Posts tagged with "Medicine"

Marijuana illustration by Heather Skovlund for 360 Magazine

Cultural history of marijuana 

One of the most controversial and talked about topics over the course of recent human history has been marijuana and its consumption. It has been the topic of debate for a number of years now as it was always considered a drug that could be potentially dangerous to a person’s health, much like any chemical drug might do. 

All of this controversy led to the recreational use of marijuana being banned practically worldwide, and the medicinal use only available to those who were absolutely desperate for it. Today, many states in America have legalised both just the medicinal use and even the recreational use as well, making the market grow insanely and be massively successful. This has led to exciting new inventions for those with an interest in the marijuana culture, like vaporizers, electric grinders, or even electric dab rigs. While people may know these basic facts, they might not know the actual cultural history that comes surrounding marijuana, so if you want to learn more, here is some information about the cultural history of marijuana. 

Ancient times

Marijuana, also known as weed, cannabis, or pot, has an incredibly long history that could consider it to be an ancient drug. Most countries and cultures didn’t intend to grow the plant and make use of it in order to feel a high, but rather for medicinal purposes. It is said that it was most likely to have been discovered somewhere in Asia all the way around 500 BC. 

Earlier hemp plants are known to be native to Asia and are slightly different to the cannabis plants that we make use of today that have been specially grown with different strains to feel different and more intense highs. Typically, beyond its medicinal use, hemp fibre was used to make paper, clothes, and ropes and even provide food from the seeds. 

It has also been seen to have been used ceremonially with the graves of shamans in both Siberia and china having burned cannabis seeds in them, dating all the way back to 500BC

The 19th century

Moving forward with technology and research, in the early 1800s an Irish doctor who was studding in India discovered that marijuana extracts would help people with severe stomach pain and nausea who were likely suffering from cholera. Throughout the 1800s these extracts were sold by doctors and pharmacies all over Europe and the USA as treatment but there were problems that had been noticed. 

Through further research is was discovered that the source of the problems was THC, a chemical compound within the marijuana plant that has psychoactive properties. Before this discovery, marijuana was considered a miracle plant that as curing people of all sorts of ailments. 

The 20th century

Moving in to the 20th century, this is when things started going downhill for the marijuana industry with the Marijuana tax Act being imposed in 1937 as a way to heavily tax those who sell, are in possession, or use marijuana and ultimately ban the product. Later on in the 1900s there was a big stigma placed around the use of marijuana classifying it as a drug in the same category as that of heroine, LSD, and cocaine, all of which are chemical that can be harmful to the body. 

With every single part of the marijuana plant now being illegal, some people lost their means of natural medication and had to go through a lengthy process and fight in order to get the right to at least have marijuana for medicinal purposes. To this day, some places will still only allow people to buy marijuana from dedicated dispensaries and only if they have a medical marijuana card allowing them to do so. 

2021

2021 has seen the insane growth of the marijuana market practically worldwide. Today, there are states all over the US and countries around the world that have started to legalise the recreational use of marijuana. Now, because we are living in a time where technology is ever evolving and research is more easily done than ever, there are so many new and innovative ways to consume marijuana and so many different accessories available on the market for cannabis lovers to make use of and try out. 

There are many different methods of delivery from oral, to inhalation, to even topical. With all this, there are more and more health benefits being discovered almost daily making marijuana a great alternative to modern medicine and for those who would rather be using something more natural. 

Green covid by Mina Tocalini for 360 Magazine

Tuberculosis Bacteria Paradox

TB-causing bacteria remember prior stress, react quickly to new stress

Tuberculosis bacteria have evolved to remember stressful encounters and react quickly to future stress, according to a study by computational bioengineers at Rice University and infectious disease experts at Rutgers New Jersey Medical School (NJMS).

Published online in the open-access journal mSystems, the research identifies a genetic mechanism that allows the TB-causing bacterium, Mycobacterium tuberculosis, to respond to stress rapidly and in manner that is “history-dependent,” said corresponding author Oleg Igoshin, a professor of bioengineering at Rice.

Researchers have long suspected that the ability of TB bacteria to remain dormant, sometimes for decades, stems from their ability to behave based upon past experience.

Latent TB is an enormous global problem. While TB kills about 1.5 million people each year, the World Health Organization estimates that 2-3 billion people are infected with a dormant form of the TB bacterium.

“There’s some sort of peace treaty between the immune system and bacteria,” Igoshin said. “The bacteria don’t grow, and the immune system doesn’t kill them. But if people get immunocompromised due to malnutrition or AIDS, the bacteria can be reactivated.”

