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7 Side Effects of Steroids – Steroid Shots Side Effects

Posted: December 10, 2021 at 2:30 am

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If youre a regular lifter, the idea of juicing has probably crossed your mind. After all, you've been putting in the work, so why not reap the rewards?

In fact, most steroid users are just regular guys who just want to bulk up, according to findings published in Endocrine Reviews. Specific numbers are hard to come by, though estimates suggest that up to 20 percent of men who do recreational strength training have taken anabolic steroids at some point in their lifting history.

The number one reason I see people choose to use anabolic steroids is in hopes of more rapid muscle gains from their workout program, says Vijay Jotwani, M.D., primary care sports medicine physician at Houston Methodist Hospital. And the temptation can be big, especially if you see other guys at the gym taking them with huge results.

But just because steroids are popular doesnt make them safe. Here are seven side effects of steroids every lifter must know.

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1Acne.

Steroids wreck your skin in two ways. First, they cause oil glands to produce more fat and cholesterol, which makes your skin greasier. At the same time, they also prompt your skin to ramp up production of bacteria, explains Hallie Zwibel, D.O., director of the Center for Sports Medicine at New York Institute of Technology College of Osteopathic Medicine. And that combo can clog your pores and lead to pimples.

While the oil and bacteria productionand the zits that come with itwill go away after you stop juicing, you could be left with lifelong damage. Acne caused by steroids can be severe, which ups the risk for permanent scarring, Dr. Zwibel says.

2High blood pressure.

The hormones in steroids cause your body to retain sodium and fluids within a matter of days. That puts extra stress on your blood vessels, which can lead to high blood pressure.

In fact, when researchers measured the BP of regular steroid users, their numbers were, on average, 8 to 10 millimeters of mercury (mm Hg) higher compared to guys who didnt take steroids. That might not seem like much, but over time it can take a toll.

Chronically high blood pressure can cause your heart muscles to stiffen, Dr. Jotwani says, which can lead to heart disease or heart failure. And while the effects can be reversed within a few days of stopping steroids, if your heart muscle has already sustained damage, that could lead to a permanent increase in your diastolic blood pressure (the bottom number), because your heart has to work harder to pump blood through your body.

3Heightened heart attack risk.

In addition to raising your blood pressure, steroids can increase your LDL (bad) cholesterol and lower your HDL (good) cholesterol.

Both of those things cause atherosclerosis (when your arteries become more narrow with plaque), which can lead to a heart attack. This happens because steroids alter the production of hepatic triglyceride lipase, an enzyme in the liver thats responsible for cholesterol regulation, explains Dr. Zwibel.

Experts cant say for sure how long youd need to take steroids for your heart attack risk to increase. But findings published in the journal Circulation show that male weight lifters who regularly used steroids for more than two years had irreversible damage to their arteries.

4Aggressive behavior.

Steroids dont just make you irritable and short-tempered. They can send you into a full-on rage and make you do things that normally youd never dream of. They can also make you more anxious: you might perceive more people as threatening, and you could end up responding violently in an effort to protect yourself, Dartmouth researchers have shown.

The flood of testosterone hijacks your central nervous system and suppresses the production of the feel-good neurotransmitter serotonin. As a result, youre more prone to feeling angry or stressed.

5Breast growth.

You might be skeptical that male hormones could give you man boobs. But they canwithin months or even weeks. Thats because certain enzymes in the body can convert testosterone into estradiol (a form of estrogen), which promote the growth of breast tissue, explains Dr. Zwibel.

Worse, the results will be permanent, even if you quit juicing. Once your breast tissue expands, itll never go back to its original size, Dr. Zwibel says.

6Baldness.

You might notice some of your hair thinning within weeks or months after starting steroids. High levels of testosterone are the hormonal factor that induce alopecia, or baldness, Dr. Jotwani says. And since anabolic steroids send your testosterone levels through the roof, they usually cause hair loss.

In fact, testosterone is so good at causing hair loss that hair-restoring drugs like Propecia actually work by blocking the hormone, adds Dr. Jotwani. And once your hair is gone, it wont come backeven after your roid run ends.

7Infertility.

All that extra testosterone from the steroids can shrink your testicles and zap your sperm count. Too-high levels of the hormone can suppress the production of luteinizing hormone and follicle-stimulating hormone, which tell the testicles to produce sperm, explains Dr. Jotwani.

Problems with sperm production affect around half of all steroid users, estimates the National Institute of Drug Abuse. Itll reverse itself eventually once you stop juicing, but it can take months or even years for things down there to get back to normal, Dr. Jotwani says.

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Dignity Health | The Pros and Cons of Cortisone Shots

Posted: December 10, 2021 at 2:30 am

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You've probably heard of a professional athlete having to receive a cortisone shot to fight through an injury. You may even know a friend, a family member, or a co-worker who's undergone the procedure. But for many of us, the treatment is outside our realm of direct experience.

Even though they're administered relatively frequently, cortisone shots are typically reserved for significant discomfort. In the 60-plus years since the treatment was introduced, it's helped an incalculable number of people gain relief from pain and inflammation, particularly in their joints. And even though cortisone shots are common among professional sports players, you don't have to be a hard-charging athlete to benefit from this injectable medication.

Despite the effectiveness of cortisone, it can come with some considerable side effects. Let's take a closer look at the treatment, its uses, and its potential drawbacks.

What Is Cortisone?

Cortisone is a type of man-made steroid that mimics the effect of cortisol, a hormone naturally occurring in the body. This is what distinguishes the medicine from anabolic steroids, which mimic testosterone.

Corticosteroids, as they're also called, can be extremely helpful in alleviating pain for patients suffering from a range of conditions, including:

Rarely does a physician select a cortisone shot as the initial treatment. In many cases, the doctor will first recommend less invasive steps such as weight loss, physical therapy, exercise, or over-the-counter medications like ibuprofen.

