#immuno suppressive therapy

[cljordan-imperium]

There I am...making a list of all chars and FC for the stories about humans I start posting next week. Bombs, Bodyguards, and Broken Artifacts....no problem. Got new sub-blog setup. Pics set aside to do editing this weekend. All good.

Then I went to Bending the Law. Now, one thing you need to understand is that I've been writing both of these since 2019 on and off while also writing hundreds of prequel chapters for Abriella and also a prequel for BBB. So I start to do the same thing for BTL and this sign goes off in my head...

Apparently at some point my brain had the amazing idea to bring in some characters from OTHER stories I've written as side characters...like the main one from BBB. SO...I am going to get to do some editing as I go because I am an idiot. I also somehow managed to drag Abriella in, but human form...I think this is when I was on immuno suppression therapy and why I don't write when that sick anymore. That I think I can fix rather easily though. We'll see. This will be exciting for me as it is for y'all to discover. SURPRISE!! 🙄😬🤦‍♀️

THE IMPERIUM CHRONICLES TAG LIST - @ceph-the-ghost-writer @kjscottwrites @writingpotato07 @saltysupercomputer @careful-pyromancer @late-to-the-fandom @autumnalwalker @perasperaadastrawriting @fearofahumanplanet @jessica-writes22 @dogmomwrites @mjjune @verba-writing @blind-the-winds @shipping-through-eternity   @outpost51 @inkspellangel @blind-the-winds @sunset-a-story @writingmaidenwarrior @clairelsonao3

Anyone wanting +/- tag list just let me know

[iikciim]

Immunosuppressant Drugs

Anatomy, Physiology, and Pathophysiology of Disease Overview 

The purpose of the immune system is to distinguish self from nonself and to protect the body from foreign material (antigens). 

In addition to performing this beneficial function, the immune system can also attack itself and cause what are known as autoimmune diseases or immune-mediated diseases. The immune system also participates in hypersensitivity, or anaphylactic, reactions, which can be life-threatening. 

There are three layers of barriers to protect the body: (1) mechanical barriers and chemical barriers, (2) inflammation response and phagocytosis, and (3) specific immune responses and natural killer cells. There are two types of immunity: humoral immunity, which is mediated by B lymphocytes, and cellular immunity, which is mediated by T lymphocytes. 

Immunosuppressants decrease or prevent the body’s immune response. Treatment with such drugs is referred to as immunosuppressive therapy. 

Some clinical uses for immunosuppressants are suppression of immune-mediated disorders and malignancies and improvement of short-term and long-term allograft survival. 

Immunosuppressants are used for many immune-related disorders, including rheumatoid arthritis, systemic lupus erythematosus, Crohn’s disease, multiple sclerosis, myasthenia gravis, psoriasis, and others. 

These drugs include cyclophosphamide, glatiramer acetate, fingolimod, and many immunomodulators. 

Transplant patients receive immunosuppressant therapy for their lifetime. 

https://bb-csuohio.blackboard.com/bbcswebdav/pid-7116324-dt-content-rid-80385731_1/xid-80385731_1

Pharmacology Overview 

All immunosuppressants have similar mechanisms of action in that they selectively suppress certain T-lymphocyte cell lines. 

The major classes of immunosuppressant drugs used in preventing organ rejection include glucocorticoids, calcineurin inhibitors, antimetabolites, and biologics. 

Corticosteroids inhibit all stages of T-cell activation and are used for induction, maintenance immunosuppression, and acute rejection. 

Calcineurin inhibitors (e.g., cyclosporine, tacrolimus, sirolimus) inhibit the phosphate required for interleukin-2 production. Sirolimus does not inhibit calcineurin but instead inhibits the mammalian target of rapamycin (mTOR), which ultimately inhibits interleukin-2 communication. 

Cyclosporine and cyclosporin modified (Neoral, Gengraf) are not interchangeable. 

Antimetabolites (e.g., azathioprine, mycophenolate) inhibit cell proliferation. 

Biologics (e.g., basiliximab, daclizumab) inhibit cytotoxic T killer cell function. 

Mycophenolate and tacrolimus are indicated for both prevention of rejection and treatment of organ rejection. 

Mycophenolate has a black box warning stating that it is associated with an increased risk for congenital malformations and spontaneous abortions when used during pregnancy, as well as an increased risk for infections and the development of lymphoma and skin cancers. 

Fingolimod and glatiramer acetate are immunosuppressants that are indicated for the reduction of the frequency of relapses (exacerbations) in a type of multiple sclerosis known as relapsing-remitting multiple sclerosis. 

Relative contraindications, depending on the patient’s condition, may include renal or hepatic failure, hypertension, and concurrent radiation therapy. Pregnancy is not necessarily a contraindication, but these drugs should be given only in clinically urgent situations. 

By virtue of their actions, immunosuppressants place patients at increased risk of opportunistic infections. Immunosuppressant drugs may also increase the risk of certain types of cancers, especially skin cancers. 

Other serious adverse effects are limited to the particular drug. Cyclosporine and tacrolimus can cause nephrotoxicity, and corticosteroids, cyclosporine, and tacrolimus can cause posttransplant diabetes mellitus. 

Patients taking immunosuppressant drugs need to avoid live vaccines. 

Immunosuppressants have narrow therapeutic windows, and drug interactions can be significant. 

Drugs that cause increased levels of immunosuppressant drugs can cause toxicity, whereas drugs that reduce immunosuppressant drug levels may lead to organ rejection. 

Grapefruit can inhibit metabolizing enzymes and thus can increase the activity of cyclosporine, tacrolimus, and sirolimus. Grapefruit juice may increase the bioavailability of cyclosporine by 20% to 200% and should be avoided. 

Foods that are high in potassium, such as bananas and tomatoes, can increase cyclosporine nephrotoxicity. Meals that have high-fat content can increase sirolimus levels. 

There is potential for interactions between immunosuppressant drugs and herbal preparations. The enzyme-inducing properties of St. John’s wort have been demonstrated to reduce the therapeutic levels of cyclosporine and cause organ rejection. The immunostimulant properties of cat’s claw and echinacea may be undesirable in transplant recipients because they have effects that are opposite those of the immunosuppressants. 

