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Category Archives: Transhuman News

Intellia Therapeutics Demonstrates Pioneering CRISPR/Cas9 Genome Editing Efficiency Data Using Lipid … – GlobeNewswire (press release)

Posted: March 8, 2017 at 12:50 pm

March 08, 2017 07:30 ET | Source: Intellia Therapeutics, Inc.

CAMBRIDGE, Mass., March 08, 2017 (GLOBE NEWSWIRE) -- Intellia Therapeutics, Inc. (NASDAQ:NTLA), a leading genome editing company focused on the development of potentially curative therapies, today reported updated data showing increased levels of genome editing efficiency in vivo and durability results with its CRISPR/Cas9 technology, following a single administration. Using its lipid nanoparticle (LNP) technology, Intellia achieved approximately a 97 percent reduction in serum transthyretin (TTR) protein driven by 70 percent gene editing efficiency in the mouse liver. These results are extremely promising, as they demonstrate compelling activity with lipid nanoparticles observed in the liver following a single dose, said Executive Vice President, R&D John Leonard, M.D. We are excited by the extent of the effect, which confirms the power of CRISPR/Cas9 for potential therapeutic uses. These high levels of gene editing are the result of Intellias effort to identify highly efficient delivery of CRISPR/Cas9 using lipid nanoparticles. The data advance our efforts as we look to transform the way we treat disease. The data are being presented for the first time at the Cowen and Company 37th Annual Health Care Conference in Boston on Wednesday, March 8, 2017 at 8:40 am ET. Complete data are being presented on March 22, 2017 at the Le Stadium Conference on Messenger RNA Therapeutics in Orleans, France. Data showed robust editing and sustained results including:

Study Background

The ongoing, preclinical editing studies were designed to explore the use of lipid nanoparticles for delivery of CRISPR/Cas9 components to the liver in mice and to mediate editing of target DNA within hepatocytes. For the LNPs in the studies, Cas9 mRNA was co-formulated with chemically synthesized gRNAs targeting the mouse TTR gene, and administered via one intravenous tail vein injection. Additional studies were performed to evaluate the impact of editing of variables in guide format, degree of guide chemical modification, and dose response on editing efficiency. The durability of the liver editing was evaluated through a four-month time period, and pharmacokinetic (PK) parameters for Cas9 mRNA and sgRNA were measured.

About Intellia Therapeutics

Intellia Therapeutics is a leading genome editing company, focused on the development of proprietary, potentially curative therapeutics using the CRISPR/Cas9 system. Intellia believes the CRISPR/Cas9 technology has the potential to transform medicine by permanently editing disease-associated genes in the human body with a single treatment course. Our combination of deep scientific, technical and clinical development experience, along with our leading intellectual property portfolio, puts us in a unique position to unlock broad therapeutic applications of the CRISPR/Cas9 technology and create a new class of therapeutic products. Learn more about Intellia Therapeutics and CRISPR/Cas9 at intelliatx.com; Follow us on Twitter @intelliatweets.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward looking statements include, but are not limited to, express or implied statements regarding our ability to advance CRISPR/Cas9 into therapeutic products for severe and life-threatening diseases; the potential timing and advancement of our clinical trials; the potential targets or indications we may pursue; and potential commercialization opportunities for product candidates. Any forward-looking statements in this press release are based on management's current expectations of future events and are subject to a number of risks and uncertainties that could cause actual results to differ materially and adversely from those set forth in or implied by such forward-looking statements.These risks and uncertainties include, but are not limited to, the risk that any one or more of our product candidates will not be successfully developed and commercialized, the risk that positive results from a preclinical or clinical study may not necessarily be predictive of the results of future preclinical or clinical studies, risks related to our ability to protect and maintain our intellectual property position, the risk of cessation or delay of any of the ongoing or planned clinical trials and/or our development of our product candidates, the risk that the results of previously conducted studies involving similar product candidates will not be repeated or observed in ongoing or future studies involving current product candidates, and the risk that our collaboration withNovartis or Regeneronwill not continue or will not be successful. For a discussion of other risks and uncertainties, and other important factors, any of which could cause our actual results to differ from those contained in the forward-looking statements, see the section entitled "Risk Factors" in our most recent quarterly report on Form 10-Q filed with the Securities and Exchange Commission, as well as discussions of potential risks, uncertainties, and other important factors in our subsequent filings with theSecurities and Exchange Commission.All information in this press release is as of the date of the release, and Intellia Therapeutics undertakes no duty to update this information unless required by law.