If a physician does think corticosteroids are the best option, shots are typically injected directly into a particular area of the body for local relief. Shortly after a cortisone injection, the anti-inflammatory action reduces swelling and pain. Within several days, the relief can be nearly complete, even for those suffering from extreme pain.

However, the effects aren't permanent; they can last anywhere from a few weeks to six months. In that sense, cortisone does not represent a cure, merely a temporary way to mitigate pain and swelling.

The Downsides

Cortisone shots' ability to almost fully alleviate extreme pain is extraordinary, but there are some negatives to consider. The side effects that a cortisone shot can trigger may counterbalance or outweigh its ability to reduce pain and inflammation.

According to the National Institutes of Health, the side effects from cortisone shots include:

Some side effects can be serious. These include:

Side effects can vary from person to person. They could be mild or severe. They might appear with short-term use or never show up at all. Long-term, repeated administration of cortisone shots can be particularly problematic, as frequent injections in the same joint can damage it, as well as the surrounding soft tissue.

It's important to remember that cortisone injections alter your immunity function, lowering the inflammatory response that your body mounts to fight injury and infection. This will reduce pain and swelling, but it can leave you open to infections and other issues.

While it's true that the list of possible side effects is long, the advantages of corticosteroids can be significant. If you or someone you love is suffering from a condition that may require a cortisone shot, be sure to talk to your physician about the pros and cons. Discuss how other medical conditions you or your loved one have may affect the use of cortisone. It's an important decision, and you don't have to make it alone.

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Will We Ever Cheat Death and Become Immortal With Mind Uploading? – Interesting Engineering

Posted: December 10, 2021 at 2:24 am

Humans have always been fascinated with the concept of immortality but what seems to be even more exciting to some is the thought of using technology to make immortality a real-world application. A movement called transhumanism is even devoted to using science and technology to augment our bodies and our minds, and to allow humans to merge with machines, eradicating old age as a cause of death. So the big question is can we really evade death?

From Hans Moravecs classic book Mind Children to Gene Roddenberrys iconic TV series Star Trek: The Next Generation, the idea of uploading a persons feelings, memories, and experiences onto a machine, has been explored in many popular non-fiction and fiction works. However, whether or not mind uploading could become a reality, like 3D printers, robots, and driverless cars? We are yet to find out.

Mind uploading describes a hypothetical process of separating a persons consciousness (which involves their emotions, thought process, experiences, and basically everything that makes a person unique), then converting it into a digital format, and finally transferring the digital consciousness into a different substrate, like a machine.

The process would conceivably incorporate different steps, like mind copying, mind transfer, mind preservation, and whole brain emulation (WBE). Here is a detailed overview of how mind uploading can actually work:

The human brain regularly performs complex processes with the help of its 86 billion neurons that function simultaneously in a large neural network. And the complexity does not stop there. There aremore than 125 trillion synapsesjust in the cerebral cortex alone. That is a lot of information and storage capacity. Some have suggested that, in order to completely replicate an individual's brain, it would be necessary to first dissect the brain.

However, mind uploading advocates claim that noninvasive brain scans can provide sufficient resolution for copying the brain without actually killing the person to do it. The information stored in our brain would then be used to create aconnectome, a complete map of the neural connections in the brain, created using incredibly precise scanning of the neurons, and the synapses.

However, to date, we only have a complete connectome for a 1.5-millimeter roundworm called Caenorhabditis elegans, which has just 302 neurons and about seven thousand synaptic connections.In 2014, theOpenWorm projectwhich mapped the brain replicated it as software and installed it in a Lego robot which was capable of the same sensory and motor actions as the biological model.

Building a human connectome is clearly a much more complicated process. Even in the case of the C. elegans, researchers had to work for more than a decade to understand the organisms neuronal pathway.

Now imagine how much time and resources will be required for the identification of about 86 billion neurons, determination of their precise location, and tracing and cataloging of their projections on one another. Building and interpreting even a single human connectome is inconceivable using existing technologies.

Another proposed method of getting information from the brain is through a brain-computer interface (BCI). There are already existing implanted devicesthat can translate some types of neuronal information into commands, and arecapable of controlling external software or hardware, such as a robotic arm.However, modern BCIs are only very slightly related to the theoretical BCIs which would be needed to allow us to transfer our brain states into a digital medium.

Brain-computer interfaces which would allow mind uploading would need a technology similar to modern-day brain scanning technology. Some suggest that downloading consciousness would require technology capable of scanning human brains at a quantum particle level.

Elon Musks Neuralink is one company working on aspects of mind-uploading. They are designing a neural implant which would work "like a Fitbit in your skull". It would have many micron-scale electrode threads connected to different parts of the brain. While this technology is showing some promise in allowing humans to interface with computers in a limited way, it is not close to the technology needed to upload an entire brain.

Neuralinks website mentions that their chip will kick off a new kind of brain interface technology and as it develops further, they will be able to increase the channels of communication with the brain, accessing more brain areas and new kinds of neural information.

Some wealthy individuals who wish to live foreverare opting to preserve their brains and sometimes bodies through cryopreservation. In theory, in the future when human connectome technology is fully developed, their consciousness could then be retrieved and uploaded. An American cryonics company Alcor Life Extension Foundation already stores around 180 cryopreserved human bodies (with more preserving just their head) at its Phoenix-based facility.

However, some experts also claim that such cryonic techniques may damage the brain beyond repair.

Recently, an MIT graduate Robert McIntyre, rekindled the brain preservation hype when he announced his Y-Combinator backed startup Nectome is building some next-generation tools to preserve brains in the microscopic detail needed to map the connectome.

While previously working at a cryo research firm 21st Century Medicine, McIntyre along with cryobiologist Greg Fahy developed a method that combines embalming with cryonics. Fahy suggests that through this technique they could preserve the entire brain to the nanometer level, including the connectome. They even received an $80,000 science prize from the Brain Preservation Foundation for preserving a pigs brain so well that every synapse inside it could be seen with an electron microscope.

