Leprosy drug holds promise as at-home treatment for COVID-19

by Sanford Burnham Prebys Medical Discovery Institute

Sumit Chanda, Ph.D., a professor at Sanford Burnham Prebys Medical Discovery Institute, shows the experimental assays that test for compounds that may treat COVID-19. Credit: Sanford Burnham Prebys Medical Discovery Institute

A Nature study authored by scientists at Sanford Burnham Prebys Medical Discovery Institute and the University of Hong Kong shows that the leprosy drug clofazimine, which is FDA approved and on the World Health Organization's List of Essential Medicines, exhibits potent antiviral activities against SARS-CoV-2 and prevents the exaggerated inflammatory response associated with severe COVID-19. Based on these findings, a Phase 2 study evaluating clofazimine as an at-home treatment for COVID-19 could begin immediately.

20 mar 2021--"Clofazimine is an ideal candidate for a COVID-19 treatment. It is safe, affordable, easy to make, taken as a pill and can be made globally available," says co-senior author Sumit Chanda, Ph.D., professor and director of the Immunity and Pathogenesis Program at Sanford Burnham Prebys. "We hope to test clofazimine in a Phase 2 clinical trial as soon as possible for people who test positive for COVID-19 but are not hospitalized. Since there is currently no outpatient treatment available for these individuals, clofazimine may help reduce the impact of the disease, which is particularly important now as we see new variants of the virus emerge and against which the current vaccines appear less efficacious."

Promising candidate revealed by screening drug library

Clofazimine was initially identified by screening one of the world's largest collections of known drugs for their ability to block the replication of SARS-CoV-2. Chanda's team previously reported in Nature that clofazimine was one of 21 drugs effective in vitro, or in a lab dish, at concentrations that could most likely be safely achieved in patients.

In this study, the researchers tested clofazimine in hamsters—an animal model for COVID-19—that were infected with SARS-CoV-2. The scientists found that clofazimine lowered the amount of virus in the lungs, including when given to healthy animals prior to infection (prophylactically). The drug also reduced lung damage and prevented "cytokine storm," an overwhelming inflammatory response to SARS-CoV-2 that can be deadly.

"The animals that received clofazimine had less lung damage and lower viral load, especially when receiving the drug before infection," says co-senior author Ren Sun, Ph.D., professor at the University of Hong Kong and distinguished professor emeritus at the University of California, Los Angeles (UCLA). "Besides inhibiting the virus, there are indications that the drug also regulates the host response to the virus, which provides better control of the infection and inflammation."

Clofazimine also worked synergistically with remdesivir, the current standard-of-care treatment for people who are hospitalized due to COVID-19, when given to hamsters infected with SARS-CoV-2. These findings suggest a potential opportunity to stretch the availability of remdesivir, which is costly and in limited supply.

How clofazimine works

The study showed that clofazimine stops SARS-CoV-2 infection in two ways: blocking its entry into cells and disrupting RNA replication (SARS-CoV-2 uses RNA to replicate). Clofazimine was able to reduce the replication of MERS-CoV, the coronavirus that causes Middle East Respiratory Syndrome (MERS), in human lung tissue.

"Potentially most importantly, clofazimine appears to have pan-coronavirus activity, indicating it could be an important weapon against future pandemics," says co-senior author Kwok-Yung Yuen, M.D., chair of Infectious Diseases at the University of Hong Kong, who discovered the coronavirus that causes severe acute respiratory syndrome (SARS). "Our study suggests that we should consider creating a stockpile of ready-made clofazimine that could be deployed immediately if another novel coronavirus emerges."

In July 2020 Sumit Chanda shared more about his team's race to find a treatment for COVID-19.

Testing clofazimine in the clinic

A Phase 2 trial evaluating clofazimine in combination with interferon beta-1b as a treatment for people with COVID-19 who are hospitalized is ongoing at the University of Hong Kong. Interferon beta-1b is an immunoregulator that is given as an injection and is currently used to treat people with multiple sclerosis.

