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Study: New mutation in H1N1 viruses potentially led to more disease in middle-aged Americans last year

BY Michael Johnsen

PHILADELPHIA — A team of scientists, led by researchers at the Wistar Institute, has identified a possible explanation for why middle-aged adults were hit especially hard by the H1N1 influenza virus during the 2013-14 influenza season. The findings, published Tuesday in the Proceedings of the National Academy of Sciences, offer evidence that a new mutation in H1N1 viruses potentially led to more disease in these individuals. Their study suggests that the surveillance community may need to change how they choose viral strains that go into seasonal influenza vaccines, the researchers reported.
 
“We identified a mutation in recent H1N1 strains that allows viruses to avoid immune responses that are present in a large number of middle-aged adults,” said Scott Hensley, a member of Wistar’s Vaccine Center and an assistant professor in the Translational Tumor Immunology program of Wistar’s Cancer Center.
 
Historically, children and the elderly are most susceptible to the severe effects of the influenza viruses, largely because they have weaker immune systems. However, during the 2013-2014 physicians saw an unusually high level of disease due to H1N1 viruses in middle-aged adults — those who should have been able to resist the viral assault. Although H1N1 viruses recently acquired several mutations in the hemagglutinin (HA) glycoprotein, standard serological tests used by surveillance laboratories indicate that these mutations do not change the viruses’ antigenic properties.
 
However, Wistar researchers have shown that, in fact, one of these mutations is located in a region of HA that allows viruses to avoid antibody responses elicited in some middle-aged adults. Specifically, they found that 42% of individuals born between 1965 and 1979 possess antibodies that recognize the region of HA that is now mutated. The Wistar researchers suggest that new viral strains that are antigenically matched in this region should be included in future influenza vaccines.
 
“Our immune systems are imprinted the first time that we are exposed to influenza virus,” Hensley said. “Our data suggest that previous influenza exposures that took place in the 1970s and 1980s influence how middle-aged people respond to the current H1N1 vaccine.”
 
The researchers noted that significant antigenic changes of influenza viruses are mainly determined using anti-sera isolated from ferrets recovering from primary influenza infections. However humans are typically re-infected with antigenically distinct influenza strains throughout their life. Therefore, antibodies that are used for surveillance purposes might not be fully reflective of human immunity.
 
“The surveillance community has a really challenging task and they do a great job, but we may need to re-evaluate how we, as a community, detect antigenically distinct influenza strains and how we choose vaccine strains,” Hensley said.  “It makes sense to base these analyses on human antibodies.”
 
“Without a doubt, the best way to prevent getting influenza infection is to receive an influenza vaccine,” Hensley concluded. “Right now influenza vaccines are pretty effective, but our studies suggest ways that we can potentially make them work even better.”
 

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Study: OTC analgesics, anti-inflammatory drugs may also help with depression

BY Michael Johnsen

AARHUS, Denmark — Over-the-counter painkillers and anti-inflammatory drugs may also be effective in the treatment of people suffering from depression, according to a meta-analysis published Tuesday by a research group from Aarhus University in the American scientific journal JAMA Psychiatry. The meta-analysis is based on 14 international studies with a total of 6,262 patients who either suffered from depression or had individual symptoms of depression.
 
In recent years research has demonstrated a correlation between depression and physical illnesses, such as painful conditions or infections in the individual patient.
 
"The meta-analysis supports this correlation and also demonstrates that anti-inflammatory medication in combination with antidepressants can have an effect on the treatment of depression. When combined they give an important result which, in the long term, strengthens the possibility of being able to provide the individual patient with more personalized treatment options," stated Ole Köhler, who is first author of the scientific article and a member of the research group from Aarhus University."However, these effects must always be weighed against the possible side effects of the anti-inflammatory drugs. We still need to clarify which patients will benefit from the medicine and the dose-sizes required," he said. "The biggest problem with depression is that we do not know the causes that trigger the condition in the individual patient. Some studies suggest that the choice of antidepressant medication can be guided by a blood sample that measures whether there is an inflammatory condition in the body. Other studies show that the same blood samples could be used as a guideline on whether a depressive patient can be treated with anti-inflammatory drugs that works better when there is inflammation present simultaneously with the depression. These findings must, however, be verified before they can be implemented in clinical practice." 
 
Köhler emphasized that it is not possible to conclude on the basis of the meta-analysis that an inflammatory state can be the sole explanation for a depression. "The analysis should be seen as a significant milestone in a research context and this could be a landmark for what future research projects and treatment need to focus on," he said.

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HRG posts ’99 Ways to Make a Positive Difference in Your Pharmacy’ blog series

BY Michael Johnsen

WAUKESHA, Wis. — Hamacher Resource Group on Tuesday announced its 99 Ways to Make a Positive Difference in Your Pharmacy blog series. 99 Ways offers actionable ideas for community pharmacies to implement that can improve store operations and refresh the customer experience.
 
The short-format blog series is written by the company’s team of independent pharmacy experts and includes viewpoints from category analysts, pricing analysts, operational experts, customer service professionals, marketers and business development managers. Blog posts vary by topic and can be read quickly, offering actionable suggestions that pharmacists can easily implement in their stores to improve the patients experience, build customer loyalty and strengthen operations. 
 
Additionally, HRG is offering pharmacists a free, downloadable poster listing all 99 Ways to Make a Positive Difference in Your Pharmacy topics that pharmacists can retrieve from the company’s website to post in-store or share with staff.
 
“The convenient, short format of the blog makes it easy for busy pharmacists to quickly enjoy the posts and come away inspired, armed with practical ideas that can improve their businesses,” stated Tom Boyer, director of national accounts and member of the owner’s group.
 
99 Ways to Make a Positive Difference in Your Pharmacy will continue to be updated with one-to-two new posts per week into 2015. To explore the blog or to subscribe to receive new posts directly to your inbox, visit Hamacher.com/99ways.
 

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