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marți, 13 decembrie 2011

News From The Journal Of Clinical Investigation : Dec. 12, 2011

Main Category: Immune System / Vaccines
Also Included In: Dermatology;  HIV / AIDS;  Transplants / Organ Donations
Article Date: 13 Dec 2011 - 1:00 PST

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IMMUNOLOGY: Finding a new immune function for NEMO

Ectodermal dysplasias are a group of inherited conditions in which there is abnormal development and function of the skin, hair, nails, teeth, and/or sweat glands. Individuals with ectodermal dysplasia with immune deficiency (EDI) also have a dysfunctional immune system that renders them susceptible to severe infections. EDI is caused by mutations in the NEMO gene that reduce but do not abolish expression of NEMO protein. Now, a team of researchers led by Ashish Jain, at the National Institute of Allergy and Infectious Diseases, Bethesda, has identified two patients with EDI caused by genetic mutations that are not within the NEMO gene but do markedly reduce the level of expression of NEMO. Detailed analysis of cells from these patients defined a new and unexpected function for NEMO - it controls the activity of the protein IKK-alpha in the nucleus. Importantly, the data indicate that defects in this function of NEMO result in the immune deficiency that is characteristic of EDI.

TITLE: Defective nuclear IKK-alpha function in patients with ectodermal dysplasia with immune deficiency

View this article at: http://www.jci.org/articles/view/42534?key=05ee401b0eeda41b75be

IMMUNOLOGY: Putting a stop to immune responses

To clear an invading microbe from the body the immune system must become activated. However, once the microbe has been cleared it is important to shut down the immune response so that it does not cause damage to healthy tissue surrounding the site of infection. In some instances, suppression of the immune response occurs before the immune system has done its job. For example, many tumors contain cells known as MDSCs that suppress antitumor immune responses. A team of researchers led by Leo Koenderman, at the University Medical Center Utrecht, The Netherlands, has now identified in humans a new population of immune system-suppressing cells characterized by high levels of expression of the proteins CD11c, CD11b, and CD16 and low levels of expression of the protein CD62L. The cells were observed in humans during acute body-wide inflammation induced by injection of a bacteria-derived toxin or by severe injury. Further analysis identified the mechanisms by which these cells suppressed the immune system, providing potential targets for preventing unwanted immune system suppression.

TITLE: A subset of neutrophils in human systemic inflammation inhibits T cell responses through Mac-1

View this article at: http://www.jci.org/articles/view/57990?key=ffff831d2c7a509bd694

IMMUNOLOGY: Numbers of immune first responders kept constant by LXRs

One of the first immune cells to respond to an invading microbe is the neutrophil. Numbers of these cells are tightly regulated because of their importance as a first responder. In healthy individuals, more than 1 - 109 neutrophils per kilogram body weight are released from the bone marrow every day; an equivalent number must be cleared from the circulation to ensure numbers remain constant. A team of researchers - led by Steven Bensinger and Peter Tontonoz, at UCLA, Los Angeles - has now determined that proteins known as LXRs are key regulators of neutrophil clearance and production in mice and identified the molecular pathways by which the LXRs do so. As dysregulation of neutrophil clearance has been implicated in the development of lupus, future studies will focus on determining whether modulating LXR signaling can modify disease in animal models of lupus.

TITLE: Coordinate regulation of neutrophil homeostasis by liver X receptors in mice

View this article at: http://www.jci.org/articles/view/58393?key=abc382b18a21deb76dfb

HIV/AIDS; Recruitment (of CD4+ T cells) a problem for the gut

HIV-1 infection is characterized by the loss of key immune cells known as CD4+ T cells. Combined antiretroviral therapy (cART) largely restores CD4+ T cell numbers in the blood, but the gut remains substantially depleted of these cells. A team of researchers led by Pierre Delobel, at INSERM, UMR1043, France, has now determined that the inefficient restoration of CD4+ T cell numbers in the gut of cART-treated HIV-infected individuals is likely to be a result of a lack of recruitment of CD4+ T cells; in particular, those CD4+ T cells that express the proteins CCR9 and beta-7. Moreover, this is probably because expression of the molecule CCL25, which attracts CD4+ T cells expressing the protein CCR9, is decreased in the small intestine of HIV-infected individuals. These data provide a potential explanation for the inefficient restoration of gut CD4+ T cell numbers in HIV-infected individuals receiving effective cART, something that was poorly understood.

