StemCell Therapy

SAN DIEGO--(BUSINESS WIRE)--Ligand Pharmaceuticals Incorporated (NASDAQ: LGND) announces that recent new contracting with partners and investments in manufacturing capacity have contributed to its Captisol business operating at the highest levels in the history of the technology and position Captisol for major growth. Significant new clinical and regulatory developments with Evomela and Kyprolis, among other drugs, are reinforcing the role the proprietary technology serves in enabling important medicines. During 2020, Ligand has facilitated the successful installation of equipment to allow production at significantly higher levels to support anticipated demand. In addition to manufacturing at partner Hoviones facilities in Ireland and Portugal, Ligand has now added final step processing capacity for Captisol in both the United States and England. Ligand also introduces guidance for 2021 Captisol material sales of approximately $200 million.

The global medical need for Captisol-enabled drugs has never been higher, said John Higgins, Chief Executive Officer of Ligand. Our recently expanded operating team has successfully positioned our Captisol technology for the substantial growth we now expect in 2021 and beyond. There is significant ongoing investment by our partners for over 30 Captisol-enabled medicines in clinical development. We have entered into more contracts this year than any other year and are proud to be working closely with Gilead under our recently extended 10-year supply contract. We continue to be pleased with the momentum relating to Captisol, as it is a critical component in multiple life-saving medicines.

Recent Captisol technology business highlights include the following:

Ligands forecast for 2021 Captisol material sales of approximately $200 million is based on information it has on anticipated demand from its major partners given growth in existing and new markets, clinical requirements for Captisol-enabled development programs and binding orders from certain commercial or pre-commercial partners. The 2021 Captisol outlook compares with the Companys guidance for 2020 Captisol material sales of approximately $90 million.

About Captisol

Captisol is a patent-protected, chemically modified cyclodextrin with a structure designed to optimize the solubility and stability of drugs. Captisol was invented and initially developed by scientists in the laboratories of Dr. Valentino Stella, University Distinguished Professor at the University of Kansas Higuchi Biosciences Center for specific use in drug development and formulation. This unique technology has enabled several FDA-approved products, including Gileads VEKLURY, Amgens KYPROLIS, Baxter Internationals NEXTERONE, Acrotech Biopharma L.L.C.s and CASI Pharmaceuticals EVOMELA, Melinta Therapeutics BAXDELA and Sage Therapeutics ZULRESSO. There are many Captisol-enabled products currently in various stages of development. Ligand maintains a broad global patent portfolio for Captisol with more than 400 issued patents worldwide relating to the technology (including 37 in the U.S.) and with the latest expiration date in 2033. Other patent applications covering methods of making Captisol, if issued, extend to 2040.

About Ligand Pharmaceuticals

Ligand is a revenue-generating biopharmaceutical company focused on developing or acquiring technologies that help pharmaceutical companies discover and develop medicines. Our business model creates value for stockholders by providing a diversified portfolio of biotech and pharmaceutical product revenue streams that are supported by an efficient and low corporate cost structure. Our goal is to offer investors an opportunity to participate in the promise of the biotech industry in a profitable, diversified and lower-risk business than a typical biotech company. Our business model is based on doing what we do best: drug discovery, early-stage drug development, product reformulation and partnering. We partner with other pharmaceutical companies to leverage what they do best (late-stage development, regulatory management and commercialization) to ultimately generate our revenue. Ligands OmniAb technology platform is a patent-protected transgenic animal platform used in the discovery of fully human mono- and bispecific therapeutic antibodies. The Captisol platform technology is a patent-protected, chemically modified cyclodextrin with a structure designed to optimize the solubility and stability of drugs. The Vernalis Design Platform (VDP) integrates protein structure determination and engineering, fragment screening and molecular modeling, with medicinal chemistry, to help enable success in novel drug discovery programs against highly challenging targets. Ab Initio technology and services for the design and preparation of customized antigens enable the successful discovery of therapeutic antibodies against difficult-to-access cellular targets. Icagen has established deep biological expertise focused on ion channels and transporters and has a strong track record in ion channel drug discovery from screening to lead optimization. Ligand has established multiple alliances, licenses and other business relationships with the worlds leading pharmaceutical companies including Amgen, Merck, Pfizer, Sanofi, Janssen, Takeda, Servier, Gilead Sciences and Baxter International. For more information, please visit http://www.ligand.com.

Follow Ligand on Twitter @Ligand_LGND.

Forward-Looking Statements

This news release contains forward-looking statements by Ligand that involve risks and uncertainties and reflect Ligand's judgment as of the date of this release. Words such as plans, believes, expects, anticipates, and will, and similar expressions, are intended to identify forward-looking statements. These forward-looking statements include, without limitation, statements regarding: Ligands expectation that Captisol demand will increase significantly in 2021 and beyond (particularly for sales to Gilead and to partners in Gileads consortium) and Ligands ability to supply Captisol to Gilead and other partners, including Ligands ability to increase supply capacity; the timing of initiation, enrollment and expected results with respect to the planned clinical trial of CE-Iohexol; and guidance regarding Ligands 2020 and 2021 Captisol material sales. Actual events or results may differ from Ligand's expectations due to risks and uncertainties inherent in Ligands business, including, without limitation: Ligand may not receive expected revenue from Captisol sales; the COVID-19 pandemic has disrupted Ligands and its partners business, including delaying manufacturing, preclinical studies and clinical trials and product sales, and impairing global economic activity, all of which could materially and adversely impact Ligands results of operations and financial condition; Ligand may not achieve its Captisol material sales guidance for 2020 and/or 2021; remdesivir may be later shown to not be effective or safe for the treatment of COVID-19 and/or the FDA (and/or equivalent agencies in other countries) may revise or revoke its emergency use authorization for remdesivir for the treatment of COVID-19 in patients hospitalized with moderate or severe disease if the FDA (and/or another such agency) determines that authorization no longer meets the statutory criteria for issuance; alternative COVID-19 therapies or vaccines may be approved or the risk of coronavirus infection could significantly diminish, any of which could materially and adversely affect the commercial opportunity for remdesivir; Gilead may terminate the supply agreement without cause upon 30 days prior written notice; Ligand may be unable to scale-up the supply of Captisol or at acceptable prices; Ligand is currently dependent on Hovione as a single source sole supplier for certain Captisol manufacturing functions and failures by such supplier may result in delays or inability to meet the Captisol demands of its partners; Amgen, Acrotech Biopharma or other Ligand partners may not execute on their sales and marketing plans for marketed products for which Ligand has an economic interest; Ligand or its Captisol partners may not be able to protect their intellectual property and patents covering certain products and technologies may be challenged or invalidated; Ligand's Captisol partners may terminate agreements or development or commercialization of products; Ligand may not generate expected revenues under its existing license agreements and may experience significant costs as the result of potential delays under its supply agreements; Ligand and its Captisol partners may experience delays in the commencement, enrollment, completion or analysis of clinical testing for product candidates, or significant issues regarding the adequacy of clinical trial designs or the execution of clinical trials, which could result in increased costs and delays, or limit the ability to obtain regulatory approval; unexpected adverse side effects or inadequate therapeutic efficacy of Ligand's or its Captisol partners product(s) could delay or prevent regulatory approval or commercialization; and ongoing or future litigation could expose Ligand to significant liabilities and have a material adverse effect on the company. The failure to meet expectations with respect to any of the foregoing matters may reduce Ligand's stock price. Additional information concerning these and other risk factors affecting Ligand can be found in prior press releases available at http://www.ligand.com as well as in Ligand's public periodic filings with the Securities and Exchange Commission available at http://www.sec.gov. Ligand disclaims any intent or obligation to update these forward-looking statements beyond the date of this release. This caution is made under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.

a Monahan, et al. Biology of Blood and Marrow Transplantation, September 2020

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Ligand Announces its Captisol Business is Positioned for Major Growth and Forecasts 2021 Captisol Material Sales of $200 Million - Business Wire

Editor's note: Life can be stressful, and many of us have a hard time administering self-care. The current world situation ripe with conflicts, shortages and a pandemic makes things even harder. Dr. Amit Sood, formerly of Mayo Clinic and now head of the Global Center for Resiliency and Wellbeing, is the author of books including "The Mayo Clinic Handbook for Happiness" and "SMART with Dr. Sood, and creator of the mobile app Zizo: Your Resilience Pal. Now, he is writing a weekly column answering readers' questions on these topics. See the tagline to learn how to send him your questions, and he will answer in future columns.

Dear friend,

Of the hundreds of ice-creams I have eaten so far, the only one I remember is the ice-cream I never ate.

That was in 1993. My wife Richa and I were sitting outside a shop in the sweltering New Delhi. We had just bought an ice cream to cool down. From the corner of my eye, I saw a little boy who could use a few calories. I walked up to him and offered my cone that he gladly took. I have savored the gleam I saw in his eyes at least a dozen times since then.

In a very interesting study, researchers looked at the genetic fingerprint of the two types of happiness hedonistic (self-centric) and eudaimonic (other-centric). People who were hedonistically happy had a higher inflammatory and lower anti-viral gene expression. It was just the opposite for the eudaimonic ones. With many illnesses caused by inflammation, you can see why this is so important for our health.

My take on this research is that our genes and the immune system know what is right for us and society. In the current times when a healthy immune system is extremely important for us, promoting kindness is imperative.

Kindness, research shows, pays three times over. Your kind words and actions enhance your health and wellbeing, help others, and the memory of kind actions by itself enhances your wellbeing. A very simple way to enhance your self-worth and happiness today is to count your previous kind actions.

I suggest take out a pen and paper and write the three most selfless things you have done in your life. If you feel up to it, share your experience with someone. Just counting previous acts of kindness can enhance your self-worth and bring happiness to others (you guessed it right witnessing or hearing about others kind actions also increases happiness).

In kindness,

Amit

Dr. Amit Sood answers your questions about stress, resilience, happiness, relationships, and related topics in his column. Email dearfriend@postbulletin.com.

Original post:
Our genes know kindness is the best medicine - Brainerd Dispatch

dnaPower Inc, a biotechnology company that offers DNA testing for health and wellness, announces their partnership with Inagene Diagnostics. Inagene Diagnostics is a DNA testing company that uses genetic information to predict response to medications commonly used to treat pain and mental health conditions. These two Canadian DNA testing companies have joined forces to crack the code on personalized healthcare, empowering people to take control of their health and live their best lives.

dnaPower is committed to helping people make better data-driven decisions about their day to day health using genetics. We are delighted to be partnering with Inagene, a strong female-led, Canadian DNA company to include their pharmacogenetic testing.In addition to providing tailored health solutions for your diet, exercise and lifestyle, we can now add the ability to identify the medications best suited for your body to keep you safe and get the best health outcome. Dr. Lois Nahirney, CEO, dnaPower Inc.

Through their partnership, dnaPower and Inagene offer a suite of tailored health solutions for anyone looking to maximize insights to optimize their health. Comprehensive DNA testing is available for preventative health and medical treatment optimization. Personalized insights include tailored diet, exercise, lifestyle recommendations, and medications to optimize ones treatment plan based on their genetic information. Together, these powerful genetic insights act as a biological roadmap to help individuals navigate their best health.

Advancements in technology have opened up a world of opportunities to personalized healthcare in ways never seen before. There is no one size fits all solution when it comes to health. Unique genes can respond differently to foods, types of exercise, and medications. Spending years through trial and error to find the best diet, exercise, and medication is a way of the past. Individuals can now enjoy the ability to take control of their health without the guesswork through genetic testing.

We are excited and proud to partner withdnaPower another leading-edge Canadian company! Our teams care deeply about helping clients and are passionate about bringing innovation and personalized medicine to consumers. Helping individuals and their healthcare providers determine which drug and dose will work best, with less trial and error, is just part of the equation; the opportunity to learn what diet and exercise regimen works best for you, further enhances the client experience. Nancy White, CEO, Inagene Diagnostics.

