An Introduction to Transfection, Transfection Protocol and Applications – Technology Networks

The ability to alter the genetic composition of living cells has revolutionized biology. Scientific advances, from treating genetic disorders through gene therapy to reprograming skin cells into neurons, have been made possible by the increasing proficiency in introducing foreign nucleic acids (DNA and RNA) into cells using a technique known as transfection.

In 1928, Griffith proposed the transforming principle having observed that bacterial cells could take up foreign hereditary genetic material.1 This led to the discovery of DNA as that genetic material,2 a discovery that enabled great strides in science. In the 1960s, viruses were employed to transfer genetic material into animal cells in a controlled manner and it was shown that foreign genetic material could be expressed in animal cells; this opened up the possibility of gene therapy.3 The simultaneous advances in the field of recombinant technology the discovery of plasmids4 followed by an increased application of plasmids in the 1970s and the discovery of restriction enzymes5,6 facilitated the manipulation of genes. Around the same time, chemical and physical methods of introducing the genetic material into cells, such as electroporation,7 calcium phosphate transfection8 and liposomal9 transfection were also developed, thus providing a plethora of methods to deliver the modified genes into cells of interest.

With the development of transfection methods, many discoveries in basic and translational sciences have been possible and the technique has a plethora of applications in biology. This includes understanding the role of target genes in healthy and diseased cells, unraveling molecular pathways, designing gene therapeutic approaches, cellular reprograming and many more. Thus, transfection is now an indispensable molecular and cell biology laboratory technique. In this article, we discuss the fundamentals of transfection and provide an overview of some of the commonly employed methods. A sample protocol that can be used as a starting point is included and finally, we consider some of the key applications of transfection.

Transfection is a commonly used technique employed to transfer foreign nucleic acids into eukaryotic cells.10 The purpose of transfection is to alter the genetic content of the host cells, thus changing the expression of desired genes in these cells.

It is important here to distinguish between the terms transfection and transformation. While the term transfection is used when the host cells are eukaryotic, the term transformation is used to denote the transfer of nucleic acids to bacterial cells. This distinction is vital because in higher eukaryotic cells, transformation refers to the process by which the cells become malignant.11

The primary objective of a transfection technique is to ensure that the desired foreign nucleic acid can cross the cell membrane and that a substantial amount of that nucleic acid is protected from degradation to allow its expression within the cell. The transfer of nucleic acids into host cells can be achieved through various physical, chemical and biological methods. In most of these cases, the cellular uptake of the nucleic acids is mediated through endocytosis12 of the nucleic acid along with a carrier (Figure 1). A portion of these nucleic acids can avoid lysosomal degradation through what is known as endosomal escape and make their way to the nucleus where they can be transcribed to affect gene expression. While this is not an exhaustive list of the methodologies employed to achieve transfection, we summarize here some of the most commonly used transfection methods.

Figure 1:Diagrammatic representation of the generalized mechanism of transfection.

Physical methods of transfection apply electrical, mechanical or thermal forces13 to facilitate nucleic acid entry into host cells. Some examples include microinjection, electroporation, biolistic transfection (gene gun), sonoporation, magnetofection and laser optoporation. While the microinjection method employs a special needle to inject the nucleic acids directly into the cells, the other physical methods involve inducing transient and reversible permeabilization of the cell membrane while simultaneously placing the nucleic acids in the vicinity of the permeabilized membrane.14 In electroporation, short and intense electrical pulses are applied to achieve transient permeabilization of the cell membrane. Similarly, ultrasound waves achieve transient cell membrane permeabilization in the case of sonoporation; and the same effect is achieved using controlled exposure to a laser beam in the case of laser optoporation. Biolistic approaches propel naked DNA coated with heavy metal particles into the cell using gas discharge. Magnetofection utilizes magnetic nanoparticles to guide the nucleic acids to the cell membrane where they can be taken up by the process of endocytosis. Physical methods of transfection have the advantage that they do not pose an immunogenic risk like viral methods and are not restricted in the length of the nucleic acid sequences that can be used like viral and some chemical methods. However, these methods require dedicated and expensive equipment and reagents, and they often offer low transfection efficiencies with high cellular mortality.

A number of chemical reagents have been developed to assist DNA/RNA to cross the cell membrane.15 These include cationic lipids, calcium phosphate, cationic polymers and nanoparticles. Transfection using cationic liposomal lipids is termed as lipofection and involves the formation of positively charged lipid aggregates surrounding the negatively charged nucleic acid molecules that can easily merge with the bilipid cell membrane and enter the host cell. Positively charged calcium phosphate molecules form a complex with the negatively charged nucleic acid molecules and generate a precipitate that enters the host cells through endocytosis. The calcium phosphate method of transfection does not require special reagents and is inexpensive. However, this method has limited reproducibility with low transfection efficiency that depends on the cell type. Cationic polymers, such as dendrimers, linear or branched poly (ethylene imine) (PEI), poly (L-lysine) and others are examples of cationic polymers. Several polymeric nanoparticles, solid lipid nanoparticles (SLNP) and inorganic nanoparticles have been used for chemical transfection.12

Viral vectors of transfection offer the highest efficiency and can transfect a large variety of cell types. Virus-mediated biological transfection is termed transduction. Although the term transfection is sometimes used when nucleic acid delivery into host cells is achieved using viral particles, transduction is the correct term that should be used to refer to this process of viral-mediated delivery. Adenoviruses, adeno-associated viruses and retroviruses have been developed for transduction.16 Adenoviruses are double-stranded DNA viruses that can be used to transduce both dividing and non-dividing cells for a short duration. They can elicit strong host immune responses and the experiments with adenoviruses need to be performed in biosafety level 2 laboratories. Adeno-associated viruses (AAV) are single-stranded DNA viruses with an inability to replicate. They induce a weaker immune response in host cells. Retroviruses are RNA viruses that are characterized by the integration of their RNA into the host genome after reverse transcription. This leads to prolonged expression of the gene of interest. Lentiviruses, gammaretroviruses, spumaviruses and alphateroviruses are examples of retroviruses that have been used for biological transfection.12

Whats the difference between stable transfection and transient transfection?

Transfection can be classified as stable or transient (Figure 2) depending on the duration of retention of the genetic material in the host cells.17 If the transfected nucleic acids are incorporated into the host DNA or are retained in the host nucleus as an extrachromosomal element, leading to a permanent change in the expression of the desired gene, the process is termed stable transfection. Stable transfection facilitates constitutive expression of genetic material in cell lines and is useful for the generation of clonal cell lines, large-scale protein production applications and also for stable expression during gene therapy.

Transient transfection, on the other hand, does not involve the incorporation of the foreign nucleic acid into the host cell genome, resulting in short-term expression of the target genetic material. The nucleic acids are often removed from the cell as a result of environmental perturbation or cell division. Transient transfection is often used to understand the temporary effect of the change in expression on the desired cellular processes.

Here, we describe a generalized lipofection protocol18 for adherent secondary cell lines and primary cell cultures with plasmid DNA (Figure 3). The quantities of the plasmid DNA and reagents used are applicable for a single well of a 6-well plate and will have to be scaled depending on the size of the culture dish. Lipofection is a relatively low cost, safe, easy and quick method of transfecting cells. While this protocol can be a good starting point, the parameters will have to be standardized and optimized based on the properties of the DNA/RNA as well the host cell type. All procedures are performed under sterile conditions.

