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Researchers at U of T developing antibodies to ‘neutralize’ novel coronavirus before it invades cells – News@UofT

Posted: April 6, 2020 at 11:53 pm

Universityof Toronto researcherSachdev Sidhuand his collaborators are engineering antibody molecules that can neutralize the novel coronavirus in the body before it invades cells.

Sidhu (left) already leads a differentteam that received supportin the first round of federal funding. The goal of that project is to design antiviral medicines that block viral replication.

With our two funded projects, we are working to develop molecules that can target the virus both inside human cells and on the outside to prevent it from getting in, says Sidhu, who is a professor of molecular genetics in the Faculty of Medicine.

Other teams in Canada, as well as in the U.K. and U.S., are looking to infuse Covid-19 survivors blood plasma containing antibodies into patientsto aid their recovery. Plasma transfusion, however, is fraught with challenges, including variability in efficacy between different donors and risk of disease transmission. Synthetic antibodies, on the other hand, represent a defined drug in terms of molecular content, efficacy and dosing regimen.

Rini has previously helped to determine how antibodies bind to and inactivate the SARS virus, the coronavirus that caused the outbreak in Asia more than 15 years ago. Also on the team isAlan Cochrane, a professor in the department of molecular genetics and an HIV virologist with expertise in viral RNA processing.

The antibodies will be engineered to block the so-called S-protein that forms spikes on the virus's surface. The spikes lock on to a protein called ACE2 on the surface of human cells to gain entry. Coating viral particles with synthetic antibodies should prevent the spikes from binding to ACE2.

Sidhu and Rini will also engineer antibodies that bind ACE2 to make it inaccessible to the virus. This type of engineered immunity surpasses the capacity of the bodys natural immune system since antibodies that react against self-proteins have been filtered out. If successful, the approach may obviate worries about viral mutations that can render drugs ineffective to new emerging viral strains becausethe host protein ACE2 does not change over time.

Sidhus team has advanced a technology called phage display to rapidly create and select human antibodies with desired biological properties, including blocking the virussspike protein. Over the last decade, his team has created hundreds of antibodies with therapeutic potential some of which are in clinical development through spin-off companiesand large pharmaceutical firms.

The group has demonstrated success with both approaches for inhibiting viral entry, having developed neutralizing antibodies that target the Ebola virus as well as antibodies that target the human host receptor of hantavirus or hepatitis C. Moreover, other research has shown that antibodies targeting SARS, a related virus whose genetic material is over 80 per cent identical to the one causing COVID-19, can clear infection in cells and mice.

Using phage display, in which tiny bacterial viruses called phages are instructed to create vast libraries of diverse antibodies, the team will select the antibodies that can kill the virus in human cells before testing them on mice and, eventually, patients. Experiments on mice could start within three to six months, Sidhu says.

In addition to creating antibodies tailored to the new virus from scratch, the researchers will also modify existing SARS-blocking antibodies so that they attack COVID-19 and provide an additional route to the development of a therapeutic.

Given the global spread of the virus, its possible that it will become endemic and circulate in the population like seasonal flu. And, like the flu, it could mutate into new strains that will evade acquired immunity and the vaccines that are being developed. By generating a panel of different antibodies, the researchers aim to stay one step ahead of the virus.

Our advances in antibody engineering technologiesand access to the complete genomes of the COVID-19 virus and its relatives provides us with an opportunity to create tailored therapeutic antibodies at a scale and speed that was not possible even a few years ago, says Sidhu.

Ultimately, we aim to optimize methods to the point where the evolution of new drugs will keep pace with the evolution of the virus itself, providing new and effective drugs in response to new outbreaks.

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How ‘viral load’ and genetics could explain why young people have died from coronavirus – The Independent

Posted: April 6, 2020 at 11:53 pm

The coronavirus pandemic has hit older people far harder than those who are younger, but scientists are yet to fully understand why this is.

Many of the elderly people who have died have had pre-existing health conditions such as heart disease, lung disease and diabetes, all of which make fighting the virus more difficult, but many have not had any such health problems, and occasionally the virus has caused the deaths of younger, apparently healthy people.

Researchers around the world are racing to learn how the virus behaves, which health factors put people most at risk, and are trying to work out whether there may be genetic traits that could mean some people respond to the infection differently to others.

Sharing the full story, not just the headlines

There are various theories to suggest why the virus is so unusually and devastatingly selective.

Some scientists have suggested the greater the amount of virus that infects an individual known as the viral load could make a large difference to how the body is able to respond to infection.

Put simply,the larger the dose of the virus a person gets, the worse the infection is, and the least promising the outcome.

A parallel school of thought is that genetic variations between humans differences in our DNA could affect how susceptible an individual is to the virus.

And another candidate for why apparently healthy young people are dying is they may have a highly reactive immune system, which is sent into overdrive fighting off the virus. In such a scenario, a huge inflammation storm could inadvertently overwhelm vital organs such as the lungs.

None of the theories compete with one another, and aspects of all of them, as well as innumerable other factors, could be at play in an individual case.

Viral load

No hype, just the advice and analysis you need

Dr Edward Parker of the London School of Hygiene and Tropical Medicine, explained how a high viral load can impact humans. He said: After we are infected with a virus, it replicates in our bodys cells. The total amount of virus a person has inside them is referred to as their viral load. For Covid-19, early reports from China suggest the viral load is higher in patients with more severe disease, which is also the case for Sars and influenza.

The amount of virus we are exposed to at the start of an infection is referred to as the infectious dose. For influenza, we know that that initial exposure to more virus or a higher infectious dose appears to increase the chance of infection and illness. Studies in mice have also shown that repeated exposure to low doses may be just as infectious as a single high dose.

He added: So all in all, it is crucial for us to limit all possible exposures to Covid-19, whether these are to highly symptomatic individuals coughing up large quantities of virus or to asymptomatic individuals shedding small quantities. And if we are feeling unwell, we need to observe strict self-isolation measures to limit our chance of infecting others.

Professor Wendy Barclay, the head of the Department of Infectious Disease at Imperial College London, said existing knowledge of viral load means healthcare workers can be at greater risk of infection.

