Archive for March, 2017

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Stem Cell Therapies for Degenerative Disc Disease Clinical Pain Advisor (registration) MSCs derived from bone marrow have been successfully differentiated into cardiopoietic cells and used in treatment of heart failure. Fourth- and fifth-generation techniques use genetically modified MSCs and induced pluripotent stem cells (iPSCs), ...

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A discovery, several years in the making, by a University at Buffalo research team has demonstrated that adult skin cells can be converted into neural crest cells (a type of stem cell) without any genetic modification, and that these stem cells can yield other cells that are present in the spinal cord and the brain.

The practical implications could be very significant, from studying genetic diseases in a dish to generating possible regenerative cures from the patient's own cells.

"It's actually quite remarkable that it happens," says Stelios T. Andreadis, PhD, professor and chair of UB's Department of Chemical and Biological Engineering, who recently published a paper on the results in the journal Stem Cells.

The identity of the cells was further confirmed by lineage tracing experiments, where the reprogrammed cells were implanted in chicken embryos and acted just as neural crest cells do.

Stem cells have been derived from adult cells before, but not without adding genes to alter the cells. The new process yields neural crest cells without addition of foreign genetic material. The reprogrammed neural crest cells can become smooth muscle cells, melanocytes, Schwann cells or neurons.

"In medical applications this has tremendous potential because you can always get a skin biopsy," Andreadis says. "We can grow the cells to large numbers and reprogram them, without genetic modification. So, autologous cells derived from the patient can be used to treat devastating neurogenic diseases that are currently hampered by the lack of easily accessible cell sources."

The process can also be used to model disease. Skin cells from a person with a genetic disease of the nervous system can be reprogrammed into neural crest cells. These cells will have the disease-causing mutation in their chromosomes, but the genes that cause the mutation are not expressed in the skin. The genes are likely to be expressed when cells differentiate into neural crest lineages, such as neurons or Schwann cells, thereby enabling researchers to study the disease in a dish. This is similar to induced pluripotent stem cells, but without genetic modification or reprograming to the pluripotent state.

The discovery was a gradual process, Andreadis says, as successive experiments kept leading to something new. "It was one step at a time. It was a very challenging task that took almost five years and involved a wide range of expertise and collaborators to bring it to fruition," Andreadis says. Collaborators include Gabriella Popescu, PhD, professor in the Department of Biochemistry in the Jacobs School of Medicine and Biomedical Sciences at UB; Song Liu, PhD, vice chair of biostatistics and bioinformatics at Roswell Park Cancer Institute and a research associate professor in biostatistics UB's School of Public Health and Health Professions; and Marianne Bronner, PhD, professor of biology and biological engineering, California Institute of Technology.

Andreadis credits the persistence of his then-PhD student, Vivek K. Bajpai, for sticking with it.

"He is an excellent and persistent student," Andreadis says. "Most students would have given up." Andreadis also credits a seed grant from UB's office of the Vice President for Research and Economic Development's IMPACT program that enabled part of the work.

The work recently received a $1.7 million National Institutes of Health grant to delve into the mechanisms that occur as the cells reprogram, and to employ the cells for treating the Parkinson's-like symptoms in a mouse model of hypomyelinating disease.

"This work has the potential to provide a novel source of abundant, easily accessible and autologous cells for treatment of devastating neurodegenerative diseases. We are excited about this discovery and its potential impact and are grateful to NIH for the opportunity to pursue it further," Andreadis said.

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Materials provided by University at Buffalo. Original written by Grove Potter. Note: Content may be edited for style and length.

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From skin to brain: Stem cells without genetic modification - Science Daily

A study led by Indiana University School of Medicine researchers demonstrates how electroacupuncture triggers a neurological mechanism that can help promote tissue repair and relieve injury-induced pain.

Their findings, published online March 16 in the journal Stem Cells, provide the most comprehensive picture yet of how electroacupuncture stimulates the brain to facilitate the release of stem cells and adds new insight relating to the cells' healing properties.

Electroacupuncture is a form of acupuncture that uses a small electrical current to augment the ancient Chinese medical practice of inserting fine needles into the skin at pre-determined points throughout the body.

For the study, a team of more than 40 scientists at institutions in the United States and South Korea was led by four senior authors including IU School of Medicine's Maria B. Grant, MD, Marilyn Glick Professor of Ophthalmology and co-corresponding author; Mervin C. Yoder, MD, IU Distinguished Professor, Richard and Pauline Klingler Professor of Pediatrics, associate dean for entrepreneurial research at IU School of Medicine, director of the Herman B Wells Center for Pediatric Research and co-corresponding author; and Fletcher A. White, PhD, Vergil K. Stoelting Chair of Anesthesia, professor of anesthesia, pharmacology and toxicology.

"This work is a classic example of the power of team science, where investigators in different institutions with specific expertise worked together to unravel the complexity of how electroacupuncture works to help the body respond to stressors," said Dr. Yoder.

The researchers performed a series of lab tests involving humans, horses and rodents that follow the effects of electroacupuncture from the stimulus of the needle all the way to the brain, resulting in the release of reparative mesenchymal stem cells (MSCs) into the bloodstream.

Depending on the species, electroacupuncture led to activation of the hypothalamus -- a part of the brain that controls the nervous system and involuntary bodily functions such as heart rate and digestion -- within nine to 22 minutes. The stem cells were mobilized within two hours.

"The acupuncture stimulus we're giving these animals has a rapid effect on neuroanatomical pathways that connect the stimulus point in the arm to responsive neurons in the spinal cord and into a region in the brain called the hypothalamus. In turn, the hypothalamus directs outgoing signals to stem cell niches resulting in their release," said Dr. White, who is a neuroscientist at the Richard L. Roudebush VA Medical Center in Indianapolis.

The researchers found electroacupuncture treatments resulted in higher thresholds for injury-induced pain, as well as considerable increases in the presence of a type of collagen that promotes tendon repair and anti-inflammatory cells known to be predictors of faster healing time.

Dr. White said these findings could lead to new strategies for tissue repair and pain management related to injuries.

"We could potentially capture the MSCs from an individual's blood following electroacupuncture and save the cells for future re-introduction in the patient post-surgery or to treat chronic pain due to an injury," he said.

The horses used in the study had been injured during training for international dressage competitions, and the six people who took part were healthy volunteers, who still showed activation of their hypothalamus through brain imaging.

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Electroacupuncture releases stem cells to relieve pain, promote tissue repair, study finds - Science Daily

Unregulated, for-profit stem cell clinics might be the next snake oil salesmen. Three women went blind following injections of stem cells extracted from liposuction treatments in a clinic in Florida. Though they paid for the treatment, they were led to believe that they were participating in a government-approved clinical trial. (New York Times)

Scientists used to think of groups of 10 to 20 humpback whales as large, but groups of up to 200 have been spotted off the coast of South Africa.

Visual by iStock.com/YinYang

Its better to have cystic fibrosis in Canada. More efficient lung transplant allocation, high-fat diets, and ultimately more comprehensive insurance increases the average life expectancy of Canadians living with the genetic disorder. (STAT)

Trumps first budget proposal would include a nearly 20 percent cut to the NIH budget and eliminate the Fogarty International Center, an organization dedicated to building partnerships with health researchers scientists in other countries. (Washington Post)

Humpback whales are also organizing at unprecedented rates. Researchers report huge pods of the usually solitary whales congregating around South Africa at a time of the year when the whales are usually feeding in Antarctica. (Popular Science)

Despite typhoons, rooftop farming and self-grown organic foods are taking off in Hong Kong. (The New Yorker)

A study in the New England Journal of Medicine demonstrates that patient-specific, induced pluripotent stem cells are safe for transplant into eyes, but are still far from effective or affordable. (Science)

NASA released satellite images detailing green slush ice around the Granite Harbor in Antarctica. The presence of so much phytoplankton in an icy region has worrisome implications for algal blooms in the spring. (The Huffington Post)

Startups and health care providers are increasingly looking for ways to standardize the selfie. By providing patients with a color card to include in photos of their urine sample, pregnancy pre-eclampsia and chronic kidney conditions are caught earlier. (The Economist)

In an effort to curb prescription opioid abuse, Endo Pharmaceuticals reformulated Opana into crush-resistance capsules. The new capsules are much easier to dissolve, leading to a rise in injection and subsequent HIV and Hepatitis C outbreaks. An FDA advisory panel concluded risks outweighed the benefits of prescribing Opana. (NPR)

And finally, a look at how the chemistry of how lithium-ion batteries turn into skin-searing firebombs. (Wired)

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Abstracts: Stem Cells, Selfies, Whales, and More - Undark Magazine

The new report says the three women, in their 70s and 80s, paid $5,000 to be treated in 2015 for age-related macular degeneration. Participants can also report their concerns to the Office for Human Research Protections within the U.S. Department of Health and Human Services.

The "devastating outcomes" experienced by the women raise the "need for oversight of such clinics and for the education of patients by physicians and regulatory bodies", the paper said.

The women all suffered detached retinas, vision loss, and hemorrhages in their eyes.

"We don't mean to say all stem cell clinical studies are risky", coauthor Dr. Thomas Albini of the University of Miami told Reuters Health in a telephone interview.

Paul Knoepfler, a stem-cell scientist at the University of California at Davis who is a frequent critic of the clinics, said he didn't understand why the FDA and the NIH have not moved more aggressively to ensure patient safety. They sought treatment at a Florida clinic that had announced a study to treat the condition on clinicaltrials.gov, a federal database of research studies. Two out of the three patients found the trial through the website, which doesn't fully vet trials for scientific soundness. "Platelet count increased to 1.01m3 following the treatment and there were remarkable improvements in other symptoms", said Geeta Shroff, Stem Cell Specialist, Director, Nutech Mediworld. Stem cell clinics have cropped up all over the United States in recent years and are operating in a self-perceived regulatory loophole. Stem cells were then extracted from the fat and injected into their eyes. Albini says the complications could have come from injecting a contaminant into the eye, or from the fact that the stem cells may have turned into myofibroblasts after the injections, which are cells associated with scarring.

