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Archive for the ‘Genetic medicine’ Category

‘Beethoven mice’ prevent deafness: Medicine’s next big thing? – WNDU-TV

Saturday, February 1st, 2020

Researchers at Harvard Medical School and Boston Children's Hospital have found a potential treatment for hereditary deafness, the same condition thought to have caused Ludwig van Beethoven to lose his hearing.

The scientists are using a new gene-editing approach that they say could someday prevent profound hearing loss.

Beethoven's Symphony No. 5 is a cornerstone of classical music. It is hard to believe the composer was almost completely deaf from a genetic condition when he finished it.

"These children are born fairly normal, but then over 10 or 20 years, they lose their hearing," Harvard neurobiology professor Dr. David Corey.

Aptly named "Beethoven mice" might hold the key to a potential cure. Scientists believe the animals have a defect in the same gene that may have caused Beethoven's deafness.

"Our genome is composed of about 3 billion letters of DNA that together make up 20,000 genes," Corey explained. "For the disease we're studying, one mistake in the DNA in one of the genes causes deafness."

Researchers identified that hearing gene called TMC1. It's a gene that comes in pairs.

Using a newly refined gene-editing system, they disabled the defective copy of the TMC1 gene, leaving the good gene in place.

"By eliminating just the bad copy, that would be sufficient to preserve hearing," Corey said.

The scientists then delivered the edited DNA back into the cells of the mice and tested their hearing.

"We put little scalp electrodes on the back of the head, play sounds into the ear and can measure the brain activity in response," Boston Children's Hospital professor of otolaryngology Dr. Jeffrey Holt said.

Researchers say the mice were able to hear sounds as low as 45 decibels, the level of a quiet conversation.

"This could be life-changing," Holt said.

A famed composer, his namesake mice and a team of scientists are using cutting-edge medicine to help people who would otherwise go deaf.

The scientists say this research paves the way for using the new editing system to treat as many as 3,500 other genetic diseases that are caused by one defective copy of a gene.

It's important to note that Holt holds patents on TMC1 gene therapy.

MEDICAL BREAKTHROUGHSRESEARCH SUMMARYTOPIC: BEETHOVEN MICE PREVENT DEAFNESS: MEDICINE'S NEXT BIG THING?REPORT: MB #4689

BACKGROUND: In the United States, hearing loss affects 48 million people and can occur at birth or develop at any age. One out of three people over the age 65 have some degree of hearing loss, and two out of three people over the age 75 have a hearing loss. Children in the United States are estimated at 3 million in having a hearing loss, and of those, 1.3 million are under the age of three. One of the leading causes of hearing loss is noise, and while preventable, can be permanent. Listening to a noisy subway for just 15 minutes a day over time can cause permanent damage to one's hearing. Listening to music on a smartphone at high volumes over time can cause permanent damage to one's hearing as well. The number of people with hearing loss is more than those living with Parkinson's, epilepsy, Alzheimer's, and diabetes combined. (Source: https://chchearing.org/facts-about-hearing-loss/ and https://hearinghealthfoundation.org/hearing-loss-tinnitus-statistics/)

TREATMENTS: The treatment you receive will depend on the cause and severity of the hearing loss. A reversible cause of hearing loss is earwax blockage where your doctor may remove earwax using suction or a small tool with a loop on the end. Some types of hearing loss can be treated with surgery, including abnormalities of the ear drum or bones of hearing (ossicles). Repeated infections with persistent fluid may result in your doctor inserting small tubes to help your ears drain. If your hearing loss is due to damage to your inner ear, a hearing aid can be helpful. With more severe hearing loss and limited benefit from conventional hearing aids, a cochlear implant may be an option. Unlike a hearing aid that amplifies sound and directs it into your ear canal, a cochlear implant bypasses damaged or nonworking parts of your inner ear and directly stimulates the hearing nerve. (Source: https://www.mayoclinic.org/diseases-conditions/hearing-loss/diagnosis-treatment/drc-20373077)

GENE EDITING WITH CRISPR: Scientists at Harvard Medical School and Boston Children's Hospital have used a newly tailored gene-editing approach in mice thought to have the same genetic defect that caused famed composer Beethoven to go deaf in adulthood. CRISPR-Cas9 gene editing works by using a molecule to identify the mutant DNA sequence. Once the system pinpoints the mutated DNA, the cutting enzyme, or Cas9, "snips" it; however, the gene editors are not always accurate. Sometimes, the guide RNA that leads the enzyme to the target site and the Cas9 enzyme are not precise and could cut the wrong DNA. The Harvard and Boston Children's scientists are using a modified Cas9 enzyme derived from Staphylococcus aureus bacteria that they are finding is significantly more accurate. (Source: https://hms.harvard.edu/news/saving-beethoven)

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Human Longevity’s Largest Study of its Kind Shows Early Detection of Disease and Disease Risks in Adults – Cath Lab Digest

Saturday, February 1st, 2020

SAN DIEGO, January 31, 2020Human Longevity, Inc.(HLI),an innovator in providing data-driven health intelligence and precision health to physicians and patients, announced the publication of a ground-breaking study in the journalProceedings of the National Academy of Sciences(PNAS). The study titled, Precision medicine integrating whole-genome sequencing, comprehensive metabolomics, and advanced imaging, showed thatby integrating whole-genome sequencing with advanced imaging and blood metabolites, clinicians identified adults at risk for key health conditions.Data from 1190 self-referred individuals evaluated with HLIs multi-modal precision health platform, Health Nucleus, show clinically significant findings associated with age-related chronic conditions including cancer, heart disease, diabetes, chronic liver disease, and neurological disorders leading causes of pre-mature mortality in adults.

The goal of precision medicine is to provide a path to assist physicians in achieving disease prevention and implementing accurate treatment strategies, said C. Thomas Caskey, MD, FACP, FACMG, FRSC, chief medical officer for Human Longevity, Inc., lead author of the study, and a member of the National Academy of Sciences. Our study showed that by employing a holistic and data-driven health assessment for each individual, we are able to achieve early disease detection in adults.

Study highlights include:

This study shows that the definition of healthy may not be what we think it is and depends upon a comprehensive health evaluation, said J. Craig Venter, PhD, founder, Human Longevity, Inc. and a member of the National Academy of Sciences. The data underscore Human Longevitys innovative approach to helping clinicians with early detection and personalized treatments, potentially achieving better health outcomes for patients.

Our traditional approach to the annual health assessment has been very superficial and will need to be replaced by data-driven measures that will be made possible as costs continue to decline for whole- genome sequencing, advanced imaging, especially MRI, and specialized blood analytics, said David Karow, MD, PhD, president and chief innovation officer, Human Longevity, Inc.

ABOUT THE STUDY

The study cohort was composed of 1190 self-referred participants who enrolled at Health Nucleuswith a median age of 54 y (range 20 to 89+ y, 33.8% female, 70.6% European). A multidisciplinary team, including cardiologists, radiologists, primary care physicians, clinical geneticists, genetic counselors, and research scientists, integrated deep phenotype data with genome data for each study participant.Participants were enrolled in the study between September 2015 and March 2018.

ABOUT THE HEALTH NUCLEUS

Health Nucleus is Human Longevitys premier health intelligence platform utilizing state-of-the-art technology to provide an assessment of current and future risk for cardiac, oncologic, metabolic, and cognitive diseases and conditions. This is provided through a proprietary, multi-modal approach, integrating data from an individuals whole-genome sequencing, brain and body MRI imaging, cardiac CT calcium scan, metabolomics, advanced blood test, and more. The health assessment is conducted at Human Longevitys Health Nucleus precision medicine center in La Jolla, California.For more information, visitwww.healthnucleus.com.

ABOUT HUMAN LONGEVITY

Human Longevity, Inc. (HLI)is a genomics-based,health intelligence companyempowering proactive healthcare and enabling a life better lived. HLIs business focus includes the Health Nucleus, a genomic-powered, precision medicine center which uses whole-genome sequencing analysis, advanced imaging, and blood analytics, to deliver the most complete picture of individual health. For more information, visitwww.humanlongevity.com.

# # #

For more information, contact: Debbie Feinberg, VP of Marketing, Human Longevity, Inc., 858-864-1058,dfeinberg@humanlongevity.com

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Human Longevity's Largest Study of its Kind Shows Early Detection of Disease and Disease Risks in Adults - Cath Lab Digest

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UAMS Professor to Present Relationships Among Food, Health, and Disease in Food Science Seminar – University of Arkansas Newswire

Saturday, February 1st, 2020

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Dr. Mahendran Mahadevan, a professor in the Department of Obstetrics and Gynecology at the University of Arkansas for Medical Sciences, willspeakfrom 3-4 p.m. Monday, Feb.3, in Room D2 of the Food Science Building, 2650 N. Young Ave. His presentation, "Food, Health, and Disease,"is open to everyone.

Mahadevan's presentation will focus on how different types of food and beverages plays a role in human body's health defense systems (Angiogenesis, stem cells/regeneration, microbiome, DNA protection, and immunity). This basic biological knowledge related to foods will be useful for better understanding about the effects of foods on the prevention and management of human diseases.

Mahadevan's research interests include: 1) roles of genetics, obesity, nutrition, food supplements, nutraceuticals, physical activity and other environmental/life style factors on prevention/public health and maternal, fetal, and child health; 2) tissue banking; 3) embryo and stem cell culture/expansion (particularly culture medium/conditions); and 4) gene therapy and stem cell gene therapy particularly in cancer and genetic diseases.

Mahadevan received his Veterinary medicine degree in 1975 from University of Ceylon Peradeniya, Sri Lanka and his doctoral degree in Reproductive biology from Monash University, Australia in 1982. His academic experience includes faculty positions in the Department of Physiology, School of medicine at the University of Ceylon and in the Department of Obstetrics and Gynecology at the University of Arkansas for Medical Sciences.

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The mental game: Inside the mind of an elite athlete – CBS19.tv KYTX

Saturday, February 1st, 2020

With the NFL Championship game this Sunday, all eyes turn to Whitehouse native and Kansas City Chiefs quarterback Patrick Mahomes.

Over the course of the last couple weeks, CBS19 has spoken to everyone from Mahomes father, Pat Mahomes Senior, his trainer at APEC, Bobby Stroupe, and fans across the region. Mahomes environment clearly helped forge him into a future NFL MVP.

Dr. Ushimbra Buford, a psychiatrist at UT Health Science Center at Tyler says there are crucial mental aspects of becoming an elite athlete.

Buford says the phrase nature vs nurture which references conflicting theories on whether the natural instincts with which people are born or the environment in which they are brought up has more of an impact on their development, is now somewhat outdated.

When I first started in medicine, we used to say things like nature and nurture and saw them as two different things. In the past several years with the advent and understanding of epigenetics, we understand now that the nurture aspect influences the nature, the environment influences your genetics, Buford said.

Buford says a persons development in all aspects, including athleticism, is heavily influenced by their environment, down to changes their body makes at a biological level.

From a genetic standpoint, that person may have a certain kind of capacity for the muscle fibers that they will produce that they were born with. But then they get into an environment where the expectation and the understanding and like the daily living is different from what their body is genetically set. Over time, their composition would change to reflect the activities they were involved in, and the potential reality exists that over time their genetics would change to reflect the new physical reality, Buford said.

This means growing up in an environment, such as in Mahomes case, where his father is a professional baseball player and he was immediately around athletics, can be incredibly beneficial. However, Buford says in athletics and in life, it always comes down to a choice to strive for greatness.

Every quarterback is saying we're going to the Super Bowl this year, but how many of them believe that?" Buford said. "How many of them really, truly feel that this is my going to be my reality? You almost have to be delusional like that to achieve greatness in a sense. You have to see and believe something before other people can or will."

This mentality is something everyone can implement in their daily lives. Buford says the sky is the limit when a persons head is in the right place.

We all have the ability to be incredible," Buford said. "You know, we really limit ourselves and I don't know if this is a societal thing, or it's just not receiving the right messages early enough in life. But don't ever think for a minute that anyone cannot become what they want to be. Only person stopping you is you.

