StemCell Therapy

Data Bridge Market Reports Present Diabetic Neuropathy Market new report to its research database. The report first introduces the market basics like definitions, classifications, applications, and industry chain overview, and then industry policies and plans, product specifications, manufacturing processes, cost structures, and so on. The report highlights the change in the market which is taking place due to the moves of key players and brands such as product launches, joint ventures, mergers, and acquisitions that in turn change the view of the global face of the industry. According to the report, the global market is anticipated to witness a relatively higher growth rate during the forecast period. This Diabetic Neuropathy Market report also evaluates the market status, market share, growth rate, future trends, market drivers, opportunities and challenges, risks and entry barriers, sales channels, distributors, and Porters Five Forces Analysis.

This market research report surely provides productive ideas with which product can be made more effective and striking in the competitive market. The market data analyzed in this Diabetic Neuropathy Market report makes you achieve the business goal and objective in the predetermined time frame. This report deals with the precise study of the industry which explains the market definition, classifications, applications, engagements, and global industry trends. The Global Diabetic Neuropathy Market research report displays important product developments and tracks recent acquisitions, mergers, and research in the industry by the key players

Diabetic Neuropathy Market Insight:

The diabetic neuropathy market is expected to gain market growth in the forecast period of 2020 to 2027. Data Bridge Market Research analyses the market is growing at a CAGR of 4.90% in the above-mentioned research forecast period. The rising prevalence of diabetes disorders worldwide and emerging markets is the factor responsible for the growth of the diabetic neuropathy market.

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This Free report sample includes:

The report also inspects the financial standing of the leading companies, which includes gross profit, revenue generation, sales volume, sales revenue, manufacturing cost, individual growth rate, and other financial ratios.

Prominent Key Players Covered in the report:

Pfizer Inc., Janssen Pharmaceuticals, Inc., Eli Lilly and Company, ACTAVIS, Cephalon, Inc., MEDA Pharma GmbH & Co. KG, GlaxoSmithKline plc, NeuroMetrix, Inc

Key Pointers Covered in the Diabetic Neuropathy Market Industry Trends and Forecast

TheDiabetic Neuropathy marketreport provides successfully marked contemplated policy changes, favorable circumstances, industry news, developments, and trends. This information can help readers fortify their market position. It packs various parts of information gathered from secondary sources, including press releases, web, magazines, and journals as numbers, tables, pie-charts, and graphs. The information is verified and validated through primary interviews and questionnaires. The data on growth and trends focuses on new technologies, market capacities, raw materials, CAPEX cycle, and the dynamic structure of the Diabetic Neuropathy market.

Major Regions as Follows:

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The report includes accurately drawn facts and figures, along with graphical representations of vital market data. The research report sheds light on the emerging market segments and significant factors influencing the growth of the industry to help investors capitalize on the existing growth opportunities.

How insights and forecast from the reports could benefit you:

Why choose us:

Table Of Contents: Diabetic Neuropathy Market

Part 01:Executive Summary

Part 02:Scope of the Report

Part 03:Research Methodology

Part 04:Market Landscape

Part 05:Pipeline Analysis

Part 06:Market Sizing

Part 07:Five Forces Analysis

Part 08:Market Segmentation

Part 09:Customer Landscape

Part 10:Regional Landscape

Part 11:Decision Framework

Part 12:Drivers and Challenges

Part 13:Market Trends

Part 14:Vendor Landscape

Part 15:Vendor Analysis

Part 16:Appendix

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To summarize:

The global Diabetic Neuropathy market report studies the contemporary market to forecast the growth prospects, challenges, opportunities, risks, threats, and the trends observed in the market that can either propel or curtail the growth rate of the industry. The market factors impacting the global sector also include provincial trade policies, international trade disputes, entry barriers, and other regulatory restrictions.

Thank you for reading this article. You can also get chapter-wise sections or region-wise report coverage for North America, Europe, Asia Pacific, Latin America, and Middle East & Africa.

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Diabetic Neuropathy Market To Register Phenomenal Growth in the Period of 2027 - The Courier

THURSDAY, Feb. 4, 2021 (HealthDay News) -- Social deprivation is associated with diabetes-related foot disease (DFD) in patients newly diagnosed with type 2 diabetes, according to a study published online Jan. 22 in Diabetes Care.

Jenny Riley, from University of Birmingham in the United Kingdom, and colleagues investigated the relationship between social deprivation and incident DFD in newly diagnosed patients with type 2 diabetes. The analysis included 150,265 patients.

The researchers found that over 3.27 years, DFD developed in 12.1 percent of the study population. Using the Townsend deprivation index, individuals in the most deprived quintile had an increased risk for DFD versus those in the least deprived quintile (adjusted hazard ratio [aHR], 1.22) when adjusting for sex, age at type 2 diabetes diagnosis, ethnicity, smoking, body mass index, hemoglobin A1c, cardiovascular disease, hypertension, retinopathy, estimated glomerular filtration rate, insulin, glucose/lipid-lowering medication, and baseline foot risk. Additionally, compared with those in the least deprived quintile, those in the most deprived quintile had a higher risk for peripheral neuropathy (aHR, 1.18), foot ulcer (aHR, 1.44), peripheral vascular disease (aHR, 1.40), lower-limb amputation (aHR, 1.75), and gangrene (aHR, 8.49).

"Considering the high individual and economic burdens of DFD, strategies targeting patients in socially deprived areas are needed to reduce health inequalities," the authors write.

Abstract/Full Text (subscription or payment may be required)

See the rest here:
Deprivation Tied to Foot Disease With New Type 2 Diabetes - HealthDay News

A recent report added by Market Study Report, LLC, on ' Diabetic Neuropathy Treatment Market' provides a detailed analysis on the industry size, revenue forecasts and geographical landscape pertaining to this business space. Additionally, the report highlights primary obstacles and latest growth trends accepted by key players that form a part of the competitive spectrum of this business.

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This report also researches and evaluates the impact of Covid-19 outbreak on the Diabetic Neuropathy Treatment industry, involving potential opportunity and challenges, drivers and risks. We present the impact assessment of Covid-19 effects on Diabetic Neuropathy Treatment and market growth forecast based on different scenario (optimistic, pessimistic, very optimistic, most likely etc.).

The Diabetic Neuropathy Treatment research report is an all-inclusive evaluation of this industry sphere. The report estimates market share and growth rate of the industry vertical during the forecast period. It also explicates all the important facets of Diabetic Neuropathy Treatment market such as estimated revenue, industry size, and total sales generated. Furthermore, the study provides data about the industry segments as well as the growth drivers that will positively impact the profitability graph over the estimated timeframe.

The Diabetic Neuropathy Treatment market with respect to the regional analysis:

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Additional highlights about Diabetic Neuropathy Treatment market from the report:

Report Objectives:

The research study can answer the following Key questions:

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Global Diabetic Neuropathy Treatment Market Growth, Size, Analysis, Outlook by 2020 - Trends, Opportunities and Forecast to 2025 - AlgosOnline

Chemotherapy Induced Peripheral Neuropathy Treatment Market Data and Acquisition Research Study with Trends and Opportunities 2019-2024,The study of Chemotherapy Induced Peripheral Neuropathy Treatment market is a compilation of the market of Chemotherapy Induced Peripheral Neuropathy Treatment broken down into its entirety on the basis of types, application, trends and opportunities, mergers and acquisitions, drivers and restraints, and a global outreach. The detailed study also offers a board interpretation of the Chemotherapy Induced Peripheral Neuropathy Treatment industry from a variety of data points that are collected through reputable and verified sources. Furthermore, the study sheds a lights on a market interpretations on a global scale which is further distributed through distribution channels, generated incomes sources and a marginalized market space where most trade occurs.

Along with a generalized market study, the report also consists of the risks that are often neglected when it comes to the Chemotherapy Induced Peripheral Neuropathy Treatment industry in a comprehensive manner. The study is also divided in an analytical space where the forecast is predicted through a primary and secondary research methodologies along with an in-house model.

Download PDF Sample of Chemotherapy Induced Peripheral Neuropathy Treatment Market report @ https://hongchunresearch.com/request-a-sample/117227

Key players in the global Chemotherapy Induced Peripheral Neuropathy Treatment market covered in Chapter 4:,DermaXon,Solasia Pharma,PledPharma,Apexian Pharma,WinSanTor,Nemus Bioscience,Regenacy Pharmaceuticals,Asahi Kasei Pharma,Kineta,MAKScientific,PeriphaGen,Metys Pharmaceuticals,Immune Pharmaceuticals,Aptinyx,Krenitsky Pharmaceuticals,Sova Pharmaceuticals

In Chapter 11 and 13.3, on the basis of types, the Chemotherapy Induced Peripheral Neuropathy Treatment market from 2015 to 2026 is primarily split into:,Calcium Channel 2-delta Ligands,Antidepressants,Opioids,Others

In Chapter 12 and 13.4, on the basis of applications, the Chemotherapy Induced Peripheral Neuropathy Treatment market from 2015 to 2026 covers:,Platinum Agents,Taxanes,Vinca Alkaloids,Others

Geographically, the detailed analysis of consumption, revenue, market share and growth rate, historic and forecast (2015-2026) of the following regions are covered in Chapter 5, 6, 7, 8, 9, 10, 13:,North America (Covered in Chapter 6 and 13),United States,Canada,Mexico,Europe (Covered in Chapter 7 and 13),Germany,UK,France,Italy,Spain,Russia,Others,Asia-Pacific (Covered in Chapter 8 and 13),China,Japan,South Korea,Australia,India,Southeast Asia,Others,Middle East and Africa (Covered in Chapter 9 and 13),Saudi Arabia,UAE,Egypt,Nigeria,South Africa,Others,South America (Covered in Chapter 10 and 13),Brazil,Argentina,Columbia,Chile,Others,Regional scope can be customized

For a global outreach, the Chemotherapy Induced Peripheral Neuropathy Treatment study also classifies the market into a global distribution where key market demographics are established based on the majority of the market share. The following markets that are often considered for establishing a global outreach are North America, Europe, Asia, and the Rest of the World. Depending on the study, the following markets are often interchanged, added, or excluded as certain markets only adhere to certain products and needs.

Here is a short glance at what the study actually encompasses:,Study includes strategic developments, latest product launches, regional growth markers and mergers & acquisitions,Revenue, cost price, capacity & utilizations, import/export rates and market share,Forecast predictions are generated from analytical data sources and calculated through a series of in-house processes.

However, based on requirements, this report could be customized for specific regions and countries.

