StemCell Therapy

Vetek (Seniority) the Movement for Longevity and Quality of Life (Israel)

Summary

Due to the aging of the global population and the derivative increase in major aging-related non-communicable diseases and their economic burden, there is an urgent international need to promote the research, development and application of and education on effective and safe therapeutic geroscience interventions. These interventions are designed to mitigate degenerative aging processes, thus preventing and eliminating the main underlying contributors for major chronic aging-related diseases and thus improving the healthy and productive longevity for the elderly population. Insofar as aging is the main contributing factor of major chronic age-related diseases, the research and development efforts in the fields of geroscience and of major chronic diseases are integrally related. Israel can be an important contributor to these international R&D efforts, for which it can offer its proven record of scientific and technological achievements and innovation, its strong supportive infrastructure for research and development, its highly skilled scientific and technological work force, including leadership in diverse branches of biomedical research on aging and aging-related diseases. Yet a stronger effort will be needed to build on those strengths and realize the countrys potential in the field for the benefit of the Israeli and global population. Israel can help further promote the field, not only locally, but internationally, by creating and sharing policy suggestions for the advancement of the field.

1. Israel has made significant progress in the fields related to geroscience and combat of major aging-related diseases.

Israel can and should be an important contributor to the global geroscience endeavors, building on its scientific, technological and societal achievements in the field of aging and related fields[1]:

Building on the past achievements, there is still a vital need to develop the geroscience and healthy longevity field in Israel, and there exists a large space for the growth of the field.

There are several specific pressing needs and demands for the development of the geroscience and healthy longevity field in Israel. The needs and the corresponding recommendations listed below closely follow the points made by the Vetek and allied associations in their recommendations for Enhancing research, development and education for the promotion of healthy longevity and prevention of aging-related diseases in the Israel National Masterplan on Aging. Yet, here they are given a wider international perspective, insofar as these needs and recommendations are quite common and applicable for virtually any country. Moreover, these needs and recommendations can be advocated and promoted via international frameworks and organizations, both globally and for specific countries on a case-by-case basis.

Today, there are about 980,000 people in Israel over the age 65 (about 11% of the countrys population), and it is expected that the number of the elderly will increase to 1.6 million by 2035. This reality demands the preparedness of the healthcare and welfare systems to provide worthy and sufficient services for the elderly, adequate solutions for the prevention of systemic economic and healthcare collapse, as well as for the equitable social inclusion of the elderly, and as a result the improvement of their quality of life and the countys economic growth. To achieve those goals, the advancement of medical research and development is a necessary condition. The aging-related health decline is the major cause of mortality, morbidity and disability. It is thus the root cause of all healthcare and economic challenges related to the population aging and should be addressed according to the severity of the problem. Therefore, considerable resources must be dedicated to the advancement of research, development and education aimed at the amelioration of degenerative aging processes and debilitating aging-related diseases in order to extend healthy longevity as much as possible for the entire population.

Yet, the investment of human and material resources in the field is still insufficient in Israel. Presently, the State of Israel expends only about 0.5% of its general research budget for the research of aging and aging-related diseases (just about $5M dedicated annual state budget). Except for the budget framework for science, technology and innovation for the older persons within the Ministry of Science and Technology, there are no other defined budget frameworks in Israel for research and development in the field of aging, healthy longevity and prevention of aging-related diseases. There are limited support frameworks that can be adapted to the subject, such as research budgets for specific diseases, such as Alzheimer's disease, diabetes, cancer, etc., which by their nature are aging-related diseases. But in fact, there are no dedicated support frameworks specifically addressing aging-related ill health as a whole (old-age multimorbidity), neither addressing aging as the primary contributing factor for age-related diseases, and there is almost no reference to the special medical needs and characteristics of the aging individuals and the older population. Their characteristics and medical needs are often dramatically different in terms of diagnosis and treatment from the younger population, and the difference may have a decisive impact on the effectiveness of treatment. There is also a lack of centralized R&D support frameworks for the field of aging in Israel, such as the NIH's National Institute on Aging that exists in the US.

Therefore, defined budget frameworks must be established for medical research and development that will specifically address the issue of aging, and promote healthy longevity and prevention of aging-related diseases. Specifically, a defined significant percentage of the research and development budgets of the relevant ministries must be dedicated to the field. These should include the Ministry of Health; the Ministry of Science and Technology; the Planning and Budgeting Committee of the Council for Higher Education; the Israel Innovation Authority; the Israel Science Foundation; the Israel Academy of Sciences and Humanities including the National Infrastructure Forum for Research and Development; the Ministry for Social Equality; the National Insurance Institute; the bi-national and international research programs in which Israel is a partner, particularly in the divisions concerning the research and treatment of non-communicable chronic diseases.

These frameworks must provide funding for calls for research proposals, grants, scholarships, services and action plans designed to alleviate the degenerative aging process and improve the longevity and quality of life of the older population, on behalf and in cooperation of the relevant ministries and institutions.

There is a now a severe deficit of relevant educational materials of any kind in Israel, in the field of aging generally, and particular areas of geroscience and healthy longevity promotion in particular. Currently, aging research is severely under-represented in all academic and other educational frameworks. Good education may be considered a primary condition for progress. There is a need to address the large deficit of knowledge and training on the subject of biological aging, its biomedical improvement and healthy longevity, in most existing institutions of learning. The need should be obvious. It should be clear that prior to any research, development and application on biological aging, there is a need to educate specialists who will be able to contribute to the various aspects of the field. There is an even prior need to educate the broader public on the importance of such research to prepare the ground for further involvement.

Such education is currently very limited. In practical terms, there are presently rather few dedicated structures in Israel to promote and coordinate knowledge exchange and dissemination on biological aging and healthy longevity promotion. There is an urgent necessity for such educational structures to make the narrative on biology of aging and healthy longevity prevalent in the public and academic discourse. To improve the communication and integration, it appears to be crucially important to commonly include the subjects of biogerontology, geroscience and healthy longevity promotion as central parts of learning curricula, and not only in universities, but in every learning and teaching framework, especially those related to biology, medicine or natural sciences generally. Yet, unfortunately, and strangely enough, the study of the biology of aging and longevity is rarely a part of university curriculum and virtually never a part of high school or community education curriculum. Thus, there is a vast range of opportunities to develop educational and training materials and courses, including materials and courses of professional interest, from undergraduate to postgraduate levels, as well as of general interest, presenting recent advances in aging and longevity science. Educational teaching and training materials on the subject should be developed and disseminated for people at all education levels, both for the academia and the general public, for all age groups, for different sectors and in different languages, in accordance with their specific abilities and characteristics. Teaching programs that increase motivation and stimulate scientific thinking in the field should be developed for children, university students at different study stages (undergraduate and graduate), for interns and specialists, and as a part of adult enrichment studies.

In particular, it is necessary to develop study materials, such as courses, text books, problem solvers, guidelines and professional specialization programs in the biology of aging, especially for physicians and biologists in the fields adjacent to aging research, as well as educational materials for the general public. The materials for the general public should include lectures, reviews of the latest scientific developments in the field and practical recommendations for the promotion of healthy longevity and for the preparation of the younger generation to the challenges that expect them. There must be prepared and disseminated authoritative, evidence-based information about lifestyle regimens (such as nutrition, physical activity and rest) that promote healthy longevity and prevent aging-related ill health. A variety of educational teaching and training means should be developed, including conferences, printed materials, knowledge competitions, interactive web platforms, games and other accessible technological means. Relevant ministries and institutions should be involved in the development of and providing access to these educational programs, from the Ministry of Education and the Council for Higher Education to local authorities, public associations, and community centers. In order to facilitate the progress, there is a need to encourage the establishment of educational pilots and the examination of good practices in relevant ministries and other institutional frameworks.

One of the primary specific needs to develop the geroscience field, in Israel and elsewhere, appears to be the establishment of agreeable, scientific evidence-based evaluation criteria for the efficacy and safety of geroprotective (geroscience or healthspan-enhancing) therapies. Such commonly agreed evaluation criteria are presently lacking, in Israel and elsewhere. Yet, they appear to be absolutely necessary in order to set up the end points for the development of geroscience-based therapies and diagnostics and provide value-based incentives for academic, public and commercial R&D entities involved in the field. The field of geroscience is predicated on the recognition of aging as a major contributing and modifiable factor of pathogenesis, including such recognition in regulatory and budgeting frameworks. Yet, it appears that the primary necessary requirement for the degenerative aging process to be recognized as such a modifiable factor and therefore an indication for research, development and intervention, is to develop evidence-based diagnostic evaluation criteria and definitions for degenerative aging and for the efficacy and safety of potential means against it[17]. Without such scientifically grounded and clinically applicable diagnostic evaluation criteria and definitions, the discussions about treating, postponing, intervening into or even curing degenerative aging processes will be mere slogans. It appears to be impossible to treat, postpone, intervene into or cure a condition that it is impossible to diagnostically evaluate and measure the effectiveness and safety of treatment. Such evaluation criteria and measurements would need to become the basis for public geroscience-oriented health programs designed for the prevention of aging-related diseases, while measuring the effectiveness and safety of the interventions.

Therefore, it is necessary to develop and implement improved evaluation measures and criteria for assessing the aging process, for the early diagnosis and prediction of multiple aging-related diseases (old-age multimorbidity), for examining the effectiveness of treatments for their prevention and for estimating and improving the older persons functional and employment abilities. Commonly agreed, science-based and authoritative guidelines should be provided for such measures by authoritative and representative national and international organizations. To develop such measures, it is necessary to increase and improve the collection and processing of various types of data on aging, including biological and medical data in combination with behavioral and social, economic and environmental data. In this process, it is necessary to establish and/or expand relevant databases (registries) and analytical platforms and tools (knowledge centers) in order to facilitate the collection, design, accessibility, analysis, integration and sharing of data on aging, promotion of healthy longevity and prevention of aging-related diseases. These databases and analytical tools should be used predictively to model large amounts of data for more effective diagnosis and treatment and to allow personalized medicine for the older subjects, with reference to their aging process.

In Israel, in order to establish and expand these measurement and analysis systems, it is necessary to involve the relevant ministries and institutions, in particular the Ministry of Health, with the maximum possible cooperation of other entities who have access to data on aging, such as research institutions, hospitals, health maintenance organizations, local authorities and public and commercial research communities. The goals of evaluating the aging processes, early detection and prevention of aging-related ill health as a whole (preventing old-age multimorbidity) and extension of healthy lifespan, should be specifically defined in relevant frameworks and programs, such as the National Program for Personalized Medicine and the National Program for Digital Health, as well as relevant international health promotion programs where Israel takes part. Initiatives and pilots of different extents on the subject should be encouraged in all sectors, while supporting their cooperation.

The above needs and demands for the development of the geroscience and healthy longevity field, directly yield policy recommendations for the fields advancement. Currently, official policy recommendations for the promotion of the geroscience and healthy longevity field are lacking in most major international as well as national frameworks. Such recommendations, for both international and national policy frameworks, must be developed and advocated by authoritative and representative international organizations promoting geroscience research and education.

An exemplary effort to develop and advocate such policy recommendations is the position paper of the International Society on Aging and Disease (ISOAD), entitled The Critical Need to Promote Research of Aging and Aging-related Diseases to Improve Health and Longevity of the Elderly Population (2015)[18]. This position paper makes the general appeal that Governments should ensure the creation and implementation of the policies to promote research into the biology of aging and aging-related diseases, for improving the health of the global elderly population. It further provides specific policy suggestions with reference to enhancing funding, institutional support and incentives for biomedical aging research. This position paper has been translated to 12 languages and submitted for consideration to several governments. It has stimulated further discussion, encouraging the academic community, the general public and decision makers to elaborate on the policies to support the aging R&D field[19].

Such position papers and consultations can have tangible effects on public health policy and research policy, as evidenced by another position paper, jointly advanced by the International Society on Aging and Disease, American Federation for Aging Research, International Federation on Aging, International Association of Gerontology and Geriatrics and other leading organizations on aging, entitled Aging health and R&D for healthy longevity must be included into the WHO Work Program (2018)[20]. Largely thanks to this position paper and the associated advocacy campaign, the subject of healthy aging that had been originally absent, was eventually included into WHOs 13th General Programme of Work for 2019-2023, including specific end points for the reduction of elderly disability and increasing their healthy life expectancy. The contribution of this advocacy campaign was acknowledged by the director of the WHO Ageing and Life Course Division[21]. Another position paper followed the recent establishment of the UNESCO-affiliated Executive Committee on Anti-Aging and Disease Prevention, entitled The urgent need for international action for anti-aging and disease prevention[22].

These are preliminary examples, and more of such position papers, guidelines and advocacy efforts are needed to advance the geroscience and healthy longevity field, both at the national and international levels. Authoritative and representative international organizations should take on this work, preparing and advocating policy suggestions and guidelines, creating educational materials and providing platforms for scientific cooperation in the geroscience and healthy longevity field.

Specifically, building on the experience of the Israeli program for Enhancing research, development and education for the promotion of healthy longevity and prevention of aging-related diseases within the Israel National Masterplan on Aging (see the previous section), such international organizations may consider advancing the following activities and policies, within specific countries and globally:

International organizations should advocate for a significant increase in the level of governmental and non-governmental funding for basic, applied, translational and clinical research and technological development for the mitigation of degenerative aging processes, aging-related chronic non-communicable diseases and disabilities, in order to extend the healthy and productive life expectancy for the entire population throughout the entire life course. Specifically, the international organizations should advocate for the allocation of defined significant percentages of the research and development budgets of the relevant budgeting frameworks to be dedicated explicitly for the geroscience and healthy longevity field, including bi-national and international research and development programs.

International organizations should create and expand academic and public education frameworks, programs and educational materials, considering the basic and applied research on aging processes and aging-related diseases, promoting healthy longevity, preventing aging-related diseases and improving the quality of life for the elderly, including biological, medical, technological, environmental and social aspects.

International organizations should develop and implement and/or advocate for the development and implementation of evidence-based evaluation criteria, measures and indicators to estimate the effects of aging, predict and detect at an early stage multiple aging-related diseases, and examine the effectiveness and safety of therapeutic and preventive interventions against them. Concomitantly, evaluation criteria, measures and indicators must be developed and advanced for the functional and employment capacity of the elderly and for the improvement of their functional capacity. Such evaluation criteria, measures and indicators should be used for establishing and/or improving public health systems for the early detection and prevention of degenerative aging processes and aging-related diseases.

