Integrative Molecular Phenotyping
INTEGRATIVE MOLECULAR
PHENOTYPING
WHEELOCK LABORATORY
DEPARTMENT OF MEDICAL
BIOCHEMISTRY AND BIOPHYSICS
WHEELOCK LABORATORY
DEPARTMENT OF MEDICAL
BIOCHEMISTRY AND BIOPHYSICS
WHEELOCK LABORATORY
DEPARTMENT OF MEDICAL
BIOCHEMISTRY AND BIOPHYSICS
WHEELOCK LABORATORY
DEPARTMENT OF MEDICAL
BIOCHEMISTRY AND BIOPHYSICS
WHEELOCK LABORATORY
DEPARTMENT OF MEDICAL
BIOCHEMISTRY AND BIOPHYSICS
WHEELOCK LABORATORY

KI News

Updated: 1 hour 59 min ago

Transfusion with stored blood safe in heart surgery

Tue, 20/10/2015 - 17:17
A large registry study led from Sweden’s Karolinska Institutet shed new light on the much debated issue of transfusions with stored blood. The study, which is published in the journal JAMA, shows that the use of stored blood units does not influence patient outcomes after heart surgery. In Sweden and most other western countries, blood units can be stored for as long as 6 weeks before being transfused. However, a high-profile publication in 2008, which claimed that storage for a mere 14 days or more was unsafe for heart surgery, has caused confusion and anxiety at hospital clinics worldwide. “There have literally been hundreds of studies conducted on this topic the past five or six years, none of which have been able to provide a definitive answer”, says senior author Gustaf Edgren, MD, Associate Professor at the Department of Medical Epidemiology and Biostatistics. To tackle the problem at its roots, Dr. Gustaf Edgren and his research team performed a large-scale study of almost 50,000 patients in Sweden over a 16-year period. The study was made possible by linking a number of high-quality health registries, which allowed researchers to include all heart surgery patients in Sweden during the study period, with complete information about all blood transfusions administered together with clinical details about the patients. The cohort included patients receiving transfusions with blood that had been stored between 14 and 42 days. Unique health registers “This study is by far the largest investigation focusing on the issue of blood storage in this very sensitive patient group, and we find absolutely no hint of negative health effects associated with stored blood”, says lead study-author Ulrik Sartipy, a Cardiac Surgeon and Associate Professor at the Department of Molecular Medicine and Surgery.  “Thanks to these unique health registers we have been able to provide very firm reassurance that the current blood storage practices are safe,” says Gustaf Edgren. Funding was provided by the Swedish Medical Society, Karolinska Institutet Foundations and Funds, the Mats Kleberg Foundation, the Swedish Research Council, the Swedish Heart-Lung Foundation, and the Swedish Society for Medical Research. Co-authors of the study are also affiliated to Karolinska University Hospital, Sweden, and Statens Serum Institut in Denmark. Registries used in the study were amongst others the SWEDEHEART registry, which records information on patients who undergo heart surgery in Sweden, and the SCANDAT2 database, a nationwide register of blood transfusions. View our press release about thes findings Publication Red Cell Concentrate Storage and Survival after Cardiac Surgery Ulrik Sartipy, Martin J. Holzmann, Henrik Hjalgrim, Gustaf Edgren JAMA, online 20 October 2015, doi:10.1001/jama.2015.8690.

Clear link between income and survival after cardiac surgery

Tue, 20/10/2015 - 08:08
The higher a patient’s income, the better are his or her chances of surviving cardiac surgery in both the short and long term. This is the finding of a new registry study by researchers from Sweden’s Karolinska Institutet published in the Journal of the American College of Cardiology (JACC). It has long been known that socioeconomic factors such as income are linked to the risk of cardiovascular disease; what is less researched, however, is the role these factors play in post-cardiac surgery prognoses. Now, researchers at Karolinska Institutet have conducted a registry study showing that household disposable income is closely linked to long-term survival after cardiac surgery in Sweden. The study included 100,000 patients from the Swedeheart registry who had undergone cardiac surgery at some time between 1999 and 2012. The patients’ data were then cross-referenced with other registries, including the National Board of Health and Welfare’s cause of death and patient registries and Statistics Sweden’s LISA (Longitudinal integration database for health insurance and labour market studies) database, which contains such personal data as income, level of education and civil status. The patients were then divided into five equal-sized groups of approximately 20,000 individuals on the basis of household income, and tracked via the registries for an average of just over seven years. By the end of the follow-up time, a total of 29 per cent of the patients had died; amongst them, 43 per cent of the lowest income group and only 14 per cent of the highest. After factoring in other known risk-factors, the risk of dying after cardiac surgery was about 30 per cent lower in the group with the highest income than in the group with the lowest. “We can see a strong correlation between income and survival after cardiac surgery, but because of how the study was designed, we can’t say if it’s a direct causal relation, and other factors might play a part,” says Ulrik Sartipy, Associate Professor at Karolinska Institutet’s Department of Molecular Medicine and Surgery, and a cardiac surgeon at Karolinska University Hospital’s Department of Cardiothoracic Surgery. “But with the right action, it should be possible to improve the prognosis for patients with lower incomes. The difficulty is deciding on the right action to take, which should be the subject of future studies.” Making up a larger project There are other factors that are known to increase the post-cardiac surgery mortality rate. These include age (the higher the age, the higher the risk), sex, kidney disease, diabetes and other cardiovascular diseases. Such factors are quantifiable, and the researchers adjusted their figures accordingly to neutralise their influence. However, they did not take into account factors such as smoking, diet, physical activity or adherence to drug regimen, which also affect the survival rate. One reason for this is that such data were not available on an individual level to the study. The study is one of several making up a larger project. “That is one of the study’s weaknesses,” says Magnus Dalén, PhD student at Karolinska Institutet’s Department of Molecular Medicine and Surgery, and a cardiac surgery registrar at Karolinska University Hospital’s Department of Cardiothoracic Surgery. “These factors are linked to socioeconomic status and might well go some way to explaining the better survival record of the higher income groups, but this needs further investigation.” The study was financed with grants from several bodies, including the Swedish Society of Medicine, Karolinska Institutet and the Mats Kleberg Foundation. View our press release about this study Publication Household Disposable Income and Long-Term Survival After Cardiac Surgery Magnus Dalén, Torbjörn Ivert, Martin J. Holzmann and Ulrik Sartipy JACC – Journal of the American College of Cardiology, online 19 October 2015, doi: 10.1016/j.jacc.2015.08.036

