Sexual transmission of Ebola Virus in Liberia confirmed

A suspected case of sexual transmission of Ebola virus disease (EVD) in Liberia was confirmed using genomic analysis, thanks to in-country laboratory capabilities established by U.S. Army scientists in collaboration with the Liberian Institute for Biomedical Research (LIBR).
The work provides molecular evidence of Ebola virus (EBOV) transmission between an EVD survivor and his female partner. It also demonstrates the value of real-time genomic surveillance during an outbreak, according to senior author Gustavo Palacios, Ph.D., of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID).

CPT Suzanne Mate, Ph.D., of USAMRIID, said scientists working at the LIBR earlier this year analysed blood samples from a female patient who tested positive for EBOV in March 2015 when there had been no new documented cases for 30 days. The patient was reported have had recent sexual intercourse with a male partner who had survived EVD and had been declared EBOV negative in early October 2014.

Following the patient’s death on March 27, Mate said, public health officials were able to secure the consent of the male survivor to obtain and test a semen sample from him. The semen sample tested EBOV positive by quantitative RT-PCR, but the assay indicated that the level of viral RNA was low and required a different sample preparation method than the one originally deployed to sequence EBOV RNA from acute samples.

“We implemented a new enrichment strategy in collaboration with scientists from Illumina, Inc. that was pivotal in obtaining the required coverage to complete downstream genomic analysis,” said Michael Wiley, Ph.D, of USAMRIID. Next-generation sequencing of the enriched EBOV RNA extracted from the male survivor’s semen was used to compare the genome for similarity to the virus RNA extracted from the female patient’s blood sample.

“Ebola virus genomes assembled from the patient’s blood and the survivor’s semen were consistent with direct transmission,” commented Jason Ladner, Ph.D., of USAMRIID. “The samples shared three genetic substitutions that have not been found in any other Ebola virus sequences in Western Africa.”

In addition, said Ladner, these three genetic changes were distinct from the last
documented transmission chain in Liberia prior to this case. Combined with epidemiologic data, the genomic analysis provides support for sexual transmission of Ebola virus and for the persistence of infective EBOV in semen for more than 179 days after disease onset. This caused both the Centers for Disease Control and Prevention and the World Health Organization to change their recommendations for convalescent patients regarding sexual contact until more definitive information is obtained about how long Ebola virus can persist in semen. Research Institute of Infectious Diseases

Treatments for Charcot-Marie-Tooth Disease

Scientists at The Scripps Research Institute (TSRI) and the Salk Institute for Biological Studies have discovered how a mutant protein triggers nerve damage in a subtype of Charcot-Marie-Tooth (CMT) diseases, a group of currently untreatable conditions that cause loss of function in a person’s hands and feet.

The new research suggests future therapies may target this haywire protein, restoring nerve function in patients with CMT.

“This is the first major advancement toward a molecular mechanistic understanding of CMT subtype CMT2D,” said TSRI Professor Xiang-Lei Yang, senior author of the new study with Samuel Pfaff, a neuroscience professor at the Salk Institute and a Howard Hughes Medical Institute investigator. “These findings will help us develop future diagnostics and treatments.”

CMT is one of the most common inherited neurological diseases, affecting about one in 2,500 people. Genetic sequencing usually turns up an array of mutations in people with CMT, making it difficult to pin down the gene responsible and develop a treatment.

In the new study, researchers focused on a protein called glycyl-tRNA synthetase (GlyRS), which is altered in people with disease subtype CMT2D.

Previous work by Yang and her colleagues showed that mutant forms of GlyRS open up their molecular structure to reveal binding components inside—a bit like opening Velcro to reveal the sticky components.

Until now, it was not clear how mutant GlyRS harmed patients.

The work in Yang’s lab, spearheaded by TSRI graduate student Weiwei He, revealed that mutant GlyRS can interact with the Nrp1 receptor on cells. Normally, a growth factor, called vascular endothelial growth factor (VEGF), binds to part of the receptor and relays signals to maintain nerve health.

A postdoctoral researcher in the Yang lab, Huihao Zhou, found that opened-up, mutant GlyRS can bind to the same part of the Nrp1 receptor, blocking the signals for nerve maintenance. This causes motor neurons to decline and even die, breaking the connection between the brain and muscles in the limbs. “GlyRS competes with VEGF,” explained Yang.

