̽��ֱ�� of Cambridge - drugs

DNA sequencing method lifts ‘veil’ from genome black box

cr696 — Mon, 23 Jan 2023 16:00:00 +0000

In a paper published in the journal Nature Biotechnology, ̽��ֱ�� of Cambridge researchers have outlined a new DNA sequencing method that can detect where and how small molecule drugs interact with the targeted genome.

“Understanding how drugs work in the body is essential to creating better, more effective therapies,” said co-first author Dr Zutao Yu from the Yusuf Hamied Department of Chemistry. “But when a therapeutic drug enters a cancer cell with a genome that has three billion bases, it’s like entering a black box.”

̽��ֱ��powerful method, called Chem-map, lifts the veil of this genomic black box by enabling researchers to detect where small molecule drugs interact with their targets on the DNA genome.

Each year, millions of cancer patients receive treatment with genome-targeting drugs, such as doxorubicin. But despite decades of clinical use and research, the molecular mode of action with the genome is still not well-understood.

“Lots of life-saving drugs directly interact with DNA to treat diseases such as cancer,” said co-first author Dr Jochen Spiegel. “Our new method can precisely map where drugs bind to the genome, which will help us to develop better drugs in the future.”

Chem-map allows researchers to conduct in situ mapping of small molecule-genome interactions with unprecedented precision, by using a strategy called small-molecule-directed transposase Tn5 tagmentation. This detects the binding site in the genome where a small molecule binds to genomic DNA or DNA-associated proteins.

In the study, the researchers used Chem-map to determine the direct binding sites in human leukaemia cells of the widely used anticancer drug doxorubicin. ̽��ֱ��technique also showed how the combined therapy of using doxorubicin on cells already exposed to the histone deacetylase (HDAC) inhibitor tucidinostat could have a potential clinical advantage.

̽��ֱ��technique was also used to map the binding sites of certain molecules on DNA G-quadruplexes, known as G4s. G4s are four-stranded secondary structures that have been implicated in gene regulation, and could be possible targets for future anti-cancer treatments.

“I am so proud that we have been able to solve this longstanding problem – we have established a highly efficient approach which will open many paths for new research,” said Yu.

Professor Sir Shankar Balasubramanian, who led the research, said: “Chem-map is a powerful new method to detect the site in the genome where a small molecule binds to DNA or DNA-associated proteins. It provides enormous insights on how some drug therapies interact with the human genome, and makes it easier to develop more effective and safer drug therapies.”

Reference:
Zutao Yu, Jochen Spiegel et al. 'Chem-map profiles drug binding to chromatin in cells.' Nature Biotechnology (2023). DOI: 10.1038/s41587-022-01636-0

Many life-saving drugs directly interact with DNA to treat diseases such as cancer, but scientists have struggled to detect how and why they work – until now.

KTSDESIGN/SCIENCE PHOTO LIBRARY via Getty Images

Illustration of DNA molecules

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Cannabis users no less likely to be motivated or able to enjoy life’s pleasure

cjb250 — Thu, 01 Sep 2022 07:56:00 +0000

Cannabis users also show no difference in motivation for rewards, pleasure taken from rewards, or the brain’s response when seeking rewards, compared to non-users.

Cannabis is the third most commonly used controlled substance worldwide, after alcohol and nicotine. A 2018 report from the NHS Digital Lifestyles Team stated that almost one in five (19%) of 15-year-olds in England had used cannabis in the previous 12 months, while in 2020 the National Institute on Drug Abuse reported the proportion in the United States to be 28% of 15-16-year-olds.

A common stereotype of cannabis users is the ‘stoner’ – think Jesse Pinkman in Breaking Bad, ̽��ֱ��Dude in ̽��ֱ��Big Lebowski, or, more recently, Argyle in Stranger Things. These are individuals who are generally depicted as lazy and apathetic.

At the same time, there has been considerable concern of the potential impact of cannabis use on the developing brain and that using cannabis during adolescence might have a damaging effect at an important time in an individual’s life.