In general with respiratory viruses, the outcome of infection whether you get severely ill or only get a mild cold can sometimes be determined by how much virus actually got into your body and started the infection off. Its all about the size of the armies on each side of the battle, a very large virus army is difficult for our immune systems army to fight off.

So standing further away from someone when they breathe or cough out virus likely means fewer virus particles reach you and then you get infected with a lower dose and get less ill. Doctors who have to get very close to patients to take samples from them or to intubate them are at higher risk so need to wear masks.

Genetic differences between those infected

Scientists are currently preparing to scour Covid-19 patients genomes for DNA variations that might indicate why some people are more at risk than others.

The findings could then be used to identify groups most at risk of serious illness and those who might be protected, and this knowledge could then inform the hunt for effective treatments.

A huge effort to pool DNA research from patients around the world is now on, with the ultimate goal being to build a body of evidence from people with no underlying health issues, but who have reacted differently to infection by the virus.

One promising strand of research into why some people are more susceptible to the coronavirus is on the gene variation for the cell surface protein angiotensin-converting enzyme 2 (ACE2), found on the outer membranes of cells, and which the coronavirus uses to enter cells in the lungs and airways.

Variations in production of ACE2 could make it easier or more difficult for the virus to enter and infect cells.

We see huge differences in clinical outcomes and across countries. How much of that is explained by genetic susceptibility is a very open question, geneticist Andrea Ganna, of the University of Helsinkis Institute for Molecular Medicine Finland, told Science Magazine.

Another fascinating line of inquiry is whether different blood types could lead to differing levels of susceptibility to the disease.

A Chinese research team reported in a non-peer-reviewed article that people with type O blood may be protected from the virus, and those with type A blood could be at greater risk.

Were trying to figure out if those findings are robust, Stanford University human geneticist Manuel Rivas told Science Magazine.

The first results from the investigations into genetic differences and susceptibility are expected in less than two months time.

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How COVID-19 Silent Spreaders May Be Infecting Others – Medscape

Posted: April 6, 2020 at 11:53 pm

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

We've been told to avoid people who are obviously sick, coughing, and sneezing to prevent us from getting the new coronavirus.

But up to 25% of people infected may never have symptoms. And in others, their symptoms may not show up until 48 hours after being infected, according to new evidence. Yet researchers have said people in both groups may be "silent spreaders" of the virus.

Several recent studies have backed this up. One that studied transmission in Singapore and China found infection was transmitted between 2.55 and 2.89 days, respectively, before symptoms started.

Another that identified seven clusters of COVID-19 cases in which transmission likely occurred before symptoms found that 6.4% of cases were attributed to transmission before there were symptoms. Another study in China found that 12.6% of the transmissions could have occurred before symptoms began in the "source" patient.

"The initial epidemiologic [research] suggests that asymptomatic spreading is happening," says Timothy Schacker, MD, a vice dean for research and professor of medicine at the University of Minnesota Medical School.

So how exactly is the virus being spread?

"People think, 'If I don't feel bad, I don't have it and can't give it to anyone,' and that is now misguided thinking," says Chad Petit, PhD, an assistant professor in the department of biochemistry and molecular genetics at the University of Alabama at Birmingham School of Medicine, who studies viruses.

Researchers don't yet have all the answers. But an expert panel from the National Academy of Sciences told White House officials Wednesday night that the virus can possibly be spread through talking or just breathing.

A letter from the Academy reads in part: "Currently available research supports the possibility that SARS-CoV-2 could be spread via bioaerosols generated directly by patients' exhalation."

Robert Mason, MD, at National Jewish Hospital in Denver, says it's little things like touching your nose or touching your eyes, then touching a doorknob or other common surface, that can help spread it, or clearing your throat. "If you have a large number of people doing little things," that's a problem, he says.

After a person is exposed, "the virus is propagating in your body, but your immune system has not recognized that something is going on systemically," says Petit. "That's why you don't get a fever right away. Just because you don't have symptoms doesn't mean you don't have the virus."

The Singapore researchers say the spread of the virus before there are symptoms might happen "through generation of respiratory droplets or possibly through indirect transmission. Speech and other vocal activities such as singing have been shown to generate air particles, with the rate of emission corresponding to voice loudness." They cite the report about singers in Washington State attending choir practice, with 40 of 60 later testing positive for the virus.

Basically, the infection is transmitted from the silent spreaders the same ways obviously sick people do, Petit says. "If somone sneezes or coughs and wipe their nose, and those droplets get on you or your hands and you touch your face that's thought to be the most common route of transmission at the moment," he says, although the virus shed on surfaces can also be infectious.

People who have mild symptoms may pass it off as allergies or a slight cold, he says.

The CDC says that people are thought to be the most contagious when they are symptomatic, or sickest. But as more information emerges about how the virus spreads, more people are taking to wearing masks. On Wednesday, Los Angeles Mayor Eric Garcetti said he was not waiting on revised guidance and advised residents to wear non-medical masks when out doing essential tasks such as grocery shopping.

Academy of Sciences member Harvey Fineberg, MD, told CNN he will start wearing a homemade mask when he goes food shopping, saving the surgical masks for health care providers.

Evidence of transmission by silent spreaders reinforces the importance of measures already in place, experts agree. That means continuing to use social distancing, frequent hand-washing, and disinfecting household surfaces.

WebMD senior writer Brenda Goodman contributed to this report.

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What Does The Novel Coronavirus Have To Do With Snakes? – Women’s Health

Posted: April 6, 2020 at 11:53 pm

Much is still unknown about the novel coronavirus, as you knowbut experts are gathering more and more interesting info every day about the virus, how it behaves, and where it came from. One surprising tp of investigation? The new coronavirus and snakes.

While most scientists are in agreement that the virus started in animalsbats, specificallyand jumped to humans, researchers are still trying to figure out the details on how exactly that transfer went down. Since the first cases of COVID-19 were identified in December (the number of cases is now over 693,000 worldwide, according to the World Health Organization report from March 30), experts have looked into bats, pangolins (aka anteaters!), and, yup, snakes as all potential players in the spread of the virus.

