Immunology

Immunology: The neccesary requirements to practice – Study International News

Immunology is an exciting area of biomedical sciences.Over two centuries ago, Edward Jenner, the father of immunology, purposefully infected an eight year-old-boy with a disease that killed almost 10% of Englands population. Many people questioned his actions, but Jenner remained confident in his method. The young boy, James Phipps, did not die. In fact, he exhibited no signs of smallpox whatsoever.The result of this experiment? The worlds very first vaccine.

This life-saving medicine was the product of immunology. In light of the COVID-19 pandemic, we have learned that there will never be such a thing as too many life-saving professionals who specialise in creating these preventive substances.

Immunology, by definition, is the study of the human immune system. It is not just an important branch of biomedical sciences, it is also one of the most complex. These professionals work as scientists or clinicians across different areas of research in diverse clinical specialities, ranging from allergy to cancer. Some might deal with human illnesses, while some also work within veterinary sciences.

Maria Ferreira, 74, is vaccinated by a health worker. Source: Michael Dantas / AFP

Depending on an individuals interest area or the organisation they work for, they often take on various kinds of work. Many teach and conduct research at universities. Others work in laboratories for government health agencies. Some are employed by pharmaceutical and biotechnology companies, developing new medical products and treatments. Many also work in medical offices, treating patients with autoimmune diseases.

Aspiring immunologists will need the right education and extensive training and an undergraduate degree is only the first step.Clinical positions that involve work with patients requires a medical school background and a doctor of medicine qualification.

Many schools offer pre-med programmes leading up to a bachelor of science. A major in biology is another pathway.Regardless of the path you choose, courses in biology, chemistry, organic chemistry, physics, statistics, and mathematics are extremely crucial in designing your path.

The next step will include passing the Medical College Admissions Test, otherwise known as the MCAT. Once participants obtain a good score, medical school is the next destination.During this time, students spend the first two years in classrooms and laboratories, learning every aspect of human body systems, disease, pharmacology, medical ethics, and skills such as how to properly conduct examinations on patients.

The following two years are spent completing clinical rotations. Here, students apply their knowledge, diagnosing and treating patients under the supervision of a licensed physician. Upon completion, medical school graduates are required to complete a residency, oftentimes conducting extensive lab work to gain experience with immunological testing methods.

A fellowship will usually last three years. Once training and studies are completed, aspiring immunologists will be able to obtain a license from their states health board or a similar governing body.In the US, immunologists must be certified by the American Board of Paediatrics (ABP) or the American Board of Internal Medicine (ABIM) as a prerequisite for being certified by the American Board of Allergy and Immunology (ABAI).

Once all the educational steps are complete, graduates will finally be able to begin their careers. With immunologists being highly trained and respected, these professionals reap rewards that go beyond saving lives.

As of 2019, the US Bureau of Labor Statistics (BLS) reported that allergists and immunologists earned a median annual salary of US$206,500. The BLS also indicates that these physicians would see a job growth rate of 3 to 4% or higher from 2019 to 2029, faster than the average for all occupations.

Apart from the demand and the benefits that come with it, there are many reasons why immunology can offer long-term job stability. Overall, it is an excellent career path for anyone passionate about utilising science to solve global challenges.

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Immunology: The neccesary requirements to practice - Study International News

Immunology

Does Prior Exposure to Coronaviruses Protect You? | In the Pipeline – Science Magazine

Theres a new paper out that clears up some of our thinking about the current pandemic and what protection people might have had before the latest coronavirus showed up. As so many people know by now, there are a lot of coronaviruses running around out there, and they are responsible for a small-but-real fraction of common cold type illnesses every year. Heres the CDC page on that topic, and here (from Wikipedia) is the phylogenetic tree of coronaviruses in general.

A lot of people have had one or more of the coronaviruses that are listed on the CDC page (229E, NL63, OC43, HKU1). But none of these are in the exact same family as the current beast the first two are alpha-coronaviruses and are fairly closely related to each other. The second two are in another genus, beta-coronaviruses, and are also pretty closely related to each other, but theyre off in a different lineage inside the beta-coronaviridae compared to the SARS-type coronaviruses like the current one. All of these things have spike proteins decorating them, but the spikes themselves vary in sequence, enough so that some of them have found completely different surface proteins to use for viral entry, as opposed to the SARS ones going for the ACE2 protein.

