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[메디컬투데이=이승재 기자] Research has shown that repeated infections increase the risk of dementia.

Cognitive decline is normally observed during the aging process. Similarly, pathological aging processes are associated with cognitive impairments such as Alzheimer’s disease.

According to previous studies, inflammation caused by bacterial infection accelerates brain aging, which can lead to cognitive impairment. In particular, studies have shown that LPS, a toxin present in the outer membrane of bacteria, plays a key role in reducing cognitive function caused by inflammation.

However, since these studies investigated cognitive functions in laboratory animals exposed to LPS for a short period of time, it is difficult to know the changes in cognitive abilities that occur when repeatedly exposed to LPS for a long period of time.

The research team administered progressively higher doses of LPS to mice five times over 75 days and observed changes in their cognitive abilities. As a result of the study, mice given LPS showed difficulty in learning and maintaining memory.

As a result of a brain biopsy, mice that received LPS showed changes in the hippocampus, an area in the brain responsible for memory and learning. The hippocampus is the area where the earliest degenerative changes appear in Alzheimer’s disease.

As a result of further research, when LPS was administered, the expression level of interleukin-6, an inflammatory substance, increased in the hippocampus and the extent of organ enhancement decreased. Long-term potentiation (LTP) refers to the fact that one neuron is activated more frequently than another and synapses between neurons are strengthened, which is the basis for memory and learning. This decrease in the extent of organ enhancement indicates that cognitive impairment is caused by inflammation.

The researchers concluded that repeated infection reduces cognitive abilities, which increases the risk of dementia.

Reporter Lee Seung-jae of Medical Today (ecctomas@mdtoday.co.kr)

[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]

[메디컬투데이=한지혁 기자] A study has been published that multiple sclerosis can be caused by toxins in the gut microbes.

A study published in The Journal of Clinical Investigation found that toxins produced by gut bacteria can cause multiple sclerosis.

Multiple sclerosis is a chronic autoimmune disease that affects the central nervous system. According to statistics, about 2.8 million people worldwide have been diagnosed with multiple sclerosis, and the number is increasing.

In multiple sclerosis, a patient’s immune system attacks the myelin covering nerve fibers, which can cause symptoms such as muscle weakness, cramps, tingling and burning sensations, urinary problems, vision problems, fatigue, and dizziness.

‘Relapsing-remitting multiple sclerosis’, the most common form of multiple sclerosis, accounts for 85% of all cases and is characterized by repeated increases and decreases in symptoms. Although the exact cause is still unknown, many experts speculate that genetic and environmental factors may contribute to the development of the disease.

In this study, the researchers found that epsilon toxin produced by bacteria living in the small intestine can lead to the development of multiple sclerosis and cause persistent symptoms.

The gut microbiome consists of trillions of microorganisms living in the digestive tract, most of which are bacteria, but viruses, fungi, and protozoa also exist. These gut microbes are generally essential for maintaining health, but losing the proper balance can lead to a variety of problems, some leading to autoimmune diseases.

Changes in the gut microbiome are common in patients with multiple sclerosis. The research team found that there is a high probability that a bacterium called ‘Clostridium perfringens’ is present in the intestines of patients with multiple sclerosis.

C. perfringen produces epsilon toxin, which helps inflammatory cells access the central nervous system through blood vessels in the brain.

After taking fecal samples from multiple sclerosis patients and normal participants, they analyzed them through polymerase chain reaction (PCR) to identify the ‘ETX’ gene that produces epsilen toxin.

They found that the ETX gene was found in 61% of fecal samples from patients with multiple sclerosis, compared to only 13% of normal participants. Additionally, patients with multiple sclerosis were more likely to have C. perfringen predominate in their gut microbiome than age- and sex-matched healthy controls.

Next, the researchers conducted an experiment in a mouse model to investigate whether injection of epsilon toxin caused symptoms of multiple sclerosis.

Mice injected with ETX exhibited central nervous system demyelination similar to that seen in patients with multiple sclerosis. In particular, lesions in the cerebellum, a commonly affected area in multiple sclerosis, were prominent.

C. perfringen is known to produce epsilon toxin only during periods of rapid growth. The researchers explained the change in symptoms of relapsing-remitting multiple sclerosis by the fact that symptoms do not occur when the bacteria do not produce epsilon toxin.

They said that developing therapies that target these mechanisms would be the next step in their research, which would previously require clinical trials in humans.

Medical Today Reporter Han Ji-hyeok (hanjh3438@mdtoday.co.kr)

[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]

​​[메디컬투데이=정현민 기자] Human papillomavirus (HPV) is a virus that causes disease by infecting through the skin or subcutaneously, and there are more than 120 types. The problem is that the possibility of infection in high-risk groups such as condyloma (genital warts) and cervical cancer cannot be ruled out.