Fingolimod (Gilenya), which failed as an antirejection drug, was approved in 2010 for multiple sclerosis. It is the only oral drug for relapsing forms of multiple sclerosis. It has significant adverse effects, including headache, hepatotoxicity, flulike symptoms, back pain, AV block, bradycardia, hypertension, and macular edema.

https://bb-csuohio.blackboard.com/bbcswebdav/pid-7116324-dt-content-rid-80385730_1/xid-80385730_1

Nursing Process 

Before administering any of the immunosuppressants, perform a thorough patient assessment with baseline measurements of vital signs and weight. 

Obtain a thorough history of past and present medical conditions. 

With azathioprine, assess white blood cell and platelet counts, noting any signs and symptoms of infection as well as any bleeding tendencies due to the potential for drug-related leukopenia and thrombocytopenia. 

With cyclosporine therapy: 

Specifically assess the functional level of all organs as well as assess for any underlying cardiovascular, central nervous system, hepatic, and/or renal disease because of potential drug-related toxicities involving these systems and the physiologic impact of the organ transplant process on multiple systems. 

Perform a baseline oral assessment because of the possible adverse effect of drug-induced gingival hyperplasia. 

Assess and document baseline blood pressures because as many as 50% of patients taking this drug have moderate hypertension.  

Cyclosporine is now available in several oral formulations, but these are not to be used interchangeably. Do not refrigerate these oral solutions. Oral solutions may be mixed in a glass container with chocolate milk, milk, or orange juice and served at room temperature. Once the solution is mixed, make sure the patient drinks it immediately. Avoid Styrofoam containers or cups because the drug has been found to adhere to the inside wall of such containers. 

Administered intravenously, cyclosporine is usually diluted with normal saline or 5% dextrose in water and infused using an intravenous (IV) infusion pump. Always infuse over the recommended time period. Monitor the patient very closely during the infusion, especially during the first 30 minutes, for any allergic reactions, as manifested by facial flushing, urticaria, wheezing, dyspnea, and rash. 

With tacrolimus: 

Obtain a thorough patient history with attention to medication use, and perform a physical assessment with close attention to renal functioning through monitoring of blood urea nitrogen (BUN), serum creatinine, and serum electrolyte levels. 

Concern for anaphylactic reaction also continues past the first 30 minutes and first dose, and it is usually important to confirm that resuscitative equipment is accessible and functioning. 

Sirolimus and tacrolimus are administered as ordered by intravenous or oral route. If IV tacrolimus is to be discontinued and maintenance dosing is needed, oral tacrolimus is usually ordered to be given 8 to 12 hours after the discontinuation of the IV drug. 

With sirolimus and tacrolimus, do not store IV solutions in polyvinyl chloride containers. It must be administered in an appropriately designed container and tubing. 

With basiliximab and daclizumab, complete a thorough documentation of baseline vital signs and presenting complaints because of the possible occurrence of cytokine release syndrome with resultant fever, dyspnea, tachycardia, sweating, chills, vomiting, diarrhea, muscle/joint pain, and general malaise. 

Immunosuppressants must be given at the same time every day. 

Oral immunosuppressants need to be taken with food to minimize GI upset. Oral forms of the drugs are used whenever possible to decrease the risk of infection associated with parenteral injections and subsequent injury to the first line of defense (the skin). 

The use of premedication protocols involving various antihistamines and/or anti-inflammatory drugs is common. 

It is very important with the use of any of the immunosuppressants to be sure that supportive treatment equipment and related drugs are available in case of an anaphylactic or allergic reaction. 

Oral dosage forms of tacrolimus should not be put in Styrofoam containers. Inform the patient to avoid the consumption of grapefruit within 2 hours of taking the drug. 

Patients need to always have a 1-week supply of medications available so that there is never a risk of running out. 

Oral antifungals are generally given with immunosuppressant medications to treat the oral candidiasis that occurs as a result of immunosuppression and fungal overgrowth. 

Inspect the oral cavity as often as necessary (at least once every shift) for any white patches on the tongue, mucous membranes, and/or oral pharynx that may indicate oral candidiasis. 

Monitor the results of prescriber-ordered laboratory studies such as hemoglobin level, hematocrit, and white blood cell and platelet counts. If the values drop below normal ranges, notify the prescriber. 

Therapeutic responses to immunosuppressants may include acceptance of the transplanted organ or graft in transplant patients and improved symptoms in those with autoimmune disorders. 

Because of the lifelong nature of the diseases or disease states being managed with these immunosuppressants, always be aware of the financial, emotional, psychosocial, cultural, and body-image impact on the patient, significant other, and/or family members. 

[bornredheadedme-blog]

The Reality of Cancer (cont.)

The first week after my first chemo treatment, my hair began to fall out in large areas. It was so bad that my daughter shaved my head for me and I wore a baseball cap to cover my lack of hair. I also began itching all over my body and nothing took the itch away. The only time I didn't itch was when they hung a bag of steroids at the time of chemo. I tried every antihistamine available and combinations of several. I'm still alive so we know they didn't kill me, but at the time, I began to have thoughts of how much easier my life would be if I were dead. Hopefully I wouldn't itch.

I have Hashimotos disease so I'm already immuno-compromised, and now chemo, which is supposed to suppress my immune system even further, has taken any shred of protection I have. I developed pneumonia from a simple cold, had endless UTIs, and the little cyst on my shoulder suddenly exploded into a giant abscess that required hospitalization.

I only had 4 chemo treatments the first 2 months, and then 1 each week after that for 12 weeks. Then, the surgery, where they cut out the areas where the tumors were and also the lymph glands to check the spread. So I ended up with 4 incisions and breasts that looked like the Ripper had paid a visit. But...I was instantly cancer-free.

A month later the tortuous radiation therapy began. I didn't realize it, but radiation for breast cancer is like exposing the tender skin under and around each breast, and in both armpits to intense sunlight without the brightness. I developed huge blisters in all places mentioned, and nothing much can be done about them. I tried the salve they gave me but that really didn't help. I just had to wait it out. So 3 times each week, I went in and let them burn my boobs.

After 12 weeks of radiation, I got to ring the bell while one of the nurses took my picture. She cut off my head, and left me hoping that wasn't an omen. But I was done! In another few weeks I was pronounced cancer-free and that's what I wanted to hear.

But, once that dreaded word enters your body and psyche, you're never free. I think about it every day and check my breasts weekly, in case a lump appears. I don't want to miss it. I know I didn't the first time, but the two weeks that it took me to get the mammogram made me worry about allowing the cells to multiply that much faster.

