Year: 2025

Categories : Neurodegenerative DiseasesTags : Leave a comment

X-Chromosome Gene Behind Greater MS and Alzheimer’s Risk in Women

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Mouse study reveals how females’ double X chromosomes drives brain inflammation and identifies diabetes drug as potential treatment

Photo by Karolina Grabowska on Pexels

New research by UCLA Health has identified a sex-chromosome linked gene that drives inflammation in the female brain, offering insight into why women are disproportionately affected by conditions such as Alzheimer’s disease and multiple sclerosis as well as offering a potential target for intervention. 

The study, published in the journal Science Translational Medicine, used a mouse model of multiple sclerosis to identify a gene on the X chromosome that drives inflammation in brain immune cells, known as microglia. Because females have two X chromosomes, as opposed to only one in males, they get a “double dose” of inflammation, which plays a major role in ageing, Alzheimer’s disease and multiple sclerosis.  

When the gene, known as Kdm6a, and its associated protein were deactivated, the multiple sclerosis-like disease and neuropathology were both ameliorated with high significance in female mice.  

“It has long been known that there are sex differences in the brain. These can impact both health and neurological diseases,” said study lead author Dr Rhonda Voskuhl, director of the Multiple Sclerosis Program at UCLA Health and lead neurologist for the UCLA Comprehensive Menopause Program. “Multiple sclerosis and Alzheimer’s disease each affect women more often than men, about two to three times as often. Also, two-thirds of healthy women have ‘brain fog’ during menopause. These new findings explain why and point to a new treatment to target this.”  

When first author Dr Yuichiro Itoh of the Voskuhl lab genetically “knocked out” the gene Kdm6a in brain immune cells, the inflammatory molecules shifted from being activated to a resting state. Additionally, the Voskuhl team performed a pharmacologic “knock down” of the protein made by this gene using metformin. Metformin is widely used as a treatment for diabetes, but is currently being researched for potential anti-ageing properties.  

While these interventions were highly significant in female mice, their effect was almost undetectable in males, Voskuhl said. 

“This is consistent with there being ‘more to block’ in females due to having two copies of the X-linked gene,” said Voskuhl, who is also a professor of neurology at UCLA Health. “It’s also why females are more likely to get MS and AD than males. This has implications for the clinic. Women may respond differently to metformin treatment than men.” 

Voskuhl said the findings may also have implications for explaining a connection to brain fog in healthy women during menopause.  

“Sex chromosomes and sex hormones achieve a balance through evolution,” Voskuhl said. “There is a selection bias to do so. Females have a balance between X chromosome-driven inflammation that can be good to fight infections at child-bearing ages. This is held in check by oestrogen, which is anti-inflammatory and neuroprotective. As women age, menopause causes loss of oestrogen, unleashing the proinflammatory and neurodegenerative effects of this X chromosome the brain immune cell.”  

Voskuhl says together, these findings may support use of oestrogens that target the brain to keep the balance, and thereby protect the brain, during menopause.

Source: UCLA Health

Categories : Obstetrics & GynaecologyTags : Leave a comment

Caesarean Delivery Linked to Higher Risk of Pain and Sleep Problems After Childbirth

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New mothers are more likely to experience severe pain that disrupts sleep and activities of daily living, as well as develop sleep disorders, if they give birth by caesarean delivery (C-section), suggests research presented at the ANESTHESIOLOGY® 2025 annual meeting.

“Sleep is often overlooked in postpartum recovery, but it is central to a mother’s physical and mental health,” said Moe Takenoshita, MBBCh, lead author of the study and a postdoctoral scholar in the department of anaesthesia at Stanford University Center for Academic Medicine. “Caesarean delivery in particular appears to increase the risk for severe pain and sleep disorders, which can lead to postpartum depression, thinking and memory problems, and fatigue, as well as disrupt bonding with their babies and relationships with family and friends.”

The study included both qualitative and quantitative analyses. For the qualitative analysis, the authors interviewed 41 mothers about their pain and sleep experiences after childbirth, 24 of whom had vaginal births, 11 who had scheduled C-sections and six whose C-sections were unplanned. More than two-thirds of the mothers who had C-sections (73% of the scheduled cesareans and 67% of the unplanned) reported severe pain that disrupted sleep and activities of daily living, compared to 8% of those who had vaginal births.

For the quantitative study, the authors analysed a nationwide insurance database of more than 1.5 million mothers who delivered babies between 2008 and 2021. They determined that individuals who have C-sections are 16% more likely to be diagnosed with a new sleep disorder (eg, insomnia, sleep deprivation or obstructive sleep apnoea) between a month and a year after giving birth, compared to those who delivered vaginally.