Combined, these measures and policies should advance the geroscience and healthy longevity field, nationally and internationally, for the benefit of the elderly and the entire population.

References

[20] Stambler I, Jin K, Lederman S, Barzilai N, Olshansky SJ, Omokaro E, Barratt J, Anisimov VN, Rattan S, Yang S, Forster M, Byles J (2018). Aging health and R&D for healthy longevity must be included into the WHO Work Program. Aging and Disease, 9(2): 331-333 http://www.aginganddisease.org/article/2018/2152-5250/ad-9-2-331.shtml.

Ilia Stambler is an IEET Affiliate Scholar. He completed his PhD degree at the Department of Science, Technology and Society, Bar-Ilan University. His thesis subject, and his main interest, is the History of Life-extensionism in the 20th Century.

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Israel can and should become an important contributor to the international geroscience research, development, application and education - Institute...

With fear and misinformation spreading alongside the new coronavirus, a scientist has explained why a humble bar of soap is one of the most important weapons in our arsenal against the bug which causes COVID-19.

Soap wipes out viruses including SARS-CoV-2the pathogen which causes the disease COVID-19 not to be confused with the SARS virusbecause it is able to dissolve its fat membrane, explained Palli Thordarson, a chemistry professor at the University of New South Wales.

In a Twitter thread, Thordarson said this causes the virus to fall apart "like a house of cards" and become inactive (but not die as they aren't technically alive). Water alone isn't enough, according to Thordarson, because it "'only' competes with the strong 'glue-like' interactions between the skin and virus via hydrogen bonds. They virus is quite sticky and may not budge."

"Soapy water is totally different," said Thordarson. "Soap contains fat-like substances knowns as amphiphiles, some structurally very similar to the lipids in the virus membrane. The soap molecules "compete" with the lipids in the virus membrane."

And as our hands are "quite rough and wrinkly," we need to rub and soak them to make sure the soap reaches every part of the skin, he said.

Thordarson went on to address why soap works better to deactivate viruses than other products. "Disinfectants, or liquids, wipes, gels and creams containing alcohol (and soap) have a similar effects but are not really quite as good as normal soap. Apart from the alcohol and soap, the 'antibacterial agents' in these products don't affect the virus structure much at all."

"Consequently, many antibacterial products are basically just an expensive version of soap in terms of how they act on viruses. Soap is the best but alcohol wipes are good when soap is not practical or handy (e.g. office receptions)," he said.

Donald Schaffner, distinguished professor at Rutgers University and an expert in topics including handwashing, told Newsweek soaps also work to remove viruses from the hands as they wash them down the drain, while hand sanitizers inactivate virus already on the hands. "For an added 'one-two' punch you can use both," he said.

Contrary to some recommendations that hot water must be used when handwashing, Schaffner said the level of heat doesn't matter and people should simply use a comfortable temperature.

"People should practice washing all the areas of their hands, and perhaps give special attention to places where microbes may get trapped in dirt such as under the fingernails," he said.

Schaffner added: "Alcohol-based hand sanitizers are very effective against this virus. There are some viruses like norovirus, where hand sanitizers don't work as well." That's not the case with SARS-CoV-2 because of its structure, he said.

"Of course it doesn't help that many store shelves are sold out, but I would recommend getting a bottle to have on hand the next time it's available," said Schaffner.

The advice is in line with that given by the World Health Organization, which last month urged the public to "never underestimate the power of the humble bar of soap!"

"Washing your hands regularlyeither with alcohol-based rub or ordinary soap and wateris one of the most effective ways to protect yourself and others from #COVID19 and many other diseases."

For more WHO advice of preventing the spread of COVID-19, scroll to the bottom of the piece.

The U.S. Centers for Disease Control and Prevention advises people to sing the Happy Birthday song twice, which lasts about 20 seconds, while washing their hands to ensure they are doing so for long enough to rid their hands of germs.

After you've washed your hands, don't forget to moisturise, Dr. Sara Hogan, a dermatologist at UCLA Medical Center, told Slate. That's because the practice can disturb the outer layer of skin which is made up of dead cells and protects our skin from dirt and microbes, and locks in moisture.

Dr. Evan Rieder, a dermatologist at NYU Langone told the website "really greasy" moisturizers and emollients are best, followed by creams and lotions which contain more water and are therefore less hydrating.

All this can help to stem the spread of the COVID-19, which has killed over 3,800 people in 111,000 cases worldwide, with more than 62,300 people recovered, according to a tracker run by Johns Hopkins University.

Most deaths have occurred in Hubei, China, where the outbreak started in the province's capital of Wuhan in December 2019. As shown in the map below by Statista the virus has reached every continent except Antarctica.

Hygiene advice

Medical advice

Mask usage

This article has been updated with comment from Donald Schaffner.

Originally posted here:
This Is Why Soap Is So Effective at Stopping Spread of Coronavirus - Newsweek

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2018 Today Show Book Recommendations: picks this week - Today.com

Transfusion of red blood cells (RBCs) is a life-saving treatment for numerous conditions such as severe anaemia, injury-related trauma, supportive care in cardiovascular surgery, transplant surgery, pregnancy-related complications, solid malignancies and blood-related cancers.

However, blood banks particularly in developing countries often face a severe shortage of whole blood as well as components of blood like red blood cells.

Researchers across the world are exploring possibilities to generate RBCs outside the body (in vitro) from haematopoietic stem cells (HSCs). These HSCs have the capability to give rise to the different types of cells found in the blood. Various groups have been able to produce RBCs in the laboratory from HSCs.

However, the process takes a long time - around twenty-one days. The resources required to grow cells in the laboratory over such a long duration can be very expensive for generation of RBCs on a large scale for clinical purposes.

A team of researchers led by Dr. L. S. Limaye, ex-scientist at the Department of Biotechnologys National Centre for Cell Science (NCCS) at Pune have found a way to tackle the issue.

They have found that the process can be speeded up by adding a very low concentration of a small protein molecule called `transforming growth factor 1 (TGF-1), along with a hormone called `erythropoietin (EPO), to the growth medium. They could cut down the process time by three days.

Dr. Limaye noted that several tests to assess the quality of the cells formed, and examination of many of their characteristics, including physical appearance, revealed that the RBCs formed using this procedure were normal.

The findings are worthy of further exploration. Additional investigations based on the insights gained from these studies could help assess the relevance of using this approach for blood transfusions in the future. The researchers have published a report on their work in the journal, `Stem Cell Research and Therapy.

(India Science Wire)

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New approach to speed up red blood cells generation in the lab - BusinessLine

The Peers family were overjoyed when doctors told them Callum had beaten cancer.

Life returned to normal but, tragically, it would not stay that way.

The battling ten-year-old, who has twice successful fought cancer, has the disease once again.

This time the odds are heavily stacked against him. Doctors here give him just a ten per cent chance of living more than five years.

But his parents are determined to fight on and are pinning their hopes on pioneering drug trials.

They are trying to raise 150,000 to get Callum treatment in the US that is not available on the NHS.

Callums mum Nicola, 37, said: Seeing my son fight this disease for seven years has been heartbreaking but he has never given up.

Hes fought it and beaten it twice and I know he can do it again. We must give him that chance. I am not losing my boy.

Callum, of Leigh, Gtr Manchester, was just three when he began getting symptoms. Nicola first took Callum to his GP with stomach pains.

In June 2013, after hed turned four, he was diagnosed with an aggressive stage-4 neuroblastoma.

She said: It was such a shock when they told us, the last thing we expected. It was a body blow.

I was heartbroken but I had to carry on and be strong for Callum.

We told him he had a lump in his tummy and was having medicine for it. He was a little hero and never complained.

Callum had an operation to remove a tumour in his stomach and gruelling chemotherapy, immunotherapy and stem cell treatment.

He lost his hair, endured sickness, lethargy, high temperatures and spent months in hospital.

Then, in December 2014, the family got the news they were hoping for when his scans came back all clear.

Nicola recalled: We were over the moon. Life slowly went back to normal and we started going on family caravan holidays again.

But just over two years later, in January 2017, when Callum was getting ready for school he complained of feeling unwell.

Nicola noticed a lump on his neck. An emergency scan at the hospital confirmed the cancer had returned.

Nicola said: To get that news a second time was devastating. It could easily have broken us, but we had to fight on.

Callum had three types of chemo and after 12 months in and out of hospital he had kicked the cancer again.

But in August last year there was a lump on his neck and Nicola knew what to expect. The cancer had spread to the right side of his stomach. She said: Id thought after his treatment had finished the second time we were going to go back to normal.

Being told again and again your boy has cancer is awful.

Since then a tumour on Callums chest has been surgically removed and, days before his tenth birthday, another growing on his spine, which could have paralysed him, was taken out.

He has been through more chemo and radiotherapy, been rushed into intensive care with complications four times.

He spent his Christmas at Great Ormond Street hospital in London. Nicola said: Callum is the definition of a fighter. I know he can beat this again and beat it for good.

Treatment options in the UK for Callum have run out but Nicola and his dad Alan, 56, brothers Jake, 19, Joshua, 18, and Cameron, nine, and sister Bethany, 17, arent giving up hope.

Helen Devos Childrens Hospital in Michigan is one of the few centres offering a treatment that works by targeting specific cancer stem cell pathways. Nicola spoke to consultants there and said: Children are going over there and are still clear of disease years and years later.

Callum has been through so much. He just carries on and he deserves this chance.

Were all feeling really hopeful. Its been proven to work.

She added: I know Callum can win his fight if we can give him the best possible chance.

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'I'm not losing my boy,' sobs mum after son is diagnosed with cancer for third time - Mirror Online

Researchers are occupied with finding novel strategies to make human stem cells. This is to address the expanding interest for stem cell creation for potential examination in malady administration. This factor is absolutely anticipated that would quicken the improvement of regenerative pharmaceutical, along these lines driving mechanical development. Also, cellular treatments are perceived as the following real progressions in changing social insurance. Firms are extending their cellular therapy portfolio, understanding the future capability of this field in the treatment of Parkinsons ailment, type 1 diabetes, spinal string damage, Alzheimers sickness, and others.

One of the essential variables driving this present Stem Cell Therapy market development is the restrictions in customary organ transplantations. The developing worries with organ transplantations have driven the interest for stem cell therapy items. Traditional organ gift is related with disease hazard, immunosuppression hazard, and dismissal. Additionally, the interest for organs is expanding, and the doctors very subject to organ benefactors. To beat these issues scientists are presently investigating approaches to distinguish the use of stem cell treatments in different transplants. For example, pluripotent stem cells offer a conceivably boundless wellspring of human cells, which can determine the majority of the cells in the body. Besides, the join dismissal can be diminished with the stem cells, as these are developed utilizing a similar individual cells. These points of interest in the transplantations of organs will bring about the development of the worldwide stem cell therapy market.

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Another key variables boosting the development of this market is the constraints of customary organ transplantation, for example, the danger of disease, dismissal, and immunosuppression hazard. Another disadvantage of ordinary organ transplantation is the fact that specialists need to rely upon organ contributors totally. Every one of these problems can be killed, by the utilization of stem cell therapy. The other factor which is helping the development in this market is the developing pipeline and advancement of medications for rising applications. Expanded research thinks about meaning to extend the extent of stem cell will likewise fuel the development of the market. Researchers are continually occupied with endeavoring to discover novel strategies for making human stem cells because of the developing interest for stem cell creation to be utilized for malady administration.

The worldwide market for stem cell therapy can be fragmented into North America, Europe, Latin America, Asia Pacific, the Middle East and Africa. North America rose as the main territorial market, activated by the rising rate of government help and interminable wellbeing conditions. Europe additionally shows huge development potential, as the advantages of this therapy are progressively recognized.

Asia Pacific is known for most extreme development, on account of the monstrous patient pool, main part of interests in stem cell therapy ventures, and the expanding acknowledgment of development openings in nations, for example, Japan, China, and India by the main market players.

The worldwide stem cell therapy market is in an early stage with the nearness of couple of universal merchants. With changing directions regarding transplantations in different created and creating nations, various new players are relied upon to enter the market space. Additionally, the developing pipeline and advancement of medications for rising applications will build the opposition among merchants amid the conjecture time frame.

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Other conspicuous merchants in the stem cell therapy market incorporate VistaGen Therapeutics, AbbVie, Anterogen, Astellas Pharma, Beike Biotechnology, Cellular Dynamics International (a backup of Fujifilm), Cellular Biomedicine Group, Opsis Therapeutics, Mesoblast, Laboratorios Salvat, TWO CELLS, Pharmicell, Ivy Institute of Stem Cells, Pluristem Therapeutics, U.S. Stem Cell, Taiwan Bio Therapeutics, ReNeuron, Translational Biosciences, Nuo Therapeutics, BIOTIME, Promethera Biosciences.

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Stem Cell Therapy Market: Using Stem Cell Therapy to Accelerate Cardiovascular Healing - BioSpace

AmnioBoost has potential for use in the treatment of ARDS, which is the principal cause of death in COVID-19 infection.1 Mortality in COVID-19 infected patients with the inflammatory lung condition (ARDS) is reported to approach 50%, and is associated with older age, co-morbidities such as diabetes, higher disease severity, and elevated markers of inflammation.1 Current therapeutic interventions do not appear to improve in-hospital survival.1

AmnioBoost is believed to have immunomodulatory properties to counteract the inflammatory processes that are implicated in several diseases by down-regulating the production of pro-inflammatory cytokines, increasing production of anti-inflammatory cytokines, and enabling recruitment of naturally occurring anti-inflammatory cells to involved tissues.

Major anti-inflammatory cytokines found in AmnioBoost include: interleukin (IL)-1beta, IL-1ra, TNF-alpha, IL-6, IL-8, IL-16, CCL2, CXCL7, MIF, and GRO a/b/g. Specific cytokine receptors for IL-1, and tumor necrosis factor-alpha, function as proinflammatory cytokine inhibitors.

