Day: October 26, 2021

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Lateral Flow Tests now Approved for Travellers to England

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Fully vaccinated passengers arriving in England and most under 18s arriving from non red-list countries (which now includes South Africa) can use a lateral flow test (LFT) on or before day 2 of their arrival in England, the UK government has announced.

LFTs must be taken as soon as possible on the day of arrival in England or at the latest before the end of a passenger’s second day and can now be purchased from the list of private providers on GOV.UK from as little as £22 – significantly cheaper than PCR tests.

LFTs for international travel must be purchased from a private provider as NHS Test and Trace lateral flow tests cannot be used for international travel. Passengers who have already bought a PCR to use for travel do not need to buy another test as PCRs can still be used.

Passengers have to take a photo of their lateral flow test and booking reference supplied by the private provider, then send it back to them to verify the result. Failure to do so could result in a fine of £1000 (R20 000). It is also possible for passengers to book a test at some airport testing centres. People using PCR tests for travel will have their test reported by the company they purchase the test from.

Anyone who tests positive will need to isolate and take a confirmatory PCR test, at no additional cost to the traveller, which can be genomically sequenced to help identify new variants. PCR tests can be accessed free of charge by ordering in the usual way through NHS Test and Trace – via nhs.uk/coronavirus or by calling 119.  Test providers will be expected to advise people to self-isolate and direct people towards the NHS Test and Trace booking page.

In addition, all travellers must complete a passenger locator form beforehand, including providing a test booking reference number supplied by a testing provider.

However, these new rules apply only to those arriving in England: anyone travelling on to Ireland, Northern Ireland, Scotland, Wales, the Channel Islands or the Isle of Man within 10 days after arrival in England have to follow the rules for testing and quarantine in those places.

Those passengers who are not fully vaccinated with an authorised vaccine returning from a non-red list destination must still take a pre-departure test (antigen/PCR), a PCR test on day 2 and day 8 test and complete 10 days’ self-isolation (with the option of doing Test to Release on day 5).

Source: UK Government

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A Genetic Risk Score to Identify Alchol-related Cirrhosis

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In a world first, researchers have developed a genetic risk score (GRS) test able to identify patients at high-risk of developing alcohol-related cirrhosis.

Cirrhosis results in approximately 300 000 deaths each year world-wide. In their study, the researchers found that a high GRS from the test of excessive alcohol consumers resulted in a three-fold increase in cirrhosis risk. Having diabetes together with a high GRS increased the cirrhosis risk among drinkers more than 10-fold.

Joint senior author of the study, Clinical Associate Professor Devanshi Seth, said that only a minority of high-risk drinkers – approximately 10 to 15%– actually end up developing alcohol-induced cirrhosis. To date, however, there had been no way to identify those at-risk individuals.

“Our GRS test lets us identify at-risk individuals at an early stage enabling the application of focused interventions. Evidence suggests that even just informing excessive drinkers that they have an increased cirrhosis risk may motivate them to reduce their alcohol intake, helping prevent serious disease,” said Clinical Associate Professor Seth.

The lead author of the study, Dr John Whitfield from QIMR Berghofer Medical Research Institute, said that the test had been developed by examining samples from patients with and without alcohol-related cirrhosis, but who all had a history of heavy alcohol consumption.

“This was classified as men consuming more than 80 grams (8 standard drinks) of alcohol daily and women more than 50 grams daily, both for a time period of ten or more years.”

“Risk scores were computed by the analysis of up to eight gene variations and three clinical risk factors (including type 2 diabetes) associated with alcohol-related cirrhosis,” Dr Whitfield said.

“We’ve shown that a GRS based on only three genetic risk variants plus diabetes status can be extremely meaningful in determining overall cirrhosis risk. Our test will allow for early and personalised management of high-risk patients,” said Clinical Associate Professor Seth.

Source: Centenary Institute

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‘Sutrodes’ Could Treat Spleen Conditions Using Electricity

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Photo by Zoltan Tasi on Unsplash

Using a flexible ‘sutrode’ – a combination of suture and electrode – a group of researchers has advanced a way to treat spleen conditions by applying only electrical current.

Electroceuticals, where electrical stimulation is used to modify biological functions, could minimally invasively treat medical conditions and result in few side effects.  

