Month: December 2020

Omega-3 Carboxylic Acid Does not Prevent Recurrence of Heart Attacks

Omega-3 carboxylic acid (CA) is often prescribed by healthcare professionals to patients following a heart attack to lower the risk of a recurrence. However, new evidence from the STRENGTH trial shows that it has no effect in this regard.

Phase III of the STRENGTH trial involved 13 078 adult participants at 675 centres across 22 countries. They were randomised to either receive a 4gm of omega-3 CA medication or a maize oil placebo. All of the patients were being treated with statins and were at increased risk due to factors such as diabetes, or had experienced arterial blockages.

The participants were all monitored for rates of cardiovascular death, heart attack, stroke, need for coronary revascularisation or hospitalisation for unstable angina, starting in 2014 and concluding in 2020.

The trial was stopped slightly early due to the low likelihood of a benefit emerging from continuing to take omega-3 CA; furthermore, there was evidence of increased rates of atrial fibrillation among participants taking omega-3 CA.

Source: Science Daily

Steroids Indicated Only for Most Severe COVID Patients

According to new research, treating COVID patients with steroids to manage inflammation and stave off a cytokine storm may only be useful in patients with severe COVID.

Most patients with moderate to severe COVID in fact have a suppressed immune system, suggesting that treatment with steroids such as dexamethasone should only be applied to patients with most severe COVID. Severe COVID patients develop a hyperinflammatory reaction known as a cytokine storm.

The researchers measured cytokine levels in 168 adults with COVID, 26 with flu and 16 that were healthy volunteers. When dexamethasone or other steroids are administered to patients with already lowered immune system, they can backfire.

“We did identify a subset of Covid-19 patients with the broadly upregulated array of cytokines.. But, overall, the average person with Covid-19 had less inflammation than the average person with flu,” said study co-author Paul Thomas of St Jude Children’s Research Hospital.

The study authors thus believe that steroids should only be directed at the small subset of COVID patients with an overactive immune response. What they say is an urgent requirement now is a fast, reliable and cheap test to measure cytokines, thereby identifying those patients that are likely to benefit from dexamethasone.

Source: Times of India

Diet can Affect Sperm through Epigenetics

A team of researchers have investigated the effect of adding nuts to a Western style diet on epigenetic effects of sperm quality.

The epigenetic effects are expressed through DNA methylation, where methyl groups are added to DNA sequences, altering their activity without changing the actual sequence.

A range of lifestyle and environmental factors have been investigated in the search for the cause in the drop of human sperm fertility observed over the pasty 70years. Specific sperm DNA methylation signatures are associated with sperm quality.

The researchers took data from 72 young non-smoking adults from the FERTINUTS trial. In the assigned nut-eating group, the participants’ sperm was found to have significantly sperm count, viability, motility, and morphology. Additionally, alterations in 36 specific DNA methylation regions were observed compared to the control group, and hypermethylation was seen in 97.2% of them.  

Albert Salas-Huetos, first author of the article stated that, “This work demonstrates that there are some sensitive regions of the sperm epigenome that respond to diet, and which can result in changes in sperm and in its ability to fertilise.”

Source: Science Daily

New Study Shows Pollution May Accelerate COVID Spread

A study from the McKelvey School of Engineering at Washington University shows that pollution may have contributed to the rapid spread of COVID through the United States.

The spread of COVID is directly associated with the long-term ambient level of PM2.5 (particles less 2.5 micrometres in diameter) and the reproduction number R0 for the coronavirus. PM2.5 are small enough to enter the lungs and cause damage. Matters are only worsened with secondary inorganic components in PM2.5.

Looking at 43 factors such as age, population density and time delays in lockdown orders, and comparing it to pollution statistics, they found a linear association with PM2.5 concentrations and inorganic components. Interestingly, this relationship only appeared above a certain level of air pollution.

“Annual mean PM2.5 national standards are set at or below 12 microgrammes per cubic metre, below that you are supposed to be safe,” said Rajan Chakrabarty, associate professor in the Department of Energy, Environmental & Chemical Engineering. “What we saw, the correlation we’re seeing is well below that standard.”

More detailed analysis showed that black carbon in the form of soot had a synergistic effect. “We found black carbon acts as a kind of catalyst. When there is soot present, PM2.5 has more of an acute effect on lung health, and therefore on R0.”

Source: Science Daily

Black Market for Negative COVID Tests

According to Business Insider South Africa, falsified negative COVID tests are being used around the world, with even a black market for them existing.

In France, seven people were arrested when a traveller at Charles de Gaulle Airport was discovered trying to travel with a falsified negative COVID digital certificate. The fraudulent certificates were being sold for $180 (R2,800) to $360 (R5,600) each. In October, a group of travellers in Brazil faked their own COVID test results trying to get into the Fernando de Noronha island group. While in the UK, a number of people admitted altering the test results for friends, because the certificates were electronic and very simple to alter and then print.

COVID Risks Resurgence of a Tropical Disease

In an article on The Conversation, Raphael Taiwo Aruleba, a PhD in the Department of Molecular and Cell Biology, University of Cape Town, writes that COVID is causing a dangerous setback for the battle against preventable diseases, potentially leading to the resurgence of a particular tropical disease.

One of these is the tropical disease leishmaniasis, which is caused by a parasite transmitted by sandflies in environments with open sewage. It can cause disability, social stigma and death.