This is supported by recently published results from an investigator-initiated clinical study conducted in China which reported that allogeneic mesenchymal stem cells (MSCs) cured or significantly improved functional outcomes in all seven treated patients with severe COVID-19 pneumonia.2

AmnioBoost

AmnioBoost was originally developed for chronic adult inflammatory conditions such as osteoarthritis, but has found multiple uses in the treatment of bone and cartilage repair, as well as soft tissue repair. It is an investigational therapy comprising concentrated allogeneic MSCs and cytokines derived from amniotic fluid.

The amniotic fluid is donated from non-related, healthy mothers and recovered by caesarian section; the baby is not harmed in any way. Additionally, AmnioBoost has been injected in over 1,000 patients with no adverse events, and appears to be well tolerated.

References

1. Liu Y et al. Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. Medrxiv 2020; https://doi.org/10.1101/2020.02.17.20024166 2. Leng Z, et al. Transplantation of ACE2- Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia[J]. Aging and Disease, 10.14336/AD.2020.0228

About Lattice Biologics Ltd.:

Lattice Biologics is traded on the TSX-V under the symbol: LBL. The Company is an emerging leader in the field of cellular therapies and tissue engineering, with a focus on dental indications.

Lattice Biologics develops and manufactures biologic products to domestic and international markets. The Companys products are used in a variety of surgical applications.

Lattice Biologics maintains its headquarters, laboratory and manufacturing facilities in Belgrade, Montana as well as offices in Phoenix, Arizona. The facility includes ISO Class 1000 clean rooms, and specialized equipment capable of crafting traditional allografts and precision specialty allografts for various clinical applications. The Lattice Biologics team includes highly trained tissue bank specialists, surgical technicians, certified sterile processing and distribution technicians, and CNC operators who maintain the highest standards of aseptic technique throughout each step of the manufacturing process. From donor acceptance to the final packaging and distribution of finished allografts, Lattice is committed to maintaining the highest standards of allograft quality, innovation, and customer satisfaction.

Lattice Biologics maintains all necessary licensures to process and sell its tissue engineered products within the U.S. and internationally. This includes Certificates to Foreign Governments from the U.S. Food and Drug Administration (FDA) and registrations for multiple countries, which allow the export of bone, tendon, meniscus, ligament, soft tissue, and cartilage products outside of the U.S.

Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

Cautionary Statement on Forward-Looking Information:

Certain information contained in this news release constitutes forward-looking statements within the meaning of the safe harbour provisions of Canadian securities laws. All statements herein, other than statements of historical fact, are to be considered forward looking. Generally, forward-looking information can be identified by the use of forward-looking terminology such as planned, potential, future, expected, could, possible, goal, intends, will or similar expressions. Forward-looking statements in this news release include, without limitation: information pertaining to the Companys strategy, plans, or future financial performance, such as statements with respect to the Transaction, and other statements that express managements expectations or estimates of future performance. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results, level of activity, performance or achievements of Lattice to be materially different from those expressed or implied by such forward-looking statements.

Forward-looking statements are necessarily based upon a number of factors and assumptions that, while considered reasonable by management as of the date such statements are made, are inherently subject to significant business, economic and competitive uncertainties and contingencies. The factors and assumptions that could prove to be incorrect, include, but are not limited to: that market prices will be consistent with expectations, the continued availability of capital and financing, and that general economic, market and business conditions will be consistent with expectations. The forward-looking statements are not guarantees of future performance. We disclaim any obligation to update or revise any forward-looking statements, except as required by law. Readers are cautioned not to put undue reliance on these forward-looking statements.

United States Advisory: The securities referred to herein have not been and will not be registered under the United States Securities Act of 1933, as amended (the "U.S. Securities Act"), and may not be offered, sold, or resold in the United States or to, or for the account of or benefit of, a U.S. Person (as such term is defined in Regulation S under the U.S. Securities Act) unless an exemption from the registration requirements of the U.S. Securities Act is available. This press release shall not constitute an offer to sell or the solicitation of an offer to buy any securities, nor shall there be any sale of securities in the state in the United States in which such offer, solicitation or sale would be unlawful.

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Lattice Biologics to Evaluate Anti-Inflammatory Stem Cell Therapy Treatment of COVID-19 Lung Disease - BioSpace

Researchers report that a patient who underwent stem-cell transplantation and a chemotherapy drug regimen has been cured of HIV.

An HIV patient to undergo stem cell transplantation from donors with a HIV-resistant gene no longer suffers from the condition, according to a new study. Researchers reveal that there was no active viral infection in the patients blood 30 months after they stopped anti-retroviral therapy, making him the second person cured of HIV.

However, they report that although there was no active viral infection in the patients body, remnants of integrated HIV-1 DNA remained in tissue samples, which were also found in the first patient to be cured of HIV. The authors suggest that these can be regarded as so-called fossils, as they are unlikely to be capable of reproducing the virus.

We propose that these results represent the second ever case of a patient to be cured of HIV. Our findings show that the success of stem cell transplantation as a cure for HIV, first reported nine years ago in the Berlin patient, can be replicated, said lead author on the study, Professor Ravindra Kumar Gupta at the University of Cambridge, UK.

The London and Berlin patient are examples of using the CCR5 gene in curative therapies outside of gene editing

He emphasised that as a high-risk treatment, this therapy is unlikely to be offered widely to patients with HIV who are on successful antiretroviral treatment.

In 2011, a patient based in Berlin (the Berlin patient) was the first HIV patient to be reportedly cured of the virus three and half years after undergoing similar treatment. This therapy included total body irradiation, two rounds of stem cell transplant from a donor who carried a CCR532/32 gene, which is resistant to HIV and finally a chemotherapy drug regimen. The transplant aimed to make the virus unable to replicate in the patients body, whilst the body irradiation and chemotherapy targeted any residual HIV virus.

The patient reported in this study (the London patient), underwent one stem-cell transplantation and a reduced-intensity chemotherapy drug regimen, without whole body irradiation. In 2019, it was reported that his HIV was in remission and the new study provides follow-up viral load blood test results at 30-months, as well as a modelling analysis to predict the chances of viral re-emergence.

Ultrasensitive viral load sampling from the London patients cerebrospinal fluid, intestinal tissue or lymphoid tissue was taken at 29 months after interruption of antiretroviral therapy (ART) and viral load sampling of his blood at 30 months. At 29 months, CD4 cell count (indicators of immune system health and stem cell transplantation success) was measured and analysed to identify the extent to which the patients immune cells have been replaced by those derived from the transplant.

The results showed no active viral infection was detected in samples of the patients blood at 30 months or in his cerebrospinal fluid, semen, intestinal tissue and lymphoid tissue 29 months after stopping ART.The patient also had a healthy CD4 cell count, suggesting he recovered well from the transplant, with his CD4 cells replaced by cells derived from the HIV-resistant transplanted stem cells. Furthermore, 99 percent of his immune cells were derived from the donors stem cells, indicating the stem-cell transplant had been successful.

The authors highlight that their case study of the London patient represents a step towards a less intensive treatment approach. They suggest that the long-term remission of HIV can be achieved using reduced intensity drug regimens, with one stem cell transplant (rather than two) and without total body irradiation.

However, being only the second reported patient to undergo this experimental treatment successfully, the authors note that that the London patient will need continued, but much less frequent, monitoring for re-emergence of the virus.

Speculating on what their results might mean for future developments of HIV cures that utilise the CCR5 gene, co-author on the study, Dr Dimitra Peppa at the University of Oxford, UK, said: Gene editing using the CCR5 has received a lot of attention recently. The London and Berlin patient are examples of using the CCR5 gene in curative therapies outside of gene editing. There are still many ethical and technical barriers eg, gene editing, efficiency and robust safety data to overcome before any approach using CCR5 gene editing can be considered as a scalable cure strategy for HIV.

The study was published in The Lancet HIV.

HIV

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Second patient cured of HIV using stem cell therapy - European Pharmaceutical Review

NEW YORK, March 10, 2020 (GLOBE NEWSWIRE) -- Mesoblast Limited(Nasdaq: MESO; ASX:MSB) today announced that it plans to evaluate its allogeneic mesenchymal stem cell (MSC) product candidate remestemcel-L in patients with acute respiratory distress syndrome (ARDS) caused by coronavirus (COVID-19) in the United States, Australia, China and Europe. The Company is in active discussions with various government and regulatory authorities, medical institutions and pharmaceutical companies to implement these activities.

Mortality in COVID-19 infected patients with the inflammatory lung condition acute respiratory distress syndrome (ARDS) is reported to approach 50%, and is associated with older age, co-morbidities such as diabetes, higher disease severity, and elevated markers of inflammation.1 Current therapeutic interventions do not appear to be improving in-hospital survival.1

Remestemcel-L has potential for use in the treatment of ARDS, which is the principal cause of death in COVID-19 infection.1 This is supported by recently published results from an investigator-initiated clinical study conducted in China which reported that allogeneic MSCs cured or significantly improved functional outcomes in all seven treated patients with severe COVID-19 pneumonia.2

Additionally, in post-hoc analyses of a 60-patient randomized controlled study in chronic obstructive pulmonary disease (COPD), remestemcel-L infusions were well tolerated, significantly reduced inflammatory biomarkers, and significantly improved pulmonary function in those patients with elevated inflammatory biomarkers. Since the same inflammatory biomarkers are also elevated in COVID-19, these data suggest that remestemcel-L could be useful in the treatment of patients with ARDS due to COVID-19.The COPD study results have been submitted for presentation at an international conference, with full results to be submitted for publication shortly.

Remestemcel-L is being studied in numerous clinical trials across several inflammatory conditions, including in elderly patients with lung disease and adults and children with steroid-refractory acute graft versus host disease (aGVHD).3-5 This product candidate is currently being reviewed by the United States Food and Drug Administration (FDA) for potential approval in the treatment of children with steroid-refractory aGVHD.

Remestemcel-L Remestemcel-L is being developed for rare pediatric and adult inflammatory conditions. It is an investigational therapy comprising culture-expanded MSCs derived from the bone marrow of an unrelated donor and is administered in a series of intravenous infusions. Remestemcel-L is believed to have immunomodulatory properties to counteract the inflammatory processes that are implicated in several diseases by down-regulating the production of pro-inflammatory cytokines, increasing production of anti-inflammatory cytokines, and enabling recruitment of naturally occurring anti-inflammatory cells to involved tissues.

Intellectual PropertyMesoblasts intellectual property (IP) portfolio encompasses over 1,000 patents or patent applications in all major markets and includes the use of MSCs obtained from any source for patients with acute respiratory distress syndrome (ARDS),and for inflammatory lung disease due to coronavirus (COVID-19), influenza and other viruses. Additionally, these patents cover Mesoblasts manufacturing processes that yield industrial-scale cellular medicines.This IP position is expected to provide Mesoblast with substantial commercial advantages as it develops its product candidates for these conditions.

References1. Liu Y et al. Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. Medrxiv 2020; https://doi.org/10.1101/2020.02.17.200241662. Leng Z, et al. Transplantation of ACE2- Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia[J]. Aging and Disease, 10.14336/AD.2020.02283. Kurtzberg J et al. Annual Meeting of the American Society for Transplantation Cell Therapy, 2020.4. Chaudhury S et al. A Phase 3 Single-Arm, Prospective Study of Remestemcel-L, Ex-Vivo Cultured Adult Human Mesenchymal Stromal Cells, for the Treatment of Steroid Refractory Acute GVHD in Pediatric Patients. Biol Blood Marrow Transplant 2018; 24:S119S290.5. Kurtzberg J et al. Allogeneic human mesenchymal stem cell therapy (remestemcel-L, Prochymal) as a rescue agent for severe refractory acute graft-versus-host disease in pediatric patients. Biol Blood Marrow Transplant. 2014 Feb;20(2):229-35.

About MesoblastMesoblast Limited (Nasdaq: MESO; ASX: MSB) is a world leader in developing allogeneic (off-the-shelf) cellular medicines. The Company has leveraged its proprietary mesenchymal lineage cell therapy technology platform to establish a broad portfolio of commercial products and late-stage product candidates. Mesoblasts proprietary manufacturing processes yield industrial-scale, cryopreserved, off-the-shelf, cellular medicines. These cell therapies, with defined pharmaceutical release criteria, are planned to be readily available to patients worldwide.

Mesoblast has filed a Biologics License Application to the United States Food and Drug Administration (FDA) to seek approval of its product candidate RYONCIL (remestemcel-L) for steroid-refractory acute graft versus host disease (acute GvHD). Remestemcel-L is also being developed for other rare diseases. Mesoblast is completing Phase 3 trials for its product candidates for advanced heart failure and chronic low back pain. If approved, RYONCIL is expected to be launched in the United States in 2020 for pediatric steroid-refractory acute GVHD. Two products have been commercialized in Japan and Europe by Mesoblasts licensees, and the Company has established commercial partnerships in Europe and China for certain Phase 3 assets.

Mesoblast has locations in Australia, the United States and Singapore and is listed on the Australian Securities Exchange (MSB) and on the Nasdaq (MESO). For more information, please see http://www.mesoblast.com, LinkedIn: Mesoblast Limited and Twitter: @Mesoblast

Forward-Looking StatementsThis announcement includes forward-looking statements that relate to future events or our future financial performance and involve known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance or achievements to differ materially from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. We make such forward-looking statements pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 and other federal securities laws. Forward-looking statements should not be read as a guarantee of future performance or results, and actual results may differ from the results anticipated in these forward-looking statements, and the differences may be material and adverse. Forward- looking statements include, but are not limited to, statements about: the initiation, timing, progress and results of Mesoblasts preclinical and clinical studies, and Mesoblasts research and development programs; Mesoblasts ability to advance product candidates into, enroll and successfully complete, clinical studies, including multi-national clinical trials; Mesoblasts ability to advance its manufacturing capabilities; the timing or likelihood of regulatory filings and approvals, manufacturing activities and product marketing activities, if any; the commercialization of Mesoblasts product candidates, if approved; regulatory or public perceptions and market acceptance surrounding the use of stem-cell based therapies; the potential for Mesoblasts product candidates, if any are approved, to be withdrawn from the market due to patient adverse events or deaths; the potential benefits of strategic collaboration agreements and Mesoblasts ability to enter into and maintain established strategic collaborations; Mesoblasts ability to establish and maintain intellectual property on its product candidates and Mesoblasts ability to successfully defend these in cases of alleged infringement; the scope of protection Mesoblast is able to establish and maintain for intellectual property rights covering its product candidates and technology; estimates of Mesoblasts expenses, future revenues, capital requirements and its needs for additional financing; Mesoblasts financial performance; developments relating to Mesoblasts competitors and industry; and the pricing and reimbursement of Mesoblasts product candidates, if approved. You should read this press release together with our risk factors, in our most recently filed reports with the SEC or on our website. Uncertainties and risks that may cause Mesoblasts actual results, performance or achievements to be materially different from those which may be expressed or implied by such statements, and accordingly, you should not place undue reliance on these forward-looking statements. We do not undertake any obligations to publicly update or revise any forward-looking statements, whether as a result of new information, future developments or otherwise.