The Japanese case marks the first time anyone has given induced pluripotent stem (iPS) cells to a patient to treat any condition.

Legitimate medical research seldom requires patients to pay and, in the case of eye treatments, only one eye is treated at a time so doctors can gauge its effectiveness, the Kuriyan team said.

Although the women had moderate vision loss prior to the stem cell treatments, a year later their vision ranged from total blindness to 20/200, which is considered legally blind.

And even if the interventions were done well, they say, there is no evidence that they could have restored the patients' vision. They first cultivate stem cells to form the retinal pigmented epithelial cells that are needed to restore a damaged retina.

Shoddy stem cell preparation may have led to some of the complications, said the study authors.

The episode, described Wednesday in an article in the New England Journal of Medicine, represents one of the most egregious examples of patient injury involving a stem-cell clinic. The company also noted that it does not now treat eye patients.

The paper also mentions that the women believed that they were taking part in a clinical trial because they were aware of the clinic's work on the ClinicalTrials.gov website run by the U.S. National Library of Medicine. In other words, the company claims the study was stopped before patients were enrolled. In fact, doctors have done bone marrow transplant, a procedure where stem cell transplantation is performed.

"There's this perception that there are all these stem cell therapies out there that are close to clinical application that. are being held back by regulators and if they just step back, there would be all these treatments", he said. However, it can be hard for patients to distinguish between trials that are legitimate, and those that are not, the authors wrote.

"There's no excuse for not designing a trial properly and basing it on preclinical research", added study Jeffrey Goldberg, also a study author, of Stanford University's School of Medicine.

Researchers from the Luxembourg Centre for Systems Biomedicine (LCSB) of the University of Luxembourg and an global team have now identified an ingenious mechanism by which the body orchestrates the regeneration of red and white blood cells from progenitor cells.

See if a trial is affiliated with an academic medical center - that's a good sign it is legitimate, they say.

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3 women blinded after receiving stem cell therapy for macular degeneration - ClickLancashire

March 17, 2017 Left: Cross-sectional view of the cerebrum in normal ferret. Neurons are localized in the cerebral cortex, the surface layer of the cerebrum. Since the surface of the cerebrum has folds (gyri), the layer containing neurons winds on its way. Right: Cross-sectional view of the cerebrum in TD ferret. Clusters of neurons (indicated by arrows) are found deep in the cerebrum, which are not detected in the cerebrum of normal ferret. They are called 'periventricular nodular heterotopia,' PNH. In addition, in the surface layer, a larger number of smaller folds (gyri) are seen than normal (indicated by asterisks). They are called polymicrogryri. Credit: Kanazawa University

Thanatophoric dysplasia (TD) is an intractable disease causing abnormalities of bones and the brain. In a recent study of ferrets, which have brains similar to those of humans, researchers using a newly developed technique discovered that neuronal translocation along radial glial fibers to the cerebral cortex during fetal brain development is aberrant, suggesting the cause underlying TD.

In TD cases, the limb and rib bones are shorter than normal, and brain abnormalities manifest, including polymicrogyria and periventricular nodular heterotopia. Previous research has determined that a gene, fibroblast growth factor receptor 3 (FGFR3), is responsible. However, as a result of TD rarity and the difficulty of obtaining brain samples from human patients, the pathophysiology of TD is largely unknown, and effective therapy has not been established.

The present research team of Kanazawa University generated an animal model of TD using ferrets that reproduces the brain abnormalities found in human TD patients. By using this animal model, the team elucidated the formation process of polymicrogyria, one of the abnormalities found in the TD brain. The team has also investigated the formation process of PNH, the other brain abnormality found in human TD patients.

First, PNH was analyzed in terms of composing cell types to reveal that a large number of neurons but few glial cell exist in PNH. In a healthy brain, neurons are found in the cerebral cortex near the brain surface. The researchers believe that during fetal brain development, PNH formation might be induced by the inability of neurons to translocate themselves to the cerebral cortex. The researchers found that the spatial arrangement of radial glial cells was distorted; radial glial fibers are believed to serve as the "track" for neurons to translocate themselves. Thus, the distortion of radial glial fibers seems to be a reason for aberrant localization of neurons.

Research on abnormalities of bones in TD is progressing with iPS cells at Kyoto University, and it is expected that the whole aspect of TD with brain and bone abnormalities would be elucidated and that the therapeutic methods would be developed. The present study on PNH was only possible using the experimental technique for ferrets developed by the research team. This animal model technique could also contribute to studies of other neurological diseases that have been difficult to investigate with conventional model animals.

Explore further: Researchers discover a gene's key role in building the developing brain's scaffolding

More information: Naoyuki Matsumoto et al, Pathophysiological analyses of periventricular nodular heterotopia using gyrencephalic mammals, Human Molecular Genetics (2017). DOI: 10.1093/hmg/ddx038

(Medical Xpress)Researchers have pinpointed the role of a gene known as Arl13b in guiding the formation and proper placement of neurons in the early stages of brain development. Mutations in the gene could help explain ...

A protein that may partly explain why human brains are larger than those of other animals has been identified by scientists from two stem-cell labs at UC San Francisco, in research published in the November 13, 2014 issue ...

Today, a stroke usually leads to permanent disability but in the future, the stroke-injured brain could be reparable by replacing dead cells with new, healthy neurons, using transplantation. Researchers at Lund University ...

Research on fragile X syndrome, the most common inherited cause of mental retardation, has focused mostly on how the genetic defect alters the functioning of neurons in the brain. A new study focusing on a different type ...

Zika's hypothesized attraction to human neural stem cells may come from its ability to hijack a protein found on the surface of these cells, using it as an entryway to infection. In Cell Stem Cell on March 30, researchers ...

The difference between an old brain and a young brain isn't so much the number of neurons but the presence and function of supporting cells called glia. In Cell Reports on January 10, researchers who examined postmortem brain ...

The majority of genes associated with nephrotic syndrome (NS) in humans also play pivotal roles in Drosophila renal function, a conservation of function across species that validates transgenic flies as ideal pre-clinical ...

Britain's Newcastle University says its scientists have received a license to create babies using DNA from three people to prevent women from passing on potentially fatal genetic diseases to their childrenthe first time ...

Columbia University Medical Center (CUMC) researchers have discovered a common genetic variant that greatly impacts normal brain aging, starting at around age 65, and may modify the risk for neurodegenerative diseases. The ...

Studies of autoimmune and inflammatory diseases have identified hundreds of genetic regions thought to be associated with these conditions. At the same time, studies of expression quantitative trait loci (eQTLs) have revealed ...

Scientists studying the role of a protein complex in the normal development of the mouse brain unexpectedly created a mouse model that replicates clinical symptoms of patients with complex neurological disorders such as hyperactivity, ...

Genetic variation in the non-coding DNA could give rise to language impairments in children and other neurodevelopmental disorders including schizophrenia, autism, and bipolar disorder, scientists from the Max Planck Institute ...

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Researchers develop new animal model to study rare brain disease - Medical Xpress

A natural system for silencing genes that appears to be a way the bodys genetic material defends itself from unwanted changes is helping develop resistant crops but has not yet translated into many clinical therapies, said a 2006 Nobel Prize for Medicine recipient.

Dr. Andrew Fire, of Stanford University, was the first G. Lombard Kelly Lecturer on Thursday at the Medical College of Georgia at Augusta University. He shared the 2006 Nobel Prizein Physiology or Medicine for discovering the mechanism of RNA interference. Short pieces of double-stranded RNA (molecules that transmit genetic material) coded to a particular gene can block that gene from creating a protein, silencing that gene.

Fire first published on RNA interference in 1998, and in the years since then, RNA interference has attracted a lot of attention from both research and clinical standpoints from researchers who want to use it to target particular genes. The system, which might be a way for cells to defend against things such as viruses that attempt to assert themselves into the genome the total genetic material could also be one of the reasons why many early gene therapy trials failed.

What researchers hoped were very intelligent, scientific ways of manipulating these systems turned out to be manipulations that were recognized by the organisms as often unwanted information trying to make itself heard, Fire said. The organisms then responded to that. And those mechanisms are very interesting and exciting and one of those mechanisms is RNA interference.

Fires work was in nematode worms and it turns out that it it is much more difficult to get RNA into mammalian or human cells because it gets degraded in the body.

Its been critical to do any of those applications to develop ways of encapsulating and protecting the RNA in order to get a biological effect, he said.

While his lab has not done that work, others have made impressive progress in achieving that, Fire said. For instance, one company is in Phase III clinical trials using a RNA interference drug to combat defective amyloid protein production in the liver that causes fibril tangles to form in organs, where even blocking a significant percentage has a big clinical effect. Such applications might be more realistic for therapies than say something such as cancer, Fire said.

In some of those cases a modest effect can be quite beneficial, he said. That is something that is challenging with cancer because if you have a modest effect on cancer, generally the cancer just evolves to match that.

RNA interference might be useful for more precisely characterizing what genes are active in a tumor, for instance, and points toward ways to more precisely attack it, Fire said. It could also be helpful in moving toward more personalized medicine, he said.

In agriculture, however, RNA interference is proving to be more successful in creating genetically modified organisms that, for instance, could be more resistant to pathogens or extreme conditions, Fire said. That work predates the discovery of the precise mechanisms of RNA interference, he said, but it is still a useful tool for helping to create those organisms.

Some of those strains or species will be useful for mitigating what are really substantial problems in crops, in mitigating hunger, Fire said. So there is a benefit to this in agriculture.

Reach Tom Corwin at (706) 823-3213or tom.corwin@augustachronicle.com.

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Nobel Prize winner discusses gene therapy at AU - The Augusta Chronicle

Dear Doctor: Ive been taking thyroid medication for several years, and my doctor says my blood tests are where they should be, but my face feels like sandpaper, my nails are brittle, and Im losing so much hair that I can see my scalp. Could there be some underlying problem my physician is missing?

