Aggressive Nature of Hand Osteoarthritis

In just two years, patients with hand osteoarthritis (OA) experienced a significant increase in pain and functional limitations, according to new data presented at EULAR 2007, the Annual European Congress of Rheumatology in Barcelona, Spain. Statistically significant radiological progression was also detected in 20% of subjects.

OA is the most common form of arthritis. It generally affects older people, especially women and can occur in multiple areas of the hand and wrist, causing pain and stiffness and affecting everyday activities requiring fine motor control and hand grip e.g. writing. Over time, if left untreated, the bones that make up the joint can lose their normal shape, causing further pain and limited motion. However, knowledge about the progression of hand OA and effective therapies to prevent its progression has been lacking.

Led by Dr Stella Botha-Scheepers of Leiden University, The Netherlands, this study followed 172 patients (mean age 60.5 years, 78.5% women) with hand OA (defined by the American College of Rheumatology criteria) for two years, assessing: pain intensity upon lateral pressure in the DIP, IP, PIP and CMC 1 joints on a four-point scale; self-reported hand pain and functional limitations with subscales of the Australian/Canadian Osteoarthritis Hand Index (AUSCAN LK 3.0); and osteophytes and joint space narrowing in the right and left DIP joints, IP joints of the thumbs, PIP joints and CMC 1 joints through standardized radiographs.

Despite a relatively short follow-up period of two years, statistically significant increases in pain intensity on lateral pressure standard response mean (SRM) 0.67), AUSCAN pain scores (SRM 0.25) and AUSCAN function scores (SRM 0.23) occurred. Statistically significant radiological progression was also seen in 20% of patients, in terms of joint space narrowing (SRM 0.34) and osteophytes (SRM 0.35), with progression of osteophytes occurring more often in women and middle-aged patients, and especially in women in an early post-menopausal stage.

Hand OA tends to appear in a predictable pattern, most commonly affecting the small joints of the fingers and the joint at the base of the thumb. It can be diagnosed by medical examination and X-rays of the hand. Treatment options for arthritis of the hand and wrist include oral medication, injections, splinting and surgery.


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Research Shed Light on Computer Frustrations That Plague Older Adults

A number of evolving social changes highlight the importance of making computer technology accessible and usable for older adults. For instance, older adults are using email increasingly to keep up their social contact with others and are using the Internet to look up health information.

An innovative research study was conducted at the University of Alberta which analyzed the performance outcomes of older adults when being tested on the computer and Internet.

What researchers found can be applied as a ‘best practice’ when teaching older adults how to use computer technology. Research found that older adults feel less confident about their computer knowledge than younger adults. Older adults are also concerned about how memory issues may impact their performance.

"This lack of confidence is a major factor in older adults’ ability to become proficient with computer technology, which unfortunately results in less computer use," says Patricia Boechler from the University of Alberta.

The study also highlights the obstacles older adults experience such as a significant decrease in sensory keenness, particularly with vision and hearing, as well as a decrease in motor skills due to health problems, such as arthritis and tremors.

Boechler notes, "Often a large challenge for older adults when using the computer is navigating the mouse and keyboard, which is commonly due to a health problem like arthritis."

Boechler, Foth, and Watchorn studied approximately 40 older adults by having them complete computer exercises and measured their results to undergraduates who previously completed the exercises. The study gives a list of recommendations to help even the playing field for older adults such as increasing font sizes to accommodate vision problems, ensuring that verbal instructions are delivered at an appropriate volume with minimal noise distractions and giving demonstrations of the tasks ahead of time to reduce anxiety.

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A New Target for the Treatment of Breast Cancer

The active ingredient in a drug currently being tested to treat rheumatoid arthritis might also one day serve as an effective means of treating one of the deadliest forms of breast cancer.

Researchers with the U.S. Department of Energy’s Lawrence Berkeley National Laboratory have demonstrated that inhibiting the activity of the protease enzyme known as TACE can deprive tumor cells of a key factor needed for their proliferation. TACE is strongly present in a form of breast cancer which responds poorly to current therapies

“We have shown that inhibition of the TACE protease in breast cancer cells blocks the shedding of two critical growth factor proteins and results in an inhibition of a key signaling pathway that controls cell division,” says Paraic Kenny, a post-doctoral cell biologist with the research group of Mina Bissell in Berkeley Lab’s Life Sciences Division. “Based on analysis of cells grown in three-dimensional cultures, the inhibition of this protease results in the reversion of the malignant phenotype of these breast cancer cells and switches their behavior back to a phenotype very reminiscent of non-malignant breast epithelial cells.”

Kenny is the co-author along with Bissell of a paper published in the Journal of Clinical Investigation titled: "Targeting TACE-Dependent EGFR-ligand Shedding in Breast Cancer." This paper presents the latest experimental results from an on-going investigation led by Bissell into the ecology of tumors.

It has long been Bissell’s contention that “no tumor is an island.” Tumor cells, she maintains, exist in the same microenvironment as healthy cells and must therefore appropriate normal physiological processes to facilitate their growth and spread. As she and her colleagues have repeatedly demonstrated, this idea can open up potential new avenues and targets for diagnostic and therapeutic applications.

For this latest paper, Kenny and Bissell looked into the pathway by which the EGFR signal is carried. EGFR, which stands for Epidermal Growth Factor Receptor, is the protein on the outer surface of a cell that is activated by EGF and related growth factors and signals for the cell to divide. Given that one of the hallmarks of cancer is cell division run amok, the reduction of high levels of EGFR activity has long been a primary target for anti-cancer drug development. So far, however, drugs aimed at directly inhibiting EGFR activity have met with only limited success in the cancer clinic, primarily in a small number of lung cancers.

“Because of this, we turned our attention to the processes that regulate the production of the ligands which bind and activate EGFR,” Kenny says. “We reasoned that this binding and activation is essential for EGFR activation and that finding a way to block this interaction might prove to be an important additional approach to explore for inhibition of this pathway.”

Kenny stresses that the importance of EGFR to so many different tumor types, including lung, head and neck, bladder, colorectal and kidney, makes it likely that “TACE inhibition has the potential to be an effective means of stopping tumor growth for EGFR-dependent cancers outside the breast as well.”

<---We all know someone or are some one who has or have had cancer. The most common for women is breast cancer. Slow progress is made in the battle. A new vaccine prevents a virus that causes cervical cancer. Still cancer has no vaccine, nor cure. Scary too is the rise in cases of prostate cancer in men 18-37.--->

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