New universe of miniproteins is upending cell biology and genetics – Science Magazine
By daniellenierenberg
By Mitch LeslieOct. 17, 2019 , 2:00 PM
Mice put human runners to shame. Despite taking puny strides, the rodents can log 10 kilometers or more per night on an exercise wheel. But the mice that muscle biologist Eric Olson of the University of Texas Southwestern Medical Center in Dallas and colleagues unveiled in 2015 stood out. On a treadmill, the mice could scurry up a steep 10% grade for about 90 minutes before faltering, 31% longer than other rodents. Those iron mice differed from counterparts in just one small waythe researchers had genetically altered the animals to lack one muscle protein. That was enough to unleash superior muscle performance. "It's like you've taken the brakes off," Olson says.
Just as startling was the nature of the crucial protein. Muscles house some gargantuan proteins. Dystrophin, a structural protein whose gene can carry mutations that cause muscular dystrophy, has more than 3600 amino acids. Titin, which acts like a spring to give muscles elasticity, is the biggest known protein, with more than 34,000 amino acids. The protein disabled in the mice has a paltry 46. Although researchers have probed how muscles work for more than 150 years, they had completely missed the huge impact this tiny protein, called myoregulin, has on muscle function.
Olson and his colleagues weren't the only ones to be blindsided by Lilliputian proteins. As scientists now realize, their initial rules for analyzing genomes discriminated against identifying those pint-size molecules. Now, broader criteria and better detection methods are uncovering minuscule proteins by the thousands, not just in mice, but in many other species, including humans. "For the first time, we are about to explore this universe of new proteins," says biochemist Jonathan Weissman of the University of California, San Francisco.
Biologists are just beginning to delve into the functions of those molecules, called microproteins, micropeptides, or miniproteins. But their small size seems to allow them to jam the intricate workings of larger proteins, inhibiting some cellular processes while unleashing others. Early findings suggest microproteins bolster the immune system, control destruction of faulty RNA molecules, protect bacteria from heat and cold, dictate when plants flower, and provide the toxic punch for many types of venom. "There's probably going to be small [proteins] involved in all biological processes. We just haven't looked for them before," says biochemist Alan Saghatelian of the Salk Institute for Biological Studies in San Diego, California.
The venom of this predatory water bug has more than a dozen small proteins.
Small proteins also promise to revise the current understanding of the genome. Many appear to be encoded in stretches of DNAand RNAthat were not thought to help build proteins of any sort. Some researchers speculate that the short stretches of DNA could be newborn genes, on their way to evolving into larger genes that make full-size proteins. Thanks in part to small proteins, "We need to rethink what genes are," says microbiologist and molecular biologist Gisela Storz of the National Institute of Child Health and Human Development in Bethesda, Maryland.
Despite the remaining mysteries, scientists are already testing potential uses for the molecules. One company sells insecticides derived from small proteins in the poison of an Australian funnel-web spider. And a clinical trial is evaluating an imaging agent based on another minute protein in scorpion venom, designed to highlight the borders of tumors so that surgeons can remove them more precisely. Many drug companies are now searching for small proteins with medical potential, says biochemist Glenn King of the University of Queensland in St. Lucia, Australia. "It's one of the most rapidly growing areas."
Other short amino acidchains, often called peptides or polypeptides, abound in cells, but they are pared-down remnants of bigger predecessors. Myoregulin and its diminutive brethren, in contrast, are born small. How tiny they can be remains unclear. Fruit flies rely on a microprotein with 11 amino acids to grow normal legs, and some microbes may crank out proteins less than 10 amino acids long, notes microbial genomicist Ami Bhatt of Stanford University in Palo Alto, California. But even the largest small proteins don't measure up to average-size proteins such as alpha amylase, a 496amino-acid enzyme in our saliva that breaks down starch.
Few small proteins came to light until recently because of a criterion for identifying genes set about 20 years ago. When scientists analyze an organism's genome, they often scan for open reading frames (ORFs), which are DNA sequences demarcated by signals that tell the cell's ribosomes, its proteinmaking assembly lines, where to start and stop. In part to avoid a data deluge, past researchers typically excluded any ORF that would yield a protein smaller than 100 amino acids in eukaryotes or 50 amino acids in bacteria. In yeast, for example, that cutoff limited the list of ORFs to about 6000.
Relaxing that criterion reveals that cells carry vastly more ORFs. Earlier this year, Stanford postdoc Hila Sberro Livnat, Bhatt, and colleagues trawled genome fragments from the microbes that inhabit four parts of the human body, including the gut and skin. By searching for small ORFs that could encode proteins between five and 50 amino acids long, the researchers identified about 4000 families of potential microproteins. Almost half resemble no known proteins, but the sequence for one small ORF suggested that a corresponding protein resides in ribosomesa hint that it could play some fundamental role. "It's not just genes with esoteric functions that have been missed" when scientists overlooked small ORFs, Bhatt says. "It's genes with core functions."
For the first time, we are about to explore this universe of new proteins.
Other cells also house huge numbers of short ORFsyeast could make more than 260,000 molecules with between two and 99 amino acids, for example. But cells almost certainly don't use all those ORFs, and some of the amino acid strings they produce may not be functional. In 2011, after finding more than 600,000 short ORFs in the fruit fly genome, developmental geneticist Juan Pablo Couso of the University of Sussex in Brighton, U.K., and colleagues tried to whittle down the number. They reasoned that if a particular ORF had an identical or near-identical copy in a related species, it was less likely to be genomic trash. After searching another fruit fly's genome and analyzing other evidence that the sequences were being translated, the group ended up with a more manageable figure of 401 short ORFs likely to yield microproteins. That would still represent a significant fraction of the insects' protein repertoirethey harbor about 22,000 full-size proteins.
Weissman and colleagues found microproteins a second way, through a method they invented to broadly determine which proteins cells are making. To fashion any protein, a cell first copies a gene into messenger RNA. Then ribosomes read the mRNA and string together amino acids in the order it specifies. By sequencing mRNAs attached to ribosomes, Weissman and his team pinpoint which ones cells are actually turning into proteins and where on the RNAs a ribosome starts to read. In a 2011Cellstudy, he and his team applied that ribosome profiling method, also called Ribo-seq, to mouse embryonic stem cells and discovered the cells were making thousands of unexpected proteins, including many that would fall below the 100amino-acid cutoff. "It was quite clear that the standard understanding had ignored a large universe of proteins, many of which were short," Weissman says.
Saghatelian and his colleagues adopted a third approach to discover a trove of microproteins in our own cells. The researchers used mass spectrometry, which involves breaking up proteins into pieces that are sorted by mass to produce a distinctive spectrum for each protein. Saghatelian, his then-postdoc Sarah Slavoff, and colleagues applied the method to protein mixtures from human cells and then subtracted the signatures of known proteins. That approach revealed spectra for 86 previously undiscovered tiny proteins, the smallest just 18 amino acids long, the researchers reported in 2013 inNature Chemical Biology.
Being small limitsa protein's capabilities. Larger proteins fold into complex shapes suited for a particular function, such as catalyzing chemical reactions. Proteins smaller than about 50 to 60 amino acids probably don't fold, says chemist Julio Camarero of the University of Southern California in Los Angeles. So they probably aren't suited to be enzymes or structural proteins.
However, their diminutive size also opens up opportunities. "They are tiny enough to fit into nooks and crannies of larger proteins that function as channels and receptors," Olson says. Small proteins often share short stretches of amino acids with their larger partners and can therefore bind to and alter the activity of those proteins. Bound microproteins can also shepherd bigger molecules to new locationshelping them slip into cell membranes, for instance.
A microprotein in the poison of the deathstalker scorpion has been fused to a fluorescent dye to make tumors emit near-infrared light. (1) A tumor seen in visible light (2)Same tumor in visible and near-infrared light
Because of their attraction to larger proteins, small proteins may give cells a reversible way to switch larger proteins on or off. In a 2016 study inPLOS Genetics, plant developmental biologist Stephan Wenkel of the University of Copenhagen and colleagues genetically alteredArabidopsisplants to produce extra amounts of two small proteins. The plants normally burst into flower when the days are long enough, but when they overproduced the two microproteins, their flowering was postponed. The small proteins caused that delay by blocking a hefty protein called CONSTANS that triggers flowering. They tether CONSTANS to other inhibitory proteins that shut it down. "A cell uses things that help it survive. If a short protein does the job, that's fine," Saghatelian says.
Those jobs include other key tasks. In 2016, Slavoff, Saghatelian, and colleagues revealed that human cells manufacture a 68amino-acid protein they named NoBody that may help manage destruction of faulty or unneeded mRNA molecules. NoBody's name reflects its role in preventing formation of processing bodies (P-bodies), mysterious clusters in the cytoplasm where RNA breakdown may occur. When the protein is missing, more P-bodies form, thus boosting RNA destruction and altering the cell's internal structure. "It shows that small proteins can have massive effects in the cell," Slavoff says.
Muscles appear to depend on a variety of microproteins. During embryonic development, individual muscle cells merge into fibers that power contraction. The 84amino-acid protein myomixer teams up with a larger protein to bring the cells together, Olson's team reported in 2017 inScience. Without it, embryonic mice can't form muscles and are almost transparent.
Later in life, myoregulin steps in to help regulate muscle activity. When a muscle receives a stimulus, cellular storage depots spill calcium, triggering the fibers to contract and generate force. An ion pump called SERCA then starts to return the calcium to storage, allowing the muscle fibers to relax. Myoregulin binds to and inhibits SERCA, Olson's team found. The effect limits how often a mouse's muscles can contractperhaps ensuring that the animal has muscle power in reserve for an emergency, such as escaping a predator. Another small protein, DWORF, has the opposite effect, unleashing SERCA and enabling the muscle to contract repeatedly.
Even extensively studied organisms such as the intestinal bacteriumEscherichia coliharbor unexpected small proteins that have important functions. Storz and her team reported in 2012 that a previously undiscovered 49amino-acid protein called AcrZ helps the microbe survive some antibiotics by stimulating a pump that expels the drugs.
And the venom produced by a variety of organismsincluding spiders, centipedes, scorpions, and poisonous mollusksteems with tiny proteins. Many venom components disable or kill by blocking the channels for sodium or other ions that are necessary for transmission of nerve impulses. Small proteins "hit these ion channels with amazing specificity and potency," King says. "They are the major components of venoms and are responsible for most of the pharmacological and biological effects."
Australia's giant fish-killing water bug, for instance, doesn't just rely on sharp claws and lancelike mouthparts to subdue prey. It injects its victims with a brew of more than 130 proteins, 15 of which have fewer than 100 amino acids, King and colleagues reported last year.
Unlike hulking proteinssuch as antibodies, microproteins delivered by pill or injection may be able to slip into cells and alter their functions. Captopril, the first of a class of drugs for high blood pressure known as angiotensin-converting enzyme inhibitors was developed from a small protein in the venom of a Brazilian pit viper. But the drug, which the Food and Drug Administration approved for sale in the United States in 1981, was discovered by chance, before scientists recognized small proteins as a distinct group. So far, only a few microproteins have reached the market or clinical trials.
Cancer researchers are trying to capitalize on a microprotein in the poison of the deathstalker scorpion (Leiurus quinquestriatus) of Africa and the Middle East. The molecule has a mysterious attraction to tumors. By fusing it to a fluorescent dye, scientists hope to illuminate the borders of brain tumors so that surgeons can safely cut out the cancerous tissue. "It lights up the tumor. You can see the margins and if there are any metastases," King says. A clinical trial is now evaluating whether the dual molecule can help surgeons remove brain tumors in children.
How important small proteins will be for medicine is still unknown, but they have already upended several biological assumptions. Geneticist Norbert Hbner of the Max Delbrck Center for Molecular Medicine in Berlin and colleagues found dozens of new microproteins in human heart cells. The group traced them to an unexpected source: short sequences within long noncoding RNAs, a variety that was thought not to produce proteins. After identifying 169 long noncoding RNAs that were probably being read by ribosomes, Hbner and his team used a type of mass spectrometry to confirm that more than half of them yielded microproteins in heart cells, a result reported earlier this year inCell.
Bacteria such as Escherichia coli also churn out many microproteins, although their functions remain unclear in many cases.
The DNA sequences for other tiny proteins also occur in unconventional locations. For example, some lie near the ORFs for bigger proteins. Researchers previously thought those sequences helped manage the production of the larger proteins, but rarely gave rise to proteins themselves. Some coding sequences for recently discovered microproteins are even nested within sequences that encode other, longer proteins.
Those genomic surprises could illuminate how new genes arise, says evolutionary systems biologist Anne-Ruxandra Carvunis of the University of Pittsburgh in Pennsylvania. Researchers had thought most new genes emerge when existing genes duplicate or fuse, or when species swap DNA. But to Carvunis, microproteins suggest protogenes can form when mutations create new start and stop signals in a noncoding portion of the genome. If the resulting ORF produces a beneficial protein, the novel sequences would remain in the genome and undergo natural selection, eventually evolving into larger genes that code for more complex proteins.
In a 2012 study, Carvunis, who was then a postdoc in the lab of Marc Vidal at the Dana-Farber Cancer Institute in Boston, and colleagues found that yeast translate more than 1000 short ORFs into proteins, implying that these sequences are protogenes. In a new study, Carvunis and her team tested whether young ORFs can be advantageous for cells. They genetically altered yeast to boost output of 285 recently evolved ORFs, most of which code for molecules that are smaller than the standard protein cutoff or just over it. For almost 10% of the proteins, increasing their levels enhanced cell growth in at least one environment. The results, posted on the preprint server bioRxiv, suggest these sequences could be on their way to becoming full-fledged genes, Carvunis says.
Slavoff still recalls being astonished when, during her interview for a postdoc position with Saghatelian, he asked whether she would be willing to go hunting for small proteins. "I had never thought that there could be this whole size of proteins that was dark to us until then."
But the bet paid offshe now runs her own lab that is searching for microproteins. Recently, she unleashed some of her postdocs and graduate students on one of the most studied organisms, the K12 strain ofE. coli.The team soon uncovered five new microproteins. "We are probably only scratching the surface," she says.
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New universe of miniproteins is upending cell biology and genetics - Science Magazine
UCLA opens CAR T-cell trial focused on the most common types of lymphoma, leukemia – The Cancer Letter Publications
By daniellenierenberg
publication date: Oct. 18, 2019
The UCLA Jonsson Comprehensine Cancer Center has launched a CAR T-cell immunotherapy trialthat will attack cancer cells by simultaneously recognizing two targetsCD19 and CD20that are expressed on B-cell lymphoma and leukemia.
By launching a bilateral attack instead of using the conventional single-target approach, researchers are hoping to minimize resistance and increase the life expectancy for people diagnosed with these cancers.
One of the reasons CAR T cell therapy can stop working in patients is because the cancer cells escape from therapy by losing the antigen CD19, which is what the CAR T cells are engineered to target, Sarah Larson, a health sciences clinical instructor in hematology/oncology at UCLA Health and the principal investigator on the trial, said in a statement One way to keep the CAR T cells working is to have more than one antigen to target. So, by using both CD19 and CD20, the thought is that it will be more effective and prevent the loss of the antigen, which is known as antigen escape, one of the common mechanisms of resistance.
