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Eradication of poliomyelitis by the year 2000
Bionled & Phamlncorher 0 Elsevier. Paris
(1992)
46,
501-503
501
ales
Eradication of poliomyeiitis by the year 2000 In May 1988, The World Health Assembly declared th;. the World Health Organization was committed to b: global eradication of poliomyelitis by the year 2000 The eradication of poliomyelitis, as with smallpox, involves the additional criterion of the elimination of indigenous transmission of the wild virus. The initiative for the global eradication of poliomyelitis is being coordinated by the Expanded Programme on Immunization (EPI), established by the World Health Assembly in 1974. Poliomyelitis is the first disease whose eradication is a goal of the EPI. Eradication will depend heavily on the application of vaccines and immunisation strategies that already exist to achieve full immunization of the world’s children against poliomyelitis. Yet, operational research to improve ‘immunization strategies, epidemiological research to improve surveillance techniques, and basic research to improve vaccine performance will also contribute to the eradication effort. The eradication of smallpox by a campaign led by the World Health Organization that culminated in 1977 represents one of humanity’s greatest achievements in health. The task of eradication poliomyelitis is technically more formidable, and the final financial cost may well be greater than eradicating smallpox. Nevertheless, our goal appears to be achievable with existing vaccines and approaches. The eradication of poliomyelitis by the year 2000 would be a magnificent gift from the 20th century to future generations of children. PF Wright (1) VanderbiltUniversity, Nashville. Tennessee 37232-258 1. USA
G protein in McCune-Albright syndrome The McCune-Albright syndrome (MAS) is a rare disorder of unknown etiology characterized by bone abnormalities, cafe-au-lait birthmarks, precocious puberty and overactivity of other endocrine glands. DNA was isolated from pathology specimens and gene segments were amplified using the polymerase chain reaction. Mutations were found in the gene that codes Lor a subunit of the G protein that stimulates cyclic AMP formation. G proteins normally transmit sigrmls from activated cell surface receptors to intracellular effecters. MAS mutations results in G protein activation in the absence of hormonal signals, and may ledd to abnormal cell proliferation and function. Mutations were found
in affected e?-‘.ocrine organs and nonendocrine organs such as liver and heart. In each patient, the proportion of cells bearing the mutation varied from tissue to tissue, consistent with somatic mutation of this gene early in embryogenesis. The same mutations were previously found in pituitary and thyroid tumors. The mutation encodes the substitution of a critical amino acid, known to be the target for cholera toxin during intestinal infection. Inherited or acquired G protein defects have been implicated in several other clinical disorders, including pertussis and pseudohypoparathyroidism. LS Weinstein (2) National Institutesof Healtb, Bethesda, MA 20892. USA
Aspirin may protect against colon cancer Experiments in animals and two recent epidemiological studies in man suggest that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against colon cancer. A prospective mortality study of 662 424 US adults from 1982-1988 found that death rates from colon cancer decreased with more frequent aspirin use in both men and women. The relative risk among persons who used aspirin 16 or more times per month for at least one year was 0.60 in men (95% confidence interval 0.40 to 0.89) and 0.58 in women (0.37 to 0.90). Risk estimates were unaffected by excluding persons who, at entry into the study, reported cancer, heart disease, stroke, or other conditions that might influence both aspirin use and mortality. Adjustment for dietary factors, obesity, physical activity, and family history did not alter the findings significantly. In conclusion, regular aspirin use at low doses may reduce the risk of fatal colon t ancer. Whether this is due to a direct effect of aspirin, perhaps mediated through inhibition of prostaglandin synthesis, or to other factors indirectly associated with aspirin is unclear. MJ Thun (3) AmericanCancerSociety, Atlanta, GA 30329.USA
Implications of the recent identification of the myotonic dystrophy mutation In three papers in Narure recently, the mutation underlying myotonic dystrophy (DM) was described. This disease is the commonest form of inherited muscular dystrophy in adults. The papers describe the detection (2) N En@
(1) P,’Engl ./ Med