The work, which appears in the Nature Journal of Communications Biology, builds on previous studies when the team introduced the sutrode to the world just over a year ago. This graphene-based electrode is an electrical stimulation device that could replace the use of pharmaceuticals to treat a range of medical conditions. The sutrode, created using a technique called fibre wet spinning, has an electrode’s electrical properties and a suture’s mechanical properties.

“The flexibility and superb sensitivity of the sutrode is allowing us to expand our understanding of how the nervous system controls main body organs, a critical step towards developing advanced therapies in bioelectronic medicines,” reported the study leader, Professor Romero-Ortega. “Our collaborative work uncovered that the spleen is controlled by different terminal nerves, and that the sutrode can be used to control them, increasing the precision in which the function of this organ can be modulated.”

Paper co-author professor Gordon Wallace said the sutrode can be integrated with delicate neural systems to monitor neural activity.

“This work has widespread implications for regulating the function of the spleen, particularly the efficient regulation of the immune response for electroceutical treatment of range of diseases,” said Prof Wallace. “We have highlighted the ongoing need to develop systems with increased fidelity and spatial resolution. This will not only bring practical applications to the forefront but will enable the unattainable exploration of the human neural system.”

The work also reveals the ability to simultaneously interrogate the four individual neural inputs into the spleen. This new technical and biological achievement will not only bring about practical applications, but also enable a previously unattainable exploration of the human neural system.

Source: University of Houston

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Men and Women Have the Same Emotional Turbulence

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Contrary to widely held gender stereotypes, women are not more emotional than men, say researchers of a new study into emotional differences in gender.

Feelings such as enthusiasm, nervousness or strength are often interpreted differently between the two genders. It’s what being ’emotional’ means to men versus women that is part of a new University of Michigan study that dispels these biases.

For example, a man whose emotions fluctuate in a sporting event is described as “passionate” while a woman whose emotions change in any event, even if provoked, is considered “irrational,” said senior author Adriene Beltz, assistant professor of psychology.

Prof Beltz and colleagues followed 142 men and women over 75 days to learn more about their daily emotions, both positive and negative. The women were divided into four groups: one naturally cycling and three others who used different forms of oral contraceptives.

The researchers detected fluctuations in emotions three different ways, and then compared the sexes. Little to no differences were seen between the men and the various groups of women, suggesting that men’s emotions fluctuate to the same extent as women’s, although likely for different reasons.

“We also didn’t find meaningful differences between the groups of women, making clear that emotional highs and lows are due to many influences – not only hormones,” Prof Beltz said.

These findings could have implications for research, which has historically excluded women partly because ovarian hormone fluctuations result in variation, especially in emotion, which cannot be experimentally controlled, the researchers said.

“Our study uniquely provides psychological data to show that the justifications for excluding women in the first place (because fluctuating ovarian hormones, and consequently emotions, confounded experiments) were misguided,” Prof Beltz said.

Source: University of Michigan

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A Case of Three Teens with COVID and Psychiatric Symptoms

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A case study details three teenagers with mild or asymptomatic COVID presented with suicidal thoughts, “paranoia-like fears,” delusions and “foggy brain”, which could be explained by anti-neural antibodies – ‘turncoat’ antibodies that may attack brain tissue.

Mounting evidence points to neurological and psychiatric effects of COVID, with a UK study finding a 13% risk of a first-time diagnosis after COVID. The study, published in JAMA Neurology, is the first to look at anti-neural antibodies in paediatric patients previously infected with SARS-CoV-2.

Over five months in 2020, 18 children and teens were hospitalised with confirmed COVID at UCSF Benioff Children’s Hospital San Francisco, three of whom were the patients in the study who underwent neurological evaluations.

The researchers examined the patients’ cerebrospinal fluid (CSF) and found that two of the patients, both of whom had histories of unspecified depression and/or anxiety, had antibodies indicating that SARS-CoV-2 may have invaded the central nervous system. They also had anti-neural antibodies in their CSF, suggesting a rampant immune system accidentally targeting the brain.

The research follows a previous UCSF study that also found a high level of autoantibodies in the cerebrospinal fluid of adult patients with acute COVID, who experienced neurological symptoms, including intractable headaches, seizures and loss of smell.

“It is way too soon to know whether COVID is a common trigger for neuropsychiatric illnesses, but it does seem to be a potent trigger for the development of autoantibodies,” said co-corresponding author Samuel Pleasure, MD, PhD. “It is currently totally unknown whether patients predisposed to neuropsychiatric illnesses are more likely to develop worsened symptoms after COVID, or whether COVID infection can act as an independent trigger.”

