StemCell Therapy

Los Angles United States, August 2020: The Nanorobotics Market steadily escalating demand due to improving purchasing power is projected to bode well for the global market. WMRlatest publication, Titled Nanorobotics Market Research Report 2020, offers an insightful take on the drivers and restraints present in the market. It assesses the historical data pertaining to the Nanorobotics market and compares it to the current market trends to give the readers a detailed analysis of the trajectory of the market. A team subject-matter experts have provided the readers a qualitative and quantitative data about the market and the various elements associated with it.

The new report offers a powerful combination of latest, in-depth research studies on the Nanorobotics market. The authors of the report are highly experienced analysts and possess deep market knowledge. Some of the key players operating in this Report are:Bruker, JEOL, Thermo Fisher Scientific, Ginkgo Bioworks, Oxford Instruments, etc

Get Free Sample of the Report to understand the structure of the complete report (Including Full TOC, Table & Figures):https://www.worldwidemarketreports.com/sample/356091

Nanorobotics Players/Suppliers Profiles and Sales Data:Company, Company Basic Information, Manufacturing Base and Competitors, Product Category, Application and Specification with Sales, Revenue, Price and Gross Margin, Main Business/Business Overview.

The Best part of this report is, this analyses the current state where all are fighting with the covid-19, The report also provides the market impact and new opportunities created due to the Covid19 catastrophe.

Get the Impact Analysis of Covid-19 on Nanorobotics Industry at:https://www.worldwidemarketreports.com/covidimpact/356091

Key Benefits for Stakeholders

The study provides an in-depth analysis of the Nanorobotics market size along with the current trends and future estimations to elucidate the imminent investment pockets.Information about key drivers, restraints, and opportunities and their impact analysis on the market size is provided.Porters five forces analysis illustrates the potency of buyers and suppliers operating in the portable gaming industry.The quantitative analysis of the Nanorobotics industry from 2020 to 2026 is provided to determine the Nanorobotics market potential.

The research report is broken down into chapters, which are introduced by the executive summary. Its the introductory part of the chapter, which includes details about global market figures, both historical and estimates. The executive summary also provides a brief about the segments and the reasons for the progress or decline during the forecast period. The insightful research report on the Nanorobotics market includes Porters five forces analysis and SWOT analysis to understand the factors impacting consumer and supplier behavior.

Market Segment Analysis

The research report includes specific segments by Type and by Application. Each type provides information about the production during the forecast period of 2015 to 2026. Application segment also provides consumption during the forecast period of 2015 to 2026. Understanding the segments helps in identifying the importance of different factors that aid the market growth.

Segment by TypeNanomanipulator, Bio-Nanorobotics, Magnetically Guided, Bacteria-Based

Segment by ApplicationNanomedicine, Biomedical, Mechanical

Nanorobotics Market: Competitive Landscape

This section of the report identifies various key manufacturers of the market. It helps the reader understand the strategies and collaborations that players are focusing on combat competition in the market. The comprehensive report provides a significant microscopic look at the market. The reader can identify the footprints of the manufacturers by knowing about the global revenue of manufacturers, the global price of manufacturers, and production by manufacturers during the forecast period of 2015 to 2019.

Nanorobotics Market: Regional Analysis

The report offers in-depth assessment of the growth and other aspects of the Nanorobotics market in important regions, including the U.S., Canada, Germany, France, U.K., Italy, Russia, China, Japan, South Korea, Taiwan, Southeast Asia, Mexico, and Brazil, etc. Key regions covered in the report are North America, Europe, Asia-Pacific and Latin America.

The report has been curated after observing and studying various factors that determine regional growth such as economic, environmental, social, technological, and political status of the particular region. Analysts have studied the data of revenue, production, and manufacturers of each region. This section analyses region-wise revenue and volume for the forecast period of 2015 to 2025. These analyses will help the reader to understand the potential worth of investment in a particular region.

Table Of Content

Market Overview: Scope & Product Overview, Classification of Nanorobotics by Product Category (Market Size (Sales), Market Share Comparison by Type (Product Category)), Nanorobotics Market by Application/End Users (Sales (Volume) and Market Share Comparison by Application), Market by Region (Market Size (Value) Comparison by Region, Status and ProspectNanorobotics Market by Manufacturing Cost Analysis:Key Raw Materials Analysis, Price Trend of Key Raw Materials, Key Suppliers of Raw Materials, Market Concentration Rate of Raw Materials, Proportion of Manufacturing Cost Structure (Raw Materials, Labor Cost), Manufacturing Process Analysis

Key Strategic Developments: The study also includes the key strategic developments of the Nanorobotics market, comprising R&D, new product launch, M&A, agreements, collaborations, partnerships, joint ventures, and regional growth of the leading competitors operating in the market on a global and regional scale.

Key Market Features: The report evaluated key market features, including revenue, price, capacity, capacity utilization rate, gross, production, production rate, consumption, market share, CAGR, and gross margin.

Analytical Tools: The Nanorobotics Market report includes the precisely studied and weighed data of the key industry players and their scope in the Nanorobotics market by means of several analytical tools.

Get the Customization of the Report within 24 Hours at:https://www.worldwidemarketreports.com/quiry/356091

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Latest News: Nanorobotics Market Is Taking Foot Back Due to Covid-19! is it? Check out with Analysis of Leading Players in the Globe- Bruker, JEOL,...

HIV monotherapy trials update: 215 patients completed almost one year of monotherapy. Only some were allowed to continue in extension arm; five patients reached almost 6 years. Twenty-five reached 2 to 4 years and 20 patients are 1 to 2 years

VANCOUVER, Washington, Aug. 17, 2020 (GLOBE NEWSWIRE) -- CytoDyn Inc. (OTC.QB: CYDY), (CytoDyn or the Company"), a late-stage biotechnology company gives full update on all of its HIV programs.

HIV CureThe HIV co-receptor CCR5 has proven to be a key molecule in mediating HIV remission. The only two individuals functionally cured of HIV, one from London and the other from Berlin, received allogeneic stem cell transplantations from CCR5-deficient donors. However, because it is extremely rare to find a stem cell donor who lacks CCR5 and meets stringent MHC matching criteria, such an approach is unfeasible to cure HIV on a larger scale. CytoDyn believes its CCR5 blocking antibody, leronlimab, could be used in the setting of allogeneic stem cell transplantation to functionally convert a stem cell graft from a wildtype CCR5 stem cell donor into one from a CCR5 deficient donor, and thereby functionally cure the recipient of HIV.

CytoDyn plans to test this theory in a pilot clinical trial of five HIV patients with cancer who require bone marrow transplantation. Leronlimab will be used during the peri-transplant period to mimic a CCR5 deficient donor in order to achieve HIV cure.

HIV PrEPAs presented at the AIDS 2020 Virtual Conference, a pre-clinical study in the macaque model of HIV sexual transmission demonstrated leronlimab can prevent infection by blocking HIVs access to the CCR5 co-receptor. This protection is similar to that seen in individuals naturally CCR5 deficient and forms the rationale for use in HIV cure. CytoDyn believes leronlimab could be a once-a-month self-injectable, subcutaneous treatment for HIV PrEP and is in discussions with potential organizations to fund its next trial in HIV PrEP.

MonotherapySignificantly, for the first time documented, of the 49 HIV patients who stopped their HIV medications and used leronlimab as a monotherapy, 25 have been in monotherapy trial for two to four years and five patients for nearly or over six years. Monotherapy was successful for some of these patients by switching from 350 mg to a higher dose of 525 mg or 700 mg. The number of participants in the extension groups was limited due to costs.

The Company will submit manuscripts for two publications in regards to its findings.

Nader Pourhassan, Ph.D., President and Chief Executive Officer of CytoDyn, stated, We now have four paths forward for use of leronlimab in the HIV indication for different populations. The first path is a combination therapy where we successfully completed a Phase 3 trial with statistically significant p value for our primary endpoint. CytoDyn is awaiting a Type A meeting with the FDA for this treatment. Second is our monotherapy; we will discuss the potential approval path for label expansion at the time of our Type A meeting. Third is our PrEP study to examine the use of leronlimab for once-a-month self-injection for HIV prevention. Our fourth path is an HIV-Cure, where 5 patients will be put to test to duplicate the Berlin and London patients HIV functional cure.

About Leronlimab (PRO 140)The FDA has granted a Fast Track designation to CytoDyn for two potential indications of leronlimab for critical illnesses.

The first as a combination therapy with HAART for HIV-infected patients and the second is for metastatic triple-negative breast cancer.Leronlimab is an investigational humanized IgG4 mAb that blocks CCR5, a cellular receptor that is important in HIV infection, tumor metastases, and other diseases, including NASH.Leronlimab has completed nine clinical trials in over 800 people and met its primary endpoints in a pivotal Phase 3 trial (leronlimab in combination with standard antiretroviral therapies in HIV-infected treatment-experienced patients).

In the setting of HIV/AIDS, leronlimab is a viral-entry inhibitor; it masks CCR5, thus protecting healthy T cells from viral infection by blocking the predominant HIV (R5) subtype from entering those cells. Leronlimab has been the subject of nine clinical trials, each of which demonstrated that leronlimab could significantly reduce or control HIV viral load in humans. The leronlimab antibody appears to be a powerful antiviral agent leading to potentially fewer side effects and less frequent dosing requirements compared with daily drug therapies currently in use.

In the setting of cancer, research has shown that CCR5 may play a role in tumor invasion, metastases, and tumor microenvironment control. Increased CCR5 expression is an indicator of disease status in several cancers. Published studies have shown that blocking CCR5 can reduce tumor metastases in laboratory and animal models of aggressive breast and prostate cancer. Leronlimab reduced human breast cancer metastasis by more than 98% in a murine xenograft model. CytoDyn is, therefore, conducting aPhase 1b/2 human clinical trial in metastatic triple-negative breast cancer and was granted Fast Track designation in May 2019.

The CCR5 receptor appears to play a central role in modulating immune cell trafficking to sites of inflammation. It may be crucial in the development of acute graft-versus-host disease (GvHD) and other inflammatory conditions. Clinical studies by others further support the concept that blocking CCR5 using a chemical inhibitor can reduce the clinical impact of acute GvHD without significantly affecting the engraftment of transplanted bone marrow stem cells. CytoDyn is currently conducting a Phase 2 clinical study with leronlimab to support further the concept that the CCR5 receptor on engrafted cells is critical for the development of acute GvHD, blocking the CCR5 receptor from recognizing specific immune signaling molecules is a viable approach to mitigating acute GvHD. The FDA has granted orphan drug designation to leronlimab for the prevention of GvHD.

About CytoDynCytoDyn is a late-stage biotechnology company developing innovative treatments for multiple therapeutic indications based on leronlimab, a novel humanized monoclonal antibody targeting the CCR5 receptor. CCR5 appears to play a critical role in the ability of HIV to enter and infect healthy T-cells.The CCR5 receptor also appears to be implicated in tumor metastasis and immune-mediated illnesses, such as GvHD and NASH.

CytoDyn has successfully completed a Phase 3 pivotal trial with leronlimab in combination with standard antiretroviral therapies in HIV-infected treatment-experienced patients. The Company has requested a Type A meeting with the FDA to discuss the FDAs request for additional information in order to resubmit its Biologics License Application for this HIV combination therapy.

CytoDyn is also conducting a Phase 3 investigative trial with leronlimab as a once-weekly monotherapy for HIV-infected patients. CytoDyn plans to initiate a registration-directed study of leronlimab monotherapy indication. If successful, it could support a label extension. Clinical results to date from multiple trials have shown that leronlimab can significantly reduce viral burden in people infected with HIV. No drug-related serious site injection reactions reported in about 800 patients treated with leronlimab and no drug-related SAEs reported in patients treated with 700 mg dose of leronlimab. Moreover, a Phase 2b clinical trial demonstrated that leronlimab monotherapy can prevent viral escape in HIV-infected patients; some patients on leronlimab monotherapy have remained virally suppressed for more than five years.

CytoDyn is also conducting a Phase 2 trial to evaluate leronlimab for the prevention of GvHD and a Phase 1b/2 clinical trial with leronlimab in metastatic triple-negative breast cancer. More information is atwww.cytodyn.com.

Forward-Looking StatementsThis press releasecontains certain forward-looking statements that involve risks, uncertainties and assumptions that are difficult to predict. Words and expressions reflecting optimism, satisfaction or disappointment with current prospects, as well as words such as believes, hopes, intends, estimates, expects, projects, plans, anticipates and variations thereof, or the use of future tense, identify forward-looking statements, but their absence does not mean that a statement is not forward-looking. Forward-looking statements specifically include statements about leronlimab, its ability to have positive health outcomes, the possible results of clinical trials, studies or other programs or ability to continue those programs, the ability to obtain regulatory approval for commercial sales, and the market for actual commercial sales. The Companys forward-looking statements are not guarantees of performance, and actual results could vary materially from those contained in or expressed by such statements due to risks and uncertainties including: (i)the sufficiency of the Companys cash position, (ii)the Companys ability to raise additional capital to fund its operations, (iii) the Companys ability to meet its debt obligations, if any, (iv)the Companys ability to enter into partnership or licensing arrangements with third parties, (v)the Companys ability to identify patients to enroll in its clinical trials in a timely fashion, (vi)the Companys ability to achieve approval of a marketable product, (vii)the design, implementation and conduct of the Companys clinical trials, (viii)the results of the Companys clinical trials, including the possibility of unfavorable clinical trial results, (ix)the market for, and marketability of, any product that is approved, (x)the existence or development of vaccines, drugs, or other treatments that are viewed by medical professionals or patients as superior to the Companys products, (xi)regulatory initiatives, compliance with governmental regulations and the regulatory approval process, (xii)general economic and business conditions, (xiii)changes in foreign, political, and social conditions, and (xiv)various other matters, many of which are beyond the Companys control. The Company urges investors to consider specifically the various risk factors identified in its most recent Form10-K, and any risk factors or cautionary statements included in any subsequent Form10-Q or Form8-K, filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any responsibility to update any forward-looking statements to take into account events or circumstances that occur after the date of this press release.

CYTODYN CONTACTSInvestors:Michael MulhollandOffice: 360.980.8524, ext. 102Mobile: 503.341.3514mmulholland@cytodyn.com

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CytoDyn Will Attempt to Duplicate Berlin and London Patients' HIV Cure by Using Leronlimab During Bone Marrow Transplant for 5 HIV Patients Who also...

As the on-going COVID-19 pandemic continues we are facing a huge healthcare crisis. Globally the pandemic has accelerated or rather decelerated the entire human population into the confines. Work from home, social shielding and discreet outdoor ventures has not only disrupted our emotional well-being but has also drastically affected our physical health. As people are confined to their homes with reduced physical activity there is rapid bone resorption (loss) as muscles and bones are not getting adequate stimulation. Also lack of exposure to sun during the pandemic has critically affected vitamin D levels in our body. People are frequently feeling tired with lack of energy and strength. Everyone needs to be cautious about the health of their bones as much as their other needs. Bones support us and allow us to be mobile. Bone health is always a priority and we always tend to overlook it. Bone density problem is a silent manifestation and could lead to a major medical issue over a period of time. While osteoporosis onsets with age among men & women, women face the brunt a little earlier, like from their 30s. Well-versed with the situation and to avoid unnecessary bones issues, let us now take a look at some measures that can take care of your bones during the pandemic.Eat a well-balanced diet rich in calcium and vitamin DGood sources of calcium include low-fat dairy products, green leafy veggies and dry fruits. Good sources of vitamin D include fortified cereals, egg yolks, saltwater fish, liver and milk. Calcium and vitamin D work together to protect your bones - calcium helps to build and maintain bones; while vitamin D helps your body to effectively absorb calcium.

Get exposure to sunlight to make enough vitamin DRegular sun exposure is the most natural way to get enough vitamin D. The sun's ultraviolet B (UVB) rays hit cholesterol in the skin cells, providing the energy for vitamin D synthesis. Vitamin D has a significant role in calcium homeostasis and metabolism.

As per pan-India study the best time to get exposed to the sun is between 11 am and 1 pm since the wavelength of ultraviolet B (UVB) rays is 290-320nm during this period which is essential for skin to make vitamin D.

Get plenty of physical activityLike muscles, bones become stronger with exercise. The best exercises for healthy bones are strength-building and weight-bearing exercise like walking, climbing stairs, lifting weights and dancing. Try to get 30 minutes of exercise each day.

Strength-building and weight-bearing exercise provides stimulation to bone cells and helps to increased bone mineral density and bone size thus reduced the risk of osteoporosis.

