Thursday, 28 January 2021

Guidance on GMP & GDP: Q&A


The EMA has updated this Q&A relating to key GMP and GDP topics. Updates relate to two questions, which are questions 2 and 5:

EU GMP Guide Part 1 CH 5 Q2

 

This indicates that it is possible to use multiple batch numbers in packaging of medicinal products

 

Q5 relates to the requirements for batch numbers appearing on the packaging of medicinal products subject to parallel trade.

 

See: https://www.ema.europa.eu/en/human-regulatory/research-development/compliance/good-manufacturing-practice/guidance-good-manufacturing-practice-good-distribution-practice-questions-answers


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (http://www.pharmamicroresources.com/)

Wednesday, 27 January 2021

The State of Alzheimer’s Research in 2021

Image Source: Pixabay

A guest post by Indiana Lee

Neurodegenerative diseases have baffled and frustrated researchers and clinicians alike for decades. Despite prodigious advances in medical and biological science, Alzheimer’s Disease and related dementias have defied the experts’ staunchest efforts to understand the etiology of the disease or to intervene in its progression.

 

And that has meant that, for far too long, there had been devastatingly few options for victims, families, and healthcare providers. For too many years, patients, families, clinicians, and researchers had been largely powerless in the face of the mysterious and merciless adversary.

 

But that is changing. Every day, our understanding of progressive dementias grows. At any given moment, new and better diagnostic strategies are emerging. Now more than ever, we have an array of treatment options to slow the cognitive decline — and countless more are currently under development.

 

And that means that, though Alzheimer’s remains a fearsome nemesis, there is hope on the horizon, with an army of researchers leading the way.

An Understanding of Origins

Among the most exciting domains of Alzheimer’s research, today is in the field of microbiology. A growing body of research is supporting, and describing, the microbial mechanisms at work in the brains of patients with Alzheimer’s and other dementias.

 

Of particular interest is the role of gut bacteria in the progression of neurodegenerative diseases. According to recent research from the Human Microbiology Institute, bacteriophages, which are viruses that invade and replicate inside bacteria, appear to be implicated in the etiology of Alzheimer’s and related diseases.

 

These findings also seem to align with studies that have found that specific soy metabolites created by certain types of gut bacteria are strongly associated with fewer white matter lesions in the aging human brain. It is possible, therefore, that in the future, clinicians may be able to evaluate patients’ gut biome to assess their level of disease risk and perhaps even to intervene through dietary or pharmaceutical means.

 

However, it’s not only gut bacteria that seem to play a role. Research suggests that oral bacteria are also likely to contribute to neurodegenerative disorders, especially in those with a genetic predisposition to such diseases. Bacteria associated with gum disease, for example, are strongly associated with increased levels of inflammation, which can be damaging to the brain’s vascular system and may also contribute to the formation of plaques in the brain. Additionally, these oral bacteria are also highly likely to infiltrate the brain via the mouth’s circulatory system.

An Ounce of Prevention

This enhanced understanding of the complex etiology of Alzheimer’s and related dementias is, of course, fundamental to our efforts to mitigate risk factors and prevent or delay the onset of disease. For example, maintaining excellent oral health can be an important tool for avoiding pathological cognitive decline. Good, consistent oral care and the early treatment of periodontal disease, studies suggest, are especially important to the formation and proliferation of bacteria that can damage the brain.

 

Gene therapy is also proving to hold immense promise both for prevention and for the treatment of these disorders. For example, activation of p38gamma has been shown to significantly improve enzymatic memory. This, some studies suggest, may not only slow disease progression but may even reverse even severe memory loss.

Treatments on the Horizon

One of the greatest and most heartbreaking frustrations of neurodegenerative diseases like Alzheimer’s has been the appalling lack of effective treatment options for so many years. As our understanding of the origins and progression of these disorders grow, however, so too do the number of weapons in our arsenal.