(1991) 325, 1174
J Med (1991) 325, 1688 (3) N Engl J Med (1991) 325, 1593
(1992)
46,
501-503
501
ales
Eradication of poliomyeiitis by the year 2000 In May 1988, The World Health Assembly declared th;. the World Health Organization was committed to b: global eradication of poliomyelitis by the year 2000 The eradication of poliomyelitis, as with smallpox, involves the additional criterion of the elimination of indigenous transmission of the wild virus. The initiative for the global eradication of poliomyelitis is being coordinated by the Expanded Programme on Immunization (EPI), established by the World Health Assembly in 1974. Poliomyelitis is the first disease whose eradication is a goal of the EPI. Eradication will depend heavily on the application of vaccines and immunisation strategies that already exist to achieve full immunization of the world’s children against poliomyelitis. Yet, operational research to improve ‘immunization strategies, epidemiological research to improve surveillance techniques, and basic research to improve vaccine performance will also contribute to the eradication effort. The eradication of smallpox by a campaign led by the World Health Organization that culminated in 1977 represents one of humanity’s greatest achievements in health. The task of eradication poliomyelitis is technically more formidable, and the final financial cost may well be greater than eradicating smallpox. Nevertheless, our goal appears to be achievable with existing vaccines and approaches. The eradication of poliomyelitis by the year 2000 would be a magnificent gift from the 20th century to future generations of children. PF Wright (1) VanderbiltUniversity, Nashville. Tennessee 37232-258 1. USA
G protein in McCune-Albright syndrome The McCune-Albright syndrome (MAS) is a rare disorder of unknown etiology characterized by bone abnormalities, cafe-au-lait birthmarks, precocious puberty and overactivity of other endocrine glands. DNA was isolated from pathology specimens and gene segments were amplified using the polymerase chain reaction. Mutations were found in the gene that codes Lor a subunit of the G protein that stimulates cyclic AMP formation. G proteins normally transmit sigrmls from activated cell surface receptors to intracellular effecters. MAS mutations results in G protein activation in the absence of hormonal signals, and may ledd to abnormal cell proliferation and function. Mutations were found
in affected e?-‘.ocrine organs and nonendocrine organs such as liver and heart. In each patient, the proportion of cells bearing the mutation varied from tissue to tissue, consistent with somatic mutation of this gene early in embryogenesis. The same mutations were previously found in pituitary and thyroid tumors. The mutation encodes the substitution of a critical amino acid, known to be the target for cholera toxin during intestinal infection. Inherited or acquired G protein defects have been implicated in several other clinical disorders, including pertussis and pseudohypoparathyroidism. LS Weinstein (2) National Institutesof Healtb, Bethesda, MA 20892. USA
Aspirin may protect against colon cancer Experiments in animals and two recent epidemiological studies in man suggest that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against colon cancer. A prospective mortality study of 662 424 US adults from 1982-1988 found that death rates from colon cancer decreased with more frequent aspirin use in both men and women. The relative risk among persons who used aspirin 16 or more times per month for at least one year was 0.60 in men (95% confidence interval 0.40 to 0.89) and 0.58 in women (0.37 to 0.90). Risk estimates were unaffected by excluding persons who, at entry into the study, reported cancer, heart disease, stroke, or other conditions that might influence both aspirin use and mortality. Adjustment for dietary factors, obesity, physical activity, and family history did not alter the findings significantly. In conclusion, regular aspirin use at low doses may reduce the risk of fatal colon t ancer. Whether this is due to a direct effect of aspirin, perhaps mediated through inhibition of prostaglandin synthesis, or to other factors indirectly associated with aspirin is unclear. MJ Thun (3) AmericanCancerSociety, Atlanta, GA 30329.USA
Implications of the recent identification of the myotonic dystrophy mutation In three papers in Narure recently, the mutation underlying myotonic dystrophy (DM) was described. This disease is the commonest form of inherited muscular dystrophy in adults. The papers describe the detection (2) N En@
(1) P,’Engl ./ Med
(1991) 325, 1174
J Med (1991) 325, 1688 (3) N Engl J Med (1991) 325, 1593