New mothers, especially those recovering from C-sections, should be sure to manage pain adequately, since untreated pain can worsen sleep, said Dr Takenoshita. Other measures that can help to improve sleep include regular exercise as appropriate, sleeping when the baby sleeps, avoiding caffeine or alcohol late in the day, and relaxing before bed by taking a bath or practising deep breathing.

“About one-third of U.S. births are C-sections,” said Dr Takenoshita. “Those who are planning a C-section should understand that the procedure is linked to more severe pain after delivery and a higher risk of sleep disorders. Anyone having sleep problems during pregnancy or after childbirth should discuss their concerns with their physician, who can evaluate the issue, make recommendations and refer them to a specialist if necessary.”

Source: American Society of Anesthesiologists

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Prostate Cancer Therapy Improved with Focused Ultrasound

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Credit: Darryl Leja National Human Genome Research Institute National Institutes Of Health

Combining an existing small-molecule protein therapy called tumour necrosis factor related apoptosis-inducing ligand (TRAIL) with focused ultrasound (FUS) can significantly reduce tumour size and burden in prostate cancer models, according to a new study published in Advanced Science by researchers at Rice University and Vanderbilt University.

Around the world, about 10 million people die of cancer each year. This collaborative study, led by Michael King, bioengineering professor at Rice, and Charles Caskey, associate professor in radiology and radiological sciences at Vanderbilt, is the first to demonstrate that low-intensity mechanical force in combination with TRAIL can treat cancers.

The study sheds new light on how low-intensity focused ultrasound and soluble TRAIL specifically destroy cancer cells within the compact environment of a primary prostate cancer lesion.

Urgency for safe, effective therapy for prostate cancer

“There is urgent need to improve how we treat advanced and recurrent prostate cancer, which is the second-leading cause of death among men in the United States and is the most frequently diagnosed cancer in more than 100 countries,” said King, who is a Cancer Prevention and Research Institute of Texas Scholar. “We have now found a safe, effective and noninvasive way to enhance the antitumor effects of a specific cancer drug (TRAIL), a promising finding which we are hopeful can soon be translated for clinical care.”

Current standard-of-care prostate cancer treatments are associated with severe adverse effects. In recent years, FUS-based therapies have been gaining attention since they can be localised specifically to tumour tissue, resulting in fewer off-target effects.

Mechanical stimuli amplify anticancer effects of TRAIL via Piezo1

TRAIL protein specifically induces the death of cancer cells without harming nearby healthy cells. However, despite promising results in lab studies, only a few cancer patients have shown improvements with intravenous administration of TRAIL in clinical trials. This is because TRAIL has a very short half-life (~30 minutes) and remains in blood circulation only briefly before it gets destroyed.

Thus, to effectively eliminate cancer cells, TRAIL therapy needs to be administered multiple times per day, which is not only inconvenient but also increases the risk of unwanted side effects.

“Previously, we had found certain mechanical forces like fluid shear stress (FSS) could amplify the anticancer effects of TRAIL with an influx of calcium and activation of a protein called Piezo1 that triggered cell death,” King said.

However, FSS is not clinically applicable for solid tumours because it is only present in the circulatory and lymphatic systems and thus only effective against circulating tumour cells, which are often observed at later stages of malignancy.

“The field is still lacking a straightforward and effective clinical approach that combines the application of mechanical force with soluble TRAIL as a localised therapeutic to treat primary prostate tumours effectively before they metastasise to different locations, which prompted us to undertake this preclinical study to examine if FUS might be a good candidate to be developed into a combination therapy for prostate cancer,” King said.

Low-intensity FUS acts synergistically with TRAIL to reduce prostate tumours in lab

Using prostate cancer cell lines, Abigail Fabiano and Malachy Newman – graduate students mentored by King and Caskey respectively – performed several experiments to refine and optimise several operational parameters of in vitro FUS.

Their initial goal was to ensure that the nearby healthy cells remained unharmed by the mechanical shear forces. Next, they found that combination therapy of FUS and TRAIL was much more effective in reducing the number of cancer cells and size of tumours than FUS or TRAIL alone, supporting the idea that the synergistic action of TRAIL and FUS-mediated Piezo1 activation is key to achieving maximum tumour reduction.

“This foundational study provides crucial preclinical insights that can be used to develop a novel combination therapy for prostate cancer,” King said. “Furthermore, it opens the doors to many new avenues for using mechanotherapy in medicine and has far-reaching implications in how FUS and other mechanical therapies can be combined with small-molecule protein therapy and other drugs to effectively treat various types of cancers with fewer adverse effects in the future.”

