Important to mark DNA Day, crucial for discovery of the genome’s sequence

 

photo: afp relaxnews

EVERY year on April 25, the global scientific community unite to celebrate DNA Day, marking the momentous completion of the human genome project in 2003 and the discovery of the double helix in 1953.

On April 25, 1953, James Watson, Francis Crick, Maurice Wilkins, Rosalind Franklin and colleagues published papers in the journal Nature on the structure of DNA. By commemorating DNA Day, scientists and enthusiasts seek to emphasise the significance of DNA research and inspire future generations to pursue advancements in genetics.

DNA is like a recipe book for living things; it stores vital information that is passed down from one generation to the next. The information is stored in the form of genes that determine the characteristics of an organism, and is protected and held in place by chromosomes. In humans, the genome is made up of approximately three billion base pairs of DNA. Studying the genome and its variations can therefore provide insights into the causes of genetic disorders and help researchers develop new treatments.

DNA holds significant potential in the fields of medicine, anthropology and forensics. In forensics, DNA is frequently used to determine the guilt or innocence of suspects as well as to identify unknown deceased individuals, by analysing DNA collected from hair, skin or blood samples. DNA can also be used to trace a person’s ancestry and determine their ancestral homeland.

In medicine, genetic testing can identify mutations in a person’s DNA that increase his/her risk of developing certain diseases, such as breast or ovarian cancer. DNA sequencing can also help doctors develop personalised treatment plans for patients with cancer or other diseases by identifying specific genetic mutations driving the disease’s growth. In some cases, DNA testing can also diagnose rare genetic diseases that might be difficult to identify otherwise.

Additionally, newborns can be screened for certain genetic conditions that may not be apparent at birth, allowing for early interventions or treatments that can improve outcomes for them.

Precision medicine is an advanced approach that considers the individual characteristics of each patient, in particular their genetic profile. This approach has the potential to revolutionise scientific and medical progress and improve the health of families by providing doctors with the resources to identify specific treatments for various illnesses.

Historically, most medical therapy development has focused on the “average patient” using a “one-size-fits-all” approach to treatment. While this may be beneficial for some individuals, it can be completely ineffective for others. With precision medicine, doctors can develop tailored treatments that are customised to a patient’s specific needs, leading to more effective and personalised care.

That’s why it’s so crucial for us to have a full picture of the human genome, and why the discovery of the genome’s sequence was welcomed by academics and doctors everywhere.

As our knowledge of DNA and the information it encodes grows, we may one day live in a society with fewer and better-managed diseases, longer lifespans, and individualised medical care rather than mass-produced pharmaceuticals designed for the general population.

- PROF ZILFALIL ALWI, ABDUL HALIM FIKRI HASHIM and NOR RAFIDA MOHD SENI Universiti Sains Malaysia, Kelantan

Prof Zilfalil heads the Malaysian Node of the Human Variome Project and is also Unesco Chair in Human Genetics on Thalassaemia, a programme that involves over 850 institutions across 117 countries. 

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Malaysian Scientist in Tsinghua leads space stem cell research at top varsity , one giant leap for Malaysia

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Malaysian Scientist in Tsinghua leads space stem cell research at top varsity

 

Prof Dr Kee Keh Hooi from the School of Medicine, Tsinghua University in Beijing.

  

https://www.med.tsinghua.edu.cn/en/info/1352/1446.htm

Malaysian Scientist in Tsinghua

RealChunWai

Did you know that China is doing stem cell experiments in space? Get to know more about China's space explorations in this episode.

Guest: Prof Dr Kee Keh Kooi (Scientist, Tsinghua University)

Kampung boy leads space stem cell research at top varsity 

KUALA LUMPUR: It may seem like a galaxy far, far away when human beings from earth can stay for a long period of time in a spacecraft or even on the moon or Mars, but Malaysian scientist Prof Dr Kee Keh Kooi is already doing research on its effects on human bodies.

The Tsinghua University lecturer is heading a team to study how gravity and even radiation affect the development of human embryonic stem cells in space.

In short, understanding how human reproduction will affect human beings who will spend a long time in space.

The research is also to find answers as to how the human embryonic stem can differentiate in space.