Researchers at Salk further confirmed this finding by observing the effect of mutant GlyRS in mouse models of CMT. The team, including Salk Staff Scientist Ge Bai, used gene therapy techniques to ramp up VEGF production in mouse models. Higher levels of VEGF out-competed GlyRS, restoring function in the Nrp1 receptor. The mice with CMT regained some muscle strength and showed significant improvements in CMT symptoms.

“This solves a long-running mystery of how a gene mutation damages the neurons that carry information from the spinal cord to our muscles, resulting in a range of sensory and movement problems,” said Pfaff. “It’s an exciting finding, as we were able in experiments to reduce the symptoms of the disease by targeting the activity of these proteins.”

The next step is to develop targeted strategies that could recognize and intercept GlyRS mutants before they block VEGF. Yang is currently working to screen possible antibodies in collaboration with Kim Janda, the Ely R. Callaway Jr. Professor of Chemistry and member of the Skaggs Institute for Chemical Biology at TSRI.

The new study also has broader implications outside the subtype of CMT examined in these experiments. Yang said mutant GlyRS’s abnormal interaction with Nrp1 is a crucial clue for understanding nerve damage. “This could shed light on the mechanisms behind other forms of CMT,” said Yang. The Scripps Research Institute

Therapeutically targeted gene mutation may cause subset of pancreatic cancers

Not all cancers are the same, even if they originate from the same tissue type. A new study by University of Wisconsin Carbone Cancer Center (UWCCC) researchers has found a small subset of pancreatic cancers may be caused by a gene mutation that can be therapeutically targeted, leading to new treatment options for those patients with the mutation.

‘My lab is interested in what the mutation profiles are in cancers,’ said Dustin Deming, MD, assistant professor of medicine at UWCCC. ‘Nearly ninety percent of pancreas cancers have a mutation in the KRAS gene, but there is currently no successful drug therapy to target those mutations, making pancreas cancer one of the more difficult cancers to treat.’

‘The idea behind this study was to ask if there is potentially any other mutation in the remaining cases that can be targeted,’ Deming said.

He and his research team searched through publicly available datasets of pancreas cancer mutation profiles to see if they could identify a gene other than KRAS that appeared with some frequency.

‘We found that, though uncommon, there appears to be a small percentage of pancreas cancers that have a mutation in the PIK3CA gene, a gene we know from our work in colon cancer that we can target therapeutically, and target it pretty well,’ Deming said.

PIK3CA encodes a protein, called PI3K, that is responsible for activating many downstream targets that promote cell growth, and mutant forms of the gene can lead to persistent, uncontrollable signalling of these targets. PIK3CA mutations have been implicated in many human cancers including colorectal and breast, and an estimated three to five percent of pancreas cancers have mutations in this gene.

To directly assess the role of PIK3CA mutations in pancreas cancer development, Deming and his team generated mouse models where the mutant gene was expressed only in pancreatic cells but no other tissue types. They then performed histology and pathology tests on pancreas sections from these mice and found several hallmarks of pancreas cancer development were present.

‘We were able to show that this mutation can initiate pancreas cancer in mice, and therefore the idea that it initiates pancreas cancers in humans, though more uncommonly than KRAS mutations, might be valid,’ Deming said.

Next, they wanted to see if drugs that inhibit PI3K, like those used with some success to treat colorectal cancers, could reduce the pancreas cancer burden in these genetically altered mice. They administered a dual inhibitor drug that targets both PI3K and one of its downstream targets, and found that nearly all of the cancer hallmarks previously seen in the untreated mice were not present in the treated group.

‘Our next goal is to find patients who have this mutation, look at their clinical characteristics and try to figure out if there is some way, other than genotyping everyone’s cancer for this mutation, to predict who might benefit,’ Deming said. “We are excited that this work might have identified a more treatable subtype of pancreatic cancer that could respond to drugs that are already in clinical development.” University of Wisconsin-Madison School of Medicine

New UW model helps zero in on harmful genetic mutations

A new UW model can help narrow down which genetic mutations affect how genes splice and contribute to disease.

Between any two people, there are likely to be at least 10 million differences in the genetic sequence that makes up their DNA.

Most of these differences don’t alter the way cells behave or cause health problems. But some genetic variations greatly increase the likelihood that a person will develop cancer, diabetes, colour-blindness or a host of other diseases.

Despite rapid advances in our ability to map an individual’s genome — the precise coding that makes up his or her genes — we know much less about which mutations or anomalies actually cause disease.

Now, a new model and publicly available Web tool developed by University of Washington researchers can more accurately and quantitatively predict which genetic mutations significantly change how genes splice and may warrant increased attention from disease researchers and drug developers.

