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Stem Cell Therapy for Erectile Dysfunction

Posted: January 5, 2022 at 1:57 am

Introduction: The prevalence of erectile dysfunction (ED) is substantial and continues to rise. Current therapeutics for ED consist of oral medications, intracavernosal injections, vacuum erection devices, and penile implants. While such options may manage the disease state, none of these modalities, however, restore function. Stem cell therapy has been evaluated for erectile restoration in animal models. These cells have been derived from multiple tissues, have varied potential, and may function via local engraftment or paracrine signaling. Bone marrow-derived stem cells (BMSC) and adipose-derived stem cells (ASC) have both been used in these models with noteworthy effects.

Aim: Herein, we will review the pathophysiology of ED, animal models, current and novel stem-cell based therapeutics, clinical trials and areas for future research.

Methods: The relevant literature and contemporary data using keywords, "stem cells and erectile dysfunction" was reviewed.

Main outcome measure: Examination of evidence supporting the association between erectile dysfunction and adipose derived stem cells, bone marrow derived stem cells, placental stem cells, urine stem cells and stem cell therapy respectively.

Results: Placental-derived stem cells and urine-derived stem cells possess many similar properties as BMSC and ASC, but the methods of acquisition are favorable. Human clinical trials have already demonstrated successful use of stem cells for improvement of erectile function.

Conclusion: The future of stem cell research is constantly being evaluated, although, the evidence suggests a place for stem cells in erectile dysfunction therapeutics. Matz EL, Terlecki R, Zhang Y, et al. Stem Cell Therapy for Erectile Dysfunction. Sex Med Rev 2019;7:321-328.

Keywords: Erectile Dysfunction; Impotence; Regenerative Medicine; Stem Cell Therapy.

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Stem Cell Therapy for Erectile Dysfunction

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Effects of Stem Cell Therapy on Diabetic Mellitus Erectile Dysfunction: A Systematic Review and Meta-analysis – Newswise

Posted: January 5, 2022 at 1:57 am

Stem cell is considered a potential therapy for treating erectile dysfunction (ED), including diabetic mellitus erectile dysfunction (DMED), which was investigated in some preclinical studies. Several trials introduced stem cell into clinical practice, but divergences emerged.

To further investigate the therapeutic effects of stem cell on DMED in preclinical studies and investigate some possible factors that influence curative effects.

The literature research was conducted in Web of Science and PubMed to retrieve studies utilizing stem cell to treat DMED. Revman 5.3 was used to perform subgroup analysis of intracavernosal pressure/mean artery pressure (ICP/MAP) and structural changes. Publication bias was assessed with Egger's test, funnel plot, and sensitivity analysis by Stata 15.0.

The ICP/MAP and structural changes before and after stem cell treatment.

Of 2,115 studies retrieved, 23 studies are eligible. Plus 10 studies from a meta-analysis published in 2016, 33 studies were enrolled. Pooled analysis showed that stem cell ameliorates damaged ICP/MAP (WMD 0.26; 95% CI 0.230.29;P< .001) and structural changes induced by diabetes. Subgroup analysis indicated that adipose-derived mesenchymal stem cell (ADSC) may have better efficacy than bone marrow-derived mesenchymal stem cell (BMSC) (2= 4.21,P=.04; ADSC WMD 0.28, 95% CI [0.240.32] vs BMSC WMD 0.22 95% CI [0.170.26]). Transplantation type, diabetes type, and cell number make no difference to curative effects. Gene modification and therapy combination proved promising in improving the therapeutic effects of stem cell.

The evidence reminded that ADSC may be prior to BMSC in clinical trials and autotransplantation is probably not compulsory in the clinical practice of stem cell.

The study number and sample size are large enough. However, high degree of heterogeneity remains after subgroup analysis.

This meta-analysis suggests the efficacy of stem cell therapy for DMED and the possible superiority of ADSC over BMSC in erection restoration and structure renovation.

Yao C, Zhang X, Yu Z, et al., Effects of Stem Cell Therapy on Diabetic Mellitus Erectile Dysfunction: A Systematic Review and Meta-analysis. J Sex Med 2022;19:2136.

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Effects of Stem Cell Therapy on Diabetic Mellitus Erectile Dysfunction: A Systematic Review and Meta-analysis - Newswise

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Evaluation of the Clinical Efficacy of Stem Cell Transplantation in the Treatment of Spinal Cord Injury: A Systematic Review and Meta-analysis -…

Posted: January 5, 2022 at 1:57 am

Abstract

Stem cell transplantation has been applied to treat spinal cord injury (SCI) in clinical trials for many years. However, the clinical efficacies of stem cell transplantation in SCI have been quite diverse. The purpose of our study was to systematically investigate the efficacy of stem cell transplantation in patients with SCI. The PubMed, Web of Science, Ovid-Medline, Cochrane Library, China National Knowledge Infrastructure, VIP, Wanfang, and SinoMed databases were searched until October 27, 2020. Quantitative and qualitative data were analyzed by Review Manager 5.3 and R. Nine studies (n = 328) were included, and the overall risk of bias was moderate. The ASIA Impairment Scale (AIS) grading improvement rate was analyzed in favor of stem cell transplantation group [odds ratio (OR) = 6.06, 95% confidence interval (CI): 3.1611.62, P < 0.00001]. Urodynamic indices also showed improvement in bladder function. In subgroup analyses, the results indicated that in patients with complete (AIS A) SCI, with the application of cell numbers between n*(107 108 ), two cell types (i.e., bone marrowderived mesenchymal stem cells and bone marrow mononuclears), and treatment time of more than 6 months, stem cell transplantation was more beneficial for sensorimotor function (P < 0.05 for all groups). The risk of fever incidence in the stem cell transplantation group was 4.22 (95% CI: 1.710.22, P = 0.001), and principal component analysis (PCA) suggested it was more related to transplanted cell numbers. Thus, stem cell transplantation can promote functional recovery in SCI patients. Moreover, the type and quantity of transplanted stem cells and treatment time are important factors affecting the therapeutic effect of stem cell transplantation in SCI. Further studies are needed to evaluate the effects and elucidate the mechanisms of these factors on stem cell therapy in SCI.

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Evaluation of the Clinical Efficacy of Stem Cell Transplantation in the Treatment of Spinal Cord Injury: A Systematic Review and Meta-analysis -...

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Cellular Therapies Fill Unmet Needs in R/R Multiple Myeloma – Targeted Oncology

Posted: January 5, 2022 at 1:57 am

Innovative approaches in multiple myeloma that focus on cellular therapies offer hope to patients with multiple myeloma.

Current approaches for multiple myeloma are stratified by patient fitness and age. For patients who can tolerate them, 3- or 4-drug combinations, with or without an autologous stem cell transplant (ASCT), can result in a complete remission, ideally with no residual disease. For patients who are elderly or fragile, 2-drug or 3-drug regimens are the standard.

For the standard-risk patient, a regimen of bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd) plus a CD38 monoclonal antibody such as daratumumab (Darzalex) or isatuximab (Sarclisa) is the norm. As a whole, these combinatorial approaches are needed because multiple myeloma is a heterogenous disease whose optimal treatment takes advantage of multiple mechanisms of action. These regimens can result in first remissions that range from 4 to 5 years.

Although these outcomes are promising, there is still an unmet need for patients with relapsed or refractory disease. Innovative approaches in multiple myeloma that focus on cellular therapies offer hope to these patients.

In a presentation during the 39th Annual CFS Innovative Cancer Therapy for Tomorrow, Shambavi Richard, MD, an assistant professor in medicine, hematology, and medical oncology at The Mount Sinai Hospital in New York, New York, addressed the emerging therapeutic frontiers in multiple myeloma with a focus on chimeric antigen receptor (CAR) approaches and bispecific antibodies.1 Richard explored updated results from the KarMMa trial (NCT03361748), which enrolled 149 patients with relapsed/refractory multiple myeloma (RRMM) and who were previously exposed to immunomodulatory agents, proteasome inhibitors (PIs), and CD38 antibodies (mAbs) and reported poor outcomes. Evaluable patients received idecabtagene vicleucel (ide-cel; n = 128).2,3

At a median follow-up of 15.4 months, the objective response rate (ORR) was 73% and median progression-free survival (PFS) was 8.8 months for all treated patients (TABLE3 ). Investigators reported that at the highest targeted dose of 450 106 CAR T cells, the overall response rate (ORR) was 81%, the complete response (CR) rate was 39%, and the median PFS increased by 12.2 months with longer follow-up. In a subgroup analysis of difficult-to-treat patients, the ORR for patients with extramedullary disease was 70%; patients with high-tumor burden, 71%; and patients with R-ISS stage III disease, 48%.

Regarding safety, 97% of patients had cytopenia and 89% had grade 3/4 neutropenia; 52% experienced thrombocytopenia and 60% developed anemia. Cytokine release syndrome (CRS) had a median onset of 1 day, with a median duration of 5 days. CRS was seen in 84% of patients but grade 3/4 was observed in only 6% of patients. Neurologic toxicity was observed in 18% of patients and 4% were grade 3/4.

Updated results from the CARTITUDE-1 trial (NCT03548207)4 showed that ciltacabtagene autoleucel (cilta-cel) yielded early, deep, and durable responses in heavily pretreated patients with multiple myeloma, with a manageable safety profile at the recommended phase 2 dose.

