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Sunday, January 27, 2019

Muscle memory discovery ends ‘use it or lose it’ dogma


The old adage “use it or lose it” tells us: if you stop using your muscles, they’ll shrink. Until recently, scientists thought this meant that nuclei—the cell control centers that build and maintain muscle fibers—are also lost to sloth.
But according to a review published in Frontiers in Physiology, modern lab techniques now allow us to see that nuclei gained during training persist even when  shrink due to disuse or start to break down. These residual ‘myonuclei’ allow more and faster growth when muscles are retrained—suggesting that we can “bank”  growth potential in our teens to prevent frailty in old age. It also suggests that athletes who cheat and grow their muscles with steroids may go undetected.
Our biggest cells are in our muscles, and they’re all fused together
Syncytium. Sounds like a neo-noir comic book series. It’s actually a special type of tissue in your body, where  are fused together extra close—so close, that they behave a like a giant single cell.
“Heart, bone and even placenta are built on these networks of cells,” says Lawrence Schwartz, Professor of Biology at the University of Massachusetts. “But by far our biggest cells—and biggest syncytia—are our muscles.” Like the Sin City series, it appeared at first that everything was black and white with syncytia.
“Muscle growth is accompanied by the addition of new nuclei from  to help meet the enhanced synthetic demands of larger muscle cells,” explains Schwartz. “This led to the assumption that a given nucleus controls a defined volume of cytoplasm—so that when a muscle shrinks or ‘atrophies’ due to disuse or disease, the number of myonuclei decreases.”
A muscle can gain nuclei, but never loses them
This assumption long seemed valid, with many researchers reporting the presence of disintegrating nuclei in muscle tissue during atrophy induced by inactivity, injury or paralysis. But modern cell-type-specific dyes and genetic markers have shown that the dying nuclei other researchers had detected were in fact inflammatory and other cells recruited to atrophic muscle.
The new evidence paints a very different picture of muscle syncytium.
“Two independent studies—one in rodents and the other in insects—have demonstrated that nuclei are not lost from atrophying muscle fibers, and even remain after muscle death has been initiated.”
This suggest that once a nucleus has been acquired by a muscle fiber, it belongs to the muscle syncytium—probably for life. But Schwartz, for one, is unsurprised by the new findings.
“Muscles get damaged during extreme exercise, and often have to weather changes in  and other environmental factors that lead to atrophy. They wouldn’t last very long giving up their  in response to every one of these insults.”
“Use it or lose it—until you use it again”
Since myonuclei are the synthetic engine of , retaining them should enable muscle size and strength to recover more quickly after one of these insults, and help to explain the phenomenon of ‘muscle memory’.
“It is well documented in the field of exercise physiology that it is far easier to reacquire a certain level of muscle fitness through exercise than it was to achieve it the first place, even if there has been a long intervening period of detraining. In other word, the phrase “use it or lose it” is might be more accurately articulated as ‘use it or lose it, until you work at it again’.”
As such, the findings have important implications beyond understanding muscle biology.
“Informing public health policy, the discovery that myonuclei are retained indefinitely emphasizes the importance of exercise in early life. During adolescence muscle growth is enhanced by hormones, nutrition and a robust pool of stem cells, making it an ideal period for individuals to “bank” myonuclei that could be drawn upon to remain active in old age.”
The findings also support frequent drugs testing for competitive athletes, with permanent bans for proven steroid cheats since they will benefit from the steroids long after their use has ended.
“Anabolic steroids produce a permanent increase in users’ capacity for muscle development. In keeping with this, studies show that mice given testosterone acquire new myonuclei that persist long after the steroid use ends.”

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More information: Lawrence M. Schwartz, Skeletal Muscles Do Not Undergo Apoptosis During Either Atrophy or Programmed Cell Death-Revisiting the Myonuclear Domain Hypothesis, Frontiers in Physiology(2019). DOI: 10.3389/fphys.2018.01887