A) Before transfection:

Plasmid DNA: The quality of plasmid DNA is very important for efficient transfection. The gene of interest is usually cloned into an appropriate plasmid DNA backbone downstream from a suitable promoter. A pure and concentrated plasmid DNA preparation is required for transfection.

Plating of cells: The host cells are trypsinized, counted and plated onto an appropriate culture dish in complete culture media 1824 h before transfection. The cell numbers need to be adjusted so that they reach a confluency of 5075% at the time of transfection. Care must be taken to avoid contamination and maintain optimal cell health.

B) Transfection:

C) Post-transfection:

The transfection mix is replaced with 3 mL of complete culture media in each well. The cells are incubated for at least 48 h at 37 in the 5% CO2 incubator. The health of the cells should be monitored regularly.

We have previously described the biological methods of transfection that employ viruses for the delivery of nucleic acids. The term transduction is often used to describe virus-mediated delivery of nucleic acids into host cells. Bacteriophages were first shown to transduce bacterial cells in 1952.19 Since then, viral vectors have been developed to deliver genetic material into host cells by exploiting the natural propensity of certain viruses to transduce cells. Table 1 summarizes the differences between non-viral transfection and transduction.

Table 1: Comparison of transfection and transduction.

Transfection

Transduction

Delivery of foreign nucleic acids using non-viral methods

Delivery of foreign nucleic acids using viral vectors

Gene-transfer efficiency depends on the type of cells, media conditions etc. and is relatively low

Greater gene transfer efficiency

Serum in the media interferes with cellular uptake of nucleic acids

Transduction can be performed in the presence of serum

These methods are relatively harmless to the lab personnel

Viral contamination needs to be carefully handled. Appropriate biosafety measures should be practiced

Often requires specialized equipment and/or special reagents

Relatively easy to perform

Some methods and reagents can be cytotoxic

Viral infection of cells may induce cytopathic effects, such as insertional mutagenesis and immunogenicity

Physical methods, such as electroporation, gene gun and microinjection, and chemical methods, such as lipofection and calcium phosphate transfection, are examples of transfection

Viral transduction is mediated by DNA viruses, such as adenovirus and adeno-associated virus and RNA viruses, such as lentiviruses

Transfection methods have a wide range of applications. Here, a few of them have been briefly described.

Gene therapy: Gene therapy refers to treating genetic diseases by either silencing a defective gene, replacing a defective gene with the corrected version or amplifying the expression of a gene. Over the years, gene therapy has been used to treat diseases such as sickle cell anemia, beta thalassemia, Duchennes muscular dystrophy and hemophilia.20

DNA vaccines: DNA vaccines are vaccines that transfect host cells with engineered DNA plasmids to facilitate the expression of recombinant antigens in vivo.21 These antigens are recognized by the hosts body and stimulate the generation of adaptive immunity. The entry of DNA plasmids into host cells is achieved through in vivo electroporation.

Gene silencing: Transfection of cells with RNA interference (RNAi) molecules such as small interfering RNA (siRNA), which disintegrate the mRNA, or micro-RNA (miRNA), which suppress the translation of the gene of interest, leads to gene knockdown. Gene silencing can also be achieved using the CRISPR/Cas9 system.

Stable cell line generation: Stable transfection is used to generate stable cell lines that express a recombinant protein constitutively. These stable cell lines are extremely useful for large scale production of recombinant proteins. Stable cell lines that express recombinant proteins or have gene knock in/down are often used to study cellular processes and understand the structures of proteins22 in laboratories.

Virus production: Viral vectors for applications such as gene therapy involve the insertion of the desired gene into the viral plasmid backbone. The plasmids encoding the different components of the viral vector are transfected into a secondary cell line for assembly and large-scale production of the viruses. Moreover, viral production is employed for the generation of recombinant viruses such as, the influenza A virus, to study the effects of novel mutations and viral strains on the ability of the virus to infect and the efficiency of vaccines.23

Large-scale protein production: Recombinant proteins have many applications in therapeutics and several monoclonal antibodies, hormones, enzymes and clotting factors are produced as recombinant proteins on an industrial scale.24 Further, the rapidly progressing field of precision cellular agriculture, which is a sustainable alternative to traditional agriculture, employs transfection as an important step to enable lab-based production of future foods such as, milk, eggs and plant hemoglobin.25 Large-scale production of recombinant proteins has been achieved through transfection of recombinant DNA into mammalian cells, bacteria, yeast, plant and insect cells.

Stem cell reprograming and differentiation: Somatic cells can be reprogramed into induced pluripotent stem cells (iPSCs), which can be differentiated into specific cell types by inducing the expression of certain transcription factors. The development of iPSC technology has been possible thanks to the ability to transfect the genes required for reprograming and differentiation of the stem cells. This technology has led to the development of cellular models of human diseases and has immense therapeutic potential.26,27

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Clonal architecture evolution in Myeloproliferative Neoplasms: from ... - Nature.com

Autism Therapy Market Anticipated to Garner Significant Growth of … – GlobeNewswire

MELBOURNE, April 04, 2023 (GLOBE NEWSWIRE) -- Data Bridge Market Research completed a qualitative study titled "Autism Therapy Market" with 100+ market data tables, pie charts, graphs, and figures spread across Pages and an easy to grasp full analysis. A steadfast Autism Therapy market research report serves to be a very momentous component of business strategy. This report provides important information which assists to identify and analyze the needs of the market, the market size, and the competition with respect to Autism Therapy industry. When the market report is accompanied with precise tools and technology, it helps tackle a number of uncertain challenges for the business. This market research report is one of the key factors used in maintaining competitiveness over competitors. Autism Therapy market report supports the business to take better decisions for the successful future planning in terms of current and future trends in particular product or the industry.

Data Bridge Market Research analyses that the autism therapy market, which was USD 2.05 billion in 2022, would rise to USD 3.42 billion by 2030 and is expected to undergo a CAGR of 6.60% during the forecast period 2023 to 2030. In addition to the insights on market scenarios such as market value, growth rate, segmentation, geographical coverage, and major players, the market reports curated by the Data Bridge Market Research also include depth expert analysis, patient epidemiology, pipeline analysis, pricing analysis, and regulatory framework.

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Autism therapies are the type of therapies that are applied in autistic children or adults to improve or enhance their condition. Different therapies include speech-language therapy, behavior therapy, play-based therapy, occupational therapy, physical therapy, and nutritional therapy. This neurological disorder is related to several disabilities, such as challenges with the individual's behavior or lack of social skills. The diagnosis of autism can be made from a very early age, but the cause is still unknown.

The growing incidence of autism and pervasive developmental disorder (PDD) is essential to escalate market growth. Huge research studies performed by organizations to assess the safety and efficiency of drugs in patients with ASD are anticipated to boost market growth. The stimulants segment dominated the market with a huge revenue share due to the wide availability and ease of accessibility of drugs to patients.

Fundamental Aim of Autism Therapy Market Report

In the Autism Therapy market, every company has goals, but this report focus in on the most important ones, allowing you to gain insight into the competition, the future of the market, potential new products, and other useful information that can boost your sales significantly.

Some of the major players operating in the autism therapy market are:

Recent Development

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Opportunities:

The increasing demand for stimulants is boosting the growth of the market. Adderall, Focalin, Vyvanse, Dexedrine, and Ritalin are some stimulants approved by the U.S. FDA for treating patients who have autism. These drugs improve patient behavior by 80% when administered properly to patients. Therefore, growing efficiency related to the stimulants may attract a new target population and boost market growth.

