News

In 2019, UBC researchers reported that utilising an oral immunotherapy treatment, pre-schoolers may safely overcome peanut allergies. They now have evidence that the earlier pre-schoolers start therapy, the better.

The study’s findings were published in the ‘Journal of Allergy and Clinical Immunology.’ In Practice focuses on infants under the age of 12 months and finds that not only is oral immunotherapy helpful against peanut allergies, but it is also safer for this age group than it is for toddlers and older preschoolers.

“This treatment is affordable, very safe and highly effective, particularly if we can get the treatment going before the infant is 12 months old,” said Dr Edmond Chan, the study’s senior author who is also a clinical professor and head of allergy and immunology in UBC’s department of paediatrics at the BC Children’s Hospital Research Institute.

The study focused on the outcomes of 69 newborns among a broader study sample of 452 children aged five and under.

Oral immunotherapy is a therapeutic regimen in which a patient takes tiny amounts of the allergic food—in this example, peanut flour—with the dose progressively increasing to a maximum quantity established. The goal is to desensitise the youngster to the point when they can consume a complete meal of peanut protein without experiencing a hazardous response. To maintain their immunity, the youngster must consume peanut products on a regular basis.

Children in this research attended a paediatric allergist in a community or hospital clinic every two weeks to obtain their peanut dosage. Between clinic sessions, parents administered the same daily dose at home. After eight to eleven clinic visits, the children had reached a “maintenance dosage” of 300 milligrammes of peanut protein, or around 1.3 grammes of peanuts.

Clinicians documented any signs or reactions and counselled parents on how to handle them at home. The build-up period and one year of maintenance dosage were completed by 42 babies. At the end of the programme, none of them had more than a minor response to a 4,000-gram dosage of peanut protein, compared to 7.7 percent of the children aged one to five who finished it.

Also Read: IMA writes to Maharashtra’s health minister over ‘impractical’ changes to nursing home registration standards

Along the way, seven babies died. Four others had more severe responses, but none required epinephrine injections. Another 20 people were not tested for peanut allergy towards the end, either by choice or due to extensive wait lists.

Even before beginning the treatment, infants were shown to be at less risk than toddlers and pre-schoolers. In initial testing, only 33.9 per cent of infants had a reaction beyond mild, in comparison to 53.7 per cent of one-to-five-year-olds.

“Despite infants showing the best safety, we were still very satisfied with the safety of this treatment for older pre-schoolers. The risk of a severe reaction is much lower than it is for school-age kids,” Dr Chan noted.

“Many of the interventions we use in medicine, such as medications or surgical procedures, carry a small amount of risk that is outweighed by the benefit. If this treatment is performed by well-trained allergists and clinicians then I’m really comfortable with the risk. It’s actually very safe.”

In terms of efficacy, the medication was equally beneficial for both age groups. After a year of eating one peanut per day, almost 80% of the youngsters had built a tolerance for 4,000 mg of peanut protein in one sitting—the equivalent of around 15 entire peanuts.

At about six months of age, the first step in attempting to avoid peanut allergies in at-risk children is to introduce them to age-appropriate peanut-containing foods such as peanut butter or peanut flour.

If the newborn develops a peanut allergy, Dr. Chan’s study implies that oral immunotherapy may be a viable option to avoiding allergens for the rest of one’s life. Attempting to avoid allergies entirely entails a number of dangers, including decreased quality of life, social isolation, and anxiety.

Follow Medically Speaking on Instagram

In a big multinational research, 31.4 percent of teenagers in 13 European and Asian nations reported feeling unsafe at school.

The findings, which were published in Frontiers in Psychiatry, highlighted disparities in ensuring a safe educational environment for pupils in different nations. Between 2011 and 2017, 21,688 teenagers aged 13 to 15 from 13 countries completed self-administered questionnaires. Finland, Norway, Lithuania, Greece, India, Indonesia, Iran, Israel, Japan, China, Singapore, Vietnam, and Russia participated in the study.

The percentage of females who felt uncomfortable ranged from 11.5 percent in Finland to 69.8 percent in Japan, whereas the percentage of boys who felt dangerous ranged from 7.7 percent in Norway to 68.2 percent in Japan. The survey also discovered that there were significant differences across schools in several nations, demonstrating educational inequality within the country.

The aim is to foster favourable peer connections while also fostering healthy student-teacher relationships.

Kids who believed their instructors cared about them were more likely to feel comfortable at school, implying that teachers play a crucial role in creating students’ emotional sense of safety. According to our prior analysis, fair, clear, and consistent school policies are critical in ensuring school safety. When kids are bullied, they have a poorer sense of safety, which is reflected in their grades.

The findings revealed that feeling uncomfortable at school was linked to mental health issues that might last a lifetime. The findings emphasise the need of anti-bullying measures and mental health promotion in schools.