A team led by scientists at UCL, the ̽��ֱ�� of Cambridge and the Institute of Psychiatry, Psychology & Neuroscience at King’s College London carried out a study examining whether cannabis users show higher levels of apathy (loss of motivation) and anhedonia (loss of interest in or pleasure from rewards) when compared to controls and whether they were less willing to exert physical effort to receive a reward. ̽��ֱ��research was part of the CannTEEN study.

̽��ֱ��results are published in the International Journal of Neuropsychopharmacology.

̽��ֱ��team recruited 274 adolescent and adult cannabis users who had used cannabis at least weekly over the past three months, with an average of four days per week, and matched them with non-users of the same age and gender.

Participants completed questionnaires to measure anhedonia, asking them to rate statements such as 'I would enjoy being with family or close friends'. They also completed questionnaires to measure their levels of apathy, which asked them to rate characteristics such as how interested they were in learning new things or how likely they were to see a job through to the end.

Cannabis users scored slightly lower than non-users on anhedonia – in other words, they appeared better able to enjoy themselves – but there was no significant difference when it came to apathy. ̽��ֱ��researchers also found no link between frequency of cannabis use and either apathy or anhedonia in the people who used cannabis.

Martine Skumlien, a PhD candidate in the Department of Psychiatry at the ̽��ֱ�� of Cambridge, said: “We were surprised to see that there was really very little difference between cannabis users and non-users when it came to lack of motivation or lack of enjoyment, even among those who used cannabis every day. This is contrary to the stereotypical portrayal we see on TV and in movies.”

In general, adolescents tended to score higher than adults on anhedonia and apathy in both user and non-user groups, but cannabis use did not augment this difference.

Dr Will Lawn, from the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, said: “There’s been a lot of concern that cannabis use in adolescence might lead to worse outcomes than cannabis use during adulthood. But our study, one of the first to directly compare adolescents and adults who use cannabis, suggests that adolescents are no more vulnerable than adults to the harmful effects of cannabis on motivation, the experience of pleasure, or the brain’s response to reward.

“In fact, it seems cannabis may have no link – or at most only weak associations – with these outcomes in general. However, we need studies that look for these associations over a long period of time to confirm these findings.”

Just over half of participants also carried out a number of behavioural tasks. ̽��ֱ��first of these assessed physical effort. Participants were given the option to perform button-presses in order to win points, which were later exchanged for chocolates or sweets to take home. There were three difficulty levels and three reward levels; more difficult trials required faster button pressing. On each trial the participant could choose to accept or reject the offer; points were only accrued if the trial was accepted and completed.

In a second task, measuring how much pleasure they received from rewards, participants were first told to estimate how much they wanted to receive each of three rewards (30 seconds of one of their favourite songs, one piece of chocolate or a sweet, and a £1 coin) on a scale from ‘do not want at all’ to ‘intensely want’. They then received each reward in turn and were asked to rate how pleasurable they found them on a scale from ‘do not like at all’ to ‘intensely like’.

̽��ֱ��researchers found no difference between users and non-users or between age groups on either the physical effort task or the real reward pleasure task, confirming evidence from other studies that found no, or very little, difference.

Skumlien added: “We’re so used to seeing ‘lazy stoners’ on our screens that we don’t stop to ask whether they’re an accurate representation of cannabis users. Our work implies that this is in itself a lazy stereotype, and that people who use cannabis are no more likely to lack motivation or be lazier than people who don’t.

“Unfair assumptions can be stigmatising and could get in the way of messages around harm reduction. We need to be honest and frank about what are and are not the harmful consequences of drug use.”

Earlier this year, the team published a study that used functional magnetic resonance imaging (fMRI) to look at brain activity in the same participants as they took part in a brain imaging task measuring reward processing. ̽��ֱ��task involved participants viewing orange or blue squares while in the scanner. ̽��ֱ��orange squares would lead to a monetary reward, after a delay, if the participant made a response.

