A clinical trial that followed close to 1,000 people using a new home test for chronic kidney disease (CKD) shows a high percentage of the participants were happy with the process and preferred it to getting tested in a doctor’s office.
The National Kidney Foundation (NKF), Geisinger and Healthy.io evaluated smartphone home testing for CKD. Patients with hypertension – a major risk factor for CKD – that had not been tested in the previous 12 months were given the option of using a smartphone urinalysis test at home and the results were impressive.
Of the participants that received a kit, 71 percent adhered to testing, 98 percent of patients who attempted a home test succeeded, and 89 percent stated they prefer home testing over testing at the physician’s office. Among patients who completed home testing, the mean score for whether they would recommend home urine testing to a friend or colleague was 8.9/10 (i.e. Net Promoter Score of 62).
Despite current guidelines that recommend CKD testing yearly for adults with diabetes and/or hypertension, less than 10 percent of those with hypertension and less than 40 percent of those with diabetes are currently completely assessed.
“Albuminuria is often the earliest sign of kidney disease, and yet, in the majority of people at increased risk due to diabetes or hypertension, it is not tested,” said Kerry Willis, PhD, NKF Chief Scientific Officer. “This new test has the potential to help millions of patients find out they have CKD while there is still time to prevent progression to kidney failure.”
National Kidney Foundationhttps://tinyurl.com/y4wxhnsy

Rheumatoid arthritis (RA) is an autoimmune disorder that occurs when the immune system mistakenly attacks the body’s tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of the joints, causing painful swelling that can eventually result in bone erosion and joint deformity.
Most RA patients are positive for anticitrullinated protein antibodies (ACPA), and these antibodies are highly specific for RA diagnosis. ACPA recognizes various citrullinated proteins, such as fibrinogen, vimentin and glucose- 6-phosphate isomerase. Citrullinated proteins are proteins that have the amino acid arginine converted into the citrulline, which is not one of the 20 standard amino acids encoded by DNA in the genetic code. Autoreactivity to citrullinated protein may increase susceptibility to RA.
While many candidate citrullinated antigens have been identified in RA joints, the involvement of citrullinated proteins in blood serum remains mostly uninvestigated. To that end, a team of University of Tsukuba-centred researchers set out to explore the expression and commonality of citrullinated proteins in peptide glucose-6-phosphate isomerase-induced arthritis (pGIA) and patients with RA, and went one step further to investigate its correlation with RA disease activity.
“We examined serum citrullinated proteins from pGIA by western blotting, and the sequence was identified by mass spectrometry. With the same methods, serum citrullinated proteins were analysed in patients with RA, primary Sjögren’s syndrome, systemic lupus erythematosus, and osteoarthritis as well as in healthy subjects,” study corresponding author Isao Matsumoto explains. “In patients with RA, the relationship between the expression of the identified protein inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) and clinical features was also evaluated, and the levels of citrullinated ITIH4 were compared before and after biological treatment.”
The researchers found that citrullinated ITIH4 was highly specific to patients with RA, compared with patients with other autoimmune and arthritic diseases or in healthy subjects, indicating a potential role for citrullinated ITIH4 in RA pathogenesis. Notably, its levels were decreased in correlation with the reduction of disease activity score after effective treatment in patients with RA. Moreover, antibody response to citrullinated epitope in ITIH4 was specifically observed in patients with RA.
“Our results suggest that citrullinated ITIH4 might be a novel biomarker to distinguish RA from other rheumatic diseases and for assessing disease activity in patients with RA,” Matsumoto says. “To our knowledge, this is the first report of its kind in the literature.”

MedicalXpresshttps://medicalxpress.com

The latest research by Colliers International has revealed the current global In Vitro Fertilization (IVF) market is estimated to be between US$ 10 billion to US$ 12 billion, while the current IVF market size for Middle East & North Africa (MENA) is approximately US$ 1 billion, indicating a high demand for IVF and related treatments in the region.
The figures, published in a new report titled “In Vitro Fertilization (IVF) & Fertility in the MENA region”, revealed that compared to 10% worldwide, infertility in the MENA region is 15% or higher, with male infertility a growing problem occurring in approximately 50% of the cases in the GCC and Middle East due to lifestyle, diabetes, obesity and genetics related factors, as GCC countries have one of the highest diabetic and obesity rates in the world.
The report, which is published as part of the MEDLAB Market Report series ahead of MEDLAB 2019 which takes place from 4 – 7 February at the Dubai World Trade Centre, highlighted that although the population in the MENA region has increased from over 100 million in 1950 to 380 million in 2017 and is expected to increase to 700 million by 2050, overall fertility rates have decreased from seven children per women in 1960 to just three in 2017.
The research provides an in-depth analysis of the fertility rates in MENA region and, despite overall high population growth rates, why IVF remains in demand in the region, especially in the GCC countries.
Commenting on some of the key insights on the UAE’s IVF industry, Mansoor Ahmed, Director Healthcare, Education & PPP for MENA Region at Colliers International, said: “IVF is not only sought after locally but is one of the leading treatments undertaken by medical tourists in the UAE, especially in Dubai. Based on Colliers’ discussions with leading operators, medical tourism accounts for 10% to 15% of the IVF patient volumes.”
According to the report, new innovations and improved testing techniques are gradually creating paradigm shifts in the field of assisted reproductive technology. Particularly the increased focus on pre-marital screening for consanguineous (relatives) couples and the development of new genetic tests for screening of the embryos greatly improves the chance of minimizing certain genetic diseases common in this region.
Dr Laura Melado, Specialist – Obstetrics & Gynecology, IVF, IVI Middle East Fertility Clinic, Abu Dhabi, UAE, who will be speaking at the Cytogenetics & IVF Conference during MEDLAB 2019, commented:  “The Carrier Genetic Test (CGT) helps to determine the risk of having a child with a genetic disease. Anyone, without knowing, can be a carrier of one or more recessive mutations, but some couples have higher possibilities to carry the same genes. When this happens, Pre-implantation Genetic Testing (PGD) can be done for the embryos as part of the fertility treatment to help the couples to deliver healthy babies.”
Organized by Informa Exhibitions, MEDLAB Exhibition & Congress 2019 will welcome more than 19,600 medlical laboratory trade professionals and 670+ exhibitors from 46 countries in an effort to develop the value of laboratory medicine in shaping the future of healthcare and to provide advanced medical laboratory techniques for better health.
To download the “In Vitro Fertilization (IVF) & Fertility in the MENA region” report, please visit https://www.medlabme.com/en/forms/IVF-Fertility-MENA-2019-Report.html.