One of the most likely candidates for a genetic switch that can toggle TB bacteria into a dormant state is a regulatory network that is activated by the stress caused by immune cell attacks. The network responds by activating several dozen genes the bacteria use to survive the stress. Based on a Rice computational model, Igoshin and his longtime Rutgers NJMS collaborator Maria Laura Gennaro and colleagues predicted just such a switch in 2010. According to the theory, the switch contained an ultrasensitive control mechanism that worked in combination with multiple feedback loops to allow hysteresis, or history-dependent behavior.

“The idea is that if we expose cells to intermediate values of stress, starting from their happy state, they don’t have that much of a response,” Igoshin explained. “But if you stress them enough to stop their growth, and then reduce the stress level back to an intermediate level, they remain stressed. And even if you fully remove the stress, the gene expression pathway stays active, maintaining a base level of activity in case the stress comes back.”

In later experiments, Gennaro’s team found no evidence of the predicted control mechanism in Mycobacterium smegmatis, a close relative of the TB bacterium. Since both organisms use the same regulatory network, it looked like the prediction was wrong. Finding out why took years of follow-up studies. Gennaro and Igoshin’s teams found that the TB bacterium, unlike their noninfectious cousins, had the hysteresis control mechanism, but it didn’t behave as expected.

“Hysteretic switches are known to be very slow, and this wasn’t,” Igoshin said. “There was hysteresis, a history-dependent response, to intermediate levels of stress. But when stress went from low to high or from high to low, the response was relatively fast. For this paper, we were trying to understand these somewhat contradictory results. ”

Igoshin and study co-author Satyajit Rao, a Rice doctoral student who graduated last year, revisited the 2010 model and considered how it might be modified to explain the paradox. Studies within the past decade had found a protein called DnaK played a role in activating the stress-response network. Based on what was known about DnaK, Igoshin and Rao added it to their model of the dormant-active switch.

“We didn’t discover it, but we proposed a particular mechanism for it that could explain the rapid, history-dependent switching we’d observed,” Igoshin said. “What happens is, when cells are stressed, their membranes get damaged, and they start accumulating unfolded proteins. Those unfolded proteins start competing for DnaK.”

DnaK was known to play the role of chaperone in helping rid cells of unfolded proteins, but it plays an additional role in the stress-response network by keeping its sensor protein in an inactive state.

“When there are too many unfolded proteins, DnaK has to let go of the sensor protein, which is an activation input for our network,” Igoshin said. “So once there are enough unfolded proteins to ‘distract’ DnaK, the organism responds to the stress.”

Gennaro and co-author Pratik Datta conducted experiments at NJMS to confirm DnaK behaved as predicted. But Igoshin said it is not clear how the findings might impact TB treatment or control strategies. For example, the switch responds to short-term biochemical changes inside the cell, and it’s unclear what connection, if any, it may have with long-term behaviors like TB latency, he said.

“The immediate first step is to really try and see whether this hysteresis is important during the infection,” Igoshin said. “Is it just a peculiar thing we see in our experiments, or is it really important for patient outcomes? Given that it is not seen in the noninfectious cousin of the TB bacterium, it is tempting to speculate it is related to survival inside the host.”

Gennaro is a professor of medicine and epidemiology at Rutgers Biomedical and Health Sciences. Igoshin is a senior investigator at Rice’s Center for Theoretical Biological Physics.

The research was supported by the Welch Foundation (C-1995) and the National Institutes of Health (GM096189, AI122309, AI104615, HL149450).

Frontliners by Mina Tocalini for 360 Magazine

AHCA/NCAL Urges Guidance from CDC

In a letter addressed to Rochelle P. Walensky, the Director Centers for Disease Control and Prevention, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is requesting further guidance, data-sharing, and urgency into researching the effectiveness of the COVID-19 vaccination, especially in regard to the elderly population. The AHCA/NCAL, represents more than 14,000 nursing homes and assisted living communities across the country that provide care to approximately five million people each year.


The AHCA/NCAL reports: “need for urgency on this matter is painfully evident. For nearly a year, long term care residents have been unable to visit with their loved ones in-person or participate in enriching social activities. Despite our staff’s heroic efforts to keep residents engaged and fill the void of family members, we are deeply concerned that the prolonged isolation of our residents is impacting their health and wellbeing. Prioritizing research on the vaccines’ effectiveness among our population would help ensure these facilities can swiftly and safely reopen, improving the lives of our vulnerable seniors.”