In the study, 97 patients with a median of 6 prior lines received cilta-cel. The overall response rate per independent review committee (primary end point) was 97% (95% CI, 91%-99%), with 67% of patients achieving stringent CR (sCR). The median time to first response was 1 month (range, 1-9), and median time to CR or better was 2 months (range, 1-15). Responses deepened over time, and the median duration of response was not reached. Of 57 patients evaluable for minimal residual disease (MRD) assessment, 93% were MRD-negative at 10-5. The 12-month PFS and overall survival (OS) rates (95% CI) were 77% (66%-84%) and 89% (80%-94%), respectively; the median PFS was not reached.

In terms of adverse events, neutropenia was 94.8% grade 3/4, and 60.8% of patients had grade 3/4 anemia, said Richard. CRS was almost universal, with any-grade CRS seen in 94.8% of patients. This was a little different compared with ido-cel in terms of time of onset, which was 7 days with this product vs 1 day with the ido-cell product, she said. In both of these trials, early death within the first 2 to 3 months was 2% or less.

When comparing ide-cel to conventional treatment, according to findings presented by Shah et al,5 the investigators observed that ide-cel was associated with a significantly higher ORR compared with conventional treatment (OR, 5.11; 95% CI, 2.92-8.94; P < .001). Similarly, ide-cel significantly extended PFS (HR, 0.55; 95% CI, 0.42-0.73; P < .001) and OS (HR, 0.36; 95% CI, 0.24-0.54; P < .001) vs conventional treatment. Richard said this analysis aimed to compare efficacy outcomes observed with ide-cel treatment in KarMMa and conventional treatment in the Monoclonal Antibodies in Multiple Myeloma: Outcomes After Therapy Failure (MAMMOTH) study.6 Investigators analyzed outcomes of 275 patients with multiple myeloma with disease refractory to CD38 monoclonal antibodies at 14 academic centers.

Turning to the challenge of resistance to therapies in multiple myeloma, Richard noted that there are 3 main strategies in play: multiple myelomacell directed, T-cell directed; and CAR construct.

Possible strategies employed that use multiple myeloma celldirected treatments involve pooling CAR T products with different antigens; using dual CAR products that are constructed using 2 antigen specifi cities, such as B-cell maturation antigen (BCMA)/CD19; or taking a tandem CAR approach. Investigators also can focus on alternate antigens including SLAMF7, CD138, or integrin beta7.

Strategies that are T-cell directed can focus on those that are enriched for central or stem cell memory T cells or use combination approaches with checkpoint inhibitors or immunomodulatory imide drugs and cereblon E3 ligase modulators (CelMoD).

Efforts that tweak the CAR construct are also undergoing evaluation. These include FasTCAR, in which manufacturing takes 24 to 36 hours; next-generation CARs, which are armored CAR T cells that prevent T-cell exhaustion; CARs that use a safety switch to mitigate adverse effects; and allogeneic CARS.

Richard highlighted results from a study evaluating teclistamab, a bispecific antibody that binds to BCMA and CD3 to redirect T cells to attack multiple myeloma cells.

Findings from MajesTEC-1 (NCT03145181) demonstrated that the ORR in response-evaluable patients treated at the recommended phase 2 dose (n = 40) was 65% (95% CI, 48%-79%); 58% achieved a very good partial response or better.7 At the recommended phase 2 dose, the median duration of response was not reached. After 7.1 months median follow-up, 22 (85%) of 26 responders were alive and continuing treatment. During the 2021 American Society of Clinical Oncology Annual Meeting, Krishnan et al presented updated findings showing 58% of evaluable patients had achieved a very good partial response or better and 30% had achieved a CR or better; the median time to first confirmed response was 1.0 month (range, 0.2-3.1).8

Another bispecific antibody, talquetamab, has continued to show promising clinical activity in patients with RRMM. Updated findings from a phase 1 trial (NCT03399799)9 showed the ORR at the recommended phase 2 dose (RP2D) in response-evaluable patients (n = 24) was 63%, with 50% reaching very good partial response or better; 9/17 (53%) evaluable patients with triple-class refractory disease and 3/3 (100%) patients who were penta-refractory had a response. Median time to first confirmed response at the RP2D was 1.0 month (range, 0.2-3.8). Overall, responses were durable and deepened over time (median follow-up, 6.2 months [range, 2.7-9.7+] for responders at the RP2D).

When comparing CAR T-cell therapy to bispecific antibodies, Richard noted that patients undergo CAR T-cell therapy once with no further therapy indicated. Additionally, patients can enjoy a long chemotherapy holiday, whereas bispecific antibodies require more frequent doses. Toxicities are similar for the 2 approaches, although Richard said that CRS can be slightly more profound and at a somewhat higher grade with the CAR T-cell approach compared with that of bispecific antibodies.

In conclusion, Richard also noted that the costs associated with both these approaches will have an impact, especially in high up-front costs. Bispecific c antibodies, however, due to their chronic recurrent administration, may also come with a long-term financial burden.

REFERENCES:

1. Richard S. New therapeutic frontiers for RRMM: CAR T and bispecifi c antibodies. Presented at: 39th Annual CFS. Chemotherapy Foundation Symposium. Innovative Cancer Therapy for Tomorrow. November 3-5, 2021; New York, NY.

2. Munshi NC, Anderson LD Jr, Shah N, et al. Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma. N Engl J Med. 2021;384(8):705-716. doi:10.1056/NEJMoa2024850

3. Anderson LD, Munshi NC, Shah N, et al. Idecabtagene vicleucel (ide-cel, bb2121), a BCMA-directed CAR T cell therapy, in relapsed and refractory multiple myeloma: Updated KarMMa results. J Clin Oncol. 2021;39(suppl 15):8016-8016. doi: 10.1200/JCO.2021.39.15_suppl.8016

4. Usmani SZ, Berdeja JG, Madduri D, et al. Ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy, in relapsed/refractory multiple myeloma: updated results from CARTITUDE-1. J Clin Oncol. 2021;39(suppl 15; abstr 8005). doi: 10.1200/JCO.2021.39.15_suppl.8005

5. Shah N, Ayers D, Davies FE, et al. A matching-adjusted indirect comparison of efficacy outcomes for idecabtagene vicleucel (ide-cel, bb2121), a BCMA-directed CAR T cell therapy versus conventional care in triple-class-exposed relapsed and refractory multiple myeloma. Presented at: 62nd American Society of Hematology Meeting and Exposition, December 5-8, 2020. Abstract 1653. https://bit.ly/3nQb458

6. Gandhi UH, Cornell RF, Lakshman A, et al. Outcomes of patients with multiple myeloma refractory to CD38-targeted monoclonal antibody therapy. Leukemia. 2019;33(9):2266-2275. doi:10.1038/ s41375-019-0435-7

7. Usmani SZ, Garfall AL, van de Donk NWCJ, et al. Teclistamab, a B-cell maturation antigen CD3 bispecific antibody, in patients with relapsed or refractory multiple myeloma (MajesTEC-1): a multicentre, open-label, single-arm, phase 1 study. Lancet. 2021;398(10301):665- 674. doi:10.1016/S0140-6736(21)01338-6

8. Krishnan AY, Garfall Al, Mateos M-V, et al. J Clinical Oncol. 2021;39(suppl 15):8007-8007. doi: 10.1200/JCO.2021.39.15_suppl.8007

9. Berdeja JG, Krishnan AY, Oriol A, et al. Updated results of a phase 1, first-in-human study of talquetamab, a G protein-coupled receptor family C group 5 member D (GPRC5D) CD3 bispecific antibody, in relapsed/refractory multiple myeloma (MM). J Clin Oncol. 2021;39(suppl 15):8008. doi: 10.1200/JCO.2021.39.15_suppl.8008

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Cellular Therapies Fill Unmet Needs in R/R Multiple Myeloma - Targeted Oncology

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Bring in the bulldozers: Cynatas CEO on how heavyweight FujiFilm will turbocharge its … – Stockhead

Posted: January 5, 2022 at 1:55 am

Stem cell therapy, sometimes called regenerative medicine, is one of the most exciting areas of the life sciences sector right now.

It has emerged as a promising alternative approach in many medicine specialties, with some even saying that its the medical innovation of the century.

In clinical studies, stem therapy has been shown to be effective against multiple diseases like diabetes, osteoathritis, and graft-versus-host disease (GvHD).

But despite the enormous amount of research being undertaken,the biggest problem still remains:how to produce these cell therapy products economically at a commercial scale.

ASX-listed Cynata Therapeutics (ASX:CYP) is one company thats well ahead on sorting the problem out.

Cynatas proprietary platform Cymerus uses a unique method that could produce the stem cells at scale, without having to use multiple donors and ensuring no loss of potency.

The company has just partnered with Japan-based, stem cell manufacturing heavyweight Fujifilm Cellular Dynamics to produce Cynatas Cymerus therapeutic stem cell products.

Partnering with FujiFilm is like migrating from picks and shovels to having big bulldozers and front-end loaders, Cynata CEO, Dr Ross McDonald, told Stockhead today.

And if you stay with the mining analogy, itd be like discovering an iron ore reserve in Central Australia. But if you cant get it out of the ground, there wont be a lot of interest and use, he continued.

Dr McDonald explained there are two approaches to using cell therapy, the autologous and the allogeneic approach.

The autologous approach is where the patient themselves serves as their own donor.

This is obviously bespoke and inefficient, because the drug can only be manufactured for that one patient, and is obviously not an industrialised process, he said.

But by taking an allogeneic approach, Cynata has the ability to start with a one time donation of cells from one single donor.

Well never have to go back to that human donor ever again, so our process of producing cells has become a very much more typical industrialised process.

Cynata was formed in October 2011 by two of the inventors of the Cymerus technology, in collaboration with famed Australian technology entrepreneur, Dr Ian Dixon.

