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Soldiers exposed to bomb blasts may be at higher risk of Alzheimer’s

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Soldiers exposed to the shock waves from military explosives may be at an increased risk of developing Alzheimer’s in later life.

A study supported by the Leonard Wood Institute in Missouri in cooperation with the US Army Research Laboratory (ARL), has found that the brains of otherwise healthy military personnel who are exposed to explosions show an abnormal accumulation of amyloid-beta protein.

The build-up of certain forms of this toxic protein is known to cause brain cells to become sick and die, leading to cognitive decline and neurodegenerative diseases, such as Alzheimer’s.

Research conducted over several decades has suggested there may be a relationship between repetitive or severe traumatic brain injury (TBI) caused by contact sports like rugby and football, assaults, falls, and traffic accidents, and abnormal amyloid-beta accumulation.

TBI can also result from indirect forces, however, such as shock waves from battlefield explosions, that shake the brain violently in the skull.

Previous autopsy studies have shown the presence of amyloid plaques as early as hours after severe brain injury.

For this latest study published in Radiology, a journal of the Radiological Society of North America, researchers recruited nine military grenade or breacher instructors at Fort Leonard Wood Military Base in Fort Leonard, Missouri, from January 2020 to December 2021.

Grenade and breacher instructors are military officers who train recruits in the use of hand grenades and explosives or other mechanical methods to force open doors.

An additional nine civilians were included in the study as a healthy control group. All participants had no previous history of concussion, and they were all males in their early 30s, an age at which amyloid accumulation is not expected.

The 18 participants were evaluated twice. The first evaluation was to establish a baseline and the second occurred after blast exposure, approximately five months after the baseline examination.

The military instructors filled out a digital log with the number of exposures to explosions, including the firing of weapons. The control participants were evaluated at similar time points.

All participants underwent a PET scan of the head to evaluate and quantify amyloid changes. Analysis software was used to segment six brain regions that are usually associated with Alzheimer’s disease and TBI.

Abnormal amyloid accumulation was seen in six of the nine participants who were exposed to explosions. Three of the participants had one region of the brain with increased amyloid accumulation, two had two areas, and one had three zones with abnormal accumulation.

None of the healthy control participants showed any abnormal amyloid build-up.

Study author Carlos Leiva-Salinas, associate professor of radiology at the University of Missouri School of Medicine in Columbia, Missouri, said: “Amyloid-beta is a molecule not normally found in the brains of young patients. Amyloid-beta accumulation in the brain is proposed to be an early event in the pathogenesis of Alzheimer’s disease, the most common type of dementia worldwide, impacting millions of people.

“Further research needs to be done to establish the relationship between the frequency and the severity of traumatic brain injury and the degree of amyloid changes in the brain, the natural course of the observed accumulation, and other potential biologic risk factors for amyloid plaque deposition and the development of cognitive decline.”

He suggested that non-invasive positron emission tomography, or PET, imaging could be used to identify early-stage amyloid-beta accumulation in individuals or professions exposed to traumatic brain injury such as military personnel, police officers, firefighters, and sports people, like football players.

This is not the first study to make a link between soldiers exposed to explosions and a higher risk of Alzheimer’s.

Analysis published in February 2021 conducted by researchers at the University of North Carolina in collaboration with the US Army Combat Capabilities Development Command, the ARL, and the National Institutes of Health, that tested the impact of controlled military blast waves on rats, identified selective reductions in components of brain connections that are required for memory.

The researchers also observed a sharp drop in electrical activity from those neuronal connections. They stated that blast-induced effects were evident among healthy neurons, which could explain the increased risk of Alzheimer’s disease among soldiers without any apparent brain damage.

At the time the ARL’s Army Research Office programme manager, Dr Frederick Gregory, said: “Blasts can lead to debilitating neurological and psychological damage but the underlying injury mechanisms are not well understood.

“Understanding the molecular pathophysiology of blast-induced brain injury and potential impacts on long-term brain health is extremely important to understand in order to protect the lifelong health and wellbeing of our service members.”

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Shingles vaccine may slow biological ageing in older adults

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Shingles vaccination may slow biological ageing in older adults, research suggests.

The study examined more than 3,800 people aged 70 and older and found that those who received the vaccine showed slower biological ageing on average than unvaccinated individuals.

The study used data from a nationally representative US survey to assess how shingles vaccination related to several measures of biological ageing.

Even when controlling for other sociodemographic and health variables, vaccinated individuals had lower inflammation measurements, slower epigenetic ageing (changes in how genes are switched on or off) and slower transcriptomic ageing (changes in how genes are transcribed into RNA used to create proteins).

The research was carried out at the USC Leonard Davis School of Gerontology, using data from the US Health and Retirement Study.

Shingles, also called herpes zoster, is a painful, blistering skin rash caused by reactivation of the chickenpox virus. Anyone who has had chickenpox is at risk of shingles. While shingles can occur at younger ages, risk is higher for those 50 and older and for immunocompromised people. Vaccination offers protection from shingles and lowers the chance of postherpetic neuralgia, or long-term pain after infection.

While vaccines are designed to protect against acute infection, recent research has highlighted a possible link between adult vaccines, including those for shingles and influenza, and lower risks of dementia and other neurodegenerative disorders, said research associate professor of gerontology Jung Ki Kim, the study’s first author.

“This study adds to emerging evidence that vaccines could play a role in promoting healthy ageing by modulating biological systems beyond infection prevention.”

Biological ageing refers to how the body changes over time, including how well organs and systems are working, unlike chronological ageing, which is simply time passing. Two people who are both 65 years old may look very different inside: one may have the biological profile of someone younger, while another may show signs of ageing earlier.

