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Fructose Identified as a Surprise Driver of Metastasis

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Photo by Sharon Mccutcheon on Unsplash

A new study from The Wistar Institute has uncovered an unexpected link between fructose and the spread of an aggressive form of ovarian cancer. Published in Nature Aging, the study found that cancer cells not killed by chemotherapy send signals to neighbouring tumour cells, driving metastasis. The researchers identified fructose as a key messenger in this process, revealing a previously unrecognised way that treatment-surviving cancer cells may promote metastasis.

“Some cancer cells that survive chemotherapy aren’t dividing anymore, but they’re still biologically active,” said Aidan Cole, PhD, a postdoctoral fellow in the lab of Katherine Aird, PhD, at The Wistar Institute and first author on the study. “Instead, they continue to release molecules that send signals to nearby cells. Our study is among the first to show that a nutrient – in this case, fructose – can act as one of those signals.”

Ovarian cancer is treated almost universally with platinum-based chemotherapy, and many patients respond well at first. However, the disease recurs in most patients and almost always spreads through the abdominal cavity. That spread, called metastasis, accounts for roughly 90% of deaths from the disease.

Prior research has suggested that cancer cells not killed by chemotherapy play a role in recurrence in part through the ability of these cells to release a complex mix of signalling molecules. Cole and his colleagues began their research by designing a unique experiment: they collected the molecules released by chemotherapy-surviving cells and found these factors alone could significantly increase the spread of cancer cells.

“As far as we know, this is the first time anyone has shown, in a preclinical model rather than just a dish, that it’s the molecules these cells release – not the cells themselves – that drive the cancer’s spread,” said Cole.

That finding sent the team looking for what was being released that caused the cancer cells to spread. Fructose, it turned out, was being made by the surviving cells and sent as the signal for increased spread. Even more interesting, they found that without chemotherapy treatment, consuming the high levels of fructose found in sugary drinks can also signal cancer to spread. The fructose finding is especially compelling because it raises the possibility that simple dietary changes could help shape how cancer progresses. This is particularly important given the prevalence of fructose consumption in the United States, with high fructose corn syrup accounting for ~8-20% of the daily caloric intake in some individuals. Unlike many cancer risk factors outside of patient control, fructose consumption can be modified by dietary choices. While the effectiveness of limiting fructose intake hasn’t yet been tested directly in patients, the study raises the possibility that nutrition could influence cancer progression in previously unrecognised ways.

The researchers next aimed to understand why fructose increases cancer cell spread. Through a variety of large-scale analytical techniques, including the use of a CRISPR screen, they discovered that fructose suppresses cholesterol within the neighbouring cells. Cholesterol is important for cells to stick to each other like a biological glue, so decreased cholesterol allows cells to more easily escape and spread.

The finding that fructose lowers cholesterol production has important clinical implications. Statins, which are taken by 39 million people in the United States, lower cholesterol production. The team found that statins alone decreased the glue between cells to promote escape. The research team is now examining whether these medications could be interfering with the effects of chemotherapy – though they stress this isn’t a reason for patients to stop taking them.

“We haven’t tested this effect in patients yet, but it raises questions about combining cholesterol-lowering drugs with chemotherapy, especially since ovarian cancer is most common in postmenopausal women who are often already on statins,” said Katherine Aird, PhD, professor and co-leader of the Molecular and Cellular Oncogenesis Program in the Ellen and Ronald Caplan Cancer Center at The Wistar Institute, and senior author of the study.

The researchers are also looking into how this mechanism might extend beyond ovarian cancer.

“We think other cancers that spread within the torso – pancreatic, colon, liver – could behave similarly. We can’t call it universal yet, but we think the effects are not just limited to ovarian cancer,” said Aird.

She and Cole have already started designing follow-up experiments to test the reproducibility of their findings in a variety of other cancer types.