Meet one of this year's academic awardees – Rune Brautaset

Fri, 16/10/2015 - 08:08
This Thursday, October 15, the 2015 academic awardees received their prizes at the installation ceremony at Karolinska Institutet. Dr Rune Brautaset, head of KI’s optometry programme, was awarded this year’s Pedagogical Prize. A banana box full of old glasses and a converted quiet room. These are two of the reasons why Dr Rune Brautaset, head of KI’s optometry programme, was awarded this year’s Pedagogical Prize. But there are more reasons, one of the most important being the training laboratory at St Erik’s Eye Hospital, where eleven fully equipped optometry stations have been installed. Here, students can examine each other’s eyes – and they do. In a lunch room we meet optometry student Mirza Karamovic, who feels ready to take on his forthcoming customers and patients. “The training lab is open until ten at night, and even at weekends,” he says. “We go there of our own accord to practise different kinds of eye test. I feel comfortable with it now.” I’ve tried to explain to people in the industry that if they want skilled opticians, they’ll have to help pay for them. The room was expensive to fit out, but contributions have come from different quarters of the optometry business. “I’ve tried to explain to people in the industry that if they want skilled opticians, they’ll have to help pay for them,” says Dr Brautaset. Dr Brautaset studied optometry in his native Norway and in England, two countries that were quick to modernise their training programmes to match developments in the industry, which have taken it from a profession for craftspeople focused on grinding and mounting lenses to one of registered healthcare providers working with vision and ocular health. In 2000, Dr Brautaset moved to Sweden, where he started working as a junior lecturer on KI’s optometry programme. “Our lecture halls were full of grinding machines,” he says. “I wanted to make space for what I’d learnt in Norway and England.” While working at KI, Dr Brautaset was studying for his doctorate in England, and in 2003 he became the first optician in Sweden to hold a PhD. Two years later he was made director of KI’s study programme in optometry and began to develop the optometry unit, which also offers a one-year Master’s degree for opticians and the opportunity to conduct research. Nowadays we discuss what characterises a scientific approach from the very first term. In 2012, the then National Agency for Higher Education (now the Swedish Higher Education Authority) criticised the programme for the inferior quality of its students’ degree projects. The Master’s programme was, however, found to be satisfactory. “It was true, but we’d already started making improvements by then,” he says. “Nowadays we discuss what characterises a scientific approach from the very first term, and give the students more training in writing papers.” Today, half of the teachers hold PhDs, and here too, the business sector has done its bit. “Without it, we’d never get started,” he says, “Thanks to the funding we’ve got from the industry, we were able to set aside time for research so that we could turn out our first doctoral graduates. Now we have research results and ongoing projects, and can apply for regular funding.” Dr Brautaset received the Pedagogical Prize on 15 October in Aula Medica. The judges citation praises his clinical and scientific achievements and is punctuated with terms like sustainable development and diversity – which is where the banana boxes and quiet room come in. The boxes contain old glasses, the lens strengths of which are measured and noted down by the students as they learn to operate the measuring equipment. They are then donated to aid projects in which needy people in other countries get help choosing the most suitable pair for themselves. As for the quiet room, it has been turned into a oft-frequented prayer room. “We’ve got many students with a foreign background,” explains Dr Brautaset, “which I think is because we’re rumoured to be good at making people feel welcome.” Text: Annika Lund This article was published in KI Bladet 3/2015.

Ebola virus can persist in the semen of survivors

Thu, 15/10/2015 - 10:10
Preliminary results of a study into persistence of Ebola virus in body fluids show that some men still produce semen samples that test positive for Ebola virus nine months after onset of symptoms. The first phase of this study has focused on testing for Ebola virus in semen because of past research showing persistence in that body fluid.  Better understanding of viral persistence in semen is important for supporting survivors to recover and to move forward with their lives. Ninety three men over the age of 18 from Freetown, Sierra Leone, provided a semen sample that was tested to detect the presence of Ebola virus genetic material. The men enrolled in the study between two and 10 months after their illness began. For men who were tested in the first three months after their illness began, all were positive. More than half of men who were tested between four to six months after their illness began were positive, while one quarter of those tested between seven to nine months after their illness began also tested positive. The men were given their test results along with counseling and condoms. Why some study participants had cleared the fragments of Ebola virus from semen earlier than others remains unclear. Until more is known, the more than 8000 male Ebola survivors across the three countries need appropriate education, counseling and regular testing so they know whether Ebola virus persists in their semen; and the measures they should take to prevent potential exposure of their partners to the virus. In the current West African outbreak, continued vigilance to identify, provide care for, contain and stop new cases, are key strategies on the road to achieving zero cases.  The report, published in the New England Journal of Medicine, provides the first results of a long-term study being jointly conducted by the Sierra Leone Ministry of Health and Sanitation, Sierra Leone Ministry of Defence, the World Health Organization and the U.S. Centers for Disease Control and Prevention. Professor Anna Ekéus Thorson, Department of Public Health Sciences at Karolinska Institutet is one of the researchers behind the study. Publication “Ebola RNA Persistence in Semen of Ebola Virus Disease Survivors - Preliminary Report”, New England Journal of Medicine, online 14 October 2015, DOI: 10.1056/NEJMoa1511410. View the press release from the WHO   

Professors at Karolinska Institutet to be installed October 15

Wed, 14/10/2015 - 21:21
Karolinska Institutet's yearly installation ceremony will be held Thursday October 15, 2015, at which new professors, adjunct professors, visiting professors and, not least, foreign adjunct professors will be presented. This year's academic prizes and awards will also be announced. All new professors at Karolinska Institutet are presented on the KI website, please visit to find out more about their research (in Swedish as well as in English): KI's new professors 2015 on their research. The following adjunct professors will also be presented during the ceremony: Barbro Dahlén, Pulmonary Medicine and Allergology. Solvig Ekblad, Multicultural Health Services Research. Mikael Forsman, Ergonomics. Eva Hurt-Camejo, Biochemical Cardiovascular Research. Ralph Knöll, Genetic Cardiology. Nina Lundberg, E-Health in Medical Radiology. Jonas Mattsson, Cell Therapy. Ali Mirazimi, Clinical Virology. Magnus Nord, Experimental Pulmonary Medicine. Ann Nordgren, Clinical Genetics. Lennart Nordström, Obstetrics. Claes Norring, Clinical Psychology. Håkan Wallén, Cardiology. The following visiting professors will also be presented:  Lauri Aaltonen, Cancer Genetics. Patrick Cramer, Structure Biology and Systems Biology. Ann-Charlotte Granholm, Neurosciences. Anu Kantele, Infectious Medicine specialising in Travel Medicine. Terumi Kohwi-Shigematsu, Cancer Epigenetics. Ilona Koupil, Social Epidemiology, especially Children and Adolescents. Matti Lehtinen, Epidemiology. Hans Morten Lossius, Prehospital Emergency Care. Karl-Johan Malmberg, Cellular Immune Therapy. Anders Persson, Medical Radiology. Thomas Sakmar, Molecular Biology and Biochemistry. Timo Sorsa, Periodontics. Peter Svensson, Clinical Oral Physiology. The following foreign adjunct professors will also be introduced: Pak Chung Ho, Obstetrics and Gynecology, University of Hong Kong, Department of Obstetrics and Gynecology, Hong Kong. Guido Kroemer, Paediatric Oncology, Université Paris Descartes, Centre de Recherche des Cordeliers, Paris, France. Christoph Lange, Infectious Diseases, Research Center Borstel – Leibniz Center for Medicine and Biosciences, Borstel, Germany. Soumaya Raychadhuri, Molecular Medicine, Harvard Medical School, Boston, USA. Steven Rosenberg, Cell Therapy, NIH, National Cancer Institute, Bethesda, USA. Ulf Skoglund, Structural Cell Biology, Okinawa Institute of Science and Technology, Structural Cellular Biology Unit, Okinawa, Japan. Find out more about the prizes and awards that will be presented during the installation ceremony 2015: The Grand Silver Medal: Gunnel Biberfeld, Britta Wahren and SGO Johansson. The Dimitris N. Chorafas prize: Miriam Elfström. The Eric K. Fernström Prize: Sten Linnarsson (in Swedish only). The Håkan Mogren prize: Elisabet Lidbrink. The Karolinska Institutet Ethics Prize: Lena Marions. Karolinska Institutet's Pedagogical Prize: Rune Brautaset. The Malin och Lennart Philipson prize: Erik Norberg. Lennart Nilsson Award: ​Katrin Willig. The Sven and Ebba-Christina Hagberg Prize: Emma Andersson och Robert Månsson.

