Author Interviews, Gastrointestinal Disease, Microbiome, Pediatrics / 16.11.2018

MedicalResearch.com Interview with: Thomas Thymann PhD DVM MSc Department of Veterinary and Animal Sciences Comparative Pediatrics and Nutrition Faculty of Health and Medical Sciences University of Copenhagen Frederiksberg, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infants that are born preterm are at risk of developing a severe and life threatening intestinal disease referred to as necrotizing enterocolitis (NEC). This condition is known to be under influence of several factors including the microorganisms that start to colonize the intestine immediately after birth. We wanted to see whether fecal matter collected from healthy 10-day old piglets, would benefit the pattern of early colonization, and prevent NEC. (more…)
Author Interviews, CDC, Gastrointestinal Disease, Infections, Vaccine Studies / 15.11.2018

MedicalResearch.com Interview with: "Day 19: Norovirus (stomach flu) visits our home." by Loren Kerns is licensed under CC BY 2.0Rachel M. Burke, PhD, MPH Epidemiologist, Viral Gastroenteritis Branch Centers for Disease Control and Prevention Atlanta, GA 30329 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Noroviruses are the leading cause of vomiting and diarrhea from acute gastroenteritis (inflammation of the stomach or intestines) among people of all ages in the United States. Each year in the United States, norovirus illness is responsible for an estimated 19 to 21 million cases of acute gastroenteritis, and contributes to 56,000 to 71,000 hospitalizations and 570 to 800 deaths, mostly among children and the elderly. CDC linked information from two different surveillance systems to analyze 3,747 norovirus outbreaks reported by health departments from 2009 to 2016. Our study provides a comprehensive description of norovirus outbreaks from the epidemiology and laboratory perspectives, using the National Outbreak Reporting System (NORS) and CaliciNet, respectively.  Norovirus outbreaks caused by GII.4 strains occurred more often in healthcare settings, affected older adults, and caused more severe illness, leading to hospitalization or death. (more…)
Author Interviews, Gastrointestinal Disease / 03.11.2018

MedicalResearch.com Interview with: RedHill BiopharmaDror Ben-Asher Co-Founder, Chairman & CEO RedHill Biopharma Ltd. MedicalResearch.com: Your presentation at United European Gastroenterology Week (UEGW) covered top-line data from your recently completed Phase 3 study of RHB-104 in Crohn’s disease. Can you please briefly remind us of the background for this study and what results you previously announced? Response: Crohn's disease is a devastating gastrointestinal disorder that affects millions of people worldwide. Crohn's is a chronic relapsing disorder that plagues people throughout their lives with a variety of symptoms including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The existing treatments for Crohn's disease leave a lot to be desired – they are only partially effective in the long-term control of Crohn's and are associated with serious side effects. In addition, the existing therapies only target treating the symptomatic inflammation associated with Crohn's. We began developing RHB-104 with the MAP hypothesis in mind, a theory that suggests Crohn's is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP), in susceptible patients. RHB-104 is a patent-protected orally-administered combination of three antibiotics (clarithromycin, clofazimine and rifabutin) in a single oral capsule that has demonstrated its potential to benefit Crohn's patients. When we announced top-line results from the MAP US study, our Phase 3 trial of RHB-104 in patients with moderate to severe Crohn's disease, we showed that RHB-104 demonstrated a significant clinical benefit to patients versus placebo control. Patients treated with RHB-104 showed significant increase in remission at 26-weeks post treatment initiation in addition to being generally safe and well tolerated. (more…)
Author Interviews, Gastrointestinal Disease, Parkinson's / 01.11.2018