Live a healthy lifestyle

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What do we need to know about our bone health during this pandemic - Times of India

LAGUNA BEACH, Calif., Aug. 18, 2020 /PRNewswire/ -- "Through an evidence-based innovative program that merges modern integrative medicine with traditional martial arts, Kids Kicking Cancer addresses the overwhelming needs of children with illness," said Rabbi Elimelech Goldberg, founder and global director for Kids Kicking Cancer. He adds, "We offer one-on-one training and group classes for both pediatric inpatients and outpatients in over fifty hospitals and institutions around the globe."

"We are thrilled to help this extraordinary organization expand their programs as broadly as possible," states Roger Holzberg, co-founder of Reimagine Well.

Together the two organizations are partnering to launch the Kids Kicking Cancer Infusionarium Platform, available to any pediatric hospital that would like to have the educational programs, immersive healing experiences, and live events as a part of what they offer to their patients and families as they undergo treatment. If your hospital would like access to the platform; contact us and we will find a way to make it available to you.

A patient and family version of the program is also available 24/7, to provide support whenever and wherever it's needed, over the course of the entire patient journey. Patients and families are able to use it on their smartphones, tablets, or home computers. If you, or someone you care about, would benefit from the Kids Kicking Cancer patient and family platform - click hereto get started.

All services provided by Kids Kicking Cancer are at no cost to the children and their families.

About Reimagine WellReimagine Well provides a proprietary platform and programs designed for infusion therapy, assisted living, and more; and has compiled an extensive library of patient-directed immersive healing experiences and disease-specific 'Learn Guides' hosted by clinicians and medical experts. Roger Holzberg and Leonard Sender, MD, founded Reimagine Well. Sender is the Medical Director of the Hyundai Cancer Institute at CHOC Children's Hospital, Orange County, California. He is board certified in Pediatric Hematology/Oncology and his primary interest is in immuno-oncology. Holzberg is the founder of My Bridge 4 Life, a former award-winning Disney Imagineer, the first (consulting) Creative Director of the National Cancer Institute and a 15-year cancer survivor.

About Kids Kicking Cancer Kids Kicking Cancer's mission is to ease the pain of very sick children while empowering them to heal physically, spiritually and emotionally.Kids Kicking Cancer provides services in 92 facilities in 7 countries. Their vision is to lower the pain of one million children by 2025. All services provided by Kids Kicking Cancer are at no cost to the children and their families. Children 3 years & older, and their siblings, are eligible for the program.

Contacts: Pam Carstens / (949) 793-8777 / [emailprotected]Cindy Cohen, MS, CCLS / (248) 864-8238 / [emailprotected]

SOURCE Reimagine Well

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Reimagine Well and Kids Kicking Cancer Partner on Innovative Platform for Patients and Families - PRNewswire

Whole grains may be better for your health, but figuring out which products are healthier by relying on whole grain labels can actually make it difficult to make healthy choices.

A new study found that these labels on cereal, bread, and crackers can be confusing for people trying to make smarter food choices.

The report published in the journal Public Health Nutrition detailed a survey of 1,030 U.S. adults. The participants were shown photos of real and hypothetical products with food labels. They were asked to identify healthier options for the hypothetical products or assess the whole grain content of the real products.

A significant number of respondents had the wrong answer for which product was healthier.

Our study results show that many consumers cannot correctly identify the amount of whole grains or select a healthier whole grain product, Parke Wilde, PhD, study author and professor at the Tufts University, said in a statement.

The authors wanted to find out if there was a strong legal argument that whole grain labels are misleading. Evidence could back up a movement for increased labeling requirements.

I would say when it comes to deceptive labels, whole grain claims are among the worst, added co-author Jennifer L. Pomeranz, an assistant professor of public health policy and management at New York University in New York City.

The labeling of whole grains has been a source of confusion and deception for a long time, said Dr. Amy Burkhart, an integrative medicine physician and registered dietitian based in Napa, California. Many brands use the term whole grain and others to influence customers purchasing decisions by creating a healthy product facade.

The term whole grain means that all portions of the kernel are included in the product, Burkhart explained.

The blurring of lines begins here, she said. The product only has to contain 51 percent whole grain ingredients to use the term whole grains.

For example, a label can say whole grain but up to 49 percent of the product may include processed grains.

There are whole grains and refined grains, said Vicki Shanta Retelny, RDN, a consultant for Northwestern Memorial Hospital in Chicago. Whole grains contain three parts: the bran, germ, and endosperm layers. Refined grains have been stripped of the bran and the germ layers and, in turn, are devoid of fiber, iron, B-vitamins, fatty acids, and antioxidants, which are inherent in the whole intact grain.

Refined grains are white flour products that may be enriched or fortified with vitamins and minerals to provide nutritional value.

Whole grains that are wheat-based contain gluten. Wheat-free grains are typically gluten-free unless there is cross-contamination during processing of the grain, Retelny said.

According to the U.S. Department of Health and Human Services and the U.S. Department of Agricultures 2015-2020 Dietary Guidelines for Americans, half of all grains consumed should be whole grains. Getting enough whole grains has been linked with lower risk of heart disease, type 2 diabetes, and cancer.

The most common types of whole grains that contain gluten include wheat, barley, rye, and spelt. Gluten-free whole grains include corn, oats, brown rice, quinoa, buckwheat, brown rice, sorghum, teff, millet, and amaranth, Burkhart said.

Ancient grains such as farro and spelt are those that have not been changed by modern breeding methods over the last several hundred years. Nonwheat ancient whole grains include sorghum, quinoa, and millet, she noted.

This doesnt mean they are necessarily more nutritious but they do require a lower amount of pesticides and water to be grown which is beneficial to the planet, Burkhart said.

As part of the survey, the packages on the hypothetical products either had no front-of-package whole grain label or were marked with multigrain, made with whole grains, or a whole grain stamp. The packages on the real products displayed the actual product markings, including multigrain, honey wheat, and 12 grain.

When looking at the hypothetical products, people had to answer if they thought the product was healthier. For the real products, they were asked to assess the whole grain content.

Of the hypothetical products, 29 percent to 47 percent incorrectly identified the healthier item. Specifically, they had the wrong answer 31 percent of the time for cereal, up to 37 percent for crackers, and 47 percent for bread items.

Of the real products that were not mostly composed of whole grains, 43 to 51 percent of respondents overstated the whole grain content depending on the products.

Researchers found 41 percent overstated the grain content for multigrain crackers, 43 percent for honey wheat bread, and 51 percent for 12-grain bread.

However, respondents more accurately identified the whole grain content of an oat cereal that mostly included whole grain.

While experts find the labeling standards by the Food and Drug Administration confusing, other groups have pushed for more transparency.

The Whole Grains Council, a nonprofit consumer advocacy group, has created three stamps to guide consumers but they are not on all products.

Companies must apply to use the stamp. The 100 percent stamp includes products where all grains are whole grain and the product contains at least 16 grams of whole grain per serving. The 50 percent stamp means that 50 percent or more of the grains in the product are whole and the product contains at least 8g of whole grain per serving. The basic stamp means the item contains at least 8 grams of whole grain per serving, Burkhart explained.

Terms such as wheat, semolina, durum wheat, organic flour, stoneground, multigrain, fiber, and cracked wheat may or may not be whole grains.

When youre buying a whole grain product, such as bread or crackers, look for the first ingredient to be a whole grain ingredient such as whole grain flour or whole wheat flour, said Amy Gorin, MS, a registered dietitian nutritionist in New Jersey. Many whole grain products are made with whole grains but dont contain them as a primary ingredient.

On bread labels, for example, the first ingredient should be whole grain flour, whole wheat flour, or another whole grain ingredient. It should not, for example, be enriched wheat flour.

The fiber content on the nutrition label is another giveaway whole grain products are likely to be good or excellent sources of fiber, Gorin said.

Retelny advises her clients to focus on the ingredients list of a product for the word whole before the grain. For example, look for whole wheat or whole oats instead of enriched wheat or oats, because those are refined versions of the grain, she said.

Just because its a brown bread doesnt mean its whole grain, Gorin said.

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Whole Grain Labels Confuse People Trying to Pick Healthy Options - Healthline

Construction is complete on Mercy Hospital Souths new cancer center.

This week, patients walked in to the David M. Sindelar Cancer Care Center to receive the first treatments provided in the new, state-of-the-art, comprehensive cancer center. The centers first day of operation was Monday.

What these patients will find are services to meet all their needs, to treat any type of cancer, all under one roof, said Dr. Shaun Donegan, Mercy regional medical director of medical oncology. Were talking about more than just their medical needs. We are seeking to provide for their emotional, spiritual, nutritional and other needs that come with a cancer diagnosis.

The Sindelar Cancer Center is a standalone, 2-story, 78,000-square-foot facility located on the Mercy South campus across the main drive from the emergency department. Patients and visitors walking through the main entrance are greeted by the open, invitingBoniface FoundationAtrium filled with natural light. The Rooney Breast Center has its own dedicated entrance on the opposite end of the facility, providing patients with direct access to mammography and other breast health services.

Once inside, patients will have access to the infusion center, radiation oncology services, imaging, laboratory, integrative medicine, Mercy Clinic offices, chapel, specialty boutique, cafe, conference center and more. Specialized co-workers, including oncology nurse navigators, counselors, chaplains, social workers and dietitian, provide the individualized care to each patient.

Weve listened to our patients over the years about what we can do to improve their care, Donegan said in a news release. The infusion center weve created is a great example of taking those suggestions and putting them into practice to meet the varying needs of our patients.

The infusion center includes three different spaces where patients can choose to receive treatment based on the level of privacy they want. A community room allows them to spend time with other patients, especially those patients they may see on a regular basis because they receive treatment on similar schedules. The open room includes a fireplace, virtual aquarium and a great view of the outdoors from the second floor.

Patients seeking more privacy can choose to use a semi-private bay that allows them to close or open a curtain as they wish. Another option patients may choose is a private room by themselves.

The radiation oncology unit is where the newest technology is most obviously on display with two state-of-the-art linear accelerators, including one of only six Accuray Radixact with Synchrony machines in use in the United States. This device is able to pinpoint where it needs to deliver its radiation treatment and follow that targeted area even when a patient moves. This helps a patient relax because they do not feel the pressure to remain perfectly still during the treatment, which can help relieve some of their stress.

The Sindelar Cancer Center also houses an Elektra Versa HD linear accelerator.

Imaging services include MRI, CT, PET, X-ray, ultrasound, mammography (both 3D tomosynthesis and 2D) and bone densitometer.

Another example of the steps taken to improve the comfort of patients is the addition of sensory suites to the mammography rooms to create a more relaxing environment.

Mercy Clinic physicians located in the cancer center include medical oncologists and hematologists, surgical specialists, breast surgery specialists and palliative care.

Working close to each other allows us to better collaborate, said Dr. John Whitfield, Mercy Clinic colorectal surgeon. That collaboration between different specialties in turn leads to better care for our patients.

The cancer center is a special place because weve brought together all the services a patient and their caregivers need in one building, said Kim McGrath, executive director of cancer and imaging services. We have physicians, lab, imaging, financial counseling, navigation and integrated medicine all in one place to provide quality care and exceptional service to make the most of their experience and time.

Integrative medicine includes services some people might not associate with cancer care and traditional medicine, such as acupuncture, chiropractic care, healing touch therapy, massage therapy, reflexology, mindfulness and meditation, tai chi, Pilates and yoga.

The Comfortable Cup Caf provides patients and visitors with healthy options to meet the nutritional needs of cancer patients. A specialty boutique offers a variety of items designed specifically for cancer patients, such as wigs and scarfs.

Patients, their family and friends can rely on chaplains for help with their spiritual needs, and a chapel provides a prayer space. Much of the furniture in the chapel was built byAnew Naturefrom trees removed from the site to make way for the cancer center. Anew teaches job skills to felons through its internship and employment program.

The center also includes conference space and plentiful parking with an extensive number of handicapped accessible spaces.

There are a lot of these details, from massage therapy to the cafe, from the boutique to the chapel, and from all the natural light to the decor, that by themselves are nice to have, Donegan said. But when you put them all together the way we have, they create an environment that benefits our patients a great deal, lowers their stress and promotes healing.

The name of the cancer center honorsDavid Sindelarand the leadership he provided St. Anthonys Medical Center for many years through the decision to join Mercy. That agreement was reached shortly before Sindelar lost his own battle with cancer in March 2017. Groundbreaking for the cancer center that bears his name took place in September 2018.

The name of theRooney Breast Center honors Sara Sindelar, whose maiden name is Rooney, along with the rest of the Sindelar and Rooney families, for their continued support of this project and the mission to serve the south St. Louis County community.

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Mercy South's new cancer center opens to public this week - Call Newspapers

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Even people who experienced mild infection may have long-term symptoms.

Once the most severe phase of COVID-19 infection has passed, many patients experience long-term issues.These patients often describe themselves as long-haulers or as having long-COVID.As the number of Australians diagnosed with COVID-19 has grown, so too has the number of patients with post-acute issues.This has led many GPs to seek information on how to best manage these ongoing concerns. Melbourne-based GP Associate Professor Vicki Kotsirilos, founding Chair of the RACGP Specific Interests Integrative Medicine network, is one of them.I actually thought about that last week when I read an article about long-term effects [of COVID-19], she told newsGP.I thought, Okay, what will I be advising my patients?Associate Professor Kotsirilos says it is totally understandable that robust clinical guidelines are not yet in place to help GPs manage patients with long-term sequelae of COVID-19.COVID-19 is a new disease and it takes a while for health authorities to prepare clinical, treatment and even practice guidelines, she said.I dont think weve been slow to provide that information. In fact, if anything, I think the RACGP and health authorities have been excellent.That said, Associate Professor Kotsirilos says it is imperative GPs are provided with more detailed information when it comes to specific clinical guidelines on helping manage potential long-term effects, such as the hypercoagulable state seen in some patients.We clearly do need better and quicker clinical guidelines for us to access, she said.It is important for GPs to know the best evidence-based treatments in those situations from a long-term perspective.A new article, published in The BMJ on 11 August, explores management of post-acute issues in COVID-19 patients; though the authors acknowledge there are not yet definitive, evidence-based recommendations for management.We therefore used a pragmatic approach based on published studies on SARS and MERS, early editorials and consensus based guidance on COVID-19, a living systematic review, early reports of telerehabilitation (support and exercise via video link), and our own clinical experience, they wrote.According to the article, which is directed at primary care practitioners, approximately 10% of people remain unwell beyond three weeks after diagnosis with COVID-19.Post-acute COVID-19 long COVID seems to be a multi-system disease, sometimes occurring after a relatively mild acute illness, the authors wrote.They say such patients can broadly be divided into those who may have serious sequelae, such as thromboembolic complications, and those with a non-specific clinical picture, mainly characterised by symptoms such as fatigue and breathlessness.The authors define long-COVID as extending beyond three weeks from the onset of first symptoms, while chronic-COVID is defined as extending beyond 12 weeks.The authors list the symptoms of post-acute COVID-19 as:

On the other hand, severe breathlessness may require urgent referral. The following management principles apply:

Associate Professor Vicki Kotsirilos says clinical guidelines are needed to help GPs manage patients with post-acute symptoms of this infection.

