Allergies, Author Interviews, Dermatology / 09.03.2023
Eczema: Mount Sinai Study Finds No Increase Risk of Cancer in 5 Year Study of Dupilumab
MedicalResearch.com Interview with:
[caption id="attachment_60156" align="alignleft" width="150"] Dr. Gulati[/caption]
Nicholas Gulati, MD, PhD
Director, Early Detection of Skin Cancer and Oncodermatology Clinic
The Kimberly and Eric J. Waldman
Department of Dermatology
Mount Sinai Health System
New York, New York
MedicalResearch.com: What is the background for this study? What is dupilumab primarily used for?
Response: Dupilumab is a monoclonal antibody that inhibits a specific part of the immune system known as Th2 cells, which are important in the development of various diseases including atopic dermatitis (eczema) and asthma. Therefore, dupilumab has become one of the major treatments for these conditions. Given the increasing use of this drug, it is important to understand the safety of it in terms of cancer development, as that is currently largely unknown.
Dr. Gulati[/caption]
Nicholas Gulati, MD, PhD
Director, Early Detection of Skin Cancer and Oncodermatology Clinic
The Kimberly and Eric J. Waldman
Department of Dermatology
Mount Sinai Health System
New York, New York
MedicalResearch.com: What is the background for this study? What is dupilumab primarily used for?
Response: Dupilumab is a monoclonal antibody that inhibits a specific part of the immune system known as Th2 cells, which are important in the development of various diseases including atopic dermatitis (eczema) and asthma. Therefore, dupilumab has become one of the major treatments for these conditions. Given the increasing use of this drug, it is important to understand the safety of it in terms of cancer development, as that is currently largely unknown.
Dr. Lazarus[/caption]
Philip Lazarus, PhD
Boeing Distinguished Professor, Pharmaceutical Sciences
Professor, Dept of Pharmaceutical Sciences
College of Pharmacy and Pharmaceutical Sciences
Washington State University
Spokane, WA 99210
MedicalResearch.com: What is the background for this study?
Response: Smoking and tobacco use remains a major health issue. Smokers use cigarette over the course of the day because the levels of nicotine, the addictive agent in cigarettes and other forms of tobacco, dimmish with time in the bloodstream due to the breakdown of nicotine by enzymes in the body. By inhibiting the breakdown of nicotine in smokers, one would expect that the levels of nicotine would remain higher after smoking a single cigarette, and that these individuals may not require lighting up another cigarette so quickly, reducing the number of cigarettes smoked over the course of a day. This could have a profound effect on reducing the overall harm incurred from smoking or from using other forms of tobacco.
In a single previous study, smokers who used a CBD inhaler exhibited a 40% reduction in cigarette use. In addition, while cannabis users are often smokers, previous studies have indicated that they smoke less cigarettes than non-cannabis-using cigarette smokers. In previous studies published in 2021, we found that major cannabinoids present in cannabis like THC and CBD inhibit major metabolizing enzymes in our body, including several that are important in drug metabolism. We hypothesized that CBD and its major active metabolite, 7-hydroxy (OH)-CBD, may also be inhibiting one or more of the enzymes important in the metabolism (or breakdown) of nicotine.
Dr. Roca[/caption]
Anna Roca PhD
MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine
Fajara, The Gambia
MedicalResearch.com: What is the background for this study?
Response: Context specific interventions are needed to decrease the high burden of severe neonatal morbidity and mortality in sub-Saharan Africa. Severe bacterial infections are a main cause of neonatal mortality in the continent. Oral intra-partum azithromycin is a cheap intervention easily scalable. Before embarking on this trial, we conducted a proof-of-concept trial that showed the intervention reduced maternal and neonatal bacterial carriage of the most prevalent bacteria causing neonatal sepsis in the continent.
Dr. Khullar[/caption]
Dhruv Khullar, M.D., M.P.P.
Director of Policy Dissemination
Physicians Foundation Center for Physician Practice and Leadership
Assistant Professor of Health Policy and Economics
Weill Cornell Medicine, NYC
MedicalResearch.com: What is the background for this study?
Response: From prior research, we know that there are racial/ethnic differences in the acute impact of COVID-19, including higher rates of hospitalization and death among Black and Hispanic individuals compared to white individuals. Less is known about whether there are differences in the rates or types of long COVID by race and ethnicity.
Alexia Aguilar[/caption]
Alexia Aguilar
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Traditional antidepressants like Zoloft and Lexapro have three major drawbacks.
Dr. Gaudino[/caption]
Mario FL Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA
Dr. Martens[/caption]
Christopher R. Martens PhD
Assistant Professor
Director, Delaware Center for Cognitive Aging Research
Department of Kinesiology & Applied Physiology
University of Delaware
Newark, DE
MedicalResearch.com: What is the background for this study?
Response: One of the main issues with Alzheimer's disease is an impaired ability to make energy in the brain. NAD+ is critically involved in the creation of energy within cells and there is strong evidence that nicotinamide riboside (NR), a precursor to NAD+, can restore brain function in mice that exhibit similar characteristics as people with Alzheimer's disease.
We had previously studied the effects of NR in healthy older adults and wanted to see whether it is even capable of getting into brain tissue. We used remaining blood samples from our original study and measured the amount of NAD+ within tiny "vesicles" in the blood that we are quite confident originated from the brain and other neural tissue
Yuxia Wei[/caption]
Yuxia Wei | PhD Student
Unit of Epidemiology
Institute of Environmental Medicine
Karolinska Institutet
Stockholm | Sweden
MedicalResearch.com: What is the background for this study?