A growing number of product launches associated with autism therapy boost market growth. For instance, the FDA granted fast-track designation to Curemark's CM-AT specified for ASD in 3-8 years old children in 2022. Furthermore, Indian researchers developed the 6BIO compound in 2021, which has shown the potential to enhance daily activities in the pre-clinical investigation of patients with an autism spectrum disorder. Thus, this factor boosts market growth.

Key Growth Drivers:

The increasing incidence of the autistic population is boosting the market's growth. For instance, France and Portugal have the lowest rates of autism in the world, with approximately 0.69% and 0.71%, respectively, as per the research published by Health Data Exchange. In 2021, the CDC stated that nearly 1 in 44 children in the U.S. is diagnosed with an autism spectrum disorder (ASD). Thus, this increasing prevalence demands high adoption of therapies, boosting the market growth.

Huge research studies performed by organizations to assess the safety and efficacy of drugs in patients with ASD are anticipated to drive the market. The positive outcomes of these studies lead to new growth opportunities for the market. For instance, Stalicla completed phase 1b trials of precision medicine candidate STP1 and witnessed positive results with symptom improvement in patients with ASD in 2022. Therefore, the effective completion of the trial and following product approvals are estimated to drive the market. Thus, this factor boosts market growth.

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Key Market Segments Covered in Autism Therapy Industry Research

Age Group

Type

Treatment Type

Drug

Distribution Channel

Autism Therapy Market Regional Analysis/Insights:

The countries covered in the autism therapy market report are U.S., Canada, and Mexico in North America, Germany, France, U.K., Netherlands, Switzerland, Belgium, Russia, Italy, Spain, Turkey, Rest of Europe in Europe, China, Japan, India, South Korea, Singapore, Malaysia, Australia, Thailand, Indonesia, Philippines, Rest of Asia-Pacific (APAC) in the Asia-Pacific (APAC), Saudi Arabia, U.A.E, South Africa, Egypt, Israel, Rest of Middle East and Africa (MEA) as a part of Middle East and Africa (MEA), Brazil, Argentina and Rest of South America as part of South America

North America dominates the autism therapy market due to increasing R&D activities and the launching several new products through mergers and strategic partnerships in this region. Also, the increasing awareness about the availability of numerous therapies to treat patients with autism spectrum disorders in this region

Asia-Pacific is expected to witness significant growth due to the wide presence of major market players and strategic initiatives undertaken by them to develop and commercialize several new products to treat patients.For instance, Teijin Pharma and Hamamatsu Medical University confirmed the safety, efficiency, and tolerability of oxytocin nasal spray for treating patients with an autism spectrum disorder in 2022

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Autism Therapy Market Anticipated to Garner Significant Growth of ... - GlobeNewswire

10th International Multithematic Scientific Bio-Medical Congress … – Nature.com

The 10th International Multithematic Bio-Medical Congress (IMBMC) 2022, Bio-Medical Scientific Cyprus, took place at European University Cyprus (EUC), Nicosia, Cyprus, under the auspices of the Ministry of Health and the Cyprus Medical Association. IMBMC is an internationally recognized event that was founded and established by Professor Dr Ioannis Patrikios, the Deputy Dean and Faculty member of the School of Medicine at EUC. During the 10th IMBMC, both Sir Gregory Winter (Nobel Prize in Chemistry, 2018, on protein and antibody engineering and antibody therapies) and Sir Martin Evans (awarded the 2007 Nobel Prize in Physiology or Medicine for his groundbreaking discoveries on embryonic stem cells and DNA recombination in mammals) were announced as Honorary Professors of the School of Medicine, European University Cyprus.

The first honorary keynote speaker Professor Sir Gregory Winters contribution engaged in the science of protein engineering. Being the founder of both Cambridge Antibody Technology (1989) and Domantis (2000), he spearheaded the use of a new class of drugs using engineered antibody technology to treat pathological diseases. At the Laboratory of Molecular Biology, Dr Winter focused on innovating techniques to familiarize the use of antibodies in the field of therapeutics, with his goal being to develop entirely humanized antibodies, using combinational gene repertoires. Over half of the antibodies sold today are a result of his inventions, including the humanized antibodies Campath-1H, Herceptin, Avastin, Synagis, and the first human antibody (Humira) to receive approval by the US Food and Drug Administration. Precisely, antibodies, as todays principal biological drug, especially for the treatment of cancer and autoimmune diseases, have replaced areas that were poorly served by chemical drugs. Will such developments thrive.

Professor Dr Kypros Herodotou Nicolaides spoke on preeclampsia (PE), which is a leading cause of maternal mortality and severe morbidity, in association with increased perinatal risks. He focused on ways to approach PE. These included actions on specific weeks and interventions to tackle PE, the rate, and the rate of term. Three methods were used. The first method to target PE was aspirin (150mg per day from 12 to 36 weeks reduced the rate of PE <32 weeks by 90%, PE <37 weeks by 60%), which had no effect on term PE. The second one included the incorporation of maternal characteristics in blood pressure, serum placental growth factor, and serum sFlt-1, which identified about 70% of women who developed term PE. Unfortunately, it was found that the use of pravastatin did not reduce the rate of term PE. The last approach to prevent term PE involved screening at 36 weeks with planned delivery at 37, 38, 39, and 40 weeks, respectively. This method was considered to reduce the rate of PE by more than 50%.

Professor Dr Gregg L. Semenza gave a speech that featured his lab discovery of hypoxia-inducible factor 1 (HIF-1). As he mentioned, a continuous supply of oxygen is necessary for each of the fifty trillion cells in the adult human body. HIF regulates thousands of genes according to oxygen availability, a discovery that awarded him with the 2019 Nobel Prize in Physiology or Medicine. The aim targeted the inhibition of cancer progression, relying on the molecular mechanisms of oxygen homeostasis, in association with HIF-1. It was intended to develop HIF inhibitors that could treat cancer and blinding eye diseases.

Professor Dr Stylianos E. Antonarakis presented two research themes, the former entitled Human Genomes and the Evolution of Medicine and the latter How to make an external ear: the story of FOXI3. The first study focused on the human genome sequence and variation as a fundamental component in health and disease. He stated the importance and impact of genomic variation on phenotypic variation and the evolving knowledge of individual genomic variation; the practice of medicine is gradually evolving. Diagnosis, prevention, and therapy are all evolving as the mysteries of the genome are elucidated. Genomic Medicine takes the spotlight regarding the etiology of the myriad of constitutional and somatic disorders and raises expectations for the development of rationalistic and intelligent therapeutic methods. His second speech focused on the developmental disorder craniofacial microsomia (CFM), which has a variety of manifestations, including external ear deformity. The CFM inheritance structure is obscure and debatable. The researchers identified pathogenic variants in the transcription factor FOXI3 that cause one form of CFM. Observations in human and mouse studies point to a recessive mode of inheritance in which the phenotypic diversity is caused by a fusion of rare (causative) and common (modifier) FOXI3 alleles. His studies pertain to the relationship between genomic variability and phenotypic variation that he has studied throughout his life.

