Type 2 diabetes – drinking pomegranate juice may lower high blood sugar levels

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Type 2 diabetes is the eventual outcome of processes in the body that are not functioning properly. Namely, your pancreas is not producing enough insulin or the insulin it does produce is not being absorbed efficiently by the cells. Insulin is a hormone that polices blood sugar levels in the body.

Blood sugar – also known as glucose – is obtained through the foods we eat and is the main type of sugar found in blood.

The sugar supplies the body with energy and nourishes the body’s organs, muscles and nervous system.

However, regularly having high blood sugar levels for long periods of time can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels.

Insulin therefore plays a protective role by regulating the supply of blood sugar in the body.

Poor insulin production therefore puts people with diabetes at a higher risk of severe complications.

Luckily, you can control blood sugar through another means – healthy dietary choices.

According to research published in the journal Nutrition Research, pomegranate juice may perform this function.

The researchers were interested in assessing whether the benefits of drinking pomegranate juice, which include lowering blood pressure due to its antioxidant properties, extend to lowering blood sugar.

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To investigate this, they recruited 85 people with type 2 diabetes and assigned them to receive 1.5 millilitres of pomegranate juice per kilogram of body weight.

Blood sugar and insulin levels, and beta cell function were assessed three hours after ingestion.

Beta cells are unique cells in the pancreas that produce, store and release the hormone insulin.

Results showed that pomegranate juice was associated with significant lower fasting glucose levels compared with control participants.

While the exact mechanisms involved remain unclear, the researchers suggest it may lie in juice’s antioxidant ability, which helps to thwart oxidative stress.

Oxidative stress is an imbalance of unstable atoms called free radicals and antioxidants in the body, which can lead to cell and tissue damage.

Oxidative stress plays a pivotal role in the development of diabetes complications.

General tips to lower blood sugar

There’s nothing you cannot eat if you have type 2 diabetes, but you’ll have to limit certain foods.

That’s because certain foods can send blood sugar levels soaring; the worst being carbohydrates.

Carbohydrate is broken down into glucose relatively quickly and therefore has a more pronounced effect on blood sugar levels than either fat or protein.

Physical exercise helps lower your blood sugar level – you should aim for 2.5 hours of activity a week, advises the NHS.

“You can be active anywhere as long as what you’re doing gets you out of breath,” it adds.

Type 2 diabetes – how to spot it 

Many people have type 2 diabetes without realising – this is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes include:

  • Peeing more than usual, particularly at night
  • Feeling thirsty all the time
  • Feeling very tired
  • Losing weight without trying to
  • Itching around your penis or vagina, or repeatedly getting thrush
  • Cuts or wounds taking longer to heal
  • Blurred vision.

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Rheumatoid arthritis treatment: The herbal supplement shown to ease swollen joints

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Rheumatoid arthritis, which affects more than 400,000 people in the UK, is an autoimmune disease. An autoimmune disease happens when the body’s natural defence system can’t tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. “In rheumatoid arthritis, the body’s immune system targets affected joints, which leads to pain and swelling,” explains the NHS.

When the joints come under attack from the immune system, it can cause joint pain, swelling and stiffness.

According to the NHS, it may also cause more general symptoms, and inflammation in other parts of the body.

The symptoms can vary in their intensity but you may experience flares when your condition deteriorates and your symptoms become worse, says the health body.

Regular flare-ups can greatly diminish your quality of life, impeding your ability to perform even basic tasks.

Unfortunately, there is no cure for rheumatoid arthritis, but this doesn’t mean you have to live with the symptoms.

Evidence has identified a number of natural solutions that can ameliorate the effects of rheumatoid arthritis.

Borage seed oil, which is extracted from the seeds of the borage plants native to the Mediterranean region, has been supported by two notable studies.

In the first trial, 37 people with rheumatoid arthritis were randomly assigned to receive either borage seed oil containing 1.4 grams of GLA or a placebo of cotton seed oil daily for 24 weeks.

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GLA is an essential fatty acid that is found in borage seed oil.