Source: Rice University

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Hope Blooms in Durban – A Spring High Tea with Purpose

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Photo by Joanna Kosinska on Unsplash

October is Breast Cancer Awareness Month, and what better way to celebrate than with floral elegance, an exquisite high tea, motivational speakers, and a live auction – all in the spirit of hope and healing.

On Saturday morning, 25th October 2025, at 11 am, PinkDrive will host their Hope Blooms High Tea at the Radisson Blu Hotel, Durban Umhlanga, a time of spring celebration and impactful fundraising.  And you’re invited!

PinkDrive is a non-profit organisation (NPO) committed to prolonging lives through early detection of gender-related cancers. They operate mobile health units – those iconic pink trucks – that travel to rural and township areas to provide essential screenings to those who lack or have limited access to adequate healthcare.

Recent Rio Tinto outreach statistics highlight the urgent need for such interventions. In just one week in KwaZulu-Natal, 2251 health services were rendered, including 146 mammograms and 141 clinical breast examinations.

PinkDrive receives no government funding, relying entirely on donations, corporate partnerships, and community support to sustain its essential work. Among these partners is Lee-Chem Laboratories through their Mandy’s brand.

“This cause is deeply important to us – we’ve proudly supported PinkDrive for many years as a long-term corporate partner because of the difference they make in communities that need it most,” says Bhavna Sanker, Marketing Manager at Lee-Chem Laboratories. “It is a privilege to stand alongside them in their efforts to promote early detection and prolong lives. The Hope Blooms fundraiser perfectly reflects our shared commitment to raising awareness, providing crucial screening, and ultimately bringing hope where it’s needed most,” she explains. “We therefore want to encourage the public to also get involved by purchasing a ticket and enjoying an uplifting morning in support of PinkDrive’s vital work.

According to Janice Benecke from PinkDrive, corporate sponsors and partnerships, like that of Mandy’s, enable them to deliver this essential community service. “Mandy’s has been a proud supporter of PinkDrive for many years, generously providing branding, hampers, and product samples, along with an annual donation,” she says. “Through sponsored events like Hope Blooms, we hope to inspire further partnerships and support for our mission.”

Dr Marion Algar, Clinical Oncologist at Hopelands Cancer Centre specialising in breast cancer treatment, and Advocate Pria Hassan, founder of Women of Africa and champion of accessible healthcare through initiatives like iBreast, will share their insights as guest speakers. The elegant affair will be hosted by the lovely Delia Kroll, Mrs SA 2024 finalist, and attendees can also look forward to a welcome drink, networking opportunities, raffle prizes, gift bags, and an exciting live auction. Proceeds will go towards supporting PinkDrive’s free services, including clinical breast examinations, education, pap smears, and funding toward a new mammogram truck. Last year’s event raised R25 000; this year’s goal is to double that amount through your support.

“Hope Blooms reflects the courage, resilience, and renewal that come with a breast cancer journey,” notes Benecke. “Just like flowers that bloom after winter, it’s a reminder that through awareness, support, and love, hope always finds a way to grow.”

She concludes: “We want everyone to leave with this key message, and it’sa motto that I live by: ‘Only Believe, All Things Are Possible.’ Just look at me, I am a walking miracle.”

Tickets are R695 per person with a floral dress code. 10% of proceeds go directly to PinkDrive, and bookings can be made at info.durban.umhlanga@radissonblu.com. So why not consider purchasing a corporate table, inviting members from your sports or social club, or coming along with friends to enjoy a morning of elegance and purpose?

We look forward to welcoming you.

Categories : Ageing CancerTags : Leave a comment

Global Study Challenges Age-Based Treatment Decisions in Leukaemia

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Study of 2,800 patients suggests moving beyond chronological cut-offs in cancer care

SAG Leukaemia. Credit: Scientific Animations CC0

An international study conducted by the Alliance for Clinical Trials in Oncology and the Acute Myeloid Leukemia Cooperative Group reveals that age-based classifications in the treatment of acute myeloid leukaemia (AML) may be outdated and overly simplistic.

AML is a fast-growing cancer of the blood and bone marrow that disproportionately affects older adults. Historically, age has been a key factor in determining treatment intensity, eligibility for clinical trials, and access to targeted therapies. However, this new research suggests that age alone is not a reliable indicator of disease biology or prognosis.

