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Nanotechnology: On the Plus Side
Products incorporating nanotechnology are being developed and manufactured at an ever-growing rate, especially among clothing manufacturers that incorporate nanomaterials into fabrics to enhance stain and wrinkle resistance, and water repellence. However, Dr. Nasir explained that a substantial proportion of patents issued for nanotechnology-based discoveries are currently in the realm of cosmetic and consumer skin care products. In fact, the cosmetic industry leads all other industries in the number of patents for nanoparticles, which have the potential to enhance sunscreens, shampoos and conditioners, lipsticks, eye shadows, moisturizers, deodorants, after-shave products and perfumes.

One example of how nanoparticles are being considered for use is to improve some of the undesirable properties of skin care products. Dr. Nasir explained that when certain ingredients are included in micrometer-sized particles, which are considerably larger than nanosized particles, the result is a product than can be cosmetically unappealing.

For example, one common ingredient in broad-spectrum sunscreens, which protect the skin from both UVA and UVB rays, is avobenzone, which can make a sunscreen greasy and very noticeable when applied to the skin. Since titanium, another common sunscreen ingredient, requires an oily mixture to dissolve, a white residue can be apparent on the skin upon application. However, when these active ingredients in sunscreens are converted into nanoparticles, they can be suspended in less greasy formulations – which seem to vanish on the skin and do not leave a residue – while retaining their ability to block UVA and UVB light.

“While widespread use of this technology is currently under evaluation, I think one of the main benefits of nanoparticles used in sunscreens will be that the particles can fit into all the nooks and crannies of the skin, packing more protection and more even coverage on the skin’s surface than microsized particles,” said Dr. Nasir. “Since sunscreen formulations using nanoparticles may be more cosmetically appealing and seem to vanish when applied, consumers may be more inclined to use them on a regular basis.”

Nanotechnology also is generating excitement for its potential use in anti-aging products. When properly engineered, nanomaterials may be able to topically deliver retinoids, antioxidants and drugs such as botulinum toxin or growth factors for rejuvenation of the skin in the future.

In anti-aging products, Dr. Nasir added that nanotechnology may allow active ingredients that would not normally penetrate the skin to be delivered to it. For example, vitamin C is an antioxidant that helps fight age-related skin damage which works best below the top layer of skin. In bulk form, vitamin C is not very stable and is difficult to penetrate the skin. However, in future formulations, nanotechnology may increase the stability of vitamin C and enhance its ability to penetrate the skin.

“Since anti-aging products that contain nanoparticles of antioxidants will be harder to make, we expect that these products will cost more than products using traditional formulations,” said Dr. Nasir. “Once these products are determined to be safe, the consumer will have to decide if the increased costs are worth the added benefits.”

The rapidly growing field of nanotechnology and its future use in cosmetic products holds both enormous potential and potential concern for consumers. Currently, major cosmetic manufacturers have imposed a voluntary ban on the use of nanoparticles in products while they await a ruling from the Food and Drug Administration (FDA) regarding the safety of this technology. However, these manufacturers know that when ingredients in products such as sunscreens and anti-aging products are converted into nano-sized particles, the end product displays unique properties that can benefit the skin in ways that otherwise could not be achieved using larger-sized particles.

Speaking today at the 68th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Adnan Nasir, MD, PhD, FAAD, clinical assistant professor in the department of dermatology at the University of North Carolina in Chapel Hill, presented an overview of nanotechnology and how nanoparticles may eventually be used in cosmetic products.

“Research in the area of nanotechnology has increased significantly over the years, and I think there will be considerable growth in this area in the near future,” said Dr. Nasir. “The challenge is that a standard has not been set yet to evaluate the safety and efficacy of topical products that contain nanosized particles.”

An investigational vaccine for the asbestos-related cancer mesothelioma is safe, according to a new study.

Researchers in the Netherlands tested the vaccine — which infuses a patient’s own dendritic cells with antigen from the patient’s tumor — on 10 patients and found that it induced an immune T-cell response against mesothelioma tumors.