FatigueFatigue is a common complaint following infection with COVID-19.It has also been called the most common and debilitating symptom in [ICU] survivors.A letter to the editor published in Medical Hypotheses on 27 June highlights the potential for a post-viral syndrome to manifest following COVID-19.After the acute SARS episode some patients, many of whom were healthcare workers, went on to develop a chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)-like illness, which nearly 20months on prevented them returning to work, the authors of the letter wrote.We propose that once an acute COVID-19 infection has been overcome, a subgroup of remitted patients are likely to experience long-term adverse effects resembling CFS/ME symptomatology such as persistent fatigue, diffuse myalgia, depressive symptoms, and non-restorative sleep.The authors of the BMJ article say they found no published evidence on the efficacy of either pharmacological or non-pharmacological interventions on fatigue after COVID-19.Associate Professor Kotsirilos says she would advise patients experiencing fatigue to address lifestyle and behavioural factors.Ensuring that they eat well, that they rest, theyre cared for by other people, go to bed early for a good nights sleep and a graded exercise program, she said. It would be just like [management strategies for] patients suffering post-viral fatigue.Chest painThis is another common symptom after acute COVID-19, and clinical assessment should follow similar principles to that for any chest pain.Where the diagnosis is uncertain, or the patient is acutely unwell, urgent cardiology referral may be needed for specialist assessment and investigations (including echocardiography, computed tomography of the chest, or cardiac magnetic resonance imaging), the BMJ authors wrote.Ventricular dysfunctionThe authors advise intense cardiovascular exercise must be avoided for three months in all patients after myocarditis or pericarditis.Meanwhile, athletes are advised to take 36 months of complete rest from cardiovascular training followed by specialist follow-up.ThromboembolismIt is now recognised that COVID-19 can cause a hypercoagulable state with increased risk of thromboembolic events.The authors say many hospitalised patients receive prophylactic anticoagulation.Recommendations for anticoagulation after discharge vary, but higher risk patients are typically discharged from hospital with 10 days of extended thromboprophylaxis, they wrote.If the patient has been diagnosed with a thrombotic episode, anticoagulation and further investigation and monitoring should follow standard guidelines.It is not known how long patients remain hypercoagulable following acute COVID-19.Associate Professor Kotsirilos would like further detailed information for GPs on this topic, including whether the best anticoagulant in this situation is warfarin or another blood thinner, such as low-dose aspirin.That is important for GPs to know, she said.Clinical guidelines are required to help us keep up-to-date with evidence-based appropriate treatments such as the role of blood thinners when to prescribe them and for how long.Neurological sequelaePatients with serious complications such as stroke, seizures or encephalitis should be referred to a neurologist.Meanwhile, non-specific symptoms such as headaches, dizziness and brain fog require supportive management and symptom monitoring.Brain fog is a particularly common symptom reported by patients who describe themselves as long-haulers.Associate Professor Kotsirilos says measures that can help a patient manage fatigue are also applicable for brain fog.Brain fog has been seen with other post-viral chronic fatigue syndromes, she said.With brain fog, its all about resting, avoiding the computer, letting the head or brain rest, not returning to work too quickly, exercise especially outdoors for fresh air but gradually.Other measures include ensuring adequate sleep, reducing stress and eating well.Mental healthWhile a minority of patients may benefit from referral to mental health services, it is important not to pathologise the majority, the authors wrote.Patient organisations emphasise wellbeing, mindfulness, social connection, self-care (including diet and hydration), peer support, and symptom control.Associate Professor Kotsirilos agrees these measures can assist with mental health issues. However, she says regular check-ins with a GP and a mental health care plan may also be important if patients are not coping.Holistic management of the patientAssociate Professor Kotsirilos believes GPs are ideally placed to help manage COVID-19 patients with post-acute issues.When patients have suffered from COVID-19 infection and are suffering long-term effects like chronic fatigue, GPs are in a great position to validate their symptoms, reassure them, explain to them that it is a new disease, were only just coming to understand it, but it is common to get post-viral fatigue, brain fog and other symptoms, she said.GPs play an important role in helping patients make a full recovery post COVID-19 infection.She says GPs can also use this opportunity to discuss lifestyle measures, exercise, reducing stress and avoiding harmful substances like excessive alcohol and smoking.The BMJ authors agree primary care practitioners are in an ideal position to ensure ongoing patient care for those with post-acute symptoms of COVID-19.From the limited current evidence, we anticipate that many patients whose COVID-19 illness is prolonged will recover without specialist input through a holistic and paced approach, they wrote.GPs can also offer their patients much-needed reassurance throughout this process.Patients, many of whom were young and fit before their illness, have described being dismissed or treated as hypochondriacs by health professionals, the authors wrote.In these uncertain times, one key role that the primary care practitioner can play is that of witness, honouring the story of the patient whose protracted recovery was unexpected, alarming, and does not make sense.Log in below to join the conversation.

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newsGP - Managing post-acute issues in COVID patients: What GPs need to know - RACGP

By Deepak Chopra,TM MD and Menas C. Kafatos, PhD

As we go about everyday life, we are embedded in a mystery no one has ever solved. The mystery was voiced by one of the most brilliant quantum pioneers, Werner Heisenberg: Not only is the Universe stranger than we think, it is stranger than we can think. (There are variants of the quote that use reality for universe, and the remark has also been attributed to other famous scientists, but the gist is always the same.)

If we take this remark seriously, it turns out to be truer today than it was in 1900 when the quantum revolution began and the revolutionary new theory of quantum mechanics was put together. How can reality be stranger than we could possibly think? Look at the framework of your life. You pick up your morning coffee, and instantly you are acting in space and time. Your perception of the cup in your hand depends upon the five senses as communicated through the brain. You can think about anything you fancy as you sip your coffee.

These might not seem so mysterious, but there is one mystery after another nested inside everyday experience. Science can reach no consensus on the following:

Where did time come from? Why do properties of physical objects have their origin in invisible waves of probability of observation? Where does a thought come from? How did matter transform into mind? Is consciousness solely a human trait or is it everywhere in the universe?

The pioneers of quantum physics werent the first to ask such questions, but quantum physics got to the nub of how the physical universe is constructed. Everything in existence emerges from ripples in the quantum field, and underlying these ripples is an invisible or virtual domain that goes beyond spacetime, matter, and energy. In the virtual domain, the universe and everything in it is a field of infinite possibilities, and yet the virtual domain cannot be observed directly. As a result, contemporary physics can take us to the horizon of reality, the womb of creation, but it cannot cross the boundary between us and our source of existence.

Almost all the recent models that have gained popularity, including superstrings, the multiverse, and dark matter and energy, exist in so-called mathematical space, or Hilbert space, in recognition that they are not going to yield direct empirical evidence that can be perceived with our senses. Astrophysics had already gotten used to the fact that just 4% of the created universe is accounted for by the matter and energy visible to the eye or to telescopes. With dark matter and energy added in, most of what we see is not really what the universe consists of.

Leaving the technicalities aside, it has become far more difficult to foresee that the human mind can fully comprehend the nature of reality when so many crucial aspects are beyond the setup that our brains can grasp. The thinking mind needs the brain in order to operate, and the brain is a creation in spacetime consisting of matter and energy, that are in spacetime. We wear mind-made manacles. When this fact dawned on the late Stephen Hawking, he ruefully conceded that scientific models might no longer describe reality in any reliable or complete way.

When we discussed these issues in our book, You Are the Universe, the title reflected another approach entirely. Instead of founding the universe on physical things, however small, or even ripples in the quantum field, which are knowable only through advanced mathematics, reality can be grounded in experience. Everything we call real is an experience in consciousness, including the experience of doing science. Mathematics is a very refined, complex language, but there is no language, simple or complex, without consciousness.

The vast majority of scientists will continue to engage in experimentation and theoretical modeling without this venture into metaphysics, which is a no-no word in science (a famous put down when things get to speculative is Shut up and calculate). But it was quantum physics that brought the mystery of reality into the laboratory in modern terms, even though Plato and Aristotle also wondered about what is real.

A younger generation has proved more open-minded, and a growing cadre of cosmologists now hold to the notion of panpsychism, which holds that mind is built into reality from the start. This is a huge turn-around from the view that mind evolved out of matter here on Earth as a unique creation. The fact is that nobody in the physicalist camp could explain how atoms and molecules learned to thinkcreating mind out of matter was dead on arrival, even though the vast majority of scientists still hold on to this view as an assumption or superstition.

Ironically, to say that reality is stranger than we can think isnt confined to the queer behavior of atoms and subatomic particles. You cannot think about consciousness, either, any more than the eye can see itself or the brain know that it exists (without cutting through the skull to seethe brain from the outside). A fish cannot know that water is wet unless it jumps out of the sea and splashes back down again. We cannot think about consciousness without a place to stand outside consciousness, and such a place doesnt exist in the entire cosmos.

The source of space isnt inside space; the source of time isnt in time. Likewise, the source of mind isnt inside the mind. The ceaseless stream of sensations, images, feelings, and thoughts that run through your mind are the products of consciousness. Consciousness itself has no location. It is infinite, without dimensions in space and time, unborn and undying. Can you really think about such a thing as consciousness? And yet you know without a doubt that you are conscious. This is what allows us to make peace with reality being too strange to think about.

We can simply drop the strange part. Reality can be founded on knowing that you exist and that you are aware. Existence is consciousness. If science is dedicated to the simplest, most complete explanation of things, existence = consciousness is the simplest and most complete explanation. There is no need for religious or spiritual beliefs in order to accept this foundation for reality, since it is based on what science has arrived at. By removing our outdated allegiance to things existing independently of consciousness, the basis of reality can be seen clearly. In our everyday life we navigate with existence and consciousness at our side, indivisible, secure, inviolate, and unchallengeable. A whole new future may spring from accepting this simple but awe-inspiring fact.

DEEPAK CHOPRATM MD, FACP, founder of The Chopra Foundation, a non-profit entity for research on well-being and humanitarianism, and Chopra Global, a modern-day health company at the intersection of science and spirituality, is a world-renowned pioneer in integrative medicine and personal transformation. Chopra is a Clinical Professor of Family Medicine and Public Health at the University of California, San Diego and serves as a senior scientist with Gallup Organization. He is the author of over 89 books translated into over forty-three languages, including numerous New York Times bestsellers.His 90th book, Metahuman: Unleashing Your Infinite Potential, unlocks the secrets to moving beyond our present limitations to access a field of infinite possibilities. TIME magazine has described Dr. Chopra as one of the top 100 heroes and icons of the century.

Menas C. Kafatos is the Fletcher Jones Endowed Professor of Computational Physics at Chapman University. Author, physicist and philosopher, he works in quantum mechanics, cosmology, the environment and climate change and extensively on philosophical issues of consciousness, connecting science to metaphysical traditions. Member or candidate of foreign national academies, he holds seminars and workshops for individuals, groups and corporations on the universal principles for well-being and human potential. His doctoral thesis advisor was the renowned M.I.T. professor Philip Morrison who studied under J. Robert Oppenheimer. He has authored 334 articles, is author or editor of 20 books, including The Conscious Universe, Looking In, Seeing Out, Living the Living Presence (in Greek and in Korean), Science, Reality and Everyday Life (in Greek), and is co-author with Deepak Chopra of the NY Times Bestseller You are the Universe (Harmony Books), translated into many languages and at many countries. You can learn more at http://www.menaskafatos.com

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The Spread of 'Stranger Than We Can Think' - SFGate

A Sino-U.S. collaborative study has demonstrated that acupuncture regulates inflammation by activating pro- or anti-inflammatory signaling pathways, while mitigating cytokine storms in mice with systemic inflammation, the study authors reported in the Aug. 12, 2020, edition of Neuron.

The study also found that the acupuncture site, intensity and timing determined how it affected response, which has important implications for acupuncture use in inflammatory diseases and as adjunctive cancer therapy.

Acupuncture was further shown to influence how mice coped with the aberrant immune system reaction of cytokine storm due to rapid excessive release of pro-inflammatory cytokines.

Our study provides an insight into how acupuncture can drive distinct autonomic pathways and modulate inflammation in acupoint-, stimulation intensity- and disease state-dependent manners, said study leader Qiufu Ma, a professor in the Dana Farber Cancer Institute and the Department of Neurobiology at Harvard Medical School.

Cytokine storms are a characteristic of inflammatory diseases, notably bacterial or viral infections causing sepsis, an organ-damaging, often-fatal inflammatory response.

Cytokine storms can also be caused by excessive inflammatory responses to traumatic tissue injury, some surgeries, and cancer immunotherapies such as immune checkpoint inhibition, but currently there are no FDA-approved treatments for severe cytokine storms, noted Ma.

For cancer patients receiving immunotherapy who develop inflammatory side effects, milder symptoms might be relieved by corticosteroids, which have their own side effects, he said.

In COVID-19 patients, early pilot studies have suggested using an antibody against the cytokine, interleukin-6 (IL-6), but larger clinical trials are needed to confirm the efficacy and safety of this approach, he told BioWorld.

A traditional Chinese medicine technique, acupuncture has become increasingly integrated into Western medicine, particularly for treating chronic pain and gastrointestinal disorders.

It involves mechanical stimulation of acupoints, supposedly triggering nerve signaling and affecting the function of internal organs corresponding to those acupoints, but acupunctures basic underlying mechanisms have not been fully elucidated.

In their new study, Ma and his research team investigated the use of electroacupuncture stimulation (ES), in which ultra-thin electrodes offer better control of stimulation intensity than traditional needles.

The researchers investigated two cell types secreting the neurotransmitters known to be important inflammatory mediators: adrenal gland chromaffin cells, the main producers of adrenaline, noradrenaline (NA) and dopamine, and peripheral NA neurons.

To determine the precise role these cells play in inflammatory responses, the researchers used a novel genetic tool to ablate chromaffin cells or NA neurons.

We genetically introduced the human diphtheria toxin receptor (DTR) selectively to molecularly defined sympathetic cells, such as those marked by expression of neuropeptide Y (NPY), explained Ma.

Injecting a modified diphtheria toxin that does not cross the brain-blood barrier can selectively ablate DTR-expressing cells, creating mice lacking both NPY-expressing chromaffin cells and NA neurons, or those with a more selective ablation of NPY-expressing chromaffin cells via injecting low-dose toxin only into the adrenal gland.

That allowed inflammatory response comparison in mice with and without those cells, to determine their role in modulating inflammation. The markedly different responses then identified those cells as key regulators of inflammation.

Hind-limb administration of low-intensity ES to mice with a bacterial toxin-induced cytokine storm was shown to activate the vagus-adrenal axis, inducing dopamine secretion from chromaffin cells.

We used the induction of a neuronal activation marker to show that low-intensity ES activated hind-brain vagal efferent neurons, which are known to innervate thoracic and visceral organs and tissues, said Ma.

We then showed that low-intensity ES could reduce cytokine storms and promote survival, and that these ES effects were lost in mice with transected vagal efferents or in those with ablation of NPY-expressing adrenal chromaffin cells, suggesting involvement of the vagal-adrenal anti-inflammatory axis.

Specifically, treated animals had more than 50% reductions in the cytokines, tumor necrosis factor-alpha (TNF-a), IL-6 and IL-1b, than untreated controls, and prolonged survival rates of 60% vs. 20%, respectively.

In addition, the vagus-adrenal axis was shown to be activated by hind-limb ES, but not by that using abdominal acupoints, demonstrating the importance of acupoint selectivity in driving specific anti-inflammatory pathways.

Treatment timing was also found to be critical, with high-intensity abdominal stimulation producing markedly different outcomes, depending on when treatment occurred.

For example, animals treated before developing cytokine storm had lower levels of inflammation during subsequent disease and their survival increased from a range of 20% to 30% to a range of 70% to 80%.

Conversely, those treated after disease onset and during the cytokine storm peak experienced worse inflammation and more severe disease.

Together, those findings suggest that ES could be a versatile treatment modality, from adjunct therapy for sepsis to targeted treatment of site-specific inflammation, such as in inflammatory intestinal diseases.

Acupuncture might also help modulate inflammation due to cancer immune therapy, which can trigger cytokine storms, and is currently used in integrative cancer treatment to help patients tolerate treatment side effects.

However, before considering any therapeutic use, those findings must be further confirmed in animals and humans, optimal ES parameters must be defined and its safety established.

Safety

High-intensity ES can drive spinal-splenic noradrenergic sympathetic neuronal pathway, potently reducing inflammation if performed before cytokine storm induction, said Ma.

However, after the first cytokine storm wave has peaked, high-intensity ES can exacerbate inflammation and increase fatality rates, due to altered NA receptor profiles in immune cells switching from anti-inflammatory to pro-inflammatory dominance.

As such, high intensity ES may be associated with unforeseen safety issues, but fortunately low intensity ES is sufficient to drive the vagal-adrenal axis and safely attenuate inflammation in a disease state-independent manner, Ma said.

In the future, he said, inflammation modulation needs to be fine-tuned, since excessive suppression could reduce the ability of the immune system to fight with infection, necessitating future human studies to optimize stimulation parameters.

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Acupuncture shown to regulate inflammation in mice - BioWorld Online

Kayla Brim laughed when she learned it could take 10 days to get her COVID-19 test results back. I thought, Okay, well, within 10 days I should be fine, she remembers.

That was on July 2. More than a month later, Brim is still far from fine.

Prior to the pandemic, the 28-year-old from Caldwell, Idaho, juggled homeschooling her two kids with her work as a makeup artistshe was supposed to open her own salon in July. Now, she suffers daily from shortness of breath, exhaustion, excruciating headaches, brain fog, neuropathy, high blood pressure and loss of taste and smell. She feels like a little old lady, completely knocked out by simple tasks like making lunch for her children. Shes working just enough to help pay the bills and the lease on her empty salon, but she has no idea when shell be able to work full-time again, and no idea how she and her husband will manage financially if she cant. Half of my day is spent trying to sleep, and the other half of it is trying to pretend like Im okayand I dont know when Ill be okay, Brim says.