While earlier guidance from the CDC urged nursing homes to restrict group activities and visitors, the vaccination has now been administered millions of nursing home residents. As a result of this, the AHCA/NCAL hopes to see changes in the guidance previously administered by the CDC in order to improve the quality of life for their residents under these new conditions.

To achieve this goal, the NHCA/NCAL is asking for CDC’s support to rapidly evaluate the vaccines’ effectiveness among the long term care population in both preventing spread and in reducing morbidity and mortality. The NHCA reports that the organization understands that clinical trials only evaluated the effectiveness in preventing symptomatic disease and severe illness, and participants did not include long term care residents. Therefore, they are requesting further study regarding the vaccines’ impact on transmission and the elderly population before revising guidance to long term care settings. The NHCA/NCAL asks that the CDC expedite this evaluation of the vaccines in order to bring clarity to states, providers, residents and family members as soon as possible.

Fortunately, preliminary analysis by AHCA/NCAL reports that the vaccines may be as effective as hoped. Their research division, the Center for Health Policy Evaluation in Long Term Care (CHPE), found that COVID-19 cases decreased at a faster rate among nursing homes that had completed their first vaccine clinic, compared to nearby nursing homes that had not yet administered the vaccine. More specifically, the CHPE analysis reports:

  • Vaccinated nursing homes experienced a 48% decline in new resident cases three weeks after the first clinic, compared to a 21% decline among non-vaccinated nursing homes located in the same county.
  • Similarly, new staff cases declined by 33% in vaccinated nursing homes compared to 18% in non-vaccinated facilities.

While encouraging, further study is needed to determine if these trends will continue in subsequent clinics or after the second dose of the vaccine. The AHCA/NCAL requests that data and funding be made available to the research community to expedite this ongoing analysis. Both organizations are willing to assist the CDC in this effort through facilitating data sharing between providers and researchers, as well as connecting with experts from the public and private sector to assist with data waiting to be evaluated.

As the CDC has taken great effort to administer residents and staff their second dose of the vaccine, many states have started planning reopening strategies. The AHCA/NCAL reports on the reopenings: “State governments play a vital role in contributing to the protection of our residents and staff during this time. However, in this situation, we believe that cohesion is needed to ensure effective outcomes. Without guidance from the federal government, states may create confusing or inconsistent practices.”

In hope of creating consistent practices surrounding reopening, the American Health Care Association and National Center for Assisted Living is requesting that the CDC reiterate their most up-to-date guidance on COVID-19 safety practices. Since the effectiveness of the vaccine isn’t fully determined, the AHCA/NCAL emphasizes the importance of clear communication with stakeholders to make sure that everyone understands the stressed importance and vigilance of vaccination efforts.

Dentistry illustration by Kaelen Felix for 360 Magazine

Cold Sore Flareup Triggers

Virus Highjacks Important Immune Response, UVA Discovery Reveals

Researchers at the University of Virginia School of Medicine have shed light on what causes herpes simplex virus to flare up, explaining how stress, illness and even sunburn can trigger unwanted outbreaks.

The discovery could lead to new ways to prevent cold sores and recurrent herpes-related eye disease from reoccurring, the researchers report.

“Herpes simplex recurrence has long been associated with stress, fever and sunburn,” said researcher Anna R. Cliffe, PhD, of UVA’s Department of Microbiology, Immunology and Cancer Biology. “This study sheds light on how all these triggers can lead to herpes simplex-associated disease.”

About Herpes Simplex Recurrence

Once you’re infected with herpes simplex virus (HSV) – and more half of Americans are – the virus never really goes away. Instead, it lurks inside neurons, waiting for the right moment to strike again, a process known as reactivation.

Cold sores, also known as fever blisters, are one of the most common symptoms of HSV reactivation. Recurrent reactivation in the eye leads to herpes keratitis, which, if left untreated, can result in blindness. HSV infection has also been linked to the progression of Alzheimer’s disease.

Recurrences of HSV are typically associated with stress, illness or sunburn, but doctors have been uncertain exactly what causes the virus to reactivate. Cliffe and her collaborators found that when neurons harboring the virus were exposed to stimuli that induce “neuronal hyperexcitation,” the virus senses this particular change and seizes its opportunity to reactivate.

Working in a model developed by the Cliffe lab using mouse neurons infected with HSV, the researchers determined that the virus highjacks an important immune response within the body. In response to prolonged periods of inflammation or stress, the immune system releases a particular cytokine, Interleukin 1 beta. This cytokine is also present in epithelial cells in the skin and eye and is released when these cells are damaged by ultraviolet light.

