MATURE MARKET HEADLINES POSTED 10/14/98
Gene Therapy Used to Treat Heart Disease
Like beltways designed to allow traffic to bypass clogged city streets, a gene therapy treatment to help the body's own blood vessels build "detours" around blocked or congested arteries in the heart is being tested by Johns Hopkins researchers. The treatment, administered through a catheter, delivers a growth factor gene that triggers production of a protein to stimulate new blood vessel growth, a process known as
angiogenesis.
The newly formed vessels may provide alternate routes for blood to bypass clogged and blocked arteries that feed the heart, according to Jeffrey A. Brinker, M.D., director of interventional cardiology at Hopkins and principal investigator for the trial. "If this treatment proves successful, it could reduce the need for surgery or lifelong drug therapy in patients with early signs of coronary disease," says Brinker. Angiogenesis is a natural biological healing process, but the body's natural response is often insufficient to overcome injury caused by ischemia, or a lack of blood flow. Gene therapy is designed to enhance the body's abilities to build new routes.
For the study, the interventional cardiology group is seeking patients with moderate chest pain and early signs of coronary artery disease. Patients should be able to exercise on a treadmill for at least three minutes. To evaluate the therapy's effects, researchers will have patients take part in treadmill exercise tests and stress echocardiography four and 12 weeks following treatment. The clinical trial is sponsored by Berlex Laboratories Inc., a subsidiary of Schering AG, Germany, in collaboration with Collateral Therapeutics of San Diego.
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"ACE Human Performance Gene Discovered"
AgeVenture News Service, www.demko.com
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Nasal Spray Medicine Fights Osteoporosis
A new drug for the treatment of osteoporosis that was studied at The University of Arizona College of Medicine in Tucson has been shown to prevent spinal fractures. UA investigators contributed research on bone fracture prevention that shows that Miacalcin® (calcitonin-salmon) Nasal Spray reduces the incidence of new spinal fractures by 36 percent in postmenopausal women with established osteoporosis.
Osteoporosis -- loss of bone mass and decrease in bone mineral density -- primarily affects women after menopause and makes bones fragile and susceptible to fracture. Fractures most often occur in the spinal vertebrae, resulting in back pain, spinal deformity and a loss of height. Calcitonin is a thyroid hormone that helps in the formation of normal bone. "Our research shows that calcitonin nasal spray is a viable option in the treatment of osteoporosis in women who are more than five years past menopause," said Michael Maricic, M.D., chief of rheumatology and director of the metabolic bone disease clinic at the Arizona Arthritis Center, and co-investigator for the study.
"While hormone-replacement therapy remains the primary treatment option, nasal calcitonin therapy works well in older women who want an alternative to HRT and its side-effects." More than 1,200 women participated in the five-year international study, known as Miacalcin PROOF (Prevent Recurrence of Osteoporotic Fractures), which was conducted by independent investigators at 47 medical institutions throughout the United States and the United Kingdom.
Miacalcin was given once a day in a single nasal spray of 200 I.U. (international units). The incidence of spinal fractures in women who received Miacalcin was found to be lower than that of women who received a placebo. Currently, these data are under review by the U.S. Food and Drug Administration. The study was funded by Novartis Pharmaceuticals Corporation, which manufactures and markets Miacalcin.
On the market since 1995, the drug is the only treatment available in an easy-to-use nasal spray, according to the company. The drug is most effective in treating osteoporosis in women who are more than five years past their menopause and who have low bone mass compared with healthy women before menopause. It is recommended for women who refuse or cannot tolerate estrogens or in whom estrogens should not be used. Miacalcin should be taken with adequate daily supplements of calcium and vitamin D. Coupled with exercise, this regimen helps prevent loss of bone mass.
According to the National Osteoporosis Foundation, more than 28 million Americans - 80 percent of
whom are women -- have or are at risk of developing osteoporosis. The disease is responsible for more than 1.5 million fractures annually, including approximately 700,000 vertebral fractures, 300,000 hip fractures, 250,000 wrist fractures and 300,000 other fractures. Osteoporosis-related treatment costs are estimated to be $13.8 billion annually in the U.S. and as the population ages this cost is expected to increase dramatically.