To celebrate their partnership, dnaPower and Inagene are offering a combined special on their DNA tests. The Ultimate Insights Package includes the suite of dnaPower and Inagene DNA tests at the incredible price of $648 (retail value $1495). See this special offer.

Together, dnaPower and Inagene are passionate about empowering individuals to control their health with genetic testing, sharing a unified principle that knowledge is power.

About Inagene Diagnostics

With over two decades of experience in genetic research and diagnostics, combined with over 30 years of commercial health experience, Inagene has witnessed and been a part of the growing technology that now makes personalized healthcare possible. Inagene believes patients are not simply seeking more information, but practical and individualized information they can use to help make the best decisions about their health. Inagene Personalized InsightsTM makes it easy for patients and health care practitioners to navigate to the safest and most effective treatment options for medications used for pain and mental health conditions, and steer clear of those that arent.

About dnaPower Inc

dnaPower was one of the first in the world to offer DNA health testing, launching in 2008. They saw enormous potential for new DNA technology to help support peoples health and wellness, particularly in diet and fitness. dnaPower was a pioneer in applying leading-edge gene research to develop targeted gene panels. Since then, they have been providing personalized testing and professional support to help people like you make better, data-driven decisions about your health. With years of experience, dnaPower provides clear results and specific recommendations to help you take proactive and positive action for your unique body.

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Cracking the code to live your best life: Canadian DNA testing companies, dnaPower and Inagene, partner to unlock true personalized health through...

(UroToday.com) Since 2015, multiple studies together have suggested that approximately a quarter of metastatic castration-resistant prostate cancer (mCRPC) tumors have mutations in DNA damage repair (DDR) genes. These alterations, especially those in genes for homologous recombination repair (HRR), are associated to varying degrees with response to PARP inhibitor therapy. Two PARP inhibitors are now approved for the care of patients with mCRPC and mutations in certain HRR genes: olaparib (based on PROfound trial) and rucaparib (based on TRITON2 trial). Given the significance of alterations in HRR genes in mCRPC, genomic testing for HRR alterations has been included in mCRPC treatment guidelines with the purpose of guiding genetic counseling and therapy selection.

In this poster, Dr. Neal Shore and colleagues describe real-world patterns and predictors of tissue testing for alterations in HRR genes. They focused on the community cancer care setting. Data were collected from the Flatiron Health Electronic Health Record derived database that was collected between 2013 and March 2019, prior to the approval of PARP inhibitor therapy in mCRPC, and focused on testing for alterations in BRCA1, BRCA2, ATM, CDK12, FANCA, and PALB2). The Flatiron database contains information on patient demographics, prostate cancer characteristics, and treatment, as well as genetic testing results.

From the Flatiron database, 5,213 patients with mCRPC were identified, 91% of which were managed at community oncology care centers. Of these patients, 674 (12.9%) underwent testing for the specified HRR gene alterations. Patient characteristics are shown below.

The breakdown of the 674 patients by testing method and number of genes tested is shown below.

BRCA1 and BRCA2 were the most commonly tested genes. A substantial portion of patients underwent only blood/saliva testing (40.5%, capable of detecting germline or circulating tumor DNA) or tumor-tissue testing only (42.1%, capable of detecting germline or tumor tissue DNA alterations). Only 1.8% of patients undergoing blood/saliva testing were tested for all 6 HRR genes, and 69% of tumor-tissue testing covered all 6 genes. Amongst the 286 patients who had negative blood/saliva testing, only 12.6% underwent tumor-tissue profiling, and 5 of these patients (13.9%) had an HRR alteration found.

The most common testing platform utilized was Foundation Medicine, followed by Guardant. Testing rates and the inclusion of more genes increased with time.

The prevalence of HRR alterations found is shown below.

Treatment at an academic medical center or having received multiple prior lines of therapy was associated with a higher likelihood of having HRR mutational profiling. Older age and higher PSA value at diagnosis of mCRPC were significantly associated with a lower likelihood of HRR mutation profiling.

The poster concludes that rates of HRR mutational testing did not increase dramatically with changes to the NCCN guidelines recommending this testing in 2017. Increased awareness of recommendations for testing, especially with the approval of two therapeutic agents contingent upon the presence of HRR alterations, is critical for the care of patients with mCRPC.

Presented by: Neal Shore, MD FACS, Urologist, and Director of the Carolina Urologic Research Center, Myrtle Beach, South Carolina

Written by: Alok Tewari, MD, Ph.D., Medical Oncologist at the Dana-Farber Cancer Institute, at the 2020 European Society for Medical Oncology Virtual Congress (#ESMO20), September 19th-September 21st, 2020

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ESMO Virtual Congress 2020: Real-World Patterns of Genomic Testing in Patients with Metastatic Castration-R... - UroToday

BOSTON--(BUSINESS WIRE)--Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today announced that data from the companys portfolio of cystic fibrosis (CF) medicines will be presented at the 43rd European Cystic Fibrosis Digital Conference (ECFS) held September 24-25, 2020 and the 2020 North American Cystic Fibrosis Virtual Conference (NACFC) taking place October 7-23, 2020. An oral presentation at the ECFS Digital Conference will highlight, for the first time, interim results from the TRIKAFTA open-label extension study, which showed safety and efficacy consistent with the results of the Phase 3 pivotal studies in patients with CF ages 12 and older with F508del/Minimal Function (F/MF) or F508del/F508del (F/F) genotypes. Four additional scientific abstracts for ORKAMBI and TRIKAFTA were published in the Journal of Cystic Fibrosis as part of the ECFS conference. In addition, six scientific presentations will occur at NACFC regarding KALYDECO, ORKAMBI and TRIKAFTA, including new data from KALYDECO in infants ages 4 to less than 6 months old.

As we continue to reach additional people with CF with our medicines, gaining a better understanding of their long-term and real-world impact becomes even more important, said Carmen Bozic, M.D., Executive Vice President, Global Medicines Development and Medical Affairs, and Chief Medical Officer at Vertex. We are pleased to report the first longer-term data for TRIKAFTA which show the significant benefits seen early are maintained through one year of treatment.

Data highlighting interim results from the ongoing TRIKAFTA open-label extension (OLE) study to evaluate long-term safety and efficacy in people with CF ages 12 and older with F508del/Minimal Function (F/MF) or F508del/F508del (F/F) genotypes who completed pivotal studies will be presented at the ECFS Digital Conference. In the interim analysis, TRIKAFTA was generally well-tolerated, with no new safety concerns. The data show that the marked improvements observed in the prior pivotal studies across multiple efficacy endpoints, including, percent predicted forced expiratory volume in 1 second (ppFEV1), sweat chloride (SwCl), Cystic Fibrosis Questionnaire Revised (CFQ-R) respiratory domain score, and body mass index (BMI), were sustained with continued treatment with TRIKAFTA.

A full listing of Vertex scientific presentations at ECFS and NACFC are below:

Abstract Title

PresentationType

PresentingAuthor

Date/ Time

ELX/TEZ/IVA

A phase 3, open-label extension study of elexacaftor/tezacaftor/ivacaftor: interim analysis of safety and efficacy in people with cystic fibrosis and F508del/minimal function or F508del/F508del genotypes

ECFS Oral Presentation

Professor Griese

September 24, 2020

11:21-11:45 a.m. CET

Impact of elexacaftor/tezacaftor/ivacaftor triple combination therapy on health-related quality of life in people with cystic fibrosis heterozygous for F508del and a minimal function mutation: results from a phase 3 clinical study

ECFS published abstract: Journal of Cystic Fibrosis 19S2 (2020) S55S168, P221

NACFC Poster Presentation #447

Professor Fajac

Oct 7 Oct 23, 2020

Impact of elexacaftor/tezacaftor/ivacaftor triple combination therapy on health-related quality of life in people with cystic fibrosis homozygous for F508del: results from a phase 3 clinical study

ECFS published abstract: Journal of Cystic Fibrosis 19S2 (2020) S1S36, WS19.6

NACFC Poster Presentation #478

Professor Majoor

Oct 7 Oct 23, 2020

IVA

An observational study of ivacaftor in people with cystic fibrosis and selected non-G551D gating mutations: outcomes from the third interim analysis of the VOCAL study

NACFC Poster Presentation

#466

Professor Kors van der Ent

Oct 7 Oct 23, 2020

Ivacaftor in 4 to < 6-month-old infants with a gating mutation: results of a 2-part, single-arm, phase 3 study

NACFC Poster Presentation

#415

Dr. Rosenfeld

Oct 7 Oct 23, 2020

Real-world outcomes in children aged 2-5 with CF treated with ivacaftor

NACFC Poster Presentation

#141

Dr. Volkova

Oct 7 Oct 23, 2020

LUM/IVA

Long-term safety of lumacaftor/ivacaftor in persons with cystic fibrosis aged 2-5 years homozygous for the F508del-CFTR mutation (F/F)

ECFS Published abstract:

Journal of Cystic Fibrosis 19S2 (2020) S1S36, WS19.2

Disease progression in F508del homozygous (F/F) persons with cystic fibrosis treated with lumacaftor/ivacaftor (LUM/IVA): interim results of a long-term safety study using data from the US Cystic Fibrosis Foundation Patient Registry (CFFPR)

ECFS Published abstract:

Journal of Cystic Fibrosis 19S2 (2020) S1S36, WS13.1

NACFC Poster Presentation

#190

Dr. Bower

Oct 7 Oct 23, 2020

About Cystic Fibrosis

Cystic Fibrosis (CF) is a rare, life-shortening genetic disease affecting approximately 75,000 people worldwide. CF is a progressive, multi-system disease that affects the lungs, liver, GI tract, sinuses, sweat glands, pancreas and reproductive tract. CF is caused by a defective and/or missing CFTR protein resulting from certain mutations in the CFTR gene. Children must inherit two defective CFTR genes one from each parent to have CF. While there are many different types of CFTR mutations that can cause the disease, the vast majority of all people with CF have at least one F508del mutation. These mutations, which can be determined by a genetic test, or genotyping test, lead to CF by creating non-working and/or too few CFTR proteins at the cell surface. The defective function and/or absence of CFTR protein results in poor flow of salt and water into and out of the cells in a number of organs. In the lungs, this leads to the buildup of abnormally thick, sticky mucus that can cause chronic lung infections and progressive lung damage in many patients that eventually leads to death. The median age of death is in the early 30s.

INDICATION AND IMPORTANT SAFETY INFORMATION FOR KALYDECO (ivacaftor), TRIKAFTA (elexacaftor/tezacaftor/ivacaftor and ivacaftor), and ORKAMBI (lumacaftor/ivacaftor)

What is KALYDECO?KALYDECO is a prescription medicine used for the treatment of cystic fibrosis (CF) in patients age 6 months and older who have at least one mutation in their CF gene that is responsive to KALYDECO. Patients should talk to their doctor to learn if they have an indicated CF gene mutation. It is not known if KALYDECO is safe and effective in children under 6 months of age.

What is TRIKAFTA?TRIKAFTA is a prescription medicine used for the treatment of CF in patients aged 12 years and older who have at least one copy of the F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Patients should talk to their doctor to learn if they have an indicated CF gene mutation. It is not known if TRIKAFTA is safe and effective in children under 12 years of age.

What is ORKAMBI?ORKAMBI is a prescription medicine used for the treatment of CF in patients age 2 years and older who have two copies of the F508del mutation (F508del/F508del) in their CFTR gene. ORKAMBI should only be used in these patients. It is not known if ORKAMBI is safe and effective in patients under 2 years of age.

