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Coronavirus study shows more deaths, no benefit from Trump's drug treatment suggestion

Researchers did not track side effects, but noted a hint that hydroxychloroquine might have damaged other organs, too.




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Robbers shot, injure woman at ATM, made off with cash

LAHORE: Robbers shot at and injured a woman at an ATM and made off with cash from her in the Model Town police limits Friday. The robbers intercepted the woman and demanded cash and on resistance,...

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Kim Jong-un Did Not Have Heart Treatment, Say Spies

The National Intelligence Service here said Wednesday that North Korean leader Kim Jong-un did not have any heart treatment as widely rumored before he resurfaced last week.In a closed-door briefing to lawmakers, the NIS said Kim is believed to have conducted state affairs even when he was out of th...




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Japan approves remdesivir as treatment for Covid-19 patients

TOKYO: Japan on Thursday approved Gilead Sciences Inc’s remdesivir as a treatment for Covid-19, making it the country’s first officially authorised drug to tackle the coronavirus disease.

Japan reached the decision just three days after the US drugmaker filed for fast-track approval for the treatment.

“There has so far been no coronavirus medicine available here so it is a significant step for us to approve this drug,” a Japanese health ministry official said at a press briefing. Remdesivir will be given to patients with severe Covid-19 symptoms, he added.

With no other approved treatments for Covid-19, interest in the drug is growing around the world. Administered by intravenous infusion, it was granted authorisation last week by the US Food and Drug Administration for emergency use for the disease caused by the novel coronavirus.

Gilead says the drug has improved outcomes for people suffering from the respiratory disease and has provided data suggesting it works better when given in the early stages of infection.

Japan, with just over 16,000 infections and under 800 deaths, has recorded fewer cases than other major industrialised nations.

However, a steady rise in cases has put pressure on medical facilities in some parts of the country, and a drug that helps patients recover more quickly could help in freeing up hospital beds.

A trial performed by the US Institutes of Health (NIH) showed the drug cut hospital stays by 31 per cent compared with a placebo treatment, although it did not significantly improve survival.

On Monday, Japanese Prime Minister Shinzo Abe extended a month-long state of emergency until the end of May in an attempt to slow the spread of the coronavirus.

Japan as yet does not know when it will get its first doses of remdesivir or how much, the health ministry official said.

Gilead on Tuesday said it was in discussion with several companies, including generic drugmakers in India and Pakistan to produce remdesivir in large quantities.

Remdesivir, which previously failed as a treatment for Ebola, is designed to disable the ability by which some viruses make copies of themselves inside infected cells.

Published in Dawn, May 8th, 2020




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Belgian, US scientists look to llamas in search for Covid-19 treatment

A llama called Winter could prove useful in the hunt for a treatment for Covid-19, according to US and Belgian scientists who have identified a tiny particle that appears to block the new coronavirus.

The scientists, from Belgium’s VIB-UGent center for medical biotechnology and the University of Texas at Austin, published research on Tuesday in the journal Cell, with the llama in Belgium central to their studies.

The group began four years ago looking into antibodies that might counter the Sars virus, which spread in 2003, and the Mers virus that flared up in 2012.

“The work was a side project in 2016. We thought maybe this was interesting,” said Xavier Saelens, joint leader of the Belgian part of the collaboration. “Then the new virus came and it became potentially more crucial, more important.”

Winter, the llama, was given safe versions of the Sars and Mers viruses and samples of its blood were later taken.

Llamas and other members of camel family are distinct in creating standard antibodies and smaller antibodies, with which scientists can more easily work.

The Belgian part of the research team, also led by Bert Schepens, identified fragments of the smaller antibodies, known as nanobodies, to see which bound most strongly to the virus.

Saelens describes the new coronavirus as the cousin of the Sars virus. Both have a corona, or crown, shape with protein spikes, onto which an antibody can latch.

The team intend to begin tests on animals, with a view to allowing trials with humans to begin by the end of the year. Saelens said negotiations were under way with pharmaceutical companies.

