Monday, 19 August 2019

Pharmaceutical microbiology: current and future challenges


On 15th October 2018 Tim Sandle delivered the key note address to the PDA Microbiology Europe conference. Tim Sandle has written an article which takes the form of an edited transcript of the presentation.

Whilst there is a continuing need for monitoring of the environment and conducting standardized laboratory tests, pharmaceutical microbiology has moved on to embrace:
  • Microbiological audits;
  • Rapid microbiological methods;
  • Conducting risk assessments, both proactive in terms of minimizing contamination and reactive, in terms of addressing microbial data deviations;
  • Ensuring that processes meet ‘quality by design’ principles;
  • And getting the microbiologist away from the bench and into the plant.

These themes are captured in the auricle, for which the reference is:

Sandle, T. (2019) Pharmaceutical microbiology: current and future challenges, Pharmig News, Issue 75, pp12-15

For details, please contact Tim Sandle

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Sunday, 18 August 2019

Some Useful Tips to Open PCD Franchise Company


India carefully monitors their healthcare services, so opening a pharma company in India can be a good business idea. In this guide, we will explain how to open a monopoly pharma franchise company in India. Find out the requirements, read the tips for choosing a place to place a new business and consult the list of the best franchises currently operating in India.

A guest post by Satvir Singh

Open a PCD pharma franchise in India:

In addition to selling over-the-counter drugs, you can sell health and beauty products, such as cosmetics, baby products, and food for specific needs, such as celiac disease, diabetics or low-calorie products, and most veterinary drugs.

Do I need to have a pharmaceutical education to open a pharmacy in India? This may surprise you, but the answer is no. Having 3-5 years of working experience in the pharma sector is enough. But if you do not have an education, you will definitely need to hire a qualified pharmacist to sell medicines. This means that the owner of the company can be anyone, but in this case he will have to consider the need for constant cooperation with one or more certified pharmacists.

The presence of a pharmacist is not the only requirement required to open a pharmacy.

Requirements for opening a pharmacy in India

As we explained several paragraphs above, even if you do not need to have a pharmacist diploma to open a pharmacy, there are other requirements and procedures that must be followed. For example, you need to get a ISO, GMP and WHO certificates if you decide to sell pharma product and supplements, even if they are packaged.

As for opening a pharmacy, you also need:

Request registration of a pharmacy at the Ministry of Health & FSSAI
Make a message about starting a business in the municipality

Register with the Chamber of Commerce.

The second and third points are not different from the procedure for opening any other business. Registration of activities in the Ministry of Health is the only way to organize the subsequent delivery of drugs to the warehouse of the outlet. In fact, after checking the submitted documentation, the pharmacy will be assigned the code necessary for the purchase of medicines. In addition, after obtaining permission from the Ministry of Health, the company will be registered in the database of authorized pharmacies and pharmacies and, therefore, can sell its products even through the Internet.

How to choose a place for the pharmacy: a few tips?

Some franchise requires certain functions from the premises in which the franchisee’s pharmacy will be opened. However, regardless of this, keep in mind that it is always recommended to open a company in areas with a large inflow of people, in any case, in urban centers, at least medium-sized.
Always make sure that there are no other suppliers in the immediate locality, and in any case carefully consider whether a potential clientele, based on the population of the area, can be sufficient for a new point of sale.

As for the size of the place, an average / large area is always recommended. Keep in mind that you definitely need a medium size store room. You can take assistance from the top PCD pharma franchise company listed on PharmafranchiseeIndia . Our experts are always there to help you out and clear your doubts and answer your questions 24/7.


Careless disposal of medicines increases antimicrobial resistance

There are a number of ways by which antimicrobial resistance can spread, and one that is of growing concern is the disposal of medicines by consumers down sinks and toilets. A new technique can help to assess the extent of the spread.

Antimicrobial resistance is an established global health problem which is characterized by the ability of microorganisms to counter the effects of medicines. The threat posed by this to human populations is such that the tackling of the problem is classed as one of the Sustainable Development Goals of the World Health Organization.

