Vaccine May Stop Immune Attack in Type 1 Diabetes, Study Suggests

Early trial found it boosts insulin production, appears safe

By Serena Gordon

HealthDay Reporter

WEDNESDAY, June 26 (HealthDay News) -- A new type of vaccine may stop the autoimmune attack that occurs in people with type 1 diabetes, researchers report.

Although an initial trial of the vaccine wasn't able to free anyone from their daily insulin injections, it did boost insulin production, which could help prevent some of type 1 diabetes' most devastating complications.

Instead of increasing the immune system's activity like the polio or influenza vaccine does, the new vaccine turns off a portion of the immune response, acting as a reverse vaccine. The researchers were able to isolate a part of the immune response that only seems to be involved with type 1 diabetes, according to the study. That means the vaccine likely wouldn't have the risks that medications that suppress the immune system do.

"We were able to destroy the rogue cells that are attacking the insulin-producing cells without destroying any other part of the immune system, and that's truly exciting," said senior study author Dr. Lawrence Steinman, a professor of pediatrics and neurology and neurological sciences at Stanford University School of Medicine.

"Once the immune attack is stopped, I believe there's great potential for recovery in the beta cells," Steinman added.

Beta cells in the pancreas produce the hormone insulin. In people with type 1 diabetes, it's believed that the immune system mistakenly destroys the healthy beta cells, leaving the person with no or too little insulin.

Insulin is a crucial hormone because it's involved in the metabolism of the carbohydrates. It allows the glucose (sugar) from those carbohydrates to fuel the cells in the body and brain. Without enough insulin, a person will die. That's why people with type 1 diabetes must take multiple daily injections of insulin, or deliver insulin through a catheter inserted under the skin that's attached to an insulin pump.

The vaccine was designed by changing a piece of immune-system DNA so that it would shut down the immune system's response to signals in the body that have previously triggered the mistaken destruction of beta cells. These signals come from fragments of a protein (peptides) called proinsulin, which is found on the surface of beta cells. Proinsulin is a precursor to insulin.

"We just wanted to throw the off switch for the one cell being attacked," Steinman explained.

The researchers recruited 80 volunteers diagnosed with type 1 diabetes during the past five years. They were randomly placed in one of five groups. Four groups received various doses of the vaccine, and the fifth group received placebo injections. Shots were given weekly for 12 weeks.

No one in the study was able to stop using insulin. "That's a possible goal, but it's too early to start saying cure," Steinman noted.

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What is chelation therapy, and can it reduce my risk of heart attack?

Posted June 18, 2013, 2:00 am

I have heart disease. Will chelation therapy help reduce my risk of a heart attack?

That’s a timely question, because a recent study of chelation therapy has generated a lot of interest and debate.

Chelation therapy is used to eliminate metals or other toxins from your body. During the procedure, chemicals are infused into your bloodstream. When these chemicals find unwanted substances as they travel through your blood, they attach themselves to them and carry them out of the body in your urine. For people with toxic levels of lead or mercury, chelation therapy is an FDA-approved method to help with their removal from the body.

Its use for heart disease is more controversial. Here’s the idea: Heart disease results when your blood vessels are narrowed by atherosclerotic plaques that limit blood flow. These plaques are largely made up of fat, cholesterol and calcium. Chelation with a chemical called EDTA pulls calcium out of atherosclerotic plaques — or so the thinking goes. This is supposed to shrink plaques and make artery walls healthier. Thus, the risk of heart attack, stroke and other problems related to blood vessel diseases should decrease.

For decades, chelation practitioners have claimed that the procedure works. But results of a recently published study didn’t support the positive claims.

The study included 1,708 adults age 50 and older who had a previous heart attack. Half of the patients got 40 infusions of EDTA solution along with high doses of vitamin and mineral supplements. Half got a placebo (saltwater) solution. People were chosen for the chelation therapy group and the placebo group by a random process.

The researchers followed the patients for about 4.5 years. Twenty-six percent of people in the chelation group had heart attack, stroke or hospitalization for chest pain or heart bypass surgery. That was compared with 30 percent of patients in the placebo group. Statistical testing showed that the slightly lower rate of heart problems in the chelation group could have occurred by chance.

More troubling was the fact that many people who were assigned to have chelation therapy never actually received the therapy. Nearly 20 percent dropped out of the study before completing the therapy. So drawing conclusions about the value of chelation therapy from this study is difficult.

There are more established ways to prevent heart attacks, stroke and premature death. For example:

Get activeEat betterDon’t smokeControl cholesterolManage blood pressureLose weightReduce blood sugar

If you already have atherosclerosis, you should be taking a statin drug and a daily aspirin.