Response: Diabetes is traditionally known for having two types (type 1 diabetes and type 2 diabetes). However, it is becoming increasingly clear that diabetes is much more complex than this traditional classification. Several attempts have been made to address this heterogeneity and in 2018, a Swedish ground-breaking study proposed that there are five distinct subtypes of diabetes in adults. They have been replicated in different populations and it has been shown that there are differences between the subtypes in terms of genetics and risks of complications. Another way of elucidating the relevance of these subtypes is to investigate whether the influence of known risk factors for diabetes is different on different subtypes. Our study is one of the first attempts to address this. We used a study design known as Mendelian randomization, to investigate the influence of childhood obesity on these diabetes subtypes that typically occur after age 35. This work was a collaboration between Karolinska institutet in Stockholm, University of Bristol in the UK and Sun Yat-Sen University in China.
Dr. Stevermer[/caption]
James Stevermer, M.D., M.S.P.H.
Vice chair for clinical affairs
Professor of family and community medicine
University of Missouri
Medical director of MU Health Care Family Medicine–Callaway Physicians,
Dr. Stevermer joined the U.S. Preventive Service Task Force in January 2021.
MedicalResearch.com: What is the background for this study?
Response: Genital herpes is a common sexually transmitted infection (STI) that unfortunately has no cure and cannot accurately be detected in people who do not have signs of the condition. The current screening tests have limitations and there is a high chance that test results will say a person has the condition when they do not. In addition, the available treatments are focused on managing symptoms and preventing the condition from reoccurring. As a result, the Task Force concluded that the harms of screening outweigh the benefits.
Dr. Goodrich[/caption]
Jesse Goodrich PhD
Assistant Professor
Department of Population and Public Health Sciences
Keck School of Medicine
University of Southern California
MedicalResearch.com: What is the background for this study?
Response: Per- and poly-fluoroalkyl substances (PFAS) are a group of persistent chemicals that are known to interfere with hormones and metabolism. In our previous research, we have found that PFAS exposure is associated several specific diseases, especially in children and adolescents. These include obesity, type 2 diabetes, liver disease, and even liver cancer. However, we are still only just starting to fully understand all of the health effects of the many different PFAS in existence. Previous studies have focused primarily on one or two main PFAS. However, there are over 9,000 known PFAS, and people are exposed not just to a single PFAS but to mixtures of many PFAS. Importantly, the combination of these chemical exposures may affect us differently than single exposures alone.
To address this challenge, we used an innovative approach to study design to examine how exposure to PFAS impacts biological processes which may underly the development of many different diseases in adolescents and young adults. To do this, we first measured thousands of naturally occurring chemicals, known as metabolites, in people's blood. Then, using a new biostatistical method developed by our team, we identified how exposure to a mixture of several PFAS impacted each individual chemical. Finally, we used this information to determine which biological processes are changed by PFAS exposure.
Dr. Mahdavi[/caption]
Dr. Sara Mahdavi, PhD
Clinical Scientist and Clinical Instructor
Research Appointment in the Faculty of Medicine
University of Toronto
Toronto, ON
MedicalResearch.com: What is the background for this study?
Response: This was a long-term study spanning 16 years and began with a population of young adults who were medically assessed on a regular basis. It was remarkable to see just how striking the effects of coffee were in the group that had the susceptible genetic variant, what we termed “slow caffeine metabolizers” yet no effect whatsoever in those who did not were termed “fast metabolizers”.
Kenya Colvin[/caption]
Kenya Colvin, MBS
Department of Medical Education
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Vaccine hesitancy is a major driver of COVID-19 vaccination disparities between minority and non-Hispanic White communities. Our goal was to understand what factors influenced vaccine hesitancy among individuals in Eastern Pennsylvania to identify more effective ways to promote vaccine uptake within minority communities.
Dr. Kim[/caption]
Brian S Kim, MD, MTR
Sol and Clara Kest Professor
Vice Chair of Research | Site Chair, Mount Sinai West and Morningside
Director, Mark Lebwohl Center for Neuroinflammation and Sensation
The Kimberly and Eric J. Waldman Department of Dermatology
Precision Immunology Institute | Friedman Brain Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: We generated preliminary data in mice that difelikefalin suppresses itch robustly with very little to no effect on inflammation in a model of atopic dermatitis. This led us to hypothesize that the primary mode of action of difelikefalin must be by direct modulation of sensory neurons to suppress itch and thus would be best suited for a neuropathic itch condition. These are conditions in which itch occurs relatively independently of skin inflammation as in atopic dermatitis due to hyperactive nerves.
Dr. Pierce[/caption]
Karen Pierce, Ph.D.
Professor, Department of Neurosciences, UCSD
Co-Director, Autism Center of Excellence, UCSD
MedicalResearch.com: What is the background for this study?
Response: The mean age of ASD diagnosis and eventual treatment remains at ~52 months in the United States1 - years beyond the disorder’s prenatal origins2, and beyond the age when it can be reliably diagnosed in many cases3.
Currently the only way to determine if a child has autism spectrum disorder (ASD) is to receive a developmental evaluation from an experienced clinician (usually a licensed clinical psychologist). There are often long waiting lists, and only a small number of clinicians have the experience required to make early-age (i.e., between 12-36 months) diagnoses of ASD. Thus, there are many places in the country as well as world wide wherein children wait months or years to receive a formal diagnosis due to a lack of available expertise. Moreover, diagnostic evaluations are expensive and usually cost the parent and/or insurance approximately ~$2,000 or more per evaluation. Finally, clinical evaluations usually take between 2-3 hours to complete and result in fatigue for both the parent and toddler.
Eye-tracking, which generates biologically-relevant, objective, and quantifiable metrics of both visual and auditory preference profiles in babies and toddlers in just minutes, is a technology that can dramatically change how ASD is diagnosed.