Yoga Combats Fibromyalgia
Posted by on November 1, 2010 - 2:22pm

According to new research conducted at Oregon Health & Science University, yoga exercises may have the power to combat fibromyalgia — a medical disorder characterized by chronic widespread pain. The research is being published in the November 10 edition of the journal Pain and will appear online Thursday, Oct. 14.

Fibromyalgia is a syndrome predominantly characterized by muscle pain and fatigue. It can cause sleep problems and psychological stress. Other symptoms often include morning stiffness, tingling or numbness in the extremities, headaches, memory problems, difficulty with swallowing, and bowel and bladder problems.  Fibromyalgia affects between 11 million and 15 million Americans with 85-90% of the cases in women.  The cause of fibromyalgia is currently unknown, but it is believed that genetics and physical/emotional stress may play a role.

“Previous research suggests that the most successful treatment for fibromyalgia involves a combination of medications, physical exercise and development of coping skills,” said James Carson, Ph.D., a clinical health psychologist and an assistant professor of anesthesiology and perioperative medicine in the OHSU School of Medicine. “Here, we specifically focused on yoga to determine whether it should be considered as a prescribed treatment and the extent to which it can be successful.”

In this study, researchers enrolled 53 female study subjects previously diagnosed with fibromyalgia. The women were randomly assigned to two research groups. The first group participated in an eight-week yoga program, which included gentle poses, meditation, breathing exercises and group discussions. The second group of women — the control group — received standard medication treatments for fibromyalgia.

Following completion of the yoga program, researchers assessed each study subject using questionnaires and physical tests. The results were then compared with testing results obtained prior to the yoga classes. The members of the control group underwent the same evaluations. In addition, each participant in the yoga group was urged to keep a daily diary to personally assess their condition throughout the entire program.

Comparison of the data for the two groups revealed that yoga appears to assist in combating a number of serious fibromyalgia symptoms, including pain, fatigue, stiffness, poor sleep, depression, poor memory, anxiety and poor balance. All of these improvements were shown to be not only statistically but also clinically significant, meaning the changes were large enough to have a practical impact on daily functioning. For example, pain was reduced in the yoga group by an average of 24 percent, fatigue by 30 percent and depression by 42 percent.

“One likely reason for the apparent success of this study therapy was the strong commitment shown by the study subjects. Attendance at the classes was good as was most participants’ willingness to practice yoga while at home,” added Carson. “Based on the results of this research, we strongly believe that further study of this potential therapy is warranted.”

Sex Differences and Vaccine Response
Posted by on June 1, 2010 - 8:56am

Biological differences between the sexes could be a significant predictor of responses to vaccines, according to researchers at the Johns Hopkins Bloomberg School of Public Health. They examined published data from numerous adult and child vaccine trials and found that sex is a fundamental, but often overlooked predictor of vaccine response that could help predict the efficacy of combating infectious disease. The review is featured in the May 2010 issue of The Lancet Infectious Diseases.

“Sex can affect the frequency and severity of adverse effects of vaccination, including fever, pain and inflammation,” said Sabra Klein, PhD, lead author of the review and an assistant professor at the Bloomberg School’s W. Harry Feinstone Department of Molecular Microbiology and Immunology. “This is likely due to the fact that women typically mount stronger immune responses to vaccinations compared to men. In some cases, women need substantially less of a vaccine to mount the same response as men. Pregnancy is also a factor that can alter immune responses to vaccines.”

Researchers conducted a review of existing literature on several vaccines including yellow fever, influenza, measles, mumps and rubella, hepatitis and herpes simplex to obtain evidence of the difference in responses between women and men. They also examined the effect hormonal changes that occur during pregnancy have on vaccine efficacy. Researchers found that despite data supporting a role for sex in the response to vaccines, most studies did not document sex-specific effects in vaccine efficacy or induced immune responses.

“Understanding the biological differences between men and women to vaccines could have led to better distribution of the 2010 H1N1 vaccine during the early months. Our review of the literature found that healthy women often generated a more robust protective immune response to vaccination when compared to men,” said Andrew Pekosz, PhD, associate professor at the Bloomberg School’s W. Harry Feinstone Department of Molecular Microbiology and Immunology. “An understanding and appreciation of the effect of sex and pregnancy on immune responses might change the strategies used by public health officials to start efficient vaccination programs, optimizing the timing and dose of vaccines so that the maximum number of people are immunized.” added Klein.
“The Xs and Y of Immune Responses to Viral Vaccines” was written by Sabra L. Klein, Anne Jedlicka and Andrew Pekosz.

Source:   Johns Hopkins Newscenter

Do women need such big flu shots?
Posted by on November 4, 2009 - 11:34am

Dr. Sabra L. Klein, an assistant professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, and Phyllis Greenberger, the president and chief executive of the nonprofit Society for Women’s Health Research, recently wrote an opinion piece for the New York Times called, "Do Women Need Such Big Flu Shots?".

Image: McAlpin, NYdailynews.com

Image: McAlpin, NYdailynews.com

The gist of their argument is actually based on the same idea as many of our recent blog entries: women, on average, have a much stronger immune system than men. The authors cite studies that demonstrate that women produce more antibodies in response to the same vaccine dose than men do. The authors conclude that women could therefore be given a smaller dose of the H1N1 flu vaccine and still get the same protection; the vaccine that is saved by giving women smaller doses would allow more people to get the much in-demand shot.