One factor that is not helping with the rise of antimicrobial resistance is the way that medicines are disposed of. Various reports indicate the significant role of the environment in the emergence and spread of resistance to antimicrobials. Antimicrobials, like antibiotics, enter the environment through too many people choosing to dispose of medicines themselves at home (such as by flushing the unwanted medications down a sink of via the toilet) rather than returning the unused medication to the originating pharmacy for safe disposal.

As to how widespread the presence of antimicrobial organisms are in the sewage system and the extent that this related to human activity has been difficult to discern, particularly any variations with the patterns of resistance worldwide. A new method, based on a mix of genetics and statistical analysis aims to address this knowledge gap.

The novel method, which comes from the Technical University of Denmark, involves assessing genetic materials recovered from untreated sewerage. The technique demonstrates how this analysis can assist scientists which identifying antimicrobial resistance patterns in areas where there are human populations worldwide. The focus of the research, and where data was collected for the analysis, was in regions of Africa, Asia and South America. These data, where it was found there are high levels of antimicrobials, were contrasted with North America and Western Europe, where levels were found to be relatively lower.

These patterns were visualized through an examination of the genetic materials extracted from untreated sewerage in 74 cities, from samples drawn across 60 countries. The follow-up step was to analyze the data using statistical methods. From this, the researchers were able to estimate patterns of resistant bacteria across different global regions.

According a summary by Science Development: "The countries standing out as having the most divergent distribution of antimicrobial resistance genes were Brazil, India and Vietnam, suggesting that these countries could be hot spots for emergence of novel antimicrobial resistance mechanisms."
The concern for less developed regions is that antimicrobial resistance gene abundance strongly correlates with socio-economic, health and environmental factors, meaning that countries with fewer resources and poorer populations will face greater challenges in addressing the concern.
The new method to assess resistance patterns has been reported to the journal Nature Communications, where the paper is titled "Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage."

Written by Dr. Tim Sandle, Pharmaceutical Microbiology

Saturday, 17 August 2019

Is anxiety linked to our gut microbiome?