Source: The Wistar Institute

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Researchers Find Immune Pathway that Keeps Candida in Check

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IL-1 pathway prevents a normally harmless fungus developing into a fatal infection

Bacterial-Fungal Clusters in Saliva. An interkingdom assemblage formed by fungi (Candida albicans in blue), bacteria (Streptococcus mutans in green), and bacteria-derived extracellular polymers (α-glucans in red) in human saliva. Credit: Zhi Ren, University of Pennsylvania. NIH support from: National Institute of Dental and Craniofacial Research (NIDCR)

A study from King’s College London provides the first potential clue as to why only certain patients with weakened immune systems, including those undergoing chemotherapy or living with HIV, are at risk of life-threatening Candida albicans infections. Candida albicans is a fungus that normally lives harmlessly in areas such as the mouth and gut but can sometimes spread through the body and cause fatal disease. If the results, published in Nature Microbiology, are confirmed in humans, the results could provide a test to understand who is at risk of developing fatal fungal infections and represent a potential therapeutic target to reduce the risk of developing the disease.

Fungal infections kill more than 2.5 million people each year, with Candida albicans alone killing almost a million. However, until now we knew little about why fungi escape their natural location in mouths and gut and cause life-threatening disease in around 10% of patients who have a weakened immune system.

The scientists focused on a signal produced by the immune system to trigger symptoms to fight off infection, IL-1. Mice which were genetically modified not to produce IL-1 experienced severe disease when exposed to Candida albicans. The findings suggest that the IL-1 immune pathway is critical in preventing Candida albicans from spreading around the body and causing life-threatening disease.

They investigated this further by injecting IL-1-deficient mice with a drug that removes neutrophils, a type of white blood cell that is among the first to respond to infections and help fight threats such as bacteria and fungi. This allowed the researchers to mimic the weakened immune system seen in some immunocompromised patients. By then introducing Candida albicans to the mouths of those mice, they for the first time observed the fungus spread throughout the body and cause fatal disease, confirming that IL-1 is critical in preventing disease spreading.

While the study focused specifically on Candida albicans, the researchers say the IL-1 immune pathway may be a broader defence mechanism that helps keep fungi normally found in healthy microbiomes from spreading and causing fatal disease, and further research is needed to confirm whether this applies to other fungal species.

Understanding what causes fungi that are naturally present in our microbiomes, such as Candida albicans, to cause life-threatening disease could help spot at-risk patients earlier. The researchers suggest that, if confirmed in humans, the findings could lead to a test that identifies which immunocompromised patients have low levels of IL-1 and so are at risk of Candida albicans escaping their microbiomes and causing disease before it happens.

While drugs such as antibiotics are currently used to treat life-threatening fungal diseases, more targeted therapies are needed that tackle the root cause of infection. The researchers suggest future clinical studies in humans could test whether drugs targeting IL-1 could work as a personalised therapy for preventing life-threatening Candida albicans infection.

Source: King’s College London

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Earlier Discharge for Children with Severe Pneumonia After Switching to Oral Antibiotics

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Children hospitalised with severe pneumonia can safely switch from injectable to oral antibiotics once they begin to recover, allowing many to return home sooner and complete treatment outside hospital, according to a major clinical trial involving 13 hospitals in Southern Africa.

The new results were published in The Lancet. The trial involved partners across Europe and Africa and was led with researchers at City St George’s, University of London.

Pneumonia remains one of the leading infectious killers of children worldwide, particularly in low- and middle-income countries. Current World Health Organization (WHO) guidelines recommend five days of injectable antibiotics for children hospitalised with severe community-acquired pneumonia, often requiring them to stay in hospital even after they have already substantially improved.

Longer hospital stays are more expensive, placing a higher burden on already pressurised healthcare systems and facilities, whilst increasing the risk of hospital-acquired antibiotic-resistant infections and impacting the wellbeing of the children and their families.

The PediCAP trial is one of the largest studies to assess antibiotic treatment for severe childhood pneumonia in Africa. The study enrolled 1101 children aged two months to six years with community-acquired pneumonia that developed outside hospital but was severe enough to require hospital treatment. Thirteen hospitals across South Africa, Uganda, Zambia, Zimbabwe and Mozambique contributed to the study.

