COVID-19 And Diabetes Can Be A Dangerous Mix – WFYI

FARAH YOUSRY - Side Effects Public Media

Agatha Walston leads a busy life. Shes a nurse in southern Indiana and a single mother of two young kids.

Shes kept control of her type 1 diabetes for over 28 years partly through a healthy lifestyle. I would rather snack on veggies than trash food, the Clarksville woman says.

But when the pandemic hit, she feared that the control she maintained for so long could be unraveling. I told my kids, I said, Okay, there's this super-killer virus on the loose, and I'm a nurse and I will probably get it.

That was really hard conversation to have with the kids to make sure that they knew that, you know, if mom goes, they're still going to have each other.

People living with diabetes are not more likely to get COVID-19. But they are at a much greater risk of developing severe symptoms and complications. A COVID study in England examined more than 20,000 deaths and found that a third of those people were diabetic.

In mid-April, Walston tested positive.

She survived without hospitalization, but months later, she noticed new health issues. She was diagnosed with high cholesterol, elevated blood pressure, heart problems and glaucoma a condition that could cause blindness.

She recalls, The glaucoma specialist, he had said, You know, you're already at risk for glaucoma. So we won't know if it was COVID or diabetes.

Walstons doctors are unsure if COVID is behind any of these complications or if her diabetes was a contributing factor.

But many diabetics worldwide are battling health complications from a COVID infection.

Even if your blood glucose control is perfect, you're still going to have some risks, says Dr. Carmella Evans-Molina, director of the Diabetes Research Center at Indiana University.

COVID has the power to elevate blood sugar levels and cause insulin resistance even in previously healthy people, she says. For diabetics, this effect is magnified.

So they might then need to make changes in their insulin regimen or changes in their diabetes medication, Evans-Molina says. If they're in the hospital, obviously their providers in the hospital will be taking care of these things. But if they're recovering from COVID at home, they need to be very careful and checking their blood glucose very frequently, and then be in communication with their doctors.

She says that such drastic changes in blood sugar levels could cause long-term complications if not managed carefully.

Dr. Francisco Rubino, a professor at Kings College London, also has been watching the emerging problem. Since the beginning of the pandemic, we noticed there is a bidirectional relationship between COVID and diabetes.

In a letter to the New England Journal of Medicine, he and other healthcare professionals noted that the severe insulin resistance caused by COVID might have another shocking effect. Even people who didn't have any history of diabetes, coming up to the hospital with clear signs of having diabetes, he says.

Rubino says data is still limited, so he set up a global registry called CoviDiab to track these cases.

Dr. Evans-Molinas team has studied pancreatic cells of patients who died from COVID. They did not see evidence of the virus being able to trigger new on-set diabetes, she says, adding, I think we're really early in our understanding of that.

She notes that managing COVID patients requires the use of steroids, which causes elevated blood sugar levels. This is one of many factors that could have damaging effects on diabetics or someone with pre-diabetes.

So we know that we're probably seeing people who were very close to a diagnosis pass over that threshold and become diagnosed with diabetes, she says.

As doctors and scientists work to understand the relationship between COVID and diabetes, Walston is dealing with her medical problems. She says this year has been rough physically and emotionally.

She adds, The best thing about 2020 [is] not dying.

This story was produced by Side Effects Public Media, a news collaborative covering public health.

This reporting is supported by the GBH Educational Foundation through the Corporation for Public Broadcasting. To learn more about the diabetes epidemic in America, watch the documentary"Blood Sugar Rising."

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Life Management Course To Be Offered Throughout All UC Campuses – New University

Life 101, a life skills and self-care management course developed and taught by UCI pharmaceutical sciences professor Dr. Mahtab Jafari, will be offered for students at all 10 UC campuses through cross-campus enrollment beginning Jan. 4.

The two-unit course, also known as Pharmaceutical Sciences 42, has been taught at UCI each winter quarter since 2013. While required for pharmaceutical sciences students, it is open as an elective to students of all majors. According to the syllabus,[T]he only prerequisite for this course is to have an enthusiasm to learn, to question and to change.

I learned that our students dont have the time to learn the skills to cope with their stress, so lets teach them these skills, Dr. Jafari said in a UCI TEDx presentation during the inaugural year of the course. In my mind, these skills are as important, or maybe more important, than teaching physics, chemistry, biology and calculus.

The course content of Life 101 largely revolves around strategies to ensure that students maintain their physical and emotional health, including such topics as stress management, self-care, nutrition and managing personal finances. Some specific modules explain the importance of acknowledging and coping with mental health struggles, establishing a consistent sleep schedule and using the natural environment as a source of tranquility.

Considering that stress levels and poor lifestyle choices in college students are increasing at an alarmingly fast pace, this course may serve as an effective educational tool to teach healthy lifestyle choices, promote students well-being and help them to recognize and manage their stress, the course syllabus states.

While stress remains prevalent in college and university settings, the COVID-19 pandemic in particular has contributed to a significant rise in overall mental health struggles among students. A study conducted between March and May by the Healthy Minds Network in conjunction with the American Association of Colleges found that 66% of college students report that they have had more stressful financial situations due to the pandemic while access to mental health resources has become more difficult. It also found that the prevalence of depression has risen by 5.2% compared to fall 2019.

With this in mind, Dr. Jafari continues to ensure that Life 101 adapts to the circumstances, implementing more detailed course content to address mental and emotional health in the upcoming quarter of the course.

I look at this course as a constant work in progress, Dr. Jafari said. For instance, because of the pandemic, I will include more information on emotional health in the winter quarter.

Created with the ultimate goal to combat the stress of balancing schoolwork and life, the upcoming quarter of Life 101 will offer an asynchronous option, allowing for convenient access adapted to students schedules.

I was inspired to make changes for myself as well as to become a better person, a student who completed the inaugural Life 101 course said in an anonymous submitted comment. It changed my life and my perceptions in a positive way.

Over 400 UCI students have enrolled to take Life 101 this winter quarter. UC students can continue to enroll in the course through the deadline of Jan. 22.

Ariana Keshishian is a City News Intern for the 2020 fall quarter. She can be reached at ankeshis@uci.edu.

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Shingles: What triggers this painful, burning rash? – Harvard Health Blog – Harvard Health

If youre like 95% of American adults, you had chickenpox as a kid. Before the United States started its widespread vaccination program in 1995, there were roughly four million cases of chickenpox every year. So, most people suffered through an infection with this highly contagious virus and its itchy, whole-body rash.

But unlike many childhood viruses, the varicella-zoster virus that causes chickenpox doesnt clear from the body when the illness ends. Instead it hangs around, taking up residence and lying dormant in the nerves, sometimes for decades, with the immune system holding it in check. In some people, it lives there harmlessly for the rest of their life. But in others, the virus can suddenly emerge and strike again, this time appearing as a different condition known as shingles.

Like chickenpox, shingles also causes a blistering rash, but this time it generally appears as a painful band around one side of your ribcage or on one side of your face. The first symptom for many people is pain or a burning sensation in the affected area. You may also have fever, a headache, and fatigue. Along with the rash and other temporary symptoms, shingles can also bring unpleasant, long-lasting, and sometimes permanent complications, such as skin infections, nerve pain in the area where the rash appeared, or even vision loss.

Experts dont fully understand this. One theory is that shingles occurs when your immune system loses its ability to keep the virus in check.

After you get chickenpox, your immune system is able to recognize the varicella-zoster virus thanks to specialized immune system cells, called B and T cells, that are able to remember the virus and quickly marshal an attack on it. Factors that weaken the immune system increase your risk of developing shingles. These include

While you may not be able to control certain factors that might trigger shingles, there are strategies you can use to prevent shingles. The most important is vaccination. Research shows that the shingles vaccine Shingrix is 90% effective in preventing an outbreak of shingles. Even if you do get shingles after being vaccinated, Shingrix greatly reduces your risk of developing persistent pain in the affected area, known as post-herpetic neuralgia.

In addition to getting vaccinated, its always a good idea to take steps to keep your body healthy, such as choosing healthy foods, staying active, and getting sufficient sleep. Its not clear if healthy lifestyle habits like these can prevent shingles, but even if they dont, theyre worthwhile because they will benefit your body in many other ways.

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The New You: The many benefits of yoga – WKYC.com

You don't have to be a professional to feel real benefits from the practice of yoga. Even small, low impact movements can have big results

CLEVELAND Since embarking on this "The New You journey, Ive learned that that a healthy lifestyle is not only about eating well, its also about reducing anxiety and moving your body two huge factors in the ancient practice of yoga.

Thats why, each week during our shared medical appointment, we take some time to work with Cleveland Clinics lead yoga therapist Judi Bar.

"The reason yoga is in the program is because it does help with mindfulness. Were going to look at body awareness, am I breathing am I holding in my breath because just allowing ourselves to make a breath can many times, help us make a nice non-emotional decision," Bar told us the first week of the program.

Though virtual yoga has been great, Kati, Kim and I recently had the chance to practice with Judi in person, at Cleveland Clinics Wellness Center campus in Lyndhurst.

In our class, Judi explained that yoga can get a bad rap for being complicated and physically advanced. But right away, Judi told us yoga can be modified for all, and even low impact, simple motions can have lasting results. She had us start by using a chair to help us modify the poses instead of practicing on the floor.

"The key here is we don't start out running a marathon. In yoga we can build our core, we can stretch our our rotator cuffs we can help support our back we can get better stronger legs more flexible feet," Bar said.

"All I ask you to do is listen to your body if something that I'm suggesting isn't working then you adjust and adapt."

But its not all about the physical workout. Just like we learned in our culinary medicine class, like food, yoga can even help fight infections in the body.

"The variety we get in yoga and the moving helps to really support a healthy immune system too it pumps that lymphatic fluid through to to get some detoxing done," she told us.

Though none of us would call ourselves professionals, Kim, Kati and I all settled in pretty quickly to learn some of those famous poses youve probably heard about - including my favorite - the "warrior pose."

It wasn't all easy, but by the end of class, I think we looked pretty good! And Judi just may have convinced me to incorporate yoga into my daily routine. Namaste.

Were in this together!

If you're interested in learning more, or signing up for a similar program through the Cleveland Clinic, visit:

call: 216.448.4325 or email: cilm@ccf.org

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Papa Expands Support for Aging Americans During the Pandemic with the Launch of Papa Health – PR Web

With companionship at our core, we have a unique opportunity to encourage and facilitate medical care into the home.

MIAMI (PRWEB) December 15, 2020

Papa, a service that provides older adults and families with companionship and assistance with everyday tasks, today announced the launch of Papa Health. The comprehensive health management platform expands on the companys existing services and is aimed at improving health outcomes of older adults and families.

Papa Health offers virtual primary care, urgent care, and chronic care management to its members through the Papa platform. The new service connects members with their Papa Doc virtually, while their Papa Pal is alongside the member and can help them navigate the appointment and provide transportation and care facilitation. Papa Pals are youthful, energetic, and caring companions who provide support and assistance to plan members.

Researchers believe that SDoH (Social Determinants of Health) drive more than 80 percent of health outcomes (1). Papa Pals also serve as boots-on-the-ground, making sure that beyond doctors appointments, members are eating the right foods, exercising, and are taking their medications.

"Engaging in a healthy lifestyle is imperative to leading a long, fulfilling life and our Papa Pals represent the missing link in delivering high-quality and effective healthcare to older adults, said Joel Rabasco, Head of Papa Health. Whether it's helping coordinate a successful virtual primary care visit, or providing a trusted companion to assist in chronic care management, their guidance and advocacy will lead to dramatically better health outcomes for our members."

Since launching in Miami, FL in 2018, Papa has seen dramatic growth, with plans to be in all 50 states by January 2021. Company growth has accelerated due to the COVID-19 pandemic and membership has increased 500 percent year-over-year.

Never before has it been more important to support older adults and families throughout the aging journey, said Andrew Parker, Founder and CEO of Papa. With companionship at our core, we have a unique opportunity to encourage and facilitate medical care into the home, where our members prefer to be for routine consultations and healthcare planning.

Papa services are available through health plan providers, including Aetna, AvMed, Florida Blue Medicare, Humana, Priority Health, and Regence Blue Shield, among many others.

For more information please visit: http://www.papa.health

About Papa Papa is a family on-demand service providing companionship and care to older adults and families through an expansive client base of Medicare Advantage and state managed Medicaid health plans. Papa was founded in 2017 in Miami, FL. For more information, visit joinpapa.com.

Sources: (1) https://healthpayerintelligence.com/news/addressing-the-real-implications-of-social-determinants-of-health

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Bengaluru-based AltLife aims to help patients with lifestyle diseases lead a healthier life, reduce intake of – YourStory

Lifestyle diseases such as diabetes, PCOD, obesity, cardiovascular diseases, and hypertension are on the rise in India. According to the GoQii India Fit India 2020 report, about 70 million people are struggling with diabetes mellitus. Apart from this, 51.7 percent of diabetes patients have cholesterol, leading to heart diseases, and around 13.4 percent of them suffer from high blood pressure.

After getting diagnosed with diabetes, Vivek Subramanyam realised that no amount of medicines and increased dosages were helping him in maintaining his blood sugar levels. After extensive research, he understood that medicines and other interventions mostly focus on managing the symptoms and not the core illness. He realised that lifestyle choices and incorrect metabolism are the major reasons behind such diseases, and one needs to maintain a good lifestyle to overcome such health problems.

In 2018, Vivek launched AltLife to help people maintain their well being and beat the diseases. Later, Kartik Sarwade, Monika Manchanda, Naren Santhanam and Purushotham Govindarajan, who are also victims of lifestyle diseases, joined as co-founders.

This Bengaluru-based healthtech company provides patients with a tech platform to connect with doctors and nutritionists in order to get expert consultations on food, fitness, mental well-being and medical diagnosis. The company also has a team of in-house chefs who make and supply food made with organic produce. The platform connects the patients with trainers who help them with regular exercises and meditation to maintain their body weight and mental health.

AltLife Team. [Image Credit: AltLife]

Vivek explains that the solutions are designed to be engaging and enjoyable for the patients to help them continue to maintain a healthy lifestyle.

Patients can connect with AltLife via the official website or phone number and subscribe to their weekly trial, 30-days or 90-days plan. Then the startup will help them connect with nutritionists and doctors to get a thorough test and diagnosis of their diseases. Patients will be sent organic and therapeutic meals every day, and will have to participate in daily exercises and meditation sessions organised by the experts. Healthcare workers will also test and monitor their health using the mobile app and guide them in maintaining a healthy life.

According to the CEO, the flagship 90-day Health Restore Program helps people fight their disorders through solutions including therapeutic food delivery, exercise or yoga, meditation classes, periodic diagnostics, and expert consultations. The 30-days programme is aimed at preventing diseases by focusing on gut health and immunity revival.