This is long-haul COVID-19. Even young, healthy people can become long-haulers (as many call themselves), left unable to work, lead a normal life or, some days, get out of bed. The consequences for each individual can be devastatingand at scale, theyre staggering. Over time, long-haul coronavirus may force hundreds of thousands of people out of work and into doctors offices, shouldering the double burden of lost wages and hefty medical bills for the indeterminate future. To treat them, the health care system may have to stretch already-thin resources to the breaking point.

Its going to be an impending tsunami of patientson top of all the [usual] chronic care that we do, says Dr. Zijian Chen, medical director of the Center for Post-COVID Care at New York Citys Mount Sinai Health System, one of the countrys only clinics devoted to caring for patients in the aftermath of coronavirus infection. At some point it becomes very unsustainablemeaning, the system will collapse.

When most people think of COVID-19, they imagine two possibilities: a flu-like illness that clears on its own, or a life-threatening condition that requires ventilation and a hospital stay. Its not hard to see how the latter scenario leads to long-term damage. Mechanical ventilation is incredibly hard on the lungs, and days or weeks spent sedated in a hospital bed can sap physical and mental strength. In a small study published in 2011, nearly all the participants who needed intensive treatment for a severe lung injury reported decreased physical ability and quality of life five years after leaving the hospital. Some took years to return to work. Hospitalized coronavirus patients may face a similar fate.

But with COVID-19, its not just the sickest who face a long road back. A July 24 report from the U.S. Centers for Disease Control and Prevention (CDC) found that, out of about 300 non-hospitalized but symptomatic COVID-19 patients, 35% were still experiencing symptoms like coughing, shortness of breath and fatigue up to three weeks after diagnosis. (By contrast, more than 90% of non-hospitalized influenza patients fully recover within two weeks.) Recovery from COVID-19 can be a drawn-out process for patients of all ages, genders and prior levels of health, potentially leading to prolonged absence from work, studies, or other activities, the report noted.

The CDCs surveyors only checked up on people a few weeks after they tested positive for coronavirus, but emerging evidence suggests a large subset of patients are sick for months, not just weeks, on end. Dr. Michael Peluso, who is studying long-term COVID-19 outcomes at the University of California, San Francisco, says about 20% of his research participants are still sick between one and four months after diagnosis.

Kayla Brim with her family, outside their home in Caldwell, Idaho, on Aug. 11. Brim has been sick with COVID-19 since early July.

Angie Smith for TIME

The implications of that problem are enormous. If even 10% of the more than 5 million (and counting) confirmed COVID-19 patients in the U.S. suffer symptoms that last this long, half a million people are already or could soon become chronically ill for the foreseeable future.

When Mount Sinai opened its Post-COVID Center in May, the hospital advertised it as the first in the country; since then, a handful of others have opened in states including Colorado, Indiana and Illinois. Mount Sinais clinic was modeled after the practice the hospital opened to treat survivors of the 9/11 terrorist attacks. Its very similar. Its a new group, and they need special care, Chen says. The biggest difference, he says, is the size of the group. Significantly more people have survived COVID-19 than were directly affected by 9/11. Mount Sinai has only scratched the surface of that demand, treating about 300 people so far. The wait time for new patients extends into October.

The challenge for doctors like Chen is that nobody really knows why long-haul COVID-19 happens, let alone how to treat it. Other viral diseases with long-term symptoms, such as HIV/AIDS, offer some clues, but every day in the clinic is essentially uncharted territory. One hypothesis is that the virus persists in the body in some form, causing continuing problems. Another is that coronavirus pushes the immune system into overdrive, and it stays revving even after the acute infection passes. But at this point, its not clear which theory, if either, is right, or why certain patients recover in days and others suffer for months, Peluso says.

Plus, just as theres huge variation in acute COVID-19 symptoms, not all long-term patients have the same issues. A researcher from the Indiana University School of Medicine in July surveyed 1,500 long-haulers from Survivor Corps, an online COVID-19 support group. They reported almost 100 distinct symptoms, from anxiety and fatigue to muscle cramps and breathing problems. A JAMA Cardiology study published in July suggested many recently recovered patients had lingering heart abnormalities, with inflammation the most common.

Some long-term COVID-19 patients have abnormal test results or damage to a specific organ, giving doctors clues as to how they should be treated. But for others, theres no obvious reason for their suffering, making treatment an educated guessing game. We dont know why they [still] have symptoms. We dont know if our techniques are working, Chen says. We dont know if theyre going to get back to 100%, or 90%, or 80%.

With little evidence, some doctors turn coronavirus long-haulers away or try to convince them their symptoms are psychological. Marcus Tomoff, a 28-year-old in Tampa, Fla. who is in his second month of debilitating fatigue, back and chest pain, nausea and anxiety after a bout of coronavirus, says he hasnt been taken seriously by friends or even his doctors. Several times Ive cried in front of my doctors and they say, You need to deal with this, youre young, he says.

The haphazard testing system in the U.S. has further complicated patients searches for care. Mount Sinais Post-COVID Center, for example, only accepts patients who tested positive for COVID-19 or its antibodies, and Chen fears potential patients who couldnt get tested or got false-negative results may be falling through the cracks. The best he can do right now is refer them to specialists and hope they find a doctor who can help.

For 46-year-old Andrea Ceresa, getting better is a full-time jobminus the paycheck. Ceresa had to stop working as a New Jersey dental office manager after she got sick in mid-April with what she and her doctors believe was COVID-19. (She tested negative for the virus and its antibodies, but her doctors think they were false negatives.) More than 100 days later, shes in regular contact with her primary care physician, an integrative care doctor and a rotating cast of specialists who she hopes can treat her lingering gastrointestinal problems, hearing and vision issues, weight and hair loss, heart palpitations, migraines, brain fog, neuropathy, fatigue, nausea and anxiety. She cant get into post-COVID programs without a positive test result, so shes cobbling together her own care team.

Ceresa has paid for her own health insurance through the federal COBRA program since she stopped working, which has put her in a precarious financial state. I have a stack of bills and I just am starting to open them now, she says. Im definitely, at this point, going to be in the hole thousands of dollars. Im collecting unemployment. I know Im going to have to go on disability. Even then, she says, it may not be enough to pay her bills.

There may soon be a lot of patients like Ceresa, says Dr. Bhakti Patel, a pulmonologist at University of Chicago Medicine who studies the long-term effects of critical care. Patel says patients with long-term issues after surviving coronavirus may face a number of obstacles. Patients who remain too sick to return to work (or who are unemployed due to the economic climate) may lose employer-sponsored health insurance at the moment they need it most. Younger patients who do not qualify for Medicare but need public insurance will likely be funneled toward Medicaid, which Patel says is already over-stretched. The services long-haul coronavirus patients may needlike physical therapy and mental health carecan be difficult to access, especially via public insurance networks like Medicaid, Patel says. That bottleneck will only get worse if more people need public aid.

As patients with an emerging disease, long-haulers also need an intensity of outpatient care and expertise, that goes beyond what the average primary care physician can offer, Peluso says. Very few doctors are experienced in treating long-haul symptomsand even among those who are, experienced is a relative term. This wasnt a specialty three months ago, says Chen.

People who cant get into a dedicated post-COVID program may need to try a slew of specialists before they find one who can help, an expensive and tiring game of trial-and-error. (Thats assuming patients can get appointments with specialists like pulmonologists and neurologists, who are often few and far between outside of densely populated areas.) The sickest long-haul patients may also require pricey and difficult-to-access rehab or in-home care, on top of other medical costs. If a family member has to give up work to become a caregiver, that can also have serious economic consequences.

Some long-haulers will likely have to file for disability benefits, a byzantine system of its own thats at risk of becoming overwhelmed. From 2008 to 2017, only about a third of people who applied for disabled-worker benefits in the U.S. were initially approved, according to Social Security Administration (SSA) data. It can be especially difficult for patients without a clear diagnosis or cause of illness, since SSA requires claimants to provide objective medical evidence of an impairment.

With few other resources available, thousands of long-haulers have sought help from virtual support groups like Survivor Corps and Body Politic, where members talk about their symptoms and celebrate signs of recovery. Programs like COVID Bootcamp 101, an online rehab series run by the nonprofit Pulmonary Wellness Foundation, are also trying to fill gaps in care. The scientific community is doing its best to catch up, but Chen says the government may need to help develop long-term solutions that address the economic consequences of long-term coronavirus symptoms, like a medical safety net program (as it has done for HIV/AIDS patients) or financial assistance for COVID-19 patients (as it did for 9/11 survivors).

Without clear answers about what happens next, all doctors can offer the public is yet another plea to take coronavirus seriouslybecause right now, the only surefire way not to become a long-hauler is to not get COVID-19 at all.

That doesnt help people like Ceresa, though. After more than 100 days of feeling sick, Cersa says shes still baffled this happened to her, an active and healthy woman whos been a vegan for decades. She stayed home all April except for a couple trips to the grocery store and still had her life destroyed by the virus. She cant work, sing in her band or plan her wedding after getting engaged a few weeks before the pandemic hit. She tries to comfort herself by thinking about ways it could be worseit could be cancerbut the truth is, things are bad. You try to be hopeful and think somehow, miraculously, youre going to be better, and it doesnt happen, she says. I cant imagine living like this for another day, let alone the rest of my life.

At this point, no one knows if shell have to.

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Some Coronavirus Patients Are Reporting Symptoms That Last Months. Nobody Knows Exactly How to Treat Them - TIME

Experts estimate that nearly 2,000 chimpanzees may be lost to the wildlife trade each year. Once taken from the wild, young chimpanzees that survive the trauma of capture are sold as pets or for entertainment and can end up almost anywhere; theyve been intercepted by authorities in locations all over the globe.

Theyre confiscated in maybe Moscow, or San Francisco, or Hong Kong it can be anywhere and we dont know where they came from, says Peter Frandsen, a conservation genomics researcher at Copenhagen Zoo in Denmark.

Thats a problem when conservationists need to decide which countrys sanctuaries an animal should return to or where it could be safely reintroduced into the wild.

The answer may lie in the chimpanzees own genetic code. A global team of researchers is working to determine how chimpanzee genetics vary based on where the animals come from. By creating this genetic reference map, scientists hope to be able to determine the origins of confiscated chimpanzees as well as identify high-risk areas for wildlife trafficking.

Just a century ago, a million chimpanzees roamed the rainforests and grasslands of Africa. Now, fewer than 200,000 may be left in the wild, and conservationists fear that without widespread change these animals may go extinct in their natural habitats.

Pretty much all of the big conservation threats are facing chimpanzees right now, says Mimi Arandjelovic, a primatologist at the Max Planck Institute for Evolutionary Anthropology in Germany. Logging, mining, all of the extractive industries that are going on in equatorial Africa And then of course theres the huge threat of disease Theres the bushmeat trade, so people hunt and eat apes. And theres the primate pet trade.

Chimpanzees are currently listed as endangered by the IUCN (the western chimpanzee, one of four subspecies, is listed as critically endangered), and their numbers are still declining.

While chimpanzee conservation has many components, researchers say genetic studies are an increasingly important piece of the conservation puzzle.

One recently published study sheds new light on just how valuable genetic information could be in the conservation of this endangered species.

In this study, a group of researchers from Denmark, Spain, Russia and the U.K. analyzed nearly 60,000 ancestry-related genetic markers from captive-born and wild-born chimpanzees. In collaboration with dozens of zoos and sanctuaries across Europe and Africa, the researchers used hair samples to source DNA, a technique that is less invasive and stressful for animals than collecting blood.

Using the genetic data from wild-born chimpanzees whose birthplace was known, the researchers constructed a genetic reference map. They then compared this map with the DNA from chimpanzees who ended up in sanctuaries after being confiscated from illegal wildlife trafficking operations. In this way, researchers were able to estimate where the sanctuary chimpanzees had come from.

So just like popular DNA testing services for humans can tell us about our ancestry and origins, genetic information can reveal where chimpanzees come from.

Frandsen, one of the study authors, says learning where chimpanzees come from is important for many reasons.

For example, he says, genetic analysis provides essential information for captive-breeding programs. Even though chimpanzees may all look similar, there are actually four different accepted subspecies (and a fifth proposed subspecies), each with their own distinct range and unique genetic makeup. But there arent always records about where animals come from and which subspecies they are, which makes it difficult for captive-breeding programs to maintain the integrity of subspecies.

Frandsen says its important for captive-breeding programs to preserve these unique subspecies. Modern zoos are often referred to as Noahs Arks. You could call it a living museum sample, he says. So, we want to make sure that [zoo populations] resemble what you would find in the wild.

That way, he says, if a subspecies goes extinct in the wild, it wouldnt be lost altogether and eventually individuals of that subspecies could be reintroduced to the wild from these captive populations.

But genetic information may be even more valuable for combating animal trafficking.

Arandjelovic, who was not involved in the 2020 study by Frandsen and colleagues, says its unfortunately common for people to kill chimpanzee mothers for bushmeat and sell the babies as pets. Chimpanzees that are recovered from this wildlife trade can be candidates for reintroduction into the wild, so knowing where they came from is essential for deciding where they should be released.

Although Frandsen acknowledges that reintroduction can be challenging, especially as animals get older, he says its still very important. Theyre filling up in the sanctuaries, they dont have enough space and one of the main goals is to reintroduce as many as they can, he says. The sanctuary shouldnt be the endpoint for these chimpanzees if theres an opportunity to relocate them. Determining where an animal came from using genetic data may give it a better chance at a successful return to the wild.

Its possible that genetic data could even help prevent chimpanzee trafficking altogether. Identifying where chimpanzees in the illegal pet trade have come from could reveal poaching hotspots, thus allowing countries to appropriately target anti-poaching efforts. This is especially important in places where conservation funding may be limited.

But Frandsen says they dont yet have enough data to identify these high-risk areas. In this early proof-of-principle project, researchers analyzed just a few dozen animals that were rescued from the wildlife trade and ended up in sanctuaries. Frandsen says there are about 1,000 chimpanzees currently in African sanctuaries; the research team wants to expand their data collection to include these animals so that they can build a more accurate picture of poaching hotspots.

Future projects also include collecting more data from individuals born at known locations to build a more detailed genetic reference map, Frandsen says. The more detailed this map is, the more accurately researchers can determine where a trafficked animal has been taken from.

For some of the subspecies, we have pretty good data from the wild, Frandsen says. But for some of the other subspecies we are still data-deficient. So right now, the plan is to fill those knowledge gaps on the map.

Arandjelovic agrees that having accurate and detailed genetic reference maps is very important for determining the provenance of apes confiscated from the pet trade. She says the technique used in the present study analyzing thousands of different markers provides very detailed information about an individual. However, because of the cost and the specialized supplies needed to run this sort of analysis, it often cannot be done in the chimpanzees country of origin.

She says she wants to see if a reference map could be built using a simpler and cheaper technique that analyzes fewer locations in the genome. This technique would have the advantage of being more feasible to carry out in the countries where chimpanzees live. It would be great if we didnt have to export the samples, if we could do everything in-country, she says. That would be faster (we dont have to deal with permits), but we can also start capacity-building and having people in the country of origin do that work instead of sending it to Europe or North America. On the other hand, its not yet clear if this simpler technique would provide enough genetic information to create a useful reference map.

Frandsen and Arandjelovic agree that this is just the beginning for the application of genetic techniques to locate the origins of trafficked animals. The present study is a proof of concept, Frandsen says. So, theres a lot of work ahead to complete this project, but this is just for the chimpanzees, he says. Its also really a blueprint for other conservation projects. There are a ton of other taxa that this could be applied to.

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A genetic map hopes to trace rescued chimps back to their homes - Mongabay.com

Many thousands of studies about gut microbiota and 16s RNA analysis are available to us nowadays. And while many results and interesting concepts emerge from those studies, a gold standard protocol for data analysis is not yet available. Moreover, the studies are carried out by different teams from different parts of the world, their designs are not the same, DNA extraction protocols differ, and 16s RNA region sequences vary between projects. As such, sample processing variables and the numerous environmental factors influencing an individuals gut microbiota mean association studies between the human genome and gut microbiota genome are less powerful.

Writing in Nature Microbiology, David A. Hughes and colleagues have created a new analytical pipeline that disentangles associations between human host genotype and gut microbiome variation in 3 distinct cohorts, paving the way for causal inference analyses in the field.

Researchers harmonized the analytical pipeline across three independent cohorts: the Flemish Gut Flora Project (n = 2,223) and two German cohorts (Food-Chain Plus, n=950; and PopGen, n= 717).