Core patents underpinning Cynatas Cymerus technology are owned by the Wisconsin Alumni Research Foundation (WARF), with Cynata being granted an exclusive worldwide licence to the relevant patents.

In 2013, Cynata was acquired by ASX-listed company called EcoQuest, subsequently changing its name to Cynata Therapeutics.

Since then, the company has progressed the use of the groundbreaking patent in multiple diseases and clinical trials.

Dr McDonald says that so far, Cynata has been able to make all the products its needed to carry out these trials, but hes anticipated that at some point, the scale of manufacturing is going to have to be increased as it moves towards commercialisation.

The companys pipeline for 2022 is quite stacked, with four concurrent clinical trials underway: osteoarthritis, respiratory diseases including COVID-19, diabetic foot ulcers, and graft-versus-host disease (GvHD).

Dr McDonald says the GvHD trial in particular marks a major shift, as it will take place in the US.

The GvHD trial is a big deal for us in uplifting our product portfolio, and the maturation of that, he said.

Any company who moves forward in the US is usually a big de-risking event. And we see that as being a major value driver for Cynata.

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Bring in the bulldozers: Cynatas CEO on how heavyweight FujiFilm will turbocharge its ... - Stockhead

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January 2022: 2021 Papers of the year – Environmental Factor Newsletter

Posted: January 5, 2022 at 1:54 am

Research funded by grantsMetals from e-cigarette aerosols accumulate in the brain

Mice exposed to e-cigarette aerosols had a buildup of toxic metals in the brain, according to NIEHS-funded researchers. The exposure also altered brain levels of essential metals, which play a key role in many biological processes. The findings provide clues about the onset of neurodegenerative diseases, which have been linked to toxic metal exposure and the dysregulation of essential metals.

The researchers exposed mice to either the equivalent of secondhand e-cigarette aerosol or a five-fold higher level for two months. They then measured levels of 15 different metals in brain and other central nervous system (CNS) tissues, such as the spinal cord.

Compared with unexposed mice, mice exposed to e-cigarette aerosol had significant buildup of several metals in the brain and CNS. Many of the metals that accumulated in exposed mice were known neurotoxins, including chromium, copper, iron, and lead.

Citation: Re DB, Hilpert M, Saglimbeni B, Strait M, Ilievski V, Coady M, Talayero M, Wilmsen K, Chesnais H, Balac O, Glabonjat RA, Slavkovich V, Yan B, Graziano J, Navas-Acien A, Kleiman NJ. 2021. Exposure to e-cigarette aerosol over two months induces accumulation of neurotoxic metals and alteration of essential metals in mouse brain. Environ Res 202:111557. (Synopsis(https://factor.niehs.nih.gov/2021/9/papers/dert/index.htm#a1))

An NIEHS-funded study in mice showed how chlorine exposure leads to acute chest syndrome, a leading cause of death in patients with sickle cell disease (SCD). The results point to a potential lifesaving therapy for SCD patients exposed to chlorine, which is found in some household cleaning products.

The researchers used genetically engineered mice that resembled SCD in humans (sickle mice) and compared them with healthy control mice with human hemoglobin. They exposed both groups to chlorine gas or normal air.

Within six hours of chlorine exposure, 64% of sickle mice died, whereas none of the controls died. Compared with controls, surviving sickle mice experienced lung injury and hemolysis, or the rupture of red blood cells, which releases hemoglobin into the blood. Hemopexin treatment following exposure significantly improved survival and reduced blood heme levels and lung injury.

Citation: Alishlash AS, Sapkota M, Ahmad I, Maclin K, Ahmed NA, Molyvdas A, Doran S, Albert CJ, Aggarwal S, Ford DA, Ambalavanan N, Jilling T, Matalon S. 2021. Chlorine inhalation induces acute chest syndrome in humanized sickle cell mouse model and ameliorated by postexposure hemopexin. Redox Biol 44:102009. (Synopsis(https://factor.niehs.nih.gov/2021/8/papers/dert/index.htm#a1))

Women exposed to higher temperatures had a lower ovarian reserve, according to NIEHS-funded researchers. Ovarian reserve refers to the number and quality of a womans eggs. A diminished ovarian reserve reduces a womans ability to get pregnant.

The study included 631 women aged 18-45 years enrolled in a reproductive health study in Massachusetts. Using each womans home address, the researchers estimated daily ambient temperature exposures for three months, one month, and two weeks before the ovarian reserve examination. They used ultrasonography to measure antral follicle count (AFC), a measure of ovarian reserve.

Exposure to higher temperatures was associated with a lower AFC. The negative association between temperature and AFC was stronger in November through June compared with the summer months. The finding suggests women may be more susceptible to heat during certain times of the year, potentially because they adapt to heat in the summer.

Citation: Gaskins AJ, Minguez-Alarcon L, VoPham T, Hart JE, Chavarro JE, Schwartz J, Souter I, Laden F. 2021. Impact of ambient temperature on ovarian reserve. Fertil Steril 116(4):10521060. (Synopsis(https://factor.niehs.nih.gov/2021/8/papers/dert/index.htm#a2))

NIEHS grantees developed a gene expression atlas that captures the cellular makeup of the mammary gland across life stages, providing clues on how breast cancer originates. To build the atlas, the researchers used single cell RNA sequencing data, which assesses gene and protein expression of an individual cell. They integrated data from 50,000 mouse mammary cells, covering eight life stages, and 24,000 adult human mammary cells.

Using known genetic markers, team members identified the clusters as three breast epithelial cell types. The scientists compared genetic profiles for each epithelial cell type with known cancer-related genes to infer breast cancer cells of origin. They also examined how reorganization during different life stages altered breast cellular makeup and breast cancer subtype risk. According to the authors, the atlas provides insights into cellular makeup and development of breast cancer subtypes.

Citation: Saeki K, Chang G, Kanaya N, Wu X, Wang J, Bernal L, Ha D, Neuhausen SL, Chen S. 2021. Mammary cell gene expression atlas links epithelial cell remodeling events to breast carcinogenesis. Commun Biol 4(1):660. (Synopsis(https://factor.niehs.nih.gov/2021/8/papers/dert/index.htm#a3))

Children exposed to lead have altered brain structure and poorer cognitive function in midlife, according to NIEHS-funded research. These lead-related brain changes may increase the risk of neurodegenerative disease, like dementia, in later life.

The study included 564 children who were enrolled in a New Zealand birth cohort in the early 1970s and followed to midlife. The researchers measured child blood lead levels at age 11 years. Using magnetic resonance imaging, they examined participants structural brain integrity at age 45 years. They also assessed adult cognitive function and intelligence using a standardized IQ test.

Higher lead exposure in childhood was associated with structural deficits in the middle-aged brain. The results suggest that adults exposed to lead as children may be at increased risk of neurodegenerative diseases in later life and reinforce the need for long-term follow-up of lead-exposed child cohorts.

Citation: Reuben A, Elliott ML, Abraham WC, Broadbent J, Houts RM, Ireland D, Knodt AR, Poulton R, Ramrakha S, Hariri AR, Caspi A, Moffitt TE. 2020. Association of childhood lead exposure with MRI measurements of structural brain integrity in midlife. JAMA 324(19):19701979. (Synopsis(https://factor.niehs.nih.gov/2021/1/papers/dert/index.htm#a2))

Exposure to semi-volatile organic compounds (SVOCs) was linked with changes to young childrens gut microbiome, according to a new NIEHS-funded study. SVOCs are common contaminants of indoor air and dust.

The researchers measured levels of 44 SVOCs, including phthalates and per- and polyfluoroalkyl substances (PFAS), in the blood and urine of 69 children aged 3 to 6 years. Using genetic sequencing techniques, they determined the types and abundance of bacteria and fungi present in child stool samples.

Children with higher levels of PFAS in their blood had a lower number and diversity of bacteria in their gut. Higher phthalate levels were associated with a reduction in gut fungal populations. Surprisingly, children with higher levels of certain SVOCs, including triclosan, had several types of bacteria in their gut known to break down toxic chemicals in the environment.

Citation: Gardner CM, Hoffman K, Stapleton HM, Gunsch CK. 2021. Exposures to semivolatile organic compounds in indoor environments and associations with the gut microbiomes of children. Environ Sci Technol Lett 8(1):7379. (Synopsis(https://factor.niehs.nih.gov/2021/1/papers/dert/index.htm#a4))

A new NIEHS-funded study showed that exposure to nearly 300 common chemicals can cause cells to produce more estrogen or progesterone, which may increase breast cancer risk.

The study included data for more than 650 chemicals tested in the U.S. Environmental Protection Agencys ToxCast program. The researchers examined the data to identify chemicals that increased progesterone or estradiol, a form of estrogen, in a human cancer cell line.

Of the chemicals tested, 296 increased estradiol or progesterone in cells, whereas 71 chemicals increased both hormones. Using data from existing animal studies, the researchers then classified the hormone-increasing chemicals as either likely or unlikely to cause cancer or result in poor reproductive or developmental outcomes. Thirty percent were classified as likely carcinogens or reproductive or developmental toxicants, whereas only 5%-13% were classified as unlikely to cause these health outcomes.

Citation: Cardona B, Rudel RA. 2021. Application of an in vitro assay to identify chemicals that increase estradiol and progesterone synthesis and are potential breast cancer risk factors. Environ Health Perspect 129(7):77003. (Synopsis(https://factor.niehs.nih.gov/2021/9/papers/dert/index.htm#a2))

A study by NIEHS-funded researchers provides insight into how SARS-CoV-2, the virus that causes COVID-19, damages heart cells. The findings may inform treatment strategies to protect heart health in COVID-19 patients.

