Document Directory

12 Mar 01 - Medicine - Cancers emerge after link to pylons
09 Mar 01 - Medicine - First volunteers test new AIDS vaccine
09 Mar 01 - Medicine - Affluence clue to breast cancer
09 Mar 01 - Medicine - Anti-obesity drug available on NHS
09 Mar 01 - Medicine - Exercise could help to prevent breast cancer
08 Mar 01 - Medicine - Breakthrough in Aids vaccine race
06 Mar 01 - Medicine - Children's Study: Pets A Major Cause of Asthma in Kids
02 Mar 01 - Medicine - Drug to combat cocaine abuse goes on trial - Ananova Alerting
02 Mar 01 - Medicine - Female sex hormone could help schizophrenics
02 Mar 01 - Medicine - Scientists find out how breast cancer spreads
02 Mar 01 - Medicine - One in three will develop cancer
28 Feb 01 - Medicine - Gene fed to mice 'controls cancer'
28 Feb 01 - Medicine - Parents pay to beat ban on removal of tonsils
28 Feb 01 - Medicine - Gene therapy halt on cancers
28 Feb 01 - Medicine - Big rise in cancer cases
26 Feb 01 - Medicine - Gene therapy 'prevents cancer'
26 Feb 01 - Medicine - Autism cases show tenfold increase
26 Feb 01 - Medicine - Perfect match for transplant
26 Feb 01 - Medicine - Stem cell storage buys child health cover for £600
24 Feb 01 - Medicine - Stem cell breakthrough could end cloning row
24 Feb 01 - Medicine - U.S. Scientists Craft Mouse with Human Brain Cells
24 Feb 01 - Medicine - Herbs and Surgery Can Be a Harmful Combination
24 Feb 01 - Medicine - Skin change offers key to cancer
24 Feb 01 - Medicine - Tissue transplant advance
23 Feb 01 - Medicine - Autism increase renews fears over MMR jab
23 Feb 01 - Medicine - 'Epidemic is lurking behind cancer success'
22 Feb 01 - Medicine - UN backs use of cheap generic anti-Aids drugs
22 Feb 01 - Medicine - Each year, thousands die waiting for a new organ.
22 Feb 01 - Medicine - Pig organ transplants 'too risky' for humans
22 Feb 01 - Medicine - New test hope over cervical cancer
22 Feb 01 - Medicine - Gene Method Distinguishes Breast Cancer Types
22 Feb 01 - Medicine - Asthma gene 'could aid treatment'
22 Feb 01 - Medicine - Bears' winter workout may hold clues for human health
22 Feb 01 - Medicine - Gene discovery heralds asthma cure
22 Feb 01 - Medicine - MMR jab linked to skin rash

12 Mar 01 - Medicine - Cancers emerge after link to pylons

Lucy Adams

Sunday Times--Monday 12 March 2001

Evidence of a new cancer cluster has emerged in a Renfrewshire village after the Sunday Times last week revealed links between electricity pylons and childhood leukaemia, writes.

Residents in the village of Brookfield believe their proximity to high-voltage pylons has caused a substantial increase in the number of people developing cancer.

The village council recently contacted MSPs to ask why more than seven women in two adjoining streets had developed breast cancer.

The Sunday Times reported last week that a study by government scientist Sir Richard Doll revealed a significant link between pylons and leukaemia and a possible link to adult cancers.

Last November Colin Campbell, MSP for West of Scotland, asked Susan Deacon, the health minister, if there was any evidence of concentrations of breast cancer near high-voltage cables and whether there was a higher than average incidence of breast cancer in Brookfield.

A local health authority correlation test failed to establish a link, but local residents are now calling for new research in the wake of Doll's findings. One woman who has suffered breast cancer claims that in the last year and a half, rates of cancer in the village have "shot up".

"In my road, in the last year and a half, five more people have contracted breast cancer," she said. "This seems to be far above average. We fear there is a connection with the pylons, which run across Sandholes Road. I won't be looking for compensation myself but if this research means compensation could be gained then they should put this money into moving the pylons."

Alasdair Duncan, secretary of the village council, said concern had grown in the light of the new research findings.

"We decided that cancer was becoming so common as to warrant an inquiry and a letter to parliament," said Duncan.

John Scott, conservative MSP for Ayr, said the government should demand that all new power cables be buried underground as a precaution.

Brookfield is the latest in a series of cancer clusters identified in Scotland. Others have been discovered in Kilmarnock, the Caithness area around Dounreay nuclear power station, Cambuslang and Rutherglen in Lanarkshire and Benbecula in the Outer Hebrides.

The clusters have been blamed on proximity to nuclear reactors, power cables and carcinogenic chemicals.

09 Mar 01 - Medicine - First volunteers test new AIDS vaccine

By Andrew England, AP

Independent--Friday 9 March 2001

Pamela Mandela smiles shyly, then grimaces as a needle carrying the first AIDS vaccine specifically designed for Africa sinks into her left arm.

"I went into the medical profession to alleviate human suffering, but with AIDS, I have often found myself not able to help," says the 31-year-old doctor, who volunteered to test the vaccine. "I fear AIDS, but I also hate AIDS. With this step of being one of the first volunteers, I am fighting back."

Mandela is the first African to publicly acknowledge her participation in the trial of the vaccine, which was developed by Kenyan and British scientists based largely on research on a group of Kenyan prostitutes who are apparently immune to HIV, the virus that causes AIDS.

The vaccine has been designed to combat the strain of the virus that is most common in eastern Africa. Other vaccines have been developed, but those target strains prevalent in Europe and North America.

The first tests of the African vaccine on Kenyans were to begin in December, but wrangles over ownership of the patent caused delays. In the last two weeks, three other Kenyans have also received the vaccine - but away from the glare of publicity.

Mandela said she was confident about volunteering.

"My colleagues... understand the frustration of looking at a patient suffer, deteriorate and eventually die (from AIDS), knowing there is very little you can do," she said. "I appeal to more Kenyans to come forward and volunteer so that we can fight back."

Scientists from Britain's Medical Research Council and the University of Nairobi have been cooperating on the project for more than four years. Much of their research has been based on a group of prostitutes in a Nairobi slum who have not become infected with AIDS.

It seems the prostitutes have particularly strong immune systems that have been able to fend off HIV. The researchers have found the prostitutes have significantly high levels of cytoxic T cells, which stimulate the immune system to kill a virus. They believe that may be the key to their immunity.

HIV is so destructive that by the time the normal immune system has kicked in, it is devastated by the virus and cannot fight back.

The vaccine is designed to boost the immune system by delivering a set of instructions that help the body recognize HIV more easily so it can attack it sooner.

The researchers have developed a double vaccine.

The first component is a simple DNA vaccine, which delivers the genetic information on HIV. The second component is a vaccine that delivers the same genetic information, but uses a weakened smallpox virus to carry it to the cells.

The simple DNA vaccine is in its first phase of testing on both Kenyans and Britons, while initial tests of the smallpox vaccine are only being conducted in England.

If the two vaccines prove to be safe, they will be combined and the combination vaccine will be tested. There is no HIV virus in the vaccines; the safety tests will show whether they have any toxic effects.

Once the combination vaccine has proven safe, it will be tested on many people to see if it actually wards off AIDS. The process is expected to take several years.

"Vaccine development is a marathon, not a sprint, but at least we can rejoice that the race has started," Gilbert Carnathan, project manager at the International AIDS Vaccine Initiative, said.

Africa, the world's poorest continent, is ground zero in the fight against HIV/AIDS. More than 24 million Africans live with the virus, but they cannot afford expensive drugs designed to slow the effects of the virus.

Health Minister Sam Ongeri said more than 2.6 million Kenyans have HIV/AIDS, and 600 more are infected each day.

"Lessons learned from smallpox eradication through immunization give us reason to believe that availability of an effective HIV vaccine is the only hope of stopping an AIDS epidemic in Kenya, Africa and the world," Ongeri said.

09 Mar 01 - Medicine - Affluence clue to breast cancer

Sarah Boseley, health editor

Guardian--Friday 9 March 2001

Eating less and exercising more may protect women from breast cancer, according to research published today.

The study, in this week's British Medical Journal, focuses on the lower levels of breast cancer in the developing world than in affluent countries where food for most is unlimited.

Grazyna Jasienska, assistant professor at the institute of public health at Jagiellonian University in Krakow, Poland, believes there is a link between low food intake and lower levels of the ovarian hormones, oestrogen and progesterone, which are crucial in the development of breast cancer.

She looked at data on the hormone levels of women in Bolivia, the Democratic Republic of Congo, Nepal, Poland and the United States which had been ascertained by saliva samples.