Cerebrospinal fluid test to track tumor progression in some gliomas


A team of researchers from Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College used genetic testing of cells found in cerebrospinal fluid to track certain brain tumors. In their paper published in the journal Nature, the group describes tests they conducted with cancer patients and analysis of their cerebrospinal fluid, and what they found.
Doctors who treat patients with brain cancer face unique challenges when attempting to track tumor progression due to the difficulty of extracting tumor samples. Performing simple biopsies generally involves invasive and dangerous brain surgery. In this new effort, the researchers found that biopsies for some patients can be done via , a procedure in which fluid is removed from the spinal column and tested.
Many tumors, including those that form in the brain, shed cells into the body around them. Such cells often make their way into the bloodstream. Testing for these can offer information about the tumor. Brain tumors cell shedding, unfortunately, does not usually result in  entering the bloodstream due to the blood/brain barrier. But they do sometimes make their way into cerebrospinal fluid, the researchers found, where it is relatively easy to extract and test them. Testing involves conducting DNA sequencing on suspicious cells to see if they are normal body cells or tumor cells.
To find out if tumor cells in cerebrospinal fluid could be tested as a form of biopsy to track , the researchers collected samples from 85 adult brain . They report that they found tumor cells in 42 of the samples, suggesting the technique could be viable for some patients. They report also that some of the same patients also underwent brain surgery as part of biopsy collection, and the cells in their tumors matched exactly with tumor cells in their cerebrospinal fluid. They also found that those patients with larger tumors were more likely to have tumor cells in their cerebrospinal fluid. They note that they do not know why shed tumor cells did not enter the  for the other 43 patients.

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More information: Alexandra M. Miller et al. Tracking tumour evolution in glioma through liquid biopsies of cerebrospinal fluid, Nature (2019). DOI: 10.1038/s41586-019-0882-3

Suicidal Thoughts, Attempts Common With Atopic Dermatitis


Atopic dermatitis appears to put patients at higher risk for having suicidal thoughts and attempting suicide, a systematic review and meta-analysis found.
When compared with individuals who did not have atopic dermatitis, patients with the condition had a 36% greater chance of attempting suicide (pooled odds ratio 1.36, 95% CI 1.09-1.70), and they also had a 44% greater chance of having suicidal thoughts (pooled OR 1.44, 95% CI 1.25-1.65), reported April Armstrong, MD, MPH, of University of Southern California Keck School of Medicine in Los Angeles, and colleagues in JAMA Dermatology.
The skin condition is apparent, so patients with atopic dermatitis suffer from a number of psychosocial challenges. Previous reports have drawn associations between children with atopic dermatitis and poor academic performance versus other children. And adults with atopic dermatitis have fewer career opportunities and don’t do as well at work, the researchers noted.
Other findings have linked atopic dermatitis with depression and anxiety, the investigators highlighted. “However, the evidence for an association between [atopic dermatitis] and suicidality is inconclusive,” Armstrong’s group continued.
When a patient’s screening results point to suicidality, “the dermatology provider should send a referral to the patient’s primary care or mental health provider for follow-up care,” the investigators wrote. And when a patient admits to having a suicide plan, “this patient should be urgently referred to the emergency department for further assessment.”
Clinicians should also refer patients to resources like the suicide prevention hotline and even suicide awareness brochures in nonemergent cases, the study authors noted.
Armstrong and colleagues reviewed 15 studies conducted in Europe, Africa, North America, and Asia published over the past 20 years. Those investigations included more than 4.5 million patients. Among them, 310,681 had atopic dermatitis and 52.7% were female. All studies included were observation and examined suicidality in all forms. Case series or case reports were excluded.
Data from the analysis showed inconsistencies when it came to completed suicides in patients with atopic dermatitis, the investigators noted. For example, one study showed that when compared to control participants, there was a greater risk of completed suicide in patients with atopic dermatitis as the relative risk was 1.4 (95% CI 1.1-1.8). Another study showed no significant risk for complete suicides, with point estimates for hazard ratios less than 1. Overall, the pooled data did not show a clear increase in risk for completed suicides.
Studies also showed varying results for suicidal thoughts and attempts, with some indicated significant risk associated with atopic dermatitis across the board, whereas others only found increased risk for certain subgroups such as female children. But the pooled data did indicate a significant risk for suicidal thoughts and attempts associated with the skin condition.
“Despite these findings, there is a shortage of studies investigating subpopulations, and more studies are needed to better understand these associations,” the study authors wrote.
The data analysis was funded by the Southern California Clinical and Translational Science Institute and the National Center for Advancing Translational Science of the National Institutes of Health.
Armstrong disclosed relationships with AbbVie, Janssen, Lilly, Pfizer, UCB, Dermira, Ortho Dermatologics, Sanofi, Regeneron, Science 37, and Modernizing Medicine.