Still, immunology being what it is, the question has been open whether the B-cell and T-cell memory of past infections with these other coronviruses might give a person some protection against the current one. Ive wondered about that here on the blog myself. Its not at all a crazy idea, because what we have seen is that there are people out there who with cross-reactive antibodies that can bind to the pandemic coronavirus, some of these in blood samples from well before the current one started going through the human population. but (until now) weve lacked enough hard data to say.

Heres the MedrXiv version of the paper under discussion, and heres the version coming out now in Cell. The authors looked at 431 pre-pandemic blood samples, and compared them to 251 samples from people who have been infected in the current outbreak and recovered, as well as analyzing antibody profiles in people who are currently hospitalized. What theyve found is first, that most people have indeed been infected with one or more of the garden-variety coronaviruses. The pre-pandemic samples show plenty of antibody responses to these. Second, about 20% of these patients raised antibodies that do cross-reaction with the Spike or nucleocapsid proteins of the current pandemic coronavirus. And whats more, levels of such antibodies are elevated when a person in this group gets infected with SARS-Cov2: the immune system memory (as present in these patients B cells) responds by increasing production of the antibodies to the previous coronaviruses.

But heres the key part: cross-react does not mean neutralize and it does not mean provide protection from. These antibodies may or may not have been neutralizing against the other coronaviruses, but they dont seem to have any such effect on the current one. And in keeping with that, having such cross-reactive antibodies seems to provide no protection against catching SARS-Cov2 or against being hospitalized with it if you do. Theres no difference in the infection/hospitalization rates of the people who had cross-reactive coronavirus serum antibodies ready to go versus those who didnt. Theyre basically useless.

Now, you can still make an argument that the T cell component of immunity might provide some protection after a previous coronavirus infection. The current study didnt address this directly, but after these results, its at least less likely that thats happening. The authors make a note of this, and also note that pre-existing mucosal antibodies might exert a protective effect (which this study didnt examine, either). But prior circulating human coronavirus antibodies, even ones that can bind to the current one those it looks like we can rule out. Which is too bad.

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Does Prior Exposure to Coronaviruses Protect You? | In the Pipeline - Science Magazine

Immunology

Eurofins’ US Transplant Diagnostics and Cleveland Clinic Sign a Licensing Agreement to Expand Access to an Innovative, Novel Biomarker for Detecting…

LEE'S SUMMIT, Mo., Feb. 8, 2021 /PRNewswire/ --Eurofins Viracor, a leading infectious disease, immunology, and allergy diagnostics company focused on advancing diagnostic tests for transplant patients, announced today that it has entered into a license agreement with Cleveland Clinic for exclusive rights to an innovative urine biomarker test for detecting rejection in kidney transplant patients.

Detecting transplant rejection before damage to the transplanted kidney occurs remains a major unmet need. Additionally, diagnosing clinical acute rejection (cAR) without a biopsy and distinguishing cAR from other non-rejection causes of dysfunction remains a challenge for the transplant community.

The number of kidney transplants steadily rises each year in the United States1 with nearly 20 percent of transplants failing within three years2. This highlights the critical need for solutions that will address patient impact and the growing cost of medical treatment associated with kidney transplant complications.

Through years of basic and clinical research, Robert Fairchild, Ph.D., Cleveland Clinic in collaboration with Roslyn Mannon, MD, University of Alabama, have identified a number of RNA molecules in urine that are highly accurate for the diagnosis of rejection and elevated risk of rejection in kidney transplant patients. As a specimen type, urine is a readily available, non-invasive, and convenient sample for patients.

Eurofins Viracor laboratory and Dr. Fairchild will work collaboratively to begin the critical process of sharing expertise and methods developed at Cleveland Clinic with the long-term goal of validating the novel, innovative diagnostic assay for use in patient testing.

With the combined transplant diagnosticsportfolio of Eurofins Viracorlaboratory and Transplant Genomics, Inc.innovative, non-invasive testing for subclinical rejection,this strategic collaboration marks another critical step in Eurofins' US Transplant Diagnostics' mission in improving graft and transplant outcomes, prolonging the life of a kidney, and addressing additional unmet needs across the continuum of transplant patient care.

About Viracor

With over 30 years of specialised expertise in infectious disease, immunology and allergy testing for immunocompromised and critical patients, Viracor Eurofins is committed to delivering results to medical professionals, transplant teams, reference laboratories and biopharmaceutical companies faster, when it matters most. Eurofins Viracor is passionate about delivering value to its clients by providing timely, actionable information, never losing sight of the connection between the testing it performs and the patients it ultimately serves.

