Researchers at Queen Mary University London and the University of Leicester have announced a potential breakthrough to treat a rare, fatal medical complication that affects children and young people.

The preliminary data highlighting efficacy of the breakthrough was published as a letter in the New England Journal of Medicine and one patient has already been treated and experienced promising results as per scientists and clinicians from the two universities.

From Sciencedaily.com:

“Affected patients have episodes of bleeding in the lungs, which often need hospital admissions, and in some cases it can be life threatening. This is normally combated by the use of continuous oral steroids (which can have major side effects).

“In a child local to Leicester, we were able to show, for the first time, that there was high levels of oxidative stress in the lungs. In addition, we treated the increased oxidative stress by using of an antioxidant, N-acetyl cysteine - which has no side effects. Since she has been on this treatment she has had no lung bleeds, and the steroid dose has been significantly reduced.”

Dr Marcus Cooke, Senior lecturer in the Radiation and Oxidative Stress Section at the University of Leicester, added: “It is a really good feeling to be involved in a project looking at oxidative stress, that can make such an enormous difference to a person’s quality of life.

Idiopathic pulmonary haemosiderosis is a rare disease with an unknown cause, according to Jonathan Grigg, Professor of Paediatric Respiratory and Environmental Medicine at Queen Mary University London.

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CH-1504, considered by many as a potential oral drug for rheumatoid arthritis (RA), can motivate women to treat their condition earlier because it is less difficult than currently-available treatment options.

Chelsea Therapeutics, a pharmaceutical company specializing in treatment for rheumatoid arthritis and other immunological diseases, is currently on a developing spree to formulate an oral anti-inflammatory drug and conducting Phase I clinical trials in the UK with an aim to provide an amicable solution for this condition that is more prevalent in women and develops between ages of 35 and 50.

From News-Medical.Net:

Current treatment options for RA include over-the-counter oral nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers; oral steroids; but the gold standard for treatment is still methotrexate, a drug that been used for nearly 30 years. Newly available compounds known as biologic response modifiers, such as etanercept and infliximab are used when the disease progresses (mostly in combination with methotrexate) but have to be injected and are very expensive.

While methotrexate is often effective, long-term chronic doses of the drug can be toxic to the liver, kidneys and other organs. Short-term tolerability issues such as nausea, vomiting and diarrhea also often limit its use.

“Given the problems that many patients have tolerating methotrexate along with its long-term safety concerns, a drug candidate that is proven to be as effective or more effective than with fewer side effects would be a major breakthrough in the treatment of RA. This may prompt patients to treat their condition earlier and continue treatment longer,” says Dr. Pedder.

Dr. M. Gopal Nair, a professor and vice-chairman at the department of Biochemistry and Molecular Biology at the University of South Alabama, initially developed the CH-1504 therapy.

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Black teenagers are more likely to develop steroid-resistant asthma than their white counterparts, according to a research conducted at the National Jewish Medical and Research Center.

It was disclosed in the study that black asthmatic teens are more likely to be sick and suffer from a higher mortality rate than white teens with asthma.

From News.Bio-Medicine.Org:

“Our results suggest that children with steroid-resistant asthma are more likely to be African-American, to have required treatment with oral steroids at an earlier age and to require larger amounts of oral steroids for only marginal control of their asthma,” said Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.

Other recent epidemiological studies have shown that blacks with asthma are sicker and have a higher mortality rate than whites with asthma. Doctors at National Jewish now are trying to determine whether blacks have a more vigorous immune response to airway inflammation–which means that higher doses of steroids must be used to control inflammation–or a poor response to steroids secondary to a genetic resistance to the drugs.

“The theory is that with ongoing airway inflammation you get worsening asthma and diminished steroid sensitivity,” Dr. Spahn said.

This study of 164 teen-agers treated at National Jewish also showed that 25 percent of the group was steroid resistant. Children with less than a 15 percent improvement in lung function following a “burst” of inhaled steroids–high doses over seven days–were considered steroid resistant.

“Twenty-five percent of the kids admitted to National Jewish have steroid-resistant asthma, which is much greater than anyone thought,” Dr. Spahn said.

African-American children are prone to steroid-resistant asthma, according to Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.

The study was published in the Journal of Allergy and Clinical Immunology.

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A potential breakthrough was announced by researchers at Queen Mary University London and the University of Leicester for treating Idiopathic pulmonary haemosiderosis, a rare but devastating disease with an unknown cause.

One patient affected with this devastating condition has already been treated by clinicians and scientists from the two universities and noticed promising results.

From Sciencedaily.com:

“Affected patients have episodes of bleeding in the lungs, which often need hospital admissions, and in some cases it can be life threatening. This is normally combated by the use of continuous oral steroids (which can have major side effects).

