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Exercise found to block chronic inflammation in mice – Harvard Gazette

Posted: November 9, 2019 at 11:44 am

Scientists at Harvard-affiliated Massachusetts General Hospital (MGH) have identified a previously unknown biological pathway that promotes chronic inflammation and may help explain why sedentary people have an increased risk for heart disease and strokes.

In a study to be published in the November issue ofNature Medicine, MGH scientists and colleagues at several other institutions found that regular exercise blocks this pathway. This discovery could aid the development of new therapies to prevent cardiovascular disease.

Regular exercise protects the cardiovascular system by reducing risk factors such as cholesterol and blood pressure. But we believe there are certain risk factors for cardiovascular disease that are not fully understood, said Matthias Nahrendorf of the Center for Systems Biology at MGH. In particular, Nahrendorf and his team wanted to better understand the role of chronic inflammation, which contributes to the formation of artery-clogging blockages called plaques.

Nahrendorf and colleagues examined how physical activity affects the activity of bone marrow, specifically hematopoietic stem and progenitor cells (HSPCs). HSPCs can turn into any type of blood cell, including white blood cells called leukocytes, which promote inflammation. The body needs leukocytes to defend against infection and remove foreign bodies.

When these [white blood] cells become overzealous, they start inflammation in places where they shouldnt, including the walls of arteries.

Matthias Nahrendorf

But when these cells become overzealous, they start inflammation in places where they shouldnt, including the walls of arteries, said Nahrendorf.

Nahrendorf and his colleagues studied a group of laboratory mice that were housed in cages with treadmills. Some of the mice ran as much as six miles a night on the spinning wheels. Mice in a second group were housed in cages without treadmills. After six weeks, the running mice had significantly reduced HSPC activity and lower levels of inflammatory leukocytes than the mice that simply sat around their cages all day.

Nahrendorf explains that exercising caused the mice to produce less leptin, a hormone made by fat tissue that helps control appetite, but also signaled HSPCs to become more active and increase production of leukocytes. In two large studies, the team detected high levels of leptin and leukocytes in sedentary humans who have cardiovascular disease linked to chronic inflammation.

This study identifies a new molecular connection between exercise and inflammation that takes place in the bone marrow and highlights a previously unappreciated role of leptin in exercise-mediated cardiovascular protection, said Michelle Olive, program officer at the National Heart, Lung, and Blood Institute Division of Cardiovascular Sciences. This work adds a new piece to the puzzle of how sedentary lifestyles affect cardiovascular health and underscores the importance of following physical-activity guidelines.

Reassuringly, the study found that lowering leukocyte levels by exercising didnt make the running mice vulnerable to infection. This study underscores the importance of regular physical activity, but further focus on how exercise dampens inflammation could lead to novel strategies for preventing heart attacks and strokes. We hope this research will give rise to new therapeutics that approach cardiovascular disease from a completely new angle, said Nahrendorf.

The primary authors of theNature Medicinepaper are Nahrendorf, who is also a professor of radiology at Harvard Medical School; Vanessa Frodermann, a former postdoctoral fellow at MGH who is now a senior scientist at Novo Nordisk; David Rohde, a research fellow in the Department of Radiology at MGH; and Filip K. Swirski, an investigator in the Department of Radiology at MGH.

The work was funded bygrantsHL142494 andHL139598from the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

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Arkuda bags $44M to target progranulin and head off inherited dementia – FierceBiotech

Posted: November 9, 2019 at 11:44 am

Its a common refrain in dementia studies: We should have treated them earlier. Its why treating neurodegenerative diseases has been so difficult, Gerhard Koenig, Ph.D., told FierceBiotech.

We believe that the challenges in treating neurodegeneration stem from targeting disease pathologies rather than root causes such as lysosomal dysfunction, as well as from treating patients too late in their disease when significant damage has already occurred, said Koenig, CEO and co-founder of Arkuda Therapeutics, in a statement.

