How close we are for the cure of diabetes?

How close we are for the cure of diabetes?

Diabetes also known as diabetes mellitus is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period of time. Diabetes has become endemic sentencing over 422 million people worldwide to lifelong medication. It has become the major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Science is striving to find the cure for this endemic. Buthow close we are?

Despite there is a huge impact, there is still no cure for any type of diabetes. The biotech industry has seen this opportunity and is striving to develop new diabetes treatments and chasing the holy grail: a cure. Let’s have a look at what’s brewing in the field and how it will change the way diabetes is treated.

Cells can change identity 

Researchers at University of Bergen in collaboration with other researchers has discovered that glucagon producing cells in the pancreas can change its identity. They have the capability to change their identity and adapt so they do the job their neighboring cells when they are damaged or missing insulin cells. They came to know that it is not passive process, but is a result of signals from the surrounding cells. In the study, researchers were able to increase the number of insulin producing cells to 5 per cent by using a drug that influenced the inter-cell signaling process. Thus far, the results have only been shown in animal models.  "We are possibly facing the start of a totally new form of treatment for diabetes, where the body can produce its own insulin, with some start-up help," says Researcher Luiza Ghila. 

"If we gain more knowledge about the mechanisms behind this cell flexibility, then we could possibly be able to control the process and change more cells' identities so that more insulin can be produced, " Ghila explains.

Replacing missing cells with cell therapy

Cell therapy is one of the biggest hopes towards developing a cure for diabetes, especially for type 1 diabetes. Replacing the missing insulin- producing cells could potentially recover normal insulin production and cure patients. However, early attempts to transplant pancreatic cells have largely failed, mostly due to immune reactions that reject and destroy the implanted cells. The lack of donors is also a limitation.

One of the most advanced alternatives comes from the Diabetes Research Institute in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. In 2016, the DRI announced that the first patient in Europe treated with this approach in an ongoing phase I/II trial no longer requires insulin therapy. 

“This can be the beginning of a new era in islet transplantation. Our ultimate goal is to prevent the need for life-long anti-rejection therapy,” stated Camillo Ricordi, Director of the DRI.

Attacking the origin with immunotherapy

In type 1 diabetes immune system progressively attacks the pancreatic beta cells which are responsible for insulin production also known as insulin producing cells. Stopping this process early enough could preserve the cells and provide cure.

With this goal, Imcyse, a Belgium company running a clinical trial with an immunotherapy designed to stop type 1 diabetes by specifically killing the immune cells that destroys the pancreas. 

Early after diagnosis, between 3 to 6 months, it is estimated that around 10% of the insulin-producing cells are still alive and producing insulin. After stopping the autoimmune process, the remaining beta cells would be protected and could continue producing insulin,” Pierre Vandepapelière, CEO of Imcyse, told me.

ActoBio Therapeutics, a company in Belgium, is now running a phase I/II clinical trial with an unusual approach to stop the progression of type 1 diabetes. The company uses cheese-producing bacteria to deliver two drugs that stimulate regulatory T cells to instruct the immune system not to attack insulin-producing cells.

“It is potentially a safe oral treatment that will be given for a limited period of time and could lead to patients who develop type 1 diabetes not needing to use insulin, or delay the need for insulin after diagnosis” said Pieter Rottiers, CEO of ActoBio.

Diabetics researchers are making great progress in understanding the basic of science of diabetes. Many findings have already proceeded on the road to new treatments. For every new strategy that succeed, the benefit to millions of people will be huge. 

How far we came to communicate with coma patients.

How far we came to communicate with coma patients. 

Imagine being able hear, feel and think. Clinically, a coma can be defined as the inability to consistently follow a one-step command.  For a patient to maintain consciousness, the components of wakefulness and awareness must be maintained.  For decades’ people have spoken to people in vegetative states, hoping their voices will be heard. 

