Some Weight-Loss Drugs Might Disrupt Brain Growth in Kids

Wed May 7, 11:46 PM ET

WEDNESDAY, May 7 (HealthDay News) -- A new class of weight-loss drugs that suppresses appetite by blocking cannabinoid receptors in the brain should be used with caution in children, U.S. scientists report.
ADVERTISEMENT

In research with mice, they found this class of drugs also suppresses the adaptive rewiring of the brain necessary for neural development in young animals. The findings are in the May 8 issue of Neuron.

One such drug is rimonabant (Acomplia), which was developed by Sanofi-Aventis and is awaiting approval by the U.S. Food and Drug Administration. Other pharmaceutical companies are developing similar drugs.

In this study, researchers concluded that a cannabinoid receptor-blocking drug called AM 251 affected experience-dependent cortical plasticity in the brains of juvenile mice. This plasticity is the experience-prompted adaptive rewiring of the brain that plays an critical role in the neural development of young animals.

"Our finding of a profound disruption of cortical plasticity in juvenile mice treated with AM 251 suggests caution is advised in the use of such compounds in children," wrote Mark F. Bear and his colleagues, of the Howard Hughes Medical Institute, The Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, in Cambridge, Mass.

Gene therapy shows promise in rare brain disease

By Maggie Fox, Health and Science Editor Tue May 13, 11:32 AM ET

WASHINGTON (Reuters) - An experimental gene therapy treatment appears to have helped eight children with a rare and incurable neurological disorder, although it may have been responsible for the death of one, researchers reported on Tuesday.

They said the treatment appeared safe and effective enough to try in more children with late infantile neuronal ceroidlipofuscinosis, or LINCL, a form of deadly Batten disease.

The treatment, in which a virus carrying the corrective gene was infused directly into the brain, appeared to slow the decline of eight out of 10 children treated, Dr. Ron Crystal of New York-Presbyterian Hospital/Weill Cornell Medical Center and colleagues reported.

"We are encouraged by this. It's not a cure," Crystal said in a telephone interview.

Like all forms of gene therapy, the hope is that the mutant cells will take up the new gene and start working normally.

Children with LINCL start showing symptoms at about age 4. They lose coordination, vision and speech and usually die unable to breathe on their own, between 10 and 12.

One child suffered an epileptic seizure weeks after treatment and died and another child died of unknown causes two years after treatment.

Eight of the children showed a measurable slowing of the inevitable decline usually seen in the condition.

Only about 200 children are alive with the disease globally at a given time.

"The disease is caused by mutations in the CLN2 (ceroid lipofuscinosis, neuronal 2) gene," Crystal and colleagues wrote in their report, which was published in the journal Human Gene Therapy.

INTERNATIONAL TRIAL

The researchers chose 10 children from the United States, Britain, Australia and Germany, five severely affected by the disease and five moderately affected.

Tiny glass tubes infused the adeno-associated viruses carrying the corrective gene into the brains of the children. Crystal's team watched the 10 children for 18 months, comparing them to four untreated children with the same condition.

"The primary variable was a clinical rating scale based on the number of seizures, language skills, motor skills and so on," Crystal said. "That's where we saw what appeared to be statistically significant."

Magnetic resonance imaging scans of the brain also appeared to show slowing of the disease but this was less clear, he said.

"You can't give back more brain cells. You can't improve it. All you can hope to do is to delay progression," Crystal said.

One child suffered a seizure and died after 49 days. "We know it's related to what we did," Crystal said. "But we don't know whether it related to the virus or not."

He said there was no evidence the virus caused an immune reaction and noted that putting a glass tube into the brain could have caused a seizure. Children with Batten's often have seizures as a manifestation of the disease.

Crystal said the dangerous and experimental therapy was justified for the children. The mutations affect a mechanism that rids nerve cells of waste materials.

"It's like the garbage man of the cell is not able to do its job," Crystal said. "The trash keeps getting backed up inside the cell until the cells can no longer function properly and then eventually die throughout the entire brain."

Gene therapy is a controversial field but last month doctors reported a gene therapy approach improved the vision in four patients with a blinding condition.

In 1999 an 18-year-old volunteer died during a gene therapy experiment and in 2002 gene therapy cured two French boys with a fatal immune disorder but gave then leukemia -- which was also treated.