“It is already happening as Chinese astronauts could stay for a period of time in a station on the moon, astronauts could orbit around the earth, and even ordinary people could travel to space,’’ he said.

The Sitiawan-born renowned academician was interviewed online from Beijing by Star Media Group adviser Datuk Seri Wong Chun Wai on his webcast programme @realchunwai on Thursday.

His accomplishment was highlighted by Prime Minister Datuk Seri Anwar Ibrahim when he spoke at Tsinghua University during an official visit to China last month.

China recently announced its readiness to start its lunar base on the moon within five years, ahead of landing astronauts there in subsequent years.

Dr Kee has also conducted his research via China’s first cargo spacecraft, Tianzhou-1, which was launched in 2017.

Its main task was to deliver fuel and supplies to the orbiting Tiangong 2 space lab, but it also played host to ground-breaking scientific experiments conducted remotely by earth-based scientists in China.

Dr Kee specialises in stem cell research and how it can be cultured for medical technologies to help patients suffering from Parkinson’s and Alzheimer’s diseases and even spinal cord injuries.

Besides devoting his time in laboratories, he also lectures undergraduate and post-graduate students at Tsinghua, which is regarded as China’s top university.

He spent decades in the United States, where he obtained bachelor’s and master’s degrees at Iowa State University. This was followed by a PhD at Weill Cornell University.

Later, he worked at the University of California, San Francisco, before taking up a three-year stint as a research associate at Stanford University.

The opportunity for him to take a leading role as a principal researcher came when he applied for a post at Tsinghua University after seeing a vacancy advertised in an academic journal in 2009.

“There was an opening for stem cell research at the university, and it caught my interest immediately,’’ he said.

Asked about the differences in the manner in which research is conducted in China and the United States, Dr Kee said that in the United States, individual research was common, while in China, a team of between 50 and 100 people could be involved in a big project.

Despite having spent over 12 years in Beijing, Dr Kee, who grew up in Johor Baru, makes it a point to visit Malaysia annually, especially during Chinese New Year.

His parents, who moved to Johor Baru from Sitiawan to run a coffee shop, are still operating at the premises in Gelang Patah.

Dr Kee is a former student of Foon Yew High School, one of the elite independent schools in Johor.

“Balik kampung is always on my mind. The minute China reopened its border, I took my family home to Malaysia for three weeks,” he said.

Dr Kee, who was born in Kampung Remis, a small fishing village, described himself as a kampung boy. His family, he said, is “a simple Teochew family”.

Dr Kee said he would be happy to conduct talks on his work at Malaysian universities if there are opportunities.

His advice to Malaysians who wish to study at Tsinghua or Peking University is simply to study hard, get good grades and be focused.

However, he added that there are many other universities in China besides these top two.

He said Tsinghua also offers other disciplines, especially at the post-graduate level in economics, architecture, and law, which are conducted in English for international students.

To watch the full interview with Dr Kee, follow @realchuwai on Facebook and YouTube. 

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Mask up now !

 

More people are falling sick and seeking treatment at hospitals as the Air Pollutant Index readings seem to be going up in parts of the country. With the hazy and dry conditions, and Covid-19 still a concern, health experts are advising people to wear face masks when they are outdoors. 

‘Take cover from virus, air pollution’

PETALING JAYA: Face masks now serve a dual purpose, protecting oneself from Covid-19 and also the haze that has been blanketing the country the past week, say experts.

Universiti Kebangsaan Malaysia’s Prof Dr Sharifa Ezat Wan Puteh is advising the public to continue masking up, especially the elderly and children, to protect them from the harmful effects of the haze.

She said the air pollution consists of fine particles that could enter the human body through the respiratory system and cause health problems.

“The fine particles can go into our breathing system through our throat and lungs, which may cause health issues such as bronchitis. It could also settle on the skin and eyes, which can cause irritation,” the professor and public health expert said.

As Hari Raya Aidilfitri approaches, Prof Sharifa said the public should try to reduce outdoor activities.

“It is important to wear a face mask when outside, especially an N95 that could block fine particles.

“Haze is always related to extreme heat that could lead to heat stroke; hence, staying hydrated is also the best way to ensure good health conditions,” she said.

Prof Sharifa also said that setting up air purifiers in the house would also help ensure the indoor air is free of pollutants.