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World’s largest autism genome database shines new light on many ‘autisms’ – Science Daily

Posted: at 12:50 pm


Spectrum
World's largest autism genome database shines new light on many 'autisms'
Science Daily
It involved the analysis of 5,205 whole genomes from families affected by autism -- making it the largest whole genome study of autism to date. The omitted letters in MSSNG (pronounced 'missing') represent the missing information about autism that the ...
Sequencing thousands of whole genomes yields new autism genesSpectrum
18 new genes have been linked to autism spectrum disorderWired.co.uk
DNA Scan Uncovers 18 Genes Newly Associated With AutismNBCNews.com

all 13 news articles »

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Humans may live up to 140 years in two generations – Trade Arabia – Trade Arabia

Posted: at 12:50 pm

Scientists gathered in Abu Dhabi for a forum on human longevity said humans may live up to 140 years within the next two generations with one expert arguing that the first person to live 1,000 years is probably already born.

Speaking at the Aspen Abu Dhabi Ideas Forum, Dr Brad Perkins, chief medical officer, Human Longevity, said: Right now the most daunting and expensive human health problem that the world is facing is age related chronic disease. Our hypothesis at Human Longevity is that genomics and the technologies that support its application in medicine and drug discovery are going to be the next accelerant in extending a high performance human lifespan.

The two-day part private conference, part public festival aims to tackle some of the worlds largest moonshot challenges.

Dr Maha Barakat, director general, Health Authority Abu Dhabi, argued that the world is in a transition phase, and on the cusp of major improvements in medicine that will help people live longer.

Once we have gone through this phase and through this research we are hearing about, we will be heading towards a phase where we can live longer without disease. And that I would say is the Holy Grail. This is the utopian society that we are heading towards, where we can live much longer.

Speakers shared some of the current developments in medicine which will help to achieve this goal, such as regenerative medicine, which is already a reality.

Dr Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest University, spoke about strategies that exist to promote regeneration include using cells alone, using cells and scaffolds together for structural defects, alongside bio-printing to create human organoid microchips which can be used to test the effectiveness of drugs.

He said challenges exist surrounding cost, scale and regulation, but the goal is to keep bringing these technologies to more patients.

Dr Aubrey de Grey, a biomedical gerontologist based in Mountain View, California, US, and chief science officer of SENS Research Foundation, a California-based biomedical research charity that performs and funds laboratory research dedicated to combating the aging process, argued that the first person to live to 1,000 years is already probably alive today.

He further commented that fixing ageing is difficult, but not impossible and the only way in which people are going to stay alive a long time is by staying healthy a long time.

He further concluded: We won World War II and World War I. World War III hasnt happened yet. But World War 0 which we have been fighting against nature since the dawn of civilization is still there to be won.

The Aspen Abu Dhabi Ideas Forum is a collaboration between Tamkeen, a Government of Abu Dhabi-owned company, and the Aspen Institute, an educational and policy studies organisation based in the US.

The event was held in partnership with McKinsey & Company, the UAE Space Agency, Mohammed bin Rashid Space Centre, Health Authority Abu Dhabi, Cleveland Clinic Abu Dhabi, US-UAE Business Council, NYUAD, The National, Al Ittihad, DubaiEye and Park Hyatt Abu Dhabi Hotel and Villas. -TradeArabia News Service

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Eczema – symptomfind.com

Posted: at 12:49 pm

By Tiffany Tseng. May 7th 2016

Have you ever had a red, itchy rash that does not go away? Chances are, it may be eczema. While mild eczema is not life threatening, it may be extremely uncomfortable with an itch. Symptoms usually vary depending on the individual, and may include dry, scaly, red and itchy skin. If left untreated, constant scratching may lead to bleeding, crusting, or broken skin open to possible infection. It is usually easily diagnosed by doctors by a physical check-up, and most of the time, does not require biopsies or additional testing.