(Editing by Will Dunham and Bill Trott)

Childhood anxiety may worsen anorexia

Fri May 16, 3:58 PM ET

NEW YORK (Reuters Health) - Anorexic women with a history of childhood anxiety may have particularly severe symptoms of the eating disorder, a study suggests.

It's known that anxiety disorders, like social phobia and obsessive compulsive disorder, are far more common among people with anorexia than in the general population. Often, these anxiety disorders appear before the eating disorder does.

In the new study, published in the International Journal of Eating Disorders, researchers looked at whether a history of childhood "overanxious disorder" was related to the severity of women's anorexia.

Dr. Cynthia M. Bulik, of the University of North Carolina at Chapel Hill, and colleagues found that of 637 women with anorexia, 39 percent reported symptoms of childhood overanxious disorder. In nearly all cases, those symptoms arose before the onset of their anorexia.

In general, the researchers found, women with a history of childhood anxiety exhibited "more extreme personality traits" and attitudes -- like perfectionism and obsessive tendencies related to food -- than women without a history of early anxiety disorders.

They were also more likely to purge, by vomiting or abusing laxatives, in addition to strictly limiting their food intake.

According to Bulik's team, childhood anxiety disorders "may represent one entree" into anorexia. This, they say, underscores the importance of recognizing and treating these conditions early on.

SOURCE: International Journal of Eating Disorders, May 2008.

Health Tip: Traveling During Pregnancy

Thu May 15, 11:47 PM ET

(HealthDay News) -- If you're planning to take a trip while pregnant, you should check with your doctor to be sure it's safe for you to travel. Unless you have complications with your pregnancy, most women can travel safely.

Here are some travel tips to keep you safe and comfortable during pregnancy, courtesy of the American Pregnancy Association:

* Travel during the second trimester is usually most comfortable -- after morning sickness has passed and the fatigue of the third trimester is still ahead.
* Wear comfortable, loose clothing and comfortable shoes.
* Take things to make you more comfortable, like a pillow from home and some snacks that satisfy you.
* If you're driving, stop to get up and stretch often and take plenty of bathroom breaks.
* Always take your prenatal records with you on the road.
* Be safe: Wear your seat belt and follow safety instructions for whatever transportation you use.

Heart risks high in childhood cancer survivors

By Julie Steenhuysen Thu May 15, 9:27 PM ET

CHICAGO (Reuters) - Children who survive cancer while they are young are five to 10 times more likely than their healthy siblings to develop heart disease, U.S. researchers said on Thursday.

The finding comes from a study of more than 14,000 survivors of childhood cancers, and suggests that cancer survivors and their doctors need to be vigilant about heart risks.

"This study clearly shows for children, and particularly children treated with radiation therapy to the chest or certain drugs that are particularly toxic to the heart, there are significant risks of cardiovascular disease at a far younger-than-expected age," said Dr. Richard Schilsky of the University of Chicago.

The preliminary results were released ahead of a meeting later this month of the American Society of Clinical Oncology.

Schilsky, who is president-elect of ASCO, said the study highlights the challenges faced by cancer survivors, who have to live with the health consequences of having had cancer and having been treated for cancer.

Dr. Daniel Mulrooney of the University of Minnesota and colleagues conducted the study, which looked at 14,358 survivors of childhood leukemia, central nervous system tumors, Hodgkin's and non-Hodgkin's lymphoma, kidney tumors, bone cancers, neuroblastoma and soft-tissue sarcoma between 1970 and 1986.

They compared these to 3,899 of their siblings. Cancer survivors on average were 7 years old at diagnosis and 27 at follow up.

The cancer survivors were 10 times more likely to have clogged arteries, 5.7 times more likely to have heart failure, 4.9 times more likely to have heart attacks, 6.3 times more likely to have pericardial disease -- affecting the sac surrounding the heart -- and 4.8 times more likely to have diseased heart valves compared with their siblings.

"We found 5-year survivors of childhood and adolescent cancers are at an elevated risk for early cardiovascular disease," Mulrooney told reporters in a telephone briefing.

They also found the risks were two to five times greater in people who had been treated with chest radiation and chemotherapy from the anthracycline class of drugs, such as doxorubicin, compared to survivors who did not have those treatments.

