Month: October 2023

Fear is in the Eye of the Beholder, Researchers Find

Photo by Stormseeker on Unsplash

Looking away from something frightening may be due to a specific cluster of neurons in a visual region of the brain, according to new research at the University of Tokyo. Researchers found that, in fruit fly brains, these neurons release a chemical called tachykinin which appears to control the fly’s movement to avoid facing a potential threat. Fruit fly brains can offer a useful analogy for larger mammals, so this study, published in Nature Communications, may help studies of human reactions to fearful situations and phobias.

“We discovered a neuronal mechanism by which fear regulates visual aversion in the brains of Drosophila (fruit flies). It appears that a single cluster of 20-30 neurons regulates vision when in a state of fear. Since fear affects vision across animal species, including humans, the mechanism we found may be active in humans as well,” explained Assistant Professor Masato Tsuji from the Department of Biological Sciences at the University of Tokyo.

The team used puffs of air to simulate a physical threat and found that the flies’ walking speed increased after being puffed at. The flies also would choose a puff-free route if offered, showing that they perceived the puffs as a threat (or at least preferred to avoid them). Next the researchers placed a small black object, roughly the size of a spider, 60 degrees to the right or left of the fly. On its own the object didn’t cause a change in behavior, but when placed following puffs of air, the flies avoided looking at the object and moved so that it was positioned behind them.

To understand the molecular mechanism underlying this aversion behavior, the team then used mutated flies in which they altered the activity of certain neurons. While the mutated flies kept their visual and motor functions, and would still avoid the air puffs, they did not respond in the same fearful manner to visually avoid the object.

“This suggested that the cluster of neurons which releases the chemical tachykinin was necessary for activating visual aversion,” said Tsuji. “When monitoring the flies’ neuronal activity, we were surprised to find that it occurred through an oscillatory pattern, ie, the activity went up and down similar to a wave. Neurons typically function by just increasing their activity levels, and reports of oscillating activity are particularly rare in fruit flies because up until recently the technology to detect this at such a small and fast scale didn’t exist.”

By giving the flies genetically encoded calcium indicators, the researchers could make the flies’ neurons shine brightly when activated. Thanks to the latest imaging techniques, they then saw the changing, wavelike pattern of light being emitted, which was previously averaged out and missed.

Next, the team wants to figure out how these neurons fit into the broader circuitry of the brain. Although the neurons exist in a known visual region of the brain, the researchers do not yet know from where the neurons are receiving inputs and to where they are transmitting them, to regulate visual escape from objects perceived as dangerous.

“Our next goal is to uncover how visual information is transmitted within the brain, so that we can ultimately draw a complete circuit diagram of how fear regulates vision,” said Tsuji. “One day, our discovery might perhaps provide a clue to help with the treatment of psychiatric disorders stemming from exaggerated fear, such as anxiety disorders and phobias.”

Source: University of Tokyo

Selenium Reduces Health Impact of Pollutant Mixtures

Photo by Bill Oxford on Unsplash

A study in mice conducted by the University of Cordoba proves that exposure to mixtures of metals and drug residue exacerbates health impacts, and evaluates the positive effects of a diet enriched in selenium to reduce this harm.

People are exposed daily, through the environment and their diets, to external substances that can be harmful to their health. Metals and the residue of pharmaceuticals, for example, in high doses, contaminate water and food, creating mixtures where they can interact, with this increasing their individual toxicity.

Analysing the effects of environmental pollution on organisms is essential to develop regulations establishing maximum doses of these pollutants for people. But mixtures of pollutants pose unknown challenges as they may interact with each other.

To understand the health effects of exposure to these ‘cocktails of contaminants’, a team at the University of Cordoba, evaluated, in mice, the toxicity of a mixture of contaminants that is very common in the environment and that accumulates along the food chain: a combination of metals (arsenic, cadmium, mercury) and drugs (diclofenac, flumequine).

In order to determine how these compounds interacted with each other, “we studied the controlled exposure of mice to this mixture and analysed how it affects the proteins in the liver; that is, how their liver proteostasis changes when ingesting these mixtures of contaminants for two weeks,” explained Professor Nieves Abril, senior author of the paper published in Science of the Total Environment.