Up to two-thirds of the patients who experience relapse after being treated with the FDA-approved CD19 CAR T-cell therapy develop tumors that have lost CD19 expression. UCLA researchers are identifying and testing new strategies like this one so many more patients can benefit from the therapy.
In preclinical studiesled byYvonne Chen, an associate professor of microbiology, immunology, and molecular genetics at UCLA and the sponsor of the trial, the team was able to show that by simultaneously attacking two targets, the engineered T cells developed in her lab could achieve a much more robust defense compared to conventional, single-target CAR T cells against tumors in mice.
Chens team designed the CARs based on the molecular understanding of the CARs architecture, the antigen structure and the CAR/antigen binding interaction to achieve optimal T cell function. This design helps the T cells have dual-antigen recognition to help prevent antigen escape.
Based on these results, were quite optimistic that the bispecific CAR can achieve therapeutic improvement over the single-input CD19 CAR thats currently available, said Chen, who is also the co-director of the Jonsson Cancer Centers Tumor Immunology Program and a member of the UCLA Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research.
This first-in-humans study will evaluate the therapy in patients with non-Hodgkins B-cell lymphoma or chronic lymphocytic leukemia that has come back or has not responded to treatment. The goal is to determine a safe therapeutic dose.
Patients enrolled in the trial will have their white blood cells (T cells) collected intravenously then reengineered in the laboratory so the T cells can produce tumor-specific receptors (CARs), which allow the T cells to recognize and attack the CD19 and CD20 proteins on the surface of tumor cells. The new smarter and stronger T cells are then infused back into the patient and primed to recognize and kill cancer cells.
The trial is currently only offered at UCLA.
Results from STELLAR trial in MPM published in The Lancet Oncology
Novocure said the results from the STELLAR trial were published inThe Lancet Oncology.
The STELLAR trial was a prospective, single-arm trial including 80 patients that studied the use of Tumor Treating Fields, delivered via the NovoTTF-100L System, in combination with pemetrexed plus cisplatin/carboplatin as a first-line treatment for patients with unresectable, locally advanced or metastatic malignant pleural mesothelioma.
Data showed a median overall survival of 18.2 months (95 percent CI, 12.1 months-25.8 months) for patients treated with NovoTTF-100L and pemetrexed plus cisplatin or carboplatin. One- and two-year survival rates were 62.2 percent (95 percent CI, 50.3 percent-72.0 percent) and 41.9 percent (95 percent CI, 28.0 percent-55.2 percent), respectively. No serious systemic adverse events were considered to be related to the use of NovoTTF-100L. The most common mild to moderate adverse event was skin irritation beneath the transducer arrays.
The STELLAR trial demonstrated encouraging overall survival results with no increase in systemic toxicity observed in MPM patients treated with Tumor Treating Fields and standard chemotherapy, Giovanni Luca Ceresoli, head of pulmonary oncology at the Humanitas Gavazzeni Hospital in Bergamo, Italy, and principal investigator in the STELLAR trial, said in a statement. The median overall survival of 18.2 months is impressive given that MPM is a tumor with a dismal prognosis and few effective therapeutic options.
Median progression free survival was 7.6 months (95 percent CI, 6.7 percent-8.6 percent) for patients treated with NovoTTF-100L and pemetrexed plus cisplatin or carboplatin. There was a 97 percent disease control rate in patients with at least one follow-up CT scan performed (n=72). 40 percent of patients had a partial response, 57 percent had stable disease and 3 percent had progressive disease.
IASLC invites comments on Multidisciplinary Recommendations for Pathologic Assessment of Lung Cancer Resection Specimens Following Neoadjuvant Therapy
The International Association for the Study of Lung Cancer announced an open comment period for the IASLC Multidisciplinary Recommendations for Pathologic Assessment of Lung Cancer Resection Specimens Following Neoadjuvant Therapy paper.
The paper has been made available hereto provide an opportunity for public review of new draft recommendations. The open comment period runs from Oct. 14 to Nov. 7.
With the recent growing number of neoadjuvant therapy clinical trials for non-small cell lung cancer, there is a great need for standardization of specimen processing since major pathologic response has consistently been shown to be an important prognostic indicator.
The purpose of the paper is to outline detailed recommendations on how to process lung cancer resection specimens and to define pathologic complete response including major pathologic response and pathologic complete response following neoadjuvant therapy.
Currently there is no established guidance on how to process and evaluate resected lung cancer specimens following neoadjuvant therapy in the setting of clinical trials and clinical practice, Giorgio Scagliotti, past president of the IASLC and co-author of the paper, said in a statement. There is also a lack of precise definitions on the degree of pathologic response, including MPR or pCR.
IASLC is making an effort to collect such data from existing and future clinical trials. These recommendations are intended as guidance for clinical trials, although it is hoped they can be viewed as suggestions for good clinical practice outside of clinical trials, to improve consistency of pathologic assessment of treatment response.
The recommendations were developed by the IASLC Pathology Committee in collaboration with an international multidisciplinary group of experts in medical oncology, thoracic surgery and radiology.
We are crossing an exciting period of preclinical and clinical research around thoracic oncology. Targeted therapies and immunotherapy have greatly improved survival expectations in advanced disease and we believe they can equally generate benefit in the systemic therapy of earlier stages of the disease, Scagliotti said in a statement. Our initiative aims to use rigorous experimental conditions to analyze tissue specimens, collected in the context of already performed or ongoing neoadjuvant studies with targeted therapies and immunotherapy, to generate a diagnostic algorithm to be used in all subsequent studies in order to accelerate the scientific information about the clinical benefit produced by the neoadjuvant approach.
Expert second opinion improves reliability of melanoma diagnoses
Getting a reliable diagnosis of melanoma can be a significant challenge for pathologists.The diagnosis relies on a pathologists visual assessment of biopsy material on microscopic slides, which can often be subjective.
Of all pathology fields, analyzing biopsies for skin lesions and cancers has one of the highest rates of diagnostic errors, which can affect millions of people each year.
Now, a study led by UCLA researchers, has found that obtaining a second opinion from pathologists who are board certified or have fellowship training in dermatopathology can help improve the accuracy and reliability of diagnosing melanoma, one of the deadliest and most aggressive forms of skin cancer.
A diagnosis is the building block on which all other medical treatment is based,Joann Elmore, a professor of medicine at the David Geffen School of Medicine at UCLA and researcher at the UCLA Jonsson Comprehensive Cancer Center, said in a statement.All patients deserve an accurate diagnosis. Unfortunately the evaluation and diagnosis of skin biopsy specimens is challenging with a lot of variability among physicians.
In the study, led by Elmore and colleagues, the value of a second opinion by general pathologists and dermatopathologists were evaluated to see if it helped improve thecorrect diagnostic classification.
To evaluate the impact of obtaining second opinions, the team used samples from the Melanoma Pathology Study, which comprises of 240 skin biopsy lesion samples. Among the 187 pathologists who examined the cases, 113 were general pathologists and 74 were dermatopathologists.
The team studied misclassification rates, which is how often the diagnoses of practicing US pathologists disagreed with a consensus reference diagnosis of three pathologists who had extensive experience in evaluating melanocytic lesions. The team found that the misclassification of these lesions yielded the lowest rates when first, second and third reviewers were sub-specialty trained dermatopathologists. Misclassification was the highest when reviewers were all general pathologists who lacked the subspecialty training.
Our results show having a second opinion by an expert with subspecialty training provides value in improving theaccuracy of thediagnosis, which is imperative to helpguide patients to the most effective treatments, said Elmore, whois also the director of the UCLA National Clinician Scholars Program.
Elmore is now studying the potential impact of computer machine learning as a tool to improve diagnostic accuracy. She is partnering with computer scientists who specialize in computer visualization of complex image information, as well as leading pathologists around the globe to develop an artificial intelligence (AI)-based diagnostic system.
Michael Piepkorn of the University of Washington School of Medicine is the studys first author. Raymond Barnhill of the Institut Curie is the co-senior author.
The study was published in JAMA Network Open and supported by NCI.
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UCLA opens CAR T-cell trial focused on the most common types of lymphoma, leukemia - The Cancer Letter Publications
The Best Fruit-Based Skincare Products You Need This Season – Men’s Journal
By daniellenierenberg
All-natural grooming product labels are starting to read like grocery shopping lists. Thats because fruit is more than a healthy snack. Many of them possess skin-saving properties that eliminate the need for lab-made chemicals. Heres what were slathering on.
(1) Brandless Avocado Basil Hand Cream ($4) rejuvenates dry paws with a blend of avocado (yes, its a fruit) and almond oils, plus shea butter.
(2) Citrus is a natural stimulant, so a swipe of Way of Will 02 Lime + Black Spruce Deodorant ($13) perks you up, while geranium extract nixes body odor.
(3) For city dwellers, Malin+Goetz Advanced Renewal Moisturizer ($76) uses antioxidant-rich apple stem cells to protect the face from urban grime.
(4) Cold-pressed oils from apricot kernels, sunflower seeds, sage leaves, and more in Caldera Labs The Good Serum ($97) are so moisturizing that a few drops can sub in for face lotion. Use twice daily to help with fine lines, too.
(5) Nondrying Ye Ol Goat Soap Lemon + Verbena ($14) mixes olive oil and goat milkfor skin elasticitywith antibacterial citrus extract.
(6) Lucky Bastard Co. Premium Lip Balm ($8) combines fruit oils (coconut, avocado, raspberry seed) with beeswax to create a hydrating seal. And the flat slider container wont bulk up your front pocket.
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The Best Fruit-Based Skincare Products You Need This Season - Men's Journal
Incyte Announces that the REACH2 Pivotal Trial of Ruxolitinib (Jakafi) Meets Primary Endpoint in Patients with Steroid-Refractory Acute…
By daniellenierenberg
WILMINGTON, Del.--(BUSINESS WIRE)--Incyte Corporation (Nasdaq:INCY) today announced positive results from the Novartis-sponsored pivotal Phase 3 REACH2 study evaluating ruxolitinib (Jakafi) in patients with steroid-refractory acute graft-versus-host disease (GVHD). The study met its primary endpoint of improving overall response rate (ORR) at Day 28 with ruxolitinib treatment compared to best available therapy. No new safety signals were observed, and the ruxolitinib safety profile in REACH2 was consistent with that seen in previously reported studies in steroid-refractory acute GVHD.
Further analysis of the safety and efficacy data is ongoing. Novartis expects to initiate discussions with ex-U.S. regulatory authorities in 2020, and to submit REACH2 results for presentation at an upcoming scientific meeting.
GVHD is a challenging and serious disease, and physicians around the world need access to therapies that can improve outcomes for patients, said Peter Langmuir, M.D., Group Vice President, Targeted Therapies, Incyte. This positive result of the REACH2 study is excellent news for patients as it further reinforces the potential of ruxolitinib as a treatment option that can provide meaningful results for patients with steroid-refractory acute GVHD.
GVHD is a condition that can occur after an allogeneic transplant (the transfer of stem cells from a donor) where the donated cells initiate an immune response and attack the transplant recipients organs, leading to significant morbidity and mortality. There are two major forms of GVHD, acute and chronic, that can affect multiple organ systems including the skin, gastrointestinal (digestive) tract and liver.
Earlier this year, Jakafi was approved by the U.S. Food and Drug Administration (FDA) for the treatment of steroid-refractory acute GVHD in adult and pediatric patients 12 years and older based on results of the REACH1 trial. Jakafi is marketed by Incyte in the U.S.; ruxolitinib (Jakavi) is licensed to Novartis ex-U.S.
In addition, the pivotal REACH3 trial evaluating ruxolitinib in patients with steroid-refractory chronic GVHD is ongoing. A recent interim efficacy and safety analysis conducted by an Independent Data Monitoring Committee has recommended that REACH3, which is co-sponsored by Incyte and Novartis, should continue without modification. The results of the REACH3 trial are expected to be available in 2020.
About REACH2
REACH2 (NCT02913261) is a randomized, open-label, multicenter Phase 3 study sponsored by Novartis, evaluating safety and efficacy of ruxolitinib compared with best available therapy in patients with steroid-refractory acute GVHD.
The primary endpoint was overall response rate (ORR) at Day 28, defined as the proportion of patients demonstrating a best overall response (complete response or partial response). Secondary endpoints include durable ORR at Day 56, ORR at Day 14, duration of response, overall survival and event-free survival, among others. For more information about the study, please visit https://clinicaltrials.gov/ct2/show/NCT02913261.
About REACH
The REACH clinical trial program is evaluating Jakafi in patients with steroid-refractory GVHD and includes the collaborative Novartis-sponsored randomized pivotal Phase 3 trials: REACH2 and REACH3. The ongoing REACH3 trial is evaluating patients with steroid-refractory chronic GVHD with results expected next year. For more information about the REACH3 study, please visit https://clinicaltrials.gov/ct2/show/NCT03112603.
The REACH program was initiated with the Incyte-sponsored REACH1 trial, a prospective, open-label, single-cohort, multicenter, pivotal Phase 2 trial (NCT02953678) evaluating Jakafi in combination with corticosteroids in patients with steroid-refractory grade II-IV acute GVHD. For more information about the study, including trial results, please visit https://clinicaltrials.gov/show/NCT02953678.
About Jakafi (ruxolitinib)
Jakafi is a first-in-class JAK1/JAK2 inhibitor approved by the U.S. FDA for treatment of steroid-refractory acute GVHD in adult and pediatric patients 12 years and older.
Jakafi is also indicated for treatment of polycythemia vera (PV) in adults who have had an inadequate response to or are intolerant of hydroxyurea as well as adults with intermediate or high-risk myelofibrosis (MF), including primary MF, post-polycythemia vera MF and post-essential thrombocythemia MF.
Jakafi is marketed by Incyte in the United States and by Novartis as Jakavi (ruxolitinib) outside the United States. Jakafi is a registered trademark of Incyte Corporation. Jakavi is a registered trademark of Novartis AG in countries outside the United States.
Important Safety Information
Jakafi can cause serious side effects, including:
Low blood counts: Jakafi (ruxolitinib) may cause your platelet, red blood cell, or white blood cell counts to be lowered. If you develop bleeding, stop taking Jakafi and call your healthcare provider. Your healthcare provider will perform blood tests to check your blood counts before you start Jakafi and regularly during your treatment. Your healthcare provider may change your dose of Jakafi or stop your treatment based on the results of your blood tests. Tell your healthcare provider right away if you develop or have worsening symptoms such as unusual bleeding, bruising, tiredness, shortness of breath, or a fever.
Infection: You may be at risk for developing a serious infection during treatment with Jakafi. Tell your healthcare provider if you develop any of the following symptoms of infection: chills, nausea, vomiting, aches, weakness, fever, painful skin rash or blisters.
Skin cancers: Some people who take Jakafi have developed certain types of non-melanoma skin cancers. Tell your healthcare provider if you develop any new or changing skin lesions.