The research is not the first into nanobodies derived from camels or llamas. French group Sanofi paid 3.9 billion euros ($4.23 billion) in 2018 to buy Ghent-based nanobody specialist company Ablynx.




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ADB, Maxwealth Financial Leasing Sign Loan Deal to Improve Wastewater Treatment in PRC

ADB today signed a $60 million loan deal (in Chinese Yuan equivalent) with Maxwealth Financial Leasing Co., Ltd. to improve municipal and industrial wastewater treatment capacity and standards in the People’s Republic of China...




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ATMISP7

ATMISP7




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ATmega640/1280/1281/2560/2561 - Complete Datasheet

ATmega640/1280/1281/2560/2561 - Complete Datasheet




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ATM90E25

ATM90E25




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ATMX150RHA Power-supply sequencing

ATMX150RHA Power-supply sequencing




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JBL® Introduces Its First Soundbar with Dolby Atmos, the JBL Bar 9.1 True Wireless Surround Sound

CES 2020, LAS VEGAS – JANUARY 6, 2020 – Movie lovers, listen up. The latest addition to JBL’s popular Bar Series brings the audio experience of a movie theater to your living room. The JBL Bar 9.1 creates true wireless surround sound with crowd-pleasing...




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HARMAN in new partnership on digital therapeutic autism treatment




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Coronavirus treatment: What drugs could work and when can we get them?

To fight the new coronavirus, researchers are investigating more than 60 drugs, including remdesivir and hydroxychloroquine and brand new ones. Here’s a breakdown of progress so far





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Common Treatment May Not Help Seniors With Underactive Thyroid

Title: Common Treatment May Not Help Seniors With Underactive Thyroid
Category: Health News
Created: 5/4/2020 12:00:00 AM
Last Editorial Review: 5/5/2020 12:00:00 AM




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New Treatment for Bleeding Disorder Approved

Title: New Treatment for Bleeding Disorder Approved
Category: Health News
Created: 5/1/2007 2:00:00 AM
Last Editorial Review: 5/1/2007 12:00:00 AM




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Cancer Risk After Kidney Transplant Unaffected by Type of Drug Treatment

Title: Cancer Risk After Kidney Transplant Unaffected by Type of Drug Treatment
Category: Health News
Created: 4/29/2010 4:10:00 PM
Last Editorial Review: 4/30/2010 12:00:00 AM




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Girls With Autism May Need Different Treatments Than Boys

Title: Girls With Autism May Need Different Treatments Than Boys
Category: Health News
Created: 5/1/2013 12:36:00 PM
Last Editorial Review: 5/2/2013 12:00:00 AM




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FDA Warns Against Bogus Autism Treatments

Title: FDA Warns Against Bogus Autism Treatments
Category: Health News
Created: 4/25/2014 2:36:00 PM
Last Editorial Review: 4/28/2014 12:00:00 AM




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Complications Fairly Common, Costly With Some Kidney Stone Treatments

Title: Complications Fairly Common, Costly With Some Kidney Stone Treatments
Category: Health News
Created: 4/29/2014 9:35:00 AM
Last Editorial Review: 4/29/2014 12:00:00 AM




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Complications Common, Costly With Some Kidney Stone Treatments

Title: Complications Common, Costly With Some Kidney Stone Treatments
Category: Health News
Created: 4/29/2014 12:35:00 PM
Last Editorial Review: 4/30/2014 12:00:00 AM




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Gene Discoveries Could Help Rheumatoid Arthritis Treatment

Title: Gene Discoveries Could Help Rheumatoid Arthritis Treatment
Category: Health News
Created: 4/28/2015 12:00:00 AM
Last Editorial Review: 4/29/2015 12:00:00 AM




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Brain Research Fuels New Migraine Treatments

Title: Brain Research Fuels New Migraine Treatments
Category: Health News
Created: 5/3/2017 12:00:00 AM
Last Editorial Review: 5/3/2017 12:00:00 AM




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VA Clinic Investigating Unsanitary Treatment Room

Title: VA Clinic Investigating Unsanitary Treatment Room
Category: Health News
Created: 5/1/2018 12:00:00 AM
Last Editorial Review: 5/1/2018 12:00:00 AM




