Publications by authors named "Howard Gendelman"

Antiretroviral therapy (ART) improves the quality of life for those living with the human immunodeficiency virus type one (HIV-1). However, poor compliance reduces ART effectiveness and leads to immune compromise, viral mutations, and disease co-morbidities. Here we develop a drug formulation in which a lipid-based nanoparticle (LBNP) carrying rilpivirine (RPV) is decorated with the C-C chemokine receptor type 5 (CCR5) targeting peptide.

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Diagnosing and then treating disease defines theranostics. The approach holds promise by facilitating targeted disease outcomes. The simultaneous analysis of finding the presence of disease pathophysiology while providing a parallel in treatment is a novel and effective strategy for seeking improved medical care.

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An extended action fostemsavir (FTR) lipid nanoparticle (LNP) formulation prevents human immunodeficiency virus type one (HIV-1) infection. This FTR formulation establishes a drug depot in monocyte-derived macrophages that extend the drug's plasma residence time. The LNP's physicochemical properties improve FTR's antiretroviral activities, which are linked to the drug's ability to withstand fluid flow forces and levels of drug cellular internalization.

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Article Synopsis
  • Antiretroviral therapy (ART) significantly enhances the quality of life for individuals with HIV-1, but issues with patient adherence can lead to negative health outcomes, including viral mutations and co-existing medical conditions.
  • A new drug delivery system using lipid nanoparticles (LNP) decorated with CCR5 is designed to effectively target and deposit rilpivirine (RPV) in areas where the virus hides, improving delivery and retention in immune cells.
  • This innovative approach, including the use of focused ultrasound to cross the blood-brain barrier, shows promise in enhancing HIV suppression, especially in hard-to-reach sites within the body such as the brain.
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Disordered immunity, aging, human immunodeficiency virus type one (HIV-1) infection, and responses to antiretroviral therapy are linked. However, how each factor is linked with the other(s) remains incompletely understood. It has been reported that accelerated aging, advanced HIV-1 infection, inflammation, and host genetic factors are associated with host cellular, mitochondrial, and metabolic alterations.

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The success of long-acting (LA) drug delivery systems (DDSs) is linked to their biocompatible polymers. These are used for extended therapeutic release. For treatment or prevention of human immune deficiency virus type one (HIV-1) infection, LA DDSs hold promise for improved regimen adherence and reduced toxicities.

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  • The World Health Organization has endorsed dolutegravir (DTG) as a primary treatment for individuals with HIV, expecting 15 million people to be treated with it by 2025, including pregnant women.
  • While DTG is effective and cost-efficient, there are concerns about its potential negative effects on fetal development, leading to a need for safer alternatives.
  • Researchers hypothesized that a long-acting injectable form of DTG (NDTG) could reduce fetal exposure and toxicity, showing that NDTG treatment in pregnant mice resulted in lower oxidative stress and better neurodevelopment outcomes compared to the standard oral DTG.
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  • Regulatory T cells (Tregs) can help manage immune responses but lack specific targeting in treating neurodegenerative diseases like Alzheimer's, which this study addresses by engineering Tregs to target amyloid-beta (Aβ) antigens.
  • The researchers created Tregs with a transgenic T cell receptor (TCR) specific for Aβ using CRISPR-Cas9 technology and tested their effectiveness in a mouse model of Alzheimer's disease.
  • Results showed that these engineered Tregs successfully reduced Aβ levels, improved cognitive functions, and had a positive impact on brain health, highlighting their potential as a targeted therapy for Alzheimer's disease.
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Objectives: To evaluate the linkage between age and deficits in innate and adaptive immunity which heralds both Alzheimer's disease (AD) onset and progression. The pathobiological events which underlie and tie these outcomes remain not fully understood.

Methods: To investigate age-dependent immunity in AD, we evaluated innate and adaptive immunity in coordinate studies of regulatory T cell (Treg) function, T cell frequencies, and microglial integrity.

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Synucleinopathies are a group of neurodegenerative disorders characterized by pathologic aggregates of neural and glial α-synuclein (α-syn) in the form of Lewy bodies (LBs), Lewy neurites, and cytoplasmic inclusions in both neurons and glia. Two major classes of synucleinopathies are LB disease and multiple system atrophy. LB diseases include Parkinson's disease (PD), PD with dementia, and dementia with LBs.

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For the past decades, gene editing demonstrated the potential to attenuate each of the root causes of genetic, infectious, immune, cancerous, and degenerative disorders. More recently, Clustered Regularly Interspaced Short Palindromic Repeats-CRISPR-associated protein 9 (CRISPR-Cas9) editing proved effective for editing genomic, cancerous, or microbial DNA to limit disease onset or spread. However, the strategies to deliver CRISPR-Cas9 cargos and elicit protective immune responses requires safe delivery to disease targeted cells and tissues.

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A major roadblock to achieving a cure for human immunodeficiency virus type one (HIV-1) is the persistence of latent viral infections in the cells and tissue compartments of an infected human host. Latent HIV-1 proviral DNA persists in resting memory CD4+ T cells and mononuclear phagocytes (MPs; macrophages, microglia, and dendritic cells). Tissue viral reservoirs of both cell types reside in the gut, lymph nodes, bone marrow, spleen, liver, kidney, skin, adipose tissue, reproductive organs, and brain.

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Adherence to daily oral antiretroviral therapy (ART) is a barrier to both treatment and prevention of human immunodeficiency virus (HIV) infection. To overcome limitations of life-long daily regimen adherence, long-acting (LA) injectable antiretroviral (ARV) drugs, nanoformulations, implants, vaginal rings, microarray patches, and ultra-long-acting (ULA) prodrugs are now available or in development. These medicines enable persons who are or at risk for HIV infection to be treated with simplified ART regimens.