This is the first time DC-based immunotherapy has been tested in patients with mesothelioma, which typically occurs in the lungs but can arise at other body sites. The study was published online March 4 in advance of an upcoming print issue of the American Journal of Respiratory and Critical Care Medicine.

Asbestos has been banned in developed countries for decades, but the incidence of mesothelioma is expected to continue to increase until 2020. Median survival after mesothelioma diagnosis is about 12 months. The standard chemotherapy treatment improves survival by about three months.

“The possibility to harness the potency and specificity of the immune system underlies the growing interest in cancer immunotherapy,” study author Dr. Joachim Aerts, a pulmonary physician at Erasmus Medical Center, said in a news release. “One such approach uses the patient’s own [dendritic cells] to present tumor-associated antigens and thereby generate tumor-specific immunity.”

Dendritic cells are a form of immune system cell.

“The major problem in mesothelioma is that the immunosuppressive environment caused by the tumor will negatively influence our therapy so we are now working on a method to lower this immunosuppressive environment,” Aerts said. “We hope that by further development of our method it will be possible to increase survival in patients with mesothelioma and eventually vaccinate persons who have been in contact with asbestos to prevent them from getting asbestos related diseases.”

SOURCE: American Thoracic Society

Countering prior indications that long-term use of NSAID painkillers might help reduce cancer risk, a new study suggests that these anti-inflammatory drugs offer no protection against a common skin cancer.

Previous research had suggested that routine use of NSAIDs — including such over-the counter medications as Advil, Motrin, aspirin, Celebrex and Aleve (but not Tylenol) — is associated with a reduced risk for the onset of colorectal, breast, prostate and lung cancer.

“Although there is some prior evidence, mostly laboratory-based, to suggest that NSAIDs can reduce the risk for the particular type of skin cancer called cutaneous squamous cell carcinoma, in our study, we didn’t find that association,” said the lead author, Dr. Maryam M. Asgari, an investigator in the research division at Kaiser Permanente Northern California (KPNC) in Oakland, Calif.

The study, which was supported by the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases and the U.S. National Cancer Institute, is published in the Feb. 15 online issue of the Archives of Dermatology.

To explore the potential connection between NSAIDs and skin cancer risk, Asgari and her colleagues administered questionnaires to a randomly selected pool of 415 patients between the ages of 43 and 85 who were diagnosed with skin cancer in 2004 and sought care at KPNC.

This group’s self-reported NSAID-use history between 1994 and 2004 was stacked up against that of a group of 415 healthy patients. Both groups were similar in terms of age, race and gender. As well, records detailing pharmacy-dispensed NSAID patterns among all the patients were also examined for links to skin cancer incidence.

The authors noted that 61 percent of all the patients reported routine use of NSAIDs in the decade preceding the study. Specifically, 48 percent said they had used aspirin, 18 percent ibuprofen, 5 percent naproxen (ie, Aleve), and 4 percent nabumetone (Relafen).

But regardless of dosage used, type of medication taken, and/or whether NSAIDs were pharmacy-dispensed, the anti-inflammatory drugs were not found to be associated with a drop in skin cancer risk.

In fact, those patients who had taken NSAIDs for a relatively short period of time –anywhere from one to three years– actually appeared to have a slightly increased risk for developing squamous cell carcinoma, the researchers said.

They concluded that NSAIDs did not seem to offer any protective effect with respect to skin cancer, and — given the potential toxic side-effects of long-term NSAID use — they suggested that patients at higher risk for skin cancer should be directed towards other safer, and perhaps more effective, interventions.

“We were surprised at the lack of NSAID protection,” Asgari remarked. “Particularly when we saw an increased risk for skin cancer associated with the short-term use of NSAIDs. But actually that’s not been unheard of, and I think there could be various explanations for this. Maybe people using NSAIDs short-term have other co-morbidities that make them more prone to having a weaker immune system and having poorer health. And also there are some forms of NSAIDs that do make you sun-sensitive, and more prone to getting DNA damage. That might be another explanation. But we were surprised.”

However, Eric Jacobs, strategic director of pharmaco-epidemiology for the American Cancer Society, said Asgari’s findings were not surprising.