One element of this process that may give some pause for thought, however, is that the "brain embalming" needs to take place while the person is still alive. The company hopes the process will be allowed as part of doctor-assisted suicide programs. Even if it does not lead to an uploading technology, any brains that Nectome manages to preserve might help in the research towards building the human connectome.

Once all the neural activity is mapped out and the connectome is ready, the next step would be to digitize it. According to a rough estimate published in Scientific American, the memory storage capacity of the human brain could be around 2.5 Petabytes (2,500 TB).

While the popular notion is that we only use 10% of our brain, neurologists say this is actually a myth and we actually use almost all of our brain, all the time. That's a lot of storage.

Apart from the storage, we will require a computer architecture on which the brain can be reconstructed in the form of computable code. And there is the issue of power for that architecture.Today, a computer with the same memory and processing power as the human brain would require around 1 gigawatt of power, or "basically a whole nuclear power station to run one computer that does what our 'computer' does with 20 watts," according to Tom Bartol, a neuroscientist at the Salk Institute.

In computing, artificial neural networks (ANN) have been created which are inspired by the biological neural networks. An ANN is based on a collection of connected units or nodes which loosely model the neurons in a biological brain. However, there are some major differences between an ANN and a human (or animal) brain:

Also, the human brain uses approximately 300 times more parameters (neurons combined with synapses) as compared to GPT3, the largest artificial neural network ever built.

Once all the requirements are fulfilled and the artificial brain is ready, the mind can now be uploaded into a simulation, such as a virtual world,like the metaverse, or into a network of artificial brains connected to each other in a swarm (also called hive mind). Another transhumanist idea suggests that the mind can also be uploaded on a humanoid robot. Uploading into a physical robot would require robots that are a lot more functional than any that currently exist.

However, if the consciousness is uploaded as a substrate-independent mind (SIM), and if the SIM is deemed to be conscious, then it will also need toexist in a place and be able to interact with things. This will require virtual reality that is identical to how humans experience actual reality, everything from tasting a soda to feeling the pain of a car accident. All of this will require yet more storage capacity, signal bandwidth, and power.

Neuroscientist Michael Hendricks from McGill University called mind uploading an abjectly false hope in his 2015 report published in the MIT Technology Review. According to Hendricks, scientists still dont know exactly what kind of technology can allow them to replicate a human mind.

In his report, Hendricksalso raised doubts about the success of current or foreseeable freezing methods for brain preserving, as well as methods for retrieving the information stored in the human brain. Furthermore, as an expert on the neural activity of the C. Elegans roundworm, he says that having a connectome is by itself not a sufficient condition to simulate a nervous system.

Even once we figure out the technical side of whole brain emulation, there's still the philosophical part of the equation. Would that emulation still be you? Answering that will require a great deal of thinking about what it is that constitutes consciousness and identity something there is no clear answer to.

Another study reveals, that depending on their personal views on death, suicide, fiction, philosophy, and science, some people may show great support for mind uploading, while others strongly disapprove of any such practice.

Sure, mind uploading has the potential to change human lives forever, but this is also why the advent of this sci-fi technology in the real world might also give rise to a lot of conflicts revolving around its ethical and social impact on humanity.

Steve Jobs once said, "Death is very likely the single best invention of Life. It is Life's change agent. It clears out the old to make way for the new." If this is true, then defeating death by mind uploading may in fact be self-defeating. It would allow a few individuals to go on, but at the expense of everything and everyone else.

For now, a number of scientists, researchers, and tech companies are working towards making mind uploading a reality. Whether they would be successful or not, and how our society would react to consciousness transfer, only the future could tell.

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Cell types outside the pancreas make insulin, too, study shows – Yale News

Posted: December 10, 2021 at 2:22 am

Researchers at Yale and the Weizmann Institute of Science have found the first evidence that the human fetus can spontaneously produce insulin outside the pancreas in the small intestine, specifically a startling discovery that stands in contrast to the longheld belief that insulin production is unique to the pancreas.

While other researchers had previously been able to manipulate the proteins that regulate insulin secretion thereby getting other cells to produce insulin there have been no previous reports of other cells (outside of the pancreas) making insulin on their own.

Insulin is known to be produced by pancreatic cells to regulate glucose levels in the blood. It is also a growth factor. Destruction of insulin-producing cells in the pancreas causes Type 1 diabetes, while Type 2 is triggered by insulin resistance. The possibility that other cells are able to produce insulin can open up new avenues for diabetes treatment, researchers say. It also suggests that insulin might be involved in intestinal growth in the fetus.

The findings are published in the December issue of Nature Medicine.

For the study, researchers analyzed single cell data on both fetal tissue and neonatal tissue. When they first noted insulin-producing cells in the gut, they were surprised.

It was completely serendipitous, said Dr. Liza Konnikova, an assistant professor in pediatrics and obstetrics, gynecology and reproductive sciences at Yale School of Medicine, a member of the Human and Translational Immunology Program, and co-senior author of the study. The more we looked into it, we realized that insulin was originating from within the small intenstine. We were able to show that both the RNA and the protein are made in the small intestinal cells. Moreover, signaling for insulin production is also intact in these cells.

For the study, the researchers wanted to see what the transcriptional or RNA differences were between the fetus, which is not exposed to an abundant microbiome and is continuously developing, and newborns, who are exposed to an abundant microbiome. Looking at how immune and epithelial development are different between the fetuses and newborns highlighted not only the existence of intestinal insulin-producing cells, but also their complete expression signature. This could provide avenues through which this dormant ability might be awakened in adults.

Cells in the intestinal tract are a wonderful potential source of insulin because they are continuously renewed from intestinal stem cells, said co-lead author Shalev Itzkovitz, associate professor at the Weizmann Institute of Science, a research institution based in Israel. This could be an advantage in Type 1 diabetes, where insulin-producing cells are under attack from our immune system.

