PDSA E-News: October 26, 2016

 


 

ITP & PLATELET DISORDERS RESEARCH & TREATMENTS

Small but Mighty: New Test of Platelet Strength Diagnoses Bleeding Disorders

PlateletsA new laboratory test can be used to diagnose bleeding disorders, especially for those who perform normally in standard diagnostic tests. It has been developed by biomedical engineers at Emory University and Georgia Tech. The scientists devised an assay where platelets can exhibit their strength by pulling together two tiny dots of fibrinogen, a precursor protein of fibrin, which forms a net around platelets during a clot. When a clot forms, the platelets and fibrin contract, which helps to close the wound. Although it has been previously established that platelets can exert forces that are significantly larger (considering their size), in comparison with muscle cells, the role platelet strength plays in clotting factors had been previously undetermined due to a number of interfering variables when studied in vivo. This novel assay studies the platelets in the laboratory on a tiny gel full of small fibrinogen dots, analyzing the distance over which the platelets can pull the protein together.

What researchers found may not surprise ITP patients: platelets harvested from bleeding disorder patients were not able to pull the protein as far in comparison with platelets from “healthy” donors. The assay can be used as a new “physics-based method to test for bleeding disorders, complementary to current methods.”

Additionally, the platelet strength assay indicated the mechanism of platelet contraction mediation: an inhibitor of a specific enzyme (ROCK, Rho-associated Protein Kinase) prevents platelet contraction, whereas a similar mechanism in a related pathway (MLCK, Myosin Light Chain Kinase) did not inhibit contraction. Understanding this relationship in platelet contraction in conjunction with the platelet assay will be an invaluable resource in refining blood thinning medications.

Emory University. “How to Measure Individual Platelets’ Strength” Phys.org. 10/10/2016.
http://phys.org/news/2016-10-individual-platelets-strength.html

 

 

ITP Patients’ Urine Found to Differ from that of Healthy Volunteers

Blood TestIn this research the role of food intolerance in ITP was studied by replacing a normal diet with an elemental diet (E028) (liquid nutrition); however, this change did not increase patients’ platelet counts. Researchers have found that urine from people with ITP differs from the urine of healthy volunteers. Some toxic volatile organic compounds (VOCs) were found in the gas given off by the urine of ITP volunteers. Possibly this finding could mean the intestines of ITP patients process food in a different way compared to healthy controls. Researchers speculate that abnormal metabolic activity of the intestinal microbiome may be a factor causing ITP. Further work is needed to confirm this conclusion. THE VOCs are likely to be of bacterial origin since their production is affected by manipulating the diet.

Batty C, Cauchi M, Hunter J, et al. “Differences in Microbial Metabolites in Urine Headspace of Subjects with Immune Thrombocytopenia (ITP) Detected by Volatile Organic Compound (VOC) Analysis and Metabolomics.” Clin. Chim. Acta. 2016, Oct. 1; 461:61-8, doi: 10.1016.
https://www.ncbi.nlm.nih.gov/pubmed/27475979

 

HOSPITALS, INSURANCE & HEALTH CARE

Fungal-Bacterial Interaction Offers New Clue to Cause of Crohn’s Disease

MicroscopeResearchers are closer to understanding the underlying causes of Crohn’s disease. Over 700,000 people in the US suffer from Crohn’s. Patients experience severe abdominal pain, persistent diarrhea, weight loss, and fatigue. There is no cure and it sometimes has life-threatening complications. The underlying cause of Crohn’s is still unknown but is likely a combination of factors including genetics and a malfunctioning immune system. Previous research has also shown it connected to certain bacteria. A new study from Case Western Reserve University suggests fungi may also play a role in Crohn’s disease. The researchers looked at both bacteria and fungi because both organisms live in the body and interact with one another.

Researchers analyzed fecal samples of 20 Crohn’s patients and 49 Crohn’s-free patients from France and Belgium. They found strong fungal-bacterial interactions in patients with Crohn’s disease: two bacteria – E. coli and Serratia Marcescens—and one fungus – Candida tropicalis. Presence of all three in Crohn’s patients was significantly higher than in healthy patients. This is the first time Serratia and any type of fungus have been found linked to Crohn’s disease. Additionally the researchers found in test-tube research that the three microorganisms worked together to produce a biofilm (a thin, slimy layer of microorganisms that clings to the inside of the intestines, as well as other parts of the body). This biofilm leads to inflammation, which causes symptoms of Crohn’s disease.

Finally, researchers found that sick patients had lower numbers of beneficial bacteria in their guts compared to healthy participants. These findings may lead to potential new treatments, such as probiotics. Also understanding what makes the ‘bad’ microorganisms work together could lead to development of a drug to disrupt the connection. The research needs to be repeated in more populations, with greater numbers of people to better understand the role of bacteria and fungi in Crohn’s disease.

Welch, A. “New Research Offers Clues to Cause of Crohn’s Disease.” CBS News, September 28, 2016
http://www.cbsnews.com/news/new-research-offers-clues-to-cause-of-crohns-disease

 

GENERAL HEALTH & MEDICINE

The Power of Support Groups

Holding handsIn contemporary society, the need for social connection is paramount. For patients especially, Dr. Dean Ornish, founder of the Preventive Medicine Research Institute and clinical professor of medicine at the University of California, San Francisco, claims that support groups can be an excellent outlet to safely and intimately communicate frustrations and triumphs, and even ask questions regarding a disease state during treatment. Most importantly, support groups diminish feelings of loneliness, depression, and isolation, ultimately eliminating some of the stress that accompanies sickness.

In an interview with Medscape, Dr. Ornish also talked about the significant mental and physical health benefits found in receiving care and affection. Most physicians agree, affection contributes to overcoming heart disease, depression, addictive behaviors, and chronic diseases. With a shift in the mindset of some physicians to “repair” the patient as efficiently as possible, the emphasis on the physician-patient connection has suffered. A preventive medicine specialist concurs, claiming that “the magic touch of a [doctor] with a holistic approach yields better outcomes than treating patients as business clients with a quick fix approach.” Furthermore, some doctors who emphasize human connection during consults claim that their patients are more likely to follow medical advice when they feel that the physician truly cares about the patient’s health outcomes.

Cohen, Brandon. “Love is a Much-Debated Thing.” Medscape. 6/9/2016.
http://www.medscape.com/viewarticle/864301.  (You must register for a free Medscape.com account before viewing full article)

 

 


 

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