One step closer to a new drug for alcohol dependence

Wed, 14/10/2015 - 11:11
Researchers at Karolinska Institutet and the Sahlgrenska Academy in Sweden might be one step closer to finding an effective drug for alcohol dependence. In two separate studies, they show that the dopamine stabilizer OSU6162 can reduce the craving for alcohol in alcohol dependent people and normalises the level of dopamine in the brain reward system of rats that have consumed alcohol over a long period of time. However, thorough clinical studies are needed to determine if the OSU6162 also can help alcohol dependent people drink less alcohol. “The results of our studies are promising, but there is still a long way to go before we have a marketable drug,” says Pia Steensland, Associate Professor at the Department of Clinical Neuroscience, Karolinska Institutet and co-author of both studies. “The socioeconomic costs of alcohol are huge, not to mention the human suffering. It is inspiring to continue working.” Roughly a million Swedes over 15 years of age drink so much alcohol that they risk damaging their health, and it is estimated that some 300,000 of these people are dependent. Despite the pressing need, there are only a few approved drugs for the treatment of alcohol dependence, but their effects vary from person to person and the prescriptions rates are low. Consequently the hunt for new, more efficacious drugs for alcohol dependence continues. Clinical study The studies of OSU6162 are based on the knowledge of how the brain reward system stimulates us to act in the interests of our own survival. Since dopamine creates a feeling of wellbeing, such as when we exercise or eat good food, the memory associates the two so that we will repeat the behaviour. Alcohol makes the brain reward system release more dopamine than normal, creating a pleasant euphoric sensation. However, the more alcohol drunk, the more the reward system is desensitised and the less dopamine is released. With time, greater volumes of alcohol are needed to cause intoxication and eventually to attain a state of physical and emotional normality – addiction has set in. In the clinical study, which is published in the scientific journal European Neuropsychopharmacology¸ the scientists examined for the first time if OSU6162 can reduce the craving for alcohol in people with alcohol dependence. Half the participants were treated with OSU6162 and half with placebo for a fortnight, after which both groups were exposed to different situations that could be assumed to elicit a craving for alcohol. The results show that the experimental group experienced less of a craving for alcohol after drinking one glass of an alcoholic beverage. “At the same time, the OSU6162 group reported not enjoying the first zip of alcohol as much as the placebo group,” says Dr Steensland. “One interesting secondary finding was that those with the poorest impulse control, that is those thought to be most at risk of relapse after a period of abstinence, were those who responded best to the OSU6162 treatment.” Adds to the understanding A study of rats published at the same time in the scientific journal Addiction Biology adds to the understanding of how OSU6162 works, as it shows that rats that voluntarily consumed alcohol for almost a year had lower levels of dopamine in their brain reward system than rats that had never drunk alcohol. However, when the “alcohol rats” were treated with OSU6162 it was found that the substance counteracted the low concentrations of dopamine in the brain reward system. “We therefore think that OSU6162 can reduce the alcohol craving in dependent people by returning the downregulated levels of dopamine in their brain reward system to normal,” says Dr Steensland. The rights to OSU6162 are owned by Nobel Laureate Arvid Carlsson, professor emeritus at the Sahlgrenska Academy, University of Gothenburg, whose team also invented the substance. Emeritus Professor Carlsson is also one of the co-authors of the clinical study. The research was financed with grants from several bodies, including the Swedish Brain Foundation, the Swedish Research Council, the Torsten Söderberg Foundation, Systembolaget’s alcohol research council and the Swedish Research Council for Health, Working Life and Welfare (FORTE). View our press release about these findings Publications ‘The Effects of the Monoamine Stabilizer (-)-OSU6162 on Craving in Alcohol Dependent Individuals: A Human Laboratory Study’,  Lotfi Khemiri, Pia Steensland, Joar Guterstam, Olof Beck, Arvid Carlsson, Johan Franck, Nitya Jayaram-Lindström, European Neuropsychopharmacology, online 6 October 2015, doi:org/10.1016/j.euroneuro.2015.09.018. ‘The Monoamine Stabilizer (-)-OSU6162 Counteracts Down-Regulated Dopamine Output in the Nucleus Accumbens of Long-Term Drinking Wistar Rats’, Kristin Feltmann, Ida Fredriksson, Malin Wirf, Björn Schilström, Pia Steensland. Addiction Biology, online 14 October 2015, doi: 10.1111/adb.12304. 

Healthy diet may reduce cognitive decline as people age

Tue, 13/10/2015 - 11:11
Eating healthier may reduce cognitive decline and diminish the negative impact of an unhealthy diet on memory and thinking abilities in older adults, suggests a new study by researchers at Karolinska Institutet. The findings are being published online by the journal Alzheimer’s & Dementia. “Most people eat a combination of healthy and less healthy foods, but we know little about how a mix of dietary patterns may impact cognitive function,” says study author Behnaz Shakersain, doctoral student at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and also affiliated to the Aging Research Center in Stockholm. “In our study population, we saw evidence that those who mostly consumed an unhealthy diet had approximately twice as much cognitive decline than those who consumed healthy and unhealthy diets together over time.” The study analyzed the diets of 2,223 Swedish adults aged 60 or older and compared this information with their cognitive function over a six-year period. All individuals were dementia-free at the start of the study and underwent cognitive testing at the start and again after three years and six years. Cognitive abilities were measured using the Mini-Mental State Examination, which is frequently used in research settings and by health care professionals to screen for dementia and is scored from 0 to 30. Different food and beverage items A questionnaire given at the beginning of the study asked participants how often nearly 100 different food and beverage items were consumed over the previous 12 months. The researchers used the responses to group participants by how strongly they adhered to a “Western” pattern diet (red/processed meat, saturated/trans-fat, refined grains, sugar, beer, and spirits) and a “prudent” pattern diet (vegetables, fruits, cooking/dressing oil, cereals and legumes, whole grains, rice/pasta, fish, low-fat dairy, poultry, and water). The results show that people with the highest adherence to the “prudent” diet and the least adherence to the “Western” diet, labeled as the “high protection, low risk group,” experienced the smallest decline in cognitive function over time. Individuals in the study with the least adherence to the “prudent” diet and the highest adherence to the “Western” diet, labeled as the “low protection, high risk group,” showed a statistically significant increase in cognitive decline with an average of more than 1 point decline in general cognitive test score over time compared to those in the “high protection, low risk group.” The study was funded by, amongst others, the Swedish Research Council for Health, Working Life and Welfare, Stiftelsen Ragnhild & Einar Lundströms Minne, Gun & Bertil Stohnes Foundation. This news article is an edited version of a recent press release from the Alzheimer’s Association, USA.   Publication Prudent diet may attenuate the adverse effects of Western diet on cognitive decline Behnaz Shakersaina, Giola Santonia, Susanna C. Larsson, Gerd Faxén-Irvingc, Johan Fastbom, Laura Fratiglioni, Weili Xu Alzheimer’s & Dementia, online 2 September, doi: http://dx.doi.org/10.1016/j.jalz.2015.08.002