According to Versus Arthritis, the essential fatty acid is important for maintaining a joint’s cell structure and function.

Compared to the placebo group, who showed no improvement during the trial, participants who received borage seed oil showed an improvement in:

  • Joint tenderness
  • Number of swollen joints
  • Morning stiffness.

In the second trial, 56 participants with rheumatoid arthritis were randomly assigned to take either a daily dose of borage seed capsules containing 2.8 g GLA or placebo capsules of sunflower seed oil for six months.

By the end of the study, 64 percent of those on borage seed oil showed improvement in joint tenderness and morning stiffness, compared to only 21 percent of those on placebo treatment.

There was a significant difference in the treatment outcome of the two patient groups in favour of borage seed oil.

General self-help tips

Engaging in regular exercise can also help to alleviate the symptoms associated with rheumatoid arthritis.

How? “Exercising regularly can help relieve stress, help keep your joints mobile, and strengthen the muscles supporting your joints,” explains the NHS.

As the health body explains, exercise can also help you lose weight if you’re overweight, which can put extra strain on your joints.

According to the National Rheumatoid Arthritis (NRAS), you should talk to a member of your rheumatology team or your GP about what exercise(s) you are considering.

“Think about a goal that exercise may help you to realistically achieve and reward yourself when you achieve your goal,” says the NRAS.

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New developments for the treatment of muscle spasticity after stroke and nervous system defects

Chronic muscle spasticity after nervous system defects like stroke, traumatic brain and spinal cord injury, multiple sclerosis and painful low back pain affect more than 10% of the population, with a socioeconomic cost of about 500 billion USD. Currently, there is no adequate remedy to help these suffering people, which generates an immense medical need for a new generation antispastic drugs.

András Málnási-Csizmadia, co-founder of Motorpharma Ltd. and professor at Eötvös Loránd University in Hungary leads the development of a first-in-class drug candidate co-sponsored by Printnet Ltd. MPH-220 directly targets and inhibits the effector protein of muscle contraction, potentially by taking one pill per day. By contrast, current treatments have low efficacy and cause a wide range of side effects because they act indirectly, through the nervous system.

“We receive desperate emails from stroke survivors, who suffer from the excruciating symptoms of spasticity, asking if they could participate in our research. We work hard to accelerate the development of MPH-220 to alleviate these people’s chronic spasticity,” said Prof. Málnási-Csizmadia.

The mechanism of action of MPH-220 and preclinical studies are recently published in Cell. Dr. Máté Gyimesi, CSO of Motorpharma Ltd. highlighted: “The scientific challenge was to develop a chemical compound which discriminates between skeletal and cardiac muscle myosins, the motor proteins of these contractile systems. This feature of MPH-220 makes it highly specific and safe.”

Prof. James Spudich, co-founder of Cytokinetics, MyoKardia and Kainomyx, all companies developing drugs targeting cytoskeletal components, is also very excited about MPH-220 as a possible next generation muscle relaxant. “Cytokinetics and MyoKardia have shown that cardiac myosin is highly druggable, and both companies have potential drugs acting on cardiac myosin in late phase clinical trials. Skeletal myosin effectors, however, have not been reported. Motorpharma Ltd. has now developed a specific inhibitor of skeletal myosin, MPH-220, a drug candidate that may reduce the everyday painful spasticity for about 10% of the population that suffers from low back pain and neurological injury related diseases,” said Professor Spudich, former chair of Stanford medical school’s Biochemistry department, a Lasker awardee.

Drug development specifically targeting myosins is becoming a distinguished area, as indicated by last week’s acquisition of MyoKardia by Bristol-Myers Squibb Co. for 13.1 billion dollars in an all-cash deal, in the hope of marketing their experimental heart drug targeting cardiac myosin. This business activity shows the demand for start-up biotech companies such as Myokardia or Motorpharma.

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The need to urinate more at this time of the day may signal prostate cancer

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Prostate cancer is the result of cancerous cells dividing uncontrollably in the prostate — a small walnut-shaped gland in men. It usually develops slowly, so there may be no signs for many years. Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra), explains the NHS.

