Tag Archives: caffeine

Early Look: Caffeine for Cancer Prevention

Dr. Paul Lizzul and Dr. Allan Conney, along with their colleagues, are in the early stages of research that hints at broad implications for preventing squamous cell and basal cell skin cancer. After starting in the lab and progressing with animal models, they took a hypothesis about the effect of caffeine on actinic keratoses and applied it to humans in a recent phase I study. They shared some thoughts on this research with the Skin & Allergy News blog, the Mole:

The Mole: What prompted you to conduct this study?

Dr. Lizzul: Skin cancer of the nonmelanoma type (i.e., squamous cell and basal cell carcinoma) is the most common skin cancer and is most often a result of sunlight exposure. Ultraviolet B light is believed to be mostly responsible for these cancers. Many squamous cell skin cancers are curable if detected early. However, many people still suffer from these cancers and some also die from them. Actinic keratoses are precancerous skin tumors that mainly result from long-term sun exposure in susceptible persons. They have the potential to progress to squamous cell carcinoma. Finding effective methods of preventing UV-induced cancers and precancerous lesions would have a major impact on the total amount of human cancer.

Chemistry of caffeine image courtesty of Icey, ClockworkSoul via wikimediacommons

The Mole: Could you briefly explain your hypothesis?

Dr. Conney: In studying the effect of tea on UVB carcinogenesisis in an animal model, we found that caffeine was the major active constituent, and that pure caffeine inhibited carcinogenesis in this animal model. Topical caffeine was also active. Topical caffeine inhibited carcinogenesis in mice pretreated with UVB with a high risk of skin cancer in the absence of further UVB. Mechanistic studies showed that caffeine enhanced apoptosis (programmed cell death) in UVB-treated epidermis and in tumors. We hypothesize that topical caffeine will inhibit proliferation and stimulate apoptosis in the actinic keratoses.

Dr. Lizzul: The hypothesis to be tested in this study is that treatment of actinic keratoses with caffeine for 2 weeks will enhance apoptosis and inhibit the growth of these skin lesions in humans. The purpose of this study is to determine the effects of topical applications of caffeine on apoptosis (programmed cell death), proliferation, and the ATR/Chk1 pathway in actinic keratoses in human skin in vivo.

Our collaborators at Rutgers University found that treatment of UVB-pretreated high-risk mice with caffeine topically once a day, 5 days a week for 18 weeks inhibited the formation of keratoacanthomas and squamous cell carcinomas, decreased the size of the tumors, and enhanced apoptosis in the tumor. 

At Rutgers University, Drs. Yaoping Lu, Yourong Lu, and Allan Conney are participating in the study.

(Read more at “The Mole” blog on SkinandAllergyNews.com.) 

 —Heidi Splete (on Twitter @hsplete)

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Filed under Dermatology, IMNG, Oncology

Caffeine Tunes Motor in Parkinson’s Disease

Many people drink caffeine to get their body’s motor running, so to speak. Now preliminary data from an ongoing pilot study suggest that caffeine might provide some mojo to improve the motor state of people with Parkinson’s disease.

Dr. Altman, his poster, and his coffee (Photo by Sherry Boschert)

 The multinational, double-blind study was designed to assess whether caffeine might help patients with Parkinson’s counteract excessive daytime sleepiness, an often debilitating symptom that affects an estimated 25%-50% of people with the disease.  Treatments are limited. Surprisingly, caffeine hadn’t been studied before in Parkinson’s disease to treat excessive somnolence, despite being used for centuries as a psychostimulant, Dr. Robert Altman said in a poster discussion at the annual meeting of the American Academy of Neurology.

Sixteen patients with Parkinson’s disease and excessive daytime somnolence who were ingesting less than 200 mg/day of caffeine were randomized to take capsules containing 100 mg of caffeine or placebo twice a day for 3 weeks, then the dose was increased to 200 mg twice a day for another 3 weeks. That’s the equivalent of two to three cups of coffee per day, depending on the size, but without that delicious coffee aroma. Just sayin’.

One patient in the placebo group dropped out before finishing the 6-week study, complaining of motor worsening. Prescient, perhaps, because the study found only a mild and statistically insignificant improvement in somnolence in the caffeine group, compared with placebo (measured by the Epworth Sleepiness Scale, or ESS), but found significant improvements in the “motor state” of patients in the caffeine group, Dr. Altman and his associates reported.

Here’s what motor state means: The caffeinated patients showed improvement in the overall quality of their gait, less rigidity in gait, and a mean decrease of 4.5 points on the Unified Parkinson Disease Rating Scale (UPDRS), compared with a 2.1-point increase on the UPDRS in the non-caffeinated group, a significant difference. ESS scores for sleepiness improved in both groups, modestly (but not significantly) more in the caffeine group than on placebo, with decreases of 4.4 points and 2.8 points, respectively.

Caffeine is a nonspecific adenosine-A2A antagonist. Researchers on the hunt for new Parkinson’s treatments have theorized that A2A receptor mechanisms may contribute to Parkinson’s symptoms and that selectively blocking the receptor might reduce symptoms.

The ongoing study expects to enroll 42 patients. With caffeine’s well-understood safety profile and relatively low cost, these early results suggest that caffeine has “considerable promise” as a therapeutic agent in Parkinson’s disease, Dr. Altman said. It seems to provide motor benefits and might or might not give a wee bit of pick-me-up to sleepy patients. “If they also get more awake from it, all the better,” said Dr. Altman, a fourth-year neurology resident at McGill University, Montreal.