Their conclusion is negative: the cocktail effect synergises these compounds, doing increased damage to health when the compounds act together.

“We used a massive protein detection technique (shotgun proteomic), which allowed us to compare how the proteins of the group exposed to the mixture of contaminants were altered compared to the control group,” April explained.

Of the proteins affected, they selected 275 as sentinels to verify what was changing and, after computer analysis, they were able to determine the metabolic pathways that were altered and their consequences for health. These analyses revealed a disproportionate defence response having a contrary and harmful effect on the system.

The researcher stressed that “although these pollutants generated oxidation in the cells separately too, when they acted together we found that the oxidation was so intense that all the antioxidant defence responses were activated continuously, without deactivating them, which ends up doing damage and causing many proteins to stop working.” The analyses showed a sustained expression of the response mediated by NRF2, which is the regulator that sets in motion a good part of the antioxidant defences, which caused a reducing stress.

Selenium as hope

It’s not all bad news in the study, as selenium could be a way to reduce the damage caused by exposure to these pollutants. A third group of mice were given doses of selenium, a mineral often found in vitamin supplements found in pharmacies, and proteomic analyses showed relief from the molecular damage done by the pollutants.

Selenium itself is an oxidant, but in low doses it activates responses in a controlled manner, predisposing the body to better defence.

Source: University of Córdoba

GEMS Hosts its 14th Annual Symposium, Bringing Together Key Healthcare Industry Stakeholders and Policymakers

The Government Employees Medical Scheme (GEMS) will, on November 2nd, 2023, host its 14th annual GEMS Symposium under the theme: “Advancing Health Equity by Addressing the Social Determinants of Health”. Experts, thought leaders and specialists in healthcare will engage in discussions towards a better understanding of the societal determinants of health in South Africa. 

For this hybrid event, delegates will attend both in person at Sandton and virtually.

Dr Moloabi states that the “Symposium is an important event on the GEMS calendar, providing a platform for academic, clinical, government and business minds to discuss what social issues are at play in determining the nation’s health status and how to improvements in health equity can be realized”. Moreover, he also highlights the need to remove practical obstacles that make us an unequal society if we are to achieve collaborative and cohesive solutions to our healthcare challenges.”

Speakers will include: 

  • Dr Ingrid Pooe – Chief Operations Officer, Government Employees Medical Scheme (GEMS),
  • Dr Sebayitseng Millicent Hlatshwayo – Chairperson, Government Employees Medical Scheme (GEMS),
  • Dr Chana Pilane-Majake – Deputy Minister of Public Service and Administration (DPSA),
  • Professor Mcebisi Ndletyana – Professor of Political Science, Department of Politics and International Relations, University of Johannesburg,
  • Dr Selaelo Mametja – Chief Research Officer, Government Employees Medical Scheme (GEMS),
  • Mr Barry Childs – Joint Chief Executive Officer Insight Actuaries & Consultants,
  • Dr Vuyo Gqola – Chief Healthcare Officer, Government Employees Medical Scheme (GEMS),
  • Mr Louis Botha – Chief Executive Officer, Health Quality Assessment (HQA),
  • Ms Yoliswa Makhasi – Director General, Department of Public Service and Administration (DPSA),
  • Mr Frikkie de Bruin- General Secretary, Public Service Coordinating Bargaining Council (PSCBC),
  • Dr Pali Lehohla – Director of Economic Modelling Academy (EMA), 
  • and
  • GEMS Principal Officer Dr Stanley Moloabi.

Dr Pilane-Majake, the Deputy Minister for the Department of Public Service and Administration (DPSA) will deliver the keynote address, elucidating, amongst other insights, the crucial relationship between the DPSA as employer and GEMS as an implementor of a mandate to ensure access to health and wellness by government employees and thus contributing towards the attainment of the ideals of Universal Healthcare Coverage.