̽��ֱ��researchers used this set up to investigate how the brain responds to rewards, focusing in particular on the ventral striatum, a key region in the brain’s reward system. They found no relationship between activity in this region and cannabis use, suggesting that cannabis users had similar reward systems as non-users.

Professor Barbara Sahakian, from the Department of Psychiatry at the ̽��ֱ�� of Cambridge, said: “Our evidence indicates that cannabis use does not appear to have an effect on motivation for recreational users. ̽��ֱ��participants in our study included users who took cannabis on average four days a week and they were no more likely to lack motivation. However, we cannot rule out the possibility that greater use, as seen in some people with cannabis-use disorder, has an effect.

“Until we have future research studies that follow adolescent users, starting from onset through to young adulthood, and which combine measures of motivation and brain imaging, we cannot determine for certain that regular cannabis use won’t negatively impact motivation and the developing brain.”

This research was funded by the Medical Research Council with additional support from the Aker Foundation, National Institute for Health Research and Wellcome.

References

Skumlien, M, et al. Anhedonia, apathy, pleasure, and effort-based decision-making in adult and adolescent cannabis users and controls. IJNP; 24 Aug 2022; DOI: 10.1093/ijnp/pyac056

Skumlien, M, et al. Neural responses to reward anticipation and feedback in adult and adolescent cannabis users and controls. Neuropsychopharmacology; 6 April 2022; DOI: 10.1038/s41386-022-01316-2

Adult and adolescent cannabis users are no more likely than non-users to lack motivation or be unable to enjoy life’s pleasure, new research has shown, suggesting there is no scientific basis for the stereotype often portrayed in the media.

We’re so used to seeing ‘lazy stoners’ on our screens that we don’t stop to ask whether they’re an accurate representation of cannabis users. Our work implies that this is in itself a lazy stereotype

Martine Skumlien

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Female hands rolling a marijuana joint

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Autistic individuals may be more likely to use recreational drugs to self-medicate their mental health

cjb250 — Thu, 01 Jul 2021 22:30:48 +0000

There is significant debate about substance use of autistic adolescents and adults. Some studies indicate that autistic individuals are less likely to use substances, whereas others suggest that autistic individuals are at greater risk of substance misuse or abuse. ̽��ֱ��team at the Autism Research Centre in Cambridge used a ‘mixed methods’ design to consider both the frequency of substance use among autistic individuals, as well as their self-reported experiences of substance use.

Overall, 1,183 autistic and 1,203 non-autistic adolescents and adults (aged 16-90 years) provided information about the frequency of their substance use via an anonymous, online survey; of this group, 919 individuals also gave more in-depth responses about their experiences of substance use.

Autistic adults were less likely than non-autistic peers to use substances. Only 16% of autistic adults, compared to 22% of non-autistic adults, reported drinking on three or more days per week on average. Similarly, only 4% of autistic adults reported binge-drinking compared to 8% of non-autistic adults.

There were also some sex differences in patterns of substance use: autistic males were less likely than non-autistic males to report ever having smoked or used drugs. In contrast, the team did not find differences in the patterns of frequency of smoking or drug use between autistic and non-autistic females.

However, despite lower rates of substance use overall, the qualitative findings of the study provide a much less hopeful picture: autistic adults were nearly nine times more likely than non-autistic peers to report using recreational drugs (such as marijuana, cocaine and amphetamines) to manage unwanted symptoms, including autism-related symptoms.

Drugs were used to reduce sensory overload, help with mental focus, and provide routine, among other reasons. Several autistic participants also indirectly referenced using substances to mask their autism. Past research has shown that this behavioural management (also known as ‘camouflaging’ or ‘compensating’) has been linked to emotional exhaustion, worse mental health, and even increased risk of suicide among autistic adults.

Autistic adolescents and adults were also over three times more likely than others to report using substances to manage mental health symptoms, including anxiety, depression, and suicidal thoughts. Several participants specifically noted that they used drugs for self-medication. However, this self-medication was not always viewed as negative by participants, and several noted that using recreational drugs allowed them to reduce the doses of prescribed medications for mental health conditions, which was a welcome change due to the sometimes significant side effects from their prescribed medications.