Unlike most psychiatric presentations, the three patients in the UCSF study had symptoms with sudden onset and rapid progression, representing a marked change from their baselines, said co-first author Claire Johns, MD. “The patients had significant neuropsychiatric manifestations despite mild respiratory symptoms, suggesting potential short and long-term effects of COVID.”

After hospitalisations lasting weeks and ongoing psychiatric medications, the two UCSF patients, whose cerebrospinal fluid tested positive for SARS-CoV-2 antibodies and anti-neural antibodies, were treated with intravenous immunoglobulin, an immunomodulatory therapy that curbs inflammation in autoimmune disorders. After five days, the first patient had “more organised thoughts, decreased paranoia and improved insight.”

Autoantibodies targeting the protein TCF4 were also found, which has genetic links in some schizophrenia cases. However, “we don’t know that the antibodies are actually interfering with the protein’s function,” said co-corresponding author, Michael R. Wilson, MD, noting that the diagnosis of schizophrenia is based on a constellation of symptoms, not a biomarker.
The second patient partially responded to immunotherapy with improved cognition and working memory, but continued to have “impaired mood and cognitive symptoms” six months later. The third patient, with no psychiatric history and without SARS-CoV-2 antibodies or anti-neural antibodies in their cerebrospinal fluid, recovered with psychiatric medications. Their symptoms were attributed to recreational drug use.

In another case study, a 30-year-old patient with mildly symptomatic COVID who presented at a hospital emergency department with delusions, violent outbursts, hyper-anxiety and paranoia was unresponsive to antipsychotic medication but after being diagnosed with possible “autoimmune-mediated psychosis”, responded to intravenous immunoglobulin.

Nonetheless, the researchers agree it’s unlikely that there were pre-existing autoantibodies, and they point to other disorders with psychiatric symptoms, like anti-NMDAR encephalitis syndrome, that are caused by anti-neural antibodies and respond to treatment directed at these rogue antibodies.

The researchers agree that more study is warranted, although Dr Pleasure noted that the rarity of cerebrospinal fluid samples from paediatric patients is a challenge, as they rarely have severe enough COVID to warrant a lumbar puncture.

Source: University of California San Francisco

Categories : Nutrition Respiratory DiseasesTags : Leave a comment

Fermented Soy Products Found to Reduce Asthma Inflammation

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A bowl of tofu, a fermented soy food. Photo by Polina Tankilevitch from Pexels

Fermented soy products are common in the Japanese diet, and one brand known as ImmuBalance has been found to suppress airway inflammation in animal models of asthma.

Bronchial asthma causes symptoms such as wheezing and cough due to chronic airway inflammation, but there is no fundamental treatment for it, leaving a desire for new prevention and treatment methods. Osaka University researchers found that in a ImmuBalance-treated group of asthma model mice, eosinophils associated with asthma were significantly reduced in the bronchoalveolar lavage fluid (BALF). As well as a decrease in inflammation and mucus around the bronchi, the team observed a suppression of proteins that induce eosinophilic inflammation.

“The relationship between soy intake and allergic diseases has been epidemiologically reported in the past,” explained first author Hideaki Kadotani, “suggesting that the components of soy may have some anti-allergic effects”

“It was reported that imbalances in the gut microbiota may be involved in immune system and allergic diseases, and fermented dietary fiber, like that found in soy, might have beneficial effects in allergic asthma models.” continues Associate Professor Kazuhisa Asai, supporting author of the study.

In the study, which appears in the journal Nutrients, such a gut imbalance’s effect on asthma were examined by giving ImmuBalance-enriched feed to asthma model mice. In the ImmuBalance-treated group, there was a significant drop in the number of eosinophils in BALF, and inflammation around the bronchi and mucus production in the bronchial epithelium was suppressed. Additionally, the expression of Th2 cytokines and the immunoglobulin serum IgE that induce eosinophilic inflammation in BALF were found to be significantly suppressed.