NHS to offer paid-for DNA tests if patients share data


People in England will be able to pay the NHS to sequence their genes on condition they share their data.
Those taking part in the planned scheme will be given a health report which can predict the risk of developing conditions like cancer or Alzheimer’s.
Health Secretary Matt Hancock says it will help develop treatments “that will benefit everyone in the future”.
But concerns have been raised over the plans by the chairwoman of the British Society for Genetic Medicine.
It is possible DNA tests could alert patients to issues in need of further investigation. All data would be shared with scientists anonymously.

‘Unlocking treatments’

Mr Hancock said: “While healthy people should not have this service free on the NHS, there are huge benefits to sequencing as many genomes as we can.
“Every genome sequenced moves us a step closer to unlocking life-saving treatments.”
The Department of Health said the project – which will be led by Genomic England, a company set up and owned by the NHS – is still in the development phase.
No detail has been provided on a launch date or how much the service would cost.
It follows the successful completion of the 100,000 Genomes Project in December 2018.
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What is the 100,000 Genome Project?

  • Launched in 2012, the project reached its goal in December 2018
  • About 85,000 people had their entire genetic code (genome) sequenced. But because cancer patients also had their tumour DNA mapped, the number of genomes totalled 100,000
  • One in four participants with rare diseases received a diagnosis for the first time
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But Dr Anneke Lucassen, the chairwoman of the British Society for Genetic Medicine, said: “The NHS has always been free at the point of delivery.
“It has the potential to create a two-tier system.”
And she warned: “You can use genetic code to confirm a clinical picture, but you can’t use it to predict what will happen in the future very accurately.”
Dr Lucassen said the government otherwise had good and sensible plans for genetic medicine, lauding its commitment to collecting research data.
Genomics needs large data sets, ideally shared internationally.
The government has now announced plans to sequence at least one million whole genomes within five years.
In addition to the paid-for DNA sequencing, the NHS routinely offers seriously ill children and adults with genetic conditions and cancer DNA analysis.
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Analysis

By Michelle Roberts, BBC health correspondent
This isn’t about looking for rare genetic diseases in people at very high risk. Those types of checks are already being offered for free to NHS patients.
The idea behind Matt Hancock’s latest announcement is getting data from the general population to help scientists better understand diseases and human genetics.
He wants healthy people to become “genomic volunteers” to help research.
From a sample of blood, experts can look for small changes or errors in our DNA – the genetic code of life.
The anonymised data will help them build a picture of the nation’s health and design life-saving new treatments.
Genomic volunteers would be able to pay to receive a personalised report into their own unique DNA profile.
But there are a few things people should realise before they consent:
  • DNA tests will not necessarily give a clear prediction or definitive result
  • Healthy people are unlikely to benefit directly from the testing
  • And tests can turn up findings that may need investigating
  • Volunteers may also be asked to take part in other research projects, depending on their test results
And there are still many unknowns:
  • How much it will cost?
  • Where will the testing be done?
  • How long will people have to wait for their results?
  • Could it affect my health insurance policy?

