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New Medicine Stem Cell Clinic in Moscow, Russia

May 11th, 2019 3:51 pm

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Welcome to New Medicine Stem Cell Clinic

New Medicine Stem Cell Clinic, located in Moscow, Russia, has been among the first centers in this country to use the innovative stem cell therapy for prevention, and rehabilitation, as well as for organism revitalization and rejuvenation.

The mesenchymal stem cells (MSCs) are stem cells that have been harvested from mesenchymal tissues, such as cartilage, bones, derma and connective tissue. These cells have the ability to differentiate into various cell types.

MSCs fulfill three groups of tasks:

Stem cells (SCs) are able to divide asymmetrically, leading to self-renewal and their ability to turn into specialized cells of any organ and tissue.

The New Medicine clinic uses the following stem cells for therapy:

Range of diseases that may be treated successfully with stem cells

Cardiological diseases

Vascular diseases

Endocrine system diseases

Nervous System Diseases

Hereditary diseases

Ophthalmic diseases

Hepatic diseases

Gastrointestinal diseases

Respiratory diseases

Diseases of genitourinary system

Musculoskeletal System Diseases

Skin diseases

Revitalization

Why choose us?

If you want to find out more about the treatments and procedures offered by New Medicine Stem Cell Clinic, please contact us!

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New Medicine Stem Cell Clinic in Moscow, Russia

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Rituximab With or Without Stem Cell Transplant in Treating …

May 11th, 2019 3:51 pm

This randomized phase III trial studies rituximab after stem cell transplant and to see how well it works compared with rituximab alone in treating patients with in minimal residual disease-negative mantle cell lymphoma in first complete remission. Monoclonal antibodies, such as rituximab, may interfere with the ability of cancer cells to grow and spread. Giving chemotherapy before a stem cell transplant helps kill any cancer cells that are in the body and helps make room in the patient's bone marrow for new blood-forming cells (stem cells) to grow. After treatment, stem cells are collected from the patient's blood and stored. More chemotherapy is then given to prepare the bone marrow for the stem cell transplant. The stem cells are then returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy. Giving rituximab with or without stem cell transplant may work better in treating patients with mantle cell lymphoma.

PRIMARY OBJECTIVES:

I. To compare overall survival in mantle cell lymphoma (MCL) patients in minimal residual disease (MRD)-negative first remission who undergo autologous hematopoietic stem cell transplantation (auto-HCT) followed by maintenance rituximab versus (vs.) maintenance rituximab alone (without auto-HCT).

SECONDARY OBJECTIVES:

I. To compare progression-free survival in MCL patients in MRD-negative first remission who undergo auto-HCT followed by maintenance rituximab vs. maintenance rituximab alone.

II. To define the overall survival and progression-free survival at 2 and 5 years of chemosensitive but MRD-positive (or MRD-indeterminate) patients who undergo auto-HCT followed by 2 years of maintenance rituximab.

III. To describe the rate of complications (serious infection, hospitalization, need for intravenous immune globulin) in MCL patients undergoing maintenance rituximab following auto-HCT.

IV. To determine the prognostic impact of MRD status at day 100, in MCL patients who were MRD-positive prior to auto-HCT.

OUTLINE: Patients are randomized to 1 of 2 groups.

GROUP I: Patients receive standard of care preparative chemotherapy and undergo auto-HCT. Beginning 60-120 days after transplant, patients receive rituximab intravenously (IV) once every 8 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity.

GROUP II: Patients receive standard of care induction chemotherapy. Beginning 40-120 days after completion of chemotherapy, patients receive rituximab as in Group I.

After completion of study treatment, patients are followed up every 3 and 6 months for 10 years.

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‘Stem-cell tourism’ needs tighter controls, say medical …

May 9th, 2019 5:47 pm

LONDON (Reuters) - Stem-cell tourism involving patients who travel to developing countries for treatment with unproven and potentially risky therapies should be more tightly regulated, international health experts said on Wednesday.

With hundreds of medical centers around the world claiming to be able to repair damaged tissue in conditions such as multiple sclerosis and Parkinson's disease, tackling unscrupulous advertising of such procedures is crucial.

These therapies are advertised directly to patients with the promise of a cure, but there is often little or no evidence to show they will help, or that they will not cause harm, the 15 experts wrote in the journal Science Translational Medicine.

Some types of stem cell transplant mainly using blood and skin stem cells have been approved by regulators after full clinical trials found they could treat certain types of cancer and grow skin grafts for burns patients.

But many other potential therapies are only in the earliest stages of development and have not been approved by international regulators.

"Stem cell therapies hold a lot of promise, but we need rigorous clinical trials and regulatory processes to determine whether a proposed treatment is safe, effective and better than existing treatments," said one of the 15, Sarah Chan of Britain's University of Edinburgh.

The experts called for global action, led by the World Health Organization, to introduce controls on advertising and agree international standards for the manufacture and testing of cell and tissue-based therapies.

"The globalization of health markets and the specific tensions surrounding stem cell research and its applications

have made this a difficult challenge," they wrote. "However, the stakes are too high not to take a united stance."

(Reporting by Kate Kelland, editing by John Stonestreet)

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Consumer Awareness of Personalized Medicine Has Only Grown by …

May 8th, 2019 6:48 am

Consumer awareness of personalized medicine is up 4% from 2018, according to a new report from Dosis, an AI-powered personalized dosing platform. The 2019 Dosis Personalized and Digital Medicine Consumer Report surveyed more than 1,000 consumers, weighted for the U.S. population, to gain a better understanding of how big the disconnect is between the advances in personalized medicine approaches and general consumer awareness of its benefits.

Consumer Awareness of Personalized Medicine Continues to be Slow

While the report found consumer awareness of personalized medicine has risen to 33% in 2019 from 29% in 2018, the progress with educating patients on the improvements in care that it can bring, along with the treatments associated with its practice, continues to be slow. In fact, consumer awareness has only grown by around 1% year-over-year since 2013.

Somewhat surprisingly, those 65+ were the most likely (37%) to be familiar with personalized medicine. Its often believed that elderly patients are reluctant to try new technologies or innovative alternatives to traditional medicine, but its also true that they are the age group most likely to be dealing with some type of healthcare issue.

Additionally, the earliest uses of personalized medicine have been in oncology, and one-quarter of new cancer cases are diagnosed in people aged 65 to 74. As these older patients are spending more time within care facilities and with their primary care provider than younger adults, its likely that theyve become more familiar with the potential for medicine personalized to address unique health ailments.

Familiarity with Personalized Medicine Increases Patient Interest in It

To find out if unfamiliarity with personalized medicine leads to less interest in using it as a treatment option, we provided respondents with this definition of personalized medicine after their initial familiarity responses: A medical treatment determined to be best for you based on your unique predicted response or risk of disease.

Respondents were asked if they would be interested in personalized medicine options defined in this way. Of the subset of consumers that previously noted they had familiarity with personalized medicine, nearly half (49%) said they were interested in personalized medicine under this definition. Comparatively, of those that said they were previously unaware of personalized medicine only 22% noted they would be interested in personalized medicine with this definition.

Patients Need to Be Educated on Personalized Medicine

Clearly, simply defining personalized medicine is not enough to get consumers to jump on the idea of using it for their future treatments. This is just further proof that patients need to be educated on personalized medicine, as well as the broader notion that they are different in their own way from any other patient over a period of time. Many consumers will still need to be walked through how their unique complement of genes, lifestyle and environmental factors should be considered when creating the best treatment plan for them.

Other key findings from the report include:

60% of those tracking data willing to share it with their healthcare provider to improve their health; however, only 14% said they would be willing to share their data with a provider to specifically influence personalized treatment.

Generation Z (18-24-year-olds) were the most likely (17%) to say they would be willing to share their tracked data with their providers to gain access to more personalized treatments.

Respondents wereasked consumers if they have taken a direct-to-consumer DNA or Gene Test with the specific goal of sharing with their provider to inform their treatment plan. Nearly 6% of consumers indicated that they took a test with that direct aim in mind, meaning that may be a top driver of interest in taking these at-home test.

Only 24% of consumers said they would be willing to take a diagnostic test for access to personalized medicine treatments.

So would consumers opt for a personalized treatment outside their insurance coverage if they were confronted with a serious condition? 32% of consumers said they would seek personalized medicine alternatives for a serious condition, but there are financial limits. Nearly two-thirds of that 32% said they would stop pursuing personalized medicine alternatives for a serious condition if treatments were priced more than their annual deductible.

Impact of Findings

As more consumers are educated on how their genetic makeup, lifestyle and environmental factors uniquely affect their medical treatments, I believe both awareness of and interest in personalized medicine will continue to grow, said Shivrat Chhabra, Founder & CEO of Dosis. Younger patients have expressed growing dissatisfaction with traditional care, and the findings of our report indicate that their interest in technology may be a major opportunity to further their awareness in personalized medicine alternatives.

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Efficient Implementation of Penalized … – genetics.org

May 6th, 2019 12:48 pm

Abstract

Polygenic Risk Scores (PRS) combine genotype information across many single-nucleotide polymorphisms (SNPs) to give a score reflecting the genetic risk of developing a disease. PRS might have a major impact on public health, possibly allowing for screening campaigns to identify high-genetic risk individuals for a given disease. The Clumping+Thresholding (C+T) approach is the most common method to derive PRS. C+T uses only univariate genome-wide association studies (GWAS) summary statistics, which makes it fast and easy to use. However, previous work showed that jointly estimating SNP effects for computing PRS has the potential to significantly improve the predictive performance of PRS as compared to C+T. In this paper, we present an efficient method for the joint estimation of SNP effects using individual-level data, allowing for practical application of penalized logistic regression (PLR) on modern datasets including hundreds of thousands of individuals. Moreover, our implementation of PLR directly includes automatic choices for hyper-parameters. We also provide an implementation of penalized linear regression for quantitative traits. We compare the performance of PLR, C+T and a derivation of random forests using both real and simulated data. Overall, we find that PLR achieves equal or higher predictive performance than C+T in most scenarios considered, while being scalable to biobank data. In particular, we find that improvement in predictive performance is more pronounced when there are few effects located in nearby genomic regions with correlated SNPs; for instance, in simulations, AUC values increase from 83% with the best prediction of C+T to 92.5% with PLR. We confirm these results in a data analysis of a case-control study for celiac disease where PLR and the standard C+T method achieve AUC values of 89% and of 82.5%. Applying penalized linear regression to 350,000 individuals of the UK Biobank, we predict height with a larger correlation than with the best prediction of C+T (65% instead of 55%), further demonstrating its scalability and strong predictive power, even for highly polygenic traits. Moreover, using 150,000 individuals of the UK Biobank, we are able to predict breast cancer better than C+T, fitting PLR in a few minutes only. In conclusion, this paper demonstrates the feasibility and relevance of using penalized regression for PRS computation when large individual-level datasets are available, thanks to the efficient implementation available in our R package bigstatsr.

