December 31, 2024

DNA Nanostructure

DNA Nanostructure as an Efficient Drug Delivery Platform for Immunotherapy


Immunotherapy has received increasing attention due to its low potential side effects and high specificity. For instance, cancer immunotherapy has achieved great success. CpG is a well-known and commonly used immunotherapeutic and vaccine adjuvant, but it has the disadvantage of being unstable and low in efficacy and needs to be transported through an effective nanocarrier. With perfect structural programmability, permeability, and biocompatibility, DNA nanostructures are one of the most promising candidates to deliver immune components to realize immunotherapy. However, the instability and low capability of the payload of ordinary DNA assemblies limit the relevant applications. Consequently, DNA nanostructure with a firm structure, high drug payloads is highly desirable.

In the paper, the latest progress of biostable, high-payload DNA nanoassemblies of various structures, including cage-like DNA nanostructure, DNA particles, DNA polypods, and DNA hydrogel, are reviewed. Cage-like DNA structures hold drug molecules firmly inside the structure and leave a large space within the cavity. These DNA nanostructures use their unique structure to carry abundant CpG, and their biocompatibility and size advantages to enter immune cells to achieve immunotherapy for various diseases. Part of the DNA nanostructures can also achieve more effective treatment in conjunction with other functional components such as aPD1, RNA, TLR ligands.

DNA nanostructures, drug delivery, immunotherapy, cancer therapy, targeted therapy, nanomedicine, precision medicine, molecular self-assembly, biocompatibility, controlled release, immune modulation, nanoscale precision, stimuli-responsive systems, immune response, surface functionalization, molecular engineering, therapeutic payloads, nanobiotechnology, autoimmune diseases, infectious diseases.

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December 30, 2024

Psychiatric Disorders

Seasonality of brain function: role in psychiatric disorders


Seasonality patterns are reported in various psychiatric disorders. The current paper summarizes findings on brain adaptations associated with seasonal changes, factors that contribute to individual differences and their implications for psychiatric disorders. Changes in circadian rhythms are likely to prominently mediate these seasonal effects since light strongly entrains the internal clock modifying brain function. Inability of circadian rhythms to accommodate to seasonal changes might increase the risk for mood and behavior problems as well as worse clinical outcomes in psychiatric disorders.

Understanding the mechanisms that account for inter-individual variations in seasonality is relevant to the development of individualized prevention and treatment for psychiatric disorders. Despite promising findings, seasonal effects are still understudied and only controlled as a covariate in most brain research. Rigorous neuroimaging studies with thoughtful experimental designs, powered sample sizes and high temporal resolution alongside deep characterization of the environment are needed to better understand the seasonal adaptions of the human brain as a function of age, sex, and geographic latitude and to investigate the mechanisms underlying the alterations in seasonal adaptation in psychiatric disorders.

Conclusions and future agenda

We reviewed seasonal effects on the human brain by first summarizing neuroimaging findings on relevant neurotransmitters, intrinsic brain networks, brain structure and task-induced brain activation. Most of the evidence from published studies point to the important role of DA and 5HT systems in seasonal fluctuations of psychiatric symptoms. Beyond 5-HT and DA, the seasonal patterns of other neurotransmitter systems and neuropeptides remain to be investigated in humans.

brain function, seasonality, psychiatric disorders, circadian rhythms, serotonin, melatonin, seasonal affective disorder, bipolar disorder, depression, anxiety, environmental factors, vitamin D, sleep-wake cycles, light therapy, genetic predisposition, immune function, hormonal balance, hypothalamus, cognitive function, mood regulation.

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December 28, 2024

Pre-Marital Genetic

How pre-marital genetic screening will empower families


It has taken a significant step to secure the health of future generations as it makes it mandatory for Emiratis to undergo genetic screening before marriage.

The genetic screening, which will become an integral part of the premarital screening programme from January 2025, involves testing 570 genes and covers over 840 disorders.

According to the Ministry of Health and Prevention (MOHAP), these tests can identify if couples carry shared genetic mutations that might be passed on to their future children. However, various factors can influence a child's health, and genetic screening is just one aspect to consider in family planning.

Often, these mutations remain hidden, only surfacing when both parents are carriers. The results empower couples to make informed decisions about family planning.

A simple process

Dr Shanitha Fathima, a specialist obstetrician and gynecologist at Medcare Royal Speciality Hospital, explains the first step. “The process begins with enquiries about family health histories. Any diseases present in the family should be checked, such as through the family tree. If there’s a specific disease identified, we always recommend genetic testing.”

“The procedure itself is simple,” said Dr Rehab Yousuf Al Saadi, Head of Family Medicine at Saudi German Hospital Dubai. “Genetic testing is done through a blood or saliva sample, which is analysed for specific genetic conditions,” added Dr Al Saadi. The results, available within 14 days, reveal potential genetic risks for future children.

Genetic compatibility

According to the MoHAP, the results of genetic testing can determine compatibility between couples. If the results indicate compatibility, it means that neither partner carries the same disease-causing genetic variant. In this case, the consultation is typically conducted by the primary care physician during the premarital session.