She also said that before visiting an area during Hari Raya, the public are advised to check the air pollution index (API) of the location.

“If the area records bad API readings, then, if possible, avoid going there,” she said.

Malaysian Medical Association president Dr Muruga Raj Rajathurai concurred, saying that the public must stay informed about the haze and take heed of any warnings or advice from the authorities.

“Face masks will indeed serve a dual purpose if the haze is still around during the Aidilfitri holidays.

“It will also be important to stay hydrated as the heat can cause dryness of the throat and eyes,” he said.

To continuously ensure Covid19 can be contained, Dr Muruga also said the public must wear face masks when visiting houses where there are vulnerable groups, such as the elderly.

“Those with an existing respiratory illness will need to take extra care to avoid exposure to both the haze and Covid-19.

“Whether it’s the haze or Covid19, if you’re having trouble breathing, you should go to the emergency department of a hospital immediately,” he added.

Health Minister Dr Zaliha Mustafa has advised the public to take precautionary measures as the haze situation is expected to worsen, with air quality dropping in several areas of the country.

“People should limit physical activities during the hot weather that could lead to illness.

“Limit being outdoors, use suitable face masks and protect yourselves from the haze by using umbrellas and caps to prevent direct exposure to the hot weather,” she said in a statement yesterday.

She urged the public to halt activities that would lead to air pollution, such as smoking, and to drink more warm water (at least eight glasses) to prevent dehydration.

According to a Swiss air quality index (AQI) monitoring company, a monitoring station in Kuala Lumpur recently recorded an unhealthy air quality of 117.

However, as of yesterday afternoon, almost all 68 air pollution index (API) stations in the country showed moderate readings below 100.

The website also forecast that the AQI in Kuala Lumpur on Friday (April 21) and Saturday (April 22), when Hari Raya Aidilfitri is expected, would be moderate, with readings of 80 or higher. 

 

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Covid-19 increased by 17.6%, time to mask up again , say experts

Better safe than sorry: people who had not completed their vaccination, either with a booster or prime vaccinations, should be masked when in public, say health experts.  

 

PETALING JAYA: With the rise in Covid-19 cases of late and more Hari Raya social gatherings expected, public health experts are suggesting that face masks be worn in public.

High risks individuals, such as the elderly, the obese, those with high comorbidities and immunocompromised issues such as diabetes and cancer, are among those who are at risk of an infection or re-infection.

“As such, they are highly encouraged to wear masks,” said Universiti Kebangsaan Malaysia public health expert Prof Dr Sharifa Ezat Wan Puteh.

Likewise, she said people who had not completed their vaccination, either with a booster or prime vaccinations, should be masked when in public.

“It is better to be safe than sorry. Get yourself vaccinated, including the boosters. If you’re at high risk, wear a mask in public areas where there are many people who may be transmitting or carrying the virus,” she said.

She also spoke about an upsurge in cases at certain schools, so students who are at risk should mask up.

“The increase in Covid-19 cases is expected, due to a few highly transmissible Omicron strains, unmasking and many of us moving freely across states and in our workplaces.

“However, the main issue is whether the rise in cases will lead to hospitalisation or even deaths,” she said.

A Health Ministry statement on April 13 said that Covid-19 hospital admission had increased by 17.6% in the beginning of April compared to the previous month.

Health Minister Dr Zaliha Mustafa said 63.8% involved patients aged 60 and above, while 90.7% were among those with comorbidities.

Most of them had mild symptoms and deaths among patients who were not vaccinated was six times higher than those who received a single dose, she added.

Prof Dr Moy Foong Ming of Universiti Malaya’s Department of Social and Preventive Medicine suggested that the ministry should intensify its public messages on the importance of masking and encourage the people to do so during the surge in cases.

As for Covid-19 infections in schools, she said that parents should not send their children, who showed symptoms, to school.

“The school management should be alert to the health status of their staff and students. Take appropriate action when any of the staff or students are unwell,” she said.

However, experts like Dr Moy are of the view that it is not necessary to make it mandatory for people to wear mask.

She said that making masks mandatory was no longer feasible as the country was in the transition to the endemic phase.

“We are to co-exist with the virus. The public should have internalised the preventive measures and carry them out voluntarily when there is a surge in cases,” she said.