RELATED: CHIEFS DAY: Whitehouse ISD wears red, gold in support of Patrick Mahomes' first Super Bowl

RELATED: Patrick Mahomes' foundation '15 and the Mahomies' helping kids achieve their dreams

RELATED: Patrick Mahomes' high school baseball coach: He is 'just an unbelievable athlete'

RELATED: Mahomes & Friends: KC Chiefs QB close with his hometown buddies

RELATED: Whitehouse alum designs Patrick Mahomes inspired ties

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Sarepta Therapeutics, Inc. And Arrowhead Pharmaceuticals Now Top-Ranked Biotech Stock Buys – Seeking Alpha

Saturday, February 1st, 2020

Investment Thesis

Objective: Wealth-building of an always fully-invested portfolio via repeated near-term (weeks or months) capital gains from careful, diversified, odds-on issue selection and timely price opportunity capture.

The stocks compared here are Sarepta Therapeutics, Inc. (NASDAQ:SRPT) and Arrowhead Pharmaceuticals Inc. (NASDAQ:ARWR). SRPT was inadvertently omitted from the Biotech Developer review recently published. Rather than picture it by itself, ARWR is provided here as a best-ranked alternative.

These market pros have insights you and I can't have because their everyday job is to satisfy investment organizations running billion-dollar portfolios who want to adjust their holdings in multi-million-dollar trade transactions. These market-makers [MMs] have to round up sellers when their clients want to buy, and buyers when they want to sell. That's hard to do when most investors will hold off to get better prices, whether they are buying or selling.

And when lots of money is involved in each trade, the players get pretty careful about what they want to do and when they will do it. But the big-money types work hard to be on top of developments, following some issues intently, anticipating what is likely to be happening to stock prices in the near future. Depending on what they know, or think they know, and what they think others believe is likely to happen, they may take surprising postures. Often their holding-period horizons are months, not years. Or even less.

So, the MMs have to respond when a big-money house says "sell a bunch of this and buy a lot of that, and do it in the next 15 minutes, or you can forget about keeping us as a good repeat-order client".

The MMs will round up any of their other clients who they know have holdings in the stocks or appetites (at a price) to initiate, expand or contract holdings in the issues involved. It's rare when a "cross" can be made with enough "other side of the trade" exists at acceptable prices to "fill" the trade order without having to put some of their own firm's capital at risk in order to balance buying demand with selling supply.

As market-makers, they will provide the balancing position when they can set up a hedge deal to protect the market risk involved in their "facilitation" of the trade's being completed. If they can't, then the trade order gets killed, not filled, to wait for a time when the market is more accommodating.

But what it takes to buy that market risk price-change protection for the MM tells what the players on both sides of the "insurance" market believe can happen to the stock's price during the limited lives of the derivative contracts for options, futures, swaps, or other highly leveraged involved instruments used in the hedge.

That's where we find the balances between forecast upside price gain prospects and price drawdown exposures today and can compare them with what has been seen day by day over the past couple of decades. That is what supports the opening statements above about +15% to +30% gains in specific stocks. Those are fact-based histories of all prior real-market experiences from forecasts made before the fact, not just blown smoke over some after-the-fact single illustration of convenient history.

"Sarepta Therapeutics, Inc. focuses on the discovery and development of RNA-based therapeutics, gene therapy, and other genetic medicine approaches for the treatment of rare diseases. The company offers EXONDYS 51, a disease-modifying therapy for Duchenne muscular dystrophy (DMD). Its products pipeline include Golodirsen, a product candidate that binds to exon 53 of dystrophin pre-mRNA, which results in exclusion or skipping of exon during mRNA processing in patients with genetic mutations; and Casimersen, a product candidate that uses phosphorodiamidate morpholino oligomer [PMO] chemistry and exon-skipping technology to skip exon 45 of the DMD gene. In addition, the company's pipeline comprises SRP-5051, a peptide conjugated PMO that binds to exon 51 of dystrophin pre-mRNA. It has collaboration agreements with Nationwide Children's Hospital to advance micro-dystrophin gene therapy program under the research and license option agreement; Galgt2, a gene therapy program for the treatment of DMD; and Neutrophin 3, a gene therapy program to treat Charcot-Marie-Tooth neuropathies. The company also has a license agreement with Lysogene to develop LYS-SAF302, a gene therapy for mucopolysaccharidosis IIIA; a license and option agreement with Lacerta to develop treatments for CNS-targeted and lysosomal storage diseases; and research collaboration and option agreement with Genethon to develop micro-dystrophin gene therapy products. In addition, it has a research agreement with Duke University to advance gene editing CRISPR/Cas9 technology for restoring dystrophin expression; a collaboration agreement with Summit (Oxford) Ltd. to commercialize products in Summit's utrophin modulator pipeline; a strategic collaboration with Paragon Bioservices; and a strategic collaboration with CENTOGENE for the identification of patients with DMD in the Middle East and North Africa region. Sarepta Therapeutics, Inc. was founded in 1980 and is headquartered in Cambridge, Massachusetts."

Source: Yahoo Finance

SRPT's and ARWR's recent daily price ranges over the past 6 months are shown in Figures 1 and 2, along with measures of their current forecast price up-to-down balances. Also shown are the odds of long position gains being earned in the couple of months subsequent to points in time in the past 5 years when MMs had the same kind of outlook they have today.

Figure 1

source: Author

Figure 2

source: Author

As a contrast, here is what MM forecasts for the "market-index" ETF of SPDR S&P 500 Trust (SPY) looks like at this time:

Figure 3

source: Author

How effective the MMs have been in forecasting for these stocks is a matter of market records, when conditions of uncertainty similar to today's are examined. That was done in the row of data between the graphics of Figures 1-3. For ease of comparison, they are repeated and slightly expanded in Figure 4.

Figure 4

source: Author

As explained in the prior Biotech Developer revue featuring ARWR, the SRPT Range Index [RI] of 23 produced 108 of 124 net gain %Payoffs under TERMD of +30.1%.

A comparison of the +30.1% payoffs with the present forecast of +23.1% suggests an exceptional profit achievement with a degree of credibility for the current outlook of 1.30, as indicated at column [N] of Figure 4.

So much for the "good side" of a buy proposition; what about the "bad side"?

As we condition the credibility of the upside price change forecast by comparison with actual experience, so too do we look to see how bad the downside might get. But with concern only during those "long" holding periods when committed capital would be at risk under the TERMD discipline. All other periods are irrelevant, shocking as they may be.

Figure 1's data row tells what the worst case price drawdowns have been (an average of them) during all of each actual exposure period when they were to be held. What matters is how bad a fear of loss may get induced any time, not just whether or not it existed at the end of the holding. Investors will have varied reactions to the exposures, so there is no way to evaluate potential risk impact by historic outcomes. But some useful guidance may be provided by having knowledge of the maximum degree of intensity possibly becoming present.

One logically-simplified way to address the combination of stock price risk and reward is to weight each part by its probability and combine the two. The "Win Odds" of profitable position odds here for SRPT of 108 out of 124, or 87 out of 100 offer such a probability. One minus those odds, or 100 - 87 provides the loss probability weight. Thus 0.87 times +30.1% plus 0.13 times -8.7% produces a weighted net payoff of +25.1%.

To make this style of evaluation more comparable between varied investment opportunity situations, an integration of the likely holding periods used in the calculation is helpful. For SRPT, the average number of market days required by all 129 positions of the sample was only 40 out of the maximum 63 possible, because of the high proportion of upside target prices reached.

A standard evaluation measure used in many capital planning decision situations is the expected net payoff stated in "basis points" of 1/100ths 1%, per day of capital involvement. On a 365-day calendar year +19 bp/day when sustained for a year doubles the original capital, or a CAGR of +100%. When a smaller-count of 252 market days makes up a relevant year, the fewer days are each proportionally more powerful, so only 14 bp/mkt day does the 100% equivalent.

Comparison is the essence of evaluation. If the investing objective is to make capital as productive of future spend-able amounts as possible, using an odds-weighted bp/d yardstick can be helpful.

To that end, Figure 4 includes the relevant MM forecasts and their prior outcomes for ARWR and the market-index proxy of the SPDR S&P 500 Index ETF (SPY). Also, the average of some 2,700 current-day MM price-range forecast issues, and a ranked set of the day's likely 20 best of those near-term wealth-building stocks under TERMD portfolio discipline.

All of these comparisons in Figure 4 have the same basic data as included in the row of Figure 1 for SRPT. That is expanded by the columns [O] through [R] to provide for odds-weighted bp/day price-prospect evaluation comparisons.

Competition from the market-index alternative SPY at this point in time is rather limited because of an unenthusiastic upside target outlook of only +5.5% at a CAGR of only +9% and an Odds-Weighted net prospect [Q] of +0.8%. That is better, though, than the overall population of 2,711 where MM forecasts are a modest net decline (-2.2%).

Sarepta Therapeutics, Inc. and Arrowhead Pharmaceuticals Inc. both offer outstanding prospects for capital gains with strong odds for achievement in short periods of holding. SRPT has the larger potentials, but ARWR appears historically to have quicker achievement prospects. Payoff potentials in basis points per day are exceptional. For further information, please check my blog here on Seeking Alpha.

Disclosure: I/we have no positions in any stocks mentioned, but may initiate a long position in SRPT over the next 72 hours. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

Additional disclosure: Disclaimer: Peter Way and generations of the Way Family are long-term providers of perspective information, earlier helping professional investors and now individual investors, discriminate between wealth-building opportunities in individual stocks and ETFs. We do not manage money for others outside of the family but do provide pro bono consulting for a limited number of not-for-profit organizations.We firmly believe investors need to maintain skin in their game by actively initiating commitment choices of capital and time investments in their personal portfolios. So, our information presents for D-I-Y investor guidance what the arguably best-informed professional investors are thinking. Their insights, revealed through their own self-protective hedging actions, tell what they believe is most likely to happen to the prices of specific issues in coming weeks and months. Evidences of how such prior forecasts have worked out are routinely provided in the SA blog of my name.

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Pigs Genetically Engineered With Human Cells May Pave The Way For Future Skin Transplants – IFLScience

Saturday, February 1st, 2020

A team of researchers in China have genetically engineered a pig with human DNA and transplanted skin grafts onto monkeys in a milestone they say will pave the way for future skin and organ transplantations.

In the United States alone, more than 113,000 people are awaiting organ transplants yet just over 36,000 occur each year, according to the Health Resources and Services Administration. Xenotransplantation, the process of grafting or transplanting organs or tissues between different species, may be a solution to the shortage of organs around the world and provide treatment for patients with terminal organ failure, write the researchers in bioRxiv, a pre-print server for biology that has not been certified by peer-review for publication in a journal.

Pigs are widely used in biomedical research yet they are not phylogenetically close to humans, so rejection and incompatibility can occur. Genetically modifying donor pigs to serve as a potential organ source may provide a potentially viable solution, but the necessary combinations of genetic modifications in pigs for human xenotransplantation have not yet been determined.

To test these parameters, researchers at the First Affiliated Hospital of Nanchang University in China removed key pig genes that trigger organ rejection and added eight human genes to modified pigs in order to further reduce the chance of an organ being rejected. Skin was then transplanted from the pigs to monkeys and survived up to 25 days without the monkeys requiring immunosuppressive drugs.

Genetic modification of the pig is necessary to account for the differences between the pig and human genome, especially from the immune and molecular compatibility aspects, write the authors, adding that CRISPR/Cas9 technology has accelerated this process but determining which combinations remains an open question.

The authors note that extensive genome editing in certain pig cells is not a practical endeavor because of the telomere length, which requires complex and extensive editing and a long cell culture time that may lead to cell aging or death. There is also a low risk that porcine endogenous retrovirus (PERV), a virus integrated into the genomes of pigs, could infect human hosts. Even so, the findings have great potential for clinical value to save severe and large area burn patients and other human organ failure.

As the skin is considered the vital, unique and immunogenicity organ, our preliminary success in skin xenotransplantation using the combination of multi-gene modified pig in NHP provides the approval of the concept, paves a way to initiate the other organ preclinical trial and clinical trial, implies a success of these organs xenotransplantation, writes study author Wang Gang in a comment, adding that genetically altered pigs may have the potential to become an unlimited organ source for future clinical transplantation.

The researchers add that their findings may also have applications for human disease modeling and potentially help to one day establish disease-resistant animals.

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Soccer Heading Has Greater Impact on Memory in ApoE4 Carriers – Alzforum

Saturday, February 1st, 2020

31 Jan 2020

Soccer players who repeatedly bonk their noggins against the ball have losses in episodic memory. The losses are subtle and likely unnoticeable. This subclinical effect is strongest in ApoE4 carriers, according to a study published January 27 in JAMA Neurology.

