Study reveals blood pressure connected to eye health in young children

Agencies
June 29, 2020

Washington DC, Jun 29: Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study.

The first study to show this connection in children was published today in Hypertension, an American Heart Association journal.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. 

"Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate: children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; retinal vessel diameters could explain 29 -31 per cent of the changes in systolic blood pressure progression between 2014 and 2018; children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and initial blood pressure measures explained 66-69 per cent of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting.

Developmental stage including puberty status of each child was not accounted for in the study, as well as genetic factors or birth weight - variables that could impact blood pressure development and microvascular health.

In addition, reference values for appropriate retinal vessel diameters in children do not currently exist, so future studies are needed to determine age-related normal values during childhood.

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Agencies
September 12,2020

New Delhi, Sept 12: Drugs Controller General of India (DCGI) has directed Serum Institute of India to suspend till further orders new recruitment in phase 2 and 3 clinical trials of the Oxford COVID-19 vaccine candidate in the backdrop of pharma giant AstraZeneca pausing the trials in other countries.

In an order, a copy of which has been accessed by PTI, DCGI Dr V G Somani on Friday also directed Serum Institute of India (SII) to increase the safety monitoring of the subjects already vaccinated as part of the trial, and submit the plan and report.

Somani also asked the firm to submit clearance from Data and Safety Monitoring Board (DSMB) in the UK as well as in India to obtain clearance from his office (DCGI) prior to resumption of future recruitment in the trial.

The central drug regulator DCGI had issued a show-cause notice to SII on September 9 for not informing it about AstraZeneca pausing clinical trials of the vaccine candidate in other countries and also for not submitting casualty analysis of the "reported serious adverse events".

Following which the Pune-based firm, which has partnered with the British-Swedish biopharmaceutical giant AstraZeneca for manufacturing the Oxford vaccine candidate, on Thursday said it is pausing the clinical trials in India.

Earlier this week, AstraZeneca said it had paused the trials because of 'an unexplained illness' in a participant in the study.

"We are reviewing the situation and pausing India trials till AstraZeneca restarts the trials," SII said in a statement on Thursday.

According to the DCGI's order issued on Friday, the SII in its reply stated that DSMB has noted no safety concerns from the Indian study (part 1-phase-2 study) with the first dose and seven days post vaccination safety data.

In its reply, SII also stated that DSMB further recommended "to pause further enrolment into the study until ongoing investigations of SAE reported in the UK study is completed and the sponsor and the UK DSMB are satisfied that it doesn't pose any safety concerns".

"In the view of the above, I Dr V G Somani, Drugs Controller General of India, Central Licensing Authority, after careful examination of your reply and the recommendations of the DSMB in India, in exercise of the powers vested under Rule 30 of the New Drugs and Clinical Trials Rules, 2019, direct to you suspend any new recruitment in the phase 2 and 3 clinical trial till further orders," the order read.

"Increase the safety monitoring of the subjects already vaccinated with the vaccine under trial and submit the plan and report," the order further stated.

On August 2, the DCGI had granted permission to the Pune-based SII to conduct Phase 2 and 3 human clinical trials of the coronavirus vaccine candidate.

AstraZeneca, the biopharmaceutical giant in a tie-up with the Oxford University to produce the vaccine, described the pause of trials as a "routine" one following what was "an unexplained illness".

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News Network
September 18,2020

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Ludhiana, Sept 18: DMCH Cancer Care Centre in collaboration with American Oncology Institute recently started a new diagnostic service (PSMA-PET Scan) in treating various prostate cancer.

Prostate cancer is the most common cancer in men and one of the leading causes of cancer death. Prostate Specific Membrane Antigen (PSMA ) is highly expressed in prostate cancer and its expression increases with tumour aggressiveness, metastatic disease and disease recurrence.

