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Artificial Intelligence (AI) Used to Successfully Determine Most Likely Repurposed Antibiotic Against Deadly Superbug Acinetobacter baumanni

Posted in Antibiotic resistance, Artificial Intelligence in Health Care - Tools & Innovations, Artificial Intelligence in Medicine - Applications in Therapeutics, Drug Development Process, drug repurposing, Evidence-based decision-making, Infectious Disease & New Antibiotic Targets, Inflammatory Pathophysiology, Pharmaceutical Drug Discovery, Transformative Technologies in Healthcare, tagged Acinetobacter baumanni, AI, Antibiotic resistance, Artificial intelligence, Artificial Intelligence ( AI), artificial intelligence in drug design, drug screens, in silico, rational drug design, superbug, WHO on May 26, 2023| Leave a Comment »

Artificial Intelligence (AI) Used to Successfully Determine Most Likely Repurposed Antibiotic Against Deadly Superbug Acinetobacter baumanni

Reporter: Stephen J. Williams, Ph.D.

The World Health Organization has identified 3 superbugs, or infective micororganisms displaying resistance to common antibiotics and multidrug resistance, as threats to humanity:

Three bacteria were listed as critical:

Acinetobacter baumannii bacteria that are resistant to important antibiotics called carbapenems. Acinetobacter baumannii are highly-drug resistant bacteria that can cause a range of infections for hospitalized patients, including pneumonia, wound, or blood infections.
Pseudomonas aeruginosa, which are resistant to carbapenems. Pseudomonas aeruginosa can cause skin rashes and ear infectious in healthy people but also severe blood infections and pneumonia when contracted by sick people in the hospital.
Enterobacteriaceae — a family of bacteria that live in the human gut — that are resistant to both carbepenems and another class of antibiotics, cephalosporins.

It has been designated critical need for development of antibiotics to these pathogens. Now researchers at Mcmaster University and others in the US had used artificial intelligence (AI) to screen libraries of over 7,000 chemicals to find a drug that could be repurposed to kill off the pathogen.

Liu et. Al. (1) published their results of an AI screen to narrow down potential chemicals that could work against Acinetobacter baumanii in Nature Chemical Biology recently.

Abstract

Acinetobacter baumannii is a nosocomial Gram-negative pathogen that often displays multidrug resistance. Discovering new antibiotics against A. baumannii has proven challenging through conventional screening approaches. Fortunately, machine learning methods allow for the rapid exploration of chemical space, increasing the probability of discovering new antibacterial molecules. Here we screened ~7,500 molecules for those that inhibited the growth of A. baumannii in vitro. We trained a neural network with this growth inhibition dataset and performed in silico predictions for structurally new molecules with activity against A. baumannii. Through this approach, we discovered abaucin, an antibacterial compound with narrow-spectrum activity against A. baumannii. Further investigations revealed that abaucin perturbs lipoprotein trafficking through a mechanism involving LolE. Moreover, abaucin could control an A. baumannii infection in a mouse wound model. This work highlights the utility of machine learning in antibiotic discovery and describes a promising lead with targeted activity against a challenging Gram-negative pathogen.

Schematic workflow for incorporation of AI for antibiotic drug discovery for A. baumannii from 1. Liu, G., Catacutan, D.B., Rathod, K. et al. Deep learning-guided discovery of an antibiotic targeting Acinetobacter baumannii. Nat Chem Biol (2023). https://doi.org/10.1038/s41589-023-01349-8

Figure source: https://www.nature.com/articles/s41589-023-01349-8

Article Source: https://www.nature.com/articles/s41589-023-01349-8

Liu, G., Catacutan, D.B., Rathod, K. et al.Deep learning-guided discovery of an antibiotic targeting Acinetobacter baumannii. Nat Chem Biol (2023). https://doi.org/10.1038/s41589-023-01349-8

For reference to WHO and lists of most pathogenic superbugs see https://www.scientificamerican.com/article/who-releases-list-of-worlds-most-dangerous-superbugs/

The finding was first reported by the BBC.

Source: https://www.bbc.com/news/health-65709834

By James Gallagher

Health and science correspondent

Scientists have used artificial intelligence (AI) to discover a new antibiotic that can kill a deadly species of superbug.

The AI helped narrow down thousands of potential chemicals to a handful that could be tested in the laboratory.

The result was a potent, experimental antibiotic called abaucin, which will need further tests before being used.

The researchers in Canada and the US say AI has the power to massively accelerate the discovery of new drugs.

It is the latest example of how the tools of artificial intelligence can be a revolutionary force in science and medicine.

AI breakthrough could spark medical revolution

Stopping the superbugs

Antibiotics kill bacteria. However, there has been a lack of new drugs for decades and bacteria are becoming harder to treat, as they evolve resistance to the ones we have.

More than a million people a year are estimated to die from infections that resist treatment with antibiotics.The researchers focused on one of the most problematic species of bacteria – Acinetobacter baumannii, which can infect wounds and cause pneumonia.

You may not have heard of it, but it is one of the three superbugs the World Health Organization has identified as a “critical” threat.

It is often able to shrug off multiple antibiotics and is a problem in hospitals and care homes, where it can survive on surfaces and medical equipment.

Dr Jonathan Stokes, from McMaster University, describes the bug as “public enemy number one” as it’s “really common” to find cases where it is “resistant to nearly every antibiotic”.

Artificial intelligence

To find a new antibiotic, the researchers first had to train the AI. They took thousands of drugs where the precise chemical structure was known, and manually tested them on Acinetobacter baumannii to see which could slow it down or kill it.

This information was fed into the AI so it could learn the chemical features of drugs that could attack the problematic bacterium.

The AI was then unleashed on a list of 6,680 compounds whose effectiveness was unknown. The results – published in Nature Chemical Biology – showed it took the AI an hour and a half to produce a shortlist.

The researchers tested 240 in the laboratory, and found nine potential antibiotics. One of them was the incredibly potent antibiotic abaucin.

Laboratory experiments showed it could treat infected wounds in mice and was able to kill A. baumannii samples from patients.

However, Dr Stokes told me: “This is when the work starts.”

The next step is to perfect the drug in the laboratory and then perform clinical trials. He expects the first AI antibiotics could take until 2030 until they are available to be prescribed.

Curiously, this experimental antibiotic had no effect on other species of bacteria, and works only on A. baumannii.

Many antibiotics kill bacteria indiscriminately. The researchers believe the precision of abaucin will make it harder for drug-resistance to emerge, and could lead to fewer side-effects.

In principle, the AI could screen tens of millions of potential compounds – something that would be impractical to do manually.

“AI enhances the rate, and in a perfect world decreases the cost, with which we can discover these new classes of antibiotic that we desperately need,” Dr Stokes told me.

The researchers tested the principles of AI-aided antibiotic discovery in E. coli in 2020, but have now used that knowledge to focus on the big nasties. They plan to look at Staphylococcus aureus and Pseudomonas aeruginosa next.

“This finding further supports the premise that AI can significantly accelerate and expand our search for novel antibiotics,” said Prof James Collins, from the Massachusetts Institute of Technology.

He added: “I’m excited that this work shows that we can use AI to help combat problematic pathogens such as A. baumannii.”

Prof Dame Sally Davies, the former chief medical officer for England and government envoy on anti-microbial resistance, told Radio 4’s The World Tonight: “We’re onto a winner.”

She said the idea of using AI was “a big game-changer, I’m thrilled to see the work he (Dr Stokes) is doing, it will save lives”.