“In a child local to Leicester, we were able to show, for the first time, that there was high levels of oxidative stress in the lungs. In addition, we treated the increased oxidative stress by using of an antioxidant, N-acetyl cysteine - which has no side effects. Since she has been on this treatment she has had no lung bleeds, and the steroid dose has been significantly reduced.”

Dr Marcus Cooke, Senior lecturer in the Radiation and Oxidative Stress Section at the University of Leicester, added: “It is a really good feeling to be involved in a project looking at oxidative stress, that can make such an enormous difference to a person’s quality of life.

Preliminary data was published as a letter in the New England Journal of Medicine.

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Children afflicted with severe asthma should be taking an over-the-counter calcium supplement and a multi-vitamin every day for preventing loss of bone associated with osteoporosis, as per an article published in the Journal of Allergy and Clinical Immunology.

Joseph Spahn, M.D., an author of the article and a pediatric asthma specialist at National Jewish Medical and Research Center, said that a child does not have to be dependent on steroids to get osteoporosis.

From Sciencedaily.com:

Researchers did not find a connection between high usage of inhaled and oral steroids, and osteoporosis. Osteoporosis causes brittle bones and can lead to bone fractures, especially in active children. Nearly 5 million children in the United States have asthma.

Researchers also found that in the 1990s children had fewer growth problems than their counter-parts in the mid-1960s.

National Jewish looked at the side effects of steroids on adrenal gland suppression, cataracts, cushionoid disease and hypertension, making National Jewish’s study the most comprehensive ever published focusing on steroid side effects in children. The last time medical researchers performed a similar study was more than 35 years ago.

Because asthma is better controlled today—in the ’60s inhaled steroids didn’t exist as an asthma treatment—the disease has less of an impact of growth. Even though inhaled steroids can cause limited, short-term growth suppression—and children do catch up to the height of their peers as they get older—control of asthma is so much improved in the past three decades that the trade-off is a positive one for young patients. In addition, asthma itself can limit growth.

It is worth noting here that inhaled corticosteroids reduce and prevent swelling of the airways and oral (pills or syrup) corticosteroids relax tight muscles around the airways.

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A protein known for stimulating growth of blood vessel was recently found to be behind the cell overgrowth in the development of polyps, which characterize one of the most severe sinusitis forms.

This finding was disclosed by researchers from John Hopkins and is expected to provide a new target to develop novel therapies for treating this disease form that usually resists all presently available treatment options.

From Sciencedaily.com:

“This type of sinusitis isn’t subtle — you can spot the patients with polyps from across the room. They’re breathing through their mouths, they talk with nasal voices, they’re constantly sniffling, and their faces are swollen,” says Jean Kim, M.D., Ph.D., assistant professor in the Departments of Otolaryngology and Allergy and Clinical Immunology at the Johns Hopkins University School of Medicine, and a researcher at the Johns Hopkins Allergy and Asthma Center at the Johns Hopkins Bayview Medical Center.

Kim explains that surgery to remove the polyps is one of the most common treatments for this disease. However, nasal and sinus polyps in these patients almost always regrow. “Once the patient has entered the cycle of growing polyps, it’s very hard to get out,” she says. Another common treatment is oral steroids, but these drugs are fraught with many harmful side effects and also only temporarily treat the disease.

She and her Johns Hopkins colleagues have long studied sinusitis, often growing sinus cells isolated from patients in petri dishes. After noticing that cells from patients with polyps typically multiplied faster than cells from normal patients, the researchers speculated that cells from polyp patients might be producing extra amounts of some type of growth factor, a protein that encourages cell growth.

Other researchers participating in this study were Hyun Sil Lee, Ph.D., and Allen Myers, Ph.D.

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The use of steroids (corticosteroids) in association with the risk of cataract was recently examined by a study conducted by the Centre for Vision Research, University of Sydney, Australia.

This population-based study, a cohort of the Blue Mountains Eye Study, examined 3,654 Australians, aged 49 years or older, five and 10 years after initial (baseline) examinations were conducted between 1992 and 1994.

From Medicalnewstoday.com:

Elevated cataract risks were found only in patients who, at the time of their baseline exams, had ever used inhaled steroids, had also used oral steroids for at least one month, and had no cataracts. Patients at highest risk for two types of cataract were those defined at baseline as “current users” of both steroid forms; although this was a small group, follow up exams found that nearly all of them developed cataracts. Of seven current user patients, five had used either steroid form for more than five years, and four of the five developed posterior subcapsular cataract (PSC). Three additional current user patients developed nuclear cataracts. In nuclear cataracts the center of the lens is obscured, and in PSC the cataract develops in the rear area of the lens. Earlier research had established a higher risk for PSC in oral steroids users.

