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Calcium and Vitamin D Supplements Offer Little to No Meaningful Benefit on Fracture and Fall Prevention

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Recommendations for calcium and vitamin D supplementation should be re-evaluated, suggest researchers

Photo by Kampus Production

Calcium, vitamin D, or combined supplements offer little to no clinically meaningful benefit on fracture and fall prevention in most older people, finds an in-depth review of the latest evidence published by The BMJ.

Almost a third of people aged 65 and older fall each year, often resulting in fractures, which are linked to pain, reduced quality of life, and the need for residential care. Preventing falls and fractures is therefore a global public health priority.

Several previous evidence reviews have found no reduction in fractures with either calcium or vitamin D supplements and results are inconsistent for combined use. The benefit of vitamin D on falls also remains unclear.

Yet despite this, many clinicians, guidelines, and regulatory agencies recommend vitamin D supplements (with or without calcium) for bone health, and prescriptions have increased substantially in recent years.

To address this uncertainty, researchers in Canada reviewed the results of 69 randomised controlled trials involving 153,902 adults that assessed the effect of calcium or vitamin D supplements – or a combination of both – on reducing the number of fractures and falls compared with placebo or no treatment.

The trials were of varying quality, but the researchers were able to assess their risk of bias and certainty of evidence using established tools.

After agreeing on clinically meaningful thresholds, the researchers found little to no effect for experiencing any fracture from use of calcium supplements (moderate certainty evidence from 11 trials; 9,067 participants), vitamin D supplements (high certainty evidence from 36 trials; 92 045 participants), or combined supplementation (high certainty evidence from 15 trials; 51 126 participants).

Calcium, vitamin D, or combined supplementation also appeared to have little to no effect on specific fractures, such as hip fractures, or falls, based largely on moderate to high certainty of evidence.

The researchers acknowledge that some analyses included a small number of trials and participants, so these findings should be interpreted with caution, and results may not apply to individuals with specific bone disorders or to those receiving drug treatment for osteoporosis.

However, the findings were consistent after further analyses to account for differences such as participant age, sex, history of fractures and falls, and average dietary calcium intake, supporting the strength of their conclusions.

As such, they say these findings “do not support routine supplementation with calcium or vitamin D, or combined supplementation to prevent fractures and falls” and they suggest clinicians, guideline panels, and regulatory agencies “should re-evaluate their general recommendations for calcium and vitamin D supplementation in light of current evidence.”

Evidence from rigorous and well-powered trials is needed to inform recommendations for supplementation in higher-risk groups, say researchers in a linked editorial.

In the meantime, they suggest that focus and funding should be redirected towards interventions that have been shown to offer meaningful prevention of falls and falls related injuries, such as balance and resistance exercise, and interventions that combine elements like exercise, hazard assessment or education, tailored to individual risk.

Source: The BMJ Group

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One‑week Radiotherapy Course Effective for Early‑stage Breast Cancer

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New UK research has found that a one-week course of post-surgery radiotherapy is just as safe and effective as the traditional three-week course for people with early-stage breast cancer. 

The FAST-Forward trial, led by Keele’s Professor Murray Brunt and sponsored by The Institute of Cancer Research, London, followed more than 4000 patients for a decade after their treatment.  

The 10-year results of this phase III randomised trial, funded by the National Institute for Health and Care Research (NIHR) and published in the Lancet Oncology, show that a shorter, five-day radiotherapy schedule provides the same level of cancer control as the traditional three-week treatment.  

These findings build on previous five-year results that have already driven a shift in clinical practice. Since 2020, it is estimated that tens of thousands of people in the UK have already benefited from the shorter course on the NHS. Researchers expect this approach will also reduce the burden on people undergoing treatment for breast cancer worldwide and expand access to life-saving radiotherapy.  

Breast cancer is one of the most common cancers globally, and radiotherapy plays a critical role in reducing the risk of recurrence after surgery. A shorter treatment course is not only more convenient for patients – it also reduces hospital visits and eases pressure on radiotherapy services, making treatment more accessible.  

The research team compared the traditional schedule of 15 treatments over three weeks with two shorter schedules that used five treatments over one week. The two shorter courses gave slightly different amounts of radiation to allow the research team to work out the best dose.   