Microbiome research has advanced considerably since the first results from the U.S. National Institutes of Health led Human Microbiome Project were released. One area of interest is the connection between our microorganisms and anxiety symptoms. At first glance, the connection between the array of different microorganisms that are found within the human gut and feelings such as anxiety is not an obvious one. However, there is a growing level of evidence that variations within microbial communities are influential upon metabolic processes.
Human microbiome
The human microbiome refers to the totality of microorganisms and their genetic interactions within a given niche. Our understanding of the microbiome has advanced following a study of 300 men and women, who volunteered to take part in an international study. The advancement in understanding relating to developments with the methods used to characterize the microorganisms (including metagenomics) and the in-depth nature of the study, relating to the sampling of many body parts over a prolonged period of time, and drawing upon of the subjects from different geographical locales.
FDA microbiologist prepares DNA samples for gel electrophoresis analysis
FDA microbiologist prepares DNA samples for gel electrophoresis analysis
FDA / File
With the specific effects in relation to the human gut, then the understanding by scientists of the gut-brain axis has increased during the past ten years, suggesting a bidirectional nature between the gut and brain microbiome interactions. This includes a connection relating to the pathophysiology and pathogenesis of irritable bowel syndrome (IBS), as an example.
In another research field, there is growing evidence of psychiatric and neurologic disorders like autism spectrum disorders, affective disorders, Parkinson's disease, and multiple sclerosis, being connected to the human gut microbiome.
The reason for this is that, with most people, the gut microbiota assist with the healthy functioning of the immune system. Furthermore, organisms assist with the metabolism by contributing inflammatory mediators, vitamins, and nutrients. Moreover, microbiologists have demonstrated that the intestinal microbiota can modulate communication between the intestinal tract and human brain via the nervous, immune, and endocrine systems.
It may be possible to treat superbugs with a predatory bacteria.
It may be possible to treat superbugs with a predatory bacteria.
University of Nottingham
However, when the intestinal microbial balance is altered, then changes occur and these can be manifest in terms of physical, and potentially mental, symptoms. One area being investigated in relation to a mental system is anxiety.
Anxiety
Anxiety is an emotion characterized by an inner turmoil. It is often accompanied by nervous behaviour, somatic complaints, and rumination. The condition includes subjectively unpleasant feelings of dread over anticipated events. When experienced regularly the individual may suffer from an anxiety disorder. The global incidence of anxiety disorder is estimated to be between 3-25 percent. Typical treatment for anxiety is usually psychopharmacological therapies and psychotherapy.
New research
With the new research, scientists have attempted to see if anxiety symptoms can be improved by regulation of intestinal microorganisms. By assessing some 3,334 published articles the researchers focus on 21 major studies. Across these studies,1,503 participants included "patients with IBS (10 studies), healthy controls (six studies) and other patients with chronic diseases such as chronic fatigue syndrome (CFS), rheumatoid arthritis (RA), obesity, fibromyalgia, and type 2 diabetes mellitus."
Of the 21 studies, 14 had chosen probiotics as interventions to regulate intestinal microbiota (IRIFs), and seven chose non-probiotic ways, such as adjusting daily diets. Those studies that utilized "interventions regulating intestinal flora" consisting of probiotics with Lactobacillus alone or a mixture of LactobacillusStreptococcus, and Bifidobacterium, showed some positive results. Overall, 11 of the 21 studies suggested a positive effect on anxiety symptoms by regulating intestinal microbiota, meaning that more than half (52 percent) of the studies showed this approach to be effective.
Some of the bacteria found by scientists in 3.5-billion-year-old fossils are now extinct  while oth...
Some of the bacteria found by scientists in 3.5-billion-year-old fossils are now extinct, while others are similar to contemporary microbes
MARTIN BERNETTI, AFP/File
To draw these conclusions the review was subjected to meta-analysis, considering the research design, subjects, interventions, and anxiety assessment scales. This drew out the connected between anxiety and disturbances to the gut microbiome and indicated that it may be possible to regulate the intestinal microbiota through the use of probiotics, although further research will be required.
The researchers conclude: "We find that more than half of the studies included showed it was positive to treat anxiety symptoms by regulation of intestinal microbiota.
"There are two kinds of interventions (probiotic and non-probiotic interventions) to regulate intestinal microbiota, and it should be highlighted that the non-probiotic interventions were more effective than the probiotic interventions. More studies are needed to clarify this conclusion since we still cannot run meta-analysis so far."
Research paper
The new research has been published in the British Medical Journal, with the research paper titled “Effects of regulating intestinal microbiota on anxiety symptoms: A systematic review.”

Written by Dr. Tim Sandle, Pharmaceutical Microbiology

Friday, 16 August 2019

ICH M10 on bioanalytical method validation


The draft ICH guidance is currently out for review. This proposed new multidisciplinary guideline will address the validation of bioanalytical assays. This guideline will provide recommendations on how to validate a bioanalytical assay for drug quantification and how to apply validation during study sample analysis. However, this guideline does not provide recommendations which analyte should be analysed. This is covered in other ICH and regional regulatory documents.

The draft looks at:

Concentration measurements of chemical and biological drug(s) and their metabolite(s) in biological matrices are used as part of regulatory decisions regarding the safety and efficacy of drug products. It is therefore critical that the bioanalytical methods used are well characterised, appropriately validated and documented in order to ensure reliable data to support regulatory decisions. The objective of the validation of a bioanalytical assay is to demonstrate that it is suitable for its intended purpose. This guideline is intended to provide recommendations for the validation of bioanalytical assays for chemical and biological drug quantification and their application in the analysis of study samples.

See: https://www.ema.europa.eu/en/ich-m10-bioanalytical-method-validation

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Thursday, 15 August 2019

EMA Offers Q&A on Using OOS Batches of Authorized ATMPs


The European Medicines Agency’s (EMA) Committee for Advanced Therapies (CAT), together with the GMDP Inspectors Working Group and the Blood Products Working Party, have released a questions and answers (Q&A) document on how companies should go about using OOS batches of authorized cell or tissue-based advanced therapy medicinal products (ATMPs).

