Category: 8. Health

  • CRISPR-edited cells pump out insulin in a person – and evade immune detection

    CRISPR-edited cells pump out insulin in a person – and evade immune detection

    Pancreatic islets (artificially coloured) no longer secrete sufficient insulin in people with type 1 diabetes. Credit: Steve Gschmeissner/Science Photo Library

    In a medical first, researchers report that they have implanted CRISPR-edited pancreas cells into a person with type 1 diabetes. The cells pumped out sugar-regulating insulin for months — without the need for the recipient to take immune-dampening drugs, thanks to gene edits that allowed the cells, collected from a deceased donor, to evade detection by the recipient’s immune system1.

    The study, orchestrated by the firm Sana Biotechnology in Seattle, Washington, raises hopes of an enduring cure for an autoimmune disease that consigns millions of people to a life of strict monitoring and dependence on injected insulin. “The preliminary data has definitely lifted the spirits of our community — and it’s a really elegant approach”, says Aaron Kowalski, the chief executive of Breakthrough T1D, a non-profit organization in New York City formerly known as JDRF.

    Stealthy stem cells to treat disease

    The ultimate goal is to apply immune-cloaking gene edits to stem cells and then direct their development into insulin-secreting islet cells. Unedited islets made from stem cells have already shown promise for treating type 1 diabetes in a small trial, according to results published in June2.

    But some independent research groups have failed to confirm that the Sana method confers immune-skirting abilities on edited cells. And the study involved only one person who received a low dose of cells for a short time — not enough “to achieve insulin independence, so clinical efficacy remains unproven”, says Tim Kieffer, a molecular endocrinologist at the University of British Columbia in Vancouver, Canada.

    Still, Kieffer calls the demonstration of immune cloaking “convincing” and “a major milestone toward the goal of effective cell therapy without chronic immunosuppression”. Kieffer previously held the role of chief scientific officer at biotechnology company ViaCyte (that has since been acquired by Vertex Pharmaceuticals in Boston, Massachusetts), which, like Sana, focused on developing cell therapies for type 1 diabetes.

    Stem-cell solutions

    Currently, the only way for someone with type type 1 diabetes to avoid dependence on injected insulin is through the transplantation of cadaveric islet cells. The procedure can restore insulin production for years, but it is rarely performed — constrained by the scarcity of donor pancreases and the need for lifelong immune-suppressing drug therapy, which carries risks of infection, cancer and other serious side effects.

    ‘Smart’ insulin prevents diabetic highs — and deadly lows

    To address the donor shortage, some companies have turned to stem-cell technologies to generate limitless supplies of replacement islets in the laboratory.

    Vertex is furthest along. As reported in June, the company transplanted embryonic stem-cell-derived islets into 12 people with type 1 diabetes. After one year, ten participants no longer required insulin injections2. The company plans to seek regulatory approval for this cell therapy next year.

    In a similar vein, scientists at regenerative-medicine company Reprogenix Bioscience in Hangzhou, China, are creating islets from reprogrammed stem cells derived from a recipient’s own fat tissue, with early reports of success3. Both approaches, however, still require recipients to take anti-rejection drugs, either to fend off immune attacks on donor cells or to counter the autoimmune assault that persists even against a person’s own cells.

    Stealth mode

    Sana’s strategy aims to bypass the need for those drugs entirely. Company scientists began with islets from a deceased donor who did not have diabetes. Using CRISPR gene editing system, the researchers disabled two genes that normally help to flag foreign invaders to T cells, the immune system’s front-line defender. They then used a virus to shuttle genetic instructions for a protein called CD47 into the cells. This protein serves as a protective ‘do not eat me’ signal that prevents immune watchdogs, known as natural killer cells, from attacking the edited cells.

    Brain cells given an ‘invisibility cloak’ fix Parkinson’s symptoms in rats

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  • ALS Biomarker Identified in Single Strand of Hair – Inside Precision Medicine

    1. ALS Biomarker Identified in Single Strand of Hair  Inside Precision Medicine
    2. Single Hair Strand Could Provide Biomarker for ALS, Mount Sinai Study Finds  Mount Sinai
    3. Is ALS Written In Your Hair? Researchers Say The Evidence Is Growing  Study Finds
    4. ALS: Scientists Identify Disease From Single Hair Strand  Newsweek
    5. Single hair strand reveals elemental patterns linked to ALS  News-Medical

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  • A Scoping Review of Nutritional Intake and Physical Activity in Adoles

    A Scoping Review of Nutritional Intake and Physical Activity in Adoles

    Arina Nursafrina Rahmatina,1,* Mohammad Ghozali,2,* Qorinah Estiningtyas Sakilah Adnani,3 Dany Hilmanto,4 Yenni Zuhairini,3 Hadi Susiarno,5 Ramdan Panigoro2

    1Master of Midwifery Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, West Java, Indonesia; 3Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Department of Pediatrics, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 5Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

    Correspondence: Mohammad Ghozali, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang Km. 21, Jatinangor, West Java, 45363, Indonesia, Tel +6281320359090, Fax +62227795595, Email [email protected]

    Abstract: Anemia is a significant health concern in adolescents, linked to diminished physical stamina and productivity. Menstruation is a prevalent cause of iron deficiency anemia. If this persists until pregnancy, it may elevate the risk of having infants with low birth weight. Consequently, efficacious preventive interventions are necessary. This literature review investigates the correlation between dietary intake and physical activity with anemia in adolescent girls. The evaluation was per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. A thorough search was conducted across various databases, including PubMed (n = 59), Scopus (n = 103), and ScienceDirect (n = 5546), along with manual citation tracking (n = 6) and previously published reviews (n = 2), yielding a total of 5708 articles. Following the screening process, 157 articles were eliminated for irrelevance, four articles were deemed inaccessible, and 14 articles were added based on the eligibility assessment. The results emphasize that macronutrient and micronutrient consumption are essential for erythropoiesis and the prevention of anemia. Dietary diversity and sufficient energy intake were substantially correlated with enhanced anemia status. Furthermore, moderate to strenuous physical activity correlated favorably with hemoglobin and ferritin concentrations. Excessive body fat may impede iron absorption. Overall, sufficient dietary consumption and consistent physical exercise seem complementary to preventing anemia. This is important as an effort to prevent disease throughout the life span because anemia that persists into adulthood hurts pregnancy, childbirth, and the health outcomes of the newborn. However, we have not identified a certain frequency and duration of activity that affects anemia. Consequently, additional investigation is required regarding this matter.