Preventive measures such as psychoeducation and social-emotional learning programmes should be included in the treatments to improve children’s good interactions and lessen behavioural difficulties. According to researcher Yuko Mori of the University of Turku’s Research Centre for Child Psychiatry, the findings revealed a clear need for initiatives to offer educational environments where all kids may feel safe, regardless of their background.

Doctor Andre Sourander, Professor in Child Psychiatry at the University of Turku agrees: “Physically, cognitively and emotionally safe school environment is essential for the development and educational success of children and young people. All children have the right to attend schools where they can feel safe and protected without fear or anxiety of any danger. In the wake of recent school shootings, we must take steps to enhance safety in educational settings and protect students from all forms of violence and abuse.

Transgender and non-binary kids, according to recent study, have a significantly greater risk of suicide ideation and attempts than their cisgender peers.

The research has been published in the journal, “Canadian Medical Association Journal” Suicide is the second leading cause of death in adolescents and young adults aged 15-24 years in Canada. Sexual minority youth — those attracted to the same gender or multiple genders or who identify as lesbian, gay, bisexual or queer — are also at increased risk of mental health issues, suicidal ideation (thoughts) and suicide attempts.

“The transition from adolescence to adulthood is a very stressful time for all young people, but particularly for gender and sexual minority teens. These findings, showing dramatic increases in suicide risk, should sound a clarion call that additional support is needed,” said Dr Ian Colman, a professor at the University of Ottawa and the Norwegian Institute of Public Health, Oslo, Norway, with coauthors.

Researchers used data from the national 2019 Canadian Health Survey on Children and Kids to enhance the knowledge base on the risk of suicide ideation and attempts among transgender and nonbinary youth. The study included 6800 teenagers aged 15 to 17, the majority of whom (99.4%) were cisgender (meaning they identify with the gender assigned at birth) and 0.6 percent were transgender (meaning they identify with a gender not assigned at birth). The majority of respondents (78.6%) were heterosexual, with 14.7 percent attracted to several genders, 4.3 percent undecided, 1.6 percent of girls attracted to females, and 0.8 percent of boys attracted to boys.

Overall, 14% of teens experienced suicidal ideation within the previous year, and 6.8% had previously attempted suicide. Transgender youth were 5 times more likely to think about suicide and 7.6 times more likely to have ever attempted suicide than cisgender youth.

“A really concerning finding is that more than half of all transgender youth reported seriously considering suicide in the previous 12 months. This is a crisis, and it shows just how much more needs to be done to support transgender young people,” says coauthor Fae Johnstone, executive director, Wisdom2Action, who is a trans woman herself.

The researchers also discovered that the percentage of teenagers who expressed some level of attraction to more than one gender was significantly greater than in prior studies. This might be due to the fact that this poll looked at attraction to other genders rather than self-reported sexual identity, or it could be due to a decrease in the stigma associated with bisexuality. This group was also more than twice as likely to have considered suicide.

Overall, 4.3 percent of teenagers said they were unsure about their sexual desire, which is referred to as “questioning.”

“Given that the exploration of romantic and sexual relationships is a major developmental task of adolescence, it is perhaps unsurprising that many begin to question sexual attraction and orientation during this time,” says lead author Dr Mila Kingsbury, University of Ottawa.

The association between suicidality and being a sexual or gender minority was partially explained by bullying or cyberbullying experienced by those teens.

The study’s findings are similar to those from the only other nationally representative study on the topic, which reported a fivefold increased risk of suicide attempts among transgender adolescents in New Zealand.

“Suicide prevention programs specifically targeted to transgender, nonbinary and sexual minority adolescents, as well as gender-affirming care for transgender adolescents, may help reduce the burden of suicidality among this group.

Given that these associations were partially mediated through the experience of bullying, systemic change in the form of primary prevention programs aimed at public awareness and promoting inclusivity may lead to a reduction of the experience of minority stress among sexual minority and transgender youth, reducing their risk of poor mental health and suicidality,” said Johnstone.

Virus infections during pregnancy have an effect on the mother’s brain and postpartum care behavior, according to a recent study from the Medical University of Vienna.

The researchers’ findings were reported in the journal Molecular Psychiatry. There is plenty of evidence from mice research that viral infections during pregnancy can impact the developing brain of the young in utero (in the womb), with long-term effects on brain function and behavior.

For the first time, a preclinical investigation has showed that a viral-like immune activation during pregnancy impacts the maternal brain and impairs mother care behavior after delivery. These findings were published by a study team led by behavioral biologist Daniela D. Pollak of MedUni Vienna’s Center for Physiology and Pharmacology, in collaboration with colleagues from MedUni Vienna’s Center for Brain Research and Columbia University (USA).