See: https://www.ema.europa.eu/en/documents/other/questions-answers-use-out-specification-batches-authorised-cell/tissue-based-advanced-therapy-medicinal-products_en.pdf

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Wednesday, 14 August 2019

Biotechnology: From Idea to Market


A new and important book has been released "Biotechnology: From Idea to Market", edited by Fred Mermelstein, Carl Novina, and Richard Prince.

Biotechnology: From Idea to Market, is an invaluable guide and reference for anyone involved in the development of a product, from idea generation through commercialization.

The goal of this book is to provide this comprehensive overview for students and professionals alike in how to think about and to navigate the necessary development process for healthcare product candidates, including biologics, new chemical entities, and other related products that address medical need. This instructional text enables anyone at any level or in any sector of the industry to easily achieve a basic knowledge of the critical steps (or the questions to ask) to properly evaluate an idea or technology, develop a viable product candidate, and ultimately advance it to the marketplace.

Expertly conceived and crafted by co-editors Fred Mermelstein, Richard Prince, and Carl Novina, with a foreword by Nobel Laureate Philip Sharp, this book features 22 chapters written by renowned subject matter experts in their respective fields. Collectively, these chapters illuminate and unify the healthcare products innovation process, spanning from academia to industry, from research to commercialization.

See below for further details and visit the PDA Bookstore.

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Cost of Tick-Borne Disease Misdiagnosis


Nearly 36 percent of patients with a tick-borne disease spent more than $10,000 on tests, treatments, appointments, and other costs associated with their disease, a new IGeneX survey found.

The survey analyzed the cases of 198 patients from 2018 and 2019 who were tested by IGeneX, a leading testing lab in California. Researchers sought to determine how long it took for patients to obtain a proper diagnosis, how many doctors they had visited, and how much financial impact they had ultimately incurred.

According to the survey:

• 45% of patients needed more than three years to obtain the proper diagnosis
• 65% of patients were forced to quit a job or cut back on their hours due to their symptoms
• 24% of patients saw more than ten doctors before receiving a proper diagnosis
• 86% of patients suffer from long-term side effects from not having been diagnosed sooner

Most experts agree that the best patient outcomes are achieved when Lyme disease and other tick-borne diseases are diagnosed and treated as early as possible. “When a tick-borne illness is misdiagnosed, the disease-causing infection has more time to spread, which can lead to more severe or chronic health issues,” says Dr. Jyotsna Shah, President of IGeneX. “That can lead to months and even years of escalating costs for patients and their families due to ongoing doctor visits, diagnostic tests, ineffective medications, and other medical expenses.”

Tick-borne diseases are on the rise and prevention should be on everyone’s mind, particularly during the spring, summer, and early fall when ticks are most active. Prevention and early detection are part of the safety protocol extended by the Centers for Disease Control and Prevention.

Researchers hope that the survey will help educate the public on the risks associated with delaying testing or relying on old testing techniques. "In our view, many patients are missed because much of the testing recommended by general practitioners is based on technology from 25 years ago," says Dr. Shah. "Science has progressed, and we can now give patients a much more accurate diagnosis than was available years ago."

For an infographic of key findings from the survey, please go here. For a complete view of the survey results, please go here. For more information on tick-borne diseases and how to get tested, please visitwww.igenex.com or www.cdc.gov.

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Tuesday, 13 August 2019

Malaria - High-Tech Bednet Use Monitoring Tool


Study Finds High-Tech Bednet Use Monitoring Tool Produces Detailed Data on Daily Usage, Offering a New Tool to Study Declining Efficacy In Malaria Prevention

A new technology sewn into the lining of mosquito-fighting bednets provides precise, detailed data on household bednet use, insights that could help answer why the effectiveness of this mainstay of malaria control appears to be waning, according to a new study from researchers at the University of California, San Francisco appearing today in the American Journal of Tropical Medicine and Hygiene.

A global effort to distribute long-lasting insecticide-treated bednets has been credited as a key force driving a dramatic reduction in malaria infections and deaths. But the researchers cited recent studies indicating that bednets may no longer be as effective as previously thought, though exactly why is not clear.

