Twiga, a 14-year-old female giraffe with advanced arthritis and osteoporosis in her feet, was fitted with custom shoes. (Photo courtesy of the Cheyenne Mountain Zoo.)

Cheyenne Mountain Zoo appears to have made medical history with its innovative giraffe treatments.

Mahali, a 14-year-old male giraffe who suffered from chronic lameness, is believed to be the first in the world to be injected with stem cells grown from giraffe blood, according to a news release from the zoo.

Stem cell therapy was chosen in the treatments led by Dr. Liza Dadone, the zoo's head veterinarian, because it has proven to repair damaged tissue. Staff at Colorado State University's James L. Voss Veterinary Teaching Hospital in Fort Collins helped with the treatment.

Nearly a month after the procedure, when Mahali was injected with about 100 million stem cells, thermographic images of the giraffe's front legs show "a considerable decline" in inflammation in his front left leg, the leg that had been giving him trouble, the zoo said.

"This is meaningful to us not only because it is the first time a giraffe has been treated with stem cells, but especially because it is bringing Mahali some arthritis relief and could help other giraffes in the near future," Dadone said in a written statement.

Dadone said it's not clear whether the successful results are due only to the stem cell treatment or a combination of treatments.

"Prior to the procedure, he was favoring his left front leg and would lift that foot off the ground almost once per minute," she said in the statement. "During the immobilization, we did multiple treatments that included hoof trims, stem cell therapy and other medications. "Since then, Mahali is no longer constantly lifting his left front leg off the ground and has resumed cooperating for hoof care. A few weeks ago, he returned to life with his herd, including yard access. On the thermogram, the marked inflammation up the leg has mostly resolved."

Twiga, a 14-year-old female giraffe with advanced arthritis and osteoporosis in her feet, was fitted with custom shoes with the help of farriers Steve Foxworth and Chris Niclas of the Equine Lameness Prevention Organization.

"We've had Twiga on medicine to help reverse her osteoporosis, but we wanted to do more to protect her feet. So with the help of the farriers, we gave her 'giraffe sneakers' to help give her some extra cushion," Dadone said in a written statement.

The giraffe's behavior was immediately changed - "Twiga instantly shifted her weight off of her right foot, indicating she was comfortable and her pain had considerably lessened" - but she will likely wear the shoes for about six more weeks, the zoo said.

Giraffes' size can make them more susceptible to issues like arthritis and osteoporosis. "Like all animals, these issues are exacerbated as they age," according to the zoo news release.

The zoo has a herd of 17 giraffes, including a newborn in April. The calf, a girl, was the 199th to be born in the 63-year history of the zoo's breeding program.

Giraffes' status was recently changed from "least concern" to "vulnerable" by the International Union for Conservation of Nature because the population in the wild has decreased by 40 percent in the last 30 years, the zoo said.

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Contact Ellie Mulder: 636-0198

Twitter: @lemarie

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Cheyenne Mountain Zoo makes medical history with 'giraffe sneakers,' stem cell treatments - Colorado Springs Gazette

A small trial involving 10 boys with autism spectrum disorder showed promising results from treatment with a drug called suramin, which was originally developed 100 years ago to treat African sleeping sickness, a parasitic disease. Boys who received a single dose of the drug showed measurable, though not permanent, improvements in autism spectrum disorder symptoms.

A report on the trial - led by the University of California-San Diego (UCSD) - is published in the Annals of Clinical and Translational Neurology.

Autism spectrum disorder (ASD), or autism, is a developmental disability with a cluster of behavioral symptoms that typically surface in childhood and generally affect social interaction and communication.

ASD is considered a complex, wide-spectrum disorder because the many symptoms can vary in combination and intensity. For this reason, no two people with ASD will have exactly the same symptoms.

Some of the behavioral symptoms of ASD include:

According to the Centers for Disease Control and Prevention (CDC), ASD affects around 1 in 68 children in the United States and occurs in all socioeconomic, racial, and ethnic groups. However, it is about 4.5 times more common in boys than in girls.

There is no single cause of ASD, but it is thought that a combination of genetic and environmental factors is involved, ranging from pollutants to viral infections and pregnancy complications.

Robert K. Naviaux, a professor of medicine, pediatrics, and pathology at UCSD School of Medicine and first author of the new study, believes that the idea of an abnormal "cell danger response" may offer a unifying theory for the development of ASD.

The cell danger response is a normal signal sent out by all cells when they suffer injury or stress. Its purpose, says Prof. Naviaux, "is to help protect the cell and jump-start the healing process." The signal causes the cell to stiffen its cell walls, stop talking to other cells, and withdraw until the threat subsides.

