Research into Acupuncture for the Treatment of Cystic Fibrosis in Teenagers and Young Adults

Up to 59% of patients with Cystic Fibrosis (CF) experience

Brenda Golianu, MD, Associate Professor of Anesthesiology, Perioperative & Pain Medicine
Brenda Golianu, MD, Associate Professor of Anesthesiology, Perioperative & Pain Medicine

significant pain and discomfort that may decrease their quality of life. The research we are conducting at Stanford University School of Medicine and Lucile Packard Children’s Hospital Stanford, generously funded by the Tracie Lawlor Trust for CF, is investigating whether acupuncture can help teens and young adults with CF improve their pain and sleep. Our overall goal is to determine if acupuncture is a safe, feasible and effective integrative medicine approach that may improve CF patients’ pain and quality of life.

We, Dr. Brenda Golianu, an anesthesiologist, and Dr. Ann Ming Yeh, a gastroenterologist, are leading this pilot study, with a larger cross-disciplinary team. We are both physicians and certified medical acupuncturists, and have completed fellowships in Integrative Medicine at the University of Arizona. Medical acupuncture has been used for many years to help alleviate chronic pain in various parts of the body. However, few studies have been conducted to examine the efficacy of medical acupuncture in reducing the pain or other symptoms of discomfort experienced by teens and young adults with CF.

We are investigating whether a regimen of one medical acupuncture treatment per week for four weeks could be effective in improving young CF patients’ pain, sleep, and quality of life. Using a randomized placebo-controlled crossover study design, study participants were assigned to initially receive either traditional medical acupuncture or sham (pretend) acupuncture. After the first cycle of true or sham treatment, the patients had a 2-week waiting period. Then those who had received sham acupuncture received true acupuncture, and those who had received true acupuncture received sham acupuncture. Thus, all participants had a chance to benefit from the therapeutic approach.

To help us determine acupuncture’s efficacy in improving CF patients’ pain, we measured each participant’s pain before and after each treatment and on each day of the study between treatments. We also measured participants’ sleep duration and sleep quality. To more broadly evaluate important quality of life measures, such as fatigue and energy level, we used the Cystic Fibrosis Quality of Life Questionnaire. We are now in the data analysis phase and anticipate our pilot study’s completion at the end of summer. We greatly appreciate the support of the Tracie Lawlor Trust for CF and its many wonderful supporters and hope our work will contribute to the well-being of young people with CF.

Ann Ming Yeh, MD, Assistant Professor of Pediatrics–Gastroenterology
Ann Ming Yeh, MD, Assistant Professor of Pediatrics–Gastroenterology

 

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*The opinion(s) expressed herein are the sole opinion of the author are not necessarily the opinion(s) of the Tracie Lawlor Trust. Always consult your physician and healthcare team before making any changes to your medical regime. For information purposes only not to be considered medical advice. Please see Disclaimer

– See more at: http://www.tracielawlortrust.com/category/complementary-intergrated-medicine/#sthash.lRiauVIk.dpuf

TLT co-funded researcher at Harvard Uni tackles Pseudomonas aeruginosa resistance

 

By Sara Leiman post graduate student at Harvard University, USA

Pseudomonas aeruginosa infections are the leading cause of mortality for cystic fibrosis (CF) patients . Work over the past decade has demonstrated that the danger of P. aeruginosa infections rests not only in this bacterium’s genetic resistance to many antibiotics, but also in its propensity to live in a biofilm.  P. aeruginosa biofilms comprise a mixture of metabolically active and dormant cells encased by a self-produced exopolymer matrix.  The biofilm matrix has a drastic therapeutic consequence, magnifying the minimum inhibitory concentrations of antibiotics as much as 1000-fold when compared with free-living P. aeruginosa.  Improved strategies to treat and clear chronic P. aeruginosa infections must therefore overcome this protective exopolymeric barrier.  Importantly, while many factors contributing to P. aeruginosa have been identified – including quorum sensing molecules, the secondary messenger cyclic-di-GMP, and genes responsible for making matrix – the mechanisms by which these diverse components interact to establish a biofilm state are largely mysterious.

