Daily Archives: 25 March 2024

How gum disease exacerbates chronic obstructive pulmonary disease

Severe gum disease has been identified as a factor contributing to the advancement of chronic obstructive pulmonary disease (COPD). Yet, the specifics of how this connection manifests within the immune system must be discovered. A recent publication in mSystems unveils a study elucidating the immune cells’ role in the microbial bridge between COPD and gum disease.

The investigation, conducted by a team at Sichuan University, China, highlighted how bacteria linked to gum disease could facilitate the progression of COPD by activating two crucial types of immune cells: γδ T cells and M2 macrophages. The focus on these mechanisms opens up potential avenues for preventing or managing COPD, according to researchers at the West China Hospital of Stomatology at Sichuan University.

Microbiologists Boyu Tang, PhD, and Yan Li, PhD, who spearheaded the study, suggest that enhancing periodontal treatment and explicitly targeting the inhibition of γδ T cells and M2 macrophages could offer a means to mitigate COPD’s progression.

Globally, COPD ranks as the sixth primary cause of death, as reported by the World Health Organization. While tobacco smoking is a predominant cause in wealthier nations, both smoking and household air pollution are significant contributors in countries with lower and middle incomes.

Periodontitis, a severe gum condition, stems from the accumulation of plaque, a bacterial film, which, if not addressed, can calcify into tartar, aggravating gum inflammation and leading to deep pockets between teeth and gums. This environment fosters bacterial growth and can result in bone loss. As a chronic infectious disease, periodontitis has been linked to various other health issues, including diabetes, hypertension, certain cancers, cardiovascular diseases, and COPD.

Li and Tang’s prior research established the significant role of the oral bacterium Porphyromonas gingivalis in gum disease. Their latest work utilized mouse models to demonstrate how this bacterium could exacerbate COPD progression. One part of their study showed that mice afflicted with both periodontitis and COPD experienced more severe COPD progression compared to those with COPD alone.

Further, the researchers discovered that in mice orally infected with P. gingivalis, the bacterium migrated to and infected the lungs, significantly altering the lung microbiota. Additional experiments revealed that periodontitis could expand immune cells in the lung tissue. Using mouse lung tissue in their experiments, the team established that P. gingivalis could trigger these immune cells, enhancing cytokine production linked to COPD aggravation.

Although the observed decline in lung function and rise in immune cell numbers were less than anticipated, this discrepancy might stem from the experimental conditions. The researchers created COPD models in mice through cigarette smoke exposure and suggested that extended exposure could amplify these effects. Li indicated plans for further research to explore how increased smoke exposure impacts the immune response.

The team is also preparing to validate their findings through studies involving human participants suffering from both conditions. They aim to assess the impact of periodontitis treatment on lung function and immune cell levels. This research could pave the way for a novel approach to treating COPD, offering hope for more effective management strategies.

More information: Kaixin Xiong et al, Periodontitis aggravates COPD through the activation of γδ T cell and M2 macrophage, mSystems. DOI: 10.1007/10.1128/msystems.00572-23

Journal information: mSystems Provided by American Society for Microbiology

The likelihood of rehospitalisation following surgery is significantly elevated among elderly Americans

A recent investigation by Yale University has uncovered that elderly Americans face a heightened likelihood of being readmitted to the hospital within 180 days following major surgery. This risk is particularly pronounced for those who are either frail or suffering from dementia. The research, published on February 28 in the journal JAMA Network Open, marks a significant advancement in understanding the postoperative challenges faced by the older population.

This study builds upon earlier work by the same Yale team, which established that major surgery is not uncommon among older Americans and highlighted an increased risk of mortality within one year post-surgery for individuals aged 65 and over. The current research is pioneering in examining this demographic’s immediate (within 30 days) and medium-term (within 180 days) hospital readmission risks. Analysing data from a nationally representative cohort of 1,477 older Americans who were not residing in nursing homes and underwent at least one major surgery between 2011 and 2018, the study found that more than a quarter (27.6%) were readmitted to the hospital within 180 days post-surgery, with nearly one in eight (11.6%) readmitted within just 30 days.

Dr. Robert D. Becher, associate professor of surgery at Yale School of Medicine and co-senior author, expressed concern over the previously unaddressed issue of longer-term readmissions post-major surgery among older individuals. He emphasised the significance of these findings for understanding the recovery process from major surgery in the older population. The study also highlights that the rates of readmission are alarmingly higher among patients with conditions commonly associated with geriatric patients, such as frailty and dementia, and those aged 90 and above, pointing towards the need for more targeted preoperative assessments and surgical planning.

Dr Thomas M. Gill, the Humana Foundation Professor of Geriatric Medicine at Yale and co-senior author of the study, stressed the critical role of recognising frailty and dementia before surgery in informing patients, families, and surgical decisions about the potential postoperative outcomes associated with these geriatric conditions.

