Early birth linked to greater risk of hospital visits during childhood

Being born early (before 37 weeks’ gestation) is associated with a higher risk of hospital admission throughout childhood than being born at full term (40 weeks’ gestation), finds a study published by The BMJ today.

Although the risk declined as the children grew up, particularly after age 2, an excess risk remained up to age 10, even for children born at 38 and 39 weeks’ gestation, representing many potentially vulnerable children, say the researchers.

Preterm birth is a major contributor to childhood ill health. Existing evidence suggests that the risk of illness associated with preterm birth declines as children grow up, but it remains unclear at what age this begins to happen and how these changes vary by week of gestational age at birth.

To explore this further, a team of UK researchers set out to examine the association between gestational age at birth and hospital admissions to age 10 years and how admission rates change throughout childhood.

Their findings are based on data from more than 1 million children born in NHS hospitals in England between 1 January 2005 and 31 December 2006. Children were monitored from birth until 31 March 2015 (an average of 9.2 years per child), during which time the researchers analysed numbers of hospital admissions.

Gestational age at birth was analysed in weeks, from less than 28 up to 42 weeks.

Over 1.3 million hospital admissions occurred during the study period, of which 831,729 (63%) were emergency admissions. Just over half (525,039) of children were admitted to hospital at least once during the study period.

After taking account of other potentially influential risk factors, such as mother’s age, marital status and level of social deprivation, and child’s sex, ethnicity and month of birth, the researchers found that hospital admissions during childhood were strongly associated with gestational age at birth.

The hospital admission rate during infancy in babies born at 40 weeks was 28 per 100 person years—this figure was about six times higher in babies born extremely prematurely (less than 28 weeks). By the time the children were aged 7-10 years, the hospital admission rate in children born at 40 weeks was 7 per 100 person years—this figure was about three times higher in those born at less than 28 weeks.

But even children born a few weeks early had higher admission rates. Being born at 37, 38, and 39 weeks’ gestation was associated with a difference in the rate of admission of 19, 9, and 3 admissions per 100 person years during infancy, respectively, compared with those born at 40 weeks.

The risk of hospital admission associated with gestational age decreased over time, particularly after age 2. However, an excess risk remained up to age 10, even for children born at 38 and 39 weeks’ gestation.

Although this excess risk at 38 and 39 weeks was relatively small, the large number of babies born globally at these gestational ages suggests that they are likely to have a large impact on hospital services, say the researchers.

Infections were the main cause of excess hospital admissions at all ages, but particularly during infancy. Respiratory and gastrointestinal conditions also accounted for a large proportion of admissions during the first two years of life.

This is an observational study, so can’t establish cause, and the researchers point to some limitations, such as being unable to take account of several factors that can impact child health like maternal smoking and breastfeeding.

However, they say this was a large study using routinely collected data over a 10 year period, and the findings remained relatively stable after further analyses, suggesting that the results withstand scrutiny.

As such, the researchers say their findings indicate that gestational age at birth “is a strong predictor of childhood illness, with those born extremely preterm being at the greatest risk of hospital admission throughout childhood.”

And the finding that infections were the main cause of excess hospital admissions at all ages prompt the researchers to call for targeted strategies to help prevent and better manage childhood infections.

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COVID-19 anxiety linked to body image issues

A new study has found that anxiety and stress directly linked to COVID-19 could be causing a number of body image issues amongst women and men.

The research, led by Professor Viren Swami of Anglia Ruskin University (ARU) and published in the journal Personality and Individual Differences, involved 506 UK adults with an average age of 34.

Amongst women, the study found that feelings of anxiety and stress caused by COVID-19 were associated with a greater desire for thinness. It also found that anxiety was significantly associated with body dissatisfaction.

Amongst the male participants, the study found that COVID-19-related anxiety and stress was associated with greater desire for muscularity, with anxiety also associated with body fat dissatisfaction.

