Daily Archives: August 27, 2022

Ellen White has broken her silence on one of the main reasons why she decided to retire from professional football following Englands historic Euro 2022-winning summer.

Off the back of her emotional retirement statement, the Lionesses all-time top goalscorer has shed light on a traumatic incident that left her with a punctured lung last year.

White revealed the injury was a big factor in her decision to hang up her boots and look towards the next chapter in her career.

The former Manchester City star suffered a lung injury after receiving acupuncture for a back spasm issue following the 2020 Olympics.

Acupuncture is a form of alternative medicine, derived from traditional Chinese practice, where thin needles are inserted into the skin. It is most often used in attempt to aid pain relief.

White helped Great Britain reach the quarter-finals at the Tokyo Games before returning to City, who arranged for an external specialistto perform the treatment.

The club reportedly outsourced the acupuncture specialist due to a high amount of injuries in the Man City camp at the time.

Speaking to BBC Sport, White revealed the treatment had punctured her lung, which was a lot for me to have to go through and a big reason that accelerated my want to retire.

The 33-year-old admitted if someone had suggested two or three years ago that she would retire in 2022, she would not have believed it.

However, her injury hampered her fitness and it is something she is still trying to work out.

It punctured my lung which isnt something that happens normally, obviously, White said. It was a really traumatic time for me and something that Im still figuring out now, still working through.

The puncture left White unable to exercise due to being constantly short of breath.

She revealed she had a needle put into her chest to drag all the air out to help the lung inflate again.

White was able to return to the pitch and reach huge team and individual milestones, but she is still affected by the injury and admitted she feels a phantom pain as though it is still there.

Its important for me now to tell my story, and say it was a big factor in my year and leading up to the decision of wanting to retire. Obviously there are other factors that come into that as well.

I dont want it to happen to anybody else again is my main thing. I dont want to walk away from the sport having not told it and not say that I want things in place for it not to happen to anyone else.

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White leaves behind a magnificent legacy on the football pitch and bows out following a history-making summer at Euro 2022.

In November 2021, the striker earned her 100th cap for England and followed up in the next match by becoming the Lionesses top goalscorer.

She surpassed Kelly Smiths tally and came within two goals of beating Wayne Rooneys all-time record of 53 goals scored for England. She hangs up her boots with 52 goals scored in 113 appearances for her country.

The evergreen White also boasts the second highest goal return in Womens Super League history. With 61 goals in Englands top flight, she is behind only Vivianne Miedema, who leads the table with 74 goals for Arsenal.

On the international stage, White has represented England at three World Cups, including the bronze medal finish in 2015. She was also called up to Team GB for two Olympic Games. She was named England Womens Player of the Year in 2011, 2018 and 2021.

During her domestic career, the 33-year-old played for Chelsea, Leeds, Arsenal, Notts County, and Birmingham before joining Man City in 2019.

Throughout her 17 years as a senior player, White won two Womens Super League titles, four League Cups, and three FA Cups. She also won the 2017/18 WSL Golden Boot and holds the record for most goals scored by an England player at the Womens World Cup, as well as being Team GBs female all-time record goalscorer.

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Ellen White reveals "traumatic" incident that played huge role in her retirement - GIVEMESPORT

Non-Hodgkins lymphoma is the most common cancer of the immune system and one of the most common cancers in the United States.

Characterized by solid tumors that first develop in the lymph nodes, it is estimated that more than 80,000 Americans will receive a diagnosis of non-Hodgkins lymphoma in 2022.

In addition to its high prevalence, there are several subtypes of non-Hodgkins lymphoma that pose challenges for effective treatment and management.

For instance, diffuse large B-cell lymphoma is a common subtype of non-Hodgkins lymphoma that has shown resistance to current treatments, potentially increasing the risk of recurrence in some people.

Thus, researchers continue to explore new and alternative treatment options that are effective and safe. One such natural product is curcumin, an active compound found in the spice turmeric.

This article explains curcumin and its potential benefits and downsides for treating or preventing non-Hodgkins lymphoma.

Curcumin is not proven to prevent non-Hodgkins lymphoma, but it shows great potential as an alternative therapy in symptom management when taken in combination with conventional cancer treatments.