However, if the results show non-compatibility, it means that both partners are carriers of the same disease-causing gene. This situation requires further consultation by a genetic councellor and for rare challenging cases, a clinical geneticist will be available for support.

What do the tests detect?

Doctors said that the genetic tests screen for a wide range of inherited conditions, including sickle cell anemia, thalassemia, and other genetic disorders. “It helps in identifying carrier status for various diseases and assessing potential health risks for future generations,” said Dr Al Saadi. This preventative approach ensures that families are better prepared for the future.

What if the results are positive?

The results of genetic screening can be life-changing. For couples, they may reveal shared genetic risks, posing a critical question; Would you marry the one you love, if the test results are positive?

Dr Fathima shared a story of a couple where both parents were carriers of a disease-causing gene. “This couple faced unimaginable loss, out of eight pregnancies, only three children survived, and the others passed away shortly after birth. With genetic screening and proper intervention, we are able to help them have a healthy child,” said Dr Fathima.

Alternatives for couples with shared mutations

For couples who discover they carry the same genetic mutations, modern medicine offers hope. “We can perform pre-implantation genetic diagnosis (PGD) along with IVF to select embryos that do not carry the genetic pattern associated with certain diseases,” said Dr Fathima. “This ensures that their babies born will be safe and free from genetic disorders.”

Cost and availability

Genetic testing is available at both public and private healthcare facilities in the UAE, according to doctors. Accredited private hospitals provide the service as part of the premarital screening program. While the exact cost is yet to be determined, Dr Al Saadi said: “The government may subsidise the cost for citizens as part of the mandatory programme.”

‘Awareness necessary’

Dr Fathima highlighted the importance of awareness. “Genetic testing examines family history to identify patterns of hereditary diseases, including metabolic disorders and fetal anomalies. Many of these conditions can be prevented through early detection and intervention,” said Dr Fathima.

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December 27, 2024

Study Reveals Genetic and Linguistic Roots

Study Reveals Genetic and Linguistic Roots of Indo-European Populations


A comprehensive study involving 91 researchers, including Eske Willerslev from the Lundbeck Foundation GeoGenetics Centre at the University of Copenhagen, has provided critical insights into the genetic and linguistic origins of Indo-European populations. The findings, identify two significant migrations during the Bronze Age that contributed to the spread of steppe ancestry across the Mediterranean. The genetic research links Spanish, French and Italian populations to Bell Beaker ancestry, while Greek and Armenian populations have been connected directly to Yamnaya ancestry from the Pontic Steppe region.

Analyses of Steppe Ancestry Distribution

According to the study published on the preprint server bioRxiv, steppe ancestry in Western Europe is attributed to Bell Beaker populations, who combined their genetic profile with local Neolithic farmers. These migrations align with linguistic theories suggesting a shared origin for Italo-Celtic languages. In contrast, Greek and Armenian ancestry reflects direct Yamnaya influence, with no significant local admixture. This divergence between Eastern and Western Mediterranean populations aligns with the Italo-Celtic and Graeco-Armenian linguistic hypotheses.

Genomic and Strontium Isotope Studies

As per reports, the study sequenced 314 ancient genomes dated between 2,100 and 5,200 years ago from regions including Spain, Italy, Greece, and Turkey. A total dataset of 2,403 genomes was analysed, alongside 224 strontium isotope assessments to trace human mobility. Results showed active migration patterns during the Bronze Age, with non-local individuals identified in Greece, Cyprus and Italy. A notable finding was a Scandinavian individual in Cyprus, suggesting Mediterranean trade routes extended far beyond local boundaries.

Implications for Linguistic Migration Models

These findings substantiate linguistic theories connecting Italic and Celtic languages to Bell Beaker ancestry and Greek and Armenian languages to Yamnaya ancestry. The research contradicts alternative hypotheses, including Indo-Greek and Italo-Germanic models. This study provides a clearer understanding of the genetic and linguistic history of Indo-European populations, offering a vital reference for future investigations into ancient human migrations

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December 26, 2024

Geneticists Solve the Mystery

Geneticists Solve the Mystery of Why Some Cats Are Orange-and Why They Tend to Be Males


Orange cats have earned an online reputation for being chaotic, energetic rascals. But among scientists, they’ve long been known for something else: the enduring mystery of their distinctive coats.

Now, two independent studies by American and Japanese scientists have probed the genetic origins of these cats’ color—and, working separately, the teams reached the same conclusion. They suggest that orange cats have their bright, warm pelts as a result of genetic variations on their X chromosomes. The papers, which have not yet been peer-reviewed, were recently posted to the preprint server bioRxiv.

Scientists Greg Barsh from Stanford University and Hiroyuki Sasaki from Japan’s Kyushu University and their teams studied feline genomes to pinpoint which protein encoded by a cat’s genes brought out the orange hue. What they found was astonishing: a tiny deletion on the cat’s DNA influenced its entire color scheme.

“Our work provides an explanation for why orange cats are a genetic unicorn of sorts,” Kelly McGowan, a Stanford University geneticist who participated in the American study, says to Tom Howarth at Newsweek. The orange cat is a “fascinating exception” to the way orange-like color variants occur in many other domestic species, such as dogs, sheep, horses or rabbits, she adds.