Each year, I have a mammogram at the breast specialist, and then I also see my oncologist and they palpate my breasts so I don't feel like I'm waging this battle by myself. I am aware that when I first discussed family history of cancer, I flaked.

I know my dad had a tumor attached to the outside of his large intestine, but his doctors said it was due to his smoking. I still don't have a clue how they arrived at that. My grandmother (paternal) also had some type of cancer, but I'm not sure what kind. My mother had fibercystic disease, but it never developed into cancer. She did have one incident of skin cancer, but nothing more.

Cancer seemed to be more common on my father's side of the family. His father was an alcoholic and died of stomach cancer. His sister died of ovarian cancer, various aunts and uncles died because of it. At one time we determined that out of 12 members of his extended family, 11 died from cancer. Most of my family were smokers, and both my parents died from emphysema so the cancer thing is not a surprise. My mother smoked up to the very end and quite literally suffocated with nothing to be done for her. I try to convince my children and their children not to smoke, but I remember listening to people tell me that in the 25 years I smoked. Fat lot of good that did for me. I have asthma, but not emphysema. I win.

[crownbioscience]

Tumor Microenvironment and Immuno-Oncology: Understanding the Interplay

Introduction

In the intricate landscape of cancer, the tumor microenvironment (TME) plays a pivotal role in shaping the immune response and influencing disease progression. This article explores the dynamic interplay between the tumor microenvironment and immuno-oncology, shedding light on the complexities that researchers and healthcare professionals navigate in the quest for more effective cancer treatments.

The Tumor Microenvironment Unveiled

The TME encompasses a complex milieu of cells, including cancer cells, immune cells, fibroblasts, and blood vessels, as well as signaling molecules. Understanding this ecosystem is crucial as it significantly impacts the success of immuno-oncology interventions.

Immune Cells in the Tumor Microenvironment

Immune cells within the TME can either promote or inhibit anti-tumor responses. T cells, for instance, are instrumental in recognizing and attacking cancer cells, while regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs) can dampen immune responses, creating a challenging environment for effective immunotherapy.

Cytokines and Signaling Molecules

Cytokines and signaling molecules within the TME act as messengers, influencing the behavior of immune cells. Their intricate signaling networks can either enhance or suppress immune responses, directly impacting the efficacy of immuno-oncology treatments.

Immuno-Oncology Strategies Targeting the TME

Researchers are developing innovative immuno-oncology strategies that specifically target the TME. These include therapies aimed at modifying the TME to be more receptive to immune attack or inhibiting immunosuppressive signals, thereby unleashing the full potential of the immune system against cancer.

Challenges in the Tumor Microenvironment

The TME poses challenges for immuno-oncology treatments. Factors such as hypoxia, acidity, and the presence of immunosuppressive cells create a hostile environment that can undermine the effectiveness of immunotherapies. Recognizing and overcoming these challenges is critical for advancing treatment outcomes.

Biomarkers and Predictive Tools

Identifying biomarkers within the TME can serve as predictive tools for treatment response. Researchers are actively exploring molecular signatures that can guide clinicians in tailoring immuno-oncology interventions based on the unique characteristics of the TME.

Personalized Medicine and the TME

The concept of personalized medicine in immuno-oncology extends to understanding and targeting the unique features of the TME for each patient. This tailored approach aims to optimize treatment responses while minimizing potential side effects.

Clinical Trials and TME Research

Ongoing clinical trials focus on unraveling the complexities of the TME and testing novel immuno-oncology interventions. Participation in these trials is essential for advancing our understanding and refining treatment strategies.

Future Directions and Innovations

As the field of immuno-oncology evolves, researchers are exploring cutting-edge technologies and therapeutic approaches to further manipulate the TME. This includes precision medicine, gene therapies, and advanced imaging techniques to gain deeper insights into the TME's dynamics.

Collaborative Efforts in TME Research

The intricate interplay between the TME and immuno-oncology necessitates collaborative efforts among researchers, clinicians, and pharmaceutical companies. Sharing insights and data is crucial for accelerating breakthroughs in cancer treatment.

Conclusion

Understanding the interplay between the tumor microenvironment and immuno-oncology is paramount for advancing cancer therapies. As researchers continue to unravel the complexities of the TME, the potential for more effective and personalized immuno-oncology treatments becomes increasingly promising. This symbiotic relationship between science and clinical application holds the key to unlocking new frontiers in the fight against cancer.

[musicofthenightphantomoftheopera]

Man, do you ever just wonder what the point of living is anymore?

Every day I wake up, and just when I think things can't get any worse, it gets worse.

But there's not a lot I can do about it. I can't go out and protest cuz no one wears masks anymore and I'm immuno compromised and I want to actually be alive to see a better world,

texas is currently still under the tyrranical rule of a mass murderer and it's in talks of enacting even worse acts of voter suppression so "vote them out' may no longer be a viable option to fix this shit anymore.

we apparently only have 6 or 7 years left b4 climate change is nigh irreversable

I can't leave the country because I'm broke and disabled and all the countries I had listed as exit plan candidates bar autistic ppl from entering the country on a visa

I can't even reach out to any local communities cuz I'm in the middle of Hitler Fanboy territory and none of my friends live anywhere near me.

And I can't go to therapy for anything cuz I actually have to afford it first and finding a therapist that actually sees an Autistic person as a human being and not a broken diseased psychopath that needs to be "fixed" is harder than I originally thought.

I'm stuck no matter which direction I want to move.

I have suicidal thoughts all the time even though I never actually plan on going through with it

I just want a reason to live or keep going or a sign things are actually gonna get better. Cuz right now I don't see one

[anamelessdragon]

E-mailed my doctor over the last couple of days. He recommended drinking some unsweetened tart cherry juice (1 oz in lots of water) daily to help balance hormones and the immune system/inflammation, but basically everything I’ve already been doing is all we can do. Because, even though the pain is technically being caused by damage from an adjacent auto-immune disease, I have a large host of idiotic macrophages in my abdomen who like to build tissue wherever they please, tissue including overactive and abundant nerves that are completely unresponsive to pain medication.

Literally my biggest problem in life, currently, is a whump disease.