After 10 years, cancer coming back in the treated breast was very low in all three groups: 3.6% for the standard three-week treatment, 2.9% with the one-week treatment with a slightly higher dose, 2.1% with the one-week treatment with a slightly lower dose.   

The lower dose one-week treatment had side effects that were very similar to the standard approach, with no increase in long-term breast or chest wall changes. Because of this, this dose and schedule are now the recommended option.  

Professor Murray Brunt, chief investigator of the FAST-Forward study and Professor of Clinical Oncology at Keele University, said: “These 10-year results provide definitive long-term evidence that one-week radiotherapy given at an appropriate dose to the breast is a safe, effective, and more practical option for people with breast cancer. 

“By reducing treatment from 15 sessions to just five, we can offer patients the same excellent cancer control with fewer hospital visits, less disruption to their daily life, and reduced pressure on healthcare services. This approach has already transformed practice in the UK and has the potential to improve access to life-saving treatment for people with cancer worldwide. 

“Hearing patients talk about how much it helps to only need one week of radiotherapy has been really encouraging for everyone involved.”  

Professor Judith Bliss, Professor of Clinical Trials at The Institute of Cancer Research, London, who co-led the trial, said: “The FAST-Forward trial is transforming cancer treatment by reducing standard breast radiotherapy from 3 weeks to just one week, without compromising effectiveness.  

“The streamlined schedule has made radiotherapy more accessible, particularly for people who find it difficult to attend hospital and those in lower-income countries.”  

“The FAST-Forward trial is part of a long-term programme of research into improving breast cancer radiotherapy at The Institute of Cancer Research (ICR).  

“These final 10-year results mark a significant milestone in breast cancer treatment and reinforce the growing shift toward more efficient radiotherapy approaches. The success of FAST-Forward has led to the ongoing NIHR-funded FAST-Forward Boost trial, which is investigating whether more extensive radiotherapy – including an additional ‘boost’ dose for some patients – can also safely be delivered in five days.  

Professor Anthony Gordon, Director for NIHR’s Health Technology Assessment (HTA) Programme, added: “The legacy of the FAST-Forward trial is clear to see, with thousands of women benefiting from shorter courses of radiotherapy and fewer hospital visits, helping the health and care sector to achieve more effective and efficient use of resources. The new 10-year results show the benefit of investing in high-quality, long-term research to improve the health and wealth of the nation.  

“NIHR’s research aims to tackle the most urgent health and social care challenges, targeting the areas of greatest need and where the most significant impact can be made. The findings from the FAST-Forward trial have already made a considerable difference to the treatment regimens that breast cancer patients undergo, making them more efficient, while at the same time, easing pressure on NHS services.”

Source: Keele University

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Can New Research on Malaria Enzymes Help Overcome Challenges to Treatment?

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Photo by Ekamelev on Unsplash

Research published in The FEBS Journal may help overcome challenges to the treatment of malaria – a tropical disease caused by infection of red blood cells with Plasmodium parasites, which are transmitted through infected mosquito bites. The research is based on a strategy that targets an enzyme specific to the parasite, Falcipain-2 (FP2), which is essential for parasite survival and growth within the host.

FP2 allows the parasite to digest human haemoglobin so that it can replicate inside red blood cells, which leads to severe malaria symptoms, including red blood cell destruction. Although FP2 is parasite-specific, it is highly similar to a class of human enzymes called cathepsins. This study therefore sought to determine the detailed structural and functional characterizations of FP2 so that it could be targeting without harming cathepsins.

Previously, the researchers identified that polyethylene glycol (PEG) can form stable interactions with FP2. In this latest study, they focused on how different PEG molecules bind to FP2 and its target, haemoglobin. Their computational analyses identified a binding region, or pocket, of a particular PEG called PEG400 with FP2. This pocket exhibits minimal conservation in human cathepsins. PEG400 was capable of binding FP2 and affecting its digestion of haemoglobin.

“The findings pave the way for designing and incorporating new small molecule inhibitors of FP2 activity, suggesting opportunities for selective antimalarial therapies with a cumulative benefit of reducing off-target specificity,” said corresponding author Sampa Biswas, PhD, who conducted this work while at the Saha Institute of Nuclear Physics, in India, and is currently at InBOL (Indian Barcode of Life) Health Care.

Source: Wiley

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One Mother Beat Blood Cancer Against the Odds. Thousands of Others Are Still Searching for Their Chance.