Using stem cells, the researchers created three types of human heart cells cardiomyocytes, cardiac fibroblasts, and endothelial cells and exposed them to small amounts of the SARS-CoV-2 virus for 48 hours. The virus was only able to infect and replicate in cardiomyocytes, the heart muscle cells. Unlike the other cell types, cardiomyocytes had ACE2 receptors on their surface, which serve as the cellular entry point for the virus.

Infected cardiomyocytes showed structural defects and had decreased expression of genes important in heart contraction. Many cardiomyocytes were missing nuclear DNA. Without this DNA, cells cannot function. Heart tissue samples from deceased COVID-19 patients mirrored the structural and genetic changes observed in cell models.

Citation: Perez-Bermejo JA, Kang S, Rockwood SJ, Simoneau CR, Joy DA, Silva AC, Ramadoss GN, Flanigan WR, Fozouni P, Li H, Chen PY, Nakamura K, Whitman JD, Hanson PJ, McManus BM, Ott M, Conklin BR, McDevitt TC. 2021. SARS-CoV-2 infection of human iPSC-derived cardiac cells reflects cytopathic features in hearts of patients with COVID-19. Sci Transl Med 13(590):eabf7872. (Synopsis(https://factor.niehs.nih.gov/2021/7/papers/dert/index.htm#a2))

Using machine learning, NIEHS-funded researchers identified patterns in maternal autoantibodies, immune proteins that attack a persons own proteins or tissues, that were highly associated with the diagnosis and severity of autism spectrum disorder (ASD).

The team previously identified maternal autoantibodies against eight key proteins related to ASD. In this study, the researchers developed an accurate test for reactivity patterns against those proteins that could predict ASD. They analyzed plasma samples from 450 mothers of children with autism and 342 mothers of typically developing children from the Childhood Autism Risks from Genetics and Environment (CHARGE) study.

The researchers found autoantibody reactivity to a single protein did not correlate with ASD diagnosis. Instead, reactivity to autoantibodies to CRIMP1 combined with any of the top proteins increased the likelihood of a higher ASD severity score. The approach may aid early ASD detection, which can help facilitate early interventions.

Citation: Ramirez-Celis A, Becker M, Nuno M, Schauer J, Aghaeepour N, Van de Water J. 2021. Risk assessment analysis for maternal autoantibody-related autism (MAR-ASD): a subtype of autism. Mol Psychiatry 26(5):15511560. (Synopsis(https://factor.niehs.nih.gov/2021/3/papers/dert/index.htm#a1))

Elevated levels of phthalates during pregnancy may negatively affect executive function in children, according to an NIEHS-funded study. Executive function a set of complex cognitive skills, such as emotional regulation, impulse control, working memory, and attentional flexibility enables people to focus, follow directions, and handle emotions.

Researchers measured 12 phthalate metabolites in urine samples collected at 17 weeks of pregnancy. Among those children sampled, born between 2003 and 2008, the researchers compared 262 children who had attention-deficit hyperactivity disorder symptoms with 78 typically developing children.

Exposure to higher levels of mono-benzyl phthalate (MBzP) in maternal blood during the prenatal period was associated with poorer executive function in both sexes. Also, higher levels of mono-n-butyl phthalate and mono-iso-butyl phthalate affected executive function, but results varied by evaluation method. For example, inhibition reported by parents was most affected by both chemicals, with stronger associations among boys.

Citation: Choi G, Villanger GD, Drover SSM, Sakhi AK, Thomsen C, Nethery RC, Zeiner P, Knudsen GP, Reichborn-Kjennerud T, Overgaard KR, Herring AH, Skogan AH, Biele G, Aase H, Engel SM. 2021. Prenatal phthalate exposures and executive function in preschool children. Environ Int 149:106403. (Synopsis(https://factor.niehs.nih.gov/2021/5/papers/dert/index.htm#a2))

NIEHS-funded researchers observed an increase in respiratory disease and other hospitalizations among older adults following exposure to tropical cyclones, which may help hospitals become better prepared in the future. Tropical cyclone is a generic term used to describe tropical depressions, tropical storms, and hurricanes.

The team used data on 70 million Medicare hospitalizations for individuals 65 years and older and a comprehensive database of county-level local winds to estimate tropical cyclone exposures between 1999 and 2014. Using advanced statistical models, they examined how tropical cyclone exposure related to hospitalizations for 13 different causes.

In the week following tropical cyclone exposure, researchers observed an average increase in hospitalizations from several causes, including respiratory diseases, infectious and parasitic diseases, and injuries. The results demonstrate the need for targeted hospital preparedness strategies before, during, and after tropical cyclones and other extreme weather.

Citation: Parks RM, Anderson GB, Nethery RC, Navas-Acien A, Dominici F, Kioumourtzoglou MA. 2021. Tropical cyclone exposure is associated with increased hospitalization rates in older adults. Nat Commun 12(1):1545. (Synopsis(https://factor.niehs.nih.gov/2021/5/papers/dert/index.htm#a3))

Portable air cleaners may improve respiratory symptoms among former smokers with chronic obstructive pulmonary disease (COPD), according to an NIEHS-funded study. COPD is a progressive disease characterized by lung injury and inflammation and has limited treatment options.

Smoking cessation can slow the advancement of COPD, but former smokers continue to be affected by the disease, which can be worsened by exposure to air pollutants, such as particulate matter and nitrogen dioxide. The team conducted a blinded, randomized controlled trial of 116 former smokers with moderate to severe COPD. Participants received active or sham portable HEPA air cleaners for their homes and were followed for six months.

The active HEPA filter group experienced reduced respiratory symptoms and fewer urgent health care visits compared with the sham group. They also had lower rates of systemic steroid, antibiotic, or rescue medication use.

Citation: Hansel NN, Putcha N, Woo H, Peng R, Diette GB, Fawzy A, Wise RA, Romero K, Davis MF, Rule AM, Eakin MN, Breysse PN, McCormack MC, Koehler K. 2021. Randomized clinical trial of air cleaners to improve indoor air quality and COPD health: results of the CLEAN AIR STUDY. Am J Respir Crit Care Med; doi:10.1164/rccm.202103-0604OC [Online 27 August 2021]. (Synopsis(https://factor.niehs.nih.gov/2021/11/papers/dert/index.htm#a1))

An international team of researchers, funded in part by NIEHS, identified promising new targets for treatment and early diagnosis of pancreatic ductal adenocarcinoma (PDAC), a highly aggressive condition with poor patient survival.

Using samples from 140 pancreatic cancers and more than 70 normal pancreatic tissues, the scientists carried out genomic, RNA, and microRNA sequencing, combined with detailed analyses of protein modifications. Focusing on 222 proteins that were at least twice as abundant in cancerous cells than in normal cells, they identified 12 proteins that they say could aid early detection in blood samples.

They also found nearly 5,000 sites within these proteins with increased phosphate groups and more than 1,700 sites with increased carbohydrate chains. The team said several of these patterns offered clues for treatment, such as blocking the enzymes involved in specific protein modifications associated with PDAC.

Citation: Cao L, Huang C, Cui Zhou D, Hu Y, Lih TM, Savage SR, Krug K, Clark DJ, Schnaubelt M, Chen L, da Veiga Leprevost F, Eguez RV, Yang W, Pan J, Wen B, Dou Y, Jiang W, Liao Y, Shi Z, Terekhanova NV, Cao S, Lu RJ, Li Y, Liu R, Zhu H, Ronning P, Wu Y, Wyczalkowski MA, Easwaran H, Danilova L, Mer AS, Yoo S, Wang JM, Liu W, Haibe-Kains B, Thiagarajan M, Jewell SD, Hostetter G, Newton CJ, Li QK, Roehrl MH, Feny D, Wang P, Nesvizhskii AI, Mani DR, Omenn GS, Boja ES, Mesri M, Robles AI, Rodriguez H, Bathe OF, Chan DW, Hruban RH, Ding L, Zhang B, Zhang H; Clinical Proteomic Tumor Analysis Consortium. 2021. Proteogenomic characterization of pancreatic ductal adenocarcinoma. Cell 184(19):50315052.e26. (Synopsis(https://factor.niehs.nih.gov/2021/11/papers/dert/index.htm#a3))

Working with citizen-scientists, NIEHS-funded researchers demonstrated that leaves can be used as a low-cost, reliable method to assess the level of metals in airborne dust. The method can help assess exposure from former mine sites that emit heavy metals that can be distributed by wind to nearby communities.

Twenty participants from Superior, Arizona, placed a potted peppermint plant and disc sampler in a self-selected area, usually outside of their home. After one month, they submitted two leaves and the disc for analysis of seven different metals arsenic, lead, cadmium, copper, aluminum, nickel, and zinc.

On both the leaves and discs, levels of all metals decreased as distance from the mine increased. The results suggest that plant leaves can serve as a reliable monitor of metal-laden aerosols and that the low-cost technique is applicable to sites where resources are limited.

Citation: Zeider K, Van Overmeiren N, Rine KP, Sandhaus S, Eduardo Saez A, Sorooshian A, Munoz HC Sr, Ramirez-Andreotta MD. 2021. Foliar surfaces as dust and aerosol pollution monitors: an assessment by a mining site. Sci Total Environ 790:148164. (Synopsis(https://factor.niehs.nih.gov/2021/10/papers/dert/index.htm#a2))

Thousands of COVID-19 cases and deaths in the western U.S. may be attributable to increases in fine particulate matter air pollution (PM2.5) from wildfires, according to NIEHS-funded research. Exposure to wildfire smoke can increase the risk of lung infections, including COVID-19.