According to the National Eczema Association, the term "eczema" is a general term used to describe dermatitis and can be interchangeably used. Although it comes in many forms, eczema mostly describes a dry skin condition that may be relieved by moisturizers and emollients. This skin condition is not contagious, so you cannot pass it on to other people or catch them from someone else.

A specific cause for eczema has yet to be identified. Many believe that this skin condition is attributed to a combination of factors that include:

Many of these factors are still speculation, with further research needed to confirm a specific cause for eczema. Factors like asthma and hay fever that are often associated with eczema could pose as possible leads. However, not all people who have been diagnosed with eczema have shown these particular medical conditions.

Since eczema can refer to various types of irritated skin, the types can almost be endless. Here are some of the more common types of eczema:

The most common symptom of eczema is red, swollen and itchy skin. The symptoms may vary depending on the specific type of eczema you are dealing with. Blisters and scaly patches are also possible symptoms of eczema. These blisters might also ooze, crust and even bleed. Skin color may also change, and can even become thick and leathery. These outbreaks can appear practically anywhere on the body, and the location of the affected area can be used to classify the particular type of eczema that the person is suffering from.

Unfortunately, there is no known treatment for eczema, but there are many ways to relieve symptoms. For example, there are several easy home remedies that can help relieve itch and irritation should a breakout take place.

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Results of Johnson & Johnson’s Psoriasis Clinical Trials Impressive – Yahoo Finance

Posted: at 12:48 pm

- By Alberto Abaterusso

Janssen Research & Development LLC, part of Johnson & Johnson (JNJ) Pharmaceutical Research and Development reported last March 3 through the PRNewswire the results from two Phase 3 clinical trials, VOYAGE 2 and NAVIGATE.

During the studies the pharmaceutical company assessed its guselkumab for the treatment of adult patients affected by severe plaque psoriasis.

The patients treated with Janssen Research & Development's guselkumab achieved meaningful improvement in terms of skin clearance and other disease activity's measures versus the placebo and AbbVie's (ABBV) Humira (adalimumab).

At the end of the VOYAGE 2 clinical trial, in 84.1% of patients affected with severe plaque psoriasis and treated with Janssen Research & Development's guselkumab, a clear or minimal disease at week 16 was observed versus 8.5% of patients under placebo and versus 67.7% of patients taking Humira.

During the NAVIGATE clinical trial, the patients experienced a significantly greater improvement in skin clearance. These patients failed to respond adequately to an IL-12/23 monoclonal antibody (Stelara) and switched to guselkumab.

Results from VOYAGE 2 and NAVIGATE trials were presented at the 2017 American Academy of Dermatology Annual Meeting in Orlando, Florida, from March 3 to March 7.

The company says that "guselkumab is a human monoclonal antibody with a novel mechanism of action that specifically targets the protein interleukin (IL)-23 and is currently under review by health authorities in the U.S. and in Europe as a subcutaneously administered therapy for the treatment of adults living with moderate to severe plaque psoriasis."

Johnson & Johnson was trading at $123.61 per share Wednesday, down 22 cents or minus 0.19% from the previous trading day.

The 52-week range is between $106.07 and $126.07. The forward price-earnings (P/E) ratio is 16.79, and the stock is trading at 4.69 times its sales computed over the 12 trailing months period, at 4.64 times the book value and 13.01 times the EBITDA.

The stock is less volatile than the stock market with a beta of 0.68. It is uptrending and gained 7.48%.

As of Dec. 31, 2016, the company has $41.91 billion in cash on hand and securities and the total debt amounts to $27.13 billion, of which 82.6% is the portion of long-term debt.

The total debt to equity ratio is 38.52 versus an industry average of 11.52. The company is more indebted than its peers, however, the interest coverage ratio is 50.53. This means that the company can easily pay interest expenses on the outstanding debt.

Over the 12 trailing months time frame the company generated cash flow of $18.77 billion from its operations.

The free cash flow was $15.54 billion and part of this has been used to distribute dividends to the shareholders. Johnson & Johnson pays a quarterly dividend of 80 cents per share that leads to an annual dividend of $3.20 for a dividend yield of 2.59%.

The company has approximately 2.71 billion shares outstanding of which 0.02% is held by insiders and 67.30% by institutions.

