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The Best Face and Body Skin-Care Products for 2020 – Shape Magazine

April 18th, 2020 7:41 am

When our panelists were asked which innovation showed the best results, scalp injections of platelet-rich plasma (PRP) for hair growth was at the top of many lists. You get significant benefits with very little downside, Dr. Schultz says. First, your blood is drawn and spun in a centrifuge to separate the PRP, which is then injected all over your scalp. Using your bloods growth factors to stimulate collagen and follicles lets your own body work its magic, says dermatologist Mona Gohara, M.D.

Another new option is a laser called Lutronic KeraLase ($750 to $1,000 per treatment), which is paired with a synthetic growth factor serum. The device stamps across your scalp, stimulating the area and creating tiny channels in the follicles, where the serum is then applied. It delivers active ingredients where theyre needed, says dermatologist Jeanine Downie, M.D. The serum can contain even more growth factors than a persons own PRP, plus stem cells to help hair growth, she says. Nutrafol for Women (Buy It, $79 $88 for 1 month, nutrafol.com), a supplement brand for hair loss, also garnered multiple mentions from our panel. Ive seen promising results, especially in conjunction with the above treatments, Dr. Downie says.

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Researchers Move Closer to Industrial Production of Heparin in Cell Culture – Genetic Engineering & Biotechnology News

April 17th, 2020 2:47 am

Scientists at the University of California-San Diego say they have moved one step closer to the ability to make heparin in cultured cells. Heparin is a potent anti-coagulant and the most prescribed drug in hospitals, yet cell-culture-based production of heparin is currently not possible, according to the researchers who published their study, ZNF263 is a transcriptional regulator of heparin and heparan sulfate biosynthesis in PNAS.

In particular, the researchers found a critical gene in heparin biosynthesis: ZNF263 (zinc-finger protein 263). The team believes this gene regulator is a key discovery on the way to industrial heparin production. The idea would be to control this regulator in industrial cell lines using genetic engineering, paving the way for safe industrial production of heparin in well-controlled cell culture.

Heparin is the most widely prescribed biopharmaceutical in production globally. Its potent anticoagulant activity and safety makes it the drug of choice for preventing deep vein thrombosis and pulmonary embolism. In 2008, adulterated material was introduced into the heparin supply chain, resulting in several hundred deaths and demonstrating the need for alternate sources of heparin. Heparin is a fractionated form of heparan sulfate derived from animal sources, predominantly from connective tissue mast cells in pig mucosa. While the enzymes involved in heparin biosynthesis are identical to those for heparan sulfate, the factors regulating these enzymes are not understood, write the investigators.

Examination of the promoter regions of all genes involved in heparin/heparan sulfate assembly uncovered a transcription factor-binding motif for ZNF263, a C2H2 zinc finger protein. CRISPR-mediated targeting and siRNA knockdown of ZNF263 in mammalian cell lines and human primary cells led to dramatically increased expression levels of HS3ST1, a key enzyme involved in imparting anticoagulant activity to heparin, and HS3ST3A1, another glucosaminyl 3-O-sulfotransferase expressed in cells. Enhanced 3-O-sulfation increased binding to antithrombin, which enhanced Factor Xa inhibition, and binding of neuropilin-1. Analysis of transcriptomics data showed distinctively low expression of ZNF263 in mast cells compared with other (nonheparin-producing) immune cells. These findings demonstrate a novel regulatory factor in heparan sulfate modification that could further advance the possibility of bioengineering anticoagulant heparin in cultured cells.

The UC San Diego scientists reasoned that heparin synthesis must be under the control of transcription factors, whose tissue-specific occurrence might give mast cells the unique ability to produce heparin. Since regulators for heparin were not known, a research team led by UC San Diego professors Jeffrey Esko, PhD, and Nathan Lewis, PhD, used bioinformatic software to scan the genes encoding enzymes involved in heparin production and specifically look for sequence elements that could represent binding sites for transcription factors. The existence of such a binding site could indicate that the respective gene is regulated by a corresponding gene regulator protein, i.e. a transcription factor.

One DNA sequence that stood out the most is preferred by a transcription factor called ZNF263 (zinc-finger protein 263), explains Lewis, who holds appointments in the UC San Diego School of Medicines Department of Pediatrics and in the UC San Diego Jacobs School of Engineerings Department of Bioengineering.

Using CRISPR/Cas9, the researchers mutated ZNF263 in a human cell line that normally does not produce heparin. They found that the heparan sulfate that this cell line would normally produce was now chemically altered and showed a reactivity that was closer to heparin. Experiments further showed that ZNF263 represses key genes involved in heparin production. Analysis of gene expression data from human white blood cells showed suppression of ZNF263 in mast cells (which produce heparin in vivo) and basophils, which are related to mast cells. The researchers report that ZNF263 appears to be an active repressor of heparin biosynthesis throughout most cell types, and mast cells are enabled to produce heparin because ZNF263 is suppressed in these cells.

This finding could have important relevance in biotechnology. Cell lines used in industry (such as CHO cells that normally are unable to produce heparin) could be genetically modified to inactivate ZNF263 which could enable them to produce heparin, like mast cells do.

Philipp Spahn, PhD, a project scientist in the Lewis lab, described further directions the team is pursuing: Our bioinformatic analysis revealed several additional potential gene regulators which can also contribute to heparin production and are now exciting objects of further study.

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Better Predicting the Unpredictable Byproducts of Genetic Modification – NC State News

April 17th, 2020 2:47 am

Researchers are interested in genetically modifying trees for a variety of applications, from biofuels to paper production. They also want to steer clear of modifications with unintended consequences. These consequences can arise when intended modifications to one gene results in unexpected changes to other genes. A new model aims to predict these changes, helping to avoid unintended consequences, and hopefully paving the way for more efficient research in the fields of genetic modification and forestry.

The research at issue focuses on lignin, a complex material found in trees that helps to give trees their structure. It is, in effect, what makes wood feel like wood.

Whether you want to use wood as a biofuel source or to create pulp and paper products, there is a desire to modify the chemical structure of lignin by manipulating lignin-specific genes, resulting in lignin that is easier to break down, says Cranos Williams, corresponding author of a paper on the work and an associate professor of electrical and computer engineering at NCState. However, you dont want to make changes to a trees genome that compromise its ability to grow or thrive.

The researchers focused on a tree called Populus trichocarpa, which is a widely used model organism meaning that scientists who study genetics and tree biology spend a lot of time studying P. trichocarpa.

Previous research generated models that predict how independent changes to the expression of lignin genes impacted lignin characteristics, says Megan Matthews, first author of the paper, a former Ph.D. student at NCState and a current postdoc at the University of Illinois. These models, however, do not account for cross-regulatory influences between the genes. So, when we modify a targeted gene, the existing models do not accurately predict the changes we see in how non-targeted genes are being expressed. Not capturing these changes in expression of non-targeted genes hinders our ability to develop accurate gene-modification strategies, increasing the possibility of unintended outcomes in lignin and wood traits.

To address this challenge, we developed a model that was able to predict the direct and indirect changes across all of the lignin genes, capturing the effects of multiple types of regulation. This allows us to predict how the expression of the non-targeted genes is impacted, as well as the expression of the targeted genes, Matthews says.

Another of the key merits of this work, versus other models of gene regulation, is that previous models only looked at how the RNA is impacted when genes are modified, Matthews says. Those models assume the proteins will be impacted in the same way, but thats not always the case. Our model is able to capture some of the changes to proteins that arent seen in the RNA, or vice versa.

This model could be incorporated into larger, multi-scale models, providing a computational tool for exploring new approaches to genetically modifying tree species to improve lignin traits for use in a variety of industry sectors.

In other words, by changing one gene, researchers can accidentally mess things up with other genes, creating trees that arent what they want. The new model can help researchers figure out how to avoid that.

The paper, Modeling cross-regulatory influences on monolignol transcripts and proteins under single and combinatorial gene knockdowns in Populus trichocarpa, is published in the journal PLOS Computational Biology. The paper was co-authored by Ronald Sederoff, a professor emeritus of forestry and environmental resources at NCState; Jack Wang, an assistant professor of forestry and environmental resources at NCState; and Vincent Chiang, a Jordan Family Distinguished Professor Emeritus and Alumni Outstanding Research Professor with the Forest Biotechnology Group at NCState.

This work was supported by the National Science Foundation Grant DBI-0922391 to Chiang and by a National Physical Science Consortium Graduate Fellowship to Matthews.

-shipman-

Note to Editors: The study abstract follows.

Modeling cross-regulatory influences on monolignol transcripts and proteins under single and combinatorial gene knockdowns in Populus trichocarpa

Authors: Megan L. Matthews, Ronald Sederoff and Cranos M. Williams, North Carolina State University; Jack P. Wang and Vincent L. Chiang, Northeast Forestry University, Harbin, China, and North Carolina State University

Published: April 10, PLOS Computational Biology

Abstract: Accurate manipulation of metabolites in monolignol biosynthesis is a key step for controlling lignin content, structure, and other wood properties important to the bioenergy and biomaterial industries. A crucial component of this strategy is predicting how single and combinatorial knockdowns of monolignol specific gene transcripts influence the abundance of monolignol proteins, which are the driving mechanisms of monolignol biosynthesis. Computational models have been developed to estimate protein abundances from transcript perturbations of monolignol specific genes. The accuracy of these models, however, is hindered by their inability to capture indirect regulatory influences on other pathway genes. Here, we examine the manifestation of these indirect influences on transgenic transcript and protein abundances, identifying putative indirect regulatory influences that occur when one or more specific monolignol pathway genes are perturbed. We created a computational model using sparse maximum likelihood to estimate the resulting monolignol transcript and protein abundances in transgenicPopulus trichocarpabased on targeted knockdowns of specific monolignol genes. Using in-silicosimulations of this model and root mean square error, we showed that our model more accurately estimated transcript and protein abundances, in comparison to previous models, when individual and families of monolignol genes were perturbed. We leveraged insight from the inferred network structure obtained from our model to identify potential genes, including PtrHCT, PtrCAD, and Ptr4CL, involved in post-transcriptional and/or post-translational regulation. Our model provides a useful computational tool for exploring the cascaded impact of single and combinatorial modifications of monolignol specific genes on lignin and other wood properties.

