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Use of PD-1/PD-L1 and VEGF Inhibition Combination Is Expanding – Pharmacy Times

May 2nd, 2021 1:53 am

Antivascular endothelial growth factor (VEGF) therapy is used to treat a wide variety of malignancies, in the front-line setting and beyond.4 Sorafenib (Nexavar; Bayer HealthCare Pharmaceuticals Inc) was the first VEGF tyrosine kinase inhibitor (TKI), approved in 2005 for the treatment of advanced renal cell carcinoma.5 After this approval, anti-VEGF therapies began expanding into other areas in cancer care in a similar manner to PD-1/PD-L1 inhibitors.

Results from clinical trials studying the combination of PD-1/PD-L1 and VEGF inhibitors for the treatment of various malignancies began to be published and FDA approvals followed shortly thereafter. The first approved combination of antiPD-1/PD-L1 and anti-VEGF therapy, atezolizumab (Tecentriq; Genentech, Inc) and bevacizumab (Avastin; Genentech, Inc), in December 2018, was for the treatment of metastatic nonsquamous nonsmall cell lung cancer.6 The same combination was also approved for the treatment of hepatocellular carcinoma in May 2020.7

Pharmacology

AntiPD-1/PD-L1 monoclonal antibodies, also termed checkpoint inhibitors, are referred to generally as immunotherapy, and more recently as immuno-oncology. These agents exert anticancer activity by binding PD-1 or PD-L1 that is present on the surface of tumor cells and CD8-positive T cells, thus blocking the interaction. When PD-1 and PD-L1 bind normally, it causes downregulation of the immune system. Therefore, the prevention of these inhibitory signals, in effect, stimulates the immune system to target tumors. Whether the agent is an antiPD-1 or antiPD-L1 monoclonal antibody, the effect is the same.8 At present, FDA-approved antiPD-1 monoclonal antibodies include pembrolizumab, nivolumab, and cemiplimab (Libtayo; Regeneron Pharmaceuticals, Inc), and antiPD-L1 monoclonal antibodies include atezolizumab, avelumab (Bavencio; EMD Serono), and durvalumab (Imfinzi; AstraZeneca Pharmaceuticals LP).9

Anti-VEGF therapies are subdivided into 3 subclasses: orally administered TKIs, intravenous (IV) monoclonal antibodies, and an IV recombinant fusion protein. The TKIs sorafenib, sunitinib (Sutent; Pfizer), pazopanib (Votrient; Novartis Pharmaceuticals Corporation), lenvatinib (Lenvima; Eisai Inc), regorafenib (Stivarga; Bayer HealthCare Pharmaceuticals Inc), cabozantinib (Cabometyx; Exelixis, Inc), axitinib (Inlyta; Pfizer), and vandetanib (Caprelsa; AstraZeneca Pharmaceuticals LP) are multikinase inhibitors, as they bind and antagonize several types of receptor tyrosine kinases in addition to VEGF.10 PDGFRs, FGFRs, and KIT inhibitors also lend their use in diverse malignancies according to driver mutations in these receptors.10

The anti-VEGF monoclonal antibodies are inherently more specific than the TKIs; those on the market include bevacizumab and ramucirumab (Cyramza; Eli Lilly and Company).9 Bevacizumab binds to circulating VEGF type A, preventing it from binding a VEGF receptor. Ramucirumab, on the other hand, binds to the extracellular portion of the VEGF receptor, thereby blocking the binding of VEGF and causing a similar effect.10

Lastly, ziv-aflibercept (Zaltrap; Sanofi-Aventis US LLC) is a recombinant fusion protein with limited indications; it acts as a decoy receptor for VEGF type A and B.11

Combination Therapy

Previous research results have elucidated the role of tumor-produced VEGF in solid tumor angiogenesis in addition to immune system downregulation, which allows for tumor growth and immune system escape.4,12 Although the antiangiogenetic effects of VEGF inhibitors are partly responsible for the disease responses observed, the inhibition of immune system downregulation caused by tumor-produced VEGF is another pharmacodynamic mechanism that can be exploited to achieve better outcomes.4

Considering the anti-immunosuppressive effects of VEGF inhibitors, it stands to reason that synergy is seen when VEGF inhibitors are combined with PD-1/PD-L1 inhibitors.13 Therefore, investigators and drug manufacturers are exploring this combination in several malignancies in which PD-1/PD-L1 inhibitors and VEGF inhibitors currently play a role in treatment, exclusive of one another.

The fundamental approach taken in combination chemotherapy is such that the individual agents in a regimen have differing dose-limiting toxicities and mechanisms. In this manner, multiple agents can be combined with differing adverse effects so that toxicities are not additive. Rather, toxicities that are separated over a range of types can be individually managed while the additive or even synergistic efficacy of all the agents is maintained.14

The strategy of combination therapy began with cytotoxic chemotherapy regimens and has since evolved into targeted and monoclonal antibody therapies, with PD-1/PD-L1 and VEGF inhibitors representing a relatively novel pairing in cancer care. The Table shows a summary of PD-1/PD-L1 and VEGF inhibitor combinations currently approved by the FDA.

Patient Eligibility

AntiPD-1/PD-L1 monoclonal antibodies are often approved with minimum requirements of PD-L1 expression upon tumor staining, which is measured in combined positivity score (CPS) or tumor proportion score (TPS). Tumors with microsatellite instabilityhigh (MSI-H) status or mismatch repair deficiency (dMMR) may be another condition often attached to the indication for antiPD-1/PD-L1 monoclonal antibodies. Notably, only 1 indication for a PD-1/PD-L1 and VEGF inhibitor combination has 1 of these conditions: patients with advanced endometrial cancer must not have MSI-H or dMMR disease status to qualify for treatment with pembrolizumab and lenvatinib.15 No other PD-1/PD-L1 and VEGF inhibitor combinations have these requirements included with their FDA approval, affording more opportunities for patients to benefit from therapy.

Dozens of clinical trials evaluating PD-1/PD-L1 and VEGF inhibitor combinations are listed on ClinicalTrials.gov, and most are actively recruiting. They are assessing combinations along with the addition of chemotherapy and other targeted therapies. Given the number of trials in process and the results previously seen, it is likely that more approvals of this combination are on the horizon.

Conclusions

PD-1/PD-L1 inhibitors continue to change the cancer treatment landscape, and the relatively new combination with VEGF inhibitors represents a promising option for patients with various malignancies. Most likely, the trend of combined PD-1/PD-L1 and VEGF inhibition therapy will keep expanding into areas in which PD-1/PD-L1 and VEGF inhibitors are already being used.

VINCENT J CASCONE, PHARMD, BCOP, is a clinical oncology pharmacist at the University of Kansas Health System in Kansas City.

REFERENCES

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Rise and Fall of Antibiotic Resistance During Infection Driven by Host Immunity and Rapid Evolution – Technology Networks

May 2nd, 2021 1:53 am

Antibiotic resistance poses a serious threat to human health. Resistant infections now cause more than 750,000 deaths per year and are predicted to increase to 10 million deaths per year by 2050. It is known that treating patients with antibiotics is associated with the emergence of resistance - and worse outcomes for patients. But how resistance emerges during infections remains poorly understood.

In a new study published today in Nature Communications, an international team led by Oxford University scientists reports that rapid bacterial evolution interacts with host immunity to shape both the rise, and fall, of resistance during infection.

This study highlights the need to understand better how our immune system works with antibiotics to suppress bacterial infections.

Craig MacLean, co-author and Professor of Evolution and Microbiology at the University of Oxford, said: Our study suggests that natural immunity can prevent resistance during infection and stop the transmission of resistant strains between patients. Exploiting this link could help us to develop new therapeutics to use against bacterial pathogens and to better use the antibiotics that we have now.

The collaborators discovered that antibiotic treatment killed the overwhelming majority of bacteria causing the infection, but bacteria with resistant mutations continued to grow and replicate during treatment. However, they also learned that the resistant mutants had low competitive ability, leading to the loss of resistance after treatment as resistant mutants were replaced by sensitive competitors that managed to escape antibiotic treatment.

Professor MacLean said: Both the rise and fall of resistance during infection are simple and elegant examples of evolution by natural selection.

Host immunity helped to suppress the infection, probably removing >90% of resistant mutants that were present at the start of antibiotic treatment. Host immunity also eventually eliminated the resistant populations that were present after treatment.

The team was able to generate these insights by tracking changes in the bacterial population in a single subject at an unprecedented level of resolution, and combining this with data on patient health and immune function. The bacterial pathogen in this case was Pseudomonas aeruginosa, an opportunistic pathogen that mainly causes infections in hospitalised patients and in people with cystic fibrosis or bronchiectasis.

Professor MacLean said: This is the kind of study that I could have only dreamed of 10 years ago. Technological progress was certainly important to this project, but the real key to our success was increased collaboration and cross-talk between medical researchers and evolutionary biologists.

The research described in this paper is part of a larger ASPIRE-ICU study, which stands for Advanced understanding of Staphylococcus aureus and Pseudomonas aeruginosa Infections in EuRopE Intensive Care Units. The ASPIRE-ICU trial was conducted by the COMBACTE consortium and brought together multiple collaborators from leading academic research labs along with AstraZeneca scientists. The COMBACTE consortium is a major academia-industry collaboration exploring new approaches to antimicrobial resistance.

ReferenceWheatley R, Diaz Caballero J, Kapel N, et al. Rapid evolution and host immunity drive the rise and fall of carbapenem resistance during an acute Pseudomonas aeruginosa infection. Nature Comms. 2021;12(1):2460. doi:10.1038/s41467-021-22814-9

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Pooled CRISPR screening identifies m6A as a positive regulator of macrophage activation – Science Advances

May 2nd, 2021 1:53 am

Abstract

m6A RNA modification is implicated in multiple cellular responses. However, its function in the innate immune cells is poorly understood. Here, we identified major m6A writers as the top candidate genes regulating macrophage activation by LPS in an RNA binding protein focused CRISPR screening. We have confirmed that Mettl3-deficient macrophages exhibited reduced TNF- production upon LPS stimulation in vitro. Consistently, Mettl3flox/flox;Lyzm-Cre mice displayed increased susceptibility to bacterial infection and showed faster tumor growth. Mechanistically, the transcripts of the Irakm gene encoding a negative regulator of TLR4 signaling were highly decorated by m6A modification. METTL3 deficiency led to the loss of m6A modification on Irakm mRNA and slowed down its degradation, resulting in a higher level of IRAKM, which ultimately suppressed TLR signalingmediated macrophage activation. Our findings demonstrate a previously unknown role for METTL3-mediated m6A modification in innate immune responses and implicate the m6A machinery as a potential cancer immunotherapy target.

Macrophages, serving as the first line of host defense, recognize pathogen-associated molecular patterns (PAMPs) of invading pathogens and damage-associated molecular patterns (DAMPs) from stressed or injured cells. These processes involve pattern recognition receptors (PRRs), such as Toll-like receptors (TLRs) (1). Depending on their genetic background and environmental stimuli, macrophages can be polarized to either an M1-like proinflammatory or tumoricidal phenotype with high capacity for antigen presentation and T cell activation or to an M2-like anti-inflammatory or protumoral phenotype with immunosuppressive function (24). Activated macrophages produce large numbers of chemokines and proinflammatory cytokines that attract and activate T cells to eliminate the invading pathogens. Tumor-associated macrophages (TAMs) within the tumor microenvironment represent a functional heterogeneous cell population that has a critical role in orchestrating tumor initiation and progression (3, 5, 6). Macrophage-centered strategies, including macrophage-targeting and TAM tumor-promoting blockade, began to enter clinical trials and show great potential for macrophage-based immunotherapy (3, 6, 7). Therefore, understanding the signaling involved in the activation and plasticity of TAMs will help develop better strategies for cancer immunotherapy.

The discovery of the components of the TLR signaling pathways has significantly advanced our knowledge of innate immune responses, which represent one of the most important evolutionarily conserved innate mechanisms for sensing invading pathogens. One of the most studied TLRs, TLR4, stimulates the myeloid differentiation primary response protein 88 (MyD88)- and TIR domain-containing adapter protein-inducing interferon (TRIF)dependent pathways, activating the transcription factor nuclear factor B (NF-B) and mitogen-activated protein kinases (MAPKs) and consequently inducing type I interferons and inflammatory cytokines such as tumor necrosis factor (TNF-) and interleukin-6 (IL-6) (8, 9). It has been demonstrated that negative regulation of the TLR signaling is strongly associated with the pathogenesis of inflammation and autoimmune diseases (1013). We and others have shown that IL-1 receptorassociated kinase 3 (IRAK3), also known as IRAKM, is an essential negative regulator of TLR signaling pathways (1417). The expression of IRAKM induced by the activation of macrophages prevents the dissociation of IRAK and IRAK4 from MyD88 and inhibits the formation of IRAK-TRAF6 (TNF receptorassociated factor 6) complexes. These effects of IRAKM suppress NF-B activation and the expression of inflammatory cytokines and chemokines in macrophages, preventing the development of pathologic immune reactions (10, 14). However, it remains unknown whether the posttranscriptional regulation, particularly the epigenetic modification of RNA, is involved in the control of innate immune responses in macrophages.

RNA modifications, especially the formation of N6-methyladenosine (m6A), represent one of the most delicate posttranscriptional mechanisms regulating gene expression (18). m6A, the most abundant mRNA modification, is modulated by m6A writer, eraser, and reader. The m6A writer complex comprises the catalytic core consisting of methyltransferase like 3 (METTL3) and methyltransferase like 14 (METTL14) and the adapter proteins Wilms tumor 1 associated protein (WTAP), RNA binding motif protein 15 (RBM15), vir like m6A methyltransferase associated (VIRMA), zinc finger CCCH-type containing 13 (ZC3H13), and Cbl proto-oncogene like 1 (CBLL1) (19, 20). It has been extensively documented that m6A is involved in pre-mRNA splicing, mRNA export, initiation, translation, and, predominantly, mRNA degradation (21, 22). m6A methylation has been regarded as a key regulator in various biological and pathological processes (19, 21), but its function in the immune system has not been recognized until recently (23). Our previous studies demonstrated that silencing the m6A methyltransferase METTL3 disrupts T cell homeostasis by targeting the IL-7/signal transducer and activator of transcription 5 (STAT5)/suppressor of cytokine signaling (SOCS) pathway and causes a systemic loss of the suppressive function of regulatory T cells (Tregs) (24, 25). The METTL3-mediated m6A modification on Cd40, Cd80, and TIR domain containing adaptor protein (Tirap) transcripts enhances their translation in dendritic cells, promoting dendritic cell activation (26). Together, these studies indicate that m6A methylation plays an essential role in the maintenance of immune cell homeostasis and function. In addition, the deletion of m6A demethylase alkB homolog 5, RNA demethylase (ALKBH5) in macrophages has been recently demonstrated to inhibit viral replication in vivo and in vitro (27, 28). The m6A reader YTH N6-methyladenosine RNA binding protein 3 (YTHDF3) suppresses interferon-dependent antiviral responses by promoting forkhead box O3 (FOXO3) translation (29). In addition, the loss of YTHDF1 in classical dendritic cells enhances the cross-presentation of tumor antigen and the cross-priming of CD8+ T cells in vivo (30). These findings, which highlight the significance of m6A modification in the immune response, prompted us to explore further the function of METTL3-mediated m6A modification in macrophage activation and polarization and the role of TAMs during tumorigenesis.

Here, we have identified METTL3 as a positive regulator of the innate response of macrophages by pooled RNA binding protein (RBP) CRISPR-Cas9 screening. We have demonstrated that Mettl3 deficiency in macrophages attenuates their ability to fight against pathogens and eliminate tumors in vivo, suggesting that METTL3-mediated m6A modification is required for proper activation of macrophages. We have shown that Mettl3 deficiency impairs the TLR4 signaling pathway in macrophages by inhibiting the degradation of Irakm transcripts. Thus, the present work uncovers the epitranscriptional control of the innate immune response of macrophages, providing a novel strategy to target the m6A machinery for macrophage-based cancer immunotherapy.

