Navigation Links
Leeds medics solve an ancient riddle -- and offer new tool for diagnosis
Date:5/30/2008

A puzzling medical condition, identified more than 2,000 years ago by Hippocrates, has finally been explained by researchers at the University of Leeds.

The phenomenon of "finger clubbing", a deformity of the fingers and fingernails, has been known for thousands of years, and has long been recognized to be a sign of a wide range of serious diseases especially lung cancer.

"It's one of the first things they teach you at medical school," explained Professor David Bonthron of the Leeds Institute of Molecular Medicine. "You shake the patient by the hand, and take a good look at their fingers in the process."

Lung cancer, heart disease, hyperthyroidism, various gastrointestinal diseases and many other conditions all result in finger clubbing. But exactly why swollen, reddened fingers should be an indicator of serious illness has remained a mystery until now.

"There are benign cases of clubbing, where it isn't associated with other illnesses, but particularly because of the link to lung cancer, it is generally regarded as rather sinister," said Bonthron. "You look at the range of conditions connected to finger clubbing and wonder what on earth they could have in common."

The researchers found clues in the medical literature, detailing past cases and previous research. "We knew that in cystic fibrosis patients who have undergone a lung transplant, their finger clubbing goes away. The same goes for empyema patients who have had their lungs drained. It suggested that impaired lung function was somehow crucial to finger clubbing but we didn't understand how."

Prof Bonthron, Dr Chris Bennett of the Yorkshire Regional Genetics Service and their colleagues studied a group of patients suffering from inherited primary hypertrophic osteoarthropathy (PHO), a genetic disorder in which the finger clubbing is accompanied by painful joint enlargement and a thickening of the bone.

Their findings implicated a fatty compound called PGE2, which is produced naturally by the body to mediate the effects of internal inflammation. Crucially, once it has done its work, PGE2 is broken down by an enzyme 15-HPGD, produced in the lungs. The patients followed by the Leeds study were found to have a genetic mutation which prevented the production of 15-HPGD, reulting in up to ten times as much of the PGE2 in their systems.

"If you don't have this enzyme the PGE2 isn't broken down normally and simply builds up," said Bonthron, whose findings are published online this week in Nature Genetics.

In lung cancer patients, it is most likely overproduction of PGE2 by the tumour that causes the clubbing. In congenital heart disease, blood bypasses the lungs, where PGE2 is normally broken down by 15-HPGD.

The researchers have suggested that a straightforward urine test for levels of PGE2 may be a useful first step in the diagnosis of individuals with unexplained clubbing, and to understanding whether it is the symptom of something far more serious. The results also suggest that existing drugs such as aspirin, which are already used to prevent PGE2 production, may be effective in reducing the painful symptoms of finger clubbing.

It has taken 2,000 years to make the connection, but Bonthron adds: "Actually, when you look back, it's rather obvious. When we found this gene, everything else fell neatly into place it was like a smack on the forehead."


'/>"/>

Contact: Simon Jenkins
S.Jenkins@leeds.ac.uk
44-011-334-34031
University of Leeds
Source:Eurekalert  

Related medicine news :

1. Paramedics, EMTs in Oregon, Washington State Ratify First-Ever Teamsters Contract
2. Medicsight Announces Appointment of NM Rothschild & Sons Limited as Corporate Adviser
3. Psychemedics Corporation Announces First Quarter Results
4. Psychemedics Corporation Announces Year End Results Record Annual and Quarterly Revenue
5. MGT Capital Investments, Inc. is Delighted with the Announcement of Medicsights Commercial Agreement with Toshiba PACS Division
6. Paramedics can provide an effective alternative to standard ambulance service in the community
7. Jennifer Chmieleski Joins Psychemedics Corporation as Top Financial Officer
8. Psychemedics Corporation Joins Accenture in Co-Sponsoring Innovative Chief Talent Officer Book
9. Medtronic Spine, Formerly Kyphon Inc., to Pay U.S. $75 Million to Resolve Allegations Of Defrauding Medicare
10. MultiVu Video Feed: Richard Simmons and Ocean Spray Team-Up to Solve
11. Aerospace business leader, supreme problem solver
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Leeds medics solve an ancient riddle -- and offer new tool for diagnosis
(Date:6/24/2016)... ... ... in a crisis. Her son James, eight, was out of control. Prone to extreme mood ... something upset him, he couldn’t control his emotions,” remembers Marcy. “If there was a ... children and say he was going to kill them. If we were driving on ...
(Date:6/24/2016)... San Francisco, CA (PRWEB) , ... June 24, ... ... at CitiDent, is now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has ... , self-ligating Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... People across ... in Genome magazine’s Code Talker Award, an essay contest in which patients and their ... award to be presented at the 2016 National Society of Genetic Counselors (NSGC) Annual ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Investment Group (TGIG), has initiated cultivation and processing operations at its production facility, ... Pahrump, Nevada. , Puradigm is the manufacturer of a complete system of proactive ...
(Date:6/24/2016)... ... June 24, 2016 , ... Venture Construction Group (VCG) sponsors ... on June 20th at the Woodmont Country Club at 1201 Rockville Pike, Rockville, Maryland, ... to helping service members that have been wounded in battle and their families. Venture ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 ... "Pharmaceutical Excipients Market by Type (Organic Chemical (Sugar, ... Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast to ... The global pharmaceutical excipients market ... at a CAGR of 6.1% in the forecast period ...
(Date:6/23/2016)... , June 23, 2016 Research and ... News Issue 52" report to their offering. ... influenza treatment creates a favourable commercial environment for MedImmune to ... patient base that will serve to drive considerable growth for ... would serve to cap sales considerably, but development is still ...
(Date:6/23/2016)... , June 23, 2016 ... Oticon , industry leaders in advanced ... launch of Oticon Opn ™, the world,s first ... of possibilities for IoT devices.      (Photo: ... Oticon introduces a number of ,world firsts,: ...
Breaking Medicine Technology: