Day: April 22, 2026

Categories : Dermatology NeurologyTags : Leave a comment

Novel Research Reveals the Active Role that Skin Cells Play in Rabies Infection

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New findings identify keratinocytes as replication hubs and immune responders, contributing to the risk of rabies infection from superficial scratches or minor bites

Skin cell (keratinocyte)
This normal human skin cell was treated with a growth factor that triggered the formation of specialised protein structures that enable the cell to move. We depend on cell movement for such basic functions as wound healing and launching an immune response. Credit: Torsten Wittmann, University of California, San Francisco

While it was previously thought that keratinocytes (skin cells) were only passive conductors that allow the rabies virus to pass through, novel research reveals that these cells play a much more active role. The findings of a new study in the Journal of Investigative Dermatology (JID), published by Elsevier, provide direct evidence that keratinocytes can support viral replication and transmit the rabies virus to neurons. The investigators offer a mechanistic explanation for how superficial skin exposures from scratches or minor bites by dogs and bats can lead to neuroinvasion, contributing to the risk of infection.

Rabies is a fatal zoonotic infection caused by rabies virus (RABV), responsible for at least 59 000 human deaths per year. The virus is transmitted through the saliva of infected animals. While most cases are caused by dog bites, superficial exposures such as bat bites or scratches can also lead to infection, although the underlying mechanisms remain poorly understood.

“In our previous work, we discovered that keratinocytes – cells that form the epidermis, the outermost layer of the skin – were infected at the site of entry of the rabies virus, both in natural and experimental infections. This was unexpected, as rabies pathogenesis has traditionally focused on muscle cells and motor neurons,” explains lead investigator Corine H. Geurts van Kessel, MD, PhD, Department of Viroscience, Erasmus Medical Centre, Rotterdam, The Netherlands. “Given the strategic position of keratinocytes at the skin barrier and their close proximity to sensory nerve endings, we wanted to understand whether these cells are simply bystanders or active participants in early rabies infection and neuroinvasion.”

The investigators used primary human keratinocyte cultures to investigate susceptibility to rabies virus infection and characterise the resulting antiviral immune responses. Three viral strains were tested: a vaccine strain and two wild-type (“street”) strains derived from fatal human cases associated with bat and dog exposures. The dog-associated strain caused only minimal infection and limited keratinocyte immune activation, whereas the other two strains infected keratinocytes more readily and triggered a pronounced antiviral response.

To simulate the close contact between keratinocytes and intra-epidermal nerve endings, a co-culture model of keratinocytes and neurons was developed. In this model, virus produced in infected keratinocytes was successfully transmitted to adjacent neurons, giving the virus a direct route into the nervous system. Once the virus has established infection in the central nervous system, it is almost inevitably fatal.

“Our study demonstrates that the skin might play a more important role in rabies infection than previously recognised. We were particularly surprised by the strong antiviral response mounted by keratinocytes to the bat-related rabies virus strain,“ notes co-investigator Keshia Kroh, PhD candidate, Department of Viroscience, Erasmus Medical Centre, Rotterdam, The Netherlands. “Wild-type rabies viruses are known for their immunosuppressive capacities, and we expected an immune evasive effect in keratinocytes. Instead, we observed the opposite. This raises new questions about how keratinocyte-derived immune responses influence overall disease progression in rabies and other viral infections of the skin.”

This in vitro co-culture model is the first to study rabies virus entry to the nervous system across a cell barrier. Future in-depth studies should be performed to provide mechanistic insight into the differential strain tropism, the interactions of infected keratinocytes with immune cells, and the mechanisms of neuroinvasion from superficial skin contact.

According to the World Health Organization (WHO), any transdermal exposure (including small scratches or abrasions) should be assessed as a potential rabies risk and managed appropriately based on exposure category and clinical context.

“Our study provides a biological rationale for these recommendations,” says co-investigator Carmen W.E. Embregts, PhD, Department of Viroscience, Erasmus Medical Centre, Rotterdam, The Netherlands. “At the same time, it is important to emphasise that the risk of rabies virus infection via superficial exposures depends on multiple factors, including the nature of the exposure and the epidemiological setting. Rather than causing alarm, our findings support informed decision-making. Awareness that superficial skin exposures can represent a route of neuroinvasion helps ensure that potential risks are recognised and evaluated appropriately, while treatment decisions remain guided by established public health criteria.”