He admits to being a one- to two-cups-per-day coffee drinker himself but said he has no other conflicts of interest. One of his associates in the study declared relationships with Abbott, Allon Therapeutics, Astra Zenica, Biovail, Boerhinger-Ingelheim, Cephalon, Eisai, Medtronic, Lundbeck A/S, Novartis, Merck Serono, Solvay, and Teva.

–Sherry Boschert

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Filed under Family Medicine, IMNG, Internal Medicine, Neurology and Neurological Surgery, Uncategorized

Got Gout? Put Down that Coffee and Cola

As if suffering from gout isn’t bad enough, new research presented this week at American College of Rheumatology’s annual scientific meeting in Atlanta adds insult to injury.

Researchers led by Dr. Tuhina Neogi of Boston University reviewed data from their study of more than 600 adults with gout. Although previous studies have suggested that long-term caffeine use might relieve gout pain, short-term caffeine used might bring it on.

courtesy of flickr user doug88888 (creative commons)

 In this study, people who drank more coffee, tea, or soda, were significantly more likely to have a gout attack, even after controlling for all the other drinks they had. More specifically, 3-4 caffeinated drinks within the 24 hours prior to a gout attack was associated with a 40 to 80 percent risk of recurrent gout.

And there’s more bad news for gout patients, but this is just for women. Another Boston University research team led by Dr. Hyon Choi presented 22 years’ worth of data from the Nurses’ Health Study showing that women who drank more than two fructose-rich beverages daily (such as orange juice and Atlanta’s lifeblood, Coke) were more than twice as likely to develop gout as those who drank less than one of these beverages per month.

The good news? Diet soda was not associated with any increased risk for gout. Phew! But what about the caffeine? Ok, here’s the deal: Women with gout should stock up on caffeine-free diet soda, at least until the next study comes out. And if I look hard enough, there might be a study about the benefits of chocolate for people with arthritis around here somewhere . . .

–Heidi Splete (@hsplete on twitter)

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Filed under Family Medicine, IMNG, Rheumatology

Caffeine with Your Energy Drink, Kid?

The light bulb went off in Dr. Michele LaBotz‘s head soon after she watched a TV reality show in which a mother encouraged her 6-year-old daughter to down three cans of Red Bull energy drink before a competition. Dr. LaBotz was laughing about this example of bad parenting with the mother of a high-school-age girl who then admitted that her daughter was “down to two cans a day” of Red Bull.

Image courtesy of flickr user Mike Licht, NotionsCapital.com (Creative Commons)

That prompted Dr. LaBotz to take a closer look at use of these stimulant-containing drinks and at a related category — sports drinks — and to talk about them at the annual  meeting of the American Academy of Pediatrics. I’ve always been acutely sensitive to caffeine, so my nerves started buzzing just listening to her.

There are no standard definitions, but energy drinks are beverages containing carbohydrates, stimulants, and other ingredients — Red Bull being the 800-pound gorilla on the $11 billion market in energy drinks. Sports drinks are beverages containing some combination of carbohydrates and electrolytes — with Gatorade claiming 75% of the market share.

The “crime” is that these products are found side-by-side with products categorized as food, which are subject to stricter safety standards, Dr. LaBotz said.

Red Bull contains 80 mg of caffeine per 8-ounce can, more than twice as much as in two 12-ounce cans of Coca-Cola. Other brands package themselves in larger sizes to get around caffeine regulations or condense into super-caffeine “energy shots” containing 200-350 mg caffeine per 1-2 ounces. The larger 16-ounce size of SoBe No Fear, for example, contains 174 mg caffeine, roughly equivalent to a Starbucks Grande Mocha, except that No Fear also contains guarana, a plant extract that packs another 40 mg of caffeine per gram of guarana.

Photo by flickr user rynosoft (Creative Commons)

Young athletes start off using them because they think they’ll improve performance in sports or other parts of their lives. New data from a randomized, double-blind, placebo-controlled study that will be published in the December issue of the Journal of Alcohol & Drug Education says that reality is flipped. Sport psychology consultant Conrad Woolsey, Ph.D. and his associates will report that energy drinks make users feel like they’re doing better even though they’re making more mistakes on tests of coordination and multidimensional skills.

Sports drinks are a bit more benign but unnecessary and too often take the place of healthier alternatives, potentially depriving young athletes of the nutrients their bodies need to prepare for or recover from exercise. The only time they may be convenient is during exercise lasting longer than an hour, when kids need more fluids, and the bright colors, sweetness and saltiness of sports drinks may entice them to stay hydrated.

Do you know the healthy alternatives to recommend to young athletes instead of sports or energy drinks, or how to talk to them about all this? Dr. LaBotz likes the Academy’s “Sports Shorts #6” on Nutrition and Sports, and the useful handouts available from the U.S. Anti-Doping Agency such as the Joy of Sport.

And while she urges physicians to take a strong stand against child and adolescent use of energy drinks, she suggests not over-playing the dangers of caffeine, especially when talking to parents who may be regular caffeine users themselves. “I think we lose a lot of credibility if we overstate the risk,” she said.

–Sherry Boschert (on twitter @SherryBoschert)

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Filed under Family Medicine, IMNG, Internal Medicine, Pediatrics, Sports Medicine, Uncategorized