In most other mammals, mutations in a protein called Mc1r lead to red hair color. But this has failed to explain orange color patterns in cats. “It’s been a genetic mystery, a conundrum,” Barsh tells Science’s Sara Reardon.

Instead, the new studies point to a gene called Arhgap36, a protein on the X chromosome. It had never been in the lineup of potential candidates for the “orange gene,” so to speak, because it controls aspects of embryonic development. As a result, scientists thought major mutations to Arhgap36 would likely kill the animal, Barsh said.

Nevertheless, Barsh’s team found that Arhgap36 in orange cats produced almost 13 times more RNA—molecules that help translate DNA into proteins the body can use—compared to the same gene in other types of cats. When they took a closer look, they saw that an increased amount of Arhgap36 in melanocytes, or skin cells that produce hair color, led to production of a light red pigment, making a cat’s fur appear orange.

But the change wasn’t due to a dangerous mutation. Rather, there was a small portion of DNA missing, preventing the unusual amount of Arhgap36 from affecting anything aside from the melanocytes. So, cats with the orange variation “are not only healthy, but also cute,” Science writes.

Because Arhgap36 is on the X chromosome, the orange coloration is sex-linked, researchers suggest. That makes sense, because fully ginger cats are mostly males. The new findings also help explain why calicos and tortoiseshells—which have patterns with a mixture of colors, including orange—are almost always female.

This is because a male kitten inherits just one X chromosome, from its mother, whereas female kittens inherit an X chromosome from each parent. So, it’s less likely that a female cat would receive two copies of the Arhgap36 variant that produces orange color. For a male, however, the cat only has to receive one copy of the gene.

As for tortoiseshells and calicos, they are often the offspring of a black cat and an orange cat. These kittens would have inherited one X chromosome with the “orange gene” and one without that variant, making them female. As the embryo develops, cells randomly choose which chromosome to express, or make visible, on different parts of the cat’s pelt. The chromosome that is not chosen is “inactivated,” and the randomness of this process is what gives tortoiseshells their striking pattern. Calico cats, additionally, have patches of white.



Even though the findings still have to undergo peer review, scientists are thrilled with the new work. “This means that a new pathway for pigment production has been discovered,” write geneticists Frank Nicholas, Imke Tammen and Leslie A. Lyons for the Conversation. This opens “the way for exciting and important research into a basic biological process,” add the three researchers, who were not involved with the work.

“I am fully convinced this is the gene and am happy,” Carolyn Brown, a geneticist at the University of British Columbia in Canada who was not involved in either study, tells Science. “It’s a question I’ve always wanted the answer to.”

“Studying coat color allows us to learn how cells communicate, because a pigment cell’s decision to make light or dark pigment is influenced by signals from its neighboring cells,” Christopher Kaelin, a geneticist at Stanford University and co-author of the American study, tells Newsweek.

Sasaki, from the Japanese study, is excited for what could come next. He tells Newsweek that “an obvious next question is when and where the genetic variation arose and how it spread, as our work showed that this variation is common in cats with orange coloration worldwide.”

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December 24, 2024

Gene vs. genome

Gene vs. genome: What is the difference?

Genes are specific segments of DNA that influence certain aspects of growth and health. Collectively, scientists refer to all of an organism’s genes as a genome.

DNA is the genetic material or code that tells cells in the body how to replicate themselves. Almost every cellTrusted Source in an organism’s body contains a complete copy of its genome, packaged into chromosomes. Chromosomes are thread-like structures consisting of DNA and protein that sit inside cells.

This article will explain what DNA, genes, and genomes are. It will also look at the differences between a gene and a genome and answer some frequently asked questions.
What are genes?


Genes consist of DNA, which is the genetic material that tells cells how to reproduce. Strands of DNA look like a twisted ladder, which scientists call a double helix.

DNA consists of four chemicals, which are known as bases. They are:
adenine (A)
cytosine (C)
guanine (G)
thymine (T)

The order of these chemical bases in a person’s DNA determines how their cells grow and develop.

A gene is a segment of DNA that contains sequences of many bases, varying in size from a few hundred to 2 million. Each gene affects a specific aspect of health. For example, some genes contain instructions on how to make specific proteins.

Parents pass on their genes to their biological children. As a result, each person has two copies of each human gene — one from each parent. In total, the human body has between 20,000 and 25,000 genes.

What is a genome?

The word “genome” refers to all the genetic material in an organism. The human genome consists of around 3 billionTrusted Source DNA base pairs.

Almost every cell in the body contains a complete copy of the organism’s genome, tightly packaged inside its chromosomes. Chromosomes are present in the nucleus of every cell.

Does everyone have the same genome?

Most of the human genome is the same in all people. However, about 0.001%Trusted Source of the genetic material will be different from person to person. This figure is even smaller in people who are related to each other.

Genes vs. genome comparison

Below are some of the differences between genes and genomes:

GeneHuman genome

Function contains the information a cell needs to carry out a specific function, such as how to make a particular protein contains the entirety of the person’s genetic material Length A few hundred to 2 million DNA base pairs 3 billion DNA basesTrusted Source field of study genetics genomics.