Brief about Chemotherapy Induced Peripheral Neuropathy Treatment Market Report with [emailprotected]https://hongchunresearch.com/report/chemotherapy-induced-peripheral-neuropathy-treatment-market-size-2020-117227

Some Point of Table of Content:

Chapter One: Report Overview

Chapter Two: Global Market Growth Trends

Chapter Three: Value Chain of Chemotherapy Induced Peripheral Neuropathy Treatment Market

Chapter Four: Players Profiles

Chapter Five: Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Analysis by Regions

Chapter Six: North America Chemotherapy Induced Peripheral Neuropathy Treatment Market Analysis by Countries

Chapter Seven: Europe Chemotherapy Induced Peripheral Neuropathy Treatment Market Analysis by Countries

Chapter Eight: Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Market Analysis by Countries

Chapter Nine: Middle East and Africa Chemotherapy Induced Peripheral Neuropathy Treatment Market Analysis by Countries

Chapter Ten: South America Chemotherapy Induced Peripheral Neuropathy Treatment Market Analysis by Countries

Chapter Eleven: Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Segment by Types

Chapter Twelve: Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Segment by Applications 12.1 Global Chemotherapy Induced Peripheral Neuropathy Treatment Sales, Revenue and Market Share by Applications (2015-2020) 12.1.1 Global Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Market Share by Applications (2015-2020) 12.1.2 Global Chemotherapy Induced Peripheral Neuropathy Treatment Revenue and Market Share by Applications (2015-2020) 12.2 Platinum Agents Sales, Revenue and Growth Rate (2015-2020) 12.3 Taxanes Sales, Revenue and Growth Rate (2015-2020) 12.4 Vinca Alkaloids Sales, Revenue and Growth Rate (2015-2020) 12.5 Others Sales, Revenue and Growth Rate (2015-2020)

Chapter Thirteen: Chemotherapy Induced Peripheral Neuropathy Treatment Market Forecast by Regions (2020-2026) continued

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List of tablesList of Tables and Figures Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Size Growth Rate by Type (2020-2026) Figure Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Share by Type in 2019 & 2026 Figure Calcium Channel 2-delta Ligands Features Figure Antidepressants Features Figure Opioids Features Figure Others Features Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Size Growth by Application (2020-2026) Figure Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Share by Application in 2019 & 2026 Figure Platinum Agents Description Figure Taxanes Description Figure Vinca Alkaloids Description Figure Others Description Figure Global COVID-19 Status Overview Table Influence of COVID-19 Outbreak on Chemotherapy Induced Peripheral Neuropathy Treatment Industry Development Table SWOT Analysis Figure Porters Five Forces Analysis Figure Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Size and Growth Rate 2015-2026 Table Industry News Table Industry Policies Figure Value Chain Status of Chemotherapy Induced Peripheral Neuropathy Treatment Figure Production Process of Chemotherapy Induced Peripheral Neuropathy Treatment Figure Manufacturing Cost Structure of Chemotherapy Induced Peripheral Neuropathy Treatment Figure Major Company Analysis (by Business Distribution Base, by Product Type) Table Downstream Major Customer Analysis (by Region) Table DermaXon Profile Table DermaXon Production, Value, Price, Gross Margin 2015-2020 Table Solasia Pharma Profile Table Solasia Pharma Production, Value, Price, Gross Margin 2015-2020 Table PledPharma Profile Table PledPharma Production, Value, Price, Gross Margin 2015-2020 Table Apexian Pharma Profile Table Apexian Pharma Production, Value, Price, Gross Margin 2015-2020 Table WinSanTor Profile Table WinSanTor Production, Value, Price, Gross Margin 2015-2020 Table Nemus Bioscience Profile Table Nemus Bioscience Production, Value, Price, Gross Margin 2015-2020 Table Regenacy Pharmaceuticals Profile Table Regenacy Pharmaceuticals Production, Value, Price, Gross Margin 2015-2020 Table Asahi Kasei Pharma Profile Table Asahi Kasei Pharma Production, Value, Price, Gross Margin 2015-2020 Table Kineta Profile Table Kineta Production, Value, Price, Gross Margin 2015-2020 Table MAKScientific Profile Table MAKScientific Production, Value, Price, Gross Margin 2015-2020 Table PeriphaGen Profile Table PeriphaGen Production, Value, Price, Gross Margin 2015-2020 Table Metys Pharmaceuticals Profile Table Metys Pharmaceuticals Production, Value, Price, Gross Margin 2015-2020 Table Immune Pharmaceuticals Profile Table Immune Pharmaceuticals Production, Value, Price, Gross Margin 2015-2020 Table Aptinyx Profile Table Aptinyx Production, Value, Price, Gross Margin 2015-2020 Table Krenitsky Pharmaceuticals Profile Table Krenitsky Pharmaceuticals Production, Value, Price, Gross Margin 2015-2020 Table Sova Pharmaceuticals Profile Table Sova Pharmaceuticals Production, Value, Price, Gross Margin 2015-2020 Figure Global Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Global Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) and Growth (2015-2020) Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Sales by Regions (2015-2020) Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Regions (2015-2020) Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) by Regions (2015-2020) Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Regions (2015-2020) Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Regions in 2015 Table Global Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Regions in 2019 Figure North America Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Europe Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Middle East and Africa Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure South America Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure North America Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) and Growth (2015-2020) Table North America Chemotherapy Induced Peripheral Neuropathy Treatment Sales by Countries (2015-2020) Table North America Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries (2015-2020) Figure North America Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries in 2015 Figure North America Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries in 2019 Table North America Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) by Countries (2015-2020) Table North America Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries (2015-2020) Figure North America Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries in 2015 Figure North America Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries in 2019 Figure United States Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Canada Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Mexico Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth (2015-2020) Figure Europe Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) Growth (2015-2020) Table Europe Chemotherapy Induced Peripheral Neuropathy Treatment Sales by Countries (2015-2020) Table Europe Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries (2015-2020) Figure Europe Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries in 2015 Figure Europe Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries in 2019 Table Europe Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) by Countries (2015-2020) Table Europe Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries (2015-2020) Figure Europe Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries in 2015 Figure Europe Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries in 2019 Figure Germany Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure UK Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure France Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Italy Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Spain Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Russia Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) and Growth (2015-2020) Table Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Sales by Countries (2015-2020) Table Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries (2015-2020) Figure Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries in 2015 Figure Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Sales Market Share by Countries in 2019 Table Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) by Countries (2015-2020) Table Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries (2015-2020) Figure Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries in 2015 Figure Asia-Pacific Chemotherapy Induced Peripheral Neuropathy Treatment Revenue Market Share by Countries in 2019 Figure China Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Japan Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure South Korea Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Australia Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure India Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Southeast Asia Chemotherapy Induced Peripheral Neuropathy Treatment Sales and Growth Rate (2015-2020) Figure Middle East and Africa Chemotherapy Induced Peripheral Neuropathy Treatment Revenue ($) and Growth (2015-2020) continued

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Chemotherapy Induced Peripheral Neuropathy Treatment Market Size 2020 Analysis By Industry Share, Emerging Demands, Growth Rate, Recent & Future...

This transcript has been edited for clarity.

Matthew F. Watto, MD: I am Dr Frank Watto, and that is Dr Stuart K. Brigham. With us is our good friend, Dr Paul Nelson Williams.

Paul N. Williams, MD: This time around we are going to talk about our episode with Dr Jorge Castillo on monoclonal gammopathy of undetermined significance (MGUS) and interpreting the notorious serum protein electrophoresis (SPEP) test. We'll start with Stuart and find out what takeaway points he gleaned from this episode.

Stuart K. Brigham, MD: My takeaway is a way to understand SPEP using the "shaka sign."

You have the albumin, alpha 1, alpha 2, beta, and gamma region. What you should see is the smooth appearance of the gamma region, but if you have a gammopathy in the gamma region, you'll see a spike. That's why it's called M-spike. If you have a polyclonal gammopathy, it shifts the albumin:globulin ratio.

To springboard on that, what I took away from the episode is the importance of immunofixation in identifying that protein in the gamma region and how to interpret it.

Watto: The SPEP tells you whether there is an M-spike, meaning that some kind of monoclonal protein is being produced. Immunofixation tells you whether it's IgG, IgM, IgA. Is it a light chain? It basically tells you the specificity.

One of the biggest points for me from this episode was the "big three" in MGUS. MGUS is where you have a monoclonal protein, and MGUS doesn't often progress to anything. About 1% a year progresses to multiple myeloma. An IgM type of MGUS progresses a little more, maybe 1.5%.

The big three are multiple myeloma, amyloidosis, and Waldenstrom's macroglobulinemia. The illness scripts for those are relatively simple and really good to just keep in your back pocket.

For multiple myeloma, think CRAB: C (hypercalcemia); R (renal abnormality; usually elevated creatinine); A (anemia); and B (bone lesions). That's why we get a bone survey looking for lytic lesions.

Amyloidosis can cause cardiac abnormalities, macroglossia, nephrotic syndrome, and a type of neuropathy. Dr Castillo pointed out that patients can have both a motor and sensory neuropathy, and associated muscle wasting, which is different from the typical diabetic neuropathy.

Finally there is Waldenstrom's macroglobulinemia, which is really more of a lymphoma. Waldenstrom's has anemia as well as hyperviscosity syndrome. I had no idea what that meant.

Williams: This was a really helpful illness script, because Waldenstrom's was something that I knew for the boards at one point but I've probably forgotten about and don't think about much. Dr Castillo made the point that you could potentially save a patient's life if you have the right threshold of suspicion.

In terms of the hyperviscosity seen in Waldenstrom's, you have the epistaxis but you also have symptoms that should tip you off, including persistent headache and blurred vision that doesn't correct with glasses. There are all sorts of characteristic findings on fundoscopic examination.

This can get somewhat confusing, so don't fear referral. In amyloidosis, if you have the pathologic tissue diagnosis, congratulations; but if you don't, it doesn't mean the patient doesn't have it. If you aren't sure what to do, this is a great time to call on your friendly neighborhood hematologist. Even MGUS, which is recognized as benign, can progress, so they have to monitor and know what fancy-pants labs to order. It's okay to be confused because we all are. I was certainly helped by this episode. Just don't be afraid to call hematology if you aren't sure what to do.

Watto: One more thing about Waldenstrom's that I'm not sure I mentioned earlier: The neuropathy associated with it is more of a peripheral neuropathy that tends to involve the hands and the feet. If someone has a symmetrical distal neuropathy and it doesn't quite make sense because they don't have diabetes, this might be something to think about. It's different from amyloidosis because there's no motor involvement with this one.

This was a really complicated topic and our guest did a great job of explaining it. To hear the full episode, go to #247: SPEP It Up, or find The Curbsiders' podcasts on iTunes.

You can read our show notes on that episode and join our mailing list. Thank you for watching.

The Curbsiders are a national network of students, residents, and clinician educators from across the country, representing 15 different institutions. They "curbside" experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge, and bad puns. Learn more about their contributors and follow them on Twitter.

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MGUS, SPEP, and the Shaka Sign - Medscape

Chemotherapy Induced Peripheral Neuropathy Treatment Marketresearch report is the new statistical data source added byA2Z Market Research.

Chemotherapy Induced Peripheral Neuropathy Treatment Market is growing at a High CAGR during the forecast period 2021-2027. The increasing interest of the individuals in this industry is that the major reason for the expansion of this market.

Chemotherapy Induced Peripheral Neuropathy Treatment Marketresearch is an intelligence report with meticulous efforts undertaken to study the right and valuable information. The data which has been looked upon is done considering both, the existing top players and the upcoming competitors. Business strategies of the key players and the new entering market industries are studied in detail. Well explained SWOT analysis, revenue share and contact information are shared in this report analysis.

Get the PDF Sample Copy (Including FULL TOC, Graphs and Tables) of this report @:

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Note In order to provide more accurate market forecast, all our reports will be updated before delivery by considering the impact of COVID-19.

Top Key Players Profiled in this report are:

DermaXon, Solasia Pharma, PledPharma, Apexian Pharma, WinSanTor, Nemus Bioscience, Regenacy Pharmaceuticals, Asahi Kasei Pharma, Kineta, MAKScientific, PeriphaGen, Metys Pharmaceuticals, Immune Pharmaceuticals, Aptinyx, Krenitsky Pharmaceuticals, Sova Pharmaceuticals.

The key questions answered in this report:

Various factors are responsible for the markets growth trajectory, which are studied at length in the report. In addition, the report lists down the restraints that are posing threat to the global Chemotherapy Induced Peripheral Neuropathy Treatment market. It also gauges the bargaining power of suppliers and buyers, threat from new entrants and product substitute, and the degree of competition prevailing in the market. The influence of the latest government guidelines is also analyzed in detail in the report. It studies the Chemotherapy Induced Peripheral Neuropathy Treatment markets trajectory between forecast periods.

Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Segmentation:

Market Segmentation: By Type

Calcium Channel 2-delta LigandsAntidepressantsOpioidsOthers

Market Segmentation: By Application

Platinum AgentsTaxanesVinca AlkaloidsOthers

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Regions Covered in the Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Report 2021:The Middle East and Africa(GCC Countries and Egypt)North America(the United States, Mexico, and Canada)South America(Brazil etc.)Europe(Turkey, Germany, Russia UK, Italy, France, etc.)Asia-Pacific(Vietnam, China, Malaysia, Japan, Philippines, Korea, Thailand, India, Indonesia, and Australia)

The cost analysis of the Global Chemotherapy Induced Peripheral Neuropathy Treatment Market has been performed while keeping in view manufacturing expenses, labor cost, and raw materials and their market concentration rate, suppliers, and price trend. Other factors such as Supply chain, downstream buyers, and sourcing strategy have been assessed to provide a complete and in-depth view of the market. Buyers of the report will also be exposed to a study on market positioning with factors such as target client, brand strategy, and price strategy taken into consideration.

The report provides insights on the following pointers:

Market Penetration:Comprehensive information on the product portfolios of the top players in the Chemotherapy Induced Peripheral Neuropathy Treatment market.