“If masking is made compulsory, then there should be punitive measures on those who don’t comply.

“This will not educate the public but rather they mask up because of fear of possible punitive action taken against them.”

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar also said that masking should not be made mandatory but strongly encouraged.

“I think the public will not be too receptive if mandatory masking and added regulations are imposed,” he said.

He said that people should be encouraged to self-test and self-quarantine should they show symptoms.

Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said current measures could be maintained but those who tested positive must wear a mask to protect others.

“Those who are sick should stay at home, and be quarantined. If they need to be in public, wearing a mask is a must,” she said.

She added that the decision to make masking compulsory should only be made when the rise of Covid-19 cases posed a threat to the country’s healthcare system.

“Currently, there is no such indication, so there is no urgent need to make it compulsory,” she said.

However, she said there was a need to enhance public awareness, so that the people could be responsible to each other.

Dr Malina said the rise in cases was most likely due to the current strain being highly infectious.

“In general, we have to be more cautious. As such, people are encouraged to mask up in public, be mindful of hand hygiene and cough etiquette,” she said. 

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In desperation, US tries to drag EU into its camp

 

Clare Daly, a member of the European Parliament from Ireland, sat down with CGTN reporter Li Jingjing in Beijing on April 2 to discuss the current challenges Europe is facing and the importance of developing deeper and more stable ties with China. Daly believes most politicians in the EU understand the interconnectedness of relations with China and the necessity of it for the economy. Despite this, anti-China rhetoric is still on the rise as Europe finds itself under immense pressure from the United States.

China and Europe.

 

Editor's Note:

A flurry of trips by European leaders to China are taking place. It is in line with the interests of European citizens, and reflects a genuine and welcome effort on behalf of China to try and develop international relations, Clare Daly (Daly), an Irish politician and member of the European Parliament, told Global Times (GT) reporters Li Aixin and Wang Zixuan in an interview before wrapping up her China visit.

GT: During your China visit, there have been some European leaders coming to China or planning to visit China. What signal do you think it conveys?

Daly: We found it very interesting that everybody is coming to China. Brazilian President Lula is coming soon also. Everybody is beating at the door here. I think what it reflects is a very genuine and welcome effort on behalf of China to try and develop international relations.

To be honest, the relations between the EU and China have not been good. We have noticed, in the period of time since we have been in the European Parliament, hostility and anti-Chinese rhetoric creeping into the debates. That's not in the EU's interest. It doesn't make any sense.

We have tried to understand where it comes from. The only conclusion we can come to is that China is a "threat" to US economic interests, not security interests. In desperation, they [the US] are trying to drag the EU with them into their camp. But we don't think anybody should have camps.

China is a hugely important world economy. It's in the interests of the EU to have good relations with China. From what we've seen, [French] President Macron has improved his relations with China. The comments before European Commission President Ursula von der Leyen came were rude, undiplomatic, arrogant and beyond what the EU should be doing. It was quite disgraceful diplomatically. But this is what we have come to expect from the EU. 

 

 

https://youtube.com/shorts/MyYl2ViLyLw?feature=share

EU President Ursula von der Leyen https://youtube.com/shorts/MyYl2ViLyLw?feature=share via @YouTube

 We have a very weak leadership that is behaving in a way that is not in the interests of EU citizens. They need to stay on side with China, but they are bending the knee to the US like they always do. We think they should develop an independent path and forge good relations with everybody.

GT: Do you think the visits by European leaders might show that the EU's political circle is turning toward a more rational and practical mentality toward China?

Daly: I would like to think that, but I've seen too much of the EU think that rationality is part of their plan. Unfortunately, we shot ourselves in our two feet in terms of our relations with Russia in response to the war, rather than championing peace, as we should have been doing. We have been ensuring that the conflict continues there.

Would they suddenly become intelligent and rational? Unfortunately, I don't think so. I think it's probably a result of Chinese diplomacy. Let's hope that the outcome is better relations. I think the visits will certainly help.

More important, in some ways, is the role that China is playing now on the world stage in terms of international affairs, arguing for peace in Ukraine. That is very welcome, because for too long, the world has been dominated by the US who has acted in their own interests, as all countries do. But unfortunately, that interest was to the detriment of people all over the world, and all of us are paying a price for that. We would like to see a real return to international law and multilateral arrangements, which is not really possible in a US-dominated world.