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Speed of Heart Attack Treatment Can Vary by State

Title: Speed of Heart Attack Treatment Can Vary by State
Category: Health News
Created: 5/1/2018 12:00:00 AM
Last Editorial Review: 5/2/2018 12:00:00 AM




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Earlier Mammograms May Mean Less Need for Aggressive Treatments

Title: Earlier Mammograms May Mean Less Need for Aggressive Treatments
Category: Health News
Created: 5/3/2018 12:00:00 AM
Last Editorial Review: 5/4/2018 12:00:00 AM




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Treatments Targeting Social Behavior Hormone Show Promise With Autism

Title: Treatments Targeting Social Behavior Hormone Show Promise With Autism
Category: Health News
Created: 5/1/2019 12:00:00 AM
Last Editorial Review: 5/2/2019 12:00:00 AM




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Red Tape Means Many Cancer Patients Get Radiation Treatments Late

Title: Red Tape Means Many Cancer Patients Get Radiation Treatments Late
Category: Health News
Created: 5/2/2019 12:00:00 AM
Last Editorial Review: 5/3/2019 12:00:00 AM




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Pepcid Ingredient Famotidine Being Tested as COVID-19 Treatment

Title: Pepcid Ingredient Famotidine Being Tested as COVID-19 Treatment
Category: Health News
Created: 4/27/2020 12:00:00 AM
Last Editorial Review: 4/27/2020 12:00:00 AM




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Costs Would Keep 1 in 7 Americans From Seeking COVID-19 Treatment

Title: Costs Would Keep 1 in 7 Americans From Seeking COVID-19 Treatment
Category: Health News
Created: 4/28/2020 12:00:00 AM
Last Editorial Review: 4/29/2020 12:00:00 AM




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Blood Count May Offer Clues to Treatment of COVID-19: Study

Title: Blood Count May Offer Clues to Treatment of COVID-19: Study
Category: Health News
Created: 5/1/2020 12:00:00 AM
Last Editorial Review: 5/1/2020 12:00:00 AM




atm

Ear Infection Home Treatment

Title: Ear Infection Home Treatment
Category: Diseases and Conditions
Created: 1/25/2018 12:00:00 AM
Last Editorial Review: 3/21/2020 12:00:00 AM




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Researchers Move Toward Once-Yearly Treatment for HIV

Title: Researchers Move Toward Once-Yearly Treatment for HIV
Category: Health News
Created: 4/30/2020 12:00:00 AM
Last Editorial Review: 5/1/2020 12:00:00 AM




atm

Sinus Headache Pain, Symptoms, Treatments, Remedies, and Cures

Title: Sinus Headache Pain, Symptoms, Treatments, Remedies, and Cures
Category: Diseases and Conditions
Created: 1/11/2010 12:00:00 AM
Last Editorial Review: 1/13/2020 12:00:00 AM




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First Treatment for Peanut Allergy Approved by FDA

Title: First Treatment for Peanut Allergy Approved by FDA
Category: Health News
Created: 2/3/2020 12:00:00 AM
Last Editorial Review: 2/3/2020 12:00:00 AM




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First Drug Approved for Treatment of Peanut Allergy in Children

Title: First Drug Approved for Treatment of Peanut Allergy in Children
Category: Health News
Created: 2/3/2020 12:00:00 AM
Last Editorial Review: 2/4/2020 12:00:00 AM




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Could AI Help Doctors Map Out Treatments for Brain Cancers?