Negative body image is one of the main causes of eating disorders, such as anorexia and bulimia, and this new study adds to recent research indicating that fears around COVID-19, and the consequences of the restrictions introduced to help tackle it, could be contributing to a number of serious mental health issues.

Lead author Viren Swami, Professor of Social Psychology at Anglia Ruskin University (ARU), said: “In addition to the impact of the virus itself, our results suggest the pandemic could also be leading to a rise in body image issues. In some cases, these issues can have very serious repercussions, including triggering eating disorders.

“Certainly during the initial spring lockdown period, our screen time increased, meaning that we were more likely to be exposed to thin or athletic ideals through the media, while decreased physical activity may have heightened negative thoughts about weight or shape. At the same time, it is possible that the additional anxiety and stress caused by COVID-19 may have diminished the coping mechanisms we typically use to help manage negative thoughts

“Our study also found that when stressed or anxious, our pre-occupations tend to follow gender-typical lines. During lockdown, women may have felt under greater pressure to conform to traditionally feminine roles and norms, and messaging about self-improvement may have led to women feeling dissatisfied with their bodies and having a greater desire for thinness.

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‘Foreign disinformation’ social media campaigns linked to falling vaccination rates

‘Foreign disinformation’ social media campaigns are linked to falling vaccination rates, reveals an international time trends analysis, published in the online journal BMJ Global Health.

Every 1 point increase in effort is tied to an average 2% drop in annual coverage around the globe, and a 15% increase in the number of negative tweets about vaccination, shows the study, which forms part of a BMJ Collection on Democracy and Health published for the World Health Summit this weekend.

Last year, the World Health Organization (WHO) listed vaccine hesitancy—reluctance or refusal to be vaccinated because of safety concerns—-as one of the top 10 threats to world health.

While vaccine hesitancy isn’t new, the proliferation of ‘anti-vaxx’ messaging on social media is of particular public health concern, given that vaccination is seen as a key route out of the current coronavirus pandemic, say the researchers.

Deliberate ‘disinformation’ campaigns by foreign agencies on social media also have their part to play, they add.

To gauge the impact of social media use and foreign disinformation campaigns on vaccine hesitancy around the world, the researchers analysed two different dimensions of social media activity for up to 190 countries.

These were: the public use of Twitter to organise action/resistance; and the amount of tweets expressing negative sentiments about vaccines.

They also drew on national survey data about public attitudes to vaccination safety and annual vaccination rates for the 10 most commonly reported vaccine doses between 2008 and 2018.

They used recognised analytical tools to measure sentiment (Polyglot Python Library); public use of social media to organise (Digital Society Project or DSP); foreign sources of disinformation (Varieties of Democracy Institute expert network + DSP); public attitudes to vaccine safety (2019 Wellcome Global Monitor).

They also logged measures of GDP (gross domestic product) per head of the population for each country and levels of internet usage.

Analysis of all the data revealed that the prevalence of foreign disinformation activity was “highly statistically and substantively significant” in predicting a drop in average vaccination rates.

A one-point shift upwards in the five-point disinformation scale was associated with an average fall in the annual vaccination rate of 2 percentage points, and a cumulative drop of 12 percentage points across the decade.

A belief that vaccines are inherently unsafe was associated with organisation of action/resistance on social media: and the more organisation on social media, the greater was the level of belief that vaccines are unsafe.

Foreign disinformation was also associated with negative social media activity about vaccination, boosting the number of negative vaccine tweets by 15%, on average.

While the study is unique, it wasn’t able to specify the particulars of foreign disinformation campaigns or the prevalence of anti-vacccination propaganda, the researchers acknowledge.

What’s more, Twitter isn’t used in every country, and the survey data were only available at one point in time.

Nevertheless, write the researchers: “Foreign disinformation campaigns are robustly associated with declines in [average] vaccination rates. The use of social media to organise offline action is highly associated with an increase in public belief in vaccines being unsafe.