“Our findings support a more flexible, biology-driven approach to AML treatment and trial design. Age alone should not be a gatekeeper to potentially life-saving therapies,” said Alliance researcher and lead author Ann-Kathrin Eisfeld, MD, associate professor of Internal Medicine and director of the Clara D. Bloomfield Center for Leukemia Outcomes Research at The Ohio State University. “Our results suggest reconsidering age-based eligibility criteria for treatments. By focusing on molecular and genetic profiles rather than chronological age, clinicians may better tailor treatments to individual patients, improving outcomes and expanding access to novel therapies.”

Published in Leukemia, the study analysed data from 2823 adult AML patients treated in the setting of large cooperative group frontline trials across the United States (CALGB/Alliance) and Germany (AMLCG), uncovering nuanced age-related trends in genetic mutations and survival outcomes that challenge current clinical practices. This research is the first large-scale, cross continental study to analyse the mutational patterns and outcomes among patients of all age groups with AML.

The analysis included patients treated with frontline cytarabine-based chemotherapy between 1986 and 2017. Molecular profiling was conducted using targeted sequencing platforms, and survival outcomes were assessed using the 2022 European LeukemiaNet (ELN) genetic-risk classification.

The study found no clear age threshold that could biologically or prognostically separate patients into distinct groups. Instead, genetic mutations and survival outcomes varied continuously across the age spectrum. This challenges the long-standing practice of using arbitrary age cut-offs, such as 60 or 65 years, to guide treatment decisions.

Survival outcomes also declined steadily with age, even among patients classified as having favourable genetic risk. For example, patients aged 18 to 24 with favourable-risk AML had a five-year overall survival rate of 73%, while those aged 75 and older had a survival rate of just 21%. This trend was consistent across all risk categories, indicating that age negatively impacts prognosis regardless of genetic classification.

“This research arrives at a critical moment in oncology, as precision medicine continues to transform cancer care,” added Dr Eisfeld. “Most targeted treatment options are still only available for patients above a certain age threshold that is dictated by corresponding inclusion criteria of pivotal clinical trials, even though patients outside of that age range might equally benefit from these often less toxic treatments.”

Source: Alliance for Clinical Trials in Oncology

Categories : Ethics and Law HIVTags : Leave a comment

Pharmacists Can Treat People with HIV, Appeal Court Rules

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“Legitimate and compelling public interests” to allow pharmacists to initiate antiretroviral treatment, says judge

By Tania Broughton

Pharmacists can initiate people with HIV on antiretroviral treatment, the Supreme Court of Appeal has ruled. Photo: GroundUp Staff

The Supreme Court of Appeal (SCA) has dismissed, with costs, an appeal by a doctor’s organisation, the IPA Foundation, aimed at stopping specially trained pharmacists from treating people with HIV and TB.

The IPA first took its dispute with the South African Pharmacy Council (SAPC) to the Gauteng High Court in Pretoria. In 2023, Judge Elmarie van der Schyff ruled in favour of the pharmacists, giving a judicial go-ahead for the council to introduce its Pharmacy-Initiated Management of Antiretroviral Treatment (PIMART) initiative.

However the IPA Foundation, intent on having the initiative set aside, took this ruling on appeal to the SCA. In that court, five judges this week ruled against it. The ruling came nearly 11 months after the case was heard, far more than the three months that judicial norms provide for when a judgment is reserved.

Read the judgment

Justice Tati Makgoka, writing for the court, said the initiative was created in response to a persistent rise in new HIV infection rates.

The SAPC, at the department’s request, deemed PIMART suitable for addressing this issue.

“As the high court correctly found, the SAPC evaluated the risks associated with pharmacists initiating first-line ART [antiretroviral treatment] and TPT [tuberculosis preventive therapy] as well as providing medicines for PrEP [Pre-Exposure Prophylaxis of HIV] and PEP [Post Exposure Prophylaxis of HIV], considering the risks when deciding to approve the PIMART training.

“The uncontested evidence presented by the SAPC demonstrates that the approved accreditation process for PIMART was rigorous and thorough,” Makgoka said.

In her previous judgment, Van Der Schyff had noted that a pilot project had emphasised the value of the initiative, which was in line with the World Health Organisation’s vision to promote widely accessible primary health care.

“The untapped value of pharmacists in fighting HIV was also emphasised by the efficient role pharmacies played in meeting health care needs and providing health care services during the Covid-19 pandemic,” she said.

“The need to widen access to first line ART and TPT therapy on a community level is not a figment of SAPC’s imagination but a dire need that is also evinced in other countries.”

