Latest news with #ANCA
Medscape
22-05-2025
- Health
- Medscape
Novel Neutrophil Subset Predicts Relapse in ANCA Vasculitis
Researchers in Japan showed that a unique neutrophil subset, characterized by type II interferon signature genes (T2ISG), along with elevated levels of interferon gamma in the blood, can predict the risk for relapse in patients with new-onset microscopic polyangiitis (MPA). METHODOLOGY: Researchers conducted single-cell transcriptome and surface proteome analyses of peripheral white blood cells from patients with new-onset MPA to study neutrophil dynamics in antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis. They collected 179,664 peripheral white blood cells from six patients with new-onset MPA (three women; average age, 74 years) and seven healthy donors (four women; average age, 67 years). Patient samples were taken before starting immunosuppressive therapy. Interferon gamma concentrations in the serum were measured for 37 patients with MPA, of whom 24 had new-onset disease and 13 had started receiving treatment. TAKEAWAY: Compared with healthy donors, patients with MPA showed higher proportions of two distinct neutrophil populations: Immature neutrophil and T2ISG neutrophil populations. Certain differentially expressed genes in the neutrophils of patients with MPA vs healthy donors were linked to interferon gamma signaling. The T2ISG neutrophil subset differentiated from mature neutrophils upon stimulation with interferon gamma and tumor necrosis factor. This subset was characterized by the surface exposure of pathogenic molecules that may contribute to neutrophil-mediated inflammation in MPA. Of the six patients with new-onset MPA, those who showed higher proportions of the T2ISG neutrophil subset exhibited persistent vasculitis symptoms. Elevated serum concentrations of interferon gamma at the onset of vasculitis were associated with subsequent relapses. Among the patients with new-onset disease, those who had the highest serum interferon gamma concentrations experienced relapses despite treatment. A model based on serum interferon gamma, myeloperoxidase-ANCA, and C-reactive protein levels efficiently predicted the risk for relapse before the initiation of immunosuppressive treatment (area under the curve, 0.84; sensitivity, 93%; specificity, 78%). IN PRACTICE: 'Our work elucidates neutrophil dynamics at the single-cell level and suggests a potential biomarker for predicting relapse in MPA,' the authors of the study wrote. SOURCE: This study was led by Masayuki Nishide and Kei Nishimura, Osaka University, Osaka, Japan. It was published online on April 24, 2025, in Nature Communications . LIMITATIONS: This study recruited only Japanese patients, which may limit the evaluation of racial differences. The absence of neutrophil profiles from other diseases made it unclear whether the identified profile was specific to MPA. The interferon gamma signaling pathway may be a common feature in the pathophysiology of various forms of ANCA-associated vasculitis. DISCLOSURES: This study received financial support from multiple organizations, including the Japan Society for the Promotion of Science, the Japan Science and Technology Agency, and the Japan Agency for Medical Research and Development. Several authors reported receiving grants, being employed by, and/or holding stocks in a pharmaceutical company.
Hamilton Spectator
22-05-2025
- Politics
- Hamilton Spectator
Anmore group threatens legal action against village over Anmore South development
The Village of Anmore has been threatened with a legal action over its handling of the contentious Anmore South development, with the Anmore Neighbours Community Association (ANCA) alleging procedural and constitutional violations. In a May 15 letter addressed to Mayor John McEwen and council, ANCA's lawyers accuses the village of bias, democratic suppression, and violations of free expression under the Canadian Charter of Rights and Freedoms. The letter warns that unless the Official Community Plan (OCP) amendment process is halted and corrected, ANCA will petition the B.C. Supreme Court to quash any resulting decision. 'If the village chooses to ignore (these complaints) and forge ahead with the OCP amendment, it can expect a legal proceeding brought by ANCA, and perhaps others, to set the decision aside,' ANCA's lawyers stated. The Anmore South project, proposed by Icona Properties, aims to transform 151-acres on the municipality's southwest border into a mixed-use development with approximately 2,200 units, commercial space, a community centre, parks, and a connection to Metro Vancouver's wastewater system. Anmore's population could nearly triple over the next 25 years if council were to approve an amendment to its official community plan changing the designation of the lands from rural to urban. The Village of Anmore did not respond to a request for comment by press time. Accusations of bias ANCA claimed three of the five Anmore councillors – Mayor John McEwen and Couns. Polly Krier, and Kim Trowbridge – have 'prejudged' their decision on the OCP amendment by publicly endorsing the proposed 'preferred plan' before a public hearing has occurred. Several statements from the councillors are provided. ANCA argued that those statements show their 'minds are made up' regarding the OCP amendment. 