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HOROSCOPES: How Thursday’s new moon will affect your week, according to your star sign. – Mamamia

By daniellenierenberg

Venus pokes Uranus, provoking your mother, sister or aunt to ruffle your feathers. Stand your ground and dont allow anyone to sway you from your purpose. Although well-intentioned, this person isnt fully informed, and most importantly,she isnt living your life. Theres no need for harsh words, just gently remind her thatyoure capable of making your own decisions. And thats that!

Although this week brings a breath of fresh air in the form of a new project or chapter, someone is intent on undermining you. Their doubts stem from jealousy, so dont allow them to project their negativity onto you. Stay your course, Pisces. Come up with your own facts rather than listening to biased opinions. Believe in yourself and toss the naysayers to the curb.

A self-confessed astrology nerd, Natashas horoscopes, research and articles have been published in Todays Astrologer, in addition to international publications across the globe. A senior member of the Australian Academy of Astrology and Cosmobiology and a member of the American Federation of Astrologers, she has presented cosmic updates for Your Life Naturally and has appeared as a special guest on podcasts, including Sivana and Healthy-ish.

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Sherrie Hewson turns 70 with second facelift after tough year left her ‘broken’ – Mirror Online

By daniellenierenberg

Sherrie Hewson faced up to turning 70 this week by giving herself a real lift.

The Benidorm and Corrie star, who hits the milestone birthday on Thursday, has had a second facelift to boost her confidence after a really tough year that saw her beloved brother die and left her lonely in lockdown.

Sherrie says she was completely broken after her older sibling Brett Hutchinson passed away in April and she couldnt visit him because of coronavirus restrictions.

Brett died of a brain tumour and the shock of his death has left Sherrie more determined than ever to live life to the full.

She told the Sunday Mirror: I am still not very strong, I still have moments. Whenever I hear any Motown music, which he loved, I just cry. The pain is so terrible, my heart is broken.

Now I look at my life and think, Hang on a minute, what have I got, how long have I got?

I mean, look at my brother. Two years ago he was the healthiest thing on this planet.

So none of us know whats going to happen.

In ten years time I am going to be 80, so I need to be healthy and well for my grandchildren.

I wish I had planned more when I was younger. Instead I just went steaming ahead, thinking I was going to live forever.

Brett was only a couple of years older than me, so as I go into my seventies his death has made me want to live every day to the max.

I want to do everything now everything crazy, mad and wonderful. Everything that is possible to do I want to do it now.

And that all started with her facelift.

Dubbed the love handle facelift or LHF Sherries procedure took just minutes and she went out to lunch straight afterwards.

The procedure involved removing fat from around her hips and stomach. This was then combined with her blood, to release stem cells from the fat.

The mixture, a thick serum, was then injected into layers into her face without even drawing blood. The results will last five years.

Sherrie said: The LHF was a quick treatment and its given me such a boost. I feel like its rejuvenated my skin and restored all the volume its natural looking with no cutting, and it was all done in under an hour.

I absolutely love the results.

She adds: I had a facelift when I was 50 and Ive had bits and bobs done throughout the years a bit of botox and filler. But I havent had anything done for a long time now.

But as I approached 70. I just thought, What will I do for myself at this age? I thought I would give myself a last kind of boost so I can look in the mirror and think, Youre not bad for your age.

Its to give myself a lift after all the stuff I have been through, particularly in the last 18 months.

I need to give my self-confidence and self-worth a big kick up the a**e so can I feel good about myself and hold my head up high.

The actress , who lives alone, says she found lockdown awful and even turned to drinking wine every night to get through it.

She says: It was just terrifying being alone. Thank God for the internet! I have been doing the Wonderbirds show and Ive been presenting courses on Zoom. That kept my mind busy.

I did put on weight and I am trying to be more sensible now. I started drinking, and I was drinking every night which I would never do. Then I thought, I must stop this.

So I stopped for two months and I didnt even miss it. Thats when I realised I didnt have a problem. I was just bored and lonely.

Now Sherrie is hoping to spend the next decade healthy and happy and maybe even in love.

Her Corrie character Maureen Webster had four husbands, including Reg Holdsworth, played by Ken Morley. But Sherrie says she hasnt even had a proper date since her marriage to Ken Boyd broke down in 2001, after he had an affair.

Now she hopes her facelift will give her the boost she needs to start going out with people again.

She says: Dating is harder as you get older - the older you get, the more you lack confidence. I sometimes look in the mirror and dont know who that much older woman is.

Sherrie would be more than happy with a kiss and cuddle with someone with their arms around you.

She says: I cant imagine any more what that feels like that warmth and that someone who wants to be with me. Just that alone would be enough.

Sherrie, who played flirty hotel manager Joyce Temple-Savage in ITV sitcom Benidorm, says she has had a couple of potential love interests.

One was a younger American man she met on dating site Plenty of Fish. But they came to nothing.

She says: I havent really dated since I broke up with my husband except I did go for a meal with a man and I ordered a bottle of wine. He put the cork in the bottle and said he was driving and I said, Im bloody not! and took the cork out.

We got back to my house and he tried kissing me and I just thought, No!

But passion is still on Sherries wishlist as shes still open to an unbelievable affair with the right man.

She also has dreams of launching a travel programme for older people showing that they can still do crazy, mad and wonderful things.

Because coronavirus restrictions are set to change again tomorrow, with the new Rule of Six, Sherrie wont be able to celebrate her birthday as she had hoped with a big bash. But she will spend the day with daughter Keeley and youngest grand-daughter Rosie, who turned one in May.

Reflecting on her own age, the gran-of-three says: I have been on this earth for 70 years. Doesnt that sound weird?

The thing is how the hell did I get to number seven? When I got to number six I was gobsmacked. But you know what? A lot of people dont get to number seven, so how lucky am I?

Ive got a wonderful family and Ive had a fabulous career. My family are my life blood, I breathe for them.

And Im healthy, thank God. When you moan and groan about getting older and I do, all the time I tell myself my great grandmother, grandmother and my mum all lived until their eighties and nineties. So I am on a good wicket there arent I?

Sherrie admits she sometimes envies her daughters family life.

She says: Ive been on stage since I was four and, when I look back, my whole life has been my career.

I have no regrets, except that I would have had more children, given the chance. Keeley is at home with her three and I never had the privilege to do that. I was working so much.

But instead of dwelling on the past, Sherrie is determined to look ahead from now on. She says: At 70, I am still finding out who I am and what I want to do with my life.

Fat Transfer and Stromal Vascular fraction

We are increasingly using fat along with concentrated platelet rich plasma as a natural lipo filler to add volume where there has been for fat loss and to help with skin rejuvenation.

Fat is the bodys major source of mesenchymal stem cells, which are considered multi-potent, as they have the ability to differentiate themselves into a number of different types of stem cells that are useful for regeneration, tissue repair and wound healing. PRP is used to promote cell growth and collagen production, so is extremely useful for Creping and thinning skin.

Combined they make the perfect treatment to regenerate and rejuvenate and replace lost volume due to ageing.

What is it? An all-natural alternative incision free facelift

Downtime? 0-24 hours

How long does it last? Up to five years

Where can I get it? http://www.harleystreetskinclinic.com 0207 436 4441

How much is it? FROM 3,950

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Impact Of Covid-19 on Cosmetic Skin Care Market 2020 Industry Challenges, Business Overview and Forecast Research Study 2026 – Owned

By daniellenierenberg

The study of Cosmetic Skin Care market is a compilation of the market of Cosmetic Skin Care broken down into its entirety on the basis of types, application, trends and opportunities, mergers and acquisitions, drivers and restraints, and a global outreach. The detailed study also offers a board interpretation of the Cosmetic Skin Care industry from a variety of data points that are collected through reputable and verified sources. Furthermore, the study sheds a lights on a market interpretations on a global scale which is further distributed through distribution channels, generated incomes sources and a marginalized market space where most trade occurs.

Along with a generalized market study, the report also consists of the risks that are often neglected when it comes to the Cosmetic Skin Care industry in a comprehensive manner. The study is also divided in an analytical space where the forecast is predicted through a primary and secondary research methodologies along with an in-house model.

Download PDF Sample of Cosmetic Skin Care Market report @ https://hongchunresearch.com/request-a-sample/77005

Key players in the global Cosmetic Skin Care market covered in Chapter 4:HenkelNatura & CoKaoLaboratories IPRADMary KayBeiersdorfEste Lauder CompaniesCotyColgate-PalmoliveUnileverP&GShiseidoChanelJohnson & JohnsonAmorepacificRevlonKoseAvonLVMHL BrandsLOreal

In Chapter 11 and 13.3, on the basis of types, the Cosmetic Skin Care market from 2015 to 2026 is primarily split into:Anti-Aging Cosmetic ProductsSkin Whitening Cosmetic ProductsSensitive Skin Care ProductsAnti-Acne ProductsDry Skin Care ProductsWarts Removal ProductsInfants Skin Care ProductsAnti-Scars Solution ProductsMole Removal ProductsMulti Utility Products

In Chapter 12 and 13.4, on the basis of applications, the Cosmetic Skin Care market from 2015 to 2026 covers:Stem Cells Protection Against UVFlakiness ReductionRehydrate the Skin SurfaceMinimize wrinklesIncrease the viscosity of Aqueous

Geographically, the detailed analysis of consumption, revenue, market share and growth rate, historic and forecast (2015-2026) of the following regions are covered in Chapter 5, 6, 7, 8, 9, 10, 13:North America (Covered in Chapter 6 and 13)United StatesCanadaMexicoEurope (Covered in Chapter 7 and 13)GermanyUKFranceItalySpainRussiaOthersAsia-Pacific (Covered in Chapter 8 and 13)ChinaJapanSouth KoreaAustraliaIndiaSoutheast AsiaOthersMiddle East and Africa (Covered in Chapter 9 and 13)Saudi ArabiaUAEEgyptNigeriaSouth AfricaOthersSouth America (Covered in Chapter 10 and 13)BrazilArgentinaColumbiaChileOthers

For a global outreach, the Cosmetic Skin Care study also classifies the market into a global distribution where key market demographics are established based on the majority of the market share. The following markets that are often considered for establishing a global outreach are North America, Europe, Asia, and the Rest of the World. Depending on the study, the following markets are often interchanged, added, or excluded as certain markets only adhere to certain products and needs.

Here is a short glance at what the study actually encompasses:Study includes strategic developments, latest product launches, regional growth markers and mergers & acquisitionsRevenue, cost price, capacity & utilizations, import/export rates and market shareForecast predictions are generated from analytical data sources and calculated through a series of in-house processes.

However, based on requirements, this report could be customized for specific regions and countries.

Brief about Cosmetic Skin Care Market Report with [emailprotected] https://hongchunresearch.com/report/cosmetic-skin-care-market-size-2020-77005

Some Point of Table of Content:

Chapter One: Report Overview

Chapter Two: Global Market Growth Trends

Chapter Three: Value Chain of Cosmetic Skin Care Market

Chapter Four: Players Profiles

Chapter Five: Global Cosmetic Skin Care Market Analysis by Regions

Chapter Six: North America Cosmetic Skin Care Market Analysis by Countries

Chapter Seven: Europe Cosmetic Skin Care Market Analysis by Countries

Chapter Eight: Asia-Pacific Cosmetic Skin Care Market Analysis by Countries

Chapter Nine: Middle East and Africa Cosmetic Skin Care Market Analysis by Countries

Chapter Ten: South America Cosmetic Skin Care Market Analysis by Countries

Chapter Eleven: Global Cosmetic Skin Care Market Segment by Types

Chapter Twelve: Global Cosmetic Skin Care Market Segment by Applications12.1 Global Cosmetic Skin Care Sales, Revenue and Market Share by Applications (2015-2020)12.1.1 Global Cosmetic Skin Care Sales and Market Share by Applications (2015-2020)12.1.2 Global Cosmetic Skin Care Revenue and Market Share by Applications (2015-2020)12.2 Stem Cells Protection Against UV Sales, Revenue and Growth Rate (2015-2020)12.3 Flakiness Reduction Sales, Revenue and Growth Rate (2015-2020)12.4 Rehydrate the Skin Surface Sales, Revenue and Growth Rate (2015-2020)12.5 Minimize wrinkles Sales, Revenue and Growth Rate (2015-2020)12.6 Increase the viscosity of Aqueous Sales, Revenue and Growth Rate (2015-2020)

Chapter Thirteen: Cosmetic Skin Care Market Forecast by Regions (2020-2026) continued

Check [emailprotected] https://hongchunresearch.com/check-discount/77005

List of tablesList of Tables and FiguresTable Global Cosmetic Skin Care Market Size Growth Rate by Type (2020-2026)Figure Global Cosmetic Skin Care Market Share by Type in 2019 & 2026Figure Anti-Aging Cosmetic Products FeaturesFigure Skin Whitening Cosmetic Products FeaturesFigure Sensitive Skin Care Products FeaturesFigure Anti-Acne Products FeaturesFigure Dry Skin Care Products FeaturesFigure Warts Removal Products FeaturesFigure Infants Skin Care Products FeaturesFigure Anti-Scars Solution Products FeaturesFigure Mole Removal Products FeaturesFigure Multi Utility Products FeaturesTable Global Cosmetic Skin Care Market Size Growth by Application (2020-2026)Figure Global Cosmetic Skin Care Market Share by Application in 2019 & 2026Figure Stem Cells Protection Against UV DescriptionFigure Flakiness Reduction DescriptionFigure Rehydrate the Skin Surface DescriptionFigure Minimize wrinkles DescriptionFigure Increase the viscosity of Aqueous DescriptionFigure Global COVID-19 Status OverviewTable Influence of COVID-19 Outbreak on Cosmetic Skin Care Industry DevelopmentTable SWOT AnalysisFigure Porters Five Forces AnalysisFigure Global Cosmetic Skin Care Market Size and Growth Rate 2015-2026Table Industry NewsTable Industry PoliciesFigure Value Chain Status of Cosmetic Skin CareFigure Production Process of Cosmetic Skin CareFigure Manufacturing Cost Structure of Cosmetic Skin CareFigure Major Company Analysis (by Business Distribution Base, by Product Type)Table Downstream Major Customer Analysis (by Region)Table Henkel ProfileTable Henkel Production, Value, Price, Gross Margin 2015-2020Table Natura & Co ProfileTable Natura & Co Production, Value, Price, Gross Margin 2015-2020Table Kao ProfileTable Kao Production, Value, Price, Gross Margin 2015-2020Table Laboratories IPRAD ProfileTable Laboratories IPRAD Production, Value, Price, Gross Margin 2015-2020Table Mary Kay ProfileTable Mary Kay Production, Value, Price, Gross Margin 2015-2020Table Beiersdorf ProfileTable Beiersdorf Production, Value, Price, Gross Margin 2015-2020Table Este Lauder Companies ProfileTable Este Lauder Companies Production, Value, Price, Gross Margin 2015-2020Table Coty ProfileTable Coty Production, Value, Price, Gross Margin 2015-2020Table Colgate-Palmolive ProfileTable Colgate-Palmolive Production, Value, Price, Gross Margin 2015-2020Table Unilever ProfileTable Unilever Production, Value, Price, Gross Margin 2015-2020Table P&G ProfileTable P&G Production, Value, Price, Gross Margin 2015-2020Table Shiseido ProfileTable Shiseido Production, Value, Price, Gross Margin 2015-2020Table Chanel ProfileTable Chanel Production, Value, Price, Gross Margin 2015-2020Table Johnson & Johnson ProfileTable Johnson & Johnson Production, Value, Price, Gross Margin 2015-2020Table Amorepacific ProfileTable Amorepacific Production, Value, Price, Gross Margin 2015-2020Table Revlon ProfileTable Revlon Production, Value, Price, Gross Margin 2015-2020Table Kose ProfileTable Kose Production, Value, Price, Gross Margin 2015-2020Table Avon ProfileTable Avon Production, Value, Price, Gross Margin 2015-2020Table LVMH ProfileTable LVMH Production, Value, Price, Gross Margin 2015-2020Table L Brands ProfileTable L Brands Production, Value, Price, Gross Margin 2015-2020Table LOreal ProfileTable LOreal Production, Value, Price, Gross Margin 2015-2020Figure Global Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Global Cosmetic Skin Care Revenue ($) and Growth (2015-2020)Table Global Cosmetic Skin Care Sales by Regions (2015-2020)Table Global Cosmetic Skin Care Sales Market Share by Regions (2015-2020)Table Global Cosmetic Skin Care Revenue ($) by Regions (2015-2020)Table Global Cosmetic Skin Care Revenue Market Share by Regions (2015-2020)Table Global Cosmetic Skin Care Revenue Market Share by Regions in 2015Table Global Cosmetic Skin Care Revenue Market Share by Regions in 2019Figure North America Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Europe Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Asia-Pacific Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Middle East and Africa Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure South America Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure North America Cosmetic Skin Care Revenue ($) and Growth (2015-2020)Table North America Cosmetic Skin Care Sales by Countries (2015-2020)Table North America Cosmetic Skin Care Sales Market Share by Countries (2015-2020)Figure North America Cosmetic Skin Care Sales Market Share by Countries in 2015Figure North America Cosmetic Skin Care Sales Market Share by Countries in 2019Table North America Cosmetic Skin Care Revenue ($) by Countries (2015-2020)Table North America Cosmetic Skin Care Revenue Market Share by Countries (2015-2020)Figure North America Cosmetic Skin Care Revenue Market Share by Countries in 2015Figure North America Cosmetic Skin Care Revenue Market Share by Countries in 2019Figure United States Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Canada Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Mexico Cosmetic Skin Care Sales and Growth (2015-2020)Figure Europe Cosmetic Skin Care Revenue ($) Growth (2015-2020)Table Europe Cosmetic Skin Care Sales by Countries (2015-2020)Table Europe Cosmetic Skin Care Sales Market Share by Countries (2015-2020)Figure Europe Cosmetic Skin Care Sales Market Share by Countries in 2015Figure Europe Cosmetic Skin Care Sales Market Share by Countries in 2019Table Europe Cosmetic Skin Care Revenue ($) by Countries (2015-2020)Table Europe Cosmetic Skin Care Revenue Market Share by Countries (2015-2020)Figure Europe Cosmetic Skin Care Revenue Market Share by Countries in 2015Figure Europe Cosmetic Skin Care Revenue Market Share by Countries in 2019Figure Germany Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure UK Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure France Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Italy Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Spain Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Russia Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Asia-Pacific Cosmetic Skin Care Revenue ($) and Growth (2015-2020)Table Asia-Pacific Cosmetic Skin Care Sales by Countries (2015-2020)Table Asia-Pacific Cosmetic Skin Care Sales Market Share by Countries (2015-2020)Figure Asia-Pacific Cosmetic Skin Care Sales Market Share by Countries in 2015Figure Asia-Pacific Cosmetic Skin Care Sales Market Share by Countries in 2019Table Asia-Pacific Cosmetic Skin Care Revenue ($) by Countries (2015-2020)Table Asia-Pacific Cosmetic Skin Care Revenue Market Share by Countries (2015-2020)Figure Asia-Pacific Cosmetic Skin Care Revenue Market Share by Countries in 2015Figure Asia-Pacific Cosmetic Skin Care Revenue Market Share by Countries in 2019Figure China Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Japan Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure South Korea Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Australia Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure India Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Southeast Asia Cosmetic Skin Care Sales and Growth Rate (2015-2020)Figure Middle East and Africa Cosmetic Skin Care Revenue ($) and Growth (2015-2020) continued

About HongChun Research:HongChun Research main aim is to assist our clients in order to give a detailed perspective on the current market trends and build long-lasting connections with our clientele. Our studies are designed to provide solid quantitative facts combined with strategic industrial insights that are acquired from proprietary sources and an in-house model.