Using fecal 16s RNA gene sequencing, the researchers first estimated the proportion of gut microbiome variation explained by genetic variation (heritability) between individuals. In total, they identified 13 genera that were heritable. Eight were from the phylum Firmicutes, five of which were from the family Lachnospiraceae and two from Ruminococcaceae.

Dorea and Anaerostipes genera, which are short-chain fatty acid producers, along with Hespellia were three of the most heritable bacteria.

During a second stage, the researchers identified associations between bacteria species and human genes, encountering two strong associations:

The two strong associations were followed by the discovery of 11 associations showing low heterogeneity. Among those 11 associations, they found a relationship between the butyrate-producing genus Butyricicoccus and the SLC5A11 gene, which is a sodium-dependent myo-inositol glucose cotransporter that is highly expressed in the brain and intestine. The findings are in agreement with previous studies suggesting that butyrate-producing bacteria are associated with blood glucose and appetite regulation.

Another association was identified between Veillonella and rs117338748. This gene is involved in regulating low-density lipoproteins (LDLs) and transporting high-density lipoproteins (HDLs). The researchers observed that the presence of Veillonella was associated with a drop in LDL-cholesterol.

Using a Mendelian randomization model, the researchers estimated relationships between 5 microbial pathways and 7 outcomes (diseases). For instance, Bifidobacterium was associated with body composition. However, in the absence of clear microbiome-driven effects, any interpretation requires caution. In other words, it could be the causeless Bifidobacterium means the individual has a higher body mass index (BMI)or the consequencean individual with a higher BMI will present less Bifidobacterium in their gut.

In conclusion, this in-depth study on human genome-gut microbiome associations in 3 distinct cohorts generated a growing catalogue of genetic associations and showed better associations between the hosts genetics and its gut microbiota. Next steps should look at understanding the causation factors for a better understanding of gut microbiota function and association with outcomes.

Reference:

Hughes DA, Bacigalupe R, Wang J, et al. Genome-wide associations of human gut microbiome variation and implications for causal inference analyses. Nat Microbiol. 2020. doi: 10.1038/s41564-020-0743-8.

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Consistent associations between human genetic variation and the gut microbiome identified in 3 independent European cohorts - Gut Microbiota for...

The unusual cases of pneumonia began to appear in midwinter, in China. The cause, researchers would later learn, was a coronavirus new to science. By March, the infection began to spread to other Asian countries and overseas. People were dying, and the World Health Organization issued a global health alert.

But this was 2003, not 2020, and the disease was SARS, not Covid-19. By June, the outbreak was almost gone, with just 8,098 confirmed infections and 774 deaths worldwide. No cases of SARS have been reported since 2004.

Contrast that with the closely related coronavirus that causes Covid-19 today:more than 13,600,000 confirmed cases as of July 16, and more than 585,000 deaths.

Why did SARS go away while todays coronavirus just keeps on spreading? Why, for that matter, did both these coronaviruses spill over into people at all, from their original bat hosts?

And just as vital as those questions is another: What happens next?

As we face the current pandemic, it will be important to understand how SARS-CoV-2, the virus that causes Covid-19, is likely to evolve in the months and years ahead. Its possible the virus could lose its lethal character and settle into an evolutionary dtente with humanity. It might end up as just another cold virus, as may have happened to another coronavirus in the past. But it could also remain a serious threat or perhaps even evolve to become more lethal. The outcome depends on the complex and sometimes subtle interplay of ecological and evolutionary forces that shape how viruses and their hosts respond to one another.

One thing you learn about evolution is never to generalize, says Edward Holmes, an evolutionary virologist at the University of Sydney, Australia, and author of an article onthe evolution of emerging virusesin theAnnual Review of Ecology, Evolution, and Systematics. It depends entirely on the biological nuance of the situation.

Many of the scariest viruses that have caused past or current epidemicsoriginated in other animals and then jumped to people: HIV from other primates, influenza from birds and pigs, and Ebola probably from bats. So, too, for coronaviruses: The ones behind SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome) and Covid-19 all probably originatePostd inbatsand arrived in people via another, stepping-stone species, likely palm civets, camels and possibly pangolins, respectively.

But making the jump from one species to another isnt easy, because successful viruses have to be tightly adapted to their hosts. To get into a host cell, a molecule on the viruss surface has to match a receptor on the outside of the cell, like a key fitting into a lock. Once inside the cell, the virus has to evade the cells immune defenses and then commandeer the appropriate parts of the hosts biochemistry to churn out new viruses. Any or all of these factors are likely to differ from one host species to another, so viruses will need to change genetically that is, evolve in order to set up shop in a new animal.

Host switching actually involves two steps, though these can overlap. First, the virus has to be able to invade the new hosts cells: Thats a minimum requirement for making the host sick. But to become capable of causing epidemics, the virus also has to become infectious that is, transmissible between individuals in its new host. Thats what elevates a virus from an occasional nuisance to one capable of causing widespread harm.

SARS-CoV-2 shows these two stages clearly. Compared with the virus in bats, both the virus that infects people and a close relative in pangolins carry a mutation that changes the shape of the surface spike protein. The alteration is right at the spot that binds to host cell receptors to let the virus in. This suggests that the mutation first arose either in pangolins or an as yet unidentified species and happened to allow the virus to jump over to people, too.

But SARS-CoV-2 carries other changes in the spike protein that appear to have arisen after it jumped to people, since they dont occur in the bat or pangolin viruses. One isin a region called the polybasic cleavage site, which is known to make other coronaviruses and flu viruses more infectious. Another appears to make the spike protein less fragile, and in lab experiments with cell cultures, itmakes the virus more infectious. The mutation has become more common as the Covid-19 pandemic goes on, which suggests but does not prove that it makes the virus more infectious in the real world, too. (Fortunately, though it may increase spread, it doesnt seem to make people sicker.)

This evolutionary two-step first spillover, then adaptation to the new host is probably characteristic of most viruses as they shift hosts, says Daniel Streicker, a viral ecologist at the University of Glasgow. If so, emerging viruses probably pass through a silent period immediately after a host shift, in which the virus barely scrapes by, teetering on the brink of extinction until it acquires the mutations needed for an epidemic to bloom.

Streicker sees this in studies of rabies in bats which is a good model for studying the evolution of emerging viruses, he says, since the rabies virus has jumped between different bat species many times. He and his colleagues looked at decades worth of genetic sequence data for rabies viruses that had undergone such host shifts. Since larger populations contain more genetic variants than smaller populations do, measuring genetic diversity in their samples enabled the scientists to estimate how widespread the virus was at any given time.

The team found that almost none of the 13 viral strains they studied took off immediately after switching to a new bat species. Instead, the viruseseked out a marginal existence for years to decades before they acquiredthe mutations of as yet unknown function that allowed them to burst out to epidemic levels. Not surprisingly, the viruses that emerged the fastest were those that needed the fewest genetic changes to blossom.

SARS-CoV-2 probably passed through a similar tenuous phase before it acquired the key adaptations that allowed it to flourish, perhaps the mutation to the polybasic cleavage site, perhaps others not yet identified. In any case, says Colin Parrish, a virologist at Cornell University who studies host shifts, by the time the first person in Wuhan had been identified with coronavirus, it had probably been in people for a while.

It was our bad luck that SARS-CoV-2 adapted successfully. Many viruses that spill over to humans never do. About 220 to 250 viruses are known to infect people, but only about half are transmissible many only weakly from one person to another, says Jemma Geoghegan, an evolutionary virologist at the University of Otago, New Zealand. The rest are dead-end infections. Half is a generous estimate, she adds, since many other spillover events probably fizzle out before they can even be counted.

SARS-CoV-2, of course, is well past the teetering stage. The big question now is: What happens next? One popular theory, endorsed by some experts, is that viruses often start off harming their hosts, but evolve toward a more benign coexistence. After all, many of the viruses we know of that trigger severe problems in a new host species cause mild or no disease in the host they originally came from. And from the viruss perspective, this theory asserts, hosts that are less sick are more likely to be moving around, meeting others and spreading the infection onward.

I believe that viruses tend to become less pathogenic, says Burtram Fielding, a coronavirologist at the University of the Western Cape, South Africa. The ultimate aim of a pathogen is to reproduce, to make more of itself. Any pathogen that kills the host too fast will not give itself enough time to reproduce. If SARS-CoV-2 can spread faster and further by killing or severely harming fewer of the people it infects, we might expect that over time, it will become less harmful or, as virologists term it, less virulent.

This kind of evolutionary gentling may be exactly what happened more than a century ago to one of the other human coronaviruses, known as OC43, Fielding suggests. Today, OC43 is one of four coronaviruses that account for up to a third of cases of the common cold (and perhaps occasionally more severe illness). But Fielding and a few others think it could also have been the virus behind a worldwide pandemic, usually ascribed to influenza, that began in 1890 and killed more than a million people worldwide, including Queen Victorias grandson and heir.

Scientists cant prove that, because no virus samples survive from that pandemic, but some circumstantial evidence makes the case plausible, Fielding says. For one thing, people who were infected in the 1890 pandemic apparently experiencednervous-system symptomswe now see as more typical of coronaviruses than of influenza. And when Belgian researchers sequenced OC43s genome in 2005 and compared it to other known coronaviruses, they concluded that it likely originated as a cattle virus and may havejumped to people right around 1890. They speculated that it may have caused the 1890 pandemic and then settled down to a less nasty coexistence as an ordinary cold virus.

Other evolutionary biologists disagree. The pandemic certainly faded as more people became immune, but theres no solid evidence that OC43 itself evolved from highly virulent to mostly benign over the last century, they say. Even if it did, that does not mean SARS-CoV-2 will follow the same trajectory. You cant just say its going to become nicer, that somehow a well-adapted pathogen doesnt harm its host. Modern evolutionary biology, and a lot of data, shows that doesnt have to be true. It can get nicer, and it can get nastier, says Andrew Read, an evolutionary microbiologist at Penn State University. (Holmes is blunter: Trying to predict virulence evolution is a mugs game, he says.)

To understand why its so hard to predict changes in virulence, Read says its important to recognize the difference between virulence that is, how sick a virus makes its host and its transmissibility, or how easily it passes from one host individual to another. Evolution always favors increased transmissibility, because viruses that spread more easily are evolutionarily fitter that is, they leave more descendants. But transmissibility and virulence arent linked in any dependable way, Read says. Some germs do just fine even if they make you very sick. The bacteria that cause cholera spread through diarrhea, so severe disease is good for them. Malaria and yellow fever, which are transmitted by mosquitos, can spread just fine even from a person at deaths door.

Respiratory viruses, like influenza and the human coronaviruses, need hosts that move around enough to breathe on one another, so extremely high virulence might be detrimental in some cases. But theres no obvious evolutionary advantage for SARS-CoV-2 to reduce its virulence, because it pays little price for occasionally killing people: It spreads readily from infected people who are not yet feeling sick, and even from those who may never show symptoms of illness. To be honest, the novel coronavirus is pretty fit already, Geoghegan says.

Nor are there many documented instances of viruses whose virulence has abated over time. The rare, classic example is the myxoma virus, which was deliberately introduced to Australia in the 1950s from South America to control invasive European rabbits. Within a few decades, the virusevolved to reduce its virulence, albeit only down to 70 to 95 percent lethality from a whopping 99.8 percent. (It has since ticked up again.)

But myxoma stands nearly alone, Parrish says. For instance, he notes, there is no evidence that recent human pathogens such as Ebola, Zika or chikungunya viruses have shown any signs of becoming less pathogenic in the relatively short time since jumping to humans.

The faded nightmares of our past pandemics that terrorized, then receded, such as SARS in 2003 and flu in 1918-20 and again in 1957, 1968 and 2009 went away not because the viruses evolved to cause milder disease, but for other reasons. In the case of SARS, the virus made people sick enough that health workers were able to contain the disease before it got out of hand. People who got SARS got very sick, very fast and were easily identified, easily tracked and readily quarantined and their contacts were also readily identified and quarantined, says Mark Cameron, an immunologist at Case Western Reserve University in Cleveland, who worked in a Toronto hospital during the height of the SARS outbreak there. That was never going to be as easy to do for Covid-19 because people who dont show symptoms can spread the virus.

Flu pandemics, meanwhile, have tended to recede for another reason, one that offers more hope in our present moment: Enough of the population eventually becomes immune to slow the virus down. The H1N1 influenza virus that caused the 1918 pandemic continued as the main influenza virus until the 1950s, and its descendants still circulate in the human population. What made the virus such a threat in 1918-20 is that it was novel and people had little immunity. Once much of the population had been exposed to the virus and had developed immunity,the pandemic waned, although the virus persisted at a lower level of infections as it does to this day. It appears less lethal now largely because older people, who are at greatest risk of dying from influenza, have usually encountered H1N1 influenza or something like it at some point in their lives and retain some degree of immunity, Read says.

With the new coronavirus, Parrish says, were sort of in that 1918 period where the virus is spreading fast in a naive population. But that will change as more people either catch Covid-19 or are vaccinated (if and when that becomes possible) and develop some level of immunity. Theres no question that once the population is largely immune, the virus will die down, Parrish says.

The question is how long that immunity will last: for a lifetime, like smallpox, or just a few years, like flu? In part, that will depend on whether the vaccine induces a permanent antibody response or just a temporary one. But it also depends on whether the virus can change to evade the antibodies generated by the vaccine. Although coronaviruses dont accumulate mutations as fast as flu viruses, they do still change. And at least one, which causes bronchitis in chickens, has evolved new variants that arent covered by previous vaccines. But at this point, no one knows what to expect from SARS-CoV-2.

There is, at least, one encouraging aspect to all this. Even if we cant predict how the virus will evolve or how it will respond to the coming vaccine, there is something all of us can do to reduce the risk of the virus evolving in dangerous ways. And it doesnt involve any complicated new behaviors. Viruses can only evolve if theyre replicating and transmitting, Streicker says. Anything that reduces the replication of a virus will in consequence reduce the amount of evolution that happens. In other words, we can do our part to slow down the evolution of the Covid-19 virus by behaving exactly as weve been told to already to avoid catching it: Minimize contact with others, wash your hands and wear a mask.

Bob Holmes is a science writer in Edmonton, Canada, who hopes not to contribute to the further evolution of SARS-CoV-2. Find him at his website.

A version of this article was originally published at Knowable Magazine and has been republished here with permission. Sign up for their newsletter here. Knowable can be found on Twitter @KnowableMag

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Why SARS disappeared in 2003 while the coronavirus keeps on spreading - Genetic Literacy Project

This global EXOSOME THERAPEUTIC MARKET analysis report presents an edge to not only compete but also to outshine the competition. Global market research analysis report serves a lot for the business and bestows with the solution for the toughest business problems. This EXOSOME THERAPEUTIC MARKET business document gives a detailed synopsis on the study of ABC industry and its impact on the market environment. Market shares of the major players in the important areas of the globe such as Europe, North America, Asia Pacific, South America, Middle East and Africa are also studied. This EXOSOME THERAPEUTIC MARKET report is a sure fire solution that businesses can adopt to thrive in this swiftly changing marketplace.

Exosome therapeutic marketis expected to gain market growth in the forecast period of 2019 to 2026. Data Bridge Market Research analyses that the market is growing with a CAGR of 21.9% in the forecast period of 2019 to 2026 and expected to reach USD 31,691.52 million by 2026 from USD 6,500.00 million in 2018. Increasing prevalence of lyme disease, chronic inflammation, autoimmune disease and other chronic degenerative diseases are the factors for the market growth.

Get Sample Report + All Related Graphs & Charts (with COVID 19 Analysis) @https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-exosome-therapeutic-market&pm

Exosomes are used to transfer RNA, DNA, and proteins to other cells in the body by making alteration in the function of the target cells. Increasing research activities in exosome therapeutic is augmenting the market growth as demand for exosome therapeutic has increased among healthcare professionals.

Increased number of exosome therapeutics as compared to the past few years will accelerate the market growth. Companies are receiving funding for exosome therapeutic research and clinical trials. For instance, In September 2018, EXOCOBIO has raised USD 27 million in its series B funding. The company has raised USD 46 million as series a funding in April 2017. The series B funding will help the company to set up GMP-compliant exosome industrial facilities to enhance production of exosomes to commercialize in cosmetics and pharmaceutical industry.

Increasing demand for anti-aging therapies will also drive the market. Unmet medical needs such as very few therapeutic are approved by the regulatory authority for the treatment in comparison to the demand in global exosome therapeutics market will hamper the market growth market. Availability of various exosome isolation and purification techniques is further creates new opportunities for exosome therapeutics as they will help company in isolation and purification of exosomes from dendritic cells, mesenchymal stem cells, blood, milk, body fluids, saliva, and urine and from others sources. Such policies support exosome therapeutic market growth in the forecast period to 2019-2026.