See related articles in the AgeVenture archives.
"Calcium - Vitamin D Combo Reduces Bone Loss"
"Boomers Better Prepared for Menopause"
"Women's Health Initiative"
AgeVenture News Service, www.demko.com
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Gender and Age Bias in Medical Rationing
There is an on-going attempt to cut medical costs in the cost-conscious environment of managed care. Efforts include establishing a more restrictive screening process to determine eligibility for cataract surgery. A study in Ophthalmology, the journal of the American Academy of Ophthalmology, warns rationed cataract surgery, based on a hierarchy of visual impairments, could lead to women and older people being denied coverage.
Medicare's current system for determining who receives cataract surgery weighs visual impairments associated with activities of daily life, employment, or driving more heavily than recreational limitations. However, the study's authors Tobacman, Zimmerman, Lee, and others found men to be more affected by an inability to work and/or drive, while women were unable to perform recreational activities or activities of daily life. As expected, younger people were more likely to have problems working due to cataracts, while older people were more likely to have trouble performing recreational activities.
The authors note this difference sets up an inherent prejudice against women and older people in relation to cataract surgery. According to the study, "These implications are potentially of crucial importance, if rationing of cataract surgery is contemplated, for the findings suggest adoption of a hierarchy of visual impairments may result in a gender and age bias in the determination of who receives cataract surgery." Instead, authors state quality of life should be considered when determining appropriateness of cataract surgery.
See related articles in the AgeVenture archives.
"Aspirin Raises Cataract Risk for Boomers"
"Insurer Targets Needs Of Mature Women"
"Job Discrimination More Costly to Women"
AgeVenture News Service, www.demko.com
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Computer Improves Sight in Stroke Victims
A new, specialized regimen of computer therapy can restore some vision lost due to brain injuries caused by stroke or trauma, says Princeton Professor Bernhard A. Sabel. Until now, this type of vision loss has been considered untreatable. In Sabel's experiment, adult patients who had suffered a stroke or brain trauma and lost major portions of their field of vision were able to regain an average of 5 degrees of the field, which is the equivalent of a half-page of a standard magazine held at arm's length.
On average, patients improved their vision between 30 and 70 percent above baseline; some patients who had lost their ability to read regained it. Members of a control group did not achieve similar results. "We were able to show for the first time that lost sight can be restored in man, thus offering new hope for the many patients who are afflicted each year by partial blindness," Sabel said. Thus, he said, the brain's visual system in adults is not as unchangeable as previously thought, but instead possesses tremendous potential for "neuroplasticity," a term that describes the brain's ability to adapt to change.
According to Sabel, the use of a computer as a therapeutic tool to treat blindness is also significant. "It is non-invasive, and it has no side effects," he said. Also, because the test subjects can do the computer therapy at home, it is cost-effective and compliance is extremely high -- of 38 patients, evenly divided into therapy and control groups, only one member of the control group dropped out of study. The computer in the experiment targeted the "transition zone" in each test subject's vision field, which is located between the field with intact vision and the area where vision was completely lost. In this area of partial vision are cells that have survived the injury. These "islands of residual vision" allow patients to see some stimuli, while others go unseen.
Getting patients to focus on this transition zone offers the best hope of restoring the vision field, Sabel said, because the repetitive activation of the surviving cells strengthens their synaptic connections. Sabel explained that when vision loss occurs after a brain injury, many cells are destroyed but some number of the hardiest cells survive. These "survivor cells," as he calls them, offer the potential for restored vision. With proper stimulation, these cells undergo dramatic change. "I've always been interested in how the brain repairs itself," said Sabel. "When we get a cut on our skin and it heals, no one thinks anything of it. But people don't think the brain can repair itself, yet it does."
See related articles in the AgeVenture archives.
