Snot. It’s not something most of us spend a lot of time thinking about, but, for a team of researchers in Washington, D.C., it’s front and center.
Robert I. Henkin, founder of the Taste and Smell Clinic in is charmingly self-deprecating. He says with a chuckle that he’s often called a “spit and snot doctor,” but he knows all too well that for his patients – those who no longer can appreciate the fragrance of fresh-cut grass or the intricacies of an herb-infused sauce – such loss is no laughing matter.
“You might think: ‘Oh well, you can still hear. You can still see.’ But it’s amazingly important to be able to taste and smell,” Henkin said. “When you say ‘hello’ in (some parts of China), you don’t say ‘hello’ – you say ‘Have you eaten yet?’ In other words, the social aspects of being able to eat and enjoy that are critical, and to lose that – you lose a significant part of life.”
Henkin, who at the National Institutes of Health established the first clinical program to study taste and smell dysfunction, has spent the better part of his professional life trying to get the lay of the land when it comes to the fluids that contribute to those two senses. He and his team over the years have conducted countless experiments to figure out what makes up nasal mucus and saliva and how those components affect taste and smell.
“The thing to recognize is there are 21 million people in the United States who have some abnormality of smell function. That’s an amazing number,” said Henkin.
On April 21, Henkin presented new research results at the Experimental Biology 2013 conference with the hope that attendees there also will take the mission seriously, build upon his findings and come up with new therapies for patients like his.
Henkin’s newest work describes the concentrations of cytokines, molecules involved in cell signaling, in nasal mucus. He’ll present his findings at the annual meeting of the American Society for Biochemistry and Molecular Biology, which is being held in conjunction with the Experimental Biology 2013 conference.
“In a rather naïve way, we went ahead and looked at these cytokines in nasal mucus because nobody’s ever done it before,” Henkin explained.
This kind of strategy is par for the course for Henkin, who also was the first to report which proteins are present in saliva in 1978 and which proteins are present in nasal mucus in 2000. He emphasizes that “you can’t understand the (disease) mechanisms unless you understand what’s there.”
“This whole role of nasal mucus – what’s there, how it works — is something that (researchers) haven’t really considered,” he said. “It takes a dumb guy like me to go ahead and say ‘OK, let’s figure out what’s there, and then we can see what we’re going to do about it. It’s a different approach.”
What’s so different about it? Henkin says most of his patients come to him as a last resort, because their primary physicians and even specialists can’t offer any lasting solutions.
“The people who are interested in (smell loss) are primarily otolaryngologists, and they’re trained as surgeons … They’re not trained to think about this” on the molecular level, Henkin said. “So they look at the nose, and if there’s a polyp they’ll take it out and say, ‘Aha, there’s the answer. We’ll make the nasal cavity cleaner.’ Well, these (molecular) structures in the nose that cause these problems are manifestations of some underlying disease process, which they’ve been trying to figure out for a while but haven’t really succeeded.”
Henkin’s group has succeeded in restoring smell loss in many patients – and sometimes by seemingly unconventional means. A few years back, they tested out a drug long used in asthmatics, theophylline, and they found that oral use could induce higher levels of a protein called cAMP in nasal mucus, which improved some patients’ ability to smell. The team later found that administering a smaller dose intranasally produced a more profound effect.
Henkin said examples like that underscore the importance of understanding the molecular makeup of nasal mucus and the interactions within, rather than immediately turning to surgery or, another common practice, giving patients steroids.
“Because they’ve used these (steroids) to inhibit polyp formation in the nose, what happens is that in some people the smell comes back for a limited period of time. It may come back for a day or a week. And then when the drug wears off, they can’t smell again,” Henkin said. “We now understand a little bit about how that works – how it affects those cytokines and other substances.”
Cytokines are molecules that deliver information and induce some kind of response – usually during immunological and inflammatory processes.
Henkin’s team found that in nasal mucus of patients with smell loss the concentration of anti-inflammatory cytokines was much higher than the concentrations of pro-inflammatory cytokines. This balance is important, he says, because the cytokine interleukin-6, which is pro-inflammatory, was particularly abundant.
“We’d looked at the literature and recognized that IL-6 is obviously elevated in a number of inflammatory diseases, such as rheumatoid arthritis. As a matter of fact, with rheumatoid arthritis you commonly have smell loss,” Henkin said. “We’re trying to make these connections, you see, and understand the relationships in these underlying interactions – to give people some idea (about) homeostasis in the nasal cavity, how it’s occurring, what’s in nasal mucus and how each of these substances plays a specific role in smell function.”
SACRAMENTO – The Assembly has approved AB 394, a bill authored by Assemblymember Mariko Yamada (D-Davis) and Assemblymember Shannon Grove (R-Bakersfield), extending the sunset date for the Alzheimer’s Disease and Related Disorders Research Fund income tax check-off through 2020.
The bill passed from the Assembly Floor with strong bipartisan support.
Assemblymember Yamada, who chairs the Assembly Committee on Aging and Long-Term Care, said the decision to jointly author the bill with Assemblymember Grove reflects their shared experience of caring for an aging parent.