“Results from this study are consistent with those of most previous studies,” he said. “The best way to lower the risk of non-melanoma skin cancer, including squamous cell carcinoma, is to limit your exposure to strong sunlight — for example by wearing a hat and using sunscreen — and to avoid using tanning beds and sun lamps.”

Dr. Alfred I. Neugut, head of cancer prevention and control at Columbia University’s cancer center in New York City, also found the study’s results unsurprising.

“Cutaneous squamous cell carcinoma is not your typical, run-of-the-mill cancer,” noted Neugut, who is also co-director of cancer prevention at New York Presbyterian Hospital. “While it’s one of the most common cancers — maybe the most common — it’s not aggressive, not systemic, and related almost exclusively to sun exposure. So it is not really in the same category of cancers as, say, colorectal cancer or breast cancer.”

Neugut added, “The fact that they found [NSAID use] has no effect is logical.”

SOURCES: Maryam M. Asgari, M.D., M.P.H., investigator, division of research, Kaiser Permanente Northern California, Oakland, California; Eric Jacobs, PhD, strategic director of pharmaco-epidemiology, American Cancer Society, Atlanta; Alfred I. Neugut, M.D., PhD, head of cancer prevention and control, Herbert Irving Comprehensive Cancer Center, Columbia University, and co-director, cancer prevention, New York Presbyterian Hospital, New York City

Exercise during pregnancy, while healthy for both mother and baby, has only a minor impact on an infant’s birth weight, suggest findings from a large study from Norway.

On the other hand, the findings confirm a strong association between being heavy prior to becoming pregnant and having a heavier baby, Caroline Fleten of the Norwegian Institute of Public Health in Oslo, and colleagues report.

Fleten and colleagues evaluated associations between exercise during pregnancy, prepregnancy weight and the baby’s weight at birth for 43,705 women aged 15 to 49 years old and pregnant with a single fetus.

They determined body mass index (BMI), a standard measure of how fat or thin a person is. On average, prepregnancy BMI of the women in the study was 24. For reference, a BMI of 25 or higher is considered overweight, while a BMI of 30 or higher is considered obese.

Fleten’s team found that each single unit increase in mothers’ prepregnancy BMI was associated with about 20 grams (0.70 ounces) heavier weight at birth. As an example, an increase in BMI of 5 units — 29 versus 24 for example — would result in a birth weight increase of 103 grams (3.63 ounces).

The women reported brisk walking, jogging, bicycling, aerobics, fitness or weight training, or other physical activities an average of 6 times a month during the first 17 weeks of pregnancy and then 4 times a month until week 30.

The average weight of infants at birth was 3,677 grams (about 8 pounds) and, according to the investigators, exercise during pregnancy had no significant effect on birth weight.

“Exercise during pregnancy cannot be used as a means of ‘normalizing’ birth weight,” Fleten commented in an email to Reuters Health.

She and her colleagues suggest that health care professionals focus on preventing or treating overweight and obesity in women of childbearing age, which would reduce the risk of giving birth to a baby weighing too much.

SOURCE: Obstetrics and Gynecology

Repeat weight-loss surgery carries a higher risk of complications than the initial surgical procedure, new research has found.

The surgical treatment, known as bariatric surgery, is the only effective method for long-term weight loss in severely obese people. Rates of repeat bariatric surgery are reported to range from 5 percent to 56 percent, according to background information in the new study.

In their report, Greek researchers looked at 56 patients who had repeat bariatric surgery between 1995 and 2008. The patients had an average age of 39.6, and an average body mass index (BMI) of 46.9. (BMI is a measurement that takes into account weight and height, and those with a BMI over 30 are considered obese.)

The three main reasons for the “revisional” bariatric surgery were: unsatisfactory weight loss after the initial procedure; severe nutritional complications such as protein malnutrition; and intolerable side effects such as blocking or narrowing of the digestive tract.

The patients were followed-up for an average of 102 months after their revisional surgery. None of them died, but 19 (33.9 percent) had serious complications within one to three months after surgery, including internal leakage from the surgical site, acute kidney failure and pneumonia.