Increases in cholesterol: You may have changes in your blood cholesterol levels. Your healthcare provider will do blood tests to check your cholesterol levels during your treatment with Jakafi.
The most common side effects of Jakafi include: for certain types of MF and PV - low platelet count, low red blood cell count, bruising, dizziness, and headache; and for acute GVHD low red blood cell counts, low platelet counts, low white blood cell counts, infections and fluid retention.
These are not all the possible side effects of Jakafi. Ask your pharmacist or healthcare provider for more information. Tell your healthcare provider about any side effect that bothers you or that does not go away.
Before taking Jakafi, tell your healthcare provider about: all the medications, vitamins, and herbal supplements you are taking and all your medical conditions, including if you have an infection, have or had tuberculosis (TB), or have been in close contact with someone who has TB, have or had hepatitis B, have or had liver or kidney problems, are on dialysis, have a high level of fat in your blood (high blood cholesterol or triglycerides), had skin cancer or have any other medical condition. Take Jakafi exactly as your healthcare provider tells you. Do not change or stop taking Jakafi without first talking to your healthcare provider.
Women should not take Jakafi while pregnant or planning to become pregnant. Do not breast-feed during treatment with Jakafi and for 2 weeks after the final dose.
Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi, is available at http://www.jakafi.com.
About Incyte
Incyte Corporation is a Wilmington, Delaware-based biopharmaceutical company focused on the discovery, development and commercialization of proprietary therapeutics. For additional information on Incyte, please visit the Companys website at http://www.incyte.com.
Follow @Incyte on Twitter at https://twitter.com/Incyte.
Forward Looking Statements
Except for the historical information set forth herein, the matters set forth in this press release, including statements regarding whether and when the REACH2 data will be presented, when results from the REACH3 study will be available, and the effect of the REACH2 results on patients with GVHD, contain predictions, estimates and other forward-looking statements.
These forward-looking statements are based on the Companys current expectations and subject to risks and uncertainties that may cause actual results to differ materially, including unanticipated developments in and risks related to: unanticipated delays; further research and development and the results of clinical trials possibly being unsuccessful or insufficient to meet applicable regulatory standards or warrant continued development; the ability to enroll sufficient numbers of subjects in clinical trials; determinations made by the FDA; the Companys dependence on its relationships with its collaboration partners; the efficacy or safety of the Companys products and the products of the Companys collaboration partners; the acceptance of the Companys products and the products of the Companys collaboration partners in the marketplace; market competition; sales, marketing, manufacturing and distribution requirements; greater than expected expenses; expenses relating to litigation or strategic activities; and other risks detailed from time to time in the Companys reports filed with the Securities and Exchange Commission, including its Form 10-Q for the quarter ended June 30, 2019. The Company disclaims any intent or obligation to update these forward-looking statements.
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Incyte Announces that the REACH2 Pivotal Trial of Ruxolitinib (Jakafi) Meets Primary Endpoint in Patients with Steroid-Refractory Acute...
Racial Disparities In NIH R01 Funding May Be Partly Caused By Topic Choice : Shots – Health News – NPR
By daniellenierenberg
A recent study looked at funding rates for R01 grant applications, which are designed to support "health-related research and development based on the mission of the NIH." In general, population-based projects were less likely to be funded than explorations of cellular mechanisms, the study found. Will & Deni McIntyre/Science Source hide caption
A recent study looked at funding rates for R01 grant applications, which are designed to support "health-related research and development based on the mission of the NIH." In general, population-based projects were less likely to be funded than explorations of cellular mechanisms, the study found.
Black applicants to a prestigious research grant program at the National Institutes of Health are awarded funding at a significantly lower rate than their white peers. The NIH has been intensively investigating this funding gap since a 2011 report revealed the extent of the problem, looking for underlying mechanisms to use as opportunities for corrective intervention.
NIH's latest finding, described in a study released this month in the open-access journal Science Advances, reveals that part of the gap can be attributed to differences in the types of topics scientists propose studying and how those topics are valued by grant reviewers.
The study of grant applications submitted between 2011 and 2015 suggests African American scientists may be more likely to pursue research in topic areas such as community-oriented research on disease prevention, for example, versus more microscopic-level research on cellular mechanisms or the basics of genetics. Those population-based topics aren't being funded as readily.
And that's a problem with the system, some outside researchers point out not with the choice of research topic.
"I do think that the areas of research that apparently are being funded at a lower rate are important," says David Asai, senior director for science education at Howard Hughes Medical Institute and an advocate for diversity in STEM, who was not involved in the NIH analysis. "This study might prompt the community to think about the underlying biases we might have in deciding what sorts of research deserve greater attention."
The NIH study looked at funding rates in the form of successful applications for R01 grants, which are designed to support "health-related research and development based on the mission of the NIH."
Despite NIH efforts to diversify the pool of scholars doing medical research, white applicants for these grants continue to receive funding at nearly twice the rate of black applicants 17.7% of white applicants were approved in fiscal years 2011-2015 compared with 10.7% of black applicants.
The researchers analyzed keywords in the topics of 157,549 grant applications and found that some topics were close to four times more likely to gain funding support.
"Among the less favored [topics] are areas that include study of groups of people," says Dr. James Anderson, deputy director for program coordination, planning and strategic initiatives at the NIH and one of the authors of the paper.
"These topics are are described by words like socioeconomic status, physical activity, pregnancy," Anderson says. "The ones that did best were really about molecular mechanisms cells, or parts of cells. Words like cilium, DNA polymerase, chimeral chemistry, ribosome. It's not absolute, but it's really quite a striking distinction." The success rates by topic ranged from about 29% to 7.5%.
The researchers used self-reported demographic data in an optional portion of the application one that was not visible to the grant reviewers to identify each applicant's race. They found that over a third of the applications from black scientists were tied to just eight of the 150 topic clusters.
Six of those eight topics involved "communities, or health disparities, and so on," says Anderson, "and those were in the topics that didn't do quite as well" in the funding process.
This difference in topic preference can account for 20% of the overall funding gap for black applicants, the study found, after controlling for other variables such as the applicant's prior academic and professional experience and accomplishments.
Dr. Hannah Valantine, director of the Office of Scientific Workforce Diversity at the NIH and another author on the paper, says black scientists might be more drawn to certain topic areas at the population level because "connection to one's community, and seeing the disparities, drives people to go into science to create a better environment for their community."
"It's critically important that African American scientists are able to advance their career and stay in academia, not only for their own success, but for enhancing the diversity of the biomedical workforce," Valantine says. "Because we know already that when we have a diverse scientific enterprise, we come up with more creative solutions to the problems that we seek to solve."
That concern resonates with Stephani Page, a postdoctoral fellow in biophysics at Duke University Molecular Physiology Institute and initiator of the Twitter hashtag #BLACKandSTEM, even though her field of study lies on the more statistically successful end of the grant-getting spectrum.
"For me, personally," Page says, "the science that gets me really excited, and I get tingles about, tends to be more quantitative, mechanistic science. But I also have the experience of coming up growing up and being a mom as a black woman in this skin. So when I think about what I want my career to be, it's difficult for me to detach from my career meaning something to my community more broadly."
Page says she is losing hope that she can have the community impact she wants helping black scientists feel affirmed while working in her current field. "I don't want to be a scientist who can't be committed and devoted to changing the system," she says.
One underlying cause of the disparity this study documented, Page says, might be that many of the NIH reviewers who evaluate grant proposals only 2.4% of whom were black in this study lack a certain lens when evaluating what research topics deserve priority.
"If you haven't grown up with inequity as deeply ingrained in your lived experience, it's not going to be as important a lens in your life decisions," she says. "The fact that there's data behind it now gives us a space to talk about it differently. Now we can begin to say that the lens makes a difference."
Valantine says the NIH is also actively evaluating whether the disparity is partly due to racial bias by reviewers. A study to be published early next year, she says, "will tell us whether, if we anonymize an application, we can close this gap."
Whatever the causes of the diversity gap, she says, the NIH is committed to closing it, and the study's results suggest several areas of intervention that could help. For one, the NIH has already begun mentoring programs aimed at increasing the diversity of the grant applicant pool.
"Black applicants submitted only 1.5% of the total applications for these R01s," Valantine says, adding that "we must do all we can" to increase that percentage.
In the meantime, the underfunded topics that the study identified are " 'mission critical' areas of NIH," Valantine says. "The solution is figuring out, within NIH, how we can make sure that those areas are funded."
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Racial Disparities In NIH R01 Funding May Be Partly Caused By Topic Choice : Shots - Health News - NPR
Dr. Raj & Stem Cell Therapy Innovation – LATF USA
By daniellenierenberg
For anyone who has had hip replacement surgery, Im sure they will agree that it is better to get hit by a bus than to undergo another one. Last year after several years of suffering, I decided to take the leap and go for the hip replacement that my specialist recommended. I was told that it was a common surgery and that it was the best solution for me. Between us; it was probably the most painful thing I have ever gone through. So much so, that at the time, I just wanted to die. Not only did the pain persist for several weeks after the operation, but I was on painkillers for days, which eventually added to my suffering. I had to use a walker for the first 2 weeks and then depended on a cane for over 2 months before I could walk on my own.
My entire demeanor changed, as well as the way I dealt with what once were minor things in life. I feared slipping in the shower, going down the stairs or walking my dogs. No one had prepared me for this. Ive had my share of surgeries including a double mastectomy when I was diagnosed with breast cancer but pain wise; this one was by far the worse. I was hoping after a very long recovery that I would never have to face this situation again. Unfortunately, a year later, I am starting to feel pain on the other side and dread the re-experience of my nightmare.
Although, I heard about Stem Cell, I did not know much about it. So I started to investigate for myself, speak to people, enquire about the procedure and look for a doctor in my area who specialized in Stem Cell. I was willing to do just about anything before considering another hip replacement. After extensive research, I came across Dr. Raj, a Double-Board Certified Orthopedic doctor in Beverly Hills, CA. Going to his website; I learned that he has been in private practice for 10 years. He has been named as one of Americas Top Orthopedists, been featured on the Best of LA and has received numerous other accolades and awards as one of the Top Orthopedic doctors. Providing the ultimate in state-of-the-art orthopedic care, Dr. Rajs practice is always on the cutting-edge of surgical and nonsurgical technologies, such as PRP (Platelet Rich Plasma) injections, stem cell injections for tendinitis and arthritis, minimally invasive surgery and more.
He is Board Certified as a Medical Legal Specialist in America, as well as, Canada and Dubai (Trial, Testimony, Deposition, IME) with a Subspecialty in Hip and Knee Surgery in Los Angeles, including Sports Surgeries.
He is also an Undergraduate from Dalhousie University in Halifax and Canada. He pursued his medical education at Memorial University PGME, before doing his internship and residency in the Department of Orthopedic Surgery. Now that I had found Dr. Raj, all I needed was to get myself educated. So lets start by what are stem cells? This is what I read: Mesenchymal stem cells (MSCs), commonly called stem cells, are precursor cells that havent decided yet what they are going to be in the body. They can differentiate into multiple forms including bone, cartilage, fat and other connective tissues. They play a significant role in the reparative processes throughout the human body.
Where do we find stem cells?
They may be harnessed from fat tissue, bone marrow, synovial tissue or umbilical cord tissue. While stem cell therapy is a promising technology, there is much we are still learning about the causes and pathways that lead to symptomatic osteoarthritis. We have not optimized the factors found in stem cell therapies. To be sure, only the good cells and growth factors are injected into a specific joint. And that is why further research is necessary before being approved by the FDA.
My next move would be to consult with Dr. Raj who would tell me the medical truth, beginning with this question:
What is the current state of Stem Cells and its success rate?
It's relatively new. It's been popular for about 20 years, internationally. In areas like Germany and Korea, it was utilized a lot more. It became popular here when athletes like Kobe Bryant started going to Germany for modified versions of PRP, which led on to regenerative technologies. We have a stigma correlating stem cells with abortions and issues like that. This in itself is completely different. We are not utilizing amniotic stem cells or placenta stem cells. We're utilizing your own stem cells. For issues such as a hip replacement, the most powerful stem cells are the ones in your body. Bone marrow stem cells work well on joints. Joints have zero blood supply. So, if God or the higher power created us where we had blood supply going through our joints, like a cut in our skin - we would constantly replenish or repair. A break in our bone would repair. If you get stem cells and you're in decent enough shape, you will heal no matter what because these stem cells will deposit. Will you heal straight? Probably not - that's where we come into play.
The reason why joints; hips, knees and shoulders degenerate is because there is no blood supply. So, if you have a cut or a loss of cartilage, it stays like that and accumulates overtime. The only way you can control it is externally. You get stronger, you lose weight and you increase your range of motion. But you can't control anything internally.
So regenerative technology is basically utilizing these cells to regenerate cartilage and repair. These are the same cells that flow through our body - and upon signal of an injury will heal skin to skin, bone to bone, tendon to tendon, muscle to muscle. Our joints are just an alcove of joint fluid and no blood supply. The whole concept is - throughout the years, we did steroid injections - they're like band aids. Basically they mask pain. What does masking pain do? It propagates injury. Because we put the band aid on, we don't feel it and we do more. We take this little cut or loss of cartilage and we make it even more over time.
Why is it that specialists do not recommend seeing a surgeon at a certain stage?
There are a lot of people who think one way and everyone is entitled to their own opinions. You can't change opinions.
Are people afraid of stem cells?
Some people are afraid because of stem cells causing cancer. But that's embryonic stem cells.
What is the process?
Bone marrow stem cells are the best because there is a higher chance of live stem cells. Less manipulation, meaning that - in a Mayo Clinic study 4 or 5 years ago, which has a two year follow through on people who are ready to get replacements for joint or knee - they had an 80% success rate where they didn't need it. I do replacements and I do stem cells.
How do you determine what's better for the patient?
My knowledge and years of experience. Also, my knowledge with fitness and being athletic myself. Understanding at a certain point, someone is mechanically compromised. Bone on bone is a term that's been used for years. There are a lot of people who think they are 'bone on bone." Coming from Canada, the US is notorious for doing unnecessary surgeries and replacements. It's the highest rate of replacements in the world. I do not like the term 'bone on bone' because a surgeon will look at an x-ray and say you're bone on bone because that's all they do: replacements. They become a 7-11 or 99 Cents store, lining up 21 people a day. That's not the right way to do things. You don't want to be one of those 21 people getting a replacement because you're not getting that surgeon's full attention. The reality is - you have a PA or an old plastic surgeon who's doing most of your surgery and there is more likelihood of issues. Amongst every specialty there is a lot of ignorance. The whole concept is - you preserve what you have for as long as you can. You have beauty on the outside; you need beauty on the inside too. What's beauty on the inside? Feeling good, you're less inflamed and your joints are healthy.
How does it work with a stem cell procedure?