This exosome therapeutic market report provides details of market share, new developments, and product pipeline analysis, impact of domestic and localised market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, product approvals, strategic decisions, product launches, geographic expansions, and technological innovations in the market. To understand the analysis and the market scenario contact us for anAnalyst Brief, our team will help you create a revenue impact solution to achieve your desired goal.

The market analysis and insights covered in this EXOSOME THERAPEUTIC MARKET business document offers key statistics on the market status of global and regional manufacturers and is an imperative source of guidance which provides exact direction to the companies and individuals interested in the industry. This report contains a bottomless knowledge and information on what the markets definition, classifications, applications, and engagements are and also explains the drivers and restraints of the market which is derived from SWOT analysis. The important highlights of this market report are key market dynamics, current market scenario and future prospects of the sector.

Competitive Landscape and Exosome Therapeutic Market Share Analysis

Global exosome therapeutic market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, global presence, production sites and facilities, company strengths and weaknesses, product launch, product trials pipelines, concept cars, product approvals, patents, product width and breadth, application dominance, technology lifeline curve. The above data points provided are only related to the companys focus related to global exosome therapeutic market.

The major players covered in the report are evox THERAPEUTICS, EXOCOBIO, Exopharm, AEGLE Therapeutics, United Therapeutics Corporation, Codiak BioSciences, Jazz Pharmaceuticals, Inc., Boehringer Ingelheim International GmbH, ReNeuron Group plc, Capricor Therapeutics, Avalon Globocare Corp., CREATIVE MEDICAL TECHNOLOGY HOLDINGS INC., Stem Cells Group among other players domestic and global. Exosome therapeutic market share data is available for Global, North America, Europe, Asia-Pacific, and Latin America separately. DBMR analysts understand competitive strengths and provide competitive analysis for each competitor separately.

Many joint ventures and developments are also initiated by the companies worldwide which are also accelerating the global exosome therapeutic market.

For instance,

Partnership, joint ventures and other strategies enhances the company market share with increased coverage and presence. It also provides the benefit for organisation to improve their offering for exosome therapeutics through expanded model range.

Global Exosome Therapeutic Market Scope and Market Size

Global exosome therapeutic market is segmented of the basis of type, source, therapy, transporting capacity, application, route of administration and end user. The growth among segments helps you analyse niche pockets of growth and strategies to approach the market and determine your core application areas and the difference in your target markets.

Based on type, the market is segmented into natural exosomes and hybrid exosomes. Natural exosomes are dominating in the market because natural exosomes are used in various biological and pathological processes as well as natural exosomes has many advantages such as good biocompatibility and reduced clearance rate compare than hybrid exosomes.

Exosome is an extracellular vesicle which is released from cells, particularly from stem cells. Exosome functions as vehicle for particular proteins and genetic information and other cells. Exosome plays a vital role in the rejuvenation and communication of all the cells in our body while not themselves being cells at all. Research has projected that communication between cells is significant in maintenance of healthy cellular terrain. Chronic disease, age, genetic disorders and environmental factors can affect stem cells communication with other cells and can lead to distribution in the healing process. The growth of the global exosome therapeutic market reflects global and country-wide increase in prevalence of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases, along with increasing demand for anti-aging therapies. Additionally major factors expected to contribute in growth of the global exosome therapeutic market in future are emerging therapeutic value of exosome, availability of various exosome isolation and purification techniques, technological advancements in exosome and rising healthcare infrastructure.

Rising demand of exosome therapeutic across the globe as exosome therapeutic is expected to be one of the most prominent therapies for autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases treatment, according to clinical researches exosomes help to processes regulation within the body during treatment of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases. This factor has increased the research activities in exosome therapeutic development around the world for exosome therapeutic. Hence, this factor is leading the clinician and researches to shift towards exosome therapeutic. In the current scenario the exosome therapeutic are highly used in treatment of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases and as anti-aging therapy as it Exosomes has proliferation of fibroblast cells which is significant in maintenance of skin elasticity and strength.

TABLE OF CONTENTS

PART 01: EXECUTIVE SUMMARY

PART 02: SCOPE OF THE REPORT

PART 03: RESEARCH METHODOLOGY

PART 04: MARKET LANDSCAPE

Market ecosystem Market characteristics Market segmentation analysis

PART 05: PIPELINE ANALYSIS

Pipeline analysis

PART 06: MARKET SIZING

Market definition Market sizing Market size and forecast

PART 07: FIVE FORCES ANALYSIS

Bargaining power of buyers Bargaining power of suppliers Threat of new entrants Threat of substitutes Threat of rivalry Market condition

PART 08: MARKET SEGMENTATION

Segmentation Comparison Market opportunity

PART 09: CUSTOMER LANDSCAPE

PART 10: REGIONAL LANDSCAPE

Geographical segmentation Regional comparison North America South America Europe MEA APAC Market opportunity

PART 11: DECISION FRAMEWORK

PART 12: DRIVERS AND CHALLENGES

Market drivers Market challenges

PART 13: MARKET TRENDS

PART 14: VENDOR LANDSCAPE

Overview Landscape disruption

PART 15: VENDOR ANALYSIS

Vendors covered Vendor classification Market positioning of vendors

PART 16: APPENDIX

List of abbreviations

For More Insights Get FREE Detailed TOC @https://www.databridgemarketresearch.com/toc/?dbmr=global-exosome-therapeutic-market&pm

Exosome therapeutic Market Country Level Analysis

The global exosome therapeutic market is analysed and market size information is provided by country by type, source, therapy, transporting capacity, application, route of administration and end user as referenced above.

The countries covered in the exosome therapeutic market report are U.S. and Mexico in North America, Turkey in Europe, South Korea, Australia, Hong Kong in the Asia-Pacific, Argentina, Colombia, Peru, Chile, Ecuador, Venezuela, Panama, Dominican Republic, El Salvador, Paraguay, Costa Rica, Puerto Rico, Nicaragua, Uruguay as part of Latin America.

Country Level Analysis, By Type

North America dominates the exosome therapeutic market as the U.S. is leader in exosome therapeutic manufacturing as well as research activities required for exosome therapeutics. At present time Stem Cells Group holding shares around 60.00%. In addition global exosomes therapeutics manufacturers like EXOCOBIO, evox THERAPEUTICS and others are intensifying their efforts in China. The Europe region is expected to grow with the highest growth rate in the forecast period of 2019 to 2026 because of increasing research activities in exosome therapeutic by population.

The country section of the report also provides individual market impacting factors and changes in regulation in the market domestically that impacts the current and future trends of the market. Data points such as new sales, replacement sales, country demographics, regulatory acts and import-export tariffs are some of the major pointers used to forecast the market scenario for individual countries. Also, presence and availability of global brands and their challenges faced due to large or scarce competition from local and domestic brands, impact of sales channels are considered while providing forecast analysis of the country data.

Research objectives

Huge Investment by Automakers for Exosome Therapeutics and New Technology Penetration

Global exosome therapeutic market also provides you with detailed market analysis for every country growth in pharma industry with exosome therapeutic sales, impact of technological development in exosome therapeutic and changes in regulatory scenarios with their support for the exosome therapeutic market. The data is available for historic period 2010 to 2017.

About Data Bridge Market Research:

An absolute way to forecast what future holds is to comprehend the trend today!Data Bridge set forth itself as an unconventional and neoteric Market research and consulting firm with unparalleled level of resilience and integrated approaches. We are determined to unearth the best market opportunities and foster efficient information for your business to thrive in the market. Data Bridge endeavors to provide appropriate solutions to the complex business challenges and initiates an effortless decision-making process.

Contact:

Data Bridge Market Research

US: +1 888 387 2818

UK: +44 208 089 1725

Hong Kong: +852 8192 7475

Email @[emailprotected]

Read this article:
Exosome therapeutic Market Enhancement And Its growth prospects forecast 2020 to 2027 - Scientect

The large scale EXOSOME THERAPEUTIC MARKET report contains wide-ranging and comprehensive market insights which are based on business intelligence. A strong research methodology used in this marketing report comprises of data models that include market overview and guide, vendor positioning grid, market time line analysis, company positioning grid, company market share analysis, standards of measurement, top to bottom analysis and vendor share analysis. EXOSOME THERAPEUTIC MARKET business report helps make known uncertainties that may come up due to changes in business activities or introduction of a new product in the market. It also provides top to bottom examination of the market for estimating income, return on investment (ROI) and developing business strategies.

This global EXOSOME THERAPEUTIC MARKET analysis report presents an edge to not only compete but also to outshine the competition. Global market research analysis report serves a lot for the business and bestows with the solution for the toughest business problems. This EXOSOME THERAPEUTIC MARKET business document gives a detailed synopsis on the study of ABC industry and its impact on the market environment. Market shares of the major players in the important areas of the globe such as Europe, North America, Asia Pacific, South America, Middle East and Africa are also studied. This EXOSOME THERAPEUTIC MARKET report is a sure fire solution that businesses can adopt to thrive in this swiftly changing marketplace.

Exosome therapeutic market is expected to gain market growth in the forecast period of 2019 to 2026. Data Bridge Market Research analyses that the market is growing with a CAGR of 21.9% in the forecast period of 2019 to 2026 and expected to reach USD 31,691.52 million by 2026 from USD 6,500.00 million in 2018. Increasing prevalence of lyme disease, chronic inflammation, autoimmune disease and other chronic degenerative diseases are the factors for the market growth.

Get Sample Report + All Related Graphs & Charts (with COVID 19 Analysis) @https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-exosome-therapeutic-market&pm

Exosomes are used to transfer RNA, DNA, and proteins to other cells in the body by making alteration in the function of the target cells. Increasing research activities in exosome therapeutic is augmenting the market growth as demand for exosome therapeutic has increased among healthcare professionals.

Increased number of exosome therapeutics as compared to the past few years will accelerate the market growth. Companies are receiving funding for exosome therapeutic research and clinical trials. For instance, In September 2018, EXOCOBIO has raised USD 27 million in its series B funding. The company has raised USD 46 million as series a funding in April 2017. The series B funding will help the company to set up GMP-compliant exosome industrial facilities to enhance production of exosomes to commercialize in cosmetics and pharmaceutical industry.

Increasing demand for anti-aging therapies will also drive the market. Unmet medical needs such as very few therapeutic are approved by the regulatory authority for the treatment in comparison to the demand in global exosome therapeutics market will hamper the market growth market. Availability of various exosome isolation and purification techniques is further creates new opportunities for exosome therapeutics as they will help company in isolation and purification of exosomes from dendritic cells, mesenchymal stem cells, blood, milk, body fluids, saliva, and urine and from others sources. Such policies support exosome therapeutic market growth in the forecast period to 2019-2026.

This exosome therapeutic market report provides details of market share, new developments, and product pipeline analysis, impact of domestic and localised market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, product approvals, strategic decisions, product launches, geographic expansions, and technological innovations in the market. To understand the analysis and the market scenario contact us for anAnalyst Brief, our team will help you create a revenue impact solution to achieve your desired goal.

The market analysis and insights covered in this EXOSOME THERAPEUTIC MARKET business document offers key statistics on the market status of global and regional manufacturers and is an imperative source of guidance which provides exact direction to the companies and individuals interested in the industry. This report contains a bottomless knowledge and information on what the markets definition, classifications, applications, and engagements are and also explains the drivers and restraints of the market which is derived from SWOT analysis. The important highlights of this market report are key market dynamics, current market scenario and future prospects of the sector.

Competitive Landscape and Exosome Therapeutic Market Share Analysis

Global exosome therapeutic market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, global presence, production sites and facilities, company strengths and weaknesses, product launch, product trials pipelines, concept cars, product approvals, patents, product width and breadth, application dominance, technology lifeline curve. The above data points provided are only related to the companys focus related to global exosome therapeutic market.

The major players covered in the report are evox THERAPEUTICS, EXOCOBIO, Exopharm, AEGLE Therapeutics, United Therapeutics Corporation, Codiak BioSciences, Jazz Pharmaceuticals, Inc., Boehringer Ingelheim International GmbH, ReNeuron Group plc, Capricor Therapeutics, Avalon Globocare Corp., CREATIVE MEDICAL TECHNOLOGY HOLDINGS INC., Stem Cells Group among other players domestic and global. Exosome therapeutic market share data is available for Global, North America, Europe, Asia-Pacific, and Latin America separately. DBMR analysts understand competitive strengths and provide competitive analysis for each competitor separately.

Many joint ventures and developments are also initiated by the companies worldwide which are also accelerating the global exosome therapeutic market.

For instance,

Partnership, joint ventures and other strategies enhances the company market share with increased coverage and presence. It also provides the benefit for organisation to improve their offering for exosome therapeutics through expanded model range.

Global Exosome Therapeutic Market Scope and Market Size

Global exosome therapeutic market is segmented of the basis of type, source, therapy, transporting capacity, application, route of administration and end user. The growth among segments helps you analyse niche pockets of growth and strategies to approach the market and determine your core application areas and the difference in your target markets.

Based on type, the market is segmented into natural exosomes and hybrid exosomes. Natural exosomes are dominating in the market because natural exosomes are used in various biological and pathological processes as well as natural exosomes has many advantages such as good biocompatibility and reduced clearance rate compare than hybrid exosomes.

Exosome is an extracellular vesicle which is released from cells, particularly from stem cells. Exosome functions as vehicle for particular proteins and genetic information and other cells. Exosome plays a vital role in the rejuvenation and communication of all the cells in our body while not themselves being cells at all. Research has projected that communication between cells is significant in maintenance of healthy cellular terrain. Chronic disease, age, genetic disorders and environmental factors can affect stem cells communication with other cells and can lead to distribution in the healing process. The growth of the global exosome therapeutic market reflects global and country-wide increase in prevalence of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases, along with increasing demand for anti-aging therapies. Additionally major factors expected to contribute in growth of the global exosome therapeutic market in future are emerging therapeutic value of exosome, availability of various exosome isolation and purification techniques, technological advancements in exosome and rising healthcare infrastructure.

Rising demand of exosome therapeutic across the globe as exosome therapeutic is expected to be one of the most prominent therapies for autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases treatment, according to clinical researches exosomes help to processes regulation within the body during treatment of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases. This factor has increased the research activities in exosome therapeutic development around the world for exosome therapeutic. Hence, this factor is leading the clinician and researches to shift towards exosome therapeutic. In the current scenario the exosome therapeutic are highly used in treatment of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases and as anti-aging therapy as it Exosomes has proliferation of fibroblast cells which is significant in maintenance of skin elasticity and strength.

TABLE OF CONTENTS

PART 01: EXECUTIVE SUMMARY

PART 02: SCOPE OF THE REPORT

PART 03: RESEARCH METHODOLOGY

PART 04: MARKET LANDSCAPE

Market ecosystem Market characteristics Market segmentation analysis

PART 05: PIPELINE ANALYSIS

Pipeline analysis

PART 06: MARKET SIZING

Market definition Market sizing Market size and forecast

PART 07: FIVE FORCES ANALYSIS

Bargaining power of buyers Bargaining power of suppliers Threat of new entrants Threat of substitutes Threat of rivalry Market condition

PART 08: MARKET SEGMENTATION

Segmentation Comparison Market opportunity

PART 09: CUSTOMER LANDSCAPE

PART 10: REGIONAL LANDSCAPE

Geographical segmentation Regional comparison North America South America Europe MEA APAC Market opportunity

PART 11: DECISION FRAMEWORK

PART 12: DRIVERS AND CHALLENGES

Market drivers Market challenges

PART 13: MARKET TRENDS

PART 14: VENDOR LANDSCAPE

Overview Landscape disruption

PART 15: VENDOR ANALYSIS

Vendors covered Vendor classification Market positioning of vendors

PART 16: APPENDIX

List of abbreviations

For More Insights Get FREE Detailed TOC @https://www.databridgemarketresearch.com/toc/?dbmr=global-exosome-therapeutic-market&pm

Exosome therapeutic Market Country Level Analysis

The global exosome therapeutic market is analysed and market size information is provided by country by type, source, therapy, transporting capacity, application, route of administration and end user as referenced above.

The countries covered in the exosome therapeutic market report are U.S. and Mexico in North America, Turkey in Europe, South Korea, Australia, Hong Kong in the Asia-Pacific, Argentina, Colombia, Peru, Chile, Ecuador, Venezuela, Panama, Dominican Republic, El Salvador, Paraguay, Costa Rica, Puerto Rico, Nicaragua, Uruguay as part of Latin America.

