A multicenter team of researchers led by Barbara Murphy, MD, of the Icahn School of Medicine at Mount Sinai has identified a panel of genes which can help predict whether a transplanted kidney will later develop fibrosis, an injury which can cause the organ to fail.

Researchers in the Genomics of Chronic Allograft Rejection (GoCAR) study obtained biopsy samples from transplanted kidneys three months and twelve months after transplantation. Using microarray, a method by which the expression levels of a large numbers of genes or proteins can be measured simultaneously, the researchers determined which genes were correlated with biopsy samples which had an increased Chronic Allograft Damage Index (CADI) score at the 12-month biopsy. The CADI score is a measure of the level of fibrosis in the transplanted kidney. The researchers then narrowed the genes down to a predictive gene set that identified patients at risk for decline in renal function and loss of the transplanted kidney beyond one year. The rate of correlation of the identified gene set with damage was greater than the clinico-pathological variables currently used in practice to identify kidney transplant recipients at risk of allograft damage and loss.

‘This is the first finding of its kind,’ said Barbara Murphy, System Chair of Medicine for the Mount Sinai Health System and Murray M. Rosenberg Professor of Medicine (Nephrology) at the Icahn School of Medicine at Mount Sinai, and the lead investigator on the study. ‘By helping us better understand the causes of damage to transplanted kidneys, this study has the potential to change how we monitor and manage all renal transplant patients.’

‘The study offers the potential to identify renal transplant recipients at risk for a loss of the new organ prior to the development of irreversible damage,’ said Dr. Murphy. ‘This would mean that doctors might eventually have the opportunity to change the therapeutic treatment approach in order to prevent fibrosis from progressing at all.’

Mount Sinai Health System www.mountsinai.org/about-us/newsroom/press-releases/mount-sinai-researchers-identify-way-to-predict-and-prevent-damage-in-donated-kidneys

Researchers at Lund University in Sweden have discovered a new and more accurate way to distinguish between harmful and harmless plaque in the blood vessels by using ultrasound. This can help healthcare providers determine the risk of strokes and heart attacks – which means avoiding unnecessary surgery for many patients.
In many parts of the world, atherosclerosis is one of the diseases responsible for a large number of cases of premature death.
Six years ago, a handful of researchers at Lund University in Sweden started taking an interest in how to make it easier to recognize unstable plaques that in worst case scenarios rupture and cause heart attacks or strokes.
When Tobias Erlov, who at the time was a doctoral student in biomedical engineering at the Lund Faculty of Engineering, discovered that there is a fairly simple mathematical calculation that can be used to interpret ultrasound signals and thereby figure out whether the plaque in the carotid artery is harmful or not, the researchers were somewhat surprised.
Vascular surgery is currently only performed if there is excessive blockage to the blood flow, due too large plaques. However, determining whether or not the plaque is unstable cannot be done by simply studying flow rates and plaque sizes – knowing the type of cell concerned is more important.
Simply put, harmless plaques consist of connective tissue and smooth muscle cells. Harmful plaques consist of fat (lipids) and macrophages. Unstable plaques can also involve bleeding.
‘We have shown that there is a strong correlation between changes in the centre frequency and the size of the reflecting particles. The more harmful substances, the greater the so-called centre frequency shift’, says Tobias Erlov, who is currently continuing his research at the Department of Biomedical Engineering.
The method can become useful to identify patients at risk of developing acute cardiovascular diseases, but also to follow up after surgery where plaque has already been removed.
In the future, ultrasound scans of the carotid artery will lead to the ability to perform surgery at an earlier stage in some cases, and the ability to avoid surgery completely in others.
People with cardiovascular diseases, and diabetics who risk developing them, can benefit from this new and accurate method.
‘Ultrasound enables you to screen a larger population, and that in turn means that life-threatening cardiovascular diseases can be detected at an earlier stage’, says Magnus Cinthio, senior lecturer in biomedical engineering and one of the researchers leading the work.
‘Another advantage is that the method is inexpensive and completely harmless to patients’, says Tobias Erlov.

Lund University http://tinyurl.com/jp8fbbz

Varian Medical Systems announced in July that Varex Imaging Corporation will be the name for its imaging components business upon the completion of the planned spin-off of that business as a new, stand-alone public company via a tax-free distribution to Varian stockholders in a transaction anticipated to be completed by the end of calendar year 2016.
The Varex Imaging name will draw from the 65-plus years of technology leadership and strong industry brand recognition of Varian and its reputation in X-ray imaging technology. As an independent company, Varex Imaging will pursue new growth strategies by leveraging its position as a global leader in components, software and services for expanded imaging applications and markets.
Varian Imaging Components president Sunny Sanyal, who will assume the role of CEO of Varex Imaging upon completion of the spin-off, stated, ‘As a trusted imaging components partner, we have a laser focus on providing our customers with high-quality and cost effective products that enable them to develop and deliver new next-generation imaging systems. Excellence in imaging is a top priority and this is evident in the new company name.’
Varian Imaging Components is a leading global supplier of components, software and engineering services for imaging equipment manufacturers and system integrators in the medical diagnostics, dentistry, veterinary care, security and industrial inspection industries. It manufactures X-ray tubes, high energy X-ray sources, flat panel image detectors, connectors, collimators and image processing software; all key components of X-ray imaging systems. The planned spin-off of Varian Imaging Components is subject to numerous conditions, including final approval by the Varian Board of Directors, effectiveness of a Registration Statement on Form 10 to be filed with the Securities and Exchange Commission, and receipt of an opinion of counsel regarding the federal income tax treatment of the spin-off.