Other authors on the study included Dhana Llivichuzhca-Loja and Blake McCourt from the Yale School of Medicine.

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Exploring New Cancer Therapies that use a Patients Immune System to Fight Tumors – Newswise

Posted: December 10, 2021 at 2:22 am

Newswise New Brunswick, N.J., December 9, 2021 Research underway at Rutgers Cancer Institute of New Jersey will contribute to the development of new cancer treatments that are based on the administration of cancer-fighting immune cells to patients. This type of treatment is known as adoptive cell therapy. Healthy volunteers with no history of cancer are being sought to contribute blood cells that may be used in the development of cancer clinical trials.

The blood cells are collected through a procedure called apheresis in which blood is run through a machine that separates plasma and cells from the blood. The cells will be stored and used to manufacture adoptive cell transfer therapies as part of approved clinical trials and other clinical research that are separate from this study. The role of the healthy volunteer cells is to make the cancer-fighting immune cells collected from patients grow to large numbers in the laboratory so that they can be given as a cancer treatment.

Christian Hinrichs, MD, chief of the Section of Cancer Immunotherapy and co-director of the Duncan and Nancy MacMillan Cancer Immunology and Metabolism Center of Excellence at Rutgers Cancer Institute, is the principal investigator of the study. Adoptive cell therapy is a living treatment that harnesses the ability of immune cells to multiply and fight cancer in patients. This type of treatment is emerging as an effective, and sometimes curative, strategy for certain cancers that cannot be treated any other way. The availability of cells from healthy volunteers is crucial to ongoing development of these treatments and specifically to the generation of treatments for our patients participating in clinical trials at Rutgers Cancer Institute of New Jersey, notes Dr. Hinrichs, who is also a professor of medicine at Rutgers Robert Wood Johnson Medical School.

Individuals aged 18 and older who weigh at least 100 pounds are eligible to take part in the study. Other criteria also must be met. Prior to being accepted into the study, participants are required to undergo other tests including routine bloodwork and a physical exam.

Approximately 500 participants are being sought to take part in the study, which is available through Rutgers Cancer Institute. For more information on how to take part in this trial, individuals can email: [emailprotected].

About Rutgers Cancer Institute of New Jersey

As New Jerseys only National Cancer Institute-designated Comprehensive Cancer Center, Rutgers Cancer Institute, together with RWJBarnabas Health, offers the most advanced cancer treatment options including bone marrow transplantation, proton therapy, CAR T-cell therapy and complex surgical procedures. Along with clinical trials and novel therapeutics such as precision medicine and immunotherapy many of which are not widely available patients have access to these cutting-edge therapies at Rutgers Cancer Institute of New Jersey in New Brunswick, Rutgers Cancer Institute of New Jersey at University Hospital in Newark, as well as through RWJBarnabas Health facilities. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 848-932-8013 or visit http://www.cinj.org/giving.

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Cancer-fighting spinoff from UAB grows through IPO, preclinical research results and a clinical trial – EurekAlert

Posted: December 10, 2021 at 2:22 am

BIRMINGHAM, Ala. A clinical-stage biopharmaceutical company developing intellectual property licensed from the University of Alabama at Birmingham and two other institutions is testing its technology to treat glioblastoma multiforme, the most aggressive type of cancer that originates in the brain.

In a preclinical study published in the Nature portfolio journal Scientific Reports, researchers led by Larry Lamb, Ph.D., former associate professor of medicine at UAB, scientific co-founder and current chief scientific officer at IN8bio Inc., report that IN8bios proprietary Drug Resistant Immunotherapy (DRI) technology resulted in significant improvement of survival outcomes in a mouse model of human primary high-grade gliomas. A Phase I interventional clinical trial is being conducted at UAB of IN8bios INB-200, the DRI technology, in adults with newly diagnosed glioblastoma multiforme who are also receiving temozolomide (TMZ) chemotherapy. The clinical trial is led by Burt Nabors, M.D., professor in theUAB Department of Neurology.

DRI was developed based on two observations. First, when tumors are damaged by TMZ treatment, they develop stress-induced ligands on the cell surface. Normally, these signals would incite the immune watchdog gamma-delta T cells to recognize and kill the damaged tumor cells, through their ability to differentiate between healthy and diseased tissue. However, the second observation reveals a problem TMZ therapy kills lymphatic immune cells, including the gamma-delta T cells. This hinders the immune systems ability to leverage the TMZ-induced state of increased tumor vulnerability.

In DRI, peripheral blood mononuclear cells are collected from the mouse or patient. The gamma-delta T cells in that collection are purified, and then they are given a gene that makes them resistant to TMZ. Next, the drug-resistant gamma-delta T cells are expanded and reintroduced into the mouse or patient, concomitantly with TMZ chemotherapy. The resistant gamma-delta T cells should then be able to recognize the stress-induced ligands on the surface of TMZ-treated tumor cells and start to eliminate them.

In the Scientific Reports study, intracranial tumors were established in the mice using classical or mesenchymal patient-derived xenolines of glioblastoma.

In the UAB clinical trial, IN8bio earlier this year successfully completed treatment of the first cohort of three newly diagnosed glioblastoma patients, using its genetically modified gamma-delta T cell candidate for treating the solid tumors, says William Ho, CEO and co-founder of IN8bio. The gamma-delta T cell treatment, called INB-200, was generally well tolerated by the three patients, with no observed infusion reactions, cytokine release syndrome, neurotoxicity or dose limiting toxicities, the company reported at the 2021 American Society of Clinical Oncology Annual Meeting. All three patients exceeded their expected median progression-free survival based on their respective age and O-6-methylguanine-DNA methyltransferase status. Additional data from this Phase I trial is expected later this year. The second cohort of patients will receive multiple repeat doses of the DRI gamma-delta T cells.

IN8bio is the first company to advance genetically modified gamma-delta T cells into the clinic. The company is located in New York City, while its primary scientific operations remain in Birmingham, Alabama.