I extract bone marrow from your pelvis. Take approximately 6 ccs. Under slight sedation, it takes about 5 minutes to take it. Then we separate it via an FDA approved technique. Per FDA, we cannot add anything to it, nor would I want to. We cannot harvest it because the longer it's outside of the body, the better it is. Basically, we then inject those pure cells right away into the joint. It's a four month process for an 80% of regeneration. So, it's not just reduction of inflammation, it's regeneration. It will be a year for a 100% effect. I've had probably about 20% of patients who have taken 6 months+. I've had over a 95% success rate with this technology.
Are you one of the only doctors doing this in LA?
I'm one of them. There are some family and pain management doctors who are doing it. I'm the only Orthopedic surgeon doing it. I'm sure different practitioners are starting to.
Dr. Raj and patient Paula Abdul
How often do you do the stem cell procedure?
You do it one time. It's a powerful injection and there are people Ihave 6 years out who are doing well.
Does it hurt after the fact?
No, not at all. You can walk and move. For example, with your hip - I would combine it with physical therapy to increase your range of motion. Once you have the anti-inflammatory effect, you have to take advantage of it. If you don't increase your range of motion - what happens is - you're walking on one nail vs. 100 nails. You want to dissipate the force over a greater area so that there's a higher chance of external success. Then you strengthen the muscles.
Are there people who are not good candidates for it?
Yes, when it's too far gone. Like I said, people are told they're bone on bone when they're not. They show you different views. It's a marketing gimmick. That person is lined up and ready to sell. Age is relative. There's physiologic age. It really depends on the person. Hypothetically, if you're an inflamed mess, a drinker and abusive to your body, then nothing is going to work. If you take care of yourself and you're motivated with the right protoplasm, then it's going to work.
What about the skeptics or the ones who think it's bad for you?
Don't get me wrong; amniotic stem cells are good for certain situations. Embryonic is bad. It means that it's too far gone. You want live stem cells in an area that does not have blood supply. The data is out there. How can you argue against a Mayo Clinic study with an 80% success rate? How can you argue against the hospitals for special surgery in New York that's doing it, or the Steadman Hawkins Clinic, I'm doing it. Top facilities in the world are doing it and a number of top athletes who are getting it done with success rates. Who's ignorant? Is it that one surgeon or everyone else?
Does insurance cover it?
No, not yet. Insurances are very backwards in terms of their understanding. They would rather cover a replacement.
Is it expensive?
If you break it down par and par and avoid a replacement, not really. On average, you're talking about $7,000, versus hospital, surgeon, facility fees+++,which can be about $25,000.
You're very progressive.
There are a lot of things that I do to try and reduce pain significantly.When I use screws, I use screws that are made out of calcium so they dissolve in your body. Some of my colleagues use tourniquet, I don't use one. I control bleeding and do it in less than an hour. The whole concept is, you don't have atourniquetsqueezing your leg and toxins causing significant pain.
And there you have it. Everything is a risk in life, we do not know if we will wake up tomorrow or if you will get hit by a car and so on so why not try this procedure. I believe that I am lucky enough to have met Dr. Raj. I have taken the decision to undergo the stem cells therapy FDA approved or not, anything before going under the knife one more time. Stay tuned, I will give you a report on the progress.
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Dr. Raj & Stem Cell Therapy Innovation - LATF USA
Global Cosmetic Skin Care Market 2019: Industry Analysis and Detailed Profiles of Top Industry Players LOral, Unilever, New Avon Company, Este Lauder…
By daniellenierenberg
Global Cosmetic Skin Care Market report covers the present scenario and the growth prospects of the global market and includes a discussion of the key vendors operating in the market. It intends to supply an entire 360-degree perspective of this market concerning cutting edge technology, key advancement, drivers and restraints and prospective trends with impact analysis. This study also analyzes the market status, market share, growth rate, future trends, market drivers, opportunities and challenges, risk and entry barriers. This Global Cosmetic Skin Care Market report presents the market competitive landscape and a corresponding detailed analysis of the major vendor/key players in the market.
Global cosmetic skin care market is set to witness a substantial CAGR of 5.5% in the forecast period of 2019- 2026. The report contains data of the base year 2018 and historic year 2017. Increasing self-consciousness among population and rising demand for anti- aging skin care products are the factor for the market growth.
Key Market Competitors:
Few of the major competitors currently working in the global cosmetic skin care market are LOral, Unilever, New Avon Company, Este Lauder Companies, Espa, Kao Corporation, Johnson & Johnson Services, Inc., Procter & Gamble, Beiersdorf, THE BODY SHOP INTERNATIONAL LIMITED, Shiseido Co.,Ltd., Coty Inc., Bo International, A One Cosmetics Products, Lancme, Clinique Laboratories, llc., Galderma Laboratories, L.P., AVON Beauty Products India Pvt Ltd, Nutriglow Cosmetics Pvt. Ltd, Shree Cosmetics Ltd among others.
Market Definition:
Cosmetic skin care is a variety of products which are used to improve the skins appearance and alleviate skin conditions. It consists different products such as anti- aging cosmetic products, sensitive skin care products, anti- scar solution products, warts removal products, infant skin care products and other. They contain various ingredients which are beneficial for the skin such as phytochemicals, vitamins, essential oils, and other. Their main function is to make the skin healthy and repair the skin damages.
Segmentation:Global Cosmetic Skin Care Market
Global Cosmetic Skin Care Market By Product (Anti-Aging Cosmetic Products, Skin Whitening Cosmetic Products, Sensitive Skin Care Products, Anti-Acne Products, Dry Skin Care Products, Warts Removal Products, Infant Skin Care Products, Anti-Scars Solution Products, Mole Removal Products, Multi Utility Products), Application (Flakiness Reduction, Stem Cells Protection against UV, Rehydrate the skins surface, Minimize wrinkles, Increase the viscosity of Aqueous, Others), Gender (Men, Women), Distribution Channel (Online, Departmental Stores and Convenience Stores, Pharmacies, Supermarket, Others), Geography (North America, Europe, Asia-Pacific, South America, Middle East and Africa) Industry Trends and Forecast to 2026
Competitive Analysis:
Global cosmetic skin care market is highly fragmented and the major players have used various strategies such as new product launches, expansions, agreements, joint ventures, partnerships, acquisitions, and others to increase their footprints in this market. The report includes market shares of cosmetic skin care market for Global, Europe, North America, Asia-Pacific, South America and Middle East & Africa.
Table Of Content: Cosmetic Skin Care Market
Part 01: Executive SummaryPart 02: Scope Of The ReportPart 03: Cosmetic Skin CarePart 04: Global Cosmetic Skin Care Market SizingPart 05: Global Cosmetic Skin Care Market Segmentation By ProductPart 06: Five Forces AnalysisPart 07: Customer LandscapePart 08: Geographic LandscapePart 09: Decision FrameworkPart 10: Drivers And ChallengesPart 11: Market TrendsPart 12: Vendor LandscapePart 13: Vendor Analysis
Continue. .
For Detailed TOC @ https://www.databridgemarketresearch.com/toc/?dbmr=global-cosmetic-skin-care-market
Market Drivers:
Market Restraints:
Key Developments in the Market:
Key Insights in the report:
The report provides insights on the following points:
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Data Bridge Market Research set forth itself as an unconventional and neoteric Market research and consulting firm with unparalleled level of resilience and integrated approaches. We are determined to unearth the best market opportunities and foster efficient information for your business to thrive in the market. Data Bridge endeavors to provide appropriate solutions to the complex business challenges and initiates an effortless decision-making process.
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Global Cosmetic Skin Care Market 2019: Industry Analysis and Detailed Profiles of Top Industry Players LOral, Unilever, New Avon Company, Este Lauder...
Top 5 stories on cosmetic formulation and science – CosmeticsDesign-Asia.com
By daniellenierenberg
1 VIDEO: Alternative animal testing device may soon be available to the cosmetics industry
The team behind an alternative animal testing device, skin-on-a-chip, is forming new start-up to commercialise the product and offer its services to the cosmetic industry.
At this years Society of Comstics Scientists (SCSS) Suppliers Day, we sat down with Dr. Massimo Alberti, from Polaris Science to learn more about the innovation, which is backed by The Singapore Institute of Manufacturing Technology (SIMTech).
Alberti and his colleagues successfully reconstructed human skin on a compact, microfluidic device which can reduce or eventually replace animal testing.
The device is a system where you can stimulate blood flow, recreate the microenvironment in which the skin or the tissue you want to study is absolutely close to the physiological condition, said Alberti, who believes will be a game-changer for the industry.
[The cosmetic industry] is constantly struggling with the cost of R&D and need to bring products on the market as fast as they can. At the same time, the whole supply chain is affected because the ingredient providers and research organisations that have to follow those needs and also be able to provide those kinds of service rapidly and reliably, he said.
2 Dior collaborates with leading Japanese lab to study the mechanism of skin metabolism
The research arm of LVMH is collaborating with the Centre for iPS Cell Research and Application of Kyoto University (CiRA) to study the mechanism of skin metabolism for Parfums Christian Dior.
The aim of the joint project is to explore how oxidative metabolism affects skin keratinocyte self-renewal or differentiation capabilities.
The effects of age on mitochondrial status, skin regeneration and differentiation will be investigated with the hope of contributing to major therapeutic discoveries in the skin and cutaneous rejuvenation, said CiRA in a press statement.
Under the direction of Nobel Prize laureate Shinya Yamanaka, CiRA is a leading centre for induced pluripotent stem cell research.
According to CiRA, iPS cells are cells generated by introducing a small number of factors into body cells such as skin cells and blood cells.
3 Super hydrator: Kao develops new formulation that targets rough and dry skin
Kao Corporation has developed a novel formulation which it claims can smooth away roughness caused by dry skin.
Developed by the Japanese firms Skin Care Laboratory, Material Science Laboratory, and Analytical Science Laboratory, the formulation is a combination of large water-content alpha-gel and an OXP-SI polymer.
The combined formula was found to be absorbed into regions with micro-scaling. According to Kao, micro-scaling is a condition in which the horny layer skin is thinly exfoliated in pieces.
According to a survey conducted by Kao, an increasingly large number of Japanese women now suffer from dry skin. Among them, more than 90% were found to have micro-scaling on the skin surface.
4 Moisture-retaining membrane: Kao develops new formula with fine fibre tech to reduce moisture-loss on skin
Further research on Kaos fine fibre technology has revealed its effects on protein expression in the stratum corneum and potential to improve skin condition with what the firm claims is a unique formula.
Kao Corporation first announced the development of its fine fibre technology in 2018. The technology creates a barely-visible film on the skins surface, creating an ultra-thin membrane on looks and feels natural.
Since then, the companys Skincare Research Laboratory and Analytical Science Laboratory have developed a novel formula based on fine fibre tech which claims to control water evaporation on the surface of skin.
Futher research found that controling the moisture premaebility affects the expression of the proteins that were linked to healthy skin conditions.
5 Base notes with benefits: Down Under expands wood oils portfolio to meet APAC consumer demands
Australian ingredient provider Down Under Enterprises has launched a collection of native Aussie wood oils to cater to the increasingly complex demands of APAC beauty consumers.
The collection consists of locally-scoured Australian blue cypress oil, Australian buddha wood oil, Australian sandalwood oil, Indian sandalwood oil and Australian white cypress wood oil.
Phil Prather, head of marketing and operations at Down Under Enterprises, told CosmeticsDesign-Asia that the firm believed there was a need for more variety of oils that offer functional benefits.
For instance, Prather elaborated, buddha wood oil and blue cypress oil have anti-inflammatory properties while white cypress oil has demonstrated skin brightening properties.
What we want formulators to understand is that these oils are more than just a base note. These oils can provide functional properties for their formulations. Properties that are based on clear science that has been published in clinical papers, he said.
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Top 5 stories on cosmetic formulation and science - CosmeticsDesign-Asia.com
9 Iconic Anti-Aging Eye Creams, and Their More Affordable Dupes – Yahoo Lifestyle
By daniellenierenberg
We know we're not alone when we say that we could easily spend a large chunk of our salaries on skincare. Between the constant new launches and those OG holy grails, there are just too many opportunities to shop. As beauty editors, we're lucky enough to have access to the most luxurious products on the market, but we're well aware that it's not always feasible to shell out so much money on lotions and potionsespecially on a polarizing product like eye cream.
Some folks swear by the stuff for refining fine lines and keeping puffiness at bay, while others just don't see the point. We happen to identify with the former and as such are quite looped into the formulas that perform best. On the other hand, we're committed to bringing you the affordable options that still get the job done. Luckily, there are plenty of lower-costproducts that can help mitigate the effects that aging has on the delicate orbital skin.
Here, find nine iconic eye creams beauty insiders swear by and the similar, more affordable dupes that will help you leave tired eyes in 2019. Just because there are bags under your eyes doesn't mean you have to pay designer prices to get rid of them. (Unless you want to, in which case, you also have our blessing.)
MZ Skin Soothe & Smooth Collagen Activating Eye Complex ($149)
Beautycounter Countertime Ultra Renewal Eye Cream ($69)
Savings: $80
How they're similar:The hero ingredient in both of these potent eye treatments is albizia bark, otherwise known as Persian silk tree. This extract can help eliminate toxic collagen inhibitors likeglycogens. On top of reducing the appearance of crow's-feet and other fine lines, you can also expect either of these products to de-puff and brighten the eye area.
IS Clinical Youth Eye Complex ($98)
Image Skincare Ageless Total Eye Lift Crme ($48)
Savings: $50
How they're similar:You can thank a number of exfoliating and hydrating acids and highly efficacious stabilized vitamin C for the lifting and plumping effects you'll see when using these science-backed formulations. Both are highly respected among skincare professionals, so you really can't go wrong here.
Royal Fern Phytoactive Anti-Aging Eye Cream ($190)
Miracle Age Miracle Age Repair Eye Cream ($56)
Savings: $134
How they're similar:While the Royal Fern option is beloved for its ultra-clean approach to effective, result-oriented skincare, the price tag certainly says a lot about the barrier of entry for experiencing the products. While you're saving up, try the similarly natural select by Korean label Miracle Age, which boasts cooling aloe, moisturizing shea butter, and plumping ceramides.
Tata Harper Restorative Eye Creme ($105)
Youth to the People Superfood Peptide Eye Cream ($35)
Savings: $70
How they're similar:Aloe barbadensis leaf extract is at the forefront of both of these plant-based products. Each of their ingredient lists is densely populated with organic, botanical ingredients that deliveryouth-preserving results.
PCA Skin Ideal Complex Restorative Eye Cream ($88)
Boots No7 Protect Perfect Advanced Intense Eye Cream ($22)
Savings: $66
How they're similar: While the PCA Skin version is admittedly more advanced in its formulation (hello, orange stem cells!), each of these formulas contains wrinkle-reducing peptides as well as light-reflecting titanium dioxide.
Goop by Juice Beauty Perfecting Eye Cream ($90)
Mario Badescu Olive Eye Cream ($18)
Savings: $72
How they're similar: It's no surprise that the Goop option is cleaner than the Mario Badescu cream (and most others on the market, honestly), but oliveleaf drives the hydration factor in both formulas. You'll get a luxurious-feeling, deeply hydrating cream either way.