Researchers developed and tested a technology called SmartNet that uses a battery-powered microcontroller connected to a conductive fabric in the bednets to record when they are in use or folded up. Testing in 10 households in rural Uganda over 418 days found average use was relatively high—85 to 90 percent between 9 p.m. and 6 a.m., when malaria-carrying mosquitoes are out in force. But usage was also highly variable, with some households using them only half as much as others and in some instances failing to use them at all, increasing risks of malaria.

The researchers hope this kind of automated monitoring can provide an inexpensive, unobtrusive way of tracking household patterns of bednet use. They note that while the search to understand the decline in bednet efficacy has focused on mosquito biting behavior, insecticide resistance and bednet durability, the role of human behavior “is a potentially important and under-researched component” of the problem.

>> Abstract


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Monday, 12 August 2019

Best practices for microbial control


Sterile pharmaceutical products need to be manufactured to the highest possible standards and the technology, processes and regulatory expectations continue to shift. Understanding these changes, in light of the latest regulatory thinking, was theme of a two-day event in the Adriatic region.

In relation to this area of microbiological best practices, Tim Sandle has written a new article. The reference is:

Sandle, T. (2019) Best practices for microbiological control, Pharmig News, Issue 75, pp6-7

For details, contact Tim Sandle

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Sunday, 11 August 2019

Are the ‘viral’ agents of MS, ALS and schizophrenia buried in our genome?


What if the missing ‘environmental’ factor in some of our deadliest neurological diseases were really written in our genome?

Writing in Frontiers in Genetics, researchers from the University of Düsseldorf explain how viruses ended up in our DNA – and what puts them in the frame in unsolved diseases like multiple sclerosis.

The enemy within

A whopping 8% of our DNA comes from viruses. Specifically, ones called retroviruses – not because they’re old, but because they reverse the normal process of reading DNA to write themselves into their host’s genome.

Retroviruses are old though: they began merging with our earliest, primordial ancestors millions of years ago. Over the millennia, most of their remnants in our DNA – known as human endogenous retroviruses or HERVs – have been silenced by mutations. Others, which had evolved to fend off rival viruses, formed the prototypical immune system and to this day protect us from infection.

However, HERVs might also be the missing causative link in major ‘unsolved’ neurological diseases.

“HERVs have been implicated in the onset and progression of multiple sclerosis [MS], amyotrophic lateral sclerosis [ALS] and schizophrenia [SCZ],” says senior author Prof. Patrick Küry. “Dormant HERVs can be reactivated by environmental factors such as inflammation, mutations, drugs, or infection with other viruses, so could provide a mechanism for their well-established epidemiological link to these disorders.”

Role in MS

So far, the strongest evidence links HERVs to MS.

“MS is caused by direct autoimmune attacks on myelin – the fatty coating of nerve cells – in the brain and spinal cord,” explains Küry. “But we don’t yet understand how these attacks are triggered.”

A variety of studies suggest that reactivation of HERV could be just such a trigger.

“Retroviruses were first associated with MS in 1989, but only decades later was it realized that these are in fact HERVs.

“Subsequently, it was shown that levels of HERV RNA and protein – the ‘readouts’ from reactivated HERV DNA – are increased in the brain and spinal cord fluid [CSF] of sufferers, as well as in their brain tissue postmortem.

“Linking this HERV reactivation to autoimmune attacks in MS, it was found that HERV proteins can trigger an immune response against myelin, which triggers MS-like disease in mouse models.”

Mechanistically, HERV proteins could trigger autoimmunity through ‘molecular mimicry’.

“In addition to direct effects of HERV on myelinating cells, several groups report structural similarities between HERV and myelin oligodendrocyte glycoprotein – a molecule displayed on the surface of myelin. This similarity could fool the immune system into damaging myelin, when it mounts an attack on HERVs.”

Experimental proof in humans

Similar experiments have linked HERVs to the peripheral demyelinating disease CIDP, as well as more distinct disease processes like progressive loss of motor neurons in ALS (Lou Gehrig's disease).