The online platform was beta-launched in June 2020 and the company is looking for a complete rollout by Jan 2021.

We also help people predict the future of their health with our proprietary health and risk assessment product. This helps people understand their current health and gives insights into the possible risks to their future health and takes a proactive approach now with a goal of prevention, he adds.

Illustration: YS Design

AltLife has a team of over 10 doctors, nutritionists, physiotherapists, yoga masters, and counselors, and is working with over 150 patients as of now. Users need to subscribe to get access to the healthcare solutions.

Vivek adds that while the COVID-19 pandemic had impacted the product rollout, eventually it became a blessing in disguise as the pandemic outbreak led people to further care about their health, especially those suffering from lifestyle diseases.

We had planned our commercial launch in the month of March, it got pushed to June because of the country-wide lockdown. However, to our surprise, the response was encouraging because people started prioritising their health and well-being like never before, he says.

While the founder did not reveal details about the initial investment, he says that the bootstrapped company was launched after collecting funds from friends and families. However, the company is looking for investors and plans to raise external funding in 2021.

AltLife competes with notable players including Twin Health, Well Thy, Beato, HealthifyMe, and Truweight among others. The CEO explains that while some players are involved in tracking data and behaviour, some are advisory companies, and many offer focused services such as devices or fitness coaching etc. Given the size of the problem, I do hope each of us ends up being successful in partnering with clients to improve their health, he adds.

Speaking about future plans, he adds that the current goal is to reach out to more people and help them understand the solution.

The immediate plan is to let more people know about us and help them solve this problem and take control of their health. We are serving Bangalore city currently but would gradually scale the business and expand our reach in terms of geography and product portfolio, Vivek says.

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The Salt Lake Tribune Names Young Living a Winner of the Utah Top Workplaces 2020 Award – PRNewswire

LEHI, Utah, Dec. 14, 2020 /PRNewswire/ -- Young Living, the global leader in essential oils, today announced it has been awarded a Top Workplaces 2020 honor by The Salt Lake Tribune. Young Living was selected among hundreds of applicants due to its commitment to employees and company culture, especially during a year filled with uncertainties.

"It has been a challenging year for everyone, but I'm extremely proud of the work our team has put in to maintaining our great culture," said Mary Young, co-founder and CEO of Young Living. "We've become a family over the years and as we pivoted business operations due to COVID-19, we wanted to make sure each and every employee was taken care of as best possible. It is because of this culture that our team has done some of their best work despite this global crisis and continues to uplift and enhance lives around the world."

Young Living's company vision is focused on creating a healthy home for each of us, a healthy world for all of us. This mantra feeds the award-winning employee experience program that has guided Young Living through the COVID-19 pandemic. In an unprecedented year, Young Living was one of the first Utah-based companies to implement a work-from-home policy that transitioned 95% of the company's employees to work remotely. Young Living acted fast to help maintain everyone's health and safety while providing a meaningful working environment in a critical time.

Young Living made it a priority to address the physical and mental health of all employees as they shifted to a new remote workforce. Initiatives included the following:

The Top Workplaces list is based solely on employee feedback gathered through a third-party survey administered by employee engagement technology partner Energage, LLC. The anonymous survey uniquely measures 15 drivers of engaged cultures that are critical to the success of any organization: including alignment, execution, and connection, just to name a few.

"In times of great change, it is more important than ever to maintain a connection among employees," said Eric Rubino, Energage CEO. "When you give your employees a voice, you come together to navigate challenges and shape your path forward based on real-time insights into what works best for your organization. The Top Workplaces program can be that positive outcome your company can rally around in the coming months to celebrate leadership and the importance of maintaining an employee-focused culture, even during challenging times."

About Young Living Essential OilsYoung Living Essential Oils, LC, based in Lehi, Utah, is the world leader in essential oils, offering the highest quality oil-infused products available. Young Living takes its industry leadership seriously, setting the standard with its proprietary Seed to Seal quality commitment, which involves three critical pillars: Sourcing, Science, and Standards. These guiding principles help Young Living protect the planet and provide pure, authentic products that its members can feel confident about using and sharing with friends and family. Young Living's productswhich all come from corporate-owned farms, partner farms, and Seed to Seal-certified suppliersnot only support a healthy lifestyle but also provide opportunities for over 6 million global members to find a sense of purpose and whole-life wellness by aligning their work with their values and passions. For more information, visit YoungLiving.com, follow @youngliving on Instagram, or like us on Facebook.

SOURCE Young Living Essential Oils

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Foundation Software, LLC selected for Healthy Worksite Award from Healthy Business Council of Ohio – PRNewswire

STRONGSVILLE, Ohio, Dec. 14, 2020 /PRNewswire/ -- Foundation Software, LLC, developer of America's #1 construction accounting and project management software, has been selected by the Healthy Business Council of Ohio(HBCO) as a recipient of the Silver Level Healthy Worksite Awardfor medium-sized businesses. Recipients must demonstrate a commitment to healthy worksite practices with comprehensive promotions and wellness programs.

Matt Ode, the wellness director at Foundation Software, was happy with the recognition. He said that he wants to keep the workplace as healthy as possible.

"Receiving the Silver Healthy Worksite Award for the third year is a true testimony to the dedication of our team and employees on living a healthy lifestyle," Ode said. Foundation has previously received the awardtwice.

100 different Ohio employers from three different size groups (Small, Medium, or Large) were eligible to win four different levels of the award (Bronze, Gold, Silver, or Platinum). They were judged on their efforts in facilitating and encouraging employee health, enhancing productivity, and ensuring a healthy work environment.

An additional award was given to workplaces that included resources to help prevent cancer. Applying businesses could also complete the "Pandemic Response" section to share how they adjusted their program offerings and continued to offer support to employees throughout the pandemic.

As a recipient of the Silver Level Award, Foundation Software excelled in creating a healthy and productive culture with the following initiatives:

Ode indicated that Foundation Software is still looking to create more initiatives that keep employees engaged and healthy.

"At Foundation Software, mental and physical health has always been a key factor in creating a positive and productive culture in the work environment," Ode said. "Moving forward, we will continue to make our wellness program a top priority for all employees."

Winners are eligible tobecome membersof the Healthy Business Council of Ohio. The Health Action Council's 2021 Virtual Conference Series & Expoawards ceremony will take place during the online event on Feb. 4, 2021. The event will feature discussions on wellbeing, resilience, and health reform. The public can register for the event on the Health Action Council website.

About Foundation Software, LLC

Foundation Software delivers job cost accounting, project management, and mobile applications, along with payroll services, to help contractors run the business side of construction. For information, call (800) 246-0800 or email [emailprotected].

Media Contact: Tracie Kuczkowski | Director of Marketing [emailprotected] (800) 246-0800 x 7933

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Local Businesses React To New COVID-19 Restrictions – LevittownNow.com

Area eateries and breweries spent the weekend adjusting to new COVID-19 restrictions put in place by Gov. Tom Wolfs administration.

On Thursday afternoon, Wolf announced a series of new restrictions intended to curb COVID-19 cases. Some of those restrictions that last through 8 a.m. on January 4 included ending indoor dining and closing gyms. The restrictions are on top of mitigation measures already in place since spring due to the pandemic that has claimed more than 770 Bucks Countians lives and sickened more than 22,000 locals.

With these measures in place, we hope to accomplish three goals: First, stop the devastating spread of COVID-19 in the commonwealth. Second, keep our hospitals and health care workers from becoming overwhelmed. And third, help Pennsylvanians get through the holiday season and closer to a widely available vaccine as safely as possible. This is a bridge to a better future in Pennsylvania, the governor said.

The news was met not all that warmly by many area business owners who serve food and drinks and have followed past restrictions and put their own safety measures in place.

Mike LaCouture, one of the owners of Broken Goblet Brewing that started in Bristol Township and is now located along State Road in Bensalem Township, said he was disappointed by the latest restrictions.

I am not surprised. I am saddened, unbelievably so, for all the employees ours included who are affected by this two weeks before the holidays. He is taking a sledgehammer approach to the problem, which is both expected and unfortunate because a business like ours has been taking this so seriously and is probably one of the safest, cleanest places you would visit in the last nine months, he said.

Additionally, LaCouture said the governor is in a tough position because some businesses arent following the guidelines that have already been in place.

We suffer for others flippancy to the whole thing, he said.

Jake Howell, one of the owners of Second Sin Brewing Company on Grundy Lane in Bristol Township, said he understands the steps that are being taken to control the spread of COVID-19.

Overall, given the rise in cases something needs to be done, shutdown or otherwise. The issue is that the orders seem to be disproportionately targeted at bars and restaurants, but somehow 500 people going into a big box store isnt an issue. Also, one would imagine that the six months since the last shutdown would have been used to plan for this one, so that service industry workers and small business owners could have some assistance, especially at this time of year, he said.

Nicholas Brachelli, who owns Hoagie Xpress on Bristol-Emilie Road in Bristol Township, said the restrictions are tough on restaurants and bars.

Is it a necessary evil? I dont have the right answer for that, but it is hard to watch local businesses shut down and local families directly impacted during the holiday season, he said, adding he hopes the community would pull together to support local eateries.

John Longstreet, president and CEO of the Pennsylvania Restaurant and Lodging Association,said the governors latest order would have a considerable impact on businesses. He also noted theres not the federal aid like in spring to help small businesses and their owners and employees.

The short notice of the shutdown and timing could not be worse as employers will be forced to lay off thousands of more workers as we head into the holiday season, he said.

LaCouture said Broken Goblet Brewing has gone back to outdoor seating only to comply with the governors order.

I really think that will dwindle, and so we will have to try and survive on takeout and our new shipping services, he said.

At Broken Goblet Brewing, which has a large outdoor area, a few outdoor heaters wouldnt be enough to keep customers warm as the cold weather moves in. He said the team priced it out and it would cost them $60,000 to create an effective setup or 15 propane heaters at more than $5,000, plus the price of propane.

For now, the brewery has been making it work with six fire pits that use a cord of wood per a weekend, LaCouture said.

At Second Sin Brewing Company, Howell said theyre making due with outdoor seating and a propane heater.

Hopefully we can continue to offer the space to our guests, he said. We will be shortening up our hours to close around sundown on the weekend. Well post our finalized hours on social media once they are set. Also, we have had curbside pickup as an option since the previous shutdown. Finally, we will be starting delivery on Fridays and Saturdays.

Brachelli, whose Hoagie Xpress hasnt offered indoor seating since the pandemic started, said takeout has been keeping his business steady.

Simply call in your order ahead of your arrival. When you arrive at the store you walk up to the window pay and collect your order and on your way. It creates minimal contact not only for our customers but also our staff. It worked rather seamlessly in the spring when we had heightened restrictions so we will be revisiting it starting next week when we open for business, he said.

For the two breweries, both have been complying with government safety guidance and even taking precautions steps further.

LaCouture said Broken Goblet Brewing has spent thousands on safety for customers and employees. They added Plexiglass, upgrades to the HVAC system, and completely reworked their new taproom.

In the restaurant and bar industry, COVID-19 and the restrictions has made business tough locally and nationwide.

The impact of COVID-19 truly cannot be put into words, Brachelli said. It has impacted everything from day-to-day operations to bearing a heavy mental toll on everyone. As long as everyone practices social distancing mask wearing, and good hand washing hygiene, possibly and end is in sight.

For Second Sin Brewing Company, they just passed a year since opening. The first shutdown lasted longer than they had been open at that point.

I think we can say the COVID has had a substantial negative impact on our business. All we are doing now is trying to make it through the winter and hope that the vaccine roll out lets us get back to normal as soon as possible, Howell said.

When our employees suffer, the owners suffer. And I know there are others like us in the area, LaCouture said.

Overall, Broken Goblet Brewing has seen business drop 60 percent to 70 percent due to COVID-19 and even with a 350 percent to 400 percent increase in takeout and the sale of packaged beer.

The general consumer is unaware of the mathematics of in-house dining/drinking versus takeout, but that really is not their problem. It is a fact of life right now for us, LaCouture said.

While most restaurants, bars, and other businesses seem to be following the states new regulations, there has been talk of some that are not.

Two area eateries that are rumored to be protesting the mitigation measures did not respond to requests for comment.

A high-profile objection has come from Jim Worthingtons Newtown Athletic Club in Newtown Township. The large regional health club said will remain open for the sake of our loyal members.

We believe that we are doing more service to our community if we remain available for them to continue their exercise and healthy lifestyle regimes which in the end, according to the science, are among the best lines of defense against COVID-19, a social media post from the club said.

Local and state authorities are empowered through law to enforce the governors orders. While there have been some county and state enforcement actions, local Levittown-area law enforcement have not been involved in any high-profile enforcement actions.

Bucks County Commissioners Chairperson Diane Ellis-Marseglia said she is sure state officials would not implement the mitigation measures unless they believe circumstances are dire.

I am looking forward to a federal response
with national standards so that every state, and every county, can be aligned with a greater plan. Rather than think of this as being imposed, I suggest thinking of it doing our share to contribute and cooperate for the greater good, she said.

We have consistently told people to mask up and follow the protocols. Its obvious that while most people followed that advice there are many who ignored it for whatever reason. The new mitigation measures will hopefully help stop the spread so that our hospitals arent overwhelmed. We know restaurants will suffer the most. We encourage Bucks Countians to help our restaurants as much as they can through takeout and delivery orders, Commissioner Bob Harvie said.

During this critically important time we need our elected officials in Washington Democrats and Republicans alike to come up with a stimulus package that will help every American in need and lift our business community through this public health crisis, said Commissioner Gene DiGirolamo.

We all need to support our heroes: the healthcare workers, people on the front lines caring for others and our emergency service providers, and the way we can do that is by continuing to wear masks, staying safe and following the social distancing guidelines, he added.

I certainly understand the governor felt he needed to do something to stem the high tide of cases, Bucks County Health Department Director Dr. David Damsker said in a statement. However, I do feel very badly for the affected businesses, and was hoping we could have been successful reducing the cases prior to implementing any additional restrictions. In the meantime, we need to continue wearing masks and limiting any unnecessary gatherings from now through the holidays.

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Testosterone Replacement Therapy Market Set to Register Healthy CAGR and Competitive Outlook to 2027 – SpinazzolaLive

Data Bridge Market Research has recently published the Global research Report TitledTestosterone Replacement Therapy Market. The study provides an overview of current statistics and future predictions of the Global Testosterone Replacement Therapy Market.The study highlights a detailed assessment of the Market and displays market sizing trends by revenue & volume (if applicable), current growth factors, expert opinions, facts, and industry-validated market development data.