When this happens, you may notice a number of changes to your urinary habits.

One telltale sign of advanced prostate cancer is the need to urinate more often, especially at night, according to the American Cancer society (ACS).

Other symptoms include:

  • Blood in the urine or semen
  • Trouble getting an erection (erectile dysfunction or ED)
  • Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones
  • Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord.

According to the ACS, most of these problems are more likely to be caused by something other than prostate cancer.

“For example, trouble urinating is much more often caused by benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate,” says the health body.

Still, it’s important to flag up any unusual changes with your doctor to rule out prostate cancer, it adds.

How is prostate cancer treated?

Treatment for prostate cancer will depend on your individual circumstances, such as the stage of the cancer.

“When treatment is necessary, the aim is to cure or control the disease so it affects everyday life as little as possible and does not shorten life expectancy,” explains the NHS.

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Sometimes, if the cancer has already spread, the aim is not to cure it but to prolong life and delay symptoms, notes the health body.

Am I at risk?

It’s not known exactly what causes prostate cancer, although a number of things can increase your risk of developing the condition.

Age, ethnicity, genetics and lifestyle factors can all contribute to your risk of prostate cancer.

According to Cancer Research UK, prostate cancer is most prevalent in men aged 75 to 79 years.

Some inherited genes can also increase your risk of developing prostate cancer.

“These inherited genes are rare and account for only a small number of prostate cancers,” explains Cancer Research UK.

Evidence also suggests being overweight or obese increases your risk of advanced prostate cancer.

Obese means being very overweight with a body mass index (BMI) of 30 or higher, and being overweight means having a BMI of between 25 and 30.

Researchers have found a link between being obese or overweight and cancers being higher grade (faster growing).

According to the NHS, research is ongoing into the links between diet and prostate cancer, and there is some evidence that a diet high in calcium is linked to an increased risk of developing prostate cancer.

What is most important is to focus on your overall dietary approach rather than singling out specific items.

As Cancer Research UK points out, having a healthy and balanced diet can reduce the risk of cancer by helping you keep a healthy weight or lose weight.

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Study identifies brain cells most affected by epilepsy and new targets for their treatment

Epilepsy is one of the most common neurological diseases. It is caused by a malfunction in brain cells and is usually treated with medicines that control or counteract the seizures.

Scientists from the Faculty of Health and Medical Sciences, University of Copenhagen and Rigshospitalet have now identified the exact neurons that are most affected by epilepsy. Some of which have never been linked to epilepsy before. The newfound neurons might contribute to epileptogenesis—the process by which a normal brain develops epilepsy—and could therefore be ideal treatment targets.

“Our findings potentially allows for the development of entirely new therapeutic approaches tailored towards specific neurons, which are malfunctioning in cases of epilepsy. This could be a breakthrough in personalized medicine-based treatment of patients suffering from epileptic seizures,” says Associate Professor Konstantin Khodosevich from Biotech Research & Innovation Center (BRIC), Faculty of Health and Medical Sciences.

A major step towards more effective drugs

It is the first time a study investigates how every single neuron in the epileptic zone of the human brain is affected by epilepsy. The researchers have analyzed more than 117,000 neurons, which makes it the largest single cell dataset for a brain disorder published so far.

Neurons have been isolated from tissue resected from patients being operated as part of the Danish Epilepsy Surgery Programme at Rigshospitalet in Copenhagen.

“These patients continue to have seizures despite the best possible combination of anti-seizure drugs. Unfortunately, this is the case for 30-40% of epilepsy patients. Active epilepsy imposes serious physical, cognitive, psychiatric and social consequences on patients and families. A more precise understanding of the cellular mechanism behind epilepsy could be a major step forward for developing drugs specifically directed against the epileptogenic process compared to the current mode of action reducing neuronal excitability in general throughout the brain’ says associate professor Lars Pinborg, head of the Danish Epilepsy Surgery Program at Rigshospitalet.

