aquatic exercise programme led to greater alleviation of disability than from physical modalities and suggested that clinicians should recommend aquatic exercise to patients with chronic low back pain as part of their treatment .
References 1 Maher C et al . Non-specific low back pain . Lancet 2017 ; 389 ( 10070 ): 736 – 47 . 2 IASP Fact Sheet . The Global Burden of low back pain . www . iasp-pain . org / resources / fact-sheets / the-global-burdenof-low-back-pain / ( accessed January 2022 ). 3 Miyamoto GC et al . Different doses of Pilates-based exercise therapy for chronic low back pain : a randomised controlled trial with economic evaluation . Br J Sports Med 2018 ; 52:859 – 68 4 Jauregui JJ et al . A meta-analysis of transcutaneous electrical nerve stimulation for chronic low back pain . Surg Technol Int 2016 ; 28:296 – 302 . 5 Dundar U et al . Clinical effectiveness of aquatic exercise to treat chronic low back pain : a randomised controlled trial . Spine 2009 ; 34 ( 14 ): 1436 – 40 . 6 Shi Z et al . Aquatic exercises in the treatment of low back pain ; a systematic review of the literature and meta-analysis of eight studies . Am J Phys Med Rehabil 2018 ; 97 ( 2 ): 116 – 22 . 7 Meng-Si P et al . Efficacy of Therapeutic Aquatic Exercise vs Physical Therapy Modalities for Patients with Chronic Low Back Pain . A Randomized Clinical Trial . JAMA Netw Open 2022 ; 5 ( 1 ): e2142069 .
Blood cancer gene defect identified and treatable with existing agents
A mutation in the SF3B1 gene found in chronic lymphocytic leukaemia and other blood cancers could potentially be treated with a variety of chemotherapeutic agents .
Mutations in the SF38B1 gene appear to respond to treatment with poly adenosine diphosphate-ribose polymerase ( PARP ) inhibitor drugs , which are currently used in the management of cancers with other mutations such as those in the BRCA1 and BRCA2 genes . This was the finding by a team from the Patrick G Johnston Centre for Cancer Research , Queen ’ s University , Belfast , UK .
The DNA damage response ( DDR ) in cells , represents a complex pathway that has evolved to protect and maintain genomic stability against malignant transformation . One of the key proteins within this pathway is BRCA1 and mutations in the BRCA1 gene increase the risk of breast and ovarian cancer . 1 Moreover , research has uncovered how the DDR is also involved in the control of a number of RNA regulatory processes such that a BRCA1 protein complex , containing BCLAF1 and SF3B1 , is required for the correct mRNA splicing of a number of genes that play an important role in the initiation of processes involved in the creation of genomic stability and repair . Damage to this system increases the sensitivity of DNA to defective repair and SF3B1 mutations have been detected in cancers such as chronic lymphocytic leukaemia , 2 which highlights the importance of SF3B1 gene in the repair process .
According to the Belfast team , this aberrant DNA replication can be exploited therapeutically to selectively target tumour cells with the SF3B1 mutation using chemotherapy agents such as etoposide or PARP inhibitors which serve to repair the DNA damage .
In their study , 3 the researchers first demonstrated that SF3B1 depletion had an adverse effect on cell survival and an inability to undertake effective DNA repair , particularly when exposed to ionising radiation . They demonstrated the mutations in SF3B1 give rise to cells with a BRCA-like phenotype , present in other cancers and that using existing treatments such as etoposide and olaparib , which is the most used PARP , it was possible to prevent the development of tumour cells that contained mutations in SF3B1 . They suggested that if such mutations are present in a cancer , such drugs could be a therapeutically valuable option .
Although this represents preliminary work , the authors suggest that their findings could form the basis for a clinical trial to examine the efficacy of PARP inhibitors , where the SF3B1 mutation is present in a cancer , enabling a more personalised approach to the treatment of these cancers .
References 1 Savage KI et al . Identification of a BRCA1-mRNA splicing complex required for efficient DNA repair and maintenance of genomic stability . Mol Cell 2014 ; 54 ( 3 ): 445 – 9 . 2 Foy A , McMullin MF . Somatic SF3B1 mutations in myelodysplastic syndrome with ring sideroblasts and chronic lymphocytic leukamia . J Clin Path 2019 ; 72:778 – 82 . 3 Lappin KM et al . Cancer-associated SF3B1 mutations confer a BRCA-Like cellular phenotype and synthetic lethality to PARB inhibitors . Cancer Res 2022 ; doi : 10.1158 / 0008-5472 .
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38 | Issue 100 | hospitalpharmacyeurope . com