Tuesday, March 27, 2007

Preeclampsia and Future Cardiovascular Risk

7/10/2007: I'm not sure why but I've gotten at least 30 hits on this post in the last few days. A lot of people are being referred to this post via their email accounts. Anyone care to share what is so interesting about this post? As a survivor of preeclampsia, I'd love to hear what brings you here. Leave a comment please. :) Jen

More bad news for me as a two time severe preeclampsia survivor who developed hypertension after the birth of my 2nd daughter. Guess I'd better see what my internist thinks about this...

1: Expert Rev Cardiovasc Ther. 2007 Mar;5(2):283-94. Links
Preeclampsia and future cardiovascular risk.Newstead J, von Dadelszen P, Magee LA.
University of Saskatchewan, Department of Medicine, Saskatoon, SK, Canada. jill.newstead@shaw.ca

Pregnancy is a metabolic and vascular 'stress test' for women and those who 'fail' are at increased risk of long-term cardiovascular complications. Specifically, women who develop preeclampsia (and/or other manifestations of placental dysfunction) are at increased risk of coronary heart disease, stroke and cardiovascular disease in general. The risk is highest among women who develop both maternal (e.g., hypertension and proteinuria) and fetal (e.g., intrauterine growth restriction) manifestations of abnormal placentation, especially with preterm delivery. Most women who develop a maternal placental syndrome return to a normal clinical state in the weeks following pregnancy and their absolute risk of cardiovascular disease in the short term is very low. However, perhaps having a placentally complicated pregnancy affords women the opportunity to personalize risk and take action. Action is needed. The fact that we, as a population, are getting heavier and more sedentary is an urgent public health issue. The American Heart Association recommends that all women (even those at low cardiovascular risk) pursue dietary and lifestyle changes, in addition to smoking cessation. Engaging women of child-bearing age who may be motivated by a complicated pregnancy would be very valuable, from a public health perspective, given the prevalence and importance of cardiovascular disease in women, and the central role of the woman as caregiver to children, spouses and other family members.

PMID: 17338672 [PubMed - in process]

Saturday, March 24, 2007

"This Close"

It has been a hard week for some of my online friends. Amanda from Imagine Bright Futures informed all of us at Liver Families that she had been diagnosed with breast cancer. It just seems like cruel irony that Amanda has to endure cancer along with her niece's biliary atresia. I will be praying for her as she undergoes a mastectomy on the 29th.

Then, I began reading heartbreaking posts from my pal, Sheri, whose son Antonio was critically ill. He had a liver transplant, but then developed Posttransplantation Lymphoproliferative Disorder (PTLD), which is a form of cancer caused by exposure to the Epstein-Barr Virus (EBV). It can happen in children who are immunosuppressed due to organ transplantation. After reading about Sheri's elation that Antonio had been given his life-saving gift of life, it seemed nearly impossible that she would be again watching her son slowly fade, and actually come "this close" when he had to fight pnuemonia on top of the PTLD.

Thankfully, Antonio has made marked improvement. Sheri has been away from her other three children for nearly a month, and like a God send, Kim, another Liver Families mom flew up from Texas to comfort Sheri. I think Kim's positive energy played a pivotal role in lifting Sheri up out of the darkest places that our minds can go when faced with life or death situations.

Charlie, Meghan, and I went to visit Sheri last night. She is still quite fragile and now her emotions are begining to bubble up at random points as it appears she is realizing how "this close" brushed up against her precious Antonio.

Antonio, I hope you are making your bull frog noise soon. Your mommy really, really needs to hear it soon. I hope those good vibes that Kim brought with her can somehow make their way through space and time and land on Amanda.

Monday, March 19, 2007

88

Today, my grandma Eve turned 88 years old. I've tried to imagine myself at the age of 88, and wonder if I'll be as eloquent, calm, stubborn, and diplomatic as she. What will unfold in my life between now and then, if I make it to 88 in the year 2060?

Will I still live in my own home?
Will I still drive my car, just around town?
Will I still cook? (Ha ha, my husband is laughing at that one.)
Will I revel in my children's accomplishments?
Will I revel in my grand children's accomplishments?
Will I revel in my great grand children, especially how they grow up so fast?
Will I still remember the subtle details of my life as she does?

Will I know how truly loved I am?
Will I know that my loved ones are dreading the "call" that will eventually come?

Tonight, Gram was her true self. She wouldn't let me ask much about her day. She wanted to know about me, my husband, my girls. Gram wouldn't have it any other way.

I got one hint from her though. She was extremely pleased that Mary Buchanan had sent her a birthday card. What made this such a blessing was that she believed her friend had passed on already. I could hear the happiness in her speech as it became rapid. She couldn't wait to tell me. Her pure joy emanated through the telephone as she expressed her friend from Oxford was alive.

Upon hearing the name, I had a flashback to being in a tiny church near Oxford and watching my grandparents greet the Buchanans before mass started. I was craning my neck to see their faces at about hip level on my Gram. Grandpa said, "Well, hi-a honey!" Mary smiled at me, and said, "I see the girls are up for a visit."

As conversations do, the topic eventually drifted to Grandma being proud of her three sons and how their families have blossomed. I suppose since birthdays make a person reflect, Gram revealed that she had actually had 5 pregnancies. "I was always so pleased that I had three boys, but I might have liked a daughter. I always thought that my miscarriages were my girls. You know my doctor wouldn't tell me whether they were boys or girls. She said it was better to focus on having another baby. I think she was right."

