Akut lymfatisk leukemi är den vanligaste formen av blodcancer hos barn. Trots att behandlingen med cellgifter har blivit bättre så blir det ofta återfall av cancern. Johan Janssons forskning visar att cancerceller som utsatts för cellgifter och överlevt var mindre känsliga för cellgifter och dessutom mer aggressiva. Men forskningen visade också på upptäckter som skulle kunna förbättra behandlingen mot sjukdomen.
Johan Janssons forskning visar att leukemiceller som har utsatts för cellgifter och överlevt inte utvecklade resistens mot benmärgstransplantation från exempelvis ett syskon. Däremot sågs flera viktiga förändringar hos dessa cancerceller. Dels blev de mindre känsliga för cellgifter och dels ökade tillväxthastigheten hos dem.
Johan Jansson har också identifierat flera immunologiskt viktiga gener som antingen ökade eller minskade när de hade utsatts för benmärgstransplantation. Av dessa gener var tre särskilt intressanta eftersom de hade att göra med aktivering av immunförsvaret och dödandet av cancerceller. Det visade sig också att sådan benmärgstransplantation kunde ha en hämmande effekt på de leukemiceller som också visade sig kunna aktivera delar av immunförsvaret.
Till sist har Johan Jansson undersökt om det går att kontrollera de leukemiceller som finns kvar efter en benmärgstransplantation. Det gick till genom att man vaccinerade möss med en blandning av “döda” leukemiceller och immunceller från en donator. Man såg då att immunförsvaret aktiverades till en viss del, men att mössen inte levde längre för det. Däremot såg man att de här mössen hade B-celler som producerade antikroppar mot leukemiceller. Den här kunskapen skulle kunna användas vidare för att utveckla och förbättra effekterna av en benmärgstransplantation.
Johan Jansson kommer ursprungligen från Köping. Sin grundutbildning inom biomedicin gick han vid Högskolan i Kalmar. Forskarutbildningen har han också gjort vid Högskolan i Kalmar, men skött den i princip helt på distans från Rochester universitetet i staten New York på USA:s östkust. Rent praktiskt har han haft en vetenskaplig handledare i USA och i Kalmar har han haft sin huvudhandledare professor Sven Tågerud som han via mejl och Skype med mera har haft kontakt med under hela utbildningen.
Johan Jansson disputerade den 29 september med avhandlingen Acute Lymphoblastic Leukemia in the Allogenic Environment.
Handledare: Prof. Craig A. Mullen, University of Rochester, NY, USA, Prof. Sven Tågerud, Högskolan i Kalmar.
Biträdande handledare: Prof. Kristina Nilsson Ekdahl, Högskolan i Kalmar.
Opponent: Prof. Mikael Sigvardsson, Linköpings universitet
Källa: Högskolan i Kalmar

New research by Weill Cornell Medical College researchers looks at the specific ways parents and peers influence teenagers to smoke, drink and use marijuana in combination. Among their findings: attitudes toward smoking influenced teenagers’ use of multiple drugs (smoking, drinking and marijuana), and that this manifested itself differently in boys and girls.
For girls, friends were shown to be central. Ambivalent or permissive attitudes within their social group toward smoking were associated with poly-drug use — defined as two or more of the following behaviors: smoking, drinking and marijuana use. This wasn’t the case with boys, whose poly-drug use was instead predicted by the extent to which they perceived smoking to be prevalent in their larger age group — not just among their friends.
“If a teenager feels smoking is socially acceptable and widely practiced, they are much more likely not only to smoke, but to also drink and possibly use marijuana,” says lead author Dr. Jennifer A. Epstein, assistant professor of public health in the Division of Prevention and Health Behavior at Weill Cornell Medical College. “While the differences between how boys and girls are influenced by these social factors are subtle, they could help us develop new gender-specific educational tactics for preventing these behaviors.”
The study also revealed several factors that were the same for boys and girls. When their friends drank alcohol or smoked or when their parents had permissive or ambivalent attitudes toward drinking, both teenage boys and girls were more likely to report poly-drug use. Other major variables included teenagers’ inability to refuse drugs and achieve goals through their own efforts.
“A parent’s opinion matters. Moms and dads are critical role models and should let their attitudes against drug use be known. It’s also important to keep an eye on their child’s social circle, since, especially for girls, it’s their friends who are so central to influencing their behavior,” says Dr. Epstein. “At the same time, parents can do things that reduce their child’s risk for using drugs, such as teaching them to set goals and assert themselves.”
Researchers analyzed confidential surveys taken by 2,400 sixth- and seventh-graders in inner-city schools in New York City. Questions dealt with substance use and several psychological factors that previous research suggests may be related to drug use. The majority of the schools serve youths from families with incomes averaged well below the federal poverty level.
The current study is one of the first to look at the relationships between smoking, drinking and marijuana use. The vast majority of research in this area has focused on a single substance in isolation, especially among white middle-class suburban populations. The importance of Dr. Epstein’s approach is backed up by evidence suggesting that teenage poly-drug use is a significant risk factor for adult poly-drug use.
One implication of these findings, according to Dr. Epstein, is that “comprehensive prevention programs focusing on multiple gateway drugs (alcohol, cigarettes and marijuana) may prove to be more valuable than programs focusing on a single drug.”
Study co-authors included Dr. Gilbert J. Botvin, chief of the Public Health Department’s Division of Prevention and Health Behavior and professor of psychology in public health and psychology in psychiatry at Weill Cornell Medical College; and Margaret Doyle, formerly of Weill Cornell.
The study appears online in the July 1 issue of the Journal of Child and Adolescent Substance Abuse. The research was supported by a grant to Dr. Epstein from the National Institute on Drug Abuse (NIDA) to analyze data previously collected under a grant to Dr. Botvin from the National Cancer Institute (NCI). Some students in the NCI study received a prevention program called Life Skills Training (LST), while others did not. Dr. Botvin receives income from sales of the LST program. The data used by Dr. Epstein for the current NIDA study were from students who did not receive the LST program.
Weill Cornell Medical College
Weill Cornell Medical College, Cornell University’s medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Weill Cornell, which is a principal academic affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in areas such as stem cells, genetics and gene therapy, geriatrics, neuroscience, structural biology, cardiovascular medicine, transplantation medicine, infectious disease, obesity, cancer, psychiatry and public health — and continue to delve ever deeper into the molecular basis of disease and social determinants of health in an effort to unlock the mysteries of the human body in health and sickness. In its commitment to global health and education, the Medical College has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances — including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson’s disease, the first indication of bone marrow’s critical role in tumor growth, and most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient.