Media personality Ms. Faith Mangope will facilitate conversations as the panel covers key discussion points, including:

  • Achieving the Sustainable Development Agenda 2030.
  • Beyond Healthcare: Addressing health equity and social determinants of health.
  • Policy Interventions for Addressing Social Determinants of Health: Lessons and best practices.
  • Value-Based Care and Social Determinants of Health: Integrating social context into healthcare delivery.
  • Advancing health equity by addressing social determinants of health; and
  • Exploring the interplay between healthcare quality and social determinants.

At GEMS, we are dedicated to fulfilling our responsibilities towards our members and the people of South Africa. The Symposium is a testament to our commitment to Universal Healthcare Coverage, and we are eagerly anticipating a productive outcome that will be memorable and provide an insightful experience for all involved, Dr. Moloabi” concludes. 

To learn more about the GEMS Symposium, visit

World-renowned Vaccinologist Shabir Madhi Awarded CBE

Professor Shabir Madhi has been appointed as an honorary Commander of the Most Excellent Order of the British Empire (CBE) by King Charles III.

Wits Professor of  Vaccinology Shabir Madhi led the Oxford University sponsored Oxford/AstraZeneca Covid-19 vaccine clinical trials in South Africa

Wits University and the University of Oxford contributed scientifically to informing the public health response to the Covid-19 pandemic in South Africa and globally.

Madhi receives the Order in recognition of his services to science and public health in a global pandemic.

Madhi led South Africa and the continent’s first Covid-19 vaccine trials in 2020/2021 as founder and Director of the South African Medical Research Council (SAMRC) Wits Vaccines and Infectious Diseases Analytics (Wits VIDA) Research Unit.

An internationally recognised leader in his field, the National Research Foundation A-rated scientist was involved in multiple clinical and serology epidemiology studies on Covid-19, in addition to his research on vaccines against other life-threatening diseases.

The first of (subsequently two) Wits University-led South African Covid-19 vaccine trials, Madhi led the Oxford/AstraZeneca Covid-19 vaccine clinical trials in South Africa, in association with the University of Oxford.

Professor Sir Andrew Pollard, Director of the Oxford Vaccine Group, University of Oxford, and Madhi’s UK counterpart in these Covid-19 vaccine trials, says of Madhi’s CBE appointment: “I am delighted that Professor Shabir Madhi CBE has been honoured by King Charles for his remarkable contributions to global public health and particularly for his extraordinary leadership in the midst of a global pandemic. It has been a huge privilege for me to work alongside him and his team on the development of the globally impactful Oxford-AstraZeneca vaccine.”

Over the course of the pandemic (2020-2022), Madhi had been an outspoken, articulate, and ardent advocate of Covid-19 vaccination as well as for increased access to these and other vaccines in Africa.

On his appointment as CBE, Madhi says: “The privilege of being conferred this honour is credit to the tremendous effort of the incredible Wits VIDA research team that I have the privilege of leading at Wits University – before, during and beyond the Covid-19 pandemic. As a collective, and together with colleagues at the University of Oxford and in South Africa, we are proud to have contributed scientifically to informing the public health response to the Covid-19 pandemic in South Africa and globally.”

Source: Wits University

Genetic Analysis Reveals Secrets of Vlad Dracula the Impaler

Mediaeval tyrant and inspiration for vampires, protein analysis reveals health secrets about Vlad the Impaler

New research analysing ancient protein residues left in letters written by the sadistic 15th century tyrant – and vampire inspiration – Vlad Dracula the Impaler suggests that he suffered from a number of health conditions. One of these conditions seemingly confirms one of the more outlandish tales about him – that he cried tears of blood.

Vlad the Impaler got his nickname because he impaled thousands of people on stakes: enemies (mainly the Ottoman Empire), criminals and anyone suspected of conspiring against his rule. He was eventually defeated in 1460, but the newly invented printing press spread the tale of his gruesome deeds all over Europe. Tales surrounding him may have inspired the iconic character of Bram Stoker’s Count Dracula in 1897. Nevertheless, more modern vampire stories such as Netflix’s ‘Castlevania’ make use of Vlad as inspiration.