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Model warns of genetic modification gone awry in trees – Futurity: Research News

April 17th, 2020 2:47 am

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A new model aims to predict genetic changes that have unintended consequences in trees that researchers genetically modify.

It could pave the way for more efficient research in the fields of both genetic modification and forestry.

Researchers want to genetically modify trees for a variety of applications, from biofuels to paper production. They also want to steer clear of modifications to one gene that result in unexpected changes to other genes.

The research at issue focuses on lignin, a complex material found in trees that helps to give trees their structure. It is, in effect, what makes wood feel like wood.

Whether you want to use wood as a biofuel source or to create pulp and paper products, there is a desire to modify the chemical structure of lignin by manipulating lignin-specific genes, resulting in lignin that is easier to break down, says corresponding author Cranos Williams, an associate professor of electrical and computer engineering at North Carolina State University. However, you dont want to make changes to a trees genome that compromise its ability to grow or thrive.

The researchers focused on a tree called Populus trichocarpa, which is a widely used model organismmeaning that scientists who study genetics and tree biology spend a lot of time studying P. trichocarpa.

Previous research generated models that predict how independent changes to the expression of lignin genes impacted lignin characteristics, says Megan Matthews, first author of the paper, a former PhD student at NC State, and a current postdoctoral researcher at the University of Illinois.

These models, however, do not account for cross-regulatory influences between the genes. So, when we modify a targeted gene, the existing models do not accurately predict the changes we see in how non-targeted genes are being expressed. Not capturing these changes in expression of non-targeted genes hinders our ability to develop accurate gene-modification strategies, increasing the possibility of unintended outcomes in lignin and wood traits.

To address this challenge, we developed a model that was able to predict the direct and indirect changes across all of the lignin genes, capturing the effects of multiple types of regulation. This allows us to predict how the expression of the non-targeted genes is impacted, as well as the expression of the targeted genes, Matthews says.

Another of the key merits of this work, versus other models of gene regulation, is that previous models only looked at how the RNA is impacted when genes are modified, Matthews says. Those models assume the proteins will be impacted in the same way, but thats not always the case. Our model is able to capture some of the changes to proteins that arent seen in the RNA, or vice versa.

This model could be incorporated into larger, multi-scale models, providing a computational tool for exploring new approaches to genetically modifying tree species to improve lignin traits for use in a variety of industry sectors.

In other words, by changing one gene, researchers can accidentally mess things up with other genes, creating trees that arent what they want. The new model can help researchers figure out how to avoid that.

The paper appears in the journal PLOS Computational Biology. Support for the work came from the National Science Foundation and a National Physical Science Consortium Graduate Fellowship.

Source: NC State

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University of Arkansas Biologists Receive NSF CAREER Awards – University of Arkansas Newswire

April 17th, 2020 2:47 am

University Relations

Sarah DuRant and Jeffrey Lewis, assistant professors of biology, were awarded major early career awards by the National Science Foundation.

FAYETTEVILLE, Ark. Two researchers Sarah DuRant and Jeffrey Lewis from the Department of Biological Sciences in the J. William Fulbright College of Arts and Sciences recently received Faculty Early Career Development Awards from the National Science Foundation. DuRant, an assistant professor, received $1.5 million, while Lewis, also an assistant professor, received $1.2 million.

Known as CAREER awards, they are the NSF's most prestigious award for early-career faculty who have the potential to serve as academic role models in research and education and to lead advances in the mission of their department or organization. The awards are for five years and include teaching and public-outreach components.

Working with domestic canaries, DuRant plans to study the effects of disease on avian parental care behaviors and subsequent offspring responses to disease, including likelihood of disease transmission.

"In the world of the disease, a lot of focus is on how mothers, when they are exposed to a pathogen, develop antibodies to the pathogen and can pass them along to the offspring," she said. "One of the things I am interested in how behavior is shaping the immune phenotype of the offspring."

A pathogen can affect reproductive traits in parents such as incubation behaviors, DuRant explained, which in turn shape how an offspring responds to pathogens. "Ultimately what can happen is that how any individual responds to the pathogen can start to shape pathogen growth, transmission and virulence."

Lewis is studying how organisms with different genetic makeups respond differently to environmental stress. Using brewer's yeast, he will try to unlock the reasons why some strains are more sensitive to high levels of stresses such as ethanol than others.

"In pretty much every organism, if you expose them to mild stress there are a bunch of stress-protective proteins that get turned on," he said. "The thought has long been that this response is for adapting to that initial stress. But the genes getting turned on by stress seemed largely dispensable for stress survival. The big question was why is the cell turning these genes on if they are not required to protect cell from insult that provoked the response?"

It turns out that the function of the proteins is, in part, to protect the cell against future severe stress, "analogous to vaccinating the cell," he said.

Yeast cells are easy to grow and manipulate with genetic engineering, he added, making them a good test subject for identifying the genes necessary for acquiring resistance to severe stress. "We can grow billions of them really easily and do high-throughput genetics really easily."

A side benefit is that the research could lead to improved yeast strains for brewing beer. "Some strains do better withstanding brewing stresses than others. We will have students analyze and incorporate genomic data and gain experience with that."

Both DuRant and Lewis are in the first year of the five-year CAREER funding cycle.

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Next-generation gene-editing technology: Path to a second Green Revolution? – Genetic Literacy Project

April 17th, 2020 2:47 am

One of the major limitations of the first-generation rDNA-based GM methods is the randomness of DNA insertions into plant genomes, just as the earlier mutagenesis methods introduced mutations randomly. The newer methods increase the specificity and precision with which genetic changes can be made. Known under the general rubric of sequence-specific nuclease (SSN) technology or gene/genome-editing, this approach uses proteins or protein-nucleic acid complexes that bind to and cut specific DNA sequences.1 SSNs include transcription activator-like effector nucleases (TALENs), zinc-finger nucleases (ZFNs), and meganucleases.2

[This is part three of a four-part series on the progress of agricultural biotechnology. Read part one and part two.]

The DNA cuts made by SSNs are repaired by cellular processes that often either change one to several base pairs or introduce deletions and/or insertions (aka indels) at the target site. Another recently added technology capable of editing gene sequences is termed oligonucleotide-directed mutagenesis (ODM) and uses short nucleic acid sequences to target mutations to selected sites.3

The hottest and the coolest

What is rapidly emerging as the most powerful of the SSN technologies is known by the uninformative acronym CRISPR/Cas, which contracts the unwieldy designation clustered regularly interspaced short palindromic repeats (CRISPR)CRISPR-associated protein (Cas9). Its based on a bacterial defense system against invading viruses and promises extraordinary versatility in the kinds of genome changes that it can make.1,4

The CRISPR/Cas editing molecular machine is comprised of an enzyme (Cas9 and other variants) that binds an RNA molecule (called the guide RNA or gRNA) whose sequence guides the complex to the matching genomic sequence, allowing the Cas9 enzyme to introduce a double-strand break within the matching sequence. The CRISPR/Cas system can be used to edit gene sequences, to introduce a gene or genes at a pre-identified site in the genome, and to edit multiple genes simultaneously, none of which could be done with rDNA methods.1,5

Many of the genetic changes created using either SSN or ODM are indistinguishable at the molecular level from those that occur in nature or are produced by mutation breeding. Since both spontaneous mutants and chemical- and radiation-induced mutants have been used in crop improvement without regulation, there is no scientific rationale for regulating mutants produced by the newer methods. In hopes of creating a distinction that will permit exemption of gene-edited crops from regulation, the newer methods are increasingly referred to as new plant breeding techniques (NPBTs or just NBTs).

Quick successes for NBTs?

Prime targets of gene editing are cellular proteins that are involved in pathogenesis.6 Virus reproduction requires the recruitment of cellular proteins for replication, transcription and translation. There can be sufficient redundancy in the requisite protein infrastructure so that partial or complete virus resistance can be achieved by disrupting genes that code for proteins required for viral replication without damaging crop productivity.

For example, work with mutants of the model plant Arabidopsis identified translation initiation factor eIF4E as required for potyvirus translation. CRISPR/Cas-induced point mutations and deletions have recently been reported to enhance viral resistance not only in Arabidopsis, but in cucumber and cassava, as well.7

The many ways that plants and their bacterial and fungal pathogens interact offer opportunities to use gene editing to enhance plant disease resistance and reduce agricultures dependence on chemical control agents.6 The two main strategies are to inactivate genes whose products render the host plant sensitive to pathogen invasion and to enhance the ability of the host plant to resist invasion by providing functional resistance factors they lack.

An example of the former is provided by the mildew resistance resulting from the inactivation of all three homeoalleles of the mildew resistance locus (MLO) of hexaploid wheat.8 The efficiency of targeting both multiple alleles and multiple loci has taken a further jump with the development of multiplexed gene editing using vectors carrying several gRNA sequences capable of being processed by cellular enzymes to release all of them. This allows the gRNAs to edit multiple genes simultaneously.9

The second approach is to capitalize on the formidable arsenal of resistance genes residing in plant genomes.10 Fungal resistance genes have long been a major target of breeders efforts and have proved frustratingly short-lived, as pathogens rapidly evolve to evade recognition.11 While desirable resistance genes missing from domesticated crops still reside in wild relatives, extracting them by conventional breeding methods can be time-consuming or impossible.

