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Profil Institute Unites Leading Experts in Biomarker Discovery and Clinical Research to Address the Medical Challenges of NAFLD/NASH

Profil Institute for Clinical Research, a clinical research organization (CRO) focused on diabetes, obesity and NAFLD/NASH, announced today a collaboration of experts in biomarker discovery and clinical research in the fields of metabolism, diabetes and obesity to address the medical challenges of NAFLD and NASH.

Enteris BioPharma and Nordic BioScience’s KeyBioScience Enter Strategic Licensing Agreement to Develop Metabolic Peptides Using Enteris’ Proprietary Oral Drug Delivery and Manufacturing Platform

Enteris BioPharma, Inc., an industry leader in innovative oral dosage formulations, and KeyBioScience, a wholly-owned subsidiary of Nordic Bioscience, recently announced a strategic licensing agreement for Enteris’ oral drug delivery and recombinant manufacturing technologies to advance the development of KeyBioScience’s recently acquired family of proprietary metabolic peptides for various indications, including the treatment of Type 2 diabetes, obesity and other inflammatory conditions with high unmet medical and socioeconomic needs.

IMDEA Food and Metabolon, Inc. Announce Strategic Collaboration to Advance Nutrition-based Personalized Medicine

IMDEA Food, a Translational Research Institute from the Community of Madrid, dedicated to investigating the relationships among nutrition, food and health, and the US-based company Metabolon Inc., the pioneering leader in the field of metabolomics and molecular diagnostics serving the pharmaceutical and food industries, recently announced an ambitious collaboration program. The agreement, signed in Madrid by Dr. John Ryals, President and CEO of Metabolon, and Dr. Guillermo Reglero, Director of IMDEA Food, establishes the framework for future strategic projects aimed to develop functional foods and diagnostic tools.

Of particular interest are the prevention of prevalent chronic diseases with high societal impact, such as cardiovascular disease, cancer, obesity and neurological diseases, which are highly dependent on understanding food science and nutritional impact. To achieve this goal, individual in-depth studies to characterize the molecular mechanisms underlying the health benefits of foods and food components are needed.

“These studies promise to lead toward an efficient decrease of morbimortality due to chronic degenerative diseases and a better quality of life. IMDEA Food and Metabolon will combine their knowledge to advance towards this objective. A combined functional genomics and metabolomics approach involving complementary technologies and multidisciplinary expertise is paramount to achieve the scientific rigor and level of evidence required to bring nutrition-based personalized medicine to the public with the final objective of living longer and healthier”, commented Prof. Jose Ordovas of Tufts University, a world-renowned pioneer in nutrigenomics. Prof. Ordovas serves as the Senior Scientist and Director for the Nutrition and Genomics Laboratory and as the Chair of the Functional Genomics Core of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Since its inception in 2007 Prof. Ordovas has been Chairman of the Board and Scientific Director of IMDEA Food.

The IMDEA Food Institute carries out human nutrigenomic studies, which are reviewed by a Research Ethical Committee, on its platform comprised of common services for genomics, biostatistics, bioinformatics and nutritional counseling. Metabolon is the world leader in metabolomic analysis of complex biological samples and has made major contributions to the discovery of biomarkers and biochemical pathways associated with nutrients and drugs, and which have led to the development of unique diagnostic tools. Scientists from IMDEA Food and Metabolon have met in IMDEA Food’s new headquarters located in Madrid to define the lines of common interest and greatest priority and to launch the first of a series of studies aimed at defining the molecular basis of action of key food ingredients.

Dr. Steve Watkins, Chief Technology Officer, Metabolon commented, “Collaborative studies with IMDEA will employ the combined resources and expertise of our organizations to identify appropriate biomarkers of disease risk and prevention and to monitor biological impact of nutritional components in foods. This strategic collaboration is pivotal to advancing our understanding of nutrition’s influence on health and disease.”

Source: Business Wire

Decades of Improving Cholesterol Levels Abruptly Ended in 2008, PLOS ONE Study Finds

Decades of declines in LDL cholesterol blood levels, a key marker of death risk from heart disease, abruptly ended in 2008, and may have stalled since, according to a multi-year, national study published recently in PLOS ONE.

