The Gander

Pat Kelly | 26 Nov 2018 | 0 Comment(s)

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The Medical Independent blog takes a look at the more unconventional niches in science and research

Gut reaction in Parkinson’s

Research involving 1.6 million Swedish nationals has suggested that people who have had their appendix removed may have a lower risk of developing Parkinson’s disease.

The study, which was published recently in Science Translational Medicine, sought to explore why symptoms of Parkinson’s can manifest earlier in the gut than they do in the brain. The researchers found that in healthy individuals, their appendix contained clumps of protein similar to those found in the brains of people with Parkinson’s disease. This led the authors to suggest that the appendix plays an early role in Parkinson’s via protein accumulation, indicating that those who have had an appendectomy may avoid the negative effects of alpha-synuclein protein clumps.

Overall, the researchers, based at a number of facilities from the US, Canada, France and Sweden, found a 19 per cent decrease in risk of developing Parkinson’s in those who had undergone an appendectomy. In addition, 46 out of 48 samples taken from a healthy individual’s appendix showed accumulations of alpha-synuclein, which is found in the brains of people with Parkinson’s disease.

“Given recent evidence linking gut inflammation to PD [Parkinson’s disease]... and the role of the appendix in immunosurveillance and microbiome regulation... it is possible that the appendix contributes to PD via inflammation and microbiome alterations,” wrote the authors.

“Given that the appendix is responsible for monitoring and repopulating the microbiome in the small and large intestine... any subclinical inflammation in the appendix may signify the presence of proinflammatory bacteria, which would then be dispersed throughout the intestine.”

School of hard knocks 

A US-based research team has sought to build on advances in recent years in treating traumatic brain injuries, particularly among those who engage in contact sports, and has found that lasting evidence of brain injuries is detectable at a surprisingly young age.

Furthermore, the team found evidence of elevated levels of microRNAs in young sports-people who had experienced American football-related brain trauma, even before the season had begun.

The researchers, from the Concussion Neuroimaging Consortium and Orlando Health in the US, conducted blood tests on American college football players and identified evidence of higher microRNA levels in participants younger than they expected.

“It was quite shocking to learn that the biomarkers were high before they were even involved in one hit or tackle for the season,” commented Dr Linda Papa, Emergency Medicine Physician at Orlando Health and lead author of the research. “This suggests that the effects of past head injuries are persisting over time.”

She continued: “There is a lot more awareness about head injuries than there used to be, and it’s really up to each parent to do their research and talk to coaches and athletic trainers. Researchers from across the country are coming together to examine this issue. Once we’re aware of the dangers and risks, we can take steps to minimise them and keep the sport as it should be, a healthy activity for everybody to participate in.

“We’re hoping that the biomarkers are actually going to give us a quantity of injury, rather than just saying whether this a concussion or not,” added Dr Papa. “We can say to these players, ‘yes, I can see you have had an injury because the levels of the biomarkers are elevated, and now we are going to help you’.”

The study was published in the Journal of Neurotrauma.

Middle-age matters 

A study, authored by researchers at Stanford Medical School in the US, has shown evidence that babies born to older fathers have an increased risk of a range of issues, such as seizures, low birth-weight and intensive care unit admission.

The team examined data from over 40 million births in the US where the father was at what they termed “advanced parental age”, which they defined as over 35, 45 and 50 years.

Children born to fathers aged over 45 years were associated with a 14 per cent greater risk of admission to an intensive care unit, compared to the children of fathers aged 25-to-34 years, which is the average age for fatherhood in the US. These children were also 18 per cent more likely to experience seizures, 14 per cent more likely to be born with low birth weight and 14 per cent more likely to be born prematurely.

If the father was aged 50 years or older, their children were 28 per cent more likely to require treatment in a neonatal intensive care unit and 10 per cent more likely to require ventilation at birth.

The figures were obtained using a joint data-sharing programme, organised by the National Centre for Health Statistics and Centres for Disease Control and Prevention, and allowed for confounding factors such as mother’s age, access to care, education, race, smoking history and marital status.

Dr Michael Eisenberg, study author and Associate Professor of Urology at Stanford, commented: “We tend to look at maternal factors in evaluating associated birth risks, but this study shows that having a healthy baby is a ‘team sport’, and the father’s age contributes to the baby’s health too.”

Dr Eisenberg pointed to the fact that 10 per cent of children in the US are now born to fathers aged 40 years or more, compared to 4 per cent 10 years ago. However, he added that the findings, published in the British Medical Journal, should not deter older men from fathering children. “If you buy two lottery tickets instead of one, your chances of winning double, so it’s increased by 100 per cent,” he explained. “But that’s a relative increase. Because your chance of winning the lottery started very small, it’s still unlikely that you’re going to win the lottery. This is a very extreme example, but the same concept can be applied to how you think about these birth risks.”

Dr Eisenberg said he and his co-authors hope the findings will help to educate potential older fathers planning a family, as well as public health policy-makers.

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