Month: June 2021

Categories : COVID VaccinesTags :

ImmunityBio Vaccine Trial Expanding in Western Cape

On By ModernMedia
In addition to traditional subcutaneous administration for the vaccine candidate, the trial will measure immune responses generated by sublingual and nasal administration routes. Photo by Gustavo Fring from Pexels

The Phase I clinical trial of ImmunityBio’s experimental COVID vaccine, designed to be effective against COVID variants, is about to be expanded to include different administration routes as well as effectiveness in people who previously had COVID. 

Co-investigator Prof Graeme Meintjes, second chair in the Department of Medicine at UCT, said that the Phase I trial has started and is still ongoing at the Wellcome Centre for Infectious Diseases Research in Africa’s (CIDRI-Africa) Khayelitsha clinical research site.

He said that the first two cohorts of ten participants each both received two subcutaneous injections of the vaccine, three weeks apart, with one cohort receiving a higher dose.

“The purpose of that was to assess safety, so participants were followed up very carefully for side effects and for reactions to the vaccine. And the review of that suggests no major safety concerns,” he explained. He added that the Phase I trial design has since been adapted to include four more cohorts, which is going through the approval process.
These four additional cohorts will include people who have had COVID because the researchers want to look at the effect the vaccine will have on boosting existing immunity against COVID. Each cohort will have ten participants, bringing the expected total number of participants for Phase I to 60 people.

New administration routes

To see whether different administration routes produce a sufficient immune response, each participant in these new cohorts will receive one dose of the vaccine through one of four routes. These would be either a subcutaneous injection, a sublingual route, a combination of subcutaneous injection and sublingual method, or an intranasal route.

“We’ll be measuring the antibody responses as well as the T-cell responses to the vaccine, but we do not have results yet,” said Meintjes. He added that enrolment should be complete in the next two months, pending the outcome of the approval process.

Phase II/III trial plans

Phase II and Phase III trials in South Africa are being planned, which will be headed by the South African Medical Research Council (SAMRC), Mentjes confirmed.

Details will be made available once the trial has been approved by SAHPRA. It is unlikely that placebos will be used, now that vaccines are shown to be effective; rather different vaccines will be compared.

Broader immune response with two-pronged defence

The vaccine has been designed to potentially offer a broader, long-lasting immune response, Mentjes noted. In this way it should also provide improved protection against COVID variants.

Currently, most of the COVID vaccines are designed to produce an immune response against the spike protein of the virus, but it mutates rapidly, allowing certain variants to partially or fully escape vaccines. 

The ImmunityBio vaccine aims to offer a two-pronged or dual defence, Meintjes said, with the vaccine containing two proteins from the SARS-CoV-2 virus: the spike protein along with the more stable nucleocapsid protein. The nucleocapsid is an RNA-binding protein which is critical for viral replication and genome packaging.

He explains that targeting nucleocapsid could potentially provide more durable and long-term protection against different variants of the SARS-CoV-2 virus because the immune system will recognise the nucleocapsid even when the spike protein changes.

“The hope is that by including the nucleocapsid you would generate a vaccine response that covers emerging variants, those that have emerged and those that might emerge in the future,” he says.

Human-adenovirus based vaccine carrier

The ImmunityBio vaccine will use an adenovirus vector to deliver the antigens. Director of the Africa Health Research Institute (AHRI), Professor Willem Hanekom, explained that a vector is needed in order to stimulate the immune system’s response, and a viral vector is effective since it is foreign to the immune system, helping provoke an immune response. The virus is designed to simply carry the antigens into the body.

The AstraZeneca vaccine uses a modified chimpanzee adenovirus while Johnson & Johnson’s uses the human adenovirus Ad26, which has been used before in a number of vaccines including HIV. ImmunityBio’s vaccine uses the human adenovirus hAd5, which was initially used in failed gene therapy trials — but which proved to be an excellent vaccine delivery system. However, its development over the past two decades has been halting.

According to Prof Hanekom, if there is previous immunity against the adenovirus being used in a vaccine, the immune system will destroy it before the antigens inside are released. This has been circumvented with the ImmunityBio vaccine so that the immune system doesn’t immediately recognise the hAd5 vector. There was concern that the Johnson & Johnson vaccine would have limited efficacy in sub-Saharan Africa due to the fact that about half the population have immunity to Ad26.