The IPA Foundation had approached the Pretoria court, under the Promotion of Administrative Justice Act (PAJA), seeking to review and set aside the SAPC’s decision to implement PIMART.

IPA claimed that the SAPC had failed to give interested parties an adequate opportunity to comment before the initiative was implemented. It further contended that PIMART unjustifiably encroached on the domain of medical practitioners and was in conflict with legislation.

On appeal, the IPA persisted with these arguments.

Dealing with the background, Justice Makgoka said the SAPC had published a notice in the government gazette in March 2021 regarding the proposed adoption of PIMART, giving interested parties 60 days to comment. This resulted in government approval later that year.

It was only after this that the IPA submitted its comments and objections.

Following engagements, the IPA lodged the review application in the high court.

On the issue that the IPA and its members claimed they were not given sufficient notice of PIMART, because it was advertised in the government gazette during the Covid-19 pandemic – Makgoka said there was no suggestion that the pandemic had “paralysed the administrative functions” of the IPA.

Remarkably, the judge said, the IPA had not suggested that the notice did not come to its attention, finding that adequate notice had been given. Makgoka said that several other organisations had submitted comments during the prescribed period.

He said the IPA had also not challenged the validity of the Pharmacy Act, which specified publication in the gazette and in the absence of that, it was not open for it to say the publication was inadequate.

Makgoka said the IPA had introduced the issue of “rationality” only in its notice of appeal. However, the court had dealt with this because there was no prejudice to the SAPC.

In ruling on this issue, he said PIMART was a crucial intervention in the public interest, which had been devised by a group of medical experts.

“Through PIMART, the SAPC aimed to improve access to healthcare. Contrary to the IPA’s contentions, PIMART is an essential intervention in the fight against HIV/AIDS. Its introduction constitutes a rational legislative and practical measure with the competence of the SAPC as an organ of the state in enhancing access to healthcare for HIV treatment, in fulfilment of the state’s obligation under the Constitution,” Makgoka said.

“These are legitimate and compelling public interests.”

He said the IPA was wrong in believing that PIMART was a blanket licence for pharmacists to treat HIV patients.

“Its scope is limited and applies only to accredited pharmacists. It will not alter the scope of practice for medical practitioners. The fact is that medical practitioners do not have the exclusive rights to care for people living with HIV/AIDS. This is a collaborative effort involving various health professionals.”

The IPA had also submitted that pharmacists were not authorised to prescribe schedule 3, 4 and 5 medicines without a prescription.

However, the judge said, the Medicines Act carved out an exception to this with authorisation of the Director-General. It was through this that PIMART-accredited pharmacists could apply for permits to prescribe schedule 3 – 5 substances.

The appeal was dismissed with costs.

Certainly not all doctors oppose the idea of pharmacists initiating patients with HIV on treatment: the South African HIV Clinicians Society stated: “We look forward to supporting the rollout of PIMART which will further contribute to South Africa’s HIV response and progress towards the 2030 target of eliminating HIV as a public health concern.”

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

Read the original article.

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Targeted Steroid Use Might Offer a Universal Complimentary Treatment for TB

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Tuberculosis bacteria. Credit: CDC

While steroids like dexamethasone are used in certain tuberculosis cases (eg, TB meningitis), their impact on immune cells is not well understood. Given the renewed interest in the steroid dexamethasone, as a host-directed treatment during the COVID-19 pandemic, a Trinity College Dublin team provides evidence that treating patients with steroids may enhance the function of their macrophages to kill the mycobacteria, while diminishing pathways of inflammatory damage. The study is published now in the journal Scientific Reports.

The team’s goal was to determine whether dexamethasone impacts the macrophage’s ability to fight TB. Although glucocorticoids can reactivate TB, they are paradoxically the only adjunctive host-directed therapies that are recommended by the World Health Organization for TB. Steroids are given to patients alongside antimicrobials in certain circumstances, however, scientists don’t fully understand the effect of these drugs on the immune system, especially innate immune cells such as macrophages.

The researchers studied immune cells called macrophages derived from the blood of healthy volunteers or isolated from lung fluid donated by patients undergoing routine bronchoscopies. By treating and infecting these macrophages in the lab with Mycobacterium tuberculosis (Mtb), the scientists could examine and understand how dexamethasone affects the immune response that protects the lungs during infection.