POLYGENIC risk scores (PRS) combine genotype information across many single-nucleotide polymorphisms (SNPs) to give a score reflecting the genetic risk of developing a disease. PRS are useful for genetic epidemiology when testing polygenicity of diseases and finding a common genetic contribution between two diseases (Purcell et al. 2009). Personalized medicine is another major application of PRS. Personalized medicine envisions to use PRS in screening campaigns in order to identify high-risk individuals for a given disease (Chatterjee et al. 2016). As an example of practical application, targeting screening of men at higher polygenic risk could reduce the problem of overdiagnosis and lead to a better benefit-to-harm balance in screening for prostate cancer (Pashayan et al. 2015). However, in order to be used in clinical settings, PRS should discriminate well enough between cases and controls. For screening high-risk individuals and for presymptomatic diagnosis of the general population, it is suggested that, for a 10% disease prevalence, the AUC must be >75% and 99%, respectively (Janssens et al. 2007).

Several methods have been developed to predict disease status, or any phenotype, based on SNP information. A commonly used method often called P+T or C+T (which stands for Clumping and Thresholding) is used to derive PRS from results of Genome-Wide Association Studies (GWAS) (Wray et al. 2007; Evans et al. 2009; Purcell et al. 2009; Chatterjee et al. 2013; Dudbridge 2013). This technique uses GWAS summary statistics, allowing for a fast implementation of C+T. However, C+T also has several limitations; for instance, previous studies have shown that predictive performance of C+T is very sensitive to the threshold of inclusion of SNPs, depending on the disease architecture (Ware et al. 2017). In parallel, statistical learning methods have also been used to derive PRS for complex human diseases by jointly estimating SNP effects. Such methods include joint logistic regression, Support Vector Machine (SVM) and random forests (Wei et al. 2009; Abraham et al. 2012, 2014; Botta et al. 2014; Okser et al. 2014; Lello et al. 2018; Mavaddat et al. 2019). Finally, Linear Mixed-Models (LMMs) are another widely used method in fields such as plant and animal breeding, or for predicting highly polygenic quantitative human phenotypes such as height (Yang et al. 2010). Yet, predictions resulting from LMM, known e.g., as gBLUP, have not proven as efficient as other methods for predicting several complex diseases based on genotypes [see table 2 of Abraham et al. (2013)].

We recently developed two R packages, bigstatsr and bigsnpr, for efficiently analyzing large-scale genome-wide data (Priv et al. 2018). Package bigstatsr now includes an efficient algorithm with a new implementation for computing sparse linear and logistic regressions on huge datasets as large as the UK Biobank (Bycroft et al. 2018). In this paper, we present a comprehensive comparative study of our implementation of penalized logistic regression (PLR), which we compare to the C+T method and the T-Trees algorithm, a derivation of random forests that has shown high predictive performance (Botta et al. 2014). In this comparison, we do not include any LMM method, yet, L2-PLR should be very similar to LMM methods. Moreover, we do not include any SVM method because it is expected to give similar results to logistic regression (Abraham et al. 2012). For C+T, we report results for a large grid of hyper-parameters. For PLR, the choice of hyper-parameters is included in the algorithm so that we report only one model for each simulation. We also use a modified version of PLR in order to capture not only linear effects, but also recessive and dominant effects.

To perform simulations, we use real genotype data and simulate new phenotypes. In order to make our comparison as comprehensive as possible, we compare different disease architectures by varying the number, size and location of causal effects as well as disease heritability. We also compare two different models for simulating phenotypes, one with additive effects only, and one that combines additive, dominant and interaction-type effects. Overall, we find that PLR achieves higher predictive performance than C+T except in highly underpowered cases (AUC values lower than 0.6), while being scalable to biobank data.

We use real genotypes of European individuals from a case-control study for celiac disease (Dubois et al. 2010). This dataset is presented in Supplemental Material, Table S1. Details of quality control and imputation for this dataset are available in Priv et al. (2018). For simulations presented later, we first restrict this dataset to controls from UK in order to remove the genetic structure induced by the celiac disease status and population structure. This filtering process results in a sample of 7100 individuals (see supplemental notebook preprocessing). We also use this dataset for real data application, in this case keeping all 15,155 individuals (4496 cases and 10,659 controls). Both datasets contain 281,122 SNPs.

We simulate binary phenotypes using a Liability Threshold Model (LTM) with a prevalence of 30% (Falconer 1965). We vary simulation parameters in order to match a range of genetic architectures from low to high polygenicity. This is achieved by varying the number of causal variants and their location (30, 300, or 3000 anywhere in all 22 autosomal chromosomes or 30 in the HLA region of chromosome 6), and the disease heritability (50 or 80%). Liability scores are computed either from a model with additive effects only (ADD) or a more complex model that combines additive, dominant and interaction-type effects (COMP). For model ADD, we compute the liability score of the i-th individual aswhere is the set of causal SNPs, are weights generated from a Gaussian distribution or a Laplace distribution , is the allele count of individual i for SNP j, corresponds to its standardized version (zero mean and unit variance for all SNPs), and follows a Gaussian distribution . For model COMP, we simulate liability scores using additive, dominant and interaction-type effects (see Supplemental Materials).

We implement three different simulation scenarios, summarized in Table 1. Scenario N1 uses the whole dataset (all 22 autosomal chromosomes 281,122 SNPs) and a training set of size 6000. For each combination of the remaining parameters, results are based on 100 simulations except when comparing PLR with T-Trees, which relies on five simulations only because of a much higher computational burden of T-Trees as compared to other methods. Scenario N2 consists of 100 simulations per combination of parameters on a dataset composed of chromosome six only (18,941 SNPs). Reducing the number of SNPs increases the polygenicity (the proportion of causal SNPs) of the simulated models. Reducing the number of SNPs (p) is also equivalent to increasing the sample size (n) as predictive power increases as a function of (Dudbridge 2013; Vilhjlmsson et al. 2015). For this scenario, we use the additive model only, but continue to vary all other simulation parameters. Finally, scenario N3 uses the whole dataset as in scenario N1 while varying the size of the training set in order to assess how the sample size affects predictive performance of methods. A total of 100 simulations per combination of parameters are run using 300 causal SNPs randomly chosen on the genome.

In this study, we use two different measures of predictive accuracy. First, we use the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) (Lusted 1971; Fawcett 2006). In the case of our study, the AUC is the probability that the PRS of a case is greater than the PRS of a control. This measure indicates the extent to which we can distinguish between cases and controls using PRS. As a second measure, we also report the partial AUC for specificities between 90 and 100% (McClish 1989; Dodd and Pepe 2003). This measure is similar to the AUC, but focuses on high specificities, which is the most useful part of the ROC curve in clinical settings. When reporting AUC results of simulations, we also report maximum achievable AUC values of 84% and 94% for heritabilities of 50% and 80%, respectively. These estimates are based on three different yet consistent estimations (see Supplemental Materials).

In this paper, we compare three different types of methods: the C+T method, T-Trees and PLR.

The C+T method directly derives PRS from the results of Genome-Wide Associations Studies (GWAS). In GWAS, a coefficient of regression (i.e., the estimated effect size ) is learned independently for each SNP j along with a corresponding P-value . The SNPs are first clumped (C) so that there remain only loci that are weakly correlated with one another (this set of SNPs is denoted ). Then, thresholding (T) consists in removing SNPs with P-values larger than a user-defined threshold . Finally, the PRS for individual i is defined as the sum of allele counts of the remaining SNPs weighted by the corresponding effect coefficientswhere are the effect sizes (P-values) learned from the GWAS. In this study, we mostly report scores for a clumping threshold at within regions of 500kb, but we also investigate thresholds of 0.05 and 0.8. We report three different scores of prediction: one including all the SNPs remaining after clumping (denoted C+T-all), one including only the SNPs remaining after clumping and that have a P-value under the GWAS threshold of significance (, C+T-stringent), and one that maximizes the AUC (C+T-max) for 102 P-value thresholds between 1 and (Table S2). As we report the optimal threshold based on the test set, the AUC for C+T-max is an upper bound of the AUC for the C+T method. Here, the GWAS part uses the training set while clumping uses the test set (all individuals not included in the training set).

T-Trees (Trees inside Trees) is an algorithm derived from random forests (Breiman 2001) that takes into account the correlation structure among the genetic markers implied by linkage disequilibrium (Botta et al. 2014). We use the same parameters as reported in table 4 of Botta et al. (2014), except that we use 100 trees instead of 1000. Using 1000 trees provides a minimal increase of AUC while requiring a disproportionately long processing time (e.g., AUC of 81.5% instead of 81%, data not shown).

Finally, for PLR, we find regression coefficients and that minimize the following regularized loss function(1)where , x denotes the genotypes and covariables (e.g., principal components), y is the disease status to predict, and are two regularization hyper-parameters that need to be chosen. Different regularizations can be used to prevent overfitting, among other benefits: the L2-regularization (ridge, Hoerl and Kennard (1970)) shrinks coefficients and is ideal if there are many predictors drawn from a Gaussian distribution (corresponds to in the previous equation); the L1-regularization (lasso, Tibshirani 1996) forces some of the coefficients to be equal to zero and can be used as a means of variable selection, leading to sparse models (corresponds to ); the L1- and L2-regularization (elastic-net, Zou and Hastie 2005) is a compromise between the two previous penalties and is particularly useful in the situation (p is the number of SNPs), or any situation involving many correlated predictors (corresponds to ) (Friedman et al. 2010). In this study, we use a grid search over . This grid-search is directly embedded in our PLR implementation for simplicity. Using should result in a model very similar to gBLUP.

To fit PLR, we use an efficient algorithm (Friedman et al. 2010; Tibshirani et al. 2012; Zeng and Breheny 2017) from which we derived our own implementation in R package bigstatsr. This algorithm builds predictions for many values of , which is called a regularization path. To obtain an algorithm that does not require to choose this hyper-parameter , we developed a procedure that we call Cross-Model Selection and Averaging (CMSA, Figure S1). Because of L1-regularization, the resulting vector of estimated effect sizes is sparse. We refer to this method as PLR in the results section.

To capture recessive and dominant effects on top of additive effects in PLR, we use simple feature engineering: we construct a separate dataset with three times as many variables as the initial one. For each SNP variable, we add two more variables coding for recessive and dominant effects: one variable is coded 1 if homozygous variant and 0 otherwise, and the other is coded 0 for homozygous referent and 1 otherwise. We then apply our PLR implementation to this dataset with three times as many variables as the initial one; we refer to this method as PLR3 in the rest of the paper.

We use Monte Carlo cross-validation to compute AUC, partial AUC, the number of predictors, and execution time for the original Celiac dataset with the observed case-control status: we randomly split 100 times the dataset in a training set of 12,000 individuals and a test set composed of the remaining 3155 individuals.

We compared PLR with the C+T method using simulations of scenario N1 (Table 1). When simulating a model with 30 causal SNPs and a heritability of 80%, PLR provides AUC of 93%, nearly reaching the maximum achievable AUC of 94% for this setting (Figure 1). Moreover, PLR consistently provides higher predictive performance than C+T across all scenarios considered, except in some cases of high polygenicity and small sample size, where all methods perform poorly (AUC values below 60% Figure 1 and Figure 3). PLR provides particularly higher predictive performance than C+T when there are correlations between predictors, i.e., when we choose causal SNPs to be in the HLA region. In this situation, the mean AUC reaches 92.5% for PLR and 84% for C+T-max (Figure 1). For the simulations, we do not report results in terms of partial AUC because partial AUC values have a Spearman correlation of 98% with the AUC results for all methods (Figure S3).

