Allergies, Author Interviews, Dermatology / 09.03.2023
Eczema: Mount Sinai Study Finds No Increase Risk of Cancer in 5 Year Study of Dupilumab
MedicalResearch.com Interview with:
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Dr. Gulati[/caption]
Nicholas Gulati, MD, PhD
Director, Early Detection of Skin Cancer and Oncodermatology Clinic
The Kimberly and Eric J. Waldman
Department of Dermatology
Mount Sinai Health System
New York, New York
MedicalResearch.com: What is the background for this study? What is dupilumab primarily used for?
Response: Dupilumab is a monoclonal antibody that inhibits a specific part of the immune system known as Th2 cells, which are important in the development of various diseases including atopic dermatitis (eczema) and asthma. Therefore, dupilumab has become one of the major treatments for these conditions. Given the increasing use of this drug, it is important to understand the safety of it in terms of cancer development, as that is currently largely unknown.
Dr. Gulati[/caption]
Nicholas Gulati, MD, PhD
Director, Early Detection of Skin Cancer and Oncodermatology Clinic
The Kimberly and Eric J. Waldman
Department of Dermatology
Mount Sinai Health System
New York, New York
MedicalResearch.com: What is the background for this study? What is dupilumab primarily used for?
Response: Dupilumab is a monoclonal antibody that inhibits a specific part of the immune system known as Th2 cells, which are important in the development of various diseases including atopic dermatitis (eczema) and asthma. Therefore, dupilumab has become one of the major treatments for these conditions. Given the increasing use of this drug, it is important to understand the safety of it in terms of cancer development, as that is currently largely unknown.
Dr. Lazarus[/caption]
Philip Lazarus, PhD
Boeing Distinguished Professor, Pharmaceutical Sciences
Professor, Dept of Pharmaceutical Sciences
College of Pharmacy and Pharmaceutical Sciences
Washington State University
Spokane, WA 99210
MedicalResearch.com: What is the background for this study?
Response: Smoking and tobacco use remains a major health issue. Smokers use cigarette over the course of the day because the levels of nicotine, the addictive agent in cigarettes and other forms of tobacco, dimmish with time in the bloodstream due to the breakdown of nicotine by enzymes in the body. By inhibiting the breakdown of nicotine in smokers, one would expect that the levels of nicotine would remain higher after smoking a single cigarette, and that these individuals may not require lighting up another cigarette so quickly, reducing the number of cigarettes smoked over the course of a day. This could have a profound effect on reducing the overall harm incurred from smoking or from using other forms of tobacco.
In a single previous study, smokers who used a CBD inhaler exhibited a 40% reduction in cigarette use. In addition, while cannabis users are often smokers, previous studies have indicated that they smoke less cigarettes than non-cannabis-using cigarette smokers. In previous studies published in 2021, we found that major cannabinoids present in cannabis like THC and CBD inhibit major metabolizing enzymes in our body, including several that are important in drug metabolism. We hypothesized that CBD and its major active metabolite, 7-hydroxy (OH)-CBD, may also be inhibiting one or more of the enzymes important in the metabolism (or breakdown) of nicotine.
Dr. Roca[/caption]
Anna Roca PhD
MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine
Fajara, The Gambia
MedicalResearch.com: What is the background for this study?
Response: Context specific interventions are needed to decrease the high burden of severe neonatal morbidity and mortality in sub-Saharan Africa. Severe bacterial infections are a main cause of neonatal mortality in the continent. Oral intra-partum azithromycin is a cheap intervention easily scalable. Before embarking on this trial, we conducted a proof-of-concept trial that showed the intervention reduced maternal and neonatal bacterial carriage of the most prevalent bacteria causing neonatal sepsis in the continent.
Dr. Khullar[/caption]
Dhruv Khullar, M.D., M.P.P.
Director of Policy Dissemination
Physicians Foundation Center for Physician Practice and Leadership
Assistant Professor of Health Policy and Economics
Weill Cornell Medicine, NYC
MedicalResearch.com: What is the background for this study?
Response: From prior research, we know that there are racial/ethnic differences in the acute impact of COVID-19, including higher rates of hospitalization and death among Black and Hispanic individuals compared to white individuals. Less is known about whether there are differences in the rates or types of long COVID by race and ethnicity.
