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Bacteria causing two different illnesses belong to the same family and share much of the same genetic code providing unexpected cross protection
Hopes to fight untreatable strains of gonorrhoea have risen after it emerged that a new vaccine against meningitis unexpectedly reduced the risk of people getting the sexually transmitted infection.
Some strains of gonorrhoea are resistant to all available drugs, making vaccine development an urgent global health priority. But according to a study in The Lancet, a vaccine has offered protection against the sexually transmitted disease for the first time.
Gonorrhoea spreads through unprotected vaginal, oral or anal sex and many of those who contract the disease experience no symptoms. If left untreated, the disease can cause infertility and can increase the transmission of HIV infection.
A New Zealand meningitis epidemic in the early 2000s prompted the mass vaccination of a million people and fortuitously set the scene for the current study. The vaccine used, known as MeNZB, was designed to protect against meningococcal group B infection the cause of the most deadly form of meningitis.
But intriguingly, over the next few years, scientists noticed fewer gonorrhoea cases than expected in those who had been vaccinated against meningitis.
Dr Helen Petousis-Harris, a vaccine specialist from the University of Auckland who led the study, was optimistic: Some types of gonorrhoea are now resistant to every antibiotic we have, and there appeared [to be] little we could do to prevent the steady march of gonorrhoea to superbug status. But now theres hope, she added.
The research team studied over 14,000 people aged 15-30 whod been diagnosed with gonorrhoea at sexual health clinics across New Zealand and who had been eligible for the MeNZB vaccine during the emergency vaccination programme. They found vaccinated individuals were over 30% less likely to develop gonorrhoea.
Despite meningitis and gonorrhoea being very different illnesses, both are caused by bacteria from the same family and share much of the same genetic code, providing a possible explanation for the cross-protection that the team observed.
More than 78 million people worldwide get gonorrhoea each year with most infections in men and women under the age of 25. It is the second most common bacterial sexually transmitted infection in the UK after chlamydia. In England alone, almost 35,000 people were affected in 2014.
British Association for Sexual Health and HIVs President, Dr Elizabeth Carlin, who was not involved in the study, was more sceptical: These early findings are to be welcomed but its important to keep in perspective that the vaccine offered only moderate protection …. an individual receiving this vaccine remains susceptible to gonorrhoea but just less so than if unvaccinated.
The MeNZB vaccine used in the current study is no longer manufactured, but Petousis-Harris has high hopes for a similar meningitis vaccine called 4CMenB, available in many countries.
Petousis-Harris was clear about what needed to happen next. We need an urgent assessment of current meningitis vaccines to see if they protect against gonorrhoea. It may be possible to eliminate many gonorrhoea infections using a vaccine with only moderate protection. It does not need to be perfect, she added.
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World Health Organization tells of very serious situation after confirming three known cases where all antibiotics were ineffective
The World Health Organization has warned of the spread of totally untreatable strains of gonorrhoea after discovering at least three people with the superbug.
Giving details of studies showing a very serious situation with regard to highly drug-resistant forms of the sexually transmitted disease (STD), WHO experts said on Friday it was only a matter of time before last-resort gonorrhoea antibiotics would be of no use.
Gonorrhoea is a very smart bug, said Teodora Wi, a human reproduction specialist at the Geneva-based UN health agency. Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it.
The WHO estimates 78 million people a year get gonorrhoea, an STD that can infect the genitals, rectum and throat.
The infection, which in many cases has no symptoms on its own, can lead to pelvic inflammatory disease, ectopic pregnancy and infertility, as well as increasing the risk of getting HIV.
Wi, who gave details in a telephone briefing of two studies on gonorrhoea published in the journal PLOS Medicine, said one had documented three specific cases one each in Japan, France and Spain of patients with strains of gonorrhoea against which no known antibiotic is effective.
These are cases that can infect others. It can be transmitted, she told reporters. And these cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.
The WHOs programme for monitoring trends in drug-resistant gonorrhoea found in a study that from 2009 to 2014 there was widespread resistance to the first-line medicine ciprofloxacin, increasing resistance to another antibiotic drugs called azithromycin, and the emergence of resistance to last-resort treatments known as extended-spectrum cephalosporins (ESCs).
In most countries, it said, ESCs are now the only single antibiotics that remain effective for treating gonorrhoea. Yet resistance to them has already been reported in 50 countries.
Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership, said the situation was grim and there was a pressing need for new medicines.
The pipeline, however, is very thin, with only three potential new gonorrhoea drugs in development and no guarantee any will prove effective in final-stage trials, he said.
We urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline, he said. Any new treatment developed should be accessible to everyone who needs it, while ensuring it is used appropriately, so that drug resistance is slowed as much as possible.
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Research suggests people on proton pump inhibitors are more likely to die than those taking different antacid or none at all
Millions of people taking common heartburn and indigestion medications could be at an increased risk of death, research suggests.
