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Archive - Jun 2019

Date

June 9th

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.

June 8th

Using MicroRNA from Exosomes to Detect Early Signs of Type 2 Diabetes in Teens-- Hyperglycemic Obese Teens Have Different Exosomes Than Normoglycemic Obese Teens, with MicroRNAs Targeting Carbohydrate Metabolism & Visceral Fat

Researchers know that exosomes, tiny subcellular membrane-bound nanoparticles released from fat cells (and all cells studied), travel through the bloodstream and body, regulating a variety of processes, from growth and development to metabolism. The exosomes are important in lean, healthy individuals in maintaining homeostasis, but when fat gets “sick,” the most common reason for this is too much weight gain—the exosomes from fat cells show an altered phenotype, becoming inflammatory, and they can disrupt how our organs function, from how our skeletal muscle and liver metabolize sugar to how our blood vessels process cholesterol. Robert J. Freishtat (photo), MD, MPH, the Chief of Emergency medicine at Children's National Health System and a Professor of Precision Medicine and Genomics at the George Washington University School of Medicine and Health Sciences, and Sheela N. Magge MD, MSCE, who is now the Director of Pediatric Endocrinology and an Associate Professor of Medicine at the Johns Hopkins School of Medicine, were curious about what this process looked like in teens who fell in the mid-range of obesity. Obesity is a major risk factor for insulin resistance and type 2 diabetes, but Dr. Freishtat and Dr. Magge wanted to know: Why do some teens with obesity develop type 2 diabetes over others? Why are some teens in this mid-range of obesity metabolically healthy while others have metabolic syndrome? Can fat in obese people become sick and drive disease? To test this, Dr. Freishtat and Dr. Magge worked with 55 obese adolescents, ages 12 to 17, as part of a study at Children's National Health System. The participants (32 obese normoglycemic youth and 23 obese hyperglycemic youth) were similar in age, sex, race, pubertal stage, body mass index, and overall fat mass.

Hepatitis C Virus (HCV) Inhibits Normal Immune Response by Triggering Suppressor of Cytokine Signaling (SOCS) Regulator Molecule

Scientists from Trinity College Dublin have discovered how the highly infectious and sometimes deadly hepatitis C virus (HCV) "ghosts" our immune system and remains undiagnosed in many people. The rsearchers reported their findings on June 5, 2019 in The FASEB Journal. The article is titled “The Hepatitis C Virus (HCV) Protein, P7, Suppresses Inflammatory Responses to Tumor Necrosis Factor (TNF)-α Via Signal Transducer and Activator of Transcription (STAT)3 and Extracellular Signal-Regulated Kinase (ERK)–Mediated Induction of Suppressor of Cytokine Signaling (SOCS)3.” HCV's main route of transmission is via infected blood, but over the past 40 years, the virus has accidentally been given to many patients across the world via infected blood products. The virus replicates particularly well in the liver, and the damage it causes makes it a leading cause of liver disease worldwide. Even though HCV can be deadly, initial infection is rarely accompanied by any obvious clinical symptoms for reasons that have, until now, remained unknown. As a result, it often goes undiagnosed for the first 6-12 months following infection. If left untreated, HCV spreads throughout the liver, stimulating a low-level inflammatory response. Over several months, these mild responses, accompanied by subsequent liver repair, result in fibrotic scarring of the liver. The liver's main job is to filter out toxins, but during HCV infection the build-up of fibrotic, non-functioning liver tissue, results in reduced liver function. Without a fully functioning liver, one major side-effect is the build-up of toxins, often manifest as "jaundice.” If patients do not realize they are infected with HCV, their first noticeable symptoms are the side-effects of liver fibrosis (such as jaundice).

