In a series of articles published in Nature Genetics, researchers used data from the SPARK (Simons ... [+] Powering Autism Research) to show differences in genetic influences among people all along the autism spectrum.

In a series of articles published in Nature Genetics, researchers used data from the SPARK (Simons Powering Autism Research) to show differences in genetic influences among people all along the autism spectrum.

Autism is a spectrum and includes individuals with profound autism who often have cognitive differences or epilepsy, as well as talented and exceptional individuals in specific areas. In addition, we are now appreciating that the genetic contributions to different phenotypes vary in terms of the genes involved; when those genes are activated during brain development; and how common some of the genetic variants are in the population, said Wendy Chung, M.D., Ph.D., a board-certified clinical and molecular geneticist with Columbia University's Department of Pediatrics.

One study, Integrating de novo and inherited variants in 42,607 autism cases identifies mutations in new moderate effect genes, was published in Nature Genetics today, on August 18, 2022. Researchers analyzed the DNA of almost 43,000 people with autism, including 35,000 participants from the SPARK autism research study.

To better understand the full spectrum of autism genes, the researchers analyzed 19,843 participants ... [+] with autism, along with one or both of their biological parents, and found that roughly 20% of people with autism have de novo genetic variants that affect the function of the associated gene. Nearly 70% of this genetic contribution can be attributed to known autism or neurodevelopmental disorder genes. However, this means that although known autism-associated genes are responsible for most de novo variants, others are still to be identified.

It is widely known that autism is heritable. Still, previous studies have primarily identified autism genes with de novo variants (DNV), which occur spontaneously in germ cells before conception that are not inherited. These variants are also implicated in other neurodevelopmental disorders (NDDs). Most genetic variants of this type associated with autism have profound effects on the brain in those individuals when they occur. However, according to a study by NCBI, only 20% of individuals with autism have this type of genetic variant.

For many years, we have known from twin studies that there must be inherited genetic variants that lead to autism, but we have not been able to identify individual genes until now systematically, said lead author Pamela Feliciano, Ph.D. SPARKs scientific director. We have identified a group of genes associated with autism that can include inherited variants, which begin to explain a different part of the autism spectrum.

To better understand the full spectrum of autism genes, the researchers analyzed 19,843 participants with autism, along with one or both of their biological parents, and found that roughly 20% of people with autism have de novo genetic variants that affect the function of the associated gene. Nearly 70% of this genetic contribution can be attributed to known autism or neurodevelopmental disorder genes. However, this means that although known autism-associated genes are responsible for most de novo variants, others are still to be identified.

The researchers added 22,764 individuals with autism and 236,000 people without autism from the general population. This meta-analysis identified 60 autism genes whose contribution to autism is largely driven by the rare inherited loss of function (LOF) variants transmitted by parents who do not have cognitive differences or autism. Of these genes, five have not previously been implicated in neurodevelopmental conditions.

Individuals with autism who carry inherited variants in these moderate effect genes are less likely to have cognitive differences than people with autism who take LOF variants in well-established autism genes, such as CHD8 and SCN2A.

Most parents who passed down these genetic variants in our study do not have cognitive differences or autism, but we know that these genes are associated with autism because we find that children with autism more frequently inherit these variants. Therefore, we hypothesized that people with autism with these inherited genetic variants are less likely to have seizures and cognitive differences than those with de novo genetic variants. So far, our data strongly support[s] this hypothesis, said Dr. Feliciano.

A second study also published in Nature Genetics, Rare coding variation provides insight into the ... [+] genetic architecture and phenotypic context of autism, led by a team of investigators supported by the Simons Foundation Autism Research Initiative (SFARI) and the Autism Sequencing Consortium (ASC), performed analyses on genetic data from 20,627 people with autism, with new genetic data derived primarily from SPARK.

A second study also published in Nature Genetics states, Rare coding variation provides insight into the genetic architecture and phenotypic context of autism. This study was led by a team of investigators supported by the Simons Foundation Autism Research Initiative (SFARI) and the Autism Sequencing Consortium (ASC). They performed analyses on genetic data from 20,627 people with autism, with new genetic data derived primarily from SPARK.

The team developed new methods to discover gains and losses of DNA, or copy number variants (CNVs), from exome sequencing and strategies to integrate data from these CNVs with other classes of de novo and rare inherited variants identified 72 genes associated with autism. Most evidence came from de novo variants, with smaller but significant contributions from rare inherited variants. The researchers then combined data from the autism studies with a large dataset of 31,000 families in which the child was diagnosed with developmental delay or other neurodevelopmental conditions. These analyses discovered 373 genes associated with these diverse neurodevelopmental outcomes, allowing the team to identify genes more associated with autism than other neurodevelopmental conditions and vice versa. In addition, they found that genes associated predominantly with developmental delay tend to be important in early neuronal development. In contrast, autism genes tend to play a role in more mature neurons.

The studys senior author, Michael Talkowski, Ph.D., director, Center for Genomic Medicine at Massachusetts General Hospital and member of the Broad Institute, noted that the scale of the data collections from SPARK, the ASC and other sources as well as the newly developed methods has allowed us to explore the relative contribution of the diverse classes of genetic variants that contribute to a continuum of neurodevelopmental variability across these datasets. These analyses suggested that most genes identified play a role very early in brain development. However, the genes with higher mutation rates in autism displayed slightly greater enrichment in more mature excitatory neurons.

Finally, two other studies (Antaki et al., 2022, Warrier et al., 2022) appearing in a recent issue of Nature Genetics analyzed the SPARK datasets. These two studies used the ASC and SPARK whole genomes, exomes, and single nucleotide polymorphism (SNP) genotypes to determine the contributions of multiple genetic factors to ASD, including de novo mutations, inherited rare variants, common polygenic variants, and sex. The study by Antaki et al. found that different forms of genetic contributors are associated with various ASD symptoms and that the wide variety of clinical presentations of individuals across the autism spectrum can be explained by the combinations of hereditary factors they carry. Antaki also found that genetic contributors to ASD influence behavior in all family members, including parents and typically developing siblings.

Jonathan Sebat, Ph.D., professor of psychiatry and cellular and molecular medicine at UCSD and senior author on Antaki et al., said, The spectrum of symptom severity in ASD is attributable to a spectrum of genetic influence. People who meet diagnostic criteria for autism may have the most genetic factors for autism, but these types of factors are present to varying degrees in all of us. So we are all somewhere on a continuum.

Together, the four papers provide new insights into the genetic basis of autism, a condition so ... [+] varied in its characteristics that it has been difficult to understand its neurobiological basis. Although researchers have yet to identify the fuller picture of brain molecules and pathways that underlie autism, these new studies will lead the way toward an improved understanding of this complicated and common condition.

Together, the four papers provide new insights into the genetic basis of autism, a condition so varied in its characteristics that it has been difficult to understand its neurobiological basis. Although researchers have yet to identify the fuller picture of brain molecules and pathways that underlie autism, these new studies will lead the way toward an improved understanding of this complicated and common condition.

There are so many new genes and insights into neurodevelopment to be pursued from these findings.

Read more:
New Study Identifies How A Group Of Genes Are Linked To Behavioral Conditions - Forbes

A variant typical of the Finnish population that protects against heart diseases was identified in the FinnGen genomic study coordinated by the University of Helsinki. The risk of developing heart diseases is roughly one-fifth lower in carriers of the variant compared to the population on average.

The protective effect of the newly discovered variant against coronary heart disease is likely to be caused by the below-average arterial stiffness of variant carriers.

The variant in question is located in the MFGE8 gene that produces a protein called lactadherin, which is known to affect the process of arterial stiffening. The results indicate that the variant inhibits the function of the lactadherin protein. However, further studies are needed to ascertain this.

The findings, published in the Communications Biology journal on 17 August 2022, are based on a FinnGen dataset comprising more than 260,000 Finnish biobank sample donors.

Discovery made possible by the FinnGen research dataset

Cardiovascular diseases remain the most common cause of death worldwide. In Finland too, one-third of all deaths are caused by cardiovascular diseases.

In the recently published study, genomic variation between individuals with coronary heart disease and other study subjects was compared in the FinnGen dataset. The results exposed 38 genetic loci associated with a risk of coronary heart disease, of which four, including the MFGE8 gene, were previously unknown.