Dear reader: Hair loss can be a distressing symptom, made all the more so when its cause is a mystery.

Your thyroid hormone levels are an obvious place to start, because both low and high thyroid levels can lead to hair and nail changes. Symptoms of high thyroid levels include hair loss, skin that is unusually smooth and warm, and nails that soften and loosen from the nail bed. The remaining hair becomes thinner, softer and does not hold a wave. Symptoms of low thyroid levels also include hair loss, including in the armpits and genital area, but the hair in this scenario is dull, coarse and fragile. As for the nails, they tend to be delicate, thin and have multiple grooves. That said, if your physician has done a complete panel of thyroid tests and the results have been normal, then most likely the function of your thyroid gland is not the cause of the brittle nails nor the hair loss.

That doesnt mean the thyroid isnt a factor. Autoimmune thyroid disease can lead to hair loss, both patchy and more diffuse, as well as inflammatory conditions of the skin. Such disease isnt always reflected in thyroid hormone levels. Checking anti-thyroid antibodies in the blood can identify autoimmune thyroid disease, and point you and your doctor in a clearer direction.

Hair loss also can be caused by androgenic alopecia, linked to an excess of androgens, a type of male hormone. These hormones are present in both men and women, but theyre higher than normal in some women, such as those with congenital adrenal hyperplasia or polycystic ovarian disease, which is relatively common. Simply checking levels of testosterone and dehydroepiandrosterone (DHEA) can either rule out androgenic alopecia or suggest that it be explored further.

Another potential cause is medication. Some medications can lead to hair loss, so if your symptoms seem coincidental to starting a new medication, there might be an association.

Biotin deficiency, which is rare, can also cause hair loss and inflammation of the facial skin. But if you have a normal diet and eat eggs, you have a low likelihood of this condition. Nonetheless, its something to rule out.

Iron deficiency also can lead to both brittle nails and hair loss. This doesnt explain the skin manifestations that you have, but if you are looking at other possibilities, checking the iron level of the blood should be part of the workup.

Any major illness can lead to hair loss and nail changes, and psychological stress can lead to hair loss. So, if there have been major stressors in your life, either physical or psychological, consider that a potential culprit.

In summary, if your thyroid levels are normal, it would be wise to check your thyroid antibodies, androgens and iron levels and your level of stress.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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Keith Roach, To Your Health 5:09 p.m. ET March 16, 2017

Dear Dr. Roach: I am a 78-year-old woman who was just diagnosed with celiac disease. I had an endoscopy in 2007 because I was anemic, and the doctor told me I had an ulcer that healed itself. This year I had an endoscopy because I again was anemic, but this time he did a biopsy, which came back as celiac. I have no dysentery or stomach pains, which are red lights for celiac; I have had inflamed joints for years, accompanied by dry skin. Is it possible that I have had this disease for years and was never diagnosed? My doctor told me not to eat wheat but never went any further than that. I have been educating myself about the disease. Who else would I see about this? Also, what would happen if I ate wheat by mistake? I also have been short of breath for years, but heart and pulmonary tests all come back normal. Could celiac be causing this shortness of breath?

Anon.

Dear Anon.: Celiac disease, also called gluten-sensitive enteropathy or nontropical sprue, is an uncommon but increasingly recognized condition caused by a reaction to gliadin, a protein found in gluten-containing grains, especially wheat, rye and barley. The spectrum of symptoms caused by celiac disease and its associated conditions is too broad for this column to cover comprehensively.

Not everyone with celiac disease has gastrointestinal symptoms, such as diarrhea and weight loss. Some people get mild abdominal pain and mood changes, and never put these together with their diet. At age 78, its very likely that you have had celiac disease for many years. The anemia 10 years ago possibly was celiac-related, through iron deficiency. People with celiac disease are more likely to develop arthritis as well, and one skin condition, dermatitis herpetiformis, is so characteristic of celiac that a biopsy is not needed.

Shortness of breath is uncommon with celiac disease, but a severe anemia can cause it, as can one rare lung disease, pulmonary hemosiderosis, which often goes away on a gluten-free diet. Disease of the heart muscle itself is rare but more common in people with celiac disease.

Unfortunately, the dietary information you got was woefully inadequate, so I would strongly recommend a visit with a registered dietician nutritionist, who can give you much more information. Dont eat wheat: Proper care of this disease depends on meticulous avoidance of gluten, and even small amounts count.

Dear Dr. Roach: My doctor just tested me for high calcium, and my vitamin D was low. He put me on 12 weeks of 50,000 IU once a week. You said something in a recent article about high vitamin D. Why the difference?

A.K.

Dear A.K.: Unfortunately, I am confused by your vitamin D treatment: I suspect the vitamin D has nothing to do with the calcium. A high calcium level can be caused by many things, including faulty technique in obtaining blood (if the tourniquet is on too long, the blood can become more acidic, which makes the calcium level appear higher), but I mentioned excess vitamin D (a rare cause) and elevated parathyroid hormone levels in my recent column. A repeated high calcium level should get your doctor to check a PTH hormone level. A high PTH level almost always means a benign tumor of the parathyroid gland, which is often but not always treated surgically.

Dr. Roach Writes: I solicited opinions about televisions in physician waiting rooms, and have the results of what readers wrote me. Ninety-three percent of respondents did not like them. Some suggestions included artwork or an aquarium instead; music (especially classical) to provide white noise and privacy; and 1950s television shows or informational shows with closed captioning.

Email questions to ToYourGoodHealth@med.cornell.edu.

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Doc: Dietitian a resource in treating celiac disease - The Detroit News

A new study links low levels of the hormone allopregnanolone in the second trimester of pregnancy, to the risk of developing postpartum depression.

Researchers at Johns Hopkins University in Baltimore, Maryland, said the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The small-scale study consisted of women with previously diagnosed mood disorders, with findings published online inPsychoneuroendocrinology.

Investigators said the study used an observational methodology among women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression.

But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.Postpartum depression affects early bonding between the mother and child.

Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping, and developing normally.

Moreover, an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

Many earlier studies havent shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individuals vulnerability to fluctuations in these hormones, and they didnt identify any concrete way to tell whether a woman would develop postpartum depression, saidLauren M. Osborne, M.D., assistant director of the Womens Mood Disorders Center for Johns Hopkins Medicine.

For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible.

In the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at Johns Hopkins University and the University of North Carolina at Chapel Hill.

About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost one-third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood.

Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV, for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression.

However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later, saidOsborne.

She said many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication, making it difficult to detect trends in those women most at risk.

Because the study data suggested that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne saidin the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression.

She saidJohns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautioned that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne said, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Prior research by Osborne and her colleagues previously showed that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression. Investigators discovered these modifications target genes that work with estrogen receptors and are sensitive to hormones.

These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she said, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers.

The researchers say that the medication dosages werent prescribed by the study group and were monitored by the participants primary care physician, psychiatrist, or obstetrician instead.

We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we dont have any evidence that this is true, Osborne said.

If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mothers illness.

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians dont screen for it, and there is a stigma for mothers.

A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

Source: Johns Hopkins

APA Reference Nauert PhD, R. (2017). Low Hormone Level Linked to Postpartum Depression. Psych Central. Retrieved on March 16, 2017, from https://psychcentral.com/news/2017/03/16/low-hormone-level-linked-to-postpartum-depression/117738.html

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Low Hormone Level Linked to Postpartum Depression - PsychCentral.com

In a small-scale study of women with previously diagnosed mood disorders, Johns Hopkins researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a report on the study, published online on March 7 in Psychoneuroendocrinology, the researchers say the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The researchers caution that theirs was an observational study in women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression. But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.

Postpartum depression affects early bonding between the mother and child. Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping and developing normally, and an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

"Many earlier studies haven't shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individual's vulnerability to fluctuations in these hormones, and they didn't identify any concrete way to tell whether a woman would develop postpartum depression," says Lauren M. Osborne, M.D., assistant director of the Johns Hopkins Women's Mood Disorders Center and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible."

For the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at The Johns Hopkins University and the University of North Carolina at Chapel Hill. About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost a third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood. Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression. However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

"Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later," says Osborne. She says that many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication -- making it difficult to detect trends in those women most at risk.

Because the study data suggest that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne says in the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression. She says Johns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautions that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne says, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Osborne and her colleagues previously showed and replicated in Neuropsychopharmacology in 2016 that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression; these modifications target genes that work with estrogen receptors and are sensitive to hormones. These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she says, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers. The researchers say that the medication dosages weren't prescribed by the study group and were monitored by the participant's primary care physician, psychiatrist or obstetrician instead. "We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we don't have any evidence that this is true," says Osborne. "If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mother's illness."

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians don't screen for it, and there is a stigma for mothers. A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

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Low levels of 'anti-anxiety' hormone linked to postpartum depression ... - Science Daily

Testosterone therapy has mixed results, studies find Fort Worth Star Telegram They looked at the impact of testosterone therapy in hundreds of men 65 and older who had measurably low levels of the hormone. (About 20 percent of men over 60 have diagnosable low testosterone.) The findings: One less-than-positive conclusion was ...

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Testosterone therapy has mixed results, studies find - Fort Worth Star Telegram

Over the course of seven years, Sezenia Tzeni endured seven rounds of in vitro fertilization. Typically, women undergo only three or four IVF treatments before either getting pregnant or giving up. But for Tzeni and her husband, conceiving a child was more important than almost anything else.

My mother and friends told me to do an adoption, 36-year-old Tzeni told Gizmodo. But I wanted to feel it, to feel the feeling of pregnancy and the moving in my belly.

Each time, though, the cycle of hope and disappointment became more devastating. After the seventh round, finally, she stopped trying.