Professor Dr Philippe Menasch, a cardiac surgeon, gave a presentation entitled Cells for Heart Failure: Replacement Therapy or Paracrine Signaling? He noticed the benefit in terms of function even though the cells were no longer physically present in the transplanted tissue, which prompted a change from the original idea of replacement therapy to paracrine signaling, in which the combination of biomolecules secreted by the cells and primarily gathered in extracellular vesicles (EV) harness endogenous repair pathways. Despite the issues presented in the field, biodistribution and fate-tracking studies suggest that intravenously delivered cells or their secreted products are trapped in remote organs with very limited cardiac homing even though using EV from cardiac-committed cells may improve their targeting at same-tissue recipient cells. The bridge between this remote sequestration and a cardiac benefit might be a shift of the phenotype of locally present endogenous immune cells toward a reparative pattern. Thereby making these cells the conveyors of the cell- or secretome-induced protective effects. Thus, while the initial hypothesis underlying the use of cells for treating heart failure was that they could act as a replacement therapy, the current trend is to rather consider them as inducers of paracrine signaling. In the case of heart failure, but also for other conditions, the major effect of this signaling seems to be a modulation of systemic inflammation whose benefits then translate at the level of the diseased organ. More recently, the group has refocused its interest toward leveraging the paracrine effect of cells to generate a cellular secretome, which might help streamline clinical applications.

Professor Dr Paul Moss, who specializes in the field of hematology, presented: From Diagnostics to Therapeutics; Antibodies Take Centre Stage in COVID-19, focusing on the worldwide increase in mortality rates due to COVID-19. He highlighted that both innate and adaptive immune systems provide partial protection against reinfection of the disease. Spike-specific antibodies are the major correlate of protection following vaccination, and individual responses depend on a range of factors such as age, gender, and comorbidity as specifically heighted. Considering that the coronavirus distinguishes among other infections, as the biological basis is unclear and further studies should be conducted around memory B cells and plasma cells, antibodies have also emerged as powerful therapeutic agents. Hence, antibodies have been the spotlight in the control, prevention, and policy management of the COVID-19 pandemic. The information that has been derived from this challenge can now be applied effectively to a range of other medical conditions.

Professor Dr Nikolai N. Korpan specializes in cryosurgery, which is defined as clinical implications that are used at extremely low temperatures, including an organ preservation technique. He presented his unique longstanding clinical experiences with ultra-low temperatures in treating patients with severe primary and secondary malignant diseases worldwide. Ice crystallization processes are of high importance, which damage the protein denaturation and rupture the cell membranes by the action of subzero cold in intracellular ice formation. This anti-cancer concept includes radical and palliative cryosurgical operations. Cryosurgical palliative methods with a pain reduction (painlessness or pain reduction) and fetor ex ore as well as improvement of the general state by getting the tumor under control are to achieve the major subjective facilitation with cancer patients, as he noted. Hence, in the near future, a new norm for oncological diagnosis and surgery will set a new bar for modern science and modern medicine. These theoretical stages will soon become a reality in medical practice according to his personal estimation.

Professor Dr Paolo Madeddu discussed the topic entitled Using Pericytes to Mend Broken Hearts: Where do we Stand? Pericytes were first found in the nineteenth century by Rouget. These cells surround capillaries in every organ of the human body, and he indicated the possible use of pericytes as a novel therapeutic avenue in regenerative medicine. He emphasized that pericytes are tissue-specific, multi-functional cells that are capable of treating vascular diseases. Dr Madeddus research activity examined the therapeutic effect of pericytes regarding ischemic heart disease, given the ability of pericytes to regenerate and repair heart tissue after myocardial infarction.

Professor Dr Amanda Varnava continued the session on The Ultimate Goal: Is Gene Therapy in Hypertrophic Cardiomyopathy Yet Possible? Dr Varnava has an interest in the cardiology of child-bearing period and runs a specialist pregnancy and heart disease service. Hypertrophic cardiomyopathy is the most prevalent congenital heart condition, affecting 1 in 500 of the population with devastating incidences of sudden cardiac death among young people. It is shown that the underlying genetic basis of the disease concerns gene mutation in the gene encoding of the cardiac sarcomere apparatus. A single change in the encoding system may lead to protein degradation and malfunction. Sequentially, sarcomeric dysfunction is inevitable as well as hypertrophy and myocardial fibrosis. Even though no therapeutic options are available to date, she discussed the importance of these molecular targets and suggested new targeted therapies to avoid complications and limit the mortality rate.

Professor Dr Gerasimos Filippatos gave a talk about Heart Failure Update. It was shown that sodium-glucose cotransporter 2 inhibitors, as drugs that improve the symptoms of heart failure and improves the left ventricular ejection fraction (LVEF). However, it remains unclear how these drugs benefit heart failure, as he clearly pointed out. Another second-line agent that was found to control heart failure outcomes is the oral soluble guanylate cyclase stimulator vericiguat, which is used for patients who have a reduced LVEF. Concerning inotropes, in patients who suffer from progressed heart failure with reduced ejection fraction, the myosin activator omecamtiv mecarbil can also improve HF outcomes again as he explained. Researchers have focused on the effect of diuretics, as when they are used in combination with other drugs, as they can improve both diuretic response and relieve congestion in hospitalized HF patients. Moreover, as he noted, diabetics and patients with chronic kidney diseases that are given non-steroidal mineralocorticoids in combination with spironolactone and eplerenone can have a positive effect on their cardiovascular and renal function. Prof. Filippatos concluded that in the field of ventricular assist devices, transdermal charging is the new frontier, as it eliminates the need for external leads providing a lower risk of infection and a better quality of life.

Professor Dr Vasso Apostolopoulos spoke on Vaccines in The New Era: What Have We Learnt in The Last 30 Years? Recently, her interest has shifted on how chronic diseases, such as cancer, autoimmune disorders, mental health, and infectious diseases, can be treated if approached from an immunologic perspective. The current research on checkpoint markers is shown to lead to apoptotic T cell behavior and immune escape mechanisms in the event of cancer. In the last 5 years, researchers have published numerous information about checkpoint markers as they relate to diseases such as autoimmune disorders, inflammatory disorders, and cancer. Peptide alterations of T cell epitopes with 12 amino acid mutations can control immune responses, by downregulating or upregulating feedback. The aim of her research is to reinforce innovative immune modulators/therapeutics/vaccines. Several innovative immune modulators against cancer, autoimmune disorders, and infectious diseases have been successfully established.

Professor Dr Kevin Harrington gave a speech entitled Is There a Rationale for Combining Radiotherapy and Immunotherapy in Patients with Head and Neck Cancer? Dr Harrington is a clinical oncologist who specializes in the development of novel treatments concerning head and neck cancer, for which he led multiple phase I, II, and III trials. In CheckMate-141 and KEYNOTE-040 and -048 studies, it was found that these agents, when combined with radiotherapy, are active regarding palliative treatment of relapsed and metastatic diseases. In preclinical studies, it was advised that ICPI therapy should be given simultaneously with RT. This suggestion was generalized into trial designs based on anti-PD1/-PD-L-1 therapy given 1 week before. The results of this study brought negative endpoints, similar to other studies, which also delivered negative outcomes at primary and secondary points, as he pointed out. The presentation greatly focused on the innovation of strategies to enhance the development of combination regimens for patients suffering from locally advanced head and neck cancers.

