Monthly Archives: July 2018

Health, Medical, Research, Science

Could a new ‘universal vaccine’ stop all strains of flu virus?

MEDICAL RESEARCH

A NEW universal long-lasting vaccine could prevent the need for yearly flu jabs.

Currently, scientists have to predict every year what the new strain of flu will look like, but by the time the vaccine has been made, the strain of virus may already have mutated and changed.

Recently released figures reveal the vaccine given to ten million over-65s, children and at-risk adults last year offered little protection against the killer H3N2 strain, known as Aussie flu, which put unprecedented pressure on the NHS during the winter months.

Public Health officials have admitted the jab had “no significant effectiveness” in preventing people from being struck down – and was deemed only 15 per cent effective overall.

UK researchers are now working on a “universal” vaccine to protect against a number of strains.

The cells of the flu virus are like spherical cushions with lots of pins sticking out. Flu vaccines currently work by triggering an immune response to antigens – the heads of the pins – on the cell’s surface.

The immune system creates antibodies, which are then primed to attack and block the real flu virus when it comes along: the antibodies recognise the virus by its antigens.

The new vaccine, developed at the University of Oxford, protects the body against flu in a way that makes it more universal.

 

SCIENTISTS have found that while flu strains vary, all flu viruses contain epitopes (parts of the antigen to which antibodies attach), which vary much less than previously thought. Targeting these epitopes through vaccination would protect against all strains of the virus.

The new vaccine is designed to home in on these common epitopes and help the immune system create antibodies to fight them.

So far they’ve identified specific epitopes for two main types of flu – influenza A virus (subtypes H1 and H3) and influenza B. Researchers say a vaccine using this new approach could provide immunity without the need for yearly vaccinations, and could work against many types of flu even if the virus mutates.

Two or three injections would give long-term protection against different strains, they say.

Sunetra Gupta, a professor of theoretical epidemiology who led the research, says: “We believe our methods can be applied to produce vaccines against all subtypes of influenza, thereby providing the opportunity to develop not only a more effective vaccine against endemic influenza, with lower healthcare costs, but also better protection against potential influenza pandemics.

“The same strategy can also be used to produce vaccines for swine and avian influenza, which will have significant economic consequences, and the control of which will reduce the probability of new lineages emerging with pandemic potential.”

Vaccination is the most effective way to protect against the virus and is given annually in the UK to people at risk, including the over-65s, children aged two to nine, pregnant women, and people in long-stay residential care homes.

But the problem with existing vaccines is that the flu virus frequently mutates in two ways.

The first, known as antigenic drift, involves small changes in the genes of influenza viruses as the virus replicates.

These small genetic changes usually produce viruses that are closely related to one another, and share the same antigenic properties, so an immune system exposed to a similar virus will usually recognise it and respond.

But these small changes can accumulate over time and eventually the immune system may not recognise them and respond.

The less common route is antigenic shift – an abrupt, major change in the influenza A virus, and most people have little or no protection against the new virus.

 

TO ENSURE vaccines are available when needed, six months before the flu season, scientists try to predict the new strain. However, as the latest figures show, they don’t always get it right.

Commenting on the research, Professor Wendy Barclay, the Action Medical Research Chair in Virology at Imperial College London, says: “There are lots of different ideas about to make a universal flu vaccine and how universal it would actually be.

“This work from the Oxford group would mean we don’t have to update the flu vaccine yearly, but if a new pandemic came along, chances are this type of vaccine wouldn’t work against that.

“But it would mean we don’t have to chase after the virus as it constantly drifts and we try to keep up.”

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Health, Medical, Research, Science

Blood pressure study linked to dementia

MEDICAL RESEARCH

A major study suggests that hundreds of thousands of people could be saved from dementia if blood pressure tablets were used more widely.

Researchers have shown for the first time that aggressively treating high blood pressure – particularly in middle age – could also significantly reduce the risk of dementia later on.