Arkuda is trying to change that. Armed with $44 million from the likes of Atlas Venture and Pfizer Ventures, the Cambridge, Massachusetts-based biotech is going after progranulin, a protein that plays a role in neuronal health and the function of lysosomesorganelles involved in removing waste from cells. Its first target? GRN-related frontotemporal dementia (FTD-GRN), an inherited form of dementia.

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Its starting with FTD-GRN because its an autosomal dominant disease, meaning everyone who has a faulty copy of the GRN gene will have low levels of progranulin and develop dementia, typically in their 40s or 50s. Here, progranulin is both the biomarker and the targetArkuda is using progranulin levels to identify patients who have FTD-GRN and developing small molecules to boost those levels and return lysosomes and neurons to health.

RELATED: Finding of dementia genes could speed drug discovery in Alzheimer's and other brain disorders

Arkuda has shown the approach works in preclinical models and hopes to be testing it in humans in 2021, Chief Business Officer Andy Hu told FierceBiotech.

The series A is designed to enable us to take our lead program all the way through phase 1b proof of mechanism in humans Were also doing work on better understanding of the biology around progranulin, granulin [its subunits] and, more broadly, in the lysosome and we expect to yield some other interesting directions we can take future programs, Hu said. Were also thinking about other potential clinical applications for our lead program.

The company kept mum on what those other applications may be, but Koenig said it has very concrete ideas and internal data to point it toward its next programs. These could include Alzheimers disease, in which the bulk of research has targeted the buildup of amyloid and tau proteins in the brain.

When asked why Arkuda chose FTD-GRN rather than something like Alzheimers disease for its first focus, Koenig emphasized the importance of discipline.

RELATED: Small Alzheimer's hopeful biotech nabs $15M series B for metabolic drug approach

We can have big dreams of what we want to change, but we have to be more precise inour initial approach We need to be disciplined about what we know, which mechanism we are addressing and then later on, look at additional things, he said.

We often talk in these areas about gain of toxic protein function. That is now what we are treating here, Koenig said. We are treating the loss of a protein function I personally believe its a big difference than going after reducing something that is already deposited. Its a differentiated approach, trying to intervene early before the organ is failing and its too late.

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Novel Molecule Reduces the Aggressiveness of Pediatric Cancer – Technology Networks

Posted: November 8, 2019 at 1:50 pm

In Brazil, scientists affiliated with the Human Genome and Stem Cell Research Center (HUG-CELL) at the University of So Paulo (USP) have identified a molecule capable of reducing the aggressiveness of embryonal central nervous system tumors. These are malignant tumors that start in fetal cells in the brain and mainly affect children up to four years old.

The results arepublishedin the journalMolecular Oncology.HUG-CELLis one of the Research, Innovation and Dissemination Centers (RIDCs) supported by So Paulo Research Foundation - FAPESP. Its principal investigator isMayana Zatz, Professor of Human and Medical Genetics at USP's Institute of Biosciences (IB).

The approach proposed by the group can be classified as a type of microRNA-based therapy. A microRNA is a small RNA molecule that does not encode protein but plays a regulatory role in the genome. In this study, researchers used a synthetic version of an inhibitor of microRNA-367 (miR-367) with anti-tumor activity.

"We demonstrated in an animal model of a central nervous system tumor that treatment with a microRNA inhibitor attenuates properties of tumor stem cells and prolongs survival," saidOswaldo Keith Okamoto, a professor at IB-USP and the principal investigator for the study.

Okamoto explained that embryonal central nervous system tumors such as medulloblastomas and atypical teratoid/rhabdoid tumors (AT/RTs) tend to contain cells with characteristics similar to those of stem cells, which boosts their tumorigenic potential and capacity to invade tissue while also making them more resistant to cell death.

These tumors are caused by genetic or epigenetic aberrations in stem cells and neural progenitors when the nervous system is being formed during embryonic development. The neural stem cells that undergo these alterations later give rise to tumor cells. They form aggressive, fast-growing tumors that may appear shortly after birth, in later childhood or in adolescence.

In a previous study, the group tested an approach that used the Zika virus to destroy tumor stem cells (read more atagencia.fapesp.br/27677).