Release authorized by the Chief Executive.

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Mesoblast To Evaluate Anti-Inflammatory Cell Therapy Remestemcel-L For Treatment Of COVID-19 Lung Disease - BioSpace

In this report, the global Cancer Stem Cell Therapy market is valued at USD XX million in 2019 and is projected to reach USD XX million by the end of 2025, growing at a CAGR of XX% during the period 2019 to 2025.

For top companies in United States, European Union and China, this report investigates and analyzes the production, value, price, market share and growth rate for the top manufacturers, key data from 2019 to 2025.

The Cancer Stem Cell Therapy market report firstly introduced the basics: definitions, classifications, applications and market overview; product specifications; manufacturing processes; cost structures, raw materials and so on. Then it analyzed the worlds main region market conditions, including the product price, profit, capacity, production, supply, demand and market growth rate and forecast etc. In the end, the Cancer Stem Cell Therapy market report introduced new project SWOT analysis, investment feasibility analysis, and investment return analysis.

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The major players profiled in this Cancer Stem Cell Therapy market report include:

The following manufacturers are covered:AVIVA BioSciencesAdnaGenAdvanced Cell DiagnosticsSilicon Biosystems

Segment by RegionsNorth AmericaEuropeChinaJapanSoutheast AsiaIndia

Segment by TypeAutologous Stem Cell TransplantsAllogeneic Stem Cell TransplantsSyngeneic Stem Cell TransplantsOther

Segment by ApplicationHospitalClinicMedical Research InstitutionOther

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The study objectives of Cancer Stem Cell Therapy Market Report are:

To analyze and research the Cancer Stem Cell Therapy market status and future forecast in United States, European Union and China, involving sales, value (revenue), growth rate (CAGR), market share, historical and forecast.

To present the Cancer Stem Cell Therapy manufacturers, presenting the sales, revenue, market share, and recent development for key players.

To split the breakdown data by regions, type, companies and applications

To analyze the global and key regions Cancer Stem Cell Therapy market potential and advantage, opportunity and challenge, restraints and risks.

To identify significant trends, drivers, influence factors in global and regions

To analyze competitive developments such as expansions, agreements, new product launches, and acquisitions in the keyword market.

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Cancer Stem Cell Therapy Market Global Size, Demand-sales, Suppliers by Key Applications 2019 Detailed Analysis and Growth Aspects on Manufacturing...

This is a full transcript of Disabled and out of money in North Korea as first broadcast on 13 March and presented by Beth Rose

JITE- I got a few stares of course. I'm bald. I had a beard. I was in a wheelchair. I'm black. The first two that I went to said, "No, no, no, we probably can't do that." I didn't want to do something which was challenging for me only, rather than North Korea. Oh, well that's a tough place to go to.

[jingle: Ouch]

BETH-I've been so excited about bringing you this Ouch podcast. A few months ago I received an email. It said, "Hi Beth, a friend of mine, Jite Ugono has multiple sclerosis, or MS, and uses a wheelchair. He's just about to travel to North Korea. Would you like to talk to him?" "Yes," was my answer, "very much so."

I'm Beth Rose, and you're listening to the BBC Ouch podcast, and for a while Jite has been on my mind. From the day he flew to China to get his visa, to the five days he would spend in the country we know very little about. And finally, he's back. Also, just a quick note to say that this podcast was recorded long before the Corona virus outbreak.

[music]

BETH-Hello.

JITE-Hello, hi.

BETH-So how was the trip?

JITE-Everyone says surreal, but it was surreal. Being inside a communist country and being restricted. Also in a wheelchair, there are no provisions at all for wheelchair access and that kind of stuff. Most of the places I went to were only accessible by stairs, so they carried me, which was nice. And that's one of the good things about having a guide, because I had two guides and a driver.

BETH-So you said you were thinking about this trip a year ago. It's the kind of trip that most people won't even think you can do, so why did you suddenly decide to book your holiday to North Korea?

JITE-Well I've got MS so they said one of the treatments of MS could be stem cell therapy. So stem cell therapy involves chemo and the rest of it. I thought to myself why not do something as rare as stem cell therapy? It was almost like a redefinition of my identity. I didn't really want to be known solely because of MS or the treatment, because everyone's going to ask about the chemo. I wanted to do something else which was kind of equal and opposite.

BETH-It's quite rare, stem cell therapy for multiple sclerosis isn't it?

JITE-It is. I hadn't heard of it. Chemo for cancer, we know all about that, but as soon as she said chemo for this For me it was quite emotional because my mum died the year before of cancer and she went through chemo as well. It was a shock, but it was also some hope. It seems less bleak. What I have is Primary Progressive MS, a steady degradation of mobilities. And they have less treatment for that, so most other treatment comes for Secondary Remitting, when you have attacks and then you can recover.

BETH-So what does the chemo do?

JITE-Chemo reduces your immune system. So what they want to do is kind of knock out the immune system and then reintroduce the stem cells and then restart the immune system.

BETH-That sounds quite an intense treatment.

JITE-I was in hospital for a month. So I went in for chemo, I was in hospital for a week or so, first of all, came back out, did the injections, back into hospital for a month. It was tough going through, but easier when you do it in stages. You think, okay I'm going to do this chemo first, in ten days I'll do the injections. Bite size. So by the end of it it's like oh, I've done it. I think it taught me whatever I go through I have to be a bit more patient.

BETH-How long ago were you diagnosed with MS?

JITE-2009.

BETH-So you were quite young?

JITE-I'm 45 now, so yeah, the symptoms got worse maybe six or seven years ago in terms of difficulty walking. And that's the main thing. The first thing was the eyesight, so the eyes were playing up and I thought maybe I should go to the optician. It didn't really make a difference. So it got progressively worse. I did an MRI scan and then the consultant said, "Well, it could be MS." So I was kind of aware and I kind of knew that it was something quite serious. So when he came back and he said MS. You make a decision about how you're going to deal with it.

For me, it was you're not going to feel sorry for yourself because people go through worse. For me, it's only when I'm faced with stuff you realise you can do it. I didn't just want to survive. Because when you're diagnosed with stuff it's like getting through the day. Everyone says, "Oh, you're so brave. You went to work?" For me it's just one life, you can't spend it getting through the day, you want to do something else.

BETH-So was it when you were having your chemo when you were in hospital, the idea for North Korea?

JITE-It was actually the first consultation when she told me, "You're going to do stem cell therapy." They told me that I was going to be able to maybe walk with sticks and I thought, why waste it?

BETH-I feel like a lot of people would have had similar thoughts but maybe thought South of France would be quite nice?

JITE-It would have been challenging. If anyone said they were going to the South of France, oh okay. I didn't want to do something which was challenging for me only, rather than North Korea, oh well, that's a tough place to go to, regardless of whether you're in a wheelchair. It was important to me to do something which was challenging, not because of MS, not because of the wheelchair, but it was challenging.

BETH-So how do you go about booking a trip? Can you go to a travel agent?

JITE-I mean, that's what I did. So the first two that I went to said, "No, no, no. We can't do that, there's no access." And I was probably more determined. That's another lesson it taught me, it's more important for me that I wanted to do it. And no one was coming back to me to say, "Why don't you go?" So when the third person came back and said, "Actually, we could do that," the normal way of going to North Korea is through a group tour, with my condition anyway. You think about what the problems could be. Getting onto the coach. Holding people up.

So my tour was me on my own. I had two guides and a driver and that was it. They sorted out the visa to China and once you get to China you get the visa to North Korea from China.

BETH-Touching upon the issues of getting onto a bus, what is it like for you with MS? How does it manifest itself?

JITE-My balance is a problem. I can't really use my left leg at all. My eyesight's a problem. Maybe sometimes my memory and my vocabulary. They're difficulties which arose mainly because I did chemo. We know that the drugs are quite aggressive and concentrated, so they give you lots of water to dilute and because you're given that you're given drugs to help you relieve that stuff, so you're peeing like every ten minutes.

So it went down to probably once every hour and that became a problem and that affects your confidence, you're afraid to kind of go out, maybe there won't be toilets around, that's kind of what I was thinking about, going to North Korea.

BETH-Did you even know about that? Is there information about toilets or accessibility?

JITE-Not at all, not at all. It's only when I got there that I realised that the And sorry to go on about toilets, but it was important to me. [laughs] Okay, so in North Korea they had two types of toilets, they had the European toilets and then they had the Korean toilets, ground toilets, so you have to kind of balance, which I didn't even attempt. So everywhere we went to it was okay, "Is it a Korean toilet here or a European toilet?" Even the guides started to realise and started to know after a while.

BETH-I mean, that's such a gamble isn't it, not knowing the accessibility, not knowing what the toilet situation's going to be like. I'm guessing this was all in your mind?

JITE-Every problem has to have a solution. So before I went I'd got it up to you can pass an hour now, because I'd gone to the gym, I'd started doing core stuff, even in the plane, because it was ten and a half hours there. You think about the problems that you could face, it's personal of course, but also there are people around that can give you a hand.

And that was another thing, getting vaccinations was a problem, because when you do chemo and your immune system is low they don't advise that you have vaccinations. So I was intending to go to Korea in September but that was super close to my stem cell.

BETH-When you were flying, initially to China, what was going through our mind?

JITE-It was just getting through that first bit, hoping that someone's going to be there to meet me. The luggage I even took I had to make sure that I could carry. That's one of the solutions with a wheelchair, you're going to have to push the luggage as well so it can't be too big. Two pieces of hand luggage is what I took. That's what I was thinking about, I wasn't thinking about Pyongyang yet, I was thinking about how to get to China.

Beijing was packed, traffic everywhere. It was surprisingly western. The cars were German cars. In North Korea I had the guides, in China I didn't have guides, I had a person to take me from the airport to the hotel and that was it. So I didn't really have the confidence to kind of venture out. I got in a day before, so as soon as I landed in China I had to go and get the visa. As soon as you get the visa is when they give you a briefing, what you should and shouldn't do. The chap apparently had been doing it for 28 years, and no one had ever missed a briefing until me.

BETH-Ah! [laughs]

JITE-I mean, only because the person who picked me up said, "Oh, I can get the visa for you."

BETH-So they were being helpful, but actually

JITE-Yeah, so they went out and got the And I was appreciative, because getting in and out of the car was such a pain. And I am quite lazy naturally. If I can do without it then I won't do it, you know. So when they gave me an opportunity not to, oh okay. The travel agent contact in China was almost panicky on the phone, "No one's ever done this."

BETH-Wow, and I bet your heart was racing at that point.

JITE-To an extent, but I kind of knew what not to do. I mean, I'm not rude, and plus I'd seen stuff on YouTube and the guides tell you as well. So I was quite prepared. I flew into Pyongyang. The airport was a surprise. They only have a few planes that land for the day. They had one from Beijing, one from Shanghai and one from Moscow. There are soldiers everywhere, but the soldiers were, "Oh, look at this guy," I suppose maybe because I was a novelty in a sense. They'd never really seen someone in a wheelchair before. They were super helpful.

I'd met the guides at the airport as well. I got a few stares of course. I'm bald, and they have like five haircuts. I had a beard, I was in a wheelchair. I'm black. So all those things together.

BETH-So did you feel like you stuck out?

JITE-I didn't feel like I could relax, only because you feel like you're always on. I couldn't be anonymous, there's always someone watching, and that's tiring.

BETH-And did you feel like you were being watched by your guides?

JITE-Maybe the brief was to watch, but it is different when you have a relationship with people. So I didn't feel that way. I suppose they were constantly on about how great the leader is and after a while it got a bit tedious. Everyone walked around with badges. And it's difficult to tell because they spoke the language quite a bit. I don't know what they're saying.

BETH-They greeted you at the airport.

JITE-Yes.

BETH-Had they had disabled travellers before?

JITE-I don't think they had. What happens is that when you go on your own there is no camaraderie, I was mostly alone, but the advantage is you could probably get closer to people. There's good and there's bad about it.

BETH-What's it like, Pyongyang?

JITE-For me it was super quiet. I mean here we have adverts and stuff, people are selling you stuff all the time, there is different, you have pictures of the leaders surrounded by flowers and you have to respect that. If there's an image of a leader you can't really take a photo of it and you can't stand in front of it obscuring it. Or you can't crop it. Apparently they check people's phones to see what they've taken.

BETH-Did you take photos?

JITE-I took photos but they didn't check. But everywhere was empty. The place is set up for tourists but there are not many tourists. You go into a restaurant and there are people standing around. The restaurants are empty. It's bizarre.

BETH-So it's not really like a bustling city?

JITE-Not at all. Actually I went during King Il Sung who's the grandad of this present leader, it was his birthday, so there were two days of celebrations. I think there were more people on the street than normal, and then they had volunteers picking up stuff or gardening or I mean, because it's a communist environment they pay for everything but you have to work. They've got big roads, no cars.

BETH-Wow.

JITE-Yeah. The days were quite long. Maybe eight o'clock they'll come for me and then eight o'clock in the evening I'd finish. So there was always something to do and you were always with people. I think they had five channels, that was about it.

BETH-TV channels?

JITE-Five TV channels. On the channels they have the leader, Kim, pointing at stuff. He designed the theme park.

BETH-What's the tourist trail like?

JITE-There is an itinerary, so you would go to the war museum, flower exhibition. I went to their subway, it's the deepest subway in the world. So everything's the best in the world or the tallest in the world.

BETH-How did the subway compare to the tube?

JITE-It was more opulent. I only saw two of them and I think those are the two they show people, so maybe the others are less. There are chandeliers and stuff.