The researchers linked publicly available data on daily PM2.5 levels and the number of COVID-19 cases and deaths that occurred between March and December 2020 in 92 counties across California, Oregon, and Washington. They developed a model to estimate the association between daily changes in PM2.5 and percentage increase in COVID-19 cases and deaths up to 28 days after exposure.

From August to October 2020, when fire activity was greatest, daily levels of PM2.5 during wildfire days were significantly higher than on non-wildfire days. The total number of COVID-19 cases and deaths attributable to daily increases in PM2.5 from wildfires were 19,742 and 748, respectively.

Citation: Zhou X, Josey K, Kamareddine L, Caine MC, Liu T, Mickley LJ, Cooper M, Dominici F. 2021. Excess of COVID-19 cases and deaths due to fine particulate matter exposure during the 2020 wildfires in the United States. Sci Adv 7(33):eabi8789. (Synopsis(https://factor.niehs.nih.gov/2021/10/papers/dert/index.htm#a4))

Male hormones can protect from inflammation and pre-cancerous conditions in the stomach, according to a study by NIEHS scientists. The study offers novel mechanistic insight into how male hormones regulate stomach inflammation by restraining specialized immune cells.

The authors observed that glucocorticoids, a type of steroid hormone produced by adrenal glands, is required to protect female mice from stomach inflammation. However, in male mice, they found that in addition to glucocorticoids, male sex hormones provide an additional layer of protection against stomach inflammation. The researchers found that the inflammatory response from specific immune cells called type 2 innate-lymphoid cells (ILC2) drives the development of gastric inflammation. Importantly, the study showed that male sex hormones directly repress the proinflammatory state of ILC2, thereby preventing harmful inflammation.

Citation: Busada JT, Peterson KN, Khadka S, Xu X, Oakley RH, Cook DN, Cidlowski JA. 2021. Glucocorticoids and androgens protect from gastric metaplasia by suppressing group 2 innate lymphoid cell activation. Gastroenterology 161(2):637652.e4. (Synopsis(https://factor.niehs.nih.gov/2021/7/papers/dir/index.htm#a3)) (Story)

NIEHS scientists have identified five clusters of conventional dendritic cells (cDC2s) in the lungs of mice following their inhalation of house dust extract. As a result, the team is closer to understanding the cellular and molecular mechanisms involved in pulmonary diseases, such as cystic fibrosis, chronic obstructive pulmonary disease (COPD), and asthma.

The researchers used mass cytometry, single cell RNA sequencing, and a mouse model of asthma to assess how the developmental progression of cDC2s affects their ability to promote differentiation of the distinct T-helper (Th) cell lineages, Th2 and Th17. The researchers found that Ly6C, a cell-surface marker of immature dendritic cells, is associated with those cells ability to promote the differentiation of Th17 cells. This finding is important because cDC2s in the lung direct immune responses to inhaled agents in the environmental bioaerosol.

Citation: Izumi G, Nakano H, Nakano K, Whitehead GS, Grimm SA, Fessler MB, Karmaus PW, Cook DN. 2021. CD11b+ lung dendritic cells at different stages of maturation induce Th17 or Th2 differentiation. Nat Commun 12(1):5029. (Synopsis(https://factor.niehs.nih.gov/2021/10/papers/dir/index.htm#a2))

NIEHS researchers discovered that removal of perineuronal nets (PNNs) a specialized form of extracellular matrix in a Mecp2-null mouse model of Rett syndrome (RTT) salvages synaptic plasticity in the hippocampal area CA2 of the brain early in postnatal development. Synaptic plasticity refers to the brains ability to respond to environmental stimuli. RTT is a neurodevelopmental disorder characterized by normal development in the first year of life, followed by rapid, significant decline in cognitive, motor, and social function. The condition affects 1 in 10,000 girls worldwide.

The authors previously found that PNNs limit synaptic plasticity in CA2, a region associated with social learning in mice and an area that is atypically resistant to long-term potentiation. The scientists observed increased PNNs in the CA2 region of postmortem human tissue from an individual with RTT and found that PNNs develop precociously in the murine model of RTT.

Citation: Carstens KE, Lustberg DJ, Shaughnessy EK, McCann KE, Alexander GM, Dudek SM. 2021. Perineuronal net degradation rescues CA2 plasticity in a mouse model of Rett syndrome. J Clin Invest 131(16):e137221. (Synopsis(https://factor.niehs.nih.gov/2021/9/papers/dir/index.htm#a5))

NIEHS researchers and their collaborators found an association between exposure to consumer product chemicals and oxylipins during pregnancy. Oxylipins are lipids that play important roles in inflammation, tissue repair, and blood clotting.

The researchers looked at biomarkers of exposure to three classes of consumer product chemicals, including phenols, phthalates, and organophosphate esters (OPEs) in the urine of 90 mothers during multiple points of pregnancy. These biomarkers were simultaneously examined alongside a panel of oxylipins found in serum.

The scientists demonstrated that several oxylipins involved in inflammatory responses were higher in pregnant women with elevated concentrations of urinary phenol, phthalate, and OPE biomarkers. These associations varied by the class of consumer product chemical and the pathway by which oxylipin was produced. Taken together, this study provides insight into how exposure to environmental chemicals during pregnancy affects specific processes of inflammation.

Citation: Welch BM, Keil AP, Bommarito PA, van T' Erve TJ, Deterding LJ, Williams JG, Lih FB, Cantonwine DE, McElrath TF, Ferguson KK. 2021. Longitudinal exposure to consumer product chemicals and changes in plasma oxylipins in pregnant women. Environ Int 157:106787. (Synopsis(https://factor.niehs.nih.gov/2021/11/papers/dir/index.htm#a2))

Using a mouse model that lacked the gene IRGM1, a research team led by NIEHS researchers determined that a buildup of defective mitochondria led to an autoimmune condition that resembled Sjogrens syndrome. In humans, Sjogrens is characterized by dryness in the mouth, eyes, and other parts of the body. The research suggests a possible mechanism for how autoimmunity develops in people.

IRGM1 is the mouse version of a human gene called IRGM. These genes are responsible for autophagy, a process that removes malfunctioning organelles from the cell. In addition to displaying symptoms of autoimmunity, the scientists determined that IRGM1 knockout mice also had evidence for increased signaling by an inflammatory protein called type 1 interferon. The scientists also provided evidence that the DNA and RNA that spills out of faulty mitochondria elicit an immune response that causes an overproduction of type 1 interferon.

Citation: Rai P, Janardhan KS, Meacham J, Madenspacher JH, Lin WC, Karmaus PWF, Martinez J, Li QZ, Yan M, Zeng J, Grinstaff MW, Shirihai OS, Taylor GA, Fessler MB. 2021. IRGM1 links mitochondrial quality control to autoimmunity. Nat Immunol 22(3):312321. (Synopsis(https://factor.niehs.nih.gov/2021/3/papers/dir/index.htm#a4)) (Story)

NIEHS researchers have revealed how a protein called INO80 controls the fate of pluripotent stem cells, which can give rise to all cell types in the body.

INO80 is involved in many cellular and developmental processes, as well as neurological diseases and cancer. As a chromatin remodeler, INO80 can regulate gene activity by altering the structure of chromatin, which consists of DNA and proteins such as histones.

The researchers inactivated the INO80 gene in mouse stem cells at different developmental stages and found that INO80 enhanced the binding of a histone variant called H2A.Z to key DNA sequences at the later developmental stage. This event triggered the addition of certain chemical groups to histones, thereby decreasing the activity of nearby genes that play important roles in development. The findings revealed unexpected functions of INO80 in regulating the genomic positioning of H2A.Z and gene activity.

Citation: Yu H, Wang J, Lackford B, Bennett B, Li JL, Hu G. 2021. INO80 promotes H2A.Z occupancy to regulate cell fate transition in pluripotent stem cells. Nucleic Acids Res 49(12):67396755. (Synopsis(https://factor.niehs.nih.gov/2021/8/papers/dir/index.htm#a2))

Researchers at NIEHS led a team that reported that short sleep and apnea-specific hypoxia, which is the lack of adequate oxygen because of apnea, are associated with chronic kidney disease (CKD) in a multi-ethnic population. The findings indicate that sleep disturbance was twice as prevalent among African American participants with CKD compared with white participants. The research incorporated novel, more sensitive assessments of sleep apnea and evaluated these associations in a racially and ethnically diverse population. Such data are lacking in the literature.

The scientists found that very short sleep, five or fewer hours per night, and sleep apnea-specific hypoxia were associated with moderate-to-severe CKD. These sleep deficiencies may contribute to CKD by worsening known risk factors, such as dyslipidemia, hypertension, and type 2 diabetes. The association between sleep deficiencies and CKD could be studied by clinicians and public health professionals to address health disparities.

Citation: Jackson CL, Umesi C, Gaston SA, Azarbarzin A, Lunyera J, McGrath JA, Jackson WB, Diamantidis CJ, Boulware E, Lutsey PL, Redline S. 2020. Multiple, objectively measured sleep dimensions including hypoxic burden and chronic kidney disease: findings from the Multi-Ethnic Study of Atherosclerosis. Thorax 76(7):704713. (Synopsis(https://factor.niehs.nih.gov/2021/2/papers/dir/index.htm#a3))

The gene regulatory protein GLIS1 is associated with glaucoma in humans and the regulation of intraocular pressure inside the eyes of mice, according to NIEHS researchers and their collaborators. This study sheds light on the cellular and molecular causes of the second most common cause of blindness in the U.S. and may lead to the development of new therapies.