Key findings from the study

  • Dexamethasone a potent glucocorticoid reduces glycolysis in human lung and blood derived macrophages. This reduces the amount of energy available in the cell.
  • Dexamethasone reduced the production of both pro and anti-inflammatory cytokines measured in the study, IL-1β, TNF, IL-6, IL-8 and IL-10. Although helpful for immunity, limiting the production can also limit damage from excessive inflammation.
  • Mtb-infected macrophages have increased survival when they were treated with dexamethasone. This suggests that dexamethasone may protect macrophages from dying due to the harmful effects of infection or detrimental immune responses to infection.
  • Dexamethasone reduces bacterial burden in infected macrophages, and we have identified that this is at least partly mediated by autophagy and phagosomal acidification. Dexamethasone can enhance the macrophages’ ability to degrade and clear bacteria helping to overcome infection with Mtb.

This study identifies that macrophages from different sources have differential responses to glucocorticoids. This highlights that tissue origin can influence how macrophages react to drugs, which may be important for targeting treatment strategies. This is one of the first studies to show that dexamethasone can reduce inflammation while preserving or enhancing antimicrobial function in primary human lung macrophages infected with Mtb.

How could this research change a patient’s life?

The findings support the use of steroids as an extra therapy in conjunction with existing antimicrobial therapies in TB treatment, especially in cases with excessive inflammation. Steroids might also be useful with antimicrobials in TB preventative therapy, to reduce progression from latent TB infection to active TB disease. This study opens avenues for macrophage-targeted steroid therapies that balance inflammation control with antimicrobial defence.

For now, researchers hope this study will hasten the recovery of TB patients who experience debilitating symptoms, often for months into existing therapy.

Dr Donal Cox, Senior Research Fellow, Clinical Medicine, Trinity College Dublin said:

“Our study shows that dexamethasone, which is known to dampen inflammation, can also help macrophages fight tuberculosis more effectively. This challenges the assumption that steroids always suppress immunity and opens the door to smarter, targeted adjunctive therapies that balance inflammation control with antimicrobial defence.”

Prof Joseph Keane, Professor of Medicine, Trinity College Dublin and Consultant Respiratory Physician, St James Hospital said:

“In clinical practice, steroids are the most under-used adjunctive therapy for TB. We often rely on steroids to manage inflammation in tuberculosis, particularly in severe forms like TB meningitis. What’s reassuring from this study, is that dexamethasone not only tempers inflammation but also appears to support the macrophage’s ability to control infection. This study provides new evidence to help us redefine steroid use in TB care—targeting inflammation without compromising antimicrobial defence.”

Next steps for this research

Developing steroid therapies that can be specifically targeted to lung macrophages via mechanisms such as inhaled nanoparticles might be an option to translating this into better therapy. The team also wants to identify how steroids altered different metabolic pathways in human lung macrophages and not in blood derived macrophages so they can exploit this to make steroid therapies better in the future.

Source: Trinity College Dublin

Categories : Ageing Metabolic DisordersTags : Leave a comment

Small Reductions in Cholesterol Could Slash Risk of Dementia for Those with Certain Genetics

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Photo by Kampus Production: https://www.pexels.com/photo/a-man-in-blue-sweater-sitting-beside-man-in-white-long-sleeves-7551646/

Low cholesterol can reduce the risk of dementia, a new University of Bristol-led study with more than a million participants has shown.

The research, led by Dr Liv Tybjærg Nordestgaard while at the University of Bristol and the Department of Clinical Biochemistry at Copenhagen University Hospital – Herlev and Gentofte, found that people with certain genetic variants that naturally lower cholesterol have a lower risk of developing dementia.

The study, which is based on data from over a million people in Denmark, England, and Finland, has been published in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 

Some people are born with genetic variants that naturally affect the same proteins targeted by cholesterol-lowering drugs, such as statins and ezetimibe. To test the effect of cholesterol-lowering medication on the risk of dementia, the researchers used a method called Mendelian Randomisation – this genetic analysis technique allowed them to mimic the effects of these drugs to investigate how they influence the risk of dementia, while minimising the influence of confounding factors like weight, diet, and other lifestyle habits.

By comparing these individuals to individuals without these genetic variants, the researchers were able to measure differences in the risk of dementia. They found reducing the amount of cholesterol in the blood by a small amount (one millimole per litre) to be associated with up to 80% reduction in risk of developing dementia for certain drug targets.

“What our study indicates is that if you have these variants that lower your cholesterol, it looks like you have a significantly lower risk of developing dementia,” said Dr Nordestgaard, who now works in the Department of Clinical Biochemistry at Copenhagen University Hospital – Bispebjerg and Frederiksberg hospital.

The results suggest that having low cholesterol, whether due to genes or medical treatment, can help reduce the risk of dementia. However, the study does not say anything definitive about the effect of the medicine itself.  