“They’ve modified the adenovirus so it will still work and still be seen by the immune system even if there is pre-existing immunity because they’ve taken out the parts that the pre-existing immunity sees,” Prof Hanekom said.

Enhanced T-cell response

The vaccine is specifically designed to elicit strong T-cell responses to the nucleocapsid, and this has been seen in animal studies, Mentjes noted.

“Obviously one purpose of these studies is to see whether this design element generates those strong T-cell responses in humans as well,” he says. “All COVID vaccines elicit T and B cell responses, it’s not one or the other. But this (vaccine) is specifically designed to enhance those T-cell responses.”

B-cells and T-cells form part of the body’s adaptive immune response. B-cells form the antibodies to respond to a pathogen, and when the virus is introduced again, memory B-cells provide the antibodies to respond quickly.

Vardas says that with the ImmunityBio vaccine, B-cells and memory B-Cells will be formed that will remember the spike protein and the nucleocapsid and how to attack it. She likens this to a sniper attack. She explains that when a memory B-cell detects the spike or nucleocapsid protein, it signals for the production of B-cell antibodies. These antibodies then coat the outside of the virus, which signals the T-cells to attack and essentially “eat up” the virus-infected cells.

There are two types of T-cells, explains Vardas – CD4 cells which attack the virus, and CD8 cells, which also form a memory cell as the B-cell does. “You’ll have groups of CD4 and CD8 cells that are spike protein-specific and groups that are nucleocapsid specific, so improving that kind of attack to two sides of the war,” said Vardas.

Source: University of Cape Town

Categories : Mental HealthTags :

Low Doses of Nitrous Oxide can Relieve Stubborn Depression

On By ModernMedia
A small dose of nitrous oxide may be able to relive the symptoms of medication-resistant depression. Photo by Mockup Graphics on Unsplash

A new study at the University of Chicago Medicine and Washington University found that inhaling low doses of nitrous oxide gas rapidly relieved symptoms of treatment-resistant depression, with few adverse side effects. They found that this was as effective as higher doses of the gas, with fewer unpleasant side effects.

These findings add to the growing body of evidence of non-traditional treatments that may be a viable option for patients with depression that is unresponsive to typical antidepressant medications. It may also be a fast-acting and effective treatment option for patients in crisis.

Often called ‘laughing gas’, nitrous oxide is widely used as an anaesthetic, providing short-term pain relief in dentistry, emergency response and surgery.

A previous study tested a one-hour inhalation session with 50% nitrous oxide gas, which resulted in rapid improvements in depressive symptoms that lasted for at least 24 hours. However, several patients reported negative side effects, including nausea, vomiting and headaches.

“This investigation was motivated by observations from research on ketamine and depression,” said Peter Nagele, MD, Chair of Anesthesia and Critical Care at UChicago Medicine. “Like nitrous oxide, ketamine is an anaesthetic, and there has been promising work using ketamine at a sub-anesthetic dose for treating depression. We wondered if our past concentration of 50% had been too high. Maybe by lowering the dose, we could find the ‘Goldilocks spot’ that would maximize clinical benefit and minimize negative side effects.”

The new study used a similar protocol with 20 patients, this time adding an additional inhalation session with 25% nitrous oxide. They found that the halved-concentration treatment was nearly as effective as 50% nitrous oxide, but there were only one quarter of the negative side effects.

Additionally, researchers tested the patients’ depression scores following treatment over a longer period of up to two weeks compared to 24 hours in the previous protocol. Surprisingly, they found that after only a single administration, some patients had improvements that lasted for the entire follow-up period.

“The reduction in side effects was unexpected and quite drastic, but even more excitingly, the effects after a single administration lasted for a whole two weeks,” said Dr Nagele. “This has never been shown before. It’s a very cool finding.”

These findings point to nitrous oxide being a promising, rapid and effective treatment for those suffering from severe depression which is unresponsive to the usual medication such as SSRIs.

“A significant percentage — we think around 15% — of people who suffer from depression don’t respond to standard antidepressant treatment,” said Charles Conway, MD, Professor of Psychiatry and Director of the Treatment Resistant Depression and Neurostimulation Clinic at Washington University School of Medicine. “These ‘treatment-resistant depression’ patients often suffer for years, even decades, with life-debilitating depression. We don’t really know why standard treatments don’t work for them, though we suspect that they may have different brain network disruptions than non-resistant depressed patients. Identifying novel treatments, such as nitrous oxide, that target alternative pathways is critical to treating these individuals.”