Eurofins Viracor is a subsidiary of Eurofins Scientific (EUFI.PA), a global leader in bio-analytical testing, and one of the world leaders in genomic services. For more information, please visit https://www.eurofins.com/ and https://www.viracor-eurofins.com/ .

About Eurofins the global leader in bio-analysis

Eurofins is Testing for Life. Eurofins is a global leader in food, environment, pharmaceutical and cosmetic product testing and in agroscience Contract Research Organisation services. Eurofins is one of the market leaders in certain testing and laboratory services for genomics, discovery pharmacology, forensics, advanced material sciences and in the support of clinical studies, as well as having an emerging global presence in Contract Development and Manufacturing Organisations. The Group also has a rapidly developing presence in highly specialised and molecular clinical diagnostic testing and in-vitro diagnostic products.

With over 50,000 staff across a decentralised and entrepreneurial network of more than 800 laboratories in over 50 countries, Eurofins offers a portfolio of over 200,000 analytical methods to evaluate the safety, identity, composition, authenticity, origin, traceability and purity of a wide range of products, as well as providing innovative clinical diagnostic testing services and in-vitro diagnostic products.

The Group's objective is to provide its customers with high-quality services, innovative solutions and accurate results on time. Eurofins is ideally positioned to support its clients' increasingly stringent quality and safety standards and the increasing demands of regulatory authorities as well as the requirements of healthcare practitioners around the world.

In 2020, Eurofins reacted quickly to meet the global challenge of COVID-19, by creating the capacity for over 10 million patient tests per month to support efforts to identify and suppress the virus. The Group has established widespread PCR testing capabilities and has carried out over 10 million tests in its own laboratories, is supporting the development of a number of vaccines and has established its SAFER@WORK testing, monitoring and consulting programmes to help ensure safer environments during COVID-19.

Eurofins has grown very strongly since its inception and its strategy is to continue expanding its technology portfolio and its geographic reach. Through R&D and acquisitions, the Group draws on the latest developments in the field of biotechnology and analytical chemistry to offer its clients unique analytical solutions.

Shares in Eurofins Scientific are listed on the Euronext Paris Stock Exchange (ISIN FR0014000MR3, Reuters EUFI.PA, Bloomberg ERF FP).

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SOURCE Eurofins Viracor, Inc.

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Eurofins' US Transplant Diagnostics and Cleveland Clinic Sign a Licensing Agreement to Expand Access to an Innovative, Novel Biomarker for Detecting...

Biochemistry

Biochemistry professor Tansey discovers protein that could melt tumors – The Vanderbilt Hustler

The discovery of MYC-HCF1 interactions may lead to a future tumor-shrinking treatment.

Vanderbilt University Medical Center (VUMC), pictured above, manages more than 2 million patients each year and is one of the largest academic medical centers in the Southeast, according to its website. (Hustler Multimedia/Truman McDaniel)

On Jan. 8, a study published in the journal eLIFE by Vanderbilt professor of biochemistry and cell and developmental biology, Dr. William Tansey, detailed the discovery of a genetic mutation that can be applied to shrink tumors quite quickly.

The protein, called MYC, is used by animals and humans alike for cell division and cell growth, which also allows tumor cells to rapidly expand. Tumors typically form when cells no longer have control of their growth, and MYC often enables cells to grow out of control, creating tumors. When Tansey and colleagues discovered a particular mutation that blocks the interaction between MYC and another protein, Host Cell Factor-1 (HCF1), tumors rapidly shrunk.

The next step, according to Tansey, is to identify certain molecules that are able to bind to HCF1 to prevent it from interacting with MYC.

Now that we know what we have to go after, the question is if we can do this beneficially and safely, Tansey said.

If molecules that bind to HCF1 are able to be identified, clinical trials could begin within the next decade for a potential tumor-melting clinical drug in the distant future, according to Tansey. However, the process is often long, and it may take years before this discovery is manifested into a drug, per Tansey.

If you had a molecule that was able to bind to HCF1 and prevent it from being touched by MYC, then that could form the basis of a future anti-cancer drug, Tansey said.

This discovery is the second time that a cancer-treating drug was discovered at Vanderbilt. In 2015, Vanderbilt professor of biochemistry, pharmacology and chemistry, Stephen Fesik, alongside Tansey, discovered a protein named WDR5 that similarly halts interactions with MYC. WDR5 is expected to be in clinical trials shortly, and is currently supported by the National Cancer Institutes Experimental Therapeutics Program, according to Tansey.

We are looking for something that will treat pre-existing tumors, and it seems as if this discovery could lead down that path, Tansey said.