FMRI

Recent researchers has shown that coma patients have more ability to understand than that was previously thought. Researchers are going much further than that: in controversial experiments, a group of scientists are working out how to communicate with people in comas. Nature has a wonderful feature piece which centers around Adrian Owen, a maverick in the field of neuroscience. The article describes one of Owen's early successful experiments:

"The patient was only 24 years old when his life was devastated by a car accident. Alive but unresponsive, he had been languishing in what neurologists refer to as a vegetative state for five years, when Owen, a neuro-scientist then at the University of Cambridge, UK, and his colleagues at the University of Liège in Belgium, put him into a functional magnetic resonance imaging (fMRI) machine and started asking him questions.

"Incredibly, he provided answers. A change in blood flow to certain parts of the man's injured brain convinced Owen that patient 23 was conscious and able to communicate. It was the first time that anyone had exchanged information with someone in a vegetative state."

One goal is to identify other brain systems, such as smell or taste, that might be intact and usable for communication. Imagining sucking a lemon, for example, can produce a pH-level change in the mouth and a recognizable brain signal. Owen has shown that registering jokes provokes a characteristic response in healthy people and plans to try it on patients in a vegetative state. He hopes that he can use these tests to find some level of responsiveness in patients who cannot produce the tennis and navigation patterns of activity because of their level of brain damage.

"The studies will also explore whether these patients have the capacity for greater intellectual depth. Owen thinks that some people in a vegetative state will eventually be able to express hopes and desires, perhaps like French magazine editor Jean-Dominique Bauby, who dictated his memoirs by repeatedly winking one eye. "I don't see a reason why they could not have a similar richness of thought, although undoubtedly some will not," Owen says."

Perhaps unsurprisingly, many scientists are skeptical of Owen's work. Were his early successes just fluke? Are his hopes for the future wildly optimistic? Maybe. But while his experiments continue to point in the right direction, we'd be fools not embrace his work Coma patients, who were for long thought unable to receive stimuli from their environment, could answer simple questions with yes/no and activate some zones of the brain like imagination as a response to certain stimuli.

 SME Instrument

The project was developed by Guger Technologies, a growing company with two branches in Austria (Graz and Schiedlberg), one branch in Spain (Barcelona), one branch in the US (Albany) and distribution partners all over the world. All hardware and software developments are done in-house by a team of researchers, engineers and developers. G.tec is also an active member in a number of national and international research projects and is active in scientific publishing. The technologies developed by the company have earned multiple awards for innovation and are sold in 70 different countries worldwide.

The company received an SME Instrument Phase 2 grant in October 2015 to build a new headset the mindBEAGLE. In addition to providing assessment and communication, the new mindBEAGLE prototype will also be able to provide prediction and rehabilitation.

With this technology, patients will once again be able to convey their needs and desires to carers, influence decisions about therapy and communicate with their family and friends.

The world is experiencing unprecedented economic growth in low- and middle-income countries. An increasing number of people in India, China, Latin America and Africa have become wealthier, and this is reflected in their consumption of meat and dairy products. In Africa, meat consumption has risen by more than half; in Asia and Latin America it is up by two-thirds.

The world is experiencing unprecedented economic growth in low- and middle-income countries. An increasing number of people in India, China, Latin America and Africa have become wealthier, and this is reflected in their consumption of meat and dairy products. In Africa, meat consumption has risen by more than half; in Asia and Latin America it is up by two-thirds.

To meet this growing demand, animal husbandry has been intensified, with among other things, an increased reliance on the use of antimicrobials. Farmers use antimicrobials to treat and prevent infections for animals raised in crowded conditions but these drugs are also used to increase weight gain, and thus improve profitability.

This excessive and indiscriminate use of antimicrobials has serious consequences: the proportion of bacteria resistant to antimicrobials is rapidly increasing around the world. Drugs are losing their efficacy, with important consequences for the health of animals but also potentially for humans.

Mapping resistance hotspots

ow- and middle income countries have limited surveillance capacities to track antimicrobial use and resistance on farms. Antimicrobial use is typically less regulated and documented there than in wealthy industrialized countries with established surveillance systems.

The team of researchers led by Thomas Van Boeckel, SNF Assistant Professor of Health Geography and Policy at ETH Zurich, has recently published a map of antimicrobial resistance in animals in low- and middle-income countries in the journal Science.

