Team identifies protein that blocks body’s ability to clear bad cholesterol

Team identifies protein that blocks body's ability to clear bad cholesterol

A team of researchers at the University of Alberta has uncovered a long-sought link in the battle to control cholesterol and heart disease.

The protein that interferes with low-density lipoprotein (LDL) receptors that clear ‘bad’ cholesterol from the blood was identified in findings recently published in Nature Communications by Dawei Zhang, associate professor of pediatrics in the Faculty of Medicine & Dentistry. Excess LDL cholesterol can lead to atherosclerosis—a narrowing and hardening of arteries—and ultimately, heart attack.

“We have known for many years that these receptors could be cleaved, but nobody knew which protein was responsible,” said Zhang. “There had been several attempts around the world but nobody else was successful.”

Now that the culprit has been identified, Zhang’s lab is already at work to find a drug to target the protein, allowing the receptors to clear more LDL.

A cholesterol-reducing class of drugs called statins—Lipitor and Crestor are two well-known brand names—has been shown to reduce cardiac events by 20 to 40 percent, but they have side-effects that mean they can’t be given in high enough doses to work for everyone. The new drug would be used in combination with statins to boost their effect, Zhang said.

Zhang’s team stumbled upon the role of the protein—membrane type 1 matrix metalloproteinase—by accident while studying another protein involved in heart function. They then set out to repeat and confirm their findings in mouse, rat and human cells, working in collaboration with researchers in China and other faculty members at the U of A. Their study was funded by the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research. Zhang is also a member of the Women and Children’s Health Research Institute.

The protein has other critical physiological functions, Zhang explained, so his lab will work to identify and focus on the specific region within the protein that acts on the LDL receptor. They are also working with a new technique to further target their potential drug so it will work only within the liver, further reducing the likelihood of unwanted side-effects. Their early results are encouraging, Zhang said.

Zhang noted the protein is also critical for cancer tumor invasion, so the team will collaborate with U of A oncology experts to learn more.

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Woman begs doctors to remove womb after suffering period pains so bad she faints

A woman who suffers with period pains so agonising they leave her suicidal, says doctors won’t remove womb in case she decides she wants children.

Kacey Read has suffered with horrific period pains since she was 12. The pain gets so bad that screams involuntarily, vomits and sometimes even passes out.

Doctors have tried the 21-year-old on various birth control methods to manage the pain, but have had no success. Kacey says the pain and her symptoms mean she is unable to hold down a job.

Kacey has begged doctors to remove her womb to stop the pain and help her mental state, but said they refused due to the fact she might want kids one day.

So now, the graduate is crowdfunding to pay for the operation privately.

‘Every doctor said I’d grow out of it, but nearly ten years on I’m still getting cramps so severe that I pass out from the pain,’ says Kacey, from Brighton.

‘It isn’t just the physical pain I experience, but also the cyclical emotional dips I go through because of my periods. So I really don’t get a day’s rest.

‘I’m tired of it making me so depressed that I can’t get out of bed for a week. I’m tired of having to plan my life around it.’

Kacey says that every time she has asked about the possibility of a hysterectomy, medical professionals have dismissed her.

‘I’ve been told that it’s not possible, I’m too extreme and that it would “destroy me as a woman”,’ she explains.

‘I’m tired of doctors taking away my autonomy and telling me they can’t operate because I might want kids one day.

‘I’ve had suicidal thoughts because of this – it’s not about whether I have kids, it’s about whether I have any quality of life. I’m an adult and I’ve made my mind up, I want this to end.’

Kacey’s extreme period pain is likely to have been caused by an underlying medical condition, such as endometriosis or adenomyosis.

She has never been formerly diagnosed with either of these conditions, which are known to be incredibly hard to diagnose, women often suffer for years before they are officially given a diagnosis.

Kacey was due to undergo an investigative laparoscopy to see if she has endometriosis, but sadly the procedure has been cancelled twice over the past year due to Covid-19.

After doctors refused to perform a hysterectomy, Kacey is now fundraising for the surgery and hopes to raise £8,500 for both the procedure and consultation appointments.

She says: ‘It will mean I won’t have to face four or five days of unbearable pain – and I won’t have to keep calling in sick.

‘In terms of my mood, it’s not an instant fix, but I’m hoping it will help. I think this is the perfect treatment. I can finally have autonomy over my body.

‘It’s not fair that I have to try and raise £8,500 just to be in control of my own life. I don’t want to be doing this, but it’s my only hope.’