GT: When the US media discussed the European leaders' visits to China, they said French diplomacy was undermining US efforts to reign China in. What's your take in this?

Daly: This is the constant mantra from the US, this is what they do all of the time. Sadly, they generally bring the EU with them and the EU repeats this nonsense as well. It just reveals that China is an economic "threat" to the US in terms their dominant position.

The US has been working full time to drive a wedge between the EU and China and Russia and everybody else. They are trying to hang on to their global position, which they are losing and will lose and have lost in reality. They've lost the hearts and minds of most of the world's population, but they are desperately trying to keep the EU, maybe Australia and the UK, as the last group of people to bring with them.

Unfortunately, those countries have a disproportionate influence on international bodies, way beyond their numbers. But we're in a new dawn of world relations and the old one, represented by the US and sadly the EU, is in decline. The EU doesn't have to be, and the US doesn't either. The US should have good relations with China. Everybody should work with everybody to their own mutual benefit. Sadly, the military industrial complex that dominates the political agenda in the US wanted a different way, and they need to have enemies and bad guys to justify the expenditure.

Clare Daly. Photo: Courtesy of Daly

GT: How would you describe US and EU's role in the world?

Daly: What I think is that the global rule of the US is facing a long and agonizing death. Their days are coming to an end, but that death agony is going to be protracted and take some time.

We're living in an incredibly dangerous period in world history where there is an attempt to redevelop Cold War politics. Most of it is coming from the US. Sadly, the EU, rather than being on the side of saying, "no, we're not interested in that," have sided with the US in that agenda and they're playing that game.

They have sided into the "bad guys, good guys" narrative. They call it democracy vs authoritarianism, which is absolutely ridiculous. We have a chance to vote every five years. Usually the people we vote for tell lies and then they come into power, there's nothing we can do about it. So what is democracy? It's a bit crazy.

Europe should be aligning with the countries that form the majority of the world's population, which is outside the Global North, and arguing for peace in an independent way and working with everybody. They are not doing that. Hopefully. That will change.

GT: What do you think of China's position paper on the political settlement of the Ukraine crisis, and in what ways can China and Europe work together to ease or maybe end the conflict?

Daly: We very much welcome it. We are for peace, we are against war. We thought it was really helpful that the Chinese did come up with a peace plan. It's not detailed, it's common sense. It's what we have been saying since the beginning in the parliament. We think that Russia made a very big mistake. A lot of people have suffered since then and still are. World relations are in a very difficult place. The only way out of that is through peace and dialogue.

I think the proposal was helpful, but people need to get behind it. The problem is that Europe is still continuing to provide arms for Ukraine. They're still increasing and escalating the rhetoric and the hostility, which is growing all the time. When these things happen, it can get to a place where it's very hard to claw back.

We believe that President Lula's visit to China is partly linked with trying to see a peace plan for Ukraine. How sad that the leadership of the EU, on the continent of Europe, where the war is on, doesn't seem to be bothered.

It shows how much in control of the agenda is the military industrial complex, particularly in the US but right across Europe. Now we see a securitized agenda, in which there are attempts to even drag China into that as well through escalating tensions in Taiwan and so on.

GT: As the victim of the Nord Stream pipeline sabotage, why is Europe not carrying out a joint investigation into the bombing?

Daly: Because they're afraid of the truth - the only explanation that would make sense. Early on, they tried to say it was Russia who did it. The idea that they might blow up their own pipelines when they could just turn it off was a bit crazy. I'm glad that they have abandoned that lunacy.

If it was the US, which is entirely possible, then that is an act of war by the US, our supposed like-minded partner and friend. Your friends don't go around doing things like that. The ramifications will be enormous.

So the only reason is they know the answer or they are afraid of the answer, and they don't want to go there. But can you imagine if there was any suspicion or suggestion that China might have been involved in doing it, or Iran, or somebody like that, you would have had massive calls in the international community for sanctions, for investigations, meetings, everything. But now, the silence. The silence tells its own story.

GT: In the European Parliament, have you sensed pressure because of your position toward China?