NHS officials are under growing pressure to lower the threshold at which people can be given the drugs, a policy that could make 14million eligible for treatment.

Patients are currently considered to have hypertension – or high blood pressure – only if they have a reading of more than 140/90 mm Hg.

But a study of 9,400 people in the US found cutting the systolic threshold – the higher reading – to 120 instead of 140 slowed cognitive decline.

An ideal blood pressure reading is between 90/60 millimetres of mercury (mm Hg) and 120/80. The first figure is the systolic pressure, the “surge” that occurs with each heartbeat. The second is the diastolic reading, which measures the pressure in the “rest” between heartbeats.

Using the new threshold over eight years reduced rates of dementia and mild cognitive impairment by 15 per cent, according to results presented at the Alzheimer’s Association International Conference in Chicago.

Similar trials have shown cutting the threshold for treatment would reduce the risk of heart disease by a fifth, and strokes by about a quarter.

Health watchdogs are already reviewing blood pressure guidelines with a view to cutting rates of heart disease and a decision is expected next year.

But they will now face greater pressure to change the rules after the new research, the first to look in detail at the impact of such a policy on dementia.

Study leader Professor Jeff Williamson, of the Wake Forest School of Medicine in North Carolina, said: “These results support the need to maintain well-controlled blood pressure, especially for persons over 50.”

A second study of 670 patients by the University of Pennsylvania found that the lower threshold also showed shrinkage of white brain matter, strengthening the link between blood pressure and dementia.

The US has led the way on blood pressure policy, lowering the treatment threshold in November from a systolic score of 140 to 130.

If the UK followed suit, it would mean an estimated 14million people – a third of all adults – would be eligible. Currently seven million are eligible.

A policy to increase this, however, would be controversial as it would affect many people who until now have been considered healthy. A similar change that lowered the threshold for cholesterol-busting statin drugs in 2014 led to a huge backlash, fueling accusations that health professionals were “over-medicalising” the middle aged.

A spokesperson for Alzheimer’s Research UK, said: “This study suggests treating high blood pressure intensively . . . may help to reduce the risk of memory and thinking problems.

“There is robust evidence that what’s good for the heart is also good for the brain and maintaining good vascular health is one of the key things people can do to reduce their risk of dementia.”

But Professor Clive Ballard, of Exeter University, warned: “All anti-hypertensives come with some risk of adverse effects, most seriously for kidney function.”

 

THOSE who feel light-headed when standing up after a long time sitting may be at a greater risk of dementia and stroke, according to a US study of more than 11,000 people.

Scientists at John Hopkins University found those whose blood pressure dropped when they stood up – a problem known as orthostatic hypotension – had twice the risk of suffering a stroke in later life. Their risk of dementia was 54 per cent higher.

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Government, Legal, Scotland

Scotland’s EU Continuity Bill now being tested in Supreme Court

SCOTLAND: BREXIT

THE highest court in the UK has been urged to strike down the SNP’s Brexit legislation because it relates to international powers which are not devolved to Holyrood.

A legal battle between the Scottish and UK Governments is underway in the Supreme Court. It could have huge ramifications for Theresa May’s Brexit plans.

The UK’s top law officers argued that the SNP’s Continuity Bill, which has been passed by a majority of MSPs in the Scottish Parliament, “cannot stand” because it is “fundamentally inconsistent” with the law.

But the Scottish Government’s top legal officer insisted that the Bill was “carefully framed” not to cut across EU laws and was modelled on the UK Government’s Withdrawal Bill.

The case was called after the SNP opted to press ahead with its own Brexit legislation following its decision to refuse to give consent to Mrs May’s Bill.

The legislation was fast-tracked through parliament, despite Holyrood’s Presiding Officer Ken Macintosh concluding that it was “not within the legislative competence of the parliament”.

The Supreme Court is considering the issue after UK law officers asked for a judgment. The case is continuing, with a verdict expected in October.