            To address the gaps in the current understanding of P. aeruginosa biofilm development, our studies have focused on uncovering novel components and interactions involved in Pseudomonas aeruginosa biofilm formation, maintenance, and disassembly.  Our approach has been unique in that we developed and implemented a new screen, based on biofilm morphology, which lends itself to the recognition of subtle biofilm phenotypes.  We conducted a transposon mutagenesis screen using a P. aeruginosa strain background in which the biofilm-inhibitory gene amrZ was deleted.  We have completed collecting and analyzing the biofilm morphologies of this transposon library and know the locations of the transposon insertions for the 62 mutants we selected using this screen. 

            The results of our screen include well-known biofilm-related genes, thus validating our method.  Our results also include uncharacterized genes as well as annotated genes whose roles in biofilm formation are unclear.  For both of these classes of results, we have constructed strains with directed mutations (deletions, complementations, and/or overexpressions) to verify the biofilm functions of the loci we have uncovered.  The biofilm phenotypes of these genes have been confirmed by a qualitative morphological screen as well as by a quantitative Congo Red-binding assay, a standard read-out of structured biofilm formation.

Sara Leiman (BSc) working at her lab bench, under the supervision of Professor Richard M. Losick at the department of molecular and cellular biology, Harvard University, USA

            Our group is currently focused on uncovering the mechanisms of action of two uncharacterized genes identified through our transposon mutagenesis screen.  The first gene encodes a putative TetR transcriptional repressor that has been previously implicated in quorum sensing.  Uncovering the mechanism of this protein may not only reveal its specific role in biofilm formation, but it may also elucidate how quorum sensing components may be leveraged for future anti-biofilm treatments.

            Our second gene of interest is a hypothetical protein with structural similarity to a known P. aeruginosa cyclic-di-GMP-binding protein.  Cyclic-di-GMP levels are positively correlated with biofilm formation, though the precise signaling pathways by which this secondary messenger regulates biofilm formation remain unknown.  By identifying the localization and interaction partners of this putative cyclic-di-GMP-binding protein, we may be able to shed more light on the mechanisms driving biofilm formation in P. aeruginosa and find new targets for anti-biofilm compounds.

Our future directions are targeted to understanding the biochemistry of the two aforementioned genes as well as several other candidates from our transposon mutagenesis screen.  Among these efforts, we plan to measure and compare the intracellular cyclic-di-GMP levels of our mutants.  We also plan to implement pull-down assays, followed by mass spectrometry, to identify protein-protein interactions and complexes.  Overall, our goal is to combine our genetic manipulations of P. aeruginosa with biochemical analyses to yield a more refined picture of the P. aeruginosa biofilm formation process and facilitate the development of treatments for P. aeruginosa infections.

Further reading:
1. Kirov et al. (2007) Microbiology. 153, 3264-74.    
2. Foweraker. (2009) Br Med Bull. 89, 93-110.
3. Hill et al. (2005) J Clin Microbiol. 43, 5085-90.
4. Ellis T.E. et al. (2010) Infec and Immunity. 78(9), 3822-3831.
5. The Leeds Method of Management (2008) Intravenous antibiotics and Pseudomonas aeruginosa. Available from http://www.cysticfibrosismedicine.com
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Sara’s work was co-funded by the Tracie Lawlor Trust and Natural Health Research Institute . For more information on our ongoing research http://www.tracielawlortrust.com/research/

Integrative Care: A mother’s point of view.

By Louise Byrne

http://louisebyrnebooks.com/index.html

Ava Li was diagnosed in 2008, a week before I turned 40. She was our first and only child and although the news broke our hearts at the time, there was some element of relief to know that we had been correct all along in feeling that something was awry. Because there was no new born screening in Ireland then (it has since been introduced); she was 14 months old at her diagnosis. In those 14 months we had been in A&E twice; she had been on several courses of antibiotics and once we had been sent home by a ‘relief’ doctor with a pat on the head and told to buy a honey and lemon mixture to ease her cough.