“The data in this study support the increasingly recognised concept that cells in the skin are in snug communication with the nervous system. That a scratch or bite is needed for the transmission of rabies is further evidence of the importance of an intact skin barrier in health,” observes JID Associate Editor Ethan Lerner, MD, PhD, Associate Professor of Dermatology, Harvard Medical School, and Massachusetts General Hospital, Boston, MA, USA.

Source: Elsevier

Categories : Cardiovascular DiseaseTags : Leave a comment

AI Model Predicts How CPAP Affects Cardiovascular Risk in Obstructive Sleep Apnoea

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Photo by Navy Medicine on Unsplash

Mount Sinai researchers have created an analytic tool using machine learning that can predict cardiovascular disease risk in millions of patients with obstructive sleep apnoea, according to findings recently published in Nature Communications Medicine.  

The team said their study is the first to provide estimates of whether continuous positive airway pressure (CPAP), a widely used therapy for obstructive sleep apnoea, will increase or decrease an individual’s cardiovascular risk. It highlights the potential for precision medicine and varied approaches to tailor clinical care and reduce cardiovascular disease risk in vulnerable patients. 

Obstructive sleep apnoea is a common, serious condition in which breathing repeatedly stops and starts during sleep. It is associated with elevated risks for cardiovascular disease, including stroke and heart disease. CPAP, which provides a continuous stream of pressurised air through a mask and helps eliminate breathing disturbances during sleep, remains the most effective treatment for sleep apnoea. However, prior large studies have not shown that CPAP lowers risks for cardiovascular disease in patients with this disease.  

The Mount Sinai researchers used a machine learning algorithm to create an analysis model that predicts how CPAP could affect an individual’s cardiovascular health – estimating each patient’s likeliness of benefit or harm from the therapy, based on their sleep and health information.  

“Our findings represent a significant advancement in personalised medicine, moving away from a one-size-fits-all strategy in the treatment of obstructive sleep apnoea,” said co-corresponding author Neomi A. Shah, MD, MPH, MSc, ATSF, Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) and Artificial Intelligence and Human Health, and System Vice Chair of Faculty Affairs for the Department of Medicine at Icahn School of Medicine at Mount Sinai. “This underscores the value of new data-driven approaches like our model to assist clinicians in making informed decisions about CPAP treatment recommendations, enhancing personalised care to meet the individual needs of every patient.” 

The Mount Sinai team analysed data from the Sleep Apnea Cardiovascular Endpoints (SAVE) trial, the largest clinical cohort evaluating CPAP for cardiovascular disease prevention with more than 2,600 participants from 89 sites in seven countries, to estimate individualised treatment effect scores. They considered more than 100 predictors from sleep and health information to establish 23 key baseline features, such as prior medical conditions and smoking status, in their analysis model.  

The researchers found that treatment response significantly varied across the cohort. The model identified a subgroup who were expected to have improved cardiovascular risk with CPAP treatment; participants in this subgroup who were randomly assigned to receive the therapy experienced a 100-fold improvement in future cardiac risk compared with patients from this subgroup on usual care. Conversely, those in a subgroup predicted to be harmed by the therapy experienced a greater than 100-fold increase in cardiovascular disease outcomes, including recurrent strokes and heart attacks, when receiving CPAP compared with usual care.  

“These results demonstrate the power of machine learning for prediction of treatment effects in an era of precision medicine; however, such models require careful validation to prove their utility in clinical practice,” said co-primary author Oren Cohen, MD, Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) at the Icahn School of Medicine. 

“Artificial intelligence in medicine must move beyond pattern recognition to causal reasoning,” said co-corresponding author Mayte Suarez-Farinas, PhD, Co-Director for the Division of Biostatistics and Data Science, and Professor of Population Health Science and Policy, and Artificial Intelligence and Human Health, at the Icahn School of Medicine. “By estimating individualised treatment effects over time using randomised clinical trial data, we move predictive AI toward decision-support tools grounded in causality and capable of informing real-world treatment decisions and improving outcomes.”  

Source: Mount Sinai

Categories : Neurology PaediatricsTags : Leave a comment

Early Warning Signs of Brain Infection in Children Identified in New Study

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Photo by Chayene Rafaela on Unsplash

Despite new diagnostic methods and expanded vaccination programmes, many children in Uganda continue to suffer from severe brain infections. This is shown in a new study from Karolinska Institutet, published in The Lancet Regional Health – Africa. The researchers’ analysis highlights simple clinical signs that can help healthcare providers more quickly identify children at high risk of death.