However, Prof. Naviaux explains that the cell danger response "can get stuck" and stop the completion of the cell's healing cycle. The cell persists in the threat response state, which can "permanently alter the way the cell responds to the world."

The effect at the molecular level is to disrupt the chemistry of cell equilibrium and cause chronic disease. Prof. Naviaux says that "when this happens during early child development, it causes autism and many other chronic childhood disorders."

Cells activate the cell danger response by releasing a small molecule from their energy-making compartments, or mitochondria. The release of this molecule is what acts as the danger signal, and it keeps being released as long as the cell danger response is active.

Suramin blocks the ability of the small molecule to release the danger signal. The effect, says Prof. Naviaux, is to signal that "the cellular war is over, the danger has passed and cells can return to 'peacetime' jobs like normal neurodevelopment, growth, and healing."

The drug was originally developed in 1916 by the German firm Frederich Bayer and Co. for treating diseases caused by trypanosome parasites, such as those that cause African sleeping sickness and river blindness.

For their small study - which took the form of a randomized, double-blind, placebo-controlled phase I/II clinical trial involving 10 boys, all aged between 5 and 14, who were diagnosed with ASD - the team tested the effect of a single dose of suramin on symptoms of ASD.

The aim of the trial was to find out whether the cell danger response theory might explain the development of ASD and to assess the safety of suramin, which is not approved for the treatment of ASD. An earlier trial that tested the drug on mice had found that a single dose "temporarily reversed" symptoms of ASD.

The boys were randomly assigned to receive either a single intravenous transfusion of suramin, or a placebo.

The results showed that all five boys who received the active drug showed measurable improvements in ASD symptoms not seen in the placebo group. The improvements were specifically in speech and language, social communication and play, coping skills, calm and focus, and repetitive behavior.

The researchers used a battery of standardized tests and interviews to measure the improvements. When these involved parent observations, the team only counted a change as an improvement if it persisted for at least a week. This was to rule out any fluctuations in day-to-day behavior that may have occurred anyway.

Prof. Naviaux says that there were four non-verbal children in the trial: two aged 6 and two aged 14, with one of each age having been assigned to the drug group and the placebo group.

"The 6-year-old and the 14-year-old who received suramin said the first sentences of their lives about one week after the single suramin infusion," he notes. "This did not happen in any of the children given the placebo."

The team reports that while the children were on suramin, there was a dramatic improvement in the benefits they derived from the speech therapy, occupational therapy, and other programs that they were taking part in.

However, the effects of the drug waned over time. The measured improvements peaked and then gradually dwindled after a few weeks.

The team is not dispirited by this. They say that the findings are sufficient to show that it is worth testing different doses of suramin in larger, more diverse groups of people with ASD, over longer periods. This could help to establish how long improvements last, and also whether side effects other than the mild skin rash observed in the small trial might emerge.

Andrew W. Zimmerman, a clinical professor of pediatrics and neurology at UMass Memorial Medical Center, was not involved in the trial but is also researching in a similar field. He says that the results of the trial are "encouraging for the field of autism," both in terms of the promising changes in the children and also because it supports the cell danger response theory. He comments:

"As the authors point out, many genetic variants have been found in ASD, but few have led to specific treatments. The CDR [cell danger response] includes a number of metabolic pathways that may be affected by a number of genetic mutations or by environmental factors that have effects epigenetically - beyond the genes themselves."

Prof. Naviaux and colleagues point out that suramin is not approved for the treatment of autism. They strongly urge against using it in unauthorized settings. The drug must undergo years of rigorous testing through clinical trials to identify any rare side effects and establish safe doses.

Learn how a new biochemical method accurately diagnosed autism in children.

Continued here:
Old drug points to promising new direction for treatment of autism - Medical News Today

M. Medina-Snchez, L. Schwarz, A. K. Meyer, F. Hebenstreit & O. G. Schmidt/Nano Lett. 16, 555561 (2016)

A helical micromotor helps an immotile but healthy bovine sperm cell get to an egg in culture.

More than 50 years ago, physicist Richard Feynman spoke of swallowing the surgeon in his classic lecture, 'There's plenty of room at the bottom'. Today, scientists are designing microscopic devices microbots and micromotors to eventually move through the body to perform medical tasks. Synthetic rods, tubes, helices, spheres or cages as small as a cell could be sent into the blood, liver, stomach or reproductive tract to diagnose conditions, carry drugs or perform surgery.

So far, most microbot experiments have been done in vitro under conditions very different from those in the human body. Many devices rely on toxic fuels, such as hydrogen peroxide. They are simple to steer in a Petri dish, but harder to control in biological fluids full of proteins and cells, and through the body's complex channels and cavities.