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Bacterial multidrug resistance problem solved by a broad-spectrum synthetic antibiotic

The Journey of Antibiotic Discovery

FDA cleared Clever Culture Systems’ artificial intelligence tech for automated imaging, analysis and interpretation of microbiology culture plates speeding up Diagnostics

Artificial Intelligence: Genomics & Cancer

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Genetic variation causes human lupus, systemic lupus erythematosus (SLE)

Posted in Autoimmune Inflammatory DIseases, CRISPR/Cas9 & Gene Editing, Genome Biology, Genomic Endocrinology, Inflammatory Pathophysiology, RNA Biology, Signaling & Cell Circuits, Single Cell Genomics, Single-cell sequencing, Systemic Inflammatory Response Related Disorders, Variation in human protein-coding regions on February 23, 2023| Leave a Comment »

Genetic variation causes human lupus, systemic lupus erythematosus (SLE)

Reporter: Aviva Lev-Ari, PhD, RN

TLR7 gain-of-function genetic variation causes human lupus

Abstract

Although circumstantial evidence supports enhanced Toll-like receptor 7 (TLR7) signalling as a mechanism of human systemic autoimmune disease^{1,2,3,4,5,6,7}, evidence of lupus-causing TLR7 gene variants is lacking. Here we describe human systemic lupus erythematosus caused by a TLR7 gain-of-function variant. TLR7 is a sensor of viral RNA⁸,⁹ and binds to guanosine^10,11,–¹². We identified a de novo, previously undescribed missense TLR7^Y264H variant in a child with severe lupus and additional variants in other patients with lupus. The TLR7^Y264H variant selectively increased sensing of guanosine and 2′,3′-cGMP^10,11,12, and was sufficient to cause lupus when introduced into mice. We show that enhanced TLR7 signalling drives aberrant survival of B cell receptor (BCR)-activated B cells, and in a cell-intrinsic manner, accumulation of CD11c⁺ age-associated B cells and germinal centre B cells. Follicular and extrafollicular helper T cells were also increased but these phenotypes were cell-extrinsic. Deficiency of MyD88 (an adaptor protein downstream of TLR7) rescued autoimmunity, aberrant B cell survival, and all cellular and serological phenotypes. Despite prominent spontaneous germinal-centre formation in Tlr7^Y264H mice, autoimmunity was not ameliorated by germinal-centre deficiency, suggesting an extrafollicular origin of pathogenic B cells. We establish the importance of TLR7 and guanosine-containing self-ligands for human lupus pathogenesis, which paves the way for therapeutic TLR7 or MyD88 inhibition.

SOURCE

Brown, G.J., Cañete, P.F., Wang, H. et al. TLR7 gain-of-function genetic variation causes human lupus. Nature 605, 349–356 (2022). https://doi.org/10.1038/s41586-022-04642-z

Scientists finally discover the cause of lupus

[Feb. 20, 2023: Alice Deeley, The Francis Crick Institute]

An international team of researchers has identified DNA mutations in a gene that senses viral RNA, as a cause of the autoimmune disease lupus, with the finding paving the way for the development of new treatments.

Lupus is a chronic autoimmune disease which causes inflammation in organs and joints, affects movement and the skin, and causes fatigue. In severe cases, symptoms can be debilitating and complications can be fatal.

In their genetic analysis, carried out at the Centre for Personalised Immunology at the Australian National University, the researchers found a single point mutation in the TLR7 gene. Via referrals from the US and the China Australia Centre of Personalised Immunology (CACPI) at Shanghai Renji Hospital, they identified other cases of severe lupus where this gene was also mutated.

To confirm that the mutation causes lupus, the team used CRISPR gene-editing to introduce it into mice. These mice went on to develop the disease and showed similar symptoms, providing evidence that the TLR7 mutation was the cause. The mouse model and the mutation were both named ‘kika’ by Gabriela, the young girl central to this discovery.

“While it may only be a small number of people with lupus who have variants in TLR7 itself, we do know that many patients have signs of overactivity in the TLR7 pathway. By confirming a causal link between the gene mutation and the disease, we can start to search for more effective treatments.”

The work may also help explain why lupus is about 10 times more frequent in females than in males. As TLR7 sits on the X chromosome, females have two copies of the gene while males have one. Usually, in females one of the X chromosomes is inactive, but in this section of the chromosome, silencing of the second copy is often incomplete. This means females with a mutation in this gene can have two functioning copies.

“There are other systemic autoimmune diseases, like rheumatoid arthritis and dermatomyositis, which fit within the same broad family as lupus. TLR7 may also play a role in these conditions.”

SOURCE

https://www-thebrighterside-news.cdn.ampproject.org/c/s/www.thebrighterside.news/amp/2202023-scientists-finally-discover-the-cause-of-lupus

Connecting the Immune Response to Amyloid-β Aggregation in Alzheimer’s Disease via IFITM3

Posted in Alzheimer's Disease, Immunology, Neurological Diseases, Systemic Inflammatory Response Related Disorders, tagged Alzheimer Disease, Beta amyloid, IFITM3, immune response, Tau protein on October 13, 2020| Leave a Comment »

Connecting the Immune Response to Amyloid-β Aggregation in Alzheimer’s Disease via IFITM3

Reporter : Irina Robu, PhD

Alzheimer’s disease is a complex condition and it begins with slow aggregation of amyloid-β deposits over the course of years. This produces a mild cognitive impairment and a state of chronic inflammation enough to trigger harmful aggregation of the altered tau protein. Clearing amyloid-β from the brain hasn’t produced telling benefits to patients suggesting that it is not the key process in the development of the condition.

Recent research indicates that beta-amyloid has antiviral and antimicrobial properties, indicating a possible link between the immune response against infections and development of Alzheimer’s disease. Scientists have discovered evidence that protein interferon-induced transmembrane protein 3 (IFITM3) is involved in immune response to pathogens and play a key role in the accumulation of beta amyloid in plaques. IFITM3 is able to alter the activity of gamma-secretase enzyme, which breaks down the precursor proteins into fragments of beta-amyloid that make up plaques.

Yet it was determined that the production of IFITM3 starts in reply to activation of the immune system by invading viruses and bacteria. Indeed, researchers found that the level of IFITM3 in human brain samples correlated with levels of certain viral infections as well as with gamma-secretase activity and beta-amyloid production. Age is the number one risk factor for Alzheimer’s and the levels of both inflammatory markers and IFITM3 increased with advancing age in mice.

Innate immunity is also correlated with Alzheimer’s disease1, but the influence of immune activation on the production of amyloid beta is unknown. They were able to identify IFITM3 as γ-secretase modulatory protein, and establish a mechanism by which inflammation affects the generation of amyloid-β.

According to the current research, inflammatory cytokines induce the expression of IFITM3 in neurons and astrocytes, which binds to γ-secretase and upregulates its activity, thereby increasing the production of amyloid-β. The expression of IFITM3 is increased with ageing and in mouse models that express Alzheimer’s disease genes. IFITM3 protein is upregulated in tissue samples from a subset of patients with late-onset Alzheimer’s disease that exhibit higher γ-secretase activity. The amount of IFITM3 in the γ-secretase complex has a strong and positive correlation with γ-secretase activity in samples from patients with late-onset Alzheimer’s disease. These conclusions disclose a mechanism in which γ-secretase is controlled by neuroinflammation via IFITM3 and the risk of Alzheimer’s disease is thus amplified

SOURCE

https://www.nature.com/articles/s41586-020-2681-2

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National Public Radio interview with Dr. Anthony Fauci on his optimism on a COVID-19 vaccine by early 2021

Posted in Biomarkers: Inflammation, Coronavirus Gene Expression, Drug Development Process, Economic Impact of Coronavirus Pandemic, FDA, FDA, CE Mark & Global Regulatory Affairs: process management and strategic planning - GCP, GLP, ISO 14155, Inflammatory Pathophysiology, number of asymptomatic infections, Pharmaceutical Discovery, Population genetics, SARS-CoV-2, Systemic Inflammatory Response Related Disorders, Treatment Protocols for COVID-19, Vaccinology, Virus Infective Acute Respiratory Syndrome: SARS-CoV, tagged #COVID-19, Anthony Fauci, Coronavirus Vaccines, interview with scientific leaders, National Public Radio, neutralizing antibody, NPR, pharmaceutical development, SARS-CoV-2, vaccine development on July 19, 2020| Leave a Comment »

National Public Radio interview with Dr. Anthony Fauci on his optimism on a COVID-19 vaccine by early 2021

Reporter: Stephen J. Williams, PhD

Below I am giving a link to an important interview by NPR’s Judy Woodruff with Dr. Anthony Fauci on his thoughts regarding the recent spikes in cases, the potential for a COVID-19 vaccine by next year, and promising therapeutics in the pipeline. The interview link is given below however I will summarize a few of the highlights of the interview.

Some notes on the interview

Judy Woodruff began her report with some up to date news regarding the recent spike and that Miami Florida has just ordered the additional use of facemasks. She asked Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases (NIAD), about if the measures currently in use are enough to bring this spike down. Dr. Fauci said that we need to reboot our efforts, mainly because people are not doing three things which could have prevented this spike mainly

universal wearing of masks
distancing properly from each other
close the bars and pubs (see Wisconsin bars packed after ruling)

It hasn’t been a uniform personal effort

Dr. Fauci on testing

We have to use the tests we have out there efficiently and effectively And we have to get them out to the right people who can do the proper identification, isolation, and do proper contract tracing and need to test more widely in a surveillance way to get a feel of the extent and penetrance of this community spread. there needs to be support and money for these testing labs

We have a problem and we need to admit and own it but we need to do the things we know are effective to turn this thing around.

