Inside this issueCover stories$5 million grant funds dyslexia studyDoing the right thing: can neuroscience research make it easier?Philanthropists aid a young scientist’s innovative researchPeopleSkin cancer expert is appointed new Smith ProfessorLifelines: Judy ChoInnovative teacher, RNA expert is new Ford Professor
New Duberg Professor explores the brain’s intricate networksProtein sorting, kidney disease are interests of Long ProfessorProtein basic to life is research focus of new Higgins ProfessorOut & aboutScienceNewest research building is recognized for environmental features Advances: Versatile molecule protects against IBD | Aspirin for the heart, now for the liver? | Can we really ‘catch’ healthy behaviors? | A needless barrier to good patient care
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AdvancesHealth and science news from YaleVersatile molecule protects against IBD
Immune system signaling molecules known as cytokines are believed to play a major inflammatory role in autoimmune diseases, in which the body’s immune defenses somehow turn on its own cells. Things aren’t so simple in the case of the cytokine interleukin-22 (IL-22; right), which promotes the inflammation of skin cells seen in psoriasis but appears to protect cells in inflamed livers. Scientists from the laboratory of Richard A. Flavell,Ph.D., Sterling Professor of Immunobiology, and Regeneron Pharmaceuticals have now found that IL-22 also plays a protective role in inflammatory bowel disease (IBD; see “Intestinal Fortitude”). As reported in the December issue of Immunity, mice that were deficient in interleukin-22 had more severe forms of colitis and higher mortality. Postdoctoral associate and first author Lauren A. Zenewicz, Ph.D., says the discovery could lead to IBD treatments without the side effects of current immunosuppressive therapies, which include increased susceptibility to infections. Aspirin for the heart, now for the liver?The popular pain and fever reliever acetaminophen, best known as Tylenol but sold under many other trade names, is usually thought of as an aspirin alternative. But a new Yale study suggests that adding a bit of aspirin to acetominophen might deal with the risk of liver toxicity that is one of the drug’s most problematic side effects. In an article published online in the Journal of Clinical Investigation in January, Associate Professor of Medicine Wajahat Z. Mehal, Ph.D., and colleagues describe how acetominophen-induced liver damage (which can progress to acute liver failure) is caused by a biochemical double whammy: first liver cells die, then their death triggers an inflammatory response mediated by the coordinated activation of two components of the innate immune system, TLR9 and Nalp-3. The team showed that liver damage could be headed off in mice either with TLR-blocking drugs or by using aspirin to tamp down the Nalp-3 response. These results may have wide application, says Mehal. “Many agents such as drugs and alcohol cause liver damage, and we have found two ways to block a central pathway responsible for such liver injury,” he says. “Our strategy is to use aspirin on a daily basis to prevent liver injury, but if it occurs, to use TLR antagonists to treat it.”
Can we really ‘catch’ healthy behaviors?
Research suggesting that certain behaviors affecting health are “contagious”—that people who quit smoking are likely to influence friends to do the same, or that happiness spreads from one person to another—has generated a great deal of media buzz. But the statistical techniques used to establish these so-called network effects are prone to “large biases that might produce effects where none exist,” says Jason M. Fletcher, Ph.D., M.S., assistant professor of public health. Fletcher and a colleague studied headaches, acne and height, conditions for which network effects are implausible. In the December 4 issue of the British Medical Journal, the team reports “surprisingly high” network effects for these conditions that disappeared with statistical refinements. “Our results suggest caution in attributing similarities of health outcomes between friends to a ‘contagious’ process,” Fletcher explains. A needless barrier to good patient careAccording to the 2000 U.S. Census, more than 22 million Americans have limited proficiency in English, a 53 percent increase from 1990. Language barriers in health care settings can lead to poor understanding of instructions for medications, longer hospital stays and an increased risk of medical errors and misdiagnoses. Despite these dangers, many physicians fail to use readily available interpreters with their non–English speaking patients, according to a study published in the February issue of the Journal of General Internal Medicine. “It has become acceptable for a physician to rely on his or her own limited language skills, hand gestures or on the convenience of a patient’s family member instead of calling a professional interpreter, even when one is available,” says lead author Lisa C. Diamond, M.D., now of the Palo Alto Medical Foundation Research Institute, who initiated the study as a Robert Wood Johnson Clinical Scholar at the School of Medicine. “The study shows that there will be no easy fix,” says Elizabeth H. Bradley, Ph.D., M.P.H., professor of public health, who co-authored the new report along with Research Scientist Leslie Curry, Ph.D., M.P.H.. “But clearly this is an important and widespread problem.”  |
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