From ‘neuronal soup’ to single cell analysis

The study from the Khodosevich Group differs from previous work by using single cell analysis. Earlier studies on neuronal behavior in regards to epilepsy have taken a piece of the human brain and investigated all the neurons together as a group or a ‘neuronal soup.” When using this approach, diseased cells and healthy cells are mixed together, which makes it impossible to identify potential treatment targets.

“By splitting the neurons into many thousands of single cells, we can analyze each of them separately. From this huge number of single cells, we can pinpoint exactly what neurons are affected by epilepsy. We can even make a scale from least to most affected, which means that we can identify the molecules with the most promising potential to be effective therapeutic targets,” says Khodosevich.

Next step is to study the identified neurons and how their functional changes contribute to epileptic seizures. The hope is to then find molecules that can restore epilepsy related neuronal function back to normal and inhibit seizure generation.

Expanding knowledge on underlying mechanisms of epilepsy

The study confirms expression from key genes known from a number of previous studies, but is also a dramatic expansion of knowledge on the subject. Previously, gene expression studies have identified a couple of hundred genes that changes in epilepsy.

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Antibiotics May Be Best First Treatment for Appendicitis

TUESDAY, Oct. 6, 2020 — For some patients suffering from appendicitis, antibiotics may do the trick, a large U.S. trial suggests.

More than 70% of patients who received antibiotics avoided surgery for at least 90 days, according to the new report.

“When we compared the outcomes of people treated with antibiotics alone or surgery to remove the appendix, we found that people receiving either treatment felt well at 30 days,” said co-principal investigator Dr. David Talan. “In terms of overall health status, antibiotics were no worse than surgery and allowed most people to avoid an operation in the short term.”

Talan is a professor of emergency medicine and infectious diseases at the David Geffen School of Medicine at UCLA.

In the trial, more than 1,500 patients in 14 U.S. states randomly received antibiotics first or an appendectomy. The trial is the largest ever clinical randomized look at appendicitis treatment, the study authors said.

According to Bonnie Bizzell, chairwoman of the trial’s patient advisory board, “People treated with antibiotics more often returned to the emergency department, but missed less time from work and school. Information like this can be important for individuals as they consider the best treatment option for their unique circumstance.”

About three in 10 patients given antibiotics had surgery within 90 days, according to researcher Dr. David Flum, associate chairman of surgery at the University of Washington School of Medicine, in Seattle. “There were advantages and disadvantages to each treatment, and patients will value these differently based on their unique characteristics, concerns and perspectives.”

Initial treatment with antibiotics created a higher risk for patients with an appendicolith — a calcified deposit within the appendix that occurs in roughly one-quarter of patients. It is associated with more complications and a 40% chance of surgery within 90 days, the researchers said.

The findings were published online Oct. 5 in the New England Journal of Medicine.

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Study: Sleep apnea treatment reduces heart problems in patients with prediabetes

A new study found that continuous positive airway pressure (CPAP) treatment at night can lower daytime resting heart rates in patients with prediabetes who have obstructive sleep apnea, reducing their risk of cardiovascular disease.

The study, published Oct. 1 in the Journal of the American Heart Association, was conducted by Esra Tasali, MD, Director of the Sleep Research Center at the University of Chicago Medicine, and Sushmita Pamidi, MD, a sleep physician-scientist at McGill University in Montreal.

The discovery could potentially help the 1 billion people worldwide with obstructive sleep apnea, in which the prevalence of prediabetes and diabetes is over 60 percent. Furthermore, the vast majority of patients with obstructive sleep apnea are undiagnosed.

The study’s findings are especially timely, given that people with diabetes or cardiovascular problems are among the most vulnerable to COVID-19.

“Any way we can improve cardiovascular health is more important than ever these days,” Tasali said.

This randomized controlled trial studied people with prediabetes, a condition where blood sugar levels are higher than normal but not high enough to be considered diabetic. Those who used CPAP treatment for two weeks had a drop in their resting heart rate by four to five beats per minute, compared to those who received placebo. Notably, with optimal CPAP treatment, their heart rates were not only lower at night, but also during the day.