The model — the first to train a machine learning algorithm on vast amounts of genetic data created with synthetic biology techniques — is outlined in a paper recently published.

“Some people have variations in a particular gene, but what you really want to know is whether those matter or not,” said lead author Alexander Rosenberg, a UW electrical engineering doctoral student. “This model can help you narrow down the universe — hugely — of the mutations that might be most likely to cause disease.”

In particular, the model predicts how these genetic sequence variations affect alternative splicing — a critical process that enables a single gene to create many different forms of proteins by including or excluding snippets of RNA.

“This is an avenue that’s unexplored to a large extent,” said Rosenberg. “It’s fairly easy to look at how mutations affect proteins directly, but people have not been able to look at how mutations affect proteins through splicing.”

For example, a scientist studying the genetic underpinnings of lung cancer or depression or a particular birth defect could type the most commonly shared DNA sequence in a particular gene into the Web tool, as well as multiple variations. The model will tell the scientist which mutations cause outsized differences in how the gene splices — which could be a sign of trouble — and which have little or no effect.

The researcher would still need to investigate whether a particular genetic sequence causes harmful changes, but the online tool can help rule out the many variations that aren’t likely to be of interest to health researchers. To validate the model’s predictive powers, the UW team tested it on a handful of well-understood mutations such as those in the BRCA2 gene that have been linked to breast and ovarian cancer.

Compared to previously published models, the UW approach is roughly three times more accurate at predicting the extent to which a mutation will cause genetic material to be included or excluded in the protein-making process — which can change how those proteins function and cause biological processes to go awry. University of Washington

New gene a key to fighting sepsis

Scientists have identified a gene that could potentially open the door for the development of new treatments of the lethal disease sepsis.

Researchers from The Australian National University (ANU) and the Garvan Institute of Medical Research worked with Genentech, a leading United States biotechnology company, to identify a gene that triggers the inflammatory condition that can lead to the full-body infection sepsis.

‘Isolating the gene so quickly was a triumph for the team,’ said Professor Simon Foote, Director of The John Curtin School of Medical Research (JCSMR) at ANU.

Sepsis is a severe whole-body infection that kills an estimated one million people in the US alone each year. It occurs as a complication to an existing infection, and if not treated quickly can lead to septic shock and multiple organ failure, with death rates as high as 50 per cent.

Researchers were aware that sepsis occurs when molecules known as lipopolysaccharides (LPS) on the surface of some bacteria infiltrate cells, triggering an immune response that causes the cells to self-destruct. But exactly how the self-destruct button was pressed remained a mystery.

Scientists at Genentech showed that Gasdermin-D usually exists in cells in an inactive form. When the LPS molecules enter the cells they trigger an enzyme called caspase-11, a kind of chemical hatchet, to lop the protective chemical cap off Gasdermin-D, which in turn leads the cells to self-destruct.

The team employed a large-scale forward genetics discovery platform to screen thousands of genes for those involved in the LPS driven self-destruct pathway of cells.

The team found that the new gene created a protein, Gasdermin-D, that triggers cell death as part of the pathway to sepsis.

Nobuhiko Kayagaki, PhD, Senior Scientist from Genentech, said the work will help researchers understand and treat other diseases as well as sepsis.

‘The identification of Gasdermin-D can give us a better understanding not only of lethal sepsis, but also of multiple other inflammatory diseases,’ he said. Australian National University

Sarcoidosis: surface marker allows new diagnostic approaches

A team of scientists at the Helmholtz Zentrum München together with colleagues of the Ludwig Maximilians University Munich recently developed a new strategy to determine monocyte subsets involved in diseases. The results could help facilitating the diagnosis of sarcoidosis and may improve the respective patient management.

Monocytes are white blood cells that are crucial to human immune defence.  They are precursor cells of macrophages and dendritic cells and are circulating in the blood until they invade their respective target tissue where they defend the body against exogenous structures. So far, scientist categorized subtypes of monocytes only with regards to the surface markers CD14 and CD16* – however, this might change in the future.

In the current study, the team headed by Prof. Loems Ziegler-Heitbrock was able to show that the analysis of an additional marker molecule called slan allows a more precise determination of monocyte subgroups. The results of the researchers show that this classification might also lead to a better understanding of certain diseases.