    Keywords: nutritional intake, physical activity, iron deficiency, female adolescents, anemia

    Introduction

    Anemia constitutes a significant global health issue. Globally, there are 1.9 billion instances of anemia, with 30% occurring in women aged 15 to 49.1–3 Menstruation in women is a prevalent cause of iron deficiency anemia.4 Mitigating anemia is a global health goal; nevertheless, not all nations have succeeded in attaining a 50% reduction in its prevalence.5 Anemia can result in a decrease in body resistance and cognitive agility, which can lead to a decrease in the productivity of adolescents.6 Anemia adversely affects physical development and jeopardizes the life cycle of women.7,8 Chronic anemia in pregnancy correlates with elevated risks during childbirth and a greater probability of a low-birth-weight infant.6,9

    A contributing factor to anemia is insufficient dietary intake.3,10 The predominant causes of nutritional deficiency anemia encompass deficiencies in iron, vitamin A, vitamin B9 (folate), and vitamin B12 (cobalamin).3 Impairment of DNA synthesis can result from deficiencies in folate and vitamin B12, which disrupts the erythropoiesis process and leads to the apoptosis of hematopoietic cells.11,12 Conversely, those with iron deficient anemia exhibited a reduction in hemoglobin and MCV levels.11 In 2021, iron deficiency anemia among women was a significant issue in Southeast Asian countries.2 Iron deficiency is the predominant etiology of anemia, accounting for about 60% of cases.13

    Individuals with insufficient dietary intake may suffer from malnutrition. Malnutrition arises from an imbalance in dietary consumption, nutritional status, body tissue mass, and levels of physical activity.14 The nutritional status of teenagers can be assessed by measures such as body mass index (BMI) and mid-upper arm circumference (MUAC). Adolescents with either underweight or overweight status exhibit an increased propensity for developing anemia in comparison to their counterparts with a normal BMI. Furthermore, reduced MUAC measures correlate with a heightened risk of anemia in teenagers.15 Globalization, urbanization, and swift economic development have led to significant alterations in Indonesia’s dietary habits and physical activity levels. Individuals are progressively consuming energy-dense foods while engaging infrequently in physical activity, hence elevating the incidence of overweight and obesity.16 Engaging in physical activity helps mitigate the risk of obesity.17 Mid-upper arm circumference (MUAC) is one of the measures utilized to assess malnutrition,18 which additionally indicates muscular and adipose reserves.19,20 Excess adipose tissue may hinder vitamin absorption and affect erythropoiesis, thereby diminishing red blood cell synthesis.21,22 Moreover, physical activity correlates with muscle mass, indicative of a metabolic state that facilitates erythrocyte production.19,21,22

    According to the World Health Organization, 75% of adolescents do not adhere to the minimum physical activity guidelines.23 Physical activity is recognized for its capacity to diminish the risk of obesity and enhance physical fitness and cognitive outcomes.24 Consistent physical activity in children and adolescents correlates with enhanced physical fitness, bolstered immunological function, improved cardiometabolic health, stronger bones, better cognitive results, enhanced mental health, effective weight management, and decreased body fat.25

    The World Health Organization (WHO) has implemented measures to mitigate anemia in teenagers by advocating for iron supplementation. This study examines the relationship between dietary intake, physical activity, and anemia in teenagers in light of this guideline. At present, there is a scarcity of research that investigates the combined impact of physical activity and nutritional intake on anemia in adolescent females.

    Methods

    This literature analysis utilizes the scoping review methodology, a technique that identifies and examines knowledge deficiencies and critical attributes or elements related to a concept. Furthermore, we employ this strategy to locate and delineate available evidence.26 We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) standards and utilized the PRISMA flowchart for search stages.27

    Research Question

    The objective of this review is to comprehend the significance of physical activity and nutritional intake in the context of anemia in adolescent females. Subsequently, the inquiry becomes, “Is there a correlation between anemia in adolescents, physical activity, and nutritional intake?”

    Eligibility Criteria

    This review centers on adolescents as the target demographic, examining dietary intake and physical activity as key exposures, with iron deficiency anemia as the significant outcome. The review is not limited by geographical constraints and encompasses papers published from 2011 to 2024. To be eligible for inclusion, articles had to satisfy the following criteria: (1) original research articles composed in English, (2) published in indexed journals, and (3) accessible in full text. Studies were omitted if they were duplicates, review articles, theses, dissertations, concentrated on pregnancy, or did not investigate the relationship between dietary intake, physical activity, and anemia.

    Search Strategy

    Upon formulating the study questions, we employed the PICO framework, utilizing customized MeSH terms to obtain search results congruent with the research aims. Following the conversion of MeSH terms into the Boolean format, keywords were produced in this sequence: “adolescent” AND “Nutrient Intake” OR “Dietary Intake” AND “Physical activity” OR “Exercise” AND “Anemia”. Articles were searched from November to December 2024.

    Selection Process

    We searched the PubMed, Scopus, and ScienceDirect databases. The PRISMA flowchart (Figure 1) was modified to detect publications. This flowchart comprises three phases: identification, screening, and inclusion. In the identification phase (Stage I), the quantity of articles obtained from the database search and the count left after the elimination of duplicates were ascertained. At this step, automation tools were employed to filter articles according to criteria like language (English), full-text availability, classification as research papers, year of publication, and open access status. The screening process (Stage II) entailed categorizing papers based on the study topic and eligibility criteria, utilizing keywords, titles, and abstracts. During the inclusion step (Stage III), all the texts of the retrieved articles were assessed. At this level, authors evaluated papers for review eligibility. The selected literature sources were required to fulfill specific requirements, including publication in indexed journals and possessing a designated journal number and volume. Only papers that fulfilled these criteria were included in the final round of the review process.

    Figure 1 PRISMA flowchart of the article’s selection process from 2011 to 2024.

    Results

    The results document data from studies investigating the correlation between nutritional consumption and physical activity with anemia. We identified articles according to their profiles, attributes, demographic data, and results from the statistical studies conducted inside the articles.

    The Study Profile Counts

    A total of 5708 publications were identified by an extensive search of various databases, including PubMed (n = 59), Scopus (n = 103), and ScienceDirect (n = 5546). Six supplementary papers were located through manual citation monitoring, and two articles were obtained from prior literature studies. After eliminating 95 duplicate entries, 5430 articles were discarded based on automated screening criteria, and one item was eliminated for failing to align with the designated keywords. Subsequent to the title and abstract screening, 157 publications were eliminated due to their lack of relevance to the research topic. Additionally, five items were inaccessible owing to access limitations. Of the 27 papers evaluated for eligibility, 13 were rejected for failing to meet the inclusion criteria. In conclusion, 14 papers from databases and additional sources were incorporated into the final review.

    The Study Demographic Profiles

    Most of the selected papers regarding demographic aspects originated from the Asia-Pacific region (Figure 2). This pertains to undernourishment in the Asia and Pacific subregion. The Food and Agriculture Organization (FAO) reports that despite a reduction in undernourishment by 12 million individuals in 2021, the total number of undernourished people remained 55 million higher than in 2019.28 Early malnutrition is recognized to impede skeletal development and menarche while extending the growth period in females.29 Malnutrition is frequently linked to anemia.30

    Figure 2 Characteristics of selected articles by continent (n = 14).