To enter clinical trials, microbots must clear two major hurdles. First, researchers need to be able to see and control them operating inside the body current imaging techniques have insufficient resolution and sensitivity. Second, the vehicles need to be biocompatible and be removed or stabilized after use. Achieving both aims would set the stage for further improvements in steering and mobility, materials and capabilities.

We call on microrobotics researchers, materials scientists and bioimaging and medical specialists to work together to solve these problems. And regulatory agencies need to put in place directives for testing therapeutics that are based on microbots.

There are three types of micromotors. They can be categorized according to their main propulsion mode: chemical, physical or biological (see 'Three micromotor prototypes'). Each has pros and cons.

Chemical micromotors transform fuel energy into motion1. Often, a catalyst (such as platinum, silver or palladium) within the micromotor reacts with liquid surrounding it (usually hydrogen peroxide or organic compounds). These motors are hard to control. Some move by expelling gas bubbles from one end of an asymmetrical tube. Others are made of two metals (usually gold and platinum) and propelled by differences in, for instance, tension, fuel consumption or light absorption rates between their faces. They may be guided by chemical or thermal gradients in their surroundings, or by applying magnetic fields, light or ultrasound.

Outside the body, micromotors can be based on poisonous fuels. For example, they could burn a pollutant in water as fuel, or be used for on-chip chemical and biological sensing. For in vivo uses, they need to co-opt fuels that are present in the body, such as glucose, urea or other physiological fluids2. For example, tubular micromotors have been propelled by dissolving zinc in acid in a mouse's stomach3. The endurance and efficiency of these motors need to be improved.

Physical micromotors are propelled by varying fields. For instance, a helix of magnetic material spins around its axis under a rotating magnetic field. These devices are easier to control: changing the field's orientation and frequency alters the direction and speed of the motor. Such 'magnetic swimmers' mimic flagella, the tails that propel some microorganisms4. Ultrasound, too, can be used for propulsion and guidance5.

These micromotors have less thrust than the chemical motors and need complicated actuation systems. They hold promise for carrying cargo (sensors, drugs and genetic therapies), for capturing and transporting cells and for performing microsurgery and biopsies1.

Biohybrid micromotors combine a biological agent such as a bacterium, muscle or sperm cell with a synthetic part. They can be directed by external fields or by the cells and microorganisms themselves, as they move, sense and respond to biochemicals, acidity or magnetic fields. For example, bacteria that perceive Earth's magnetism have been explored as potential drug carriers in blood vessels6. Biohybrid swimmers may travel naturally through the body. They can pass through tissues to deliver drugs deeply and can stimulate reactions such as those involved in fertilization.

For example, we have demonstrated how a motile sperm cell, loaded with a drug, could be coupled to a magnetic microstructure that guides and then releases the spermdrug complex to potentially treat cancers in the reproductive tract7. And we have used rotating magnets to drive a helix-shaped physical micromotor to deliver a live but immotile bovine sperm cell to an oocyte (egg). Such 'spermbots' could lead to new assisted-reproduction techniques8, 9. Low sperm count and motility are the two main causes of male infertility, accounting for 40% of all cases. If spermbots can capture and guide sperm to an oocyte to fertilize it in vivo, this should result in higher fertilization rates, procedures that are less invasive, and more-natural conditions for the developing embryo.

All three micromotor types share challenges. The materials they are made from must be proved to be biocompatible (such as polymers; metals including gold and zinc; proteins and DNA) or biodegradable (alginate, gelatin, calcium carbonate). They need to be able to perform a wide range of tasks: from sensing and responding to their environment to storing and delivering molecules or cells when stimulated by physical cues or by certain molecules, disease biomarkers, temperatures or levels of acidity. They need to be more manoeuvrable in three dimensions, in viscous and elastic body fluids and in phantom organs. And their targeting must be accurate.

Before any of these tiny vehicles can be used in vivo, we need to plan how to remove or stop them. They might be driven back to the starting point (mouth, eyes, ear, vagina, urethra), but this could be tedious, especially when many have been introduced. They could degrade, with the products absorbed or expelled naturally, as with tissue-engineering scaffolds, for instance. Biodegradable materials such as chitosan, polylactic acid or polyacrolactone dissolve at a certain pH, temperature or time. But small amounts of magnetic substances, metals or oxides will also be present, and their degradation and toxicity need to be studied. Stable biorobots could remain in the body as implants, monitoring the function of an organ, say.

Regulation lags behind research. Whereas active micromotors are far from being applied in clinics, some passive micro and nanoscale therapeutics have been approved. For example, silver nanoparticles are used as antibacterial wound dressings. Therapeutics that encapsulate drugs within cells or use cellular processes to modify genes or deliver drugs could be made more targeted and personalized, if more were known about their side effects.