The posttranscriptional regulation of TLR signaling and proinflammatory cytokines is fine-controlled during macrophage activation. However, these processes have not been adequately studied. Therefore, we have investigated the posttranscriptional events in mRNA metabolism that are tightly regulated by RBPs to orchestrate fundamental cellular processes. To screen RBPs critical for macrophage activation, we prepared customized pooled RBP CRISPR-Cas9 screens. TNF- was selected as the readout for the targeted RBP CRISPR screening since this cytokine represents the primary response during macrophage activation and can be easily detected by flow cytometry. Moreover, TNF- has also been shown to act as a master regulator of inflammatory cytokine synthesis, and its aberrant production is associated with the pathogenesis of several inflammatory diseases (31, 32). We have compiled and synthesized a targeted lentivirus mini-library with 7272 single guide RNAs (sgRNAs) targeting 782 genes coding for classical RBPs known in the mouse genome, as well as positive and negative controls with 10 gRNAs for each gene (listed in the Supplementary Materials). We have also generated a Raw 264.7 macrophage cell line stably expressing Cas9 and validated its functionality and effectiveness (fig. S1A). In each of the two replicate screens, 109 Cas9-expressing Raw 264.7 cells were infected with a lentivirus library at a multiplicity of infection (MOI) of 0.3. After selection with puromycin for 7 days, cells were stimulated with LPS and sorted on the basis of TNF- expression (Fig. 1A and fig. S1B). sgRNAs from cells with high (TNF-Hi) and low (TNF-Low) TNF- expression and from cells harvested on the last day of selection before sorting (presort) were amplified and sequenced. The top-ranked sgRNA enriched in TNF-Hi or TNF-Low cells showed high concordance between biological screen replicates (Fig. 1B). As expected, sgRNAs targeting known positive regulators (e.g., Myd88 and Irf3) and negative regulators (e.g., Zfp36 and Tnfaip3) of the LPS response were enriched in TNF-Low and TNF-Hi cells, respectively, demonstrating the success and high quality of the screens (Fig. 1C).

(A) Scheme of pooled CRISPR-Cas9 screening of RBPs playing critical roles in macrophage activation. Briefly, Cas9-expressing Raw 264.7 cells were infected with lentivirus library containing sgRNAs targeting RBP genes in the mouse genome. After selection with puromycin for 7 days, the cells were stimulated with LPS and sorted by flow cytometry on the basis of the expression levels of TNF-. (B) Venn diagrams showing the overlap between the top 100 ranked candidate genes enriched in TNF-Low and TNF-Hi populations in two replicate screens. (C) Volcano plot showing sgRNA-targeted genes enriched in the TNF-Hi (blue) and TNF-Low (red) populations. Known positive regulators (purple), negative regulators (green), and m6A modulators (black) of TNF- production in macrophages are highlighted. (D) Protein level of METTL3 and the overall RNA m6A methylation levels in WT and Mettl3-KO Raw 264.7 cells were measured by Western blotting and m6A dot blot assay. (E) Expression of TNF- in METTL3-depleted and control Raw 264.7 cells after LPS stimulation measured by flow cytometry. MFI, median fluorescence intensity; NT, not treated. (F) GO enrichment analysis of down-regulated transcripts in Mettl3-KO Raw 264.7 cells compared to WT control cells. (G) Heatmap illustrating the expression of transcripts downstream of the TLR4 signaling pathway in Mettl3-deficient and WT Raw 264.7 cells. (H) Expression of TNF- in bone marrowderived macrophages (BMDMs) from Mettl3flox/flox;Lyzm-Cre and Mettl3flox/flox control mice upon LPS stimulation measured by flow cytometry. Data are shown from two experiments (B and C), as a representative result of three independent experiments (D), or as means SEM (E and H).*P < 0.05 and ****P < 0.0001 (unpaired two-tailed Students t test).

Besides the known regulators, we have also found that sgRNAs targeting the components of the m6A writer complexMettl3, Mettl14, Rbm15, and Nudt21were highly enriched in the top-ranked hits in TNF-Low cells. These results indicate important functions and a general role of m6A modification in the activation of macrophages (Fig. 1C). To validate the involvement of m6A in macrophage activation, Mettl3 was knocked out in Raw 264.7 cells using CRISPR with new sgRNAs, and the deficiency of Mettl3 and the substantial decrease in the overall RNA m6A methylation level were confirmed (Fig. 1D). Consistent with the CRISPR screen results, the expression of TNF- and IL-6 in Mettl3-depleted Raw 264.7 cells stimulated with LPS was markedly reduced in comparison to control cells (Fig. 1E and fig. S1, C to H). To further explore the biological effects of m6A deficiency on macrophages, we performed RNA sequencing (RNA-seq) analysis on Mettl3 knockout (KO) and wild-type (WT) control Raw 264.7 cells. The Gene Ontology (GO) enrichment analysis documented that the down-regulated transcripts in Mettl3-KO Raw 264.7 cells were enriched in innate immune response related to defense and external stimulus (Fig. 1F). Notably, in both replicates of RNA-seq, transcripts of the downstream components of the TLR4 signaling pathway, such as proinflammatory cytokines (Tnf-, Il-6, Il-1, Il-18, and Il-23) and costimulation molecules (Cd86), were down-regulated in Mettl3-deficient cells (Fig. 1G), suggesting that METTL3 has a critical function in controlling the innate immune response of Raw 264.7 macrophages.

To further confirm the biological role of the m6A modification in macrophages, Mettl3 conditional KO (CKO) mice were generated by crossing Mettl3flox/flox mice with mice expressing Cre recombinase under the control of lysozyme 2 promoter (Lyzm-Cre). We have documented the loss of both the METTL3 protein and the overall m6A modification in bone marrowderived macrophages (BMDMs) from Mettl3flox/flox;Lyzm-Cre mice (fig. S1I). No differences in the frequency of major immune cell populations were observed between Mettl3flox/flox mice and Mettl3flox/flox;Lyzm-Cre mice in steady state, indicating that the depletion of Mettl3 did not affect the development and maturation of macrophages (fig. S1J). Next, we examined whether METTL3 affects macrophage activation. Consistent with the results obtained in Raw 264.7 cells, BMDMs from Mettl3flox/flox;Lyzm-Cre mice showed significantly decreased expression of proinflammatory cytokines, such as TNF-, IL-6, IL-1, and IL-12, upon LPS stimulation (Fig. 1H and fig. S1K). Together, these results demonstrate that METTL3 promotes the activation of macrophages.

Notably, the m6A readers, including YTHDF1, YTHDF2, YTHDF3, YTHDC1, YTHDC2, IGF2BP1, IGF2BP2, IGF2BP3, HNRNPC, and HNRNPA2B1, did not reach significance in either TNF-Low or TNF-High population (fig. S2A and table S1), indicating that these genes either play a minimal role or have redundant functions in regulating the LPS-induced Tnf- production. To further assess the functional role of m6A readers in macrophages, small interfering RNAs (siRNAs) were used to knock down the expression of Ythdf2 and other readers, including Ythdf1, Ythdf3, and Ythdc1 in bone marrow derived macrophages (BMDMs) (fig. S2B). As shown in fig. S2C, we found that knocking down Ythdf2, Ythdf3, or Ythdc1 individually had a minor impact on Tnf- expression upon LPS stimulation, whereas knocking down Ythdf1 decreased the expression of Tnf-, and markedly higher down-regulation of Tnf- was seen when knocking down the expression of Ythdf1, Ythdf2, and Ythdf3 simultaneously. These results suggested the functional redundancy of YTHDF proteins in the innate immune response of macrophages (33, 34). In addition to the involvement of m6A modification in the activation of macrophages by LPS, other pathways associated with the mRNA metabolic process have also been found by GO and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the top 100 ranked hits in TNF-Hi and TNF-Low cells (fig. S2, D to G), which merits further exploration.

Upon recognizing invading pathogens, macrophages are activated to produce proinflammatory cytokines, such as TNF- and IL-6, that enhance the defense response of the host, facilitating pathogen clearance. To test the screen results in vivo, we investigated the physiological role of m6A modification in the macrophage-mediated defense against LPS-producing Gram-negative bacteria. For this purpose, Mettl3flox/flox; Lyzm-Cre mice and Mettl3flox/flox littermates were infected orally with S. typhimurium and sacrificed 4 days after infection to assess the inflammation and bacterial load in the intestine and other organs. Mettl3flox/flox;Lyzm-Cre mice showed significantly lower body weight than Mettl3flox/flox littermates (Fig. 2A) and had a higher bacterial load in the feces and cecum (Fig. 2, B to D). Furthermore, Mettl3flox/flox; Lyzm-Cre mice had a higher bacterial burden in the spleen and liver than Mettl3flox/flox littermates (Fig. 2, E and F). Together, these data suggest that METTL3 promotes the antibacterial activity of macrophages in vivo.

(A) Body weight of Mettl3flox/flox;Lyzm-Cre (n = 14) and their Mettl3flox/flox littermates (n = 10) measured 2 and 3 days after S. typhimurium infection. (B to F) Bacteria load of the feces (B and C), cecum (D), spleen (E), and liver (F) of infected Mettl3flox/flox;Lyzm-Cre (n = 14) and Mettl3flox/flox littermates (n = 10) measured by counting colony-forming units (CFU) in cultures of serially diluted homogenates of organs on MacConkey agar plates. Data are shown as representative results of three independent experiments (A to F) or as means SD of indicated determinants (B to F). *P < 0.05 and **P < 0.01 (unpaired two-tailed Students t test).

Given the function of m6A in promoting macrophage activation, we next sought to determine the role of METTL3 in macrophage-mediated antitumor immunity. Therefore, MC38 murine colon adenocarcinoma cells were subcutaneously implanted into the flanks of Mettl3flox/flox; Lyzm-Cre mice and their Mettl3flox/flox littermates. The growth of tumors was significantly faster in Mettl3flox/flox;Lyzm-Cre mice (Fig. 3, A and B, and fig. S3A). The mice were sacrificed 3 weeks after injection, and tumor-infiltrating immune cells were characterized by flow cytometry and real-time quantitative polymerase chain reaction (qPCR). There was no significant difference in the percentage of tumor-infiltrating lymphocytes between Mettl3flox/flox;Lyzm-Cre mice and Mettl3flox/flox littermates (fig. S3B). Notably, TAMs from Mettl3flox/flox;Lyzm-Cre mice exhibited reduced M1-like markers, such as the proinflammatory cytokine TNF- and the costimulatory protein CD86 (Fig. 3, C to E, and fig. S3C), while the expression of the mannose receptor CD206, a well-established M2-like marker, was increased in comparison with TAMs from Mettl3flox/flox mice (Fig. 3F and fig. S3C). These differences indicate that Mettl3 deficiency promotes the immunosuppressive function of TAMs. In addition, the expression of major histocompatibility complex II (MHC II) was comparable in TAMs from Mettl3flox/flox;Lyzm-Cre mice and Mettl3flox/flox littermates (fig. S3C). Consistent with these observations, both tumor-infiltrating CD4+ and CD8+ T cells from Mettl3flox/flox;Lyzm-Cre mice displayed a more exhausted phenotype, as evidenced by the elevated expression of the immune checkpoint receptor programmed cell death 1 (PD-1) (Fig. 3, G and H, and fig. S3D). Furthermore, in comparison with Mettl3flox/flox mice, BMDMs from Mettl3flox/flox;Lyzm-Cre mice were characterized by blunted TNF- production after the stimulation with MC38 tumor culture medium (TCM) (Fig. 3, I and J) and increased formation of the M2-like marker Arg-1 after either TCM or IL-4 stimulation (Fig. 3K and fig. S3E). Collectively, these data demonstrate that METTL3 promotes the tumoricidal ability of macrophages by facilitating the polarization bias of TAMs toward the M1 type macrophages.

MC38 cells were subcutaneously injected into the flanks of Mettl3flox/flox;Lyzm-Cre mice and their Mettl3flox/flox littermates. The tumor was excised, and tumor-infiltrating cells were characterized by flow cytometry and real-time qPCR. (A) Representative images of tumors excised from Mettl3flox/flox;Lyzm-Cre mice (n = 10) and Mettl3flox/flox littermates (n = 10) 21 days after cell injection. Photo credit: Jiyu Tong, Shanghai Jiao Tong University School of Medicine. (B) Tumor growth in Mettl3flox/flox;Lyzm-Cre mice (n = 10) and Mettl3flox/flox littermates (n = 10). (C and D) Relative expression of Mettl3 (C) and Tnf- (D) in TAMs from Mettl3flox/flox;Lyzm-Cre mice (n = 4) and Mettl3flox/flox littermates (n = 4) measured by real-time qPCR. (E and F) Flow cytometry profile and MFI of CD86-positive (E) and CD206-positive (F) TAMs from Mettl3flox/flox;Lyzm-Cre mice (n = 4) and Mettl3flox/flox littermates (n = 4). (G and H) Fractions of intratumoral PD-1positive CD4+ T cells (G) and PD-1positive CD8+ T cells (H) measured by flow cytometry (n = 3). (I and J) BMDMs from Mettl3flox/flox;Lyzm-Cre mice and Mettl3flox/flox littermates were stimulated with medium conditioned by MC38 tumor cells in vitro. The expression of TNF- was measured by flow cytometry and shown as a histogram (I) and MFI (J). Arg-1 expression in TAMs from Mettl3flox/flox;Lyzm-Cre mice and Mettl3flox/flox littermates measured by real-time qPCR after TCM or IL-4 treatment. Data are shown as representative results of three independent experiments (A, E, F, and I), as means SD (B, G, and H), or as means SEM (C to F, J, and K). *P < 0.05 and ***P < 0.001 (unpaired two-tailed Students t test).

To distinguish whether macrophage activation was impeded by the disruption of m6A modification rather than an m6A-independent activity of METTL3, we performed rescue experiments by overexpressing WT METTL3 (METTL3-WT) or catalytic mutant METTL3 (METTL3-MUT) in BMDMs from Mettl3flox/flox;Lyzm-Cre mice and Mettl3flox/flox littermate controls. The expression of TNF- in BMDMs from Mettl3flox/flox;Lyzm-Cre animals could only be restored by the Mettl3-WT, but not Mettl3-MUT constructs (fig. S4A). Since Tnf- mRNA can also be m6A-modified according to the m6AVar database, we hypothesized that Tnf- might be directly regulated by m6A. First, the degradation rate of Tnf- mRNAs was measured using RNA decay assays. Both Mettl3-depleted and WT Raw 264.7 cells were treated with the transcription inhibitor actinomycin D, and the changes in the abundance of Tnf- transcripts over time were measured by qPCR. The degradation of Tnf- mRNAs was similar in Mettl3-depleted Raw 264.7 cells and WT control cells (fig. S4B). Next, a mutagenesis assay was performed to directly assess the effect of m6A modification on TNF- expression. The assay used a WT Tnf- construct in which WT Tnf- 5 untranslated region (5UTR) and WT Tnf- 3UTR were replaced with either Tnf- 5UTR-MUT or Tnf- 3UTR-MUT harboring a point mutation in m6A sites predicted according to the m6AVar database (fig. S4C). The coding region of Tnf- was substituted with a green fluorescent protein (GFP) coding region to allow direct measurement of TNF- expression. A similar level of GFP expression was observed when human embryonic kidney (HEK) 293 cells were transfected with the same amount of each construct (fig. S4D). Therefore, these experiments demonstrated that although macrophage activation was indeed regulated by the m6A catalytic activity of METTL3, Tnf- mRNA was not the direct target of the m6A modification.

It is well established that the engagement of PAMPs or DAMPs with TLR4 receptors activates MyD88- and TRIF-dependent pathways and ultimately induces the synthesis of proinflammatory cytokines required for pathogen clearance or the destruction of tumor cells (6, 35). Since a defective expression of a broad range of cytokines was observed (Fig. 1G and fig. S1K), we hypothesized that the TLR4 receptor and its downstream pathway were compromised in Mettl3-deficient macrophages and could represent the direct m6A targets. Upon LPS stimulation, the phosphorylation of p65, p38, c-Jun N-terminal kinase (JNK), and extracellular signalregulated kinase (ERK) in Mettl3-deficient BMDMs was markedly decreased, but the total levels of these proteins were comparable between BMDMs from Mettl3flox/flox;Lyzm-Cre mice and their Mettl3flox/flox littermates (Fig. 4A). These data indicate that the Mettl3 deficiency probably affects molecules upstream of the NF-B and mitogen-activated protein kinase (MAPKs) pathways. Therefore, we examined the expression levels of essential upstream adaptors in the TLR4 pathway, including Tirap, Myd88, Traf6, Irak1, Irak4, Trif, and Tram, using real-time qPCR. The expression of these key adaptors was similar in WT and Mettl3-deficient BMDMs (Fig. 4B). However, we have noted that the mRNA and protein levels of Irakm, a well-established negative regulator of the TLR signaling pathway, were remarkably increased in Mettl3-deficient BMDMs in either steady-state or upon LPS stimulation (Fig. 4, A and C). The expression of IRAKM in WT macrophages was reduced immediately after LPS stimulation and began to recover 2 hours after TLR4 activation. This phenomenon was strongly inhibited in Mettl3-KO macrophages, resulting in a sustained overexpression of IRAKM (Fig. 4A and fig. S4E). Thus, we have raised the possibility that the overexpression of IRAKM caused by Mettl3 deficiency is responsible for the inhibition of TLR4 activation. To test this hypothesis, rescue experiments were performed by introducing either Irakm small hairpin RNA (shRNAs) (sh-Irakm) or control shRNAs (sh-CTL) into Mettl3-deficient BMDMs (Fig. 4D). Consistent with our prediction, the decrease in TNF- production in Mettl3-deficient BMDMs was largely reversed by the shRNA-mediated knockdown of Irakm (Fig. 4E). Together, these data indicate that the overexpression of Irakm in Mettl3-deficient macrophages suppresses the TLR4 signaling and consequently inhibits macrophage activation.