"Our data suggests that clofazimine should also be tested as a monotherapy for people with COVID-19, which would lower many barriers to treatment," says Chanda. "People with COVID-19 would be able to simply receive a regime of low-cost pills, instead of traveling to a hospital to receive an injection."

More information: Nature (2021). DOI: 10.1038/s41586-021-03431-4 , www.nature.com/articles/s41586-021-03431-4

 

New study finds shared origins for individual chronic diseases in multimorbidity

by UK Research and Innovation

Each segment of the graph depicts the number of small molecules associated with one out 27 diseases. Coloured segments and connections between disease indicate the fraction of small molecules common between at least two diseases. Credit: Dr Maik Pietzner at the MRC Epidemiology Unit

A new study published today in Nature Medicine has identified key risk factors that increase the likelihood of individuals developing not only one but multiple non-communicable diseases, which include cardiovascular disease, cancer, chronic respiratory disease and diabetes.

20 mar 2021--The analysis of over 11,000 people found that rather than being due to chance, there are often underlying biological links in individuals with multimorbidity, which is defined as the co-occurrence of two or more long-term health conditions and is a growing public health challenge.

Multimorbidity, which affects about two thirds of people aged 65 years or over in the UK, impairs an individual's quality of life over and above the cumulative burden from each individual disease. Understanding which diseases co-occur not at random but through common mechanisms can aid the identification of preventive strategies and lead to improvements in health care.

A research team led by Dr. Claudia Langenberg at the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge and Berlin Institute of Health, Charité University Medicine Berlin, Germany, analysed the levels of 1,014 metabolites in more than 11,000 participants in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. These metabolites are small circulating molecules, such as sugars, vitamins, or lipids, which objectively reflect influences and interactions of genetics, lifestyle, environment, medical treatment, and gut microbes, on human physiology.

By integrating all of the available data to gain a holistic view, the team was able to identify and document the association of these metabolites with 27 different non-communicable diseases that are frequently observed in multimorbidity, finding that almost half of the metabolites examined were associated with at least one of the 27 diseases. Two-thirds of the disease associated metabolites were shared by multiple diseases and hence with the onset of multimorbidity, for example elevated plasma levels of the carbohydrate N-acetylneuraminate were associated with a higher risk of 14 diseases.

The researchers then examined the relationship between more than 50 characteristics of EPIC-Norfolk study participants identified when they were enrolled onto the study, ranging from waist-to-hip-ratio to smoking behaviour, to identify to which extend the profound changes in small molecules can explain the effect of common risk factors onto disease risk. This analysis highlighted poor kidney and liver health, blood glucose and lipids, gut microbial diversity, and lifestyle factors as potential targets tor prevention or treatment to lower the burden of multimorbidity.

Dr. Claudia Langenberg, who led the study at the MRC Epidemiology Unit said: "Such a deep understanding of molecular process has the potential to not only improve treatment of disease, but also aid earlier identification of individuals at risk. For example, we found that several metabolites measured were better predictors of future kidney-related disease risk than the current standard clinical tests."

"This work has only been possible because we were able to measure the concentrations of hundreds of small molecules in patient's blood using stored samples taken up to twenty years before the onset of any disease, and the electronic health record linkage of more than 11,000 EPIC-Norfolk study participants."

Dr. Maik Pietzner, co-lead author of the study at the MRC Epidemiology Unit, added: "Our observation that two-thirds of the small molecules were linked to at least two, even seemingly unrelated, diseases strongly contrasts the disease-centric approach still common in biomedical research. People do not usually develop just one long-term disease, so by taking a broader approach rather than just focusing on one disease at a time we can gain a more useful understanding of the underlying biological processes. Treatments that target pathways that are shared by two or more of a patient's conditions may be better able to provide benefit in a more consistent way that avoids increasing the risk of other conditions."

Dr. Ivan Pavlov, programme lead at the Medical Research Council, said: "This study moves us one step further towards understanding the biochemical pathways involved in multimorbidity, which is not just critical for early disease detection and prediction, but identifying these metabolic footprints could help to develop preventive therapeutics in the future. Importantly, the paper discovers possible links between seemingly unrelated diseases opening potential new avenues for research."