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As a professional photographer and mother of two young children, Claire had always been busy, but the long hours and constant fatigue felt like an occupational hazard. She never imagined that exhaustion could signal something far more serious than a demanding schedule.

Then, in January 2024, it happened: Claire blacked out at her desk while editing videos. It was her body’s final, unmistakable warning. What followed was a hospital stay, a bone marrow biopsy, and a diagnosis that would change her life forever. Claire had been diagnosed with blood cancer, specifically Myelodysplastic Syndrome (MDS), a serious bone marrow condition that, without treatment, can be fatal.

She was just 30 years old. And she was far from alone. Blood cancer remains one of the top five causes of cancer death in South Africa. Despite being potentially curable, countless patients never find their matching donor in time. Claire was determined not to become another statistic.

A Road Full of Obstacles

Claire’s path to diagnosis was not straightforward. Doctors initially attributed her worsening symptoms to iron deficiency, leaving her untreated as her condition quietly progressed. By the time MDS was correctly identified, the only viable path forward was a stem cell transplant.

While awaiting a donor match, Claire endured bi-weekly injections to keep her body stable, a gruelling holding pattern as her family and medical team searched for hope. That hope came through DKMS Africa, which successfully identified a fully matched, unrelated donor for Claire.

The first transplant, using cells from that 100% unrelated matched donor, was performed with great hope. Unfortunately, it was not successful.

Claire’s medical team was not deterred. Turning to family, they proceeded with a haplo-identical transplant, a “half-match” procedure using stem cells donated by Claire’s brother. This second transplant was successful.

Why Every Match Still Matters

Claire’s outcome is cause for deep gratitude and genuine celebration. But her journey also carries an urgent message that must not be lost in the relief of her survival.

Haplo-identical transplants, where stem cells are donated by a family member who is only a partial genetic match rather than a full one, can offer a path forward when a fully matched donor cannot be found. However, this option is not available or ideal for everyone. Not all patients have a suitable family donor, and even when they do, the procedure carries greater medical complexity and risk than a fully matched stem cell transplant.

For most patients, a 100% match from an unrelated donor remains the gold standard: the safest and most effective option. Yet only around 30% of patients find a compatible donor within their own family, meaning the remaining 70% depend entirely on a stranger’s decision to join the registry. The more people who register as potential donors, the greater the chance that every patient in need will find their match.

The critical shortage of registered donors, particularly from diverse ethnic backgrounds, means that for many, the search ends without a match. Despite blood cancer being potentially curable, countless patients never find their matching donor in time.

Every name added to the registry is a potential lifeline for someone, somewhere, waiting for their match.

A Family Restored

Today, Claire is recovering. Her children have their mother. Her family, who stood beside her through diagnosis, uncertainty, and two transplants, now share in a renewed sense of hope and possibility.

Her story does not end with survival. It continues with a plea to every person who has considered registering as a stem cell donor and hasn’t yet done so. “Help save others like me. We need more people to register as potential stem cell donors. Your registration could mean the difference between life and death.”

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Self-reported Family History Often Underestimates Relatives’ Heart Attacks

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A new study from Karolinska Institutet shows that people’s own reports of heart attacks in the family only partially correspond with register data. The findings suggest that heart attacks among relatives are often underreported, particularly for events occurring early in life.

Asking patients about cardiovascular disease in the family is common practice in both research and clinical risk assessment. But how reliable is this information? Researchers at Karolinska Institutet have investigated this by comparing self-reported family history with Swedish national registers. 

The study included just over 25 000 participants from the Swedish SCAPIS cohort. Participants were asked to state whether their parents or siblings had suffered a heart attack, and the information was then compared with diagnoses in the Patient and Cause of Death Registers.

The results, published in the European Journal of Epidemiology, show that the agreement between self-reported data and register data was only moderate. 

“Our findings show that data from questionnaires only capture part of the occurrence of heart attacks in families,” says Agnes Wahrenberg, researcher at the Department of Clinical Research and Education and resident physician at Södersjukhuset. The study forms part of her doctoral thesis.

For heart attacks in close relatives, the sensitivity was 57.6 per cent, meaning that many cases identified in the registers were not reported in the questionnaires. Misreporting was more common for cases of heart attack occurring early in life.

At the same time, the study highlights the unique opportunities that Swedish health registers offer for research into hereditary cardiovascular disease.

