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Health Care Tips Health Care News livemedinfo-News: September 2008

Wednesday, September 24, 2008

Study Provides Clues about How Cancer Cells Develop Resistance to Chemotherapy Drug

Researchers have shown that increased expression of a gene called SIRT1 in cancer cells plays a significant role in the development of resistance to the chemotherapy drug cisplatin. The SIRT1 gene, which regulates several important cellular processes including nutrient use and metabolism, appears to contribute to the development of cisplatin resistance by reducing the uptake and use of glucose by cells and by altering the function of their mitochondria, which are cellular structures that produce most of the energy in cells. These findings, by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), and colleagues, were published in the Sept. 15, 2008, issue of Molecular Cancer Research.

Cisplatin, a chemotherapy drug that contains the metallic element platinum, is widely used in the treatment of many types of cancer, including bladder, lung, ovarian, and testicular cancer. It slows or stops the growth of cancer cells by binding to DNA. Tumors that recur after an initially positive response to treatment with cisplatin are frequently resistant to it, meaning the drug is no longer effective. Knowing more about how cells become resistant to cisplatin will enable researchers to devise strategies to circumvent resistance and increase the effectiveness of this important anticancer drug.

To investigate mechanisms that contribute to cisplatin resistance in cancer cells, the researchers generated cells that were resistant to the drug by exposing them to cisplatin in the laboratory. They found that expression of the SIRT1 gene increased three to five fold as the levels of cisplatin were increased, producing increasing levels of resistance in the cells. On the other hand, the researchers found that cisplatin-resistant cancer cells became more sensitive to the drug when the level of SIRT1 expression was reduced. By decreasing the levels of SIRT1 expression three to five fold, the cancer cells became approximately two fold more sensitive to cisplatin. "It appears that SIRT1 contributes to 50 percent of the cellular resistance to cisplatin, but it does not account for all of the resistance," said Michael Gottesman, M.D., of NCI's Center for Cancer Research, and an author of the study.

Many factors contribute to cisplatin resistance and may include mechanisms that limit cellular uptake of the drug, altered mechanisms that allow cells to repair damage to their DNA, and mechanisms that help cells survive. "This study is part of a larger effort by scientists to determine important cellular changes that cause cancer cells to become resistant to chemotherapy drugs," said Gottesman. "Different types of genetic mutations can occur during the development of cellular resistance to anticancer drugs. Therefore, the first step is to elucidate the genes that contribute to this resistance in tumors."

Previous research by this team and others has shown that cisplatin-resistant cells grow more slowly and demonstrate reduced uptake of certain substances, including nutrients such as glucose, than cells that are sensitive to the drug. It was also known that, as a survival strategy, tumors alter their metabolism when nutrients are scarce. In this study, the researchers found that cancer cells increased their expression of SIRT1 and became more resistant to cisplatin treatment as the level of glucose in their environment was reduced. They also found that the uptake of glucose in resistant cells was four to five fold less than in cells that were sensitive to cisplatin. Oxygen consumption, an indicator of glucose use and energy production, decreased by 30 percent to 60 percent compared to cisplatin-sensitive cells.

Because mitochondria use glucose and oxygen to produce energy, the team investigated the function of mitochondria in cisplatin-resistant cells. They found that, as cellular resistance to cisplatin increased, the potential of mitochondria to produce energy decreased, indicating that the metabolic role of mitochondria in resistant cells is different from that in cells that are sensitive to the drug. The researchers also found that the mitochondria of resistant cells were smaller and that the internal structures were irregular compared to the mitochondria of cells that were sensitive to the drug.

Gottesman and colleagues are developing molecular tools to define the drug-resistance genes that are expressed in individual cancers, and, in the future, hope to use this information to predict a patient's response to therapy and to design new ways to circumvent resistance.

In addition to NCI, researchers from the National Heart, Lung, and Blood Institute, part of the NIH; the U.S. Food and Drug Administration; and the National Center of Nanoscience and Technology, Beijing, People's Republic of China, participated in the study.

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Study Provides Clues about How Cancer Cells Develop Resistance to Chemotherapy Drug

Researchers have shown that increased expression of a gene called SIRT1 in cancer cells plays a significant role in the development of resistance to the chemotherapy drug cisplatin. The SIRT1 gene, which regulates several important cellular processes including nutrient use and metabolism, appears to contribute to the development of cisplatin resistance by reducing the uptake and use of glucose by cells and by altering the function of their mitochondria, which are cellular structures that produce most of the energy in cells. These findings, by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), and colleagues, were published in the Sept. 15, 2008, issue of Molecular Cancer Research.

Cisplatin, a chemotherapy drug that contains the metallic element platinum, is widely used in the treatment of many types of cancer, including bladder, lung, ovarian, and testicular cancer. It slows or stops the growth of cancer cells by binding to DNA. Tumors that recur after an initially positive response to treatment with cisplatin are frequently resistant to it, meaning the drug is no longer effective. Knowing more about how cells become resistant to cisplatin will enable researchers to devise strategies to circumvent resistance and increase the effectiveness of this important anticancer drug.