BETH-And the restaurants, you said you went into one, but they've got all the staff just waiting around?

JITE-Yeah, the restaurants seem to be for tourists, and because I was on my own, seven, ten people just standing around looking. I went to a casino, which was strange.

BETH-Oh, okay?

JITE-Yeah. But the casino was in the hotel. I think I was the only one in there. So when I went to North Korea I didn't take enough cash, and that was a problem obviously because no cards. So the guys were like, "You need some money? Go to the casino, you can change your money."

BETH-Oh, I thought you were going to say to like gamble and win.

JITE-At first I went to change money, but they didn't take sterling, they took US dollars and euros, but I didn't have either, so they allowed me to gamble, so I did.

BETH-Did you win? Did you get some money?

JITE-Yeah, I did. I don't want to get used to it. [laughs]

BETH-What game did you play?

JITE-Black Jack. I didn't know what was going on, but people around, they were almost cheering, and I was thinking by the time I won a hundred dollars I thought it's time to go, it's time to go. And everyone's around you willing you on and you don't want to disappoint them but you think okay, I'm going guys.

BETH-Is it expensive then, if you ran out of money and you're having to gamble to boost your-?

JITE-To boost. Okay, so I mean they have their own currency and they don't let you take the currency out.

BETH-I bet your guides quite enjoyed being in the casino.

JITE-The guides said, "Oh, we're not allowed in." Even when they came up to my hotel room I had to have Al Jazeera because that's the only English speaking channel, but they were almost transfixed. They were shaking their heads. Look around the world, look how happy we are type of thing. So you kind of understand why they would let Al Jazeera in, because Al Jazeera can be quite, look what's happening around the world, the protests here, the protests there.

BETH-And did you find people were willing to help you?

JITE-I think it was more because they see you as being vulnerable. "Oh, you're not comfortable, let me move your legs." So you always get somebody helping, which is not necessarily what you want all the time. Because you want to be able to be self-sufficient. Certainly in London people are a bit more patient to offer, "Okay, how can I help?" and then they stand back. In Korea it was, "Oh, we can do that for you." [laughs]

BETH-Did you see any other disabled people out and about?

JITE-No, I didn't.

BETH-No one at all?

JITE-I didn't at all. One of the guides was quite insistent on how great their society is. That's why they stay kind of thing, away from everyone else, and they obviously saw it as a good thing.

BETH-Oh, that's interesting. I was going some research, and there's a lot of reports from the UN and different charities where they say basically they send people away in an out of town community.

JITE-Yeah, they don't expect you to try. So maybe that was part of it, they were almost surprised that this person is doing something on their own.

BETH-And were they quite surprised how you just got on with everything?

JITE-Yeah, I suppose. Maybe they were. So even when I'd be going down the road people would lean over and look. They weren't rude about it. They would look, they were curious, but they weren't intrusive. And sometimes you look and they look away, except the kids, so the kids would be staring. But that's normal though, even in London you'll get kids staring. One of the guides took a video of me being lifted up the stairs, and it was quite tough to watch because you don't really see yourself as being vulnerable, except when you see it.

It's like hearing a recording of yourself and you think oh, do I sound like that? Or do I look like that? Am I really that vulnerable kind of thing? No wonder everyone helps. [laughs] It was tough to see. I didn't really see the footage until I got to the hotel and you kind of think, you know, is that how it is? They were helpful, and it sounds ungrateful almost, but it is what you think about.

It's a lack of confidence to think people only help you because you look so vulnerable. Maybe people are just nice. And that was one of the good things about going to North Korea. People say that Londoners are quite cold and I don't find that, Londoners can be helpful, and especially if you're patient enough. And MS for me does that, it allows you to be patient.

BETH-So what kinds of things is nice to have help for?

JITE-Probably getting in and out of cars. In London not so much, in London you kind of want to get strong. I know that I'm going to have to get in a car, and not everybody gives the same level of help, so you have to be self-sufficient. In North Korea there's no need. And I'm never going to be in North Korea again.

BETH-How did the access pan out? Because that was the big mystery wasn't it really? I mean, you had no idea.

JITE-It was just people lifting me. Only one place, the museum was difficult.

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Transcript: Disabled and out of money in North Korea - BBC News

Canine Stem Cell Therapy Market size will reach xx million US$ by 2029, from xx million US$ in 2018, at a CAGR of xx% during the forecast period. In this study, 2018 has been considered as the base year and2029 as the forecast period to estimate the market size for Canine Stem Cell Therapy.

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Canine Stem Cell Therapy Market to Witness Growth Acceleration During 2029 - Monroe Scoop

The novel coronavirus disease 2019 (COVID-19) has grown to become a global public health emergency. Currently, no specific drugs or vaccines are available to cure the patients with COVID-19 infection. Hence, there is a large unmet need for a safe and effective treatment for COVID-19 infected patients, especially the severe cases. A new study offers a promising pathway for developing such a treatment.

The new approach involves intravenous transplantation of mesenchymal stem cells (MSCs) into the patients. It was successfully tested in 7 COVID-19 patients, in Beijing YouAn Hospital, Capital Medical University, China. The results are published in the scientific journal Aging and Disease, entitled "Transplantation of ACE2- Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia".

http://www.aginganddisease.org/article/0000/2152-5250/ad-0-0-216.shtml

The study was conducted by a team led by Dr. Robert Chunhua Zhao, with Shanghai University and Chinese Academy of Medical Sciences & Peking Union Medical College, China.

Moreover the study was reviewed by a scientific committee of the International Society on Aging and Disease (ISOAD) and the recently established UNESCO-affiliated committee on Anti-Aging and Disease Prevention http://www.aginganddisease.org/article/2020/2152-5250/ad-11-1-212.shtml

Based on the 14 days observation, MSCs could cure or significantly improve the functional outcomes of all the seven tested patients without observed adverse effects, contrary to 3 controls. The pulmonary function and symptoms of these seven patients were significantly improved after MSC transplantation. Among them, one severe and two common patients recovered and were discharged in 10 days after the treatment. The improvement was particularly dramatic for an elderly (65 y.o.) male patient in severe critical condition. All of his primary and secondary outcomes improved: the inflammation status, the oxygen saturation, and the functional biochemical indicators returned to normal reference values in 2~4 days after the treatment.

The presented evidence suggests that the therapeutic effects are based on the immunomodulatory capacity of mesenchymal stem cells (restoring the balance of the immune system). The coronavirus infection can stimulate a terrible cytokine storm in the lung, disrupting the balance of cytokines (signaling molecules of the immune system) such as IL-2, IL-6, IL-7, GSCF, IP10, MCP1, MIP1A and TNF cytokines, followed by the edema, dysfunction of the air exchange, acute respiratory distress syndrome, acute cardiac injury and the secondary infection, which may lead to death. The bone-marrow derived MSCs could inhibit the over-activation of the immune system and promote endogenous repair by improving the microenvironment, thus they could represent a safe and effective treatment for patients with COVID-19 pneumonia, especially for the patients in critically severe conditions. A larger validation study is required and is already underway, yet the initial results are encouraging.

Notably, the coronavirus-infected pneumonia is more likely to affect older individuals, especially older males, with comorbidities, resulting in their severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In other words, aging appears to be the main risk factor for bad outcomes. However, the cure essentially depends on the patient's own immune system. When the overactivated immune system kills the virus, it produces a large number of inflammatory factors, leading to the severe cytokine storms. This suggests that the main reason for the organs damage may be the virus-induced cytokine storm. Older subjects may be much easier to be affected due to immunosenescence. The study showed remarkable recovery of the elderly patients thanks to restoring their immune function.

Thus, the study may have a broader significance, even beyond the treatment of the severe coronavirus disease. This study exemplifies that the general therapeutic improvement of the immune system in the elderly can improve outcome and survival, which may have more general relevance for other aging-related communicable diseases. Thus, this study may inspire and pave the way for further promising directions to investigate the connection between aging and disease, and to treat both communicable and non-communicable aging-related diseases.

The Romanian journalist Laura tefnu spoke with Dr. Ilia Stambler about the broader implications of this research. Ilia Stambler is a co-author in this study who was involved in the study review, interpretation and discussion. He serves as the Outreach Coordinator of the International Society on Aging and Disease (ISOAD) and Director of Research and Development at Shmuel Harofe Geriatric Medical Center in Israel.

Q: How does it feel to be part of the team which discovered a groundbreaking treatment for what is currently considered one of the biggest global challenges?

A: I feel very honored to be included in this extended international team. I hope this team continues its work that will also involve additional collaborations.

Q: As a researcher, what did you find most interesting about this novel coronavirus? What seems most threatening about this new virus?

A: The spreading ability of this virus is relatively high and it has the capacity to affect the entire global population. This is what makes this virus a particularly strong concern for global public health. The social effects of this epidemic are also of great importance. In a sense, this virus is testing the strength of our public health systems. Will the immunity of our public healthcare be strong enough to contain it? I hope it is.

Q: Did the discovery of this groundbreaking new therapeutic approach make you more optimistic (when it comes to containing and limiting the damage of Covid-19)? In which sense (where was your optimism before the discovery)?

A: I was optimistic before, as I believe that, same as for many infectious diseases in the past, also for this disease, effective therapeutic and preventive measures will be found and used. This work further increased my optimism. Of course, this is an initial study, and this is only one of the potential means in the therapeutic, preventive and hygienic arsenal. More research and confirmation will be needed. Yet, even at this stage, the clear positive result of this study shows that it is indeed possible to improve the outcomes for COVID-19 patients even in severe conditions. Moreover, it gives more hope that effective treatments can be sought and found also for other aging-related infectious diseases and conditions.

Q: Is there an explanation regarding the reasons why Covid-19 seems to pardon children and affects the most elder individuals, especially men?

A: There is yet no clear or fully agreed explanation. But a plausible cause may be due to the so called immuno-senescence phenomenon, or the inability of the aging immune system to cope with new threats and restore the immune balance following the infection. In men the immuno-senescence effects are often more strongly present than in women. Thus, aging appears to be the main risk factor for this disease and if we really wish to defeat this epidemic, we need to address this main risk factor, in other words, we need to therapeutically intervene and ameliorate the degenerative aging process. The proposed mesenchymal stem cell therapy shows the so-called immuno-modulation effects or the ability to generally improve the immune system, help restore the immune balance after disturbances, especially for the elderly. And this can be the more general explanation for its effects against the aging-related COVID-19 pneumonia, as well as potentially other aging-related diseases.

Q: How did you manage to find so fast a treatment that is responding so well?

A: The mesenchymal stem cell treatment has been researched and developed by Dr. Zhao and his team for many years, and indicated positive effects for multiple health conditions. It is exactly because of the common and critical role of the immune system impairment in all these conditions, that the treatment developed by Dr. Zhaos team was already in place and could be immediately used also for this condition dependent on the immune function. Moreover, the success of this therapy against COVID-19 can further boost the research and therapy of other immunity-dependent health conditions and diseases, especially aging-related diseases, due to the common mechanisms of action.

Q: How may this discovery change the game?

A: Unlike other public health measures, like quarantine and hygiene, that can be very quickly applied, the research, development, regulatory approval and application of new therapies is a much slower process. So we should first of all apply the public health measures to contain the epidemic. But the hope is that this therapy will undergo further research and validation as soon as possible, and in case of validated efficacy and safety, will be used in as many patients who need it as possible, as soon as possible. That is exactly why we need to accelerate the research, development and application of promising new therapies. When the new therapy enters wide clinical practice, there are grounds to believe it can improve the health and even save the lives of many patients, not only suffering from COVID-19, but also other conditions.

Q: Which was the response/reaction of authorities after you published the results of your research?

A: The outreach to the authorities in several countries has only started. Moreover, the study is only initial and it is too early to make policy recommendations. A larger validation study is required. Yet, if there is even a slight possibility this could become a life-saving therapy for COVID-19 patients and others, this opportunity should not be missed by the decision makers.

Q: Some treatments are more expensive than others. Will the treatment you discovered be accessible to people, or the cost for producing it will limit its accessibility?

A: The cells for this treatment can be mass produced and can be rather affordable. Of course, the actual price will depend both on the scale of production and pricing policies. And this is already a question that goes beyond pure technology, but becomes a question about the social means to make new therapies available to all. This should also be a crucial part of the public discussion about the social need to promote the rapid research and development as well as broad application of new therapies that are proven to be safe and effective.

Q: Which are the best measures a country can take to limit the spread and the consequences of the novel coronavirus?

The usual quarantine and public hygiene measures are the most feasible and effective: minimization of large gatherings, minimization of travel, cleanliness. We should hope and work for new effective therapies to arrive as soon as possible. But so far public health measures are the most effective and feasible.

Ilia Stambler is an IEET Affiliate Scholar. He completed his PhD degree at the Department of Science, Technology and Society, Bar-Ilan University. His thesis subject, and his main interest, is the History of Life-extensionism in the 20th Century.

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A new therapeutic approach against COVID-19 Pneumonia - Institute for Ethics and Emerging Technologies

Londoner Jite Ugono never expected to find himself playing blackjack in a North Korean casino having run out of cash, but a few life-changing moments had led him there.

In his 30s he was diagnosed with multiple sclerosis (MS), then 10 years later in 2019 he was offered rare stem cell therapy, involving chemotherapy, on the NHS to help stall the progress of the condition.

It was hopeful, but he didnt want this complex treatment to become the main topic of conversation for friends and family so he decided to "do something equally rare, but opposite" and booked his trip to North Korea.

But would the country be ready to accept a traveller in a wheelchair and would his guides even turn up?

Presented by Beth Rose. A full transcript is available here.

Subscribe to Ouch Disability Talk podcast on BBC Sounds or say "Ask the BBC for Ouch" to your smart speaker.

Excerpt from:
Disabled and out of money in North Korea - BBC News

The global stem cell and regenerative medicines market should grow from $21.8 billion in 2019 to reach $55.0 billion by 2024 at a compound annual growth rate (CAGR) of 20.4% for the period of 2019-2024.

Report Scope:

The scope of this report is broad and covers various type of product available in the stem cell and regenerative medicines market and potential application sectors across various industries. The current report offers a detailed analysis of the stem cell and regenerative medicines market.