Ran Nir-Paz presentation entitled The Enemy of Your Enemy is Your Friend The Reintroduction of Bacteriophages for Resistant and Persistent Infections. His study focused on introducing phage therapy for resistant and persistent infections. Recently, the treatment method with bacteriophages for preserving infections has reappeared. The research involved a wide phage band with over 500 identified phages used to discover the most effective lytic phage and to develop treatment schemes. After supplying 15 Israeli patients with intravenous bacteriophages, it was found that 50% of the requests concerned respiratory, skin, and soft tissue infections. The clinical trials mentioned above were further analyzed in his lecture.

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10th International Multithematic Scientific Bio-Medical Congress ... - Nature.com

From filler to CoolSculpting: Woman ranks 10 best cosmetics procedures and reveals which to avoid – Yahoo News

An aesthetic industry professional has ranked all the cosmetics procedures shes had done and revealed which to get and which to avoid.

Lacey is a 27-year-old content creator living in Los Angeles, California, who shares fashion and beauty advice to her 17,000 followers. Most recently, the cosmetics industry worker went viral on TikTok when she shared all the treatments and cosmetic work shes had done, ranking them from worth it to never again.

Lifes good working in the aesthetics industry, she captioned the TikTok video, which has been viewed more than 650k times since it was posted in December last year.

First, Lacey began by revealing she had platelet-rich plasma (PRP) injections in her under eyes. She ranked the overall treatment a nine out of 10 because it left her under eyes swollen for the first day and gave her a really weird feeling during the treatment. Still, the injections naturally brightens and fills under eyes once its fully healed.

PRP treatments have grown in popularity in recent years. More commonly known as the vampire facial, the unusual treatment involves drawing a persons blood and placing it into a machine that separates the platelets from the rest of their blood. Then, the part of the blood that contains a high concentration of platelets is re-injected into the skin.

According to the American Academy of Dermatology, PRP has been used as a possible treatment for hair loss. Some dermatologists have also used the treatment to give patients younger-looking skin, such as reduced wrinkles, acne scars, or deep creases.

For her second cosmetic procedure, Lacey shared that she had a brow lamination and keratin lash lift, which she ranked an 100000/10. She said: [Im] obsessed with it and it lasts for at least 12 weeks. Bye, mascara.

Brow lamination is a relatively new chemical treatment to help make the eyebrows appear neater and fuller. Its done using different chemical solutions to coat the brows, before brushing the hair upward to remove any curls. Laminated eyebrows can last anywhere from six to eight weeks.

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Meanwhile, a keratin lash lift is a semi-permanent treatment that uses keratin to enhance the natural look of eyelashes. A keratin lash lift can last from four to six weeks and typically costs $100-$200.

Another cosmetic procedure Lacey recommended was a microneedling treatment using PRP therapy and exosomes, which helps stimulate growth factors using collagen. Microneedling is done using small needles to prick the skin mainly on the face to generate new collagen and skin tissue. This helps create smoother, firmer, more toned skin while minimising scars, wrinkles, and large pores.

Lacey gave the microneedling treatment a 10 out of 10 ranking, saying that shed get it all day everyday. While she warned her followers that you will smell like youre rotting on the first day of the treatment, she added: I swear its worth it

The cosmetics industry professional has also had some injectable fillers placed in her lips and chin. Lacey said she loved getting her lip filler with Restylane Kysse, which is designed with XpresHAn Technology for natural-looking lips lasting up to one year. Lacey said the fillers made her lips appear much more natural and gave the injections a 10 out of 10.

As for her chin filler, Lacey said the treatment can be used for a temporary fix and is amazing for facial balancing. Chin filler is a non-surgical procedure that involves injecting temporary dermal filler into the chin to help its shape and firm the surrounding area of the skin. Lacey gave her chin filler treatment an 8.9 out of 10 and said a chin implant may be better for those who prefer a more long-lasting option.

After Lacey revealed her favourites of the cosmetic procedures shes had done, it was time to go through the ones shed never do again. Beginning with a lip filler treatment using Juvederm, which is a popular injectable gel containing hyaluronic acid, Lacey gave this procedure a -20 out of 10.

Looks nice for, like, three months then migrates like crazy, she said.

The next procedure that she disliked was called Morpheus 8, a microneedling treatment that combines radiofrequency with the microneedling technique. During the treatment, tiny needles that emit radiofrequency energy are stamped into the skin to create a controlled injury to boost collagen and elastin production. Lacey gave this treatment a zero out of 10 for its high pain level but minimal results.

CoolSculpting was another cosmetic treatment that Lacey simply gave a one out of 10. CoolSculpting, which is the brand name for cryolipolysis or fat-freezing, is a non-invasive cosmetic procedure that uses cold temperatures to break down fat cells. It uses cooling paddles, which are applied to areas on the body to suction the skin to break down fat cells. Although Lacey said that the CoolSculpting procedure works for some, it made her body proportions really weird after the treatment.

Although the last two on her list werent exactly cosmetic procedures, Lacey said that applying sunscreen and retinol to her face made it so smooth and bright. Meanwhile, the one that received an infinity out of 10 ranking was having a reputable provider who can recommend what you need based on your goals.

With any cosmetic surgery, invasive or non-invasive, a patient must be made aware of the risks that are involved. Recently, model and TV personality Blac Chyna documented the process of removing her facial filler and silicone implants due to their physical dangers.

The physical dangers of getting illegal fillers are many, said Blac Chynas plastic surgeon, Dr David Matlock, after spending more than eight hours removing the injections from her butt. You can have infections, abscesses, sepsis, sepsis patients can die from that.

The Food and Drug Administration (FDA) has previously warned against injectable silicone and dermal fillers for large-scale body contouring due to risks such as long-term pain, infections, and serious injuries, such as scarring and permanent disfigurement, embolism (blockage of a blood vessel), stroke, and death.

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From filler to CoolSculpting: Woman ranks 10 best cosmetics procedures and reveals which to avoid - Yahoo News

For long Covid patients who lost their taste or smell, a new treatment offers hope – NBC News

A numbing procedure usually used to treat pain and post-traumatic stress disorder is being tested as a way to restore smell and taste in people with long Covid.

It's called a stellate ganglion block. In the procedure, a doctor uses a temporary, local anesthetic like what a dentist would give before filling a cavity and injects it into a specific bundle of nerves called the stellate ganglion on both sides of a person's neck. The nerves are part of the sympathetic nervous system, which controls automatic bodily functions, such as blood pressure, digestion and heart rate.

The area is not known to have any impact on how a person perceives odors, however, leaving some experts skeptical of the approach. Other doctors say they have seen real improvements in patients who either can't smell anything or find previously delicious food and drinks now taste repulsive.

Smell disorders tend to become more common with age, and affect millions of people. As many as 1 out of every 8 people in America over age 40 have some kind of olfactory dysfunction, according to the National Institute on Deafness and Other Communication Disorders.

A survey last yearfound that about 15% of people with Covid-related olfactory loss still had trouble smelling correctly six months later.

Not many treatments are available for smell disorders. Doctors may try olfactory retraining, in which patients concentrate on sniffing four scents usually rose, eucalyptus, lemon and clove twice a day for at least three months. Smell therapy has shown promise in some clinical trials.

At Cleveland Clinic, doctors are offering stellate ganglion blocks to long Covid patients, with the hope of launching a clinical trial.

Jennifer Henderson, 54, of Franklin, Ohio, got Covid in January 2021 and immediately lost the ability to taste or smell anything. A year later, her senses came back, but were wildly distorted.