In schizophrenia, a complex neurodevelopmental disorder, the link to HERVs is more circumstantial.

“HERV proteins have been reported to increase expression of schizophrenia-linked genes in cultured human brain cells,” reports Küry. “However, studies on schizophrenia sufferers show inconsistent changes in HERV expression in blood, CSF and postmortem brain tissue compared to healthy controls.”

Whether or not HERVs contribute to these and other unexplained neurological conditions requires further investigation. An important step will be to test the effects of HERV-neutralizing antibodies in humans.

“Of note, in relapsing MS patients a phase 2b clinical trial using HERV protein-neutralizing antibody Temelimab has been conducted. We’re now waiting to see if the treatment showed beneficial effects on remyelination or attenuated neurodegeneration.”

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Saturday, 10 August 2019

U.S. Must Ensure Resources to Adequately Address the Healthcare Issues of Migrants


To see migrants dying while fleeing for their lives anywhere in the world is heartbreaking. The most recent picture of the Salvadoran father and his daughter face down on the banks of the Rio Grande is a tragic confirmation that what is happening on the U.S. southern border is unacceptable from a health policy and humanitarian standpoint.

From the American Society of Tropical Medicine and Hygiene

“Human migration has always occurred and will always occur as people flee persecution, war, famine and climate change, or flee toward a better life for themselves and their families,” states Chandy C. John, MD, MS, FASTMH, President of the American Society of Tropical Medicine and Hygiene. “As a pediatrician, the detention of children, and the separation of children from their parents, both of which may have lifelong consequences for that child and their family, is deeply disturbing to me.”

As a global scientific Society grounded in respect for all people everywhere, ASTMH believes in upholding principles of international human rights law. We must uphold international standards for the appropriate care of children, including no detention of children and basic humanitarian standards such as appropriate medical care.

As a Society of scientists and clinicians that understand firsthand the health conditions impoverished and desperate people around the world face, ASTMH implores Congress and the Administration to ensure that the resources are available to adequately address the healthcare issues of migrants. It’s the right thing to do and the smart thing to do. Ignored or undertreated health issues of migrants will likely lead to avoidable and costly financial and human costs. In addition, outbreaks of communicable disease can occur, putting those in refugee camps and unsanitary urban encampments at risk.

We can do better. Migration medicine research and tools ensure that. The recent Congressional appropriations bill authorizing $4.6 billion in humanitarian aid is a welcome first step that must be followed by swift action on the ground. The U.S. Customs and Border Protection as well as their partner agencies within HHS, including CDC and the Administration for Children and Families, must receive the necessary resources and skilled personnel to diagnose, treat and assist migrants with any health issue.

Without safe, orderly migration, human lives are tragically lost, and societies as a whole are lessened. The issue of migration and migration medicine is a test of our humanity, and our responses, both positive and negative, will have implications for many years to come.

ASTMH stands ready to work with Congress and the Administration to develop evidence-based migration policies. By working together, we can see safe, orderly policies put into place that reflect the ideals and values of all Americans.



Friday, 9 August 2019

Massive antibody discovery used to probe structure–function relationships


A paper of interest:

Study title: 'Massive antibody discovery used to probe structure–function relationships of the essential outer membrane protein LptD'

The overuse and misuse of antibiotics has led to the rise of multi-drug resistant bacteria which threaten global public health. Antibiotics interfere with essential processes in bacteria so they are unable to divide or survive, but over time, the microbes have found ways to become immune to the drugs. New antibiotics are now desperately needed.

Gram-negative bacteria are wrapped in an outer membrane made of large molecules called lipopolysaccharides. This structure is an extra barrier to molecules (such as drugs) that try to enter the cell, but it could also hold new targets for antibiotics to exploit.

A protein called LptD is embedded in the outer membrane, where it inserts new lipopolysaccharides. It is critical for bacteria to grow and survive, and is a relatively new potential target for antibiotic development. The protein has a number of ‘extracellular loops’ that extend into the environment, but their roles in the structure and the activity of LptD are still largely unknown. This is partly due to a lack of tools to investigate these elements.