I had always been a firm believer in alternative remedies and whilst I was content to give the first couple of antibiotics I got increasingly upset when I saw they were not working and I felt they were potentially damaging her young immune system.  I recall introducing Vitamins C and D and probiotics and noting a marked improvement in her health during that time. However, when the diagnosis came, I was shocked into doing everything the doctors said and because I knew very little about cystic fibrosis in the early days, I looked to them entirely for guidance and answers. 

However, in the following 16 months, I felt increasingly powerless and depressed; Ava Li was hospitalised twice with a total of three different sets of IVs and she was prescribed a further ten courses of heavy strength antibiotics for infections of varying grades.  Breaking point for me was the tenth antibiotic course which was for – as I discovered midway through the course – a scanty growth of staph aureus. At that point I realised I could not continue on the path we were on.  I felt that her immune system had to be capable of and allowed to fight some battles itself, and I realised I could not put her health entirely into the hands of prescribed antibiotics.  I had read, researched and cross examined all information relating to cf I could get my hands on. I realised that I had to regain control of my child’s health and steer a different course for our family. I would gratefully accept modern medicine at appropriate times, whilst utilising the generations of natural medicine, therapies and knowledge that had always been my basic instinct.

From the moment I made that conscious decision our lives changed for the better. I felt empowered and alive again. I reintroduced various vitamins, minerals and supplements that I would have used previously, I researched dosage, I googled cf with the words ‘good news’ attached, instead of ‘life expectancy’ or ‘severe mutations.’ I made contact with scientists who ha

Lou and Ava Li

d done research on various promising therapies e.g. silver and glutathione. I worked intuitively again and believed in my ability to make a positive difference.

Following these initial changes, Ava Li remained off antibiotics for 10 months until evidence of infection showed up on a chest x-ray. She was then antibiotic free for a further 23 months until a scanty growth of pseudomonas and, is currently 11 months hale and healthy. I usually dislike discussing or comparing periods without antibiotics as I understand everybody is different and nothing is certain or guaranteed – everything can change.  I use it here purely to display what I firmly believe was the difference my approach and attitude had on our daughter’s health and outlook.

The specific changes I made at that time are as follows:

Diet: I began daily juicing organic fruit and vegetables, included daily portions of raw, unprocessed food, kept sugar intake to a minimum and removed most dairy (we still do limited amounts and try to veer towards goat dairy whenever possible).

Supplements: we added daily Vit C, D, selenium, probiotics and glutathione.

Exercise: We make a huge effort to incorporate elements of fun exercise. Currently Ava Li has running, swimming, dance and dog walking incorporated into her week!

Attitude: This is arguably the most vital element of all for me. I believe we are truly lucky and have an immense debt of gratitude. I also believe that we have control over our bodies, minds and health. It is not that I think we will not suffer or become ill at times. Rather, it is a belief that we have more ability to deal with those challenges that we often give ourselves credit for, and that our physical, emotional and spiritual bodies have an immense healing capacity which we need to nurture and develop.

Of course I still have times of worry, doubt and anxiety, but I attempt to recognise those times as a human condition rather than weaknesses!  I gratefully recognise western medicine and the benefits and advances it brings to our world. However, I also feel that western medicine owes much of its foundations and many future endeavours to nature, yet it often displays little respect or awareness of this and is too often solely profit driven. In Karmic terms alone this can’t continue; it is not possible to continually take from one source and repay with disrespect and self-serving greed. It is therefore unthinkable for me to allow my daughter’s future to be entirely in the hands of western medicine.

I truly believe that as a global community we need to begin to see the natural healing and life giving properties of our universe, and ourselves, and gratefully recognise the benefits that a holistic approach to health and living brings.   

I believe that by raising our daughter with a healthy awareness, empathy and respect towards all living things, she will be well armed to rise to whatever challenges she may meet along her path.