She found that higher concentrations of ovarian progesterone were strongly associated with a higher incidence of breast cancer, from Congo at the bottom of the league to Nepal, Bolivia, Poland and the United States with the highest risk.

She points out that food intake can influence women's reproductive systems - too little food can cause women to stop ovulating. But when women regularly eat a lot, they ovulate more regularly and have high hormone concentrations. She believes women can lower their risk by eating less and taking more exercise.

Cancer charities were cautious over the findings. Tim Key of the Imperial Cancer Research Fund, said: "Obesity increases breast cancer risk among women after the menopause and even moderate levels of physical activity can reduce breast cancer risk.

"However, the strength of the association may not be as great as the authors suggest because other factors probably explain some of the low breast cancer risk in poor countries".

Jackie Graveney of Breakthrough Breast Cancer, said: "The report shows an interesting correlation but also highlights the need for large and high powered clinical trials"

09 Mar 01 - Medicine - Anti-obesity drug available on NHS

Staff and agencies

Guardian--Friday 9 March 2001

The controversial anti-obesity drug Orlistat should be prescribed on the NHS, a government body ruled today.

However, patients in England and Wales will only receive the drug if they fulfil criteria laid down by the National Institute for Clinical Excellence (Nice).

Adults must have lost at 2.5kg by dieting and exercise in the month prior to receiving the first prescription of Orlistat, which is traded under the name Xenical.

They must also have a body mass index (their weight in kg divided by their height in metres squared) of at least 28 and have another serious illness such as diabetes or high blood pressure, or have a BMI of 30 with no other associated illnesses.

Nice estimate that the recommendations will mean 11,000 more people in England and Wales will be prescribed the drug at a cost to the NHS of £12m a year.

Professor Peter Littlejohns, clinical director of Nice, said: "Today's guidance is another example of how Nice can help doctors and patients be clear about the value and appropriate use of a new medicine.

"Obesity has a major impact on a person's physical, social and emotional wellbeing and future health.

"Doctors and patients need to work together to manage this condition and today's guidance provides advice on the contribution which Orlistat can make."

The drug is the first anti-obesity treatment that does not work by suppressing appetite. Instead it works in the gut by impairing the digestion of fats and stopping their passage into the bloodstream.

The capsules are taken three times a day with meals and clinical trials have shown it to be highly effective in helping people lose weight.

One in five adults in the UK are classed as obese and 30,000 people die prematurely every year partly as a result of chronic weight problems.

09 Mar 01 - Medicine - Exercise could help to prevent breast cancer

By Nigel Hawkes, Health Editor

Times--Friday 9 March 2001

Eating less and doing more exercise could help reduce a woman's risk of developing breast cancer, according to research published yesterday.

Researchers from Poland and Norway have shown a strong link between levels of the hormone progesterone and the risk of breast cancer.

Both are much lower in developing countries, where food is less plentiful and women do much of the labour.

The more developed the country, the higher the levels of progesterone. A 70 per cent rise in progesterone levels translates into an eightfold increase in breast cancer, Grazyna Jasienska of Jagiellonian University in Cracow, and Inger Thune of Tromso University, said.

The findings are based on measurements of the hormone in saliva samples taken from women in the US, Poland, Bolivia, Nepal and Congo. The remedy, they suggest in the British Medical Journal, is to take a leaf from the lives of women in the Third World - eat less and exercise more.

Tim Key, of the Imperial Cancer Research Fund, an expert on how lifestyle influences cancer risks, said: "It is established that obesity increases risk among women after the menopause and there is reasonably good evidence that moderate levels of physical activity can reduce risk."

The strength of the association may not be as great as suggested. Other factors may explain the low breast cancer risk in some poor countries.More than 30,000 women in Britain are diagnosed with breast cancer each year and 13,000 die from the disease.

08 Mar 01 - Medicine - Breakthrough in Aids vaccine race


PA News--Thursday 8 March 2001

Scientists have made a breakthrough in the race to produce an Aids vaccine.

A new inoculation which primes the immune system's memory kept the virus in check in monkeys, even when given high doses of an HIV equivalent seven months after immunisation.

The results were better than any previous tests in the field and the vaccine is now on a fast track for human clinical trials.

"We have been really excited about the level of control we have achieved with our memory response," Dr Harriet Robinson, who headed the study at Atlanta's Emory University, told Science journal.

"Even among the groups that received the low-dose vaccine, the infections were controlled."

The vaccine comprises two DNA priming inoculations followed by a second booster made using a smallpox vaccine first developed in the 1960s.

Together they provoke the immune system to generate more "memory" cells which are capable of recognising how HIV looks and launching a rapid defence if infection occurs.

Although it does not prevent HIV infection, it controls it by keeping the virus from replicating in large numbers.

In tests, 24 inoculated monkeys remained healthy months after being injected with the virus.

In contrast, four non-vaccinated monkeys which were also given the virus developed Aids-related illnesses within 28 weeks and were put to sleep.

"These are among the very best outcomes we have seen in an animal model," said Peggy Johnston from the US National Institute of Allergy and Infectious Diseases.

06 Mar 01 - Medicine - Children's Study: Pets A Major Cause of Asthma in Kids

Associated Press

Cincinatti Now--Tuesday 6 March 2001

Man's best friend may be one of the worst things for young children with asthma and allergies. A new Cincinnati study says there's a strong link between pets, kids and asthma that could be making hundreds of thousands of children sick every year.

A Cincinnati Children's Hospital researcher says asthma in young children would drop by almost 40 percent; if children at risk weren't exposed to pets or other allergy triggers.

The study suggests that eliminating known household risks could prevent asthma in more than 500,000 children a year and underscores the important role environmental factors play in development of the disease. "This could have a profound effect on medical costs in the United States and, more importantly, on the health of children," said Dr. Bruce Lanphear, associate professor of pediatrics at Children's Hospital Medical Center in Cincinnati.

Youngsters with pet allergies were 24 times more likely to have asthma than children who didn't have pets. The report, published in the latest issue of Pediatrics, says pets are over 10 times more likely to trigger asthma in children than other risk factors like parents who smoke cigarettes.

Dr. Lanphear says, "We tried to inform parents that they need to make choices about the risks that pets may pose versus having a pet that may be a wonderful thing for a child, because they reduce stress (etc).... but it is a trade-off."

Dr. Lanphear says what may make pets such an asthma trigger now is that more homes than ever before have carpets. He says, "Since the 1960s, carpeting has skyrocketed. That's when it became cheap to manufacture. When we go into many homes now, and we can find, from the same homes, levels about 100 times higher in carpets compared to the same surfaces on bare surfaces in those same homes."

"If residential exposures, including tobacco smoke and indoor allergens, were eliminated, and if these exposures are determined to causes asthma, which is the central hypothesis among experts, we would reduce asthma in this age group by 39 percent, or about 530,000 cases a year," Lanphear said.

The data he examined did not include information on exposure to dust mites or cockroaches, two other known household risk factors for asthma.

More than 17 million Americans are estimated to have asthma, including nearly 5 million under age 18, according to the American Academy of Allergy, Asthma and Immunology.

Researchers believe that the chronic lung inflammation may be inherited and that allergies or exposure to substances that irritate the airways trigger attacks, which typically include wheezing and difficulty breathing.

Asthma-related costs total an estimated $12.6 billion annually, including medical treatment and lost productivity, according to the academy.

If you have an asthmatic child, Dr. Lanphear suggests keeping the pet out of the child's bedroom and making sure the home is as well ventilated.

Dr. Gillian Shepherd, a New York allergist and member of the academy's board of directors, said the study underscores a consensus among asthma experts that "we should be a lot more aggressive at trying to block young kids' exposure to allergic materials."

"If you come from a family that has a history of allergies, you absolutely positively should not own a pet with kids at home. The likelihood that those kids will develop allergies to the pet is high," and that could trigger asthma, Shepherd said.

02 Mar 01 - Medicine - Drug to combat cocaine abuse goes on trial - Ananova Alerting


PA News--Friday 2 March 2001

CeNeS Pharmaceuticals is to trial a drug aimed at cutting dependence on cocaine and alcohol.

The Cambridge-based group says in Britain alone recent data shows one in 20 adults has a drink problem.

It adds that current treatments for alcohol abuse are limited.

Daniel Roach, chief executive of the group, said: "A new approach is urgently needed to deal with the escalating problem of substance abuse and the resulting physical and social consequences."

It has received approval to move its CEE 03-310 drug project, aimed at cutting dependence on substances such as cocaine and alcohol, into clinical trials.

A placebo-controlled Phase II study will be carried out at Yale University in the US, and the initial clinical trial will measure the extent that its drug reduces problem drinkers' craving for alcohol.