“In clinical practice, steroid inhalants are the basis of asthma treatments, yet they are known to have adverse side effects“, stated lead advisor to the study, Professor Tomoya Kawaguchi. “Our results suggest that the intake of fermented soybean products should be recommended as a complementary coping strategy to asthma with fewer side effects”

Source: Osaka University

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Interleukin-12 no Longer the Villain in Psoriasis

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Psoriatic plaque, showing a silvery center surrounded by a reddened border. Source: Wikimedia. By James Heilman, MD – Own work, CC BY-SA 3.0

Considered to be the trigger for psoriais, the immune messenger molecule Interleukin-12 (IL-12) has now been shown to actually cause the skin disease but in fact protects against it. This finding also explains why common psoriasis drugs that block the messenger show insufficient treatment efficacy.

Psoriasis is a chronic inflammatory autoimmune disease that manifests as red, scaly skin patches. No causal treatment for the disease exists, but the symptoms can be significantly alleviated with modern therapies. The development of the skin disease arises from complex changes immune cell networks and the messengers they use for communication. Clinical trials showed that newly developed drugs that blocked only IL-23 are more effective than previous treatments targeting both IL-23 and IL-12 in psoriasis patients, but why this was so was not known. Now, researchers at the University of Zurich (UZH) have uncovered the underlying molecular mechanisms.

From human and mouse studies, they found that various cell types in the skin are also equipped with receptors for IL-12. Not only the T cells of the immune system, but also keratinocytes, horn-forming skin cells that build up the epidermis, can thus recognise the messenger. In fact, the recognition of interleukin-12 by these skin cells was responsible for the protective effect of the messenger, as the researchers found out. “Interleukin-12 is essential for the normal, physiological function of keratinocytes. For example, it prevents the increased cell division observed in psoriasis,” explained group leader Sarah Mundt from the Institute of Experimental Immunology at UZH.

“These results surprised us, because so far drugs for the treatment of psoriasis also aim at blocking interleukin-12,” said immunology professor Burkhard Becher.

“Our findings indicate that blocking IL-12 is not advisable, and such drugs should therefore no longer be used to treat psoriasis patients,” advised first author  Pascale Zwicky, PhD student. Accordingly, psoriasis drugs should only block the messenger substance IL-23, but no longer IL-23 and -12 together.

The UZH researchers’ findings could be important for the treatment of other diseases. “The combined blocking of IL-23 and -12 is also used in the treatment of chronic inflammatory bowel diseases and psoriatic arthritis,” said Prof Becher. “In these diseases, the role of IL-12 has not yet been sufficiently studied. But here, too, a protective role of the messenger substance is possible.”

Source: University of Zurich

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A New, Lasting Diabetes Treatment

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Source: National Cancer Institute on Unsplash

Israeli researchers have come up with a novel approach to the treatment of type 2 diabetes, using an autograft of muscle cells engineered to take in sugar at increased rates.

The disease’s long-term complications include heart disease, strokes, retinal damage leading to blindness, kidney failure, and poor blood flow in the limbs that may result in amputations. Currently a combination of lifestyle changes, medication, and insulin injections are used to treat it, however it is still associated with a 10-year reduction in life expectancy.

Professor Shulamit Levenberg led the study alomg with PhD student Rita Beckerman from the Stem Cell and Tissue Engineering Laboratory in the Technion’s Faculty of Biomedical Engineering. An autograft of muscle cells engineered to take in sugar at increased rates were tested in mice, which displayed normal blood sugar levels for months after a single procedure. The study findings were published in Science Advances.

Muscle cells are among the main targets of insulin, and they are supposed to absorb sugar from the blood. In their study, Prof. Levenberg’s group isolated muscle cells from mice and engineered these cells to present more insulin-activated sugar transporters (GLUT4). These cells were then grown to form an engineered muscle tissue, and finally put back into diabetic mice. The engineered cells not only proceeded to absorb sugar correctly, improving blood sugar levels, but also induced improved absorption in the mice’s other muscle cells through intercellular signalling. After this one treatment, the mice remained cured of diabetes for four months – the entire observation period. Their blood sugar levels remained lower, and they had reduced levels of fatty liver normally seen in type 2 diabetes.

Prof. Levenberg explained how the process worked. “By taking cells from the patient and treating them, we eliminate the risk of rejection.” These cells can easily integrate back into being part of the body and respond to the body’s signaling activity.

An effective treatment, especially as a once-off, could significantly improve both quality of life and life expectancy of those who have diabetes. The same method could also be used to treat various enzyme deficiency disorders.

Source: Technion Israeli Institute of Technology