The study followed 212 children aged 0 to 12 who were treated for suspected central nervous system infections at two hospitals in southwestern Uganda. Fifteen per cent of the children died during hospitalisation, and 18 per cent were discharged with neurological disabilities such as seizures or muscle weakness. Malaria and the bacterium Streptococcus pneumoniae were the most commonly identified causes.

Simple observations can provide crucial information

“Our results show that even in settings where advanced diagnostics are not always available, simple clinical observations can provide crucial information about which children are in greatest need of rapid care,” says Phuthumani Mlotshwa, doctoral student at the Department of Global Public Health and the study’s first author.

The infections were caused by several different microorganisms. Malaria was detected in 20 per cent of the children, and bacteria in the cerebrospinal fluid in 11 per cent. For nearly half of the cases, no specific pathogen could be identified, which the researchers say underscores the need for improved diagnostic tools.

“The combination of high mortality and significant disabilities among survivors shows that we need to strengthen prevention, diagnostics, and follow-up,” says Giulia Gaudenzi, researcher at the same department and the study’s senior author.

Source: Karolinska Institutet

Categories : Diet and NutritionTags : Leave a comment

Increasing Fruit, Fibre, Dairy and Caffeine Linked to Lower Risk of Tinnitus

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But quality of evidence low and further studies needed to verify the relationship, say researchers

Photo by Dylann Hendricks on Unsplash

Increased consumption of fruit, dietary fibre, dairy products and caffeine may be associated with a reduced risk of tinnitus (ringing in the ears), suggests an analysis of the available evidence, published in the open access journal BMJ Open.

The researchers stress that their findings can’t establish a direct (causal) relationship and should be interpreted with care because of the low quality of the evidence. But they say possible reasons may involve the protective effects of these diets on blood vessels and nerves, as well as their anti-inflammatory and antioxidant properties.

Tinnitus is the perception of sound (ringing, buzzing or clicking) when there’s no external source. Data suggests it affects around 14% of adults worldwide and is associated with depression, anxiety, stress, and in severe cases, suicide.

There is no cure, but treatments such as counselling, behavioral therapy, medications, and hearing aids can help to reduce symptoms.

Diet can also have a significant impact on tinnitus. It’s thought that eating high-quality nutrients can have a positive effect on hearing by improving blood flow to the inner ear and reducing oxidative damage and inflammation. But previous studies show conflicting results and it’s still uncertain which specific foods worsen or relieve symptoms.

To explore this further, the researchers trawled research databases looking for studies linking tinnitus and diet in adults published up to May 2024.

They found eight observational studies involving 301,533 people that assessed 15 dietary factors using validated questionnaires that were of suitable quality to include in their analysis.

The dietary factors included carbohydrates, caffeine, eggs, fruits, fibres, fat, meat, protein, sugar, fish, vegetables and dairy.

The combined findings revealed that increased consumption of fruit, dietary fibre, dairy products and caffeine was associated with a reduced occurrence of tinnitus. These reductions were 35% for fruit intake, 9% for dietary fibre, 17% for dairy products, and 10% for caffeine intake.

No associations were found between other dietary factors and tinnitus and results were consistent after further analyses, although the authors note that the association between caffeine intake and tinnitus remains contentious.

The authors acknowledge that due to the observational design of included studies, causality cannot be established, and the relatively small number of included studies may have led to certain conventionally accepted beneficial dietary factors (such as vegetables and eggs) not demonstrating significant differences.

However, they suggest that “the primary underlying mechanisms may involve the protective effects of these diets on blood vessels and nerves, as well as their anti-inflammatory and antioxidant properties” and say further large-scale studies are needed “to complement and verify the relationship between dietary intake and tinnitus.”

Source: BMJ Group

Categories : Infection ControlTags : Leave a comment

From Gogo to Citizen Scientist – The Women Helping to Defeat Malaria

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World Malaria Day is commemorated every year on 25 April to raise awareness and highlight the global efforts against malaria.

Photo by Ayo Ogunseinde on Unsplash

by Dr Taneshka Kruger, Project Manager: University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) and Prof Tiaan de Jager, Director: UP ISMC

Eliminating malaria requires effort that goes far beyond our laboratories. It also happens in homes, villages and clinics, where gogos (grandmothers), mothers, young women and other citizen scientists play a vital role in prevention, early action and creating public awareness.

