Individuals taking class of steroid medications at high risk for COVID-19

Individuals taking a class of steroid hormones called glucocorticoids for conditions such as asthma, allergies and arthritis on a routine basis may be unable to mount a normal stress response and are at high risk if they are infected with the virus causing COVID-19, according to a new editorial published March 31, 2020, in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Glucocorticoids are a class of medications used to treat a variety of inflammatory conditions and administered by many different routes, including tablets, topical creams and inhaled medications. Patients taking these medications may be more susceptible to COVID-19 as a result of the medication suppressing the immune system. They may also experience more severe disease once infected because these medications suppress their own steroid response to infection. Injectable supplemental glucocorticoid therapy in this setting can reverse the risk of potentially fatal adrenal failure and should be considered in every case. Individuals with known primary adrenal insufficiency, also known as Addison's disease, and secondary adrenal insufficiency occurring in hypopituitarism should also take extra precautions. If patients develop symptoms such as a dry continuous cough and fever, they should double their oral glucocorticoid dose immediately and continue doing so until the fever has subsided. They, too, will require injectable glucocorticoid therapy should their condition worsen. Endocrinologists can play a key role in recognizing, managing and implementing these measures, according to the authors.

Broken bone location can have significant impact on long-term health

In older individuals, the location of a broken bone can have significant impacts on long-term health outcomes, according to research accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting, and publication in a special supplemental section of the Journal of the Endocrine Society. The study found older people with broken bones closer to the center of the body, known as proximal fractures (such as upper arm, upper leg, pelvis and ribs) face a greater risk of being admitted to the hospital for major medical conditions and of dying prematurely following their fracture than similarly aged people without fractures. "It is well-known that a hip fracture can have devastating health implications for older individuals, but less is known about the effects of other fractures in the body," said lead study author Jacqueline Center, of the Garvan Institute of Medical Research in Sydney. "Not only should people be treated for their bone health, but we now have information allowing us to understand why people do badly after a fracture and how we may intervene to improve outcomes." The researchers used the Danish National Database to study 300,000 patients 50 years or older with a low-trauma fracture (due to falls from a standing height). They examined differences in the reasons for subsequent hospital admission and death patterns between patients with proximal fractures compared with those fractures further away from the center of the body, known as distal bones (such as the wrist, ankle, hand or foot), where there is no increased risk of death. They matched people with fractures to people without fractures who had a similar age and other medical diagnoses. They found that people with broken bones at proximal sites had a 1.5- to 4-fold greater risk of death over the next two years than their non-fracture counterparts, whether they were admitted to the hospital after their fracture or not. They were also more likely to have an admission to the hospital for cardiovascular disease, cancer, stroke, diabetes, pneumonia and lung disease. By contrast, those people who had a distal fracture had similar or lower risk of death, as well as similar hospital admission patterns as their counterparts with no fractures.

(Re)generation next: Novel strategy to develop scaffolds for joint tissue regeneration

In a new study published in Chemistry of Materials, scientists from Japan found a new method for developing tissue regeneration scaffolds. To begin with, the scientists wanted to find self-assembling compounds that could form independent 3D networks without interfering with each other. They began by selecting a peptide called RADA16, which, under physiological conditions, forms a network owing to electrostatic and hydrophobic interactions. Then, they turned to a biopolymer called chitosan (CH) and a compound called polyethylene glycol (PEG), which form networks with each other via chemical reactions. Because the mechanisms of network formation in RADA16 and CH/PEG were drastically different, the scientists speculated that these networks would not interfere with each other. By simply mixing the two compounds, they found that this was indeed true. Next, the researchers wanted to check if the proposed interpenetrating polymer network (IPN) could effectively act as a scaffold to promote the growth of healthy chondrocytes (cells that produce cartilage). The scientists tested the scaffold using human cells and found that cells are embedded uniformly in the hydrogel, effectively generating functional cartilage tissue. In fact, in mice, implanting human chondrocytes within the hydrogel scaffold led to cartilage formation over a period of eight weeks, even surpassing the performance of conventional tissue scaffolds. The biggest advantage of this technique was that not only did it successfully regenerate cartilage tissue, it was also performed in just one step or "pot," making it much simpler than existing techniques. These findings could potentially overcome the limitations of tissue regeneration and pave the way for further applications such as drug delivery, diagnosis, and surface modification. The article is titled, “Interpenetrating Polymer Network Hydrogels via a One-Pot and in Situ Gelation System Based on Peptide Self-Assembly and Orthogonal Cross-Linking for Tissue Regeneration.”

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