Contact Details:Jennifer GrayManager Global Sales+ 852 8170 0792[emailprotected]

NOTE: Our report does take into account the impact of coronavirus pandemic and dedicates qualitative as well as quantitative sections of information within the report that emphasizes the impact of COVID-19.

As this pandemic is ongoing and leading to dynamic shifts in stocks and businesses worldwide, we take into account the current condition and forecast the market data taking into consideration the micro and macroeconomic factors that will be affected by the pandemic.

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Impact Of Covid-19 on Cosmetic Skin Care Market 2020 Industry Challenges, Business Overview and Forecast Research Study 2026 - Owned

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New Data Further Reinforce Genentech’s Ocrevus (ocrelizumab) as a Highly Effective Treatment for People With Multiple Sclerosis – BioSpace

By daniellenierenberg

Sept. 11, 2020 05:00 UTC

SOUTH SAN FRANCISCO, Calif.--(BUSINESS WIRE)-- Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced new data that show Ocrevus (ocrelizumab) is a highly effective treatment option for people with relapsing-remitting multiple sclerosis (RRMS) who experienced a suboptimal response to their prior disease modifying therapy (DMT). Subgroup analysis from the two-year open-label Phase IIIb CASTING study also demonstrates that patients benefit across a wide range of disease related and demographic subgroups, regardless of prior treatment background. Findings will be presented at MSVirtual2020, the 8th Joint Meeting of the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) and the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).

For a wide range of people with MS who experienced a suboptimal response to prior treatment, we continue to see evidence that Ocrevus provides significant benefit in slowing disease progression, said Levi Garraway, M.D., Ph.D., chief medical officer and head of Global Product Development. New real-world Ocrevus data show high persistence and adherence to the only B-cell therapy with a twice-yearly dosing schedule, which we know can be very important to both people with MS and their physicians.

Phase IIIb open-label CASTING study

Approximately 75% of RRMS patients (492/658) had no evidence of disease activity (NEDA; brain lesions, relapses and worsening of disability) two years after switching to twice-yearly Ocrevus treatment (with prespecified MRI re-baselining at 8 weeks) in the primary analysis of the CASTING study. Patients enrolled in the study had prior suboptimal response to at least six months of treatment with up to two DMTs. The analysis also showed the proportion of patients achieving NEDA remained consistently high across all measured patient subgroups, including baseline MRI activity, relapse activity, disability level, age and the number of prior DMTs. Further, 78% of patients treated with only one prior DMT compared with 70% of patients treated with two prior DMTs achieved NEDA.

Additionally, patients treated with Ocrevus experienced an improvement in the majority of symptoms measured by SymptoMScreen after two years. SymptoMScreen is a patient-reported outcome tool to assess symptom severity across twelve domains. The most pronounced significant improvements (p<0.001) were seen in sensory symptoms, fatigue and vision, which are important for daily living.

CONFIDENCE real-world safety study

A 97% treatment persistence for Ocrevus patients at 18 months, and strong adherence to infusions every six months, was seen in an interim analysis of more than 1,600 patients in the ongoing German CONFIDENCE study. Separate data from a U.S. commercial claims database that support high persistence and sustained adherence to Ocrevus treatment will also be presented.

Ocrevus longer-term safety data

New safety data as of January 2020 will be presented, representing 5,680 patients with RMS and PPMS and 18,218 patient-years of exposure to Ocrevus, across all Ocrevus clinical trials. These findings further demonstrate the consistently favorable benefit:risk profile of Ocrevus over seven years.

With rapidly growing real-world experience and more than 170,000 people treated globally, Ocrevus has twice-yearly (six-monthly) dosing and is the first and only therapy approved for RMS (including relapsing-remitting MS [RRMS] and active, or relapsing, secondary progressive MS [SPMS], in addition to clinically isolated syndrome [CIS] in the U.S.) and primary progressive MS (PPMS). Ocrevus is approved in 92 countries across North America, South America, the Middle East, Eastern Europe, as well as in Australia, Switzerland and the European Union.

About multiple sclerosis

Multiple sclerosis (MS) is a chronic disease that affects nearly one million people in the United States, for which there is currently no cure. MS occurs when the immune system abnormally attacks the insulation and support around nerve cells (myelin sheath) in the brain, spinal cord and optic nerves, causing inflammation and consequent damage. This damage can cause a wide range of symptoms, including muscle weakness, fatigue and difficulty seeing, and may eventually lead to disability. Most people with MS experience their first symptom between 20 and 40 years of age, making the disease the leading cause of non-traumatic disability in younger adults.

Relapsing-remitting MS (RRMS) is the most common form of the disease and is characterized by episodes of new or worsening signs or symptoms (relapses) followed by periods of recovery. Approximately 85 percent of people with MS are initially diagnosed with RRMS. The majority of people who are diagnosed with RRMS will eventually transition to secondary progressive MS (SPMS), in which they experience steadily worsening disability over time. Relapsing forms of MS (RMS) include people with RRMS and people with SPMS who continue to experience relapses. Primary progressive MS (PPMS) is a debilitating form of the disease marked by steadily worsening symptoms but typically without distinct relapses or periods of remission. Approximately 15 percent of people with MS are diagnosed with the primary progressive form of the disease. Until the FDA approval of Ocrevus, there had been no FDA approved treatments for PPMS.

People with all forms of MS experience disease activity inflammation in the nervous system and permanent loss of nerve cells in the brain even when their clinical symptoms arent apparent or dont appear to be getting worse. An important goal of treating MS is to reduce disease activity as soon as possible to slow how quickly a persons disability progresses. Despite available disease-modifying treatments (DMTs), some people with RMS continue to experience disease activity and disability progression.

About Ocrevus (ocrelizumab)

Ocrevus is the first and only therapy approved for both RMS (including clinically isolated syndrome, RRMS and active, or relapsing, SPMS) and PPMS, with dosing every six months. Ocrevus is a humanized monoclonal antibody designed to target CD20-positive B cells, a specific type of immune cell thought to be a key contributor to myelin (nerve cell insulation and support) and axonal (nerve cell) damage. This nerve cell damage can lead to disability in people with MS. Based on preclinical studies, Ocrevus binds to CD20 cell surface proteins expressed on certain B cells, but not on stem cells or plasma cells, suggesting that important functions of the immune system may be preserved.

Ocrevus is administered by intravenous infusion every six months. The initial dose is given as two 300 mg infusions given two weeks apart. Subsequent doses are given as single 600 mg infusions.

Important Safety Information

What is Ocrevus?

Ocrevus is a prescription medicine used to treat:

It is not known if Ocrevus is safe or effective in children.

Who should not receive Ocrevus?

Do not receive Ocrevus if you have an active hepatitis B virus (HBV) infection.

Do not receive Ocrevus if you have had a life threatening allergic reaction to Ocrevus. Tell your healthcare provider if you have had an allergic reaction to Ocrevus or any of its ingredients in the past.

What is the most important information I should know about Ocrevus?

Ocrevus can cause serious side effects, including:

These infusion reactions can happen for up to 24 hours after your infusion. It is important that you call your healthcare provider right away if you get any of the signs or symptoms listed above after each infusion.

If you get infusion reactions, your healthcare provider may need to stop or slow down the rate of your infusion.

Before receiving Ocrevus, tell your healthcare provider about all of your medical conditions, including if you:

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the possible side effects of Ocrevus?

Ocrevus may cause serious side effects, including:

Most common side effects include infusion reactions and infections.

These are not all the possible side effects of Ocrevus.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

For more information, go to http://www.Ocrevus.com or call 1-844-627-3887.

For additional safety information, please see the full Prescribing Information and Medication Guide.

About Genentech in neuroscience

Neuroscience is a major focus of research and development at Genentech and Roche. Our goal is to pursue groundbreaking science to develop new treatments that help improve the lives of people with chronic and potentially devastating diseases.

Genentech and Roche are investigating more than a dozen medicines for neurological disorders, including multiple sclerosis, stroke, Alzheimers disease, Huntingtons disease, Parkinsons disease, Duchenne muscular dystrophy and autism spectrum disorder. Together with our partners, we are committed to pushing the boundaries of scientific understanding to solve some of the most difficult challenges in neuroscience today.

About Genentech

Founded more than 40 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures and commercializes medicines to treat patients with serious and life-threatening medical conditions. The company, a member of the Roche Group, has headquarters in South San Francisco, California. For additional information about the company, please visit http://www.gene.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200910006081/en/

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New Data Further Reinforce Genentech's Ocrevus (ocrelizumab) as a Highly Effective Treatment for People With Multiple Sclerosis - BioSpace

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Scientists at the Salk Institute Came Across a Possible Way to Slow Down Aging – Gilmore Health News

By daniellenierenberg

Arteries and veins are the blood vessels that help transport blood and nutrients in the body. Each type of blood vessel has its own specific structure and set of features that enable the functioning of blood vessels at an optimal level.

For example, arteries, which are the vessels responsible for carrying oxygenated blood from the heart to the rest of the body are generally thick and more elastic than their counterpart, veins. Veins carry the deoxygenated blood from the body back to the heart and are generally thinner than arteries.

It is important to note that the thickness or thinness of the blood vessel refers to the wall size and the diameter of the vessel.

Read Also: Senolytic Agents: The Potential Forerunners in the Fight Against Aging

The blood vessels over time become less elastic and can be calcified over time. This is referred to as an age-related change, something everyone goes through. The entire body undergoes these types of changes as one ages. Most of the changes are associated with the general weakness of body physiology. Over time, these changes, after being affected by comorbidities can be severely detrimental to an individuals health.

As people age, the blood vessels in the body become weak and less elastic. This weakness presents in the form of leakiness. Furthermore, the loss of elasticity results in rigid and hardened vessels. All of this can result in serious consequences to ones health.

Hence, making blood vessels an important topic of research, However, this research topic comes riddled with limitations as the study of blood vessels requires a sample which can only be obtained in an invasive manner. This is not a suitable method for long term research and study of blood vessels and the effect of age on them has been performed using pluripotent stem cells.

Read Also: Anti-Aging: HGH Can Reduce Biological Age by One Year and a Half Study Shows

The use of stem cells by researchers leads to the second limitation in this field of research. Stem cells are the undifferentiated cells in the embryonic stage that can differentiate into any other type of cells. These are the cells that all humans start off as. However, differentiating them into cells of the blood vessels to study them further doesnt provide the results scientists hoped for.

Martin Hetzer, Salks vice president and chief science officer is the head of the new research in which he and his team claim to have found a solution to this problem. However, in 2015, Hetzer was in the team that initially used stem cells to form cells of the blood vessels. The limitation of this study was that the blood vessel formed had no age-markers and was brand new and couldnt be studied for the effects of aging on blood vessels.

A recent study published in the eLife Journal in September 2020, performed by a team of scientists from Salk headed by Hetzer found that using fibroblasts may be more useful than pluripotent stem cells. Fibroblasts, a type of cells in the connective tissue, were derived from skin cells and used in this study to form induced vascular endothelial cells (iVECs) and induced smooth muscle cells (iSMCs)

Read Also: Is NAD+ The Anti Aging Substance Mankind Has Been Searching For?

For this study, researchers used skin cells from three groups of subjects; young subjects between the ages of 19 and 30 years, older subjects between the ages of 62 and 87 years, and patients suffering from Hutchinson-Gilford progeria syndrome (HGPS), an accelerated aging disorder.

Three samples from young subjects, three from older subjects, and 8 from patients affected by Hutchinson-Gilford Progeria Syndrome were taken and stimulated to develop into iVECs and iSMCs.

Hetzer and his team found that these iVECs and iSMCs had all the age-markers and showed different genetic expression dependant on age. This helped the researchers find genes and proteins associated with aging and age-related effects on blood vessels.

One such protein, namely BMP4, was found in higher amounts in the samples from older individuals and the iSMCs from the HGPS patients. Researchers assumed that this protein might be the reason for the accelerated aging seen in HGPS.

Read Also: HGH and Anti Diabetic drugs, an Anti-Aging Cocktail According to Study

To test their hypothesis, they used antibodies against BMP4 in volunteers with vascular disease. Hetzer and the team found that blocking BMP4 in these volunteers resulted in lesser vascular leaking, a feature of vascular disease. This finding is being recommended by the researchers as the new target for the treatment of HGPS or progeria.

Hetzer and his team aim to continue working on this to isolate the genes associated with aging and the exact mechanism of them, especially at the molecular level.

Direct reprogramming of human smooth muscle and vascular endothelial cells reveals defects associated with aging and Hutchinson-Gilford progeria syndrome

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Scientists at the Salk Institute Came Across a Possible Way to Slow Down Aging - Gilmore Health News

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Can High Blood Sugar Haunt People with Diabetes Even After it is Under Control? – BioSpace

By daniellenierenberg

Yes, even your metabolism has a memory and it can hold a grudge for years. In people with diabetes, periods of high blood sugar can negatively impact their health years later, even if they get their blood sugar under control. While this metabolic memory phenomenon has been known for years, why it happens is poorly understood.

Rama Natarajan, Ph.D., Professor and Chair of the Department of Diabetes Complications & Metabolism at City of Hope, turned to our epigenome for the answer.

Weve shown the first link between DNA methylation in blood and stems cells, blood sugar history, and future development of complications, said Natarajan. This highlights the importance of good glycemic control to prevent long-term complications.

The history of metabolic memory

We now know high blood sugar can lead to a variety of complications, including eye disease, kidney disease, nerve problems, heart disease, and stroke. But the relationship between strict blood sugar control and complication risk wasnt well understood before the 1980s.

Back in 1983, the Diabetes Control and Complications Trial (DCCT) began tracking complications in 1,441 participants with type 1 diabetes. Researchers compared the occurrence of long-term complications between participants who tightly regulated their blood glucose levels to those who followed less strict standard regulation.

After 10 years, the difference was striking the risk of diabetic complications was reduced in participants who tightly regulated their blood sugar but not in those following standard regulation. In other words, a person with higher blood sugar had a higher risk of complications.

To continue following the DCCT patients, the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up trial began at the end of DCCT in 1993 and is ongoing. At the end of DCCT, all participants were encouraged to adopt strict blood sugar regulation; many in the standard regulation group did.

Despite blood sugar regulation being very similar in all the patients (as measured by hemoglobin A1c, called HbA1c), differences persisted between the two original intervention groups. The phenomenon of long-term effects from high or variable blood sugar control is called metabolic memory (or the legacy effect in type 2 diabetes).

Complications resulted from total high blood sugar exposure it didnt matter whether the person was exposed to slightly elevated levels over a long time or high levels over a short time.

So, what caused the sweet sugar molecule to become so destructive?

Sugary destruction

Extra sugar in your blood can interact with your cells, DNA, and proteins, adding itself onto things it shouldnt be on through a process called glycation. In fact, HbA1c can be thought of as sugar-coated red blood cells.

The sugar-coated molecules cant function as well, if at all, and the damage begins a self-perpetuating cycle. Not only do these damaged molecules stop working, they can also accumulate in the skin, eyes, and other organs, causing damage. Build-up of sugar-coated molecules can trigger the creation of harmful free radicals, causing oxidative stress and feeding a destructive cycle.

Although sugar can directly modify molecules, it can also trigger other epigenetic modifications. These modifications can control how genes are expressed, changing protein levels in cells.

There hasnt been a strong genetic association with diabetic complications very few genetic mutations have been strongly linked to complications, Natarajan explained. But we knew the epigenome is what makes identical twins different and can have implications into why one gets diabetes or cancer and the other doesnt. So, we turned our focus to epigenetics.

Epigenetics and diabetes

Natarajan sought to explain the long-term sugary destruction wrought by high blood sugar by searching the epigenome. Her lab specifically looks for one type of modification called DNA methylation, where a tiny molecule called a methyl group is added onto DNA.

Epigenetics is the coating on top of genetics that can be altered by environmental influences, Natarajan said. We started focusing on the role of epigenetics in developing diabetes and its complications because we know that lifestyles, improper diet, lack of exercise, and even viruses can affect epigenetics.

Natarajans lab began collaborating with the DCCT trial group, analyzing data collected through the trial for epigenetic clues to explain the metabolic memory of complications. They found more modifications associated with active genes on proteins called histones that are wrapped by DNA in participants with regular blood sugar control compared to the strict controllers. Even more interesting was that many epigenetic DNA methylation variations between the two groups persisted through at least 17 years of follow-up in the EDIC study.