More information: Plasma metabolites to profile pathways in noncommunicable disease multimorbidity, Nature Medicine (2021). DOI: 10.1038/s41591-021-01266-0 , dx.doi.org/10.1038/s41591-021-01266-0

 

Study: 94% of older adults prescribed drugs that raise risk of falling

by Marcene Robinson, University at Buffalo

Credit: CC0 Public Domain

Nearly every older adult was prescribed a prescription drug that increased their risk of falling in 2017, according to new University at Buffalo research.

20 mar 2021--The study found that the percentage of adults 65 and older who were prescribed a fall- risk-increasing drug climbed to 94% in 2017, a significant leap from 57% in 1999. The research also revealed that the rate of death caused by falls in older adults more than doubled during the same time period.

Even minor falls may be dangerous for older adults. Falls that are not fatal can still result in injuries—such as hip fractures and head traumas—that may drastically lower remaining quality of life. Each year, nearly $50 billion is spent on medical costs related to fall injuries among older adults, according to the Centers for Disease Control and Prevention.

The alarming results solidify the importance of interventions to de-prescribe potentially inappropriate drugs among older, frailer patients, says Amy Shaver, PharmD, lead investigator and postdoctoral associate in the UB School of Public Health and Health Professions.

"Our study indicates two trends increasing concurrently at a population level that should be examined at the individual level. Our hope is it will start more conversations on health care teams about the pros and cons of medications prescribed for vulnerable populations," says Shaver.

Additional investigators in the UB School of Pharmacy and Pharmaceutical Sciences include Collin Clark, PharmD, clinical assistant professor; David Jacobs, PharmD, Ph.D., assistant professor; Robert Wahler Jr., PharmD, clinical associate professor; and Mary Hejna, PharmD, pharmacy resident at Kaleida Health.

Recently published in Pharmacoepidemiology and Drug Safety, the study examined data on deaths due to falls and prescription fills among people 65 and older from the National Vital Statistics System and the Medical Expenditure Panel Survey.

Fall-risk-increasing drugs include antidepressants, anticonvulsants, antipsychotics, antihypertensives (for high blood pressure), opioids, sedative hypnotics, and benzodiazepines (tranquilizers such as Valium and Xanax), as well as other nonprescription medications.

From 1999-2017, more than 7.8 billion fall-risk-increasing drug orders were filled by older adults in the United States. The majority of the prescriptions were for antihypertensives. However, there was also a sharp rise in the use of antidepressants, from 12 million prescriptions in 1999 to more than 52 million in 2017.

"The rise in the use of antidepressant medications seen in this study is likely related to the use of these agents as safer alternatives to older medications for conditions such as depression and anxiety," says Shaver. "However, it is important to note that these medications are still associated with increased risks of falls and fractures among older adults."

Women were also found more likely than men to be prescribed fall-risk-increasing drugs, particularly Black women, who received the medications at the highest rate compared to women of other races. White women who were 85 and older experienced the largest increase in deaths from falls, rising 160% between 1999 and 2017.

The investigators are involved in multidisciplinary de-prescribing initiatives conducted through Team Alice and the UB Center for Successful Aging. The efforts encourage and evaluate patient/caregiver-initiated de-prescribing conversations with health care providers, promote interprofessional education on de-prescribing, and advocate for policy and system changes.

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More information: Amy L. Shaver et al, Trends in fall‐related mortality and fall risk increasing drugs among older individuals in the United States,1999–2017, Pharmacoepidemiology and Drug Safety (2021). DOI: 10.1002/pds.5201

Journal information: Pharmacoepidemiology and Drug Safety 

 

Scientists report gastrointestinal manifestations and mechanisms of COVID-19

by University of Science and Technology of China

The potential faecal-oral transmission of SARS-CoV-2 Credit: GUO Meng

Recently, Prof. Zhu Shu from University of Science and Technology of China (USTC) of CAS and Prof. Richard A. Flavell from Yale University were invited to publish a review article in Nature Reviews Gastroenterology and Hepatology. They systematically summarized the gastrointestinal manifestations in patients with COVID-19 and explored the possible mechanisms of intestinal symptoms caused by COVID-19 infection.