'The public hearing itself is pointless – the mayor and these councillors will sit and listen to suggestions, but not whether to vote 'yes' or 'no' on the amendment, which is the vote that will come before them,' the letter stated. Earlier this year, McEwen said it would be a loss if only single-family homes were built in the area. 'I think the key thing that we have to remember is, this land is going to be developed at some point,' McEwen said at a February meeting. 'I've said very publicly, I certainly don't want it to go RS-1 the way some areas of the other village have.' Council has discussed development of the Anmore South site since it was designated as a special study area in 2007. More recently, council discussed three visions for the land, including one pitch for approximately 3,500 units. ANCA cited several Supreme Court of Canada decisions, arguing the legal standard for disqualifying a member of council from participating in a decision is if they are no longer capable of being persuaded. It further claims the councillors have shown to prejudge the amendment decision by rushing the process through despite late completion of a consultant reports, an incomplete neighbourhood plan, and treating the first and second reading of the bylaw as routine 'housekeeping' steps. The letter urged all three representatives to recuse themselves from further deliberations, warning that if they do not, any vote on the OCP amendment will be legally tainted. Because this recusal would leave council without quorum, ANCA suggested the village seek direction from the court to allow the decision to proceed with a modified quorum. ANCA stated it would expect Mayor McEwen's participation to be conditional on a court order requiring him to consider public input 'with as open a mind as possible.' Accusations of Charter breaches The municipality is also being accused of suppressing political dissent regarding Anmore South by unreasonably limiting free expression at council meetings and through local signage restrictions. ANCA highlighted recent changes to the village's procedure bylaw , which bar comments on any topic that may be the subject of a future public hearing. They state this 'broadly drafted' clause is unconstitutional because it stifles political expression on pending issues before they are formally up for debate. The bylaw was invoked during the May 6 council meeting, when residents were barred from raising questions about Anmore South during question period, while the developer and two opposing delegations were permitted to speak about the project during the same meeting. ANCA contended this inconsistent application shows the bylaw is being enforced in a discriminatory manner and suppressing community opposition while giving the developer a platform. Icona CEO Greg Moore defended the consultation process, noting that 28 public engagement events have been held since 2021. The ANCA letter also raised concerns about a zoning bylaw which restricts residential signage to only certain types such as real estate or home business signs. Political signage is not permitted, even on private property. While the bylaw is in place to limit visual pollution, ANCA claimed it is being used as a way to prohibit 'political expression on a matter of fundamental importance to the community.' According to the letter, ANCA has received reports that village staff have removed signs opposing Anmore South, while leaving up other signs that also contravene the bylaw. ANCA argued this suggests 'discretionary unfairness' and points to an active effort by the village to suppress opposition to Anmore South. The letter is calling on council to delay the public hearing and OCP amendment decision by 'at minimum several months' until both the procedure bylaw and zoning bylaw are amended to comply with Charter protections. Only after residents are given a 'reasonable period' for unrestricted political expression, should the amendment return to council for a vote, ANCA stated. The letter follows several months of escalating tension around the Anmore South proposal, with groups like ANCA and the Anmore Residents Association describing the process as 'developer-dominated,' and calling for a referendum to decide the project's fate.