SkinCeuticals A.G.E. Eye Complex ($98)
Yes To Blueberries Age Refresh Eye Firming ($29)
Savings: $69
How they're similar:Powerful, yet natural, blueberry is the antioxidant that helps each of these creams reverse the signs of damage while also preventing new lines and wrinkles from setting in.
SkinMedica TNS Eye Repair ($102)
Olay Regenerist Retinol 24 Night Eye Cream ($39)
Savings: $63
How they're similar:Retinoids are at play here, with SkinMedica's use of vitamin A and Olay's implementation of retinol. In addition to smoothing out the delicate eye area, both formulas visibly firm and brighten while also working to even out the skin tone.
Dermalogica AGE Smart Age Reversal Eye Complex ($80)
First Aid Beauty Eye Duty Triple Remedy A.M. Gel Cream ($36)
Savings: $44
How they're similar:Both of these lightweight gel creams absorb quickly and offer skin-firming effects from tree barks and peptides. The Dermalogica utilizes retinol to encourage cell turnover, while red algae and seaweed help the First Aid Beauty select deliver similar results.
Up next,I have access to free beauty products, and I still choose these drugstore buys.
This article originally appeared on Who What Wear
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9 Iconic Anti-Aging Eye Creams, and Their More Affordable Dupes - Yahoo Lifestyle
Lab-grown mini brains shed light on how humans split from great apes – The Conversation UK
By daniellenierenberg
Humans diverged from chimpanzees and other great apes roughly 6m years ago. But despite us being closely related, human brains are vastly different enabling us to engage in complex language, science, art, morality and much more. But what exactly was it that enabled our brains to reach such mindboggling heights?
We know that the human brain has dramatically expanded in size over the past 6m years. Humans are in fact the mammals with the largest brain relative to body size. But which specific evolutionary genetic changes enabled larger and more complex brains has long remained a bit of a mystery. Now a new study, published in Nature, offers clues.
One important reason why it has been so hard to study primate brain development is that, until relatively recently, scientists did not have access to living, developing brain tissue. This is what can ultimately allow us to functionally test theories of brain evolution as we can essentially watch how a brain develops over time in a dish and manipulate biological pathways to see what role they play in brain development.
But in the last few years, scientists have worked out how to make lab-grown models of developing brain tissue so-called brain organoids to begin to address these questions.
Organoids are clusters of cells that organise themselves into mini versions of our organs, such as the brain or the liver. Thats because they are made by culturing stem cells, which have the potential to develop into any tissue of the body. These stem cells can be generated directly from cells of adult origin, such as skin or blood cells. They are then grown in a gel that allows them to develop three dimensionally. And thats exactly what the researchers behind the new study did.
So what kind of genetic changes do we think contributed to human brain evolution? Only about 1.5% of our DNA actually consists of genes with instructions for making proteins. Proteins are the molecules that do most of the work in cells and determine the cells structure and function. It was once thought that the remaining 98.5% of DNA was junk with no clear purpose. However, it is now known that some of this DNA may play an important role in controlling which genes are expressed meaning determining how they are turned on and off.
The number of changes in protein-coding regions of DNA are far too few to explain the striking differences observed between humans and other primates. In fact, of the genetic regions that have changed the most since our divergence from chimpanzees, 92% do not overlap with protein-coding DNA.
It is predicted that at least a third of these regions play a role in controlling the expression of genes. It has long been hypothesised that the majority of differences observed between the brains of great apes and us are due to changes in the timing and expression of genes, rather than changes to the gene itself. The vast majority of our genes are therefore identical.
The main focus of the new study was to identify how genes are regulated differently in humans compared to other primates. The authors did this by generating brain organoids from human, chimpanzee and macaque stem cells and compared these at various points over the course of four months. This mimics how a brain forms in the womb, with organoids consisting of multiple growing buds of brain tissue that first consist largely of neural progenitor cells that in later stages begin to make neurons.
From the outside, brain organoids look more like small popcorn than a mini brain and do not reach sizes larger than around five or six millimetres due to a lack of blood supply.
The authors observed that human brain development occurs at a slower pace than the other two primates. This delayed maturation of the human brain makes sense as, given more time, the cells that generate neurons will have a longer period to expand their population, giving rise to more neurons and a bigger brain later on.
The researchers were also able to look at the expression of genes in individual cell types of the brain organoids. They measured the expression of a gene by looking at the levels of a messenger molecule that is made from reading DNA and is necessary to direct the formation of proteins. By comparing gene expression in cells that were developing to become the cerebral cortex which plays an important role in advanced cognitive processes such as awareness, thought, memory, language and consciousness they detected 98 genes that were differently expressed in humans.
Gene expression doesnt tell the whole story though. Its rate is ultimately controlled by a process called gene regulation. In order to identify potential regulatory mechanisms, the authors pinpointed regions of DNA that are accessible or open at the various stages in particular cells. These accessible regions of DNA have the potential to interact with proteins and can regulate gene expression.
By comparing organoids between human and chimpanzee, the researchers were able to identify regions of DNA that were differently accessible in humans potentially playing a regulatory role. Regulatory regions of DNA are more likely to be found in close proximity to the genes they are regulating the expression of. More than 60% of the genes that were expressed differently in humans were also in close proximity to differently accessible regions. This suggests that human-specific development and gene expression is a result of evolutionary changes in regions of DNA that are capable of regulating gene expression.
A significant proportion of the regions of DNA that we already know have changed the most since our divergence from chimps were found to overlap with those being different in terms of accessibility suggesting the team has indeed highlighted key regulatory processes responsible for making us humans.
This study takes the first steps in pinpointing interesting candidate genetic regions responsible for human brain complexity. The authors do not dive deeper into the mechanisms of what the altered expression of a specific gene actually means in terms of how the brain grows and functions. It does, however, provide an excellent resource and starting point to direct future research in this direction.
This research is not only important in understanding what makes us human, but also in working out how certain human disorders may arise. Several studies have found that mutations in regions of DNA with human-specific changes are associated with neurodevelopmental disorders.
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Lab-grown mini brains shed light on how humans split from great apes - The Conversation UK
Stem Cell Therapy Market By 2026 Industrial Analysis, Global Research With Geron Corporation, Vericel Corporation, Pluristem Therapeutics, Cytori…
By daniellenierenberg
This Stem Cell Therapy Market research report is a careful investigation of current scenario of the market and future estimations which spans several market dynamics such as websites, annual reports of the companies, journals, and others.
Stem Cell Therapy Market is expected to reach USD 15.63 billion by 2025, from USD 7.72 billion in 2017 growing at a CAGR of 9.2% during the forecast period of 2018 to 2025. The Stem Cell Therapy market report contains data for historic year 2016, the base year of calculation is 2017 and the forecast period is 2018 to 2025 (Updated values listed in sample report).
Get Sample of This Research Report:https://databridgemarketresearch.com/request-a-sample/?dbmr=global-stem-cell-therapy-market
Stem cell therapy is the therapy which uses stem cells for the treatment or prevention of a disease. Bone marrow transplant is the widely applicable therapy which is followed by umbilical cord blood. Research is going on to develop various sources (such as cord blood cells, bone marrow and skin) to use these cells for treatment of various disorders like neurodegenerative diseases and conditions such as heart disease, diabetes and other conditions. Some of the major players operating in the global stem cell therapy market are
Others: ViaCyte, Inc, AbbVie, Mesoblast Ltd., Roslin Cells, Regeneus Ltd, ReNeuron Group plc,, International Stem Cell Corporation, Aastrom Biosciences, Inc., Advanced Cell Technology, Cryo Cell International, Cytori Therapeutics, Inc., Geron Corporation, and Invitrogen and others. The global stem cell therapy market is highly fragmented and the major players have used various strategies such as new product launches, expansions, agreements, joint ventures, partnerships, acquisitions, and others to increase their footprints in this market. The report includes market shares of the global stem cell therapy market for global, Europe, North America, Asia Pacific and South America.
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Major Market Drivers and Restraints:
Drivers:
Restraints:
Segmentation:
The global stem cell therapy market is segmented based on
Type
Product
Application
End Users
Geographical Segments
On the basis of type, the market is segmented into
Allogeneic stem cell therapy
Autologous stem cell therapy
The allogeneic stem cell therapy segment is expected lead the market because of commercialization of allogeneic stem cell therapy products and wide application with easy scale up process.
Based on products, the market is segmented into
Adult stem cells
Human embryonic stem cells
Induced pluripotent stem cells and others
The adult stem cells accounts highest share in market due to ability to generate trillions of specialized cells which may lower the risks of rejection and repair tissue damage.
Based on application, the market is segmented into
Musculoskeletal disorders
Wounds and injuries
Cardiovascular diseases
Surgeries
Gastrointestinal diseases, and other applications
The musculoskeletal disorders segment leads the market due to availability of stem cell-based products for the treatment of musculoskeletal disorders, high prevalence of musculoskeletal disorders and bone & joint diseases.
Based on end users, the market is segmented into
Therapeutic companies
Cell and tissues banks
Tools and reagent companies
Service companies
The growing number of stem cell donors, improved stem cell banking facilities and because of the research and development therapeutic companies held the largest share in stem cell therapy.
By Geography
North America (U.S., Canada, Mexico)
South America (Brazil, Argentina, Rest of South America)
Europe (Germany, France, United Kingdom, Italy, Spain, Russia, Turkey, Belgium, Netherlands, Switzerland, Rest of Europe)
Asia-Pacific ( Japan, China, South Korea, India, Australia, Singapore, Thailand, Malaysia, Indonesia, Philippines, Rest of Asia Pacific)
Middle East & Africa (South Africa, Egypt, Saudi Arabia, United Arab Emirates, Israel, Rest of Middle East & Africa)
The rest is here:
Stem Cell Therapy Market By 2026 Industrial Analysis, Global Research With Geron Corporation, Vericel Corporation, Pluristem Therapeutics, Cytori...
Fit and healthy teacher dies 20 days after discovering he had leukaemia at 33 – The Sun
By daniellenierenberg
WHEN teacher Matt Meads started suffering with stomach pains, night sweats and tiredness - he quickly dismissed it as end of school year fatigue.
He was fit and healthy, and avoided drinking and smoking.
8
But just three weeks after first falling ill, Matt died - aged just 33 - and after just three chemo sessions.
He and his wife Abi were devastated when they discovered his symptoms were actually a sign ofleukaemia.
Heartbroken Abi, 27, from Nottingham, is now sharing his story to raise awareness and to urge others to be vigilant for signs of acute lymphoblastic leukaemia, a rare and aggressive form of blood cancer.
"I've got so many people around me offering help and support but I still feel really lonely because I've lost my best mate, my husband, my soulmate," Abi said.
It comes as blood cancer charity Bloodwise warns thousands of people are dying of the disease because it's diagnosed too late.
Matt and Abi first suspected something was wrong on July 6, when he began feeling more and more fatigued.
8
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And when he started vomiting to the point of being unable to keep ice cubes down, Abi urged him to go to the doctor.
At first he was told by his GP he had gastroenteritis or constipation but he soon returned to the hospital for a second time where they did a blood test.
Abi, who works as a teacher too, said: "Obviously I wish it was spotted sooner.
"I don't feel any anger towards to the hospital.
"I genuinely believe they did everything they could for him.
"He would say he was feeling sick."He would send a text saying he wasn't feeling well so was going to bed. I was out with some friends.
8
"He said something about feeling hot as well, but we didn't put that down to anything because it was the middle of summer and everyone was feeling hot.
"He was sleeping a lot, particularly at weekends which he would spend mostly asleep.
"But we're both teachers, it was coming up to the end of the school year and we had both got a lot of work on.
"We put it down to the job, and just tried to keep going because we had five weeks off soon.
"We thought it was the usual fatigue that we feel at the end of the year.
"There were sickness bugs going around at both of our schools so it wasn't anything out of the ordinary.
"He was referred to A&E for the second time thinking it was gallstones.
I've got so many people around me offering help and support but I still feel really lonely because I've lost my best mate, my husband, my soulmate
"They did some blood tests on him, sent him for a CT scan. The doctor came back and basically said that it was leukaemia."
Despite the devastating diagnosis, Abi said her brave husband remained positive as he came to terms with what was really happening.
She added: "Matt was a really positive person and was always somebody who believed what would be would be, it is what it is and all that stuff.
"So when the doctor told him he was quite composed.
"He didn't really give anything away about what he was feeling.
"It was obviously a massive shock for him but he didn't really respond in the way I would have done. He was listening to the doctor.
8
8
"The doctor actually stopped at one point because he was explaining what would happen next.
"He actually stopped at one point to ask him if he was okay, it was really big news and is he taking it all in?
"Matt's response was, 'yes, but there's nothing I can do about it. It is what it is'.
"He was definitely really brave."
And Abi says the diagnosis came as even more of a shock given how healthy he was.
8
She was forced to watch her husband go from happy and sporty to intensive care within days, before he passed away from a pulmonary embolism after just three chemotherapy sessions.
She said: "We knew he was poorly, but maybe not quite how poorly he was.
"I certainly wasn't expecting a phone call from the hospital.
"I don't know how I am now. It's hard. I don't think I really started to grieve until after the funeral.
"It's hard to think ahead for anything. It's a case of taking everything one day at a time.
"Some days are better than others. Some days are horrific and I don't want to get out of bed.
What is Acute Lymphoblastic Leukaemia?
Acute lymphoblastic leukaemia (ALL) is a type of blood cancer that starts from young white blood cells called lymphocytes in the bone marrow.
Adults and children can get it but it is most often diagnosed in younger people.
It'svery rare, with around 650 people diagnosed with the condition each year in the UK.
Many symptoms of ALL are vague and non specific. It may feel like the flu as symptoms are caused by too many abnormal white blood cells and not enough normal white cells, red cells and platelets.
Symptoms can include:
Recently blood cancer charity Bloodwise warned thousands of patients in England could be unnecessarily dying from blood cancer because they are diagnosed too late.
Experts analysed NHSdata and found 28 per cent of patients are told they have the disease after needing emergency treatment for their symptoms.
Figures show there are around 40,000 cases of blood cancer - a group of diseases including leukaemia, lymphoma and myeloma - each year in the UK.
Around 77 per cent of patients will survive for three years if they are diagnosed after visiting their GP, Bloodwise says.
In contrast, the same survival rate plummets to just 40 per cent for patients who are diagnosed as an emergency.
This is because symptoms develop over a few weeks and become more severe as the number of immature white blood cells increases.
"Matt was a really happy person. He was really positive.
"He was kind, caring, loving, wicked sense of humour. He would make a joke about anything and was very quick-witted.
"As a teacher he would have done anything for his students. He would have done anything for his family.
"He was just a really positive person who would have done anything for anybody.
"He loved his sport. He would go to the gym, he loved being outside and walking. He liked cycling. He was careful about what he ate.
"Everything the doctors warn you about, he didn't do. He didn't drink, he didn't smoke, he had a good diet, he exercised.