‘I predict a great revolution’: inside the struggle to define life


Paul Davies thinks combining physics and biology will reveal a pattern of information management
All the brain cells of life on Earth still cannot explain life on Earth. Its most intelligent species has uncovered the building blocks of matter, read countless genomes and watched spacetime quiver as black holes collide. It understands much of how living creatures work, but not how they came to be. There is no agreement, even, on what life is.
The conundrum of life is so fundamental that to solve it would rank among the most important achievements of the human mind. But for all scientists’ efforts – and there have been plenty – the big questions remain. If biology is defined as the study of life, on this it has failed to deliver.
But enlightenment may come from another direction. Rather than biology, some scientists are now looking to physics for answers, in particular the physics of information. Buried in the rules that shape information lie the secrets of life and perhaps even the reason for our existence.
That, at least, is the bold proposal from Paul Davies, a prominent physicist who explores the idea in his forthcoming book, The Demon in the Machine. Published next week, it continues a theme of thinking that landed Davies the $1m Templeton prize for contributions to religious thought and inquiry.
Paul Davies.
 Paul Davies. Photograph: Facebook
As director of the Beyond Center for Fundamental Concepts in Science at Arizona State University, Davies is well placed to spot the next wave that will crash over science. What he sees on the horizon is a revolution that brings physics and biology together through the common science of information.
“The basic hypothesis is this,” Davies says. “We have fundamental laws of information that bring life into being from an incoherent mish-mash of chemicals. The remarkable properties we associate with life are not going to come about by accident.”
The proposal takes some unpacking. Davies believes that the laws of nature as we know them today are insufficient to explain what life is and how it came about. We need to find new laws, he says, or at least new principles, which describe how information courses around living creatures. Those rules may not only nail down what life is, but actively favour its emergence.
To understand what bothers Davies, consider a hypothetical device: a life meter. Wave it over a sterile rock and the dial stays at zero. Wave it over a purring cat and it swings over to 100. But what if you dunked it in the primordial soup, or held it over a dying person? At what point does complex chemistry become life, and when does life revert to mere matter? Between an atom and an amoeba lies something profound and perplexing.
Davies suspects that information is the answer because it seems increasingly fundamental to both physics and biology. In recent years, physicists have shown that information is more than the bits and bytes that course through computers. Information can be converted into energy, for example, such that physicists now build little information engines and information-powered refrigerators, if not with the appearance their names suggest.
Similar machines are found in biology. Constructed from proteins, they chunter away inside living cells where they manipulate information at the nanoscale. “What we’re seeing in the lab is these two worlds colliding in a very practical way,” he says. “The physics is really connecting with the biology and that’s why I think we’re on the verge of this great new revolution.”
Davies believes that life will turn out to bear telltale patterns of information processing that distinguish it from non-life. Few people would argue that a computer is alive no matter how the ones and zeroes zip around inside it. What Davies suspects is that life exploits, and arises from, particular patterns of information flow.
“When you look at a living system, the way information is managed is very far from random. It will show patterns that could lead us to a definition of life,” he says. “We talk about informational hallmarks and these might be used to identify life wherever we look for it in the universe.”
It is not always easy to convert speculation into science. One of the hurdles Davies raises is the difficulty in describing biological information in terms of mathematics. It is a necessary move if new laws of life are to have any meaning. “I really think we need new physics to understand how information couples to matter and makes a difference in the world,” he says.
Find these new rules and the future could look very different. Davies anticipates “digital doctors”, who will analyse information flows in cells to spot aberrant patterns driven by early cancers and other diseases. When pathological patterns are found, they could be corrected through some form of molecular shiatsu, he suggests.
Most radical, though, is Davies’s proposal that any laws of information that shape life might favour its emergence too. Under this scenario, life would not arise on habitable planets by random chance but would be nurtured by “biofriendly” rules. It is the kind of teleological argument that many scientists reject, but one that Davies cannot help finding attractive.
“People often say that the probability of life forming by chance is so low there must have been intelligent design or a miracle. I find that anathema,”he says. Religious people have got to move on and get away from the idea that there’s a superbeing who fits it all up. What I find more congenial and much more intellectually respectable is the notion of fundamental laws of organisation that turn matter into life – a life principle built into the laws of the universe.”
He concedes: “It is wishful thinking because at this stage I can’t demonstrate it. But if we live in a universe in which the emergence of life is built into it in a fundamental way then we can feel more at home in the universe. It’s no substitute for a caring superbeing watching over us. It won’t help us deal with the problem of death, and it doesn’t help in a moral crisis, but it would certainly be more comforting than to believe we live in an empty, sterile universe.”
Before leaving Britain for posts abroad, Davies worked under Fred Hoyle, the maverick former director of the Institute of Astronomy at Cambridge University. Davies concedes that his one-time mentor helped him to keep an open mind in science. Hoyle was a brilliant academic but among his more fanciful proposals was that flu pandemics were spread by viruses that rained down on Earth from passing comets.
“He was one of these curious people who did some really great things and then some really crazy things,” Davies says. “What I did learn from Fred was not to be afraid of wild thinking.”

UK looks to ensure pharma submissions can continue under no deal Brexit


The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) is preparing to ensure that if the UK leaves the EU without a deal, pharmaceutical companies can continue to submit regulatory and notification information to the UK.
“If the UK leaves the EU with no deal, the UK would no longer be part of the EU medicines and medical devices regulatory networks. Submissions related to human medicines would need to be submitted directly to the MHRA,” the agency said.
As per the MHRA’s contingency plan, the agency is looking to deliver new IT systems and processes if access to the EU systems is lost. “Where feasible, we are trying to minimise additional administrative burdens and are trying to make any changes as simple to use as possible,” MHRA said.
The agency has put together a new webinar for pharmaceutical companies that make regulatory submissions and conduct vigilance activities.
According to the presentation slides, MHRA stresses that if a no deal EU exit occurs, the pharmaceutical industry can no longer submit data relevant to the UK to the MHRA via the Common European Submission Portal (CESP) or other EU portals.
“Therefore, we are building a UK equivalent of these, but the EU portals will still be available for EU transactions. This UK portal is referred to as the eSubmissions Portal throughout the presentation,” MHRA said.
The webinar also warns that it is not possible to move existing CESP administrative details over to our new portal. “We will be giving more detail on the registration process over the next two months,” the slides say.
The webinar focuses on submissions for human medicines, pediatric investigation plans, periodic safety update reports and individual case safety reports.
Upcoming communications will also provide tailored information on what medical device and medicinal product brokers will need to know, MHRA said.