These changes were in important genes related to complications, showing something about persistent epigenetic programming in peripheral blood cells, commented Natarajan. Previous high blood sugar episodes could be a key factor in why these genes were continually misbehaving.

Now, Natarajans lab illuminated even more links between epigenetic changes, blood sugar history, and metabolic memory in their recent Nature Metabolism paper. Persistent epigenetic modifications of a few key genes were detected in participants with previously less regulated blood sugar who developed either retinopathy or nephropathy. They showed that DNA methylation is a key link between a patients HbA1c history, metabolic memory, and development of future complications.

Many HbA1c-associated modifications were in stem cells and the blood cells they create. Even though blood cells are turned over relatively quickly, stem cells stick around for a long-time, so changes in stem cells can have long-term consequences.

The important thing we found was the connection to stem cells, explained Natarajan. Were asking how these changes alter inflammatory gene expression and how we can interrupt those pathways.

Sugar-modified genes arent so sweet

Natarajans lab sorted through all the modified genes to find the most common modifications in participants with less strict blood sugar control. The most commonly modified gene coded for thioredoxin-interacting protein (TxNIP).

TxNIP is not a new protein, but the discovery that its DNA methylation is altered by different glycemic control is new, Natarajan added.

Thioredoxin-interacting protein is known to be highly regulated in certain pancreas cells, called beta cells, that release insulin. The plot thickened when high blood sugar was found to increase TxNIP protein production. Even more interesting, high TxNIP protein levels make beta-cells dysfunctional, ultimately leading to their untimely death. So, high blood sugar triggers more TxNIP to be produced, possibly through epigenetic modifications of the TxNIP gene, which ultimately leads to the death of insulin-producing beta cells.

Showing that the TxNIP gene can be epigenetically modified for years and years suggests that it could be one of the culprits causing long-term problems in diabetes, Natarajan said.

The proteins that TxNIP interacts with, called thioredoxins, protect against oxidative stress. TxNIP can bind to and inactivate thioredoxin to increase oxidative stress by increasing reactive oxygen species (ROS). In mouse cells in a dish, high glucose exposure triggered increased ROS levels mediated by TxNIP, leading to oxidative stress. Oxidative stress can trigger cell and organ damage, so this could be one mechanism explaining diabetes-induced damage.

Her lab also found epigenetic changes in other genes related to inflammation and inflammation-related processes.

Next steps and clinical implications

Natarajans lab is continuing to study the link between blood sugar history, epigenetics, and other complications of diabetes. They are also expanding their scope, searching the entire genome for more epigenetic modifications linked with past blood sugar maintenance.

This study also lays the groundwork for further studies with meaningful clinical implications, including developing epigenetic biomarkers for diabetic complications. In the future, Natarajan says a simple blood test looking at key epigenetic modifications, along with HbA1c history, could be used to predict future risk of retinopathy, nephropathy, and neuropathy. This would allow the doctor to figure out who should have early and more aggressive treatment to mitigate complication risk.

While these studies were done in type 1 diabetes patients, other studies in type 2 diabetes patients have shown similar epigenetic modifications after history of higher blood sugar levels.

Turning knowledge into potential drugs

What about doing something about the epigenetic modifications can we remove them? As a matter of fact, yes!

There is an interesting new type of experimental drug on the horizon called epigenetic editing. The hot new technology CRISPR isnt just for cutting out chunks of DNA or controlling genes it can also be used to insert or remove epigenetic modifications. While this technology is still experimental and in early preclinical animal studies, the potential is very exciting.

A CRISPR/enzyme pair can be used the CRISPR genetic material can hunt down the genetic spot you want to change; and the attached enzyme can snip or add certain molecules to the DNA, effectively removing or creating an epigenetic modification, thereby activating or silencing the targeted gene.

Enzymes such as methyltransferase or demethylase can add or remove methyl groups from genes. Because they just change what is on the gene or histone wrapped around it (not the genetic sequence itself), the gene itself isnt tampered with, meaning there could be less genetic complications associated with CRISPR epigenetic editing.

This is a futuristic thing, Natarajan concluded. The combination of genetics and epigenetics is going to be the future of personalized medicine.

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Study Identifies New Set of Genes That May Explain Why People with Down Syndrome Have a Higher Risk of Leukemia – DocWire News

By daniellenierenberg

A study which appeared in the journal Oncotarget sheds light on why people with Down syndrome are at higher risk of Leukemia. Researchers pinpointed a new set of genes overexpressed in endothelial cells of individuals with Down syndrome, thus creating an environment conducive for leukemia.

Down syndrome occurs in approximately in one in 700 babies, and individuals with the syndrome not only development physical impairments, they have a greatly augmented risk of developing leukemia. Specifically, people with Down syndrome have a 500-fold risk of developing acute megakaryoblastic leukemia (AMKL) and a 20-fold risk of being diagnosed with acute lymphoblastic leukemia (ALL).

In this study, researchers used skin samples from patients with Down syndrome to create induced pluripotent stem cells (iPSC). They subsequently differentiated the iPSC cells into that were then endothelial cells. The researchers observed that the endothelial cell genetic expression produced altered endothelial function throughout cell maturation. We found that Down syndrome, or Trisomy 21, has genome-wide implications that place these individuals at higher risk for leukemia, says co-lead author Mariana Perepitchka, BA, Research Associate at the Manne Research Institute at Lurie Childrens via a press release. We discovered an increased expression of leukemia-promoting genes and decreased expression of genes involved in reducing inflammation. These genes were not located on chromosome 21, which makes them potential therapeutic targets for leukemia even for people without Down syndrome.

Our discovery of leukemia-conducive gene expression in endothelial cells could open new avenues for cancer research, said co-lead author Yekaterina Galat, BS, Research Associate at the Manne Research Institute at Lurie Childrens.

Fortunately, advances in iPSC technology have provided us with an opportunity to study cell types, such as endothelial cells, that are not easily attainable from patients, stated senior author Vasil Galat, PhD, Director of Human iPS and Stem Cell Core at Manne Research Institute at Lurie Childrens and Research Assistant Professor of Pathology at Northwestern University Feinberg School of Medicine. If our results are confirmed, we may have new gene targets for developing novel leukemia treatments and prevention.

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Scientists May Have Discovered a Way to to Slow Aging by Direct Reprogramming of Human Cells – SciTechDaily

By daniellenierenberg

Skin fibroblasts were successfully reprogrammed into the smooth muscle cells (red) and endothelial cells (white) which surround blood vessels. The cells nuclei are shown in blue. Credit: Bersini, Schulte et al. CC by 4.0

Salk study is the first to reveal ways cells from the human circulatory system change with age and age-related diseases.

Salk scientists have used skin cells called fibroblasts from young and old patients to successfully create blood vessels cells that retain their molecular markers of age. The teams approach, described in the journal eLife on September 8, 2020, revealed clues as to why blood vessels tend to become leaky and hardened with aging, and lets researchers identify new molecular targets to potentially slow aging in vascular cells.

The vasculature is extremely important for aging but its impact has been underestimated because it has been difficult to study how these cells age, says Martin Hetzer, the papers senior author and Salks vice president and chief science officer.

Research into aging vasculature has been hampered by the fact that collecting blood vessel cells from patients is invasive, but when blood vessel cells are created from special stem cells called induced pluripotent stem cells, age-related molecular changes are wiped clean. So, most knowledge about how blood vessel cells age comes from observations of how the blood vessels themselves change over time: veins and arteries become less elastic, thickening and stiffening. These changes can contribute to blood pressure increases and a heightened risk of heart disease with age.

From left: Martin Hetzer and Simone Bersini. Credit: Salk Institute

In 2015, Hetzer was part of the team led by Salk President Rusty Gage to show that fibroblasts could be directly reprogrammed into neurons, skipping the induced pluripotent stem cell stage that erased the cells aging signatures. The resulting brain cells retained their markers of age, letting researchers study how neurons change with age.

In the new work, Hetzer and his colleagues applied the same direct-conversion approach to create two types of vasculature cells: vascular endothelial cells, which make up the inner lining of blood vessels, and the smooth muscle cells that surround these endothelial cells.

We are among the first to use this technique to study the aging of the vascular system, says Roberta Schulte, the Hetzer lab coordinator and co-first author of the paper. The idea of developing both of these cell types from fibroblasts was out there, but we tweaked the techniques to suit our needs.

The researchers used skin cells collected from three young donors, aged 19 to 30 years old, three older donors, 62 to 87 years old, and 8 patients with Hutchinson-Gilford progeria syndrome (HGPS), a disorder of accelerated, premature aging often used to study aging.

The resulting induced vascular endothelial cells (iVECs) and induced smooth muscle cells (iSMCs) showed clear signatures of age. 21 genes were expressed at different levels in the iSMCs from old and young people, including genes related to the calcification of blood vessels. 9 genes were expressed differently according to age in the iVECs, including genes related to inflammation. In patients with HGPS, some genes reflected the same expression patterns usually seen in older people, while other patterns were unique. In particular, levels of BMP-4 protein, which is known to play a role in the calcification of blood vessel, were slightly higher in aged cells compared to younger cells, but more significantly higher in smooth muscle cells from progeria patients. This suggests that the protein is particularly important in accelerated aging.

The results not only hinted at how and why blood vessels change with age, but confirmed that the direct-conversion method of creating vascular endothelial and smooth muscle cells from patient fibroblasts allowed the cells to retain any age-related changes.

One of the biggest theoretical implications of this study is that we now know we can longitudinally study a single patient during aging or during the course of a treatment and study how their vasculature is changing and how we might be able to target that, says Simone Bersini, a Salk postdoctoral fellow and co-first author of the paper.

To test the utility of the new observations, the researchers tested whether blocking BMP4 which had been present at higher levels in smooth muscle cells developed from people with HGPS could help treat aging blood vessels. In smooth muscle cells from donors with vascular disease, antibodies blocking BMP4 lowered levels of vascular leakiness one of the changes that occurs in vessels with aging.

The findings point toward new therapeutic targets for treating both progeria and the normal age-related changes that can occur in the human vascular system. They also illustrate that the direct conversion of fibroblasts to other mature cell types previously successful in neurons and, now, in vascular cells is likely useful for studying a wide range of aging processes in the body.

By repeating what was done with neurons, weve demonstrated that this direct reprogramming is a powerful tool that can likely be applied to many cell types to study aging mechanisms in all sorts of other human tissues, says Hetzer, holder of the Jesse and Caryl Philips Foundation Chair.

The team is planning future studies to probe the exact molecular mechanisms by which some of the genes they found to change with age control the changes seen in the vasculature.

Reference: Direct reprogramming of human smooth muscle and vascular endothelial cells reveals defects associated with aging and Hutchinson-Gilford progeria syndrome by Simone Bersini, Roberta Schulte, Ling Huang, Hannah Tsai and Martin W Hetzer, 8 September 2020, eLife.DOI: 10.7554/eLife.54383

Other researchers on the study were Ling Huang and Hannah Tsai of Salk. The work was supported by grants from the National Institutes of Health, the NOMIS Foundation and an AHA-Allen Initiative in Brain Health and Cognitive Impairment award made jointly through the American Heart Association and the Paul G. Allen Frontiers Group. Simone Bersini was supported by the Paul F. Glenn Center for Biology of Aging Research at the Salk Institute.

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Got uneven skin tone? There’s a cult natural range with vitamin C that’s changing the game. – Mamamia

By daniellenierenberg

As we move into spring, the seasonal change and being indoors more often can leave our skin feeling a little lacklustre.

If you've also got uneven skin tone, you might find yourself reaching for vitamin C products to bring that long-lost glow back to your skin. (I know I have.)

Yep, you know what I mean - dull spots or patches that make an unwelcome visit on your face. Somuch fun.

You've probably seen a few skincare ranges with vitamin C as a key ingredient, but some have harsh and unnatural chemicals too. In fact, slathering harsh chemicals on your face to try achieve a more radiant, even complexion can do more harm than good if you're not exactly sure what you're putting onto your skin.

That's why Andalou Naturals' Brightening range is the perfect example of a high-performance cult natural skincare range that addresses concerns like uneven skin tone and pigmentation, all while using potent, vitamin C-rich ingredients that pack some serious punch. Oh, it's cruelty-free too.

Andalou Clementine + C Illuminating Toner. Image: Supplied

According to a recent trial*, 86 per cent of people saw a more radiant and luminous complexion, while 73 per cent saw a more even skin tone and reduced pigmentation in 28 days when using Andalou's Brightening Range.

It's been so high in demand that the famous Brightening Pumpkin Honey Glycolic Face Mask, which Mamamia reviewed back in April, recently sold out on their website(it's back now, thankfully). While they can't make their pumpkins grow any faster, if you can't get it online you can also get it from your local Chemist Warehouse or Priceline.

You've probably seen the Andalou's Brightening Range popping up on your Instagram, with model Natalia Kalinowski, author and lifestlye influencer Sjana Elise Earp, and model and lifestyle influencer Ruby Tuesday Matthews, all singing its praises.

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The one thing all beauty therapists should know about exfoliating – Professional Beauty

By daniellenierenberg

The one thing all beauty therapists should know about exfoliatingWhen were young, our cells typically take 28 days to complete the cell turnover cycle. This begins in the lowest layer of the epidermis the stratum germinativum where the stem cells are housed. From here the skin cells migrate through each layer of the epidermis until they reach the outermost layer the stratum corneum.

This process takes about 14 days, after which the cells stay in the stratum corneum for approximately another 14 days for a 28 day total cycle. At this point, the skin begins to slough off these dead skin cells, which will be replaced by new ones a process known as desquamation.

As we age, the desquamation cycle naturally slows down and leaves us with a build-up of dull, dry and dehydrated cells. Exfoliation helps speed up desquamation, making it an essential part of every clients skin care regimen.

Chemical and physical exfoliants both remove the dulling, dead skin cells that accumulate on skins surface, revealing brighter, fresher-looking skin. Regular exfoliation can also help stimulate skin cell renewal, encouraging the cells to come to skins surface more quickly.

Additionally, removing dead cells serves to increase the penetration of hydrating ingredients and other targeted treatments.

While this is common knowledge among beauty therapists, clients are often unaware of this benefit. For example, if youve ever heard a client say that their skincare products arent working anymore, its likely that a build-up of dead skin cells is preventing active ingredients from being absorbed and acting effectively on the skin. The solution: regular exfoliation.

If your clients suffer with dull, flaky skin, dryness or dehydration, then you may reach for a hydrating masque in treatment to remedy these symptoms, but if you havent exfoliated first, then dead cell build-up can act as a barrier, stopping hydrating ingredients from being effectively absorbed.

The quickest way to smooth and renew your skin is with an exfoliant. However, did you know that its critical to replenish lost moisture in the barrier within 60 seconds after exfoliating or skin will become dehydrated? WithDermalogicas Hydro Masque Exfoliantyou dont need to worry about applying two separate formulas as it combines both regimen steps in one.

DermalogicasHydro Masque Exfoliantisa hydrating and exfoliating five-minute masque that smooths and renews for healthy looking skinand offers a personalised way to exfoliate via unique touch-activated bamboo spheres.

The spheres can be moved to the areas you think clients need more exfoliation where the skin is drier or rougher in texture. The ultra-fine bamboo filled spheres dissolve upon application of light pressure, delivering a gentle level of physical exfoliation. The spheres also contain a hydrating polysaccharide and glycerin to protect the skins moisture barrier, usually depleted by exfoliating. This allows a customised exfoliating experience in contrast to dual action formulas that have no isolation of the exfoliating actives.

Another unique aspect ofthe product isthat it delivers instant and long-lasting hydration immediately as you exfoliate. The hydro-cream base of the masque contains lots of hydrating ingredients to deliver moisture and barrier restoring properties.

Snow mushroom holds 450 times its weight in water, infusing skin with hydration, and it is also rich in antioxidants and Vitamin D. The masque also contains jojoba ester and amino acids derived from sugar beets to hydrate and strengthen the skins natural barrier, with cucumber extract providing a soothing, refreshing finish.

In clinical studies,Hydro Masque Exfoliantis proven to give a smoother feeling and more hydrated skin after just one use, with 80% of consumers saying their skin felt smoother and they liked the appearance of their skin.

Exfoliation is an important regimen step for healthier, more luminous skin, just dont forget to hydrate too.

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27 De-Stressing Vegan Products to Help You Get Through The Rest of 2020 – VegNews

By daniellenierenberg

Well, weve made it more than halfway through the yearcan you believe it? Schools are once again starting up (online and in-person), the weather is crisper (and drier), election season is in full throttle (register to vote!), and the global pandemic continues to ravage (please wear a mask!). As we begin to settle into September, its more important than ever to take care of our bodies and minds so we can show up at full capacity for ourselves in the present. Take a moment and check-in with yourself today, whether its with a calming, immune-boosting coffee mix-in or a CBD-infused bath soak. Wake me up when September (and 2020) ends!

1. African Botanics Revitalizing Therapy GelHunched over your laptop all day? Aside from investing in a laptop stand, utilize this invigorating gel from South African-made, eco-luxury skincare brand African Botanics to soothe neck and shoulder aches. This miracle-in-a-chic-tube promises to reduce swelling, promote circulation, and provide a cooling, thermal feeling so you can restore muscles for the next workday.

2. Clevr Golden SuperLatteCancel the caffeine jitters and opt for a turmeric-and-oat-milk latte. Naturally sweetened with monk fruit and chock-full of warming spices, this Clevr spin on trendy golden milk lattes hits the spot for a comforting, post-lunch pick-me-up.

3. OUAI Chill PillsIts Friday night and youre not going anywhere, so whats there to do? Light some candles, play some jazz, draw a hot bath, and drop in these adorable OUAI Chill Pills for some seriously luxurious me-time. Each jasmine-and-rose-scented vegan tablet is filled with hemp, jojoba, and safflower seed oil to leave skin ultra moisturized.