 

In addition to gene therapies, managing the gut microbiome, and ensuring superb oral health, there are also a rapidly growing number of sophisticated and effective therapies. Most importantly, for the first time, emerging therapies are increasingly capable not only of treating disease symptoms but of slowing and mitigating disease evolution.

 

For example, therapies are being developed to prevent the formation of beta-amyloid plaques using a range of targeted therapies. These include the use of monoclonal antibodies to harness the power of the immune system to clear plaques from the brain, or the deployment of Fyn proteins to improve synaptic function.

 

In conjunction with the therapeutic approach, research is demonstrating the efficacy of a more holistic strategy. Lifestyle management that centers on the integration of diet, exercise, sleep, social interaction, and cognitive stimulation is highly effective in reducing symptoms and delaying disease progression.

The Takeaway

Neurodegenerative diseases are among the most feared and tragic of human ailments. And what makes it even worse, perhaps, is that for far too long there had been precious little that anyone could do about it. There is, however, significant hope on the horizon. As our understanding of the etiology and progression of these dreaded diseases grow, so too does our ability to delay, prevent, mitigate, and even reverse their effects. And that means that there may well soon come a day when no family is forced to face this long goodbye.

Tuesday, 26 January 2021

Excipients labelling




The European Medicines Agency (EMA) has updated this guidance relating to excipients labelling. Here Marketing Authorisation (MA) holders and applicants will need to identify the excipients included in any human medicine authorised in the EU in its product information.


The notification states that guidance is available from the European Commission and European EMA on what needs including in the labelling and package leaflet.


 

See: https://www.ema.europa.eu/en/human-regulatory/marketing-authorisation/product-information/reference-guidelines/excipients-labelling


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (http://www.pharmamicroresources.com/)

Monday, 25 January 2021

Recall trends and the primary causes for product recalls



Pharmaceutical product recalls relate to a type of flaw, ranging from mislabelling to contaminated ingredients. Generally, pharmaceutical companies conduct voluntary recalls in collaboration with a regulatory agency. This article looks at recent data for pharmaceutical recalls pertaining to the US and Europe, both as overall trends and in relation to specific occurrences. The assessment suggests that the rate of recalls is increasing.

Tim Sandle has written a new article:

Recall trends and the primary causes for product recalls, GMP Review, 19 (2): 4-9

The types of pharmaceutical products that undergo a recall are as varied as the available products on the market. They include over-the-counter, prescription and compounded drugs, ranging from tablets and capsules, injectable drugs, liquids, lotions and creams, and many more. Similarly, the reason for recalls are equally varied although there is more commonality in terms of the general types of problems that trigger recalls to occur.

The leading causes of pharmaceutical recalls are sterility, the presence of particulate/foreign matter, and failed specification testing, according to figures from the US Office of Pharmaceutical Quality. Every recall is different, so the financial impact varies greatly. It is based on a number of factors, including the number of units affected and the global reach of the recall. There are also indirect costs that need to be factored in. For example, if pharmaceutical companies don’t work with partners to execute the recall, their internal staff must step in at the expense of their usual duties.

This article presents the main types of recalls occurring within the US, Europe and other territories, noticing some differences in trends and approaches to recalls.
 

For details, please contact Tim Sandle

Or go to Euromed Communications to see how you can subscribe to GMP Review


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (http://www.pharmamicroresources.com/)


Sunday, 24 January 2021

Poor gut health connected to severe COVID-19




The connection between COVID-19 symptoms and other underlying health conditions continues to be researched. A new finding draws a connection between symptom severity and intestinal health, in relation to the gut microbiome.

As an example of one of the connections between COVID-19 symptom severity and an underlying health condition, it as been established that diabetes can make the disease worse. This is possibly because the coronavirus triggers inflammation in the body and high blood (glucose) sugar levels also cause inflammation inside our body, hence the action of the virus exacerbates the diabetic condition. 


With the new strand of research, scientists have examined emerging evidence suggesting that poor gut health adversely affects COVID-19 prognosis. Central to this the microbiome and the variations between the microbial communities in the gut between individuals. 