To this end Dr. Thomas Hofer and Dr. Marion Frankenberger, scientists of the Comprehensive Pneumology Center (CPC) at Helmholtz Zentrum München, analysed blood samples of patients suffering from sarcoidosis. This disease, which often leads to damage of the patients’ lungs, is caused by a strong immune reaction and a concomitant formation of nodules in the tissue. The underlying mechanisms are still unclear but scientists are convinced that monocytes play a critical role. “Our data clearly indicate which subtype of the monocytes is involved in the disease”, explains Hofer. “In the patients’ blood we found significant numbers of monocytes, which were positive for CD16 and negative for slan.” According to Hofer, these cells might play a major role in sarcoidosis.

Moreover, in further experiments the scientist found that the marker slan might also serve to gain insights into a brain disease: “To test the predictive value of our new diagnostic tool, we also analysed samples of patients suffering from HDLS, a disease which leads to destruction of neurons of the brain”, said Frankenberger. “Our results show that a clearly definable subgroup of monocytes (CD16 positive/slan positive) was almost absent in the blood of these patients. Therefore we presume that these cells are important for normal brain function”, explains the Co-author.

“With this novel approach we now have a new diagnostic tool and we expect this to have an impact in many areas of medicine”, concludes principle investigator Ziegler-Heitbrock. “In the future we are planning to investigate whether slan might also lead to new insights with regards to other diseases.” The Helmholtz Zentrum München

Genetics can increase the risk of heart disease in women

The researchers from University College London studied a group of genes that have previously been linked to an increased risk of disease in the arteries. They studied data from nearly 4,000 men and women from across Europe, comparing their genes, their artery thickness and their artery health.

The scientists, led by BHF Professor Steve Humphries, believe they have pinpointed the gene in the group that is associated with an increased risk of a heart attack or stroke in women, but not in men.

Called BCAR1, the gene they identified is involved in many processes in the body that are affected by the female sex hormone oestrogen. The researchers believe that a high risk version of the BCAR1 gene – the GG version – when combined with a woman’s naturally occurring high oestrogen levels, could lead to the increased risk of cardiovascular disease compared with the low risk version – the AA version. Men with the GG version of the BCAR1 gene do not seem to be affected.

Over the five-year study, women with the high risk BCAR1 gene – around a third of those studied – had an increased risk (6.1%) of having a heart attack, stroke or diseased blood vessels compared with those with the low risk version of the gene (2.5%).

Heart disease is the major cause of heart attack and someone has a heart attack in the UK every three minutes. Understanding what puts people at risk of heart attacks is an important part of finding ways to prevent them and potentially treat people with medication to lower their risk of having a heart attack. British Heart Foundation

Randox Quality Control releases new educational guides

This new 5-part series of educational guides from Randox Quality Control explains how to improve laboratory performance through quality control.
It is easy for laboratories to get caught up in an abundance of QC statistics and forget the fundamental reason why QC exists in the first instance. QC is about detecting errors and ensuring that the results produced are accurate and reliable. With 70% of all medical decisions based on laboratory results, clinical lab specialists are not examining statistics, but real patients, real results and real lives. These five guides are individually titled as follows:
Designing an appropriate QC procedure for your lab – An effective QC strategy is not as complicated as one might think. It is vitally important that each and every laboratory has a well-designed QC procedure in place.
Troubleshooting QC errors – One analyte has been flagged as “out-of-control”, what is to be done next?
How often is Right for QC? – It is widely accepted that laboratories should perform QC at least every day of patient testing. However, is this adequate for every assay and for every laboratory?
Which QC is the Right QC? – When running internal QC, laboratories need to be assured of the accuracy of the results produced and, to ensure this, have confidence in the QC materials used.
The role of EQA in QC – External Quality Assessment plays an essential role in assuring laboratory quality by facilitating inter-laboratory performance comparison and enabling assessment of the complete testing process.
These guides are available as PDF documents on:www.slideshare.net/Acusera

