September 20, 2021

Be taught news tip sheet: Yarn tips from Johns Hopkins Medication

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Credit: Johns Hopkins Medication

PREVALENCE OF CHRONIC KIDNEY DISEASE AMONG MEXICAN AMERICANS HAS DOUBLED IN RECENT YEARS


Media Contact: Michael E. Newman, mnewma25@jhmi.edu

A fresh look taking a peep at nearly three decades of recordsdata from some 54,000 folks has certain that the total incidence of power kidney disease (CKD) for several racial/ethnic and socioeconomic groups within the United States has stabilized in contemporary years, rather then Mexican Americans.

Results from the be taught, conducted by investigators from the U.S. Facilities for Illness Regulate and Prevention (CDC) and three scientific institutions — in conjunction with Deidra Crews, M.D., associate professor of remedy on the Johns Hopkins College Faculty of Medication — had been reported within the July 16, 2020, anguish of JAMA Community Initiate.

Prevalence, as defined by the CDC, is “the proportion of participants in a inhabitants who grasp a particular disease or attribute at a specified level in time or over a specified time period.” The look team checked out CKD incidence amongst adults age 20 or older from 1988 to 1994 and from 1999 to 2016 for four racial/ethnic groups (non-Hispanic white, non-Hispanic Sunless, Mexican American and varied), three instructional ranges (lower than highschool, highschool and more than highschool) and three income ranges (low, center and excessive).

“We chanced on that total incidence of CKD, moreover to the charges for the total groups rather then one — Mexican Americans — stayed very a lot the an analogous from 2005 thru 2016,” says Crews. “Amongst Mexican Americans for the length of that period, the incidence doubled, even when our analyses accounted for several potentially confounding variables, equivalent to age and intercourse.”

Crews says the discovering is in step with contemporary be taught displaying a worsening total properly being space for the Mexican American inhabitants in contrast with non-Hispanic whites.

One other revelation from the look, Crews provides, is that even though CKD incidence charges stabilized between 2005 and 2016 for most of the racial/ethnic groups and socioeconomic ranges analyzed, necessary disparities in who will get CKD unruffled remain throughout racial/ethnic groups and socioeconomic ranges.

“To slim the gaps and scamper nearer to properly being equity, stronger efforts are necessary to effectively factual these power disparities in kidney properly being,” Crews says.

Recordsdata for the look came from the Nationwide Neatly being and Nutrition Examination Discover (NHANES), a federal program to assess the properly being and dietary space of adults and children within the United States over prolonged classes of time. NHANES findings are old to make your mind up on the incidence of vital ailments and threat components for these sicknesses.

GENE THERAPY ALLEVIATES OBSTRUCTIVE SLEEP APNEA IN MICE


Media Contact: Vanessa McMains, vmcmain1@jhmi.edu

Floppy, untoned muscle tissues in a particular person’s tongue and airway can block airflow and consequence in obstructive sleep apnea — a typical disorder wherein respiratory usually starts and forestalls for the length of sleep, most ceaselessly hundreds of times every night. Sleep apnea can trigger daylight tiredness, elevate the probability of accidents from falling asleep while riding, disrupt metabolism and if left untreated for years, lead to depression, excessive blood stress, coronary heart disease, stroke or loss of life. Now, Johns Hopkins Medication researchers grasp shown in mice that they can treat the situation and encourage the airway open by the utilize of gene therapy to stimulate the nerve that contracts muscle tissues within the tongue.

The researchers train their findings, printed on-line on July 16, 2020, by the American Journal for Respiratory and Extreme Care Medication, in the end would possibly perchance well very properly be translated into therapy for folks at most attention-grabbing threat of loss of life from obstructive sleep apnea’s impact, equivalent to these with prerequisites like stroke or excessive atherosclerotic coronary heart disease.

“The tongue muscle tissues that are partly accountable for obstructive sleep apnea grasp a reveal line by design of a nerve to the home of the brain that controls them,” says senior author Vsevolod Polotsky, M.D., Ph.D., director of sleep usual be taught and professor of remedy on the Johns Hopkins College Faculty of Medication. “Colorful this, we looked for a technique to utilize this pathway in two directions: first, to move to the encourage watch over home with gene therapy to invent it receptive to drug stimulation, after which once it be been activated, send a signal abet to the tongue to invent the predicament muscle tissues contract.”

Obstructive sleep apnea affects 30% of grownup males and 15% to 20% of ladies, says Polotsky. Constant with contemporary scientific be aware, the gold usual for treating the situation is a continuous certain airway stress (CPAP) machine that provides a accurate stream of air to the particular person for the length of sleep. “Nonetheless,” he provides, “exclusively 50% of folks adhere to the therapy, so our team has been investigating substitute therapies.”

The tongue has eight pairs of muscle tissues. One in every of these sets, the genioglossus, is stimulated by the hypoglossal nerve, which runs to it from the medulla, the bottom share of the brainstem. The medulla is attached to the spinal wire and controls involuntary capabilities, equivalent to respiratory and heartbeat. By implanting a pacemaker within the tongue, varied researchers grasp shown that electrical pulses can invent the hypoglossal nerve contract the genioglossus and end sleep apnea. The predicament with this assignment, Polotsky says, is that it requires invasive surgical procedure.

