Wednesday, April 29, 2020

Key nose cells identified as likely COVID-19 virus entry points

Two specific cell types in the nose have been identified as likely initial infection points for COVID-19 coronavirus. Scientists discovered that goblet and ciliated cells in the nose have high levels of the entry proteins that the COVID-19 virus uses to get into our cells. The identification of these cells by researchers from the Wellcome Sanger Institute, University Medical Centre Groningen, University Cote d'Azur and CNRS, Nice and their collaborators, as part of the Human Cell Atlas Lung Biological Network, could help explain the high transmission rate of COVID-19.

Reported today (23rd April) in Nature Medicine, this first publication with the Lung Biological Network is part of an ongoing international effort to use Human Cell Atlas data to understand infection and disease. It further shows that cells in the eye and some other organs also contain the viral-entry proteins. The study also predicts how a key entry protein is regulated with other immune system genes and reveals potential targets for the development of treatments to reduce transmission.

Novel coronavirus disease -- COVID-19 -- affects the lungs and airways. Patient's symptoms can be flu-like, including fever, coughing and sore throat, while some people may not experience symptoms but still have transmissible virus. In the worst cases, the virus causes pneumonia that can ultimately lead to death. The virus is thought to be spread through respiratory droplets produced when an infected person coughs or sneezes, and appears to be easily transmitted within affected areas. So far the virus has spread to more than 184 countries and claimed more than 180,000 lives.

Scientists around the world are trying to understand exactly how the virus spreads, to help prevent transmission and develop a vaccine. While it is known that the virus that causes COVID-19 disease, known as SARS-CoV-2, uses a similar mechanism to infect our cells as a related coronavirus that caused the 2003 SARS epidemic, the exact cell types involved in the nose had not previously been pinpointed.

To discover which cells could be involved in COVID-19 transmission, researchers analysed multiple Human Cell Atlas (HCA) consortium datasets of single cell RNA sequencing, from more than 20 different tissues of non-infected people. These included cells from the lung, nasal cavity, eye, gut, heart, kidney and liver. The researchers looked for which individual cells expressed both of two key entry proteins that are used by the COVID-19 virus to infect our cells.

Dr Waradon Sungnak, the first author on the paper from Wellcome Sanger Institute, said: "We found that the receptor protein -- ACE2 -- and the TMPRSS2 protease that can activate SARS-CoV-2 entry are expressed in cells in different organs, including the cells on the inner lining of the nose. We then revealed that mucus-producing goblet cells and ciliated cells in the nose had the highest levels of both these COVID-19 virus proteins, of all cells in the airways. This makes these cells the most likely initial infection route for the virus."

Dr Martijn Nawijn, from the University Medical Center Groningen in the Netherlands, said, on behalf of the HCA Lung Biological Network: "This is the first time these particular cells in the nose have been associated with COVID-19. While there are many factors that contribute to virus transmissibility, our findings are consistent with the rapid infection rates of the virus seen so far. The location of these cells on the surface of the inside of the nose make them highly accessible to the virus, and also may assist with transmission to other people."

The two key entry proteins ACE2 and TMPRSS2 were also found in cells in the cornea of the eye and in the lining of the intestine. This suggests another possible route of infection via the eye and tear ducts, and also revealed a potential for fecal-oral transmission.

When cells are damaged or fighting an infection, various immune genes are activated. The study showed that ACE2 receptor production in the nose cells is probably switched on at the same time as these other immune genes.

The work was carried out as part of the global Human Cell Atlas consortium which aims to create reference maps of all human cells to understand health and disease. More than 1,600 people across 70 countries are involved in the HCA community, and the data is openly available to scientists worldwide.

Dr Sarah Teichmann, a senior author from the Wellcome Sanger Institute and co-chair of the HCA Organising Committee, said: "As we're building the Human Cell Atlas it is already being used to understand COVID-19 and identify which of our cells are critical for initial infection and transmission. This information can be used to better understand how coronavirus spreads. Knowing which exact cell types are important for virus transmission also provides a basis for developing potential treatments to reduce the spread of the virus."

