This e-newsletter is a monthly publication of the Platelet Disorder Support Association. The information in this newsletter is for educational purposes only. For advice on your unique medical condition, please consult a health care professional.
Contents:
ITP and Platelet Disorders Research and Treatments
- Stress Impairs Blood Cell Production
- Infection-Induced Thrombocytopenia: New Insights and Treatment
- Working Group Comments on Anti-D Safety
- Feverfew Compound Enhances Platelet Production
Hospitals, Insurance, and Medical Care
General Health and Medicine
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ITP and Platelet Disorders Research and Treatments
STRESS IMPAIRS BLOOD CELL PRODUCTION
Hematopoietic stem cells (HSCs) give rise to all types of white and red blood cells as well as platelets. They cycle between the bone marrow and circulating blood, sometimes resting, sometimes multiplying to form new blood cells lines. An over-stressed body creates abnormal levels of reactive oxygen species (ROS), chemically reactive molecules that damage DNA and can exhaust these stem cells, leading to their premature death. In their study of highly-stressed mice, the authors found that anti-oxidants can help mitigate the ROS-related damage to these stem cells.
Pang Q. “HSCs: stressing out over ROS” Blood. 2011 Sep 15;118(11):2932-4:
http://bloodjournal.hematologylibrary.org/content/118/11/2932.full
Yahata T et al. “Accumulation of oxidative DNA damage restricts the self-renewal capacity of human hematopoietic stem cells.” Blood. 2011 Sep 15;118(11):2941-50:
http://www.ncbi.nlm.nih.gov/pubmed/21734240
Note: PDSA has recently added a mind body page that provides information and resources to help you reduce stress:
http://www.pdsa.org/treatments/complementary/mind-body-medicine.html
INFECTION-INDUCED THROMBOCYTOPENIA: NEW INSIGHTS AND TREATMENT
When the body encounters bacteria, white blood cells release histones, proteins in cells that activate platelets to form blood clots, presumably to help stop the spread of the bacteria. Sometimes the histone-prompted platelet activation and clumping can go too far and cause thrombocytopenia and/or organ damage. Researchers in Boston found that heparin can neutralize the histone reaction and prevent the associated platelet clumps and thrombocytopenia.
Esmon CT, “Extracellular histones zap platelets.” Blood. 2011 Sep 29;118(13):3456-7:
http://bloodjournal.hematologylibrary.org/content/118/13/3456.full.pdf+html
Fuchs TA et al. “Histones induce rapid and profound thrombocytopenia in mice.” Blood. 2011 Sep 29;118(13):3708-14:
http://www.ncbi.nlm.nih.gov/pubmed/21700775
WORKING GROUP COMMENTS ON ANTI-D SAFETY
After the FDA added a black-box warning in March, 2010, for anti-D products (ex. Win Rho SDF), a group of hematologists convened a working group to comment on the product’s safety. A very small percent of people who received anti-D developed blood clots in their veins and renal failure, but the proportion and severity of adverse events has not risen since the discovery of these problems years ago. In their report, the hematologists in the working group suggest ways to screen patients to help prevent these rare, but very severe adverse events. They conclude that “RhIG [anti-D] has comparable safety and efficacy to other front-line agents for the treatment of children and adults with ITP.”
Despotovic JM et al. “RhIG for the treatment of immune thrombocytopenia: consensus and controversy.” Transfusion. 2011 Oct 7. doi: 10.1111/j.1537-2995.2011.03384.x. [Epub ahead of print]:
http://www.ncbi.nlm.nih.gov/pubmed/21981825
Note: For more information about anti-D see:
http://www.pdsa.org/treatments/conventional/anti-d.html
FEVERFEW COMPOUND ENHANCES PLATELET PRODUCTION
Parthenolide, a compound derived from feverfew, an herb and ornamental plant, enhances platelet production according to researchers in Rochester, NY. They tested the compound in test tubes using mice and human megakaryocytes, cells that give rise to platelets, and found that parthenolide increased the number of platelets by inhibiting nuclear factor-κB, a protein involved in regulating the cell’s response to various stimuli. Parthenolide also inhibited platelet coagulation making it an interesting possibility when both thrombocytopenia and clots are a problem, but a bad option for those prone to bleeding or on ‘blood thinners’.
Sahler J et al. “The Feverfew plant-derived compound, parthenolide enhances platelet production and attenuates platelet activation through NF-κB inhibition.” Thromb Res. 2011 May;127(5):426-34:
http://www.ncbi.nlm.nih.gov/pubmed/21272923
Hospitals, Insurance, and Medical Care
PATIENTS RECEIVE TOO MUCH CARE REPORTS SURVEY
Of the 627 primary care physicians who responded to a survey conducted by a Veterans Affairs Outcomes group, 42% felt that patients in their own practice were receiving too much care. Malpractice concerns were the largest contributor to over-treating followed by clinical performance measures and lack of time with patients. Most said that financial incentives support aggressive treatment, including the profit from diagnostic tests. Almost all said that physicians vary in what they would do for individual patients.
Sirovich BE et al. “Too Little? Too Much? Primary Care Physicians' Views on US Health Care: A Brief Report.” Arch Intern Med. 2011 Sep 26;171(17):1582-5:
http://www.ncbi.nlm.nih.gov/pubmed/21949169
COMPANIES SHIFTING HEALTH INSURANCE COSTS TO WORKERS
According to the Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey, health insurance premiums increased much faster than wages and the cost-of-living and now average more than $15,000 for each worker. Thirty-one percent of workers are in high-deductible plans, with deductibles reaching at least $2,000 in 12% of the cases. The companies surveyed added 2.3 million young adults to their parent’s plan since people up to 26 years of age lacking their own employer coverage can now be included.
Kaiser Family Foundation Press Release: “Average Annual Premiums for Family Health Benefits Top $15,000 in 2011, Up 9 Percent, Substantially More than the Growth in Worker’s Wages, Benchmark Employer Survey Finds” September 27, 2011:
http://www.kff.org/insurance/092311nr.cfm
General Health and Medicine
PLANTS CLEAN INDOOR AIR, IMPROVE HEALTH
Plants add oxygen to the air, metabolize some toxic chemicals, and sequester heavy metals, all contributing to a healthier indoor environment. In studies done by NASA, plants were able to clear toxic levels of formaldehyde, found in many home construction and decorating materials, mercury, and other volatile organic compounds. The areca palm, lady palm, and bamboo palm were the top cleansers.
Claudio L. “Planting Healthier Indoor Air.” Environmental Health Perspectives. 2011 October:119(10): A426-7:
http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.119-a426
SAFETY TIPS FOR PAIN MEDICATION
Over-the-counter pain medications such as acetaminophen (ex. Tylenol) and nonsteroidal anti-inflammatory (NSAID) drugs (ex. ibuprofen/Advil/Motrin) are widely used, but can cause injury if not taken as directed, counsels the US Food and Drug Administration (FDA) in their recently updated web page. The page contains links to brochures, articles, announcements, fact sheets, and more in an effort to warn people about the harms of over-medicating. According to the FDA, people with bleeding problems should avoid NSAIDS and taking too much acetaminophen can cause liver damage.
The updated web site:
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/SafeUseofOver-the-CounterPainRelieversandFeverReducers/ucm164977.htm
Note: If you or your child has ITP, please consult your doctor before taking any over-the-counter pain medications.
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This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, e-mail:
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