On Vaccines

“May be later this year”

His response to Merck’s CEO Ken Frazer who said officials are giving false hop if they say ‘end of year’ but Dr. Fauci disagrees. He says a year end goal is not outlandish.

What we have been doing is putting certain things in line with each other in an unprecedented way.

Dr. Fauci went on to say that, in the past yes, it took a long time, even years to develop a vaccine but now they have been able to go from sequence of virus to a vaccine development program in days, which is unheard of. Sixty two days later we have gone into phase 1 trials. the speed at which this is occurring is so much faster. He says that generally it would take a couple of years to get a neutralizing antibody but we are already there. Another candidate will be undergoing phase 3 trials by end of this month (July 2020).

He is “cautiously optimistic” that we will have one or more vaccines to give to patients by end of year because given the amount of cases it will be able to get a handle on safety and efficacy by late fall.

Now he says the game changer is that the government is working with companies to ramp up the production of doses of the candidate vaccines so when we find which one works we will have ample doses on hand. He is worried about the anti vaccine movement derailing vaccine testing and vaccinations but says if we keep on informing the public we can combat this.

Going back to school

Dr. Fauci is concerned for the safety of the vulnerable in schools, including students and staff. He wants the US to get down to a reasonable baseline of cases but in the US that baseline after the first wave was still significantly higher than in most countries, where the baseline was more like tens of cases not hundreds of cases.

For more information on COVID-19 Please go to our Coronavirus Portal at

https://pharmaceuticalintelligence.com/coronavirus-portal/

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Obesity related insulin resistance is regulated by gut associated immune cells

Posted in Artificial Pancreas for Type1 Diabetes, Diabetes Mellitus, Diagnostic Immunology, Gestational diabetes, Glycobiology: Biopharmaceutical Production, Glycobiology: Biopharmaceutical Production, Pharmacodynamics and Pharmacokinetics, Gut Microbiome and Obesity, Human Immune System in Health and in Disease, Immunology, Immunotherapy, Inflammatory Pathophysiology, Nutrition Disorders, Obesity, Population Health Management, Population Health Management, Nutrition and Phytochemistry, Signaling & Cell Circuits, Synergistic Innate and Adaptive Immunotherapy, tagged Gut, IgA, immune system, Insulin resistance, Obesity on September 20, 2019| Leave a Comment »

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

Obesity is a global concern that is associated with many chronic complications such as type 2 diabetes, insulin resistance (IR), cardiovascular diseases, and cancer. Growing evidence has implicated the digestive system, including its microbiota, gut-derived incretin hormones, and gut-associated lymphoid tissue in obesity and IR. During high fat diet (HFD) feeding and obesity, a significant shift occurs in the microbial populations within the gut, known as dysbiosis, which interacts with the intestinal immune system. Similar to other metabolic organs, including visceral adipose tissue (VAT) and liver, altered immune homeostasis has also been observed in the small and large intestines during obesity.

A link between the gut microbiota and the intestinal immune system is the immune-derived molecule immunoglobulin A (IgA). IgA is a B cell antibody primarily produced in dimeric form by plasma cells residing in the gut lamina propria (LP). Given the importance of IgA on intestinal–gut microbe immunoregulation, which is directly influenced by dietary changes, scientists hypothesized that IgA may be a key player in the pathogenesis of obesity and IR. Here, in this study it was demonstrate that IgA levels are reduced during obesity and the loss of IgA in mice worsens IR and increases intestinal permeability, microbiota encroachment, and downstream inflammation in metabolic tissues, including inside the VAT.

IgA deficiency alters the obese gut microbiota and its metabolic phenotype can be recapitulated into microbiota-depleted mice upon fecal matter transplantation. In addition, the researchers also demonstrated that commonly used therapies for diabetes such as metformin and bariatric surgery can alter cellular and stool IgA levels, respectively. These findings suggested a critical function for IgA in regulating metabolic disease and support the emerging role for intestinal immunity as an important modulator of systemic glucose metabolism.

Overall, the researchers demonstrated a critical role for IgA in regulating intestinal homeostasis, metabolic inflammation, and obesity-related IR. These findings identify intestinal IgA+ immune cells as mucosal mediators of whole-body glucose regulation in diet-induced metabolic disease. This research further emphasized the importance of the intestinal adaptive immune system and its interactions with the gut microbiota and innate immune system within the larger network of organs involved in the manifestation of metabolic disease.

Future investigation is required to determine the impact of IgA deficiency during obesity in humans and the role of metabolic disease in human populations with selective IgA deficiency, especially since human IgA deficiency is associated with an altered gut microbiota that cannot be fully compensated with IgM. However, the research identified IgA as a critical immunological molecule in the intestine that impacts systemic glucose homeostasis, and treatments targeting IgA-producing immune populations and SIgA may have therapeutic potential for metabolic disease.

References:

https://www.nature.com/articles/s41467-019-11370-y?elqTrackId=dc86e0c60f574542b033227afd0fdc8e

https://www.jci.org/articles/view/88879

https://www.nature.com/articles/nm.2353

https://diabetes.diabetesjournals.org/content/57/6/1470

https://www.sciencedirect.com/science/article/pii/S1550413115001047?via%3Dihub

https://www.sciencedirect.com/science/article/pii/S1550413115002326?via%3Dihub

https://www.sciencedirect.com/science/article/pii/S1931312814004636?via%3Dihub

https://www.nature.com/articles/nature15766

https://www.sciencedirect.com/science/article/pii/S1550413116000371?via%3Dihub

https://www.nature.com/articles/nm.2001

https://www.sciencedirect.com/science/article/abs/pii/S1550413118305047?via%3Dihub

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Highlighted Progress in Science – 2017

Posted in Anemia, Autism Spectrum Disorders, Cardiovascular and Vascular Systems, Cell Biology, Cell Biology, Signaling & Cell Circuits, Chemical Biology and its relations to Metabolic Disease, Circulating Progenitor Cells, Diabetes Mellitus, Disease Biology, Disease Biology, Small Molecules in Development of Therapeutic Drugs, Inflammatory Pathophysiology, Innovations, Lipid metabolism, Lipidomics, Metabolomics, Neurological Diseases, Neuroscience, Nutrition Disorders, Obesity, Pharmacotherapy of Cardiovascular Disease, Proteomics, Stem Cells for Regenerative Medicine, Stress Disorders, Systemic Inflammatory Response Related Disorders, tagged autism, blood stem cells, brain injury, chemical toxicity, cytomegalovirus, Diabetes, drug, hair growth, Hypertension, inflammation, ketogenic diet, lungs, Marijuana, memory failure, Monounsaturated fat, Multiple sclerosis, platelets, Regulatory T cell on February 17, 2018| Leave a Comment »

Highlighted Progress in Science – 2017

Reporter: Sudipta Saha, PhD

Lungs can supply blood stem cells and also produce platelets: Lungs, known primarily for breathing, play a previously unrecognized role in blood production, with more than half of the platelets in a mouse’s circulation produced there. Furthermore, a previously unknown pool of blood stem cells has been identified that is capable of restoring blood production when bone marrow stem cells are depleted.

A new drug for multiple sclerosis: A new multiple sclerosis (MS) drug, which grew out of the work of UCSF (University of California, San Francisco) neurologist was approved by the FDA. Ocrelizumab, the first drug to reflect current scientific understanding of MS, was approved to treat both relapsing-remitting MS and primary progressive MS.

Marijuana legalized – research needed on therapeutic possibilities and negative effects: Recreational marijuana will be legal in California starting in January, and that has brought a renewed urgency to seek out more information on the drug’s health effects, both positive and negative. UCSF scientists recognize marijuana’s contradictory status: the drug has proven therapeutic uses, but it can also lead to tremendous public health problems.

Source of autism discovered: In a finding that could help unlock the fundamental mysteries about how events early in brain development lead to autism, researchers traced how distinct sets of genetic defects in a single neuronal protein can lead to either epilepsy in infancy or to autism spectrum disorders in predictable ways.

Protein found in diet responsible for inflammation in brain: Ketogenic diets, characterized by extreme low-carbohydrate, high-fat regimens are known to benefit people with epilepsy and other neurological illnesses by lowering inflammation in the brain. UCSF researchers discovered the previously undiscovered mechanism by which a low-carbohydrate diet reduces inflammation in the brain. Importantly, the team identified a pivotal protein that links the diet to inflammatory genes, which, if blocked, could mirror the anti-inflammatory effects of ketogenic diets.