Testosterone Replacement Therapy Market Insight:

Get Free Sample Report + All Related Graphs & Charts@https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-testosterone-replacement-therapy-market

The Worldwide Testosterone Replacement Therapy Market research report assembles data collected from different regulatory organizations to assess the growth of the segments. In addition, the study also appraises the global Testosterone Replacement Therapy market on the basis of topography. It reviews the macro-and microeconomic features influencing the growth of the Testosterone Replacement Therapy Market in each region. Various methodological tools are used to analyze the growth of the Global Testosterone Replacement Therapy market.

Prominent Key Players Covered in the report:

AbbVie Inc., Bausch Health Companies Inc., Allergan, Amneal Pharmaceuticals LLC, Pfizer Inc., Endo International plc, Teva Pharmaceutical Industries Ltd., Perrigo Company plc, Cipla Inc., Lupin, Novartis AG, Sun Pharmaceuticals Industries Ltd., Hikma Pharmaceuticals PLC, among others.

Major Regions as Follows:

North America (USA, Canada and Mexico)

Europe (Germany, France, the United Kingdom, Netherlands, Russia , Italy and Rest of Europe)

Asia-Pacific (China, Japan, Australia, New Zealand, South Korea, India and Southeast Asia)

South America (Brazil, Argentina, Colombia, rest of countries etc.)

Middle East and Africa (Saudi Arabia, United Arab Emirates, Israel, Egypt, Nigeria and South Africa)

A complete value chain of the global Testosterone Replacement Therapy market is presented in the research report. It is associated with the review of the downstream and upstream components of the Testosterone Replacement Therapy Market. The market is bifurcated on the basis of the categories of products and customer application segments. The market analysis demonstrates the expansion of each segment of the global Testosterone Replacement Therapy market. The research report assists the user in taking a decisive step that will be a milestone in developing and expanding their businesses in the global Testosterone Replacement Therapy market.

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How Does This Market Insights Help?

Key Pointers Covered in the Testosterone Replacement Therapy Market Industry Trends and Forecast

Reasons to Purchase this Report

Download Free Exclusive Sample (350 Pages PDF) Report: To Know the Impact of COVID-19 on this Industry @https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-testosterone-replacement-therapy-market

TABLE OF CONTENTS

Part 01:Executive Summary

Part 02:Scope of the Report

Part 03:Research Methodology

Part 04:Market Landscape

Part 05:Pipeline Analysis

Pipeline Analysis

Part 06:Market Sizing

Market Definition

Market Sizing

Market Size And Forecast

Part 07:Five Forces Analysis

Bargaining Power Of Buyers

Bargaining Power Of Suppliers

Threat Of New Entrants

Threat Of Substitutes

Threat Of Rivalry

Market Condition

Part 08:Market Segmentation

Segmentation

Comparison

Market Opportunity

Part 09:Customer Landscape

Part 10:Regional Landscape

Part 11:Decision Framework

Part 12:Drivers and Challenges

Market Drivers

Market Challenges

Part 13:Market Trends

Part 14:Vendor Landscape

Part 15:Vendor Analysis

Vendors Covered

Vendor Classification

Market Positioning Of Vendors

Part 16:Appendix

In conclusion, the Testosterone Replacement Therapy Market report is a reliable source for accessing the research data that is projected to exponentially accelerate your business. The report provides information such as economic scenarios, benefits, limits, trends, market growth rates, and figures. SWOT analysis is also incorporated in the report along with speculation attainability investigation and venture return investigation.

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Testosterone Replacement Therapy Market Set to Register Healthy CAGR and Competitive Outlook to 2027 - SpinazzolaLive

Hormone Replacement Therapy Market Size Worth $33.77 Billion | Global Industry Research on Growth, T – PharmiWeb.com

Pune, Maharashtra, India, December 10 2020 (Wiredrelease) Brandessence Market Research and Consulting Pvt ltd :Brandessece Market Research recently added the Hormone Replacement Therapy Market research report which offers a thorough study of the market scenario regarding the market size, share, demand, growth, trends, and forecast from 2020-2026. The report deals with the impact analysis of the COVID-19 pandemic. The COVID-19 pandemic has impacted exports, imports, demand and trends in the industry and is expected to have some economic impact on the market. The report offers a comprehensive analysis of the impact of the pandemic across the industry and provides insights into a post-COVID-19 market scenario.

Hormone Replacement Therapy Market Size

Global Hormone Replacement Therapy Market is valued at USD 19.45 Billion in 2019 and expected to reach USD 33.77 Billion by 2026 with the CAGR of 8.2% overtheforecast period

Get Sample of This Report@ https://brandessenceresearch.com/requestSample/PostId/1402

Scope of Hormone Replacement Therapy Market Report-

Hormone replacement therapy is a treatment used to release symptoms of the menopause. The main advantage is that it is a very effective method of controlling menopausal symptoms, and it can make an important difference to a womans quality of life and security. Hormone replacement therapy can also reduce a womans risk of developing osteoporosis and cancer of the colon and rectum. Additionally, hormones are secreted predominantly from the endocrine glands and absorbed into the bloodstream. The hormones that have been most commonly utilised in hormone replacement therapy are progesterone, estrogen, testosterone, adrenal hormones, DHEA, thyroid hormones, pregnenolone, melatonin, and human growth hormone. It is the most effective treatment for menopause symptoms. Systemic hormone replacement therapy helps in treating cancer, rheumatoid arthritis and other diseases. Moreover, this treatment is particularly favorable for patients with growth hormone deficiency, women nearing menopause and elderly people suffering from hypogonadism. It may also protect against osteoporosis.

Global Hormone Replacement Therapy market report is segmented on the basis of product, administration, disease and region & country level. Based upon product, global hormone replacement therapy market is classified into estrogen replacement therapy, human growth hormone replacement therapy, thyroid replacement therapy and testosterone replacement therapy. Based upon administration, the market is divided into oral, parenteral and transdermal. Based upon disease, global hormone replacement therapy market is classified into menopause, hypothyroidism, male hypothyroidism, growth hormone deficiency, cancer and other.

The regions covered in this Hormone Replacement Therapy market report are North America, Europe, Asia-Pacific and Rest of the World. On the basis of country level, market of Hormone Replacement Therapy sub divided into U.S., Mexico, Canada, U.K., France, Germany, Italy, China, Japan, India, South East Asia, GCC, Afria, etc.

Hormone Replacement Therapy Companies 2020

Global Hormone Replacement Therapy report covers prominent players

Abbott Laboratories Novo Nordisk Novarti Merck Serono Bayer Healthcare Eli Lilly Mylan Laboratories Roche Genentech Orion Pharma AB Allergen Plc

News-

Big Study Found No Rise in Death Risk among Women who Took Hormone Therapy

September 12th, 2017; after a massive study of hormone replacement therapy was halted due to higher rates of breast cancer, heart attack and stroke among women assigned to the drugs to treat menopausal symptoms, a new follow-up study has found those women had no higher risk of death as of 2014 than participants who took a placebo.

The Growing Awareness about Hormone Replacement is the Key Factor Influencing the Global Hormone Replacement Therapy Market Growth.

Increasing healthcare expenditure due to growing awareness about health related problems. For example, According to OECD, the US spent $10,209 on healthcare per capita, or per person, in 2017. Thats more than any other country in OECDs 36-country consortium, and over $2,000 more than Switzerland, the second-highest spending country. In addition, rising drug development and hormonal imbalance disorders with rising geriatric population are also boosting the hormone replacement therapy market growth. Additionally, the rising womens population between the age group of 45 to 60, which increases the range of menopausal window due to this factor the demand of hormonal replacement therapy, is also growing. However, the hormone replacement therapy has number of side effects which may hamper the market growth. For example, fluid retention, indigestion, headache, and depression, bloating, swelling, nausea, leg cramps. Combined hormone replacement therapy slightly increases the risk of developing breast cancer, womb cancer, ovarian cancer and stroke. For example, Women who take hormone replacement therapy for more than 1 year have a higher risk of breast cancer than women who never use hormone replacement therapy. The risk is linked to all types of hormone replacement therapy except vaginal oestrogen. In spite of that, technological advancements in this field may create the number of opportunities within the forecast period.

North America is expected to Dominate the Global Hormone Replacement Therapy Market

North America is expected to dominate the global hormone replacement therapy market due to the increasing awareness about the hormonal replacement therapy And Increasing number of womens which have menopause problems in this region. For example, National Center for Biotechnology Information, in the United States, approximately 1.3 million women become menopausal each year and, 1% of women experience premature menopause before the age of 40. The Asia Pacific is expected to experience surge of demand too, owing to the factors such as increased awareness levels among the end users and improving healthcare infrastructure. Rising geriatric population is one of the primary factors responsible for the growth of the hormonal replacement therapy marketin the Europe.

Key Benefits for Global Hormone Replacement Therapy Market Report- Global hormone replacement therapy market report covers in depth historical and forecast analysis. Global hormone replacement therapy market research report provides detail information about Market Introduction, Market Summary, Global market Revenue (Revenue USD), Market Drivers, Market Restraints, Market opportunities, Competitive Analysis, Regional and Country Level. Global hormone replacement therapy market report helps to identify opportunities in market place. Global hormone replacement therapy market report covers extensive analysis of emerging trends and competitive landscape.

Global Hormone Replacement Therapy Market Segmentation:

By Product: Estrogen Replacement Therapy Human Growth Hormone Replacement Therapy Thyroid Replacement Therapy Testosterone Replacement Therapy

By Administration: Oral Parenteral Transdermal

By Disease: Menopause Hypothyroidism Male Hypothyroidism Growth Hormone Deficiency Cancer Others

By Regional & Country Analysis:North America, U.S., Mexico, Canada , Europe, UK, France, Germany, Italy , Asia Pacific, China, Japan, India, Southeast Asia, South America, Brazil, Argentina, Columbia, The Middle East and Africa, GCC, Africa, Rest of Middle East and Africa

Table of Content

1. Chapter Report Methodology1.1. Research Process1.2. Primary Research1.3. Secondary Research1.4. Market Size Estimates1.5. Data Triangulation1.6. Forecast Model1.7. USPs of Report1.8. Report Description

2. Chapter Global Hormone Replacement Therapy Market Overview: Qualitative Analysis2.1. Market Introduction2.2. Executive Summary2.3. Global Hormone Replacement Therapy Market Classification2.4. Market Drivers2.5. Market Restraints2.6. Market Opportunity2.7. Hormone Replacement Therapy Market: Trends2.8. Porters Five Forces Analysis2.9. Market Attractiveness Analysis

3. Chapter Global Hormone Replacement Therapy Market Overview: Quantitative Analysis

4. Chapter Global Hormone Replacement Therapy Market Analysis: Segmentation By Type

5. Chapter Global Hormone Replacement Therapy Market Analysis: Segmentation By Application

Continued.

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Hormone Replacement Therapy Market Size Worth $33.77 Billion | Global Industry Research on Growth, T - PharmiWeb.com

Testosterone Replacement Therapy Market Size By Regional Industry Growth, Statistics And Forecast To 2027 – International Debt Observatory

New Jersey, United States,- Verified Market Reports, one of the worlds prominent market research firms has released a new report on the Testosterone Replacement Therapy Market. The report contains crucial insights on the market that will support the clients to make the right business decisions. This research will help both existing and new aspirants for the Testosterone Replacement Therapy market to figure out and study market needs, market size, and competition. The report talks about the supply and demand situation, the competitive scenario, and the challenges for market growth, market opportunities, and the threats faced by key players.

The report also includes the impact of the ongoing global crisis i.e. COVID-19 on the Testosterone Replacement Therapy market and what the future holds for it. The published report is designed using a vigorous and thorough research methodology and Verified Market Research is also known for its data accuracy and granular market reports.

Market Research Report Covers Impacts of COVID-19 To The Market.

The COVID-19 pandemic has dramatically changed the dynamics of the Testosterone Replacement Therapy market. This market research report includes extensive data on the impacts of the market. The research analyst team of the firm have been monitoring the market during this coronavirus crisis and has been talking with the industry experts to finally publish a detailed analysis about the future scope of the market. They have followed a robust research methodology and got involved in the primary and secondary research to prepare the Testosterone Replacement Therapy market report.

This market report comprises of possible revenue growth, potential lucrative opportunities, product ranges, pricing factors, and parameters to confer the emerging and new entrants in the industry with a structured market data. This report encompasses the crucial government policies and regulations that significantly controls the Testosterone Replacement Therapy market. Moreover, it includes the recent business agreements, mergers, acquisitions, partnerships, and even fallouts to provide the industry players with complete overview of the Testosterone Replacement Therapy market.

The report provides comprehensive data on the Testosterone Replacement Therapy market and its trends to assist the reader in formulating decisions to accelerate the business. The report provides a complete overview of the economic scenario of the market, along with benefits and limitations.

Testosterone Replacement Therapy market report contains industrial chain analysis and value chain analysis to provide a comprehensive view of the Testosterone Replacement Therapy market. The study is composed of market analysis along with a detailed analysis of the application segments, product types, market size, growth rate, and current and emerging trends in the industry.

Geographically, the market is spread across several key geographical regions, and the report covers the regional analysis as well as the production, consumption, revenue, and market share in those regions for the forecast period of 2020-2027. The regions include North America, Latin America, Europe, Asia-Pacific, and the Middle East and Africa.

Radical Coverage of the Testosterone Replacement Therapy Market:

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Verified Market Reports is a leading Global Research and Consulting firm servicing over 5000+ customers. Verified Market Reports provides advanced analytical research solutions while offering information enriched research studies. We offer insight into strategic and growth analyses, Data necessary to achieve corporate goals, and critical revenue decisions.

Our 250 Analysts and SMEs offer a high level of expertise in data collection and governance use industrial techniques to collect and analyze data on more than 15,000 high impact and niche markets. Our analysts are trained to combine modern data collection techniques, superior research methodology, expertise, and years of collective experience to produce informative and accurate research.

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Testosterone Replacement Therapy Market Size By Regional Industry Growth, Statistics And Forecast To 2027 - International Debt Observatory

Lipocine (LPCN) Receives a Buy from H.C. Wainwright – Smarter Analyst

In a report released today, Oren Livnat from H.C. Wainwright reiterated a Buy rating on Lipocine (LPCN), with a price target of $3.00. The companys shares closed last Wednesday at $1.32.

According to TipRanks.com, Livnat is a 4-star analyst with an average return of 6.8% and a 48.9% success rate. Livnat covers the Healthcare sector, focusing on stocks such as Collegium Pharmaceutical, Satsuma Pharmaceuticals, and Zynerba Pharmaceuticals.

The word on The Street in general, suggests a Moderate Buy analyst consensus rating for Lipocine with a $3.00 average price target.

