วันเสาร์ที่ 28 มีนาคม พ.ศ. 2558

‘หนังสือ’ อาหารสมอง สร้างสรรค์ปัญญา

‘การอ่านหนังสือ’ เป็นอีกหนึ่งกิจกรรมสร้างสรรค์ และส่งเสริมการเรียนรู้ รวมทั้งช่วยเสริมสร้างศักยภาพทางความคิด อารมณ์ และจิตใจ ให้กับผู้อ่านได้ทุกช่วงวัย
‘หนังสือ’ อาหารสมอง สร้างสรรค์ปัญญา thaihealth
“หนังสืออาหารสมอง”
นางสุดใจ พรหมเกิด  ผู้จัดการแผนงานสร้างเสริมวัฒนธรรมการอ่าน พูดถึงความสำคัญของการอ่านหนังสือว่า ‘การอ่าน’เป็นรากฐานของกระบวนการทางความคิด และยังเป็นเครื่องมือสำคัญในการพัฒนาศักยภาพมนุษย์ ซึ่งการสร้างวัฒนธรรมการอ่านเป็นสิ่งที่สมควรปลูกฝังให้กับเด็กและเยาวชน โดยพ่อแม่มีส่วนสำคัญอย่างยิ่งที่ทำให้เด็กๆ หันมาสนใจการอ่านหนังสือ ซึ่งการคัดเลือกหนังสือและสร้างเสริมพฤติกรรมที่เหมาะสมกับลูกน้อย พ่อแม่ต้องเข้าใจพัฒนาการของลูกแต่ละช่วงวัย โดยใช้‘หน้าต่างแห่งโอกาส’ ที่หมายถึง โอกาสทองในการพัฒนาสมองและลักษณะที่เหมาะสมกับเด็ก ซึ่งมีความสำคัญต่อลูกน้อยเช่นกัน
“หน้าต่างแห่งโอกาส”
นางสุดใจ อธิบายว่า ‘หน้าต่างแห่งโอกาส’ ที่พ่อแม่ช่วยเสริมสร้างของเด็กในช่วงวัย 0-2 ปี จะเป็นเรื่องของความรักความผูกพัน ความไว้วางใจผู้อื่น เมื่อเข้าสู่วัย 3-5 ปี สามารถเสริมสร้างเรื่องของการควบคุมอารมณ์ และรู้จักถูกผิด ส่วนวัย 6-9 ปี ควรเสริมสร้างด้านการเรียนรู้ การเห็นคุณค่าของตนเอง มีวินัย ประหยัด และรู้จักคุณค่าของสิ่งแวดล้อมรอบตัว รวมถึงมีปฏิสัมพันธ์ต่อสังคม
เมื่อเข้าสู่ช่วงวัย 9-12 ปี เป็นวัยที่เหมาะสมแก่การพัฒนาคุณภาพของสมอง ความคิด ทักษะการใช้ชีวิต การตื่นรู้ทางปัญญา และเมื่ออายุ 12 ปีขึ้นไป สามารถเสริมสร้างด้านค่านิยมเชิงบวก ค่านิยมทางสังคมและทางเพศ ซึ่งการเสริมสร้างหน้าต่างแห่งโอกาสให้กับเด็กอย่างเหมาะสม จะทำให้ลูกน้อยเติบโตเป็นผู้ใหญ่อย่างมีประสิทธิภาพและความสุข
‘หนังสือ’ อาหารสมอง สร้างสรรค์ปัญญา thaihealth
“หนังสือกับช่วงวัยที่เหมาะสม”