    Characteristics of the Studies

    We selected attributes based on author names, publication year, country of study, title, objectives, participant data, methodologies, and outcomes. The research characteristics incorporated in this scoping review are delineated in Table 1. The participant count ranged from 47 to 22,486. While the research recruited participants beyond adolescence, the literature specifically encompassed the cohort of adolescent girls. Most of the articles employed a cross-sectional design,10,31–40 an article employing a cohort design41 and two further articles employed retrospective studies.42,43 Four research employed bivariate analysis,32,35,36,38 Ten studies examined utilizing multivariate testing.10,31,33,34,37,39–43 The particular analysis differs based on the data type (Table 2).

    Table 1 The Characteristics of Selected Studies (n = 14)

    Table 2 The Analytical Methods of Selected Studies (n = 14)

    Synthesis of the Result

    Table 3 presents the study’s findings concerning the correlation between dietary intake, physical activity, and anemia. The analysis revealed that the results pertained to nutritional intake of macronutrients and micronutrients, dietary diversity, energy consumption, and frequency of food intake. The analysis pertains to physical activity through sports club membership, sports participation, standing board jumps, and several nutritional parameters, including participant socio-demographics and average monthly income. A statistical investigation of the correlation between these variables and anemia was conducted using bivariate and multivariate methods.

    Table 3 Summary of the Findings (n = 14)

    Figure 3 shows a network visualization of keywords based on the selected studies. A label and a circle indicate each item. The weight of the item determines the size of the label and circle—the higher the weight, the larger the label and circle. The color of each item indicates the cluster in which the item is located. The lines connecting the items indicate the relationship or association between the items.44 The blue signifies the correlation between iron deficiency anemia and teenage females; the green denotes food consumption in relation to anemia; whilst the red illustrates the association between physical activity and anemia. The map lacks terms about muscle mass and fat mass.

    Figure 3 Map of Keywords Based on Selected Studies. Blue indicates the link between iron deficiency anemia and adolescent girls; green shows dietary intake; red reflects physical activity in relation to anemia.

    Discussion

    Anemia is a nutritional issue that adversely affects the growth and development of adolescent females and is closely linked to their nutritional status.13 A multitude of studies have examined the relationship between adolescent food consumption, physical activity, and anemia; however, only fourteen papers fulfilled the review requirements. The analysis indicated insufficient information about the correlation between nutritional intake, physical activity, and anemia globally (Table 3).

    The examined studies assessed macronutrient intake, micronutrient intake, dietary diversity, energy intake, and frequency of food consumption. The physical exercise included sports club membership, various sports, and standing board jumps. We also incorporated additional characteristics about nutrition, including participant socio-demographics and average monthly income. Seven articles indicated a correlation between nutritional intake.10,31,32,40–43 Nonetheless, three investigations indicated that nutritional intake was not substantially associated with anemia.34,35,39 Three studies indicated a strong link in physical activity,36,38,41 two studies revealed no significant link.31,42 Two studies addressed both topics but yielded insignificant analytical results for the physical activity component.31,42

    Only one study examined the relationship between dietary consumption, physical activity, and anemia, yielding significant analytical data.41 The results of this review are, however, corroborated by a number of studies. According to a systematic review, motor competence is an indispensable component of a healthy lifestyle, and both a balanced diet and physical activity are beneficial for the health of adolescents.45 This aligns with a study conducted in Portugal, which discovered that physical activity positively corresponds with body–food choice congruence, indicating a propensity to select foods that enhance bodily health and function, such as those that supply energy and stamina.46 Moreover, elevated levels of physical activity correlate with more autonomous eating behaviors, resulting in healthier dietary selections.47

    The review indicated a correlation between the intake of both micronutrients and macronutrients and anemia.10,31,32,40,42 Two investigations showed a substantial correlation between the intake of vitamin B12 and folate and the incidence of anemia. Women with anemia had a markedly greater frequency of folate insufficiency than their non-anemic counterparts.32,42 Folate and vitamin B12 collaborate synergistically in creating red blood cells. A shortage in either folate or vitamin B12 impairs DNA synthesis and the erythropoiesis process.12 This aligns with research in India, indicating that anemia is prevalent among adolescent girls with vitamin B12 deficiency.48 A study in Palestine indicated that vitamin C is essential for the metabolism and absorption of iron.32 Iron is crucial for numerous cellular operations, encompassing enzyme activities, DNA synthesis, oxygen transport, and mitochondrial energy generation.4 Ascorbic acid, or vitamin C, facilitates the retention of iron in its reduced state, enhancing its bioavailability for absorption by the body.49 Ascorbic acid significantly improves the absorption of both ferric (Fe3+) and ferrous (Fe2+) iron ions. This results from the reducing characteristics of vitamin C, which maintains iron’s solubility across different pH levels, therefore enhancing its absorption via iron transporters in the small intestine.50

    Four studies demonstrated that the intake of protein- and fat-dense meals, such as meat, correlates with a diminished risk of anemia.10,31,32,40 A study in Vietnam indicated a notable rise in hemoglobin and iron levels among participants who received animal-based diets compared to the control group.51 This indicates that meat-based diets assist in averting the reduction of iron levels. One study indicated that a high overall body fat percentage correlates with anemia.36 Excess body fat may hinder vitamin absorption and the erythropoiesis process, thereby affecting red blood cell production,21,22 increased body fat triggers an inflammatory response that elevates hepcidin levels, thereby impairing iron absorption in the gastrointestinal tract.22 Conversely, protein is crucial for the synthesis of hemoglobin and myoglobin. When amino acids for protein synthesis are scarce, the body degrades muscle protein to fulfill amino acid needs. Extended protein shortage results in a reduction in skeletal muscle mass.52 No studies about muscle mass were identified in this review.

