Develop Blood Test For Alzheimer's Disease

Sep 27, 2008

Researchers from Nottingham's two universities are joining forces to develop a simple blood test to diagnose Alzheimer's disease.
The £200,000 study, funded by the leading charity the Alzheimer's Research Trust, will aim to find out whether 'biomarkers' in blood could be used to identify someone with Alzheimer's.
A biomarker is a term for something present in the body which can indicate disease, such as a certain protein or molecule. The Nottingham team will be identifying biomarkers by looking at proteins in the blood of Alzheimer's patients compared to a control group of healthy older people.
Currently, identification of Alzheimer's disease is difficulty and delays in diagnosis can mean that irreversible damage to the brain has already occurred before treatment can be given.
Doctors believe that catching the disease in its early stages and beginning treatment is a much more effective approach.
Professor Kevin Morgan in The University of Nottingham's School of Molecular Medical Sciences, said: "A reliable, accurate test to identify affected individuals would mean future treatments could be given much earlier when drugs are likely to be most effective. It would also give people with dementia and their families more time to prepare and plan for the future."
The researchers at The University of Nottingham hit upon the idea of using biomarkers as a means of diagnosis and will be involved in collecting the samples in conjunction with collaborators in the UK and EU, while the samples will be tested using technology based at Nottingham Trent University.
Rebecca Wood, Chief Executive of the Alzheimer's Research Trust, said: "We are delighted to be funding what could be a breakthrough study in the diagnosis of Alzheimer's.
"There are 700,000 people in the UK with dementia and this number is expected to double within a generation. We desperately need to fund research looking at different ways to tackle this devastating disease."
The news of the study comes shortly before World Alzheimer's Day on Sunday September 21, which aims to raise awareness about the reality of living with dementia.

Estrogen Cream Eases Vaginitis with No Endometrial Safety Signals

 Sep 27, 2008

Moderate to severe atrophic vaginitis can be eased for postmenopausal women by either of two low doses of estrogen cream, with no endometrial safety signals, investigators reported here. Both low-dose regimens of the conjugated estrogen cream led to significant improvement in vaginal maturation index, vaginal pH, and most bothersome symptoms compared with placebo, Gloria Bachmann, M.D., of Robert Wood Johnson Medical School in New Brunswick, N.J., said at the North American Menopause Society meeting. The improvement was statistically significant at 12 weeks and persisted during follow-up for a year. In a subgroup of patients who had endometrial biopsies, no cases of endometrial hyperplasia or carcinoma occurred with either estrogen cream regimen.

"Low-dose [vaginal estrogen cream] represents an important therapy for treating atrophic vaginitis without endometrial safety concerns over a one-year study period," Dr. Bachmann and colleagues concluded. As many as 40% of postmenopausal women are affected by atrophic vaginitis. Vaginal application of topical low-dose estrogens is thought to reduce systemic exposure to estrogen and limit its stimulatory effects on the endometrium, the investigators said. Both daily and twice-weekly vaginal administration of low-dose vaginal estrogen cream have demonstrated efficacy for reducing symptoms of atrophic vaginitis.

Dr. Bachmann reported findings from a randomized clinical trial comparing the two regimens. The study involved 423 postmenopausal women who were randomized and received at least one dose of assigned therapy. The patients had symptoms of moderate or severe atrophic vaginitis, including a baseline composite symptom score of 5 for vaginal dryness, itching, burning, and dispareunia; a total score of <15 on the General Health Clinical Evaluation. The patients were randomized to four treatment groups: daily or twice-weekly vaginal estrogen cream (0.5 g) or a matching placebo group for each administration schedule. Patients assigned to daily treatment were on therapy for 21 days, followed by seven days off.

 The primary efficacy assessment was the change from baseline to week 12 in vaginal maturation index, vaginal pH, and most bothersome self-reported symptom. Patients continued open-label treatment of assigned therapy for the remaining 40 weeks. Both active-therapy regimens led to significantly greater improvement in all outcome measures at 12 weeks compared with placebo. A total of 155 patients treated with either regimen of vaginal estrogen cream had evaluable endometrial biopsies.

 In the patients assigned to daily therapy, six of 85 had evidence of proliferative endometrium. Among 72 assigned to twice-weekly treatment, six had proliferative endometrium. No patient in either group developed endometrial hyperplasia or carcinoma. Transvaginal ultrasound at the end of the study revealed endometrial thickness ≥5 mm in 18 patients assigned to daily vaginal estrogen cream and in 12 patients on the twice-weekly regimen. In general, adverse events were similar in the active-treatment and placebo groups, Dr. Bachmann reported, and treatment-emergent adverse events were uncommon.

Treatment-emergent vaginal bleeding occurred in no more than two patients in any randomized group during the double-blind and open-label phases of the study.