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Childhood obesity major link to hip diseases

New research from the University of Liverpool, published in the Archives of Disease in Childhood journal, shows a strong link between childhood obesity and hip diseases in childhood.

Significant hip deformities affect around 1 in 500 children. Slipped Capital Femoral Epiphysis (SCFE) is the most common hip disease of adolescence. The condition always requires surgery, can cause significant pain, and often leads to a hip replacement in adolescence or early adulthood.

Children with a SCFE experience a decrease in their range of motion, and are often unable to complete hip flexion or fully rotate the hip inward. Unfortunately many cases of SCFE are misdiagnosed or overlooked, because the first symptom is knee pain, referred from the hip. The knee is often investigated and found to be normal. Early recognition of SCFE is important as the deformity may worsen if the slip remains untreated.

Factors explored

In an effort to identify children at higher risk of this condition researchers from the University’s Institute of Translational Medicine, led by National Institute of Health Research (NIHR) Clinician Scientist and Senior Lecturer in Orthopaedic Surgery Daniel Perry, examined hospital and community based records to explore factors associated with SCFE, and explanations for diagnostic delays.

All of the records examined were of individuals under 16-years-of-age with a diagnosis of SCFE and whose electronic medical record was held by one of 650 primary care practices in the UK between 1990 and 2013.

Using the height and weight of children recorded in the notes at some point before the disease was diagnosed the researchers were able to identify that obese children appear at highest risk of this condition.

The study was funded by the Academy of Medical Sciences.

Best evidence

Daniel Perry, who is also an Honorary Consultant Orthopaedic Surgeon at Alder Hey Children’s Hospital, said: “This is the best evidence available linking this disease to childhood obesity – which makes this condition to be one of the only obesity-related disease that can cause life-long morbidity starting in childhood.

“A significant proportion of patients with SCFE are initially misdiagnosed and those presenting with knee pain are particularly at risk.

“Ultimately this study helps us to better understand one of the main diseases affecting the hip in childhood. Whilst we confirm a strong association with obesity, we are still unable to say that obesity causes this disease.”

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Researchers Studying Debilitating Lung Disease that Targets Puerto Ricans

Loyola Medicine is enrolling patients in the first major study of a rare, debilitating lung disease that disproportionately affects people from Puerto Rico.

The hereditary disease is called Hermansky-Pudlak syndrome (HPS). It can cause bleeding problems, low vision, albinism and in some patients, a debilitating and often fatal lung disease called pulmonary fibrosis, said Loyola Medicine pulmonologist Daniel Dilling, MD.

HPS affects fewer than 1 in 500,000 people worldwide. But it is more common in certain geographic pockets, especially Puerto Rico, where it affects 1 in 1,800 people.

Loyola is the only center in Illinois participating in a multicenter study of how HPS develops in patients over time. The first Loyola HPS patient to enroll is Jonathan Colon, 44, of Chicago, whose parents are from Puerto Rico. Puerto Ricans who have HPS are believed to have descended from a single founding patient.

Mr. Colon has pulmonary fibrosis, characterized by a buildup of scar tissue in the lungs. Pulmonary fibrosis makes breathing increasingly difficult, and in later stages patients need supplemental oxygen around the clock. Small exertions such as walking across a room can leave a patient gasping for breath. Without a lung transplant, the condition can be fatal.

The course of the disease varies among patients. Mr. Colon was diagnosed relatively early in the disease, and is taking a new drug that has slowed the progression of his pulmonary fibrosis. Dr. Dilling said Mr. Colon eventually may need a lung transplant. The operation would be challenging, because in HPS patients, blood does not coagulate normally, increasing the risk of bleeding.

Dr. Dilling said people of Puerto Rican descent who have albinism (abnormally light coloring) should be screened for HPS to ensure early treatment. Many Puerto Ricans with albinism do not know they are at risk for HPS, Dr. Dilling said.

The study is called “A Longitudinal Study of Hermansky-Pudlak Syndrome Pulmonary Fibrosis.” Its purpose is to identify the earliest evidence of pulmonary disease in individuals who are at risk for HPS pulmonary fibrosis. Researchers also hope to identify biomarkers that will help them understand the cause of HPS pulmonary fibrosis and facilitate future clinical trials. (A  biomarker is a substance in the body that predicts the incidence or outcome of a disease.)

The study is funded by the National Heart, Lung and Blood Institute of the National Institutes of Health. Principal investigator of the overall study is Lisa Young, MD, of Vanderbilt University.

For 29 years, Loyola has operated the largest and most successful lung transplant program in Illinois. More than 900 lung transplants—by far the most of any center in Illinois—have been performed and Loyola’s 40 lung transplants in 2016 were more than all other programs in Illinois combined.

Loyola’s lung transplant program regularly evaluates and successfully performs transplants in patients who have been turned down by other centers in Chicago and surrounding states and consistently records outstanding outcomes.

Loyola also is the only center in Illinois to join the recently launched Rare Lung Diseases Consortium, which is spearheading cutting-edge research on HPS and other rare lung diseases.The consortium is a unique collaboration among patient groups, researchers and the National Institutes of Health. Its mission is to conduct research into new diagnostic tests and treatments, provide clinical research training and focused clinical care and educate patients, physicians, researchers and the public about rare lung diseases.

The study will enroll about 150 patients aged 12 and older who have been diagnosed with HPS. For more information about enrolling at the Loyola site, contact Josie Corral, RN, at 708-216-5744 or at  jcorral@luc.edu.

