Critical process for how breast cancer spreads in bones

Once breast cancer spreads to bone, treatment becomes nearly impossible. Breast cancer cells can lie dormant in the bone, often undetectable and able to escape typical treatments. Unfortunately, these dormant cells can awaken at any time to generate tumors. All of this combined makes it difficult to understand how the cells proliferate and how to stop them from doing so. However, researchers from the University of Notre Dame have now identified a pair of proteins believed to be critical for spreading, or metastasizing, breast cancer to bone. One protein, known as CXCL5, was discovered to be key for signaling growth of cancer cells once it binds to its receptor, called CXCR2. Published in Nature Communications, the study shows that these two proteins cause breast cancer cells – including those that lie dormant – to rapidly reproduce and spread throughout the bone and marrow. With a new model developed, the research team were able to identify factors that could either activate breast cancer proliferation or inhibit proliferation and induce cancer cell dormancy in the bone. The protein CXCL5 was identified as a proliferative factor. Previously, its receptor CXCR2 had been linked with poor responses to chemotherapy treatments. Therefore, researchers investigated how CXCL5 and CXCR2 may work together to increase cancer cell proliferation. The team found that when the CXCR2 receptor was blocked, CXCL5-induced signaling was inhibited, preventing rapid proliferation of breast cancer cells in bone. To further test their findings, Notre Dame researchers collaborated with Lukas Nystrom from the Loyola University Medical Center and confirmed that CXCL5 and CXCR2 were present in a human bone sample from a patient with breast cancer metastasized to bone. The article is titled “CXCL5/CXCR2 axis is sufficient to promote breast cancer colonization during bone metastasis.”

Early spinal patterns may predict scoliosis in teen years

A pediatric researcher has identified patterns of spinal curvature in younger children that may be likely to develop into scoliosis by adolescence. Accurately predicting scoliosis, a common, abnormal curvature of the spine, may set the stage for the first-ever methods to prevent the potentially disabling condition. "This was the first study to quantitatively explain how variation in spinal patterns may lead to the spinal deformities seen in scoliosis and may eventually guide us to early interventions for children at risk," said researcher Saba Pasha, director of Orthopaedic Engineering and 3D Musculoskeletal Imaging at Children's Hospital of Philadelphia. Her study appeared online Nov. 11, 2019, in Nature Scientific Reports. In the study, Pasha used computer simulations to investigate how elastic rods, modeling children's spines, change shape in response to mechanical loading. Pasha drew on spinal X-rays of 129 adolescents with or without scoliosis. Computer analysis transformed those images into 2D patterns, designated sagittal spinal profiles. She used those patterns to create S-shaped elastic rods in the computer simulation and applied simulated mechanical forces to observe how those rods deformed in 3D shapes. The results were intriguing. Under this simulated mechanical force, S-shaped 2D patterns in the model deformed into the 3D patterns seen in scoliosis patients with the same sagittal curve. However, the rods in the model that represented the sagittal curves of patients without scoliosis did not twist into a 3D scoliosis-like deformation. This model provides strong evidence, said Pasha, that the shape of a person's sagittal profile can be a leading cause of scoliosis. If follow-up studies verify that imaging studies can identify patients at risk for later scoliosis, these studies may allow clinicians to develop strategies to prevent a condition for which no preventive measures now exist.

Yoga and physical therapy as treatment for chronic lower back pain also improves sleep

Yoga and physical therapy (PT) are effective approaches to treating co-occurring sleep disturbance and back pain while reducing the need for medication, according to a new study from Boston Medical Center (BMC). Published in the Journal of General Internal Medicine, the research showed significant improvements in sleep quality lasting 52 weeks after 12 weeks of yoga classes or 1-on-1 PT, which suggests a long-term benefit of these non-pharmacologic approaches. In addition, participants with early improvements in pain after six weeks of treatment were three and a half times more likely to have improvements in sleep after the full, 12-week treatment, highlighting that pain and sleep are closely related. Sleep disturbance and insomnia are common among people with chronic low back pain (cLBP). Previous research showed that 59% of people with cLBP experience poor sleep quality and 53% are diagnosed with insomnia disorder. Medication for both sleep and back pain can have serious side effects, and risk of opioid-related overdose and death increases with use of sleep medications. The randomized controlled trial included 320 adults with cLBP from BMC and seven surrounding community health centers. At the beginning of the study, over 90% of participants with cLBP were found to suffer from poor sleep. Participants were assigned one of three different therapies for cLBP: physical therapy, weekly yoga, or reading educational materials. The results for sleep improvements were compared over a 12-week intervention period and after 1 year of follow-up. "The high prevalence of sleep problems in adults with chronic low back pain can have detrimental effects on a person's overall health and well-being," the researchers said. "This really emphasizes the need for providers to ask patients with chronic low back pain about the quality of their sleep. Given the serious risks of combining pain and sleep medications, nonpharmacologic approaches should be considered for these patients." The article, published on Oct. 30, 2019, is titled Yoga, Physical Therapy, and Back Pain Education for Sleep Quality in Low-Income Racially Diverse Adults with Chronic Low Back Pain: a Secondary Analysis of a Randomized Controlled Trial.”

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