 I see her as a strong and healthy child. I make a conscious effort to believe in the power of myself; so that she can believe in the power of herself.

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This story was kindly re-published with the consent of our Uk friends at http://dearcf.com/. Louise Byrne has authored two books specifically for children with Cystic Fibrosis, in particluar she has received notable media attention from her book “Can you see what I see?”, which she decidated to her mother, a book that no doubt encapulates Louise’s own ‘Zen’ positive philosophy. Read more on her book here!  The information contained herein is for information purposes only and is not to be taken as medical advice. Always consult your doctor or healthcare professional before making any changes to your medical regime. Notice Disclaimer

Organic Foods – Are They Worth It?

by Dustin Rudolph PharmD

www.PursueAHealthyYou.com

Ever find yourself in the produce section at the supermarket staring down two colorful apples wondering which one is worthy of making its way into your grocery cart? Both apples look the same but one has that familiar USDA Organic sticker plastered on it. One things for sure they definitely aren’t priced the same.

With an average cost of 10%-40% higher[1] are organic foods worth it? Do they have more nutritional value? And does this make a difference to your overall health? I invite you to read further as I help you get to the bottom of all this organic talk so that you can make the decision that feels the best for you.

What Deems a Food To Be Organic?

The U.S. government establishes strict standards to be met for farmers before they can use the USDA Organic seal on their food products. A product can use the USDA Organic seal if it contains at least 95% organically produced ingredients.

The following chart shows the differences between organic vs. conventionally farmed food:

organic vs. conventional

Does Organic Food Contain More Nutritional Value?

This question has created a lot of controversy over the past few decades as organic food has become increasingly more popular. More and more studies have been conducted in recent years factoring in things like farming methods, climate variability, food formulations, and harvest rates among other things to assess the nutritional content of our food in terms of its vitamin, mineral, phytochemical, antioxidant, and toxin load. Here’s a few of the findings below.

● A study looking at organic and conventionally grown pears and peaches found that the organic fruits had an improved antioxidant defense system (higher levels of polyphenols, PPO, vitamin C, & vitamin E) in comparison with their conventionally grown counterparts [2]. Another study found that organically grown strawberries have more antioxidant activity and anti-cancer effects than conventionally grown strawberries [3]. Scientists suggest that this data shows that organically grown food is in effect “beefing up” its own defense mechanisms to protect itself in the absence of pesticides.
● A review in 2006 showed that organic foods had significantly higher amounts of antioxidants (vitamin C, polyphenols, & flavanoids) and minerals in addition to lower levels of pesticide residues, nitrates, and some heavy metal contaminations than conventionally grown crops. They concluded that because of this organic crops had a higher nutritional value and a lower risk of causing disease due to contamination [4].
● A number of studies have shown that organically grown food contains more dry matter (less water) than conventionally grown fruits and vegetables [5,6]. An increase in dry matter means that there are more nutrients per unit weight of food.
● One study looked at the nutrient content of eggplants cultivated over two successive years by both conventional and organic methods. The study found that the organic crop was higher in potassium, calcium, magnesium, copper, and phytochemicals called phenolics [7].
● Whole wheat production was studied over a 3 year period comparing organic and conventional crops. The study found that there was no difference in concentrations of the phytochemicals (carotenoids & phenolic acids) between the two groups. Instead, improved climate factors produced a 55% increase in phytochemical composition in year to year production [8].

The best overall review to date of the nutritional value of organic vs. conventionally grown crops was published by The Organic Center in March of 2008. In this review they assessed the results of 97 peer-reviewed studies published over a 27 year period comparing the nutrient levels in organic and conventionally grown foods [9]. To determine the nutrient quality of the food they focused on 11 different nutrients using matched pairs which is defined as “crops grown on nearby farms, on the same type of soil, with the same irrigation systems and harvest timing, and grown from the same plant variety”.

What they found was that organically grown crops had a 25% overall higher nutrient content than conventional crops. A little over 60% of the organic crops had higher levels of a disease fighting flavonol named Quercetin. Vitamin C was found in higher concentrations in approximately 50% of the organic crops compared to conventional crops. And to top it off they also found that 80% of the organic crop samples had a higher total antioxidant capacity than conventional crops!