Product Development/Innovation:Detailed insights on the upcoming technologies, R&D activities, and product launches in the market.

Competitive Assessment: In-depth assessment of the market strategies, geographic and business segments of the leading players in the market.

Market Development:Comprehensive information about emerging markets. This report analyzes the market for various segments across geographies.

Market Diversification:Exhaustive information about new products, untapped geographies, recent developments, and investments in the Chemotherapy Induced Peripheral Neuropathy Treatment market.

Table of Contents

Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Research Report 2021 2027

Chapter 1 Chemotherapy Induced Peripheral Neuropathy Treatment Market Overview

Chapter 2 Global Economic Impact on Industry

Chapter 3 Global Market Competition by Manufacturers

Chapter 4 Global Production, Revenue (Value) by Region

Chapter 5 Global Supply (Production), Consumption, Export, Import by Regions

Chapter 6 Global Production, Revenue (Value), Price Trend by Type

Chapter 7 Global Market Analysis by Application

Chapter 8 Manufacturing Cost Analysis

Chapter 9 Industrial Chain, Sourcing Strategy and Downstream Buyers

Chapter 10 Marketing Strategy Analysis, Distributors/Traders

Chapter 11 Market Effect Factors Analysis

Chapter 12 Global Chemotherapy Induced Peripheral Neuropathy Treatment Market Forecast

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Impact of COVID-19 on Chemotherapy Induced Peripheral Neuropathy Treatment Market 2021 | Size, Growth, Demand, Opportunities & Forecast To 2027 |...

DataIntelo, the fastest growing market research company, has published a report on the Neuropathy Pain Treatment market. This market report provides a holistic scope of the market which includes future supply and demand scenarios, changing market trends, high growth opportunities, and in-depth analysis of the future market prospects. The report covers the competitive data analysis of the emerging and prominent players of the market. Along with this, it provides comprehensive data analysis on the risk factors, challenges, and possible new market avenues.

The report has been prepared with the help of a robust research methodology to cover the market in a detailed manner. To publish a top-notch Neuropathy Pain Treatment Market report, the market report has undergone extensive primary and secondary research. The dedicated research team conducted interviews with the delegated industry experts to lay out a complete overview of the market. This market research report covers the product pricing factors, revenue drivers, and growth. Furthermore, it can possibly assist the new entrants and even the existing industry players to tailor a strategic business strategy for their products.

You can buy the sample report @ https://dataintelo.com/request-sample/?reportId=43829

Impact of COVID-19 to the Neuropathy Pain Treatment Report

This coronavirus outbreak has led various industry players to change business strategies and innovate their products. Moreover, it has created lucrative opportunities and few fallbacks that has revamped the overall industry. This report has integrated the data influenced by the COVID-19 effect and provided granular analysis on what market segments would play a crucial role in the growth of the Neuropathy Pain Treatment market. It also includes insights into the successful strategies implemented by the leading players to stay ahead in the competition.

The market research team has been closely monitoring the market since 2015 and has covered the wide spectrum of the market to provide insightful data for the forecast period 2020-2027. DataIntelo has provided crucial data in a graphical representation with the help of tables, bar graphs, pie charts, histograms, and infographics. To give a detailed analysis of the market, the market segments have been fragmented into sub-segments. The segments drivers, challenges, and restraints are also considered which is vital for the market growth. Besides this, it also covers the impacts of government regulation policies and regulations on the market.

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Market Segmentation Covered in the Report

By Product Type

Calcium Channel Alpha 2-delta LigandsSerotonin-norepinephrine Reuptake InhibitorsOthers

By Applications

Retail PharmaciesHospitalsOthers

By Regional Analysis

Asia Pacific: China, Japan, India, and Rest of Asia PacificEurope: Germany, the UK, France, and Rest of EuropeNorth America: The US, Mexico, and CanadaLatin America: Brazil and Rest of Latin AmericaMiddle East & Africa: GCC Countries and Rest of Middle East & Africa

Competitive Landscape

The major players of the Neuropathy Pain Treatment market are:

DepomedEli LillyEndo InternationalPfizerAllodynic TherapeuticsArbor Pharmaceuticals

*Note: Additional companies detailed analysis can be added in the report.

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Table of Content of the Report

Executive Summary

Assumptions and Acronyms Used

Research Methodology

Neuropathy Pain Treatment Market Overview

Global Neuropathy Pain Treatment Market Analysis and Forecast by Type

Global Neuropathy Pain Treatment Market Analysis and Forecast by Application

Global Neuropathy Pain Treatment Market Analysis and Forecast by Sales Channel

Global Neuropathy Pain Treatment Market Analysis and Forecast by Region

North America Neuropathy Pain Treatment Market Analysis and Forecast

Latin America Neuropathy Pain Treatment Market Analysis and Forecast

Europe Neuropathy Pain Treatment Market Analysis and Forecast

Asia Pacific Neuropathy Pain Treatment Market Analysis and Forecast

Asia Pacific Neuropathy Pain Treatment Market Size and Volume Forecast by Application

Middle East & Africa Neuropathy Pain Treatment Market Analysis and Forecast

Competition Landscape

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Neuropathy Pain Treatment Market Analysis With Key Players, Applications, Trends And Forecasts To 2027 Iran Independent News Service - Iran...

Patients with advanced melanoma who had previously not respondedto immunotherapy showed a response after treatment with fecal transplants.

The material for the fecal transplants was obtained from patients who were experiencing a response to immunotherapy with the anti-PD-1 agent, pembrolizumab.

When the fecal transplants were given to the patients who had not responded, they "changed the gut microbiome and reprogrammed the tumor microenvironment to overcome resistance" to the immunotherapy, say researchers reporting a proof-of-concept study in Science.

The trial included 15 patients who received a fecal transplant and were then treated with pembrolizumab.

Six of the 15 showed a response.

One patient experienced a complete response; two experienced partial responses, one of which was ongoing in the absence of treatment after 2 years; and among three patients, disease was stable past 1 year.

One of the patients with stable disease again experienced disease progression after taking antibiotics for a soft tissue infection. Response resumed after a second transplant from their donor.

All six patients had been experiencing disease progression prior to the fecal transplant.

Dr Hassane Zarour

"The likelihood that the patients treated in this trial would spontaneously respond to a second administration of anti-PD-1 immunotherapy is very low, so any positive response should be attributable to the administration of fecal transplant," senior author Hassane Zarour, MD, a cancer immunologist and professor at the University of Pittsburg, Pittsburgh, Pennsylvania, said in a press release.

Dr Diwakar Davar

"Our findings show that a single FMT [fecal microbiota transplant] administered colonoscopically together with PD-1 blockade successfully colonized the gut of responders and reprogrammed the tumor microenvironment to overcome primary resistance to anti-PD-1," say investigators led by Diwakar Davar, MD, a medical oncologist and assistant professor at the University of Pittsburgh.

After transplant, the gut microbiome of the patients with restored responses was much like that of their donors. There was an increase in bacteria associated with CD8+ T-cell activation and with strong response to immune checkpoint inhibition, including bacteria of phyla Firmicutes and Actinobacteria. In these patients, levels of circulating and intertumoral interleukin-8, an immunosuppressive cytokine that interferes with PD-1 blockade. In addition, there were other cellular and biochemical changes that favored response.

"This is an excellent study," said Erez Baruch, MD, PhD, a researcher and internal medicine resident at the University of Texas Health Science Center, Houston, Texas, when asked for comment.

He led a similar but smaller study that was reported in Science in December 2020. In that study, 3 of 10 patients with metastatic melanoma whose conditions had stopped responding to checkpoint inhibition experienced a restored responseto nivolumab after fecal transplants from melanoma patients who had experienced complete and durable responses.

"The fact that two completely different cancer centers using different anti-PD-1 agents for reinduction reached the same clinical findings emphasizes the key role of the gut microbiota in immunotherapy. The two clinical trials validate each other," Baruch told Medscape Medical News.

The findings support the increasing realization in oncology that the gut microbiome affects the response to immunotherapy and that altering the microbiome might improve long-term response rates, which currently are not quite 40% in cases of advanced melanoma.

It's a hot topic, Baruch commented. Multiple clinical trials are in the works that will combine anti-PD-1 therapy with FMT for skin cancer and other malignancies. Investigators are looking for predictors of response and the particular bacterial species in play, in part so that they can be delivered in pill form some day.

"A lot of further lab work is required to understand exactly why some patients respond and why others do not. Samples collected in the trials will feed the lab work, and findings from the lab work will refine the trials. The circle will continue until the mechanisms of action are fully unmasked," Baruch said.

The material for the fecal transplants used in the pembrolizumab study came from seven donors, all of whom experienced response to pembrolizumab treatment for advanced melanoma. For four of the seven donors, the response was complete. The remaining three patients showed a partial response. The median progression-free survival (PFS) was 56 months.

The FMT success was unrelated to whether the material came from donors who had complete or partial responses, the researchers note.

In the trial, the patients who had not previously responded received pembrolizumab 200 mg at the time of transplant then every 3 weeks until progression or intolerable toxicity. Among the six responders, median PFS and overall survival was 14 months. A patient who had experienced a complete response died shortly after transplant from unrelated complications of spinal stenosis surgery. Among the entire cohort, median PFS was 3 months, and median overall survival was 7 months.

Adverse events were common but were of low grade except for grade 3 fatigue, which occurred in two patients, and peripheral motor neuropathy that required hospitalization, which occurred in one patient. The neuropathy resolved upon reintroduction of pembrolizumab.

The study was funded by the National Cancer Institute and by Merck, the maker of pembrolizumab. Davar, Zarour, and two other investigators have numerous ties to industry, among them research and/or consulting relationships with Merck and Bristol-Myers Squibb, maker of nivolumab. Baruch has disclosed no relevant financial relationships.

Science. Published online February 5, 2021. Abstract

M. Alexander Otto is a physician assistant with a masters degree in medical science, and an award-winning medical journalist who has worked for several major news outlets before joining Medscape, including McClatchy and Bloomberg. He is an MIT Knight Science Journalism fellow. Email: aotto@mdedge.com.

For more from Medscape Oncology, join us on Twitter and Facebook.

Originally posted here:
Fecal Transplant Overcomes Resistance to Immunotherapy - Medscape

By now, we know the symptoms of COVID-19 to watch for:

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

In addition to these, the CDC recommends seeking emergency medical care if you experience:

While the aforementioned symptoms seem to be more common, there have also been some outliers.

Throughout the pandemic, weve heard about COVID toes and rashes, pink eye and even people losing their appetite. So why does it seem like every time we turn around, some new symptom is making a special guest appearance?

According to pulmonary and critical care physician Joseph Khabbaza, MD, some of these reactions are quite normal, while others are symptoms that the medical community is still learning about.

Really, nothing is off the table when it comes to COVID. I always get texts from people asking if something theyre experiencing is normal. Well, theres nothing thats truly abnormal when it comes to COVID literally almost anything goes and we dont exactly know why, says Dr. Khabbaza.

Dr. Khabbaza says that two people who might appear to be similar on paper can react in totally different ways to COVID-19. As for uncommon symptoms of the virus, he says the following have popped up frequently.

Dr. Khabbaza reports that hes seen these symptoms quite often. While the medical community is still trying to figure out what causes brain fog, its believed that its likely a result of the bodys immune response to the virus or inflammation throughout the nervous system andblood vessels that lead to the brain. As for hallucinations and delirium, those, too, stem from the body fighting off the virus.

He explains.

Brain fog is kind of a big one. Its a kind of mental cloudiness like youre in a daze. You hear a lot about it with mild outpatients, but we also see it more severely in the ICU. Hallucinations and confusion are commonly experienced duringall sorts ofsevere illnesses. When you have a kind stressor like COVID-19 in the body, youre more likely to be confused, especially if you are elderly. This symptom is very common with older people as the body is trying to fight off an infection. COVID patients in the ICU sometimes experience a really bad delirium, worse than it seems with other patients who are critically ill. This delirium can worsen during a hospital stay when youre not sleeping normally or if youre in pain. Some medications that are used to keep patients comfortable on ventilators can even intensify delirium. With COVID-19, as someone gets worse, the type of brain manifestation that they experience can get worse as well. This can be due to a combination of blood flow and inflammation in the body or potentially alterations in blood flow at the microvascular level that cause these reactions.

