Skip to content

Are online tools effective in combatting depression in socially isolated seniors?

Imagine your family has moved across the state or across country. You’re retired, and your spouse has passed away. Lacking the social connections previous generations once found in church or fraternal organizations, it doesn’t take much time to begin feeling isolated and alone.

Social isolation and depression have become commonplace in older adults, with estimates suggesting almost 5 percent of adults aged 50 and above lived with major depression in 2015.

What if you could address the problem through ?

A new study led by researchers at OHSU in Portland, Oregon, discovered that, of four online communication technologies, using  to connect with friends and family appeared to hold the most promise in staving off depression among seniors. Researchers compared four different types of online communication technologies—video chat, email, social networks and instant messaging—used by people 60 and older and then gauged their symptoms of depression based on survey responses two years later.

The findings were published in the American Journal of Geriatric Psychiatry.

“Video chat came out as the undisputed champion,” said lead author Alan Teo, M.D., associate professor of psychiatry in the OHSU School of Medicine and a  at the VA Portland Health Care System. “Older adults who used video chat technology such as Skype had significantly lower risk of depression.”

Data were obtained through the Health and Retirement Study supported by the National Institute on Aging of the National Institutes of Health. Since 1992, the nationwide study has surveyed seniors every two years.

The researchers identified 1,424 participants from the 2012 survey who completed a set of questions about technology use. These same participants also responded to a follow-up survey two years later that measured, among other things, depressive symptoms.

Those who used email,  or social media platforms like Facebook had virtually the same rate of depressive symptoms compared with older adults who did not use any communication technologies. In contrast, researchers found that people who used video chat functions such as Skype and FaceTime had almost half the estimated probability of , after adjusting for other factors that could confound results, such as pre-existing depression and level of education.

“To our knowledge, this is the first study to demonstrate a potential link between use of video chat and prevention of clinically significant symptoms of depression over two years in ,” the authors wrote.

Researchers said video chat’s appeal isn’t necessarily surprising. Video chat engages users in face-to-face interactions rather than having them passively scrolling through a Facebook feed, for example.

“I still maintain that face-to-face interaction is probably best of all,” Teo said. “However, if we’re looking at the reality of modern American life, we need to consider these communication technologies. And when we do consider them and compare them, our findings indicate that I’m better off Skyping with my dad in Indiana than sending him a message on WhatsApp.”

 Explore further: Arthritis and depression often occur together in older adults

More information: Alan R. Teo et al, Using Skype to Beat the Blues: Longitudinal Data from a National Representative Sample, The American Journal of Geriatric Psychiatry (2018). DOI: 10.1016/j.jagp.2018.10.014

https://medicalxpress.com/news/2018-11-effectiveness-online-tools-combatting-depression.html

Advertisements

To resolve inflammation, location matters

To resolve inflammation, location matters
Researchers from Penn and Technical University of Dresden found that the protein Del-1 takes on different functions depending on the cell that secretes it. 

Health conditions that involve inflammation run the gamut, from multiple sclerosis and lupus to arthritis, diabetes, and cancer. While inflammation can serve as a normal response to help the body deal with injury or infection, problems arise when it persists, potentially harming surrounding tissues.

To prevent or ameliorate this damage, the body relies on a strategy to actively clear inflammation. “It’s not just extinguishing the fire of inflammation,” says George Hajishengallis of the University of Pennsylvania. “You also have to return things to the way they were before the inflammatory destruction.”

A new study led by Hajishengallis, the Thomas W. Evans Centennial Professor in Penn’s School of Dental Medicine, and Triantafyllos Chavakis of the Technical University of Dresden has illuminated a key player in this resolution process, the protein Del-1, which the pair has studied extensively before. While prior research had underscored Del-1’s role in curbing the initiation of inflammation, the new work finds that it can serve a very different function, actively working to clear inflammation. Which function the protein performs depends on the cell type that expresses it, the team found.

“Our findings prompted us to propose the ‘location principle’ in the spatial regulation of the immune response,” says Chavakis. “In other words, homeostatic molecules—those responsible for maintaining equilibrium in the body—may perform different regulatory functions depending on their location.”

The work appears in the journal Nature Immunology.