Interleukin 1 beta then increases the excitability in the affected neurons, setting the stage for HSV to flare up, the UVA researchers discovered.

“It is really remarkable that the virus has hijacked this pathway that is part of our body’s immune response,” Cliffe said. “it highlights how some viruses have evolved to take advantage of what should be part of our infection-fighting machinery.”

The scientists say that more research will need to be done to fully understand the potential factors which play into herpes simplex disease. It may vary depending on the virus strain or the type of neuron infected, even. And it is still unknown if the virus alters how neurons respond to cytokines such as Interleukin 1 beta. But the new insights help doctors better understand what is happening in neurons and the immune system, and that could lead to ways to prevent unwanted outbreaks, the researchers hope.

“A better understanding of what causes HSV to reactivate in response to a stimulus is needed to develop novel therapeutics,” Cliffe said. “Ultimately, what we hope to do is target the latent virus itself and make it unresponsive to stimuli such as Interleukin 1 beta.”

Findings Published

The researchers have published their findings in the scientific journal eLife. The research team consisted of Sean R. Cuddy, Austin R. Schinlever, Sara Dochnal, Philip V. Seegren, Jon Suzich, Parijat Kundu, Taylor K. Downs, Mina Farah, Bimal N. Desai, Chris Boutell and Cliffe.

The work was supported by the National Institutes of Health’s National Institute of Neurological Disorder and Stroke, grant R01NS105630; the National Institute of Allergy and Infectious Diseases, grant T32AI007046; the National Eye Institute, grant F30EY030397; the National Institute of General Medical Sciences, grants T32GM008136, T32GM007267, GM108989 and GM007055and Medical Research Council grant MC_UU_12014/5.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog.

AC_LatinoCovid by Allison Christensen for 360 Magazine

Antibody Cocktail May Prevent Symptomatic COVID-19 Infections

An antibody cocktail being tested at UVA Health and other sites was able to block 100% of symptomatic COVID-19 infections among people exposed to the virus, early results from the clinical trial suggest.

In addition, those who developed asymptomatic infections accumulated far less virus in their bodies than usual and saw their infections resolve within a week, according to interim data released by the cocktail’s manufacturer, Regeneron Pharmaceuticals.

“This is the first treatment shown to prevent COVID-19 after a known exposure, and offers protection for unvaccinated individuals caring for a family member with COVID-19,” said UVA Health’s William Petri Jr., MD, PhD, one of the leaders of the trial at UVA. “We expect that Regeneron will file for Emergency Use Authorization from the FDA so that this drug can be used outside of the context of a clinical trial.”

Antibodies for COVID-19

The phase 3 clinical trial aims to determine if the antibodies will prevent COVID-19 infection in people who have been exposed but not yet developed the disease. This is known as “passive immunization.”

Regeneron’s new analysis, which has not yet been published in a scientific journal, looked at outcomes in approximately 400 trial participants. Of 186 people who received the antibodies, none developed symptomatic COVID-19. Of the 223 who received a placebo, eight developed symptomatic COVID-19, the company reports.

Asymptomatic infections occurred in 15 of the antibody recipients and in 23 of the placebo recipients. Overall rates of infection, including both symptomatic and asymptomatic infections, were approximately 50% lower in the antibody group.

Among those who developed infections, placebo recipients had, on average, a peak viral load (the amount of virus in the body) that was more than 100 times greater than antibody recipients. The antibody group also recovered more quickly–all the infections resolved within seven days, while 40 percent of infections in the placebo group lasted three to four weeks, Regeneron said.

The cocktail also appears to shorten the duration of viral shedding, the time when the virus is being manufactured in the body. The viral shedding period was nine weeks among antibody recipients and 44 weeks among the placebo recipients. While people with COVID-19 are not infectious for this entire time, reducing the duration of viral shedding may shorten the period when they can spread the disease.

There were more adverse events reported among placebo recipients than among antibody recipients – 18 percent and 12 percent, respectively. Regeneron attributed this to the larger number of COVID-19 infections in the placebo group.

There was one death and one COVID-19-related hospitalization in the placebo group and none in the antibody group. Injection-site reactions were reported among 2 percent of both groups.

“We are profoundly grateful to the nurses and staff of the UVA COVID-19 clinic, led by Dr. Debbie-Anne Shirley,” Petri said. “Their day-to-day support made our participation in this trial possible.”

About the Clinical Trial

Phase 3 clinical trials, such as the one under way at UVA, examine the safety and effectiveness of new drugs and treatments in large numbers of people. Positive results in the phase 3 trial could spur the federal Food and Drug Administration to make the antibody cocktail available for post-exposure COVID-19 prevention.