The team assembled a large literature database and found out where, and in which animals species resistance occurred for the common foodborne bacteria Salmonella, E. coli, Campylobacter and Staphylococcus.

According to this study, the regions associated with high rates of antimicrobial resistance in animals are northeast China, northeast India, southern Brazil, Iran and Turkey. In these countries, the bacteria listed above are now resistant to a large number of drug that are used not only in animals but also in human medicine. An important finding of the study is that so far, few resistance hotspots have emerged in Africa with the exception of Nigeria and the surroundings of Johannesburg.

The highest resistance rates were associated with the antimicrobials most frequently used in animals: tetracyclines, sulphonamides, penicillins and quinolones. In certain regions, these compounds have almost completely lost their efficacy to treat infections.

Alarming trend in multi-drug resistance

The researchers introduced a new index to track the evolution of resistance to multiple drugs: the proportion of drugs tested in each region with resistance rates higher than 50%. Globally, this index has almost tripled for chicken and pigs over the last 20 years. Currently, one third of drugs fail 50% of the time in chicken and one quarter of drug fail in 50% of the time in pigs.

"This alarming trend shows that the drugs used in animal farming are rapidly losing their efficacy," Van Boeckel says. This will affect the sustainability of the animal industry and potentially the health of consumers.

It is of particular concern that antimicrobial resistance is rising in developing and emerging countries because this is where meat consumption is growing the fastest, while access to veterinary antimicrobials remains largely unregulated. "Antimicrobial resistance is a global problem. There is little point in making considerable efforts to reduce it on one side of the world if it is increasing dramatically on the other side," the ETH researcher says.

Input from thousands of studies

For their current study, the team of researchers from ETH, Princeton University and the Free University of Brussels gathered thousands of publications as well as unpublished veterinary reports from around the world. The researchers used this database to produce the maps of antimicrobial resistance.

However, the maps do not cover the entire research area; there are large gaps in particular in South America, which researchers attribute to a lack of publicly available data. "There are hardly any official figures or data from large parts of South America," says co-author and ETH postdoctoral fellow Joao Pires. He said this surprised him, as much more data is available from some African countries , despite resources for conducting surveys being more limited than in South America.

Open-access web platform

The team has created an open-access web platform resistancebank.org to share their findings and gather additional data on resistance in animals. For example, veterinarians and state-authorities can upload data on resistance in their region to the platform and share it with other people who are interested.

Van Boeckel hopes that scientists from countries with more limited resources for whom publishing cost in academic journal can be a barrier will be able to share their findings and get recognition for their work on the platform. "In this way, we can ensure that the data is not just stuffed away in a drawer" he says, "because there are many relevant findings lying dormant, especially in Africa or India, that would complete the global picture of resistance that we try to draw in this first assessment. The platform could also help donors to identify the regions most affected by resistance in order to be able to finance specific interventions.

As meat production continues to rise, the web platform could help target interventions against AMR and assist a transition to more sustainable farming practices in low- and middle-income countries.

"The rich countries of the Global North, where antimicrobials have been used since the 1950s, should help make the transition a success," says Van Boeckel.

The research was funded by the Swiss National Science Foundation and the Branco Weiss Fellowship.

The ancient Incan sanctuary of Machu Picchu is considered one of humanity's greatest architectural achievements. Built in a remote Andean setting atop a narrow ridge high above a precipitous river canyon, the site is renowned for its perfect integration with the spectacular landscape. But the sanctuary's location has long puzzled scientists: Why did the Incas build their masterpiece in such an inaccessible place? Research suggests the answer may be related to the geological faults that lie beneath the site

The ancient Incan sanctuary of Machu Picchu is considered one of humanity's greatest architectural achievements. Built in a remote Andean setting atop a narrow ridge high above a precipitous river canyon, the site is renowned for its perfect integration with the spectacular landscape. But the sanctuary's location has long puzzled scientists: Why did the Incas build their masterpiece in such an inaccessible place? Research suggests the answer may be related to the geological faults that lie beneath the site

On Monday, 23 Sept. 2019, at the GSA Annual meeting in Phoenix, Rualdo Menegat, a geologist at Brazil's Federal University of Rio Grande do Sul, will present the results of a detailed geoarchaeological analysis that suggests the Incas intentionally built Machu Picchu -- as well as some of their cities -- in locations where tectonic faults meet. "Machu Pichu's location is not a coincidence," says Menegat. "It would be impossible to build such a site in the high mountains if the substrate was not fractured."