If you take these steps, I think the current evidence says that you’re unlikely to get any extra benefit from chelation therapy. In contrast to that inconclusive evidence, the evidence on each of these lifestyle changes and medications is conclusive: They all definitely protect you from heart disease, strokes and premature death.

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Sibling's Death May Boost Your Own Risk of Dying From Heart Attack: Study

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, Feb. 27 (HealthDay News) -- When a brother or sister dies -- especially from a heart attack -- the risk of a surviving sibling also dying from a heart attack increases sharply in the following years, a large new study from Sweden suggests.

Chronic stress or lifestyle choices like drinking, smoking, unhealthy diet and lack of exercise may follow the loss of a sibling, increasing the risk of a heart attack over time, the researchers said.

"Health care providers should follow bereaved siblings to help recognize signs of acute or chronic psychosocial stress mechanisms that could lead to heart attack," said lead researcher Mikael Rostila, an associate professor at Stockholm University and the Karolinska Institute.

"We might be able to prevent heart attacks and other heart-related conditions by treating these siblings early on and recommending stress management," he added.

Reasons for the association between a sibling's death and the death of a brother or sister years later aren't clear, Rostila noted. And although the study showed an association between a sibling's heart attack death and heightened death risk, it did not establish a cause-and-effect relationship.

"More detailed information from medical records, shared childhood social environment and family characteristics, and data on personal and relational characteristics is needed to uncover the mechanisms causing the association between sibling death and heart attack," Rostila said.

The report was published in the Feb. 27 issue of the Journal of the American Heart Association.

To see the effect of a sibling's death on their other siblings, Rostila's team collected data on more than 1.6 million people in Sweden, aged 40 to 69.

They found the risk of dying from a heart attack increased 25 percent among surviving sisters and 15 percent among surviving brothers compared to people who had not lost a sibling. If their brother or sister died of a heart attack, risk of also dying from a heart attack in the following years increased by 62 percent among women and 98 percent among men, Rostila's team found.

Death from a heart attack was not likely to happen immediately after siblings died, the researchers said. Rather, the risk rose in the four to six years after a sibling's death among women and in the two to six years afterward among men, they found.

"This is a red flag for families," said Dr. Stephen Green, associate chairman of the department of cardiology at North Shore University Hospital, in Manhasset, N.Y. "We know that heart disease is genetic and environmental and typically siblings and family members share the same gene pool, but also share the same bad habits."

Many siblings whose brother or sister died from a heart attack have undiagnosed heart disease, Green said.

If you -- or someone you know -- has a family member with a history of heart disease or heart attack, or a family member who died from heart disease, it is important to talk with your primary care doctor or a cardiologist to make sure it doesn't happen to you, Green said.

More information

To learn more about heart attacks, visit the American Heart Association.

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Emerging SARS-Like Virus Well-Suited to Attack Humans: Study

By Mary Elizabeth Dallas

HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- The new SARS-like "coronavirus" that first emerged in the Middle East can invade the lungs and immune system as easily as the common cold, according to a new study.

But in the event of a large-scale outbreak, researchers in Switzerland found the virus -- known as HCoV-EMC -- may be treatable with components of the immune system, known as interferons. This immunotherapy has shown promise in the treatment of the respiratory disease SARS and hepatitis C, the study authors said.

"Surprisingly, this coronavirus grows very efficiently on human epithelial cells," said study co-author Volker Thiel of the Institute of Immunobiology at Kantonal Hospital in St. Gallen, in a news release from the American Society for Microbiology. Epithelial cells line hollow organs and glands.

"The other thing we found is that the viruses [HCoV-EMC, SARS, and the common cold virus] are all similar in terms of host responses: they don't provoke a huge innate immune response," he said.

The study was published online Feb. 19 in mBio.

HCoV-EMC, which may have jumped from animal to human very recently, was first isolated in June after a man in Saudi Arabia died from a severe respiratory infection and kidney failure. Following his death, health officials identified 11 more people infected with the virus, the latest in Great Britain. So far, six of the 12 people with known infections have died. Nearly all patients have lived or traveled in the Middle East.

Concerns have been raised that the new strain could trigger a pandemic similar to the SARS outbreak of 2002-03, which infected more than 8,000 people and killed 774.

"We don't know whether the cases we observed are the tip of the iceberg, or whether many more people are infected without showing severe symptoms," noted Thiel.

The World Health Organization on Saturday said that doctors should test patients for the new coronavirus if they have unexplained pneumonia or unexplained complicated respiratory illness not responding to treatment.