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  • The study assessed the long-term safety and tolerability of sargramostim (Leukine) in five patients with Parkinson's disease (PD) over a 33-month period, examining its effects on immune response and motor functions.
  • Adverse effects noted included injection-site reactions, elevated white blood cell counts, and bone pain, but no significant side effects were found during blood analyses related to long-term use.
  • Results indicated stable motor function scores and increased regulatory T cell activity, suggesting that sargramostim may provide immune benefits and maintain clinical stability in PD, warranting further investigation in larger trials.
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Treatment of HIV-1-infected CD34+ NSG-humanized mice with long-acting ester prodrugs of cabotegravir, lamivudine, and abacavir in combination with native rilpivirine was followed by dual CRISPR-Cas9 C-C chemokine receptor type five (CCR5) and HIV-1 proviral DNA gene editing. This led to sequential viral suppression, restoration of absolute human CD4 T cell numbers, then elimination of replication-competent virus in 58% of infected mice. Dual CRISPR therapies enabled the excision of integrated proviral DNA in infected human cells contained within live infected animals.

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  • Researchers developed a new algorithm to improve the accuracy of CEST MRI methods for tracking antiretroviral drugs (ARVs) in tissues, which previously faced limitations due to interference from biomolecules.
  • The algorithm was specifically tested on lamivudine (3TC), a common ARV, and successfully fitted its proton peaks, providing a more precise measurement of 3TC's presence in the brains of treated mice.
  • The results showed that this dual-peak fitting method correlated better with actual drug levels compared to traditional methods, indicating a significant advancement for the mapping of various ARVs using CEST MRI.
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More than fifteen million women with the human immunodeficiency virus type-1 (HIV-1) infection are of childbearing age world-wide. Due to improved and affordable access to antiretroviral therapy (ART), the number of antiretroviral drug (ARV)-exposed children has exceeded a million and continues to grow. While most recommended ART taken during pregnancy suppresses mother to child viral transmission, the knowledge of drug safety linked to fetal neurodevelopment remains an area of active investigation.

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Effective antigen delivery facilitates antiviral vaccine success defined by effective immune protective responses against viral exposures. To improve severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigen delivery, a controlled biodegradable, stable, biocompatible, and nontoxic polymeric microsphere system was developed for chemically inactivated viral proteins. SARS-CoV-2 proteins encapsulated in polymeric microspheres induced robust antiviral immunity.

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Treatment of chronic hepatitis B virus (HBV) requires lifelong daily therapy. However, suboptimal adherence to the existing daily therapy has led to the need for ultralong-acting antivirals. A lipophilic and hydrophobic ProTide was made by replacing the alanyl isopropyl ester present in tenofovir alafenamide (TAF) with a docosyl phenyl alanyl ester, now referred to as M1TFV.

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Children born to mothers, with or at risk, of human immunodeficiency virus type-1 (HIV-1) infection are on the rise due to affordable access of antiretroviral therapy (ART) to pregnant women or those of childbearing age. Each year, up to 1.3 million HIV-1-infected women on ART have given birth with recorded mother-to-child HIV-1 transmission rates of less than 1%.

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Porous polymer microspheres are employed in biotherapeutics, tissue engineering, and regenerative medicine. Porosity dictates cargo carriage and release that are aligned with the polymer physicochemical properties. These include material tuning, biodegradation, and cargo encapsulation.

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The HIV-1 often evades a robust antiretroviral-mediated immune response, leading to persistent infection within anatomically privileged sites including the CNS. Continuous low-level infection occurs in the presence of effective antiretroviral therapy (ART) in CD4+ T cells and mononuclear phagocytes (MP; monocytes, macrophages, microglia, and dendritic cells). Within the CNS, productive viral infection is found exclusively in microglia and meningeal, perivascular, and choroidal macrophages.

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Article Synopsis
  • Inflammation plays a significant role in various diseases, contributing to tissue damage and neuron death through an overactive immune response involving effector T cells.
  • Regulatory T cells (Tregs) help maintain immune balance by suppressing unwanted immune reactions and controlling inflammation, thereby preventing autoimmunity.
  • Recent studies highlight the potential of Tregs as therapeutic agents in a range of neurological disorders, including multiple sclerosis and Alzheimer's disease, suggesting they could have broader applications in treating various nerve-related conditions.
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  • Dysregulation of both innate and adaptive immunity can lead to the misfolding and accumulation of alpha-synuclein (α-syn), contributing to the neurodegeneration seen in Parkinson's disease (PD) due to neuroinflammation and oxidative stress.
  • *Strategies to tackle this include vaccines and antibodies aimed at clearing misfolded α-syn, as well as gene therapies that deliver nanobodies or neurotrophic factors to support neuron health.
  • *Recent research has also highlighted the role of the gut microbiome in influencing immune responses, suggesting that targeting inflammation and restoring immune balance could offer new therapeutic avenues for improving outcomes in PD patients.*
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  • Dysregulation of both innate and adaptive immunity is linked to the onset and progression of Parkinson's disease, particularly through impairments in monocyte activity and inflammation.
  • A study evaluated changes in monocyte gene and protein expression in PD patients undergoing treatment with GM-CSF, revealing a neuroprotective biomarker profile related to motor function improvement.
  • The findings suggest a unique monocyte biomarker strategy for monitoring immune therapies in PD, although further validation in larger studies is needed.
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