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"Antidepressants may help body fight HIV and cancer" was the headline in The Independent recently. The newspaper article was on research that suggests that antidepressant drugs may help the immune system to fight off serious infection. The newspaper says the drugs could increase the activity of Natural Killer (NK) cells, a part of the immune system that targets cancerous and infected cells and induces "apoptosis" or "cell suicide". The Daily Mirror focuses on the possible effect on cancerous cells, with a headline claiming "Big C hope for Prozac".
Although the current research will be of scientific and medical interest, claims about the efficacy of antidepressants in HIV and cancer should not be made prematurely. This study involved laboratory research on blood samples from a specific group of women with HIV, and its findings cannot be generalised outside of this context. Much further research will be needed in people with HIV to see whether antidepressants could have any role in enhancing immunity.
At the current time, antidepressants should continue to be viewed in their role as treatments of depression, stress and anxiety - not as potential treatments for HIV or anti-cancer drugs.
Where did the story come from?
Dwight L. Evans and colleagues from the University of Pennsylvania School of Medicine carried out the research. kaufen levitra Ohne Rezept The study was supported by a grant from the National Institute of Mental Health. The lead author is a consultant to a number of pharmaceutical companies, including the company that makes citalopram, the antidepressant that was used in the study.
The study was published in the peer-reviewed medical journal: Biological Psychiatry.
What kind of scientific study was this?
In this experimental laboratory study, the researchers investigated what controls the function of natural killer (NK) cells. NK cells are part of the immune system and protect the body from viruses and tumours. In people infected with HIV, the function of these cells progressively declines making them more susceptible to other infections and to the growth of new tumours.
It has been suggested that, possibly due to changes in the immune system, depression is a risk factor for more severe illness and increased risk of mortality in several diseases including HIV. There are three regulating systems in the human body that have been extensively studied for their potential effects on stress and depression; the serotonin, neurokinin and glucocorticoid systems. The researchers aimed to examine what effects the drugs aimed at inhibiting each of these systems would have on immune function.
In order to test this theory, the researchers recruited 51 women infected with HIV (80% black), half with depression and half without. They excluded any women with a chronic illness other than HIV, neurological disorders or history of schizophrenia or psychosis, alcohol or substance abuse, who were pregnant, or had used any antidepressant or anti-anxiety medications within the past month. More than three-quarters of the women (78%) were currently taking anti-retroviral (anti-HIV) therapy. Each woman received a full medical assessment and any diagnoses of depression or mood disorders were made using recognised criteria. During this assessment, a blood sample was taken so the researchers could look at the activity of immune cells in the sample. The samples were taken at the same time, each day in all women, to allow for any fluctuations in immune levels that can occur.
Blood samples were tested to determine the HIV viral load of each woman (the severity of infection with the virus) and to check the levels and function of different white blood cells, including NK cells, that make up the immune system. A specific subset of white blood cells that included NK cells was then purified from this blood sample, and separate samples of it were incubated with one of the drugs that acted on the regulatory systems being tested: an SSRI antidepressant (citalopram) that inhibits serotonin; a substance P inhibitor, CP-96345 (SP binds to a neurokinin receptor); and a glucocorticoid inhibitor, RU486 (mifepristone).
The researchers looked at the effects that these drugs had on the function of the NK cells. The drugs had previously been tested on blood samples from healthy donors to determine the drug concentrations needed to produce maximal NK cell activity without killing the cells.
They used statistical methods to look at the effects that each of the three drugs had on the NK cells of each woman’s blood sample, compared to her sample with none of the drugs present. They also looked at whether the effects on NK cells differed based on whether a woman was depressed, whether she was taking anti-retroviral therapy, or her viral load.
What were the results of the study?
Compared to the blood sample without any of the drugs, citalopram and the SP inhibitor CP-96345 both significantly increased NK cell activity. The two drugs were equally effective. The glucocorticoid inhibitor RU486 had no effect on NK activity.
Overall, there was no difference in the effect of the drugs between those women with depression and those without. The viral load and use of anti-retroviral therapy did not seem to make a difference on the effects that the drugs had on NK activity.
What interpretations did the researchers draw from these results?
The researchers concluded that, in the laboratory, an SSRI and an SP inhibitor both enhance NK activity in blood samples taken from HIV positive women. They say that clinical studies are needed to see whether NK activity can be improved in the patient, and to look at the potential role these drugs could have in delaying HIV progression or improving survival.