Country Level Analysis, By Type

North America dominates the exosome therapeutic market as the U.S. is leader in exosome therapeutic manufacturing as well as research activities required for exosome therapeutics. At present time Stem Cells Group holding shares around 60.00%. In addition global exosomes therapeutics manufacturers like EXOCOBIO, evox THERAPEUTICS and others are intensifying their efforts in China. The Europe region is expected to grow with the highest growth rate in the forecast period of 2019 to 2026 because of increasing research activities in exosome therapeutic by population.

The country section of the report also provides individual market impacting factors and changes in regulation in the market domestically that impacts the current and future trends of the market. Data points such as new sales, replacement sales, country demographics, regulatory acts and import-export tariffs are some of the major pointers used to forecast the market scenario for individual countries. Also, presence and availability of global brands and their challenges faced due to large or scarce competition from local and domestic brands, impact of sales channels are considered while providing forecast analysis of the country data.

Research objectives

Huge Investment by Automakers for Exosome Therapeutics and New Technology Penetration

Global exosome therapeutic market also provides you with detailed market analysis for every country growth in pharma industry with exosome therapeutic sales, impact of technological development in exosome therapeutic and changes in regulatory scenarios with their support for the exosome therapeutic market. The data is available for historic period 2010 to 2017.

About Data Bridge Market Research:

An absolute way to forecast what future holds is to comprehend the trend today!Data Bridge set forth itself as an unconventional and neoteric Market research and consulting firm with unparalleled level of resilience and integrated approaches. We are determined to unearth the best market opportunities and foster efficient information for your business to thrive in the market. Data Bridge endeavors to provide appropriate solutions to the complex business challenges and initiates an effortless decision-making process.

Contact:

Data Bridge Market Research

US: +1 888 387 2818

UK: +44 208 089 1725

Hong Kong: +852 8192 7475

Email @ [emailprotected]

See more here:
EXOSOME THERAPEUTIC MARKET (Covid 19 Update) In-Depth Research on Market Dynamics, Applications & Emerging Growth Factors - Scientect

Latin America has been especially hard hit in recent months by the ongoing COVID-19 pandemic, as described in WilmerHales recent client alert here. The resulting travel restrictions, physical safety precautions and public health concerns have created uncertainty for many companies confronting the need to conduct cross-border Foreign Corrupt Practices Act (FCPA) investigations in the region, where some countries are currently difficultor impossibleto access.1

Despite these challenges, effective internal investigations remain central to a robust FCPA compliance program, as underscored by the recently released FCPA 2020 Resource Guide, summarized by WilmerHale here. The Department of Justice (DOJ) has announced that it does not expect any slowdown in its FCPA enforcement actions during the pandemic.2 Moreover, the goals of an internal investigation go beyond satisfying the requirements of government authorities. Conducting a thorough, reliable and effective FCPA investigation is in the best business interests of the company itself.

With this difficult environment in mind, this client alert sets out 10 key tips for conducting effective Latin America-focused FCPA investigations under pandemic conditions.

1. Frame the Investigation: Whats the Issue, Whos the Client and Whats the Form of the Investigation?

The first step in any internal investigation is important: frame the investigation. Ask the following questions, which can be especially important and complex during the pandemic:3

2. Get the Right Team in Place.

In any Latin American FCPA investigation, having a well-organized team in place is criticaleven more so during the current crisis. While the pandemic restricts travel, an investigation may rely even more heavily on local resources to stand up, carry out and manage the investigation.4

A combination of local and international expertise is essential. Be sure to consider the language skills of these team members and to structure any engagement so that their work enjoys applicable attorney-client privilege and/or work product privilege protections. The team should include:

3. Understand and Guard Legal Privilege, as Applied in the Relevant Jurisdiction(s).

A crucial consideration for assembling a team is understanding how legal privilege will apply. Failing to understand how privilege appliesor doesntin the country where the investigation is taking place can be a major and potentially fatal pitfall. Because many Latin American countries are civil law jurisdictions, their legal privilege protections operate in a manner fundamentally different from those familiar to US lawyers.5

For example, only in fall 2019 did Mexicos antitrust authority, the Federal Economic Competition Commission (COFECE, as abbreviated in Spanish), issue guidelines for recognizing attorney-client communication protections in connection with antitrust investigations.6 Although Mexican law does generally prohibit the disclosure of client information, it does not include broad legal protection from government seizure. This risks sensitive disclosure to government authorities if not handled correctly. Recent case law suggests that these protections may be expanding, but the current legal landscape presents more questions than answers.7

Companies should be vigilant in maintaining and protecting privileged material during the course of a Latin America FCPA investigation. This may prove even more important during the pandemic, when coordinating is more likely to be done via email, text and other written meansmeans that government authorities may try to collect and over which companies may not have as much control as in non-pandemic conditions.

4. Promptly Preserve and Collect Documents.

Even prior to the pandemic, preserving, archiving and collecting local documents and evidence for investigations in Latin America could prove challenging. Today, in the midst of COVID-19, those challenges have multiplied. Working swiftly and coordinating with the on-the-ground team will be critically important.

Prompt document preservation is the most important first step to ensure a complete investigation. Of course, relying on individuals themselves for preservation and collection while working remotely raises its own issues. When planning out the document preservation and collection process, consider how to stage processes and requests to minimize the possibility of spoliation. A truly bad actor may be willing to destroy evidence at the first sign of an investigation, so to the extent practical, IT should take steps to preserve evidence (such as by remote back up and capture of data) before preservation notices are sent.

Once those key preservation steps have been taken, another important step is sending a preservation notice to individuals who are likely to have relevant evidence. The preservation notice directs these individuals not to delete or destroy material relevant to the investigation.8 In Latin America, even in companies where employees are expected to have a working knowledge of English, providing translations of this noticein Spanish, Portuguese and/or any other relevant languageswill be critical to ensuring compliance. In addition, employees who receive a preservation notice should be required to acknowledge receipt via email or other written means, and IT experts should track this acknowledgment information.9

The pandemic will likely also make traditional in-person collection efforts difficult if not impossible to complete, so creativity will be required. Obviously, where employees cell phones or laptops can be imaged remotely, such imaging is a key first step. In addition, identifying and collecting text messages, chats and conversations through applications such as WhatsApp (widely used for business in Latin America) is essential.10 You may also consider collecting from personal accounts or personal devices, especially if individuals indicate that they used personal accounts for business-related communications and data storagewhich is likely happening more often with people working more from home. But when doing so, pay particular attention to the limits local privacy law and regulation may place on those efforts, as discussed next.

5. Understand and Comply With Local Privacy and Data Protection Laws.

The process of preserving and collecting relevant data and documents is made more complex by Latin Americas patchwork of data privacy protections, which can complicate even the most straightforward FCPA investigation. This is especially true if an investigation might attract the interest of enforcement authorities in the United States or Europe. Add to this the specific challenges presented by the pandemic, and the risks can seem dizzying. Local counsel or US counsel with links to trusted local practitioners will be invaluable in navigating Latin Americas complex and ever-changing data privacy regimes.

Many Latin American countries have been heavily influenced by the European Unions General Data Protection Regulation. But countries in the region also have adopted a special emphasis on consent for processing data and for legitimizing transfers to inadequate countries (though it is rarely clear which outside countries are deemed adequate).11 Each country also presents unique data protection rules and investigation challenges, which require country-specific legal analysis. For more discussion on privacy laws in Latin America, see WilmerHales detailed analysis here.

Not surprisingly, the pandemic itself now shapes and tests the regions maintenance of these privacy rules. In Brazil and Panama, for example, the implementation of recently enacted privacy laws will likely be postponed in response to the pandemic.12 On the other hand, COVID-19 and the response to it have complicated some of the commonly used approaches to comply with foreign data privacy laws. In some cases, investigation teams have deployed US counsel to review data within the jurisdiction; that is difficult now, if not impossible, in many jurisdictions due to travel restrictions.

With this complicated and ever-changing set of data privacy protections across Latin Americamany of which are not intuitive to counsel trained in the United States, Europe or elsewherecompanies conducting FCPA investigations in Latin America should engage local experts to ensure that an investigation does not run afoul of local data privacy laws.

6. Understand Local Labor and Employment Law That May Impact Interviews and Discipline.

In addition, local labor and employment law may impact when, how and whether employee interviews may take place in an FCPA investigation as well as what the scope of permissible employee discipline may be. A discussion of employment law across Latin America is beyond the scope of this alert. The complexity of local employment law, like privacy law, underscores the importance of considering at the outset of an FCPA investigation whether and how to engage experienced local counsel in the jurisdiction at issue.13

7. Consider Local Enforcement Authorities and Local Anti-Corruption Laws and Requirements.

As WilmerHale described in its 2019 FCPA Year in Review, local enforcement authorities in Latin America have continued recently to investigate alleged corruption within their borderswith or without US authorities cooperation.

For example, Brazils President Jair Bolsonaro initiated his administration in January 2019 with a promise to stamp out corruption in Brazil. President Bolsonaro has introduced broad anti-corruption legislation14 and Brazilian prosecutors have been active over the past few years in tackling deep-rooted corruption in the country. However, the pandemicand the Bolsonaro administrations own corruption scandalspresent fundamental challenges to these goals, including the Brazilian governments diversion of resources that had been dedicated to investigating and prosecuting COVID-19-related corruption.15

In Mexico, President Andrs Manuel Lpez Obrador also campaigned on an anti-corruption platform and took actions at the outset of his administration to combat graft. For example, his administration has gone after the countrys national oil company, Pemex, including charging and even arresting former Pemex executives living abroad.16 In 2019, President Obrador appointed the countrys first chief anticorruption prosecutor, Luz Mijangos Borja, who was reported to have initiated 680 investigative cases in the first eight months of her term.17

Given this and similar recent investigation activity,18 local enforcement interests have always been an important consideration in FCPA investigations. But during the pandemic, local authorities enjoy greater access to documents and individuals on the ground than do US officials. The importance of expecting and planning for potential local investigations is only heightened as a result.

8. Where Appropriate, Communicate With Outside Auditors and Enforcement Authorities About Challenges Faced in the Investigation Due to the Pandemic.

Communication with relevant outside stakeholders in an FCPA investigation, including, where relevant, enforcement authorities and external auditors, has always been critically important.

The pandemic has only underscored this need for communicationDOJ and Securities and Exchange Commission (SEC) officials have recently highlighted the importance of communicating COVID-19 challenges to enforcement authorities, and they have signaled that these agencies will work with companies to address investigatory issues presented by the pandemic. For example, in April, officials from the DOJ and SEC FCPA units explained that they are trying very hard to be sensitive to the realities of what everybody is dealing with.19 A few weeks thereafter, in mid-May, DOJ and SEC officials shared that their foreign bribery units were experiencing pandemic-related challenges but were in no way hitting the pause button on their investigations.20

Similar considerations also apply to communicating with external auditors. In certain instances, a company may be required to inform its regular outside auditor of an FCPA investigation.21 In those cases, pandemic-related challenges that affect the inquirys timing, scope and action plan should be communicated to external auditors sooner rather than later.

9. Use Technology to Your Advantage.

Although the pandemic presents challenges to Latin America FCPA investigations for companies and regulators alike, it has also presented opportunities to take advantage of new technologies and creative strategies. For example, firms might cut significant costs by standing up remote document review platforms via remote secure workspacesof course, ensuring compliance with local privacy laws.22 For further discussion of such technology and strategies in the investigations and strategic response context, see WilmerHales analysis here. (WilmerHale also releases CLE credit webinars about cutting-edge investigation strategies during COVID-19, as here, so please feel free to subscribe to the latest news and events from the firm.)

In the current environment, conducting interviews virtually where possible under local law and investigation circumstances has become a common approach.23 Video interviews, of course, pose their own challenges and limitations. It is important to be realistic about how long participants can be engaged during a videoconference;24 it may be better to break interviews into two half-day sessions rather than one full day. Finally, in the interest of maintaining the confidentiality of the investigation, counsel should attempt to avoid sending documents to the intervieweeparticularly one who is not employed by the client or its subsidiarybut rather should try to share documents on screen during the interview, in real time.

When relying on new technologies, hope for the best but plan for the worst. For example, if you are conducting a videoconference, have a backup telephone line. If conducting remote document review, make sure to build in time for technical difficulties and system shutdowns.

10. Expect Changes as the COVID-19 Landscape Continues to Evolve in Latin AmericaBe Creative, Flexible and Ready to Adapt.

Finally, the most important tip for conducting an FCPA investigation in Latin America during the pandemic: be flexible. Companies, individuals and regulators are all working to continue their lives and livelihoods during this global health emergency. Even the most seasoned investigators should be prepared for both the challenges and the opportunities presented by the pandemic, as outlined in each of the tips above.

WilmerHale, too, remains abreast of the latest developments in FCPA enforcement, Latin America COVID-19 response (for example, see WilmerHales latest client alert on COVID-19 response in Latin America) and other legal issues around the globe. We are available to provide timely guidance for our clients and partners.

WilmerHale has strong relationships with a wide range of local consultants and local counsel throughout Latin America. In certain countries, we have connections with multiple firms that might be considered collaborative partners, depending on the nature of the matter. The firm also taps its alumni network where useful in pursuit of our clients legal and business objectives. These resourcesemployed in concert with WilmerHales FCPA investigation expertisehave helped countless firms navigate complicated and high-stakes issues in cross-border investigation and litigation, including some of the most common complications discussed in this alert.

Read this article:
COVID-19: Investigations in the Time of Coronavirus: Conducting FCPA Investigations during the Pandemic - Lexology

This Exosome Therapeutic Market Report insights will guide for an actionable ideas, better decision-making and better business strategies. Competitive landscape underlines the strategic profiling of key players in the market, comprehensively analyzing their core competencies, & strategies. Exosome Therapeutic Market report also analyzes the market status, growth rate, future trends, market drivers, opportunities and challenges, risks and entry barriers, sales channels, distributors & Porters Five Forces Analysis.

Get Sample PDF (including COVID19 Impact Analysis) of Market Report @https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-exosome-therapeutic-market&rp

Market Analysis and Insights:Global Exosome Therapeutic Market

Exosome therapeutic market is expected to gain market growth in the forecast period of 2019 to 2026. Data Bridge Market Research analyses that the market is growing with a CAGR of 21.9% in the forecast period of 2019 to 2026 and expected to reach USD 31,691.52 million by 2026 from USD 6,500.00 million in 2018. Increasing prevalence of lyme disease, chronic inflammation, autoimmune disease and other chronic degenerative diseases are the factors for the market growth.

The major players covered in theExosome Therapeutic Marketreport areevox THERAPEUTICS, EXOCOBIO, Exopharm, AEGLE Therapeutics, United Therapeutics Corporation, Codiak BioSciences, Jazz Pharmaceuticals, Inc., Boehringer Ingelheim International GmbH, ReNeuron Group plc, Capricor Therapeutics, Avalon Globocare Corp., CREATIVE MEDICAL TECHNOLOGY HOLDINGS INC., Stem Cells Group among other players domestic and global.Exosome therapeutic market share data is available for Global, North America, Europe, Asia-Pacific, and Latin America separately. DBMR analysts understand competitive strengths and provide competitive analysis for each competitor separately.

Get Full TOC, Tables and Figures of Market Report @https://www.databridgemarketresearch.com/toc/?dbmr=global-exosome-therapeutic-market&rp

Exosomes are used to transfer RNA, DNA, and proteins to other cells in the body by making alteration in the function of the target cells. Increasing research activities in exosome therapeutic is augmenting the market growth as demand for exosome therapeutic has increased among healthcare professionals.

Increased number of exosome therapeutics as compared to the past few years will accelerate the market growth. Companies are receiving funding for exosome therapeutic research and clinical trials. For instance, In September 2018, EXOCOBIO has raised USD 27 million in its series B funding. The company has raised USD 46 million as series a funding in April 2017. The series B funding will help the company to set up GMP-compliant exosome industrial facilities to enhance production of exosomes to commercialize in cosmetics and pharmaceutical industry.

Increasing demand for anti-aging therapies will also drive the market. Unmet medical needs such as very few therapeutic are approved by the regulatory authority for the treatment in comparison to the demand in global exosome therapeutics market will hamper the market growth market. Availability of various exosome isolation and purification techniques is further creates new opportunities for exosome therapeutics as they will help company in isolation and purification of exosomes from dendritic cells, mesenchymal stem cells, blood, milk, body fluids, saliva, and urine and from others sources. Such policies support exosome therapeutic market growth in the forecast period to 2019-2026.

