Gene editing reverses Huntington's in mouse model

This is a concrete example, not yet clinical, of what can be done with CRISPR/Cas9 gene Read more

Urine tests for prostate cancer could reduce biopsies

Urine RNA tests could reduce the number of biopsies by giving a preview of a cancer's aggressiveness. Featuring Martin Sanda and Carlos Read more

Mitochondrial blindness -- Newman's Emory story

Neuro-ophthalmologist Nancy Newman’s 2017 Dean’s Distinguished Faculty Lecture and Award were unexpectedly timely. Her talk on Tuesday was a tour of her career and mitochondrial disorders affecting vision, culminating in a description of gene therapy clinical trials for the treatment of Leber’s hereditary optic neuropathy. The sponsor of those studies, Gensight Biologics, recently presented preliminary data on a previous study of their gene therapy at the American Academy of Neurology meeting in April. Two larger trials Read more

fecal microbiota transplant

Fecal transplant replants microbial garden

When facing a life-threatening infection, the “yuck factor” is a minor concern. Fecal microbiota transplant (FMT for short) has become an accepted treatment for recurrent Clostridium difficile infection, which can cause severe diarrhea and intestinal inflammation.

In a new video, Emory physicians Colleen Kraft and Tanvi Dhere explain how FMT restores microbial balance when someone’s internal garden has been disrupted.

C. difficile or “C diff” is a hardy bacterium that can barge into the intestines after another infection has been treated with antibiotics, when competition for real estate is low. In the last few years, doctors around the world have shown that FMT can resolve recurrent C diff infection better than antibiotics alone.

At Emory, Kraft and Dhere have performed almost 300 FMTs and report a 95 percent success rate when treating recurrent C diff. They have established a standard slate of stool donors, whose health is carefully screened.

Building on their experience with the procedure, Kraft and Dhere are studying whether FMT can head off other antibiotic-resistant infections besides C diff in kidney transplant patients. They have teamed up with infectious disease specialists Aneesh Mehta and Rachel Friedman-Moraco to conduct this study. Read more

Posted on by Quinn Eastman in Uncategorized Leave a comment

Four biomedical research topics to watch in 2017

HIV/AIDS

The example of the “Berlin patient,” the only person ever cured of HIV infection, has energized HIV/AIDS researchers around the world. They are exploring a variety of tactics to attack the HIV reservoir in infected people, ranging from gene editing to “kick and kill.” A host of Emory/Yerkes researchers are among those pushing this forward.

This past year, an Emory/NIAID team led by Tab Ansari showed that a gentle, antibody-based approach could suppress SIV infection in macaques for extended periods, which surprised many in the field. The human test of this approach is now underway at the National Institutes of Health.

On the preventive vaccine side, a large scale efficacy study recently begun in South Africa, the first in seven years. Geovax’s Emory-rooted technology continues to advance in clinical studies. Further back in the pipeline, Yerkes researchers are testing innovative approaches, such as Rama Amara’s milk-bacteria-based mucosal vaccine and the potent nanoparticle adjuvants developed by Bali Pulendran’s group.

Zika

Despite the World Health Organization’s declaration in November that the public health emergency is over, Zika infection is still driving brain-related birth defects in several countries. Expect to hear more about Zika epidemiology and vaccine research, including from Emory investigators, next year.

In contrast with HIV, which seems to escape from almost anything we or our immune systems throw at it, Zika is doable, scientists think. At a Vaccine Dinner Club talk in September, Harvard’s Dan Barouch made the case that Zika is a slam dunk, immunologically. Two big questions remain: does dengue get in the way? And can vaccine makers test quickly and distribute widely?

FMT for antibiotic-resistant infections

Emory physicians have been leaders in developing fecal microbiota transplant as a remedy for recurrent Clostridium dificile infection. This form of diarrhea, which can be life-threatening, sometimes arises as a result of antibiotics that wipe out the helpful bacteria that live in the intestines, paving the way for “C diff.”

Now the Emory team (Colleen Kraft/Tanvi Dhere/Aneesh Mehta/Rachel Friedman-Moraco) is testing whether FMT could prevent other antibiotic-resistant infections besides C diff. This approach will be examined in a group of patients that tends to have a lot of antibiotic exposure: kidney transplant recipients. The team’s first publication on this topic from 2014 is here. Read more

Posted on by Quinn Eastman in Immunology, Neuro Leave a comment

An effective alternative to fecal transplant for C. difficile?

Bacterial spores in capsules taken by mouth can prevent recurrent C. difficile infection, results from a preliminary study suggest.

Clostridium difficile is the most common hospital-acquired infection in the United States and can cause persistent, sometimes life-threatening diarrhea. Fecal microbiota transplant has shown promise in many clinical studies as a treatment for C. difficile, but uncertainty has surrounded how such transplants should be regulated and standardized. Also, the still-investigational procedure is often performed by colonoscopy, which may be difficult for some patients to tolerate.

The capsule study, published Monday in Journal of Infectious Diseases, represents an important step in moving away from fecal microbiota transplant as a treatment for C. difficile, says Colleen Kraft, MD, assistant professor of pathology and laboratory medicine and medicine (infectious diseases) at Emory University School of Medicine.

Kraft and Tanvi Dhere, MD, assistant professor of medicine (digestive diseases) have led development of the fecal microbiota transplant program at Emory. They are authors on the capsule study, along with investigators from Mayo Clinic, Massachusetts General Hospital, Miriam Hospital (Rhode Island), and Seres Therapeutics, the study sponsor.

While this study involving 30 patients did not include a control group, the reported effectiveness of 96.7 percent compares favorably to published results on antibiotic treatment of C. difficile infection or fecal microbial transplant. Read more

Posted on by Quinn Eastman in Uncategorized Leave a comment