In the News

LBD Diagnonis in Just 3 Minutes

Stay in the Loop with Genes and Enzymes

Dangers of Fluoride

Metagenics Unveils OmegaGenics® SPM Active, a Supplement for Tissue Health and Immune Response

Natural Partners Appoints Joyce Ito as New Vice President of Marketing and Business Development

LBD Diagnonis in Just 3 Minutes

The long wait for diagnosis is over. A new three-minute test has been developed to distinguish Lewy Body disease (LBD) from other degenerative diseases.

Although Lewy Body disease is the second-most-common degenerative disease after Alzheimer’s disease, it’s not exactly a household name. It affects more than 1.3 million Americans, is poorly recognized, and its diagnosis is often significantly delayed. Patients with LBD simultaneously experience losses in cognitive function, mobility, and behavior. The late Robin Williams as well as legendary NHL coach Alger Joseph “Radar” Arbour had this form of dementia, which also can cause visual hallucinations and make depression worse. Until now, there has been no way to assess or operationalize many of the cognitive and behavioral symptoms of LBD in clinical practice.

A leading neuroscientist at Florida Atlantic University has developed the “Lewy Body Composite Risk Score” (LBCRS) to quickly and effectively diagnose LBD and Parkinson’s disease dementia (PDD) in about three minutes. The LBCRS is a brief rating scale that can be completed by a clinician to assess clinical signs and symptoms highly associated with the pathology of this disease. With this important tool, a clinician can assess whether the patient has bradykinesia, rigidity, postural instability, or rest tremor without having to grade each extremity. This simple, one-page survey provides structured yes/no questions for six non-motor features that are present in patients with LBD, but are much less commonly found in other forms of dementia.

The LBCRS study, “Improving the Clinical Detection of Lewy Body Dementia with the Lewy Body Composite Risk Score,” recently published in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, involved 256 patients who were compared with the clinical dementia rating and gold standard measures of cognition, motor symptoms, function, and behavior. The test was administered in a “real-world” clinic setting with patients who were referred from the community rather than in a research sample. The clinic sample had a mixture of gender, education, comorbidities, behavioral, affective, motor symptoms, and diagnoses. The LBCRS was able to discriminate between Alzheimer’s disease and LBD with 96.8 percent accuracy, and provided sensitivity of 90 percent and specificity of 87 percent.

For the study, caregivers completed evaluations to determine the presence and severity of non-cognitive symptoms observed in the patient and their impact on the caregiver. Each patient was administered a 30-minute test battery at the time of the office visit to assess their cognitive status. The LBCRS was completed after all other rating scales were scored and the diagnosis was presented to the patient and family.

“Most patients never receive an evaluation by a neurologist skilled in the diagnosis of Lewy body dementia, and significant delays and misdiagnoses occur in most patients with this disease,” said James E. Galvin, M.D., M.P.H., one of the most prominent neuroscientists in the country who developed the LBCRS, and a professor of clinical biomedical science in FAU’s Charles E. Schmidt College of Medicine and a professor in FAU’s Christine E. Lynn College of Nursing. “This new tool has the potential to provide a clearer, more accurate picture for those patients who are unable to be seen by specialists, hastening the correct diagnosis and reducing the strain and burden placed on patients and caregivers.”

Another important aspect of the LBCRS is its ability to improve the sensitivity of diagnosis, thereby reducing the risk of exposure to patients with LBD to medications that can have potentially serious adverse consequences. The survey also increases the potential opportunity to receive appropriate symptomatic therapies in a timely fashion, and lessens the inappropriate exclusion from and inclusion into clinical trials.

“Early detection of Lewy body dementias will be important to enable future interventions at the earliest stages when they are likely to be most effective,” said Galvin. “Our study provides evidence-based methodology that will have applications in clinical practice, participation in clinical trials, prevention studies, community surveys, and biomarkers research.”

Galvin is one of the leading international experts on LBD and has been working to improve clinical detections by combining biomarkers including high density EEG, functional and structural MRI, PET scans and CSF biomarkers to characterize and differentiate LBD from healthy aging and other neurodegenerative diseases.

Galvin has led efforts to develop a number of dementia screening tools, including the Quick Dementia Rating System (QDRS), AD8, a brief informant interview to translate research findings to community settings. He has done cross-cultural validation of dementia screening methods in comparison with Gold Standard clinical evaluations and biomarker assays. His team also has developed sophisticated statistical models to explore transition points in clinical, cognitive, functional, behavioral, and biological markers of disease in healthy aging, mild cognitive impairment, Alzheimer disease, and Parkinson’s disease.

Stay in the Loop with Genes and Enzymes

Think you’ve got the basics of gene regulation down? Think again.

