Cocoa for diabetics

For people with diabetes, sipping a mug of steaming, flavourful cocoa may seem a guilty pleasure. But new research suggests that indulging a craving for cocoa can actually help blood vessels to function better and might soon be considered part of a healthy diet for the prevention of cardiovascular disease.

Flavanols, natural plant compounds also found in tea, red wine, and certain fruits and vegetables, are responsible for cocoa's healthful benefits. In fact, according to new research published in the 3 June 2008 issue of the Journal of the American College of Cardiology (JACC), after diabetic patients drank specially formulated highflavanol cocoa for one month, blood vessel function went from severely impaired to normal.

The improvement was as large as has been observed with exercise and many common diabetic medications, the researchers noted. These findings suggest that it may be time to think not just outside the box, but inside the cup, for innovative ways to ward off cardiovascular disease – the number one cause of death in diabetic patients.  

Lab breakthrough for monoclonal antibodies  

US scientists have managed to produce human monoclonal antibodies (mAbs) for influenza in the lab in just a few weeks rather than the two to three months it usually takes. The new technique is a major advance and opens the way to the potential use of mAbs for a range of diseases.

mAbs are highly specific, identical, infection-fighting proteins produced in large quantities in the lab in cell lines that are derived from a single antibody- producing cell.

The researchers describe the new method in the journal Nature [DOI: 10.1038/ nature06890 (2008)].

The first therapeutic mAb was approved for human use in 1986 and there are now more than 20 US FDA-approved mAbs, including two human mAbs, most of which are used to treat certain cancers or immunological diseases. Human mAbs have long been envisioned as possible treatments for acute or chronic infections, but various technical barriers have slowed their development.

In addition to being relatively quick to make, the influenza mAbs the researchers created also bound tightly to virus strains in the seasonal influenza vaccine. Such high affinity for the vaccine's viruses suggests that the mAbs would also bind well to the circulating viruses targeted by the vaccine and thus could be used either as a therapy or as a way to diagnose the strain of influenza virus an individual is infected with, say the investigators.

The mAbs made in this study were not tested on influenza virus strains with pandemic potential, such as H5N1. Nevertheless, notes lead researcher Rafi Ahmed, PhD, of Emory Vaccine Center of the School of Medicine, the ability to make high-affinity influenza mAbs quickly raises the possibility of deploying them in combination with other disease control strategies in the event of a global influenza pandemic. According to Dr Ahmed, the research team is now planning to use their technique to generate mAbs against H5N1.  

First-in-man use of miniature aortic endograft system  

Cook Medical has announced the first-in-man use of the next generation miniaturised aortic aneurysm endograft and delivery system.

The company says the new Zenith Low Profile AAA Endograft System is radically smaller and will benefit Thoracic Aortic Aneurysm and Abdominal Aortic Aneurysm patients around the world for whom no endovascular treatment option currently exists.

The system has been simplified to eliminate the top cap and uses more highly compressible Z-stent bodies instead of the existing stents used in the current Zenith Flex endografts, says Cook Medical, a leading developer of advanced technologies to treat diseases of the aorta.

Currently, delivery systems for endografts to treat aneurysms in the abdominal and thoracic regions of the aorta must be inserted through incisions in the femoral arteries because they are most often too large in diameter to be easily inserted percutaneously. The larger diameter sheath also means the device is stiffer, making it more difficult to negotiate through narrow, tightly curved arteries to reach the diseased section of the aorta where the endograft needs to be deployed. In addition, in smaller patients the vascular anatomy may be too small to accept the current generation of largersized delivery systems.

The Zenith Low Profile AAA Endograft System addresses those areas of concern by reducing the size of the delivery sheath to 16 French. This development, if proven safe and effective in an upcoming clinical trial, could open endovascular treatment of aneurysms to a new class of patients who currently have only open surgery as a treatment option due to the small diameter of their blood vessels and other anatomic issues. In addition, it may enable physicians to eliminate the need for a surgical cut to access the femoral artery and allow the use of the percutaneous entry technique.  

Insulin islet transplant procedure to be tested  

Researchers from 11 medical centres in the United States, Canada, Sweden, and Norway have begun testing new approaches to transplanting clusters of insulin-producing islets in adults with difficult-tocontrol type 1 diabetes. The clinical studies, funded by the US National Institutes of Health (NIH), will determine whether changes to current methods of islet transplantation lead to improved, long-lasting control of blood glucose with fewer side effects.