It was remarked by lead researcher, Jie Jin Wang, MMed, PhD, Centre for Vision Research that combined use of steroids in cumulatively high doses could raise risks for two types of cataract.

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Low vitamin D levels share a relationship with lower lung function and greater medication use in children affected with asthma, as per researchers at National Jewish Health in a paper published online in the Journal of Allergy & Clinical Immunology.

It was reported by Daniel Searing, MD, and his colleagues that vitamin D has the ability to improve the activity of corticosteroids, which are considered to be the most effective of all asthma control medications.

From Sciencedaily.com:

Patients low in vitamin D generally had higher levels of IgE, a marker of allergy, and responded positively to more allergens in a skin prick test. Allergies to the specific indoor allergens, dog and house dust mite, were higher in patients with low vitamin D levels. Low vitamin D also correlated with low FEV1, the amount of air a person can exhale in one second, and lower FEV1/FVC, another measure of lung function. Use of inhaled steroids, oral steroids and long-acting beta agonists were all higher in patients low in vitamin D.

“Our findings suggest two possible explanations,” said senior author Donald Leung, MD, PhD. “It could be that lower vitamin D levels contribute to increasing asthma severity, which requires more corticosteroid therapy. Or, it may be that vitamin D directly affects steroid activity, and that low levels of vitamin D make the steroids less effective, thus requiring more medication for the same effect.”

The researchers performed a series of laboratory experiments that indicated vitamin D enhances the action of corticosteroids. They cultured some immune cells with the corticosteroid dexamethasone alone and others with vitamin D first, then dexamethasone. The vitamin D significantly increased the effectiveness of dexamethasone. In one experiment vitamin D and dexamethasone together were more effective than 10 times as much dexamethasone alone.

Dr. Leung said that the work suggested that vitamin D improves the anti-inflammatory function of corticosteroids.

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A potential oral drug for rheumatoid arthritis (RA), CH-1504, could encourage women in treating their condition earlier since it is less arduous than the presently available treatment forms.

Chelsea Therapeutics, a pharmaceutical company specializing in treatment for RA and other immunological diseases, is presently developing an oral anti-inflammatory medication and conducting Phase I clinical trials in the U.K. to offer a suitable solution for this condition that develops between the ages of 35 and 50 and is 2-3 times more prevalent in women.

From News-Medical.Net:

Current treatment options for RA include over-the-counter oral nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers; oral steroids; but the gold standard for treatment is still methotrexate, a drug that been used for nearly 30 years. Newly available compounds known as biologic response modifiers, such as etanercept and infliximab are used when the disease progresses (mostly in combination with methotrexate) but have to be injected and are very expensive.

While methotrexate is often effective, long-term chronic doses of the drug can be toxic to the liver, kidneys and other organs. Short-term tolerability issues such as nausea, vomiting and diarrhea also often limit its use.

“Given the problems that many patients have tolerating methotrexate along with its long-term safety concerns, a drug candidate that is proven to be as effective or more effective than with fewer side effects would be a major breakthrough in the treatment of RA. This may prompt patients to treat their condition earlier and continue treatment longer,” says Dr. Pedder.

CH-1504, the potential therapy, was initially developed by Dr. M. Gopal Nair, a professor and vice-chairman at the department of Biochemistry and Molecular Biology at the University of South Alabama.

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A potential breakthrough has been announced by researchers at Queen Mary University London and the University of Leicester for treating a rare but devastating medical condition that can affect children and young people.

One patient has already been treated and experienced promising results by the clinicians and scientists from the two universities. The preliminary data was published as a letter in the New England Journal of Medicine.

From Sciencedaily.com:

“Affected patients have episodes of bleeding in the lungs, which often need hospital admissions, and in some cases it can be life threatening. This is normally combated by the use of continuous oral steroids (which can have major side effects).

“In a child local to Leicester, we were able to show, for the first time, that there was high levels of oxidative stress in the lungs. In addition, we treated the increased oxidative stress by using of an antioxidant, N-acetyl cysteine - which has no side effects. Since she has been on this treatment she has had no lung bleeds, and the steroid dose has been significantly reduced.”

Dr Marcus Cooke, Senior lecturer in the Radiation and Oxidative Stress Section at the University of Leicester, added: “It is a really good feeling to be involved in a project looking at oxidative stress, that can make such an enormous difference to a person’s quality of life.

Jonathan Grigg, Professor of Paediatric Respiratory and Environmental Medicine at Queen Mary University London, said idiopathic pulmonary haemosiderosis is a rare disease with an unknown cause.

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Tags: idiopathic pulmonary haemosiderosis, Oral Steroids, steroids

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