Sanitation: Preventing gluten damage, symptoms

Health Rounds

By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we feature some promising news for people dealing with gluten issues from celiac disease. We also report on studies that appear to debunk cannabis as a sleep enhancer, and another way in which artificial intelligence could help people monitor and better understand various health conditions.

Among our breaking news stories: Financial, mental health issues pushing women towards early retirement; CDC to deploy additional support to Pennsylvania to probe measles outbreak; US measles cases rise to 4,080, CDC says; Congo's Ebola infections surpass 9,000; and WHO unsure what caused pneumonia that killed plague-lab worker in Russia.

Industry Updates

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Pope Leo diagnosed with cancer as doctors remove part of lung, Vatican says

REUTERS/Ciro de Luca TPX IMAGES OF THE DAY

Pope Leo was diagnosed with a common form of lung cancer after surgeons removed a part of his right lung on Tuesday, the Vatican said in a medical bulletin. Read more here.

Study Rounds

Experimental drug protects against gluten damage, symptoms

A drug being developed by First Tracks Biotherapeutics not only reduced symptoms from gluten exposure in patients with celiac disease but also protected against gluten-induced intestinal damage, according to results of a small early-stage trial.

Participants in the 32-patient study had been diagnosed with celiac disease at least a year prior and were following a gluten-free diet, but still had moderate damage to their intestines as seen on biopsies.

Even trace exposure to gluten can cause intestinal damage and debilitating symptoms despite general adherence to a gluten-free diet, the researchers noted.

Patients were given three subcutaneous injections of First Tracks' ANB033 or a placebo at the start of the trial, at week 2 and week 4, followed by two weeks of daily consumption of 6 grams of gluten, or about the equivalent of two slices of bread.

A second set of biopsies done at the end of the study showed patients who received the drug had statistically significant protection against intestinal damage compared with those who got a placebo, according to the company.

Furthermore, ANB033 prevented an increase in symptoms throughout the entire gluten challenge, whereas patients in the placebo group experienced a marked increase in symptoms, the researchers found.

Only 6% of ANB033 patients needed permitted medications to mitigate their gastrointestinal symptoms, compared with 47% of placebo patients.

“It is remarkable to see, for the first time, both statistically significant prevention of symptoms and (intestinal) benefit in the same study,” study leader Dr. Benjamin Lebwohl of New York-Presbyterian/ Columbia University Irving Medical Center said in a statement.

ANB033 inhibits immune cell proteins IL-15 and IL-2, two key drivers of inflammation that damage the intestine, with IL-2 closely linked to symptom development, Lebwohl noted.

As part of the same trial, the researchers are assessing intestinal healing and symptom severity at 12 weeks in a second group of patients, with initial results expected early next year.

They expect to present the full results of the study at the International Celiac Disease Symposium in Melbourne, Australia, next month.

Studies do not support cannabis as a sleep aid

Two recent studies challenge the idea that cannabis helps to improve sleep.

For one study, researchers reviewed data from nine trials involving 537 adults with insomnia who were randomly assigned to treatment with medical cannabis, a placebo or an antidepressant.

Medical cannabis showed little to no clinically meaningful improvement in sleep quality and satisfaction, total sleep time, or daytime functioning compared with placebo or the antidepressant, the researchers reported on Tuesday in The Cochrane Database of Systematic Reviews.

However, the various trials used different cannabis products, none of them followed participants for more than 12 weeks, and the overall quality and certainty of the evidence were rated very low to low because of possible bias and other limitations, the researchers noted.

Therefore, the findings cannot reliably answer whether medical cannabis helps people with insomnia, they said.

“Rather than viewing the findings as either an endorsement or a rejection of medical cannabis, clinicians and patients should recognize the uncertainty and consider individual circumstances while better evidence is generated,” study leader Dr. Luis Garegnani from Universidad Hospital Italiano de Buenos Aires in Argentina said in a statement.

A separate study that followed 1,266 participants from young adulthood into middle age found long-term cannabis use was linked to lower sleep quality as measured by wrist-worn monitors.

The findings, published in JAMA Network Open, also suggested that cannabis-related sleep disruptions may go unnoticed by users themselves.

“The wearable device detected more nighttime disruption among participants with long-term cannabis exposure, but the participants themselves generally did not report worse sleep,” study leader Dr. Thanh-Huyen T. Vu of Northwestern University Feinberg School of Medicine said in a statement.

“This study challenges the common belief that cannabis helps people sleep better,” she added. “Our findings suggest cannabis may actually be associated with poorer sleep quality, even if people don't perceive those changes.”

AI lets patients interact with health monitoring devices

An AI platform allowed patients to “converse” with their medical devices in a pilot study of 13 patients, all with frequent seizures due to epilepsy who were undergoing continuous brain monitoring using electroencephalography, researchers reported on Tuesday.

Through a smartphone app, the patients could text their monitoring equipment to ask about their brain activity, request charts and other graphics showing trends in their data, and receive alerts or surveys throughout the day.

The device could contact the patient when it saw changes that might be of interest, and it could learn “on the fly” based upon patient responses.

Although the study focused on epilepsy, the researchers say the platform could have broad applications for conditions that use cardiac devices, insulin pumps, and emerging treatments for neuropsychiatric disorders such as Parkinson’s disease, depression, obsessive-compulsive disorder, addiction, and cognitive disorders.

“We envision medical devices becoming partners in care that learn alongside patients and help them make better decisions every day,” study leader Dr. Brian Litt of the University of Pennsylvania said in a statement.

As reported in Nature Medicine, researchers analyzed 1,307 messages exchanged between patients and the system over an average of about five days, most involving discussions about seizure events, sleep, mood, energy levels, and other factors that can influence seizure activity.

Several participants said the platform helped explain patterns they had previously observed but struggled to understand, such as associations of seizure episodes with emotions.

Patients could also teach the system about their condition, noting which seizures the program correctly identified and which were false alarms, helping the system to improve its accuracy.

The patients’ doctors could also converse with the system.

“Patients often understand aspects of their disease that sensors cannot measure directly,” Litt said.

“Imagine an insulin pump that can answer questions about how a meal will affect blood sugar, or a Parkinson’s device that adjusts treatment based on how a patient feels during a walk or writing a letter,” he said.