Genital warts are HPV contagious diseases that occur around the genitals and are characterized by the appearance of warts like millet around the genitals. If left untreated, the number will increase over time and the lesions will become wider. Above all, you need to be careful as the possibility of contagion is very high even with just one relationship.

Treatment is also not easy, but there are many cases of recurrence even after trying drug treatment, cryotherapy, and electrocautery. In fact, there are not a few cases where genital warts are chronically ill without treatment at the root.

Cervical cancer refers to a malignant tumor that appears in the cervix. Most of them are infected with HPV high-risk group, and they develop into invasive cervical cancer through dysplasia and cervical carcinoma in situ.

The problem is that the stage of cervical cancer takes place over a long period of 7 to 8 years. In addition, there are many unfortunate women who do not easily notice the onset of the disease because there are no special clinical features. In particular, it is known that it takes about 14 years to develop from carcinoma in situ to microinvasive carcinoma.

As the treatment process for genital warts is difficult and it is difficult to know the early onset of cervical cancer, it is desirable to make active preventive efforts. The cervical cancer vaccination vaccine helps strengthen immunity against HPV with Gardasil. In other words, the antibodies produced by the vaccine lower the possibility of persistent HPV infection.

Gardasil is divided into 2-ga, 4-ga, and 9-ga. Bivalent and quadrivalent means that it prevents 2 and 4 types of HPV infection, respectively. That is, the higher the number, the wider the range of prevention can be defined. The representative preventive method is the Gardasil 9-valent vaccine, which can be vaccinated by men and women aged 9 to 26 and 9 to 45, respectively. The number of vaccinations for Gardasil is divided into 2 and 3 times by age. The second dose can be administered 6 to 12 months after the first dose. For the 3 doses, additional doses are required 2 months after the first dose and 6 months after the first dose.

Goldman Urology Seoul Branch Director Ryu Je-man said, “In case of HPV, it is good to actively practice Gardasil vaccination regardless of gender because it can cause anal cancer, genital warts, and oral cancer in men.”

Reporter Jung Hyun-min of Medical Today (august@mdtoday.co.kr)

[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]

[메디컬투데이=최재백 기자] It has been argued that all newborns should be screened for MLD to prevent metachromatic leukodystrophy (MLD).

Children with inherited MLD, a rare genetic disease, show progressive decline in thinking, motor, and sensory abilities. Pediatric patients with MLD may lose the ability to walk, swallow, speak, hear, see, respond to stimuli, and most die before the age of five.

People with the faulty MLD gene are relatively common, with about 1 in 100 people. Fortunately, MLD is inherited in a recessive way, so the disease manifests only when the faulty gene is inherited from both parents.

The faulty MLD gene causes defects in the normal enzyme Arylsulfatase A (ARSA), which breaks down a fatty substance called sulfatide in the white matter of the brain and spinal cord. Sulfatide, which is decomposed at this time, is a key component of myelin sheath that protects and insulates nerve cells. However, in MLD children with a defect in the ARSA enzyme, excessive accumulation of sulfatide in the myelin sheath inhibits nerve activity and causes inflammation.

Experts explained that when the ARSA enzyme, which is key to brain function, fails to function properly, sulfatide continues to accumulate in the brain, and by the time MLD children reach the age of 2, they lose all abilities.

There are methods to treat MLD patients by transplanting healthy bone marrow or injecting normal ARSA enzymes, but they only delay the progression of the disease rather than cure it, and the injected enzymes are large protein molecules that do not penetrate the blood-brain barrier. .

Gene therapy, which was developed under the trade name Libmeldy (atidarsagene autotemcel) in the past few years, has achieved successful results in various clinical trials by providing normal genes that make normal enzymes.

While stem cells are collected from the patient’s blood and healthy genes are inserted into the cells using an engineered virus, chemotherapy removes the abnormal stem cells remaining in the patient’s bone marrow, and finally, ‘engineered stem cells’ into which the gene has been inserted. ‘ is re-injected into the blood circulation, the stem cells migrate to the bone marrow and differentiate into normal blood cells that produce enzymes that work properly.

According to an Italian research team in January 2022, good effects were seen in most of the children treated with Livmeldi in the early stages of MLD, and Livmeldi was approved by the National Institute for Health and Care Excellence (NIHCE) in March 2022.

The cost of Livmeldi treatment was £2.87 million per patient (approximately 4.5 billion won), which was the most expensive treatment in the world at the time (currently, another gene therapy approved in the United States is the most expensive treatment).