Dr. Khabbaza says hes seen patients heart rates shoot up after minimal activity shortly after becoming infected. This along with elevated temperatures are a result of autonomic dysfunction.

Were seeing this more and more. When it occurs, our immune system is attacking autonomic nerves so nerves that regulate things in the body like heart rate and temperature that thermostat can be thrown off. When this occurs, peoples heart rates are not being regulated. Once you lose that balance, you can have a super-high heart rate or elevated temperature for no reason. Weve seen that in a lot of people and it seems to be an immune-mediated response, meaning the antibodies that you make somehow attack these kinds of nerves. Thats most likely playing a role in a lot of the unusual symptoms that were seeing, says Dr. Khabbaza.

Skin is the bodys largest organ, so it has the largest number of blood vessels. Dr. Khabbaza says skin irritations like rashes or discoloration isnt out of the ordinary when viruses or even autoimmune diseases are present.

When you think about it, anywhere where blood flows could be affected. Skin is the bodys largest organ so it has the most blood vessels. Its natural to see manifestations of illness in our skin. A lot of autoimmune diseases, in general, are associated with skin manifestations, especially viruses.

He adds that we can look back at our childhoods for evidence of this. Mainly, the rashes that developed during illness.

The skin is a place where a lot of things end up. If your blood count gets very low, your blood is too thick or you form tiny clots in the vessels, that sometimes can cause changes in your skins appearance.

While skin irritations arent as common, Dr. Khabbaza said theyre still something that the medical community is trying to understand as it battles COVID-19.

Loss of taste or smell have been associated with COVID-19, and while theyre alarming, Dr. Khabbaza says theres no need to panic if you experience these symptoms.

When this occurs, those senses are just not working normally. Nerves can be inflamed or secondarily irritated by our own immune system. But gradually with time, we should gain the ability to use them again.

Vocal cord neuropathy can occur when the nerves of the vocal cords are not working normally. This can often be a result of upper respiratory infections and can cause hoarseness or speaking problems, shortness of breath or swallowing issues. Dr. Khabbaza says this is mainly related to the vagus nerve being irritated and not working normally. This is the nerve that regulates digestion, heart rate, respiratory rate and reflex actions like coughing, sneezing and swallowing. Symptoms of vocal cord neuropathy, especially after a viral infection, often are first confused with post-viral asthma, but the symptoms often dont improve with the use of inhalers.

Dr. Khabbaza says experiencing one of these weird or unusual COVID symptoms isnt automatically a reason to panic, but if it does affect your ability to do daily activities, let your healthcare provider know sooner than later.

Most things are going to run their course and should gradually improve, but it can be a very slow process. If anything occurring is significantly affecting your daily living, your healthcare provider needs to know about it. If your heart rate shoots up to 170 when youre just walking down the hall, thats going to affect your ability to do anything, so thats something that warrants prompt attention. If a symptom is affecting your ability to work or your ability to accomplish your normal day-to-day activities, tell your healthcare provider. There may not always be some intervention that can be done, but COVID changes every day. We learn more every day and there are so many moving parts. If youre having difficulty, you always want to make sure your healthcare provider is aware of everything.

Continue reading here:
10 Unusual Symptoms of COVID-19 - Health Essentials from Cleveland Clinic

An extensive study of the product application and services conducted by subject matter experts assessing the Neuropathic Pain Market will help product owners to make a wise decision.

This press release was orginally distributed by SBWire

New York, NY -- (SBWIRE) -- 02/02/2021 -- The global research report titled 'Global Neuropathic Pain Market' recently published by Reports and Data is formulated with an aim to provide valuable insights and guidance to the businesses and new entrants. The report focuses on the major leaders of the global Neuropathic Pain market along with company profiles, product portfolios, manufacturing and production capacity, financial standings, and global position in the market.

The report on the Global Neuropathic Pain Market analyzes the impact of the COIVD-19 pandemic on the Neuropathic Pain industry. Since its outbreak, the virus-induced illness has spread across the world, compelling the WHO to declare it as a public health emergency. Moreover, COVID-19 has impacted the market by disrupting the supply chains, production, and demand, and brought about a financial slowdown and uncertainty on the markets. The pandemic is anticipated to affect the Neuropathic Pain industry, and the report gives a rundown of the present and future impact analysis of the pandemic on the market.

Get a Sample of the Report @ https://www.reportsanddata.com/sample-enquiry-form/3603

The report on the Global Neuropathic Pain Market is an investigative study that focuses on the important business aspects such as recent developments, technology advancements, and various products and processes developments. The report is formulated via a thorough primary and secondary research with data insights from industry experts and professionals.

The report further studies the major competitors of the Neuropathic Pain market in the industry to provide a comprehensive overview of the competitive landscape. Key factors such as productivity, manufacturing and production capacity, demand and supply ratio, among others, are also discussed in the report. The key companies profiled in the report are Eli Lily and Company, Pfizer Inc., Johnson & Johnson Services Inc., GlaxoSmithKline PLC, Bristol-Myers Squibb and Company, Sanofi SA, Baxter Healthcare Corporation, and Biogen Idec Inc. . Moreover, the report also analyses the key business initiatives undertaken by companies such as mergers and acquisitions, joint ventures, collaborations, and partnerships, among others.

To gain a better understanding of the competitive landscape, the report further analyses the companies operating in the key regions. The regional analysis includes examinations of the major geographical regions such as North America, Latin America, Europe, Asia-Pacific, and the Middle East & Africa. The report covers import/export ratio, supply and demand trends and patterns, production and consumption ratio, revenue generation, gross profit and margin, and other vital factors.

In market segmentation by types of Neuropathic Pain, the report covers-

By Indication (Revenue, USD Million, 2017 - 2027)-Diabetic neuropathy-Chemotherapy-induced neuropathy-Postherpetic neuralgia-Others

By Treatment (Revenue, USD Million, 2017 - 2027)-Medication-Multimodal Therapy

By End User (Revenue, USD Million, 2017 - 2027)-Hospitals-Clinics-Research Organizations

Get Discount on the Report @ https://www.reportsanddata.com/discount-enquiry-form/3603

Objectives of the Report:-Study of the global Neuropathic Pain market size by key regions, types, and applications with reference to historical data (2017-2018) and forecast (2020-2027)-Industrial structure analysis of the Neuropathic Pain market by identification of various sub-segments-Extensive analysis of key market players along with their SWOT analysis-Competitive analysis-Analysis of Neuropathic Pain market based on growth trends, outlook, and contribution to the total growth of the market-Analysis of drivers, constraints, opportunities, challenges, and risks in the global Neuropathic Pain market-Comprehensive analysis of competitive developments such as expansions, agreements, new product launches, and other strategic alliances

In addition to the key segments, the report also offers information about different aspects that can assist in the progress of the industry. The report covers applicable sales strategies, research and development advancements, online and offline trends, latest product launches and brand promotions, and strategic business expansions. Statistical information about the market is categorized and organized into tables, charts, figures, diagrams, and other graphical presentations.

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Related Report:1.Frozen Food Market Analysis 2.Plastic Fasteners Market Demand3.Dairy Alternatives Market Growth4.Etanercept Market Forecast5.Electrocardiograph Market Share6.Anti-Snoring Devices And Snoring Surgery Market Size

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Neuropathic Pain Market Overview, Size, Share : Global Industry Outlook and Statistics, Segmentation and Forecast to 2027 : Pfizer , Johnson &...

GenSight Biologics Lumevoq (lenadogene neparvovec) drew expert caution about its approval prospects in Lebers hereditary optic neuropathy (LHON) based on nebulousdata from the first two of three Phase III trials. Results from two late-stage trials showed the gene therapy had an effect on the sham eye, and so data from an ongoing third Phase III is needed to clarify efficacy information gaps, experts said.

Data from the RESCUE and REVERSE Phase III trials show patients sham eye also improved, thus diluting efficacy data in the treated eye, experts said. Since the gene therapy also had an impact on the sham eye, questions have been raised about whetherLumevoqs mechanism is fully understood, some noted.

Nevertheless, the level of visual improvement seen in RESCUE and REVERSE is strong enough to draw optimism about the ongoing Phase III REFLECT, as REFLECTs design is intended to clarify the issue, they added. REFLECT is treating both or one eye instead of using a sham injection. Topline REFLECT data is expected in 2Q, with results to be part of its FDA approval filing in 2H.

In its September 2020 EMA filing, GenSight submitted results from RESCUE and REVERSE versus natural history data from LHON patients in other trials, with a decision expected in 4Q. However, experts said it is best to wait for REFLECT results rather than to use natural history data to clarify efficacy issues. The use of natural history data as a benchmark may be confounded by Lumevoq having incompatible patient profiles with RESCUE and REVERSE patients, they said. Natural history data may also include patients receiving prior treatments, which would dilute the datas value as an efficacy benchmark, they added.

GenSight, which has a $282.86m market cap, declined a request for comment.

The function of the 90-patient REFLECT is to clarify data from RESCUE and REVERSE, which showed the sham eye also experienced improvements, said REFLECT investigator Dr Piero Barboni, consultant ophthalmologist, University of Bologna, Italy. While bilateral improvement is possible, localised treatment is assumed to not transfer into the sham eye, added REFLECT investigator Dr Prem Subramanian, professor of ophthalmology, University of Colorado, Denver.

Both the 39-patient RESCUE and 37-patient REVERSE did not meet the primary endpoint of a 15-letter difference or higher in visual acuity for treated eyes compared to sham-treated eyes at 48 weeks. RESCUE patients treated eye experienced a mean improvement of 13 additional letters over baseline versus 11 additional letters in the sham-treated eye, according to a February 2019 press release. In REVERSE, patients treated eye improved by 15 or more letters, compared with 13 or more for the sham-treated eye, as per a 10 December 2020 press release.

Gene therapy studies in animal models show sham eye improvement may becaused by the treatment moving back up the optic nerve and into the untreated eye, explained Alan Boyd, CEO of his eponymous healthcare regulatory consulting firm in Crewe, UK. However, if any trial is designed to use the patients other eye as a control, then there should be no systemic effect, noted Janet Wittes, president, Statistics Collaborative, Washington, DC. There should be stronger understanding of the therapys mechanism, she added. Lumevoq features a recombinant adenoassociated viral vector containing the wild-type ND4 gene. This gene rescues retinal ganglion cells from LHON-induced apoptosis.

With an effect seen in the sham eye, REFLECT needs to demonstrate how both eyes improve when only one is treated, said Subramanian and Barboni. It also needs to show whether it is effective in patients who have lost or are close to losing vision, Subramanian added. REFLECT does not have asham injection, but injects one or both eyes. It is recruiting patients with LHON due to mutations of the ND4 gene, with vision loss present up to one year.

GlobalData's TMT Themes 2021 Report tells you everything you need to know about disruptive tech themes and which companies are best placed to help you digitally transform your business.

Although RESCUE and REVERSE did not meet their primary endpoints, other data from these trials show the promise of the gene therapys clinical value, which is reassuring for REFLECTs success prospects, added Subramanian. For example, in REVERSEs primary endpoint, 81% of 37 patients experienced clinically relevant recovery in the treated eye, defined as a 10-letter improvement or higher in the Early Treatment Diabetic Retinopathy Study (EDTRS) Visual Acuityscore, according to the aforementioned December 2020 release.

Given the level of the treated eyes visual recovery reported in RESCUE and REVERSE, it is difficult to argue visual improvement was down to the natural history of the condition and not without the gene therapys impact, said Dr Byron Lam, professor of Ophthalmology, University of Miami, Florida. Based on the natural progression of the disease, patients do not typically recover to the same extent as patients in RESCUE and REVERSE, he explained, adding REFLECT, by removing the sham injection, will underscore the gene therapys efficacy.

RESCUE and REVERSEs data may be strong enough for FDA approval, Boyd said. He pointed to Roches Luxturna (voretigene neparvovec), which was approved in 2017 for biallelic RPE65 mutation-associated retinal dystrophy. While its Phase III(NCT00999609) data did not have a control group, it did not reduce its approval prospects, he added. Data from the first two Phase III Lumevoq trials may be enough for conditional EMA approval, and REFLECT data may lead to full EMA approval, added Boyd.