Another area of concern was the strong association between vulnerability and substance use among autistic teenagers and adults. Previous work from the Cambridge team suggests that autistic adults may be much more likely to have adverse life experiences and be at greater risk of suicide than others. ̽��ֱ��findings of the new study indicate that autistic individuals are over four times more likely to report vulnerability associated with substance use compared to their non-autistic peers, including dependence/addiction, using drugs to deal with past trauma, and substance use associated with suicide.

In addition, the study identified two new areas of vulnerability not been previously reported: being forced, tricked, or accidentally taking drugs; and childhood use of substances (at the age of 12 years or younger).

Elizabeth Weir, a PhD student at the Autism Research Centre in Cambridge, and the lead researcher of the study, said: “Whether or not the substances currently classed as ‘recreational’ could be used medically remains an open question. It is evident that the current systems of health and social care support are not meeting the needs of many autistic teenagers and adults.

“No one should feel that they need to self-medicate for these issues without guidance from a healthcare professional. Identifying new forms of effective support is urgent considering the complex associations between substance use, mental health, and behaviour management—particularly as camouflaging and compensating behaviours are associated with suicide risk among autistic individuals.”

Dr Carrie Allison, Director of Research Strategy at the Autism Research Centre and a member of the research team, said: “While some of our results suggest lower likelihood of substance use overall, physicians should not assume that their autistic patients aren’t using drugs. Drug use can be harmful so healthcare providers should aim to establish trusting relationships with autistic and non-autistic patients alike to foster frank and honest conversations about substance use.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “We continue to see new areas in which autistic adults experience vulnerability: mental health, physical health, suicide risk, lifestyle patterns, the criminal justice system, and so on. Substance use is now another area that we need to consider when developing new forms of support for autistic individuals. It is essential that we ensure that autistic people have equal access to high quality social and healthcare that can appropriately support their specific needs; and, unfortunately, it seems clear that our current systems are still not meeting this mark.”

̽��ֱ��research was funded by the Autism Research Trust, Rosetrees Trust, Cambridge and Peterborough NHS Foundation Trust, Corbin Charitable Trust, Medical Research Council, Wellcome and the Innovative Medicines Initiative.

Reference
Weir, E, Allison, C, & Baron-Cohen, S. Understanding the substance use of autistic adolescents and adults: a mixed methods approach. ̽��ֱ��Lancet Psychiatry (2021).

While autistic individuals are less likely to use substances, those who do so are more likely to self-medicate for their mental health symptoms, according to new research from the ̽��ֱ�� of Cambridge and published today in ̽��ֱ��Lancet Psychiatry.

It is essential that we ensure that autistic people have equal access to high quality social and healthcare that can appropriately support their specific needs; and, unfortunately, it seems clear that our current systems are still not meeting this mark

Simon Baron-Cohen

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Cannabis farms are a modern slavery 'blind spot' for UK police, study suggests

fpjl2 — Tue, 15 Sep 2020 08:23:08 +0000

Research from Cambridge criminologists suggests that those charged with drug cultivation have often been forced into illegal work as a condition of debt to criminal gangs for smuggling them into the UK.

̽��ֱ��researchers, including a Detective Inspector who completed a Masters at Cambridge's Institute of Criminology, argue that police take too narrow a view of modern slavery when it comes to 'growers' arrested during cannabis farm raids.

While growers – often Vietnamese nationals – are not always imprisoned within farms, many work under threat of extreme violence towards themselves or family back home, with little in the way of language or contacts in the UK.

̽��ֱ��researchers say that arresting officers often lack detailed training on modern slavery, and make only 'perfunctory' enquiries: a brief question that places the onus on a victim who doesn't understand their own situation.

As such, migrants end up serving years in UK prisons despite being forced to commit the cultivation crimes by gangs who seize passports and threaten – and administer – violence.

" ̽��ֱ��abuses of freedom in cannabis farm cases do not tally with traditional perceptions of slavery. Victims may be held against their will, forced to work and unable to leave, despite an unlocked door," said Prof Heather Strang, the study's senior author.