Then, in 2015, a friend told Tzeni, who lives on a small island in Greece, about a clinic in Athens called Genesis. There, a gynecologist named Konstantinos Sfakianoudis claimed to have found a way to rejuvenate aging ovaries with a blood treatment typically used for healing wounds. So far, Sfakianoudis says, the technique has helped nine women nearing menopause who were having difficulty conceiving to get pregnant via IVF. In pre-clinical trial data provided by Sfakianoudis, 11 of 27 menopausal women saw menopause reversed, with hormone levels returning to those associated with fertility, and menstruation beginning again. Two of those women were able to generate healthy eggs, and one of them got pregnant, though she has not yet given birth.

In another case study, a menopausal German woman treated by Genesis got pregnant and gave birth, according to information Sfakianoudis provided to Gizmodo.

Now, the group is planning to bring its treatment to the US. Genesis is currently in the process of enrolling 50 patients in a clinical trial in collaboration with scientists from UC Berkeley and a La Jolla IVF practice. But the clinics work has engendered plenty of skepticism. Its bold claim suggests it has managed to reverse a milestone event in a womans lifein a sense, to undo the process of aging itself. But other than a brief presentation at a conference last summer, Genesis has yet to publish its findings. And even if its technique works, some wonder, is reinstating fertility in women well into their fifties and sixties something we should even really be doing?

We were skeptical, too, when it started to work, Sfakianoudis told Gizmodo, via phone from Greece. Now I could not be more optimistic.

This seemingly miraculous treatment contradicts what has been considered fact since the 1950s: That women are born with all the eggs they will ever have. Estimates suggest that from the time she is born, a woman loses about 1,000 egg cells, called oocytes, a month. At puberty, oocytes begin to mature, and during each cycle of ovulation, usually just one ripens to maturity. Eventually, at some point, conventional wisdom holds that a womans supply of oocytes runs out. Her ovaries stop producing the hormones needed to maintain fertility, and she enters menopause.

Over the past decade or so, though, a small trickle of research has challenged this picture. In 2004, a reproductive biologist then at Massachusetts General Hospital named Jonathan Tilly published a paper suggesting that in mice, oocytes were regularly replenished by stem cells. If he was right (and if the finding held true in humans)it meant that stem cells could be harnessed to produce new eggs, perhaps even reverse menopause. His work wasand still iscontroversial. But since then, new research by Tilly and others gave the idea more credibility. A year after his initial study, Tilly announced that he had identified bone marrow as the source of those egg-producing stem cells. In 2009, a team in China reported that they had similarly isolated female germline stem cells in the ovarian tissue of mice, which they then transplanted into infertile mice. Eventually, the mice were able to give birth.

The Greek groups work is rooted in this idea, that a womans ovaries might just need a boostfrom stem cells, or something elseto kickstart egg production again. Instead of stem cells, though, Genesis turned to a blood treatment known as platelet-rich plasma (PRP). Its an old practice typically used to help muscle and tendon injuries heal faster, though just how effective it is for healing remains unclear. The idea is to spin down a sample of a persons blood in a centrifuge to isolate molecules that help trigger tissue and blood vessel growth, then inject this enriched blood back into the body, hopefully stimulating tissue regeneration to help a wound heal faster. Bone marrow transplants and (the far less invasive) PRP transfusions contain similar growth factors, so Genesis put two-and-two together and began offering their clients transfusions of PRP.

Genesis idea isnt totally without precedent. At least one fertility clinic in New York offers PRP as a ovarian rejuvenation treatment for a cool $3,500, citing, accompanied by many asterisks, a single case study presented at a conference of a postmenopausal woman who gave birth after being treated with PRP. A 2015 Chinese study of five infertile women with thin uterine linings all became pregnant after PRP infusions stimulated that lining to grow thicker. A similar trial is currently underway at UCSF. Meanwhile, OvaScience, a biotech startup founded by Tilly, is working to rejuvenate egg cells from older women by adding new cytoplasm and mitochondria.

In 2015, the Greek clinic began treating patients past and nearing menopause with PRP, as well as younger women who had other conditions like uterine scarring that made it difficult to conceive. They found that in all three scenarios, PRP seemed to stimulate egg production. Additionally, and notably less scientifically, they concluded that the overall state of feminine mental and physical health appeared to improve significantly with the restoration of youthful hormone levels.

Last July, Sfakianoudiss team presented early results at the European Society of Human Reproduction and Embryology annual meeting in Finland. More recently, the clinic partnered with a biotech firm with transhumanist leanings, Ascendance Biomedical, to spin the treatment off into a company, Inovium.

The US trials are an effort by the company to gather more data to back up their findings and lend it legitimacy. The trial will be held at the Center for Advanced Genetics in Carlsbad, CA and supervised by Michael and Irina Conboy, a husband and wife research team at UC Berkeley known for their pioneering work studying aging and rejuvenation in mice.

Still, its hard not to raise an eyebrow at a company that mixes up the name of the scientist who supposedly inspired its work on the science tab of the company website. (Inovium referred to scientist Jonathan Tilly as Dr. Roger Tilley. When Gizmodo pointed this out, the company edited the page, but still spelled Tillys name incorrectly.) More troublingly, Inovium and Genesis are offering women that are desperate for children and willing to pay a very high price a treatment for which they still have published no peer-reviewed data, have done very small studies, and have little more than untested theories to explain how it all actually works.

I would be very cautious proceeding with such a clinical investigation, said Christos Coutifaris, president-elect of the American Society of Reproductive Medicine. Infertility patients are very vulnerable, he added, referring to the emotional toll that fertility treatments can take.

Genesis is the biggest private fertility clinic in Greece. Fertility is big businessthe industry is expected to surpass $30 billion by 2023and Genesis founder, Kostas Pantos, envisioned turning Greece into a hub for medical tourism in this fast-growing market. Since opening in 1995, the clinic has often been at the forefront of fertility technology, with early forays into genetic screening of embryos and research identifying which embryos are most likely to make it to term.

So far, more than 60 women who were either past menopause or having trouble getting pregnant have received PRP treatment at Genesis, including Tzeni, according to Sfakianoudis. In over 75 percent of those cases, the clinic claims that hormone levels (AMH, FSH, LH, and Estradiol) returned to youthful levels. The nine women who ultimately wound up pregnant after undergoing PRP and IVF were between 36 and 54, and experienced no complications.

Were still in the very early process of trying to figure out when it works, how it works and why it works, Sfakianoudis said.

Ultimately, the end goal is to publish the results of the US trial in a peer-reviewed journal.

Michael and Irina Conboy, the Berkeley scientists who have signed on as advisors and researchers on the project, said that while its plausible the treatment works and early data is promising, a proper pilot study is needed before anyone can really judge anything.

What I like most about this trial, Michael Conboy told Gizmodo, is that it sounds very unlikely it will harm anyone.

Unlike traditional PRP transfusions, which require donor blood, the Greek clinics procedure uses a patients own genetic material, removing their blood plasma, enriching it, and then injecting it back into the ovaries in a relatively noninvasive procedure. The study will look at menopausal and perimenopausal women looking to conceive, and follow them through IVF treatment and, if all goes well, birth.

The Conboys said that they were enticed by the clinic and spin-off company seeking to back-up its wild-sounding claims with actual science.

They specifically mentioned that they dont want to be another Ambrosia, Irina Conboy said, referencing the Silicon Valley startup that offers blood transfusions to youth-seekers based on questionable science. All of this needs to start with a study, she added.

The Conboys own lab has found that old blood can be damaging to younger mice, and that young blood is not as effective at rejuvenation as fans of the theory, like billionaire Peter Thiel, have hoped it would be. The couples work, though, has also indicated that regulating certain blood proteins that change with age to maintain youthful levels can allow stem cells to more effectively repair the body, as they do in youth.

The idea is that the stem cells themselves are not too old, but its the environment around them that suppresses them, Conboy said.

PRP, he speculated, could be sending signals to stem cells in the ovaries that produce oocytes to regenerate.

The trial is still in its early stagesbasic details, like whether or not UC Berkeley will officially oversee it, are still being worked out.

Even if the trial does indicate Inoviums treatment is effective, though, it is not likely to quell all detractors. The treatment raises questions of whether women at or nearing menopause should be having children at all. Because risks of pregnancy complications increase with age, most IVF clinics have an upper age limit under 45 years of age. In some countries, like Israel, performing IVF over a certain age is illegal. Most of the women Sfakianoudiss team have treated so far have been between 45 and 64.

For Tzeni, Sfakianoudis concluded that her pregnancy woes were due to chronic inflammation in the lining of her uterus.

At first, the clinic tried treating the inflammation with several different antibiotic pills. Still, there was significant inflammation. Then they tried PRP. The inflammation disappeared.

He told me, Now its perfect to have embryos success, she said of Sfakianoudis. He told me, Dont worry, you will have children and Im sure you will have twins.

After another round of IVF, on September 17, 2016 she gave birth to twins.

Visit link:
The Crazy Plan to Restore a Woman's Fertilityand Defy the Limits of Nature - Gizmodo

Read More: Dr. Wendy Klein, Health Brigade, Jennifer Gallienne

Last night, Donald Trump stood on a stage in Nashville, Tennessee and once again reiterated his determination to repeal Obamacare, throwing his support behind the American Healthcare Act.

The bill that I will ultimately sign will get rid of Obamacare and make healthcare better for you and your family, Trump said.

This comes on the heels of a series of blows for one of the most vulnerable groups in America, the transgender community. There was the Trump administration rescinding federal guidelines instructing schools to allow transgender students to use the facilities that correspond with their gender identity. The caused the Supreme Court to send the case of Gavin Grimm, a transgender teenager who was unable to use the boys restroom at his high school, which would have potentially determined if Title IX protections extend to gender identity, not just sex.

For the trans community, who are often the subjects of discrimination in healthcare settings and are twice as likely as other Americans to live in poverty, the repeal of the Affordable Care Act could have devastating consequences.

There is real fear, Jennifer Gallienne said. But, we will continue to see people no matter what.