In practice, a particular value of the threshold of inclusion of SNPs should be chosen for the C+T method, and this choice can dramatically impact the predictive performance of C+T. For example, in a model with 30 causal SNPs, AUC ranges from <60% when using all SNPs passing clumping to 90% if choosing the optimal P-value threshold (Figure S4).

Concerning the threshold of the clumping step in C+T, we mostly used the common value of 0.2. Yet, using a more stringent value of 0.05 provides equal or higher predictive performance than using 0.2 in most of the cases we considered (Figure 2 and Figure 3).

Our implementation of PLR that automatically chooses hyper-parameter provides similar predictive performance than the best predictive performance of 100 models corresponding to different values of (Figure S8).

We tested the T-Trees method in scenario N1. As compared to PLR, T-Trees perform worse in terms of predictive ability, while taking much longer to run (Figure S5). Even for simulations with model COMP in which there are dominant and interaction-type effects that T-Trees should be able to handle, AUC is still lower when using T-Trees than when using PLR (Figure S5).

We also compared the two PLRs in scenario N1: PLR vs. PLR3 that uses additional features (variables) coding for recessive and dominant effects. Predictive performance of PLR3 are nearly as good as PLR when there are additive effects only (differences of AUC are always <2%) and can lead to significantly greater results when there are also dominant and interactions effects (Figures S6 and S7). For model COMP, PLR3 provides AUC values at least 3.5% higher than PLR, except when there are 3000 causal SNPs. Yet, PLR3 takes two to three times as much time to run and requires three times as much disk storage as PLR.

First, when reproducing simulations of scenario N1 using chromosome six only (scenario N2), the predictive performance of PLR always increase (Figure 2). There is a particularly large increase when simulating 3000 causal SNPs: AUC from PLR increases from 60% to nearly 80% for Gaussian effects and a disease heritability of 80%. On the contrary, when simulating only 30 or 300 causal SNPs with the corresponding dataset, AUC of C+T-max does not increase, and even decreases for a heritability of 80% (Figure 2). Second, when varying the training size (scenario N3), we report an increase of AUC with a larger training size, with a faster increase of AUC for PLR as compared to C+T-max (Figure 3).

Joint PLRs also provide higher AUC values for the Celiac data: 88.7% with PLR and 89.1% with PLR3 as compared to 82.5% with C+T-max (Figure S2 and Table 2). The relative increase in partial AUC, for specificities larger than 90%, is even larger (42 and 47%) with partial AUC values of 0.0411, 0.0426, and 0.0289 obtained with PLR, PLR3, and C+T-max, respectively. Moreover, logistic regressions use less predictors, respectively, at 1570, 2260, and 8360. In terms of computation time, we show that PLR, while learning jointly on all SNPs at once and testing four different values for hyper-parameter , is almost as fast as the C+T method (190 vs. 130 sec), and PLR3 takes less than twice as long as PLR (296 vs. 190 sec).

We tested our implementation on 656K genotyped SNPs of the UK Biobank, keeping only Caucasian individuals and removing related individuals (excluding the second individual in each pair with a kinship coefficient >0.08). Results are presented in Table 3.

Our implementation of L1-penalized linear regression runs in <1 day for 350K individuals (training set), achieving a correlation of >65.5% with true height for each sex in the remaining 24K individuals (test set). By comparison, the best C+T model achieves a correlation of 55% for women and 56% for men (in the test set), and the GWAS part takes 1 hr (for the training set). If using only the top 100,000 SNPs from a GWAS on the training set to fit our L1-PLR, correlation between predicted and true heights drops at 63.4% for women and 64.3% for men. Our L1-PLR on breast cancer runs in 13 min for 150K women, achieving an AUC of 0.598 in the remaining 39K women, while the best C+T model achieves an AUC of 0.589, and the GWAS part takes 15hr.

In this comparative study, we present a computationally efficient implementation of PLR. This model can be used to build PRS based on very large individual-level SNP datasets such as the UK biobank (Bycroft et al. 2018). In agreement with previous work (Abraham et al. 2013), we show that jointly estimating SNP effects has the potential to substantially improve predictive performance as compared to the standard C+T approach in which SNP effects are learned independently. PLR always outperforms the C+T method, except in some highly underpowered cases (AUC values always <0.6), and the benefits of using PLR are more pronounced with an increasing sample size or when causal SNPs are correlated with one another.

When there are many small effects and a small sample size, PLR performs worse than (the best result for) C+T. For example, this situation occurs when there are many causal variants (3K) to distinguish among many typed variants (280K) while using a small sample size (6K). In such underpowered scenarios, it is difficult to detect true causal variants, which makes PLR too conservative, whereas the best strategy is to include nearly all SNPs (Purcell et al. 2009).

When increasing sample size (scenario N3), PLR achieves higher predictive performance than C+T and the benefits of using PLR over C+T increase with an increasing sample size (Figure 3). Moreover, when decreasing the search space (total number of candidate SNPs) in scenario N2, we increase the proportion of causal variants and we virtually increase the sample size (Dudbridge 2013). In this scenario N2, even when there are small effects and a high polygenicity (3000 causal variants out of 18,941), PLR gets a large increase in predictive performance, now consistently higher than C+T (Figure 2).

The choice of hyper-parameter values is very important since it can greatly impact the performance of methods. In the C+T method, there are two main hyper-parameters: the and the thresholds that control how stringent are the C+T steps. For the clumping step, appropriately choosing the threshold is important. Indeed, on the one hand, choosing a low value for this threshold may discard informative SNPs that are correlated. On the other hand, when choosing a high value for this threshold, too much redundant information is included in the model, which adds noise to the PRS. Based on the simulations, we find that using a stringent threshold leads to higher predictive performance, even when causal SNPs are correlated. It means that, in most cases tested in this paper, avoiding redundant information in C+T is more important than including all causal SNPs. The choice of the threshold is also very important as it can greatly impact the predictive performance of the C+T method, which we confirm in this study (Ware et al. 2017). In this paper, we reported the maximum AUC of 102 different P-value thresholds, a threshold that should normally be learned on the training set only. To our knowledge, there is no clear standard on how to choose these two critical hyper-parameters for C+T. So, for C+T, we report the best AUC value on the test set, even if it leads to overoptimistic results for C+T as compared to PLR.

In contrast, for PLR, we developed an automatic procedure called CMSA that releases investigators from the burden of choosing hyper-parameter . Not only this procedure provides near-optimal results, but it also accelerates the model training thanks to the development of an early stopping criterion. Usually, cross-validation is used to choose hyper-parameter values and then the model is trained again with these particular hyper-parameter values (Hastie et al. 2008; Wei et al. 2013). Yet, performing cross-validation and retraining the model is computationally demanding; CMSA offers a less burdensome alternative. Concerning hyper-parameter that accounts for the relative importance of the L1 and L2 regularizations, we use a grid search directly embedded in the CMSA procedure.

We also explored how to capture nonlinear effects. For this, we introduced a simple feature engineering technique that enables PLR to detect and learn not only additive effects, but also dominant and recessive effects. This technique improves the predictive performance of PLR when there are nonlinear effects in the simulations, while providing nearly the same predictive performance when there are additive effects only. Moreover, it also improves predictive performance for the celiac disease.

Yet, this approach is not able to detect interaction-type effects. In order to capture interaction-type effects, we tested T-Trees, a method that is able to exploit SNP correlations and interactions thanks to special decision trees (Botta et al. 2014). However, predictive performance of T-Trees are consistently lower than with PLR, even when simulating a model with dominant and interaction-type effects that T-Trees should be able to handle.

The computation time of our PLR implementation mainly depends on the sample size and the number of candidate variables (variables that are included in the gradient descent). Indeed, the algorithm is composed of two steps: first, for each variable, the algorithm computes an univariate statistic that is used to decide if the variable is included in the model (for each value of ). This first step is very fast. Then, the algorithm iterates over a regularization path of decreasing values of , which progressively enables variables to enter the model (Figure S1). In the second step, the number of variables increases and computations stop when an early stopping criterion is reached (when prediction is getting worse on the corresponding validation set, see Figure S1).

For highly polygenic traits such as height and when using huge datasets such as the UK Biobank, the algorithm might iterate over >100,000 variables, which is computationally demanding. On the contrary, for traits like celiac disease or breast cancer that are less polygenic, the number of variables included in the model is much smaller so that fitting is very fast (only 13min for 150K women of the UK Biobank for breast cancer).

Memory requirements are tightly linked to computation time. Indeed, variables are accessed in memory thanks to memory-mapping when they are used (Priv et al. 2018). When there is not enough memory left, the operating system (OS) frees some memory for new incoming variables. Yet, if too many variables are used in the gradient descent, the OS would regularly swap memory between disk and RAM, severely slowing down computations. A possible approach to reduce computational burden is to apply penalized regression on a subset of SNPs by prioritizing SNPs using univariate tests (GWAS computed from the same dataset). Yet, this strategy was shown to reduce predictive power (Abraham et al. 2013; Lello et al. 2018), which we also confirm in this paper. Indeed, when using only the 100K most significantly associated SNPs, correlation between predicted and true heights is reduced from 0.656/0.657 to 0.634/0.643 within women/men. A key advantage of our implementation of PLR is that prior filtering of variables is no more required for computational feasibility, thanks to the use of sequential strong rules and early stopping criteria.

Our approach has one major limitation: the main advantage of the C+T method is its direct applicability to summary statistics, allowing to leverage the largest GWAS results to date, even when individual cohort data cannot be merged because of practical or legal reasons. Our implementation of PLR does not allow yet for the analysis of summary data, but this represents an important future direction. The current version is of particular interest for the analysis of modern individual-level datasets including hundreds of thousands of individuals.

Finally, in this comparative study, we did not consider the problem of population structure (Vilhjlmsson et al. 2015; Mrquez-Luna et al. 2017; Martin et al. 2017), and also did not consider nongenetic data such as environmental and clinical data (Van Vliet et al. 2012; Dey et al. 2013).

In this comparative study, we have presented a computationally efficient implementation of PLR that can be used to predict disease status based on genotypes. A similar penalized linear regression for quantitative traits is also available in R package bigstatsr. Our approach solves the dramatic memory and computational burdens faced by standard implementations, thus allowing for the analysis of large-scale datasets such as the UK biobank (Bycroft et al. 2018).

We also demonstrated in simulations and real datasets that our implementation of penalized regressions is highly effective over a broad range of disease architectures. It can be appropriate for predicting autoimmune diseases with a few strong effects (e.g., celiac disease), as well as highly polygenic traits (e.g., standing height) provided that sample size is not too small. Finally, PLR as implemented in bigstatsr can also be used to predict phenotypes based on other omics data, since our implementation is not specific to genotype data.

We are grateful to Flix Balazard for useful discussions about T-Trees, and to Yaohui Zeng for useful discussions about R package biglasso. We are grateful to the two anonymous reviewers who contributed to improving this paper. The authors acknowledge LabEx Pervasive Systems and Algorithms (PERSYVAL)-Lab [Agence Nationale de Recherche (ANR)-11-LABX-0025-01] and ANR project French Regional Origins in Genetics for Health (FROGH) (ANR-16-CE12-0033). The authors also acknowledge the Grenoble Alpes Data Institute, which is supported by the French National Research Agency under the Investissements davenir program (ANR-15-IDEX-02). This research was conducted using the UK Biobank Resource under Application Number 25589.