11 mar 2021--Although the clinical manifestations of COVID-19 are primarily fever, cough, and pulmonary imaging, gastrointestinal symptoms have also been reported. About 50% of COVID-19 patients have shown detectable SARS-CoV-2 RNA in their fecal samples. Evidence of SARS-CoV-2 intestinal infection has also been reported based on multiple in vitro and in vivo animal studies.

Existing evidence of intestinal infection in COVID-19 were summarized. Intestinal expression of SARS-CoV-2 receptor and serine protease remain relatively high level. Virus particles and intestinal inflammation were detected at autopsy and biopsy of the patient's intestines. In vitro intestinal cell lines and intestinal organs were identified as susceptible to SARS-CoV-2. The mouse, hamster, ferret, rhesus monkey and other animal models that can be used to investigate the intestinal infection of SARS-CoV-2 were also summarized and compared

The risk of potential fecal-oral transmission of SARS-CoV-2 was discussed. A rigorous and systematic determination of whether the virus titre in fecal fomites can exceed the minimum infection dose is essential to accurately quantify the true risk of SARS-CoV-2 transmission through a fecal-oral route.

This work deepened the understanding of COVID-19 gastrointestinal manifestations and suggest a potential relation between intestinal infections and disease severity. It is important for understanding the pathogenicity and transmission mechanism of the virus and developing scientific prevention and control strategies.

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More information: Meng Guo et al, Potential intestinal infection and faecal–oral transmission of SARS-CoV-2, Nature Reviews Gastroenterology & Hepatology (2021). DOI: 10.1038/s41575-021-00416-6

Provided by University of Science and Technology of China

 

A trio that could spell trouble: Many with dementia take risky combinations of medicines

by University of Michigan

Credit: CC0 Public Domain

People over 65 shouldn't take three or more medicines that act on their brain and nervous system, experts strongly warn, because the drugs can interact and raise the risk of everything from falls to overdoses to memory issues.

11 mar 2021--But a new study finds that 1 in 7 people with dementia who live outside nursing homes are taking at least three of these drugs.

Even if they received the drugs to calm some of dementia's more troubling behavioral issues, the researchers say, taking them in combination could accelerate their loss of memory and thinking ability, and raise their chance of injury and death.

The new study is published in JAMA by a team led by a University of Michigan geriatric psychiatrist who has studied the issue of medication for dementia-related behaviors for years.

It's based on data from 1.2 million people with dementia covered by Medicare and focuses on medications such as antidepressants, sedatives used as sleep medications, opioid painkillers, antipsychotics, and anti-seizure medications.

More than 831,000 of the entire study population received at least one of the medications at least once during the study period in 2018. More than 535,000 of them—nearly half of all the people with dementia in the study—took one or two of them for more than a month.

But the researchers focused on the 13.9% of the study population who took three or more drugs that act on the central nervous system, and took them for more than a month. They dubbed this "CNS-active polypharmacy."

That level of use goes beyond the limits recommended by the internationally accepted guidelines called the Beers criteria.

Key message for patients, caregivers and providers

The federal government has long targeted use of these medications in nursing homes, but not in people who live at home or in less-regulated settings like assisted living facilities.

"Dementia comes with lots of behavioral issues, from changes in sleep and depression to apathy and withdrawal, and providers, patients and caregivers may naturally seek to address these through medications," says Donovan Maust, M.D., M.S., the lead author of the study and an associate professor of psychiatry at Michigan Medicine, U-M's academic medical center.

"But the evidence supporting the use of many of them in people with dementia is pretty thin," he says, "while there is a lot of evidence about the risks, especially when there are multiple medications layered on top of one another."

Maust and his colleagues suggest that regular prescription drug reviews could help spot risky combinations, especially ones of three or more drugs that act on the brain and nervous system. Medicare covers such appointments with providers or pharmacists.