Using a combination of satellite imagery and field measurements, Menegat mapped a dense web of intersecting fractures and faults beneath the UNESCO World Heritage Site. His analysis indicates these features vary widely in scale, from tiny fractures visible in individual stones to major, 175-kilometer-long lineaments that control the orientation of some of the region's river valleys.

Menegat found that these faults and fractures occur in several sets, some of which correspond to the major fault zones responsible for uplifting the Central Andes Mountains during the past eight million years. Because some of these faults are oriented northeast-southwest and others trend northwest-southeast, they collectively create an "X" shape where they intersect beneath Machu Picchu.

Menegat's mapping suggests that the sanctuary's urban sectors and the surrounding agricultural fields, as well as individual buildings and stairs, are all oriented along the trends of these major faults. "The layout clearly reflects the fracture matrix underlying the site," says Menegat. Other ancient Incan cities, including Ollantaytambo, Pisac, and Cusco, are also located at the intersection of faults, says Menegat. "Each is precisely the expression of the main directions of the site's geological faults."

Menegat's results indicate the underlying fault-and-fracture network is as integral to Machu Picchu's construction as its legendary stonework. This mortar-free masonry features stones so perfectly fitted together that it's impossible to slide a credit card between them. As master stoneworkers, the Incas took advantage of the abundant building materials in the fault zone, says Menegat. "The intense fracturing there predisposed the rocks to breaking along these same planes of weakness, which greatly reduced the energy needed to carve them."

In addition to helping shape individual stones, the fault network at Machu Picchu likely offered the Incas other advantages, according to Menegat. Chief among these was a ready source of water. "The area's tectonic faults channeled meltwater and rainwater straight to the site," he says. Construction of the sanctuary in such a high perch also had the benefit of isolating the site from avalanches and landslides, all-too-common hazards in this alpine environment, Menegat explains.

The faults and fractures underlying Machu Picchu also helped drain the site during the intense rainstorms prevalent in the region. "About two-thirds of the effort to build the sanctuary involved constructing subsurface drainages," says Menegat. "The preexisting fractures aided this process and help account for its remarkable preservation," he says. "Machu Picchu clearly shows us that the Incan civilization was an empire of fractured rocks."

Mosasaurs were true sea monsters of late Cretaceous seas. These marine lizards -- related to modern snakes and monitor lizards -- grew as long as fifty feet, flashed two rows of sharp teeth, and shredded their victims with enormous, powerful jaws.

Mosasaurs were true sea monsters of late Cretaceous seas. These marine lizards -- related to modern snakes and monitor lizards -- grew as long as fifty feet, flashed two rows of sharp teeth, and shredded their victims with enormous, powerful jaws.

Now, new research suggests that mosasaurs had yet another potent advantage: a muscular breast stroke that may have added ambush-worthy bursts of speed.

"We know that mosasaurs most likely used their tails for locomotion. Now we think that they also used their forelimbs, or their tail and forelimbs together," explains lead author Kiersten Formoso, a Ph.D. student in vertebrate paleontology at the University of Southern California. That dual swimming style, she says, could make mosasaurs unique among tetrapods (four limbed creatures), living or extinct.

Previous studies noted that mosasaurs had an unusually large pectoral girdle -- the suite of bones that support the forelimbs. But most assumed the creature's swimming was mainly driven by their long tails, something like alligators or whales. That smooth, long distance-adapted swimming style is called "cruising," as opposed to "burst" motion. "Like anything that swims or flies, the laws of fluid dynamics mean that burst versus cruising is a tradeoff," explains co-author Mike Habib, Assistant Professor of Anatomical Sciences at USC. "Not many animals are good at both."