So far, no cases of the coronavirus have been reported in the United States, according to the U.S. Centers for Disease Control and Prevention.

To test the new virus, the researchers used cultured bronchial cells to mimic the lining of the human airway. Although this lining is a key barrier against respiratory viruses, the study revealed these cells didn't mount a big defense against HCoV-EMC. Instead, they found human lungs are highly susceptible to the virus, which can multiply at a faster initial rate than SARS.

The study authors noted, however, that pre-treating the airway with proteins that play a critical role in immune response to infections -- known as lambda-type interferons -- significantly reduced the number of infected cells.

Although their findings suggest there is promise for an effective treatment against HCoV-EMC, the researchers added ongoing cooperation between scientists and health agencies around the world is needed to prevent outbreaks of this virus and other diseases.

More information

The World Health Organization provides more information on coronavirus infections.

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Marriage May Cut Heart Attack Risk for Both Spouses

THURSDAY, Jan. 31 (HealthDay News) -- Marriage appears to reduce the risk of heart attacks for both men and women, according to researchers in Finland.

Other studies have shown that being single or living alone increases the risk for developing and dying from heart disease. Many of these studies, however, were only among men, the researchers said, while this new study includes both sexes.

"Our study suggests that marriage reduces the risk of acute coronary events and death due to acute coronary events in both men and women and at all ages," said lead researcher Dr. Aino Lammintausta, of Turku University Hospital.

"Furthermore, especially among middle-aged men and women, being married and cohabiting are associated with considerably better prognosis of incident acute coronary events both before hospitalization and after reaching the hospital alive," she said.

The report was published Jan. 31 in the European Journal of Preventive Cardiology.

For the study, Lammintausta's team collected data on more than 15,300 people who suffered heart attacks between 1993 and 2002. Among these people, about 7,700 died within 28 days of their attack.

Looking at the role marriage might play in the likelihood of having a heart attack, the researchers found that unmarried men were 58 percent to 66 percent more likely to have a heart attack, as were 60 percent to 65 percent of single women, compared to members of married couples.

The gap in risk of dying from a heart attack was even greater for single men and women, the researchers said. For single men, the risk of dying within 28 days of a heart attack was 60 percent to 168 percent higher than for married men; for single women, the risk of death due to heart attack was 71 percent to 175 percent higher than for married women.

The odds of dying from a heart attack were increased for unmarried men and women regardless of age, compared with similar-aged married couples, the researchers noted.

Why marriage might have this effect isn't clear. The researchers, however, suggest several possible reasons.

Single people may be more likely to be in poor health, they said. Married people may be better off financially, live healthier lives and have more friends and social support, all of which promotes health. Married people also may be more likely to call an ambulance sooner than single people, the researchers said.

In addition, married couples get better treatment in the hospital and after discharge, the researchers noted.

On the other hand, the researchers suggested, single people may be less likely to follow measures that might help prevent heart attacks -- such as taking daily aspirin, cholesterol-lowering statins and medications to control high blood pressure.

"For better or worse, marriage is associated with better cardiovascular health and a lower risk of death due to an acute coronary event," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles.

The reasons marriage or cohabitation may protect people from heart attacks requires further study, he added. Further research is also needed to establish a cause-and-effect relationship between marital status and heart attack incidence and survival.

More information

To learn more about heart attacks, visit the American Heart Association.

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Women's Heart Attack Symptoms: 6 Possible Signs

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Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Heart Health Center Heart Disease Health Center Heart Disease Feature Stories Email a FriendPrint Article Heart Disease Health Center Tools & ResourcesAfter a Heart AttackA Diet To Lower CholesterolA Visual Guide to Heart Disease Test Your Cholesterol SmartsExercising for a Healthy HeartHeart-Healthy Living With Diabetes webmd.m.share.init(); Font Size A A A webmd.m.fontSizer.init(); 6 Symptoms of Women's Heart Attacks ByLisa Fields
WebMD Feature Reviewed byBrunilda Nazario, MD

When a heart attack strikes, it doesn’t always feel the same in women as it does in men.

Women don't always get the same classic heart attack symptoms as men, such as crushing chest pain that radiates down one arm. Those heart attack symptoms can certainly happen to women, but  many experience vague or even “silent” symptoms that they may miss.

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Heart palpitations are a feeling that your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.Heart palpitations can be bothersome or frightening. They usually aren't serious or harmful, though, and often go away on their own. Most of the time, they're related to stress and anxiety or to consumption of stimulants such as caffeine, nicotine, or alcohol. Palpitations also often occur during pregnancy.In about one...