Among the top institutional holders, the Vanguard Group Inc. stands out with 191,188,744 shares of Johnson & Johnson, or 7.03% of the company's total shares outstanding, valued $22.03 billion at Dec. 31, 2016.

AbbVie is trading at $64.12 per share, up 43 cents or plus 0.68% from the previous trading day.

Disclosure: I have no positions in any stock mentioned in this article.

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This article first appeared on GuruFocus.

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Psoriatic Arthritis Risk Increased by Depression Among Patients With Psoriasis – Clinical Pain Advisor (registration)

Posted: at 12:48 pm

Psoriatic Arthritis Risk Increased by Depression Among Patients With Psoriasis
Clinical Pain Advisor (registration)
Researchers from Canada have demonstrated that depression is a significant risk factor for progression from psoriasis to psoriatic arthritis (PsA). Led by Ryan Lewinson, MD, PhD, from the Cumming School of Medicine at the University of Calgary, Alberta ...

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Novartis’ Cosentyx shows almost all psoriasis patients rapidly regain skin clearance following a treatment pause – Yahoo Finance

Posted: at 12:48 pm

EAST HANOVER, N.J., March 6, 2017 /PRNewswire/ --Novartis announced today a new analysis (post hoc) of an uncontrolled extension study which shows moderate to severe plaque psoriasis patients treated with Cosentyx (secukinumab) rapidly regained clear or almost clear skin (Psoriasis Area Severity Index, PASI 100 or 90) following relapse during a treatment pause. The analysis also showed no anti-secukinumab antibodieswere observed during retreatment.1 PASI measures the redness, scaling and thickness of psoriatic plaques, and the extent of involvement in four regions of the body. Treatment efficacy is assessed by the reduction in the total score from baseline (i.e., a 75% reduction is known as PASI 75 and a 90% reduction is known as PASI 90). PASI 90 and 100 are higher standards of skin clearance compared to PASI 75. These findings were presented at the 2017 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Fla., where Novartis presented over 35 scientific abstracts.

Previous data has shown favorable results for continuous over intermittent treatment, however sometimes patients have treatment pauses.3 This new analysis shows that if psoriasis patients relapse during treatment pauses, the majority can achieve previous high levels of efficacy after only 16 weeks of retreatment with Cosentyx.1

"It is very clear that patients get the best results from continuous treatment," said Vasant Narasimhan, Global Head, Drug Development and Chief Medical Officer, Novartis. "However, if for some reason treatment has been interrupted, this analysis gives patients and clinicians the peace of mind that Cosentyx is likely to help people quickly achieve clear skin once again."

The data show the majority of patients with the highest response levels to Cosentyx (PASI 90, PASI 100) after one year of treatment on the 300 mg dose regained a high response level (PASI 75 or higher) 12-16 weeks after treatment re-initiation. For patients who previously achieved PASI 75 and relapsed after treatment discontinuation (n=136), this analysis shows that by Week 16 of retreatment with Cosentyx, 94% of patients regained a PASI 75 response, 79% of prior PASI 90 responders (n=117) regained a PASI 90 response and 67% of prior PASI 100 responders (n=67) regained a PASI 100 response. The median time to relapse was 28 weeks.1

In addition, the safety profile was consistent with that observed in previous studies. No patients in this analysis tested positive for anti-secukinumab antibodies. The most common adverse events (AEs) in the Cosentyx-treatment arm were nasopharyngitis (20.7 exposure adjusted Incidence Rate [IR] per 100 patient years), arthralgia (12.6 IR) and upper respiratory tract infections (12.4 IR).1

"This study addresses a common issue in clinical practice that happens when plaque psoriasis patients are on biologic therapy and have to stop for any number of reasons, and then re-start the biologic," said Andrew Blauvelt, MD, MBA, President of the Oregon Medical Research Center and lead study investigator. "Importantly, we found that stopping and re-starting Cosentyx led to good re-capture of clinical responses. Low immunogenicity associated with Cosentyx may offer a partial explanation of these results and warrants further analysis."

Cosentyx is the only IL-17A inhibitor approved in plaque psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS), and more than 30,000 U.S. patients have been prescribed Cosentyx in the post-marketing setting across all indications.2

About Cosentyx (secukinumab) and interleukin-17A (IL-17A)

Launched in January 2015, Cosentyx is a fully human monoclonal antibody (mAB) that selectively binds to the interleukin-17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor.