Hundreds of genetic factors affecting the risk of developing cardiovascular diseases have already been identified. However, the number of known variants that reduce the risk of disease and directly indicate the active gene, like the MFGE8 variant, is relatively low,says Doctoral Researcher Sanni Ruotsalainen from the University of Helsinkis Institute for Molecular Medicine Finland, who carried out the study.

Identifying the link between MFGE8 and coronary heart disease is a good example of the special benefits the Finnish population offers to genetic research. The variant in question is 70 times more common in Finland than in the overall European population, which is why it has not been observed in previous similar gene studies elsewhere. The variant is found in roughly 5.5% of Finns, with slightly higher frequency in eastern Finland than in western parts of the country.

A protective effect against coronary heart disease opens up perspectives in drug development

The variant was also found to have an effect on the age of onset of coronary heart disease. Carriers of the protective variant suffered a myocardial infarction or were diagnosed with coronary heart disease on average 18 months later than the rest of the population.

In terms of developing new drug therapies, variants that reduce the risk of developing diseases are particularly interesting, says the studys principal investigator, Professor Samuli Ripatti from the University of Helsinki.

For example, PCSK9 inhibitors, the next-generation cholesterol drugs already in use, have been developed on the basis of a similar observation. This new finding introduces a new mechanism of action alongside cholesterol that protects against cardiovascular diseases.

Our findings also demonstrated that the MFGE8 variant did not increase the risk of any other disease. Therefore, a drug molecule mimicking the functioning of the gene could make it possible to develop entirely novel therapies for the prevention of cardiovascular diseases, Ripatti notes.

Communications Biology

Cells

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New gene variant that protects against coronary heart disease uncovered - EurekAlert

Summary: DKT, a Japanese herbal remedy containing ginger, pepper, ginseng, and maltose, reduced symptoms of colitis in mice, a new study reports.

Source: RIKEN

Zhengzheng Shi and colleagues at the RIKEN Center for Integrative Medical Sciences (IMS) in Japan report the effects of a common herbal remedy on colitis, one of two conditions that comprise inflammatory bowel disease (IBD).

Published inFrontiers in Immunology, the study shows that DKTa standard formula containing ginger, pepper, ginseng, and maltosereduced the severity of colitis in lab mice by preventing the characteristic imbalance in gut microbes and by increasing levels of immune cells in the colon that fight inflammation.

Colitis is a chronic inflammation of the colon, characterized by an imbalance ingut bacteriaand an abnormal immune response. Prevalence has doubled over the last 20 years, and its currently a global health concern, particularly in Europe and North America. Although treatments are numerous, they are only partially effective.

This has led some researchers to take a closer look at traditional herbal medicines that originated in China, and are now commonly used in Japan and other Asian countries.

Daikenchuto (DKT) is a formula containing specific amounts of ginger, pepper, ginseng, and maltose, and is one of 148herbal medicinescalled Kampo, which have been developed in Japan and are often prescribed by doctors to treat a variety of illnesses.

Previous research has hinted that DKT might be useful for treating colitis, but evidence, particularly at themolecular level, has been lacking. Thus, Shi and the team of researchers at RIKEN IMS led by Naoko Satoh-Takayama conducted a detailed examination of its effects on a mouse model of colitis.

Colitis was induced in mice using dextran sodium sulfate, which is toxic to the cells that line the colon. When these mice were given DKT, their body weights remained normal, and they had lower clinical scores for colitis. Additional analysis revealed much less damage to the cells lining the colon.

Having thus shown that DKT does indeed help protect against colitis, the researchers proceeded to analyze the gut microbiome of the mice and expression levels of anti-inflammatory immune cells.

Gut microbiomes contain numerous bacteria and fungi that aid in digestion and help the immune system.

Colitis is associated with an imbalance in thesegut microbiota, and analysis showed that a family of lactic acid bacteria were depleted in the colitic mice of this study. Also depleted was one of their metabolites, a short-chain fatty acid called propionate.

Treating the model mice with DKT restored much of these missing bacteriaparticularly those from the genus Lactobacillusand levels of propionate were normal.

Colitis is also associated with an abnormal immune response that causes the characteristic intestinal inflammation.

When the team looked at innate intestinal immune cells, they found that levels of a type called ILC3 were lower in the untreated colitic mice than in the DKT-treated colonic mice, and that mice engineered to lack ILC3 suffered more and could not benefit from DKT treatment.

This means that ILC3s are critical for protecting against colitis and that DKT works by interacting with them. Lastly, qPCR analysis indicated that these important immune cells had receptors for propionate, called GPR43, on their surface.

Daikenchuto is commonly prescribed to prevent and treat gastrointestinal diseases, as well as for reducingintestinal obstructionafter colorectal cancer surgery, says Satoh-Takayama.

Here we have shown that it can also alleviate intestinal diseases likecolitisby rebalancing Lactobacillus levels in the gut microbiome. This likely helps reduce inflammatory immune responses by promoting the activity of type 3 innate lymphoid cells.

Author: Press OfficeSource: RIKENContact: Press Office RIKENImage: The image is in the public domain

Original Research: Open access.A Japanese Herbal Formula, Daikenchuto, Alleviates Experimental Colitis by Reshaping Microbial Profiles and Enhancing Group 3 Innate Lymphoid Cells by Zhengzheng Shi et al. Frontiers in Immunology

Abstract

A Japanese Herbal Formula, Daikenchuto, Alleviates Experimental Colitis by Reshaping Microbial Profiles and Enhancing Group 3 Innate Lymphoid Cells

Daikenchuto (DKT) is one of the most widely used Japanese herbal formulae for various gastrointestinal disorders. It consists ofZanthoxylum Fructus(Japanese pepper),Zingiberis Siccatum Rhizoma(processed ginger),Ginseng radix, and maltose powder. However, the use of DKT in clinical settings is still controversial due to the limited molecular evidence and largely unknown therapeutic effects.

Here, we investigated the anti-inflammatory actions of DKT in the dextran sodium sulfate (DSS)-induced colitis model in mice.

We observed that DKT remarkably attenuated the severity of experimental colitis while maintaining the members of the symbiotic microbiota such as family Lactobacillaceae and increasing levels of propionate, an immunomodulatory microbial metabolite, in the colon.

DKT also protected colonic epithelial integrity by upregulating the fucosyltransferase geneFut2and the antimicrobial peptide geneReg3g. More remarkably, DKT restored the reduced colonic group 3 innate lymphoid cells (ILC3s), mainly RORthigh-ILC3s, in DSS-induced colitis. We further demonstrated that ILC3-deficient mice showed increased mortality during experimental colitis, suggesting that ILC3s play a protective function on colonic inflammation.

These findings demonstrate that DKT possesses anti-inflammatory activity, partlyviaILC3 function, to maintain the colonic microenvironment.

Our study also provides insights into the molecular basis of herbal medicine effects, promotes more profound mechanistic studies towards herbal formulae and contributes to future drug development.

See the article here:
How a Japanese Herbal Medicine Protects the Gut Against Inflammatory Bowel Disease - Neuroscience News

image:Quentin Vanhaelen, PhD, of Insilico Medicine will present on the Company's AI-powered target discovery platform PandaOmics at the 9th annual Aging Research and Drug Discovery conference. view more

Credit: c/o Insilico Medicine

The 9th annual Aging Research and Drug Discovery Conference, happening Aug. 29-Sept. 2 at the University of Copenhagen, will feature researcher Quentin Vanhaelen, PhD from Insilico Medicine discussing the Companys artificial intelligence target discovery platform, PandaOmics. The platform has been validated through numerous drugs in development, including thefirstAI-discovered and AI-designed drug for idiopathic pulmonary fibrosis,currently in Phase I trials. Vanhaelen is one of over 70academic and industry leaders in longevity speaking at the event, and will describe theprogress that PandaOmics has made since Insilico launched it in 2020.

PandaOmics uses aging as an important biomarker, sifting through trillions of data points from clinical trials, research grants, and omics data samples, including transciptomics, genomics, epigenomics, and proteomics. The system identifies where aging and disease intersect and how aging contributes to poorer health. Researchers have used PandaOmics to predict ninemolecular targets for new drugs that can combat aging as well as aging-associated diseases including Alzheimers, Parkinsons, cirrhosis, and rheumatoid arthritis.