Available freely online through the author-supported open access option.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Gene therapy reverses rare immune disorder | National …

May 5th, 2019 2:50 am

April 30, 2019

Children born with a rare genetic disorder called X-linked severe combined immunodeficiency (X-SCID) dont have a functioning immune system. As a result, they cant fight off infections. Without treatment, an infant with X-SCID will usually die within the first year or two of life.

The best option for treatment of newly diagnosed infants with X-SCID has been stem-cell transplantation from a genetically matched sibling. But less than a quarter of children with X-SCID have a matched donor available. For those without a matched donor, standard treatment has been a half-matched bone marrow transplant from a parent. But most infants receiving this type of transplant only have part of their immune system, called T lymphocytes, restored. These infants will need lifelong injections of protective antibodies. In addition, as they grow into young adulthood, they may have chronic medical problems that affect growth, nutrition, and quality of life.

To develop a better approach to fix the immune systems of children with X-SCID, researchers have used gene therapy to alter patients own blood stem cells. An engineered virus brings a healthy copy of the gene into the stem cells to replace the mutated gene that causes the disease.

Early results from trials of gene therapy for X-SCID resulted in life-saving correction of T lymphocytes. But similar to bone marrow transplant from a parent, the immune restoration was incomplete. In addition, in those first gene therapy studies, almosta third of the children developed leukemia. The approach accidentally stimulated cells to grow uncontrollably. In later studies, improved design of the engineered virus didnt cause cancer, but also didnt fully restore a healthy immune system.

In 2010, Dr. Harry Malech of NIHs National Institute of Allergy and Infectious Diseases (NIAID) and Dr. Brian Sorrentino of St. Jude Childrens Research Hospital reported a new and safer version of gene therapy for X-SCID. They designed a harmless engineered virus (called a lentivector) that could deliver genes into cells without activating other genes that can cause cancer. Before the altered stem cells were returned to their bodies, patients were given low doses of the chemotherapy drug busulfan. This made it easier for the new stem cells to grow in the bone marrow. In young adults and children treated at the NIH Clinical Center, the new therapy proved to be both safe and effective at restoring the full range of immune functions.

Based on this work, a team led by Dr. Ewelina Mamcarz of St. Jude Childrens Research Hospital began treatment in 2015 of newly diagnosed infants with X-SCID using the lentivector and busulfan. The work was funded in part by NHLBI. The team described the treatment of eight infants with the disorder on April 18, 2019, in the New England Journal of Medicine.

By 3 to 4 months after infusion of the repaired stem cells, 7 of the 8 infants had normal levels of multiple types of immune cells in their blood. The last infant required a second stem-cell infusion, after which his immune-cell levels rose to a normal range.

The infants new immune systems were able to fight off infections that the researchers had detected before the gene therapy. Four of the eight discontinued immune-system boosting medications that theyd previously needed. Of those four, three developed antibodies in response to vaccination, indicating a fully functional immune system.

A year and a half after gene therapy, all children were healthy and growing normally.

The broad scope of immune function that our gene therapy approach has restored to infants with X-SCID as well as to older children and young adults in our continuing study at NIH is unprecedented, Malech says.

The researchers will continue to follow the participants over time. They plan to track how the childrens immune systems develop and look for any late side effects.

References:Lentiviral Gene Therapy Combined with Low-Dose Busulfan in Infants with SCID-X1. Mamcarz E, Zhou S, Lockey T, Abdelsamed H, Cross SJ, Kang G, Ma Z, Condori J, Dowdy J, Triplett B, Li C, Maron G, Aldave Becerra JC, Church JA, Dokmeci E, Love JT, da Matta Ain AC, van der Watt H, Tang X, Janssen W, Ryu BY, De Ravin SS, Weiss MJ, Youngblood B, Long-Boyle JR, Gottschalk S, Meagher MM, Malech HL, Puck JM, Cowan MJ, Sorrentino BP. N Engl J Med. 2019 Apr 18;380(16):1525-1534. doi: 10.1056/NEJMoa1815408. PMID: 30995372.

Funding:NIHs National Institute of Allergy and Infectious Diseases (NIAID); National Heart, Lung, and Blood Institute (NHLBI); and National Cancer Institute (NCI); American Lebanese Syrian Associated Charities; California Institute of Regenerative Medicine; and Assisi Foundation of Memphis.

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About Gene Therapy: A Potential Treatment for Genetic Diseases

May 5th, 2019 2:50 am

Gene Therapy Research: Then and Now

The idea of gene therapy is not new. In fact, scientist have been investigating and evolving it for more than 50 years, and, to date, more than 2300 gene therapy clinical trials are planned, ongoing, or have been completed.

Gene therapy research, some in very early stages, is focusing on many diseases that are partly or fully caused by genetic mutations, such as blood clotting disorders, for example hemophilia, cardiovascular disease, neurodegenerative disorders, such as Parkinsons disease, vision disorders, and musculoskeletal disorders.

The potential of gene therapy research brings hope to millions of people living with currently untreatable diseases.

Understanding Genetic Disease

Before you can understand what gene therapy research is, its important to know what a gene is. The human body is composed of trillions of cells. Within a cell, theres a nucleus, which contains chromosomes. Chromosomes are made up of DNA, which is the bodys hereditary material. Genes are segments of DNA. Genes contain instructions for making proteins, which are molecules that build, regulate, and maintain the body.

Sometimes theres a change in a genes DNA sequence. This is called a mutation and can cause a necessary protein to not work properly or to be missing. A mutation can be a substitution, deletion, or duplication. Some mutations are harmless, but others can result in a genetic disease.

Simply put, gene therapy is an investigational approach with the goal of treating or possibly preventing a genetic disease.

Exploring the Potential of Gene Therapy

One goal of gene therapy research is to determine whether a new or functional gene can be used to restore the function of or inactivate a mutated gene. One way for this to happen is to deliver a gene into a cell. To do so, a transporter, known as a vector, is typically used. A vector can be made from an altered virus. Which means that before the virus is used, its viral genes are removed. Vectors can be given intravenously, which means they are administered into a vein, or injected into a specific tissue in the body.

There are three commonly used vectors. One of them, adeno-associated virus, or AAV is not known to cause disease, which is why it may be used as a viral vector to transport a gene into the cell.

In this example, the gene delivered into the cell does not integrate into its DNA and cannot be passed down to new cells.

Once the cell has received the functional gene, it should address the mutation by producing the necessary protein or stopping production of the harmful protein. At Spark Therapeutics, we are using AAV vectors to advance research programs against strategically selected target tissues for example, the retina, liver, and central nervous system. Which is all part of our mission to challenge the inevitability of genetic disease.

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About Gene Therapy: A Potential Treatment for Genetic Diseases

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What Stem Cell Clinics Do You Trust? | BioInformant

May 4th, 2019 3:47 am

Be in the know about leading stem cell centers you can trust in this article.

In this article:

Stem cell clinics have received a great deal of negativepress,with prominent media outlets announcing that the Food and Drug Administration (FDA) had mailed Warning Letters to stem cell centers across the United States.According to a paper published in the journalCell Stem Cell in June 2016,at least 351 businesses offer unproven stem cell interventions fromclinics spread across the U.S.

Shortly after publication, the MIT Technology Reviewand Washington Postpicked up the story, spreading the fear far and wide.Journalists then got enthralled with the story, calling it the Wild West of stem cells.

But, is this the whole story?

What this hype does not cover isthe promising medical potentialof stem celltherapies, nor had it properly credited the legitimate stem cell clinics that comply with FDA regulations to offer effective medical treatments to populations of patients who otherwise have limited options.

Today, the majority of medical clinics that offer stem cell treatments administer mesenchymal stem cells (MSCs), which they source from human fat (adipose tissue) orbone marrow.

Mesenchymal stem cells are a type of multipotent stem cell that is administered for a range of medical applications, including orthopedic repair, pain management, arthritis, and asthma.

When properly administered, multipotent self-derived stem cells (such as MSCs) can be safe for patient use.

It is important that the cells be multipotent (limited in their differentiation capacity), rather than totipotent (can become any cell) or pluripotent (can become most cells). There is also an additional level of safety that comes from having stem cells be self-derived, which doctors and scientists call autologous.

Stem cell differentiation capacity is explained below:

While it is true that many stem cell centers are not properly regulated, the therapeutic promise of stem cells is also clear.

Today, nearly 30,000 scientific publicationshighlight research and therapeutic advanceswith mesenchymal stem cells (MSCs), and approximately850+ clinical trials are investigating therapeutic uses of MSCs. Additionally, 300,000+ scientific publications about stem cells have been released.

This momentum is not surprising, because We are not made of drugs, we are made of cells.

However, the biggest issue with the hype surrounding stem cell centers is that it does not give proper credit to the companies that cooperate with regulatory bodiesto ensure a safe and efficacious patient experience. Many of these companies also collaborate withoffshore regulatory bodies to offer stem cell procedures approved by local regulatory agencies.

The FDAsCenter for Biologics Evaluation and Research (CBER)regulates human cell and tissue-based products in the U.S., known as HCT/Ps. The FDA has two different paths for cell therapies based on relative risk.

These pathways are commonly called 361 and 351 products.

The 361 products that meet all the criteria in 21 CFR 1271.10(a)are regulated as HCT/Ps and are not required to be licensed or approved by the FDA. These products are called 361 products because they are regulated under Section 361 of the Public Health Service (PHS) Act.

In contrast, if a cell therapy product doesnot meet all the criteria outlined in 21 CFR 1271.10(a), then it is regulated as a drug, device, or a biological product under the Federal Food, Drug, and Cosmetic Act (FDCA) and Section 351 of the PHS Act.[1]

These 351 products requireclinical trials to demonstrate safety and efficacy in a process that is nearly identical to that what is required for pharmaceutical products to enter the marketplace.

Stem cell centers must ensure that their treatments meet the FDAs criteria to be classified as 351 products.

Below, we cover five leading stem cell centers. Each one has treated large populations of patients with adult stem cells. At least one (Regenexx) is maintaining a Patient Registry to document long-term patient outcomes.

We are not advising patients to seek treatments from these companies.We are identifying them to allow readers to seek out more information.

Founded by Dr. Neil Riordan, a globally recognized stem cell expert and visionary, the Stem Cell Institute in Panama is among the worlds leaders in stem cell research and therapy. Their treatments focus on well-targeted combinations of allogeneic umbilical cord stem cells, as well as autologous bone marrow stem cells.

The stem cells clinic uses stem cell therapies to treat various ailments, including the following:

One of their most recent studies exhibited the clinical feasibility of stem cell transplant process as a safe and effective treatment approach for patients with multiple sclerosis (MS).

Published in the Journal of Translational Medicine, the study showed that umbilical cord stem cells can slow down MS disease progression and decrease the frequency of flare-ups.

However, these stem cells did not exhibit the ability to repair damaged nerve cells or myelin sheaths.

After the completion of this clinical study, there was an improvement in MS patient disability. The 1-month mark of the study documented improvements in mobility, hand, bladder, bowel, and sexual functions. Importantly, the study demonstrated that a sustained one-year umbilical cord stem cell therapy has more durable benefits than current MS drug therapies.