Hajishengallis, Chavakis, and their labs and collaborators have been interested in the protein Del-1 for many years. Through a series of experiments and publications, they’ve established its importance in the initiation of inflammation. Focusing on periodontitis, severe gum disease, as a model system, they’ve found Del-1 restrains the activity of neutrophils, preventing damaging inflammation and bone loss in the gums.

In the new work, they wanted to see whether Del-1 could also act not just to hold back inflammation from occurring in the first place but also to actively resolve it once it occurred.

In collaboration with co-author Jonathan M. Korostoff, professor of periodontics at Penn Dental Medicine, they found that, in humans with periodontitis, Del-1 levels rose upon treating the disease. To follow up on the finding and get at a mechanism, they turned to a mouse model of gum disease, observing that Del-1 expression levels rose when the animals’ disease began to resolve, a mirror to the human data.

“Just because Del-1 goes up doesn’t necessarily mean anything,” says Hajishengallis, “but, when we did the same experiment with  that lack Del-1, the resolution of inflammation failed.”

That suggested to the scientists that Del-1 was a necessary component of the resolution process. To further explore this possibility, they turned to another disease, peritonitis, which involves inflammation of the abdominal lining.

Here they saw the same effect and were further able to show a course of action: Del-1 was able to act as a molecular bridge to expedite the clearance of dying neutrophils by connecting them to macrophages, a distinct type of immune cells that engulf and “eat” cellular debris, and thus maintaining a healthier environment. This process of clearing dying neutrophils is called efferocytosis.

Importantly, Del-1 appeared to reprogram the efferocytic macrophages toward a type that contributes to resolution and tissue repair. Mice lacking a domain of Del-1 that interacts with macrophages were not able to promote efferocytosis.

In addition to promoting this clearance of neutrophils, the researchers discovered that Del-1 also induced a group of molecular mediators called resolvins, which promote inflammation resolution. The researchers hypothesize that Del-1 may regulate a positive feedback loop, in which it triggers resolvins and then acts downstream of them to get things back in order after inflammation clears.

Perhaps the most novel finding of the paper, was what the researchers have termed the “location principle.” In their earlier studies, they had found Del-1 secreted from endothelial cells that line tissues was responsible for regulating initiation of inflammation by inhibiting the traffic of neutrophils. But other work has shown that macrophages, too, could secrete Del-1. Using mice that overexpressed either the endothelial-derived Del-1 or the macrophage-derived Del-1, they found that the cell type mattered when it came to the protein’s activity. Overexpressing Del-1 only in , for example, made no difference in the animals’ ability to clear dying neutrophils in a model of peritonitis. Conversely, mice overexpressing Del-1 in their macrophages had no advantage in harnessing neutrophil recruitment but were better able to clear the neutrophils from the site of inflammation.

“This ‘location principle’ is novel,” says Hajishengallis. “Tissues are not a sack of molecules; the geography is very important.

“As a pro-resolution protein, Del-1 is probably acting downstream of therapeutics that promote periodontal health,” he adds. “For instance, the complement inhibitor AMY-101, which can cause a rise in Del-1 levels, may depend on Del-1 to accelerate the resolution of inflammation.”

“This fundamental mechanism of  clearance by Del-1,” says Chavakis, “may also be involved in multiple inflammatory pathologies, including metabolic-inflammatory or malignant disease.”

 Explore further: Study blocks inflammatory bone loss in gum disease

More information: Ioannis Kourtzelis et al, DEL-1 promotes macrophage efferocytosis and clearance of inflammation, Nature Immunology (2018). DOI: 10.1038/s41590-018-0249-1

https://medicalxpress.com/news/2018-11-inflammation.html

Aspirin and omega-3 reduce pre-cancerous bowel polyps

Both aspirin and a purified omega-3, called EPA, reduce the number of pre-cancerous polyps in patients found to be at high risk of developing bowel cancer, according to new research.

A clinical trial, led by the University of Leeds, found that both aspirin and EPA reduced the number of bowel polyps in patients one year on from a screening colonoscopy (large bowel camera test), although they did not reduce the chances of an individual having any polyps present in the bowel.

Patients who took aspirin developed fewer polyps overall, including on the right side of the large bowel, the part which is most difficult to monitor by colonoscopy being furthest from the back-passage.