In most cases, glaucoma is caused by an increase in intraocular pressure, which is largely regulated by an eye tissue known as the trabecular meshwork. The researchers found that mice lacking GLIS1 developed enlarged eyes and a long-lasting increase in intraocular pressure,

The study revealed that low levels of GLIS1 induce the degeneration of the trabecular meshwork, leading to inefficient drainage of the ocular fluid called the aqueous humor. The research also showed that GLIS1 regulates the expression of several glaucoma-associated genes in trabecular meshwork cells.

Citation: Nair KS, Srivastava C, Brown RV, Koli S, Choquet H, Kang HS, Kuo YM, Grimm SA, Sutherland C, Badea A, Johnson GA, Zhao Y, Yin J, Okamoto K, Clark G, Borras T, Zode G, Kizhatil K, Chakrabarti S, John SWM, Jorgenson E, Jetten AM. 2021. GLIS1 regulates trabecular meshwork function and intraocular pressure and is associated with glaucoma in humans. Nat Commun 12(1):4877. (Synopsis(https://factor.niehs.nih.gov/2021/10/papers/dir/index.htm#a3))

NIEHS researchers and their collaborators reported that an epigenetic modification known as histone crotonylation (Kcr) is necessary for the differentiation of human embryonic stem cells (hESCs) during early embryonic development. Epigenetics, the study of how genes are read and expressed, is known to be important in regulation of pluripotency and differentiation of hESCs in response to metabolic alterations, but the specific mechanisms were unclear.

Using immunofluorescence and quantitative proteomic analyses, the authors showed that histone Kcr, a specific epigenetic modification to the proteins that package DNA inside chromosomes, increases during a metabolic switch from glycolysis to oxidative phosphorylation early in the process by which hESCs differentiate into mesoendodermal cells. This increase induces mesoendodermal gene expression and promotes mesoendoderm differentiation in vitro and in vivo. The data directly link metabolic programming to histone Kcr and further demonstrate that Kcr plays a role in promoting mesoendodermal gene expression.

Citation: Fang Y, Xu X, Ding J, Yang L, Doan MT, Karmaus PWF, Snyder NW, Zhao Y, Li JL, Li X. 2021. Histone crotonylation promotes mesoendodermal commitment of human embryonic stem cells. Cell Stem Cell 28(4):748763.e7. (Synopsis(https://factor.niehs.nih.gov/2021/3/papers/dir/index.htm#a5))

The mosquito protein AEG12 disrupts the lipid envelope that covers some viruses, according to NIEHS researchers and their collaborators. Flaviviruses a class that includes dengue, yellow fever, and zika virus are mainly transmitted by mosquitos and typically covered by a protective coating of lipids. Mosquitos produce AEG12 in response to a blood meal or flavivirus infection.

After solving the three-dimensional structure of AEG12 by X-ray crystallography, the researchers identified AEG12 as a lipid-binding protein. They further demonstrated that AEG12 was capable of rupturing membranes of red blood cells and inhibiting the replication of flaviviruses and other enveloped viruses, including human coronaviruses.

AEG12 breaks open the cells or virus by swapping the lipid it carries with those in the cell membrane or virus envelop. By doing so, AEG12 contributes to both insect digestion and the antiviral immune response.

Citation: Foo ACY, Thompson PM, Chen SH, Jadi R, Lupo B, DeRose EF, Arora S, Placentra VC, Premkumar L, Perera L, Pedersen LC, Martin N, Mueller GA. 2021. The mosquito protein AEG12 displays both cytolytic and antiviral properties via a common lipid transfer mechanism. Proc Natl Acad Sci U S A 118(11):e2019251118. (Synopsis(https://factor.niehs.nih.gov/2021/5/papers/dir/index.htm#a2)) (Story)

Although women with type 2 diabetes (T2D) may have increased breast cancer risk, use of the antidiabetic drug metformin may reduce that risk. A team led by NIEHS researchers found women with T2D and long-term metformin use were 38% less likely to develop estrogen receptor-positive (ER-positive) breast cancer compared with women without T2D. However, women with T2D and metformin use were at increased risk of ER-negative breast cancer and triple-negative breast cancer (TNBC).

The scientists used data from 44,541 women in the Sister Study, a prospective study of risk factors for breast cancer and other diseases. Participants were aged 35-74 years and breast-cancer free at enrollment. Although the researchers did not find an association between T2D and breast cancer overall, 74% of those with T2D used metformin, and long-term metformin treatment was associated with reduced risk of ER-positive breast cancer.

Citation: Park Y-MM, Bookwalter DB, O'Brien KM, Jackson CL, Weinberg CR, Sandler DP. 2021. A prospective study of type 2 diabetes, metformin use, and risk of breast cancer. Ann Oncol 32(3):351359. (Synopsis(https://factor.niehs.nih.gov/2021/4/papers/dir/index.htm#a5))

NIEHS researchers and their colleagues used structural biology to study the endoribonuclease nonstructural protein 15 (Nsp15), an enzyme that cuts single- and double-strand viral RNA. Nsp15 is found in all coronaviruses and, through a complex process, helps the virus evade a hosts immune system. These findings may allow researchers to design therapeutics that bind to the Nsp15 active site of SARS-CoV-2, which could help treat COVID-19 cases.

Researchers used cryogenic electron microscopy, or cryo-EM, to visualize the structure of Nsp15. In addition to creating structural images, they performed molecular dynamics simulations to assess the biological function of the protein. They found that Nsp15 is stable and active when bound with RNA, but when it is not bound with RNA, Nsp15 constantly shifts and creates a wobble effect. Although the significance of the wobble is not completely understood, it may present a previously unexplored function.

Citation: Pillon MC, Frazier MN, Dillard LB, Williams JG, Kocaman S, Krahn JM, Perera L, Hayne CK, Gordon J, Stewart ZD, Sobhany M, Deterding LJ, Hsu AL, Dandey VP, Borgnia MJ, Stanley RE. 2021. Cryo-EM structures of the SARS-CoV-2 endoribonuclease Nsp15 reveal insight into nuclease specificity and dynamics. Nat Commun 12(1):636. (Synopsis(https://factor.niehs.nih.gov/2021/3/papers/dir/index.htm#a3))

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January 2022: 2021 Papers of the year - Environmental Factor Newsletter

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Liso-Cel Outperforms Standard Therapy in Improving QoL in Relapsed/Refractory LBCL – www.oncnursingnews.com/

Posted: January 5, 2022 at 1:54 am

Lisocabtagene maraleucel (liso-cel; Breyanzi) fostered a better quality of life (QoL) in patients with relapsed/refractory large B-cell lymphoma (LBCL) compared with current standard of care (SOC), according to data from a comparative analysis of the phase 3 TRANSFORM trial (NCT03575351) presented during the 2021 ASH Annual Meeting.1

Using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 30 items (EORTC QLQ-C30), a linear mixed model for repeated measures (MMRM) group analysis found that those in the liso-cel arm had more favorable overall least square (LS) mean changes from baseline to day 126 vs the SOC arm in most of the domains analyzed.

Evaluable patients who received the CAR T-cell therapy (n = 47) experienced a mean change in cognitive functioning of 2.21 (range, -1.48 to 5.90) vs -2.09 (range, -6.00 to 1.83) in those who received SOC (n = 43); this translated to a difference of 4.30 (range, -0.76 to 9.36) on day 126 from baseline.

Those in the liso-cel arm also experienced a mean change in fatigue of -1.95 (range, -7.40 to 3.51) compared with 3.75 (range, -2.17 to 9.68) in the SOC arm, equating to a difference of -5.70 (range, -13.24 to 1.84) on day 126 from baseline. In these domains, the liso-cel group improved, as the SOC group deteriorated.

Additionally, the liso-cel arm had a mean change in global health status/QoL (GH/QoL) of 3.08 (range, -1.83 to 7.99) from baseline to day 126; the SOC arm experienced a mean change of 0.04 (range, -5.24 to 5.31), resulting in a difference of 3.04 (range, -3.62 to 9.70) between the 2 arms.

The liso-cel group also experienced mean changes in physical functioning and pain of -2.75 (range, -6.76 to 1.25) and -11.14 (range, -16.37 to -5.92), respectively, compared with -2.17 (range, -6.64 to 2.30) and -15.56 (range, -21.25 to -9.88), respectively, for the SOC group. The differences between the 2 arms in physical functioning and pain were -0.58 (range, -6.17 to 5.01) and 4.42 (range, -2.72 to 11.56), respectively.

Individual-level analyses demonstrated that the proportion of patients with meaningful improvement was higher for GH/QoL, and deterioration was lower with liso-cel vs SOC from day 126 to month 6.

At the 6-month mark, 53% of patients in the liso-cel arm reported improvement in GH/QoL, compared with 14% of those in the SOC arm. Eighteen percent of patients in the liso-cel arm reported deterioration of GH/QoL at this time point vs 57% of those on the SOC arm. Furthermore, 47% of patients in the liso-cel group experienced improvement in fatigue at 6 months vs 29% of those in the SOC group. Eighteen percent of patients in the liso-cel arm experienced deterioration regarding fatigue at this time point vs 71% of those in the SOC arm.

It is important to emphasize that higher scores on functionality domains and lower scores on symptom domains indicate a better QoL, presenting study author Jeremy Abramson, MD, of Massachusetts General Hospital Cancer Center, said during the poster presentation of the data.