4. Apothkary Chill The F* Out Herbal SupplementAs fall seeps in and we get closer to peppermint mocha season, this stress-reducing, serotonin-boosting elixir from Apothkary tastes like a peppermint hot chocolate mix. While we reminisce of the snowy holidays ahead, two powerhouse adaptogensreishi and ashwagandhawork wonders to relieve our pent-up anxiety.

5. Shanti Rejuvenate Roll On With Hemp CBDAyurvedic essential oils and Colorado-sourced hemp blend seamlessly to bring clarity to stressed-out brains in this Shanti Wellness roll-on. The small, easy-to-use packaging provides relief for those on-the-go so you can be chill whatever the occasion (long lines for the grocery store, strangers refusing to wear a mask, disposable gloves all over the ground the usual).

6. Activist Skincare Healing Water Toning MistThe vegan skincare connoisseurs at Activist believe self-care is fuel for the activism we should all be doing every day. So while youre making calls, advocating for marginalized communities, and attending protests (safely and with a mask), remember to take a moment for yourself. Add this hydrating, hyaluronic mist to your desk essentials for a small, calming break. The matte glass, recyclable bottle adds an elegant design to your workstation and the refreshing scent of cucumbers instantly calms.

7. Tata Harper Aromatic Irritability TreatmentIs your work-from-home buddy chewing their cereal as loudly as possible before youve had your cup of coffee? Instead of blasting your headphones, try this essential oil blend from natural beauty queen Tata Harper. Dab a few drops onto palms, rub together, and inhale deeply for an instant mood-lifting hit of balancing jasmine, fresh geranium, and soothing cypress.

8. Facialworks Sonic Wave + Coast Is Clear DuoMissing your monthly facials? Orange County-based, non-toxic spa specialists Facialworks brings the expertise straight to your home. With its extraction duo, you can prepare skin for a painless mini-facial and use the ultrasonic skin spatula to cleanse, get rid of blackheads or pimples, and infuse serums for maximum absorption. Clear skin, here we come!

9. The Good Patch Be Calm PatchPatches are the new It item for wellness brandsfrom pimple zappers to calming mood boosters like this menthol-infused stick-on from The Good Patch. Simply peel and stick on your wrist (or other veiny part of your skin) for over eight hours and feel nerves calm by the mix of hemp and other natural ingredients.

10.ORPHEUS Resurrection All-In-One SerumInspired by the regenerative powers of the haberlea rhodopensis flower found in the mountains of Bulgaria, family-run business ORPHEUS spent more than 20 years researching the properties of the rare blossom. Now, theyve packed the unique plants stem cells into this all-in-one serum to craft a richly intensive, calming experience for stressed-out skin. Thats pretty much all you could ask for in a bottle.

11. Missionary Chocolates CBD TrufflesA chocolate a day keeps the doctor away or something like that. Naturopathic physician Melissa Berrys Portland-based Missionary Chocolates crafts the meltiest hemp-derived fair-trade chocolates for the ultimate mid-day pick-me-up. Plus, with its cute packaging, you can send your loved ones a treat to get through the hard days.

12. The Nue Co Magnesium SprayStaring at the ceiling for hours when bedtime rolls around? Its cooljust spray this sleep aid spray from The Nue Co. made with high-quality magnesiuma mineral that is essential for over 325 biochemical reactions in the bodyand youll soon stop counting sheep. You can also use it as a post-workout aid for faster muscle recovery.

13. Life & Apples Wellness Journal Planners are a useful tool to track your busy schedule, but they can also be beneficial for checking in with yourself. Made of eco-friendly, vegan materials, this 90-day rose gold journal makes it simple to track habits, plan healthy meals, and set weekly goals. Plus, you can write down what youre grateful for to begin day on a bright note.

14. Four Sigmatic Lions Mane ElixirCaffeine levels through the roof? Same here. Thats why Im turning to lions mane, a favorite mushroom among researchers and herbalists touting benefits such as boosting mood, supporting cognitive function, and providing physical energy. Add to smoothies, decaf coffee, and tea to get a boost of brain-healthy nootropics.

15. Derma-E Vitamin C Bright Eyes Hydro Gel PatchesNon-stop screen-time is sure to wreak havoc on your eye health. When suffering from tired, baggy eyes, turn to Derma-Es moisture-intensive gel patches before your morning Zoom call. These sparkly yellow gels contain allantoin to increase smoothness, caffeine to reduce puffiness, and vitamins C and B3 to target fine lines, wrinkles, and dullness.

16. Rosebud Awaken CBD Bath SoakIf youre one of the rare types that like to take baths in the mornings, this uplifting, magnesium-rich soak is for you. With notes of bergamot and orange essential oils, 50mg of CBD, and calming Epsom salts, heck, Im considering waking up an hour earlier (wish me luck) to run a warm bath and start the day on a much chiller note.

17. REN Clean Skincare Atlantic Kelp and Magnesium Salt Anti-Fatigue Exfoliating Body ScrubExfoliate your hard-working body with a fresh body scrub from sustainability-focused REN Clean Skincare designed to gently polish and smooth skin with fresh sea and Epsom salts. Breathe in sage, cypress, geranium, and rosemary for an uplifting start to the day.

18. No B.S. Charcoal Detox Peel-Off MaskTheres just something so satisfying about a peel-off mask, but when it takes forever to take off while also causing wincing pain, wed rather avoid it altogether. Enter: cruelty-free and vegan skincare brand No B.S.s purifying, activated charcoal mask. In less than 20 minutes, watch the clean, pH-balanced formulation gently peel away the days impurities and reveal smooth, bright skin.

19. Buddha Teas Peppermint CBD TeaRather than using hemp oil like many other CBD teas, Buddha Teas figured out a way to use dispersible water-soluble CBD, ensuring optimal bioavailability and maximum absorption of the calming, non-psychoactive compound. With flavors such as Turmeric & Ginger, Matcha Green, and Peppermint, grab your tea setsits time for relaxation!

20. Pacifica Overnight Vegan Collagen Recovery CreamYour skin repairs itself at night, making the products used for your nighttime ritual all the more important. For those needing a little more glow, this Pacifica recovery cream infuses vegan collagen, essential lipids, antioxidants, and flower extracts to work some magic during your beauty sleep. Glowing, radiant skin, were dreaming of you!

21. Future Kind Vegan Sleep SupplementsStress hits hard at night when youre trying to get your Zzzs, which is why brothers and nutritionists Shaun & Eliot Cunningham developed Future Kinds eight-ingredient, all-natural sleep supplement that promises to have you feeling energized the next morningnot sluggishthanks to the addition of L-theanine.

22. Peak + Valley Balance My Stress BlendThrough the use of adaptogens such as reishi mushroom, eleuthero root, and ashwagandha, Black-owned wellness brand Peak + Valleys chocolaty, earthy stress blend pairs well with an afternoon tea or a warm cup of oat milk to protect the immune system and decrease fatigue.

23. HERBIVORE CALM Soaking SaltsEveryones favorite Himalayan pink salt blends with ylang-ylang and vanilla to soothe the body with this bath soak from plant-based, sustainable skincare brand HERBIVORE. Dont forget to recycle the chic glass bottle to reduce waste.

24. Heartsong Herbs Anxiety Away SupplementUsing regenerative growing practices to preserve soil and create stronger, more potent plants, small farm Heartsong Herbs takes its agriculture seriously. Crafting high-quality tinctures, the apothecarys Anxiety Away pairs herbs such as skullcap, passionflower, blue vervain, and lemon balm to ease away worries and help you feel grounded.

25. Kin Euphorics High RhodeNot in the mood for another lengthy Zoom happy hour and the inevitable hangover in the A.M.? Dont fret, you can still catch up with friends without the pressure. Grab a can of non-alcoholic High Rhodean herbaceous drink promising a state of bliss through a holistic mix of adaptogens, nootropics, and botanics. Kiss the morning-after headaches goodbye!

26. Naipo Massage GunWe cant go to a spa for an hour-long deep-tissue massage, so why not bring it home? This Naipo massager puts in the work and all you have to do is hold it over tense muscles to alleviate stiffness and relieve any pain. The portable design plus long battery life means you can keep it near you at all times for when the soreness starts to set in.

27. Asop Istros Aromatique Room Spray Weve all had to keep our imaginations alive during the months-long quarantine, so spend a few minutes daydreaming a walk through a lively, smoky Greek bazaar to get the creative juices flowing during a mid-day slump. Cult-favorite plant-based skincare brand Asops room spray should help with notes of pink pepper, lavender, tobacco.

Aruka Sanchir (@arukasanchir)is the Beauty & Style Editor at VegNews and shes always trying out new calming products to find her ultimate Zen.

Please support independent vegan media and get the very best in news, recipes, travel, beauty, products, and more.Subscribe now to the worlds #1 plant-based magazine!

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The great beauty reset: how to reboot your skin – Financial Times

By daniellenierenberg

Im not saying my skin has aged significantly this year but my six-year-old recently asked me why I had asix-pack on my forehead. After six months of stressful days, sleepless nights and home-school nightmares, its become apparent that matters need taking in hand. And theres something about the early autumn, with its nip in the air, and its new-found appreciation for proper, non-negotiable routines that feels right for a skincare overhaul.

Fortunately, the seasons big skincare launches abound with new ways to reset your skin, from serious, sleeves-rolled-up jump-starting regimens, which last up to a month and deliver a rapid burst of intense reconditioning, to new strategies that claim todetoxify your daily regime without your having to somuch as cut down on caffeine.

Sorting out most modern-day skincare complaints from sluggish cell turnover caused by tiredness and stress to overstimulated skin (a result of using products not suited to one another), to undeserved lacklustre complexions caused by outdated products requires a bit of areboot. It could be a facial; it could be a peel. But inthedays when weve all become beauty hobbyists, performing DIY facials like pros, it could also be a pleasurable at-home experience for the price of a couple ofdecent salon treatments.

Dr Anita Sturnham, a London-based GP specialising in dermatology who launched her own excellent skincare line,Decree, last year, became so aware of how many of herpatients especially those suffering with breakouts, pigmentation and dehydration needed a thorough overhaul that she recently launched her own two-week Skin Reset Kit. Sturnham believes 90 per cent of the skin issues she sees are self-inflicted simply by using the wrong products and that stripping your skincare right back is an essential step for getting the best from your skin.

Another recent reset kit is Budapest brand Omoroviczas The Cure programme, which in nine days cycles through anacid phase (to resurface), a remineralise phase (tostimulate microcirculation) and a reconstruct phase (forrenewed elasticity). You can repeat it every three months, ideally to coincide with the change of seasons.

One of the best known brands for an intensive treatment is that of anthropologist-turned-dermatologist Dr Phillip Levy. A Geneva-based wound-healing specialist,he believes that only via resetting can you achieve some of the most visible anti-ageing results andhis Ultimate Stem Cell Spring Homecure (the springmeans spring clean but it can bestarted any time)is legendary. Manyofthe cures we have studied over the years seem to be everyday products nicely repackaged, he says.But to have something truly transformational, theyneed go deep enough to stimulate your own collagen, elastin and hyaluronic acid production, and last four weeks or even eight or more.

Its true that these regimes work best when they feel elevated from the everyday. And when it comes to products with a built-in sense of occasion, no one does it better than Sisley. Even before you get to the science and the scents, and the textures it has a particular French earnestness that makes every product feel like an event. Which must make LIntgral Anti-Age La Cure, its new skin-resetting regimen, at 775 for a four-week supply, a veritable tapis rouge.

For each of the four week-long phases Impulse, Reset, Consolidate, Renaissance theres a phial of creamy serum, about the size of an eye cream. You use each one for seven days, applying eight pumps of product morning and night (this feels a lot, and it takes a few minutes to properly sink in). You can follow with eye cream or moisturiser if you want to, but I didnt feel the need. The bottles have been slightly overfilled so as to ensure you dont run out, but when you get to the end of the seventh day, you must start the next one nonetheless. (This feels wasteful, but I was assured by Sisleys training manager Lorna Green that I could save up these last drops and use them a couple of weeks after the course, as a further boost).

The formulation works on the skins mitochondria the batteries where cellular energy is stored. Theylose the ability to restore themselves over time, particularly during intense periods of stress and hormonal changes, so following either one of those would be an ideal time to try it. The breakthrough wasthe discovery of the mechanisms of a process called autophagy (for which Japanese biologist Yoshinori Ohsumi won the Nobel Prize for medicine in2016), whereby damaged cell components such as mitochondria destroy themselves to protect the rest ofthe cell. La Cure boosts the elimination of these wasteelements, allowing the healthy cells left behind tosoak up energy and regenerate promoting the appearanceof healthier, more youthful skin. In skincare terms, this is no mean feat.

Where the real technology is happening, it wont be long before they eclipse the big jars of moisturiser completely

It sounds intense and its certainly super-active: by the end of the first week I had a small, yet determined, spot on my chin (which I cannot believe was a coincidence) and a little more redness than usual, too. The following week, cell detoxification week, my skin was starting to feel unusually smooth. By the end of the fourth week, my skin was smoother and clearer than I can ever remember. Its also, though, a real example of skincare as self-care: as much as the thought of a radically rejuvenated complexion, the daily reminder that youve sidelined your usual clutter of products in favour of something exceptional is almost enough to bring on a glow.

With any reset complete, the focus should then be on keeping your skin detoxified and renewed. One update worth looking at is a serum. Whereas the luxurious facecream at the end of your regime used to be the jewel in any skincare crown, these dayslightweight serums are where the real technology ishappening, and it wont be long before they eclipse thebig jars of moisturiser completely.

While serums used to be a targeted addition to your face cream specifically for age spots, say, or wrinkles the best new ones are genuinely impressive all-rounders. Este Lauder has just revamped Advanced Night Repair, one of the first ever mainstream skin serums and a product so ubiquitous that among beauty editors it has acronym status. (See also: Cliniques DDML, aka Dramatically Different Moisturizing Lotion). And in October, Suqqu, which hails from Japan where serums have been the mainstay of skincare much longer than here will launch Vialume, its most advanced line yet, containing glucosamine and amino-acid derivatives designed to targetall five key characteristics of great skin: moisture, firmness, smoothness, translucency and brightness.

Another product gaining increasingly scientific status is face oil, which should no longer be dismissed as the preserve of the militantly natural beauty brigade. Augustinus Bader, the world-leading wound-healing specialist whose Rich Cream was the runaway skincare success of 2018, has just launched The Face Oil, which contains a slew of delicious-sounding oils argan, babassu, hazelnut, karanja as wellas a healthy dose of TFC8, the complex of vitamins, amino acids and synthesised molecules that has made Baders products famous. Meanwhile, RVive Glow Elixir Hydrating Radiance Oil is bronze in colour and slightly shimmering although unusually, it leaves no evidence of glittery particles. Alongside a cocktail of seed oils, it contains the brands signature Bio-Renewal Protein, rendering it a real skincare/make-up hybrid and a great transitional product for this time of year.

Another need-to-know and a great option particularly for younger skin is Rihannas new Fenty Skin line. Theres Total Cleansr, which would work especially well as the first step of a double-cleanse, and Fat Water, which Ri-Ri calls a toner-serum hybrid but its the Hydra Vizor daily moisturiser that triumphs. This so-called Invisible Moisturizer has an SPF30 that leaves no white cast to the skin whatsoever, primarily because the product has a gorgeous pinkish hue and a blurring effect. The ghostly pallor left behind by so many SPF products is a particular challenge to people of colour and this range was designed to work seamlessly with make-up on all skin tones. It also smells great juicy with just the slightest medicinal tinge and comes in a refillable tube.

The recently launched skincare brand U Beauty wants to reset not just your skin, but the way you think about your whole regime. Were all doing too much, says founder Tina Craig, who until two years ago was working as an influencer/ambassador for the worlds biggest skincare brands but admits being as confused as anyone about what to use; she had ended up with a 13-step skincare routine. I started noticing that everyone Iknew had skin that looked translucent, which is not how it should look, she says. Then I looked at my grandma and relatives in Korea, and their skin was not like that. It was thick. Dense. Firm.

U Beauty is her answer to what she calls the cosmeticconfusion. Its first product, the Resurfacing Compound (which sold out three times on UK stockist Net-aPorter), was designed to replace toner, vitamin C, hyaluronicacid, AHAs, physical exfoliants, antioxidant serums and retinol products. From this month, theres alsoSuper Smart Hydrator, a moisturising serum that seeks out damaged cells and only treats the skin where itneeds it. Bookend these two with cleanser and SPF, saysCraig, and youre good to go.

Finally, could we reset the way we use products altogether? New US brand Noble Panacea is overseenby ascientific heavyweight: Sir Fraser Stoddart, who was awarded the 2016 Nobel Prize in chemistry. A microscopic delivery system releases its active ingredients into the skinin a programmed sequence, and it comes in individualdoses packed in mini sachets to ensure the optimal amount of these ingredients stays potent until theminute it reaches your skin.

On the one hand, they feel counter to the idea of luxury face creams more like a free sample from a beauty hall but on the other, the boxes made from renewable materials and ultra-hygienic 0.5ml doses feel modern and Covid-safe. (You can send them for recyling in a complimentary envelope to TerraCycle, with which the brand has partnered). And if nothing else, as its global ambassador ithas snapped up the actress Jodie Comer, who must havebeen pursued by every beauty company under the sun and as far as I can tell, theres no sign of a six-pack on her forehead.

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Global Skin Care Cosmetic Market 2020-2026 is Growing Rapidly and Expected to Witness a Sustainable Growth over 2027 – Scientect

By daniellenierenberg

Reportspedia announces a new report titled GlobalSkin Care Cosmetic Market, which outlines the rationale standpoint of the unpretentious forces of the market. It announces the addition of another new dimension to this industry explaining the performance of the major players. The Skin Care Cosmetic Market has also been segmented on the basis of the provincial players, out of which some are well established while some have newly entered the global market. These players have established actions such as research and development, determined to bring in new services that can efficiently compete with the other established players.