Expression and inhibition

A more recent study was led byCarolini Kaid, a postdoctoral researcher at IB-USP with a scholarship fromFAPESP.

Previous research has already shown that OCT4A, one of the genes that encode pluripotency factors, is overexpressed in aggressive medulloblastomas and that this overexpression is associated with an unfavorable prognosis. During hermaster's research, Kaid detected the expression of miR-367, a gene that promotes stem-like traits in tumor cells, in parallel with overexpression of OCT4A (read more atagencia.fapesp.br/21959).

The researchers then tested a specific synthetic inhibitor of miR-367 containing minor chemical alterations that make it more stable in cells. A patent application has been filed for the invention.

After inducing the formation of central nervous system tumors in mice using three different strains of tumor cells, the researchers injected the miR-367 inhibitor into the brain's right lateral ventricle, a pathway to the cerebrospinal fluid that surrounds the brain and spinal cord. From there, the miR-367 inhibitor was able to access the tumor cells.

Tumor size was reduced considerably, and survival improved in all groups of mice. The results confirmed what had previously been observed in cell cultures.

In this model, the researchers noted that when the synthetic molecule interacted with miR-367 in tumor cells, it prevented this microRNA from affecting the levels of proteins it normally regulates, such as ITGAV and SUZ12.

The latter is known to be involved in silencing pluripotency-related genes in embryonic stem cells.

While the role of ITGAV in embryonal central nervous system tumors is not fully understood, ITGAV is known to participate in the renewal of both normal and tumor stem cells.

"When miR-367 is inhibited in cancer cells, it stops regulating several proteins. This molecular alteration eventually affects the properties of these cells, resulting in an attenuation of the tumor's aggressiveness. This is what makes the strategy interesting," Kaid said.

The researchers believe that in humans, the synthetic molecule alone may be capable of at least containing the development of these tumors and improving survival. Even so, they are testing combinations of the molecule with drugs currently used to treat the tumors. They want to find out whether the approaches could be combined using lower doses of chemotherapy drugs.

Before clinical trials can be performed, however, pharmacology and toxicity studies will be necessary, as will pharmacokinetic testing to show how the molecule is metabolized and how long it stays in the organism (its half-life).

When embryonal central nervous system tumors are conventionally treated with surgery, chemotherapy and/or radiotherapy, morbidity and mortality rates for these patients are high. These tumors correspond to 10% of all central nervous system cancer cases in children.

Even patients who survive longer than most may suffer from permanent treatment-related sequelae that impair their quality of life, such as problems with development, cognition, locomotion and speech.

Reference: Kaid et al. 2019.miR367 as a therapeutic target in stemlike cells from embryonal central nervous system tumors. Molecular Oncology. DOI: https://doi.org/10.1002/1878-0261.12562.

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Oct4, Considered Vital for Creating iPSCs, Actually Isnt Needed – The Scientist

Posted: November 8, 2019 at 1:50 pm

Since 2006, when Shinya Yamanaka, now the director of the Center for iPS Cell Research and Application at Kyoto University, discovered a method that could guide fully differentiated cells back to their pluripotent state, scientist have been using his recipe to produce induced pluripotent stem cells. The protocol relies on overexpressing the so-called Yamanaka factors, which are four transcription factors: Oct4, Sox2, Klf4, and cMyc (OSKM). While the technique reliably creates iPS cells, it can cause unintended effects, some of which can lead to cells to become cancerous. So researchers have worked to adjust the cocktail and understand the function of each factor.

No one had succeeded in creating iPS cells without forcing the overexpression of Oct4. It was thought that this was the most crucial factor of the four. At least until now.

If this works in adult human cells, it will be a huge advantage for the clinical applications of iPS cells.

Shinya Yamanaka, Kyoto University

Four years ago, Sergiy Velychko, a graduate student at the Max Planck Institute for Molecular Biomedicine in Hans Schlers lab, and his team were studying the role of Oct4 in creating iPS cells from mouse embryonic fibroblasts. He used vectors to introduce various mutations of the gene coding for Oct4 to the cells he was studying, along with a negative controlone that didnt deliver any Oct4. He was shocked to discover that even using his negative control, he was able to generate iPS cells.