Well, Gram, you had to wait until 1972 to get me as your first grandchild. As you've told me multiple times, I know I've made you proud and that you love me. I love you too.

Happy birthday Grandma! I'm so lucky to have you in my life.

Love,
Jen

Sunday, March 11, 2007

Thursday, March 08, 2007

Promising Lung Research

Scientists develop new procedure to differentiate human embryonic stem cells

Molecular scientists at the Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases (IMM) – which is part of the University of Texas Health Science Center at Houston – have developed a new procedure for the differentiation of human embryonic stem cells, with which they have created the first transplantable source of lung epithelial cells.

The process, created in the laboratory of Rick A. Wetsel, Ph.D., a professor of molecular medicine at the IMM, is described in this week’s edition of the Proceedings of the National Academy of Sciences. Research scientist Dachun Wang, M.D., is lead author of the article, “A pure population of lung alveolar epithelial type II cells derived from human embryonic stem cells.”

“We have developed a reliable molecular procedure which facilitates, via genetic selection, the differentiation of human embryonic stem cells into an essentially pure population of lung epithelial cells,” said Wetsel, noting the procedure also can be used to create other types of highly-specialized cells.

Scientists at the IMM used the in vitro method to create lung epithelial cells known as alveolar epithelial type II. The cells were derived from a human embryonic stem cell line approved by the National Institutes of Health (NIH).

The method involves the use of protein markers under the control of cell-specific promoters to convert undifferentiated human embryonic stem cells into highly-specialized cells. The human embryonic stem cells were cultured on specially coated dishes and transfected with a lung epithelial gene regulator of a drug selection gene.

“It is a general technology for developing select cells from human embryonic stem cells,” said C. Thomas Caskey, M.D., the IMM’s chief operating officer, director and CEO-elect. “The technology has allowed us to develop a platform that could potentially be useful in the development of spinal cord cells, heart cells, nerve cells and others.”

James T. Willerson, M.D., president of the UT Health Science Center at Houston, said " I believe this is an important development by the Wetsel laboratory at the IMM. I look forward to seeing its transitional impact."

Alveolar epithelial type II cells are called “the stem cells of the lungs” because of their versatility and many important functions. They produce proteins including surfactant that inflates lungs. They also make other cells lining the inner lung. “They regulate lung fluids and oxygen levels,” Wetsel said.

The cells are part of the tiny air sacs lining the lower airways known as alveoli. Tissue thin, they transfer oxygen into the blood and remove carbon dioxide. If the walls of the hundreds of millions of alveolus in a pair of lungs could be spread out and placed side by side, they would cover the floor of a classroom.

According to Wetsel, transplantable alveolar epithelial type II cells can be explored as treatments for pulmonary genetic diseases, acquired lung disease, as well as lung trauma caused by car accidents, gunshot wounds and sports injuries.

“These are the cells that can potentially be used for regenerative lung repair,” he said.

Hereditary lung disorders most likely to benefit from transplantation of alveolar epithelial type II cells include respiratory distress syndrome of the newborn, alpha-1 related emphysema and cystic fibrosis, Wetsel believes. “All three of these diseases are caused by single gene defects and therefore have been logical candidates for gene therapy,” Wetsel said.

Respiratory distress syndrome of the newborn, a condition affecting premature infants less than 37 weeks of age, may be caused by a genetic mutation triggering a surfactant shortage. Likewise, alpha-1 related emphysema, a condition affecting 100,000 Americans, results from an inherited deficiency of alpha-1 antitrypsin. Further, cystic fibrosis is the second most common childhood onset inherited disorder in the United States.

Transplantable alveolar epithelial type II cells may also one day be helpful in the treatment of other lung diseases including chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States, claiming the lives of 122,283 Americans in 2003, and asthma, Wetsel said.

Still years away from their use in regenerative medicine, Wetsel said the next step involves research trials with mice.

Source: University of Texas Health Science Center at Houston


Source: http://www.physorg.com/news91879247.html

Saturday, March 03, 2007

Powerful Denial

Sometimes, my overwhelming desire to believe that my children will be okay runs my life very effectively. I go through the normal day-to-day experiences of raising my girls without much thought for Alpha-1. Yes, I know that they have a life threatening gene. Yes, I know that right now, things are really great for them. Yes, I know I'm lucky to have my children with me to hug and hold. I guess what I'm trying to say is that most days, I have sort of a robotic response to thinking, feeling, or talking about Alpha-1. It is like I'm on autopilot.

I can rotely tell anyone about Alpha-1...what it is, why it affects my children, what we can and cannot do about it. I even devote volunteer time to Alpha-1 by serving on the board of directors of the Alpha-1 Association, Alpha-1 Kids, and the Alpha Pack, Wisconsin's support group. Monthly, I write a newsletter for Wisconsin Alphas, and daily, I monitor an online bulletin board for Alphas. I answer questions, provide support, and remind people in the Alpha-1 community that they are not alone.

Yet, here I am alone inside my own head tonight dealing with today's breakdown of powerful denial that protects this mother's heart.

In my last blog entry I described having interviewed an Alpha-1 researcher, Dr. Ronald Sokol. He is going to head up a groundbreaking research study of children with Alpha-1. All week, I've been thinking about how excited I am about this study, but here and there, a subtle realization kept creeping in my head. This study really is about my daughters and their genetic disorder. My babies have Alpha-1, and today, that is overwhelming the hell out of me.

This mom is about to order up a good dose of autopilot again.