This terrifying reputation made him an interesting topic for a bit of genetic archaeology in a paper published in Analytical Chemistry. Using sophisticated proteomic techniques, scientists analysed three letters written in 1457 and 1475 by the voivode of Wallachia, Vlad III, also known as Vlad the Impaler, or Vlad Dracula. This allowed them to tease out information about the man who wrote the letters as well as general information about the environmental conditions of 15th century Wallachia, a place of regional trade and conflict as well as disease transmission.

While centuries-old paper is unlikely to hold entire DNA strands, scientists were still able to piece together genetic information about the writer. The technique depends on the notion that a person’s writing hand will tend to rest on the paper being written upon, rubbing off a surprising amount of organic molecules in the process. They applied ethylene vinyl acetate to the papers, and with mass spectrometry, they discovered over 500 peptides – short chains of amino acids – with about 100 being of human origin, which they looked up in database searches.

Figure 1. (a) First letter (archive catalog number is II 365), dated August 4, 1475, here investigated, also showing the positions of the EVA strips (brownish rectangles) applied to its surface for capturing biological material; (b) mapping of the fluorescence of phenylalanine, tyrosine, and tryptophan under flash UV illumination (see the original article). Anal. Chem. 2023, 95, 34, 12732-12744

The researchers noted that while many mediaeval people may have handled these papers, it is also presumable that the most prominent ancient proteins can be attributed to the one who wrote and signed them – Prince Vlad the Impaler.

First, they discovered proteins pointing to ciliopathy, which affects the cellular cilia or the cilia anchoring structures, the basal bodies or ciliary function. This can manifest in a wide range of disorders, ranging from cerebral malformation to liver disease and intellectual disability.

They also uncovered signs of an undetermined inflammatory disease which likely involved his skin and respiratory tract.

Proteomics data also suggests that, according to some stories, he might also have suffered from a pathological condition called haemolacria – he could shed tears admixed with blood. This appears to confirm what some stories said about Vlad – that he sometimes cried tears of blood. While it is a known medical condition, it would have no doubt been terrifying for superstitious mediaeval people to behold when seen in someone with a reputation like Vlad the Impaler’s.

Non-human peptides also proved to be a window into the conditions of the time, hinting at common foods, pests and diseases. Database searches of the identified, as potential endogenous original components, 3 proteins from bacteria, 24 from viruses, 4 from fungi, 17 from insects (suggesting fruit flies), and 5 from plants (including rice, wheat and thale cress). Of the bacteria, they noted that some peptides related to Enterobacterales are specific to Yersinia pestis, the pathogenic bacterium causing plague, whereas another group is specific to E. coli.

Study Shows Intermittent Fasting Effective in Type 2 Diabetes

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Time-restricted eating, also known as intermittent fasting, can help people with Type 2 diabetes lose weight and control their blood sugar levels, according to a new study published in JAMA Network Open from researchers at the University of Illinois Chicago.

Participants who ate only during an eight-hour window between noon and 8 pm each day actually lost more weight over six months than participants who were instructed to reduce their calorie intake by 25%. Both groups had similar reductions in long-term blood sugar levels, as measured by a test of haemoglobin A1C, which shows blood sugar levels over the past three months.

The study was conducted at UIC and enrolled 75 participants into three groups: those who followed the time-restricted eating rules, those who reduced calories and a control group. Participants’ weight, waist circumference, blood sugar levels and other health indicators were measured over the course of six months.

Senior author Krista Varady said that participants in the time-restricted eating group had an easier time following the regime than those in the calorie-reducing group. The researchers believe this is partly because patients with diabetes are generally told to cut back on calories by their doctors as a first line of defence, so many of these participants likely had already tried, and struggled with, that form of dieting. And while the participants in the time-restricted eating group were not instructed to reduce their calorie intake, they ended up doing so by eating within a fixed window.

“Our study shows that time-restricted eating might be an effective alternative to traditional dieting for people who can’t do the traditional diet or are burned out on it,” said Varady, a professor of kinesiology and nutrition. “For many people trying to lose weight, counting time is easier than counting calories.”

There were no serious adverse events reported during the six-month study. Occurrences of hypoglycaemia and hyperglycaemia did not differ between the diet groups and control groups.