Velychkos experiment was suggesting that it is possible to develop iPS cells with only SKM.

We just wanted to publish this observation, Velychko tells The Scientist, but he knew hed need to replicate it first because reviewers wouldnt believe it.

He and his colleagues, including Guangming Wu, a senior scientist in the lab, repeated the experiment several times, engineering vectors with different combinations of the four factors. SKMthe combination that didnt include Oct4was able to induce pluripotency in the cells with about 30 percent of the efficiency of OSKM, but the cells were of higher quality, meaning that the researchers didnt see evidence of common off-target epigenetic effects. They reported their results yesterday (November 7) in Cell Stem Cell.

Efficiency is not important. Efficiency means how many colonies do you get, explains Yossi Buganim, a stem cell researcher at the Hebrew University of Jerusalem, who was not involved in the study. If the colony is of low quality, the chances that eventually the differentiated cells will become cancerous is very high.

Finally, the team employed the ultimate test, the tetraploid complementation assay, in which iPS cells are aggregated with early embryos that otherwise would not have been able to form a fully functional embryo on their own. These embryos grew into mouse pups, meaning that the iPS cells the team created were capable of maturing into every type of cell in the animal.

Whats more is they found that the SKM iPS cells could develop into normal mouse pups 20 times more often than the OSKM iPS cells, suggesting that the pluripotency of iPS cells can be greatly improved by omitting Oct4 from the reprogramming factor cocktail.

The results will need to be verified in human cells, Buganim cautions. His team has developed methods for creating iPSCs that worked well in mouse cells only to be completely ineffective in humans.

Yamanaka himself was enthusiastic about the results, telling The Scientist in an email that his team would definitely try the method in other cell types, especially adult human blood cells and skin fibroblasts. If this works in adult human cells, it will be a huge advantage for the clinical applications of iPS cells.

S.Velychkoet al.,Excluding Oct4 from Yamanaka cocktail unleashes the developmental potential of iPSCs,Cell Stem Cell,doi:10.1016/j.stem.2019.10.002,2019.

Emma Yasinski is a Florida-based freelance reporter. Follow her on Twitter@EmmaYas24.

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The final frontier? Studying stem cells on the International Space Station – Scope

Posted: November 8, 2019 at 1:50 pm

It's not often I get to write about astronauts and space travel. In fact, it's happened exactly... never. But now, thanks to a high-flying collaboration of Stanford researchers past and present, I get to write about something that's really out of this world.

Since 2006, iPS cells (short for induced pluripotent stem cells) have been at the forefront of groundbreaking research in biology and medicine. The cells' ability to become nearly any tissue in the body makes them an invaluable resource for physicians wishing to study the effect of drugs on specific, hard-to-obtain tissues or for researchers wanting to delve into the molecular missteps that lead to all manner of diseases.

Now iPS-derived human heart muscle cells called cardiomyocytes have found their way into space, as part of a study by cardiologist and stem cell researcher Joseph Wu, MD, PhD, graduate student Alexa Wnorowski and former Stanford graduate student Arun Sharma, PhD. With the help of NASA astronaut Kate Rubins, PhD, (also a former Stanford graduate student!), Wnorowski and Sharma studied the effect of the low gravity of the International Space Station on the heart cells' structure and function.

They published their findings today in Stem Cell Reports.

As Sharma, now a senior research fellow at Cedars-Sinai, explained in an email:

This project represented an opportunity for biomedical researchers to collaborate with astronauts and engineers in order to learn more about how a very unique environment, microgravity, affects the cells of the human heart.

Sharma, Wnorowski and Wu found that the cardiomyocytes cultured on the space station exhibited different patterns of gene expression than did their counterparts grown back here on Earth. They also displayed changes in the way they handled calcium -- an important regulator of contraction rate and strength.

Interestingly (and perhaps reassuringly for astronauts like Rubins), the cells appeared to return to normal when their five-and-a-half week jaunt into low Earth orbit ended.