The anticancer potential of curcumin has been linked to its anti-inflammatory and antioxidant properties.

A 2017 research report suggests that curcumin disrupts cellular pathways between the lymphoma cancer cells responsible for its growth and spread.

Similarly, more recent test tube research found that curcumin suppressed the growth of diffuse large B-cell lymphoma the most common subtype of non-Hodgkins lymphoma and even induced death of the cancer cells.

A reduction of cancer-related inflammation via curcumin supplements was associated with an improvement in the quality of life of some people, including those with various lymphomas.

Taking curcumin at the same time as the cancer drug imatinib appeared to enhance the effectiveness of chemotherapy against non-Hodgkins lymphoma in test tube research.

The combined treatment, called rituximab, was more effective than the administration of the cancer drug alone.

This finding was consistent with other research that suggested curcumin could enhance the effects of chemotherapy and radiation cancer treatments.

Research also suggests that curcumin may reduce resistance to chemotherapy, or chemoresistance, which some people experience with non-Hodgkins lymphoma subtypes.

However, its still unclear whether these effects would be the same in humans, so we need more research.

The potential role of curcumin in cancer treatment continues to be recognized.

It may be capable of disrupting several cellular pathways related to the growth and spread of non-Hodgkins lymphoma. Plus, there are no reported side effects in doses as high as 8 to 12 grams per day.

Given that most of the research on curcumin and cancer has been in test tubes and animals, more clinical trials involving humans are needed to determine the long-term effects of curcumin for non-Hodgkins lymphoma.

Curcumin is a compound found in turmeric (Curcuma longa).

It forms part of the curcuminoids a group of compounds in turmeric with therapeutic properties and gives the traditional Indian curry spice its characteristic yellow-orange color.

It is generally recognized as safe (GRAS) by the Food and Drug Administration (FDA) and has been used extensively throughout traditional plant medicine systems for centuries.

Test tube, animal, and human research has demonstrated that curcumin has anti-inflammatory, antimicrobial, antibiotic, and antioxidant properties.

Thus, it has been the interest of scientific research for decades for its potential roles in the prevention and treatment of several inflammatory human diseases, including cancers, arthritis, and diabetes.

Curcumin can be consumed via turmeric root, spice powder, or a dietary supplement.

Check out Healthlines picks of the best turmeric supplements of 2022.

Though curcumin is considered safe, there are some potential downsides to consider.

Curcumin is a fat-soluble compound that is unstable in water-based mixtures with a low pH, such as stomach acid.

That means that when consumed alone, such as in supplement form, it is rapidly broken down and poorly absorbed. Therefore, it may not offer any benefits in this form.

Because its so unstable, curcumin has been labeled as an invalid metabolic panaceas (IMPS) candidate. IMPS refers to compounds that have been overstudied and whose benefits have been overpromised.

Some researchers even question whether test tube findings of curcumins benefits are false.

However, when combined into oil-based formulations or taken with other plant compounds like piperine from black pepper, the gut may be better able to absorb curcumin and perhaps benefit from its properties.

Learn more about the powerful combo of curcumin and piperine here.

The fact that curcumin needs to be combined with other compounds for human consumption makes it difficult to determine which health benefits observed in studies are related to curcumin alone.

Despite a few claims that curcumin may be toxic under some research conditions, doses of 8 to 12 grams per day were found safe in other research published between 2017 and 2019.

Furthermore, there may be several unsubstantiated beliefs about the use of curcumin for non-Hodgkins lymphoma and other cancers, based on test tube and animal research only.

Remember that clinical trials and long-term studies involving humans are warranted to determine safety, effective doses, and the best drug combinations for the combined treatment of non-Hodgkins lymphoma.

Non-Hodgkins lymphoma is the most common cancer of the immune system. Its characterized by solid tumors that first develop in the lymph nodes.

The many subtypes of non-Hodgkins lymphoma pose treatment challenges, so its important to explore alternative, safe, and effective treatments.

Curcumin is the yellow-orange pigment found in turmeric, and its shown to suppress the growth and spread of cancer cells while enhancing the effectiveness of chemotherapy and radiation in test tube research.