Researchers led by Michael Lipton of Albert Einstein College of Medicine in New York correlated the previous years heading exposure with memory scores. They questioned amateur players about their degree of heading, and found that people who were ApoE4-positive and regularly headed the ball had the worst delayed recall. Whether these memory blips signify a brewing subclinical pathology that could develop into neurodegenerative disease over time remains unclear, but Lipton said the findings suggest players might do best to at least tone down the number of headers they make in each game.

Multiple studies have linked participation in the military or in rough-and-tumble contact sports, such as American football, ice hockey, and boxing, to neuropsychological problems and subsequent neurodegenerative disease. However, evidence has also been mounting that that milder, subconcussive blows to the headsuch as those sustained during intentional heading of the ball by soccer playersalso take a cognitive toll and might even spark neurodegeneration (Matser et al., 2001;Feb 2017 news; Nov 2019 news).

Ouch! (And remember to buy milk.)

Little is known about how or if ApoE4, the strongest genetic risk factor for AD, influences cognitive consequences of these repetitive actions, although previous studies reported that American football players or boxers who inherited the ApoE4 allele were at greater risk of cognitive impairment than noncarriers (Jordan et al., 1997; Kutner et al., 2000).

First author Liane Hunter and colleagues investigated verbal memory loss experienced by amateur soccer players in the New York City area. Previously, the researchers had reported that the number of times a player headed the ball over a year correlated with poorer scores on tasks of verbal learning and memory (Levitch et al., 2018). Now, they factored ApoE genotype into the equation. The Einstein Soccer Study enrolled 379 participants who had been playing soccer regularly for more than five years. Of those, 355 were genotyped for ApoE. They answered a detailed computerized questionnaire, called HeadCount-12m, which incorporated information about the number of games or practices per month, months of play per year, and the average number of headers per game, to estimate the total number of headers over the prior year. They also underwent cognitive testing.

Three of the genotyped volunteers reported heading the ball more than 100,000 times over the past year, and were excluded as extreme outliers. The remaining 352 players averaged 23 years of age; 256 were men. Eighty-one carried at least one copy of ApoE4. The players headed the ball an average of more than 600 times, ranging from 70 to 3,800 headers over the year. The researchers split the volunteers into quartiles, with the lowest two considered low heading exposure, the third moderate, the fourth high. Players in the moderate and high exposure quartiles had lower scores on the CogState International Shopping List Delayed Recall (ISRL) test, a measure of verbal memory in which participants attempt to recall a 12-item shopping list 20 minutes after having it read to them. While players with low exposure recalled an average of 10 items, those in the moderate and high exposure groups recalled 9.3 and 9.2, respectively. The ISRL serves as an outcome measure in some Alzheimers clinical trials.

ApoE4 strengthened the association between heading and poor performance on the ISRL. Among carriers, the difference in ISRL scores between high- and low-frequency heading quartiles was fourfold greater than in noncarriers. When comparing scores in people with high versus moderate exposure, ApoE4 carriers had an 8.5-fold greater deficit than did noncarriers. ApoE4 seemed to amplify the differences between groups. Translated into absolute terms, noncarriers in the highest heading quartile scored 0.36 points lower on the ISRL than noncarriers with lowest heading exposure. For ApoE4 carriers, the most eager headers scored 1.49 points lower than those in the lowest quartile. Essentially, more frequent heading caused ApoE4 carriers to forget one more item on the shopping list than did noncarriers.

Lipton told Alzforum that this dip in memory is unlikely to be noticed in daily life. The mechanism behind it is unknown. The authors speculated that, as a carrier of lipids in the brain, ApoE could play a role in repairing damaged synapses following injury, and ApoE4 may do a subpar job. Lipton previously reported that high levels of soccer heading associated with microstructural damage to myelin, and considers it possible that ApoE could play a role in myelin repair (Lipton et al., 2013).

Henrik Zetterberg of the University of Gothenburg in Sweden noted that the effect on memory attributable to ApoE4 is small, and it is unclear how the allele would contribute to memory loss in response to injury at such a young age. He speculated that differences in the way microglia or astrocytes respond to injury in ApoE4 carriers could explain subtle changes in memory. He added that serum markers of axonal injury and neuroinflammationneurofilament light (NfL) and glial fibrillary acidic protein (GFAP)could connect pieces of the puzzle in future studies. Zetterberg previously reported elevated NfL in response to soccer heading (Wallace et al., 2018).

Zetterberg thinks the verbal memory dip by itself is unlikely to portend AD or other neurodegenerative diseases. To Lipton, that is the big question left open by the study. While forgetting the milk on the shopping list may not pose an issue now, could it signify a brewing subclinical pathology that could hasten neurodegeneration?

In an accompanying editorial, Sarah Banks of the University of California, San Diego, and Jesse Mez of Boston University School of Medicine emphasize that the data from this paper cannot answer this question: It should be stated explicitly that the intellectual jump from the current study findings to late-life cognitive decline and neurodegeneration, including chronic traumatic encephalopathy, is substantial.

These authors cautioned that the findings should not be used to enact policy changessuch as using ApoE screening to inform decisions about soccer play. Lipton thinks that, conceptually, using genetics to inform decisions about risk is no longer a stretch. Even without ApoE4 in the picture, reducing heading exposure among players who do it most frequently would be feasible, Lipton noted, given that the players with high heading exposure are a minority of players. Among this NYC cohort of amateurs, roughly a third of the players fell into the highest quartile of heading.Jessica Shugart

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Function of Gene Implicated in Parkinson’s Disease Discovered – Clinical OMICs News

Saturday, February 1st, 2020

Researchers at KU Leuven have discovered that a defect in the ATP13A2 gene causes cell death by disrupting the cellular transport of polyamines. When this happens in the part of the brain that controls body movement, it can lead to Parkinsons disease.

With more than six million patients around the world, Parkinsons disease is one of the most common neurodegenerative disorders. Around twenty genetic defects have already been linked to the disease, but for several of these genes, we dont know what function they fulfill. The ATP13A2 gene used to be one of these genes, but researchers at KU Leuven have now discovered its function in the cell. The researchers explain how a defect in the gene can cause Parkinsons disease in their article ATP13A2 deficiency disrupts lysosomal polyamine export published in Nature.

We found that ATP13A2 transports polyamines and is crucial for their uptake into the cell, explains senior author Peter Vangheluwe, PhD, from the Laboratory of Cellular Transport Systems. Polyamines are essential molecules that support many cell functions and protect cells in stress conditions. But how polyamines are taken up and transported in human cells was still a mystery. Our study reveals that ATP13A2 plays a vital role in that process. Our experiments showed that polyamines enter the cell via lysosomes and that ATP13A2 transfers polyamines from the lysosome to the cell interior. This transport process is essential for lysosomes to function properly as the waste disposal system of the cell where obsolete cell material is broken down and recycled. However, mutations in the ATP13A2 gene disrupt this transport process, so that polyamines build up in lysosomes. As a result, the lysosomes swell and eventually burst, causing the cells to die. When this happens in the part of the brain that controls body movement, this process may trigger the motion problems and tremors related to Parkinsons disease.

Unraveling the role of ATP13A2 is an important step forward in Parkinsons research and sheds new light on what causes the disease, but a lot of work remains to be done.

Vangheluwe continues: We now have to investigate how deficient polyamine transport is linked to other defects in Parkinsons disease such as the accumulation of plaques in the brain and malfunctioning of the mitochondria, the energy factories of the cell. We need to examine how these mechanisms influence each other, he says. The discovery of the polyamine transport system in animals has implications beyond Parkinsons disease as well, because polyamine transporters also play a role in other age-related conditions, including cancer, cardiovascular diseases, and several neurological disorders. Now that we have unraveled the role of ATP13A2, we can start searching for molecules that influence its function. Our lab is already collaborating with the Centre for Drug Design and Discoverya tech transfer platform established by KU Leuven and the European Investment Fundand receives support from the Michael J. Fox Foundation.

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Two sisters, one near-death experience, and a warning about heart disease – Buffalo News

Saturday, February 1st, 2020

You wouldnt know that Lynda Marino has a serious heart condition, save for the scar that ends near the top of her breastbone.

Marino, 40, a busy mother of two young children, is tall, slender and outgoing and fortunate to be alive.

She was diagnosed in her mid-20s with cardiomyopathy, nearly died from cardiac arrest four years ago and weathered open-heart surgery on New Years Eve at the Cleveland Clinic.

Her sister, 35-year-old Marianne Potratz, has the condition that thickens and endangers heart muscle, too.

We don't look like the average people you might expect to have heart disease, Marino said.

The two sisters have become leading advocates for the Buffalo Niagara affiliate of the American Heart Association during the last few years, not so much because their condition is rare but because heart disease is so common.

They dont want themselves or you to become another statistic for the No. 1 killer in the nation.

Cardiovascular disease can take a life suddenly or over time, at any age. Those stricken young often have a genetic predisposition like Marino, who lives in East Amherst, or Potratz, of Grand Island, but the Heart Association estimates that 80 % of cases can be prevented with healthy living and decision-making.

You need to eat right, exercise regularly and talk with your primary care provider about your family history of heart disease. Health care visits and screenings are important as often as your provider recommends, said Dr. Vijay Iyer, chief of cardiovascular medicine in the University at BuffaloJacobs School of Medicine and Biomedical Sciences.

Nobody should get to the age of 25 without knowing their blood pressure and their cholesterol numbers, he said.

Action saves lives when it comes to heart disease

Ignorance is hardly bliss when it comes to heart disease, either.

High blood pressure and even diabetes, for example, often don't manifest themselves till theyve gone too far, said Iyer, who also directs structural heart interventions at Gates Vascular Institute and the complex valve clinic at Buffalo General Medical Center.

Most of the early symptoms can be very subtle or there may be no symptoms at all, he said. People could have had hypertension for a long time, and slowly built blockages in the arteries, and the first time they show up is in the hospital when theyve had a heart attack or had a stroke so not knowing about your physical condition, your medical history, can be quite deleterious. It can be potentially fatal.

Lynda Marino, left, and her sister, Marianne Potratz, right, walk with their mother, Susan Minbiole, near the house where they grew up in East Amherst. Genetic testing after Marino suffered a cardiac arrest in 2015 showed that the sisters and their father, Barry Minbiole, have a genetic mutation that predisposes them to cardiomyopathy, a heart condition that must be closely monitored. (Robert Kirkham/Buffalo News)

It can be easy to take health for granted, particularly when you lead a busy life.

Marino knows. She learned she had cardiomyopathy in 2006, while in her mid-20s, when she was diagnosed with pneumonia. Her primary physician ordered a chest X-ray that showed signs of the condition, which thickens the heart walls, hampers blood flow and sometimes damages valves.

Marino was encouraged to see her doctor regularly, limit her exercise to moderate levels and eat right. She also was urged to be mindful of dizziness or extreme fatigue two signs of disease progression.

In the years that followed, she felt fine. She and her husband, John, chief technical officer in the Cleveland Hill School District, started a family. She also landed a job as marketing director with Canterbury Woods retirement communities.

Things changed unexpectedly on Sept. 12, 2015, when Marino went into cardiac arrest while driving home from T.J. Maxx and Aldi in the Town of Lockport.

I had a newborn son at home, she said. I had a 2-year-old daughter. I worked full time. Who knows what I was feeling, or just ignoring, beforehand because life was so insane.

Her right foot slipped off the gas as she slumped past the steering wheel onto the console. The car crawled south on Transit Road at 5 mph, while her daughter, Claire, cried frantically in a car seat behind her.

Thats when the miracles started happening, she said, recounting what others since have told her.

Chris James, a fellow motorist, saw what was happening, stopped his car, ran to the side of Marinos Forester SUV and was able to open the door because it didnt have automatic locks. He directed the car to the side of the road, turned off the ignition and called 911.

Bill and Peggy Killewald watched the commotion across four lanes of traffic while Bill, a retired veterinarian, pumped gas at a NOCO station. The couple ran to Marino, whose electrical impulses to her heart had stopped.

When Bill was doing CPR, he said I had no pulse, she said. My lips were blue and he, as a doctor, thought I was gone.

A Niagara County sheriffs deputy armed with an automated external defibrillator next joined the life-saving effort. At the time, the department was one of few in regional law enforcement that equipped its patrol cars with AEDs. Had she driven a few miles south into her home county, her odds of survival would have been worse.

Rescue workers rushed her first to Lockport Memorial Hospital, then Buffalo General, where she spent four days in an induced coma to help her recuperate.