A study of where and how an enzyme cuts DNA may have inadvertently revealed a basic principle of gene regulation, say researchers in Boston Children's Hospital's Program in Cellular and Molecular Medicine (PCMM). The study, reported in the journal Cell, suggests that the cell can lock or "sandbox" genes and enzymes that act on them within loops of DNA and protein, confining their activity to minimize the risk of genetic disaster.

In our cells, DNA and its associated proteins—a combination called chromatin—are folded and wrapped in complex ways to form chromosomes. Researchers have long noted within a chromosome, the chromatin is organized into a series of loops. These loops can range in size from a few thousand to nearly 2.5 million base pairs, large enough to contain one or more complete genes.

The study team—led by co-first authors Jiazhi Hu, PhD, and Yu Zhang, PhD, and senior author Frederick Alt, PhD—believes these loops may form the backbone of a fundamental organizing principle for genomic processes.

"These loops are hardwired. The whole genome is organized into them," explained Alt, director of the PCMM and a professor of genetics at Harvard Medical School. "We think that they are there to restrict enzyme activity so that processes occur in a very organized fashion. We think this may be a basic biological principle that's going to show up in other processes like replication and transcription."

The enzyme the team studied, called RAG, cuts DNA at specific locations in antibody-producing B-cells, helping create the immune system's immense diversity of antibodies. Initially the researchers set out to see whether RAG would cut DNA more broadly across the genome. To do so, they used an assay called high-throughput genome-wide translocation sequencing (HTGTS, which Alt's lab has applied to study the precision of the gene editing systems like CRISPR/Cas9) to map all of the possible RAG targets in the genome.

The team was struck to find that while the answer is yes, RAG will cut DNA elsewhere in the genome, its activity normally is exclusively confined within chromatin loops. When they zoomed in, the researchers were surprised to find that RAG bound to the loops and physically travelled around them in one direction or another (depending on which way the enzyme was pointing when it bound to target sites) much like a train on a track, sampling the loop's DNA sequences looking for sites to cut. The enzyme stopped once it reached the junction point at the bottom of a loop (where the loop joins the rest of the genome).

Alt's team thinks that loops work in concert with the cell's DNA damage machinery to "sandbox" genes and the enzymes that act on them, containing them to reduce the risk that the cuts an enzyme makes to DNA will trigger damaging genetic events such as translocations (fusions of one chromosome to another, which can lead to cancer). Indeed, the study team showed that in cells lacking a DNA repair protein called ATM, RAG could escape a loop and make cuts elsewhere in the genome. These off-target cuts could generate potentially cancerous gene translocations.

"What this tells us is that an enzyme can bind in a loop, and its activity will be restricted to just within that loop," Alt said. "The loops take what could be very dangerous processes and lock them up."

He added that the team's basic discovery—that an enzyme that interacts with DNA can get into a loop and actively explore that loop in two directions—could teach us something about the basic principles of genome organization. The nature of the "engine" that moves RAG around loops, however, is not yet clear, and needs to be elucidated.

"Why have loops? Why did the genome evolve that way?" Alt asked. "We find that loops can restrict processes within them, and allow enzymes to sample sequences within them in directional ways. If RAG can do it, other enzymes like transcriptional or DNA polymerization factors should be able to do it too. With new technologies like HTGTS a lot more can be done to see how loops might organize such fundamental processes."

The study was supported by the National Institute of Allergy and Infectious Diseases (grant numbers AI020047, AI032524 and T32AI007512), the Leukemia and Lymphoma Society (SCOR 70019), The Cancer Research Institute and the Robertson Foundation. Dr. Alt is a Howard Hughes Medical Institute Investigator.

About Boston Children's Hospital

Boston Children's Hospital is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including seven members of the National Academy of Sciences, 11 members of the Institute of Medicine and 10 members of the Howard Hughes Medical Institute comprise Boston Children's research community. Founded as a 20-bed hospital for children, Boston Children's today is a 397-bed comprehensive center for pediatric and adolescent health care. Boston Children's is also the primary pediatric teaching affiliate of Harvard Medical School. For more, visit our Vector and Thriving blogs and follow us on our social media channels: @BostonChildrens, @BCH_Innovation, Facebook and YouTube.

Dangers of Fluoride

Infants in New York City may be suffering from fluoride overdose.

A recently uncovered document reveals that New York City infants are fluoride overdosed and risk fluoride-damaged teeth, especially when infant formula is mixed with NYC's fluoride-laced public water supplies, reports the New York State Coalition Opposed to Fluoridation, Inc. (NYSCOF).