However, other experts were more sceptical of the gene therapys overall approval prospects based on available RESCUE and REVERSE data alone, noting the improvement in the control eye undermined the validity of both trials results. As such, REFLECT results are needed to fill in the data information gaps, they added.

In its application to the EMA, GenSight filed data combining RESCUE, REVERSE and their long-term trials (NCT03406104) results versus natural history data. Natural history data were gathered from a variety of sources, such as LHON natural history studies andGenSights Phase III REALITY trials (NCT03295071) natural history registry. The comparison shows a statistically significant (p<0.01)and clinically meaningful difference with Lumevoq in visual outcomes by month 48, according to a 21 September 2020 press release.

Still, it is not standard to use natural history data from other studies as an efficacy benchmark, noted William Feuer, biostatistician, University of Miami, Florida. There are limitations to natural history data, such as how it does not capture everyone with the disease but only those who seek medical attention, Subramanian said. How often patients chose to return for examination can confuse the natural history datas value as a benchmark, he added.

Another factor obscuring the natural history data is patients who use prior treatment may have been included in this data pool, experts said. In RESCUE and REVERSE, patients were excluded if they had not completely discontinued using Takeda Pharmaceuticals Raxone (idebenone) at least seven days prior to the second visit. Ideally, clarity is needed about how natural history data being used for comparison would exclude patients previously treated with Raxone, said Subramanian. There needs to be a distinction between natural history data and treated history, said Wittes, adding natural history is what would happen to the disease if there were no treatment whatsoever.

In the pooled data from RESCUE and REVERSE, both treated and sham eyes are referred to as treated eyes. While it is highly unusual for an analysis to include what was previously a control eye in its analysis of treated eyes, this may be beneficial as it serves to understate the therapeutic effect of the gene therapy, experts agreed. In including sham eye data showing improvements, GenSight is reducing the treatment effect, making a more conservative estimate of the gene therapys therapeutic impact, agreed Wittes and Feuer.

Sean Rai-Roche is a Reporter for Clinical Trials Arena parent company GlobalDatas investigative journalism team. A version of this article originally appeared on the Insights module of GlobalDatas Pharmaceutical Intelligence Center. To access more articles like this, visitGlobalData.

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Approval of GenSight's gene therapy based on existing Phase III results - Clinical Trials Arena

This contemporary, modern market research compilation is a systematic overview of the overall market status and structure prevalent in global Chemotherapy Induced Peripheral Neuropathy Treatment market and their rampant implications upon holistic growth trajectory and further probabilities in the near future. The report is based on extensive primary and secondary research initiatives and the insights thus achieved have been stacked systematically aided by several graphs, tables and charts to encourage seamless comprehension. The report sheds ample light into both past and current developments to infer futuristic probabilities. Relevant understanding on market prognosis, trends, policy updates and current development statistics have all been highlighted in thorough detail for quick deductions and subsequent investment discretion by Orbis Pharma Reports.

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Major Company Profiles operating in the Chemotherapy Induced Peripheral Neuropathy Treatment Market:

AptinyxMetys PharmaceuticalsKrenitsky PharmaceuticalsKinetaRegenacy PharmaceuticalsWinSanTorPeriphaGenSova PharmaceuticalsMAKScientificDermaXonSolasia PharmaAsahi Kasei PharmaNemus BioscienceImmune PharmaceuticalsApexian PharmaPledPharmaMajor Types CoveredCalcium Channel ?2-delta LigandsAntidepressantsOpioidsOthers

By the product type, the market is primarily split into

Calcium Channel ?2-delta LigandsAntidepressantsOpioidsOthers

By the application, this report covers the following segments

Platinum AgentsTaxanesVinca AlkaloidsOthers

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Regional Overview:This versatile research report presentation on global Chemotherapy Induced Peripheral Neuropathy Treatment market, presented by Orbis Pharma Reports has maintained highest parameters of research practices to unravel crucial details. Holistic geographical diversifications have been carefully analyzed and prominent growth centers have been categorically flagged to maintain uniform growth trends.Besides entailing region-specific details, country-wise detailing have also been included to encourage rapid decision making. For maximum reader discretion and subsequent investment decisions, this report on global Chemotherapy Induced Peripheral Neuropathy Treatment market as assessed by Orbis Pharma Reports reveals Germany, France, Italy, UK as ideal growth hotspots, followed by American growth hubs such as Mexico, Brazil, US and Canada. MEA countries and APAC nations have also been thoroughly scanned to understand growth patterns, competition intensity as well as vendor activities across these growth points.

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Decoding Segment Specifications:The report by Orbis Pharma Reports on global Chemotherapy Induced Peripheral Neuropathy Treatment market encourages complete stratification of the market in terms of segments to understand growth patterns. All prominent segments highlighted in the report have been assessed based on set parameters such as capital diversion, inventory management as well as utility diversification, besides exploring supply chain developments to understand segment potential in growth progression. Each of the segment identified has been assessed on the basis of various market parameters to explore growth projections and likelihood. The report is based on complete SWOT and PESTEL assessment, followed by PORTERs Five Forces assessment and evaluation of all DROT factors. These details are highly crucial to encourage appropriate investment decisions on the part of inquisitive readers and aspirational investors.Orbis Pharma Reports also sketches the prevalent competition landscape, isolating frontline players as well as their growth proficient business decisions. Based on these business decisions, this report helps investors to deliver lucrative business decisions.

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Chemotherapy Induced Peripheral Neuropathy Treatment Industry Market 2021 by Company, Regions, Type and Application, Forecast to 2027:Aptinyx, Metys...

Good news about vaccines

For once, we have some good news to talk about: the prospect of another vaccine coming online in the U.S., and a long-awaited indication that at least one vaccine reduces transmission, not just the severity of Covid-19.

Lets start with the remarkable turnaround of the experimental vaccine from Novavax, a Maryland-based company that has never before brought a vaccine to market.

Last fall, Novavax postponed U.S. clinical trials because of manufacturing delays, jeopardizing the companys $1.6 billion federal contract and leaving some to wonder whether they should write off the companys shot entirely. In December, Novavax watched from the sidelines as the Pfizer-BioNTech and Moderna vaccines were approved.

But things have changed. Novavax announced last week that its vaccine produced robust protection in a large British trial and that it worked although far less well in a smaller study in South Africa. The company has also been able to quickly recruit volunteers for its U.S. trials because the two authorized vaccines have been difficult to get, and many see the Novavax trial as their best chance to get vaccinated.

So the company now stands a chance of having trial results this spring, with possible government authorization as early as April. If everything goes well, and that is a big if, Novavax could deliver enough additional doses to vaccinate 55 million Americans by the end of June. That would be on top of the 400 million doses that Moderna and Pfizer are contracted to supply the U.S. by the middle of the year enough for 200 million people.

It gets better: Novavax has been laying the international groundwork for the eventual production of two billion doses per year and its vaccine, unlike Moderna and Pfizers, can be stored and shipped at normal refrigeration temperatures.

As for protection against transmission, AstraZeneca recently released a report that offered an answer to one of the pandemics big questions: Will vaccines prevent people from giving the virus to others?

Researchers from the University of Oxford and AstraZeneca have found that not only did their vaccine protect people from serious illness and death but also had the potential to reduce transmission. Swabs taken from trial participants showed a 67 percent reduction in virus being detected among those vaccinated, though scientists warned that the data was preliminary and that masking remained necessary for all.

The AstraZeneca-Oxford vaccine is in U.S. trials, and the company has a deal to supply 300 million doses, enough for another 150 million people.

Heres how the vaccine rollout is going in every state.

Feb. 5, 2021, 4:14 p.m. ET

Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention, laid out her agencys position on opening schools.

There is increasing data to suggest that schools can safely reopen, she said today at a news briefing, adding, Vaccination of teachers is not a prerequisite for safe reopening of schools.

Plenty of teachers dont agree. In some areas, teachers unions say they wont send members back to classrooms without vaccinations. Teachers in 24 states and Washington have begun receiving vaccines, often ahead of people in professions or living situations that may put them at higher risk.

But in some areas, teachers have taught in person for months and educators are not yet eligible for vaccines. And some say that vaccinating teachers might impede reopenings: In California, unions are calling for all teachers to receive vaccines before returning to the classroom, a demand that Gov. Gavin Newsom said could prevent schools from opening this academic year.

Teacher vaccinations remain a moral quandary for states grappling with how to allocate their growing-but-still-limited vaccine supply, especially as more contagious virus variants begin to spread. Incarcerated people, for example, are vulnerable to outbreaks and death, but often fall behind educators. Older adults, too, have sometimes taken a back seat.

In Oregon, teachers will receive vaccines before some residents who are 75 years or older, who are eligible for shots only in certain counties.

Gov. Kate Brown said the move to start vaccinating Oregons teachers was part of her plan to bring students back into the classroom this school year.

For every teacher who is back in the classroom, they help 20, 30, 35 students get their lives back on track, she said. They help ensure 20, 30, 35 kids have access to mental health support. They make sure 20, 30, 35 kids get breakfast and lunch several days a week. And they allow families to know their children are in good hands when they go to work.

Heres a roundup of restrictions in all 50 states.

We live in a small city apartment and were accustomed to going our own ways during the days before Covid. To keep things fresh while we spend so much time at home, we try to stay out of each others way during the day. We also avoid going into the living room. Then when cocktail hour rolls around, we turn on the lights, light the fire, and stream some soft jazz. Meeting there each evening feels as if we have gone out someplace special.

Susan Hanes, Chicago

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Coronavirus Briefing: What Happened Today - The New York Times

A wide ranging Placental Stem Cells market report offers the strategists, marketers and senior management with the critical information they need to assess the global market research services market. A good market research report makes it possible to develop strategies such as market segmentation that means identifying specific groups within a market and product differentiation which creates an identity for a product or service that separates it from those of the competitors. With Placental Stem Cells market research report, it gets effortless to identify growth segments for investment as well as benchmark performance against key competitors.

Placentalstem cells(PSCS) marketis expected to gain market growth in the forecast period of 2020 to 2027. Data Bridge Market Research analyses the market to growing at a CAGR of 10.25% in the above-mentioned forecast period. Increasing awareness regarding the benefits associates with the preservation of placental derived stem cells will boost the growth of the market.

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The major players covered in the placental stem cells (PSCS) market report are CBR Systems, Inc, Cordlife India, Cryo-Cell International, Inc., ESPERITE N.V., LifeCell International Pvt. Ltd., StemCyte India Therapeutics Pvt. Ltd, PerkinElmer Inc, Global Cord Blood Corporation., Smart Cells International Ltd., Vita 34, among other domestic and global players. Market share data is available for Global, North America, Europe, Asia-Pacific (APAC), Middle East and Africa (MEA) and South America separately. DBMR analysts understand competitive strengths and provide competitive analysis for each competitor separately.

Global Placental Stem Cells (PSCS) Market Scope and Market Size

Placental stemcells(PSCS) market is segmented on the basis of service type and application. The growth amongst these segments will help you analyse meagre growth segments in the industries, and provide the users with valuable market overview and market insights to help them in making strategic decisions for identification of core market applications.

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Placental Stem Cells (PSCS) Market Scope

Placental stem cells (PSCS)market on the basis of countries is segmented into U.S., Canada, Mexico, Germany, Italy, U.K., France, Spain, Netherlands, Belgium, Switzerland, Turkey, Russia, Rest of Europe, Japan, China, India, South Korea, Australia, Singapore, Malaysia, Thailand, Indonesia, Philippines, Rest of Asia- Pacific, Brazil, Argentina, Rest of South America, South Africa, Saudi Arabia, UAE, Egypt, Israel, Rest of Middle East & Africa

Table of Contents:

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Placental Stem Cells (PSCS) Market Scenario

According to Data Bridge Market Research the placental stem cells (PSCS)market in developing regions is witnessing a growth in terms of its adoption rate, due to growing awareness concerning the benefits associates with the conservation of placental derived stem cells. Growing number of diseases along with introduction of hematopoietic stem cell transplantation system are also helping the market to grow. Moreover, rising awareness among the people along with increasing number of applications from emerging economies will further create new opportunities for the growth of the market.

Now the question is which are the regions that placental stem cells (PSCS)market players should target? Data Bridge Market Research has forecasted North America to dominate the market due to the increasing stem cell process along with preferences of personal stem cell banking over public and surging network of stem cell banking services.