Evaluation of Dams’ maternal care behavior

The researchers utilized a chemical substance that triggers the same receptor pathways as viruses to stimulate the immune system of the mother during pregnancy in a way that mimicked the normal course of a viral infection in this preclinical trial. Following the birth of the young, the dams’ maternal care behavior was evaluated.

“Dams who had experienced a viral-like immune activation were less caring towards their young than animals in the control group,” said Daniela D. Pollak, describing the results. “The naturally strong drive to take care of one’s own offspring and to keep them safe from harm was much less pronounced corresponding to a significant decline in attachment behavior.”

Also Read: Rising symptoms of depression in pregnant women linked to kids’ behavioral issues: Study

Not only did the researchers see changes in the dams’ behavior, but they also discovered structural, chemical, and functional alterations in their brains, as well as some of the underlying causes.

Even while the findings from animal models cannot be directly applied to people, the research team believes they show that viral infections during pregnancy can alter mothers’ behavior toward their kids.

“Women who have had systemic viral illnesses during pregnancy may be at increased risk of impaired mother-infant bonding,” Pollak explained.

The researcher hopes that this will raise awareness so that women with a history of infection during pregnancy may be more prompted to seek medical or psychotherapeutic treatment if they experience indications of impaired bonding after birth, which may affect the well-being of the mother and child.

Follow Medically Speaking on Instagram

According to a new study, youngsters who consume fruits and vegetables have less inattention.

The research findings were published in the journal ‘Nutritional Neuroscience.’ Researchers invited parents of 134 children with ADHD symptoms to fill out a thorough questionnaire on the typical foods their children ate during a 90-day period as part of a larger study.

Another survey asked parents to rank their children’s symptoms of inattention, a characteristic of ADHD, such as difficulties remaining focused, not following directions, forgetting things, and controlling emotions.

According to Irene Hatsu, co-author of the study and associate professor of human nutrition at The Ohio State University, youngsters who ate more fruits and vegetables had fewer severe signs of inattention.

“Eating a healthy diet, including fruits and vegetables, maybe one way to reduce some of the symptoms of ADHD,” Hatsu said.

The data for this study came from the Micronutrients for ADHD in Youth (MADDY) Study, which looked at the effectiveness of a 36-ingredient vitamin and mineral supplement in treating symptoms of ADHD and poor emotional regulation in 134 children aged 6 to 12.

Children who took the micronutrients were three times more likely to exhibit substantial improvement in their ADHD and emotional dysregulation symptoms than those who took a placebo, according to the research that tested the supplement’s efficacy. The results of the study were published in the Journal of the American Academy of Child and Adolescent Psychiatry last year.

Another study of the same children, published earlier this year in the journal Nutrients, found that children from families with higher levels of food insecurity were more likely than others to exhibit severe emotional dysregulation symptoms like chronic irritability, angry moods, and outbursts of anger.

The three studies all paint a similar picture, Hatsu said: A healthy diet that provides all the nutrients that children require can help reduce the symptoms of ADHD in children.

“What clinicians usually do when kids with ADHD start having more severe symptoms is increase the dose of their treatment medication, if they are on one, or put them on medication,” Hatsu said.

“Our studies suggest that it is worthwhile to check the children’s access to food as well as the quality of their diet to see if it may be contributing to their symptom severity,” he added.

Children in the MADDY study, all of whom met the criteria for ADHD, were recruited from three sites: Columbus, Ohio; Portland, Oregon; and Lethbridge, Alberta, Canada. The study took place between 2018 and 2020. Participants were either not taking medication or stopped using it two weeks before the study began.

The studies on fruit and vegetable intake and the role of food insecurity were based on data collected when the children were first enrolled in the study before they began taking the micronutrient supplement or placebo.

Why may diet be so important in ADHD?

Researchers believe that ADHD is related to low levels of some neurotransmitters in the brain — and vitamins and minerals play a key role as cofactors in helping the body make those important neurochemicals and in overall brain function, Hatsu said.

Food insecurity may play an additional role.

“Everyone tends to get irritated when they’re hungry and kids with ADHD are no exception. If they’re not getting enough food, it could make their symptoms worse,” she said.

Additionally, the worry of parents who are concerned about not being able to provide their children enough food can lead to family friction, which can exacerbate ADHD symptoms in children.

According to Hatsu, the MADDY research is one of the first to investigate the link between ADHD symptoms and food quality in children in the United States and Canada.

This is significant since Western diets, unlike many others, such as the Mediterranean diet, are more likely to be deficient in fruit and vegetable consumption, according to her.

Also Read: Smoking during pregnancy may not promote ADHD in children, study suggests

“We believe clinicians should assess the food security status of children with ADHD before creating or changing a treatment program,” Hatsu said.

