Research Roundup For February 2020

Short summaries of recent research news from the investigators at Massachusetts General Hospital, including insights into Alzheimer’s disease, eating disorders, the development of the immune system after birth, and more.

Electronic Health Records Could Improve Early Alzheimer’s Diagnosis

Many researchers believe that the key to effectively treating Alzheimer’s disease is early diagnosis before outward symptoms such as dementia and memory loss appear.

A Mass General research team has developed a software-based method of scanning data from electronic records (EHRs) to estimate the likelihood that a currently healthy person will receive a dementia diagnosis up to eight years in advance.

The team first used machine learning technology to build a list of key clinical terms associated with cognitive symptoms. Next, they used national language processing (NLP) to comb through clinical notes from 268,000 electronic health records looking for those terms. Finally, they used those results to estimate patients’ risk of developing dementia.  

“We need to detect dementia as early as possible to have the best opportunity to bend the curve,” says Roy Perlis, MD, MSc, who led the study along with Thomas McCoy Jr., MD. “With this approach we are using clinical data that is already in the health record, that doesn’t require anything but a willingness to make use of the data.”

Raising Awareness of the Health Risks of Restrictive Eating

Children who refuse to eat certain foods typically grow out of this phase as they get older. However, a similar condition in adults called avoidant/restrictive food intake disorder (ARFID) can be a serious problem that may require treatment.

ARFID can make it difficult to eat at work or during social situations, strain relationships with friends and family members, and lead to serious medical consequences including significant weight loss and nutritional deficiencies.

A paper published by a Mass General research team led by Helen B. Murray, MS, and Braden Kuo, MD, seeks to help doctors diagnose this relatively unknown disorder and connect patients to care.

In a chart study of 97 gastroenterology patients who were retrospectively identified as ARFID patients, the team found that only one was correctly diagnosed within 18 months of their initial presentation for treatment.

“The good news is there is effective, exposure-based treatment for ARFID. The bad news is that many gastroenterologists are still not aware of this diagnosis,” Murray says.

How Microbes Influence the Development of Infant Immune System

When infants leave their mostly sterile home in the uterus during birth, they are rapidly colonized with microbes from the surrounding environment, the majority of which takes place in the intestinal tract.

This is a critical time for the newborn’s immune system, as it learns to separate friend from foe.

Research has shown that “crosstalk” between these early microbe colonizers and the immune cells in intestines plays a key role in developing a well-functioning immune system, but the specific process by which that occurs had not yet been defined.

A Mass General research team recently found these early interactions between microbes and immune cells are communicated to the thymus—an organ responsible for creating specialized immune cells early in life—through specialized cells that are imprinted with microbial signatures in the intestine and then travel up to the thymus, which is located just under the breastbone between the lungs.

If this signaling process goes awry, newly formed immune cells may start to target helpful microbes instead of harmful ones, which could disrupt the balance of the gut microbiome.

An unbalanced microbiome is believed to increase the risk of developing allergies, asthma and autoimmune disorders such as celiac disease and inflammatory bowel disease (IBD) later in life.

A better understanding of this process could lead to new strategies that promote a healthier relationship between intestinal cells and the microbiome. The study was led by Nitya Jain, PhD, and Alessio Fasano, MD, of the Mucosal Immunology and Biology Research Center.

A Cool New Way to Reduce Fat

The Mass General research team that invented a process called Coolsculpting—a popular non-surgical method for reducing fat under the skin—is now developing a new technology that can reduce fat almost anywhere in the body using a safe, injectable ice solution, or slurry.

Coolsculpting—while highly effective—is limited by the amount of fat that can be removed per session and is not practical for reaching deeply seated fat in the body. The slurry injection, by contrast, can target and remove fat tissue at any site that can be accessed by a needle or catheter.

One key benefit of the slurry technique is that it’s specifically designed to target fat and does not damage any surrounding organ or muscle tissues. In a study in pig models, the researchers reported a 55% reduction in fat thickness with no damage to skin or muscle at the injection site, and no systemic side effects or abnormalities.

More research and safety testing will have to be done before the process is approved for use in humans, but the research team is optimistic it could provide a significant upgrade in fat removal technology if approved.

 “With this new technique the doctor can do a simple injection that takes just less than a minute, the patient can go home, and then the fat gradually disappears,” says Lilit Garibyan, MD, PhD, an investigator in the Wellman Center for Photomedicine and co-author of the study along with center director Rox Anderson, MD.

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