In the coming weeks, both she, her sister and parents were tested for a gene mutation that predisposes people to cardiomyopathy.

Both sisters already knew they had the condition, confirmed through echocardiograms years earlier. They now learned they had the mutation, along with their father, Barry, 68, a retired Praxair engineer.

Nobody should get to the age of 25 without knowing their blood pressure and their cholesterol numbers, says said Dr. Vijay Iyer, a cardiologist at Gates Vascular Institute and Buffalo General Medical Center, as well as chief of cardiovascular medicine in the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. (John Hickey/News file photo)

Several weeks later, surgeons at Buffalo General implanted defibrillators and pacemakers into Marino and Potratz, who have since called themselves the Sling Sisters because they needed to wear left arm supports for six weeks as they recovered.

The regional American Heart Association affiliate offered them support along the way, which is why they now share their stories as part of the Go Red for Women campaign, which encourages women to know their cardiovascular risks and take action to reduce them.

They were discouraged from eating too much salt, fatty meat and processed foods, running marathons or lifting heavy weights. They were encouraged to walk for exercise, eat more fruits, vegetables and seafood, and drink plenty of water.

Heart Association staff also encouraged the sisters to know their health screening numbers, particularly blood pressure, cholesterol, blood sugar, weight, and any sudden increases in fluid retention.

Both women also were put on beta blocker drugs to help regulate their heart rhythms.

We live very normal lives, Marino said, or at least I did for a couple of years.

She and her sister returned from a trip to Iceland and Paris in late 2018 and Marino began to experience more dizziness, shortness of breath and chest pressure when exerting herself. She led a nearly yearlong effort to find the best solution to removing substantial muscle scarring on her heart, and secure health insurance approval.

On New Years Eve, a cardiomyopathy team at the Cleveland Clinic performed an extensive myomectomy, slicing nearly a half ounce of damaged muscle from Marinos heart nearly twice as much as generally creates urgency for such open-heartsurgery.

Before this procedure was perfected, the only alternative was a heart transplant, said the sisters' mother, Susan Minbiole.

From left, Lynda Marino, Susan Minbiole and Marianne Potratz have become key supporters of the Go Red for Women campaign, which encourages women to know their cardiovascular risks and take action to reduce them. (Robert Kirkham/Buffalo News)

Marino hasnt been able to drive or lift anything heavier than a milk carton since her surgery. She has returned to the Cleveland Clinic twice since surgery and will do so less often going forward. She also continues to work with cardiologists and electrophysiologists in Buffalo.

The Minbiole family always has been tight. Marino lives just a few blocks from her parents, while Potratz and her husband, Seth, also are regulars at family gatherings that have taken on greater meaning in recent years. Family members vacation together more regularly, and their gratitude and giving has taken on greater proportions.

Friends and family members became part of the Sling Sisters team that has become a force in regional Heart Association fundraisers.

The experience also helped underline the importance of family, community and preparedness when it comes to good health.

We really promote hands-only CPR because my life was saved in part by bystanders, complete strangers, that jumped in to help me, Marino said. You could be someone else's hero by learning CPR or suggesting your friend go see the doctor because you're hearing her complain about an ache in her arm or other symptoms of heart disease.

The sisters are CPR-trained and, because there is little research on cardiomyopathy, Marino has enrolled in a Yale University study on exercise for those with the condition.

Meanwhile, they and their families marvel at medical advances that help Marino and Potratz stay on top of their challenges.

Marino has a device similar to an Apple Watch that can take an EKG, and both sisters have another device, half the size of a toaster, that takes heart readings from their pacemakers and defibrillators and transmit them by cell signal to health specialists in the event of an unusual reading.

The pacemaker and defibrillator will always be there to protect against any future cardiac arrest, Marino said. It doesn't stop it from happening, but it would stop it from killing me.

They hope more advances will come in the future and work toward that end in part because Marinos now 6-year-old daughter and 4-year-old son, Logan, also have the MYBPC3 gene mutation that predisposes them to the same condition.

As is the case for everyone, the sisters said, its better to know something like that than not.

Some say ignorance is bliss, Potratz said, but in my case, knowing that I'm protected is far more valuable than not having the information at all.

WNY's unhealthy habits could stunt economic growth, study says

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Engineered Microbe in Bees Guts Fends off Deadly Varroa Mite – The Scientist

Saturday, February 1st, 2020

Genetically altering symbiotic gut bacteria in honey bees is successful at killing varroa mites, which tend to make bees sick and leave them at an increased risk of colony collapse disorder, according to a study published today (January 31) in Science.

Colony collapse disorder (CCD) occurs when the majority of a hive abandons ship, leaving behind the queen, honey and pollen stores, and young, immature bees behind. Without the workforce of a full hive, the colony fails. According to the US Department of Agriculture, there does not appear to be a single cause of CCD, rather, it is likely a combination of disease, parasites, poor nutrition, pesticide exposure, and other stressors on the hive.

One possible contributor to unhealthy hives are Varroa destructor mites, an invasive species that arrived in North America in the early 1980s. Not only do these parasites feed on the bees fat stores, but they also transmit a virus that leads to the deformation of their wings. As a bees health declines, it becomes more susceptible to contracting other illnesses. If a hive becomes infested with these mites, it might be enough of a threat for the healthy bees to bug out, leaving their hivemates behind.

To fight back against Varroa, researchers looked to Snodgrassella alvi, a symbiotic bacterium found within the gut of honey bees. Genetic modification of the microbes enabled them to destroy the mites from the inside out through RNA interference (RNAi). The engineered bacteria produced double-stranded RNA that induced the mites to launch an RNAi defense to destroy those sequences. Because the bacterial sequences matched those from the varroa genome critical to the mites survival, the silencing mechanism wiped out the mite transcripts as well, killing the parasites

It is a bit like a customized medicine for honey bees, Jeffrey Scott, an insect toxicologist at Cornell University who was not involved with the study, tells Science. Being able to engineer a gut microbe and specifically regulate gene expression in the host has enormous implications.

By using S. alvi as a manufacturer, the team was able to provide a continued supply of the RNA, providing a useful window for the bees to fight back against the mites. The effects lasted for the duration of the 15-day-long experiment and bees with the altered bacteria were 70 percent more likely to kill mites within 10 days than those without it.

If the technique works in the field, that could be the end of Varroa and the viruses, Robert Paxton, a bee ecologist at Martin Luther University who was not involved with the study, tells Science.

While the results of this small-scale experiment are encouraging, the method wont be used in the wild anytime soon. Releasing bacteria with gene-silencing potential invariably raises containment questions along with concerns that mutations may cause unintended consequences.

Youre turning off genes [via RNAi], honeybee epidemiologist Dennis vanEngelsdorp of the University of Maryland who was not involved with the study tells Science News. There has to be a very healthy debate about how do we regulate this?

Lisa Winter is the social media editor forThe Scientist. Email her at lwinter@the-scientist.com or connect on Twitter @Lisa831.

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Understanding the Links Between Asthma and Viral Infections in Children – Pulmonology Advisor

Saturday, February 1st, 2020

Asthma is the most common chronic respiratory disease in children, affecting approximately 6.1 million US children younger than 18 years.1 Asthmas hallmark characteristics chronic inflammation of the airways, bronchial hyperreactivity, airflow obstruction, and excessive mucus production lead to troublesome episodes of cough, wheezing, and dyspnea2 that require ongoing management and pose a consistent burden on the healthcare system.3

Furthermore, asthma can have a negative effect on the dailyroutines of both children and caregivers and hamper a childs academicperformance and ability to attend school. In 2013, the CDC found that 49% ofchildren with asthma reported 1 asthma-related missed school days.4

Although asthma can develop at any time throughout life, itmost often begins in childhood.5 A range of childhood risk factorsfor asthma have been identified in studies to date, including geneticsusceptibility, atopy, and microbial and environmental exposures.3

In this interview with Asthma Advisor, translationalresearcher Mitchell H. Grayson, MD, FAAAAI,FACAAI, chief of the Division of Allergy and Immunology at NationwideChildrens Hospital and professor of pediatrics at The Ohio State UniversityCollege of Medicine in Columbus, discussed the latest insights about theconnection between common viral infections and asthma in children.

AsthmaAdvisor: Which viral strains have been associated with the development of wheezingepisodes in children?

Mitchell H. Grayson, MD, FAAAAI, FACAAI: There are viruses that have been associated with the development of asthma and postviral wheeze, and then there are viruses associated with asthma exacerbations. Respiratory syncytial virus (RSV), rhinovirus, coronaviruses, and influenza have been associated with postviral wheeze and asthma onset; rhinovirus and coronaviruses have been more associated with exacerbations of existing disease than with induction of asthma.2 Also, parainfluenza virus types 1 and 3 have been associated with induction of disease, as well as exacerbation of existing asthma.2

AsthmaAdvisor: How is the number of wheezingepisodes in early childhood related to the development of asthma?

Dr Grayson: This is a complicated situation that leads to 2questions 1) What is asthma? and 2) What is a postviral wheeze? Obviously, wedo not get all excited about a child having asthma if they wheeze once, but thegray zone is when they wheeze 2 or more times.

First, there is no magic answer,but in the absence of emergency department visits or hospitalizations, if apatient wheezes more than 2 or 3 times due to viral illnesses, that patientprobably has asthma, but there is no hard and fast rule about that.

Asthma Advisor: In cases of true asthma, will asthma episodes also be provoked by other types of environmental stimuli?

Dr Grayson: Possibly; in children at least, almost all asthmais allergic asthma. Part of the problem in clearly defining asthma is thatwheezing is actually the lung being twitchy and bronchoconstrictingto an irritant of some sort it may be diesel smoke, a cat allergen, orrhinovirus, and that is where it becomes sort of problematic is this all thesame disease? We lump them together because the clinical symptoms are the same,but I would argue that the mechanisms of wheeze due to cat allergen andrhinovirus are very similar (immunoglobulin E [IgE] responses) but that dieselexhaust may not be driving asthma through an IgE response. So, there may bedifferent mechanisms upfront with the same downstream effect on the lung.

AsthmaAdvisor: How much is known about the connection between allergic sensitization andasthma? What comes first?

Dr. Grayson: Most studies have looked at sensitization at 1 year of age, and the problem is that the children were already wheezing before that. The COAST study (ClinicalTrials.gov Identifier: NCT00204841) investigators, for example, attempted mathematical modeling and proposed that rhinovirus infections cause asthma in children who already have atopic sensitization.6

There have also been some recentpublications suggesting that RSV infection leads to wheezing in children whoare not atopic to begin with vs the rhinovirus that leads to wheezing in childrenwho are atopic.2 So, there is a little confusion as to how thatmechanism is working. Generally, with RSV, the risk is in the age group between2 and 6 months2 who have a severe RSV infection; that is usually alittle young to be producing a lot of IgE vs the risk of asthma from rhinovirustends to be in children a little older, which would then align with the ideathat patients become atopic first.

There is also the atopic march, in which children develop atopic dermatitis in infancy and then allergic rhinitis by the time they are 3 or 4 years old and, finally, asthma by the time they are 5 or 6 years old. The traditional path to atopic asthma is one that develops with the atopic march, and therefore, clearly, the children are sensitized well before they start wheezing.7

AsthmaAdvisor: What are the risk factors for allergic asthma vs nonallergic asthma?

Dr Grayson: Allergies and allergic disease in the family andin the individual put one at risk for allergic asthma. Nonallergic asthma tendsto occur later in life and be more severe and is usually not associated witheosinophils in the peripheral blood and sputum.8,9 I would putviruses in the allergic asthma pot, although there have been studies thatsuggested that RSV drives nonallergic asthma. The risk factors for nonallergicasthma are not well defined and, in many ways, nonallergic asthma is theabsence of allergic asthma.

Asthma Advisor: What is the long-term outlook for children who develop allergic asthma in early childhood?

Dr Grayson: We do have children who outgrow their asthma. Inmany cases, it is like a lot of other allergic diseases that, when you get toyour 20s, seem to go away only to return in your 30s. In the vast majority of children,asthma gets better and becomes less problematic as the child gets older.10We assume that the more severe asthma is, the less likely it is that the childwill outgrow it, but we really do not have good predictors of who will outgrowtheir asthma.

AsthmaAdvisor: Is there a geneticsusceptibility in children who develop asthma after a viral infection?