She first tried olfactory retraining "religiously" for months, without success. Peanut butter and ranch dressing still smelled like chemicals.

Chicken was the worst, she said. "It tasted like rotting flesh. I had to spit it out."

Finally, in November last year, she received the stellate ganglion block at the Cleveland Clinic. The effect was immediate. She held a fresh cup of coffee up to her nose and burst into tears.

"It was the best smell ever," Henderson said. "I just cried like a baby."

Dr. Christina Shin, a physician specializing in pain management at the Cleveland Clinic, said that nearly every day at least one or two patients are referred to her from the long Covid clinic affiliated with the hospital system for help with their smell and taste.

She has treated roughly 30 long Covid patients with the block. About half get better, she estimates, though the level of improvement varies between 25% and 90%.

Dramatic responses like Henderson's have made the rounds on social media, igniting enthusiasm in long Covid communities. But many doctors are cautious because no one really understands how it works.

Some experts theorize that it may increase blood flow to the brain. Others suggest the block acts as a "reset button" for the sympathetic nervous system.

Some question whether it works at all.

"There is no scientific evidence that this is effective," said Dr. Justin Turner, an associate professorin the department of otolaryngologyhead and neck surgery at Vanderbilt University Medical Center in Nashville, Tennessee.

"Given the lack of data suggesting efficacy, it's really hard to advocate for this for patients who have a problem that typically resolves with time," he said.

As many as 80% will recover on their own within about six months, said Dr. Zara Patel, a professor of otolaryngology at Stanford University.

That's because stem cells in the nasal cavity have the ability to turn into brand new olfactory receptor neurons that detect odors.

"Throughout our lifetime, probably every three to four months, each olfactory receptor neuron dies off, and a new olfactory receptor neuron comes in and takes its place," Patel said.

Sometimes those new neurons get confused after they regenerate, leading chicken to smell like rotten flesh, as in Henderson's case.

Distorted smell, called parosmia, isn't just about difficulty during mealtimes. The condition can have a profound and deeply upsetting impact on a person's life.

In 2021, researchers in the United Kingdom surveyed people with Covid-related parosmia. Some worried about the effect it had on how they felt about their children.

"A lot of my maternal bonding feelings for my children are tied up with smell," one woman said in the study.

Some reported that the problem was ruining their sex lives. One person wrote about a partner's "rotten breath." The stench was "unbearable, no matter how hard I tried to put it out of my mind."

Some patients fall into despair.

"I have had many patients crying in my office telling me that the parosmia not just the smell loss, but the smell change is destroying their life," said Dr. Nyssa Farrell, an assistant professor of otolaryngology-head & neck surgery at Washington University School of Medicine in St. Louis.

However, she was wary of anecdotes of people getting better after a stellate ganglion block.

"It kind of sounds like voodoo," Farrell said. "I'm a scientist and I don't just believe what people say."

With desperate patients in mind, she started a small study to see if the block would work well enough to justify launching a large, randomized clinical trial that would give the needed evidence.

Among 20 patients with trouble smelling correctly, 10 reported "slight to moderate" improvement after the stellate ganglion block. It wasn't a strong result, but enough to move forward "to see if this is a placebo effect or if this is real," Farrell said.

A larger study is in the planning stages.

A stellate ganglion block is not the only potential remedy under investigation for loss of smell. Patel, of Stanford, ran a study looking at whether an injection of platelet-rich plasma deep into the nasal cavity might help prompt olfactory neurons to form correctly.

The procedure involves drawing the patient's own blood, removing its red and white cells, leaving behind plasma full of platelets and growth factors known to regenerate different types of tissue.

"Hopefully, what platelet-rich plasma is doing," Patel said, is getting those neurons to regenerate in a way "so that the correct signal is sent back to the brain."

Among 26 study participants, those who got the plasma injection were 12 times more likely to report improvements in their smell loss than those who got placebo shots.

Patel is now offering the procedure to all of her patients who have lost smell.

Excitement for stellate ganglion blocks' potential for treating long Covid ramped up in December 2021 when Dr. Luke Liu, a pain specialist in Anchorage, Alaska, reported the successful treatment of two long Covid patients.

Many of their ongoing symptoms, including muscle pain, fatigue, dizziness, brain fog and loss of smell and taste, improved within a week of getting the injections, he said.

Liu theorizes that a "glitch" in the autonomic nervous system plays an important role in lingering Covid and similar post-viral illnesses.

"In the case of long Covid, that glitch prevents the nervous system, and probably the rest of the body, from healing itself from a viral infection," he suggested. "The stellate ganglion block acts by pushing the reset button to that system. By doing so, it allows the entire system to reboot and become more synchronized and organized."

Liu has treated roughly 300 patients, and says about 65-70% "do really well and don't need any other intervention."

Still, he cautioned, it's too early to call stellate ganglion blocks a cure. About 5% of patients, he said, don't have any lasting improvement. About a third must go back to the clinic every few weeks or months for additional injections.

Henderson, who was treated at the Cleveland Clinic, has had to return three times. Her smell and taste are better, she said, but not back to normal.

"This should be treated as a scientific clue rather than a solution at this point," Liu said, adding that larger studies are needed.

The bundle of nerves targeted in the block procedure is right next to the carotid arteries, a pair of major vessels that supply blood to the brain. If inserted incorrectly, the medication can disrupt vocal chords and lead to trouble breathing.

The risks drop tremendously when a highly experienced doctor performs the stellate ganglion block, which has been used for decades by pain specialists to treat complex pain syndromes, Farrell said. She partnered with an anesthesiologist for her studies.

"She does stellate ganglion blocks for a living," Farrell said. "For her, the risks are very low."

The cost of the procedure varies widely and some insurance companies do not cover the block to treat smell disorders.

Liu said that he charges $500 per block, and is disheartened by anecdotes of other clinics billing their patients thousands of dollars.

"To me, this is taking advantage of people who are suffering."

CORRECTION (April 1, 2023, 11:50 a.m. ET): An earlier version of this article misspelled the name of the assistant professor of otolaryngology-head & neck surgery at Washington University School of Medicine in St. Louis. She is Dr. Nyssa Farrell, not Ferrell.

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Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

Kristen Dahlgren is an Edward R. Murrow award winning journalist. She reports for NBCs Today show, NBC Nightly News with Brian Williams, and also appears on MSNBC and CNBC. Prior to her current posting, Dahlgren spent 9 years working for NBC News Channel NBCs affiliate feed service. She has reported from around the world and covered some of the biggest stories in recent years including Hurricane Katrina, the Japanese tsunami and the Newtown massacre. Dahlgren is based in New York.

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For long Covid patients who lost their taste or smell, a new treatment offers hope - NBC News

The Med Spa on the Corner Is Probably Breaking the Law – JD Supra

Look better. Feel better. Fountain of youth promises are making med spas one of the fastest-growing segments in healthcare. Botox injections, laser hair removal, IV hydration and therapy, medical weight loss, and hormone therapy seem to be available on every corner.

But most med spas are not compliant with Texas law. Either they are formed as the wrong entity type, they lack proper oversight and ownership, or all the above.

The consequences can be significant for everyone involved.

Med spa owners face potential civil and criminal liability for the unauthorized practice of medicine. Physicians associated with those med spas could find themselves subject to disciplinary action from the Texas Medical Board. And patients are caught in the middle.

