Year: 2026

Point-of-care Rapid Tests can Improve Screening for Latent Tuberculosis

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A new test shows promising results for detecting latent tuberculosis infection in resource-limited settings. This is according to a study from Karolinska Institutet, published in the journal Clinical Infectious Diseases.

“This test can help more people with latent tuberculosis to be detected and receive preventive treatment, especially in rural areas in countries with limited resources,” says last author Lina Davies Forsman, a researcher at the Department of Medicine, Solna, Karolinska Institutet.

Tuberculosis remains one of the world’s deadliest infectious diseases. To reduce the number of new cases, infected individuals with latent infection must be detected and offered preventive treatment to avoid active tuberculosis, which can spread the disease to others.

Currently, latent tuberculosis is often diagnosed using a laboratory test called QuantiFERON-TB Gold Plus. This test involves several steps and can take one to two days before the results are available, as well as requiring advanced laboratory infrastructure and trained personnel. This makes it difficult to carry out tests in areas with a high prevalence of tuberculosis where access to laboratories and trained personnel is limited.

Results within 15 minutes

In the new study, researchers from Karolinska Institutet, together with colleagues in Vietnam, have therefore compared this test with another test, TB-Feron. This is a point-of-care test that provides results within 15 minutes and does not require an advanced laboratory or trained personnel.

The study included 345 adult participants in Hanoi, Vietnam, divided into three groups: people with confirmed tuberculosis, people in the same household as people with infectious tuberculosis, and people with no known exposure to tuberculosis. All were tested with both TB-Feron and the established laboratory test QuantiFERON-TB Gold Plus.

The results show that TB-Feron has high sensitivity – 88 percent of individuals with expected positive results were correctly identified. The corresponding figure for QuantiFERON-TB Gold Plus was 92 percent.

However, the specificity, i.e. TB-Feron’s ability to rule out tuberculosis infection in healthy individuals, was moderate at 70 percent. The corresponding figure for QuantiFERON-TB Gold Plus was 96 percent.

Among household contacts, the concordance between TB-Feron and the established test was good, with 92 percent concordance for positive samples.

“It is promising that TB-Feron works so well in an environment with a high disease burden. The test is patient-friendly and easy to use, with rapid same-day results, making it useful in primary care,” says Han Thi Nguyen, pulmonologist and doctoral student at the same department and first author of the study.

The researchers also investigated the reliability of TB-Feron by comparing results from two different groups with laboratory staff. No systematic differences were observed, indicating good reproducibility.

Source: Karolinska Institutet

Antidepressants not Linked to Serious Complications from TBI

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Taking certain antidepressants at the time of a traumatic brain injury (TBI) is not associated with an increased risk of death, brain surgery or longer hospital stays, according to a study published on January 28, 2026, in Neurology®, the medical journal of the American Academy of Neurology.

For the study, researchers looked at serotonergic antidepressants, which treat anxiety and depression by increasing serotonin activity in the brain. These included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs).

“Concerns have previously been raised that serotonergic antidepressants might increase the risk of bleeding in the brain or complicate early recovery after traumatic brain injury,” said study author Jussi P. Posti, MD, PhD, of the University of Turku in Finland. “However, our study found no evidence to support those concerns.” The study included 54 876 people in Finland who were 16 or older when hospitalised with a TBI. A total of 14% used serotonergic antidepressants at the time of the TBI.

Researchers reviewed national prescription records for preinjury antidepressant use and medical records to determine how many people died within a month, whether they needed emergency brain surgery, and how long they stayed in the hospital. A total of 4105 people died within a month. This included 7.6% of those taking antidepressants and 7.5% of people who did not. After adjusting for factors such as age, sex and other health conditions, researchers found people taking antidepressants before injury were no more likely to die within a month than those not taking them.

Antidepressant users were slightly less likely to require emergency brain surgery to relieve pressure or bleeding in the brain and prevent further damage. Of the total participants, 6.8% of the antidepressant users and 8.6% of those who did not use antidepressants needed emergency brain surgery. After adjustments, antidepressant users had an 11% lower risk. The amount of time in the hospital was the same for both groups.

“These findings provide reassurance for people who take antidepressants that antidepressant use does not appear to worsen early recovery after traumatic brain injury,” said Posti. “Future studies should examine whether these results hold true for long-term recovery and across different health care settings.”