Get a sample of Skin Care Cosmetic Market @

https://www.reportspedia.com/report/life-sciences/2015-2027-global-skin-care-cosmetic-industry-market-research-report,-segment-by-player,-type,-application,-marketing-channel,-and-region/59849#request_sample

Top Key Players:

The Body Shop International PLCKao CorporationUnilever PLCAvon Products IncJohnson & JohnsonProcter & GambleBeiersdorf AGLOreal S.A.The Estee Lauder Companies Inc

Geographically, the following regions are covered in this report:

United States, Canada, Germany, UK, France, Spain, Russia, Turkey, Switzerland, Sweden, Poland, Belgium, China, Japan, South Korea, Australia, India, Taiwan, Indonesia, Thailand, Philippines, Malaysia, Brazil, Mexico, Argentina, Columbia, Chile, Saudi Arabia, UAE, Egypt, Nigeria, South Africa and Rest of the World

The global Skin Care Cosmetic Market report covers the market landscape and its growth over the upcoming years and discussion of the Prominent Companies effective in this market. This report has been organized based on a detailed market analysis with inputs from industry experts. The report delivers a 360-degree overview of the market, listing numerous factors limiting, driving the market during the forecast period.

Get a Huge discount on this Skin Care Cosmetic Market Research Report:

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Skin Care Cosmetic Market Segment by Type:

Sensitive Skin CareDry Skin CareInfants Skin CareOthers

Skin Care Cosmetic Market Segment by Application:

Stem Cells Protection Against UVFlakiness ReductionRehydrate the Skin SurfaceMinimize wrinklesIncrease the viscosity of Aqueous

The global Skin Care Cosmetic Market is predicted to witness of enormous growth in the next six years. The growing level of competition among the players and the growing focus on the advance of new products are likely to offer promising growth during the prediction period. The research study on the global Skin Care Cosmetic Market deals with a complete overview, highlighting the key aspects that are projected to surge the growth of the market in the near future.

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Key Takeaways of the report

Some Points from Table of Contents

Global Skin Care Cosmetic Market Insight and Forecast to 2027

Chapter 1Skin Care Cosmetic Market Report Overview

Chapter 2Global Growth Trends

Chapter 3Market Competition by Manufacturers

Chapter 4Skin Care Cosmetic by Regions

Chapter 5Skin Care Cosmetic by Region

Chapter 6Skin Care Cosmetic Market by Type (2020-2027)

Chapter 7Skin Care Cosmetic Market by Application (2020-2027)

strong>Chapter 8Company Profiles and Key Figures in Skin Care Cosmetic Business

Chapter 9Production and Supply Forecast

Chapter 10 Marketing Channel, Distributors, and Customers

Chapter 11 Industry Trends and Advanced Strategy

Chapter 12Conclusions

Chapter 13Appendix

Get a Complete Table of Content, Just click on the below link @:

https://www.reportspedia.com/report/life-sciences/2015-2027-global-skin-care-cosmetic-industry-market-research-report,-segment-by-player,-type,-application,-marketing-channel,-and-region/59849#table_of_contents

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Global Skin Care Cosmetic Market 2020-2026 is Growing Rapidly and Expected to Witness a Sustainable Growth over 2027 - Scientect

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Clinics ‘peddling false hope for autism with potentially hazardous 14,000 cell therapy’ – Mirror Online

By daniellenierenberg

Clinics have been accused of peddling false hope to parents of autistic children with potentially hazardous treatment.

A Sunday People probe found dozens of private firms charging up to 14,000 for stem cell therapy, claiming it provides a whole range of benefits.

Clinics insist the treatment in which donor cells are fed into a patients bloodstream via a drip can help improve youngsters social skills, speech and concentration.

But there are counter-claims that the therapy is unproven, could be distressing for children and even cause them more harm than good.

One mum blasted adverts for it as horrifying while other parents who forked out huge sums of cash complained it had little effect.

One called the therapy a 99 per cent failure and another said: I spent a ton of money on my two kids and nothing happened.

Professor Richard Mills, consultant for non-profit AT-Autism, said: Stem cell therapy is regarded within the medical community as potentially quite hazardous and there isnt so far a reliable evidence base that would cause it to be recommended.

It is controversial and experimental and Im not aware of any independent studies which prove it works.

Prof Mills said parents should see the high costs, the absence of regulated independent trials and testimonials as red flags of caution.

He added there were also huge ethical issues linked to treating children who may lack the capacity to consent to it.

He said: Using an intravenous injection, an infusion of fluid goes into the brain, which is unpleasant at best and may be highly distressing and traumatic for an autistic child.

One in every 100 kids in the UK has some form of autism, for which there is no medical cure.

The clinics we found work on the disputed premise that autism is a neurological disorder with clear causes that can be altered by intervention.

Most say stem cells, which can develop into other types of bodily cells and renew themselves, will have a reparative effect on the brain.

Stem cells are approved for treating some blood conditions, skin grafts and cornea repairs but remain unproven in regard to autism.

Only after full clinical trials can procedures be declared safe and better than existing treatments.

Prof Mills went on: These practitioners attempt to interfere with the core symptoms of autism, as they put it, but the National Institute for Health and Care Excellence has said there are no proven ways of altering this.

The Autism Regenerative Centre in Marylebone, central London, claims to have given therapy to over 500 children since 2014 without complications and says 80 per cent of them showed improvement.

An online ad for the private clinic says its treatments pass beyond the limitations of conventional therapies. We found further clinics around the world advertising in English and welcoming patients of all nationalities.

Swiss Medica features an online testimonial from a British family whose autistic child was treated at its premises in Goldach, Switzerland.

The online clip shows Paul from Reading saying the treatment in the UK is not what we liked for his three-year-old autistic son, but that the family were now feeling more optimistic.

The Swiss clinics website claims conventional treatment methods for autism only smooth out the specific symptoms, targeting one or two of them, whereas stem cell therapy is an entirely new tool.

The Stem Cell Institute in Panama charges between 10,000 and 13,000 for four-day packages for children.

It says the therapy decreases inflammation in the brain which may alleviate autism symptoms.

German International Clinic in Frankfurt charges more than 14,000 for the procedure, which it says will be effective for just three to eight months and recommends follow-up sessions.

It lists improved communication ability and memory as benefits.

But Brit mum Emma Dalmayne, whose children Damien, 12, and Skylar, seven, are autistic, was disgusted by the ads.

Emma, 44, who is autistic herself and runs the Autistic Inclusive Meets group, said: Its horrifying that parents of vulnerable children are being presented with a medical procedure thats not scientifically proven.

There has to be regulation to stop this. Emma, of Woolwich, south-east London, begged families to invest in occupational and speech therapies instead.

She warned: If you go down the pseudo-science route, youll be encouraged to part with huge sums of money that could otherwise go towards a proven therapy.

One US mum who spent 30,000 on treatment for her two kids in Mexico with no results said she believed stem cell therapy was a scam.

The woman, a 52-year-old nurse from New York who took out loans to fund the treatment, was taken in by online testimonials.

But she said: Nothing happened, nothing at all. Its a money-maker there are a lot of desperate people out there.The National Autistic Society accused firms of exploiting parents.

Director of external affairs Jane Harris said she was not aware of any stem cell trials for autism, and added: Private companies are taking advantage of autistic people and their families, asking them to pay for unproven and even dangerous treatments.

Dr Jon Goldin, vice chair of the Child and Adolescent faculty at the Royal College of Psychiatrists, said: There is currently no known cure for autism nor is there any scientific evidence that stem cells can be used safely and effectively as a treatment.

Labour MP Jonathan Reynolds, vice chair of the All Party Parliamentary Group on autism and father of an autistic son, said: It is incredibly worrying to hear that people might be being exploited when they are in such a vulnerable position.

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Ulta’s 21 Days of Beauty sale is full of celebrity-loved makeup and skincare – Page Six

By daniellenierenberg

Ultas 21 Days of Beauty sale is in full swing, which means for the next couple of weeks, you can save 50% off a selection of bestselling skincare and must-have makeup. What better reason to refresh your beauty collection?

The biannual event began on Sunday, August 30, and runs through Saturday, September 19, and the daily deals include a number of of celebrity favorites from Kylie Cosmetics, Skyn Iceland, Benefit and Anastasia Beverly Hills, to name but a few.

Below, the A-list-approved beauty deals that are definitely worth your dollars.

Date: Tuesday, September 8

Loved by Gwyneth Paltrow whose partnered with Juice Beauty in 2016 to launch Goops own skincare line this vegan and cruelty-free cream is made with a proprietary blend of fruit stem cells and vitamin C infused into a resveratrol-rich grape formula. The lines booster serum will be half-off on September 8 as well.

$35 (usually $70)

Date: Thursday, September 10

I love a good summer tan, but the sun can be so damaging to your skin, Kim Kardashian wrote on her namesake app in 2018. I always wear SPF to protect my skin, but I also like to use self-tanners as safe alternative to tanning outside. She named this lightweight product as her formula of choice.

$22 (usually $44)

Date: Saturday, September 12

Speaking of the Kardashian-Jenners, you wont want to miss the chance to stock up on beauty mogul Kylies bestselling lip kits for a steal. Not a fan of the matte finish? The companys velvet version will also be half-off on September 12.

$14.50 (usually $29)

Date: Saturday, September 12

Kylie Jenner, Lili Reinhart, Bella Hadid and Rosie Huntington-Whiteley are just a few of the many celebs who love this brands signature pink drying lotion. Snag a travel-friendly version of the blemish-busting solution in this kit, along with Badescus equally popular rosewater facial spray.

$11 (usually $22)

Date: Sunday, September 13

Goldie Hawn, Kristen Bell and Julia Louis-Dreyfus cant get enough of these patches, which boast cooling and de-puffing powers. A travel-sized box with four pairs instead of the usual eight will also be half-off on September 13.

$16 (usually $32)

Date: Tuesday, September 15

This brands cult favorite Good Genes All-In-One Lactic Acid Treatment revitalizes the look of dull, congested and sun-damaged skin and comes approved by Jourdan Dunn and Helen Mirren. This handy kit includes a mini size, along with one of Sunday Rileys popular Ceramic Slip Cleanser to round out your skincare routine.

$12.50 (usually $25)

Date: Friday, September 18

Available in a range of shades, this bronzers beloved by the likes of Julianne Hough, Selena Gomez and Ariana Grande.

$15 (usually $30)

Date: Friday, September 18

Anastasia Soare is the eyebrow whisperer behind the flawless arches of stars including Kim Kardashian, Jennifer Lopez, Victoria Beckham and Amal Clooney, to name just a few. This kit comes with mini sizes of everything you need to maintain your brows at home, from Soares smash-hit Brow Wiz pencil to her Dipbrow taming gel.

$19 (usually $38)

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(new) The Science of Survival: Evolving Research in Advanced Non-Small Cell Lung Cancer – Reuters

By daniellenierenberg

Despite significant progress in treating cancer in recent years, the need for further improvements has persisted particularly for some of the most challenging forms of the disease, such as lung cancer. Lung cancer is one of the most common cancers, and is the leading cause of cancer death in both men and women.

The majority of lung cancer cases are non-small cell lung cancer (NSCLC), a complex disease that can affect each patient differently. Most cases of NSCLC are not diagnosed until the disease is advanced meaning it has metastasized or spread which can make it more challenging to treat.

The impact of lung cancer, and advanced NSCLC in particular, continues to be felt across our communities, explained Andrea Ferris, president and chairman of LUNGevity Foundation. While every persons experience with the disease is unique, many patients hope they can retain a sense of normalcy in their lives and are seeking more treatment options that offer a chance at a longer life.

Research Driving New Progress for Certain Patients

Researchers have accelerated their pursuit of new and differentiated approaches that address this critical unmet need, focusing on options that may offer patients a chance at a longer life. One area of research that has shown potential is combining treatments, such as immunotherapies, for certain patients with previously untreated advanced disease.

Hossein Borghaei, D.O., chief of thoracic medical oncology at Fox Chase Cancer Center in Philadelphia explains, Progress in treating advanced lung cancer has led to more options for patients with newly diagnosed advanced NSCLC. Some of the most recent developments in the field of immunotherapy are particularly exciting.

One example is the U.S. Food and Drug Administrations approval of the first and only dual immunotherapy approach for newly diagnosed patients. Opdivo (nivolumab) is a prescription medicine used in combination with Yervoy (ipilimumab) for adults with advanced stage NSCLC that has spread to other parts of your body (metastatic) and tests positive for PD-L1 and do not have an abnormal EGFR or ALK gene.

Opdivo can cause problems that can sometimes become serious or life threatening and can lead to death. Serious side effects may include lung problems (pneumonitis); intestinal problems (colitis) that can lead to tears or holes in your intestine; liver problems (hepatitis); hormone gland problems (especially the thyroid, pituitary, adrenal glands, and pancreas); kidney problems, including nephritis and kidney failure; skin problems; inflammation of the brain (encephalitis); problems in other organs; and severe infusion reactions; and complications of stem-cell transplant that uses donor stem cells (allogeneic). Additional serious side effects of Yervoy alone include: nerve problems that can lead to paralysis; eye problems; and complications of stem-cell transplant that uses donor stem cells (allogeneic). Please see Important Facts about side effects for Opdivo and Yervoy below.

Opdivo and Yervoy work with your immune system to help fight cancer in two ways. Yervoy stimulates the kind of cells that help fight cancer, while Opdivo may help these cells to find and fight the cancer cells again. While doing so, Opdivo and Yervoy can also affect healthy cells. These problems can sometimes become serious or life threatening and can lead to death. These problems may happen anytime during treatment or even after treatment has ended. Some of these problems may happen more often when Opdivo is used in combination with Yervoy.

Clinical Trial Findings: A Chance to Live Longer

Opdivo + Yervoy was studied in a clinical trial and compared to platinum-based chemotherapy among certain patients with previously untreated, advanced NSCLC that tested positive for PD-L1.

In the trial, 396 patients received Opdivo + Yervoy and 397 patients received platinum-based chemotherapy. Patients who were treated with Opdivo + Yervoy lived longer than those treated with platinum-based chemotherapy:

An additional analysis showed:

The data supporting this dual immunotherapy approach are encouraging, particularly as one third of the patients who responded to treatment with Opdivo + Yervoy were still alive at three years, said Dr. Borghaei. Further, Opdivo + Yervoy offers a non-chemotherapy option, which can be important to some patients.

The most common side effects of Opdivo, when used in combination with Yervoy, include: feeling tired; diarrhea; rash; itching; nausea; pain in muscles, bones, and joints; fever; cough; decreased appetite; vomiting; stomach-area (abdominal) pain; shortness of breath; upper respiratory tract infection; headache; low thyroid hormone levels (hypothyroidism); decreased weight; and dizziness. Please see Important Facts about side effects for Opdivo and Yervoy below.

Evolving Outlooks and Adapting Support for Patients

Facing a lung cancer diagnosis and beginning treatment can be life-altering in many ways and todays unique environment as a result of the coronavirus has brought about additional considerations for patients, caregivers and the broader healthcare community, with telemedicine and other forms of remote support playing an increasingly vital role.

Patients should know there are resources available and ways to stay connected, even during times when maintaining physical distance from others is important, said Ferris. We have transformed many of our patient support and education offerings into virtual formats, which we are updating frequently to provide the most recent information and reach and connect as many people as possible.

Dr. Borghaei also urges patients to reach out to their doctor or care team to learn about and take advantage of available remote support offerings. Advances in cancer research are still happening every day, with Opdivo + Yervoy being one example. Its as important as ever that people diagnosed with lung cancer speak with their doctor to fully understand their treatment options. While how we deliver care might look different now in some ways, our commitment to helping patients live longer hasnt changed.

To learn more about Opdivo + Yervoy, please visit http://www.Opdivo.com.

INDICATION

OPDIVO (nivolumab) is a prescription medicine used in combination with YERVOY (ipilimumab) as a first treatment for adults with a type of advanced stage lung cancer (called non-small cell lung cancer) when your lung cancer has spread to other parts of your body (metastatic) and your tumors are positive for PD-L1, but do not have an abnormal EGFR or ALK gene.

It is not known if OPDIVO is safe and effective in children younger than 18 years of age.

OPDIVO (10 mg/mL) and YERVOY (5 mg/mL) are injections for intravenous (IV) use.

Important Safety Information for OPDIVO (nivolumab) + YERVOY (ipilimumab)

OPDIVO is a medicine that may treat certain cancers by working with your immune system. OPDIVO can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become serious or life-threatening and can lead to death. These problems may happen anytime during treatment or even after your treatment has ended. Some of these problems may happen more often when OPDIVO is used in combination with YERVOY.

YERVOY can cause serious side effects in many parts of your body which can lead to death. These problems may happen anytime during treatment with YERVOY or after you have completed treatment.

Serious side effects may include: Lung problems (pneumonitis). Symptoms of pneumonitis may include: new or worsening cough; chest pain; and shortness of breath. Intestinal problems (colitis) that can lead to tears or holes in your intestine. Signs and symptoms of colitis may include: diarrhea (loose stools) or more bowel movements than usual; blood in your stools or dark, tarry, sticky stools; and severe stomach area (abdomen) pain or tenderness. Liver problems (hepatitis). Signs and symptoms of hepatitis may include: yellowing of your skin or the whites of your eyes; severe nausea or vomiting; pain on the right side of your stomach area (abdomen); drowsiness; dark urine (tea colored); bleeding or bruising more easily than normal; feeling less hungry than usual; and decreased energy. Hormone gland problems (especially the thyroid, pituitary, adrenal glands, and pancreas). Signs and symptoms that your hormone glands are not working properly may include: headaches that will not go away or unusual headaches; extreme tiredness; weight gain or weight loss; dizziness or fainting; changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness; hair loss; feeling cold; constipation; voice gets deeper; and excessive thirst or lots of urine. Kidney problems, including nephritis and kidney failure. Signs of kidney problems may include: decrease in the amount of urine; blood in your urine; swelling in your ankles; and loss of appetite. Skin problems. Signs of these problems may include: rash; itching; skin blistering; and ulcers in the mouth or other mucous membranes. Inflammation of the brain (encephalitis). Signs and symptoms of encephalitis may include: headache; fever; tiredness or weakness; confusion; memory problems; sleepiness; seeing or hearing things that are not really there (hallucinations); seizures; and stiff neck. Problems in other organs. Signs of these problems may include: changes in eyesight; severe or persistent muscle or joint pains; severe muscle weakness; and chest pain.