Just over half the participants in the study were Black and another 40% were Hispanic. This is notable as diabetes is particularly prevalent among those groups, so having studies that document the success of time-restricted eating for them is particularly useful, the researchers said.

The study was small and should be followed up by larger ones, said Varady, who is also a member of the University of Illinois Cancer Center. While it acts as a proof of concept to show that time-restricted eating is safe for those with Type 2 diabetes, Varady said people with diabetes should consult their doctors before starting this sort of diet.

Source: University of Illinois Chicago

Which Entryway a Coronavirus Uses Affects its Infection Severity

Image by Fusion Medical on Unsplash

Until now, the reason why some coronaviruses such as SARS-CoV-2 affect humans more severely than other seasonal ones has eluded scientists. Now, results published in Nature have provided a piece of the puzzle by identifying a gateway used by the seasonal coronavirus HKU1 to enter human cells. HKU1 binds to a different receptor than SARS-CoV-2, which may partly explain the difference in severity between these two coronaviruses.

Receptors provide a useful means of figuring out coronavirus transmissibility and pathology as part of surveillance work on viral evolution. Seven coronaviruses are known for their ability to infect humans. Four of these are generally mild: HKU1, 229E, NL63 and OC43, while the other three are more pathogenic: SARS-CoV-1, Mers-CoV and SARS-CoV-2.

The HKU1 virus was first identified in an elderly patient with severe pneumonia in Hong Kong in 2005. Like SARS-CoV-2, HKU1 mainly infects upper respiratory tract cells. However, it rarely affects the bronchi and alveoli in the lungs. The HKU1 virus causes colds and other mild respiratory symptoms. Complications may also occur, including severe respiratory tract infections, particularly in young children, the elderly and immunocompromised individuals. It is estimated that 70% of children are infected before the age of 6. In total, 75 to 95% of the global population has been exposed to HKU1, which is comparable to other seasonal human coronaviruses.

At the cellular level, coronavirus spike proteins are cleaved after binding to their receptors. This cleavage phenomenon is vital for viral fusion, entry and multiplication. Some coronaviruses (SARS-CoV-2 and NL63) use the ACE2 receptor as a gateway for entering cells. Until now, HKU1 and OC43 were the only coronaviruses with unknown receptors.

Through collaboration between scientists at eight Institut Pasteur units, it was possible to identify the TMPRSS2 enzyme as the receptor to which HKU1 binds to enter cells. Once binding has occurred, TMPRSS2 triggers fusion of HKU1 with the cell, leading to viral infection. Through a combination of techniques performed in vitro and in cell culture, the scientists demonstrated that the TMPRSS2 receptor has high affinity with the HKU1 spike, which is not the case for SARS-CoV-2.

“Once a receptor has been identified for a virus, it is possible to characterise target cells more accurately, while also gaining insights on viral entry and multiplication mechanisms and infection pathophysiology,” comments, Olivier Schwartz, co-last author of the study and Head of the Institut Pasteur’s Virus and Immunity unit.

“Our findings also shed light on the various evolution strategies employed by coronaviruses, which use TMPRSS2 either to bind to target cells or trigger fusion and viral entry,” adds Julian Buchrieser, co-last author of the study and scientist in the Institut Pasteur’s Virus and Immunity unit.

These human-pathogenic viruses’ use of different receptors probably affects their degree of severity. Receptor levels vary among respiratory tract cells, thus influencing the sensitivity of cells to infection and viral spread. Once the route of viral entry into cells is known, it should also be possible to fight infection more effectively by developing targeted therapies and assess the risk of virulence posed by any future emerging coronaviruses.

In parallel with this work, Institut Pasteur teams led by Pierre Lafaye and Felix Rey have developed and characterised nano-antibodies (very small antibodies) that inhibit HKU1 infection by binding to the TMPRSS2 receptor. These reagents have been patented for potential therapeutic activities.

Source: Institut Pasteur

Life-saving TB Drug is Now Cheaper in South Africa – But Not as Cheap as It can be

Diagram by the United States-based National Institute of Allergy and Infectious Diseases showing the medicine options for drug-resistant tuberculosis. (Via Flickr, CC BY 2.0 Deed)

By Daniel Steyn for GroundUp

The South African government and pharmaceutical company Johnson & Johnson (J&J) have agreed to a lower price for bedaquiline, a medicine used to treat drug-resistant tuberculosis (DR-TB) in South Africa.