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Researchers Develop Mouse That Could Provide Advance Warning of Next Flu Pandemic

Researchers in Germany have developed a transgenic mouse that could help scientists identify new influenza virus strains with the potential to cause a global pandemic. The mouse is described in a study, “In vivo evasion of MxA by avian influenza viruses requires human signature in the viral nucleoprotein,” that will be published April 10 in The Journal of Experimental Medicine.

Influenza A viruses can cause devastating pandemics when they are transmitted to humans from pigs, birds, or other animal species. To cross the species barrier and establish themselves in the human population, influenza strains must acquire mutations that allow them to evade components of the human immune system, including, perhaps, the innate immune protein MxA. This protein can protect cultured human cells from avian influenza viruses but is ineffective against strains that have acquired the ability to infect humans.

To investigate whether MxA provides a similar barrier to cross-species infection in vivo, Peter Staeheli and colleagues at the Institute of Virology, Medical Center University of Freiburg, created transgenic mice that express human, rather than mouse, MxA. Similar to the results obtained with cultured human cells, the transgenic mice were resistant to avian influenza viruses but susceptible to flu viruses of human origin.

MxA is thought to target influenza A by binding to the nucleoprotein that encapsulates the virus’ genome, and mutations in this nucleoprotein have been linked to the virus’ ability to infect human cells. Staeheli and colleagues found that an avian influenza virus engineered to contain these mutations was able to infect and cause disease in the transgenic mice expressing human MxA.

MxA is therefore a barrier against cross-species influenza A infection, but one that the virus can evade through a few mutations in its nucleoprotein. Staeheli and colleagues think that their transgenic mice could help monitor the potential dangers of emerging viral strains. “Our MxA-transgenic mouse can readily distinguish between MxA-sensitive influenza virus strains and virus strains that can evade MxA restriction and, consequently, possess a high pandemic potential in humans,” Staeheli says. “Such analyses could complement current risk assessment strategies of emerging influenza viruses, including viral genome sequencing and screening for alterations in known viral virulence genes.”

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New Arsenal Against MRSA: New Study Reports Cannabinoids Effective Against Antibiotic-Resistant MRSA

Researchers have found that cannabinoid-based therapies have unique anti-bacterial properties that fight MSRA and other infectious bacteria. In vitro studies demonstrated that bactericidal synergy was achieved against multiple species of methicillin-resistant Staphylococcus aureus (MRSA) utilizing a proprietary cannabinoid-based therapeutic platform. MRSA species tested included community acquired- (CA-MRSA), healthcare-acquired- (HA-MRSA), and mupirocin-resistant (MR-MRSA) strains of MRSA.

Researchers also found that using unique strategic cannabinoid-based cocktails, fractional-inhibitory concentration (FIC) levels demonstrating synergy between mixtures of individual cannabinoid-based components ranged from 0.06 to 0.28. FIC findings below 0.5 indicate significant killing potential of the mixture. The work was led by NEMUS BIoscience, Inc. and the company’s discovery and research partner, the University of Mississippi (UM).

Dr. Mahmoud ElSohly, professor at the National Center for Natural Products Research (NCNPR) at the University of Mississippi commented: “Historically, many types of anti-infective compounds are derived from plants so to have a series of cannabinoid-related compounds exhibit activity against this dangerous pathogen is in keeping with prior efforts of drug development. I believe that these compounds, in addition to the bacterial killing capability, could also offer benefits associated with anti-inflammatory and anti-fibrotic properties that could enhance healing, especially against an organism associated with skin and soft tissue infections. The University, in conjunction with Nemus, is looking to expand the anti-infective capabilities of this series of compounds.”

Recently, the World Health Organization (WHO) placed MRSA on their list as one of the top six organisms that pose a global public health threat. “This anti-infective platform will constitute the NB3000 series of Nemus molecules and formulations.  While there are a number of compounds in the development pipeline against MRSA, we believe that this family of drug candidates could possess an excellent safety profile in addition to efficacy in neutralizing this bacterium,” stated Brian Murphy, M.D., C.E.O. and Chief Medical Officer of Nemus. “These unique botanically derived components establish an anti-infective platform which could potentially be expanded into other types of bacteria, as well as viruses, and fungi.”

The University of Mississippi, the state’s flagship institution, is among the elite group of R-1: Doctoral Universities – Highest Research Activity in the Carnegie Classification. The university has a long history of producing leaders in public service, academics, research and business. Its 15 academic divisions include a major-medical school, nationally recognized schools of accountancy, law and pharmacy, and an Honors College acclaimed for a blend of academic rigor, experiential learning and opportunities for community action.

Nemus will work with Dr. Elsohly, the University lead researcher on this project, to have this data submitted to a future scientific meeting and anticipates performing further testing against a variety of other bacterial species. Commercially, the company looks to actively pursue partnering opportunities for these candidate molecules. “This work highlights the importance of Nemus’ relationship with the University which has significant experience and intellectual capital related to cannabinoid chemistry and physiology, dating back to 1968,” added Dr. Murphy.

Nemus Bioscience is a biopharmaceutical company, headquartered in Costa Mesa, California, focused on the discovery, development, and commercialization of cannabinoid-based therapeutics for significant unmet medical needs in global markets. Utilizing certain proprietary technology licensed from the University of Mississippi, NEMUS is working to develop novel ways to deliver cannabinoid-based drugs for specific indications, with the aim of optimizing the clinical effects of such drugs, while limiting potential adverse events. NEMUS’s strategy is to explore the use of natural and synthetic compounds, alone or in combination with partners. The Company is led by a highly-qualified team of executives with decades of biopharmaceutical experience and significant background in early-stage drug development.

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