Scientists discover more potential biomarkers of early pancreatic cancer

The researchers, from H. Lee Moffitt Cancer Center in Tampa, FL, report their findings in the journal PLOS ONE.

Only around 6% of people with pancreatic cancersurvive more than 5 years after diagnosis. The main reason is because of the lack of reliable tools to diagnose the disease early enough so surgeons can remove the cancer before it spreads.

Like work currently going on in other research centers, the Moffitt team focused on a small group of molecules called microRNAs. But in their case, they looked specifically at microRNAs linked to intraductal papillary mucinous neoplasms (IPMNs).

IPMNs are a type of pancreatic cyst or lesion that can lead to pancreatic cancer in the same way that precancerous polyps can lead to colon cancer.

IPMN lesions can be seen on computed tomography (CT) scans and magnetic resonance imaging (MRIs), but these scanning techniques are unable to tell you if the cysts are benign (low risk of cancer) or malignant (high risk of cancer).

Currently, the only way to test if the pancreatic lesions are high risk or low risk for cancer is to remove them with surgery - but this is itself high risk because it can result in long-term diabetes and death.

The other option is to wait and see if the lesions lead to cancer, but this is far from ideal because it denies doctors the chance to cure their patients of a potentially life-threatening condition.

Study found six microRNAs that differentiate high- and low-risk pancreatic lesions

MicroRNAs are small molecules that act as "master regulators" that control many cancer processes in the body. They can be found in tumor tissue and in blood and other body fluids.

There is growing evidence that microRNAs could serve as biomarkers of early pancreatic cancer.

For example, in October 2014, Medical News Today reported how researchers from Indiana University School of Medicine found a panel of microRNAs that could be used as a blood test for pancreatic cancer.

In that study, the team suggested three microRNAs - miR-10b, miR-155 and miR-106b - might serve as highly accurate early indicators of pancreatic ductal adenocarcinoma (PDAC) - the most common type of pancreatic cancer.

In this new study, the Moffitt team looked for microRNAs that might be linked with high-risk IPMN lesions that should probably be removed as soon as possible to avoid full-blown pancreatic cancer.

To do this, they analyzed IPMN tissue that had been surgically removed from patients diagnosed and treated at Moffitt and found six microRNAs that appeared to differentiate high-risk from low-risk lesions.

The six microRNAs may also contribute to pancreatic cancer progression

The six microRNAs the Moffitt team identified are: miR-100, miR-99b, miR-99a, miR-342 -3p, miR-126 and miRNA-130a.

The team also found evidence to suggest these microRNAs may contribute to pancreatic cancer progression.

First author Dr. Jennifer Permuth-Wey, applied research scientist and molecular epidemiologist in Moffitt's Cancer Epidemiology Program, says:

"The hope is that this line of research may eventually lead to a microRNA-based blood test that could be used in conjunction with imaging features and other factors to aid the medical team and patient in accurately predicting disease severity at the time of IPMN diagnosis or follow-up."

And in a more general sense, as with other groups coming forward with potential new biomarkers, the team hopes their findings will also help find new ways to prevent and detect pancreatic cancer earlier and improve the current poor prognosis for most patients with the disease.

Funds for the study came from the American Cancer Society, the National Cancer Institute, the United States Public Health Service and the Moffitt Gastrointestinal Oncology Program.

CBT to treat veterans' insomnia 'also reduced suicidal thoughts'

According to the American Academy of Sleep Medicine (AASM), more than half of veterans who served in Iraq or Afghanistan report symptoms of insomnia.

Between 15% and 20% of adults have short-term insomnia and about 10% of people have chronic insomnia disorder, report the AASM. Chronic insomnia is a sleep disturbance with associated symptoms in the daytime that has persisted for at least 3 months.

"Chronic insomnia is especially common among veterans who have put their lives at risk in service to our country," says AASM President Dr. Timothy Morgenthaler.

"This study emphasizes that effectively treating insomnia can be life-changing and potentially life-saving for veterans who may be struggling with problems such as depression, suicidal thoughts and post-traumatic stress disorder," he adds.

The study authors evaluated 405 veterans who had been diagnosed with insomnia disorder and who had received cognitive behavioral therapy for insomnia (CBT-I).

The participants were mostly male with a mean patient age of 52 years. Around 83% of the veterans had experienced conflict; 150 had served in Vietnam and 83 had served in Iraq or Afghanistan.

CBT-I reduced suicidal thoughts as well as improving insomnia

Results show that in addition to improving insomnia symptoms, CBT-I was also associated with reducing suicidal thoughts and depression symptoms and improving quality of life among the veterans.