The broader implications of hospital readmissions extend to the financial strain on the U.S. healthcare system, with costs exceeding $50 billion in 2018 alone. This is largely due to the 3.8 million cases of 30-day hospital readmissions, predominantly among Medicare beneficiaries aged 65 and older. Dr Becher pointed out the significant impact of hospital readmissions on the independence and functionality of older patients, underlining the importance of addressing this issue to preserve the quality of life for this vulnerable population.

The study represents a collaborative effort among the departments of Internal Medicine and Surgery at Yale School of Medicine and the Department of Biostatistics at Yale School of Public Health, highlighting the interdisciplinary approach required to tackle such complex health issues. Led by Yi Wang, a postdoctoral associate at Yale School of Medicine, with contributions from Linda Leo-Summers, Brent Vander Wyk, and Kendra Davis-Plourde, the research was conducted at the Yale Claude D. Pepper Older Americans Independence Center and received support from the National Institutes of Health grants.

The researchers are now focused on further exploring the causes behind the high hospital readmission rates among vulnerable older adults and devising effective strategies to reduce these risks. They aim to improve the postoperative outcomes for this growing population segment.

More information: Robert D. Becher, Thomas M. Gill et al, National Estimates of Short- and Longer-Term Hospital Readmissions After Major Surgery Among Community-Living Older Adults, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2024.0028

Journal information: JAMA Network Open Provided by Yale University

A study reveals that yoga offers distinct cognitive advantages to elderly women vulnerable to Alzheimer’s disease

A recent UCLA Health study discovered that Kundalini yoga offers numerous cognitive and memory enhancements for older women at risk of Alzheimer’s disease. These benefits include the restoration of neural pathways, prevention of brain matter reduction, and the reversal of ageing and inflammation-related biomarkers—achievements not observed in participants who underwent standard memory training exercises.

Published in Translational Psychiatry, the research adds to a growing body of evidence accumulated by UCLA Health researchers over the past decade and a half. These studies compare the effects of yoga and conventional memory enhancement training on mitigating cognitive decline and tackling other dementia risk factors.

The study was spearheaded by Dr. Helen Lavretsky, a psychiatrist at UCLA Health’s Jane and Terry Semel Institute for Neuroscience and Human Behavior. It aimed to evaluate whether Kundalini yoga could preemptively combat cognitive decline and the progression towards Alzheimer’s disease in postmenopausal women.

Women face approximately double the risk of developing Alzheimer’s disease than men, attributed to factors such as a longer lifespan, estrogen level fluctuations during menopause, and genetic predispositions.

In this latest investigation, over 60 women aged 50 and above who self-reported memory concerns and had cerebrovascular risk factors were enlisted from a UCLA cardiology clinic. They were divided into two groups: one participated in weekly Kundalini yoga sessions for 12 weeks, while the other underwent weekly memory enhancement training during the same period. Daily homework was also assigned to participants.

Kundalini yoga emphasizes meditation and breathing exercises over physical postures. Conversely, the UCLA Longevity Center’s memory enhancement training involves exercises designed to maintain or improve patients’ long-term memory, such as story-based memorization techniques and list organization.

Post-12 weeks and then again after an additional 12 weeks, the women’s cognition, subjective memory, depression, and anxiety levels were evaluated to ascertain the stability of any improvements. Blood samples were also collected to test for gene expressions related to ageing and molecules linked to inflammation, which are factors in Alzheimer’s disease. MRI scans were performed on some participants to observe changes in brain matter.

The findings indicated that the Kundalini yoga group experienced significant improvements not seen in the memory training group. These improvements included enhanced subjective memory, prevention of brain matter loss, increased hippocampal connectivity (crucial for managing stress-related memories), and better peripheral cytokines and gene expression of anti-inflammatory and anti-ageing molecules.

Lavretsky highlighted yoga’s multifaceted benefits, noting its ability to reduce stress, bolster brain health, improve subjective memory performance, and enhance neuroplasticity. Meanwhile, the memory training group’s primary advancements were long-term memory retention.

Neither intervention affected anxiety, depression, stress, or resilience levels, which Lavretsky attributed to the generally healthy status and non-depressed nature of the participants.

While further research is needed to determine Kundalini yoga’s long-term impact on preventing or delaying Alzheimer’s disease, Lavretsky suggests combining yoga with memory training could offer broader cognitive benefits for older women. She advocates for a dual approach, emphasizing that each method trains different brain areas and contributes uniquely to overall health, with yoga providing anti-inflammatory, stress-reduction, and brain-enhancing effects that complement memory training.

More information: Helen Lavretsky et al, Cognitive and immunological effects of yoga compared to memory training in older women at risk for alzheimer’s disease, Translational Psychiatry. DOI: 10.1038/s41398-024-02807-0

Journal information: Translational Psychiatry Provided by University of California, Los Angeles (UCLA), Health Sciences