Patients should not take KALYDECO or TRIKAFTA if they take certain medicines or herbal supplements, such as: the antibiotics rifampin or rifabutin; seizure medicines such as phenobarbital, carbamazepine, or phenytoin; or St. Johns wort.

Patients should not take ORKAMBI if they take certain medicines or herbal supplements, such as: the antibiotics rifampin or rifabutin; the seizure medicines phenobarbital, carbamazepine, or phenytoin; the sedatives and anti-anxiety medicines triazolam or midazolam; the immunosuppressant medicines cyclosporine, everolimus, sirolimus, or tacrolimus; or St. Johns wort.

Before taking KALYDECO, TRIKAFTA, or ORKAMBI, patients should tell their doctor about all of their medical conditions, including if they: have or have had liver problems; have kidney problems; have had an organ transplant; are pregnant or plan to become pregnant because it is not known if KALYDECO, TRIKAFTA, or ORKAMBI will harm an unborn baby; or are breastfeeding or planning to breastfeed because it is not known if KALYDECO, TRIKAFTA, or ORKAMBI passes into breast milk. Before taking ORKAMBI, patients should tell their doctor if they are using birth control as hormonal contraceptives, including oral, injectable, transdermal, or implantable forms should not be used as a method of birth control when taking ORKAMBI.

KALYDECO, TRIKAFTA, or ORKAMBI may affect the way other medicines work, and other medicines may affect how KALYDECO, TRIKAFTA, or ORKAMBI work. Therefore, the dose of KALYDECO, TRIKAFTA, or ORKAMBI may need to be adjusted when taken with certain medications. Patients should especially tell their doctor if they take antifungal medications such as ketoconazole, itraconazole, posaconazole, voriconazole, or fluconazole; or antibiotics such as telithromycin, clarithromycin, or erythromycin.

KALYDECO or TRIKAFTA can cause dizziness in some people who take it. Patients should not drive a car, use machinery, or do anything that needs them to be alert until they know how KALYDECO or TRIKAFTA affects them.

When taking ORKAMBI, patients should tell their doctor if they stop taking ORKAMBI for more than 1 week as their doctor may need to change the dose of ORKAMBI or other medicines the patient is taking.

Patients should avoid food or drink containing grapefruit or Seville oranges while taking KALYDECO. Patients should avoid food or drink containing grapefruit while taking TRIKAFTA.

KALYDECO, TRIKAFTA, and ORKAMBI can cause serious side effects, such as:

High liver enzymes in the blood have been reported in patients receiving KALYDECO, TRIKAFTA, or ORKAMBI. The patient's doctor will do blood tests to check their liver before starting treatment with KALYDECO, TRIKAFTA, or ORKAMBI; every 3 months during the first year of treatment; and every year while on treatment. For patients who have had high liver enzymes in the past, the doctor may do blood tests to check the liver more often. Patients should call their doctor right away if they have any of the following symptoms of liver problems: pain or discomfort in the upper right stomach (abdominal) area; yellowing of their skin or the white part of their eyes; loss of appetite; nausea or vomiting; or dark, amber-colored urine.

Breathing problems such as shortness of breath or chest tightness in patients when starting ORKAMBI, especially in patients who have poor lung function. If a patient has poor lung function, their doctor may monitor them more closely when starting ORKAMBI.

An increase in blood pressure in some people receiving ORKAMBI. The patients doctor should monitor their blood pressure during treatment with ORKAMBI.

Abnormality of the eye lens (cataract) in some children and adolescents treated with KALYDECO, TRIKAFTA, or ORKAMBI. If the patient is a child or adolescent, their doctor should perform eye examinations before and during treatment with KALYDECO, TRIKAFTA, or ORKAMBI to look for cataracts.

The most common side effects of KALYDECO include headache; upper respiratory tract infection (common cold), which includes sore throat, nasal or sinus congestion, and runny nose; stomach (abdominal) pain; diarrhea; rash; nausea; and dizziness.

The most common side effects of TRIKAFTA include headache, diarrhea, upper respiratory tract infection (common cold) including stuffy and runny nose, stomach (abdominal) pain, inflamed sinuses, increase in liver enzymes, increase in a certain blood enzyme called creatine phosphokinase, rash, flu (influenza), and increase in blood bilirubin.

The most common side effects of ORKAMBI include breathing problems, such as shortness of breath and chest tightness; nausea; diarrhea; fatigue; increase in a certain blood enzyme called creatinine phosphokinase; rash; gas; common cold, including sore throat, stuffy or runny nose; flu or flu-like symptoms; and irregular, missed, or abnormal periods (menses) and increase in the amount of menstrual bleeding. Additional side effects seen in children include: cough with sputum, stuffy nose, headache, stomach pain, and increase in sputum.

These are not all the possible side effects of KALYDECO, TRIKAFTA, or ORKAMBI. Please click product link to see the full Prescribing Information for KALYDECO, TRIKAFTA, or ORKAMBI.

About Vertex

Vertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. The company has multiple approved medicines that treat the underlying cause of cystic fibrosis (CF) a rare, life-threatening genetic disease and has several ongoing clinical and research programs in CF. Beyond CF, Vertex has a robust pipeline of investigational small molecule medicines in other serious diseases where it has deep insight into causal human biology, including pain, alpha-1 antitrypsin deficiency, and APOL1-mediated kidney diseases. In addition, Vertex has a rapidly expanding pipeline of genetic and cell therapies for diseases such as sickle cell disease, beta thalassemia, Duchenne muscular dystrophy and type 1 diabetes mellitus.

Founded in 1989 in Cambridge, Mass., Vertex's global headquarters is now located in Boston's Innovation District and its international headquarters is in London, UK. Additionally, the company has research and development sites and commercial offices in North America, Europe, Australia and Latin America. Vertex is consistently recognized as one of the industry's top places to work, including 10 consecutive years on Science magazine's Top Employers list and top five on the 2019 Best Employers for Diversity list by Forbes. For company updates and to learn more about Vertex's history of innovation, visit http://www.vrtx.com or follow us on Facebook, Twitter, LinkedIn, YouTube and Instagram.

Special Note Regarding Forward-looking Statements

This press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, including, without limitation, statements made by Dr. Carmen Bozic in this press release, statements regarding the potential benefits, safety and efficacy of TRIKAFTA, KALYDECO and ORKAMBI, and our plans to present data at the ECFS and the NACFC, including data from our TRIKAFA open-label extension study, scientific abstracts for ORKAMBI and TRIKAFTA, and scientific presentations regarding KALYDECO, ORKAMBI and TRIKAFTA. While Vertex believes the forward-looking statements contained in this press release are accurate, these forward-looking statements represent the company's beliefs only as of the date of this press release and there are a number of risks and uncertainties that could cause actual events or results to differ materially from those expressed or implied by such forward-looking statements. Those risks and uncertainties include, among other things, that data from the company's development programs may not support registration, approval or further development of its compounds due to safety, efficacy or other reasons, risks related to approval and commercialization of our medicines, and other risks listed under Risk Factors in Vertex's most recent annual report and subsequent quarterly reports filed with the Securities and Exchange Commission and available through the company's website at http://www.vrtx.com. You should not place undue reliance on these statements, or the scientific data presented. Vertex disclaims any obligation to update the information contained in this press release as new information becomes available.

(VRTX-GEN)

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Vertex to Present New Data at European and North American Virtual Cystic Fibrosis Conferences Highlighting Long-Term Use of CFTR Modulators - Business...

MIAMI, Sept. 22, 2020 /PRNewswire/ -- The Victor Center for the Prevention of Jewish Genetic Diseases, which offers preconception screening and genetic counseling for prospective parents, has recently expanded services to offer genetic screening and virtual clinical consults to couples and individuals in New York, New Jersey and Maryland.

The center, which also serves Florida, Massachusetts and Pennsylvania, helps future parents identify whether they are at risk of passing on genetic diseases, including those common among people of Jewish ancestry.

"Not everyone knows their full ancestral heritage, so we encourage anyone planning to start a family and their partner to undergo screening," said Debbie Wasserman, Outreach Coordinator/Genetic Counselor for the Victor Center.

Jewish genetic diseases are a group of recessive, inherited disorders that occur with significant frequency in the Ashkenazi Jewish community (those of eastern or central European descent). Individuals of Ashkenazi descent have higher carrier rates for diseases such as Tay-Sachs, Canavan, familial dysautonomia, and Gaucher. Many of the diseases are severe, and some are fatal in childhood.

One in two of those of Ashkenazi descent is a carrier for at least one Jewish genetic condition, and Sephardic and Mizrachi Jews are also at increased risk for certain genetic disorders. More than half of participants in the Victor Center screening program are carriers for one or more of the 225 plus conditions on the expanded screening panel, which also includes disorders found in other ethnicities.

The Victor Center offers a convenient screening process during this time of social distancing. Upon request, a genetic counseling session is scheduled and a screening kit is mailed to the home. Recipients provide saliva samples and return the kit to a lab for processing. Once results are available, a video consult is coordinated to convey understanding and address questions.

There is a fee for Victor Center screening services. However, most medical insurance plans cover the service. For more information, please call 786-897-9587 or visit http://www.victorcenter.org

About the Victor Center The Victor Center was founded in 2002 by Lois B. Victor in partnership with Einstein Healthcare Network in Philadelphia. Ms. Victor lost two children to a Jewish genetic disease before a test for the disorder became available. The experience galvanized her commitment to ensuring that no family endures the heartache of a preventable illness by making certain that Jews of childbearing age are screened and get the information they need to have healthy children. Nicklaus Children's Hospital was appointed the National Office for the Victor Center in 2017. The Nicklaus Children's Hospital Victor Center maintains the nation-wide collaborative work of the center in promoting education related to preconception screening while increasing knowledge, awareness, and access to genetic services.

About Nicklaus Children's HospitalFounded in 1950 by Variety Clubs International, Nicklaus Children's Hospital is South Florida's only licensed specialty hospital exclusively for children, with nearly 800 attending physicians and more than 475 pediatric subspecialists. The 309-bed hospital, known as Miami Children's Hospital from 1983 through 2014, is renowned for excellence in all aspects of pediatric medicine with several specialty programs routinely ranked among the best in the nation by U.S. News & World Report since 2008. The hospital is also home to the largest pediatric teaching program in the southeastern United States and has been designated an American Nurses Credentialing Center (ANCC) Magnet facility, the nursing profession's most prestigious institutional honor. For more information, please visit http://www.nicklauschildrens.org.

For more information: Nicklaus Children's Hospital Rachel Bixby, 305-663-8476

SOURCE Nicklaus Childrens Health System

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Victor Center for the Prevention of Jewish Genetic Diseases Now Serving New York, New Jersey and Maryland - PRNewswire

NEW YORK, Sept. 23, 2020 /PRNewswire/ --The Muscular Dystrophy Association (MDA) announced today the awarding of 15 new MDA grants totaling more than$4 million toward research focused on a variety of neuromuscular diseases (NMDs), including Duchenne muscular dystrophy (DMD), Charcot-Marie-Tooth disease (CMT), Becker's muscular dystrophy (BMD), spinal muscular atrophy (SMA), amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1) and facioscapulohumeral muscular dystrophy (FSHD). This round of grant funding reinforces MDA's unwavering commitmentin the face of declining income due to the COVID-19 pandemicto the progress of neuromuscular disease research and builds on the more than$1 billionMDA has already invested in research to uncover new treatments and cures for NMDs since its inception. Some grants will go into effect this year, while others will be awarded in 2021.

"We continue to fund the most innovative research that will lead us to cures for a range of neuromuscular diseases," saysSharon Hesterlee, PhD, executive vice president and chief research officer for Muscular Dystrophy Association. "We have already seen our investment pay off with the first effective neuromuscular disease therapies, and these grantees are pushing the envelope even further in diseases once thought incurable."