“I took care of my mother for 23 years,” Yamada said. “When I learned that Assemblymember Grove, a member of the Aging and Long-Term Care Committee, currently manages her mother’s care as she lives with Alzheimer’s, I immediately asked her to be my joint author.”
Alzheimer’s disease is now the sixth leading cause of death in California and is the only leading cause of death that lacks a means of prevention or reversal.
The California Department of Public Health reports that one in 10 Californians 55 and over are living with Alzheimer’s disease.
“There are questions about why the government picks winners and losers among the many serious diseases that deserve research,” Assemblymember Grove said. “But Alzheimer’s will hit almost every one of us – either through a parent, a sibling or ourselves.”
Since the voluntary contribution check-off for the Alzheimer’s Disease and Related Disorders Research Fund first appeared on state income tax forms in 1987, more than 1.3 million California taxpayers have donated more than $11.3 million.
The funds are distributed to Alzheimer’s researchers in California through a competitive grant process.
AB 394 will now head for consideration in the Senate.
The estimated annual cost savings from eliminating smoking in all U.S. subsidized housing would be $521 million, according to a new study from the Centers for Disease Control and Prevention.
This is the first study to estimate the costs that could be saved by prohibiting smoking in subsidized housing, including public housing and other rental assistance programs.
The bulk of those annual savings – $341 million – would come from reduced health care expenditures related to secondhand smoke.
The study also estimates savings of $108 million in annual renovation expenses and $72 million in annual smoking-related fire loses.
“Many of the more than 7 million Americans living in subsidized housing in the United States are children, the elderly or disabled,” said Tim McAfee, M.D., M.P.H., director of the Office on Smoking and Health at CDC. “These are people who are most sensitive to being exposed to secondhand smoke. This report shows that there are substantial financial benefits to implementing smoke-free policies, in addition to the health benefits those policies bring.”
The study also estimated the cost savings associated with prohibiting smoking in all U.S. public housing, which is a portion of subsidized housing managed by public housing authorities.
The total annual savings for public housing would be about $154 million a year, including $101 million from health care costs related to secondhand smoke exposure, $32 million from renovation expenses, and $21 million from smoking-attributable fire losses.
Studies have shown that people who live in multiunit housing can be particularly affected by unwanted secondhand smoke exposure. Other studies have shown that most people who live in subsidized housing favor smoke-free policies.
“Secondhand smoke enters nearby apartments from common areas and apartments where smoking is occurring,” said Brian King Ph.D., an epidemiologist with CDC’s Office on Smoking and Health and lead author of the report. “Opening windows and installing ventilation systems will not fully eliminate exposure to secondhand smoke. Implementing smoke-free policies in all areas is the most effective way to fully protect all residents, visitors, and employees from the harmful effects of secondhand smoke.”
Secondhand smoke is responsible for about 50,000 deaths a year in the United States. The 2006 Surgeon General’s Report, The Health Consequences of Involuntary Exposure to Tobacco SmokeExternal Web Site Icon, concluded that secondhand smoke is also known to cause numerous health problems in infants and children, including more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome.
In the same report, the Surgeon General concluded that there is no safe level of exposure to secondhand smoke, and that only 100 percent smoke-free indoor policies can fully protect people from secondhand smoke dangers.
The U.S. Department of Housing and Urban Development has encouraged public housing authorities, as well as owners and managers of multi-family housing rental assistance programs such as Section 8, to adopt smoke-free policies in their properties.
As of January 2012, more than 250 public housing authorities have gone smoke-free. But overall, only a small percentage of public housing authorities have implemented smoke-free policies.
Educating housing operators and residents about the health and economic benefits of prohibiting smoking and providing resources and information on quitting smoking could help increase the number of subsidized housing residents protected by smoke-free policies.
“This new study reinforces the importance of the Housing and Urban Development initiative to promote the adoption of smoke-free housing policies in public housing and other federally-assisted multifamily housing,” said Sandra Henriquez, HUD’s Assistant Secretary for Public and Indian Housing. “We have seen considerable momentum in the number of public housing agencies across the country adopting this policy, which saves health and housing costs, in places like Boston, San Antonio, Seattle, and all public housing in the state of Maine.”
To learn more about the benefits of smoke-free policies, visit www.cdc.gov/tobacco . For information on quitting smoking call 1-800-QUIT-NOW (1-800-784-8669). Also, visit www.BeTobaccoFree.gov for information on quitting and preventing children from using tobacco. For stories of people who have quit successfully, visit http://www.cdc.gov/tips .
CLEARLAKE, Calif. – A caregiver support group for families dealing with memory loss or other cognitive impairments will meet on Wednesday, April 24.
The group meets at St. John’s Lutheran Church at 14310 Memory Lane in Clearlake from 9:30 a.m. to 11 a.m.
Social worker Jenny Johnson is the facilitator.
The groups are sponsored by Redwood Caregiver Resource Center (1-800-834-1636) and the Social Day Programs in Lake County.
For more information call Jenny Johnson at 707-350-3030 or Caroline Denny at 707-263-9481.
Respite is provided by the centers at no charge.