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Inclusion Body Myositis Treatment with Celution Processed Adipose Derived Regenerative Cells (P8-11.005)
No full textObjective:
The objective of this study is to assess in Inclusion Body Myositis (IBM) the safety of an autologous graft consisting of adipose-derived regenerative cells (ADRCs) derived from the Celution 800/CRS System.
Background:
IBM is a progressive, debilitating disease leading to proximal and distal muscle weakness, most prominently in the quadriceps and finger flexors. The Celution 800/CRS System is a closed, automated system intended to digest adipose tissue to further extract, wash, and concentrate stromal stem cells and other associated progenitor cells intended for autologous reimplantation in a real-time bedside manner.
Design/Methods:
ADRCs are isolated and purified from human abdominal subcutaneous fat tissue using the Celution 800/CRS System. ADRCs with 90% mean viability are processed aseptically then suspended in lactated Ringer’s solution for injection. Nine IBM subjects are randomized 2:1 in blocks of 3 to late (Part 1) versus early (Part 2) ADRC autologous graft injections. We inject 30 million cells divided between 8 injections unilaterally: 2 sites in the flexor digitorum profundus muscle and 6 sites in the quadriceps group of muscles. We plan to follow the subjects every 3–6 months for two years after ADRC injections for safety and efficacy measures.
Results:
All 9 IBM subjects have been enrolled in the trial and have received stem cell injections via EMG-guidance. Injections were completed in late 2023 with an estimated study completion by December 2025. We are also collecting whole blood samples to assess TDP-43 biomarker profile at various timepoints in Part 1 and Part 2.
Conclusions:
While full study results are not available, stem cell injections have been well-tolerated in all 9 subjects. The study-related adverse events have been so far limited to transient mild to moderate side effects
Sympathetic Duet: Simultaneous Stellate Ganglion Block and Thoracic Epidural Analgesia in the Successful Termination of Ventricular Storm
Get PDFThis article discusses the management of ventricular storm (VS), a condition characterized by recurrent episodes of sustained ventricular tachycardia or fibrillation, which poses a significant risk of mortality. Prompt intervention is crucial, yet surgical options are often limited due to the patient\u27s unstable condition. This case report presents a 47-year-old female who experienced VS during a planned surgical procedure. Despite initial stabilization, she continued to experience life-threatening arrhythmias, prompting the implementation of simultaneous stellate ganglion block (SGB) and thoracic epidural analgesia (TEA) catheters. This combined approach successfully controlled the arrhythmias, allowing for subsequent surgical interventions. The article emphasizes the potential of SGB and TEA as a bridge to definitive therapies for refractory VS, highlighting the need for further research to solidify their role in clinical practice
Immune Responses to Mycobacterium tuberculosis Infection in the Liver of Diabetic Mice
Get PDFIndividuals with uncontrolled diabetes are highly susceptible to tuberculosis (TB) caused by Mycobacterium tuberculosis (M. tb) infection. Novel treatments for TB are needed to address the increased antibiotic resistance and hepatoxicity. Previous studies showed that the administration of liposomal glutathione (L-GSH) can mitigate oxidative stress, bolster a granulomatous response, and diminish the M. tb burden in the lungs of M. tb-infected mice. Nonetheless, the impact of combining L-GSH with conventional TB treatment (RIF) on the cytokine levels and granuloma formation in the livers of diabetic mice remains unexplored. In this study, we evaluated hepatic cytokine profiles, GSH, and tissue pathologies in untreated and L-GSH, RIF, and L-GSH+RIF treated diabetic (db/db) M. tb-infected mice. Our results indicate that treatment of M. tb-infected db/db mice with L-GSH+RIF caused modulation in the levels of pro-inflammatory cytokines and GSH in the liver and mitigation in the granuloma size in hepatic tissue. Supplementation with L-GSH+RIF led to a decrease in the M. tb burden by mitigating oxidative stress, promoting the production of pro-inflammatory cytokines, and restoring the cytokine balance. These findings highlight the potential of L-GSH+RIF combination therapy for addressing active EPTB, offering valuable insights into innovative treatments for M. tb infections
A Rare Case of Primary Squamous Cell Carcinoma of the Stomach: A Case Report
Get PDFPure primary gastric squamous cell carcinoma (PGSCC) is a notably rare gastric malignancy. We present the case of a 51-year-old woman with advanced gastric squamous cell carcinoma characterized by a 7.6 cm necrotic mass invading the proximal stomach, liver metastasis, and lymphadenopathy at diagnosis. Despite the lack of standardized treatment protocols, we review tumor markers and potential management strategies, including surgical and chemotherapeutic interventions. The rarity and aggressive nature of PGSCC necessitates further research to develop effective detection and treatment methods to improve patient prognosis and survival outcomes
Serum Levels of Interleukins in Endometriosis Patients: a Systematic Review and Meta-Analysis
No full textObjective: The aims of this systematic review and meta-analysis were to produce a comprehensive survey of the serum levels of interleukins in untreated people with endometriosis compared to people without endometriosis.
