Review of Scientific Self-Experimentation: Ethics History, Regulation, Scenarios, and Views Among Ethics Committees and Prominent Scientists

CNS Drug Discovery in Academia: Where Basic Research Meets Innovation

The involvement of academic research in drug discovery is consistently growing. However, academic projects seldom advance to clinical trials. Here, we assess the landscape of drug discovery within the National Centre of Competence in Research (NCCR) TransCure launched by the Swiss National Science Foundation to foster basic research and early-stage drug discovery on membrane transporters. This included transporters in central nervous system (CNS) disorders, which represent a huge unmet medical need. While idea championship, sustainable funding, collaborations between disciplines at the interface of academia and industry are important for translational research, Popperian falsifiability, strong intellectual property and a motivated startup team are key elements for innovation. This is exemplified by the NCCR TransCure spin-off company Synendos Therapeutics, a clinical stage biotech company developing the first selective endocannabinoid reuptake inhibitors (SERIs) as novel treatment for neuropsychiatric disorders. We provide a perspective on the challenges related to entering an uncharted druggable space and bridging the often mentioned "valley of death". The high attrition rate of drug discovery projects in the CNS field within academia is often due to the lack of meaningful animal models that can provide pharmacological proof-of-concept for potentially disruptive technologies at the earliest stages, and the absence of solid intellectual property.

Radical-Driven Methane Formation in Humans Evidenced by Exogenous Isotope-Labeled DMSO and Methionine

Methane (CH₄), which is produced endogenously in animals and plants, was recently suggested to play a role in cellular physiology, potentially influencing the signaling pathways and regulatory mechanisms involved in nitrosative and oxidative stress responses. In addition, it was proposed that the supplementation of CH₄ to organisms may be beneficial for the treatment of several diseases, including ischemia, reperfusion injury, and inflammation. However, it is still unclear whether and how CH₄ is produced in mammalian cells without the help of microorganisms, and how CH₄ might be involved in physiological processes in humans. In this study, we produced the first evidence of the principle that CH₄ is formed non-microbially in the human body by applying isotopically labeled methylated sulfur compounds, such as dimethyl sulfoxide (DMSO) and methionine, as carbon precursors to confirm cellular CH₄ formation. A volunteer applied isotopically labeled (²H and ¹³C) DMSO on the skin, orally, and to blood samples. The monitoring of stable isotope values of CH₄ convincingly showed the conversion of the methyl groups, as isotopically labeled CH₄ was formed during all experiments. Based on these results, we considered several hypotheses about endogenously formed CH₄ in humans, including physiological aspects and stress responses involving reactive oxygen species (ROS). While further and broader validation studies are needed, the results may unambiguously serve as a proof of concept for the endogenous formation of CH₄ in humans via a radical-driven process. Furthermore, these results might encourage follow-up studies to decipher the potential physiological role of CH₄ and its bioactivity in humans in more detail. Of particular importance is the potential to monitor CH₄ as an oxidative stress biomarker if the observed large variability of CH₄ in breath air is an indicator of physiological stress responses and immune reactions. Finally, the potential role of DMSO as a radical scavenger to counteract oxidative stress caused by ROS might be considered in the health sciences. DMSO has already been investigated for many years, but its potential positive role in medical use remains highly uncertain.

Results of a 5-Year N-of-1 Growth Hormone Releasing Hormone Gene Therapy Experiment

Here presented for the first time are results showing persistence over a 5+ year period in a human who had a hormone gene therapy administered to muscle. This growth hormone releasing hormone (GHRH) therapy was administered in two doses, a year apart, with a mean after the second dose of 195 ng/mL (13 × normal, σ = 143, σ_M = 34, max = 495, min = 53). This level of GHRH therapy appears to be safe for the subject, although there were some adverse events. Insulin-like growth factor 1 levels were little affected, nor were the growth hormone test results, showing no indications of acromegaly for the hormone homologue used. Heart rate declined 8 to 13 bpm, persistent over 5 years. Testosterone rose by 52% (σ = 22%, σ_M = 6%). The high-density lipoprotein/low-density lipoprotein ratio dropped from 3.61 to mean 2.81 (σ = 0.26, σ_M = 0.057, max = 3.3, min = 2.5), and triglycerides declined from 196 mg/dL to mean 94.4 mg/dL (σ = 21.9, σ_M = 5.0, min = 59, max = 133, min = 59). White blood cell counts increased, however, the baseline was not strong. CD4 and CD8 mean increased by11.7% (σ = 11.6%, σ_M = 3.3%, max = 30.7%, min = -9.6%) and 12.0% (σ = 10.5%, σ_M = 3.0%, max = 29.1%, min = -6.7%), respectively. Ancillary observations comprise an early period of euphoria, and a dramatic improvement in visual correction after the first dose, spherical correction from baseline (L/R) -2.25/-2.75 to -0.25/-0.5. Over the next 5 years, correction drifted back to -1.25/-1.75. Horvath PhenoAge was cut 44.1% post-treatment. At completion, epigenetic age was -6 years (-9.3%), and telomere age was +7 months (+0.9%).