Title: Could AI Help Doctors Map Out Treatments for Brain Cancers?
Category: Health News
Created: 4/24/2020 12:00:00 AM
Last Editorial Review: 4/27/2020 12:00:00 AM




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Genomics, Morphoproteomics, and Treatment Patterns of Patients with Alveolar Soft Part Sarcoma and Response to Multiple Experimental Therapies

Overexpression of transcription factor 3 in alveolar soft part sarcoma(ASPS) results in upregulation of cell proliferation pathways. No standard treatment algorithm exists for ASPS; multikinase inhibitors[tyrosine kinase inhibitor (TKI)] and immune checkpoint inhibitors (ICI) have shown clinical benefit. To date, no studies have reported on management strategies or sequencing of therapy. We evaluated ASPS treatment patterns and responses in an experimental therapeutics clinic. Genomic and morphoproteomic analysis was performed to further elucidate novel targets. We retrospectively reviewed patients with ASPS treated on clinical trials. Demographic and clinical next-generation sequencing (NGS) profiles were collected. AACR GENIE database was queried to further evaluate aberrations in ASPS. Morphoproteomic analysis was carried out to better define the biology of ASPS with integration of genomic and proteomic findings. Eleven patients with ASPS were identified; 7 received NGS testing and mutations in CDKN2A (n = 1) and hepatocyte growth factor (n = 1) were present. Ten patients were treated with TKIs with stable disease as best response and 4 patients with ICI (three partial responses). Within GENIE, 20 patients were identified harboring 3 called pathogenic mutations. Tumor mutation burden was low in all samples. Morphoproteomic analysis confirmed the expression of phosphorylated c-Met. In addition, fatty acid synthase and phosphorylated-STAT3 were detected in tumor cell cytoplasm and nuclei. Patients with ASPS have a quiescent genome and derive clinical benefit from VEGF-targeting TKIs. Morphoproteomic analysis has provided both additional correlative pathways and angiogenic mechanisms that are targetable for patients with ASPS. Our study suggests that sequential therapy with TKIs and immune checkpoint inhibitors is a reasonable management strategy.




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New Host-Directed Therapeutics for the Treatment of Clostridioides difficile Infection

ABSTRACT

Frequent and excessive use of antibiotics primes patients to Clostridioides difficile infection (CDI), which leads to fatal pseudomembranous colitis, with limited treatment options. In earlier reports, we used a drug repurposing strategy and identified amoxapine (an antidepressant), doxapram (a breathing stimulant), and trifluoperazine (an antipsychotic), which provided significant protection to mice against lethal infections with several pathogens, including C. difficile. However, the mechanisms of action of these drugs were not known. Here, we provide evidence that all three drugs offered protection against experimental CDI by reducing bacterial burden and toxin levels, although the drugs were neither bacteriostatic nor bactericidal in nature and had minimal impact on the composition of the microbiota. Drug-mediated protection was dependent on the presence of the microbiota, implicating its role in evoking host defenses that promoted protective immunity. By utilizing transcriptome sequencing (RNA-seq), we identified that each drug increased expression of several innate immune response-related genes, including those involved in the recruitment of neutrophils, the production of interleukin 33 (IL-33), and the IL-22 signaling pathway. The RNA-seq data on selected genes were confirmed by quantitative real-time PCR (qRT-PCR) and protein assays. Focusing on amoxapine, which had the best anti-CDI outcome, we demonstrated that neutralization of IL-33 or depletion of neutrophils resulted in loss of drug efficacy. Overall, our lead drugs promote disease alleviation and survival in the murine model through activation of IL-33 and by clearing the pathogen through host defense mechanisms that critically include an early influx of neutrophils.

IMPORTANCE Clostridioides difficile is a spore-forming anaerobic bacterium and the leading cause of antibiotic-associated colitis. With few therapeutic options and high rates of disease recurrence, the need to develop new treatment options is urgent. Prior studies utilizing a repurposing approach identified three nonantibiotic Food and Drug Administration-approved drugs, amoxapine, doxapram, and trifluoperazine, with efficacy against a broad range of human pathogens; however, the protective mechanisms remained unknown. Here, we identified mechanisms leading to drug efficacy in a murine model of lethal C. difficile infection (CDI), advancing our understanding of the role of these drugs in infectious disease pathogenesis that center on host immune responses to C. difficile. Overall, these studies highlight the crucial involvement of innate immune responses, as well as the importance of immunomodulation as a potential therapeutic option to combat CDI.