If you've got any of the symptoms which are lasting or you can't explain why you've got them, you need to go to the doctor and get checked out and be persistent in asking for a blood test
"He always put sun-cream on because he was paranoid he might catch skin cancer or something.
"He did everything he could to try and prevent anything from happening to him.
"As the doctors said there was nothing he could have done to prevent this."
Abi is now speaking out to urge others to get checked out and insist for a blood test if they have persistent symptoms of blood cancer.
She said: "If you've got any of the symptoms which are lasting or you can't explain why you've got them, you need to go to the doctor and get checked out and be persistent in asking for a blood test.
8
"You know your own body. It's as simple as having a blood test.
"If you've got it for days and it's not getting any better, if you're in any doubt, get it checked.
"We didn't know what the symptoms were.
"The only one I knew was bruising, but Matt didn't have any bruises until he was in hospital. So the one thing I knew wasn't relevant.
"I didn't realise about the night sweats, fatigue or heavy breathing.
"We never expected it would be that.
"We had thought worst case scenario it was gallstones or an impacted bowel, so when he came and said leukaemia it was just unexpected.
"When you're poorly you have all these possibilities going through your head but you never think it's going to be that.
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"I had a really good chat with Matt's consultant where I questioned whether I should have done more, if I had spotted things sooner, whether if I had been more pushy in getting him to hospital.
"But the symptoms are vague and it can come on within days. It doesn't have to be something that has been happening for weeks or months."
You can donate on Abi's fundraising page in memory of Matt here.
Read more:
Fit and healthy teacher dies 20 days after discovering he had leukaemia at 33 - The Sun
Anti-Aging Drugs Market Innovations, And Top Companies – Forecast To 2028| Allergan, Johnson and Johnson, Nu Skin – Healthcare News
By daniellenierenberg
New York City, NY: Oct 16, 2019 Published via (Wired Release) MarketResearch. Biz has a big history of serving detail research reports that help to create business opportunities through competitive study. One of the report we provide is Anti-Aging Drugs market analyzing market latest trends, identifying your rivals, validating opportunities, examining threats to your company, and changing your go-to-market and positioning strategy respectively.
The report on the Global Anti-Aging Drugs Market 2019 has been portrayed by experienced and knowledgeable market analysts and researchers. It is a phenomenal compilation of vital studies that explore the competitive landscape, segmentation, geographical exploration, and revenue, production, and consumption growth of the Global Anti-Aging Drugs market. Players can use the accurate market facts and figures and statistical analysis provided in the report to understand the current and upcoming growth of the Anti-Aging Drugs market. The Global Anti-Aging Drugs market size was XX Mn US$ and it is expected to reach XX Mn US$ by the end of 2028, with a CAGR of XX% during 2019-2028. The report includes CAGR, market shares, sales, Anti-Aging Drugs gross margin, value, volume, and other crucial market figures that give an exact view of the growth of the Anti-Aging Drugs market 2019.
Advanced primary and secondary research techniques and tools have been used by our Anti-Aging Drugs market analysts to compile this report. We use research sources and tools that are highly reliable and trustworthy. The Anti-Aging Drugs market report provides effective guidelines and recommendations for leading players to secure a position of strength in the worldwide market. Anti-Aging Drugs Market Emerging players can also use this research study to plan business strategies and get informed about upcoming challenges in the market. We provide an extensive competitive analysis that includes detailed company profiling of key players, a study on the Anti-Aging Drugs nature and characteristics of the competitors landscape, and other important studies.
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Major Players of the Global Anti-Aging Drugs Market 2019
La Roche-Posay, DermaFix, Nu Skin, Allergan, Procter & Gamble, BIOTIME Inc, Elysium Health Inc, Solta Medical, LORAL and Johnson and Johnson
Market Segmentation:
Segmentation by Product Type: serums and Supplements, antioxidants and Enzymes, stem cells and Drugs. Segmentation by Application: skin and Hair, skeletal and Muscles, age Related Disorders
Global Anti-Aging Drugs Market: Regions and Countries
The research study comprises key results and discoveries of our monitoring and analysis of the Anti-Aging Drugs market 2019. We have provided crucial information points, which include expansions, divestments, new product launches, Anti-Aging Drugs partnerships, mergers, acquisitions, and other strategic initiatives taken by Anti-Aging Drugs market players. The report also serves price trends for region-wise markets and analysis of crucial market events on a regional as well as worldwide scale. Our analysis will guide you to take vital decisions in the Anti-Aging Drugs market relating to procurement, inventory, pricing, and production. We assist you to give a tough competition to your rivals by providing latest, actionable, real-time, and quick market information.
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Our competitor profiling comprises validation of distribution channels and products and services offered by and Anti-Aging Drugs financial performance of companies operating in the market 2019. We also give Porters Five Forces, PESTLE, and SWOT analysis to identify the competitive threat and study other aspects of the Anti-Aging Drugs market. The report provides strategic recommendations, competitor benchmarking for performance measurement, and study of partnership, merger, and acquisition targets and Anti-Aging Drugs industry best practices. It also offered an analysis of profitability and cost across the Anti-Aging Drugs industry value chain.
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Important changes in the future Anti-Aging Drugs Market.
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Anti-Aging Drugs Market Innovations, And Top Companies - Forecast To 2028| Allergan, Johnson and Johnson, Nu Skin - Healthcare News
Contrasting RenovaCare (OTCMKTS:RCAR) and Haemonetics (OTCMKTS:HAE) – Covington Journal
By daniellenierenberg
RenovaCare (OTCMKTS:RCAR) and Haemonetics (NYSE:HAE) are both medical companies, but which is the better business? We will compare the two companies based on the strength of their analyst recommendations, risk, earnings, profitability, dividends, valuation and institutional ownership.
Analyst Ratings
This is a breakdown of recent ratings and price targets for RenovaCare and Haemonetics, as reported by MarketBeat.com.
Haemonetics has a consensus price target of $144.40, suggesting a potential upside of 15.46%. Given Haemonetics higher possible upside, analysts clearly believe Haemonetics is more favorable than RenovaCare.
Risk and Volatility
RenovaCare has a beta of 2.42, suggesting that its share price is 142% more volatile than the S&P 500. Comparatively, Haemonetics has a beta of 0.79, suggesting that its share price is 21% less volatile than the S&P 500.
Valuation and Earnings
This table compares RenovaCare and Haemonetics revenue, earnings per share (EPS) and valuation.
Haemonetics has higher revenue and earnings than RenovaCare.
Profitability
This table compares RenovaCare and Haemonetics net margins, return on equity and return on assets.
Institutional and Insider Ownership
99.1% of Haemonetics shares are owned by institutional investors. 0.9% of RenovaCare shares are owned by company insiders. Comparatively, 1.3% of Haemonetics shares are owned by company insiders. Strong institutional ownership is an indication that hedge funds, large money managers and endowments believe a company is poised for long-term growth.
Summary
Haemonetics beats RenovaCare on 9 of the 10 factors compared between the two stocks.
RenovaCare Company Profile
RenovaCare, Inc., a development-stage company, focuses on the acquisition, development, and commercialization of autologous cellular therapies for use in medical and aesthetic applications. It is developing CellMist System for spraying a patient's own skin stem cells onto burns and wounds for self-healing; and SkinGun, a solution sprayer device for delivering the cells to the treatment area. The company was formerly known as Janus Resources, Inc. and changed its name to RenovaCare, Inc. in January 2014. RenovaCare, Inc. is based in Scottsdale, Arizona.
Haemonetics Company Profile
Haemonetics Corporation, a healthcare company, provides hematology products and solutions. The company operates through five segments: North America Plasma; Americas Blood Center and Hospital; Europe, Middle East and Africa; Asia Pacific; and Japan. It offers automated plasma collection devices and related disposables, including NexSys PCS plasmapheresis system and PCS2 equipment and disposables, plasma collection containers, and intravenous solutions, as well as information technology platforms for plasma customers to manage their donors, operations, and supply chain; and NexLynk DMS donor management system. The company also provides automated blood component and manual whole blood collection systems, such as MCS brand apheresis equipment to collect specific blood components from the donor; disposable whole blood collection and component storage sets; SafeTrace Tx and El-Dorado Donor donation and blood unit management systems; Hemasphere software that provides support for blood drive planning; and Donor Doc and e-Donor software to enhance the donor recruitment and retention. In addition, it offers hospital products comprising TEG diagnostic systems that enables clinicians to assess the coagulation status of a patient at the point-of-care or laboratory setting; TEG Manager software, which connects various TEG analyzers throughout the hospital, providing clinicians remote access to active and historical test results that inform treatment decisions; Cell Saver Elite +, a surgical blood salvage system for cardiovascular, orthopedic, trauma, transplant, vascular, obstetrical, and gynecological surgeries; OrthoPAT, a perioperative autotranfusion system for orthopedic procedures; and BloodTrack, a suite of blood management and bedside transfusion solutions that combines software with hardware components, as well as an extension of the hospital's blood bank information system. Haemonetics Corporation was founded in 1971 and is headquartered in Braintree, Massachusetts.
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Contrasting RenovaCare (OTCMKTS:RCAR) and Haemonetics (OTCMKTS:HAE) - Covington Journal
Sarah Ferguson reveals highlight of my life as she celebrates 60th birthday – Express
By daniellenierenberg
The Duchess of York, affectionately known by British royal fans as Fergie, shared the cover of The Perfect World Magazine, where she can be seen giving Sir David Attenborough an honorary award. Fergie, who turns 60 today, revealed in an Instagram post that moment is one of the best of her life.
She wrote on Instagram: "Thank you all for the birthday messages! This is one of the highlights of my life."
In the cover, Fergie can be seen smiling as she hands the award, shaped like a rhino, toSir Attenborough, the world-famousEnglish broadcaster and natural historian.
Fergie andSir Attenborough attended together last September thePerfect World Foundation gala dinner, where she will present him the award.
The same award has been previously given toMark Shand, the late brother of the Duchess of Cornwall, and primatologist Dr Jane Goodall.
In the early afternoon, the Duchess of York published on Instagram another picture, showing her wearing a colourful sari.
She added in the caption: "Colourful moments"
Fergie's Instagram messages come after her former husband Prince Andrew celebrated her birthday on social media.
Earlier this morning, the Duke of Yorkpublished two identical messages dedicated to Fergie on both Instagram and Twitter.
READ MORE:How Fergie was 'forced to cancel birthday party due to crisis'
The messages read: "Wishing Sarah Ferguson a very Happy 60th Birthday!"
On Instagram, the message was accompanied by three pictures, one depicting Sarah surrounded by members of the York family, including Princess Eugenie's husband Jack Brooksbank and Princess Beatrice's fiancee Edoardo Mapelli Mozzi.
The second picture shows Fergie surrounded by children supported by the charity she is a patron of, Street Child UK.
And the third snap depicts Eugenie, Beatrice and Fergie together while carrying out an engagement.
DON'T MISS
Fergie has previously spoke with enthusiasm about her approaching 60th birthday.
Speaking at a charity event held onbehalf of Street Child and hosted by Hello, the Duchess said:"I think it's really important that my life is beginning at 60, I'm so excited by it."
Outspoken Fergie also revealed she has undertaken laser treatment to her skin to look her best for her milestone birthday.
Similarly, the Duchess had laser also before the wedding of her youngest daughter Princess Eugenie, which helped to make her skin glow.
But these haven't been the only beauty treatments Fergie has undertaken in the past years.
In March this year, Fergie travelled to the Bahamas toundergo stem cell therapy - an alternative to surgery which is yet to be proven fully safe and effective on humans and is therefore not widely available in the UK.
This therapy helped her solving a painful problem related to her feet, which eventually forced her to stop wearing high heels.
I went to the Bahamas in March to have the treatment.
I think my toes were ruined by all the riding I did when I was young.
See the original post here:
Sarah Ferguson reveals highlight of my life as she celebrates 60th birthday - Express
Medical Skin Care Products Market Promising Growth Opportunities over 2017 2025 – Lake Shore Gazette
By daniellenierenberg
Medical skin care products are used for beautifying or to address some other skin care problems. The cosmetic industry is booming and skin care forms a very huge part of this industry. The aesthetic appearance is so important that people spend a lot on skin care products and treatment. People being more technologically aware of the various new skin care products trending in the market. In addition to the aesthetic application, the medical skin care products are also used to address issues such as acne, pimples or scars.
Medical Skin Care Products Market: Drivers and Restraints
The medical skin care products is primarily driven by the need of natural based active ingredients products which are now trending in the market. Consumers demand medical skin care products which favor health and environment. Moreover, the consumers are updated with the trends so that various companies end up providing such products to satisfy the customers. For instance, a single product face mask has thousands of different variants.
This offers consumers different options to select the product depending on the skin type. Moreover, the market players catering to the medical skin care products are offering products with advanced technologies. For instance, Santinov launched the CICABEL mask using stem cell material based on advanced technologies. The stem cells used in the skin care product helps to to protect and activate the cells and promote the proliferation of skin epidermal cells and the anagenesis of skin fibrosis.
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Medical Skin Care Products Market: Segmentation
On the basis of product type the medical skin care products market can be segmented as:
On the basis of application, the medical skin care products market can be segment as:
On the basis of distribution channel, the medical skin care products market can be segment as:
Medical Skin Care Products Market: Overview
Medical skin care products are used to address basic skin problems ranging from acne to scars. There are various advancements in the ingredients used to offer skin care products to the consumers. For instance, the use of hyaluronic acid and retinoids is the latest development in the industry. The anti-aging creams are at the forefront as the help treating issues such as wrinkles, scars, acne, and sun damage. Another, product in demand is the probiotic skincare which include lactobacillus and bifidobacterium.
Medical Skin Care Products Market: Region-wise Outlook
In terms of geography, medical skin care products market has been divided into five regions including North- America, Asia- Pacific, Middle-East & Africa, Latin America and Europe. North America dominated the global medical skin care products market as international players are acquiring domestic companies to make their hold strong in the U.S. LOral is accelerating its U.S. market by signing a definitive agreement with Valeant Pharmaceuticals International Inc. to acquire CeraVe, AcneFree and Ambi skin-care brands for US$ 1.3 billion. The acquisition is expected LOreal to get hold of the brands in the price-accessible segment. Asia Pacific is expected to be the fastest growing region owing to the increasing disposable income and rising awareness towards the skin care products.
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Medical Skin Care Products Market: Key Market Participants
Some of the medical skin care products market participants are Avon Products Inc., Beiersdorf AG, Colgate-Palmolive Company, Kao Corporation, LOral S.A., Procter & Gamble, Shiseido Company, The Estee Lauder Companies Inc., Unilever PLC, Revlon, Clinique Laboratories, llc., Murad, LLC., SkinCeuticals, RMS Beauty, J.R. Watkins and 100% PURE.
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Medical Skin Care Products Market Promising Growth Opportunities over 2017 2025 - Lake Shore Gazette
Meet the wounded veteran who got a penis transplant – MIT Technology Review
By daniellenierenberg
Ray almost missed it, the message that would change his life. On a Saturday in March 2018, just as he was about to take his dog for an afternoon walk, he pulled his phone from his pocket and discovered a string of voicemails. Eight years had passed since the bomb had blown up underneath him while he was on patrol in Afghanistan, five since hed first met his doctor. Hed been on the waiting list a year. He was getting impatient.