Shares in the group sparked up nearly 2% on the news, rising a penny to 53p.

02 Mar 01 - Medicine - Female sex hormone could help schizophrenics


PA News--Friday 2 March 2001

The female sex hormone oestrogen could be used to help people with schizophrenia recover from psychotic episodes.

An Australian psychiatrist made the claim after treating 12 women experiencing symptoms of the mental illness with oestrogen skin patches and risperidone.

Patients taking oestrogen had less severe schizophrenia compared with 12 similar women who received only risperidone.

Schizophrenia strikes roughly one in a hundred men and women. Those affected can suffer hallucinations, delusions and jumbled thoughts.

Antipsychotic drugs such as risperidone help some patients, but many remain severely afflicted.

Jayashri Kulkarni, a psychiatrist at the Dandenong Psychiatry Research Centre in Melbourne, says the dose of oestrogen was roughly twice as high as the dose found in common contraceptive pills.

"Several patients [in the oestrogen group] went from having terrible voices and hallucinations to that subsiding over a few days. That was very striking," Kulkarni told New Scientist.

Researchers have suspected for a while that oestrogen helps protect against schizophrenia, because women suffer a milder version of the disease than men and it usually strikes them later in life.

Studies in animals suggest that oestrogen alters the activity of dopamine and serotonin, two brain chemicals that are disrupted in schizophrenia.

02 Mar 01 - Medicine - Scientists find out how breast cancer spreads


PA News--Friday 2 March 2001

A key to the way breast cancer spreads around the body has been discovered.

It may lead to new ways of controlling the disease.

The researchers believe their findings could help combat other cancers.

Chemokines are small molecules that act as messengers between cells. They play a critical role in metastasis - the spread of cancer to different organs.

Animal tests suggest that suppressing chemokine-signalling could help prevent the migration of cancer cells.

The scientists suspected metastasis had something in common with the way infection-fighting white blood cells are guided to the tissues where they are needed.

Chemokines appearing on the "target" tissues act as beacons for the white blood cells to home in on.

The international team of researchers, led by Anja Muller at the DNAX Resea Institute in Palo Alto, California, discovered that chemokines attract tumour cells in the same way.

The scientists suppressed chemokine-signalling in mice injected with cancer cells and found that this helped to prevent their tumours spreading.

Their results are reported in the journal Nature.

02 Mar 01 - Medicine - One in three will develop cancer


PA News--Friday 2 March 2001

Official figures say cancer affects around 30% more women and 20% more men than it did 30 years ago.

The Office of National Statistics say the proportion of deaths caused by cancer has risen from 15% to 27% for men.

For women the figure has risen from 16% to 23% since 1950.

According to Cancer Trends in England and Wales 1950-1999, one in three people will develop cancer at some point in their lifetime, with a quarter of the population dying from cancer.

Despite the rise in incidence, mortality rates have remained stable over the last 50 years, with 250 men in every 100,000 and 180 women in every 100,000 dying from cancer.

Other key findings from report include:

Almost one million people alive in England and Wales have been diagnosed with cancer at some point. Some 600,000 are women, while 365,000 are men.

People living in deprived areas are at greater risk of developing and dying from smoking related cancers. If incidence rates in richer areas could be duplicated across the country, 16,600 fewer people would die each year.

Women living in affluent areas are at greater risk of developing breast cancer, while men in affluent areas run a higher risk of prostate cancer.

Survival rates of skin and testicular cancers have improved dramatically over the last 30 years. But those for cancers of the lung and pancreas have shown little change.

Lung, prostate and bowel cancers are the deadliest form for men, while women are at greatest risk from breast, lung and bowel cancers.

28 Feb 01 - Medicine - Gene fed to mice 'controls cancer'

By Nigel Hawkes

Times--Wednesday 28 February 2001

Feeding mice with a gene they lack has been shown to control stomach cancer, an American team has found.

The results could have applications in human patients found to have pre-cancerous damage in the lung, head and neck, oesophagus, bladder and cervix.

Scientists at Thomas Jefferson University in Philadelphia used a breed of mice genetically engineered so they lacked a gene called FHIT, often found to be damaged in human cancers. The belief is that this gene suppresses tumour formation. When damaged, it loses the ability to do this, and cancer is the outcome.

The mice lacking FHIT were exposed to a chemical known to induce cancer. All developed stomach cancers. When they were fed with the FHIT gene, cancer rates fell.

"We were pretty surprised that it worked so well," said Dr Kay Huebner, one of the researchers, who report in Proceedings of the National Academy of Sciences.

28 Feb 01 - Medicine - Parents pay to beat ban on removal of tonsils

By David Charter, Health Correspondent

Times--Wednesday 28 February 2001

Parents are paying up to £800 for surgical equipment to beat a ban on non-emergency tonsil removals.

They are contacting the makers of surgical instruments after learning of the Nationl Health Service moratorium on routine tonsil operations because of fears of vCJD, the human form of "mad cow" disease. NHS hospitals have postponed all non-urgent tonsillectomies until they have the disposable instruments promised by the Government last month to avoid the theoretical risk of spreading vCJD.

Suppliers say these are not likely to be ready until the summer, causing a backlog. There are normally 60,000 tonsil operations a year. Patients, most of them children, already wait six months or more for the operation and surgeons agreed that it was better to wait a few more months rather than risk spreading the fatal brain condition.

Manufacturers told The Times that parents were contacting them and offering to pay the £800 cost of a 30-item set of instruments. These would have to be discarded after surgery because hospital sterilisation procedures are not guaranteed to kill the agent that causes vCJD.

Deborah Darling, of B. Braun Medical, one of the main manufacturers, said that parents were contacting the company as they learnt of the moratorium. She said: "We have had about a dozen parents contacting us and we try very hard not to encourage them. We ask them to contact their hospital because we know some instruments are available for urgent operations so people do not need to panic or order from us direct.

"Generally speaking, rather than agree with them, we tell them to contact their hospital. If they absolutely insist, we have sold a couple of sets."

The company was working "flat out" to design and produce new instruments from cheaper materials than steel. A contract to make them for the NHS would bring 90 jobs at its British factories in Sheffield and Braintree, Essex. She added that, even if the Government prepared contracts before its deadline of the end of March, it would still be several months before supplies were ready. By then, the backlog of operations could run into tens of thousands.

"We are the main supplier and at the moment we produce 50 sets a year. If we win the contract for disposable instruments, that amounts to 80,000 a year on up to 30 items. The bigger project is to develop new materials so we can meet NHS financial targets. They want us to develop new materials as quickly as physically possible and we have got an international design team working on that right now. But it is difficult because surgeons have got to approve the instruments first."

28 Feb 01 - Medicine - Gene therapy halt on cancers

James Meek, science correspondent

Guardian--Wednesday 28 February 2001

Some of the most common forms of cancer could be nipped in the bud by a new gene therapy being developed in the US, scientists said yesterday.

Following dramatic success preventing tumours in mice, researchers plan to begin clinical trials in the next twelve months in humans.

Scientists at Jefferson Medical College in Philadelphia have focused on a gene called FHIT, which appears to play a central role in preventing cancer developing in healthy cells.

The FHIT gene lies on one of the most fragile regions of the human third chromosome. It is easily deleted by carcinogens like tobacco smoke and its disappearance is often the earliest genetic signal that a cell is about to turn cancerous.

The mouse FHIT gene is very similar to humans'. Researchers in Philadelphia created a mutant mouse, born with one FHIT gene missing, which invariably shed the other gene and developed cancer when given a certain carcinogen.

But when mice fed the carcinogen were given viruses modified to carry spare copies of the FHIT gene, the number who developed cancer fell sharply.

In one group of mice, after gene therapy, only three out of eight had tumours. The research is reported in today's online edition of the proceedings of the US National Academy of Science.

The mice were expected to develop stomach cancer. One of the things which astonished scientists was that the virus carrying the "good" gene was able to survive and deliver its cargo through the stomach. Getting replacement genes into the right cells is the hardest aspect of gene therapy.

28 Feb 01 - Medicine - Big rise in cancer cases

Staff Reporter

BBC--Wednesday 28 February 2001

Cancer has become public enemy number one in England and Wales over the last 30 years, official figures show.

Data from National Statistics show that the incidence of cancer has risen by around 20% in men and 30% in women since 1970.

The report says that part of the recorded increase may simply be due to better detection of cases.

But the upwards trend is in sharp contrast to other killers such as heart disease, stroke and infectious diseases, which are now killing less people.

More people now die from cancer than from other major causes of death.

Between 1950 and 1999, the proportion of deaths due to cancer rose from 15% to 27% for men and from 16% to 23% for women, according to the study.