How do genes affect health?

Genes influence health in two main waysTrusted Source:

Genetic disorders

Some variations in genes directly result in health conditions. These conditions are known as genetic disorders. Genetic disorders can be:

Autosomal dominant: 

This means that inheriting just one copy of a gene can cause the disorder. If one biological parent carries the gene, the child has a 50%Trusted Source chance of developing the associated condition. Examples of dominant genetic conditions include Huntington’s disease, Marfan syndrome, and achondroplasia.

Autosomal recessive: 

This means that a person must inherit two copies of the gene, one from each biological parent, to cause the disease. If both parents each have a copy of the gene, the child has a 25% chance of developing the condition. Examples of recessive genetic disorders include cystic fibrosis and sickle cell disease.

In addition to inheriting genetic disorders from parents, people can also spontaneously get them if the gene mutates during fetal development or later in life. This can result in a person having a genetic variation that their parents do not have themselves.

Risk factors

In other cases, genes are merely risk factors for a condition. This means they can raise or lower the risk of someone getting a disease but do not directly cause it.

For example, some people carry genes that raise the risk of certain cancers, diabetes, or heart disease. Doctors call this a nonmodifiable risk factor because a person cannot change their genes.

However, having genes that raise the risk of a condition does not guarantee that a person will get it. Different genes, and different combinations of genes, pose different levels of risk. A person’s environment, diet, and lifestyle also influenceTrusted Source the risk.

Working on modifiable risk factors, which are things a person can control, can help offset the elevated risk of developing a condition.

Other terminology

Other terms doctors use when talking about genes include:

Genetics: 

This is the study of genes and how parents pass them on to their children.

Genomics: 

This is the study of the genome. It includes the analysis of all of a person’s genes and how they interact with each other and the environment.

Genotype: 

Genotype refers to a person’s unique genome, which people can find out by undertaking personal genome sequencing. Genotype influences things such as eye color or the risk of certain diseases.

RNA: 

RNA stands for ribonucleic acid. Similarly to DNA, it is a genetic material, but it only has one strand, or a single helix. RNA helps the cells in the body understand, interpret, and use DNA coding.

Summary

A gene is a specific segment of DNA that tells cells how to function. A genome is the entirety of the genetic material inside an organism. The human genome consists of between 20,000 and 25,000 genes.

Most of the human genome is the same from person to person, but variations in genes can influence someone’s health, appearance, and risk of developing certain diseases. There are also some conditions that occur as a direct result of specific genetic variants, such as sickle cell disease.


December 23, 2024

Gene Mutations dilated Cardiomyopathy

Comprehensive review on gene mutations contributing to dilated cardiomyopathy



Dilated cardiomyopathy (DCM) is one of the most common primary myocardial diseases. However, to this day, it remains an enigmatic cardiovascular disease (CVD) characterized by ventricular dilatation, which leads to myocardial contractile dysfunction. It is the most common cause of chronic congestive heart failure and the most frequent indication for heart transplantation in young individuals. Genetics and various other factors play significant roles in the progression of dilated cardiomyopathy, and variants in more than 50 genes have been associated with the disease. However, the etiology of a large number of cases remains elusive. Numerous studies have been conducted on the genetic causes of dilated cardiomyopathy.

These genetic studies suggest that mutations in genes for fibronectin, cytoskeletal proteins, and myosin in cardiomyocytes play a key role in the development of DCM. In this review, we provide a comprehensive description of the genetic basis, mechanisms, and research advances in genes that have been strongly associated with DCM based on evidence-based medicine. We also emphasize the important role of gene sequencing in therapy for potential early diagnosis and improved clinical management of DCM.

Clinical manifestation

Symptoms of DCM, such as dyspnea, fatigue, dizziness, syncope, and edema, may intermittently manifest in some patients during the early stages of DCM. However, these symptoms become more pronounced as the disease progresses to its severe stage (25). Uncommon yet significant signs and symptoms like abnormal skin pigmentation, skeletal myopathy, and neurosensory disorders (e.g., deafness, blindness) may indicate a specific form of multisystem disease or a unique DCM genotype. These symptoms are considered “red flags” for DCM diagnosis (26).

Conclusion

This review systematically summarizes the genes and mechanisms implicated in dilated cardiomyopathy, as well as the latest research directions in understanding its causes. It should be noted that with the advancement of medical technology, the diagnosis rate of dilated cardiomyopathy has been increasing. Nonetheless, patients often present with early onset, severe clinical manifestations, and poor prognosis. The standard approach for preventing or treating heart failure is currently the first-line treatment for patients with dilated cardiomyopathy. Cardiac resynchronization therapy and implantable cardioverter-defibrillators may be necessary to prevent life-threatening arrhythmias. It is recommended that all patients with dilated cardiomyopathy undergo sequencing of known cardiomyopathy genes. Gene-level therapy may represent a new approach for future treatments, although our current understanding of disease pathogenesis and gene therapy is primarily derived from preclinical animal models. This review also has some limitations, primarily that it only encompasses genes with substantial supporting evidence within the realm of evidence-based medicine. Due to the constraints of the review's length, there is a limited number of genes currently being researched and a lack of supporting experimental data. Consequently, some genes pertinent to “moderate classification” and “limited classification” have not been included in this review. Further research in this area is warranted.