Alexia Aguilar[/caption]
Alexia Aguilar
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Traditional antidepressants like Zoloft and Lexapro have three major drawbacks.
Dr. Gaudino[/caption]
Mario FL Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA
Dr. Stevermer[/caption]
James Stevermer, M.D., M.S.P.H.
Vice chair for clinical affairs
Professor of family and community medicine
University of Missouri
Medical director of MU Health Care Family Medicine–Callaway Physicians,
Dr. Stevermer joined the U.S. Preventive Service Task Force in January 2021.
MedicalResearch.com: What is the background for this study?
Response: Genital herpes is a common sexually transmitted infection (STI) that unfortunately has no cure and cannot accurately be detected in people who do not have signs of the condition. The current screening tests have limitations and there is a high chance that test results will say a person has the condition when they do not. In addition, the available treatments are focused on managing symptoms and preventing the condition from reoccurring. As a result, the Task Force concluded that the harms of screening outweigh the benefits.
Dr. Goodrich[/caption]
Jesse Goodrich PhD
Assistant Professor
Department of Population and Public Health Sciences
Keck School of Medicine
University of Southern California
MedicalResearch.com: What is the background for this study?
Response: Per- and poly-fluoroalkyl substances (PFAS) are a group of persistent chemicals that are known to interfere with hormones and metabolism. In our previous research, we have found that PFAS exposure is associated several specific diseases, especially in children and adolescents. These include obesity, type 2 diabetes, liver disease, and even liver cancer. However, we are still only just starting to fully understand all of the health effects of the many different PFAS in existence. Previous studies have focused primarily on one or two main PFAS. However, there are over 9,000 known PFAS, and people are exposed not just to a single PFAS but to mixtures of many PFAS. Importantly, the combination of these chemical exposures may affect us differently than single exposures alone.
To address this challenge, we used an innovative approach to study design to examine how exposure to PFAS impacts biological processes which may underly the development of many different diseases in adolescents and young adults. To do this, we first measured thousands of naturally occurring chemicals, known as metabolites, in people's blood. Then, using a new biostatistical method developed by our team, we identified how exposure to a mixture of several PFAS impacted each individual chemical. Finally, we used this information to determine which biological processes are changed by PFAS exposure.
Dr. Torkamani[/caption]
Ali Torkamani, Ph.D.
Director of Genomics and Genome Informatics
Scripps Research Translational Institute
Professor, Integrative Structural and Computational Biology
Scripps Research
La Jolla, CA 92037
MedicalResearch.com: What is the background for this study?
Response: Prior research has shown that people with higher polygenic risk for coronary artery disease achieve greater risk reduction with statin or other lipid lowering therapy. In general, adherence to standard guidelines for lipid lowering therapy is low - about 30% of people who should be on lipid lowering therapy are, with no correlation to their genetic risk. We set out to see whether communicating personalized risk, including polygenic risk, for coronary artery disease would drive the adoption of lipid lowering therapy.
Dr. Sesso[/caption]
Howard D. Sesso, ScD, MPH
Associate Professor of Medicine
Division of Preventive Medicine
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet?
Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels.
COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital.
Arman A. Shahriar
Medical Student, University of Minnesota Medical School Research
Consultant, HealthPartners Institute
Minneapolis, Minnesota
Dr. Cortese[/caption]
Rene Cortese, PhD
Assistant Professor
Department of Child Health – Child Health Research Institute
Department of Obstetrics, Gynecology and Women’s Health
School of Medicine
Core Faculty - MU Institute for Data Science and Informatics
University of Missouri
Columbia, MO 65212
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Obstructive sleep apnea (OSA) affects 22 million people in the U.S. and is linked to a higher risk of hypertension, heart attacks, stroke, diabetes, and many other chronic conditions.
We have found that untreated OSA also accelerates the biological aging process, and that appropriate treatment can slow or possibly reverse the trend. Age acceleration testing involves a blood test that analyzes DNA and uses an algorithm to measure a person’s biological age. The phenomenon of a person’s biological age surpassing their chronological age is called “epigenetic age acceleration” and is linked to overall mortality and to chronic diseases.