European academic researchers created transgenic potatoes resistant to the late blight (Phytophthora infestans) that caused the Irish potato famine by inserting resistance (R) genes cloned from wild potato species into commercial potato varieties.12 A blight-resistant variety, called the Innate Generation 2 potato, is being commercialized by J.R. Simplot company in the U.S. and Canada and is already being marketed in the U.S. as the White Russet Idaho potato.13 Transgenic disease-resistance traits have been introduced in other crops, but have yet to be commercialized.14

Plant genomes contain hundreds to thousands of potential R genes, but it is not yet possible to determine whether a given one will confer resistance to a particular pathogen. Methods are currently being developed to accelerate the identification and cloning of active ones.14 Once identified, CRISPR/Cas can be used to introduce cassettes carrying multiple R genes, making it possible to create more durable resistance than can be achieved by introducing a single R gene through conventional breeding14. Finally, direct editing of resident inactive R genes using a ribonucleoprotein (RNP) strategy that avoids creating a transgenic plant may prove useful, although no such products appear to be in the pipeline to commercialization at present.15,16

Multiplexed editing has proved particularly useful for editing genes in polyploid species. For example, Cas9/sgRNA-mediated knockouts of the six fatty acid desaturase 2 (FAD2) genes of allohexaploid Camelina sativa was reported to markedly improve the fatty acid composition of Camelina oil.17 Using a different approach, Yield10 Biosciences is moving toward commercialization of a high-oil Camelina developed by editing a negative regulator of acetyl-CoA carboxylase.18

As of this writing, the only gene-edited product that has been commercialized is a soybean oil with no trans-fat, trademarked Calyno, developed by Calyxt.19 Gene-edited crops that have been approved but not commercialized or are still in the regulatory pipeline include miniature tomatoes, high-fiber wheat, high-yield tomatoes, improved quality alfalfa, non-browning potatoes and mushrooms, as well as high starch-content and drought-resistant corn, most being developed by small biotech companies.19

Getting beyond the low-hanging fruit

It is becoming increasingly clear that yield increases in our major crops by traditional breeding approaches are not keeping pace with demand.20 The gap is likely to widen as climate warming moves global temperatures farther from those prevailing when our crops were domesticated.

Overexpression of stress-related transcription factors has been reported to increase yields under water-stress conditions, but such increases are generally not maintained under optimal conditions.21 Monsantos drought-tolerant (Genuity DroughtGard) corn hybrids are based on the introduction of bacterial chaperone genes.22 Fortunately, research into drought stress tolerance in wheat and other grains continues apace, although no drought-tolerant varieties have yet reached farmers.23

Real progress on crop yield is slow. What stands in the way is that we have so limited an understanding of how plants work at the molecular level. At every level of analysis, organisms are redundant networks of interconnected proteins that adjust their manifold physical and enzymatic interactions in response to internal signals and external stimuli, then send messages to the information storage facilities (DNA) to regulate their own production and destruction rates.

As well, many genes are present in families of between two and hundreds or thousands of similar members, making it difficult to determine either the function or the contribution of any given member to a complex trait such as stress tolerance or yield. That said, gene family functions are identifiable and some, such as transcription factor genes, encode proteins that influence multiple other genes, making them among the likeliest candidates for manipulation. Indeed, studies on the genetics of domestication often point to changes in transcription factor genes.24

But while there have been reports that constitutive overexpression of single transcription factor gene can increase grain yield in both wheat and maize, none appear to have been commercialized yet.25 The challenge of developing a yield-improved variety by simply overexpressing transcription factor genes is illustrated by a recent report from Corteva.26 It describes a tour-de-force involving generation and testing of countless transgenic plants to identify a single transcription factor gene, ZMM28, that reproducibly increased yield when incorporated into 48 different hybrids and tested over a 4-year period in 58 locations.26

Getting there by a different route

Might gene-editing facilitate the task of generating and identifying yield-enhancing genetic variation? While the CRISPR/Cas toolkit is growing at dizzying speed, its utility in crop improvement has so far been limited to the simple traits controlled by individual genes, albeit including multiple alleles.1,27

Crop domestication and plant breeding have vastly narrowed genetic diversity because the very process of selecting plants with enhanced traits imposes a bottleneck, assuring that only a fraction of the ancestral populations genetic diversity is represented in a new elite variety. This, in turn, limits what can be done by mutagenizing existing elite varieties, a process that is also burdened with the necessity to eliminate deleterious mutations through back-crossing.

But to widen the genetic base and to modify genes that contribute to quantitative traits, it is still first necessary to identify the genes that contribute to agronomically important traits. Identifying such genes is currently a slow and tedious process of conventional and molecular mapping.28 A recent report describes a method for combining pedigree analysis with targeted CRISPR/Cas-mediated knockouts that promises to markedly accelerate the identification of the individual contributing genes in the chromosomal regions that are associated with quantitative traits, technically known as quantitative trait loci (QTLs).29

Even as the QTL knowledge gap narrows, gRNA multiplexing is extending the power of SSNs to understanding and modifying complex traits in crop plants. For example, using multiplexed gRNAs, Cas nuclease was simultaneously targeted to three genes known to be negative regulators of grain weight in rice.30 The triple mutants were reported to exhibit increases in the neighborhood of 25% in each of the three grain weight traits: length, width and thousand grain weight.

In another study, 8 different genes affecting rice agronomic traits were targeted with a single multiplexed gRNA construct and all showed high mutation efficiencies in the first generation.31 Conversely, it has been reported that editing the same QTLs gives different outcomes in different elite varieties, improving yield in some but not other.32

Mutations affecting the expression of regulatory genes, such as transcription factors genes, account for a substantial fraction of the causative genetic changes during crop domestication.33 Multiplexed gRNAs constructs targeting cis-regulatory elements (CREs) have been used to generate large numbers of allelic variants of genes affecting fruit size in tomato, mimicking some of the mutations accumulated during domestication and breeding of contemporary tomato varieties.34

Knowledge of domestication genes can also be used to accelerate domestication of wild plants that retain traits of value, such as salt tolerance, as reported for tomato.35 This opens the possibility of rapidly domesticating wild species better adapted to the harsher climate conditions of the future.

While the above-described advances have been based on the CRISPR/Cas-mediated deletions, approaches to more precise sequence editing are developing as well. While Cas-generated cuts in the DNA are most commonly repaired by the non-homologous end joining pathway (NHEJ), the less frequent homology-directed repair pathway (HDR) has been shown to edit sequences at useful frequencies using Cas-gRNA ribonucleoprotein complexes.15,36

As well, mutant Cas9 proteins lacking nuclease activity have been fused with base-editing enzymes such as cytidine and adenosine deaminases to direct gene editing without DNA cleavage.37,38 This approach can change single base pairs precisely in both coding and non-coding regions, as well alter mRNA precursor processing sites.38 Finally, the sequence targeting properties of the CRISPR-Cas system can be used to deliver other types of hybrid proteins to target sequences to regulate gene expression and DNA methylation.27

In sum, the many variations on gene editing now developing hold the promise of revolutionizing crop breeding, prompting several colleagues to whimsically title a recent review of CRISPR/Cas-based methodology: Plant breeding at the speed of light.39 And indeed, the new methods make it possible to replace chemicals with biological mechanisms in protecting plants from pests and disease, as well as increase their resilience to stress.

That said, extraordinary progress in increasing grain yields has already been accomplished by what are now considered to be traditional breeding methods and increased fertilizer use. Further improvements continue, but will likely be harder won than the many-fold increases in corn, wheat and rice yields of the last century and its Green Revolution. But there is a persistent disconnect between what can be done to accelerate plant breeding using the new gene-editing toolkit and what is actually being done by both the public and private sectors to get varieties improved by these methods out to farmers.

1Zhang Y et al. (2019). The emerging and uncultivated potential of CRISPR technology in plant science. Nature Plants 5:778-94.

2Podevin N et al. (2013). Site-directed nucleases: a paradigm shift in predictable, knowledge-based plant breeding. Trends Biotechnol 31:375-83.

3Sauer NJ et al. (2016). Oligonucleotidedirected mutagenesis for precision gene editing. Plant Biotechnol J 14:496-502.

4Zhang D et al. (2016). Targeted gene manipulation in plants using the CRISPR/Cas technology. J Genet Genomics 43:251-62.

5Cong L et al. (2013). Multiplex genome engineering using CRISPR/Cas systems. Science 339:819-23.

6Borrelli VM et al. (2018). The enhancement of plant disease resistance using CRISPR/Cas9 technology. Frontiers Plant Sci 9:Article 1245.

7Chandrasekaran J et al. (2016). Development of broad virus resistance in nontransgenic cucumber using CRISPR/Cas9 technology. Molec Plant Pathol 17:1140-53; Pyott DE et al. (2016). Engineering of CRISPR/Cas9mediated potyvirus resistance in transgenefree Arabidopsis plants. Molec Plant Pathol 17:1276-88; Gomez MA et al. (2019). Simultaneous CRISPR/Cas9mediated editing of cassava eIF 4E isoforms nCBP1 and nCBP2 reduces cassava brown streak disease symptom severity and incidence. Plant Biotechnol J 17:421-34.

8Wang Y et al. (2014). Simultaneous editing of three homoeoalleles in hexaploid bread wheat confers heritable resistance to powdery mildew. Nature Biotechnol 32:947.

9Xie K et al. (2015). Boosting CRISPR/Cas9 multiplex editing capability with the endogenous tRNA-processing system. Proc Natl Acad Sci 112:3570-5; Wang W et al. (2018). Transgenerational CRISPR-Cas9 activity facilitates multiplex gene editing in allopolyploid wheat. The CRISPR J 1:65-74.

10Petit-Houdenot Y and Fudal I (2017). Complex interactions between fungal avirulence genes and their corresponding plant resistance genes and consequences for disease resistance management. Frontiers Plant Sci 8:1072.