Dr. Hesterlee added, "Although COVID led the cancellation of MDA's spring review session, we are pleased to announce the funding of these projects, which were reviewed in 2019."

The newly funded projects will aim to advance research discoveries and new therapy development in multiple areas. The awarded grants will fund studies to further advance our understanding of genetic causes of and risk factors for NMDs, investigate new approaches to developing gene therapies and other innovative potential treatments, including stopping disease progression and improving genetic testing technologies.

For a complete list of individual awards for this grant cycle, visit MDA's website and explore theGrants at a Glancesection. Highlights from thegrant awards for this grant cycleinclude:

ALS grants will be announced separately later this month, as will grants being given jointly by MDA and other organizations.

About the Muscular Dystrophy AssociationFor 70 years, the Muscular Dystrophy Association (MDA) has been committed to transforming the lives of people living with muscular dystrophy, ALS, and related neuromuscular diseases. We do this throughinnovations in scienceandinnovations in care. As the largest source of funding for neuromuscular disease research outside of the federal government, MDA has committed more than $1 billion since our inception to accelerate the discovery of therapies and cures.Research we have supportedis directly linked to life-changing therapies across multiple neuromuscular diseases.MDA's MOVRis the first and only data hub that aggregates clinical, genetic, and patient-reported data for multiple neuromuscular diseases to improve health outcomes and accelerate drug development. MDA supports thelargest network of multidisciplinary clinicsproviding best in class care at more than 150 of the nation's top medical institutions. OurResource Centerserves the community with one-on-one specialized support, and we offer educational conferences, events, and materials for families and healthcare providers. Each year thousands of children and young adults learn vital life skills and gain independence atsummer campand through recreational programs, at no cost to families.During the COVID-19 pandemic, MDA continues to produce virtual events and programming to support our community when in-person events and activities are not possible. MDA's COVID-19 guidelines and virtual events are posted atmda.org/COVID19. For more information, visitmda.org.

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Muscular Dystrophy Association Awards 15 Grants Totaling More Than $4 Million for Neuromuscular Disease Research - PRNewswire

ZUG, Switzerland and CAMBRIDGE, Mass. and BOSTON, Sept. 22, 2020 (GLOBE NEWSWIRE) -- CRISPR Therapeutics (Nasdaq: CRSP) and Vertex Pharmaceuticals Incorporated(Nasdaq: VRTX) today announced the European Medicines Agency (EMA) has granted Priority Medicines (PRIME) designation to CTX001, an investigational, autologous, ex vivo CRISPR/Cas9 gene-edited therapy for the treatment of severe sickle cell disease (SCD).

PRIME is a regulatory mechanism that provides early and proactive support to developers of promising medicines, to optimize development plans and speed up evaluations so these medicines can reach patients faster. The goal of PRIME is to help patients benefit as early as possible from innovative new therapies that have demonstrated the potential to significantly address an unmet medical need. PRIME designation was granted based on clinical data from CRISPR and Vertexs ongoing Phase 1/2 trial of CTX001 in patients with severe SCD.

About CTX001CTX001 is an investigational, autologous, ex vivo CRISPR/Cas9 gene-edited therapy that is being evaluated for patients suffering from transfusion-dependent beta thalassemia (TDT) or severe SCD, in which a patients hematopoietic stem cells are engineered to produce high levels of fetal hemoglobin (HbF; hemoglobin F) in red blood cells. HbF is a form of the oxygen-carrying hemoglobin that is naturally present at birth, which then switches to the adult form of hemoglobin. The elevation of HbF by CTX001 has the potential to alleviate transfusion requirements for TDT patients and reduce painful and debilitating sickle crises for SCD patients.

Based on progress in this program to date, CTX001 has been granted Regenerative Medicine Advanced Therapy (RMAT), Fast Track, and Orphan Drug designations from the U.S. Food and Drug Administration (FDA), and Orphan Drug Designation from the European Commission, for both TDT and SCD.

CTX001 is being developed under a co-development and co-commercialization agreement between CRISPR Therapeutics and Vertex. CTX001 is the most advanced gene-editing approach in development for TDT and SCD.

About CLIMB-111The ongoing Phase 1/2 open-label trial, CLIMB-Thal-111, is designed to assess the safety and efficacy of a single dose of CTX001 in patients ages 12 to 35 with TDT. The trial will enroll up to 45 patients and follow patients for approximately two years after infusion. Each patient will be asked to participate in a long-term follow-up trial.

About CLIMB-121The ongoing Phase 1/2 open-label trial, CLIMB-SCD-121, is designed to assess the safety and efficacy of a single dose of CTX001 in patients ages 12 to 35 with severe SCD. The trial will enroll up to 45 patients and follow patients for approximately two years after infusion. Each patient will be asked to participate in a long-term follow-up trial.

About the Gene-Editing Process in These TrialsPatients who enroll in these trials will have their own hematopoietic stem and progenitor cells collected from peripheral blood. The patients cells will be edited using the CRISPR/Cas9 technology. The edited cells, CTX001, will then be infused back into the patient as part of a stem cell transplant, a process which involves, among other things, a patient being treated with myeloablative busulfan conditioning. Patients undergoing stem cell transplants may also encounter side effects (ranging from mild to severe) that are unrelated to the administration of CTX001. Patients will initially be monitored to determine when the edited cells begin to produce mature blood cells, a process known as engraftment. After engraftment, patients will continue to be monitored to track the impact of CTX001 on multiple measures of disease and for safety.

About the CRISPR-Vertex CollaborationCRISPR Therapeutics and Vertex entered into a strategic research collaboration in 2015 focused on the use of CRISPR/Cas9 to discover and develop potential new treatments aimed at the underlying genetic causes of human disease. CTX001 represents the first treatment to emerge from the joint research program. CRISPR Therapeutics and Vertex will jointly develop and commercialize CTX001 and equally share all research and development costs and profits worldwide.

About CRISPR TherapeuticsCRISPR Therapeutics is a leading gene editing company focused on developing transformative gene-based medicines for serious diseases using its proprietary CRISPR/Cas9 platform. CRISPR/Cas9 is a revolutionary gene editing technology that allows for precise, directed changes to genomic DNA. CRISPR Therapeutics has established a portfolio of therapeutic programs across a broad range of disease areas including hemoglobinopathies, oncology, regenerative medicine and rare diseases. To accelerate and expand its efforts, CRISPR Therapeutics has established strategic collaborations with leading companies including Bayer, Vertex Pharmaceuticals and ViaCyte, Inc. CRISPR Therapeutics AG is headquartered in Zug, Switzerland, with its wholly-owned U.S. subsidiary, CRISPR Therapeutics, Inc., and R&D operations based in Cambridge, Massachusetts, and business offices in San Francisco, California and London, United Kingdom. For more information, please visit http://www.crisprtx.com.

CRISPR Therapeutics Forward-Looking Statement This press release may contain a number of forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, as well as statements regarding CRISPR Therapeutics expectations about any or all of the following: (i) the status of clinical trials (including, without limitation, the expected timing of data releases) and discussions with regulatory authorities related to product candidates under development by CRISPR Therapeutics and its collaborators, including expectations regarding the benefits of PRIME designation; (ii) the expected benefits of CRISPR Therapeutics collaborations; and (iii) the therapeutic value, development, and commercial potential of CRISPR/Cas9 gene editing technologies and therapies. Without limiting the foregoing, the words believes, anticipates, plans, expects and similar expressions are intended to identify forward-looking statements. You are cautioned that forward-looking statements are inherently uncertain. Although CRISPR Therapeutics believes that such statements are based on reasonable assumptions within the bounds of its knowledge of its business and operations, forward-looking statements are neither promises nor guarantees and they are necessarily subject to a high degree of uncertainty and risk. Actual performance and results may differ materially from those projected or suggested in the forward-looking statements due to various risks and uncertainties. These risks and uncertainties include, among others: potential impacts due to the coronavirus pandemic, such as the timing and progress of clinical trials; the potential for initial and preliminary data from any clinical trial and initial data from a limited number of patients (as is the case with CTX001 at this time) not to be indicative of final trial results; the potential that CTX001 clinical trial results may not be favorable; that future competitive or other market factors may adversely affect the commercial potential for CTX001; uncertainties regarding the intellectual property protection for CRISPR Therapeutics technology and intellectual property belonging to third parties, and the outcome of proceedings (such as an interference, an opposition or a similar proceeding) involving all or any portion of such intellectual property; and those risks and uncertainties described under the heading Risk Factors in CRISPR Therapeutics most recent annual report on Form 10-K, quarterly report on Form 10-Q and in any other subsequent filings made by CRISPR Therapeutics with the U.S. Securities and Exchange Commission, which are available on the SEC's website at http://www.sec.gov. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date they are made. CRISPR Therapeutics disclaims any obligation or undertaking to update or revise any forward-looking statements contained in this press release, other than to the extent required by law.

About VertexVertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. The company has multiple approved medicines that treat the underlying cause of cystic fibrosis (CF) a rare, life-threatening genetic disease and has several ongoing clinical and research programs in CF. Beyond CF, Vertex has a robust pipeline of investigational small molecule medicines in other serious diseases where it has deep insight into causal human biology, including pain, alpha-1 antitrypsin deficiency and APOL1-mediated kidney diseases. In addition, Vertex has a rapidly expanding pipeline of genetic and cell therapies for diseases such as sickle cell disease, beta thalassemia, Duchenne muscular dystrophy and type 1 diabetes mellitus.

Founded in 1989 in Cambridge, Mass., Vertex's global headquarters is now located in Boston's Innovation District and its international headquarters is in London, UK. Additionally, the company has research and development sites and commercial offices in North America, Europe, Australia and Latin America. Vertex is consistently recognized as one of the industry's top places to work, including 10 consecutive years on Science magazine's Top Employers list and top five on the 2019 Best Employers for Diversity list by Forbes. For company updates and to learn more about Vertex's history of innovation, visit http://www.vrtx.com or follow us on Facebook, Twitter, LinkedIn, YouTube and Instagram.

Vertex Special Note Regarding Forward-Looking StatementsThis press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, including, without limitation, statements regarding CTX001s PRIME designation or its development, the potential benefits of CTX001, our plans and expectations for our clinical trials and clinical trial sites, and the status of our clinical trials of our product candidates under development by us and our collaborators, including activities at the clinical trial sites and potential outcomes. While Vertex believes the forward-looking statements contained in this press release are accurate, these forward-looking statements represent the company's beliefs only as of the date of this press release and there are a number of risks and uncertainties that could cause actual events or results to differ materially from those expressed or implied by such forward-looking statements. Those risks and uncertainties include, among other things, that data from the company's development programs, including its programs with its collaborators, may not support registration or further development of its compounds due to safety, efficacy or other reasons, and other risks listed under Risk Factors in Vertex's annual report and subsequent quarterly reports filed with the Securities and Exchange Commission and available through the company's website at http://www.vrtx.com. Vertex disclaims any obligation to update the information contained in this press release as new information becomes available.(VRTX-GEN)

CRISPR Therapeutics Investor Contact:Susan Kim, +1 617-307-7503susan.kim@crisprtx.com

CRISPR Therapeutics Media Contact:Rachel EidesWCG on behalf of CRISPR+1 617-337-4167reides@wcgworld.com

Vertex Pharmaceuticals IncorporatedInvestors:Michael Partridge, +1 617-341-6108orZach Barber, +1 617-341-6470orBrenda Eustace, +1 617-341-6187

Media:mediainfo@vrtx.com orU.S.: +1 617-341-6992orHeather Nichols: +1 617-839-3607orInternational: +44 20 3204 5275

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CRISPR Therapeutics and Vertex Pharmaceuticals Announce Priority Medicines (PRIME) Designation Granted by the European Medicines Agency (EMA) to...