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Biochemistry professor Tansey discovers protein that could melt tumors - The Vanderbilt Hustler

Biochemistry

Researchers find a way to measure key characteristics of proteins that bind to RNA – News-Medical.net

A team of Case Western Reserve University researchers has found a way to measure key characteristics of proteins that bind to RNA in cells--a discovery that could improve our understanding of how gene function is disturbed in cancer, neurodegenerative disorders or infections.

RNA--short for ribonucleic acid--carries genetic instructions within the body. RNA-binding proteins play an important role in the regulation of gene expression. Scientists already knew that the way these proteins function depends on their "binding kinetics," a term that describes how frequently they latch on to a site in an RNA, and how long they stay there.

Until now, researchers could not measure the kinetics of RNA-binding proteins in cells. But the Case Western Reserve researchers answered this longstanding question in RNA biology. The findings open the door to a biochemical understanding of RNA protein interactions in cells.

By understanding the kinetics, researchers can quantitatively predict how an RNA binding protein regulates the expression of thousands of genes, which is critical for developing strategies that target RNA protein interactions for therapeutic purposes.

The study marks a major step toward understanding how gene function is regulated and how to devise ways to correct errors in this regulation in diseases such as cancer, neurodegenerative disorders or infections."

Eckhard Jankowsky, Study Principal Author and Professor, Biochemistry, School of Medicine, Director, Center for RNA Science and Therapeutics, Case Western Reserve University

Their study, "The kinetic landscape of an RNA binding protein in cells," was published Feb. 10 in Nature. Funding from the National Institute of General Medical Sciences and the National Science Foundation supported the research.

The co-authors, all from Case Western Reserve, are: research associate Deepak Sharma; graduate students Leah Zagore, Matthew Brister and Xuan Ye; Carlos Crespo-Hernndez, a chemistry professor; and Donny Licatalosi, an associate professor of biochemistry and member of the Center for RNA Science and Therapeutics.

To measure the kinetics of RNA binding proteins, the researchers used a laser that sends out extremely short (femtosecond) pulses of ultraviolet light to cross-link the RNA-binding protein known as DAZL to its several thousand binding sites in RNAs. (DAZL, short for Deleted in Azoospermia-Like, is involved in germ cell development.) They then used high throughput sequencing to measure the change of the crosslinked RNA over time and determined the binding kinetics of DAZL at thousands of binding sites.

The resulting "kinetic landscape" allowed the researchers to decode the link between DAZL binding and its effects on RNAs.

Source:

Journal reference:

Sharma, D., et al. (2021) The kinetic landscape of an RNA-binding protein in cells. Nature. doi.org/10.1038/s41586-021-03222-x.

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Researchers find a way to measure key characteristics of proteins that bind to RNA - News-Medical.net

Biochemistry

Science of Aging is Focus of New Bakar Research Institute – UCSF News Services

Leanne Jones, PhD, will join UCSF from UCLA to lead the new Bakar Aging Research Institute.

UC San Francisco is launching the Bakar Aging Research Institute (BARI), a scientific community that aims to translate breakthroughs in aging research across many disciplines into new approaches and treatments that help people remain healthy and vibrant in later life.

The new Institute will bring together scientists and clinicians from all UCSF sites to address the most critical questions related to the science of aging. BARI members will be drawn from the UCSF Memory and Aging Center, the UCSF Hillblom Center for the Biology of Aging, the Department of Medicines Division of Geriatrics, and the UCSF Institute for Health and Aging, as well as many individual departments.

BARI will be headed by stem-cell scientist Leanne Jones, PhD, who will join UCSF from UCLA to serve as director and professor in the Department of Anatomy, with a joint appointment in the Department of Medicines Division of Geriatrics.

For aging research, the Bay Area is one of the best places in the world to be, said Jones. Thats one of the reasons UCSF is so appealing to me in addition to the world-class labs here, youve got excellent scientists interested in aging at the Buck Institute for Research on Aging, UC Berkeley and Stanford, as well as many biotech and pharma companies on the Peninsula. Starting a new institute at UCSF focused on aging is an unparalleled opportunity. Seminal discoveries related to aging have been made at UCSF, and I see this new effort as a recognition of those, and laying the foundation for continued groundbreaking work.

Starting a new institute at UCSF focused on aging is an unparalleled opportunity. Seminal discoveries related to aging have been made at UCSF, and I see this new effort as a recognition of those, and laying the foundation for continued groundbreaking work.