However, results of test tube research cant necessarily be applied to humans. Plus, curcumin is unstable and may not offer any benefits unless combined with oil-based formulations or with other compounds like piperine.

More research involving humans related to curcumin and non-Hodgkins lymphoma is needed.

If you want to try taking curcumin supplements, theyre generally considered safe with few to no side effects. Just be sure to talk with a healthcare professional first, as you would any supplement.

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Curcumin and Non-Hodgkin's Lymphoma: Does It Help? - Healthline

In June, Rebecca A. Shatsky, MD, a medical oncologist, turned to Twitter for advice:

"What do you do/say when a patient won't believe you that they have #CANCER. As an oncologist this comes up every now and then and proves very difficult, looking to hear how others have dealt and what works best to help patients here."

About a dozen people weighed in, offering various thoughts on how to approach these thorny situations. One oncologist suggested revisiting the conversation a few days later, after the patient has more time to process; others suggested sharing the pathology report or images with their patient.

Another person simply noted that "if a [patient] doesnt want to believe they have cancer, no amount of evidence will change that."

Based on the initial responses, "it appears there is a paucity of answers sadly," wrote Shatsky, a breast cancer specialist at University of California, San Diego.

But for Shatsky, these incidents spoke to another alarming trend: a rampant mistrust of the medical community that is "becoming MORE common instead of less."

Overall, experts say that situations like the one Shatsky described patients who don't believe their cancer diagnosis occur infrequently.

But denial comes in many forms, and complete disbelief is probably the most extreme. Patients may also downplay the severity of their disease, shy away from hearing bad news, or refuse standard treatment or their doctor's advice.

Like Shatsky, these experts say they are also seeing a troubling increase in patients who don't believe their physicians or don't trust their recommendations.

"I think there's an erosion of trust in expertise, in general," saidys Ronald M. Epstein, MD, professor of family medicine and psychiatry & oncology at the University of Rochester School of Medicine, Rochester, New York. "People distrust science more than they did maybe 20 or 30 years ago, or at least that seems to be the case."

Denial and distrust in cancer care are not new. These responses along with wishful thinking, distraction, and minimization are long-established responses among oncology patients. In 1972, Avery D. Weisman, MD, a psychiatrist at Harvard Medical School, Boston, Massachusetts, wrote his book On Dying and Denying, and ever since, denial and similar responses have been explored in the oncology literature.

Much of this research has focused on the latter stages of illness, but denial can be present at diagnosis as well. One study of patients with breast cancer, carried out nearly 30 years ago, suggested that denial of diagnosis generally occurs early in a patient's course of illness and decreases over time, but may arise again in the terminal phase of cancer. Another analysis, evaluating this phenomenon across 13 studies, found that the prevalence of denial at diagnosis ranged from 4% to as high as 47%.

An oncologist delivers somewhere between 10,000 to 30,000 episodes of bad news over the course of a career, so there's always a chance that a patient will respond in a way that's on the "spectrum of disbelief," says Paul Helft, MD, professor of medicine and recently retired director of the ethics center at the Indiana School of Medicine, Indianapolis.

Diane Meier, MD, says denial and disbelief are natural, protective responses to difficult or frightening news.

When patients exhibit denial, Meier advises patience and time. Physicians can also ask the patient if there's a person they trust a family member or faith leader, for example who could speak on their behalf about possible next steps.

"The main thing is not to find ourselves in opposition to the patient or threaten them with what will happen if they don't listen to us," says Meier, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City.

And physicians should be careful when they feel themselves wanting to argue with or lecture a patient.

"The minute we feel that urge coming on, that's a signal to us to stop and realize that something is going on inside the patient that we don't understand," she notes. "Forcing information on a person who is signaling in every way that they don't want it and can't handle it is not a recipe for trust or a high-quality relationship."

Jennifer Lycette, MD, has encountered a growing number of patients who don't believe their disease should be treated the way she or other oncologists recommend. Some patients remain adamant about sticking with alternative medicine or doing nothing, despite growing sicker.