See todays analyst top recommended stocks >>

Lipocines market cap is currently $86.71M and has a P/E ratio of -3.80. The company has a Price to Book ratio of 7.65.

TipRanks has tracked 36,000 company insiders and found that a few of them are better than others when it comes to timing their transactions. See which 3 stocks are most likely to make moves following their insider activities.

Lipocine, Inc. operates as a pharmaceutical company, which engages in the research and development of treatment for use in mens and womens health through proprietary drug delivery technologies. It focuses on the oral testosterone replacement therapy and preterm birth prevention. The company was founded in 2011 and is headquartered in Salt Lake City, UT.

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Lipocine (LPCN) Receives a Buy from H.C. Wainwright - Smarter Analyst

Significant EU funding awarded to nanomedicine research Blue light used to release pharmaceutical agents at the target – India Education Diary

ProfessorTimo Laaksonen, who divides his time between the University of Helsinki and Tampere University, has received a grant of roughly 2 million from the European Research Council (ERC). Laaksonens research focuses on releasing pharmaceutical agents in a controlled way in the body using blue or ultraviolet light.

Employing light in drug release is not a new invention as such. With the help of red light, for instance, the membrane of a liposome transporting a nano-sized drug can be made more permeable, releasing the drug. However, blue light provides a more extensive set of tools compared to red light.

Blue and UV light have more energy, powerful enough, for example, to break up chemical bonds in a certain type of drug carrier and detach the drug molecules bound to the carriers surface, Laaksonen explains.

Earlier, the use of UV light has been hindered by the fact that, even at its best, it travels less than a hundred micrometres in the tissue, or the breadth of a single average hair. Red light advances much further. That UV light can damage the body adds another complication, while red light is markedly safer.

Laaksonen is now focusing on how to safely target blue or UV light to the site where the drug should be released. There are two options: either photons could be locally upconverted to a higher energy level inside the body, or a variety of drug implants activated by light could be used.

In practice, photoactivation could potentially be used to release drugs, for example, at the precise moment when another dose is needed. It could be a certain time every morning, or we could continually adjust the release rate to suit the patient.

Timo Laaksonen heads research groups at both the Faculty of Pharmacy, University of Helsinki and the Faculty of Engineering and Natural Sciences, Tampere University. The pharmacy component of the project is carried out in Helsinki and the photochemical component in Tampere. The University of Helsinki will receive 60% of the ERC grant and Tampere University 40%.

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Significant EU funding awarded to nanomedicine research Blue light used to release pharmaceutical agents at the target - India Education Diary

Clene Nanomedicine Presents Blinded Interim Results from RESCUE-ALS Phase 2 Study at the 31st International Symposium on ALS/MNDResults provide…

SALT LAKE CITY, Dec. 10, 2020 (GLOBE NEWSWIRE) -- Clene Nanomedicine, Inc., a clinical-stage biopharmaceutical company, today announced the presentation of blinded interim results from the Phase 2 RESCUE-ALS clinical trial investigating the effects of its lead clinical candidate, CNM-Au8, for the treatment of amyotrophic lateral sclerosis (ALS). CNM-Au8 is an aqueous suspension of clean-surfaced, faceted gold nanocrystals with catalytic activity that has been shown to enhance the metabolic energetic capacity of motor neurons while simultaneouslyreducing oxidative stress.

As of the data cutoff (October 27, 2020), the trial was fully enrolled with a preliminary blinded assessment of the studys primary endpoint, the motor neuron number index-4 [MUNIX(4)] score, showing that more than 40% of enrolled patients with completed week 12 data experienced improvements in motor neuron function assessed by MUNIX. When compared to baseline values, the average MUNIX(4) score of the overall trial population (including both active CNM-Au8 and placebo) experienced an absolute increase in mean MUNIX(4) values. This increase exceeded the expectations of the statistical modeling on which the study was based, which predicted a linear decline in average MUNIX(4) score from study onset (Neuwirth et al. JNNP 2015). These data, while blinded, suggest that CNM-Au8 may have neuro-reparative potential in ALS patients. Clene expects to report the complete, unblinded results from the RESCUE-ALS study in 2H 2021.

Although blinded to treatment assignment, these data are encouraging. We believe Clenes breakthrough approach with the application of physics to biology via direct electron interactions within cellular systems at the nano-scale may hold the potential to revolutionize the treatment of neurodegenerative diseases such as ALS and other motor neuron diseases, said Robert Glanzman, MD, FAAN, Chief Medical Officer of Clene.

Rob Etherington, President and CEO of Clene added, This blinded interim analysis suggests that CNM-Au8 is working mechanistically to address a foundational challenge common to many neurodegenerative diseases, namely that stressed or failing neurons need additional energy for their survival, repair, and improved function. Emerging MUNIX data potentially indicate preservation of motor units, which is promising. We eagerly anticipate final results and are encouraged that these blinded interim results may provide hope for ALS patients and their families as they search for new therapies to treat this devastating disease.

The presentation (CLT-23) titled, RESCUE-ALS Trial, A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study of CNM-Au8 to Slow Disease Progression in Amyotrophic Lateral Sclerosis Patients: Design and Interim Blinded Results, is available as a live e-Poster on December 10th at 12:10 12:50 pm EST at the Virtual 31st International Symposium on ALS/MND, held online (https://symposium.mndassociation.org/virtual-2020/).

About RESCUE-ALSRESCUE-ALS is a Phase 2 multi-center, randomized, double-blind, parallel group, placebo-controlled study examining the efficacy, safety, pharmacokinetics and pharmacodynamics of CNM-Au8 in participants who are newly symptomatic with ALS (within 24-months of screening or 12-months from diagnosis). Enrolled subjects will be randomized 1:1 to receive either active treatment with CNM-Au8 (30 mg) or placebo in addition to their current standard of care. Participants will receive their randomized treatment over 36 consecutive weeks during the treatment period. The objective of this study is to assess the impact of improving neuronal bioenergetics, reducing reactive oxygen species and promoting protein homeostasis with CNM-Au8 to slow disease progression in patients with ALS. In the trial, efficacy is assessed as the average change in motor neuron unit number index (MUNIX) estimated by electromyography for the abductor digiti minimi (ADM), abductor pollicis brevis (APB), biceps brachii (BB), and tibialis anterior (TA) (muscles of the hand, arm, and leg). The trial was fully enrolled with 44 participants as of the reported 27-October-2020 data cut. Baseline characteristics include [mean (SD)], MUNIX(4) score: 93.7 (45.8); FVC % predicted: 80.8 (16.3); ALSFRS-R: 38.6 (6.1); ALSSQOL-20: 3.3 (1.3), mean time from diagnosis: 4.7 (4.6) months; riluzole background treatment, 92%.

About CNM-Au8CNM-Au8 is a concentrated, aqueous suspension of clean-surfaced faceted gold nanocrystals that act catalytically to support important intracellular biological reactions. CNM-Au8 consists solely of pure gold nanoparticles, composed of clean-surfaced, faceted, geometrical crystals held in suspension in sodium bicarbonate buffered, pharmaceutical grade water. CNM-Au8 has demonstrated safety in Phase 1 studies in healthy volunteers and has shown both remyelination and neuroprotective effects in multiple preclinical (animal) models. Preclinical data, both published in peer-reviewed journals and presented at scientific congresses, demonstrate that treatment of neuronal cultures with CNM-Au8 improves survival of neurons, protects neurite networks, decreases intracellular levels of reactive oxygen species and improves mitochondrial capacity in response to cellular stresses induced by multiple disease-relevant neurotoxins. Oral treatment with CNM-Au8 improved functional behaviors in rodent models of ALS, multiple sclerosis, and Parkinsons disease versus vehicle (placebo). CNM-Au8 is currently being tested in a Phase 2 clinical study for the treatment of chronic optic neuropathy in patients with MS in addition to Phase 2 and Phase 3 clinical studies for disease progression in patients with ALS.

About ALSALS is a universally fatal neurodegenerative disorder that results in loss of motor neurons in the cerebral cortex, brain stem, and spinal cord. ALS, also known as Lou Gehrig's disease, leads to the death of the neurons controlling voluntary muscles resulting in weakness, muscle atrophy, and progressive paralysis. ALS affects more than 15,000 patients in the United States and is the most prevalent adult-onset progressive motor neuron disease.

About CleneClene is a clinical-stage biopharmaceutical company focused on the development of unique therapeutics for neurodegenerative diseases. Clene has innovated a novel nanotechnology drug platform for the development of a new class of orally administered neurotherapeutic drugs. Clene has also advanced into the clinic an aqueous solution of ionic zinc and silver for anti-viral and anti-microbial uses. Founded in 2013, the company is based in Salt Lake City, Utah with R&D and manufacturing operations located in North East, Maryland. For more information, please visit http://www.clene.com.

Forward-Looking StatementsThis press release contains, and certain oral statements made by representatives of Tottenham, Clene, and their respective affiliates, from time to time may contain, "forward-looking statements" within the meaning of the "safe harbor" provisions of the Private Securities Litigation Reform Act of 1995. Tottenham's and Clene's actual results may differ from their expectations, estimates and projections and consequently, you should not rely on these forward-looking statements as predictions of future events. Words such as "expect," "estimate," "project," "budget," "forecast," "anticipate," "intend," "plan," "may," "will," "could," "should," "believes," "predicts," "potential," "might" and "continues," and similar expressions are intended to identify such forward-looking statements. These forward-looking statements include, without limitation, Tottenham's and Clene's expectations with respect to future performance and anticipated financial impacts of the business combination, the satisfaction of the closing conditions to the business combination and the timing of the completion of the business combination. These forward-looking statements involve significant risks and uncertainties that could cause actual results to differ materially from expected results. Most of these factors are outside the control of Tottenham or Clene and are difficult to predict. Factors that may cause such differences include, but are not limited to: (1) the occurrence of any event, change or other circumstances that could give rise to the termination of the Merger Agreement relating to the proposed business combination; (2) the outcome of any legal proceedings that may be instituted against Tottenham or Clene following the announcement of the Merger Agreement and the transactions contemplated therein; (3) the inability to complete the business combination, including due to failure to obtain approval of the shareholders of Tottenham or other conditions to closing in the Merger Agreement; (4) delays in obtaining or the inability to obtain necessary regulatory approvals (including approval from regulators, as applicable) required to complete the transactions contemplated by the Merger Agreement; (5) the occurrence of any event, change or other circumstance that could give rise to the termination of the Merger Agreement or could otherwise cause the transaction to fail to close; (6) the inability to obtain or maintain the listing of the post-acquisition company's ordinary shares on NASDAQ following the business combination; (7) the risk that the business combination disrupts current plans and operations as a result of the announcement and consummation of the business combination; (8) the ability to recognize the anticipated benefits of the business combination, which may be affected by, among other things, competition, the ability of the combined company to grow and manage growth profitably and retain its key employees; (9) costs related to the business combination; (10) changes in applicable laws or regulations; (11) the possibility that Clene or the combined company may be adversely affected by other economic, business, and/or competitive factors; and (12) other risks and uncertainties to be identified in the Form S-4 filed by Chelsea Worldwide (when available) relating to the business combination, including those under "Risk Factors" therein, and in other filings with the Securities and Exchange Commission (SEC) made by Tottenham and Clene. Tottenham and Clene caution that the foregoing list of factors is neither exclusive nor exhaustive. Tottenham and Clene caution readers not to place undue reliance upon any forward-looking statements, which speak only as of the date made. Neither Tottenham or Clene undertakes or accepts any obligation or undertaking to release publicly any updates or revisions to any forward-looking statements to reflect any change in its expectations or any change in events, conditions or circumstances on which any such statement is based, subject to applicable law. The information contained in any website referenced herein is not, and shall not be deemed to be, part of or incorporated into this press release.

Media ContactAndrew MielachLifeSci Communications(646) 876-5868amielach@lifescicomms.com

Investor ContactBruce MackleLifeSci Advisors, LLC(929) 469-3859bmackle@lifesciadvisors.com

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Clene Nanomedicine Presents Blinded Interim Results from RESCUE-ALS Phase 2 Study at the 31st International Symposium on ALS/MNDResults provide...

NANOBIOTIX Announces Temporary Trading Halt of Its Ordinary Shares on Euronext Paris – Business Wire

PARIS & CAMBRIDGE, Mass.--(BUSINESS WIRE)--Regulatory News:

NANOBIOTIX (Euronext: NANO ISIN : FR0011341205 the Company), a clinical-stage nanomedicine company pioneering new approaches to the treatment of cancer, announced today that trading of its ordinary shares on the regulated market of Euronext in Paris (Euronext Paris) will be temporarily halted, at the Companys request, from the opening of the market at 9:00 AM CET. This trading halt takes place in the context of the initial public offering of the Company on the Nasdaq Global Select Market, in order to allow for the confirmation of allocations to investors and for the commencement of trading of the Companys American Depositary Shares (ADSs) on the Nasdaq Global Select Market.

This suspension will be effective until a new communication is released by the Company. Trading on the regulated market of Euronext Paris is expected to resume today, December 11, 2020, at approximately 4:00 pm (CET), which is the earliest time ADSs are expected to begin trading on the Nasdaq Global Select Market (10:00 am (EST)) under the ticker symbol NBTX.

About NANOBIOTIX

Incorporated in 2003, Nanobiotix is a leading, clinical-stage nanomedicine company pioneering new approaches to significantly change patient outcomes by bringing nanophysics to the heart of the cell.

The Nanobiotix philosophy is rooted in designing pioneering, physical-based approaches to bring highly effective and generalized solutions to address unmet medical needs and challenges.

Nanobiotixs novel, proprietary lead technology, NBTXR3, aims to expand radiotherapy benefits for millions of cancer patients. Nanobiotixs Immuno-Oncology program has the potential to bring a new dimension to cancer immunotherapies.

Nanobiotix is listed on the regulated market of Euronext in Paris (Euronext: NANO / ISIN: FR0011341205; Bloomberg: NANO: FP). Its headquarters are in Paris, France. Nanobiotix has a subsidiary, Curadigm, located in France and the United States, as well as a US affiliate in Cambridge, MA, and European affiliates in France, Spain and Germany.

Disclaimer

This press release contains certain forward-looking statements concerning Nanobiotix and its business, including its prospects and product candidate development. Such forward-looking statements are based on assumptions that Nanobiotix considers to be reasonable. However, there can be no assurance that the estimates contained in such forward-looking statements will be verified, which estimates are subject to numerous risks including the risks set forth in the universal registration document of Nanobiotix registered with the AMF under number R.20-010 on May 12, 2020 and in its amendment filed with the AMF under number D.20-0339-A01 on November 20, 2020 (copies of which are available on http://www.nanobiotix.com) and to the development of economic conditions, financial markets and the markets in which Nanobiotix operates. The forward-looking statements contained in this press release are also subject to risks not yet known to Nanobiotix or not currently considered material by Nanobiotix. The occurrence of all or part of such risks could cause actual results, financial conditions, performance or achievements of Nanobiotix to be materially different from such forward-looking statements.