A limitation of the study was that it was conducted only at hospitals and health care centres in Finland, so results may vary in other areas. The study was supported by the Finnish government, the Paulo Foundation, Paavo Nurmi Foundation, Research Council of Finland, Sigrid Jusélius Foundation and Finnish Foundation for Cardiovascular Research.

Source: American Academy of Neurology

Abnormal Breathing Clues Offer a Path to Treat Chronic Fatigue

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Chronic fatigue syndrome – medically unexplained fatigue lasting six months or more, preventing people from carrying out their normal activities, and often worsening after any exertion – is hard to treat. But new research could offer a lifeline. Chronic fatigue patients appear to be much more prone to disordered breathing than healthy controls, suggesting that chronic fatigue could cause respiratory issues which make patients’ symptoms worse. These findings might lead to new treatments reducing chronic fatigue symptoms by improving patients’ breathing. 

Chronic fatigue syndrome leaves patients exhausted and struggling with brain fog – and it typically gets worse after mental or physical exercise, a phenomenon called post-exertional malaise. Now scientists investigating shortness of breath in chronic fatigue patients have discovered that they are highly likely to experience dysfunctional breathing, which could be caused by dysautonomia, abnormal control of innervation to blood vessels and muscles. Targeting treatments towards these breathing problems could potentially offer patients some relief from their symptoms. 

“Nearly half of our chronic fatigue subjects had some disorder of breathing – a totally unappreciated issue, probably involved in making symptoms worse,” said Dr Benjamin Natelson of Icahn School of Medicine, senior author of the article in Frontiers in Medicine. “Identifying these abnormalities will lead researchers to new strategies to treat them, with the ultimate goal of reducing symptoms.” 

Breathe easy

The scientists recruited 57 patients diagnosed with chronic fatigue syndrome and 25 control participants whose ages and activity levels matched the chronic fatigue cohort. Both groups took part in cardiopulmonary exercise tests over two days. The scientists measured their heart rate and blood pressure, how effectively they were taking in oxygen, the oxygen saturation of their blood, and how hard they had to breathe to get enough oxygen. They also tracked how fast participants breathed and the patterns of their breathing, to identify hyperventilation and dysfunctional breathing.

Dysfunctional breathing is usually associated with asthma patients, but it can arise from many different causes. Characteristics include deep sighing in the course of ordinary breathing, overly rapid breathing, forcing your exhale from your abdomen, breathing from your chest without using your diaphragm so your lungs are never properly full, and a loss of synchrony between your chest and abdomen, so the different muscles which help you breathe aren’t working together.

“While we know the symptoms generated by hyperventilation, we remain unsure what symptoms may be worse with dysfunctional breathing,” said Dr Donna Mancini of the Icahn School of Medicine, first author of the article. “But we are sure patients can have dysfunctional breathing without being aware of it. Dysfunctional breathing can occur in a resting state.”


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Catching your breath

The scientists found that participants with chronic fatigue were taking in approximately the same amount of oxygen when they breathed compared to the control participants — their peak VO2 maxes were comparable. However, 71% of the participants with chronic fatigue experienced breathing problems — either hyperventilation, dysfunctional breathing, or both.

Almost half of the participants with chronic fatigue were observed breathing erratically during the test, compared to only four of the control participants. A third of the chronic fatigue patients hyperventilated, compared to just one control participant. Nine chronic fatigue patients displayed dysfunctional breathing as well as hyperventilation. None of the control participants had this combination of breathing issues. Both dysfunctional breathing and hyperventilation can cause symptoms similar to chronic fatigue, like dizziness, difficulty focusing, shortness of breath and exhaustion. Combining the two can also cause people to experience heart palpitations, chest pain, fatigue, and (unsurprisingly) anxiety. These breathing problems, the scientists suggest, could be exacerbating chronic fatigue symptoms or even directly contributing to post-exertional malaise.

“Possibly dysautonomia could trigger more rapid and irregular breathing,” said Mancini. “It is well known that chronic fatigue syndrome patients often have dysautonomia in the form of orthostatic intolerance, which means you feel worse when upright and not moving. This raises the heart rate and leads to hyperventilation.”

Pulmonary physiotherapy?