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The report highlights the current and future market potential of stem cell and regenerative medicines and provides a detailed analysis of the competitive environment, recent development, merger and acquisition, drivers, restraints, and technology background in the market. The report also covers market projections through 2024.

The report details market shares of stem cell and regenerative medicines based on products, application, and geography. Based on product the market is segmented into therapeutic products, cell banking, tools and reagents. The therapeutics products segments include cell therapy, tissue engineering and gene therapy. By application, the market is segmented into oncology, cardiovascular disorders, dermatology, orthopedic applications, central nervous system disorders, diabetes, others

The market is segmented by geography into the following regions: North America, Europe, Asia-Pacific, South America, and the Middle East and Africa. The report presents detailed analyses of major countries such as the U.S., Canada, Mexico, Germany, the U.K. France, Japan, China and India. For market estimates, data is provided for 2018 as the base year, with forecasts for 2019 through 2024. Estimated values are based on product manufacturers total revenues. Projected and forecasted revenue values are in constant U.S. dollars, unadjusted for inflation.

Report Includes:

28 data tables An overview of global markets for stem cell and regenerative medicines Analyses of global market trends, with data from 2018, estimates for 2019, and projections of compound annual growth rates (CAGRs) through 2024 Details of historic background and description of embryonic and adult stem cells Information on stem cell banking and stem cell research A look at the growing research & development activities in regenerative medicine Coverage of ethical issues in stem cell research & regulatory constraints on biopharmaceuticals Comprehensive company profiles of key players in the market, including Aldagen Inc., Caladrius Biosciences Inc., Daiichi Sankyo Co. Ltd., Gamida Cell Ltd. and Novartis AG

Summary

The global market for stem cell and regenerative medicines was valued at REDACTED billion in 2018. The market is expected to grow at a compound annual growth rate (CAGR) of REDACTED to reach approximately REDACTED billion by 2024. Growth of the global market is attributed to the factors such as growingprevalence of cancer, technological advancement in product, growing adoption of novel therapeuticssuch as cell therapy, gene therapy in treatment of chronic diseases and increasing investment fromprivate players in cell-based therapies.

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In the global market, North America held the highest market share in 2018. The Asia-Pacific region is anticipated to grow at the highest CAGR during the forecast period. The growing government funding for regenerative medicines in research institutes along with the growing number of clinical trials based on cell-based therapy and investment in R&D activities is expected to supplement the growth of the stem cell and regenerative market in Asia-Pacific region during the forecast period.

Reasons for Doing This Study

Global stem cell and regenerative medicines market comprises of various products for novel therapeutics that are adopted across various applications. New advancement and product launches have influenced the stem cell and regenerative medicines market and it is expected to grow in the near future. The biopharmaceutical companies are investing significantly in cell-based therapeutics. The government organizations are funding research and development activities related to stem cell research. These factors are impacting the stem cell and regenerative medicines market positively and augmenting the demand of stem cell and regenerative therapy among different application segments. The market is impacted through adoption of stem cell therapy. The key players in the market are investing in development of innovative products. The stem cell therapy market is likely to grow during the forecast period owing to growing investment from private companies, increasing in regulatory approval of stem cell-based therapeutics for treatment of chronic diseases and growth in commercial applications of regenerative medicine.

Products based on stem cells do not yet form an established market, but unlike some other potential applications of bioscience, stem cell technology has already produced many significant products in important therapeutic areas. The potential scope of the stem cell market is now becoming clear, and it is appropriate to review the technology, see its current practical applications, evaluate the participating companies and look to its future.

The report provides the reader with a background on stem cell and regenerative therapy, analyzes the current factors influencing the market, provides decision-makers the tools that inform decisions about expansion and penetration in this market.

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Stem Cell And Regenerative Therapy Market 2019-2024 Chain Analysis, Upstream Raw Materials Sourcing and Downstream Buyers - Feed Road

In a talk at UAB on March 6, the NIH director shared his thoughts on exceptional opportunities for science and young scientists and highlighted several exciting UAB projects.

NIH Director Francis Collins, M.D., Ph.D., visited UAB on March 6. In addition to his public talk, Collins had breakfast with UAB medical students and met with groups of young researchers and other investigators across campus.Speaking to a packed University of Alabama at Birmingham audience March 6, Francis Collins, M.D., Ph.D., director of the National Institutes of Health, shared his picks of 10 areas of particular excitement and promise in biomedical research.

In nearly every area, UAB scientists are helping to lead the way as Collins himself noted in several cases. At the conclusion of his talk, Collins addedhis advice for young scientists. Here is Collins top 10 list, annotated with some of the UAB work ongoing in each area and ways that faculty, staff and students can get involved.

I am so jazzed with what has become possible with the ability to study single cells and see what they are doing, Collins said. They have been out of our reach now we have reached in. Whether you are studying rheumatoid arthritis, diabetes or the brain, you have the chance to ask each cell what it is doing.

Single-cell sequencing and UAB:Collins noted that Robert Carter, M.D., the acting director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, was a longtime faculty member at UAB (serving as director of the Division of Clinical Immunology and Rheumatology). For the past several years, UAB researchers have been studying gene expression in subpopulations of immune cells inpatients with rheumatoid arthritis.

Join in:Researchers can take advantage of the single-cell sequencing core facility in UABsComprehensive Flow Cytometry Core, directed by John Mountz, M.D., Ph.D., Goodwin-Blackburn Research Chair in Immunology and professor in the Department of Medicine Division of Clinical Immunology and Rheumatology.

Learn more:Mountz and other heavy users of single-cell sequencing explain how the techniqueslet them travel back in time and morein this UAB Reporter story.

The NIHsBRAIN Initiativeis making this the era where we are going to figure out how the brain works all 86 billion neurons between your ears, Collins said. The linchpin of this advance will be the development of tools to identify new brain cell types and circuits that will improve diagnosis, treatment and prevention of autism, schizophrenia, Parkinsons and other neurological conditions, he said.

Brain tech and UAB:Collins highlighted thework of BRAIN Initiative granteeHarrison Walker, M.D., an associate professor in the Department of Neurology, whose lab has been developing a more sophisticated way to understand the benefits of deep brain stimulation for people with Parkinsons and maybe other conditions, Collins said.

Join in:UABs planned new doctoral program in neuroengineering would be the first of its kind in the country.

Learn more:Find out why neuroengineering is asmart career choicein this UAB Reporter story.

Researchers can now take a blood cell or skin cell and, by adding four magic genes, Collins explained, induce the cells to become stem cells. These induced pluripotent stem (iPS) cells can then in turn be differentiated into any number of different cell types, including nerve cells, heart muscle cells or pancreatic beta cells. The NIH has invested in technology to put iPS-derived cells on specialized tissue chips. Youve got you on a chip, Collins explained. Some of us dream of a day where this might be the best way to figure out whether a drug intervention is going to work for you or youre going to be one of those people that has a bad consequence.

iPS cells at UAB:Collins displayed images of thecutting-edge cardiac tissue chipdeveloped by a UAB team led by Palaniappan Sethu, Ph.D., an associate professor in the Department of Biomedical Engineering and the Division of Cardiovascular Disease. The work allows the development of cardiomyocytes that can be used to study heart failure and other conditions, Collins said.

Join in:UABs biomedical engineering department, one of the leading recipients of NIH funding nationally, is a joint department of the School of Engineering and School of Medicine. Learn more about UABsundergraduate and graduate programs in biomedical engineering, and potential careers, here.

Learn more:See howthis novel bioprinterdeveloped by UAB biomedical researchers is speeding up tissue engineering in this story from UAB News.

We have kind of ignored the fact that we have all these microbes living on us and in us until fairly recently, Collins said. But now it is clear that we are not an organism we are a superorganism formed with the trillions of microbes present in and on our bodies, he said. This microbiome plays a significant role not just in skin and intestinal diseases but much more broadly.

Microbiome at UAB:Collins explained that work led by Casey Morrow, Ph.D., and Casey Weaver, M.D., co-directors of theMicrobiome/Gnotobiotics Shared Facility, has revealed intriguing information abouthow antibiotics affect the gut microbiome. Their approach has potential implications for understanding, preserving and improving health, Collins said.

Join in:Several ongoing clinical trials at UAB are studying the microbiome, including a studymodifying diet to improve gut microbiotaand an investigation of the microbiomes ofpostmenopausal women looking for outcomes and response to estrogen therapy.

Learn more:This UAB News storyexplains the UAB researchthat Collins highlighted.

Another deadly influenza outbreak is likely in the future, Collins said. What we need is not an influenza vaccine that you have to redesign every year, but something that would actually block influenza viruses, he said. Is that even possible? It just might be.

Influenza research at UAB:Were probably at least a decade away from a universal influenza vaccine. But work ongoing at UAB in the NIH-fundedAntiviral Drug Discovery and Development Center(AD3C), led by Distinguished Professor Richard Whitley, M.D., is focused on such an influenza breakthrough.

Join in:For now, the most important thing you can do to stop the flu is to get a flu vaccination. Employees can schedule afree flu vaccination here.

Learn more:Why get the flu shot? What is it like? How can you disinfect your home after the flu? Get all the information atthis comprehensive sitefrom UAB News.

The NIH has a role to play in tackling the crisis of opioid addiction and deaths, Collins said. The NIHs Helping to End Addiction Long-term (HEAL) initiative is an all-hands-on-deck effort, he said, involving almost every NIH institute and center, with the goal of uncovering new targets for preventing addiction and improving pain treatment by developing non-addictive pain medicines.

Addiction prevention at UAB:A big part of this initiative involves education to help professionals and the public understand what to do, Collins said. The NIH Centers of Excellence in Pain Education (CoEPE), including one at UAB, are hubs for the development, evaluation and distribution of pain-management curriculum resources to enhance pain education for health care professionals.

Join in:Find out how to tell if you or a loved one has a substance or alcohol use problem, connect with classes and resources or schedule an individualized assessment and treatment through theUAB Medicine Addiction Recovery Program.

Learn more:Discover some of the many ways that UAB faculty and staff aremaking an impact on the opioid crisisin this story from UAB News.

We are all pretty darn jazzed about whats happened in the past few years in terms of developing a new modality for treating cancer we had surgery, we had radiation, we had chemotherapy, but now weve got immunotherapy, Collins said.

Educating immune system cells to go after cancer in therapies such as CAR-T cell therapy is the hottest science in cancer, he said. I would argue this is a really exciting moment where the oncologists and the immunologists together are doing amazing things.

Immunotherapy at UAB:I had to say something about immunology since Im at UAB given that Max Cooper, whojust got the Lasker Awardfor [his] B and T cell discoveries, was here, Collins said. This is a place I would hope where lots of interesting ideas are going to continue to emerge.

Join in:The ONeal Comprehensive Cancer Center at UAB is participating in a number of clinical trials of immunotherapies.Search the latest trials at the Cancer Centerhere.

Learn more:Luciano Costa, M.D., Ph.D., medical director of clinical trials at the ONeal Cancer Center, discusses the promise ofCAR-T cell therapy in this UAB MedCast podcast.

Assistant Professor Ben Larimer, Ph.D., is pursuing a new kind of PET imaging test that could give clinicians afast, accurate picture of whether immunotherapy is workingfor a patient in this UAB Reporter article.

The All of Us Research Program from NIH aims to enroll a million Americans to move away from the one-size-fits-all approach to medicine and really understand individual differences, Collins said. The program, which launched in 2018 and is already one-third of the way to its enrollment goal, has a prevention rather than a disease treatment approach; it is collecting information on environmental exposures, health practices, diet, exercise and more, in addition to genetics, from those participants.

All of Us at UAB:UAB has been doing a fantastic job of enrolling participants, Collins noted. In fact, the Southern Network of the All of Us Research Program, led by UAB, has consistently been at the top in terms of nationwide enrollment, as School of Medicine Dean Selwyn Vickers, M.D., noted in introducing Collins.

Join in:Sign up forAll of Usat UAB today.

Learn more:UABs success in enrolling participants has led to anew pilot study aimed at increasing participant retention rates.

Rare Disease Day, on Feb. 29, brought together hundreds of rare disease research advocates at the NIH, Collins said. NIH needs to play a special role because many diseases are so rare that pharmaceutical companies will not focus on them, he said. We need to find answers that are scalable, so you dont have to come up with a strategy for all 6,500 rare diseases.

Rare diseases at UAB: The Undiagnosed Diseases Network, which includes aUAB siteled by Chief Genomics Officer Bruce Korf, M.D., Ph.D., is a national network that brings together experts in a wide range of conditions to help patients, Collins said.

Participants in theAlabama Genomic Health Initiative, also led by Korf, donate a small blood sample that is tested for the presence of specific genetic variants. Individuals with indications of genetic disease receive whole-genome sequencing. Collins noted that lessons from the AGHI helped guide development of the All of Us Research Program.

Collins also credited UABs Tim Townes, Ph.D., professor emeritus in the Department of Biochemistry and Molecular Genetics, for developing the most significantly accurate model of sickle cell disease in a mouse which has been a great service to the [research] community. UAB is now participating in anexciting clinical trial of a gene-editing technique to treat sickle cellalong with other new targeted therapies for the devastating blood disease.

Join in:In addition to UABs Undiagnosed Diseases Program (which requires a physician referral) and the AGHI, patients and providers can contact theUAB Precision Medicine Institute, led by Director Matt Might, Ph.D. The institute develops precisely targeted treatments based on a patients unique genetic makeup.

Learn more:Discover how UAB experts solved medical puzzles for patients by uncovering anever-before-described mutationandcracking a vomiting mysteryin these UAB News stories.

We know that science, like everything else, is more productive when teams are diverse than if they are all looking the same, Collins said. My number one priority as NIH director is to be sure we are doing everything we can to nurture and encourage the best and brightest to join this effort.

Research diversity at UAB:TheNeuroscience Roadmap Scholars Programat UAB, supported by an NIH R25 grant, is designed to enhance engagement and retention of under-represented graduate trainees in the neuroscience workforce. This is one of several UAB initiatives to increased under-represented groups and celebrate diversity. These include several programs from theMinority Health and Health Disparities Research Centerthat support minority students from the undergraduate level to postdocs; thePartnership Research Summer Training Program, which provides undergraduates and especially minority students with the opportunity to work in UAB cancer research labs; theDeans Excellence Award in Diversityin the School of Medicine; and the newly announcedUnderrepresented in Medicine Senior Scholarship Programfor fourth-year medical students.