"I've even had situations where the tumor might be visible, like growing through the skin, and people still double down that whatever they're doing is working," says Lycette, a hematologist and medical oncologist at the Providence Seaside Cancer Center in Seaside, Oregon.

She encourages these patients to get a second opinion and tries to keep an open mind about alternative approaches. If she's not familiar with something a patient is considering, she'll research it with them.

But she makes sure to point out any risks associated with these approaches. While some alternative therapies can support patients through standard treatment, she strongly cautions patients against using these therapies in place of standard treatment.

"The bottom line is to keep the lines of communication open," she says.

Like Lycette, Helft has been encountering more patients with alternative health beliefs who rely on people outside of the medical system for elements of their care.

In the past, he used to tell these patients that science is incomplete, and physicians don't know everything. But he's changed his tune.

"I've taken to just telling them what I believe, which is that the majority of things that they hear and are being sold are almost certainly ineffective and a waste of money," he says. "I've come to accept that people are adults, and they make their own decisions, and sometimes they make decisions that are not the ones that I would make or want them to make."

Helft often sees patients seeking a second or third opinion on their cancer. These patients may not all be in denial about having cancer, but they typically don't want to hear bad news, which can make treatment a challenge.

To handle these scenarios, Helft has developed a system of responses for engaging with patients. He borrows an approach described in 2008 where he acknowledges a patient's emotional distress and tries to understand why they may not want to know more.

For instance, he might tell a patient: "I have formulated an opinion about your situation, but it sounds as if you have heard many negative descriptions previously. I don't want to burden you with one more if you don't feel prepared to talk about it."

Trying to understand why a patient is resistant to hearing about their condition may also help build trust. "If you could help me understand your thinking about why you would rather not talk about prognosis, it will help me know more about how to discuss other serious issues," is one approach highlighted in the 2008 guide.

Behind the scenes, Helft will privately assess how much information about a patient's prognosis is salient to their decision making, especially if the patient appears to misunderstand their prognosis or if there are various options for treatment over the long-term.

Helft will also ask patients how much they want to know. Do they want to discuss no options? A few? All and in detail?

This approach implicitly recognizes that the information is highly stressful but avoids being overly blunt, he notes. It can also help steer patients on the right treatment track and minimize poor decision making.

Samantha Winemaker, MD, a palliative care physician in Hamilton, Ontario, Canada, finds patients often go through an adjustment period after learning about a new diagnosis. The reaction tends to range from needing time to accept the diagnosis as real to jumping in to understand as much as possible.

Winemaker, who cohosts The Waiting Room Revolution podcast that focuses on helping people deal with a serious illness, encourages physicians to be realistic with patients about their prognosis and deliver news with a dose of gentle truth from the start.

"We should invite patients 'into the know' as early as possible, while maintaining hope," she says.

She calls this approach of balancing hope and reality "walking two roads" and says it extends throughout the illness journey. This way, patients are less likely to be surprised if things make a turn for the worse.

"We should never wait until the 11thhour to give someone bad news," she says.

Epstein, the family physician at the University of Rochester, Rochester, New York, has listened to hundreds of hours of discussion between doctors and patients as part of his research on communication. He often hears doctors initiate difficult conversations by lecturing a patient.

Many physicians mistakenly believe that if they say something authoritatively, patients will believe it, he says. But the opposite often happens patients shut down and instinctively distrust the physician.

Epstein teaches doctors to establish trust before providing difficult information. Even when a patient expresses outlandish ideas about their illness, treat them with dignity and respect, he advises. "If people don't feel respected, you don't have a leg to stand on and there's no point in trying to convince them."

Patients and physicians often leave conversations with discordant views of what's ahead. In one study, two thirds of patients held wildly different views on their prognosis compared with their doctors, and most had no idea they were at odds with their physician.

In the past, Epstein has tried to close the gap between his understanding of a patient's prognosis and the patient's. But more recently he has become less convinced of the need to do so.

"What I try to do now is focus more on the uncertainty there," he says. He uses phrases like: "Given that we don't know how long you will live, I just need to know what you would want me to do if things took a turn for the worse" or "I'm worried that if you don't have the surgery, you might experience more pain in the future."