"Big questions remain about how the criminal justice system should ethically manage modern slavery victims who are also illegal immigrants involved in illegal activity," she said.

̽��ֱ��new study, published in the Cambridge Journal of Evidence-Based Policing, was co-authored by DI Adam Ramiz of Surrey Police as part of his research at Cambridge, where he worked with Strang and Prof Paul Rock from LSE.

Cannabis farms are unassuming abodes in towns and city suburbs that house hundreds of plants in blacked-out rooms, grown with equipment such specialist lighting. A live-in 'grower' will work for criminal gangs to feed and protect the Class B drug crop.

̽��ֱ��latest study is small in scale – gaining access to growers willing to talk is difficult – but criminologists say that it's an important addition to this under-researched area.

̽��ֱ��team looked at criminal histories of 19 Vietnamese nationals arrested in connection with cannabis farming in Surrey and Sussex between 2014-2017, and conducted in-depth interviews with three further growers – two Vietnamese and an Albanian – as well as the arresting officers in those cases.

̽��ֱ��growers all described being in hock to human smugglers, working in farms to pay debts, and some spoke of death threats and physical intimidation. Two spoke of dangerous journeys to the UK via lorries, similar to the 39 Vietnamese nationals found dead in Essex last year.

One witnessed murder by smugglers while trekking for days through forests. Another was locked inside the house once in the UK. ̽��ֱ��victims didn't consider themselves such, as they had wanted to come here, yet had been forced into illegal labour on arrival: smuggling that becomes trafficking.

Interviews with officers revealed police questioning on slavery to be limited, cursory and 'binary' – whether or not the grower was physically locked in – and conducted with a presumption of guilt on the that the grower is an offender.

"We found that some officers only had an hour of modern slavery training, and felt that the onus is on trafficking victims to volunteer that information, rather than police to investigate further," said Ramiz, who led the study.

" ̽��ֱ��brief question or two on slavery will often come after a grower has been given the standard legal advice to say nothing and later to plead guilty," he said.

Police frustrations focus on growers, with one officer talking of "hitting a brick wall" if they won't open up, but researchers say that the legal advice offered to trafficked cannabis growers is routine and uncritical: "go quietly".

They argue that police should 're-frame' their response to cannabis farms so that the possibility of modern slavery is "more fully considered", and suggest detailed training for front-line officers along with greater willingness to refer cases to specialist investigators.

Dame Sara Thornton, the UK's Independent Anti-Slavery Commissioner, described the study as a "welcome contribution to building an evidence-based approach to preventing modern slavery".

" ̽��ֱ��Modern Slavery Act includes a statutory defence for those compelled to commit an offence as a direct result of their being a victim of modern slavery. It is essential that the police investigate all lines of enquiry when they come across these complicated cases," said Thornton.

Added Ramiz: "While much more research is needed, these accounts of debt bondage and fierce intimidation suggests the mass cultivation of cannabis is rife with modern slavery, and the grey area between offender and victim in these cases can become a blind spot for UK police."

Case study:

A 34-year-old Vietnamese man now in an English prison for growing cannabis told researchers he had been a taxi driver, before fleeing his home after taking part in protests against a Chinese oil rig in the disputed South China sea.

Accused of betraying his country by police, he entered into contract with a smuggler after fearing for his life when a friend disappeared following arrest. Unable to pay in full, he ended up in debt bondage to a criminal gang.

Believing he was going to the UK to work in kitchens, the grower found himself in a series of lorries and flights across China and Russia, and taken into Europe via the forests of Poland.

“You have to walk for maybe two, three days… I saw one person had been beaten up… when I turned around he was unconscious… he walked too slow,” the grower told researchers. He believed the person he described had died.

̽��ֱ��grower arrived in the UK in a lorry container. He was eventually taken to a house already full of cannabis plants and shown how to tend them, and given an allowance for food and phone calls home.