MedicalResearch.com Interview with: Viviane Labrie, Ph.D. Assistant Professor Center for Neurodegenerative Science Van Andel Research Institute Grand Rapids, Michigan MedicalResearch.com: What is the background for this study? Response: Our lab has an interest in the early events and initiation of neurodegenerative diseases. Parkinson’s disease for a long time was thought to be a movement disorder driven by the destruction of dopamine neurons in a specific area of the brain, the substantia nigra. In the last 10 years it has become evident that Parkinson’s disease is not just a movement disorder but hosts a whole range of non-motor systems. One of the most common non-motor symptoms in Parkinson’s patients is issues with the gastrointestinal (GI) tract. GI symptoms often occur early in Parkinson’s disease; for many patients, GI symptoms precede the onset of motor symptoms by as many as 2 decades. Moreover, the GI is not only involved in the early signs of Parkinson’s but has been proposed to be a place in the body where Parkinson’s disease begins. The hallmark pathology of Parkinson’s disease in the brain is Lewy bodies, which contains a clumped form of a protein called alpha-synuclein. There is evidence that Parkinson’s disease pathology, this clumped alpha-synuclein protein, is detectable in the GI tract, even many years before the onset of Parkinson’s motor symptoms. Clumped alpha-synuclein is also capable of traveling across nerve cells. There is evidence that clumped alpha-synuclein can travel up the nerve that connects the GI tract to the brain and enter the brain. This could be disastrous because clumped alpha-synuclein can seed and spread in the brain, which has neurotoxic effects and can eventually lead to Parkinson’s disease. In fact, in the brain of Parkinson’s patients, one of the first places where alpha-synuclein clumps are detected is at the terminal where the gut nerve connects to the brain, and this pathology advances from this point to other brain areas as the disease progresses. This intriguing connection of the GI tract to the early processes of Parkinson’s disease had us interested in trying to understand how the gut could be involved in triggering Parkinson’s. But the GI tract is a very big place, and we first asked ourselves, where should we look to better understand GI involvement in Parkinson’s disease? (more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA / 25.10.2018

MedicalResearch.com Interview with: Prof Ching-Chi Chi, MD, MMS, DPhil  Department of Dermatology Chang Gung Memorial Hospital, Linkou Guishan Dist, Taoyuan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown common genotypes, clinical course, and immunological features shared by psoriasis and inflammatory bowel disease. However, the relationship between psoriasis and inflammatory bowel disease was largely unclear. In this study, we found when compared to the general population, psoriatic patients are more likely to have concomitant inflammatory bowel disease.  (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 14.10.2018

MedicalResearch.com Interview with: Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence.  (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 11.10.2018

MedicalResearch.com Interview with: Nathaniel Ernstoff, MD University of Miami MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening. This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer. Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study's completion. (more…)
Author Interviews, Cannabis, Gastrointestinal Disease / 10.10.2018

MedicalResearch.com Interview with: Tarek Alansari, MD Metropolitan HospitalTarek Alansari, MD Metropolitan Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cannabis is the most frequently consumed recreational drug in the world. The use of cannabis is becoming increasingly accepted by the general public in the United States. The estimates of the prevalence of cannabis use in the United States is about 9.5% in the adult population and the prevalence of dependence or abuse approaches 2.9%. Those under the age of 35 years are the most frequent consumers. According to Business Insider as of June 2018, recreational cannabis is legal in 9 states and medical cannabis is legal in 30 states. Recent surveys show that about 35 million Americans are frequent cannabis users. Aiming for symptomatic relief, some patients with different gastrointestinal disorders have turned to cannabis without fully understanding the effect of its use for their individual condition. Biliary tract disease, ethanol abuse, infections, autoimmunity, and genetics are well known causes of acute pancreatitis. However, medication-induced pancreatitis remains a less common etiology. In about 20% of cases of acute pancreatitis despite of the great improvement in genetic testing and imaging modalities, the workup still fails to reveal an etiology. These cases are labeled idiopathic. Cannabis use is emerging as a rare, possibly overlooked cause of acute pancreatitis with few cases reported in the literature. In the United States, only 5 cases of cannabis - induced acute pancreatitis (AP) have been reported till September 2017. The review of literature revealed that only 26 cases of cannabis-induced AP have been reported worldwide. (more…)
Author Interviews, Gastrointestinal Disease, NYU, Surgical Research, Weight Research / 10.10.2018