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Hope can save people from making bad choices: study

Hope can save people from making bad choices: study

Hope may help prevent you from doing things that aren’t good for you, a new study claims.

The investigators wanted to find out why some people are more likely to fall into risky behaviors, such as gambling, drinking too much, taking drugs and overeating.

To do this, the team at the University of East Anglia in the United Kingdom focused on something called relative deprivation, which is when a person feels that other people have things better in life.

“I think most people have experienced relative deprivation at some point in their lives. It’s that feeling of being unhappy with your lot, the belief that your situation is worse than others, that other people are doing better than you, ” said researcher Shahriar Keshavarz, from East Anglia’s School of Psychology.

“Relative deprivation can trigger negative emotions, like anger and resentment, and it has been associated with poor coping strategies, like risk taking, drinking, taking drugs or gambling,” he explained in a university news release.

“But not everyone scoring high on measures of relative deprivation makes these poor life choices. We wanted to find out why some people seem to cope better, or even use the experience to their advantage to improve their own situation,” Keshavarz said.

“There is a lot of evidence to show that remaining hopeful in the face of adversity can be advantageous, so we wanted to see if hope can help people feel happier with their lot and buffer against risky behaviors,” he explained.

And that’s just what the researchers found with volunteers who were questioned at the start of the study to determine their levels of relative deprivation and hope.

In one experiment, participants played specially designed gambling games that involved risk-taking and placing bets with a chance to win real money.

According to Piers Fleming, also from East Anglia’s School of Psychology, “The aim of this part of the study was to see whether feeling relatively deprived—elicited by the knowledge that one has less income than similar others—causes greater risk-taking among low-hopers and decreased risk-taking among high-hopers.”

Fleming said, “We looked at the people who scored high for relative deprivation, the ones that thought their situation in life was worse than those around them. And we looked at those who also scored high for hope. We found that the volunteers who scored high for hope were much less likely to take risks in the game. Those who weren’t too hopeful were a lot more likely to take risks.”

In another part of the study, the researchers found that higher levels of hope were associated with a low risk of gambling problems, even in people with relative deprivation, according to the report published online Dec. 16 in the Journal of Gambling Studies.

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Mexico in ‘bad shape’ with coronavirus pandemic, WHO chief warns

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The head of the World Health Organization said that “Mexico is in bad shape” with the pandemic and urged its leaders to be serious about the coronavirus and set examples for its citizens.

WHO Director-General Tedros Adhanom Ghebreyesus’s comments came Monday as Mexico’s death toll rose to 105,940 — the fourth highest in the world — with 1,113,543 confirmed cases of the new coronavirus. The country’s actual numbers are believed to be much higher partly because of low testing levels.

“The number of increasing cases and deaths in Mexico is very worrisome,” he said in a press briefing.

Tedros Adhanom Ghebreyesus, director general of the World Health Organization, center, pictured in early March during a news conference on COVID-19, at the WHO headquarters in Geneva, Switzerland. (Salvatore Di Nolfi/Keystone FILE via AP)

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Mexican President Andrés López Obrador has been criticized for often not wearing a mask and, while not mentioning names or specific cases, the WHO chief urged the country’s leaders to take the pandemic seriously.

“We would like to ask Mexico to be very serious,” he said. “We have said it in general, wearing a mask is important, hygiene is important and physical distancing is important and we expect leaders to be examples …”

The Mexican government’s pointman on the pandemic, Hugo López-Gatell, said all the comments are valuable but noted the government had already warned that, with the arrival of winter, the situation would worsen. According to its latest data, the pandemic has grown by 7% in the past week.

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If sitting at a desk all day is bad during coronavirus, could I lie down to work instead?

Most of us have heard that too much sitting is bad for you. Studies show sitting increases the risk for cardiovascular disease and mortality, Type 2 diabetes and cancer.

With Americans more sedentary than ever, that’s particularly alarming. Even before COVID-19, many of us had managed to engineer physical activity out of our lives. But now, the pandemic has made things worse. Going outside less, missing the gym, working from home and countless hours on Zoom has meant, for most of us, even more sitting.

One question that occasionally comes up about this, perhaps from couch potatoes looking for a loophole, or maybe just those who prefer a more precise definition: Is reclining better? Instead of sitting upright (or slumped over) at a desk all day, is it somehow healthier to lie on the sofa, or relax in a hammock, or lean back in the easy chair? After all, your body is positioned differently. Does that distinction matter?