Join in:The Roadmap program engages career coaches and peer-to-peer mentors to support scholars. To volunteer your expertise, contact Madison Bamman atmdbamman@uab.eduorvisit the program site.

Learn more:Farah Lubin, Ph.D., associate professor in the Department of Neurobiology and co-director of the Roadmap Scholars Program,shares the words and deeds that can save science careersin this Reporter story. In another story, Upender Manne, Ph.D., professor in the Department of Pathology and a senior scientist in the ONeal Comprehensive Cancer Center, explains how students in the Partnership Research Summer Training Program gethooked on cancer research.

In answer to a students question, Collins also shared his advice to young scientists. One suggestion: Every investigator needs to be pretty comfortable with some of the computational approaches to science, Collins said. Big data is here artificial intelligence, machine-learning. We can all get into that space. But its going to take some training, and it will be really helpful to have those skills.

Join in:UAB launched aMaster of Science in Data Scienceprogram in fall 2018.

Learn more:Discover how UAB researchers areusing machine-learning in their labsand toimprove cancer treatment. Those looking for a free introduction cantake advantage of the Data Science Clubfrom UAB IT Research Computing.

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Looking to the future with Dr. Francis Collins - UAB News

In a laboratory in the depths of Imperial College London, all eyes are on a group of mice scurrying about their daily business. The rodents were injected a few weeks ago with a prototype vaccine which it is hoped will achieve what the world has so far singularly failed to do so far - stop the coronavirus Covid-19.

Progress, says Professor Robin Shattock of Imperials department of infectious disease, looks good. His team first started developingthe vaccine in mid-January and are working at record pace, taking just 14 days to get from the genetic sequencing of the virus to generating the trial vaccine in the laboratory. It relies upon a cutting-edge technique which injects new genetic code into the muscle, instructing it to make a protein found on the surface of coronavirus triggering a protective immune response. Should the mice trial prove a success then Prof Shattock hopes to be experimenting on humans in the summer and have a vaccine ready next year perhaps even the first in the world.

The laboratories at Imperial are part of the global fightback against Covid-19. At Oxford Universitys Jenner Institute, researchers are producing a vaccine seed stock, 1,000 doses of which will be manufactured in Italy for use in clinical trials. At present around 35 pharmaceutical companies are similarly working to develop a Covid-19 vaccine.

It is competitive in that people always like to be first but its a friendly competition, Prof Shattock explains. More a race against the virus than each other.

The problem is the virus is winning, coursing across the globe with a speed and severity that has shocked seasoned virologists. At a press conference on Friday afternoon, Dr Michael Ryan, head of the World Health Organisation emergencies programme, warned of a "major funding gap" for potential vaccines. Even if one does appear early next year, that would be scant defence against the months of unprecedented global devastation we are warned could lie ahead.the WHO's Dr Mike Ryan said that there is a major funding gap for potential vaccines against the virus.Even if a vaccine appears early next year, that would be scant defence against the months of unprecedented global devastation we are warned could lie ahead.

Another concern is Covid-19 has already evolved into two major lineages - dubbed L and S types. The older S-type appears to be milder and less infectious, while the L-type which emerged later, spreads quickly and currently accounts for around 70 per cent of cases. Health experts fear the virus could hit Britain in multiple waves meaning new vaccines might not work against mutated strains.

Accordingly this is a war now being waged on multiple fronts. Alongside vaccine development, researchers are focusing on antivirals to treat patients (of which currently there are none) either by hoping to create new antivirals in record time or dust off old drugs developed for previous outbreaks. At the same time scientists are working to develop better rapid diagnostics in order to more efficiently test large-scale populations for the virus something that has been hailed in South Korea for preventing its further spread.

In China alone, about 300 clinical trials are attempting to treat patients with standard antiviral therapies, while in the west attempts are being made to repurpose old treatments for Ebola, malaria and HIV to see if they can impact against Covid-19.

Many see a drug called remdesivir, originally developed to treat Ebola and production of which is currently being ramped up by the US pharmaceutical firm Gilead, as a frontrunner and one of the very few antivirals that has a reasonable prospect of helping patients in the near-term.

Should these old drugs fail then the scientific community will be required to think more creatively and it is here where a 39-year-old US tech genius called Jacob Glanville steps in. Born in Guatemala to US hippy ex-pat parents, Glanville is already something of an outlier in a field that is dominated by the pharmaceutical giants. But he is currently being backed by the US government to embark on super-accelerated engineering of antibodies produced during the SARS outbreak of 2002 to see if they might apply to the latest member of the same family of coronavirus.

It is a process that Glanville, chief executive of Distributed Bio, describes as taking five billion pieces of spaghetti and throwing them all against a wall to see what sticks.

Glanville appears in a recent Netflix series, Pandemic, which focused on a separate branch of his pioneering work to develop universal influenza vaccines. He is described as the David to the influenzas Goliath andwith Covid-19 he faces a similarly outsized challenge. Should his attempt to discover an antibody which reacts against Covid-19 prove a success then he says it is conceivable that a drug could be ready by September.

Even that would be too late for many. By next month, he is predicting 40,000 cases of Covid-19 in his home state of California overwhelming intensive care wards.

There is an enemy here and that is the virus, he says. We all want to protect our families.

Scientists across the world are indebted to their Chinese counterparts who on January 10 openly published the genetic sequencing of Covid-19. Organisations such as Cepi, set up in response to the lack of scientific progress during the Ebola crisis, are funding the rapid research of vaccines while governments are also pouring money into development.

At the University of Toronto, Sachdev Sidhu, a professor of molecular genetics, is leading a team part-funded by the Canadian federal government to develop successful antivirals. His work involves a pioneering technique he has developed to test millions of molecules stored in a library to assess whether one contains the crucial protease inhibitor for Covid-19 (which would help neutralise the virus).

He describes the rapid global progress that has been made so far as a triumph of science with the work that took a decade to understand the HIV virus being done in a month.

While he works on exploiting its Achilles heel, he says it is best to block out the human impact of Covid-19. You cant get emotional. That doesnt help. Our job is to figure out what it is, how it works, and shut it down.

Dunfermline-born researcher Kate Broderick is senior vice president of research and development at the US firm Inovio and admits she has averaged about two hours sleep each night since the virus first emerged.

As a scientist and also a mum Im extremely worried, says the 42-year-old. In my wildest nightmares I couldnt have predicted two months ago, one month ago, or even a week ago, that we would be in the situation were in today.

The day the Chinese authorities released the full genetic sequence of Covid-19, her company (which had previously worked on vaccines for the likes of Ebola, Sika, MERS and Lassa fever) designed a vaccine in just three hours and immediately started manufacturing small batches to test in the laboratory.

Inovio plans to begin testing the vaccine on humans in the US next month with parallel trials running in China and South Korea and will then move into phase two (of three) clinical trials experimenting on a wider group of people. She declines to put a timeline on when a vaccine might be ready but admits it will require at the very least tens of millions dollars in funding. Her team has been given a $9 million grant from the Coalition for Epidemic Preparedness Innovations, an initiative backed by Bill Gates, but far more investment is needed to make any vaccine widely available.

The crippling costs involved are where previous vaccines have faltered but with Covid-19 already proving to be like no virus the world has ever seen, precedent currently is being left by the wayside.

This virus is absolutely remarkable to me, she says, commenting on the speed and scale of the contagion. And I do think people should be taking this extremely seriously.

Back on the streets of London, thousands of volunteers are currently being assessed for their suitability for clinical trials of vaccine or antivirals for Covid-19. Hvivo (a subsidiary of the company Open Orphan) which has developed a rapid testing model has in recent days received 10,000 applications of those wishing to be injected with a close relative of Covid-19 to help discover an effective treatment.

Andrew Catchpole, a virologist and chief scientist at the firm, admits the offer of 3500 per person to spend two weeks in quarantine will be the prime motivation for some. But he detects in the surge in interest a wider appetite to pull together and be a force for societal good.

This is areal human emergency, he says. And a lot of people genuinely want to do their bit.

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The vaccine hunters racing to save the world from the coronavirus pandemic - Telegraph.co.uk

The first case of COVID-19 appeared in Italy on January 30th. A couple of Chinese tourists coming from Wuhan via Beijing were admitted to Spallanzani Hospital in Rome, highly specialised in infectious diseases.

The same day, the Minister of Health Roberto Speranza announced an air traffic embargo for flights coming to Italy from any Chinese city, including the autonomous regions of Hong Kong and Macau, in an attempt to block the spread of the infection.

In the days following the hospitalisation of the Chinese couple in Rome, a few new cases were detected in a group of Italians who were repatriated from the Wuhan region. Experts started to sigh in relief as all cases came from abroad and no local contagion seemed to show up.

Then, quite abruptly, on February 20th at midnight, the Councillor for Welfare in Lombardy, Giulio Gallera, announced that Mattia, a 38-year-old Italian from the small city of Codogno, in Lombardy, was hospitalised for a severe case of atypical pneumonia and tested positive for coronavirus. He had not travelled to China nor had any contact with people coming from Asia. He was tested only because a young anaesthesiologist, faced with the worsening condition of the patient, broke protocol and asked for permission to test a patient with no apparent risk factors. Codogno was the focus of a local outbreak of the disease: new cases were identified in the following days and the whole area was put under strict quarantine for 2 weeks. But it was too late.

As of March 12th, Italy has 15,113 official cases, 1016 deaths and 1258 recovered patients. The whole country is on lockdown. Cities like Milan and Bergamo, in Lombardy, are facing an exponential growth of hospitalised people with COVID-19. Schools, universities, and most shops are closed (all except the ones selling basic goods like food, drugs, electronics, and warehouses) and the National Health System is trying to cope with the flood of patients needing ventilation support. Roberto Cosentini, head of the Emergency Department at Pope John XXIII Hospital in Bergamo, one of the most affected cities, has been living in the hospital for the last 3 weeks: "It's like a wave," he says. "We have now around 60-80 new COVID-19 patients per day coming to the emergency. Most of them are in severe conditions and they arrive all together between 4 and 6 pm. We learnt that the respiratory distress worsens at the end of the afternoon and we now know that we will have to deal with most of the severe cases showing up one after another in a short time, every day." But Italy learnt from the Chinese experience: Italian experts looked at Wuhan's management of the crisis and Foreign Minister Luigi Di Maio asked his Chinese counterpart Wang Yi for assistance with supplies. Other countries in Europe are looking at Italy in order to prepare for SARS-CoV-2,the virus which causes COVID-19.

"There is a huge debate about the way we test for the SARS-CoV-2 virus," explains Giovanni Maga, director of the Institute of Molecular Genetics of the Italian National Research Council in Pavia, in Lombardy. "Many countries test only people with symptoms. At the beginning of the crisis, we decided to test everyone who was in contact with a person infected with the virus and this is what WHO also recommends. But in the long run it became impossible and now we test only symptomatic people with severe impairment."

However, this makes the analysis of the epidemic trends quite challenging. "If you test everybody, you will find more positive cases, with mild symptoms," says Maga. The strategy for testing might heavily influence the visible part of the epidemic: "According to many epidemiologists, other countries could be in the same situation as Italy was a few weeks ago," continues Maga. "But since they do not check asymptomatic people, they just don't know it." The choice of testing strategies is a crucial one for preparedness. "There are pros and cons for any choice, but what is important is to try to be as consistent as possible on the criteria since the beginning of the outbreak," he says.

The COVID-19 outbreak is a stress test for health services. Italy's Health Service, which provides universal coverage for the whole population, is national, but the organisation is distributed to regional health authorities.

When the crisis became evident, the Government regained control of crucial decisions, such as the coordination of intensive care unit availability. Antonio Pesenti, the coordinator of the ICU network in Lombardy and head of the Crisis Unit explains how Italy is trying to cope with the situation. "Since the first days of the outbreak we established a protocol to transfer patients needing ICU for non-COVID-19 diseases to the regions in Central and Southern Italy using the Civil Protection CROSS system. We prefer not to transfer COVID-19 patients because they require special isolation." Italy has around 6000 beds for intensive care, which the government plans to increase to 9000 in the coming weeks, partly by repurposing and refitting operating rooms used for elective surgeries. According to Pesenti, the projected demand of ICU beds is up to 10 times the current availability: "The number of hospitalised patients expected by March 26th, in 2 weeks, is 18,000 just in Lombardy. Between 2700 and 3200 will require intensive care."

To face such a tsunami, Italy is learning from China. Intermediate care units will be opened both in the hospitals and in other areas, such as exhibition pavilions in the Bergamo and Milan Fair. They will be equipped with ventilators coming from China and with special helmets to facilitate non-invasive ventilation support that seems to be very useful for patients who can manage without invasive ventilation. "We need such tools because 33%of the people in intensive care are between 50 and 64 years old: they are fit people who do not have pre-existing conditions. If we put them in invasive ventilation, they occupy an intensive care unit for 2-3 weeks," says Pesenti. "Any alternative is useful to relieve ICUs."

Doctors also had to deal with ethical issues. The Italian College of Anaesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) published guidelines for triage when there's a shortage of ventilatorsto help with decision making in a critical situation. The authors chose "the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources" to draw their recommendations. "Informed by the principle of maximising benefits for the largest number, the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care," the document says.

Epidemiological curves are the new weather forecast for citizens in quarantine. And policy makers rely on them to decide new policies for containment. "The available predictive models are based on data we got from China," explains Paolo Vineis, an Italian epidemiologist based at Imperial College in London, who is consulting for the scientific committee supporting the Italian Government in the decision-making process. "They mainly use the SIR model, that consists of three compartments: S for the number of susceptible, I for the number of infectious, and R for the number recovered (or immune) individuals. Any of those components can change during the epidemic, because of the local development. That's why data collection is extremely important for modelling." Italy had to face a challenge due to the regional nature of its health system: different regions used to collect data in different ways, using different templates. Regions like Lombardy, that were overwhelmed by the epidemic, had trouble feeding the databases with all the details, like comorbidities. "Epidemiological analysis needs to be centralised and properly supported to help the decision makers" says Vineis.