11Bebber DP and Gurr S (2015). Crop-destroying fungal and oomycete pathogens challenge food security. Fungal Genet Biol 74:62-4; van Esse HP et al. (2020). Genetic modification to improve disease resistance in crops. New Phytol 225:70-86.

12Jones JD et al. (2014). Elevating crop disease resistance with cloned genes. Phil Trans Royal Soc B: Biol Sci 369:20130087; Haesaert G et al. (2015). Transformation of the potato variety Desiree with single or multiple resistance genes increases resistance to late blight under field conditions. Crop Protection 77:163-75.

13Halsall M. Innate outlook. Spudsmart, 24 April 2019 https://spudsmart.com/innate-outlook/

14Dong OX and Ronald PC (2019). Genetic engineering for disease resistance in plants: recent progress and future perspectives. Plant Physiol 180:26-38.

15Svitashev S et al. (2016). Genome editing in maize directed by CRISPRCas9 ribonucleoprotein complexes. Nature Communications 7:1-7.

16Mao Y et al. (2019). Gene editing in plants: progress and challenges. Nat Sci Rev 6:421-37.

17Morineau C et al. (2017). Selective gene dosage by CRISPRCas9 genome editing in hexaploid Camelina sativa. Plant Biotechnol J 15:729-39; Jiang WZ et al. (2017). Significant enhancement of fatty acid composition in seeds of the allohexaploid, Camelina sativa, using CRISPR/Cas9 gene editing. Plant Biotechnol J 15:648-57.

18Yield10 Bioscience (Jan 16, 2020 ). Yield10 Bioscience submits Am I Regulated? letter to USDA-APHIS BRS for CRISPR genome-edited C3007 in Camelina to pave the way for U.S. field tests. https://www.globenewswire.com/news-release/2020/01/16/1971418/0/en/Yield10-Bioscience-Submits-Am-I-Regulated-Letter-to-USDA-APHIS-BRS-for-CRISPR-Genome-Edited-C3007-in-Camelina-to-Pave-the-Way-for-U-S-Field-Tests.html

19Genetic Literacy Project (2020). Global Gene Editing Regulation Tracker. https://crispr-gene-editing-regs-tracker.geneticliteracyproject.org/united-states-crops-food/

20Ray DK et al. (2013). Yield trends are insufficient to double global crop production by 2050. PloS One 8:e66428.

21Rice EA et al. (2014). Expression of a truncated ATHB17 protein in maize increases ear weight at silking. PLoS One 9:e94238; Araus JL et al. (2019). Transgenic solutions to increase yield and stability in wheat: shining hope or flash in the pan? J Experimental Bot 70:1419-24.

22Castiglioni P et al. (2008). Bacterial RNA chaperones confer abiotic stress tolerance in plants and improved grain yield in maize under water-limited conditions. Plant Physiol 147:446-55.

23Mwadzingeni L et al. (2016). Breeding wheat for drought tolerance: Progress and technologies. J Integrative Agricult 15:935-43; Sallam A et al. (2019). Drought stress tolerance in wheat and barley: Advances in physiology, breeding and genetics research. Internat J Mol Sci 20:3137.

24Swinnen G et al. (2016). Lessons from domestication: targeting cis-regulatory elements for crop improvement. Trends Plant Sci 21:506-15.

25Nelson DE et al. (2007). Plant nuclear factor Y (NF-Y) B subunits confer drought tolerance and lead to improved corn yields on water-limited acres. Proc Natl Acad Sci 104:16450-5; Qu B et al. (2015). A wheat CCAAT box-binding transcription factor increases the grain yield of wheat with less fertilizer input. Plant Physiol 167:411-23; Yadav D et al. (2015). Constitutive overexpression of the TaNF-YB4 gene in transgenic wheat significantly improves grain yield. J Experiment Bot 66:6635-50.

26Wu J et al. (2019). Overexpression of zmm28 increases maize grain yield in the field. Proc Natl Acad Sci 116:23850-8.

27Chen K et al. (2019). CRISPR/Cas genome editing and precision plant breeding in agriculture. Annu Rev Plant Biol 70:667-97.

28Cavanagh C et al. (2008). From mutations to MAGIC: resources for gene discovery, validation and delivery in crop plants. Curr Opin Plant Biol 11:215-21.

29Huang J et al. (2018). Identifying a large number of high-yield genes in rice by pedigree analysis, whole-genome sequencing, and CRISPR-Cas9 gene knockout. Proc Natl Acad Sci 115:E7559-E67.

30Xu R et al. (2016). Rapid improvement of grain weight via highly efficient CRISPR/Cas9-mediated multiplex genome editing in rice. J Genet Genom 43:529.

31Shen L et al. (2017). Rapid generation of genetic diversity by multiplex CRISPR/Cas9 genome editing in rice. China Sci Life Sci 60:506-15.

32Shen L et al. (2018). QTL editing confers opposing yield performance in different rice varieties. J Integrative Plant Biol 60:89-93; Zhou J et al. (2019). Multiplex QTL editing of grain-related genes improves yield in elite rice varieties. Plant Cell Rep 38:475-85.

33Meyer RS and Purugganan MD (2013). Evolution of crop species: genetics of domestication and diversification. Nature Rev Genet 14:840-52.

34Rodrguez-Leal D et al. (2017). Engineering quantitative trait variation for crop improvement by genome editing. Cell 171:470-80. e8.

35Li T et al. (2018). Domestication of wild tomato is accelerated by genome editing. Nature Biotechnol 36:1160-3; Zsgn A et al. (2018). De novo domestication of wild tomato using genome editing. Nature Biotechnol 36:1211-6.

36Puchta H et al. (1996). Two different but related mechanisms are used in plants for the repair of genomic double-strand breaks by homologous recombination. Proc Natl Acad Sci 93:5055-60; Zhang Y et al. (2016). Efficient and transgene-free genome editing in wheat through transient expression of CRISPR/Cas9 DNA or RNA. Nature Communications 7:1-8.

37Komor AC et al. (2016). Programmable editing of a target base in genomic DNA without double-stranded DNA cleavage. Nature 533:420-4; Hua K et al. (2019). Expanding the base editing scope in rice by using Cas9 variants. Plant Biotechnol J 17:499-504.

38Kang B-C et al. (2018). Precision genome engineering through adenine base editing in plants. Nature Plants 4:427-31.

39Wolter F et al. (2019). Plant breeding at the speed of light: the power of CRISPR/Cas to generate directed genetic diversity at multiple sites. BMC Plant Biol 19:176.

Nina V. Fedoroff is an Emeritus Evan Pugh Professor at Penn State University

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Three Chinese Vaccines against COVID-19 are on the Way – BioSpace

April 17th, 2020 2:47 am

BEIJING, April 15, 2020 /PRNewswire/ -- According to the latest news from Science and Technology Daily (April 14th), two COVID-19 inactivated vaccines were just approved for a phase I & II combined clinical trial by the National Medical Products Administration (NMPA) of China, making them the first batch in this category. The two vaccines were developed respectively by Wuhan Institute of Biological Products Co., Ltd of Sinopharm and Sinovac Research & Development Co., Ltd together with research institutes.

This is another piece of good news since the team of Chen Wei, academician at China Academy of Engineering and researcher at Academy of Military Medical Sciences, managed to get clinical trial approval for the recombinant COVID-19 vaccine they developed on March 17th.

"We are taking the lead in developing COVID-19 vaccines in a global perspective," said with pride by Wang Junzhi, academician at China Academy of Engineering. Then he proposed four factors for this achievement: early start, accurate direction, being science-based and collaboration from all parts.

Vaccine is not a distant solution for a current emergency, but rather the most powerful weapon to defeat COVID-19.

China made the decision to accelerate the pace based on rational judgement and organization with the premise of safety assurance. As early on January 21st, the Ministry of Science and Technology (MOST) announced the establishment of an expert group of joint epidemic prevention and control against COVID-19. The expert group was led by Zhong Nanshan, academician at China Academy of Engineering, and consisted of 14 experts. On 22nd, the first eight emergency programs of Scientific Response to COVID-19 were initiated swiftly.

The expert group had decided on five directions for vaccine development: inactivated vaccines, genetic engineering subunit vaccines, adenovirus vector vaccines, nucleic acid vaccines, and vaccines using attenuated influenza virus as vectors. All five directions were to be followed at the same time. Eight teams of advantage in vaccine development were singled out to collaborate on this mission with a detailed plan of work nodes accurate to the day.

Thanks to Chen Wei's accurate judgement and accumulation of knowledge and experience in vaccine development, her team was the first to reach breakthrough achievements. In early February, she suggested that COVID-19 remains a coronavirus despite its possible variation. Therefore, mutual target antigen, pathogenesis and receptor could be identified quickly with the help of bioinfomatics and big data mining once the variation appears. And the vaccine development can be improved swiftly accordingly.

Since the start of the program, Chen Wei's team has conducted research on recombinant COVID-19 vaccine (adenovirus vector vaccine) based on the successful experience in Ebola vaccine development with great speed. On March 17th, the team's recombinant COVID-19 vaccine was approved for clinical trial, which took place one month in advance than expected. By April 2nd, all 108 subjects of phase I clinical trial in Wuhan had been inoculated. On 9th, phase II clinical trial, which has a larger scale and introduces placebo control groups, started recruitment for volunteers.

Meanwhile, all other directions have also made progress.

Lei Chaozi, head of Department of Science and Technology of the Ministry of Education, introduced the current achievements: research on the safety and validity of experimental animal for attenuated influenza vector vaccine is ongoing and pre clinical trial research for vaccine candidates and application for clinical trial are expected by the end of April; animal experiments on mice and rabbits regarding recombinant protein vaccine are being conducted and the technology of large-scale production of vaccine with high quality and purity has been mastered; nucleic acid vaccine development is a new technology being explored by the whole world, but no such vaccine has entered the market yet.