The med in med spa stands for medical because many of the services they provide are medical in nature. Botox, Disport, Juvederm, and Kybella injections, microneedling, chemical peels, laser hair removal, dermaplaning, and CoolSculpting are considered nonsurgical medical cosmetic procedures by the Texas Medical Board.

IV hydration and therapy, platelet-rich plasma injections, medical weight loss injections, and hormone therapy are also medical services. If a procedure involves injecting a patient intravenously or subcutaneously, it is probably a medical procedure.

Before any medical procedure, a physician or midlevel provider (like a physician assistant or nurse practitioner) must perform a good faith exam, establish a medically appropriate treatment plan, and document everything in a medical record.

Midlevel providers must be supervised by a physician under a Prescriptive Authority Agreement. The physician must review a sample of the charts regularly and generally be available to the midlevel if they have questions.

This does not happen in many med spas.

Then theres the business side. The practice of medicine in Texas is regulated by the Texas Medical Practice Act, the Texas Medical Board, and administrative rules. Because med spas provide medical services to the public, they must comply with all these rules just like any other medical practice.

Med spas must be formed as an acceptable legal entity type. In Texas, medical practices are limited to professional associations (PAs), professional limited liability companies (PLLCs), and general partnerships with other licensed physicians. Many med spas are incorrectly formed as corporations or regular LLCs.

This is not just a technical problem. It leads to improper ownership. Medical entities, like med spas, cannot be owned by non-physicians. They must be owned by persons licensed to practice medicine in Texas.

There is a lot of information on the Internet, much of which is incomplete or wrong.

Texas is a Corporate Practice of Medicine state, which means that physicians cannot be employed to provide medical services by companies not owned by licensed physicians. In practical terms, a non-physician cannot start a company and then hire a physician to provide medical services to patients of that company. With very few exceptions, medical services can only be provided through professional entities owned by physicians.

These same prohibitions apply to midlevel providers like Physician Assistants and Nurse Practitioners. Physician Assistants can co-own a medical practice with a physician only if the physician controls a majority interest in the practice. Nurse Practitioners cannot own any percentage of a medical practice.

These are just a few of the compliance issues for Texas med spas. There are also in-office and website disclosure requirements, registration requirements, reporting requirements, and restrictions on the type of marketing or advertising the practice can engage in.

Patients are caught in the middle. Those injured at a non-compliant med spa may not know where to turn.

These types of complaints to the Texas Medical Board are growing at an alarming rate. If the non-compliant med spa has a Medical Director, the Board can discipline the physician for inappropriate supervision or unprofessional conduct. Physicians associated with non-compliant med spas are putting their medical licenses at risk.

For the unlicensed med spa owner, the Medical Board can shut down their business. In extreme cases, the unlicensed med spa owner could be charged with practicing medicine without a license. If the patient suffers a physical or psychological injury, the owner could be charged with a third-degree felony which carries jail time of two to ten years and a fine of $10,000.

If the patient hires an attorney to sue for malpractice, the med spas insurance company may deny coverage if the med spa was not formed or owned in compliance with Texas law.

Med spas are big business and growing rapidly. But with great reward comes great responsibility. Entrepreneurs owe it to themselves and patients to set up the med spa the right way, with the right supervision, and the right ownership.

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The Med Spa on the Corner Is Probably Breaking the Law - JD Supra

Top AEW star provides an update on injury, likely to be out for "weeks" – Sportskeeda

Modified Apr 04, 2023 19:50 IST

The AEW roster has undergone another shake-up after one of its top stars suffered an injury that could potentially set them back for months. Matt Jackson has now updated fans on his partially torn bicep, and it seems like he might not be out for as long as initially believed.

According to reports, Jackson suffered his injury sometime during the nine-man Trios Championship match at AEW Revolution. The House of Black ended up walking away with the gold, coincidentally allowing the star to get some much-needed time off to rehab his injury.

During the latest episode of Being The Elite, Matt Jackson explained his injury and the alternate forms of rehabilitation that he'll seek instead.

Jackson continued, emphasizing that he feels good and is hopeful that he'll recover soon.

While not a fully-fledged member of The Elite, Don Callis also recently suffered a gruesome injury during a backstage attack at the hands of The Blackpool Combat Club.

Missed out on last week's AEW Dynamite or Rampage? Catch up with the results right here.

The Brawl Out Incident brought many of AEW's backstage issues to light and became an unfortunate stain on the promotion. While fans were upset by the controversy, it seems like it also deeply affected The Young Bucks.

During the premiere episode of AEW: All Access, The Jackson brothers revealed that they had private talks about hanging up their boots.

Despite this, there were rumors that The Young Bucks could potentially jump over to WWE once their contracts expire. Fans will simply have to be patient until then.

RIP Bushwhacker Butch. We spoke to Luke moments before his passing here

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Top AEW star provides an update on injury, likely to be out for "weeks" - Sportskeeda

Want Longer, Thicker Hair? The Hair Whisperer Has The Answers – British Vogue

It was a friend with a particularly bounteous mane who first mentioned his name: Ricardo Vila Nova. She had been to see the Hair Whisperer in his sleek little salon in a corner of Harrods, and compared the feeling afterwards to scalp freedom. Freeing my own head from itchy, flaky torment was something that really appealed to me. Could this be the person who would make my scalp sing again?

Vila Nova, who is as glossy of hair and warm of manner as you could hope, began with an in-depth analysis. After plucking two of my strands, his state-of-the-art microscopical scanner revealed their construction. Its almost like an MRI, he explains. You can see the hairs genetic constitution, along with the factors that have contributed to any degeneration, whether thats hormones, nutrition, inflammation, medication or toxins. Once hes identified what is impacting the hair, a bespoke treatment plan is conjured up to tackle the root cause (pun intended).

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For me, the issue was inflammation, which, according to the scan, was sitting below my epidermis, causing itchiness, dermatitis and occasional shedding. No surprise really, given my scalp is prone to flaring up when Im stressed, eating badly or generally run-down. If inflammation continues to build up lets say youve overindulged or you take medication that could upset liver function it penetrates to a deeper level of the skin, which is when the hair starts suffering, Vila Nova explains. Thats when more serious issues, such as hair loss (which Harvard Health Publishing estimates affects around a third of all women at some point in their lives), can come into play.

If you are genetically predisposed towards a skin condition, such as eczema, dermatitis or psoriasis, youll likely know its pretty much impossible to remove the issue completely. But what you can do is manage it, keeping it dormant while boosting scalp and hair resilience, achieved by way of a 360-degree approach. Putting a balanced lifestyle a healthy diet, exercise and as little stress as possible, all of which are important to the side, the programme Vila Nova prescribes consists of multi-step treatments.

There will be scalp reparation, washing, steaming and rehydration or reconstruction, he says. Just a few of the rigorous treatments that follow include a deeply relaxing head massage, scalp microneedling (where a dermaroller is used to create micro-channels in the scalp, allowing any subsequent treatment serum to penetrate deeply) and steaming to help soften and hydrate.

Afterwards, Im instantly converted. My scalp has never looked or felt so clean. I leave swinging a bag filled with my three-step home routine (comprising a shampoo, protein mask and scalp treatment) to be used once a week between monthly appointments.

