The following highlights efforts that seek to reduce racial and ethnic health disparities.

• Colorado: The Colorado Minority Health Advisory Commission is holding several town-hall forums throughout the state to discuss ways to eliminate health disparities, the Colorado Springs Gazette reports. The commission, which was formed seven years ago, will award between $10 million and $12 million to Colorado communities to address health disparities, Ned Calonge, chief medical officer for the Colorado Department of Public Health and Environment, said. Anthony Young, a psychologist and chair of the commission, said there is a need for increased health education and awareness, including information on how to receive no-cost health screenings, in minority communities (Newsome, Colorado Springs Gazette, 5/15).

• HIV testing: Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, called for increased HIV testing among Asian and Pacific Island communities ahead of the fifth annual National Asian & Pacific Islander HIV/AIDS Awareness Day, which took place on Tuesday. According to Fauci, public health officials and caregivers should increase efforts to communicate messages about HIV prevention to Asian and Pacific Islander communities in linguistically appropriate and culturally relevant ways. In addition, the NIH Office of AIDS Research recently published the fiscal year 2010 Trans-NIH Plan for HIV-Related Research, which contains a chapter on how to address HIV/AIDS among Asians and Pacific Islanders and other minority groups (NIH release, 5/18).

• Oregon/Washington: The Oregon and Southwest Washington Affiliate of Susan G. Komen for the Cure recently awarded $2 million to organizations that support health care for American Indian, Asian, Hispanic and Russian communities in Oregon and southwest Washington to fund breast cancer research and services to medically underserved populations, the Burns Times-Herald reports. The grant also will be used to provide health care in rural areas. The initiative will provide services to more than 24,000 men and women who are experiencing language and cultural barriers, financial difficulties and transportation issues that limit their access to health care. In addition, the program will provide support services to women who are in treatment for breast cancer, as well as to breast cancer survivors (Burns Times-Herald, 5/20).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

During desperate times, such as fasting, or muscle wasting that afflicts cancer or AIDS patients, the body cannibalizes itself, atrophying and breaking down skeletal muscle proteins to liberate amino acids. In a new study published online June 8 and in the June 15, 2009 print issue of the Journal of Cell Biology, Shenhav Cohen, Alfred Goldberg, and colleagues show that muscle atrophy is a more ordered process than was previously thought. These researchers find evidence that enzyme MuRF1 selectively degrades the thick filaments in muscle, while bypassing the thin filaments.

We depend on skeletal muscles because they can produce movement, but they serve another purpose too. “Skeletal muscle is a protein reservoir that can be mobilized in times of need,” says Goldberg. The structural core of a muscle cell is the myofibril, composed of myosin-containing thick filaments and actin-containing thin filaments. During atrophy, this structure is disassembled, but exactly how was not known. MuRF1, an atrophy-related gene, is a ubiquitin ligase that “ubiquitylates,” or tags a protein, by attaching a ubiquitin molecule, marking it for degradation by the cell. It was unclear when and how ubiquitylation was involved in disassembling skeletal muscles. The researchers triggered atrophy in mice containing defective MuRF1 (lacking its RING-finger domain crucial for ubiquitylation). These mutant mice break down less muscle than wild-type mice, and less ubiquitylation takes place in the mutants.

Cohen and colleagues found that MuRF1 targets the thick filament, demolishing various components in a specific order. The researchers hypothesize that removal of certain thick filament components first permits subsequent MuRF1 access to the myosin heavy chain. However, MuRF1 doesn’t exert the same power over the thin filament, which began to come apart even when MuRF1 was absent.

“Up to now, people thought the muscle just gets smaller” during atrophy, Goldberg says. Instead, these findings paint a picture of a well-regulated process of degradation and disassembly. This mechanism “allows the muscle to still be a muscle and function,” Goldberg says. “Atrophy doesn’t just destroy muscle cells, like apoptosis.” The results indicate that MuRF1 doesn’t have to wait for caspases or calpains to “pre-digest” the myofibril components. The work also bears on the practical question of whether atrophy can be halted or reversed with drugs. “It argues against MuRF1 inhibitors” for this purpose, Goldberg says, because the enzyme is responsible for degrading only some muscle components, whereas others fall victim to other ubiquitin ligases and autophagy. Inhibitors that work upstream to block signals that activate ubiquitin ligases and initiate autophagy are a better bet.

Cohen, S., et al. 2009. J. Cell Biol. doi:10.1083/jcb.200901052.

Source:
Rita Sullivan

Rockefeller University Press

Patient / Public:
Health Professional:
Article Opinions:	php?associatednewsid=153252′ rel=’nofollow’>0 posts

Access To Second-Line Antiretrovirals In India

The successful scale-up of services for people living with HIV (PLHIV) in India “is now at risk,” write Loon Gangte, president of the Delhi Network of Positive People, and Leena Menghaney, projects manager in India for Medecins Sans Frontieres’ Campaign for Access to Essential Medicines, in a livemint.com editorial.

Although “[t]he need for access to newer combinations of ARVs has been evident from the beginning of the government treatment programme,” the authors write that “the government held back from introducing second-line ARVs in the national AIDS treatment programme on concerns about the spiralling prices of second-line ARVs.” While ten ARV centers have begun to administer second-line ARVs, there are restrictions on who can access the drugs.

“The refusal to treat spells immense hardship for PLHIV and their families, who are forced to purchase second-line ARVs themselves from pharmacies at prices significantly higher than those obtained by the government through bulk purchases directly from the generics producers,” say the authors, adding, “Many will not be able to sustain this expensive treatment, leading inevitably to further drug resistance, continuous ill health, AIDS, and death.”

The authors conclude, “The battle to start providing ARV therapy in India has been won. The battle to provide lifelong treatment to all is just beginning” (Gangte/Menghaney, livemint.com, 6/8).

Obama’s PEPFAR Funding Level, ‘Unwise,’ But ‘Understandable’ Choice

“Though President Obama’s trip to Africa [last week] focused on the Muslim world, by looking South from Egypt across the Sahara to the rest of the continent he could have seen the dramatic impact” of former President George W. Bush’s HIV/AIDS policies in Africa, columnists Cokie Roberts and Steven Roberts write in a Billings Gazette opinion piece. PEPFAR’s “efforts to deal with HIV/AIDS in Africa have saved more than a million lives; Obama needs, even in these tough times, to continue them.”

PEPFAR’s investments are “impressive” throughout the “15 focus countries of the program, where more than 2 million people have received lifesaving antiviral drugs free of charge,” according to the authors. But the “bad news is that the number of infections has not decreased and there are still millions of children who have been either orphaned or made vulnerable to a life of desperate deprivation due to HIV/AIDS,” according to Roberts and Roberts.

The opinion piece includes details about Cokie Roberts’ recent Africa trip to see how Save the Children, where she is a trustee, uses PEPFAR money. One of the group’s projects focuses on improving “the lives of [children's] caretakers” by working with local charities to teach women how to save money, according to the authors. They also describe a youth center where young boys talk about “how much they like coming to a place where adults pay attention to them and try to teach them how to make good choices.”

According to Roberts and Roberts, these are some of the “best way[s] to reduce the incidence of AIDS in the long run.” They conclude that although Obama’s budget proposal decreases PEPFAR somewhat, it’s “an understandable choice in recessionary times, but an unwise one given the success of the program” (Roberts/Roberts, Billings Gazette, 6/5).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.