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The good cough and the bad cough: Treating coughs in a targeted way, based on their type

More people seek medical advice for an unwanted, nagging cough than any other ailment. In some people their cough can persist for years without relief, as effective treatments are not readily available.

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Researchers might be able to treat a troublesome cough in disease without disrupting the protective cough we need for optimal lung health, by targeting the different brain circuits involved. That’s according to new research published this week in The Journal of Physiology.

More people seek medical advice for an unwanted, nagging cough than any other ailment. In some people their cough can persist for years without relief, as effective treatments are not readily available. 

These findings from Australian researchers have very important implications for understanding and potentially treating cough disorders because it appears that different types of coughs may use different brain circuits.

The act of coughing typically begins with an irritating stimulus within the larynx, airways or lungs that activates cough-evoking sensory nerves. These sensory nerves transmit this information to the brain, where the information is modifies the actions of the breathing muscles, to produce a cough response.  These signals are also sometimes combined with “higher order” signals that make your throat feel tickly, make you feel annoyed or anxious at having a cough, and allow you to suppress or enhance your cough voluntarily.

Previous research in animals and humans suggested that the brain processes all inputs from cough sensory nerves in a single area. However, in an earlier study using guinea pigs, published this year in The Journal of Physiology, the same research team from Monash University and the University of Melbourne demonstrated that this is unlikely to be true.

Instead, they discovered that separate pathways in the brain are involved in the response to a good (needed to clear airways, to ensure optimal lung health) vs a bad cough (a sign of disease).  

In this new study, human participants underwent behavioural testing to assess cough reflex sensitivity followed by functional brain imaging in an MRI scanner while inhaling different chemical substances.

One chemical stimulus used was capsaicin, the active component of hot chili peppers and known to activate two subsets of airway sensory nerves involved in coughing. 

Another chemical stimulus was adenosine triphosphate (ATP), best known as an energy molecule in cells but it also selectively activates one of the two subsets of sensory nerves involved in coughing.  

The final chemical stimulus was saline, used as a control stimulus because it doesn’t activate any sensory nerves. 

High resolution brainstem scans were collected during repeated randomised presentations of these stimuli, and the scans were analysed to identify where in the brainstem the neural responses to capsaicin and ATP are located. 

The outcome showed that capsaicin inhalation activated both the nucleus of the solitary tract and the area of the brainstem containing the paratrigeminal nucleus, whereas ATP inhalation only activated the nucleus of the solitary tract. 

The data confirm the team’s prior studies using guinea pigs, in that one cough pathway (sensitive to both capsaicin and ATP) is integrated in the nucleus of the solitary tract while the other cough pathway (sensitive to capsaicin only) involves integration in the paratrigeminal nucleus.   

Commenting on the study, senior author Professor Stuart Mazzone said: “Chronic cough is a horribly unpleasant ailment.  People can find themselves coughing hundreds of times every hour of their waking lives, for years on end, and current medicines simply aren’t effective at relieving this condition.”

Mazzone added: “We are now performing a similar study comparing how these two different brain networks respond in patients with chronic troublesome coughing compared to healthy participants. This new study is also motivated by recent clinical trial outcomes showing a promising cough suppressing action of drugs that inhibit ATP receptors.  How ATP is involved in cough is not fully known. We suspect that responsivity to ATP may change in patients with chronic cough and the newly identified cough circuit in the brain may be involved in this change.”

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Fitness

6 Exercise safety tips

Now, as social restrictions ease, you may find yourself stepping up your workouts, whether you’re training for an event or working to improve your game in a recreational league.

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In the wake of the COVID-19 pandemic, many Americans are more aware of their health and wellness. Now, as social restrictions ease, you may find yourself stepping up your workouts, whether you’re training for an event or working to improve your game in a recreational league.

Sprains, strains and injuries can happen to even the most seasoned athletes. When you’re testing your limits, even a minor injury can alter your performance. Consider products and supports like these from the CURAD Performance Series product line, available at Walmart and Amazon, to help you get back in the game quickly and safely.

Find more resources to support your fitness journey at CURAD.com.

Keep Dirt and Germs Away

The more active you are, the harder it can be to find a bandage that stays with you all day or all game long.

Spray Away Sore Spots

Controlling mild pain can help keep you at the top of your game, and a topical analgesic works fast to heal common pain brought on by fitness and exercise, such as pain in knees, feet, shoulders and backs.

Put Pain in the Past

When recovery becomes the name of the game and pain relief is needed after daily workouts or bodily injuries. Cold packs work to heal bruises, reduce swelling and relieve headaches and general pain points while microwavable heat packs provide satisfying heat therapy to address sore and stiff joints, muscle cramps and tension.

Reduce Impact of Knee Strain

Weak, injured or arthritic knees can come from many sources, including tendonitis and a wide range of conditions that result in strain or overuse. An adjustable band can provide support for on-field sports and during workouts or everyday activities.

Manage Pain and Relieve Pressure

If you participate in endurance and strength exercises or certain sports, you may ask a lot of your joints. Kinesiology tape can be configured a multitude of ways to help reduce pain and improve blood circulation, as well as relieve tension and pressure.

Control Back Strain

When your back is strained, your body and performance can suffer. A mild or moderate sprain can benefit from strong support and compression.

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Fitness

Exercise can provide relief for dry, itchy eyes

A significant increase in tear secretion and tear film stability after participating in aerobic exercise can be another remedy for relieving dry, itchy eyes.