Despite its ‘laughing gas’ name, patients actually fall asleep after such a low dose.

“They’re not getting high or euphoric, they get sedated,” Dr Nagele said.

Non-traditional treatments for depression faces an uphill battle for acceptance in the mainstream, though researchers hope that the findings from this and similar studies will help open physicians’ minds towards these other possible solutions.

“These have just been pilot studies,” said Dr Nagele. “But we need acceptance by the larger medical community for this to become a treatment that’s actually available to patients in the real world. Most psychiatrists are not familiar with nitrous oxide or how to administer it, so we’ll have to show the community how to deliver this treatment safely and effectively. I think there will be a lot of interest in getting this into clinical practice.”

With broader public acceptance, Dr Nagele hopes that these results help those patients who are struggling to find adequate therapies for their depression.

“There is a huge unmet need,” he said. “There are millions of depressed patients who don’t have good treatment options, especially those who are dealing with suicidality. If we develop effective, rapid treatments that can really help someone navigate their suicidal thinking and come out on the other side — that’s a very gratifying line of research.”

Source: University of Chicago Medical Center

Journal information: P. Nagele et al., “A phase 2 trial of inhaled nitrous oxide for treatment-resistant major depression,” Science Translational Medicine (2021). 

Categories : Cardiovascular DiseaseTags :

Using a Gaming Console can Improve Stroke Patient Rehabilitation

On By ModernMedia
Photo by Tima Miroshnichenko from Pexels

A study by the Faculty of Physiotherapy of the University of Valencia (UV) has shown that a physiotherapy programme using the Nintendo Wii console improves the functionality, balance and daily activities of patients who have suffered a cerebrovascular accident or stroke.
Wii research group

The study found that when the Wii is added to conventional physiotherapy techniques, the benefits are significant in stroke patients. Besides improvements in functionality and balance, the physiotherapy programme using the Wii also helps to improve daily activities.

The use of game consoles in medicine has focused on aspects such as helping build motor skills and pain management with virtual reality immersion. They are relatively cheap and available, and simple to use. One study looked at using a Microsoft Xbox to help rehabilitation of patients with Parkinson’s disease.

Previous research had already shown that the Wii can help normal treatments in restoring functionality in some chronic diseases. However, until now, there was little evidence of its use in people who had suffered strokes. “Before conducting the study we realised that not much research had been done with stroke patients, so we wanted to know if console games could promote mobility, balance and the day-to-day life of people with this pathology”, explained Elena Marqués, one of the researchers and professor of Physiotherapy at the UV.

The study recruited 29 participants into two groups, one using the Wii and conventional techniques, and the other performing traditional physiotherapy exercises. “The sample is relatively large considering it is comprised by patients who suffered strokes, as because they have many physical limitations, their treatment is usually much more individualised than that of other pathologies”, said the author.

These video games allow therapists to design rehabilitation programs that improve the principles of brain plasticity. An additional advantage is that the console provides real-time feedback on performance and progress, which can increase patient motivation, fun, and treatment adherence. “It should be taken into account that some patients have not performed any exercise before, regardless of the pathology they have, so being presented as a game can be an incentive”, said Prof Marqués.

She pointed out that other benefits include the Wii being easy to use, relatively affordable and, most importantly, can be used individually and at home, without needing to visit a rehab centre. This is particularly useful with COVID lockdowns.

This is one of the first studies using consoles as a therapeutic option, but it can be extended to patients with other pathologies, “because it allows you to work the balance with the console table, both in the chronic phase and in the subacute phase”, said Marqués.

Strengthening mirror neurons

Many Wii games use the remote control, but the console also offers a balance table that detects weight transfer by reflecting it in an avatar on the screen, letting the patient observe his/her own movements and generate positive feedback.

Thus, when the person observes his/her movements, the plasticity changes that depend on the use of sensory areas belonging to the mirror neuron system are strengthened. This exemplifies, among other factors, the improvements the Wii can provide in such patients. This feedback could result in a strengthening of the learning mechanisms of different motor and sensory activities and ultimately improving quality of life.

Source: Asociación RUVID

Categories : Lab Tests and ImagingTags :

Training Humans to Spot Abnormalities in 50 Milliseconds

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Photo by Kony Xyzx from Pexels

After looking for just one-twentieth of a second, experts in camouflage breaking can accurately detect not only that something is hidden in a scene, but precisely identify the camouflaged target, with great potential in medical diagnostic settings as well for the military.