TITLE: Altered CD4+ T cell homing to the gut impairs mucosal immune reconstitution in treated HIV-infected individuals

View this article at: http://www.jci.org/articles/view/59011?key=a0a1ec7e537acfb05110

TRANSPLANTATION: The protein haptoglobin: arising from dead cells to trigger graft rejection

The process of transplanting an organ is complex. Despite great care, some cells of the organ die during the harvesting and implantation procedures. These dead cells activate a branch of the organ recipient's immune system known as the innate immune system. This impairs the ability of the organ recipient's immune system to tolerate the new organ, which can lead to rapid rejection of the transplanted organ (acute transplant rejection). A team of researchers led by Daniel Goldstein, at Yale University School of Medicine, New Haven, has now determined that release of the protein haptoglobin from dying skin cells activates the innate immune system and accelerates transplant rejection in a mouse model of skin transplantation. As there are three major variants of haptoglobin in humans, Goldstein and colleagues suggest that it would be interesting to determine whether differential expression of these haptoglobin variants influences rejection of transplanted hearts in humans.

TITLE: Haptoglobin activates innate immunity to enhance acute transplant rejection in mice

View this article at: http://www.jci.org/articles/view/58344?key=68e86efe8058c7046e4b

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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luni, 12 decembrie 2011

Using Eyebrain Tracker In Parkinson's Therapy Clinical Trial

Using Eyebrain Tracker In Parkinson's Therapy Clinical Trial@import "/css/pagelayout.css";@import "/css/default.css";@import "/css/defaultnews.css";Medical News Today Follow us on FacebookFollow us on TwitterOur RSS feedsYour MNT
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Main Category: Parkinson's Disease
Also Included In: Neurology / Neuroscience;  Medical Devices / Diagnostics
Article Date: 12 Dec 2011 - 7:00 PST

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After Alzheimer's, Parkinson's disease is the second most common neurodegenerative disease, affecting 0.3% of the general population in western countries, with 100,000 sufferers in France and 8,000 new diagnoses each year. Its prevalence increases with age, reaching 1% in those above the age of 60 years, and as much as 4% in the over-80s.

An announcement made by EyeBrain, a company that develops medical devices for the early diagnosis of neurological diseases, states that the company's EyeBrain Tracker device will be used in a clinical trial that will explore the dyskinesia induced by treating patients suffering from idiopathic Parkinson's disease with levodopa. ?The trials' endpoint is to identify biomarkers for the late-onset complications of a treatment regime using levodopa (BIODYS). This compound, naturally transformed into dopamine in the brain, is the only drug available that can slow down the effects of Parkinson's disease, however, it induces dyskinesia in these patients over time, which is characterized as abnormal movements that primarily affect the face (tongue, lips, jaw) and extends as far as the arms and legs.

Researchers will involve a total of 30 people in the trial, half of these will be Parkinson's sufferers who will received treatment with levodopa and who have developed dyskinesia, while the other half will be the control group consisting of healthy subjects.

The trial, set up by professor Jean-François Tison, a neurologist at the CNRS Physiopathology of Parkinsonian syndromes unit at the University of Bordeaux Two (the Institute of Neurodegenerative Diseases, CNRS UMR 5293E, Bezard) is being sponsored and financed by Bordeaux University Hospital, whilst the EyeBrain Tracker device is being funded under the joint 2007-2013 State-Region Plan (Aquitaine Regional Council and the FEDER fund). ?

?Professor Tison explained:

"Patients suffering from idiopathic Parkinson's disease will undergo an acute test as part of a pre-operational assessment for stimulating the deep recesses of the brain."


The EyeBrain Tracker will evaluate and measure patients' motricity effects through speed of eye movements.

Tison said:

"We will see whether levodopa modifies the parameters of blinking in a way that is correlated with the improvement in motricity. Using the EyeBrain Tracker enables us to measure the motricity effect through eye movements, since the blinking parameters are also linked to the patient's general motricity. The patient's response to this trial is also a predictor of their reaction to the neurosurgery that will follow."?