Cosentyx is approved in more than 75 countries for the treatment of moderate to severe plaque psoriasis which includes the U.S., European Union countries, Japan, Switzerland, Australia and Canada. In the U.S., Cosentyx is approved for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy (light therapy).

In addition, Cosentyx is the first IL-17A inhibitor approved in more than 65 countries for the treatment of active AS and PsA, which includes the U.S. and European Union countries.

Read More

Novartis is committed to ensuring patients and prescribers have access to Cosentyx. Cosentyx currently is covered on over 95% of U.S. commercial formularies across its three approved indications for plaque psoriasis, PsA and AS.4

About the Cosentyx retreatment study

An uncontrolled, extension study of ERASURE (Efficacy of Response and Safety of Two Fixed Secukinumab Regimens in Psoriasis), which compared Cosentyx with placebo, and FIXTURE (Full Year Investigative Examination of Secukinumab vs. Etanercept Using Two Dosing Regimens to Determine Efficacy in Psoriasis), which compared Cosentyx with placebo and etanercept. A total of 181 patients treated with Cosentyx 300 mg who achieved a PASI 75 response at the end of the core studies (Week 52) were re-randomized to receive placebo every four weeks until relapse. Upon relapse, patients were retreated with Cosentyx 300 mg.1

About psoriasis

Affecting about 7.5 million Americans, psoriasis is a chronic immune-mediated disease characterized by thick and extensive skin lesions (plaques), which can cause itching, scaling, and pain.5Patients reported these symptoms can negatively impact their quality of life, both psychosocially and physically, which makes daily functioning difficult.6-8 Additionally, patients with psoriasis are at increased risk for other chronic illnesses.9

INDICATIONS

COSENTYX (secukinumab)is a prescription medicine used to treatadults:

IMPORTANT SAFETY INFORMATION

Do not use COSENTYX if you have had a severe allergic reaction to secukinumab or any of the other ingredients in COSENTYX. See the Medication Guide for a complete list of ingredients.

COSENTYX is a medicine that affects your immune system. COSENTYX may increase your risk of having serious side effects such as:

Infections

COSENTYX may lower the ability of your immune system to fight infections and may increase your risk of infections.

Before starting COSENTYX, tell your doctor if you:

After starting COSENTYX, call your doctor right away if you have any signs of infection listed above. Do not use COSENTYX if you have any signs of infection unless you are instructed to by your doctor.

Inflammatory Bowel Disease

New cases of inflammatory bowel disease or "flare-ups"can happen with COSENTYX, and can sometimes be serious. If you have inflammatory bowel disease (ulcerative colitis or Crohn's disease), tell your doctor if you have worsening disease symptoms during treatment with COSENTYX or develop new symptoms of stomach pain or diarrhea.

Serious Allergic Reactions

Serious allergic reactions can occur. Get emergency medical help right away if you get any of the following symptoms: feeling faint; swelling of your face, eyelids, lips, mouth, tongue, or throat; trouble breathing or throat tightness; chest tightness; or skin rash. If you have a severe allergic reaction, do not give another injection of COSENTYX.

Before starting COSENTYX, tell your doctor if you:

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Know the medicines you take. Keep a list of your medicines to show your doctor and pharmacist when you get a new medicine.

How should I use COSENTYX?

See the detailed Instructions for Use that comes with your COSENTYX for information on how to prepare and inject a dose of COSENTYX, and how to properly throw away (dispose of) used COSENTYX Sensoready pens and prefilled syringes.

The most common side effects of COSENTYX include: cold symptoms, diarrhea, and upper respiratory infections. These are not all of the possible side effects of COSENTYX. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see accompanying full Prescribing Information, including Medication Guide.