Key points in the report

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Global Placental Stem Cells (PSCS) Market 2020: Opportunity and Growth Analysis||LifeCell International Pvt. Ltd., StemCyte India Therapeutics Pvt....

The outbreak of the Covidpandemic has made many patients reluctantto undergotreatments. While their apprehension seems to overpower them, doctors need to ensure thatstrict guidelines and protocols which assure the best quality service are followed.

Among elective surgeries andtransplants, bone marrow transplant cases have increased substantially in the past few months. Adhering to guidelines for pre-transplant evaluation and the management of a common complication, graft versus host disease (GVHD)is essential.

With the diversity of practice and expertise, the following guidelines will provide a pivotal tool for learning about the rapidly updated therapy landscape in Hematopoietic stem cell transplantation (HSCT).

The guidelines intended to provide a systematic approach for transplantation and help streamline clinical practices and educate new generations of physicians-in-training. Additionally, guidelines can help to evaluate a potential transplant recipient anddetermine if the patient is an eligible candidate for the procedure.

Types and selection of transplantation:

Selection of the type of transplantation for a patient depends on factors such as the type of malignancy, availability of a suitable donor, age of the recipient, the ability to collect a tumor-free autograft, the stage, the malignancy's susceptibility to the GVM effect, and status of disease -- bone marrow involvement, the bulk of disease, chemosensitivity to conventional chemotherapy. This method is particularly applicable for Autologous or Allogeneic Transplantation where one can have a sibling donor or a matched unrelated donor. In the case of a matched unrelated donor, ensure that the collection is adequate and stem cells are available well in time especially if they are imported from countries in Europe.

A haploidentical transplant is another type of transplant that uses healthy, blood-forming cells from a half-matched donor to replace the unhealthy ones. The ideal donor in this case is a family member.

That said, for bone marrow transplant blood products are the backbone and it is important to ensure to have adequate supply before you begin with the transplant.

What are the guidelines and protocols that can be adopted in current times?

Some measures for consideration are: Minimize face-to-face visits including monitoring and consider shifting to telehealth where feasible. Some adaptive community measures like the hospital in the home services, community practices for blood collection, imaging, and support services. For radiation oncology treatment, consider reducing fractions when supported by evidence Consider alternative and less resource-intensive treatment regimes. Minimize unnecessary visitors to cancer centers, for instance, limiting to only patients and their essential caregivers based on frailty and language needs Screen for possible symptoms of COVID-19 and triage patients for admission. If necessary, the admission has to be directed to oncology/hematology departments rather than emergency departments. Immunocompromised patients are likely to have atypical presentations of COVID-19 For suspected checkpoint inhibitor-related pneumonitis prioritizes COVID-19 testing for an early decision regarding corticosteroid therapy.

These are some guidelines that you should heed during a bone marrow transplant. While it is imperative to be updated about the guidelines, timely intervention can reduce the other possible complications during the process.

(The author is the Director, Medical Oncology and Hemato Oncology, atFortis Cancer Institute, Bangalore)

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Understanding bone marrow transplant: The guidelines and the protocols - The New Indian Express

Cynata Therapeutics (ASX: CYP), founded by two clever stem cell researchers and one wise Australian techpreneur, is in the process of developing a treatment for COVID-19.

Using its in-house stem cell technology Cymerus, the ASX-listed biotech hopes to treat one of the deadliest complications of COVID-19 -acute respiratory distress syndrome (ARDS).

In doing so Cynata would achieve what competitor Mesoblast (ASX: MSB) couldn't with FDA approval.

By deploying an industrialised approach to stem cell therapeutics, Cynata CEO Ross Macdonald (pictured) is confident the clinical trial process won't leave the company hamstrung.

In 1981 scientists discovered a way to derive embryonic stem cells from early mouse embryos.

The discovery thrilled scientists, and eventually led to the development of a method to do the same in lab-grown human embryos by 1998.

While there have been plenty of discussions surrounding the ethics of using of embryonic stem cells, these major scientific movements have pushed researchers to discover new and inventive ways of treating a whole raft of diseases and infections.

One such researcher, Dr Ian Dixon, saw potential for the use of mesenschymal stem cells (MSCs) - a type of stem cell that can differentiate into a variety of cell types enabling the treatment of many diseases and infections.

However there was still an obstacle to overcome: how do you mass produce enough cells needed to commercialise a treatment?

Luckily, two researchers at the University of Wisconson, Professor Igor Slukvin and Dr Maksym Vodyanik, had invented a biotechnological breakthrough called Cymerus.

The technology was able to do exactly what Dixon needed: the consistent manufacture of MSCs on an ultra-large scale; basically what Henry Ford did to the industrialisation of the auto industry, but for stem cells.

So in 2003 Dixon partnered with the two researchers to start Cynata - now an ASX-listed biotechnology company trialing a number of different treatments for a wide variety of ailments.

Most recently, Cynata's focus has been on developing a treatment for a complication of COVID-19 called acute respiratory distress syndrome (ARDS).

The complication ravages COVID-19 infected patients, destroying their organs through what is known as a cytokine storm. The complication is estimated to kill up to half of COVID-19 patients that suffer from it.

Melbourne-based Cynata is currently in the very early stages of its investigation into whether its MSCs will be able to treat the coronavirus complication overwhelming hospitals globally.

If this all sounds familiar, you might be thinking of another ASX-listed biotech called Mesoblast (ASX: MSB).

In March last year Mesoblast, also based in Melbourne, saw its shares surge after announcing plans to evaluate its stem cell treatment solutions on COVID-19 patients.

The group commenced the arduous clinical trial process to see if its remestemcel-L therapy could treat ARDS by using bone marrow aspirate from healthy donors - a similar approach the company had already taken to treat a condition many suffer from after receiving bone marrow transplants.

Mesoblast was riding high on the ASX following positive announcements surrounding the clinical traila process, especially back in April 2020 when a trial at New York City's Mt Sinai hospital found its remestemcel-L therpay achieved "remarkable" results.

Serious attention gathered around Mesoblast, with the company even securing $138 in funds from investors to continue its important research.

The company went so far as to sign a commercialisation deal for the COVID-19 treatment with Novartis, and the US Food and Drugs Administration (FDA) fast tracked the approvals process for the potential game-changing treatment.

However, in December 2020, Mesoblast hit a stumbling block.

Mesoblast's COVID-19 treatment flunked the test - its remestemcel-L therapy failed to show a lower mortality rate for patients in the prescribed 30-day timeframe of treatment.

At that point Cynata had commenced research into its own ARDS treatment. But did Mesoblast's failure unnerve Cynata CEO Ross Macdonald? Not a chance.

"I'm more confident that our trial will be successful where theirs was a failure," Macdonald said.

"If you use a process like we have developed - we don't rely on multiple different [stem cell] donations. You start with exactly the same material every time."

To explain, Macdonald used the analogy of a local caf; you normally expect a coffee from one caf to taste more or less exactly the same every time you go there - the same beans are used every time.

Whereas Macdonald said Mesoblast's process is like going to the same caf every day, but each visit they use different beans from a different supplier which leads to inconsistency in taste and flavour.

Cynata's approach with its MSCs is in line with the first example - what you get the first time from them will be replicated in each and every dose of the drug - while MSB's is like the latter.

"Yes, you still got the coffee, but the experience of the taste is totally different than it was yesterday," he said.

"The FDA said to Mesoblast, well you've got a manufacturing problem that is reliant upon multiple donors prepared to donate bone marrow and that is flawed.

"So with that in mind it's perhaps not surprising that they had a pretty disappointing result in the clinical trials."

Additionally, Macdonald said the initial investor reactions to MSB's early COVID-19 trail results were overblown.

"The initial data from their trial that got everybody excited was, in my view, quite flawed, because they said "look at how many patients are dying in intensive care units with COVID compared the patients that we treated," he said.

"But the reality of the situation was quite different. The control group at that time - the death rate was way, way higher than you would typically see for ARDS, whether its COVID or anything else. And it was simply because of the chaos that existed in intensive care units in New York in the first wave.

"So we think that the initial enthusiasm was perhaps a little misguided."

When asked why Mesoblast is receiving so much attention compared to Cynata, especially considering the above, Macdonald said it was simply because MSB is bigger and has been around for longer. For context, MSB has a market capitalisation of $1.46 billion, whereas Cynata's is just $94.56 million.

"I'd love to know why there is less attention, and how we can get our market cap above a billion dollars," joked Macdonald.

"I think the answer though is that they've been around for a lot longer than we have, they have spent a hell of a lot more money than we've spent - their monthly spend is more than we've spent for pretty much our entire existence.

"But I think the fundamental reason why is that data drives value in biotech, so the more clinical data you generate that shows your product works, the more attention you attract from investors."

That's not to say Cynata is being totally ignored in favour of the larger Mesoblast.

The company secured a $15 million placement led by $10 million from healthcare investor BioScience Managers in December.

The funds will be used to expand Cynata's clinical development pipeline and scale their operations in Australia.

As such, the company is preparing to expand its clinical development pipeline to include idiopathic pulmonary fibrosis, renal transplantation, and diabetic foot ulcers.

"So we're starting to garner that attention now that says two things - one, cell therapies are definitely a medical revolution and two, Cynata is part of that new generation of companies," Macdonald said.

As for the company's pipeline, in addition to the COVID treatment trials, Cynata is planning on launching three new clinical candidates that will get under way this year.

There's also Cynata's osteoarthritis trial, which Macdonald describes as significant for the biotech company; with 2 million patients in Australia and 30 million in the United States the company is hoping to tap into an $11 billion plus addressable market.

"It will ultimately show whether MSCs are useful in that particularly devastating condition," he said.

"It doesn't just affect people who want to go and play golf or tennis, it affects, particularly manual labourers who can no longer work.

"So the cost to the economy of osteoarthritis is quite significant, which is of course one of the reasons why the Australian Government is funding this trial."

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Why Cynata is hopeful its COVID treatment trial will succeed where others have failed - Business News Australia

Five years ago, I sat in a hospital lounge as a nurse laid out everything I as a caregiver would need to feed my husband intravenously: a bag of fluid called total parenteral nutrition, a vitamin solution, syringe, pump, a new 9-volt battery, a quarter for opening the battery chamber, and tiny alcohol wipes. She demonstrated the fussy, time-consuming process of hooking up the whole thing to my husbands central line.

Then she handed me a 20-page pamphlet detailing the procedure and I was on my own.

At the time, my husband, Brad, had been hospitalized for more than four months after a stem cell transplant that was plagued by complications for relapsed, aggressive lymphoma. He was unable to eat much by mouth, so he relied on IV nutrition, night after night, to survive at home.

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Over the years of Brads medical ordeal, I have administered IV antibiotics, flushed and sterilized port lines, checked blood sugar, given shots of Neulasta (a booster shot for immunity after chemotherapy), and much more. My shock and anger at suddenly being expected to be a bedside nurse faded, and handling needles and central lines became routine.

Brad no longer needs this level of care, but his immune system is still suppressed and he is chronically ill. Were now mired in the long wait for Covid-19 vaccines which, in my state, California, could take several confusing, frustrating months.

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The Covid-19 vaccines are miracles of fast-moving science, but Covid-19 vaccination has so far been a slow grind. With daily deaths in the U.S. continuing to number in the thousands and the country barreling toward the devastating figure of half a million deaths, we need all hands on deck to turn vaccines into vaccinations.

The gigantic systems that must figure out how to get shots into arms U.S. health care and the federal government are better known for ponderous bureaucracy than nimble pivots and stopgap solutions. As Ive watched the delays, Ive thought often of the times I was deputized to give my husband care during the medical ordeal that left him chronically ill.

I could give him the shot, I keep thinking.

Every day, family caregivers like me, with no medical experience, volunteer or are voluntold to provide care that a generation or two ago would have been administered only by a nurse. According to a 2020 AARP survey, there are more than 50 million family caregivers in the U.S. We represent a resource that, if deployed, could help get vaccines into arms, the well-known last mile problem.

In some ways, caregivers have been sidelined during the pandemic. Because of justified concerns about infection, hospitals have had to ban family caregivers from hospital visits. When we went on lockdown, I worried about my husbands immune suppression, but briefly consoled myself with the idea that if he did get sick, I would know how to advocate and care for him, given my prior experience. Then I soon realized I wouldnt even get in the door.