He dialed back. This is it, he thought. It has to be.
A nurse picked up. Ray needed to come to the hospital immediately, she said. They had a donor. He was getting a new penis.
Ray had carried his unseen injury for yearsalways furtive, always anxious, always wondering how anyone who found out might react. Having lost both legs in the blast didnt bother him that much; Ray often left the house in the summertime wearing shorts, his prosthetics shining in the sun. But his other injury? Aside from his parents, hardly anyone knewnot even the guys he went to war with.
For men like Ray who lose their genitals, the usual treatmentif there was anywas phalloplasty: a rolled tube of tissue, blood vessels, and nerves taken from the forearm or thigh and transplanted to the groin, an ersatz penis that needs an external pump to get erect. When he first met with plastic surgeon Richard Redett, an expert in genital reconstruction at Johns Hopkins Hospital in Baltimore, phalloplasty was what he was offered. But soon after, Redett decided Ray could be a candidate for one of the worlds first full penis transplants. Not a crude substitute; the real thing.
This was actually something that could fix me, says Ray. I could go back to being normal again.
Penis transplantation is a radical frontier of modern medicine: extremely rare, expensive, and difficult to perform. Replacing a major organ like a damaged liver is one thing: it contains just one type of tissue. But grafting a penis from a deceased donor onto a living recipient is a chaotic amalgamation that entails stitching millimeters-wide blood vessels and nerves with minuscule sutures.
In 2013, when Ray first went to Johns Hopkins, there was no precedent for such a transplant. Since then, only four patients have had one.
South African urologist Andre Van der Merwe completed the first-ever successful transplant in 2014, sewing a donor penis onto a 21-year-old whose own had turned gangrenous after a grisly circumcision. In 2016, doctors at Massachusetts General Hospital transplanted a donor organ onto 64-year-old Thomas Manning, who had lost his penis to cancer. A year later, Van der Merwe and his team at Tygerberg Academic Hospital in Cape Town repeated their procedure on a 41-year-old victim of another circumcision gone wrong. Ray became patient number four.
After getting off the phone with the nurse that Saturday afternoon, he went into action. With military precision, Ray called his parents, packed the items he would need, boarded his dog, and made his way to the hospital. He checked in, as requested, at 1:30 on Sunday morning. At 2 a.m. Monday, he lay anesthetized on an operating table. And 14 hours after that, Redett and his team had completed the procedure. It was the most extensive penis transplant ever performed, and the first for a military veteran anywhere in the world.
Ray had been a US Navy corpsman trudging through Afghanistan when Taliban fighters ambushed his squad in 2010. As he rushed to give first aid to a downed soldier, he stepped on a roadside bomb. I remember everything froze and I was upside down, he says. I remember thinking a quick thought: This isnt good. And then I was on my back. The butchers bill was steep: both of his legs up to and including the thigh were blasted off, along with his penis, his scrotum, and an upside-down-U-shaped chunk of his abdominal wall. Only a handful of people know the full extent of his injuries.
Two years later, while he was learning to walk on prosthetic legs, his urologist at Walter Reed National Military Medical Center referred him to the reconstructive surgery group at Johns Hopkins.
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At the time, Hopkins was a leader in vascularized composite allotransplantation, more commonly called VCA surgery. Its used in face, hand, armand penis transplants, taking multiple types of tissue from a donor and hooking up blood vessels and nerves so they work for the recipient. In December 2012, Hopkins surgeons completed their first bilateral arm transplant, on an infantryman who had lost both his arms and legs to a roadside bomb. If anyone could help Ray, it was these surgeons.
At their first meeting, Redett talked about phalloplasty, which didnt excite Ray much. He resolved to go through with it, thinking it was the only choice. Yet Redett soon changed course, deciding that Ray was a better candidate for a transplant.
In fact, it was probably the only surgical fix given the extent of the damage. Van der Merwe calls Rays procedure the most complex to date, largely because of the scope of his injury. To repair it, Hopkins doctors didnt just transplant the penis itself. They also transplanted the donors scrotum and extensive amounts of tissue from the thigh and lower abdomen.
When I heard they wanted to do it, I felt this huge sigh of relief, says Ray.
For him, it was almost either you do this transplant, or you live the rest of your life with your defect, Redett says.
Jared Soares
Ray, who is now in his mid-30s, is a thin man of average height, with touches of gray in his beard and a wobbly gait, a result of the prosthetics he now calls his legs. He hasnt discussed his surgery since April 2018, when he gave a short interview to the New York Times. But this March, one year after his surgery, he agreed to talk to me so long as MIT Technology Review protected his identity. (His name has been changed in this article.) He did so, he says, because he wants other veterans to know about their options.
And many others are affected. A total of 1,367 American infantrymen sustained significant genital injuries in Iraq and Afghanistan between 2001 and 2013. Such hidden wounds of war represent a relatively new problem. Bombs from below used to be a death sentence, but better body armor and modern casualty care ensure that more wounded soldiers surviveand more of them with devastating genital-urinary trauma. In a report last year, military urologists wrote that groin injuries have increased to a level never before reported in the history of war.
The US Department of Defense recognized the problem as long ago as 2008, when it set up an institute to research various reconstructive transplants. Eventually, the TOUGH ProjectTrauma Outcomes and Urogenital Healthplaced a figure on it: among infantrymen with genital urinary injuries from Iraq and Afghanistan, 502 were injured so severely that a penis transplant might be their only recourse.
Quantifying the number of such injuries is easy. Outlining the psychological toll they take on guys in their 20s and 30s is much harder.
Even those closest to the trauma, like Timothy Tausch, have to use anecdotes to explain. Hes an Army lieutenant colonel and director of trauma and male reconstructive urology at Walter Reed. As soon as they wake up, theyre not asking about where their legs are, he says. Theyre asking where the testicles and the penis are. You cant put a number on how significantly this affects one of these wounded warriors lives.
Yet some experts wonder if the procedure is really necessary. Kidney and heart transplants save lives, but someone who lost a penis isnt going to die without a new one. Getting one may even be inviting a different set of psychological issues. (It bears mentioning that a poorly documented transplant attempt happened in 2006 in China, but the 44-year-old recipient apparently demanded reversal after his wife panicked, shocked at the idea he had someone elses penis.) In the months following Rays surgery, Hiten Patel, a chief resident at the Johns Hopkins Brady Urological Institute, wrote that a penis transplant lacks both life-saving and life-enhancing properties when compared to a readily available alternative in phalloplasty.
Others argue that for young men devastated by their wounds a transplant is, in fact, both life-saving and life-enhancing. Suicide risk among US veterans is already high: one study found that those deployed between 2001 and 2007 were 41% more likely to take their lives than civilians. Ray himself entertained thoughts of suicide after his injury. The idea gradually faded once he realized he could have gone to war and died; instead he was alive, on the first step of a long climb back.
Even though we do a pretty good job with phalloplasty reconstruction, its still a quantum leap to put on a real penis, says Curtis Cetrulo, one of the surgeons who operated on Thomas Manning in 2016. Phalloplasty recipients, for example, may regain some erotic sensation, but they must use a pump to achieve an erection or have intercourse.
Ray wouldnt say the transplant saved his life, exactly, but it has improved it.
This surgery was a way for me to overcome that little subconscious voice or whatever it was that would always keep me feeling different from everyone else, he says. It was one of those injuries that really stresses you out and you think, Why would I keep going? I guess I always just kept this real hope that theres an answer out there.
Several hours before the hospital contacted Ray, Richard Redett had received a phone call of his own. He had gotten it enough times before to know the words by heart: We may have a donor.
Usually such calls were dead ends: the potential transplant almost never met Redetts strict criteria. For Rays surgery to stand a chance, the donor had to be a young, healthy guy; the organ had to be a good color match and average in size; and, crucially, it had to be no more than two hours away, so that once it had been removed from the donors brain-dead but still living body, it could be brought to Johns Hopkins before it started decaying.
If you do an arm transplant, we know exactly how long that will hold up on ice. But nobody really knows that for a penis, he says.
I remember everything froze and I was upside down.
This particular call on that Saturday in March was more promising. There was a brain-dead patient nearby who was donating his organs, including his penis. Over a rapid string of conversations, Redett evaluated the patients medical history and determined when his team could get there. By the afternoon, Redett knew he had his donor.
Still, no doctor had ever worked with a graft as large as the one Ray required. To transplant a penis, you need the two dorsal arteries and the two dorsal veins from the donor. Fortunately, Rays two penis nerves were intact. But to transplant the abdominal wall and scrotum, even more veins are necessary. Fail to take those, and the new scrotum and abdominal tissue will die, along with much of the skin of the penis.
Over five years, Redett and his team had deciphered the topography of penis transplantation with cadavers and food coloring. It was basically a grand perfusion experiment: inject dye into the blood vessels of a dead man, and watch for blush on the skin to know which vessels are required as part of the transplant. We were injecting every blood vessel we could find down in the region with blue and red food color, he says. We just needed to know which vessels, and we needed to get very quick, very efficient, and very safe. We knew this had the potential to be a very long operation.
On the Sunday afternoon, his team boarded a chartered jet to meet their donor (the donors identity and the state hes from cant be disclosed). At 6 p.m., they entered the procurement room. Other doctors and medical staff, 25 in all, were there grabbing solid organs: lungs, heart, kidneys, liver. Its a bloody choreography, finding your place in an organ procurement. Redett and his team sliced into and isolated the lower abdominal wall, thigh tissue, scrotum, and penis, dissected out the requisite arteries and veins, and let the other doctors take what organs they needed before finishing.
Once they had removed and packed Rays graft, nothing else mattered except speed. Bodily tissue begins to break down the instant its deprived of blood. If enough toxins are released, the tissue can swell so much it asphyxiates. Its why you throw transplants on ice, as Redetts crew did for their Learjet flight back to Baltimoreit delays the breakdown process.
Its also why surgeons train, practice, and visualize their maneuvers. Redetts team had already run dry rehearsals of their procedure. In the operating room, they had set up the table where Ray would lie, figured out where the ice machine went, placed the optical microscope Redett would use, and even tested every power outlet to make sure they wouldnt short a circuit.
As the team ate snacks from their go-bags on the plane back to Hopkins, other surgeons wheeled Ray into the operating theater. By this time it was 11 p.m. on Sunday, almost 24 hours after he had arrived at the hospital. They prepared him by removing all the diseased tissue and exposing the blood vessels, nerves, urethra, and penile stump. At 2 a.m. Monday, Redett and his fellow surgeons took their placessome standing above Ray, the rest tending to the graft at another tableand steeled themselves. The gravity of his mission consumed Redetts thoughts.
We felt very confident we could do it, but we had never done it, he says. If youre not anxious for something like that, youre not thinking hard enough.
In the Johns Hopkins operating room, a surgical microscope with a craned neck like a brachiosaurus magnified the view by up to 20 times, enabling Redett to see the very tip of the needle-point instruments that hold the sutures for stitching together vessels barely two millimeters thick.
The threads are smaller than a human hair, he says. Unless youre under a scope, you cant really even see it.
They began by sewing Rays urethra onto the donors. Then came the arteries and veins that bring blood to the skin of the abdominal wall, scrotum, and penis shaft. Next they sutured Rays penile nerves, which were buried deep underneath his pelvic bone, to the nerves of the donor penis. Finally, Redetts team stitched together the skin.
You know how to do it, but until that last blood vessel is hooked up and you release the clamps and blood flows through itI mean, thats a huge sigh of relief, says Redett.
A kidney transplant usually takes three hours. The first penis transplant surgery in 2014 took nine. Redetts team needed an additional five hours to complete Rays transplant. In a surgery that long, doctors are allowed to take bathroom breaks, and even slug some coffee. Redett did neither.
Ray's first memory after he came out of the anesthesia was the heat. His room was warm to help keep his transplant at body temperature. It wasnt until two days later that Ray looked down and saw his new penis for the first time.
It was swollen and still had a lot of healing to do, he says. In the back of your mind, you know this is a transplant, and you wonder if its going to be too much for you to handle. Once I went through with the surgery, all of those concerns just went away.
The surgery wasnt just technically complex; it also required weighing various ethical questions. For example: if they were giving Ray a scrotum, should they give him testicles too? The answer was no: transferring sperm-generating tissue might have made it possible for Ray to have the donors genetic kids. (In the end, the donor had not given consent to use his sperm.)
Another matter was the prospect of lifelong immunosuppression. In penis transplant surgeries, its critical: Van der Merwe had to cut off half of the penis he transplanted in 2014 because the patient stopped taking his medication and rejection set in.
The world is not designed for a guy like me, says Ray.
The team came up with a novel answer to this problem. In a procedure spearheaded by Gerald Brandacher, scientific director of the reconstructive transplantation program at the Johns Hopkins School of Medicine, bone marrow and stem cells from the donors vertebral bones were isolated in the lab. Two weeks after his transplant, Ray was injected with a large amount of the donors bone marrow cells.
In organ transplants of any type, recipients are typically given a cocktail of immunosuppressant drugs every day. Ray, on the other hand, requires just one pill.
Its kind of like reeducating the immune system, says Brandacher. It allows us to minimize the need for immunosuppression but not completely stop it.
Minimizing the drugs needed after a transplant, in fact, may be what really got the US military interested in surgery like Rays. Immunosuppressants ensure that the body doesnt attack a new organ, but they also weaken the immune system and can lead to toxic complications like kidney failure. For a heart or lung, the trade-off is obvious: immune problems versus death. For a penis, the question is more muddled.
If we can get to a point where we have therapy that doesnt require that level of toxicity, the calculus changes completely, says Lloyd Rose, a former program manager for rehabilitative medicine research in the US Army. Then a transplant can become a surgery for anybody whos missing a hand or a foot or a face or a penisor anything.
If vets with transplants have to take fewer pills, it means fewer complications as they get older, and an easier life. It also saves the government money in the long term. The issue is so important to the military that the $12 million Congress appropriates each year for the Armed Forces Institute of Regenerative Medicine is now spent primarily on immunosuppressive researchnot on paying for things like penis transplants.
On a hot afternoon last April, a year after his surgery, I met Ray for the first time. He balanced his modest frame on his partmetal, part-polymer prosthetic legs, and in his left hand he carried a cane. Even with the support, he picked his way gingerly along the sidewalks until we made our way over to a public bench near a coffee shop.
When I got hurt, one thing I did realize is that the world is not designed for a guy like me, being blown up, he told me matter- of-factly. I knew then I would have to change myself to fit the world.
While he doesnt hide his prosthetics when we met, he wore gym shortshis unseen injury still causes him some consternation. Its not that he hasnt accepted his new penis. On the contrary, Ray doesnt seem to think about it as a donor organ at all. Its just that so few people know what happened to him, and hes not quite ready, and may never be ready, to identify himself.
It may not necessarily be that people are going to say bad things about it, he says. But its just one of those things. Its a private thing.
