyes, a runny nose and inflamed, swollen sinuses. Breathing through your nose can be difficult too, and you might have a cough," she explained.

The American College of Allergy, Asthma & Immunology (ACAAI) report that allergies are the sixth leading cause of chronic illness in the US. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), around 7.8% of people aged 18 and above have hay fever. Worldwide, the condition affects 10-30% of the population.

Most people with hay fever understand that their symptoms are set off by pollen, the fine powder released from flowering plants in order to reproduce. Pollens are spread by the wind and can be inhaled or land in the eyes or on the skin.

The most common trigger of seasonal allergies is pollen, though they can also be triggered by grasses and mold. Dealing with seasonal allergies, however, is not merely a matter of knowing when these airborne allergens are most prevalent and trying to avoid them. There are a few added complications to keep you on your toes.

Avoiding triggers - be aware of what sets you off

"People focus on the highs and lows of pollen counts," says Dr. James Sublett, president of ACAAI. "What they don't realize is that a high total pollen count doesn't always mean you will have allergy symptoms. The pollen from the plant you are allergic to may not be high. The key is to know what you're allergic to, and how to treat your particular symptoms."

Different kinds of pollen are prevalent at different times of the year, as well as varying from location to location. Between January and April, pollen is typically released from trees including pine, ash, birch, elm and poplar. During the summer months, grass pollens dominate, and in the fall, weed pollen is most prevalent.

People can determine whether they have an allergy or not by consulting their primary care physician and undergoing allergy testing. Dr. Andrew S. Kim, an allergist from the Allergy & Asthma Centers in Fairfax and Fredericksburg, VA, told MNT that sometimes people confuse having allergies with the flu or common cold.

Pollen is the cause of most seasonal allergies and is produced by flowers, trees, grasses and weeds alike.

"Allergies may share some similarities with sneezing and sniffling but the length of time is a big difference. Allergy symptoms usually last for weeks and months and patients typically complain of itchy nose, throat and eyes as well," he said.

"Allergy patients usually do not have fever. They do have dry cough and clear nasal drainage versus infectious cough which is characterized by yellow, or greenish nasal drainage. Some people may have asthma symptoms, such as cough, wheeze and chest tightness."

Once an individual knows that they have a seasonal allergy and is aware of what triggers it, they are in a much better position to avoid debilitating allergic reactions. Keeping track of pollen forecasts is a good place to start. It is good to remember that these change by the hour, and can be boosted when it is warm, dry and windy.

To reduce the chances of an allergic reaction, it is recommended that you stay inside when pollen counts are at their highest. These usually peak around the morning hours and maintain high levels during the afternoon.

If you do need to go outside, there are a number of steps that can be taken to reduce the chances of coming into contact with allergens. Wearing wraparound sunglasses offers protection to the eyes, and applying a small amount of petroleum jelly to the insides of the nostrils can prevent some allergens from reaching the sensitive lining of the nose.

Delegating outdoor chores to people that do not have seasonal allergies is a sensible approach. If there is no escaping lawn mowing or weed pulling, however, wear an NIOSH-rated (National Institute for Occupational Safety and Health) 95 filter mask to keep allergens out.

Laundry should not be hung to dry outside, despite the conditions being perfect for it. Pollen can stick to sheets and towels and be brought into the home - normally a haven from pollens. In fact, when tackling seasonal allergies, ensuring that your home is your castle is a great strategy.

Minimizing the risk indoors

It is impossible to remove all allergens from the air inside the home, but there are certainly steps that can help reduce levels of exposure. Keeping the windows shut is a simple strategy that should be one of the first to be adopted.

Shutting the windows might be the last thing on your mind when temperatures start to rise. To stay cool without the threat of pollen looming large, use air conditioning in the house and car. It is preferable that high-efficiency air filters are used and that units follow regular maintenance schedules.

Whenever you venture outside, there is the chance that you will bring pollen back inside with you on your clothes and hair. For this reason, people should wash their hair and clothes more regularly during periods when the pollen count is high.

If you are drying clothes indoors and keeping the windows closed, you may need to use a dehumidifier to keep the indoor air dry. Keeping the air dry indoors helps prevent the growth of other allergens such as molds.

Keeping the home clean with a vacuum cleaner that has a high-efficiency particulate air filter and using a damp duster to stop pollens moving about the home also helps to clean up any allergens that are present, reducing the chances of them getting onto and into the body.

"Simple changes like wearing wraparound sunglasses, washing your clothes and hair more regularly, keeping your home clean, avoiding open, grassy spaces where possible and keeping your windows shut can help lessen the effect of summer allergies," Jan Batten told.

All of these measures are relatively simple to take and can go a long way toward protecting the body from seasonal allergies. However, as stated before, it is nigh-on impossible to completely avoid exposure to allergens. Particularly for people who experience severe reactions to pollen, the best route to ease symptoms is often a medical one.

Medicine and other treatment

People tend to have unique allergic responses, so the treatment that works best for each individual will vary accordingly. While some people will be able to cope with seasonal allergies with over-the-counter medication and being careful about their exposure to allergens, others may require personal treatment plans drawn up by specially trained allergists.

Oral antihistamines are a form of nonprescription medication that alleviate many of the symptoms of seasonal allergies.

There is a wide range of nonprescription medication available for people who have seasonal allergies. Oral antihistamines relieve symptoms such as sneezing, itching and runny noses. Decongestants relieve nasal stuffiness and come in both oral and nasal form. Some medications contain a combination of the two.

Two types of immunotherapy are available to those who require relief from severe symptoms. These are allergy shots and tablets, and they are provided and prescribed by allergists. Allergy testing will need to be carried out first to determine precisely what allergens trigger symptoms.

Allergy shots consist of injecting a patient with diluted extracts of an allergen. Increasing doses are administered until a maintenance dose is established. This process helps the body to build up a form of resistance to the allergen and reduces the severity of symptoms.

Tablets can currently be used to treat allergies to grass and ragweed pollens. Beginning at least 3 months before the relevant pollen season begins, patients take one tablet daily, with the treatment continuing for as long as 3 years.

Dr. Kim told MNT that one of the best ways to reduce the influence of seasonal allergies is to start taking medication - such as topical nasal steroids - about a week before the beginning of the allergy season:

"Don't wait until symptoms kick in and you're already feeling bad before taking allergy medication. Instead, prepare by taking medications just before the season starts to minimize the symptoms of seasonal allergies."

A number of alternative treatments are also available, including natural remedies that feature extracts of butterbur and spirulina. It is recommended that any use of alternative treatments is discussed with a physician first, as some remedies may not be entirely safe for use.

There are many options for alleviating seasonal allergies

Allergies can be worrying, especially for people who are otherwise healthy and unused to experiencing sudden debilitating symptoms. If left unchecked, seasonal allergies can often turn an otherwise enjoyable time of year for many into misery.

Thankfully, there are many routes available for people with seasonal allergies to alleviate their symptoms. As ever, if there are any concerns or worries, it is best to speak with a health care professional who will be able to offer advice, provide treatment or refer on to a specialist.

Although there is no cure at present for seasonal allergies, the multiple options for treatment should hopefully provide some relief until winter rolls around again and we can shiver together, happy in the fact that pollen has gone for another year.

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