[manicddaily]

Modern Day Haiku

Modern Day Haiku Bone marrow patch blinksfirefly green through the undies,saying, still here…here…. **************************** Still don’t know if I’ll manage a poem a day for April–Poetry Month, but here’s a try. The patch described above is given to counteract immuno-suppressive aspects of certain chemo therapy drugs. All rights reserved. Have a good day.

[treatmentforblepharitis66-blog]

Home

What Do You Need to Understand About Blepharitis Treatment Antibiotics?  

The inflammation of the eyelids is called Blepharitis. One can get additional info about it upon the net or by referring to a doctor if the condition is severe. Blepharitis treatment can be helpful in treating it. It generally affects both eyes and also the eyelid edges, which causes redness and irritation in the eye and also eyelids. Blepharitis can happen due to many diseases or conditions. But most often, this condition occurs chronically, which is difficult for treating. The condition can be uncomfortable, but it does not harm your eyesight and is also not contagious. Blepharitis creates crusty flakes on your eyelashes.

The main treatment for Blepharitis is done by routinely cleaning your eyelids and preventing crust formation. Typically, Blepharitis does not go away completely, yet you can manage the symptoms by taking some steps. There are numerous symptoms of Blepharitis, and also they are generally the words in the morning. The symptoms are watery eyes in the morning, waking up with red eyes, discomfort in eyes, greasy eyelids, eyelids becoming red as well as swollen, skin flaking around the eyes like dandruff, crusting of eyelashes, stickiness in eyelids, blinking becomes frequent, increased sensitivity to light and also the blurred vision recovers with blinking frequently.

How to Deal With as well as Prevent Blepharitis?

Suppose somebody has signs and symptoms of Blepharitis, which does not improve, although you maintain excellent hygiene by frequently cleaning and also taking care of the affected area. In that case, one must make an appointment with the doctor quickly. The doctor will help him in this situation and will certainly offer him blepharitis treatment anti-biotics.

The actual root cause of Blepharitis is not clear to date. However, it is believed that it spreads through physical contact. Several of its reasons are seborrheic dermatitis, infections, oil glands malfunctioning and also clogging, Rosacea, allergies including reactions to eye medications, mites or lice in eyelash and also Dry eyes. If you deal with any issue regarding Blepharitis and need even more info, quickly visit a doctor, as well as he will offer treatment.

For the medication of Blepharitis, diluted baby shampoo and eyelid washes are used universally. This assists in preventing and treating Blepharitis. However if you consult a doctor, he might recommend or prescribe you for using topical corticosteroids or anti-biotics and more often together. Stubborn cases of Blepharitis and those caused by oral rosacea antibiotics are required for treating it. In short, the doctor will offer or recommend you eyelid washes, lubricating eye drops topical antibiotics, topical corticosteroids, immuno-suppressants, as well as oral antibiotics.

Blepharitis has several causes, and also individuals rarely experience these conditions. Others normally have Blepharitis chronically. As a result of this reason, there is no best medication available for Blepharitis. Simply the right therapy combination for each patient brings the situation under control and also prevents future flaring up of Blepharitis. The major treatment lies in your home only. Simply make sure to clean your eyes properly with mild baby shampoo and maintain personal hygiene. By doing this you will certainly lower the risk of Blepharitis and also can stop it from flaring up again.Click here for more info https://www.theralife.com/blepharitis/

[arefbhuiya]

Dermatologist Westlake Village CA

Dermatologist - 4 Specialty Fields to Become a Dermatologist

A Dermatologist Westlake Village CA is a physician who specializes in various fields involving the epidermis, scalp, and skin. If you were to look at a Dermatologist in action on any given day, you would see him or her:

Treat a newborn baby s first visible birthmark which threatens the baby s eyesight. Remove a sun-damaged mother of melanoma at its earliest, most effectively treat a painful melanoma that has spread to the lymph nodes in the neck. Treat severe psoriasis, an embarrassing skin condition that makes the skin of the body flaky, red, itchy, and thick. A dermatologist can also provide treatment for: eczema, acne, cellulite, wrinkles, spots and scars, hyperpigmentation, hyperhidrosis, rosacea, herpes, ringworm, jock itch, acne vulgaris, seborrheic dermatitis, sebaceous cysts, fungal infections, and staph infections.

Dermatologists specialise in all areas of medicine. The field of dermatology now encompasses many specialisations. Skin Cancer A Dermatologist can diagnose and treat skin cancer. Skin cancer can be any form of cancer that occurs in the epidermis, such as melanoma, squamous cell, melanoma multiforme, etc. Dermatologists use various methods of diagnosis such as; Cut-down techniques, lymph node examination, microscopic examination and tissue culture as well as epithelial cell nuclear analysis. Treatments for skin cancer can range from surgery to chemotherapy and radiation therapy.

Eczema Dermatologist can diagnose eczema by determining if there is a skin condition known as eczema. There are various types of eczema; atopic dermatitis, contact dermatitis, dyshidrotic, atrophic, sebaceous, allergic and xerotic eczema. Eczema can cause skin irritation, redness, itching, blisters, crusting, oozing, scaly and even bleeding.

Skin conditions such as eczema are often treated using topical ointments and lotions, while some people may have to take antibiotics. These treatments are aimed at reducing inflammation and healing the damaged layers of the skin. Oral antihistamines are sometimes given in order to prevent further attacks of the conditions. Some dermatologists recommend immunomodulators such as Immuno-suppressant drugs (MSIDs) in order to reduce swelling, while others recommend phototherapy as a means of preventing skin conditions.

Dermatology has become a very popular career option because of its lucrative nature. However, not many dermatologists actually finish their four years of graduate studies and obtain the doctorate degree. For many dermatologists who have this goal, it usually depends on how quickly they want to pursue other forms of Dermatology. For those who opt for this path, it's important that they have Dermatology as their major, along with an associate's degree in Biology, chemistry, and biology, English, or math. Only then will they be considered for Dermatology residencies and full-time positions.

An individual who wants to become a dermatopathologist should first complete his medical schooling, obtain a bachelor's degree, and get certified through the American Board of Dermatology (ABD). Some states also require that applicants for doctorate degrees in dermatology, including diagnostic skin testing, pathology, and primary care, complete an ABD examination. However, these requirements vary from state to state, so applicants should always check the regulations thoroughly before applying to a particular medical school or university.