The organic world is not without its critics though. An article titled “Nutritional quality of organic foods: A systemic review” published in 2009 in The American Journal of Clinical Nutrition claims that there was no evidence suggesting organically grown foods were nutritionally superior to conventionally grown foods. Come to find out this article originated as a report commissioned by the Foods Standards Agency (FSA) out of the UK. According to Paula Crossfield (co-founder and managing editor of civileats.com) the report was heavily biased and heavily tied to special interests of agribusiness, the dairy industry, Sarah Lee Corporation, and one of UK’s biggest grocery chains. You can read Paula’s full review here about the misleadings in this article.

Does Organic Food Significantly Improve Your Overall Health?

It is clear from the scientific literature to date that organic food is certainly more nutritious and less toxic than conventional food but does this equate to better overall health and a lower risk of chronic diseases? You might be surprised by the answer to this as you’ll soon find out.

Much of the published data on pesticide exposure and disease does show an increased risk in some cases. The biggest fear of many people is cancer. The National Cancer Institute states that “studies of people with high exposure to pesticides, such as farmers, pesticide applicators, manufacturers, and crop dusters, have found high rates of blood and lymphatic system cancers; cancers of the lip, stomach, lung, brain, and prostate; as well as melanoma and other skin cancers”. Another study performed a meta-analysis on 40 case-controlled studies and found that exposure to pesticides for greater than 10-20 years was associated with a higher risk of Parkinson’s disease but several other risk factors such as rural living, well-water consumption, and farming played a part as well [10]. Another study showed an increased risk of Alzheimer’s disease in occupational workers exposed to pesticides [14].

So while there is a link to pesticide exposure and disease it appears that the highest risk is in those who have the greatest exposure (farmers, workers, etc.) and only after being exposed to high amounts over long periods of time. The amount of pesticide residue left on the food you buy is much lower than what these studies elude to.

An even more important aspect of this topic in regards to pesticide exposure and your overall health is what you can do to prevent the risk of disease from occurring. A large body of evidence points to the fact that consuming a nutrient dense, plant-based diet and avoiding processed and animal-based foods reduces your risk not only of cancer due to pesticide exposure but also many other chronic diseases (heart disease, diabetes, dementia, etc.).

The CDC actually reported in 2009 that the primary source of exposure to organochlorine pesticides was from fatty foods such as dairy products and fish [11]. So just by avoiding fatty animal-based foods you are already decreasing your exposure to pesticides.

The most influential evidence to date concerning diets relation to cancer has been conducted by Dr. T Colin Campbell who has spent over 40 years in nutritional research. Dr. Campbell conducted several studies on a known potent carcinogen called aflatoxin. In animal studies he was able to show that the cancer causing effects of aflatoxin could be “turned on” and “turned off” simply by how much protein was consumed. When more than 10% of the total calories were consumed as casein (animal based protein found in dairy) then cancer growth was ignited and tumors began to form [12]. He then conducted a similar experiment testing both animal protein (casein) and plant proteins (wheat and soy). This time he fed 3 different groups of lab animals a 20% protein diet (far exceeding the 10% needed to cause cancer growth) that consisted of either casein, wheat, or soy protein. Remarkably, the 20% wheat and soy groups had no signs of cancer growth while the 20% casein group all developed cancer [13].

Dr. Campbell’s work is further validated by Dr. Joel Fuhrman’s review of the scientific data on the benefits of eating a plant-based diet to reduce your risk of cancer as seen in the video below.

Organic foods have clearly been shown in a large body of scientific studies to have a higher nutritional value than their conventionally grown counterparts. However, even though eating non-organic foods increases your exposure to pesticides it doesn’t mean that you’re on the fast track to develop cancer and other debilitating diseases. What is more important is that you eat a diet that contains large amounts of nutrient dense, health promoting foods such as fruits & vegetables as well as legumes, whole grains, & nuts/seeds. By doing this you are arming yourself with an excellent defense mechanism against so many of the chronic diseases that we’re experiencing today in our society. You’re best bet is to eat a diet that consists 100% of these foods with the highest emphasis on fruits and vegetables. You can learn more about how to do this by visiting my website.