Medical College of Georgia neuroscientist Dr Jay Hegdé and his colleagues developed a relatively rapid method for training civilian novices to become expert camouflage breakers, a skill that even allowed them to sense that something was amiss even when there was no specific target to identify.

Experienced radiologists also have this intuitive sense, detecting subtle changes in mammograms, sometimes years before there is a detectable lesion. One of the main goals of radiology education is training novices to develop advanced or ‘expert’ search methods to improve their recognition of abnormalities, While artificial intelligence may significantly improve diagnosis, there is also the potential to improve the skills of humans. 

The researchers behind the camouflage breaking technique wanted to know if trainees could detect the actual camouflaged target or just sense that something is out of place, an issue that is highly significant in real world circumstances.

They already knew that they could train most nonmilitary individuals with good vision to break camouflage in as little as an hour daily for two weeks, which could benefit the military.

“The potential for rapid training of novices in the camouflage-breaking paradigm is very promising as it highlights the potential for application to a wide variety of detection and localisation tasks,” said Dr Frederick Gregory, programme manager, US Army Combat Capabilities Development Command Army Research Laboratory. “Results in experts highlight an opportunity to extend the training to real world visual search and visualisation problems that would be of prime importance for the Army to solve.“

This sort of enhanced ability to spot something amiss could have great applications in medical diagnosis and in search and rescue situations, to name a few.

For this study, six adult volunteers with normal or corrected-to-normal vision were trained to break camouflage using Hegdé’s deep-learning method, but received no specific  training on how to pinpoint the target. Participants viewed digitally synthesised camouflage scenes such as foliage or fruit and each scene had a 50-50 chance of containing no target versus a camouflaged target like a human head or a novel, 3D digital image. Similar to how computer scientists ‘trained’ self-driving cars, the idea is to get viewers to get to know the lay of the land that is their focus. “If it turns out there is something that doesn’t belong there, you can tell,” he said.

Trainees could then either look at the image for 50 milliseconds or as long as they wanted, then proceed to the next step where they quickly viewed a random field of pixels, that work like a visual palate cleanser, before acknowledging whether the camouflage image contained a target then using a mouse to show where the target was. “You have to work from memory to say where it was,” he notes.

When the participants could look at the image for as long as they wanted, the reported target location was not much different from when they only had 50 milliseconds — which is not a lot of time for their eyes to move around, Dr Hegdé said.

Again, participants had no subsequent training on identifying precisely where the target was. Yet even without that specific training, they could do both equally well. “This was not a given,” Dr Hegdé noted.

In a second experiment with seven different individuals they used a much-abbreviated training process, which basically ensured participants knew which buttons to push when, using a clearly more pronounced ‘pop-out’ target with scenarios like a black O-shaped target among a crowd of black C shapes. Both the longer and shorter viewing times yielded similar results to the more extensively trained camouflage-breakers both in accuracy and reaction time.

Camouflage is used extensively by the military, from deserts to jungles, with the visual texture changing to blend with the natural environment. “You often are recognised by your outline, and you use these patterns to break up your outline, so the person trying to break your camouflage doesn’t know where you leave off and the background begins,” he said. Animals have also used camouflage for millions of years to evade predators, or to sneak up on prey.

Context is another important factor for recognition, he pointed out, giving the example of not recognising a person whose face you have seen several times when you see them in a different setting. His current Army-funded studies aim to further explore the importance of context, and the ramifications of ‘camouflage breaking’ in identifying medical problems.

He noted that even with his training, some people are inherently better at breaking camouflage than others (he is really bad at it, he admitted) and the reason why is a goal for future research.

Source: Augusta University

Categories : Metabolic DisordersTags :

A New Bacterium Might Help Treat Type 2 Diabetes and Obesity

On By ModernMedia
E. Coli bacteria. Image by CDC
E. Coli bacteria. Image by CDC

A newly discovered bacterium has been shown to have a possible link to type 2 diabetes and obesity, and may yield pathways to possible treatments.

It began when Patrice Cani, FNRS researcher at University of Louvain (UCLouvain), and his team repeatedly observed that a certain bacterium, Subdoligranulum, is usually lacking in obese and diabetic people, while it is systematically present in healthy people. Based on this, they decided to examine this family of bacteria.