At first glance, the death rate from COVID-19 in Italy appears to be much higher than it was in China, but according to experts, this is likely to be due to a combination of several factors, ranging from the testing strategy to the advanced age and comorbidities of most patients. "The average age of deceased patients is over 80 years, but when one looks at the age-stratified data the lethality is very similar to China," explains Giovanni Rezza, epidemiologist and director of the Department of Infectious Diseases at the Higher Institute of Health in Rome, who sits on the scientific committee advising the Italian Government. Based on the analysis of medical records, the first 100 deceased patients had an average of 2.5 concurrent diseases. Still, in the Italian system they are accounted for when calculating the lethality of COVID-19. Another confounding factor is the testing strategy, which was concentrated on people with serious symptoms, worth being hospitalised. Those who had mild symptoms were recommended to stay at home, but were not systematically tested for SARS-CoV-2. "This has likely kept the denominator very low," explains Rezza.

Italian doctors followed the suggestions from China on the use of antiviral drugs that were already tested during the SARS epidemic, but are also working actively for new clinical trials. A phase III clinical trial with remdesivir, an investigational antiviral drug being developed by Gilead Sciences to treat Ebola, is being conducted on patients recruited in the main hospitals like Spallanzani Hospital in Rome, Pavia Polyclinic, Padua and Parma University hospitals and Sacco Hospital in Milan.

The drug is not yet approved for any indication globally but is provided for compassionate use. The US Food and Drug Administration (FDA) granted investigational new drug authorisation to study it in February 2020. The same hospitals will be involved in the trial using the antiviral combination lopinavir/ritonavir as COVID-19 treatment. Paolo Ascierto, from Fondazione Pascale Cancer Institute in Naples, announced on March 10th to have observed good results on two very critical patients receiving tocilizumab, a monoclonal antibody used in rheumatoid arthritis acting on IL6 cytokine and on the spike proteins of the virus. The drug is also used to reduce severe side effects in chemotherapies. After this anecdotal report, a proper clinical trial is being planned.

General practitioners have been hit hard, acting as a first line to identify patients with symptoms suggesting COVID-19. And they are paying a high price for the lack of training, appropriate tools and a proper plan. Filippo Anelli, president of the National Federation of the Orders of Doctors and Dentists (FNOMCeO) sent a letter to Prime Minister Giuseppe Conte asking permission to stop all outpatient health activities. "By March 11th, 50 doctors were infected by the virus and three of them died," he wrote. General practitioners face a shortage of protective tools like gloves, masks and disposable scrubs. And even when they have them, they are not trained to properly manage potentially infected clothes and tools, said Claudio Cricelli, president of the Italian Society of General Practice (SIMG).

Since the end of February, the hospitals in Northern Italy have been reorganised. Most of them have special areas for COVID-19 patients. In Milan, some hospitals are working as 'hubs' to collect patients with the same disease. Most of the outpatient clinics have been closed and non-urgent visits are postponed, to make resources available for the most severe cases. This was a good strategy to increase the availability in hospitalwards but a very challenging and stressful burden on general practice. Protocols for patients with flu-like symptoms have been established by the Health Authorities. The first evaluation is done by telephone or e-mail. In case of symptoms suggesting a possible COVID-19 infection, the patient is invited to stay home, isolated from the rest of the family. The GP monitors the evolution of the symptoms while avoiding as much direct contact as possible with these patients. In case of respiratory distress, a special hotline number has been set up to dispatch a team that can transfer the patient to the hospital. "This is the only way to guarantee a proper care of the patients with other diseases," says Cricelli.

A lockdown like the one Italy is experiencing, together with continuous news coverage on the epidemic risks, are not without mental health risks. On February 26th, the Lancet published a paper by Samantha Brooks and colleagues from King's College in London, reviewing studies on the psychological effects of quarantine and how to reduce it. "Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger.

Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma," the review said. "Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable." Enrico Zanalda, president of the Italian Society of Psychiatry (SIP) confirms: "Patients with depression and OCD tend to relapse," he says. "And the general level of anxiety is very high." Children and adolescents are particularly at risk of post-traumatic stress disorder, according to the review. "A proper planning for psychiatric support and for the diagnosis of PTSD is necessary."

When the lockdown was extended to the whole country, the association of medical oncologists (AIOM, Associazione Italiana di Oncologia Medica) published a statement inviting specialists to reschedule all 'non-urgent' activities, such as cancer screenings and follow-up visits for successfully-treated patients, and in some cases adjuvant therapy.

"The rationale is to make sure that the oncology wards, especially in general hospitals that are also treating COVID-19-positive patients, can respect all the safety procedures, including social distancing, for cancer patients who are being treated or may need to start a new treatment," explains vice-president of AIOM Saverio Cinieri, who is co-director of Milan's European Institute of Oncology (IEO). "This also reduces the social interactions of immunocompromised persons who are at higher risk both of infection and of developing more serious symptoms." AIOM recommended contacting patients via phone or e-mail, to verify which patients may need to be visited, and is developing an app for video consultations.

Daniela Ovadia is a writer for Agenzia Zoe.

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, Rubin GJ. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020 Feb 26. pii: S0140-6736(20)30460-8. doi: 10.1016/S0140-6736(20)30460-8. [Epub ahead of print]

Adapted from Univadis from Medscape.

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COVID-19: What Can the World Learn From Italy? - Medscape

Researchers from the University of Torontos Donnelly Centre for Cellular and Biomolecular Research are working on developingantivirals that can combat thenovel coronavirus outbreak.

Led bySachdev Sidhu, a professor of molecular genetics, the team will apply their protein engineering technology to identify promising therapeutics.

We have diverse expertise on our team from across U of T and the University of Manitoba, which is renowned for its virology research, and we have already demonstrated that we can engineer proteins that inhibit MERS, a related coronavirus, says Sidhu, who, in addition to the Donnelly Centre holds cross appointments in the Faculty of Medicine and at the Institute of Biomaterials and Biomedical Engineering. We will now expand on this work to design therapeutics for COVID-19.

The team recently received almost $900,000 over two years from the federal government through a rapid funding competition announced on Feb. 10 to address the COVID-19 outbreak.

Sidhu is collaborating withRoman Melnyk, a senior scientist at the Hospital for Sick Children and assistant professor of biochemistry at U of T, andBrian Mark, a structural virologist and professor at the University of Manitoba. In a 2016 proof-of-principle study withMarjolein Kikkert, a virologist at Leiden University in the Netherlands, they applied a protein engineering pipeline developed by Sidhus team to create proteins that inhibit a related coronavirus that caused the Middle East Respiratory Syndrome (MERS) outbreak in 2012.

Wei Zhang, then a post-doctoral researcher in Sidhus lab and now an assistant professor at the University of Guelph,received a national innovation award for this research.

The researchers now plan to use the same strategy to battle the coronavirus behind the COVID-19global health crisis, which the World Health Organization today declared a pandemic.

Since the outbreak began in China in late 2019, the virus has spread to every continentexcept Antarctica, with more than 120,000 confirmed cases and more than 4,000 deaths, according to the latest figures. And while researchers around the world are racing to develop a vaccine, that is only a part of the solution, Sidhu says.

Even if a vaccine becomes available, not everyone is going to get vaccinated, says Sidhu. We see that with the flu the vaccination rates are far from 100 per cent. Should the virus become endemic and end up circulating in the population like the flu, medicines that stop the virus from replicating in an already infected person will be as important as vaccines, which prevent infection, according to Sidhu.

Jacky Chung, a research associate in the Sidhu lab, will spearhead the project by first engineering proteins that can inhibit the virus. The team will then search for small molecules that behave in the same way since they are easier to develop into therapeutics than proteins.

It's important to get the therapeutic inside the cells, which is where the virus replicates, says Chung. And small molecules can get into cells much more readily than proteins, which are much larger.

At the heart of the approach lies a protein called ubiquitin, named for being present in all plant and animal cells. Ubiquitin is an essential part of the cellular machinery that the virus hijacks for its own benefit. Upon infection, the virus releases proteins that interfere with human ubiquitin and allow it to bypass the hosts defence system and spread in the body.

To block the virus, the researchers will create synthetic ubiquitin variants (UbV) that thwart rather than aid its ability to replicate. By analyzing the molecular structures of different UbVs bound to the viral protein, they will gain clues into the kinds of small molecules that are most likely to be effective against the virus.

Sidhu says that, within two years, they should have candidate molecules that could be developed into therapeutics. We know there are literally armies of medicinal chemists and various companies that could then optimize the molecule into a drug that can be given to humans, says Sidhu who was previously at pharmaceutical giant Genentech and has founded six startups since joining the university.

Read more here:
U of T researchers hunt for antivirals to treat COVID-19 patients - News@UofT

The genie is out of the coronavirus bottle and has officially arrived in Minnesota.

Although this particular genie is not easily seen based on clinical symptoms, fortunately, science has provided us with genie glasses. If you believe in that kind of thing you know science.

From a testing standpoint, viruses have always been hard to detect. Theyre difficult to grow in a culture, like we often do with bacteria, and checking for antibodies against a specific virus is often imprecise, particularly early in an infection, when the body hasnt had enough time to produce antibodies.

Then came reverse transcription-polymerase chain reaction (RT-PCR) testing, a lab technique that allows us to identify fragments of genetic material (RNA in the case of coronavirus) in a body fluid sample. Like giving a search-and-rescue dog a sniff of the victims clothing, a specific RT-PCR test has to be developed for each specific viral or bacteria: It has to be told what its supposed to be looking for. (Visit tinyurl.com/molecular-assays for more information.)

RT-PCR testing isnt exactly new, but like so many other things in modern life, technological advances have made it much more accessible and affordable. In scientific terms, its a damn good test. It rarely misses a virus thats there, and it rarely mistakes another virus (or something else) for the virus it was seeking. It wont mistake influenza or strep throat for coronavirus. RT-PCR testing isnt perfect, but its the best weve ever had.

Ideally, we would have made a lot of RT-PCR genie glasses before the genie actually arrived on our shores. The delay wasnt because we couldnt figure out the gene sequence of this new coronavirus. In a tribute to the stunning sophistication of modern genetics, scientists in China released the viruss mug shot its entire genome sequence on Jan. 10, a month after they became aware of the infection (or so we are told, China being China).

An aside here for freaky cool genome science: Because RNA viruses mutate at a somewhat predictable rate, scientists can use mutations to estimate the age of a virus, like counting growth rings on a tree stump. A young virus will have few if any extra mutations. Scientists believe the COVID-19 virus was born no earlier than Oct. 30, 2019, and no later than Nov. 29th (tinyurl.com/coronvirus-genome).

This genome map provides the template for developing both vaccines and RT-PCR testing. When Germany flew 126 of its citizens home from Hubei province on Feb. 1, they PCR-tested each of them. Two of the 126 tested positive, and they were not among the 11 people with symptoms.

In medicine, we are trained to avoid testing in situations where the likelihood of finding anything is low. Routine testing for rare or low-likelihood diseases, or in healthy people, just wastes a lot of money and generates more testing for those inevitable cases where the test returns falsely positive. It rarely saves lives. Men do get breast cancer, but not at a rate that justifies routine mammograms.

All that is different with the COVID-19 virus.

At the beginning of the outbreak, when the virus was thought to be isolated to a single province in China, travel history screening was an incredibly cheap and powerful test. But as the virus continues on its worldwide tour, travel history will become an increasingly nondiscriminating test (example: Have you or a close contact traveled to any one of the following 30-and-counting states?). And thanks to widespread RT-PCR testing in other countries, we now know that our other test signs and symptoms of an upper respiratory infection has been a crude one from the beginning. It appears that a majority of those infected have either no symptoms or minor symptoms and yet remain capable of passing the virus to others. Never mind that we are still in the midst of our winter cold and flu season, where COVID-19 impostors abound.

So now that we know travel history and signs/symptoms are no more than beer-goggle-quality tests, its time to break out the genie glasses: RT-PCR. If the airline industry alone stands to lose $100 billion, it could offer the Centers for Disease Control and state and private labs $20 billion to rev up RT-PCR production, and still save itself $80 billion.

I asked Joanne Bartkus, director of the Minnesota Department of Healths Public Health Laboratory, exactly how does a RT-PCR lab rev up capacity? Is it more machines, more reagents (substances used in chemical reactions), more staff?

Yes to all of those things, she replied as she went on to explain the COVID-19 virus testing process.

Somewhat surprisingly, the RT-PCR test itself is the simplest part of the process: The samples are placed in a machine called a thermal cycler, and in 2.5 fully automated hours, the data is ready to be interpreted. The rate-limiting, most-tedious part of the process is getting the specimens ready for the cycler.

As test kits arrive from around the state, each sample must be accessioned: Information such as patient identifiers, location and ordering physician must be logged into the computer, and the sample must be tagged with a bar code. It might sound mundane, but imagine the implications of attributing a particular test result to the wrong patient. This is serious stuff.

Then comes the process of extracting the viral RNA out of the immunological fog of war found in any snot sample. In the beginning, the RNA extraction process certified by the CDC was labor-intensive.

It really limited the number of samples we could turn around in a day, and thats one of the reasons that initial testing was limited to individuals with known risk factors, Barkus told me. But as we move toward community surveillance, well need higher throughput extraction methods, and who could ever argue with higher-throughput extraction methods? Good news: On the day I spoke with Barkus, the CDC had just greenlighted a technical change that will allow 96 tests to be done in a platform that previously handled 24.

So things are heating up at MDH labs, and elsewhere, too, as the Mayo Clinic and private labs like Quest Diagnostics and LabCorp have all recently rolled out their own RT-PCR testing. Under normal circumstances, every new RT-PCR would need to be tested and approved by the FDA, but under emergency conditions like COVID-19, the FDA can loosen the reins and allow labs to internally validate their new test and get the FDA seal of approval later.

All of that, and the prospect of broader testing, is welcome news. Then well have some real data to guide our containment strategy, rather than hunches and case reports, or the difficult, labor-intensive, gumshoe detective work by public health workers.

And then well have a much better chance of putting this genie back in the bottle.

Craig Bowron is a physician and writer in the Twin Cities. On Twitter: @billcarlosbills.

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OPINION EXCHANGE | The testing that can help us put the coronavirus genie back in the bottle - Minneapolis Star Tribune