Dr Grayson: I am not aware of any good studies findinga specific genetic link. There is no good genetic marker to predict if someonewill wheeze or not wheeze with a viral infection. With a family history ofatopy, you are more likely to have asthma, but whether you would have it with avirus is a different issue.

AsthmaAdvisor: How much is known about themechanism by which viral infections cause asthma exacerbations?

Dr Grayson: There are a couple of ideas about this. There was a clinical trial (ICATA Asthma Mechanistic Study; ClinicalTrials.gov Identifier: NCT00377390) where the investigators used anti-IgE therapy in children with allergic asthma and reduced asthma exacerbations in the pollen season, but they also reduced asthma exacerbations basically back to the level seen in the control group during the viral respiratory season in the winter.11 My argument would be that the anti-IgE therapy removes antiviral IgE, preventing mast cell activation and subsequent histamine release, all ending up preventing bronchoconstriction from the viral infection. If you do not have bronchoconstriction, it is likely that you will not have asthma. That is a rationale for using anti-IgE therapy to prevent viral induced wheezing and asthma.

Another explanation, proposed by the Inner-City Asthma Consortium, is that there is a certain type of dendritic cell that makes type I interferon, which is a major player in the antiviral immune response.12 Crosslinking IgE on these cells reduces the amount of type I interferon that they produce. So, if you are allergic and produce more IgE, you have an impaired immune response because you are making less type I interferon and, therefore, that leads to worsening disease.

I have 2 problems with this: First,I do not know about the mechanistic connection between type I interferon andwheeze, and second, solid data supporting the idea that viral titers are higher,or that type I interferon is markedly suppressed in patients with asthma, arelacking. We do not have a good studyusing antiviral IgE therapy at the time of initial viral infection to see if itwill prevent the development of postviral wheeze or a study where we giveindividuals a virus, whether they are or are not receiving antiviral IgEtherapy, to see if it will prevent them from wheezing.

Disclosure:Dr Grayson reported serving onadvisory boards for AstraZeneca, Genentech,Novartis, Genzyme, DBVTechnologies, and Aimmune.

References

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ICR research showcased in major new Science Museum gallery documenting history of medicine – The Institute of Cancer Research

Saturday, February 1st, 2020

Image: Professor Chris Lord andDr Stephen Pettitt next to the olaparib display in the Science Museum's medicine galleries

The Science Museum's new 24 millionmedicine galleriesshowcases pioneering research from The Institute of Cancer Research, London, as part of its story of modern medicine.

The new galleries, which have transformed the first floor of the world-famous museum, explore humanity's relationship with medicine and health through more than 500 years of history.

Included in the exhibition are extraordinary medical artefacts from the collections of Henry Wellcome and the Science Museum Group, including the world's first MRI scanner, Fleming's penicillin mould, a professional pianist's prosthetic arm and robotic surgery equipment.

Science MuseumLatesare adults-only, after-hours theme nights that take place in the museum on the last Wednesday of every month. Medicine Lates was held on Wednesday 29 January.

Follow #smLates on Twitter

The museum chose to showcase the ICR's pioneering research underpinning the development of targeted drug olaparib, which has transformed the lives of tens of thousands of women with breastand ovariancancers.

Olaparib's origins lie in ICR research into the BRCA genes in the 1990s, when our scientists tracked down the BRCA2 gene.

A decade after the identification of BRCA2, ICR researchers found that targeting a DNA repair protein called PARP was a potential way to kill cancer cells with a faulty BRCA gene. This helped lead to the development of olaparib, and other so-called PARP inhibitors.

The gallery features plates which replicate the original ICR experiment to successfully show that olaparib specifically kills cancer cells with defects in their BRCA genes, while leaving healthy cells unaffected.

You can see these in the Medicine and Bodies gallery, which explores how the search to understand more about the human body has transformed medicine.

Displayed alongside Crick and Watson's molecular DNA model, the plates represent how understanding the genetic basis of cancer has transformed our ability to treat it through the creation of targeted therapies.

Professor Chris Lord,Deputy Head of the Breast Cancer Now Toby Robins Research CentreandDivision of Breast Cancer Researchat the ICR (pictured above), said:

"The fact that the Science Museum have chosen to highlight PARP inhibitors in their new gallery is a real testament to how cancer research can genuinely lead to improvements in the treatment of the disease. We are immensely proud of this, as are the other labs across the world who also contributed to these discoveries."

"Despite PARP inhibitors now being highlighted in Science Museum, this is not the end for us we are still working very hard at the ICR to think about how we can improve the effectiveness of these drugs and to make sure that each patient receives the best possible treatment approach."

Daisy Henesy, the ICRs Public Engagement Officer, said:

"It's a thrill to see the ICR's research showcased alongside other huge advances in modern medicine, and richly deserved.

"I urge everyone to visit the new Science Museum galleries and have a look for yourself and don't forget to tweet us with any pictures @ICR_Londonand let us know what you think!"

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Friday Frontline: Cancer Updates, Research and Education on January 31, 2020 – Curetoday.com

Saturday, February 1st, 2020

From NFL Hall of Famer Kurt Warner leading a recognition service for cancer caregivers during the Super Bowl to Tylenols key ingredient possibly being added to Californias proposition 65 list for chemicals that may cause cancer, heres what is making headlines in the cancer space this week.

We understand that they take their own journey, said Warner in a press release. They take on their own pain. They take on their own suffering. They are unselfishly giving of themselves in so many ways solely to have impact on so many that they are caring for.

Participants in the 30 Days of Cancer Prayer event are sent daily cancer prayer videos by phone, email or Facebook by well-known Christians, like Warner. The range of topics discussed and prayed over in the videos include finances, chemotherapy and multiple tumor types.

We live in a society where I feel like so many give simply due to an expectation of what they are going to receive, Warner explained. With caregivers we know that there is very little that they receive. That it is so much giving.

TrialJectory announced a new partnership with specialty cancer diagnostics companyPrecipio, Inc., to provide patients with cancer worldwide with a first-of-its-kind diagnostic and clinical trial-matching service combining the companies platforms.

While this partnership offers enormous benefits for both patients and physicians, it ultimately allows patients to take back control of their health and empowers them to make decisions that are right for them based on accurate information from advanced new technologies, said Tzvia Bader, TrialJectorys CEO and co-founder, in a press release.

TrialJectory is an A-based clinical trial matching platform that helps facilitate clinical trial searches and enrollment for patients with cancer and their physicians. Precipio is a platform that helps to create accurate diagnostic platforms by using all of the data from academic institutions, and providing that information to patients and physicians. The two combines are looking to their merger to help patients throughout the entirety of their cancer journey, from diagnosis to treatment.

Not only are patients entitled to receive an accurate diagnosis at the start of their battle with cancer, but they also deserve access to match and enroll in the best clinical trials available for their unique situation without having to struggle through the complex matching and enrollment process, explained Ilan Danieli, CEO of Precipio.

Five years after a group of patients were given synthetic psilocybin, the psychedelic compound of magic mushrooms, to help with cancer related depression and anxiety new research shows that they are still feeling the positive effects.

In the initial 2016 study, 80% of the patients reported their symptoms faded and the effects lasted up to 6 months a landmark finding at the time. In the follow up study, which included 15 patients, 80% were still experiencing significant improvement in their cancer-related depression and anxiety and nearly all of them attributed it to the psychedelic-assisted therapy.

Its a powerful experience that creates a lasting memory that involves them dealing with the demons of their cancer or their mortality, explained Dr. Stephen Ross, director of addiction psychiatry at New York Universitys Langone Medical Center, who led the 2016 study and co-authored the new research.

Although some patients in the follow up study noted the return of social anxiety, their fear of their cancer and own mortality did not.

Next Generation Sequencing for people with inherited ovarian or breast cancer will now be covered by the Centers for Medicare & Medicaid Services (CMS).

We recognize that cancer patients shoulder a heavy burden, so were leaving no stone unturned in supporting womens health and getting all patients the care, they need, stated CMS Administrator Seema Verma in a press release. Next Generation Sequencing testing provides clinically valuable information to guide patients and physicians in developing a personalized treatment plan.

Patients with inherited ovarian and breast cancer have a limited number of treatments, and for patients on Medicare even more so. Now, patients will have access to the genetic testing that allows patients access to personalized treatments that can better target their cancers.

This spring, California lawmakers will hold a public hearing to determine whether acetaminophen, the key active ingredient in Tylenol, should be added to the states list of chemicals that are known to the state to cause cancer or reproductive toxicity.

This falls under the states Proposition 65, otherwise known as the Safe Drinking Water and Toxic Enforcement Act of 1986. The list includes arsenic, asbestos, cocaine, coke oven emissions, wood dust and over 900 other chemicals. However, acetaminophen marks a major possible addition to the list as its a key ingredient in drugs meant to relieve pain or reduce fever.

In addition to Tylenol, acetaminophen is also found in other over-the-counter medications, such as Alka-Seltzer Plus Liquid Gels, Dayquil, Dimetapp, Excedrin, Midol, Nyquil, Sudafed and Theraflu.Cancer risk associated with acetaminophen have only been associated in animal studies where mutations have been observed and indirect evidence in other studies where further study is ongoing. The Food and Drug Administration has not seen fit to issue a warning.

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What the Axolotl’s Limb-Regenerating Capabilities Have to Teach Us – Discover Magazine

Saturday, February 1st, 2020

As amphibians go, axolotls are pretty cute. These salamanders sport a Mona Lisa half-smile and red, frilly gills that make them look dressed up for a party. You might not want them at your soiree, though: Theyre also cannibals. While rare now in the wild, axolotls used to hatch en masse, and it was a salamander-eat-salamander world. In such a harsh nursery, they evolved or maybe kept the ability to regrow severed limbs.

Their regenerative powers are just incredible, says Joshua Currie, a biologist at the Lunenfeld-Tanenbaum Research Institute in Toronto whos been studying salamander regeneration since 2011. If an axolotl loses a limb, the appendage will grow back, at just the right size and orientation. Within weeks, the seam between old and new disappears completely.

And its not just legs: Axolotls can regenerate ovary and lung tissue, even parts of the brain and spinal cord.

The salamanders exceptional comeback from injury has been known for more than a century, and scientists have unraveled some of its secrets. It seals the amputation site with a special type of skin called wound epithelium, then builds a bit of tissue called the blastema, from which sprouts the new body part. But until recently, the fine details of the cells and molecules needed to create a leg from scratch have remained elusive.

With the recentsequencingandassemblyof the axolotls giant genome, though, and thedevelopment of techniques to modify the creatures genes in the lab,regeneration researchers are now poised to discover those details. In so doing, theyll likely identify salamander tricks that could be useful in human medicine

Already, studies are illuminating the cells involved, and defining the chemical ingredients needed. Perhaps, several decades from now, people, too, might regrow organs or limbs. In the nearer future, the findings suggest possible treatments for ways to promote wound-healing and treat blindness.

The idea of human regeneration has evolved from an if to a when in recent decades, says David Gardiner, a developmental biologist at the University of California, Irvine. Everybody now is assuming that its just a matter of time, he says. But, of course, theres still much to do.

In a working limb, cells and tissues are like the instruments in an orchestra: Each contributes actions, like musical notes, to create a symphony. Amputation results in cacophony, but salamanders can rap the conductors baton and reset the remaining tissue back to order and all the way back to the symphonys first movement, when they first grew a limb in the embryo.

The basic steps are known: When a limb is removed, be it by hungry sibling or curious experimenter, within minutes the axolotls blood will clot. Within hours, skin cells divide and crawl to cover the wound with a wound epidermis.

Next, cells from nearby tissues migrate to the amputation site, forming a blob of living matter. This blob, the blastema, is where all the magic happens, said Jessica Whited, a regenerative biologist at Harvard University, in a presentation in California last year. It forms a structure much like the developing embryos limb bud, from which limbs grow.

This movie shows immune cells, labeled to glow green, moving within a regenerating axolotl fingertip. Scientists know that immune cells such as macrophages are essential for regeneration: When they are removed, the process is blocked.

Finally, cells in the blastema turn into all the tissues needed for the new limb and settle down in the right pattern, forming a tiny but perfect limb. This limb then grows to full size. When all is done, you cant even tell where the amputation occurred in the first place, Whited tellsKnowable Magazine.

Scientists know many of the molecular instruments, and some of the notes, involved in this regeneration symphony. But its taken a great deal of work.