This summer, IN8bio completed an initial public offering of 4 million shares of common stock at an offering price of $10 per share. Net proceeds for IN8bio after expenses were $32.6 million.

This coming year, the IN8bio research lab expects to graduate from Birminghams Innovation Depot a business incubator into a new, 10,440-square-foot IN8bio lab and office space in the Martin Biscuit building at Birminghams Pepper Place, Second Avenue South and 29th Street, which is currently under development.

Ho says the IN8bio DRI approach targets an evolutionarily conserved pathway, the DNA Damage Response, that has potential applicability across a broad range of solid and liquid tumors for which chemotherapy remains the mainstay of treatment.

This includes potentially combining INB-200 with other approaches such as checkpoint inhibitors and other targeted therapies in orthogonal combinations to maximize the tumor impact, Ho said. Combined with our expertise in genetically engineering these cells ex-vivo, we look forward to continuing to develop our deep pipeline of gamma-delta T cell-based therapies for cancer.

Co-authors with Lamb for the Scientific Reports study, A combined treatment regimen of MGMT-modified T cells and temozolomide chemotherapy is effective against primary high grade gliomas, are Larisa Pereboeva and Samantha Youngblood, UAB Department of Medicine, Division of Hematology and Oncology; G. Yancey Gillespie, James M. Markert and Catherine Langford, UAB Department of Neurosurgery; L. Burton Nabors, UAB Department of Neurology; and Anindya Dasgupta and H. Trent Spencer, Emory University Department of Pediatrics, Atlanta, Georgia.

The UAB departments of Medicine, Neurology and Neurosurgery are part of the UAB Marnix E. Heersink School of Medicine. At UAB, Nabors holds the William Austin Brown Endowed Professorship in the ONeal Comprehensive Cancer Center.

Scientific Reports

Experimental study

Animals

A combined treatment regimen of MGMT-modified T cells and temozolomide chemotherapy is effective against primary high grade gliomas

26-Oct-2021

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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Protein Variant Identified that Renders Chemotherapy Ineffective in Gastric Cancer – Weill Cornell Medicine Newsroom

Posted: December 10, 2021 at 2:22 am

A new protein variant underlies the ability of gastric cancers to resist an otherwise effective family of chemotherapy drugs, according to a study by a multidisciplinary team at Weill Cornell Medicine. The results suggest a treatment strategy that could improve the prognoses of many patients with cancer.

The study, published Oct. 20 in Developmental Cell, and led by co-first authors, Drs. Prashant Thakkar and Katsuhiro Kita, former postdocs at Weill Cornell Medicine, combined clinical insight, laboratory experiments and sophisticated computational analysis to determine how some tumor cells resist a family of chemotherapy drugs called taxanes. Taxane treatment works by interfering with proteins that make up the cells internal skeleton, but the variant protein, called CLIP-170S, allows cancer cells to dodge that interference.

"We identified a novel variant that is clinically prevalent and is expressed in more than 60 percent of patients with gastric cancer and operates with a mechanism that's different from previously discovered ones," said co-senior author Dr. Paraskevi Giannakakou, professor of pharmacology in medicine and director of research in the Division of Hematology and Medical Oncology, and associate director for education in the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine.

Taxanes, based on compounds originally discovered in yew trees, are first-line treatments for many cancers. Unfortunately, taxane-resistant cells often arise and survive the treatment, leaving patients with few options and poor prognoses. The problem is especially bad in gastric cancer.

"Most patients with gastric cancer live less than a year, and if we could figure out a way to make the taxanes more effective, we could have a bigger impact on patients," said co-senior author Dr. Manish Shah, director of the Gastrointestinal Oncology Program and chief of the Solid Tumor Oncology Service in the Division of Hematology and Medical Oncology at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center and the Bartlett Family Professor of Gastrointestinal Oncology and member of the Meyer Cancer Center at Weill Cornell Medicine. About 80 percent of gastric cancer patients develop taxane-resistant tumors, he said.

While years of research has revealed multiple ways cancer cells can resist taxane-mediated killing, those results have done little to change the clinical statistics.

"Everyone tries to understand mechanisms of taxane resistance, and yet nothing is helping patients clinically, none of the resistance mechanisms identified in the lab has made a clinical impact," Dr. Giannakakou said.

Wanting to take another stab at the problem, Dr. Shah approached Dr. Giannakakou with a reanalysis he'd done on data from the clinical trial that led to the FDA approval of taxanes for the treatment of patients with gastric cancer. The analysis revealed a subset of gastric cancer patients who didn't benefit at all from taxane treatment, suggesting that their tumors were drug-resistant even before being exposed to the compound.

The researchers, along with a multi-institutional team of collaborators, compared cells derived from taxane-resistant with those from taxane-sensitive tumors. They discovered that the taxane-resistant cells carried a variant form of a protein called CLIP-170, which normally helps the function of the cell's cytoskeleton.

Next, the team enlisted the aid of computational biologists to look for ways to overcome the newly discovered taxane resistance mechanism. Starting with a database of approved drugs, we created a computational program that was able to screen through these molecules, in silico, to identify the ones that would essentially make resistant cells look more like cells that are sensitive to taxanes," said co-senior author Dr. Olivier Elemento, director of the Caryl and Israel Englander Institute for Precision Medicine, associate director of the HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine and a professor of physiology and biophysics at Weill Cornell Medicine.

The algorithm highlighted a surprising candidate: imatinib, a leukemia drug sold under the brand name Gleevec. Imatinib's known mechanism of action is completely unrelated to that of taxanes, while gastric cancer is not one of its clinical indications. Nevertheless, the researchers confirmed that a combination of the two drugs kills taxane-resistant tumors in lab dishes.

"That's important, because it demonstrates how you can go in without preconceptions and use computational screening to come up with molecules that have an effect," said Dr. Elemento, who is also a co-founder and equity stakeholder of OneThree Biotech, an artificial intelligence-driven drug discovery and development company.