All children in the trial began treatment with a WHO-recommended injectable antibiotic. Some were assigned to switch to either oral amoxicillin or oral amoxicillin-clavulanate when their condition had improved, as confirmed by a healthcare worker. Researchers compared these children to those who received the WHO-recommended injectable treatment for the full five days.

Children who switched to oral antibiotics recovered just as well as those who remained on injectable treatment for five days. Rates of hospital readmission or death within 28 days were similar across all groups – 6% for oral amoxicillin, 7% for oral amoxicillin-clavulanate and 6% for injectable antibiotics – showing that an early switch to oral treatment is a safe and effective strategy.

The standard amoxicillin performed just as well as the broader-spectrum antibiotic amoxicillin-clavulanate, supporting the use of a treatment that is cheaper and widely available.

Researchers also compared how well children recovered with different durations of antibiotic treatment, ranging from four to eight days in total. A total antibiotic course of four to five days was as effective as longer courses of seven or eight days, suggesting many children can be treated successfully with substantially less antibiotic exposure than is often used in practice.

Children who switched to oral antibiotics left hospital around one day earlier compared to those who remained on injectable treatment for the full five days.

Co-lead author Dr Michelle Clements, based at UCL Innovative Clinical Trials Unit, said: “PediCAP is the first large-scale study to use an innovative multi-arm trial design, which we developed here at UCL, to evaluate different antibiotics and treatment durations at the same time. Rather than simply comparing one short course with one longer course, this approach allowed us to establish that the shortest studied treatment strategy was effective and safe, while also helping us to understanding the relationship between treatment length and effect.

“By generating robust evidence more efficiently, this trial design has helped answer questions that we hope will support changes to global treatment guidelines and improve care for millions of children with pneumonia worldwide.”

Co-lead author Professor Julia Bielicki, from City St George’s, University of London, said: “Every year millions of children around the world are admitted to hospital with severe pneumonia. Our study shows that once a child is clinically improving, it is safe to switch from injectable to oral antibiotics, and complete treatment at home.

“This simple change could help children get back to their families sooner, reduce pressure on busy hospitals, lower healthcare costs and avoid sometimes catastrophic financial impacts on families from lost caregiver earnings. Because amoxicillin is affordable and widely available, these findings have the potential to change clinical practice and improve care for children around the world.”

The trial was funded by the European Union’s EDCTP2 programme and sponsored by the Penta Foundation.

Source: University of London

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Exercise Helps Hip Arthritis Pain, but Perhaps Less than We Thought

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Photo by RDNE Stock project


A new Cochrane review finds that exercise may improve pain and function, but the benefits may fall short of what patients would notice in daily life.

Hip osteoarthritis is a condition affecting millions of people worldwide and a leading cause of chronic pain and disability. Exercise is widely recommended as a first-line treatment for managing hip arthritis pain.

Led by researchers from University of Sydney and University of Melbourne, the findings show exercise produces small improvements in pain and physical function for people with hip osteoarthritis, but those improvements may not be large enough to make a meaningful difference to patients.

The review included 18 clinical trials involving 1368 people. Participants were mostly women (63%) and were aged between 53 and 74 years, meaning findings may not apply to younger people. Exercise programmes in the included studies varied widely, lasting between two and 52 weeks and covering a range of types including strengthening, aerobic, and mind-body approaches.

Compared with no treatment or usual care, exercise probably reduces pain by around 7 points on a 100-point scale. However, experts generally consider an improvement of at least 12 points necessary for patients to notice a meaningful difference in daily life. Physical function showed a similar pattern. The authors note, however, that these thresholds were derived largely from knee and mixed osteoarthritis populations, and may not entirely reflect the hip osteoarthritis experience.

Quality of life, arguably the outcome patients care about most, showed little to no improvement with exercise regardless of the comparison used.
 

“Exercise is recommended as a primary treatment for hip osteoarthritis, and this review doesn’t overturn that, but it does suggest we should be honest with patients that the average benefit may be modest, and that we need better-designed trials to understand who benefits most and from which type of exercise.”

— Michelle Hall, co-lead author from the University of Sydney. 


This update analysed results differently from its 2014 predecessor, which pooled all available data together and found high-quality evidence that exercise slightly reduced pain. The new review separated trials according to what exercise was being compared against.