Late complications, which are those that occurred more than 90 days after surgery, were reported in 13 patients (23.2 percent). These complications included hernia at the incision site and narrowing of the passageway between the stomach and intestine, the study authors noted.

The 39 patients who had revisional surgery due to inadequate weight loss after their initial procedure achieved a significant decline in BMI, from an average of 55.4 to an average of 35, with an average loss of nearly 69 percent of excess body weight. The revisional surgery also benefited those who experienced nutritional complications and intolerable side effects after their initial procedure, according to the study published in the February issue of the journal Archives of Surgery.

“The accelerated growth of bariatric surgery during the last decade has led to a proportional increase of bariatric revisions worldwide. As improvements in technique and instrumentation take place in this surgical field, along with the novel compelling application of bariatric surgery in the treatment of severe metabolic disorders, it is very likely that revision rates of both failed operations of the past and currently popular procedures will increase considerably in the near future,” concluded the researchers at the University Hospital of Patras in Rion, Greece.

“New concepts and improved techniques by well-trained surgeons in properly organized institutions coupled with cautious patient selection represent the cornerstone for achieving favorable results and for extending patients’ longevity,” the researchers added.

SOURCE: JAMA/Archives journals, news release

A new study shows that candy, soda and other junk foods are commonly sold at stores not traditionally associated with food — in a trend that researchers say may be contributing to the U.S. obesity problem.

The study, of more than 1,000 non-food retail stores across the U.S., found that 41 percent sold candy, soft drinks, chips and other sweet and salty snacks. The foods were most commonly placed at check-out counters, where they were “within arm’s reach” of impulsive buyers, the researchers report in the American Journal of Public Health.

Nearly all drug stores and gas stations in the study sold snack foods — as did a majority of general merchandise stores, hardware and garden stores and automobile repair shops.

Even some stores selling clothes, books or furniture offered customers a snack selection.

The problem, the researchers contend, is that this “ubiquity” of snack foods may tempt many people into buying calories that they otherwise would not.

And over time, those calories could add up to extra pounds, write Dr. Thomas A. Farley and colleagues at Tulane University School of Public Health in New Orleans.

A number of studies, the researchers note, have found that when people grab snacks throughout the day, they typically do not compensate by eating less at meals.

“This suggests that calories consumed through impulse purchases of snack foods will increase total daily (calorie) intake and thus contribute to weight gain,” Farley and his colleagues write in their report.

They estimate that if a person sees snack foods at retail stores twice per week, and ends up buying a typical product only 10 percent of the time, that would mean an extra 2,600 calories in a year. That, in turn, could translate to close to a pound of weight gain per year.

For their study, the researchers evaluated 1,082 retail stores in 19 U.S. cities. They found that about 95 percent of drug stores and gas stations sold soft drinks and prepackaged snacks and sweets. The same was true of two-thirds of general merchandise stores.

In addition, a number of retailers not normally associated with food carried snack items, in some cases via vending machines or offered to customers for free. That included 39 percent of salons, 29 percent of rental businesses and bookstores, 22 percent of stores selling furniture and electronics, and 16 percent of clothing and accessory retailers.

The researchers note that traditional food establishments are required to have a permit to sell food. But that is not true of stores that sell only “prepackaged foods that are not potentially hazardous” — that is, they do not present a risk of foodborne illness.

The researchers add, however, that the 100,000 annual deaths in the U.S. attributed to obesity far outnumber deaths from foodborne pathogens. “So it may be justified,” they write, “to revisit the definition of potentially hazardous and to include (calorie)-dense snack foods.”

SOURCE: American Journal of Public Health

Exercise appears to help prevent and improve mild cognitive impairment, two new studies show.

Researchers found that people who did moderate physical activity in midlife or later had a reduced risk of mild cognitive impairment and that six months of high-intensity aerobic exercise improved cognitive function in people with mild cognitive impairment.

Mild cognitive impairment is an in-between state between the normal changes in thinking, learning and memory changes that come with age and dementia, one of the studies explained. Up to 15 percent of people with mild cognitive impairment develop dementia each year, compared with 1 percent or 2 percent of the general population.