Gene mutations in dilated cardiomyopathy (DCM) play a critical role in its pathogenesis, highlighting keywords like MYH7, TTN, LMNA, TNNT2, DSP, RBM20, SCN5A, ACTC1, PLN, TPM1, TNNI3, MYBPC3, BAG3, DES, CRYAB, LDB3, JPH2, GATA4, NKX2-5, ZASP, showcasing genetic and molecular insights into this cardiac condition

#DilatedCardiomyopathy, #GeneMutations, #CardiomyopathyResearch, #MYH7, #TTN, #LMNA, #TNNT2, #RBM20, #CardiacHealth, #HeartDisease, #DCMGenetics, #MedicalGenetics, #InheritedDisorders, #Cardiology, #GenomicResearch, #RareDiseases, #HeartFailure, #PrecisionMedicine, #CardiacGenes, #GeneticTesting

December 21, 2024

Wonder Drug

Scientists Finally Crack 60-Year Mystery Behind Diabetes ‘Wonder Drug’ Metformin



The antidiabetic drug metformin, widely prescribed for managing Type 2 diabetes, has long been recognized for its capacity to reduce blood glucose levels, attenuate inflammation, and slow tumor progression. Despite its widespread use for over 60 years, the precise molecular mechanisms underlying its effects have remained unclear.

A recent study from Northwestern Medicine, published in Science Advances, sheds light on this longstanding question by identifying mitochondrial complex I as a primary target of metformin.
Targeting Mitochondria To Regulate Blood Sugar

Metformin exerts its glucose-lowering effects by disrupting energy production within the mitochondria, a key organelle responsible for cellular metabolism. The study demonstrates that the drug inhibits mitochondrial complex I, a crucial component of the mitochondrial electron transport chain. This disruption impairs cellular energy production in select cell types, including those implicated in disease, while sparing healthy cells.

“While millions of people take metformin, its mechanism of action has remained enigmatic,” said Navdeep Chandel, senior author and professor of medicine and biochemistry at Northwestern University Feinberg School of Medicine. “This research provides clear evidence that metformin lowers blood glucose levels by targeting mitochondrial complex I.”

The Experimental Approach: Using Genetically Engineered Mice


The team conducted experiments on genetically engineered mice expressing NDI1, a yeast-derived enzyme that mimics the function of complex I but is resistant to metformin. By comparing glucose levels in mice treated with metformin, the study uncovered the following key findings:

In wild-type mice, metformin significantly reduced blood glucose levels.
Mice expressing NDI1 exhibited reduced sensitivity to metformin, with a less pronounced decrease in blood glucose levels.

The partial resistance observed in NDI1-expressing mice suggests additional pathways may contribute to metformin’s glucose-lowering effects.

This work builds on earlier research showing metformin’s ability to inhibit mitochondrial complex I in cancer cells, potentially slowing tumor growth.

Metformin’s Broad Applications and Future Research

Metformin’s benefits extend beyond diabetes management. Research has linked it to:Cancer therapy: Inhibiting complex I in cancer cells.

Inflammation reduction: Alleviating pollution-induced inflammation in studies with mice.

COVID-19 outcomes: Preliminary studies suggest metformin might improve survival rates.

These results strongly implicate mitochondrial complex I as a critical target of metformin in glucose regulation. Furthermore, earlier research from the Chandel lab demonstrated that metformin’s inhibition of complex I also contribute to its anti-cancer effects in cells expressing metformin transporters.

“We believe the diverse effects of metformin—ranging from glucose regulation to inflammation reduction and potential anti-cancer properties—can be partially explained by its inhibition of mitochondrial complex I,” Chandel said. He emphasized the need for further research to corroborate these findings and explore additional mechanisms.

A Historic Drug With a Modern Understanding

Metformin, derived from compounds in the French lilac plant, has been a cornerstone of diabetes management since its introduction more than six decades ago. Its low cost and efficacy make it a first-line therapy for millions of patients worldwide. In the United States, it is frequently used alongside newer antidiabetic medications, including semaglutides like Ozempic and Mounjaro.

The drug’s multifaceted effects have prompted numerous hypotheses about its mechanisms over the years. However, many of these theories have lacked definitive experimental evidence or consensus within the scientific community.

What Lies Ahead

The identification of mitochondrial complex I as a primary target of metformin opens new avenues for research. By elucidating the specific pathways involved in its action, scientists can refine therapeutic strategies for diabetes and potentially extend metformin’s application to other diseases.

“Metformin’s interaction with mitochondrial complex I offers a cohesive explanation for its effects across multiple conditions,” Chandel noted. “This understanding provides a foundation for further exploration into how targeting mitochondria can enhance human health.”

This study not only resolves a decades-old question about metformin’s mechanism of action but also underscores the potential of mitochondrial biology as a focal point for developing novel therapeutic interventions.