www.varian.com

A quick, reliable and cost-effective mobility assessment tool may help to identify elderly patients at risk for adverse post-surgery outcomes, according to Wake Forest Baptist Medical Center researchers.
In their study of 197 men and woman over age 69 who underwent elective, non-cardiac, inpatient surgery at Wake Forest Baptist over a 20-month period, the researchers found that the participants’ preoperative scores on the Mobility Assessment Tool: Short Form (MAT-sf) were predictive of early postoperative complications, longer hospital stays and discharges to nursing homes.
‘Preoperative assessment of patient characteristics that may lead to adverse postoperative outcomes is important to patients, their families and their surgeons, especially with older adults, in whom complications are more likely,’ said Leanne Groban, M.D., professor of anesthesiology at Wake Forest Baptist.
‘Mobility is a powerful indicator of overall health in the elderly, and our results indicate that self-reported mobility, as measured by the MAT-sf, can complement existing assessment tools in determining which patients are at risk of adverse postoperative outcomes.’
The MAT-sf features animated video clips of 10 common physical activities, each followed by questions about the participant’s ability to perform the particular task. In addition to the MAT-sf, participants in the study also underwent four other commonly employed preoperative risk assessments. After controlling for factors such as the participants’ age, sex and body mass index and their scores on the other tests, the researchers found that low (poor) scores on the MAT-sf were associated with short-term complications, later time to discharge and increased nursing home placement to a greater degree than any of the other indicators.
‘The traditional risk assessments may be too comprehensive, too focused on single organ systems or too impractical to be effective in this setting,’ Groban said.
The next steps, she said, are to validate these findings in a larger, multi-centre study and to test whether preoperative strength and balance training might limit undesirable postoperative outcomes in older adults with mobility limitations.

Wake Forest Baptist Medical Centerhttp://tinyurl.com/jxd3bsp

Scientists at The Scripps Research Institute (TSRI) have developed a vaccine that blocks the pain-numbing effects of the opioid drugs oxycodone (oxy) and hydrocodone (hydro) in animal models. The vaccine also appears to decrease the risk of fatal opioid overdose, a growing cause of death in the United States.

‘We saw both blunting of the drug’s effects and, remarkably, prevention of drug lethality,’ said Kim D. Janda, the Ely R. Callaway Jr. Professor of Chemistry and member of the Skaggs Institute for Chemical Biology at TSRI. ‘The protection against overdose death was unforeseen but clearly of enormous potential clinical benefit.’

The new oxy/hydro vaccine takes advantage of the immune system’s ability to recognize, seek out and neutralize invaders.

Opioids were designed to reach receptors in the brain, causing pain reduction and feelings of euphoria. For their vaccine, the researchers combined a signature opioid structure with a molecule to trigger an immune response. When injected, the vaccine teaches the immune system to bind to the drug molecule and remove it from circulation.

The vaccine-derived antibodies were tailored by TSRI scientists to seek out the prescription drug and block the opioid from reaching the brain, potentially depriving a person of the ‘reward’ of consuming the drug, Janda explained.

The scientists believe a vaccine approach could have an advantage over current opioid addiction therapies because it would not alter brain chemistry like many of today’s anti-addiction therapies do.

‘The vaccine approach stops the drug before it even gets to the brain,’ said study co-author Cody J. Wenthur, a research associate in the Janda laboratory. ‘It’s like a pre-emptive strike.’

The researchers found that their vaccine design blocked pain perception of oxy/hydro use in mice. Indeed, those given the vaccine did not display the usual symptoms of a drug high, such as ignoring pain and discomfort.

In further tests, the rodents also appeared less susceptible to fatal overdose. Although it was found that some vaccinated mice did succumb to the opioid drug’s toxic effects, the researchers noted that it took much longer for the drug to impart its toxicity. If this effect holds true in humans, the vaccine could extend the window of time for clinical assistance if overdose occurs.

The scientists also discovered that the vaccine remained effective in mice for the entire 60-day study period, and they believe it has the potential to last even longer.

This oxy/hydro vaccine is not the first ever tested, but it is the first to use a faithful representation of the opioid in its design, which prompts the remarkable efficacy seen with the TSRI vaccine. ‘Our goal was to create a vaccine that mirrored the drug’s natural structure. Clearly this tactic provided a broadly useful opioid deterrent,’ said study first author Atsushi Kimishima, a research associate in the Janda laboratory.

The study did raise some new questions. For example, researchers found that once antibodies bound to the drug, the drug stayed in the body-though neutralized-for a long time. The next steps will be to investigate this phenomenon and further study the optimal vaccine dose and injection schedule. The scientists also stated it may be possible to make the vaccine even more effective.

Scripps Research Institute www.scripps.edu/news/press/2016/20161123janda.html