Data sources: A systematic literature search of English language studies within Cinahl, Medline Complete, PubMed, and Scopus from inception to May 2023 was performed.
Methods of study selection: We included studies that compared interleukin serum levels in people with endometriosis to those without endometriosis. Meta-analysis was performed on IL-1RA, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17A, IL-18, IL-23, and IL-37.
Tabulation, integration, and results: The systematic search retrieved 651 studies, of which 77 underwent a full text review. A total of 30 studies met inclusion criteria for the meta-analysis. IL-1Ra, IL-6, and IL-37 serum levels were 2.56 (95% CI 2.20-2.92, p \u3c 0.001), 1.38 (95% CI: 0.58-2.17, p \u3c 0.001), and 1.77 (95% CI: 1.33-2.20, p \u3c 0.001) standard deviations higher in the patients with endometriosis compared to patients without endometriosis while IL-23 serum levels 0.40 (95% CI: -0.73 to -0.07, p = 0.02) standard deviations lower, respectively.
Conclusion: There is mounting evidence that interleukins, especially IL-6, may be good candidates for unique non-invasive diagnostic tools and/or treatment pathways for endometriosis
Inequities in Air Pollution on Stroke Mortality Among Older Americans: A U.S. Nationwide Analysis
Get PDFBackground: Air pollution is a known risk factor for cardiovascular diseases, including stroke. This study examines the impact of county-level air pollution on ischemic and hemorrhagic stroke mortality among U.S. individuals aged 65 and older, emphasizing racial and socioeconomic disparities.
Methods: Using data from the Center for Disease Control (CDC) Interactive Atlas of Heart Disease and Stroke, we analyzed county-level ischemic stroke mortality rates for older residents between 2016 and 2020. The data on air pollution at the county level, specifically particulate matter (PM2.5) levels, were obtained from the CDC. We applied multivariable linear and logistic regression models to examine the association between PM2.5 levels and stroke mortality, as well as the probability of meeting the Environmental Protection Agency (EPA) air quality standards.
Results: County-level analysis revealed a significant correlation (R = 0.68, R2 = 0.48, p \u3c 0.001) between PM2.5 levels and overall stroke mortality. For every 1 μg/m3 increase in PM2.5, there was an increase of 1.89 ischemic stroke deaths per 100,000 residents. Racial and socioeconomic disparities were evident. Counties with predominantly Black populations exhibited a stark disparity, with each 1 μg/m3 increase in PM2.5 correlating with a significant rise in mortality, amounting to 5.81 additional deaths per 100,000 residents. Persistently poor counties displayed vulnerability, experiencing a 4.05 increase in ischemic stroke deaths per 100,000 residents for every 1 μg/m3 increase in PM2.5 levels. Conversely, in counties with a White majority and counties without a persistent state of poverty, the associated increases in stroke mortality per 100,000 residents for every 1 μg/m3 rise in county-level PM2.5 were 1.85 and 1.60, respectively. Counties with a majority of Black residents were over twice as likely to be non-compliant with EPA air quality standards compared to predominantly White counties (aOR 2.36 95% CI: 1.27–4.38, p = 0.006).
Conclusion: This study underscores the significant impact of county-level air pollution, particularly PM2.5, on ischemic stroke mortality among older U.S. residents. Our findings indicate that counties with predominantly Black populations and those experiencing persistent poverty not only suffer from higher mortality rates but also are more likely to be non-compliant with EPA air quality standards. Targeted interventions and policies are urgently needed to reduce air pollution in these vulnerable communities and promote equitable public health outcomes