To investigate mechanisms that contribute to cisplatin resistance in cancer cells, the researchers generated cells that were resistant to the drug by exposing them to cisplatin in the laboratory. They found that expression of the SIRT1 gene increased three to five fold as the levels of cisplatin were increased, producing increasing levels of resistance in the cells. On the other hand, the researchers found that cisplatin-resistant cancer cells became more sensitive to the drug when the level of SIRT1 expression was reduced. By decreasing the levels of SIRT1 expression three to five fold, the cancer cells became approximately two fold more sensitive to cisplatin. "It appears that SIRT1 contributes to 50 percent of the cellular resistance to cisplatin, but it does not account for all of the resistance," said Michael Gottesman, M.D., of NCI's Center for Cancer Research, and an author of the study.

Many factors contribute to cisplatin resistance and may include mechanisms that limit cellular uptake of the drug, altered mechanisms that allow cells to repair damage to their DNA, and mechanisms that help cells survive. "This study is part of a larger effort by scientists to determine important cellular changes that cause cancer cells to become resistant to chemotherapy drugs," said Gottesman. "Different types of genetic mutations can occur during the development of cellular resistance to anticancer drugs. Therefore, the first step is to elucidate the genes that contribute to this resistance in tumors."

Previous research by this team and others has shown that cisplatin-resistant cells grow more slowly and demonstrate reduced uptake of certain substances, including nutrients such as glucose, than cells that are sensitive to the drug. It was also known that, as a survival strategy, tumors alter their metabolism when nutrients are scarce. In this study, the researchers found that cancer cells increased their expression of SIRT1 and became more resistant to cisplatin treatment as the level of glucose in their environment was reduced. They also found that the uptake of glucose in resistant cells was four to five fold less than in cells that were sensitive to cisplatin. Oxygen consumption, an indicator of glucose use and energy production, decreased by 30 percent to 60 percent compared to cisplatin-sensitive cells.

Because mitochondria use glucose and oxygen to produce energy, the team investigated the function of mitochondria in cisplatin-resistant cells. They found that, as cellular resistance to cisplatin increased, the potential of mitochondria to produce energy decreased, indicating that the metabolic role of mitochondria in resistant cells is different from that in cells that are sensitive to the drug. The researchers also found that the mitochondria of resistant cells were smaller and that the internal structures were irregular compared to the mitochondria of cells that were sensitive to the drug.

Gottesman and colleagues are developing molecular tools to define the drug-resistance genes that are expressed in individual cancers, and, in the future, hope to use this information to predict a patient's response to therapy and to design new ways to circumvent resistance.

In addition to NCI, researchers from the National Heart, Lung, and Blood Institute, part of the NIH; the U.S. Food and Drug Administration; and the National Center of Nanoscience and Technology, Beijing, People's Republic of China, participated in the study.

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Study Provides Clues about How Cancer Cells Develop Resistance to Chemotherapy Drug

Researchers have shown that increased expression of a gene called SIRT1 in cancer cells plays a significant role in the development of resistance to the chemotherapy drug cisplatin. The SIRT1 gene, which regulates several important cellular processes including nutrient use and metabolism, appears to contribute to the development of cisplatin resistance by reducing the uptake and use of glucose by cells and by altering the function of their mitochondria, which are cellular structures that produce most of the energy in cells. These findings, by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), and colleagues, were published in the Sept. 15, 2008, issue of Molecular Cancer Research.

Cisplatin, a chemotherapy drug that contains the metallic element platinum, is widely used in the treatment of many types of cancer, including bladder, lung, ovarian, and testicular cancer. It slows or stops the growth of cancer cells by binding to DNA. Tumors that recur after an initially positive response to treatment with cisplatin are frequently resistant to it, meaning the drug is no longer effective. Knowing more about how cells become resistant to cisplatin will enable researchers to devise strategies to circumvent resistance and increase the effectiveness of this important anticancer drug.

To investigate mechanisms that contribute to cisplatin resistance in cancer cells, the researchers generated cells that were resistant to the drug by exposing them to cisplatin in the laboratory. They found that expression of the SIRT1 gene increased three to five fold as the levels of cisplatin were increased, producing increasing levels of resistance in the cells. On the other hand, the researchers found that cisplatin-resistant cancer cells became more sensitive to the drug when the level of SIRT1 expression was reduced. By decreasing the levels of SIRT1 expression three to five fold, the cancer cells became approximately two fold more sensitive to cisplatin. "It appears that SIRT1 contributes to 50 percent of the cellular resistance to cisplatin, but it does not account for all of the resistance," said Michael Gottesman, M.D., of NCI's Center for Cancer Research, and an author of the study.

Many factors contribute to cisplatin resistance and may include mechanisms that limit cellular uptake of the drug, altered mechanisms that allow cells to repair damage to their DNA, and mechanisms that help cells survive. "This study is part of a larger effort by scientists to determine important cellular changes that cause cancer cells to become resistant to chemotherapy drugs," said Gottesman. "Different types of genetic mutations can occur during the development of cellular resistance to anticancer drugs. Therefore, the first step is to elucidate the genes that contribute to this resistance in tumors."