“These registers can be used to supplement and validate family history information in both large cohorts and future register studies,” says Per Svensson, associate professor at the same department and senior physician at Södersjukhuset.

Despite these limitations, the researchers emphasise that self-reported information remains valuable, as it is easy to obtain and can help identify individuals at increased risk in everyday clinical practice.

“It can be difficult to know exactly which diseases have occurred in relatives, particularly further back in time. The Swedish registers are a unique complement to studies on family history and cardiovascular disease, as they enable a more comprehensive assessment of disease in relatives”, says Agnes Wahrenberg.

Source: Karolinska Institutet

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Can Aerobic Exercise Lessen the Health Effects of Exposure to Nanoplastics?

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Photo by FLY:D on Unsplash

Using female zebrafish as a model, researchers have found that aerobic exercise may influence various connections in the body to lessen the damaging health impacts of environmental nanoplastics. In the study, which is published in The FASEB Journal, adult female zebrafish were exposed to polystyrene nanoplastics for 21 days, with or without moderate aerobic exercise.

“Once ingested, nanoplastics may cross epithelial barriers and accumulate in multiple organs, including the liver, heart, brain, and ovary, eliciting oxidative stress, inflammation, and endocrine disruption,” the authors wrote. “Among these targets, the ovary appears particularly susceptible, yet the mechanisms underlying nanoplastic-induced ovarian accumulation and toxicity remain poorly characterized.”

Exposure to nanoplastics alone caused significant ovarian accumulation of particle-like structures, elevated oxidative stress, increased follicular cell death, and disrupted reproductive hormones. It also induced anxiety‑ and depression-like behaviors in tank and shoaling tests, accompanied by elevated stress hormone levels. In contrast, concurrent aerobic exercise lessened these effects.

Investigators also found that aerobic exercise counteracted gut microbe imbalances caused by nanoplastics. Analyses linked these microbial shifts to enhanced fatty acid and tryptophan metabolism, which correlated with improved neuroendocrine health.

The findings indicate that aerobic exercise may mitigate nanoplastic-induced neuroendocrine dysfunction via gut–ovary–brain connections.

Source: Wiley

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AFib Found to Cause Profound Changes in Both Atria

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Human heart. Credit: Scientific Animations CC4.0

New research findings from the University Medical Center Göttingen (UMG) show that both atria undergo profound changes in cases of persistent atrial fibrillation. Until now, the left atrium was considered the primary site of the disease. The results of the international study were published in the journal Cardiovascular Research.

Atrial fibrillation is the most common persistent heart rhythm disorder worldwide, and is caused by chaotic electrical activity in the atria. As a result, the heart beats irregularly and often too fast. Many patients suffer from palpitations, shortness of breath, reduced physical performance, or exhaustion. The so-called persistent form of atrial fibrillation is particularly problematic, as the arrhythmia no longer resolves on its own. Over time, this leads to structural and functional changes in the heart tissue. The condition significantly increases the risk of stroke, heart failure, and premature mortality. Until now, research and treatment have focused primarily on the left atrium and the pulmonary veins that drain into it, which are considered major triggers of atrial fibrillation. 

A research team at the University Medical Center Göttingen (UMG) investigated whether and to what extent the right atrium is also affected by long-term atrial fibrillation. The study shows that the right atrium also undergoes profound remodelling processes and increasingly resembles the left atrium. 

“The results suggest that persistent atrial fibrillation must be understood as a disease of both atria,” says Dr Aiste Liutkute, the study’s first author. “This could also explain why established therapies are often not permanently successful in cases of long-standing atrial fibrillation.” 

The Approach

The research team analysed tissue samples from the right and left atria of patients with persistent atrial fibrillation, which had been collected during heart surgery. Samples from non-transplanted donor hearts with no known cardiac arrhythmias served as the control group.

Using state-of-the-art mass spectrometry techniques, the scientists examined thousands of proteins simultaneously to identify disease-related changes in heart tissue. Mass spectrometry is a high-resolution analytical method that allows molecules to be precisely identified and quantified based on their mass. This makes it possible to determine which proteins are present in heart muscle cells and how their composition changes in the presence of disease. For the study, the researchers first created a comprehensive reference library of the human heart proteome. The proteome refers to the totality of all proteins in a tissue or cell. Proteins perform central functions in the body and provide insight into which biological processes are active in the cells. In addition to the proteome analyses, the team examined the scarring of heart tissue under a microscope, confirmed notable protein changes using biochemical methods, and identified blood markers that indicate stress on the heart.