Headquartered in Denver, CO, Regenexx offers self-derived (autologous transplant) same-day stem cell treatments to patients with orthopedic injuries and conditions. Regenexx clinicsincorporate a variety of regenerative approaches, drawing patients from all over the U.S. who are seeking innovative, non-surgical treatments.

TheRegenexx technologyinvolvesa procedure in whicha small bone marrow sample is extracted through a needle and blood is drawn from a vein in the arm. These samples are then processed in a laboratory and the cells they contain are injected into the area needing repair, with the goal of delivering large numbers of stem cells to the site of injury.

Regenexx is also a licensedoffshore clinic in the Cayman Islands where patients can undergo treatments that utilize laboratory-expanded (ex vivo) stem cell populations. This approach allows for a much larger number of stem cells to be administered to the patient than is supported by U.S. law, which currently prohibits laboratory procedures that the FDA considers to exceed minimal manipulation.

Dr. Christopher Centenois the Founder and CEO of Regenexx. He is a global authority in the culture expansion and clinical use of adult stem cells to treat orthopedic injuries and thevisionary behind the Regenexx technology.

I am also a Regenexx patient.Click here to read my experience.

Founded in 2011,Okyanosis a stem cell therapy provider that specializes in treating patients with congestive heart failure (CHF) and other chronic degenerative conditions. Okyanos Cell Therapy uses internationally-approved technology to deliver a mixed population of fat (adipose) derived stem and regenerative cells (ADRCs) to patients with conditions such as the following:

Okyanos maintains both a North American Office in Clearwater, FL, and a purpose-built Cell Therapy Surgical Center inFreeport, GrandBahama. Okyanos stem cell treatments are performed in their state-of-the-art surgical centers under the care of board-certified doctors.

Okyanos is also fully licensed and regulated under the Bahamas Stem Cell Therapy and Research Actand adheres to U.S. surgical center standards. Click here to access our recent interview withMatthew Feshbach, Co-Founder and CEO of Okyanos.

The Global Institute of Stem Cell Therapy and Research (GIOSTAR) provides adult stem cells for autologous and allogeneic stem cell therapy to patients around the world, based on research byDr. Anand Srivastava. The stem cell clinic offers adult stem cells for rejuvenation treatment, muscular injuries, and degenerative diseases.

Each of GIOSTARs clinics is licensed for the application of stem cell therapy.Since 2000, its team of scientists and clinicians have been developing and utilizing stem cell-based clinical protocols for the purpose of stem cell treatment.

Although the company is headquartered in San Diego, California, GIOSTAR Mexico has provided stem cell therapy to patients from all over the world. Mexicos regulation of stem cell therapeutics differs from the regulations imposed by the U.S. FDA, making it a growing site for medical tourism.

Celltex specializes in cryopreserving mesenchymal stem cells (MSCs) for therapeutic use. Celltex acquires stem cells by collecting a small fat sample from a patient, from which MSCs are extracted,isolated, multiplied, and stored for future use (known as cell banking).

Patients can then use their stored stem cells for regenerative purposesthrough infusions or injections performed by a licensed physician.

Because the FDA considers an individuals stem cells a drug if they have been expanded in large quantities, Celltex has begun the process of undertaking clinical trials on stem cells as a treatment for a range of medical conditions, seeking approval from the FDA to allow physicians to utilize these cells.

Nonetheless, to meet the immediate needs of its clients, the company also has taken steps to meet the requirements of the FDA and COFEPRIS, a Mexican institution equivalent to FDA in MSCs import and export.

Celltex also works with Mexican hospitals that are established and certified that allowed the companys cell-banking clients to receive their stem cells for medical purposes.

Although these leading stem cell centers have built a good reputation in regenerative medicine, it is still important to probe these clinics before the proper procedure. These questions should cover what to expect from the treatment, safety and emergencies, cost, and the patients rights.

Treatment

Safety and Emergencies

Costs

Patients Rights

Understanding how these leading stem cell centers operate and what they do allows the patient to assess which of them is the right investment. While the information above is important to understand from a scientific and regulatory perspective, patient experiences are valuable too.

If you found this blog valuable, subscribe to BioInformants stem cell industry updates.

As the first and only market research firm to specialize in the stem cell industry, BioInformant research is cited by The Wall Street Journal, Xconomy, AABB, and Vogue Magazine. Bringing you breaking news on an ongoing basis, we encourage you to join more than half a million loyal readers, including physicians, scientists, executives, and investors.

Have you had a stem cell transplant?What stem cell clinic did you use? What treatment did you get and for what condition? Share your answers in the comments below.

Footnotes [1] Aabb.org. (2017). Cellular Therapies. [online] Available at: http://www.aabb.org/advocacy/regulatorygovernment/ct/Pages/default.aspx [Accessed 1 Aug. 2017].

What Stem Cell Clinics Do You Trust?

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Stem Cell Procedure | Arizona | Stem Cell Rejuvenation Center

May 3rd, 2019 7:48 am

PROCEDURE

What is anAutologousAdipose Stem Cell Procedure?

A small sample of Adipose tissue (fat) is removed from above the Superior Iliac spine (love handles) or abdomen under a local anesthetic.

How do I know if stem cell therapy is right for me?

Discussing treatment options with your physician is an important first step in making a decision regarding stem cell therapy. Potential outcomes, an integrative and comprehensive treatment plan, and financial costs are all factors to consider.

A small sample of Adipose tissue (fat) is removed from above the Superior Iliac spine (love handles) or abdomen under a local anesthetic.

Obtaining Adipose-Derived Stem Cells (ADSCs) is much easier and less invasive than performing a bone marrow extraction. In addition, adipose tissue contains much larger volumes of mesenchymal stem cells than does bone marrow. We use the patient's own adipose tissue to extract the stem cells. Autologous means that the donor and the recipient are the same person.

Benefits of ADSCs: Stem cells play an integral part in wound healing and regeneration of tissue at the cellular level.

What is anAutologousAdipose Stem Cell Procedure?

Is this procedure a significant improvement on other treatments currently available?

The Major Advantages of Adipose Stem Cell Therapy:

Our technology allows us to complete the entire procedure on the same day, using less than minimally manipulated methods.

*High Yield: A high-dose of stem cells can be obtained in just a couple of hours.

*Mesenchymal stem cell yields from peripheral fat are much higher than from bone marrow.

*Patients receive their own autologous cells, so there is a very low risk of immune rejection.

*A minimally invasive outpatient procedure makes it easier to harvest from fat than from bone marrow and more comfortable for patients.

Yes We can now obtain Adult Stem Cells (ASCs) from a fat sample. This in-clinic treatment is completed the same day, and there is no need to ship samples to an outside laboratory and wait days for the cells to be returned for an injection on a second visit.

This faster process provides increased stem cell counts, without manipulation.

Is an Autologous Adipose Stem Cell Procedure Safe?

Yes because the adipose tissue is removed from one's own body via sterile technique and remains in a controlled environment there are no problems with cell rejection or disease transmission.

The interview, physical, harvesting, and administration of stem cells are all performed in-house under a physicians control.

How do I know if stem cell therapy is right for me?

Discussing treatment options with your physician is an important first step in making a decision regarding stem cell therapy. Potential outcomes, an integrative and comprehensive treatment plan, and financial costs are all factors to consider.

I have heard Stem Cell Treatments are VERY expensive, can I afford this?

Yes you can!

Due to our advanced adult stem cell technology provided in the form of an in house procedure, our Stem Cell Center can now provide this service at a fraction of the cost previously incurred. Even better, its a same day procedure.

We offer theentirety of our treatment in Phoenix, Arizona -USA and we have been able to lower our cost to a flat rate of $7,100.00 per treatment (including consultation). Fees are subject to change and some more complex proceduresmay incur additional costs.

Why Choose an Adipose Stem Cell Procedure?

Adipose-derivedmesenchymalstem cells areeasier to harvest than bone marrowand can be obtained in much larger quantities. In addition, it is much less painful and involves lower risks.

*There is a much shorter time from extraction to the administration oftreatment.No culturing or manipulation is needed using our procedure, as opposed to a bone marrow extraction which requires days or weeksto reach the necessary therapeutic threshold.

*There are no ethical or moral issues involved in harvestingautologousAdult Stem Cells (ASCs).

Are There Detrimental Side Effects from an Adipose Stem Cell Procedure?

No, the adipose tissue is extracted from the patients own body sono foreign donors are used. This minimizes the potential for immune rejection.Our procedure is performed completely in-house and administered by licensed physicians here in the United States.

Please keep in mind that every procedure does have its risks, but we do practice sterile technique which makes the risk of infectionvery low.In fact, we have not had any infections develop in any of the stem cell patients we have treated as we take great care in keeping a sterile environment.

AutologousGrowth Factor Components ofPRP:

PRP(Platelet Rich Plasma) contains many growth factors, and has been successfully used clinically to improve hard and soft tissue healing

TGF-(Transforming growth factor alpha & beta)

EGF(Epidermal growth factor)

FGF(Fibroblast growth factor)

IGF(Insulin growth factor)

PDEGF(platelet derived epidermal growth factor)

PDAF(platelet derivedangiogenesisfactor)

IL-8 (Interleukin-8)

TNF-(Tumor necrosis factor alpha)

CTGR(Connective tissue growth factor)GM-CSF (Granulocytemacrophage colony stimulating factor)

KGF(Keratinocytegrowth factor)

High concentration of leukocytes (neutrophils,eosinophils) formicrobicidalevents

High concentration of wound macrophages and otherphagocyticcells, for biological debridement

Histamines, Serotonin, ADP,ThromboxaneA2, and othervasoactiveandchemotacticagents

High platelet concentration and native fibrinogen concentration for improvedhemostasis

What You Can Expect When Visitingthe Stem Cell Rejuvenation Center:

Consultation: Each patient receives a consultation lasting up to 1 1/2 hours prior to the treatment: History, Medications, Patient desires and expected outcomes are discussed.

Harvest:Using a tumescent anesthetic, a sample of adipose tissue is collected from the patient.

PRP:If needed, it is isolated from the patient's own blood.

Stem Cells:Ourlaboratory staff will isolate the Adult Stem Cells (ASCs) and other progenitor cells in a sterile environment from the collected fat sample ensuring that no contamination occurs. There is a difference betweenaspeticand sterile technique. It is extremely important to note that sterility means that the cells are not exposed to air particles and contaminants.

Prepare: If the doctor wishes, she/he will offer antioxidant and nutritional IV's prior to infusion to prepare the patient for the therapy.

Infuse:The cells are then administered back to the patient through one or more of the following modes of administration:

Intravenous:The Stem Cells are administered via an intravenous push

Localized:The Stem Cells are administered directly into a localized area.

Intramuscular:The Stem Cells are implanted into the muscle.

Intranasal:This therapy relies on direct transmission through thecribiformplate, bypassing the Blood Brain Barrier, along the olfactory andtrigeminalnerve pathways.

Differences BetweenAn Adipose And A Bone Marrow Procedure:

Disclaimer:Even though our Treatments are done usingautologouscells, our Stem Cell Therapies are not approved by the FDA. Stem Cell Treatments are not a cure for any condition, disease or injury, nor a substitute for proper medical diagnosis and care.Again, StemCell Treatments are not a cure for any condition, disease or injury, nor a substitute for proper medical diagnosis and care. The information we communicate is not medical advice. It is intended to be used for educational and information purposes only. We do not usecollagenasein our stem cell treatment.Its important for you to do your own research based on the options that we present to you so that you can make an informed decision.