While the scientific community has largely ruled out snakes as being directly involved in the transfer of the virus to humans, research on the role reptiles played in the outbreak has helped scientists better understand other aspects of this virus. Here, everything you need to know about snakes and novel coronavirus.

A little background info: The novel coronavirus is a zoonotic virus, which means it belongs to a class of diseases that are able to be transferred from animals to humans and vice-versa. About 80 percent of viruses that exist are zoonotic, says Richard J. Kuhn, PhD, a professor of biological sciences at Purdue University. (Other diseases like Ebola, Zika, and the flu are all zoonotic viruses as well.) In the case of novel coronavirus, researchers have determined that bats were the likely original host.

But these diseases often jump from the origin animal to humans with the help of an intermediate host, meaning an animal that isnt the first carrier of a virus, but one that contracts it and then transfers the virus to another animal, or a human. That's why you may have seen headlines about snakes and the novel coronavirus recently.

In a study published in the Journal of Medical Virology in January, researchers compared parts of the novel coronavirus RNA to the RNA of suspected hosts of the virus and found similarities between that of the novel coronavirus and the RNA of certain snakes (specifically, the Chinese krait and cobra).

At the time of the study, that RNA similarities were thought to be indications that snakes were a natural reservoir for the virus, explains Haitao Guo, PhD, a professor of microbiology and molecular genetics at the University of Pittsburgh. A "disease reservoir" is an environment or organism in which a pathogen can live and reproduce, the Centers for Disease Control and Prevention (CDC) explains.

The short answer is no. Snakes hunt bats in the wild, and snakes were sold in the Wuhan seafood market, which is where scientists believe the virus first jumped to humans, notes Guo. So it seemed plausible that a snake could have come in contact with an infected bat (or bat feces) and served as the intermediate host.

But, as scientists have done more research, many have raised questions about methodology and parameters of the initial snake study, Guo explains. Additionally, a study published by the American Chemical Society noted that coronaviruses usually only infect birds and mammals.

What's more: Reptiles dont normally play a role at all in viral outbreaks like this one. Neither Guo nor Kuhn could think of any examples where a reptile played a major role in a viral outbreak in humans. This is partly due to the fact that reptiles are cold-blooded and mammals are warm-blooded, explains Kuhn. This temperature difference would affect the virus ability to replicate in a new species, which means that in order for the virus to actually infect a human from a reptile, it would have to evolve much more than if it was jumping from another mammal to another human.

Research published within the past month points to pangolins, a scaly anteater found in parts of Asia and Africa, as a more likely candidatethough this is still up for debate in the scientific community.

For one thing, pangolins are also mammals. Plus, the dried scales of pangolins are often sold in wet markets, and likely were sold in the Wuhan market. The aforementioned American Chemical Society study also found genetic similarities between a coronavirus found in pangolins and the current novel coronavirus presenting in humans. However, the similarities are not strong enough for researchers to say for certain that the pangolin is the secret missing piece in the transmission of the novel coronavirus from animals to humans.

Per the latest CDC guidelines, the best way to avoid getting sick and help stop the spread of germs is by washing your hands with soap and water for 20 seconds, avoiding touching your face or hands, and disinfecting often-touched surfaces. Also, continue practicing social distancing and stay 6 feet away from other people if you do have to go out for groceries or supplies.

If you do feel sick, self-quarantine for at least two weeks. Even if you dont feel sick, if youve been in contact with someone who has tested positive for COVID-19, the best thing you can do to protect others is to *stay home.*

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United States Hematologic Malignancies Testing Industry (2018 to 2025) – Featuring Illumina, Invitae Corporation & Invivoscribe Among Others -…

Posted: April 6, 2020 at 11:53 pm

Dublin, April 06, 2020 (GLOBE NEWSWIRE) -- The "U.S. Hematologic Malignancies Testing Market: Focus on Product, Disease, Technology, End User, Country Data and Competitive Landscape - Analysis and Forecast, 2018-2025" report has been added to ResearchAndMarkets.com's offering.

This report projects the market to grow at a significant CAGR of 14.60% during the forecast period, 2019-2025. The U.S. hematologic malignancies market generated $723.9 million revenue in 2018, in terms of value.

The U.S. hematologic malignancies market growth has been primarily attributed to the major drivers in this market, such as rising incidence of hematologic malignancies, favorable reimbursement scenario, and increase in funding in the hematologic malignancies market. However, there are factors hindering the growth of the market, such as lack of training professionals, high pricing pressure, and issue pertaining to the analytic validity of genetic testing.

Key Questions Answered in this Report:

Market Segmentation

Key Companies in the U.S. Hematologic Malignancies Market

The key manufacturers that have been contributing significantly to the U.S. hematologic malignancies market include Abbott Laboratories, Illumina, Inc., F. Hoffmann-La Roche Ltd, Bio-Rad Laboratories, Inc., Sysmex Corporation, Cancer Genetics Inc., QIAGEN N.V., ICON plc, Quest Diagnostics Incorporated, Invitae Corporation, Opkp Health, Laboratory Corporation of American Holdings, NeoGenomics Laboratories, Inc., ASURAGEN, INC., ArcherDX, Inc., Adaptive Biotechnologies, ARUP Laboratories, and Invivoscribe, Inc, among others.

Key Topics Covered:

1 Product Definition

2 Market Scope

3 Research Methodology

4 Epidemiology of Hematological Malignancies in U.S.

5 U.S. Hematologic Malignancies Testing Market: Value and Volume Data 2019 (U.S. State Regions)5.1 Midwest U.S.5.2 Mid Atlantic5.3 The Southwest5.4 New England5.5 The West5.6 The South

6 Market Dynamics6.1 Market Drivers6.1.1 Rising Incidence of Hematologic Malignancies6.1.2 Increasing Adoption of Inorganic Growth Strategies in the Market6.1.3 Favorable Reimbursement Scenario in the U.S. hematologic Malignancies Testing Market6.1.4 Increase in Funding in Hematologic Malignancies Testing Market6.2 Restraints6.2.1 High Pricing Pressure6.2.2 Lack of Trained Professionals6.2.3 Issues Pertaining to the Analytical Validity of Genetic Testing for Cancers6.3 U.S. Market Opportunities6.3.1 An Underlying Relaxation in Revised 2018 PAMA Criteria6.3.2 Informatics and Technological Innovation for Larger Consumer Base6.3.3 Technological Advancements in the Field of Molecular Diagnostics