New research suggests that Parkinson's disease is not one but two diseases, starting either in the brain or in the intestines. Which explains why patients with Parkinson's describe widely differing symptoms,. The findings points towards personalized medicine as the way forward for people with Parkinson's disease.

This is the conclusion of a study which has just been published in the leading neurology journalBrain.

The researchers behind the study are Professor Per Borghammer and Medical Doctor Jacob Horsager from the Department of Clinical Medicine at Aarhus University and Aarhus University Hospital, Denmark.

"With the help of advanced scanning techniques, we've shown that Parkinson's disease can be divided into two variants, which start in different places in the body. For some patients, the disease starts in the intestines and spreads from there to the brain through neural connections. For others, the disease starts in the brain and spreads to the intestines and other organs such as the heart," explains Per Borghammer.

He also points out that the discovery could be very significant for the treatment of Parkinson's disease in the future, as this ought to be based on the individual patient's disease pattern.

Parkinson's disease is characterised by slow deterioration of the brain due to accumulated alpha-synuclein, a protein that damages nerve cells. This leads to the slow, stiff movements which many people associate with the disease.

In the study, the researchers have used advanced PET and MRI imaging techniques to examine people with Parkinson's disease. People who have not yet been diagnosed but have a high risk of developing the disease are also included in the study. People diagnosed with REM sleep behaviour syndrome have an increased risk of developing Parkinson's disease.

The study showed that some patients had damage to the brain's dopamine system before damage in the intestines and heart occurred. In other patients, scans revealed damage to the nervous systems of the intestines and heart before the damage in the brain's dopamine system was visible.

This knowledge is important and it challenges the understanding of Parkinson's disease that has been prevalent until now, says Per Borghammer.

"Until now, many people have viewed the disease as relatively homogeneous and defined it based on the classical movement disorders. But at the same time, we've been puzzled about why there was such a big difference between patient symptoms. With this new knowledge, the different symptoms make more sense and this is also the perspective in which future research should be viewed," he says.

The researchers refer to the two types of Parkinson's disease as body-first and brain-first. In the case of body-first, it may be particularly interesting to study the composition of bacteria in the intestines known as the microbiota.

"It has long since been demonstrated that Parkinson's patients have a different microbiome in the intestines than healthy people, without us truly understanding the significance of this. Now that we're able to identify the two types of Parkinson's disease, we can examine the risk factors and possible genetic factors that may be different for the two types. The next step is to examine whether, for example, body-first Parkinson's disease can be treated by treating the intestines with faeces transplantation or in other ways that affect the microbiome," says Per Borghammer.

"The discovery of brain-first Parkinson's is a bigger challenge. This variant of the disease is probably relatively symptom-free until the movement disorder symptoms appear and the patient is diagnosed with Parkinson's. By then the patient has already lost more than half of the dopamine system, and it will therefore be more difficult to find patients early enough to be able to slow the disease," says Per Borghammer.

The study from Aarhus University is longitudinal, i.e. the participants are called in again after three and six years so that all of the examinations and scans can be repeated. According to Per Borghammer, this makes the study the most comprehensive ever, and it provides researchers with valuable knowledge and clarification about Parkinson's disease - or diseases.

"Previous studies have indicated that there could be more than one type of Parkinson's, but this has not been demonstrated clearly until this study, which was specifically designed to clarify this question. We now have knowledge that offers hope for better and more targeted treatment of people who are affected by Parkinson's disease in the future," says Per Borghammer.

According to the Danish Parkinson's Disease Association, there are 8,000 people with Parkinson's disease in Denmark and up to eight million diagnosed patients worldwide.

This figure is expected to increase to 15 million in 2050 due to the ageing population, as the risk of getting Parkinson's disease increases dramatically the older the population becomes.

Reference:

This article has been republished from materials provided by Aarhus University. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Second Variant of Parkinson's Disease That Begins in the Gut Is Identified - Technology Networks

Research coming out of the University of Pennsylvania School of Medicine last month demonstrated how artificial intelligence (AI) can be utilized to fight against opioid abuse. It focused on a chatbot which sent reminders to patients who underwent surgery to fix major bone fractures.

The research was published in the Journal of Medical Internet Research.

Christopher Anthony, MD, is the studys lead author and the associate director of Hip Preservation at Penn Medicine. He is also an assistant professor of Orthopaedic Surgery.

We showed that opioid medication utilization could be decreased by more than a third in an at-risk patient population by delivering psychotherapy via a chatbot, he said. While it must be tested with future investigations, we believe our findings are likely transferable to other patient populations.

Opioids are an effective treatment for pain following a severe injury, such as a broken arm or leg, but the large prescription of the drugs can lead to addiction and dependence for many users. This is what has caused the major opioid epidemic throughout the United States.

The team of researchers believe that a patient-centered approach with the use of the AI chatbot can help reduce the number of opioids taken after such surgerys, which can be a tool used against the epidemic.

Those researchers also included Edward Octavio Rojas, MD, who is a resident in Orthopaedic Surgery at the University of Iowa Hospitals & Clinics. The co-authors included: Valerie Keffala, PhD; Natalie Ann Glass, PhD; Benjamin J. Miller, MD; Mathew Hogue, MD; Michael Wiley, MD; Matthew Karam, MD; John Lawrence Marsh, MD, and Apurva Shah, MD.

The research involved 76 patients who visited a Level 1 Trauma Center at the University of Iowa Hospitals & Clinics. They were there to receive treatment for fractures that required surgery, and those patients were separated into two groups. Both groups received the same prescription for opioids to treat pain, but only one of the groups received daily text messages from the automated chatbot.

The group that received text messages could expect two per day for a period of two weeks following their procedure. The automated chatbot relied on artificial intelligence to send the messages, which went out the day after surgery. The text messages were constructed in a way to help patients focus on coping better with the medication.

The text messages, which were created by a pain psychologist specialized in pain and commitment therapy (ACT), did not directly go against the use of the medication, but they attempted to help the patients think of something other than taking a pill.

The text messages could be broken down into six core principles, : Values, Acceptance, Present Moment Awareness, Self-As-Context, Committed Action, and Diffusion.

One message under the Acceptance principle was: feelings of pain and feelings about your experience of pain are normal after surgery. Acknowledge and accept these feelings as part of the recovery process. Remember how you feel now is temporary and your healing process will continue. Call to mind pleasant feelings or thoughts you experienced today.

The results showed that the patients who did not receive the automated messages took, on average, 41 opioid pills following the surgeries, while the group who did receive the messages averaged 26. The 37 percent difference was impressive, and those who received messages also reported less overall pain two weeks after the surgery.

The automated messages were not personalized for each individual, which demonstrates success without over-personalization.

A realistic goal for this type of work is to decrease opioid utilization to as few tablets as possible, with the ultimate goal to eliminate the need for opioid medication in the setting of fracture care, Anthony said.

The study received funding by a grant from the Orthopaedic Trauma Association.

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AI Algorithms Can Enhance the Creation of Bioscaffold Materials and Help Heal Wounds - Unite.AI

Before lockdown began in March, Lenny Kravitz packed a bag for a week and headed to his home in Eleuthera in the Bahamas. His stay ended up being much longer than that. The singer and guitarist has spent the last six and a half months on the island he loves, returning to his Bahamian roots and living off the land. Save for a bottle of YSL Beautys Y eau de parfum, that is. As the newand lets face it, entirely fittingface of the French fashion houses seductive fougre scent, its become his signature.

Its fresh, its clean, its got spice, says Kravitz of Y, which opens with sparkling notes of green apple and bergamot, with a heart of lavender and geranium thats warmed by a zing of lemony ginger. During this period of being here on this island and living very simplybeing in the ocean, in the sun, and in the bush, as we call itit just fits. The art of presentation has always been a force within Kravitzs life, and like many during these challenging times, hes looked to his choice fragrance to elevate his mood. Im only around a few people and have no social functions, but some days I just need a little lift, explains Kravitz. I put on a nice shirt, and Ill spray on some fragrance, and it just makes me feel better. You dont have to do it for somebody, something, or some function. You can just do it for yourself.

Sticking to whats tried-and-true, Kravitz has been rotating between his rock-and-roll wardrobe signaturesdenim button-downs, love-worn ripped jeans, and printed skinny scarvesas well as following a streamlined beauty routine. The things that I use on my body are the same that Ive always used, he says, rattling off a list of natural oils and butters, including coconut oil, shea butter, and cocoa butter, as well as Dr. Bronners Almond Pure-Castile Liquid Soap, adding, I wash my body in it. I wash my hair with it. I washed my clothes in it. In his haven of the Caribbean, hes also been enjoying the spoilsand skin-care benefitsof the beach, the pearlescent white sand in particular. We have the most beautiful sand here in the Bahamasits very, very, very powdery, very, very fine, he explains. So when Im in the ocean, and I want to scrub my body, I use the sand. Thats what going on over here.

Besides the kind of head-to-toe exfoliation only a one-way ticket to Eleuthera can buy, Kravitz has been staying well, mind and body, by tending to his garden, cooking his own meals, and juicing with daily shots of immunity-boosting ginger. And hes been feeding off the island for his daily workout, an hour-long bike ride, as well. Thats been my form of cardio that I enjoy the most here, rather than being on a treadmill, he says. Its getting out in the sun and riding on the road with a lot of it on the ocean. Its so beautiful, and it gives you time to meditate. For mental clarity, hes also been limiting his news intake in an effort to tune out the noise. I only check the news and whats going on in the world often enough so that Im not in the dark, but Im not watching the television and inside of all of this negativity, he says. In terms of staying creative, Kravitz, who is working on his next album, is letting inspiration come to him in time. Its almost like if you have a radio receiver, and youre turning the dial, and all you hear is static until you finally hear music, he explains of his process. I prefer it that way because then its really pure. Im not involving my own ego or my own ideas or projections. Im getting what Im getting.

While Kravitz has always followed his own path doing what feels right to look and feel his best, he credits genetics and familial role models as the true secrets to his longevityand his impossibly ageless physique. My grandfather lived up into his 90s, and he had a thirst for life, for learning, for growing, and I think Ive inherited that from him, he explains. With the genes that I have from my parents and my grandparents, we dont seem to visibly age like one might think, so all of those things togetherwith, of course, taking care of yourself, putting the right things in your body, and taking care of your mind and spirithave contributed to aging just being about experiencing and living, not about falling apart.

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Lenny Kravitz on His Signature Scent, His Beach Beauty Routine, and the Secret to His Longevity - Vogue

Provided by the Pennsylvania Department of Health:

Secretary of Health Dr. Rachel Levine today reminded Pennsylvanians of the seriousness of sickle cell disease and the importance of getting tested for it. Sickle cell disease is the most common inherited blood disease.

We want people to get tested for sickle cell disease if they believe they could be a carrier of it, Levine said. We inherit traits from our parents like eye and hair color, but they also pass along internal traits like blood type and sickle cell conditions. It is important to be tested to confirm if you have sickle cell disease, so that treatment for the disease can be started right away to further protect yourself and your family.

Sickle cell disease is an inherited blood disease where an individuals red blood cells take a crescent or sickle shape. This change in shape can create blockages that prevent blood from reaching parts of the body. As a result, people with sickle cell complications can experience anemia, gallstones, stroke, chronic pain, organ damage and even premature death.

According to the Centers for Disease Control and Prevention (CDC), sickle cell disease affects approximately 100,000 Americans. This disease has a greater influence on African American and Hispanic populations but is also found among many other races and ethnicities.

Sickle cell disease is one of the 10 mandatory diseasesscreened for newborns. These screenings are conducted with the goal of eliminating or reducing death, disease and disability in newborn children. In addition, sickle cell disease can be diagnosed before birth to provide an early diagnosis and find treatment.