MedicalResearch.com Interview with: Violeta Popov, MD PhD FACG Assistant Professor of Medicine Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan) Division of Gastroenterology NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Bariatric surgery is the most effective method currently available for durable weight loss. In the first few months after surgery, patients typically experience significant weight loss. Rapid weight reduction though can lead to the development of gallstones and biliary disease, described in up to 40% of post-bariatric patients. To avoid these complications, the gallbladder was removed during open bariatric procedures in the past. However, with the advent of laparoscopic surgery, concomitant cholecystectomy with bariatric surgery is no longer performed for many reasons.  The aim of is study is to assess if biliary diseases such as acute pancreatitis, acute cholecystitis, acute cholangitis, and cholecystectomy have increased with this change in practice. This is a retrospective cohort analysis of the National Inpatient Sample (NIS), the largest publicly available inpatient database in the United States of nonfederal institutions, with approximately 1000 hospitals participating and information on over 7 million inpatient admissions. We found that from 2006 to 2014 there has been an approximately 10-fold increase in hospital admissions for biliary diseases, as well as similar increase in cholecystectomies, in patients who have a history of bariatric surgery. There was no significant change in admissions in patients without bariatric surgery between 2006 and 2014 admitted for the same biliary diseases.  (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Microbiome, Science / 27.09.2018

MedicalResearch.com Interview with: Joao Xavier PhD Associate Faculty Member | Computational & Systems Biology Memorial Sloan Kettering Cancer Center New York, NY 10065  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our team at Memorial Sloan Kettering has been investigating the intestinal microbiota of patients receiving bone marrow transplantations for more than eight years now. We have found through several studies that these patients lose important healthy bacteria from their microbiota, and that these losses are mostly caused by the antibiotics given as prophylaxis or to treat infections. We also found that the drastic changes in the microbiota composition, especially the intestinal dominations by bacteria such as Enterococcus, increase the risk of transplant-related complications and lowered patient survival. We aimed to determine the feasibility of autologous microbiota transplant (auto-FMT) as a way to reconstitute lost bacteria. This randomized study found that indeed auto-FMT could reconstitute important microbial groups to patients.  (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Infections / 14.09.2018

MedicalResearch.com Interview with: Nina R. Salama. PhD Member Human Biology Division Member Public Health Sciences Division Affiliate Member Basic Sciences Division Dr. Penny E. Petersen Memorial Chair for Lymphoma Research Director of Molecular and Cellular Biology (MCB) Graduate Program Fred Hutchinson Cancer Research Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to better understand why certain patients infected with H. pylori developed stomach cancer and how we could better identify them. H. pylori is one of the strongest risk factors for stomach cancer, but how much it predisposes individuals to gastric cancer varies around the world. Working closely with colleagues from Zhengzhou University, we ran tests on 49 samples from China and found that 91 percent of patients infected with the EPIYA D gene variant of H. pylori also had stomach cancer. (more…)
Author Interviews, Gastrointestinal Disease, Infections, JAMA, Pediatrics, Vaccine Studies / 07.09.2018

MedicalResearch.com Interview with: Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated. In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage.  (more…)
Author Interviews, Gastrointestinal Disease, Pharmaceutical Companies / 15.08.2018

MedicalResearch.com Interview with: RedHill Biopharma LtdMr. Gilead Raday, MPhil, MSc Chief Operating Officer RedHill Biopharma Ltd MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Crohn's disease?  How common is it and whom does it affect?  Response: Crohn's disease (CD) is a chronic, relapsing inflammatory gastrointestinal disorder characterized by a variety of symptoms, including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The underlying cause of Crohn's is unknown; however, CD is believed to arise secondary to genetic and environmental stimuli. More than 1.5 million people suffer from CD globally and it is prevalent in the U.S., affecting more than 200 people per 100,000. The current standard of care for Crohn's disease is limited to anti-inflammatories, immuno-suppressants and biologics that treat auto-immune disorders. These therapies target symptomatic improvement in the inflammation associated with CD, are widely considered to be of limited efficacy in the long term, and are associated with numerous side effects. This speaks to the great unmet need for an effective therapy for this debilitating disease. Additionally, there is no current therapy that treats the suspected underlying cause of Crohn’s disease. We have developed RHB-104 with the MAP hypothesis in mind, which posits that Crohn's disease is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP). This is similar to peptic ulcer disease, a condition that was initially associated with stress, smoking, NSAIDs and other behavioral factors, yet was found to be caused by H. pylori bacterial infection in the 1980s, revolutionizing the field of ulcer treatment. Validation of this theory would revolutionize how Crohn's disease is viewed and treated by the medical community and RHB-104 is the only therapy in development targeting MAP infection.  (more…)
Author Interviews, Cannabis, Gastrointestinal Disease / 14.08.2018