The drugs, known as proton pump inhibitors (PPIs), neutralise the acid in the stomach and are widely prescribed, with low doses also available without prescription from pharmacies. In the UK, doctors issue more than 50m prescriptions for PPIs every year.
Now researchers say the drugs can increase risk of death, both compared with taking a different type of acid suppressant and not taking any at all.
We saw a small excess risk of dying that could be attributed to the PPI drug, and the risk increased the longer they took them, said Ziyad Al-Aly, an epidemiologist from the University of Washington and co-author of the study.
The team say the study suggests those who take the drugs without needing to could be most at risk. They urged people taking PPIs to check whether this was necessary.
Previous research has raised a range of concerns about PPIs, including links to kidney disease, pneumonia, more hip fractures and higher rates of infection with C difficile, a superbug that can cause life-threatening sepsis, particularly in elderly people in hospitals.
But the latest study is the first to show that PPIs can increase the chance of death. Published in the journal BMJ Open, it examined the medical records of 3.5 million middle-aged Americans covered by the US veterans healthcare system.
The researchers followed 350,000 participants for more than five years and compared those prescribed PPIs to a group receiving a different type of acid suppressant known as an H2 blocker. They also took into account factors such as the participants age, sex and conditions ranging from high blood pressure to HIV.
The results show that those who took PPIs could face a 25% higher risk of death than those who took the H2 blocker.
In patients on [H2 blocker] tablets, there were 3.3 deaths per 100 people over one year. In the PPI group, this figure was higher at 4.7 per 100 people per year, said Al-Aly.
The team also reported that the risk of death for those taking PPIs was 15% higher than those taking no PPIs, and 23% higher than for those taking no acid suppressants at all.
Similar levels of increased risk were seen among people who used PPIs but had no gastrointestinal conditions, a result which the authors speculated might be driving the higher risk seen overall.
Gareth Corbett, a gastroenterologist from Addenbrookes hospital in Cambridge who was not involved with the study, cautioned against panic, pointing out that in most cases the benefits of PPI far outweighed any risk. What was more, he said, while the increased risk sounded high, it was still very low for each person.
PPIs are very effective medicines, proven to save lives and reduce the need for surgery in patients with bleeding gastric and duodenal ulcers and several other conditions, he said.
The studys authors said it was important that PPIs were used only when necessary and stopped when no longer needed.
Corbett agreed that many people take PPIs unnecessarily. They could get rid of their heartburn by making lifestyle changes, such as losing weight and cutting back on alcohol, caffeine and spicy foods, he said.
The authors said the study was observational, meaning it did not show that PPIs were the cause of the increased risk of death, and that it was unclear how the drugs would act to affect mortality. They said the drugs could affect components within cells, known as lysosomes, that help break down waste material, or shortening protective regions at the end of chromosomes, known as telomeres.
Aly said people on PPIs should check with their GP whether the drugs were still needed, adding: In some cases we expect that PPIs can be safely stopped, particularly in patients who have been taking them for a long time.
Dr. Karim Galil was tired. He was tired of losing patients to cancer. He was tired of messy medical records. And he was tired of trying to stay on top of the avalanche of clinical trials touting one solution or another. Losing both patience and too many patients, Galil decided to create an organized and artificially intelligent system to match those under his care with thebest diagnostic and treatment methods available.
He called his new system Mendel.ai after Gregor Mendel, the father of modern genetics science, and has just raised $2 million in seed funding from DCM Ventures, Bootstrap Labs and Launch Capitalto get the project off the ground.
Mendel.ai is similar in many ways to the U.K.-based BenevolentBio, which is focused on skimming through scientific papers to find the latest in cutting-edge medical research. But rather than using keyword data, Mendal.ai uses analgorithm that understands the unstructured, natural language content within medical documents pulled from clinicaltrials.gov,and then compares it to a patients medical record. The search process returns a fully personalized match and evaluates the patients eligibility for each suggested treatment within minutes, according to Galil.
The startup could prove useful for doctors whoincreasingly find it difficult to keep up on the exhaustive amount of clinical data.
Patients are also overwhelmed at the prospect of combing through mountains of clinical trial research. A lung cancer patient, for example, might find 500 potential trials on clinicaltrials.gov, each of which has a unique, exhaustive list of eligibility criteria that must be read and assessed, says Galil. As this pool of trials changes each week, it is humanly impossible to keep track of all good matches.
Mendel.ai seeks to reduce the time it takes and thus save more lives. The company is now integrating with the Comprehensive Blood & Cancer Center (CBCC) in Bakersfield, Calif, which will allow the centers doctors to quickly match their patients with available clinical trials in a matter of minutes, according to Galil.
The plan going forward is to workwith hospitals and cancer genomics companies like the CBCC to improve Mendel.ai and introduce the system. A more immediate goal, Galil says, would be challenging IBMs Watson against his system to see which one can match up the patients better.
This is the difference between someone dying and someone living. Its not a joke, Galil told TechCrunch.