This could mean that tackling dysfunctional breathing would relieve some patients’ symptoms. The scientists intend to follow up on this research to learn more about how dysfunctional breathing and hyperventilation interact. Although more research will be needed before treatments can be rolled out, they already have ideas for possible therapies that could improve breathing function.

“Breathing exercises via yoga could potentially help, or gentle physical conditioning where breath control is important, as with swimming,” suggested Natelson. “Or biofeedback, with assessment of breathing while encouraging gentle continuous breath use. If a patient is hyperventilating, this can be seen by a device that measures exhaled CO2.  If this value is low, then the patient can try to reduce the depth of breathing to raise it to more normal values.”

Source: Frontiers

Natural Killer Cells are Suppressed by Anxiety and Insomnia

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Anxiety and insomnia have been shown to weaken the immune system and make us more prone to disease. Now, researchers found that this may be because experiencing symptoms of either can reduce the number of natural killer cells, our bodies’ machinery for defence. Their findings showed that in young women who experience insomnia symptoms, the number of total NK cells was lower. If they experienced anxiety symptoms, the number of NK cells that circulate through the body was lower. These findings could inform the development of novel strategies to raise awareness about the physiological consequences of anxiety and insomnia and help in the prevention of immune-related disorders and cancers, the team said.

Natural killer (NK) cells are the bodyguards of our immune system. As a first line of defense, they destroy invading pathogens, foreign bodies, and infected cells in early stages, thereby preventing them from spreading. NK cells can circulate within the blood stream (circulatory) or reside in tissue and organs. Having too few NK cells can lead to immune system dysfunction and increase susceptibility to disease.

Anxiety disorder and insomnia are two conditions that can disrupt the normal functioning of the immune system. Given these disorders are on the rise, researchers in Saudi Arabia have now examined the association between anxiety, insomnia, and NK cells in young, female students. They published their results in Frontiers in Immunology.

“We found that in students with insomnia symptoms, count and percentage of total NK cells and their sub-populations were declined,” said first author Dr Renad Alhamawi, an assistant professor of immunology and immunotherapy at Taibah University. “Students with general anxiety symptoms, on the other hand, had a lower percentage and number of circulatory NK cells and their sub-populations, compared to symptom-free students.”

Decimated defence

60 female students, aged between 17 and 23 years old, participated in the study. They filled out three questionnaires about sociodemographics as well as anxiety and insomnia symptoms. The symptoms of the latter two were self-reported. The surveys showed that around 53% of the participants reported sleeping disturbance suggestive of insomnia, and 75% reported anxiety symptoms, with around 17% and 13% reporting moderate and severe symptoms, respectively.

Participants also provided blood samples through which percentages of NK cells and their subtypes were determined. NK cells have two subtypes: CD16+CD56dim cells make up the majority of NK cells in the nervous system that connects the central nervous system to the rest of the body (peripheral NK cells). Cells belonging to this subtype also exhibit cytotoxicity, which means they can damage or kills cells that invade the body. The other subtype, CD16+CD56high cells, are less frequent and involved in the production of proteins that function as chemical messengers and in immunoregulation. Both subtypes are circulatory NK cells.

The results showed that students with anxiety symptoms had a lower percentage and number of circulatory NK cells and their sub-populations, compared to students who did not report symptoms. Severity of symptoms also played a role as students with moderate and severe anxiety symptoms had a significant lower percentage of circulatory NK cells compared to students without them. Among students with minimal or mild anxiety symptoms, only a statistically insignificant decline in NK cell percentage was observed. In students with insomnia symptoms, higher anxiety scores were negatively associated with the proportion of total peripheral NK cells.


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Stressed immune systems

A reduction of these cells can lead to the impairment of the immune system, which may result in diseases, cancers, and mental disease, including depression. “Understanding how these psychological stressors influence the distribution and activity of immune cells, especially peripheral NK cells, may provide valuable insights into the mechanisms underlying inflammation and tumorigenesis,” Alhamawi explained.

The study is limited in some respects, the team pointed out. It only included young females – the group amongst whom anxiety and sleeping disorders have been rising disproportionally, limiting the generalizability of the results. The researchers said that future studies that include different age groups, sexes, and people from different regions, are necessary to gain a better overall view of the hidden effects of anxiety and insomnia on the proportion and function of these immune cells.