At the same time, Wang Junzhi specifically emphasized the safety issue of the vaccine: "On the one hand, Chinese scientists seek to make full use of time with great effort. On the other hand, they conduct research under scientific laws and ensure the safety and validity of the vaccine. All research and development activities are in accordance with corresponding regulations and technological requirements."

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Study: Better Predicting the Unpredictable Byproducts of Genetic Modification – Tdnews

April 17th, 2020 2:47 am

Researchers are interested in genetically modifying trees for a variety of applications, from biofuels to paper production. They also want to steer clear of modifications with unintended consequences. These consequences can arise when intended modifications to one gene results in unexpected changes to other genes. A new model aims to predict these changes, helping to avoid unintended consequences, and hopefully paving the way for more efficient research in the fields of genetic modification and forestry.

The research at issue focuses on lignin, a complex material found in trees that helps to give trees their structure. It is, in effect, what makes wood feel like wood.

Whether you want to use wood as a biofuel source or to create pulp and paper products, there is a desire to modify the chemical structure of lignin by manipulating lignin-specific genes, resulting in lignin that is easier to break down, says Cranos Williams, corresponding author of a paper on the work and an associate professor of electrical and computer engineering at NC State. However, you dont want to make changes to a trees genome that compromise its ability to grow or thrive.

The researchers focused on a tree called Populus trichocarpa, which is a widely used model organism meaning that scientists who study genetics and tree biology spend a lot of time studying P. trichocarpa.

Previous research generated models that predict how independent changes to the expression of lignin genes impacted lignin characteristics, says Megan Matthews, first author of the paper, a former Ph.D. student at NC State and a current postdoc at the University of Illinois. These models, however, do not account for cross-regulatory influences between the genes. So, when we modify a targeted gene, the existing models do not accurately predict the changes we see in how non-targeted genes are being expressed. Not capturing these changes in expression of non-targeted genes hinders our ability to develop accurate gene-modification strategies, increasing the possibility of unintended outcomes in lignin and wood traits.

To address this challenge, we developed a model that was able to predict the direct and indirect changes across all of the lignin genes, capturing the effects of multiple types of regulation. This allows us to predict how the expression of the non-targeted genes is impacted, as well as the expression of the targeted genes, Matthews says.

Another of the key merits of this work, versus other models of gene regulation, is that previous models only looked at how the RNA is impacted when genes are modified, Matthews says. Those models assume the proteins will be impacted in the same way, but thats not always the case. Our model is able to capture some of the changes to proteins that arent seen in the RNA, or vice versa.

This model could be incorporated into larger, multi-scale models, providing a computational tool for exploring new approaches to genetically modifying tree species to improve lignin traits for use in a variety of industry sectors.

In other words, by changing one gene, researchers can accidentally mess things up with other genes, creating trees that arent what they want. The new model can help researchers figure out how to avoid that.

The paper, Modeling cross-regulatory influences on monolignol transcripts and proteins under single and combinatorial gene knockdowns in Populus trichocarpa, is published in the journal PLOS Computational Biology. The paper was co-authored by Ronald Sederoff, a professor emeritus of forestry and environmental resources at NC State; Jack Wang, an assistant professor of forestry and environmental resources at NC State; and Vincent Chiang, a Jordan Family Distinguished Professor Emeritus and Alumni Outstanding Research Professor with the Forest Biotechnology Group at NC State.

This work was supported by the National Science Foundation Grant DBI-0922391 to Chiang and by a National Physical Science Consortium Graduate Fellowship to Matthews.

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Despite Qualms, Arthritis Drug Is to Be Tested in Coronavirus Study – The New York Times

April 17th, 2020 2:45 am

An Eli Lilly drug for rheumatoid arthritis carries a warning on its label saying patients with infections should not take it because it can make infections worse. Yet the National Institutes of Health is about to test it in people hospitalized with coronavirus infections.

The study, whose innovative design is meant to find out fast what works, began at the end of February with the antiviral drug remdesivir made by Gilead Sciences. Four hundred patients have been treated either with remdesivir or a placebo. The results are now being analyzed and will be known within a few weeks.

Then the study will move on to baricitinib, made by Eli Lilly and Company, the company said.

Jennifer Routh, a spokeswoman at the National Institute of Allergy and Infectious Diseases, confirmed that the drug would now be tested in the federal trial but said the institute could offer no further comment.

Dan Skovronsky, chief scientific officer at Lilly, explained how and why baricitinib was chosen.

In February, when the new coronavirus was emerging as a pandemic threat, a company in the United Kingdom called Benevolent AI began using its artificial intelligence system to look for approved drugs that could possibly help people with coronavirus infections. It pointed toward baricitinib precisely because it suppresses the immune system. That, the company suggested, might allow it to quell a cytokine storm, a disastrous immune system response that kills patients.

As a coronavirus infection progresses, the amount of the virus infecting cells does not appear to be extremely high. But the immune system in some people goes into overdrive, sending out vast amounts of small proteins cytokines that trigger inflammation. Cytokine storms can kill patients with other diseases, including flu. This immune overreaction, some scientists think, could explain why some people infected with coronavirus have only mild symptoms while others have severe or fatal illnesses.

Benevolent AI also noted another potential advantage of baricitinib, said Dr. Vincent Marconi of Emory University, a key investigator in the federal trial. The drug might have anti-viral activity. That, plus the chance of subduing cytokine storms, Dr. Marconi said, made a compelling case for baricitinib to be explored further in a clinical trial.

At Lilly, executives were a bit skeptical.

Our initial reaction was, Does it make sense to immunosuppress when patients are trying to fight off an infection? Dr. Skovronsky said. The warning label on the drug, he added, tempered our enthusiasm.

As Covid-19 spread, some doctors started giving patients the drug anyway. It is a pill and there is a huge supply, making it easy for doctors to prescribe it off-label.

Dr. Skovronsky and his colleagues at Lilly were concerned.

We are extremely cautious, said Patrik Jonsson, Lillys president of biomedicines. We cannot encourage use.

But such warnings were not enough.

In desperate times, doctors are trying everything, Dr. Skovronsky said. Various drugs are just being tried on patients in clinical trials without a control. It is really hard to interpret those kinds of data.

The company realized it had to accept the offer to contribute its drug for the federal trial.

Dr. Andre Kalil, a principal investigator in the federal trial, urged doctors and patients to refrain from using baricitinib until the results of the federal trial are known, which should be in a matter of months.

This is a drug that has never been used before in this situation, he said. That is why it needs to be tested in a randomized clinical trial. We dont know if it will help or harm. We have so much uncertainty.

The final design of the next phase of the federal trial is still being worked out, but the expectation is that it will include 600 to 800 patients, Dr. Marconi said. If the first phase of the study finds that remdesivir seems to help patients, half of the patients in the second phase will take remdesivir plus a placebo pill, and half will get remdesivir plus baricitinib.

If remdesivir is no better than or even worse than placebo a very real possibility given the progress so far of a company-sponsored study in China one group of patients will get a placebo pill and the other group will get baricitinib.

We are looking for a strong effect, Dr. Skovronsky said. If it works, it will be big. If it doesnt, we will move on.

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GSU researchers: Lab tests with rheumatoid arthritis drug reduce or eliminate COVID-19 from human cells – 11Alive.com WXIA

April 17th, 2020 2:45 am

ATLANTA Georgia State University researchers report potential progress in identifying a medicine that can help people who are infected with COVID-19, by reducing symptoms, or even getting rid of the virus altogether.

The research team, led by Dr. Mukesh Kumar, said the drug - in lab tests- attacks and kills coronavirus that has infected human cells.

So when we treat the cells with this drug, Dr. Kumar said Wednesday, the virus completely goes away. And all the inflammation that we see with the untreated cell also goes away. So thats very significant.

Kumar and his teamjust shared their findings online, prior to routine peer review and publication in a medical journal, so researchers world wide can see the preliminary research right away.

What Kumars team reports is that a drug called Auranofin, which is already approved by the U.S. Food and Drug Administration to treat rheumatoid arthritis, can also, in lab tests, kill coronavirus that has infected a human cell.

Georgia State University

RELATED: Four students at GSU work tirelessly to create COVID-19 test kits

If you do not treat that [infected] cell,Kumar said, eventually there will be so much virus duplication that it will kill that cell. So eventually, after a few hours, you will not have any cells. The virus will just kill everything. But when you treat it with this drug, you see that all the cells are still there, they are healthy."

"Theres no virus after a few hours," he said. "Theres no other stress to that cell, the cell looks very healthy. So it protects you, both from the virus, as well as the lung injury.

The Georgia State University team is among dozens of research teams across the country conducting experiments with many, existing FDA-approved drugs, to see if any of them can be repurposed and quickly approved- to treat COVID-19 patients, as well.

RELATED: 'This will give us the answer' | Emory expert explains importance of new coronavirus antibody test

And the good thing about that is because theres previous data with existing medication, youre not reinventing the wheel, it shouldnt take as long" to get FDA approval for use in treating COVID-19 patients, said 11Alive Medical Correspondent Dr. Sujatha Reddy. "Some of the drugs that are really showing promise are the ones like at Georgia State, and Im quite hopeful that one of these is really going to help us conquer this virus.

The goal is to get a medicine on the market some time this year, to treat COVID-19 patients, while researchers continue trying to develop a vaccine that would prevent infection in the first place.

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Tradition of Caring recipient: Arthritis Foundation – KELOLAND.com

April 17th, 2020 2:45 am

Posted: Apr 15, 2020 / 04:42 PM CDT / Updated: Apr 15, 2020 / 04:42 PM CDT

The Arthritis Foundation helps people living with arthritis live their best life by creating a powerful network of support through shared experiences, empowering information and meaningful connections. Thats important now more than ever. Darci Hustrulid is the executive director of the Arthritis Foundation of South Dakota. We are also joined by Gerard Faini with Faini Designs Jewelry Studio via zoom. They are here to tell us how the Arthritis Foundation is working to push for change and create community connections that welcome, inform and uplift everyone involved with this very worthwhile cause.