MEETING REPORT: Circulating Biomarkers 2015

The Beatson Institute of Cancer Research, Bearsden, Glasgow, hosted ‘Circulating Biomarkers 2015’, a Biotexcel conference and workshop. The role of circulating biomarkers in early diagnosis and treatment monitoring is gaining momentum with kits for analysing DNA and RNA from circulating tissue already on the market, and liquid biopsy products in development. The analysis of circulating biomarkers allows less expensive and less invasive screening of patients, and so would enable the early diagnosis of disease and hence timely treatment, for example in pancreatic cancer where presentation typically occurs too late for a cure to be achieved. Also, monitoring of treatment in, for example, breast cancer patients by screening of circulating tumour cells will allow clinicians to make better and quicker decisions about the best therapy for the patient.
In the now familiar format, the meeting included a mix of lectures, a networking workshop, a panel debate, and technology presentations.  The lectures included, among others, presentations on the analysis of circulating tumour DNA (Prof. Charles Coombes, Imperial College London, UK; Dr Gerhardt Attard, Institute of Cancer Research and the Royal Marsden, Surrey, UK), RNA (Prof. Sue Burchill, Leeds Institute of Cancer and Pathology, UK), circulating tumour cells (CTCs) (Dr Vera Cappelletti, National Cancer Institute, Milan, Italy; Dr François-Clément Bidard, Institut Curie, Paris, France) and micro RNA (Dr Alberto Rocci, Manchester Royal Infirmary, Manchester, UK). Other talks discussed the potential of metabolomic biomarkers in cancer (Dr Oliver Maddocks, Beatson Institute for Cancer Research, Glasgow, UK) and how to use a variety of biomarkers and other parameters for the evaluation of the complex  situation of ageing and lifespan (Prof. Paul Shiels, University of Glasgow, Glasgow, UK).
The technology presentations included talks on technology for the enrichment of circulating cell-free DNA (Dr Vipulkumar Patel, Analytik Jena), coupling the CellSearch system (CellSearch) and DEPArray platform (Silicon Biosystems) to isolate single CTCs (by Dr Francesca Fontana (Silicon Biosystems) and targeted biomarker detection by MassARRAY (Dr Malcolm Plant, Agena Bioscience).
The panel debate was centred around the question, ‘CTCs vs. cfDNA vs. miRNA vs. mRNA: which is better and why?’ but perhaps the more interesting discussion that evolved was on the ethics of biomarker analysis (Is it ethical to screen for a condition where there is no treatment ?) and the practicalities of screening (How do we screen for conditions that need to be caught before the presentation of symptoms?). Additionally, the meeting provided many networking opportunities and the benefit of such discussion will, no doubt, be borne out by the development and continuation of new and existing collaborations. A very profitable meeting for all involved.

Studying cancer DNA in blood may help personalize treatment in liver cancer

Fragments of cancer DNA circulating in a patient’s bloodstream could help doctors deliver more personalized treatment for liver cancer, Japanese researchers report.

The new research may help address a particular challenge posed by liver cancers, which can be difficult to analyse safely. One serious risk of existing biopsy methods is that doctors who want to obtain a tumour sample for analysis might cause the cancer to spread into the space around organs.

‘Doctors need non-invasive methods that will allow them to safely study cancer progression and characterize the genomic features of a patient’s tumour,’ said Professor Kazuaki Chayama, a principal investigator in this study. ‘Testing for these circulating DNA fragments may be a much easier and safer way of doing this than conventional liver biopsy.’

The researchers showed that detecting DNA released by damaged cancer cells, called circulating tumour DNA (ctDNA), in serum before surgery could predict the recurrence of cancer and its spread through the body (metastasis) in patients with an advanced form of the most common type of liver cancer. They also demonstrated that the level of serum ctDNA reflected the treatment effect and the progression of hepatocellular carcinoma (HCC).

Recent studies have suggested that ctDNA might be a useful biomarker in various cancers. The new study brings this technique closer to clinical reality in patients with advanced HCC by showing that ctDNA provided valuable clinical information about the patient’s disease progression.

Professor Chayama and colleagues in Hiroshima University including Dr. Atsushi Ono, together with researchers at RIKEN and the University of Tokyo, investigated whether they could detect ctDNA in serum of 46 HCC patients. They found ctDNA in seven patients. These patients were more likely than the others to experience recurrence and metastasis of their cancer. ‘Furthermore, we found that the level of ctDNA correlated with progression of HCC and the treatment,’ said Professor Chayama.

The Japanese team also says that ctDNA has the potential to be a non-invasive way of studying the genetic rearrangements that a cancer has undergone. This information could help doctors provide targeted therapy specific to a patient’s cancer, they note.

Recently, detection of cancer-specific mutations by genome sequencing has attracted attention as a way to help select appropriate therapy selection, Professor Chayama said. The researchers were able to identify 25 common mutations in samples of cell-free DNA, which includes DNA from both normal cells and cancer cells, and DNA from tumours themselves. Furthermore, 83% of mutations identified in the tumour tissues could be detected in the cell-free DNA.

Although further study is necessary to develop more effective methods, the new study adds to growing evidence about the usefulness of ctDNA in cancer treatment, and shows that it is a promising biomarker that provides a new way to treat liver cancer. EurekAlert