?The EyeBrain Tracker has already been utilized for early diagnosis of Parkinsonian syndromes, such as progressive supra-nuclear paralysis (PSP), cortico-basal degeneration (CBD) and multiple systems atrophy (MSA). With the new trial, the device is broadening its field of application as a valuable aid in the early diagnosis and follow-up of these diseases, and now plays a significant part in clinical research into other neurological diseases, such as multiple sclerosis. ?

The chairman of EyeBrain, Serge Kinkingnéhun states:

"We are delighted to know that the EyeBrain Tracker is playing a part in a clinical trial targeting idiopathic Parkinson's. This forms part of our goal of making the benefits of eye motricity available to a larger number of people suffering from neurological pathologies." ?
?About EyeBrain? Tracker
eyebraintracker


EyeBrain Tracker allows clinicians for the first time to depend on a simple set of eye movement parameters to differentiate between very similar syndromes, such as progressive supra-nuclear paralysis (PSP) and cortico-basal degeneration (CBD). The tests are easy to perform, non-invasive and low-cost, with results being available in less than 20 minutes. ? ?

The Mobile EyeBrain Tracker (EBT) is a complete unit, including headphones, a computer with two monitors and software for stimulation and analysis and is already routinely utilized in hospitals to assist in the early characterization of Parkinsonian syndromes, with studies also underway for the diagnosis of multiple sclerosis (MS). ? ?

The Mobile EBT is a globally novel device that has obtained CE marking in addition to the company's ISO-9001 and ISO-13485 certification.

?EyeBrain is based in the Paris suburb of Ivry-sur-Seine

Written by: Petra Rattue

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Additional References Citations Visit our parkinson's disease section for the latest news on this subject. http://www.eyebrainpedia.com
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duminică, 11 decembrie 2011

First Genome Sequencing Clinical Trial For Triple Negative Cancer Points To New Treatments

Main Category: Breast Cancer
Also Included In: Genetics
Article Date: 11 Dec 2011 - 0:00 PST

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Initial results from an ongoing clinical trial, the first designed to examine the utility of whole-genome sequencing for triple negative breast cancer, were reported during the CRTC-AACR San Antonio Breast Cancer Symposium.

The results indicate activation of targets not previously associated with triple negative disease and could point toward new treatment strategies. Based on mutations uncovered by sequencing, physicians recommended the women enter treatment protocols for either existing drugs or new agents being evaluated in pharma-sponsored clinical trials.

Triple negative breast tumors, which make up nearly 20 percent of breast cancers, do not respond to treatment with targeted therapies such as Herceptin® (trastuzumab).

Of eleven tumors sequenced to date, each was genomically unique, but commonalities were observed. Some patients displayed amplified genes in the RAS pathway; one patient had amplification of the BRAF oncogene, as well as activation of a growth pathway known as the MEK/AKT pathway. This patient displayed an impressive response to a MEK/AKT inhibitor currently in a phase I clinical study.

"Those results are quite striking considering that these are women with advanced disease," said Joyce O'Shaughnessy, M.D., who presented the data. "If MEK/AKT activation is found to be present in a substantial fraction of triple negative patients, inhibitors of this pathway could prove a significant tool in fighting this disease."

Dr. O'Shaughnessy is medical director and co-chair of the Breast Cancer Research Committee, US Oncology Research; a practicing oncologist with Texas Oncology; and the Celebrating Women Chair of Breast Cancer Research at Baylor Charles A. Sammons Cancer Center.

"This is among the largest studies of a single tumor type in which whole genome sequencing is being used to identify potential options for targeted treatment," said John Carpten, Ph.D., director of the Integrated Cancer Genomics Division at the Translational Genomics Research Institute (TGen). "As the field of genomic medicine matures, this study is sure to provide key early insights into how sequencing can best be utilized in the clinic."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our breast cancer section for the latest news on this subject. The study, titled "Next Generation Sequencing Reveals Co-Activating Events in the MAPK and PI3K/AKT Pathways in Metastatic Triple Negative Breast Cancers," is sponsored by the Translational Genomics Research Institute (TGen) and US Oncology Research with support from Life Technologies Corporation. Whole-genome sequencing of tumors and normal tissue was performed on Life Technologies' Applied Biosystems SOLiD™ platform, and results were validated in a CLIA-certified laboratory.