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Outcomes, Complication Rates, and Stem Cell Procedures …

May 2nd, 2019 6:52 am

POSTED ON 03/26/2017 IN Knee Latest News BY Chris Centeno

Given the quite reasonable concerns this past week over the blinding of three womenby a stem cell clinic injecting fat stem cells into eyes, I thought it was time to take a look at stem-cell-procedure complications. All medical procedures have complications. So what bar can we use to see if those complications are reasonable, and how should those be reported and measured?

First, to decide what complications might be reasonable, we need to understand the playing field of common side effects of conventional treatments. So what are some common complications in my world of orthopedic care, and how often do they happen?

So conventional procedures and widely used medications can have big time complications and rates!

To date, I think weve reported the most comprehensive paper on stem-cell-related complications. In more than 2,300 patients and 3,000 procedures, the total complication rate was 2.0%. Of those, four were deemed to be more serious and definitely related to the procedure by at least one independent reviewer not related to our group. Since this is out of 3.012, this is a serious-complication rate of 0.13%. Pretty small compared to the rates reported above for common orthopedic procedures.

This week we saw reported that the complication rate for the fat stem cell clinic that blinded three consecutive patients was approximately 0.01%. That seems about ten times less, despite the significant reported complications. Why? The data is an apples to oranges comparison.

For our reported data, a registry infrastructure was used where questionnaires were sent to every patient, and if they failed to respond, telephone calls were made. Based on conversations I have had with participating physicians, the stem cell outfit with the complications uses a passive system where the doctors are told to report the complications. Its likely that pinging patients about whats wrong can find more complications when compared to relying on a busy physician to report his or her complications.

Regrettably, the stem cell outfit that blinded these patients hasnt published any safety data on the widespread use of fat stem cells, so there is no research to review. This is concerning.

As you can see from the above risks, stem-cell-based orthopedic therapies have low-risk profiles when compared to conventional orthopedic procedures. Hence, when complications do occur, they are rare. However, to determine risk, efficacy is also needed as part of the calculus. So lets look at knee replacement.

So how good is knee replacement compared to garden-variety physical therapy (PT)? Not great. In a recent study (video below), 3 in 4 knee-replacement candidates undergoing PT instead of surgery decided not get a knee replacement after one year.Also you need to amputate 56 knees to find just one patient who reports more than a 15% functional improvement as a result of this maximally invasive surgery.

Looking at the relative efficacy of two procedures is hard without a head-to-head comparison trial. However, in the case of knee arthritis, we can comparetwo different studies that both compare to PT. In the above caseof knee replacement, we know how that invasive procedure fared, and below well look at a same-day stem cell procedure.

For the stem cell procedure, well be looking at the Regenexx bone-marrow-based version. Below is a graphic that discusses that out of more than 5,000 knee stem-cell-treated patients, as of this month, only about 12% went on to get a knee replacement despite their treatment at 12 years. This was based on 100% response rate from a random sample of 100 registry patients.

Below are the yet unpublished results of our randomized controlled trial where knee-replacement candidates were treated with our Regenexx knee stem cell procedure versus physical therapy:

The patients with a stem cell procedure report more knee function more quickly compared to the physical therapy group (listed here as Exercise Therapy). The PT group crossed over to the stem cell procedure at three months, which is why the PT data is only tracked for that long.

So comparing risks and benefits of these two therapies, the risk of knee replacement is significantly greater and the outcome based on a randomized controlled trial is likely no better than a stem cell injection. Hence, the risk/benefit of a Regenexx-protocol knee stem cell procedure is good compared to traditional care.

The upshot? While the risks of stem cell therapy are likely lower than most traditional treatments, for some indications, like injecting fat stem cells in the eye, that equation goes in the wrong direction. The goal with todays review was also to open a debate about when stem cell therapy is likely the better option.So lets have a reasonable discussion about stem cell risks and not throw the baby out with the bathwater!

*DISCLAIMER: Like all medical procedures, Regenexx Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else. Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

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What is Biotechnology: Types, Examples and Applications …

May 2nd, 2019 6:49 am

Biotechnology is the use of biological systems found in organisms or the use of the living organisms themselves to make technological advances and adapt those technologies to various different fields. These include applications in various fields from agricultural practice to the medical sector. It does not only include applications in fields that involve the living, but any other field where the information obtained from the biological aspect of an organism can be applied.

Biotechnology is particularly vital when it comes to the development of miniscule and chemical tools as many on the tools biotechnology uses exist at the cellular level. In a bid to understand more regarding biotechnology, here are its types, examples and its applications.

According to Biotechnology Innovation Organization,

Biotechnology is technology based on biology biotechnology harnesses cellular and biomolecular processes to develop technologies and products that help improve our lives and the health of our planet. We have used the biological processes of microorganisms for more than 6,000 years to make useful food products, such as bread and cheese, and to preserve dairy products.

Medical biotechnology is the use of living cells and other cell materials for the purpose of bettering the health of humans. Essentially, it is used for finding cures as well as getting rid of and preventing diseases. The science involved includes the use of these tools for the purpose of research to find different or more efficient ways of maintaining human health, understanding pathogen, and understanding the human cell biology.

Here, the technique is used to produce pharmaceutical drugs as well as other chemicals to combat diseases. It involves the study of bacteria, plant and animal cells to first understand the way they function at a fundamental level.

It heavily involves the study of DNA (Deoxyribonucleic acid) to get to know how to manipulate the genetic makeup of cells to increase the production of beneficial characteristics that humans might find useful such as the production of insulin. The field usually leads to the development of new drugs and treatments, novel to the field.

Vaccines are chemicals that stimulate the bodys immune system to better fight pathogens when they attack the body. They achieve this by inserting attenuated (weakened) versions of the disease into the bodys bloodstream. This causes the body to react as if it was under attack from the non-attenuated version of the disease. The body combats the weakened pathogens and through the process takes note of the cell structure of the pathogens and has some cell remember the disease and store away the information within the body.

When the individual becomes exposed to the actual disease, the body of the individual immediately recognizes it and quickly forms a defense against it since it already has some information on it. This translates to quicker healing and less time being symptomatic.

The attenuated disease pathogens are extracted using biotechnological techniques such as growing the antigenic proteins in genetically engineered crops. An example is the development of an anti-lymphoma vaccine using genetically engineered tobacco plants made to exhibit RNA (A similar chemical to DNA) from malignant (actively cancerous) B-cells.

Strides have been made in the development of antibiotics that combat pathogens for humans. Many plants are grown and genetically engineered to produce the antibodies. The method is more cost effective than using cells or extracting these antibodies from animals as the plants can produce these antibodies in larger quantities.

Agricultural biotechnology focuses on developing genetically modified plants for the purpose of increasing crop yields or introducing characteristics to those plants that provide them with an advantage growing in regions that place some kind of stress factor on the plant namely weather and pests.

In some of the cases, the practice involves scientists identifying a characteristic, finding the gene that causes it, and then putting that gene within another plant so that it gains that desirable characteristic, making it more durable or having it produce larger yields than it previously did.

Biotechnology has provided techniques for the creation of crops that express anti pest characteristics naturally, making them very resistant to pests, as opposed to having to keep dusting them and spraying them with pesticides. An example of this would be the fungus Bacillus thuringiensis genes being transferred to crops.

The reason for this is that the fungus produces a protein (Bt) which is very effective against pests such as the European corn borer. The Bt protein is the desired characteristic scientist would like the plants to have and for this reason, they identified the gene causing Bt protein to express in the fungus and transferred it to corn. The corn then produces the protein toxin naturally, lowering the cost of production by eliminating the cost of dusting the crop with pesticide.

Selective breeding has been a practice humans have engaged in since farming began. The practice involves choosing the animals with the most desirable characteristics to breed with each other so that the resulting offspring would also express these traits. Desirable characteristics included larger animals, animals more resistant to disease and more domicile animals, all geared to making the process of farming as profitable as possible.

This practice has been transferred to the molecular level with the same purpose. Different traits are selected among the animals and once the genetic markers have been pointed out, animals and plants with those traits are selected and bred for those traits to be transferred. A genomic understanding of those traits is what informs the decisions on whether the desired traits will express or get lost as recessive traits which do not express.

This information provides the basis for making informed decisions enhancing the capability of the scientists to predict the expression of those genes. An example is its use in flower production where traits such as color and smell potency are enhanced.

One of the biggest uses of biotechnology is the infusion of nutrients into food in situations such as aid. Therefore, it provides food with heavy nutrients that are necessary in such situations. An example of this application is the production Golden Rice where the rice is infused with beta-carotene. The rice has Vitamin A, which the body can easily synthesise.

There is actually very little land on earth that is arable with some estimates place it at around 20 percent. With an increase in the worlds population, there is a need for the food sources available to be as effective as possible to produce as much food in as little space as possible. There is also need to have the crops grown to be able to make use of the less arable regions of the world.

This means that there is a need to develop crops that can handle these abiotic stresses such as salinity, drought and frost from cold. In Africa and the Middle East, for instance, where the climate can be unforgiving, the practice has played a significant role in the development of crops that can withstand the prevailing harsh climates.

The industrial applications of biotechnology range from the production of cellular structures to the production of biological elements for numerous uses. Examples include the creation of new materials in the construction industry, and the manufacture of beer and wine, washing detergents, and personal care products.

One of the materials with the strongest tensile strength is spider webs. Amongst other materials with the same cross sectional width, spider webs can take more tensional force before breaking than even steel. This silk has created a lot of interest with the possible production of materials made from silk including body armour such as bullet proof jackets. Silk is used because it is stronger than Kevlar (the material most commonly used to make body armour).

Biotechnological techniques have been used to pick the genes found in spiders and their infusion in goats to produce the silk proteins in their milk. With this initiative, it make production easier as goats are much easier to handle compared to spiders and the production of silk via milk also help make the processing and handling much easier compared to handling the actual silk strands.

One of the biggest applications of biotechnology is in the energy production sector. With fears over the dwindling oil resources in the world and their related environmental impacts, there is a need to protect the globes future by finding alternative environmentally friendly fuel sources. Biotechnology is allowing this to happen with advances such as using corn to produce combustible fuel for running car engines. These fuels are good for the environment as they do not produce the greenhouse gases.

Biotechnology is applied in the healthcare sector is the development of pharmaceuticals that have proven problematic to produce though other conventional means because of purity concerns.

A true environmentalist by heart . Founded Conserve Energy Future with the sole motto of providing helpful information related to our rapidly depleting environment. Unless you strongly believe in Elon Musks idea of making Mars as another habitable planet, do remember that there really is no 'Planet B' in this whole universe.

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Stem Cell Treatment in India | Stem Cell Therapy in Uttar …

May 2nd, 2019 6:49 am

We have expanded an expertise & capacities in accumulating and separating stem cells from the available organic material Adipose Tissue, Umbilical Cord Blood & Tissue, Amniotic Fluid, Amniotic Sac, Dental Pulp, Bone Marrow and Menstrual Blood.

We truly believe that stem cells is the perfect future to prevent age related degeneration. A period will come when the bodys own particular cells will assist in restoring youth and staying healthy without any drugs.