7 Competitive Landscape7.1 Key Strategies and Developments7.1.1 Synergistic Activities7.1.2 Approvals7.1.3 Product Launches and Enhancements7.1.4 Merger, Acquisitions & Expansions7.2 Product Scenario7.3 Funding Scenario7.4 Market Share Analysis7.5 Growth Share Analysis (Opportunity Mapping)7.5.1 By Company7.5.2 By Product

8 Industry Insights8.1 Regulatory Framework8.1.1 Legal Requirements and Framework in the U.S.8.2 Reimbursement Scenario8.2.1 Protecting Access to Medicare Act (PAMA) Criteria for Advanced Diagnostic Laboratory Tests (ADLT)8.3 Physicians' Perceptions

9 U.S. Hematologic Malignancies Testing Market (by Product) 2018-2025 ($ Million)9.1 Services9.2 Kits9.2.1 NGS-Based Gene Panels9.2.1.1 Leukemia9.2.1.2 Lymphoma9.2.1.3 Multiple Myeloma9.2.1.4 Myeloproliferative Neoplasms9.2.1.5 Myelodysplastic Syndromes9.2.2 NGS-Based Molecular Clonality Testing9.2.2.1 Leukemia9.2.2.2 Lymphoma9.2.2.3 Multiple Myeloma9.2.2.4 Myeloproliferative Neoplasms9.2.2.5 Myelodysplastic Syndromes9.2.3 NGS-Based Translocation Testing9.2.3.1 Leukemia9.2.3.2 Lymphoma9.2.3.3 Multiple Myeloma9.2.3.4 Myeloproliferative Neoplasms9.2.3.5 Myelodysplastic Syndromes9.2.4 NGS-Based Mutation Testing9.2.4.1 Leukemia9.2.4.2 Lymphoma9.2.4.3 Multiple Myeloma9.2.4.4 Myeloproliferative Neoplasms9.2.4.5 Myelodysplastic Syndromes9.2.5 NGS-Based Minimal Residual Disease (MRD) Testing9.2.5.1 Leukemia9.2.5.2 Lymphoma9.2.5.3 Multiple Myeloma9.2.5.4 Myeloproliferative Neoplasms9.2.5.5 Myelodysplastic Syndromes

10 U.S. Hematologic Malignancies Testing Market (by End User)10.1 Specialty Clinics and Hospitals10.2 Diagnostic Laboratories10.3 Reference Laboratories10.4 Research Institutions

11 U.S. Hematologic Malignancies Testing Market (by Disease)11.1 Leukemia11.2 Lymphoma11.3 Multiple Myeloma11.4 Myeloproliferative Neoplasms11.5 Myelodysplastic Syndromes

12 U.S. Hematologic Malignancies Testing Market (by Technology)12.1 Next-generation Sequencing (NGS)12.2 Polymerase Chain Reaction (PCR)12.3 Fluorescence In-Situ Hybridization (FISH)12.4 Immunohistochemistry (IHC)12.5 Flow Cytometry12.6 Other Technologies

13 Company Profiles

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Companies Mentioned

For more information about this report visit https://www.researchandmarkets.com/r/xcrdeu

Research and Markets also offers Custom Research services providing focused, comprehensive and tailored research.

CONTACT: ResearchAndMarkets.comLaura Wood, Senior Press Managerpress@researchandmarkets.comFor E.S.T Office Hours Call 1-917-300-0470For U.S./CAN Toll Free Call 1-800-526-8630For GMT Office Hours Call +353-1-416-8900

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Its Still Hard to Predict Who Will Die From Covid-19 – Yahoo Finance

Posted: April 6, 2020 at 11:53 pm

(Bloomberg Opinion) -- In every epidemic, some die, others become ill and recover, and the luckiest live through infection without symptoms. In todays pandemic, we are seeing this play out before our eyes. Although the initial epidemiological data show that Covid-19 is more severe in older people, men and those with pre-existing conditions such as heart and lung disease, not everyone with severe disease has these risk factors. And not everyone at risk has the same symptoms, prognosis or outcome.

Why do people manifest such differences? And why is it not possible to predict an individuals experience? To address this complex question, it is important to first get our terminology right. Infection means acquisition of the coronavirus after exposure to it. Infection is not synonymous with exposure or with disease. Disease is a clinical state associated with cough, fever and other symptoms that ranges from mild to severe. These symptoms arise from damage to tissues and the immune system. Death occurs when there is so much damage that the body cannot maintain blood oxygenation and other necessary functions.

In past epidemics, death and survival were attributed to providence or fortune. Modern medicine and science provide a better understanding of why infection can lead to such different outcomes. Among individuals in the same risk group the same age, say differences in infection outcome can result from five different variables outside their control.

The first of these is microbial dosage or inoculum, the number of viral particles that cause infection. Small numbers of viral particles are more likely to be contained effectively by the bodys defenses. Then, infection may cause no symptoms or only mild disease. In contrast, a large number of particles can lead to increased viral growth, overwhelming the immune system and causing more severe disease.

Genetics may also influence susceptibility to severe infection. Viruses often gain access to host cells via surface proteins, which vary in presence and nature from person to person. Someone with no such surface proteins may be resistant to infection. In the case of HIV, for example, some people lack the receptors needed for viral infection and are not susceptible to the virus.

A third variable that influences infection outcome is the route by which a virus enters the body. Its possible that virus inhaled in the form of aerosolized droplets triggers different immune defenses than does virus acquired by touching contaminated surfaces and then touching ones face. The nose and the lung differ in local defenses, so the route of infection could significantly affect the outcome.

The fourth variable is the strength of the coronavirus itself. Viruses differ in virulence their capacity to damage host tissues or immunity even when they are all the same species. This is why flu seasons vary in severity from year to year. The varieties of a virus such as coronavirus differ depending on small genetic characteristics and how these affect the interaction with human hosts. As the coronavirus spreads from person to person, it may undergo unique changes in its genetic structure that enhance or attenuate its capacity to do harm. Strains that are more virulent could lead to more severe disease.