“Both of these findings suggest that combating disinformation and misinformation regarding vaccines online is critical to reversing the growth in vaccine hesitancy around the world.”

They add: “These findings are especially salient in the context of the COVID-19 pandemic, given that the vaccines under development will require deployment globally to billions of people in the next year.”

Public outreach and education campaigns will, of course, be needed, but they won’t be enough by themselves to counter the tide of mistrust, they emphasise.

“First, governments must mandate that social media companies are responsible for taking down anti-vaccination content (whether originating from genuine domestic actors or foreign propaganda operations),” they advise.

“Second, foreign disinformation campaigns should be addressed at their source. A preponderance of such campaigns amplifying anti-vaccination content originate from within Russia or via pseudo-state actors informally associated with Russia,” they warn.

None of this will be easy, they acknowledge, because it means reconciling the principles of free speech with the policing of social media for “damaging falsehoods,” and persuading Russia to adopt a ceasefire on internet information warfare in the interests of the health of its own people.

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Coronavirus outbreak linked to spin studio in Canada: officials

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More than 60 cases of the novel coronavirus have been linked to a spin studio in Canada, according to public health officials there. 

Some 61 people have been infected with the virus in connection with an outbreak at the cycling studio Spinco in Hamilton, which is located in the province of Ontario. 

Exposure dates range between Sept. 28 and Oct. 4.
(iStock)

Dr. Elizabeth Richardson, the medical officer of health in Hamilton, said 44 of the cases have been reported among spin studio patrons, while 17 are secondary cases linked to the primary cases. 

"We haven't kept an exact count on how many of those [secondary cases] have had contacts," she said. "In general, we're up to having people having 20 to 25 contacts per case that we investigate … we haven't specifically tracked contacts for this outbreak and don't do that generally,” she said when warning the outbreak could grow larger, according to the Canadian outlet CBC News. 

CLOTH CORONAVIRUS FACE MASKS WORK — BUT ONLY IF YOU DO THIS AFTER WEARING THEM, STUDY FINDS

Exposure dates range between Sept. 28 and Oct. 4. 

It’s not currently clear how the outbreak began, as the studio reportedly has taken “proper pandemic protocol” since reopening, per the outlet. 

"Gyms are a higher risk place because of the fact generally people are taking off their masks, breathing at a higher rate and more deeply, and especially in classes where there's coaching going on, that tends to be a louder tone to speak over music," Richardson said. 

On its website, Spinco lists the precautions it has taken, including enhanced sanitation and social distancing measures. Both staff and members are required to wear masks at all times while in the studio, but class participants are, however, allowed to remove their masks once they are clipped into their bike. 

RISKIEST BEHAVIORS TO AVOID DURING CORONAVIRUS PANDEMIC, ACCORDING TO AN EXPERT

“Instructors must request all riders put their masks back on prior to getting off their bikes at the end of class, and must wear them out of the studio,” the website notes. 

In a statement posted to Instagram earlier this week, the owners of the Spinco studio in Hamilton said that everyone who has tested positive is doing well. 

"We love you and we miss you!" the statement reads in part. "When we started the journey to open a SPINCO franchise in Hamilton, we had a dream of building an inclusive space for everyone to exercise. We got the green light to reopen in July, like everyone we were hesitant, but we took all the measures public health offered, even added a few, and still the pandemic struck us again!" 

"It started September 28 and spread amongst specific classes until October 5th," the post reads. "SPINCO Hamilton has been closed from the moment the outbreak was identified. As of today, everyone who has tested positive, are well. Our team, alongside Public Health has notified everyone. "We have been following all the procedures set in place by public health. We have been in constant contact with our riders and we will continue to do so, if not daily, then every few days, with updates." 

The owners vowed to come back stronger once it's deemed safe to do so. 

"So we are at a point, where either we let this pandemic own us, or we take ownership back. We are determined to switch the script! We can and we know the power of our community," the post read. "So while we wait and remain closed, you have our commitment that we will not re-open until it is safe to do so, we need to show our city and the rest of our province that the SPINCO community is not going anywhere! We are strong, we are tough and we fight together.."  