As for the reason for the high price of Liv Meldi, experts explained that it took 20 years to develop, and that only 7 to 8 children in the UK are eligible for the indication for Liv Meldi treatment each year. In other words, a significant number of pediatric patients with MLD are only diagnosed with MLD when their older siblings reach severe symptoms, and treatment after symptoms appear is too late to prevent progression of the disease.

Accordingly, researchers, medical staff, and families of pediatric patients with MLD have requested that all newborns be screened for MLD. In the UK, blood tests currently performed on all newborns screen for nine inherited diseases, including sickle cell disease and cystic fibrosis, but not MLD.

Experts have pointed out that not screening for a fatal disease that can be prevented if diagnosed early is abandoning a minority of pediatric patients.

Currently, biochemical methods that measure sulfatide or ARSA enzyme levels in a patient’s blood can be considered as an MLD screening test, but there are limitations in that there are many false positive results. Nonetheless, experts and medical staff are emphasizing the need for MLD screening in all newborns.

Medical Today Reporter Jaebaek Choi (jaebaekchoi@naver.com)

[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]

[메디컬투데이=이승재 기자] Phthalates, a plastic additive, increase the risk of diabetes in white women, a new study has found.

A study on the effects of phthalates on diabetes was published in the Journal of Clinical Endocrinology & Metabolism.

Plastic is pervasive throughout our lives. Microplastics are found in food packaging, cosmetics, clothes, and even the water we drink.

However, several studies have shown that plastic is harmful to health. One of the reasons is that phthalates, which are chemicals added to make plastics flexible, cause problems such as endocrine disruption, obesity, and allergies.

Phthalates in particular affect insulin among the hormones in our body. Insulin plays a key role in metabolic processes, including regulating blood sugar and making glucose available to cells. Previous studies have shown that elevated levels of phthalates in the body increase insulin resistance and increase the risk of developing type 2 diabetes.

Researchers at the University of Michigan studied the effects of phthalates on diabetes in 1,308 women over six years.

They first measured the concentrations of 12 phthalates in participants’ urine samples at the start of the study. Participants were followed and observed for 6 years.

At 6 years at the end of the study, 61 women (4.7%) developed diabetes. When their urine samples were compared with those of women without diabetes, women with diabetes had higher concentrations of 10 phthalates. In particular, there was a significant correlation between phthalate concentration and diabetes risk in Caucasians.

The researchers concluded that phthalates increased the risk of diabetes in white women.

Reporter Lee Seung-jae of Medical Today (ecctomas@mdtoday.co.kr)

[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]

[메디컬투데이=김영재 기자] A new diagnostic technique and treatment effect for the cerebrospinal fluid outflow tract that causes dementia was announced.

The results of a study showing that surgical treatment for cerebrospinal fluid leakage is effective in preventing dementia was published in the journal ‘Alzheimer’s & Dementia’.

When nerve cells in the frontal and temporal lobes of the brain are damaged, a type of early-onset dementia called frontotemporal dementia (FTD) can occur. FTD is relatively rare in the elderly compared to other types of dementia, but is the most common cause of dementia in people under the age of 60.

Some patients with FTD fall under ‘behavioral frontotemporal dementia (bvFTD)’, which involves gradual changes in behavior, personality, thinking, etc. do. On the other hand, memory problems characteristic of dementia in bvFTD occur at the end of the disease.

Cerebrospinal fluid provides buoyancy to the brain and acts as a shock absorber. When the cerebrospinal fluid leaks, the brain sags inside the skull, interfering with its normal functioning. Signs of cerebrospinal fluid leak include severe headache that improves when lying down and daytime sleepiness that does not improve even with sound sleep.

Magnetic resonance imaging (MRI) can reveal brain sagging relatively accurately, but it can often be mistaken for other disorders and does not always identify the cause of cerebrospinal fluid leakage. CT myelogram can pinpoint damage or cysts in the membrane surrounding the cerebrospinal fluid, but limitations exist because the cerebrospinal fluid may leak into a vein through an almost invisible fistula.

A more specialized CT scan called ‘digital subtractive myelogram (DSM)’ is needed to detect these leaks. The test identifies the outflow route of the cerebrospinal fluid through a technique of injecting a fluorescent substance into the cerebrospinal fluid and tracking the movement of the substance.

In this study, the researchers performed the DSM test on 21 patients with bvFTD who exhibited brain sagging.

They found cerebrospinal fluid-venous fistulas in a total of nine patients, and successfully reversed brain sagging and alleviated dementia symptoms in all nine patients through fistula closure surgery. They gave treatment to alleviate brain sagging to the remaining 12 patients, but only 3 of them showed symptom relief.

“More efforts are needed to improve the detection rate of cerebrospinal fluid leaks in these patients,” the researchers said.

Reporter Kim Young-jae of Medical Today (wannabefd21@mdtoday.co.kr)

[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]