The Translational Genomics Research Institute

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joi, 8 decembrie 2011

How To Better Predict Success In HIV Prevention Clinical Trials

Main Category: HIV / AIDS
Also Included In: Preventive Medicine;  Clinical Trials / Drug Trials
Article Date: 08 Dec 2011 - 3:00 PST

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New research from the University of North Carolina at Chapel Hill schools of medicine and pharmacy may help explain the failure of some recent clinical trials of prevention of HIV infection, compared to the success of others that used the same drugs.

The study published online December 7, 2011 in the journal Science Translational Medicine, also suggests how to improve the chances for success, even before the research begins. These suggestions are reinforced in an editorial by several of the UNC authors writing in The Lancet, also published online December 7, 2011.

Over the past two years, results from several clinical trials involving pre-exposure prophylaxis (PrEP) for HIV infection have been a mixed bag of successful prevention and futility. Reports described varying degrees of successful HIV infection prevention in four trials and failure in two others. In all the PrEP trials, the drugs used were tenofovir (TFV) and emtricitabine (FTC) in daily oral and/or gel combinations.

These drugs have been shown to be protective against HIV infection in animal PrEP studies and are now being used clinically, and tenofovir is considered the backbone of HIV therapy, both used orally and topically.

The new UNC study looked at drug concentrations in the mucus membrane tissues that are most susceptible to HIV infection: the tissue lining the vagina, cervix and rectum.

The study was led by Angela D.M. Kashuba, PharmD, professor in the UNC Eshelman School of Pharmacy and director of the UNC Center for AIDS Research Clinical Pharmacology and Analytic Chemistry Core. She also is a member of the UNC Institute for Global Health & Infectious Diseases.

"We did this study to understand how much drug got into these tissues and how long they lasted over two weeks," Kashuba said. And after giving normal, healthy volunteers a single pill combination of TFV/FTC, "What we found over the next 14 days was somewhat surprising. When a person takes a drug, it doesn't end up in the same concentration in different tissues."

Indeed, concentrations of tenofovir were 100 times higher in rectal tissue than in vaginal or cervical tissue. "And FTC achieved concentrations 10 to 15 times higher in vaginal and cervical tissue than they were in rectal tissue," Kashuba said.

"And this raised some questions: because of these discrepancies can the two drugs be used equally well in both populations women at risk for HIV infection and men at risk for HIV infection? And are the concentrations achieved even after a single dose high enough to prevent HIV infections?"

According to Kashuba, it's clear from the recent clinical studies that drug concentration in tissue may make a difference in effectiveness. For example, in one of the placebo-controlled PrEP clinical trials involving men who have sex with men, the combination of these drugs provided about 44 percent effectiveness overall.

But the half the men given the active form of the drugs had no detectable drug in their system when they were sampled during the study and, therefore, were not taking it consistently every day. Thus, the high tenofovir concentrations in rectal tissue could explain the relatively high efficacy of 44 percent.

Results of a PrEP clinical trial (VOICE) conducted in heterosexual women in Uganda, South Africa and Zimbabwe, also paralleled the UNC findings. The daily tenofovir arm was stopped because no protection was seen for the drug taken daily. "If these women did not take the drug every single day, we think our study supports the fact there would not be good efficacy because tenofovir drug concentrations in the vagina and cervix are so much lower than what we see in rectal tissue, Kashuba said."

The authors of the study and the editorial say adherence to taking the drug as prescribed is crucial. They lament that the only prospective means of measuring adherence now available is what the patient reports. "And so if you ask someone did you take all your doses, most will say yes," Kashuba said "People want to be considered good study participants, and sometimes they just can't remember how many doses they took last week, or in the last month, be it almost all of the doses or half of them."

The UNC researcher points to lessons learned: "Before delving into a clinical trial, we need to keep in mind that when someone takes a pill, you can't assume that the drug gets in all places at the same amount. And before we can select the drugs and the right doses for a clinical trial, we need to know what concentrations in tissue prevent HIV infection. They could be different."

And along with the above, the authors emphasize the need to develop ways to objectively measure drug-taking behavior in clinical studies so that the research can be designed and interpreted correctly.

The study was funded in part from the National Institutes of Health, the UNC Center for AIDS Research, the UNC TraCS Clinical Translational Research Center, and the Gilead Sciences Investigator Initiated Research Program.

Article adapted by Medical News Today from original press release. Source: University of North Carolina
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