Medscape
12-05-2025
- Health
- Medscape
Prophylaxis in Vasculitis Cuts Risk for Non-PJP Infections
Prophylactic treatment with trimethoprim-sulfamethoxazole (TMP-SMX) significantly reduced the risk for serious infections by approximately 50% in patients with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis, with the greatest benefits observed during the first 180 days of treatment. METHODOLOGY: Researchers conducted an observational study that used a target trial emulation framework to examine the effect of prophylactic TMP-SMX on the incidence of serious infections in patients with ANCA-associated vasculitis. They included 296 patients with new-onset or relapsing ANCA-associated vasculitis from four tertiary referral hospitals in South Korea who received either rituximab or cyclophosphamide as induction therapy between 2005 and 2023. Of these, 240 patients received TMP-SMX prophylaxis (prophylaxis group; mean age, 63.7 years; 55.8% women) within 14 days of induction therapy, and 56 patients did not receive prophylaxis (control group; mean age, 61.5 years; 60.7% women) during the same period. Physicians at each institution determined patient eligibility for prophylactic TMP-SMX, with dosage being either one single-strength tablet (TMP 80 mg and SMX 400 mg) daily or one double-strength tablet (TMP 160 mg and SMX 800 mg) every other day, adjusted for renal function. The primary outcome was the incidence of serious infections requiring intravenous antimicrobial treatment, hospitalization, or extended hospital stay. Secondary outcomes included infection-related deaths and severe adverse drug reactions related to TMP-SMX. TAKEAWAY: Approximately 45.8% of patients discontinued the use of prophylactic TMP-SMX within the first 180 days. During 252.1 person-years of observation, 77 serious infections occurred in 65 patients, with an incidence rate of 30.5 per 100 person-years and a fatality rate of 18.5%. Most serious infections (85.7%) occurred within the first 180 days of observation (incidence rate ratio, 5.43; 95% CI, 2.87-10.28). The prophylaxis group had a significantly lower 1-year incidence than the control group (hazard ratio [HR], 0.48; 95% CI, 0.32-0.72), particularly during the first 180 days (HR, 0.41; 95% CI, 0.22-0.76) but not thereafter (HR, 3.76; 95% CI, 0.46-29.43). Infection-related mortality was also significantly lower in the prophylaxis group than in the control group (HR, 0.23; 95% CI, 0.10-0.53). Over 127.4 person-years of TMP-SMX prophylaxis, 35 cases of adverse events occurred, eight of which were adverse drug reactions related to prophylactic TMP-SMX, and 27 patients discontinued TMP-SMX. Only one case of severe adverse drug reaction was noted, which was resolved after treatment discontinuation. IN PRACTICE: 'Our results strongly suggest that prophylactic TMP-SMX provides additional benefits in patients with AAV [ANCA-associated vasculitis] beyond reducing the risk of PJP [ Pneumocystis jirovecii pneumonia],' the authors wrote. SOURCE: This study was led by Yun Kyu Kim, MD, Seoul National University College of Medicine, Seoul, Republic of Korea, and was published online on April 14, 2025, in Arthritis & Rheumatology . LIMITATIONS: Unmeasured confounders, such as compliance with prophylactic TMP-SMX, may have influenced the findings. The varied duration of TMP-SMX use in the prophylaxis group, with many patients discontinuing within 180 days, may have led to biased estimates. Additionally, the impact of TMP-SMX on COVID-19 incidence and related infectious complications could not be estimated for patients with an index date prior to 2018. DISCLOSURES: This study was supported by a grant from the National Research Foundation of Korea. One author reported receiving salary from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Two authors reported receiving grants and consulting fees from various pharmaceutical companies.
Yahoo
08-04-2025
- Business
- Yahoo
USDA cuts threaten strained North Country food systems
When grass is healthy, it's full of protein and easy for cows to digest. Sometimes the summers are unbearably hot, and the grass dries up and energy is sent instead to the seed. The grass becomes less nutritious and the cows don't produce as much milk. If the summer then becomes unusually wet, the withered grass will struggle to recover. Over her 12 years as owner of the North Country Creamery, Ashlee Kleinhammer has seen these unusual weather patterns become more common. To make their pastures and their 100% grass-fed herds more resilient in any kind of weather, Kleinhammer embarked on a project to plant trees. The trees help enrich the soil, protect from erosion and give the cows someplace to escape the sun — and resulting heat stress — that can affect their milk production. They even provide an alternate snack for the cows to munch on. The funding that was promised by the U.S. Department of Agriculture to buy these trees is now on hold, perhaps indefinitely — just one example of how farmers and nonprofits that work to support the pieces of the fragile food system in the Adirondack region are now facing uncertainty, loss of funding and layoffs resulting from USDA cuts. Jon Ignatowski works with a team at the Adirondack North Country Association that oversees programs related to food systems. ANCA serves as the lead manager for three USDA grant programs that benefit a variety of small businesses and farms in the North Country. North Country Creamery is one of eight farms that ANCA is working with as part of the Partnerships for Climate Smart Commodities program. This program supports $3.09 billion for projects across the U.S. and $1.08 billion in New York, according to a USDA dashboard. These North Country projects are agroforestry projects like Kleinhammer's. 'At the end of the day, we're really improving the bottom line of our farms over many, many years,' Ignatowski said. 