Treatment can help those with sickle cell disease live well and be healthy, but there is ultimately no cure for sickle cell disease. Treatment requires:

Finding good medical care and getting regular checkups;

Staying up to date on vaccinations and washing hands frequently to prevent infections;

Learning healthy habits;

Looking into clinical studies; and

Finding support and assistance.

Studies have shown that donated bone marrow or stem cell transplants have helped cure sickle cell disease in children with severe cases of the disease. This means that the healthy donated bone marrow or stem cell transplant replaces an individuals bone marrow that is not working properly. Bone marrow or stem cell transplants can be risky and for the donation to work the individual would need to be a close match like a brother or sister.

The Wolf administration has developed aprescribing guideline for the treatment of acute and chronic pain in patients with sickle cell diseaseto assist physicians treating patients with the disease. The guideline provides best practices to treat acute painful crises that occur with sickle cell disease patients as well as best practices for chronic pain care. The sickle cell disease guideline addresses the specific needs of that patient population. This can help prevent the misapplication of recommendations to populations that are outside the scope of other prescribing guidelines, including patients experiencing acute sickle cell crises. It is especially important to have resources specifically for the treatment of sickle cell disease patients as this patient population often experiences racial disparities and stigma.

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PA Health Secretary: Sickle Cell Disease Treatment Hinges On Getting Testing - LevittownNow.com

When youre in pain, its important to find effective, long-lasting solutions that can provide short recovery periods. This is what regenerative medicine offers. Over the past decade, there has been a growing field of medicine that utilizes the bodys own healing capabilities using platelet-rich plasma and mesenchymal stem cells (MSCs). This growing field is labeled as regenerative medicine. Regenerative therapies focus on healing and help regrow damaged tissue naturally. Regenerative injection therapy is used to provide relief to musculoskeletal injuries that involve damage to ligaments, tendons, cartilage, joints, and discs.

Watch video of PRP:

PRP therapy on Better CT

PRP is safeas we are using what your body naturally produces, concentrating the desired critical components and transplanting them into the affected area for effective tissue regeneration and healing. There is no risk of rejection and very minimal overall procedural risk.

FDA regulations do not allow for the cloning of stem cells or growing them in a lab. Also, stem cells derived from fat cells are not approved by the FDA as it does not allow for manipulation. This leaves us to another rich stem cell source in our body which is bone marrow. Stem cells exist in our bodies and are rudimentary cells that can differentiate into other cells.

Think of bone marrow stem cells as the mother cell that is responsible for producing new blood cells. Bone marrow contains hundreds of growth factors and is often used for severe degenerative conditions or where PRP therapy may not be sufficient to provide the growth factors needed to provide relief.

Lastly, there are many offshoot therapies that use biologics derived from placental tissue or blood cord. These biologics are sometimes marketed as Stem cells but are not stem cells and contain zero viable cells. What they contain are growth factors that can also aid when combined with PRP or Stem Cells derived from your own body.

MSCs and PRPmay be used to target a number of conditions that could benefit from their healing and regenerative qualities. Especially when considering chronic pain, alternative solutions may be necessary if it has been difficult to find relief. Along with generalized joint pain, MSCs and PRPmay be used to target:

With so many options for joint pain out there, you may be wondering what benefits choosing stem cell therapy provides. Overall, because mesenchymal stem cell therapy utilizes biologic material harvested directly from the patients body, the general benefits include minimal risk, minimal recovery time, and minimal worry:

Avoid surgery and its many complications and risks: Stem cell therapy is a minimally invasive, non-surgical procedure.

Minimal post-procedural recovery time: One of the most time-consuming factors of any injury is not always the treatment itself, but actually the recovery time. With stem cell therapy, recovery time is minimal.

No risk of rejection: Due to using biologics extracted from the patient, there is no risk of rejection.

No communicable disease transmission: As the cells originate within your own body, there is no risk of spreading disease from or to another person.

If you are suffering from joint pain, back pain, or a debilitating condition like osteoarthritis, it is important to consider all of your available options. Our elite team of professionals can determine if you are the right candidate for MSCs. If youre interested in learning more, contact us today.

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Regenerative Therapy by Dr. Roshni Patel on Better CT - Farmington, CT - Patch.com

Cannabis is celebrated for the benefits it offers in the management of certain medical conditions. As awareness around cannabis grows, consumers are becoming better versed in the therapeutic potential of cannabinoids in the treatment of specific autoimmune diseases, inflammation, and gastrointestinal disorders.

But how does cannabis affect the immune system as a whole? If youre a regular consumer, you may have pondered whether cannabis weakens or boosts your immune system. Can frequent cannabis use render you more prone to infections or contagious diseases?

As it turns out, research into cannabis and the immune system hasnt historically piqued the interest of scientists. However, as our understanding of the effects of cannabis on the body becomes more sophisticated, we need to also broaden our knowledge of how cannabis influences the immune system.

Present evidence suggests that cannabis can suppress immune system function. While this can be helpful for individuals with autoimmune illnesses, it may not be so beneficial for those with functional immune systems.

The immune system is one of the bodys most sophisticated networks. A collection of specialized cells, endogenous chemicals, and organs work in concert to ward off pathogens and infections, protecting the health and homeostasis of the body.

The immune system is multifaceted, and its core components that actively combat infection include white blood cells, the complement system, antibodies, the lymphatic system, the spleen, the thymus, and bone marrow, but well mainly talk about white blood cells.

Memories of every microbe previously defeated by the immune system are logged in white blood cells. These memories enable the fast tracking and elimination of infections that have already been experienced. The immune system is also responsible for detecting and eradicating malfunctioning cells.

The knowledge we have about the interaction of cannabis with specific immune elements is limited. While there is some research exploring the effects of cannabinoids on white blood cell count and the lymphatic system, we know less about how cannabis impacts the thymus or the complement system.

An elegant connection exists between the bodys endocannabinoid system (ECS) and its immune system. The ECS is generally considered to be one of the gate-keepers of the immune system, preventing the onset of overwhelming inflammatory responses that may result in disease. The ECS can also influence the function of immune cells.

CB1 and CB2 receptors in the endocannabinoid system mediate the effects of cannabis within the immune system. The two major cannabinoids, THC and CBD, appear to have distinctive effects on the immune system due to their unique interactions with cannabinoid receptors. Abundant literature suggests that cannabinoids affect the functions of most types of immune cells.

A 2020 review found robust evidence that CBD suppresses certain inflammatory responses in the immune system and may induce cellular death in immune cells. Immune cell death isnt always a bad thingits a normal part of the cellular life cycle, and helps to protect a person by alleviating inflammatory responses.

Like CBD, THC also suppresses immune activity, dialing down inflammatory responses. THC has also been shown to alter the function of immune cells responsible for antimicrobial activity.

When scientists discuss cannabis and the immune system, they often discuss its effects as immunomodulatory or immunosuppressive. Immunomodulation refers to any therapy that modifies the immune system response. When cannabis suppresses the expression of aspects of the immune system, this form of modulation is known as immunosuppression.

Its vital to point out here that marijuanas ability to subdue or suppress immune system cells can be useful if the immune system is dysregulated and in need of suppression. If not, immune suppression might not be helpful.

Research published in 2017 indicated that both CBD and THC have an immunomodulatory effect on the human intestinal lymphatic system, the major host of immune cells. The lymphatic system also contains more than half the bodys lymphocyteswhite blood cells that play a critical role in finding and destroying foreign cells or substances that have infiltrated the body.

The studys authors found that oral administration of CBD and THC with fats resulted in extremely high cannabinoid levels in the intestinal lymphatic system: CBD concentrations in lymph cells were 250 times higher than in plasma, while THC concentrations in lymph cells were 100 times higher than in plasma.

So, whats the significance of this? For individuals with autoimmune diseases, cannabis can achieve higher concentrations in the lymphatic system and suppress unhealthy inflammatory immune responses more successfully.

While the immunosuppressive properties of cannabis may be just what the doctor ordered for autoimmune patients, they can cause problems for other cannabis users.

Research carried out in 2003 on healthy volunteers suggests that regular cannabis may subdue immune function. Cannabis users were found to have fewer proinflammatory cells and more anti-inflammatory cells.

While less potential for inflammation may sound like a win, in this case, it was associated with a significant reduction in white cell functionality, and impaired white cells can mean a hindered ability to fight off infections. Regular cannabis users also had decreased amounts of natural killer cells, which limit the spread of tumors and microbial infections.

The study also indicated that there may be a dose-response relationship between cannabis use over an individuals lifetime, and a decrease in certain immune system markers, meaning those who use cannabis regularly may be more susceptible to the progression of infectious disease.

What about the effects of cannabis on extremely immunocompromised individuals? Unfortunately, cannabis can substantially decrease infection-fighting cells in people undergoing chemotherapy. This suppressive response may further add to the detrimental effects of chemotherapy on immune systems of those with cancer.

Research on people with HIV+ and AIDS, who are particularly vulnerable to infections, however, indicates that there is no firm evidence that cannabis adversely affects immune function.

Instead, findings suggest cannabis use among HIV+ patients may enhance the immune system by producing a statistically significant decrease in viral load and an increase in CD4 cells. CD4 cells can be considered a marker that indicate the robustness of the immune system.

While existing research allows us to glean insights into cannabis and the immune system, we need more rigorous data to paint broad brushstrokes. According to the most recent 2017 report from the National Academies of Science, Engineering, and Medicine (NASEM), theres insufficient research on the effects of cannabis or cannabinoid-based medicines on the human immune system to draw firm conclusions.

Within the current global climate shaped by COVID-19, theres an impulse among the research community to enhance our understanding of the impact of cannabis on the immune system. Some cannabis researchers are currently channeling their focus into investigating whether cannabis may be helpful or harmful in treating COVID-19.

More profound exploration into the effects of cannabinoids on the immune system is also being encouraged. Watch this space as new frontiers are forged.

Emma Stone is a journalist based in New Zealand specializing in cannabis, health, and well-being. She has a Ph.D. in sociology and has worked as a researcher and lecturer, but loves being a writer most of all. She would happily spend her days writing, reading, wandering outdoors, eating and swimming.

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Drugs currentlyused to keep the HIV virus in check also cause immune-system changesthat mightmake humans better able toresist viral infectionsbutmight also cause harmful inflammation, according to a study published today in Cell Reports Medicine.

The UW Medicine-led studyby Dr.Florian Hladik and Sean Hughes examined the effects ofa commonly prescribed drug cocktail of drugs on the body.

Sold under the brand name Truvada, tenofovir disoproxil fumarate and emtricitabine (TDF/FTC)are prescribed in tandem formost HIV/AIDS patients to suppress viral loads to undetectable levels. First allowed for use in the United States 20 years ago, the drugs haveenabledpeopleto live for decades beyond their initial diagnosis.

However, Hladik said,"the virus itself never goes away."

In this research, the investigatorsstudied the effect of TDF/FTC in patients who were using the drugto prevent HIV, and in the absence of active HIV infection. The researchers observed patientsover the past five yearsand also includeddata from two earlier studies.

We wanted to know how the drugs themselves affect the immune system, Hughes said. We found that they stimulated type I / III interferon responses, a part of the immune system that is crucial for the bodys ability to fight off viruses. This only happened in the gut.

The clinical consequences of the findings are uncertain and merit further study.

Increased type I / III interferons could be a good thing and actually make the drugs more effective at suppressing viral infections, including HIV. However, they could also cause inflammation, which could contribute to conditions such as cardiovascular disease that are common in people living with HIV, Hladik said. These effects might even make it harder to find a cure for HIV if they make cells silently infected with HIV (called latent cells) more likely to survive or even cause them to proliferate.