What does the NHS Knowledge Service make of this study?
Although the current research will be of scientific and medical interest, claims about the effects of antidepressants in HIV and cancer are premature.
- This study only involved laboratory research on blood samples. To date, there has been no investigation of the drugs’ effects on the immune system, HIV progression, or survival of living patients. These effects may differ from what happens when the drugs are applied directly to the blood sample.
- It is not possible to generalise the findings outside of this specific group, who are mostly black women with HIV. The women had different HIV viral loads, but the majority (60%) had undetectable levels and three-quarters of the 51 women were also taking current anti-retroviral therapy. The sample also didn’t include women with other chronic illnesses or any mental health conditions other than depression.
- The sample size was relatively small and could not reliably detect differing effects of each of the three drugs on NK activity between women with and without depression.
- The possible underlying mechanisms of how the antidepressant drugs could be affecting NK cells, e.g. whether they act directly on them or whether the increased activity is caused via other cell mediators, has not been studied and is unclear.
- It is only a theory that any increased NK activity caused by these drugs might help to fight cancer. The study did not investigate if this is true and the authors make no claims about any roles of these treatments in cancer prevention.
As the authors say, "These findings represent an initial step in identifying serotonin and substance P regulation of immunity in HIV infection." Much further research will be needed in people with HIV to see whether the drugs could have any role as treatments to enhance immunity.
At the current time, antidepressants should continue to be viewed in their role as treatments of depression, stress and anxiety - not as potential treatments for HIV or anti-cancer drugs.
Links to the headlines
Antidepressants may help body fight HIV and cancer. The Independent, May 12 2008
Big C hope for Prozac. Daily Mirror, May 12 2008
This news comes from NHS Choices
View drug information on Prozac Weekly.
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Almost one in six cases of depression among working Victorians are caused by job stress. This means more than 21,000 cases of preventable depression are caused by job stress each year, a new University of Melbourne study shows.
Stressful working conditions in this study were defined as a combination of high job demands and low control over how the job gets done (or ‘job strain’).
The study, led by Associate Professor Tony LaMontagne from the McCaughey Centre: VicHealth Centre for the Promotion of Mental Health and Community Wellbeing at the University of Melbourne with research partners from Monash and British Columbia universities is published this month in the international journal BMC Public Health.
It estimates that:
More working women than men experience job stress, and job stress is more likely in lower skilled occupations;
Job stress exposure patterns were then combined with previous research showing that job stress doubles the risk of depression to estimate the proportion of depression caused by job stress among working people;
Nearly one in five (17 per cent) working women suffering depression can attribute their condition to job stress and more than one in eight (13 per cent) working men with depression have problems due to job stress;
This translates to 21,437 working Victorians suffering from preventable depression caused by job stress;
By comparison, 30-times fewer workers receive workers’ compensation for stress-related mental disorders, suggesting that workers’ compensation statistics grossly under-represent the true extent of the problem.
National Depression Initiative beyondblue estimates that at least one in five Australians will experience depression or another mental illness at some stage in their lives.
Researchers analysed job stress data collected from a 2003 survey of 1100 Victorian workers.
Numbers of prevalent depression cases among working Victorians were estimated from the National Mental Health survey and workers’ compensation statistics were obtained from a national database.
Associate Professor LaMontagne said women and those in lower-skilled occupations are more likely to experience job stress, and so bear a greater share of job stress-related depression.
"This represents a substantial and inequitably distributed public health problem," Associate Professor LaMontagne said.
"The burden of mental illness in the general population follows a similar demographic pattern, suggesting that job stress is a substantial contributor to mental health inequalities," he said.
Associate Professor LaMontagne said that solutions are available to address this problem.
"The evidence shows that improving job control, moderating demands, and providing more support from supervisors and co-workers makes a difference,” he says. "Our hope is that a better understanding of the scale of this problem will lead to more support for employees, particularly for lower-skilled workers and working women."
VicHealth CEO, Todd Harper said the study shows that workplaces need to do more to prevent workplace related mental health problems.
"Given so many people spend a large part of their day at work, we need to find the best ways workplaces can promote good health rather than cause health problems," Mr Harper said.
"Workplaces provide an important setting to prevent illness through strategies to reduce stress, as well as programs that address nutrition, physical inactivity and smoking," Mr Harper added.
—————————-
Article adapted by Medical News Today from original press release.