Additional serious side effects observed during a separate study of YERVOY alone include: Nerve problems that can lead to paralysis. Symptoms of nerve problems may include: unusual weakness of legs, arms, or face; and numbness or tingling in hands or feet. Eye problems. Symptoms may include: blurry vision, double vision, or other vision problems; and eye pain or redness.

Get medical help immediately if you develop any of these symptoms or they get worse. It may keep these problems from becoming more serious. Your healthcare team will check you for side effects during treatment and may treat you with corticosteroid or hormone replacement medicines. If you have a serious side effect, your healthcare team may also need to delay or completely stop your treatment.

OPDIVO and OPDIVO + YERVOY can cause serious side effects, including: Severe infusion reactions. Tell your doctor or nurse right away if you get these symptoms during an infusion: chills or shaking; itching or rash; flushing; difficulty breathing; dizziness; fever; and feeling like passing out. Graft-versus-host disease, a complication that can happen after receiving a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic), may be severe, and can lead to death, if you receive YERVOY either before or after transplant. Your healthcare provider will monitor you for the following signs and symptoms: skin rash, liver inflammation, stomach-area (abdominal) pain, and diarrhea.

Pregnancy and Nursing: Tell your healthcare provider if you are pregnant or plan to become pregnant. OPDIVO and YERVOY can harm your unborn baby. If you are a female who is able to become pregnant, your healthcare provider should do a pregnancy test before you start receiving OPDIVO. Females who are able to become pregnant should use an effective method of birth control during treatment and for at least 5 months after the last dose. Talk to your healthcare provider about birth control methods that you can use during this time. Tell your healthcare provider right away if you become pregnant or think you are pregnant during treatment. You or your healthcare provider should contact Bristol Myers Squibb at 1-800-721-5072 as soon as you become aware of the pregnancy. Pregnancy Safety Surveillance Study: Females who become pregnant during treatment with YERVOY are encouraged to enroll in a Pregnancy Safety Surveillance Study. The purpose of this study is to collect information about the health of you and your baby. You or your healthcare provider can enroll in the Pregnancy Safety Surveillance Study by calling 1-844-593-7869. Before receiving treatment, tell your healthcare provider if you are breastfeeding or plan to breastfeed. It is not known if either treatment passes into your breast milk. Do not breastfeed during treatment and for 5 months after the last dose.

Tell your healthcare provider about: Your health problems or concerns if you: have immune system problems such as autoimmune disease, Crohns disease, ulcerative colitis, lupus, or sarcoidosis; have had an organ transplant; have lung or breathing problems; have liver problems; or have any other medical conditions. All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

The most common side effects of OPDIVO, when used in combination with YERVOY, include: feeling tired; diarrhea; rash; itching; nausea; pain in muscles, bones, and joints; fever; cough; decreased appetite; vomiting; stomach-area (abdominal) pain; shortness of breath; upper respiratory tract infection; headache; low thyroid hormone levels (hypothyroidism); decreased weight; and dizziness.

These are not all the possible side effects. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see U.S. Full Prescribing Information and Medication Guide for OPDIVO and YERVOY.

2020 Bristol-Myers Squibb Company.

OPDIVO and YERVOY are registered trademarks of Bristol-Myers Squibb Company.

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(new) The Science of Survival: Evolving Research in Advanced Non-Small Cell Lung Cancer - Reuters

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Exciting new technologies could change the way we age – TheSpec.com

By daniellenierenberg

On April 15, 2002, the FDA approved a temporary treatment for wrinkles that would revolutionize aging. All of a sudden, you could waltz into a derms office and get your frown lines ironed out faster than it would take to iron an actual shirt. It was called botulinum toxin, Botox for short.

Eighteen years later, a few units of Botox every three months has become the norm for millions around the world (more than seven million yearly in the U.S. alone). Now, if someone had told your grandparents, or even your parents, 20 years ago that people would be getting their foreheads frozen to look younger, they likely would have scoffed at the idea. So just imagine what other wild fixes could be coming to a medi-spa near you.

Its exciting to think about how the next 10 years will look, says Dr. Rohan Bissoondath, medical director of Calgarys Preventous Cosmetic Medicine clinic. With lifespan increasing, people are routinely going to be living into their hundreds, so we want to look great as well. From magic pills to creams that mimic injections, we take a look at the incredible innovations on the horizon.

You wont need surgery to lift your face

The way science is progressing, facelifts are set to become obsolete, says Dr. Lisa Kellett of Torontos DLK on Avenue. I think that the gold standard will eventually be finding ways to regenerate and kick-start our own collagen instead of doing a facelift. Kellett is already trying out cutting-edge technology to accomplish this, such as a laser that delivers growth factors right in the dermis to regenerate tissue. Its pretty snazzy stuff, but she anticipates even greater advances in coming years. I think well be able to use stem cells in conjunction with technology to regenerate collagen I think thats what well be doing one day.

Youll (hopefully) be able to nix wrinkles without needles

Botox in a cream? This has been in the pipeline for a while, says Bissoondath. The challenge is getting the molecules to penetrate the skin so that they can act on the muscle. Maybe on crows feet because its a thinner area, thinner muscles; that may be an area where we see some utility for it, but its still out there. Topical Botox had some success in trials, but scientists still have kinks to work out. In the meantime, a Botox cream might be beneficial even if it doesnt reach muscles, says Bissoondath. I see the potential for having it in a cream and applying it to the whole face, not necessarily affecting facial expressions, but giving an improved glow and better skin quality.

Therell be more all-in-one solutions

If you want to smooth, you get Botox. If you want to brighten, you get IPL. If you want to tighten, you get Thermage. But what if there was a treatment that did it all? I think thats the future of aging, says Kellett, who is just about to launch such a treatment at her clinic. Marketed as the next generation of laser and light-based platform technology, Etherea MX is a multiple modality device that can tackle everything from dark spots and skin laxity to textural issues and wrinkles. It means that when patients come in, theyre not just doing one thing, says the doc. Instead, in the same appointment, shes able to address a variety of concerns with a single machine.

Youll be able to take a pill instead of hitting the gym

OK, this is very cool. Something I think is possible is a pill to replace exercise, says Bissoondath, who adds that this could be developed in the not so distant future. With the advances were making in understanding the functions of our body down to the cellular level and intracellular level, and understanding how our mitochondria actually ages, were looking at ways now where we can manipulate that from a pill perspective. The pill wouldnt deliver all the benefits of physical activity, such as the positive impact on our mood, but it would replicate its effects on our body. It wont take the place of walking around outside and soaking up nature it cant do the mental part of it. But as far as the physiologic, biochemical part of it, were really understanding that better and making big strides. Its exciting.

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How Groups of Cells Cooperate to Build Organs and Organisms – The Scientist

By daniellenierenberg

Efforts to use regenerative medicinewhich seeks to address ailments as diverse as birth defects, traumatic injury, aging, degenerative disease, and the disorganized growth of cancerwould be greatly aided by solving one fundamental puzzle: How do cellular collectives orchestrate the building of complex, three-dimensional structures?

While genomes predictably encode the proteins present in cells, a simple molecular parts list does not tell us enough about the anatomical layout or regenerative potential of the body that the cells will work to construct. Genomes are not a blueprint for anatomy, and genome editing is fundamentally limited by the fact that its very hard to infer which genes to tweak, and how, to achieve desired complex anatomical outcomes. Similarly, stem cells generate the building blocks of organs, but the ability to organize specific cell types into a working human hand or eye has been and will be beyond the grasp of direct manipulation for a very long time.

But researchers working in the fields of synthetic morphology and regenerative biophysics are beginning to understand the rules governing the plasticity of organ growth and repair. Rather than micromanaging tasks that are too complex to implement directly at the cellular or molecular level, what if we solved the mystery of how groups of cells cooperate to construct specific multicellular bodies during embryogenesis and regeneration? Perhaps then we could figure out how to motivate cell collectives to build whatever anatomical features we want.

New approaches now allow us to target the processes that implement anatomical decision-making without genetic engineering. In January, using such tools, crafted in my lab at Tufts Universitys Allen Discovery Center and by computer scientists in Josh Bongards lab at the University of Vermont, we were able to create novel living machines, artificial bodies with morphologies and behaviors completely different from the default anatomy of the frog species (Xenopus laevis) whose cells we used. These cells rebooted their multicellularity into a new form, without genomic changes. This represents an extremely exciting sandbox in which bioengineers can play, with the aim of decoding the logic of anatomical and behavioral control, as well as understanding the plasticity of cells and the relationship of genomes to anatomies.

Deciphering how an organism puts itself together is truly an interdisciplinary undertaking.

Deciphering how an organism puts itself together is truly an interdisciplinary undertaking. Resolving the whole picture will involve understanding not only the mechanisms by which cells operate, but also elucidating the computations that cells and groups of cells carry out to orchestrate tissue and organ construction on a whole-body scale. The next generation of advances in this area of research will emerge from the flow of ideas between computer scientists and biologists. Unlocking the full potential of regenerative medicine will require biology to take the journey computer science has already taken, from focusing on the hardwarethe proteins and biochemical pathways that carry out cellular operationsto the physiological software that enables networks of cells to acquire, store, and act on information about organ and indeed whole-body geometry.

In the computer world, this transition from rewiring hardware to reprogramming the information flow by changing the inputs gave rise to the information technology revolution. This shift of perspective could transform biology, allowing scientists to achieve the still-futuristic visions of regenerative medicine. An understanding of how independent, competent agents such as cells cooperate and compete toward robust outcomes, despite noise and changing environmental conditions, would also inform engineering. Swarm robotics, Internet of Things, and even the development of general artificial intelligence will all be enriched by the ability to read out and set the anatomical states toward which cell collectives build, because they share a fundamental underlying problem: how to control the emergent outcomes of systems composed of many interacting units or individuals.

Many types of embryos can regenerate entirely if cut in half, and some species are proficient regenerators as adults. Axolotls (Ambystoma mexicanum) regenerate their limbs, eyes, spinal cords, jaws, and portions of the brain throughout life. Planarian flatworms (class Turbellaria), meanwhile, can regrow absolutely any part of their body; when the animal is cut into pieces, each piece knows exactly whats missing and regenerates to be a perfect, tiny worm.

The remarkable thing is not simply that growth begins after wounding and that various cell types are generated, but that these bodies will grow and remodel until a correct anatomy is complete, and then they stop. How does the system identify the correct target morphology, orchestrate individual cell behaviors to get there, and determine when the job is done? How does it communicate this information to control underlying cell activities?

Several years ago, my lab found that Xenopus tadpoles with their facial organs experimentally mixed up into incorrect positions still have largely normal faces once theyve matured, as the organs move and remodel through unnatural paths. Last year, a colleague at Tufts came to a similar conclusion: the Xenopus genome does not encode a hardwired set of instructions for the movements of different organs during metamorphosis from tadpole to frog, but rather encodes molecular hardware that executes a kind of error minimization loop, comparing the current anatomy to the target frog morphology and working to progressively reduce the difference between them. Once a rough spatial specification of the layout is achieved, that triggers the cessation of further remodeling.

The deep puzzle of how competent agents such as cells work together to pursue goals such as building, remodeling, or repairing a complex organ to a predetermined spec is well illustrated by planaria. Despite having a mechanistic understanding of stem cell specification pathways and axial chemical gradients, scientists really dont know what determines the intricate shape and structure of the flatworms head. It is also unknown how planaria perfectly regenerate the same anatomy, even as their genomes have accrued mutations over eons of somatic inheritance. Because some species of planaria reproduce by fission and regeneration, any mutation that doesnt kill the neoblastthe adult stem cell that gives rise to cells that regenerate new tissueis propagated to the next generation. The worms incredibly messy genome shows evidence of this process, and cells in an individual planarian can have different numbers of chromosomes. Still, fragmented planaria regenerate their body shape with nearly 100 percent anatomical fidelity.

Permanent editingof the encoded target morphology without genomic editing reveals a new kind of epigenetics.

So how do cell groups encode the patterns they build, and how do they know to stop once a target anatomy is achieved? What would happen, for example, if neoblasts from a planarian species with a flat head were transplanted into a worm of a species with a round or triangular head that had the head amputated? Which shape would result from this heterogeneous mixture? To date, none of the high-resolution molecular genetic studies of planaria give any prediction for the results of this experiment, because so far they have all focused on the cellular hardware, not on the logic of the softwareimplemented by chemical, mechanical, and electrical signaling among cellsthat controls large-scale outcomes and enables remodeling to stop when a specific morphology has been achieved.

Understanding how cells and tissues make real-time anatomical decisions is central not only to achieving regenerative outcomes too complex for us to manage directly, but also to solving problems such as cancer. While the view of cancer as a genetic disorder still largely drives clinical approaches, recent literature supports a view of cancer as cells simply not being able to receive the physiological signals that maintain the normally tight controls of anatomical homeostasis. Cut off from these patterning cues, individual cells revert to their ancient unicellular lifestyle and treat the rest of the body as external environment, often to ruinous effect. If we understand the mechanisms that scale single-cell homeostatic setpoints into tissue- and organ-level anatomical goal states and the conditions under which the anatomical error reduction control loop breaks down, we may be able to provide stimuli to gain control of rogue cancer cells without either gene therapy or chemotherapy.

During morphogenesis, cells cooperate to reliably build anatomical structures. Many living systems remodel and regenerate tissues or organs despite considerable damagethat is, they progressively reduce deviations from specific target morphologies, and halt growth and remodeling when those morphologies are achieved. Evolution exploits three modalities to achieve such anatomical homeostasis: biochemical gradients, bioelectric circuits, and biophysical forces. These interact to enable the same large-scale form to arise despite significant perturbations.

N.R. FULLER, SAYO-ART, LLC

BIOCHEMICAL GRADIENTS

The best-known modality concerns diffusible intracellular and extracellular signaling molecules. Gene-regulatory circuits and gradients of biochemicals control cell proliferation, differentiation, and migration.

BIOELECTRIC CIRCUITS

The movement of ions across cell membranes, especially via voltage-gated ion channels and gap junctions, can establish bioelectric circuits that control large-scale resting potential patterns within and among groups of cells. These bioelectric patterns implement long-range coordination, feedback, and memory dynamics across cell fields. They underlie modular morphogenetic decision-making about organ shape and spatial layout by regulating the dynamic redistribution of morphogens and the expression of genes.

BIOMECHANICAL FORCES

Cytoskeletal, adhesion, and motor proteins inside and between cells generate physical forces that in turn control cell behavior. These forces result in large-scale strain fields, which enable cell sheets to move and deform as a coherent unit, and thus execute the folds and bends that shape complex organs.

The software of life, which exploits the laws of physics and computation, is enabled by chemical, mechanical, and electrical signaling across cellular networks. While the chemical and mechanical mechanisms of morphogenesis have long been appreciated by molecular and cell biologists, the role of electrical signaling has largely been overlooked. But the same reprogrammability of neural circuits in the brain that supports learning, memory, and behavioral plasticity applies to all cells, not just neurons. Indeed, bacterial colonies can communicate via ionic currents, with recent research revealing brain-like dynamics in which information is propagated across and stored in a kind of proto-body formed by bacterial biofilms. So it should really come as no surprise that bioelectric signaling is a highly tractable component of morphological outcomes in multicellular organisms.

A few years ago, we studied the electrical dynamics that normally set the size and borders of the nascent Xenopus brain, and built a computer model of this process to shed light on how a range of various brain defects arise from disruptions to this bioelectric signaling. Our model suggested that specific modifications with mRNA or small molecules could restore the endogenous bioelectric patterns back to their correct layout. By using our computational platform to select drugs to open existing ion channels in nascent neural tissue or even a remote body tissue, we were able to prevent and even reverse brain defects caused not only by chemical teratogenscompounds that disrupt embryonic developmentbut by mutations in key neurogenesis genes.

Similarly, we used optogenetics to stimulate electrical activity in various somatic cell types totrigger regeneration of an entire tadpole tailan appendage with spinal cord, muscle, and peripheral innervationand to normalize the behavior of cancer cells in tadpoles strongly expressing human oncogenes such as KRAS mutations. We used a similar approach to trigger posterior regions, such as the gut, to build an entire frog eye. In both the eye and tail cases, the information on how exactly to build these complex structures, and where all the cells should go, did not have to be specified by the experimenter; rather, they arose from the cells themselves. Such findings reveal how ion channel mutations result in numerous human developmental channelopathies, and provide a roadmap for how they may be treated by altering the bioelectric map that tells cells what to build.

We also recently found a striking example of such reprogrammable bioelectrical software in control of regeneration in planaria. In 2011, we discovered that an endogenous electric circuit establishes a pattern of depolarization and hyperpolarization in planarian fragments that regulate the orientation of the anterior-posterior axis to be rebuilt. Last year, we discovered that this circuit controls the gene expressionneeded to build a head or tail within six hours of amputation, and by using molecules that make cell membranes permeable to certain ions to depolarize or hyperpolarize cells, we induced fragments of such worms to give rise to a symmetrical two-headed form, despite their wildtype genomes. Even more shockingly, the worms continued to generate two-headed progeny in additional rounds of cutting with no further manipulation. In further experiments, we demonstrated that briefly reducing gap junction-mediated connectivity between adjacent cells in the bioelectric network that guides regeneration led worms to regenerate head and brain shapes appropriate to other worm species whose lineages split more than 100 million years ago.

