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Blood Protein May Curb Bacterial Fatalities

Say 'Aaah' | Capsules

September 18, 2000|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

A protein originally isolated from white blood cells may produce at least a 25% reduction in the death rate from meningococcemia, a rare but often fatal bacterial infection.

The disease has an incidence of only about four cases per 100,000 population, but its high mortality rate makes it one of the most common infectious causes of death in children and young adults. Symptoms develop rapidly, and victims often die within 24 hours after admission to a hospital.

Meningococcemia is caused by a bacterium called Neisseria meningitidis, which releases a toxin that can cause damage to blood vessels, tissues and organs. The bacterium can be killed with antibiotics, but the dead bacteria continue to release toxin, exacerbating symptoms. One in 10 victims dies, and many survivors must have one or more limbs amputated. The new treatment is aimed at destroying this toxin before it can further damage vital organs.

Dr. Brett Giroir and his colleagues at the Children's Medical Center of Dallas isolated a protein called bactericidal permeability-increasing protein (BIP) that both kills the bacteria and destroys the toxin. The body does not make enough of it naturally to fight off an infection, so they produced it by genetic engineering.

Giroir led an international study of 393 children between the ages of 3 months and 18 years with meningococcemia. All received conventional antibiotic treatment; in addition, 190 received BIP and the rest a placebo. The researchers reported in Friday's issue of the Lancet (http://www.thelancet.com) that the drug increased survival by at least 25% and reduced the number of amputations by 68%.

Researchers believe results would have been even better if the protein had been given immediately after diagnosis. Because of the constraints of the study, children did not receive it until six hours after they entered the hospital. By that time, an additional 59 patients had already died.

Depression Could Show Early Hormonal Signs

Pennsylvania researchers have for the first time been able to demonstrate biochemical changes in children at high risk for depression before they actually show symptoms--a discovery that could allow physicians to treat them before their condition deteriorates.

The discovery grew out of a 1994 finding by the same researchers that children and adolescents with acute episodes of major depression secrete less growth hormone than healthy children. Dr. Boris Birmaher and his colleagues at the University of Pittsburgh School of Medicine studied 64 children and adolescents between the ages of 8 and 16 who were at high risk of depression because of a family history of the problem and 55 without a family history of it. The researchers administered a hormone called growth hormone-releasing factor and measured the children's subsequent production of growth hormone.

They reported in Friday's issue of the Archives of General Psychiatry (http://archpsyc.ama-assn.org) that the at-risk children secreted significantly lower amounts of growth hormone in response to the challenge. In children who had been depressed and then improved, furthermore, the low response to growth hormone-releasing factor continued, indicating that the response is a marker for depression in children, they said.

Chickenpox Vaccine Is Performing Well

The varicella vaccine for chickenpox is both safe and effective, according to an analysis of the first three years of use, during which nearly 10 million children were immunized.

The federal government received 6,574 reports of problems linked to vaccination, but most were minor complications such as rashes or pain at the injection site, Dr. Robert P. Wise and his colleagues at the federal Centers for Disease Control and Prevention reported in Wednesday's issue of the Journal of the American Medical Assn. (http://jama.ama-assn.org).

Fourteen deaths were reported, but none were conclusively linked to the vaccine. In contrast, 4,000 to 9,000 hospitalizations and 100 deaths per year were attributed to chickenpox itself before vaccination became widespread.

Gene Seems to Hamper Heroin Withdrawal

A gene that has previously been associated with pleasure-seeking may make withdrawal from heroin addiction more difficult, according to new research from UCLA.

Dr. Ernest Noble of UCLA's Neuropsychiatric Institute had previously shown that a particular variant of the D2 dopamine receptor gene is associated with increased pleasure seeking.

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