Dermatologist jobs primarily involve the diagnosis and treatment of a variety of skin disorders, such as acne, psoriasis, vitiligo, skin cancer, sunburns, warts, jaundice, and more. As a dermatologist, it is your responsibility to ensure that the patients' overall health and well-being are protected. This is why it is very important for you to keep up with accurate and up-to-date information regarding skin conditions, diseases, and general health. This way, you will be able to provide your clients with the best service possible.

In terms of specialization, dermatology specialists specialize in almost any type of skin care, not just hair and nail care. While many dermatologists do not deal with certain diseases or conditions, like skin cancer, they can still perform various tests on patients, like blood and urine tests. They may also treat and diagnose several other conditions, depending on their expertise.

If you are interested in becoming a dermatologist, one of the best options is to choose one in the East Coast, where there are several schools that offer training in the field. You can attend school at an accredited college or university and get an associate's degree in skin care, nail care, or other specializations that are offered. Once you graduate, you can begin working, and depending on your level of experience, you may find employment in a clinic, doctor's office, spa, or other health care facility. If you have a specific area of expertise in mind, look for a local practice that hires only professionals who have been trained and have certification from an accredited program.

Another way to become a dermatologist is to be employed by a company that specializes in skin care, and you will have more time to concentrate on training. However, you must know what you are doing and be able to provide excellent service. Many corporate employers to screen potential employees based on their knowledge and skill in diagnosing and treating skin disorders. Dermatologists can specialize in a specific type of disorder, like eczema, acne, genital warts, psoriasis, sebaceous cysts, warts, herpes, warts and more. They can treat skin diseases and disorders with chemicals, surgery, lasers, and sometimes even medications.

[scifigeneration]

Super-soldier T-cells fight cancer better after a transformational DNA delivery

by Andy Tay

Delivering DNA to immune cells is the trickiest part of developing new gene-based therapies. SAK Design/SHutterstock.com

I enjoy online shopping. However, I often find myself fussing about the delivery options during checkout. This is because not all delivery services are equally efficient and stress-free.

This personal experience has also inspired my research. As a postdoctoral scholar at Stanford University, I have engineered tiny nano-materials – objects about 10,000 times smaller than a grain of rice – to better deliver DNA into white blood cells called T-cells that defend us against cancer. My method – which I think of as the equivalent of FedEx and UPS – delivers DNA efficiently to T-cells that then transforms them into super-soldiers for tracking and attacking cancer cells.

The promise of immuno-medicine

Despite decades of research, cancer remains a challenging disease to treat because cancer cells mutate rapidly, becoming resistant to treatments such as chemotherapeutic drugs and radiation. The World Health Organization estimates that in 2018, close to 10 million individuals died of cancer. The estimated economic cost due to treatments and lost productivity when patients couldn’t work during treatment was a whopping US$1.2 trillion, and this is expected to increase with an aging population.

Andy Tay, CC BY-SA

These are figurines from a toy kit called ‘Rainbow Heroes.’ I created the kit with the Stanford Design School to educate children with cancer aged 5-10 about cancer immunotherapy. The black figurines represent the ‘enemy’ cancer cells while the colorful figurines are the ‘hero’ immune cells. Andy Tay, CC BY-SA

In the 1990s James Allison and Tasuku Honjo, who won the 2018 Nobel Prize in Medicine or Physiology for cancer immunotherapy, discovered that cancer cells can inhibit T-cells and prevent them from detecting tumor cells. They pioneered a strategy using proteins called antibodies to bind to cancer cells. This prevents the cancer cells from interfering with T-cells and suppressing them.

The second type of cancer immunotherapy, which I study, involves genetically engineering T-cells with tailored DNA. The DNA I insert into T-cells encodes proteins that function like weapons that kill cancer cells faster before they get a chance to develop new mutations.

Unfortunately, it isn’t easy to deliver DNA into cells, and the existing methods are inadequate and may compromise the cancer-fighting functions of T-cells. Some T-cells may become hyperactive after DNA delivery and attack the patients’ own organs.

Improving DNA delivery

There are two predominant ways to deliver DNA into T-cells. The first uses viruses to deliver DNA. The second uses bulk electroporation, a technique that uses electricity to punch holes in the cells allowing the DNA to enter. However, both are inefficient and have several disadvantages.

Viruses insert their own viral DNA into host cells alongside the therapeutic DNA during delivery. This is dangerous, as the long-term consequence of having viral genes in our body is unknown. Viruses can also trigger toxic immune responses such as persistent fever and even death. Another disadvantage is that viruses can carry only small packages of DNA, making it difficult to cram the latest gene editing tools inside them.

These shortcomings paved the way for electroporation. This method works by subjecting cells to strong electric fields that create holes in cells’ membrane and allow DNA to pass through. However, this technique is akin to a courier blasting holes in a person’s home to deliver packages. I and others have shown that this approach harms the T-cells and dampens their cancer-fighting ability.

The power of nano-engineering

To bridge this technological gap, I have developed a new technique named magnetic nano-electro-injection, or MagNEI, that can deliver DNA into T-cells up to four times more efficiently than virus and bulk electroporation. This is necessary to produce high numbers of genetically engineered T-cell soldiers – one billion or so – needed to fight cancer.

This is how MagNEI works. I first decorate the T-cells with FDA-approved magnetic particles to activate them and make them more receptive to DNA delivery. Then I use magnets to secure these cells onto hollow nano-tubes. These tubes are 10,000 times smaller in diameter than a grain of rice. Next, electric fields are applied through the nano-tubes to create small pores, or tunnels, into the cell membrane for DNA to enter cells. Magnetic forces then direct DNA into the nucleus of the cell. This is a much gentler procedure than electroporation.

Left: T-cell decorated with magnetic particles that activate it, preparing it for DNA delivery. Right: Scanning electron microscopic image of hollow nano-tubes. Andy Tay, CC BY-SA

New metrics to assess delivery techniques

Besides looking at DNA delivery efficiency – the percentage of cells that are successfully transformed with genetically engineered DNA – it is also important to consider the other consequences of various delivery methods. For example, I have found that the ability of engineered T-cell soldiers to migrate and hunt down cancer cells can be weaker after DNA delivery.

In my opinion, the cancer immunotherapy community needs to expand beyond simple assessments such as efficiency and cell survival to evaluate the utility of new DNA delivery techniques.