Learning and memory failure due to brain injury is now restorable by drug: In a finding that holds promise for treating people with traumatic brain injury, an experimental drug, ISRIB (integrated stress response inhibitor), completely reversed severe learning and memory impairments caused by traumatic brain injury in mice. The groundbreaking finding revealed that the drug fully restored the ability to learn and remember in the brain-injured mice even when the animals were initially treated as long as a month after injury.

Regulatory T cells induce stem cells for promoting hair growth: In a finding that could impact baldness, researchers found that regulatory T cells, a type of immune cell generally associated with controlling inflammation, directly trigger stem cells in the skin to promote healthy hair growth. An experiment with mice revealed that without these immune cells as partners, stem cells cannot regenerate hair follicles, leading to baldness.

More intake of good fat is also bad: Liberal consumption of good fat (monounsaturated fat) – found in olive oil and avocados – may lead to fatty liver disease, a risk factor for metabolic disorders like type 2 diabetes and hypertension. Eating the fat in combination with high starch content was found to cause the most severe fatty liver disease in mice.

Chemical toxicity in almost every daily use products: Unregulated chemicals are increasingly prevalent in products people use every day, and that rise matches a concurrent rise in health conditions like cancers and childhood diseases, Thus, researcher in UCSF is working to understand the environment’s role – including exposure to chemicals – in health conditions.

Cytomegalovirus found as common factor for diabetes and heart disease in young women: Cytomegalovirus is associated with risk factors for type 2 diabetes and heart disease in women younger than 50. Women of normal weight who were infected with the typically asymptomatic cytomegalovirus, or CMV, were more likely to have metabolic syndrome. Surprisingly, the reverse was found in those with extreme obesity.

References:

https://www.ucsf.edu/news/2017/12/409241/most-popular-science-stories-2017

https://www.ucsf.edu/news/2017/03/406111/surprising-new-role-lungs-making-blood

https://www.ucsf.edu/news/2017/03/406296/new-multiple-sclerosis-drug-ocrelizumab-could-halt-disease

https://www.ucsf.edu/news/2017/06/407351/dazed-and-confused-marijuana-legalization-raises-need-more-research

https://www.ucsf.edu/news/2017/01/405631/autism-researchers-discover-genetic-rosetta-stone

https://www.ucsf.edu/news/2017/09/408366/how-ketogenic-diets-curb-inflammation-brain

https://www.ucsf.edu/news/2017/07/407656/drug-reverses-memory-failure-caused-traumatic-brain-injury

https://www.ucsf.edu/news/2017/05/407121/new-hair-growth-mechanism-discovered

https://www.ucsf.edu/news/2017/06/407536/go-easy-avocado-toast-good-fat-can-still-be-bad-you-research-shows

https://www.ucsf.edu/news/2017/06/407416/toxic-exposure-chemicals-are-our-water-food-air-and-furniture

https://www.ucsf.edu/news/2017/02/405871/common-virus-tied-diabetes-heart-disease-women-under-50

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LIVE – OCTOBER 16 – DAY 1- Koch Institute Immune Engineering Symposium 2017, MIT, Kresge Auditorium

Posted in Adaptive Immune Response to Biomaterials and Tissue Repair, Biological Engineering, CANCER BIOLOGY & Innovations in Cancer Therapy, Cancer-Immune Interactions, combination immunotherapies., Conference Coverage with Social Media, Drug Carrier Design, Efficacy of Anti-Tumor T Cells, Engineering Better T Cells, Engineering Enhanced Cancer Vaccines, Human Antibody Response, Human Naive B Cell Repertoire, Inflammatory Pathophysiology, Synthetic Immunology: Hacking Immune Cells, Systemic Inflammatory Response Related Disorders, Tissue Microenvironment, tumor microenvironment on October 14, 2017| Leave a Comment »

LIVE – OCTOBER 16 – DAY 1- Koch Institute Immune Engineering Symposium 2017, MIT, Kresge Auditorium

Reporter: Aviva Lev-Ari, PhD, RN

Image Source:Koch Institute

Koch Institute

The Immune System, Stress Signaling, Infectious Diseases and Therapeutic Implications: VOLUME 2: Infectious Diseases and Therapeutics and VOLUME 3: The Immune System and Therapeutics (Series D: BioMedicine & Immunology) Kindle Edition – on Amazon.com since September 4, 2017

https://www.amazon.com/dp/B075CXHY1B

SYMPOSIUM SCHEDULE

OCTOBER 16 – DAY 1

7:00 – 8:15 Registration

8:15 – 8:30Introductory Remarks
Darrell Irvine | MIT, Koch Institute; HHMI

Stimulating the Immune system not only sustaining it for therapies

K. Dane Wittrup | MIT, Koch Institute

8:30 – 9:45Session I
Moderator: Douglas Lauffenburger | MIT, Biological Engineering and Koch Institute

Garry P. Nolan – Stanford University School of Medicine
Pathology from the Molecular Scale on Up

Intracellular molecules,
how molecules are organized to create tissue
Meaning from data Heterogeneity is an illusion: Order in Data ?? Cancer is heterogeneous, Cells in suspension – number of molecules
System-wide changes during Immune Response (IR)
Untreated, Ineffective therapy, effective therapy
Days 3-8 Tumor, Lymph node…
Variation is a Feature – not a bug: Effective therapy vs Ineffective – intercellular modules – virtual neighborhoods
ordered by connectivity: very high – CD4 T-cells, CD8 T-cels, moderate, not connected
Landmark nodes, Increase in responders
CODEX: Multiples epitome detection
Adaptable to proteins & mRNA
Rendering antibody staining via removal to neighborhood mapping
Human tonsil – 42 parameters: CD7, CD45, CD86,
Automated Annotations of tissues: F, P, V,
Normal BALBs
Marker expression defined by the niche: B220 vs CD79
Marker expression defines the niche
Learn neighborhoods and Trees
Improving Tissue Classification and staining – Ce3D – Tissue and Immune Cells in 3D
Molecular level cancer imaging
Proteomic Profiles: multi slice combine
Theory is formed to explain 3D nuclear images of cells – Composite Ion Image, DNA replication
Replication loci visualization on DNA backbone – nascent transcriptome – bar code of isotopes – 3D 600 slices
use CRISPR Cas9 for Epigenetics

Susan Napier Thomas – Georgia Institute of Technology
Transport Barriers in the Tumor Microenvironment: Drug Carrier Design for Therapeutic Delivery to Sentinel Lymph Nodes

Lymph Nodes important therapeutics target tissue
Lymphatic flow support passive and active antigen transport to lymph nodes
clearance of biomolecules and drug formulations: Interstitial transport barriers influence clearance: Arteriole to Venule –
Molecular tracers to analyze in vivo clearance mechanisms and vascular transport function
quantifying molecular clearance and biodistribution
Lymphatic transport increases tracer concentrations within dLN by orders of magnitude
Melanoma growth results in remodeled tumor vasculature
passive transport via lymphatic to dLN sustained in advanced tumors despite abrogated cell trafficking
Engineered biomaterial drug carriers to enhance sentinel lymph node-drug delivery: facilitated by exploiting lymphatic transport
TLR9 ligand therapeutic tumor in situ vaccination – Lymphatic-draining CpG-NP enhanced
Sturcutral and Cellular barriers: transport of particles is restriced by
Current drug delivery technology: lymph-node are undrugable
Multistage delivery platform to overcome barriers to lymphatic uptake and LN targeting
nano particles – OND – Oxanorbornade OND Time sensitive Linker synthesized large cargo – NP improve payload
OND release rate from nanoparticles changes retention in lymph nodes – Axilliary-Brachial delivery
Two-stage OND-NP delivery and release system dramatically – OND acumulate in lymphocyte
delivers payload to previously undraggable lymphe tissue
improved drug bioactivity – OND-NP eliminate LN LYMPHOMAS
Engineered Biomaterials

Douglas Lauffenburger – MIT, Biological Engineering and Koch Institute
Integrative Multi-Omic Analysis of Tissue Microenvironment in Inflammatory Pathophysiology