“I do not dare leave the house without telling them, because I fear for my life… They told me if I tried to escape they would harm my family,” said the grower.

He remembered police asking some questions about being forced to work, and he had told them. His legal advisor asked no such questions. He did not consider himself a trafficking victim, as he had wanted to come to the UK.

̽��ֱ��police interviewer of the grower was a 33-year-old probationary police officer. He had been given an interview plan, and told researchers he viewed the matter in simple terms: “…you’re interviewing him as a suspect to get a confession, or to get the points across to get the conviction or charge…”.

No trafficking questions were in the officer’s plan, but he asked some anyway based on the grower’s response. ̽��ֱ��officer acknowledged his ignorance of modern slavery legislation to researchers.

A further interview was done by the officer’s supervisor, who was in charge of the investigation. He told researchers the training given to police on slavery – one hour-long session – was insufficient, and until guidance improved they had to rely on instinct.

̽��ֱ��officer-in-charge entered a submission to the National Referral Mechanism – the framework set up in 2009 to ensure victims of trafficking receive help. The NRM returned a decision that the grower had “consented” to the illegal work, so was not a victim, and he was sentenced to prison.

Migrants arrested for tending plants in the flats, houses and attics where cannabis is grown in bulk are often victims of trafficking and 'debt bondage' – yet many are not recognised as such by police, according to a new study.

Big questions remain about how the criminal justice system should ethically manage modern slavery victims who are also illegal immigrants involved in illegal activity

Heather Strang

West Midlands Police

A cannabis setup inside a residential premises in the West Midlands.

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Strategic partner: AstraZeneca

skbf2 — Mon, 11 Nov 2019 16:20:03 +0000

Scientists at AstraZeneca, a global biopharmaceutical company, have been working with Cambridge ̽��ֱ�� for more than two decades. What are the secrets of their success?

Brexit puts UK’s ability to tackle drug-related crime at risk, say experts

cjb250 — Fri, 03 May 2019 06:21:20 +0000

̽��ֱ��decision to leave the European Union comes at a time when parts of the UK are experiencing a marked rise in gun and knife crimes. Many of these crimes are linked to gangs fighting for control of parts of the illicit drug markets. In 2015, the UK experienced 3,070 drug-related deaths, a 13% increase from 2014.

While illicit drugs are usually regarded as an issue for the criminal justice system, this view has been changing in recent years. ̽��ֱ��Commissioner of the Metropolitan Police has joined calls for a public health, rather than criminal justice response. This approach was successful in tackling violent crime in Scotland where the Violence Reduction Unit, created in 2005, confronted what was then the second highest murder rate in western Europe by establishing collaborations between education, social services, child and adolescent mental health teams, and community groups.

Collaboration between the police and public health community depends on access to accurate and timely intelligence on the market for illicit drugs, including street price, prevalence of use, volumes of seizures, and the activities of organised crime networks.

However, local intelligence is of limited value if it is not linked to information from elsewhere, including other parts of Europe, say the researchers. ̽��ֱ��EU plays an important role in assembling the evidence and intelligence to tackle drug-related harm linked to serious and organised crime, but access to this vital information could be threatened by the UK leaving the EU.

A key player in the fight against drug-related crime is the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). However, this agency is accountable to the European Commission, Council, and Parliament, and is subject to the judicial oversight of the European Court of Justice; these are all provisions that the UK government is currently ruling out of any future agreement.

̽��ֱ��UK Focal Point on Drugs, based in Public Health England, works closely with the Home Office, other government departments to provide information to EMCDDA and, in return, receives intelligence on emerging developments from agencies across the EU. This information exchange is only possible because of existing EU legislation, especially on data protection.

In addition, the researchers argue, the UK would also lose access to EU-wide databases such as European Dactyloscopy (EURODAC), an information system containing finger-print information on asylum seekers and illegal migrants, and the European Criminal Records Information System.