Vanhaelen will discuss the possibilities of developing dual-purpose drugs using AI, and talk about how the PandaOmics platform works using data to discover where age-associated and non-age-associated diseases overlap, and evaluating targets' therapeuticpotential by ranking them for druggability and safety. And Vanhaelen will talk about the benefits of an AI approach, which allows scientists to make these discoveries in record time. The nine novel dual-purpose aging and disease targets were discovered and published in less than two months.

Identifying ways to identify and treat aging is one of the many topics being explored relative to expanding human lifespan and healthspan at the ARDD. The conference, founded by Insilico Medicine founder and CEO Alex Zhavoronkov, PhD, brings together experts in longevity to share breakthroughs, collaborate, and advance aging research.

This conference was designed to create the worlds first platform for the pharmaceutical industry to actively engage in and incorporate the latest discoveries in credible aging research into every aspect of their internal R&D strategy, says Zhavoronkov.

Vanhaelen has been working with Insilico since 2016 and holds a PhD in theoretical physics from the University of Brussels. He founded a consultancy company called Insilicoscreen on the analysis of signaling pathways dynamics that was acquired by Insilico Medicine and his research interests includetheories of aging, signaling pathways activation, modeling of dynamical systems, and applications of deep learning techniques for drug discovery.

He will present on PandaOmics on September 2, 7:40-8pm EST.

About the ARDD

The 9th annual Aging Research and Drug Discovery (ARDD) conference brings together leading academic and industry speakers in aging research with prominent startups, venture capitalists, and editors of industry journals. The event will be held virtually and in person at the University of Copenhagen Aug. 29-Sept. 2.

Details and registration: http://www.agingpharma.org/

About Insilico Medicine

Insilico Medicine, a clinical stage end-to-end artificial intelligence (AI)-driven drug discovery company, is connecting biology, chemistry, and clinical trials analysis using next-generation AI systems. The company has developed AI platforms that utilize deep generative models, reinforcement learning, transformers, and other modern machine learning techniques to discover novel targets and to design novel molecular structures with desired properties. Insilico Medicine is delivering breakthrough solutions to discover and develop innovative drugs for cancer, fibrosis, immunity, central nervous system (CNS) diseases and aging-related diseases.

For more information, visit http://www.insilico.com

For media inquiries, contact media@insilicomedicine.com

News article

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Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Insilico Medicine presents on AI for drug discovery at 9th Annual Aging Research and Drug Discovery Conference - EurekAlert

Polio cases in Western nations are likely from imported cases of unvaccinated individuals visiting countries where polio has yet to be eradicated, says Dawn Bowdish, a professor of pathology and molecular medicine.

August 17, 2022

A rise in polio cases in Western countries has put the virus, which was eradicated in Canada nearly 30 years ago, back on the radar of health officials.

It was never fully eradicated in countries like Afghanistan and Pakistan, and periodically there are parts of the world where if there was a disruption of their vaccine campaign, like a war, there might be local outbreaks, Dawn Bowdish,professor of pathology and molecular medicine, told the Toronto Star.

Polio cases in Western nations are likely from imported cases of unvaccinated individuals visiting countries where polio has yet to be eradicated, she explained.

The Public Health Agency of Canada will be testing wastewater across the country for any indication of the virus.

Its not totally unexpected to occasionally find this in the wastewater, but where its increasingly concerning now is because of the COVID pandemic and public resistance to vaccination there are going to be some people who are unprotected, she said.

According to Bowdish, because most Canadians are vaccinated against polio, there is a strong protection against the virus, she said.

Officials should focus on ensuring everyone is getting their routine vaccinations.

We want to make sure we really focus on the very young and anyone whos been missed for any reason, she says.

Link:
Why polio is back on the radar of Canadian health officials - Brighter World

Angela DeMichele, MD, MSCE, spoke about the I-SPY2 trial, which evaluates patients with early breast cancer who are treated with experimental neoadjuvant systemic therapy regimens.

At the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork spoke with Angela DeMichele, MD, MSCE, co-leader of the Breast Cancer Research Program, co-director of 2-PREVENT Breast Cancer Translational Center of Excellence, and Alan and Jill Miller Professor in Breast Cancer Excellence at Penn Medicine in Philadelphia, about the rationale of the phase 2 I-SPY2 platform trial (NCT01042379) investigating various experimental systemic therapy regimens in patients with early breast cancer presenting with various baseline characteristics and molecular subtypes. She highlighted how this protocol was instrumental in quickly and efficiently bringing novel therapies to patients, many of which have now been accepted as standard of care options in the space.

The I-SPY2 trial was designed over 10 years ago to evaluate new drugs in the early breast cancer setting. That was a novel idea back when we started because traditional drug development started in the metastatic setting. Its been borne out that that is somewhat misleading in terms of how drugs can ultimately help patients. By moving evaluation of drugs to an earlier setting, we can help patients earlier and cure more patients. The trial is a platform trial, which means that we set it up and continue to run drugs through the platform. We dont have to set up a new trial every time we want to evaluate a new drug. Weve evaluated almost 30 drugs now over the last 10 years, and some of those are now things that are standard of care, like PARP inhibitors and immunotherapy. We were able to show in patients who were starting neoadjuvant therapy that these drugs could improve patient outcomes. Those led to phase 3 trials that now have resulted in drugs being approved as standard of care.

Reference

Huppert LA, Rugo HS, Pusztai L, et al. Pathologic complete response (pCR) rates for HR+/HER2- breast cancer by molecular subtype in the I-SPY2 Trial. J Clin Oncol. 2022;40(suppl 16):504. doi:10.1200/JCO.2022.40.16_suppl.504

Visit link:
Angela DeMichele, MD, MSCE, Assesses the Value of I-SPY2 for Neoadjuvant Treatment of Early Breast Cancer - Cancer Network

Would you like to contribute your creativity to an international team of scientists from various disciplines focusing on basic research in the area of molecular life sciences?

The European Molecular Biology Laboratory (EMBL) invites you to apply for PhD positions in Heidelberg, Barcelona, Grenoble, Hamburg, Hinxton (near Cambridge) and Rome.

Information about the PhD Programme and fellowships as well as research topics at EMBL can be found here.

We welcome candidates with diverse backgrounds, such as in Biology, Chemistry, Physics, Mathematics, Computer Science, Engineering and Molecular Medicine.

EMBL provides PhD students with a starting platform for a successful career in science by fostering early independence and interdisciplinary research. The enriching encounter of different nationalities, the friendly and collaborative atmosphere, and the passion for science is what unites EMBL s diverse staff and provides an ideal setting to forge long-lasting connections and make studying at EMBL a formative experience. Our PhD positions are fully funded and offer broad health care and pension benefits.

Learn more about the EMBL International PhD Programme and apply onlinehere: https://www.embl.org/about/info/embl-international-phd-programme/application/.

The deadline for submitting the online application is 4 October 2022. References must be submitted by 6 October 2022.

Interviews will take place in January - February 2023. Successful candidates would start their work at EMBL latest by mid of October 2023.

EMBL is a signatory of DORA. Find out how we implement best practices in research assessment in our recruitment processes here.

For further information, please contact EMBL Graduate Office via graduate-office@embl.org.

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Exciting PhD positions at the European Molecular Biology Laboratory (EMBL) job with EUROPEAN MOLECULAR BIOLOGY LABORATORY (EMBL) | 304753 - Times...

image:A tiny, touch-based sensor uses sweat to detect the level of lithium in the body. view more

Credit: Jialun Zhu and Shuyu Lin

CHICAGO, Aug. 21, 2022 Lithium can alleviate the symptoms of bipolar disorder and depression if taken in just the right amount. Too little wont work, while too much can bring on dangerous side effects. To precisely monitor the amount of this medication in the body, patients must undergo invasive blood tests. But today, scientists report the invention of a tiny sensor that detects lithium levels from sweat on the surface of a fingertip in as little as 30 seconds, without a trip to the clinic.