Previous studies have suggested healthy lifestyles with regular physical activity, stress reduction, and a healthy and balanced diet can boost the number and function of NK cells. However, the impact of anxiety and insomnia can disrupt the normal functioning of various body systems, including the immune system, thereby contributing to the development of chronic and inflammatory diseases. “Such impacts ultimately compromise overall health and quality of life,” concluded Alhamawi.

Source: Frontiers

Cipla Confirms Continued Support for ARV Supply Following Changes in Supplier Landscape

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Cipla Medpro South Africa reaffirmed its commitment to ensuring the uninterrupted supply of critical antiretroviral (ARV) medicines to the Department of Health. It is essential that people living with HIV have uninterrupted access to these life-saving medicines. Any disruption of supply puts patients at risk of developing resistance to the drugs or adversely affecting health outcomes. According to Statistics South Africa, the number of people living with HIV in the country is estimated to be approximately 8 million (12,7% of the population)[1].

Recently, two suppliers who were awarded the current antiretroviral (ARV) tender, Barrs Pharmaceuticals Industries (Pty) Ltd and Innovata Pharmaceuticals (Pty) Ltd (subsidiaries of Avacare Health), have entered business rescue.

Cipla acknowledges the uncertainty this may create within the ARV supply chain and underscores its readiness to assist in maintaining stability and continuity.

Cipla has been manufacturing tenofovir/lamivudine/dolutegravir (TLD) for the government for the past 7 years, and has been one of the main suppliers of ARVs to the government for more than 12 years. Cipla has made significant investments in its local manufacturing facility, upgrading the capacity of the ARV production line with the installation of a new Countec bottle line and have increased its tablet filing capacity by 190%. The company is able to locally produce 475 million tablets annually and has upscaled its manufacturing capabilities to ensure sufficient capacity to meet current demand and support near‑term growth, while reinforcing Cipla’s commitment to secure and reliable ARV supply.

“We have mobilised resources to help maintain equitable access to quality, affordable critical medication. Cipla confirms its willingness to support national requirements under the current tender agreement and, if needed, contribute meaningfully to any supplementary procurement processes to safeguard patient access to essential treatment. We want people to live a long and healthy life as part of our commitment to caring for life,” said Paul Miller, CEO of Cipla Africa.

“In addition, we believe this tender presents an opportunity to further advance government’s commitment to strengthening local manufacturing capacity. By ensuring greater support for locally produced medicines, future allocations could meaningfully contribute to South Africa’s industrial development agenda while maintaining continuity of supply,” said Miller.

The total ARV tender is for a period of three years, and is worth an estimated R15.5bn, of which the TLD component comprises R12.6bn.

Scientists Find Hidden Diversity Among T. Gondii

UC Riverside study reshapes understanding of toxoplasmosis and identifies new paths for treatment

Toxoplasma gondii. Source: Wikimedia CC0

A University of California, Riverside team of scientists has found that Toxoplasma gondii, a common parasite affecting up to one-third of the global population, is far more complex than previously believed. The findings, published in Nature Communications, offer new insight into how T. gondii causes disease and why it has been so difficult to treat.

Humans commonly contract toxoplasmosis by eating undercooked meat or through exposure to contaminated soil or cat faeces. The parasite is best known for its ability to hide in the body by forming tiny cysts in the brain and muscles. 

Most people who are infected never notice any symptoms. However, the parasite remains in the body for life as cysts, which can contain hundreds of parasites. The parasites they lodge can become active again later, however, especially in people with weakened immune systems, leading sometimes to serious problems affecting the brain or eyes. Most people who are infected never notice any symptoms. Infection during pregnancy can cause serious complications for developing babies with limited immune systems. 

Until now, scientists believed that the cysts contained a single, uniform type of parasite lying dormant until it reactivated. But using advanced single-cell analysis techniques, the UC Riverside team discovered that each cyst contains multiple distinct subtypes of parasites, each with different biological roles.

“We found the cyst is not just a quiet hiding place – it’s an active hub with different parasite types geared toward survival, spread, or reactivation,” said Emma Wilson, a professor of biomedical sciences in the UCR School of Medicine who led the study. 

Wilson explained that cysts form slowly under immune pressure and are encased in a protective wall, housing hundreds of slow-replicating parasites called bradyzoites. Although microscopic, cysts are relatively large for intracellular pathogens, reaching up to 80 microns in diameter, with each bradyzoite measuring roughly five microns in length. They reside primarily within neurons but are also commonly found in skeletal and cardiac muscle, which is important since humans are often infected by consuming undercooked meat containing these cysts.