This press release has been prepared in both French and English. In the event of any differences between the two texts, the French language version shall supersede.

This press release does not constitute an offer to sell nor a solicitation of an offer to buy, nor shall there be any sale of ordinary shares or ADSs of Nanobiotix in any state or jurisdiction in which such an offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction.

The distribution of this document may, in certain jurisdictions, be restricted by local legislations. Persons into whose possession this document comes are required to inform themselves about and to observe any such potential local restrictions.

A French listing prospectus comprising (i) the 2019 universal registration document filed with the AMF under number R.20-010 on May 12, 2020, as completed by a first amendment to such universal registration document filed with the AMF under number D.0339-A01 on November 20, 2020 and a second amendment to such universal registration document, which will be filed with the AMF on December 11, 2020, and (ii) a Securities Note (Note dopration), including a summary of the prospectus, will be submitted to the approval by the AMF and will be published on the AMFs website at http://www.amf-france.org. Following the filing of the second amendment to the universal registration document with the AMF, copies of Companys 2019 universal registration document, as amended, will be available free of charge at the Companys head office located at 60 rue de Wattignies, 75012 Paris.

European Economic Area

In relation to each Member State of the European Economic Area (each, a Member State) no offer to the public of ordinary shares and ADSs may be made in that Member State other than:

- to any legal entity which is a qualified investor as defined in the Prospectus Regulation;

- to fewer than 150 natural or legal persons (other than a qualified investor as defined in the Prospectus Regulation); or

- in any other circumstances falling within Article 1(4) of the Prospectus Regulation,

provided that no such offer of ordinary shares and ADSs shall require us or any Underwriter to publish a prospectus pursuant to Article 3 of the Prospectus Regulation or supplement a prospectus pursuant to Article 23 of the Prospectus Regulation and each person who initially acquires any shares or to whom any offer is made will be deemed to have represented, acknowledged and agreed to and with each of the Underwriters and the Company that it is a qualified investor as defined in the Prospectus Regulation.

For the purposes of this provision, the expression an offer to the public in relation to any ordinary shares and ADSs in any Member State means the communication in any form and by any means of sufficient information on the terms of the offer and any ordinary shares and ADSs to be offered so as to enable an investor to decide to purchase any ordinary shares and ADSs, and the expression Prospectus Regulation means Regulation (EU) 2017/1129 (as amended).

France

The ADSs and the ordinary shares have not been and will not be offered or sold to the public in the Republic of France, and no offering of this prospectus or any marketing materials relating to the ADSs and the ordinary shares may be made available or distributed in any way that would constitute, directly or indirectly, an offer to the public in the Republic of France (except for public offerings defined in Article L.411-2 1 of the French Code montaire et financier).

The ordinary shares in the form of ADSs may only be offered or sold in France pursuant to article L. 411-2 1 of the French Code montaire et financier to qualified investors (as such term is defined in Article 2(e) of Regulation (EU) n 2017/1129 dated 14 June 2017, as amended) acting for their own account, and in accordance with articles L. 411-1, L. 411-2 and D. 411-2 to D.411-4, D.744-1 and D. 754-1 and D. 764-1 of the French Code montaire et financier.

This announcement is not an advertisement and not a prospectus within the meaning of the Prospectus Regulation.

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NANOBIOTIX Announces Temporary Trading Halt of Its Ordinary Shares on Euronext Paris - Business Wire

Global Nanomedicine Market Analysis and Forecast to 2025 by Cancer Detection, Monitoring Therapy & Disease Detection – ResearchAndMarkets.com -…

The "Nanomedicine Global Market Insights 2020, Analysis and Forecast to 2025, by Manufacturers, Regions, Technology, Application" report has been added to ResearchAndMarkets.com's offering.

This report describes the global market size of Nanomedicine from 2015 to 2019 and its CAGR from 2015 to 2019, and also forecasts its market size to the end of 2025 and its CAGR from 2020 to 2025. For the geography segment, regional supply, demand, major players, price is presented from 2015 to 2025.

For the competitor segment, the report includes global key players of Nanomedicine as well as some small players.

The information for each competitor includes:

Company Profile

Main Business Information

SWOT Analysis

Sales, Revenue, Price and Gross Margin

Market Share

Applications Segment:

Cancer Detection

Monitoring Therapy

Disease Detection

Companies Covered:

Abbott Laboratories

Cepheid

Philips

GE Healthcare

Siemens

Gen-Proberporated

MDxHealth SA

EpiGenomics AG

Roche Diagnostics

Sequenom

Manhattan Scientifics

Key Topics Covered:

Chapter 1 Executive Summary

Chapter 2 Abbreviation and Acronyms

Chapter 3 Preface

3.1 Research Scope

3.2 Research Sources

3.2.1 Data Sources

3.2.2 Assumptions

3.3 Research Method

Chapter 4 Market Landscape

4.1 Market Overview

4.2 Classification/Types

4.3 Application/End-users

Chapter 5 Market Trend Analysis

5.1 Introduction

5.2 Drivers

5.3 Restraints

5.4 Opportunities

5.5 Threats

Chapter 6 Industry Chain Analysis

6.1 Upstream/Suppliers Analysis

6.2 Nanomedicine Analysis

6.2.1 Technology Analysis

6.2.2 Cost Analysis

6.2.3 Market Channel Analysis

6.3 Downstream Buyers/End-users

Chapter 7 Latest Market Dynamics

7.1 Latest News

7.2 Merger and Acquisition

7.3 Planned/Future Project

7.4 Policy Dynamics

Chapter 8 Trading Analysis

8.1 Export of Nanomedicine by Region

8.2 Import of Nanomedicine by Region

8.3 Balance of Trade

Chapter 9 Historical and Forecast Nanomedicine Market in North America (2015-2025)

9.1 Nanomedicine Market Size

9.2 Nanomedicine Demand by End Use

Story continues

9.3 Competition by Players/Suppliers

9.4 Type Segmentation and Price

9.5 Key Countries Analysis

9.5.1 US

9.5.2 Canada

9.5.3 Mexico

Chapter 10 Historical and Forecast Nanomedicine Market in South America (2015-2025)

10.1 Nanomedicine Market Size

10.2 Nanomedicine Demand by End Use

10.3 Competition by Players/Suppliers

10.4 Type Segmentation and Price

10.5 Key Countries Analysis

10.5.1 Brazil

10.5.2 Argentina

10.5.3 Chile

10.5.4 Peru

Chapter 11 Historical and Forecast Nanomedicine Market in Asia & Pacific (2015-2025)

11.1 Nanomedicine Market Size

11.2 Nanomedicine Demand by End Use

11.3 Competition by Players/Suppliers

11.4 Type Segmentation and Price

11.5 Key Countries Analysis

11.5.1 China

11.5.2 India

11.5.3 Japan

11.5.4 South Korea

11.5.5 Asean

11.5.6 Australia

Chapter 12 Historical and Forecast Nanomedicine Market in Europe (2015-2025)

12.1 Nanomedicine Market Size

12.2 Nanomedicine Demand by End Use

12.3 Competition by Players/Suppliers

12.4 Type Segmentation and Price

12.5 Key Countries Analysis

12.5.1 Germany

12.5.2 France

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Global Nanomedicine Market Analysis and Forecast to 2025 by Cancer Detection, Monitoring Therapy & Disease Detection - ResearchAndMarkets.com -...

Nanobiotix Announces Trading Resumption of Its Ordinary Shares on Euronext Paris – Business Wire

PARIS, France & CAMBRIDGE, Mass.--(BUSINESS WIRE)--Regulatory News:

NANOBIOTIX (Paris:NANO) (Euronext: NANO ISIN : FR0011341205 the Company), a clinical-stage nanomedicine company pioneering new approaches to the treatment of cancer, announced the trading resumption of its ordinary shares on Euronext in Paris (Euronext Paris) as from 4:00 pm CET.

Trading in the ordinary shares of Nanobiotix was halted at the request of the Company on December 11, 2020 from 9:00 am CET in connection with its previously announced global offering, in order to allow for the confirmation of allocations to investors and for the commencement of trading of the Companys American Depositary Shares on the Nasdaq Global Select Market.

About NANOBIOTIX

Incorporated in 2003, Nanobiotix is a leading, clinical-stage nanomedicine company pioneering new approaches to significantly change patient outcomes by bringing nanophysics to the heart of the cell.

The Nanobiotix philosophy is rooted in designing pioneering, physical-based approaches to bring highly effective and generalized solutions to address unmet medical needs and challenges.

Nanobiotixs novel, proprietary lead technology, NBTXR3, aims to expand radiotherapy benefits for millions of cancer patients. Nanobiotixs Immuno-Oncology program has the potential to bring a new dimension to cancer immunotherapies.

Nanobiotix is listed on the regulated market of Euronext in Paris (Euronext: NANO / ISIN: FR0011341205; Bloomberg: NANO: FP). Its headquarters are in Paris, France. Nanobiotix has a subsidiary, Curadigm, located in France and the United States, as well as a US affiliate in Cambridge, MA, and European affiliates in France, Spain and Germany.

Important Notice

This press release contains certain forward-looking statements concerning Nanobiotix and its business, including its prospects and product candidate development. Such forward-looking statements are based on assumptions that Nanobiotix considers to be reasonable. However, there can be no assurance that the estimates contained in such forward-looking statements will be verified, which estimates are subject to numerous risks including the risks set forth in the universal registration document of Nanobiotix registered with the AMF under number R.20-010 on May 12, 2020 as completed by an amendment to such universal registration document filed with the AMF under number D.0339-A01 on November 20, 2020 (copies of which are available on http://www.nanobiotix.com) and to the development of economic conditions, financial markets and the markets in which Nanobiotix operates. The forward-looking statements contained in this press release are also subject to risks not yet known to Nanobiotix or not currently considered material by Nanobiotix. The occurrence of all or part of such risks could cause actual results, financial conditions, performance or achievements of Nanobiotix to be materially different from such forward-looking statements.

This press release has been prepared in both French and English. In the event of any differences between the two texts, the French language version shall supersede.

This press release does not constitute an offer to sell nor a solicitation of an offer to buy, nor shall there be any sale of ordinary shares or ADSs of Nanobiotix in any state or jurisdiction in which such an offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction.

The distribution of this document may, in certain jurisdictions, be restricted by local legislations. Persons into whose possession this document comes are required to inform themselves about and to observe any such potential local restrictions.

A French listing prospectus comprising (i) the 2019 universal registration document filed with the AMF under number R.20-010 on May 12, 2020, as completed by a first amendment to such universal registration document filed with the AMF under number D.0339-A01 on November 20, 2020 and a second amendment to such universal registration document, which will be filed with the AMF on December 11, 2020, and (ii) a Securities Note (Note dopration), including a summary of the prospectus, will be submitted to the approval by the AMF and will be published on the AMFs website at http://www.amf-france.org. Following the filing of the second amendment to the universal registration document with the AMF, copies of Companys 2019 universal registration document, as amended, will be available free of charge at the Companys head office located at 60 rue de Wattignies, 75012 Paris.

European Economic Area

In relation to each Member State of the European Economic Area (each, a Member State) no offer to the public of ordinary shares and ADSs may be made in that Member State other than:

- to any legal entity which is a qualified investor as defined in the Prospectus Regulation;- to fewer than 150 natural or legal persons (other than a qualified investor as defined in the Prospectus Regulation); or- in any other circumstances falling within Article 1(4) of the Prospectus Regulation,

provided that no such offer of ordinary shares and ADSs shall require us or any Underwriter to publish a prospectus pursuant to Article 3 of the Prospectus Regulation or supplement a prospectus pursuant to Article 23 of the Prospectus Regulation and each person who initially acquires any shares or to whom any offer is made will be deemed to have represented, acknowledged and agreed to and with each of the Underwriters and the Company that it is a qualified investor as defined in the Prospectus Regulation.

For the purposes of this provision, the expression an offer to the public in relation to any ordinary shares and ADSs in any Member State means the communication in any form and by any means of sufficient information on the terms of the offer and any ordinary shares and ADSs to be offered so as to enable an investor to decide to purchase any ordinary shares and ADSs, and the expression Prospectus Regulation means Regulation (EU) 2017/1129 (as amended).

France

The ADSs and the ordinary shares have not been and will not be offered or sold to the public in the Republic of France, and no offering of this prospectus or any marketing materials relating to the ADSs and the ordinary shares may be made available or distributed in any way that would constitute, directly or indirectly, an offer to the public in the Republic of France (except for public offerings defined in Article L.411-2 1 of the French Code montaire et financier).

The ordinary shares in the form of ADSs may only be offered or sold in France pursuant to article L. 411-2 1 of the French Code montaire et financier to qualified investors (as such term is defined in Article 2(e) of Regulation (EU) n 2017/1129 dated 14 June 2017, as amended) acting for their own account, and in accordance with articles L. 411-1, L. 411-2 and D. 411-2 to D.411-4, D.744-1 and D. 754-1 and D. 764-1 of the French Code montaire et financier.

This announcement is not an advertisement and not a prospectus within the meaning of the Prospectus Regulation.

See the article here:
Nanobiotix Announces Trading Resumption of Its Ordinary Shares on Euronext Paris - Business Wire

NANOBIOTIX Announces the Filing of an Amended Registration Statement, Including an Estimated Initial Public Offering Range – Business Wire

PARIS & CAMBRIDGE, Mass.--(BUSINESS WIRE)--Regulatory News:

NANOBIOTIX (Paris:NANO) (Euronext: NANO ISIN : FR0011341205 the Company), a clinical-stage nanomedicine company pioneering new approaches to the treatment of cancer, today announced the filing of an amended registration on form F-1 in connection with its intention to issue and sell, subject to market and other conditions, 6,500,000 ordinary shares of the Company in an initial public offering of American Depositary Shares (ADSs), each representing the right to receive one ordinary share, in the United States (the U.S. Offering) and a concurrent offering of ordinary shares in certain jurisdictions outside the United States to certain investors (the European Offering and together with the U.S. Offering, the Global Offering). The offering price per ADS is expected to be between $13.50 and $14.50, or between 11.15 and 11.97 per ordinary share (assuming an exchange rate of 1.00 = $1.2109, the exchange rate published by the European Central Bank on December 9, 2020).