Gallienne is the Trans Health Services Coordinator for the Health Brigade. Health Brigade, formerly the Fan Free Clinic, has been providing healthcare services to the poor and underserved in Richmond for fifty years and, for the past ten years, has been providing primary care services to the transgender community.

Health Brigade offers a variety of services, including medical services, health outreach and advocacy, mental health services, HIV testing, and transgender healthcare. Because of their mission to provide healthcare to the those unable to afford or access healthcare, eligible patients cannot earn more than 200% of the federal poverty level.

Dr. Wendy Klein, Medical Director, who oversees the medical clinic and primary care services, has been at the clinic for two years and is proud to be a part of Health Brigades history of championing healthcare.

We provide a broad range of services to our patients, she said.

She discussed the Health Brigades long-standing mission of inclusiveness and and compassion to those least served, especially the trans community.

We have the long history of being in the forefront of AIDS/HIV care and testing, which led to a keen awareness of the need for excellent LGBT care, she said. We are one of the few places that have providers trained in specifically transgender health care.

Part of Health Brigades mission is to provide quality, appropriate, and affirming healthcare to the non-binary, gender-nonconforming, and transgender community. This includes hormone administration, gynecological care, individual counseling, and legal services. Health Brigade prides itself on its dedication to complete wellness, not just medical services.

At Health Brigade, we have always tried to improve the way that trans people are receiving healthcare and have more positive outcomes for them so they can live healthier lives, Gallienne said.

Dr. Klein explained that the trans health clinic was once separate from the main clinic, but has since been integrated as part of Health Brigades mission to provide overall care. And, in order to work and volunteer at the trans clinic, one must be educated and trained to serve their trans patients.

Our whole staff is aware of preferred pronouns and gender identity, she said. Its compassionate, sensitive care based on established evidence.

Gallienne, who does intake for trans patients and oversees staff education, emphasized the importance of providers understanding their patients as whole people rather than singular parts.

The most important is making sure that the people that were seeing and that the care theyre getting is quality care, affirming care, and informed care, she said. Making sure that who they are seeing is knowledgeable about trans identities and what theyre going through so our patients dont have to become the educators. They know theyll be treated with respect and dignity and as a whole person.

Part of providing overall wellness in healthcare is providing a wide array of services. Health Brigade also provides mental health counseling, psychiatric services, and wellness groups.

We have a mental health clinic with counselors and limited psychiatry services, Dr. Klein said. We cant take care of acute mental illness, but were able to provide counseling and care for general psychological problems.

Its important to see someone as a whole human being, Gallienne agreed. Its not required that any of our trans patients see mental health before they receive hormones, but it available to them if they want to access someone to talk to.

Dr. Klein explained that, built within the medical clinic, behavioral coaching is provided to address things such as smoking cessation, weight management, stress reduction, and other issues.

The integrated approach to care that combines mental health, behavioral health, nutrition, all of these things, make for a nice fabric of care, like threads in a fabric, she said.

The trans community faces particular obstacles in receiving healthcare, such as discrimination, harassment, and gate-keeping. As the Trans Health Services Coordinator, Gallienne strives to not only provide quality care to the trans community, but assist them in getting connected to additional community resources.

There is no average patient, she said. But, we do see a lot of our patients struggling with the same trends going on in the community, struggling to find resources and places they can go that are safe or that they can get treatment or care without facing harassment and discrimination. A common theme we see is not knowing where to go or if where theyre going will be safe or not.

With the possible repeal of the Affordable Care Act and increasing concerns over the American Healthcare Act, which the CBO predicted would cost up to 24 million Americans to lose healthcare coverage, Dr. Klein stated that the Health Brigades mission of providing affordable healthcare to the uninsured and the poor will only become more vital to the community.

If anything, the need for our services will increase if people lose their insurance on the exchange, she said.

We wanted to get the word out that we do accept new trans patients and that were a resource for people, Gallienne explained. As long as they meet our eligibility services, they are welcome to come. We are always accepting newcomers.

Dr. Klein and Gallienne agreed that community support is vital to the mission of the Health Brigade and to increasing awareness and acceptance of the LGBT community at large.

We exist on grants and donations, donations of money and donations of time, she said, referencing how the community could assist in supporting the clinics mission. There is also lobbying for improved care, lobbying to protect the ACA, lobbying for healthcare for all.

All support is welcome.

Health Brigade is located at 1010 N. Thompson Street in Richmond. For more information you can visit http://www.healthbrigade.org or call (804) 358-6343.

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In the face of Trump's healthcare reform, RVA's Health Brigade steps up to cover the region's most vulnerable ... - GayRVA

Updated March 17, 2017 13:31:00

Queensland researchers have used stem cells to create a beating human heart muscle, as well as heart tissue that is able to repair itself.

Doctors James Hudson and Enzo Porello from the University of Queensland worked with German researchers to create the samples in a laboratory, and will use them to study cardiac biology and diseases.

"The patented technology enables us to now perform experiments on human heart tissue," Dr Hudson said.

Up until now researchers have had no "living" tissue to study, but now scientists have a viable, functioning heart muscle to work on.

Dr Hudson said it would help them model the cardiovascular disease, screen new drugs and investigate heart repair.

"Immature tissues were found to have the ability to regenerate following injury something that did not occur naturally for adults," he said.

"In the laboratory we used dry ice to kill part of the tissue while leaving the surrounding muscle healthy and viable.

"We found that when we injured those tissues in contrast to what happens normally in the heart where you get a 'dead' patch muscle function fully recovered because the cells regenerate.

"Our goal is to use this model to potentially find new therapeutic targets to enhance or induce cardiac regeneration in people with heart failure."

While the researchers have grown samples of beating heart tissue, they are not full size.

Dr Hudson said they were about 1 centimetre long and 1 millimetre wide.

He said about 54,000 Australians had heart attacks each year, with an average of about 23 deaths a day.

"Current pharmaceuticals can help those people in the shorter term, however some of those patients still progress to heart failure," Dr Hudson said.

"The holy grail goal of all this is to come up with new regenerative therapeutics to cure those patients."

The research team hopes to commercialise the technology, which it believes will help save lives.

The project has been supported by the National Health and Medical Research Council (NHMRC) and the National Heart Foundation.

Topics: medical-research, health, diseases-and-disorders, heart-disease, science-and-technology, research, qld, university-of-queensland-4072, australia

First posted March 17, 2017 13:11:06

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Self-repairing heart tissue breakthrough brings hope for cardiac patients - ABC Online

Scientists at The University of Queensland have taken a significant step forward in cardiac disease research by creating a functional beating human heart muscle from stem cells.

Dr James Hudson and Dr Enzo Porrello from the UQ School of Biomedical Sciences collaborated with German researchers to create models of human heart tissue in the laboratory so they can study cardiac biology and diseases in a dish.

The patented technology enables us to now perform experiments on human heart tissue in the lab, Dr Hudson said.

This provides scientists with viable, functioning human heart muscle to work on, to model disease, screen new drugs and investigate heart repair.

The UQCardiac Regeneration Laboratoryco-leaders have also extended this research and shown that the immature tissues have the capacity to regenerate following injury.

In the laboratory we used dry ice to kill part of the tissue while leaving the surrounding muscle healthy and viable, Dr Hudson said.

We found those tissues fully recovered because they were immature and the cells could regenerate in contrast to what happens normally in the adult heart where you get a dead patch.

Our goal is to use this model to potentially find new therapeutic targets to enhance or induce cardiac regeneration in people with heart failure.

Studying regeneration of these damaged, immature cells will enable us to figure out the biochemical events behind this process.

Hopefully we can determine how to replicate this process in adult hearts for cardiovascular patients.

UQ scientists create beating human heart muscle from The University of Queensland on Vimeo.

Each year, about 54,000 Australians suffer a heart attack, with an average of about 23 deaths every day.

The UQ research has been supported by the National Health and Medical Research Council (NHMRC) and the National Heart Foundation.

Heart Foundation Queensland CEO Stephen Vines said the charity was excited to fund such an important research project.

Heart attack survivors who have had permanent damage to their heart tissue are essentially trying to live on half an engine, Mr Vines said.

The research by Dr Hudson and Dr Porello will help unlock the key to regenerating damaged heart tissue, which will have a huge impact on the quality of life for heart attack survivors.

Dr Hudson and Dr Porello are deserved recipients of our highest national research accolade the Future Leader Fellowship Award.

The research is published in Circulation and Development.

Media: Dr James Hudson, j.hudson@uq.edu.au; Kim Lyell, k.lyell@uq.edu.au, 0427 530 647.

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Scientists create 'beating' human heart muscle for cardiac research - UQ News

Gizmodo

3 Women Blinded After Stem Cell Therapy Newser CORRECTS FROM MD ANDERSON HOSPITAL TO MD ANDERSON CANCER CENTER -Senior Clinical Cell Therapy Specialist Megan Raggio prepares stem cells from bone marrow before they are transplanted into sportscaster... (AP Photo/David J. Phillip). Florida Clinic Blinds Three Patients in Botched 'Clinical Trial'Gizmodo Stem Cell Therapy Market To Grow At A CAGR of 36.52% From 2017 To 2021 : Radiant Insights,IncMedgadget (blog) From Hope To Despair: Three Women Blinded By Unproven Stem Cell Therapy [VIDEO]Counsel & Heal The New England Journal of Medicine -National Eye Institute - NIH -ClinicalTrials.gov all 95 news articles »

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3 Women Blinded After Stem Cell Therapy - Newser

I recently donated peripheral blood stem cells (PBSC) to a middle-aged man with myelodysplastic syndrome. This is similar medically to a bone marrow donation (though less painful) and much more involved than a blood donation (which I have done regularly since I was seventeen). I found the whole process fascinating and a testament to the glory of mans mind and modern civilization.