 “การคัดเลือกหนังสือให้เหมาะสม และเสริมสร้างหน้าต่างแห่งโอกาสให้กับเด็กตั้งแต่  0-6 ปี จะเริ่มจากช่วงวัย 8-10 เดือน สายตาเริ่มทำงานได้แล้ว ควรเลือกหนังสือที่มีลักษณะนุ่ม ปลอดสารพิษ เพราะเด็กวัยนี้จะมองหนังสือเป็นของเล่น จนมีอายุถึง 2 ขึ้นไป จนถึง 6 ปี ควรให้เด็กได้สัมผัสหนังสือที่เป็นรูปเล่ม เลือกหนังสือที่มีภาพมากกว่าคำบรรยาย พ่อแม่อาจสังเกตความชอบของลูกๆ ว่าเขาให้ความสนใจกับอะไรเป็นพิเศษ และหาหนังสือให้สอดคล้องกับสิ่งนั้น” ผู้จัดการแผนงานฯ แนะนำ
ผู้จัดการแผนงานฯ เสริมว่า พอเด็กถึงวัย 9-12 ปี จะชอบการสืบค้น และสนุกกับการตอบคำถามปริศนาคำทายต่างๆ สามารถเลือกหนังสือที่เกี่ยวข้องกับภาษา คณิตศาสตร์ และความคิดให้อ่านได้ หนังสือที่มีความสำคัญต่อเด็กวัยนี้ คือ หนังสือประเภทวรรณกรรมเยาวชน วรรณกรรมคลาสสิค และวรรณกรรมใหม่ หนังสือการ์ตูนคอมมิค หรือ หนังสือภาพการ์ตูน หนังสือประเภทสาระความรู้ ที่มีเนื้อหาทำให้เกิดความเกื้อกูล เห็นคุณค่า ทัศนคติเชิงเพศและสังคม จะมีความเป็นเรื่องราวที่เหมาะกับเด็กวัยนี้ซึ่งเป็นวัยที่ชอบค้นหาและช่างสังเกต
‘หนังสือ’ อาหารสมอง สร้างสรรค์ปัญญา thaihealth
“อ่านหนังสือกันเถอะ”
ผู้จัดการแผนงานฯ บอกว่า การอ่านหนังสือให้ลูกฟังก่อนนอนเป็นสิ่งที่ดี เนื่องจากเป็นช่วงเวลาที่ผ่อนคลาย  ลูกจะเกิดจินตนาการตามสิ่งที่พ่อแม่อ่าน และจะมองเห็นว่าสิ่งที่เขาชอบมาจากตัวหนังสือที่พ่อแม่อ่านให้ฟัง และจะส่งเสริมให้เด็กเริ่มอยากอ่านหนังสือตาม พ่อแม่สามารถอ่านหนังสือให้ลูกฟังได้ทุกวัน วันละ 10-15 นาที ลูกน้อยจะมีพฤติกรรมทางไอคิว และอีคิวแตกต่างจากเด็กที่ไม่ได้อ่านหนังสืออย่างชัดเจน เริ่มแรกอาจเลือกหนังสือที่มีเนื้อหาเบาๆ  สบายสมอง ช่วยให้เด็กไม่รู้สึกเบื่อ
“ที่สำคัญคือ เด็กช่วงวัย 9-12 ปี จะมีความคิดแบบเป็นเหตุเป็นผลมากขึ้น มีความสามารถในการเรียนรู้สูงมาก จะจดจำคำได้เยอะ อ่านหนังสือได้อย่างรวดเร็ว”
เพราะเมื่อเด็กได้มีโอกาสพัฒนาด้านการอ่านอย่างเต็มที่ จะทำให้เขากล้าเข้าไปสู่การเรียนรู้ที่ไร้ขอบเขตและพรมแดนได้ตลอดชีวิต