MedicalResearch.com Interview with: Beth A. McCormick, Ph.D. Professor and Vice Chair | Department of Microbiology & Physiological Systems Founding Executive Director | University of Massachusetts Center for Microbiome Research Board of Editors | Gastroenterology University of Massachusetts Medical School Worcester, MA 01655 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been extensive, but to date mostly anecdotal, support for a beneficial role for cannabinoids and cannabis-derived agents to provide benefit for symptoms in individuals suffering from intestinal inflammatory disease (IBD). Our studies have provided one possible rationale for these previous findings: that there is a constitutively active efflux system at the luminal surface of cells that line the intestine that pumps out one class of lipids of the family known as endocannabinoids. In doing so, the intestine floods this surface with these endocannabinoids in a manner that counteracts the actions of a particular potent stimulators of intestinal inflammation that appears to be over-active in certain forms of IBD. This is most significant because a number of cannabinoids and cannabis-derived agents can mimic the actions of this class of endocannabinoids. Moreover, while cannabinoids and endocannabinoids have been shown to provide anti-inflammatory actions, these studies have identified one mechanism used by the body to localize and focus this protective function at a critical site where pro-inflammatory and anti-inflammatory events intersect, providing new insights into how to treat that imbalance in these process that occurs in certain forms of IBD. Therefore, there is the immediate opportunity to use this research to identify new therapeutic strategies to treat individuals suffering from IBD that could include either agents extracted from marijuana plants or novel molecules selected based upon superior properties made obvious by this newly defined mechanism. (more…)
Author Interviews, Biomarkers, Cancer Research, Gastrointestinal Disease, JAMA / 10.08.2018

MedicalResearch.com Interview with: Wei Zhang, Ph.D. Hanes and Willis Family Professor in Cancer Director Cancer Genomics and Precision Oncology Wake Forest Baptist Comprehensive Cancer Center Winston-Salem, NC  27157-1082 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gastric cancer is a leading cause of cancer-related death worldwide. Infection by the Helicobacter pylori is the major cause of gastric cancer, which accounts for more than 60% of cases. Despite progress in helicobacter pylori eradication and early cancer diagnosis, the five-year survival rate of gastric cancer remains less than 30%. Gastric cancer is one of the most common cancer types in Asia but the incidence for gastric cancer has seen a steadily increase in the United States in recent years. Immunotherapy treatment has shown remarkable benefit for some cancer patients whereas others experience toxicities. It is important to identify markers that help oncologists decide which patient would benefit from this promising new treatment strategy. It has been suggested that gastric cancer that is positive for Epstein-Barr Virus is likely more responsive to immunotherapy but only about 10% of gastric cancer patients belong to this category. More potential markers are urgently needed for clinical practice. There is accumulating evidence that high tumor mutation load, which means there are high numbers of gene mutations in the tumor, can provide a signal to activate immune response systems thus rendering tumors more sensitive to immunotherapy. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, HIV, JAMA / 05.08.2018

MedicalResearch.com Interview with: Shan Rajendra MBBCh, MSc , MD, FRCP, FRACP Professor of Medicine University of New South Wales Director of Medicine & Clinical Executive Director Bankstown-Lidcombe Hospital Director Gastro-Intestinal Viral Oncology Group Ingham Institute for Applied Medical Research Sydney  MedicalResearch.com: What is the background for this study?   Response: High-risk human papillomavirus(HPV)  infection has been strongly associated with a subset of Barrett’s dysplasia and oesophageal adenocarcinoma. The research question was; Does HPV status of Barrett’s high-grade dysplasia and esophageal adenocarcinoma influence survival as in viral positive head and neck cancers? We therefore sought to determine the prognostic significance of esophageal tumor HPV status and associated viral transcriptional markers (E6/E7 mRNA and p16INK4A) and TP53. (more…)
Author Interviews, Cocaine, Gastrointestinal Disease, PLoS, Surgical Research, Vanderbilt, Weight Research / 27.07.2018

MedicalResearch.com Interview with: Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation. Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways. We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding. (more…)
Author Interviews, Environmental Risks, Gastrointestinal Disease, Pediatrics / 18.06.2018