When exercise was tested against a placebo or sham treatment, the evidence for pain relief weakened considerably. And adding exercise on top of another treatment made little difference either. While no single type of exercise came out on top, the authors caution that the evidence to answer that question properly simply isn’t there yet.

Not a recommendation away from exercise

The review stops short of saying exercise is ineffective or should be abandoned as a recommendation. Exercise carries broad health benefits beyond arthritis, is low-cost, and is unlikely to cause harm. 

Most studies included in this review were small and unblinded, which may have influenced outcomes. Because pain and function were largely self-reported, and participants knew whether they were exercising, exercise may appear more effective than it truly is.

The authors call for larger, better-designed trials to give patients and clinicians a clearer picture of what exercise can realistically achieve for hip osteoarthritis specifically.
 

“There just isn’t a huge body of evidence out there. For some people struggling with hip pain, exercise can really be their only hope, but I also don’t want to give patients false hope. It’s important future research is done with larger, better-quality trials, examining what types of exercise work specifically for different people.” 

— Belinda Lawford, co-lead author from the University of Melbourne. 

Read the review

By Mia Parkinson

Source: Cochrane

Categories : Regenerative MedicineTags : Leave a comment

Company Successfully Bioprints Kidney and Liver Tissues in Space

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Weightlessness of space allows tissues to be bioprinted without collapsing

Bioprinted liver tissue
Bioprinted nerve implant

Auxilium Biotechnologies announced a major milestone in space biomanufacturing with the successful bioprinting of kidney and liver tissues aboard the International Space Station (ISS), marking the first time either tissue type has been manufactured in space. Auxilium’s bioprinted biological tissues and nerve repair implants returned to earth on Mission AXLM-3 that flew on a SpaceX capsule and returned to Earth on June 17th, 2026.

“Successfully bioprinting living liver & kidney tissue aboard the International Space Station marks an important step forward for regenerative medicine.” — Dr. Anthony Atala, MD, Professor & Director of the Wake Forest Institute for Regenerative MedicineShare

During the mission, Auxilium’s AMP-1 orbital bioprinter successfully manufactured kidney, liver, and cartilage tissues while also producing 28 nerve repair implants. The achievement represents the first demonstration of kidney tissue manufacturing in space, the first demonstration of liver tissue manufacturing in space, and the first mission to manufacture three distinct tissue types during a single spaceflight. The production of multiple tissue types and clinically relevant nerve repair implants represents the first demonstration of a scalable, multi-product biomanufacturing platform in space.

Equally important, the mission demonstrated the ability of a single autonomous manufacturing platform to produce both living tissues and implantable medical products during the same flight. The simultaneous production of multiple tissue types alongside 28 nerve repair implants highlights not only the versatility of the platform, but also its scalability and higher-throughput manufacturing in space.

The kidney and liver tissues were manufactured in support of research conducted by the Wake Forest Institute for Regenerative Medicine (WFIRM) using the institute’s cells and tissue designs. Auxilium provided the orbital manufacturing platform that enabled tissue fabrication in microgravity.

“This mission represents a significant milestone for both Auxilium and the future of space biomanufacturing,” said Jacob Koffler, PhD, MBA, CEO of Auxilium. “For the first time, we successfully bioprinted kidney and liver tissues in space, demonstrating that complex biological products can be manufactured in orbit. We also produced cartilage tissue and 28 nerve repair implants during the same mission using the same manufacturing platform. The ability to manufacture multiple tissue types alongside clinically relevant medical products highlights both the versatility and scalability of our technology. These results build on our previous demonstration of large-scale medical device manufacturing in space and represent another step toward establishing practical production capabilities for biomedical products beyond Earth.”

Dr. Anthony Atala, MD, Professor and Director of the Wake Forest Institute for Regenerative Medicine (WFIRM) commented, “Successfully bioprinting living liver and kidney tissue aboard the International Space Station marks an important step forward for regenerative medicine. The uniform cell distribution achieved aboard the space station points to real possibilities for manufacturing medical devices and tissues in space.”