เรื่องโดย พิมพ์ชนก ศรเพชร Teacm Content www.thaihealth.or.th

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วันอังคารที่ 24 มีนาคม พ.ศ. 2558

Iron Supplements Hasten Recovery in Blood Donors

Every year, more than 9 million Americans donate nearly 16 million pints of blood. Blood donors are allowed to give one pint of blood every 8 weeks. But about 25-35% of regular donors develop iron deficiency. The body needs iron to make red blood cells. These cells transport oxygen and carbon dioxide around the body using the iron-rich protein hemoglobin.



Arm of a person donating blood.
Iron supplements may help many blood donors who have to delay donations due to low hemoglobin levels. Credit: ninsiri/iStock/Thinkstock.
It can take months to completely recover the iron and hemoglobin lost from blood donations. Deficiencies can lead to anemia, a condition in which the blood can’t supply enough oxygen to bodily tissues, causing fatigue and other symptoms. Nearly 7% of donors are forced to delay their donation due to low hemoglobin levels. Deferring larger number of donors could greatly affect the already-strained U.S. blood supply.

One potential solution is to provide donors with iron supplements. Past studies have shown that iron supplementation can reduce the number of iron-related deferrals. Researchers led by Dr. Joseph Kiss at the Institute for Transfusion Medicine in Pittsburgh examined how supplements affect blood levels of iron and hemoglobin. Their study was funded by NIH’s National Heart, Lung, and Blood Institute (NHLBI). Results were published on February 10, 2015, in the Journal of the American Medical Association.


The team followed 215 blood donors, ages 18 to 79, at 4 U.S. blood centers. Participants had previously donated blood, but hadn’t given blood within the last 4 months. The researchers measured participants’ levels of ferritin—a protein that stores iron and can be used as an indirect measure of iron levels. The participants donated blood on the first day of the study and then were placed into 2 groups based on their original ferritin levels: higher and lower ferritin. Half of each group took an oral iron supplement daily for the next 168 days, and the other half didn’t.

In both groups, those taking iron supplements showed faster recovery of iron and hemoglobin levels. Compared to donors who didn’t take iron, those taking iron supplements more quickly returned to 80% of pre-donation hemoglobin levels in both the lower ferritin (32 days versus 23 weeks) and higher ferritin groups (31 days versus 11 weeks). Similarly, donors taking iron supplements recovered iron more rapidly. However, the median time for iron to reach pre-donation levels was 11 weeks among those taking supplements and 24 weeks in the no-supplement group.

“This study highlights the importance of maintaining iron levels after blood donation and shows that supplemental iron effectively restores hemoglobin, even in donors with higher iron levels,” Kiss says.

These results suggest that 8 weeks may not be enough time for many donors to sufficiently recover lost iron, particularly without taking iron supplements. Future studies will investigate the optimal dosage and duration of supplementation as well as which donors would benefit from taking iron supplements.
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วันอาทิตย์ที่ 22 มีนาคม พ.ศ. 2558

How extreme isolation warps the mind

(Getty Images)

Our top 12 stories of 2014 - #6: When people are isolated from human contact, their mind can do some truly bizarre things, says Michael Bond. Why does this happen?

 Sarah Shourd’s mind began to slip after about two months into her incarceration. She heard phantom footsteps and flashing lights, and spent most of her day crouched on all fours, listening through a gap in the door.

 That summer, the 32-year-old had been hiking with two friends in the mountains of Iraqi Kurdistan when they were arrested by Iranian troops after straying onto the border with Iran. Accused of spying, they were kept in solitary confinement in Evin prison in Tehran, each in their own tiny cell. She endured almost 10,000 hours with little human contact before she was freed. One of the most disturbing effects was the hallucinations.

 “In the periphery of my vision, I began to see flashing lights, only to jerk my head around to find that nothing was there,” she wrote in the New York Times in 2011. “At one point, I heard someone screaming, and it wasn’t until I felt the hands of one of the friendlier guards on my face, trying to revive me, that I realised the screams were my own.”

 We all want to be alone from time to time, to escape the demands of our colleagues or the hassle of crowds. But not alone alone. For most people, prolonged social isolation is all bad, particularly mentally. We know this not only from reports by people like Shourd who have experienced it first-hand, but also from psychological experiments on the effects of isolation and sensory deprivation, some of which had to be called off due to the extreme and bizarre reactions of those involved. Why does the mind unravel so spectacularly when we’re truly on our own, and is there any way to stop it?