Leanne Jones, PhD

The diverse perspectives and breadth of approaches, coupled with UCSFs strongly collaborative culture, ensure that the Institute is uniquely positioned to achieve its primary goals. First, BARI will unite researchers and encourage cross-collaboration, and will also position UCSF to make key recruitments in aging science to bridge and build research groups. Second, BARI researchers will strive to uncover the molecular and cellular underpinnings of how and why we age, as a roadmap to understand what sets the stage for developing age-related diseases such as cancer, neurodegeneration, and cardiovascular disease. Working with UCSFs world-renowned clinicians, BARI researchers will develop cutting-edge technologies and therapeutic strategies to slow or reverse the aging process, as well as new ways to diagnose and tackle diseases of aging. Finally, the Institute will help to establish best practices for equitable care for older adults in our communities, thereby improving quality of life for everyone.

Saul Villeda, PhD, a UCSF neuroscientist, will serve as associate director of the new Bakar Aging Research Institute.

To lead the new Institute, Jones will be joined by UCSF neuroscientist Saul Villeda, PhD, assistant professor of anatomy, who will serve as associate director. Villeda is well known for his innovative research on aging. In a much-publicized study published in 2020, for example, he showed how exercise prompts the liver to produce an enzyme that promotes better cognitive function and helps prevent neurodegenerative decline. He believes that this enzyme might one day be administered as a drug to provide the same benefits to those unable to do vigorous physical activities.

In addition to Jones and Villeda, the institute will be guided by an executive committee that includes Nobel laureate Elizabeth Blackburn, PhD, professor emeritus of biochemistry and biophysics; Diana Laird, PhD, associate professor of obstetrics, gynecology, and reproductive sciences; Hao Li, PhD, professor of biochemistry and biophysics; and John Newman, MD, PhD, assistant professor of medicine.

BARI takes flight in the Bay Area at an opportune time. California has the largest aging population in the United States, and in San Francisco the trend is even more pronounced some 30 percent of the population will be over age 60 by 2030 according to the San Francisco Human Services Agency.

Meeting the growing health care needs of this expanding demographic will be challenging, but Bay Area institutions are well suited to address these challenges, said Jones, whose work in tissue regeneration has revealed the impact that aging has on the ability of stem cells to maintain tissues throughout the body.

Being able to take an observation in the lab and immediately work with clinicians to develop a novel therapy or intervention to target the processes that contribute to aging is one of the immediate goals of the new Institute. Therefore, Jones and Villeda said, fostering communication between basic scientists and clinicians to enhance translational medicine is essential.

Philanthropy received for this Institute will invest in the people, technologies, and research projects needed to drive deeply collaborative aging research at UCSF, said UCSF Chancellor Sam Hawgood, MBBS. The Bakar Aging Research Institute will be a key driver for innovation throughout UCSF, and particularly at Parnassus Heights, where it will be headquartered. By aligning our community around a shared research agenda, and empowering them with cutting-edge technology and new faculty positions, work at the BARI will leapfrog our current knowledge in the field.

The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.UCSF Health, which serves as UCSFs primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area.

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Science of Aging is Focus of New Bakar Research Institute - UCSF News Services

Biochemistry

Newest Report of Biochemistry Analyzer Market with Current Trends, Drivers, Strategies, Applications and Competitive Landscape 2026 URIT Medical…

The Biochemistry Analyzer Market grew in 2019, as compared to 2018, according to our report, Biochemistry Analyzer Market is likely to have subdued growth in 2020 due to weak demand on account of reduced industry spending post Covid-19 outbreak. Further, Biochemistry Analyzer Market will begin picking up momentum gradually from 2021 onwards and grow at a healthy CAGR between 2021-2025.

Deep analysis about Biochemistry Analyzer Market status (2016-2019), competition pattern, advantages and disadvantages of products, industry development trends (2019-2025), regional industrial layout characteristics and macroeconomic policies, industrial policy has also been included. From raw materials to downstream buyers of this industry have been analysed scientifically. This report will help you to establish comprehensive overview of the Biochemistry Analyzer Market

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The Biochemistry Analyzer Market is analysed based on product types, major applications and key players

Key product type:Semi-Automatic Biochemical AnalyzersFully Automated Biochemistry Analyzers

Key applications:Academic Research InstitutesBiotechnology CompaniesContract Research OrganizationsDiagnostic CentresHospitalsPharmaceutical CompaniesOthers

Key players or companies covered are:URIT Medical ElectronicELITechGroupEKF DiagnosticsSpinreactMindrayDanaherRoche Diagnostics