Because imatinib is already an approved drug, the investigators hope to start clinical trials on the combined treatment soon. CLIP-170 variants could also serve as biomarkers for taxane resistance in many types of solid tumors. The whole story is really quite remarkable, and it opens the door for overcoming taxane resistance in other cancers as well, said Dr. Shah, who is also co-director of the Center for Advanced Digestive Care at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center.

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Protein Variant Identified that Renders Chemotherapy Ineffective in Gastric Cancer - Weill Cornell Medicine Newsroom

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Workout warrior benefits from regenerative medicine – Sanford Health News

Posted: December 10, 2021 at 2:22 am

Anthony Soyak is a self-described gym rat. Hes been doing CrossFit and lifting weights for years. But three years ago, he started feeling a pain in his shoulder.

He started with treatments like physical therapy, dry needling, and chiropractic visits. He saw some relief, but the pain would always reappear.

The pain started while he and his family lived in Milwaukee, Wisconsin. Eventually, he took his current job at Sanford Health, moving to Sioux Falls, South Dakota.

At Sanford, he met with orthopedic surgeon Jason Hurd, M.D. in March 2021, who told him some unexpected news.

We discovered that I had a partial rotator cuff tear in my left shoulder, said Soyak.

Soyak had two treatment routes. The first was surgery, where he would face over a year of recovery time.

The second was cell therapy.

Dr. Hurd recommended Soyak visit with Donella Herman, M.D., who does the cell treatment.

She answered all of my questions, and explained that its less invasive and has a quicker recovery time. That was the selling point for me, he said.

Learn more: Cell therapies at Sanford Health

BMAC treatment, or bone marrow aspiration concentrate, is the cell therapy Soyak received.

The same-day procedure takes bone marrow cells from an area of the body. Then, the concentration is separated, isolating the therapeutic cells. An ultra-concentrated BMAC dosage is then injected back into the site of injury, using an ultrasound to target the exact location, to expedite the healing process.

But, before the therapeutic cells are injected back into a patient, theyre rigorously tested to ensure safety and efficacy.

This meticulous nature is what separates Sanford Health from other health care providers who claim to offer cell therapy.

Soyak walked out the same day in a sling. Instead of a year, or possibly more, his recovery time was three weeks.

He periodically met with Dr. Herman, to see how the tear was responding to the therapy. Each time he went, they did an ultrasound.

Youd see the initial scans where there was a gap in the muscles, and actually see where the tear was. Then, she would compare that to where we were.

There is no more gap. Not only how I felt, but to actually see the progress was really cool, he said.

The more Soyak takes it slow, the stronger hes become.

I dont have any pain in my daily activities anymore. I dont wake up in pain. So, from a normal standpoint, I feel great, and Im starting to get more confident in the gym.

Posted In Orthopedics, Rehabilitation & Therapy, Research, Sioux Falls, Sports Medicine

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Greenwich LifeSciences Announces Presentation of 5 Year Data for GP2 Phase IIb Clinical Trial, Revealing Potential For New T Cell Platform Technology…

Posted: December 10, 2021 at 2:22 am

STAFFORD, Texas--(BUSINESS WIRE)--Greenwich LifeSciences, Inc. (Nasdaq: GLSI) (the Company), a clinical-stage biopharmaceutical company focused on the development of GP2, an immunotherapy to prevent breast cancer recurrences in patients who have previously undergone surgery, today announced the publication of a poster for the GP2 Phase IIb clinical trial at the San Antonio Breast Cancer Symposium 2021 (SABCS). The CEO of Greenwich LifeSciences, Snehal Patel, recorded an audio track providing an overview. The abstract can be viewed at the bottom of this press release. The full poster with figures, tables, and audio can be accessed or downloaded from the Companys website here.

Figure 1 is the new data published yesterday evening at SABCS, which shows that GP2 immune response at baseline could be a prognosticator of cancer recurrence. The Phase IIb clinical trial enrolled HER2 positive patients, who received a standard course of trastuzumab after surgery, and HER2 low patients, who did not receive trastuzumab after surgery. A Delayed-Type Hypersensitivity (DTH) reaction was used to assess baseline in vivo immune responses to GP2 in patients prior to exposure to GP2 treatment or placebo.

The poster data can be summarized as follows:

It was observed that 22.8% or 33 patients of the 145 patients reacted to GP2 at baseline with a positive immune response, which is defined as an induration of 5 mm or greater in the baseline DTH test.

Of the 33 patients who did have a positive baseline DTH immune response to GP2, 8 patients recurred, which is a recurrence rate of 24.2% over 5 years of follow up, with a median time to recurrence of 99 days (0.27 years).

Of the 77.2% or 112 patients who did not have a positive DTH baseline immune response to GP2, 14 patients recurred, which is a recurrence rate of 12.5% over 5 years of follow up, with a median time to recurrence of 438 days (1.2 years).

Mr. Patel commented, This new GP2 specific T cell data suggests that patients with a positive baseline immune response to GP2 recurred twice as fast and approximately 7 to 11 months sooner than those without a positive baseline immune response did. While this data is very promising, the number of recurrences are low, thus we need to further confirm these observations in the upcoming Phase III clinical trial to determine if they are statistically significant. To further diversify our pipeline, we plan to fully characterize GP2 specific T cells by sequencing the DNA of the T cells at baseline and after treatment with GP2 to assess how these T cells change over time and if they can be developed into CAR-T drug candidates. Expansion into GP2 specific CAR-T cells could potentially become another platform technology to complement GP2 peptide treatment in higher risk patients. We expect new T cell data from the Phase III trial to become available in 2022.