—————————-
acheter cialis mastercard The study was funded by the Victorian Health Promotion Foundation (VicHealth), the National Heart Foundation, the National Health and Medical Research Council, Canadian Institute for Health Research and the Michael Smith Foundation (Canada).
This latest study follows a major report by Associate Professor Anthony La Montagne in 2006,
Workplace Stress in Victoria - Developing a Systems Approach.
Source: Janine Sim-Jones
University of Melbourne
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A study into teenagers with food allergies will investigate what life is like for them in an attempt to improve their quality of life and curb the number of allergy-related deaths.
Scientists at the University of Portsmouth have created a quality of life questionnaire which asks teenagers what it is like for them to live with a food allergy. They are inviting young people with food allergies to come forward to take part in the study.
A previous UK study which examined all deaths from food-related allergies between 1992-2001 suggested that 35 per cent of deaths occurred in youngsters aged from 10-19.
Children aged 10-14 years accounted for 10 per cent of food allergy deaths and those aged 15-19 accounted for 25 per cent.
Heather Mackenzie, from the University’s School of Health Sciences and Social Work said:
"Although deaths from food allergy are rare, teenagers are overrepresented in these figures. This indicates that they find food allergies the most difficult to deal with."
In order to develop a draft questionnaire she has interviewed youngsters and discovered that their attitudes to food allergies vary and that the severity of the condition doesn’t always dictate the way they feel about it and the way they manage it. She said:
"Some teenagers have relatively mild food hypersensitivity but it has a drastic affect on their quality of life, and vice versa. Teenagers are especially vulnerable because they are learning to take responsibility for their food allergy, which is challenging in itself, whilst also trying to be a normal teenager. Those with serious allergies carry around pre-loaded injection kits containing adrenaline and some see it as a nuisance but it’s vital that they understand that it can save their lives and that thousands of others are in the same boat."
The aim of the new study is to provide doctors and other healthcare professionals with a tool to assess teenagers’ quality of life by finding out how they feel about their allergy. It will help doctors give them advice on how to manage their allergy and sources of further help.
Mackenzie says she wants more volunteers to complete the questionnaire in order to ensure that it accurately reflects teenagers’ concerns. She wants to hear from teenagers who would like to help people to understand more about what living with a food allergy is like for them.
kaufen viagra soft Ohne Rezept The Anaphylaxis Campaign, a national charity for people with potentially life-threatening allergies (www.anaphylaxis.org.uk), will be helping the study by sending questionnaires to some of its teenage members.
David Reading, director of the Anaphylaxis Campaign, said: "Food allergy can occasionally be serious, but we are convinced that teenagers who are affected can learn how to protect themselves. We would hope that this study will lead to a greater understanding of the problem that allergic teenagers face and better medical advice for them."
Young people aged 13-18 who would like to take part can go to www.port.ac.uk/foodallergysurvey or contact Heather Mackenzie on 023 9284 4441 or heather.mackenzie@port.ac.uk. They will be asked to complete a short questionnaire about how having food allergies affects their life and will be entered into a prize draw to win an iPod.
For more information visit the following
link.
Food allergies affect approximately 2.3% of teenagers and approximately 1.4-1.8% of the UK adult population as a whole
The most common allergies are to peanuts and other nuts and they frequently severe but other foods which can be triggers include egg, milk, fish, shellfish, soya, sesame and wheat.
Any allergic reaction, including the most extreme form, anaphylactic shock, occurs because the body’s immune system reacts inappropriately in response to the presence of a substance that it wrongly perceives as a threat.
From 1992 - 2002 the UK the youngest person to die from a fatal reaction to peanut was 13 years old and the median age was 21 years.
6 children aged between 10-14 years died in the years between 1992-2001 in the UK and 15 teenagers aged 15-19 years died (25%).
Symptoms of food related allergies include
- generalised flushing of the skin
- nettle rash (hives) anywhere on the body
- abdominal pain, nausea and vomiting
- swollen lips
- anaphylaxis
- sense of impending doom
- swelling of throat and mouth
- difficulty in swallowing or speaking
- alterations in heart rate
- severe asthma
- sudden feeling of weakness (drop in blood pressure)
- collapse and unconsciousness
University of Portsmouth

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Men’s Health News
Erectile dysfunction is always a matter of the heart, but new research shows that more than romance is at stake. Two new studies of men with type 2 diabetes found that erectile dysfunction (ED) was a powerful early warning sign for serious heart disease, including heart attack and death.
