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Archive - Jun 9, 2019

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Large International Study Finds Diabetes Drug (Dulaglutide) Cuts Cardiovascular & Kidney Problems in Older Patients with Type 2 Diabetes; Dulaglutide Is Glucagon-Like Peptide-1 Receptor Agonist; Two Articles in The Lancet

A clinical trial that followed more than 9,900 people in 24 countries has found that the drug dulaglutide reduced cardiovascular events and kidney problems in middle-aged and older people with Type 2 diabetes. During more than five years of follow-up, cardiovascular events like heart attacks and strokes were reduced by 12% in people taking dulaglutide compared to people taking a placebo. This effect was seen in both men and women with or without previous cardiovascular disease. In addition, during the same period, the drug reduced the development of kidney disease by 15%. The trial was led by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences, both in Hamilton, Ontario, Canada. Two papers describing the cardiovascular and kidney results of the trial were published on June 9, 2019 in The Lancet from the study called the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial. The two articles are titled “Dulaglutide and Cardiovascular Outcomes in Type 2 Diabetes (REWIND): a Double-Blind, Randomised Placebo-Controlled Trial” and “Dulaglutide and Renal Outcomes in Type 2 Diabetes: an Exploratory Analysis of the REWIND Randomised, Placebo-Controlled Trial.” "Compared to others, people with diabetes have twice the rate of cardiovascular events like heart attacks and strokes, and up to 40% of people with diabetes develop kidney disease," said Hertzel C. Gerstein (photo), MD, principal investigator for the study, Professor of Medicine at McMaster and Deputy Director of the PHRI. "The REWIND trial shows that dulaglutide can safely reduce these events while improving diabetes control and modestly lowering weight and blood pressure in middle-aged people with Type 2 diabetes."

Experimental Drug Delays Type 1 Diabetes in People at High Risk; NIH-Funded Study Shows That Immunotherapy with Monoclonal Anti-CD3 Antibody (Teplizumab) Slows Progression to Clinical Disease by Two Years or More

A treatment affecting the immune system effectively slowed the progression to clinical type 1 diabetes in high-risk individuals, according to findings from National Institutes of Health-funded research. The study is the first to show that clinical type 1 diabetes can be delayed by two or more years among people who are at high risk. These results were published online on June 9, 2019 in The New England Journal of Medicine and presented at the American Diabetes Association Scientific Sessions (June 7-11) in San Francisco. The NEJM article is titled “An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes.” The study, involving treatment with an anti-CD3 monoclonal antibody (teplizumab), was conducted by Type 1 Diabetes TrialNet (https://www.trialnet.org/), an international collaboration aimed at discovering ways to delay or prevent type 1 diabetes. Researchers enrolled 76 participants ages 8-49 who were relatives of people with type 1 diabetes, had at least two types of diabetes-related autoantibodies (proteins made by the immune system), and abnormal glucose (sugar) tolerance. Participants were randomly assigned to either the treatment group, which received a 14-day course of teplizumab, or the control group, which received a placebo. All participants received glucose tolerance tests regularly until the study was completed, or until they developed clinical type 1 diabetes - whichever came first. During the trial, 72% of people in the control group developed clinical diabetes, compared to only 43% of the teplizumab group. The median time for people in the control group to develop clinical diabetes was just over 24 months, while those who developed clinical diabetes in the treatment group had a median time of 48 months before progressing to diagnosis.

Oral Administration of Antigen-Specific Exosomes Carrying MicroRNA-150 Suppresses Delayed-Type Hypersensitivity (DTH) Underlying Casein Allergy in Mouse Model; Results Suggest Possible Treatment Approach for Patients with Clinical Conditions Like Asthma