CLICK FOR COMPLETE CORONAVIRUS COVERAGE 

In other parts of Ontario, namely Peel, Ottawa, and Toronto, gyms are facing a second closure. But Richardson said officials are continuing to review the outbreak in Hamilton before again shutting down fitness studios there. 

"If we saw something that extended beyond this one particular instance we would definitely move to do something more quickly, but right now … saying make sure you're wearing a mask, make sure you're distancing, turn that music down, don't be yelling …while we look at this and see what more could be done,” she said, according to CBC News. 

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Prospective parents’ mental health linked to premature births

Both a mother’s and father’s mental health are associated with increased risk that their baby will be born premature, a new study has found.

The research, led by the Murdoch Children’s Research Institute (MCRI) and published in EClinicalMedicine, found men with persistent mental health problems through adolescence and young adulthood were more likely to have a baby born premature. Women with anxiety and depression during pregnancy were more likely to have a preterm birth.

Study co-lead MCRI’S and Deakin University’s Dr. Elizabeth Spry said prior to this study the impact of maternal and paternal mental health history on offspring preterm birth and birth weight was unknown.

The study involved 398 women and 267 men from the Victorian Intergenerational Health Cohort Study (VIHCS), who were assessed over 15 years for anxiety and depressive symptoms from adolescence to young adulthood and during subsequent pregnancies.

Dr. Spry said that fathers were often neglected in research on children’s early growth and development.

“We found that men with persistent mental health symptoms in the decades leading up to pregnancy were more likely to have premature babies. Our study joins growing evidence of the important role that fathers play in the health and development of their children, and suggests that these links begin well before babies are conceived,” she said.

“Most research on children’s early development has focused on mums. This means that public health recommendations are also almost entirely focused on what mums should and shouldn’t do when planning pregnancy or having a child. In contrast, men receive very little guidance or support.”

Study co-lead, King’s College London’s Dr. Claire Wilson, said understanding how mental health problems starting in adolescence affect birth outcomes could open up new opportunities for the prevention of premature birth.

“Mental health may affect parental reproductive biology and antenatal pathways and can have an impact on genetic and environmental influences such as substance use and nutrition, which could be linked to a baby’s development,” she said.

“Pre-term birth is common and is a leading cause of infant deaths worldwide, but the underlying causes have been largely unknown. Early and mid-late preterm birth can carry lifelong effects on health and development such as visual and hearing impairments and poor health and growth.”

MCRI Professor George Patton said the findings further strengthened the need for expanding preconception mental health care to both men and women, prior to them becoming parents.

“The findings emphasize a need for coordinated care between child and adolescent, adult and specialist perinatal health services,” he said.

“Intervention in adolescence is likely to yield benefits not only for parents’ own continuing mental health, but also for their child’s development, both by reducing the risk of premature birth and promoting positive engagement and nurturing care across the early years of life.”

Professor Patton said prospective parent’s mental health had also suffered during COVID-19 and the subsequent lockdowns.

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Elevated clotting factor V levels linked to worse outcomes in severe COVID-19 infections

Patients hospitalized with severe COVID-19 infections who have high levels of the blood clotting protein factor V are at elevated risk for serious injury from blood clots such as deep vein thrombosis or pulmonary embolism, investigators at Massachusetts General Hospital (MGH) have found.

On the other hand, critically ill patients with COVID-19 and low levels of factor V appear to be at increased risk for death from a coagulopathy that resembles disseminated intravascular coagulation (DIC), a devastating, often fatal abnormality in which blood clots form in small vessels throughout the body, leading to exhaustion of clotting factors and proteins that control coagulation, report Elizabeth M. Van Cott, MD, investigator in the deparment of pathology at MGH and colleagues.