This comes off the back of mounting pressure from activists and amid an ongoing investigation by the Competition Commission, looking into J&J’s pricing of the drug.

An estimated 14 000 people in South Africa fell ill with DR-TB in 2019. Bedaquiline is one of the main drugs used to treat DR-TB. Before bedaquiline became available, treatment for DR-TB would consist of up to two years of injections with serious side effects. The bedaquiline-containing regimen has no injectables, far fewer side effects and is typically six months. 

Bedaquiline has been provided by the South African government since 2018.

In July, J&J agreed to sell bedaquiline to lower and middle-income countries through the Stop TB Partnership’s Global Drug Facility for $130 (R2470) per six-month regime, but South Africa does not make use of this facility due to national procurement policies.

Instead, about the same time that J&J made this announcement, the National Health Department agreed to pay J&J R5500 for the drug.

The Competition Commission announced in September that it will be investigating Johnson & Johnson’s pricing of the drug. The commission assisted the Department of Health in renegotiating the price, says department spokesperson Foster Mohale.

This week the department sent out a circular indicating that it will be paying R3,148 for bedaquiline.

Bedaquiline is prescribed to 7000 to 8000 people a year, Mohale told GroundUp. Mohale says the new price amounts to a 40% saving on bedaquiline for the next two years.

Candice Sehoma, Access Campaign Advocacy Advisor for Medicines Sans Frontiere (MSF), told GroundUp that the “momentous” cost saving is a “big achievement”. Sehoma says it is a sign that the global campaign to ensure accessible and affordable treatment for TB is yielding results.

MSF has estimated that bedaquiline could be manufactured and sold for profit for as little as $102 (R1940).

Fatima Hassan, director of the Health Justice Initiative, says that while the price drop is a victory, it is important to ensure that this does not happen again.

“The significant price reduction emphasises why price scrutiny is significant,” Hassan told GroundUp.

Alleged “evergreening”

J&J’s patent for bedaquiline expired in July 2023, but J&J had already applied for a new patent for a slightly different version of bedaquiline, which was granted. This meant their patent protection continued in South Africa after the original patent expired.

This amounts to “evergreening”, says Hassan. Evergreening, as explained in this article in The Conversation, “is achieved by seeking extra patents on variations of the original drug – new forms of release, new dosages, new combinations or variations, or new forms”.

The Competition Commission will be looking into J&J’s alleged “evergreening” as part of its investigation.

After making its agreement with the Global Drug Facility, J&J has announced it will not be enforcing the new patent – a move that will allow generic versions of the product to enter the market and further lower the price.

GroundUp sent questions to J&J but received no response.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Study Reveals a Touchy Secret in Hair Follicles

Photo by Tobias Aeppli

Imperial researchers have discovered a hidden mechanism within hair follicles that allows the sensation of touch. Previously, touch was thought to be detected only by nerve endings present within the skin and surrounding hair follicles. This new research from Imperial College London has found that that cells within hair follicles (the structures surrounding the hair fibre) are also able to detect the sensation in cell cultures.

The researchers also found that these hair follicle cells release the neurotransmitters histamine and serotonin in response to touch. These findings, published in Science Advances, might help us in future to understand histamine’s role in inflammatory skin diseases like atopic dermatitis.

Lead author of the paper Dr Claire Higgins, from Imperial’s Department of Bioengineering, said: “This is a surprising finding as we don’t yet know why hair follicle cells have this role in processing light touch. Since the follicle contains many sensory nerve endings, we now want to determine if the hair follicle is activating specific types of sensory nerves for an unknown but unique mechanism.”

A touchy subject

We feel touch using several mechanisms: sensory nerve endings in the skin detect touch and send signals to the brain; richly innervated hair follicles detect the movement of hair fibres; and sensory nerves known as C-LTMRs, that are only found in hairy skin, process emotional, or ‘feel-good’ touch.

