Fertility Hormone Relaxin Shows Promise Against Scleroderma
A fertility hormone appears to be the first effective treatment for scleroderma, a disfiguring and sometimes fatal tissue disease that afflicts about 100,000 Americans, mostly women of childbearing age.
Scleroderma is caused by overproduction of the protein collagen. It can make fingers and joints inflexible, leaving patients unable to feed and groom themselves. It also hardens internal organs, including the esophagus, gastrointestinal tract and blood vessels. Existing treatments are aimed at symptoms, but do nothing to halt the progression of the disease, and many of those treatments have severe side effects.
Only 50% of patients survive 10 years after the onset of symptoms. An additional 200,000 to 300,000 Americans suffer from a milder version that does not affect internal organs.
Dr. James R. Seibold of the University of Medicine and Dentistry of New Jersey in New Brunswick and his colleagues enrolled 68 patients in the six-month study. A third of them received a low dose of the hormone relaxin, a third received a much higher dose, and a third received a placebo.
The team reported in Tuesday’s Annals of Internal Medicine (https://www.acponline.org/journals/ annals/06jun00/nts/seibold.htm) that patients getting the high dose and the placebo fared about the same, with a few getting worse and nearly half showing no improvement. More than half of those getting the low dose of relaxin improved greatly, a few improved only somewhat and none got worse. How the hormone works is not clear.
The study was sponsored by Connetics Corp. of Palo Alto, which manufactures a synthetic version of relaxin.
Brain Procedure May Ease Parkinson’s
Creating a small hole in Parkinson’s patients’ brains to destroy tremor-causing tissue can reduce the symptoms of the disease for at least five years, according to researchers from the University of Toronto.
In the first long-term study of the effects of the procedure, known as a pallidotomy, the team followed 40 patients who had undergone the surgery to destroy cells in the globus pallidus, which controls movement. Half were eliminated from the study because they had other procedures later or had died. But all 20 who could be evaluated retained their improvements after an average of 52 months, the team reported in Thursday’s New England Journal of Medicine (https://www.nejm.com).
Study Tracks Fractures in Steroid Users
Using oral corticosteroids to treat various diseases is known to reduce bone density, but a major new study shows the extent of the risk.
A multinational team enrolled 244,235 steroid users and a control group of 244,235 healthy people who were not using them. The team reported in the June Journal of Bone and Mineral Research (https://www.jbmr-online.org) that the risk of forearm fracture was 33% higher, that of hip fracture 61% higher, and that of a fracture of the vertebrae 2.6 times higher in those receiving steroids.
Researchers were surprised that the risk increased very quickly, rising to its maximum within three months of the onset of therapy. Even more surprising, risk dropped back to normal levels soon after steroid use was halted.
In the same issue, another multinational team studied the use of the drug risedronate in 290 patients receiving steroids. They found that the drug increased bone density by an average of 1.8% to 2.9% compared with patients receiving only a placebo. The incidence of vertebral fractures was 70% lower in those receiving the drug. The study was sponsored by Procter & Gamble Pharmaceuticals, which manufactures risedronate.
Researchers Link Herb, Kidney Damage
The Chinese herb Aristolochia fangchi, found in a weight-loss preparation, damaged the kidneys of 105 patients at a Belgian clinic and apparently caused 18 cases of kidney cancer among them, researchers reported in Thursday’s New England Journal of Medicine (https://www.nejm.com).
“Our findings reinforce the idea that the use of natural herbal medicine may not be without risk,” said Dr. Joelle L. Nortier of the Universite Libre de Bruxelles in Brussels.
The Food and Drug Administration announced June 2 that it is stopping the importation of herbs in the Aristolochia family because they had caused kidney failure in Belgium and in Britain, where they were being used to treat a skin condition. Other cases of kidney damage from Chinese herbs have been reported in France, Spain, Japan and Taiwan, according to Nortier.
In Belgium, the herb was not listed among the ingredients of the weight-loss pills and was put into them by mistake, Nortier said. Its name in Chinese is similar to that of Stephania tetrandra, the herb that was supposed to be in the pills, and it often is substituted for the Stephania, according to Dr. David Kessler of Yale University, former head of the FDA.
Team Finds Exercise, Diet Cuts Diabetes Risk
Changes in eating and exercise habits can significantly reduce the risk of developing Type 2 diabetes in people at high risk, Finnish researchers reported Sunday at an American Diabetes Assn. meeting in San Antonio.
The study showed that a modest weight loss of less than 10 pounds, combined with a healthy diet and regular moderate exercise reduced the incidence of full-blown diabetes in people with impaired glucose tolerance by 58%.
Impaired glucose tolerance is, in effect, an intermediate state between normal health and diabetes. Most people with it eventually develop diabetes.
A group from the National Public Health Institute in Helsinki studied 523 adults, most of them overweight, who suffered from impaired glucose tolerance. Half participated in the program of weight loss and exercise and half didn’t. During the two-year study, 57 cases of diabetes occurred in the control group, but only 26 in the intervention group.
New Urine Test Detects Illegal Hormone
French researchers have developed a new urine test to detect the use of the banned hormone erythropoietin, or EPO, in athletes. The test, devised by Jacques de Ceaurriz and Francoise Lasne of France’s National Anti-Doping Laboratory, can detect synthetic EPO, one of the most widely abused drugs in cycling and some other sports.
EPO stimulates the production of red blood cells, which transport oxygen around the body. It gives a quick boost that replaces expensive training at high altitude. The hormone is produced naturally in the body, but athletes use synthetic EPO to improve their endurance in sports such as cycling, rowing and distance running.
The French researchers tested their method on 102 frozen urine samples from participants in the 1998 Tour de France, which was rocked by a drug scandal. The test spotted the difference between natural and synthetic EPO correctly in 14 samples, the team reported in Thursday’s Nature.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