 The human microbiome refers to the totality of microorganisms and their genetic interactions within a given niche. The human body is an intricate system that hosts trillions of microbial cells across the epithelial surface, and within the mouth and gut. These microorganisms play a role in human physiology and organ function, including digestion and immunity. 



The research finds that intestinal dysfunction appears to exacerbate the severity of coronavirus infection. This is through enabling the virus to access the surface of the digestive tract and the internal organs. These organs are, in particular, vulnerable to infection because the cells have ACE2 on their surfaces, which is the protein target of the coronavirus. 


In terms of the cause, the researchers consider diet to be an important determinant. Of concern is the so termed "western diet", which is characterized by a diet low in fiber. A fiber-deficient diet is one of the main causes of altered gut microbiomes


The research has been published in the journal mBio, and it is titled "Do an Altered Gut Microbiota and an Associated Leaky Gut Affect COVID-19 Severity?"


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (http://www.pharmamicroresources.com/)

Saturday, 23 January 2021

Bacteria that survive on deadly copper surfaces



The descendants of regular wild-type bacteria can evolve to survive for a long time on metallic copper surfaces that would usually kill them within a few minutes. An international research team led by Martin Luther University Halle-Wittenberg (MLU) and the Bundeswehr Institute of Microbiology was able to produce these tiny survivalists in the lab and has been able to study them more closely. 


 

Bacterial infections are usually treated with antibiotics. However, in recent decades many pathogenic bacteria have developed an increasing tolerance to common drugs. So-called multidrug-resistant bacteria are of particular concern as they can no longer be combated with most antibiotics. Copper surfaces -- for example on door handles -- are a good weapon to fight these germs. 

Most bacteria die within minutes after landing on a copper surface.On the copper surfaces, however, the bacteria are literally flooded to death with copper ions because that they can no longer stave them off using their normal defence strategies.

Two typical species of bacteria, Escherichia coli and Staphylococcus aureus, are theoretically able to adapt to survive on copper surfaces. Researchers placed the bacteria on the surfaces for only a few minutes before returning them to a normal culture medium where they were allowed to recover. This process was repeated several times, with the survivors gradually being exposed to the deadly surface for longer and longer periods of time. Within three weeks, the researchers had produced bacteria that could survive for more than one hour on a copper surface. 

The inference is that if copper surfaces are not cleaned regularly, insulating layers of grease can begin to form on them, which could produce a similar development over time.

Using comprehensive genetic analyses, the researchers sought to understand why the bacteria no longer died on the surfaces. 

What happened was not genetic, but physiological: The bacteria's metabolism slowed down to a bare minimum and they fell into a kind of hibernation. Because most antibiotics aim to disrupt the metabolism of growing bacteria, they are almost completely ineffective against these special bacteria, which are also known as "persisters." 

There are always a handful of persisters in every generation. These are not considered antibiotic-resistant bacteria, because their offspring are once again susceptible to the drugs.

Normally only a tiny proportion of bacteria become persisters. However, in the case of the isolated bacteria, it was the entire population. Although they were able to grow just as fast as their predecessors, they were also able to rescue themselves by switching rapidly into an early state of persistence under adverse conditions. 

The bacteria also inherited this capability over 250 generations, even though the offspring had not come into contact with a copper surface.

It is recommended that copper surfaces be cleaned regularly and thoroughly with special agents so that no persister bacteria can develop in the first place. 




Journal Reference:


Pauline Bleichert, Lucy Bütof, Christian Rückert, Martin Herzberg, Romeu Francisco, Paula V. Morais, Gregor Grass, Jörn Kalinowski, Dietrich H. Nies. Mutant Strains of Escherichia coli and Methicillin-Resistant Staphylococcus aureus Obtained by Laboratory Selection To Survive on Metallic Copper Surfaces. Applied and Environmental Microbiology, 2020; 87 (1) DOI: 10.1128/AEM.01788-20


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (http://www.pharmamicroresources.com/)

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