The researchers will present their results today at the fall meeting of the American Chemical Society (ACS). ACS Fall 2022 is a hybrid meeting being held virtually and in-person Aug. 2125, with on-demand access available Aug. 26Sept. 9. The meeting features nearly 11,000 presentations on a wide range of science topics.

Not only must lithium be taken at a certain dosage, but patients often struggle to take it as prescribed and may miss pills. So, when the medication doesnt appear to be working, health care providers need to know how much medication the patient is actually swallowing. But current options for monitoring have significant drawbacks. For example, blood draws produce accurate results, but they are invasive and time consuming. Pill counters, meanwhile, dont directly measure the intake of the medication. To address these limitations, the team turned to another body fluid.

Although it may not be visible, the human body constantly produces sweat, often only in very small amounts, says Shuyu Lin, Ph.D., a postgraduate student researcher who is co-presenting the work with graduate student Jialun Zhu at the meeting. Small molecules derived from medication, including lithium, show up in that sweat. We recognized this as an opportunity to develop a new type of sensor that would detect these molecules.

Through a single touch, our new device can obtain clinically useful molecular-level information about what is circulating in the body, says Sam Emaminejad, Ph.D., the projects principal investigator, who is at the University of California, Los Angeles (UCLA). We already interact with a lot of touch-based electronics, such as smart phones and keyboards, so this sensor could integrate seamlessly into daily life.

Devising a sensor to detect lithium presented some technical challenges, however. Sweat is generally only present in minute amounts, but the electrochemical sensing needed to detect charged particles of lithium required an aqueous, or watery, environment. To provide it, the team engineered a water-based gel containing glycerol. This extra ingredient prevented the gel from drying out and created a controlled environment for the electronic portion of the sensor.

To trap the lithium ions after they traversed the gel, the team used an ion-selective electrode. The accumulating ions generate a difference in electrical potential compared with a reference electrode. The researchers used this difference to infer the concentration of lithium present in sweat. Together, these components comprise a tiny, rectangular sensor that is smaller than the head of a thumbtack and can detect lithium in about 30 seconds. The sensor is still in the preliminary testing phase, but ultimately, the researchers envision incorporating it into a larger, yet-to-be designed system that provides visual feedback to the provider or the patient.

After characterizing the sensor using an artificial fingertip, the team recruited real people to test it, including one person on a lithium treatment regimen. The researchers recorded this persons lithium levels before and after taking the medication. They found that these measurements fell close to those derived from saliva, which prior research has shown to accurately measure lithium levels. In the future, the researchers plan to study the effects of lotion and other skin products on the sensors readings.

This technology also has applications beyond lithium. Emaminejad is developing similar touch-based sensors to monitor alcohol and acetaminophen, a painkiller also known as Tylenol, while also exploring the possibility of detecting other substances. The complete sensing systems could include additional features, such as encryption secured by a fingerprint, or, for substances prone to abuse, a robotic dispensing system that releases medication only if the patient has a low level in their bloodstream.

The researchers acknowledge support and funding from the National Science Foundation, Brain and Behavior Foundation, Precise Advanced Technologies and Health Systems for Underserved Populations and the UCLA Henry Samueli School of Engineering and Applied Sciences.

ACS Fall 2022 will be a vaccination-required and mask-recommended event for all attendees, exhibitors, vendors and ACS staff who plan to participate in-person in Chicago. For detailed information about the requirement and all ACS safety measures, please visit the ACS website.

The American Chemical Society (ACS) is a nonprofit organization chartered by the U.S. Congress. ACS mission is to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and all its people. The Society is a global leader in promoting excellence in science education and providing access to chemistry-related information and research through its multiple research solutions, peer-reviewed journals, scientific conferences, eBooks and weekly news periodical Chemical & Engineering News. ACS journals are among the most cited, most trusted and most read within the scientific literature; however, ACS itself does not conduct chemical research. As a leader in scientific information solutions, its CAS division partners with global innovators to accelerate breakthroughs by curating, connecting and analyzing the worlds scientific knowledge. ACS main offices are in Washington, D.C., and Columbus, Ohio.

To automatically receive press releases from the American Chemical Society, contact newsroom@acs.org.

Note to journalists: Please report that this research was presented at a meeting of the American Chemical Society.

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TitleTouch-based non-invasive lithium monitoring using an organohydrogel-based sensing interface

AbstractLithium salt is one of the most widely-used psychiatric medications for individuals with bipolar disorder. Due to its narrow therapeutic window (~ 0.6 - 1.2 mM) and high nonadherence rate (~ 40%), it needs to be closely monitored to maximize the treatment efficacy. Standard practices of lithium monitoring for precise dosing are confined to centralized hospitals and involve invasive blood draw and high-cost lab-based analysis with long turnaround time. Moreover, currently there is no direct lithium adherence monitoring available, and the indirect monitoring solutions (e.g., pill counters) are incapable of verifying the actual intake event (inherently non-specific).

Overcoming these limitations, here, we developed a touch-based non-invasive lithium monitoring solution for decentralized lithium pharmacotherapy management. This solution is based on a hydrogel coated-sensing interface that collects and analyzes (in-situ) the flux of circulating lithium molecules that partition onto fingertips. This interface was constructed using a thin organohydrogel-coated lithium ion-selective electrode (TOH-ISE), where the TOH coating was specially engineered to render stabilized conditions for sensing. In particular, by adopting a water-glycerol bi-solvent matrix, the gel was endowed with anti-dehydration property (negligible weight loss for > 2 weeks storage in an ambient environment), resolving the dehydration challenge of previously-reported hydrogel-based interfaces. Furthermore, in the devised interface configuration, the TOH coating serves as a controlled micro-environment to condition the ISE in-situ; thus, it minimizes the ISE signal drift (a key challenge prohibiting the translation of ISEs in real-life applications).

To illustrate the clinical utility of our solution, the developed touch-based sensing interface was tested on a patient prescribed with lithium-based medicine, where the elevation of the circulating drug levels after the medicine intake was successfully captured. Collectively, our preliminary results demonstrate the suitability of our touch-based solution for lithium adherence monitoring, and more broadly for managing lithium-based pharmacotherapy.

View post:
Sensor could help patients stay on top of their meds - EurekAlert

Centre of Excellence will focus on creating unparalleled medical discoveries to transform healthcare delivery

Trivitron Healthcare, a global manufacturer of medical devices has constantly strived towards novel innovation and applications to transform healthcare with quality products, services & smart ventures. For millions of healthcare practitioners across the world, Trivitron is known for trust, quality, safety, and innovationdriven products. Further to cater to the growing healthcare needs, a Centre of Excellence (CoE) with state-of-the-art R&D and Manufacturing facilities was launched on 19th August 2022 at AMTZ Campus, Vishakhapatnam, India by Prof. Ajay Kumar Sood, Principal Scientific Advisor to the Government of India and Prof. (Dr) Balram Bhargava, Former Director General, Indian Council of Medical Research.

At the inauguration, Dr GSK Velu, Chairman & Managing Director, Trivitron Healthcare said: Trivitron is committed to providing futuristic applications by encompassing advanced R&D, which will be coupled with strong manufacturing capabilities under the supervision of leading scientists and industry experts in this center which spans over 43,000 square feet area. This centre will implement research and innovation in the field of metabolomics, genomics, newborn screening, and molecular diagnostics and bring out cost-effective and affordable medical technology products and services. With 15 certified manufacturing facilities in India, USA, Finland, Turkey & China, Trivitron spearheads innovation in the field of in-vitro diagnostics, medical imaging and critical care solutions.

By harnessing the enormous power of genomic research and Trivitrons expertise in advanced diagnostics, this CoE will focus on creating unparalleled medical discoveries to transform healthcare delivery. The new centre is equipped with state-of-art infrastructure to support the entire product & process development lifecycle at the respective domain specific labs to achieve optimal scale-up to industrial production.

A great venture to futuristic medicine and diagnosis

IVD CE-approved kits for various newborn screening, infectious, non-infectious diseases and cancer markers based on RT-PCR, ELISA, Rapid cards/POCT, clinical chemistry and CLIA will be manufactured at this facility. Since all the components are made in-house, Trivitron will have the fastest turnaround time in the country. The major focus of this facility will be on the manufacturing of genomics-based kits and reagents. This will include the synthesis of customised primers and probes for RTPCR based screening kits, enzymes, master mixes etc.