Patients who took purified omega-3 EPA (eicosapentaenoic acid) also developed fewer polyps, but this effect was seen only on polyps on the left side of the bowel, which is nearest the back-passage.

The seAFOod Trial, the result of a multidisciplinary collaboration between the Universities of Leeds, Nottingham, Bradford and Newcastle, as well as others, is published today in The Lancet.

The trial was launched to determine whether aspirin or EPA could reduce the number of people who had any polyps at their one year follow up test, which they did not. However, both compounds had preventative effects by reducing the number of polyps of specific types in patients.

Lead author Mark Hull, Professor of Molecular Gastroenterology at the University of Leeds, said: “The seAFOod Trial demonstrates that both aspirin and EPA have preventative effects, which is particularly exciting given that they are both relatively cheap and safe compounds to give to patients.

“Given this new evidence, clinicians need to consider these agents for patients at elevated risk of , alongside regular colonoscopy surveillance.”

Bowel cancer remains the second largest cause of cancer deaths in the UK. Despite a national screening programme, bowel cancer still resulted in over 16,000 deaths in England and Wales in 2014.

People at  of the disease are regularly monitored by specialists who use a flexible camera to examine the lining of the large bowel, also called the colon, by a technique called colonoscopy.

During a colonoscopy, a specialist looks for polyps, which are fleshy growths on the lining of the colon. The growths are usually benign but they can turn cancerous and so they are removed. However, colonoscopy is not fool-proof and a significant number of people still continue to develop bowel cancer.

The seAFOod Trial, funded by the EME Programme—a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership—was conducted to see if aspirin and EPA could provide another layer of prevention, alongside colonoscopy.

Professor Hull is a practising Gastroenterologist at the Leeds Teaching Hospitals Trust and is a member of the NHS Bowel Cancer Screening Programme (BCSP) Research Committee. He said: “With the BCSP in England being extended to cover everyone from the age of 50 in England, there will be even more people found to have bowel polyps, who we know are at increased risk of bowel cancer. We should now evaluate how aspirin and EPA can best provide added benefits to patients given our limited colonoscopy resources.”

Just over 700 people took part in the study from 53 hospitals in England, all of whom were identified as being at higher risk of developing bowel cancer after having a colonoscopy in the BCSP. This study is the first drug trial to have taken place in the English BCSP.

People who took part were randomly allocated to one of four treatment groups and, each day over the following year, they took either a 300 milligram aspirin tablet; 2 grams EPA in four capsules; a combination of both aspirin and EPA; or placebos only.

Patients who took aspirin had 22% fewer polyps at the end of the one year study compared to those who took the placebo.

Those who took EPA had 9% fewer polyps at the end of the study compared to those who took the placebo, although this difference was not statistically significant. However, patients who took EPA had 25% fewer polyps in the left side of the bowel compared to those who took the placebo.

The study suggests that a ‘precision medicine’ approach may be the most appropriate way to use aspirin and omega-3 to prevent bowel polyps, in which patients at risk of particular types of  are given treatment specific to that risk.

Professor David Crossman, Interim Director of the NIHR’s Efficacy and Mechanism Evaluation (EME) Programme, said: “The seAFOod Trial results are very exciting and I’m particularly pleased that the MRC/NIHR collaboration funded this study.

“Prevention is key in this common disease and it’s fascinating that the combination of widely available and relatively cheap drugs seemed to have such an impact.”

EPA is naturally present in fish oil, but was given to  at a higher dose than is present in most omega-3 supplements that are available to the public. Aspirin was provided by Bayer AG and EPA was partly provided by SLA Pharma AG.

Although aspirin and EPA had beneficial effects on polyp number on their own, the combination of aspirin and EPA together appeared to have an even greater effect.

However, the trial was not designed to provide a definitive answer about combination treatment and further research is needed to test aspirin and EPA treatment together for polyp prevention.

Treatment with  and EPA was safe with no increased bleeding risk seen. Individuals who took EPA on its own had a slight increase in stomach-upset symptoms.

 Explore further: When is a colonoscopy necessary?