 (Flickr/Cyri)
Inside prison walls, solitude can play disturbing tricks on the mind (Flickr/Cyri)
We’ve known for a while that isolation is physically bad for us. Chronically lonely people have higher blood pressure, are more vulnerable to infection, and are also more likely to develop Alzheimer’s disease and dementia. Loneliness also interferes with a whole range of everyday functioning, such as sleep patterns, attention and logical and verbal reasoning. The mechanisms behind these effects are still unclear, though what is known is that social isolation unleashes an extreme immune response – a cascade of stress hormones and inflammation. This may have been appropriate in our early ancestors, when being isolated from the group carried big physical risks, but for us the outcome is mostly harmful.

 Yet some of the most profound effects of loneliness are on the mind. For starters, isolation messes with our sense of time. One of the strangest effects is the ‘time-shifting’ reported by those who have spent long periods living underground without daylight. In 1961, French geologist Michel Siffre led a two-week expedition to study an underground glacier beneath the French Alps and ended up staying two months, fascinated by how the darkness affected human biology. He decided to abandon his watch and “live like an animal”. While conducting tests with his team on the surface, they discovered it took him five minutes to count to what he thought was 120 seconds. 

 A similar pattern of ‘slowing time’ was reported by Maurizio Montalbini, a sociologist and caving enthusiast. In 1993, Montalbini spent 366 days in an underground cavern near Pesaro in Italy that had been designed with Nasa to simulate space missions, breaking his own world record for time spent underground. When he emerged, he was convinced only 219 days had passed. His sleep-wake cycles had almost doubled in length. Since then, researchers have found that in darkness most people eventually adjust to a 48-hour cycle: 36 hours of activity followed by 12 hours of sleep. The reasons are still unclear.

 Michel Siffre (Getty Images)
After emerging from a nine week stint in underground darkness, Michel Siffre needed to wear a blindfold to protect his eyes (Getty Images)
As well as their time-shifts, Siffre and Montalbini reported periods of mental instability too. But these experiences were nothing compared with the extreme reactions seen in notorious sensory deprivation experiments in the mid-20th Century.

 In the 1950s and 1960s, China was rumoured to be using solitary confinement to “brainwash” American prisoners captured during the Korean War, and the US and Canadian governments were all too keen to try it out. Their defence departments funded a series of research programmes that might be considered ethically dubious today.

 The most extensive took place at McGill University Medical Center in Montreal, led by the psychologist Donald Hebb. The McGill researchers invited paid volunteers – mainly college students – to spend days or weeks by themselves in sound-proof cubicles, deprived of meaningful human contact. Their aim was to reduce perceptual stimulation to a minimum, to see how their subjects would behave when almost nothing was happening. They minimised what they could feel, see, hear and touch, fitting them with translucent visors, cotton gloves and cardboard cuffs extending beyond the fingertips. As Scientific American magazine reported at the time, they had them lie on U-shaped foam pillows to restrict noise, and set up a continuous hum of air-conditioning units to mask small sounds.

 After only a few hours, the students became acutely restless. They started to crave stimulation, talking, singing or reciting poetry to themselves to break the monotony. Later, many of them became anxious or highly emotional. Their mental performance suffered too, struggling with arithmetic and word association tests.

 (Akuei/Flickr)
Sensory deprivation can cause hallucinations - sometimes starting with geometric shapes or points of light, and then getting stranger... (Akuei/Flickr)
But the most alarming effects were the hallucinations. They would start with points of light, lines or shapes, eventually evolving into bizarre scenes, such as squirrels marching with sacks over their shoulders or processions of eyeglasses filing down a street. They had no control over what they saw: one man saw only dogs; another, babies.

 Some of them experienced sound hallucinations as well: a music box or a choir, for instance. Others imagined sensations of touch: one man had the sense he had been hit in the arm by pellets fired from guns. Another, reaching out to touch a doorknob, felt an electric shock.