The antibody cocktail is not a vaccine and is not expected to provide permanent immunity to COVID-19.

The team conducting the study at UVA is led by Petri and Shirley and includes Gregory Madden, MD; Chelsea Marie, PhD; Jennifer Sasson, MD; Jae Shin, MD; Cirle Warren, MD; Clinical Research Coordinator Igor Shumilin; assistant Rebecca Carpenter; and COVID-19 Clinic nurses Michelle Sutton, Elizabeth Brooks, Danielle Donigan, Cynthia Edwards, Jennifer Pinnata, Samantha Simmons and Rebecca Wade.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog.

Woman at Computer by Mina Tocalini for 360 Magazine

UVA’s DNA Discovery

Scientists have identified a group of drugs that may help stop a leading cause of vision loss after making an unexpected discovery that overturns a fundamental belief about DNA.

The drugs, known as Nucleoside Reverse Transcriptase Inhibitors, or NRTIs, are commonly used to treat HIV. The new discovery suggests that they may be useful against dry macular degeneration as well, even though a virus does not cause that sight-stealing condition.

A review of four different health insurance databases suggests that people taking these drugs have a significantly reduced risk of developing dry macular degeneration, a condition that affects millions of Americans.

“We are extremely excited that the reduced risk was reproduced in all the databases, each with millions of patients,” said Jayakrishna Ambati, MD, a top macular degeneration researcher at the University of Virginia School of Medicine. “This finding provides real hope in developing the first treatment for this blinding disease.”

Targeting Macular Degeneration

The new discovery comes from Ambati; Fred H. Gage, PhD, of the Salk Institute for Biological Studies; and collaborators around the world. The work rewrites our understanding of DNA, revealing for the first time that it can be manufactured in the cytoplasm of our cells, outside the cell nucleus that is home to our genetic material.

The buildup of a certain type of DNA in the cytoplasm, Alu, contributes to macular degeneration, the researchers found. This buildup appears to kill off an important layer of cells that nourishes the retina’s visual cells.

Based on this discovery, the researchers decided to look at drugs that block the production of this DNA, to see if they might help prevent vision loss. They analyzed multiple U.S. health insurance databases – encompassing more than 100 million patients over two decades – and found that people taking NRTIs were almost 40% less likely to develop dry macular degeneration.

The researchers are urging further study to determine if these drugs or safer derivatives known as Kamuvudines, both of which block a key inflammatory pathway, could help prevent vision loss from dry macular degeneration.

“A clinical trial of these inflammasome-inhibiting drugs is now warranted,” said Ambati, the founding director of UVA’s Center for Advanced Vision Science. “It’s also fascinating how uncovering the intricate biology of genetics and combining it with big data archeology can propel insights into new medicines.”

Ambati, of UVA’s Department of Ophthalmology, previously determined that NRTIs may help prevent diabetes as well.

Findings Published

The researchers have published their findings in the scientific journal PNAS. The research team consisted of Shinichi Fukuda, Akhil Varshney, Benjamin J. Fowler, Shao-bin Wang, Siddharth Narendran, Kameshwari Ambati, Tetsuhiro Yasuma, Joseph Magagnoli, Hannah Leung, Shuichiro Hirahara, Yosuke Nagasaka, Reo Yasuma, Ivana Apicella, Felipe Pereira, Ryan D. Makin, Eamonn Magner, Xinan Liu, Jian Sun, Mo Wang, Kirstie Baker, Kenneth M. Marion, Xiwen Huang, Elmira Baghdasaryan, Meenakshi Ambati, Vidya L. Ambati, Akshat Pandey, Lekha Pandya, Tammy Cummings, Daipayan Banerjee, Peirong Huang, Praveen Yerramothu, Genrich V. Tolstonog, Ulrike Held, Jennifer A. Erwin, Apua C.M. Paquola, Joseph R. Herdy, Yuichiro Ogura, Hiroko Terasaki, Tetsuro Oshika, Shaban Darwish, Ramendra K. Singh, Saghar Mozaffari, Deepak Bhattarai, Kyung Bo Kim, James W. Hardin, Charles L. Bennett, David R. Hinton, Timothy E. Hanson, Christian Röver, Keykavous Parang, Nagaraj Kerur, Jinze Liu, Brian C. Werner, S. Scott Sutton, Srinivas R. Sadda, Gerald G. Schumann, Bradley D. Gelfand, Fred H. Gage and Jayakrishna Ambati.