As the main health care consultant, stem cell center takes care of all section of the medical Tourism to New Delhi. We guarantee our patients get the best health care services by bringing in place, the famous multi-specialty hospitals, recent stem cell treatments, economical accommodations and travel alternatives for the patients.

We are passionate about the recent developments in stem cell therapies in India and endeavor to deliver safe and viable treatment alternate to patients all over the world at the highest medical standards.

At stem cell center, we have a vigorous team of researchers and clinicians at the helm of fundamental research in stem cells. We trust in creating a network of researchers and experts who are bound by a common interest and add to each others comprehension of the subject.

Our Stem cell Treatment services for Degenerative diseases

Spinal Cord Injury

Non-union Fracture

Peripheral Arterial Disease

Optic Nerve Damage

Diabetes

Brain Stroke/Injury/Coma

Avascular Necrosis

Coronary Arterial Disease

Retinitis Pigmentosa

Acute/Chronic Kidney Disease

Cerebral Palsy/Atrophy

Rheumatoid Arthritis

Macular Degeneration

Myocardial Infarction (MI)

Autism

Knee Cartilage Damage

Muscular Dystrophy as DMD, LGMD & BMD

Parkinsons Disease

Lung Fibrosis or COPD

Alzheimer Disease

Diabetic Foot Ulcer & Gangrene

Motor Neuron Disease

Sports Injury Treatment

Multiple Sclerosis

Liver Cirrhosis

Our Vision

The vision of stem cell center is to be a pioneer in the zone of stem cell research, stem cell banking and development of numerous stem cell based procedures and products that will address the neglected medical requirement.

Our Mission

In accordance with the activities of the group in the area of hematology, pathology and transfusion drug, stem cell based medicine will be the following in the pipeline .The group has the mission to think with cell based procedures and results of highest quality for clinical utilize. The mission is to have an authorize facility that meets the directions of both Indian and global standards.

If you have any queries related to stem cell therapy then contact us without any hesitation on our contact numbers:-

Md. No:- +91-9650988899, 91-9891404143

To get quick response, fill our quick contact form

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Adult Stem Cell Therapy Is A Resounding Healing Success …

May 2nd, 2019 6:49 am

Adult stem cell therapy is enjoying widespread success around the world, but if the FDA gets its way, it may soon be banned here in the U.S....

There have been nearly 12,000 adult stem cell therapies performed in the United States with an over 90 percent success healing rate for mostly joint and spinal conditions. It involves using the patients own stem cells, so no patent-able drugs are involved.

They are targeting the most influential stem cell scientist in the U.S., Dr. Kristin Comella in Florida.

Differentiating the Types of Stem Cell Therapy

They could be considered seeds for growing body tissues. They are mostly able to function for cellular repair and growth no matter what organ is in need of repair or healing from chronic inflammation.

There is a considerable controversy surrounding stem cell therapy research, a branch of regenerative medicine. Much of the controversy has to do with not differentiating between adult stem cell therapy and embryonic stem cell therapy.

Read: Scientists Discover That Fasting Triggers Stem Cell Regeneration & Fights Cancer

Embryonic stem cell therapy is the controversial one. It cultures or creates stem cells from terminated or aborted fetuses.

Currently, the FDA is harassing stem cell clinics that do not derive their stem cell solutions from aborted fetus tissue. They extract the stem cells from the patients own adipose tissue and inject them into areas where that same patient needs repair. Its an autologous process called adult stem cell therapy.

U.S. Stem Cell based out of South Florida is one of the clinics being targeted by the FDA, and the clinics Chief Scientist is Dr. Kristin Comella, PhD.

Many other nations have been using adult stem cell therapy successfully over the past 15 years, leaving the USA dead last in this field. The FDA is trying to make sure it stays that way and allows costly pharmaceutical versions to prevail.

Dr. Kristin Comella and her clinic have been under attack from the FDA.

This short 3-minute video was produced interviewing Dr. Comella and some of her patients.

Examining and Comparing the Different Types of Stem Cell Therapy

Human embryonic stem cell (hESC) therapy has received most of the medias attention and government support. But it is the most controversial because it involves extracting tissues from terminated human embryos, aka aborted fetuses.

In addition to moral and ethical issues, human embryonic stem cell (hESC) solutions create cells so rapidly where theyre injected they lead to cancerous tumors. To avoid that, researchers have to use immuno-suppressant drugs to curb the embryonic stem cells tendency toward cancer.

Using pharmaceutical drugs to curb hESC cancer side effect issues leads to other unexplored and unexpected side effects from those patented stem cell solutions.

But the profit motive for embryonic stem cell therapies was strong and a lot of government funds had been put into its research. Pharmaceutical companies were motivated because they could patent stem cells created from embryonic tissues.

Bone marrow stem cell therapy was among the first to depart from flawed hESC (human embryonic stem cell) therapies developed over the past two decades. Bone marrow stem cell therapy was the segue into the adult stem cell therapy movement.

Bone marrow extractions are painful, requiring general anesthesia. Its relatively difficult and expensive compared to adipose (fat) tissue stem cell harvesting.

Bone marrows high white blood cell count also encourages inflammation, making it counter-productive for patients already suffering from chronic inflammation or autoimmune disorders.

Most importantly, adipose (fat) tissue yields up to 500 times more mesenchymal stem cells than bone marrow sources, according to Dr. Comella. These are potent stem cells that can differentiate into a wide variety of other cell types. Furthermore, the adipose white blood cell count is lower than bone marrow matter.

Overactive, confused immune responses attack organs continually and create chronic inflammation and autoimmune diseases. The lower white blood cell count automatically lowers the risk of further inflammation among patients already suffering from chronic inflammation and autoimmune diseases.

The outpatient treatment involves creating a very small and shallow incision that wont require stitches on an area of skin covering adipose tissue (fat). From there, liposuction can withdraw a portion of the fat. This part of the procedure requires only a local anesthetic.

Then what is extracted is spun at high speed in a special centrifuge to isolate the stem cells which are then purified for IV drip delivery or injection into the same patient from whom it was extracted. Total costs range from five to ten thousand dollars or more in some cases.

Dr. Comella and her colleagues mission is to get adult stem cell therapy available for everyone. Private and government health insurance providers cover medical treatments that are much more expensive.

Why not cover one that would save money with its lower expense and fewer side effects?

Over the years, there have been nearly 12,000 adult stem cell therapies performed in the United States with an over 90 percent success healing rate for mostly joint and spinal conditions as well as heart and lung issues.

But the three known adverse side effect cases continually get all the media attention.

The Panama College of Cell Science, which helped launch Kristin Comellas research and development, had this to say about her:

"Perhaps the most influential clinician on the subject of adult stem cell therapy, Dr. Comella has been able to quietly develop patient treatment protocols and treat patients via collaborating physicians and health care providers using legal patient-specific FDA guidelines, including studies permitted by Institutional Review Boards, patient-specific stem cell clinical trials, and direct treatments using the patients own stem cells that are harvested and re-injected for therapeutic purposes.

"Through Dr. Comellas leadership, she and her team have trained and certified more than 700 physicians worldwide in adult stem cell therapy." (Source)

The interview below allows the energetic Dr. Kristin Comella to give a thorough and upbeat description of adult stem cell therapy.

Big Pharma Is Using the FDA to Eliminate Unregulated Adult Stem Cell Competition

Since the late 1990s, adult stem cells used therapeutically were not under the control of the FDA and the adult stem cell movement took off.

There were complaints from some MDs that the adult stem cell practice should be regulated by the FDA. The Panama College of Cell Science responded to those outcries with this statement:

"The motive in opposing adult stem cell therapy is money. The big institutions want to keep federal funding of embryonic stem cell research at a high level with the promise that cures are just around the corner despite the fact that embryonic stem cells will never be useful in any way for patient treatment because they immediately cause tumors when transplanted." (Source)

Adult stem cell therapy is an autologous treatment method. The stem cells are not lab-created. They are only isolated and purified after extracting them from the patient being treated. Injecting them back into that patient powers up the bodys own healing mechanism to overcome chronic ailments.

The FDA didnt and shouldnt have anything to do with regulating stem cells from ones own body. That situation has recently been arbitrarily and suddenly changed.

Around 2014, the FDA started tweaking their guidance rules for stem cell therapy with the purpose of getting new rules made into laws through Congress that could be interpreted according to FDA whims and enforced arbitrarily. Their agenda is to consider adult stem cells as FDA-regulated drugs.

During our phone conversation, Dr. Comella explained how the FDA ignored testimonies from adult stem cell practitioners during their 2015 public hearings regarding new guideline proposals. Then they arranged to create new rules behind closed door meetings that included pharmaceutical industry allies and insiders.

The result was that by 2017, the FDAs hands-off policy with adult stem cell therapy came to a sudden halt after years of highly successful stem cell practice.

By 2018, the FDA got nastier with the the most influential clinician on the subject of adult stem cell therapy as its target. The FDA started doing inspections of Dr. Comellas South Florida clinic that are designed for labs that manufacture drugs.

The standards for hospitals and clinics are not as strict as drug manufacturers. Those inspections were inappropriate for a clinic. But those inspections made it easier to create damaging reports.

When the inspectors came by, they demanded to go into rooms while treatments were taking place with semi-nude or nude patients, which Dr. Comella prohibited. The inspectors also demanded to view patient medical records. She allowed that after redacting their names on the copies she gave them.

For her actions to protect patients privacy, inspectors allegedly cited Dr. Comella for resisting and obstructing FDA inspections.

Soon after the inspections, the FDA served Dr. Comella with a lawsuit for practicing medicine with unapproved drugs. The drugs were only those stem cell solutions drawn from patients to be used on them.

The FDA has allegedly offered to drop the lawsuit if Dr. Comella signed an agreement to stop doing adult stem cell therapy and no longer promote it.

She refused. She said she has witnessed people leave their wheelchairs for good from this therapy. The trial is set for a Federal Court hearing beginning June 2019, in Miami, Florida.

If Dr. Comella loses this court case, adult stem cell therapy in the USA may be forced out of the country and only be available to those who can afford medical tourism.

Reference: HealthImpactNews.com

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Animal Hospital Serving Mesa, AZ – 1st Pet Veterinary Centers

May 2nd, 2019 6:48 am

.col > .col-inner { padding: 0px 0px 0px 0px; } Entrust Your Pet to a Skilled Veterinarian in Mesa, AZ.

Your pet is part of your family. Whether you own a dog or a cat you want your pet to live free of disease and injury. When your pet needs preventative care or emergency services, you need to bring your beloved companion somewhere it can receive the treatment it needs.

Whether your pet needs preventative veterinary medicine or an after-hours exam by an emergency vet in Mesa, AZ, contact 1st Pet Veterinary Centers.

In 1989, 1st Pet began with the desire to bring first-class veterinary care to the Mesa area. As we grew, so did our ability to serve your pets. Like us, animals can receive a variety of primary care services, including vaccines, dental care, and cleaning. Other primary care services we offer include these:

In addition to these general pet care services, 1st Pet offers emergency aid for your injured or sick animals. Available 24-hours a day, 365 days a year, our team can handle all your pets veterinary needs. We work around the clock because emergencies do not usually happen at convenient times.Our veterinary specialists have training in critical care, internal medicine, and veterinary surgery. Our staff will also give your pets the same care they would give to their own pets.