The patient with myelodysplastic syndrome lives in central Europe. His bodys bone marrow was no longer producing healthy functioning blood cellsthat is, red blood cells, white blood cells, and plateletsa deficiency that could have resulted in his bodys loss of ability to fight infections or control bleeding, and possibly leukemia. The cure for his disease involved destroying his defective natural bone marrow and replacing it with someone elsesmine.

Bone marrow compatibility between donor and recipient is more complicated than blood types. He needed a donor whose human leukocyte antigen (HLA) proteins most closely matched his own in order to minimize the chance of graft-versus-host disease. His doctors found my data in the Be the Match Registry, where Im registered as a potential donor, and they judged my HLA proteins to be his best hope.

Eight weeks before the operation would take place, I was notified by phone about the match and the donation process. I was then asked whether I was willing to donate. I said yes (and was given several opportunities later to change my mind). In the following weeks, I provided two sets of blood samples to verify that I was healthy enough to donate and still a good match. I was flown out to the donation facility in Michigan to be examined physically, preview the process, and speak with the doctors and nurses who would collect the donation. My donor representative called me periodically to keep me informed and to verify my continuing consent. She also made the arrangements for collecting the samples, managed my travels, and ensured that my expenses were covered.

Here I am holdingthe final product just prior to its transportation to the recipientin central Europe.

As the donation date drew closer, I received ten shots of Filgrastim, a drug designed to stimulate additional blood stem cell formation, one shot in each arm for five days. This increased my white blood cell count far above normal and forced extra blood stem cells into my bloodstream, thus enabling the technicians to run my blood through an apheresis machine, which separated the phases of blood by density using centripetal acceleration. On the donation day, I sat in a comfy chair with an IV in each arm for four hours as a machine took blood from one arm, separated out the stem cells, and returned the rest of my blood via my other arm. While the process continued throughout the morning, the nurses took a few notes here and there, and, as my arms couldnt bend, fed me lunch (chicken wings from Jets Pizza). Once the machine had collected enough stem cells for the recipient (Im fifteen pounds heavier than he is, so it was easier on my body than it could have been), the IVs were removed, my blood was tested one final time to make sure I was OK to drive home, and I left.

My blood stem cells were then transported by private courier to the patient in central Europe. In preparation for the donation, his entire immune system and blood-producing machinery (bone marrow) had been destroyed using myeloablative chemotherapy in order to eliminate any remaining diseased cells and to suppress any immune response from his body to my replacement tissue. My blood stem cells were injected into his bloodstream by IV and then migrated to his bones to replace his destroyed bone marrow and eventually start producing new red blood cells, white blood cells, and platelets. Essentially, my blood and my immune system are regrowing in his body. With these, he inherits my allergies and infectious disease history, and, if all goes well, my life force for another few decades.

Although the organization through which I donated does not pay for stem cells (because payment is against international registry standards), I was treated well and fully reimbursed for expenses. They paid for flights, a half dozen meals, a private driver at one point, hundreds of miles of my own driving, and my stays at nice hotels.

It is worth noting that the Institute for Justice (IJ) recently sued the U.S. attorney general to legalize bone marrow and stem cell donor compensation.1 As the IJ reports, the Ninth Circuit ruled in our favor, holding that the National Organ Transplant Acts ban on donor compensation does not apply to the most common method for donating marrow. This victory is especially helpful for certain minorities and people with multiracial ancestries who face significantly reduced odds of finding unrelated marrow donors. But direct compensation has been met with strong resistance by the major national and international marrow registry organizations, which also lobbied against IJs efforts in court.2 Currently, compensation for donations is being offered only by smaller organizations.

My motivation for donating cannot be reduced to just one reason, but it certainly was not a sacrifice. My reasons varied in depth and weight, but all were self-interested. I thought the process itself was fascinating. I was able to ask the doctors and nurses unlimited questions and to experience firsthand a medical procedure about which I had no previous knowledge. I enjoyed business-class travel, which, as a college student was a significant treat. Most broadly, I participated in an important aspect of the kind of civil society in which I want to live. I want someone to be willing to donate lifesaving tissue to me or my loved ones, should we need it in the future, and I was happy to donate first. The costs were trivialabout twenty-five hours of volunteered time and some minor discomfort. Overall, the experience was positive and spiritually rewarding.

The option to make a donation of this kind did not even exist a few decades ago. It is a function of many interrelated parts of todays modern, relatively free-market, science-oriented cultures. The establishment and maintenance of an international donor registry requires stable, relatively rights-protecting legal systems that enable long-range and large-scale planning among cooperative strangers. To find matches in a timely manner requires the speed and integrating capacities of computers and the Internet. The medical procedure itself requires the kinds of scientific knowledge and expensive technologies made possible by todays relatively free markets. The ability to pay for such a procedure requires substantial personal wealth, which more people have today than ever before. I am exceedingly grateful to live in our rich, science-oriented, relatively capitalist civilization at the time that I do. And I hope the recipient of my donation is able to enjoy many years more of living and loving life as I do.

Related:

Endnotes

1. Bone MarrowNOTA Challenge, Institute for Justice, http://ij.org/case/bonemarrow/.

2. Coalition Says PBSC Donor Compensation Poses Health Risks to Patients and Donors, Be the Match, February 2, 2012, https://bethematch.org/news/news-releases/coalition-says-pbsc-donor-compensation-poses-health-risks-to-patients-and-donors/.

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My Non-Sacrificial Donation of Stem Cells to Save a Life - The Objective Standard

Studying brain disorders is complicated for many reasons, not the least being the ethics of obtaining living neurons. To overcome that obstacle, UC San Francisco postdoc Aditi Deshpande, PhD, is starting with skin cells.

Thanks to developments in stem cell technology, new information about the human brain is now being gleaned from a simple cheek swab or skin sample. This technology is key to the kind of progress Despande and researchers like her are making. It allows them to work with cells otherwise unobtainable living brain cells that have the same genetics as the patients.

Deshpande begins with skin cells obtained from the Simons Foundation from volunteers whose DNA contains a specific deletion or duplication of one chromosome. She cultures these cells and then turns them into induced pluripotent stem cells cells that have been coaxed back to their embryonic state and are able to become any other type of cell. From there, she reprograms them to become a specific type of neuron thats involved in attention and information processing.

The deletion or duplication Deshpande is looking for stems from a 2008 finding by Lauren Weiss, PhD, an associate professor of neurology in the UCSF Department of Psychiatry and the UCSF Institute for Human Genetics.

Weiss discovered a 29-gene region of DNA on chromosome 16 that is associated with autism, seizures and other brain disorders. Normally, a person has two copies of the region one on each copy of chromosome 16. In some of Deshpandes samples, the region is deleted from one chromosome, leaving one copy. In others, the region is duplicated, resulting in three copies. Subjects with only one copy of the region were more likely to have macrocephaly an enlarged brain than a typical subject, and those with three copies were more likely to have microcephaly a smaller brain.

Whats really interesting, said Deshpande, is that although these subjects seem to have opposite features in terms of brain size, we see a related effect, based on whether they have fewer or more copies of the region.

Some known models of autism show a connection between a neurons growth or appearance and macrocephaly, she explained. We wanted to know if the same thing is happening here.

To compare the effect of the mutation, Deshpande first stains the obtained skin cells so that she can visualize the neurons under a microscope. After staining, Deshpande used cell-counting software to assess several thousands of neurons from deletion and duplication samples and measure them against normal neurons. She found that the neurons missing the DNA region exhibited some differences compared to typical neurons.

Her next step in her research is to discern which of the regions 29 genes are involved in these differences.

The work is meticulous, but Deshpande doesnt mind. I simply love looking at neurons, she said. It really makes you appreciate the complexity of the brain.

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Science in Focus: Creating Neurons from Skin Cells to Understand Autism - UCSF News Services

Summer is behind us. But that's not all bad, because autumn and winter are the ideal seasons for treating most skin concerns thanks to shorter days, which equal less sun exposure.

That's because UVA and UVB rays damage the skin and many treatments can make the complexion more susceptible.

So as we say goodbye to summer, consider using the cooler months to address your skin concerns. Here are three new treatments which do exactly that.

Ultimate Renewal is a 90-minute procedure which first involves two types of laser to break up hyperpigmentation and resurface the skin, then dermal stamp micro needling to rejuvenate fresh collagen. The process stresses the skin so that it is forced to regenerate, much like putting stress on a muscle doing weights in order to make it bigger.

Dr Jeremy Cumpston from Ageless Clinics has been performing this special combination of treatments for the past few years, with great results.

In conjunction with the micro needling, Dr Cumpston draws some of the client's blood and spins it in a special machine which separates out the platelets, known as platelet rich plasma, which is a honey coloured substance. Those platelets are then used on the skin while the dermal stamp is in operation as they stimulate cells to generate new tissue.

"Using a client's own platelets is the fastest and most effective way to heal and rejuvenate the skin. The platelets speak a language the body naturally understands so they get to work to stimulate stem cells," Cumpston told The Huffington Post Australia.

Leftover platelets that aren't used at the time of derma stamping are mixed with an organic face cream and then frozen with nitrogen in order to maintain their biological activity. The client then takes small tub of this patent pending cream home to use on the skin as it heals over the following three days.

The last (optional) step of the treatment is called the Beauty Boost and is performed a week later. A gun-like device is used to distribute hyaluronic acid into the skin. Tiny molecules of hyaluronic acid can hold an impressive amount of water, which is why it's so good at plumping the skin. The HA paired with antioxidants and collagen factors give an overall glow, radiance and fullness to the complexion.

The treatments together recently won the national Teosyal Blue Diamond Award 2017. The Ultimate Renewal alone costs $850 and the two combined cost $1500.

The RVR90 'journey', which stands for Real Visible Results, is a custom combination of three months of at-home skincare combined with in-salon treatments, designed to correct your skin concern.

Ultraceuticals is an Australian made and owned cosmeceutical brand and is held in high regard in the skincare industry for its cutting edge research and development.