To dive in more closely on whether mosasaurs were burst-adapted, cruise-adapted, or an unusual balance of both, Formoso and co-authors focused on the oversized pectoral girdle. They studied a fossil Plotosaurus, a type of mosasaur, at the Natural History Museum of Los Angeles County. In addition, they used measurements of mosasaur pectoral girdles published in other studies.

They determined that the mosasaurs' unusually large and low-placed pectoral girdle supported large muscle attachments. In addition, says Habib, asymmetry in the bone structure is a telltale sign of the strong, inward pull-down motion called adduction. These analyses suggest that mosasaurs used their forelimbs to swim, breast-stroke style, adding powerful bursts of propulsion to their ability to cruise.

The team continues to model bone structure, morphology, measurements, and fluid dynamics such as drag to learn exactly how, and how fast, these sea monsters swam. Along with applications to biomechanics, and even robotics, say Formoso and Habib, the study also sheds light on how evolution and ecosystems are affected by fluid dynamics.

Formoso points out that it's a challenge to study kinematics on extinct animals, considering that the subjects are missing flesh, skin, and many bones. But one thing is nearly certain, she says. "Mosasaurs swam unlike anything else

Management of HIV according to Ayurveda

Management of HIV according to Ayurveda

It is estimated that total 23 million people worldwide are having HIV infection and of which over 8.1 million people have developed AIDS. India is having the largest number of HIV infected cases in South Asia. The situation is going to be worse in the coming years. The role of traditional, complementary and alternative health care is rapidly changing in the world climate. People with HIV often consult with Ayurvedic practitioners to help improve their overall health. Ayurvedic medicine does not cure HIV infection. Many people, however believe that it has helped them improve their overall energy levels, improve their immune system, help fight off the HIV infections or deal with the side effects of antiviral therapy. Ayurveda believe that the body uses three doshas or types of energy.

Vatta, the energy of movement 

Pitta, the energy of digestion and metabolism

Kapha, the energy of lubrication 

According to Ayurveda the AIDS disease may be correlated with “Kshaya’ or “Ojakshaya meaning loss of energy. The symptoms and causative factors treatment for the latter are found mentioned in many ancient ayurvedic tests like, Charakha Samhita, Bhavaprakasha, Vaidyachintamani and Chakradatta etc, Shosha is another condition, which results from loss of energy that is similar to AIDS.

AYURVEDIC TREATMENT FOR HIV/ AIDS

The first step to stem the disease is to ensure a good and healthy atmosphere for the patient. He should be surrounded by well meaning friends and relatives who must affirm that the disease state is totally curable. Nothing negative should be discussed before the patient.

The patient should be given nourishing food which is easily digestible. He should be encouraged to do easy exercise which does not strain his fragile health. He should be kept engaged in fruitful activities which strengthen the good tendencies inherent in him.

Initially, the patient is given tonics and rejuvenators (Rasayanas) to boost immunity levels and to strengthen the system and stimulate appetite.

After gaining some strength, shodhana (elimination) techniques are used to expel toxins from the body through enemas, purgation and emesis. The medications administered at this stage are not hard or drastic, but soft, ghee-based so that the patient withstands them with ease.

Secondly the blood is purified with appropriate medications. Liver corrective measures also play an important role.

A strengthening diet along with medicated ghee preparations and soups is recommended. But spicy, oily and acidic foods are to be avoided. A little alcohol is recommended as anupana (carrier) to aid the digestive process, and also remove blockages in the flow of Rasadi dhatus, i.e. srothorodha.

Patient is advised to do regular exercise. If the patient is incapable of exercising or running due to weakness, then steaming (swedanam) is also recommended. reason behind this is 'Heated blood is said to weaken, and even destroy, the virus in some cases'.