He urges doctors to pay attention to their word choices. Use care with the phrase "response rate" patients sometimes mistake this to mean that they are being cured. And, instead of telling patients they "must" do something, he says that he worries about consequences for them if they don't.

He asks patients what they're hearing from other people in their lives or online. Sometimes patients say that people close to them are encouraging them to stop medical treatment or pursue alternative therapies. When that happens, Epstein asks to meet with that person to talk to them about his concerns for their loved one.

He also acknowledges calculated uncertainty often exists in medicine. That, he says, leaves open the potential for exceptional circumstances.

"And we all want to hope," Epstein says.

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In Denial: When Patients Don't Want to Believe They Have Cancer - Medscape

In the early days of the COVID-19 pandemicPiotr Szyhalski became a strident, comforting voice of reason and truth. The interdisciplinary artist created a new drawing daily, using the aesthetics of propaganda posters to speak to living through the pandemic. Posted on social media each day, Szyhalskis pandemic images went viral.

Printed as posters, they were hung on street lamps and boarded up buildings in cities across the United States. They were also shown in exhibitions at the Minneapolis Institute of Art (which now owns digital files of the collection) and multiple institutions here in Minnesota and internationally.

The posters were part of a larger series called Labor Camp, where Szyhalski explores what he calls extreme historical phenomena. Also his Instagram handle, the term Labor Camp encompasses work Szyhalski began creating in 1998 in a multiplicity of mediums, including performance, musical scores, and media arts, as a way to respond to historical events of immense impact and change. A chapter of his Labor Camp project became COVID 19: Labor Camp Reports.

This is something that as a concept emerged for me in the late 90s, he tells a group of journalists about the larger Labor Camp milieu, at a recent media event at the Weisman Art Museum for a survey exhibition of his work called We Are Working All The Time!

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Born in Poland in 1967 when it was a satellite state of the Soviet Union, Szyhalski trained as an artist in Poland in a time when great change was at the cusp. He moved to the U.S. in 1990, in the wake of the fall of the Soviet Union. Since 1994, he has been a professor of media arts at the Minneapolis College of Art and Design. His work crosses genres, finding new ways to explore performance, mail art, digital media, printmaking, sound art, and installation, often in collaboration with other artists.

Courtesy of the Weisman Art Museum

"We Are Working All The Time!" book cover jacket image

When the COVID-19 emerged, I understood that we were living in one of those extreme historical phenomena, Szyhalski says. So the idea of responding to it through or processing that material was kind of a natural or obvious way to be in that moment.

He thought he was done with the project, completing the COVID 19: Labor Camp Report (2021) on Nov. 3, 2021. The posters often responded to the experience of living through COVID the trauma of mass death, the isolation, and the myopic response of the Donald Trump administration to the international emergency. Later, when Russia invaded Ukraine, he realized a new chapter of the Labor Camp series had begun.

At least at the very beginning, we were literally talking about looking at the potential of World War III happening, he said. So this edge of something much larger than it appears on the surface was always there.

Ive been referring to these as War Reports, Szyhalski says of the new drawings. Part of my thinking about this new body of work was how to pay attention to this event, both as a very specific, localized tragedy, but how to also talk about it in a way where we are engaged in a more direct, emotional way.

One drawing depicts Ukrainian victims that were found on the streets of Bucha. Szyhalski studied natural landscapes of Ukraine, in order to directly connect to Ukraines geographical place in the world. As an example, he includes chestnut trees in the image. Another work speaks to the refugee experience of Ukrainians fleeing their country. Thats a direct connection to the experience of my family in Poland, Szyhalski says.

MinnPost photo by Sheila Regan

"Alternative Medicine," 1990

The exhibition was supposed to open in the summer of 2020, but got postponed because of COVID. According to Diane Mullin, senior curator for the Weisman, the exhibition was put together in time for the original opening in 2020, before the COVID-19 works were created. The catalog was not meant necessarily to be before the show, but ends up being this monument before it, she said.

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Working with Szyhalski on how to organize the survey, Mullin says, was a practice of criss crossing and overlapping themes and ideas from across time. Not chronological, nor biographically organized, its instead structured around objects, materials, and thematics.