A publication in the April 23, 2019 issue of Nutrients presents new data, from the lab group of Philip Askenase (photo), MD, at the Yale University School of Medicine, describes the successful oral administration of suppressor T cell-derived exosomes strongly inhibiting immune inflammation in the skin. Exosomes are nano-sized, membrane-bounded vesicles secreted by cells, often to communicate between cells, mostly by exchange of RNAs. The article, which was included in Nutrients special issue "Cow's Milk and Allergy" is titled "Delayed-Type Hypersensitivity Underlying Casein Allergy Is Suppressed by Extracellular Vesicles Carrying miRNA-150." The results in this study were largely generated by visiting Professors Krzysztof Bryniarski and Katarzyna Nazimek from the Jagellonian College of Medicine in Krakow, Poland. The Askenase group studied allergic CD4pos T cell- and macrophage-orchestrated effector inflammation in the ear skin of mice that was strongly inhibited by oral administration of antigen-specific suppressor CD8pos T cell-derived exosomes delivering miRNA-150. Quantitated skin responses were measured kinetically over five days and the responses were to casein, a common protein of milk allergy. The antigen specificity was due to anti-casein antibody light chains coating the exosomes. This was demonstrated by flow cytometry, which also showed that the suppressive exosomes also expressed CD9, CD63, and CD81 (typical markers of classical exosomes) on their surfaces. The functioning exosomes were definitively identified by specific affinity column fractionation with beads linked to casein antigen and separately to anti-CD9. The exosomes were recovered and tested for function in vivo.

Millions of Cardiovascular Deaths Attributed to Not Eating Enough Fruits & Vegetables—New Study Tracks Toll of Suboptimal Fruit & Vegetable Intake By Region, Age, and Gender

Preliminary findings from a new study reveal that inadequate fruit and vegetable consumption may account for millions of deaths from heart disease and strokes each year. The study estimated that roughly 1 in 7 cardiovascular deaths could be attributed to not eating enough fruit and 1 in 12 cardiovascular deaths could be attributed to not eating enough vegetables. Low fruit intake resulted in nearly 1.8 million cardiovascular deaths in 2010, while low vegetable intake resulted in 1 million deaths, according to researchers. Overall, the toll of suboptimal fruit intake was almost double that of vegetables. The impacts were most acute in countries with the lowest average intakes of fruits and vegetables. "Fruits and vegetables are a modifiable component of diet that can impact preventable deaths globally," said lead study author Victoria Miller, PhD, a postdoctoral researcher at the Friedman School of Nutrition Science and Policy at Tufts University. "Our findings indicate the need for population-based efforts to increase fruit and vegetable consumption throughout the world." Dr. Miller presented the research findings at Nutrition 2019 (https://meeting.nutrition.org/), the American Society for Nutrition annual meeting, being held June 8-11, 2019 in Baltimore, Maryland. The title of her presentation (FS01-01-19)is “Estimated Global, Regional, and National Cardiovascular Disease Burdens Related to Fruit and Vegetable Consumption: An Analysis from the Global Dietary Database.”

Sun-Exposed Oyster Mushrooms Help Patients Fight Tuberculosis with Vitamin D

Tuberculosis (TB) remains one of the deadliest infectious diseases in low-income countries, with approximately 1.6 million people dying of the disease each year. In a new study, researchers show that sun-exposed oyster mushrooms offer a readily available source of vitamin D that can help TB patients respond better to anti-TB drugs by improving immune response. "TB is becoming more difficult to fight due to the emergence of drug-resistant strains, creating an urgent need for new treatments that can support first-line drugs," said TibebeSelassie Seyoum Keflie, a doctoral fellow at University of Hohenheim, in Stuttgart, Germany. "This source of vitamin D is ideal for low-income countries because mushrooms can easily be distributed and administered in a safe, low-cost, easy-to-replicate manner." Keflie, who performed the research with Hans Konrad Biesalski, PhD, at the University of Hohenheim, will present the research at Nutrition 2019 (https://meeting.nutrition.org/), the American Society for Nutrition annual meeting, held June 8-11, 2019 in Baltimore, Maryland. The title of the abstract (OR15-04-19) is “Vitamin D2 as Adjunctive Therapy of Tuberculosis” (https://www.eventscribe.com/2019/ASN/fsPopup.asp?Mode=presInfo&Presentat...). Studies have shown that vitamin D induces the body to form an antimicrobial compound that attacks the bacterial cause of TB. Although sun exposure can boost a person's vitamin D levels, it must be obtained through diet when sun exposure is scarce. The researchers used oyster mushrooms because they offer a cheap, safe, and readily available source of vitamin D that is easily absorbed by the body. Although fresh oyster mushrooms contain almost no vitamin D, the fungus produces it the after exposure to sunlight much like the human body.