A particular concern expressed is access to intelligence on newly developed drugs. ̽��ֱ��European Union Early Warning System on new psychoactive substances, in which Europol and EMCDDA play a major role, provides a means to detect new psychoactive drugs, assess their characteristics, and share information to inform decisions of member states on measures that they might wish to take. Exclusion from this process would undermine a crucial part of the UK’s current drug strategy, they say.

“ ̽��ֱ��scale of collaboration between the UK and European institutions in the field of illicit drugs is extensive, and it is not at all obvious how it might be replicated after any transition period given the UK government’s position on key elements of any future relationship,” says Dr Andres Roman-Urrestarazu from the Institute of Public Health at the ̽��ֱ�� of Cambridge, one of the authors of today’s policy brief.

“We will need an alternative framework of collaboration between the UK and the EU to facilitate data sharing and drug surveillance after Brexit,” said Christina Gray from the Faculty of Public Health Special Interest Group in Mental Health. “But it is not possible to develop meaningful solutions until the UK can make credible, workable proposals for its future relationships with European institutions and, in particular, its willingness to accept oversight of the European Court of Justice.”

̽��ֱ��researchers point out that the problem goes beyond the UK’s engagement with the EU. Just as in international trade, the UK benefits from a series of international collaborations with EMCDDA. New provisions will be required for the UK to continue to participate in these arrangements and these will take time to agree.

“Given the enormous challenges posed by Brexit to almost every aspect of life in the UK, it is easy to overlook areas such as tackling drug-related crime,” adds Professor John Middleton, President of the Faculty of Public Health, London. “At a time when European trade in illicit drugs is changing rapidly and when the often-fatal consequences of this trade are seen on the streets of British cities every week, this would be a mistake.”

Reference
Brexit threatens the UK's ability to tackle illicit drugs and organised crime: what needs to happen now? Health Policy; DOI: 10.1016/j.healthpol.2019.04.005

Brexit could threaten the UK’s ability to tackle drug-related crime linked to serious and organised crime, according to public health experts writing today in the journal Health Policy.

̽��ֱ��scale of collaboration between the UK and European institutions in the field of illicit drugs is extensive, and it is not at all obvious how it might be replicated after any transition period

Andres Roman-Urrestarazu

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Synthetic organs, nanobots and DNA ‘scissors’: the future of medicine

lw355 — Thu, 12 Oct 2017 08:00:43 +0000

In a new film to coincide with the recent launch of the Cambridge Academy of Therapeutic Sciences, researchers discuss some of the most exciting developments in medical research and set out their vision for the next 50 years.

Professor Jeremy Baumberg from the NanoPhotonics Centre discusses a future in which diagnoses do not have to rely on asking a patient how they are feeling, but rather are carried out by nanomachines that patrol our bodies, looking for and repairing problems. Professor Michelle Oyen from the Department of Engineering talks about using artificial scaffolds to create ‘off-the-shelf’ replacement organs that could help solve the shortage of donated organs. Dr Sanjay Sinha from the Wellcome Trust-MRC Stem Cell Institute sees us using stem cell ‘patches’ to repair damaged hearts and return their function back to normal.

Dr Alasdair Russell from the Cancer Research UK Cambridge Institute describes how recent breakthroughs in the use of CRISPR-Cas9 – a DNA editing tool – will enable us to snip out and replace defective regions of the genome, curing diseases in individual patients; and lawyer Dr Kathy Liddell, from the Cambridge Centre for Law, Medicine and Life Sciences, highlights how research around law and ethics will help to make gene editing safe.

Professor Gillian Griffiths, Director of the Cambridge Institute for Medical Research, envisages us weaponising ‘killer T cells’ – important immune system warriors – to hunt down and destroy even the most evasive of cancer cells.

All of these developments will help transform the field of medicine, says Professor Chris Lowe, Director of the Cambridge Academy of Therapeutic Sciences, who sees this as an exciting time for medicine. New developments have the potential to transform healthcare “right the way from how you handle the patient to actually delivering the final therapeutic product - and that’s the exciting thing”.

Read more about research on future therapeutics in Research Horizons magazine.