Presenting the UK case, Advocate General for Scotland Lord Richard Keen told the seven judges considering the matter that “the Scottish Bill as a whole cannot stand”.

He told the panel, including Supreme Court president Lady Hale and deputy president Lord Reed, that the Bill “impermissibly modifies the UK Act on withdrawal from the EU” and is “fundamentally inconsistent” with legislation passed by MPs.

He argued that the Continuity Bill was “directly inconsistent with the UK Act at the most basic of levels” and that “the two simply cannot stand together”.

The UK law officers’ written case states: “The Scottish Bill is not law because it relates to the reserved matter of international relations as defined in Section 7 (1) of Schedule 5, and is therefore outside of competence.”

The UK Bill was given Royal Assent on June 26 and became the European Union (Withdrawal) Act 2018.

The law officers say that the Scottish Bill was passed “without knowledge” of the outcome of negotiations between the UK Government and the EU.

In his written case, Scottish Lord Advocate James Wolffe said: “The purpose of the Scottish Bill is to promote legal certainty by making provision for the continuity within the domestic legal system of existing EU-derived law upon and following withdrawal.”

HOLYROOD’S Brexit Bill is “perfectly practical”, the Lord Advocate told the UK Supreme Court as the Scottish Government continued its unprecedented constitutional battle with Whitehall.

In the second and final day of the court hearing in London, James Wolffe rejected the UK Government’s main contention that, by Passing Edinburgh’s Continuity Bill, the Scottish Parliament was in some way trying to cut across Westminster’s authority in international relations.

He argued that the Scottish bill was not incompatible with EU law, which was based on the principles of “legal certainty and continuity”.

The Lord Advocate said the Holyrood legislation only impacted on the “domestic legal order” and so could not affect the UK’s negotiations with Brussels.

Crucially, Mr Wolffe told the court the Scottish legislation had been passed by MSPs several months before the UK Government’s flagship EU Withdrawal Bill became law, noting: “It was not intended to modify the UK bill and could not do so.”

On the first day of the hearing, Lord Keen of Elie, Advocate General for Scotland, leading for the UK Government, argued that “any reasonable consideration” of the Scottish bill and the UK act showed the former sought to modify, that is undermine, the latter and so the “two simply cannot stand together” as they produced two “dual but inconsistent regimes” in respect of retained EU law.

But the Lord Advocate’s points were supported by Michael Fordham for the Welsh Government, who claimed the UK Government’s contention that the Scottish bill would cut across Whitehall’s reserved powers on international relations was “wrong and incoherent”.

He said the UK’s argument that devolved administrations could not legislate in devolved areas currently managed by the EU because they touched on international treaty negotiations was an “extravagant claim which has very alarming logical implications”.

He explained that this would have the effect of restricting the powers of devolved parliaments even after Brexit and EU law was transferred on to the UK Statute Book.

John Larkin, the Northern Irish Attorney General, also argued that the Scottish bill was “within the legislative competence of the Scottish Parliament”.

But, in response, Lord Keen suggested it was “unjustified” for devolved governments to expect that all devolved powers should be handed over after Britain left the EU because, when the devolution settlement was drawn up 20 years ago, no one could have predicted Brexit.

He said it was “not open to the Scottish Government and the Scottish Parliament to assume that no new legislative constraints” would be introduced because of Britain leaving the EU.

He claimed the Continuity Bill was “fundamentally inconsistent” with the purpose of the UK act and that the confusion over which Parliament had jurisdiction over which European regulations would result in the undermining of the UK Government’s Brexit strategy.

Seven judges of the Supreme Court, including two Scottish judges, will now spend the summer considering their ruling. If they were to find for the Scottish Government, then this would mean the Continuity Bill would receive royal assent and become law.

However, this would mean there would be two competing pieces of legislation on the statute book, which would likely result in the matter returning to the Supreme Court to determine which act took precedence.

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