Scientists Edge Closer to Root Causes of Multiple Sclerosis; Study of 32 Families Having Multiple Members with MS Demonstrates 12 Different Disease-Associated Candidate Genes; These Genes May Offer Guideposts to Development of Effective MS Treatment

An international team of researchers led by the University of British Columbia scientists has made a scientific advance they hope will lead to the development of preventative treatments for multiple sclerosis (MS). In a study published online on June 6, 2019 in PLOS Genetics, researchers found mutations in 12 genes believed to be largely responsible for the onset of MS in families with multiple members diagnosed with the disease. The open-access article is titled “Exome Sequencing in Multiple Sclerosis Families Identifies 12 Candidate Genes and Nominates Biological Pathways for the Genesis ff Disease.” "These genes are like a lighthouse illuminating where the root cause of MS is," said lead author Carles Vilariño-Güell, PhD, Assistant Professor in the UBC Faculty of Medicine's Department of Medical Genetics and a Michael Smith Scholar. MS is a disease that affects the central nervous system, in which cells from the immune system attack and damage the nerve cells' protective myelin sheath (see larger image at end). The disease often results in disability and can have a significant impact on quality of life. For this study, researchers sequenced all known genes in three or more MS patients from 34 families and examined the genetic variants in family members both affected by and unaffected by MS. By looking at the genes of 132 patients, they identified 12 genetic mutations that can lead to an overactive autoimmune system that attacks myelin, the insulating layer around nerves in the brain and spinal cord. Of people diagnosed with MS, only 13 per cent are believed to have a genetic form of the disease, but those presenting the mutations identified in this new study were estimated to have an up to 85 per cent chance of developing MS in their lifetime. Dr.

June 7th

Novel Gene Therapy--Japanese Researchers Develop Modified Anti-Sense Oligo (ASO) for Possible Treatment & Prevention of Parkinson’s Disease; ASO Is Targeted Against mRNA for α-Synuclein

An Osaka University-led research team has recently published findings that provide a ray of hope for the millions of Parkinson's disease (PD) sufferers worldwide. Although more common in those aged over sixty, PD can strike at any age, with an estimated prevalence of 41 per 100,000 people in their forties. And, while not fatal in and of itself, the progressive neurodegeneration that is characteristic of PD can often cause secondary effects that lead to death. The exact cause of PD is still a mystery, but researchers believe that both genetics and the environment are likely to play a part. Importantly though, all PD patients show a loss of dopaminergic neurons in the brain and increased levels of a protein called α-synuclein (image), which accumulates in Lewy bodies. Lewy bodies are a pathological feature of both familial and sporadic forms of the disease, as well as some types of dementia. In the study published online on May 21, 2019 in Scientific Reports, the team led by researchers from Osaka University's Graduate School of Medicine focused on α-synuclein as a target for a novel PD treatment. The open-access article is titled "Amido-Bridged Nucleic Acid (AmNA)-Modified Antisense Oligonucleotides Targeting α-Synuclein As A Novel Therapy for Parkinson's Disease.” "Although there are drugs that treat the symptoms associated with PD, there is no fundamental treatment to control the onset and progression of the disease," explains lead author Takuya Uehara, PhD. "Therefore, we looked at ways to prevent the expression of α-synuclein and effectively eliminate the physiological cause of PD." To do this, the researchers designed short fragments of DNA that are mirror images of sections of the α-synuclein gene mRNA. The constructs were stabilized by the addition of amido-bridging.

June 5th

Scientists Resolve Genetic Origins of Persian Walnut

Prized worldwide for its high-quality wood and rich flavor of delicious nuts, the Persian walnut (Juglans regia) is an important economic crop. The Persian walnut is one of 22 species in the genus Juglans, which includes black and white walnuts and butternuts, grown across Europe, the Americas, and Asia. China leads world production, followed by California, Turkey, and Iran. But until now, the evolutionary history of walnuts has been unknown. Walnuts have a rich fossil record, which suggest an origin of walnuts and initial divergence into black walnuts and butternuts (white walnuts) in North America some 35-45 million years ago. With this high age, both walnut lineages would have had ample opportunity to migrate into the Old World via the Bering and North Atlantic land bridges, yet only butternuts have been detected in the fossil records of Europe and Asia, and no ancient fossils of the Persian walnut are known. Using genomic data analyzed with phylogenetic and population genetic approaches, researchers have now cracked this mystery, showing that the Persian walnut is the result of hybridization between two long-extinct species approximately 3.45 million years ago. Past analyses by the team based on some 2900 single-copy nuclear genes from 19 species of walnuts were unable to sort out the relationships among North American, Asian, and Persian walnut species. However, the researchers excluded incomplete lineage sorting as the cause of the phylogenetic uncertainty. "This led us to speculate that ancient hybridization might be involved in the origin of the Persian walnut and the American butternut," said Da-Yong Zhang, PhD, Peking University, a population geneticist who is one of the senior authors.