The global HCA Lung Biological Network continues to analyse the data in order to provide further insights into the cells and targets likely to be involved in COVID-19, and to relate them to patient characteristics.

Professor Sir Jeremy Farrar, Director of Wellcome, said: "By pinpointing the exact characteristics of every single cell type, the Human Cell Atlas is helping scientists to diagnose, monitor and treat diseases including COVID-19 in a completely new way. Researchers around the world are working at an unprecedented pace to deepen our understanding of COVID-19, and this new research is testament to this. Collaborating across borders and openly sharing research is crucial to developing effective diagnostics, treatments and vaccines quickly, ensuring no country is left behind."



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Thursday, January 16, 2020

Scientists identify 'modifier gene' that determines severity of inherited kidney disease

Scientists have developed a new way to understand complex genetic diseases and have identified a gene that modifies the severity of inherited kidney disease, paving the way for personalised treatments.

Experts at Newcastle University, UK, have shown that the rate of kidney disease in people with Joubert syndrome is determined by the genetic makeup of the individual and each patient may respond differently to treatment.

Joubert syndrome is a complex disorder, affecting approximately one in 80,000 newborns, causing varying degrees of physical, mental and sometimes visual impairments. It is often associated with severe kidney disease that requires dialysis and ultimately transplantation.

The study, published online in the Proceedings of the National Academy of Sciences, is the first time that an explanation has been given for the difference of disease progression in Joubert syndrome patients.


Significant breakthrough

The Newcastle research has identified a second gene called BSND - a 'modifier gene' - which determines the severity of kidney disease in patients with CEP290 mutations of Joubert syndrome.

It has been assumed that these modifier genes exist, but they have never been found before in rare genetic conditions until now.

Professor John Sayer and Dr Colin Miles, from the Translational and Clinical Research Institute, Newcastle University, led the Medical Research Council-funded research.

Professor Sayer said: "We have shown, using mouse and human DNA samples, that BSND is a modifier gene for the severity of kidney disease in Joubert syndrome.

"This is the first time that a modifier gene for inherited kidney disease has been identified, and this information will improve diagnoses and will be used to develop therapies to reduce the severity of kidney disease in affected patients.

"Our research is a major step forwards and, in the future, we may be able to offer a therapy that switches on the protective modifier gene and reduces the development of genetic kidney disease.

"This work paves the way towards personalised therapies in patients with the inherited kidney disease."

The international study used mouse models and DNA samples from patients with Joubert syndrome to progress the research.

Scientists used mouse models of disease and genetic manipulation to see how the kidney disease responded to modifier gene manipulation, cross-referenced with DNA sequencing data from patients around the world to prove the modifier gene was relevant in humans.


Challenging disease
Professor Sayer, a Consultant Nephrologist at Newcastle Hospitals NHS Foundation Trust, said: "The treatment of genetic kidney disease is challenging, as this requires both the correction of the underlying gene defect and the delivery of the treatment.

"We have shown that the kidney disease in a mouse can be dramatically changed by switching on or off a modifier gene.

"This will mean that we can use this information to carry out treatments, including genetic therapies, to lessen the effects of inherited kidney diseases, such as Joubert syndrome.

"We are testing these treatments further in our model systems before we move into patient studies."

Within the next three years, research will start to test treatment of patients with modifier genes in the hope of developing personalised treatment plans.
Patient story

Siblings Emma, 11, and Ben Buckley, eight, have Joubert syndrome and both developed kidney failure before the age of eight.

They were diagnosed with Joubert syndrome from a few months of age and both have required dialysis and a kidney transplant.

They suffer from a range of medical issues due to Joubert syndrome, including visual impairment, communication problems and developmental delay.

The two children, of Whitley Bay, North Tyneside, have been instrumental in helping further the research over the years, allowing the Newcastle scientists to study the mutation in detail.

Parents Leanne and Michael say they welcome the findings of the Newcastle University-led study as it will help to give patients a chance of preventing kidney failure in the future.

Leanne said: "It is very important that research is done into Joubert syndrome and the linked kidney damage, as this will hopefully prevent patients in the future needing a kidney transplant.

"All throughout Ben and Emma's lives, they have lived with the effects of Joubert syndrome and scientists found they had a problem with the CEP290 gene.