It's an interesting hypothesis that really highlights the need for more gender-aware research and clinical trials. Sure, women were included in the clinical trials of the vaccine, but were they ever tested with a more tailored dosage? I'd guess not; I'd imagine the tests were more simply on the efficacy of the standard, male-tailored dose in women, not on whether a different dose could work as well. I applaud the article for highlighting these questions that definitely need to be addressed!

Science Mini-Lesson: X chromosome inactivation
Posted by on October 21, 2009 - 10:00am
Image: Indigo Instruments

Image: Indigo Instruments

In a recent post called, "Autoimmunity and Gender", we mentioned that one reason women are more prone to autoimmune disorders, or those conditions where the body's immune system attacks its own cells, is because of chromosomal influence, but we didn't elaborate. If you're guessing that it has something to do with the sex chromosomes, the X and Y, you are totally correct...but it may not be for the reason you think. It is not merely the presence of the two X chromosomes in genetic females that leads to autoimmune disorders, but the way the body handles them.

Genetic females have two X chromosomes while genetic males have one X and one Y, so females have twice as many X genes as males, right? Wrong! The X chromosome is incredibly rich in genes that are then made into proteins, while the Y has significantly fewer important genes. Fortunately, the body recognizes this potentially harmful difference in gene number and corrects the problem by a process called X-chromosome inactivation. In this process, every cell in the body chooses one X chromosome, either the one inherited from the mother or the one from the father, to make inactive. That DNA in that chosen chromosome is then wound up very very tightly to form what is called a barr body. Because it is wound up so very tightly (a formation called heterochromatin), the genes from the barr body can not be made into proteins, so it is considered inactive.

If genetic females have one active X chromosome, and so do males, how does this influence the risk of autoimmune disorders? Well, remember that every cell chooses which X chromosome to inactivate and that they do this independently of each other. One heart cell may inactive the X chromosome from the mother, while another right beside it inactivates the X chromosome inherited from the father. This makes all genetic females a type of genetic mosaic: our cells can express two different sets of chromosomes depending on which X chromosome is inactivated.

Image: Haane-Mugaas.com

Image: Haane-Mugaas.com

Getting to the point, think about immune cells: they're these destroyer cells whose sole mission is to hunt down and kill any cells that don't match their DNA code. Usually, this is a good way to target the bacteria and viruses that don't belong, but the immune cells can also get a little too good at their job. If an immune cell that has inactivated the maternal X chromosome meets a nerve cell that has inactivated the paternal X chromosome, that immune cell could be triggerred to destroy the "invader." That, in the end, is how having two X chromosomes can lead to increased risk of autoimmune disorders in genetic females.

PS- Why the picture of the calico cat? Besides the fact that cats rule, fur color is also X linked and depends on X chromosome inactivation. One fur cell decides to inactivate the maternal X carrying orange color, so that cell (and all the cells that come from it) are black or white. Nearby, the opposite happens and you get a patch of orange fur from Mom's X chromosome staying active. It's science in action!

For more information:

Autoimmunity Disorders and Gender
Posted by on September 22, 2009 - 12:48pm

The NIH has a pretty cool monthly podcast called “Pinn Point on Women’s Health,” which is hosted by Dr. Vivian Pinn, director of the NIH’s Office of Research on Women’s Health. For September, the topic was Autoimmune Disease in women (NIH summary and directions for downloading the podcast can be found here.)

The topic is fascinating! Autoimmune diseases are those where the body , for whatever reason, starts fighting its own cells with an immune response in the same way it would if the cells were a foreign invader (bacteria, virus etc). Women are more likely to get a whole host of autoimmune diseases than men are, including multiple sclerosis, rheumatoid arthritis, and lupus. Apparently, out of all the people suffering from auto-immune diseases in the US, 80% are female. That’s a phenomenal bias for a condition that, on the surface at least, has no clear tie to gender. According to the research (great review here), our increased risk of getting these diseases is simply our great immune systems working against us. Apparently, our immune systems are so great that we’re less prone to infection and have a much greater antibody response to those little invaders that do get in. Unfortunately, our systems are so strong that they also tend to go into overdrive, leading to this attack of our own bodies. The culprits (or overachieving heroes, depending on how you look at it), are likely exactly what you’d expect: hormones or chromosomal influences. The hormone research actually shows that during pregnancy, women's immune systems switch to a far less aggressive regimen, likely to avoid attacking the fetus as an invader. This decreased immunity is the reason for the increased risk of pregnant women getting the flu that Alison mentioned, but it’s also the reason that many pregnant women notice a decrease in their symptoms of autoimmune disorders. I actually have/had a condition called tranverse myelitis, which is thought to be an autoimmune disorder; I also very rarely catch the normal seasonal bugs that float around the office, and I don’t think I’ve ever had the flu (knock on wood!). It’s kind of amazing to think that both the bad and the good stem from the same source: an incredibly strong immune system! Anyone else notice that same thing in his/her self, or anyone they know with autoimmune disorders?