MedicalResearch.com Interview with: Kris R. Jatana, MD, FAAP, FACS Associate Professor Director, Pediatric Otolaryngology Quality Improvement Department of Otolaryngology-Head & Neck Surgery Nationwide Children's Hospital & Wexner Medical Center at Ohio State University MedicalResearch.com: What is the background for this study?   Response: More than 2,500 pediatric button battery ingestions occur annually in the United States. When lodged in the esophagus, rapid injury can occur from the tissue and saliva connecting the circuit of the battery. Serious injury can occur in a matter of hours. This results in a highly alkaline caustic injury that dissolves tissue, a process called liquefactive necrosis. There was a need for novel mitigation strategies to slow the progression of esophageal injury caused by presence of a button battery. This study aimed at identifying a palatable liquid that can be given at home or hospital setting to reduce esophageal injury until the battery can be removed. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Gastrointestinal Disease, Technology, Weight Research / 13.06.2018

MedicalResearch.com Interview with: Jeff Karp B.Eng. PhD. Professor of Medicine Center for Nanomedicine and Division of Engineering in Medicine Brigham and Women’s Hospital Harvard Medical School Boston MA MedicalResearch.com: How would you briefly explain the most important findings and conclusions of this study to a non-expert?
  • The type-2 diabetes (T2D) epidemic will affect over 642 million people worldwide by 2040. As a result, diabetes costs the US healthcare over $174 billion dollars annually and is the leading cause of blindness, amputations, renal failure, and poor cardiovascular outcomes. Recently, bariatric surgery, bypassing stomach and intestine from the food stream, has shown promising results and shown to be superior to pharmaceuticals in managing T2D. However, the risks of surgery along with permanent changes to gastrointestinal anatomy deters many suitable patients from surgery, with less than 1-2% of Americans who qualify for weight loss surgery actually undergoing the procedure. Therefore, there is an urgent need for a safe, non-invasive and effective treatment for wider diabetic patient population.
  • We envisioned a pill that a patient can take before a meal that transiently coats the gut to replicate the effects of surgery. During the past 8 years, we’ve been working on this idea and have developed a safe gut-coating material that can potentially mimic the beneficial effects of gastric bypass procedures in the form a pill.
  • LuCI can be activated in any part of gastrointestinal tract (e.g. stomach, duodenum, intestine, colon) to form a temporary physical barrier that isolates that part of gastrointestinal tract. In our pre-clinical models, LuCI coated the duodenum to modulate glucose responses in oral glucose tolerance tests.
  • These beneficial effect are observed without any evidence of systemic absorption of the drug.
  • We believe that LuCI could be a new therapeutic approach for T2D that is based on Roux-en-Y gastric bypass surgery, but is safer, associated with significantly less complications, and thus can potentially help a wide T2D patient population.
  • In a separate set of studies, we also showed that luCi allows delivery of certain proteins and drugs, which would normally be degraded by the gastric acid, to the GI tract, protecting it from gastric acid digestion and prolonging their luminal exposure.
(more…)
Amgen, Author Interviews, Gastrointestinal Disease, Gluten / 07.06.2018

MedicalResearch.com Interview with: Markku Mäki, MD, PhD Professor (emeritus) at the University of Tampere and Presently research director at the Tampere University Hospital Tampere, Finland MedicalResearch.com: What is the background for this study? Response: The only treatment for this life-long gluten-induced autoimmune systemic disease is a strict avoidance of wheat, rye and barley, the food cereals which contain gluten, the environmental trigger and driving force in celiac disease.  Gluten causes intestinal inflammation, usually with (but sometimes without) gastrointestinal or nutritional symptoms or signs, and with frequent extra-intestinal diseases. However, it is impossible for celiac disease patients to avoid gluten entirely and indefinitely and a third of patients report symptoms on a strict gluten-free diet. Gut mucosal healing is not optimal in half of the patients, and inflammation and injury is detected for years after starting the diet, presumably due to contamination with gluten in the diet. This is why patients are requesting, and academia and industry are looking for novel adjunct therapies for celiac disease. Initially, these therapies are tested to prevent the consequences of hidden gluten; the ultimate goal being that also celiacs could one day eat safely wheat, barley and rye products. Some 20 novel experimental therapies are at present actively being investigated (modifying wheat or different drugs, devices and vaccines/immunotherapy). The present study investigated whether blocking interleukin 15, an important mediator of celiac disease, reduces or prevents gluten-driven ill health, both the inflammation and injury at the small intestinal mucosal level and gluten-induced symptoms. The experimental drug used was Amgen’s AMG 714, a human monoclonal antibody, used at a low and high dose, in the presence or absence of a high-dose gluten challenge. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease / 06.06.2018