My group has developed the use of voltage-sensitive dyes to visualize the bioelectric pattern memory that guides gene expression and cell behavior toward morphogenetic outcomes. Meanwhile, my Allen Center colleagues are using synthetic artificial electric tissues made of human cells and computer models of ion channel activity to understand how electrical dynamics across groups of non-neural cells can set up the voltage patterns that control downstream gene expression, distribution of morphogen molecules, and cell behaviors to orchestrate morphogenesis.

The emerging picture in this field is that anatomical software is highly modulara key property that computer scientists exploit as subroutines and that most likely contributes in large part to biological evolvability and evolutionary plasticity. A simple bioelectric state, whether produced endogenously during development or induced by an experimenter, triggers very complex redistributions of morphogens and gene expression cascades that are needed to build various anatomies. The information stored in the bodys bioelectric circuitscan be permanently rewritten once we understand the dynamics of the biophysical circuits that make the critical morphological decisions. This permanent editing of the encoded target morphology without genomic editing reveals a new kind of epigenetics, information that is stored in a medium other than DNA sequences and chromatin.

Recent work from our group and others has demonstrated that anatomical pattern memories can be rewritten by physiological stimuli and maintained indefinitely without genomic editing. For example, the bioelectric circuit that normally determines head number and location in regenerating planaria can be triggered by brief alterations of ion channel or gap junction activity to alter the animals body plan. Due to the circuits pattern memory, the animals remain in this altered state indefinitely without further stimulation, despite their wildtype genomes. In other words, the pattern to which the cells build after damage can be changed, leading to a target morphology distinct from the genetic default.

N.R. FULLER, SAYO-ART, LLC

First, we soaked a planarian in voltage-sensitive fluorescent dye to observe the bioelectrical pattern across the entire tissue. We then cut the animal to see how this pattern changes in each fragment as it begins to regenerate.

We then applied drugs or used RNA interference to target ion channels or gap junctions in individual cells and thus change the pattern of depolarization/hyperpolarization and cellular connectivity across the whole fragment.

As a result of the disruption of the bodys bioelectric circuits, the planarian regrows with two heads instead of one, or none at all.

When we re-cut the two-headed planarian in plain water, long after the initial drug has left the tissue, the new anatomy persists in subsequent rounds of regeneration.

Cells can clearly build structures that are different from their genomic-default anatomical outcomes. But are cells universal constructors? Could they make anything if only we knew how to motivate them to do it?

The most recent advances in the new field at the intersection of developmental biology and computer science are driven by synthetic living machines known as biobots. Built from multiple interacting cell populations, these engineered machines have applications in disease modeling and drug development, and as sensors that detect and respond to biological signals. We recently tested the plasticity of cells by evolving in silico designs with specific movement and behavior capabilities and used this information to sculpt self-organized growth of aggregated Xenopus skin and muscle cells. In a novel environmentin vitro, as opposed to inside a frog embryoswarms of genetically normal cells were able to reimagine their multicellular form. With minimal sculpting post self-assembly, these cells form Xenobots with structures, movements, and other behaviors quite different from what might be expected if one simply sequenced their genome and identified them as wildtype X. laevis.

These living creations are a powerful platform to assess and model the computations that these cell swarms use to determine what to build. Such insights will help us to understand evolvability of body forms, robustness, and the true relationship between genomes and anatomy, greatly potentiating the impact of genome editing tools and making genomics more predictive for large-scale phenotypes. Moreover, testing regimes of biochemical, biomechanical, and bioelectrical stimuli in these biobots will enable the discovery of optimal stimuli for use in regenerative therapies and bioengineered organ construction. Finally, learning to program highly competent individual builders (cells) toward group-level, goal-driven behaviors (complex anatomies) will significantly advance swarm robotics and help avoid catastrophes of unintended consequences during the inevitable deployment of large numbers of artificial agents with complex behaviors.

Understanding how cells and tissues make real-time anatomical decisions is central to achieving regenerative outcomes too complex for us to manage directly.

The emerging field ofsynthetic morphology emphasizes a conceptual point that has been embraced by computer scientists but thus far resisted by biologists: the hardware-software distinction. In the 1940s, to change a computers behavior, the operator had to literally move wires aroundin other words, she had to directly alter the hardware. The information technology revolution resulted from the realization that certain kinds of hardware are reprogrammable: drastic changes in function could be made at the software level, by changing inputs, not the hardware itself.

In molecular biomedicine, we are still focused largely on manipulating the cellular hardwarethe proteins that each cell can exploit. But evolution has ensured that cellular collectives use this versatile machinery to process information flexibly and implement a wide range of large-scale body shape outcomes. This is biologys software: the memory, plasticity, and reprogrammability of morphogenetic control networks.

The coming decades will be an extremely exciting time for multidisciplinary efforts in developmental physiology, robotics, and basal cognition to understand how individual cells merge together into a collective with global goals not belonging to any individual cell. This will drive the creation of new artificial intelligence platforms based not on copying brain architectures, but on the multiscale problem-solving capacities of cells and tissues. Conversely, the insights of cognitive neurobiology and computer science will give us a completely new window on the information processing and decision-making dynamics in cellular collectives that can very effectively be targeted for transformative regenerative therapies of complex organs.

Michael Levinis the director of the Allen Discovery Center at Tufts University and Associate Faculty at Harvard Universitys Wyss Institute. Email him atmichael.levin@tufts.edu. M.L. thanks Allen Center Deputy DirectorJoshua Finkelsteinfor suggestions on the drafts of this story.

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Emerging Evidence Supports the Use of Narsoplimab in HSCT-TMA – OncLive

By daniellenierenberg

During the 2020 European Society for Blood and Marrow Transplantation Annual Meeting, Rafael F. Duarte, MD, PhD, FRCP, of the Hospital Universitario Puerta de Hierro Majadahonda in Madrid, Spain, presented 2 real-world clinical cases in which the investigational monoclonal antibody narsoplimab (OMS721) demonstrated clinical benefit in patients with hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA).

Because the selection of patients for clinical trials has limitations, and more so, because running a trial is a hard endeavor for this difficult complication, [I wanted to share] some hands-on experience that we have had with narsoplimab outside of the trial with some case studies of patients who have been treated in a compassionate-use basis, said Duarte.

First, Duarte shared a case of a 19-year-old female who received narsoplimab following matched-sibling allogeneic HSCT to treat her B-cell acute lymphoblastic leukemia (B-ALL) in first complete remission.

At 5 months, the patient experienced late-onset acute graft-versus-host disease (GVHD) and severe HSCT-TMA with lower gastrointestinal (GI) bleeding and ischemic ulcers. While skin involvement of GVHD resolved, she received initial treatment with 1 dose of eculizumab (Soliris) due to persistent GI symptoms after steroids, mesenchymal stromal cells, and extracorporeal photopheresis. Additionally, she received 4 mg/kg of narsoplimab once or twice weekly for a total of 18 doses.

We asked for narsoplimab purely on the basis that this was a severely immunocompromised patient who had experienced complications before and who had been receiving a lot of immunosuppression for the treatment of GVHD, said Duarte. We tried to minimize immunosuppression, so we thought narsoplimab would be a good option.

According to Duarte, the patients GI bleeding and microangiopathy hemolytic anemia resolved quickly and dramatically after starting narsoplimab. Additionally, she became transfusion independent with platelet counts above 100 x 109 per liter.

At 21 months, the patient remains in complete remission (CR) of B-ALL and is devoid of signs of HSCT-TMA after discontinuing narsoplimab.

Subsequently, Duarte presented another, more complex case of a 48-year-old male with HIV and Hodgkin lymphoma who was in his third CR.

Following CCR5-32/32 HSCT, the patient experienced very early HSCT-TMA on day 0. Subsequently, he had rapid severe renal failure that required hemodialysis.

Initial treatment with calcineurin inhibitor withdrawal did not elicit any response, so he was started on narsoplimab at 4 mg/kg twice weekly on day 6. He received a total of 8 doses of narsoplimab.

The patients lactate dehydrogenase (LDH), bilirubin, and schistocyte counts improved rapidly following narsoplimab initiation. Additionally, the patient derived partial improvement of renal function and fluid management, although he required continued dialysis.

Despite this, at 31 days post-transplant, the patient had multiple secondary complications as a result of the CCR5-32/32 HSCT and experienced sudden death. The death was not thought to be related to TMA and no autopsy was granted.

We dont have a better explanation regarding what happened with this patient, unfortunately, Duarte explained. We think we are seeing that many of the patients who undergo transplant with this mutated CCR5-32/32 tend to have greater mortality and greater complications than HIV-positive patients who undergo transplant with standard [procedure].

Duarte also presented findings from the pivotal, phase 2 trial, in which narsoplimab demonstrated high rates of CRs, as well as improved laboratory and clinical markers among patients with HSCT-TMA.

Narsoplimab was previously granted a breakthrough therapy designation by the FDA for the treatment of patients with high-risk TA-TMA. In addition, the agent was granted an orphan drug designation for TA-TMA therapy and complement-mediated TMA prevention.

Findings from the single-arm, open-label phase 2 trial demonstrated a 54% CR rate in all treated patients (n = 28) with the mannan-binding lectin-associated serine protease-2 inhibitor (95% CI, 34%-72%). Additionally, patients treated per protocol recommendations (n = 23), which entailed 4 weeks or more of dosing, achieved a CR rate of 65% (95% CI, 43%-84%).

At 100 days following HSCT-TMA diagnosis, 68% of all treated patients, 83% of patients treated per protocol, and 93% of treatment responders (n = 15) were alive.

Eligible patients had to be 18 years of older at screening, which occurred during the patients first visit. Additionally, patients had to have persistent HSCT-TMA as defined by a platelet count less than 150,000 per L, evidence of microangiopathy hemolysis such as the presence of schistocytes, serum LDH greater than upper limit of normal, or haptoglobin less than the lower limit of normal, and renal dysfunction defined as doubling of serum creatinine compared with pre-transplant level. All of the following had to be present for at least 2 weeks following modification or discontinuation of calcineurin inhibitors.

Patients who had eculizumab therapy within 3 months of screening, positive direct Coombs test, or active systemic bacteria or fungal infection that required antimicrobial therapy beyond prophylactic antimicrobial therapy as a standard of care were excluded from the study.

Response-based efficacy requiring improvement in TMA laboratory markers of platelet count and LDH and improvement in clinical status, as well as safety, served as the primary end points of the trial. Secondary end points included survival and change from baseline laboratory markers.

Regarding laboratory markers, LDH had to be less than 1.5 L. For patients who had a baseline platelet count of 20,000/L, improvement was defined as a tripling of baseline platelet count more than 30,000 and freedom from platelet transfusion. For patients with a baseline platelet count of more than 20,000, improvement was defined as an increased count of least 50% and absolute count of more than 75,000, as well as freedom from platelet transfusion.

Clinical improvement was based off any of the following improvements in specific organ function. Patients could derive blood improvement defined as transfusion freedom; renal improvement defined as a reduction of creatinine of more than 40%, normalization of creatinine and more than 20% reduction of creatinine, or discontinuation of renal replacement therapy; pulmonary improvement defined as extubation and discontinuation of ventilator support, or discontinuation of non-invasive mechanical ventilation; gastrointestinal improvement defined as improvement assessed by MAGIC (Mount Sinai GVHD International Consortium) criteria; or neurological improvement defined as limited to stroke, posterior reversible encephalopathy syndrome, seizures, and weakness.

Eligible patients had an average age of 48, and 71% were male. Moreover, 96% of patients had malignant underlying disease. Regarding risk factors, 64% had GVHD, 75% had significant infection, 14% had non-infectious pulmonary complications, such as idiopathy pneumonia syndrome or diffuse alveolar hemorrhage, and 50% had neurological signs.

Moreover, the study population was defined as high risk as 93% of patients had multiple risk factors associated with poor outcome.

Regarding safety, any-grade toxicities were observed in 92.9% of patients treated with narsoplimab. The most common adverse effects (AEs) included nausea, vomiting, diarrhea, hypokalemia, neutropenia, and fever.

Additionally, 21% of patients died while on study; however, all deaths were attributed to common complications of HSCT.

Investigators concluded that similar AEs are associated with patients who undergo transplant and that narsoplimab was generally well tolerated.

These are very highly encouraging results with narsoplimab in patients with very severe TMA who are unresponsive to other treatments. These results suggest that narsoplimab may be of benefit in these severely ill, complex patients with TMA, including those in the most complex clinical scenarios, Duarte concluded.

Reference

Duarte R. MASP-2 inhibition with the investigational agent narsoplimab for the treatment of HSCT-TMA: overview of data and case discussion. Presented at: 2020 European Society for Blood and Marrow Transplantation Annual Meeting; August 30-September 2, 2020; Virtual. Session IS28-4.

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Unraveling the use of CBD in veterinary medicine – Jill Lopez

By daniellenierenberg

It was about the 3rd week into Bastions recovery from his TPLO surgery and he was already having a rough time. Bastion was a gregarious yellow Labrador who had his injured stifle about 25 days ago. Fortunately, his family elected for him to have his stifle surgically reconstructed. Initially, he had recovered well from surgery. But one day in particular, he presented to the hospital because he had a brief setback. He was limping far more severely than what would be normally expected at this stage of recovery.

The osteotomy from his surgery had not yet completely healed and he was still in the middle of his prescribed 5 weeks of exercise strict restriction. His family was trying their best but Bastion wasnt having it. He was too active at home and his humans were growing frustrated. Anti-anxiety medications had been dispensed but they were not given. Instead, his family had decided to give him CBD oil at home. When I asked why the prescribed medications had not been given, the client responded, I found CBD oil at the local farmers market and I figured it would work just as well.

Like Bastion, an increasing number of pets are receiving cannabidiol (CBD) supplements. The popularity of CBD continues to rise and many clients are incorporating CBD as part of the medication protocol for their pets, either as an adjunct or, as alternative treatment option.

Perhaps the initial interest in the benefits of CBD can be traced back to 1998, or possibly earlier, when scientists at the National Institutes of Health discovered that CBD could protect cells from oxidative stress. These findings fueled interest in the human medical field and, in large part, that appeal has been transmuted into veterinary medicine. The regard for this molecule has risen to such levels that in many homes, CBD is being used as the sole treatment option for a variety of medical conditions.

Veterinarians are becoming more fluent in the fascinating pharmacology regarding the use of this phytocannabinoid. A recent survey indicated that most veterinarians (61.5%) felt comfortable discussing the use of CBD with their colleagues, but only 45.5% felt comfortable discussing this topic with clients.1 Furthermore, veterinarians and clients in states with legalized recreational marijuana were more likely to talk about the use of CBD products to treat canine ailments than those in other states.2 Lastly, CBD was most frequently discussed as a potential treatment for pain management, anxiety and seizures.1 At first glance, the use of CBD has tangential or limited relevance in the world of veterinary surgery. However, as one takes a closer look at the putative, and proven benefits, it is clear that we are just scratching the surface of its therapeutic benefits. This article takes a brief dive into the world of CBD and its promise in the field of veterinary surgery.

Pain

Whether you perform surgery within a specialty discipline (oncology, orthopedics, neurology, soft tissue surgery, mixed animal, oral/dental, etc), or surgery is only a small part of your general practice, every veterinarian endeavors to aggressively manage pain. The first choice for pain relief among many clinicians are the medications that have been more extensively studied including, but not limited to, anti-inflammatories, gabapentinoids, opioids, local anesthetics, and other analgesics (acetaminophen, amantadine, cerenia etc). These medications or a combination thereof, have been prescribed to treat pain from orthopedic surgery, soft tissue surgery, surgical neuropathic conditions, pain from intestinal surgery, to name just a few. In the most basic schema, pain is divided into four categories: nociceptive pain (a response to damaged tissue), neuropathic pain (a response to directly-damaged sensory or spinal nerves), centralized pain (the result of pain signals being improperly amplified), and inflammatory pain.1 Cannabinoids may have a role to play in mediating all four of these types of pain states. When tissue is damaged, histamine, serotonin, TNF-alpha, IL-1-beta, IL-6, and Il -17 6, and interleukin 17 are released.2 Cannabinoids bind to the CB1 receptors and attenuate the pain signal by slowing down the release of those neurotransmitters.3 This process can take place locally or in the central nervous system.3 Cannabinoids have also been shown to inhibit the release of GABA, a well known neurotransmitter associated with pain.3 Although there is a paucity of clinical research on the use of CBD to treat postoperative pain in the veterinary medical setting, there has been heartening research conducted in humans. Indeed, National Academies of Sciences, Engineering, and Medicine concluded that there is, substantial evidence that cannabis is an effective treatment for chronic pain in adults.

Opioids have long been the go to option, or cornerstone of pain management, however, the potential for the adverse events associated with the use of opioids in veterinary patients is universally accepted.38 I have seen how distressing it can be for a family to see their pet experiencing any of the unpleasurable side effects of opioids including urine retention, delayed bowel movements, whining, panting, disorientation, or other manifestations of dysphoria. Those are just some of the challenges that clinicians face when using opioids for chronic pain management. Considering the ongoing consequences of the opioid epidemic, there is a search for pain management solutions that are innovative, prone to less adverse events, and are more effective. As the scientific community begins to evaluate the evidence for use of CBD , it is clear that more research is needed.

Anecdotal reports of CBDs efficacy as a pain reliever are ubiquitous but more are turning to scientific data for evidence of CBDs efficacy. A study in 2020 evaluating effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients found that over half of chronic pain patients (53%) reduced or eliminated their opioids within 8 weeks after adding CBD-rich hemp extract to their regimens.5 Almost all CBD users (94%) reported quality of life improvements.5 And in a recent study evaluating orally consumed cannabinoids for long-lasting relief of allodynia in a mouse model, found that cannabinoids reduced hyperalgesia and a similar effect was not found with morphine.4 Mouse vocalizations were recorded throughout the experiment, and mice showed a large increase in ultrasonic, broadband clicks after sciatic nerve injury, which was reversed by THC, CBD, and morphine.4 The study demonstrated that cannabinoids provide long-term relief of chronic pain states.4 If research shows that use of cannabinoids in animals, specifically, CBD, can help to decrease the use of opioids for pain management, that would help make more animals comfortable and potentially help to fight the tragic epidemic of human prescription opioid abuse. Further research is needed in a variety of species, specifically, both the canine and feline species.