    A study conducted in India revealed that teenagers suffering from anemia exhibited a higher propensity for poor individual dietary diversity. Dietary diversity and trends are shaped by dietary variety as geographic, cultural, and economic limitations.43 A study in Tanzania indicated that adolescents with suboptimal diet quality exhibited elevated rates of overweight and anemia compared to their counterparts with superior diets. The study revealed that teenagers residing in urban regions exhibited a greater risk of overweight and anemia in comparison to those in rural settings.33 A study in Ethiopia revealed that adolescent females from households with low monthly income were ten times more likely to be anemic.37 This monthly income pertains to energy use. A study conducted in Japan revealed that reduced calorie consumption was inversely correlated with low ferritin levels.41

    Physical activity is essential for teenage nutrition.53 Physical activity is recognized to enhance calorie expenditure, aiding in the prevention of obesity,17 reduces body fat,25 and enhances red blood cell volume during youth.53 This study discovered that low to moderate-intensity physical activity correlates with a reduced risk of being overweight compared to a sedentary lifestyle.33 A study conducted in China indicates that moderate to high-intensity physical activity can diminish fat mass.54 Excess adipose tissue can impede vitamin absorption and erythropoiesis, affecting red blood cell synthesis.21 Physical exercise is correlated with muscle mass. Increased muscle mass signifies favorable metabolic health and facilitates the production of healthy erythrocytes.21 In individuals with low exercise intensity, there is a reduction in muscle mass and oxidative capability of the muscles.55 Muscle oxidative capability pertains to mitochondrial oxidative phosphorylation, a mechanism via which the body transforms nutrients into ATP utilizing oxygen.56 In mitochondria, proteins engage with enzymes that facilitate energy production and contribute to the regulation of energy metabolism and erythropoiesis.57

    A significant correlation between ferritin and hemoglobin levels and fitness has been seen in females.38 A study indicated a shorter exercise experience correlated with reduced ferritin levels.41 A study in Dubai revealed analogous findings, indicating that students with anemia engaged in less physical activity than their non-anemic counterparts. This study identified a correlation among anemia, insufficient physical activity, and total body fat percentage. This may be associated with a nutritionally deficient diet and a predilection for fast food.36 A study conducted in Palestine revealed no correlation between anemia and physical activity.31 This aligns with a study conducted in Japan, which indicated that the contributor to anemia in long-distance runners is the hepcidin response, which diminishes iron absorption in the gastrointestinal tract.42 This study demonstrated that excessive physical activity may elevate hepcidin levels.

    Based on the review, we suspect that adequate food consumption and consistent exercise complement each other in preventing anemia. It is known that adequate nutritional intake by doing exercise is a combination that increases oxidation and restores muscle mass.55,58,59 Physical activity is related to muscle mass, which indicates a metabolic condition that supports erythrocyte formation.21,53,55 We concluded that adequate nutrition and consistent physical activity are crucial in preventing anemia in young women, thereby contributing to optimal quality of life, particularly in preparing for future pregnancy and childbirth.

    However, considering the discrepancies in findings on the association between physical activity and anemia, we deduce that specific limitations about the frequency of physical exercise may influence anemia. Additional research is required on this subject. The interplay of adequate energy consumption and physical activity influences the body’s capacity to absorb, retain, and utilize iron effectively. This indicates that a comprehensive approach is essential in preventing anemia. Preventing anemia involves a multifaceted approach rather than concentrating on a singular issue.

    This study is advantageous due to the existing paucity of studies on dietary intake and physical activity concerning anemia in adolescent girls. This study possesses multiple drawbacks. We incorporated research including adolescent samples without accounting for their menstrual health and erythrocyte genetics.

    Conclusion

    Anemia in teenagers is affected by various factors, including nutritional consumption, physical activity, and socioeconomic conditions. Intake of both macronutrients and micronutrients, especially iron, vitamin B12, folate, and vitamin C, is essential for red blood cell production and preventing anemia. Diversity in dietary intake and energy adequacy substantially influence anemic status. Moderate to high-intensity physical activity is favorably correlated with hemoglobin and ferritin levels. Conversely, excessive adiposity and diminished muscular mass can adversely impact erythropoiesis and iron absorption mechanisms. This review indicates that nutritional intake and physical exercise are interconnected and positively affect anemia prevention. Nonetheless, additional research is required to ascertain the precise frequency and duration of physical exercise that affects anemia. Preventing anemia should not depend on isolated interventions. A holistic strategy is required, encompassing sufficient nutritional education, monitoring of nutritional status, provision of iron supplements, and programs promoting physical activity among adolescents. Moreover, governmental measures are essential to guarantee justice, sustainability, and the enduring effects of anemia prevention a single intervention.

    Acknowledgments

    The Academic Leadership Grant Universitas Padjadjaran funded the APC.

    Disclosure

    The authors declare that there are no conflicts of interest in the writing or publishing of this article.

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    31. Jalambo MO, Karim NA, Naser IA, Sharif R. Prevalence and risk factor analysis of iron deficiency and iron-deficiency anaemia among female adolescents in the Gaza Strip, Palestine. Public Health Nutr. 2018;21(15):2793–2802. doi:10.1017/S1368980018001568

    32. Qasrawi R, Badrasawi M, Al-Halawa DA, et al. Identification and prediction of association patterns between nutrient intake and anemia using machine learning techniques: results from a cross-sectional study with university female students from Palestine. Eur J Nutr. 2024;63(5):1635–1649. doi:10.1007/s00394-024-03360-8

    33. Mchau G, Killel E, Azizi K, et al. Co-occurrence of overweight, stunting, and anemia among adolescents (10–19 years) in Tanzania Mainland: a school-based cross-sectional study. Curr Dev Nutr. 2024;8(1):1–8. doi:10.1016/j.cdnut.2023.102016

    34. Sigit FS, Ilmi FB, Desfiandi P, et al. Factors influencing the prevalence of anaemia in female adolescents: a population-based study of rural setting in Karanganyar, Indonesia. Clin Epidemiol Glob Health. 2024;25:101500. doi:10.1016/j.cegh.2023.101500

    35. Oy S, Witjaksono F, Mustafa A, Setyobudi SI, Fahmida U. Problem nutrients in adolescent girls with anemia versus nonanemic adolescent girls and the optimized food-based recommendations to meet adequacy of these nutrients in adolescent school girls in East Java, Indonesia. Food Nutr Bull. 2019;40(3):295–307. doi:10.1177/0379572119851326

    36. Al Sabbah H. Prevalence of overweight/obesity, anaemia and their associations among female university students in Dubai, United Arab Emirates: a cross-sectional study. J Nutr Sci. 2020;9(e26):1–26. doi:10.1017/jns.2020.23

    37. Mengistu G, Azage M, Gutema H. Iron deficiency anemia among in-school adolescent girls in rural area of bahir dar city administration, North West Ethiopia. Anemia. 2019;2019:1–8. doi:10.1155/2019/1097547

    38. Monyeki MA, Veldsman T, Coetzee B, et al. Relationships between iron status and selected physical fitness components of South African adolescents: the PAHL-study. Children. 2024;11(659):1–12. doi:10.3390/children11060659

    39. Ayogu RNB, Nnam NM, Ibemesi O, Okechukwu F. Prevalence and factors associated with anthropometric failure, vitamin A and iron deficiency among adolescents in a Nigerian urban community. Afr Health Sci. 2016;16(2):389–398. doi:10.4314/ahs.v16i2.7

    40. Ford ND, Bichha RP, Parajuli KR, et al. Factors associated with anaemia among adolescent boys and girls 10–19 years old in Nepal. Matern Child Nutr. 2022;18(S1):1–14. doi:10.1111/mcn.13013

