GENERAL MEDICAL NEWS 

The staff of The Reproductive Times here offers brief referenced notifications on interesting general medical and scientific news with broad relevance to reproductive medicine and biology. Some of these news items may become subjects of more detailed reporting in The Reproductive Times on later occasions. The purpose of these short notifications is to give readers the opportunity to get immediately more detailed information by looking up the reference of the notification.


CAN A POTENTIAL VACCINE PROTECT WOMEN AND MEN FROM ARTERIOSCLEROTIC CARDIOVASCULAR DISEASE?

Antibodies against the cell-membrane component phosphorylcholine (anti-PC) have been reported to be protective against atherosclerosis, cardiovascular disease (CVD), and other chronic inflammatory conditions. Two underlying potential mechanisms appear to be anti-inflammatory, clearance of dead cells, and inhibition of oxidized low-density lipoprotein effects.

 

Most of related research has, however, so-far been done only in men. In a very interesting article in the JACC Swedish investigators now determined the role of IgM anti-PC on the incident of CVD among women. In a total of 932 women, age 66 ± 6 years, IgM anti-PC levels were measured. Prospective associations with any first CVD, ischemic heart disease (IHD), myocardial infarction (MI), and ischemic stroke were assessed, with the model adjusted for potential confounding factors.

 

Over 16 years (13,033 person-years), 113 cases of composite CVD were noted.  IgM anti-PC was statistically significantly inversely associated with risk of ischemic heart disease, and with myocardial infarction (MI), but not with ischemic stroke. The authors concluded that IgM anti-PC may play an active role in inhibition of CVD development in women, especially MI. Furthermore, low IgM anti-PC levels may play a role in identifying those at risk.1 Postmenopausal women in the highest of three possible antibody levels demonstrated a 73% lower risk of CVD than women with lowest levels of antibody.

A few additional comments appear in place: (i) The antibody to phosphorylcholine is a so-called “natural” autoantibody. This means that we all have this antibody even in absence of any disease. (ii) This autoantibody should not be mixed up with another natural autoantibody, the anti-phosphatidylcholine antibody, which is one of several anti-phospholipid antibodies (APAs) and—like other APAs—has been associated with miscarriage and thrombosis risk. (iv) Here the association is inverted in contrast to APAs (high levels are good, while with APAs high levels are bad). (v) This has not only diagnostic significance but may also lead to therapeutic utilization of this antibody. (vi) Isotype IgM antibodies are the acute-phase reactants in the first 30 days of exposure to a stimulant, demonstrating another principle in recent years better and better understood: some inflammatory process—especially if low grade—can be beneficial.  

 

The authors concluded—and we fully agree—that chronic inflammation contributes to atherosclerosis and CVD, and that low levels of anti-PC among men and women contributes to this process. They, furthermore, suggested that involved mechanisms include anti-inflammatory activity of the antibody and increased clearance of dead cells and oxidized lipids, furthermore suggesting that the raising of anti-PC antibodies through immunization deserves consideration as a preventive treatment for certain CVDs.


Reference

  1. Frostegård ey al., G Am Col Card. 2024; Epublished DOI: 10.1016/j.jacadv.2024.101298


YET ANOTHER LINK BETWEEN GUT HEALTH AND BRAIN HEALTH

That gut health may be involved in the development of Parkinson’s disease has been suspected for some time and has been summarized under the so-called “gut-first hypothesis.” What, however, may be the inciting event has remained unknown. In a new study published in JAMA Network Open (1), investigators now developed evidence that that upper gastrointestinal mucosal damage was associated with increased risk to develop Parkinson’s disease. Specifically, patients with Parkinson’s were found to have more likely a history of H pylori infection, a history of having been treated with proton-pump inhibitors, with chronic non-steroidal anti-inflammatory medication use, gastroesophageal reflux disease, smoking, constipation, and dysphagia. The authors concluded that patients with these diagnoses may require special vigilance for Parkinson’s disease.


References

  1. Chang et al., JAMA Network Open 2024;7(9):e2431949


DO WE FINALLY HAVE A REAL REVERSIBLE MALE CONTRACEPTIVE?


This is what, according to an article by Derek Bagley in Endocrine News, the audience at Endo 2024 believed after presentation of an abstract about a male contraceptive gel that suppressed sperm production faster than anything else proposed before. Supposedly the Boston Convention Center “was abuzz” (1). 

 

The treatment was presented as a Phase 2b clinical trial of a gel applied to both shoulders, which contained segesterone acetate (called Nestorone, also an ingredient of the Annovera vaginal birth control ring) and testosterone. A total of 222 men completed at least three weeks of daily treatment with the gel, which contained eight milligrams of segesterone acetate and 74 milligrams of testosterone. Study subjects applied the gel once daily to each shoulder blade (to reduce the risk of exposing the gel to others).

 

The gel induces an endocrine feedback loop between the pituitary and the gonads, which involves secretion of luteinizing hormone (LH) from the pituitary that causes the testes to make testosterone and follicle-stimulating hormone (FSH). Segesterone acetate stops the pituitary from secreting LH and FSH, shutting down the production of testosterone. Local testosterone concentration in testes is higher than in blood; when testosterone falls below a threshold, the testes stop producing sperm. But men would like to maintain a normal libido and muscle mass, so the gel replaces testosterone in blood, though without it accumulating in the testes.

 

As the article also noted, researchers see male contraception as a women’s health issue since women are the ones who get pregnant if they don’t have a contraceptive, and women don’t always have the best experiences with contraceptives.


Reference

  1. Bagley D. Endocrine News. October 2024. https://endocrinenews.endocrine.org/shouldering-responsibility-could-a-male-contraceptive-gel-be-a-birth-control-game-changer/

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