How to intervene, in predictive manner, in immunesystem-associated complex diseases
Understand cell communication beteen immune cells and other cells, i.e., tumor cells
Multi-Variate in Vivo – System Approach: Integrative Experiment & COmputational Analysis
Cell COmmunication & Signaling in CHronic inflammation – T-cell transfer model for colitis
COmparison of diffrential Regulation (Tcell transfer-elicited vs control) anong data types – relying solely on mRNA can be misleading
Diparities in differential responses to T cell transfer across data types yield insights concerning broader multi-organ interactions
T cell transfer can be ascertained and validated by successful experimental test
Cell COmmunication in Tumor MIcro-Environment — integration of single-cell transcriptomic data and protein interaction
Standard Cluster Elucidation – Classification of cell population on Full gene expression Profiles using Training sets: Decision Tree for Cell Classification
Wuantification of Pairwise Cell-Cell Receptor/Ligand Interactions: Cell type Pairs vs Receptor/Ligand Interaction
Pairwise Cell-Cell Receptor/Ligand Interactions
Calculate strength of interaction and its statistical significance
How the interaction is related to Phenotypic Behaviors – tumor growth rate, MDSC levels,
Correlated the Interactions translated to Phynotypic behavior for Therapeutic interventions (AXL via macrophage and fibroblasts)
Mouth model translation to Humans – New machine learning approach
Pathways, false negative, tumor negative expression
Molecular vs Phynotypical expression
Categories of inter-species translation
Semi-supervised Learning ALgorithms on Transcriptomic Data can ascertain Key Pathways/Processes in Human IBD from mapping mouse IBD

9:45 – 10:15 Break

10:15 – 11:30Session II
Moderator: Tyler Jacks | MIT, Koch Institute; HHMI

Tyler Jacks – MIT, Koch Institute; HHMI
Using Genetically Engineered Mouse Models to Probe Cancer-Immune Interactions

Utility of genetically-engineered mouse models of Cancer:

Immune Response (IR),
Tumor0immune microenvironment

Lung adenocarcinoma – KRAS mutation: Genetically-engineered model, applications: CRISPR, genetic interactions
Minimal Immune response to KP lung tumors: H&E, T cells (CD3), Bcells (B220) for Lenti-x 8 weeks
Exosome sequencing : Modeling loss-and gain-of-function mutations in Lung Cancer by CRISPR-Cas9 – germline – tolerance in mice, In vivo CRISPR-induced knockout of Msh2
Signatures of MMR deficient
Mutation burden and response to Immunotherapy (IT)
Programmed neoantigen expression – robust infiltration of T cells (evidence of IR)
Immunosuppression – T cell rendered ineffective
Lymphoid infiltration: Acute Treg depletion results in T cell infiltration — this depletion causes autoimmune response
Lung Treg from KP tumor-bearing mice have a distinct transcriptional heterogeneity through single cell mRNA sequencing
KP, FOXP3+, CD4
Treg from no existent to existance, Treg cells increase 20 fold =>>> Treg activation and effectiveness
Single cells cluster by tissue and cell type: Treg, CD4+, CD8+, Tetramer-CD4+
ILrl1/II-33r unregulated in Treg at late time point
Treg-specific deletion of IL-33r results in fewer effector Tregs in Tumor-bearing lungs
CD8+ T cell infiltration
Tetramer-positive T cells cluster according to time point: All Lung CD8+ T cells
IR is not uniform functional differences – Clones show distinct transcriptional profiles
Different phynotypes Exhaustive signature
CRISPR-mediated modulation of CD8 T cell regulatory genes
Genetic dissection of the tumor-immune microenvironment
Single cell analysis, CRISPR – CRISPRa,i, – Drug development

Wendell Lim – University of California, San Francisco

Synthetic Immunology: Hacking Immune Cells

Precision Cell therapies – engineered by synthetic biology
Anti CD19 – drug approved
CAR-T cells still face major problems

success limited to B cells cancers = blood vs solid tumors
adverse effects
OFF-TUMOR effects

Cell engineering for Cancer Therapy: User remote control (drug) – user control safety
Cell Engineering for TX

new sensors – decision making for
tumor recognition – safety,
Cancer is a recognition issue

How do we avoid cross-reaction with bystader tissue (OFF TISSUE effect)
Tumor recognition: More receptors & integration
User Control
synthetic NOTCH receptors (different flavors of synNotch) – New Universal platform for cell-to -cell recognition: Target molecule: Extracellular antigen –>> transciptional instruction to cell
nextgen T cell: Engineer T cell recognition circuit that integrates multiple inputs: Two receptors – two antigen priming circuit
UNARMED: If antigen A THEN receptor A activates CAR
“Bystander” cell single antigen vs “tumor” drug antigen
Selective clearance of combinatorial tumor – Boulian formulation, canonical response
Cell response: Priming –>> Killing: Spatial & Temporal choreographed cell
CAR expression while removed from primed cells deminished
Solid Tumor: suppress cell microenvironment: Selected response vs non-natural response
Immune stimulator IR IL2, IL12, flagellin in the payload — Ourcome: Immune enhancement “vaccination”
Immune suppression – block
Envision ideal situation: Unarmed cells
FUTURE: identify disease signatures and vulnerabilities – Precision Medicine using Synthetic Biology

Darrell Irvine – MIT, Koch Institute; HHMI
Engineering Enhanced Cancer Vaccines to Drive Combination Immunotherapies

Vaccine to drive IT
Intervening in the cancer-immunity cycle – Peptide Vaccines
poor physiology of solute transport to tissue
endogenous albumin affinity – Lymphe Node dying
Designing Albumin-hitchhiking vaccines
Amphiphile-vaccine enhance uptake in lymph nodes in small and large animal models
soluble vaccine vs Amphiphile-vaccine
DIRECTING Vaccines to the Lymph nodes
amph-peptide antigen: Prime, booster, tetramer
albimin-mediated LN-targeting of both antigen and adjuvant maximizes IR
Immuno-supressed microenvironment will not be overcome by vaccines
Replacing adoptive T cell transfer with potent vaccine
exploiting albumin biology for mucosal vaccine delivery by amph-vaccines
Amph-peptides and -adjuvants show enhanced uptake/retention in lung tissue
Enhancing adoptive T cell therapy: loss of T cell functionality, expand in vivo
boost in vivo enhanced adoptive T cell therapy
CAR-T cells: Enable T cells to target any cell surface protein
“Adaptor”-targeting CAR-T cells to deal with tumor cell heterogeneity
Lymph node-targeting Amph as CAR T booster vaccine: prining, production of cytokines
Boosting CAR T with amph-caccines: anti FITC CAR-T by DSPE=PEG-FITC coated
Targeting FITC to lymph node antigen presenting cells
Modulatory Macrophages
Amph-FITC expands FITC-CAR T cells in vivo – Adjuvant is needed
Hijacking albumin’s natural trafficking pathway

11:30 – 1:00 Lunch Break

1:00 – 2:15Session III
Moderator: Darrell Irvine | MIT, Koch Institute; HHMI

Nicholas P. Restifo – National Cancer Institute
Extracellular Potassium Regulates Epigenetics and Efficacy of Anti-Tumor T Cells

Why T cell do not kill Cancer cells?

co-inhibition
hostile tumor microenvironment

CAR T – does not treat solid tumors

Somatic mutation

resistence of T cell based IT due to loss of function mutations
Can other genes be lost?

CRISPR Cas9 – used to identify agents – GeCKOv2 Human library

Two cell-type (2CT) CRISPR assay system for genome-wide mutagenesis

work flow for genome-scale SRISPR mutagenesis profiling of genes essential for T cell mediate cytosis
sgRNA enrichment at the individual gene level by multiple methods:

subunits of the MHC Class I complex
CRISPR mutagenesis cut germline

Measutring the generalizability of resistance mechanism and mice in vivo validation
Validation of top gene candidates using libraries: MART-1
Checkpoint blockade: cells LOF causes tumor growth and immune escape
Weird genesL Large Ribisomal Subunit Proteins are nor all essential for cell survival
Bias in enrichment of 60S vs 40S
Novel elements of MHC class I antigen processing and presentation
Association of top CRISPR hits with response rates to IT – antiCTLA-4
CRISPR help identify novel regulators of T cells
Analyzed sgRNA – second rarest sgRNA for gene BIRC2 – encoded the Baculoviral Inhibitor
Drugs that inhibit BIRC2
How T cells can kill tumor cells more efficiently
p38kiaseas target for adoptive immunotherapy
FACS-based – Mapk14
Potent targets p38 – Blockade PD-1 or p38 ??
p38 signaling: Inhibition augments expansion and memory-marked human PBMC and TIL cells, N. P. Restifo
Tumor killing capacity of human CD19-specific, gene engineered T cells