Courtesy of the Weisman Art Museum

"Plan Your Work"

Often in the exhibition, works made many years ago resonate with the newer works. Looking at a set of postcards he made in Poland in the late 1990s, Szyhalski says he was struck by how much visual language, ideas, and sentiments are shared between his older works and newer works.

For roughly half of my life, I lived in what we described as a communist state. And half my life Ive lived in a capitalist society, Szyhalski said. One of the threads in the exhibition as a whole is acknowledging the complexities of both of those systemic structures, and how similar in many ways they are, especially in the way that they tend to polarize us, tend to dehumanize us, and tend to paint the other as less than us.

Courtesy of the Weisman Art Museum

"You Work, You Eat," 2019, enamel paint on found ceramic plates

Szyhalskis merciless satirical voice emerges from the works. In one linoleum cut print, Alternative Medicine, (1990), a tag that reads alternative medicine pokes through a slit in an old persons throat. His series We Are Working All The Time! (2007-21), repeats the same phrase across multiple screen prints, mocking the notion of tireless overproduction in the series itself.

Perhaps the most chilling work is made of surgical drapes sewn together. At first, the work looks abstract, until you look at it as some kind of mass surgery. The piece evokes the mass carnage of war.

In the exhibition there are giant rollers, sound pieces, and ephemera from Szyhalskis performance art pieces. Whether through objects, imagery or text, Szyhalski sifts through the artifice, calling out with clarity his visceral response to the world.

Piotr Szyhalski: We Are Working All the Time! runs through December 31 at the Weisman Art Museum (free). More information here.

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Piotr Szyhalski depicts living through COVID-19 and other extreme historical phenomena - MinnPost

Chemotherapy is a painful experience. The treatments in general have terrible side effects and it's no secret that the medications used are frequently hazardous to both the patient and the tumour. Because tumours spread so quickly, the theory is that chemotherapy will kill the disease before its side effects kill the patient. That is why, scientists and doctors are always looking for more effective treatments. The findings of the study were published in the Journal of Medicinal Chemistry.

A team led by researchers at UC Santa Barbara, including collaborators from UC San Francisco and Baylor College of Medicine, has identified two compounds that are more potent and less toxic than current leukemia therapies. The molecules work in a different way than standard cancer treatments and could form the basis of an entirely new class of drugs. What's more, the compounds are already used for treating other diseases, which drastically cuts the amount of red tape involved in tailoring them toward leukemia or even prescribing them off-label. "Our work on an enzyme that is mutated in leukemia patients has led to the discovery of an entirely new way of regulating this enzyme, as well as new molecules that are more effective and less toxic to human cells," said UC Santa Barbara Distinguished Professor Norbert Reich, the study's corresponding author.

The epigenome All cells in your body contain the same DNA, or genome, but each one uses a different part of this blueprint based on what type of cell it is. This enables different cells to carry out their specialized functions while still using the same instruction manual; essentially, they just use different parts of the manual. The epigenome tells cells how to use these instructions. For instance, chemical markers determine which parts get read, dictating a cell's actual fate.

A cell's epigenome is copied and preserved by an enzyme (a type of protein) called DNMT1. This enzyme ensures, for example, that a dividing liver cell turns into two liver cells and not a brain cell. However, even in adults, some cells do need to differentiate into different kinds of cells than they were before. For example, bone marrow stem cells are capable of forming all the different blood cell types, which don't reproduce on their own. This is controlled by another enzyme, DNMT3A.

This is all well and good until something goes wrong with DNMT3A, causing the bone marrow to turn into abnormal blood cells. This is a primary event leading to various forms of leukaemia, as well as other cancers. Toxic treatments

Most cancer drugs are designed to selectively kill cancer cells while leaving healthy cells alone. But this is extremely challenging, which is why so many of them are extremely toxic. Current leukemia treatments, like Decitabine, bind to DNMT3A in a way that disables it, thereby slowing the progression of the disease. They do this by clogging up the enzyme's active site (essentially, its business end) to prevent it from carrying out its function. Unfortunately, DNMT3A's active site is virtually identical to that of DNMT1, so the drug shuts down epigenetic regulation in all of the patient's 30 to 40 trillion cells. This leads to one of the drug industry's biggest bottlenecks: off-target toxicity.