Assuming an offering price of $14.00 per ADS in the U.S. Offering and 11.56 per ordinary share in the European Offering, which are the midpoints of the respective price ranges, the Company expects to receive net proceeds of approximately $79.6 million (65.8 million) from the Global Offering. The Company intends to grant the underwriters a 30-day option to purchase, at the same price, additional ADSs and/or ordinary shares in an aggregate amount of up to 15% of the total number of ADSs and ordinary shares proposed to be sold in the Global Offering. If such option is exercised in full, the expected net proceeds to the Company will increase to approximately $92.3 million (76.2 million).

All securities to be sold in the Global Offering will be offered by the Company. The ADSs have been approved for listing on the Nasdaq Global Select Market under the ticker symbol NBTX. The Companys ordinary shares are listed on the regulated market of Euronext Paris under the ticker symbol NANO.

The Company plans to use the net proceeds of the Global Offering to advance the overall development of NBTXR3, prioritizing the treatment of locally advanced head and neck cancers, including approximately $58.1 million to advance its clinical trial of NBTXR3 in the United States and Europe for the treatment of locally advanced head and neck cancers through an interim analysis of efficacy data, and approximately $20.6 million to advance the development of its other clinical and pre-clinical programs. The Company expects to use the remainder of the net proceeds, if any, from the Global Offering for working capital funding and other general corporate purposes.

The Company expects that the net proceeds from the Global Offering, together with its cash and cash equivalents of 42.4 million as of September 30, 2020, will be sufficient to fund its operating expenses and capital expenditure requirements through the end of 2022.

Jefferies LLC is acting as global coordinator and joint book-running manager for the Global Offering, and Evercore Group, L.L.C. and UBS Securities LLC are acting as joint book-running managers for the U.S. Offering. Jefferies International Limited and Gilbert Dupont are acting as managers for the European Offering.

The final offering price per ADS in U.S. dollars and the corresponding offering price per ordinary share in euros, as well as the final number of ADSs and ordinary shares to be sold in the Global Offering, will be determined by the Companys executive board following a bookbuilding process commencing immediately. The offering price per ADS and per ordinary share will be at least equal to the volume weighted average price of the Companys ordinary shares on the regulated market of Euronext in Paris over the last three trading days preceding the start of the offering (i.e., December 7, 8 and 9, 2020), subject to a maximum discount of 10%.

On an indicative basis, the completion of the Global Offering would result in a dilution of approximately 25% of the Company's outstanding share capital on a non-diluted basis (excluding the exercise by the underwriters of the option to purchase additional ordinary shares) and approximately 28% of the Companys outstanding share capital on a non-diluted basis (in the event that the underwriters exercise in full their option to purchase additional ordinary shares (including in the form of ADSs)).

The ADSs and/or ordinary shares will be issued through a capital increase without shareholders preferential subscription rights by way of a public offering excluding offerings referred to in Article L. 411-2 1 of the French Monetary and Financial Code (Code montaire et financier) and under the provisions of Article L.225-136 of the French Commercial Code (Code de commerce) and pursuant to the 2nd and 7th resolutions of the Company's extraordinary general shareholders' meeting held on November 30, 2020. The European Offering will be open only to qualified investors as such term is defined in article 2(e) of the regulation (EU) 2017/1129 of the European Parliament and of the Council of June 14, 2017.

The Company plans to announce the result of the Global Offering as soon as practicable after pricing thereof in a subsequent press release.

The existing liquidity contract between the Company and Gilbert Dupont is suspended until the end of the stabilization period.

The securities referred to in this press release will be offered only by means of a prospectus. When available, copies of the preliminary prospectus relating to and describing the terms of the Global Offering may be obtained from Jefferies LLC, 520 Madison Avenue New York, NY 10022, or by telephone at 877-547-6340 or 877-821-7388, or by email at Prospectus_Department@Jefferies.com; or from Evercore Group L.L.C., Attention: Equity Capital Markets, 55 East 52nd Street, 35th Floor, New York, New York 10055, or by telephone at 888-474-0200, or by email at ecm.prospectus@evercore.com; or from UBS Securities LLC, Attention: Prospectus Department, 1285 Avenue of the Americas, New York, New York 10019, or by telephone at 888-827-7275, or by email at ol-prospectusrequest@ubs.com.

A registration statement on Form F-1 relating to the securities referred to herein has been filed with the U.S. Securities and Exchange Commission (SEC) but has not yet become effective. These securities may not be sold, nor may offers to buy be accepted, prior to the time the registration statement becomes effective. The registration statement can be accessed by the public on the website of the SEC.

About NANOBIOTIX

Incorporated in 2003, Nanobiotix is a leading, clinical-stage nanomedicine company pioneering new approaches to significantly change patient outcomes by bringing nanophysics to the heart of the cell.

The Nanobiotix philosophy is rooted in designing pioneering, physical-based approaches to bring highly effective and generalized solutions to address unmet medical needs and challenges.

Nanobiotixs novel, proprietary lead technology, NBTXR3, aims to expand radiotherapy benefits for millions of cancer patients. Nanobiotixs Immuno-Oncology program has the potential to bring a new dimension to cancer immunotherapies.

Nanobiotix is listed on the regulated market of Euronext in Paris (Euronext: NANO / ISIN: FR0011341205; Bloomberg: NANO: FP). Its headquarters are in Paris, France. Nanobiotix has a subsidiary, Curadigm, located in France and the United States, as well as a US affiliate in Cambridge, MA, and European affiliates in France, Spain and Germany.

Disclaimer

This press release contains certain forward-looking statements concerning the Global Offering as well as Nanobiotix and its business, including its prospects and product candidate development. Such forward-looking statements are based on assumptions that Nanobiotix considers to be reasonable. However, there can be no assurance that the estimates contained in such forward-looking statements will be verified, which estimates are subject to numerous risks including the risks set forth in the universal registration document of Nanobiotix registered with the AMF under number R.20-010 on May 12, 2020 and in its amendment filed with the AMF under number D.0339-A01 on November 20, 2020 (copies of which are available on http://www.nanobiotix.com) and to the development of economic conditions, financial markets and the markets in which Nanobiotix operates. The forward-looking statements contained in this press release are also subject to risks not yet known to Nanobiotix or not currently considered material by Nanobiotix. The occurrence of all or part of such risks could cause actual results, financial conditions, performance or achievements of Nanobiotix to be materially different from such forward-looking statements.

This press release does not constitute an offer to sell nor a solicitation of an offer to buy, nor shall there be any sale of ordinary shares or ADSs of Nanobiotix in any state or jurisdiction in which such an offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction.

The distribution of this document may, in certain jurisdictions, be restricted by local legislations. Persons into whose possession this document comes are required to inform themselves about and to observe any such potential local restrictions.

A French listing prospectus comprising (i) the 2019 universal registration document filed with the AMF under number R.20-010 on May 12, 2020, as completed by a first amendment to such universal registration document filed with the AMF under number D.0339-A01 on November 20, 2020 and a second amendment to such universal registration document, which will be filed with the AMF on December [11], 2020, and (ii) a Securities Note (Note dopration), including a summary of the prospectus, will be submitted to the approval by the AMF and will be published on the AMFs website at http://www.amf-france.org. Following the filing of the second amendment to the universal registration document with the AMF, copies of Companys 2019 universal registration document, as amended, will be available free of charge at the Companys head office located at 60 rue de Wattignies, 75012 Paris.

European Economic Area

In relation to each Member State of the European Economic Area (each, a "Member State") no offer to the public of ordinary shares and ADSs may be made in that Member State other than:

For the purposes of this provision, the expression an "offer to the public" in relation to any ordinary shares and ADSs in any Member State means the communication in any form and by any means of sufficient information on the terms of the offer and any ordinary shares and ADSs to be offered so as to enable an investor to decide to purchase any ordinary shares and ADSs, and the expression "Prospectus Regulation" means Regulation (EU) 2017/1129 (as amended).

France

The ADSs and the ordinary shares have not been and will not be offered or sold to the public in the Republic of France, and no offering of this prospectus or any marketing materials relating to the ADSs and the ordinary shares may be made available or distributed in any way that would constitute, directly or indirectly, an offer to the public in the Republic of France (except for public offerings defined in Article L.411-2 1 of the French Code montaire et financier).

The ordinary shares in the form of ADSs may only be offered or sold in France pursuant to article L. 411-2 1 of the French Code montaire et financier to qualified investors (as such term is defined in Article 2(e) of Regulation (EU) n 2017/1129 dated 14 June 2017, as amended) acting for their own account, and in accordance with articles L. 411-1, L. 411-2 and D. 411-2 to D.411-4, D.744-1 and D. 754-1 and D. 764-1 of the French Code montaire et financier.

This announcement is not an advertisement and not a prospectus within the meaning of the Prospectus Regulation.

MIFID II product governance / Retail investors, professional investors and ECPs only target market Solely for the purposes of each manufacturers product approval process, the target market assessment in respect of the new shares has led to the conclusion that: (i) the target market for the new shares is retail investors, eligible counterparties and professional clients, each as defined in MiFID II; and (ii) all channels for distribution of the new shares to retail investors, eligible counterparties and professional clients are appropriate. Any person subsequently offering, selling or recommending the new shares (a distributor) should take into consideration the manufacturers target market assessment; however, a distributor subject to MiFID II is responsible for undertaking its own target market assessment in respect of the new shares (by either adopting or refining the manufacturers target market assessment) and determining appropriate distribution channels. For the avoidance of doubt, even if the target market includes retail investors, the manufacturers have decided that the new shares will be offered, as part of the initial offering, only to eligible counterparties and professional clients.

This press release has been prepared in both French and English. In the event of any differences between the two texts, the French language version shall supersede.

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NANOBIOTIX Announces the Filing of an Amended Registration Statement, Including an Estimated Initial Public Offering Range - Business Wire

Targeted exosome coating gene-chem nanocomplex as nanoscavenger for clearing -synuclein and immune activation of Parkinson’s disease – Science…

INTRODUCTION

For neurodegenerative diseases, gene and small-molecule drugs can be used for clearing pathological substances synergistically that cause neuronal degeneration (1). In Parkinsons disease (PD), -synuclein (-syn) aggregates are considered to be the main pathological substance (2, 3). Small interfering RNA (siRNA) shows potential in rare disease or disease with no good drug options but is gene related. For example, Onpattro (patisiran) has been applied as the clinical treatment of multiple sclerosis. siRNA targeting SNCA (siSNCA) can down-regulate -syn protein synthesis to inhibit the formation of -syn aggregates and could specifically down-regulate -syn expression without targeting - or -synuclein (4).The neuroprotective small-molecule drug curcumin has a reducing effect on the existing -syn aggregates (57). Therefore, the combination of siSNCA with curcumin can synergistically reduce the cytotoxicity of -syn aggregates on dopaminergic neurons for PD treatment. Even so, these drugs with poor bioavailability are difficult to accumulate in the action site of target neurons because of their poor absorption and rapid metabolism (8, 9). In addition, brain delivery problems are mainly manifested in the fact that it is difficult for delivery systems to pass through the blood-brain barrier (BBB) and could not accurately recognize the target cell (10). Synthetic gene and chemical drug (gene-chem) nanocomplexes including liposomes and polymer particles have been modified with cell-penetrating peptides or cell-targeting molecules for enhanced drug delivery in brain diseases or other disease therapy (11). However, synthetic nanocomplexes are easily recognized as foreigners, resulting in natural immune activation, cell apoptosis, and short blood circulation time, which is unsafe and with low efficiency (12). In addition, when being internalized, these synthetic carriers would undergo an endosomal-lysosomal pathway, which tends to cause drug degradation and exocytosis as well as leads to inflammasome activation (12). Furthermore, it is necessary to control the release of drugs in the lesion area to reduce nonspecific toxicity. Therefore, to efficiently deliver gene-chem drugs to the action site of target cells for safe PD therapy, it is necessary to develop a delivery system that could overcome these delivery bottlenecks including low BBB permeation, poor neuron targeting, inefficient endocytosis into cytoplasm, and uncontrolled drug release.

To realize the above aims, we designed a targeted exosome coating gene-chem nanocomplex as an engineering nanoscavenger for neuronal -syn aggregates and immune activation of PD. Exosome is a well-researched natural source carrier for siRNA and chemical drugs, with diameter of 30 to 100 nm (4, 13, 14). It has a membrane structure on whose surface the specific protein tetraspanin CD9 facilitates direct membrane fusion and helps the internal substances directly transport into the cytoplasm of the recipient cell, which avoids lysosomal trapping (15, 16). To further efficiently deliver drugs through the BBB and to the dopaminergic neurons, the first process of the engineering was constructing the shell, REXO, a targeted immature dendritic cell (imDC)derived exosome with modification of rabies virus glycoprotein (RVG) peptide with 29 amino acids, which could specifically bind to the acetylcholine receptor expressed by neuronal cells and the BBB (17). Because it was difficult for exosomes to load hydrophilic gene and hydrophobic small-molecule drugs simultaneously, the second process of the engineering was achieved as a product of a gene-chem coloaded core, which is a reactive oxygen species (ROS)responsive gene-chem drug nanocomplex loading these two drugs with different characteristics (8, 9). The third process of the engineering was REXO-C/ANP/S nanoscavenger preparation. REXO was coated on the nanocomplex to form a nanoscavenger. Therefore, the engineering delivery system could efficiently cross the BBB, target neurons, and release drugs in high ROS environment of diseased dopaminergic neurons. The enriched siSNCA and curcumin could have functions on -syn protein down-regulation and -syn aggregate inhibition synergistically.

Literatures indicated that neurodegenerative diseases are immune disorders (18, 19). For example, PD is an adaptive immune disorder because T cells are activated by pathological substances such as -syn peptides (20). In addition, studies have indicated that immune activation of PD was associated with T helper 17 (TH17) functions and that differentiated TH17 cells could induce the inflammatory response (21). In brain diseases, the factors secreted by TH17 cells would induce neuron apoptosis or death and enhance central nervous system inflammation (22). Moreover, regulatory T (Treg) cells could inhibit immune activation and maintain immune stability and tolerance due to interleukin-10 (IL-10) and transforming growth factor (TGF-). These cytokines could promote the survival of neurons (23), inhibit the differentiation of TH17 cells, activate macrophages and microglia, and exert anti-inflammatory effects (24). In addition, neuroprotection of Treg cells can be exerted by inhibiting the response of microglia to stimuli-nitrated -syn (25). It was well known that imDC had immunosuppressive effects and played an important role in autoimmune diseases (2628). Inspired by this, we further speculated that exosomes derived from imDC, which coat the hybrid system REXO-C/ANP/S, might have an effect on immunosuppression as imDC does (29). The study further confirmed that the hybrid system REXO-C/ANP/S was effective in inhibiting TH17 cell immune activation and promoting immunosuppression-related Treg cell functions in the nervous system.