    41. Nabeyama T, Suzuki Y, Saito H, et al. Prevalence of iron-deficient but non-anemic university athletes in Japan: an observational cohort study. J Int Soc Sports Nutr. 2023;20(1):984–995. doi:10.1080/15502783.2023.2284948

    42. Yamamoto K, Takita M, Kami M, et al. Profiles of anemia in adolescent students with sports club membership in an outpatient clinic setting: a retrospective study. PeerJ. 2022;10:1–13. doi:10.7717/peerj.13004

    43. Ganpule-Rao AV, Bhat D, Yajnik CS, Rush E. Dietary diversity scores, nutrient intakes and biomarkers vitamin B 12, folate and Hb in rural youth from the Pune maternal nutrition study. Br J Nutr. 2021;126(2):236–243. doi:10.1017/S0007114520004018

    44. Jan van Eck N, Waltman L. VOSviewer Manual. 2023. Available from: https://www.vosviewer.com/documentation/Manual_VOSviewer_1.6.20.pdf. Accessed May 6, 2025.

    45. Koehler K, Drenowatz C. Integrated Role of Nutrition and Physical Activity for lifelong Health. Vol. 11. Nutrients. MDPI AG; 2019.

    46. Carraça EV, Rodrigues B, Teixeira DS. A motivational pathway linking physical activity to body-related eating cues. J Nutr Educ Behav. 2020;52(11):1001–1007. doi:10.1016/j.jneb.2020.08.003

    47. Fernandes V, Rodrigues F, Jacinto M, et al. How does the level of physical activity influence eating behavior? A self-determination theory approach. Life. 2023;13(2):298. doi:10.3390/life13020298

    48. Dhurde VS, Patel AB, Locks LM, Hibberd PL. Anemia prevalence, its determinants, and profile of micronutrient status among rural school adolescent girls aged 14-19 years: a cross-sectional study in Nagpur district, Maharashtra, India. Public Health Nutr. 2024;27(e248):1–10. doi:10.1017/S1368980024002234

    49. Bender D, Fontana L. Vitamin C. In: Caballero B, editor. Encyclopedia of Human Nutrition. 4th ed. Elsevier; 2023:504–514.

    50. Skolmowska D, Głąbska D. Effectiveness of dietary intervention with iron and vitamin c administered separately in improving iron status in young women. Int J Environ Res Public Health. 2022;11877(19):1–19.

    51. Hall AG, Ngu T, Nga HT, Quyen PN, Hong Anh PT, King JC. An animal-source food supplement increases micronutrient intakes and iron status among reproductive-age women in rural Vietnam. J Nutr. 2017;147(6):1200–1207. doi:10.3945/jn.116.241968

    52. Wu G. Dietary protein intake and human health. Food Funct. 2016;7(3):1251–1265. doi:10.1039/C5FO01530H

    53. Montero D, Lundby C. Red cell volume response to exercise training: association with aging. Scand J Med Sci Sports. 2017;27(7):674–683. doi:10.1111/sms.12798

    54. Meng C, Yucheng T, Shu L, Yu Z. Effects of school-based high-intensity interval training on body composition, cardiorespiratory fitness and cardiometabolic markers in adolescent boys with obesity: a randomized controlled trial. BMC Pediatr. 2022;22(1):1–12. doi:10.1186/s12887-021-03079-z

    55. Dideriksen K, Reitelseder S, Holm L. Influence of amino acids, dietary protein, and physical activity on muscle mass development in humans. Nutrients. 2013;5(3):852–876. doi:10.3390/nu5030852

    56. Yoshiko A, Shiozawa K, Niwa S, et al. Association of skeletal muscle oxidative capacity with muscle function, sarcopenia-related exercise performance, and intramuscular adipose tissue in older adults. Geroscience. 2024;46(2):2715–2727. doi:10.1007/s11357-023-01043-6

    57. Fujiwara T. Mitochondrial metabolism and erythroid differentiation. 2024: p. 183–187. Available from: https://pubmed.ncbi.nlm.nih.gov/38569864/. Accessed February 19, 2025.

    58. Deutz NEP, Ashurst I, Ballesteros MD, et al. The underappreciated role of low muscle mass in the management of malnutrition. J Am Med Dir Assoc. 2019;20(1):22–27. doi:10.1016/j.jamda.2018.11.021

    59. Frontera WR, Jullien O. Skeletal muscle: a brief review of structure and function. Calcif Tissue Int. 2015;96(3):183–195. doi:10.1007/s00223-014-9915-y

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  • Cholera remains Africa’s leading public health concern: Africa CDC-Xinhua

    ADDIS ABABA, Sept. 5 (Xinhua) — The Africa Centers for Disease Control and Prevention (Africa CDC) has warned that cholera remains the leading public health concern in Africa in terms of the number of cases and fatalities.

    Some 23 cholera-affected African countries have reported a total of 239,754 cases and over 5,274 associated deaths since the beginning of this year, with a case fatality rate of 2.2 percent, Yap Boum II, deputy incident manager for mpox at the Africa CDC, told an online media briefing on Thursday evening.

    Data from the African Union’s specialized healthcare agency showed the death toll from Africa’s multi-country cholera outbreak so far in 2025 has surpassed last year’s total of 4,725.

    “This is much higher than what we had in 2024 in terms of the number of deaths. A total of 23 countries are currently affected, which highlights the need for a stronger multi-sectoral approach,” Boum II said.

    Meanwhile, the Africa CDC has raised the alarm regarding the increasing trend of public health emergencies occurring throughout Africa, as the continent reported more than 166 moderate-to-high risk public health emergencies so far in 2025.

    “The number of high-risk and moderate public health events keeps increasing. With the current trend, we expect to have much more than what we actually had in 2024. This is the result of quite a number of drivers, including climate change and the crisis that we see in Sudan, which affected the accelerated spread of cholera in Sudan, Chad, and South Sudan,” Boum II said.

    Cholera, an acute diarrhoeal infection caused by consuming contaminated food or water, results in acute watery diarrhoea and severe dehydration. The disease can be fatal within hours if untreated.

    Inadequate clean and safe water is identified as the primary driver of recurring cholera outbreaks in Africa, which is further exacerbated by peace and security challenges, as well as strained health systems as the continent grapples with a number of disease outbreaks and public health emergencies. ■

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  • Rapid epigenomic classification of acute leukemia

    Rapid epigenomic classification of acute leukemia

    Tuesday 07 October 2025
    08:00 [PDT] 11:00 [EDT] 16:00 [BST]
    Alternative time zones

    Unlock the potential for faster, more comprehensive leukemia characterization with this webinar from Dana-Farber Cancer Institute expert Salvatore Benfatto.