Unique stem cell brittle-bone study starts

Tue, 13/10/2015 - 10:10
A study is to be conducted for the first time involving the transplantation of stem cells into unborn babies with the brittle-bone disease osteogenesis imperfecta, which causes repeated fractures often before birth. The study is to be coordinated by Karolinska Institutet but to be run as a collaboration between several leading European research centres and companies. Babies born with the severe form of osteogenesis imperfecta, or congenital brittle-bone disease, are often seriously ill. Repeated fractures in all parts of the skeleton give rise to physical disabilities, postural abnormalities, and stunted growth. The child’s breathing and pulmonary function can also be affected with the narrowing of the rib cage. There is currently no cure. Collagen is a thread-like protein found in bone that has a similar reinforcing function to iron rods in concrete. Since the disease is caused by an inability of the developing body to form collagen, scientists at Karolinska Institutet have produced a special strain of stem cell, which when injected into the body of sufferers targets and strengthens the bone by producing collagen. Studies on mice have shown a positive response to the treatment, which has also been tried on a couple of children with the disease. “The oldest child to have received the treatment is now 13 and is performing better than expected and is still growing,” says Cecilia Götherström, a researcher at Karolinska Institutet’s Department of Clinical Sciences, Intervention and Technology. “But we believe that we can improve the treatment for other patients by administering it to the unborn baby and again in repeated doses during the child’s first years of life.” Dr Götherström will be leading the study, which will test the treatment on unborn babies. Thirty babies will be included in the study, half of whom will receive stem cells before birth, and half after. New treatments will then be done at six-monthly intervals over a period of two years to enhance the effect. The researchers will then assess the results by analysing the development of bones and counting the number of fractures that the children in both groups suffer and compare the results with children who have not been treated with stem cells. The “Boost Brittle Bones Before Birth” (BOOSTB4) project This research project will start in January 2016 and will be coordinated by Karolinska Institutet. Other participating research centres and companies include University College London, Great Ormond Street Hospital, London, the University of Leicester, Universitair Medisch Centrum Utrecht, Leiden University Medical Centre, Uniklinik Köln, Lund University, Cell Protect Nordic Pharmaceuticals AB, Nordic Health Economics, MedSciNet and Euram Ltd. The study will also include patients from other European countries. Funding has been obtained from several sources, including the Swedish Research Council (grant agreement number E0720901, € 1,760,000) and the European Union’s Horizon 2020 research and innovation programme under grant agreement No 681045 (€ 6,608,752). View our press release

Causal link between telomere shortening and Alzheimer’s disease

Tue, 13/10/2015 - 09:09
In a newly published study, researchers at Karolinska Institutet show that the shortening of the telomeres – the caps at each end of the chromosomes in our cells – can be linked statistically to the active mechanism responsible for Alzheimer’s disease. However, the effect is small and telomere length cannot yet be used to assess disease risk at an individual level. The results are presented in the journal JAMA Neurology. Every cell in our body contains our entire genome, packed into the nucleus in the form of 46 chromosomes. Every time a cell divides, the telomeres at the tips of the chromosomes become slightly shorter until they reach a critical length, at which point the cell dies. Just where this critical threshold goes depends on the individual, partly because the telomeres are of different lengths to start with, and partly because in some people the telomeres shorten more on cell division than in others. The shortening process takes place when we age, but previously telomere length was only used as a marker for biological ageing.  For the first time, a group of scientists at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet has shown that telomere length is causally linked to the risk of developing Alzheimer’s disease. “That there’s some kind of link between telomere length and the risk of Alzheimer’s disease is nothing new in itself, but it was thought that it was down to other underlying commonalities,” says principal investigator Dr Sara Hägg, docent of molecular epidemiology. “In this study we’ve been able to show that the telomeres are involved in the actual active mechanism behind the development of the disease, which is completely new and very interesting.” The entire genome To arrive at their results, the researchers used data from studies that identified gene variants linked to telomere length and to Alzheimer’s disease by examining the entire genome. By using a special study design, they were then able to show statistically the presence of a causal link between short telomeres and a higher risk of Alzheimer’s disease. The researchers stress, however, that since the telomere process is so complex, nothing can be said about the degree of an individual person’s risk from the mere measurement of their telomeres. “What’s more, the effects are very small,” adds Dr Hägg. “But from a biological perspective, they’re very interesting.” The study was financed with grants from various bodies, including the Loo and Hans Österman Foundation, FORTE, the Swedish Research Council, KID-grant from Karolinska Institutet for doctoral education, and the Foundation for Geriatric Diseases at Karolinska Institutet. Publication Telomere Length Shortening and Alzheimer Disease – A Mendelian Randomization Study Yiqian Zhan, Ci Song, Robert Karlsson, Annika Tillander, Chandra A. Reynolds, Nancy L. Pedersen & Sara Hägg JAMA Neurol. 2015;72(10):1202-1203, online first 12 October 2015, doi:10.1001/jamaneurol.2015.1513

Congratulations on winning the Nobel Prize, Tomas Lindahl!