In response, Storek et al. built a library of over 3,000 custom antibodies, which are small Y-shaped proteins that can each recognise a specific portion in one of the extracellular loops and potentially incapacitate LptD. The antibodies were used to target LptD in its native environment, when it is embedded in the bacteria. In parallel, mutant bacteria were created in which the loops were genetically removed one by one to assess their importance for LptD activity.

The experiments revealed that although the antibodies could target most extracellular loops, they could not target the few loops that were essential for LptD to work properly. This suggests that antibody-accessible loops are expendable and that these structures could serve to shield other regions of LptD which are critical for survival.

The findings will help to prioritise research that develops other approaches to inhibit LptD. Finally, the antibody workflow designed by Storek et al. can serve as a road map to study other membrane proteins in their native cellular environment.

Full plain-language summary ('eLife digest'): https://doi.org/10.7554/eLife.46258.002

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Thursday, 8 August 2019

FDA - Submitting Documents Using Real-World Data and Real-World Evidence


The FDA has issued a new guidance document, titled “Submitting Documents Using Real-World Data and Real-World Evidence to FDA for Drugs and Biologics.”

This guidance is intended to encourage sponsors and applicants who are using real-world data (RWD) to generate real-world evidence (RWE) as part of a regulatory submission to FDA to provide information on their use of RWE in a simple, uniform format.  FDA will use this information for internal tracking purposes only.  This guidance applies to submissions for investigational new drug applications (INDs), new drug applications (NDAs), and biologics license application (BLAs) that contain RWE used to support regulatory decisions regarding safety and/or effectiveness. 


For the purposes of this guidance, FDA defines RWD and RWE as follows: RWD are data relating to patient health status and/or the delivery of health care that are routinely collected from a variety of sources. RWE is the clinical evidence regarding the usage and potential benefits or risks of a medical product derived from analysis of RWD.



Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

Wednesday, 7 August 2019

Pneumonia mapped in largest genomic survey



Researchers have mapped the most common bacterial cause of pneumonia around the world and revealed how these bacteria evolve in response to vaccination. Scientists from the Wellcome Sanger Institute, Emory University (Atlanta, USA), and the U.S. Centers for Disease Control and Prevention carried out a global genomic survey of Streptococcus pneumoniae, discovering 621 strains across more than fifty countries.

The research reveals which strains of S. pneumoniae (also known as the pneumococcus) are circulating around the world and explains why pneumococcal pneumonia rates are still high despite the existing vaccines. Funded by a grant from the Bill & Melinda Gates Foundation, this work will help predict which strains will be important for new pneumococcal vaccines, and shows that ongoing global genomic surveillance is vital.

Pneumonia is an infection of the lungs that is responsible for the deaths of hundreds of thousands of people a year globally and is the single largest infectious cause of death of children under 5 years old worldwide. Streptococcus pneumoniae is the most common cause of bacterial pneumonia. Healthy people often carry these bacteria without becoming ill, but they can cause fatal infection, especially in young children and some adults.

Samples were collected both before and after PCV introduction, and the DNA sequences and health data were compared. This makes it possible to determine changes in the bacteria that could affect how well the vaccine protects against the pneumococcus, and whether new strains are emerging that would impact disease severity and ease of treatment.

The researchers discovered 621 genetic strains globally, each associated with one or more coat types. They also saw that the levels of non-vaccine type bacteria rose after the introduction of PCV, showing how bacteria evolve in response to the vaccine.

The pneumococcus can cause disease in other areas of the body too, for example infecting the brain or blood, causing meningitis or bloodstream infections, which can all lead to sepsis. Infant vaccination with PCV protects against these pneumococcal infections too. By reducing the transmission of S. pneumoniae between children, PCV also reduces the number of adult infections through herd immunity.


See:

Stephanie W Lo, Rebecca A Gladstone, Andries J van Tonder et al.  Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study. The Lancet Infectious Diseases, 2019; DOI: 10.1016/S1473-3099(19)30297-X

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

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