Jayakrishna Ambati is a co-founder of Inflammasome Therapeutics, iVeena Holdings, iVeena Delivery Systems and DiceRx; a full list of the authors’ disclosures is included in the paper.

The research was supported by UVA’s Strategic Investment Fund, the National Institutes of Health Director’s Pioneer Award, the National Institutes of Health’s National Eye Institute and many other generous contributors. A full list is included in the paper.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog.

COVID-19 Trial Tests if Common Drug Can Keep Patients Out of Hospital

At-risk people diagnosed with COVID-19 across the United States and Canada can participate in a clinical trial testing whether a common drug can keep them from getting sicker and keep them out of the hospital.­­

The trial, conducted by Washington University School of Medicine in St. Louis, is based on a discovery by the University of Virginia School of Medicine’s Alban Gaultier, PhD, and a former graduate student, Dorian A Rosen, PhD.

Gaultier and Rosen found last year that the antidepressant fluvoxamine may stop the deadly inflammation known as sepsis, in which the immune response spirals out of control. The drug’s apparent benefit for dampening dangerous inflammation prompted the Washington University researchers to begin investigating its potential benefit for COVID-19, which can also cause dangerous overreactions of the immune system.

“If this clinical trial is proven successful, fluvoxamine could become a standard treatment for patients newly diagnosed with COVID-19, especially patients at risk,” Gaultier said. “Even the best vaccines do not protect 100% of the population, and discovery of safe and affordable treatments to prevent COVID-19-associated complications is critical.”

Fluvoxamine and COVID-19

Earlier this year, the Washington University researchers launched their first clinical trial of the drug in patients with COVID-19. That trial compared fluvoxamine with a harmless placebo in 152 adult outpatients. None of the 80 participants who received fluvoxamine became seriously ill after 15 days, while six patients who received placebo did. Of those six, four were hospitalized, for periods ranging from four to 21 days. One was on a ventilator for 10 days.

Based on those initial results, Washington University is now launching a much larger trial open to residents across the United States and Canada. The trial is seeking approximately 880 at-risk participants, age 18 and older, who have tested positive for COVID-19 and are experiencing mild symptoms.

Participants will be provided with either fluvoxamine or a placebo for approximately 15 days. No face-to-face contact is required; everything necessary will be sent to the participants’ doorsteps.

Contactless Check-Ins

The researchers will track the patients by videochat, email or telephone to determine if fluvoxamine provides a benefit and helps keep participants out of the hospital. During brief daily check-ins, trial participants will report their oxygen levels, blood pressure and temperature, along with whether they are feeling shortness of breath or have had any other problems.

The study team will continue to follow the participants for approximately 90 days after they have finished taking fluvoxamine or the placebo.

The trial is open to people who have at least one risk factor for severe COVID-19, such as being 40 or older, being part of a high-risk racial/ethnic group (such as African-American, Hispanic, Native American or biracial), or having one or more medical conditions such as obesity, diabetes, high blood pressure, heart disease, a lung disease or an immune disorder such as rheumatoid arthritis.

For more information about the trial, visit this website.

Breast Cancer Illustration by Kaelen Felix for 360 Magazine

UVA Breast Cancer Discovery

University of Virginia Cancer Center researchers have identified a gene responsible for the spread of triple-negative breast cancer to other parts of the body – a process called metastasis – and developed a potential way to stop it.

Triple negative breast cancer (TNBC) is an aggressive form of breast cancer that accounts for 40,000 deaths in the United States annually. The majority of these deaths result from resistance to chemotherapy and subsequent aggressive metastases. So UVA researchers asked: What causes a primary tumor to become metastatic? This is an important question in cancer biology because patients with metastatic tumors have the highest death rate.

UVA’s Sanchita Bhatnagar, PhD, and her team found that the breast cancer oncogene TRIM37 not only causes the cancer to spread but also makes it resistant to chemotherapy. A new approach she and her colleagues have developed could possibly address both, the researchers hope.

“Despite metastasis being the key reason for failure of cancer therapies, it remains poorly understood. We do not clearly understand what drives the metastatic growth in patients,” said Bhatnagar, who was the first to identify TRIM37 as a breast cancer oncogene. “In general, several genes are altered during tumorigenesis. However, whether targeting the same genes will prevent metastatic transition remains to be addressed.”

Promising research from Bhatnagar’s team shows that targeting TRIM37 prevents metastatic lesions in mouse models. Those findings form the foundation of her lab’s current work exploring the role of TRIM37 in racial disparities in triple negative breast cancer. Incidence of the disease is disproportionately higher in African-American women compared with other races, with a 5-year survival rate in African-American patients of only 14% compared with 36% in non-African-American women.