The study reports that up to six sessions of CBT-I were associated with a 33% decrease in suicidal ideation. Also, insomnia severity decreased concurrently with odds of suicidal ideation.

The authors say that this association remained significant after controlling for depression severity and other potential confounding factors.

Co-lead author Bradley Karlin, PhD, who served as national mental health director for psychotherapy and psychogeriatrics in the US Department of Veterans Affairs Central Office at the time the evaluation was conducted, says:

"It was striking to see that the reduction in insomnia severity was associated with reduced suicidal ideation even after controlling for improvement in depression severity. The results suggest that effective treatment of insomnia with CBT-I is an important target for reducing suicide risk among veterans and others at risk for suicide."

Karlin says the results show that focusing greater attention on detecting and treating insomnia could also "produce substantial public health benefits."

In 2013, Medical News Today reported on another study published in Sleep that found military personnel who have severe sleeping problems before being deployed are at increased risk for developing anxiety, depression and post-traumatic stress disorder (PTSD) when they return home.

In that study, the researchers found that even sleeping less than 6 each hours each night - which is not classified as general insomnia - was associated with an increased risk of PTSD.

Another 2013 study published in Sleep also found a high prevalence of sleep disorders and short sleep duration among active duty military personnel. Researchers were startled to find that 85.1% of participants had a clinical sleep disorder, with obstructive sleep apnea being the most frequent disorder (51.2% of participants), followed by insomnia (24.7%).

Could strenuous jogging do more harm than good?

Dr. Peter Schnohr, of the Frederiksberg Hospital in Copenhagen, Denmark, and colleagues publish their findings in the Journal of the American College of Cardiology.

Numerous studies have associated physical activity with reduced mortality, with some suggesting that just small amounts of exercise can do the job. A recent study reported by Medical News Today, for example, claims that a daily 20-minute brisk walk could reduce the risk of early death by 16-30%.

The link between lower levels of exercise and reduced mortality is supported with this latest study, which suggests light jogging is most beneficial for lowering the risk of premature death.

To reach their findings, Dr. Schnohr and colleagues analyzed 5,048 healthy individuals who were a part of the Copenhagen City Heart Study. Of these, 1,098 were joggers and 3,950 were sedentary non-joggers.

Over 12 years of follow-up, the researchers tracked participants' frequency of jogging, the number of hours they spent jogging and their jogging pace.

Jogging more than a few times a week at a strenuous pace 'may be harmful'

During the study, there were 28 deaths among joggers and 128 among non-joggers. The team notes that overall, the joggers were younger, had a lower prevalence of diabetes and smoking, and had lower blood pressure and body mass index (BMI).

The researchers found that participants who jogged for 1-2.4 hours a week over no more than 3 days had the lowest mortality, and lower mortality rates were identified among those who jogged at a slow or moderate pace. The highest mortality rates were found in both the fast-paced joggers and sedentary non-joggers.

Commenting on the findings, Dr. Schnohr says:

"The U-shaped association between jogging and mortality suggests there may be an upper limit for exercise dosing that is optimal for health benefits. If your goal is to decrease risk of death and improve life expectancy, jogging a few times a week at a moderate pace is a good strategy. Anything more is not just unnecessary, it may be harmful."

The Physical Activity Guidelines for Americans state that adults should engage in either 2.5 hours of moderate-intensity aerobic activity or 1.25 hours of vigorous-intensity aerobic activity every week.

Dr. Schnohr notes that light jogging in this study represents vigorous exercise, while strenuous jogging represents very vigorous exercise. "When performed for decades, this activity level could pose health risks, especially to the cardiovascular system," he adds.

In November 2014, MNT reported on a study suggesting running for 30 minutes at least three times a week may slow the aging process.

Three-parent embryos approved in UK

The IVF technique replaces faulty mitochondrial DNA in an egg or embryo with healthy DNA from a female donor.

Next month, when the House of Lords votes to support the change - which it is expected to - the UK will be the first country in the world to permit embryos to be made with the genetic material of three people: a man and two women.

Diseases arising from faulty mitochondrial DNA usually affect several organs, and include symptoms like muscle wasting, loss of movement control, diabetes and epilepsy. They can also cause liver failure, heart problems, stroke-like episodes, and - in severe cases - death.

According to a new study published in a leading journal recently, around 2,500 women could benefit from mitochondrial donation in the UK. This would amount to an average of 150 babies born each year.

The study also estimates around 12,400 women in the US would benefit from the procedure should it be introduced, amounting to around 770 or more births a year.

Three-parent babies could be born in 2016

The team that pioneered the technique at Newcastle University in the UK - led by Doug Turnbull, professor of neurology - is ready to begin trialling the procedure as soon as the new law comes into effect in October 2015, so the first three-parent babies could be born in 2016.