"Working with the cells that launched to and returned from the International Space Station was an incredible opportunity," Wnorowski said. "Our study was the first conducted on the station that used human iPS technology, and demonstrated that it is possible to conduct long-term, human cell-based experiments in space."

All in all, the researchers were interested to see how nimbly the cells adjusted to their new, free floating life.

"We were surprised by how quickly human heart cells adapted to microgravity," Sharma said. "These results parallel known organ-level adaptations that happen to the heart during spaceflight."

Photos of Kate Rubins by NASA

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Human heart cells are altered by spaceflight, but return mostly to normal on Earth – Space Daily

Posted: November 8, 2019 at 1:50 pm

Heart muscle cells derived from stem cells show remarkable adaptability to their environment during and after spaceflight, according to a study publishing November 7 in the journal Stem Cell Reports.

The researchers examined cell-level cardiac function and gene expression in human heart cells cultured aboard the International Space Station for 5.5 weeks. Exposure to microgravity altered the expression of thousands of genes, but largely normal patterns of gene expression reappeared within 10 days after returning to Earth.

"Our study is novel because it is the first to use human induced pluripotent stem cells to study the effects of spaceflight on human heart function," says senior study author Joseph C. Wu of Stanford University School of Medicine.

"Microgravity is an environment that is not very well understood, in terms of its overall effect on the human body, and studies like this could help shed light on how the cells of the body behave in space, especially as the world embarks on more and longer space missions such as going to the moon and Mars."

Past studies have shown that spaceflight induces physiological changes in cardiac function, including reduced heart rate, lowered arterial pressure, and increased cardiac output. But to date, most cardiovascular microgravity physiology studies have been conducted either in non-human models or at tissue, organ, or systemic levels. Relatively little is known about the role of microgravity in influencing human cardiac function at the cellular level.

To address this question, Wu and his collaborators (including graduate student Alexa Wnorowski, former Stanford graduate student Arun Sharma, now a research fellow at Cedars-Sinai in Los Angeles, and former Stanford graduate student turned astronaut Kathleen Rubins) studied human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). They generated hiPSC lines from three individuals by reprogramming blood cells, and then differentiated them into hiPSC-CMs.

Beating hiPSC-CMs were then launched to the International Space Station aboard a SpaceX spacecraft as part of a commercial resupply service mission. Simultaneously, ground control hiPSC-CMs were cultured on Earth for comparison purposes.

Upon return to Earth, space-flown hiPSC-CMs showed normal structure and morphology. However, they did adapt by modifying their beating pattern and calcium recycling patterns.

In addition, the researchers performed RNA sequencing of hiPSC-CMs harvested at 4.5 weeks aboard the International Space Station, and 10 days after returning to Earth. These results showed that 2,635 genes were differentially expressed among flight, post-flight, and ground control samples.

Most notably, gene pathways related to mitochondrial function were expressed more in space-flown hiPSC-CMs. A comparison of the samples revealed that hiPSC-CMs adopt a unique gene expression pattern during spaceflight, which reverts to one that is similar to groundside controls upon return to normal gravity.

"We're surprised about how quickly human heart muscle cells are able to adapt to the environment in which they are placed, including microgravity," Wu says. "These studies may provide insight into cellular mechanisms that could benefit astronaut health during long-duration spaceflight, or potentially lay the foundation for new insights into improving heart health on Earth."

According to Wu, limitations of the study include its short duration and the use of 2D cell culture. In future studies, the researchers plan to examine the effects of spaceflight and microgravity using more physiologically relevant hiPSC-derived 3D heart tissues with various cell types, including blood vessel cells. "We also plan to test different treatments on the human heart cells to determine if we can prevent some of the changes the heart cells undergo during spaceflight," Wu says.

Research Report: "Effects of Spaceflight on Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Structure and Function"

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At the American Academy of Stem Cell Physicians Live Congress 2019, FDA Safety Panel Says No to the Bad Actors – Yahoo Finance

Posted: November 8, 2019 at 1:50 pm

The American Academy of Stem Cell Physicians hosted the panel on Nov. 2 to discuss safety standards for Physicians who practice stem cell medicine.

