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Common blood pressure meds may lower colon cancer risk

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Millions of Americans take medication to keep their blood pressure down. A new study suggests that two types of blood pressure drugs might do double-duty, keeping colon cancer away, too.

Angiotensin converting enzyme inhibitors (often called ACE inhibitors) and angiotensin II receptor blockers (ARBs) help lower blood pressure by relaxing and opening up narrowed blood vessels, allowing blood to flow freely.

Researchers analyzed the health records of almost 200,000 adult patients in Hong Kong from 2005 to 2013. Compared to nonusers of the drugs, those who took ACE inhibitors or ARBs had a 22 percent lower risk of developing colon cancer in the three years following a colonoscopy that declared them cancer-free, they found.

The researchers, from the University of Hong Kong, excluded all patients who had a prior history of colon cancer.

The benefit was especially true for patients 55 or older, and those with a history of colon polyps — potentially cancerous growths.

In the three years following a clean colonoscopy, there is already low risk of developing colon cancer. Still, study author Dr. Wai Leung, a professor of medicine at the University of Hong Kong, said that cancer can develop during this period.

“We found that there’s a very strong, protective effect, particularly within that short period of time after a negative colonoscopy,” Leung explained.

But the protective effects only lasted for those first three years.

The results were published July 6 in the journal Hypertension. They showed that the drugs do not reduce the risk of all colon cancer, but are particularly beneficial in preventing colon cancer that arrives soon after a colonoscopy.

Colon cancer is the third most common cancer and the second leading cause of cancer death worldwide.

If commonly prescribed drugs could be repurposed to prevent colon cancer, it would have a significant public health impact, said Dr. Raymond Townsend, director of the hypertension program and a professor of medicine at the Hospital of the University of Pennsylvania.

Townsend said the results of this study are significant, especially since the researchers looked at such a large population.

“A 22 percent reduction is not trivial, so I think there’s a story here,” added Townsend, who had no role in the study.

The study also found that the longer you use the medications, the more likely you are to experience a benefit.

For every year that the patients took the drugs, the risk of developing colon cancer in the three years following a clear colonoscopy was lowered by 5 percent.

But Townsend emphasized that studies like this generate more questions than answers.

The population of people who take medications to lower their blood pressure are often older and have other risk factors for cancer.

As people age, their chances of developing high blood pressure go up dramatically — as do their chances of developing cancer.

“You’ve got a population that is primed to develop the problem in the first place,” Townsend said.

Since the study looked at people in the real world, there are risk factors and variables that naturally affect the results.

“Is it the person, or is it the medication?” Townsend wondered.

And prior research has shown the opposite effect — that medications for high blood pressure could cause cancer, instead of preventing it.

“Since 1976 or so, this issue of cancer in patients on blood pressure medicines has been in the literature repeatedly,” Townsend explained.

Based on how these blood pressure medications work, there is some reason to believe they could prevent cancer.

For cancers to grow, they have to develop new blood vessels, and blood pressure medications may block the formation of these new vessels.

“It’s possible that these medications really cut off the blood supply of these tumors and prevent them from growing,” said Dr. Andrew Chan, a colon cancer specialist and professor at Harvard Medical School. He was not involved in the study.

However, the study cannot show a direct cause-and-effect relationship. And Chan added, “one study is not enough to sway clinical practice, and you really need to verify that you have similar associations in other studies.”

More information

There’s more about colon cancer at the American Cancer Society.

Copyright 2020 HealthDay. All rights reserved.



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More using pot for depression, but it may not help, researchers say

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Folks struggling with depression are much more likely to turn to marijuana to ease their symptoms these days, and that’s not necessarily a good thing, researchers report.

Depressed people are more than twice as likely to have used pot within the last month and three times more likely to use it nearly every day in 2015-2016, a far higher number than 10 years before, the new study found.

Experts say this boom in use among the depressed is probably linked to the spread of marijuana legalization across the United States, particularly for medical purposes.

“Its accessibility has increased over the specific time period that this study measures,” noted Michael Wetter, director of adolescent and young adult medicine with the UCLA David Geffen School of Medicine.

The problem is that previous studies have shown pot actually can worsen mood disorders like anxiety or depression, said Dr. Elie Aoun, assistant professor of clinical psychiatry with the Columbia University College of Physicians and Surgeons.

Marijuana does not change anything in the underlying brain pathology that contributes to depression,” Aoun said. “It just numbs your feelings so you can get through a couple of hours without thinking about your problems. When the effect dissipates, you’re going to be more depressed than you were before.” He and Wetter were not part of the research.

The new study relied on data drawn from the National Health and Nutrition Examination Survey, a federal poll regularly conducted by the U.S. Centers for Disease Control and Prevention.