"It appears that we have a lot of people on a lot of medications without a very good reason," he says.

Classes of drugs studied

Antipsychotics have received the most attention for their risk to people with dementia, and 47% of those taking three or more of the medications in the study received at least one antipsychotic, most often Seroquel (quetiapine).

Even though such antipsychotics aren't approved for people with dementia, they're often prescribed to such patients for agitation and sleep issues, and more, Maust notes.

But two other classes of drugs were even more commonly prescribed to patients in the CNS polypharmacy group. Nearly all (92%) of those on three or more of the medications were taking an antidepressant, and 62% were taking an anti-seizure medication.

One drug in that last class, gabapentin, accounted for one-third of all the days of prescription supply that the patients in the study received during the study period.

While gabapentin is approved to treat epilepsy, few of these older adults had a seizure disorder. The vast majority of prescriptions were probably for other reasons because it is commonly prescribed off-label as a pain medication or to help with anxiety, Maust explains.

Another 41% of the people in the three-or-more medication group were taking a benzodiazepine, such as lorazepam (Ativan), often used for anxiety or agitation in people with dementia.

Maust's past work on benzodiazepine prescribing in older adults focused on long-term use, variation by geographic region, and the effects of national efforts to reduce the use of such drugs because of their risks.

New approaches needed

Maust says that providers and caregivers have the right motivation for trying to address dementia-related behaviors through medication: to reduce distress in the patients, and sometimes also in the caregivers.

Often the long-term goal is to make it possible for the person with dementia to avoid having to move to a long-term care facility. The high death toll of people with dementia in such facilities during the COVID-19 pandemic may increase that motivation, he notes.

And the lack of information for clinicians on the use of these drugs in dementia makes every prescription a judgment call.

But it's important to know that prescribing a medication combination that might be safe in younger people can be dangerous in older ones. Those with reduced cognitive abilities may be especially sensitive to potential risks. The changes in brain chemistry and response to medication that come with age and with dementia alter the reaction to these drug combinations.

For instance, opioid pain medications already come with a black-box warning against combining them with other drugs that affect the central nervous system, for any user. But these combinations can be especially risky in older adults. Yet 32% of the people in the study group were taking an opioid, most often hydrocodone.

Even as people with dementia receive drugs that act on their central nervous system for behavioral reasons, those same drugs may hasten their cognitive decline. For instance, a clinical trial of the antidepressant citalopram (Celexa) as a way to treat dementia-related agitation showed that in just nine weeks, participants lost a measurable portion of their cognitive ability.

"It's important for family members and providers to communicate often about what symptoms are happening, and what might be done with non-medication interventions such as physical therapy or sleep hygiene, as well as medications, to address them," Maust says. "Talk about what medications the patient is on, why they're on each one, and whether it might be worthwhile to try tapering some of them because the symptom that prompted the prescription originally might have waned over time."

In some cases, the medications may even be prescribed in response to the distress that a caregiver feels when seeing their loved one behave in a certain way. Connecting caregivers with resources through nonprofit organizations, or their local Area Agency on Aging, could help them support their loved ones better.

The researchers are now looking at which providers prescribed each of the medications to the patients taking three or more of the medications, to look for patterns and opportunities to educate providers or put systems in place after hospitalizations or other events.

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More information: JAMA (2021). DOI: 10.1001/jama.2021.1195

Journal information: Journal of the American Medical Association 

 

Happiness of centenarians a severely neglected area of research

by CHeBA

Credit: Unsplash/CC0 Public Domain

A systematic review by researchers at the Centre for Healthy Brain Aging (CHeBA), UNSW Sydney has highlighted the need for clearer definitions of 'happiness', 'life satisfaction' and 'positive affect' in centenarians. This is the first systematic review to summarize the literature on the subjective wellbeing of this unique age group.

11 mar 2021--The review, published in Aging & Mental Health, identified 18 studies that followed patients from several weeks to 18 years and looked at subjective wellbeing, comprising a cognitive component and an affective component.

The cognitive component is represented as 'life satisfaction' and the affective or mood component defined in relation to a person's immediate emotional state.