"Both Ben and Emma have needed dialysis and kidney transplants because of their kidney problems and I would like to hope this research will help prevent kidney failure for other affected children.

"We were happy for Ben and Emma to provide samples for the study as anything that helps further understanding into the condition is well worth doing, so it's great to see the study's positive results."



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Saturday, September 28, 2019

Researchers discover new blood test which can detect multiple types of cancer

Researchers have discovered a new kind of blood test in development which is capable of screening for a number of types of cancer.

Moreover, it has a high degree of accuracy, according to the results presented at the recently held seminar.


The test, developed uses next-generation sequencing technology to probe DNA for tiny chemical tags ( methylation) that influence whether genes are active or inactive.


When applied to nearly 3,600 blood samples, some from patients with cancer, some from people who had not been diagnosed with cancer at the time of the blood draw- the test successfully picked up a cancer signal from the cancer patient samples and correctly identified the tissue from where cancer began ( the tissue of origin).


The test's specificity- its ability to return a positive result only when cancer is actually present- was high, as was its ability to pinpoint the organ or tissue of origin researchers found.


The new test looks for DNA, which cancer cells shed into the blood stream when they die. In contrast to ' liquid biopsies', which detest genetic mutations or other cancer-related alterations in DNA, the technology focuses on modifications to DNA known as methyl groups.


Methyl groups are chemical units that can be attached to DNA, in a process called methylation, to control which genes are 'on' and which are ' off'.


Abnormal patterns of methylation turn out to be, in many cases, more indicative of cancer- and cancer type- than mutations are.


The new test zeroes in on portions of the genome where abnormal methylation patterns are found in cancer cells. 


Our previous work indicated that methylation-based assays outperform traditional DNA-sequencing approaches to detecting multiple forms of cancer in blood samples, said the study's lead author.
In the study, investigators analysed cell-free DNA ( DNA that had once been confined to cells but had entered the bloodstream upon the cells' death) in 3,583 blood samples, including 1,530 from patients diagnosed with cancer and 2,053 from people without cancer.


The patients samples comprised more than 20 types of cancer,  including hormone receptor-negative breast, colorectal, esophageal, gallbladder, gastric, head and neck, lung, lymphoid leukemia, multiple myeloma, ovarian and pancreatic cancer.


The overall specificity was 99.4 %, meaning only 0.6% of the results incorrectly indicated that cancer was present.


The sensitivity of the assay for detecting pre-specified high mortality cancer ( the percent of blood samples from these patients that tested positive for cancer) was 76 %.


Within this group, the sensitivity was 32 % for patients with stage 1 cancer, 76 % for those with stage 2 , 85 % for stage 3 and 93 % for stage 4.


Sensitivity across all cancer types was 55%, with similar increases in detection by stage. For the 97 % of samples that returned a tissue of origin result, the test correctly identified the organ or tissue of origin in 89 % of cases.


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Thursday, September 26, 2019

Genes linked to heart failure identified

Researchers have found the way for earlier identification of people at risk of heart failure and development of new treatments.

The research team applied an artificial intelligence (AI) technique to analyse the heart MRI images of 17,000 healthy UK Biobank volunteers and found that genetic factors accounted for 22-39 per cent of variation in the size and function of the heart’s left ventricle, the organ’s main pumping chamber.
Enlargement and reduced pumping function of the left ventricle can lead to heart failure, the study said.

“It is exciting that the state-of-the-art AI techniques now allow rapid and accurate measurement of the tens of thousands of heart MRI images required for genetic studies,” said study lead researcher.

“The findings open up the possibility of earlier identification of those at risk of heart failure and of new targeted treatments,”lead researcher said.

The research, suggests that genetic factors significantly influence the variation in heart structure and function. 

The team identified 14 regions in the human genome associated with the size and function of the left ventricle – each containing genes that regulate the early development of heart chambers and the contraction of heart muscle.

Previous studies have shown that differences in the size and function of the heart are partly influenced by genes but the researchers have not really understood the extent of that genetic influence. 

This study has shown that several genes known to be important in heart failure also appear to regulate the heart size and function in healthy people. 