Daly: We wouldn't call it pressure, but there is a racism there. There is anti-China racism and stereotyping. I find it very strange to understand where that has come from.

My belief is that it has to be created. When I was in school and when China began to come onto the world stage and opened up, everybody wanted to learn Chinese. If you were intelligent and you were really in the top, you would learn Chinese. If anybody went to China, people will be, "wow, you've gone to China, that's the cutting edge."

That's about 30 years ago. Now if you say you're going to China, people go, "Why are you going to China? That's scary! They're kind of the enemy." So how did we get into that place?

The media in Ireland has demonized us, [me and] my colleague Mick Wallace, who is a kind of a celebrity in Chinese state media. They say we are the puppets of authoritarian regimes, because some of the comments that we make may have been covered on Chinese television, but the comments we make are covered in Irish television, on American television. It doesn't make us puppets of Europe or America.

It's ignorance, but it doesn't change anything. Our job is to use the chance we have in the parliament of Europe, which is very unrepresentative of the citizens of Europe. So don't worry, if crazy people in the European Parliament are voting on stupid motions that make no sense, our job is to use that platform to represent the interests of the citizens of Europe. The interest of the citizens of Europe is to have good relations with China.

And it's a bit crazy because all of the media and some of the politicians in the countries who complain - they all have diplomatic relations with China, they all have business relations with China.

Relations are bad. It's not China's fault, I think China is doing what it can do. But the door isn't open enough. So hopefully some of these visits now are the beginning of the door opening, the beginning of breaking that US domination and the idea that the EU must be in their camp and not China's camp.

The countries where most people in the world live, big economies, Brazil, South Africa, India, all those emerging economies, they're all going to follow China. And the Global North will be sitting in that little corner thinking they're the most important when the world has changed dramatically when they were asleep.

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EUROPE TO SHIFT AWAY FROM USA

 

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These glands churn out essential hormones

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Endocrine System: How Hormones Work?

Here is an unusually dark skin (hyperpigmented) hands of a child with adrenal insufficiency compared to his sibling. — Photo: Dr JEANNE WONG SZE LYN

 

 

adrenal glands loc­ated above the kid­neys.

 The adrenal glands and their hormones are vital for life

The adrenal glands are small triangle-shaped glands located on top of the kidneys. They produce hormones such as cortisol, aldosterone and adrenaline.

These hormones help to regulate essential body functions that include blood pressure, metabolism, salt homeostasis and the body’s response to stress and infections.

The release of hormones by the adrenal glands is controlled in part by the hypothalamus and pituitary gland in the brain. The kidneys and the body’s sympathetic nervous system also interact with the adrenal glands.

The adrenal glands are composed of two parts: the cortex (outer part) and the medulla (inner part).

Each part is responsible for producing different hormones. Cortisol, aldosterone and androgens are produced at the cortex and adrenaline and noradrenaline at the medulla.

Adrenal hormones

Cortisol: A glucocorticoid hormone that helps the body to respond to illness and injury. It also helps to maintain normal blood pressure, glucose levels and sleep-wake rhythm.Common symptoms of adrenaline insufficiency.Common symptoms of adrenaline insufficiency.  

 

The com­mon symp­toms of adrenal insuf­fi­ency

Aldosterone: A mineralocorticoid hormone that stabilises blood pressure, salt and water in the body.

Androgens: These hormones are also known as “male” hormones. The most commonly known androgen is testosterone. Androgens are usually thought of as male hormones, but the females produce a small number of androgens too.

Adrenaline (epinephrine) and noradrenaline (norepinephrine): These hormones are sometimes called the “fight or flight” hormones.

They make the heart pump faster and stronger, regulate blood pressure and glucose levels.

Like cortisol hormones, these hormones are released in larger amounts when the body faces stressful situations.

Can we live without adrenal glands?

The adrenal glands produce essential hormones that the body cannot function without.

Babies and children who do not make enough cortisol or aldosterone hormones can develop a life-threatening medical condition known as adrenal crisis.

In adrenal crisis, the blood pressure and glucose levels are low.

There is also an imbalance of essential salts in the body.

An adrenal crisis usually happens in times of stress such as during an acute illness, surgery or if a child with an adrenal disorder is not taking his or her medications appropriately.

