Open medicine digest: COPD treatment, atrial remodeling, genomic cancer signatures, and more

Open medicine digest explores recent research published elsewhere across open access medicine. Here we take a look at the highlights from the past couple of weeks.

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Genomic signatures of cancer prognosis

Many gene expression signatures associated with cancer incidence and prognosis have been discovered, but most have not yet been translated into the clinic. In many cases, this is due to lack of reproducibility of such signatures in subsequent studies, owing to the genetic heterogeneity of cancer. Now, a study has shown that constructing gene expression signatures based on a new method – anti-profile analysis – can create reproducible predictors of cancer relapse and survival.

The anti-profile method is a novel approach to developing cancer genomic signatures that takes variability of gene expression into account, and has been shown to distinguish between tumor and noncancerous tissue. The authors applied this method to analyze gene expression datasets for lung cancer, breast cancer, colon cancer and adrenocortical tumor, finding that the anti-profile approach can generate reproducible genomic classifiers of tumor recurrence and patient survival.

Taken together with other studies, these results highlight that the anti-profile method can be used to develop prognostic signatures for various cancer types, which could be adopted in the clinic to help guide treatment decisions.

Dinalankara et al., Cancer Informatics

Is tacrolimus safe in SLE patients with renal involvement?

Renal complications can occur in patients with systemic lupus erythematosus (SLE), and kidney failure is one of the leading causes of death among people with lupus. Therefore, it is important to monitor kidney health during SLE treatment so that any problems can be identified promptly.

Now, an observational study has been conducted to assess whether the safety and efficacy of tacrolimus – an immunosuppressive drug used to treat SLE – is compromised in patients with SLE and renal complications. Analyzing data from 57 patients, the researchers showed that SLE disease activity scores and serum c3 levels improved with tacrolimus treatment, and the drug was associated with a reduction in proteinuria, indicating better kidney health.

Taken together, these observations suggest that tacrolimus is associated with beneficial effects in patients with SLE and renal complications, providing support for its use in this patient group.

Ishii et al., LUPUS Science & Medicine

Pregnancy, malaria and anemia

Flickr, Sam Ouandja
Pregnant woman at UNICEF
Flickr, Sam Ouandja

Both anemia and malaria are common in sub-Saharan Africa, particularly among pregnant women and young children. Furthermore, pregnancy-associated malaria (PAM) is a risk factor for maternal and infant malaria. Now, a study has been conducted in Benin to assess the impact of PAM on infant hemoglobin concentrations during the first few months of life.

400 infants were followed for one year after birth, and it was found that placental malaria and maternal parasite density at delivery are associated with infant hemoglobin levels. Infant malaria infection was also associated with lower hemoglobin levels, confirming the importance of antimalarial interventions delivered around the time of pregnancy to reduce infant anemia in sub-Saharan Africa.

Accrombessi et al., PLOS One

Is atrial remodeling linked to heart attack prognosis?

Left atrial (LA) volume is a strong predictor of prognosis following a heart attack, but little is known about the prognostic significance of changes in LA volume over time. In a subgroup analysis of a randomized clinical trial examining the cardioprotective effect of exenatide, researchers from Denmark assessed whether LA remodeling, defined as MRI-measured changes in LA volume or function over 3 months, is related to prognosis after ST-segment elevation myocardial infarction (STEMI).

The authors found that LA remodeling is associated with simultaneous ventricular-atrial remodeling, and those with larger infarct size had greater levels of LA remodeling. Furthermore, adverse LA remodeling was associated with poor prognosis. Although it is unlikely that MRI scanning will be employed for routine cardiovascular risk stratification, these findings increase our understanding of how cardiac remodeling could be linked to prognosis after heart attack.

Kyhl et al., Open Heart

Exploring the efficacy of bronchodilators for COPD

Current guidelines recommend the use of bronchodilators for patients with chronic obstructive pulmonary disease (COPD) to reduce dyspnea, prevent exacerbations, and improve quality of life. To better understand the efficacy of different bronchodilators in Chinese patients with COPD, QVA149 – a fixed-dose combination of two long-acting bronchodilators – was compared with the beta2-adrenergic receptor agonist/corticosteroid combination salmeterol/fluticasone (SFC) in the LANTERN randomized controlled trial. The trial was conducted as a collaboration between universities in China and Novartis Pharma.

Lungs
iStock Photo

All patients included in the study had moderate-to-severe COPD, with one or more exacerbations in the previous year. QVA149 was associated with significantly improved lung function as measured by the FEV1 test, as well as a reduction in the number of exacerbations, when compared with SFC. The safety profile was similar for both treatment groups.

The results of the LANTERN trial provide support for the use of QVA149 as a treatment option for COPD patients at risk of exacerbations.

Zhong et al., International Journal of Chronic Obstructive Pulmonary Disease

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Tim

This is a very resourceful blog. I am interested in Malaria research and I found the information in this post and other posts in this blog very helpful. I am interning in a medical facility in an area where malaria is one of the major causes of death among pregnant mothers. Thank you.

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