Formulation and organoleptic evaluation of Poly Herbal Cream of Punica, Neem, Carrot & Jamun as Active Ingredients

Assuming that herbal preparation is better with fewer side effects than synthetics, natural treatments are more effective than allopathy in terms of side effects for better human body healing. Herbal products have a growing demand in the world market, and the plants have been reported in the literature as having various pharmacological activities such as anti-microbial, anti-oxidant, anti-inflammatory activity, anti-cancer, anti-diabetic. The purpose of this study was to develop anti-aging poly-herbal cream by mixing the extract of Punica leaf, Neem Oil, Jamun powder, Carrot powder as the main ingredient, and then creams were developed based on the anti-oxidant ability of herbal extracts and performed their evaluation study. Punica granatam leaves were shade dried and extracted using the Soxhlet method with different solvents such as n-hexane, benzene, and alcohol. Fine extract powder was collected and removed distilled water thoroughly. The cream was formulated into different concentrations, namely F1, F2, F3, and F4. Similar types of research with similar components have been reported, but in this experiment, the formulation is different, and this work is kept cost-efficient and straightforward; it's an attempt to reduce few components and prepare cream and evaluate its potential. According to The International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use ICH guidelines, the cream was stable during stability studies, and F3 turned out to be a better formulation than the other three.

First immunohistochemical evidence of human tendon repair following stem cell injection: A case report and review of literature

BACKGROUND

Current clinical treatment options for symptomatic, partial-thickness rotator cuff tear (sPTRCT) offer only limited potential for true tissue healing and improvement of clinical results. In animal models, injections of adult stem cells isolated from adipose tissue into tendon injuries evidenced histological regeneration of tendon tissue. However, it is unclear whether such beneficial effects could also be observed in a human tendon treated with fresh, uncultured, autologous, adipose derived regenerative cells (UA-ADRCs). A specific challenge in this regard is that UA-ADRCs cannot be labeled and, thus, not unequivocally identified in the host tissue. Therefore, histological regeneration of injured human tendons after injection of UA-ADRCs must be assessed using comprehensive, immunohistochemical and microscopic analysis of biopsies taken from the treated tendon a few weeks after injection of UA-ADRCs.

CASE SUMMARY

A 66-year-old patient suffered from sPTRCT affecting the right supraspinatus and infraspinatus tendon, caused by a bicycle accident. On day 18 post injury [day 16 post magnetic resonance imaging (MRI) examination] approximately 100 g of abdominal adipose tissue was harvested by liposuction, from which approximately 75 × 10⁶ UA-ADRCs were isolated within 2 h. Then, UA-ADRCs were injected (controlled by biplanar X-ray imaging) adjacent to the injured supraspinatus tendon immediately after isolation. Despite fast clinical recovery, a follow-up MRI examination 2.5 mo post treatment indicated the need for open revision of the injured infraspinatus tendon, which had not been treated with UA-ADRCs. During this operation, a biopsy was taken from the supraspinatus tendon at the position of the injury. A comprehensive, immunohistochemical and microscopic analysis of the biopsy (comprising 13 antibodies) was indicative of newly formed tendon tissue.

CONCLUSION

Injection of UA-ADRCs can result in regeneration of injured human tendons by formation of new tendon tissue.

1,1-Difluoroethane Forensic Aspects for the Toxicologist and Pathologist

1,1-Difluoroethane (DFE) is a halogenated hydrocarbon that is commonly used as a propellant in air duster products. Herein, the pharmacology of DFE was reviewed, and questions relevant to medicolegal investigations were addressed. Particular emphasis was given to detection time in biological specimens and the range, onset and duration of effects. DFE may be abused as an inhalant and is rapidly absorbed through the lungs. Onset of central nervous system (CNS) depressant effects is within seconds and the duration may only last minutes. The effects may lead to impairment of human performance, including confusion, lethargy, impaired judgment, loss of motor coordination and loss of consciousness. Death may result even after the first use. With heavy use or in combination with other CNS depressants, extended periods of drowsiness or loss of consciousness may be observed with an increased risk of a fatal event. A majority of impaired driving investigations where DFE was identified included a collision demonstrating the significant impact its use may have on traffic safety. When DFE is identified alone, without other drugs that cause CNS impairment, the effects may not be observable minutes after the crash, making identification of its use difficult. Although concentrations dissipate rapidly, DFE has been detected in blood specimens collected up to 3 hours after the driving incident. Two studies on passive exposure presented herein demonstrated that it is unlikely to detect DFE above concentrations of ∼2.6 µg/mL in blood or urine due to even extreme unintentional exposure. Alternative specimens such as brain, lung and tracheal air should be considered in some postmortem investigations. DFE has been identified in blood specimens from postmortem cases at concentrations from 0.14 to 460 µg/mL and in impaired driving cases from 0.16 to 140 µg/mL.