Nanobots that patrol our bodies, killer immune cells hunting and destroying cancer cells, biological scissors that cut out defective genes: these are just some of technologies that Cambridge researchers are developing which are set to revolutionise medicine in the future.

̽��ֱ��Future of Medicine

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

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Concerns over side effects of statins stopping stroke survivors taking medication

cjb250 — Mon, 17 Jul 2017 08:19:58 +0000

Individuals who have had a stroke are at risk of a second stroke, which carries a greater risk of disability and death than first time strokes. In fact, one third of all strokes occur in individuals who have previously had a stroke. To prevent this recurrence, patients are offered secondary preventative medications; however, adherence is a problem with 30% of stroke patients failing to take their medications as prescribed.

To examine the barriers to taking these medications, researchers at the ̽��ֱ�� of Cambridge and Queen Mary ̽��ֱ��, London (QMUL), analysed posts to TalkStroke, a UK-based online forum hosted by the Stroke Association, across a seven year period (2004-2011). ̽��ֱ��forum was used by stroke survivors and their carers.

̽��ֱ��team, led by Dr Anna De Simoni, a lecturer in Primary Care Research at QMUL and visiting researcher at the Department of Public Health and Primary Care, ̽��ֱ�� of Cambridge, has previously used the forum to explore issues such as the impairment that can make it difficult for stroke survivors to maintain a job.

̽��ֱ��findings of the study, which looked at posts by 84 participants, including 49 stroke survivors and 33 caregivers, are published today in the journal BMJ Open. ̽��ֱ��Stroke Association gave the researchers permission to analyse the results, and to prevent identification of individuals, the team did not use verbatim comments.

Among the reasons cited by the forum users, side effects were a major factor in decisions to stop taking medication. Several contributors had experienced negative side effects and as a result had stopped taking the medication, sometimes in consultation with their GP and other times unilaterally. Others reported that they, or the person they were caring for, had stopped taking the medication after reading negative stories in the press about side effects.

Other users expressed concerns over the medication they were offered. There were conflicting views about the efficacy of the medications – some contributors believed they were very important, while others believed that their risk could be managed by lifestyle changes alone.

Contributors also reported mixed views of healthcare professionals – some felt confident in their doctor’s decision, while others questioned their decisions, some even questioning their motivation for prescribing particular drugs.

“These findings have highlighted the need for an open, honest dialogue between patients and/or their carers, and healthcare professionals,” says Dr De Simoni. “Doctors need to listen to these concerns, discuss the benefits and drawbacks of taking the medication, and be willing to support a patient’s informed decision to refuse medications.”

However, perceptions did not present the only barriers to adherence: there were often practical considerations. Drugs were sometimes too large and difficult to swallow, or a drug regime was too burdensome. ̽��ֱ��complexities of the drug regimens sometimes meant having to develop routines and strategies to ensure patients kept to them. One survivor described having to pay for the medications by credit card as she was unable to work and had no money or benefits coming in.

“By analysing people’s views as expressed in online forums, where they are more open and less guarded, we’ve seen some valuable insights into why some stroke survivors have difficulty adhering to their medication,” says PhD candidate and first author James Jamison from the Department of Public Health and Primary Care at Cambridge.

“Challenging negative beliefs about medication and adopting practices that make routines for taking medication simpler, particularly for those patients who have suffered disability as a result of stroke, should increase adherence and ultimately improve health outcomes.”

̽��ֱ��research was supported by the National Institute of Health Research, the Stroke Association and the British Heart Foundation.

For more information about statins, visit NHS Choices.

Reference
Jamison, J et al. Barriers and facilitators to adherence to secondary stroke prevention medications after stroke: Analysis of survivors’ and caregivers’ views from an online stroke forum. BMJ Open; 19 July 2017; DOI: 10.17863/CAM.10458

Negative media coverage of the side effects associated with taking statins, and patients’ own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially life-saving drugs, according to research published today.

These findings have highlighted the need for an open, honest dialogue between patients and/or their carers, and healthcare professionals

Anna De Simoni

jarmoluk

Medications

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

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