Of course, the slow pace of vaccination has many causes: dose shortages, the negligence of the Trump administration, the ethical questions surrounding who to prioritize, and personnel shortages.

What if the valuable experience of each and every caregiver could be applied to the most critical effort of this moment, vaccination?

Caregivers, many of us already trained in basic at-home care and used to cutting through health-care bureaucracy, could pitch in to speed up vaccinations. Deputizing caregivers to give shots at home could ease the enormous, yearlong strain on the medical and public health systems while also providing a safer, more accessible vaccination method for vulnerable seniors, those with limited mobility, and immune-compromised people like my husband, who shouldnt be waiting for hours in mass clinics.

The Biden administrations strategic plan to combat the pandemic promises federal leadership and faster action on vaccination nationwide, bringing much-needed hope in a dark time. Reports indicate the administration will deploy the National Guard and the Federal Emergency Management Agency to aid the effort.

I hope it will also explore tapping ordinary citizens. In addition to finding ways to use caregivers, we should consider mass volunteer efforts for both direct care and support. The United Kingdom, for instance, started a volunteer corps in which not only retired doctors but also teachers and other laypeople are giving shots. In Connecticut and Alberta, veterinarians have been deputized. Its time to extend such efforts more broadly.

Vaccination campaigns in regions beset by childhood diseases have long relied heavily on volunteers for last-mile delivery. My sister-in-law recently told me that, at age 17, she went on a volunteer summer program to vaccinate kids in Ecuador. She and her fellow teens practiced, first on oranges and then on each other, with syringes filled with saline. Im not proposing we send out needle-wielding minors, even in a crisis as deep as the present one, but the moment cries out for innovative solutions.

Both the individual family care I am expected to provide for my husband and the broad tragedies of the pandemic reflect the profound strains on American health care. But shifting higher-level care tasks to family caregivers, hard though it is on individuals, represents innovation a workaround to save lives despite systemic challenges and has given millions of Americans experience that could help meet the moment.

With the availability of Covid-19 vaccines, the end of the pandemic is tantalizingly close. Lets use every resource we have to get there, including an often-overlooked one: caregivers.

Kate Washington, a journalist based in Sacramento, Calif., is the author of Already Toast: Caregiving and Burnout in America (Beacon Press, March 2021).

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Mobilize family caregivers to speed the rollout of Covid-19 vaccines - STAT

People living with cancerincluding those undergoing treatmentshould receive COVID-19 vaccines as soon as they are available, according to new guidelines from the National Comprehensive Cancer Network (NCCN).

While people with some types of cancer and those receiving certain cancer treatments may not respond quite as well, the vaccines should still provide partial protection, which is especially important because some cancer patients are at higher risk for COVID-19 complications.

Right now, there is urgent need and limited data, said committee co-leader Steve Pergam, MD, MPH,of the Seattle Cancer Care Alliance and the Fred Hutchinson Cancer Research Center, headquarters of the National Institutes of Healths COVID-19 Prevention Network. Our number one goal is helping to get the vaccine to as many people as we can. That means following existing national and regional directions for prioritizing people who are more likely to face death or severe illness from COVID-19. The evidence we have shows that people receiving active cancer treatment are at greater risk for worse outcomes from COVID-19, particularly if they are older and have additional comorbidities, like immunosuppression.

Much remains to be learned about COVID-19 in people with cancer. Studies have shown that people with blood cancers like leukemia or lymphoma and lung cancer are at greater risk for severe COVID-19 and death, but those with other types, such as breast or lung cancer, do not appear to be at higher risk. Patients with active or advanced cancer are likely to fare worse. Although studies of the effects of cancer treatment on COVID-19 outcomes have yielded conflicting results, therapies that cause immune suppression seem to lead to poorer outcomes.

Two mRNA vaccines from Pfizer/BioNTech and Moderna were authorized by the Food and Drug Administration in December. These vaccines were 95% and 94% effective for preventing symptomatic COVID-19 in Phase III clinical trials. Vaccine candidates from AstraZeneca, Johnson and Johnson and Novavax are also effective, especially for preventing severe disease, and are likely to receive emergency use authorization in the coming months. All the vaccines were shown to be safe.

A Centers for Disease Control and Prevention (CDC) advisory committee developed a vaccine prioritization plan that puthealth care workers and residents of long-term care facilitiesfirst in line, followed bypeople overage 75 and certain frontline essential workers. The CDC later expanded eligibility to include everyone over 65 and people with underlying health conditionsincluding cancerthat put them at risk for more severe COVID-19. But current supplies are nowhere near adequate to vaccinate everyone whos eligible.

The NCCNs COVID-19 Vaccine Committee, which includes top hematology and oncology experts in the areas of infectious diseases, vaccine development and delivery, medical ethics and health information technology, recommends that all people with cancer should get a vaccine. The committee also advises that caregivers and people living in the same household with cancer patients should also get vaccinated when they are eligible.

While clinical trials have shown that the vaccines are highly effective at reducing the risk of becoming ill with COVID-19, it is still not clear how well they prevent asymptomatic infection and transmission, so the committee emphasizes the importance of continuing to follow precautions such as wearing masks and social distancing.

Although people on cancer treatment were excluded from the COVID-19 vaccine trials, experts say theres no reason to think the vaccines wont be safe for this group. The currently authorized vaccines do not contain live virus and therefore cannot cause disease, even in immunocompromised people.

The data we have on these vaccines shows theyre remarkably safe in the general population based on the trials. Admittedly, very few patients with active cancer or in active therapy were included in the trials. But having gone through all the documentation for both of these vaccines, it looks remarkably safe, Gary Lyman, MD, of Fred Hutch, who helped start the COVID-19 and Cancer Consortium, told the Fred Hutch News Service. I have no real concerns that there will be big surprises when it comes to safety for the cancer patient population. The risk to these patients from COVID is high and the risks from the vaccines appear very low.

While the vaccines appear safe for people with cancer, some patients may not respond as well, particularly those whose cancer or treatment causes immune suppression. Some blood cancers affect B cells, the white blood cells that produce antibodiesa key player in vaccine response. Chemotherapy and radiation can deplete white blood cells, and people undergoing stem cell transplants or receiving CAR-T therapy have their own immune cells killed off with chemo or radiation to make room for the new cells.

The NCCN committee recommends that people receiving intensive chemotherapy for leukemia should wait to be vaccinated until their white blood cell count recovers. Stem cell transplant and CAR-T recipients should delay vaccination until three months after the procedure to improved the chances that the vaccine will produce a good immune response. People undergoing major surgery should wait at least a few days. But everyone elseincluding patients receiving chemotherapy for solid tumors, targeted therapy, immunotherapy or radiation therapyshould get a vaccine as soon as they can.

If it is necessary to prioritize among people with cancer, the committee recommends moving those on active treatment (except those taking only hormone therapy), those who plan to start treatment soon and those who have recently finished treatment to the front of the line. Cancer patients with other risk factors, including older age and additional health conditions, should also be prioritized.

Finally, the guidance acknowledges the disparities and social inequities related to COVID-19Black and Latino people are more likely to be exposed to the coronavirus and more likely to develop severe disease and die from it, but are less likely to get vaccinated.

One of our primary goals is reducing morbidity and mortality, saidSirisha Narayana, MD,chair of the University of California at San Francisco Ethics Committee. We also have to take social determinants of health into account and make special efforts for people in high-risk communities.

The medical community is rising to one of the biggest challenges we have ever faced, addedNCCN CEO Robert Carlson, MD. The COVID-19 vaccines exemplify the heights of scientific achievement. Now we have to distribute them quickly, equitably, safely and efficiently, using clearly defined and transparent principles.

Given their higher risk for COVID-19, the NCCN, the American Society of Clinical Oncology and other advocates are asking that people with cancer be given priority for vaccination.

People with metastatic and active cancers die at a rate similar to people over age 75; if we die at the rate of 75 year olds we should be vaccinated with the 75 year olds, Kelly Shanahan, an advocate living with metastatic breast cancer, told Cancer Health. Those of us with active and metastatic cancers dont have the luxury of just staying home. We must get our treatments and scans and see our oncologists. Keep us out of the hospitalsand morguesby prioritizing us for the COVID19 vaccinations!

Click here to read the full NCCN COVID-19 vaccine guidance.

Click here for more news about COVID-19.For more, visit our sister site, COVID Health.com.

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People With Cancer Should Receive COVID-19 Vaccine, Experts Say - Cancer Health Treatment News

DGAP-News: Evotec SE / Key word(s): Miscellaneous04.02.2021 / 07:30 The issuer is solely responsible for the content of this announcement.

Hamburg, Germany, 04 February, 2021:Evotec SE (Frankfurt Stock Exchange: EVT, MDAX/TecDAX, ISIN: DE0005664809) today announced that the Company has entered into a multi-year partnership with the Medical Center Hamburg-Eppendorf ("UKE") for the development of a highly innovative first-in-class cell therapy approach for the treatment of heart failure.

Under the terms of the partnership, Evotec and UKE will leverage their complementary strengths for the development of a new cell therapy approach using Engineered Heart Tissue for the treatment of heart failure. Heart failure is frequently associated with ischemic heart disease and often comes with a poor prognosis. Mortality is comparable to that of the most common cancers, with <50% 4-year survival. Treatment of patients suffering from heart failure is expected to deliver significant patient benefit through improved heart function, ultimately leading to an improved prognosis.

Evotec leverages its industry-leading human induced pluripotent stem cells ("hiPSCs") platform to establish GMP-compatible process development and upscaling for large-scale generation of clinical-grade heart muscle cells known as cardiomyocytes. Evotec will also contribute genetically modified GMP iPSC lines, which contain alterations preventing rejection of the cardiomyocyte-containing product by patient immune systems ("cloaking"), and include additional safety mechanisms to control unwanted proliferation of graft cells. By using these GMP-grade iPSC lines, the project will deliver off-the-shelf products, which can be implanted in broad patient populations with little to no immunosuppression. UKE applies its proprietary Giga Patch Method for the generation of fully functional heart tissue suitable for cardiac transplantation. Further in vivo validation and development activities will be shared jointly between the partners. Evotec will be responsible for GMP and pre-clinical activities as well as for any subsequent partnering of the programme.

Dr Cord Dohrmann, Chief Scientific Officer of Evotec, commented: "We are very excited about this collaboration with the UKE. Both Evotec and UKE have developed and refined their respective technology platforms over a number of years and have now decided to jointly drive this cardiac cell therapy programme towards clinical development. We are confident that this partnership will deliver a new therapeutic option for patients who suffer from heart failure."

Prof. Dr Thomas Eschenhagen, Director of the Institute of Experimental Pharmacology and Toxicology at UKE, added: "We are excited about the new opportunities the partnership with Evotec will create. After having worked on means to repair injured heart by 3-dimensional heart muscle patches for over two decades, joining forces with Evotec and its industrialized hiPSC platform and new cell lines, will bring this development to a new stage. We are aiming at the most efficient and safest therapy in the field."

"We are very happy to see a scientific success story advance to a feat of technology transfer. Translation of scientific insights into therapeutic options is a key mission of our University Medical Center", says Prof. Dr Blanche Schwappach-Pignataro, the Dean of Faculty of Medicine of the UKE.

No financial terms of the agreement were disclosed.

About heart failureHeart failure is a severe global health burden with more than 26 million people suffering with the condition worldwide, disproportionately affecting elderly people. While there are options to treat heart failure both medicinally and with devices, there is currently no treatment that targets the cause of the disease or significantly slows down its progression.

About Evotec and iPSCInduced pluripotent stem cells (also known as iPS cells or iPSCs) are a type of pluripotent stem cell that can be generated directly from adult cells. Pluripotent stem cells hold great promise in the field of regenerative medicine. Because they can propagate indefinitely, as well as give rise to every other cell type in the body (such as neurons, heart, pancreatic and liver cells), they represent a single source of cells that could be used to replace those lost to damage or disease.