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Photo by Quinten de Graaf from Unsplash.com

A team led by researchers from the University of Waterloo discovered that a significant increase in tear secretion and tear film stability after participating in aerobic exercise can be another remedy for relieving dry, itchy eyes. 

Every time we blink, our eyes are covered in tear film—an essential protective coating necessary for maintaining healthy ocular function. Healthy tear film comprises three layers–oil, water, and mucin–that work together to hydrate the ocular surface and protect against infection-causing irritants like dust or dirt.

When any part of the tear film becomes unstable, the ocular surface can develop dry spots, causing eye symptoms like itchiness or stinging and burning sensations.

“With so much of our activity tied to screen usage, dry eye symptoms are becoming increasingly common,” said Heinz Otchere, a PhD candidate in vision science at Waterloo. “Instead of having to use eye drops or other alternative treatments, our study aimed to determine if remaining physically active can be an effective preventative measure against dryness.”

Fifty-two participants were divided into two groups—athlete and non-athlete—to participate in an exercise session. Participants in the athlete group exercised at least five times per week, while non-athlete participants exercised no more than once per week. Researchers, which included experts from the University of Cape Coast in Ghana, performed visual examinations before and five minutes after each exercise session, where tear secretion and tear break-up time were assessed.

While participants in the athlete group showed the largest increase, Otchere says all participants experienced a meaningful boost in tear quantity and tear film stability after the exercise session. 

“It can be challenging for people to regularly exercise when the demand is there to work increasingly longer hours in front of screens,” Otchere said. “However, our findings show physical activity can be really important for not just our overall well-being, but for our ocular health too.”

The study, Differential effect of maximal incremental treadmill exercise on tear secretion and tear film stability in athletes and non-athletes, was co-authored by Otchere, the University of Cape Coast’s Samuel Abokyi, Sekyere Nyamaah, and Michael Ntodie, and Ghana’s Our Lady of Grace Hospital’s Yaw Osei Akoto. It was recently published in the Experimental Eye Research journal.

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Fitness

Late-life exercise shows rejuvenating effects on cellular level

Late-life exercise mitigates skeletal muscle epigenetic aging.

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Photo by Caley Vanular from Unsplash.com

For people who hate exercising, here comes some more bad news: it may also keep you younger. Not just looking younger, but actually younger, on an epigenetic level. By now, the benefits of exercise have been well established, including increased strength of bones and muscles, improved mobility and endurance, and lower risk of heart disease, diabetes and high blood pressure.

But younger?

A study recently published in Aging Cell, “Late-life exercise mitigates skeletal muscle epigenetic aging,” suggests this could be the case. The paper was written by a team of seven researchers across three institutions, including Kevin Murach, an assistant professor in the Department of Health, Human Performance and Recreation at the U of A. Murach’s grant from the National Institute of Health funded the study, and he was one of three co-first authors.

Bootcamp for Mice

While the paper is dense with data, reflecting the use of several analytic tools, the experiment that generated the data was relatively straightforward. Lab mice nearing the end of their natural lifespan, at 22 months, were allowed access to a weighted exercise wheel. Generally, mice require no coercion to run and will do so voluntarily. Older mice will run anywhere from six to eight kilometers a day, mostly in spurts, while younger mice may run up to 10-12 kilometers. The weighted wheel ensured they built muscle. While there isn’t a direct analogue to most human exercise routines, Murach likened it to “a soldier carrying a heavy backpack many miles.”

When the mice were studied after two months of progressive weighted wheel running, it was determined that they were the epigenetic age of mice eight weeks younger than sedentary mice of the same age — 24 months. Murach noted that while the specific strain of mice and their housing conditions can impact lifespans, “historically, they start dropping off after 24 months at a significant rate.” Needless to say, when your lifespan is measured in months, an extra eight weeks — roughly 10 percent of that lifespan — is a noteworthy gain.

Methylation, My Dear Watson

The science behind this, while complicated, hinges largely on a biological process known as DNA methylation. A recent New York Times article discussing Murach’s work on muscle memory described methylation “as a process in which clusters of atoms, called methyl groups, attach themselves to the outside of genes like minuscule barnacles, making the genes more or less likely to turn on and produce particular proteins.”

As the body ages, there tends to be increased DNA methylation, or even hypermethylation, at promoter sites on genes in muscle. “DNA methylation changes in a lifespan tend to happen in a somewhat systematic fashion,” Murach explained, “to the point you can look at someone’s DNA from a given tissue sample and with a fair degree of accuracy predict their chronological age.” Due to this, researchers can use one of a number of “methylation clocks” to determine the age of a DNA sample.

DNA Methylation, Aging and Exercise

While the paper strengthens the case for exercise, there is still much that needs to be learned. Though the connection between methylation and aging is clear, the connection between methylation and muscle function is less clear. Murach is not yet prepared to say that the reversal of methylation with exercise is causative for improved muscle health. “That’s not what the study was set up to do,” he explained. However, he intends to pursue future studies to determine if “changes in methylation result in altered muscle function.”

“If so, what are the consequences of this?” he continued. “Do changes on these very specific methylation sites have an actual phenotype that emerges from that? Is it what’s causing aging or is it just associated with it? Is it just something that happens in concert with a variety of other things that are happening during the aging process? So that’s what we don’t know.”

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