 When they emerged from the experiment they found it hard to shake this altered sense of reality, convinced that the whole room was in motion, or that objects were constantly changing shape and size.

 Distressing end

 The researchers had hoped to observe their subjects over several weeks, but the trial was cut short because they became too distressed to carry on. Few lasted beyond two days, and none as long as a week. Afterwards, Hebb wrote in the journal American Psychologist that the results were “very unsettling to us… It is one thing to hear that the Chinese are brainwashing their prisoners on the other side of the world; it is another to find, in your own laboratory, that merely taking away the usual sights, sounds, and bodily contacts from a healthy university student for a few days can shake him, right down to the base.”

 In 2008, clinical psychologist Ian Robbins recreated Hebb’s experiment in collaboration with the BBC, isolating six volunteers for 48 hours in sound-proofed rooms in a former nuclear bunker. The results were similar. The volunteers suffered anxiety, extreme emotions, paranoia and significant deterioration in their mental functioning. They also hallucinated: a heap of 5,000 empty oyster shells; a snake; zebras; tiny cars; the room taking off; mosquitoes; fighter planes buzzing around.
A clip from BBC Horizon’s Total Isolation experiment – read more information about the programme here.

 Why does the perceptually deprived brain play such tricks? Cognitive psychologists believe that the part of the brain that deals with ongoing tasks, such as sensory perception, is accustomed to dealing with a large quantity of information, such as visual, auditory and other environmental cues. But when there is a dearth of information, says Robbins, “the various nerve systems feeding in to the brain’s central processor are still firing off, but in a way that doesn’t make sense. So after a while the brain starts to make sense of them, to make them into a pattern.” It creates whole images out of partial ones. In other words, it tries to construct a reality from the scant signals available to it, yet it ends up building a fantasy world.

 Such mental failures should perhaps not surprise us. For one thing, we know that other primates do not fare well in isolation. One of the most graphic examples is psychologist Harry Harlow’s experiments on rhesus macaque monkeys at the University of Wisconsin-Madison during the 1960s, in which he deprived them of social contact after birth for months or years. They became, he observed, “enormously disturbed” even after 30 days, and after a year were “obliterated” socially, incapable of interaction of any kind. (A comparable social fracturing has been observed in humans: consider the children rescued from Romanian orphanages in the early 1990s, who after being almost entirely deprived of close social contact since birth grew up with serious behavioural and attachment issues.)

 (Getty Images)
We may crave solitude occasionally, but in the long term it's not good for us physically or mentally (Getty Images)
Secondly, we derive meaning from our emotional states largely through contact with others. Biologists believe that human emotions evolved because they aided co-operation among our early ancestors who benefited from living in groups. Their primary function is social. With no one to mediate our feelings of fear, anger, anxiety and sadness and help us determine their appropriateness, before long they deliver us a distorted sense of self, a perceptual fracturing or a profound irrationality. It seems that left too much to ourselves, the very system that regulates our social living can overwhelm us.

 Take the 25,000 inmates held in “super-maximum security” prisons in the US today. Without social interaction, supermax prisoners have no way to test the appropriateness of their emotions or their fantastical thinking, says Terry Kupers, a forensic psychiatrist at the Wright Institute in Berkeley, California, who has interviewed thousands of supermax prisoners. This is one of the reasons many suffer anxiety, paranoia and obsessive thoughts. Craig Haney, a psychologist at the University of California, Santa Cruz, and a leading authority on the mental health of inmates in the US, believes that some of them purposefully initiate brutal confrontations with prison staff just to reaffirm their own existence – to remember who they are.

 Coping strategy

 Social isolation is not always debilitating, however. Are some better than others at coping? And can you train yourself to resist the worst effects? Here scientists have fewer hard answers, but we can at least look to the lessons of individuals who thrived – or floundered – under isolation.