The centre includes an Advanced Genomics and Molecular diagnostics facility for developing kits and reagents for Next Generation Sequencing (NGS) and oligonucleotide synthesis (synthesis of customised primers and Taq Man Chemistry dual labelled probes), Protein Chemistry (design and expression of different recombinant enzymes and proteins), cell culture and analytical lab. The company plans to manufacture all the raw materials and components of molecular diagnostics, NBS, and NGS in-house following advanced protocols and research approaches.

The new centre of Trivitron will have provision to manufacture 300 million RTPCR tests and over 70 million tests of Rapid Card/POCT per annum. Additionally, more than 100 million tests can be manufactured for genomics, ELISA, CLIA, NBS and other diagnostics kits

Read more from the original source:
Trivitron Healthcare launches CoE in metabolomics, genomics, newborn screening and molecular diagnostics - Express Healthcare

Introduction

Pain is an unpleasant sensory and emotional perception associated with actual or underlying tissue pathology, which can bring major clinical, social, and economic problems in communities around the world. Notably, pain appears to have a greater negative effect on the quality of life than other diseases, and is also the greater cause of disability around the world.1 It was estimated that more than 20% of the population visit the clinic with pain as the main complaint each year.2 Additionally, pain also creates enormous economic pressure on society, with a total cost of about 3.0% of GDP.3 Unfortunately, treatment options for pain are poorly targeted due to the complex etiology and recurring symptoms. As commonly identified, pain disease can be the classification by time (acute or chronic), etiology (traumatic, pathological, neurogenic, etc.), location (head and neck, spine and joint, etc.) and other methods. Pharmacological therapy options can relieve pain in a short time but the safety concerns of using muscle relaxants, non-steroidal anti-inflammatory drugs or other painkillers need to be fully evaluated. Thereby, effective complementary and alternative therapies attract both patients and practitioners.4

Moxibustion, a typical therapeutic procedure of traditional Chinese medicine (TCM), which restores the function of visceral organs and meridians by applying heat from burning herbs such as moxa to a certain area or acupoints, is widely sought after and used in the current healthcare system.5 It cures disease by stimulating specific spots on the skin to treat many medical conditions such as asthma, colds and influenza, irritable bowel syndrome (IBS), cancer-related fatigue, disorders of the spinal column, pain, and others.610 Accumulating evidence indicates that the combined effect of thermal effects and non-thermal radiation effects of pharmacological responses such as smoke and moxa extracts contribute significantly to the overall analgesic efficacy of moxibustion treatment.11

Preliminary studies were carried out to show the benefits of moxibustion in recent years. The current discussions show that moxibustion treatment was an efficient and safe option for the treatment of pain, including arthritis,9 dysmenorrhea,10 low back pain or neck pain,12 and some other disorders. These trials had been shown that moxibustion can significantly relieve pain and improve function in patients. However, the kinds of literature in this field were diversified and had not been systematically classified and sorted out. Therefore, bibliometric analysis was needed to summarize the current research trend and elicit hotspots in this field. These dissertations seek to investigate the use of moxibustion in analgesia aiming to analyze the current status of moxibustion research for pain disease.

Bibliometrics is a quantitative analysis of published academic literature by using mathematical and statistical methods, and it is a statistical analysis and quantitative tool to study publications.13 Based on mathematical and statistical tools, bibliometrics is used to measure established and emerging research areas through co-authorship, co-citation, and co-occurrence analyses in a certain research field.14 CiteSpace software typically falls into bibliometric visualization tools that can visualize and analyze emerging trends and transition patterns in scientific literature widely.15

This study aims to explore the current status of year, countries, journals, research areas, authors, keywords, and explore hot topics and emerging trends in the field of moxibustion for pain treatment over the past 10 years by using bibliometric analysis.

All data in this study were collected from the core collection database for WoS via the Zhejiang Chinese Medical University Library website including Science Citation Index Expanded (SCI-Expanded), Social Sciences Citation Index (SSCI), Arts & Humanities Citation Index (A&HCI) and Emerging Sources Citation Index (ESCI) on April 3, 2022. The search strategy was TS=(moxibustion OR moxa OR Moxabustion) AND TS=(pain* OR nocicep* OR ache* OR analg* OR headache* OR migraine* OR stomach ache* OR abdominal ache* OR toothache* OR neck painweek pain OR back pain OR musculoskeletal pain OR sciatic* OR fibromyalg* OR neuralgi* OR hyperalg* OR radiculalg* OR arthralg* OR causalg* OR earache* OR cancer pain OR osteoarthritis OR arthritis). The publications timespan ranged from 2012 to 2021. A total of 360 records were retrieved in this study. In addition, the countries, categories and language of publications were not restricted. The specific search strategies and results are shown in Table 1.

Table 1 The Topic Search Query

Descriptive statistical analysis, co-occurrence analysis and cluster analysis were executed by using CiteSpace 5.8 and Excel 2016, the former mainly to achieve analysis of journals, cited journals, dual-map of cited journals, countries, institutions, authors, references, and keywords; while the latter was mainly applied to depict the annual publications. The parameters of CiteSpace were set as below: (1) time slicing: from January 2012 to December 2021, per slice represent 1 year; (2) term source: all options were selected; (3) selecting criteria: factor k = 25; (4) pruning: pathfinder, pruning sliced networks and pruning merged network were chosen. In this multivariate, time-sharing, dynamic visualization knowledge graph, each node represented an element. The size of the circle represented the frequency of items and the width of lines served as the connection between items. The large size and warm color of a node implied that it has recently exploded with high frequency. The thick links between nodes meant a strong co-leading relationship. Additionally, the nodes with wide purple around them often represented the literature with higher centrality.

A total of 360 publications were included in this study. As shown in Figure 1, the number of publications increased obviously from 20 in 2012 to 71 in 2021. From 2012 to 2018, the number of publications fluctuated at a low level, with the lowest number of publications being in 2012 (with only 20 publications). However, the number of publications increased rapidly in 2019. Furthermore, the number of publications increased continually is reach 71 from 2019 to 2021. The trend of publications indicated that moxibustion, as a complementary treatment, has received more attention, and more studies have been carried out to observe the efficacy of moxibustion on pain in recent years.

Figure 1 The number of moxibustion therapy for pain treatment publications from 2012 to 2021.

Results of our statistical analysis revealed that the total number of journals that published articles on moxibustion treatment for pain was 97. The top 10 journals of moxibustion therapy for pain treatment are shown in Table 2 and the publishers of these journals were mostly located in the United States or England. Evidence-Based Complementary and Alternative Medicine (Evid-based Compl Alt) was the most productive journal (with 62 publications, 17.22% of 360), followed by Medicine (60, 16.67% of 360), and Journal of Traditional Chinese Medicine (20, 5.56% of 360). Furthermore, Lancet Gastroenterology & Hepatology the journal with the highest impact factor (IF), with an IF of 18.486.

Table 2 Top 10 Journals Related to Moxibustion Therapy for Pain Treatment

The analysis of the co-citation of journals indicated a distribution of significant knowledge sources in a particular field. Cited journal map consists of a total of 430 references (as shown in Figure 2 and Table 3). In terms of centrality, the top 5 journals were Gut, Journal of clinical epidemiology, JAMS Journal of Acupuncture and Meridian Studies, BMC Complementary and Alternative Medicine, and BMC Research Notes, respectively.

Table 3 Cited Journals and Centrality Related to Moxibustion Therapy for Pain Treatment

Figure 2 Cited journal maps related to moxibustion therapy for pain treatment from 2012 to 2021.

A dual-map overlay with citing and cited matrices of journals was generated by using CiteSpace 5.8 software (Figure 3). The left side of the map represents citing journals while the right is cited journals which are linked with four citation paths in this illustration. The green paths illustrate that studies published in medicine, medical, clinical journals tended to cite journals primarily in the domains of Molecular, Biology, Genetics and health, nursing, medicine. The paths colored with an orange showcase that research published in Molecular, Biology, Immunology journals preferred to quote journals mostly in the domains of Molecular, Biology, Genetics and health, nursing, medicine.