“Some symptoms might be more manageable by helping families become more food secure and able to provide a healthier diet.”

Follow Medically Speaking on Instagram

Swallowing pills or tablets is challenging for most kids and even some adults. To make it simpler to provide such medications, MIT and Brigham and Women’s Hospital researchers developed a drug-delivery gel that is considerably easier to swallow and may be used to administer a range of therapies.

The gels, which are created from plant-based oils like sesame oil, come in a range of textures, ranging from a thickened liquid to a yogurt-like consistency. The gels are stable without refrigeration, which might make them more accessible to children in impoverished countries, but the researchers believe they could benefit children everywhere. Adults who have trouble swallowing medicines, such as the elderly or those who have had a stroke, may benefit from them.

“This platform will change our capacity for what we can do for kids, and also for adults who have difficulty receiving medication. Given the simplicity of the system and its low cost, it could have a tremendous impact on making it easier for patients to take medications,” says Giovanni Traverso, the Karl van Tassel Career Development Assistant Professor of Mechanical Engineering at MIT, a gastroenterologist at Brigham and Women’s Hospital, and the senior author of the study.

In animal trials, Traverso and his colleagues demonstrated that the gels could deliver numerous types of drugs for the treatment of infectious illness in the same amounts as pills or tablets. The research team is currently preparing to launch a clinical trial in the coming months.

The study’s principal authors include former MIT postdoc Ameya Kirtane, who is now an instructor at Brigham and Women’s Hospital, MIT postdoc Christina Karavasili, and former technical associate Aniket Wahane.

Easy to swallow

Nearly 10 years ago, while working on other kinds of ingestible drug-delivery systems, the research team started to think about new ways to make it easier for children to take medications that are normally given as pills. There are existing strategies that can help with this, but none is a perfect solution. Some antibiotics and other drugs can be suspended in water, but that requires clean water to be available, and the drugs need to be refrigerated after being mixed. Also, this strategy doesn’t work for drugs that are not soluble in water.

With drugs that are only available as pills, health care providers may try to dissolve them in water for children to drink, but that also requires a clean water supply, and the dosages may be difficult to get right if the pills are meant for adults.

To try to address those issues, the researchers set out to develop a new drug-delivery system that would be inexpensive, palatable, stable at extreme temperatures, and compatible with many different drugs. They also wanted to make sure that drugs would not need to be mixed with water before dosing, and that the system could be delivered either orally or as a suppository.

Because they wanted their formulation to work with drugs that can’t be dissolved in water, the researchers decided to focus on oil-based gels. Such gels, also known as oleogels, are commonly used in the food industry to change the texture of oily foods, and also to raise the melting point of chocolate and ice cream.

“That approach gave us the capacity to deliver very hydrophobic drugs that cannot be delivered through water-based systems,” Kirtane says. “It also allowed us to make these formulations with a really wide range of textures.”

The researchers explored several types of plant-derived oils, including sesame oil, cottonseed oil, and flaxseed oil. They combined the oils with edible gelling agents such as beeswax and rice bran wax, and found that they could achieve different textures depending on the concentration and type of oil and gelling agent. Some gels end up with a texture similar to that of a thick beverage, like a protein shake, while others are more like yogurt or pudding.

To identify the gels that were the most palatable, the researchers worked with Sensory Spectrum, a consulting firm that specializes in consumer sensory experiences. Working with the company’s panels of professionally trained tasters, the researchers found that the most appealing gels included those made from oils that had a neutral flavor (such as cottonseed oil) or a slightly nutty flavor (like sesame oil).

Delivering many drugs

The researchers chose to test their gels with three water-insoluble drugs drawn from the World Health Organization’s list of essential medicines for children: praziquantel, used to treat parasitic infections; lumefantrine, used to treat malaria; and azithromycin, used to treat bacterial infections.

“Based on that list, infectious diseases really stood out in terms of what a country needs to protect its children,” Kirtane says. “A lot of the work that we did in this study was focused on infectious disease medications, but from a formulation standpoint, it doesn’t matter what drug we put into these systems.”

For each of those drugs, the researchers found that oleogels were able to deliver doses equal to or higher than the amounts that can be absorbed from tablets, in tests in animals. The researchers also showed that a water-soluble drug, an antibiotic called moxifloxacin hydrochloride, could be successfully delivered by an oleogel.

To make it possible to use these formulations in areas that may not have refrigeration available, the researchers designed them so that they can be stable at 40 degrees Celsius (104 degrees Fahrenheit) for several weeks, and even up to 60 C (140 F) for one week. Such high temperatures are uncommon but could be reached when drugs are being transported by trucks without refrigeration.

Source: Massachusetts Institute of Technology