 When Shourd was imprisoned in Iran, she was arguably among the least-equipped people to cope, because her incarceration came out of the blue. People in her circumstances have their world suddenly inverted, and there is nothing in the manner of their taking – no narrative of sacrifice, or enduring for a greater good – to help them derive meaning from it. They must somehow find meaning in their predicament – or mentally detach themselves from their day-to-day reality, which is a monumental task when alone.

 Hussain Al-Shahristani managed it. He was Saddam Hussein’s chief nuclear adviser before he was tortured and shut away in Abu Ghraib prison near Baghdad after refusing on moral grounds to cooperate on the development of an atomic weapon. He kept his sanity during 10 years of solitary confinement by taking refuge in a world of abstractions, making up mathematical problems which he then tried to solve. He is now deputy energy minister of Iraq. Edith Bone, a medical academic and translator, followed a similar strategy during the seven years she spent imprisoned by the Hungarian communist government after World War Two, constructing an abacus out of stale bread and counting out an inventory of her vocabulary in the six languages she spoke fluently.

 Military (Thinkstock)
Some believe a military background may help prevent the worst effects of isolation (Thinkstock)
Such experiences may be easier to take if you belong to a military organisation. Keron Fletcher, a consultant psychiatrist who has helped debrief and treat hostages, says mock detention and interrogation exercises of the kind he himself underwent while serving with the Royal Air Force are a good preparation for the shock of capture. “They teach you the basics of coping,” he says. “Also, you know your buddies will be busting a gut to get you back in one piece. I think the military are less likely to feel helpless or hopeless. Hopelessness and helplessness are horrible things to live with and they erode morale and coping ability.”

 US senator John McCain is a good example of how a military mindset bestows psychological advantages. His five-and-a-half years as a prisoner of war in Vietnam, during which he refused to yield to his interrogators, actually seemed to strengthen him. Though note what he had to say about the two years he spent in isolation: “It’s an awful thing, solitary. It crushes your spirit and weakens your resistance more effectively than any other form of mistreatment… The onset of despair is immediate, and it is a formidable foe.”

 Extreme reality

 Psychologists who study how people cope with isolation have learnt much from solo explorers and mountaineers. For many adventurers deprived of human company – albeit voluntarily – the landscape itself can serve as an effective surrogate, drawing them out of themselves into the beauty or grandeur of their surroundings. Norwegian psychologist Gro Sandal at the University of Bergen in Norway, who has interviewed many adventurers about how they cope in extreme environments, says that transcending the reality of their situation in this way is a common coping mechanism. “It makes them feel safer. It makes them feel less alone.”

 A similar psychological mechanism could explain why shipwrecked mariners marooned on islands have been known to anthropomorphise inanimate objects, in some cases creating a cabal of imaginary companions with whom to share the solitude. It sounds like madness but is likely a foil against it. Take the way sailor Ellen MacArthur nicknamed her trimaran “Mobi”, during her record-breaking solo circumnavigation of the globe in 2005. During the voyage she signed emails to her support team “love e and mobi”, and in her published account uses “we” rather than “I”.

 Boat on a vast ocean (Thinkstock)
Sailors have been known to combat the loneliness of the ocean by anthropomorphising inanimate objects (Thinkstock)
There is no more poignant illustration of the power of solitude to sink one person while lifting up another than the stories of Bernard Moitessier and Donald Crowhurst, two of the competitors in the 1968 Sunday Times Golden Globe round-the-world yacht race. The trophy, offered to the first sailor to complete a solo non-stop circumnavigation of the globe, was won in 313 days by Robin Knox-Johnston, the only one out of nine starters to finish. He seemed to relish being alone with his boat, but not as much as Moitessier, an ascetic Frenchman who practised yoga on deck and fed cheese to the shearwater birds that shadowed him. Moitessier found the experience so fulfilling, and the idea of returning to civilisation so distasteful, that he abandoned the race despite a good chance of victory and just kept on sailing, eventually landing in Tahiti after travelling more than halfway round the world again. “I continue non-stop because I am happy at sea,” he declared, “and perhaps because I want to save my soul.”