“That’s significant,” Tasali said, noting that a drop of even one beat per minute in resting heart rate can lower the mortality rate and future risk of developing cardiovascular disease.

“A four- to five-beat-per-minute drop in heart rate that we observed is comparable to what you would get from regular exercise,” she added. “Our breakthrough finding is the carryover of the lowered resting heart rate into the daytime and the cardiovascular benefit of that.”

Resting heart rate is key to a person’s health and well-being. A high resting heart rate signals increased stress to the heart. It is a strong predictor of heart problems and death, the doctors said. Prior research has shown that in middle-aged people, every beat-per-minute increase in resting heart rate is associated with a 3% higher mortality rate.

Obstructive sleep apnea is a disorder that causes people to repeatedly stop breathing at night, decreasing oxygen intake and disrupting their sleep. It is a serious health concern, increasing the risk of cardiovascular conditions such as high blood pressure, stroke and heart attack. It makes people sleepy during the day and heightens their “fight or flight” stress hormones, elevating their resting heart rate all day and night.

Doctors use CPAP to treat obstructive sleep apnea. It keeps a person’s airway open and oxygen levels steady during the night, thus lowers their heart rate. However, Pamidi isn’t encouraging people to go online and buy the machine. Obstructive sleep apnea is a medical diagnosis that must be made by a doctor after a sleep study.

“Our recent findings urge people who have prediabetes, diabetes or sleeping problems to be screened for sleep apnea,” Pamidi said.

Today, about 80% of sleep apnea cases are undiagnosed. An estimated 50% to 70% of people with prediabetes or diabetes have sleep apnea.

“The majority of patients don’t make a connection as to how their sleep can affect their hearts. With regards to their sleep apnea, patients just think how sleepy they are the next day,” Tasali said. “I always explain to my patients that sleep apnea can also be harmful to their cardiovascular health.”

This study is the first to examine the impact of optimal CPAP treatment on daytime resting heart rate,” said Pamidi. Before joining McGill, she was a clinical fellow and then faculty at UChicago Medicine’s Division of Pulmonary and Critical Care Medicine.

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Study Examines Effect of Cancer Treatment on COVID-19 Mortality

TUESDAY, Sept. 22, 2020 — Cancer patients treated one to three months prior to COVID-19 diagnosis and those treated with chemoimmunotherapy have the highest 30-day mortality, according to a study presented at the annual meeting of the European Society for Medical Oncology, held virtually from Sept. 19 to 21.

Trisha M. Wise-Draper, M.D., Ph.D., from the University of Cincinnati Cancer Center, and colleagues examined outcomes related to systemic cancer treatment within one year of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection. Data were analyzed for 3,920 patients as of July 31, 2020.

The researchers found that 42 percent of the patients received systemic anticancer treatment within 12 months and 159 distinct medications were administered. Patients treated within one to three months prior to COVID-19 had the highest rates of COVID-19-associated complications; all-cause mortality was 26 percent in this group. By most recent treatment type, 30-day mortality was 20, 18, 17, 29, 20, and 11 percent for chemotherapy, immunotherapy, chemoradiotherapy, chemoimmunotherapy, targeted therapy, and endocrine therapy, respectively. The standardized incidence ratio for mortality was lowest for endocrine treatments and highest for chemoimmunotherapy or chemotherapy less than two weeks before COVID-19 diagnosis. Targeted agents within three to 12 months also had a high standardized incidence ratio. Mortality was 14 percent for patients untreated in the year prior to COVID-19 diagnosis.

“Targeted therapies, especially those causing immune cell depletion, used one to three months before [the diagnosis of] COVID-19, are associated with very high mortality, up to 50 percent,” Wise-Draper said in a statement.

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Small molecule treatment reduces colon cancer metastasis

When cancer metastasizes and spreads throughout the body, it can severely change the prognosis of the disease. It is estimated that metastasis is responsible for 90 percent of cancer deaths.

University of Chicago Medicine investigators have found a new way to slow the metastasis of colon cancer: by treating it with a small molecule that essentially locks up cancer cells’ ability to change shape and move throughout the body.