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Activity and Metabolic Versatility of Complete Ammonia Oxidizers in Full-Scale Wastewater Treatment Systems

ABSTRACT

The recent discovery of complete ammonia oxidizers (comammox) contradicts the paradigm that chemolithoautotrophic nitrification is always catalyzed by two different microorganisms. However, our knowledge of the survival strategies of comammox in complex ecosystems, such as full-scale wastewater treatment plants (WWTPs), remains limited. Analyses of genomes and in situ transcriptomes of four comammox organisms from two full-scale WWTPs revealed that comammox were active and showed a surprisingly high metabolic versatility. A gene cluster for the utilization of urea and a gene encoding cyanase suggest that comammox may use diverse organic nitrogen compounds in addition to free ammonia as the substrates. The comammox organisms also encoded the genomic potential for multiple alternative energy metabolisms, including respiration with hydrogen, formate, and sulfite as electron donors. Pathways for the biosynthesis and degradation of polyphosphate, glycogen, and polyhydroxyalkanoates as intracellular storage compounds likely help comammox survive unfavorable conditions and facilitate switches between lifestyles in fluctuating environments. One of the comammox strains acquired from the anaerobic tank encoded and transcribed genes involved in homoacetate fermentation or in the utilization of exogenous acetate, both pathways being unexpected in a nitrifying bacterium. Surprisingly, this strain also encoded a respiratory nitrate reductase which has not yet been found in any other Nitrospira genome and might confer a selective advantage to this strain over other Nitrospira strains in anoxic conditions.

IMPORTANCE The discovery of comammox in the genus Nitrospira changes our perception of nitrification. However, genomes of comammox organisms have not been acquired from full-scale WWTPs, and very little is known about their survival strategies and potential metabolisms in complex wastewater treatment systems. Here, four comammox metagenome-assembled genomes and metatranscriptomic data sets were retrieved from two full-scale WWTPs. Their impressive and—among nitrifiers—unsurpassed ecophysiological versatility could make comammox Nitrospira an interesting target for optimizing nitrification in current and future bioreactor configurations.




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Obstructive sleep apnoea treatment and blood pressure: which phenotypes predict a response? A systematic review and meta-analysis

The treatment for obstructive sleep apnoea (OSA) with continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs) is associated with blood pressure (BP) reduction; however, the overall effect is modest. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effect of such treatments on BP was to identify subgroups of patients who respond best to treatment.

The article search was performed in three different databases with specific search terms and selection criteria. From 2289 articles, we included 68 RCTs that compared CPAP or MADs with either passive or active treatment. When all the studies were pooled together, CPAP and MADs were associated with a mean BP reduction of –2.09 (95% CI –2.78– –1.40) mmHg for systolic BP and –1.92 (95% CI –2.40– –1.43) mmHg for diastolic BP and –1.27 (95% CI –2.34– –0.20) mmHg for systolic BP and –1.11 (95% CI –1.82– –0.41) mmHg for diastolic BP, respectively. The subgroups of patients who showed a greater response were those aged <60 years (systolic BP –2.93 mmHg), with uncontrolled BP at baseline (systolic BP –4.14 mmHg) and with severe oxygen desaturations (minimum arterial oxygen saturation measured by pulse oximetry <77%) at baseline (24-h systolic BP –7.57 mmHg).

Although this meta-analysis shows that the expected reduction of BP by CPAP/MADs is modest, it identifies specific characteristics that may predict a pronounced benefit from CPAP in terms of BP control. These findings should be interpreted with caution; however, they are particularly important in identifying potential phenotypes associated with BP reduction in patients treated for OSA.




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Nickel Allergic Contact Dermatitis: Identification, Treatment, and Prevention

Nickel is a ubiquitous metal added to jewelry and metallic substances for its hardening properties and because it is inexpensive. Estimates suggest that at least 1.1 million children in the United States are sensitized to nickel. Nickel allergic contact dermatitis (Ni-ACD) is the most common cutaneous delayed-type hypersensitivity reaction worldwide. The incidence among children tested has almost quadrupled over the past 3 decades. The associated morbidities include itch, discomfort, school absence, and reduced quality of life. In adulthood, individuals with Ni-ACD may have severe disabling hand eczema. The increasing rate of Ni-ACD in children has been postulated to result from early and frequent exposure to metals with high amounts of nickel release (eg, as occurs with ear piercing or with products used daily in childhood such as toys, belt buckles, and electronics).