DisclaimerThe foregoing release contains forward-looking statements that can be identified by words such as "launch," "can," "may," "launched," "committed," or similar terms, or by express or implied discussions regarding potential new indications or labeling for Cosentyx, or regarding potential future revenues from Cosentyx. You should not place undue reliance on these statements. Such forward-looking statements are based on the current beliefs and expectations of management regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forth in the forward-looking statements. There can be no guarantee that Cosentyx will be submitted or approved for any additional indications or labeling in any market, or at any particular time. Nor can there be any guarantee that Cosentyx will be commercially successful in the future. In particular, management's expectations regarding Cosentyx could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and additional analysis of existing clinical data; regulatory actions or delays or government regulation generally; the company's ability to obtain or maintain proprietary intellectual property protection; general economic and industry conditions; global trends toward health care cost containment, including ongoing pricing pressures; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG's current Form20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.

About NovartisLocated in East Hanover, NJ, Novartis Pharmaceuticals Corporation is an affiliate of Novartis which provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, eye care and cost-saving generic pharmaceuticals. Novartis has leading positions globally in each of these areas. In 2016, the Group achieved net sales of USD 48.5 billion, while R&D throughout the Group amounted to approximately USD 9.0 billion. Novartis Group companies employ approximately 118,000 full-time-equivalent associates. Novartis products are sold in approximately 155 countries around the world. For more information, please visit http://www.novartis.com.

Novartis is on Twitter. Sign up to follow @Novartis at http://twitter.com/novartis For Novartis multimedia content, please visit http://www.novartis.com/news/media-library For questions about the site or required registration, please contact media.relations@novartis.com

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To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/novartis-cosentyx-shows-almost-all-psoriasis-patients-rapidly-regain-skin-clearance-following-a-treatment-pause-300418218.html

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Study: Gene Test Needed Before Using Alzheimer’s Drug ‘Off-Label’ – Montana Standard

Posted: at 12:48 pm

TUESDAY, March 7, 2017 (HealthDay News) -- A drug used to treat Alzheimer's disease should not be prescribed to people with milder mental impairment without first giving them a genetic test, a new study urges.

The drug is donepezil (brand name: Aricept).

Donepezil could speed mental decline in someone with mild cognitive impairment who has a specific genetic variation, according to Sophie Sokolow, an associate professor at the UCLA School of Nursing.

She and her colleagues found that patients with the K-variant of the butyrylcholinesterase (BChE) gene who took donepezil deteriorated faster than those who took a placebo.

Donepezil is approved in the United States to treat Alzheimer's disease but not mild cognitive impairment -- the stage between normal age-related decline and dementia. However, doctors often prescribe it "off-label" for patients with mild cognitive impairment, the study authors said.

For this study, the researchers examined data from a U.S. government-funded study published in 2005 that assessed donepezil as a possible treatment for mild cognitive impairment.

The findings reinforce the importance of physicians discussing the possible benefits and risks of donepezil with their patients, the researchers said in a university news release.

The study was published recently in the Journal of Alzheimer's Disease. Funding was provide by the U.S. National Institute on Aging.

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Did Gene Therapy Cure Sickle Cell Disease? | American Council on … – American Council on Science and Health

Posted: at 12:48 pm

A number of recent headlines imply a case study just published in the New England Journal of Medicine proves that gene therapy has cured sickle cell diseasea genetic disorder that incurs tremendous pain, suffering and diminished life expectancy. Here, we will unpack the significance of the researchers findings.

First, lets address why this news could be so groundbreaking to those afflicted and their loved ones.

Sickle Cell Disease is an inherited condition that causes a mutated hemoglobinthe protein within red blood cells (RBCs) that carries oxygen for delivery to vital tissues. Oxygen feeds our organs so they can stay healthy and perform their respective jobs. This Hemoglobin S (aka Sickle Hemoglobin) polymerizes on deoxygenation and rids the RBCs of their malleability. As a result, these malformed sickled cells are stiff and clump together thereby occluding vessels which in turn prompts organ damage.

Roughly 90,000 Americans have Sickle Cell Disease. (1) The natural course of the illness involves a complex cascade of events intermingled with crises often triggered by infections. Anemia is commonplace (and often profound) given these faulty cells get readily destroyed, over consumed and dont last as long as healthy RBCs. Vasoocclusive Crises result from infarction and ischemiain infants the hands and feet swell, in particular. Basically, adequate blood flow is halted wherever the obstruction takes place. Aggressive pain management and rehydration is essential.

