Author Interviews, Dermatology, Yale / 08.04.2022
JAK Inhibitors Show Promise For Treatment of Severe Alopecia Areata
MedicalResearch.com Interview with:
Brett King, MD, PhD, FAAD
Associate Professor of Dermatology
Yale School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Alopecia areata is an autoimmune disorder marked by disfiguring, non-scarring hair loss, and there are no therapies approved by the U.S. Food and Drug Administration for treatment of the disease. JAK inhibitors are showing promise for treatment of severe alopecia areata. In this work, the pooled results of two phase 3 clinical trials of the JAK inhibitor baricitinib were reported out to 52 weeks.
Brett King, MD, PhD, FAAD
Associate Professor of Dermatology
Yale School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Alopecia areata is an autoimmune disorder marked by disfiguring, non-scarring hair loss, and there are no therapies approved by the U.S. Food and Drug Administration for treatment of the disease. JAK inhibitors are showing promise for treatment of severe alopecia areata. In this work, the pooled results of two phase 3 clinical trials of the JAK inhibitor baricitinib were reported out to 52 weeks.
Dr. Klimis-Zacas[/caption]
Dorothy Klimis-Zacas, MS, PhD, FACN
Professor of Clinical Nutrition
School of Food and Agriculture
Graduate Faculty
School of Biomedical Sciences
Associate Faculty, Institute of Medicine
Fulbright Fellow
University of Maine Orono, Maine 04469
MedicalResearch.com: What is the background for this study?
Response: Bioactive compounds such as polyphenols have been documented to have wound healing properties . In the Klimis-Zacas laboratory, phenolic extracts (PE) from wild blueberries (WB) were reported to promote angiogenesis in HUVEC cells via cell migration, angiogenesis, through VEGF/P13K/AKT pathway documented that the PE, primarily composed of chlorogenic acid significantly promoted cell migration and closure speed of wound by 38% above the control as well as angiogenesis and gene expression for proteins critical for cell movement while the anthocyanin fraction inhibited the above processes (5,6). 
Ali M. Fazlollahi[/caption]
Ali M. Fazlollahi, MSc, McGill Medicine Class of 2025
Neurosurgical Simulation and Artificial Intelligence Learning Centre
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital
Faculty of Medicine and Health Sciences
McGill University, Montreal, Canada
MedicalResearch.com: What is the background for this study?
Response: COVID-19 disrupted hands on surgical exposure of medical students and academic centres around the world had to quickly adapt to teaching technical skills remotely. At the same time, advances in artificial intelligence (AI) allowed researchers at the Neurosurgical Simulation and Artificial Intelligence Learning Centre to develop an intelligent tutoring system that evaluates performance and provides high-quality personalized feedback to students. Because this is the first AI system capable of providing surgical instructions in simulation, we sought to evaluate its effectiveness compared with learning from expert human instructors who provided coaching remotely.
Dr. Ying-Hui Fu[/caption]
Ying-Hui Fu, PhD
Professor, Neurology
Weill Institute for Neurosciences
UCSF
MedicalResearch.com: What is the background for this study?
Response: Most people are aware that a lack of sleep is associated with all sorts of health issues. However, familial natural short sleeper (FNSS) individuals sleep 4-6.5 hours a night most of their live and stay healthy. We set out to determine whether natural short sleep mutations can offer protection from various diseases. We chose Alzheimer as an example to start.
Dr. Palatini[/caption]
Paolo Palatini, M.D.
Professor of Internal Medicine
University of Padova
Padova, Italy
MedicalResearch.com: What is the background for this study?
Response: Up to now doctors measured blood pressure (BP) on standing only in elderly people on pharmacological treatment with the purpose of detecting orthostatic hypotension. In young-to-middle-age people BP is currently measured only in the lying or the sitting posture.
Our starting point was that young borderline hypertensive people have an increased sympathetic activity and thus they might be hyperreactive to physical stimuli such as assuming the orthostatic posture which may be deleterious in the long run. This hypothesis was tested in the HARVEST, a study initiated in Italy in 1990, in which over 1200 young patients screened for stage 1 hypertension were enrolled.
Dr. Rathmann[/caption]
Prof. Wolfgang Rathmann MSPH
Prof. of Epidemiology
Deputy Director, Institute for Biometrics and Epidemiology,
German Diabetes Center, Heinrich Heine University
Düsseldorf, Germany
MedicalResearch.com: What is the background for this study?