TRANSFORM enrolled patients between the ages of 18 and 75 years who had aggressive non-Hodgkin lymphoma and who were refractory or relapsed 12 months or less following first-line treatment containing an anthracycline and a CD20-targeted agent. To be eligible for enrollment, patients needed to have an ECOG performance status of 0 or 1, be eligible for hematopoietic stem cell transplantation and have a left ventricular ejection fraction of over 40%. Patients with secondary central nervous system lymphoma were permitted. There was no minimum lymphocyte count.

Participants were randomized 1:1 to receive either SOC comprised of 3 cycles of salvage chemotherapy and BEAM (carmustine, etoposide, cytarabine, and melphalan) plus autologous stem cell transplantation for responding patients, or liso-cel following lymphodepletion treatment. Crossover to the liso-cel arm was permitted for patients who failed SOC treatment. Patients received the CAR T-cell therapy at a dose of 100 x 106CAR-positive T cells.

The primary end point of the trial was event-free survival (EFS), and key secondary end points comprised complete response (CR) rate, progression-free survival (PFS), and overall survival. Other end points of interest included duration of response, objective response rate, PFS on the next line of treatment, safety, and patient-reported outcomes (PROs).

In a prespecified interim analysis of data from TRANSFORM, liso-cel demonstrated highly statistically relevant and clinically meaningful improvement vs SOC regarding the primary end point of EFS, plus secondary end points of CR and PFS.2In the analysis presented during the 2021 ASH Annual Meeting, Abramson reported findings pertaining to QoL.

Investigators evaluated QoL by leveraging the EORTC QLQ-C30 and FACT-LymS tools. The former evaluated cancer-associated symptoms and functioning and is comprised of 30 items that address 15 domains. Primary functional domains of interest that were evaluated in TRANSFORM were GH/QoL, physical functioning, and cognitive functioning. Primary symptom domains of interest were fatigue and pain. The FACT-LymS tool evaluated symptoms that were specific to lymphoma and was comprised of 15 items. With this assessment, higher scores are representative of better QoL.

To assess the between-treatment differences in overall LS mean change from baseline for each primary domain, a MMRM analysis was conducted, and this leveraged data collected up to day 126 for visits with a sample size per are of 10 or more. All analyses were prospectively defined, and the findings reported during the 2021 ASH Annual Meeting are descriptive.

To be eligible for PRO analyses, patients needed to complete a baseline assessment and at least 1 post-baseline assessment. Notably, a similar proportion of patients were included in the EORTC QLQ-C30 analyses sets for liso-cel (51%) and SOC (47%).

In the liso-cel group of 92 patients, 47 were evaluable for the EORTC QLQ-C30 analysis, and 45 were evaluable for the FACT LymS analysis. Notably, 45 patients were not included in the EORTC QLQ-C30 analysis because they did not complete a baseline assessment (n = 28), a post-baseline assessment (n = 1), or both (n = 16).

In the SOC group, 43 and 40 out of 92 patients were evaluable for the EORTC QLQ-C30 and FACT Lym-S analyses, respectively. Patients from this group were excluded from the EORTC QLQ-C30 analysis due to lack of baseline assessment (n = 20), lack of post-baseline assessment (n = 6), or lack of both (n = 23).

Additional data presented during the 2021 ASH Annual Meeting showed that with regard to the Functional Assessment of Cancer Therapy - Lymphoma Subscale (FACT-LymS), the difference in mean change between the 2 arms was -0.16 (range, -2.71 to 2.40). On the 126-day mark, the liso-cel group had a FACT-LymS mean change of 1.48 (range, -0.30 to 3.26), compared with 1.63 (range, -0.41 to 3.68) in the SOC group. Notably, for FACT-LymS, similar proportions of patients between the investigative and control arms experienced deterioration (24% and 29%, respectively) and improvement (47% and 43%) at month 6.

Overall QoL was either improved or maintained from baseline in patients with relapsed/refractory LBCL who received liso-cel as second-line treatment, Abramson concluded. These results were achieved despite only responders to salvage chemotherapy remaining in the SOC arm past day 64. These findings corroborated with previously reported HRQoL associated with liso-cel treatment.

References

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Liso-Cel Outperforms Standard Therapy in Improving QoL in Relapsed/Refractory LBCL - http://www.oncnursingnews.com/

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FDA Grants Fast Track Designation to CYNK-001 for AML Treatment – Targeted Oncology

Posted: January 5, 2022 at 1:53 am

A novel natural killer cell therapy is now on the fast track to FDA approval and being assessed in a phase 1 clinical trial.

The FDA has granted fast track designation to, CYNK-001, a novel on-genetically modified cryopreserved human placental hematopoietic stem cell-derived natural killer (NK) cell therapy for the treatment of patients with acute myeloid leukemia, according to a press release issued by Celularity Inc.1

CYNK-001 contains NK cells derived from human placental CD34+ cells and culture-expanded. In a new phase 1 multi-dose study (NCT04310592) of approximately 56 adult patients with AML, CYNK-001 cells will be given after lymphodepleting chemotherapy to determine its safety and whether NK cells be used to treat AML.1,2

The majority of patients with AML continue to have poor long-term outcomes, particularly those who suffer relapse or have measurable residual disease, necessitating development of novel therapies, including CYNK-001, said Andrew Pecora, MD, president of Celularity, in a press release.1

We believe that the unique properties of our cell source, including the ability to proliferate and maintain activity, could be the key to improving response rates and durability for patients. We are pleased to receive this fast-track designation from the FDA for AML supporting continued development of our placental-derived NK cell platform. CYNK-001 previously received orphan drug designation for malignant gliomas and fast track designation for glioblastoma multiforme, said Robert Hariri, MD, PhD, founder, chairperson, and chief executive officer of Celularity, in the press release.

In the phase 1 study of CYNK-001 the coprimary end points include dose-limiting toxicity (DLT) in minimal residual disease (MRD) positive patients with AML, DLT in relapsed or refractory patients with AML, the maximum-tolerated dose (MTD) in the MED -positive population, MTD in the relapsed/refractory population, and the frequency and severity of adverse events (AEs). Secondary end points that will be evaluated in the study include the number of patients who experienced MRD response, time to MRD response, duration of MRD response, progression-free survival, time to progression, duration of morphologic complete remission, overall survival, overall response rate, and duration of response.2

Patients aged 18 to 80 years with either primary/secondary AML or relapsed/refractory AML are eligible to enroll. Patients are required to have an ECOG performance status of 2 and must be able off immunosuppressive drugs for at least 3 days before CYNK-001 infusion. Both male and female patients are required to contraception during the study and females cannot be pregnant when enrolling. The study also permits the inclusion of patients with central nervous system involvement that has been treated and who have clear cerebral spinal fluid for at least 2 weeks before joining the study.

The study is actively recruiting adults with AML to at 8 centers across the United States, including in Colorado, Illinois, New Jersey, New York, Tennessee, Washington.

References:

1. Celularity receives fast track designation from U.S. FDA for its NK cell therapy CYNK-001 in development for the treatment of AML. News release. December 27, 2021. Accessed December 29, 2021. https://bit.ly/3sE9g1O

2. Natural killer cell (CYNK-001) infusions in adults with AML (CYNK001AML01). Clinicaltrials.gov. Accessed December 29, 2021.

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Jacques Fresco, ‘a major figure in the birth of modern molecular biology,’ dies at 93 – Princeton University

Posted: January 5, 2022 at 1:52 am

Jacques Robert Fresco, the Damon B. Pfeiffer Professor in the Life Sciences, Emeritus, died on Dec. 5 of complications from heart disease, surrounded by his family. He was 93.

Jacques Robert Fresco, professor of biology, emeritus

Photo by Denise Applewhite

Jacques was a pioneer in the biochemistry of nucleic acids, said Lynn Enquist, the Henry L. Hillman Professor of Molecular Biology, Emeritus. He has a remarkable history of training students and mentoring spectacular faculty.

He was a great mentor, a brilliant scientist and an amazing storyteller who has lived through and created so many of the important milestones of the scientific revolution in molecular biology, said Oguzhan Atay, a 2011 graduate who wrote his thesis with Fresco. Listening to him was listening to the history of science. He had so many amazing stories about Crick, Pauling, Oppenheimer, Delbruck and so on. If it were not for Jacques, we would not have had so many monumental contributions to science, either through his own work, such as the understanding of the mechanism of mutations and their connection to DNA structure, or through the students he mentored, a remarkable list that includes Nobel laureates and National Academy of Science members.

Tomas Lindahl, winner of the 2015 Nobel Prize in Chemistry, was a postdoctoral researcher in Frescos lab from 1964-67. He made impressive contributions to biology throughout his career, said Lindahl, an emeritus scientist at the Francis Crick Institute. Together with a brilliant student, Bruce Alberts, Fresco proposed the now generally accepted conformation of RNA.

He was a giant in the field of RNA structure indeed he created the field, said Edward Ziff, a 1969 Ph.D. graduate who is now a professor of biochemistry and molecular pharmacology at NYU Grossman School of Medicine. He was forthright, knew his own mind and left a great legacy by fostering the growth of the original Program in Biochemical Sciences of the 1960s into the rich and varied community of biologists that flourishes at Princeton today.

Fresco joined Princeton in 1960 and retired in 2013 a 53-year tenure that makes him one of the longest-serving members of the Universitys storied faculty. "When I was chair of the department, Jacques was a regular visitor to my office," Enquist said. "What I liked most was his regular deliveries of reprints of his early papers and the discussion of the good old days that followed."