One in three

One in three people will develop cancer during their life and one in four people will die from the disease.

It is estimated that about 600,000 women and 365,000 men in England and Wales have been diagnosed with cancer, and are currently living with the disease.

People living in more deprived areas are at greater risk of dying from smoking-related cancers.

The report found that cancer occurs mainly in old people and the numbers of cases rise more quickly with age in women than in men owing largely to cancers of the breast and cervix.

In men, under 3% of cases occur in those under 40, and 19% in those under 60, while for women the figures are 6% and 28%.

The risk of women developing breast cancer and men developing prostate cancer is greater in more affluent areas.

Survival from some cancers, such as melanoma of the skin and testicular cancer, has improved dramatically since the early 1970s.

However, survival from some of the highly fatal cancers such as those of the lung and pancreas has shown little change.

The study showed that women have higher survival than men for many cancers and for most cancers, survival is lower in patients who are older when they are diagnosed.

But for most of the common cancers, survival in Britain is lower than in several comparable European countries.

The position compared with the United States is even worse.

Encouraging developments

Dr Peter Sasieni, Head of Mathematics & Statistics at Imperial Cancer Research Fund, said overall trends in cancer mortality were "extremely encouraging".

"Although cancer was left behind when the rates of heart disease and stroke fell in the 1960s, 70s and 80s, the last decade has seen a 15% reduction in cancer mortality rates in both men and women.

"The reasons for this improvement include a reduction in smoking in men, better treatment of breast cancer, earlier detection of bowel cancer and cervical screening.

"The overall effect is that some 23,000 fewer people died of cancer in 1999 than would have at the 1989 rates."

26 Feb 01 - Medicine - Gene therapy 'prevents cancer'

Staff Reporter

BBC--Monday 26 February 2001

A gene therapy technique has successfully prevented cancer in mice for what the researchers say is the first time.

The scientists say the same approach might also be used in some cases of human cancer.

And, significantly, it works as an oral preparation - raising the possibility that it might one day be made available to humans in pill form.

The technique cannot cure cancer, but the researchers think it might help prevent the disease from developing in the first place in vulnerable people, such as smokers.

It might also help speed the development of more effective anti-cancer drugs.

Researcher Professor Kay Huebner, of Jefferson Medical College in Philadelphia, said: "We were pretty surprised that it worked so well."

"We knew we could kill cancer cells in the laboratory, but we didn't know if the viruses would get eaten up by the stomach juices. We expected differences, but not so dramatic."

The researchers targeted a gene called FHIT, which is damaged in many common forms of cancer, such as those affecting the breast and colon.

FHIT causes damaged cells to commit suicide before they can start the out-of-control growth of cancer.

When the gene is defective, the cells are able to keep dividing in the uncontrolled manner typical of cancer.

The gene can be damaged by toxins, such as those found in cigarette smoke.

Specially bred

Professor Huebner's team bred mice that did not have the FHIT gene.

These mice were vulnerable to developing a condition that resembles the human disease Barrett's oesophagus - an irritation of the throat that can lead to oesophageal cancer.

The mice were exposed to a chemical known to cause oesophageal cancer.

However, mice who were then given gene therapy to provide them with a working copy of the FHIT gene appeared to be protected from developing cancer.

The researchers found that the most effective way to give the mice a copy of the FHIT gene was to attach it to a virus, called an adeno-associated virus.

This virus is thought to be particularly safe because it does not cause disease in humans.

Lead researcher Dr Carlo Croce said: "I predict the disease we will prevent first will be Barrett's oesophagus.

"The next will be bronchial dysplasia. Most heavy smokers have bronchial dysplasia, which will later lead to lung cancer."

The findings may help to combat a range of cancers in which the FHIT gene is damaged.

These include cancer of the lung, colon, breast and bladder.

Professor Gordon McVie, director general of the Cancer Research Campaign, told BBC News Online that developing a form of gene therapy that could be taken orally would be a major step forward.

He said: "So far the major hurdle for gene therapy has been that it is hard to deliver to the right tissue in the body.

"The only effective method of delivery so far has been direct injection, but cancer spreads, and one cannot go round the body sticking a needle into every area where the cancer occurs."

The research is published in the Proceedings of the National Academy of Sciences

26 Feb 01 - Medicine - Autism cases show tenfold increase

By David Charter, Health Correspondent

Times--Monday 26 February 2001

Rates of autism have risen faster in the past decade than previously thought, but the cause remains a mystery, researchers said yesterday.

A British study to be presented at a conference in April will show a tenfold rise in diagnosis of the condition, which restricts a person's ability to communicate and make sense of the world.

The figures for 1983 to 1999, compiled by the Autism Research Unit at Sunderland University, are so high that researchers at first thought they were wrong. But they have been repeated by several other teams, including an American study of figures from British GPs, published in the British Medical Journal on Saturday. This showed a sevenfold rise in newly diagnosed autism between 1988 and 1999.

A recent study of children in Cambridgeshire by the Autism Research Centre at Cambridge University suggested that the rate of autism could be one in every 175 primary school children.

Paul Shattock, director of the Autism Research Unit and vice-president of the World Autism Organisation, said there were many possible causes of the rise, from better diagnosis to vaccinations to pollutants in food and water, such as pesticides, hormones, plastics and heavy metals. He refused to rule out the mumps, measles and rubella (MMR) vaccination, which was linked to autism by some researchers but dismissed by the Department of Health as a cause.

The latest study in the BMJ also found no link between autism and the MMR.

Researchers from Boston University School of Medicine said that because MMR rates remained constant while autism was rising sharply, the vaccine could not be the cause of the increase.

26 Feb 01 - Medicine - Perfect match for transplant

By Dr Thomas Stuttaford

Times--Monday 26 February 2001

Cord blood is particularly rich in stem cells, the immature cells that usually develop into part of the immune system but can be persuaded to grow into cells that form the basis of many of the human body's tissues.

Should the baby need a transplant of stem cells in childhood, adolescence or early adult life, a supply would be immediately available - the cord blood having been frozen in liquid nitrogen and kept at a centre near Brussels. Never again in the person's life will blood with such an abundance of stem cells be available.

Cryo-care estimates that the cord blood with its stem cells can be guaranteed for 20 years. These cells will be a perfect match for an autologous transplant and therefore without any danger of inducing rejection - should the child sicken with such diseases as leukaemia, Hodgkin's disease or other lymphomas. Autologous cell transplantation, the transplantation of stem cells donated by the sufferer, is already recommended as a treatment for patients who have relapsed after chemotherapy prescribed for many conditions. It is difficult to obtain a good supply of these cells but even 50 millilitres of cord blood contain millions of stem cells.

It is hoped that means will be devised whereby the cells saved at birth can later be modified so that their potential usefulness would still be available in the child's middle and old age. They could then be used in the treatment of degenerative diseases and could, for example, after modification, provide the immature brain cells to restore the damage caused by a stroke, or to replace the lost cells in the brain that are causing the symptoms of Parkinson's disease or Alzheimer's disease.

26 Feb 01 - Medicine - Stem cell storage buys child health cover for £600

By Steve Bird

Times--Monday 26 February 2001

Parents will be able to buy the "ultimate health insurance" for their children by freezing and storing stem cells surgically removed from their babies' umbilical cords at birth.

The procedure, expected to cost around £600, could herald a medical revolution that will see future generations leading lives free from serious disease.

Only a few dozen millilitres of blood can be removed from the umbilical cord, but scientists hope those few drops will hold the key to curing the country's biggest killer diseases. The blood sample is rich in stem cells, the building blocks for all other cells in the body, including blood, brain and bone cells.

In the battle against diseases such as leukaemia, transfusions of cells are already in use. But like any donor scheme, a patient may reject the cells as alien.

Cryo-Care UK is now planning to offer parents the chance to store their babies' own unique stem cells for 20 years. They will be kept in liquid nitrogen.

In the next few days Derek Tuffnell, 40, a gynaecologist and obstetrician at Bradford Royal Infirmary, will extract stem cells from a baby to test the company's storage system. Mr Tuffnell said: "Stem cells are the progenitors of all other cells in our bodies. They develop into blood, bone, brain and other cells. That is why they are so important.

"If a child or adolescent gets a disorder, for example leukaemia, their stem cells will give us the means to replenish their bodies with healthy blood and save their lives."

He added: "There is also all sorts of work going on into what stem cells could be used for. It offers the possibility of being able to treat diseases like Parkinson's and strokes. Essentially it's an insurance policy against your child getting some form of disease in which he or she needs a bone marrow transplant."

At the meeting of the American Association for the Advancement of Science last week, scientists claimed that research had shown that patients suffering from stroke or brain injury could also be treated with the cells.