The report provides analysis & data at a regional level (North America, Europe, Asia Pacific, Middle East & Africa , Rest of the world) & Country level (13 key countries The U.S, Canada, Germany, France, UK, Italy, China, Japan, India, Middle East, Africa, South America)

Inquire or share your questions, if any: https://i2iresearch.com/need-customization/?id=31944

Key questions answered in the report:1. What is the current size of the Biochemistry Analyzer Market, at a global, regional & country level?2. How is the market segmented, who are the key end user segments?3. What are the key drivers, challenges & trends that is likely to impact businesses in the Biochemistry Analyzer Market?4. What is the likely market forecast & how will be Biochemistry Analyzer Market impacted?5. What is the competitive landscape, who are the key players?6. What are some of the recent M&A, PE / VC deals that have happened in the Biochemistry Analyzer Market?

The report also analysis the impact of COVID 19 based on a scenario-based modelling. This provides a clear view of how has COVID impacted the growth cycle & when is the likely recovery of the industry is expected to pre-covid levels.

Contact us:i2iResearch info to intelligenceLocational Office: *India, *United States, *GermanyEmail: [emailprotected]Toll-free: +1-800-419-8865 | Phone: +91 98801 53667

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Newest Report of Biochemistry Analyzer Market with Current Trends, Drivers, Strategies, Applications and Competitive Landscape 2026 URIT Medical...

Biochemistry

Study: Consume walnut regularly to diminish negative results of H. pylori infection – Devdiscourse

A new study using mice models, distributed in the Journal of Clinical Biochemistry and Nutrition recommends that regular walnut consumption might be a promising mediation for lessening negative results related to Helicobacter pylori (H. pylori) disease, a broad bacterial infection that influences the greater part of the world's population. Using mice models, researchers from the CHA Cancer Prevention Research Center in Korea found preliminary evidence that eating a diet rich in walnuts may help protect against negative outcomes associated with H. pylori infection. Specifically, the research found that walnut extracts, formed from whole walnuts, may help create protective proteins and anti-inflammatory actions in the gut that may safeguard against H. pylori infection and resulting in cancer in mice. The study was supported by the California Walnut Commission.

Prevalence of H. pylori is most common in developing countries as it is generally related to socioeconomic status and hygienic conditions and is thought to be spread through person to person contact or even through food and water. H. pylori infection is a major cause of ulcers in the stomach and small intestine as well as stomach cancer and peptic ulcer disease. While treatments are currently available, there are concerns about the bacteria's growing resistance to antibiotics. Due to increasing challenges associated with antibiotic resistance, researchers have been investigating dietary and other non-bacterial approaches to improve the impact of H. pylori infection, such as in this new study.

This is not the first time walnuts have been linked to a lower risk of gastrointestinal cancer development in mice. Two other animal studies published in Cancer Prevention Research and Nutrients found that walnuts in the diet may suppress colon tumour development by modifying gut bacteria as well as inhibit the progression of colorectal cancer by suppressing angiogenesis - the development of new blood vessels which facilitates the growth of cancer cells. Animal studies are valuable for providing background information and can be used as a basis for future research in humans. Based on the existing body of evidence, including this study on walnuts, dietary approaches to reduce symptoms of H. pylori infection, such as inflammation, seem worthwhile to pursue in a well-designed clinical trial to confirm the findings. (ANI)

Also Read: Firmenich Appoints Levenza Toh as Vice President, Perfumery, Southeast Asia, Japan & Korea

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)

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Biochemistry

[Full text] The Recurrent Liver Disorder of a Pregnant Mother: Intrahepatic Choles | IMCRJ – Dove Medical Press

Background

As described by Ahlfeld (1883), intrahepatic cholestasis of pregnancy (ICP), is a frequent jaundice in pregnancy that can be relieved following delivery, it may reoccur in subsequent pregnancies.1 ICP is a common pregnancy-related liver disease seen in the second and third trimesters of pregnancy.2 Clinically it characterized by a rash and an itching sensation all over the body, particularly on the hands and feet. Elevated liver enzymes, including serum aminotransferases and/or elevated serum bile acid levels (>or = 10 micromol/L) are usually spontaneously relieved after delivery, and no later than one month post-partum. ICP may reoccur in subsequent pregnancies.3 ICP is a liver disease unique to pregnancy with a global prevalence ranging from 0.3% and 5.6% of pregnancies. Its prevalence differs from one country to the other and is more common in countries like Chile and Bolivia.1,4