The Results

The analyses show that, in cases of persistent atrial fibrillation, the right atrium exhibits pathological changes similar to those in the left atrium. In both atria, the researchers found increased tissue scarring, a breakdown of important heart muscle structures, and clear signs of cellular stress and remodeling processes. These changes impair normal electrical signal transmission in the heart and may contribute to the persistence of atrial fibrillation. At the same time, many of the molecular differences that normally exist between the right and left atria disappeared. For instance, the right atrium lost typical protein markers that normally characterize its specific function and increasingly took on features of the left atrium, including proteins associated with altered energy metabolism and structural remodeling of heart muscle cells.

Source: University Medical Center Göttingen

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South Africa’s Dangerous Mix of Fake Medicines and Bogus Doctors

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Photo by Rodion Kutsaiev on Unsplash

By Spotlight Editors

Fake and substandard medicines, along with bogus healthcare practitioners, pose a growing threat to patient safety in South Africa.

The sale of fake and substandard medicines is a significant threat to patient safety around the world. In South Africa, the main affected products are painkillers, antibiotics, weight-loss and sexual enhancement products, skin-lightening products, and some chronic medicines.

In pealing back the different layers of this problem, it is essential to get the definitions right.

  • Substandard products are those that do not meet quality standards and specifications.
  • Falsified products deliberately misrepresent their identity, composition or source.
  • Neither of these should be confused with generic medicines, which have the medicines regulator’s green light for being safe, effective, and of good quality.

People are often duped into purchasing substandard and falsified products, especially when the real thing is not available or too expensive. But, as Elna Schütz this week reports for Spotlight, there are also people who buy these medicines fully aware of the risks.

These unregulated medicines are mostly distributed through informal channels, unregulated outlets, online platforms, and cross-border smuggling networks. It is also possible that some substandard and falsified medicines have been infiltrated into otherwise reputable medicines distribution channels.

Data on the scale of the problem is scant, but there is agreement that the problem is substantial. The WHO estimates that around 1 in 10 medicines in low- and middle-income countries are substandard or falsified.

The South African Health Products Regulatory Authority (SAHPRA) is the main body responsible for regulating substandard and falsified medicines. It does this through post-market surveillance and inspections, a whistleblower reporting system, product recalls, and monitoring illegal advertising and online sales. A new National Action Plan and comments from the Minister of Health suggests there is some intent to step up these efforts.

What of regulated medicines?

In two separate columns for Spotlight, Dr Andy Gray looked at the broader issues of the quality of medicines and sanctions for non-compliance with medicines legislation.

The good news is that we can generally trust that the medicines we buy at pharmacies contain what they are supposed to and that they were manufactured according to good quality standards. As regulatory entities go in South Africa, SAHPRA is generally one of the better-functioning ones.

But, outdated legislation means that SAHPRA doesn’t have all the tools it needs to stamp out the sale of unauthorised medicines. For instance, it has limited powers in relation to advertising and marketing, cannot block a web site, and cannot issue infringement notices, or impose sanctions on entities or individuals whose actions potentially place the public at risk of harm.

Fake health professionals 

Falsified medicines are not the only misrepresentations that should concern us in the health sector. Spotlight recently reported that South Africa is also battling the problem of bogus health practitioners. The issue goes beyond people pretending to be doctors and can include physiotherapists, interns, or anyone else treating patients without being properly qualified or registered.

The misrepresentation may include using fraudulent certificates, using another practitioner’s registration, or still offering healthcare services while being suspended or erased from the register.

From early 2024 through late 2025, 66 bogus practitioners were caught and arrested, with the majority operating in the economic hubs of the Western Cape, Gauteng, and KwaZulu-Natal.

You can help curb these problems. Suspicious practitioners can be reported to the HPCSA, and suspicious products or sellers can be reported to SAHPRA. People are also advised to buy only from licensed and authorised pharmacies and checking if healthcare providers are registered.

And then there is fake news

In some areas, as with bogus health professionals and falsified medicines, the solution to misrepresentation is clearly to have legally empowered regulators with enough muscle to consistently enforce the law.