One of the challenges is that dementia typically does not appear until late in life, and therefore research in the area typically requires a very long period of follow-up. 

It is still not known exactly why high cholesterol can increase the risk of dementia, but one possible explanation proposed by Dr Nordestgaard is that high cholesterol can lead to atherosclerosis. 

“Atherosclerosis is a result of the accumulation of cholesterol in your blood vessels,” Dr Nordestgaard said.  “It can be in both the body and the brain and increases the risk of forming small blood clots – one of the causes of dementia. 

“It would be a really good next step to carry out randomised clinical trials over 10 or 30 years, for example, where you give the participants cholesterol-lowering medication and then look at the risk of developing dementia,” Dr Nordestgaard added. 

The study used data from the UK Biobank, the Copenhagen General Population Study, the Copenhagen City Heart Study, the FinnGen study, and the Global Lipids Genetics Consortium.

Source: University of Bristol

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Acidic Tumour Environment Promotes the Survival and Growth of Cancer Cells

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Cancer cells reshape their mitochondria (stained yellow) when exposed to acidosis. The composed image shows two cells under neutral pH (left) compared to an acidic environment (right), where mitochondria form elongated networks.

Tumours are not a comfortable place to live: oxygen deficiency, nutrient scarcity, and the accumulation of sometimes harmful metabolic products constantly stress cancer cells. A research team from the German Cancer Research Center (DKFZ) and the Institute of Molecular Pathology (IMP) in Vienna has now discovered that the acidic pH value in tumour tissue – known as acidosis – is a decisive factor in how pancreatic cancer cells adapt their energy metabolism to survive these adverse conditions. The results were published in the journal Science.

Poor blood circulation and increased metabolic activity often create hostile conditions in tumours: typical symptoms include a lack of oxygen, glucose, and other nutrients, the accumulation of sometimes harmful metabolites, and acidification of the tumour environment, known as acidosis.

The team led by Wilhelm Palm from the DKFZ and Johannes Zuber from the IMP investigated how cancer cells adapt to these harsh conditions. First, the researchers systematically switched off each gene individually in pancreatic cancer cells using the CRISPR-Cas9 gene editing tool and then tracked how its loss affected the survival and growth of the cells under defined stress conditions. These experiments were initially conducted in culture dishes. The genes identified using this approach were then specifically switched off in mice with pancreatic cancer, and the effects were compared with the results from the cell culture.

The comparative analysis of hundreds of such genes relevant to cancer cell growth under stress conditions surprisingly showed that the metabolism of cancer cells in the mouse model was strongly influenced by adaptations of their energy balance to tumour acidosis. The metabolism of cancer cells within a tumour differs significantly from that in conventional cell culture and can best be replicated by an acidic environment.

“It is not just the lack of oxygen or nutrients that changes the metabolism in the tumour – it is primarily the acidification of the tumour environment,” explains Wilhelm Palm. Acidosis helps cancer cells switch from sugar-based energy production (glycolysis) to more efficient energy production through respiration in the mitochondria. These cell structures, known as organelles, are also referred to as the “powerhouses of the cell.”

The researchers were able to show that the acidic pH value triggers profound changes in the mitochondria. Normally, they are present in cancer cells as small, fragmented structures. Under acidic conditions, however, they merge into extensive networks that are significantly more efficient.

This is possible because acidosis inhibits the activity of the signalling protein ERK. Overactivation of this signalling pathway normally causes mitochondria in cancer cells to repeatedly divide into many small fragments. If this fragmentation does not occur as a result of tumour acidosis, mitochondria can use various nutrients more efficiently for energy production. If genetic intervention prevents the mitochondria from fusing, cancer cells lose their metabolic flexibility and grow much more slowly in the acidic environment of a tumour.

“Our results show that acidosis is not simply a by-product of tumour metabolism, but an important switch that controls the energy supply and survival strategies of cancer cells,” explains co-study leader Johannes Zuber. In the long term, these findings could open up new avenues for therapies that specifically target the energy metabolism of tumours.

Source: German Cancer Research Center

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A Decade of Hope and Healing: Surgeons for Little Lives Marks 10 Years of Transforming Paediatric Care

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Every day for ten years, Surgeons for Little Lives has stood beside children and families, providing life-saving care and support.

Professor Jerome Loveland, Founder and Chair of Surgeons for Little Lives at the Chris Hani Baragwanath Academic Hospital paediatric surgery department

For the past ten years, Surgeons for Little Lives has stood as a lifeline for thousands of children at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto – the largest hospital in the southern hemisphere. In a healthcare system often stretched to its limits, this dedicated non-profit organisation has filled critical gaps with compassion, resilience and an unwavering belief that every child deserves the best possible care.