    Acute leukemia (AL) is an aggressive form of blood cancer that requires precise molecular classification and urgent treatment. However, standard-of-care diagnostic tests are time- and resource-intensive and do not capture the full spectrum of AL heterogeneity, making diagnosis and basic research investigations into AL a challenge. Researchers at Dana-Farber Cancer Institute (MA, USA) have developed MARLIN (methylation and AI-guided rapid leukemia subtype inference), a machine learning tool currently for research use only that enables the rapid classification of acute leukemia using real-time DNA methylation data generated by Oxford Nanopore sequencing. In both retrospective and prospective studies, Oxford Nanopore sequencing enabled MARLIN to deliver accurate molecular subtyping within two hours. This approach highlights the potential of nanopore technology to support faster, more comprehensive leukemia characterization.

    REGISTER NOWWhat will you learn?Who may this interest?Speaker

    What will you learn?

    • How the leukemia classification approach developed by Dana Farber offers a framework that can be easily implemented anywhere in the world.
    • How research with Oxford Nanopore sequencing is unlocking the potential to shorten the diagnosis and classification of acute leukemia to within hours.
    • Why rapid and accurate treatment for acute leukemias is crucial to survival rates.

    Who this may interest?

    • Cancer researchers: basic and translational
    • Core lab directors, managers and technicians
    • Clinical lab directors, managers and technicians

    Speaker

    Salvatore Benfatto

    Postdoctoral researcher

    Dana-Farber Cancer Institute (MA, USA)

    Salvatore Benfatto is a postdoctoral researcher at the Dana-Farber Cancer Institute. As a computational biologist, he works at the intersection of artificial intelligence and cancer research. In a multidisciplinary team, he develops machine learning models to foster the next generation of rapid DNA methylation- and AI-powered cancer diagnostics.

    In association with

     

    Submit Your Research to the F1000Research Genomics & Genetics Gateway

    Advance the fields of genomics and genetics by publishing your research with the F1000Research Genomics & Genetics Gateway. With trusted publishing, open access, and transparent peer review, your work will uphold the highest standards of rigor and integrity while driving innovation in PCR, sequencing, and genetic analysis.

    Join a platform that values transparency, openness, and author control. Submit your research today at F1000Research Genomics & Genetics Gateway.

     

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  • can they end the outbreaks?

    can they end the outbreaks?

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    Once thought to be under control, yellow fever is making an alarming comeback, and the numbers are climbing. With treatment gaps that prevent yellow fever from being eradicated, new approaches are being sought after to curb infection rates, a major one being germ-free egg-based vaccines.  

    Yellow fever cases on the rise: how can vaccines control spread? 

    Around 212 cases of yellow fever, including 85 deaths, were reported in the six months to April 2025, according to the World Health Organization (WHO). These cases were reported in Bolivia, Brazil, Colombia, Ecuador, and Peru. Yellow fever cases are endemic in the tropical regions of Central and South America and Africa. In fact, in Columbia, a nationwide emergency was declared when at least 34 people died of yellow fever in April. 

    The WHO blames increased sylvatic transmission cycles for the recent spike in cases. A sylvatic transmission cycle refers to the natural process of a pathogen in which it spreads in animals, even via carrier animals, like mosquitoes in the case of yellow fever. So, the higher the number of these cycles where yellow fever-causing viruses called flaviviruses circulate, the higher the rate of infections in humans when they are bitten by mosquitoes carrying the virus. 

    Catherine Caulfield, chief executive officer (CEO) and co-founder of Irish vaccine maker Ovagen, explained that yellow fever is an acute viral hemorrhagic disease, meaning that infection is accompanied by intense bleeding, which can be fatal. Some patients experience high fever, and organs like the liver and kidneys are affected in the more toxic phase, even after patients have recovered from the initial symptoms. Many of these people are also likely to develop jaundice – caused by the excess of a pigment called bilirubin in the blood – resulting in the yellowing of the skin and eyes, hence the name yellow fever. 

    Sanofi’s YF-VAX vaccine is probably the best-known yellow fever vaccine in the market at present. It has been prepared by culturing a specific strain of the yellow fever virus that is found in chicken embryos. When the weakened strain is injected through the skin, it elicits an immune response, and antibodies against yellow fever prevent infection. A single dose of the yellow fever vaccine provides long-lasting protection; however, it is an expensive vaccine, priced between $220 and $250 for people traveling to or living in endemic areas, according to a report by Better Care. 

    As cases escalate, there is a need for cheaper alternatives. Caulfield’s company Ovagen wants to “transform vaccine production” by implementing germ-free technology in yellow fever vaccine development. 

    “The technology offers immediate scalability and significant margins for manufacturers, all while reducing waste and environmental impact. For public health systems and vaccine developers alike, it enables faster response times, lower costs, and substantially increased yellow fever viral yield per egg, which means increased vaccine doses per egg, therefore improving access for poorer nations and increased resilience in the face of a public health crisis,” Caulfield told Labiotech. 

    Yellow fever vaccines: how can germ-free eggs bring costs down? 

    A germ-free egg is completely free of bacteria. Germ-free chickens breed naturally, and scientists make sure that they are kept in conditions that don’t have bacteria and other pathogens lurking around. Some of these measures include filtering the air where the chickens live, sterilizing bedding, food, and water, employing an automated system for egg collection and packing, routine monitoring, and maintaining maximum biosecurity. 

    There are several merits to eliminating bacterial contamination. As antibiotics are typically required in traditional egg-based manufacturing, this can lead to antimicrobial resistance, which occurs when parasites change over time and no longer respond to medicines. Antimicrobial resistance is no longer a worry with germ-free eggs as the use of antibiotics dwindles. Caulfield believes this is a “holy grail for vaccine manufacture.”  

    “Our germ-free egg platform eliminates bacterial contamination and reduces the need for antibiotics in vaccine production while delivering significantly higher viral yield. This is high-impact science with high-value commercial outcomes.”

    Catherine Caulfield, CEO of Ovagen

    This also substantially increases vaccine yield per egg, and improves quality, security, and sustainability, according to Caulfield. 

    Moreover, this process cuts the carbon footprint as fewer eggs are required to produce the same number of vaccines, and there is a drop in waste and costs that are linked to contaminated batches being thrown out. This in turn allows for more efficient and cost-effective production of vaccines, therefore improving access for poorer nations, Caulfield pointed out. 

    “This yield advantage significantly lowers the cost per dose and drastically improves production efficiency, with major cost-saving implications, combining scalability with the elimination of the use of antibiotics in vaccine manufacture,” said Caulfield. 

    The platform, which is ready for the market now, has been validated with a viral yield study proved the technology’s benefit. Ovagen’s germ-free eggs produced up to 1,350 times more yellow fever virus strain 17D – the same strain in YF-VAX – compared to the conventional specific pathogen free (SPF) eggs. The latter has been regarded as the industry’s current gold standard for a long time. This study was conducted independently by the Pirbright Institute, a research center in the U.K. 