When you need an animal hospital in Mesa, AZ, call us at (480) 924-1123 or visit us at 5404 E. Southern Ave. We offer compassionate veterinary services to help your pet return to full health.

5404 E. Southern Ave.Mesa, AZ 85206tel:(480) 924-1123

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Ethical, Legal and Social Implications Research Program …

April 30th, 2019 3:57 pm

NIH is institutinga number ofchanges tohow it categorizes clinical trial research.Many ELSI studiesthat previously were not considered clinical trials will now be categorized as such and will be subject to new application, review and reporting requirements.Please visit theClinical Trials definition websitefor guidance indetermininghow your study will be categorized. If you have any questions or concerns, please contact ourELSIprogram directors

ELSI applications that do not involve a clinical trial can still be submitted under the ELSI R01, R21 and R03 program announcements listed below.

ELSI applicationsthat are determined to involve a clinical trial cannot be submitted under these announcements and must now besubmitted under either the NIHParent R01--Clinical Trial Required(PA-18-345)or the NIHParent R21--Clinical Trial Required (PA-18-344)program announcements.When submitting these applications, researchers shoulduse thePHS Assignment Request Formtorequest thatNHGRI (and any other relevant Institutes or Centers) be assigned the grant, andtorequest study section review assignment to theContinuous Special Emphasis Panel on Societal and Ethical Issues in Research Study Section(ZRG1 SEIR).

The NHGRI, along with several other National Institutes of Health (NIH) institutes, has released revised general program announcements to solicit research projects that anticipate, analyze, and address the ethical, legal, and social implications of the discovery of new genetic technologies and the availability and use of genetic information resulting from human genetics and genomic research.

The NHGRI ELSI Program accepts Conference Grant (R13) applications. For specific instructions for preparing a conference grant application, see:

The ELSI program participates in a number of training and career development funding opportunities.

The Fogarty International Center'sinternational bioethics training programs[fic.nih.gov] support education and research training to develop ethics expertise in low- and middle-income countries (LMICs). The programs complement other global health research and research training programs in the mission areas of NIH Institutes and Centers.

PA-16-288:Research Supplements to Promote Diversity in Health-Related Research (Admin Supp)Expiration Date: September 30, 2019

PA-16-289:Research Supplements to Promote Re-Entry into Biomedical and Behavioral Research Careers (Admin Supp)Expiration Date: September 30, 2019

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Russia Opens the Door for Stem Cell Clinical Trials | BioSpace

April 30th, 2019 3:56 pm

Stem Cell Global Boom

The widespread global outreach potential of stem cell therapies is becoming apparent, especially given the recent news of a second person going into long-term remission (some saying cured) of HIV after undergoing a stem cell transplant. Regenerative medicine is becoming a powerful instrument for providing cures to previously incurable diseases. According to a recent statement, the US FDA expects to receive over 200 investigational new drug (IND) applications per year by 2020, many of which include cell and gene therapies. In fact, the FDA estimates that 10 to 20 new cell and gene therapy products per year will be approved by 2025. The number of stem cell trials carried out globally has also been growing exponentially, having over 7000 trials registered on ClinicalTrials.gov with 16 FDA-approved cellular and gene therapies.

The Official Launch of Biomedical Cell Products (BCP) in Russia

While the US, Europe and some Asian countries have had a fully functional, comprehensive regulatory platform for BCP procedures for over two decades, Russia is relatively new to the area, only recently approving a regulatory framework. 2018 marked a key breakthrough for the Russian market and the global pharmaceutical arena, when the Russian government enacted a law involving amendments to biomedical cell product guidelines, which officially opened the door for Russia to enter the stem cell technologies industry. The regulation stipulates and defines what a BCP is, specifying that both registered medical products and pharmaceuticals can be classified as BCPs.

When speaking about the current pharma industry landscape, the major development of the past several years is, without doubt, the creation and implementation of stem cell product regulation and related clinical trial procedures," Dmitry Goryachev, head of Expertise and Control of Ready Medicaments at the FSBI Russian Ministry of Health Scientific Centre for Expert Evaluation of Medicinal Products, noted during the 6th annual OCT Conference on Clinical Trials.

Although cellular biomedicines show great promise, there are some important scientific and practical nuances to note, such as patent rights, certification procedures, and BCP costs. Experts from the I. M. Sechenov Institute for Regenerative Medicine claim that one of the key challenges for biomedical stem cell production in Russia lies in the absence of suitable production sites, with an estimated cost of building such infrastructure as high as USD 7 million.

Alexey Martynov, Director of the Stem Cell Products Manufacturer Association, added that with the stem cell industry on the rise, there is an exponentially growing demand for trained professionals in the field, therefore relevant courses are being included in the universities curriculum for students as well as professionals. There are also a few widescale government programs which stimulate the emergence of new medical products and innovative technology in healthcare. One such program is aimed at developing stem cell technologies.

The Russian Federation government has recently issued specific decrees which outline the stem cell technologies development strategy for 2018-2020. This program undertakes the development of knowledge sharing centers, both from the product development and production points of view, as well as medical center accreditations for them to be eligible for such studies, Vadim Merkulov, Deputy Director of the Russian Ministry of Health Scientific Centre for Expert Evaluation of Medicinal Products, elaborated.

According to the previously mentioned BCP procedure law, the number of accredited entities eligible to accommodate stem cell clinical trials will grow from 5 in 2018 to 20 in 2019 then up to 50 in 2020. The budget for BCP production, called production capacity, is also estimated to reach USD 230 million by 2020, up from USD 180 million in 2018. This strategy will stimulate and potentially boost stem cell studies in Russia, ultimately resulting in increased patient access to stem cell therapies.

Russian Market Potential for Stem Cell Studies

The Russian pharmaceutical and healthcare markets have a lot of potential for stem cell studies and clinical trials in general. Key strengths of the region include fast patient enrollment, large clinical trial participation and favorable currency exchange rates. Fast patient enrollment is especially essential for early-stage trials to allow for faster project initiation. Some US and European corporations might be cautious to enter the market because of language barriers or logistic issues. However, these concerns can be avoided by choosing a reputable CRO with experience

It is high time for the biomedicine and stem cell industry in our country to enter the phase when it is possible to grow and develop within the regulatory framework. Understanding the registration procedures and a solid regulatory platform, without doubt, create a very favorable environment to launch progressive stem cell studies in Russia, commented Dmitry Sharov, president of OCT, a CRO located in Russia and Eastern Europe. In the upcoming years, we will witness a giant leap in the development of new treatment methods.

The first uptick in medical product applications is already being seen as the first licensing application for a cartilage restoration BCP was filed in February. Despite the fact that this technology has been in development since 2016, it is just now possible to apply for a license as the new bill is being implemented.

About OCT

OCT is a leading full-service CRO serving Russia and Eastern Europe. OCT offers a full range of services to manage Phase 1-4 and BE studies, as well as offering standalone services, such as medical writing, consulting, project management and monitoring, and data management and biostatistics. More information can be found on their website.

This article was provided by OCT and modified by Chelsea for clarity.

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Gene Therapy : Homology Medicines

April 30th, 2019 3:56 pm

Homology Medicines gene therapy approach utilizes our proprietary AAVHSC vectors to deliver a functional gene to a cell where there is a missing or mutated gene. Once delivered, the functional gene may lead to therapeutic protein expression. With gene therapy, the genes do not integrate into the genome so this approach can be curative in slow- or non-dividing cells (e.g., adult liver or central nervous system).

Our gene therapy construct includes a functional copy of the gene and a promotor sequence that is designed to enable the gene to be turned on in the cell and ultimately transcribed to express a therapeutic protein without integrating into the genome.

Our unique vectors have demonstrated significant systemic biodistribution to multiple tissue types in preclinical studies, including liver, central nervous system (CNS), muscle (skeletal and cardiac) and eye*. This enables us to potentially address a broad range of monogenic diseases.

Our lead development program is an AAVHSC-mediated gene therapy treatment for adults with the rare disease phenylketonuria. Learn more about our pipeline and therapeutic focus.

*Homology data on file; Ellsworth JL, Smith LJ, Rubin H, et al. Widespread transduction of the central nervous system following systemic delivery of AAVHSC17 in non-human primates. American Society of Gene & Cell Therapy Annual Meeting. May 2017.

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Integrative Medicine Of NYC | Top Integrative Medicine …

April 30th, 2019 12:52 am

Mary-Laura Klesaris MD

Dr. Mary-Laura Klesaris is a compassionate and energetic Integrative Medicine Doctor at Integrative Medicine of NYC,who takes a multidimensial, evidence based approach to medicine with a focus on bioidentical hormone therapy and seeks to treat the root cause of physical and emotional health issues, including anxiety, depression, insomnia, headaches, menopause, weight gain and chronic fatigue/pain. She is committed to cultivating strong relationships with her patients and collaborates with each patient to help them attain their health and wellness goals.

In addition to nineteen years of experience in internal medicine as well as extensive post-graduate training in age management, Dr. Klesaris completed a fellowship in bio-identical hormone replacement therapy with Dr. Sangeeta Pati, whose distinguished Sajune Institute for Restorative and Regenerative Medicine in Orlando, Florida, is among the most acclaimed centers in the country practicing restorative medicine. Her Five Point Restorative approach includes VortexHealing sessions from practitioner, Susan Hwang, and consultation with a functional nutritionist.

Dr. Klesaris is completing her fellowship in regenerative medicine through the American Academy of Age Management Medicine (A4M). She graduated from St. Georges University School of Medicine and was appointed Chief Medical Resident at the Mt. SinaiCabrini Hospital program in New York City.

Note: sees patients age 18 and older.

Interests:

Bioidentical Hormone Replacement Therapy

Exercise, Nutrition, Weight Management

Lifestyle Modification

Preventive Health and Education

Stress Management

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Integrative Medicine | Long Island, New York | Oasis Medicine

April 30th, 2019 12:52 am

my passion is to empower and transform you, to go beyond disease, pain and suffering and find your true vitality! Dr. DAve

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Genomics and Medicine | NHGRI

April 30th, 2019 12:52 am

It has often been estimated that it takes, on average, 17years to translate a novel research finding into routine clinical practice. This time lag is due to a combination of factors, including the need to validate research findings, the fact that clinical trials are complex and take time to conduct and then analyze, and because disseminating information and educating healthcare workers about a new advance is not an overnight process.

Once sufficient evidence has been generated to demonstrate a benefit to patients, or "clinical utility," professional societies and clinical standards groups will use that evidence to determine whether to incorporate the new test into clinical practice guidelines. This determination will also factor in any potential ethical and legal issues, as well economic factors such as cost-benefit ratios.

The NHGRIGenomic Medicine Working Group(GMWG) has been gathering expert stakeholders in a series of genomic medicine meetingsto discuss issues surrounding the adoption of genomic medicine. Particularly, the GMWG draws expertise from researchers at the cutting edge of this new medical toolset, with the aim of better informing future translational research at NHGRI. Additionally the working group provides guidance to theNational Advisory Council on Human Genome Research (NACHGR)and NHGRI in other areas of genomic medicine implementation, such as outlining infrastructural needs for adoption of genomic medicine, identifying related efforts for future collaborations, and reviewing progress overall in genomic medicine implementation.

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Genomics and Medicine | NHGRI

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