Washington — For the first time, researchers have uncovered a genetic variant of Alzheimer’s disease among people who inherit two copies of a concerning gene.

Scientists have long known that a gene known as APOE4 is one of numerous factors that can increase people’s chance of developing Alzheimer’s disease, including just growing older. The great majority of Alzheimer’s cases develop after age 65. However, new research published on Monday reveals that for people who carry two copies of the gene, it is more than a risk factor; it is an underlying cause of the mind-robbing disease.

The findings have “profound implications,” according to Dr. Juan Fortea, who led the study at the Sant Pau Research Institute in Barcelona, Spain.

Symptoms can appear seven to ten years earlier than in other elderly people who get Alzheimer’s.

An estimated 15% of Alzheimer’s patients have two copies of APOE4, which means that those instances “can be tracked back to a cause, and the cause is in the genes,” according to Fortea. Until recently, hereditary variants of Alzheimer’s were thought to be the only types that struck at considerably younger ages, accounting for less than 1% of all cases.

According to scientists, the findings highlight the need of developing medicines targeting the APOE4 gene. Some doctors will not provide Leqembi, the only treatment found to modestly reduce the disease, to people with the gene pair because they are more likely to experience a dangerous side effect, according to Dr. Reisa Sperling, a study coauthor at Harvard-affiliated Brigham and Women’s Hospital in Boston.

Sperling is looking for ways to prevent or at least delay Alzheimer’s, and “this data for me says wow, what an important group to be able to go after before they become symptomatic.”

However, the revelation does not imply that people should race to get a DNA test. “It’s important not to scare everyone who has a family history” of Alzheimer’s because this gene combination isn’t responsible for the majority of instances, she told The Associated Press.

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How Does Genetics Affect Alzheimer’s?

Alzheimer’s disease affects more than 6 million Americans and millions more throughout the world. A few genes are known to create rare “early-onset“ forms, which are mutations passed down through generations that cause symptoms to appear unusually early, before the age of fifty. Some occurrences have also been connected to Down syndrome.

However, Alzheimer’s disease most typically strikes after the age of 65, particularly in the late 1970s and 1980s, and the APOE gene, which also affects how the body manages lipids, has long been thought to have a role. There are three major variations. Most people have the APOE3 variation, which does not appear to raise or decrease Alzheimer’s risk. Some people carry APOE2, which offers some protection against Alzheimer’s.

APOE4 has long been identified as the most significant genetic risk factor for late-life Alzheimer’s, with two copies being more risky than one. Approximately 2% of the world’s population is predicted to inherit one copy from each parent.

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Research suggests a cause for a subset of Alzheimer’s.

To better comprehend the gene’s function, Fortea’s team analyzed data from 3,297 brains given for research and over 10,000 patients in Alzheimer’s studies in the United States and Europe. They investigated Alzheimer’s symptoms and early warning signs, such as sticky amyloid in the brain.

According to a study published in the journal Nature Medicine, people with two APOE4 copies accumulated more amyloid at age 55 than those with one copy or the “neutral“ APOE3 gene type. By age 65, brain scans revealed considerable plaque buildup in nearly three-quarters of those double carriers, who were also more likely to develop Alzheimer’s symptoms at that age rather than in their 70s or 80s.

Fortea stated that the disease’s basic biology was comparable to young inherited kinds.

It appears to be “a familial form of Alzheimer’s,“ according to Dr. Eliezer Masliah of the National Institute on Aging. “It is not just a risk factor.”

Importantly, not everyone with two APOE4 genes develops Alzheimer’s symptoms, and researchers need to figure out why, Sperling said.

“It’s not quite destiny,“ she explained.

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How the new findings may affect Alzheimer’s research and treatment

The medicine Leqembi works by removing some sticky amyloid, but Sperling said it’s unclear whether carriers of two APOE4 genes benefit because they are at a higher risk of the drug’s side effects, which include hazardous brain swelling and hemorrhage. One research topic is whether they might benefit from starting such medications sooner than others.

Masliah stated that other study tries to produce gene therapies or medications that precisely target APOE4. He believes it is especially critical to study APOE4’s impact across varied communities, as it has been investigated primarily in white people of European heritage.

Gene tests are now solely used to determine whether someone is a candidate for Leqembi or to enroll in Alzheimer’s research, particularly investigations of potential disease prevention methods. According to Sperling, the persons who are most likely to carry two APOE4 genes have parents who both developed Alzheimer’s disease in their 60s rather than 80s.

SOURCE – (AP)

KINSHASA, Congo – Congo is battling to contain its largest mpox outbreak, and scientists believe a new strain of the disease discovered in a mining town could spread more easily among people.

Congo has reported over 4,500 probable mpox cases and over 300 deaths since January, substantially double from the same period last year, according to the World Health Organization. Congo recently declared the outbreak a national health emergency.

An analysis of patients hospitalized between October and January in Kamituga, eastern Congo, suggests that recent mpox genetic mutations are the result of the disease’s continued transmission in humans; this is occurring in a town where people have little contact with the wild animals thought to naturally carry the disease.

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A New Form Of Mpox That May Spread More Easily Found In Congo’s Biggest Outbreak

“We’re in a new phase of mpox,” said Dr. Placide Mbala-Kingebeni, the study’s principal researcher, who added that it would soon be submitted to a journal for publication. Mbala-Kingebeni is the head of a lab at Congo’s National Institute of Biomedical Research that researches disease genetics.

Mbala-Kingebeni stated that the majority of patients’ lesions are milder and located in the genitals, making the disease more difficult to identify. In earlier African outbreaks, lesions were usually found on the chest, hands, and feet. He also noted that the new type seemed to have a decreased fatality rate.