MedicalResearch.com Interview with: Anas Raed, MD Section of General Internal Medicine Augusta University MedicalResearch.com: What is the background for this study? Response: Colorectal cancer (CRC) incidence and mortality rates have been decreasing in the US since mid 1980s, however, recent evidence shows that incidence and mortality rates of CRC in patients younger than 50 years have been increasing significantly. In spite of the increasing trend of colorectal cancer, routine screening of this population has not been addressed due to lack of evidence and cost-effectiveness. Administering screening colonoscopy for all individuals younger than 50 years might not be feasible and, therefore routine screening colonoscopy for specific age groups might reduce the disparity of the incidence in this disease. (more…)
Author Interviews, Gastrointestinal Disease, Pain Research / 09.04.2018

MedicalResearch.com Interview with: Dr. Joseph Pergolizzi MD Senior Partner and Director of Research Naples Anesthesia and Pain Associates Naples, Florida MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There are roughly 100 million Americans living with chronic pain and many battle debilitating side effects because of their pain medication, including Painstipation otherwise known as opioid-induced constipation (OIC.) In fact, OIC is the most common side effect with approximately 40-80 percent of patients on chronic opioid therapy experiencing it. To better understand this community, the Painstipation survey, conducted by Salix Pharmaceuticals in partnership with the U.S. Pain Foundation, surveyed 441 U.S. adults with chronic pain who were on opioid therapy and suffering from OIC. It gave great insight into this community as it found:
  • More than half (51 percent) of chronic pain patients have been suffering from opioid-induced constipation  for three years or longer
  • Most patients (73 percent) agree that one of the biggest challenges of having OIC is that medications don’t work quickly enough to relieve pain associated with OIC.
  • 53 percent of patients say they want relief for OIC in under four hours
  • Only half of patients surveyed (73 percent) surveyed said they were informed by their doctors that taking opioid medications might result in constipation before they began taking them
  • 77 percent of respondents reported suffering from OIC for at least one year
  • When asked, roughly one-third (32 percent) of patients reported that their doctor does not talk to them specifically about potential adverse drug-to-drug interactions (DDI) of their current prescription and/or over-the-counter medications.
(more…)
Author Interviews, Diabetes, Gastrointestinal Disease, Pharmacology / 22.03.2018

MedicalResearch.com Interview with: Devin Abrahami, graduate student Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal Department of Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, QC, Canada MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The goal of our study was to assess whether a class of antidiabetic drugs, the dipeptidyl peptidase-4 (DPP-4) inhibitors, is associated with the risk of inflammatory bowel disease (IBD). While these drugs control blood sugar levels in patients with type 2 diabetes, there is some evidence that they may also be involved in immune function, and possibly in conditions such as IBD. In our study, we found that the use of DPP-4 inhibitors was associated with a 75% increased risk of IBD, with the highest risk observed after three to four years of use. (more…)
Author Interviews, Gastrointestinal Disease, Infections / 08.03.2018

MedicalResearch.com Interview with: Esther Bullitt, Ph.D. Associate Professor Dept. of Physiology & Biophysics Boston University School of Medicine Boston, MA  02118-2526  MedicalResearch.com: What is the background for this study? Response:      We know that saliva has properties that allow us to swallow easily, and to help prevent gum disease and infections in the mouth. But is that really the only use for the 1-2 liters (1-2 quarts) of saliva we produce every day?  We decided to test whether a component of saliva, Histatin-5, can help prevent diarrheal disease (Traveler’s Diarrhea by Enterotoxigenic Escherichia coli (ETEC)) that is caused by bacteria commonly found in contaminated food and water. ETEC are bacteria that have hundreds of thin hair-like fibers on their surface, called pili. These bacteria bind specifically to the surface of the gut using these pili, and the bacteria need to stay bound long enough to initiate disease. Studies by Mike Levine’s group in the 1970’s showed that pili are necessary for enterotoxigenic Escherichia coli (ETEC) to cause disease. No adhesion, no disease. One aid to remaining bound is the unwinding and rewinding of the pili. These helical fibers can unwind up to 8 times their original length, acting as shock absorbers during fluid flow.   (more…)
Author Interviews, Biomarkers, Cancer Research, Gastrointestinal Disease, UT Southwestern / 09.02.2018