Hladik and Hughesalso want to look for those same effects in people infected with HIV.

New drug regimens have just become available that highly suppress the HIV virus in patients and dont contain TDF/FTC or other drugs of thatclass. Bothhope to conduct a trial comparing immunity in HIV-infected individuals using TDF/FTC to others using these newer regimens to determine whether their findings are true in HIV-infected individuals. The researchers hypothesize that the newer regimens will avoid chronic immune activation and decrease the number of latent cells.

The most important next step is to repeat our studies in HIV-infected individuals, and to find out if replacing drugs such as TDF/FTC with newer regimens has clinically relevant effects on reducing chronic inflammation and persistence of latent HIV, Hladik said.

This work was funded by the National Institutes of Health(R01AI116292, R01AI111738,R01AI134293,AI027757,AI069481,R01DK112254);the Bill and Melinda Gates Foundation;the Microbicide Trials Network (UM1AI068633); the Canadian Institutes for Health Research;the Emory University-CDC HIV/AIDS Clinical Trials Unit (UM1AI069418, from the NIAID). The ddPCR work was supported by a grant from the James B. Pendleton Charitable Trust. A National Cancer Institute grant supported the Fred Hutchinson Cancer Research Center Experimental Histopathology core facility.

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Common HIV drugs increase a type of immunity in the gut - UW Medicine Newsroom

Its unusual that a virus would be less severe in children than it is in adults. But when it comes to COVID-19, kids make up just a small percentage of severe cases. Yale researchers are working to understand why that is.

Their discoveries can help guide understanding of the virus and possible treatment options.

Ina paper published recently in Proceedings of the National Academy of Sciences(PNAS),Dr. Naftali Kaminski, theBoehringer-Ingelheim Endowed Professor of Internal Medicine and chief of Pulmonary, Critical Care and Sleep Medicine, and colleagues shared findings related tochildrens surprising immunity to the virus. They detailed how factors including allergies, asthma, the common cold, and existing vaccines may be having a protective effect.

Meanwhile,Carrie Lucas, assistant professor of immunobiology at Yale, is looking at blood samples from the small percentage of children who develop the rare condition known as Multi-Inflammatory Syndrome in Children, or MIS-C, in response to COVID-19. Her lab is analyzing blood samples for molecular and genetic clues to figure out why a certain subset of kids are most at risk.

Findings just published in the journal Science Translational Medicine led byKevan Herold, the C.N.H. Long Professor of Immunology and Internal Medicine at Yale, revealed that children diagnosed with COVID-19 express higher levels of two specific immune system molecules, a factor that might be leading to better health outcomes.

Related story:Childrens immune response more effective against COVID-19

Understanding why children appear to be better protected from severe cases than adults could provide important clues on how the novel coronavirus spreads, who is at greatest risk, and how to treat it.

This is different from other viruses that affect kids more seriously, Kaminski said. Its an interesting conundrum and could provide implications for therapeutics.

In the PNAS paper, researchers point to the possibility that allergies and asthma in children has a protective effect. When the body responds to an allergy or asthma trigger, the immune system releases Th2 cells, which in turn increases a type of cell called the eosinophil in the blood and tissues. This allergic inflammation has been shown to dramatically reduce the levels of a key receptor to the COVID-19 molecule, known as ACE2. They added that astudy of 85 older adultswho died of COVID-19 in China showed that they had very low levels of blood eosinophils.

Initially, there was a concern about the impact of COVID-19 on children with asthma, said Kaminski. Some 7.5% of U.S. children under 18, or 5.5 million kids, have asthma, according to the Centers for Disease Control and Prevention. But, in fact, it seems that compared to other chronic lung diseases, people with asthma are infected less, and, when they are infected, asthma is not a risk factor.

Instead, risk factors known to drive worse COVID-19 outcomes include age, obesity, hypertension, and cardiac diseases.

The greater exposure children have to the common cold may also offer protection. Coronaviruses are a large family of viruses so named for their crown-like shape under a microscope, of which the common cold is one. SARS-CoV-2, which causes COVID-19, is another.

It is thought that exposure to colds may cause viral interference, when one virus interferes with the replication of a second virus. Exposure to common colds, and more severe illnesses like croup, more common in children, are associated with decreased expression of the ACE2 COVID-19 receptor. Studies have found that children symptomatic with COVID-19 may have high viral loads in their noses but, because they have lower levels of ACE2, their lungs are less likely to become infected. In other words, they can still easily spread the virus, but are less likely to develop serious symptoms.

Kaminski added that there is even evidence that vaccines can provide protection. Astudyof Department of Defense personnel found that the 2017-2018 seasonal flu vaccine produced a statistically significant number of individuals who tested positive for common cold-related coronaviruses. If future flu vaccines are designed to increase common coronaviruses, he said, this phenomenon may actually provide some protection to SARS-CoV-2 through cross-reactive immunity.

Of course, not all children are protected from the worst effects of COVID-19. Lucas and her team of pediatric immune disease researchers at Yale are looking at the rare cases of children who have been seriously affected by the virus. Specifically, they looked at children who were asymptomatic during SARS-CoV-2 infection, but weeks later developed a high fever, vomiting, abdominal pain, and sometimes shock, a condition known as MIS-C.As of Sept. 17, there were 935 confirmed cases of MIS-C in the U.S., and 19 deaths.

Lucas lab, which has enrolled 16 pediatric MIS-C patients, is analyzing immune cells in their blood at the single-cell level, as well as thousands of blood proteins, to understand what is happening.

Mostly, right now, our data are showing what the syndrome isnot, she said. For instance, we have found no sign of an active viral or bacterial infection during acute MIS-C.

They are also collecting saliva samples from parents to compare to childrens samples, which might reveal information about genetic variants. Were looking for the needle in the haystack that could be causing this rare manifestation, Lucas said. So far, theres no evidence that this is something that runs in families. I dont know of any cases where two children in a family developed MIS-C.

What they do know, she said, is that inflammatory markers are high, and most patients respond well to immunosuppressive therapies such as steroids. Additional findings will be published in the coming weeks on MedRxiv, a preprint server founded by Yale scientists which publishes studies before they have been peer-reviewed.

While children largely seem to be protected from the immediate effects of COVID-19, there are still long-term concerns, Kaminski and the authors caution. The pandemic and social distancing, they note, affect maturation of the immune system, psychological health, education, and childhood obesity.

We know that the health of children is strongly affected by socioeconomic downturns, Kaminski said, and this potential adverse outcome should not be overlooked.

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What we know about COVID-19 and kids - Yale News

Amid the rush to test and develop potential treatments for COVID-19, lab-made antibodies are showing hints of success. In news releases, two companies announced preliminary results, though shared only limited data, that suggest the experimental drugs may help patients both early and late in infection.

One clinical trial of monoclonal antibodies human-made versions of immune system defenders produced by the body suggests that the drugs can help keep people hospitalized with COVID-19 from needing a ventilator or from dying. And a second trial appears to show that the drugs can bring down levels of the coronavirus in recently infected people, and help reduce the chances that a person would need hospitalization.

Antibodies are part of the bodys natural defense against infectious pathogens. The proteins typically attach to parts of bacteria or viruses to fight off infection. In the lab, scientists can engineer versions of antibodies to recognize specific targets in order to hinder the virus replication or prevent the bodys immune system from overreacting to the virus (SN: 2/21/20).

A monoclonal antibody drug called tocilizumab is one of the latter types; it blocks a part of the immune response that can cause inflammation, a protein known as IL-6. By curbing inflammation, the drug could help people whose immune systems have become overactive through a process called a cytokine storm, which can cause severe COVID-19 symptoms (SN: 8/6/20).

In a Phase III clinical trial of 389 people hospitalized with COVID-19, those who received tocilizumab were 44 percent less likely to need a ventilator or die compared with people who got a placebo, San Franciscobased biotechnology company Genentech announced September 17 in a news release. Of those who received the drug, 12.2 percent of people needed a ventilator or died, compared with 19.3 percent of patients who received a placebo. Still, when the researchers looked at death alone, the drug did not result in a statistically significant difference in mortality between the groups.

Saying that it was still analyzing the data, the company did not provide such specifics as how many people died in each group.

A 44-percent decrease is definitely very intriguing, says Abhijit Duggal, a critical care specialist at the Cleveland Clinic who has treated people with COVID-19. But because the results have been publicized in a news release, without key patient information, I dont know what to really make of that, Duggal says. Only as more data come in will experts be able to conclusively say whether the drug might help people, he says. The announced results have not yet been vetted by outside experts or published in a peer-reviewed journal.

Unlike many other clinical trials of potential COVID-19 drugs and treatments, the Genentech trial focused on groups of people that have been disproportionately impacted by the virus (SN: 4/10/20). Around 85 percent of people in the study are Black, Hispanic and Native American. People in these groups are more likely than white people to be infected or die from COVID-19, studies have shown. In part thats due to high rates of underlying conditions like high blood pressure and jobs with a higher risk of exposure to the virus.

Its really important that [the researchers] are including a diverse population, says Rajesh Gandhi, an infectious disease physician at Massachusetts General Hospital and Harvard Medical School in Boston. That is critical as we do these trials.

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In a previous Genentech-related trial that included 452 people with severe COVID-19, tocilizumab did not help improve symptoms or prevent death, researchers reported in a preliminary study posted September 12 at medRxiv.org. Other trials of the drug have reported improved outcomes in people with moderate or severe COVID-19 symptoms.

Importantly, the new trial focused on hospitalized people before they required a ventilator, says Jamie Freedman, Genentechs head of U.S. medical affairs. So differences among trials could be a timing issue. If you give it too early, before cytokines are elevated, would there be a benefit there? When patients are already in the ICU, is it too late? Or is there some sweet spot in the middle? Freedman says. Those are analyses that really need to continue.

Scientists working on another monoclonal antibody, which targets the coronavirus spike protein, also recently reported promising results (SN: 2/21/20). Called LY-CoV555, the drug can reduce the amount of virus in the bodies in newly infected people and help prevent COVID-19 hospitalizations, Indianapolis-based pharmaceutical company Eli Lilly announced September 16 in a news release.

People in this ongoing Phase II clinical trial to determine efficacy receive either a low, medium or high dose of the antibody or a placebo. So far, those who get a medium dose of LY-CoV555, which is based on an antibody from one of the first COVID-19 patients in the United States, appear to clear the virus faster than those on the placebo, according to the release. Fewer treated patients still had high viral loads later on in the study. Most people, including those on a placebo, cleared the virus from their bodies by day 11. Like Genentech, Eli Lilly released only limited data. The announced results have not yet been vetted by outside experts or published in a peer-reviewed journal.

Its really intriguing and tantalizing information, Gandhi says. But without the full details of the study, like patient age or whether any people had underlying conditions, its difficult to know how solid the findings are, he says.

Its surprising that people on the medium dose had a benefit from the drug but those on the higher dose didnt, but that could be because the results are preliminary and could change as people are added to the trial, says Nina Luning Prak, an immunologist at the University of Pennsylvania. But in principle, it looks hopeful, she says.

Whats more, of 302 people treated with any amount of LY-CoV555, five, or 1.7 percent, landed in the hospital, while nine people, or 6 percent, in a control group of 150 patients who received a placebo, were hospitalized. Its unclear based on the results included in the news release, however, whether the difference between the two groups is meaningful. But if its borne out, well see hopefully soon that this is important because it shows that an antibody is having an antiviral effect, Gandhi says.

There are many other monoclonal antibody trials ongoing around the world, many of which feature drugs that bind to a variety of both virus and host proteins. Experts are carefully watching for results, keen to know for sure whether such treatments can help patients. Still, compared with where treatments were in March and April, weve made progress, Gandhi says. I think that progress is going to just accelerate.