In a report on the worldwide mpox situation published this week, WHO stated that the new strain of the disease may necessitate a new testing technique to detect mutations.

With specialists pointing out that fewer than half of Congo’s mpox patients are tested, Mbala-Kingebeni stated: “The risk is that unless patients themselves come forward, we will have a silent transmission of the disease and nobody will know.”

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A New Form Of Mpox That May Spread More Easily Found In Congo’s Biggest Outbreak

According to Mbala-Kingebeni, the majority of people become infected through intercourse, with sex workers accounting for almost one-third of all mpox cases. It wasn’t until the 2022 worldwide mpox emergency that scientists discovered the disease was transmitted through sex, with the majority of cases affecting gay or bisexual men. WHO confirmed the first sexual transmission of mpox in Congo in November.

Mpox is classified into two types, or clades, related to smallpox and found in central and western Africa. Clade 1 is more severe, killing up to 10% of those afflicted. Clade 2 sparked the 2022 outbreak, and more than 99% of those afflicted survived.

Mbala-Kingebeni and colleagues stated they discovered a novel type of clade 1 that could be responsible for over 240 cases and at least three deaths in Kamituga, a location with a large transitory population going throughout Africa and beyond.

Dr. Boghuma Titanji, an infectious diseases expert at Emory University who was not involved in the study, expressed alarm about the new mutations.

“This suggests the virus is adapting to spread efficiently in humans and could cause some pretty consequential outbreaks,” she went on to say.

Vaccines and treatments were used to control mpox epidemics in the West, but few were accessible in Congo. Congo’s minister of health has authorized the deployment of vaccines in high-risk provinces, according to Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee. He added officials are in talks with donor countries such as Japan to help pay for the doses.

“Once a sufficient quantity of vaccines is available … vaccination will be implemented as part of the response,” Kacita Osako, the minister of health, stated.

Dr. Dimie Ogoina, an mpox expert at Niger Delta University, believes the new findings are a frightening reminder of a previous — but distinct — outbreak.

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A New Form Of Mpox That May Spread More Easily Found In Congo’s Biggest Outbreak

“The notable spread among sex workers is reminiscent of the early stages of HIV,” he said, adding that biases about treating sexually transmitted infections and persons with mpox’s unwillingness to speak up were concerning.

Dr. Michael Ryan, WHO’s emergency chief, stated last week that, despite the continuous spread of mpox in Africa and elsewhere, “there has not been a single donor dollar invested.”

SOURCE – (AP)

On Tuesday, Walmart, the biggest retailer in the United States, announced that it would shut down all 51 healthcare centers in six states and terminate its virtual healthcare services.

In the past several years, Walmart has significantly expanded its presence in the healthcare industry. The company has opened clinics adjacent to its superstores in several states, including Arkansas, Florida, Georgia, Illinois, Missouri, and Texas.

These clinics provide a wide range of medical services, such as basic and urgent care, laboratory testing, X-rays, behavioral health services, and dental treatments. Walmart was confident that it could utilize its extensive financial resources and network of stores to provide convenient and affordable services to people in rural and underserved regions where access to primary healthcare was limited.

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Walmart Will Close All Of Its Health Care Clinics

However, this statement signifies a sudden change in Walmart’s approach, which could result in a lack of access to healthcare, especially for economically disadvantaged individuals without insurance who depend on these clinics. Additionally, Walmart announced its decision to discontinue virtual healthcare services.

One distinctive aspect was their emphasis on stores situated in underprivileged communities. Ateev Mehrotra, a professor of health care policy and medicine at Harvard Medical School who studies retail health clinics, expressed disappointment that Walmart was unable to succeed in providing care for individuals who have few options.

Walmart stated that its decision to discontinue its healthcare initiative was based on the lack of profitability due to the difficult reimbursement environment and increasing operating costs.

The organization stated that it has concluded that there is no viable and enduring business model for it to proceed with.

Mehrotra stated that Walmart’s closures indicate the difficulties faced by primary care professionals in the United States. The Association of American Medical Colleges predicts a potential deficit of up to 55,000 primary care physicians in the coming decade.

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Walmart Will Close All Of Its Health Care Clinics

“This experience underscores the financial challenges that primary care faces as a whole.” “It truly reflects the challenges that primary clinics are encountering,” he stated.

Walmart has announced its intention to maintain the operation of its 4,600 pharmacies and over 3,000 optical facilities nationwide.

Walmart established clinics to address the needs of its customers who lack health insurance and those who have insurance plans with substantial deductibles and out-of-pocket expenses.

In 2020, Walmart CEO Doug McMillion indicated that the healthcare care field appeared to be a significant prospect shortly after the initial clinics were established.

High expenses and limited availability of primary healthcare services remain ongoing obstacles, particularly in rural regions. Walmart selected certain locations based on their higher prevalence of chronic diseases and lower number of primary care providers compared to the average towns in the United States.

In 2020, Marcus Osborne, the former vice president of health and wellness transformation at Walmart, informed CNN that those who frequently visited the clinics had not received medical attention from a primary care physician for two to three years or dental care for five years.

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Walmart Will Close All Of Its Health Care Clinics

According to Robert Field, a professor of health administration and policy at Drexel University, Walmart encountered various difficulties with its health clinics, such as a scarcity of medical personnel.

According to him, the closures of Walmart demonstrate that success in the retail industry does not necessarily indicate success in the healthcare sector.

“Selling services is distinct from selling products such as toothpaste and breakfast cereal, and necessitates distinct expertise and management,” Field stated.

SOURCE – (CNN)