    While each SPF egg can generate 300 to 400 vaccine doses, a germ-free egg could create up to 7,600 doses of vaccine. Simply put, germ-free eggs are far more cost-effective than traditional manufacturing techniques. 

    “That is the kind of game-changing innovation and disruption that changes the economics of global vaccine production,” said Caulfield.  

    The germ-free egg platform could greatly cut the reliance on SPF eggs to meet manufacturing needs. Currently, there is a global shortfall of 60 million doses, and to hit the mark, traditional approaches would require more than 140,000 eggs. Ovagen’s germ-free method would take less than 8,000 eggs to get there, greatly reducing costs, time, eggs, and antibiotics. 

    “What we have developed isn’t incremental; it’s a complete rethink of the vaccine manufacturing process. Our germ-free egg platform eliminates bacterial contamination and reduces the need for antibiotics in vaccine production while delivering significantly higher viral yield. This is high-impact science with high-value commercial outcomes,” she said. 

    Island Pharmaceuticals’ Galidesivir targets viruses 

    Meanwhile, Australian company Island Pharmaceuticals is moving fast with its antiviral drug called Galidesivir to address viral infections, including yellow fever. Galidesivir is an analogue – a substance that has a similar structure to another – of the compound adenosine, a building block of genetic material like RNA. The antiviral works by binding to the region in the virus’ RNA where adenosine would typically bind, causing a structural change to the virus. This disrupts enzyme activity in the virus, thereby blocking its pathogenic effects. 

    The antiviral, which was bought from American pharmaceutical BioCryst Pharmaceuticals in July, is in the running for approval to treat Marburg virus, another hemorrhagic fever virus. Island will soon be in talks with the FDA to get the green light. This could pave the way for approval in yellow fever, despite BioCryst’s pause on clinical trials for Galidesivir in 2021. 

    Yellow fever outbreaks amid budget cuts: time for efficient strategies 

    As infectious disease and vaccine research have faced setbacks in the U.S. owing to recent budget cuts, pandemic preparedness has taken a hit. Yellow fever deaths declined in the 2000s, and other infectious diseases like the deadly meningitis A were wiped out thanks to vaccines and emergency stockpiles. Indeed, yellow fever saw the biggest gains in routine vaccine programs, as they slashed death rates by 99 per cent, according to a 2025 United Nations report. 

    But this progress is now at risk, warned the United Nations. 

    “Funding cuts to global health have put these hard-won gains in jeopardy,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, in a report. 

    With yellow fever making a comeback as outbreaks plague regions in South America and Africa in 2025, there is a demand for efficient ways to halt the spread. And Ovagen’s germ-free vaccines might just be the solution we have been looking for. 

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  • WHO updates list of essential medicines to include key cancer, diabetes treatments

    WHO updates list of essential medicines to include key cancer, diabetes treatments

    Today, the World Health Organization (WHO) has released updated editions of its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), adding new treatments for various types of cancer and for diabetes with associated comorbidities such as obesity. Medicines for cystic fibrosis, psoriasis, haemophilia and blood-related disorders are among the other additions.

    WHO EML and EMLc include medicines for priority health needs of populations. They are adopted in over 150 countries, serving as a basis for public sector procurement, supply of medicines and health insurance, reimbursement schemes. The revisions mark the 24th edition of WHO EML and 10th edition of EMLc.

    “The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact,” said Dr Yukiko Nakatani, Assistant Director-General for Health Systems, Access and Data.

    Launched in 1977 largely to promote better access to medicines in developing countries, the WHO Model Lists have become a trusted global policy tool for decisions related to the selection and universal coverage of medicines within all health systems.

    The WHO Expert Committee on the Selection and Use of Essential Medicines reviewed 59 applications, including 31 proposals for the addition of new medicines or medicine classes. As a result, 20 new medicines were added to the EML and 15 to the EMLc, along with new use indications for seven already-listed products. The updated lists now include a total of 523 essential medicines for adults and 374 for children, reflecting the most pressing public health needs.

    Cancer medicines

    Cancer is the second leading cause of death globally, claiming nearly 10 million lives each year and responsible for almost one in three premature deaths from noncommunicable diseases. Cancer treatments have been a major focus of the WHO EML for the past decade. With cancer medicines accounting today for about half of all new drug approvals by regulatory agencies, the Expert Committee applies rigorous criteria to recommend only those therapies that offer the greatest clinical benefit. As a result, few approved cancer medicines are included – only those proven to prolong life by at least 4-6 months.

    Seven applications encompassing 25 cancer medicines were evaluated. As part of broader efforts to reduce inequities in cancer care, the Committee recommended increasing access to PD-1/PD-L1 immune checkpoint inhibitors, a class of immunotherapy medicines that help the body’s immune system recognize and attack cancer cells more effectively. Pembrolizumab was added to the EML as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer. For the latter, atezolizumab and cemiplimab are included as therapeutic alternatives.

    The Committee also considered several expert-recommended strategies – highlighted in the cancer experts report – aimed at improving access to and affordability of cancer treatments. It endorsed evidence-based clinical and health system strategies, including dose optimisation approaches, to improve access. The Committee emphasized that while health system reforms require time and government action, clinical strategies can be implemented immediately to deliver faster benefits, especially in resource-limited settings.

    Medicines for diabetes and obesity

    Diabetes and obesity are two of the most urgent health challenges facing the world today. Over 800 million people were living with diabetes in 2022, with half going untreated. At the same time, more than 1 billion people worldwide are affected by obesity, and rates are rising especially fast in low- and middle-income countries. These two conditions are closely linked and can lead to serious health problems, including heart disease and kidney failure.

    The WHO Expert Committee reviewed strong scientific evidence showing that a group of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists can help people with type 2 diabetes – especially those who also have heart or kidney disease – by improving blood sugar control, reducing the risk of heart and kidney complications, supporting weight loss, and even lowering the risk of early death.

    GLP-1 receptor agonists – semaglutide, dulaglutide and liraglutide – and the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist (tirzepatide) have been added to the EML. They are used as glucose lowering therapy for adults with type 2 diabetes mellitus with established cardiovascular disease or chronic kidney disease and obesity (defined as body mass index (BMI) ≥ 30kg/m2). This provides clear guidance to countries on which patients can benefit most from these therapies.

    High prices of medicines like semaglutide and tirzepatide are limiting access to these medicines. Prioritizing those who would benefit most, encouraging generic competition to drive down prices and making these treatments available in primary care – especially in underserved areas – are key to expanding access and improving health outcomes. WHO will continue monitoring developments, support fair pricing strategies, and help countries improve access to these life-changing treatments.

    “A large share of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that, in principle, should be financially accessible to everyone,” said Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products. “Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centred programmes that leave no one behind.”