More information: The Lancet (2018). DOI: 10.1016/S0140-6736(18)31775-6

https://medicalxpress.com/news/2018-11-aspirin-omega-pre-cancerous-bowel-polyps.html

Sandoz, Pear Launch reSET® for Substance Use Disorder

reSET® is the first and only FDA-authorized prescription digital therapeutic for Substance Use Disorder (SUD)

Adding reSET to outpatient therapy significantly improved abstinence in substances of abuse and treatment retention compared to standard of care alone

Sandoz and Novartis continue to embrace digital technologies to enhance R&D and deliver better outcomes for patients

 

Sandoz, a Novartis division, and Pear Therapeutics, Inc., announced today the commercial launch of reSET® for patients with Substance Use Disorder (SUD). reSET, the first and only FDA-authorized prescription digital therapeutic, is immediately available.

https://www.businesswire.com/news/home/20181119005922/en/Sandoz-Pear-Therapeutics-Announce-Launch-reSET%C2%AE-Treatment

Tesaro rallies after canceling appearance at Evercore conference

Shares of Tesaro are moving higher after contacts confirmed the company has cancelled its appearance at next week’s Evercore ISI HealthconX conference. The stock in afternoon trading is up 8%, or $2.86, to $37.82. Bloomberg on Friday reported that Tesaro is exploring a sale after receiving buyout interest. Cantor Fitzgerald analyst Alethia Young earlier today said she believes Tesaro could be valued at $89-$97 per share in a takeout scenario.

https://thefly.com/landingPageNews.php?id=2825859

RNAi therapy mitigates preeclampsia symptoms

A collaboration of scientists from the University of Massachusetts Medical School, Beth Israel Deaconess Medical Center and Western Sydney University, have shown that an innovative new type of therapy using small interfering RNAs (siRNA) can temper the symptoms of preeclampsia in an animal model. The research, led by Anastasia Khvorova, Ph.D., and Melissa Moore, Ph.D., of UMass Medical School’s RNA Therapeutics Institute and Ananath Karumanchi, MD, of Beth Israel and Harvard Medical School—suggests that RNA interference therapy could be a potential strategy for the treatment of preeclampsia in humans.

“For women with preeclampsia, being able to carry a pregnancy for just a few more weeks can make a huge difference in the health of the baby,” said Dr. Khvorova, professor of RNA therapeutics. “Thanks to rapid advances in siRNA, we’ve developed an siRNA that displays the potential to allow women with preeclampsia to extend their pregnancy from 24 or 25 weeks to as long as 30 weeks, greatly improving outcomes for the infant.”

Preeclampsia is a hypertensive disorder associated with pregnancy; preeclampsia has no cure or adequate treatment options. Women experiencing preeclampsia suffer from the onset of high blood pressure and excess protein in the urine, called proteinuria, beginning around 20 weeks of pregnancy. In severe cases,  can break down, blood platelet counts fall, liver and kidney function is impaired and fluid can fill the lungs causing shortness of breath and increasing the risk to both mother and baby. A complication in 2 to 8 percent of all pregnancies, preeclampsia is responsible for 100,000 premature births and more than 10,000 infant deaths in the U.S. every year. The only treatment for the illness is the delivery of the baby and placenta.

Symptoms of preeclampsia arise from a defect found in the placenta associated with abnormally high levels of the protein sFLT1 in the blood, which acts as an on/off switch for inhibiting the growth of new blood vessels. Reducing levels of circulating sFLT1 is considered a promising therapeutic target for the disease.

The study, published in Nature Biotechnology, shows that ‘short interfering RNAs’ or siRNAs can be used to reduce circulating sFLT1 in the blood of pregnant mice. An emerging class of drugs that target nucleic acids, siRNAs degrade the messenger RNAs (mRNAs) that carry the instructions for making proteins from DNA. By reducing the number of mRNAs for a specific DNA sequence, scientists can reduce the number of mature proteins that get made. When siRNAs targeting some of the messenger RNAs that encode sFLT1 were delivered to pregnant mice, scientists were able to reduce the amount of circulating levels of the protein by up to 50 percent.

In collaboration with Annemarie Hennessy, Ph.D., MBA, MBBS, dean of the School of Medicine at Sydney University Medical School, investigators tested this approach in pregnant baboons, an established preclinical model for human preeclampsia. The researchers found that a single injection of siRNA lowers circulating sFLT1 levels and normalizes both high blood pressure and proteinuria in the mothers. “Six years ago, this wouldn’t have been possible,” said Khvorova. “Scientific advances that now allow us to chemically stabilize and produce siRNAs so they can be delivered to tissues outside of the liver have lead to rapid advances in these compounds. The preeclampsia compounds we are developing are an example of what siRNA can do and how far they’ve come.”