Figure 3 A dual-map overlay of journals related to moxibustion therapy for pain treatment from 2012 to 2021.

The distribution of the countries map consists of 24 nodes and 30 links (Figure 4). The 360 references were published by researchers from 24 countries, indicating that 24 countries participated in the study of moxibustion therapy for pain. As a result, China (267) had the most publications, followed by South America (37), Korea (36) and England (13) (Table 4). Considering the country centrality, England (0.83) ranked first among the countries, followed by Germany (0.7) and China (0.48).

Table 4 The Top 5 Publications and Centrality of Countries Related to Moxibustion Therapy for Pain Treatment

Figure 4 A country cooperation map related to moxibustion therapy for pain treatment from 2012 to 2021.

CiteSpace was applied to estimate the 238 institutions that have made significant contributions in this field (Figure 5). Shanghai University of Traditional Chinese Medicine (44) ranked first for publications, followed by Chengdu University of Traditional Chinese Medicine (43), and Jiangxi University of Traditional Chinese Medicine (27). Besides, the top 3 institutions with higher centrality were Chengdu University of Traditional Chinese Medicine, the University of Hong Kong, and Shanghai University of Traditional Chinese Medicine (Table 5). Therefore, based on the publications and centrality, we found that the institutions from China paid more concerned with the research of moxibustion treatment in pain currently, and Shanghai University of Traditional Chinese Medicine and Chengdu University of Traditional Chinese Medicine was the strongest cooperation institutions.

Table 5 The Top 10 Publication and Centrality of Institutions Related to Moxibustion Therapy for Pain Treatment

Figure 5 An institution cooperation map related to moxibustion therapy for pain treatment from 2012 to 2021.

Co-authors map consists of 315 nodes and 418 links using CiteSpace software (Figure 6), indicating that the total eligible publications in this study were published by 315 authors. The map of authors was designed to reveal the most prolific author or co-author, as well as demonstrate the closeness of collaboration among the authors, which could provide information on influential research groups and potential collaborators, and help researchers establish cooperative relationships. The top 3 productive authors were Huangan Wu (19), Jun Xiong (18), Luyi Wu (12) (Table 6). Among them, the most prolific author was Huangan Wu, from the Shanghai University of Traditional Chinese Medicine in China, with 19 articles. In terms of centrality, the top 4 authors were Jun Xiong (0.06), Fanrong Liang (0.06), Guixing Xu (0.05) and Adi Wirawan Tjahjono (0.05). From the network, few links between these top authors suggest an urgent need to strengthen the collaboration between these researchers.

Table 6 The Top 5 Publication and Centrality of Authors Related to Moxibustion Therapy for Pain Treatment

Figure 6 Map of cited author related to moxibustion therapy for pain treatment from 2012 to 2021.

Lin Zhao has published many articles in this field recently, and the content of his articles is comparatively original. One of the studies suggested that moxibustion is an effective and safe approach for pain relief in osteoarthritis of the knee.16 System reviews and meta-analysis had proved the effectiveness of moxibustion therapy; nonetheless, there was still a lack of high-quality articles.17 Those scholars with high attainments in this field could create more cooperation and exchanges so as to complete more high-quality articles and scientific research achievements.

Co-citation implies that two articles appear together in the reference list of a third cited article thus the two articles form a co-citation relationship. Co-citation suggests that the cited literature and corresponding research are related in content, and the literature usually contains high-quality content which has significant influence in a particular field of research. By analyzing the literature with high co-citation frequency and centrality, the knowledge foundation of the subject could be obtained. Moreover, the relationship between literature co-citation is likely to change with time. A total of 403 references were generated from 360 records to analyze cited-references. The top 5 cited-references were shown in Figure 7, Table 7. The study published by Shamseer L in 2015 had the highest co-citation counts, followed by Li A (2016) and Song GM (2016), intending to clarify the clinical effect of moxibustion treatment for Knee Osteoarthritis (KOA) through a systematic Review and Meta-Analysis. The review published by Li A concluded that moxibustion can mitigate the symptoms of KOA to some extent.18 Yang MX conducted a randomized controlled trial to identify the synergy between moxibustion therapy and conventional drug.10 With respect to centrality, the first was the article published in 2013 by Deng HY who reviewed on the mechanism of moxibustion effects, among which the most acceptable view is adjusting the nerve-endocrine-immune network and circulatory system to achieve the effects of preventing and curing diseases.19

Table 7 The Top 5 Frequency and Centrality of Citation Related to Moxibustion Therapy for Pain Treatment

Figure 7 (A) Map of cited references related to moxibustion therapy for pain treatment from 2012 to 2021. (B) The top 10 clusters of cited reference related to moxibustion therapy for pain treatment from 2012 to 2021.

To investigate the clusters of a cited-references, the logarithmic likelihood ratio (LLR) algorithm was used to assess nominal terms extracted from the keyword list of articles to the naming of clusters to explore research models and emerging trends in knowledge systems, and to obtain key information from cited references. Seventy-one clusters were generated with a modularity value of 0.86777, indicating that clustering results were highly reliable (Figure 7B). As the figure showed the silhouette was 0.8785, which demonstrated that the resulting network community structure was significant and our cluster was acceptable concurrently. The top 5 clusters were osteoarthritis, primary osteoporosis, clinical research, knee osteoarthritis and metabolomics. Among these groups, the largest one was osteoarthritis, which consisted of 38 reference articles. Cluster #53 angina pectoris was depicted in most vivid yellow which indicated a new research direction that had recently emerged.

The research trend in this field is often represented by analyzing keywords, the increase in occurrence and citation frequency is considered to predict the research frontier in this field. A keyword co-occurrence network containing 302 notes and 538 links (Figure 8). Acupuncture, pain, randomized controlled trial, moxibustion, and management were the top 5 keywords with the highest frequencies; while meta-analysis, acupuncture treatment, randomized controlled trial, irritable bowel syndrome, and ankylosing spondylitis were the top 5 keywords with the highest centrality (Table 8). Interestingly, randomized controlled trial is of high position both in frequency and centrality. RCT was essential for evaluating the efficiency of a certain therapeutic method, but inadequate reporting and design elicited a high level of concern to formulate proper ethical standards. Hence, developing the Consolidated Standards of Reporting Trial (CONSORT) statement is employed promising to improve the quality of reporting of RCTs.20 As double-blind is difficult to meet in clinical trials, single-blind trials were chosen to deploy. The findings suggested that one possible explanation for relieving the joint swelling and pain symptoms in rheumatoid arthritis patients was that moxibustion restricts inflammatory factor release.21 Another trial delivered the consequence that the effectiveness of moxibustion has been implicated in the quantity of stimulus. Experiments displayed that penetrating stimulation could gain yet more moxibustion sensation in analgesia and enhance the quality of life of patients with migraine without aura.22 Management and prevalence are in the front position in the ranking list of frequency which indicates moxibustion is one of the complemental therapies in prophylaxis and treatment. KOA is the only specific disease in the ranking list that demonstrates a relatively mature research trend in this field. IBS ranks highly in the list of centrality makes us investigate the interconnection between moxibustion therapy and chronic visceral hyperalgesia. Moxibustion has its advantages in treating chronic pain in the spine and joints such as ankylosing spondylitis and arthritis. Additionally, the moxibustion method needs to manipulate by following the specific acupuncture point. As different acupuncture points are selected in studies, more attention should be paid to assessing the therapeutic effect of distinct acupuncture points.

Table 8 Top 10 Keywords Related to Moxibustion Therapy for Pain Treatment

Figure 8 Map of keywords related to moxibustion therapy for pain treatment from 2012 to 2021.

The top 20 keywords with the strongest citation burst from 2012 to 2021 are shown in Figure 9. Systematic review and knee osteoarthritis were ranked at the top, while herpes zoster has burst recently. Research progress of moxibustion treatment of pain can be drawn from the strongest citation bursts of keywords evolution. Suspended moxibustion and spinal cord exerted their influences earlier, while herpes zoster and knee osteoarthritis were lucubrated in 2020 and arouse wide public concern hitherto. Particular attention in this area of research has been given to moxibustion therapy in treating certain pain diseases. These keywords will be further discussed in the following section.