Enabling the Next Generation of Biomedical Research

The successful bioprinting of kidney, liver, and cartilage tissues represents an important step toward enabling advanced biomedical research in space. One particularly promising application is the production of organoids, three-dimensional miniature tissue models that replicate key structural and functional characteristics of human organs. Organoids are increasingly used by researchers and pharmaceutical companies to study disease mechanisms, evaluate drug safety, screen new therapeutics, and predict responses to treatment.

Interest in organoid technologies has accelerated significantly as regulators and researchers seek more human-relevant alternatives to traditional animal testing. The U.S. Food and Drug Administration has identified organoids and other advanced tissue models as important components of its New Approach Methodologies initiative, while the National Institutes of Health has expanded efforts to advance and validate next-generation non-animal research platforms.

Today, organoids used for space-based research are manufactured on Earth and transported to orbit. The ability to manufacture these biological models directly in space could provide researchers with on-demand access to experimental systems while reducing dependence on launch schedules and Earth-based supply chains. As commercial space stations begin supporting larger research programmes, in-space production of organoids will create new opportunities for drug discovery, disease modelling, precision medicine, and human health research in microgravity.

By demonstrating the ability to manufacture multiple tissue types in orbit, Auxilium is helping establish the foundation for future space-based biomedical laboratories capable of producing advanced biological research tools whenever and wherever they are needed.

Source: Businesswire

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Global Burden of Road Injuries Reveals Mortality Risks in Developing Countries

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Photo by Camilo Jimenez on Unsplash

A comprehensive new study published in The Lancet provides a global assessment of road traffic injuries from 1990 to 2023.

Analysing data across 204 countries and various income groups, researchers found that while global mortality and incidence rates have generally decreased, progress is dangerously uneven and heavily influenced by a nation’s wealth. Low-income countries face a death rate nearly six times higher than high-income nations, despite often having lower overall case numbers. The report identifies road injuries as the leading cause of death for males aged 10–39, highlighting a major public health crisis for young people. Beyond fatalities, the study quantifies the massive burden of long-term disability, frequently caused by severe head injuries and fractures. A separate study in South African Family Practice explored the local challenges in reducing road traffic mortality.

Ultimately, the authors argue that meeting international safety targets requires urgent structural reform and significantly increased investment in poorer regions.

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Researchers Create Microrobots to Repair Spinal Cord

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At the start and after three days: the top images show the uninjured spinal cord of a zebrafish; those in the middle show the injured spinal cord; and those at the bottom illustrate how the nerve cells grow thanks to the microrobots. (Image: ETH Zurich)

A research team from ETH Zurich and the University of Zurich (UZH) has developed a novel approach to treating spinal cord injuries: controllable microrobots deliver stem cells directly to the site of an injury, where they promote nerve cell regeneration. In animal experiments, this approach significantly improved mobility.

Spinal cord injuries can have devastating consequences for those affected. Nerve cells in the spinal cord rarely regenerate naturally, while scarring often prevents the regrowth of nerve fibres. Modern therapies attempt to influence implanted stem cells using electrical stimulation to promote the growth of new nerve cells. This approach has several drawbacks: it requires implanted electrodes, and the transplanted cells do not always survive or integrate properly into the existing tissue.

Cells and nanoparticles cleverly combined 

Researchers in Zurich are pursuing a new approach, which they have published in the journal Nature Materials. This involves combining therapeutic stem cells with magnetoelectric nanoparticles in such a way that the cells can be guided magnetically to the precise site of an injury and stimulate the stem cells to accelerate repair.

To achieve this, the researchers created a biohybrid microrobot, which combines living neural progenitor cells (NPCs) with a technical component in the form of specially engineered nanoparticles. The NPCs are derived from induced pluripotent stem cells (iPS cells), which are regular body cells reprogrammed in the laboratory to regain stem cell properties. These iPS cells have the potential to differentiate into various types of nervous system cells.

The nanoparticles consist of two layers: an inner layer that responds to magnetic fields and an outer layer that converts this response into electrical signals. By combining these special nanoparticles with the progenitor cells, the researchers fabricate what are known as NPCbots.