Jennifer Elisseeff – Johns Hopkins University
The Adaptive Immune Response to Biomaterials and Tissue Repair

design scafolds, tissue-specific microenvironment
clinical translation of biosynthetic implants for soft tissue reconstruction
Local environment affects biomaterials: Epidermis, dermis
CD4+ T cells
Immune system – first reponders to materials: Natural or Synthetic
Biological (ECM) scaffolds to repair muscle injury
Which immune cells enter the WOUND?
ECM alters Macrophages: CD86, CD206
Adaptive system impact on Macrophages: CD86
mTOR signaling pathway M2 depend on Th2 Cells in regeneration of cell healing of surgical wounds
Systemic Immunological changes
Is the response antigen specific? – IL-4 expression in ILN,
Tissue reconstruction Clinical Trial: FDA ask to look at what cells infiltrate the scaffold
Trauma/biomaterial response – Injury induction of Senescence, anti apoptosis
Injury to skin or muscle
Is pro-regenerative environment (Th2/M2) pro-tumorigenic?
SYNTHETIC Materials for scafolds
Biomaterials and Immunology

Immune response to bioscafolds
environment modulate the immune system

Regenerative Immunetherapy

Marcela Maus – Massachusetts General Hospital

Engineering Better T Cells

Comparing CD19 CARs for Leukemia – anti-CD19- directed CAR T cells with r/r B-cell ALL – age 3-25 – FDA approved Novartis tisagenlecleucel – for pediatric r/r/ ALL
Phase II in diffuse large B cell lymphoma. Using T cells – increases prospects for cure
Vector retroviral – 30 day expression
measuring cytokines release syndrome: Common toxicity with CAR 19
neurological toxicity, B-cell aplagia
CART issues with heme malignancies

decrease cytokine release
avoid neurological toxicity – homing
new targets address antigene escape variants – Resistance, CD19 is shaded, another target needed
B Cell Maturation Antigen (BCMA) Target
Bluebird Bio: Response duratio up to 54 weeks – Active dose cohort
natural ligand CAR based on April
activated in response to TACI+ target cells – APRIL-based CARs but not BCMA-CAR is able to kill TACI+ target cells

Hurdles for Solid Tumors

Specific antigen targets
tumor heterogeneity
inhibitory microenvironment

CART in Glioblastoma

rationale for EGFRvIII as therapeutic target
Preclinical Studies & Phase 1: CAR t engraft, not as highly as CD19
Upregulation of immunosuppression and Treg infiltrate in CART EGFRvIII as therapeutic target, Marcela Maus

What to do differently?

2:15 – 2:45 Break

2:45 – 4:00 Session IV
Moderator: Arup K. Chakraborty | MIT, IMES

Laura Walker – Adimab, LLC
Molecular Dissection of the Human Antibody Response to Respiratory Syncytial Virus

prophylactic antibody is available
Barriers for development of Vaccine
Prefusion and Postfusion RSV structures
Six major antigenic sites on RSV F
Blood samples Infants less 6 month of age and over 6 month: High abundance RSV F -specific memory B Cells are group less 6 month

Arup K. Chakraborty – MIT, Institute for Medical Engineering & Science
How to Hit HIV Where it Hurts

antibody – Model IN SILICO
Check affinity of each Ab for the Seaman panel of strain
Breadth of coverage
immmunize with cocktail of variant antigens
Mutations on Affinity Maturation: Molecular dynamics
bnAb eveolution: Hypothesis – mutations evolution make the antigen binding region more flexible,
Tested hypothesisi: carrying out affinity maturation – LOW GERMLINE AFFINITY TO CONSERVE RESIDUES IN 10,000 trials, acquire the mutation (generation 300)

William Schief – The Scripps Research Institute
HIV Vaccine Design Targeting the Human Naive B Cell Repertoire

HIV Envelope Trimer Glycan): the Target of neutralizing Antibodies (bnAbs)
Proof of principle for germline-targeting: VRC)!-class bnAbs
design of a nanoparticle
can germline -targeting innumogens prime low frequency precursors?
Day 14 day 42 vaccinate
Precursor frequency and affinity are limiting for germline center (GC) entry at day 8
Germline-targeting immunogens can elicit robust, high quality SHM under physiological conditions of precursor frequency and affinity at day 8, 16, 36
Germline-targeting immunogens can lead to production of memory B cells

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Systemic Inflammatory Diseases as Crohn’s disease, Rheumatoid Arthritis and Longer Psoriasis Duration May Mean Higher CVD Risk

Posted in Frontiers in Cardiology and Cardiovascular Disorders, Origins of Cardiovascular Disease, Systemic Inflammatory Diseases as CVD Risk, Systemic Inflammatory Response Related Disorders on October 9, 2017| Leave a Comment »

Systemic Inflammatory Diseases as Crohn’s disease, Rheumatoid Arthritis and Longer Psoriasis Duration May Mean Higher CVD Risk

Reporter: Aviva Lev-Ari, PhD, RN

Longer Psoriasis Duration May Mean Higher CVD Risk

Effect size ‘similar to that of smoking’

Several studies have shown that methotrexate, which has anti-inflammatory effects, reduces CV risk in patients with rheumatoid arthritis, suggesting that good anti-inflammatory control may be expected to reduce CV risk in patients with psoriasis.

Menter has worked closely with the senior author of the current study, Nehal Mehta, MD, of the University of Pennsylvania in Philadelphia, to identify cardiovascular issues in the psoriasis population. In one recent study, investigators found that the prevalence of moderate-to-severe coronary calcification was similar between patients with psoriasis and those with type 2 diabetes, and approximately five times greater than healthy controls.

Investigators found that moderate-to-severe psoriasis was a significantly stronger predictor of coronary calcification than type 2 diabetes, and the effect was independent of known CV and cardiometabolic risk factors.

SOURCE

https://www.medpagetoday.com/Dermatology/Psoriasis/68429?xid=nl_mpt_cardiodaily_2017-10-09&eun=g99985d0r

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Nutrition: Articles of Note @PharmaceuticalIntelligence.com

Posted in CANCER BIOLOGY & Innovations in Cancer Therapy, Metabolism, Metabolomics, Nutrition, Systemic Inflammatory Response Related Disorders, tagged Cancer, health, inflammation, Nutrition, Wellbeing on March 28, 2016| Leave a Comment »

Nutrition: Articles of Note @PharmaceuticalIntelligence.com

Author and Curator: Larry H. Bernstein, MD, FCAP and Curator: Aviva Lev-Ari, PhD, RN

Nutrition and Wellbeing

Introduction

Larry H. Bernstein, MD, FCAP

The chapters that follow are divided into three parts, but they are also a summary of 25 years of work with nutritional support research and involvement with nutritional support teams in Connecticut and New York, attendance and presentations at the American Association for Clinical Chemistry and the American Society for Parenteral and Enteral Nutrition, and long term collaborations with the surgeons Walter Pleban and Prof. Stanley Dudrick, and Prof. Yves Ingenbleek at the Laboratory of Nutrition, Department of Pharmacy, University Louis Pasteur, Strasbourg, Fr. They are presented in the order: malnutrition in childhood; cancer, inflammation, and nutrition; and vegetarian diet and nutrition role in alternative medicines. These are not unrelated as they embrace the role of nutrition throughout the lifespan, the environmental impact of geo-ecological conditions on nutritional wellbeing and human development, and the impact of metabolism and metabolomics on the outcomes of human disease in relationship to severe inflammatory disorders, chronic disease, and cancer. Finally, the discussion emphasizes the negative impact of a vegan diet on long term health, and it reviews the importance of protein sources during phases of the life cycle.

Malnutrition in Childhood

Protein Energy Malnutrition and Early Child Development

Curator: Larry H. Bernstein, MD, FCAP

The Significant Burden of Childhood Malnutrition and Stunting

Curator: Larry H. Bernstein, MD, FCAP

Is Malnutrition the Cost of Civilization?

Curation: Larry H. Bernstein, MD, FCAP

Malnutrition in India, High Newborn Death Rate and Stunting of Children Age Under Five Years

Curator: Larry H Bernstein, MD, FCAP

Under Nutrition Early in Life may lead to Obesity

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

Protein Malnutrition

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

Cancer, Inflammation and Nutrition

A Second Look at the Transthyretin Nutrition Inflammatory Conundrum

Author and Curator: Larry H. Bernstein, MD, FACP

Cancer and Nutrition

Writer and Curator: Larry H. Bernstein, MD, FCAP

The history and creators of total parenteral nutrition

Curator: Larry H. Bernstein, MD, FCAP

Nutrition Plan

Curator: Larry H. Bernstein, MD, FCAP

Nutrition and Aging

Curator: Larry H Bernstein, MD, FCAP

Vegetarian Diet and Nutrition Role in Alternative Medicines

Plant-based Nutrition, Neutraceuticals and Alternative Medicine: Article Compilation the Journal PharmaceuticalIntelligence.com

Curator: Larry H. Bernstein, MD, FCAP

Metabolomics, Metabonomics and Functional Nutrition: the next step in nutritional metabolism and biotherapeutics

Reviewer and Curator: Larry H. Bernstein, MD, FCAP

2014 Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism Conference: San Francisco, Ca. Conference Dates: San Francisco, CA 3/18-21, 2014

Reporter: Aviva Lev-Ari, PhD, RN

Metabolomics: its Applications in Food and Nutrition Research

Reporter and Curator: Sudipta Saha, Ph.D.