"Bionic Brain Battery Battles Parkinson's"
"Brain Booster"
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Enzyme Linked to Age-related Hearing Loss
Age-related hearing loss may be lessened or prevented in the future by regulating an enzyme that neutralizes free-oxygen radicals, destructive molecules that can destroy sensory hair cells of the inner ear, suggests preliminary research conducted in the University at Buffalo's Center for Hearing and Deafness. Using mice lacking one or both components of the genes responsible for production of the antioxidant enzyme superoxide dismutase, or SOD, the UB researchers showed that age-related hearing loss was greater and progressed faster in mice deficient in the enzyme than in mice with a normal genetic makeup and SOD production that served as a control group.
"Before this present study, we thought that hearing loss was a normal process of aging," said Richard Salvi, Ph.D., co-director of the Center for Hearing and Deafness and leader of the research group. "Then we found people with no loss, and we figured it was related to a low-noise environment. Now we believe that at least some age-related hearing loss is due to a genetic deficiency in antioxidant enzymes, such as SOD. If we are able to regulate the enzyme and modulate the number of free radicals present, there is hope for a therapy for age-related hearing loss. "
To arrive at their findings, the researchers used mice in which one or both components of the gene responsible for production of SOD had been eliminated, along with mice with a normal amount of SOD. "Mice are good models for studying human hearing loss," said Sandra McFadden, Ph.D., a researcher in the study group, "because like humans, they lose hearing at high frequencies first, while hearing loss in most other animals begins in the lower frequencies."
"We know that the free radicals produced throughout the body as by-products of normal cell metabolism can cause extensive damage to living tissues, including the sensory hair cells in the inner ear, if they are not neutralized by antioxidant enzymes," McFadden said. "We think that SOD deficiencies may increase cochlear vulnerability to environmental insults, such as noise or drugs, as well as to injury from normal free-radical activity during aging. "An increase in antioxidant enzymes that neutralize free radicals, such as SOD, may protect the cochlea from these insults and prevent or lessen hearing loss." The studies were funded by the National Institutes of Health.
See related articles in the AgeVenture archives.
"300 Million Worldwide Suffer Deafness"
"Merrill Lynch Offers Financial Planning for the Deaf "
AgeVenture News Service, www.demko.com
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Maine Health Problems of Elders Isolated
Their voices tell a familiar story. They talk of loneliness, of sons and daughters
working far from home and of the importance of neighbors. These ten Bucksport senior citizens
describe what it's like to grow old in a rural Maine community, and their stories have become part of an
educational program for health care students. "Aging in Rurality: the Bucksport Project" is a new compact disc offered by a group of health care providers and the University of Maine, known as the Academic-Community Partnership for Aging in Rural Areas. Nationwide distribution to health educators and students is planned this fall under a grant from the U.S. Department of Health and Human Services.
"We have an idyllic picture that elderly people in rural areas are going to be taken care of, that they have good social networks and that their families and neighbors will always be there. In reality, that's often not true. The economic pressures in rural Maine mean that family and friends are not there to provide that support system," says Joann Kovacich, director of the Interdisciplinary Training for Health Care for Rural Areas (ITHCRA) project at UMaine.
The result is that the burden of care falls to neighbors and professional health care providers such as
nurses, social workers and occupational therapists. In some cases, Kovacich says, family members
who live nearby assume new responsibilities for transporting a parent to the doctor or making sure that
meals are being eaten. "What happens is that the son or daughter can become exhausted," says Kovacich, "because he or she is responsible for two households."
"Our goal was to expose students to the real people that health care practitioners serve in a rural community", Kovacich stresses. The program presents health care providers such as a registered nurse, social worker, occupational and physical therapists and a dietician. Each discusses the work they do and the experiences they've had in serving people in rural Maine.
"Rural health care providers often have to be alert for problems outside their area of expertise. For example, a social worker may need to be aware of mobility problems that a physical therapist can address. Or a dietician may need to be consulted if meals aren't adequate," says Kovacich. Among the circumstances addressed in the program are loneliness, personal mobility, transportation and security," she adds. The compact disc program was developed with technical assistance from John Sproul, a UMaine computer science student who worked as an intern with The Artist Group, Inc. of Fairfield, a multi-media design company.
See related articles in the AgeVenture archives.
"Gatekeeper Program Identifies Isolated Elders"
"PCA's Public-Private Partnership in Eldercare"
AgeVenture News Service, www.demko.com
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