Of their look, Polotsky and his team grew to become to a non-invasive approach — an innocuous virus — to bring laboratory-developed chemical receptors to the brains of overweight mice. Once in set up contained within the medulla, these receptors — acknowledged as DREADDs (Clothier Receptors Completely Activated by Clothier Medication) — enable the brain cells within the medulla to settle for an man made (“vogue designer”) drug. The man made DREADD receptors remain within the medulla for months after a single tongue injection.

After Polotsky and his colleagues injected the drug below the skin of the overweight mice, it traveled up the hypoglossal nerve to the ready DREADDs and stimulated the brain cells, which in turn activated the nerve to send a return signal to contract the tongue’s genioglossus muscle tissues.

The researchers old magnetic resonance imaging on the sound asleep mice to say that their airways opened after handing over the drug, but now not in varied mice injected with exclusively saline. The researchers additionally measured six-fold increased electrical assignment within the tongue muscle tissues of the drug-handled mice, which indicated the tongue became once contracting.

In upcoming mouse be taught, the researchers thought to refine the virus starting up machine to invent particular it exclusively will get DREADDs into the form of brain cells that encourage watch over the hypoglossal nerve, in desire to varied shut by neurons. They additionally will survey on the role that varied tongue muscle tissues would possibly perchance well play in obstructive sleep apnea.

In accordance to these be taught, human trials of DREADDs would possibly perchance well apply.

“We imagine that if this therapy works in humans, the drug to suggested the receptors will most most likely be given orally every night and its results will final about five to six hours,” says be taught associate Thomaz Fleury Curado, Ph.D., who led the look. “Subsequently, by the level a particular person will get up, talking and ingesting would possibly perchance well now not be a problem.”

NATIONAL STUDY SHOWS KIDNEY TRANSPLANTATION BETWEEN PEOPLE WITH HIV IS SAFE AND SUCCESSFUL


Media Contact: Michael E. Newman, mnewma25@jhmi.edu

Kidney transplantation from deceased donors who had the human immunodeficiency virus (HIV) to folks living with HIV and cease-stage kidney disease is stable and continuously yields certain outcomes, in accordance with researchers at Johns Hopkins Medication and 13 varied scientific institutions. They are saying their discovering would possibly perchance well pave the vogue for more HIV-certain organs of all varieties — now not upright kidneys — being available for lifesaving transplants for folks with HIV who need them.

The look became once posted on-line on July 23, 2020, by the American Journal of Transplantation. It became once conducted below the authority of the HIV Organ Protection Equity (HOPE) Act, passed by Congress and signed into regulation in 2013. The act permits organ transplants from donors with HIV to recipients with HIV in authorized U.S. be taught be taught.

“Right here’s a thrilling culmination of 10 years of work: estimating the national impact of HIV-to-HIV transplants in 2011, serving to write the HOPE Act in 2013, performing the first HIV-to-HIV transplants within the United States in 2016, and now collaborating throughout the nation to level to the protection of this assignment,” says Dorry Segev, M.D. Ph.D., professor of surgical procedure and epidemiology on the Johns Hopkins College Faculty of Medication and co-leader of the HOPE in Motion look team. “Completely worthwhile implementation of the HOPE Act would possibly perchance well mean hundreds of additional transplants and hundreds of additional lives saved every 365 days.”

Between March 2016 and July 2019, the HOPE in Motion team enrolled 75 adults with cease-stage kidney disease and HIV whose virus became once suppressed by anti-HIV therapy. Of the participants, 25 got kidneys from deceased donors with HIV and 50 got kidneys from deceased donors without HIV.

All participants survived transplantation, with median apply-up of 1.4 years for recipients of HIV-certain kidneys and 1.8 years for recipients of HIV-negative kidneys. At one 365 days after transplantation, total graft survival became once wonderful and similar between HIV-certain kidneys (91%) and HIV-negative kidneys (92%). Moreover, there had been no variations in hospitalizations attributable to infections, charges of excessive destructive events or HIV-associated problems, that grasp been uncommon.

“Other folks living with HIV face a increased threat of kidney failure than these without the virus, but their lack of score entry to to staunch donor organs has beforehand intended many deaths while ready for a transplant,” says Christine Durand, M.D., associate professor of remedy on the Johns Hopkins College Faculty of Medication and co-leader of the HOPE in Motion look team. “So it be a vital step forward for our look to say that transplant outcomes the utilize of HIV-certain organs are a lot like HIV-negative ones.”

In a 2011 look, additionally printed within the American Journal of Transplantation, a team led by Brian Boyarsky, M.D., a surgical be taught fellow and assistant resident on the Johns Hopkins College Faculty of Medication, estimated that 300 to 500 folks with HIV would possibly perchance well become deceased organ donors every 365 days, potentially providing as many as 1,000 transplants every 365 days for recipients living with the virus.

The fresh look affords solid evidence that the rise to the organ donor pool predicted nearly a decade within the past is feasible.

The work became once primarily funded by the Nationwide Institute of Allergy and Infectious Diseases with additional toughen from the Nationwide Most cancers Institute.

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