Previous research by this team and others has shown that cisplatin-resistant cells grow more slowly and demonstrate reduced uptake of certain substances, including nutrients such as glucose, than cells that are sensitive to the drug. It was also known that, as a survival strategy, tumors alter their metabolism when nutrients are scarce. In this study, the researchers found that cancer cells increased their expression of SIRT1 and became more resistant to cisplatin treatment as the level of glucose in their environment was reduced. They also found that the uptake of glucose in resistant cells was four to five fold less than in cells that were sensitive to cisplatin. Oxygen consumption, an indicator of glucose use and energy production, decreased by 30 percent to 60 percent compared to cisplatin-sensitive cells.

Because mitochondria use glucose and oxygen to produce energy, the team investigated the function of mitochondria in cisplatin-resistant cells. They found that, as cellular resistance to cisplatin increased, the potential of mitochondria to produce energy decreased, indicating that the metabolic role of mitochondria in resistant cells is different from that in cells that are sensitive to the drug. The researchers also found that the mitochondria of resistant cells were smaller and that the internal structures were irregular compared to the mitochondria of cells that were sensitive to the drug.

Gottesman and colleagues are developing molecular tools to define the drug-resistance genes that are expressed in individual cancers, and, in the future, hope to use this information to predict a patient's response to therapy and to design new ways to circumvent resistance.

In addition to NCI, researchers from the National Heart, Lung, and Blood Institute, part of the NIH; the U.S. Food and Drug Administration; and the National Center of Nanoscience and Technology, Beijing, People's Republic of China, participated in the study.

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Monday, September 15, 2008

Patients endorse Home Oxygen Service

95% of patients in England and Wales are happy with the service they receive from the Home Oxygen Service, the Department of Health announced today.

The first annual National Patient Satisfaction Survey of the Home Oxygen Service, published today, was commissioned jointly by the Department of Health and oxygen suppliers and is an important measure of the quality of care patients receive to show satisfaction with the service.

The Home Oxygen Service supplies oxygen delivered directly to the home of over 90,000 patients in England and Wales who suffer a range of conditions including Chronic Obstructive Pulmonary Disease, lung cancer and supporting the discharge of premature babies. It provides equipment and oxygen as well as education and training and 24/7 support for patients.

The survey results show:,

* 88% of patients believe that their quality of life has improved since receiving the service;

* 75% of patients say they speak highly about the service; and

* The helpline provided by oxygen suppliers is the greatest factor in driving patient satisfaction

Commenting on the results Health Minister Ben Bradshaw said:

"The Home Oxygen Service plays an important role in improving quality of life for thousands of patients with a wide range of conditions. I am very pleased to see such high levels of patient satisfaction and we will use this data to continue to improve the service patients receive."

The National Patient Satisfaction Survey is the first measure of patient satisfaction since the service was modernised in February 2006. The new integrated service means that all patients' needs are met by one supplier in each area to provide better support at home. It also offers greater access to the latest equipment and expert knowledge of latest oxygen technologies.

Patients who have been receiving the oxygen since before February 2006 also have similar or higher levels of satisfaction than newer patients, reflecting the success of the new service.

The Department of Health will continue to work together with oxygen suppliers to improve satisfaction with regards to the convenience of oxygen deliveries and confidence that oxygen will be delivered on time.

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Tuesday, September 9, 2008

Federal Report Looks at Risks from Plastics Chemical

The US National Toxicology Program (NTP) recently released its final report on the potential negative health effects of bisphenol A (BPA), a chemical widely used in consumer plastic products. The agency found that there is "some concern" about the chemical's effects on infants and children. They had lower levels of concern for other groups and concluded more research is needed to determine just what the risks of BPA exposure might be.

Their conclusion echoes that of the US Food and Drug Administration (FDA). The FDA issued a draft report last month saying that there is not enough evidence to ban BPA. A public hearing is planned for later this month to discuss results from their review.

Concern about the chemical, which may be linked possible reproductive and developmental problems, has been growing. In April 2008, Canada became the first country to ban baby bottles containing bisphenol A. And water bottle manufacturer Nalgene decided to phase out use of BPA in its containers in response to public concern.

The NTP report focuses primarily on the possible reproductive and developmental effects of BPA (such as changes in fertility, birth weight, and the development of certain brain regions), not on cancer. However it does note that in some animal studies, BPA has shown effects on breast and prostate tissue, as well as on how early puberty occurs. These effects could be linked to cancer, the report says, but the authors caution that there is not enough evidence to know whether BPA actually causes cancer -- in animals or in people.

The health effects of BPA are being studied because so many people are exposed to it on a daily basis. The chemical is widely used in plastic water and baby bottles, food packaging, compact discs, and other consumer products; plastics made with BPA usually have the number 7 on the bottom. One survey conducted by the US Centers for Disease Control and Prevention detected BPA in the urine of 93% of people age 6 years and older.

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