Summary

Larry H. Bernstein, MD, FCAP

The interest in human malnutrition became a major healthcare issue in the 1980’s with the publication of several seminal papers on hospital malnutrition. However, the basis for protein-energy malnutrition that focused on the distinction between kwashiorkor and marasmus was first identified in seminal papers by Ingenbleek and others:

Ingenbleek Y. La malnutrition protein-calorique chez l’enfant en bas age. Repercussions sur la function thyroidienne et les protein vectrices du serum. PhD Thesis. Acco Press. 1997. Univ Louvain.

Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutrition index scoring critically ill patients. Internat J Vit Nutr Res 1985; 55:91-101.

Ingenbleek Y, Young VR. Transthyretin (prealbumin) in health and disease. Nutritional implications. Ann Rev Nutr 1994; 14:495-533.

Ingenbleek Y, Hardillier E, Jung L. Subclinical protein malnutrition is a determinant of hyperhomocysteinemia. Nutrition 2002; 18:40-46.

It was these early papers that transfixed my attention, and drove me to establish early the transthyretin test by immunodiffusion and later by automated immunoassay at Bridgeport Hospital.

Among the important studies often referred to with respect to hospital malnutrition are:

Hill GL, Blackett RL, Pickford I, Burkinshaw L, Young GA, Warren JV. Malnutrition in surgical patients: An unrecognised problem. Lancet.1977; 310:689–692. [PubMed]
Bistrian BR, Blackburn GL, Vitale J, Cochrane D, Naylor J. Prevalence of malnutrition in general medical patients. JAMA. 1976; 235:1567–1570. [PubMed]
Butterworth CE. The skeleton in the hospital closet. Nutrition Today.1974; 9:4–8.
Buzby GP, Mullen JL, Matthews DC, Hobbs CL, Rosato EF. Prognostic nutritional index in gastrointestinal surgery. Am. J. Surg. 1980; 139:160–167.[PubMed]
Dempsey DT, Mullen JL, Buzby GP. The link between nutritional status and clinical outcomes: can nutritional intervention modify it? Am. J. Clin. Nutr. 1988; 47:352–356. [PubMed]
Detsky AS, Mclaughlin JR, Baker JP, Johnston N, Whittaker S, Mendleson RA, Jeejeebhoy KN. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987; 11:8–13. [PubMed]
Scrimshaw NS, DanGiovanni JP. Synergism of nutrition, infection and immunity, an overview. J. Nutr. 1997; 133:S316–S321.
Chandra RK. Nutrition and the immune system: an introduction. Am. J. Clin. Nutr. 1997; 66:460S–463S. [PubMed]
Hill GL. Body composition reserach: Implications for the practice of clinical nutrition. JPEN J. Parenter. Enteral Nutr. 1992; 16:197. [PubMed]
Smith PE, Smith AE. High-quality nutritional interventions reduce costs.Healthc. Financ. Manage. 1997; 5:66–69. [PubMed]
Gallagher-Allred CR, Voss AC, Finn SC, McCamish MA. Malnutrition and clinical outcomes. J. Am. Diet. Assoc. 1996; 96:361–366. [PubMed]
Ferguson M. Uncovering the skeleton in the hoapital closet. What next? Aust. J. Nutr. Diet. 2001; 58:83–84.
Waitzberg DL, Caiaffa WT, Correia MITD. Hospital malnutrition: The Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition.2001; 17:573–580. [PubMed]

The work on hospital (and nursing home) treatment of malnutrition described in this series led to established standards. It first requires identifying a patient at malnutrition risk to be identified via either screening or assessment. This needs to be done on admission, and it has been made mandatory by health care accrediting bodies. In order to achieve this, dietitians need to have the confidence and knowledge to detect malnutrition, which is ideally done using a validated assessment for patient outcomes and financial benefits to be realized.

There is a worldwide relationship between ecological conditions, religious practices, soil conditions, availability of animal food sources, and altitude and river flows has not received the attention that evidence requires. We have seen that the emphasis on the Hindu tradition of not eating beef or having dairy is possibly problematic in the Ganges River basin. There may be other meat sources, but it is questionable that sufficient animal protein is available for the large population. The additional problem of water pollution is an aggravating situation. However, it is this region that is one of the most affected by stunting of children. We have a situation here and in other poor societies where veganism is present, and there is also voluntary veganism in western societies. This is not a practice that leads to any beneficial effect, and it has been shown to lead to a hyperhomocystenemia with the associated risk of arterial vascular disease. For those who voluntarily choose veganism, this is an unexpected result.

Met is implicated in a large spectrum of metabolic and enzyme activities and participates in the conformation of a large number of molecules of survival importance. Due to the fact that plant products are relatively Met-deficient, vegan subjects are more exposed than omnivorous to develop hyperhomocysteinemia – related disorders. Dietary protein restriction may promote supranormal Hcy concentrations which appears as the dark side of adaptive attempts developed by the malnourished and/or stressed body to preserve Met homeostasis. Summing up, we assume that the low TTR concentrations reported in the blood and CSF of AD or MID patients result in impairment of their normal scavenging capacity and in the excessive accumulation of Hcy in body fluids, hence causing direct harmful damage to the brain and cardiac vasculature.

The content of these discussions has also included nutrition and cancer. This is perhaps least well understood. Reasons for such an association may well include chronic exposure to radiation damage, or persistent focal chronic inflammatory conditions. These would result in a cirumferential and repeated cycle of injury and repair combined with an underlying hypoxia. I have already established a fundamental relationship between inflammation, the cytokine storm, the decreased hepatic synthesis of essential plasma proteins, such as, albumin, transferrin, retinol-binding protein, and transthyretin, and the surge of steroid hormones. This results in an imbalance in the protein and free protein equilibrium of essential vitamins, the retinoids, and other circulating ligands transported. This is discussed in the ‘nutrition-inflammatory conundrum”. As stated, whatever the nutritional status and the disease condition, the actual transthyretin (TTR) plasma level is determined by opposing influences between anabolic and catabolic alterations. Rising TTR values indicate that synthetic processes prevail over tissue breakdown with a nitrogen balance (NB) turning positive as a result of efficient nutritional support and / or anti-inflammatory therapy. Declining TTR values are associated with an effect of maladjusted dietetic management and / or further worsening of the morbid condition.

Inflammatory disorders of any cause are initiated by activated leukocytes releasing a shower of cytokines working as autocrine, paracrine and endocrine molecules. Cytokines regulate the overproduction of acute-phase proteins (APPs), notably that of CRP, 1-acid glycoprotein (AGP), fibrinogen, haptoglobin, 1-antitrypsin and antichymotrypsin. APPs contribute in several ways to defense and repair mechanisms, being characterized by proper kinetic and functional properties. Interleukin-6 (IL-6) is regarded as a key mediator governing both the acute and chronic inflammatory processes, as documented by data recorded on burn, sepsis and AIDS patients. IL-6-NF possesses a high degree of homology with C/EBP-NF1 and competes for the same DNA response element of the IL-6 gene. IL-6-NF is not expressed under normal circumstances, explaining why APP concentrations are kept at baseline levels. In stressful conditions, IL-6-NF causes a dramatic surge in APP values with a concomitant suppressed synthesis of TTR.

Inadequate nutritional management, multiple injuries, occurrence of severe sepsis and metabolic complications result in persistent proteolysis and subnormal TTR concentrations. The evolutionary patterns of urinary N output and of TTR thus appear as mirror images of each other, which supports the view that TTR might well reflect the depletion of TBN in both acute and chronic disease processes. Even in the most complex stressful conditions, the synthesis of visceral proteins is submitted to opposing anabolic or catabolic influences yielding ultimately TTR as an end-product reflecting the prevailing tendency. Whatever the nutritional and/or inflammatory causal factors, the actual TTR plasma level and its course in process of time indicates the exhaustion or restoration of the body N resources, hence its likely (in)ability to assume defense and repair mechanisms.