Figure 9 Top 20 keywords with the strongest citation bursts. The red color represents the keyword was cited in high frequency and the green color represents in low frequency.

To the best of our knowledge, this is the first bibliometric study of moxibustion therapy for pain management. The general information concluded from the results is listed as follows: (1) The annual number of publications boosted steadily over the past 10 years and the output was expected to grow swiftly which indicates a promising direction in this research field. (2) The Evid Based Complement Alternat Med and the Gut were the top-cited journals in frequency and centrality. (3) The most prolific country is China, which successfully provided crucial research foundation trends. Given that the other top countries were of poor yield, efforts should be paid to strengthen collaboration between countries to potentiate their output. Shanghai University of Traditional Chinese Medicine and Chengdu University of Traditional Chinese Medicine have profound academic backgrounds, and the institutions can achieve more high-quality results by cooperative closely. (4) Huangan Wu was the most active author with the highest cited frequency. (5) The top cited reference in frequency and centrality was the article published by Shamseer L and Deng HY respectively. (6) Pain disease (eg, arthritis, ankylosing spondylitis, herpes zoster, IBS), research method (eg, RCT), and risk assessment (eg, quality of life, economic burden, physical and psychological problems) were the hotspots and frontier trends in this field according to the analysis of the keyword.

The results of co-citation demonstrated the fact that literature usually contains high-quality and strong impacts in this research field. Moreover, it may represent the research foundation of a certain field. The current research type relies on meta-analysis and RCTs, and the content involves mechanism and clinical. One of the frontier research hotpots is osteoarthritis which provides novel perspectives on moxibustion therapy indications. Osteoarthritis is a prevalent pain disease that affects people all over the world. Moxibustion, because of the thermal effect on the local area, often has a therapeutic efficacy to analgesia. Recent research has shown that it directly promotes knee cartilage repair, in the meanwhile regulates the composition of the intestinal flora to prohibit inflammatory factor release.23 Some RCTs have suggested that moxibustion therapy is a safe choice for treatment.9,24,25 However, the top-cited were the standard of meta-analysis, indicating that the number of RCTs in this field is relatively limited and the quality needs to be improved. Therefore, researchers should strengthen the study on efficacy evaluation, to promote the view of moxibustion in the treatment of pain and push forward further research in this field.

Interestingly, as we searched publications related to moxibustion and pain, we found that IBS ranked forward in the list with high centrality as an important research spot. IBS is a functional gastrointestinal (GI) disorder that manifests as abdominal pain and a change in bowel habit.26 The research found abundance and diversity of intestinal microflora in the GI were risks of IBS.27 Alteration of intestinal microbiota activated the immune system to foster the formation of inflammatory cytokines to induce intestinal inflammation. However, a recent study found moxibustion treatment can reverse the changes in microbiota profiles and balance GI function.28 Besides, the NOD-like receptor family pyrin domain containing 6 (NLRP6) inflammasome signaling is considered a medium for regulating gut microbiota and intestinal homeostasis.29 Another research indicated that mild moxibustion can control NLRP6 inflammasome signaling to alleviate inflammation to achieve analgesia.30 These results discussed how moxibustion contributes to pain relief.

Recent emerging trends in moxibustion therapy on pain disease were identified according to the keyword bursts from 2012 to 2021, as follows:

(1) Rheumatoid arthritis (RA): Studies have shown that inhibition of relevant cytokines can reduce joint neovascularization to alleviate pain and dysfunction caused by RA.31 Interestingly, moxibustion can regulate inflammatory cytokines released in RA at the molecular level. Downregulated hypoxia-inducible factor-1/vascular endothelial growth factor level can effectively relieve pain intensity in rheumatoid arthritis.32 In addition, moxibustion may diminish the level of inflammatory factors to improve the symptoms of swelling and pain.21 Further technologies in the specific mechanism of moxibustion to RA are urgently warranted.

(2) KOA: Moxibustion therapy is an efficient intervention without pharmacological and surgical for KOA. Current studies have proved that moxibustion is effective in the treatment of KOA. However, it is notable that the smoke of bursting moxa is harmful to ones health. Therefore, it is necessary to find a moxibustion method with less influence of smoke. The study found that maybe smokeless moxibustion can achieve the same therapeutic effect. This will become a new research direction. One exciting recently discovered is that CO2 laser moxibustion is a device as a convenient and environmental substitution that simulates the traditional moxibustion but without smoke or smell.33 Another trial evaluated the effect of the laser moxibustion device with the thermal effect but no smoke is promising for KOA symptoms.9 More smokeless moxibustion therapies are expected to be developed in the future.

(3) Risk: In recent years, the risk of pain diseases attracted more attention from researchers. In particular, suffering from pain disease could raise the occurrence of diverse physical and psychological problems. The high cost of treatment also increases the burden on society.34 Besides, it has an adverse impact on quality of life and physical function. Thus, much more attention should be paid to being aware of the risks of diseases and focusing on prevention and treatment.

(4) Herpes zoster: Herpes zoster can bring health burdens for people of all ages. Complications usually manifest as pain, fever, and itching. The most common is postherpetic neuralgia, which affects one in five people suffering from this disease.35 Moreover, these uncomfortable feelings caused by herpes zoster bring a heavy economic burden from individuals to society.36 Recently, a systematic review and meta-analysis have shown that moxibustion can alleviate postherpetic neuralgia to some extent, which highlights the great potential of moxibustion therapy.37 This review provides a new perspective on interventions for herpes zoster.

In this review, we discuss current adaptable indications of moxibustion therapy, for instance, AS, arthritis, KOA, RA, herpes zoster, IBS and other pain conditions. Most of them are a class of chronic inflammatory conditions affecting the spine or joints and typically fall into musculoskeletal disease. Additionally, our results provide a novel perspective on the therapeutic efficacy and potential of moxibustion therapy in neuralgia and chronic visceral hyperalgesia. These findings provide future possibilities for moxibustion therapy as a complement and alternative to pain management.

This study has used bibliometrics for the first time to perform a visual analysis of literature related to moxibustion for pain treatment, summarized research status and key research forces in this field, and predicted the research trend. In addition, we have used a variety of methods to analyze data, which is suitable for multi-angle interpretation of conclusions. However, this study has limitations that need to be addressed. This study only analyzed the core collection database for Web of Science, because CiteSpace is currently unable to analyze cited references for other databases. It is anticipated that the improvement of this software will enable the expansion of the selection range for databases in the future.

In conclusion, this study reveals hot spots and frontier issues in the field of moxibustion therapy for pain treatment. The findings presented here are expected to promote the optimization of treatment options.

The following information was supplied regarding data availability: the raw data can be directly obtained from the WoSCC of Thomson Reuters.

Thanks to Prof. Chaomei Chen for opening the use of CiteSpace.

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

This study was supported by the key plan of Zhejiang Province Traditional Chinese Medicine Prevention and Treatment of Major Disease of the Health and Family Planning Commission of Zhejiang Province (No. 2018ZY008). The trial sponsor is the Third Affiliated Hospital of Zhejiang Chinese Medicine University (219 Moganshan Road, Xihu District, Hangzhou City, Zhejiang Province 310005, China, +86-571-88393504). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors declare that they have no conflicts of interest in this work.

1. Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of chronic pain and high-impact chronic pain among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(36):10011006. doi:10.15585/mmwr.mm6736a2

2. Ashar YK, Gordon A, Schubiner H, et al. Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: a randomized clinical trial. JAMA Psychiatry. 2022;79(1):1323. doi:10.1001/jamapsychiatry.2021.2669

3. Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin proc. 2015;90(1):139147. doi:10.1016/j.mayocp.2014.09.010

4. Gao Z, Zhang J, Liu GF, Ji LX. Research trends from 2010 to 2020 for pain treatment with acupuncture: a bibliometric analysis. J Pain Res. 2021;14:941952. doi:10.2147/JPR.S300911

5. Region WHOWP. WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region. Geneva, Switzerland: World Health Organization; 2007.