Currently only one cultivated strain of this family is available in the world (the only known member of a large family) and was not the strain that was seen to be decreased in obese and diabetic people. This is not unusual: nearly 70% of bacteria in the intestine have not yet been identified — this is called the dark matter of the intestine.

In 2015, the team then set out to isolate the bacterium themselves in order to learn about its action on the human body, knowing that it is only present in healthy people. To find a second member of the family, the scientists spent two years searching, isolating and cultivating nearly 600 intestinal bacteria. 

All of this was in vain. Instead, the UCLouvain team uncovered a bacterium of a new, previously unknown kind. They named it Dysosmobacter welbionis: Dysosmo (“which smells bad”, in Greek), bacter (bacterium) is the bacterium which stinks, “Because, when you grow it, it has a slight odour,” they explained. Welbionis for WELBIO, the organisation in the Walloon region which funded this research.

The bacterium is peculiar for a number of reasons, including the fact that it produces butyrate. Though many other bacteria produce this colon cancer-promoting molecule, for example by strengthening the intestinal barrier and boost immunity. But the team also discovered that Dysosmobacter welbionis was less present in people with type 2 diabetes.

By analysing the microbiota from 12 000 faecal samples gathered from around the world, the UCLouvain scientists observed that the bacteria is present in 70% of the population. As to why such a widely prevalent bacteria was never discovered before, the answer likely lies in the improved cultivation techniques developed by the UCLouvain team.

The UCLouvain team including doctoral student Emilie Moens de Hase and post-doctoral fellow Tiphaine Le Roy then tested the action of Dysosmobacter welbionis in mice. The Results? The bacteria increased the number of mitochondria (a kind of power plants within cells that burns fat), thereby lowering sugar levels and weight, in addition to having strong anti-inflammatory effects. All these effects are very promising for type 2 diabetic and obese subjects and resemble those of Akkermansia, a beneficial bacterium that is at the heart of the research in Patrice Cani’s lab.

They also observed that the bacteria’s effects are not limited to the gut: Scientists have found that certain molecules produced by Dysosmobacter migrate around the body and have distant actions as well. This could explain the effects the bacteria have on the fat tissues, and also opens the doors for a possible impact on other diseases such as cancer. This is currently being investigated by the team.

The next step is to test the action of Dysosmobacter welbionis coupled with that of Akkermansia, in order to see if their association has cumulative effect on health, while always keeping in mind the fight against type 2 diabetes, inflammatory diseases, obesity and cancer. “That’s the fun of research: you dig for dinosaur bones and you end up finding a treasure,” Patrice Cani enthused.

Source: Université catholique de Louvain

Journal reference: Roy, T. L., et al. (2021) Dysosmobacter welbionis is a newly isolated human commensal bacterium preventing diet-induced obesity and metabolic disorders in mice. Gut. doi.org/10.1136/GUTJNL-2020-323778.

Categories : Exercise Neurodegenerative DiseasesTags :

Lifestyle Changes Shown to Reduce Risk of Dementia

On By ModernMedia
Photo by Ketut Subiyanto from Pexels

After almost two decades, a new drug for Alzheimer’s disease has been approved in the US. However, some experts say it doesn’t really work — only treating amyloid plaques which are thought to cause the disease — and worry that it may cost a lot.

The amount of attention around this news reflects the importance of preventing dementia, with its devastating toll on families and patients. But millions of adults could lower their chances of needing such a drug by taking preventative measures.

That’s why a national panel of experts including the University of Michigan’s Deborah Levine, MD, MPH, recently published a guide for primary care providers on this topic as an official Scientific Statement from the American Heart Association.

People dread Alzheimer’s disease, she said. Helping people understand that they can prevent or slow future dementia by taking specific steps now could motivate them to increase their healthy behaviours for a positive effect.

The first step is to recognise that dementia risk is higher among people with seven major modifiable risk factors.

These are: depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidaemia, poor diet, smoking, social isolation, excessive alcohol use, sleep disorders and hearing loss. Addressing each of these factors can, to varying extents, help reduce the risk of developing dementia, a fact backed by decades of research.

The second step is using medication, lifestyle change and other interventions to help patients reduce their dementia risk.

“Dementia is not inevitable,” said Dr Levine, a primary care provider at the University of Michigan Health, part of Michigan Medicine. “Evidence is growing that people can better maintain brain health and prevent dementia by following healthy behaviours and controlling vascular risk factors.”