But when it comes to misinformation and disinformation – call it fake news if you will – the way forward is much less obvious. In recent years, we’ve seen a toxic mix of political polarisation, conspiracy theories, disinformation campaigns, and twisted social media algorithms – often fuelling a rejection of science and evidence-based policy-making. Beyond just our screens, these trends have unfortunately started to distort the real world, as we’ve seen at various critical health institutions in the United States.

In our view, regulators should have a role in preventing misinformation and disinformation about medicines. But how exactly to make such regulation work in an age of largely unaccountable social media networks is not at all clear.

What we think is clear, is that much of the solution to the problem of health misinformation and disinformation, is simply to keep creating its opposite, high-quality, rigorous, and evidence-based journalism.

This is the core of what we try to do at Spotlight. It is also why we have made our journalism subject to the South African Press Code, work hard to stick to our Editorial Policy and Style Guide, and why we urge you to hold us accountable when we get things wrong, as we will inevitably do from time to time.

Please always feel free to get in touch at Editors@SpotlightNSP.co.za.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

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New Study Links GLP-1 Agonists to Reduction of Asthma Exacerbations and Inhaler Use

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New research presented at this year’s European Congress on Obesity in Istanbul, Turkey (12-15 May) shows the use of the new GLP-1 class of obesity drugs in people with asthma is associated with a 26% fall in the number of asthma exacerbations and a 14% drop in use of asthma inhaler reliever use. The study is by Simon Høj and Dr Kjell Erik Julius Håkansson Copenhagen University Hospital, Copenhagen Denmark and colleagues.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are now widely used to treat overweight, obesity and type 2 diabetes (T2DM), with growing evidence of benefits that extend beyond blood sugar control.

In asthma, where overweight, obesity and metabolic dysfunction can lead to increased severity of symptoms and adverse events such as acute exacerbations, the authors suggest that GLP-1 RAs may improve asthma outcomes through weight loss, modulation of airway inflammation, and improvements in metabolic functions. Reductions in occurrence of asthma exacerbations are likely to reduce systemic corticosteroid exposure (a common treatment for acute asthma exacerbations orally or intravenously) and thus may reduce the risk of corticosteroid exposure-associated adverse events such as osteoporosis or new-onset T2DM. As such, as the clinical use of GLP-1 RAs expands, reliable estimates of their impact on asthma control are needed for individuals living with both asthma and overweight, obesity or T2DM.

The researchers conducted a nationwide self-controlled cohort study using linked Danish health registers. Adult individuals with a prior asthma diagnosis or ≥2 asthma inhaler prescriptions redeemed within 12 months) were included on the date of their first GLP-1 RA dispensing (index date). Eligible individuals had continuous registration data for at least 12 months before and after the index date.

Individuals with COPD or patients with severe asthma treated with new and relatively expensive biologic drugs within 12 months before or after the index date were excluded. Overweight or obesity was defined using ICD-10 codes for those conditions. Those who had no evidence of T2DM – with no diagnosis recorded or no evidence of other first line diabetes drugs prescribed – were also placed in the with obesity/overweight group. Those with a T2DM diagnosis or prescriptions recorded for first line diabetes drugs such as metformin were placed in the T2DM group.

The primary outcome was exacerbations, defined as an inpatient asthma hospital contact(s) and/or systemic oral or intravenous corticosteroid course(s). Secondary outcomes were the use of rescue medication (inhaled short-acting β2-agonists), inhaled corticosteroid exposure, and chest infection events defined as redemption of antibiotics commonly used for lower airway infections

The cohort comprised 27,523 individuals (mean age 54 years, 66% female) with asthma and comorbid overweight or obesity (49%) or T2DM (61%) and 26% recorded as having both conditions. Around 50% of the GLP-1 prescriptions were liraglutide, 48% semaglutide, and 2% others (exenatide, dulaglutide, lixisenatide).

Compared with the year before GLP-1 RA treatment, GLP-1 RA treatment was associated with a 26% lower exacerbation rate overall; and 28% lower in men compared with 23% lower in women. When stratified according to GLP1 RA treatment indication, the analysis showed individuals with asthma and comorbid overweight or obesity and individuals with asthma and comorbid T2DM had similar effect estimates – a 22% reduction in those with overweight or obesity and a 26% reduction in those with T2D.