MIAMI, Nov. 7, 2019 /PRNewswire/ -- The American Academy of Stem Cell Physicians (AASCP) was joined by the alliance leader Janet Marchibroda in hosting a safety standards panel on Nov. 2 at the AASCP Live Congress 2019. The panel which was moderated by Janet Marchibroda, the president of The Alliance for cell therapy now, and included attendance via Skypeby Dr. Peter Marks, director of the Center for Biologics and Evaluation and Research was well-received by physicians from around the world.

The panel discussed safety precautions and considered guidelines for the safety of patients, calling out the bad actors in the field. They noted that current safety guidelines are antiquated and need revision to meet the demands of new cutting-edge medicine such as stem cells, which is a growing field in medical biologics.

Dr. A.J. Farshchian, a spokesperson forthe AASCP, was honored with the 2019 Visionary Award for his pioneering work with the AASCP and the stem cell industry. He said, "There's been too much talk but no action. We need to change that to ensure the safety of the patients who receive care. AASCP will gladly point out the bad actors to the FDA, are we telling on each other? Yes. Are we breaking the Code? No, we are just preserving what's left of this industry."

Later he added, "Many physicians and scientists are starting to believe that some of the regulations regarding stem cells which have been written many years ago have not kept up with the rapidly advancing science. These regulations must be revisited because they are all pass."

At the AASCP Live Congress, board certifications were also provided. To receive the board certification, physicians must meet stringent qualifications, including attending weekly meetings and pass a written and oral exam. The AASCP congratulates those who were recognized, including Dr. Rene Blaha, Dr. Warren Bleiweiss, Dr. Paula Marchionda and Dr. Kalpana Patel, all of whom received diplomat status; and Dr. Max Citrin, who received associate diplomat status.

The American Academy and its board also granted the title of associate professor and all rights therein to Dr. Richard Hull and Dr. Leonid Macheret. Dr. Richard Hull, who also earned tenure with the AASCP, said of the conference, "It is a great pleasure teaching this group of physicians. I love to teach and these physicians are so eager to learn."

To learn more about the AASCP, their educational initiatives and certification, visit AASCP.net.

About AASCP

The American Academy of Stem Cell Physicians (AASCP) is an organization created to advance research and the development of therapeutics in regenerative medicine, including diagnosis, treatment, and prevention of disease related to or occurring within the human body. The AASCP aims to serve as an educational resource for physicians, scientists, and the public. To learn more, visit AASCP.net

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Johns Hopkins professor to lecture on interplay of secular bioethics, religion as part of Honors Colloquium – URI Today

Posted: November 8, 2019 at 1:50 pm

KINGSTON, R.I. Nov. 4, 2019 As part of this years Religion in America Honors Colloquium, Dr. Jeremy Sugarman will visit the University of Rhode Island to share his thoughts on the inevitable tangling of religion and medicine, and the ethical issues that arise when religious and secular values collide. He will also discuss the emergence of secular bioethics, and spend time analyzing a real-world example.

The lecture, Ethical Controversies in Medicine and Medical Research: The Interplay of Secular Bioethics and Religion, will take place Tuesday, Nov. 12, at 7 p.m. in Edwards Hall, 64 Upper College Road, on the Kingston Campus. This event will not be livestreamed, nor will it be archived. It is free and open to the public.

Sugarman is an internationally recognized leader in the field of biomedical ethics, and has particular expertise in applying empirical methods and evidence-based standards to evaluate and analyze bioethical issues. He is the Harvey M. Meyerhoff Professor of Bioethics and Medicine, professor of medicine, professor of Health Policy and Management, and deputy director for medicine of the Berman Institute of Bioethics at the Johns Hopkins University.

In the past, Sugarman has researched and made contributions to medical ethics and policy, including but not limited to his work on the ethics of informed consent, umbilical cord blood banking, stem cell research, international HIV prevention research and global health and research oversight. Sugarman is the author of more than 300 articles, reviews and book chapters.