I’d also like to mention an excellent resource from the Environmental Working Group which publishes a list of foods from best to worst in relation to their pesticide exposure. I think you’ll find their list very helpful if you’re wondering which foods have higher amounts of pesticides compared to others.

In the end, I would say that if you can buy organically grown food products and they are readily available at a price that you can afford then you should absolutely do it. But more importantly, you should eat a nutrient dense, plant-based diet and stay away from processed and animal-based foods regardless of their organic or inorganic nature if you want to do what’s best for your overall health.

Now I’d love to hear from you…
Do you buy organic?
If so, what are the reasons for doing so?
Do you have any other resourceful information for your fellow readers on this topic?

Dustin Rudolph Pharm.D.
www.PursueAHealthyYou.com

References:
1 Winter, C. K. and Davis, S. F. (2006), Organic Foods. Journal of Food Science, 71: R117-R124. doi: 10.1111/j.1750-3841.2006.00196.x
2 Carbonaro M, Mattera M, Nicoli S, et al. Modulation of antioxidant compounds in organic vs conventional fruit (peach, Prunus persica L., and pear, Pyrus communis L.). J Agric Food Chem. 2002 Sep 11;50(19):5458-62.
3 Olsson ME et al. Antioxidant levels and inhibition of cancer cell proliferation in vitro by extracts from organically and conventionally cultivated strawberries. J Agric Food Chem. 2006 Feb 22;54(4):1248-55.
4 Györéné KG, Varga A, Lugasi A. A comparison of chemical composition and nutritional value of organically and conventionally grown plant derived foods. Orv Hetil. 2006 Oct 29;147(43):2081-90.
5 K Woese, D Lange, C Boess, KW Bogl, A comparison of organically and conventionally grown foods: results of a
review of the relevant literature, Journal of Science, Food and Agriculture, 74, 281-293, 1997.
6 V Basker, Comparison of taste quality between organically and conventionally grown fruit and vegetables, American
Journal of Alternative Agriculture, 7, 129-135, 1992.
7 Raigón MD, Rodríguez-Burruezo A, Prohens J. Effects of organic and conventional cultivation methods on composition of eggplant fruits. J Agric Food Chem. 2010 Jun 9;58(11):6833-40.
8 Stracke BA, Eitel J, Watzl B, Mäder P, Rüfer CE. Influence of the production method on phytochemical concentrations in whole wheat (Triticum aestivum L.): a comparative study. J Agric Food Chem. 2009 Nov 11;57(21):10116-21.
9 Benbrook C, Zhao X, Yáñez J, Davies N, Andrews P. State of Science Review: Nutritional Superiority of Organic Foods. 2008 March. Available: http://www.organic-center.org/reportfiles/5367_Nutrient_Content_SSR_FINAL_V2.pdf. Accessed 7 Jan 2011.
10 Brown TP et al. Pesticides and Parkinson’s Disease-Is There a Link? Environ Health Perspect 114:156-164 (2006).
11 United States Center for Disease Control Fourth National Report on Human Exposure to Environmental Chemicals: Organochlorine Pesticides.
12 Dunaif GE, Campbell TC. Dietary protein level and aflatoxin B1-induced preneoplastic hepatic lesions in the rat. J Nutr. 117 (1987): 1298-1302.
13 Schulsinger DA, Root MM, Campbell TC. Effect of dietary protein quality on development of aflatoxin B1-induced hepatic preneoplastic lesions. J Natl Cancer Inst 81 (1989): 1241-1245.
14 Hayden KM, Norton MC, Darcey D. Occupational exposure to pesticides increases the risk of incident AD. Neurology.2010 May 11;74(19):1524-30.