Prophylactic antibiotics are a mainstay in an effort to stave off infection which can routinely catapult patients into a life-threatening crisis. By early childhood, they develop a functional asplenia or ineffective spleen. So, they become especially susceptible to overwhelming infection by encapsulatedbacteriahence, why vaccination for pneumococcus and the like is so important. Sepsis can result. Parvovirus can cause an aplastic crisis.

Strokes. Pulmonary infarcts with subsequent hypoxia. Acute Chest Syndrome. Gallstones. Blood transfusions are frequent. Though the blood supply is well-tested for safety, recurrent transfusion can lead to issues like iron overload, for instance. This too must be treated. The list goes on of the challenges, battles and treatment complexities these patients endure. Because fetal hemoglobin has a higher oxygen carrying capacity, a disease-modifying drug like Hydroxyurea that increases its presence is used.

Allogeneic hematopoietic stem-cell transplantation represents the only cure, but less than 18% of those with severe disease have sibling donors who are a match. (2) This is also not without great risk, though those need to be weighed against how advanced the disease. Due to such limited progress in management of this condition, this team of researchers sought to examine whether therapeutic ex vivo gene transfer into autologous hematopoietic stem cells referred to as gene therapy, may provide a long-term and potentially curative treatment for sickle cell disease. (3)

What does this mean? They took samples from the bone marrow of a patient with severe disease. The cells here provide the origins of our blood components which includes our red blood cells. This is where the problem begins in generating the sickling. A cancer drug, busulfan, was used to condition the body expected adverse effects from this occurred which resolved with standard care (e.g. anemia, low platelets, neutropenia and so on). Using a lentiviral vector, they transferred an anti-sickling gene into the patients stem cells (retrieved from the bone marrow) which get put back into the patient in the hope they will multiply and replace the cells made with the defective gene.

In a study funded in part by Bluebird Bio whose product is LentiGlobin BB305 (the antisickling gene therapy subject of this publication), the team concludes their patient had complete clinical remission with correction of hemolysis and biologic hallmarks of the disease. Furthermore, after fifteen months the antisickling protein remained high at approximately 50% and the patient had no crises or hospitalizations. Before, the patient required regular transfusions. After, all medications were stopped, no pain ones were needed, and the patient returned to full activities at school. (4)

Ongoing research is underway in a U.S. multi center, phase 1/2 clinical study. The intention is to use this gene therapy to treat those with severe sickle cell disease and another condition called beta-thalessemia. So far, in the few patients who have participated, their results seemingly support this work. Clearly, longer term follow-up and larger populations are crucial to understanding the significance of this report. Additionally, stem cell transplantation is no minor feat.

That said, for a disease that disables at such a young age, this option could be quite an extraordinary one if the success persists. ACSHs Senior Fellow in Molecular Biology, Dr. Julianna LeMieux, puts the promise of gene therapy into even greater context for this and other disease entities:"This is an incredibly promising result, even with the obvious caveat that it is only one person. Sickle Cell is a disease that is ripe for genetic advances for a few reasons. First,the gene that is affected is known andcan be replaced by the healthy variant. Also, the cells that are needed to be alteredare easily accessible inthe bone marrow. In many diseases, this is not the case. But, this one success story is incredibly encouraging for the sickle cell community and for moving the field of curing diseases using genetic editing forward."

The team proved their concept. To know if "cure" is in this gene therapy's future, much more data needs to be acquired and study be implemented. Promising with cautious optimism might be the most apt description.

Source(s):

(1) (2) (3) (4) Jean-Antoine Ribeil, M.D., Ph.D. et al. Gene Therapy in a Patient with Sickle Cell Disease. N Engl J Med. 376;848-855. March 2, 2017.

Note(s):

To learn more about "Orphan Diseases" or rare ones that afflict less than 200,000 (but in total impact 25 million Americans) and drug discovery challenges, review: Did Pompe Disease Geta New Champion in President Trump? and Pompe Disease, Newborn Screening and Inborn Errors of Metabolism.