What common conditions affect the adrenal glands?

Adrenal gland disorders happen when the adrenal glands make too much or too little of one or more hormones.

Some conditions are temporary whereas others are life-long.

Causes of adrenal disorders include:

> Genetic mutations which affects the production of adrenal hormones e.g. congenital adrenal hyperplasia, adrenal leukodystrophy

> Autoimmune diseases involving the adrenal glands

> Damage to the adrenal glands through injury, infection or blood loss.

> Adrenal tumours

> Hypothalamus or pituitary gland disorders in the brain which regulate release of adrenal glands hormones

> Certain medications, such as prolonged use of steroids.

The symptoms of adrenal gland disorders depend on which hormones are affected and if it is too much or too little.

Many of the symptoms may be similar to other illnesses and need to be correlated with the history and examination by the specialist doctor.

Adrenal insufficiency (not enough adrenal hormones)

Adrenal insufficiency is a condition in which the body is unable to produce enough cortisol and sometimes aldosterone.

This usually happens due to genetic conditions or damage to the adrenal glands following surgery, injury, blood loss or an infection.

Adrenal insufficiency can also happen when the pituitary gland in the brain fails to produce adrenocorticotrophic hormone (ACTH), which is the signal that regulates adrenal function.

Long-term steroid medications such as prednisolone, hydrocortisone or dexamethasone may also results in suppression of production of ACTH resulting in the adrenal glands producing less endogenous cortisol.

Hence children who had received prolonged or high doses of steroids need to have their adrenal function monitored.

A child with adrenal insufficiency may have these symptoms:

> Unexplained poor weight gain

> Easily tired

> Severe illness

> Low blood pressure and glucose levels, and

> Salt cravings.

They may also appear to have unusually dark skin pigmentation especially at the skin creases, and gums.

In certain adrenal condition, such as congenital adrenal hyperplasia, the baby or child may have abnormal sexual characteristics e.g. enlargement of the clitoris in girls and penile enlargement in young pre-pubertal boys.

Cushing syndrome

Cushing syndrome is a condition that is due to excess cortisol. It can be from an outside source for example taking long-term or high doses of steroid medications

 

 

The com­mon symp­toms of Cush­ing Syn­drome.

More rarely, Cushing syndrome can be due to excess production of the hormone by the body itself such as by an adrenal tumour or growth in the pituitary gland, which stimulates the adrenal glands to make too much hormones.

Common symptoms in children are:

> Weight gain, more prominent at the face and belly

> Poor growth despite weight gain

> Muscle wasting

> Increased hair growth over the body.

Complications include:

> High blood pressure

> Diabetes

> Prone to infections

> Thin, easily bruised skin

> Brittle bones, and

> Irregular menses in adolescent girls.

Diagnosis and testing

Diagnosis of adrenal disorders is based on the history, physical examination and blood test that measure the amount of adrenal hormones in the body.

Interpretation of adrenal hormone levels must be correlated with the probable cause and clinical picture.

Sometimes additional endocrine (hormone) stimulation tests or imaging of the brain and adrenal glands are needed.

Treatment options

If the adrenal gland does not make enough hormones, treatment consists of replacing these hormones with medication; e.g. steroid (glucocorticoids) medication is needed to replace cortisol.

Some children may also need to take Fludrocortisone medication to replace aldosterone.

During acute illness or surgery, the steroid medication needs to be taken in larger amounts. In rare cases where the adrenal gland is producing too much hormones e.g, certain adrenal tumours, medications are given to suppress the hormones or to relieve the symptoms.

The underlying cause for the adrenal disorder must also be addressed, e.g. surgical removal of tumours where indicated.

The duration of treatment depends on the underlying cause. Medications often need to be taken life-long in genetic causes.

In others, such as in adrenal insufficiency due to tapering off of long-term steroid use, treatment is only needed until the adrenal glands “wake up” and begin producing its own hormones again.

With treatment, the symptoms of adrenal insufficiency can be controlled enabling children with this condition to live normal lives.

However, regular specialist follow-up and blood testing are important for treatment adjustment to ensure proper growth, development and prevention of adrenal crisis.

Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. This is the fourth article in a monthly series called Hormones and Kids. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

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