The study, by researchers at Quest Diagnostics (NYSE: DGX), examined low-density lipoprotein, or LDL, blood-serum cholesterol test results of nearly 105 million individual adult Americans of both genders in all 50 states and the District of Columbia from 2001-2011. The study is the largest of LDL cholesterol levels in an American population, and the first large-scale analysis to include data from recent years 2009-2011.

“Our study suggests that significant improvements in heart disease risk through declines in LDL cholesterol blood levels over the past several decades came to an unexpected and sudden end in 2008,” said investigator Robert Superko, M.D., medical director, cardiovascular disease, Quest Diagnostics. “The unprecedented scale of our data set should spur additional research to identify the cause or causes in order to prevent a possible reversal in years of gains in cardiovascular health in the U.S. population.”

The study found a net 13% decline in the annual mean LDL cholesterol level of the study population over the 11-year period. Between 2001 and 2008, the average age-adjusted mean LDL levels declined from about 120 mg/dL to 104.7 mg/dL, but plateaued at that level for the remainder of the study period. LDL levels of 100 mg/dL or lower are considered optimal by the American Heart Association. By 2011, about 46% of patients had achieved LDL levels lower than 100 mg/dL, while 6% of patients had LDL levels in the high-risk category of 160 mg/dL or higher.

Blood cholesterol levels are the primary biomarker for cardiovascular disease, which accounts for one in every three deaths in America. High levels of LDL (“bad”) cholesterol can cause arterial clogging, increasing the risk of stroke and heart disease. Treatments typically include lifestyle modification and therapy with lipid-lowering medications such as statins. Every 10 mg/dL decline in LDL is associated with an approximately 5-13% decline in major vascular disease events, such as strokes and mortality.

Prior research, including results of three National Health and Nutrition Examination Surveys (NHANES) of nearly 40,000 patients for the years 1988 to 2010, demonstrated that LDL levels have declined in the United States while the use of lipid-lowering medications has increased.

The Quest Diagnostics Health Trends study, “Blood Cholesterol Trends 2001-2011 in the United States: Analysis of 105 Million Patient Records,” was published online May 10, 2013 in the peer-reviewed, open-access journal PLOS ONE.

Theories for the LDL Plateau

The observational study in PLOS ONE did not identify a cause for the trends in LDL cholesterol blood levels, although investigators suggested several hypotheses.

“It is possible that the economic recession that began at about the same time LDL values plateaued in our study played a role. Patients dealing with financial constraints may have been less inclined to visit their physician or use their medications at full dose, limiting access to and effectiveness of treatment. Individuals may also have experienced changes in stress levels, diet, sleep and other behaviors, due to the poor economy, which in turn may have adversely impacted lipids,” said Harvey W. Kaufman, M.D., senior medical director, Quest Diagnostics.

The investigators also theorized that statins users in the study may have reached the maximum therapeutic-threshold level or that increases in obesity prevalence or other co-morbid factors during the 11 years of the study period contributed to the LDL plateau.

“These speculative, but plausible theories deserve additional research so the cause of the trend seen in our data can be addressed and hopefully reversed,” said Dr. Kaufman.

Gender Differences

The investigators also found differences in LDL cholesterol declines by gender. The decline in annual age-adjusted mean LDL cholesterol blood levels was slightly greater among men than women, with an average 13.4% decline for men compared to a decline of 12.5% for women.

“Though the differences are not statistically significant, they may reflect meaningful differences in the prescription rate and effectiveness of lipid-lowering interventions, including statins and lifestyles, between genders,” wrote investigators in the study. They also theorize that the differences may be due in part to “under-appreciation of heart disease risk in women,” given female-specific AHA guidelines and risk-classification algorithms for women were introduced only in 1999 and 2007, respectively.

Greater Vigilance Required

“Like other Quest Diagnostics Health Trends reports, our goal is to provide insights, based on diagnostic data, to enhance public health and patient management and, fundamentally, create a healthier world,” said Dr. Kaufman.

“We believe this new study will encourage additional population research to inform public health efforts. But we also believe the study should prompt individual patients to be vigilant about practicing healthy behaviors and lipid-lowering treatment plans. Our hope is physicians and patients will have more productive conversations about the importance of LDL control to cardiovascular health as a result of this study,” said Dr. Kaufman.