As Currie started as a new postdoc with Elly Tanaka, a developmental biologist at the Research Institute of Molecular Pathology in Vienna, he recalls wondering, Where do the cells for regeneration come from? Consider cartilage. Does it arise from the same cells as it does in the developing embryo, called chondrocytes, that are left over in the limb stump? Or does it come from some other source?

To learn more, Currie figured out a way to watch individual cells under the microscope right as regeneration took place. First, he used a genetic trick to randomly tag the cells he was studying in a salamander with a rainbow of colors. Then, to keep things simple, he sliced off just a fingertip from his subjects. Next, he searched for cells that stuck out say, an orange cell that ended up surrounded by a sea of other cells colored green, yellow and so on. He tracked those standout cells, along with their color-matched descendants, over the weeks of limb regeneration. His observations, reported in the journalDevelopmental Cellin 2016,illuminated several secrets to the regeneration process.

Regenerative biologist Joshua Currie labeled the cells in axolotls with a rainbow of colors, so that he could follow their migration after he amputated the tip of the salamanders fingertips. In this image, three days after amputation, the skin (uncolored) has already covered the wound. (Credit: Josh Currie)

For one thing, cell travel is key. Cells are really extricating themselves from where they are and crawling to the amputation plane to form this blastema, Currie says. The distance cells will journey depends on the size of the injury. To make a new fingertip, the salamanders drew on cells within about 0.2 millimeters of the injury. But in other experiments where the salamanders had to replace a wrist and hand, cells came from as far as half a millimeter away.

More strikingly, Currie discovered that contributions to the blastema were not what hed initially expected, and varied from tissue to tissue. There were a lot of surprises, he says.

Chondrocytes, so important for making cartilage in embryos, didnt migrate to the blastema (earlier in 2016, Gardiner and colleaguesreported similar findings). And certain cells entering the blastema pericytes, cells that encircle blood vessels were able to make more of themselves, but nothing else.

The real virtuosos in regeneration were cells in skin called fibroblasts and periskeletal cells, which normally surround bone. They seemed to rewind their development so they could form all kinds of tissues in the new fingertip, morphing into new chondrocytes and other cell types, too.

To Curries surprise, these source cells didnt arrive all at once. Those first on the scene became chondrocytes. Latecomers turned into the soft connective tissues that surround the skeleton.

How do the cells do it? Currie, Tanaka and collaborators looked at connective tissues further, examining the genes turned on and off by individual cells in a regenerating limb. In a 2018Sciencepaper, the team reported thatcells reorganized their gene activation profileto one almost identical, Tanaka says, to those in the limb bud of a developing embryo.

Muscle, meanwhile, has its own variation on the regeneration theme. Mature muscle, in both salamanders and people, contains stem cells called satellite cells. These create new cells as muscles grow or require repair. In a 2017 study inPNAS, Tanaka and colleagues showed (by tracking satellite cells that were made to glow red) that most, if not all, ofmuscle in new limbs comes from satellite cells.

If Currie and Tanaka are investigating the instruments of the regeneration symphony, Catherine McCusker is decoding the melody they play, in the form of chemicals that push the process along. A regenerative biologist at the University of Massachusetts Boston, she recently published arecipe of sorts for creating an axolotl limb from a wound site. By replacing two of three key requirements with a chemical cocktail, McCusker and her colleagues could force salamanders to grow a new arm from a small wound on the side of a limb, giving them an extra arm.

Using what they know about regeneration, researchers at the University of Massachusetts tricked upper-arm tissue into growing an extra arm (green) atop the natural one (red). (Credit: Kaylee Wells/McCusker Lab)

The first requirement for limb regeneration is the presence of a wound, and formation of wound epithelium. But a second, scientists knew, was a nerve that can grow into the injured area. Either the nerve itself, or cells that it talks to, manufacture chemicals needed to make connective tissue become immature again and form a blastema. In their 2019 study inDevelopmental Biology, McCusker and colleagues guided byearlier work by a Japanese team used two growth factors, called BMP and FGF, to fulfill that step in salamanders lacking a nerve in the right place.

The third requirement was for fibroblasts from opposite sides of a wound to find and touch each other. In a hand amputation, for example, cells from the left and right sides of the wrist might meet to correctly pattern and orient the new hand. McCusckers chemical replacement for this requirement was retinoic acid, which the body makes from vitamin A. The chemical plays a role in setting up patterning in embryos and has long been known to pattern tissues during regeneration.

In their experiment, McCuskers team removed a small square of skin from the upper arm of 38 salamanders. Two days later, once the skin had healed over, the researchers made a tiny slit in the skin and slipped in a gelatin bead soaked in FGF and BMP. Thanks to that cocktail, in 25 animals the tissue created a blastema no nerve necessary.

About a week later, the group injected the animals with retinoic acid. In concert with other signals coming from the surrounding tissue, it acted as a pattern generator, and seven of the axolotls sprouted new arms out of the wound site.

The recipe is far from perfected: Some salamanders grew one new arm, some grew two, and some grew three, all out of the same wound spot. McCusker suspects that the gelatin bead got in the way of cells that control the limbs pattern. The key actions produced by the initial injury and wound epithelium also remain mysterious.

Its interesting that you can overcome some of these blocks with relatively few growth factors, comments Randal Voss, a biologist at the University of Kentucky in Lexington. We still dont completely know what happens in the very first moments.

If we did know those early steps, humans might be able to create the regeneration symphony. People already possess many of the cellular instruments, capable of playing the notes. We use essentially the same genes, in different ways, says Ken Poss, a regeneration biologist at the Duke University Medical Center in Durham who describednew advances in regeneration, thanks to genetic tools, in the 2017Annual Review of Genetics.

Regeneration may have been an ability we lost, rather than something salamanders gained. Way back in our evolutionary past, the common ancestors of people and salamanders could have been regenerators, since at least one distant relative of modern-day salamanders could do it. Paleontologists have discovered fossils of300-million-year-old amphibians with limb deformities typically created by imperfect regeneration.Other members of the animal kingdom, such as certain worms, fish and starfish, can also regenerate but its not clear if they use the same symphony score, Whited says.

These fossils suggest that amphibians calledMicromelerpetonwere regenerating limbs 300 million years ago. Thats because the fossils show deformities, such as fused bones, that usually occur when regrowth doesnt work quite right. (Credit: Nadia B Frbisch et al./Proceedings of the Royal Society B, 2014)

Somewhere in their genomes, all animals have the ability, says James Monaghan, a regeneration biologist at Northeastern University in Boston. After all, he points out, all animals grow body parts as embryos. And in fact, people arent entirely inept at regeneration. We can regrow fingertips, muscle, liver tissue and, to a certain extent, skin.

But for larger structures like limbs, our regeneration music falls apart. Human bodies take days to form skin over an injury, and without the crucial wound epithelium, our hopes for regeneration are dashed before it even starts. Instead, we scab and scar.

Its pretty far off in the future that we would be able to grow an entire limb, says McCusker. I hope Im wrong, but thats my feeling.

She thinks that other medical applications could come much sooner, though such as ways to help burn victims. When surgeons perform skin grafts, they frequently transfer the top layers of skin, or use lab-grown skin tissue. But its often an imperfect replacement for what was lost.

Thats because skin varies across the body; just compare the skin on your palm to that on your calf or armpit. The tissues that help skin to match its body position, giving it features like sweat glands and hair as appropriate, lie deeper than many grafts. The replacement skin, then, might not be just like the old skin. But if scientists could create skin with better positional information, they could make the transferred skin a better fit for its new location.

Monaghan, for his part, is thinking about regenerating retinas for people who have macular degeneration or eye trauma. Axolotls can regrow their retinas (though, surprisingly, their ability to regenerate the lens is limited to hatchlings). He is working with Northeastern University chemical engineer Rebecca Carrier, whos been developing materials for use in transplantations. Her collaborators are testing transplants in pigs and people, but find most of the transplanted cells are dying. Perhaps some additional material could create a pro-regeneration environment, and perhaps axolotls could suggest some ingredients.

Carrier and Monaghan experimented with the transplanted pig cells in lab dishes, and found they were more likely to survive and develop into retinal cells if grown together with axolotl retinas. The special ingredientseems to be a distinct set of chemicals that exist on axolotl, but not pig, retinas.Carrier hopes to use this information to create a chemical cocktail to help transplants succeed. Even partially restoring vision would be beneficial, Monaghan notes.

Thanks to genetic sequencing and modern molecular biology, researchers can continue to unlock the many remaining mysteries of regeneration: How does the wound epithelium create a regeneration-promoting environment? What determines which cells migrate into a blastema, and which stay put? How does the salamander manage to grow a new limb of exactly the right size, no larger, no smaller? These secrets and more remain hidden behind that Mona Lisa smile at least for now.

10.1146/knowable-012920-1

This article originally appeared in Knowable Magazine, an independent journalistic endeavor from Annual Reviews.

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Largest-ever study ties over 100 genes to autism – Health24

Saturday, February 1st, 2020

More than 100 genes appear to be involved in autism spectrum disorders (ASD), according to the largest genetic study of the condition to date.

The study, involving over 50 centres around the globe, identified 102 genes associated with ASD including a few dozen that had not been recognised before.

Some of the genes are also associated with intellectual disabilities and developmental delays, the researchers said. But others are unique to ASD, and appear related to the social difficulties that mark the disorder.

Knowing the genes involved in ASD will help researchers better understand the causes and possibly develop new drug therapies for children with severe impairments, said senior researcher Joseph Buxbaum.

"Autism exists on a spectrum, and many people wouldn't need any new, targeted drug therapies because they're doing fine," said Buxbaum, who directs the Seaver Autism Center for Research and Treatment at Mount Sinai, in New York City.

But for children who are profoundly affected, he said, there could be promise in the "precision medicine" approach treatments that are tailored to individuals based on their characteristics, like the genes they carry.

ASD is a brain disorder that affects social skills, communication and behaviour control. In the United States, it affects one in 59 children, according to the US Centers for Disease Control and Prevention.

The disorder is complex and varies widely from one person to the next. Some children have milder problems with socialising and communicating, while others are profoundly affected speaking little, if at all, and getting wrapped up in repetitive, obsessive behaviours, for example. Some children with ASD have intellectual disabilities, while others have average or above-average IQs.

Experts have long believed that a combination of genetic susceptibility and environmental exposures conspire to cause ASD but genes are the bigger factor. A recent study, of about two million people, estimated that genes account for 80% of the risk of ASD.

But the precise genes will vary among individuals, experts say.

"We realise that large studies like this as well as even larger ones will be needed to truly understand why we say, 'If you have seen one person with autism, you have seen one person with autism,'" said Dean Hartley.

Hartley, who was not involved in the new study, is senior director of genomic discovery and translational science at the non-profit Autism Speaks.

Previously, researchers had identified 65 genes associated with ASD. Buxbaum said his team was able to find more, in part, because of the study size: It involved over 35 000 people, including nearly 12 000 with ASD; the rest were their parents, unaffected siblings or other individuals without ASD.

Using newer analytic techniques, Buxbaum said, the researchers were able to zero in on 102 genes associated with ASD.

Some genes, he explained, are "high risk" and carry outright mutations. Most people with ASD possibly 80% would not harbor those, according to Buxbaum. Instead, they would carry "tiny, tiny changes across multiple genes," he said.

More research is needed to understand precisely what all these genes do. But most risk genes are active early in brain development, and have roles in regulating the activity of other genes or communication among brain cells, the investigators found.

The risk genes are also active in both "excitatory" and "inhibitory" neurons (nerve cells). That, Buxbaum said, shows that autism is not only related to one major type of brain cell but involves "many disruptions" in brain cell function.

The findings were published online in the journal Cell.

New targets for treatments

Dr Andrew Adesman is chief of developmental and behavioural paediatrics at Cohen Children's Medical Center, in New Hyde Park, New York. He said, "This study represents yet another major advance in our understanding of some of the underlying genetic causes for ASD."

At this point, though, he noted, it's not possible to root out the genetic cause in most children diagnosed with ASD.

Hartley agreed that the latest findings could eventually lead to new therapies. "This study importantly confirms previous biological pathways in autism, but has identified new biological processes possibly involved," he added. "These pathways are important for finding new targets for treatment and more personalised health care."

The hunt for ASD-related genes is not over, however. Buxbaum said he expects a "couple hundred more" will be found.