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These six heart attack symptoms are common in women:

Chest pain or discomfort. Chest pain is the most common heart attack symptom, but some women may experience it differently than men. It may feel like a squeezing or fullness, and the pain can be anywhere in the chest, not just on the left side. It's usually "truly uncomfortable" during a heart attack, says cardiologist Rita Redberg, MD, director of Women’s Cardiovascular Services at the University of California, San Francisco. "It feels like a vise being tightened." Pain in your arm(s), back, neck, or jaw. This type of pain is more common in women than in men. It may confuse women who expect their pain to be focused on their chest and left arm, not their back or jaw. The pain can be gradual or sudden, and it may wax and wane before becoming intense. If you're asleep, it may wake you up. You should report any "not typical or unexplained" symptoms in any part of your body above your waist to your doctor or other health care provider, says cardiologist C. Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles. Stomach pain. Sometimes people mistake stomach pain that signals a heart attack with heartburn, the flu, or a stomach ulcer. Other times, women experience severe abdominal pressure that feels like an elephant sitting on your stomach, says cardiologist Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center in New York. Shortness of breath, nausea, or lightheadedness. If you're having trouble breathing for no apparent reason, you could be having a heart attack, especially if you're also having one or more other symptoms. "It can feel like you have run a marathon, but you didn't make a move," Goldberg says. Sweating. Breaking out in a nervous, cold sweat is common among women who are having a heart attack. It will feel more like stress-related sweating than perspiration from exercising or spending time outside in the heat. "Get it checked out" if you don't typically sweat like that and there is no other reason for it, such as heat or hot flashes, Bairey Merz says. Fatigue. Some women who have heart attacks feel extremely tired, even if they've been sitting still for a while or haven't moved much. "Patients often complain of a tiredness in the chest," Goldberg says. "They say that they can't do simple activities, like walk to the bathroom."

Not everyone gets all of those symptoms. If you have chest discomfort, especially if you also have one or more of the other signs, call 911 immediately.

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Some Migraines Linked to Heart Attack, Blood Clots

Jan. 15, 2013 -- Women who have migraine with aura may have a higher risk of heart attacks, and they may face a higher risk of dangerous blood clots if they use certain hormonal contraceptives.

Those are the findings from two newly published studies to be presented in March at the 65th annual meeting of the American Academy of Neurology in San Diego.

Migraine with aura refers to migraine headaches that are preceded by visual or other sensory symptoms such as flashing lights, blind spots, smell distortion, numbness, or tingling of the hands and face.

About 1 in 4 people with migraines have this type of migraine.

In the first study, having migraine with aura, but not regular migraines, was a risk factor for heart attacks among middle-aged and older women.

The analysis included data on close to 28,000 women enrolled in the ongoing Women’s Health Study.

During 15 years of follow-up, about 1,400 women who had migraine with aura were identified, and there were 1,030 heart attacks, strokes, or deaths from cardiovascular causes.

After having high blood pressure, having migraine with aura was found to be the second strongest contributor to heart attack and stroke risk, according to researcher Tobias Kurth, MD, of Brigham and Women’s Hospital in Boston and the French National Institute of Health.

Migraine with aura was found in the study to be a bigger risk factor for these cardiovascular conditions than having a family history of early heart disease or having diabetes or being obese or a smoker.

“We have known that migraine with aura is associated with cardiovascular risk,” neurologist and migraine specialist Noah Rosen, MD, says. “What is striking about this study is that it shows just how big this risk is.”

Rosen directs the Headache Center at the Cushing Neuroscience Institute, of the North Shore-LIJ Health System in Manhasset, N.Y.

In the second study, women with migraines who used combined hormonal contraceptives had a higher risk for dangerous deep vein blood clots, and the risk was highest in women with migraine with aura. Combined hormonal contraceptives contain both estrogen and progestin.

While there was a suggestion that newer-generation combined hormonal contraceptives might carry a greater risk for blood clots, researcher Shivang Joshi, MD, of Boston’s Brigham and Women’s Faulkner Hospital, says the difference among users of newer- and older-generation hormonal contraceptives was not that great.

Joshi and colleagues examined the impact of migraine type and combined hormonal contraception type on blood clot risk using data from a health insurance registry that included women enrolled between 2001 and 2012.

The researchers identified around 145,000 women who used combined hormonal contraceptives, including 2,691 who had migraines with aura and 3,437 who had migraines without aura.

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Health Tip: Stay Active After a Heart Attack

Title: Health Tip: Stay Active After a Heart Attack
Category: Health News
Created: 12/5/2012 8:35:00 AM
Last Editorial Review: 12/5/2012 12:00:00 AM

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