Shamshed Ahmed, of Cryo-Care UK, said: "Bone marrow cannot be removed from a newborn baby but stem cells can. A baby's umbilical cord is rich in the stuff, which means that if we can preserve such blood, we will have a unique supply and can use it if that child grows up to develop a serious illness."

The company has already introduced its storage services in Holland and Germany. Mr Ahmed said: "We can guarantee the cells will survive for at least 20 years. After 2020 we will have to look to see if we can extend the scheme even further, and I anticipate that should be possible."

For now the firm will dispatch the cells to its laboratory in Brussels but plans to set up a separate base in Britain.

Mr Tuffnell, a father of two, said if he and his wife had another baby they would use the technique to insure the health of the child for all time.

24 Feb 01 - Medicine - Stem cell breakthrough could end cloning row

By Roger Highfield, Science Editor

Telegraph--Saturday 24 February 2001

Scientists have turned skin cells into beating heart cells that could be used to repair a damaged heart.

First they "turned the clock back" on the cells to produce stem cells, which have the ability to develop into any desired type, from nerve to liver and muscle. Then they transformed those into heart cells.

The breakthrough has been achieved using cells from cattle, but work on human cells will start in a few months. Even a speck of dandruff could be used to start the process. If perfected, it would sidestep therapeutic cloning, which involves the creation and destruction of human embryos to make tissue for repairs to the body. Pro-life groups bitterly oppose this, which they liken to human sacrifice.

The new development, by an American subsidiary of the British biotech company PPL Therapeutics, was announced at a meeting of the British Fertility Society in London yesterday. It marks the first step towards what Prof Liam Donaldson, Chief Medical Officer, has called the "Holy Grail": the ability to make a patient's own tissue without destroying cloned embryos.

Dr Alan Colman, research director at PPL, stressed that it was too early to rule out therapeutic cloning, which was recently approved, and said that all options should be kept open. He said: "If we can replace the more controversial source with this source, all well and good. But we can't promise that at present." Dr Ron James, managing director, said: "I believe that the method we are developing as a source of stem cells will be equally applicable to humans."

For commercial reasons, details were not disclosed and the company has applied for patents. But a clue was given in PPL's statement. It described how a marker gene was inserted into the initial skin cell population so that scientists could identify resulting stem and heart cells. This suggests that the cells were in a larger population of tissue. If scientists had converted skin cells into heart cells in a test tube, there would have been no need to label them.

PPL's initial commercial target for its stem cell research is to grow pancreatic islet cells, which produce insulin, for the treatment of diabetes.

24 Feb 01 - Medicine - U.S. Scientists Craft Mouse with Human Brain Cells

By Andrew Quinn

Altavista--Saturday 24 February 2001

SAN FRANCISCO (Reuters) - U.S. researchers have produced laboratory mice with human brain cells, marking a potential step toward developing treatments for human brain disease like Alzheimer's but promising to fuel fresh debate over the evolving ethics of bioengineering.

The research at California biotechnology company StemCells Inc. breaks new ground by demonstrating that human brain stem cells can be induced to grow within a mouse's skull, scientists said on Friday.

"We are not recreating a human brain. We're really just trying to understand how these stem cells can function, and how they can be used in the treatment of specific diseases," said Ann Tsukamoto, vice president of scientific operations at StemCells Inc.

Irving Weissman, a Stanford university professor involved in the two-year research project, said the next step could be to produce mice with brains made up almost entirely of human cells -- although he said there would have to be a thorough ethical review before this step is taken.

"You would want to ask the ethicist what percentage of the brain would be human cells before you start worrying, and if you start worrying, what would you start worrying about," Weissman said.

The California study involved isolating human stem cells in the laboratory and then introducing them into mice. As the mice matured, the human stem cells -- "master cells" that can develop into any other type of cell -- grew into a full range of specialized cells throughout each mouse brain.

"It looks like human cells can follow the developmental instructions put in by the mouse brain. They are making human components in what is clearly a mouse brain," Weissman said.

The researchers believe that these mice could be used to test treatments for human brain diseases such as Parkinsons and Alzheimer's, although these tests have not yet been undertaken.

Tsukamoto added that the experiment also demonstrated that StemCell Inc's process for isolating and developing human stem cells was viable, and that cell banks could be established for future transplantation into humans.

"We're of course moving this into the development phase, and looking at which disease indications these cells would be best used for in preclinical trials," she said.

Both scientists stressed that their research, while marking a new breakthrough in the controversial world of stem cell research, was in no way aimed at blurring the lines between human and animal.

But Weissman added that he had already requested a review panel to look at the research to determine if there may be ethical problems in taking the work further.

"It is not the objective to go make mice with human brains," Weissman said. "(But) it is in the domain of the ethicists, not the experimenters, to figure out what our limits are."

24 Feb 01 - Medicine - Herbs and Surgery Can Be a Harmful Combination

By Margaret Pearson

YAHOO--Saturday 24 February 2001

SAN DIEGO (Reuters Health) - Using herbal supplements before undergoing surgery may interfere with anesthesia or put patients at risk for complications such as increased bleeding. Patients would do well to lay off the herbs before going under the knife, according to Dr. Suzanne Yee, a plastic and cosmetic surgeon of the University of Arkansas at Little Rock.

Speaking here at the annual meeting of the American Academy of Cosmetic Surgery, Yee said there is ``an unspoken 'don't ask, don't tell' policy in most doctors' offices, where physicians don't ask and patients rarely tell about their herbs or dietary supplements.''

She stressed that ``the patient's silence could be deadly, since many herbs can increase bleeding time during and after surgery, cause changes in blood pressure and prolong the effects of anesthesia.''

Because people may not regard herbs as medication, they may be unaware herbal supplements can carry side-effects. Some supplements that can interfere with bleeding time during surgery include ginkgo, feverfew, ginger and vitamin E.

In addition, ginseng may trigger high blood pressure, while garlic supplements may lower blood pressure. Herbs that can intensify or prolong anesthesia include St. John' s wort and kava kava.

Yee advised that ``all herbal supplements be stopped two weeks prior to elective surgery, no matter how minor.''

She also urges patients to speak with their doctors about their supplement use and advises physicians to make it a formal part of the patient's medical history. Such awareness can prevent problems, alter care and help manage complications, Yee said.

24 Feb 01 - Medicine - Skin change offers key to cancer

Staff Reporter

BBC--Saturday 24 February 2001

A simple molecular change can make normal skin cells behave just like cancer cells, shedding light on how tumours develop.

Scientists altered just one molecule which normally plays a role in how skin cells join up with other skin cells.

But this produced huge shifts in the behaviour, spread and appearance of the resulting cells.

"This component's loss appears to be an early critical event in the development of skin cancer," said Professor Elaine Fuchs, from the University of Chicago.

He said: "This molecule appears to be doing more than simply participating in cell-cell junctions."

Doctors believe subtle damage to cells, perhaps caused in some cases by overexposure to UV radiation from sunlight, may cause them to divide and grow out of control into a skin tumour.

But it is uncertain what sort of damage is likely to produce the malign growths.

Stick together

In this case, the scientists at Chicago bred mice missing the gene which produces alpha-catenin, a molecule with a role in causing cells to stick together and form part of the normal structure of the skin.

The mice suffered severe changes in the skin, which was thick and "disorganised" - the different cell layer types were distorted.

Cells often had more than one nucleus - a sure sign that there were not just defects in the way cells were joining together, but also problems in cell division.

Squamous carcinoma

The skin changes observed were very similar to those normally seen in squamous cell carcinoma, a pre-cancerous condition associated with overexposure to sunlight, and affecting thousands of Britons each year.

Looking closer into how alpha-catenin loss could have this effect, the team found that system which regulates cell growth had been activated.

Missing this molecule could lead to unregulated cell growth which characterises many forms of skin cancer.

If a key "missing link" to skin cancer development can be identified, it throws open a possible doorway to gene therapies which could help restore correct functioning to affected skin, or prevent cancers from developing in the first place.

24 Feb 01 - Medicine - Tissue transplant advance

Staff Reporter

BBC--Saturday 24 February 2001

The scientists who helped clone Dolly the Sheep say they have managed to turn cow skin into heart muscle in a move that could one day be used to create replacement tissues for transplant.

The US subsidiary of PPL Therapeutics announced on Friday that it had re-wound the genetic clock of skin cells, to create "master" stem cells.

The reverted cells were then programmed to develop into functioning beating heart cells, in the laboratory.

The research has major implications for the controversy over using cloned human embryos to conduct research into new medical treatments.