One of the studies also showed that cholesterol-lowering medications could cut the risk of heart problems by about one-third-and suggested that Viagra and other compounds in the same drug family might offer similar protection.
The research, which was published in the May 27, 2008, issue of the Journal of the American College of Cardiology (JACC), underscores the importance of encouraging men to report ED to their physicians, and of focusing treatment not only on overcoming sexual dysfunction but also on improving overall cardiovascular health.
"The development of erectile dysfunction should alert both patients and healthcare providers to the future risk of coronary heart disease," said Peter Chun-Yip Tong, Ph.D., an associate professor in the Department of Medicine & Therapeutics at The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong. "Other risk factors such as poor blood glucose control, high blood pressure, high cholesterol levels, smoking and obesity should be reviewed and addressed aggressively."
Diabetes, erectile dysfunction and heart disease share an ominous link: damage to the blood vessels by high blood sugar levels. The same process that hinders the extra blood flow needed to maintain an erection can have even more serious consequences in the heart. "The first event is probably endothelial dysfunction-when the smoothness and reactivity of the blood vessel are damaged," said Dr. Tong. "This process encourages local inflammation on the inner surface of the blood vessels and the deposition of cholesterol, resulting in formation of clots and atherosclerosis. Therefore, there is a high risk of blockage of blood vessels in the heart, which can lead to a heart attack."
Men typically show signs of ED more than three years before the onset of symptoms of coronary heart disease. In one study of diabetic men, symptoms of ED always preceded coronary symptoms.
In the Hong Kong-based study, Dr. Tong and his colleagues set out to determine whether ED could be used as an early warning sign of poor cardiovascular health. Researchers recruited 2,306 men with type 2 diabetes, performing a thorough medical evaluation of diabetic control and complications, including damage to the kidneys, eyes and cardiovascular system. At the beginning of the study, just over one-quarter of the study participants had ED. Kaufen generishe viagra soft None of the participants had any signs or history of heart disease, vascular disease or stroke.
The researchers followed-up the patients for an average of four years. During that time, 123 men either suffered a heart attack, died from heart disease, developed chest pain caused by clogged arteries, or needed bypass surgery or a catheter procedure to restore blood flow to the heart. Men who had ED at the beginning of the study were far more likely to develop one of these signs of coronary heart disease-or a "CHD event"-than were men who initially did not have ED. Statistical analysis showed that out of every 1,000 diabetic men with ED, 19.7 could be expected to experience a CHD event each year, as compared to only 9.5 of 1,000 diabetic men without ED.
The research team then performed an analysis that included many different characteristics that, like erectile dysfunction, were associated with the development of CHD, including age, high blood pressure, the need for cholesterol- or blood-pressure-lowering medications, the duration of diabetes, and damage to the kidneys or the eyes as a result of diabetes. Even when these characteristics were taken into account, ED was found to be an independent early warning sign of coronary heart disease. In fact, ED signaled a 58 percent increase in the risk of CHD. Only spillage of large amounts of protein in the urine-a sign of extensive kidney damage-was a stronger warning sign, doubling the risk of heart disease.
The second study, conducted by researchers from four medical centers in Italy, focused on 291 men who not only had type 2 diabetes but also silent CHD discovered by stress testing and confirmed by x-ray angiography. Of these, 118 had ED at the beginning of the study. Lead investigator Carmine Gazzaruso, M.D., Ph.D., and his colleagues followed-up patients for an average of nearly four years, documenting major adverse cardiac events (MACE), which they defined as not only CHD events but also stroke, mini-stroke (transient ischemic attacks) and arterial disease in the legs. They found that patients who had ED at the beginning of the study were twice as likely to suffer a major adverse cardiac event when compared to those without ED.
The study also showed that among patients who were taking cholesterol-lowering statins, the risk of MACE was reduced by one third (hazard ratio, 0.66, p = 0.036). Viagra and other medications in a family known as 5-phosphodiesterase (5PDE) inhibitors also appeared to reduce the MACE risk (hazard ratio, 0.68); however this finding was just beyond the cusp of being statically significant (p = 0.056).