Kim and coauthor Eileen Crimmins, USC university professor and AARP professor of gerontology, measured seven aspects of biological ageing: inflammation, innate immunity (the body’s general defences against infection), adaptive immunity (responses to specific pathogens after exposure or vaccination), cardiovascular haemodynamics (blood flow), neurodegeneration, epigenetic ageing and transcriptomic ageing. The team also used the measures collectively to record a composite biological ageing score.

Chronic, low-level inflammation is a contributor to many age-related conditions, including heart disease, frailty and cognitive decline. This phenomenon is known as inflammaging, Kim said.

“By helping to reduce this background inflammation, possibly by preventing reactivation of the virus that causes shingles, the vaccine may play a role in supporting healthier ageing. While the exact biological mechanisms remain to be understood, the potential for vaccination to reduce inflammation makes it a promising addition to broader strategies aimed at promoting resilience and slowing age-related decline.”

The effect may persist. When analysing how time since vaccination related to results, Kim and Crimmins found that participants who received their vaccine four or more years before providing their blood sample still showed slower epigenetic, transcriptomic and overall biological ageing on average than unvaccinated participants.

“These findings indicate that shingles vaccination influences key domains linked to the ageing process. While further research is needed to replicate and extend these findings, especially using longitudinal and experimental designs, our study adds to a growing body of work suggesting that vaccines may play a role in healthy ageing strategies beyond solely preventing acute illness.

The work was supported by the National Institute on Aging at the National Institutes of Health. The Health and Retirement Study is supported by the National Institute on Aging.

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Thousands of men in England to be offered life-extending prostate cancer drug

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Thousands of men in England will get the prostate cancer drug abiraterone on the NHS within weeks.

For the first time, patients in England whose cancer has not spread will be able to receive abiraterone as the health service widens access to the treatment.

Around 2,000 men diagnosed in the last three months whose cancer has not spread will get access to the treatment if it is of clinical benefit.

An additional 7,000 men are expected to be diagnosed each year and will be eligible for the drug.

The national clinical director for cancer at NHS England, professor Peter Johnson, said: “For thousands of men with prostate cancer, this treatment option could be life-changing by helping keep their cancer at bay for several years.

“The life-extending treatment available on the NHS within weeks will mean thousands of men can kick-start their year with the news that they will have a better chance of living longer and healthier lives.

“The NHS will continue to work hard to offer people the most effective and evidence-based treatments, with several new prostate cancer drugs rolled over the last five years.”

Abiraterone is a hormone-blocking tablet that helps stop prostate cancer spreading by cutting off the testosterone it needs to grow.

Research has shown that for these earlier-stage patients, survival after six years is improved, with trials showing 86 per cent of men alive after six years on abiraterone compared with 77 per cent on standard treatment (hormone therapy with or without radiotherapy).

NHS England has been able to expand access to the drug for thousands more eligible patients by securing better-value supply, following clinical advice to roll this out last year.

The NHS has set a target to save over £1bn on clinically effective biosimilar drugs during this parliament. Biosimilars are approved, lower-cost versions of biological medicines.

More than eight in 10 drugs the NHS now prescribes are lower-cost biosimilar or generic medicines, creating funding for other treatments.

The NHS in England already commissions abiraterone, now available as a lower-cost generic medicine, for advanced prostate cancer, having introduced a policy to commission the treatment in December 2024, nearly one year ahead of positive NICE guidance recommending it in November 2025.

NHS England has worked with campaigners including Prostate Cancer UK to secure this rollout.

In the past five years alone, the NHS in England has also commissioned targeted prostate cancer therapies, including the branded drugs enzalutamide, darolutamide, relugolix and apalutamide.

The health and social care secretary, Wes Streeting, said: “When you’re living with prostate cancer, every day with your loved ones matters.

“I’m delighted the NHS have taken the steps needed to make the drug available, giving thousands of men access to abiraterone, a treatment that significantly improves survival rates and can give patients precious extra years of life.

“We’re backing the best clinical evidence, making smart funding decisions, and ensuring patients get the care they need when they need it most.

“We’re serious about improving prostate cancer outcomes, treating it faster and giving loved ones more time together.”

In parallel with confirming abiraterone’s commissioning, NHS England will also offer blood plasma treatment for people with the rare condition Clarkson’s Syndrome, and genetic testing for parents with pre-existing conditions going through IVF, following clinical advice and enabled by long-term funding.

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Blood sugar spike after meals may increase Alzheimer’s risk

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Sharp rises in blood sugar after meals may raise Alzheimer’s risk, according to genetic analysis of more than 350,000 adults.

The findings point to after-meal glucose, rather than overall blood sugar, as a possible factor in long-term brain health.

Researchers examined genetic and health data from over 350,000 UK Biobank participants aged 40 to 69, focusing on fasting glucose, insulin, and blood sugar measured two hours after eating.

The team used Mendelian randomisation, a genetic method that helps test whether biological traits may play a direct role in disease risk.

People with higher after-meal glucose had a 69 per cent higher risk of Alzheimer’s disease.

This pattern, known as postprandial hyperglycaemia (elevated blood sugar after eating), stood out as a key factor.

The increased risk was not explained by overall brain shrinkage (atrophy) or white matter damage, suggesting after-meal glucose may affect the brain through other pathways not yet fully understood.

Dr Andrew Mason, lead author, said: “This finding could help shape future prevention strategies, highlighting the importance of managing blood sugar not just overall, but specifically after meals.”

Dr Vicky Garfield, senior author, added: “We first need to replicate these results in other populations and ancestries to confirm the link and better understand the underlying biology.

“If validated, the study could pave the way for new approaches to reduce dementia risk in people with diabetes.”

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