He initially joined the Department of Chemistry, and he soon helped found the Program in Biochemical Sciences, which then grew into a department that he chaired from 1974 to 1980. The Department of Molecular Biology was created in 1984, and Fresco soon moved to that department. He continued to conduct full-time research long after his transfer to emeritus status, ultimately publishing more than 170 papers, abstracts and patents, many written with former students or fellows.

A remarkable thing about Jacques was his drive to keep doing science well into his 90s, said Stephen Buratowski, a professor of biological chemistry and molecular pharmacology at Harvard University who did his undergraduate thesis with Fresco in 1984. Every time I would speak or email with him, he absolutely had to tell me about some new idea or paper he was working on. He put off retirement for quite a long time, and even when he went emeritus, he just couldnt stop being an active scientist. His love for science will always inspire me.

Jacques Fresco, seen here with a 3-D model of the standard Watson-Crick DNA double helix, made seminal contributions to the understanding of RNA and DNA. He died surrounded by his family on Dec. 5, 2021, at the age of 93. Keenly aware of the importance of visualizing genetic structures as well as performing experiments, Frescodesignated a room within his lab for physical models like this one.The plastic atoms snapped together to build molecules in which each element -- oxygen, carbon, nitrogen and others -- had its own color.

Photo courtesy of the Fresco Family

I coauthored papers with Jacques in 1961 and in 2002! recalled Arthur Lesk, who followed Fresco from Harvard to Princeton. I wonder whether that is some kind of record.

Many of his students mentioned what an enormous role Fresco played in shaping their careers, in large and small ways. Jacques treated everybody with the same respect, irreverence and love of life, said Steven Broitman, a professor of biology at West Chester University in Pennsylvania who completed his Ph.D. with Fresco in 1988. In addition to all he taught me about science, he also modeled the simple enjoyment in doing science that I have always tried to keep with me and pass on to my own students. He was larger than life, a major figure in the birth of modern molecular biology. He was deeply loved, and he will be missed.

Jacques Fresco was a great man, said Juan Alvarez-Dominguez of the Class of 2009, one of Frescos last thesis students; he is now a professor at the University of Pennsylvania Perelman School of Medicine. His contributions to science and mentoring ushered in an enlightened era of passionate endeavor. His infectious enthusiasm and unwavering support birthed a cadre of trainees that have gone on to win a Nobel Prize, preside over the National Academy of Sciences, and further his legacy among the worlds most prestigious academic institutions.

The Guatamalan-born scientist added: Jacques not only spoke my mother tongue, Spanish, he spoke a 15th-century Judeo-Spanish called Ladino. His ancestors fled Spain then, and their language remained frozen in time through the generations. I will never forget how Jacques explained, in elegant Ladino, how his grandmother passed it on to him.

Ladino was Frescos first language. The son of Sephardic Jewish immigrants Robert Fresco of Istanbul and Lucie Asso Fresco of Edirne, Turkey, Jacques was born in New York in 1928, the first of three children. After skipping three grades, he graduated from Bronx High School of Science at age 16 in June 1944. He headed to New York University (living at home and attending classes on the Bronx campus) and completed his B.A. in biology and chemistry at age 18 in January 1947, followed by an M.S. in biology and then a Ph.D. in biochemistry in 1952, all from NYU. He did postdoctoral work at Sloan-Kettering Institute for Cancer Research, then worked as a research fellow at Harvard University.

Jacques spent his entire career working on the chemistry of nucleic acids (DNA and RNA), starting with his Ph.D. dissertation in 1952, said Buratowski. So when the famous Watson and Crick paper proposing a structure for DNA came out in 1953, he was perfectly positioned to ride the resulting wave of DNA mania. As a postdoc with Paul Doty in Watsons new department at Harvard, and then as a faculty member at Princeton, he was a leader in showing that DNA and RNA conformations go well beyond the canonical Watson-Crick base pairing of A-T and G-C within the double helix. Jacques studies of triple helices and alternative base-pairings were foundational for understanding how DNA mutations occur and how RNA-based enzymes (for example, ribosomes, RNAi, and CRISPR) can function.

His work in Dotys lab, performing the first experiments in thermal melting of DNA, RNA, and RNA:DNA hybrids using UV absorbance, would much later earn him a nomination (along with Julius Marmur and Paul Doty) for the Nobel Prize.

While at Harvard, Jacques mentored then-undergraduate Bruce Alberts, who taught at Princeton from 1966 to 1976, served as president of the National Academy of Sciences and wrote the seminal textbook, The Molecular Biology of the Cell.

In addition to reassuring Alberts parents that they shouldnt worry about their sons choice to pursue science instead of medical school a story Fresco enjoyed telling he also played a key role in bringing the young scientist to Princeton. Before I had even completed my Ph.D., he convinced Princeton to offer me an assistant professorship that I did not deserve, Alberts recalled. And at Princeton for 10 years, we of course spent an enormous amount of time together. So Jacques was very central to my life as a scientist and a close friend.

From Harvard, Fresco was invited by Francis Crick to Cambridge to tackle a problem that he solved in weeks instead of months, so he went on to Paris to research with Marianne Grunberg-Manago at the Institut de Biologie Physico-Chimique.

While walking the streets of Paris to cool down after an experiment got knocked over, he met his future wife Rosalie Burns, lost on the Place Saint-Michel with her parents. His offer to guide them through the streets of Paris led to a loving marriage of nearly 64 years that gave them three daughters and much happiness.

Frescos research included many fields within molecular biology and biochemistry, including gene repair for sickle cell anemia, fluorescent cytogenetic probes for genes that are amplified in cancers, and the evolution of the genetic code. He was one of the early leaders in the field of triple-stranded nucleic acid helices DNA oddities that can form under special conditions.

Shapeshifting polynucleotides were unraveled as much by his scientific rigor as by the sheer force of his creativity, Alvarez-Domingo said. Paving the way for fleshing out transfer RNA helped unlock how the code of life itself is translated. Widening DNA base pairing possibilities provided a chemical basis for the origin of substitution mutations. And discovering that DNA can self-mutate offered a mechanism for the evolution and potentiation of genetic diversity.

Fresco received the American Scientist Writing award in 1962; a Guggenheim fellowship to the Medical Research Council Laboratory of Molecular Biology in Cambridge, England, in 1969-70; a visiting professorship at the Hebrew University of Jerusalem in 1973; an endowed chair from Princeton, the Damon B. Pfeiffer Professor in the Life Sciences, in 1977; an honorary doctorate (M.D. honoris causa) from University of Gothenburg, Sweden, in 1979; and many other awards.

When he transferred to emeritus status in 2013, a colleague noted, One cannot pass by Jacques in the hall without him catching your eye, smiling and remarking with excitement about the new ideas that are coming from his laboratory.

His family describes him as a liberal thinker with a creative mind and a strong sense of tradition and obligation, outspoken and detail-oriented; a devoted family man and friend who promoted the careers of mentees in his lab and courses and maintained life-long close contacts with extended family, in-laws and friends; and a nurturing and dedicated tutor who strove to inspire his children and grandchildren. He was a humanitarian who spoke out against antisemitism and other forms of prejudice, a staunch defender of teaching evolution, a champion for animals and the less fortunate and joined in all of these by his beloved wife.

He is survived by his wife Rosalie Fresco, his daughter Lucille (Lulu) Fresco-Cohen and her husband Moshe Cohen, his daughter Suzette (Suzi) Fresco Johnson and her husband David Johnson, his daughter Linda Fresco and her husband Craig Comiter, as well as eight grandchildren Erik Johnson, Nicole Johnson of Princetons Class of 2012, Mikaela Johnson, Jacqueline Comiter, Golan Cohen, Galil Cohen, Laurel Comiter and Hayley Cohen and two great-grandchildren, Ben Johnson and Tommy Johnson, as well as cousins, nieces, and a nephew. Funeral services and burial were private at the Sephardic Jewish Brotherhood section of Cedar Park Cemetery.

You are invited to view and contribute comments on a memorial blog honoring Frescos life and legacy. In lieu of flowers, contributions in his memory may be made to the Southern Poverty Law Center, the World Jewish Congress, or Disabled American Veterans.

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US orders another 10 million courses of Pfizer COVID-19 treatment | TheHill – The Hill

Posted: January 5, 2022 at 1:52 am

The United States is purchasing an additional10 million courses of Pfizer's COVID-19 treatment Paxlovid, the company said Tuesday, bringing the total U.S. order to 20 million.

The move comes as the Biden administration seeks to ramp up the treatments available as another tool to battle the virus.

Pfizer also said Tuesday that the delivery of the first 10 million courses has been accelerated to June, with the following 10 million coming by September.

Experts have been pushing the White House to do more to ramp up production of the treatment given that it can play a major role in defanging the virus, but it is expected to be in shortage in the near term.

The White House previously said that just 265,000 courses of the treatment would be available in January, amid a major surge of COVID-19.

Officials have pointed to a complex manufacturing process as posing hurdles to getting doses sooner.

"Its still way too small and too late to meet the anticipated needs," Eric Topol, professor of molecular medicine at Scripps Research, wrote in an email after the announcement of the new order.

President BidenJoe BidenTrump blasts 'low-life Twitter' after Greene's account suspended Jill Biden to visit Kentucky to see tornado damage On The Money Biden's beef with the meat industry MORE is set to give remarks on the omicron variant and the latest in the response to the surge later Tuesday afternoon.

Pfizer did not give a price for the latest order of its treatment. The U.S. paid$5.295 billion for the original 10 million courses.

Trials showed that the pill is highly effective, reducing the risk of hospitalization or death by 89 percent in high-risk patients. It is intended to be taken within five days of the onset of symptoms.

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