The study’s strengths include its size, national representation, longitudinal analysis and incorporation of data up through 2011. It also includes its separation of data into distinct years, as opposed to other large-scale studies, such as NHANES, which group findings into multiple years. The study represents patients under medical care and not the general American population and did not include results of clinical records, such as medical history and medications, to assess contributing factors to the results. The study examined test results of patients tested by Quest Diagnostics. Data was de-identified prior to analysis and the Western Institutional Review Board exempted the study from review.

Study: Blood Cholesterol Trends 2001–2011 in the United States: Analysis of 105 Million Patient Records

Source: Quest Diagnostics

AAPA Poster Presentation Explores Connection between Biomarkers and Science-Based Personalized Nutrition Therapy in the Management of Major Depressive Disorder

An examination of the latest genetic and physiologic biomarker research and its application in viable therapeutic options for patients with Major Depressive Disorder (MDD) was the focus of a breakthrough poster presentation which debuted at the American Academy of Physician Assistants (AAPA) annual conference, IMPACT 2013. The poster and complete study findings were presented by Ian V. Mackey, M.S., P.A.-C, Physician Assistant, Rush University Medical Center.

Building on data that shows obesity and inflammation predict poorer response to antidepressant therapy, the poster shed light on the link between biomarkers associated with conditions of inflammation, oxidative stress, and obesity and a patient’s potential response to treatment with adjunctive L-methylfolate. The presentation was aimed at helping inform and educate physician assistants (PA), who are often the first line of defense for patients presenting with MDD and critical to the proper treatment of the condition. The poster findings also come on the heels of a study published in the American Journal of Psychiatry which demonstrated twice as many patients responded when given adjunctive L-methylfolate 15mg compared to adjunctive placebo (continuation of SSRI monotherapy). In terms of tolerability, discontinuations due to adverse events were no different than placebo when adding L-methylfolate to SSRI treatment in patients with MDD.

“It’s vital that we make it a practice to assess the patient as a whole as opposed to assessing just their symptoms of MDD,” said Ian Mackey, M.S., P.A.-C. “As these findings indicate, other medical problems, concomitant medications and inflammation are becoming increasingly important in choosing the correct interventions for patients with MDD.”

Taking into account MDD can include metabolic components associated with poor Selective Serotonin Reuptake Inhibitors (SSRI) response, the poster presentation, Effect of L-methylfolate on Inflammatory Markers a Randomized Clinical Trial of Patients with Major Depression, analyzed 75 outpatients inadequately responding to an SSRI who were enrolled in a 60-day study, divided into two, 30-day evaluation periods according to Sequential Parallel Comparison Design (SPCD). Patients were randomized to receive L-methylfolate 15mg + SSRI for 60 days; placebo + SSRI for 30 days followed by L-methylfolate 15mg + SSRI for 30 days; or placebo + SSRI for 60 days. The SSRI doses remained constant during the study. Pooled 30-day results demonstrated significantly greater benefits in all-comers with adjunctive L-methylfolate 15mg + SSRI compared to placebo + SSRI (continued SSRI monotherapy). The magnitude of difference between response to adjunctive L-methylfolate and adjunctive placebo was 17.7% (p=0.04). Pooled differences in mean change on HDRS-17 and HDRS-28 were significantly greater (p=0.05 and p=0.02 respectively) with L-methylfolate superior to placebo.

Results also show that patients with SSRI-resistant MDD stratified by biomarkers of inflammation (hsCRP), oxidative stress (4-HNE) and methylation (SAM/SAH ratio) responded better to adjunctive L-methylfolate 15mg compared to adjunctive placebo. In an analysis of a priori endpoints, patients with baseline levels of hsCRP at or above the median (p=0.05) and 4-HNE (p=0.003) at or above the median and SAM/SAH ratio below the median (p=0.005) experienced a significantly greater treatment effect in favor of adjunctive L-methylfolate. In an exploratory analysis, patients with obesity defined as BMI ≥30 kg/m2 demonstrated a significantly greater treatment effect with adjunctive L-methylfolate versus adjunctive placebo (p=0.001).

The AAPA’s annual conference is focused on identifying and discussing innovative solutions that empower PAs at all stages of their careers to improve patient health. IMPACT 2013 remains the largest PA-focused Continuing Medical Education (CME) event in the world, with approximately 6,000 PAs and students in attendance. IMPACT 2013 took place May 25-29 at the Walter E. Washington Convention Center in Washington, D.C.

Source: Business Wire