As an exercise physiologist, I can give you a short answer to that: No. (Sorry.) And instead of “sitting,” maybe we should use the term “sedentary behavior,” which is any waking behavior (note the word “waking”) that’s associated with low levels of energy expenditure. That includes sitting, reclining or lying down, according to the 2018 Physical Activity guidelines.

Move, move, move

Does physical activity help reduce, even eliminate, the negative impact of sedentary behavior? A 2016 study reviewed data from more than 1 million men and women. Those who sat a lot, and had little moderate or vigorous physical activity, had the highest risk of mortality from all causes. Those who sat only a little, and had high levels of moderate or vigorous physical activity, had the lowest risk.

What about someone in between? Someone who sits a lot but also engages in plenty of physical activity? The findings show mortality risk decreases as long as physical activity increases, regardless of sitting time. But the best way to go: high levels of activity, low levels of sedentary behavior.

How much activity do you need? The current estimate is 60 to 75 minutes a day of moderate activity, or 30 to 40 minutes of vigorous activity; do at least one of the two.

Physical activity: Good for everyone

Now let’s define physical activity: body movements that require energy expenditure, according to the World Health Organization. That covers plenty of ground: Any movement while working or playing counts, whether chores around the house or walks around the neighborhood. Your benefits from this activity begin immediately, and any amount helps. It doesn’t matter if you’re very young, very old or if you have chronic disabilities.

Notice I haven’t yet used the word “exercise”—until now. Exercise, obviously, is a type of physical activity, structured to improve flexibility, balance and speed, along with cardio and muscular fitness. It’s one of the best things you can do to improve your health and quality of life.

Benefits include a lower risk of mortality from all causes: heart disease, stroke, Type 2 diabetes, cancer, obesity, hypertension and osteoporosis. Your brain health will be better, perhaps enough to help ward off depression, anxiety, dementia and Alzheimer’s. And your sleep will improve.

Sleep on it

About sleep: The sedentary behavior referenced earlier does not include sleep. For optimal health, sleep is an absolute must.

Everyone is compromised by sleep deficiency, sometimes known as short sleep, or fewer than six hours per day. Difficulties with behavior, emotional control, decision-making and problem-solving are just some of the effects in people of all ages.

Poor sleep can also affect the immune system in people of all ages, leading to vulnerability to infections. It can be a factor in suicide, depression and high-risk behavior. And poor sleep also promotes obesity; essentially, a deficiency increases your “hunger hormone” (ghrelin) and decreases the “satiety hormone” (leptin). This makes you more likely to overeat.

In adults, sleep deficiency is associated with an increased risk of heart disease, high blood pressure, stroke and kidney disease. Adults need seven to eight hours per day.

Kids also suffer when they do not get enough sleep. Lack of sleep slows the release of growth hormone. Teens need 8-10 hours of sleep, and children age 6-12 need 9-12 hours.

Physical activity and good sleep go hand in hand. Moderate to vigorous activity lets you fall asleep faster and get more deep sleep; it reduces daytime sleepiness and use of sleep medications.

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Why is wildfire smoke so bad for your lungs?

If I dare to give the coronavirus credit for anything, I would say it has made people more conscious of the air they breathe.

A friend texted me this week after going for a jog in the foothills near Boise, Idaho, writing: “My lungs are burning … explain what’s happening!!!”

A wildfire was burning to the east of town — one of dozens of fires that were sending smoke and ash through communities in hot, dry western states. As an environmental toxicologist, I research how air pollution, particularly wood smoke, impacts human health and disease.

I gave my friend the short answer: The state had issued a yellow, or moderate, air quality index warning due in part to wildfires. The high temperature for the day was expected to reach 100 degrees Fahrenheit, and it was already approaching 90. That combination of high temperatures and elevated levels of particles from a fire can affect even healthy lungs. For someone with lung damage or respiratory illness, moderate levels of smoke particulate can exacerbate respiratory problems.

That’s only the start of the story of how wildfire smoke affects humans who breathe it. The rest, and how to stay healthy, is important to understand as the western wildfire season picks up.

What’s in wildfire smoke?

What exactly is in a wildfire’s smoke depends on a few key things: what’s burning — grass, brush or trees; the temperature — is it flaming or just smoldering; and the distance between the person breathing the smoke and the fire producing it.

The distance affects the ability of smoke to “age,” meaning to be acted upon by the sun and other chemicals in the air as it travels. Aging can make it more toxic. Importantly, large particles like what most people think of as ash do not typically travel that far from the fire, but small particles, or aerosols, can travel across continents.