Dr. Sugarman consults and speaks internationally on a range of issues related to bioethics. He served as senior policy and research analyst for the White House Advisory Committee on Human Radiation Experiments, consultant to the National Bioethics Advisory Commission, and Senior Advisor to the Presidential Commission for the Study of Bioethical Issues. He also served on the Maryland Stem Cell Research Commission. Sugarman is a member of the Scientific and Research Advisory Board for the Canadian Blood Service and the Ethics and Public Policy Committees of the International Society for Stem Cell Research. He is co-chair of the Johns Hopkins Institutional Stem Cell Research Oversight Committee. In addition, he is chair of the Ethics Working Group of the HIV Prevention Trials Network and co-leads the Ethics and Regulatory Core of the NIH Health Care Systems Research Collaboratory.

Dr. Sugarman has been elected as a member of the American Society of Clinical Investigation, the Association of American Physicians, and the Institute of Medicine. He is a fellow of the American Association for the Advancement of Science, the American College of Physicians and the Hastings Center.

Lauren Poirier, an intern in the Marketing and Communications Department at URI and public relations and English major, wrote this press release.

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Sequencing the genome of every UK baby would be an ethical minefield – New Scientist News

Posted: November 8, 2019 at 1:49 pm

By Clare Wilson

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Plans for the National Health Service to sequence the DNA of every baby born in the UK, starting with a pilot scheme of 20,000 children, were announced by health minister Matt Hancock this week. It sounds like the UK is leading the way in high-tech healthcare but doctors are saying the idea is ethically questionable.

Babies are already tested for certain health conditions soon after birth, so it may seem as though sequencing their genome, their entire set of genes, is a simple upgrade of this routine screening, but that isnt the case.

UK babies are tested for nine carefully selected conditions, all of which can be avoided or lessened with pre-emptive treatment. For instance, the metabolic disorder phenylketonuria can cause brain damage, but this can be avoided through a low-protein diet.

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Unfortunately, most illnesses arent as simple or treatable. We are only at the beginning of our journey to understand the complexity of the human genome, and some of the information we have learned so far can create difficult dilemmas.

Take the genetic condition Huntingtons disease, which starts with mild symptoms in middle age, eventually progressing to severe disability and early death. There is no cure.

When people learn that Huntingtons is in their family, they may spend years deciding whether to take the test. Many choose not to. Parents who ask doctors to test their child are turned down, as set out in international guidelines. Deciding to learn if you have the gene responsible is such a personal choice that it must be left to the individual concerned once they turn 18.

Huntingtons is rare, but there are similar dilemmas over more common conditions such as genes that predispose people to Alzheimers disease and some types of cancer. There is currently little you can do to avoid dementia, and for women who learn they have a certain gene that increases cancer risk, the safest step is to have their breasts and ovaries removed.

Some people would rather not know about these risks before it is necessary. We have endless discussions about [the ethics of] testing children for conditions that dont manifest until later life, says Frances Elmslie of the British Society for Genetic Medicine.

Nor would it make sense to sequence children at birth then wait until they are 18 to give the results. In the intervening years, DNA sequencing is bound to become cheaper and more powerful. It would make more sense to offer it to every 18-year-old, says Martin Brunet, a family doctor in Surrey, UK.

There is a small group of children for whom genome sequencing can be useful: those with rare undiagnosed medical conditions. In one study, sequencing led to a diagnosis in a fifth of children in intensive care, and that figure is likely to improve over time. In these cases, parents can consent for their children because there is a medical benefit but that is very different to sequencing everyone out of curiosity.

A US group has begun a small trial of routine genome sequencing of healthy babies. The families are being monitored to see how they cope and to measure any harms and benefits.

No details are available about the UK plans and Hancock didnt respond to New Scientists requests for comment. But introducing sequencing for everyone is a massive step. It will require public consultation over the ethical questions not to mention on practical issues like how the data will be stored securely and the impact on doctors workloads, says Elmslie. We need to think really carefully about this.