Finally, peoples immune status especially their history of prior infectious diseases crucially determines how they respond to a new infection. The immune system remembers previous encounters with microbes, and that affects how it fights and responds to new ones. In the case of dengue, infection with one type of the virus can make the individual more susceptible to infection with a different type of the same virus. In other situations, a recent infection with a virus can affect susceptibility to an unrelated new infection. For example, having had the flu before coronavirus infection could change the course of Covid-19 disease in unpredictable ways. When a persons immune system has no memory of an infectious agent, it may be unable to rapidly respond, and this may allow the invader to escape detection, giving it more time to cause damage.

Taken together, these variables create a complex picture. The amount of virus, our genes, the route of infection, the variety of the virus and our immunological history combine to produce outcomes ranging from asymptomatic infection to death. And because these parameters can vary so much from infected person to infected person, its impossible to predict who will live and who will die. Therefore, despite accumulating evidence that most who acquire the coronavirus will not develop severe disease, the uncertainty of who is at grave risk enhances the pandemics terror.

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In this regard, todays situation is similar to past pandemics in which the matter of who would live and who would die was also mysterious and led people to attribute outcomes to fortune or supernatural intervention. However, Covid-19 is different than the 1918 flu, in that today a robust scientific establishment can quickly analyze whats happening and help figure out how best to prevent and treat infections. Science is humanitys lifeline. In the days ahead, physicians, scientists, epidemiologists and many more will work hard to understand individual susceptibility to coronavirus. The Covid-19 pandemic will teach us a great deal of new science that will make us better prepared for the next outbreak.

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

Arturo Casadevall is a Bloomberg Distinguished Professor of molecular microbiology and immunology and infectious diseases at the Bloomberg School of Public Health and the School of Medicine at Johns Hopkins University.

Liise-anne Pirofski is a professor of medicine and chief of infectious diseases at Albert Einstein College of Medicine and Montefiore Medical Center.

For more articles like this, please visit us at bloomberg.com/opinion

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2020 Bloomberg L.P.

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Yiviva Announces Dosing of First Patient in Phase 2b Study of First-Line YIV-906 Plus Sorafenib Combination Therapy in the Treatment of Hepatocellular…

Posted: April 6, 2020 at 11:51 pm

- First-in-class oncology therapeutic candidate YIV-906 applies an integrative systems biology approach -- Global study to evaluate efficacy, safety, and quality of life in patients with hepatitis B-positive hepatocellular carcinoma -

NEW YORK and SHANGHAI, China, April 06, 2020 (GLOBE NEWSWIRE) -- Yiviva today announced that the first patient has been dosed in a Phase 2b study of YIV-906 in combination with sorafenib in the treatment of patients with hepatitis B-positive hepatocellular carcinoma (HCC). YIV-906 is a novel, proprietary therapeutic candidate based on molecular profiling of extracts identified from use in traditional botanical medicine. YIV-906 has demonstrated that it can potentiate the anti-tumor activity of sorafenib, enhance innate and adaptive immune function in the tumor microenvironment, protect cells of the gastrointestinal tract by reducing inflammation mediated by IL-6, NF-kappaB, COX2, iNOS, and accelerate regeneration of damaged gastrointestinal tissue by promoting progenitor and stem cell growth via the Wnt signaling pathway.

Patients and providers are eager to have evidence-based systemic treatment options for cancer, such as YIV-906, commented Edward Chu, M.D., Chief of the Division of Hematology and Oncology, Deputy Director at the UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine and senior advisor to Yiviva. YIV-906 applies a novel systems biology approach that has been shown in preclinical and preliminary clinical studies to enhance immune function in the tumor microenvironment and protect gastrointestinal tissue. Observations of the effects of YIV-906 in proof of concept clinical studies provide a compelling rationale for conducting this large global study in the first-line treatment setting. In addition, patients with hepatitis B-positive HCC represent a population with particularly limited treatment options where the YIV-906 approach could have a particularly significant impact on care.

The development of YIV-906 is a state-of-the-art approach using modern science, bioinformatics, and current GMP manufacturing to develop a precisely engineered botanical medicine, commented Yun Yen, M.D., Ph.D., Co-Global PI Coordinator of the YIV-906 study and former President of Taipei Medical University. The components of YIV-906 have been selected for their expected effects across multiple targets when administered as a complex mixture in combination. Given the major need for better treatments for patients with liver cancer, and the safety and efficacy profile of YIV-906 as seen to date, we look forward to the results of this global study. This could lead to new therapeutic strategies to treat cancer patients holistically.

The randomized, placebo-controlled Phase 2b study of YIV-906 is evaluating efficacy, safety, and quality of life in patients with hepatitis B-positive HCC. The clinical study is designed to enroll approximately 125 patients at 20 sites in the U.S., mainland China, Hong Kong, and Taiwan, including Memorial Sloan Kettering Cancer Center, Taipei Medical University, Queen Mary Hospital in Hong Kong and the China National Cancer Center in Beijing. Patients will be randomized 2:1 to either the study arm (YIV-906 plus sorafenib) or control arm (placebo plus sorafenib). The primary endpoint of the study is an evaluation of progression free survival. Secondary endpoints include safety and quality of life assessments and additional measures of clinical efficacy, including time to progression, overall survival, objective response rate and disease control rate. Change of quality of life will be assessed according to HCC18 and EORTC QLQ-C30 assessments. Additional information is available at https://clinicaltrials.gov/ct2/show/NCT04000737.

