Leonardo Da Vinci - View Of A Skull c.1489 (Pen and Ink), Galleria dell’Accademia, Venezia

I spend a lot of time talking at schools about life, money, careers, and yes, health. I know it is next to useless to say to a teenager “Don’t Do Drugs!” - however, show then MRI scans of damage to the hippocampus from ecstasy use, or current statistics of early onset Alzheimer’s in chronic cannabis users, or psychiatric statistics of drug involvement in teenage schizophrenia and manic / depressive behaviour, or finally, amputees testimonies from collapsed veins cutting off circulation and how they just got started with gateway drugs, and yes, you get some interest.

So a little science regarding the incredible dangers of anorexia on the system is justified occasionally. The research lead by Dr Miriam Bredella, and presented at the Radiological Society of North America last weekend is compelling. Bone isn’t just there to hold up the muscle and stop us looking like a big pancake; it is essential for disease management, renewal of red and white blood cells, and for posture.

The damage to looks as well as the immune system is seriously dangerous, and even irreversible. Given that the largest source of fat in the human body is not our behinds but our brains. The body must have fat to survive and grow. It will take it from the last available source: the brain. Teenage brains are plastic; this means they are growing and changing, depriving the brain of its base composite has horrific effects on intelligence, IQ, careers, and emotional lives. Awful. Now we are seeing that the same is true for bone structure.

We need to find a way to get beyond media imaging into pictures of health and that starts with education. Hope it helps.

Children and teenagers with even mild cases of anorexia exhibit abnormal bone structure, according to a new study appearing in the December issue of Radiology and presented at the annual meeting of the Radiological Society of North America (RSNA).

“Adolescence is the most critical period for growth of bone mass, and the onset of anorexia interferes with that process,” said Miriam A. Bredella, M.D., musculoskeletal radiologist at Massachusetts General Hospital and assistant professor of radiology at Harvard Medical School in Boston. “Impairment of bone development may permanently alter bone structure and increase the risk of fractures and osteoporosis in adult life.”

Anorexia is an eating disorder characterized by emaciation, distorted body image and intense fear of gaining weight. People with the disorder are obsessed with weight control and often perceive themselves as overweight, even when they are dangerously thin. The disorder primarily occurs among young women and affects one in 100 adolescent girls, according to the National Women’s Health Information Center.

Among the many health problems associated with anorexia is bone loss. Typically, dual energy x-ray absorptiometry (DXA) is used to test bone mineral density in adolescents with anorexia.

Dr. Bredella and colleagues set out to determine if alterations in bone structure occur before significant decreases in bone mineral density become evident.

The researchers used high-resolution, flat-panel volume computed tomography (CT) and DXA to study 10 adolescent girls, age 13 to 18, with mild anorexia and 10 age-matched girls without the disorder. The new, high-resolution CT exam allowed the researchers to identify differences in bone structure between the patients with anorexia and the healthy controls, whereas bone mineral density measurements obtained using DXA did not.

The results showed that while there was not a significant difference in bone mineral density between the anorexic patients and the healthy control group, there were significant structural differences, indicating that changes in bone structure begin to occur in anorexic patients well before decreases in bone density.

“Our data suggest that reassuring values of bone mineral density obtained using DXA may not reflect the true status of bone structure in this undernourished population,” Dr. Bredella said. “In patients with anorexia, bone structure should be analyzed to detect abnormal bone health. Flat-panel volume CT allows the examination of bone at high resolution with relatively low radiation exposure making it a suitable technique for evaluation of bone structure in adolescent patients.”

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Article adapted by Medical News Today from original press release.
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“Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with Very High Resolution Flat-Panel Volume CT.” Collaborating with Dr. Bredella on this paper were Madhusmita Misra, M.D., Karen K. Miller, M.D., Ijad Madisch, M.D., Ammar Sarwar, M.D., Arnold Cheung, M.D., Anne Klibanski, M.D., and Rajiv Gupta, M.D., Ph.D.

Yes, this is a blog about the brain and work, but as I was going through the medical sites I cam across this fascinating piece from Oxford University and a team led by Professor Thomas Helleday that hasn’t appeared on Digg or other aggregate sites.

Here is the article by Jonathan Wood from the OxSciBlog site:

A new concept for cancer therapy could lead to treatments personalised to each patient’s tumour without any side effects, says Professor Thomas Helleday, who is pioneering the idea at Oxford University [watch a video describing this work].

He believes cancer may have an ‘Achilles’ heel’: The genetic damage that builds up in cancer cells and the subsequent escape from the body’s normal controls on growth may also make them very susceptible to treatments that block repair of DNA.

‘DNA damage is a prerequisite for most cancers,’ explains Professor Helleday of the Gray Institute for Radiation Oncology and Biology at Oxford University. ‘Whether that damage is a result of the tar in cigarettes, toxins or genetic and environmental factors, it can result in mutations that alter genes. That genetic instability drives cancer.’

Normal cells have many pathways and mechanisms to correct and repair DNA breaks and damage as they occur. These are crucial to maintain the normal functioning of the cell. If the damage is too great, the cells are either killed by a process called apoptosis or their growth and division is arrested so that the damage doesn’t go any further.

Many cancers have defects in one or more repair processes which enables them to sidestep these controls. ‘We can exploit these defects,’ says Professor Helleday. ‘If we can block the remaining repair systems, the body will knock out the cancer cells. Normal cells with a full set of repair kits will be fine.’

Such treatments, designed to each patient’s individual cancer, should mean patients experience few, if any, side effects from the treatment. It would be a great advance over standard chemotherapy techniques which are toxic to all dividing cells.

Professor Helleday’s group have studied defects in the BRCA1 and BRCA2 genes which predispose women to developing breast and ovarian cancer. In these cancers, a pathway that repairs mistakes when DNA is replicated no longer works, and the cancer cells are reliant on a different process based on a protein called PARP for survival.

The researchers showed that these breast and ovarian cancers could be targeted using an existing drug that inhibits the PARP protein. The idea has now been licensed to Astra Zeneca and phase II clinical trials of the drug involving a few hundred patients began in May 2007.

‘The results are better than expected,’ says Professor Helleday. ‘I thought we might see the cancers in these people stop growing. But in many cases the drug is killing off the cancer cells. The tumours have shrunk substantially and the patients report no serious side effects.’

Professor Helleday is sure this can be a general concept for tackling many cancers: ‘If there are two possible pathways for repairing damage and one is lost in a cancer, we can target the second one. This is called synthetic lethality as the drug is not toxic on it own – only for the cancer cells with this extra defect.’

‘In the future, you could imagine screening a patient’s cancer for defects, picking out the precise inhibitors to target the remaining DNA repair pathways, and treat that person’s tumour in a very targeted way.’

‘We know of thousands of these pathways in yeast. We want to extend this knowledge into humans so we can exploit them and come up with selectively toxic therapies with no side effects and no damage to normal tissue,’ he says.

Truly amazing stuff!