Mitochondria are small "battery packs" inside the body's cells that convert food into energy for cells to function. They have their own DNA that only controls mitochondrial function and energy production.

Mitochondrial diseases particularly affect tissues that have high energy demands, such as the brain, heart, muscles, liver and kidneys.

Mitochondrial DNA is separate from the DNA in the cell nucleus that determines a person's physical appearance and personality.

In normal human reproduction, mitochondria are usually passed on almost exclusively from the mother; the small amount that is present in sperm is only just enough to fuel its passage to the egg and is normally destroyed by the egg cell after fertilization.

Thus, because babies inherit their mitochondria from their mothers, the new IVF technique only replaces genetic material in the eggs of mothers with faulty mitochondrial DNA.

Mitochondrial DNA is 'less than 0.054% of total DNA'

There are two ways to carry out mitochondrial DNA transfer. In one, the nuclear DNA is removed from the egg of the mother and is inserted into the egg of a female donor where the nuclear DNA has been stripped out. The egg is then fertilized with the father's sperm.

In the other technique, the mother's egg is first fertilized with the father's sperm, creating a fertilized egg with nuclear DNA from both parents. This nuclear DNA is then removed and inserted into an egg from a female donor that has had the nuclear DNA removed.

In both cases, the result is an embryo with nuclear DNA from the mother and the father, but with healthy mitochondrial DNA from the female donor, enabling a child to be born free of mitochondrial DNA disease.

Prof. Dame Sally Davies, chief medical officer for England - who strongly urged members of parliament (MPs) to vote in favor of changing the law - says we should remember that mitochondrial DNA is less than 0.054% of total DNA.

Concerns about mitochondrial DNA transfer

Those against legalizing mitochondrial DNA transfer are concerned that it opens the door to other types of genetic manipulation.

If it is okay to repair faulty mitochondrial DNA to prevent genetic disease passing from mother to child, then what about other genetic diseases caused by faults in nuclear DNA? Once you cross this line, then it becomes easier to move toward "designer babies," whose genes are manipulated to select preferred traits.

Campaigning watchdogs like Human Genetics Alert say their main objection to mitochondrial DNA transfer is it alters the "germline" of children. The genetic changes would be present in all cells of their bodies and would be transferred to descendants of girls using the technique.

Others object on the grounds that the new technique is not safe. Dr. Rhiannon Lloyd, from the Zoological Society of London in the UK, warns that in half of animal studies, faulty mitochondrial DNA was transferred over during the procedure, reports The Daily Telegraph. Some say this could raise the risk of cancer.

In contrast to the UK position, in the US there are no plans to change the law, as the Cellular, Tissue and Gene Therapies Advisory Committee of the Food and Drug Administration (FDA) says there is not enough evidence to support the use of mitochondrial transfer in people.

And there are also concerns that mitochondrial DNA influences personality. Dr. Ted Morrow, an evolutionary biologist at the University of Sussex in the UK, notes there are published studies that show this.

'Bold step for parliament'

The MPs who supported the change were of the opinion that the benefits outweigh the risks. During the debate in the House of Commons, ministers said the new IVF procedure was a "light at the end of a dark tunnel" for families.

Public Health Minister Jane Ellison told MPs: "This is a bold step for parliament to take, but it is a considered and informed step."

Prime Minister David Cameron - whose own son Ivan died aged only 6 in 2009 from cerebral palsy and epilepsy - says there is no danger of the procedure leading to "designer babies." He said in an interview on LBC Radio that he saw mitochondrial DNA transfer as more like a kidney donation or a lung donation than a fundamental change. "It is not like playing God," he said.

Dr. Jeremy Farrar, director of the Wellcome Trust, which funds the work of Prof. Doug Turnbull and his team at Newcastle University, welcomes the vote and hopes the House of Lords reaches a similar conclusion. He says the UK's regulatory system is admired around the world and notes:

"This is a vote of confidence in the patients, scientists, doctors and ethicists who have worked hard for a decade to explain this complex research to politicians, the public and the media, and in the exemplary process for reviewing scientific, ethical and public opinion led by the Human Fertilisation and Embryology Authority."

Robert Meadowcroft, chief executive of the Muscular Dystrophy Campaign, agrees and adds:

"There are currently no means to treat devastating mitochondrial diseases, which can cause muscle wastage, loss of vision, stroke-like episodes and a premature death. Preventing inheritance, where possible, remains our only option, and that is why we have invested in and wholly support this pioneering technique."

He says the next step is to make sure the peers in the House of Lords are fully armed with the facts about mitochondrial donation IVF before their debate next month because iIt is absolutely crucial that they fully understand what is at stake for women affected by this condition."