Designing a SARS-CoV-2 T-Cell-Inducing Vaccine for High-Risk Patient Groups

We describe the results of two vaccinations of a self-experimenting healthy volunteer with SARS-CoV-2-derived peptides performed in March and April 2020, respectively. The first set of peptides contained eight peptides predicted to bind to the individual's HLA molecules. The second set consisted of ten peptides predicted to bind promiscuously to several HLA-DR allotypes. The vaccine formulation contained the new TLR 1/2 agonist XS15 and was administered as an emulsion in Montanide as a single subcutaneous injection. Peripheral blood mononuclear cells isolated from blood drawn before and after vaccinations were assessed using Interferon-γ ELISpot assays and intracellular cytokine staining. We detected vaccine-induced CD4 T cell responses against six out of 11 peptides predicted to bind to HLA-DR after 19 days, following vaccination, for one peptide already at day 12. We used these results to support the design of a T-cell-inducing vaccine for application in high-risk patients, with weakened lymphocyte performance. Meanwhile, an according vaccine, incorporating T cell epitopes predominant in convalescents, is undergoing clinical trial testing.

Ethical Inclusion of Health Care Workers in Covid-19 Research

Employees are often considered a vulnerable research population due to concerns about consent and confidentiality, but there is insufficient guidance regarding their ethical inclusion in research. In the context of Covid-19, frontline health care workers comprise a particularly relevant research population in light of their risks of viral exposure and psychological strain, among other factors. They may therefore be targeted for research conducted at their place of employment and benefit from participating in such research. Beyond Covid-19, there are other circumstances in which health care workers may be considered for inclusion in research conducted by or with the involvement of their colleagues and employers. As investigators, sponsors, institutional review boards, and others assess the ethical permissibility of these scenarios, as well as relevant protections, we recommend systematic consideration of social and scientific value, validity, fairness, risks and benefits, voluntary consent, respect, and independent review. There is often good reason to specifically target health care workers for inclusion in Covid-19 research (beyond convenience), and they should not be excluded from research offering the prospect of direct benefit. However, additional safeguards may be necessary in employer-based research to avoid scientific bias, promote voluntariness, and solicit stakeholder input. Research personnel should be permitted to enroll in their own Covid-19 studies only when participation offers them the prospect of unique benefits.

Neurobehavioural signatures in race car driving: a case study

Recent technological developments in mobile brain and body imaging are enabling new frontiers of real-world neuroscience. Simultaneous recordings of body movement and brain activity from highly skilled individuals as they demonstrate their exceptional skills in real-world settings, can shed new light on the neurobehavioural structure of human expertise. Driving is a real-world skill which many of us acquire to different levels of expertise. Here we ran a case-study on a subject with the highest level of driving expertise-a Formula E Champion. We studied the driver's neural and motor patterns while he drove a sports car on the "Top Gear" race track under extreme conditions (high speed, low visibility, low temperature, wet track). His brain activity, eye movements and hand/foot movements were recorded. Brain activity in the delta, alpha, and beta frequency bands showed causal relation to hand movements. We herein demonstrate the feasibility of using mobile brain and body imaging even in very extreme conditions (race car driving) to study the sensory inputs, motor outputs, and brain states which characterise complex human skills.

A new synthetic toll-like receptor 1/2 ligand is an efficient adjuvant for peptide vaccination in a human volunteer

BACKGROUND

We previously showed that the bacterial lipopeptide Pam₃Cys-Ser-Ser, meanwhile established as a toll-like receptor (TLR) 1/2 ligand, acts as a strong adjuvant for the induction of virus specific CD8⁺ T cells in mice, when covalently coupled to a synthetic peptide.

CASE PRESENTATION

We now designed a new water-soluble synthetic Pam₃Cys-derivative, named XS15 and characterized it in vitro by a TLR2 NF-κB luciferase reporter assay. Further, the capacity of XS15 to activate immune cells and stimulate peptide-specific CD8⁺ T and NK cells by 6-sulfo LacNAc⁺ monocytes was assessed by flow cytometry as well as cytokine induction using immunoassays. The induction of a functional immune response after vaccination of a volunteer with viral peptides was assessed by ELISpot assay and flow cytometry in peripheral blood cells and infiltrating cells at the vaccination site, as well as by immunohistochemistry and imaging. XS15 induced strong ex vivo CD8⁺ and T_H1 CD4⁺ responses in a human volunteer upon a single injection of XS15 mixed to uncoupled peptides in a water-in-oil emulsion (Montanide™ ISA51 VG). A granuloma formed locally at the injection site containing highly activated functional CD4⁺ and CD8⁺ effector memory T cells. The total number of vaccine peptide-specific functional T cells was experimentally assessed and estimated to be 3.0 × 10⁵ in the granuloma and 20.5 × 10⁶ in peripheral blood.

CONCLUSION

Thus, in one volunteer we show a granuloma forming by peptides combined with an efficient adjuvant in a water-in-oil-emulsion, inducing antigen specific T cells detectable in circulation and at the vaccination site, after one single vaccination only. The ex vivo T cell responses in peripheral blood were detectable for more than one year and could be strongly boosted by a second vaccination. Hence, XS15 is a promising adjuvant candidate for peptide vaccination, in particular for tumor peptide vaccines in a personalized setting.