 Crowhurst, meanwhile, was in trouble from the start. He left England ill-prepared and sent fake reports about his supposed progress through the southern seas while never actually leaving the Atlantic. Drifting aimlessly for months off the coast of South America, he became increasingly depressed and lonely, eventually retreating to his cabin and consolidating his fantasies in a rambling 25,000-word philosophical treatise before jumping overboard. His body was never found.

 What message can we take from these stories of endurance and despair? The obvious one is that we are, as a rule, considerably diminished when disengaged from others. Isolation may very often be the “sum total of wretchedness”, as the writer Thomas Carlyle put it. However, a more upbeat assessment seems equally valid: it is possible to connect, to find solace beyond ourselves, even when we are alone. It helps to be prepared, and to be mentally resilient. But we shouldn’t underestimate the power of our imagination to knock over prison walls, penetrate icy caves or provide make-believe companions to walk with us.
This article is based on the book The Power of Others by Michael Bond (Oneworld Publications).
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Strengthening the immune system’s fight against brain cancer

When cancer strikes, it may be possible for patients to fight back with their own defenses, using a strategy known as immunotherapy. According to a new study published in Nature, researchers have found a way to enhance the effects of this therapeutic approach in glioblastoma, a deadly type of brain cancer, and possibly improve patient outcomes. The research was funded by the National Institute of Neurological Disorders and Stroke (NINDS) as well as the National Cancer Institute (NCI), which are part of the National Institutes of Health.


An artist’s representation of a human dendritic cell
Recruiting dendritic cells for cancer fight. An artist’s representation of the surface of a human dendritic cell. Image courtesy of the National Cancer Institute.
“The promise of dendritic cell-based therapy and other immunotherapies for brain cancer has been upheld for some time, but an important implication of this work is a demonstrated capacity to significantly improve the clinical impact of immunotherapy for patients with this very difficult disease,” said Duane A. Mitchell, M.D., Ph.D., director of the Brain Tumor Immunotherapy Program at the University of Florida in Gainesville and co-lead author of the study.

Dendritic cells are specialized immune cells that normally capture microorganisms, and then migrate to the lymph nodes to prepare other immune players, such as T cells, to fight off the invaders.

Dendritic cells have been used for immunotherapy to target a variety of tumor types, including those that affect the brain. These cells are taken from the patient, engineered to express antigens from the tumor­ to create a vaccine, and then injected back into the patient. Once in the patient, the engineered dendritic cells activate T cells, which can fight the tumor and also prevent it from coming back, via an immune memory response.

Dr. Mitchell and his colleagues wanted to know if increasing dendritic cell migration to lymph nodes would improve the effects of the vaccine. To test this idea, a group of glioblastoma patients was randomized to receive a tetanus booster shot before getting the tumor-antigen expressing dendritic cell vaccine. The booster was designed to set off an inflammatory response at the site of the vaccination, prepping the immune system for a larger battle. The other group of patients were injected with their own native dendritic cells instead of a tetanus shot, and then treated with the tumor-antigen expressing dendritic cell vaccine. Both sets of patients were treated with the vaccine which was being tested for effectiveness against glioblastoma.

The vaccine used in this study was targeted against cytomegalovirus (CMV). Studies have shown that CMV is found in glioblastoma tumors, but it is unclear if the virus causes tumors or contributes to disease progression. Glioblastomas are a devastating form of brain cancer with five year survival rates under 10 percent. From the time of diagnosis, average survival time is less than two years.

“The role of CMV in glioblastoma has been a controversial area of research for several years. These new findings, and especially the dramatic survival rates, suggest that the virus may be an effective target for immune therapy. The results presented by Dr. Mitchell and his colleagues should stimulate more basic research on CMV and its potential therapeutic role in brain tumors and possibly other cancers,” said Jane Fountain, Ph.D., program director at the NINDS.