Mon, 12/10/2015 - 09:09
One of the three 2015 Nobel Laureates in chemistry, Tomas Lindahl, made his award-winning discoveries at Karolinska Institutet in the 1970s. Despite the competition for resources, a post as a research associate made it possible for him to do research, as he explains in an interview, in which he also talks about his former colleagues at KI. Congratulations on winning the chemistry prize. How have you been celebrating? “I’ve not had time to do much celebrating, what with all the emails and phone calls I’ve had to answer. But I cracked open a good vintage last night. I love wine, so it was a good excuse!” The crucial discoveries that earned you the prize were made at Karolinska Institutet in the 1970s. How did you find the research environment at KI back then? “There was some squabbling and a lot of competing for resources. And I wasn’t the one to draw the longest straw either. But it was thanks to my research associateship I had from the research council that I could concentrate on my work.” Was the lack of resources a reason for your leaving KI? “In part. I’d met my wife and wanted to live with her. But I’d also been given an offer from the Imperial Cancer Research Fund, now Cancer Research UK, to set up a powerful new research environment. It would’ve been hard to do that in Sweden. I was made director of the new institution, Clare Hall Laboratories in Hertfordshire, which focused on DNA repair and the mechanisms of DNA replication.” Did you realise at the time that you’d made such an important breakthrough? “In a way. But I can’t put my finger on any specific moment. Discoveries are based, as you might know, on a series of experiments that take time to do, but as we progressed it started to dawn on me that we’d come across something new and important.” How fully did your colleagues in the scientific community grasp the importance of your discoveries? “Often when you do something new it can take a while to convince those at home of the magnitude of the whole thing. This is something I discussed a great deal with my good friend and colleague Svante Pääbo, who also left Sweden in the 1990s to start a new research environment, in his case the Max Planck Institute for Evolutionary Anthropology in Germany.”  Your doctoral supervisor back then at KI was the legendary Swedish scientist Einar Hammarsten – what do you think he would have said had he still been alive? “He would’ve been delighted! Einar Hammarsten had one passion in life: basic research. His drive made an impression on me. I found it fascinating.” He was the uncle of Tove Jansson and according the rumour was the model for Snufkin, the free-thinking character from the Moomin stories. “I didn’t know that. But it’s a pretty good description of Einar. When KI was relocating to its current site in Solna, he received a large sum of money to spend on the move. But when the payment was due, he just snorted ‘the money’s been spent’ and said that he had no plans to get any more. ‘Go ahead and arrest me,’ was all he said. And he got away with it.   Was he a role model? “My role model was more Peter Reichard, who was also one of Einar Hammarsten’s doctoral students. One of the things he showed me was how important it was to select competent co-workers.” How do you become a good scientist? “You’ve got to find your own line of research to follow and not just do what everyone else is doing. I also think you need to be fascinated by your subject – as a researcher, your career becomes your hobby. Just like a musician needs to practise their scales 8 hours a day, a scientist needs to spend hours every day in the lab. It’s not always what you want, but you just have to do it if you’re going to be any good.” You yourself now have a lot of successors in the research field that you’ve created. What does the future hold for them, do you think? “It’s great to see that research into DNA repair has become such a large field. It shows that I was right when I followed my intuition and went down that path. But today resources are scarce, which means that today’s junior researchers have to compete fiercely for funding and spend an unreasonable amount of time writing applications, which I’m afraid to say I find a complete waste of their time.” What do you mean? “You can rarely know in detail how your research will develop. It’s pointless to spend time describing this. It’d be better if these talented people could go straight into the lab and get on with their research. But then just how funding bodies are to know who to award grants to, well that’s a different, more complicated question that will take too long for me to go into.” So what is next for you? “I’m 77 years old and won’t be starting any new research projects. But I’ll still be academically involved, as a scientific advisor amongst other things.” Is there anyone in particular you’d like to thank? My supervisor Einar Hammarsten and colleague Peter Reichard. I also had several wonderful co-workers, such as laboratory technologist Barbro Nyberg, now Söderman, and my doctoral students Siv Lundquist and Stefan Söderhäll, who assisted us with some important experiments. And I should also mention Sir Walter Bodmer at the Imperial Cancer Research Fund, who made it possible for me to develop the research field.” Congratulations again! And finally – will we be seeing you at Karolinska Institutet soon? “I hope to go to KI in December for the award ceremony. I’m looking forward to meeting my Swedish colleagues. Text: Cecilia Odlind

Karolinska Institutet researchers to receive SEK 150 million from the Knut and Alice Wallenberg Foundation

Fri, 09/10/2015 - 17:17
The Knut and Alice Wallenberg Foundation has decided to award close to SEK 133 million to fund research on embryonic stem cells, cancer treatments, brain research and possible causes of infertility, as well as SEK 16 million in continued funding for a research project on hereditary blood lipid disorders. Investigating the mechanisms behind more effective cancer treatments Professor Elias Arnér at the Department of Medical Biochemistry and Biophysics will receive SEK 43.7 million over five years for a project involving a total of seven research teams exploring how modulation of reactive oxygen species (ROS) could improve the treatment of various cancers. They will focus their initial research on melanomas and lung cancer. “High levels of ROS may have a direct effect on destroying cancer cells; at the same time, ROS can also counteract the immune system’s ability to recognise and eliminate cancer cells. Our hypothesis is that it is possible to develop more effective cancer treatments by increasing ROS levels in cancer cells, while simultaneously reducing ROS levels in cells of the immune system,” says Elias Arnér.   Single-cell analysis gives an understanding of complex biological processes at the systemic level Professor Sten Linnarsson at the Department of Medical Biochemistry and Biophysics will receive SEK 26.8 million over five years to investigate, through DNA sequencing, the mechanisms that allow cells in specific organs to specialise on certain functions. This fundamental research will be of great significance for our basic understanding of the body’s building blocks: the cells. It will also provide a more detailed explanation of what goes wrong when gene regulation causes illness, e.g., in the case of tumours. “We believe that a fundamental mechanism in the formation of specific cell types is modular gene regulation. In this project, we want to systematically discover and map this type of gene modules in the brain,” says Sten Linnarsson. “We will also map molecular enhancers, i.e., DNA sequences that control gene activity. Many types of cancers are caused by mutations in these enhancers, and if we can better understand how they regulate gene activity, we could by extension find or choose better drugs.”   Molecular mechanisms behind infertility Juha Kere, Professor and Chief Physician at the Department of Biosciences and Nutrition, will receive SEK 17 million over five years to clarify the molecular and cellular mechanisms that regulate early embryo development and fertility. In addition to its inherent scientific value, this research also has clinical implications. The causes of infertility remain largely unknown, and there is a need to improve our understanding of the biological mechanisms that are critical to early embryo development and pregnancy. During the first week of development after fertilisation, the embryo must complete four critical processes: the fertilisation itself; the activation of the embryo's own genes; the specification of the placental cell lineage, foetal membranes and embryonal tissues; and finally the attachment to the uterus. It is in these early embryos that embryonal stem cells can be isolated. The project led by Juha Kere will combine the expertise of three research groups to reach an overarching understanding of how these four processes are regulated on the molecular level. The research program is closely linked to clinical work, facilitating the translation of findings to clinical practice. “Our current knowledge of early embryo development is primarily based on studies in mice,” says Juha Kere. “The development of the human embryo, on the other hand, is poorly understood on the molecular and cellular level. In fact, the few comparative studies that have been conducted point to fundamental differences in the mechanisms that regulate both the early embryo and the pluripotent stem cells. Due to the rapid development of both RNA sequencing methods and gene modification technologies we can now study how genes are regulated in individual cells and then study their functions.”   Precision medicine to optimise therapies for cancer patients Professor Olli Kallioniemi of Karolinska Institutet and SciLifeLab will receive SEK 46 million to develop new strategies and clinical collaborations in translational and precision medicine, using existing SciLifeLab technological platforms and developing new ones for rapid research application. The initial goal is to find targeted cancer therapies for patients with leukaemia. The researchers intend to create a platform for systematic precision medicine for leukaemia that can later be used for other forms of tissue tumours as well.  “We will look at how cells or tumours from leukaemia patients respond to 461 cancer drugs and simultaneously identify genetic and molecular factors that influence the effect of these drugs,” says Olli Kallioniemi. “We systematically monitor cell growth, cell death, changes and signalling after the drug treatments. As this is done on patients undergoing treatment, the systematic drug profile could enable better choices in terms of medication in the future. We will be studying the genesis and development of cancer clones, how these adapt physically to drugs, and how resistance occurs. We are starting with leukaemia, in particular acute myeloid leukaemia, but we will also look at whether our platform is suitable for tissue tumours, including ovarian and kidney tumours.”   Mapping the genes that control elevated levels of blood lipids Bo Angelin, Professor of Clinical Metabolism at the Department of Medicine, Huddinge, will receive SEK 16.2 million in continued funding for a project that was funded by the Knut and Alice Wallenberg Foundation in 2013. “Hereditary blood lipid disorders are a common reason why relatively young individuals suffer from cardiovascular disease," says Professor Bo Angelin. "The disease requires early discovery and treatment, and our research will improve diagnostic and therapeutic techniques for this important patient group. If we can identify new disease-related genetic mutations, we'll also be able to develop new drugs of benefit to larger patient groups with high cardiovascular risk." The Knut and Alice Wallenberg Foundation