About YIV-906

YIV-906 (also PHY906 or KD018) is a therapeutic candidate comprised of a proprietary cGMP botanical extract of four herbs inspired by a traditional Chinese medicine formulation used for over a millennium. YIV-906 has the potential to be developed as a platform oncology therapeutic when administered in combination with chemotherapy, immunotherapy and radiation therapies, in multiple cancer indications. YIV-906 has been shown to enhance immune function in the tumor microenvironment (by polarizing M1 macrophages and activating T cells), protect the gastrointestinal tract (by inhibiting inflammation via IL-6, NF-kappa-B, COX2, and iNOS pathways) and promote intestinal tissue repair (by increasing activity and expression of components of the Wnt signaling pathway). YIV-906 has been observed to enhance the anti-tumor activity of sorafenib in preclinical models of hepatocellular carcinoma and has shown promise in preliminary clinical studies in liver, pancreatic, colorectal and rectal cancers. YIV-906 has been granted Orphan Drug designations from the U.S. Food and Drug Administration (FDA) for development of YIV-906 in the treatment of hepatocellular carcinoma and pancreatic cancer. Yiviva holds worldwide intellectual property for YIV-906 including 32 patents related to methods of use, manufacturing and quality control. YIV-906 is being developed for approval under the U.S. FDA Botanical Drug regulatory pathway.

About Yiviva

Yiviva is a clinical stage biotechnology company developing multi-target botanical therapeutics using a systems biology approach, focused on cancer, inflammatory and chronic diseases. The Yiviva STAR (signal transduction, activity and response) discovery platform accelerates the identification of botanical therapeutics that influence immune function, inflammatory responses, cell growth and metabolic functions and hormone activity. Yiviva applies patented, mechanism-based quality control linked to biological activity to satisfy established regulatory requirements for complex products. The company was launched with Yale University as a co-founder and co-founders include Yung-Chi Cheng, Ph.D., with teams in New York, New Haven, Connecticut and Shanghai. For further information, please visit https://yiviva.com.

Contact:Tel: +1 646-883-3906Email: hello@yiviva.com

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Coronavirus vaccine will take time, so researchers are hunting for and finding promising new COVID-19 tre – OregonLive

Posted: April 6, 2020 at 11:50 pm

A vaccine is the ultimate goal in the fight against the coronavirus pandemic, but its arrival is likely at least a year off, with that aggressive timeline being called a moonshot by one pharmaceutical company.

In the meantime, researchers are working to identify meaningful treatment options for patients with COVID-19, the deadly respiratory illness caused by the virus. And some early experiments and trials are encouraging.

For a much-needed dose of potential good news on the pandemic front, lets consider a handful of the many efforts underway to help COVID-19 patients.

Perhaps the best-known treatment being studied right now involves the anti-malaria drug hydroxychloroquine. President Donald Trump heralded it during a March 20 press conference. A few days later an Arizona man died after self-medicating with non-pharmaceutical chloroquine phosphate, leading the Centers for Disease Control and Prevention to warn people not to take the substance to ward off coronavirus.

Despite this tragedy, hydroxychloroquine does indeed show promise in treating COVID-19, and doctors are already trying it out on patients.

Eight coronavirus patients at a veterans home in Lebanon, Oregon, for example, have been treated with hydroxychloroquine and the antibiotic azithromycin. The oldest of the patients, 104-year-old William Lapschies, appears to have fully recovered from the illness.

I was using it to give them a fighting chance, their doctor, Rob Richardson, told The Associated Press.

The Henry Ford Health System in Michigan announced last week that it is also treating some seriously ill COVID-19 patients with hydroxychloroquine.

Early indications are that the drug reduces viral shedding, which help arrest the progression of COVID-19 in patients who are experiencing shortness of breath or who have developed pneumonia.

We are not using it in outpatients, and were not using it in patients with mild infection, Henry Ford infectious-disease specialist Dr. Marcus Zervos told reporters. We are using it, however, in patients who are sick enough to be hospitalized with pneumonia who we feel are at risk of progressing their infection.

University of Minnesota infectious-disease scientist David Bouware has begun a nationwide trial to determine if hydroxychloroquine could prevent people exposed to the coronavirus from developing COVID-19. The trial will have 1,500 participants.

Bouware says he is encouraged by the data, which indicates the drug might keep the coronavirus from entering cells, but he points out its early days.

Our goal, he said, is to find out, Does this actually work?

Preventing the progression of COVID-19 once someone is infected with the coronavirus is a key objective of medical researchers. The reason: So far, a significant percentage of the patients who have had to be put on ventilators have died.

In hopes of fewer severe cases reaching that point, researchers in Belgium have launched a clinical trial of the drug Leukine.

The study will use Leukine to treat 80 Covid-19 patients who are suffering from respiratory distress but not on ventilation. The goal is to try to prevent them from going to intensive care, Partner Therapeutics chief medical officer Dr. Debasish Roychowdhury told The Oregonian/OregonLive. Massachusetts-based Partner Therapeutics owns the rights for Leukine.

Earlier studies have shown that the drug, a yeast-derived version of GM-CSF, promotes lung repair. GM-CSF, or granulocyte macrophage colony stimulating factor, is an important protein the body makes and is critical for maintaining normal, healthy lungs, Roychowdhury pointed out.

Leukine has been around for 30 years and is currently being used to aid leukemia- and- bone-marrow-transplant patients.

The safety of the drug is very well-known, Roychowdhury said.

One of the worst-case scenarios for a COVID-19 patient is cytokine storm, when the immune system overreacts to the novel virus and floods the lungs with immune cells, causing severe inflammation. One possible way to keep those patients alive is through transfusions of plasma with COVID-19 antibodies from people who have recovered from the illness.

Five COVID-19 patients with acute respiratory distress syndrome (ARDS) at a hospital in Shenzhen, China, recently received such transfusions, a study posted to the Journal of the American Medical Association (JAMA) reported on March 27.

Though the sample size is quite small (and the critically ill patients were receiving various treatments, including antiviral medications, as part of all-out efforts to save them), the results are encouraging. All five of the patients receiving the transfusions were on ventilation when the treatment began. Following plasma transfusion, body temperature normalized within 3 days in 4 of 5 patients, the study states. A month after the transfusion, three of the five patients had been released from the hospital and the other two were in stable condition.

In another small experiment, doctors treated seven COVID-19 patients with mesenchymal stem cells, which are known for their peculiar and powerful immunoregulatory abilities. This treatment also showed promise. The pulmonary function and symptoms of these seven patients were significantly improved in 2 days after MSC transplantation, stated a study published in the journal Aging and Disease. Among them, two common and one severe patient were recovered and discharged in 10 days after treatment -- significantly faster than is typical for both moderate and severe cases.