Therefore, in a recent review, I proposed a framework with new criteria for evaluating which DNA delivery methods are most effective. One way to assess the impact of DNA delivery is to measure how the activity of specific genes are altered by the delivery of foreign DNA.

For instance, I found that bulk electroporation causes significant changes in the activity of genes linked to metabolism. That may explain why cells treated with this method grow slowly. This reduction in cell growth can increase manufacturing costs of these engineered T-cells and lengthen the treatment time for patients.

Magnet-based nano-scale methods such as mine offer advantages over virus and bulk electroporation for DNA delivery, but thus far, I have tested them only in animal studies and in experiments outside of human bodies. In the future, I hope to use nano-materials for delivering DNA to create cell-based therapies.

About The Author:

Andy Tay is a Postdoctoral Research Fellow in Materials Science and Engineering at Stanford University

This article is republished from our content partners over at The Conversation under a Creative Commons license. 

[audio-sexual]

I’m off today/tomorrow b/c I got my infusion today (fresh immuno-suppressants! & lots o’ pain from driving b/c it’s not kicked in yet) & I emailed my job...I wanted to work from home but might end up solely with the flex leave they’re offering. I am doing what I need to but mentally I feel fucking anxious & awful b/c not working like I think I should...but not wanting to be exposed when I’m categorized as “higher risk/special population”.

Also my supervisor had been hand waving Covid-19 a lot as overblown (she’s probably at risk too considering her health issues but she will absolutely not skip work), so my brain is having a field day with me.

I’m fortunate to be in a better position than a lot of people with work. & I feel relieved that I don’t have a temp (RA doc’s office checked everyone before you could go in) nor do I have other symptoms so definitely just plan to self-isolate/social distance as much as possible.

Which...tbh...ain’t hard, I’m an introvert who’s been isolated for so long it’s natural. So, I’ll focus on my therapy essay, Korean lessons (I hope), video games, & annoying Persephone.

Take care of yourselves & each other - Don’t freak out but don’t dismiss this either. Good luck.

[mgcancerhospital]

All Cancers Are Not The Same!

Contrary to widespread belief, Cancer is not the same in every patient. Just as there are so many parts in the human body, there are thousands of cancer variants a person can get affected with.

The two key determinants of outcomes of cancer therapy are the BODY ORGAN which is involved and the STAGE at which it is detected in the patient.

Cancers are basically divided into solid organ cancers and hematological (blood and lymphatic system) cancers. The survival of a patient differs where it affects, thyroid/brain/lung/kidney/gallbladder/intestine/bones/blood etc.. Most of the solid organ cancers which have not metastasized (spread to other parts of the body) are treated with surgery, sometimes with radiation and many times with a combination of surgery, radiation, and chemotherapy. Meanwhile, chemotherapy is the mainstay of treatment in hematological cancers, occasionally supplemented by radiotherapy and very rarely with surgery.

Cancers are usually categorized into four stages with stage one being the earliest and stage four being the last stage where patients are not expected to live long and usually have a tumultuous few months to live. In well-developed nations, due to better education, awareness, and access to good healthcare facilities, cancers are detected in an early stage whereas, in underdeveloped countries and underprivileged socioeconomic groups, cancers are usually detected in late stages leading to poor outcomes.

It is difficult to predict the outcome of treatment for cancer. For example, a variant of thyroid cancer called papillary cancer has very good treatment outcome and most of these patients live a normal and uncomplicated life. The same is the case with early stage breast cancer. Whereas, lung cancers are usually detected in a late stage and most patients succumb to it within a few months of diagnosis. The treatment of blood cancers is usually prolonged and requires multiple cycles of chemotherapy, complicated bone marrow, and stem cell transplants, immuno-suppression related complications, high cost, etc., which makes treating these patients a challenge. Cancer specialists gain experience over time and are able to predict and treat better.

Cancer patients need to be evaluated with multiple tests initially to accurately diagnose and predict the stage of cancer which often takes a few days to a couple of weeks during which period the patients and their relatives experience a lot of anxiety. The exact identification of site, variant, and the stage is key to chalk out the appropriate treatment plan. This is best achieved in experienced cancer centers with trained and experienced group of oncologists who hold tumor-board discussions before finalizing treatment plans.

So, it is important NOT to generalize all cancers and to treat each patient as unique and advise as per that specific patient’s condition.

CORE POINT: Cancer is an imminently curable condition when detected at an early stage and treated by good oncologists at an established cancer center like Mahatma Gandhi Cancer Hospital & Research Institute, Visakhapatnam.

Written by Dr. Karthik Chandra Vallam, MS, M.Ch., DNB, Surgical Oncologist, Robotic and Laparoscopic Surgeon, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam.

[healthcare-market]

In-vitro Transcription Templates Market to Flourish with an Impressive CAGR by 2030

In-Vitro Transcription Templates Market: Introduction

According to the report, the global in-vitro transcription templates market was valued at ~US$ 120 Mn in 2020 and is projected to expand at a CAGR of ~20% from 2021 to 2030. Increase in R&D funding in healthcare and biotechnology and rise in technological advancements in molecular biology are anticipated to drive the global in-vitro transcription templates market during the forecast period. Additionally, rise in prevalence of various types of cancer and infectious diseases, such as COVID-19, is expected to propel the global in-vitro transcription templates market over the next few years. Investments by key players to strengthen their position is likely to create significant opportunities in the market. For instance, in June 2020, Promega Corporation announced CE marking for the OncoMate MSI Dx Analysis System as a new in-vitro diagnostic (IVD) medical device in Europe. OncoMate MSI is a PCR-based, validated gold standard for determining microsatellite instability (MSI) status in solid tumors.

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The usage of mRNA-based personalized cancer vaccines for the treatment of cancer has increased. For instance, Moderna’s Immuno-Oncology focuses on therapeutic vaccines and intratumoral immuno-oncology therapeutics. Moderna is able to make modified, mRNA-based personalized cancer vaccines to distribute one custom-tailored medicine for one patient at a time, which is concluded through next-generation sequencing and able to recognize mutations found on a patient’s cancer cells. Hence, increase in incidence of cancer boosts usage of in-vitro transcription templates in RNA-derived vaccines and therapeutics.

North America dominated the global in-vitro transcription templates market in 2020. The trend is likely to continue during the forecast period. Well-established healthcare and life science industries, early adoption of technologically advanced products, high awareness about various infectious as well as chronic diseases, and high per capita healthcare expenditure are the major factors attributed to North America’s large market share in 2020.