Image credit: iStock

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Genome Medical Adds Population Genomics Offering to Enable Increased Access for Individuals Nationwide – P&T Community

Thursday, January 23rd, 2020

SOUTH SAN FRANCISCO, Jan. 23, 2020 /PRNewswire/ --Genome Medical, a leader in telegenomics-based clinical care, today announced that it has expanded its services to enable collaborative population genomics programs with health systems across the country. To support this augmented offering, the company has appointed renowned geneticist Huntington Willard, Ph.D., as Chief Scientific Officer and SVP, Medical Affairs.

Genome Medical uses its Genome Care DeliveryTM platform to drive large scale population genomics programs that will increase the understanding of genetic factors within specific populations. The information gleaned from these programs has the potential to help health systems and their clinicians understand how genetics and genomics contribute to the overall health and well-being of patients within the communities they serve.

The comprehensive range of services offered to health systems includes strategic advice and guidance; program development and implementation support; engagement of patients and providers; genetic testing coordination; and return of results to both patients and providers. Health systems will be able to create programs supported by a national network of licensed medical geneticists and genetic counselors, who are accessible on-demand through the company's telemedicine platform. This benefits not only patients and their families, but also clinicians who can receive consultation to determine appropriate clinical action plans.

"I am thrilled to bring new talent to the Genome Medical team as we expand our services," said Lisa Alderson, co-founder and CEO of Genome Medical. "Hunt has led multiple significant initiatives in genomics, including launching the National Precision Health program at Geisinger. Under his leadership, this team will help us execute on key partnerships with hospitals and health systems to further democratize genomics for all populations."

Willard brings decades of leadership experience in genetics and genomics to his position at Genome Medical, where he will oversee various strategic initiatives including clinical and research partnerships in population genomics with hospitals and health systems. He is an elected member of the National Academies of Medicine and of Sciences, a former president of the American Society of Human Genetics, and founding director of the Duke Institute for Genome Sciences and Policy. Most recently, he served as founding director of Geisinger National Precision Health.

"Genome Medical's business needs as a leading medical practice and telegenomics company align well with my expertise in developing and operating precision health initiatives," Willard said. "I look forward to working with Lisa and the team to transform the way hospitals and health systems utilize population genomics programs to improve the quality of clinical care."

In addition to Willard, Genome Medical also announced expansion of its population genomics team by welcoming two other former team members from Geisinger National, one of the world leaders in population genomics and precision health:

Genome Medical's network of genetic specialists and cloud-based Genome Care Delivery technology platform overcome the service delivery challenges in genetics. More than 50 clinicians are available for on-demand, virtual care in all 50 states across six specialty areas; this level of reach is paramount to the successful implementation of population genomics. The platform delivers education, engagement and provider-to-provider e-consultations, as well as genetic wellness assessments and screening for population health management.

About Genome MedicalGenome Medical is a national telegenomics technology, services and strategy company bringing genomic medicine to everyday care. Through our nationwide network of genetic specialists and efficient Genome Care DeliveryTM technology platform, we provide expert virtual genetic care for individuals and their families to improve health and well-being. We also help healthcare providers and their patients navigate the rapidly expanding field of genetics and utilize test results to understand the risk for disease, accelerate disease diagnosis, make informed treatment decisions and lower the cost of care. We are shepherding in a new era of genomic medicine by creating easy, efficient access to top genetic experts. Genome Medical is headquartered in South San Francisco. To learn more, visit http://www.genomemedical.comand follow @GenomeMed.

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Whats wrong with my son? Wisconsin rejects $4 test for rare, terminal disease – WITI FOX 6 Milwaukee

Thursday, January 23rd, 2020

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WISCONSIN RAPIDS They thought their newborn baby was perfect, but a Wisconsin couple soon discovered he had a deadly disease. The FOX6 Investigators found the state of Wisconsin has, so far, declined to test newborns for the rare condition that killed their son.

It's a genetic disorder known as Krabbe disease, which affects fewer than 1 in 100,000 children. Experts say early detection is critical to an affected child's chances of survival. Other states are adding newborn screening for Krabbe, but state officials in Wisconsin say there's not enough research to justify the four-dollar test.

The first day of parenthood is all about nerves, and relief.

"What do I do?!" Kevin Cushman recalls thinking, the day his son, Collin, was born. "'I don't know what to do!' I said, 'Is he OK?' And she said, 'He's perfect.'"

"And he was," said Judy Cushman, Collin's mom. "I mean, he was perfect when he was born. He was perfect."

Kevin always wanted a boy, but he and Judy agreed that's not what mattered most.

"Just as long as they're healthy," he said.

"As long as the child is healthy," Judy repeated. "And I had every reason to believe that my child was going to be healthy."

Ten years later, they can hardly remember thosefirst few months when Collin was just like any other baby.

What they will never forget is when everything changed.

"His whole body is stiff," Kevin says in a home video recorded when Collin was about 9 months old.

That's when Collin's muscles began to get tight. His reactions slowed. He became incessantly irritable. And, eventually, his face fell into an open-mouthed expression that would never go away.

"I remember holding Collin with tears, going, 'What's wrong with my son?'" Kevin said.

The answer was worse than they'd ever imagined. Collin had a rare, genetic disorder known as Krabbe disease. That meant he was going to die at an early age.

"You know, your dreams are shattered," Kevin said.

First, there would be years of tube feedings, vibration machines, and round-the-clock care.

"It was... challenging," Kevin said.

Collin was lucky enough to survive until the age of 9. Most Krabbe children die before they turn 2.

"It's horrifying," said Dr. Barbara Burton, a specialist in genetic medicine at Lurie Children's Hospital of Chicago.

She says Krabbe disease is a form of leukodystrophy that causes the body's nerves to degenerate.

"You lose the coating on the nerve fibers that transmit signals from one nerve cell to another," said Dr. Burton.

"So as the myelin was destroyed, [Collin] slowly lost more and more abilities," his father said.

The disease affects fewer than one in every 100,000 newborns -- perhaps even as few as one in 400,000 -- and there is no cure. There is, however, a way to treat the disease and improve a child's chance of living a longer, more functional life.

"We would've had a totally different boy," Judy said.

The trouble is, the treatment -- a hematopoietic stem cell transplant, or HSCT -- only works to treat Krabbe if it's done within a baby's first 30 days alive. Most parents have no idea their child even has the disease until symptoms surface months later.

"By the time the symptoms show themselves, it's too late," Kevin said. "There's no hope."

In 2018, Dr. Burton joined a team of experts in publishing guidelines that recommend newborns be screened for Krabbe before they leave the hospital. All 50 states already have programs to test newborns for a host of other disorders by pricking the child's heel to draw blood and placing that blood inside circles on a laboratory test card.

"It might just be another circle that they fill out," Kevin Cushman said.

New York was the first state to start testing for Krabbe in 2006, followed by Missouri, Kentucky, Ohio, Tennessee, and Illinois. At least five more states are now working to implement the screening, but so far, Wisconsin has rejected efforts to add Krabbe to the 48 disorders tested for at birth, in part, because there's not enough long-term research to prove the treatment works.

"I hear that argument over and over again, and I think it's ridiculous because the same thing could be said for almost any other condition for which we do newborn screening," said Dr. Burton.

Five years ago, the Cushmans nominated Krabbe disease for inclusion in Wisconsin's newborn screening program, but Chuck Warzecha, deputy administrator for the Wisconsin Division of Public Health, said the test results in too many "false positives."

"There are some risks and emotional impacts on the family when they get that false positive," said Warzecha.

The state's 2015 review of Krabbe testing relied on research that's now more than 10 years old and Dr. Burton says newer testing is more accurate.

"Our technology has gotten much better," said Dr. Burton.

In addition, some Krabbe patients who have gotten transplants are living longer more functional lives.

"We know if it gets detected early that it's treatable," said Senator Patrick Testin, a Stevens Point Republican. He's working on a bill to require Krabbe testing in Wisconsin -- as long as the cost doesn't derail his plan.

"Yeah, that might be a potential roadblock," Testin said.

In 2015, the state said Krabbe screening would cost an extra $300,000 a year, or roughly $4 per test.

"For $4, why wouldn't you?" Judy asked.

"Try to imagine yourself in the shoes of a family who finds out their child has Krabbe disease, and then talk about whether $4 per baby is worth it," Dr. Burton said.

"No child should have to go through this," Kevin said.

Even if Collin had been tested for Krabbe at birth, the Cushmans can't say for sure if they would have gone through with a transplant. The procedure is risky, and some children don't survive.

"I would've given anything to have had that choice," Kevin said. "Even if it didn't change the outcome. As a father, I think I would've felt at least a little more comfortable knowing that I literally did everything I could to save my child."

Of course, the risk of an early death without the transplant is 100%.

On Jan. 6, 2019 -- seven years to the day after Collin was diagnosed -- his father held him for the last time.

"I was gonna hold him as long as it took," he said. "If it took two days before he passed, I was not gonna let go of him."

It's not how the Cushmans imagined things when they welcomed their firstborn child into the world, but they couldn't have asked for a better goodbye.

"Surrounded by family," said Kevin Cushman. "It was perfect."

Krabbe is not on the federal government's recommended list of disorders for newborn screening, but two similar disorders are, including Pompe disease. The state of Wisconsin recently completed a pilot project for Pompe, and they are considering whether to test for it permanently. If they do, DHS says adding Krabbe testing after that would be less expensive than it would have been in the past, because the equipment and training would be similar.

For now, Krabbe is not part of Wisconsin's newborn screening program. The Cushmans intend to keep pushing until it is.

Krabbe is a recessive genetic disorder that is passed down, like blue eyes or attached earlobes. A child is only at risk if both parents are carriers of the mutated gene that causes Krabbe. Even then, there's only a 25% chance the child will get the Krabbe gene from both of them.

Parents can be tested before having a baby to determine if they are carriers of the disease, but -- because it is so rare -- most soon-to-be parents know nothing about it.

Even after Collin was diagnosed, the Cushmans chose to have a second child. This time, they knew there was a 25% risk the second child would have Krabbe. Judy Cushman called it "the worst lottery ever."

Fortunately for them, Kendra Cushman was born without the disease. Five years later, she is symptom free.

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Autistic people have increased incidence of neurological problems – Spectrum

Thursday, January 23rd, 2020

Brain food: Autism appears to be closely linked to headaches.

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People with autism have more brain-related health problems, such as headaches and epilepsy, than typical people do, according to a survey of twins1. The study is the first to look at associations between autism and physical health problems among twins.

The study found no association between autism and other physical conditions, such as gastrointestinal problems and infectious diseases, however.

I find it particularly remarkable that our results are so clear in terms of confirming that [autism] but also autistic traits are associated with neurological alterations, and no other somatic issues are equally associated, says lead investigator Sven Blte, director of the Center of Neurodevelopmental Disorders at the Karolinska Institutet in Stockholm, Sweden. The findings also support the idea that autism is a condition of the brain, Blte says, and not of the immune system or the gut.

Understanding associations such as these can help clinicians look out for autistic peoples health problems. That is particularly important when treating people who may have difficulties communicating, says Thomas Challman, medical director of the Geisinger Autism and Developmental Medicine Institute in Lewisburg, Pennsylvania.

Associated health issues can be really important in maximizing peoples quality of life, Challman says. If there is a higher rate of various other medical conditions in individuals with a developmental condition, we want to have a higher level of alertness in detecting these things.

The researchers surveyed 172 pairs of twins both identical and fraternal enrolled in the Roots of Autism and ADHD Twin Study Sweden. Of this group, 75 pairs have at least one twin with autism; 18 pairs of identical twins have only one twin with autism. Because identical twins who grow up together share a nearly identical genetic background and environment, they are particularly helpful in teasing out how these factors can shape an individuals health.

The researchers gave the participants, who ranged in age from 8 to 31 years, diagnostic exams and the Social Responsiveness Scale, Second Edition, a standard survey of autism traits. The participants or their parents then filled out a questionnaire that asked about the participants history of infectious and cardiovascular diseases, neurological problems such as epilepsy and headaches, gastrointestinal problems such as lactose intolerance, and immunological conditions such as asthma and allergies.

The researchers found that people with an autism diagnosis have more neurological and immunological health problems than those without the diagnosis. They also found that within identical twin pairs in which only one twin has autism, the twin with more neurological problems is more likely to be autistic than the neurotypical twin is.

In their analysis, the researchers weighted common problems such as headaches as equal to rarer problems such as heart defects. This approach may have affected the results, so the team should confirm the finding in a larger sample size, says Lior Brimberg, who was not involved in the research. Brimberg is assistant professor of neuroimmunology at the Feinstein Institute for Medical Research in Manhasset, New York.

