Study finds green tea may reduce Down syndrome facial traits

A questionable new study suggests green tea may be able to reduce the effect of Down syndrome on facial features.

When a child is born with Down syndrome (DS), he or she has three #21 chromosomes rather than the typical two. The medical term for the syndrome is “Trisomy 21,” and it’s the reason 3/21 is celebrated in the U.S. as World Down Syndrome Day. Perhaps, then, it’s no coincidence that there’s been a lot of coverage lately of a newly published Spanish study that suggests a compound in green tea may be able to reduce the facial morphology, the flattened facial profile and nose, indicative of Down syndrome.

The study, published March 8, 2018, looked at the effect of the compound on a computer mouse model, and on an extremely small — some might say “statistically insignificant” — human sample. Within the former, different dosages produced drastically different results, and so the scientists are not recommending the treatment of anyone with green tea extract right now. Still, the research is interesting and worth following going forward. 

Understanding Down syndrome

Down syndrome is the most commonly occurring chromosomal condition, occurring in one in every 700 babies born in the U.S., or about 6,000 infants a year. It’s not a disability, though most people with Down syndrome do experience some cognitive disabilities. However, as the National Down Syndrome Society (NDSS) notes, “the effect is usually mild to moderate and is not indicative of the many strengths and talents that each individual possesses nonetheless.” People with Down syndrome live full, rich lives, though statistically have a reduced life expectancy of 60 years. Even so, things are getting better: In 1985, life expectancy was 25 years.

As bioethicist Chris Kaposy writes, however, we as a society have a troubling ambivalence about Down syndrome. One one hand, baby-product maker Gerber has been acclaimed for naming a child with Down syndrome, Lucas Warren, as their 2018 Gerber baby. In contrast, Netflix recently saw nothing wrong with airing a special in which comedian Thom Segura makes fun of people with Down syndrome.

Adorable Lucas Warren (Gerber/Cortney Warren)

More meaningfully, even as much of society has evolved in its acceptance of people with Down syndrome, it’s still the case that from roughly 60% to 90% of expecting parents informed their child will have Down syndrome choose to terminate the pregnancy.

These statistics indicate that, a Kaposy writes, “there is still enormous reluctance for prospective parents to choose to include children with Down syndrome in their families.” And yet, he says, “When children with Down syndrome are included in their families they tend to become beloved full participants.” (Contrary to some reports, Iceland does not require such terminations and has not eliminated Down syndrome in newborns.)

Families raising children with Down syndrome may not even want to “normalize” their children’s appearance. As Linda Gilmore of Queensland University of Technology in Australia tells New Scientist, “Some are keen to try anything that might make things easier cognitively and socially,” but “Others feel strongly about not changing their child’s personality or appearance — not changing the person they are.”

The study’s findings

The new study looked at the effect of epigallocatechin-3-gallate (EGCG), a compound found in green tea. It’s known to slow down the production of DYRK1A, an enzyme that may produce a range of Down syndrome characteristics, including its typical facial features.

The researchers studied the effect of EGCG in mouse models, and the results were both encouraging and worrying: “Our results showed that mouse models treated with low dose of EGCG during pre‐ and postnatal development improved facial dysmorphology.

Analysis of the global facial shape in DS mouse models treated at high and low EGCG dose (Dierssen, et al)

However, the same treatment at high dose produced disparate facial morphology changes with an extremely wide and abnormal range of variation.” As a result, the authors concluded, “Current evidence warns against the non‐prescribed intake of this supplement as a health‐promoting measure.”
Previous reports have linked EGCG to reducing the cognitive effects of Down syndrome — though the research is inconclusive — and some families have already been treating their children with non-prescription, over-the-counter supplements containing the compound. It’s a group of 13 such families from which the human aspect of the new study derives. Again, this is a tiny sample, and with no standardized dosage or timing protocols — each child consumed roughly the equivalent of eight cups of green tea per day — so the families’ experience by no means constitutes a controlled study.

The children were studied in three groups:

  • Age 13-18: four children who’d been receiving green-tea extract for since late in adolescence
    Age 4-12: two children for whom the report doesn’t specify the age at which treatment began, but is presumably a few years 
  • Age 0-3: seven children four children who’d been receiving green-tea extract for since early in their development

The researchers conducted structural analyses of children without DS and the children in the study. They examined 3D coordinates for 21 facial landmarks and found that six of the seven 0-3-year-olds exhibited facial features that were most like the non-DS (or “euploid”) children in their age group. The scientists suspect that this is because such the underlying structural development of such young kids is still underway and most susceptible to the influence of EGCG.

There was about 30% less facial variation from non-DS (EU) kids in children 0-3 with Down syndrome who’d been treated with EGCG (Dierssen, et al)

Put down that supplement

As we said earlier, this was a small study, and the results of the mouse-modeling element indicated that dosages can be critical both to the success of the treatment and also in avoiding risk. As Jean Maurice Delabar at Paris’ Brain and Spine Institute points out New Scientist, those results suggest that high amounts of EGCG can result is extreme facial and skeletal issues.

'Upstreamism': Your zip code affects your health as much as genetics

Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."

Sponsored by Northwell Health
  • Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
  • Patients from low-income neighborhoods are most at risk of negative health impacts.
  • Thankfully, health care professionals are not alone. Upstreamism is increasingly part of our cultural consciousness.
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  • A huge segment of America's population — the Baby Boom generation — is aging and will live longer than any American generation in history.
  • The story we read about in the news? Their drain on social services like Social Security and Medicare.
  • But increased longevity is a cause for celebration, says Ashton Applewhite, not doom and gloom.

After death, you’re aware that you’ve died, say scientists

Some evidence attributes a certain neurological phenomenon to a near death experience.

Credit: Petr Kratochvil.
Surprising Science

Time of death is considered when a person has gone into cardiac arrest. This is the cessation of the electrical impulse that drive the heartbeat. As a result, the heart locks up. The moment the heart stops is considered time of death. But does death overtake our mind immediately afterward or does it slowly creep in?

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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.