These strategies can help preserve cognitive function and lower risk for heart attacks and strokes, said Dr Levine, who heads the Cognitive Health Services Research Program and sees patients at the Frankel Cardiovascular Center.

“We need to address the significant disparities that lead women, Black, Hispanic and less-educated Americans to have a much higher risk of dementia,” said Levine, a member of the U-M Institute for Healthcare Policy and Innovation.

She added that it’s never too late in life to start working on cognitive risk factor control.

“We have no treatments that will halt dementia – so it’s important to protect your brain health.”

Source: University of Michigan

Categories : COVID Diseases, Syndromes and ConditionsTags :

Why the Origin of COVID Matters

On By ModernMedia
Photo by Artem Podrez from Pexels

As interest mounts in the ‘lab leak’ hypothesis for the origin of SARS-CoV-2, more scientists are starting to take it seriously, especially because of the important implications of its actual origins.

MedPage Today reported that many experts it approached for the story were hesitant to speculate on its exact implications, they agreed that further research into its origins is important to ward off future pandemics.

A natural origin’s implications

Back in 2007, scientists who were studying coronaviruses warned: “The presence of a large reservoir of SARS-CoV–like viruses in horseshoe bats… is a time bomb. The possibility of the re-emergence of SARS and other novel viruses… should not be ignored.”

On May 26 2021, in the midst of the greatest disaster the world has faced since World War II, US President Joe Biden gave US intelligence 90 days to reach a “definitive conclusion” on the origins of SARS-CoV-2.

Vincent Racaniello, PhD, professor of microbiology and immunology at Columbia University, said finding an answer is unlikely within Biden’s deadline. After all, it took 14 years to find the ancestor of the first SARS virus in wildlife.

For Prof Racaniello, this renewed concern underscores the need for better surveillance of viruses in wildlife.

“All human viruses begin in nature. There’s an overwhelming preponderance of data that shows that, so it makes sense to look in nature when we’re looking for the source of new viruses,” Prof Racaniello told MedPage Today.

As a result of human population pressure, more viruses are spilling over into humans from nature. Examples of this include Ebola, SARS-1, MERS, and bird and swine flu. Because of the evolutionary closeness of mammals and humans, they are major pathogen sources. Rodents and bats (accounting for 20% of mammals), as well as various species of birds are good places to look. However our surveillance of wildlife is spotty, so we have “very little” understanding of the viruses these types of animals harbour, and which ones could be threats to humans, Prof Racaniello warned.

“We need to do more wildlife sampling, to find out what’s out there and what’s potentially a threat,” he said. “More investment in this could have prevented the trillions of dollars that we’ve spent to take care of this pandemic.”

A lab leak’s implications

On the other hand, Richard Ebright, PhD, a molecular biologist and professor of chemistry and chemical biology at Rutgers University in New Jersey, believes the real issue lies in addressing the potential for future pandemics that could originate from lab accidents, a discussion that “needs to begin now.”

“Irrespective of whether COVID originated in a natural accident or a lab accident, the risk of a future pandemic originating in a lab accident is real,” he told MedPage Today.

Prof Ebright explained that, in the US and other countries, only voluntary biosafety guidelines exist, and these are about preventing accidental release of pathogens. While the US has legal regulations against several pathogens that could be used as biological weapons, there are no biosecurity regulations for other pathogens. In most of the world, no biosecurity regulations exist for pathogens other than smallpox, not even voluntary ones, Prof Ebright said.

In 2017, the US implemented a bio-risk policy requiring a risk-benefit analysis before federal funding can be approved for high-risk research, such as ‘gain of function’ research that could be used to increase a pathogen’s transmissibility or pathogenicity to better understand and control it, Prof Ebright said. But this bio-risk policy has been essentially ignored by federal agencies, and the other countries with bio-risk policies only apply it to smallpox.

“Discussion now, especially among policy makers and the public, needs to turn to the inadequacy of biosafety, biosecurity, and biorisk-assessment standards worldwide, and to the essentially complete absence of biosafety regulation worldwide,” he said.

The return of the lab leak hypothesis

While evidence is largely circumstantial, the basic idea is that a laboratory at the Wuhan Institute of Virology had been experimenting on a virus called RaTG13 (a coronavirus closely related to SARS-CoV-2, which infects horseshoe bats), and genetically manipulating other horseshoe bat viruses collected around China. It is thought that one of these laboratory viruses could have infected a staffer at the institute, who then transmitted it to the broader public, Dr Ebright explained.