(A) Activation of the TLR4 signaling pathway in Mettl3-KO and Mettl3-WT BMDMs upon LPS stimulation was analyzed by Western blotting of p65, JNK, p38, ERK, and IRAKM. (B) Relative expression of Tirap, Myd88, Traf6, Irak, Irak4, Trif, and Tram in Mettl3flox/flox;Lyzm-Cre mice and Mettl3flox/flox littermates measured by real-time qPCR. (C) Relative expression of Irakm in control (NT) and LPS-treated Mettl3flox/flox;Lyzm-Cre and Mettl3flox/flox littermates measured by real-time qPCR. (D) Knockdown efficiency of shRNA targeting Irakm in BMDMs measured by real-time qPCR (n = 3). (E) TNF- synthesis in WT BMDMs transfected with control shRNA (sh-CTL) and Mettl3-deficient BMDMs transfected with sh-CTL or IRAKM shRNA (sh-IRAKM) measured by flow cytometry (n = 3). Data are shown as representative results of three independent experiments (A) or as means SEM (B to E). **P < 0.01 and ***P < 0.001 (unpaired two-tailed Students t test).

In addition, we tested other TLR pathways known to be regulated through IRAKM, especially TLR3 and TLR9. Similarly, TNF- production of BMDMs from Mettl3flox/flox; Lyzm-Cre mice was significantly decreased upon poly (I:C) or CpG stimulation (fig. S5A and S5B). Thus, m6A regulates TLR-mediated macrophage activation through Irakm.

RNA m6A methylation is involved in multiple aspects of RNA metabolism (36), predominantly affecting RNA stability. Mettl3 deficiency results in a significantly decreased m6A marker and, in turn, retards RNA decay of m6A target transcripts (37, 38). To assess whether the deletion of Mettl3 can decrease m6A methylation of Irakm mRNA, we profiled the transcriptome-wide m6A modification in WT and Mettl3-deficient Raw 264.7 cells using m6A immunoprecipitation followed by high-throughput sequencing (MeRIP-seq). Specific m6A peaks were clearly enriched in the 3UTR of Irakm mRNAs in WT cells, but the deletion of Mettl3 eliminated the Irakm m6A peaks completely (Fig. 5A). Notably, we did not detect significant m6A peak reduction in the Tnf- transcript (fig. S6A) and did not observe any significant m6A peaks throughout Il-6 transcript (fig. S6B), indicating that Tnf- and Il-6 are not direct m6A targets in macrophages. In agreement with the sequencing data, MeRIP-qPCR demonstrated that Irakm mRNA from WT but not Mettl3-deficient macrophages was immunoprecipitated by m6A-specific antibody (Fig. 5B). Together, these findings document that Irakm transcripts are bona fide m6A targets in macrophages.

(A) Specific m6A peaks enriched in the 3UTR of Irakm mRNAs in Raw 264.7 macrophages profiled using MeRIP-seq. CDS, coding sequences. (B) m6A peaks enriched in the 3UTR of Irakm mRNAs in WT cells were lost in Mettl3-KO Raw 264.7 cells. (C) WT or Mettl3-deficient BMDMs were treated with the transcription inhibitor actinomycin D, and the level of Irakm transcripts was measured over time. (D) Relative luciferase activity of pGL4-luc2 with WT-3UTR (IRAKM-WT) or with IRAKM-3UTR containing mutated m6A sites (IRAKM-MUT) transfected into HEK293T cells was measured. The firefly luciferase activity was normalized to Renilla luciferase activity. Data are shown as representative results of three independent experiments (A) or as means SEM (B to D). **P < 0.01 and ****P < 0.0001; NS, not significant (unpaired two-tailed Students t test).

To further test whether the up-regulation of IRAKM resulted from the decreased degradation of m6A-deficient Irakm transcripts, we have performed RNA decay assays by treating either WT or Mettl3-deficient BMDMs and Raw 264.7 cells with actinomycin D and measured the abundance of Irakm transcripts over time (Fig. 5C and fig. S6C). At 3 hours after actinomycin D treatment, Irakm mRNA level was significantly higher in Mettl3-deficient BMDMs and Raw 264.7 cells than in the WT control cells (Fig. 5C and fig. S6C). To directly evaluate the role of m6A in modulating the stability of Irakm mRNA, luciferase reporter assays were conducted. In comparison with WT Irakm-3UTR (Irakm-WT) constructs, the ectopically expressed constructs harboring m6A mutant Irakm-3UTR (Irakm-MUT) showed substantially increased luciferase activity (Fig. 5D). We also constructed a plasmid harboring IRAKM with either WT-3UTR or m6Amut-3UTR. Consistent with our previous results, we found that the transcription level of Irakm with m6Amut-3UTR was notably higher than that of Irakm with WT 3UTR (fig. S6D). In addition, we also tested the effect of METTL3 deficiency on transcription of Irakm mRNA. As shown in the fig. S6E, we found that the transcription rate of Irakm mRNA only slightly increased upon Mettl3 KO. Therefore, the effect of METTL3 deficiency on Irakm expression was a combination of both transcription and decay but mainly due to decelerated degradation of Irakm mRNAs. Collectively, these data demonstrate that METTL3-mediated m6A modification promotes the TLR4 signaling mainly by accelerating the degradation of Irakm mRNAs.

A novel mechanism has recently been revealed by which m6A methylation facilitates the decay of the chromosome-associated regulatory RNAs (carRNAs), including promoter-associated RNAs (paRNAs), enhancer RNAs (eRNAs), and repeat RNAs, affecting local chromatin state and downstream transcription (39). To assess the potential function of Mettl3 on chromatin openness and nascent transcripts synthesis in BMDMs, we performed deoxyribonuclease I (DNase I)terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphate nick end labeling (TUNEL) and 5-ethynyl uridine (EU) labeling assays in BMDMs from Mettl3flox/flox and Mettl3flox/flox;Lyzm-Cre mice (fig. S7, A and B). Similar chromatin accessibility and nascent transcripts synthesis were observed between WT and Mettl3-deficient BMDMs (fig. S7, A and B). Furthermore, by analyzing the m6A-modified carRNAs in macrophages based on our MeRIP-seq data, we did not identify any significant m6A peaks on paRNA and eRNA upstream of Tnf- and Irakm (fig. S7, C and D), under the conditions that successfully called significant m6A-marked carRNAs for genes such as Vars (fig. S8A). In addition, no significant carRNAs were identified in BMDMs for TLR-related genes, including TRIAP, MyD88, TRAF6, IRAK4, and TRAM (fig. S8, B to E). Further, although carRNAs of Irakm were observed in mouse embryonic stem cells (mESCs) (table S4), no significant Irakm carRNAs were identified in BMDMs of our MeRIP-seq data. In addition, our MeRIP-qPCR results showed that the levels of Irakm carRNAs were largely unchanged with knockout of METTL3 in BMDMs, except for a slight decrease in Irakm eRNA(+), which may account for the slightly increased transcription of Irakm in METTL3-KO BMDMs. Therefore, in contrast to the findings in mESCs, our results demonstrated that in macrophages, m6A regulates TNF-a production by targeting the degradation of Irakm mRNA.

RBPs play a vital role in RNA metabolism, which is tightly connected to all aspects of cellular functions. However, the mechanisms by which RBP-mediated RNA regulation affects the activation of innate immune cells are largely unknown. Here, we have identified METTL3 as a positive regulator of the innate response of macrophages by using pooled RBP CRISPR-Cas9 screens. Specifically, we have demonstrated that METTL3-mediated m6A modification of Irakm mRNA accelerates its degradation, resulting in reprogramming macrophages for activation. These findings provide a previously unappreciated mechanism for epitranscriptional control of innate response in macrophages. Nevertheless, we have not observed high-ranked individual m6A readers in either TNF-Low or TNF-Hi cell population in our pooled RBP CRISPR-Cas9 screening. The functional redundancy of YTHDF proteins appears to exist in the innate immune response of macrophages (33, 34), and our data show that the simultaneous knockdown of Ythdf1, Ythdf2, and Ythdf3, in contrast to knocking down each of these readers individually, can significantly reduce Tnf- expression upon LPS stimulation.

Recent studies have shown that transcripts of key genes of the innate immune signaling pathway are marked by m6A modifications, which are required for the maintenance of proper innate antiviral responses (27, 28, 40, 41) or are essential for dendritic cell activation (26), indicating that the m6A modification is implicated in innate immune responses. Our data document that Mettl3 deficiency in macrophages reduces their proinflammatory cytokine production and thus suppresses their ability to defend against pathogens and eliminate tumors. Thus, the METTL3/m6A modification appears to be required for macrophage activationmediated innate immunity.

Activation of the TLR4 signaling and subsequent induction of effective positive feedback to augment immune response by proinflammatory cytokines has a pivotal role in eliminating invading pathogens. However, the magnitude of the immune response must be tightly regulated to avoid pathologic immune reactions. A previous study has shown that TLR4 activation could negatively regulate the stimulation of macrophages by inducing the expression of Irakm (14). Our data document that Mettl3-KO macrophages have a higher level of IRAKM expression than their WT counterparts, resulting in reduced TLR4 signaling. Except for TLR4 signaling, we observed that Mettl3 deficiency could decrease TNF- expression upon the activation of TLR3 or TLR9 signaling individually. These data support our previously proposed m6A working model in which m6A acts as a gas pedal specifically targeting immediate-early response genes, such as Socs in T cells and Irakm in macrophages, to trigger their rapid degradation and to ensure that the immune cells can quickly respond to the external stimuli and adapt to the environment (24). Later on, these cells increase the expression levels of Socs or Irakm genes to brake the signaling by a feedback mechanism, thus preventing its overactivation.

The MeRIP-seq data demonstrated that Irakm transcripts were marked by m6A modifications, removal of which retarded the degradation of Irakm mRNA, and the resulting excess of IRAKM protein blocked the TLR4 signaling. Thus, Irakm mRNA decay controlled by m6A modification represents a novel mechanism of releasing the brake from the TLR4 signaling pathway. Consistently, our previous study showed that m6A modification selectively targets the transcripts of the SOCS family genes, the gatekeeper of the IL-7/STAT5 signaling pathway, accelerating their degradation necessary to reprogram naive T cells for differentiation and proliferation (24). It was also demonstrated that IRAKM promotes lung tumor growth (42) and fibrosis in multiple organs (15, 43) by skewing macrophage toward an alternative activated phenotype. Mettl3-deficient mice displayed enhanced tumor growth. TAMs and BMDMs from Mettl3flox/flox;Lyzm-Cre mice polarized with either TCM or IL-4 exhibited elevated M2-related markers, suggesting that the balance of macrophage polarization was modulated at an epitranscriptional level by the m6A modification of Irakm mRNA.

A recent study reported that the m6A modification promotes dendritic cell activation by enhancing the translation of target transcripts, CD40, CD80, and Tirap (26). However, our MeRIP-seq data documented that CD40 transcripts were not m6A-marked, indicating that the targets of m6A modification may be cell type specific. Moreover, the m6A peaks of CD80 and Tirap mRNA were not affected in Mettl3-deficient macrophages, suggesting the presence of additional unidentified m6A writer (s) catalyzing the m6A modification of CD80 and Tirap transcripts in macrophages; such a possibility warrants further investigation.

The high ranking of m6A writer genes in our CRISPR screening indicates the fundamental importance of m6A regulation in macrophage activation. It has been recently reported that m6A on carRNAs can globally tune chromatin state and transcription (39). However, neither did we observe a difference in chromatin openness and nascent RNA synthesis between BMDMs from Mettl3flox/flox mice and Mettl3flox/flox;Lyzm-Cre mice, nor did we identify a significant m6A peak on paRNA and eRNA upstream of Tnf- and Irakm. Moreover, no significant carRNAs from TLR-related genes were identified. Therefore, in contrast to the observations in mESCs, our results demonstrated that in macrophages, m6A regulates the levels of TNF- posttranscriptionally, mostly by targeting the degradation of Irakm mRNA. In addition, we found that the m6A levels of carRNAs for Esrrb, Kmt2d, and LINE, which have been proven to be decreased in Mettl3-KO mESCs, were not totally decreased in Mettl3-KO BMDMs (fig. S9). The difference in m6A effects on chromatin status between METTL3-KO mESCs and METTL3-KO BMDMs may reflect differences in cellular contents and environmental context of stimuli-sensitive immune cells versus pluripotent ESCs (21, 34).

In summary, our study demonstrates that m6A modification represents a novel mechanism controlling the innate immune response of macrophages against environmental stimuli. In addition, the obtained results suggest that targeting m6A modulators might be an effective therapeutic approach for inflammatory diseases and cancer.

Mettl3flox/flox mice were generated as previously described (24) and crossed with Lyzm-Cre mice (the Jackson laboratory, Bar Harbor, ME, USA) to obtain CKO mice. The animals were maintained in specific pathogenfree facilities and used according to protocols approved by Animal Care and Use Committees of the Shanghai Jiao Tong University School of Medicine.

Age- and sex-matched Mettl3-WT and Mettl3-KO mice were infected orally with S. typhimurium strain ATCC 14028 at 108 bacteria per mouse. Body weights were monitored daily. Four days after infection, the bacterial burden in the spleen, liver, colon, and feces was determined by counting the colony-forming units (CFU) of the homogenized tissue on MacConkey agar plates.

MC38 murine colon adenocarcinoma cells were provided by Q. Zou, Shanghai Institute of Immunology of Shanghai Jiao Tong University, Shanghai. MC38 cancer cells were injected subcutaneously into 8-week-old female mice (5 105 cells per mouse). Tumor growth was measured as the tumor area.

For the pooled CRISPR screen, we designed 7272 sgRNAs targeting 782 RBPs using CRISPR-FOCUS (http://cistrome.org/crispr-focus/), listed in table S2. sgRNAs were cloned into lenti-puro-guide plasmid following an established protocol (31). Lenti-sgRNA constructs and packaging vectors (pMD2.G and psPAX2) were cotransfected into HEK293T cells, and virus-containing supernatant was collected. Cas9-expressing Raw 264.7 cells were infected with the lentiviral library at an infection rate of 30% and selected with puromycin. Seven days after selection, the infected cells were stimulated with LPS (100 ng/ml) plus brefeldin A for 6 hours and fixed and stained with phycoerythrin (PE)conjugated TNF- antibody for fluorescence-activated cell sorting.

The genomic DNA of cells collected just before sorting or sorted on the basis of TNF- expression was isolated. The sgRNA library was barcoded and amplified with primers listed in table S3 for two rounds of PCR. Amplicons were purified and quantified for sequencing on Illumina HiSeq. The sequencing data generated from the screen and raw sgRNA counts have been submitted to the National Center for Biotechnology Information (NCBI) Database of Gene Expression Omnibus (GEO) Dataset under accession number GSE162469.

Total RNA from Raw 264.7 cells or BMDMs was extracted and enriched in mRNA with Dynabeads mRNA Purification Kit (Thermo Fisher Scientific, Ambion, 61006). mRNAs were then denatured at 95C for 3 min and chilled on ice immediately. A 2-l drop of mRNA was applied directly onto Amersham Hybond-N+ membrane (GE Healthcare, RPN203B) and cross-linked to the membrane by Stratalinker 2400 UV Crosslinker. Unbounded mRNA was washed off with TBST [1 phosphate-buffered saline (PBS) supplemented with 0.02% Tween 20] for 5 min at room temperature and blocked with 5% nonfat milk in TBST for 1 hour at room temperature. The m6A level was determined with an anti-m6A antibody (Synaptic Systems, 202003).

Cells were collected and lysed on ice for 30 min in radio-immunoprecipitation assay buffer containing cocktails of protease and phosphatase inhibitors, and the supernatants were subject to Western blot analysis.

BMDMs and Raw 264.7 cells were stimulated with LPS, IL-4, or TCM along with Golgi inhibitor for the indicated time. Then, single-cell suspensions were prepared from either cultured cells or tumor samples and incubated with antibody cocktails for 15 min at 4C for cell surface staining. For intracellular cytokine staining, cells were fixed with BD Fixation/Permeabilization buffer (BD 554714) for 30 min at 4C and subsequently stained with antibodies for 30 min at 4C. Data were recorded on BD LSRFortessa X-20 and analyzed with FlowJo software.

MC38 cancer cells were cultured in Dulbeccos modified Eagles medium (DMEM) supplemented with 10% fetal bovine serum (FBS) for 72 hours. The supernatant was collected, centrifuged, and stored at 80C for further use.