Today is the one year anniversary of the Companys SABCS 2020 poster, which became the basis for Figure 2. This figure summarizes the efficacy, immune response, and safety Phase IIb data presented over the past year. The Kaplan Meier analysis for HER2 positive patients treated with GP2 immunotherapy shows 100% disease free survival (0% breast cancer recurrences, p = 0.0338) following surgery and Herceptin treatment over median 5 years of follow-up. These patients completed the Primary Immunization Series (PIS) which led to peak immunity at 6 months. No serious adverse events attributable to GLSI-100 were observed. Figure 1 and Figure 2 summarize all of the 5 year GP2 data published to date.

SABCS Abstract P2-13-29:

Title: Analysis of GP2 immune response and relationship to recurrence in a prospective, randomized, placebo-controlled, single-blinded, multicenter, phase IIb study evaluating the reduction of recurrences using HER2/neu peptide GP2 (GLSI-100) vs. GM-CSF alone after adjuvant trastuzumab in HER2 positive women with operable breast cancer

Snehal S Patel, David B McWilliams, Mira S Patel, Christine T Fischette, Jaye Thompson and F Joseph Daugherty.

Greenwich LifeSciences, Stafford, TX

Background: Delayed type hypersensitivity (DTH) skin tests in the randomized, active-controlled, single-blinded, multicenter Phase IIb trial investigating GLSI-100 (GP2+GM-CSF) administered in the adjuvant setting to node-positive and high-risk node-negative breast cancer patients with tumors expressing any degree of HER2 (immuno-histochemistry [IHC] 1-3+) (NCT00524277) have been analyzed. The trial enrolled HLA-A*02 patients randomized to receive GLSI-100 versus GM-CSF alone. The trial's primary objective was to determine if treatment with GLSI-100, a HER2-derived peptide, reduces recurrence rates. Analyses for this trial showing GLSI-100 to be efficacious, safe and immunogenic have been previously reported by Patel et al. and Mittendorf et al.

Methods: Consented patients were randomized and scheduled to receive GLSI-100 (500 mcg GP2: 125 mcg GM-CSF) or control (GM-CSF only) via 6 intradermal injections every 3-4 weeks as part of the Primary Immunization Series (PIS) for the first 6 months and 4 booster intradermal injections every 6 months thereafter. Boosters were introduced during the trial, thus some patients did not receive all 4 boosters. DTH skin tests were assessed at baseline and after the 6th dose with the orthogonal mean of each skin reaction measured 48-72 hours after injection using the sensitive ballpoint-pen method.

Results: The study enrolled 180 patients across 16 clinical sites with both HER2 3+ positive and low HER2 expressors (1-2+). After 5 years of follow-up, the Kaplan-Meier estimated 5-year DFS rate in the 46 HER2 3+ patients treated with GLSI-100, if the patient completed the PIS, was 100% versus 89.4% (95% CI:76.2, 95.5%) in the 50 placebo patients treated with GM-CSF (p = 0.0338). GLSI-100 was shown to be well tolerated with no SAEs deemed related to study medication and elicited a potent immune response measured by local skin tests and immunological assays. Injection site reactions were common, occurring in almost 100% of patients treated with either GLSI-100 or GM-CSF alone. Previous publications have reported the increase in DTH response reported among patients after treatment with GLSI-100. However, it was of interest to understand the positive DTH responses to GP2 noted at baseline. 22.8% of patients reacted to GP2 at baseline with induration of 5mm or greater. In the subgroup of patients who later experienced a breast cancer recurrence, 36.4% (8/22) had such a baseline response. Analysis of the time to recurrence among those recurring found that the median time to recurrence was 0.6 years for those with a baseline response while those that did not have a positive baseline DTH response to GP2 took 1.2 years to recur.

Conclusions: This study demonstrated that GLSI-100 safely elicited a potent immune response as evidenced by increased DTH skin responses with treatment paired with improved disease-free survival. It is theorized that a positive baseline DTH skin test to GP2 may be evidence of an existing immune response to GP2 associated with residual disease, impending recurrence, or prior treatments. Further studies assessing if GP2 immune response is an important prognosticator of cancer disease state or recurrence are planned.

About SABCS

The 44th annual SABCS has grown to be the industrys premier breast cancer conference for basic, translational, and clinical cancer research professionals. It is well-known for presenting the latest breast cancer data from all over the world. More than 7,500 health care professionals from more than 90 countries attend annually. Baylor College of Medicine became a joint sponsor of SABCS in 2005. The Cancer Therapy & Research Center at UT Health Science Center San Antonio and American Association for Cancer Research began collaborations with SABCS in 2007. For more information, please visit the conference website at: https://www.sabcs.org/

About FLAMINGO-01 and GLSI-100

The Phase III clinical trial will be called FLAMINGO-01 and the combination of GP2 + GM-CSF will be called GLSI-100. The Phase III trial is comprised of 2 blinded, randomized, placebo-controlled arms for approximately 500 HLA-A*02 patients and 1 open label arm of up to 100 patients for all other HLA types. An interim analysis has been designed to detect a hazard ratio of 0.3 in IDFS, where 28 events will be required. An interim analysis for superiority and futility will be conducted when at least half of those events, 14, have occurred. This sample size provides 80% power if the annual rate of events in placebo-treated subjects is 2.4% or greater. The trial is currently being registered on clinicaltrials.gov and the link and trial identifier will be published shortly. For future updates about FLAMINGO-01 please visit the Companys clinical trial tab at https://greenwichlifesciences.com/clinical-trials/.

About Breast Cancer and HER2/neu Positivity

One in eight U.S. women will develop invasive breast cancer over her lifetime, with approximately 282,000 new breast cancer patients and 3.8 million breast cancer survivors in 2021. HER2/neu (human epidermal growth factor receptor 2) protein is a cell surface receptor protein that is expressed in a variety of common cancers, including in 75% of breast cancers at low (1+), intermediate (2+), and high (3+ or over-expressor) levels.

About Greenwich LifeSciences, Inc.