Evotec has built an industrialised iPSC infrastructure that represents one of the largest and most sophisticated iPSC platforms in the industry. Evotec's iPSC platform has been developed over the last years with the goal to industrialise iPSC-based drug screening in terms of throughput, reproducibility and robustness to reach the highest industrial standards, and to use iPSC-based cells in cell therapy approaches via the Company's proprietary EVOcells platform.

ABOUT THE MEDICAL CENTER HAMBURG-EPPENDORF (UKE)Since its foundation in 1889, the Medical Center Hamburg-Eppendorf (UKE) has been one of the leading clinics in Europe. With about 13,600 employees, the UKE is one of the largest employers in Hamburg. Each year, the UKE treats around 511,000 patients, 106,000 of whom are inpatients and 405,000 outpatients. The emphasis in UKE's research are the neurosciences, cardiovascular research, care research, oncology, as well as infections and inflammations. Other potential areas of the UKE are molecular imaging and skeletal biology research. The UKE trains about 3,400 medical specialists and dentists.Knowledge, Research, Healing through Shared Competence: The UKE | http://www.uke.de

ABOUT EVOTEC SEEvotec is a drug discovery alliance and development partnership company focused on rapidly progressing innovative product approaches with leading pharmaceutical and biotechnology companies, academics, patient advocacy groups and venture capitalists. We operate worldwide and our more than 3,500 employees provide the highest quality stand-alone and integrated drug discovery and development solutions. We cover all activities from target-to-clinic to meet the industry's need for innovation and efficiency in drug discovery and development (EVT Execute). The Company has established a unique position by assembling top-class scientific experts and integrating state-of-the-art technologies as well as substantial experience and expertise in key therapeutic areas including neuronal diseases, diabetes and complications of diabetes, pain and inflammation, oncology, infectious diseases, respiratory diseases, fibrosis, rare diseases and women's health. On this basis, Evotec has built a broad and deep pipeline of more than 100 co-owned product opportunities at clinical, pre-clinical and discovery stages (EVT Innovate). Evotec has established multiple long-term alliances with partners including Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CHDI, Novartis, Novo Nordisk, Pfizer, Sanofi, Takeda, UCB and others. For additional information please go to http://www.evotec.com and follow us on Twitter @Evotec.

FORWARD-LOOKING STATEMENTSInformation set forth in this press release contains forward-looking statements, which involve a number of risks and uncertainties. The forward-looking statements contained herein represent the judgement of Evotec as of the date of this press release. Such forward-looking statements are neither promises nor guarantees, but are subject to a variety of risks and uncertainties, many of which are beyond our control, and which could cause actual results to differ materially from those contemplated in these forward-looking statements. We expressly disclaim any obligation or undertaking to release publicly any updates or revisions to any such statements to reflect any change in our expectations or any change in events, conditions or circumstances on which any such statement is based.

Media Contact Evotec SE:Gabriele Hansen, SVP Head of Global Corporate Communications & Marketing, Phone: +49.(0)40.56081-255, gabriele.hansen@evotec.com

IR Contact Evotec SE:Volker Braun, SVP Head of Global Investor Relations & ESG, Phone: +49.(0)40.56081-775, volker.braun@evotec.com

04.02.2021 Dissemination of a Corporate News, transmitted by DGAP - a service of EQS Group AG.The issuer is solely responsible for the content of this announcement.

The DGAP Distribution Services include Regulatory Announcements, Financial/Corporate News and Press Releases. Archive at http://www.dgap.de

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Evotec and Medical Center Hamburg-Eppendorf Enter Partnership to Develop iPSC-Based Tissue Therapy f - PharmiWeb.com

29 Jan 2021

Part 2 of a two-part series. Click here for Part 1.It turns out a persons risk associated with ApoE4 goes beyond Alzheimers and vascular disease. This apolipoprotein allele can also worsen infections caused by certain viruses. One of those appears to be SARS-CoV-2, the cause of COVID-19, according to two epidemiological studies. In the January 11 Gerontology, researchers led by Miguel Calero, Queen Sofia Foundation Alzheimer Research Center, Madrid, Spain, reported that aged ApoE4 carriers are more likely to show COVID-19 symptoms than ApoE3 carriers. This supports a paper in the September 16, 2020, Journals of Gerontology. Researchers led by David Melzer, University of Exeter, England, U.K., reported that older ApoE4 carriers are more likely to test positive for the virus and more likely to die from COVID-19 than are ApoE3s carriers. Why might this be?

In the January 4 Cell Stem Cell, researchers led by Yanhong Shi, Beckman Research Institute, Duarte, California, and Vaithilingaraja Arumugaswami, University of California, Los Angeles, reported that the new coronavirus infected more ApoE4 neurons and astrocytes than their ApoE3 counterparts in cell culture. Astrocytes stoked the fire, upping the number of infected cells in co-cultures and in astrocyte-containing brain organoids. Infected neurons degenerated, while astrocytes swelled and their nuclei broke apart. Though this may not explain why ApoE4 carriers are at higher risk of COVID-19, it suggests that they may be more prone to long-term neurological symptoms of the disease (see Part 1 of this series).

To probe how various factors, including ApoE genotype, affect the severity of a persons COVID-19, Calero and colleagues phoned people ages 75-94 who, as part of in the Vallecas Project in Madrid, had been genotyped for ApoE. From 20112013, this observational cohort study tracked markers that might predict future dementia (Olarzaran et al., 2015).In April 2020, first author Teodoro del Ser Claero asked Vallecas participants if they had any COVID-19 symptoms, and learned that ApoE4 carriers were 2.4 times as likely to reply in the affirmative, and to have had a COVID-19 diagnosis.

This aligns with Melzer and colleagues data. They sifted through the U.K. Biobank database, which now includes COVID-19 infection data. First author Chia-Ling Kuo stratified participants based on APOE genotype. ApoE4/4 carriers were 2.2 times as likely to have tested positive or have had severe disease, and 4.3 times as likely to have died from COVID-19 than were ApoE3/3s. These differences remained even after the researchers corrected for comorbidities known to worsen COVID-19, such as dementia, hypertension, and Type 2 diabetes.

Even so, Caleb Finch, University of Southern California, Los Angeles, and Alexander Kulminski, Duke University, Durham, North Carolina, think the comorbidities may explain the association. ApoE cluster haplotypes associate with the same morbidities from cardiovascular disease and obesity that increase vulnerability to COVID-19, they note in a review in the same journal. The ApoE locus was first recognized as a genetic determinant of cardiovascular disease in the 1980s, through its effect on blood lipid and cholesterol levels (Sing et al., 1985). Some research even indicated ApoE4 protected people from lipophilic pathogens (Martin, 1999). But at least for COVID, the latest data suggest the opposite. The ApoE trail, like a Moebius strip, takes us back to where we started from, four decades ago, with another view, wrote Finch and Kulminski. To understand how ApoE4 may increase COVID-19 infectivity and mortality, we have returned to the original associations of ApoE variants with blood lipids, vascular disease, and cognition.

Zooming in to the cellular level may provide insight on how ApoE4 renders cells more susceptible to viruses. For example, HIV more easily penetrates human cells if they are ApoE4/4 (Burt et al., 2008). In mice, herpes simplex virus (HSV) exploits the lipoprotein to enter brain cells, leading to a higher viral burden in ApoE4 than ApoE3 transgenic mice (Burgos et al., 2006). What about SARS-CoV-2?

ApoE4 Worsens SARS-CoV-2 Damage. The virus infected neurons and astrocytes in cell culture and brain organoids. ApoE4 cells fared worse, remdesivir protected them. [Courtesy of Wang et al., Cell Stem Cell, 2021.]

Shi wondered if ApoE4 could explain the neurological effects of SARS-CoV-2 in some people. To begin with, co-first authors Cheng Wang, Mingzi Zhang, and colleagues confirmed the virus penchant for certain brain cells (see Part 1 of this series). They differentiated human induced pluripotent stem cells (hiPSCs) into neuronal progenitors (NPCs), neurons, astrocytes, oligodendrocyte progenitor, or brain endothelial cells, then infected them with SARS-CoV-2. Immunostaining detected the viral spike protein in less than 5 percent of NPCs, neurons, and astrocytes, which Shi called a low-grade infection. The virus also infected 60-day-old brain organoids comprising NPCs and neurons.

Astrocytes are known to spread neurotropic viruses in the CNS, including Japanese encephalitis, West Nile, and Zika viruses (Soung et al., 2018; Potokar et al., 2019). Could astrocytes stoke the COVID fire in neurons and organoids? Indeed, more neurons tested positive for SARS-CoV-2 spike protein in neuron-astrocyte co-cultures than in monoculture. The scientists also saw higher viral RNA loads in neurons from organoids that had incorporated astrocytes than in those that did not.

Wang, Zhang, and colleagues then homed in on APOE genotype. They used CRISPR/Cas9 to create isogenic cell lines from iPSCs taken from ApoE3/3 and ApoE4/4 donors. They differentiated the cells into neurons and co-cultured them with ApoE3 astrocytes for three weeks. Then they added SARS-CoV-2, using one viral particle per cell. Immunostaining revealed spike protein in all neurons within 24 hours. After 72 hours, the viral protein content in all neurons had grown, but E4 neurons had 1.5 times more than E3 neurons (see image below).

Viral Invasion. After SARS-Cov-2 infects neurons (purple, left panels), its spike protein (green) popped up within 24 hours (middle) and accumulated over 72 hours (right panel). Infected ApoE4 neurons (bottom) had more viral protein than isogenic ApoE3 lines (top). [Courtesy of Wang et al., Cell Stem Cell, 2021.]

At that point, infected cells formed fewer neurites than did uninfected cells, and the neurites were short. Infected ApoE4 cells had even fewer neurites than ApoE3 cells, and they were shorter still. Staining with Syn 1 revealed fewer synapses in both infected neurons.

What about astrocytes? More iPSC-derived ApoE4/4 astrocytes were infected than iPSC-derived ApoE3/3 cells. The former had fatter somas, longer processes, and nuclei that were more fragmented compared to infected ApoE3 cells (see image below). Taken together, these findings hint at an ApoE-dependent reaction to viral infection, with ApoE4 neurons and astrocytes more severely damaged.

Angrier Astrocytes. SARS-CoV-2-infected (red) E4 astrocyte soma (right four panels) had fragmented nuclei (blue) and grew fatter (green) than E3 astrocyte soma (left four panels) whose nuclei remained intact. [Courtesy of Wang et al., Cell Stem Cell, 2021.]

Why were E4 astrocytes worse off than the E3 cells? Jessica Young, University of Washington, Seattle, thinks it may have to do with endosomes. Of 40 genes previously identified as crucial for SARS-CoV-2 infection, two, the endosomal entry receptor ACTR2 and the ATP6AP2 ATPase, are involved in endosome function (Daniloski et al., 2021). Both are more highly expressed in ApoE4 astrocytes, which have larger early endosomes than do E3 cells (Oct 2020 news). Proteins involved in endosomal entry and transport are more abundant in APOE4 cells, which may facilitate the cellular infectivity of the virus, Young told Alzforum (full comment below). G. William Rebeck, Georgetown University, Washington, D.C., agreed the endosome might be involved. The speculation that these ApoE effects may be due to differentially expressed genes related to endosomal trafficking builds on a model that has been developed across several labs over the past two decades. (Full comment below.)

The FDA-approved drug remdesivir quelled SARS-CoV-2 infection in cultured neurons and astrocytes. When Wang, Zhang, and colleagues pretreated cells with 10 M remdesivir two hours before adding the virus, fewer neurons and astrocytes became infected. The drug also bumped up the number and length of neurites and reduced the number of fragmented nuclei in infected astrocytes compared to vehicle treatment.

Whether this remdesivir is relevant in the clinic remain to be seen. Remdesivir is thought to poorly enter the brain, Rik van der Kant, Vrije Universiteit Amsterdam, and Diederik van de Beek, Amsterdam UMC, wrote in a joint comment (below). David Clifford, Washington University, St. Louis, cautioned against overinterpreting these results based on what he hears from fellow clinicians who are treating COVID-19 patients. Clinically, remdesivir appears minimally effective and is increasingly considered unimportant in COVID-19 patient care, he wrote. Treating the CNS is always more challenging than treating peripheral infections.Chelsea Weidman Burke

Originally posted here:
APOE Tied to Increased Susceptibility to SARS-CoV-2 | ALZFORUM - Alzforum