In islet transplantation, clusters of islets are extracted from a donor pancreas and infused into the recipient's liver. In a successful transplant, the islets become embedded in the liver and begin producing insulin.

In 2000, a research team led by Dr James Shapiro at the University of Alberta in Edmonton, Canada, reported sustained insulin independence in seven patients transplanted with islets from two to four donor pancreases and treated with an immunosuppressive regimen that omitted glucocorticoids, thought to be toxic to islets. In the next few years, other researchers replicated the “Edmonton protocol” and most centres adopted this approach to islet transplantation.

Since the Edmonton advance, scientists have been working to lengthen the survival of donor islets and reduce the side effects – such as anaemia, nerve and kidney damage, and vulnerability to infection – of drugs that prevent the body's destruction of donor islets. In the new studies, the researchers will culture islets before transplantation to enhance their viability. They will also compare specific antirejection drugs for the ability to maximise islet survival while reducing toxicity. As the procedure becomes safer and new sources of beta cells become available, more people are likely to benefit.  

Plants made more suitable to medicine production  

A research team of scientists from Wageningen University and Research Centre in the Netherlands has succeeded in further unravelling and manipulating the glycosylation of proteins in plants. The research is expected to be published in the Plant Cell. The scientists expect that this knowledge will allow plants to be applied more often in the production of therapeutic proteins, an important type of medicine.

The discovery fits in with technology developed by the Wageningen UR research institute Plant Research International for the production of biopharmaceuticals in plants.

Proteins in plants, animals and people are equipped with various sugar chains in a process known as glycosylation. The sugar chains are of significance to the functioning of many proteins. Moreover, their identity and uniformity is crucial to the quality of therapeutic proteins.

The glycosylation of proteins in plants, people and animals basically consists of three stages. Initially sugar chains are constructed, which then attach to the protein in specific locations. Finally, the sugar chains are further modified as specific sugars are attached to the chain.

“We are the first institute in the world to identify a gene in plants that is involved in the construction of these sugar chains, the first stage in glycosylation,” says scientist Maurice Henquet. “It seems that the chains become increasingly uniform as the expression of this gene is reduced.” One type of chain, a relatively simple one, is mainly developed. The sugar chains which are attached to the proteins are therefore a better starting point for making adjustments that are designed to optimise the biological function as medicine.

“From now on we will be able to improve the manipulation of glycosylation,” Henquet said. “And plants will become even more suitable for medicine production.”

Oregano – the spice for inflammation

Oregano doesn’t only give a pizza its typical taste. Researchers at Bonn University and the ETH Zürich have discovered that this spice also contains a substance which, amongst other qualities, appears to help cure inflammations. The researchers administered its active ingredient – known as beta-caryophyllin (E-BCP) – to mice with inflamed paws. In seven out of ten cases there was a subsequent improvement in the symptoms. E-BCP might possibly be of use against disorders such as osteoporosis and arteriosclerosis. The study appeared 23 June in the “Proceedings of the National Academy of Sciences” (PNAS).

E-BCP is a typical ingredient of many spices and food plants. Hence it is also found in plants such as basil, rosemary, cinnamon, and black pepper.  

Autonomous robot surgery takes a few steps closer  

The day may be getting a little closer when robots will perform surgery on patients in dangerous situations or in remote locations, such as on the battlefield or in space, with minimal human guidance.

Engineers at Duke University believe that the results of feasibility studies conducted in their laboratory represent the first concrete steps toward achieving this space age vision of the future. Also, on a more immediate level, the technology developed by the engineers could make certain contemporary medical procedures safer for patients, they said.

For their experiments, the engineers started with a rudimentary tabletop robot whose “eyes” used a novel 3-D ultrasound technology developed in the Duke laboratories. An artificial intelligence program served as the robot’s “brain” by taking real-time 3-D information, processing it, and giving the robot specific commands to perform.

“In a number of tasks, the computer was able to direct the robot's actions,” said Stephen Smith, director of the Duke University Ultrasound Transducer Group and senior member of the research team. “We believe that this is the first proof-of-concept for this approach. Given that we achieved these early results with a rudimentary robot and a basic artificial intelligence program, the technology will advance to the point where robots – without the guidance of the doctor – can someday operate on people.”

The results of a series of experiments on the robot system directing catheters inside synthetic blood vessels was published online in the journal IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. A second study, published in April in the journal Ultrasonic Imaging, demonstrated that the autonomous robot system could successfully perform a simulated needle biopsy.

Advances in ultrasound technology have made these latest experiments possible, the researchers said, by generating detailed, 3-D moving images in real-time.

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