Vila Novas fastidiousness is no surprise given that his background is in skincare he worked as an aesthetic facialist in the 90s. He became one of the first to bring the same principles applied to looking after the skin into haircare. All you had back then was shampoo to clean the surface of the scalp and masks. If you wanted to help the scalp or enable hair to regenerate or recover, it would be medication and steroids.

Amanda Gorman On Natural Hair, Winged Eyeliner And How She Gets Into The Writing Zone

Hannah Coates

Youll remember American poet and activist, Amanda Gorman, from President Joe Bidens inauguration in 2021. Resplendent in a yellow coat and ruby red Prada hairband, she gave a moving reading of her poem, The Hill We Climb, as the eyes of the world looked on. Two years later, Gorman has now been unveiled as Este Lauders first global changemaker. Here, she talks to acting senior beauty and wellness editor, Hannah Coates, about her writing process, hair accessories and the wellbeing workout she loves.

While the scalp doesnt need certain ingredients common in facials, like retinol or vitamin C, it does need hydrolipids, hydration, collagen and protein plus a balanced pH to make it strong and healthy, all of which is incorporated into Vila Novas luxurious treatments. Nowadays, with more than 20 years under his belt, he also embraces a number of hi-tech tools in his clinic, such as PRP (or platelet-rich plasma injections, where blood is taken from the patient, run through a machine to separate the platelets and then re-injected), which he says is excellent for treating alopecia, healing and boosting regrowth. With injectable technology, the response is much faster its not instant and it takes time, but you do notice a longer-lasting effect in terms of how the hair and scalp feels, how strong it is, how it recovers, he says.

PRP is also his secret weapon against postpartum hair loss, a common issue among his clientele. During pregnancy, your own growth factors rise naturally in the blood, and growth factor is the main ingredient in PRP, he explains. Even a laboratory couldnt create the same amount of growth factors as a pregnant woman. Once the baby has been delivered, the growth factors decrease and thats when hair starts falling. I give my clients a one-month window, maximum, after birth to collect their growth factors we reuse them, and then extend the pregnancy effects on the hair.

However significant your concerns are, what used to be a serious, medical experience at the trichologist is now something to look forward to. Optimal health of the body, the mind, and yes, the scalp too is the goal, and Vila Nova notes that his clients, who fly in from all over the world to see him, are those who want to make their hair stronger, double in quantity and enjoy a super comfortable scalp.

As for me, thanks to a thorough diagnosis and a clear understanding of whats going on up there, so far its made it much easier not to despair when the itchiness and flaking gets out of control. Not only will I know when its time to get some rest, eat better or address my stress levels, Ill also know its time to call Ricardo for more scalp therapy. Like I said, Im a convert.

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Want Longer, Thicker Hair? The Hair Whisperer Has The Answers - British Vogue

What is ‘male pattern baldness’? – Livescience.com

Androgenetic alopecia, also known as male pattern baldness (MPB), is the most common cause of hair loss in men. It begins as a receding hairline or bald spot on the top of the head, progressing over time to the sides and rear of the head. The factors that drive this type of hair loss can also cause hair thinning, where hairs grow smaller in diameter, according to the American Academy of Dermatology (opens in new tab) (AAD).

Male pattern baldness affects males of all ages. Two-thirds of American men will experience some degree of hair loss due to MPB by age 35, and approximately 25% of men begin the process before they reach age 21, according to the American Hair Loss Association (opens in new tab) (AHLA).

People may lose their hair for many reasons, including serious diseases, reactions to certain medications, and in rare cases, extremely stressful events, but most hair loss in men can be ascribed to genetic and hormonal factors. However, the exact mechanisms behind male pattern baldness aren't fully understood, and it is likely to have more than one cause.

People with MPB tend to carry genes that make their hair follicles highly sensitive to dihydrotestosterone (DHT), a byproduct of testosterone, according to AHLA (opens in new tab). An enzyme called Type 2 5-alpha-reductase converts a small percentage of the body's testosterone into DHT; this enzyme can be found in various body parts, as well as in hair follicles. Hair follicles around the temples, mid-anterior scalp and hairline appear to be most sensitive to DHT, and in general, balding scalp may have a higher concentration of DHT than non-balding scalp, according to a 2020 study published in the journal Frontiers in Pharmacology (opens in new tab).

DHT binds to androgen receptors on hair follicles, causing the follicles to shrink and their life spans to shorten. Eventually, these hair follicles stop producing hair.

Hair follicles in balding scalp may carry more androgen receptors (opens in new tab) than those in non-balding scalp. In addition, certain genetic variations in the androgen receptor (AR) gene may make hair follicles more susceptible to the effects of DHT (opens in new tab), which in turn increases the risk of MPB. The age at which MPB starts may also be determined by genetic variations (opens in new tab) in the AR gene.

In a 2017 study published in the journal Nature Communications (opens in new tab), scientists analyzed genetic profiles of 10,846 participants and found that, in addition to genes involved in the hair growth cycle, androgenetic alopecia may also be linked to genes involved in the sleep-wake cycle and the formation of fat cells within the body.

Changes in the activity of stem cells may also play a role in male pattern baldness. For example, a 2020 study in mice suggests that hair follicle stem cells (HFSCs) in aging skin show different gene activity (opens in new tab) than those in young skin, and this may be linked to declines in hair growth. In addition, stem cells derived from fat tissue in the scalp tend to secrete more inflammatory proteins in balding areas than in non-balding areas, according to a 2022 study published in the journal Experimental Dermatology (opens in new tab). Such inflammatory markers have been linked to impaired activity in genes involved in hair growth (opens in new tab).

Researchers have also found that disrupted functioning of testosterone receptors (opens in new tab) in the scalp may lead to the degeneration of blood vessels that nourish hair follicles. This can result in a reduction in supply of oxygen and nutrients necessary for hair growth.

Hair loss can often be treated with a variety of at-home treatments, including over-the-counter and prescribed medications, according to AAD (opens in new tab).

Over-the-counter minoxidil (brand name Rogaine) can help during the early stages of hair loss. Many people see some regrowth when using this medication, but it may take about six to 12 months to see results. Minoxidil appears to be particularly effective when used along with another treatment, such as microneedling, a type of treatment that uses small needles to cause tiny punctures in the skin, AAD said.

Microneedling may stimulate hair follicle growth (opens in new tab) and allow topical treatments, such as steroid creams, to reach deeper layers of the scalp. Available evidence suggests that this strategy is safe and effective for MPB, but more large, gold-standard clinical trials are "strongly recommended to provide more definitive evidence," according to a 2022 review published in the journal Aesthetic Plastic Surgery (opens in new tab).

Prescription medication, such as finasteride (brand name Propecia) can also stimulate hair growth, according to AAD. However, this medication carries a risk of side effects that minoxidil doesn't, such as decreased libido and changes in cognition, including brain fog, according to a 2012 review published in The Journal of Sexual Medicine (opens in new tab).

Other procedures to regrow hair involve injections of corticosteroids into the bald areas, hair transplants and platelet-rich plasma treatment, a procedure that involves injecting blood plasma into the area with hair loss, AAD said. Platelet-rich plasma treatment, in particular, is considered a safe and effective alternative to hair loss medications, because it carries a low risk of serious side effects (opens in new tab).

In addition, there are surgical treatments available for hair loss, including hair transplants and scalp reductions, which involve removing balding tissue from the scalp, according to Stanford Medicine (opens in new tab).

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What is 'male pattern baldness'? - Livescience.com