A lab the size of a chip

The researchers create the NPCbots in specialised labs on a surface measuring one square centimetre. This process can be illustrated graphically. “We place a reservoir in the centre where we trap the cells. Then we inject the nanoparticles and wait for the two components to bind,” explains Professor Salvador Pané i Vidal of the Multi-Scale Robotics Lab at ETH Zurich.

Illustration of how microrobots are fabricated on a lab-on-a-chip (LoC).  (Image: ETH Zurich)

After just thirty minutes, the NPCbots – each around six micrometres in size – are ready for use. “To scale up fabrication, we operate several lab-on-chip systems in parallel,” explains Hao Ye, senior scientist and the study’s first author. Depending on the test in question, the ETH researchers need hundreds of thousands of microrobots for cell-based studies and several million for animal experiments.

Injured zebrafish swim again

The team tested the NPCbots on zebrafish larvae with spinal cord injuries. The microrobots were injected precisely into the site of the fish’s injury, and electromagnetic fields were generated. For Pané Vidal, teamwork was vital to the experiment’s success: “Stephan Neuhauss and Jingjing Zang at the University of Zurich did extremely valuable work. They enabled us to demonstrate, in a well-characterised regenerative model system, how quickly cells differentiate using our method and how our bots repair the spinal cord.” In just three days, the zebrafish exhibited nearly normal swimming and exploratory behaviour.

Schematic illustration of nerve cell recovery in zebrafish and mice. (Image: ETH Zurich)

The researchers also tested the NPCbots on mice with completely severed spinal cords. Here, too, the results were very promising: after 28 days, the animals’ nerve cells had reconnected at the site of the injury. During this period, the treated mice exhibited increasingly normal movement patterns – their gait, stride length, coordination and exploratory behaviour improved significantly.

This result is particularly significant because, unlike in zebrafish, the mouse spinal cord does not normally regenerate. The treatment was well tolerated by the animals, with no evidence of any adverse effects or immune reactions. 

Success through minimally invasive stimulation 

These successes were made possible through electrical stimulation of stem cells, greatly enhancing their differentiation after transplantation. In this process, nanoparticles convert magnetic signals directly into electrical impulses that stimulate specific stem cells. When employing NPCbots, researchers need only apply external magnetic fields around the injury site, eliminating the need for implanted electrodes or cables in previous approaches. This is crucial because the spinal cord is extremely sensitive. “Microrobotic guidance makes the treatment more precise and minimally invasive,” Hao explains.

Magnetic fields are particularly well-suited for stimulating stem cells because they can penetrate tissue easily, and their frequency and field strength can be flexibly adjusted to the specific application. Once the progenitor cells have been stimulated and differentiated into nerve cells, the NPCbots essentially dissolve within the tissue. The researchers expect the nanoparticles to be stable and minimally reactive due to their barium titanate coating. Further studies will determine whether and how the particles are degraded or excreted over the long term.

The idea can be expanded as required

The results from animal experiments are extremely promising, but further research will be needed before NPCbots can be tested in humans. “In addition to many clinical aspects, we first need to test which magnetic fields work best in humans and determine the optimal stimulation duration,” Hao explains. Nevertheless, the researchers are already considering further applications: “The reproducible and scalable production of microrobots using our lab-on-a-chip system demonstrates that the platform’s application potential extends beyond basic research,” explains Professor Pané i Vidal. It could also be adapted for other biomedical applications – for example, in cardiology, oncology, wound healing and other targeted regenerative therapies. This could make these treatments safer, more controllable and more effective. 

By Franziska Schmid

Source: ETH Zurich

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South Africa’s Weight-Management Market Needs Stronger Safeguards for Women

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By Dr Gerhard Vosloo, Founder and Head Consulting Practitioner at Dr GL Vosloo Medical Practice, managed by BioWell

Prescription-based weight management treatment has surged into the mainstream, giving more people with genuine clinical needs access to potentially life-changing care. However, the market’s growth has not been matched by consistently high standards of care. This Women’s Month, we must confront the fact that many women remain particularly vulnerable to inadequate clinical oversight, inappropriate prescribing practices, and black-market products that operate outside established medical safeguards.