Another drug being studied in the fight against COVID-19 is the anti-viral Remdesivir, which was developed for Ebola.

Remdesivir might stop the coronavirus from reproducing in the body. Northwestern Memorial Hospital infectious-disease specialist Dr. Babafemi Taiwo has called it a really special drug.

These and other treatments are in the very earliest stages of study, seeing as the novel coronavirus didnt exist in humans until late last year. It remains to be seen whether they will be effective and safe in large numbers of patients.

-- Douglas Perry

@douglasmperry

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What isn’t seen isn’t heard: trans and non-binary health amid COVID-19 – The CT Mirror

Posted: April 6, 2020 at 11:48 pm

March 31 was International Transgender Day of Visibility. Minus a few posts online by media outlets, little was said about it this year. As a public health student, I have been wondering how marginalized communities will be negatively affected by COVID-19 and how some communities needs will be overshadowed as healthcare systems become overwhelmed and medical resources are focused on treating coronavirus patients.

Ryan Sutherland

One of the communities that will undoubtedly face increased pressure is the transgender and non-binary community as a result of restrictive coronavirus lockdowns, disrupted access to social services, barriers to prescribing and managing hormone therapy medications, and hospital decisions to halt gender-affirming surgeries.

And in some ways, stay-at-home orders and enforced social distancing policies, while they effectively reduce opportunities for viral transmission, also contribute to trans erasure and create more opportunities for the existence of members of the trans and non-binary communities to be ignored, denied or minimized. What isnt seen isnt heard, and only through increased visibility comes equal rights.

Recently, Gov. Brad Little of Idaho signed into law House Bill 500, the Fairness in Womens Sports Act, and House Bill 509, the Idaho Vital Statistics Act. H.B. 500 states that athletic teams or sports designated for females, women, or girls shall not be open to students of the male sex and that disputes can be resolved by inspecting the students reproductive anatomy, genetic makeup, or normal endogenously 19 produced testosterone levels, effectively banning female-identifying transgender athletes from performing on teams aligned with their chosen gender identity.

H.B. 509 prohibits transgender individuals from changing their gender on their birth certificates. These bills originated from complaints strikingly similar to those articulated in a recent lawsuit filed against the Connecticut Association of Schools, Connecticut Interscholastic Athletic Conference and the boards of education in Bloomfield, Cromwell, Glastonbury, Canton and Danbury aimed to block transgender athletes from participating in girls sports.

With more than 40 states that have introduced similar legislation this year, statewide stay-at-home orders and social distancing policies limit the ability for transgender activists to protest and overturn discriminatory legislation such as these bills. And the media focus on COVID-19 developments might allow this type of legislation to fall through the cracks.

Additionally, trans and non-binary workers are three times more likely to be unemployed compared to the general population, and a lack of employer-based insurance results in a disproportionate insurance coverage gap. The pandemic has only exacerbated existing disparities. The International Foundation for Employee Benefit Plans reported that transgender inclusive healthcare benefits are offered to less than one-third of U.S. employees. With widespread furloughing and unemployment in response to the pandemic, even those with insurance benefits that cover hormone replacement therapy (HRT), counseling, or gender-affirming surgery are at risk of losing coverage.

While over 3 million Americans filed for unemployment as a direct result of layoffs caused by COVID-19, applying for unemployment might create unique challenges for trans individuals who might be required to use their deadname, a name assigned at birth that has electively been changed to match their gender identity, to prove their identity on government forms this can undoubtedly be traumatizing. Furthermore, trans and non-binary individuals might be wary to seek unemployment help as waiting in long lines outside unemployment offices might put them at an increased risk of discriminatory violence.

And it is no secret that, as a result of social stigma and discrimination, the transgender population has a higher rate of unstable housing and homelessness. According to the Williams Institute, over 30% of individuals served by drop-in centers, street outreach workers, and housing programsidentified as LGBT. Unfortunately, those who are transgender and homeless are at increased risk of exploitation, violence, and abuse, and may be turned away from shelters as a result of their gender identities. As some homeless shelters close or limit occupancy to stop the spread of COVID-19, this further limits available housing options for unhoused transgender individuals.

Past negative experiences of being misgendered or refused service when seeking care or out of fears of contracting COVID-19 in healthcare settings may cause trans people to forego care. And trans individuals may be reluctant to go to hospitals and clinics to request hormone replacement therapy (HRT) treatment during the pandemic already overburdened hospitals might not have the capacity to provide sufficient social services or hormone treatments.

Furthermore, gender-confirmation surgeries, deemed non-essential and elective, have been delayed or cancelled at many U.S. hospitals due to coronavirus. Interruptions in HRT provision or postponing long-awaited gender-affirming surgeries could augment feelings of isolation and gender dysphoria and amplify psychological distress. The Trevor Projects 2019 survey reported that more than half of transgender and non-binary young people have contemplated suicide and one-third have attempted it.

The minority stress model, a social psychology theory widely adopted in public health, describes how extreme minority stress causes adverse health outcomes among stigmatized minority groups. Consistent stress, discrimination and internalized stigma faced by transgender people increases their risk of suicidality. And as health systems react to treat coronavirus patients and critical services previously available to transgender patients are interrupted or deprioritized, feelings of isolation and marginalization might further increase rates of suicide or affect transgender mental and physical health and wellbeing.

School closures might also pose unique challenges to transgender youth. With campus LGBTQ resource centers and peer support unavailable and the suspension of all school-based social activities, transgender students might feel unsupported. Furthermore, self-quarantining with abusive family members who do not affirm their trans identity can be extremely traumatizing to trans youth.

As one trans commenter pointed out on a recent Buzzfeed article, I have to make a decision about whether to stay in the UK where I study or fly back to the States to be with my parents, one of whom doesnt use my name or pronouns and has refused to do so. With campuses and dormitories closed to suppress viral transmission, some transgender students must return home to unsafe emotionally and physically abusive homes because they are left with nowhere else to go. And once there, due to enforced lockdowns, they potentially cannot leave.