Now, researchers may have uncovered a new process in hair follicles. To carry out the study, the researchers analysed single cell RNA sequencing data of human skin and hair follicles and found that hair follicle cells contained a higher percentage of touch-sensitive receptors than equivalent cells in the skin.

They established co-cultures of human hair follicle cells and sensory nerves, then mechanically stimulated the hair follicle cells, finding that this led to activation of the adjacent sensory nerves.

They then decided to investigate how the hair follicle cells signalled to the sensory nerves. They adapted a technique known as fast scan cyclic voltammetry to analyse cells in culture and found that the hair follicle cells were releasing the neurotransmitters serotonin and histamine in response to touch.

When they blocked the receptor for these neurotransmitters on the sensory neurons, the neurons no longer responded to the hair follicle cell stimulation. Similarly, when they blocked synaptic vesicle production by hair follicle cells, they were no longer able to signal to the sensory nerves.

They therefore concluded that in response to touch, hair follicle cells release that activate nearby sensory neurons.

The researchers also conducted the same experiments with cells from the skin instead of the hair follicle. The cells responded to light touch by releasing histamine, but they didn’t release serotonin.

Dr Higgins said: “This is interesting as histamine in the skin contributes to inflammatory skin conditions such as eczema, and it has always been presumed that immune cells release all the histamine. Our work uncovers a new role for skin cells in the release of histamine, with potential applications for eczema research.”

The researchers note that the research was performed in vitro, and will need to be replicated in vivo The researchers also want to determine if the hair follicle is activating specific types of sensory nerves. Since C-LTMRs are only present within hairy skin, they are interested to see if the hair follicle has a unique mechanism to signal to these nerves that we have yet to uncover.

Source: Imperial College London

Terminally Ill Patients Need More than Prayer from Spiritual Leaders

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A study conducted among advanced cancer patients in Soweto has found that most patients who received palliative care and are at the end of life, have spiritual needs beyond regular prayers from spiritual leaders. Furthermore, patients who received religious or spiritual care had less physical pain, used less morphine and had higher odds of dying where they wish than those who did not.

The study involving 233 participants was conducted by a team of local and international experts led by Wits researchers.

Lead researcher Dr Mpho Ratshikana-Moloko from the Centre for Palliative Care in the Faculty of Health Sciences at Wits University says that previous research has shown that religion and spirituality are important to most patients facing life-threatening illnesses. However, this study probed further.

Using the African Palliative Care Association Palliative Outcome Scale, the research confirmed previous international findings that nearly 98% of the participants had a religious or spiritual need.

The most common spiritual need expressed by patients in Soweto was “seeking a closer connection with their God” and “forgiveness for sins”, says Ratshikana-Moloko. This finding is of significance because it calls on faith leaders to provide relevant support that responds to the needs of patients. This research-led intervention empowers leaders to move beyond prayer, explains Ratshikana-Moloko.

“This is the first study to assess the spiritual and religious needs, and religious and spirituality care provided to advanced cancer patients who received palliative care in Soweto,” says Ratshikana-Moloko.

Since the study was concluded in 2018, Wits University has developed a course in Spiritual and Chaplaincy in Palliative Care. The first cohort of faith leaders from all religious backgrounds completed in September 2023.

Palliative care to increase

Palliative care is one of the key pillars in illness management among terminally ill patients who are judged by a specialist physician as unlikely to benefit from curative-intent therapy. Often, patients are unlikely to survive beyond six months.

The South African National Policy Framework and Strategy for Palliative Care (2017–2022) incorporates spirituality into health care. However, palliative care services in South and southern Africa and elsewhere, rarely address these needs, despite available policies, guidelines and evidence.

“We have to implement what we know. The integration of spiritual care within the clinical care setting is recommended,” Ratshikana-Moloko.

South Africa faces a heavy burden of communicable and non-communicable diseases. One in six deaths globally is due to cancer, and cancer diagnoses are expected to increase by 70% in the next two decades, especially in low- and middle-income countries.

“Failure to identify and address the religious and spiritual needs of terminally-ill patients may increase distress and suffering,” Ratshikana-Moloko.