Vitamin D deficiency may increase amphotericin B-related kidney toxicity

Graph showing that mice with vitamin D deficiency had more kidney toxicity from amphotericin B

Do you take vitamin D supplements over winter?

Current NHS/PHE guidelines say that all adults should consider taking vitamin D supplements between October and March, or all year round if they are at risk of deficiency (e.g. people who have darker skin, or spend most of their time indoors or covered up).

But a new study suggests it might be even more important for people living with aspergillosis. Ferreira et al 2019 found that mice with a vitamin D deficiency experienced more kidney toxicity when given amphotericin B (lipid formulation). Click here to read more here.

If you haven’t had your levels tested recently, it might be worth getting your doctor to check them.

When taking vitamin D supplements:

  •  For best absorption, take it with a meal containing fat and calcium
  •  Check the label for the dosage – it should be 10-25 mcg per day, or 400-1000 IU (don’t rely on % RDA/NRV)
  •  There are two forms: D3 (cholecalciferol) is more effective than D2 (ergocalciferol)

For more information on Vitamin D guidelines:

We Are Undefeatable

We Are Undefeatable is a campaign which aims to help those with chronic health conditions exercise. Both the conditions and forms of exercise vary widely – the goal is to find out what works best for you!

Visit the website to discover how exercise has helped other people with chronic conditions, and what the campaign can do for you : We Are Undefeatable

For more information on exercises specific to aspergillosis and chronic lung conditions:

Aspirin may reduce harmful effects of air pollution on lungs

A recent study by Dr Xu Gao and colleagues has looked at the relationship between lung function and the use of non-steroidal anti-inflammatory drugs (which include aspirin) in 2,280 veterans. The researchers then compared this with air pollution data from the previous month in their hometown of greater Boston. Other factors, including whether or not the participant was a smoker were also taken into consideration.

The study found that NSAIDs nearly halved the effect of particulate matter (all solid and liquid particles suspended in air) on lung function. The mechanism by which this protection happens is unknown, but may be due to NSAIDS reducing inflammation in the lung caused by pollution. As most of the participants in the study were taking aspirin, this effect was deemed to be predominantly due to aspirin, but the effect of other NSAIDs would be useful to study.

These results show that aspirin may be useful in the short-term protection of lungs against air pollution. However, air pollution contributes to a number of other harmful bodily effects so it is still important to minimise overall exposure.

To check air pollution in your area, click here

References:

Keeping your washing machine clean

A recent study has found that a hospital washing machine was the reservoir of multi-drug resistant bacteria, which were transmitted to newborn babies. Hospitals normally use high temperatures and disinfectants to clean clothes, but in this case a normal, household machine was used. The lower temperature, energy efficient cycles used by these machines means that they do not kill pathogens as effectively. In addition to bacteria, washing machines can provide the perfect conditions for the growth of mould. Here are some of our tips for keeping your washing machine clean:

Cleaning:

Either get a family member or friend without a condition complicated by mould to help you, or make sure that you are wearing an appropriate mask and rubber gloves for the job.

Take out the dispenser drawer if possible and wash it in hot soapy water. If you can’t remove it, clean it as well as you can and use a pipe cleaner or toothbrush to reach around the back.

Don’t remove the rubber door seal but pull it back and clean underneath with hot soapy water and/or mould remover. Dry it thoroughly.

Using either a cup of bleach or a washing machine cleaner, put your machine on for the longest, hottest spin cycle – some machines even have a cleaning cycle. Make sure you check your manual first as some companies discourage the use of certain products in their machines and it may invalidate your guarantee if you use them.

If, after cleaning the drawer and seal thoroughly and running several cleaning washes, there is still a smell of mould you may have a clogged drain or filter, or mould growing behind the back of the drum. To solve this problem you may need to seek professional help.

Prevention:

Once you have cleaned your washing machine you should consider the following tips to prevent the build up happening again:

Only use the recommended volume of detergent/fabric conditioner, as left over residues can provide the perfect conditions for mould to grow.

Between washes, leave the door and dispenser drawer open to allow air to circulate around the machine.

Dry the rubber seal after each cycle.

Check the drawer and seal regularly, and run a cleaning cycle once a month.

NOTE Disinfectants containing quaternary ammonium salts, bleach, alcohol & hydrogen peroxide have recently (2017 study on heavy occupational exposure) been implicated as a risk factor for increasing the incidence of COPD. We don’t yet know why it does this or if it is a hazard to domestic users, but assuming it is caused by the fumes released, ensure that you clean in a well ventilated area and wear waterproof gloves to prevent skin contact. Cleaning products containing these chemicals are used very widely – if in any doubt check the list of chemicals contained in any product (bleach is often referred to as sodium hypochlorite). Quaternary ammonium salts go by several different chemical names so if in doubt check against the list published here under ‘antimicrobials’

If you can’t find an alternative disinfectant and don’t want to use one of the irritant disinfectants listed above then you might follow guidelines suggested by the US EPA which suggest just using a simple detergent and thoroughly drying the wetted surfaces.

Fungal biofilm structure and its indications in invasive aspergillosis

Example of increased furrowing and white, non-sporing edges at lower oxygen levels (Kowalski et al., 2019)

Microorganisms can group together on a surface to form collections of cells called biofilms; one example of this is dental plaque. Grouping together as a community protects these cells from environments which they may not be able to survive alone, such as the wrong pH or a lack of water or oxygen. Biofilms may be made up of many different species of microorganism and these species may be varied further by strain. In a recent paper, Caitlin Kowalski and colleagues at the Geisel School of Medicine at Dartmouth, USA, studied the ability of Aspergillus fumigatus biofilms to grow in low oxygen environments and cause invasive aspergillosis in mice.  

Kowalski and colleagues exposed A. fumigatus to low levels of oxygen, which reflect the levels found in the lesions where the fungus grows in the lung, in order to identify genes and mechanisms involved in allowing the pathogen to grow under these conditions. They then discovered a specific mutation which allowed the strain to both grow better in low oxygen, but also cause disease better under these conditions. It remains to be discovered how this particular mutation allows the strain to grow more successfully and be more virulent in low oxygen. However in other fungal biofilms, for example the yeast Candida albicans, the colony can form wrinkles which improve oxygen penetration. Understanding how the structure of biofilm colony growth reflects advantages in the ability of the fungus to cause disease may allow clinicians and scientists to better predict the progression of disease and improve patient care.

Find out more:

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