Quarantine and lockdowns may also increase rates of domestic and intimate partner violence perpetuated against transgender individuals. According to conservative estimates, the National Coalition Against Sexual Violence reports that one in three women and one in nine men will experience sexual violence during their lifetime, and these estimates do not accurately capture the increased risk of sexual violence within the LGBTQ community. Lockdowns and social distancing policies, budget cuts to IPV-related social services and mental health counseling, and financial instability due to unemployment all create opportunities for abusers to perpetrate sexual violence and make it more difficult for transgender victims to leave abusive relationships or report abuse.

Lastly, conservative graphs from the Imperial College COVID-19 Response Team and others by the Centers for Disease Control and Prevention (CDC) show frightening estimates that up to 2.2 million Americans mainly older adults, those who are immunocompromised, or those who have other pre-existing health conditions such as diabetes or lung disease might die as a result of contracting COVID-19. Elderly trans individuals at higher risk of contracting COVID-19 might refuse help from aging providers such as meal delivery programs, senior centers, or other social programs because they are afraid of harassment or discrimination.

Furthermore, statistics show the LGBTQ community is 50% more likely to smoke than the general population, potentially resulting in increased susceptibility to respiratory failure brought on by COVID-19, a respiratory illness. Moreover, trans individuals are more likely than the general population to be diagnosed with cancer and HIV, and reduced immune function could put them at a higher risk to contract coronavirus and face harsher symptoms.

Overall, the coronavirus has not just affected the trans and non-binary communities by restricting access to gender-affirming surgeries or HRT, but has effectively reduced their visibility. Fears of being misgendered or mistreated when seeking unemployment benefits or care in healthcare settings may cause trans and non-binary people to forego seeking assistance during this crisis.

Disruptions in hormone replacement therapy (HRT), counseling, or gender-affirming surgeries and self-quarantining with abusive family members may increase psychological distress and can augment rates of suicidality. Widespread unemployment might result in a loss of employer-based insurance coverage of hormone therapy and gender-affirming surgeries and cause an increase in homelessness among this population. And transphobic legislation may pass in the absence of assembled protestors who remain sequestered at home due to public health efforts to stop the spread of the coronavirus.

While COVID-19 has had a pronounced effect on everyone, those most vulnerable, such as those in the trans community, are poised to receive the most collateral damage.

Ryan Sutherland is a Master of Public Health candidate at the Yale School of Public Health in the Social and Behavioral Science Department with a concentration in global health.

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Global Testosterone Replacement Therapy Market Research Report By Key Players, Geographical Regions and Growth Analysis Outlook Up To 2025 – Fashion…

Posted: April 6, 2020 at 11:48 pm

Global Testosterone Replacement Therapy Market presenting the fundamental market overview, market trends, past, present and forecast data related to the Testosterone Replacement Therapy Market From 2020-2025. A complete analysis of the Testosterone Replacement Therapy based on the definition, product specifications, market gains, key geographic regions, and imminent Testosterone Replacement Therapy players will drive key business decisions.

Global Testosterone Replacement Therapy market report presents a thorough and latest market insights in the form of graphs, pie charts, tables to provide a clear picture of the Testosterone Replacement Therapy Market. Global Testosterone Replacement Therapy report is divided into different chunks based on the type, diverse applications, key geographical regions, market share of each player, their production volume, and supply-demand ratio.

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Global Testosterone Replacement Therapy Market Report is Segmented Into Different Parts As Below:

Testosterone Replacement Therapy Market Details Based On Key Players:

AbbVieAllerganBayerEli Lilly and CompanyKyowa Kirin InternationalNovartisPfizer

Testosterone Replacement Therapy Market Based On Product Type:

General Type

Testosterone Replacement Therapy Market Based On Product Applications:

Medical

In this study, the years examined to evaluate the market size of Testosterone Replacement Therapy are as per follows:

History Year: 2014-2019

Base Year: 2019

Estimated Year: 2020

Forecast Year: 2020 to 2025

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The Global Testosterone Replacement Therapy Market Report Covers The Following Data Points:

Section 1: This section covers the Global Testosterone Replacement Therapy Market overview, including the basic market introduction, market analysis by its applications, type, and regions. The major regions of the Global Testosterone Replacement Therapy Market include, Europe, Asia, Middle East & Africa. Testosterone Replacement Therapy Market statistics and outlook (2020-2025) are presented in this section. Testosterone Replacement Therapy market dynamics states the opportunities, key driving forces, market risk are studied.

Section 2: This section covers Testosterone Replacement Therapy manufacturers profile based on their business overview, product type, and application. Also, the sales volume, Testosterone Replacement Therapy product price, gross margin analysis, and Testosterone Replacement Therapy market share of each player is profiled in this report.

Section 3 and Section 4: These sections present the Testosterone Replacement Therapy competition based on sales, profits, and market division of each manufacturer. It also covers the Testosterone Replacement Therapy market scenario based on regional conditions. Region-wise Testosterone Replacement Therapy sales and growth (2020-2025) are studied in this report.

Section 5 and Section 6: These two sections cover the Testosterone Replacement Therapy Market by countries. Under this, the Testosterone Replacement Therapy revenue, the market share of the countries like United States, Canada & Mexico are provided.

Section 7, Section 8 and Section 9: These 3 sections covers Testosterone Replacement Therapy sales revenue and growth in all the regions. Under these regions Testosterone Replacement Therapy report covered, the growth and sales in these regions are illustrated in this Testosterone Replacement Therapy Market report.

Section 10 and Section 11: These sections depict the Testosterone Replacement Therapy market share, revenue, sales by product type and application. The Testosterone Replacement Therapy sales growth seen during 2015-2020 is covered in this report.

Section 12 and Section 13: These sections provide forecast information related to Testosterone Replacement Therapy market (2020-2025) for each region. The sales channels include direct and indirect Testosterone Replacement Therapy marketing, traders, distributors, and development trends are presented in this report.

Section 14 and Section 15: In these sections, Testosterone Replacement Therapy market key research conclusions and outcome, analysis methodology, and data sources are covered.

*** Thank you for reading. You may also request custom information, such as chapter-wise or unique region-wise research, depending on your interest. ***

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