Bone marrow cells were isolated from the hind leg femur of mice and differentiated into macrophages in DMEM supplemented with 10% FBS (Gibco) and 20% L929 cell culture supernatant for 7 days. Differentiated BMDMs were collected and replated in DMEM without the L929 cell culture supernatant for 12 hours and then stimulated with LPS (Sigma-Aldrich L2880, 10 ng/ml) and IL-4 (PeproTech 214-14-20, 25 ng/ml) for M1 and M2 polarization, respectively.

pLVX-IRES-ZsGreen lentiviral vectors were a gift from Q. Zou (Shanghai Institute of Immunology, China). Lentiviruses encoding Mettl3 and their mutants in pLVX-IRES-ZsGreen plasmids were produced in 293T cells, then collected, filtered through a 0.22-m MCE membrane (Millipore), and used to infect BMDMs. MG-guide retrovirus vectors were a gift from R.A.F. (Department of Immunobiology, Yale University School of Medicine, USA). Retroviruses expressing specific shRNA targeting Irakm in MG-guide plasmids were produced and used to infect BMDMs as described above. The shRNA target Irakm transcripts are listed in table S3. The WT and m6A motif disrupted 3UTRs of Irakm were synthesized and cloned into MG-guide plasmids.

siRNAs targeting Ythdf1, Ythdf2, Ythdf3, and Ythdc1 were transfected into BMDMs using Lipofectamine RNAiMAX (Invitrogen, Carlsbad, CA, USA) according to the manufacturers instructions. The cells were analyzed 48 to 72 hours later. The siRNA sequences are listed in table S3.

The analysis of chromatin openness with DNase ITUNEL assay was performed according to the method of Liu et al. (39). Briefly, BMDMs were permeabilized by 0.1% Triton X-100 in PBS for 10 min before digesting with DNase I (0.2 U/ml; New England Biolabs) and then fixed in 4% paraformaldehyde. Subsequently, the TUNEL assay (DeadEnd Fluorometric TUNEL System, Promega) was performed according to the manufacturers instructions and followed by DAPI staining. Images were captured with an Olympus FV3000 confocal microscope, and the intensity of the nuclear TUNEL signal was quantified using ImageJ software.

Nascent transcripts synthesis was analyzed according to the method of Liu et al. (39). Briefly, BMDMs were cultured on precoated cover glasses. A nascent RNA synthesis assay was conducted 24 hours later using the Click-iT RNA Imaging Kit (Invitrogen, C10329) according to the manufacturers protocol. Images were captured with an Olympus FV3000 confocal microscope, and the intensity of the signal was quantified using ImageJ software.

Nascent transcription rate was analyzed according to the method of Liu et al. (39). Briefly, BMDMs were seeded to the same amount of cells. After 48 hours, EU was added to 0.5 mM at 60, 30, 20, and 10 min before trypsinization collection. Total RNA was purified by TRIzol, and nascent RNA was captured by using Cell-Light EU Nascent RNA Capture Kit (RiboBio). RNA amount and EU adding time were fitted to a linear equation, and the slope was estimated as transcription rate of RNA.

The m6A level of chromosome-associated RNAs was analyzed according to the method of Liu et al. (39). Briefly, total RNA was isolated from the chromosome-associated fraction of BMDMs, and nonribosomal RNA was further enriched by using Ribo-off rRNA Depletion Kit (human/mouse/rat; Vazyme). Fragmentation and MeRIP-qPCR were performed following the protocol in this paper.

RNA purification, reverse transcription, library construction, and sequencing were performed at WuXi NextCODE (Shanghai, China) according to the manufacturers instructions (Illumina). Briefly, polyadenylated mRNA was purified from total RNA using oligo-dTattached magnetic beads and fragmented by the fragmentation buffer. Taking these short fragments as templates, the first-strand cDNA was synthesized using reverse transcriptase and random primers, followed by the second-strand cDNA synthesis. The synthesized cDNA was subjected to end repair, phosphorylation, and A base addition, according to Illuminas library construction protocol. Next, Illumina sequencing adapters were added to both sides of the cDNA fragments. After PCR amplification for DNA enrichment, the target fragments of 200 to 300 base pairs (bp) were cleaned up.

After library construction, Qubit (Thermo Fisher Scientific) was used to quantify the concentration of the resulting sequencing libraries, while the size distribution was determined using the Agilent Bioanalyzer 2100 (Agilent). Then, the Illumina cBot cluster generation system with HiSeq PE Cluster Kits (Illumina) was used to generate clusters. Paired-end sequencing was performed at WuXi NextCODE (Shanghai, China) using an Illumina HiSeq system following the manufacturers protocols for 2 150 paired-end sequencing. These RNA-seq data have been deposited on GEO public database under the accession number GSE162248.

Total RNA from WT or Mettl3-KO Raw 264.7 cells (with or without LPS stimulation) was extracted with the TRIzol reagent (Thermo Fisher Scientific, 15596018), and approximately 100 g of total RNA for each condition was fragmented to ~100 bp in length with fragmentation buffer (10 mM tris-HCl and 10 mM ZnCl2). The RNA size after the fragmentation was validated by 2200 TapeStation detection (Agilent). A sample of 100 ng of the fragmented RNA was saved as the input control, while the remaining RNA was mixed with 50 l of protein A magnetic beads (Thermo Fisher Scientific, 10002D) and 50 l of protein G magnetic beads (Thermo Fisher Scientific, 10004D) premixed with 10 g of anti-m6A antibody (Merck Millipore, ABE572). The samples were incubated for 4 hours at 4C in IP buffer [10 mM tris-HCl, 30 mM NaCl, and 0.1% (v/v) IGEPAL CA-630 supplemented with ribonuclease (RNase) inhibitor]. The beads were washed twice with 1 IP buffer, twice with low-salt IP buffer [50 mM NaCl, 10 mM tris-HCl (pH7.5), and 0.1% IGEPAL CA-630], and twice in 1000 l of high-salt IP buffer [500 mM NaCl, 10 mM tris-HCl (pH7.5), and 0.1% IGEPAL CA-630]. RNA was eluted and purified with the RNeasy kit (QIAGEN) and eluted with 15-l RNase-free water. Both input and enriched RNA samples were used for library preparation with TruSeq Stranded Total RNA Library Prep Human/Mouse/Rat (Illumina) according to the manufacturers instructions.

For MeRIP-qPCR, approximately 1 g of total RNA from WT or Mettl3-KO BMDMs was used. The input and enriched RNA were prepared using the same protocol as described above, but with scaled-down reagents, and dissolved in 10 l of RNase-free water. The enrichment of m6A was analyzed using the LightCycler 480. Myc peak and Myc body were used, respectively, as a positive and negative control for MeRIP-qPCR.

The raw reads were mapped to mouse ribosomal RNA sequences using bowtie2 to remove the reads that came from ribosomal RNA. The unmapped reads were then mapped to the mouse genome (GRCm38.p6 and gencode.vM20) using STAR. The potential bias caused by PCR amplification was removed using the Picard Mark Duplicates command. For m6A-seq data, the fragment coverage of each base of all transcripts was calculated using custom script. The peak calling algorithm was modified from Ma et al. (44). To calculate the enrichment score, the average fragment coverage of the window was used instead of the read count. The m6A level on carRNAs upstream of indicated genes was analyzed according to the method from Liu et al. (39). The m6A RIP-seq data from this study have been deposited to GEO series GSE162254.

BMDMs were seeded on 24-well plates with 1 million cells per well. Actinomycin D was added at a final concentration of 5 M. Cells were collected (after 0, 0.5, 1, 2, and 3 hours), and total RNA was extracted for real-time qPCR. Data were normalized to the t = 0 time point.

pGL4-luc2 (Firefly luciferase) vector of the Dual-Luciferase Reporter Assay System (Promega, E1910) was used to determine the function of m6A modification within the 3UTR of Irakm transcripts. The assay was performed according to the manufactures instruction: Briefly, 100 ng of WT or m6A-mutant IRAKM-3UTR and 25 ng of pRL-TK (Renilla luciferase) control vector were cotransfected into HEK293T cells in triplicates. The relative luciferase activity was accessed 24 to 48 hours after transfection.

All data are presented as means SEM. Comparisons between groups were analyzed by the unpaired two-tailed Students t test or two-way analysis of variance (ANOVA). Statistical analysis was performed using Prism 6 (GraphPad).

Acknowledgments: We thank M. Yang, S. Hu, Y. Zhou, and all other members of the Hua-Bing Li laboratory for discussions and comments. Funding: This work was supported by the National Natural Science Foundation of China (91753141/82030042/32070917 to H.-B.L., 81822021/91842105 to S.Z., 81801550 to J.T., and 81901580 to Y.L.), the Shanghai Science and Technology Committee (grant no. 20JC1417400/201409005500/20JC1410100 to H.-B.L.), the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning (to H.-B.L.), the start-up fund from the Shanghai Jiao Tong University School of Medicine (to H.-B.L.), the National Key R&D Program of China (2018YFA0508000) (to S.Z.), the Strategic Priority Research Program of the Chinese Academy of Sciences (XDB29030101) (to S.Z.), and the Howard Hughes Medical Institute (to R.A.F.). Author contributions: H.-B.L. conceived the project and designed the research. J.T., X.W., and Y.L. designed and performed the murine portion of the study. H.-B.L., J.T., and X.W. analyzed and interpreted the data and wrote the manuscript. X.R., A.W., and S.Z. performed and analyzed the bacterial infection model. Y.L. and J.Y. generated Mettl3-deficient Raw 264.7 cells, and Y.L., J.Y., and K.M. helped with experiments involving Raw 264.7 cells. Q.Z. provided MC38 cells. Z.C. and Y.Z. helped with analyzing RNA-seq data. W.P., Q.Z., Y.Z., Q.X., J.L., S.Z., R.A.F., and H.-B.L. discussed the projects. This study was supervised by H.-B.L. and R.A.F. All authors read and approved the final manuscript. Competing interests: R.A.F. is a consultant for GSK and Zai Lab Ltd. All other authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Sequenced reads have been deposited in the NCBI GEO database (accession nos. GSE162254, GSE162248, and GSE162469). Additional data related to this paper may be requested from the authors.

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Hip pain when walking: Causes and treatment – Medical News Today

May 2nd, 2021 1:52 am

Hip pain when walking is a common problem, according to a 2015 study. It is usually caused by problems in the following areas:

Arthritis is a major cause of hip pain when walking. There are over 100 types of arthritis and people of all ages can develop it.

Osteoarthritis (OA) and rheumatoid arthritis (RA) are types of arthritis that affect the joints.

Arthritis typically causes an ache and stiffness in the affected area.

Osteoarthritis is one of the most common types of arthritis. It is caused by cartilage between the bones breaking down, which eventually allows the bones to rub together.

This can cause pain, stiffness and reduced movement. A person with OA in the hip may also feel pain in the groin, buttocks, and sometimes on the inside of the knee or thigh.

Treatments for OA include:

Rheumatoid arthritis (RA) occurs when a persons immune system is not working properly and attacks the joints.

A person with RA in the hip may experience pain, stiffness, and swelling in the hip, thigh, or groin. It usually affects both hips.

Treatments for RA include:

Tendons are the tissues that connect skeletal muscle to bone.

When tendons are inflamed, they can become swollen, irritated, or painful. This condition is called tendinitis, and is often caused by injury or overuse of the tendons.

A person with tendinitis may feel a dull ache where the tendon and bone meet.

Treatments for tendinitis include:

The iliotibial (IT) band is made up of fascia fibers that run from the lateral hip to the top of the shin.

The IT band can tighten if overused, causing inflammation and pain. It most often causes pain in the knee when bending, with referred pain in the hip.

Treatments for IT band tightness include:

Small, fluid-filled sacs called bursae reduce friction between muscles, bones, and tendons around joints. When the bursae become inflamed it is called bursitis.

A person with bursitis will feel pain near the affected joint. A person may develop bursitis if they overuse their muscles.

According to the Arthritis Foundation, bursitis commonly affects the hips, which may be tender and ache during movement.

Treatments for bursitis include:

Labral tears can affect the labrum, which is a ring of cartilage that helps to keep the head (ball) of the femur in place in the acetabulum (socket) of the pelvis.

Labral tears are a major cause of pain in people with symptomatic hip dysplasia. A person with a hip labral tear will feel pain across the entire hip and may experience a clicking sound and locking or a shifty feeling in the joint.

Treatments for labral tears include:

Hip flexor strain can occur when the hip flexor muscles, which connect the femur to the lower back and hip, are injured or strained. This can make it harder to move your knee and thigh upwards to your chest.

A person will usually feel a cramping or pain in the upper leg and a tugging feeling in the thighs and groin.

Treatments for hip flexor strain include:

Sprains or strains can happen when a person overuses the muscles and ligaments in their hips and legs. A person may feel a sharp pain that gets worse with activity.

Treatments for sprains and strains include:

Toxic synovitis is an inflammatory condition of the hip joint that primarily affects children. A person with toxic synovitis may feel pain spreading across the hip area that may increase when bearing weight.

Treatments for toxic synovitis include rest and pain treatment medication, such as an NSAID.

Avascular necrosis, also called osteonecrosis, limits or stops blood flow to the hip joint and other joints. A person with this condition may feel a dull or throbbing ache in the hip that may spread to the groin.

Treatments for avascular necrosis or osteonecrosis include:

According to a 2014 study, most people fracture their hip joint because of a fall. Risk factors for hip fractures include low levels of activity, low bone density, and long-term medication use.

A person with a hip joint fracture will feel pain in the groin and may not be able to put weight on the affected side.

Treatments for a fractured hip joint include:

Osteoporosis condition causes brittle, weak bones. According to a 2002 study, bone fractures can affect almost any bone because of osteoporosis.

A person may feel severe, sudden pain in the hip that worsens with movement.

Treatment of osteoporosis includes:

Joints contain a small amount of fluid. When a joint is affected by arthritis, especially an inflammatory type such as rheumatoid arthritis, fluid can build up in the joint and cause swelling.

A person with joint effusion may feel associated pain that ranges from mild to sharp.

Treatments for joint effusion include:

Hip dislocation happens when the femur slips out of place in the hip socket. According to a 2018 study, a person should seek and receive treatment within 6 hours of the injury to avoid further damage.

A person who has dislocated their hip may feel severe pain, and the hip joint may feel loose and unsteady.

Treatments for dislocation include a closed reduction, which involves a doctor carefully applying force to put the hip back into its socket, or an open reduction, which involves a doctor cutting into the joint, removing excess bone or tissue, and re-positioning bones.

Osteomyelitis of the hip is an inflammatory bone disease typically caused by microorganisms infecting the bone(s) of the hip joint. It leads to progressive bone destruction and loss.

A person may experience related muscle spasms and deep, aching pain in the pelvis and/or upper leg.

The type of treatment a person will have depends on the type of osteomyelitis.

Treatment for acute osteomyelitis includes antibiotics or antifungal medication.

Treatment for sub-acute osteomyelitis, or chronic osteomyelitis, includes:

Nerve problems near the hip joint can also cause pain in the hip when walking.

A pinched (entrapped) nerve can occur in the hip region. A nerve can be pinched by bones, tendons, or ligaments, which causes nerve signals to be irritated by pressure or friction.

A person may experience sharp pain in the thigh, buttocks, groin, and hip, as well as reduced ability in movement, numbness, or tingling.

Treatments include:

Sciatica refers to pain caused by irritation to the sciatic nerve. Sciatica is a symptom rather than a condition. This means a person should work with a doctor to find the cause of sciatica to improve their symptoms.

The sciatic nerve is the longest and widest nerve in the body and runs from the buttock to the feet.

A person may feel mild to severe pain that can be felt in the buttock, hip, and legs.

Treatments for sciatica include:

Sacroiliitis refers to inflammation where the sacral spine joins the pelvis bone, which usually causes pain that may worsen with standing or walking.

Treatments for sacroiliitis includes:

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Hip pain when walking: Causes and treatment - Medical News Today

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COMAQUATICS water workouts are helping people with arthritis – NewsWest9.com

May 2nd, 2021 1:52 am

Members at an aquatic center here in Midland are exercising in the pool to help ease their daily arthritis pains

MIDLAND, Texas More than 54 millions in Americans including 300,000 children live with arthritis everyday and battle the daily challenges that it brings.

COM Aquatics in Midland, water workouts and exercises are taught to members at the center.

Ronald Houdek has been coming to the center for over a year and has noticed a difference.

"I was almost not able to do anything, now I can get out and do errands and walk around somewhat," says Houdek.

Rita Simmons is the director at COM Aquatics and she's noticed great improvement among members.

"The first thing that they see is their balance and their strength, mobility, flexibility, functional movement during the day those are some things our members see," says Simmons.

"An individual may be coming in on a walker or a wheelchair and then getting excited with them when I see them walking on a cane or walking independently it's really neat to see the progress," Simmons says.

Progress is something that Alathea Blischke has seen since starting water walking.

"It was my rheumatologist who sent me here because I have arthritis. When I first came it was about 15, 17 years ago I hobbled into my first class and I went striding out at the end of the semester," says Blischke.

She went on to say, "I step in first it's my ankles, they start to feel good then my legs, my hips, up body, shoulders, I can feel relief coming."

Members continue to make waves of progress and they encourage other to join in on this exercise.