Since its founding in 2015, Surgeons for Little Lives has walked hand-in-hand with doctors, nurses, patients and families, not only providing vital resources but transforming the hospital experience for young patients. From upgrading surgical wards and equipment, to nurturing the next generation of paediatric specialists and creating welcoming, family-friendly spaces that offer comfort in the darkest moments – its work has made healing more than just a medical process. It’s become a human one.

“Our first ten years have shown what’s possible when people come together with one shared purpose: to save and uplift the lives of children,” says Professor Jerome Loveland, Founder and Chair of Surgeons for Little Lives. “We are deeply proud of what has been accomplished – but we know the need is growing. That’s why we will continue, every single day, to build capacity, inspire future leaders, and give every child a fighting chance at a brighter future.”

Why this work matters

South Africa has one of the highest burdens of paediatric surgical disease in the region. Children make up nearly 40% of the population, yet there are too few specialists and limited facilities to meet the demand. Severe burns, congenital conditions, childhood cancers and trauma are common, and without surgery many children would not survive.

At CHBAH alone, the paediatric surgery department sees more than 11,000 patients each year and performs over 2,300 operations. Surgeons for Little Lives works closely with the Department of Health to turn overstretched wards into spaces where children can recover with dignity.

3,650 days of achievement

Hospitals can be intimidating places for children. Surgeons for Little Lives has transformed the hospital environment with projects like an outdoor play area for recovering patients, family sleep-over facilities, and a fully revamped Ward 32 with a library, playroom, and upgraded bathrooms. Most recently, the organisation launched the Wells Paediatric Burns Unit, which doubled ICU beds, improved infection control, and added rehab spaces. For families, these changes mean children receive life-saving surgery and care in an environment designed with their needs in mind.

Beyond facilities, Surgeons for Little Lives has created programmes that focus on children’s emotional and physical wellbeing. Healing Through Art & Music gives young patients a way to process trauma through creativity and the SCAN programme, launched in 2023, helps to detect and prevent child abuse. In partnership with the South African Breastmilk Reserve, Surgeons for Little Lives also set up lactation support for new mothers. Other practical initiatives – from discharge packs to Mandela Day donations – have provided small comforts that make a big difference in long hospital stays.

Training for the future

Paediatric surgeons are scarce, and training takes years. Over the past decade, Surgeons for Little Lives has supported the journey of 17 qualified surgeons and backed another 15 registrars currently in training, supplying equipment like surgical loupes and funding access to academic opportunities. In 2024, the first Rolls Royce Oncology Fellow, Dr Andinet Beza from Ethiopia, trained at CHBAH before returning home with new skills. “This initiative, along with other training efforts, is helping to build the next generation of paediatric surgeons equipped to deliver world-class care. Training these specialists is a responsibility we take seriously and a privilege we don’t take for granted,” says Prof Loveland.

Community and partnerships

Community engagement has been central to the success of Surgeons for Little Lives. Fundraising events such as Bara Ride and Joberg2C, together with job shadowing opportunities for young people, have brought South Africans closer to the realities of paediatric care. Volunteers and donors provide not just resources but also comfort to families who spend weeks or months at a child’s bedside.

“This impact has only been possible thanks to the support of partners,” says Prof Loveland. “Contributions from corporates, foundations, and philanthropists have funded essential equipment, upgraded facilities, supported family-centred programmes, and helped fill critical gaps in care, ensuring that more children receive the treatment they need.”

10 years in numbers

  • 11,000+ patients seen in the paediatric surgery department each year
  • 2,300+ operations performed annually at CHBAH
  • 3,000+ burns patients treated since 2015
  • Mortality halved in the burns unit after upgrades
  • ICU beds increased from 6 to 11 in 2025
  • 17 paediatric surgeons trained; 15 registrars in training
  • Hundreds of families supported with sleep-over spaces, counselling, lactation services and more

Join us

Surgeons for Little Lives invites supporters, partners and the wider community to join in building the next chapter. By funding new projects, volunteering time or raising awareness, everyone can help ensure that more children get the surgery and support they deserve.

For its 10th anniversary, the organisation is calling on the public to donate R365 – one rand for every day of the year. In hospital that amount can cover burn dressings for a child, a week of meals for a parent at their child’s bedside or supplies for play therapy to make recovery less frightening, among many other things.

Every rand counts. Every day makes a difference.

For more information or to get involved, visit surgeonsforlittlelives.org.