In a mouse model, the molecule cut the rate of cancer metastasis in half. Though more research is needed, the result could ultimately become a new therapy that, when combined with radiation and chemotherapy, could help provide better outcomes for several types of cancer.

“It’s a very promising approach,” said Ronald Rock, Ph.D., Associate Professor in the Department of Biochemistry and Molecular Biology at the University of Chicago and co-author of the paper. “It appears to be broadly applicable. If you can improve outcomes by 5 or 10 percent, that will help a lot of people.”

The results are published in the journal Proceedings of the National Academy of Sciences. Rock co-authored the paper with Ralph Weichselbaum, MD, Daniel K. Ludwig Distinguished Service Professor of Radiation and Cellular Oncology and Chair of the Department of Radiation and Cellular Oncology at UChicago.

“It’s a new area of cancer treatment, and we’re really excited to see how far this can go,” Weichselbaum said.

For cancer cells to disseminate from a tumor throughout the body, they must remodel their structure and increase their deformability to essentially crawl through tissue and worm their way into the bloodstream.

But Weichselbaum, whose research focuses on metastasis, wanted to find a way to stop that process in its tracks. He and Rock began to study a small molecule called 4-hydroxyacetophenone (4-HAP), which activates a protein in the cancer cell called nonmuscle myosin-2C (NM2C). That protein is one of the machines that allows the cell to deform and travel. When activated, it becomes locked in place, ensuring that the cancer cell cannot travel.

The investigators studied this process at both the molecular level and using human colon cancer tumors in a mouse model, and found that it significantly limited the cancer’s ability to metastasize to other parts of the body, while leaving healthy cells alone. The rate of metastasis was cut in half, compared to non-treated colon cancer.

The team envisions using this molecule in tandem with chemotherapy and radiation to create a more effective cancer-killing treatment.

“Using this molecule means there are fewer cancer cells traveling in the body, so they would be easier to kill with radiation or chemotherapy,” Weichselbaum said. “It we can decrease the spread, we have a better chance of curing the patient.”

The molecule could be an improvement over other treatments for metastasis, like kinase inhibitors, which are the basis of many chemotherapies. Those treatments work by targeting the enzymes that allow cancer to proliferate, but many times, cancer cells just find a workaround.

“With our approach, we’re essentially pouring sand right into the machine,” Rock said. “There’s no way for the cell to get around it. The engine is not going to run.”

Though the experiment was conducted on colon cancer, these preliminary results show that the molecule could work on several types of cancer that metastasize. Next the team hopes to find other molecules that could also inhibit NM2C to create a multi-layer approach for hindering metastasis. That’s important for up-and-coming physicians like Darren Bryan, MD, a former UChicago Medicine surgery resident and first author on the paper.

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Researchers find potential treatment for Rett Syndrome

An experimental cancer drug can extend the life of mice with Rett Syndrome, a devastating genetic disorder that afflicts about one of every 10,000 to 15,000 girls within 6 to 18 months after birth, Yale researchers report June 10 in the journal Molecular Cell.

In addition, the drug JQ1 also restores the cellular function of neurons in human models of the disease. Rett Syndrome causes severe deficits in language, learning and other brain functions and eventually leads to death, often during teenage years.

The Yale team—led by senior author In-Hyun Park, associate professor of genetics, and a researcher at Yale’s Child Study Center and Stem Cell Center—wanted to know how a mutation in gene MECP-2 causes the severe disruption to neuronal functions in the cortex of Rett Syndrome patients.

They created a human brain organoid containing this mutation from embryonic stem cells and found severe abnormalities in multiple brain cells. A type of brain cell called interneurons, which regulate the brain’s excitatory neurons, was particularly impacted by the mutation.

The lab then screened a variety of compounds and found that one drug, JQ1, corrected abnormalities found in interneurons of the Rett Syndrome model. The drug has been investigated in several experimental trials as a potential cancer treatment.They then tested the drug in mice models of Rett Syndrome and found that the treated mice lived about twice as long as those not receiving the drug.

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