"Depending on their skin concern, clients can experience specific treatments for acne, loss of firmness, fine lines or hyperpigmentation," Tracey Beeby, Head of Global Training for Ultraceuticals told HuffPost Australia.

The system involves a three step process. Firstly a skin technician identifies the client's core skin concern and selects a specific hero treatment product to treat this problem.

Secondly, they select a matching skincare pack to suit the customer's skin type and work with the hero product. Finally, the skin technician will prescribes a course of complete treatments to accelerate progress. It is advised that clients receive a treatment every three or four weeks depending on the severity of their skin concern.

Some pretty impressive results have been achieved in the 90-day time frame. Costs vary depending on the tailored program but the skincare packs are around $200.

The use of diamonds in skincare is nothing new. Diamond dust or diamond headed exfoliating devices have long been used to buff the skin, slothing away dead cells and revealing a fresh, smooth complexion.

"Our Diamond facial, called 'Flawless' takes 60 minutes and it's our second most expensive treatment, at $349," Magen Darel, skin technician from Verdem told HuffPost Australia.

"It is a detoxifying facial to balance the skin tone and improve the elasticity. Diamond powder is used to gently exfoliate dead skin while massaging in the mask with circular motions has the benefits of stimulating collagen production."

The treatment is recommended for dry to combination skin that is too sensitive and can't have other detoxifying facials, as this is gentle and mild. It's also suggested for clients in their late 20s or older to correct accumulated sun damage.

"Highly recommend before special occasion, fine lines will diminish and you will gain a brighter skin complexion. The skin will be left soft and supple with a glow for the next upcoming days. This treatment gives similar results to diamond microdermabrasion, though the diamond cream applied as the last step offers sun protection to preserve results," Darel said.

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Three New Beauty Treatments To Whip Your Skin Into Tip Top Shape - Huffington Post Australia

March 16, 2017

A study led by Indiana University School of Medicine researchers demonstrates how electroacupuncture triggers a neurological mechanism that can help promote tissue repair and relieve injury-induced pain.

Their findings, published online March 16 in the journal Stem Cells, provide the most comprehensive picture yet of how electroacupuncture stimulates the brain to facilitate the release of stem cells and adds new insight relating to the cells' healing properties.

Electroacupuncture is a form of acupuncture that uses a small electrical current to augment the ancient Chinese medical practice of inserting fine needles into the skin at pre-determined points throughout the body.

For the study, a team of more than 40 scientists at institutions in the United States and South Korea was led by four senior authors including IU School of Medicine's Maria B. Grant, MD, Marilyn Glick Professor of Ophthalmology and co-corresponding author; Mervin C. Yoder, MD, IU Distinguished Professor, Richard and Pauline Klingler Professor of Pediatrics, associate dean for entrepreneurial research at IU School of Medicine, director of the Herman B Wells Center for Pediatric Research and co-corresponding author; and Fletcher A. White, PhD, Vergil K. Stoelting Chair ofAnesthesia, professor of anesthesia, pharmacology and toxicology.

"This work is a classic example of the power of team science, where investigators in different institutions with specific expertise worked together to unravel the complexity of how electroacupuncture works to help the body respond to stressors," said Dr. Yoder.

The researchers performed a series of lab tests involving humans, horses and rodents that follow the effects of electroacupuncture from the stimulus of the needle all the way to the brain, resulting in the release of reparative mesenchymal stem cells (MSCs) into the bloodstream.

Depending on the species, electroacupuncture led to activation of the hypothalamusa part of the brain that controls the nervous system and involuntary bodily functions such as heart rate and digestionwithin nine to 22 minutes. The stem cells were mobilized within two hours.

"The acupuncture stimulus we're giving these animals has a rapid effect on neuroanatomical pathways that connect the stimulus point in the arm to responsive neurons in the spinal cord and into a region in the brain called the hypothalamus. In turn, the hypothalamus directs outgoing signals to stem cell niches resulting in their release," said Dr. White, who is a neuroscientist at the Richard L. Roudebush VA Medical Center in Indianapolis.

The researchers found electroacupuncture treatments resulted in higher thresholds for injury-induced pain, as well as considerable increases in the presence of a type of collagen that promotes tendon repair and anti-inflammatory cells known to be predictors of faster healing time.

Dr. White said these findings could lead to new strategies for tissue repair and pain management related to injuries.

"We could potentially capture the MSCs from an individual's blood following electroacupuncture and save the cells for future re-introduction in the patient post-surgery or to treat chronic pain due to an injury," he said.

The horses used in the study had been injured during training for international dressage competitions, and the six people who took part were healthy volunteers, who still showed activation of their hypothalamus through brain imaging.

Explore further: Study finds acupuncture lowers hypertension by activating natural opioids

More information: Tatiana E. Salazar et al, Electroacupuncture Promotes CNS-Dependent Release of Mesenchymal Stem Cells, STEM CELLS (2017). DOI: 10.1002/stem.2613

Journal reference: Stem Cells

Provided by: Indiana University

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Appears to me to be approximately the same epigenetic process as high pressure - deep tissue massage work. Very interesting, I would hope some one would do a parallel study, and possible a study stacking the 2 together in the interest of quantifying a treatment method. With muscle and bone injuries estimated to cost $850 billion/year, - and to likely contribute to self medication and possible suicide we should get into the fray and assess what we know and how to incorporate what appears to work. Consultation with sports Med. docs, Massage Specialists, Osteopaths, and Chiropractors would result in development of a truly effective tool for treatment.

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Electroacupuncture releases stem cells to relieve pain, promote tissue repair, study finds - Medical Xpress

Stem cells are unspecialized cells that can develop into any type of cell in the human body. So far, however, scientists only partially understand how the body controls the fate of these all-rounders, and what factors decide whether a stem cell will differentiate, for example, into a blood, liver or nerve cell. Researchers from the Luxembourg Centre for Systems Biomedicine (LCSB) of the University of Luxembourg and an international team have now identified an ingenious mechanism by which the body orchestrates the regeneration of red and white blood cells from progenitor cells. "This finding can help us to improve stem cell therapy in future," says Dr. Alexander Skupin, head of the "Integrative Cell Signalling" group of LCSB. The LCSB team has published its results in the scientific journal PLOS Biology.

Although all cells in an organism carry the same genetic blueprints -- the same DNA -- some of them act as blood or bone cells, for example, while others function as nerve or skin cells. Researchers already understand quite well how individual cells work. But how an organism is able to create such a diversity of cells from the same genetic template and how it manages to relocate them to wherever they are needed in the body is still largely unknown.

In order to learn more about this process, Alexander Skupin and his team treated blood stem cells from mice with growth hormones and then watched closely how these progenitor cells behaved during their differentiation into white or red blood cells. The researchers observed that the cells' transformation does not occur in linear, targeted fashion, but rather more opportunistically. Each progenitor cell adapts to the needs of its environment and integrates itself into the body where new cells are needed. "So, it is not as though the cell takes a ticket at the beginning of its differentiation and then travels straight to its destination. Rather, it gets off frequently to look around and see which line is best to take," Alexander Skupin explains. By this clever mechanism, a multicellular organism can adapt the regrowth of new cells to its current needs. "Before progenitor cells differentiate once and for all, they first lose their stem cell character and then check, as it were, which cell line is currently in demand. Only then do they develop into the cell type that best suits their characteristics and which prevails in their environment," Alexander Skupin says.

The researcher likens this step to a game of roulette, where the different types of cells can be thought of as the differently numbered slots in the roulette wheel that catch the ball. "When the cells lose their stem cell character, they are quasi thrown into the roulette wheel, where they first bounce around aimlessly. Only when they have found the right environment do the cells then drop into that niche -- like the roulette ball falling into a numbered slot -- and differentiate definitively." This way, the body can orchestrate its cell regeneration and at the same time prevent stem cells from being misdirected too early. "Even if a cell takes a wrong turn, it is ultimately sorted out again if its characteristics are unsuitable for the niche, or slot, it has landed in," says Skupin.

With their study, Alexander Skupin and his team have shown for the first time that a progenitor cell's fate is not clearly predetermined and does not follow a straight line. "This observation contradicts the current doctrine that stem cells are programmed to follow a certain lineage from the beginning," Alexander Skupin says. The researcher is furthermore convinced that the processes are similar for other progenitor cells. "In the lab, we have observed the same differentiation pattern in so-called iPS cells, or induced pluripotent stem cells, which can transform into many different types of cells."

This knowledge can help the researchers to improve the effectiveness of therapies in future. Stem cell therapy involves administering a patient his or her own body's stem cells in order to replace other cells that have died as a result of an affliction such as Parkinson's disease. While this promising treatment method has been intensively researched over many years, there has so far been only limited practical success in endogenous stem cell therapy. It is also highly controversial, since it is frequently accompanied by severe side effects and it cannot be ruled out that some cells might degenerate and lead to cancer. "Because we now have a better understanding of how the body influences the direction in which stem cells differentiate, we can hopefully control this process better in future," Alexander Skupin concludes.

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Researchers decipher how the body controls stem cells ... - Science Daily

There is a fine line between falling for the delusion of the next magic pill and getting excited about the promise of the newest medical technologies. There is a risk in thinking too optimistically about the idea that whatever is wrong now, will be fixed later by technology or medical advancement. Taken to its logical conclusion, this way of thinking can lead to shirking responsibility in the present and even sacrificing quality of life in the here and now for the, sometimes false, promises of there being better things to come.

Yet, at the same time, without the hope or aspirations that come with the promise of medical advancement and that future therapies may be more effective than what our current technologies allow, progress may never be realized. So, it is with this word of caution in mind, that we will be reviewing some of the newest and most exciting medical technologies that are headed our way. The following three developments are well researched and have the potential to make huge improvements in many of our lives.