"I definitely advise it for anybody a lot of people have the pains that I do the arthritis and the rheumatism. It's very good it's a lifesaver," says Houdek.

COM Aquatics is partnering with the Arthritis Foundation to host a Water Walk to Cure Arthritis this Friday. at COM Aquatics in Midland from 8AM - 6PM. If you'd like to take part, you can honor the 54 million Americans dealing with arthritis by giving 54 dollars, telling 54 people and moving for 54 minutes. For more information, click here.

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COMAQUATICS water workouts are helping people with arthritis - NewsWest9.com

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What can people with arthritis do to manage their pain while waiting for surgery? – Barchester Healthcare

May 2nd, 2021 1:52 am

One of the various consequences of the COVID-19 pandemic has been an increase in waiting times for routine surgeries and hospital treatments, as NHS resources have been dedicated to fighting the virus.

This has left many people facing longer waits for procedures that could help them to manage debilitating or painful health conditions, such as joint replacements for those with arthritis.

In response to this situation, Versus Arthritis - the UK's largest charity dedicated to supporting people living with the condition - has offered some advice on managing pain while waiting for surgery.

Arthritis affects people of all ages, but is more common in the elderly. According to the National Institute for Health and Care Excellence, X-ray studies have shown that at least 50 per cent of people over the age of 65 show evidence of osteoarthritis, the most common form of the condition.

Pain, stiffness and restricted movement in the joints are among the main symptoms of arthritis, meaning it can have a particularly significant impact on older people, sometimes leading to a requirement for full-time care.

Family members whose loved ones are struggling to live with arthritis while waiting for surgery could be wondering what they might be able to do to help.

Versus Arthritis offered a number of tips that people can pass on to elderly relatives to help them alleviate or cope with pain in their joints.

As well as painkillers such as paracetamol, ibuprofen and non-steroidal anti-inflammatory drugs, there are options such as using a TENS (transcutaneous electrical nerve stimulation) machine - a small, battery-operated device that relieves pain by administering mild electrical currents to the skin.

Heat pads, hot water bottles, ice pads or cold compresses can also help, as can self-massage to stretch tight muscles. Some people find foam rollers useful to relieve stiffness and tension.

The charity also highlighted the importance of trying to stay in generally good health. Exercising regularly, even if it's only for a short time, can improve mobility, strengthen muscles and ease pain, as well as preparing the body to recover after surgery. If walking is too painful, other activities like swimming or chair yoga can be beneficial.

Maintaining a good diet is also one of the best ways for people to boost their general wellbeing, reduce the strain on their joints and prepare for surgery.

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What can people with arthritis do to manage their pain while waiting for surgery? - Barchester Healthcare

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Throat spray, oral drug for malaria-arthritis effective in reducing spread of Covid-19: Study – Mint

May 2nd, 2021 1:52 am

The findings were made based on a large-scale clinical trial conducted last May, involving more than 3,000 migrant workers living in Tuas South Dormitory in the Industrial District of Singapore, Channel News Asia reported.

During the six-week trial, workers were given a povidone-iodine throat spray, which can be bought off the counter, and oral hydroxychloroquine, which requires a prescription.

Both were found to reduce the incidence of coronavirus infection, according to the study.

This is the first study to demonstrate the benefits of prophylactic, or preventive therapy with either oral hydroxychloroquine or povidone-iodine throat spray in reducing SARS-CoV-2 infection among quarantined individuals living in a closed and high exposure setting," said lead author of the clinical study, Associate Professor Raymond Seet from the National University Hospital (NUH).

The two drugs were chosen because they are easily available, said Dr Seet. He also noted that they protect the throat, the key entry" for viruses.

He was presenting the study at the National University Health System and was accompanied by co-investigators Professor Paul Tambyah, Associate Professor Mikael Hartman, Associate Professor Alex Cook and Assistant Professor Amy Quek.

The findings have been published in the International Journal of Infectious Diseases.

A total of 3,037 asymptomatic healthy men aged between 21 and 60 were involved in the trial on a voluntary basis.

Participants were excluded if they had any symptoms of respiratory illnesses like fever, cough or loss of smell a month before the start of the trial. Those who had previous COVID-19 infection were also not included.

Enrolment took place in May last year amid a "slow but steady increase in (COVID-19) numbers", at the dormitory, Dr Seet said.

It was publicised to dormitory residents from countries like India, Bangladesh, China and Myanmar.

A translator had explained the study protocol, highlighting the voluntary basis of participation.

The povidone-iodine throat spray had to be used thrice a day. After six weeks, more than half of the participants had tested positive for COVID-19.

But among those who used the throat spray, only 46 per cent contracted the disease. This is compared to 49 per cent among those who took hydroxychloroquine and 70 per cent who took vitamin C.

We concluded that povidone-iodine throat spray was associated with a statistically significant reduction in infection by an absolute risk of reduction of 24 per cent while oral hydroxychloroquine was associated with a statistically significant reduction in infection by an absolute risk of reduction of 21 per cent," the channel quoted Dr Seet as saying.

This was after adjustments were made for "potential confounders", like nationalities and compliance to medications.

"This is a very simple intervention with virtually minimal side effects where we could actually cut the transmission rates in a meaningful way," Dr Hartman said.

The drugs can complement other preventive measures in high-risk settings, said researchers.

"Such settings include cruise ships, prisons, refugee camps and meat processing facilities, where there may be a pressing need for additional means to prevent spread," Dr Seet said.

Prof Tambyah gave the example of an outbreak in a nursing home.

"It's not something we are recommending across the board If there's an outbreak, then certainly that is something that's worth considering," he said.

Researchers stressed that the drugs are not meant to be used for COVID-19 prevention in the general community if it is a lower-risk setting.

The coronavirus has so far claimed 30 lives in Singapore along with 60,966 confirmed cases, according to Johns Hopkins University.

This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed.

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Throat spray, oral drug for malaria-arthritis effective in reducing spread of Covid-19: Study - Mint

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Todd McKenney on his big Botox mishap and dancing around his arthritis – Starts at 60

May 2nd, 2021 1:52 am

I make sure my mental health is always looked after as well. I think sometimes people forget about it, but I get lots of sleep so I dont just work.

While Todd might have nailed the balancing act that is a busy life in showbiz now, he says he did once cave into the pressures of the industry. Being constantly under the cameras gaze took its toll in 2012 when Todd says he gave in and found himself getting Botox a decision he jokes made him look like an ageing queen from the Gold Coast. Now, he says hes finally learned to embrace the ageing process and is even on a first-name basis with his wrinkles.

I got sucked into it because everyone was getting it and I just went with it, he said. I looked at myself on TV on one episode of Dancing with the Stars and I looked ridiculous.

I had to go on TV every week looking like that! I was like, what have I done. Ill never ever ever do it again. My face set like granite and so when I talk I use my face, I gesticulate, Im a storyteller. Id go on stage and Id be telling these stories and I knew that I wasnt getting the physical facial chaos and so I felt trapped in my own skin. I hated it.

Im now loving my wrinkles, Ive embraced them. I love them and Ive named them. Ive got these two on my forehead, Ada and Elfie. Ive just embraced it.

After a couple of years as a professional dancer, Todd says he quickly learned the importance of diversifying his skill set, after watching many dancers careers cut short because of the harsh toll it took on their body. And so, he added singing to his arsenal and his career began to show the first signs of just how successful he would become.

I always knew that Id do it, I just never knew Id still be doing it at 55, he said. Dancing has been great but Ive got arthritis, so Im now just sort of focusing on the other areas. It became very clear to me that I had to focus on singing and more of an all-round entertaining arsenal if I wanted longevity. Nowadays, I still dance but dance is actually what I do least in my shows. I dont just sit still, its very energetic but I like a chat, I like singing.

Perth in the 1980s didnt offer Todd a lot of opportunities to get into roles as a professional male dancer, but with his mum and grandma being dance teachers he was lucky to essentially grow up at the back of a dance studio, which he joked was cheaper than a babysitter. The early exposure to dance clearly sparked something in him, and by the age of 10 hed gotten into ballroom dancing and eventually would go on to represent Australia at international ballroom dance competitions.

While he always knew he was destined for stardom, his mum was a little more pragmatic and made him get a real job as a backup. When I left school, I was a travel agent. Mum made me have something to fall back on as all good parents do in our industry and I kept saying I dont need anything, Im going to make it, he laughed. I got a job at a travel agency, and then showbiz called.

Todd says the real turning point for his career is one hell be forever indebted to Peter Allen for, and that was his highly successful lead role in The Boy from Oz. He says the role put him on the map and set him up for his future role on Dancing with the Stars and allowed him to do his one-man shows.

Todd McKenney sings Peter Allen and lots more will celebrate his huge debt of gratitude toward the singer-songwriter, but also feature hits from his all-time favourite performers including Bette Midler, Tom Jones, Barry Manilow and Prince. The performer said the cabaret-style show is like a fabulous dinner party with friends. The interactive performance includes lots of chatting with the audience, banter, jokes and stories which Todd says, makes the show incredibly unpredictable and a lot of fun.

When I do these shows, the chat for me is as important as the singing and dancing, he said. So, I think its really important by the end of the show [the audience] get a sense of me, who I am and my humour.

Get your tickets to Todd McKenney sings Peter Allen and lots more here. Todd is only performing his show in Melbourne so get in quick before it sells out!

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Todd McKenney on his big Botox mishap and dancing around his arthritis - Starts at 60

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Rheum Round-up: More Rheumatic Pts Got Flu Shot, VTE in PsA, and more – DocWire News

May 2nd, 2021 1:52 am

As the United States looks to combat vaccine hesitancy, at least one group is feeling even more confident in a vaccinebut not the COVID-19 shot: Patients with autoimmune rheumatic diseases (ARDs) had a higher rate of flu vaccinations during the pandemic, researchers discovered.

A total of 1,015 patients were interviewed. A greater proportion of patients received the flu shot during the pandemic (2020-21 season) than before (2019-20 season). Fewer than 1% of patients who got the shot reported disease flares.

In the pre-pandemic period, patients were more likely to say their rheumatologist did not recommend the shot compared to during the pandemic. During both flu seasons, other reasons patients skipped out on the shot included they didnt think it would have any benefit, they didnt feel it was safe, and other.

Another study analyzed the prevalence of and risk factors for venous thromboembolism (VTE) in patients with psoriasis and psoriatic arthritis (PsA). Final analysis included 2,433 patients, and there were 26 incident VTEs. The incident rate of the first VTE was 12 events per 10,000 patient-years. By age 80, 4.6% of patients had developed their first VTE. Factors independently correlated with VTE were older age, diabetes mellitus, and corticosteroid usage.

Finally, a study compared golimumab treatment retention among patients with rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA), and PsA. Compared to patients with RA, those with AxSpA or PsA had higher rates of retention. Further, retention rates were higher when golimumab was a first-line treatment instead of third or later. Use as first-line biological therapy, having AxSpA or PsA (instead of RA), and concomitant methotrexate therapy were all correlated with increased golimumab retention, while steroid use reduced retention.

In Case You Missed It

Flu Shot Rates Increased During COVID-19 Pandemic among Patients with Autoimmune Rheumatic Diseases

Risk Factors for VTE in Patients with Psoriasis, Psoriatic Arthritis

Golimumab Treatment Retention Comparison: RA, AxSpA, and PsA

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Rheum Round-up: More Rheumatic Pts Got Flu Shot, VTE in PsA, and more - DocWire News

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NOT REAL NEWS: A look at what didn’t happen this week – Associated Press

May 2nd, 2021 1:52 am

A roundup of some of the most popular but completely untrue stories and visuals of the week. None of these are legit, even though they were shared widely on social media. The Associated Press checked them out. Here are the facts:

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Posts misrepresented a report from Israel on shingles cases

CLAIM: Herpes, shingles may be a side effect of the COVID-19 vaccine.

THE FACTS: Social media posts misrepresented a report from doctors in Israel. The report from researchers at the Tel Aviv Medical Center and Carmel Medical Center describes six mostly mild cases of shingles, also known as herpes zoster, that occurred shortly after vaccination with one or two doses of the Pfizer COVID-19 vaccine. The six cases were from among 491 women with rheumatoid arthritis or related disorders who received the vaccine. The report did not establish a definite link between shingles and the vaccine. Shingles is caused by the reactivation of the virus that causes chickenpox in people who had the childhood disease. The chickenpox virus, varicella-zoster, is one of several herpes viruses. A different herpes virus causes cold sores and herpes. The report was published two weeks ago in the journal Rheumatology. Social media users subsequently posted misleading claims that the COVID-19 vaccine may cause herpes, a sexually transmitted infection. Wow, whats next? Now they given people Herpes? an Instagram user falsely wrote. In their report, the researchers said the report wasnt designed to determine if the vaccine was triggering shingles the numbers were too small, and people with rheumatoid arthritis who hadnt been vaccinated werent included. Further monitoring is warranted, they wrote. Our report does not establish any causality or definite link but draws the attention to a possible association between mrna COVID-19 vaccine and herpes zoster, Dr. Victoria Furer, lead author of the report and rheumatologist at the Tel Aviv Medical Center, told the AP in an email. Dr. William Schaffner, an infectious disease expert at Vanderbilt University, said U.S. reporting on vaccine side effects hasnt shown an increase in shingles among people whove gotten a COVID-19 vaccine. Change can happen, but at the moment, U.S. surveillance systems do not indicate that shingles is occurring more frequently in the vaccinated than in the unvaccinated population, he said. Older people and those with weakened immune systems are at higher risk for shingles, Schaffner explained. While shingles can occur at any age, chances increase after age 50. The six cases were ages 36 to 61. We have been emphasizing the vaccination of older adults, Schaffner said. Thats the very population in which shingles is the most common, and so you would expect some cases of shingles to occur after vaccination because its going to occur anyway.

Associated Press writer Arijeta Lajka in New York contributed this report

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Study lacks evidence on masks, isnt linked to Stanford

CLAIM: A Stanford University study published on the National Institutes of Health website proves face masks are absolutely worthless against COVID-19.

THE FACTS: Websites and social media users ranging from political candidates to health influencers are falsely claiming a study published on a digital research repository came from Stanford University and proves face masks are ineffective. In reality, the study is not affiliated with Stanford, nor is the author. The study is based on debunked claims about face masks, including the false notion that wearing a face covering decreases oxygen levels and increases carbon dioxide levels. Stanford peer review study on masks says they basically do not work for C-19, the local North Dakota TV show POVNow posted on Facebook on April 19. A recent Stanford study released by the NCBI, which is under the National Institutes of Health, showed that masks do absolutely nothing to help prevent the spread of COVID-19 and their use is even harmful, read a story on the conservative website The Gateway Pundit. The story was shared widely on Facebook and Twitter last week, including by Josh Mandel, a Republican U.S. Senate candidate in Ohio. The study, titled Facemasks in the COVID-19 era: A health hypothesis, makes a variety of claims about negative health impacts of masks, including the false claim that wearing a face mask restricts breathing, leading to the conditions hypoxemia and hypercapnia. Many doctors have taken to social media to debunk claims about oxygen levels and masks, and The Associated Press also has previously debunked false claims about health risks. The study also claims there is a lack of evidence for the effectiveness of face masks in preventing the spread of COVID-19. In fact, a recent study added strong evidence that statewide mask mandates slow the spread of the coronavirus. Research shows masks block virus particles from spreading from infected people who wear them, and can even provide some protection to uninfected people who wear them. The study circulating online last week was first published in November in the journal Medical Hypotheses, which writes that its purpose is to publish interesting theoretical papers. Articles submitted to the journal are not meant to prove findings using primary data, but instead to advance hypotheses. The journal has a long history of publishing fringe science and hypotheses, according to David Gorski, a surgical oncologist who blogs about medical misinformation. The studys author, Baruch Vainshelboim, is listed in the study as being affiliated with the cardiology division at the Veterans Affairs Palo Alto Health Care System/Stanford University. However, a representative for the VA Palo Alto Health Care System told the AP in an email that Vainshelboim does not work there. I can confirm this person is not one of our physicians, wrote Michael Hill-Jackson, a public affairs specialist with the system. I do not see him in our system and our Cardiology team has never heard of him. Vainshelboim also does not work for Stanford, according to Julie Greicius, senior director of external communications for the universitys medical school. Stanford University has never employed Baruch Vainshelboim, Greicius wrote in an email to the AP. Several years ago (2015), he was a visiting scholar at Stanford for a year, on matters unrelated to this paper. Vainshelboim, who lists himself on LinkedIn as a clinical exercise physiologist and does not list any current employment, did not respond to a request for comment.

Associated Press writer Ali Swenson in Seattle contributed this report.

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Vaccinated people can participate in Red Cross blood drives

CLAIM: The Red Cross wont accept plasma donations from people who have had a COVID-19 vaccine.