On 25 April, we commemorate World Malaria Day. This day is aimed at raising awareness about one of the world’s oldest and deadliest diseases, while also recognising the progress we’ve made in controlling and eliminating it. This year’s theme, ‘Driven to end malaria: Now we can. Now we must.”, is a reminder that success depends not only on medicine and science, but also on the people who protect families and strengthen communities every day.

Malaria remains a life-threatening disease transmitted by female Anopheles mosquitoes infected with the Plasmodium parasite. Globally, hundreds of millions of cases are reported each year, with the overwhelming burden falling on sub-Saharan Africa. The most vulnerable groups include pregnant women, children under five and older persons.

Why women and children face greater malaria risks

Pregnancy reduces a woman’s immunity to malaria, increasing the risk of infection and severe illness. Malaria during pregnancy can lead to maternal anaemia and serious complications such as miscarriage, premature birth, stillbirth and low birth weight. Low birth weight is one of the leading contributors to neonatal mortality and can affect a child’s long-term development.

Children under five continue to carry the heaviest malaria burden. In Africa, they account for roughly three-quarters of malaria-related deaths. Their immune systems are still developing, making prevention, early diagnosis and prompt treatment essential for survival.

The family members who spot danger first

In many rural communities, mothers – and especially grandmothers – are the backbone of family life. They shape household health practices, encourage clinic visits, and ensure children use preventative measures against malaria, such as sleeping under protective nets, where possible. Their lived experience gives them influence and trust, and when equipped with up-to-date malaria information they become powerful advocates for prevention. They are often the first to notice symptoms such as fever, fatigue or vomiting, and frequently help decide when and how medical care is sought.

Women also care for elderly family members, who may have weaker immune systems and be more vulnerable to complications from malaria. In areas where clinics are far away or transport is limited, their vigilance can be lifesaving.

Young women – whether students, entrepreneurs, community workers or volunteers – also play an increasingly important role in sharing reliable malaria information. They help bridge the gap between scientific knowledge and everyday community life, promoting practical actions such as:

  • Seeking early testing when symptoms such as fever appear
  • Reducing mosquito breeding sites through environmental management
  • Using preventative strategies to avoid mosquito bites
  • Consistent use of insecticide-treated bed nets where available
  • Attending antenatal clinics for intermittent preventive treatment in pregnancy (IPTp), in countries where these programmes are offered.


Through each of these actions and more, women’s leadership strengthens community resilience and promotes healthier futures.

Young women spreading life-saving knowledge

One of the most encouraging developments in rural malaria response is the rise of women citizen scientists. Through training programmes supported by research institutions, women from local communities are gaining skills to assist with field data collection and malaria surveillance.

In malaria research conducted by the University of Pretoria Institute for Sustainable Malaria Control in Limpopo’s Vhembe District,  women citizen scientists have contributed by:

  • Engaging tribal authorities and communities about the purpose of the research and how communities can benefit
  • Collecting health data to assess the impact of malaria control methods on people and the environment
  • Collecting mosquito samples for vector surveillance and climate-related research
  • Gathering knowledge, attitude and practice data through surveys
  • Conducting interviews before and after interventions to assess effectiveness
  • Running focus groups to better understand community needs, behaviours and challenges.

By participating in field research, these women gain scientific skills while contributing directly to malaria control strategies. Their involvement helps ensure that research is done in local languages, reflects lived realities and leads to practical action communities can trust and use.

Just as importantly, this model expands women’s roles beyond traditional caregiving expectations. It positions them as knowledge holders, data contributors and active partners in scientific discovery. It also shows young girls in these communities that science is accessible, relevant and open to them.

From community member to citizen scientist

When mothers, gogos and young women understand the risks malaria poses – especially to pregnant women and children under five – they are better equipped to protect their families. When they are empowered as citizen scientists, they move from being passive recipients of health messaging to active drivers of change, contributing to local malaria elimination efforts. Their combined role as caregivers, educators and research partners strengthens both households and health systems.

On this World Malaria Day, we should recognise and honour the women who care for feverish children through the night, accompany pregnant daughters to clinics, share trusted advice with neighbours, and step into fields and villages as trained citizen scientists. By investing in women’s knowledge, leadership and participation at home, in communities and in science, we move closer to a future free from this preventable disease.