Jared Soares
Still, those around him recognized a change. A close friend of Rays, one of the few who know, says she noticed a little boost following the procedure. It was such a profound wound, there was a no-light-at-the-end-of-the-tunnel kind of feeling, she says. Now hes much more confident Its this feeling of being whole again.
In some ways, Ray is still figuring out how his transplanted organ will shape the contours of his life. Hes not dating at the moment, and knowing that he cant be a biological father, he wonders if that will deter women who may want to start a family.
In other ways, the surgery has made a huge difference to his daily emotional state. Hes more outgoing, less afraid to meet new people, and more fit, mentally and physically, piecing back together a life interrupted. Important questionssuch as whether hes able to pee standing up (he can), whether he gets erections (he does)already have answers.
He told me, which was the best news I could hear, that it feels normal, says Redett.
It took six months before the nerves of his transplanted penis started firing. Stitching nerves together isnt like splicing a wire; a nerve cells axons, the long threads along which impulses are sent from one cell to another, have to grow all the way out to the organ theyre supplying. Now, more than a year removed from surgery, those nerve signals have grown only stronger. Im still getting sensation back. Its pretty close, Ray says. This is not going to be a quick fix, but Ive seen improvement over time.
Where penis transplant surgery for wounded veterans goes is still up in the air. South Africas Van der Merwe, the originator of the transplant, says the VCA procedure itself is now proven; its future depends on other matters. Theres the problem of who pays, and of finding appropriate donors. And then theres the immunosuppression issue that the military is trying to solve.
The risks of immunosuppression in many peoples minds also outweigh the benefit of doing an arm, or a face, or a genital transplant, Redett says. We disagree, but that will slow down progress.
Ray barely blinked when I asked him some of these questions at our second meeting, in July. Dealing with immunosuppression, he says, is easy: he takes a pill and washes his hands frequently. Guys who need it and can handle it, he says, should get a transplant. He feels no ambivalence about that phone call, when doctors told him they were ready to sew on the donor penis for which he had waited five years.
I dont regret it, Ray says. It was one of the best decisions I ever made.
Andrew Zaleski, a writer based near Washington, DC, covers science, technology, and business.
Excerpt from:
Meet the wounded veteran who got a penis transplant - MIT Technology Review
Which Plastic Surgery Procedures Have Members of the Royal Family Had Done? – Showbiz Cheat Sheet
By daniellenierenberg
The members of the British royal family are always in the public eye. They cant blow their noses without people hearing about it. But with so much attention, comes even more scrutiny.
The royals are under pressure to be perfect at all times. Every move they make is photographed by the paparazzi and the public isunforgiving. Even after they gave birth, people expected both Meghan Markle and Kate Middleton to be back to their normal thin frames in a matter of days.
When celebrities are feeling the pressure to keep up appearances, many of them seek out plastic surgery procedures. Does the royal family do the same?
For many people, the Duchess of Cambridge is the epitome of style and grace. Youd be hardpressed to find a photo of Middleton looking less than perfect. Because of this, people have often wondered if the future Queen Consort has had any work done.
Earlier this year, Dr. Munir Somji of Dr. Medi Spa Clinic in London claimed that Middleton was one of his clients.
He shared before and after pictures of the Duchess on his Instagram.
Our Kate loves a bit of baby Botox, he wrote under the photos, which have since been deleted.
View this post on Instagram
The Duchess of Cambridge, Patron of the @Natural_History_Museum, visited the Angela Marmont Centre for UK Biodiversity to hear how it is championing and helping to protect UK wildlife. The Angela Marmont Centre (AMC) is a unique scientific hub located in the Natural History Museum, and is dedicated to the study of the UKs natural world. The AMC helps public visitors identify their finds, provides vital training in wildlife identification, and leads research and citizen science projects that are helping to transform our understanding of over 80,000 species of wildlife known to exist in the UK today. With populations of many UK species declining, and a significant proportion threatened with local extinction, the AMC brings together a host of individuals and organisations all dedicated to building understanding of the UKs wildlife, so that it can be better protected for future generations. AMC staff work with colleagues from across the Natural History Museum to carry out a range of scientific research to study how and why the UKs wildlife is changing. This ranges from applying ground-breaking scientific techniques, including analysis of environmental DNA through to detecting and identify the miniscule insects and microorganisms that play an important role in healthy environments. At the AMC today The Duchess viewed some of the Museums specimens and saw DNA sequencing live in action.
A post shared by Kensington Palace (@kensingtonroyal) on Oct 9, 2019 at 5:20am PDT
Note the reduction of fine lines on the forehead, he continued. But also note the depression of the medial (middle part) brow but elevation of the lateral tail of the brow.
So many people started believing the rumor that Kensington Palace gave a statement to the New York Post.
A spokesperson for the palace said that the post by Dr. Somji was categorically not true and in addition, The Royal Family never endorse commercial activity.
One royal who has been open about the procedures shes had done is the Duchess of York, Sarah Ferguson.
Ive had a lot of help to look like this at 60! she said in an interview withDaily Mail.
Ive started the laser treatment, but its not finished yet, she continued. The collagen needs to rebuild. I hope it will all be done by my birthday.
She also had this treatment before her daughter, Princess Eugenies, wedding last year. The procedure was done by Dr. Gabriela Mercik in a facility in London.
I dont like the frozen look, Ferguson said of why she chooses more natural procedures. Im so animated and I like to be myself. I dont like the thought of needles and am very glad if I look well and happy Im really happy to be open about what Ive had done.
Originally, the Duchess tried botox but has since switched to less invasive procedures, like her most recent treatment which refines the skins texture.
Shes also had mesotherapy, which is a non-surgical cosmetic treatment.
I need to repair the damage that was done on the beach when I was a child, she continued. Its why I had the mesotherapy, the vitamin cocktail to hydrate and boost the skin.
Not only does Ferguson get work done on her face, but she makes sure her feet are perfect as well!
I think my toes were ruined by all the riding I did when I was young, she said. They shaved the bone here. And implanted stem cells, 20 million of them taken from my midriff, into my feet to make new cartilage. It takes about six months to heal but now I can walk in heels!
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Which Plastic Surgery Procedures Have Members of the Royal Family Had Done? - Showbiz Cheat Sheet
AVROBIO Announces First Patient Dosed in Phase 1/2 Trial of Gene Therapy for Cystinosis – Business Wire
By daniellenierenberg
CAMBRIDGE, Mass.--(BUSINESS WIRE)--AVROBIO, Inc. (NASDAQ: AVRO) (the Company) today announced that the first patient has been dosed in the Companys AVR-RD-04 investigational gene therapy program for cystinosis, a devastating lysosomal storage disease, in an ongoing Phase 1/2 clinical trial sponsored by academic collaborators at the University of California San Diego. The gene therapy is derived from the patients own hematopoietic stem cells, which are genetically modified to produce functional cystinosin, a crucial protein that patients with cystinosis lack.
The trial will enroll up to six patients with cystinosis, a rare inherited disease caused by a defect in the gene that encodes for cystinosin. The cystinosin protein enables transport of the amino acid cystine out of lysosomes. When it is absent, cystine accumulates and crystalizes, causing progressive damage to the kidneys, liver, muscles, eyes and other organs and tissues. Cystinosis affects both children and adults; they face shortened life spans and often painful symptoms, including muscle wasting, difficulty breathing, blindness and kidney failure.
Cystinosis is a debilitating and progressive disease, and new treatment options are sorely needed. The current standard of care does not avert deterioration; at best, it can attenuate symptoms. Thats why gene therapy is particularly exciting: It has the potential to change the course of disease -- and the lives of patients -- by addressing the underlying cause of cystinosis, said Birgitte Volck, MD, PhD, President of Research and Development at AVROBIO. We believe we can engineer patients own stem cells so they sustainably produce the functional protein that is needed to prevent a toxic buildup of cystine and halt progression of the disease. We are so pleased that this investigational gene therapy is now in the clinic in collaboration with Dr. Stephanie Cherqui at UC San Diego.
The single-arm trial will enroll four adults and a potential follow-on cohort of two adults or adolescents at least 14 years of age who are currently being treated with cysteamine, the standard of care for cystinosis. If started at an early age and taken on a strict dosing schedule, cysteamine can delay kidney failure. However, the treatment regimen is highly burdensome, with side effects that can be severe and unpleasant, and many patients find it difficult to adhere to this treatment regimen. Even if compliance is high, cysteamine therapy cannot prevent kidney failure or avert other complications.
For people with cystinosis, there are no healthy days. They must take dozens of pills a day, around the clock, just to stay alive. It is a relentless disease and we urgently need new treatments, said Nancy J. Stack, President of the Cystinosis Research Foundation, which supported development of the gene therapy with more than $5.4 million in grants to Dr. Cherquis lab at UC San Diego. We believe that we are now an important step closer to the potential cure that our community has been working toward for many years.
The trials primary endpoints are safety and tolerability, assessed for up to two years after treatment, as well as efficacy, as assessed by cystine levels in white blood cells. Secondary endpoints to assess efficacy include changes in cystine levels in the blood, intestinal mucosa and skin and cystine crystal counts in the eye and skin. Efficacy will also be evaluated through clinical tests of kidney function, vision, muscle strength, pulmonary function and neurological and psychometric function, as well as through assessments of participants quality of life after treatment. The trial is funded by grants to UC San Diego from the California Institute for Regenerative Medicine (CIRM) as well as the Cystinosis Research Foundation.
This investigational gene therapy starts with the patients own stem cells, which are genetically modified so that their daughter cells can produce and deliver functional cystinosin to cells throughout the body. With this approach we aim to prevent the abnormal accumulation of cystine that causes so many devastating complications, said Stephanie Cherqui, PhD, an Associate Professor of Pediatrics at UC San Diego School of Medicine, and consultant to AVROBIO. We have been working toward this trial for years and we are grateful for all the support that brought us to this moment.
About AVR-RD-04
AVR-RD-04 is a lentiviral-based gene therapy designed to potentially halt the progression of cystinosis with a single dose of the patients own hematopoietic stem cells. The stem cells are genetically modified so they can produce functional cystinosin with the aim of substantially reducing levels of cystine in cells throughout the patients body. Before the infusion of the cells, patients undergo personalized conditioning with busulfan to enable the cells to permanently engraft. The Phase 1/2 clinical trial is being conducted under the name CTNS-RD-04 by AVROBIOs academic collaborators at the University of California, San Diego.
About Cystinosis
Cystinosis is a rare, inherited lysosomal storage disorder characterized by the accumulation of cystine in all the cells of the body, resulting in serious and potentially fatal damage to multiple organs and tissues and the shortening of patients life spans. The kidneys and eyes are especially vulnerable; more than 90% of untreated patients require a kidney transplant before age 20. An estimated 1 in 170,000 people are diagnosed with cystinosis.
About AVROBIO, Inc.
AVROBIO, Inc. is a leading, Phase 2 gene therapy company focused on the development of its investigational gene therapy, AVR-RD-01, in Fabry disease, as well as additional gene therapy programs in other lysosomal storage disorders including Gaucher disease, cystinosis and Pompe disease. The Companys plato platform includes a proprietary vector system, automated cell manufacturing solution and a personalized conditioning regimen deploying state-of-the-art precision dosing. AVROBIO is headquartered in Cambridge, MA and has offices in Toronto, ON. For additional information, visit http://www.avrobio.com.
Forward-Looking Statements
This press release contains forward-looking statements, including statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These statements may be identified by words such as aims, anticipates, believes, could, estimates, expects, forecasts, goal, intends, may, plans, possible, potential, seeks, will and variations of these words or similar expressions that are intended to identify forward-looking statements. These forward-looking statements include, without limitation, statements regarding the therapeutic potential of our product candidates, the design, commencement, enrollment and timing of ongoing or planned clinical trials, including the ongoing Phase 1/2 trial of the Companys AVR-RD-04 investigational gene therapy, the anticipated benefits of our gene therapy platform, the expected safety profile of our product candidates, timing and likelihood of success of our current or future product candidates, and the market opportunity for our product candidates. Any such statements in this press release that are not statements of historical fact may be deemed to be forward-looking statements. Results in preclinical or early stage clinical trials may not be indicative of results from later stage or larger scale clinical trials and do not ensure regulatory approval. You should not place undue reliance on these statements, or the scientific data presented.
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Minibrains Grown In The Laboratory Produce Brainwaves. Now What? – Forbes
By daniellenierenberg
Its hard to study the human brain. It is the most complex in the animal kingdom with its massive collection of neurons, 80-100 billion to be exact, three times more than chimpanzees. Research relating our brains to the brains of mice and monkeys can only go so far. And because of this complexity, scientists often came up short when studying diseases such as schizophrenia, autism, and Alzheimers in the brains of monkeys and mice.
Enter minibrains.
Minibrains are small clusters of human brain cells that can be grown in a Petri dish. Floating through the agar, these small gray lumps dont look particularly impressive, but they are allowing scientists to study actual living human brain tissue in ways they couldnt before.
Minibrains may look just like pea-sized gray globules, but once they started producing brainwaves, they received a lot of attention.
Growing these minibrains gives scientists a chance to study a host of psychological issues and diseases, and perhaps make advancements that they would not have made previously. Minibrains will even be sent to space to study how the human brain develops in zero-G.
But then came the surprise. These lab-grown brains started producing brainwaves.
These brainwaves, equivalent to brain wave patterns in a pre-term infant, were seen by a group of researchers at the University of California San Diego. They reported in a recent paper in Cell Stem Cell that these minibrains began showing neural activity after two months, and in four to six months, they reached levels of neural activity never before seen in a lab. At ten months, they were equivalent to pre-term babies, complete with lulls and flutters of activity.
Dan Zhang, a 4th year MD, PhD student, examines minibrains through a microscope. (Photo by Jessica Kourkounis for The Washington Post via Getty Images)
Minibrains are created by using stem cells, in this case, human skin cells. When stem cells are placed in a conducive environment, they can develop into any organ.
But minibrains are still a far cry from a full human brain. To develop into a mature brain, these minibrains would need to communicate with other areas of a larger brain and have some sort of connection with the outside world. But this might not be far off. Already, scientists have given minibrains retinal cells so they can sense light.
While some note that these minibrains are nowhere near real human brains, others begin to feel uneasy at seeing this neural activity. What does it mean? In this quickly developing field, how soon will these minibrains develop even further? There is an ethical code when dealing with animals in the lab - should this code apply to minibrains too? Could they one day feel pain, have memories, or even become self-aware?
There is now a need for clear guidelines for research, says Dr. Nita Farahany and collaborators in a 2018 Letter to Nature. They point out that as research develops and these minibrains become more advanced, it is less far-fetched to believe that one day these minibrains might have some sort of sentience or feelings such as pleasure or pain. The benefits of minibrain research are promising, but they caution, to ensure the success and social acceptance of this research long term, an ethical framework must be forged now, while brain surrogates remain in the early stages of development.
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Minibrains Grown In The Laboratory Produce Brainwaves. Now What? - Forbes