The hybrid nanoparticle (NP) REXO-C/ANP/S was prepared from two parts (Fig. 1A): preparation of gene-chem core C/ANP/S and acquisition of REXO. The core C/ANP/S was obtained by a two-step process. First, we synthesized the polymers BA-poly(2-(dimethylamino)ethyl acrylate) (BAP) and BB-poly(2-(dimethylamino)ethyl acrylate) (BBP) (fig. S1A). BBP was used as a nonROS-responsive control (30). 1H nuclear magnetic resonance of BAP and BBP indicated their successful synthesis (fig. S1, B to D). The amphiphilic polymer BAP could self-assemble and encapsulate the hydrophobic drug curcumin to form curcumin/BAP NP (C/ANP). The loading rate of curcumin in NP was calculated by Multiskan Spectrum, and the value was 70%. Next, the final C/ANP/siSNCA (C/ANP/S) and C/BNP/siSNCA (C/BNP/S) nanocomplex was formed via electrostatic interaction (Fig. 1A). We used the gel retardation assay and found that the siSNCA was completely attached to C/ANP at N/P (nitrogen portion of polymer/phosphorus portion of siRNA) of 5 (fig. S2A). The nonROS-responsive C/BNP/S nanocomplex was prepared the same way, and it could also completely absorb siSNCA at an N/P ratio of 5 (fig. S2B). The morphology of C/ANP/S was a spherical shape of approximately 30 nm in diameter (fig. S2C). Furthermore, we simulated the cytoplasmic high ROS microenvironment of the diseased dopaminergic neuron in vitro and detected the ROS-responsive characteristics of both nanocomplexes (31). The nonROS-responsive C/BNP/S slowly released curcumin in the phosphate-buffered saline (PBS) and H2O2 environment, and the final release ratios were 16.5 and 17.5% at 390 min, respectively (fig. S2D). The C/ANP/S had a low release rate of 24.4% in the PBS environment, but curcumin was more easily released in the H2O2 environment at a rate of 96.7% at 390 min. Therefore, C/ANP/S had the ROS-responsive drug release ability based on the materials structure.

(A) Scheme of REXO-C/ANP/S preparation. (B) Zeta potential and diameters of NPs under different REXO:C/ANP/S ratios. (C) TEM images of NPs under different REXO:C/ANP/S ratios (I, low REXO:C/ANP/S ratio; II, intermediate; and III, high REXO:C/ANP/S ratio). Scale bars, 100 nm. (D) Comparison in zeta potential and diameters of REXO, C/ANP/S, and REXO/ANP/S. (E) Chitosan microsphere with REXO-C/ANP/S absorption. Cy5-siSNCA, blue; curcumin, green; and DiI-labeled exosome, red. (F) Western blot band of TSG101 and CD9 of EXO and REXO-C/ANP/S.

The second part was the preparation of RVG-modified exosome REXO (Fig. 1A). First, bone marrow cells were extracted from the bone marrow of mice and were induced to differentiate into imDCs in vitro (32). The cell culture medium on the seventh day of culture was then collected. The cells and cell debris were removed by centrifugation. Next, culture medium was concentrated by ultrafiltration and passed through a qEV size exclusion column (Izon Science). The specified number 7, 8, and 9 fractions containing exosomes were separated and collected. Transmission electron microscopy (TEM) was used to identify the imDC exosome as a vesicle structure, approximately 70 nm in hydrodynamic diameter and with zeta potential of 12.7 mV (Fig. 2E). Targeted exosome could be engineered by click chemistry (33), targeting peptide plasmid transfer, or membrane fusion (13, 34, 35). However, these methods are complicated and time-consuming. In this engineering method, stearoyl-RVG was used to embed in the interior of the exosome phospholipid bilayer (table S1) (36). The mass spectrum confirmed the successful synthesis of the stearoyl-RVG (fig. S3A). To make the stearoyl-RVG visual in NPs, we then labeled it with fluorescein isothiocyanate (FITC). Stearoyl-RVG-FITC was synthesized by the condensation of amino group in stearoyl-NH2 and carboxyl group in FITC-RVG (fig. S3B). After removing the unembedded stearoyl-RVG-FITC via ultrafiltration centrifugation, stearoyl-RVG-FITC was obtained. Stearoyl-RVG-FITC had a low solubility in PBS. Therefore, the improved fluorescence intensity of stearoyl-RVG-FITC in exosomes after the ultrasound method indicated its successful modification (fig. S3, C and D) (36). We further used the lipophilic dye DiD (red), which is a lipophilic tracer like DiR, to label exosomes (37). The colocalization coefficient of DiD exosomes and stearoyl-RVG-FITC was 0.95 (fig. S3E), indicating the successful modification of RVG on exosomes.

(A) NP internalization in Transwell cells in 12 hours. I: Scheme of Transwell instrument. II: Cy5-siRNA internalization of bEnd.3 cells (top) and the SH-SH5Y cells (bottom). III: Cy5 mean fluorescence intensity in NP-treated bEnd.3 cells in Transwell model. IV: Cy5 mean fluorescence intensity in NP-treated SH-SH5Y cells in the Transwell model. (B) Cy5 mean fluorescence intensity detected by flow cytometry in SH-SH5Y cells after NP incubation in 0 min, 30 min, 1 hour, 2 hours, 4 hours, and 6 hours. ns, not significant. (C) Assessment by CLSM of SH-SY5Y cells after NP incubation in 4 hours. Endosome was labeled with LysoTracker red. Cy5-siSNCA, green. (D) Assessment by CLSM of SH-SY5Y cells after NP incubation in 0 min, 5 min, 10 min, 30 min, and 1 hour. Cell membrane was labeled with CellMask deep red membrane stain, and exosome was labeled with DiI.*P < 0.05, **P < 0.01, and ***P < 0.001. DAPI, 4,6-diamidino-2-phenylindole.

The assembly of the inner core and the outer REXO was carried out by the ultrasonic method using a bath sonicator at a frequency of 40 kHz and a power of 100 W (Fig. 1A) (38). The assembly process was assumed to be as shown in Fig. 1B and verified by TEM, size, and zeta potential measurement (Fig. 1C). Among the REXO and C/ANP/S complexes, below the REXO-to-C/ANP/S mass ratio of 0.05, the REXO absorbed to the surface of part C/ANP/S (Fig. 1C, I). The size of NPs increased to 141.0 nm at a mass ratio of 0.01, and the zeta potential decreased to 7.05 mV. At the ratio of 0.05, there was an intermediate state. The size increased to 437.5 nm, and TEM showed that C/ANP/S was cross-linked by the REXO (Fig. 1C, II). The ratio was further increased and, lastly, negative charge dominated the NPs that tended to be stable. The final core-shell monodisperse assembly forms as shown in Fig. 1C (III) at a mass ratio of 0.1, indicating that the REXO was coated on the surface of the core nanocomplexes. The final NP REXO-C/ANP/S was negatively charged at 7.1 mV, and the hydrodynamic diameter was 118.1 nm (Fig. 1D). Next, to facilitate the visual observation of the assembly components, we prepared positively charged poly-chitosan microspheres, which allowed adsorption of negatively charged assemblies on the surface (Fig. 1E). The exosomes were labeled with the lipophilic dye DiI. The result clearly showed the colocalization of DiI exosome, Cy5-siRNA, and curcumin (Fig. 1E and fig. S3F). In addition, the REXO-C/ANP/S obtained after assembly had the protein TSG101 and CD9 of EXO (Fig. 1F), which further indicated the successful coating.

In vitro, we investigated the biocompatibility of core nanocomplex C/ANP/S and the core-shell REXO-C/ANP/S. C/ANP/S and REXO-C/ANP/S were cocultured with SH-SY5Y cells under different N/P ratio conditions. As examined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the result showed that the cell viability of both groups was above 80%. The survival rate under the experimental condition N/P ratio of 5/1 was 93.9% (fig. S4A), which was suitable for in vivo application.

Next, the delivery process was simulated in vitro to explore drug delivery of REXO-C/ANP/S and C/ANP/S. First, we used the Transwell culture method to simulate the BBB (Fig. 2A, I). bEnd.3 cells were cultured in Transwell inserts (1 105 cells per polyester Transwell insert in six wells, pore diameter of 0.4 m, 4.67 cm2) for 7 days to a resulting monolayer with a transepithelial electrical resistance at least 200 ohmcm2. After adding NPs, Cy5 mean intensity fluorescence was detected by bioluminescence imaging using Kodak In-Vivo Imaging System FX Pro. The REXO coating significantly enhanced the uptake of siRNA drugs in C/ANP/S into bEnd.3 cells and then through the epithelial cells into lower SH-SY5Y cells (Fig. 2A, II to IV). As a comparison, the addition of free RVG peptide inhibited the promoting effect (Fig. 2A, II to IV). By comparing the uptake of siRNA in SH-SY5Y cells at different time points (Fig. 2B), it was found that the REXO coating significantly enhanced the uptake of the drugs in C/ANP/S. After 2 hours, the EXO and REXO coating groups EXO-C/ANP/S and REXO-C/ANP/S were significantly better than nude curcumin and siRNA (nude C + S) as well as the inner core C/ANP/S. This was because the C/ANP/S was endocytosed through the endosome-lysosome pathway due to quaternary amine compounds in the C/ANP/S, causing NP efflux and drug loss, so that the increased accumulation of drugs was not obvious with time (Fig. 2B) (39). The EXO-C/ANP/S and REXO-C/ANP/S avoided drug loss in the endosomal pathway after 2 hours, thereby enhancing drug accumulation. Second, the targeted RVG modification NP REXO-C/ANP/S more significantly increased the drug uptake than EXO-C/ANP/S. After the addition of the free RVG polypeptide, it inhibited the endocytosis of the drug due to its binding to the receptor on the cell surface, and the drug uptake was significantly reduced in the experimental results. Therefore, the results demonstrated that the exosome coating changed the endocytosis pathway, which has an important role in the increase of drug uptake.

Furthermore, to confirm the reason for the conjecture that the exosome coating C/ANP/S could avoid the drug loss of the endosome-lysosome pathway, we conducted an experiment to confirm whether the exogenous membrane fusion characteristics help. The results of the confocal laser scanning microscopy (CLSM) experiments showed a comparison of the endocytic mechanisms of the two systems (Fig. 2C). The core C/ANP/S was taken up through the endosome-lysosome pathway; thus, the drug aggregated in the endosomes (the overlap coefficient was 0.92 at 4 hours). However, the drug delivered by REXO-C/ANP/S was more dispersed in the cytoplasm, and therefore, there was less drug accumulation in the endosomes than C/ANP/S-treated cells (the overlap coefficient was 0.56 at 4 hours). Next, we labeled the exosomes with DiI and labeled the cell membrane with CellMask deep red membrane stain to detect the fusion of the two dyes in a short period. The fluorescence of DiI was enhanced with the extension of time, and it was apparently colocalized with the fluorescence of deep red membrane stain from 5 min to 1 hour (Fig. 2D and fig. S4B). These results demonstrated that the drug of REXO-C/ANP/S was enriched mostly through membrane fusion.

-Syn aggregates were the main pathological substance in PD neurons. Therefore, it was very important to clear the -syn aggregates and excess -syn for PD treatment (Fig. 3A). We constructed an SH-SY5Y cell line SNCAmCherrySH-SY5Y cell, which overexpressed SNCA-mCherry protein by plasmid transfection and cell selection. First, we examined the effects of exosomes and RVG-modified exosomes on the -syn expression and aggregates and found that there was almost no effect (fig. S4C). Next, nude drugs and different NPs were cocultured with SNCAmCherrySH-SY5Y cells for 2 days. The -syn aggregates in -synmCherryoverexpressing cell lines were observed by CLSM, in which mCherry was a red reporter for -syn (Fig. 3B). The results of the total -syn were also verified by Western blot [Fig. 3, C and D; 47 kDa (-syn was 18 kDa, and mCherry was 29 kDa)]. There was a significant decrease in -syn protein in the REXO-C/ANP/Streated cells, compared with the blank (PBS) and the nude drug curcumin and siSNCA (nude C + S) groups. Compared with C/ANP/S, NPs without ROS-responsive C/BNP/S, and nontargeted EXO-C/ANP/S, the REXO-C/ANP/S had a stronger down-regulation effect, indicating the superiority of membrane fusion, target, and controlled-release ability. In addition, REXO-C/ANP/S had a down-regulation advantage compared with the curcumin-free NP REXO-ANP/S and the siNonsense NP REXO-C/ANP/siNonsense. In addition, except the REXO-C/ANP/siNonsensetreated cells, the SNCA mRNA expression of NP-treated cells was lower than PBS-treated cells. The SNCA mRNA expression of REXO-C/ANP/Streated cells decreased 64% (Fig. 3E). Moreover, the enzyme-linked immunosorbent assay (ELISA) test showed that the -syn aggregates in the cells treated by the drug-loaded NP groups were significantly reduced (Fig. 3F). In particular, -syn aggregates in cells treated with gene-chem dual drug carrier REXO-C/ANP/S decreased most obviously. This was because the gene drug siSNCA avoided the development of excessive -syn aggregation by reducing the synthesis of -syn, and curcumin could directly inhibit -syn aggregates. This result was consistent with our prediction. The gene-chem dual drug carrier relieves the pressure on neurons caused by the -syn aggregate through the synergistic effect of two drugs. In addition, through dot blot experiments, similar results further showed that the gene-chem dual drug carrier reduced phosphorylated -syn, conformation-specific -syn aggregates, and oligomer A11 molecules, which were related molecularly to the formation of -syn aggregates (fig. S4D). Obviously, it was proven that synergistic REXO-C/ANP/S had a delivery advantage at the cell level, and these contributed to substantially effective -syn aggregate clearance. Furthermore, the changes in cellular ROS activity of nanomedicine-treated cells indicated their roles in anti-inflammation. The ROS level was evaluated in SNCAmCherrySH-SY5Y cells, and the intracellular ROS content was tested by CLSM. Treating the cells with curcumin-containing nanomedicine caused 2.7 times of ROS decrease (fig. S5) compared with treatment with PBS. However, the nanocarrier without curcumin REXO-ANP/S had little contribution to ROS decrease. Therefore, the results indicated that the curcumin loading in REXO-C/ANP/S had a strong role in inflammation regulation, but siSNCA alone had a weaker effect on ROS level than others in a short period of 72 hours.

