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April 21, 2017
Digest

Higher Death Rate Among Youth With First Psychosis

Data showed that young people with a new psychosis diagnosis had surprisingly low rates of medical oversight and only modest involvement with psychosocial treatment providers.
Data showed that young people with a new psychosis diagnosis had surprisingly low rates of medical oversight and only modest involvement with psychosocial treatment providers.

A new study shows that young people experiencing first episode psychosis have a much higher death rate than previously thought. Researchers analyzed data on approximately 5,000 individuals ages 16-30 with commercial health insurance who had received a new psychosis diagnosis and followed them for the next 12 months. They found that the group had a mortality rate at least 24 times greater than the same age group in the general population in the 12 months after the initial psychosis diagnosis.

The study, funded by NIMH, underscores that young people experiencing psychosis warrant intensive and proactive treatments, services and support.

The research, led by Dr. Michael Schoenbaum, senior advisor for mental health services, epidemiology and economics at NIMH, was published online Apr. 6 by Schizophrenia Bulletin.

The research team used insurance claims data to identify young people ages 16-30 who had been diagnosed with a first episode of psychosis in 2008-2009. They used data from the Social Security Administration to identify deaths in this population within 12 months of the initial psychosis diagnosis. Data on cause or manner of death were not available for this research.

The 12-month mortality rate for these young people—from any cause—was at least 24 times higher than their peers in the general population. In the general United States population, only individuals over age 70 come close to a similar 12-month mortality rate.

“These findings show the importance of tracking mortality in individuals with mental illness,” said Schoenbaum. “Health systems do this in other areas of medicine, such as cancer and cardiology, but not for mental illness. Of course, we also need to learn how these young people are losing their lives.”

In addition to mortality, the study examined the health care individuals received in the 12 months after the initial psychosis diagnosis. Those data showed that young people with a new psychosis diagnosis had surprisingly low rates of medical oversight and only modest involvement with psychosocial treatment providers.

Monoclonal Antibody Cures Marburg Infection in Monkeys

Scientists funded by NIH have found that an experimental treatment cured 100 percent of guinea pigs and rhesus monkeys in late stages of infection with lethal levels of Marburg and Ravn viruses, relatives of the Ebola virus. Although the Marburg and Ravn viruses are less familiar than Ebola virus, both can resemble Ebola in symptoms and outcomes in people and both lack preventive and therapeutic countermeasures.

The research was published Apr. 5 in Science Translational Medicine.

The study involved giving the animals a therapeutic candidate, MR191-N, which is a monoclonal antibody derived from a person who survived Marburg disease. Monoclonal antibodies are immune system fighters designed to bind to a specific part of an invading virus or bacterium to treat disease.

The authors report that two doses of MR191-N were able to confer protection of up to 100 percent when treatment was started up to 5 days post infection. Prior studies of different experimental Marburg treatments involved daily dosing for 7 and 14 days, respectively, with treatment beginning closer to the time of infection.

The study was led by scientists at the University of Texas Medical Branch Galveston National Laboratory and Mapp Biopharmaceutical, Inc., and included collaborators from Vanderbilt University Medical Center, the University of Natural Resources and Life Sciences in Austria and the Scripps Research Institute. NIAID provided project funding.

The researchers are now working with NIAID’s preclinical services group to perform the additional safety testing necessary to advance the monoclonal antibody treatment to initial human clinical studies.

International Scientific Teams Find Potential Approach Against Parasites

The cyclic peptide ipglycermide binds to an
PGM enzyme, blocking its activity.
The cyclic peptide ipglycermide binds to an PGM enzyme, blocking its activity.

Research teams from NIH and abroad have identified the first inhibitor of an enzyme long thought to be a potential drug target for fighting disease-causing parasites and bacteria. The teams, led by NCATS and University of Tokyo scientists, sorted through more than 1 trillion small protein fragments called cyclic peptides to uncover two that could shut down the enzyme.

The finding, reported Apr. 3 in Nature Communications, could set the stage for the potential development of new types of antimicrobial drugs.

NCATS’ expertise in early-stage, pre-clinical molecule discovery helped the teams find potential drug candidates that could have implications for millions of people worldwide.

“The work is an excellent demonstration of how NCATS delivers on its mission to provide improvements in translational processes,” said Dr. Anton Simeonov, scientific director, NCATS Division of Pre-Clinical Innovation. “Scientists have shown that a therapeutic target, previously considered undruggable by pharmaceutical companies, is actually druggable through a non-traditional therapeutic agent.”

The target enzyme, cofactor-independent phosphoglycerate mutase (iPGM), is found in both parasites and bacteria.

Several types of parasitic roundworms have iPGM, including Brugia malayi and Onchocerca volvulus, which infect roughly 150 million people living mostly in tropical regions. These parasites can cause devastating infectious diseases such as river blindness.

The enzyme also is found in bacteria, including Staphylococcus aureus, which can cause the hospital- borne infection MRSA (methicillin-resistant Staphylococcus aureus), and Bacillus anthracis, which causes anthrax.

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