If youd like to find out more about the Arthritis Foundations resources for patient support or if you wish to support the Arthritis Foundation with a donation, You can reach them by phone at 605-223-5170. You can also register and find out more about this years Art for Arthritis Gala Online at arthritis.org/southdakota.

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Eli Lilly Arthritis Drug Will Be Tested in Seriously Ill Covid-19 Patients – Barron’s

April 17th, 2020 2:45 am

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An Eli Lilly drug designed to treat arthritis is the latest anti-inflammatory being tested as a potential treatment for seriously ill Covid-19 patients.

On Friday, Eli Lilly (ticker: LLY) said its drug baricitinib, which the Food and Drug Administration has approved as a treatment for rheumatoid arthritis, would be included in a large study run by the National Institute of Allergy and Infectious Diseases to test various potential therapies to treat Covid-19.

Called the Adaptive Covid-19 Treatment Trial, the randomized, controlled study will give patients potential treatments that include Lillys baricitinib and Gileads (GILD) remdesivir, while others will receive a placebo.

In an interview on Monday, the president of Lilly Bio-Medicines, Patrik Jonsson, said the decision to test baricitinib in Covid-19 patients came after the artificial-intelligence firm BenevolentAI published an article in the medical journal The Lancet arguing that the drug might be able to keep the virus from infecting lung cells.

The first priority is to see if baricitinib is effective in treating those patients, Jonsson said. The data needs to be compelling, but if thats the case, were also in the position to rapidly work with regulatory bodies across the globe.

The NIAID trial will test baricitinib in hospitalized patients with Covid-19. Jonsson said the first patient would be receive treatment at the end April, with data expected two months later. He said that hundreds of patients would receive baricitinib during the trial.

Other arthritis drugs are also being tested in Covid-19 patients, including at least two so-called IL-6 inhibitors, Sanofi (SNY) and Regenerons (REGN) Kevzara, and Roches (RHBBY) Actemra. Baricitinib is a JAK inhibitor, rather than an IL-6 inhibitor, but part of the theory for why it might help Covid-19 patients is the same as for the IL-6 inhibitors. The idea is that the drug could beat back the inflammation in the lungs that can cause serious complications in some Covid-19 patients.

Jonsson also said that there is a secondary hypothesis that baricitinib could have an antiviral effect. He said there is a hypothesis, laid out in BenevolentAIs Lancet article, that the drug could disrupt a particular receptor used by the virus that causes Covid-19 to infect lung cells.

Independent investigators have already run some small trials involving baricitinib. Jonsson said the company has been in touch with those scientists, though it hasnt been involved in the trials. What we have heard so far is the experience is a positive experience, he said, but the trials have involved small numbers of patients.

The NIAID trial will be key to finding answers about baricitinib in Covid-19, along with other drugs.

I am very proud of the partnership with NIAID, and I am very proud of the speed at which weve been able to act, Jonsson said.

Lilly also announced Friday it will begin a smaller Covid-19 trial late this month of a monoclonal antibody initially developed to treat cancer patients. The drug, called LY3127804, will be tested in patients hospitalized with Covid-19 who are at higher risk of developing acute respiratory distress syndrome. The trial will test whether the drug can diminish the need for ventilators, or keep those patients progressing to ARDS.

Shares of Lilly were down 0.9% early afternoon as the S&P 500 fell 1.5%.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com

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Best CBD Cream for Pain: Top 3 Brands for Arthritis in 2020 – SF Weekly

April 17th, 2020 2:45 am

Arthritis is a common problem in older generations as the cartilage protecting our joints begins to wear down.

The problem can also arise in younger adults who spend a lot of time in the gym or on the pitch.

No matter who you are, joint pain can cause a major reduction in your quality of life and make it hard to get out of bed let alone moving around at work or at home.

Whats worse, arthritis can prevent us from doing the things we love. It can hinder our golf game, keep us out of the gym, or stop us from going out for a walk in the park.

This is why a lot of people are reaching for a bottle of CBD cream to help dull the pain in their joints.

In this article, well introduce you to some of the top-rated CBD creams for arthritis symptoms currently available.

Theres nothing like a gentle warming action to soothe painful joints. The heating action brought on by ingredients like cayenne pepper, ginger root, and turmeric activate special receptors known as the vanilloid receptors which have a powerful inhibitory effect on pain pathways essentially blocking the transmission of pain at the source.

This pain creamalso contains herbal extracts of arnica which is a well-known vulnerary (speeds healing) used for cuts, scrapes, and broken bones. This particular herb is perfect for promoting the healing of damaged joint tissues as well.

The rest of the formula contains a myriad of anti-inflammatory agents such as eucalyptus, sweet marjoram, roman chamomile, and of course, CBD.

This is one of the more impressive formulas weve seen yet consisting of over a dozen ingredients all working together to fight pain, inflammation, and tenderness in the joint tissue.

As with allRoyal CBD products, this is a full-spectrum hemp product made from premium-quality American-grown hemp.

If you prefer a cooling action on sore joints Royal CBD also offers a roll-on icy menthol CBD gel as well though we find the cooling option is better for muscle strains than arthritic joints.

Visit Royal CBD and use code SF10 for 10% off your order.

Gold Beeis a Delaware-based brand that specializes in making small-batch, full-spectrum,organic CBD products.

The company has won several awards locally for its CBD roll-on pain gel complete with soothing cooling action and easy applicator.

Gold Bee has become so popular, local cannabis shops struggle to keep these products on store shelves. Its even been featured on a number of popular cannabis websites such asWeed News,We Be High, and the popular parenting websiteHMHB.org.

Gold Bee only recently entered the online space and has been making moves to strengthen the supply chain in order to keep up with the increasing demand.

This pain gel is popular because it offers an ideal cost to potency ratio which means you pay less for each milligram of CBD in the formula compared to other brands.

Gold Bee pain gel is also formulated with other herbal extracts such as arnica and menthol to further improve the pain-killing effects and add a gentle cooling sensation. Within seconds youll start to feel the effects of this pain rub produce a soothing sensation in the joints.

Maximum effects gradually fade in over the course of about 20 or 30 minutes.

SF Weekly readers can save 10% off Gold Bee products by using the code SF10 during checkout.

This CBD cream combines the cooling effects of menthol with CBD isolate.

Within seconds of applying this topical joint cream, youll begin to feel a strong cooling sensation on the joints. This is especially useful if youd describe your joint pain as hot as is common with conditions like rheumatoid arthritis or autoimmune joint pain.

The CBD dose is lower than wed really like, but the cooling effect is very strong and can take the edge off just about any level of discomfort and swelling.

This CBD pain rub can also be used on other sources of skin and connective tissue pain such as sunburns, muscle strains, and sprains, or cuts and scratches (dont use on any open wounds). Its made with a broad-spectrum hemp extract which means it contains a range of cannabinoids and terpenes aside from THC.

Keeping the THC concentrations to the bare minimum (nearly undetectable) allows Hemp Bombs to sell this product all over the world. This was a wise decision from Hemp Bombs because including THC in a formula like this offers little to the therapeutic value of the rub (CBD and other ingredients are much more relevant) but significantly limits where the product can be sold. Hemp Bombs has plenty of soliduser-reviewsaround the webfrom happy customers as well.

This is a great CBD topical to keep around for use after an injury or for chronic hot arthritis or joint pain.

CBD is one of the most popular topical joint creams for muscle and joint pain around the world and for good reason.

CBD actively fights the underlying causes of pain (such as inflammation) while simultaneously muting the transmission of the pain signals sent to the brain.

Within just a few minutes after application, the active ingredients in a high-quality topical will already begin to absorb into the skin and enter the affected tissue.

Its crucial you choose a topical product from a reputable CBD manufacturer to avoid wasting your money. There are plenty of products being sold on the market that contain trace amounts of CBD yet are advertised as miracle pain-rubs. This couldnt be further from the truth.

In order to save yourself from wasting your money on impotent CBD rubs, we highly recommend you do a little bit of research on the brand youre interested in buying from before you make your order starting with some of the brands listed above.

Go to Royal CBD and use code SF10 for 10% off your order.

Best CBD Oil: Top 3 Brands of 2020Best CBD Gummies: Top 3 Brands of 2020Best CBD Capsules: Top 3 CBD Pills of 2020Best CBD Oil for Pain: Top 3 Brands for 2020Best CBD Oil for Anxiety & Depression: Top 3 Brands for 2020Best CBD Oil for Sleep: Top 3 Brands for 2020Best CBD Oil for Arthritis: Top 3 Brands of 2020Best CBD Oil for Dogs: Top 3 Brands for Sale in 2020Buy CBD Oil: Top 3 CBD Oils for Sale in 2020

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Higher BMI Associated With Reduced Foot Health in Patients With Rheumatoid Arthritis – Rheumatology Advisor

April 17th, 2020 2:45 am

In patients with rheumatoid arthritis (RA), higher body mass index (BMI) is associated with lower foot health, indicating that future RA research should consider BMI as a possible therapeutic target for improving foot health in this population, according to findings published in the Scandinavian Journal of Rheumatology.

High BMI is prevalent in patients with RA, with a possible effect on foot joints. The aim of this cross-sectional study was to examine possible associations at a single point in time of BMI and foot pain, deformity, functional limitations, and synovitis in patients from the Amsterdam Foot cohort with RA (n=230; mean age, 5813 years; 80% women). In the regression analyses, the independent variable was BMI and the dependent variables were foot pain, forefoot plantar pressure, foot synovitis, foot-related activity limitations, and foot deformity.