According to Wilson, cysts are clinically and biologically significant for several reasons. They are resistant to all existing therapies and remain in the body once established. They facilitate transmission between hosts. When reactivated, bradyzoites convert into fast-replicating tachyzoites that disseminate throughout tissues, causing severe disease such as toxoplasmic encephalitis (neurological damage) or retinal toxoplasmosis (vision loss).

Image shows a cyst which can contain hundreds of T. gondii parasites. (UCR/Wilson lab)

“For decades, the Toxoplasma life cycle was understood in overly simplistic terms, conceptualised as a linear transition between tachyzoite and bradyzoite stages,” Wilson said. “Our research challenges that model. By applying single-cell RNA sequencing to parasites isolated directly from cysts in vivo, we found unexpected complexity within the cyst itself. Rather than a uniform population, cysts contain at least five distinct subtypes of bradyzoites. Although all are classified as bradyzoites, they are functionally different, with specific subsets primed for reactivation and disease.”

Wilson acknowledged that studying cysts has long been a technical challenge. They grow slowly, are embedded deep within tissues like the brain, and do not form efficiently in standard laboratory cultures. As a result, most genetic and molecular studies of Toxoplasma have focused on tachyzoites grown in vitro, leaving the biology of cyst-resident bradyzoites poorly understood. 

“Our work overcomes those limitations by using a mouse model that closely mirrors natural infection,” Wilson said. “Because mice are a natural intermediate host for Toxoplasma, their brains can harbour thousands of cysts. By isolating these cysts, digesting them enzymatically, and analysing individual parasites, we were able to gain a view of chronic infection as it occurs in living tissue.”

Wilson explained that current treatments for toxoplasmosis can control the fast-growing form of the parasite that causes acute illness, but no existing drugs can eliminate the cysts. 

“By identifying different parasite subtypes inside cysts, our study pinpoints which ones are most likely to reactivate and cause damage,” she said. “This helps explain why past drug development efforts have struggled and suggests new, more precise targets for future therapies.”

Congenital toxoplasmosis remains a major concern when primary infection occurs during pregnancy, potentially leading to severe foetal outcomes. Although prior immunity typically protects the foetus, routine screening is lacking in some countries, reflecting how difficult it is to manage an infection that is common but usually symptom-free.

Despite its prevalence, toxoplasmosis has received relatively little attention compared to other infectious diseases. Wilson hopes her team’s work will help shift that perspective.

“Our work changes how we think about the Toxoplasma cyst,” she said. “It reframes the cyst as the central control point of the parasite’s life cycle. It shows us where to aim new treatments. If we want to really treat toxoplasmosis, the cyst is the place to focus.”

Wilson was joined in the study by Arzu Ulu, Sandeep Srivastava, Nala Kachour, Brandon H. Le, and Michael W. White. Wilson and White are co-corresponding authors of the paper.

The study was supported by grants from the National Institute of Allergy and Infectious Diseases of the National Institutes of Health. 

The title of the paper is “Bradyzoite subtypes rule the crossroads of Toxoplasma development.”

Leukotrienes May Not Drive Asthma After All, New Research Shows

Respiratory tract. Credit: Scientific Animations CC4.0

Case Western Reserve University researchers say discovery of new inflammatory molecules could transform treatment

For decades, scientists have thought they understood the biochemical machinery that causes asthma: inflammation in the lungs that constricts airways and makes it hard to breathe. Leukotrienes – molecules that get released from white blood cells due to airway irritation or allergen inhalation – were labelled the culprits. Medications have been developed to block the molecular cascade they initiate that leads to difficulty breathing.

But researchers from Case Western Reserve University think these molecules may not be the bad actors after all.

“We’ve found molecules that are alike in structure but generated through a completely different chemical pathway in the body,” said lead researcher Robert Salomon, the Charles Frederic Mabery Professor of Research in Chemistry. “We think the molecules we’re calling ‘pseudo leukotrienes,’ may be the dominant players in the inflammatory cascade that causes disease.”

The research opens new avenues for treating asthma as well as other inflammatory diseases, possibly including neurological diseases like Parkinson’s and Alzheimer’s diseases. The research, funded by the U.S. National Institutes of Health, is available online as a pre-proof ahead of publication in the Journal of Allergy and Clinical Immunology.