Secretary of DMCH Managing Society, Sh. Prem Kumar Gupta said, “Very few facilities in the region have this state-of-art facility and will be of great benefit for the patients.” He further added, “DMCH Cancer Care Centre is always in the process of acquiring new techniques and facilities for diagnosing and treating various cancer diseases. The availability of this facility will go a long way to help both patients and clinicians in knowing about the proper stage of prostate cancer, thereby helping patients with better outcome.”

Dr. Puneet Bhutani from the Department of Nuclear Medicine, American Oncology Institute stated, “This is a major milestone in diagnosis of prostate cancer. The procedure of diagnosing prostate cancer through PSMA-PET Scan is more accurate method for early detection of recurrent disease. It allows the oncologists to treat patients at an early stage and provide them a better treatment outcome.”

About American Oncology Institute:

American Oncology Institute is the leading cancer care provider across South Asia operating a chain of cancer hospitals in multiple cities across South Asia. AOI today is a wholly owned subsidiary of Varian Medical Systems (NYSE: VAR).

The team of clinical, paraclinical and healthcare operations experts pride themselves with the aim of closing the gap between standards of cancer care in South Asia and the developed cancer hospitals in the West. AOI provides comprehensive cancer management that is powered by clinical excellence, world class technology as well as best in class clinical pathways and protocols for treatment planning and execution, providing best in-class quality in cancer care across South Asia.

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Agencies
September 17,2020

Vaccine candidates for COVID-19 should elicit a broad immune response that includes antibodies, and the body's helper and killer T cells, according to a study which says weak or uncoordinated immunity may lead to a poor disease outcome.

The research, published in the journal Cell, confirms that a multi-layered, virus-specific immune response is important for controlling the novel coronavirus during the acute phase of the infection and reducing COVID-19 disease severity.

"Our observations could also explain why older COVID-19 patients are much more vulnerable to the disease," said study senior author Shane Crotty from the La Jolla Institute for Immunology in the US.

"With increasing age, the reservoir of T cells that can be activated against a specific virus declines and the body's immune response becomes less coordinated, which looks to be one factor making older people drastically more susceptible to severe or fatal COVID-19," Crotty said.

In the research, the scientists collected blood samples from 50 COVID-19 patients, and analysed multiple branches of their immune system -- novel coronavirus specific antibodies, helper and killer T cells.

"It was particularly important to us to capture the whole range of disease manifestation from mild to critically ill so we could identify differentiating immunological factors," said study co-author and infectious disease specialist Sydney Ramirez.

The researchers found that all fully recovered individuals had measurable antibody, helper and killer T cell responses against the novel coronavirus SARS-CoV-2.

However, they said the response varied widely in acute COVID-19 patients, with some lacking neutralising antibodies, others helper or killer T cells or any combination thereof.

"When we looked at a combination of all of our data across all 111 measured parameters we found that in general, people who mounted a broader and well-coordinated adaptive response tended to do better," said Carolyn Moderbacher, another co-author of the study from La Jolla Institute for Immunology.

"A strong SARS-CoV-2 specific T cell response, in particular, was predictive of milder disease. Individuals whose immune response was less coordinated tended to have poorer outcomes," Moderbacher said.

The scientists found that the effect was magnified when they broke down the dataset by age.

"People over the age of 65 were much more likely to have poor T cell responses, and a poorly coordinated immune response, and thus have much more severe or fatal COVID-19," Crotty said.

The scientists explained that as people age, the immune system's supply of deployable immature T cells dwindles, with fewer cells available to be activated to respond to a new virus.

"This could either lead to a delayed adaptive immune response that is unable to control a virus until it is too late to limit disease severity or the magnitude of the response is insufficient," Moderbacher said.

The scientists believe T cells, and helper T cells in particular, are associated with better protective immune responses.

"This was perplexing to many people, but controlling a primary infection is not the same as vaccine-induced immunity, where the adaptive immune system is ready to pounce at time zero," Crotty said.

"Thus, these findings indicate it is plausible T cells are more important in natural SARS-CoV-2 infection, and antibodies more important in a COVID-19 vaccine," he said.

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