Saturday, 30 August 2014

British Crayfish Facing Extinction Due to Fungal Infection

A recent story in the Independent newspaper tells us the sad tale of the last few British white clawed crayfish (our largest inland invertebrate) in Dorset now in imminent threat of being wiped out by a fungal infection against which they have little immunity.

It isn't known how the fungus (Aphanomyes astaci) has spread to the River Allen which holds 40% of the UK population and it could be that it will now spread to the remaining parts of the UK.

All 8,000 of the river’s white-clawed crayfish are forecast to perish at the hands of the plague, a fungal disease carried by the larger Signal Crayfish from America, which is immune to it. Matt Shardlow, head of the Buglife insect charity, said: “Generally there’s no coming back once the plague arrives and I think it means we’re looking at the imminent end of the species across the south west,” adding that there is a real danger it could eventually spread across the whole country.
The white-clawed crayfish is the UK’s only native crayfish species. Other populations exist in the UK in areas such as the Midlands and East Anglia, but numbers are sparse and traditional strongholds in the Peak District and Ribble river in the North West have been almost wiped out. The species is on the endangered list.
The spread of the disease to the River Allen will accelerate the decline of the species, which is already estimated to have tumbled by 95 per cent since its peak. Once the disease infects crayfish, they are typically killed within weeks.Signal crayfish were brought to the UK in the 1970s, with many escaping into waterways through canals and some released into water courses because they can be fished for their tails. Their damage has been intensified by the ease with which they spread through waterways.

Original article

Friday, 29 August 2014

GPs urged to test all asthma patients for allergies to reduce attacks

This recent article in the publication 'GP' highlights the issue of allergens in the patients environment causing at least some of the worsening of their symptoms, sometimes leading to acute attacks. Prevention of exposure could help two thirds of all asthma patients in the UK control their illness more effectively. Prevention starts with awareness on the part of the patient but also on the part of their doctor but the important allergy tests are not being carried out.

Asthma UK states that if more allergy tests (including dust mite, pollen, animal dander, food and mould) were carried out then patients (and their carers) would be able to avoid their triggers and thus manage their own illness better. Two thirds do not know what their triggers are!

Moulds in particular are increasingly coming under suspicion as having a lot more involvement in uncontrolled asthma than previously suspected. Severe Asthma with Fungal Sensitisation (SAFS) is a fairly new concept that affects roughly half of all severe, uncontrolled asthmatics. Treatment with an oral antifungal is known to benefit such patients.

 Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Friday, 22 August 2014

Report on the State of the Art of Rare Disease Activities in Europe – 2014

Rare diseases are diseases with a particularly low prevalence; the European Union considers diseases to be rare when they affect not more than 5 per 10 000 persons in the European Union. It is estimated that between 5 000 and 8 000 distinct rare diseases exist, estimated as affecting between 6% and 8% of the population in the course of their lives. In other words, although rare diseases are characterised by low prevalence for each of  them, the total number of people affected by rare diseases in the EU is estimated at between 27 and 36 million. Most of them suffer from less frequently occurring diseases affecting one in 100 000 people or less.

These patients are particularly isolated and vulnerable. The definition of a rare disease as having a prevalence of not more than 5 in 10 000 first appeared in EU legislation in Regulation (EC) N°141/2000 of the European Parliament and of the Council of 16 December 1999 on orphan medicinal products.

The Community action programme on rare diseases including genetic diseases for the period 1 January 1999 to 31 December 2003 then applied this definition to the field of public health.

Most rare diseases are genetic diseases, the others being rare cancers, auto-immune diseases, congenital
malformations, toxic and infectious diseases among other categories. Research on rare diseases has proved to be very useful to better understand the mechanism of common conditions such as obesity and diabetes, as
they often represent a model of dysfunction of a single biological pathway. However, research on rare diseases is not only scarce, but also scattered in different laboratories throughout the EU. The lack of specific health policies for rare diseases and the scarcity of expertise, translate into delayed diagnosis and difficult access to care. This results in additional physical, psychological and intellectual impairments, inadequate or even harmful treatments and loss of confidence in the health care system, despite the fact that some rare diseases are compatible with a normal life if diagnosed on time and properly managed. Misdiagnosis and non-diagnosis are the main hurdles to improving quality of life for thousands of rare disease patients.

The specificities of rare diseases, including a limited number of patients and scarcity of relevant knowledge and expertise, single them out as a distinctive domain of very high European added-value. European cooperation can help to ensure that scarce knowledge can be shared and resources combined as efficiently as possible, in order to tackle rare diseases effectively across the EU as a whole. The European Commission has already taken specific steps in many areas to address the issues of rare diseases. Building on those achievements, the Commission Communication on Europe's Challenges in the field of Rare Diseases (11 November 2008) and the Council Recommendation on an action in the field of rare diseases (08 June 2009) aim to give a clear direction to present and future Community activities in the field of rare diseases in order to further improve the access to and equity of prevention, diagnosis and treatment for patients suffering from a rare disease throughout the European Union.

Report on the state of the art of rare disease activities in Europe – 2014 edition (Part 1: Overview of rare disease activities in Europe)

Thursday, 21 August 2014

Aspergillus fumigatus: Wellcome Trust Image of the Week

Artists impression of Aspergillus fumigatus, painted by Peter Thwaites commissioned by the Medical Mycology and Fungal Immunology Consortium to promote medical mycology research and increase public understanding of the clinical importance of fungal infections.

The other aims of the Consortium, led by the Aberdeen Fungal Group at the University of Aberdeen and funded by a Wellcome Trust Strategic Award, are to promote cross disciplinary research across the UK, to build capacity in the medical mycology sector and to train a new generation of scientists from countries of low- and middle- income with high endemic burdens of fungal disease.

Full article

Wednesday, 20 August 2014

A Potential New Way to Attack Aspergillosis?

There has been notable success in the clinical application of a recent advance in cancer research whereby patients with Chronic Lymphoid Leukemia (CLL) have been treated with T cells that have been modified so as to target them directly at the cancer cells. T cells are an important part of our response to infection and help our bodies attack and destroy invading microbes or other foreign material.

The targeting is carried out by inserting a specific gene (Chimeric Antigen Receptors) into the T cells so as to enable the to recognise tumour specific cell surface proteins. Presumably the T cells can then recognise the cancer cells, attach to them and aid their destruction with high efficiency. Thus far we have tried this in two patients who have cancer and have achieved total remission of the cancer after 11 months. Remarkable!

Green fungal spore attacked by modified T cells

This new research group are now attempting the same thing but this time the targeted illness is not cancer but aspergillosis. They are using the same techniques but this time are guiding the T cells to the fungal cell wall and have had good success so far. They are not yet at the stage where they can start to treat 'real patients' but have released several videos (see link to paper above) that show cells attaching to the germinating fungus and killing it. The image above is a still from one of those videos - the green object in the middle is a germinating fungal spore which is surrounded by activated T cells that ultimately destroy it. Experiments in mice have also given positive results.

This may well result in a useful addition to our weaponry as we attack fungal infection - time will tell how effective it will be but we can speculate that combined with antifungal drugs that utilise different targets of attack we will have more chance of nullifying fungal infection in future.

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