Comment editor Joanne Baker explains what it would take to get microbots out of the lab and into our bodies.

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In the United States, live biotherapeutic products, including some vaccines, are regulated by the US Food and Drug Administration and must pass a barrage of tests in animals and humans. Blends of live and synthetic components will be harder to assess. Combinations of materials, microorganisms, microstructures and functions all need to be tested together in vivo.

Tracking the devices in vivo is crucial. Current imaging techniques, such as radiology, ultrasound, infrared and magnetic resonance imaging (MRI) are too coarse, insensitive and slow to find, let alone follow, micromotors operating deep within the body. The radioactive isotopes used in radiology and nuclear medicine are hazardous in high concentrations and when used for a prolonged time. Normal clinical MRI (with magnetic field strengths of up to 3 tesla) can resolve structures that are around 300 micrometres across good enough to image blood vessels. Higher magnetic fields (1012 tesla) can resolve 100 micrometres, but require expensive infrastructure. MRI scans take seconds to acquire and their resolution worsens when sequences are sped up.

Combinations of materials, microorganisms, microstructures and functions all need to be tested together in vivo.

A new method is called for. Ideally, it should be capable of imaging, in 3D, micromotors that are about 10 centimetres below the skin. It must resolve devices 150 micrometres across. And it must track them moving at minimum speeds of tens of micrometres per second typical of bacteria or sperm and ideally more to an accuracy of milliseconds for hours.

There are promising developments. Bioimaging researchers are manipulating light, sound and electromagnetic waves to minimize the two main effects that blur images: diffraction and scattering. Sensitivity and exposure times depend mainly on contrast. This can be enhanced by applying to the target cells or devices chemical agents that darken or fluoresce when stimulated (such as quantum dots). Ultrasound signals might be boosted through the use of small reflectors.

Combinations of these techniques look most encouraging, in our view. For example, Christian Wiest and his colleagues at iThera Medical in Munich, Germany, are developing multispectral optoacoustic tomography, which exploits the best attributes of infrared and ultrasound imaging. When laser pulses are fired at tissues, they expand and contract, giving off ultrasonic pressure waves that can be turned into a 3D image. These images have high contrast (governed by the absorption of light) and high spatial resolution (ultrasound scatters very little). Frequencies of light or ultrasound can be chosen to make certain molecules glow or darken. Such approaches can now reach resolutions of about 150 micrometres at depths of about 23 centimetres10. With focused research, they could become good enough to track microbots within a few years.

Cutting-edge ultrasound methods are also improving rapidly. Holography encoding a light field as an interference pattern in a photograph is a promising concept for both imaging and control of microobjects11. And our research group is exploring whether the direction and velocity of microbots can be tracked by measuring the reflection, transmission or emission of certain frequencies of infrared light as a function of wavelength and time. Ultimately, several approaches may be needed.

Over the next two years, the field needs to prepare for when the visualization systems become good enough to start testing and tracking active therapies in live animals.

Microbot researchers need to establish mechanisms for operating microbots, possibly even in swarms, inside the body. For example, ultrasound and magnetic fields could direct them broadly to the right region, from where finer, biochemical sensing would take over. The goal is a microbot that can sense, diagnose and act autonomously, while people monitor it and retain control in case of malfunction.

Research funders and universities need to support such cross-disciplinary work. Most of our activities are carried out within a nationwide priority programme called 'Microswimmers' that is funded by the DFG, one of Germany's main research-funding agencies.

With a coordinated push, microbots could usher in an era of non-invasive therapies within a decade.

Regulators and ethics panels should establish requirements for micromotor and biohybrid therapies. The long-term toxicity and immunoreactions of biodegradable materials and their functional coatings (such as metals, oxides and polymers) require exhaustive testing.

Clinicians should ask how these new materials and technologies should be harnessed to understand processes in the body and to design treatments. Which applications are most amenable to microbot therapies? How might microscopic tissue interventions actually be performed?

Regulatory restrictions mean that biohybrids will first be explored in lab-on-chip systems for biochemical sensing and immunoassay performance. But we have asked some clinicians how they see spermbots being used in their practices. Dunja Baston-Bst at Germany's University Hospital Dsseldorf, for instance, agrees that spermbots might be useful for delivering drugs or genes into the female reproductive tract to treat cancers or diseases of the oocyte. And Elkin Lucena from the Colombian Center of Fertility and Sterility (CECOLFES) in Bogot thinks that if all the challenges can be overcome, microbot fertilization could eventually become an alternative to in vitro techniques such as injecting a sperm into an egg.

With a coordinated push, microbots could usher in an era of non-invasive therapies within a decade.

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Medical microbots need better imaging and control - Nature.com