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International Conference on Genetics and Genomics of Diseases 

December 20, 2024

SCD Patients Treatment

SCD patients free of VOEs after treatment with gene-editing therapy


Nearly all the patients with severe sickle cell disease (SCD) who were treated with renizgamglogene autogedtemcel (reni-cel) remained free of vaso-occlusive events (VOEs) for up to two years, new data from the Phase 1/2/3 RUBY clinical trial shows.

The treatment also increased total hemoglobin levels and was well tolerated, according to a company press release from Editas Medicine, the developer of the gene-editing therapy.

Data from 28 patients was presented at the Annual Meeting and Exposition of the American Society of Hematology (ASH) in a poster presentation titled, “Reni-Cel, an Investigational AsCas12a Gene-Edited Cell Medicine, Led to Sustained Hemoglobin Normalization and Increased Fetal Hemoglobin in Patients with Severe Sickle Cell Disease Treated in the RUBY Trial.” The presentation was made by Rabi Hanna, MD, from the department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation at Cleveland Clinic Children’s hospital.

SCD is caused by mutations in the HBB gene that lead to the production of a defective version of adult hemoglobin, the protein that transports oxygen in red blood cells. As a result, the cells take on a sickle-like shape and die prematurely (hemolysis), often causing patients to develop anemia, one of the most common SCD symptoms.

People with SCD may also experience VOEs, which include painful vaso-occlusive crises (VOCs) and other complications that occur when sickled cells obstruct blood vessels and block blood flow, depriving tissues of oxygen.

Reni-cel, formerly EDIT-301, was designed to increase the production of fetal hemoglobin (HbF), a type that’s typically made during early fetal development and is more efficient at carrying oxygen than the protein’s adult version.

What is reni-cel gene-editing therapy?

The treatment involves collecting hematopoietic stem cells — which are capable of giving rise to all types of blood cells — from a patient’s bone marrow and modifying them to introduce genetic changes that mimic those naturally found in people with hereditary persistence of fetal hemoglobin, a benign condition where HbF production persists into adulthood.

After a course of chemotherapy to destroy stem cells in the bone marrow and make room for the modified ones, the engineered stem cells are infused back into the patient via a stem cell transplant. These modified stem cells are then expected to give rise to red blood cells that can produce HbF, which should reduce red blood cell sickling and the frequency of VOEs.

The Phase 1/2/3 RUBY trial (NCT04853576) is evaluating the safety and efficacy of a single infusion of reni-cel in patients with severe SCD, which is defined as those having at least two severe VOEs that require medical attention per year in the two years before entering the study. The patients, who researchers described as “broadly representative of the overall population of patients with severe SCD,” were a mean age of 26.1 and more than half were women (53.6%). In the two years before enrolling they had a mean of 4.6 severe VOEs a year.

Consistent with previous data, all but one patient remained free of VOEs from the time they received treatment, with the follow-up ranging from about 21 days to 25.5 months, or about two years. Moreover, after six months, the patients’ total hemoglobin levels increased to a mean of 13.8 g/dL, and HbF levels reached 48.1%. The mean percentage of HbF-producing red blood cells increased early and was maintained above 90% from four months post-treatment up to the last follow-up.

Also, mean corpuscular fetal hemoglobin, the average fetal hemoglobin levels, in HbF-producing red blood cells increased early and remained above the sickling threshold of 10 picograms per cell through the last follow-up. Markers of hemolysis reduced or normalized six months after treatment and generally remained the same at the last evaluation.

Sustained clinically meaningful improvements in patient-reported outcomes were also reported after treatment across several domains, including pain, physical function, social roles and activities.

Transplanted stem cells survived and expanded within the bone marrow in all the evaluated patients. The treatment was also well tolerated, with the therapy’s safety profile being consistent with a stem cell transplant and chemotherapy conditioning with busulfan.

Two serious adverse events were considered to be possibly related to reni-cel: a case of cute respiratory distress syndrome and another of eosinophilic gastroenteritis, a gastrointestinal disease.

Sickle Cell Disease, hemoglobinopathy, sickle hemoglobin, red blood cell deformity, vaso-occlusion, chronic hemolysis, anemia, oxidative stress, genetic mutation, hemoglobin S, pain crisis, hydroxyurea therapy, bone marrow transplant, disease management, erythrocyte dysfunction, ischemia-reperfusion injury, pediatric hematology, genetic counseling, stroke in SCD, organ damage, fetal hemoglobin, quality of life, inflammation in SCD, sickle cell trait, patient advocacy, public health,

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December 19, 2024

Rare Genetic Disorders

For kids with rare genetic disorders, customized CRISPR treatments offer hope


Lucy Landman was born with a very rare genetic disorder that causes severe intellectual disability, weak muscles and seizures, among other symptoms.

"She is expected to very much never be able to live independently, likely never be potty trained, likely never speak," says Geri Landman, Lucy's mother.

Lucy, who is now 3 years old, has trouble with coordinating her muscles. She "walks like she's drunk most of the time," Landman says. "It's hard to watch your child suffer. And Lucy does, some days, suffer a lot."

There are only a handful of kids in the world with Lucy's disorder, which is called PGAP-3 CDG. There's no way to treat it.