Their findings, based on studies of patients with COVID-19 in MGH intensive care units (ICUs), point to disturbances in factor V activity as both a potential cause of blood clotting disorders with COVID-19, and to potential methods for identifying at-risk patients with the goal of selecting the proper anticoagulation therapy.

The study results are published online in the American Journal of Hematology.

“Aside from COVID-19, I’ve never seen anything else cause markedly elevated factor V, and I’ve been doing this for 25 years,” Van Cott says.

Patients with severe COVID-19 disease caused by the SARS-CoV-2 virus can develop blood clots in medical lines (intravenous lines, catheters, etc), and in arteries, lungs, and extremities, including the toes. Yet the mechanisms underlying coagulation disorders in patients with COVID-19 are still unknown.

In March 2020, in the early days of the COVID-19 pandemic in Massachusetts, Van Cott and colleagues found that a blood sample from a patient with severe COVID-19 on a ventilator contained factor V levels high above the normal reference range. Four days later, this patient developed a saddle pulmonary embolism, a potentially fatal blood clot occurring at the junction of the left and right pulmonary arteries.

This pointed the investigators to activity of factor V as well as factor VIII and factor X, two other major clotting factors. They studied the levels of these clotting factors and other parameters in a group of 102 consecutive patients with COVID-19, and compared the results with those of current critically ill patients without COVID-19, and with historical controls.

They found that factor V levels were significantly elevated among patients with COVID-19 compared with controls, and that the association between high factor V activity and COVID-19 was the strongest among all clinical parameters studied.

In all, 33 percent of patients with factor V activity well above the reference range had either deep vein thrombosis or a pulmonary embolism, compared with only 13 percent of patients with lower levels. Death rates were significantly higher for patients with lower levels of factor V (30 percent vs. 12 percent), with evidence that this was due to a clinical decline toward a DIC-like state.

Van Cott and colleagues also found that the clinical decline toward DIC was foreshadowed by a measurable change in the shape or “waveform” of a plot charting light absorbance against the time it takes blood to coagulate (waveform of the activated partial thromboplastin time, or aPTT).

“The waveform can actually be a useful tool to help assess patients as to whether their clinical course is declining toward DIC or not,” Van Cott explains. “The lab tests that usually diagnose DIC were not helpful in these cases.”

Importantly, the MGH investigators note that factor V elevation in COVID-19 could cause misdiagnosis of some patients, because under normal circumstances factor V levels are low in the presence of liver dysfunction or DIC. Physicians might therefore mistakenly assume that patients instead have a deficiency in vitamin K.

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Genetic mutations may be linked to infertility, early menopause

A new study from Washington University School of Medicine in St. Louis identifies a specific gene’s previously unknown role in fertility. When the gene is missing in fruit flies, roundworms, zebrafish and mice, the animals are infertile or lose their fertility unusually early but appear otherwise healthy. Analyzing genetic data in people, the researchers found an association between mutations in this gene and early menopause.

The study appears Aug. 28 in the journal Science Advances.

The human gene—called nuclear envelope membrane protein 1 (NEMP1)—is not widely studied. In animals, mutations in the equivalent gene had been linked to impaired eye development in frogs.

The researchers who made the new discovery were not trying to study fertility at all. Rather, they were using genetic techniques to find genes involved with eye development in the early embryos of fruit flies.

“We blocked some gene expression in fruit flies but found that their eyes were fine,” said senior author Helen McNeill, Ph.D., the Larry J. Shapiro and Carol-Ann Uetake-Shapiro Professor and a BJC Investigator at the School of Medicine. “So, we started trying to figure out what other problems these animals might have. They appeared healthy, but to our surprise, it turned out they were completely sterile. We found they had substantially defective reproductive organs.”

Though it varied a bit by species, males and females both had fertility problems when missing this gene. And in females, the researchers found that the envelope that contains the egg’s nucleus—the vital compartment that holds half of an organism’s chromosomes—looked like a floppy balloon.