Targeting Triple-Negative Breast Cancer

Bhatnagar and UVA’s Jogender Tushir-Singh, PhD, have developed a new approach to stop the effects of TRIM37 and, hopefully, prevent or significantly delay the spread of triple-negative breast cancer. This could also lower the disease’s defenses against chemotherapy.

Blocking the gene could benefit approximately 80% of triple negative breast cancer patients, the researchers estimate.

Bhatnagar and Tushir-Singh’s approach uses nanoparticles – microscopic balls of fat – to deliver treatment to block TRIM37. These nanoparticles are paired with specially engineered antibodies that bind to the cancerous cells but not to healthy cells. “As soon as the antibody finds the triple negative breast cancer cell, it binds to the receptor and is taken up by the cell,” explained Tushir-Singh, of UVA’s Department of Biochemistry and Molecular Genetics.

“It is a kiss of death,” Bhatnagar said, “that selectively reduces the expression of TRIM37 in cancer cells and prevents the spread.”

The approach could be used to deliver targeted treatments for many other cancers as well, the researchers report. “That would not only get the treatment where it needs to be but, hopefully, help prevent unwanted side effects. Besides preventing metastases, it adds selectivity,” Bhatnagar said.

“A problem in the field is, how will you give [a nanoparticle treatment] to the patients? Most of these nanoparticles are cleared by the liver, so they never have a chance to really do their job,” she said. “In this study, researchers bypassed this issue by delivering nanoparticles by nasal route, increasing the rate of uptake in the lungs – one of the most common metastatic target sites in TNBC patients.”

The development of the new approach is in its early stages, but tests with lab mice have offered encouraging indications. “The lungs showed dramatic reduction in metastatic lesions after the treatment in comparison to the mice that received no treatment,” Bhatnagar said.

Next Steps

To verify that TRIM37 targeting might offer a potential treatment approach, Bhatnagar teamed up with Tushir-Singh, her husband, to test it in the lab. “And we find that our targeted nanoparticles significantly reduce metastatic lesions in the lungs of spontaneous metastatic murine [mouse] models – both immune compromised and immune sufficient,” she said. “This is an important proof-of-concept much needed for the bench-to-clinic transition of these important findings.”

Clinically, most women in the early stages of breast cancer are treated with surgery, followed by radiation or chemotherapy. However, metastasis remains a challenging medical problem. Bhatnagar’s research offers a potential way to target a driver of metastasis that she hopes will prevent or slow metastatic progression and improve overall survival.

Much more work needs to be done, but Bhatnagar’s research is being noticed by pharmaceutical companies interested in exploring the approach’s potential. “This is a delivery platform, not only for targeting our protein of interest but for many other chemotherapeutic drugs that can be packaged into the nanoparticles and selectively delivered,” Bhatnagar said.

Findings Published

The researchers have published their findings in the scientific journal Cancer Research. The research team consisted of Piotr Przanowski, Song Lou, Rachisan Djiake Tihagam, Tanmoy Mondal, Caroline Conlan, Gururaj Shivange, Ilyas Saltani, Chandrajeet Singh, Kun Xing, Benjamin B. Morris, Marty W. Mayo, Luis Teixeira, Jacqueline Lehmann-Che, Jogender Tushir-Singh and Sanchita Bhatnagar.

Bhatnagar, a Hartwell Investigator, is supported by the Department of Defense Breast Cancer Research Breakthrough Award (BC170197P1, BC190343P1) and Metavivor Translational Research Award. A provisional patent has been filed for the molecularly targeted nanoparticle design engineered by the Bhatnagar and Tushir-Singh laboratories.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog.

Therapies Developed to Reduce Lung Fibrosis

A new treatment option for lung fibrosis is being developed by Purdue University scientists. Lung fibrosis has been a concern for COVID-19 patients.

People with idiopathic pulmonary fibrosis (IPF) have a life expectancy of fewer than five years. Fibrotic diseases cause organ failure that leads to about 45% of all deaths in the United States. Existing therapies do little to slow progression.

Now, Philip S. Low, Purdue’s Ralph C. Corley Distinguished Professor of Chemistry and Presidential Scholar for Drug Discovery, has led a team to develop two targeted therapies for people with IPF. The two different therapeutic approaches are published in Science Translational Medicine and EMBO Molecular Medicine.