In principle, CRISPR, the gene-editing technique that enables scientists to easily make very precise changes in genes, could be a godsend for patients like Lucy. CRISPR can edit the pairs of genetic letters, or bases, that make up DNA.

"We're lucky that both of her mutations — the one that she gets from me and the one she gets from my husband — are what we call base-editable," says Landman, a pediatrician who lives outside San Francisco.

That means her mutations are good candidates for CRISPR, which could be used to "kind of cut out the wrong base pair and put back in the right one," she says.

Landman says she also feels lucky to live in 2024 when CRISPR treatments are "a legitimate possibility."

The rarest diseases get overlooked by drugmakers

But Lucy's disorder affects too few people to attract the millions of dollars necessary to find out if CRISPR could work.

"When Lucy was diagnosed, I asked a bunch of my basic science friends who work at Genentech and all these other big companies in the Bay Area and I said, "Can't we just CRISPR this? This seems like it's so feasible,'" Landman says. "And they were like: 'No one's working on this yet, Geri.'"

So Landman started a foundation to try to change that by raising money to research single-gene disorders like her daughter's.

One day, while out fundraising at a farmer's market, she bumped into Fyodor Urnov, who works at the Innovative Genomics Institute at the University of California, Berkeley. The institute was started by Jennifer Doudna, who shared a Nobel Prize for helping discover CRISPR.

Urnov and his colleagues are trying to help kids suffering from rare disorders like Lucy's. There are thousands of such conditions that affect millions of patients.

"The for-profit sector is focusing on conditions, such as sickle cell disease, such as cancer, which are commercially viable because there are just enough people with them," Urnov says.

The problem is, "that leaves 99.5% of folks outside of the big building that says, 'Come here, be healed by CRISPR' because the commercial viability is not there even though the technical feasibility is right in our hands."

A 'cookbook' for CRISPR treatments

So Urnov, as well as scientists at other universities, including the University of Pennsylvania and Harvard, are trying to develop a template for groups of rare conditions that are similar enough that a gene-editing treatment for one could be easily adapted for others.

"We are building a set of recipes and approaches for how to switch from one disease to another and not take four years and $10 million to do that," Urnov says.

The approach from one patient to the next would be essentially identical except for the specific genetic letters that are edited, he says. That way each case wouldn't necessarily have to go through a long, expensive approval process at the Food and Drug Administration.

"The central idea is that cookbook will have been reviewed by the Food and Drug Administration," Urnov says. And then scientists could approach the agency and essentially say: "FDA: We have a severely ill child with four months to live. Here is the cookbook for how to make the CRISPR on demand. We'd like to use that cookbook."

Hopefully, he says, the answer would be: " 'Yes. We understand. Please proceed.' That's the goal."

It's an ambitious goal. But others say it could work.

"CRISPR is very much like a razor blade handle and a razor," says Dr. Peter Marks, the director of the Center for Biologics Evaluation and Research, which regulates gene editing at the FDA.

"Much of CRISPR — the razor-blade handle part — is going to be the same over and over again. And so we just need to focus on the razor-blade portion, which could be different [for different rare diseases] and yet fit on that same razor," Marks says.

Urnov has already started editing some of Lucy's cells in his lab to show that CRISPR could help her and other kids with similar mutations.

Geri Landman is hopeful that maybe, someday that could help her daughter Lucy.

"And the question is: 'If we do that at age 3 or age 5 or age 7 can we cure some of the other features of her disease? Does she cognitively improve? Does she learn to speak in that way?'" Landman says. "That's certainly the hope."

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December 18, 2024

Scientists Identify Genes

Scientists Identify Genes That Shape People's Teeth


A group of genes drive the shape of each person’s teeth, including at least one gene inherited from Neanderthals, a new study published Dec. 12 in Current Biology found.

There are 18 sets of genes that influence the size and shape of teeth, 17 of which had not been previously linked to tooth development, researchers reported.

This includes a gene believed to be inherited from Neanderthals due to interbreeding with ancient humans.

“We have now identified numerous genes that impact the development of our teeth, some of which are responsible for differences between ethnic groups,” researcher Kaustubh Adhikari, a statistical geneticist with the University College London, said in a news release from the university.

These genetic revelations help inform scientists' understanding of human evolution, but they’ll also potentially contribute to better dental health, said lead researcher Qing Li, a postdoctoral researcher with Fudan University in China.

“Some of the genes that contribute to the normal variation of tooth dimensions among healthy people can also contribute to pathogenic variation, such as teeth failing to grow in or other dental health conditions,” Li said.

“We hope that our findings could be useful medically, if people with particular dental problems could undergo genetic tests to help in diagnosis, or if some dental anomalies could be treated one day with gene therapies,” Li added.

For the study, researchers analyzed data from nearly 900 volunteers in Colombia of mixed European, Native American and African ancestry.

The data included dental crown measurements derived from 3D scans of dental plaster casts taken from the participants, which researchers compared with each person’s genetic information.

The Neanderthal gene variant linked to teeth was only found in people of European descent, researchers said. Carriers of the variant have thinner incisors, the eight teeth at the front of the mouth that are best at biting into food.

Another gene known to impact incisor shape in East Asian people, EDAR, also appears to influence the width of teeth in all humans.