"Rapid population aging is an issue faced by many countries, with near centenarian and centenarian populations also increasing rapidly—with an expected global rise from 441,000 in 2013 to about 20 million in 2100," says co-author and Co-Director of CHeBA, Professor Henry Brodaty.

"Despite this rapid growth, centenarians remain an underrepresented group in aging research," says Professor Brodaty.

Professor Brodaty says that although interest in subjective wellbeing and its relationship with exceptional longevity is increasing, the happiness of centenarians remains a severely neglected area of research which needs to be addressed.

Lead author Adrian Cheng says research into the happiness of centenarians is important because examination of subjective wellbeing in this unique group can reveal factors associated with good psychological health.

According to Mr Cheng, the review revealed that while centenarians consistently have similar levels of happiness as younger age groups, it was unclear if this was the same for their life satisfaction and positive affect, which comprises positive emotions, enthusiasm and joy.

Demographic variables such as sex, living situation and ethnicity did not show any significant association with life satisfaction, positive affect or happiness.

"Perceived health—which is the perception of our own health—was consistently associated with higher levels of life satisfaction and positive affect," said Mr Cheng. "Therefore, having a positive view about our own health, or possibly simply having better health, as we age is important as part of the aging process."

"In contrast, fatigue and visual impairment were clearly associated with lower levels of life satisfaction and positive affect," says Mr Cheng.

"These may be targets for future interventions to improve life satisfaction in older populations.

Mr Cheng says an international consortium of centenarian studies could facilitate cross-cultural comparisons on subjective wellbeing.

"Future research should be directed towards interventions that promote subjective wellbeing in the oldest old," says Mr Cheng.

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More information: Adrian Cheng et al. A systematic review of the associations, mediators and moderators of life satisfaction, positive affect and happiness in near-centenarians and centenarians, Aging & Mental Health (2021). DOI: 10.1080/13607863.2021.1891197

Provided by CHeBA

 

Sesaminol prevents Parkinson's disease by activating a signaling pathway

by Osaka City University

(A) The neuroprotection by sesaminol. ARE: antioxidant response element, EpRE: electrophile responsive element, ROS: reactive oxygen species, NQO1: NAD(P)H: quinone oxidoreductase, HO-1: hemo oxygenase-1, ?-GCS:??-glutamylcysteine synthetase(B) Effects of sesaminol and 6-OHDA on the viability of SH-SY5Y cells.SH-SY5Y cells were incubated with 0.25~10 ?g/ml of sesaminol for 2 h, followed by treatment with 20 ?M 6-OHDA for 24 h. The cell viability was measured using the MTT assay. The results represent the means ± SD of 6 experiments. Values without a common letter are significantly different (p<0.01).(C) Effects of 6-OHDA and sesaminol on nuclear translocation of Nrf2.SH-SY5Y cells were incubated with 1 ?g/ml of sesaminol for 2 h, followed by treatment with 20 ?M 6-OHDA for 3 h. Intracellular Nrf2 was stained using primary and secondary antibodies and nuclei were stained using DAPI.(D) Effects of 6-OHDA and sesaminol on intracellular ROS levels.SH-SY5Y cells were incubated with 1 ?g/ml of sesaminol for 2 h, followed by treatment with 20 ?M 6-OHDA for 6 h. Intracellular ROS levels were measured using DCFH-DA. The fluorescence intensity of intracellular ROS. The results represent the means ± SD of 10 cells. Values without a common letter are significantly different (p<0.05). Credit: Akiko Kojima-Yuasa

Researchers report that the chemical sesaminol, naturally occurring in sesame seeds, protects against Parkinson's disease by preventing neuronal damage that decreases the production of dopamine. In vitro experiments show sesaminol handles oxidative stress in cells by regulating the production of reactive oxygen species and the movement of antioxidants. In vivo experiments reveal that dietary intake of sesaminol increases production of dopamine and significantly improves motor function in mice.