The first study included 1,324 dementia-free volunteers taking part in the Mayo Clinic Study of Aging. The participants completed a physical exercise questionnaire and were assessed and classified as having normal cognition (1,126) or mild cognitive impairment (198).

Those who said they did moderate exercise — such as swimming, brisk walking, yoga, aerobics or strength training — during midlife were 39 percent less likely to have mild cognitive impairment, while those who did moderate exercise later in life were 32 percent less likely to have the condition.

The Mayo team said exercise may guard against mild cognitive impairment through production of nerve-protecting compounds, increased blood flow to the brain, improved development and survival of neurons, and decreased risk of heart and blood vessel diseases.

The second study included 33 adults, average age 70, with mild cognitive impairment. Some were randomly assigned to do high-intensity aerobics for 45 to 60 minutes a day, four days a week. Others were put in a control group that had the same workout schedule, but did stretching exercises and kept their heart rate low.

After six months, the patients who did high-intensity aerobic exercise had improved cognitive function compared to those in the control group. The beneficial effects were more pronounced in women than in men, possibly because the body’s use of and production of insulin, glucose and the stress hormone cortisol differed in women and men.

“Aerobic exercise is a cost-effective practice that is associated with numerous physical benefits. The results of this study suggest that exercise also provides a cognitive benefit for some adults with mild cognitive impairment,” wrote Laura D. Baker, of the University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System in Seattle, and colleagues.

The studies appear in the January issue of the Archives of Neurology.

Researchers have found a genetic mutation that helps predict which men will have aggressive prostate cancer and said it might help doctors choose who needs treatment and who does not.

Men with the genetic change had a 26 percent higher risk of having aggressive prostate cancer, the researchers reported in the Proceedings of the National Academy of Sciences.

“A single variant with a moderate effect such as this is unlikely to be sufficient on its own at predicting risk,” said Jianfeng Xu of Wake Forest University School of Medicine in North Carolina, who led the study.

“But its identification is significant because it indicates that variants predisposing men to aggressive disease exist in the genome.”

Prostate cancer is the second-leading cancer killer of U.S. men, after lung cancer, with more than 192,000 cases diagnosed in 2009 and 27,000 deaths, according to the American Cancer Society.

Most cases are very slow-growing and would never kill the patient or even cause symptoms, but it is very difficult to predict whose tumors are likely to spread.

A report in the Journal of the American Medical Association in September said that 85 percent of cases will never spread, and another study published in August found that 1 million U.S. men had been diagnosed with and treated for prostate tumors that would never have harmed them.

“We speculate that a panel of variants could be an important part of developing a screening strategy that could reduce the number of men requiring screening, thereby reducing over-diagnosis, while also identifying men at risk for developing aggressive disease at a stage when the disease is potentially curable,” Xu said.

The international team of researchers studied 4,849 men with aggressive prostate cancer that had spread and 12,205 men with slow-growing disease, looking at 27,000 different genetic mutations called single nucleotide polymorphisms or SNPs.

They found one that was 26 percent more common in the men with aggressive disease. It was found in 32 percent of 4,829 men with aggressive disease and 28 percent of 12,205 men who had slow-growing cancers.

This could be more useful than some of the other SNPs that have been linked with prostate cancer, they said, but will not, on its own, be good for predicting who needs surgery or radiation to treat early stage prostate cancer.

Better screening, healthier living and new treatments have all continued to help cut the annual number of cancer cases and deaths in the United States, a new report says.

The findings showed that new cancer cases and deaths from cancer have declined significantly for both men and women and for most racial/ethnic populations.

These decreases were largely due to decreased incidence and death from lung, prostate and colon cancer among men and a drop in two of the three leading cancers in women (breast and colon cancers). New diagnoses for all types of cancer in the United States declined almost 1 percent per year from 1999 to 2006 and cancer deaths dropped 1.6 percent per year from 2001 to 2006.

The report, which appears in the Dec. 7 online edition of Cancer, was compiled from data by the American Cancer Society, the U.S. Centers for Disease Control and Prevention, the U.S. National Cancer Institute and the North American Association of Central Cancer Registries.