'It wasn't just an investment in this year, next year, even in the next handful of years — it was really a hedge against increasing change and really making sure these farms could be resilient 10, 20 years out.' These grants have been effectively frozen since January, and farmers are in a holding pattern. Even if the funding is eventually restored, the projects have been delayed for possibly another summer. For North Country Creamery, there are some other funds available and they might still be able to plant some trees, but for now, they are waiting on a project that they wish they started 10 years ago — trees take time to grow. 'It's just not something that has a quick or very concrete, financial return,' Kleinhammer said. 'No farmer has the capital right now to invest in this on our own, and that's why the funding is so critical.' ANCA also has a Technical Assisstance Grant for the USDA's Rural Energy for America program. This program is designed to lower energy costs for farmers and small businesses by implementing various clean energy or efficient energy projects. ANCA's payment — which is to support the organization in its role helping businesses apply for actual REAP grants — was frozen for a while, but on March 28 they received word from the state coordinator that they would be paid. However, the upcoming Sept. 30 deadline for new grants is now closed. So for the time being, ANCA can't actually help anyone apply for these programs. Many of these projects also involve the employment of contractors, so the potential economic impact of cuts goes beyond the farms, Ignatowski said. 'We're seeing the potential for a pretty sizable ripple across the regional economy,' he said. Nonprofits in crisis Francesca McClure loved her part-time job working for a small nonprofit that helps provide mentorship, education and resources for organic farmers, or farmers interested in sustainable farming practices. It was much better than her previous job as an organic certifier, where she was mostly sitting at a computer and inspecting paperwork. With her job at the Northeast Organic Farming Association of New York, she got to talk with farmers and help them navigate the arduous paperwork required in becoming a certified organic farm. That was until March 24, when she and two of her colleagues were laid off because the USDA grants funding their positions were cut. NOFA-NY only had 10 employees. There's a chance that some or all of the funding from these USDA programs might be restored, but for some organizations and the farmers they work with, the damage has already been done. McClure knows of other nonprofits that NOFA-NY partners with who have laid off or furloughed even more staff. 'This administration has already done so much damage, even in pausing them for a certain amount of time,' she said. 'Situations like that just make me think about all of the institutional knowledge that is lost now, even if the money does come back. The programs aren't going to be able to be the same, or it'll take time to recover.' McClure's job was funded by the Transition to Organic Partnership Program, which also included a mentorship program that matched more experienced organic farmers with new farmers. The mentors got a small stipend out of it, and the mentees got free education. McClure felt it was important for farmers to get to meet each other at the events they organized. 'Those moments are really important for knowledge sharing, peer-to-peer, farmer-to-farmer,' she said, 'and then also just as a community building aspect.' NOFA-NY is also impacted by the apparent loss of the Climate Smart Commodities program, specifically the Climate-Smart Farming and Marketing Program. 'That program — in terms of direct money going directly to farmers — is a big, big loss,' McClure said. McClure is in a bit of a holding pattern herself. She's looking for seasonal work to buy herself some time until the fall, hoping the situation will be a bit more clear by then. Just a few years out of college, where she studied environmental science, she is having a quarter-life crisis of sorts and wonders if she needs to pursue something else. 'I think a lot of the positions similar to mine that I'd be interested in for the same reasons are at nonprofits that are getting federal funding,' she said. 'How many of those types of positions are going to be around in the future?' Straw on an already broken back Josh Stephani is the director of the Adirondack Food System Network, a coalition of agencies in the North Country that collaborate to work towards and advocate for a stronger food system. Stephani said the pandemic revealed the lack of resiliency in the North Country food system. It also revealed the importance of a strong, interconnected local food economy. This kind of economy is at the center of the mission of Essex Food Hub. EFH serves as a resource for local farmers and their customers by helping aggregate, store, process, distribute and market local food. For example, they've offered cold storage rentals — freezer space is normally really expensive and farmers were sometimes going as far away as Vermont to find space. In 2023, EFH was the recipient of a $500,000 grant from the USDA through New York Food for New York Families. This grant was to help them purchase food from local farmers to donate to food-insecure families through partner organizations like food pantries and headstart programs. At the beginning of March, it appeared the grant was frozen and that the hub might not be reimbursed for work they had already done with local farmers. They started preparing for the worst. This grant reimbursement has since been reinstated, but it appears that USDA funding for these kinds of local food purchasing programs may not be continuing past 2026, Stephani said Friday. This money was originally funneled to the state as a type of COVID relief funding. Now, the fate of New York Food for New York Families is in the hands of the state Department of Agriculture and Markets. It was never a given that COVID relief funds would continue, but any decrease in USDA funding will hurt the region. Stephani said the North Country has a long way to go before the food system is resilient, just and equitable. The region is in dire need of capital funds and infrastructure, and Stephani said the organizations that work in this space are already stretched to the limits. 'It's just adding more straw to the camel's back — that's already broken,' he said.