6. Dubois MY, Chen L. Of low back pain and moxibustion. Pain Med. 2014;15(8):12431244. doi:10.1111/pme.12513

7. Han K, Kim M, Kim EJ, et al. Moxibustion for treating cancer-related fatigue: a multicenter, assessor-blinded, randomized controlled clinical trial. Cancer Med. 2021;10(14):47214733. doi:10.1002/cam4.4020

8. Bao C, Zhang J, Liu J, et al. Moxibustion treatment for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial. BMC Complement Altern Med. 2016;16(1):408. doi:10.1186/s12906-016-1386-4

9. Zhao L, Cheng K, Wu F, et al. Effect of laser moxibustion for knee osteoarthritis: a multisite, double-blind randomized controlled trial. J Rheumatol. 2021;48(6):924932. doi:10.3899/jrheum.200217

10. Yang M, Chen X, Bo L, et al. Moxibustion for pain relief in patients with primary dysmenorrhea: a randomized controlled trial. PLoS One. 2017;12(2):e0170952. doi:10.1371/journal.pone.0170952

11. Chiu JH. How does moxibustion possibly work? Evid-Based Complementary Alt Med. 2013;2013:198584. doi:10.1155/2013/198584

12. Yuan QL, Guo TM, Liu L, Sun F, Zhang YG. Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis. PLoS One. 2015;10(2):e0117146. doi:10.1371/journal.pone.0117146

13. Li R, Sun J, Hu H, et al. Research trends of acupuncture therapy on knee osteoarthritis from 2010 to 2019: a bibliometric analysis. J Pain Res. 2020;13:19011913. doi:10.2147/JPR.S258739

14. Guo J, Pei L, Chen L, et al. Research trends of acupuncture therapy on cancer over the past two decades: a bibliometric analysis. Integr Cancer Ther. 2020;19:1534735420959442. doi:10.1177/1534735420959442

15. Chen C. Searching for intellectual turning points: progressive knowledge domain visualization. Proc Natl Acad Sci U S A. 2004;101 Suppl 1(Suppl 1):53035310. doi:10.1073/pnas.0307513100

16. Zhao L, Cheng K, Wang L, et al. Effectiveness of moxibustion treatment as adjunctive therapy in osteoarthritis of the knee: a randomized, double-blinded, placebo-controlled clinical trial. Arthritis Res Ther. 2014;16(3):R133. doi:10.1186/ar4590

17. Yuan T, Xiong J, Wang X, et al. The effectiveness and safety of moxibustion for treating knee osteoarthritis: a PRISMA compliant systematic review and meta-analysis of randomized controlled trials. Pain Res Manage. 2019;2019:2653792. doi:10.1155/2019/2653792

18. Li A, Wei ZJ, Liu Y, Li B, Guo X, Feng SQ. Moxibustion treatment for knee osteoarthritis: a systematic review and meta-analysis. Medicine. 2016;95(14):e3244. doi:10.1097/MD.0000000000003244

19. Deng H, Shen X. The mechanism of moxibustion: ancient theory and modern research. Evid-Based Complementary Alt Med. 2013;2013:379291. doi:10.1155/2013/379291

20. Altman DG, Schulz KF, Moher D, et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001;134(8):663694. doi:10.7326/0003-4819-134-8-200104170-00012

21. Tao S, Wang X, Liao C, et al. The efficacy of moxibustion on the serum levels of CXCL1 and -EP in patients with rheumatoid arthritis. Pain Res Manage. 2021;2021:7466313. doi:10.1155/2021/7466313

22. Gao L, Xie J, Li X, et al. Effect and safety of penetrating moxibustion in treatment of migraine without aura: a randomized controlled trial. Chin J Integr Med. 2021;27(12):927932. doi:10.1007/s11655-021-3327-4

23. Chen Y, Lv J, Jia Y, et al. Effect of moxibustion on the intestinal flora of rats with knee osteoarthritis induced by monosodium iodoacetate. Evid-Based Complementary Alt Med. 2020;2020:3196427. doi:10.1155/2020/3196427

24. Kang HR, Lee YS, Kim SH, et al. Effectiveness and safety of electrical moxibustion for knee osteoarthritis: a multicenter, randomized, assessor-blinded, parallel-group clinical trial. Complement Ther Med. 2020;53:102523. doi:10.1016/j.ctim.2020.102523

25. Lin L, Cheng K, Tan MT, et al. Comparison of the effects of 10.6-m infrared laser and traditional moxibustion in the treatment of knee osteoarthritis. Lasers Med Sci. 2020;35(4):823832. doi:10.1007/s10103-019-02863-9

26. Ford AC, Sperber AD, Corsetti M, Camilleri M. Irritable bowel syndrome. Lancet. 2020;396(10263):16751688. doi:10.1016/S0140-6736(20)31548-8

27. Joo YE. Alteration of fecal microbiota in patients with postinfectious irritable bowel syndrome. J Neurogastroenterol Motil. 2015;21(1):135137. doi:10.5056/jnm14133

28. Wang X, Qi Q, Wang Y, et al. Gut microbiota was modulated by moxibustion stimulation in rats with irritable bowel syndrome. Chin Med. 2018;13:63. doi:10.1186/s13020-018-0220-y

29. Elinav E, Strowig T, Kau AL, et al. NLRP6 inflammasome regulates colonic microbial ecology and risk for colitis. Cell. 2011;145(5):745757. doi:10.1016/j.cell.2011.04.022

30. Bao CH, Wang CY, Li GN, et al. Effect of mild moxibustion on intestinal microbiota and NLRP6 inflammasome signaling in rats with post-inflammatory irritable bowel syndrome. World j Gastroenterol. 2019;25(32):46964714. doi:10.3748/wjg.v25.i32.4696

31. Elshabrawy HA, Chen Z, Volin MV, Ravella S, Virupannavar S, Shahrara S. The pathogenic role of angiogenesis in rheumatoid arthritis. Angiogenesis. 2015;18(4):433448. doi:10.1007/s10456-015-9477-2

32. Gong Y, Yu Z, Wang Y, et al. Effect of moxibustion on HIF-1 and VEGF levels in patients with rheumatoid arthritis. Pain Res Manage. 2019;2019:4705247. doi:10.1155/2019/4705247

33. Guo MH, Zhao L, Wu F, et al. CO(2) laser moxibustion for knee osteoarthritis: study protocol for a multicenter, double-blind, randomized controlled trial. Chin J Integr Med. 2020;26(8):568576. doi:10.1007/s11655-019-2714-6

34. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):20822097. doi:10.1016/S0140-6736(21)00393-7

35. Saguil A, Kane S, Mercado M, Lauters R. Herpes zoster and postherpetic neuralgia: prevention and management. Am Fam Physician. 2017;96(10):656663.

36. Johnson RW, Rice AS. Clinical practice. Postherpetic neuralgia. N Engl J Med. 2014;371(16):15261533. doi:10.1056/NEJMcp1403062

37. Wu Q, Hu H, Han D, Gao H. Efficacy and safety of moxibustion for postherpetic neuralgia: a systematic review and meta-analysis. Front Neurol. 2021;12:676525. doi:10.3389/fneur.2021.676525

38. Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;350:g7647. doi:10.1136/bmj.g7647

39. Song GM, Tian X, Jin YH, et al. Moxibustion is an alternative in treating knee osteoarthritis: the evidence from systematic review and meta-analysis. Medicine. 2016;95(6):e2790. doi:10.1097/MD.0000000000002790

40. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):14441453. doi:10.1001/archinternmed.2012.3654

41. Choi TY, Choi J, Kim KH, Lee MS. Moxibustion for the treatment of osteoarthritis: a systematic review and meta-analysis. Rheumatol Int. 2012;32(10):29692978. doi:10.1007/s00296-012-2367-7

42. Tang Y, Yin HY, Rubini P, Illes P. Acupuncture-induced analgesia: a neurobiological basis in purinergic signaling. Neuroscientist. 2016;22(6):563578. doi:10.1177/1073858416654453

43. Bao CH, Wu LY, Wu HG, et al. Moxibustion inhibits apoptosis and tumor necrosis factor-alpha/tumor necrosis factor receptor 1 in the colonic epithelium of Crohns disease model rats. Dig Dis Sci. 2012;57(9):22862295. doi:10.1007/s10620-012-2161-0

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Research Trends of Moxibustion Therapy for Pain Treatment Over the Pas | JPR - Dove Medical Press