Asia Pacific is projected to be a highly lucrative market for in-vitro transcription templates over the next few years. The market in the region is anticipated to expand at a high CAGR during the forecast period. The growth of the healthcare sector and the increase in the development of RNA-based vaccines and therapies in countries such as Japan, India, and China are expected to propel the market in the region during the forecast period.

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Technological Advancements to Drive In-Vitro Transcription Templates Market

The adoption of technologically advanced products is likely to drive the demand, and thereby the global market. Technological advances and modalities for targeting RNA include using CRISPR-Cas9 genome editing technology, DNA-directed RNA intervention (ddRNAi) technology, and the advancement of specific low molecular modulators for RNA or RNA-modifying enzymes. For instance, CAL-1, Calimmune's leading therapeutic agent, depicts RNA-based gene therapy using ddRNAi to suppress the CCR5 gene to regulate HIV infection and to prevent HIV-positive entities from developing AIDS. Several firms focused on the production of small-molecular RNA modulators have been set up over the past few years.

Targeting splice-variant control sequences within introns (non-coding regions of an RNA transcriptor DNA sequence within a gene) or exons (coding regions) offers opportunities to develop therapeutics. For instance, Skyhawk Therapeutics, Inc. (Waltham, Massachusetts, the U.S.) was founded with a platform to identify selective small molecule modulators of the RNA spliceosome complex that target RNA mis-splicing (exon skipping), which drives multiple diseases including neurological conditions and cancer. These emerging technologies offer significant opportunities to develop alternative strategies to target RNA for drug development.

N4 Pharma is developing Nuvec, an innovative silica nanoparticle for drug delivery with possible applications across cancer therapy and immunology. That includes enhancing the cellular uptake of novel and disruptive medicines such as mRNA and DNA vaccines or therapies.

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Infectious Diseases to Dominate In-Vitro Transcription Templates Market

In terms of disease, the global in-vitro transcription templates market has been classified into cancer, infectious diseases, lifestyle diseases, genetic diseases, and others. The infectious disease segment accounted for major share of the global market in 2020. The segment is projected to dominate the global market during the forecast period. mRNA vaccine has been studied for various diseases including CMV, Zika, and rabies. Development and launch of RNA-based vaccines are anticipated to propel the segment during the forecast period.

Vaccine to Hold Major Share of In-Vitro Transcription Templates Market

Based on treatment, the global in-vitro transcription templates market has been categorized into vaccine and therapeutic. The vaccine segment accounted for major share of the global market in 2020. For instance, the U.S. FDA issued an emergency use authorization (EUA) for Moderna’s COVID-19 vaccine for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Clinical to Dominate In-Vitro Transcription Templates Market

Based on research stage, the global in-vitro transcription templates market has been bifurcated into exploratory and clinical. A number of RNA-based vaccines and therapies is in the pipeline and clinical stage. This is likely to augment the clinical segment over the next few years.

Pharmaceutical & Biotechnology Companies to Account for Major Share of In-Vitro Transcription Templates Market

In terms of end user, the global vitro transcription templates market has been divided into pharmaceutical & biotechnology companies, CROs & CMOs, academics & research, and others. The need of discovery of new therapeutics, vaccines, and capacity expansion leads to high adoption of in-vitro transcription templates among pharmaceutical & biotechnology manufacturers. This is projected to drive the segment during the forecast period.

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North America to Dominate In-Vitro Transcription Templates Market

In terms of region, the global in-vitro transcription templates market has been segmented into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. North America dominated the global in-vitro transcription templates market in 2020, followed by Europe. North America accounted for major share of the global in-vitro transcription templates market in 2020. The growth of the market in the region is can be attributed to increase in demand for biopharmaceuticals such as vaccines and RNA-based therapeutics, peptides for the treatment of cancer, neurological diseases, and chronic kidney diseases. Moreover, rise in prevalence of lifestyle diseases, increase in healthcare spending, and strong economy are factors responsible for North America’s dominance of the global in-vitro transcription templates market during the forecast period.

The in-vitro transcription templates market in Asia Pacific is anticipated to grow at a rapid pace during the forecast period. Increase in disposable income and purchasing power of consumers, rise in biotechnology, research institutes, and research funding by government and private bodies, expansion of healthcare infrastructure, large population base, and rise in incidence of chronic and infectious diseases are the key factors expected to augment the in-vitro transcription templates market in Asia Pacific during the forecast period.

Competition Landscape of In-Vitro Transcription Templates Market

The global in-vitro transcription templates market is fragmented in terms of number of players. Key players in the global in-vitro transcription templates market include Thermo Fisher Scientific, Inc., Promega Corporation, Agilent Technologies, Inc., New England Biolabs, Takara Bio Inc., Lucigen Corporation, Enzynomics Co. Ltd., Enzo Life Sciences, Inc. and Cytiva (Danaher)

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[mukongs]

The soluble tumors bacteria YB1 has pioneered new methods of cancer immunotherapy, and can it pry the market by hundreds of billions of dollars in the future?

The development of life science and technology has completely subverted the social life and medical and health system of human beings in the past hundred years, and the quality of human life has been greatly improved, while completely tackling cancer, a disease that has long plagued human health, has become the common goal of the global medical and scientific community.

 In recent decades, the global field of cancer treatment has developed rapidly, and mainstream treatments have evolved from traditional methods such as surgery, radiotherapy and chemotherapy to tumor-targeted therapy and, more recently, tumor immunotherapy, which are better at improving patient outcomes while reducing systemic adverse reactions in patients in treatment. Compared with traditional tumor treatments, targeted therapy and immunotherapy benefit patients in improving efficacy, reducing symptoms or improving quality of life by targeting specific cancer-causing pathways and utilizing the patient's immune system.

 Overview of the global and Chinese cancer treatment industry

Currently, the global and Chinese cancer drug market consists of chemotherapy, targeted therapy and immunotherapy. Globally, targeted therapies and immunotherapy account for 83.8% of the global cancer treatment market and are expected to grow to 89.8% by 2030, according to public data reported?

 In the Chinese market, targeted therapies and immunotherapy in the field of cancer treatment have greater potential for growth, driven by favorable policies, increasing patient spending power and the introduction of more innovative therapies in China, with the total contribution expected to increase from 36.6% in 2020 to 85.8%  in 2030.