Nasal cartilage used to repair the knee: A type of stem cell therapy in which nasal chondrocytes are harvested, replicated, then grafted onto damaged joint surfaces is showing tremendous potential to restore the health and integrity of joints. Joint degeneration of knees, hips or even facet joints of the spine which can cause debilitating joint and/or back pain may all be treated by this new technology that would allow doctors to re-surface worn out joints. This approach is being tested in Sweden and in admittedly small sample sizes, is showing incredible results. If this technology continues to prove its reliability and value, it may be the end of joint replacement surgeries around the world.

Bone marrow stem cells to repair meniscal tears: If conditions involving the degeneration of joint surfaces are some of the most common orthopedic issues we collectively experience as we age, damage to soft tissue structures, like the meniscus in the knee or the labrum in the shoulder, are runners up. Another stem cell technology this time using stem cells harvested from ones own bone marrow is showing the potential to non-surgically repair these soft tissues. Researchers in Great Britain have demonstrated the potential of stem cells to be turned into a cell bandage that was able to heal meniscal tears that would otherwise require surgical intervention to simply remove or repair in order to treat.

CRISPR: Clustered regularly interspaced short palindromic repeats, otherwise known as CRISPR, is the common name for a gene editing technology based on a loophole found in our DNA which allows scientists to very precisely and very specifically cut and edit gene sequences. This technology literally allows us to re-write our genetic codes in a safe, relatively cheap, and extremely effective way. The promise of this technology is difficult not to overstate, but it has already demonstrated the potential to cure otherwise incurable genetic diseases like muscular dystrophy and sickle cell anemia. Other potential applications are basically unlimited as are the ethical implications of having this much power.

Regardless of what new technology is being developed in the wings, it is critical to remember that whether you are currently experiencing pain from arthritic knees or suffering from an autoimmune disease, there are libraries of research to support the benefits of currently available therapies. Physical therapy, specifically, has something to offer anyone looking to move or feel better - and is available right now!

If you have any questions about this article, or want to find out more about scheduling a nutritional consultation, contact Dr. Chris Telesmanic, PT, DPT, OCS at chris@alliancehealthfresno.com. Learn more about movement, fitness and health in this space each week or by visitingwww.alliancehealthfresno.com, or calling 478-5833.

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New medical technologies verses the 'magic pill' - Hanford Sentinel

A retina with macular degeneration. (Image: University of Iowa)

An unproven stem cell therapy conducted by a Florida clinic has blinded three patients in an apparent clinical trial gone horribly wrong. The incident showcases the extent to which unscrupulous clinics will take advantage of desperate patientsand how the lack of government oversight contributes to the problem.

As reported in the New England Journal of Medicine, the clinical trialif it can be called thatinvolved three women between the ages of 72 and 88 who were suffering from macular degeneration, a common progressive disease of the retina that leads to loss of vision. The women, all of whom were experiencing various degrees of vision loss, sought the help of a Florida clinic, which claimed to be testing a stem cell procedure designed to treat macular degeneration. Sometime in 2015, a week after stem cells were injected into their eyes, the women became blind. Two years later, doctors say theres virtually no chance the womens vision will be restored.

The authors of the new report, ophthalmologists Jeffrey Goldberg from Stanford University School of Medicine and Thomas Albini from the University of Miami, said the unfortunate incident serves as a call to awareness for patients, physicians and regulatory agencies of the risks of this kind of minimally regulated, patient-funded research.

Stem cells are undifferentiated cells that havent quite decided what they want to be when they grow up. Under the right conditions, these immature cells can be transformed into virtually any kind of cell found in the body, which is why theyve proven useful in regenerative medicine.

Eventually, scientists hope to be able to use stem cells to regenerate damaged tissue and organsand possibly even repair the effects of macular degenerationbut were not there yet. The only truly effective clinical application of stem cells to date has been in bone marrow transplants, in which stem cells extracted from a donors bone marrow are used to produce a fresh blood system for patients suffering from blood disorders such as leukemia. A recent study showed that there are nearly 600 clinics peddling unproven stem-cell procedures in the United States for a wide range of conditions, including arthritis, autism, cerebral palsy, stroke, muscular dystrophy, and cancer.

As noted in the NEJM report, two of the three patients learned about the stem cell trial for macular degeneration on ClinicalTrials.gov, a registry run by the US National Library of Medicine. The listings on this site arent fully scrutinized for scientific efficacy. The patients were reportedly under the assumption that they were participating in a bonafide clinical trial, but the consent form and other materials made no mention of a trial. Tellingly, each patient had to pay $5,000 for the procedure. This is highly unorthodox for a clinical trial, and it should have been cause for alarm. Im not aware of any legitimate research, at least in ophthalmology, that is patient-funded, Albini said in a statement.

The NEJM study didnt identify the Florida clinic responsible, but (conveniently) the authors provided the name of the trial: Study to assess the safety and effects of cells injected intravitreal in dry macular. A quick Google search calls the trial up, along with the name of the company responsible: Bioheart Inc., otherwise known as US Stem Cell. As the ClinicalTrials.gov page indicates, the study has been withdrawn prior to enrollment. According to Goldberg and Albini, the company is no longer performing the procedure, but it is still seeing patients.

The trial itself was a joke, lacking in all the components of a properly designed test. It wasnt based on prior laboratory experiments, no control group was assigned, no data was collected, and no plans were made for follow-ups.

During the procedure, the patients had some of their fat cells (i.e. adipose tissue) removed, along with a standard blood withdrawal. The fat tissues were then processed with an enzyme to draw out stem cells. Once plasma was isolated from the blood and added to the stem cells, the mixture was injected into both eyes of each patientyes, both eyes. Again, another serious clinical no-no; normally, only one eye would be injected for an experimental procedure like this in the event that something should go wrong. The entire procedure lasted less than an hour.

A week later, all three women were blind. As noted in the NEJM report, the blindness was accompanied by detached retinas and hemorrhaging.

The patients severe visual loss after the injection was associated with ocular hypertension, hemorrhagic retinopathy, vitreous hemorrhage, combined traction and rhegmatogenous retinal detachment, and lens dislocation. After one year, the patients visual acuity ranged from 20/200 to no light perception.

Goldberg and Albini say the preparation of the stem cells was likely shoddy, and the injections may have been contaminated. Once in the eye, the stem cells could have changed into myofibroblasts, a type of cell associated with scarring.

The Florida clinic, it would appear, was appealing to the desperation of their patients, while taking advantage of a regulatory loophole. As the authors write in their report:

Adipose tissuederived stem cells have been increasingly used by stem-cell clinics because of the relative ease of obtaining and preparing these cells. Many of the clinics that provide these stem-cell therapies have done so under the auspices of patient-funded, institutional review boardapproved research, and the research is listed on ClinicalTrials.gov without an investigational new drug filing with the FDA.

At the time, the procedure was not subject to FDA approval because the cells werent transferred between patients, and because the cells were considered minimally processed. The FDA has since revised its requirements, and it now needs approval for these types of procedures. In addition to updating its regulations, the FDA is also clamping down on stem cell clinics.

Thats obviously a good thing, but its a little too late for the women involved. This incident shows what happens when regulations and oversight are weak, and how shady companies will take risks with their patients health. Certainly food for thought as Trump and his cronies start to recreate the FDA in their own image.

Update: We reached out to US Stem Cell Clinic for comment and they responded with this statement:

Founded in 1999, U.S Stem Cell, Inc. has been committed to the research and development of effective cell technologies to treat patients with a variety of diseases and injuries. Since 2001, our clinics have successfully conducted more than 7,000 stem cell procedures with less than 0.01% adverse reactions reported. We are unable to comment further on specific cases due to patient confidentiality or legal confidentiality obligations. Neither US Stem Cell nor US Stem Cell Clinic currently treats eye patients.

[New England Journal of Medicine]

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Florida Clinic Blinds Three Patients in Botched 'Clinical Trial' - Gizmodo

"The impact of Alzheimer's disease is vast, far exceeding the medical community's current ability to treat it," said Joshua M. Hare, M.D., Longeveron's Co-Founder and Chief Science Officer. "Regenerative medicine and cell-based therapies offer a promising new approach to close this gap and address the urgent need for effective therapies to combat the condition."

An important component in the progression of Alzheimer's disease is neuroinflammation. Longeveron was recently awarded a $1 million Part the Cloud Challenge on Neuroinflammation grant from the Alzheimer's Association to help support this research.

"Adult stem cells are very potent anti-inflammatories. The characteristic amyloid plaques found in the brains of Alzheimer's disease patients produce inflammation, and stem cells can reduce inflammation," explained Bernard S. Baumel, M.D., Principal Investigator for the trial. "Alzheimer's also impairs the brain's ability to adequately produce new brain cells in the memory area known as the hippocampus. Stem cells can stimulate the brain to produce these new cells needed to form memory. We believe that an infusion of LMSCs may improve the condition or at least halt the progression of the disease."

Prior research shows that adult MSCs target and reduce inflammation, promote tissue repair and improve brain function in mouse models of Alzheimer's disease. Longeveron's trial is the first U.S. clinical study of exogenously administered mesenchymal stem cells derived from the bone marrow of healthy adult donors for treating Alzheimer's disease.

To learn about participating in the clinical trial, visit: https://clinicaltrials.gov/ct2/show/NCT02600130

About Longeveron

Longeveron is a regenerative medicine therapy company founded in 2014. Longeveron's goal is to provide the first of its kind biological solution for aging-related diseases, and is dedicated to developing safe cell-based therapeutics to revolutionize the aging process and improve quality of life. The company's research focus areas include Alzheimer's disease, Aging Frailty and the Metabolic Syndrome. Longeveron produces LMSCs in its own state-of-the-art cGMP cell processing facility. http://www.longeveron.com

Contact: Suzanne Liv Page spage@longeveron.com 305.342.9590

To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/longeveron-achieves-milestone-in-groundbreaking-stem-cell-trial-for-alzheimers-disease-300424206.html

SOURCE Longeveron

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Longeveron Achieves Milestone in Groundbreaking Stem Cell Trial for Alzheimer's Disease - PR Newswire (press release)