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Alzheimer’s disease: Rare genetic mutation might hold clues to preventing or treating dementia – CBS News

Posted: November 8, 2019 at 1:49 pm

Could one woman's rare genetic mutation one day have a global impact on dementia risk?

It's possible, say investigators who report on a potentially groundbreaking case of a woman whose genetic mutation staved off dementia for decades, even though her brain hadalreadybeen damaged by Alzheimer's disease.

While most Alzheimer's cases are not driven by genetic predisposition, one woman in Colombia is among about 1,200 in her country who do face a genetically higher risk for early-onset Alzheimer's.

Why? They all carry the E280A mutation of a gene called Presenilin 1 (PSEN1), which is known to increase the chances for Alzheimer's at a far younger age than usual.

"We identified an individual that was predisposed to develop Alzheimer's in her 40s," noted study author Dr. Joseph Arboleda-Velasquez. He's an assistant professor of ophthalmology with the Schepens Eye Research Institute of Mass Eye and Ear at Harvard Medical School, in Boston.

But, strangely, the woman "remained unimpaired until her 70s," Arboleda-Velasquez added.

The twist: the woman had, in fact, developed clear telltale signs of Alzheimer's in her brain. She just hadn't developed dementia.

For example, while she had fewer neural "tangles" in her brain than is typical for Alzheimer's patients, by the time she hit her 40s she did have the same unusually high level of brain amyloid-beta deposits as her E280A peers. Such deposits are a key signature of Alzheimer's.

So why didn't she develop middle-aged dementia like her peers?

To unravel the mystery, Arboleda-Velasquez and his colleagues ran an in-depth genetic analysis on the woman. And what they found is that she had not just one mutation, but two.

In addition to the E280A mutation, she also carried the so-called "Christchurch" mutation in the APOE3 gene.

But there's more. Not only did she carry the Christchurch mutation, but she hadtwoof them. Some of her E280A peers (about 6%) also carried a single copy of Christchurch. But she was the only one who carried two, the investigators found.

"It is ultra-rare, with an approximate prevalence of less than one in every 200,000 individuals," Arboleda-Velasquez said.

And having one such rare mutation did not appear to be enough. No protection against dementia was linked to only one Christchurch mutation. But as this woman's case suggests, having two such mutations did seem to throw up a shield against Alzheimer's, preserving her ability to remember things and think clearly for a few decades, long after her E280A peers had started experiencing cognitive decline.

"This is the first time a specific patient who carries the [double] mutation has been linked to such a protective benefit," Arboleda-Velasquez noted.

How does it work? It seems that "the mutation puts a block on the cascade of events linking amyloid accumulation to neural [brain cell] death," he explained.

The team did acknowledge that more research will be needed to definitively confirm the Christchurch mutation's impact, and to further explore how this mutation/dementia delay connection truly works.

But, in theory, the incredibly rare experience of this one woman in Colombia could ultimately have profound ramifications for Alzheimer's patients around the world, if "new drugs that mimic the effect of [the] mutation" could be developed, said Arboleda-Velasquez. Rather than stopping Alzheimer's from developing, such drugs would prevent Alzheimer's from causing dementia.

The study was published Nov. 4 in the journalNature Medicine, and was partly funded by the U.S. National Institutes of Health and the Alzheimer's Association.

Heather Snyder, vice president of medical and scientific relations at the Alzheimer's Association, characterized the findings as "an important discovery."

The insights gleaned from a look at this particular patient's experience are "full of possibilities for increasing our understanding of Alzheimer's disease and all dementia, and advancing potential avenues for treatment," Snyder suggested.

"Understanding what is happening in the brains of people when there appears to be a delay or stopping of the disease progression because of this gene form or otherwise gives rise to many possibilities for investigating new treatment and risk-reduction opportunities," she added.

At the same time, Snyder cautioned that "more research is needed to understand more thoroughly how genetics impacts Alzheimer's/dementia risk, and to expand and confirm these findings in a larger number of people."

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Alzheimer's disease: Rare genetic mutation might hold clues to preventing or treating dementia - CBS News

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