The ‘flames’ of oxidation

The presumed culprits in inflammatory diseases – the leukotrienes – are formed under the control of enzymes that transform lipids. By contrast, the pseudo leukotrienes Salomon and his team discovered, are formed by adding oxygen to lipids by molecules called “free radicals.”  

“The free radical process is almost like an explosion or a fire,” said Salomon, who is also professor of ophthalmology in the Case Western Reserve School of Medicine. “It’s just like when oxygen reacts with fuel and you get flames. It can easily get out of control.”

People who suffer from asthma may lack enzymes and antioxidant molecules that normally keep a damper on free radicals by scavenging for and destroying them.

The leukotrienes and their mimics initiate inflammation by fitting into a receptor, like a key in an ignition, starting a molecular cascade that constricts the airways of asthmatics. Effective asthma drugs like Singulair block the ignition so the key won’t fit.

“The real importance of this discovery is the possibility of treating these diseases with drugs that prevent the free radical process or moderate it rather than drugs that block the receptor,” Salomon said.

Inflammation: a curse or a benefit?

Not all inflammation is harmful. The body needs inflammation to direct white blood cells to the site of a wound to heal, and it is also involved in memory and development.

Asthma drugs are being repurposed off-label to treat neurological diseases. But these treatments could also block the beneficial effects of the leukotrienes.

“If the molecules that are causing the problem are not the leukotrienes but these other molecules,” Salomon said, “a better treatment would be to just stop the formation of these other molecules rather than gumming up the ignition.”

The study

Salomon and his colleagues used their decades of experience studying the oxidation of lipids – and some chemical intuition – to guess that pseudo leukotrienes existed. They made the molecules in the laboratory to develop methods to detect them.

They obtained urine samples from patients designated with mild or severe asthma and compared them to urine from people who don’t suffer from the disease.

Not only were pseudo leukotrienes found in the asthma patients’ urine, but also the amounts correlated directly to the severity of the disease. Severe asthma sufferers or even those suffering mild asthma had four to five times more than the controls. The researchers suggest this could be a new biomarker to test for the severity of disease and monitor the effectiveness of therapies.

The researchers next plan to investigate whether these pseudo leukotrienes are involved in other respiratory diseases, like respiratory syncytial virus (commonly known as RSV) and bronchiolitis in babies, and chronic obstructive pulmonary disease.

By Diana Steele

Source: Case Western Reserve University

Pain in Teens Linked to Increased Risk of Self-harm

Photo by Inzmam Khan

Adolescents who report pain at the age of 18 are at higher risk of later self-harm. This is shown by a new study from Karolinska Institutet, published in Psychiatry Research. The findings suggest that pain may form part of the chain of events leading to self-harming behaviour.

A new study from Karolinska Institutet has examined the association between pain symptoms and self-harm during childhood and adolescence. The researchers followed 16 948 twin pairs born in Sweden between 1992 and 2010. Participants reported pain at the ages of 9 and 18 and were subsequently followed through national registers until a maximum age of 24.

The aim was to investigate how genetic and environmental factors influence both pain and self-harm, as well as how the associations between pain and self-harming behaviour develop over time. Using so-called twin models, the researchers were able to estimate how much of the variation could be explained by heredity, shared environment or individual experiences.

“We see that both genetic factors and individual environmental factors play a role in both pain and self-harm in childhood as well as adolescence,” says Jenny Rickardsson, researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

The results also show that pain before and up to the age of 18 was associated with a higher likelihood of later self-harm. Adolescents with pain symptoms had approximately a 60 per cent higher risk of self-harm compared with peers without pain. The association could not be explained by factors such as family environment or genetic similarity between twins.

“Our analyses suggest that pain may partly lie within the causal pathway leading to self-harming behaviour, and that the association is not solely due to familial factors,” says Jenny Rickardsson.

The study further shows that the shared family environment had little impact on either pain or self-harm, while genetic factors and individual experiences accounted for a larger proportion of the variation.

The study is based on data from the Swedish Twin Registry and was funded by Fonden för Psykisk Hälsa and Hjärnfonden. The researchers report no conflicts of interest that may have influenced the results.

