TMC PULSE

t m c » p u l s e | a u g u s t 2 0 1 5 39 ARE YOU DEPRESSED AND BETWEEN THE AGES OF 18 AND 65? Are you currently on an antidepressant without receiving the improvement you need? If so, you may be eligible to participate in a research study of a rapidly acting medication (Ketamine) conducted in patients with major depression at Baylor College of Medicine and The Michael E. Debakey VA Medical Center Please contact us at our confidential number or email: 713-689-9856 mood@bcm.edu Traditional Pap Smear Soon to be Thing of the Past H uman papillomavirus (HPV) genotyping has a potential role in primary screening of cervical cancer. It could replace the traditional pap smear, according to experts at Baylor College of Medicine. Although pap tests have worked well over the past 70 years, there are downsides, said Matthew Anderson, M.D., Ph.D., assistant professor in the department of obstetrics and gynecol- ogy at Baylor. "During a pelvic exam the doctor has to be able to scrape cells directly from the area of the cervix where cancer is most likely to originate, and it's potentially uncomfortable," he said. "In some Harris County communities as many as 10 percent of women have never been screened for cervical cancer." About 20 years ago it was discov- ered that HPV is the cause of most cervical cancers, and every type of this cancer expresses the components and transcripts of the viral DNA. "It is now possible to test for these viral components and tran- scripts," Anderson said. "Right now it's used to decide whether or not a woman has atypical cells that can't be clearly classified." These results are used to determine whether patients need continued evalu- ation or no evaluation. According to Anderson, this data suggests it can be used under other contexts as well. "For example, if you have a patient with low grade or early stage pre-cancer, there's some data to suggest you may be able to use the information obtained with viral testing to decide whether or not the patient needs a col- poscopy, or a microscopic examination on the cervix, after a low-grade abnor- mal pap," he explained. HPV genotyping is currently offered as co-testing done with a pap smear. "This could be the more sensitive and effective route for screening," Anderson said. "It has been suggested that it might be possible to screen women, especially over age 30, for cervical cancer using genetic tests for HPV alone, rather than having to do the traditional pap test." "Ideally, it would be great to find ways to use this test to help women who have never been screened or are reticent to be screened by traditional methods," he said. Due to the HPV vaccination, smaller proportions of the population will get infected with the virus. Because of this doctors will only need to screen for the infection of HPV. Anderson emphasized that this will allow physicians to directly focus their cervical cancer screening efforts on women who test positive for HPV. — Julia Parsons, Baylor College of Medicine Sulfur Dioxide Emissions Have Decreased But the Air Pollutant Still a Concern for Asthmatics E missions of the air pollutant sulfur dioxide have been dramatically decreased during the past 30 years, but for some people, even a little inhaled sulfur dioxide may still be too much. "Asthmatics are particularly sensi- tive to sulfur dioxide and can be more likely to suffer asthma complications, but scientists still don't know exactly why that is so," said Bill Ameredes, Ph.D., director of the Inhalation Toxicology Core Facility of the Sealy Center for Environmental Health and Medicine at the University of Texas Medical Branch at Galveston. There are about 250 million people worldwide who suffer from asthma, according to the World Health Organization. Sulfur dioxide and other air pollutants may be associated with an increase in asthma complications, but how and why that is remains poorly understood, according to a paper Ameredes co-authored. To better understand what was known about asthma and sulfur dioxide, Ameredes and researchers at UTMB and the University of Texas Health Science Center at San Antonio reviewed previously published studies. In a paper in April's Environmental Health Insights, the researchers found previous studies indicated that sulfur dioxide can lead to adverse effects in asthmatics even when present in very small amounts, and asthmatics may not be able to counter the inflammatory response in the lung as non-asthmatics can. Sulfur dioxide is produced when fossil fuel is burned, when metal is extracted from ores and when gasoline is extracted from oil. According to Ameredes, due to federal emissions regulations, there has been an over 80 percent reduction in the amount of sulfur dioxide in the ambient air in the United States over the past 35 years. But studies show that even when the amount of sulfur dioxide is below what can be detected by the sense of smell, it can have adverse effects for asthmatics, Ameredes said. In high enough concentrations, at about five to 10 parts per million, sulfur dioxide can cause a burning sensation in the eyes and coughing. The rotten egg odor of sulfur dioxide can be detected at one to three parts per mil- lion. However, according to Ameredes, an asthmatic could start to experi- ence airway irritation and difficulty breathing with as little as 0.5 parts per million sulfur dioxide in the air. "Thus, if you were an asthmatic, it would be possible that you wouldn't even know that there is sulfur dioxide in the air," Ameredes said. "You'd just be having breathing difficulties and coughing, but you would not be able to detect the odor, therefore wouldn't know why you were having that experience." It could also be more difficult for asthmatics to stop or control an irritation and inflammation response once it begins because of their inabil- ity to produce interleukin-10, a major anti-inflammatory cytokine, a protein released by cells, considered to be an "off-switch" that stops the inflammatory process, Ameredes said. He added that scientists don't yet understand why asthmatics lack the ability to make interleukin-10 and it is one of the many areas still requir- ing study. — Christopher Smith-Gonzalez, UTMB

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