Source: NewYork-Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

Treating pregnant women for mild gestational diabetes resulted in fewer cesarean sections and other serious birthing problems associated with larger than average babies, according to a study conducted in part at the University of North Carolina at Chapel Hill.
‘This study is important because it clearly indicates the value to mothers and their newborns of screening for and treatment of diabetes-like conditions provoked by pregnancy,” said John M. Thorp, M.D., McAllister distinguished professor of obstetrics and gynecology at the UNC School of Medicine and a co-author of the study.
“Our work resolves a 40-year controversy in women’s health and should be immediately helpful to both pregnant women and the clinicians caring for them.”
The study is published in the Oct. 1 issue of the New England Journal of Medicine. The lead author and principal investigator is Mark B. Landon, M.D. of Ohio State University. It was conducted at 14 sites that are part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network.
About 4 percent of all pregnant women in the U.S. develop gestational diabetes, resulting in about 135,000 cases each year, Thorp said. Because these women have high blood sugar levels, their babies receive more blood glucose than they need, and the extra energy is stored as fat. These babies tend to be larger and fatter than average at birth and thus are more likely to be affected by problems associated with larger babies, such as the need for cesarean delivery, damage to their shoulders during birth and a greater risk of becoming obese as children and developing type 2 diabetes as adults.
There has been a longstanding controversy among physicians on the question of whether treating pregnant women with gestational diabetes for their high blood sugar levels would provide worthwhile benefits. Several professional organizations advocate screening, but the 2008 guidelines of the U.S. Preventive Services Task Force concluded there is insufficient evidence to support screening for and treatment of gestational diabetes.
Against this background, the MFMU Network launched a clinical trial to determine if treating mothers for mild gestational diabetes would reduce infant deaths and birth-related complications. A total of 958 women between 24 and 31 weeks of pregnancy were randomized, with 485 receiving treatment (including dietary changes, self blood glucose monitoring and insulin if necessary) and 473 in the untreated group.
There were no infant deaths in the study and no significant differences between the two groups in terms of babies born with problems such as hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia and birth trauma.
However, there were significantly fewer babies in the treatment group to experience unusually large size (7.1 percent vs. 14.5 percent), high birth weight (5.9 percent vs. 14.3 percent), shoulder damage during birth (1.5 percent vs. 4.0 percent) or to require cesarean delivery (26.9 percent vs. 33.8 percent).
In addition, Thorp said, “It’s especially intriguing that mothers in the treatment arm gained less weight during pregnancy, experienced fewer preterm births and had fewer cases of preeclampsia than mothers in the untreated group.” Preeclampsia is a syndrome marked by a sudden increase in the blood pressure of a pregnant woman after the 20th week of pregnancy, which can be fatal or lead to long-term health problems for mother and baby.
The study concludes that “these findings confirm a benefit to the identification and treatment of women with mild carbohydrate intolerance during pregnancy.”

Source: University of North Carolina at Chapel Hill School of Medicine