Even though, the pathogenesis of ICP is not well defined and its etiology is multifaceted, it is related to abnormal biliary transport across the canalicular membrane. Available literature suggest that genetic, environmental, hormonal, and exogenous factors all play a role in the occurrence of ICP.57 Even though ICP will not usually have severe and complex outcomes, it has been associated mostly with preterm delivery, meconium staining of amniotic fluid, fetal bradycardia, fetal distress and fetal demise.1,3,6,811 The underlying mechanisms associated with poor fetal outcome are largely unknown. Poor fetal outcomes, including asphyxia events and spontaneous preterm delivery, have been shown to be associated with elevated maternal total serum bile acids (TBA) (40 micromole/L) in pregnancy.3,12

It is controversial to set the standardized and the most optimal management for women with ICP.9 But pharmacotherapy, antenatal fetal monitoring, analysis of the bile acid and early elective delivery are the currently proposed management options, so as to reduce poor outcomes for both mother and baby.1,9,11,13

A 31-year-old Gravida III and Para II mother came to the outpatient clinic of the University of Gondar specialized hospital, North West Ethiopia, in January 2019 complaining of pruritus (mainly under the breasts, on the neck, palms of the hands and soles of the feet) along with jaundice at 24 weeks gestational age (GA). She had a history of antenatal care follow up at a nearby health center. She presented to us with singleton and intrauterine pregnancy.

On arrival, she was screened for both subjective and objective data for her current and past obstetric, medical, surgical, gynecological, social, personal and family history. She had a history of early neonatal loss and one living child, her bilirubin value was elevated, she suffered pruritus and hepatomegaly in her previous pregnancies. She had a personal and family history of pruritus during pregnancy. From her previous personal history, she reported a history of similar features that resembled her current clinical presentation. The rest of her laboratory investigations and physical examination results, including vital signs (blood pressure 100/70 mmHg), were in their normal range and she arranged for her next follow up after being provided with an antihistamine drug and offered counseling and health education to ensure the best outcome for her pregnancy. At 30 weeks GA, she was assessed for any complaints, including the worsening of pruritus and underwent liver biochemistry tests. Based on this, her bilirubin total and bilirubin direct tests were 4.52 mg/dl and 3.45 mg/dl respectively. Other complete blood count tests and urinalysis were within the normal range. The progress of the pregnancy was also assessed using ultrasound and showed no any abnormality. At 34 weeks GA her bilirubin values became elevated, whereas her liver function test on both alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were 83U/L and 75 U/L, respectively. The value of prothrombin time (PT) and partial thromboplastin time (PTT) were 12.2 and 34.6 seconds, respectively. Urine bilirubin, urobilinogen, urine nitrite, and Hepatitis B surface antigen (HBS-antigen) tests were negative. But there was no opportunity for a TBA laboratory test.

As a result of having some abnormally elevated liver biochemistry tests, and the clinical features of the patient's current and past obstetric history, a decision was made to admitthe patient to the obstetric ward after a diagnosis of ICP was made. After admission various checks were carried out, including: weekly fetal surveillance with ultrasound and using a kick chart; administration of four doses of dexamethasone 12 hours apart to accelerate fetal lung maturation at 33 weeks GA; administration of antihistamine drugs to alleviate the suffering from pruritus; and psychological reassurance of the patient. The patient's clinical symptoms were not improved after administering antihistamine drugs and she suffered from severe pruritus following the administration of dexamethasone. At 37 weeks GA, the obstetrician and midwives had a detailed discussion and decided to deliver the baby. Initially the cervix was ripened with a Foley catheter so as to have an acceptable BISHOP score and then induction of labor with oxytocin was carried out. During this time a non-reassuring fetal heart rate pattern was detected with a cardiotocograph (CTG) and was confirmed with ultrasound. Finally, a successful caesarean section was done performed to deliver a 2.8 kg live female baby with an APGAR score of 8 and 9 in the 1st and 5th minutes, respectively. Following delivery, the patient remained inhospital for a week and was discharged to home with both mother and baby in stable conditions. The evaluation of the patient during the puerperium two weeks after giving birth was good, with the normalization of the liver biochemistry tests and the disappearance of the pruritus. The bilirubin total, ALT and AST decreased to 1.1 mg/dl, 32 U/L, and 31 U/L respectively. The evaluation of the baby was also good, with normal physical development.