Smoke from wildfires contains thousands of individual compounds, including carbon monoxide, volatile organic compounds (VOCs), carbon dioxide, hydrocarbons and nitrogen oxides. The most prevalent pollutant by mass is particulate matter less than 2.5 micrometers in diameter, roughly 50 times smaller than a grain of sand. Its prevalence is one reason health authorities issue air quality warnings using PM2.5 as the metric.

What does that smoke do to human bodies?

There is another reason PM2.5 is used to make health recommendations: It defines the cutoff for particles that can travel deep into the lungs and cause the most damage.

The human body is equipped with natural defense mechanisms against particles bigger than PM2.5. As I tell my students, if you have ever coughed up phlegm or blown your nose after being around a campfire and discovered black or brown mucus in the tissue, you have witnessed these mechanisms firsthand.

The really small particles bypass these defenses and disturb the air sacks where oxygen crosses over into the blood. Fortunately, we have specialized immune cells present in the air sacks called macrophages. It’s their job to seek out foreign material and remove or destroy it. However, studies have shown that repeated exposure to elevated levels of wood smoke can suppress macrophages, leading to increases in lung inflammation.

What does that mean for COVID-19 symptoms?

Dose, frequency and duration are important when it comes to smoke exposure. Short-term exposure can irritate the eyes and throat. Long-term exposure to wildfire smoke over days or weeks, or breathing in heavy smoke, can raise the risk of lung damage and may also contribute to cardiovascular problems. Considering that it is the macrophage’s job to remove foreign material — including smoke particles and pathogens — it is reasonable to make a connection between smoke exposure and risk of viral infection.

Recent evidence suggests that long-term exposure to PM2.5 may make the coronavirus more deadly. A nationwide study found that even a small increase in PM2.5 from one U.S. county to the next was associated with a large increase in the death rate from COVID-19.

What can you do to stay healthy?

The advice I gave my friend who had been running while smoke was in the air applies to just about anyone downwind from a wildfire.

Stay informed about air quality by identifying local resources for air quality alerts, information about active fires, and recommendations for better health practices.

If possible, avoid being outside or doing strenuous activity, like running or cycling, when there is an air quality warning for your area.

Be aware that not all face masks protect against smoke particles. In the context of COVID-19, the best data currently suggests that a cloth mask benefits public health, especially for those around the mask wearer, but also to some extent for the person wearing the mask. However, most cloth masks will not capture small wood smoke particles. That requires an N95 mask in conjunction with fit testing for the mask and training in how to wear it. Without a proper fit, N95s do not work as well.

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Establish a clean space. Some communities in western states have offered “clean spaces” programs that help people take refuge in buildings with clean air and air conditioning. However, during the pandemic, being in an enclosed space with others can create other health risks. At home, a person can create clean and cool spaces using a window air conditioner and a portable air purifier.

The EPA also advises people to avoid anything that contributes to indoor air pollutants. That includes vacuuming that can stir up pollutants, as well as burning candles, firing up gas stoves and smoking.

This article was originally published at The Conversation. The publication contributed the article to Live Science’s Expert Voices: Op-Ed & Insights.

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The good, the bad, and the ugly of coming off antidepressants

The world has changed a lot in the three and a half years since I started taking antidepressants. I’ve changed a lot, too.

Like most people who are prescribed medication to manage their mood, taking selective serotonin reuptake inhibitors (SSRIs) — a type of antidepressant — was never really my Plan A. Nor was it my plan B, or even C. it was more like a Plan Z — after all other options had been exhausted.

And I was exhausted, too. Crippled by acute anxiety, sleeplessness, intense panic attacks, and unable to cope with even the most basic of my day-to-day responsibilities, SSRIs looked like a raft to safety. 

But like many other people I feared that once I began taking them I’d never be able to stop – that I’d become dependent. That I wouldn’t be able to function without them. It is only now that I feel ready to confront that fear head on – so this month I decided to finish my prescription for the last time. 

My life has changed so dramatically and in such a positive way since I began taking them that I had started to wonder. Had I really changed all that much? What was down to me and what was down to the drugs? 

What started as a small curiosity soon felt much more like a burning question. Added to that was the side effects of the drugs, which though not life-altering, I’d prefer not to experience if I don’t need to. These included lethargy, weight gain, jaw grinding and issues reaching orgasm. 

They were tolerable, and small sacrifices for being able to live a full and healthy life — but I wanted to feel energised again.

While SSRIs protected me from the intensity of the shocks and blows of life, they also had the same blunting effect on the highs. After meeting someone during lockdown (I know) and suddenly being in the throes of a new romance, I felt ready to be more present with my feelings. I wanted to make sure I experienced them in all of their colour, depth and intensity.