The results showed that administering a tetanus booster before the vaccine increased dendritic cell migration to lymph nodes and also had a significant effect on clinical outcomes. The patients who received the tetanus booster lived more than 36.6 months after diagnosis compared to an average survival time of 18.5 months in those who received dendritic cells alone.

“We did not expect that enhancing dendritic cell migration would be associated with such a dramatic improvement on clinical outcomes in our patients,” said Dr. Mitchell.

Next, the investigators used a mouse model to determine how the tetanus booster increased dendritic cell migration to the lymph nodes. The results suggested that giving a booster shot to mice that have received the tetanus vaccine activated a recall response in the exposed T cells. Acting through a chemical messenger known as CCL3, those T cells increased dendritic cell migration to the lymph nodes, which ultimately enhanced the effect of the dendritic cell vaccine on tumor growth suppression.
“Dendritic cell vaccines targeting glioblastoma can be very effective by enhancing migration of dendritic cells. We now understand how we may improve outcomes for patients receiving this type of therapy,” said Dr. Mitchell. He added that larger clinical studies need to be conducted to confirm these results.

In addition, more research is necessary to define the role of CMV in glioblastoma and further determine mechanisms to enhance efficacy of vaccines in cancer therapy.

This work was supported by grants from the NINDS (NS20023, NS067037) and the National Cancer Institute (CA108786, CA177476, CA134844).

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH...Turning Discovery Into Health®
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Cleaner Air Tied to Healthier Lungs in Kids

Over the past 30 years, researchers have linked a wide array of health effects to air pollution. Among these are reduced lung function, asthma, cardiovascular disease, preterm birth, and even death. The period between 11 and 15 years of age is particularly important for long-term lung function, as lungs are developing rapidly.



Teenage boy and girl on inline skates.
Better air quality over the past 20 years has helped reduce lung problems in Southern California. Image credit: Ryan McVay/Photodisc/Thinkstock.
In Southern California—long known for its levels of air pollution—public policies have helped to improve air quality over the past few decades. A team of researchers led by Dr. W. James Gauderman of the University of Southern California used these changes to examine the association between air quality improvements and children’s lung function.

The team used data from the 20-year Children’s Health Study, which took measurements of children’s health and outdoor air pollution levels in communities throughout Southern California. The researchers examined data from 3 different groups of children taken during the time periods 1994–1998, 1997–2001, and 2007–2011. Numbering over 2,100, the children came from 5 communities: Long Beach, Mira Loma, Riverside, San Dimas, and Upland. All received 2 or more tests of lung function from the ages of 11 to 15 years old. The scientists compared lung function with levels of nitrogen dioxide, ozone, and particulate matter of different sizes. The study was funded by NIH’s National Institute of Environmental Health Sciences (NIEHS) and others. Results appeared on March 5, 2015, in New England Journal of Medicine.

The researchers found improvements in lung function development were associated with declining levels of nitrogen dioxide; fine particles, which are 2.5 micrometers in diameter or less (found in smoke and haze); and larger particles with diameters up to 10 micrometers (including wind-blown dust). The proportion of children with clinically low lung function at 15 years of age also declined as air quality improved. Across the 3 time periods, the proportion with low lung function fell from 7.9% to 6.3% to 3.6%. These associations held after adjustment for several other variables, including smoking habits, health insurance, parental education, and exposure to cats, dogs, mold, and mildew.

The effects of the 3 different pollutants couldn’t be separated, as their levels were highly correlated. However, these results show that broad-based efforts to improve general air quality can significantly improve lung function in children. Improvements were seen in both boys and girls, in children with and without asthma, and in children of different racial/ethnic backgrounds.

“We expect that our results are relevant for areas outside Southern California, since the pollutants we found most strongly linked to improved health—nitrogen dioxide and particulate matter—are elevated in any urban environment,” Gauderman says.

The researchers note that these results and others suggest that further improvements to air quality could lead to even better lung health.

—by Harrison Wein, Ph.D.
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