Response: Diabetes is associated with a poor prognosis of COVID-19. There have been raised concerns about a bidirectional relationship between diabetes and COVID-19. Recent studies raised the possibility that SARS-CoV-2 can cause diabetes. However, there is a lack of studies investigating the incidence of diabetes after recovery from COVID-19 in mild cases.
To provide more evidence, we analyzed electronic health records from 1,171 general and internal medicine practices across Germany between March 2020 and January 2021. This included 35,865 patients who were diagnosed with COVID-19. The incidence of diabetes after COVID-19 was compared with patients, who were diagnosed with an acute upper respiratory tract infection (AURI), matched for sex, age, and comorbidities including obesity, high blood pressure, high cholesterol, heart attack, and stroke.
Dr. Torkamani[/caption]
Ali Torkamani, Ph.D.
Director of Genomics and Genome Informatics
Scripps Research Translational Institute
Professor, Integrative Structural and Computational Biology
Scripps Research
La Jolla, CA 92037
MedicalResearch.com: What is the background for this study?
Response: Prior research has shown that people with higher polygenic risk for coronary artery disease achieve greater risk reduction with statin or other lipid lowering therapy. In general, adherence to standard guidelines for lipid lowering therapy is low - about 30% of people who should be on lipid lowering therapy are, with no correlation to their genetic risk. We set out to see whether communicating personalized risk, including polygenic risk, for coronary artery disease would drive the adoption of lipid lowering therapy.
Dr. Sesso[/caption]
Howard D. Sesso, ScD, MPH
Associate Professor of Medicine
Division of Preventive Medicine
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet?
Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels.
COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital.
Arman A. Shahriar
Medical Student, University of Minnesota Medical School Research
Consultant, HealthPartners Institute
Minneapolis, Minnesota
Dr. Cortese[/caption]
Rene Cortese, PhD
Assistant Professor
Department of Child Health – Child Health Research Institute
Department of Obstetrics, Gynecology and Women’s Health
School of Medicine
Core Faculty - MU Institute for Data Science and Informatics
University of Missouri
Columbia, MO 65212
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Obstructive sleep apnea (OSA) affects 22 million people in the U.S. and is linked to a higher risk of hypertension, heart attacks, stroke, diabetes, and many other chronic conditions.
We have found that untreated OSA also accelerates the biological aging process, and that appropriate treatment can slow or possibly reverse the trend. Age acceleration testing involves a blood test that analyzes DNA and uses an algorithm to measure a person’s biological age. The phenomenon of a person’s biological age surpassing their chronological age is called “epigenetic age acceleration” and is linked to overall mortality and to chronic diseases.
Dr. Wong[/caption]
Susan P. Y. Wong, MD MS
Assistant Professor
Division of Nephrology
University of Washington
VA Puget Sound Health Care System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes.
We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life.
Dr. Launer[/caption]
Lenore J. Launer, Ph.D.
Chief, Laboratory of Epidemiology and Population Sciences
Intramural Research Program, National Institute on Aging.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Identifying early risk factors and early changes in the brain will have a major impact on future clinical and public health priorities related to the looming epidemic of dementia. Several studies based on older populations suggest mid-life is an important period to start prevention measures. To date control of blood pressure levels has been the most robust and promising candidate to target for prevention of future cognitive impairment. Although several studies have looked at levels of blood pressure and risk for cognitive impairment, it was not known whether trajectories from young adulthood to middle age studies provided additional information about risk. To investigate possible biomarkers of future risk, we chose to examine the association of the mean arterial blood pressure trajectories to indicators of pathology seen on MRI and that are associated with cognition.
We highlight the results of the mean arterial blood pressure (MAP) measure, which is an integrated measure of systolic and diastolic blood pressure.
Response: Cigarette smoking is one of the well-established causes of periodontitis, but the effect of using electronic cigarettes (e-cig), especially its long-term impact on periodontal health, is not yet clearly understood. Considering the increased popularity of e-cig use, especially among teenagers and young adults, and the known effect of high nicotine concentration in e-cigarette products, we conducted this clinical research to see if there were differences in periodontal health between e-cig users, traditional smokers, and nonsmokers. The study consisted of two visits, 6 months apart, where measures of oral and periodontal health were obtained.
Our data showed significantly greater clinical attachment loss in the e-cigarette users and cigarette smokers than in the non-smokers at both study visits. In only e-cigarette users, we observed an over 0.2 mm average increase in the clinical attachment loss after 6 months.