Following the WHO’s March 30 SARS-CoV-2 origins investigation report, there was a sudden about-face and the lab leak theory began to be taken seriously. Though investigators classified a laboratory origin as “extremely unlikely”, they said the conclusion was reached on the evidence made available.

Even the Director-General of the WHO, Dr Tedros Ghebreyesus, said at the time that he did not believe the assessment of a laboratory origin was “extensive enough,” that this hypothesis “requires further investigation,” and that “this report is a very important beginning, but it is not the end.”

“At this point in time, all scientific data related to the genome sequence of SARS-CoV-2 and the epidemiology of COVID are equally consistent with a natural-accident origin or a laboratory-accident origin,” Ebright said.

While the WHO report does not propose a follow-up study for laboratory origins, it acknowledges that both “follow-up of new evidence” and “regular administrative and internal review of high-level biosafety laboratories worldwide” is needed.

Source: MedPage Today

Categories : Cancer Lab Tests and ImagingTags :

An Easy to Swallow Detection Method for Oesophageal Cancer

On By ModernMedia
Image by Natural Herbs Clinic from Pixabay

In the UK, a “game-changer” method to sample cells for the detection of oesophageal cancer is being trialled in a mobile unit.

The cytosponge, a pill containing a sampling sponge, was developed at the and collects cells which are tested at a laboratory. Details on its development were published in The Lancet. In a previous trial with more than 13 000 participants receiving either the cytosponge or usual care from a GP, the odds of detecting oesophageal cancer were ten times higher than with usual care.

It is hoped the test will be much more efficient and quicker than the current detection method, requiring an endoscopy in hospital.

Prof Rebecca Fitzgerald from the University of Cambridge, which developed the test, said it was “really simple and straightforward”.

Early signs of cancer of the oesophagus are often mistaken for heartburn. It is the sixth most common cause of death from cancer worldwide.

A mobile unit will perform the test at GP surgeries at different locations around the UK.

Prof Fitzgerald, who specialises in cancer prevention, said the cytosponge “can diagnose cancer of the oesophagus really early”.

“Usually you would have to go to the hospital and get an endoscopy, with all that entails, and our idea was could you make something that was so simple you could go to a mobile unit or GP surgery,” Prof Fitzgerald said.

“The simplicity is the absolute key of this – we know the power of diagnosis is in the cells you collect.”

She added that due to COVID, “some endoscopy has been completely on hold so you might have to wait months” for the procedure, where a long, thin tube with a camera is sent down the patient’s mouth and throat.

Prof Fitzgerald explained: “You swallow the capsule on a string with water and it will go down to the top of the stomach.

“The capsule will dissolve in five to seven minutes, and as it dissolves out pops a sponge which has been compressed in that capsule. The nurse simply pulls the sponge out with the string and it will collect about a million cells on its way out.

“We put that sponge into a preservative, send it to the laboratory where it is tested to see whether there are Barrett cells or not and whether the cells look like they are turning to pre-cancer. Then we can let the patient know and if there is anything to worry about they can have an endoscopy and treatment.”

The procedure takes about 10 minutes to perform in total.

Source: BBC News

Categories : Diseases, Syndromes and ConditionsTags :

UTI Bacteria Traced to Meat Production

On By ModernMedia

A Portuguese study has found that bacteria in urinary tract infections (UTI) can be traced back to meat through the production chain where it was prepared.

UTIs are caused by both Gram-negative and Gram-positive bacteria, as well as by certain fungi. Staphylococcus saprophyticus is a major cause of UTI in young women, reaching 20% prevalence. Understanding the epidemiology of this microorganism can help identify its origin, distribution, causes, and risk factors. Researchers from ITQB NOVA led by Maria Miragaia showed that Staphylococcus saprophyticus can originate in food, specifically in the meat-production chain. Their findings were published in the journal Emerging Infectious Diseases.

Pork is the most popular meat type in Europe. S. saprophyticus can be a contaminant of that meat, and it is also found in the environment, the gut and rectal flora of pigs, and in the human gastrointestinal tract, vagina, and perineum.

The researchers used a combination of phenotypic, genomic, and pan-genome wide association approaches, which enabled them to identify two different lineages (G and S) of S. saprophyticus. Lineage G is of food origin and transmitted to humans by contact with food products, and lineage S is of human origin. Both cause disease and may be transmitted directly or indirectly between persons within the community, with an extensive geographic distribution possible.