Reliever medication use fell by 14% overall, suggesting fewer symptoms despite daily inhaled corticosteroid exposure also decreasing by 23% (inhaled corticosteroids are used to prevent exacerbations and treat symptoms in asthma). Furthermore, pneumonia events were reduced by 10%. People also living with allergic rhinitis saw similar decreases (23%) in exacerbations to those living without allergic rhinitis (28%). The authors are also working on updated analyses to show differences between men and women for these specific outcomes.

The authors conclude: “In this nationwide cohort of over 27,000 individuals with asthma and also overweight, obesity or type 2 diabetes, use of GLP-1 drugs  was associated with significant reductions in exacerbation burden as well as reliever use, exposure to inhaled corticosteroids and pneumonia events, irrespective of whether the drugs were being used to treat obesity or type 2 diabetes.”

The authors explain that their study did not have access to clinical records (just if people had used GLP-1 and hospital admissions), so data on BMI and weight loss for participants were not available.

But Dr Håkansson says: “There’s a high chance that the weight loss is a major contributor to these results. A common symptom in both asthma and obesity is shortness of breath, and the presence of excess fatty tissue creates a pro-inflammatory state in the body in general. There’s also evidence from other studies suggesting that the inflammation caused by excess adipose tissue is distinct from the ‘classic’ asthma inflammation which often is driven by allergies or cells called eosinophils.”

And he adds: “As the use of GLP-1 therapies increase, researchers are finding an increasing number of effects outside of weight loss.”

Source: EurekAlert!

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New ‘Click Clotting’ Stops Severe Bleeding with Stronger Clots

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Using a patient’s own blood or donor blood, the technique could help control severe bleeding and improve treatment for people with clotting disorders

Thrombophilia. Credit: Scientific Animations CC4.0.

Researchers at McGill University have developed a rapid way to engineer blood clots that stop severe bleeding and support tissue healing more effectively. Their technique, called “click clotting,” links red blood cell surface proteins through a chemical reaction, resulting in a biocompatible clot that is 13 times more resistant to fracturing and four times more adhesive than natural blood clots. The team said the method, described in Nature, could be used to develop life-saving biomaterials to help control severe bleeding, as well as benefit people with clotting disorders.

“Natural blood clots can be slow to form and mechanically fragile, which limits their ability to stop severe bleeding and can compromise healing,” said Jianyu Li, senior author and Professor of Mechanical Engineering and Canada Research Chair in Tissue Repair and Regeneration. “Our work shows that, when engineered appropriately, red blood cells can play a central structural role, enabling the design of stronger and more functional biomaterials.” 

Shuaibing Jiang led the research during his PhD studies at McGill. He is now a Postdoctoral Associate at Mass General Brigham and Women’s Hospital, Harvard Medical School.  

Researchers at the University of British Columbia, the Medical College of Wisconsin, the University of Colorado Boulder, the University of Toronto, and the Versiti Blood Research Institute also contributed. 

Connected by chemical reaction 

Previous efforts to crosslink red blood cells used chitosan, a polymer derived from crustacean shells, but these led to brittle clots, ruptured cells and inconsistent clotting. In “click clotting,” the clot structure is fundamentally strengthened through a fast, bio-safe chemical reaction that connects proteins on the red blood cell surface, forming a solid gel in just five seconds. 

Because the “click” reaction doesn’t interfere with normal blood chemistry, it can work alongside the body’s natural clotting process. As a result, the artificial cell‑based gel, called a “cytogel,” can be added to whole blood, where it becomes embedded within the body’s own fibrin clot. 

“The technology enables both autologous clots (using the patient’s own blood) and allogeneic clots (using type-matched donor blood). Autologous clots can be prepared in approximately 20 minutes, while allogeneic clots can be prepared within about 10 minutes. Given typical clinical time constraints, this approach has strong potential for in-patient emergency care, wound management and related settings,” Li said.  

The results were confirmed through in vitro testing, as well as by testing on rodents. A highlight was the effective healing and regeneration observed in the injured liver, with performance exceeding that of the clinically used product tested in this study. Analysis showed minimal evidence of immune reactivity and no toxicity in major organs. 

Further research required 

The researchers say that while further study is required before the cytogel can be used in clinical settings, the research establishes a foundation for its design and application. 

“Engineered blood clots have strong potential for broad clinical use and could improve outcomes across many medical situations,” Li said. 

Source: McGill University