The researchers also did not control for age or gender.

The fact that the study did not find an association between autism and gastrointestinal problems is surprising, notes Barbara McElhanon, assistant professor of pediatric gastroenterology at Emory University in Atlanta, Georgia, and a clinician at Childrens Healthcare of Atlanta.

The study may have missed this association because gastrointestinal problems, such as constipation, tend to be transient, she says, and may be more easily forgotten when responding to questionnaires than are persistent conditions such as epilepsy. Only 1.2 percent of the participants with autism and 0.8 percent of those without autism reported experiencing constipation both at the low end of prevalence estimates in the general public, which range from 0.7 to nearly 30 percent.

The study is also important in evaluating how much of autism and its traits are heritable versus environmental, Brimberg says.

Because identical twins share nearly all of their DNA, the association between autism and neurological problems in identical twins suggests that something beyond genetics, such as an interaction between genes and the environment, is at play in the origin of both conditions, Brimberg says.

Theyre almost sharing the same environment, theyre almost sharing the same genetics, and you still dont see 100 percent penetration of [autism], Brimberg says.

Brimberg notes that a study in July concluded that autism is 80 percent heritable2. I think this study suggests that, you know, not necessarily, she says.

The researchers hope to analyze a larger database, such as the Child and Adolescent Twin Study in Sweden, which has more than 32,000 participants. Ultimately, they say, they hope their work will help scientists identify autism subtypes and pathways that underlie the condition.

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Myriad Submits sPMA for myChoice CDx with Zejula in First-Line Platinum Responsive Advanced Ovarian Cancer – GlobeNewswire

Thursday, January 23rd, 2020

SALT LAKE CITY, Jan. 22, 2020 (GLOBE NEWSWIRE) -- Myriad Genetics, Inc. (NASDAQ: MYGN), a leader in molecular diagnostics and precision medicine, announced that it has submitted a supplementary premarket approval (sPMA) application to the U.S. Food and Drug Administration (FDA) for its myChoice CDx test to help predict outcomes of women with first-line platinum responsive advanced ovarian cancer treated with GSKs PARP inhibitor Zejula (niraparib). Myriads filing is based on the positive results from the Phase 3 PRIMA trial of Zejula that was published online in the New England Journal of Medicine in September 2019.

The myChoice CDx test provides valuable molecular insights into tumors and helps identify women with ovarian cancer who are most likely to benefit from PARP inhibitors, said Nicole Lambert, president, Myriad Oncology. This regulatory submission represents another important step forward for precision medicine and ensuring that women have access to the most advanced therapies.

Myriad's myChoice CDx is the most comprehensive homologous recombination deficiency test, enabling physicians to identify patients with tumors that have lost the ability to repair double-stranded DNA breaks, resulting in increased susceptibility to DNA-damaging drugs such as platinum drugs or PARP inhibitors. The myChoice CDx test comprises tumor sequencing of the BRCA1 and BRCA2 genes and a composite of three proprietary technologies (loss of heterozygosity, telomeric allelic imbalance and large-scale state transitions).

About Ovarian CancerOvarian cancer affects approximately 22,000 women per year in the United States according to the American Cancer Society. Typically, ovarian cancer is diagnosed at later stages when it has metastasised to other areas of the body and only 20 percent of patients are diagnosed with early stage disease. Ovarian cancer is one of the deadliest cancers with approximately 14,000 deaths per year attributed to the disease. Patients with certain characteristics such as a family history of the disease, certain genetic mutations such as those in the BRCA1 and BRCA2 genes, obesity and endometriosis face a higher risk from ovarian cancer.

About Myriad GeneticsMyriad Genetics Inc. is a leading precision medicine company dedicated to being a trusted advisor transforming patient lives worldwide with pioneering molecular diagnostics. Myriad discovers and commercializes molecular diagnostic tests that: determine the risk of developing disease, accurately diagnose disease, assess the risk of disease progression, and guide treatment decisions across six major medical specialties where molecular diagnostics can significantly improve patient care and lower healthcare costs. Myriad is focused on five critical success factors: building upon a solid hereditary cancer foundation, growing new product volume, expanding reimbursement coverage for new products, increasing RNA kit revenue internationally and improving profitability with Elevate 2020. For more information on how Myriad is making a difference, please visit the Company's website: http://www.myriad.com.

Myriad, the Myriad logo, BART, BRACAnalysis, Colaris, Colaris AP, myPath, myRisk, Myriad myRisk, myRisk Hereditary Cancer, myChoice, myPlan, BRACAnalysis CDx, Tumor BRACAnalysis CDx, myChoice CDx, EndoPredict, Vectra, GeneSight, riskScore, Prolaris, Foresight and Prequel are trademarks or registered trademarks of Myriad Genetics, Inc. or its wholly owned subsidiaries in the United States and foreign countries. MYGN-F, MYGN-G.

GSK is commercializing ZEJULA. ZEJULA is a registered trademark of GSK.

Safe Harbor StatementThis press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including statements relating to women getting access to the most advanced therapies; and the Company's strategic directives under the caption "About Myriad Genetics." These "forward-looking statements" are based on management's current expectations of future events and are subject to a number of risks and uncertainties that could cause actual results to differ materially and adversely from those set forth in or implied by forward-looking statements. These risks and uncertainties include, but are not limited to: the risk that sales and profit margins of our molecular diagnostic tests and pharmaceutical and clinical services may decline; risks related to our ability to transition from our existing product portfolio to our new tests, including unexpected costs and delays; risks related to decisions or changes in governmental or private insurers reimbursement levels for our tests or our ability to obtain reimbursement for our new tests at comparable levels to our existing tests; risks related to increased competition and the development of new competing tests and services; the risk that we may be unable to develop or achieve commercial success for additional molecular diagnostic tests and pharmaceutical and clinical services in a timely manner, or at all; the risk that we may not successfully develop new markets for our molecular diagnostic tests and pharmaceutical and clinical services, including our ability to successfully generate revenue outside the United States; the risk that licenses to the technology underlying our molecular diagnostic tests and pharmaceutical and clinical services and any future tests and services are terminated or cannot be maintained on satisfactory terms; risks related to delays or other problems with operating our laboratory testing facilities and our healthcare clinic; risks related to public concern over genetic testing in general or our tests in particular; risks related to regulatory requirements or enforcement in the United States and foreign countries and changes in the structure of the healthcare system or healthcare payment systems; risks related to our ability to obtain new corporate collaborations or licenses and acquire new technologies or businesses on satisfactory terms, if at all; risks related to our ability to successfully integrate and derive benefits from any technologies or businesses that we license or acquire; risks related to our projections about our business, results of operations and financial condition; risks related to the potential market opportunity for our products and services; the risk that we or our licensors may be unable to protect or that third parties will infringe the proprietary technologies underlying our tests; the risk of patent-infringement claims or challenges to the validity of our patents or other intellectual property; risks related to changes in intellectual property laws covering our molecular diagnostic tests and pharmaceutical and clinical services and patents or enforcement in the United States and foreign countries, such as the Supreme Court decision in the lawsuit brought against us by the Association for Molecular Pathology et al; risks of new, changing and competitive technologies and regulations in the United States and internationally; the risk that we may be unable to comply with financial operating covenants under our credit or lending agreements; the risk that we will be unable to pay, when due, amounts due under our credit or lending agreements; and other factors discussed under the heading "Risk Factors" contained in Item 1A of our most recent Annual Report on Form 10-K for the fiscal year ended June 30, 2019, which has been filed with the Securities and Exchange Commission, as well as any updates to those risk factors filed from time to time in our Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. All information in this press release is as of the date of the release, and Myriad undertakes no duty to update this information unless required by law.

Excerpt from:
Myriad Submits sPMA for myChoice CDx with Zejula in First-Line Platinum Responsive Advanced Ovarian Cancer - GlobeNewswire

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St. Catherine Hospital Scientists on Pharmacogenomics and Artificial Intelligence – Total Croatia News

Thursday, January 23rd, 2020

January 23, 2020 - A Croatian group of scientists from the St. Catherine Special Hospital participated in the publication of yet another remarkable scientific paper, this time explaining the concept of pharmacogenomics testing based on the principles of artificial intelligence.

"Pharmacogenomics" is one of the world's leading scientific publications in the field of pharmacogenomics (PGx) and their latest issue included an article titled "Pharmacogenomics at the center of precision medicine: challenges and perspective in an era of Big Data".

The authors are a group of the Croatian and American scientists, led by Professor Dragan Primorac, who propose the model of the systematic introduction of PGx testing into clinical practice. Along with that, they propose the implementation of the concept into the health systems of various countries, using Artificial Intelligence (AI) models, as well as some sub-systems within the AI framework, such as so-called Machine Learning.

Through the specific algorithms analysing the data, the patients' data is compared with all the data already deposited in large databases (using the Big Data approach), with the goal of optimising diagnostic procedures, the prevention of disease on time, and personalised treatment. Unlike the typical model of machine learning where the algorithms are defined by certain parameters based on expert knowledge, the concept of AI primarily uses the neural networks, continually evaluating a large amount of data and processing it in a similar manner to human thinking.

Pharmacogenomics analyses a whole series of genes, or even the entire genome, and then studies the connections between the genetic predisposition of an individual and their reaction to a drug. It helps understand why some people respond to some medicines while others don't, why some people need to have the doses of their medicines adjusted to get the perfect therapeutic response, and it can even warn you if a patient won't respond to therapy at all or even when someone will experience toxic side effects.

The model proposed in the paper is based on the experiences by the St. Catherine Hospital and the PGx testing it has been performing in cooperation with OneOme American company (a spin-off company of the famous Minnesotan Mayo Clinic).

The testing uses the RightMed system and analyses 25 genes at the same time (CYP1A2, CYP2B6, CYP2C9, CYP2C19, the CYP2C cluster, CYP2D6, CYP3A4, CYP3A5, CYP4F2, COMT, DPYD, DRD2, GRIK4, HLA-A, HLA-B, HTR2A, HTR2C, IFNL4, NUDT15, OPRM1, SLC6A4, SLCO1B1, TPMT, UGT1A1, VKORC1), which are responsible for the synthesis of the enzymes important for the drug's metabolism (especially the genes of the enzymatic system of cytochrome P450), transport proteins, receptors, other proteins important for the functioning of drugs, as well as those from the HLA system, which is important for the reactions of oversensitivity to medicines.

The system allows for the prediction of the response of each patient for over 300 of the most frequently used medicines, and so the patients are given the possibility to find the one which will help them best. All of the algorithms used in the system related to the use of the genetic information and the selection of the drug and its dosage are following the Clinical Pharmacogenetics Implementation Consortium(CPIC) guidelines.

The algorithm of the analysis of genes responsible for the drug metabolism of each patient will sort them into five categories of metabolizers: slow, intermediary, normal, fast or very fast. The paper also includes a very detailed SWOT (Strength, Weakness, Opportunity, Threat) analysis of the proposed strategy, which can lead to a significant new step in the development of modern medical sciences.

The importance of the introduction of PGx methods into routine clinical practice is best confirmed by the information recently published in the leading American medical sciences journal, JAMA, in which it was said that in the US, more than 2 million hospitalized patients have serious side-effects from the drugs they were given annually, and over 100.000 of them die. Some estimate that the number is even higher today. Today, side-effects from drugs constitute the fourth cause of mortality in all populations. In the US, the health system spends 136 billion dollars a year to mitigate the damage done by the side-effects of drugs. European data shows that between 7 and 13 percent of patients get admitted into hospitals because of the side-effects of drugs, and 30 to 50 percent of patients do not respond to therapy at all.

Professor Dragan Primorac said that the "right therapy for the right patient at the right time" is the key phrase of personalized medicine, however that can't be achieved without an insight into the molecular status of the patient.

Our goal is to reduce the morbidity caused by the side-effects of drugs to the lowest possible level, as well as to integrate pharmacogenomics through the concept of AI with all the other diagnostic procedures into an integrated system which will lead to the optimisation of diagnostic and therapeutical procedures.

The proposed concept of the integration of PGx methods into clinical practice, developed by the scientists from the St. Catherine Special Hospital and the OneOme company, has attracted huge interest on the world's health market, and the first implementation of the model outside of Croatia is soon to start in German health institutions.

More here:
St. Catherine Hospital Scientists on Pharmacogenomics and Artificial Intelligence - Total Croatia News

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