Amazon.com Inspires Exclusive Brands


To build a big line of exclusive products on its site, Amazon.com Inc. is pushing other brand manufacturers to do most of the work.
The online retail giant is asking consumer-goods companies to create brands exclusively for Amazon after finding that developing them on its own is too costly and time-consuming, according to people familiar with the strategy.
The maker of Equal sweeteners and the nutrition brand GNC are among the first to launch products through a program Amazon started last year to outsource the work. Mattress maker Tuft & Needle also recently created a brand called Nod exclusively for Amazon.
Amazon’s initiative is the latest example of the e-commerce giant flexing its muscles in order to offer the lowest prices and widest selection, as it seeks to cut into the market share of big-brand manufacturers.
Manufacturers generally benefit from selling their products through a range of retailers. Also, they risk cannibalizing higher-margin sales of their main brands by offering comparable products under different labels. But those entering deals with Amazon view the arrangement as a golden opportunity.
In exchange for creating exclusive products, the brands get help launching their products on Amazon.com, faster customer feedback when testing new products, marketing support, and, of course, revenue from the sales. They also can appear at the top of search results — a big draw given that Amazon’s platform lists an estimated 550 million items.
“We had a lot of flexibility in terms of what we could do,” said Brian Huff, North American president of Equal sweetener manufacturer Merisant US Inc. His team created a new brand called Sugarly Sweet by Equal for Amazon.
Speed was paramount. “We had to take what would normally be 12 to 24 months of development to 90 days,” he said.
However, both Equal and GNC said they have faced higher costs selling through Amazon, which can entail having to ship items in a short time frame.
“There are some kind-of-hidden expenses…so we’re trying to balance the profitability,” GNC Chief Executive Ken Martindale said on an earnings conference call in November.
Amazon, on its own, has been quietly adding to its in-house brands in recent years. Analysts estimate the site now offers more than 100. Those include the more obvious AmazonBasics brand, which makes everything from suitcases to batteries, the Happy Belly brand of foods and the Mama Bear baby-products brand. Amazon sometimes promotes its own brands higher in search results on its site, like “Amazon’s Choice” and sponsored items, or as default results in voice searches using Amazon’s Alexa virtual assistant.
In-house brands often generate a higher profit margin for retailers, including Amazon, and can draw in customers because they can’t find those brands elsewhere. But developing a new brand and formulating products takes time. Amazon spent several years crafting and launching brands like Happy Belly and Mama Bear. By getting other brand manufacturers to do that work, Amazon can ramp up its private-brand offerings faster and at a lower cost, people familiar with the program said.
An Amazon spokeswoman said the program offers manufacturers a way to “launch brands and products directly to Amazon customers.”
Amazon is increasingly important for consumer-product manufacturers. It now accounts for roughly half of all sales online, according to eMarketer.
Selling on Amazon is “a way to contemporize our brand,” Merisant’s Mr. Huff said. Equal tends to attract older shoppers, but the new brand, Sugarly Sweet by Equal, will appeal to younger consumers because of its more modern branding and the fact that it will be sold on Amazon.com, Mr. Huff said.
GNC recently began selling two new brands of supplements — Informed Nutrition and Challenge — that it created exclusively for Amazon. The company is trying to make up for the loss of sales at thousands of vitamin and health-food stores in the U.S. as shoppers moved online, and Mr. Martindale, its CEO, told investors that the online recognition may drive some customers back into the retail stores.
Amazon’s program also can be used for “orphan brands” that manufacturers have stopped selling or that never made it to market.
A coffee brand that was discontinued by a discount retailer came to Amazon through its accelerator program with the coffee beans and packaging already accounted for. Now, Amazon will have an exclusive coffee brand at virtually no cost.
“Amazon has no issue going full-court press on private label, and pursuing all these brands. If the quality and pricing architecture don’t fit and they have to pivot, they’ll do so,” said Todd Mitchell, president of Compass Marketing Inc., which works with Amazon. “They’re not limited to the constructs of shelf space.”