Clogging a protein's active site is a straightforward way to take it offline. That's why the active site is often the first place drug designers look when designing new drugs, Reich explained. However, about eight years ago he decided to investigate compounds that could bind to other sites in an effort to avoid off-target effects. Working together

As the group was investigating DNMT3A, they noticed something peculiar. While most of these epigenetic-related enzymes work on their own, DNMT3A always formed complexes, either with itself or with partner proteins. These complexes can involve more than 60 different partners, and interestingly, they act as homing devices to direct DNMT3A to control particular genes. Early work in the Reich lab, led by former graduate student Celeste Holz-Schietinger, showed that disrupting the complex through mutations did not interfere with its ability to add chemical markers to the DNA. However, the DNMT3A behaved differently when it was on its own or in a simple pair; it wasn't to stay on the DNA and mark one site after another, which is essential for its normal cellular function.

Around the same time, the New England Journal of Medicine ran a deep dive into the mutations present in leukemia patients. The authors of that study discovered that the most frequent mutations in acute myeloid leukemia patients are in the DNMT3A gene. Surprisingly, Holz-Schietinger had studied the exact same mutations. The team now had a direct link between DNMT3A and the epigenetic changes leading to acute myeloid leukemia. Discovering a new treatment

Reich and his group became interested in identifying drugs that could interfere with the formation of DNMT3A complexes that occur in cancer cells. They obtained a chemical library containing 1,500 previously studied drugs and identified two that disrupt DNMT3A interactions with partner proteins (protein-protein inhibitors, or PPIs). What's more, these two drugs do not bind to the protein's active site, so they don't affect the DNMT1 at work in all of the body's other cells. "This selectivity is exactly what I was hoping to discover with the students on this project," Reich said.

These drugs are more than merely a potential breakthrough in leukemia treatment. They are a completely new class of drugs: protein-protein inhibitors that target a part of the enzyme away from its active site. "An allosteric PPI has never been done before, at least not for an epigenetic drug target," Reich said. "It really put a smile on my face when we got the result." This achievement is no mean feat. "Developing small molecules that disrupt protein-protein interactions has proven challenging," noted lead author Jonathan Sandoval of UC San Francisco, a former doctoral student in Reich's lab. "These are the first reported inhibitors of DNMT3A that disrupt protein-protein interactions."

The two compounds the team identified have already been used clinically for other diseases. This eliminates a lot of cost, testing and bureaucracy involved in developing them into leukemia therapies. In fact, oncologists could prescribe these drugs to patients off-label right now. Building on success

There's still more to understand about this new approach, though. The team wants to learn more about how protein-protein inhibitors affect DNMT3A complexes in healthy bone marrow cells. Reich is collaborating with UC Santa Barbara chemistry professor Tom Pettus and a joint doctoral student of theirs, Ivan Hernandez. "We are making changes in the drugs to see if we can improve the selectivity and potency even more," Reich said. There's also more to learn about the drugs' long-term effects. Because the compounds work directly on the enzymes, they might not change the underlying mutations causing cancer. This caveat affects how doctors can use these drugs. "One approach is that a patient would continue to receive low doses," Reich said. "Alternatively, our approach could be used with other treatments, perhaps to bring the tumor burden down to a point where stopping treatment is an option."

Reich also admits the team has yet to learn what effect the PPIs have on bone marrow differentiation in the long term. They're curious if the drugs can elicit some type of cellular memory that could mitigate problems at the epigenetic or genetic level. That said, Reich is buoyed by their discovery. "By not targeting DNMT3A's active site, we are already leagues beyond the currently used drug, Decitabine, which is definitely cytotoxic," he said, adding that this type of approach could be tailored to other cancers as well. (ANI)

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)

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Researchers identify chemo alternative for targeted treatment of leukemia patients - Devdiscourse

Diversity in any area or sector is a characteristic that is not only intrinsically fundamental to a population but also has practical necessities. Pluralistic form of healthcare systems in India has been one such example. Indias health services system comprises both modern and traditional forms of medicine (both codified and uncodified). These services have been healing people since centuries. As India sits on a gold mine of knowledge of several health systems, the major challenge is to back them up with gold standard researched evidence and integrate them into state health services on a mass level.