To reduce exposure to metal sources with high nickel release by prolonged and direct contact with human skin, Denmark and the European Union legislated a directive several decades ago with the goal of reducing high nickel release and the incidence of Ni-ACD. Since then, there has been a global reduction in incidence of Ni-ACD in population-based studies of adults and studies of children and young adults being tested for allergic contact dermatitis. These data point to nickel exposure as a trigger for elicitation of Ni-ACD and, further, provide evidence that legislation can have a favorable effect on the economic and medical health of a population.

This policy statement reviews the epidemiology, history, and appearances of Ni-ACD. Examples of sources of high nickel release are discussed to highlight how difficult it is to avoid this metal in modern daily lives. Treatments are outlined, and avoidance strategies are presented. Long-term epidemiological interventions are addressed. Advocacy for smarter nickel use is reviewed. The American Academy of Pediatrics supports US legislation that advances safety standards (as modeled by the European Union) that protect children from early and prolonged skin exposure to high–nickel-releasing items. Our final aim for this article is to aid the pediatric community in developing nickel-avoidance strategies on both individual and global levels.




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Early and Often: The Need for Comprehensive Discussion of Treatment-Induced Cancer Late Effects




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A minor population of macrophage-tropic HIV-1 variants is identified in recrudescing viremia following analytic treatment interruption [Microbiology]

HIV-1 persists in cellular reservoirs that can reignite viremia if antiretroviral therapy (ART) is interrupted. Therefore, insight into the nature of those reservoirs may be revealed from the composition of recrudescing viremia following treatment cessation. A minor population of macrophage-tropic (M-tropic) viruses was identified in a library of recombinant viruses...




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Aerosol-photolysis interaction reduces particulate matter during wintertime haze events [Earth, Atmospheric, and Planetary Sciences]

Aerosol–radiation interaction (ARI) plays a significant role in the accumulation of fine particulate matter (PM2.5) by stabilizing the planetary boundary layer and thus deteriorating air quality during haze events. However, modification of photolysis by aerosol scattering or absorbing solar radiation (aerosol–photolysis interaction or API) alters the atmospheric oxidizing capacity, decreases...




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Large H2O solubility in dense silica and its implications for the interiors of water-rich planets [Earth, Atmospheric, and Planetary Sciences]

Sub-Neptunes are common among the discovered exoplanets. However, lack of knowledge on the state of matter in H2O-rich setting at high pressures and temperatures (P−T) places important limitations on our understanding of this planet type. We have conducted experiments for reactions between SiO2 and H2O as archetypal materials for rock...




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Inhaled Corticosteroid Treatment in Chronic Obstructive Pulmonary Disease (COPD): Boon or Bane?

Inhaled corticosteroid (ICS)–based therapy is often used for patients with chronic obstructive pulmonary disease (COPD). However, this approach is under scrutiny because of ICS overuse in patients for whom it is not recommended and because of concerns about adverse events, particularly pneumonia, with long-term ICS use. Evidence suggests ICS may be beneficial in specific patients, namely, those with high blood eosinophil counts (eg, ≥300 cells/µL) or who are at a high risk of exacerbations. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 ABCD assessment tool, these patients belong in group D. For these patients, recommended initial treatment includes ICS in combination with long-acting β2-agonists (LABAs) when blood eosinophil counts are ≥300 cells/µL or LABA + long-acting muscarinic antagonist (LAMA) when patients are highly symptomatic, that is, with greater dyspnea and/or exercise limitation. Follow-up treatments for patients with persistent dyspnea and/or exacerbations may include LABA + ICS, LABA + LAMA, or LABA + LAMA + ICS, with use of ICS being guided by blood eosinophil counts. In this review, differences in the inflammatory mechanism underlying COPD and asthma and the role of ICS treatment in COPD are summarized. Furthermore, findings from recent clinical trials where use of ICS-based dual or triple therapy in COPD was compared with LABA + LAMA therapy and trials in which ICS withdrawal was evaluated in patients with COPD are reviewed. Finally, a step-by-step guide for ICS withdrawal in patients who are unlikely to benefit from this treatment is proposed. A video of the author discussing the overall takeaway of the review article could be downloaded from the link provided: https://www.youtube.com/watch?v=Uq7Sr5jqPDI.