Dr. Moore, professor of RNA therapeutics at UMass Medical School, began researching  15 years ago after being diagnosed with the disease and being asked to participate in a study of the illness. “This project is near and dear to my heart,” Moore said. “As exciting as these results are, it still feels like we’re half done. It won’t be complete until we can get a therapy to women. Getting pregnant shouldn’t be one of the most dangerous things a woman can do.”

Although the therapy improves maternal baboon health, the study’s authors also noted a trend toward reduced birth weight in the offspring—indicating that this approach’s effects on neonatal health needs to be studied in greater detail before advancing to clinical trials. The next step for researchers will be to attract funding for the necessary studies needed to further optimize siRNA chemical configuration and extensively test safety, studies necessary before applying for an investigational new drug (IND) application from the U.S. Food and Drug Administration.

 Explore further: Increases in sFLT1 predict the onset of preeclampsia symptoms in mice

More information: RNAi modulation of placental sFLT 1 for the treatment of preeclampsia, Nature Biotechnology (2018). DOI: 10.1038/nbt.4297 ,
www.nature.com/articles/nbt.4297

https://medicalxpress.com/news/2018-11-rnai-therapy-mitigates-preeclampsia-symptoms.html

For edge in global I/O, Alphamab gets $100M-plus from marquee backers

 

Alphamab Oncology believes it has what it takes to stand out from the deluge of checkpoint inhibitors currently in development — not just in China but globally. A syndicate of well-heeled investors now shares that confidence, infusing more than $100 million to fuel an ambitious drive through the clinic.

 

Advantech, PAG and China Venture Capital Fund led the Series A, which is expected to support Alphamab’s lead asset, KN035, all the way up to registrational trials and fund late-stage programs for three other clinical drug candidates. OrbiMed, Heritage Provider Network and Janchor Partners also chipped in.

Spun out of Suzhou Alphamab, Alphamab Oncology inherited all cancer-related work done over the last nine years at the parent company under CEO Ting Xu, the founder of both entities and a former senior researcher at Biogen and Serono.

Back when the team started its programs several years ago, Xu tells me in an email, they envisioned a highly competitive PD-(L)1 field. Their strategy in response features plays in both “I/O 1.0” — a subcutaneously administered PD-L1 antibody — and “I/O 2.0” with a bispecific targeting both PD-L1 and CTLA-4.

KN035, or envafolimab, the PD-L1 antibody currently in pivotal trials, represents the most advanced program in Alphamab Oncology’s pipeline. Given that frequent intravenous administration is a major drawback to compliance and convenience, Xu says, the “user-friendliness” of a subcutaneous product, with a shorter administration time and potential for home-use, can make it attractive in the adjuvant/neoadjuvant setting and as a maintenance therapy.

It’s a competitive advantage also being pursued by Bristol-Myers Squibb through a pact with San Diego-based Halozyme, which is providing its hyaluronidase enzyme-based tech to see if the checkpoint leader can deliver its I/O drugs with a subcutaneous jab.

Alphamab is partnering with 3D Medicines, a China-based precision medicine company, on the clinical development while building a commercial manufacturing site to prepare for potential approval.

The PD-L1/CTLA-4 bispecific dubbed KN046, on the other hand, is aimed at overcoming the safety limitations of current CTLA-4 antibodies.

“We will explore the opportunities in two fronts: Increase the response rate in large indications like NSCLC, HCC etc. while addressing some PD-(L)1 non-response tumor types,” Xu adds.

Both programs, like the rest of the pipeline, are being positioned for the US, EU and Japan markets in addition to China. Some early-stage clinical trials will be conducted in Australia through an Alphamab subsidiary there.

The new funds will also go toward an aggressive recruitment plan: At 100 staffers now, the company plans to double its size by the end of 2019.

https://endpts.com/seeking-an-edge-in-the-global-i-o-race-alphamab-oncology-loads-up-100m-from-marquee-backers/