“That understanding of the genetic basis of heart structure and function in the general population improves our knowledge of how heart failure evolves,” said a study researcher.


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Monday, July 22, 2019

Study discovers how diabetes lead to vascular disease

A team of scientists and physicians identified a cellular connection between diabetes and one of its major complications- narrowing of the blood vessel- which increases risks of several health conditions, including heart disease and stroke.

The same team previously found that high blood glucose, the hallmark symptoms of diabetes, activates an enzyme known as protein kinase A (PKA), which increases calcium channel activity and constricts blood vessels.


This was a surprise since PKA is typically associated with blood vessel widening and wasn't really on our radar. We wanted to understand the molecular processes that created this opposite reaction, said senior author.


For the new study, the team conducted a series of experiments on the effects of high glucose on cerebral blood vessels and arterial cells that control blood flow. The tests were conducted on a unique genetically modified mouse and  2 mouse models of diabetes that were developed for studies of cardiovascular health.


The researchers focused on the relationship between PKA and adenylyl cyclase (AC), an enzyme involved in cyclic AMP(cAMP) production, a cellular messenger with a critical role in vascular cell function.


Their results showed that one AC in particular, AC5 mediated cAMP and PKA activation, triggering increased calcium channel activity and blood vessel narrowing. They also found that AC5 was essential for blood-vessel constriction during diabetes.


The team hopes to test the effects of the AC5 chain reaction in high-glucose conditions in human cells. This step could confirm it as a treatment target for reducing the vascular complications of diabetes, which can include eye, kidney and cerebral, gastrointestinal and cardiovascular disease.


We see every day in our clinics the devastating impact of diabetes on the health and lives of our patients. Our work brings into much clearer focus on how high glucose can damage the vascular system and gives us a new target for blocking its effects, said the co-author of the study.


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Friday, March 30, 2018

Enzyme to preserve nerve function identified

Researchers have identified an enzyme that plays a crucial role in the degeneration of axons, the threadlike portions of a nerve cell that transmit signals within the nervous system. 

The discovery could open new pathways to treating or preventing many brain diseases since axon loss occurs in all neurodegenerative diseases.

The research team discovered a new role of the enzyme Axundead -- or Axed -- in promoting self-destruction of axons.
When Axed function was blocked, injured axons not only maintained their integrity but remained capable of transmitting signals within the brain`s complex circuitry for weeks, according to the findings published.

"If you target this pathway, you have a really good chance of preserving the functional aspects of neurons after a variety of types of trauma or injury," said senior author.

"It`s a very attractive therapeutic target," said a researcher who conducted the work.

"If we can find ways to block it, maybe we can preserve function in a wide array of patients who have lost axons through neurodegenerative diseases or other neural trauma," he said.

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Saturday, July 11, 2015

Hopes rise for brain tumour cure

Genes responsible for gliomas identified; targeted therapeutics are next step

Scientists have identified a family of genes responsible for the growth of a spectrum of hard-to-treat brain tumours, known as gliomas. “With these new genetic findings, our group of researchers plan to develop targeted therapeutics that we hope will one day be used to treat patients with high-grade brain tumours and increase their survival,” said lead author Joshua Breunig, a research scientist in the Brain Programme at the Cedars-Sinai Board of Governors Regenerative Medicine Institute in the U.S.
Mutation combinations

“Any given tumour can harbour a variety of different combinations of mutations,” said Moise Danielpour, director of the Paediatric Neurosurgery Programme and the Centre for Paediatric Neurosciences in the Maxine Dunitz Children’s Health Centre.
“Despite advances in radiation and chemotherapy, there are currently no effective curative regimens for treatment for these diverse tumours,” Danielpour said.
Researchers first modelled high-grade brain tumours from resident stem cells inside the brain, using a cutting-edge method of rapid modelling that can create up to five distinct tumour models within 45 minutes. After modelling high-grade brain tumours, researchers identified the Ets family of genes as contributors to tumours. The Ets factors regulate the behaviour of tumour cells by controlling expression of genes necessary for tumour growth. When expression of the Ets genes is blocked, researchers can identify and strategise novel therapies.
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