Gold medal to the Stockholm team in iGEM

Fri, 09/10/2015 - 10:10
Hard work has paid off and now the Stockholm team can boast a gold medal and a top nomination in the category Best Health and Medicine Project. The International Genetically Engineered Machines (iGEM) Competition was a personal victory for Felix Richter and his team. The competition, with teams from all over the world, was concluded a few weeks ago in Boston. ”I was nervous, especially after seeing the other teams, but we did good and it was a great feeling to know that we fulfilled the criteria in an extensive way that brought us the gold medal,” says Utsa Karmakar at the Stockholm team. Their project, ABBBA, got positive reactions both with respect to innovation and to general design. ”At the beginning, people were more focused on our eccentric clothes than our project but at the moment of our presentation we got many warm comments. Funny thing is that coming from such a cold country, we proved to be one of the hottest topics during the conference,” says Radoslaw Góra at the Stockholm team. Applications are now being accepted for students to take part in the competition next year, either as a contestant or as a project leader. More information about the Stockholm team and iGEM: Contest - a hub for future scientists Text: Frida Wennerholm

The Nobel Prize in Chemistry 2015 to KI Alumni Tomas Lindahl

Wed, 07/10/2015 - 12:12
The Royal Swedish Academy of Sciences has decided to award the Nobel Prize in Chemistry for 2015 to KI Alumni Tomas Lindahl, Paul Modrich and Aziz Sancar “for mechanistic studies of DNA repair”. The Nobel Prize in Chemistry 2015 is awarded to Tomas Lindahl, Francis Crick Institute and Clare Hall Laboratory, Hertfordshire, UK, Paul Modrich, Howard Hughes Medical Institute and Duke University School of Medicine, Durham, NC, USA, and Aziz Sancar, University of North Carolina, Chapel Hill, NC, USA for having mapped, at a molecular level, how cells repair damaged DNA and safeguard the genetic information. Their work has provided fundamental knowledge of how a living cell functions and is, for instance, used for the development of new cancer treatments. Tomas Lindahl was born 1938 in Stockholm and has a Ph.D. from Karolinska Institutet. He was a Professor of Medical and Physiological Chemistry at University of Gothenburg 1978–82. He is now Emeritus group leader at Francis Crick Institute and Emeritus director of Cancer Research UK at Clare Hall Laboratory, Hertfordshire, UK. Tomas Lindahl made the ​​conclusive research that he has now been awarded for at Karolinska Institutet “How stable is DNA, really?”, Tomas Lindahl started wondering towards the end of the 1960s. At the time, the scientific community believed that the DNA molecule – the foundation of all life – was extremely resilient; anything else was simply out of the question. Read the full article on the KVA website. Read more in a pressrelease from The Royal Swedish Academy of Sciences (KVA).

Michael J. Fox Foundation grant to Parkinson research at KI

Wed, 07/10/2015 - 09:09
Andrea Varrone at the Department of Clinical Neuroscience at Karolinska Institutet receives 246,600 USD from the Michael J. Fox Foundation for Parkinson’s Research (MJFF), for the development of an imaging agent for the visualisation in the living brain of a pathological protein called a-synuclein using positron emission tomography (PET). The renowned advocate and actor Michael J. Fox was diagnosed with Parkinson's disease at age 30. In 2010, he was made honorary doctor of medicine at Karolinska Institutet in recognition of his work to promote research and awareness of the disease. The MJFF supports several research projects aimed to develop methods to visualise a-synuclein. a-synuclein accumulates in the brain of patients with Parkinson´s disease and is involved in the pathology of the disease in a similar way as amyloid is involved in Alzheimer´s disease. Today, a-synuclein can be visualised after death, but not in the living brain. – It would be very important for patients and clinicians to know if there is accumulation of a-synuclein in the brain. Confirmation of the pathology is important for diagnosis and choice of treatment, as well as prognosis. There is a strong interest in finding therapies based on molecules that interact directly with a-synuclein and an imaging agent could be a useful biomarker to evaluate the effect of such treatment, says Andrea Varrone. The search for an imaging agent to visualise a-synuclein will be performed in collaboration with researchers at Karolinska Institutet, National Institute of Radiological Sciences in Japan, Umeå University and Astra Zeneca. The newly started project is also funded by the Stockholm Brain Institute. – This grant is very important for me, because I have a strong interest in molecular imaging of neurodegenerative disorders and we currently have a research program in Parkinson´s disease. It will be a major breakthrough to have a new tool to study the pathology of the disease in living patients, says Andrea Varrone. Text: Karin Söderlund Leifler The Michael J. Fox Foundation for Parkinson’s Research (MJFF).