“This gene is expressed throughout the body, but we didn’t see this floppy balloon structure in the nuclei of any other cells,” said McNeill, also a professor of developmental biology. “That was a hint we’d stumbled across a gene that has a specific role in fertility. We saw the impact first in flies, but we knew the proteins are shared across species. With a group of wonderful collaborators, we also knocked this gene out in worms, zebrafish and mice. It’s so exciting to see that this protein that is present in many cells throughout the body has such a specific role in fertility. It’s not a huge leap to suspect it has a role in people as well.”

To study this floppy balloon-like nuclear envelope, the researchers used a technique called atomic force microscopy to poke a needle into the cells, first penetrating the outer membrane and then the nucleus’s membrane. The amount of force required to penetrate the membranes gives scientists a measure of their stiffness. While the outer membrane was of normal stiffness, the nucleus’s membrane was much softer.

“It’s interesting to ask whether stiffness of the nuclear envelope of the egg is also important for fertility in people,” McNeill said. “We know there are variants in this gene associated with early menopause. And when we studied this defect in mice, we see that their ovaries have lost the pool of egg cells that they’re born with, which determines fertility over the lifespan. So, this finding provides a potential explanation for why women with mutations in this gene might have early menopause. When you lose your stock of eggs, you go into menopause.”

McNeill and her colleagues suspect that the nuclear envelope has to find a balance between being pliant enough to allow the chromosomes to align as they should for reproductive purposes but stiff enough to protect them from the ovary’s stressful environment. With age, ovaries develop strands of collagen with potential to create mechanical stress not present in embryonic ovaries.

“If you have a softer nucleus, maybe it can’t handle that environment,” McNeill said. “This could be the cue that triggers the death of eggs. We don’t know yet, but we’re planning studies to address this question.”

Over the course of these studies, McNeill said they found only one other problem with the mice missing this specific gene: They were anemic, meaning they lacked red blood cells.

“Normal adult red blood cells lack a nucleus,” McNeill said. “There’s a stage when the nuclear envelope has to condense and get expelled from the young red blood cell as it develops in the bone marrow. The red blood cells in these mice aren’t doing this properly and die at this stage. With a floppy nuclear envelope, we think young red blood cells are not surviving in another mechanically stressful situation.”

The researchers would like to investigate whether women with fertility problems have mutations in NEMP1. To help establish whether such a link is causal, they have developed human embryonic stem cells that, using CRISPR gene-editing technology, were given specific mutations in NEMP1 listed in genetic databases as associated with infertility.

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Obesity is linked to gut microbiota disturbance, but not among statin-treated individuals

In 2012, the European Union MetaCardis consortium, comprising 14 research groups from six European countries with multidisciplinary expertise set out to investigate a potential role of the gut microbiota in the development of cardio-metabolic diseases. This project, coordinated by Prof Karine Clément at INSERM (France) studies more than 2,000 deeply phenotyped European participants in health and at different stages of cardiometabolic disease (obesity, diabetes and cardiovascular diseases).

Today, research teams led by Jeroen Raes (VIB-KU Leuven) and Prof. Clément (INSERM, Paris), together with the Metacardis consortium, publish their first findings in the authoritative journal Nature, identifying the common cholesterol-lowering drug statins as a potential microbiota-modulating therapeutic.

In their manuscript entitled “Statin therapy associates with lower prevalence of gut microbiota dysbiosis,” Jeroen Raes (VIB-KU Leuven) and colleagues explore gut bacteria in a Metacardis cohort subset comprising nearly 900 individuals from three countries (France, Denmark and Germany) with BMI ranging between 18 and 73 kg.m-2. While the intestinal microbiota in obese individuals had previously been shown to differ from those in lean subjects, the unique experience of the Raes Lab in quantitative microbiome profiling allowed the researchers to shed a whole new light on microbiota alterations associated with obesity.