Source: Karolinska Institutet

Researchers Uncover the Mechanism Behind Exercise-induced Bone Strengthening

Osteoporosis. Credit: Scientific Animations CC4.0

A research team from the Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine at the University of Hong Kong (HKUMed) has uncovered a key biological mechanism that explains how exercise maintain strong bones, paving the way for novel treatments for osteoporosis and bone loss in people who are unable to engage.

By identifying a protein that acts as the body’s ‘exercise sensor’, the research has opened the door to the development of drugs that mimic the effects of physical activity, offering hope for vulnerable groups, such as the elderly, bedridden patients and those with chronic illnesses who face a high risk of fractures. The research findings were published in the journal Signal Transduction and Targeted Therapy.

‘Osteoporosis and age-related bone loss affect millions worldwide, often leaving elderly and bedridden patients vulnerable to fractures and loss of independence,’ said Professor Xu Aimin, Director of the State Key Laboratory of Pharmaceutical Biotechnology and Chair Professor in the Department of Medicine, School of Clinical Medicine, HKUMed, who led the study. ‘Current treatments rely heavily on physical activity, which many patients simply cannot perform. We need to understand how our bones get stronger when we move or exercise before we can find a way to replicate the benefits of exercise at the molecular level. This study is a critical step towards that goal.’

Activating the bone’s ‘exercise sensor’ to reduce fat and build new bone

According to the World Health Organization, approximately 1 in 3 women and 1 in 5 men over the age of 50 suffer a fracture due to weak bones. In Hong Kong, the problem is significant as the population ages, with 45% of women and 13% of men aged 65 and above affected by osteoporosis. Osteoporosis-related fractures cause significant pain and disability, severely impacting quality of life and independence, while placing a heavy healthcare and economic burden on the society.

Ageing involves the natural weakening of bones, which become less dense and more porous. Mesenchymal stem cells in the bone marrow have the potential to develop into either fat cells or bone tissue. These stem cells are highly sensitive to external factors, like exercise and pressure. During the ageing process, they tend to differentiate into fat cells. As fat cells continue to accumulate in the bone marrow, it reduces the space available for healthy bone tissue, further compromising bone strength and creating a cycle of bone deterioration that is difficult to reverse with current treatments.

Using mouse models and human stem cells, the researchers identified a special ‘switch’, called Piezo1, which is a protein on the surface of mesenchymal stem cells in the bone marrow. This switch acts like an exercise sensor, detecting mechanical signals from physical activity that helps keep bones strong and preventing them from becoming frail as we age. In the mice model, when the Piezo1 protein was activated by physical activity, it reduced fat accumulation in the bone marrow and encouraged the formation of new bone. Conversely, when this protein is missing, it triggers signals that cause stem cells to accumulate fat, leading to increased bone loss. The absence of Piezo1 also promotes the release of certain pro-inflammatory signals (Ccl2 and lipocalin-2), making stem cells more likely to convert into fat cells, which hinders bone formation. Blocking these signals can help restore bone health.

Mimicking exercise for individuals with limited mobility

’We have essentially decoded how the body converts movement into stronger bones,’ said Professor Xu Aimin. ‘We have identified the molecular exercise sensor, Piezo1, and the signalling pathways it controls. This gives us a clear target for intervention. By activating the Piezo1 pathway, we can mimic the benefits of exercise, effectively tricking the body into thinking it is exercising, even in the absence of movement.’

Dr Wang Baile, Research Assistant Professor from the same department, who co-led the research, added, ‘This discovery is especially meaningful for older individuals and patients who cannot exercise due to frailty, injury or chronic illness. Our findings open the door to developing “exercise mimetics” — drugs that chemically activate the Piezo1 pathway to help maintain bone mass and support independence.’

‘This offers a promising strategy beyond traditional physical therapy,’ remarked Professor Eric Honoré, Team Leader at the Institute of Molecular and Cellular Pharmacology, French National Centre for Scientific Research, who co-led the research. ‘In the future, we could potentially provide the biological benefits of exercise through targeted treatments, thereby slowing bone loss in vulnerable groups such as the bedridden patients or those with limited mobility, and substantially reducing their risk of fractures.’

The research team is now working to translate these findings into clinical applications, with the goal of developing new treatments to preserve bone health and improve the quality of life for an ageing population and those confined to bed.