The researchers, led by Deborah Hasin, from Columbia University Medical Center, analyzed responses from two periods — 2005-2006 and 2015-2016 — to identify people with symptoms of depression and track their self-reported marijuana use.

A depressed person had 2.3 times greater odds of reporting any cannabis use during the previous month in 2015-2016, a nearly threefold increase in risk from the decade before, researchers found.

The odds of daily use were nearly 3.2 times higher, an almost sixfold increase from 2005-2006.

Because the study is observational, it can’t say in which direction this association runs — if depressed people are more likely to turn to pot, or if marijuana use fuels depression.

“I think it’s probably both of these things at the same time,” Aoun said. “Marijuana could be causing depressive symptoms. Also, people who are depressed who are looking for treatment are seeking out options to help reduce the impact or burden of their depressive symptoms. When traditional treatment options are insufficient, they are turning to marijuana.”

THC, the chemical in pot that causes intoxication, has been shown to increase levels of dopamine in the brain, Wetter said. Dopamine is a “feel good” neurotransmitter that directly stimulates the pleasure centers in the brain.

That might make a depressed person feel better temporarily, but it’s really masking feelings that will return, Aoun said.

“Drugs don’t introduce new feelings that you don’t have in you,” Aoun said. “They just allow for disinhibition. If you’re depressed and you smoke marijuana, it’s not going to cure your depression.”

What’s more, these dopamine rushes alter your brain chemistry in ways that can exacerbate your depression.

“It requires more use in order to feel good,” Wetter said. “When you don’t have that, you will start to feel the symptoms of more increased depression. You experience the crash, if you will.”

Eleven states have adopted laws permitting recreational marijuana use, but Aoun said he’s more concerned about the 34 states that have passed laws allowing medical marijuana.

“When states are pushing for the legalization of medical marijuana without credible evidence, you’re sending so many wrong messages,” Aoun said.

Not enough medical research has been done to firmly establish marijuana’s health benefits, but legalization has nonetheless made pot into a seemingly legitimate alternative for folks struggling with a mood disorder, Aoun said.

He compared pot to insulin, a treatment for diabetes tested in large-scale research studies before it became available to patients.

“With marijuana, it’s been a completely different story where these decisions are really driven primarily by companies with a significant financial interest in promoting marijuana use,” Aoun said.

People with depression or anxiety would be better off talking to their doctor about taking an approved prescription medication, Wetter said.

“People will tend to say I would rather use something that is natural and organic versus something synthetic, like Prozac or an SSRI,” Wetter said. “It is organic, it is natural, so it can’t be bad for you. If you’re feeling bad and this makes you feel better, how can it be bad? How can it be wrong?”

The new study was published recently in JAMA Network Open.

More information

The U.S. National Institute on Drug Abuse has more about marijuana and psychiatric disorders.

Copyright 2020 HealthDay. All rights reserved.



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Abuse of unapproved anxiety drug phenibut on the rise

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A growing number of Americans may be having serious reactions after taking phenibut — an unapproved anxiety drug sold in some dietary supplements.

That’s the finding of a new study looking at calls to U.S. poison control centers. The numbers are not huge: Between 2009 and 2019, there were 1,320 calls related to phenibut.

But there was a sharp rise beginning in 2015, researchers found — going from a handful of calls each year to between 300 and 400 in 2018 and 2019.

More worrisome, the effects were sometimes life-threatening or fatal, said researcher Janessa Graves, an associate professor at Washington State University.

Overall, 80 people fell into comas and three died. Often, they had taken other substances as well. But even in cases where phenibut was used alone, 10% resulted in serious effects — including one death.

“This is reason for concern,” Graves said. “[Phenibut] is easily accessible, and it may be becoming more popular.”

The findings were published Sept. 4 in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Originally developed in the Soviet Union in the 1960s, phenibut was given to cosmonauts, with the aim of combating anxiety and insomnia. It has never been an approved drug in the United States, but it is present in some dietary supplements marketed for enhancing mood and brain power.

The U.S. Food and Drug Administration has ruled phenibut is not a dietary ingredient and cannot be listed as such in dietary supplements. But phenibut supplements are widely available online, Graves noted.

There have also been reports of people abusing the drug for euphoric effects. A recent study of Minnesota poison centers found that in nearly half of calls related to phenibut, the person had used it with “abuse as the reason.”

The drug is similar to a brain chemical called GABA, which has a calming effect on the central nervous system. That can also cause side effects like sedation, reduced levels of consciousness and depressed breathing.

Previous research has uncovered signs that phenibut use is trending upward in the United States, Graves said. So her team tried to get a bigger picture, by analyzing a national database on calls to poison control centers.

From 2009 to 2014, they found there was a small number of calls each year related to “phenygam” or 4-amino-3-phenylbutyric acid — alternative names for phenibut.