These infants risk moderate dental fluorosis, which is caused by fluoride ingestion. This fluoride can come from various things an infant consumes, so be careful not to feed your infant anything made with fluoridated water. Tea is also high in fluoride, so even if your doctor prescribes white tea for your little one’s tummy ache, think twice before following through.

"Fluoride, neither a nutrient nor essential for healthy teeth, is a prescription drug with side effects. NYC government officials continue to overdose babies by mandating fluoridation," says attorney Paul Beeber, NYSCOF President.

Despite this, the Journal of the American Dental Association found that all infant formula contains fluoride at higher levels than recommended for babies (the Institute of Medicine‘s recommendation is only 0.01 milligrams daily). There are also baby foods with hidden fluoride that could mar your baby’s teeth, so be a smart consumer and research food before you buy it.

NYC residents can help the newly-formed NYC Coalition Against Artificial Fluoridation which is working to stop fluoridation in NYC. Visit http://www.nycagainstfluoride.org for more information or to get involved.

"Insist that NYC Mayor DiBlasio and the City Council stop forcing unnecessary, money-wasting, potentially health-robbing fluoride chemicals into your bodies via the water supplies," says Beeber.

"There is no scientifically valid reason to continue fluoridation," says Beeber. "It must end."

Watch a new Fluoridation documentary "Our Daily Dose."

Metagenics Unveils OmegaGenics® SPM Active, a Supplement for Tissue Health and Immune Response

Metagenics, Inc., a nutrigenomics and lifestyle medicine company focused on improving health, today announced the launch of OmegaGenics SPM Active, a first-in-class nutritional supplement with specialized pro-resolving mediators (SPMs) designed to help support the resolution of the immune response—a natural response to tissue challenges from cellular damage, unhealthy diets and lifestyles. SPM production in the body decreases with age so SPM Active is particularly supportive of healthy aging.

When tissues in the body are challenged, the body reacts by developing a tailored immune response by recruiting cells and clearing cellular debris of affected tissues to help resume normal activity and maintain tissue health. An unresolved immune response may lead to discomfort and unwanted health conditions.

Recent research has led to the discovery that biologic resolution of the immune response is not a passive response, as traditionally believed, but rather an active, naturally-induced process that triggers the body to produce SPMs from the omega-3 fatty acids EPA and DHA. Through their pro-resolving properties, SPMs play an essential role in tissue health and healthy aging through the resolution of the immune response.

"The discovery of SPMs and the role they play in resolving immune responses and for chronic health concerns relating to healthy aging offers healthcare professionals a new approach to patient care," said John P. Troup, PhD, Chief Science Officer of Metagenics, Inc. "Through advanced technology, we've designed OmegaGenics SPM Active with standardized levels of SPMs found in select fractions of marine oils that complement and support the body's natural ability to resolve an immune response."

To find an authorized Metagenics healthcare practitioner or for more information about OmegaGenics SPM Active, visit www.Metagenics.com.

Natural Partners Appoints Joyce Ito as New Vice President of Marketing and Business Development

Natural Partners, Inc., a trusted resource for integrative healthcare practitioners for more than 20 years, has appointed Joyce Ito its new Vice President of Marketing and Business Development. Joyce will be leading the company’s marketing, product and brand strategies, as well as its e-commerce and business development initiatives.

“Joyce is a seasoned professional and brings years of healthcare industry marketing, product management, business development, and management experience. Joyce’s demonstrated success in developing customer acquisition strategies and launching innovative, customer-focused technologies will enable her to make a significant contribution to the success of Natural Partners,” said Fran Towey, President of Natural Partners. “We were looking for a leader who shared our passion to improve Wellness by providing healthcare practitioners the products, services, and education they need to focus on patient care. We found that in Joyce.”

Prior to joining Natural Partners, Joyce was Director of Strategic Marketing and Business Development for McKesson Patient Relationship Solutions, a division of McKesson Corporation, where she led patient acquisition and adherence strategies, marketing automation initiatives, new business acquisition, and brand awareness strategies among many other things. Prior to that, Joyce held senior marketing roles with C.R. Bard, Orthologic, and Hewlett-Packard. Joyce holds a BA in economics from the University of California, Los Angeles and an MBA in marketing from the University of Southern California. 

About Natural Partners, Inc.

Natural Partners is a resource for practitioners who strive to improve patient wellness by providing education and professional-grade products to healthcare practitioners and their patients. Since 1995, Natural Partners has researched trusted brands and welcomed them into their portfolio, currently offering over 14,000 premium products from hundreds of high-quality manufacturers. Natural Partners works with hundreds of healthcare practitioners every week to help them set up and maintain an efficient, seamless ordering system that ensures their patients get the supplements they need, when they need them. For more information, visit naturalpartners.com.