In westernized societies, elderly persons constitute a growing population group. A substantial proportion of them may develop a syndrome of frailty characterized by weight loss, clumsy gait, impaired memory and sensorial aptitudes, poor physical, mental and social activities, depressive trends. Hallmarks of frailty combine progressive depletion of both structural and metabolic N compartments. Sarcopenia and limitation of muscle strength are naturally involutive events of normal ageing which may nevertheless be accelerated by cytokine-induced underlying inflammatory disorders. Depletion of visceral resources is substantiated by the shrinking of FFM and its partial replacement by FM, mainly in abdominal organs, and by the down-regulation of indices of growth and protein status. Due to reduced tissue reserves and diminished efficiency of immune and repair mechanisms, any stressful condition affecting old age may trigger more severe clinical impact whereas healing processes require longer duration with erratical setbacks. As a result, protein malnutrition is a common finding in most elderly patients with significantly increased morbidity and mortality rates.

TTR has proved to be a useful marker of nutritional alterations with prognostic implications in large bowel cancer, bronchopulmonary carcinoid tumor, ovarian carcinoma and squamous carcinoma of bladder. Many oncologists have observed a rapid TTR fall 2 or 3 months prior to the patient’s death. In cancer patients submitted to surgical intervention, most postoperative complications occurred in subjects with preoperative TTR 180 mg/L. Two independent studies came to the same conclusion that a TTR threshold of 100 mg/L is indicative of extremely weak survival likelihood and that these terminally ill patients better deserve palliative care rather than aggressive therapeutic strategies.

Thyroid hormones and retinoids indeed function in concert through the mediation of common heterodimeric motifs bound to DNA response elements. The data also imply that the provision of thyroid molecules within the CSF works as a relatively stable secretory process, poorly sensitive to extracerebral influences as opposed to the delivery of retinoid molecules whose plasma concentrations are highly dependent on nutritional and/or inflammatory alterations. This last statement is documented by mice experiments and clinical investigations showing that the level of TTR production by the liver operates as a limiting factor for retinol transport. Defective TTR synthesis determines the occurrence of secondary hyporetinolemia which nevertheless results from entirely different kinetic mechanisms in the two quoted studies.

Points to consider:

Protein energy malnutrition has an unlikely causal relationship to carcinogenesis. Perhaps the opposite is true. However, cancer has a relationship to protein energy malnutrition without any doubt. PEM is the consequence of cachexia, whether caused by dietary insufficiency, inflammatory or cancer.

Protein energy malnutrition leads to hyperhomocysteinemia, and by that means, the relationship of dietary insufficiency of methionine has a relationship to heart disease. This is the significant link between veganism and cardiovascular disease, whether voluntary or by unavailability of adequate source.

The last portion of these chapters deals with metabolomics and functional nutrition. This is an emerging and important area of academic interest. There is a significant relationship between these emerging studies and pathways to understanding natural products medicinal chemistry.

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Selye’s Riddle solved

Posted in Biochemical pathways, Curation, Developmental biology, Gene Regulation and Evolution, Human aging, Human Immune System in Health and in Disease, Human Sensation and Cellular Transduction: Physiology and Therapeutics, Inflammasome, Metabolism, Microbiology, Micronutrients, Nephrology, Stress Disorders, Systemic Inflammatory Response Related Disorders, tagged adaptation, Evolution, Fitness, General adaptation syndrome, Optimality, Physiology on March 26, 2016| Leave a Comment »

Selye’s Riddle solved

Larry H. Bernstein, mD, FCAP, Curator

LPBI

Mathematicians Solve 78-year-old Mystery

3/23/2016 University of Leicester http://www.scientificcomputing.com/news/2016/03/mathematicians-solve-78-year-old-mystery

Mathematicians developed a solution to Selye’s riddle which has puzzled scientists for almost 80 years.

In previous research, it was suggested that adaptation of an animal to different factors looks like spending of one resource, and that the animal dies when this resource is exhausted. In 1938, Hans Selye introduced “adaptation energy” and found strong experimental arguments in favor of this hypothesis. However, this term has caused much debate because, as it cannot be measured as a physical quantity, adaptation energy is not strictly energy.

Evolution of adaptation mechanisms: Adaptation energy, stress, and oscillating death

Alexander N. Gorban ^a^,^,, Tatiana A. Tyukina ^a^,, Elena V. Smirnova ^b^,, Lyudmila I. Pokidysheva ^b^,

Journal of Theoretical Biology 19 Jan 2016 http://www.sciencedirect.com/science/article/pii/S0022519316000205 http://dx.doi.org:/10.1016/j.jtbi.2015.12.017

Highlights

• We formalize Selye׳s ideas about adaptation energy and dynamics of adaptation.
• A hierarchy of dynamic models of adaptation is developed.
• Adaptation energy is considered as an internal coordinate on the ‘dominant path’ in the model of adaptation.
• The optimal distribution of resources for neutralization of harmful factors is studied.
• The phenomena of ‘oscillating death’ and ‘oscillating remission’ are predicted.

In previous research, it was suggested that adaptation of an animal to different factors looks like spending of one resource, and that the animal dies when this resource is exhausted.

In 1938, Selye proposed the notion of adaptation energy and published ‘Experimental evidence supporting the conception of adaptation energy.’ Adaptation of an animal to different factors appears as the spending of one resource. Adaptation energy is a hypothetical extensive quantity spent for adaptation. This term causes much debate when one takes it literally, as a physical quantity, i.e. a sort of energy. The controversial points of view impede the systematic use of the notion of adaptation energy despite experimental evidence. Nevertheless, the response to many harmful factors often has general non-specific form and we suggest that the mechanisms of physiological adaptation admit a very general and nonspecific description.

We aim to demonstrate that Selye׳s adaptation energy is the cornerstone of the top-down approach to modelling of non-specific adaptation processes. We analyze Selye׳s axioms of adaptation energy together with Goldstone׳s modifications and propose a series of models for interpretation of these axioms. Adaptation energy is considered as an internal coordinate on the ‘dominant path’ in the model of adaptation. The phenomena of ‘oscillating death’ and ‘oscillating remission’ are predicted on the base of the dynamical models of adaptation. Natural selection plays a key role in the evolution of mechanisms of physiological adaptation. We use the fitness optimization approach to study of the distribution of resources for neutralization of harmful factors, during adaptation to a multifactor environment, and analyze the optimal strategies for different systems of factors.

In this work, an international team of researchers, led by Professor Alexander N. Gorban from the University of Leicester, have developed a solution to Selye’s riddle, which has puzzled scientists for almost 80 years.

Alexander N. Gorban, Professor of Applied Mathematics in the Department of Mathematics at the University of Leicester, said: “Nobody can measure adaptation energy directly, indeed, but it can be understood by its place already in simple models. In this work, we develop a hierarchy of top-down models following Selye’s findings and further developments. We trust Selye’s intuition and experiments and use the notion of adaptation energy as a cornerstone in a system of models. We provide a ‘thermodynamic-like’ theory of organism resilience that, just like classical thermodynamics, allows for economics metaphors, such as cost and bankruptcy and, more importantly, is largely independent of a detailed mechanistic explanation of what is ‘going on underneath’.”

Adaptation energy is considered as an internal coordinate on the “dominant path” in the model of adaptation. The phenomena of “oscillating death” and “oscillating remission,” which have been observed in clinic for a long time, are predicted on the basis of the dynamical models of adaptation. The models, based on Selye’s idea of adaptation energy, demonstrate that the oscillating remission and oscillating death do not need exogenous reasons. The developed theory of adaptation to various factors gives the instrument for the early anticipation of crises.

Professor Alessandro Giuliani from Istituto Superiore di Sanità in Rome commented on the work, saying: “Gorban and his colleagues dare to make science adopting the thermodynamics style: they look for powerful principles endowed with predictive ability in the real world before knowing the microscopic details. This is, in my opinion, the only possible way out from the actual repeatability crisis of mainstream biology, where a fantastic knowledge of the details totally fails to predict anything outside the test tube.¹”

Citation: Alexander N. Gorban, Tatiana A. Tyukina, Elena V. Smirnova, Lyudmila I. Pokidysheva. Evolution of adaptation mechanisms: Adaptation energy, stress, and oscillating death. Journal of Theoretical Biology, 2016; DOI:10.1016/j.jtbi.2015.12.017. Voosen P. (2015) Amid a Sea of False Findings NIH tries Reform, The Chronicle of Higher Education.