Starting in 2015, poison control centers were able to use the term “phenibut.” After that, there was a steady, steep rise in calls related to the drug.

It’s not clear how much of that could be related to rising popularity, Graves said.

Based on internet search trends, public interest in phenibut has remained fairly stable in the past several years, said Pat Aussem, of the nonprofit Partnership to End Addiction.

“That said,” she added, “the sharp rise in calls to poison control centers is concerning, and may be attributable to people searching for and using anti-anxiety supplements without knowing their safety profiles.”

Consumers should not assume that dietary supplements are “safe,” stressed Aussem, who was not involved in the study.

She said phenibut would be particularly dangerous in combination with other substances that depress the central nervous system — including alcohol, opioids or benzodiazepines, like Xanax or Ativan.

In this study, 40% of adults and 30% of people under age 18 had used phenibut with other substances.

The findings highlight a bigger issue, according to Dr. Peter Lurie, president of the Center for Science in the Public Interest, a consumer advocacy group.

In the United States, dietary supplements are largely unregulated, Lurie said, and the FDA has limited resources to take action against companies that put unapproved drugs into supplements — or make unproven health claims.

The CSPI recently urged the FDA to take stronger steps against manufacturers and stores that sell supplements with an unapproved antidepressant called tianeptine.

The FDA has sent warning letters to a number of U.S. companies that market tianeptine or phenibut supplements. But the products are still readily available.

One of the concerns, Lurie said, is that consumers will be lured away from therapies — medication or not — that are proven to help anxiety and depression.

Graves and Aussem made the same point.

“In this age of COVID-19,” Aussem said, “many people are trying to cope with anxiety and may wish to find a ‘natural’ product to alleviate their symptoms.”

But, she said, “talking to a health care provider about their concerns is the safest approach.”

More information

The U.S. Food and Drug Administration has more on dietary supplements.

Copyright 2020 HealthDay. All rights reserved.



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Study: New COVID-19 antibody test provides fast, cheap way to identify donors

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Sept. 10 (UPI) — A widely available, inexpensive and easy-to-use test accurately identifies COVID-19 antibody levels in potential convalescent plasma donors, according to a study published Thursday by the Journal of Clinical Investigation.

The ELISA — or enzyme-linked immunosorbent assay — test has been used for decades and generates results faster than the virus neutralization titer tests currently being used, which are costly and only canbe processed by some labs, researchers said.

Using blood samples from more than 2,800 donors, the ELISA approach produced comparable results to virus neutralization titer tests at least 80% of the time.

The test successfully identified donors with COVID-19 antibody levels above a “magic number” of 1,350, which is thought by researchers to be the minimum amount needed to offer protection against the virus.

“Will there be modifications to this finding? Absolutely. That’s what science is — but I think we’re one step closer to understanding the level of antibodies needed to protect against this virus,” study co-author Dr. James M. Musser told UPI.

“I’ll put it this way: If I were being vaccinated today, I would want my titer to be above that 1,350 number,” said Musser, a pathologist at Houston Methodist Hospital.

Antibodies are proteins made by the human immune system to fight off infection. Because they are found in the blood, convalescent plasma — or the liquid component of blood — has long been used to treat infections, Musser said.

According to theory, plasma donated by people who have successfully fought off a virus can be collected and transfused into others to bolster their immune systems and, hopefully, protect them from serious illness.

In the case of COVID-19, the U.S. Food and Drug Administration last month issued an emergency use authorization for convalescent plasma donated by people who have recovered from the virus as a treatment in hospitalized patients — provided that donors have sufficient antibody levels.

However, because of limited access to virus neutralization titer tests, most donor plasma virus antibody levels remain unknown before transfusion.

For their analysis, Musser and his colleagues at Penn State, the University of Texas at Austin and the U.S. Army Medical Research Institute of Infectious Diseases developed an ELISA-based test that measures two known COVID-19 antibodies: anti-spike ectodomain and anti-receptor binding domain IgG.

They evaluated the ELISA test’s accuracy at measuring specific antibodies against COVID-19 using blood samples more than 2,800 employees at Houston Methodist Hospital.

Both the ELISA and virus neutralization titer tests revealed convalescent donors maintain high levels of immunity for several weeks, even after multiple donations, the researchers said.

In addition, donors who experienced shortness of breath while infected with COVID-19 and those who were hospitalized or had severe disease had higher levels of neutralizing antibodies, the tests showed.

They also identified 27 study participants with mild disease who had high enough antibody titers to donate usable plasma.

The FDA used the findings of this study as part of its evaluation for the emergency use authorization for convalescent plasma, Musser said.

“We think our findings give us a baseline or floor for the amount of antibodies needed to offer protection against the virus,” he said.

“More research still needs to be done, but this number will likely be an important part of identifying potential plasma donors and determining the effectiveness of any new vaccine.”



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