Although targeted therapies and immunotherapy approaches are inherently different, in many cases it has been shown that a combination of the two therapies creates synergies, usually one that complements the other, releasing the patient's anti-tumor immunity and thus improving efficacy. This combination has been improved through professional exploration to produce better results in clinical practice and has been shown to be a promising new treatment strategy in the field of cancer treatment.

 Oncology immunotherapy will hit the $100 billion Blue Sea market

Tumor immunotherapy has gradually established itself as a pillar in the global field of cancer treatment in recent years, designed to stimulate the patient's own immune system to produce or enhance an anti-tumor immune response to control or eradicate cancer cells.

 The discovery and development of cancer immunotherapy in recent years has marked a milestone in cancer treatment and will be an important boost to the growth of the global cancer drug market, as it provides lasting relief and is often well tolerated in several patients with advanced cancer. It is worth mentioning that because tumor immunotherapy works through the patient's own immune system, immunotherapy has fewer side effects than traditional cancer treatments such as chemotherapy and radiotherapy.

 The global market for oncology immunotherapy has increased from $9.6 billion in 2016 to $35.1 billion in 2020 and is expected to reach $108.2 billion by 2025, according to the institute's professional report The global cancer immunotherapy market will reach US$229.8 billion over 30 years, with CAGR of 25.3% and 16.3% from 2020 to 2025 and 2025 to 2030, respectively. For the foreseeable future, cancer immunotherapy will usher in hundreds of billions of dollars of blue sea market.

 In 2020, oncology immunotherapy accounts for 23.4% of the global cancer drug market, and by 2030 it is expected to account for approximately 47.6% of the global oncology market.

 On the domestic market, China's oncology immunotherapy market has reached RMB14.8 billion in 2020 and is expected to grow to RMB88.9 billion by 2025 and further to RMB272.8 billion by 2030, with CAGR of 66.8% and 16.4% from 2019 to 2024 and 2024 to 2030, respectively.

 According to the data, oncology immunotherapy will account for 7.5% of China's total cancer drug market revenue in 2020 and is expected to continue growing in the future, accounting for about 39.9% of China's cancer market by 2030.

   Will the innovative therapies take advantage of corner overtaking? Tumor immunotherapy shapes the development of new logic

In the face of the growing $100 billion Blue Sea market in the next five years, it is even more important to clarify the path of development in the field of oncology immunotherapy at this stage and in the future, and the choice and layout of the segmented track is about how much market share industry participants can ultimately capture.

 After years of evolving cancer treatment paradigms, the development of oncology immunotherapy is now playing an increasingly essential role, subdivision circuits continue to spawn new therapies, by improving the effectiveness of treatment of various types of cancer, to begin to provide cancer patients around the world with more valuable treatment options.

 The early stages of the development of global tumor immunotherapy, mainly characterized by immuno-checkpoint inhibitors single therapy, including PD-1/L1 inhibitors and CTLA-4 inhibitors, in a variety of tumors to achieve about 20% ORR, replacing chemotherapy as the treatment standard for a variety of cancer indications. Current mainstream immuno-tumor therapies are characterized by the combination of immuno-checkpoint inhibitors (as cornerstone drugs) with a second immuno-checkpoint inhibitor or different types of cancer therapies (e.g. chemotherapy or angiogenesis inhibitors) with an ORR (objective remission rate) of approximately 40 percent.

 Hematoma viral therapy is a new tumor immunotherapy, which, in addition to checkpoint suppression, uses several viruses to selectively replicate and kill tumors directly in tumors, as well as the ability to induce effective, patient-specific anti-tumor immune response. This soluble virus has the potential to produce an immune response to specific tumor antigen groups in individual patients, including new antigens that are uniquely present in tumors.

In recent years, hemovores therapy has become a promising anti-cancer therapy. The soluble virus, which destroys cancer cells without damaging normal tissue through tumor-specific replication, then promotes congenital and adaptive immune responses, demonstrating great potential for cancer treatment. The emergence of germ therapy for Soloma may pry into the larger market of the future.

 Hemolytic bacterial therapy is currently more cutting-edge than the tumor virus of the emerging cancer immunotherapy program, because most of the tumors in the human body (more than 90%) will form solid tumors, and solid tumor microenvironment has a significant characteristic, that is, in the center of the tumor will form a very special low oxygen region, this low oxygen region is significantly different from normal human tissue, so the physical tumor oxygen-deficient microenvironment has become an ideal target for tumor target therapy.

 The emergence of germ therapy for Hemolytic may pry into the larger market of the future

Hemolytic bacterial therapy is currently more cutting-edge than the tumor virus of the emerging cancer immunotherapy program, because most of the tumors in the human body (more than 90%) will form solid tumors, and solid tumor microenvironment has a significant characteristic, that is, in the center of the tumor will form a very special low oxygen region, this low oxygen region is significantly different from normal human tissue, so the physical tumor oxygen-deficient microenvironment has become an ideal target for tumor target therapy.

 As an anaerobic or axial anaerobic microorganism, the anaerobic region of the tumor provides an ideal place for survival - the tumor bacteria is a large class of invasive intracellular bacteria, the reaction between this type of microorganism and the host is mediated by the type III secretion mechanism, which can transmit the expression of the effect gene at the same time express a variety of therapeutic properties of proteins, therefore, detoxifying tumor bacteria is a more ideal therapeutic drug carrier.

 In 2011, the core research and development team of HKND YB1 PHARMACEUTUCAL LIMITED. realized the efficient programming technology of salmonella Lambda-RED for the first time in the experiment, established the basis of salmonella synthetic biology transformation, and solved the biosecurity risk in the research and development of bacterial therapy. After establishing the basis for the synthetic biology transformation of salmonella, the company successfully invented a genetically engineered strain of salmonella YB1, a genetically engineered strain of salmonella typhoid, which is also the world's first synthetic biology technology to transform the invention of the tumor bacterial carrier products.

In 2021’s May, YB1 technology-related machine theory was published in Nature Communications, a leading international journal, and studies showed that the safety and efficacy of the synthesis bacterial product had been verified. Thus, with the successful launch of the oncolytic bacterial carriers YB1, bacterial therapy ushered in a new era of development, the clinical application of the hemolytic bacteria is within reach, in the future, can it pry a significant share of the industry market? Believe that time will tell.