THE FACTS: The American Red Cross is accepting blood and plasma donations from those who have received COVID-19 vaccines. The Red Cross states that in most cases there is no need for donors to wait to give blood, which includes plasma, after receiving a COVID-19 vaccine as long as a donor is symptom free and feeling well. Blood donors should, however, be able to provide the name of the manufacturer of the vaccine they received when donating. Yet as more and more Americans receive COVID-19 vaccines, posts online are falsely claiming that vaccinated Americans can no longer donate plasma. The posts are part of a larger misinformation effort to falsely suggest the vaccines are dangerous. The red cross wont accept plasma donations from people who have had the covid-19 vaccine, say posts that were shared on Facebook and Twitter. Youre willing to put something in your body that is so untested that the FDA and Red Cross dont know if you can donate Plasma, yet me not wanting to take it makes me irresponsible? In fact, the posts are misstating new eligibility directives for donating convalescent plasma, which is plasma from recovered COVID-19 patients used to treat others with the illness. The Red Cross once had a dedicated program collecting convalescent plasma, but that program ended on March 26. The change happened after the U.S. Food and Drug Administration updated guidance to ensure that donations from vaccinated people would contain the antibodies needed for the convalescent plasma to be useful in treating COVID-19 patients. The Red Cross acknowledges that the U.S. Food and Drug Administration did update its guidance regarding convalescent plasma donor eligibility related to those who receive a COVID-19 vaccine, the Red Cross says on their website. We are evaluating the feasibility and timeline to implement this complex update, alongside the evolving hospital needs for COVID-19 patients. The Red Cross, however, continues to accept blood donations from people regardless of their vaccine status. All blood collected through those donations is tested for COVID-19 antibodies in case it can be used for convalescent plasma to treat patients. Due to the pandemic, the Red Cross has reported a decline in blood drives, which has created more demand for blood donations.

Associated Press writer Beatrice Dupuy in New York contributed this report.

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Photo manipulated to make Bill Clinton appear ill

CLAIM: Photo shows former President Bill Clinton looking frail and sick, showing what happens when you sell your soul.

THE FACTS: A Facebook post shared thousands of times this week compares an official White House photo of Clinton in 1993 to a more recent photo that has been edited to make the skin around his eyes red and his irises brown. This is what happens when you sell your soul, text on the post reads. Commenters on the post likened the 74-year-old former president to Satan and speculated that he had been using drugs. A reverse-image search reveals the photo in which Clinton looks ill is not genuine. Its an edited version of a 2014 photo that appears on Getty Images, taken by photographer John Lamparski. Clinton was photographed at a Christmas benefit event in New York, according to the original photos caption. In the original photo, Clintons eyes are bright blue and the skin under his eyes is not red. Internet users have previously edited this image of Clinton to make him look like he is suffering from a debilitating disease. The manipulated images have circulated so often that the online meme dictionary Know Your Meme identifies it as a common photoshop meme that it dubs AIDS Bill Clinton or Terminally Bill.

Ali Swenson

___

Vaccine not related to Danish health officials collapse on camera

CLAIM: Video shows Denmarks top health official fainting from her COVID-19 vaccine.

THE FACTS: One of Denmarks top health officials, Tanja Erichsen, collapsed during an April 14 press conference to discuss the countrys decision to discontinue use of the AstraZeneca vaccine, but it was not related to the vaccine. She had not yet been vaccinated against the disease when she fell. The video showing the collapse of Erichsen, acting director of pharmacovigilance at the Danish Medicines Agency, is being misrepresented by anti-vaccine proponents to falsely claim that she fainted as a result of receiving the AstraZeneca shot. Her fall received international press coverage that day, but footage from the video was picked up and circulated online with the false description of what happened. Literally Denmarks top health official fainting from the COVID-19 shot, claimed one Instagram post that shared the video. Shortly after Erichsens fall, Danish Health Authority Director General Soeren Brostroem told reporters at the conference that she was OK. He said she blacked out from overwork and standing too long. A spokesperson for the Danish Medicines Agency, Kim Voigt strm, told the AP that Erichsen had yet to receive a COVID-19 vaccine despite what the posts online say. Erichsen tweeted on April 19 to say that she was feeling well and to thank everyone for their concern. Denmark has primarily relied on vaccines made by Pfizer and Moderna and will continue to use those vaccines rather than AstraZeneca. The decision to discontinue AstraZeneca came after reports of rare blood clots in some recipients.

Beatrice Dupuy

___

Photo shows art piece, not lions mane mushrooms

CLAIM: Photo shows lions mane mushrooms growing in a swamp.

THE FACTS: An image viewed more than 150,000 times on Facebook last week claims to show Lions Mane mushrooms growing from a swamp but it actually shows a work of art. Lions mane mushrooms also known as bearded tooth fungus are white with long, hanging spines, similar to the figure in the picture. They are typically about the size of a football, according to British conservation charity The Woodland Trust. A reverse-image search finds the viral image shows no fungus. Instead, its an art piece made and first exhibited in 2013 by the artist Susi Brister. The work titled 613 Silky Straight in Swamp shows a platinum blonde swamp creature slowly moving through a swampy habitat, Brister told the AP in an email. To create the image, a human model posed inside a suit created from about 100 custom-made platinum blonde hair extensions, Brister wrote. The piece is part of a larger series called Fantastic Habitat, Brister wrote, in which I create and photograph sculptural coverings worn by models in the landscape that highlight both the strange confluence and disconnection between nature and artificial nature. The work was first exhibited at Lawndale Art Center in Houston. It later appeared in other galleries in Houston and Austin, Texas. It is in no way depicting a mushroom, Brister wrote. In fact, Ive never even heard of a lions mane mushroom before, but happy to have learned something new!

Ali Swenson

___

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Signs You Have an Autoimmune Disease, Like Carrie Ann Inaba | Eat This Not That – Eat This, Not That

May 2nd, 2021 1:52 am

American TV watchers were bummed on Monday when Carrie Ann Inaba, the well-known Dancing With the Stars judge and co-host of The Talk, announced she was taking a break from the afternoon chat show to deal with various health challenges, including an autoimmune condition known as Sjogren's syndrome.

Inaba's announcement was surprising, yet sadly familiar, as autoimmune disorders like lupus have increasingly become part of the public conversation in recent years; singer Selena Gomez and TV host Nick Cannon have both disclosed they suffer from that condition. Six years ago, Inaba was diagnosed with Sjogren's, an incurable immune disorder that can cause pain and fatigue. She also reportedly lives with spinal stenosis, a narrowing of the spinal canal that can cause pain and numbness, and the nerve disorder fibromyalgia.

Autoimmune disorders include a wide spectrum of issues caused when the immune system overreacts by attacking the body's own tissue. Women are more likely than men to be affected. Here are the most common signs that you're suffering from the most common autoimmune conditions. Read onand to ensure your health and the health of others, don't miss these Sure Signs Your Illness is Actually Coronavirus in Disguise.

"The classic sign of an autoimmune disease is inflammation, which can cause redness, heat, pain and swelling," says the U.S. National Library of Medicine. Autoimmune diseases can affect the muscles, leading to aches that feel like you've overdone it at the gym even if you haven't left the couch.

This may be a sign of rheumatoid arthritis, a common autoimmune disorder caused when the immune system attacks the linings of the joints, causing painful swelling. Smaller joints tend to be affected first, followed by larger joints. But about 40 percent of people affected by rheumatoid arthritis experience symptoms that don't involve the joints at all. "In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels," says the Mayo Clinic.

According to the Mayo Clinic, Sjogren's syndrome is most commonly signified by dry eyes and a dry mouth, which occurs when the disorder affects the mucous membranes, drying them out. Sjogren's is often accompanied by other immune system disorders such as rheumatoid arthritis or lupus. People with Sjogren's might also experience joint pain or stiffness or swollen glands.

The experts at Johns Hopkins Medicine say that fatigue is a common symptom of autoimmune disease. "If you've been healthy and suddenly you feel fatigue or joint stiffness, don't downplay that," says Ana-Maria Orbai, M.D., M.H.S., a rheumatologist at the Johns Hopkins Arthritis Center. "Telling your doctor helps him or her to look closer at your symptoms and run tests to either identify or rule out autoimmune disease."

RELATED: The #1 Cause of Heart Attack, According to Science

Skin issues are a common sign of autoimmune disorders. A red rash on the skin, known as the "butterfly rash" is often found in lupus. In the skin condition known as psoriasis, the body's skin-production cells go into overdrive; this can cause rough, red patches or silvery scales on the skin as cells are produced faster than the body can shed them naturally. A related condition is psoriatic arthritis, in which joint pain, redness and swelling accompany the skin scaling. This is treatable with medication. Contact a medical professional if you have any of these symptoms, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

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Signs You Have an Autoimmune Disease, Like Carrie Ann Inaba | Eat This Not That - Eat This, Not That

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Rheumatoid Arthritis Drug Market Share, Trends, Business Strategy and Forecast to 2025 The Courier – The Courier

May 2nd, 2021 1:52 am

A new report titled, Global Rheumatoid Arthritis Drug Market Professional Report 2021-2025 has been added by Garner Insights in its database of research reports. The scope of the report includes a comprehensive study of global, regional, and local markets for different segments of the market. The study provides complete details about the usage and adoption of Rheumatoid Arthritis Drug in various industrial applications and geographies. This helps the key stakeholders in knowing about the major development trends, growth strategies, investments, vendor activities, and government initiatives. Moreover, the report specifies the major drivers, restraints, challenges, and lucrative opportunities that are going to impact the growth of the market.

Section (2 3): Manufacturer Detail: AbbVie, Boehringer Ingelheim, Novartis, Regeneron Pharmaceuticals, Pfizer, Bristol-Myers Squibb Company, Roche, UCB, Johnson & Johnson

Request Sample Report of Global Rheumatoid Arthritis Drug Market @https://garnerinsights.com/Global-Rheumatoid-Arthritis-Drug-Market-Report-2020#request-sample

This report forecasts revenue growth at the global, regional, and local levels and provides an analysis of the most recent industry trends from 2021 to 2025 in each of the segments and sub-segments. In addition, the report highlights the impact of COVID-19 on the Global Rheumatoid Arthritis Drug Market. Some of the major geographies included in the market are given below:

Section 4: Region Segmentation: North America Country (United States, Canada)South AmericaAsia Country (China, Japan, India, Korea)Europe Country (Germany, UK, France, Italy)Other Country (Middle East, Africa, GCC)

Section (5 6 7) :Product Type Segmentation: BiopharmaceuticalPharmaceuticals

Industry Segmentation: PrescriptionOver-the-Counter (OTC)

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Table of Contents: Section 1 Rheumatoid Arthritis Drug Product Definition

Section 2 Global Rheumatoid Arthritis Drug Market Manufacturer Share and Market Overview2.1 Global Manufacturer Rheumatoid Arthritis Drug Shipments2.2 Global Manufacturer Rheumatoid Arthritis Drug Business Revenue2.3 Global Rheumatoid Arthritis Drug Market Overview2.4 COVID-19 Impact on Rheumatoid Arthritis Drug Industry

Section 3 Manufacturer Rheumatoid Arthritis Drug Business Introduction3.1 AbbVie Rheumatoid Arthritis Drug Business Introduction3.1.1 AbbVie Rheumatoid Arthritis Drug Shipments, Price, Revenue and Gross profit 2015-20203.1.2 AbbVie Rheumatoid Arthritis Drug Business Distribution by Region3.1.3 AbbVie Interview Record3.1.4 AbbVie Rheumatoid Arthritis Drug Business Profile3.1.5 AbbVie Rheumatoid Arthritis Drug Product Specification

3.2 Boehringer Ingelheim Rheumatoid Arthritis Drug Business Introduction3.2.1 Boehringer Ingelheim Rheumatoid Arthritis Drug Shipments, Price, Revenue and Gross profit 2015-20203.2.2 Boehringer Ingelheim Rheumatoid Arthritis Drug Business Distribution by Region3.2.3 Interview Record3.2.4 Boehringer Ingelheim Rheumatoid Arthritis Drug Business Overview3.2.5 Boehringer Ingelheim Rheumatoid Arthritis Drug Product Specification

3.3 Novartis Rheumatoid Arthritis Drug Business Introduction3.3.1 Novartis Rheumatoid Arthritis Drug Shipments, Price, Revenue and Gross profit 2015-20203.3.2 Novartis Rheumatoid Arthritis Drug Business Distribution by Region3.3.3 Interview Record3.3.4 Novartis Rheumatoid Arthritis Drug Business Overview3.3.5 Novartis Rheumatoid Arthritis Drug Product Specification

3.4 Regeneron Pharmaceuticals Rheumatoid Arthritis Drug Business Introduction3.5 Pfizer Rheumatoid Arthritis Drug Business Introduction3.6 Bristol-Myers Squibb Company Rheumatoid Arthritis Drug Business Introduction

Section 4 Global Rheumatoid Arthritis Drug Market Segmentation (Region Level)4.1 North America Country4.1.1 United States Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.1.2 Canada Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.2 South America Country4.2.1 South America Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.3 Asia Country4.3.1 China Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.3.2 Japan Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.3.3 India Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.3.4 Korea Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.4 Europe Country4.4.1 Germany Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.4.2 UK Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.4.3 France Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.4.4 Italy Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.4.5 Europe Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.5 Other Country and Region4.5.1 Middle East Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.5.2 Africa Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.5.3 GCC Rheumatoid Arthritis Drug Market Size and Price Analysis 2015-20204.6 Global Rheumatoid Arthritis Drug Market Segmentation (Region Level) Analysis 2015-20204.7 Global Rheumatoid Arthritis Drug Market Segmentation (Region Level) Analysis

Section 5 Global Rheumatoid Arthritis Drug Market Segmentation (Product Type Level)5.1 Global Rheumatoid Arthritis Drug Market Segmentation (Product Type Level) Market Size 2015-20205.2 Different Rheumatoid Arthritis Drug Product Type Price 2015-20205.3 Global Rheumatoid Arthritis Drug Market Segmentation (Product Type Level) Analysis

Section 6 Global Rheumatoid Arthritis Drug Market Segmentation (Industry Level)6.1 Global Rheumatoid Arthritis Drug Market Segmentation (Industry Level) Market Size 2015-20206.2 Different Industry Price 2015-20206.3 Global Rheumatoid Arthritis Drug Market Segmentation (Industry Level) Analysis

Section 7 Global Rheumatoid Arthritis Drug Market Segmentation (Channel Level)7.1 Global Rheumatoid Arthritis Drug Market Segmentation (Channel Level) Sales Volume and Share 2015-20207.2 Global Rheumatoid Arthritis Drug Market Segmentation (Channel Level) Analysis

Section 8 Rheumatoid Arthritis Drug Market Forecast 2020-20258.1 Rheumatoid Arthritis Drug Segmentation Market Forecast (Region Level)8.2 Rheumatoid Arthritis Drug Segmentation Market Forecast (Product Type Level)8.3 Rheumatoid Arthritis Drug Segmentation Market Forecast (Industry Level)8.4 Rheumatoid Arthritis Drug Segmentation Market Forecast (Channel Level)

Section 9 Rheumatoid Arthritis Drug Segmentation Product Type9.1 Biopharmaceutical Product Introduction9.2 Pharmaceuticals Product Introduction

Section 10 Rheumatoid Arthritis Drug Segmentation Industry10.1 Prescription Clients10.2 Over-the-Counter (OTC) Clients

Section 11 Rheumatoid Arthritis Drug Cost of Production Analysis11.1 Raw Material Cost Analysis11.2 Technology Cost Analysis11.3 Labor Cost Analysis11.4 Cost Overview

Section 12 Conclusion

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Rheumatoid Arthritis Drug Market Share, Trends, Business Strategy and Forecast to 2025 The Courier - The Courier

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EU Biologics for Rheumatoid Arthritis Treatment Market to Reach at High CAGR in Forecast Period 2019 to 2028 Clark County Blog – Clark County Blog

May 2nd, 2021 1:52 am

The EU Biologics for Rheumatoid Arthritis Treatment market for the forecasting period of 2019-2028. The report is made out with a comprehensive analysis of the current market and pulled down the key factors that propel the growth of the EU Biologics for Rheumatoid Arthritis Treatment market in the forecasted period. This report also encompasses key market drivers and the hindering restraints of the EU Biologics for Rheumatoid Arthritis Treatment market.

Request Sample [emailprotected]https://insights10.com/free-sample-report-inquiry/?id=9938

This report shed its light on the markets future trend in terms of volume (Tons) and value (US$ Bn) from 2019 to 2026 with the aid of a Qualitative forecast model which works in tandem with splendid expert judgment, national government documents, statistical databases and relevant patent and regulatory databases.

Further, this report brings in the product, price, promotion, & place (i.e., 4 Ps of marketing) and their STP (Segmentation, Targeting & Positioning) of the stakeholders for a lucrative growth in the forecasted period.