With the unknown etiology of ICP, various factors are indicated to be associated with high prevalence of ICP; these factors include genetics, the environment, coexisting liver and biliary tract conditions or abnormal metabolism of bile acid due to the high secretion of estrogen during pregnancy, hyper emesis gravidarum, multiple pregnancies and over stimulation of ovarian or oral contraception. The most frequent ICP complication to the fetus is preterm delivery.3,8 Especially the risk of preterm delivery is significantly higher for those patients with total bile acids (TBA)>40 mol/l.3 It was found that the mechanism of preterm delivery with ICP is that bile acid activity results in an increased sensitivity of the uterine muscle to oxytocin and in the increased oxytocin receptor expression. Having a TBA >11 mol/L in the third trimester of pregnancy is a direct indicative of ICP. The measurement of bile acid concentration is a basic test aimed at diagnosis and therapy monitoring of the ICP. Meanwhile, the activity of alcohol dehydrogenase (ADH) isoenzymes could be considered as having a positive interaction in the sera of women with intrahepatic cholestasis14 and having a history of allergic reactions may mean they are more likely to develop ICP15 but for our patient there was no history of allergic reactions. Hence it is better to consider such a test while suspecting and detecting this case. ICP has its own differential diagnoses including fatty liver disease, hepatobiliary disorder, HELLP syndrome, skin disease, renal pruritus and hyper emesis gravidarum. As a result, it is better to consider all these and differing diagnoses while anticipating ICP. In the management of ICP, the major role should be preventing still birth and minimizing the adverse effects of ICP clinical features on the mother. As various literatures suggest,8,11 there is no definitive cure for ICP other than alleviating the suffering from pruritus with drugs like Ursodeoxycholic acid (UDCA),2 antihistamines and delivering the baby as early as possible (from 3738 weeks GA) as the clinical features of ICP will regress and disappear after delivery.

Finally, ICP is a cholestatic liver disease unique to pregnancy with a variable worldwide prevalence ranging between 0.3% and 5.6% of pregnancies. After confirming the diagnosis of ICP with a liver biochemistry test indicating total serum bile acid and its signs and symptoms as a clinical feature, close follow up of the patient is mandatory so as to prevent and minimize the adverse outcomes of ICP. For our patient after a serial laboratory test and weekly fetal surveillance, a trial of induction with oxytocin was performed and finally an effective cesarean section was carried out to deliver a 2.8 kg living female baby with an indication of non-reassuring fetal heart rate pattern. ICP regressed and disappeared at the three week follow up in the puerperium.

ALT, alanine aminotransferase; AST, aspartate aminotransferase; GA, gestational age; ICP, intrahepatic cholestasis of pregnancy; PT, prothrombin time; PTT, partial thromboplastin time; TBA, total serum bile acid.

The data used to support the findings of this study are available from the corresponding author upon formal request.

The Ethical clearance letter was obtained from the Institutional Review Board of the University of Gondar. Patient consent was taken with written informed consent form and she was volunteer to participate.

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

We would like to acknowledge University of Gondar Department of Obstetrics and Gynecology as well as school of midwifery for allowing us to report on this case. Our deepest gratitude goes to our patient for her cooperation on revealing both her subjective and objective data, as well as her permission for us to publish this article.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

The authors declared that they did not have any competing interest.

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2. Rodrigo Zapata F. Intrahepatic cholestasis of pregnancy: even today a puzzling disease of pregnancy. 2017.

3. Rook M, Vargas J, Caughey A, Bacchetti P, Rosenthal P, Bull L. Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort. PLoS One. 2012;7(3):e28343. doi:10.1371/journal.pone.0028343

4. Chacko KR, Wolkoff AW. Intrahepatic cholestasis of pregnancy: new diagnostic insights. Ann Hepatol. 2017;16(2):176178. doi:10.5604/16652681.1231550

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8. Kenyon AP, Piercy CN, Girling J, et al. Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG. 2002;109:282288. doi:10.1111/j.1471-0528.2002.01368.x

9. Geenes V, Williamson LC, Chappell LC. Intrahepatic cholestasis of pregnancy. Obstetric Gynaecolog. 2016;18(4):273281. doi:10.1111/tog.12308

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[Full text] The Recurrent Liver Disorder of a Pregnant Mother: Intrahepatic Choles | IMCRJ - Dove Medical Press

Biochemistry

Leading Report of Automatic Veterinary Biochemistry Analyzer Market 2026: Latest Trends, Drivers, Strategies and Competitive Landscape with key…

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Leading Report of Automatic Veterinary Biochemistry Analyzer Market 2026: Latest Trends, Drivers, Strategies and Competitive Landscape with key...