Nearly seven in ten adult South African women are obese, compared to four in ten men. Women therefore account for a significant share of the weight-management market and, as a result, may face greater exposure to irresponsible medical practices and unregulated black-market options, where proper clinical support and control are virtually non-existent.

At Dr GL Vosloo Medical Practice, managed by BioWell, women make up the majority of patients seeking a holistic weight-loss and metabolic management programme, which may include prescription treatment where clinically justified. Concerningly, some patients arriving from other programmes report excessively high dosages of treatments, with scarce oversight or guidance. Others have used black-market products and later sought professional medical help after struggling to manage their treatment safely and effectively.

These experiences demonstrate exactly why prescription treatment should form part of a broader, medically-supervised programme rather than a medication-only approach. As more women seek treatment, the industry has a duty to help them understand what good clinical care and appropriate dosing practices involve, as well as how to distinguish a medically grounded programme from those built primarily around access to medication.

Not all weight-management programmes are created equal. Patients should look for a few key indicators that suggest a provider is delivering safe, responsible care:

  1. Screening should begin before the consultation

Before the first appointment is even scheduled, a reputable practice or physician should gather sufficient information to understand a patient’s medical history, current health status, and potential risk factors. For example, intake forms may ask about previous weight-loss treatments, allergies, pregnancy or breastfeeding status, eating habits, goals, and other information that may help the practitioner identify contraindications early.

Patients should expect this information to be reviewed before they proceed. Any omissions or concerns should be raised, while patients with possible contraindications, urgent medical issues, or conditions outside the programme’s scope should be informed and referred where necessary.

  1. The consultation should establish clinical need and risk

Patients should expect a thorough consultation that explores their concerns, goals, medical and treatment history, symptoms, and relevant lifestyle or health factors. It should also give the doctor an opportunity to clarify uncertainties, identify undisclosed contraindications, and assess appetite, eating behaviour, level of activity, sleep quality, and mental health.

For women, this may include menstrual health, contraceptive use, pregnancy plans, breastfeeding, menopause, polycystic ovary syndrome, hormone treatment, and previous gestational diabetes.

A medical assessment should establish whether prescription treatment is clinically appropriate, rather than being prescribed simply because a patient wants to lose weight. Relevant considerations may include body measurements, blood pressure, glucose, cholesterol, organ and thyroid function, vitamin and hormone levels, and pregnancy screening where relevant.

  1. Treatment decisions should be fully explained before consent

Doctors should provide a clear explanation of whether prescription therapy is appropriate, whether it should be delayed or avoided, or whether another treatment approach may be more suitable. Prescription-based medication should not be framed as the primary intervention, although it may form part of a broader programme covering nutrition, exercise, behaviour, supplementation, metabolic support, clinical monitoring, and guidance on how these elements work together.

Before written consent is given, patients should be informed about the expected benefits, potential side effects, serious risks, contraindications, alternatives, monitoring requirements, and circumstances under which treatment may be stopped. Women should also be informed about how pregnancy plans, breastfeeding, hormonal treatment, or changing health circumstances may affect whether treatment can begin or continue.

  1. Prescriptions should be individualised and closely monitored

Patients should be cautious of one-size-fits-all prescribing practices. Treatment should reflect the individual’s clinical needs and risk profile, using a conservative approach rather than a standard dose or automatic escalation schedule.

Ongoing follow-up is equally important. Regular check-ins should track progress, side effects, relevant eating and lifestyle factors, and any changes in health or medication use, with treatment adjusted accordingly. For women, this continuity is particularly important because hormonal, reproductive, and life-stage circumstances may change during treatment and affect how care is managed.

Women should not have to navigate a fast-moving treatment market through trial and error. By understanding the characteristics of safe, medically supervised care, patients are better equipped to make informed choices. Ultimately, however, the responsibility rests with practitioners and clinics to make ethical, medically-grounded care easy to recognise from the outset. Public trust in this treatment category will depend on how consistently the industry meets that standard.