It increases the chances of using adult stem cells, rather than those taken from embryos, to develop nerve tissue, heart muscle or even brain cells for transplant.

Stem cells are unprogrammed "master" cells with the ability to develop into any of the different kinds of tissue that make up the human body.

Commercial secret

PPL Therapeutics is keeping full details of the technique used a secret for commercial reasons. But Dr Ron James, managing director of the Edinburgh-based biotech company, revealed the early findings of the work at a meeting of the British Fertility Society in London.

"The results of this experiment give us confidence that the method we are developing as a source of stem cells is working and I believe it will be equally applicable to humans," said Dr James.

The Church of Scotland welcomed the announcement saying it was encouraging that direct reprogramming of human cells might now be possible.

The church's Society, Religion and Technology Project director Dr Donald Bruce said: "This is an encouraging breakthrough in the search for replacement cells to treat serious diseases without the need to use human embryos.

"It's obviously still too early to say that this is the solution we've been looking for, but it is certainly a step in the right direction."

Embryo research

In the past, scientists have focused on embryonic stem cells in their search for new treatments because these are more flexible than adult stem cells.

But religious and pro-life groups have condemned the use of embryos for such research.

In January, Britain became the first country to allow the use of human embryos in stem cell research.

UK politicians voted in favour of extending the research done on human embryos to allow stem cells to be taken from embryos at a very early stage of development.

23 Feb 01 - Medicine - Autism increase renews fears over MMR jab

By Shirley English

Times--Friday 23 February 2001

The number of Scottish primary schoolchildren diagnosed with autism has risen by 18 per cent in a year. The increase has prompted fresh calls for independent research into possible links with the MMR vaccine.

Parents yesterday renewed demands for an urgent inquiry into the controversial triple jab for measles, mumps and rubella after official figures released by the Scottish Executive showed a dramatic rise in the incidence of autism across the country.

The number of children aged under 12 with the condition increased by 120 in a year, taking the total to 778 in Scotland, according to latest statistics.

Yesterday, the Scottish Executive insisted that based on the scientific evidence available, there was "no casual link" between the MMR jab and autism. A spokesman claimed that one of the key reasons for the increase was probably improved diagnostic techniques.

However Jane Hook, chairman of the Scottish Society for Autism, said that better diagnosis alone could not account for such a "massive" leap in numbers.

"Whether it is down to better diagnosis or not, is not going to calm people," she said. "Parents are very frightened. There is no trust any more (in government scientists). What is needed is independent research that people will believe, and in the meantime there should be the choice of single vaccines available to avoid any epidemics."

About 54,000 children under two years old were vaccinated with the MMR jab in Scotland last year, which amounts to 92.9 per cent of the total.

The triple vaccine was introduced in Britain 13 years ago. In 1995 there was an uptake of 94.8 per cent in Scotland, but that fell to an all-time low in 1999 of 91.2 per cent. Since then, uptake has recovered slightly.

Mrs Hook, whose 14-year-old daughter Rachel is autistic and had the MMR vaccine as a child, said that if numbers with the condition continued to rise at the current rate, overstretched services would be unable to cope.

"Since this rise was identified there has been no mention of any additional financial resources to assist families with autistic children, and there has been no discussion about extra money for schools, charities or social services. Austism is a life-long condition and a devastating one," she said.

The Scottish Executive said yesterday that it recognised parental concerns about the rise in autism and possible links to the MMR vaccine, "which is why major research is currently being undertaken by the Medical Research Council to establish the exact causes of the condition," a spokeswoman said.

"Obviously we need to find the root cause of autism, to help to alleviate parents' concerns," she said, but added: "The Joint Committee on Vaccination and Immunisation and the Committee on Safety of Medicines, and all the UK's leading professional bodies including the BMA, remain unequivocal that based on the scientific evidence available, there is no casual link between the MMR vaccine and autism."

Mary Scanlon, MSP, Conservative health spokeswoman, has been asked to pull together research into autism and MMR from across the world and to report back to the Scottish Parliament's health committee by the end of March.

She said that there was no evidence proving a link between the MMR vaccination and autism. However, neither was there sufficient evidence to prove that there was no link between them.

23 Feb 01 - Medicine - 'Epidemic is lurking behind cancer success'

by Zoe Morris, Health Reporter

Evening Standard---Friday 23 February 2001

The success of a programme aimed at detecting the early signs of cervical cancer may ironically be the cause of a "hidden epidemic" particularly among young women, experts warned today.

A screening programme aimed at women aged 20 to 64 has seen the number going on to develop full-blown cancer drop by 40 per cent since 1988.

However, a new study has shown there has been a three-fold increase in the number of pre-cancerous cases being detected.

Experts fear that as the disease becomes less prevalent, affecting only around 3,000 women across the country each year, there is a danger that women may become complacent about the need for screening.

Health workers stress that the decline in the disease is largely attributable to women being successfully treated when pre-cancerous cells are detected through screening.

Consultant Amanda Herbert of St Thomas' Hospital estimates that without screening the number of cases of full-blown cancer would be more than double its current rate.

Dr Herbert said: "These findings tell us that just because cervical cancer is now much less common, we mustn't become complacent - the risk is still there. It is crucial that women have regular tests and do not miss the opportunity to reduce risk." Lifestyle factors, such as having sex from an early age, having several partners and smoking also increase the risk of developing cervical cancer and there are concerns that the women most at risk are those least likely to be screened.

Dr Herbert said research showed that women born after 1945 and growing up in an era of sexual liberation in the Sixties are more at risk.

In Lambeth, Southwark and Lewisham, public health doctors have embarked on a campaign to persuade the 20- to 24-year-old age group to go for a smear.

The take-up rate had fallen to just over half - while 76 per cent of older women were taking part in the screening programme.

Dr Alan Maryon Davis, of Lambeth, Southwark and Lewisham Health Authority, said: "We launched a 'Just Say Yes' campaign, targeted at younger women. It has not been running for a year yet, so we cannot evaluate the data, but the signs are that it has been successful."

He added: "Women aged between 20 and 24 are often at increased risk, but were also less likely to come forward for screening, often because they are moving around for education and different jobs. There is a danger that younger women will become complacent. We are faced with a hidden epidemic of pre-cancer cases."

22 Feb 01 - Medicine - UN backs use of cheap generic anti-Aids drugs

Peter Capella in Geneva and James Meikle

Guardian--Thursday 22 February 2001

The UN is preparing to challenge the multinational drug companies' control over HIV and Aids treatments in developing countries by encouraging a far wider use of cheaper, generic alternatives.

The organisation, frustrated by slow progress in brokering discounts between pharma ceutical giants and countries threatened by social and economic chaos because of Aids, is ready to back states such as Brazil, Thailand and India where national laws allow them to override drug patents in cases of dire emergency.

The new gloves-off approach, outlined by the UN's secretary general, Kofi Annan, is likely to be widely welcomed by aid agencies. It comes as 42 drug companies begin a court case to stop South Africa importing generic versions of the life-enhancing drugs it so desperately needs. The United States is meanwhile preparing to challenge Brazil's attitude towards drug patents in the World Trade Organisation.

Mr Annan, in his report to the general assembly's special session on HIV and Aids in New York in June, says that the "equitable and affordable" provision of life saving treatments is a cornerstone of the worldwide battle against Aids.

Although some progress has been made in price reductions by big companies, the UN chief says more needs to be done through other measures such as "tiered" pricing between rich and poor countries, subsidies by the public and private sector, and "the effec tive use of health safeguards in trade agreements".

Governments must bring their "power and authority" to bear in fighting the "most formidable development challenge of our time", he says.

Mr Annan praises Brazil, where reported Aids deaths have been reduced by a quarter. "With a rights-based approach to care, together with local production of generic anti-retrovirals in some countries, coverage of patients is increasing in Brazil, Argentina, Chile and Uruguay, where HIV-positive people are living longer, positive lives."

His report makes a stark case for affordable treatment and care. In many African states, more than half today's 15-year-olds will die from HIV/Aids if present rates of infection continue. Only adults who escape HIV infection can expect to survive to middle and old age.

UNAids, the agency set up to combat the disease, says it supports Oxfam and Médecins sans Frontières, which have been highly critical of drug companies' pricing policies.

A UNAids initiative to improve access to drugs and care attracted 29 applications involving generic products but the emphasis until recently appeared to concentrate on brokering discounts with five major pharmaceutical companies. The discounts have only been taken up in Rwanda, Senegal and Uganda.

UNAids insists it is sticking by a multiple approach to tackling epidemics, but its call for the "reinforcement and use" of health safeguards indicates a big change of gear.