MedicalResearch.com Interview with: Amit Singal MD MS David Bruton Jr. Professor in Clinical Cancer Research Associate Professor of Medicine Medical Director of Liver Tumor Program Clinical Chief of Hepatology University of Texas Southwestern  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatocellular carcinoma, the most common form of primary liver cancer, often has a very poor prognosis because most cancers are found at a late stage when curative treatment is not available. However, if the cancer is found early, curative therapies are possible and patients can typically live longer than 5 years. There is currently debate how at-risk patients with chronic liver disease should be screened - with an abdominal ultrasound alone or using a combination of abdominal ultrasound and a blood test called alpha fetoprotein. Many professional societies have traditionally recommended the former, i.e. ultrasound alone, given few data showing a benefit of adding alpha fetoprotein. Our study examines all available literature examining this question and found using the two tests in combination significantly increases the likelihood of finding the cancer at an early stage. Whereas abdominal ultrasound misses over half of all cancers, using it in combination with alpha fetoprotein can detect two-thirds of cancers at an early stage. (more…)
ASCO, Author Interviews, Biomarkers, Cancer Research, Gastrointestinal Disease / 02.02.2018

MedicalResearch.com Interview with: Dr. Ana Vivancos PhD, Principal Investigator Cancer Genomics Group Vall d'Hebron Institute of Oncology (VHIO Barcelona  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was designed to address a key issue in liquid biopsy testing: analytical sensitivity. We know that mutations in plasma of mCRC patients show a wide range in their allelic frequencies (0.01-90%), the biological basis for which remains unclear. We also know that around 35% of cases show very low mutant allele fractions (MAFs), < 1%, therefore highlighting the need of using high sensitivity techniques in the routine lab in order to properly detect mutations. We have compared two different testing methods that are being used in liquid biopsy: Digital PCR (OncoBEAM RAS test, BEAMing) with a limit of detection of 0.02% vs qPCR (Idylla ctKRAS test, Biocartis) with an analytical sensitivity of 1%. Our findings indicate that detection sensitivity decreases for the qPCR based method in cases with low MAF (<1%) and more so when MAF values are very low (<0.01%). (more…)
Author Interviews, Gastrointestinal Disease, Nutrition, Pediatrics, Probiotics / 05.01.2018

MedicalResearch.com Interview with: Dr Valerie Sung MBBS (Hons) FRACP MPH PhD Department of Paediatrics The University of Melbourne Murdoch Childrens Research Institute Parkville, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infant colic is excessive crying in babies less than 3 months old with no underlying medical cause. It affects 1 in 5 newborns, is very distressing, and is associated with maternal depression, Shaken Baby Syndrome, and early cessation of breastfeeding. Up to now, there has been no single effective treatment for colic. The probiotic Lactobacillus reuteri DSM 17938 has recently shown promise but results from trials have been conflicting. In particular, a previous trial from Australia, the largest in the world so far, did not find the probiotic to be effective in both breastfed and formula-fed infants with colic. This international collaborative study, which collected raw data from 345 infants from existing trials from Italy, Poland, Canada and Australia, confirms Lactobacillus reuteri to be effective in breastfed infants with colic. However, it cannot be recommended for formula-fed infants with colic. Compared to a placebo, the probiotic group was two times more likely to reduce crying by 50 per cent, by the 21st day of treatment, for the babies who were exclusively breastfed. The number needed to treat for day 21 success in breastfed infants was 2.6. In contrast, the formula fed infants in the probiotic group seemed to do worse than the placebo group, but the numbers for this group were limited. (more…)
Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease, JAMA / 21.12.2017

MedicalResearch.com Interview with: Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-level data suggests a link between gastroesophageal reflux disease and cancer of the throat and sinuses in adults over 65 years of age.  T he strength of association between reflux and cancer is strongest for anatomic sites closest to the esophagus, where acid and other stomach contents may have the greatest exposure. (more…)