Young children afflicted with chicken pox and administered with steroids are at a high risk of a more severe virus incidence that could lead to death, according to pediatric oncologists at the Brenner Children’s Hospital, a part of the Wake Forest University Baptist Medical Center.

The finding is believed to send warning signals to medical practitioners who have been treating their young patients with chicken pox with steroids.

From News-Medical.Net:

“Steroids are used to treat leukemia and they suppress the immune system,” said Thomas McLean, a pediatric oncologist at Brenner Children’s Hospital. “When a child is exposed to the varicella virus (the virus that causes chicken pox) around the time they are receiving steroid treatment, they are more likely to contract a more severe case of chicken pox.”

McLean and his colleagues studied 697 patients with acute leukemia over a nine-year period. About 16 percent or 110 patients contracted chicken pox. Of those 110 patients, 54 had severe disease, including two deaths. Of the patients whose chicken pox was diagnosed within three weeks of taking steroids, 70 percent had severe infection whereas only 44 percent of those who had not received steroid therapy within three weeks had severe infection. Although the study was limited to patients with leukemia, the findings may apply to other conditions for which steroids are used, McLean said.

“One of the things we need to remember to ask before we prescribe steroid treatment is whether the child has had a recent exposure to chicken pox,” McLean said. “If so, we recommend waiting until the incubation period has passed before beginning steroid therapy.”

Though chicken pox is mild in its nature, it can be devastating in rare cases and it is important to note here that there were as many as 12,000 casualties of chicken pox before the varicella vaccine was discovered.

Tags:  chicken pox, steroid therapy, steroid treatment, Steroids

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Recessive mutations in a gene called phospholipase C epsilon or PLCE1 could result in a to a severe, early-onset form of kidney disease and renal failure in children, a previously unknown cause. This finding was disclosed by scientists at the University of Michigan Medical School.

Identification of the mutual gene is of interest to the scientists as PLCE1 affects the development of podocytes that are specialized cells playing a vital role in ability of the kidney when it comes to removing waste products from blood and retaining important blood proteins.

From Sciencedaily.com:

Some types of nephrotic syndrome can be treated with steroids or other drugs, but steroid-resistant forms of the disease as a rule do not respond to treatment. Untreated nephrotic syndrome often causes severe scarring and a condition called focal segmental glomerulosclerosis (FSGS), which progresses about 50 percent of the time to end-stage kidney disease and renal failure.

PLCE1 is the seventh gene scientists have found to be involved in different types of steroid-resistant nephrotic syndrome, and the second gene that is expressed in podocytes — specialized cells with octopus-like tentacles surrounding the glomerulus.

Podocytes are currently under intensive study, because scientists believe they play a vital role in the blood filtration process. Identifying genes and proteins that are active in podocytes will help scientists understand how they work.

“We found that PLCE1 is expressed in developing and mature podocytes,” says Hildebrandt. “Most of the PLCE1 mutations we identified apparently prevented podocytes from developing normally in the embryo, so defects were present at birth. A milder mutation seemed to interfere with repair mechanisms in the glomerulus, so defects didn’t show up until later in life.”

Friedhelm Hildebrandt, M.D., the U-M’s Frederick G L Huetwell Professor for the Cure and Prevention of Birth Defects, remarked that this is the first report of infants with two mutuations in recessive gene for steroid-resistant nephrotic syndrome that nevertheless responded to treatment with steroids.

Tags:  kidney disease, mutant gene, steroid, steroid treatment, Steroids

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Steroid treatment is not an effective option for providing relief to infants with a common and potentially serious viral lower respiratory infection called bronchiolitis, as per a new study co-authored by Dr. Joan Bregstein of the Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center.

The study suggested that steroids do not help in preventing hospitalization or improve respiratory symptoms for bronchiolitis that is believed to be the common cause of hospitalization among infants.

From News-Medical.Net:

“Our study shows that treating bronchiolitis with steroids doesn’t work. We hope this study will resolve some of the uncertainty for physicians and families, as we move forward in developing better means of preventing and treating the infection,” says Dr. Bregstein, site principal investigator and emergency medicine pediatrician at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and assistant clinical professor of pediatrics at Columbia University College of Physicians and Surgeons.

Current recommendations suggest that simple supportive care is the best available treatment for bronchiolitis. Researchers note that steroid-based medications still play an important role in other respiratory illnesses of childhood such as asthma and croup. They point out these medications are not the androgenic steroids sometimes abused by athletes, and that the side effects seen with long-term steroid use are not a risk in the short-course treatments used for croup and asthma attacks.

The multicenter study was published in the July 26 New England Journal of Medicine and conducted by the Pediatric Emergency Care Applied Research Network (PECARN).

It was highlighted that simply supportive care is the most effective option for bronchiolitis though steroid-based medications still play an important role in respiratory illnesses of childhood such as asthma and croup.

Tags:  bronchiolitis, steroid treatment, Steroid use, Steroids

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The use of modern immunosuppressive drugs can reduce the need for a steroid therapy as early as seven days after a transplant surgery without an impact on maintenance of functions of the lung, according to a new study by researchers at UC.