Bone Healing

Both general veterinary practitioners and veterinary surgeons commonly diagnose and treat fractures. A large retrospective study of fracture incidence in dogs in North America has not been published since 1994; however, the findings from that study are still informative regarding the frequency of bone injuries. That study demonstrated that approximately 24% of all patients in the population studied over a 10 year period were affected by a disorder of the musculoskeletal system, with fractures contributing the largest proportion (over 29%) of all of the diagnosis of the appendicular skeletal system.7 Although that research is dated, the conclusions from this study - at the very least, indicate that fractures are commonplace in the clinical veterinary setting.7 Fracture repair has gradually become more straightforward due to improvements in technology. Because of these innovations, speciality surgeons and general practitioners who repair fractures have begun to see better surgical outcomes. So whether you primarily stabilize fractures with implants, or if external coaptation of fractures with the intention to refer (or perhaps as the primary means of fixation) is your treatment of choice, all veterinary practitioners aim to help fractured bones heal quickly. Despite these technological improvements, bone healing can be protracted or non existent with some fractures. There are a variety of options at a veterinarians disposal to kick-start the healing process but perhaps in the near future, CBD may be added to that armamentarium. The effect of CBD in fracture healing has been investigated evaluating bone callus formation in femur fractures in a rat model.8 The findings demonstrated enhanced biomechanical properties of healing fractures in those given CBD compared with a control group.8 This effect was not found in those only given 9-THC. Moreover, the bone forming effects (osteogenic) of CBD were weakened when test subjects were given equal amounts of CBD and 9-THC.6 Another in vivo research study indicated that when CBD is incorporated into a surface that promotes bone growth (osteoconductive scaffold) it can stimulate stem cell migration and osteogenic differentiation.9 Further studies are needed to better evaluate the role of CBD in healing and bone metabolism of companion animals so that these findings can be applied in the clinical setting.

Additionally, cannabis has been shown to be a useful addition in treatment plans optimized to improve bone health in laboratory studies. A study endeavored to more closely understand the role of CB2 receptors in maintaining bone health. CB2 receptors in bone cells have been linked to maintaining bone density and stimulating growth, and may therefore have a part in reversing the effects of osteoporosis.10 One study evaluating role of CB2 receptors, found that in mice whose genes had been altered to remove the CB1 or CB2 receptors, those that developed signs of bone weakness that were far more pronounced than those in the control group.12 Another study in 2009, investigated the relationship between CB2 expression and bone disease in humans. The study found that people with dysfunctional CB2 receptors to have significantly weaker hand bones.11

Arthritis

Osteoarthritis (OA) affects many dogs, large and small. Most often, OA is the consequence of a developmental orthopedic disease that often affects a single joint or a pair of joints, and, less often, affects multiple joints. It is axiomatic that Mother Nature likes symmetry thus developmental orthopedic diseases frequently affect both left and right joints. For example, hip dysplasia is reportedly bilateral in >60% of affected dog,s13 and elbow dysplasia is bilateral in approximately 50% of affected dogs.14 Osteoarthritis occurs secondary to a myriad of primary orthopedic conditions that affect a variety of joints including: the hip (most common causes of OA in the hip: hip dysplasia, Perthes disease); stifle (patellar luxation, cranial cruciate ligament disease, osteochondritis dissecans [OCD]); elbow (elbow dysplasia, elbow OCD, fragmentation of the medial coronoid process, incomplete ossification of the humeral condyle); shoulder (shoulder OCD, developmental shoulder subluxation); tarsus (OCD of the talus), and carpus (carpal laxity, carpal subluxation secondary to chondrodystrophy); and metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joint degenerative osteoarthritis (digital osteoarthritis) .

Cannabinoids were found to treat pain secondary to inflammation in a variety of studies on humans. Some of the most compelling research has shown that cannabis can reduce the inflammation in the joint caused in human patients diagnosed with immune mediated arthritis.15 One study found that cannabinoids could simultaneously reduce the secretion of cytokines involved in inflammation from one type of TH immune cells, which were being under-produced, while also increasing their numbers to correct their scarcity.15 Furthermore in a study in 2003, researchers found that plant-based cannabinoids could suppress the expression of interleukin-1betaone of the most prominent markers for inflammation in patients with rheumatoid arthritisby as much as 50%.16 And finally, in 2006, transdermal applications of CBD were shown to decrease biomarkers that can contribute to neurogenic inflammation in a sample of arthritic rats. 17

A report published in the journal of PAIN, lead by researchers at Baylor College of Medicine revealed the results of a large, double blinded, placebo controlled study on the positive effects CBD had in the fight against osteoarthritis.18 The study was designed with two main goals: The first portion of the research studied the effect CBD had on the inflammatory molecules and cells in mice.18 The second portion of the study, investigated whether CBD improved the quality of life in dogs diagnosed with osteoarthritis. In lab tests and in mouse models, CBD significantly decreased the production of natural chemicals that promote inflammation and it increased the natural chemicals that fight inflammation.18 Essentially, what they saw was a drop in proinflammatory cytokines and an increase in anti-inflammatory cytokines. 18 For dogs with osteoarthritis, CBD significantly decreased pain and increased mobility in a dose-dependent fashion. Importantly, A lower dose of liposomal CBD was as effective as the highest dose of nonliposomal CBD, indicating that the effect of CBD was quicker and more effective when CBD was delivered encapsulated in liposomes than without.18 Blood samples indicated no significant harmful side effects, or adverse events, over the 4-week analysis period.18 Although this study is very promising and it supports the safety and therapeutic potential of hemp-derived CBD for relieving arthritic pain in dogs, it is important to consult with your pets veterinarian before giving any supplement or medication.

In the veterinary population, use of cannabidiol and other alternative treatments may have the potential to obviate the need for other medications, and thus spare patients from adverse effects associated with their use. More likely, the use of cannabinoids could be additive or synergistic in a multimodal treatment strategy and could increase quality-of-life issues associated with painful arthritic conditions.

Intervertebral Disk Disease

As our patients age, discs in the spine also undergo degenerative changes. Thus, degeneration of intervertebral discs is evitable. This process of degeneration is multifactorial process and it involves hypoxia, inflammation, neoinnervation, accelerated catabolism, and reduction in water and glycosaminoglycan content.39 The magnitude and severity of disc degeneration can vary widely between patients. The most common locations of clinically relevant disc disease are located in the cervical spine, thoracolumbar spine, and the lumbosacral spine.40 Although there are various manifestations of disc disease, broad classifications of Hansen Type I and Type II are typically used to describe the condition. In short, disc material may either extrude (acute herniations) or protrude (chronic herniations), both of which compress the spinal cord which ultimately can cause pain, paresis, paralysis and other neurological deficits.40 The prevalence of thoracolumbar disc disease dogs has been estimated at 3.5%.40 Depending on the neurologic examination, diagnosis, severity, prognosis, and other factors, surgery may be recommended to decompress the spinal cord.

After surgical decompression, there are a host of challenges that the the patient, the family, and the surgeon, may have to work through including a potentially protracted recovery, recurrence of neurological signs, post surgical pain, spinal instability, urinary disorders, (cystitis, urinary tract infection, urinary retention, micturition disorders), ascending myelomalacia, and others.41 Could CBD play a part in helping to improve those affected by disc disease pre-, intra-, or post-operatively and what types of spinal disorders could benefit from CBD? A study conducted on the use of CBD in mice with degenerative disc disease showed promise in mitigating the effect of disc damage and wear.19 Instead of being ingested orally, CBD was injected at the site of the disc. Researchers investigated the effects of cannabidiol intradiscal injection using a combination of MRI and histological analyses.19 A puncture was created in the disc and then CBD was injected into the disc (30, 60 or 120 nmol) shortly after.19 The effects of intradiscal injection of cannabidiol were analyzed within 2 days by MRI.17 Fifteen days later, the group that received cannabidiol 120 nmol was resubmitted to MRI examination and then to histological analyses after the cannabidiol injection.19 What they found was that cannabidiol significantly decreased the effects of disc injury induced by the needle puncture.19 These results suggest that this compound could be useful in the treatment of intervertebral disc degeneration perhaps using a novel route of administration.

Unfortunately, the exact mechanism for how CBD oil helped protect disc damage is still being investigated. The hope is that the neuroprotective properties of cannabidiol can also be found in the study of canine and feline disc disease to ultimately improve functional recovery.

References:

Kogan L, Schoenfeld-Tacher R, et al. US Veterinarians' Knowledge, Experience, and Perception Regarding the Use of Cannabidiol for Canine Medical Conditions. Front Vet Sci. 2018;5:338.

Abd-Elsayed A., Deer T.R. (2019) Different Types of Pain. In: Abd-Elsayed A. (eds) Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-99124-5_3

Manzanares J, Julian MD, Carrascosa A. Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes Curr Neuropharmacol. 2006 Jul; 4(3): 239257.

Abraham AD, Leung EJ, Brenden A, Wong BA, Rivera ZM, Kruse LC, et al. Orally consumed cannabinoids provide long-lasting relief of allodynia in a mouse model of chronic neuropathic pain. 2020 Jun;45(7):1105-1114. doi: 10.1038/s41386-019-0585-3. Epub 2019 Dec 7.

Capano A, Weaver R, Burkman E. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgrad Med. 2020 Jan;132(1):56-61. doi:10.1080/00325481.2019.1685298. Epub 2019 Nov 12.

Abraham AD, Leung EJ, Wong BA, Rivera ZM, Kruse LC, Clark JJ, Land BB. Orally consumed cannabinoids provide long-lasting relief of allodynia in a mouse model of chronic neuropathic pain. Neuropsychopharmacology. 2020: 45:11051114.

Johnson, J., Austin, C., & Breur, G. Incidence of Canine Appendicular Musculoskeletal Disorders in 16 Veterinary Teaching Hospitals from 1980 through 1989. Veterinary and Comparative Orthopaedics and Traumatology, 07(02), 5669. (1994). doi:10.1055/s-0038-1633097

Kogan NM, Melamed E, Wasserman E. Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts J Bone Miner Re. 2015 Oct;30(10):1905-13. doi: 10.1002/jbmr.2513. Epub 2015 May 10.

Kamali, A., Oryan, A., Hosseini, S., Ghanian, M. H., Alizadeh, M., Baghaban Eslaminejad, M., & Baharvand, H. Cannabidiol-loaded microspheres incorporated into osteoconductive scaffold enhance mesenchymal stem cell recruitment and regeneration of critical-sized bone defects. Materials Science and Engineering: (2019). C, 101, 6475. doi:10.1016/j.msec.2019.03.070

Bab I, Zimmer A. Cannabinoid Receptors and the Regulation of Bone Mass. British Journal of Pharmacology. 2007 153:182-188 doi:10.1038/sj.bjp.0707593

I. Idris, A. Cannabinoid Receptors as Target for Treatment of Osteoporosis: A Tale of Two Therapies. Current Neuropharmacology. 2010. 8(3), 243253. doi:10.2174/157015910792246173

Meliha Karsak et al. The Cannabinoid Receptor Type 2 (CNR2) Gene Is Associated with Hand Bone Strength Phenotypes in an Ethnically Homogeneous Family Sample. Human Genetics. 2009. 5:629-36 doi:10.1007/s00439-009-0708-8.

Loder, R. T., & Todhunter, R. J. The Demographics of Canine Hip Dysplasia in the United States and Canada. Journal of Veterinary Medicine. 2017 115. doi:10.1155/2017/5723476

ONeill DG, Brodbelt DC, Hodge R,. Church DB, Meeson RL. Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK. Canine Medicine and Genetics. 2020 volume 7:1

Susan H. Pross et al. Differential Suppression of T-cell Subpopulations by THC (delta-9- tetrahydrocannabinol). International Journal of Immunopharmacology 12, no. 5 (1990): 539-44. doi:10.1016/0192-0561(90)90118-7

Robert B. Zurier et al. Suppression of Human Monocyte Interleukin-1 Production by Ajulemic Acid, a Nonpsychoactive Cannabinoid. Biochemical Pharmacology. 2003 4:649-55. doi:10.1016/s0006-2952(02)01604-0.

D.c. Hammell et al. Transdermal Cannabidiol Reduces Inflammation and Pain-related Behaviours in a Rat Model of Arthritis. European Journal of Pain. 2015 6:936-48. doi:10.1002/ejp.818

Verrico, C. D., Wesson, S., Konduri, V., Hofferek, C. J., Vazquez-Perez, J., Blair, E., Halpert, M. M. A randomized, double-blind, placebo-controlled study of daily cannabidiol for the treatment of canine osteoarthritis pain. 2020. Pain. doi:10.1097/j.pain.0000000000001896

Silveira, J. W., Issy, A. C., Castania, V. A., Salmon, C. E. G., Nogueira-Barbosa, M. H., Guimares, et al. Protective Effects of Cannabidiol on Lesion-Induced Intervertebral Disc Degeneration. 2014. PLoS ONE 9:12 doi:10.1371/journal.pone.0113161

Yam, M., Loh, Y., Tan, C., Khadijah Adam, S., Abdul Manan, N., & Basir, R. . General Pathways of Pain Sensation and the Major Neurotransmitters Involved in Pain Regulation. International Journal of Molecular Sciences. 2018 19(8), 2164. doi:10.3390/ijms19082164

Costigan, M., Scholz, J., & Woolf, C. J. Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage. Annual Review of Neuroscience. 2009 32(1), 132. doi:10.1146/annurev.neuro.051508.135531

Arora A, Taliyan R, Sharma PL. Ameliorative Potential of Cannabis Sativa Extract on Diabetes Induced Neuropathic Pain in Rats. International Journal of Pharmaceutical Sciences and Research 1. 2010 https://www.researchgate.net/publication/216536386_Ameliorative_potential_of_cannabis_sativa_extract_

Mark S. Wallace et al., Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. 2015. Pain 16(7): 616-27 doi:10.1016/j.jpain.2015.03.008.

Gruen, M. E., Roe, S. C., Griffith, E., Hamilton, A., & Sherman, B. L.. Use of trazodone to facilitate postsurgical confinement in dogs. Journal of the American Veterinary Medical Association. (2014) 245(3), 296301. doi:10.2460/javma.245.3.296

Serra, G., & Fratta, W. A possible role for the endocannabinoid system in the neurobiology of depression. Clinical Practice and Epidemiology in Mental Health. 2007. 3(1), 25. doi:10.1186/1745-0179-3-25

Kim, E. J., Pellman, B., & Kim, J. J. Stress effects on the hippocampus: a critical review. Learning & Memory. 2015. 22(9), 411416. doi:10.1101/lm.037291.114

Demirakca, T., Sartorius, A., Ende, G., et al. Diminished gray matter in the hippocampus of cannabis users: Possible protective effects of cannabidiol. 2010. Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2010.09.020

Mateus M. Bergamaschi et al. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Nave Social Phobia Patients. Neuropsychopharmacology. 2011 36(6):1219-26 doi:10.1038/npp.2011.6.

Jos Alexandre S Crippa et al. Neural Basis of Anxiolytic Effects of Cannabidiol (CBD) in Generalized Social Anxiety Disorder: A Preliminary Report. Journal of Psychopharmacology. 2010. 25: 1doi:10.1177/0269881110379283.

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Pamplona, F. A., da Silva, L. R., & Coan, A. C. Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis. 2018. Frontiers in Neurology, 9. doi:10.3389/fneur.2018.00759

Palmieri B, Laurino C, Vadal M. A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. Mar-Apr 2019;170(2):e93-e99. doi: 10.7417/CT.2019.2116.

Sangiovanni, E., Fumagalli, M., Pacchetti, B., Piazza, S., et al.. Cannabis sativa L. extract and cannabidiol inhibit in vitro mediators of skin inflammation and wound injury. (2019). Phytotherapy Research. doi:10.1002/ptr.6400

B. Van Klingeren and M. Ten Ham. Antibacterial Activity of 9-tetrahydrocannabinol and Cannabidiol. 1976. 42(1-2): 9-12 doi:10.1007/bf00399444.

Giovanni Appendino et al. Antibacterial Cannabinoids From Cannabis Sativa: A StructureActivity Study. 2008. Journal of Natural Products 71(8):1427-430, doi:10.1021/np8002673

McIver, V., Tsang, A., Symonds, N., Perkins, N., et al. Effects of topical treatment of cannabidiol extract in a unique manuka factor 5 manuka honey carrier on second intention wound healing on equine distal limb wounds: a preliminary study. 2020. Australian Veterinary Journal. doi:10.1111/avj.12932

White, D. M., Mair, A. R., & Martinez-Taboada, F. Opioid-free anaesthesia in three dogs. Open Veterinary Journal. 2017 7(2), 104. doi:10.4314/ovj.v7i2.5

Hansen T, Smolders LA, Tryfonidou MA, et al: The Myth of Fibroid Degeneration in the Canine Intervertebral Disc: A Histopathological Comparison of Intervertebral Disc Degeneration in Chondrodystrophic and Nonchondrodystrophic Dogs. Vet Pathol 2017 Vol 54 (6) pp. 945-952.

40. Jeffery ND, Levine JM, Olby NJ, et al: Intervertebral disk degeneration in dogs: consequences, diagnosis, treatment, and future directions. J Vet Intern Med 2013 Vol 27 (6) pp. 1318-33.

41. Balducci F, Canal S, Contiero B, et al: Prevalence and Risk Factors for Presumptive Ascending/Descending Myelomalacia in Dogs after Thoracolumbar Intervertebral Disk Herniation. J Vet Intern Med 2017 Vol 31 (2) pp. 498-504.

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Unraveling the use of CBD in veterinary medicine - Jill Lopez

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categoriaSkin Stem Cells commentoComments Off on Unraveling the use of CBD in veterinary medicine – Jill Lopez | dataSeptember 1st, 2020
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