The findings showed that higher BMI was associated with small to modest reductions in many of the studied measures of foot health. The most notable association was that of higher BMI and increased foot pain. With a B value (unstandardized regression coefficient) of 0.12, every 1-point increase in BMI produced a 0.12-increase in pain as measured using a 0-10 numeric rating scale (P =.001).

Higher BMI was also associated with foot-related activity limitations, as measured by the disability subscale of the Foot Function Index, the disability subscale of the Leeds Foot Impact Scale, and the physical functioning subscale of the Western Ontario and McMaster Universities Osteoarthritis Index, but not the 10-Metre Walk Test time. Although BMI was not associated with barefoot-measured plantar forefoot pressure, higher BMI was associated with higher in-shoe measured forefoot pressure.

With respect to gait characteristics, increased BMI was associated with greater contact area and longer heel contact time, but no relationship was found with BMI and total contact time. Finally, although a higher BMI was associated with foot synovitis (P =.009) and midtarsal pain, it was not associated with foot deformity. When BMI was assessed as an ordinal (categoric) variable, the results were similar, except for foot structure. Patients with BMIs in the obese range had significantly lower rates of deformity than those with BMIs in the normal range.

Study investigators concluded that these findings, particularly the associations between higher BMI and increased foot pain and activity limitations, suggest the need for mechanistic and longitudinal studies, including the effects of interventions.

Reference

Dahmen R, Konings-Pijnappels A, Kerkhof S, et al. Higher body mass index is associated with lower foot health in patients with rheumatoid arthritis: baseline results of the Amsterdam-Foot cohort [published online March 10, 2020]. Scand J Rheumatol. doi:10.1080/03009742.2019.1663920

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Conditioning Arthritic Horses: Do’s and Don’ts – TheHorse.com

April 17th, 2020 2:45 am

Its just OA, right? That common creaky, achy condition we ourselves get in our knees, backs, and other joints over time. Sure, but its important to understand some of its complexities and why it can be so challenging to manage in horses.

Osteoarthritis is a slowly progressive disease process within the horses joint, which leads to damage of the articular cartilage (within) the joint, the bone beneath the cartilage, and local soft tissue structures, Jarvis says. There are many initiating factors that could lead to OA in later life, such as general wear and tear over the years, uneven weightloading through the joint due to poor conformation or hoof care, or a traumatic incident.

Unfortunately, theres currently no cure for arthritisveterinarians cant completely stop or reverse the conditions effects. So owners of arthritic horses and their veterinarians are left to simply manage the pain caused by the condition, and thats the biggest challenge, Malinowski says.

Every horse will perceive the pain level differently, she says. Some will exercise right through it, while others will not.

Finding and implementing appropriate treatments with a veterinarians help is key, and well cover that in a moment. But theres something else thats important to remember about OA.

We know that horses with arthritic joints do benefit from movement and regular exercise, Malinowski says. Therefore, horse owners should exercise these horses as long as the animal is able to do so without obvious discomfort.

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Conditioning Arthritic Horses: Do's and Don'ts - TheHorse.com

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Dermatology-Rheumatology Care Clinic Reports High Satisfaction From Patients With Psoriasis, Psoriatic Arthritis – Rheumatology Advisor

April 17th, 2020 2:44 am

The feasibility and efficacy of a joint dermatology-rheumatology clinic for the treatment of patients with psoriasis (PsO) and psoriatic arthritis (PsA) is supported by study data published in Dermatological Therapies.

Established at Attikon General University Hospital in Athens, Greece, the Psoriasis and Psoriatic Arthritis Clinic (PPAC) integrates expertise from dermatologists and rheumatologists for the treatment of patients with psoriasis and psoriatic arthritis. The dual clinic is held once a week by 6 specialists; the same hospital also holds regular psoriasis clinics twice weekly. On average, the PPAC receives 40 new patients per month. Patients typically belong to 2 categories: patients with psoriasis who are suspected to also have psoriatic arthritis, and patients with a rheumatology diagnosis in whom psoriatic arthritis is suspected. Demographic and clinical characteristics were extracted from patients who attended the clinic from 2017 to 2018. In addition, patient satisfaction with PPAC care was assessed using a Visual Analogue Scale (VAS).

The PPAC saw 185 patients with psoriasis who were diagnosed with psoriatic arthritis from December 2018 to January 2019. In these patients, mean age of psoriasis onset was 34 16 years and mean age of psoriatic arthritis onset was 47 12 years. The majority of patients had a diagnosis of severe plaque psorisis (78%). The most commonly diagnosed psoriatic arthritis was asymmetric oligoarticular arthritis (32%). More than half of patients were receiving biologic agents (57%) as treatment for psoriasis and psoriatic arthritis. Comorbidity rates were high, with 40% and 37% reporting hypertension and dyslipidemia, respectively.

In addition, 9% and 11% were being monitored for diabetes and depression, respectively. Patients reported high levels of satisfaction with the PPAC facility compared with attending separate clinics on referrals. The mean satisfaction-VAS score was 8611.5. Patients typically endorsed that the PPAC was timely, efficient, and patient-centered. Most patients also agreed that collaboration and teamwork between dermatologists and rheumatologists was essential to their care. When surveyed, dermatologists in the PPAC also agreed that interprofessional collaboration improved patient care quality and clinical outcomes.

These data support the feasibility of dual dermatology-rheumatology clinics for the management of psoriasis and psoriatic arthritis, study authors assert. Investigators noted that a strong word of mouth impact was observed from the PPAC, with many patients recommending the clinic to spouses or other family members. From a single clinical site and a relatively small cohort, results may not be generally applicable to other patient populations. Despite this, data support the concept of combined clinics delivering better integrated care forpatients [with PsO and PsA], the authors concluded.

Reference

Theodorakopoulou E, Dalamaga M, Katsimbri P, Boumpas DT, Papadavid E. How does the joint dermatology-rheumatology clinic benefit both patients and dermatologists? [published online February 24, 2020]. Dermatol Ther. doi: 10.1111/dth.13283

This article originally appeared on Dermatology Advisor

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Dermatology-Rheumatology Care Clinic Reports High Satisfaction From Patients With Psoriasis, Psoriatic Arthritis - Rheumatology Advisor

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Arthritis Research Canada/Arthrite-recherche Canada collaborates on global initiative to respond to COVID-19 Pandemic – BioSpace

April 17th, 2020 2:44 am

VANCOUVER, April 15, 2020 /CNW/ -Arthritis Research Canada/Arthrite-recherche Canada is collaborating with the COVID-19 Global Rheumatology Alliance onan international initiative collecting information on rheumatology patients with COVID-19from around the world. By gathering data specific to rheumatology patients, the Alliance will gain important insights on how COVID-19 impacts rheumatology patients, and more specifically, how autoimmune diseases and immunosuppressive medications influence the risk of infection and the outcomes of COVID-19.

Arthritis Research Canada is pleased to announce that our Associate Scientific Director, Dr. Diane Lacaille, is the Regional Canadian Leadon the COVID-19 Global Rheumatology Alliance. "By collecting world-wide data and analysing it in real time, this important research will inform treatment recommendations specific to rheumatology patients," Dr. Lacaille said. "Simply put, we will be able to answer our patients' questions on what to do with their immunosuppressive medications, based on real data about their medications' safety and efficacy. Currently we assume it is better for people to stay on their immunosuppressants because the severe manifestations of COVID-19 are due to the immune system's reaction to the virus, but it would be very useful to have real data confirming this."

More information on this initiative may be found at: http://rheum-covid.org/.

A separate initiative by the COVID-19 Global Rheumatology Alliance, is collecting information from adults (and parents of children) with rheumatic diseases to gain a better understanding of how the COVID-19 pandemic is impacting people living with rheumatic diseases. If you would like to participate, please visit https://rheum-covid.org/patient-survey/.

Thereare currently over 6 million Canadians, young and old, who struggle with one or more of the 100 types of arthritis. This collaboration is significant to Arthritis Research Canada's scientific team as they work to address the current COVID-19 pandemic and its impact on people with arthritis.

ABOUT ARTHRITIS RESEARCH CANADA: Arthritis Research Canada is the largest clinical arthritis research institution inNorth America. Our mission is to transform the lives of people living with arthritis through research and engagement. Led by world-renowned rheumatologist, Dr.John Esdaile, Arthritis Research Canada's scientific team of over 100 are creating a future where people living with arthritis are empowered to triumph over pain and disability. Within British Columbia,AlbertaandQuebec, Arthritis Research Canada is leading research aimed at arthritis prevention, early diagnosis, new and better treatment, and improved quality of life.

SOURCE Arthritis Research Canada

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Arthritis Research Canada/Arthrite-recherche Canada collaborates on global initiative to respond to COVID-19 Pandemic - BioSpace

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Arthritis and coronavirus: All you need to know – Outlook India

April 17th, 2020 2:44 am

Arthritis and coronavirus: All you need to know

New Delhi, April 13 (IANSlife) Older people are more prone to novel Covid-19, owing to their underlying health conditions which weaken their body immunity with age. Arthritis is one of the most common health problems that comes with age and though arthritis can be immune-related (Rheumatoid arthritis) or non-immune-related (osteoarthritis), patients should take utmost precautions to reduce the risk of infection during this pandemic.

Vipul Jain, Chief Executive Officer, Advancells answers important questions regarding healthcare management for arthritis patients in times of Covid-19.

Q. Is arthritis a major risk factor for Covid-19?

Jain: When it comes to Covid-19, arthritis may not be on the frontline as cardiovascular risks or metabolic disorders in the category of underlying health conditions, but a higher percentage of the older patients who are more prone to coronavirus infection, are suffering from arthritis. Arthritis and immune dysfunction go a long way. Pain and inflammation in arthritis can trigger immune system to function in an autoimmune manner by harming one''s own body and conversely, the immune system can also trigger autoimmune disorders like rheumatoid arthritis. Thus severe arthritis can damage the body from within and pave an easier path of coronavirus to attack.