Dr. Wong[/caption]
Susan P. Y. Wong, MD MS
Assistant Professor
Division of Nephrology
University of Washington
VA Puget Sound Health Care System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes.
We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life.
Dr. Launer[/caption]
Lenore J. Launer, Ph.D.
Chief, Laboratory of Epidemiology and Population Sciences
Intramural Research Program, National Institute on Aging.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Identifying early risk factors and early changes in the brain will have a major impact on future clinical and public health priorities related to the looming epidemic of dementia. Several studies based on older populations suggest mid-life is an important period to start prevention measures. To date control of blood pressure levels has been the most robust and promising candidate to target for prevention of future cognitive impairment. Although several studies have looked at levels of blood pressure and risk for cognitive impairment, it was not known whether trajectories from young adulthood to middle age studies provided additional information about risk. To investigate possible biomarkers of future risk, we chose to examine the association of the mean arterial blood pressure trajectories to indicators of pathology seen on MRI and that are associated with cognition.
We highlight the results of the mean arterial blood pressure (MAP) measure, which is an integrated measure of systolic and diastolic blood pressure.
Response: Cigarette smoking is one of the well-established causes of periodontitis, but the effect of using electronic cigarettes (e-cig), especially its long-term impact on periodontal health, is not yet clearly understood. Considering the increased popularity of e-cig use, especially among teenagers and young adults, and the known effect of high nicotine concentration in e-cigarette products, we conducted this clinical research to see if there were differences in periodontal health between e-cig users, traditional smokers, and nonsmokers. The study consisted of two visits, 6 months apart, where measures of oral and periodontal health were obtained.
Our data showed significantly greater clinical attachment loss in the e-cigarette users and cigarette smokers than in the non-smokers at both study visits. In only e-cigarette users, we observed an over 0.2 mm average increase in the clinical attachment loss after 6 months.
Dr. Kartal[/caption]
Ece Kartal, PhD
Postdoctoral Fellow
Saez-Rodriguez Group
Universitätsklinikum Heidelberg
Institute for Computational Biomedicine
Heidelberg
MedicalResearch.com: What is the background for this study?
Response: Pancreatic cancer is one of the deadliest types of cancer: although incidence rates are relatively low (only few people develop pancreatic cancer in their lifetimes), it has a high lethality, with a five year survival rate of less than ~5%. Pancreatic cancer symptoms are generally unspecific so that the disease is usually detected very late which further limits therapeutic options. In light of this, earlier detection of pancreatic cancer could dramatically improve prognosis, but there are currently no affordable and non-invasive tests available in the clinic.
For pancreatic ductal adenocarcinoma (PDAC),the most common form of pancreatic cancer, it was previously found that the oral, gut and pancreatic microbiome are risk factors and may affect prognosis .
Dr. LaMonte[/caption]
Michael J. LaMonte, PhD, MPH
Research Professor (epidemiology)
Department of Epidemiology and Environmental Health
School of Public Health and Health Professions
Women’s Health Initiative Northeast Regional Center
University at Buffalo – SUNY
Buffalo, NY 14214
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. LaMonte: The rationale for this study was based on existing study results showing
Dr. Stingone[/caption]
Jeanette Stingone PhD
Assistant Professor, Epidemiology
Mailman School of Public Health
Columbia University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Lead is a well-established neurotoxin, particularly when exposure occurs early in life and in childhood. Associations between elevated blood lead levels and lower scores on tests of neurodevelopment and cognition are seen consistently across studies, even when examining lower levels of exposure.
While reducing exposure to lead is the primary intervention to prevent these adverse outcomes, there aren’t many interventions designed to support the neurodevelopment of children who have been exposed to lead. Some municipalities consider elevated blood lead levels as a criteria for inclusion in Early Intervention programs. Early Intervention programs are mandated under the Individuals with Disabilities Education Act and provide services for children younger than 3 years old with disabilities or developmental delays.
The objective of this study was to compare 3rd grade standardized test scores among children who had elevated blood lead levels early in life to see if children who had received Early Intervention services performed better on these tests than those who did not receive services. Using matching methods and an existing administrative data linkage of children who were born and attended public school in New York City, we observed that children exposed to lead who received Early Intervention services scored higher on standardized tests in both math and English Language arts than children exposed to lead who did not receive services. 