Greenwich LifeSciences is a clinical-stage biopharmaceutical company focused on the development of GP2, an immunotherapy to prevent breast cancer recurrences in patients who have previously undergone surgery. GP2 is a 9 amino acid transmembrane peptide of the HER2/neu protein. In a randomized, single-blinded, placebo-controlled, multi-center (16 sites led by MD Anderson Cancer Center) Phase IIb clinical trial, no recurrences were observed in the HER2/neu 3+ adjuvant setting after median 5 years of follow-up, if the patient received the 6 primary intradermal injections over the first 6 months (p = 0.0338). Of the 138 patients that have been treated with GLSI-100 to date over 4 clinical trials, treatment was well tolerated and no serious adverse events were observed related to the immunotherapy. Greenwich LifeSciences is planning to commence a Phase III clinical trial using a similar treatment regime as the Phase IIb clinical trial. For more information on Greenwich LifeSciences, please visit the Companys website at http://www.greenwichlifesciences.com and follow the Company's Twitter at https://twitter.com/GreenwichLS.

About GP2 Immunotherapy Immune Response

As previously reported, GP2 immunotherapy generated GP2-specific immune responses, leading to no metastatic breast cancer recurrence in the HER2/neu 3+ population in the Phase IIb clinical trial, thus supporting GP2s mechanism of action. Statistically significant peak immunity was reached after 6 months of GP2 treatment, as measured in both the Dimer Binding Assay and the DTH skin test. HER2/neu 3+ population immune response was similar to the HER2/neu 1-2+ population immune response, suggesting the potential to treat the HER2/neu 1-2+ population (including triple negative breast cancer) with GP2 immunotherapy in combination with trastuzumab (Herceptin) based products and other clinically active agents. The broad based immune response suggests the potential for GP2 to treat other HER2/neu 1-3+ expressing cancers. For more information on GP2 immune response and clinical data, please visit the Companys clinical trial tab at https://greenwichlifesciences.com/clinical-trials/.

Forward-Looking Statement Disclaimer

Statements in this press release contain forward-looking statements that are subject to substantial risks and uncertainties. All statements, other than statements of historical fact, contained in this press release are forward-looking statements. Forward-looking statements contained in this press release may be identified by the use of words such as anticipate, believe, contemplate, could, estimate, expect, intend, seek, may, might, plan, potential, predict, project, target, aim, should, "will, would, or the negative of these words or other similar expressions, although not all forward-looking statements contain these words. Forward-looking statements are based on Greenwich LifeSciences Inc.s current expectations and are subject to inherent uncertainties, risks and assumptions that are difficult to predict, including statements regarding the intended use of net proceeds from the public offering; consequently, actual results may differ materially from those expressed or implied by such forward-looking statements. Further, certain forward-looking statements are based on assumptions as to future events that may not prove to be accurate. These and other risks and uncertainties are described more fully in the section titled Risk Factors in the final prospectus related to the public offering filed with the SEC. Forward-looking statements contained in this announcement are made as of this date, and Greenwich LifeSciences, Inc. undertakes no duty to update such information except as required under applicable law.

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Imaging Findings May Help Detect CAR T-Cell Therapy Toxicities – Diagnostic Imaging

Posted: December 10, 2021 at 2:22 am

In patients with refractory B-cell lymphoma, thoracic imaging findings correlated with cytokine release syndrome grade following chimeric antigen receptor (CAR) T-cell infusion. This is according to a study published in Radiology which also showed that CAR T-cell therapy yielded high rates of imaging-based treatment response.

Imaging plays a critical role in the evaluation of clinical cytokine release syndrome and immune effector cellassociated neurotoxicity syndrome (ICANS) toxicity following CAR T-cell treatment, wrote Daniel Smith, M.D., a radiologist at the University Hospitals Cleveland Medical Center in Ohio. Specific findings at thoracic imagingin particular, pleural effusion and atelectasismay prove useful correlates for severe clinical grades of cytokine release syndrome, while findings related to ICANS tend to be less specific and less frequent.

CAR T-cell immunotherapy is increasingly used for refractory lymphoma, but it may lead to cytokine release syndrome and ICANS in the early period following infusion. The associations between cytokine release syndrome or ICANS grade and imaging findings are not established. The goal of this study was to characterize thoracic and neuroimaging findings associated with cytokine release syndrome and ICANS in patients with refractory B-cell lymphoma.

The retrospective analysis included 38 patients (mean age 59; 61% men) with refractory B-cell lymphoma who underwent CAR T-cell infusion. Of these, 63% and 29% experienced clinical grade 1 or higher cytokine release syndrome and ICANS, respectively. Patients with grade 2 or higher cytokine release syndrome were more likely to have thoracic imaging evidence at radiography, CT and/or MRI of pleural effusions (36% vs 8.3%, P = .04) and atelectasis (57% vs 25%, P = .048) than patients without cytokine release syndrome or with grade 1 toxicity. Positive imaging findings were identified in 43% with grade 2 or higher ICANS who underwent neuroimaging. Patients undergoing CAR T-cell therapy had higher rates of clinical response, including 56% with complete response and 19%with partial response.

Our findings further highlight the central role of PET/CT in disease response after CAR-T cell therapy, the authors wrote.

Limitations of the study included its retrospective design, small sample size, and that most patients without toxicity did not undergo imaging.

In an accompanying editorial, Mark Langer, M.D., professor of clinical radiation oncology at Indiana University School of Medicine, wrote that in the study by Smith et al, atelectasis and pleural effusions were more common in patients with severe cytokine release syndrome than in those with mild or absent cases. Edema and airway consolidation were not more common. He added, Whether such features emerge only when the case becomes clinically more severe or whether these features are early signs of disease that will eventually evolve into a higher-grade condition is a question deserving of future study.

As more data are prospectively obtained, imaging guidelines to better monitor for the important conditions examined here may be established, and the information collected used to effectively intervene early in detection and treatment, Dr. Langer wrote.

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Imaging Findings May Help Detect CAR T-Cell Therapy Toxicities - Diagnostic Imaging

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