This report on the EU Biologics for Rheumatoid Arthritis Treatment market covers various segmentation of the EU Biologics for Rheumatoid Arthritis Treatment market and analyze the market shares of those segments in the leading geographies such as North America (U.S., Canada), Europe (Germany, France, U.K., Spain, Italy, and the Rest of Europe), Asia-Pacific (China, India, Japan, South Korea, Australia, and Rest of Asia Pacific) Latin America ( Mexico, Brazil, Rest of Latin America) and Middle East & Africa (GCC countries, South Africa, and Rest of the Middle East & Africa) for the forecasted period by pinpointing the drivers and barriers of the EU Biologics for Rheumatoid Arthritis Treatment market growth.

Research Methodology

The report is a collective presentation of primary and secondary research findings. That finding helps in understanding EU Biologics for Rheumatoid Arthritis Treatment market dynamics, structure by identifying and analyzing the market segments and projects the market size.

Top Participants in the EU Biologics for Rheumatoid Arthritis Treatment Market

Roche, Novartis, Biogen Idec, Pfizer, Amgen, and Sanofi Pharmaceutical to invest in these products.

EU Biologics for Rheumatoid Arthritis Treatment Market Segmentation

A. By Treatment TypeI. IL-1 & IL-6 monoclonal therapyII. B-cell inhibitorsIII. T-cell inhibitorsIV. JAK inhibitorsV. TNF inhibitors

View Detail [emailprotected]https://insights10.com/product/eu-biologics-for-rheumatoid-arthritis-treatment-market/

Table Of Content of EU Biologics for Rheumatoid Arthritis Treatment Market

1. EU Biologics for Rheumatoid Arthritis Treatment Market Overview..A. Market Size2. Market Growth Drivers...A. Growing capital investment from the key market playersB. Growing demand and higher acceptability for innovative therapies3. Epidemiology...A. New Prevalent Cases of Rheumatoid ArthritisB. Treated cases of Rheumatoid Arthritis with Biologic drugs4. Biologics for Rheumatoid Arthritis Treatment Market SegmentationA. By Treatment TypeI. IL-1 & IL-6 monoclonal therapyII. B-cell inhibitorsIII. T-cell inhibitorsIV. JAK inhibitorsV. TNF inhibitors5. Biologics for Rheumatoid Arthritis Major Drugs Market ShareA. Market Analysis, Insights and Forecast to 2028 by Revenue6. Competitive Landscape.....A. Major PlayersB. Products in Pipeline7. Key Company Profiles...A. Sanofi Pharmaceutical Company overview, Product & Services, Strategies & FinancialsB. Pfizer Inc. Company overview, Product & Services, Strategies & FinancialsC. Novartis Company Profile, Product & Services, Strategies & Financials8. Potential Growth Opportunities...A. Advancements in drug developmentB. Untapped markets in developing economies9. Factors Driving Future Growth..A. Key Industry Trends and Recent Developments in Biologics for Rheumatoid Arthritis TreatmentB. Future Opportunities10. Conclusion

Competitors Analysis

This report not only brings out the major players in the market but also pictures out the lucrative market analysis by performing various competitor assessment techniques such as SWOT analysis, PESTEL analysis, Porters five force, value chain analysis to address the question of shareholders for prioritizing the efforts and investment soon to the emerging segment in the EU Biologics for Rheumatoid Arthritis Treatment market. Porters five forces model in the report provides insights into the competitive rivalry, supplier and buyer positions in the market, and opportunities for the new entrants in the EU Biologics for Rheumatoid Arthritis Treatment market throughout 2019 to 2028.

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EU Biologics for Rheumatoid Arthritis Treatment Market to Reach at High CAGR in Forecast Period 2019 to 2028 Clark County Blog - Clark County Blog

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EU Psoriatic Arthritis Treatment Market Segmentations by Application and Geography Trends, Growth and Forecasts to 2019 2028 Clark County Blog -…

May 2nd, 2021 1:51 am

The EU Psoriatic Arthritis Treatment market for the forecasting period of 2019-2028. The report is made out with a comprehensive analysis of the current market and pulled down the key factors that propel the growth of the EU Psoriatic Arthritis Treatment market in the forecasted period. This report also encompasses key market drivers and the hindering restraints of the EU Psoriatic Arthritis Treatment market.

Request Sample [emailprotected]https://insights10.com/free-sample-report-inquiry/?id=9888

This report shed its light on the markets future trend in terms of volume (Tons) and value (US$ Bn) from 2019 to 2026 with the aid of a Qualitative forecast model which works in tandem with splendid expert judgment, national government documents, statistical databases and relevant patent and regulatory databases.

Further, this report brings in the product, price, promotion, & place (i.e., 4 Ps of marketing) and their STP (Segmentation, Targeting & Positioning) of the stakeholders for a lucrative growth in the forecasted period.

This report on the EU Psoriatic Arthritis Treatment market covers various segmentation of the EU Psoriatic Arthritis Treatment market and analyze the market shares of those segments in the leading geographies such as North America (U.S., Canada), Europe (Germany, France, U.K., Spain, Italy, and the Rest of Europe), Asia-Pacific (China, India, Japan, South Korea, Australia, and Rest of Asia Pacific) Latin America ( Mexico, Brazil, Rest of Latin America) and Middle East & Africa (GCC countries, South Africa, and Rest of the Middle East & Africa) for the forecasted period by pinpointing the drivers and barriers of the EU Psoriatic Arthritis Treatment market growth.

Research Methodology

The report is a collective presentation of primary and secondary research findings. That finding helps in understanding EU Psoriatic Arthritis Treatment market dynamics, structure by identifying and analyzing the market segments and projects the market size.

Top Participants in the EU Psoriatic Arthritis Treatment Market

Psoriatic Arthritis Treatment are Astra Zeneca, Novartis, Glaxo Smith Kline, Merck & Co. Inc, Takeda Pharmaceutical Company

EU Psoriatic Arthritis Treatment Market Segmentation

A. By Drug ClassI. Non-steroidal Anti-inflammatory Drugs (NSAIDS)II. Non-biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs)III. Biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs)IV. OthersB. By Route of AdministrationI. OralII. ParenteralIII. TopicalIV. InjectableC. By Distribution ChannelI. Hospitals PharmaciesII. Retail PharmaciesIII. Online Pharmacies

View Detail [emailprotected]https://insights10.com/product/eu-psoriatic-arthritis-treatment-market-analysis/

Table Of Content of EU Psoriatic Arthritis Treatment Market

1. EU Psoriatic Arthritis Treatment Market Overview..A. Market Size2. EU Psoriatic Arthritis Treatment Growth Drivers..A. Rise in Customer Awareness and Increase Disease BurdenB. Promising Pipeline and New Product Launches3. EU Psoriatic Arthritis Treatment Market Segmentation.A. By Drug ClassI. Non-steroidal Anti-inflammatory Drugs (NSAIDS)II. Non-biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs)III. Biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs)IV. OthersB. By Route of AdministrationI. OralII. ParenteralIII. TopicalIV. InjectableC. By Distribution ChannelI. Hospitals PharmaciesII. Retail PharmaciesIII. Online Pharmacies4. EU Psoriatic Arthritis Treatment Major Market Share.A. Market Analysis, Insights and Forecast by Revenue5. Competitive LandscapeA. Major PlayersB. Products in Pipeline6. Key Company Profiles..A Novartis AG Company overview, Product & Services, Strategies & FinancialsB Glaxo Smith Kline Company overview, Product & Services, Strategies & FinancialsC Astra Zeneca Company overview, Product & Services, Strategies & Financials7. Healthcare Policies and Regulatory Landscape.A. Policy Changes and Reimbursement Scenario8. Factors Driving Market GrowthA. Key Industry DevelopmentsB. Mergers and Acquisitions9. Potential Growth OpportunitiesA. Market OpportunitiesB. Future Trends10. Conclusion

Competitors Analysis

This report not only brings out the major players in the market but also pictures out the lucrative market analysis by performing various competitor assessment techniques such as SWOT analysis, PESTEL analysis, Porters five force, value chain analysis to address the question of shareholders for prioritizing the efforts and investment soon to the emerging segment in the EU Psoriatic Arthritis Treatment market. Porters five forces model in the report provides insights into the competitive rivalry, supplier and buyer positions in the market, and opportunities for the new entrants in the EU Psoriatic Arthritis Treatment market throughout 2019 to 2028.

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EU Psoriatic Arthritis Treatment Market Segmentations by Application and Geography Trends, Growth and Forecasts to 2019 2028 Clark County Blog -...

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Global Psoriatic Arthritis Treatment Market 2019 : Global Industry Analysis, Business Development, Size, Share, Trends, Future Growth, Forecast to…

May 2nd, 2021 1:51 am

The Global Psoriatic Arthritis Treatment market for the forecasting period of 2019-2028. The report is made out with a comprehensive analysis of the current market and pulled down the key factors that propel the growth of the Global Psoriatic Arthritis Treatment market in the forecasted period. This report also encompasses key market drivers and the hindering restraints of the Global Psoriatic Arthritis Treatment market.

Request Sample [emailprotected]https://insights10.com/free-sample-report-inquiry/?id=5598

This report shed its light on the markets future trend in terms of volume (Tons) and value (US$ Bn) from 2019 to 2026 with the aid of a Qualitative forecast model which works in tandem with splendid expert judgment, national government documents, statistical databases and relevant patent and regulatory databases.

Further, this report brings in the product, price, promotion, & place (i.e., 4 Ps of marketing) and their STP (Segmentation, Targeting & Positioning) of the stakeholders for a lucrative growth in the forecasted period.

This report on the Global Psoriatic Arthritis Treatment market covers various segmentation of the Global Psoriatic Arthritis Treatment market and analyze the market shares of those segments in the leading geographies such as North America (U.S., Canada), Europe (Germany, France, U.K., Spain, Italy, and the Rest of Europe), Asia-Pacific (China, India, Japan, South Korea, Australia, and Rest of Asia Pacific) Latin America ( Mexico, Brazil, Rest of Latin America) and Middle East & Africa (GCC countries, South Africa, and Rest of the Middle East & Africa) for the forecasted period by pinpointing the drivers and barriers of the Global Psoriatic Arthritis Treatment market growth.

Research Methodology

The report is a collective presentation of primary and secondary research findings. That finding helps in understanding Global Psoriatic Arthritis Treatment market dynamics, structure by identifying and analyzing the market segments and projects the market size.

Top Participants in the Global Psoriatic Arthritis Treatment Market

AbbVie Inc.; Amgen Inc.; Johnson & Johnson Services, Inc.; AstraZeneca plc; Bausch Health Companies Inc.; Bristol-Myers Squibb Company; Celgene Corporation; Novartis International AG; Eli Lilly and Company; Pfizer, Inc.; and UCB S.A.

Global Psoriatic Arthritis Treatment Market Segmentation

View Detail [emailprotected]https://insights10.com/product/psoriatic-arthritis-treatment-market-analysis-2019-to-2028/

Table Of Content of Global Psoriatic Arthritis Treatment Market

Competitors Analysis

This report not only brings out the major players in the market but also pictures out the lucrative market analysis by performing various competitor assessment techniques such as SWOT analysis, PESTEL analysis, Porters five force, value chain analysis to address the question of shareholders for prioritizing the efforts and investment soon to the emerging segment in the Global Psoriatic Arthritis Treatment market. Porters five forces model in the report provides insights into the competitive rivalry, supplier and buyer positions in the market, and opportunities for the new entrants in the Global Psoriatic Arthritis Treatment market throughout 2019 to 2028.

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Global Psoriatic Arthritis Treatment Market 2019 : Global Industry Analysis, Business Development, Size, Share, Trends, Future Growth, Forecast to...

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Analyzing Impacts Of COVID-19 On Arthritis Monoclonal Antibodies Market Effects, Aftermath And Forecast To 2026 KSU | The Sentinel Newspaper – KSU |…

May 2nd, 2021 1:51 am

This report contains market size and forecasts of Arthritis Monoclonal Antibodies in Global, including the following market information:Global Arthritis Monoclonal Antibodies Market Revenue, 2016-2021, 2022-2027, ($ millions)Global top five companies in 2020 (%)

The global Arthritis Monoclonal Antibodies market was valued at XX million in 2020 and is projected to reach US$ XX million by 2027, at a CAGR of XX% during the forecast period.Research has surveyed the Arthritis Monoclonal Antibodies companies, and industry experts on this industry, involving the revenue, demand, product type, recent developments and plans, industry trends, drivers, challenges, obstacles, and potential risks.

Download PDF Sample of Arthritis Monoclonal Antibodies Market report @ https://www.themarketinsights.com/request-sample/131486

Total Market by Segment:Global Arthritis Monoclonal Antibodies Market, By Type, 2016-2021, 2022-2027 ($ millions)Global Arthritis Monoclonal Antibodies Market Segment Percentages, By Type, 2020 (%)RemicadeHumiraEnbrelRituxanOrenciaActemraSimponiCimzia

China Arthritis Monoclonal Antibodies Market, By Application, 2016-2021, 2022-2027 ($ millions)China Arthritis Monoclonal Antibodies Market Segment Percentages, By Application, 2020 (%)Rheumatoid ArthritisOsteoarthritisPsoriatic ArthritisAnkylosing SpondylitisFibromyalgiaOthers

Global Arthritis Monoclonal Antibodies Market, By Region and Country, 2016-2021, 2022-2027 ($ Millions)Global Arthritis Monoclonal Antibodies Market Segment Percentages, By Region and Country, 2020 (%)North AmericaUSCanadaMexicoEuropeGermanyFranceU.K.ItalyRussiaNordic CountriesBeneluxRest of EuropeAsiaChinaJapanSouth KoreaSoutheast AsiaIndiaRest of AsiaSouth AmericaBrazilArgentinaRest of South AmericaMiddle East & AfricaTurkeyIsraelSaudi ArabiaUAERest of Middle East & Africa

Report Customization available as per requirements Request Customization@ https://www.themarketinsights.com/request-customization/131486

Competitor AnalysisThe report also provides analysis of leading market participants including:Total Arthritis Monoclonal Antibodies Market Competitors Revenues in Global, by Players 2016-2021 (Estimated), ($ millions)Total Arthritis Monoclonal Antibodies Market Competitors Revenues Share in Global, by Players 2020 (%)

Further, the report presents profiles of competitors in the market, including the following:AbbVie IncF. Hoffmann-La Roche LtdNovartisJohnson & Johnson(Janssen)Pfizer IncMylanGenentechGSKAstraZeneca PLC

To Check Discount @ https://www.themarketinsights.com/check-discount/131486

Table of ContentChapter One: Introduction to Research & Analysis Reports

Chapter Two: Global Arthritis Monoclonal Antibodies Overall Market Size

Chapter Three: Company Landscape

Chapter Four: Market Sights by Product

Chapter Five: Sights by Application

Chapter Six: Sights by Region

Chapter Seven: Players Profiles

Chapter Eight: Conclusion

Chapter Nine: Appendix9.1 Note

9.2 Examples of Clients

9.3 Disclaimer

List of Table and FigureTable 1. Arthritis Monoclonal Antibodies Market Opportunities & Trends in Global Market

Table 2. Arthritis Monoclonal Antibodies Market Drivers in Global Market

Table 3. Arthritis Monoclonal Antibodies Market Restraints in Global Market

Table 4. Key Players of Arthritis Monoclonal Antibodies in Global Market

Table 5. Top Arthritis Monoclonal Antibodies Players in Global Market, Ranking by Revenue (2019)

Table 6. Global Arthritis Monoclonal Antibodies Revenue by Companies, (US$, Mn), 2016-2021

Table 7. Global Arthritis Monoclonal Antibodies Revenue Share by Companies, 2016-2021

Table 8. Global Companies Arthritis Monoclonal Antibodies Product Type

Table 9. List of Global Tier 1 Arthritis Monoclonal Antibodies Companies, Revenue (US$, Mn) in 2020 and Market Share

Table 10. List of Global Tier 2 and Tier 3 Arthritis Monoclonal Antibodies Companies, Revenue (US$, Mn) in 2020 and Market Share

Table 11. By Type Global Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2021 VS 2027

Table 12. By Type Arthritis Monoclonal Antibodies Revenue in Global (US$, Mn), 2016-2021

Table 13. By Type Arthritis Monoclonal Antibodies Revenue in Global (US$, Mn), 2022-2027

Table 14. By Application Global Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2021 VS 2027

Table 15. By Application Arthritis Monoclonal Antibodies Revenue in Global (US$, Mn), 2016-2021

Table 16. By Application Arthritis Monoclonal Antibodies Revenue in Global (US$, Mn), 2022-2027

Table 17. By Region Global Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2021 VS 2027

Table 18. By Region Global Arthritis Monoclonal Antibodies Revenue (US$, Mn), 2016-2021

Table 19. By Region Global Arthritis Monoclonal Antibodies Revenue (US$, Mn), 2022-2027

Table 20. By Country North America Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2016-2021

Table 21. By Country North America Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2022-2027

Table 22. By Country Europe Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2016-2021

Table 23. By Country Europe Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2022-2027

Table 24. By Region Asia Arthritis Monoclonal Antibodies Revenue, (US$, Mn), 2016-2021 continued

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US Biologics for Rheumatoid Arthritis Treatment By Future Demand and Growth Analysis with Forecast 2019-2028 Clark County Blog – Clark County Blog

May 2nd, 2021 1:51 am

The US Biologics for Rheumatoid Arthritis Treatment market for the forecasting period of 2019-2028. The report is made out with a comprehensive analysis of the current market and pulled down the key factors that propel the growth of the US Biologics for Rheumatoid Arthritis Treatment market in the forecasted period. This report also encompasses key market drivers and the hindering restraints of the US Biologics for Rheumatoid Arthritis Treatment market.