"These are important studies," said Robert A. Kloner, M.D., Ph.D., F.A.C.C., a professor of medicine at the Keck School of Medicine at the University of Southern California, and director of research for the Heart Institute at Good Samaritan Hospital in Los Angeles. "While we have known that ED shares many common risk factors with CHD, such as hypertension, smoking, dyslipidemia and diabetes, what is new here is that ED remained a significant risk factor for developing heart disease after controlling for other cardiovascular risk factors.
"Men should know that ED is a true harbinger of atherosclerotic coronary heart disease," he said.
Dr. Kloner, who wrote an editorial about the new studies in the same issue of JACC, also noted that not only have statins been shown to reduce the risk of cardiovascular illness in diabetic patients, controlling blood pressure and other risk factors is also critical.
"In diabetic patients, it is important to not only control the blood sugar level, but also to keep blood pressure below 130/80 mmHg and reduce ‘bad’ (low-density-lipoprotein, or LDL) cholesterol to less than 100 mg/dL. If a patient smokes, a smoking cessation program is crucial," Dr. Kloner said.
Dr. Tong said that he and his colleagues are continuing to analyze a database of nearly 10,000 patients with diabetes in an attempt to answer several remaining questions about the link between ED, diabetes and heart disease. For example, will improvements in the control of blood sugar and other cardiovascular risk factors reduce the likelihood of developing erectile dysfunction or suffering a heart attack or other serious heart disease" Are patients who have ED in addition to diabetes-related eye problems and kidney problems at higher risk for death or cardiovascular disease" And if so, how great is the increased risk"
"All of these questions are relevant to those who suffer from diabetes," Dr. Tong said. "The information we find will help patients to focus on improving their own health."

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Having intercourse more often may help prevent the development of erectile dysfunction (ED). A study published in the July 2008 issue of The American Journal of Medicine reports that researchers have found that men who had intercourse more often were less likely to develop ED.
Analyzing a five-year study of 989 men aged 55 to 75 years from Pirkanmaa, Finland, the investigators observed that men reporting intercourse less than once per week at baseline had twice the incidence of erectile dysfunction compared with those reporting intercourse once per week. Further, the risk of erectile dysfunction was inversely related to the frequency of intercourse.
Other factors that may affect the incidence of ED, such as age, chronic medical conditions (diabetes, heart disease, hypertension, cerebrovascular disease and depression), body mass index and smoking were included in the analysis of the data.
Erectile dysfunction incidence was 79 cases per 1000 in men who had reported sexual intercourse less than once per week, dropping to 32 cases per 1000 in men reporting intercourse once per week and falling further to 16 per 1000 in those reporting intercourse 3 or more times per week.
In addition, the frequency of morning erections predicted the development of complete erectile dysfunction, with an approximate 2.5-fold risk among those with less than 1 morning erection per week compared with 2 to 3 morning erections per week
Writing in the article, Juha Koskim?¤ki, MD, PhD, Tampere University Hospital, Department of Urology, Tampere, Finland, states; "Regular intercourse has an important role in preserving erectile function among elderly men, whereas morning erection does not exert a similar effect. Continued sexual activity decreases the incidence of erectile dysfunction in direct proportion to coital frequency."
The study clearly indicates that regular intercourse protects men from the development of erectile dysfunction, which may, in turn, impact general health and quality of life. The investigators advise clinicians to support the sexual activity of their patients.
"Regular Intercourse Protects Against Erectile Dysfunction: Tampere Aging Male Urologic Study"
Juha Koskimaki, MD, PhD, Rahman Shiri, MD, PhD, Teuvo Tammela, MD, PhD, Jukka Hakkinen, MD, PhD, Matti Hakama, ScD, and Anssi Auvinen, MD, PhD.
Generic viagra pills no prescription The American Journal of Medicine, Volume 121, Issue 7 (July 2008) published by Elsevier.
ABOUT THE AMERICAN JOURNAL OF MEDICINE
The American Journal of Medicine, known as the "Green Journal," is one of the oldest and most prestigious general internal medicine journals published in the United States. It is ranked 11th out of 100 General and Internal Medicine titles according to the 2007 Journal Citation Reports© published byThomsonReuters. www.amjmed.com.
AJM, the official journal of The Association of Professors of Medicine, a group comprised of chairs of departments of internal medicine at 125-plus U.S. medical schools, publishes peer-reviewed, original scientific studies that have direct clinical significance. The information contained in this article in The American Journal of Medicine is not a substitute for medical advice or treatment, and the Journal recommends consultation with your physician or healthcare professional. AJM is published by Elsevier.
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