(A) Scheme of REXO-C/ANP/S synergistic effect against -syn. (B) Effect of NPs on decrease in -syn aggregates after NPs were incubated with SNCAmCherrySH-SY5Y cells. Scale bars, 100 m. (C) Mouse -synmCherry (anti-syn antibody) protein levels relative to -actin by Western blot. Western blot band of cells incubated with different NPs. I, PBS; II, nude C + S; III, C/BNP/S; IV, C/ANP/S; V, EXO-C/ANP/S; VI, REXO-C/ANP/siNonsense; VII, REXO-ANP/S; and VIII, REXO-C/ANP/S. (D) Total -syn protein levels were quantified relative to -actin. (E) Total SNCA mRNA expression levels were quantified by quantitative reverse transcription polymerase chain reaction. (F) Total -syn aggregate expression levels were quantified by ELISA. In (B) to (D) and (F), NPs were incubated with cells for 72 hours. In (E), NPs were incubated with cells for 36 hours. **P < 0.01 and ***P < 0.001.

In vivo, the enrichment of NPs in tissues is a key visualization tool for drug delivery. We detected drug distribution by using Kodak In-Vivo Imaging System FX Pro. Since curcumin itself has fluorescence property (excitation, 425 nm; emission, 530 nm), drug enrichment in the brain can be visualized in that the RVG29 peptide enhanced its accumulation in the brain (fig. S6, A and B). The accumulation of drug in the brain could last at least 48 hours (fig. S6, C and D). The drug was colocalized with tyrosine hydroxylasepositive (TH+) neurons in the substantia nigra (SN) region in mice brain (fig. S6E), which was essential for treatment. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)induced mice model of PD were vein injected with REXO-C/ANP/S and other control NPs (1 mg/kg siSNCA) every other day. After 10 times of administration, behavioral measurements were recorded. PD mice showed bradykinesia in the open field, and they traversed less in the middle region (Fig. 4A, II). Quantitative data in the open field for 30 min showed that their total distance decreased, movement speed slowed, and the rest time required was getting longer [Fig. 4, B to D (II)]. Mice in the NP groups showed a trend of improvement in exercise, especially the REXO-C/ANP/S group [Fig. 4, B to D (III to VI)]. In the pole experiment, the time to the tip of the rod was significantly reduced after the REXO-C/ANP/S treatment (Fig. 4E). This advantage was also shown in the brain sections after mouse dissection. Neuronal repair in the PD mice injected with REXO-C/ANP/S was better than in other groups (Fig. 4, F and G). In addition, hematoxylin-eosin staining of NP-treated mice organ slides indicated their safety without burden on the mice liver or other organs (fig. S7).

(A) Open-field traveled trace of normal mice and different NP-treated PD mice. (B) Total distance traveled of normal mice and different NP-treated PD mice in open field instrument. (C) Total speed of normal mice and different NP-treated PD mice in open field instrument. (D) Total rest time of normal mice and different NP-treated PD mice in open field instrument. (E) Time it took the mice to climb to the top in pole test. (F) TH immunohistochemistry staining (anti-TH antibody) of the brain slides in treated mice SN region. (G) Numbers of TH+ neurons in the treated mice brain SN region. *P < 0.05, **P < 0.01, and ***P < 0.001.

Furthermore, to explore the reasons for the superiority of the drug carrier REXO-C/ANP/S in neuroprotection, we discuss it from two aspects. First, the pathological substance -syn in the neurons was a key substance that was needed to be cleared. By staining the SN region of treated mice, we concluded that the synergistic drug-loading C/ANP/S nanocomplex played a role in the clearance of -syn in TH+ neurons, but the scavenging effects of EXO-C/ANP/S and REXO-C/ANP/S were more pronounced, especially the targeted NP REXO-C/ANP/S (Fig. 5, A and C). This is due to the superior delivery advantages of targeted exosomes. In addition, we also explored improvements in the mouse immune microenvironment. The results indicated that T cell activation in mice with PD could be cleared by the action of the imDC exosomes coating themselves. After the mice were treated with NPs, we found that EXO-C/ANP/S, especially REXO-C/ANP/S, could significantly increase the expression of Fox p3 in CD4-positive (CD4+) T cells (Fig. 5, B and D). In addition, REXO-C/ANP/S could significantly increase TGF- and IL-10 in PD (Fig. 5, E and F). It has been proven that TGF- signaling exerts anti-inflammatory effects, mainly neuroprotective effects. In addition, IL-22 and IL-17 were related to autoimmune diseases and were highly expressed as immune cytokines. Activated TH17 cells secrete and produce IL-22 and IL-17 immune cytokines. As a result, REXO-C/ANP/S could significantly decrease the IL-22 and IL-17 factors in PD (Fig. 5, G and H). The results indicated that the exosomes from imDC could inhibit the immune activation of PD and that the target modification further enhanced their effect. In comparison, C/ANP/S had almost no effect on the immune regulation but instead activated the immune system. The results indicated that the exosomes from imDC could inhibit the immune activation of PD and that the target modification further enhanced their effect. Moreover, by staining the SN region of treated mice with phospho S129 -syn antibody or polymerized -syn MJFR-14-6-4-2 antibody from Abcam, we detected in pathological -syn that the scavenging effects of EXO-C/ANP/S and REXO-C/ANP/S were more pronounced on phosphorylated -syn and aggregated -syn, especially the targeted NP REXO-C/ANP/S (Fig. 5I and fig. S8).

(A) Immunofluorescence staining (anti-TH antibody and anti-syn antibody) of normal mice and different NP-treated PD mice. Scale bars, 50 m. (B) Immunofluorescence staining (anti-CD4 antibody and antiFox p3 antibody) of normal mice and different NP-treated PD mice. Scale bars, 50 m. The amplify images were the images in the white square, with a 5-m scale bar. (C) -Syn mean fluorescence intensity in (A). (D) Fox p3 mean fluorescence intensity in (B). (E) IL-10 concentration in serum of PD mice treated with NPs. (F) TGF- concentration in serum of PD mice treated with NPs. (G) IL-22 concentration in serum of PD mice treated with NPs. (H) IL-17 concentration in serum of PD mice treated with NPs. (I) Conformation-specific -syn aggregate immunohistochemistry staining (anti-conformationspecific MJFR -syn aggregate antibody) of the brain slides in treated mice SN region. *P < 0.05, **P < 0.01, and ***P < 0.001.

In summary, combining the natural delivery advantages of exosomes with synthesized gene-chem nanocomplex, we designed a REXO coating gene-chem nanocomplex with high enrichment of drugs in the action site of a target cell. The role of REXO-C/ANP/S across the BBB and membrane fusion functions in -syn aggregate clearance was confirmed at the cellular and animal levels. Efficient delivery of siRNA and chemical drugs by the target exosomes reduced the -syn aggregates in diseased dopaminergic neurons (Fig. 6).

In addition, because of the natural immunomodulatory properties of the imDC exosomes, we discussed its role in clearing immune activation, which may be caused by -syn peptides (20). TH17 cells and Treg cells are CD4+ T cell subsets. It has been reported that TH17 cells have a strong inflammatory effect and play an important role in chronic inflammation and autoimmune diseases. Treg cells have obvious immunosuppressive effects and play an important role in immune tolerance and immune homeostasis. This delivery system can provide a functionalized vector for immunotherapy of neurodegenerative diseases (Fig. 6). This functionalization and exosome derived from imDC cells are inherited by major histocompatibility complex class II (MHC II), CD80, CD86, and other costimulatory factors on the surface of imDC cells so that they also have immunosuppressive functions. Thus, regulation of TH17 and Treg cell balance, which is inhibition of TH17 differentiation and promotion of Treg production to induce immune tolerance, and reconstruction of immune homeostasis in vivo may be a therapeutic approach to neuronal protection in addition to the accumulation of misfolded proteins. Certain pathological substances, such as amyloid- protein of Alzheimers disease, are mostly the pathogenic cause of neurodegenerative diseases. Therefore, it can provide an efficient strategy for the treatment of neurodegenerative diseases.

Curcumin was acquired from Melonepharma (Dalian, China), and siSNCA (table S1), Cy5-siSNCA, and negative control siSNCA (siNonsense, antisense strand, 5-GACAAAUGUUGGAGGAGCATT-3) were synthesized by GenePharma Company (Suzhou, China). RVG peptide was purchased from GL Biochem Ltd. Co. (Shanghai, China). Other chemicals in synthesis were from J&K Scientific Ltd. MTT and MPTP were obtained from Sigma-Aldrich. SH-SY5Y cells and SNCAmCherrySH-SY5Y cell line culture were the same as in the previous work (11).

BAP and BBP were synthesized according to the method reported in our laboratory (30). The polymer BAP and BBP were dissolved in 100 l of methanol to a concentration of 20 mg/ml, and curcumin was also dissolved in 100 l of methanol to a concentration of 4 mg/ml. After mixing the two, the mixture was added dropwise to 2 ml of water or 5% glucose solution. After 3000-Da dialysis for 12 hours, the micelles C/ANP and C/BNP were obtained. C/ANP or C/BNP was incubated with siSNCA for 30 min at the appropriate N/P to obtain C/ANP/S or C/BNP/S. The incubation results were analyzed by gel electrophoresis. The final used N/P ratio was 5/1.

In general, exosomes were obtained from the primary bone marrowderived imDC. Experimental animals were 6- to 8-week-old mice (C57BL/6), specific pathogenfree (SPF) grade, and from Weitonglihua Company (China). The femur and tibia were obtained from the euthanized mice, and the bone marrow was washed with RPMI 1640 medium. The red blood cells were lysed, and the remaining cells were suspended with complete medium [95% RPMI 1640 medium, 5% exosome-free fetal bovine serum, recombinant mouse granulocyte-macrophage colony-stimulating factor (rmGM-CSF; 20 ng/ml), and IL-4 (20 ng/ml)]. The cells were cultured at 37C in an 5% CO2 incubator, and the complete medium was changed half per 2 days. The cell culture medium on the seventh day was collected. Next, the collected medium was configured at 400g at 4C for 5 min, the cells were removed, and the first supernatant was aspirated. Then, the supernatant was configured at 10,000g at 4C for 60 min, cell debris were removed, and the second supernatant was obtained. Next, the second supernatant was centrifuged in a 100-kDa ultrafiltration tube at 5000g at 4C for 30 min for three times, and 200 l of the concentrated medium supernatant solution was obtained. Therefore, cells and cell debris were removed by centrifugation, and concentrated medium was obtained from ultrafiltration. At last, the exosome fraction was collected by a qEV size exclusion column (Izon Science) to remove the protein and big vesicles. The obtained exosomes were measured for protein concentration by the BCA (bicinchoninic acid assay) kit, and 125 g of exosome was collected from one mouse. Exosomes were negatively stained with phosphotungstic acidnegative staining and observed under an electron microscope (JEM-1200EX).

RVG embedding exosome REXO was obtained by ultrasonic soaking for 5 min using an ultrasonic cleaner and cleaning three times by centrifugation through a 100-kDa ultrafiltration at 5000 revolutions per minute (rpm). REXO-C/ANP/S was prepared by ultrasonic soaking using a 40-kHz and 100-W ultrasonic cleaner for 15 min and cleaning three times by centrifugation through a 100-kDa ultrafiltration at 5000 rpm. Zeta potential and particle size of NPs were obtained by the Zetasizer Nano ZS90 (Malvern). The final mass ratio of C/ANP:siRNA:exosome was 4:1:0.5. NPs were observed under an electron microscope (JEM-1200EX).

Chitosan (10,000 to 20,000 molecular weight) was dissolved in 0.9 weight % NaCl HAc-NaAc buffer solution and was adjusted to pH 4.5. Two milliliters of chitosan solution was poured into a 60-ml oil phase (a mixture with liquid paraffintopetroleum ether ratio of 7:5), containing 1.8 g of Span 80, with 4000 rpm homogenization for 5 min, and then was washed with petroleum ether for three times. The natural drying chitosan microsphere initial emulsion was obtained. For chitosan microsphere adsorption, 60 l REXO-C/ANP/S was coincubated with 100 l of the chitosan microspheres obtained above, and then slides were prepared and observed under a confocal microscope (Zeiss LSM780).

Briefly, exosome and cells were lysed in reducing sample buffer [8% SDS, 0.25 M tris-HCl (pH 6.8), 40% glycerol, 5% 2-mercaptoethanol, and 0.04% bromophenol blue] and boiled for 10 min at 95C. Proteins were resolved by SDSpolyacrylamide gel electrophoresis, transferred to polyvinylidene fluoride membranes, blocked in 5% nonfat powdered milk in PBS-T (0.5% Tween 20), and probed with antibodies. They were incubated with antibodies (Abcam) and detected by an x-ray film after incubation with enhanced chemiluminescence reagent.

The NP-treated SH-SY5Y cells and SNCAmCherrySH-SY5Y cells were collected and analyzed by BD Calibur Flow cytometry (BD Co., USA). Cells were cultured in glass-bottom dishes (Cellvis), and the Cy5 mean fluorescence intensity and -synmCherry were calculated to measure the siRNA uptake using CLSM (Zeiss Co., Germany). Labeled exosome was obtained by incubating with 5 M of DiD for 30 min. The unincorporated dyes were removed using 300-kDa ultrafiltration centrifugation. DiI-labeled cell membrane was dissolved in the medium at a working concentration of 5 M. After coculture with the cells for 30 min, the medium was aspirated and washed repeatedly three times with the medium.

Experimental animals were 6- to 8-week-old mice (C57BL/6), SPF grade. MPTP was purchased from Sigma-Aldrich. The mice were intraperitoneally injected with MPTP (30 mg/kg) for seven consecutive days. In the treatment plan, mice were administered via tail vein injection with five numbers in each treatment group, and the cycle was once every other day for 10 times. After one treatment cycle, 100 l of blood was taken from the eyelids and collected. The total time of observation in the open field experiment was 30 min. Mouse IL-17A ELISA kit and mouse IL-10 ELISA kit were from LAIZEE, China. After the mice were euthanized, the brain was removed, paraffin sections were prepared, and the brain sections of the SN were stained with anti-syn, anti-TH, antiFox p3, and anti-CD4 antibody (Abcam). Presence of -syn aggregates in TH+ neurons and the presence of Fox p3 were analyzed by immune fluorescence staining. TH+ neurons were analyzed by immunohistochemistry staining. All procedures involving experimental animals were performed in accordance with protocols approved by the Institutional Animal Care and Use Committee of Peking University.

Acknowledgments: Funding: This work was financially supported by the Beijing Nova Program (Z201100006820140), the National High Technology Research and Development Program (2016YFA0200303), the National Natural Science Foundation of China (21905283, 31771095, and 21875254), and the Beijing Natural Science Foundation (2192057 and L172046). Author contributions: L.L., Y.L., and X.Z. designed the experiments. L.L., Y.L., H.P., R.L., W.J., and J.S. performed the experiments. L.L., Y.L., and X.Z. wrote the manuscript. Z.S. and G.M. edited the manuscript. All the authors analyzed the data and contributed to the paper. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Additional data related to this paper may be requested from the authors.

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