This exosome therapeutic market report provides details of market share, new developments, and product pipeline analysis, impact of domestic and localised market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, product approvals, strategic decisions, product launches, geographic expansions, and technological innovations in the market. To understand the analysis and the market scenario contact us for anAnalyst Brief, our team will help you create a revenue impact solution to achieve your desired goal.

Global Exosome Therapeutic Market Scope and Market Size

Global exosome therapeutic market is segmented of the basis of type, source, therapy, transporting capacity, application, route of administration and end user. The growth among segments helps you analyse niche pockets of growth and strategies to approach the market and determine your core application areas and the difference in your target markets.

Based on type, the market is segmented into natural exosomes and hybrid exosomes. Natural exosomes are dominating in the market because natural exosomes are used in various biological and pathological processes as well as natural exosomes has many advantages such as good biocompatibility and reduced clearance rate compare than hybrid exosomes.

Exosome is an extracellular vesicle which is released from cells, particularly from stem cells. Exosome functions as vehicle for particular proteins and genetic information and other cells. Exosome plays a vital role in the rejuvenation and communication of all the cells in our body while not themselves being cells at all. Research has projected that communication between cells is significant in maintenance of healthy cellular terrain. Chronic disease, age, genetic disorders and environmental factors can affect stem cells communication with other cells and can lead to distribution in the healing process. The growth of the global exosome therapeutic market reflects global and country-wide increase in prevalence of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases, along with increasing demand for anti-aging therapies. Additionally major factors expected to contribute in growth of the global exosome therapeutic market in future are emerging therapeutic value of exosome, availability of various exosome isolation and purification techniques, technological advancements in exosome and rising healthcare infrastructure.

Rising demand of exosome therapeutic across the globe as exosome therapeutic is expected to be one of the most prominent therapies for autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases treatment, according to clinical researches exosomes help to processes regulation within the body during treatment of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases. This factor has increased the research activities in exosome therapeutic development around the world for exosome therapeutic. Hence, this factor is leading the clinician and researches to shift towards exosome therapeutic. In the current scenario the exosome therapeutic are highly used in treatment of autoimmune disease, chronic inflammation, Lyme disease and chronic degenerative diseases and as anti-aging therapy as it Exosomes has proliferation of fibroblast cells which is significant in maintenance of skin elasticity and strength.

Based on source, the market is segmented into dendritic cells, mesenchymal stem cells, blood, milk, body fluids, saliva, urine and others. Mesenchymal stem cells are dominating in the market because mesenchymal stem cells (MSCs) are self-renewable, multipotent, easily manageable and customarily stretchy in vitro with exceptional genomic stability. Mesenchymal stem cells have a high capacity for genetic manipulation in vitro and also have good potential to produce. It is widely used in treatment of inflammatory and degenerative disease offspring cells encompassing the transgene after transplantation.

Based on therapy, the market is segmented into immunotherapy, gene therapy and chemotherapy. Chemotherapy is dominating in the market because chemotherapy is basically used in treatment of cancer which is major public health issues. The multidrug resistance (MDR) proteins and various tumors associated exosomes such as miRNA and IncRNA are include in in chemotherapy associated resistance.

Based on transporting capacity, the market is segmented into bio macromolecules and small molecules. Bio macromolecules are dominating in the market because bio macromolecules transmit particular biomolecular information and are basically investigated for their delicate properties such as biomarker source and delivery system.

Based on application, the market is segmented into oncology, neurology, metabolic disorders, cardiac disorders, blood disorders, inflammatory disorders, gynecology disorders, organ transplantation and others. Oncology segment is dominating in the market due to rising incidence of various cancers such as lung cancer, breast cancer, leukemia, skin cancer, lymphoma. As per the National Cancer Institute, in 2018 around 1,735,350 new cases of cancer was diagnosed in the U.S. As per the American Cancer Society Inc in 2019 approximately 268,600 new cases of breast cancer diagnosed in the U.S.

Based on route of administration, the market is segmented into oral and parenteral. Parenteral route is dominating in the market because it provides low drug concentration, free from first fast metabolism, low toxicity as compared to oral route as well as it is suitable in unconscious patients, complicated to swallow drug etc.

The exosome therapeutic market, by end user, is segmented into hospitals, diagnostic centers and research & academic institutes. Hospitals are dominating in the market because hospitals provide better treatment facilities and skilled staff as well as treatment available at affordable cost in government hospitals.

Exosome therapeutic Market Country Level Analysis

The global exosome therapeutic market is analysed and market size information is provided by country by type, source, therapy, transporting capacity, application, route of administration and end user as referenced above.

The countries covered in the exosome therapeutic market report are U.S. and Mexico in North America, Turkey in Europe, South Korea, Australia, Hong Kong in the Asia-Pacific, Argentina, Colombia, Peru, Chile, Ecuador, Venezuela, Panama, Dominican Republic, El Salvador, Paraguay, Costa Rica, Puerto Rico, Nicaragua, Uruguay as part of Latin America.

Country Level Analysis, By Type

North America dominates the exosome therapeutic market as the U.S. is leader in exosome therapeutic manufacturing as well as research activities required for exosome therapeutics. At present time Stem Cells Group holding shares around 60.00%. In addition global exosomes therapeutics manufacturers like EXOCOBIO, evox THERAPEUTICS and others are intensifying their efforts in China. The Europe region is expected to grow with the highest growth rate in the forecast period of 2019 to 2026 because of increasing research activities in exosome therapeutic by population.

The country section of the report also provides individual market impacting factors and changes in regulation in the market domestically that impacts the current and future trends of the market. Data points such as new sales, replacement sales, country demographics, regulatory acts and import-export tariffs are some of the major pointers used to forecast the market scenario for individual countries. Also, presence and availability of global brands and their challenges faced due to large or scarce competition from local and domestic brands, impact of sales channels are considered while providing forecast analysis of the country data.

Huge Investment by Automakers for Exosome Therapeutics and New Technology Penetration

Global exosome therapeutic market also provides you with detailed market analysis for every country growth in pharma industry with exosome therapeutic sales, impact of technological development in exosome therapeutic and changes in regulatory scenarios with their support for the exosome therapeutic market. The data is available for historic period 2010 to 2017.

Competitive Landscape and Exosome Therapeutic Market Share Analysis

Global exosome therapeutic market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, global presence, production sites and facilities, company strengths and weaknesses, product launch, product trials pipelines, concept cars, product approvals, patents, product width and breadth, application dominance, technology lifeline curve. The above data points provided are only related to the companys focus related to global exosome therapeutic market.

Many joint ventures and developments are also initiated by the companies worldwide which are also accelerating the global exosome therapeutic market.

For instance,

Partnership, joint ventures and other strategies enhances the company market share with increased coverage and presence. It also provides the benefit for organisation to improve their offering for exosome therapeutics through expanded model range.

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Exosome Therapeutic Market 2020-2026 Industry Report : Size, Growth, Trends, Share, Revenue || Major Gaints Jazz Pharmaceuticals, Inc., Boehringer...

Damaged cartilage can be treated through a technique called microfracture, in which tiny holes are drilled in the surface of a joint. The microfracture technique prompts the body to create new tissue in the joint, but the new tissue is not much like cartilage.

Microfracture results in what is called fibrocartilage, which is really more like scar tissue than natural cartilage, said Chan. It covers the bone and is better than nothing, but it doesnt have the bounce and elasticity of natural cartilage, and it tends to degrade relatively quickly.

The most recent research arose, in part, through the work of surgeon Matthew Murphy, PhD, a visiting researcher at Stanford who is now at the University of Manchester. I never felt anyone really understood how microfracture really worked, Murphy said. I realized the only way to understand the process was to look at what stem cells are doing after microfracture. Murphy is the lead author on the paper. Chan and Longaker are co-senior authors.

For a long time, Chan said, people assumed that adult cartilage did not regenerate after injury because the tissue did not have many skeletal stem cells that could be activated. Working in a mouse model, the team documented that microfracture did activate skeletal stem cells. Left to their own devices, however, those activated skeletal stem cells regenerated fibrocartilage in the joint.

But what if the healing process after microfracture could be steered toward development of cartilage and away from fibrocartilage? The researchers knew that as bone develops, cells must first go through a cartilage stage before turning into bone. They had the idea that they might encourage the skeletal stem cells in the joint to start along a path toward becoming bone, but stop the process at the cartilage stage.

The researchers used a powerful molecule called bone morphogenetic protein 2 (BMP2) to initiate bone formation after microfracture, but then stopped the process midway with a molecule that blocked another signaling molecule important in bone formation, called vascular endothelial growth factor (VEGF).

What we ended up with was cartilage that is made of the same sort of cells as natural cartilage with comparable mechanical properties, unlike the fibrocartilage that we usually get, Chan said. It also restored mobility to osteoarthritic mice and significantly reduced their pain.

As a proof of principle that this might also work in humans, the researchers transferred human tissue into mice that were bred to not reject the tissue, and were able to show that human skeletal stem cells could be steered toward bone development but stopped at the cartilage stage.

The next stage of research is to conduct similar experiments in larger animals before starting human clinical trials. Murphy points out that because of the difficulty in working with very small mouse joints, there might be some improvements to the system they could make as they move into relatively larger joints.

The first human clinical trials might be for people who have arthritis in their fingers and toes. We might start with small joints, and if that works we would move up to larger joints like knees, Murphy says. Right now, one of the most common surgeries for arthritis in the fingers is to have the bone at the base of the thumb taken out. In such cases we might try this to save the joint, and if it doesnt work we just take out the bone as we would have anyway. Theres a big potential for improvement, and the downside is that we would be back to where we were before.

Longaker points out that one advantage of their discovery is that the main components of a potential therapy are approved as safe and effective by the FDA. BMP2 has already been approved for helping bone heal, and VEGF inhibitors are already used as anti-cancer therapies, Longaker said. This would help speed the approval of any therapy we develop.

Joint replacement surgery has revolutionized how doctors treat arthritis and is very common: By age 80, 1 in 10 people will have a hip replacement and 1 in 20 will have a knee replaced. But such joint replacement is extremely invasive, has a limited lifespan and is performed only after arthritis hits and patients endure lasting pain. The researchers say they can envision a time when people are able to avoid getting arthritis in the first place by rejuvenating their cartilage in their joints before it is badly degraded.

One idea is to follow a Jiffy Lube model of cartilage replenishment, Longaker said. You dont wait for damage to accumulate you go in periodically and use this technique to boost your articular cartilage before you have a problem.

Longaker is the Deane P. and Louise Mitchell Professor in the School of Medicine and co-director of the Institute for Stem Cell Biology and Regenerative Medicine. Chan is a member of the Institute for Stem Cell Biology and Regenerative Medicine and Stanford Immunology.

Other Stanford scientist taking part in the research were professor of pathology Irving Weissman, MD, the Virginia and D. K. Ludwig Professor in Clinical Investigation in Cancer Research; professor of surgery Stuart B. Goodman, MD, the Robert L. and Mary Ellenburg Professor in Surgery; associate professor of orthopaedic surgery Fan Yang, PhD; professor of surgery Derrick C. Wan, MD; instructor in orthopaedic surgery Xinming Tong, PhD; postdoctoral research fellow Thomas H. Ambrosi, PhD; visiting postdoctoral scholar Liming Zhao, MD; life science research professionals Lauren S. Koepke and Holly Steininger; MD/PhD student Gunsagar S. Gulati, PhD; graduate student Malachia Y. Hoover; former student Owen Marecic; former medical student Yuting Wang, MD; and scanning probe microscopy laboratory manager Marcin P. Walkiewicz, PhD.

The research was supported by the National Institutes of Health (grants R00AG049958, R01 DE027323, R56 DE025597, R01 DE026730, R01 DE021683, R21 DE024230, U01HL099776, U24DE026914, R21 DE019274, NIGMS K08GM109105, NIH R01GM123069 and NIH1R01AR071379), the California Institute for Regenerative Medicine, the Oak Foundation, the Pitch Johnson Fund, the Gunn/Olivier Research Fund, the Stinehart/Reed Foundation, The Siebel Foundation, the Howard Hughes Medical Institute, the German Research Foundation, the PSRF National Endowment, National Center for Research Resources, the Prostate Cancer Research Foundation, the American Federation of Aging Research and the Arthritis National Research Foundation.

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Researchers find method to regrow cartilage in the joints - Stanford Medical Center Report

So with the help of Clapham, weve rounded up the five best Pilates moves to help relieve joint pain. She recommends incorporating these moves into your daily routine at least three times a week, however, Clapham cautions that you should speak with your doctor before starting a new exercise program.

Clapham says the cat-cow pose is a stretch and release exercise thats wonderful for the lower back and thoracic spine. This move is performed on your hands and knees. To get started, round your spine up towards the ceiling, and keep your gaze between your legs. This is your cat-like shape. Then, arch your back, let your belly relax and lift your head up. This is your cow-like shape.

Clapham says the pike is an effective exercise that can help loosen stiff joints in the neck, shoulders, back, hips, knees and ankles. To get started, Clapham says to start on your hands and knees. Lift your knees off the floor and place your head between your arms with your gaze between your legs. Using your upper body, push the tops of your thighs back and stretch your heels down, creating an inverted V shape with your body. Try to straighten your legs as much as possible without locking your knees.

For those less flexible you can bend your legs on the inhale and straighten them on the exhale and repeat, Clapham advises.

This is a weight-bearing strength exercise that targets your core, glutes and hamstrings, Clapham says, adding: The quadricep is beneficial for those with back pain as it improves your core muscles and [helps] stabilise your spine.

She says to start on your hands and knees, keeping your knees hip-width apart. Then lift one arm in front of you and the opposite leg behind you. Hold this for a few seconds and then repeat on the alternate arm and leg.

Clapham says horse kicks are great for those with hip pain as it loosens the hip joint and strengthens the muscles surrounding the hip. To get started, start on your hands and knees, keeping your knees hip-width apart. Using a kicking motion, lift one leg off the ground, keeping the knee bent at a 90-degree angle and the foot flexed. Lower the leg and then switch legs.

Double leg lifts are a fantastic way to improve your posture, create a stronger core and alleviate back pain, Clapham explains.

Begin by lying on your side with your legs slightly bent, then use your arms to support yourself up. Slowly lift both legs up off the floor before lowering them back down again without touching the floor.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesnt take into account your personal health requirements or existing medical conditions. That means its not personalised health advice and shouldnt be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.

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Living with arthritis? 5 easy Pilates moves that can help relieve joint pain - Starts at 60

Nobody enjoys needless pain it's not like you're getting any benefit from aching joints. Put a stop to it today by popping a simple pill.

Arthritis is a common condition, attests the National Health Service (NHS), that causes pain and inflammation in a joint.

Apparently, the disease affects "more than 10 million people" in the UK.

The consumption of a natural remedy - only 28p could help to reduce symptoms of arthritis.

These are said to block the production of inflammatory chemicals, such as "TNF-alpha", making them useful to ease joint pain.

The Cellular and Molecular Biology Division, in India, conducted a placebo- controlled study into the effects of Boswellia on joint pain.

The study enrolled 75 volunteers who had been diagnosed with osteoarthritis - a type of arthritis.

Each participant was given either 100mg or 250mg of Boswellia extract, or a daily placebo.

The trail went on for three months, and the participants were evaluated for pain and physical functions at different intervals.

On day 0, day seven, day 30, day 60, and day 90, the participants' levels of pain were documented.

In addition to this, the cartilage degrading enzyme, matrix metalloproteinase-3, was evaluated in patients' synovial fluids.

At the end of the study, the researchers noted that both doses of Boswellia extract (100mg or 250mg) showed "clinically and statistically significant improvements in pain scores and physical function scores".

The higher dosage of Boswellia extract saw a "significant improvement in pain score and functional ability" in seven days after starting treatment.

In line with these findings, the 250mg of Boswellia extract also showed a reduction in synovial fluid matrix metalloproteinase-3 in seven days.

Natures Way Boswellia Extract provides 307mg in each supplement pill, which suggests it would be an effective pain reliever.

The active ingredient is Boswellia serrata Tree Resin, which is native to India, North Africa and the Middle East.

The resin is obtained by peeling away strips of bark and then harvesting the gum that oozes out to harden over the wound.

This isn't a new development, in fact it's been used in Chinese medicine for years.

Mr Wakeman added: "[Boswellia] has the added benefit of low side effects.

"For those patients seeking an alternative to paracetamol and ibuprofen for relief of joint pain especially, it is worth considering Boswellia.

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Best supplement for arthritis: The 28p natural remedy that could ease your joint pain - Express