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Forgotten Memories Can Leave Silent Traces in the Brain

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Inaccessible memories can leave silent traces that reminders may revive or distort. Image generated by Johannes Felsenberg with the assistance of ChatGPT.

A forgotten memory is not always a vanished one. FMI neuroscientists investigating the fruit fly brain found that some memories become inaccessible while leaving a silent trace behind. The right reminder can bring them back, but misleading reminders can distort their recovery, producing false memories. The findings show how memories can be rebuilt from stored information and current clues, which may help explain why recall can sometimes alter what we remember.

Memory is not a perfect record. Some memories fade, while others remain hidden and can be brought back by reminders. But reminders can also distort what is remembered, and scientists still know little about how the brain accurately recovers memories or forms false ones.

In a new study, researchers in the group of Johannes Felsenberg trained fruit flies to associate one odour with mild electric shocks. Soon after training, the flies avoided that odour, but by 24 hours later the learned avoidance had faded. When the researchers later exposed the flies to the same odour as a reminder, the aversive memory was recovered, and the flies avoided the odour again.

The reminder only worked when key parts of the original setting, such as the chamber’s texture and lighting, were unchanged, suggesting that the fly brain used both the odour and its context to bring the memory back.

When the researchers looked inside the flies’ brain, they found that the original pattern of neural activity linked to the memory faded over time. At the same time, the memory left a silent trace in a different group of neurons. A specific reminder could reactivate this silent trace, restoring the brain activity that guides behaviour. These findings suggest that some forgotten memories are not erased but persist in the brain in a silent form that can later be recovered.

The team also showed how memory recovery can go wrong. During training, the flies had experienced a second odour that was not paired with shock. When researchers later used that harmless odour as the reminder, the flies began avoiding it too, as if it had predicted danger.

The neuronal pathways involved in forming the false memory were different from those used to recover the true memory. This suggests that, at least in flies, the brain may process recovered and distorted memories through distinct circuits.

This work does not show that fly memory is the same as human recollection, but it offers a circuit-level example of how remembering can depend on stored information, current cues and context, and why that process can sometimes distort past memories, the researchers say.

Source: Friedrich Miescher Institute for Biomedical Research

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Wits University Liver Transplant Programme Reaches 1000th Transplant Milestone

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Johannesburg, 30 July 2026: The Wits University Liver Transplant Programme has reached its 1000th liver transplant, marking a defining milestone for South African medicine and for one of Africa’s most comprehensive transplant programmes.

A collaboration between Wits Donald Gordon Medical Centre and Charlotte Maxeke Johannesburg Academic Hospital, the liver transplant programme has become a national and regional referral hub for patients across the healthcare system.

Of the 1000 liver transplants, 637 were performed in adults and 363 in children.

Since performing its first liver transplant in 2004, the programme has introduced living donor liver transplantation for both adults and children, expanded expertise in split liver transplantation and ABO (blood group)-incompatible transplantation, pioneered HIV-positive donor liver transplantation, performed monosegment liver transplantation and, most recently, introduced liver machine perfusion technology to help maximise the use of scarce donor organs.

The 1 000th transplant milestone demonstrates what is possible when academic medicine, scientific research, education and healthcare partners work together in pursuit of a common purpose, increasing access to healthcare for all.

Professor Jerome Loveland, Academic Head of Transplantation at Wits, says the programme has continually expanded the boundaries of what is possible through clinical innovation, multidisciplinary expertise, research and academic training in a country facing a severe shortage of donor organs.

“People often see the transplant operation as the defining moment. In reality, it is the culmination of years of expertise and systems development across highly specialised teams. The 1000th transplants reflect the legacy handed to us by those who built the programme, past and present, the extraordinary multidisciplinary expertise that sustains it today and our responsibility to train the people who will carry it forward.”

While the programme celebrates its 1000th transplant, it also highlights one of South Africa’s greatest ongoing healthcare challenges. Many patients continue to wait for life-saving donor organs. Advances such as living donor transplantation, split liver transplantation and liver machine perfusion are helping to expand access to transplantation, but increasing awareness of organ donation remains essential if more patients are to receive the chance of a longer, healthier life.