Platelet E-News: October 25, 2012

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

Hospitals, Insurance, and Medical Care

General Health and Medicine

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ITP and Platelet Disorders Research and Treatments

 

HP LEVELS IN BLOOD MAY PREDICT SPLENECTOMY SUCCESS

Researchers performed a detailed analysis of the blood, pre and post operation, of four people whose splenectomies were successful, four people whose spenectomies failed to raise their platelet count, and four people without ITP. They were searching for some blood protein that was different in those people who responded to splenectomy versus those who didn’t. The researchers found what they were looking for: haptoglobin (Hp), a protein that binds to free hemoglobin released by red blood cells. The Hp level of non-responders before the operation was significantly lower than those who responded or the healthy controls. The researchers then measured the Hp levels in a larger group of ITP patients and found that their theory predicted splenectomy success in about 80% of the cases.

Zheng CX et al. “Proteomics-based identification of haptoglobin as a favourable serum biomarker for predicting long-term response to splenectomy in patients with primary immune thrombocytopenia.” RJ Transl Med. 2012 Oct 7;10(1):208.
http://www.translational-medicine.com/content/10/1/208/abstract

TRANEXAMIC ACID CONTROLS BLEEDING

Trauma patients with severe bleeding given tranexamic acid had a lower death rate and a reduced risk of blood clots compared to the placebo group, researchers report in a study of 13, 273 patients in the UK. (Tranexamic acid halts the natural reactions that prevent blood clots.) The study authors conclude that tranexamic acid can be used safely in a wide variety of traumatic bleeding cases.

Here’s what ITP experts have to say about tranexamic acid: “Antifibrinolytic agents, such as oral or IV tranexamic acid and episilon-aminocaproic acid may be useful in preventing recurrent bleeding in patients with severe thrombocytopenia; however, the efficacy has not been evaluated by randomized trial in ITP patients. Tranexamic acid (1 g, 3 times daily orally) and episilon-aminocaproic acid (1-4 g every 4-6 hours [maximum dose, 24 g/d]) may be of special value in certain dental or surgical procedures.”

Roberts I et al. “Effect of tranexamic acid on mortality in patients with traumatic bleeding: prespecified analysis of data from randomised controlled trial.” BMJ 2012;345:e5839.
http://www.bmj.com/content/345/bmj.e5839

Provan D et al. “International consensus report on the investigation and management of primary immune thrombocytopenia” Blood. 2010 Jan 14;115(2):168-86.
http://bloodjournal.hematologylibrary.org/content/115/2/168.full

THE INTESTINE AUTOIMMUNE CONNECTION

Our bodies contain about 100 trillion microbes, most of them bacteria, and most of them living in the digestive tract. These microbes play a role in our adaptive immune system, the part of the immune system that disables harmful viruses and bacteria. When the beneficial bacteria living in the gut are modified by diet, antibiotics, or invading pathogens, the immune system can shift. This disturbance of the intestinal immune system can lead to various intestinal diseases and has been increasingly linked to immune-mediated diseases outside of the intestine such as rheumatoid arthritis, multiple sclerosis, and other autoimmune diseases.

Note: ITP is an autoimmune disease.

Maynard CL "Reciprocal interactions of the intestinal microbiota and immune system." Nature 489, 231–241, 13 September 2012.
http://www.nature.com/nature/journal/v489/n7415/full/nature11551.html

PLATELETS PACKED WITH PROTEINS

Scientists have now identified nearly 4,000 different proteins in platelets, about 85% of the total platelet protein content. The platelet protein level can vary with age, disease state, and some medications. However, the scientists found that 85% of the platelet proteins were constant in blood donations from healthy subjects. Understanding all of the platelet proteins and their function will provide more information on the platelets' role in health and disease.

van der Meijden PE, Heemskerk JW, "Platelet protein shake as playmaker." Blood. October 11, 2012 vol. 120 no. 15 2931-2932.
http://bloodjournal.hematologylibrary.org/content/120/15/2931.full

Burkhart JM et al. "The first comprehensive and quantitative analysis of human functional protein composition allows the comparative analysis of structural and functional pathways." Blood. October 11, 2012 vol. 120 no. 15 e73-e82.
http://www.ncbi.nlm.nih.gov/pubmed/22869793