When I began taking antidepressants, there was no doubt that I needed help. After being sent home from work after a particularly dramatic panic attack that caused me to collapse in the middle of my office — I was no longer able to pretend. 

‘You can continue battling this yourself and be patient,’ my GP said to me, ‘and you will feel better eventually…. or you can take these pills and within six weeks things are likely to feel much, much more manageable.’

I was under pressure to return to work and in my desperation, lacking the requisite confidence to even believe I could get better alone — this felt like a glimmer of hope, some relative certainty onto which I could cling. 

And so I took the drugs. I surrendered to the help offered, went back to work alongside regular therapy, and quietly waited to feel the effects.

Things really did get better — not because the pills somehow removed my sadness or anxiety, but because I was finally strong enough to be able to do the work

A lot of people assume that taking antidepressants will make you happy. That you’ll wake up one day and everything will be great without you having had to work for it. It would be nice, wouldn’t it? I didn’t know what to expect, but reasoned that anything would be better than the tortuous panic that had taken over my life.

I can’t speak for everyone, but for me the road to recovery was much, much messier. One of the side-effects that’s less well known to those without personal experience is that in the first six weeks or so of beginning treatment, your symptoms can actually get worse. 

Eventually though, things did get easier. The weight of panic began to lift a little from my chest — although it never truly disappeared. I was able to laugh for the first time in months, to concentrate for long enough that I could begin to vaguely follow the plot of TV shows (although only ones I’d seen before).

I could engage in conversation and hear about other people and challenging things that were going on with them, without then fearing that the same thing would happen to me. But my brain was still alert – like fly paper where new ideas of things to worry about could get stuck and cause me to overthink.

Eventually, CBT – a therapeutic process that helps you to challenge negative thinking patterns and therefore change your emotional responses and behaviour – helped me to get to a place where I could recognise that what was going on with me was more than just a spell of difficult mental health.

This allowed me to feel comfortable enough to get a formal psychiatric assessment, where I was diagnosed with post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) — the latter of which had become a coping mechanism to deal with the former.

My meds were increased and things really did start getting better — but not because the pills somehow removed my sadness or anxiety. It’s because I was finally strong and stable enough to be able to do the work involved to feel better.

They cushioned the blows, but didn’t eliminate them altogether. And staying healthy was – and still is – a lot of work.

I’m being explicit here because – despite progress in our general understanding of mental health as a society – there is still so much misinformation, particularly when it comes to medical intervention and prescription drugs.

Popular culture and mass media have done a lot of damage to the common perception of antidepressants as ‘happy pills’ – and I therefore bear a large amount of responsibility for correcting this, one column at a time.

There’s never a good time to come off antidepressants, but there definitely is a bad time. Many mental health professionals would advise you not to come off them in the winter (particularly in the northern hemisphere), because Vitamin D plays such a huge part in boosting your mood.

You will also be advised to titrate as you come off – which means to slowly reduce your dose over a long period of time to avoid any extreme fluctuations in mood.

There have been three times over the past three years when my plans to come off the meds have been interrupted by stressful life events, either in my personal life  or, most recently, by  the Covid-19 pandemic. 

It’s not that I needed to come off them – many people stay on them forever, and that is up to them and their own needs. It’s an incredibly personal thing and everyone feels different. There’s no ‘one size fits all’.

But there was one morning about a month or so ago, after numerous conversations with my best mate, my doctor and my therapist about whether or not it was the right time, when I suddenly felt ready. And so instead of taking the full dose with my breakfast as usual, I snapped the pill in two and only took half.

I made sure to tell those closest to me so that they could keep an eye on me over the next few weeks as things were likely to get pretty bumpy emotionally.

A month has passed and I feel OK. I don’t feel catatonic, nor jubilant. Just OK.

I’ve felt the return of some intense feelings, for better or worse. I’ve had moments when my emotions feel a lot like looking out the window of an accelerating car as the outside world starts to blur into a mess of indistinguishable colours and shapes. I’ve had moments of crying where I can’t imagine ever feeling less sad. 

I’ve felt the return of some obsessive thinking and been crippled by indecision on a number of occasions. But in each and every such moment, I have used the tools and experience learned over the past few years to steady myself until things begin to feel more solid again.

I don’t know what the future holds, but I do know I’d never rule out going back on antidepressants.

And while I’m excited to close the door on what was an incredibly challenging period of my life and move forward with more awareness and healthier habits – there’s comfort in knowing those little pills would be there if ever I needed a helping hand again. 

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