Chronic health conditions that are considered to be common to kidney transplant recipients can be minimized via elimination of a daily dose of steroids, as per Steve Woodle, MD, Chief of UC’s transplant surgery division, principal investigator and designer of the study.

From Sciencedaily.com:

“Steroids have long been the primary source of morbidity and complications following successful kidney transplantation,” Woodle says. “This study demonstrates that elimination of even small, daily prednisone (pred-ne-zone) doses does not compromise results while minimizing weight gain, diabetes and bone complications.”

Corticosteroids were the first anti-rejection drug used in transplant patients, dating back to the first transplant surgeries over 50 years ago.

Traditionally patients who have undergone organ transplantation have required life-long steroid treatments given in combination with other drugs that help suppress the body’s immune system and allow the transplanted organ to function properly.

However, the steroid treatment—given as the oral drug, prednisone—can cause serious side effects including cardiovascular disease, high cholesterol and blood pressure, weight gain, diabetes, bone weakness and cataracts.

It was remarked by Woodle that the risk of injection episodes in patients was marginally increased with an early steroid discontinuation process. He hopes that even this minor risk of increased rejection combined with long-term gains would not change much with development of new drugs and modern anti-rejection drugs.

Tags:  corticosteroids, immunosuppressive drugs, steroid, steroid therapy, steroid treatment, Steroids

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Many of the 3,000 unexplained miscarriages that happen every year can be prevented with steroid treatments, as per a research presented at the British Association conference.

Dr. Siobhan Quenby, of the University of Liverpool and the Liverpool Women’s Hospital, said that the medical tests of 120 women had brought the fact that natural killer cells are the biggest cause of concern in respect to miscarriages and failed IVF embryo implants.

It was noted during the research that three quarters of 40 women treated with steroids gave successful births despite the fact that they had a past history of multiple miscarriages.

From News-Medical.Net:

Dr. Siobhan Quenby, of the University of Liverpool and the Liverpool Women’s Hospital, says that tests involving 120 women had identified natural killer cells as a cause of miscarriages and failed IVF embryo implants.

While such natural but potentially deadly cells are beneficial in most of the body because they can destroy infected or malignant cells, in the uterus they have been found to promote rapid growth of blood vessels when present in high numbers.

These blood vessels then transport additional oxygen-bearing blood which can cause miscarriages or prevent embryos implanting.

Steroids prescribed to 40 women, who had suffered multiple miscarriages, resulted in three quarters of them successfully giving birth.

The steroid treatment has been shown to reduce the level of natural killer cells in the uterus, and this is thought to increase the chances of an embryo going to full term.

Dr. Quenby says currently there is no treatment for the thousands of women around the world who are desperate because they keep miscarrying for no reason.

Dr. Quenby also said that there is an urgent need to include steroids in treatment for women with a history of miscarriages and believe that a third of miscarriages can be prevented with a steroid treatment.

Tags:  IVF, IVF embryo implants, miscarriages, steroid treatment, Steroids

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The reason why lungs of smokers are resistant to steroid treatment and its solution has been found by scientists from the Imperial College of London.

It is believed that almost 6 percent of population of the United Kingdom is presently suffering from Chronic Obstructive Pulmonary Disease (COPD) - ‘smoker’s lung’, or chronic bronchitis and emphysema. This is considered to be the fourth most cause of mortality in the land of the Queen.

Doctors generally consider steroid treatment as an effective treatment technique for curing inflammatory ailments such as COPD but somehow some of the COPD patients do not respond to steroid therapy as per expectations.

From News-Medical.Net:

Professor Peter Barnes and his colleagues discovered that steroids act as a ‘molecular bridge’ to recruit HDAC2 to the appropriate genes where it can act to switch them off.

The London researchers found that in COPD, levels of HDAC2 are very low compared to normal cells, so that the steroids have no effect in switching off the activated inflammatory genes.

They then found that in lung cells in vitro, and in rats, low doses of a cheap and widely available drug raised the levels of HDAC2 and broke the steroid resistance.

The first stages of clinical trials to test low doses of this drug, theophylline, in COPD patients are now underway. If successful, this may lead to a change in the treatment of COPD and other severe inflammatory diseases that do not respond well to steroid therapy.

Professor Peter Barnes commented, ‘COPD kills tens of thousands of people in the UK every year and currently we can only treat the symptoms, not the underlying problem of inflammation of the lungs. Our work has finally provided an explanation for steroid resistance in COPD, and has allowed us to identify ways to combat this.

Professor Peter Barnes and his colleagues remarked that steroids are highly effective in playing an important role while acting as molecular bridge in the recruitment of HDAC2 (Histone Deacetylase 2), an enzyme, to the concerned genes where it can switch them off.

They also remarked that the levels of HDAC2 are seen to be low when compared to normal cells in the COPD patients. This clearly suggested that the steroids are no longer good enough to bring any positive effect in switching off the activated inflammatory genes. In this direction, a new steroid has been discovered that will have the ability to raise the HDAC2 level to break steroid resistance in COPD patients.

Tags:  chronic bronchitis, chronic obstructive pulmonary disease, COPD, emphysema, smoker’s lung, steroid therapy, steroid treatment, Steroids

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