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Antibodies made in the lab show some promise for treating COVID-19 - Science News

(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)

William Petri, University of Virginia

(THE CONVERSATION) With COVID-19 vaccines currently in the final phase of study, youve probably been wondering how the FDA will decide if a vaccine is safe and effective.

Based on the status of the Phase 3 trials currently underway, it is unlikely that the results of these trials will be available before November. But it is likely that not just one but several of the competing COVID-19 vaccines will be shown to be safe and effective by the end of 2020.

I am a scientist and infectious diseases specialist at the University of Virginia, where I care for patients with COVID-19 and conduct research on the pandemic. I am also a member of the World Health Organization Expert Group on COVID-19 Vaccine Prioritization.

What is the status of COVID-19 vaccines in human clinical trials?

Phase 3 studies are underway for the Moderna and BioNTech/Pfizer vaccines and the Oxford/AstraZeneca viral vector vaccine.

Each of these vaccines uses the SARS-CoV-2 spike glycoprotein, which the virus uses to infect cells, to trigger the immune system to generate protective antibodies and a cellular immune response to the virus. Protective antibodies act by preventing the spike glycoprotein from attaching the virus to human cells, thereby neutralizing the SARS-CoV-2 virus that causes COVID-19.

In the case of Modernas nucleic acid vaccine, the messenger RNA encoding the spike glycoprotein is encased in a fat droplet called a liposome to protect the mRNA from degradation and enable it to enter cells. Once these instructions are inside the cells, the mRNA is read by the human cell machinery and made into many spike proteins so that the immune system can respond and begin producing antibodies against this coronavirus.

The Oxford/AstraZeneca uses a different strategy to activate an immune response. Here an adenovirus found in chimpanzees shuttles the instructions for manufacturing the spike glycoprotein into cells.

Phase 1 and 2 studies by pharmaceutical companies Janssen and Merck also use viral vectors similar to the Oxford/AstraZeneca vaccine, while vaccines by Novavax and GSK-Sanofi use the actual spike protein itself.

Animal tests show the vaccines provide protection from coronavirus infection

Studies in animal models of COVID-19 provide convincing evidence that vaccination with the spike glycoprotein will protect from COVID-19. Experiments have show that when the immune system is shown the spike protein which alone cannot trigger disease the immune system will generate an antibody response that protects from infection with SARS-CoV-2.

In studies in hamsters an adenovirus viral vector the approach used by Oxford/AstraZeneca, for example was used to immunize with the Spike glycoprotein. When the hamsters were infected with SARS-CoV-2 they were protected from pneumonia, weight loss and death.

In nonhuman primates, DNA vaccines which deliver the gene for the spike glycoprotein reduced the amount of virus in the lungs. Animals that produced antibody that prevented virus attachment to human cells were most likely to be protected.

What have the early Phase 1 and 2 studies in humans shown?

Overall, vaccination has triggered a more potent neutralizing antibody response than even that seen in patients recovering from COVID-19.

This has also been the case for Modernas vaccine currently in Phase 3 trials and for vaccines from CanSino Biologics and Oxford/ AstraZeneca.

What side effects have been observed?

Physicians have recorded mild to moderate reactions when the subjects were observed up to 28 days after vaccination. These side effects included mild pain, warmth and tenderness at the site of injection, and fever, fatigue, joint and muscle pain.

But Phase 1 and 2 studies are by small by design, with just hundreds of participants. So these trials will not be large enough to detect uncommon or rare side effects.

The emphasis on safety as the primary goal was recently demonstrated in the Phase 3 Oxford/AstraZeneca vaccine trial where one vaccinated individual developed inflammation of the spinal cord. It isnt clear whether the vaccine caused this reaction it might be a new case of multiple sclerosis unrelated to the vaccine but the Phase 3 trial was halted in the U.S. until more is known.

How is the FDA ensuring that a vaccine will be safe yet quickly produced?

The FDA has issued guidance for industry on the steps required for developing and ultimately licensing vaccines to prevent COVID-19 these are the same rigorous safety standards required for all vaccines.

There are, however, ways to speed the process of approval that are centered on platform technology. What this means is that if a vaccine is using an approach such as an adenovirus that has previously been shown to be safe, it may be possible for a company to use previously collected data on toxicity and pharmacokinetics to fast-track clinical trial approval.

While speed and safety may appear conflicting goals, it is also encouraging to note that the rival vaccine manufacturers have jointly pledged not to bow to any political pressures to rush vaccine approval, but to maintain the most rigorous safety standards.

How protective does a vaccine need be to receive FDA approval?

The FDA has set the bar for the primary endpoint of a Phase 3 trial of 50% protection for approval of a COVID-19 vaccine.

Protection is defined as protection from symptomatic COVID-19 infection, defined as laboratory-confirmed SARS-CoV-2 infection plus symptoms such as fever or chills, cough, shortness of breath, fatigue, muscle aches, loss of taste or smell, congestion or runny nose, diarrhea, nausea or vomiting.

This means that an effective vaccine is considered one that will reduce the number of infections in vaccine recipients by half. This is the minimal protection that is anticipated to be clinically useful. That is, in part, because lower levels of efficacy could paradoxically increase COVID-19 infections if it leads vaccinated people to decrease mask wearing or social distancing because they think they are completely protected.

Since a vaccine might be more effective at preventing severe COVID-19, the FDA instructs that protection from severe COVID-19 should be a secondary endpoint.

How many people have to be vaccinated to know if a vaccine works in Phase 3?

The current Phase 3 trials are enrolling 30,000-40,000 subjects. Most of these participants will receive the vaccine and some a placebo.

When, exactly, the results of Phase 3 studies will be released depends in large part on the rate of infection in the placebo recipients. The way that these vaccine studies work is that they test if naturally acquired new coronavirus infections are lower in the group that received the vaccine compared with the group receiving the placebo.

So while it is good news that COVID-19 infections have dropped recently in the U.S. from 70,000 to 40,000 cases per day, this drop in new infections may slow the vaccine studies.

Will Emergency Use Authorization fast-track vaccine?

In an emergency such as we are faced with the COVID-19 pandemic, with approximately 700 new deaths and 40,000 new cases per day right now, the FDA is authorized to allow the use of unapproved products for the diagnosis, treatment and prevention of disease. That includes a vaccine.

The standard approval process for vaccines can require more than one year of observation after vaccination. If the short-term safety is good and the vaccine works to prevent COVID-19, then the vaccine should be approved for use under an Emergency Use Authorization while it is still being studied.

Under Emergency Use Authorization, the FDA will continue to collect information from the companies producing the vaccines for benefit and harm, including surveillance for vaccine-associated enhanced respiratory disease or other potentially rare complications that might be observed in only one in a million.

What should we expect in terms of approvals?

I expect that the FDA will approve several vaccines by the end of 2020 under its Emergency Use Authorization authority so that vaccination can begin immediately, starting with high-risk groups including first responders, health care personnel, and the elderly and those with preexisting medical conditions.

This will be followed rapidly with roll-out of vaccination to the population at large, while all of the time the FDA and vaccine manufacturers will continue to monitor for side effects and work to improve upon these first vaccines. This process is expected to take months.

It may not be life back to normal next year, but all signs point to a healthier 2021.

This article is republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/how-and-when-will-we-know-that-a-covid-19-vaccine-is-safe-and-effective-146091.

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How and when will we know that a COVID-19 vaccine is safe and effective? - Fairfield Citizen

Findings from a new study demonstrated that infants exposed to opioids prior to birth had a two times higher odds of developing asthma.

The results underscore the necessity of maintaining close follow up care in this vulnerable patient population.

In the past 10 years, prenatal opioid exposure (POE) has seen a dramatic increase among the US newborn population. As many as 100 infants are born daily with Neonatal Opioid Withdrawal Syndrome (NOWS).Therefore, there lies a great need in investigating long-term outcomes in such patients.

Isabella Cervantes, BA, of the University of New Mexico School of Medicine, and colleagues designed a retrospective cohort study to determine the association between POE and the likelihood of an altered immune response by 8 years of age. Immune response was measured by the development of asthma.

To do this. Cervantes and team pulled data from a comprehensive CERNER HealthFacts U.S. national database, which captures de-identified, longitudinal health record data from 800 hospitals across the country.

The investigators used ICD-9-CM and ICD-10-CM diagnostic codes to identify infant patients born at term who had confirmed prenatal exposure to opioids or Neonatal Opioid Withdrawal Syndrome (NOWS).

Then they compared this population of patients with infants who had neither diagnoses at birth. Data was analyzed using IBM Statistical Package for Social Sciences, and Pearsons Chi-Square test analysis was conducted to determine any association between POE and asthma diagnosis.

Overall, the study included 3021 patient records between 2000-2016. A majority of the population was male (50.7%), with Caucasian (61%) being the most represented race/ethnicity.

The investigators also noted that a majority of patients had Medicaid insurance (41.9%) and were raised in urban communities (92.5%).

As many as 50.4% of patients presented with POEversus 49.6% who had no known exposure.

In their analysis, the investigators found that up to 66.3% of all asthma patients (n = 172) were prenatally exposed to opioids.

Thus, after controlling for race, gender demographics, and insurance type, they determined that the odds of developing asthma were two times higher for the prenatally exposed group (OR, 21; 95% CI, 1.4-3.0; P<.0001) than those who did not have POE.

They considered a major strength of the study to be the vastness of the national database. Therefore, the results could be consistent across different regions in the US.

A limitation, however, were the diagnostic codes used to identify their patient population of interest. For example, the codes used to identify infants with prenatal opioid exposure included other diagnoses such as Drug Withdrawal Syndrome in Newborn. Other confounding variables included smoking in the household, among others.

To address such limitations, they highlighted a need to undertake a longitudinal, prospective, multisite study for the future.

These emerging results suggest infants with POE may have altered immune reactivity that not only impacts the newborn period but persists into childhood, they wrote.

Future investigations should aim to characterize in greater detail the impact of POE on the immune system so that new follow-up strategies or effective interventions can be developed, they concluded.

The study, Increased Incidence of Asthma in Children with Prenatal Opioid Exposure, was published online in The Univeristy of New Mexico Digital Repository.

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Prenatal Opioid Exposure Associated with Development of Asthma in Children - MD Magazine

No matter what the season is tea is undeniably one of the best beverages. After water, tea is the worlds most consumed beverage. Drinking tea could actually ward off some very serious conditions, including cancer and obesity. It might sound inflated, but some surveys have stated that the world drinks about six billion cups of tea a day.

Tea contains antioxidants, improves heart health, facilitates weight loss etc. It keeps the body hydrated. There is a large variety of teas available in the market today and in the list below, we share the ones that can build and boost your immune system.

1. Masala Chai: India is a land of spices and has mastered the art of curing ailments and illnesses using unique combination of spices and herbs. There are several magical and abundantly available spices in India that strengthen the immune system. Masala Chai usually contains six condiments, namely cardamom, cinnamon, star anise, pepper, cloves and ginger. Their concoction will keep you pink of health.

2. Ginger Green Tea: A body is more susceptible to catch flue during changing seasons. This is that time of the year when one needs to take good care of their immune system and diet. Make ginger green tea your bae. Ginger, which is used extensively in Indian households, consists of anti-inflammatory components and antioxidants that can cure inflammation.

3. Cinnamon Green Tea: Cinnamon is a commonly used spice globally. It is derived from the inner bark of a small evergreen tree. Adding cinnamon stick or cinnamon powder to the tea enhances its potential. This magical ingredient is believed to reduce the risk of cardiovascular disease, improves digestion, and keeps a check on diabetes among other health benefits.

Inputs by Nutritionist Tripti Tandon

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Need better immunity? Try these teas! - Hindustan Times