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In vitro insulin treatment reverses changes elicited by nutrients in cellular metabolic processes that regulate food intake in fish [RESEARCH ARTICLE]

Ayelen M. Blanco, Juan I. Bertucci, Jose L. Soengas, and Suraj Unniappan

This research assessed the direct effects of insulin on nutrient-sensing mechanisms in the brain of rainbow trout (Oncorhynchus mykiss) using an in vitro approach. Cultured hypothalamus and hindbrain were exposed to 1 µmol l–1 insulin for 3 h, and signals involved in appetite regulation and nutrient-sensing mechanisms were measured. Additionally, the involvement of the phosphatidylinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in the actions of insulin was studied by using the inhibitor wortmannin. Treatment with insulin alone did not elicit many changes in the appetite regulators and nutrient-sensing-related genes and enzymes tested in the hypothalamus and hindbrain. However, we found that, when insulin and nutrients were added together, insulin reversed most of the effects exerted by nutrients alone, suggesting that insulin changes responsiveness to nutrients at the central level. Effects reversed by insulin included expression levels of genes related to the sensing of both glucose (slc2a2, slc5a1, gck, pck1, pklr, g6pcb, gys1, tas1r3 and nr1h3 in the hindbrain, and slc2a2, pklr and pck1 in the hypothalamus) and fatty acid (cd36 in the hindbrain, and cd36 and acly in the hypothalamus). Nutrient-induced changes in the activity of Acly and Cpt-1 in the hindbrain and of Pepck, Acly, Fas and Hoad in the hypothalamus were also reversed by insulin. Most of the insulin effects disappeared in the presence of wortmannin, suggesting the PI3K/Akt pathway is a mediator of the effects of insulin reported here. This study adds new information to our knowledge of the mechanisms regulating nutrient sensing in fish.




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Neurologic syndromes related to anti-GAD65: Clinical and serologic response to treatment

In the article "Neurologic syndromes related to anti-GAD65: Clinical and serologic response to treatment" by Muñoz-Lopetegi et al.,1 published online March 2, 2020, the y-axis label for figure 5’s right graph should be "CSF anti-GAD65 concentration (IU/mL)." The editorial office regrets the error.




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Monoclonal antibody treatment during pregnancy and/or lactation in women with MS or neuromyelitis optica spectrum disorder

Objective

To assess possible adverse effects on breastfed infants of mothers receiving monoclonal antibodies (MAbs) during pregnancy and/or lactation.

Methods

We identified 23 patients from the German Multiple Sclerosis and Pregnancy Registry (DMSKW) who received MAbs (17 natalizumab and 6 anti-CD20) during lactation. Thirteen were already exposed to natalizumab during the third trimester of pregnancy, and 1 received ocrelizumab during pregnancy. Data were obtained from standardized, telephone-administered questionnaires completed by the mother during pregnancy and at 1, 3, 6, and 12 months postpartum. Natalizumab concentration in mother’s milk was analyzed in 3 patients and natalizumab serum concentration in 2 of these patients and their breastfed infants.

Results

We did not observe a negative impact on infant health and development attributable to breast milk exposure after a median follow-up of 1 year. Infants exposed to natalizumab during the third trimester had a lower birth weight and more hospitalizations in the first year of life. The concentration of natalizumab in breast milk and serum of infants was low; B cells normal in infants breastfed under anti-CD20.

Conclusion

More data on the effect of Mab exposure during pregnancy are needed. Otherwise, our data suggest that treatment with natalizumab, ocrelizumab, or rituximab during lactation might be safe for breastfed infants.