“For me, when I see the downturn in some cancers it says we can actually address the cancer burden through a variety of efforts,” said report author Brenda K. Edwards, associate director of the Surveillance Research Program at the U.S. National Cancer Institute.

But the battle against cancer continues, she stressed. “We see the downturn in mortality, but we still have almost 1.5 million people with new cancer diagnoses in 2009. So, we still have a large number of people affected. For some of them, we have relatively effective treatments and for others not so.”

Edwards noted that for the cancers that have seen the biggest decreases, such as breast and colon cancer, effective screening methods probably explain the downward trend, although there are still too few people who take advantage of them.

Cancer rates are still higher for men than for women, but men had the biggest declines in new cases and death, the report showed.

This year’s report focused on trends in colorectal cancer. Colorectal cancer, the third most-diagnosed cancer in both men and women, is also the second-leading cause of cancer deaths in the United States. Overall, colon cancer rates are declining, but the decline is mostly among those over 65. Increasing numbers of cases in men and women under 50 is worrisome, the report noted.

Among both men and women, there were major declines in colorectal cancer cases from 1985 to 1995, minor increases from 1995 to 1998, and significant declines from 1998 to 2006. Since 1984, death rates also dropped, with accelerated rates of decline since 2002 for men and since 2001 for women.

In fact, from 1975 to 2000, cases of colorectal cancer fell 22 percent; 50 percent of which was most likely due to changes in lifestyle, and 50 percent to more people being screened.

In addition, deaths from colorectal cancer fell 26 percent during the same time; 9 percent of the drop came from lifestyle changes, 14 percent came from screening and 3 percent came from improved treatment, according to the report.

Going forward, if there were no changes in lifestyle, screening or treatment, there would be a 17 percent drop in colorectal cancer deaths from 2000 to 2020. However, if current trends remain the same, there will be a 36 percent drop in colorectal cancer deaths.

But, if more Americans adopted more healthy lifestyles, such as quitting smoking, and were screened for colon cancer and had access to optimal treatment (such as more effective chemotherapy), deaths from colon cancer could be reduced by 50 percent by 2020, the report predicted.

Other highlights from the report were that among men, cases of prostate, lung, oral cavity, stomach, brain, colon and rectum cancers have declined, but cases of kidney/renal, liver and esophageal cancer, along with leukemia, myeloma and melanoma, are increasing.

Among women, cases of breast, colorectal, uterine, ovarian, cervical and oral cavity cancers decreased, but cases of lung, thyroid, pancreatic, bladder and kidney cancers, along with non-Hodgkin lymphoma, melanoma and leukemia are on the rise.

Where cancers have increased, Edwards noted that in most cases there are no effective screening tests to catch the cancer early. In addition, for many of these cancers, the causes aren’t known and there aren’t effective treatments, she said.

Cancer death rates remain highest among blacks and lowest among Asian/Pacific Islanders. Although death rates by race/ethnicity were similar for most cancers, deaths from pancreatic cancer, the fourth most common cause of cancer death in the United States, increased in white men and women but dropped among black men and women.

Among men, except for Asian/Pacific Islanders, the three leading causes of cancer death were lung, prostate and colorectal cancer. Among Asian/Pacific Islanders, lung, liver and colorectal cancers were the top three causes of cancer death.

For women, except Hispanic women, the three leading causes of cancer death were lung, breast and colorectal cancer. For Hispanic women, breast cancer was the leading cause of cancer deaths, the study authors noted.

These differences in death rates may be due to differences in risk behaviors, socioeconomic status and access to and use of screening and treatment, according to the report.

While these trends are expected to continue, they could be accelerated if more people would make the lifestyle changes needed to reduce their risk of cancer. These include not smoking, maintaining a healthy weight, eating a healthful diet and exercising.

In addition, lives could be saved if more people were screened for cancers such as breast and colon cancer, and if there was more access to newer treatments, the report said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said that “there is enormous detail in this comprehensive report, but the take-away message is as clear as it is compelling: the incidence and death toll from cancer are both steadily, if gradually, declining.”