22 Feb 01 - Medicine - Each year, thousands die waiting for a new organ.

By Jeremy Laurance, Health Editor

Independent--Thursday 22 February 2001

Organ donation: Dream of animal 'organ farms' to provide transplant parts for humans fade - but scientists offers new hope to stroke victims

Once, we were led to believe, the country would be dotted with "organ farms" where scientists would produce the raw material for 21st century medicine. In place of the horny-handed farmer, white-coated laboratory technicians would raise herds of genetically engineered pigs in sterile conditions to provide an unlimited supply of hearts, kidneys and other material for transplant into humans whose own organs had worn out or failed.

Today, five years after a small Cambridge-based biotechnology company called Imutran became the first in the world to transplant pigs' hearts into monkeys, demonstrating that cross-species transplantation was possible, scientists are still struggling to make the technology work.

In its most pessimistic report to date, the government body set up to monitor research on xenotransplantation - using animal organs to replace human ones - says the likelihood of its providing results "within a clinically worthwhile time frame" is starting to recede.

The UK Xenotransplantation Interim Regulatory Authority, (UKXIRA) set up by the Government to license research, has not received a single serious proposal for a human trial in its three-year existence. Last year it reduced the frequency of its meetings from six to four times a year because of the lack of progress.

This is a serious blow, not only to the drug companies which have invested millions in breeding genetically modified pigs, but crucially to the desperate patients waiting for a transplant. Throughout the Western world, thousands of patients die each year on the transplant waiting list and thousands more never make it on to the list.

In Britain, 5,486 people were waiting for a transplant at the end of last year (3 per cent up on 1999) and 2,338 transplants were carried out (2 per cent down). The supply of organs has declined in recent years owing to improved road safety and the consequent reduction inn the number of accident victims. There are also fears that would-be donors may have been discouraged by the outcry over the Alder Hey organ retention scandal.

The Secretary of State for Health, Alan Milburn, is due to address a national summit on organ donation next week called to consider ways of boosting the number of people carrying donor cards, which stands at less than one in six of the population. "He regards boosting organ donation as a high priority," a spokesman said.

No matter how successful campaigns to increase the number of human donors, they will fall far short of the potential demand. Even an "opt out" scheme, favoured by the British Medical Association - already operating in some European countries, including Sweden and Belgium, where consent to organ donation is assumed unless the individual has registered his or her opposition while alive - would only boost the supply of organs by an estimated 20 per cent.

Experts believe that if cost and availability of organs were no bar, the potential demand would be ten times the current level. In Britain that would mean around 2,000 hearts and 13,000 kidneys transplanted each year. The need for a new source of organs grows daily more urgent.

The problems that have beset xenotransplantation as a solution to the organ shortage are twofold - the difficulty of overcoming rejection of the pig organ and the risk of transmitting pig viruses into the human population.

The genetic modification of the Imutran pigs successfully dealt with the first immunological hurdle, known as hyper acute rejection, which normally causes an organ transplanted into a different species to turn black and die within minutes. But the second hurdle, acute vascular rejection, has proved more difficult to overcome.

The greater fear is the public health implications should a pig virus be transmitted and escape into the human population. With memories of Aids and BSE still fresh in the public mind, assessing this risk involves a political judgement about what is acceptable as much as a scientific one about what is possible.

Neither of these problems has been satisfactorily solved and progress appears to have stalled. Imutran, the British company that started the ball rolling which was bought by the multinational drug company Novartis in 1996, merged with the US biotechnology company Biotransplant and moved its operation to Boston last month.

Meanwhile, other technologies such as cloning, stem cell research and the use of mechanical pumps to replace the heart have opened up new fronts in the search for answers to the transplant crisis.

Stem cell technology in which the body's master cells are derived from cloned embryos to produce specialised tissue, is already being used to grow brain cells for transplant into sufferers from Parkinson's disease and Huntington's chorea. The use of human tissue overcomes the problems of rejection and viral transmission associated with animals. But the prospect of using stem cells to grow solid organs such as kidneys, with their own blood and nerve supply, is still 10 to 20 years away.

Professor John Dark, heart transplant surgeon at the Freeman Hospital, Newcastle upon Tyne and a member of UKXIRA said: "I think it is fair to say we are more pessimistic about xenotransplantation. There has been disappointingly little progress and there are unsolved immunological and viral problems. There has been a bit of progress in other areas - not enough to throw our hats in the air but the balance of the pendulum has swung."

The biggest potential application of stem cell technology is in the treatment of diabetics. If it could be used to grow the insulin-producing cells from the pancreas, known as islets of Langerhans, which could then be "transplanted" by injection into a vein, it could transform the outlook for millions of patients worldwide.

Stem cells may be used to provide the raw material for cellular transplants of this kind but they are not going to offer an early answer to the shortage of kidneys. Professor Benjamin Bradley, director of Transplant Sciences at the University of Bristol, says. "I think UKXIRA are over-optimistic about the potential of stem cell techniques and over pessimistic about xenotransplant techniques."

He added: "There is no doubt there are many hurdles to be overcome to get to a state where it is safe to use genetically engineered pigs. None the less a great deal of progress has been made. I still think the only real prospect for the future is genetically engineered animals."

A major factor which could swing public and scientific opinion behind animal transplants again is the growing recognition that human transplants also carry infection risks - with variant Creutzfeldt-Jakob disease, the human equivalent of BSE. In the past, recipients of transplanted corneas from the eye and extract of pituitary glands have been infected with conventional CJD.

Robin Weiss, professor of virology at University College London and the scientist who first raised the alarm about the risk of pig viruses spreading into the human population, now says a transplanted organ from a genetically engineered pig raised in sterile conditions might be cleaner and safer than one from a human whose medical history was unknown.

"Although I have been painted as a Jeremiah saying [xenotransplants] are far too risky I have not changed my position," he said. "I think if the hurdles of rejection were overcome people would be transplanted with animal organs and I think that would save lives. There are already dangers with human to human infection and pigs would in many ways be cleaner. I wouldn't say it should never go ahead because of the viral problem. We may be surprised how quickly stem cell techniques develop but I think [animal transplants] are the best hope for the future we have today."

22 Feb 01 - Medicine - Pig organ transplants 'too risky' for humans

By Marie Woolf, Chief Political Correspondent

Independent--Thursday 22 February 2001

The prospects for animal to human transplants - once held out as the solution to the worldwide shortage of donor organs - have been thrown into doubt after a government watchdog declared that it may never be possible to protect the public from the danger of infection with animal viruses.

In its third annual report, the UK Xenotransplantation Interim Regulatory Authority (UKXIRA), set up by the Government to monitor the research, says the use of animals for transplants has not lived up to its early promise.

Drug companies have scrambled to invest in the new technology, which was predicted to be worth billions of pounds. But UKXIRA says safer technologies, such as those based on stem cell research using human embryos, may ultimately yield greater benefits. Transplant patients who receive pigs' hearts and lungs risk passing an unknown number of animal viruses to the general population.

The report said: "The evidence of efficacy [for xenotransplantation] has not advanced at the rate predicted... The likelihood of whole-organ xenotransplantation being available within a worthwhile time-frame may be starting to recede. Stem cell technology may yet provide alternative solutions to any or all of the conditions mentioned above."

The regulator was set up by the Government three years ago to oversee the development of animal-human transplantation. Reviewing the latest research, it concluded that it was "prudent" to assume that the risks to humans from animal viruses existed.

The report said: "The potential for infectious agents to be passed from the source animal, via the transplant, to human recipient and from the patient into the wider population is still a major concern.

"Until such time as research is able to produce more definitive answers on safety... it is prudent to assume that all forms of xenotransplantation carry a risk of some degree."

A breed of "humanised" pigs with a human gene to help transplant patients stop rejecting their organs has been bred in Britain although no clinical trials of animal-human transplants have so far been conducted in this country.

Five years ago the British company Imutran - now owned by the multinational drug company Novartis - took the world by surprise when it said it was ready to put a pig's heart into a human. But the report said the early promise about the potential for the technology have not been borne out by tests.

Sarah Kite, of the British Union for the Abolition of Vivisection, said: "There has been a lot of scientific hype leading people to believe that successful animal transplants are just around the corner. But now the regulator is saying that this is not the case and there are serious concerns about safety."

MPs last night said that animal-human transplantation was no longer a viable alternative to solve the shortage of human organs for transplant.

22 Feb 01 - Medicine - New test hope over cervical cancer

By Nigel Hawkes, Health Editor

Times--Thursday 22 February 2001

A new test could cut cases of cervical cancer by 40 per cent while saving the NHS money, health experts believe. More than 1,000 women die of the disease each year.

The test detects the virus that causes the vast majority of cases of cervical cancer, human papilloma virus (HPV). It is more accurate than existing smear tests, and needs repeating less often.