The 2015 Nobel Prize: “Discoveries of immense consequence”

Tue, 06/10/2015 - 14:14
View the film from the press conference held in the Nobel Forum on 5 October. Film: Erik Cronberg Jan Andersson, co-opted member of KI’s Nobel Committee, is visibly moved when commenting on this year’s Nobel Prize in Physiology or Medicine, which has been awarded to William C. Campbell, Satoshi Ōmura and Youyou Tu. “This is a special year, as never before have we awarded a Nobel Prize for the treatment of a parasitic disease,” says Professor Jan Andersson. “The discoveries that we’re rewarding have been of immense consequence in reducing the number of deaths and disabilities caused by diseases like malaria, river blindness and elephantiasis. There are 3.4 billion people in 101 countries where these diseases are rife, and they know that if they fall sick, effective medicines are available.” To my mind, the prize strengthens interest in malaria research, and the choice strengthens the Nobel Prize. Mats Wahlgren, leading malaria researcher at KI, was not involved in the Nobel Committee’s decision, but is nonetheless delighted with this year’s laureates. “It’s fantastic! A Nobile Prize that mainly affects the world’s poorest populations. To my mind, the prize strengthens interest in malaria research, and the choice strengthens the Nobel Prize. This we can see from the Nobel Assembly’s ability to take note of and acknowledge different kinds of discovery.” Professor Wahlgren goes on to say that the two drugs discovered by this year’s laureates are still, four decades on, the most effective ones we have against these diseases. Avermectin is the most important treatment for the parasitic roundworm that causes diseases such as river blindness and elephantiasis, and the new combination drugs for malaria are still based on Artemisinin. “Artemisinin saves maybe 100,000 seriously ill children a year in Africa alone, and millions have been saved in the past decade in total. The mortality rate is dropping, but from a high level of some 500,000 deaths a year. The goal is to eradicate the disease completely by 2050, which is an enormous challenge.” As for the roundworm-related diseases, a complete eradication might be much closer at hand. “Great advances have already been made in Latin America,” says Professor Wahlgren. “The parasitic worm diseases are more widespread in Africa, but much is being done and results are showing through.” Tu discovered the treatment for malaria while working on a classified military project in post-Cultural Revolution China. While the media discussions had mainly centred on other potential winners in the run-up to the announcement, the Nobel Committee’s Patrik Ernfors is unwilling to describe this year’s laureates as dark horses. “Not at all, they are three very well-known names. But I won’t comment on the prior speculations – we do our job in the committee autonomously without being influenced by what’s being discussed on the outside.” This said, Professor Ernfors points out, in the 1960s and 70s when Youyou Tu was first doing the research for which she is now being honoured, she was almost totally unknown to the West. “Tu discovered the treatment for malaria while working on a classified military project in post-Cultural Revolution China. The West knew nothing about it until much later, at the end of the 1970s, and probably didn’t grasp its full significance until a WHO summit in the 1980s.” Text: Anders Nilsson  

The Nobel Prize in Physiology or Medicine 2015 to William C. Campbell, Satoshi Ōmura and Youyou Tu

Mon, 05/10/2015 - 11:11
The Nobel Prize in Physiology or Medicine 2015 was awarded with one half jointly to William C. Campbell and Satoshi Ōmura for their discoveries concerning a novel therapy against infections caused by roundworm parasites and the other half to Youyou Tu for her discoveries concerning a novel therapy against Malaria. Diseases caused by parasites have plagued humankind for millennia and constitute a major global health problem. In particular, parasitic diseases affect the world’s poorest populations and represent a huge barrier to improving human health and wellbeing. This year’s Nobel Laureates have developed therapies that have revolutionized the treatment of some of the most devastating parasitic diseases. William C. Campbell and Satoshi Ōmura discovered a new drug, Avermectin, the derivatives of which have radically lowered the incidence of River Blindness and Lymphatic Filariasis, as well as showing efficacy against an expanding number of other parasitic diseases. Youyou Tu discovered Artemisinin, a drug that has significantly reduced the mortality rates for patients suffering from Malaria. These two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable. Read more in a pressrelease from Nobelprize.org Read more on: Nobelprizemedicine.org William C. Campbell was born in 1930 in Ramelton, Ireland. After receiving a BA from Trinity College, University of Dublin, Ireland in 1952, he received a PhD from University of Wisconsin, Madison, WI, USA in 1957. From 1957–1990 he was with the Merck Institute for Therapeutic Research, from 1984–1990 as Senior Scientist and Director for Assay Research and Development. Campbell is currently a Research Fellow Emeritus at Drew University, Madison, New Jersey, USA. Satoshi Ōmura was born in 1935 in the Yamanashi Prefecture, Japan and is a Japanese Citizen. He received a PhD in Pharmaceutical Sciences in 1968 from University of Tokyo, Japan and a PhD in Chemistry in 1970 from Tokyo University of Science. He was a researcher at the Kitasato Institute, Japan from 1965–1971 and Professor at Kitasato University, Japan from 1975–2007. From 2007, Satoshi Ōmura has been Professor Emeritus at Kitasato University. Youyou Tu was born in 1930 in China and is a Chinese citizen. She graduated from the Pharmacy Department at Beijing Medical University in 1955. From 1965–1978 she was Assistant Professor at the China Academy of Traditional Chinese Medicine, from 1979–1984 Associate Professor and from 1985 Professor at the same Institute. From 2000, Tu has been Chief Professor at the China Academy of Traditional Chinese Medicine.  

Times Higher Education ranks KI 28th in the world

Fri, 02/10/2015 - 10:10
Karolinska Institutet is placed 28th in this year’s Times Higher Education (THE) World University Rankings and 9th in Europe. Previously, Karolinska Institutet ended up in the 30 to 45 interval. In the subject category of Clinical, Pre-clinical & Health, in which KI is compared with other medical universities, KI remains at 15th in the world and 6th in Europe. Topping the list is the California Institute of Technology (USA), followed by the University of Oxford (UK) and Stanford University (USA). American universities dominate the top positions, although also amongst the first ten places are two British universities – Oxford and Imperial College, London (8), and Switzerland’s ETH Zürich-Swiss Federal Institute of Technology in Zürich (9). Two more Swedish universities feature amongst the top 100, Lund at number 90 and Uppsala at 81.  The rankings are based on indicators such as bibliometrics and reputation surveys as well as data on employees, students, doctoral education, internationalisation and income from industry. “KI’s ranking is determined primarily by its comparatively broad, strong research and the high level of internationalisation of its scientific collaborations,” says Björn Forslöw, market analyst at KI. Since it started its ranking in 2004, Times Higher Education has changed its methods a couple of times, which renders difficult certain year-on-year comparisons. The THE World university rankings are not to be confused with the THE World reputation rankings, which are published in the spring on the basis of email surveys. View the full list on the Times Higher Education website. 