The world’s first genetic test for Huntington’s disease using nanopore-based DNA sequencing technology is now available at Guy’s and St Thomas’ NHS Foundation Trust. The test could drastically cut the waiting time for the most complicated cases of Huntington’s disease and has huge potential for other genetic disorders in the future.

The breakthrough was achieved by a collaboration between Viapath, the NIHR Guy’s and St Thomas’ Biomedical Research Centre and its academic partner King’s College London, and the London South Genomic Laboratory Hub.

The team used MinION DNA sequencing devices made by Oxford Nanopore Technologies that provide results much faster than traditional testing methods. They have shown for the first time that these sequencing devices can meet the stringent, internationally recognized standards for use in clinical laboratories, providing ‘proof-of-principle’ that this new technology can be used in the NHS.

The MinION is a small hand-held device that ‘decodes’ individual strands of DNA in real-time. It identifies any changes in the DNA sequence and then matches these to a library of known genetic sequences to detect presence of the genetic disorder. Most current technologies provide segments of DNA sequence that need to be analysed at a later date, which leads to a longer wait for results.

Huntington’s disease is an inherited neuro-degenerative disorder which stops parts of the brain working properly, with symptoms worsening over time, and is usually fatal within 20 years. Currently individuals with symptoms of Huntington’s disease have a blood test and can wait up to four weeks for the result.

Dr Deborah Ruddy, consultant clinical geneticist at Guy’s and St Thomas’, said: “This technology means that test results for people with symptoms of Huntington’s disease could be reduced to less than one week. We are now conducting research to determine where else this new technology could speed up diagnosis of other genetic disorders.

“Although there is no cure for Huntington’s disease as yet, treatment and support can help reduce some of the problems it causes. The technology can reduce the distress that patients and families experience whilst waiting for results, and also administer treatments and make support available to patients sooner than previously possible.”

This is the first time that Oxford Nanopore Technology has been used in an NHS laboratory accredited by the United Kingdom Accreditation Service (UKAS), which requires the technology to meet stringent quality control standards and produce reliable results on every sample.

Professor Jonathan Edgeworth, Viapath’s Medical Director, said: “This advance was made possible through a research partnership involving front-line clinicians, academics and healthcare scientists. Everyone came together with a single vision to speed up the pathway moving scientific discovery and technological advance to the bed-side. This approach will be of immense benefit to patients. We are evaluating whether this technology can speed up diagnosis of a range of diseases including infections and cancers, to more rapidly identify best treatments based on individual DNA profiles.”

www.guysandstthomasbrc.nihr.ac.uk/

www.nihr.ac.uk/patientdata

A new study from BUSM and BUSPH identifies a pattern of inflammation associated with cardio-metabolic risks among participants in the Black Women’s Health Study, as well as two independent groups of vulnerable women. These findings could help underserved patients benefit from precision medicine and personalized profiles of disease risk.
According to the researchers, body mass index alone is an imperfect measure of obesity-associated disease risks, such as for Type 2 diabetes, because there are some individuals with chronic obesity who are apparently protected from cardio-metabolic complications and lean individuals with high cardiovascular and diabetes risks. Abnormal, unresolved inflammation in blood and adipose (fat) tissue, rather than obesity per se, is thought to be important for development of disease. Certain biomarkers show promise in predicting obesity-associated diabetes risk; however, the clinical utility of single biomarkers is limited for complex disease phenotypes such as these.
The research team took a data-driven, systems biology approach to discover six cytokine signatures associated with Type 2 diabetes risk in a vulnerable population: African American women with obesity and varying degrees of metabolic health. These six distinct signatures are patterns of sixteen cytokines/chemokines that promote or reduce inflammation.
Analyses of plasma samples from participants in the Black Women’s Health Study, formed the basis for the discovery dataset, which was then validated in two separate groups, African American women volunteers with obesity who had donated plasma to the Komen Tissue Bank, and African American women with obesity who were breast reduction surgical patients at a safety net hospital in Greater Boston. The patterns or signatures in the validation cohorts closely resembled the distributions in the discovery cohort.
“These findings are highly relevant to an understudied and underserved population that experiences elevated risks for co-morbidities of obesity. The overall impact of this report is high because of the potential utility of the new signatures just discovered and validated, which could assist clinical decision making with more personalized information,” explained corresponding author Gerald V. Denis, PhD, Associate Professor of Pharmacology and Medicine at BUSM.

Boston University School of Medicine
www.bumc.bu.edu/busm/2018/05/08/new-study-provides-insight-into-blood-signatures-of-inflammation/