Q. Are patients with autoimmune or inflammatory arthritis more prone to the virus?

Jain: In general, people with inflammatory arthritis with severe conditions seem to have an increased risk of coronavirus infections due to higher levels of immune deregulation. Arthritis experts emphasize that one of the main concerns for people with autoimmune disease is due to the immunosuppressive drugs that they have been prescribed by their doctors. It is difficult for doctors to work around the effects of immunosuppressive drugs in case of treating coronavirus infections.

Q. How do immunosuppressive drugs risk Covid-19?

Jain: Although it is not intrinsically known whether taking immunosuppressant drugs can further risk the infection of Covid-19, previous research suggests that some of the drugs used to treat autoimmune and inflammatory types of arthritis may contribute to higher risk or severity of viral infection. The concern with immune suppression in the body is that without a triggered immune system, the virus replication is more unchecked and could replicate more freely, causing more severe disease condition. Therefore, it is very important to let the doctor know regarding your medications one is already taking, if you find flu-like symptoms during this Covid-19 outbreak.

Q. Is there an alternative to NSAIDs for arthritis in times of Covid-19?

Jain: Immunosuppressive drugs like NSAIDs (Non-steroidal Anti-Inflammatory Drugs) can be continued for arthritis patients, after a thorough consultation with the doctor in case no symptoms of Covid-19 are suspected. Although, no direct confirmation has been reported against the use of NSAIDs for aged patients with arthritis in these times of coronavirus outbreak, but it is futile to take any risk regarding this without discussing with the appropriate medical personnel.

So, is there an alternative? Yes, the alternative is to go for immune-modulation instead of immune-suppression. And that is where stem cells come into the picture. Regenerative medicine treatment of arthritis can help one overcome the issue of immune-suppression and also support the body immune system to fight against viral infections.

--IANS

pg/tb/sdr/

Disclaimer :- This story has not been edited by Outlook staff and is auto-generated from news agency feeds. Source: IANS

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Low Frequency of Flares During and After Pregnancy in Patients With Inactive or Stable Lupus – Rheumatology Advisor

April 17th, 2020 2:44 am

Among patients with systematic lupus erythematosus (SLE) who have stable or inactive disease at conception, disease flares during and after pregnancy are typically mild and occur at similar rates, according to study results published in Arthritis Research & Therapy.1

Patients with SLE with active disease have increased risk for poor fetal outcomes, ranging from preterm birth and restricted growth to fetal loss, in addition to maternal nephritis and pre-eclampsia. As a result, current clinical guidelines call for conception after low disease activity for 6 months.2 However, the effects of lupus flares and its predictors are less widely known during and after pregnancy.

The study evaluated data from 384 patients enrolled in the multicenter prospective PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study. Between September 2003 and December 2012, the study included consecutive patients who were pregnant and met the revised American College of Rheumatology criteria for SLE, as well as the inclusion criteria for age (18-45 years), hematocrit (>26%), and gestation (<12 weeks). The study aimed to assess the number, severity, and risk factors for flares during and after pregnancy in patients with quiescent or stable mildly active disease and avoid other known risk factors for pregnancy complications in patients with SLE. Patients were enrolled at 8 to 12 weeks gestation and had follow-ups monthly and at 2 to 6 months postpartum. Disease activity was measured using the Physician Global Assessment (PGA) and the Systemic Lupus Erythematosus Pregnancy Disease Activity Index (SLEPDAI); the Systemic Lupus Erythematosus National Assessment (SELENA)-SLEDAI flare index was used to assess patient flares.

Of the 384 patients (average age, 30.9 years), 100 (26%) experienced flares (SLEPDAI >4; PGA >1) at any point during their pregnancy. Among patients with flares, 20.8% had 1 mild/moderate flare and 6.25% had 1 severe flare. In postpartum patients, 27.7% had mild/moderate flares and 1.7% experienced severe flares. During pregnancy and postpartum, mild flares rarely required treatment.

Baseline demographic and clinical variables predictive of flares during and after pregnancy included ethnicity/race (P =.019) and age (P =.002), with black, Hispanic, and younger patients likelier to experience flares. Low C4 was also significantly associated with flares (P =.005), and higher disease activity at baseline significantly predicted flares during pregnancy. Among women who experienced flares vs those who did not experience flares, mean SLEPDAI >4 (P =.011) and mean PGA >1 (P =.005) were higher at baseline. In contrast, baseline patient characteristics had no correlations with postpartum flares. Similarly, no correlations existed between postpartum flares and laboratory values, disease activity, and medication use at the last visit during pregnancy.

Logistic regression analysis showed that the baseline variables that were independently predictive of 1 flare during pregnancy included age at screening (P =.003), low C4 (P =.024), and PGA score (P =.005). Overall, older patients and those with quiescent disease at baseline were at reduced risk for flares.

Study limitations included the inclusion of patients with quiescent disease at baseline and the exclusion of patients with SLE who required high-dose prednisone and with nephritis, the possibility of the researchers missing some flares because of scheduling, and the fact that postpartum visits were scheduled after 3 months and not soon after delivery.

Based on these results, physicians can reassure their patients that if they plan their pregnancy at a time of quiescence, they are unlikely to have a flare during or in the 6 months after pregnancy, the researchers concluded.

References

1. Davis-Porada J, Kim MY, Guerra MM, et al. Low frequency of flares during pregnancy and post-partum in stable lupus patients. Arthritis Res Ther. 2020;22 (1):1.

2. Skorpen CG, Lydersen S, Gilboe I-M, et al. Disease activity during pregnancy and the first year postpartum in women with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2017;69(8):1201-1208.

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Coronavirus: U of T expert on the risks to essential workers with hidden health conditions – News@UofT

April 17th, 2020 2:44 am

The COVID-19 pandemic has left many in Canadas workforce worried about their health and finances. Those worries are even greater for workers living with an underlying and invisible chronic health condition.

In the planning of health and safety responses to COVID-19 and the ultimate reopening of workplaces, employers should be aware of the unique needs of this potentially vulnerable group of workers.

Data show that some of the most commonly reported chronic health conditions experienced by Canadas working population have no visible signs or symptoms and may go unnoticed by employers.

According to the 2019 Sanofi Canada Healthcare Survey on workplace benefit plans, 54 per cent of workers reported having such a condition, with high blood pressure, arthritis and diabetes among the top five. In the same survey, employers estimated that only 29 per cent of their staff had a chronic condition, pointing to a gap in awareness within workplaces.

Our growing understanding of COVID-19 illustrates that the virus poses a particular threat to workers with underlying health conditions.

A review of 46,000 people with COVID-19 in China found that the odds of having severe symptoms were two or more times higher for people with an underlying health condition. Although the data are limited, a recent analysis conducted by the U.S.Centers for Disease Control and Prevention also shows that 38 per cent of COVID-19 cases in the United States had an underlying health condition including diabetes, cardiovascular disease, chronic lung disease and immmunocompromised conditions.

Going to work, therefore, could mean being exposed to a virus that disproportionately targets those with underlying health conditions. Of course, staying at home would be the best solution for workers with chronic health conditions. But even after the provinces ordered the closure of businesses, people in a large cross-section of essential services found themselves having to continue to show up for work.

These include people who work in health care, grocery stores, drug stores, warehouses, gas stations, fast-food chains and other restaurants, hotels, long-term care homes, among many others.

Despite the provinces encouraging workers who feel unwell to stay home and the availability of emergency relief for compensation, workers with chronic health conditions may not want to sacrifice a paycheque during a period of economic uncertainty. They may decide to accept the risk of going to work.

This is a predicament that many community groups are highlighting. As Sin Bevan, chief science officer at the Arthritis Society, puts it: Some people in these essential roles may be fearful for their employment if their condition makes them unable to work and fearful to let their employer know about their health concerns for fear of losing their jobs. Many immunosuppressed people with rheumatic conditions are afraid to go to work, but afraid to tell their employer why.

Commendably, some employers are offering hero pay to compensate for the added risk that workers face. Yet the extra wages could also have the unintended effect of encouraging people with chronic health conditions who face income insecurity to go to work.

Growing research conducted by the Toronto-based Institute for Work & Health highlights the challenges that workers with chronic health conditions face when asking for accommodations that will allow them to continue working productively while maintaining their health. This is especially the case for those living with invisible health conditions that may fluctuate in severity, young workers, those new to their jobs and other vulnerable groups.

In the current health and economic crisis brought about by COVID-19, the inability of these individuals to ask for protective accommodation poses a potentially serious risk to the health and safety, and the long-term employment, of people with chronic health conditions in the workforce.

These are trying times, and from many accounts, employers are doing their best to keep essential services running while safeguarding the health and safety of workers. As they continue to navigate the way forward and develop back-to-work plans, employers should acknowledge that they may have workers with a chronic health condition who could be reluctant to ask for support.

Employers should also be encouraged to open up the lines of communication with all workers so that those with underlying conditions feel supported in bringing forward their concerns. While workers are not obligated to talk about their health, more than ever, supportive workplace environments are needed to encourage people to communicate what assistance they need to stay healthy while working productively.

Laurie Proulx, vice-president of the Canadian Arthritis Patient Alliance, sums it up well. She sees the COVID-19 pandemic as: an opportunity for employers to build credibility with their employees by listening and finding ways for workers with underlying health conditions to still make important contributions and not put themselves and their families at risk.

Arif Jethais ascientist at the Institute of Work and Health and an assistant professor at theUniversity of Torontos Dalla Lana School of Public Health.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Link:
Coronavirus: U of T expert on the risks to essential workers with hidden health conditions - News@UofT

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