Source: Hong Kong University

More Preservatives in Diet Linked to Increased Cancer Risk

Findings may have important public health implications given the ubiquitous use of these additives, say researchers

Photo by Erik Mclean

Higher intake of food preservatives, widely used in industrially processed foods and beverages to extend shelf-life, is associated with a modestly increased risk of cancer, finds a study from France published by The BMJ.

While further research is needed to better understand these links, the researchers say these new data call for the re-evaluation of regulations governing the use of these additives by the food industry to improve consumer protection.

Preservatives are substances added to packaged foods to extend shelf life. Some experimental studies have shown that certain preservatives can damage cells and DNA, but firm evidence linking preservatives to cancer risk remains scarce.

To address this, researchers set out to examine the association between exposure to preservative food additives and risk of cancer in adults, using detailed dietary and health data from 2009 to 2023.

Their findings are based on 105,260 participants aged 15 years and older (average age 42 years; 79% women) enrolled in the NutriNet-Santé cohort study who were free of cancer and completed regular 24 hour brand-specific dietary records over an average 7.5 year period. Health questionnaires and official medical and death records were then used to track cancer cases up to 31 December 2023.

A total of 17 individual preservatives were analysed including citric acid, lecithins, total sulfites, ascorbic acid, sodium nitrite, potassium sorbate, sodium erythorbate, sodium ascorbate, potassium metabisulfite, and potassium nitrate.

Preservatives were grouped into non-antioxidants (which inhibit microbial growth or slow chemical changes that lead to spoilage) and antioxidants (which delay or prevent food deteriorating by removing or limiting oxygen levels in packaging).

During the follow-up period, 4,226 participants received a diagnosis of cancer, comprising 1,208 breast, 508 prostate, 352 colorectal, and 2,158 other cancers.

Of the 17 individually studied preservatives, 11 were not associated with cancer incidence, and no link was found between total preservatives and cancer incidence.

However, higher intakes of several preservatives (mostly non-antioxidants including potassium sorbate, potassium metabisulfite, sodium nitrite, potassium nitrate, and acetic acid) were associated with higher risk of cancers compared with non-consumers or lower consumers.

For example, total sorbates, specifically potassium sorbate, was associated with a 14% increased risk of overall cancer and a 26% increased risk of breast cancer, while total sulfites were associated with a 12% increased risk of overall cancer.

Sodium nitrite was associated with a 32% increased risk of prostate cancer, while potassium nitrate was associated with an increased risk of overall cancer (13%) and breast cancer (22%).

Total acetates were associated with an increased risk of overall cancer (15%) and breast cancer (25%), while acetic acid was associated with a 12% increased risk of overall cancer.

Among antioxidant preservatives, only total erythorbates and specific sodium erythorbate were found to be associated with higher incidence of cancer.

While more studies are needed to better understand these potential risks, the researchers note that several of these compounds can alter immune and inflammatory pathways, possibly triggering the development of cancer.

This is an observational study, so no firm conclusions can be drawn about cause and effect, and the researchers can’t rule out the possibility that other unmeasured factors may have influenced their results.

However, they say this was a large study based on detailed dietary records linked to food databases over 14 years and results are consistent with existing experimental data suggesting adverse cancer related effects of several of these compounds.

As such, they conclude: “This study brings new insights for the future re-evaluation of the safety of these food additives by health agencies, considering the balance between benefit and risk for food preservation and cancer.”

In the meantime, they call on manufacturers to limit the use of unnecessary preservatives, and support recommendations for consumers to favour freshly made, minimally processed foods.

From a policy perspective, preservatives offer clear benefits by extending shelf life and lowering food costs, which can be particularly important for populations with lower incomes, point out US researchers in a linked editorial.

However, they say the widespread and often insufficiently monitored use of these additives, with uncertainties of their long term health effects, call for a more balanced approach.

Findings from NutriNet-Santé may prompt regulatory agencies to revisit existing policies, such as setting stricter limits on use, requiring clearer labeling, and mandating disclosure of additive contents, while collaborative global monitoring initiatives, similar to those implemented for trans fatty acids and sodium, could also support evidence based risk assessments and guide reformulation by the food industry, they write.

“At the individual level, public health guidance is already more definitive about the reduction of processed meat and alcohol intake, offering actionable steps even as evidence on the carcinogenic effects of preservatives is evolving,” they conclude.

Source: BMJ Group