Sleep proteins in new DNA repair mechanism

Thu, 01/10/2015 - 08:08
Researchers at Karolinska Institutet and universities in Hong Kong have found a new molecular mechanism for DNA repair involving an unexpected interaction between the PARP-1 protein and sleep proteins in humans. Their discovery is presented in the scientific journal Molecular Cell. While it is a well-known fact that sleep is important to the body’s recovery and healing, knowledge of the molecular mechanisms that make this possible is incomplete. In the present study, the researchers show that a protein known as PARP-1 bonds and interacts in humans with another protein called Timeless and that together they control the repair of DNA in the cell nucleus. “Timeless is involved in the regulation of the body’s circadian rhythm,” says principal investigator Thomas Helleday, PhD, Professor of chemical biology at Karolinska Institutet’s Department of Medical Biochemistry and Biophysics, and also affiliated to the SciLifeLab facility in Stockholm. “We already knew that PARP-1 and Timeless each plays its own part in cell survival, but not that they interact in this interesting manner.” Professor Helleday and his team have long specialised in PARP proteins and their role in DNA repair, knowledge that is important to cancer prevention. Their work with PARP inhibitors has produced a new therapeutic principle for breast and ovarian cancer. Without damaging normal cells “This therapeutic principle has now been approved as a drug in the USA and Europe for advanced ovarian cancer, which is wonderful,” continues Professor Helleday, who is also affiliated with Stockholm’s SciLifeLab. “The new treatment kills only the mutated cells without damaging normal cells.” However, it is not yet clear just what contribution this newly discovered link between PARP and the circadian rhythm can make to cancer treatment. “Maybe our results can help to explain the side-effects that some patients can show,” he says. “However, we keep a very open mind in our lab and I’m constantly surprised by all the functions and roles that PARP proteins have in the cell.” The study was financed by grants from the Swedish Research Council, the Swedish Cancer Society, the AXA Foundation, the Helleday Foundation, the Göran Gustafsson Foundation, the Wenner-Gren Foundations, the Söderberg Foundations and the Hong Kong Research Grants Council. More on Thomas Helleday’s research Publication Timeless interacts with PARP-1 to promote homologous recombination repair Xie S, Mortusewicz O, Tang Ma H, Herr P, Poon RRY, Helleday T, Qian C Molecular Cell, 1 October 2015 issue, online 3 September 2015, doi:10.1016/j.molcel.2015.07.031

Home-based counselling did not improve neonatal survival

Wed, 30/09/2015 - 08:08
Implementing a home-based volunteer counselling strategy during pregnancy and the first few days of an infant’s life is probably not enough to improve neonatal survival in rural Africa, shows a novel study published in the journal PLOS Medicine by researchers from Karolinska Institutet and the London School of Hygiene & Tropical Medicine, UK. According to the research team, their findings points to the necessity of improving quality of facility-based care of pregnant women and newborn babies in the areas concerned. The authors of the current study conducted a large cluster-randomized trial in rural Tanzania, which aimed to test whether improvements in neonatal mortality could be achieved by training 824 female volunteers to deliver key counselling messages (including messages about hand washing with soap before delivery and early and exclusive breast feeding) and supporting messages such as the importance of childbirth in a health care facility during three home visits. The study was conducted between 2007 and 2013 in six districts in rural southern Tanzania that covered a population of 1.2 million people. The study results show that neonatal mortality reduced from 35 to 31 deaths per 1,000 live births in areas where the volunteers were active with 59% of women receiving at least one volunteer visit during pregnancy and 41% received at least one visit postpartum. However, in control wards where volunteers were not making visits neonatal mortality also reduced from 35 to 30 deaths per 1,000 live births during the study. Given similar reduction in both arms of the trial there was no evidence of an impact of the intervention on neonatal survival. “Despite moderate increases in newborn care behaviours associated with the intervention, neonatal mortality was similar in intervention and comparison areas, questioning the evidence base in support of home-based counselling, says Claudia Hanson, PhD, lead author of the study and affiliated to both Karolinska Institutet, and the London School of Hygiene & Tropical Medicine. Facility delivery improved dramatically Although the study did not find that the intervention had an effect on the study’s primary outcome, the newborn care practices reported by mothers were better in intervention compared to comparison areas, including immediate breastfeeding (42% vs 35%), feeding only breast milk for the first 3 days (90% vs 79%), and having clean hands for home delivery (92% vs 88%). Facility delivery improved dramatically in both groups from 41% to 82% and 75% in intervention and comparison wards, respectively, at the end of the study. “The lack of effect of home-based counselling on neonatal mortality despite improvements in newborn care practices, suggests that improvement in the quality of facility care is of highest relevance in this setting,” says Dr Hanson. “Our results support the recent shift to prioritize improvement in quality of facility-based care in Tanzania and other areas alike in low-income countries.” Researchers from the following organization have also been involved in the study work: Ifakara Health Institute, Tanzania; ILS Brothers, Tanzania; Commission for Science and Technology, Tanzania; Institute of Global Health, University College London, Storbritannien; Swiss Tropical & Public Health Institute, Schweiz. The study received funding from Bill & Melinda Gates Foundation through a grant by Save the Children. This news article is an edited version of a press release from PLOS Medicine. Publication Effectiveness of a home-based counselling strategy on neonatal care and survival: a cluster-randomised trial in six districts of rural Southern Tanzania Claudia Hanson, Fatuma Manzi, Elibariki Mkumbo, Kizito Shirima, Suzanne Penfold, Zelee Hill, Donat Shamba, Jennie Jaribu, Yuna Hamisi, Seyi Soremekun, Simon Cousens, Tanya Marchant , Hassan Mshinda, David Schellenberg, Marcel Tanner, Joanna Schellenberg PLOS Medicine, online 29 September 2015, DOI: 10.1371/journal.pmed.1001881     

Reducing our own pain is also reducing empathy for pain in others

Tue, 29/09/2015 - 11:11
The ability to feel the pain of others is based on neurobiological processes which underlie pain experience in oneself. In a novel study published in the journal PNAS, an international research team now show that that a reduction of self-experienced pain leads to a reduction in empathy for pain in others as well. According to the researchers, this effect is probably underpinned by endogenous opioids. The study was headed by Professor Claus Lamm from the University of Vienna in Austria and included Dr Predrag Petrovic from the Department of Clinical Neuroscience at Karolinska Institutet. To reach their conclusions, the research team used an innovative experimental “trick”, the so-called placebo analgesia effect, to close an explanatory gap in the understanding of the neurobiological mechanisms of empathy. Experimentally manipulating self-experienced pain in over 100 study participants, the researchers tested whether this manipulation also leads to an equivalent change in empathy for pain. This “trick” enabled them to conclude with higher certainty that empathy relies on simulation. Participants in the placebo group reported significantly less subjective pain experience, which was associated with reduced brain activation in anterior insula and midcingulate cortex. Opioid receptors In a follow-up study, the research team tested the involvement of the opioid system in the previously observed placebo-empathy effect in order to enable precise conclusions on the underlying neurotransmitter systems. By using a substance that blocks opioid receptors, the team induced a blocking of the placebo-empathy effect in 50 participants. According to the researchers, this result strongly suggests an involvement of the opioid system in placebo-empathy, which is an important step to a more mechanistic understanding of empathy.  The study was supported with grants from the Vienna Science and Technology Fund. This news article is an edited version of a press release from the University of Vienna. Also view a news article in Science about these findings in  Publication Empathy for pain is grounded in self pain: Evidence from placebo analgesia and its opioidergic regulation Markus Rütgen, Eva-Maria Seidel, Giorgia Silani, Igor Riecansky, Allan Hummer, Christian Windischberger, Predrag Petrovic, and Claus Lamm PNAS, online early edition 28 Sept – 2 Oct 2015, doi: 10.1073/pnas.1511269112

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