 

Hospitals, Insurance, and Medical Care

PATIENTS AGREE: PHYSICIANS SHARE YOUR NOTES

Doctors (105) and patients (13,564) in three hospitals participated in an experiment allowing patient access to physician notes via the Internet. In a follow-up survey, 99% of the patients wanted the doctors to continue sharing the notes. The majority of these patients felt more in control of their care, were more willing to adhere to medication recommendations, and wanted to be able to comment on their doctors' notes. The doctors involved reported little increase in the volume of e-mails and little increase in time spent answering questions in or outside of the office.

Delbanco T. "Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead." Annals of Internal Medicine. 2012 Oct;157(7):461-470."
http://annals.org/article.aspx?articleid=1363511

Meltsner M. "A Patient's View of OpenNotes." Annals of Internal Medicine. 2012 Oct;157(7):523-524.
http://annals.org/article.aspx?articleid=1363515

CLINICALTRIALS.GOV GETS AN UPDATE

The Web site www.clinicaltrials.gov, managed by the National Library of Medicine/National Institutes of Health, lists more than 130,000 clinical trials in all 50 states and in 179 countries. It now sports an updated home page with enhanced navigation features, new content on clinical research, more background information, and additional search assistance. The updated site also makes it easier for people to find the results of previous trials. See: http://www.clinicaltrials.gov

Huston M et al. "New Style and New Content for ClinicalTrials.gov." NLM Tech Bull. 2012 Jul-Aug;(387):e5 (editor note added September 20, 2012).
http://www.nlm.nih.gov/pubs/techbull/ja12/ja12_clinicaltrials.html

 

General Health and Medicine

COUNTERACT BPA, REDUCE STRESS, EAT SOY

BPA, an organic chemical with properties similar to estrogen, has been used since the 1950s to line metal cans and harden plastic bottles, among other things. Researchers recently showed that BPA can also alter the part of the brain responsible for managing our response to fear and stress, which in turn can affect social behavior, especially in adolescence. In a study using rats, the animals exposed to BPA fed a diet rich in soy were anxiety free compared to the animals that did not eat soy.

"Soy Diet May Lessen Anxiety Effect Of BPA On Genes." MediLexicon. Sept. 10, 2012.
http://www.medilexicon.com/medicalnews.php?newsid=250010

Patisaul HB et al. "Anxiogenic effects of developmental bisphenol a exposure are associated with gene expression changes in the juvenile rat amygdala and mitigated by soy." PLoS One. 2012;7(9):e43890. Epub 2012 Sep 5.
http://www.ncbi.nlm.nih.gov/pubmed/22957036

NANOPARTICLES KILL BLOOD CELLS

Nanoparticles are particles with one dimension 100,000 smaller than the diameter of a human hair. A variety of nanoparticles are increasingly used in packaging, clothing, cosmetics, medicine, sports equipment, and more. However little is known about the effect of these tiny particles on human health. Researchers tested the impact of one type of nanoparticle, cerium dioxide, on monocytes, a type of white blood cell. They found the nanoparticles crossed the cell membrane and increased the proteins that lead to cell death. "Given that monocytes are crucial for human immunity, the work suggests even at low doses CeO2 nanoparticles may have detrimental effects on human health."

We can expect to hear more about the safety of nanoparticles following a 2-day workshop on the subject held September, 2012, that attracted more than 100 participants.

"Cerium dioxide nanoparticles may lead to human immune cell death." Environmental Factor, National Institute of Environmental Health Sciences, October, 2012.
http://www.niehs.nih.gov/news/newsletter/2012/10/dir/index.htm#a3

Hussain S et al. "Cerium dioxide nanoparticles induce apoptosis and autophagy in human peripheral blood monocytes." ACS Nano. 2012 Jul 24;6(7):5820-9.
http://www.ncbi.nlm.nih.gov/pubmed/22717232

Loose C. "Challenges persist in the critical task of determining safety of nanomaterials." Environmental Factor, National Institute of Environmental Health Sciences, October, 2012.
http://www.niehs.nih.gov/news/newsletter/2012/10/science-nano/index.htm

 

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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, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org

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