Lack of pluralistic understanding and research in medical health systems in the country has prevented us from showcasing the world our potential and capabilities in the field. However, latest advancements in technologies have opened up several opportunities and avenues for having a better understanding of various health systems to broaden and enhance the public health landscape of the country. It is now time that we draw attention towards bridging the gap between different health systems and place them on a globally commercial level. We will be better able to plan and put into practise evidence-based policies in the future if we concentrate on developing our grasp of potential epistemic pluralism in a public health context of dealing with knowledge-related issues like pandemics.

The world has seen even the strongest and the best health structures crumbling down on their knees in the last two years. At the same time, we saw that the pluralistic form of medicine gained a new and unique contextual importance. People did look at alternative medicines. A larger explanation for this shift in public opinion can be credited to the massive promotion done by the Ministry of AYUSH. People tried traditional forms of medicine such as Ayurveda, Unani, and Siddha and later claimed that they were effective in managing the symptoms.

This shows that addressing the need of sufficient epistemic pluralism, especially in the context of public health threats, is important. However, in the case of India, there is a problem of research backing for alternate forms of medicine. Consumption of giloy, which has been used for millennia as a powder or tablet, has exponentially increased during the past two years. According to a research paper published in the Journal of Clinical and Experimental Hepatology last year, Indians careless consumption of giloy during the pandemic was causing liver damage. For us to have robust and integrated health systems, it is crucial that the Ministry of AYUSH modifies its policies, prioritises research, and makes traditional medicine evidence-based.

Medical pluralism does not only have an instrumental but also an intrinsic value for what it is in the end. There are four reasons as to why we need to have more growing and engaging discussions around the idea of pluralistic approaches towards medicine. They are: Revisiting the role of traditional medicine in national public health goals, preventing threat of commercial exploitation of indigenous knowledge, changing disease burden and search for therapies for care and addressing the shortages of human resources in rural areas.

While the consumption of traditional medicines have increased in the past two years, there is still a lot of scepticism around it. There is an urgent need to dispel both the uncertainty and hesitancy around using traditional forms of medicine. In the current state, an allopathic doctor is considered secondary to an AYUSH one. There are also significant differences in how much they are paid. Although biomedical knowledge was integrated into AYUSH training as per recommendations of the Chopra committee, no learning of AYUSH systems was incorporated into allopathy. To provide health security to people with limited financial means we need innovative and transdisciplinary perspectives on medical efficacy. This will take time and will only be possible if enough evidence is there to back up the doses and procedure.

India has an abundance of opportunities to explore and then integrate varied healing traditions. With proper evidence and research backing, we can not only just integrate other forms into modern medicine but also co-exist. Although there has been some progress since the formation of the Ministry of AYUSH. It has been noted that it is only Ayurveda that has reached the world. There is a lack of in-depth studies in other domains. Another important aspect is that India can benefit a lot through medical tourism if these fields are developed quickly in the form of verified alternative therapies. India accounts for almost 20% of global market share in medical tourism. Through appropriate measures around accessibility and ease, this can be leveraged upon and taken to a new level.

It wont be enough to simply hire AYUSH practitioners on a contract basis and provide the bare minimum infrastructure. Allopathy and AYUSH have to be compatible with one another. From ignoring, we have moved to integration of traditional medicinal knowledge to modern one. Now it is time to head towards coexistence. Both MBBS and AYUSH practitioners should be welcomed and respected, and patients should be referred back and forth between them for specialised diagnosis or treatment. In health centres, the two departments should communicate with one another for the benefit of the patients. There should be logistical preparations for a constant supply of medications.

Previously, other countries have used our traditional medicine and commercialised them on a large scale after enough research and evidence. India is sitting on a gold mine of knowledge of alternative sources of medicine. It is now time that we make appropriate use of the knowledge and leverage upon our advantages.

The writer is Assistant Programme Manager at The Takshashila Institution. The views expressed in this article are those of the author and do not represent the stand of this publication.

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