To find out if these bacteria causing UTIs could be related to the ones found in pork, the research group looked at S. saprophyticus from a slaughterhouse and compared them to those causing human UTIs. The team analysed bacteria collected from UTIs worldwide over two decades, and from UTIs and pork meat production chain in Portugal.

The results showed that bacteria found in the slaughterhouse (equipment, meat, colonisation of workers) were similar to human UTI bacteria and had the same antibiotic resistance profile.

Although S. saprophyticus colonisation rate in pigs was extremely low (1%), 35% of slaughterhouse samples were contaminated. The presence of an antiseptic resistance gene (qacA) by all the lineage G bacteria could be part of the explanation for the ineffective cleaning procedures that were used. 
“S. saprophyticus strains of animal origin (lineage G) enters the slaughterhouse through food animals, persist on the equipment, disseminate and contaminate the meat processing chain and humans. Human colonisation is a crucial step for the later occurrence of UTI,” explained first author Opeyemi Lawal.

The researchers also studied genomic data of bacteria collected from patients attending three hospitals in the Lisbon area, and found that the transmission of these pathogenic bacteria from both lineages (G and S) occurs between persons within the community. Making use of this deep-structured analysis, researchers were also able to identify putative new virulence factors for this unexplored bacterium. The team will continue to search for reservoirs of this bacterium in humans and animals, and to study the mechanisms of S. saprophyticus dissemination and disease to inform strategies against  this pathogen. 

“This a clear example of how food manipulation can impact in human health, and how important it is to educate consumers regarding good individual hygiene practices to avoid spreading of infectious diseases“, said Maria Miragaia, head of the Bacterial Evolution and Molecular Epidemiology Lab. 

“This adds to the list of bacteria that are transmitted to humans through contact with animals and animal-derived food. But the exact mechanisms associated to the conversion from a coloniser to an infectious agent remains to be clarified”, added Henrik Westh from the Copenhagen University Hospital – Amager and Hvidovre, University of Copenhagen (Denmark).

Source: ITQB NOVA

Categories : General Interest Healthcare Politics and RegulationsTags :

Meet the Two Women in the Running for SA’s Top Medical Job

On By ModernMedia
Photo by Markus Winkler on Unsplash

Health Minister Dr Zweli Mkhize is in hot water over alleged procurement fraud for a R150 million COVID contract, and is widely expected to step down shortly.

President Cyril Ramaphosa is reportedly weighing up two candidates to replace Dr Mkhize as health minister.

The candidates are the former Gauteng health MEC Dr Gwen Ramokgopa, (who took over following the Life Esidimeni tragedy) and Dr Nkosazana Dlamini-Zuma, who, as Health Minister saw the overhaul of the country’s apartheid-era healthcare systems.

As an anti-Apartheid activist, Dr Ramokgopa held various leadership positions. She qualified as a medical doctor (MBChB) in 1989 and obtained her Master’s in Public Health (MPH) in 2007. She worked as a Medical Officer at the Dr George Mukhari (then Ga-Rankuwa) Hospital until 1992.

Having served once as the Gauteng health MEC in 1999,  Dr Ramokgopa took on the role deputy health minister from 2010 to 2014. She succeeded Qedani Mahlangu as Gauteng health MEC following the shameful Life Esidimeni tragedy involving the deaths of at least 94 mental health patients released from private mental healthcare facilities to 27 unlicensed facilities. In a  statement, she vowed to tackle waste and corruption.

Dr Nkosazana Dlamini-Zuma completed her MBChB at the University of Bristol in 1978, and took part in underground ANC activities. During Mandela’s presidency, she was appointed Minister of Health, and courted controversy by voicing support for Virodene, an ‘HIV cure’ which attracted heavy criticism and which was never approved.

She then served as Minister of Foreign Affairs from 1999 to 2009, and then Minister of Home Affairs to 2012, where she turned around a department mired by mismanagement. Despite stubborn resistance from French-speaking nations, she was elected the African Union’s (AU) Chairperson from 2012 to 2017 and was praised for focusing on gender issues. After this, she began vying for the ANC presidency as an MP. In 2019, she was appointed Minister of Cooperative Governance and Traditional Affairs.

During South Africa’s lockdown, she memorably rose to internet fame for using “zol” to refer to cannabis when giving reasons for the tobacco ban.