“This is a horrible disease that claimed the lives of my next-door neighbor and a good friend’s wife,” Low said. “We developed two targeted therapies that allow us to use powerful drugs with high toxicities because we specifically deliver them to diseased cells without harming healthy ones.”

The first of the Purdue team’s novel targeted molecules is designed to slow fibrosis and extend life. The second IPF therapy suppresses fibrosis-inducing cytokine production.

The two therapies will be moving into human clinical trials within the next several months. The developments come as a number of people with COVID-19 or who have recovered from COVID-19 experience lung fibrosis or other related conditions.

The therapy technologies are licensed through the Purdue Research Foundation Office of Technology Commercialization and optioned to MorphImmune, a startup co-founded by Low. For more information on licensing a Purdue innovation, contact the Office of Technology Commercialization at otcip@prf.org.

About Purdue Research Foundation

The Purdue Research Foundation is a private, nonprofit foundation created to advance the mission of Purdue University. Established in 1930, the foundation accepts gifts; administers trusts; funds scholarships and grants; acquires property; protects Purdue’s intellectual property; and promotes entrepreneurial activities on behalf of Purdue. The foundation manages the Purdue Foundry, Purdue Office of Technology Commercialization, Purdue Research Park, Purdue Technology Centers and University Development Office. In 2020, the IPWatchdog Institute ranked Purdue third nationally in startup creation and in the top 20 for patents. The foundation received the 2019 Innovation and Economic Prosperity Universities Award for Place from the Association of Public and Land-grant Universities. For more information on licensing a Purdue innovation, contact the Purdue Office of Technology Commercialization at otcip@prf.org. For more information about involvement and investment opportunities in startups based on a Purdue innovation, contact the Purdue Foundry at foundry@prf.org.

About Purdue University

Purdue University is a top public research institution developing practical solutions to today’s toughest challenges. Ranked the No. 5 Most Innovative University in the United States by U.S. News & World Report, Purdue delivers world-changing research and out-of-this-world discovery. Committed to hands-on and online, real-world learning, Purdue offers a transformative education to all. Committed to affordability and accessibility, Purdue has frozen tuition and most fees at 2012-13 levels, enabling more students than ever to graduate debt-free. See how Purdue never stops in the persistent pursuit of the next giant leap at purdue.edu.

Writer: Chris Adam, cladam@prf.org
Source: Philip Low, plow@purdue.edu

Suraj U. Hettiarachchi, Yen-Hsing Li, Jyoti Roy, Fenghua Zhang, Estela Puchulu-Campanella, Spencer D. Lindeman, Madduri Srinivasarao, Konstantin Tsoyi, Xiaoliang Liang, Ehab A. Ayaub, Cheryl Nickerson-Nutter, Ivan O. Rosas and Philip S. Low

Loose Standards Undermined Research on COVID-19 Test Accuracy

The COVID-19 pandemic was met with a rush of research on the many factors related to the crisis, including the accuracy of different testing methods. However, many of the studies conducted in the early stages of the pandemic did not meet the usual rigorous scientific standards, according to researchers at Rice University and Baylor College of Medicine.

In “The estimation of diagnostic accuracy of tests for COVID-19: A scoping review,” which will appear in an upcoming edition of the Journal of Infection, authors Dierdre Axell-House, Richa Lavingia, Megan Rafferty, Eva Clark, E. Susan Amirian and Elizabeth Chiao found that better-designed studies are needed to appropriately evaluate the different types of COVID-19 tests.

They reviewed 49 articles published between Dec. 31, 2019, and June 19, 2020, that evaluated the validity of different types of coronavirus testing. These studies were assessed using elements of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines, which are used to evaluate if bias could be playing a role in the results of studies on diagnostic test accuracy.

Amirian, an epidemiologist at Rice’s Texas Policy Lab (TPL), said when it comes to conducting studies on testing accuracy, design is critically important. She said the major limitations found in the design of most of the studies they examined could lead to erroneous or misleading results.

“Without rigorous evaluations of which tests are the most accurate, it’s hard to know which tests are more likely to lead to false negatives, which could contribute to greater spread of the virus,” said Rafferty, a health data analyst at the TPL. “Although it’s difficult to say, some of the quality issues may have resulted from these studies being streamlined in response to the immediate need for timely information.”

“COVID-19 has now been a health crisis for nearly a year,” Amirian said. “With regard to research, the academic community needs to move away from being in acute emergency mode and think about how we’re going to handle this as a chronic crisis. When researchers are in emergency mode, we tend to be more open to sacrificing a lot of the strict quality standards for conducting research that we usually uphold.”

The paper is available online here.