11 março 2021--Sesame seed oil, used by many for its nutty aroma and high burn point, is made by extracting the fatty oils from sesame seeds, with the empty shells thrown out as waste. In a literal instantiation of the age-old adage "one man's trash is another man's treasure," researchers discovered that a chemical called sesaminol, abundant in this waste, has protective effects against Parkinson's disease.

"Currently, there is no preventive medicine for Parkinson's disease," states OCU Associate Professor Akiko Kojima-Yuasa, "We only have coping treatments." Associate Professor Kojima-Yuasa led her research group through a series of experiments to understand the effects of sesaminol on in vitro and in vivo Parkinson's disease models.

Parkinson's disease is caused when certain neurons in the brain involved with movement break down or die due in part to a situation called oxidative stress—neurons in the brain come under extreme pressure from an imbalance between antioxidants and reactive oxygen species (ROS). In cell-based in vitro experiments, the team found that sesaminol protected against neuronal damage by promoting the translocation of Nrf2, a protein involved in the response to oxidative stress, and by reducing the production of intracellular ROS.

In vivo experiments brought Associate Professor Kojima-Yuasa's team equally promising results. The impairment of movement due to Parkinson's disease is the result of damaged neurons producing less dopamine than is required. The team showed that mice with Parkinson's disease models show this lack of dopamine production. However, after feeding the mice a diet containing sesaminol for 36 days, the research team saw an increase in dopamine levels. Alongside this, a rotarod performance test revealed a significant increase in motor performance and intestinal motor function.

With the first-ever medicine for Parkinson's disease potentially being the naturally occurring food ingredient sesaminol, naturally occurring waste of the sesame seed industry, Associate Professor Kojima-Yuasa and her team are ready to take their work to the clinical trial phase and connect the consumption/production chain in a way that, as she puts it, "prevents diseases with natural foods to greatly promote societal health."

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More information: Haruka Kaji et al, Sesaminol prevents Parkinson's disease by activating the Nrf2-ARE signaling pathway, Heliyon (2020). DOI: 10.1016/j.heliyon.2020.e05342

Provided by Osaka City University

 

One in 10 people who inject drugs used the antipsychotic medicine Seroquel for nonmedical purposes

by National Drug and Alcohol Research Centre (NDARC)

Credit: CC0 Public Domain

Among 7,000 people who injected drugs (PWID) in Australia between 2011-2018, approximately one in 10 used the antipsychotic medicine quetiapine for non-medical purposes (i.e. in a way that was not prescribed), a study by researchers from the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney, has found.

02 mar 2021--Quetiapine, often referred to by its originator brand, Seroquel, is a second-generation antipsychotic medicine used for the treatment of a range of psychotic disorders, including schizophrenia and bipolar disorder. However, low doses are also often used off-label for sleep and to manage anxiety.

The report, led by Dr. Rachel Sutherland, found that national rates of non-medical quetiapine use declined slightly over time, from 15% in 2011 to 12% in 2018.

"This seems to have been largely driven by a decrease in Victoria, where non-medical quetiapine use reduced from 30% in 2011 to 15.3% in 2018," said Dr. Sutherland.

Despite the national decline in use over time, the report found that past six-month use of benzodiazepines and stimulants were independently associated with non-medical quetiapine use in both 2011 and 2018.

"These findings are largely consistent with international studies that show benzodiazepines and stimulants are commonly co-ingested with quetiapine," said Dr. Sutherland.

"Although the exact motivations for PWID to use quetiapine non-medically remains uncertain, it seems plausible that quetiapine, as well as drugs like benzodiazepines, are being used to 'come down' from stimulants."

The report also highlights that engaging in polysubstance use is concerning because this has the potential to cause other drug-related harms.

"Overall, these findings highlight that we need to target harm-reduction interventions focused on polysubstance use to reduce potential risks in this group," said Dr. Sutherland.

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More information: Rachel Sutherland et al. Trends and characteristics of extra-medical use of quetiapine among people who regularly inject drugs in Australia, 2011–2018, Drug and Alcohol Dependence (2021). DOI: 10.1016/j.drugalcdep.2021.108636

Journal information: Drug and Alcohol Dependence