Pilot schemes using HPV tests are about to begin in Bristol, Norwich and Newcastle.

When combined with a new method for taking smears, the hope is that the scheme will cut the number of repeat smears that are needed.

Some health experts believe the new techniques should be introduced more quickly.

Jeremy Holmes, managing director of the Economists Advisory Group, said: "There is substantial scientific evidence that HPV testing should be urgently incorporated into cervical screening programmes across Europe."

Mr Holmes was one of the speakers at a conference in Geneva organised by the American Social Health Association, and Digene, the makers of the test. The meeting heard evidence from experts about the benefits of the test.

"Using the UK as an example, in 1999 1,106 women died as a result of cervical cancer," Mr Holmes said. "The introduction of HPV testing could improve detection of cervical cancer by up to 40 per cent and this increased sensitivity, combined with the slow development of the disease, mean that screening intervals could be safely extended from three to five years. When these impacts are recognised it is increasingly difficult to justify not introducing HPV testing."

HPV is transmitted by sexual activity and 23 types are found in men and women.

22 Feb 01 - Medicine - Gene Method Distinguishes Breast Cancer Types

Staff Reporter

Cincinatti Now--Thursday 22 February 2001

Powerful new technology that reveals patterns of gene activity inside cells can quickly determine which type of breast cancer a woman has, raising the possibility of more effective treatments.

The technology could soon enable doctors to select the most promising treatment with the fewest side effects, and determine which women run a high risk of recurrence and need close follow-up, according to researchers at the National Human Genome Research Institute.

"That's happening today on a limited basis, and within a few years it's going to be used" routinely, said Jeffrey Trent, scientific director of the cancer genetics laboratory at the institute, part of the National Institutes of Health.

The researchers found that examining the activity of 51 genes -- whether they were turned on, and thus making proteins, or turned off -- enabled them to distinguish with surprising ease among three types of breast cancer: the non-inherited form, and inherited forms caused by either the BRCA1 or BRCA2 gene.

That is difficult to do by examining tumors under a microscope. And using gene sequencing, or looking for a misspelling in a gene's long alphabet code, to find mutations in the two huge genes known to cause breast cancer is expensive and time-consuming.

While the Human Genome Project has determined nearly the entire code spelling out the 30,000-some genes in humans, scientists still must learn what most genes do. The new technique uses computers and flourescent "labels" placed on DNA from tumors. It is called gene-expression profiling because genes express, or make, proteins.

The technique will allow doctors to "short-circuit the need to know the sequence and function of every gene" to find the best treatment, said Marvin Schwalb, director of the Center for Human and Molecular Genetics at University of Medicine and Dentistry of New Jersey in Newark.

The research was reported in Thursday's issue of the New England Journal of Medicine.

Five percent to 10 percent of breast tumors are hereditary, and usually strike younger women. Women with a mutation on the BRCA1 or BRCA2 gene have about an 80 percent lifetime risk of getting breast cancer.

Schwalb said that instead of, say, trying a toxic drug with only a 30 percent success rate, doctors could determine which drug is most likely to work for an individual woman, or whether to perform a bone marrow transplant instead.

In addition, Trent said, the research will enable development of drugs that precisely target genes involved in the mechanisms of cancer. Standard cancer drugs indiscriminately kill dividing cells, causing nausea, hair loss, even death. Last year, Trent noted, one-third of the cancer drugs approved hit specific targets.

The new technology has allowed researchers to classify subtypes of leukemia, melanoma and lymphoma, Dr. Todd Golub of Harvard Medical School noted in an editorial.

22 Feb 01 - Medicine - Asthma gene 'could aid treatment'

Rebecca Allison

Guardian--Thursday 22 February 2001

Scientists have discovered an asthma gene which could lead to the development of more effective treatment for millions of sufferers worldwide.

The gene could account for as many as 40% of all asthma cases and might offer a target not only for new drugs but for a screening test, researchers said yesterday.

Between 30 and 50 genes believed to be associated with asthma have so far been identified by scientists. The latest find is the result of five years' work by a team at the University of Southampton's School of Medicine and two American companies which are together engaged in a £50m project to pinpoint asthma genes.

Stephen Holgate, who led the team of Southampton researchers, said the discovery of the gene was an important advance in understanding the genetic causes of asthma.

Asthma affects 3.4m people in the UK alone. It is also the most common chronic childhood disease. Extensive clinical information and DNA samples were taken from more than 300 volunteer families of asthma sufferers from the south coast of England by Professor Holgate and his research team.

The study was conducted in partnership with Genome Therapeutics Corporation of Massachusetts and the Schering-Plough Corporation.

The companies are seeking a patent for the new discovery and the researchers plan to publish their findings in a scientific journal.

22 Feb 01 - Medicine - Bears' winter workout may hold clues for human health

James Meek, science correspondent

Guardian--Thursday 22 February 2001

Hibernating bears keep fit in their sleep, scientists have found.

The remarkable discovery that bears lose only a quarter of their muscle-power over 130 days of hibernation promises new knowledge of the way human strength wastes away among the bed-ridden or on long sojourns in space.

In research published in today's edition of the journal Nature, scientists point out that a human being who was inactive for 130 days would lose an estimated 90% of their strength.

Black bears spend five to seven months a year hibernating in their winter dens. Their body temperature drops to about four degrees centigrade below normal and they do not eat, drink, urinate, defecate or show any other perceptible activity.

Yet over a 130-day period of this deathly slumber, the bears lose less than 23% of their strength.

The researchers, led by Henry Harlow and Tom Lohuis from the University of Wyoming, suggest that there are three possible ways to keep good muscle tone while apparently doing nothing.

One is by stimulating the muscles unconsciously and rhythmically, for example by shivering.

The alternatives, since muscles are ultimately agglomerations of the very complicated molecules known as proteins, is to have a system in the body which recycles waste back into proteins, or draws on protein reserves outside the muscles.

The scientists still do not know how the bear does it. But they say: "Understanding these processes in hibernating bears may provide new insight into treating muscle disorders and into the effects of prolonged hospital-bed confinement, antigravity and long-distance space travel on humans."

Researchers from Wyoming, Colorado and Minneapolis found in an earlier study that muscle samples from black bears at the start and finish of denning show scarcely any of the muscular degradation, at cell level, seen in humans and rodents whose muscles are affected by inactivity or hunger.

In the latest study, intrepid researchers twice crept into the dens of six hibernating bears once in autumn, once in spring and attached a machine for measuring muscle strength to one of the bear's hind legs.

The device, rather like a foot pump for car tyres, was hooked up to a computer and a box which sent electrical impulses to the bear's nerve. When the nerve was stimulated, the leg jerked and a measurement of the bear's strength was taken.

22 Feb 01 - Medicine - Gene discovery heralds asthma cure

By David Charter, Health Correspondent

Times--Thursday 22 February 2001

An abnormal gene responsible for asthma has been found. Scientists say that it could herald a cure for up to half of sufferers.

The discovery was made after the DNA of 342 families of asthma patients from the South Coast of England was studied. The analysis was repeated on 110 families from the United States to counteract any local factors.

Stephen Holgate, of Southampton University's School of Medicine, who worked with the Genomic Therapeutics Corporation of Massachusetts and the Schering-Plough Corporation on the project, described the discovery as a once-in-a-lifetime breakthrough. It was found by a £50 million five-year analysis and is likely to be the main cause of asthma in up to 50 per cent of the UK's 3.4 million sufferers.

Between 30 and 50 genes believed to be associated with asthma have been identified by scientists. The condition has both genetic and environmental causes but the Anglo-American team believe that they have discovered the leading genetic cause.

Professor Holgate said: "I think we will be able to develop new drugs against it." He said the painstaking genome scan that led to the discovery of the gene "was like counting all the stones on the road from London to Edinburgh and finding which stone was causing the problem".

22 Feb 01 - Medicine - MMR jab linked to skin rash

By David Charter, Health Correspondent

Times--Thursday 22 February 2001

About one in 20,000 children suffers internal bleeding after the MMR immunisation, researchers said yesterday.

The injection can cause a condition called idiopathic thrombocytopenic purpura (ITP) which rarely has more serious consequences than a skin rash.

Elizabeth Miller, head of the Immunisation division at the Public Health Laboratory Service, and one of the researchers, said: "Although our study shows that some children are admitted to hospital for ITP, even in these cases the disease is rarely dangerous and can be easily treated. This is in stark contrast to measles, mumps and rubella, which can have serious consequences and be difficult to treat."

The paper, published by the PHLS and the Royal Free Hospital in the Archives of Disease in Childhood, quantifies more precisely the number of children affected, she said.