Aruleba believes that COVID has reversed the progress against  leishmaniasis by ten years. Prevention is focused on controlling the insect disease vector with surveillance, insecticides and nets. However, COVID has made it difficult for researchers to assess areas and for routine spraying to be done, and resources have been diverted to fight COVID. Only 0.6% of the WHO’s research budget is for leishmaniasis.

The Leishmania parasite and SARS-CoV-2 are also potentially co-infectious, exacerbating one another. Aruleba concludes that other diseases should not be neglected in the fight against COVID.

SA Currently Without Access to Pfizer/BioNTech’s “90% Effective” Vaccine

Despite taking part in a recent successful vaccine trial, South Africa does not have guaranteed access to it. South Africa missed out on the first deadline to take part in the WHO-backed COVAX scheme, but is currently understood to be negotiating with COVAX and manufacturers.

Early results from the Pfizer/BioNTech two-dose vaccine’s trial showed a 90% reduction in symptomatic COVID cases over placebo, and caused a media sensation. 800 South African participants are to take part in the trial.

“This is a massive development. It’s very exciting, and the interim results are very promising. It leaves me with lots of hope as this could pave the way for a vaccine to be developed before the end of the year,” said Dr Essak Mitha, the head of the South African arm of the clinical trial who is a clinical trial specialist and owner of Newtown Clinical Research in Johannesburg.

The news was met with some caution; the decision to announce the news via a company press release instead of a peer reviewed article was controversial.

The BioNTech vaccine is based around messenger RNA (mRNA). The mRNA in the vaccine carries viral proteins, and once introduced into the body’s cells, instructs them to make copies of viral proteins. One such protein coded for is the infamous “spike” protein that SARS-CoV-2 uses to latch onto cells, and which contributes to its high infectivity. 

Source: AllAfrica

Exenatide and Dapagliflozin Outlast Metformin for Diabetes Treatment

An AstraZeneca-funded trial called DURATION-8 has shown a viable alternative for metformin with a combination of two medications, exenatide and dapagliflozin.

The standard treatment for type 2 diabetes is metformin, but for many patients it loses its effectiveness over time. To get around this, a combination of exenatide (a glucagon-like peptide-1 receptor agonist) and dapagliflozin (sodium-glucose cotransporter-2 inhibitor) was trialled.

Originally a 28 week trial, DURATION-8 was extended to 52 weeks on the strength of its initial results.

“Many therapies in diabetes management are short-lived, which is why it is useful to test for long-term effect,” says first author Dr Serge Jabbour, director of the division of endocrinology and the Diabetes Center at Thomas Jefferson University.

The trial, with 695 participants, compared the two medications, either individually with a placebo or in combination. The combination group saw the greatest drop in glycated hemoglobin (HbA1c) levels. This was accompanied by drops in systolic blood pressure and body weight.

The authors note the need for a follow-on study to determine if there were protective effects against cardiovascular and renal events with the combination.

Source: Medical News Today

Discovery of New Genetic Targets for Endometriosis Treatment

Endometriosis can be a debilitatingly painful disease which can lead to infertility, and has few treatment options for more severe forms – but new treatment options are unfolding as genetic targets for drugs are discovered.

Jake Reske, a graduate student in the MSU Genetics and Genome Sciences Program, explains: “There haven’t been many successful nonhormonal therapies for this form of endometriosis that have made it to the bedside yet.”

Some severe forms of endometriosis involve a gene called ARID1A. A mutation in this gene triggers “super-enhancer” DNA which in turn allows cells to run rampant and set up outside the uterus, causing great pelvic pain.

The researchers aim to implement a novel treatment, “epigenetic therapy”, to prevent the cells from running rampant. 

“It can seriously impact women’s quality of life and their ability to have a family and work,” said study supervisor Ronald Chandler, an assistant professor of obstetrics, gynaecology and reproductive biology. “It’s not easy to treat, and it can become resistant to hormone therapy. The most clinically impactful thing we found is that targeting super-enhancers might be a new treatment for this deeply invasive form of the disease.”

The compound they used targeted protein called P300, which suppressed the super-enhancers and relieving the effects of the  ARID1A mutation. This could also possibly be applied to other forms of endometriosis. The researchers plan to look for more compounds that can also target the P300 protein.  

Source: News-Medical.Net

Aspen Shifts to SA Production of COVID Vaccines

Aspen Pharmacare has secured a deal to manufacture the Johnson & Johnson COVID vaccine, in an effort to adapt to the pharmaceutical market. 

Elective surgeries being deferred due to the pandemic has reduced demand for certain medications, and the company withheld dividends for the second year running in September. However, the company does produce some medications which are currently in demand due to COVID.

Dexamethasone, one of the medications Aspen has the rights to produce, is a key treatment for COVID patients, which according to a study done in June, reduces mortality by 30%. Colchicine is another medication used to treat COVID, normally used for gout.

Tavros Nicolaou, a senior Aspen executive, said in an interview: “In February, we looked at how we best respond to this looming disaster facing us and we split it into three buckets — what we can do at a therapeutic level, what can we do at a vaccine level and what can we do to generally help society.” This positioned them “globally as a company that had a multifaceted response to this pandemic.”

The pharmaceuticals company has invested R3 billion in a Port Elizabeth plant to manufacture the Johnson & Johnson COVID vaccine at a rate of 300 million per year, which will help supply the rest of Africa. The need for local COVID vaccines may come sooner rather than later.

Despite peaking in July, the country’s COVID pandemic is not yet over with at least two provinces seeing increases in cases again, while on the horizon a second surge is expected in January.

Source: Moneyweb