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Did Gene Therapy Cure Sickle Cell Disease? | American Council on ... - American Council on Science and Health

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Study parses influence of genes and environment in metabolic disease – Medical Xpress

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March 8, 2017 White fat stores energy, while brown fat dissipates energy by producing heat, mediated by uncoupling protein 1, or UCP1. Credit: Ray Soccio, MD, PhD, Perelman School of Medicine, University of Pennsylvania

By comparing two strains of miceone that becomes obese and diabetic on a high-fat diet and another resistant to a high-fat regimenresearchers from the Perelman School of Medicine at the University of Pennsylvania identified genome-wide changes caused by a high-fat diet.

The a team, led by Raymond Soccio, MD, PhD, an assistant professor of Medicine, and Mitchell Lazar, MD, PhD, director the Institute for Diabetes, Obesity, and Metabolism, published their findings online in the Journal of Clinical Investigation (JCI), in addition to an Author's Take video.

"We focused on the epigenome, the part of the genome that doesn't code for proteins but governs gene expression," Lazar said.

Their research suggests that people who may be genetically susceptible to obesity and type 2 diabetes due to low levels of a protein that helps cells burn fat, may benefit from treatments that ultimately increase the fat-burning molecule.

The team looked at the interplay of genes and environment in two types of white fat tissue, subcutaneous fat (under the skin) versus visceral fat around abdominal organs. The latter correlates strongly with metabolic disease. This visceral fat shows major gene expression changes in diet-induced obesity. The JCI study confirmed this relationshipand importantlyextended these findings to show that the epigenome in visceral fat also changes on a high fat diet.

Diet-induced epigenomic changes in fat cells occur at histones - proteins that package and order DNA in the nucleus, which influences gene expression - across the genome. There were also changes in the binding to DNA of an essential fat cell protein, a transcription factor called PPARgamma.

The team next treated obese mice with the drug rosiglitazone, which targets PPARgamma in fat to treat diabetes in people. "While the drug-treated obese mice were more insulin sensitive, we were surprised to see that the drug had little effect on gene expression in visceral fat," Soccio said. "This led us to look at subcutaneous fat and we discovered that this depot is much more responsive to the drug."

"These results are clinically relevant and indicate that the 'bad' metabolic effects of obesity occur in visceral fat, while the 'good' effects of rosiglitazone and other drugs like it occur in subcutaneous fat," Lazar said.

In particular, the drug-induced changes they found in subcutaneous fat reflected the phenomenon of browning, in which white fat takes on characteristics of brown fat, typically in response to cold exposure or certain hormones and drugs.

White fat stores energy, while brown fat dissipates energy by producing heat, mediated by uncoupling protein 1, or UCP1. The most interesting discovery of the study, say the authors, involves UCP1.

They showed that rosiglitazone, as expected, increases Ucp1 expression in both obesity-prone and obesity-resistant strains of mice. However, in subcutaneous fat of the obesity-resistant mice, Ucp1 expression was high even in the absence of the drug. "But the real surprise came when we looked at the offspring of obesity-resistant and obesity-prone parents, which have one of each parent's version of the Ucp1 gene," Soccio said.

Strikingly, they found that the obesity-prone mouse strain's version of the Ucp1 gene has lower expression and less PPARgamma binding than the obesity-resistant version. This imbalance shows that the obesity-prone mouse strain's Ucp1 is genetically defective, since it is less active than the other strain's version, even when both are present in the same cell nucleus.

In their final experiments, the team asked what happens when browning and Ucp1 expression are activated using rosiglitazone or exposure to cold, both environmental factors. They found that in both cases, total Ucp1 expression goes up as expected, but the obesity-prone strain's defective version of Ucp1 now reaches equal levels to the obesity-resistant strain's version.

"Importantly, we were only changing the mouse's environment with a drug or temperature, not the actual DNA sequence of the Ucp1 gene," Lazar said. "We propose that this result indicates epigenomic rescue of Ucp1 expression in subcutaneous fat cells."

The team is following up the mouse studies using human fat biopsies to figure out the exact DNA sequence differences responsible for variable Ucp1 expression, both in mice and in humans.

The relevance of this study extends even beyond UCP1 and obesity. "Many gene variants are thought to exert their effects by ultimately altering gene expression levels, and this study shows that a genetic predisposition to altered gene expression can be identified and then overcome with treatment," Lazar said. "This is the dream of precision medicine, and hopefully our study is a step in this direction."

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Study parses influence of genes and environment in metabolic disease - Medical Xpress

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