Prof. Jeroen Raes says, “Recently, our lab identified a single gut microbiota configuration (enterotype) with increased prevalence among patients suffering from intestinal inflammation (inflammatory bowel disease), multiple sclerosis, and depression. We observed this disturbed enterotype to be characterized by low bacterial abundances and biodiversity, notably deficient in some anti-inflammatory bacteria such as Faecalibacterium. In fact, even among healthy individuals, we detected slightly higher inflammation levels in carriers of what we refer to as the Bacteroides2 (Bact2) enterotype. As obesity is known to result in increased systemic inflammation levels, we hypothesized that Bact2 would also be more prevalent among obese study participants.”

Exploring gut microbiota configurations of lean and obese volunteers, the MetaCardis researchers observed that Bact2 prevalence increased with BMI. While only 4% of lean and overweight subjects were characterized as Bact2 carriers, percentages sharply rose to 19% among obese volunteers. The same trend was observed among 2,350 participants of the VIB-KU Leuven Flemish Gut Flora Project population cohort.

Sara Vieira-Silva (principal author, VIB-KU Leuven): “We found systemic inflammation in participants carrying the Bact2 enterotype to be higher than expected based on their BMI. Even though this study design does not allow inferring causality, our analyses do suggest that gut bacteria play a role in the process of developing obesity-associated comorbidities by sustaining inflammation. While these key findings confirmed our study hypothesis, the results we obtained when comparing statin-treated and -untreated participants came as a total surprise.”

Statins are commonly prescribed to reduce risk of developing cardio-metabolic diseases. Besides their target cholesterol-lowering effects, statins also tend to appease patients’ systemic inflammation levels. Now, Vieira-Silva and colleagues have identified an additional potential beneficial effect of statin therapy on the gut microbiota. In obese individuals, the prevalence of the dysbiotic Bact2 enterotype was significantly lower in those taking statins (6%) than in their non-treated counterparts (19%) – comparable to levels observed in non-obese participants (4%). These striking observations were validated not only in the independent Flemish Gut Flora Project dataset, but also in an additional MetaCardis subset consisting of 280 patients with cardiovascular diseases.

Sara Vieira-Silva says, “These results suggest statins could potentially modulate the harmful gut microbiota alterations sustaining inflammation in obesity. Several interpretations of our results remain possible. On one hand, by appeasing gut inflammation, statin therapy might contribute to a less hostile gut environment, allowing the development of a healthy microbiota. On the other hand, a direct impact of statins on bacterial growth has been previously demonstrated, which could possibly benefit non-inflammatory bacteria and underlie anti-inflammatory effects of statin therapy.”

For many years, microbiota modulation strategies have been revolving around dietary interventions, (next-generation) pro- and prebiotics, introducing or promoting growth of beneficial bacteria. Only recently, a revived interest in the effect of small molecules and drugs on the colon ecosystem appeared. This study will further fuel that momentum.

Prof. Jeroen Raes says, “The potential beneficial impact of statins on the gut microbiota opens novel perspectives in disease treatment, especially given the fact that we have associated the Bact2 enterotype with several pathologies in which a role of the gut microbiota has been postulated. Our results open a whole range of possibilities for novel, gut microbiota modulating drug development.”

At the same time, the MetaCardis team insists on a careful interpretation of their study results.

While promising, the findings reported are based on cross-sectional analyses, as opposed to following a treatment timeline. This means causality cannot be claimed based on these observations, nor can the researchers exclude that unaccounted factors could have played a role. For example, statin-medicated participants might have adopted a radically healthy lifestyle after being diagnosed with an increased risk of developing cardio-metabolic disease, which could have had a profound impact on their gut ecosystem.

“Thus,” the researchers warn, “while our results are definitely promising, they require further evaluation in a prospective clinical trial to ascertain whether the effect is reproducible in a randomized population, before considering the application of statins as microbiota-modulating therapeutics.”

The present study is part of a greater effort in unraveling the role of the gut microbiota in cardiovascular disease by the European Commission-sponsored MetaCardis consortium.

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