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This report shed its light on the markets future trend in terms of volume (Tons) and value (US$ Bn) from 2019 to 2026 with the aid of a Qualitative forecast model which works in tandem with splendid expert judgment, national government documents, statistical databases and relevant patent and regulatory databases.

Further, this report brings in the product, price, promotion, & place (i.e., 4 Ps of marketing) and their STP (Segmentation, Targeting & Positioning) of the stakeholders for a lucrative growth in the forecasted period.

This report on the US Biologics for Rheumatoid Arthritis Treatment market covers various segmentation of the US Biologics for Rheumatoid Arthritis Treatment market and analyze the market shares of those segments in the leading geographies such as North America (U.S., Canada), Europe (Germany, France, U.K., Spain, Italy, and the Rest of Europe), Asia-Pacific (China, India, Japan, South Korea, Australia, and Rest of Asia Pacific) Latin America ( Mexico, Brazil, Rest of Latin America) and Middle East & Africa (GCC countries, South Africa, and Rest of the Middle East & Africa) for the forecasted period by pinpointing the drivers and barriers of the US Biologics for Rheumatoid Arthritis Treatment market growth.

Research Methodology

The report is a collective presentation of primary and secondary research findings. That finding helps in understanding US Biologics for Rheumatoid Arthritis Treatment market dynamics, structure by identifying and analyzing the market segments and projects the market size.

Top Participants in the US Biologics for Rheumatoid Arthritis Treatment Market

oche, Novartis, Biogen Idec, Pfizer, Amgen, and Sanofi Pharmaceutical

US Biologics for Rheumatoid Arthritis Treatment Market Segmentation

A. By Treatment TypeI. IL-1 & IL-6 monoclonal therapyII. B-cell inhibitorsIII. T-cell inhibitorsIV. JAK inhibitorsV. TNF inhibitors

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Table Of Content of US Biologics for Rheumatoid Arthritis Treatment Market

1. US Biologics for Rheumatoid Arthritis Treatment Market Overview..A. Market Size2. Market Growth Drivers...A. Growing capital investment from the key market playersB. Growing demand and higher acceptability for innovative therapies3. Epidemiology...A. New Prevalent Cases of Rheumatoid ArthritisB. Treated cases of Rheumatoid Arthritis with Biologic drugs4. Biologics for Rheumatoid Arthritis Treatment Market SegmentationA. By Treatment TypeI. IL-1 & IL-6 monoclonal therapyII. B-cell inhibitorsIII. T-cell inhibitorsIV. JAK inhibitorsV. TNF inhibitors5. Biologics for Rheumatoid Arthritis Major Drugs Market ShareA. Market Analysis, Insights and Forecast to 2028 by Revenue6. Competitive Landscape.....A. Major PlayersB. Products in Pipeline7. Key Company Profiles...A. Roche Company overview, Product & Services, Strategies & FinancialsB. Pfizer Inc. Company overview, Product & Services, Strategies & FinancialsC. Novartis Company Profile, Product & Services, Strategies & Financials8. Potential Growth Opportunities...A. Advancements in drug developmentB. Untapped markets in developing economies9. Factors Driving Future Growth..A. Key Industry Trends and Recent Developments in Biologics for Rheumatoid Arthritis TreatmentB. Future Opportunities10. Conclusion

Competitors Analysis

This report not only brings out the major players in the market but also pictures out the lucrative market analysis by performing various competitor assessment techniques such as SWOT analysis, PESTEL analysis, Porters five force, value chain analysis to address the question of shareholders for prioritizing the efforts and investment soon to the emerging segment in the US Biologics for Rheumatoid Arthritis Treatment market. Porters five forces model in the report provides insights into the competitive rivalry, supplier and buyer positions in the market, and opportunities for the new entrants in the US Biologics for Rheumatoid Arthritis Treatment market throughout 2019 to 2028.

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Psoriatic Arthritis Treatment Industry | 2021 Global Market Size, Growth and Trends Analysis By COVID-19 Impact 2021-2028 – Clark County Blog

May 2nd, 2021 1:51 am

Psoriatic Arthritis Treatment Market Analysis 2021-2028 Report provides strategists, marketers and senior management with the critical information they need to assess the global Psoriatic Arthritis Treatment market as it emerges from the Covid 19 shut down. The impact of Coronavirus (COVID-19) on Psoriatic Arthritis Treatment has reinforced many trends already shaping the industry pre-COVID-19, There is a long-term trend towards the repositioning of players as entertainment providers on multiple platforms.

The report covers market characteristics, size and growth, segmentation, regional and country breakdowns, competitive landscape, market shares, trends and strategies for this market. It traces the markets historic and forecast market growth by geography. It places the market within the context of the wider Psoriatic Arthritis Treatment market, and compares it with other markets.

The market characteristics section of the report defines and explains the market. The market size section gives the market size covering both the historic growth of the market, the impact of the Covid 19 virus and forecasting its recovery.

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Why buy this report?

The regional and country breakdowns section gives an analysis of the market in each geography and the size of the market by geography and compares their historic and forecast growth. It covers the impact and recovery trajectory of Covid 19 for all regions, key developed countries and major emerging markets.

The Impact of Coronavirus on Psoriatic Arthritis Treatment global briefing offers a comprehensive guide to the Psoriatic Arthritis Treatment market at an international level. It looks at both global and regional level performances as well as providing category and channel analysis. It identifies the leading companies and offers strategic analysis of key factors influencing the industry, new product developments as well as future trends and prospects.

Competitive landscape gives a description of the competitive nature of the market, market shares, and a description of the leading companies. Key financial deals which have shaped the market in recent years are identified. The trends and strategies section analyses the shape of the market as it emerges from the crisis and suggests how companies can grow as the market recovers.

An Overview of the Impact of COVID-19 on Psoriatic Arthritis Treatment Market:

The emergence of COVID-19 has brought the world to a standstill. We understand that this health crisis has brought an unprecedented impact on businesses across industries. However, this too shall pass. Rising support from governments and several companies can help in the fight against this highly contagious disease. There are some industries that are struggling and some are thriving. Overall, almost every sector is anticipated to be impacted by the pandemic.

We are taking continuous efforts to help your business sustain and grow during COVID-19 pandemics. Based on our experience and expertise, we will offer you an impact analysis of coronavirus outbreak across industries to help you prepare for the future.

The Global Psoriatic Arthritis Treatment market 2021 research provides a basic overview of the industry including definitions, classifications, applications and industry chain structure. The Global Psoriatic Arthritis Treatment market report is provided for the international markets as well as development trends, competitive landscape analysis, and key regions development status. Development policies and plans are discussed as well as manufacturing processes and cost structures are also analysed. This report additionally states import/export consumption, supply and demand Figures, cost, price, revenue and gross margins.

The report mainly studies the size, recent trends and development status of Psoriatic Arthritis Treatment Market, as well as investment opportunities, government policy, market dynamics (drivers, restraints, opportunities), supply chain and competitive landscape. Technological innovation and advancement will further optimize the performance of the product, making it more widely used in downstream applications. Moreover, Porters Five Forces Analysis (potential entrants, suppliers, substitutes, buyers, industry competitors) provides crucial information for knowing Psoriatic Arthritis Treatment Market.

Psoriatic Arthritis Treatment Market Report Intended Audience:

Psoriatic Arthritis Treatment Market Highlights:

Psoriatic Arthritis Treatment Market Report Table Of Content:

Introduction

1.1. Research Scope

1.2. Market Segmentation

1.3. Research Methodology

1.4. Definitions and Assumptions

Executive Summary

Market Dynamics

3.1. Market Drivers

3.2. Market Restraints

3.3. Market Opportunities

Key Insights

Continued

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Psoriatic Arthritis Treatment Industry | 2021 Global Market Size, Growth and Trends Analysis By COVID-19 Impact 2021-2028

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Psoriatic Arthritis Treatment Industry | 2021 Global Market Size, Growth and Trends Analysis By COVID-19 Impact 2021-2028 - Clark County Blog

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John Stamos’ secret to longevity is to "stop trying to charm the world" – Salon

April 17th, 2021 1:54 am

Whether you know him as Blackie Parrish from "General Hospital,"Uncle Jesse from "Full House" or "ER," "Necessary Roughness," "Entourage," or "You," Emmy Award-nominated actor and producer John Stamos has been a fixture in and outside of Hollywood for decades.Though he spent years, in his own words, trying to "shed this dumb Peter Pan syndrome that I had,"Stamos has now aged gracefully into both fatherhood and roles that eschew the toxic masculinity traditionally found in films and television.

His new sports dramedy "Big Shot" is created by David E. Kelleyand featuresmany formidable female characters.Stamos says most of the writing credit goes to women."I went into the writers' room right off the bat, and I think it was about 65% women, which was great," he recalled.

On the show, Stamos playsMarvyn Korn, a top-tier basketball coach who finds himself working at an elite girls' school after getting ousted from the NCAA.Korn starts out as an arrogant, tough character who is out of his element working with teen girls, having been accustomed to working with adult male athletes.

Stamos appeared on "Salon Talks" to discuss how helikens his own personal growth in lifeas an actor to Korn's evolution to a gentler, more self-aware and thoughtful man. When Stamos started out in Hollywood, he felt pressure to look and act like a perennial bachelor."I think a lot of it came from outside . . .You know, that's the problem," he said. "You start listening to the outside world, and then you're screwed. So it just took me a long time to grow up. I think I was buying into, or I felt obligated and it was my fault to feed that image of bachelor, cocksman guy. I really wasn't that guy, but I felt like I had to puff that up at times."

When Stamos shed that image, he got serious about life and love, and this opened up many possibilities for him, including marriage and fatherhood. "Especially with a child now, you start to realize your mortality," he added.

Watch the "Salon Talks" interview with Stamos hereor read the transcript below.

This interview has been lightly edited for length and clarity.

What drew you to doing this series?

Having a show with this many women in it, first of all. Strong women. And the value of a guy like Korn, who's sort of releasing his assumptions and his preconceived ideas of these girls and connecting with them. It just breaks down every stereotype. When we start the thing, he's resistant to the idea that it's going to be a revolutionary experience for him. To him it's a step down.

There was a couple of articles before the show even came out. It was like, "Oh, women's basketball. Why are they putting it out?" They're not . . . We're building it up and we're shining a light on it. But in his mind it was. I mean, he comes from college basketball and it just starts with him waking up to the idea that these assumptions are old and they're dated, and he's got to get with it.

The line, just in general in life, as you know in our society now, is moving. And if you're not paying attention, then it's your fault. Everybody has a voice now, and people are speaking and they're saying, "I don't feel equal." "I don't feel noticed." "I don't feel that I matter." We have to listen. It's our job. Not to judge you. We don't know how they feel.

I feel the show has really been . . . Looking back at it, I didn't realize it that much when I was shooting it. I kind of did, but I didn't realize that the timing would be so good and the impact would be so important at this moment.

Somehow you've had tremendous sustaining power in the industry, which is a great accomplishment.What do you think is your magic formula for balancing doing the job and keeping yourself looking the part? Do you have any tips?

I'm glad that all that comes off. Because it took me a long time to shed this dumb Peter Pan syndrome that I had. I think a lot of it came from outside . . . You know, that's the problem. You start listening to the outside world and then you're screwed. So it just took me a long time to grow up. I think I was buying into, or I felt obligated and it was my fault, to feed that image of bachelor, cocksman guy. I really wasn't that guy, but I felt like I had to puff that up at times to I think a lot of people live vicariously through that kind of image. But it really wasn't me. So once I shed that, I just started to really get serious about life.

I've always sort of taken care of myself. I don't do a lot of creams and ointments and stuff, but I do have very good genes. I had to sober up about five-and-a-half years, almost six years now. And that did a lot for me. I mean, that opened up my life, really. It opened up marriage and a child and a solid career. So that was a big turning point for me.

It just takes a long time. It took me a long time anyway, to just not try to be funny all the time and not try to charm the pants off I was going to a shrink, or I go once in a while, he said, "Stop trying to charm the world. You did it already. Just relax."

It's just so hard. And I'm doing that in this character, I think. It's taken me a long time just to not move around and trust the writing and not have to do s**t, you know, stuff. So I think that's part of it.

Then my dad was a great example of discipline and being a good man, a hardworking man. He had fast food restaurants that he was grooming me to take over. I would watch him treat the bus boy in the back washing dishes, the same way that he treated his best customer. I didn't really realize it until years later that that's what he was doing. And that's what I try to do. I'm interested in people. But I think maybe that's part of the that's helped the longevity.

"Big Shot" starts streaming on Friday, April 16 on Disney+.

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John Stamos' secret to longevity is to "stop trying to charm the world" - Salon

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British royals’ longevity is a full three decades longer than their subjects’ – The Mandarin

April 17th, 2021 1:54 am

In the U.K. it is customary to receive a personalised message from the queen on your 100th birthday such is the relative rarity of reaching the milestone.

Prince Philip was just a couple months off, dying at the age of 99 years and 10 months on April 9, 2021. The last notable royal death before his was that of the queen mother in 2002. She was 101 years old.

Reaching such a ripe old age isnt uncommon among the British ruling family in fact, my analysis shows that on average they live an additional 30 years compared with their subjects.

I looked at the duration of life of the last six British monarchs, along with the longevity of their spouses and children in total 27 royals. What it reveals is a fascinating and familiar story for those of us who study aging and longevity for a living. As a professor of epidemiology and biostatistics, I had previously observed the exact same phenomenon among U.S. presidents they also tend to live decades longer than the general population they serve.

The ruling U.K. monarchs from Queen Victoria onward lived an average of 75 years. And this longevity will continue to rise with each day that Queen Elizabeth II currently age 95 lives. Their spouses survived even longer, reaching an average age of 83.5 years. If Victorias husband Prince Albert, who died of suspected typhoid fever at age 42 in 1861, is removed from the equation, the average duration of the life of the spouses of the monarchs was an astonishing 91.7 years.

By contrast, the average life duration of the wider U.K. population for the years the monarchs were born throughout this period was only 46 years, according to figures from the Human Mortality Database. For example, the typical life expectancy at birth for a female in the U.K. in 1819 was just under 41 years. Queen Victoria, also born in 1819, was 81 when she died. By the time Elizabeth II was born in 1926, life expectancy at birth for females in the U.K. had risen to 62 the queen has already surpassed that by some 33 years.

Such differences in lifespan with some members of the royal family living to an age double that expected of the general population are considered in aging circles to be extremely large, but not uncommon.

Lifespan differences of this magnitude are the result of a combination of genetic as well as social and behavioural influences.

No one can live long without first having won the genetic lottery at birth. To maximise the chances of achieving exceptional longevity upward of 85 years old you must begin by being lucky enough to have long-lived parents. But even for those blessed with the gift at birth of the potential for a long life, this is no guarantee youll outlive your contemporaries.

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The next challenge is to avoid behaviours that shorten life. That list is long it is a lot easier to shorten life than extend it but among the most well known are smoking, eating in excess and lack of exercise.

And then there is the influence of poverty and privilege. Being born into or living in poverty has been shown to be one of the most important factors that shortens lifespan and it is here that perhaps the royals have the greatest advantage.

Further evidence of privilege being a crucial ingredient in the recipe for exceptional longevity can be seen in the fact that the children of the last six U.K. monarchs that died from natural causes lived an average of 69.7 years. This is some 23 years more than the average age of British subjects over that period.

Put simply, British monarchs and their families live so much longer than their subjects for the same reason other subgroups of the population across the globe live longer than contemporaries born in the same year: privilege over poverty. A famous study conducted in Manchester, England, in 2017 demonstrated vast differences in life expectancy depending on the conditions of where people lived. Access to higher education and economic status was directly correlated with longer life, while lower education, income and poverty were linked to shorter lives.

In the U.S., similar studies of life expectancy by county, census tract and zip code demonstrated the same phenomenon. In fact, there are multiple instances of dramatic differences in longevity among people living as close as across the street from each other caused by differences in poverty and privilege.

Differences in duration of life are first defined by genetics, but it is then heavily mediated by education, income, health care, clean water, food, indoor living and working environments, and the overall effects of high or low socioeconomic status.

The long life of Prince Philip is a cause for celebrating the progress of medical science in being able to keep people alive for longer. But it is in part the result of a privilege denied to many and a reminder that humanity has a long way to go to equalise the chances of living a long life.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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British royals' longevity is a full three decades longer than their subjects' - The Mandarin

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