Mulrooney said there are about 270,000 childhood cancer survivors in the United States, or about 1 in every 900 young adults. He said the findings may lead to better cancer treatments that protect the heart.

"We still use radiation therapy," he said, but newer radiation treatments are more targeted, and he hopes they will have less impact on the heart.

Schilsky said other studies have found long-term cancer survivors are at greater risk of premature osteoporosis, infertility, thyroid problems, anxiety and depression and the risk of another cancer.

"It becomes incumbent on the patient and the primary care physician to be aware of their cancer history and the potential consequences of their treatment," Schilsky said.

(Editing by Maggie Fox)

Study finds heart risks in young cancer survivors

By MARILYNN MARCHIONE, AP Medical Writer Thu May 15, 9:03 PM ET

Children who survive cancer face a much greater risk of heart problems later in life than their brothers and sisters who did not have cancer, new research shows.

Doctors have long known that certain chemotherapy drugs and radiation can harm the heart, but it has been seen as a relatively small price to pay for beating cancer. Cancer itself may damage the heart. And even though the risk was higher, heart problems still were relatively rare.

The study used a national registry to track 14,358 cancer survivors diagnosed in the 1970s and 1980s, when treatments were harsher than those commonly used today, and compared them to about 4,000 healthy siblings.

The survivors had one of eight forms of the disease, including leukemia, brain tumors, Hodgkin's or non-Hodgkin's lymphoma and kidney tumors.

Compared to their healthy siblings, they had five to 10 times greater risk of heart problems, ranging from clogged arteries to heart failure and valve disease.

The risk often showed up when they were still young adults — an age when few doctors would think to check them for heart problems. The survivors were diagnosed with cancer at an average age of 8, and their average age was 28 when the follow-up study was done.

There are about 270,000 childhood cancer survivors in the United States today, said the study's leader, Dr. Daniel Mulrooney at the University of Minnesota.

"They have to live with the health consequences of having had cancer and having been treated for cancer," he said.

Still, the incidence of problems was low: 2 percent had hardening of the arteries, 4 percent had heart failure, 1 percent suffered a heart attack and 4 percent had a valve problem.

Study results were released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.

France reports leveling childhood obesity rates

By Michael Kahn Thu May 15, 9:40 AM ET

GENEVA (Reuters) - France is the first EU country to report a leveling off of childhood obesity rates, suggesting that healthier diet programs and a ban on vending machines in schools is paying off, researchers said on Thursday.

The findings from two separate studies of school-age children signal a shift in France after decades of increase, researchers told the 2008 European Congress on Obesity.

"The rates of children who are overweight are undergoing an overall stabilization in France among all socio-economic backgrounds," said Sandrine Lioret, an epidemiologist at the French Food Safety Agency, who led one of the studies.

Obesity is a major problem worldwide that increases the risk later in life of type 2 diabetes, cancer and heart disease. The World Health Organization classifies around 400 million people as obese, including 20 million children under age 5.

Many Western governments -- where the obesity problem is greatest -- have adopted programs in recent years to promote healthier diets and lifestyles to keep children from growing up to be overweight and obese.

The French findings are important because they show that government policies are a potential weapon in the fight against childhood obesity, said Tim Lobstein, a director of the International Obesity Task Force in London.

But he cautioned that only time would tell whether the French results are a one-off blip or part of a long-term trend.

"The tidal wave (of obesity) is continuing to surge in most European countries," he said. "We are seeing that wave roll on through to adulthood."

France is about in the middle when it comes to European childhood obesity rates, with the lowest seen in Scandinavia and the highest in poorer nations in Southern Europe, the researchers said.

In one of the studies, Lioret's team at the French Food Safety Agency showed no statistically significant change in the prevalence of obesity rates among randomly-selected school children age 3 to 17 in surveys taken eight years apart.

The other research from the French National Institute for Health Surveillance found that the number of obese children aged 7 to 9 had remained steady at around 18 percent in 2000 and 2007.

Government policies, a growing awareness of the dangers of obesity and the fact that children are eating less all seem to be playing a role, the researchers said.

One worry, though, is that even as the overall rate has flattened, poor children were up to three times more likely to be obese compared to wealthier children, they added.

(Reporting by Michael Kahn, Editing by Jon Boyle)