Overall, people of European descent also had smaller teeth, researchers noted.

“Our findings did not shed light on whether the genes that identify tooth shape were selected in evolution due to particular advantages to dental health, so it’s possible that the genes may have been selected due to the influences they have in other areas, with tooth shape differences resulting as a side effect, said researcher Andres Ruiz-Linares, a professor of human genetics with University College London.

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December 16, 2024

Genetic Behavior Changes

Genetic Mechanism Links Emotional Experiences to Behavior Changes



Researchers have identified a genetic mechanism that regulates behavioral adaptations to emotional experiences by forming R-loops, unique RNA:DNA structures that activate target genes. The study focused on NPAS4, a gene implicated in stress and drug addiction, showing how blocking R-loops prevents maladaptive behaviors like cocaine seeking and stress-induced anhedonia in mice.

This mechanism demonstrates how emotional experiences influence brain circuits by altering gene expression through enhancer RNA. The findings could pave the way for RNA-based therapies to treat psychiatric disorders linked to stress and substance use.R-Loop Role: R-loops form RNA:DNA structures to activate genes like NPAS4 during emotional experiences.
Behavioral Impact: Blocking R-loops in brain regions prevents drug-seeking and stress-induced behaviors in mice.

Therapeutic Potential: Insights could guide the development of RNA-based treatments for mood and substance use disorders.

Source: Medical University of South Carolina

A team of neuroscience researchers at the Medical University of South Carolina reports in Science the discovery of a new genetic regulatory mechanism involved in behavioral adaptations to emotional experiences in a preclinical model.

Although such adaptations are crucial for survival, they can become problematic in patients with certain psychiatric disorders.

Understanding the genetic changes that lead to maladaptive behaviors may help scientists to develop better RNA therapies to treat brain disorders.

The research team included Makoto Taniguchi, Ph.D., assistant professor in the Department of Neuroscience, Christopher Cowan, Ph.D., professor and chair of the Department of Neuroscience, and Rose Marie Akiki, an M.D.-Ph.D. student at MUSC.

With funding from the National Institutes of Health and a pilot grant from the South Carolina Clinical & Translational Research Institute, the researchers set out to understand how clinically relevant emotional experiences, including chronic stress and drug use, lead to long-lasting changes in behavior.

Ultimately, their findings show that loss of this genetic regulatory mechanism leads to reduced drug seeking and increased resilience to stress in mice.

“By understanding this process, we hope to get better insights into how changes in the brain can lead to maladaptive changes in behavior,” said Cowan. “We could also improve our fundamental understanding of how the brain works and how emotions and emotionally relevant experiences help to shape brain circuits.”

Scientists have long known that what we experience can cause changes in our brain, thereby altering how we behave. But how exactly do those changes occur? Well, it begins with our genes.

All cells within an individual contain essentially the same genes, but different genes can be turned on at different times.

This variability allows our bodies to adapt to a changing environment. Importantly, well over half of the human genome is devoted to producing a specific type of regulatory molecules that help to control when and where critical protein-coding genes are turned on.



These regulatory molecules, known as long non-coding RNAs (lncRNAs), have been found to differ in people with depression and substance use disorders.

The MUSC researchers focused on long non-coding enhancer RNA (Inc-eRNA), a specific type of lncRNA that interacts with the regulatory region of target genes. Upon binding to specific genes, Inc-eRNA can form unique structures, known as R-loops, to help to govern those genes.

The MUSC team looked at a gene called NPAS4, which is implicated in both stress-induced anhedonia, or lack of joy in activities that were once pleasurable, and drug-induced relapse.

Their study provides the first evidence for the role of R-loops in governing behavioral changes induced by emotional experiences.

R-loops can help to turn on specific genes by forming an RNA:DNA “sandwich” in regulatory regions of a target gene.

In the case of the NPAS4 gene, R-loops appear to help to bring the enhancer region, which includes instructions for turning on a gene and is located at a distance, together with the main body of the gene, including the important gene promoter region, and this allows the gene to be turned on in response to an experience.

“By bringing the enhancer and promoter together in space and time, R-loops seem to be facilitating their interaction and driving the response to turn on a gene,” said Cowan.

In response to emotional experiences, some people struggle more than others, and this may result in the development of maladaptive behaviors. For example, the death of a loved one is a very difficult experience to process that could lead some individuals to develop depression, while others are able to make peace with their loss.

The specific behaviors the researchers analyzed in mice were cocaine seeking and a response to chronic stress, as these are clinically relevant responses to particularly emotional experiences.

When the researchers blocked the formation of R loops in front of the NPAS4 gene in the region of the brain known as the nucleus accumbens, they found that mice did not show a preference for cocaine.

When a similar manipulation was performed in the prefrontal cortex, mice did not develop behaviors mimicking stress-induced anhedonia.

These findings suggest that lnc-eRNAs, and associated R-loops, at the NPAS4 gene are an important process in the brain by which emotional experiences can produce behaviors associated with substance use or mood disorders.

“You need a change in the genetic basis of how everything is working, what is being transcribed, what is being formed in the cell to form stronger neural circuits that underlie behavior,” said Akiki.

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