Experience has shown that certain herbo-mineral compounds prepared as per the formulae prescribed by sages like Agasthya, Charaka, Sarangadhara and others for the treatment of Kshaya have brought about significant results in improving the condition of AIDS patients. The Rasayana and Vajikara effects of the these medicines are good for the patients.

Some of the propritery ayurvedic medicines achieving good improvement in the quality of life of patients include 'Chyavanprash', 'Raktavardhak' for Immunity building and 'Sookshma Triphla tabs' to keep away the the infection.

HIV positive no more a death sentence

HIV positive no more a death sentence

Advances in care over the last 30 years have helped transform HIV from a fatal disease into a chronic, manageable condition for many people. There is currently no cure but many clinical studies are dedicated to researching a cure. Where in one place research of antiretroviral therapy has proved as a milestone that has changed lives of millions providing them a normal life by maintain the virus at controlled levels. Progress in treatment has been transformative, but significant gaps in care still remain. 

Functional cure research

Progress towards creating a ‘functional cure’ focuses not on the elimination of HIV from the body, but rather on reducing the virus to a level that is undetectable; where the person no longer needs to take HIV-related medication, nor has any risk of progressing to AIDS or transmitting the virus. 

This can more precisely be described as a level of ‘remission’. Some advisory bodies have further suggested that this term be prioritised over calling it a ‘cure’, as suppressing viral replication still leaves traces of dormant HIV in the body which have the potential to re-emerge. Early antiretroviral treatment (ART), which is initiated close to the time-point of primary infection, certainly does not cure HIV, but there has been some success in individuals achieving temporary and long-term remission through this strategy. These people are called post-treatment controllers.  

In a 2012 study, 14 French people living with HIV known as the ‘Visconti cohort’, started taking ART within 10 weeks of infection. After three years of medication, they stopped taking treatment, which would normally result in HIV re-emerging.8 Remarkably, they maintained low levels of HIV in their systems for an average of seven years before a recurrence of the virus emerged.

The 2018 ‘Control of HIV After Antiretroviral Medication Pause’ (CHAMP) study yielded similar results – some 13% of those treated in early infection were considered post-treatment controller

Sterilizing cure research

Unlike a functional cure, a ‘sterilizing cure’ hopes to eradicate HIV from the body by measurably eliminating cells from latent reservoirs. This has proved a very difficult challenge for scientists, who believe it may be unattainable in most people living with HIV. 

The Berlin Patient

Timothy Brown – also known as the ‘Berlin Patient’ – is the only documented case of a person living with HIV to have been successfully ‘cured’. Through a combination of chemotherapy to destroy most of Brown’s HIV-infected immune cells and two bone marrow transplants to treat leukaemia, the treatment also seemed to have removed all traces of HIV in Brown’s body.

In selecting a stem cell donor, Brown’s doctors deliberately sought out someone with a rare HIV-resistant genetic mutation, whose CD4 cells had a resistance to the CCR5 co-receptor. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells. Individuals with a specific mutation on the CCR5 (CCR5-delta32) are known to be naturally resistant to many HIV-1 strains because it renders deficient this co-receptor needed to inject HIV into the cell.

Brown continued to receive immunosuppressive treatment to prevent the rejection of these new stem cells for 38 months, after which his viral load tests confirmed that this treatment had effected a successful ‘sterilising cure’.

The procedure is considered very dangerous, and is unfeasible as an option for other people living with HIV. Several attempts to repeat this ‘cure’ in people with HIV who received bone marrow transplants have failed, and many of the cures currently being investigated are potentially toxic or risky, which could make clinical trials.

Although there are several approaches that could eventually bring a functional HIV cure, there are still some challenges ahead. One of the biggest concerns around any HIV treatments is the virus’ ability to quickly mutate and develop resistance, and for many of these new approaches there is still no data on whether the virus will be able to become resistant.

Extraordinary progress has been made in HIV since the epidemic emerged 37 years ago, but significant challenges still remain ahead of us. Gilead is strongly committed to driving the next generation of treatment, prevention, and cure strategy innovations that will continue changing the rajectory of the HIV epidemic by transforming care and improving overall outcomes for all people living with or at risk of HIV.