    More details of the Expert Committee’s recommendations, describing the additions, changes and removal of medicines and formulations, and decisions not to recommend medicines are available in the Executive Summary here.

    Note to editors

    The meeting of the 25th WHO Expert Committee on the Selection and Use of Essential Medicines was held at WHO Headquarters in Geneva, Switzerland, from 5 to 9 May 2025. The Expert Committee considered a total of 59 applications, assessing the scientific evidence on each medicine’s effectiveness, safety, comparative cost, and overall cost-effectiveness to inform its recommendations. The Committee also considered proposals relating to the definitions and update of the AWaRe (Access, Watch, Reserve) classification of antibiotics.

    The Model Lists are updated every two years by an Expert Committee, made up of recognized specialists from academia, research and the medical and pharmaceutical professions, to address new health challenges, prioritize highly effective therapeutics and improve affordable access.

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  • Narrow Band Ultraviolet B Phototherapy Effective as Alternative to Cyclosporine for CSU

    Narrow Band Ultraviolet B Phototherapy Effective as Alternative to Cyclosporine for CSU

    Muthu Sendhil Kumaran, MD

    Credit: ResearchGate

    Narrow Band Ultraviolet B (NB-UVB) phototherapy is an effective and well-tolerated alternative to cyclosporine for antihistamine-refractory chronic spontaneous urticaria (CSU), according to new findings.1

    Such conclusions on NB-UVB phototherapy were the result of a recent study conducting with the aim of comparing the NB-UVB phototherapy’s safety and efficacy compared to cyclosporine in antihistamine-refractory CSU. The data were authored by such investigators as Muthu Sendhil Kumaran, MD, from the Department of Dermatology, Venereology, and Leprology at the Post Graduate Institute of Medical Education and Research in India.

    Kumaran and colleagues highlighted the efficacy of NB-UVB has been proven by itself or with antihistamines in individuals who have not responded to standard therapies. The treatment option has been shown to outperform other treatments such as PUVA, but there had been a lack of prior research comparing cyclosporine and NB-UVB directly.2

    “In this context, we conducted a randomized, prospective, non-inferiority study comparing NB-UVB phototherapy with low-dose oral cyclosporine in 50 patients of oral anti-histamine refractory CSU,” the investigators wrote.1 “By characterizing the treatment responses to each modality, we seek to provide insights into their relative efficacy and safety, guiding clinicians in optimizing patient care.”

    Study Design and Notable Findings

    The investigative team involved 50 individuals as trial subjects in their randomized, prospective non-inferiority study. The study specifically looked at patients with CSU who also did not respond to antihistamines. Screening of these individuals was conducted by Kumaran et al consecutively, and patients deemed eligible were recruited after the investigators received informed consent.

    Criteria for inclusion in this study required participants to specifically report having active CSU characterized by daily or near-daily wheals and pruritus, with or without angioedema, for more than 6 months. They were also required to have been refractory to up to a fourfold increase in second-generation antihistamines for 3 months at minimum. These subjects were then randomized to be given either narrowband UVB (NB-UVB) on a 3 times per week basis or cyclosporine 3 mg/kg/day for a total of 90 days, in combination with maximally regulated doses of antihistamines. This would be followed by a 90-day observation period.

    Among the 526 individuals Kumaran and coauthors screened, 152 were found to have met the investigators’ eligibility criteria. Among these, 71 were excluded and 31 declined enrollment, resulting in 50 patients being randomized into the treatment arms. The study’s primary endpoint was the 7-day Urticaria Activity Score (UAS7). Additional outcomes evaluated by the investigative team included the Chronic Urticaria Quality of Life (CU-QoL) questionnaire, the Urticaria Control Test (UCT), and biomarker evaluations (IL-6 and IL-31).

    Overall, the team found that both of these interventions produced a significant reduction in UAS7 scores by the 15-day mark. They identified an association between NB-UVB and durable symptom control following treatment cessation. This was compared to cyclosporine, which led to rapid improvements among participants but was followed by rebound exacerbations once it was discontinued.

    Kumaran and colleagues’ non-inferiority analysis confirmed that NB-UVB was not significantly less effective than treatment with cyclosporine in the reduction of UAS7. Both of these options lowered trial participants’ serum IgE levels, while IL-6 and IL-31 demonstrated significant reductions only in the cyclosporine arm of the study. In short, NB-UVB showed efficacy and tolerability as an alternative to cyclosporine for those living with antihistamine-refractory CSU. The treatment provided prolonged suppression of disease activity following treatment. Additional studies may be warranted to look at long-term outcomes and the data’s generalizability.

    “Cyclosporine exhibited a crisis-buster effect with swift disease control, while NB-UVB showcased sustained disease activity suppression even post-intervention,” they wrote.1 “The study underscores NB-UVB’s invaluable role as a viable alternative to cyclosporine, offering a well-tolerated, effective, and potentially long-term therapeutic option for the management of CSU.”

    References

    1. N Roshini, H Mehta, A Bishnoi, et al. Narrow Band Ultraviolet B Phototherapy Versus Oral Cyclosporine in the Treatment of Chronic Urticaria. Photodermatology, Photoimmunology & Photomedicine 41, no. 5 (2025): e70050, https://doi.org/10.1111/phpp.70050.
    2. Sheikh G, Latif I, Keen A, et al. Role of Adjuvant Narrow Band Ultraviolet B Phototherapy in the Treatment of Chronic Urticaria. Indian J Dermatol. 2019 May-Jun;64(3):250. doi: 10.4103/ijd.IJD_475_16. PMID: 31148870; PMCID: PMC6537687.

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  • WHO Adds Ozempic and Mounjaro to Its List of Essential Medicines – Bloomberg.com

    1. WHO Adds Ozempic and Mounjaro to Its List of Essential Medicines  Bloomberg.com
    2. The selection and use of essential medicines, 2025: WHO Model List of Essential Medicines for Children, 10th list.  World Health Organization (WHO)
    3. WHO backs weight-loss drugs, urges affordable generics in poor nations  Punch Newspapers
    4. The selection and use of essential medicines, 2025: report of the 25th WHO Expert Committee on Selection and Use of Essential Medicines, executive summary  World Health Organization (WHO)

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  • Prefrontal Cortex Biopsies Safe During DBS – Medscape

    1. Prefrontal Cortex Biopsies Safe During DBS  Medscape
    2. Obtaining Prefrontal Cortex Biopsies During Deep Brain Stimulation Adds No Risk to Procedure  Mount Sinai
    3. Prefrontal Cortex Can Be Safely Biopsied During Deep Brain Stimulation  Diabetes In Control
    4. Prefrontal Cortex Biopsies During DBS Surgery Found to Be as Safe as Standard Procedures  geneonline.com
    5. Obtaining Prefrontal Cortex Biopsies During Deep Brain Stimulation Adds No Risk to Procedure | Newswise  Newswise

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