Category: 8. Health

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.

Each September, Childhood Cancer Awareness Month brings attention to the fight against pediatric cancers. One of the promising projects currently making waves in this field is MONALISA, a Horizon Europe-funded initiative under the EU Cancer Mission

These efforts are focused on improving the way neuroblastoma, a serious childhood cancer, is monitored after treatment.

Neuroblastoma mainly affects young children and often requires intensive treatment. Unfortunately, even after therapy, more than half of children with high-risk neuroblastoma may experience a relapse. MONALISA’s goal is to detect these relapses earlier, in a less invasive and more child-friendly way, using a cutting-edge method known as liquid biopsy.

A gentle and more effective alternative

Currently, monitoring neuroblastoma involves medical imaging and bone marrow examinations. While effective, these methods can be invasive, costly, and emotionally challenging. They often require hospital stays, sedation, and can cause stress and discomfort for both children and their families.

Liquid biopsies offer a promising alternative. These simple blood tests are capable of detecting tiny traces of cancer-related genetic material, even before symptoms appear or abnormalities show up on scans. Because the procedure is non-invasive, it can be performed more frequently without adding physical or emotional strain.

If successful, this approach could transform the way childhood cancers are tracked after treatment, making relapse detection faster, easier, and less burdensome for patients.

An international clinical trial

MONALISA is the first clinical trial of its kind to test the use of liquid biopsies for monitoring neuroblastoma in children. It involves a large-scale clinical study in 11 countries, coordinated by the European Society for Paediatric Oncology (SIOP Europe) and backed by a strong network of hospitals, scientists, and research teams.

The project is not only focused on detecting relapse earlier, but it also integrates digital decision-making tools for healthcare providers and includes emotional well-being assessments for families. The combination of medical innovation with digital and emotional support makes MONALISA a comprehensive, patient-centred initiative.

MONALISA has already faced its challenges. One major hurdle was ensuring consistency in laboratory procedures across all participating countries. Standardising these methods was critical to ensure reliable and comparable results across the entire trial.

Another challenge was managing data, making sure that patient information from multiple sources could be connected securely and efficiently while maintaining privacy standards. The project has made substantial progress on both fronts and is now ready to begin patient enrolment.

Looking ahead, a key focus will be on integrating these innovations into national healthcare systems. This includes exploring pathways for insurance coverage and working with policymakers to ensure widespread adoption of the technology.

The success of MONALISA relies heavily on the support provided by the EU Cancer Mission and the Health and Digital Executive Agency (HaDEA). EU funding has enabled the collaboration of top experts across Europe, the development of digital support tools, and engagement with startups and small research teams driving innovation.

Nominations open until 30 September 2025

Bridgetown, Barbados, 5 September 2025 (PAHO/WHO) — The Pan American Health Organization (PAHO) has launched the Suzan McLennon-Miguel Caribbean Antimicrobial Resistance (AMR) Leadership Award, a new regional honor recognizing exceptional leadership in the fight against antimicrobial resistance—a growing global health threat often referred to as the “silent pandemic.”

The award celebrates the legacy of Dr. Suzan McLennon-Miguel, a Jamaican veterinarian whose three-decades career spanned veterinary public health, disaster response, food safety, and AMR advocacy. Affectionately known as “Doc Sue,” she was a passionate champion of the One Health approach, which unites human, animal, and environmental health to tackle complex health challenges like AMR.

PAHO welcomes the nominations of individuals or organizations from across the Caribbean who have demonstrated outstanding commitment to addressing AMR. Eligible nominees may include those who have led impactful community-based AMR initiatives; contributed to education, policy, or public health solutions; or advanced research or innovation using a One Health lens. Self-nominations are encouraged.

Nominations are open until 30 September 2025, and the winner will be announced on 18 November 2025, during World Antimicrobial Resistance Awareness Week.

Celebrating a legacy of Caribbean leadership

Dr. McLennon-Miguel passed away in July 2023 after a battle with cancer, but her influence continues to shape public health in the Caribbean. She led animal health responses during the 2021 volcanic eruption in St. Vincent and served as a food safety specialist at the Caribbean Agricultural Health and Food Safety Agency (CAHFSA) in Suriname.

Her impact extended beyond science and policy. In Jamaica, she created “Doc Sue’s Happy Rooms”—colorful spaces in hospitals where sick children could play, learn, and dream. “It’s more than a playroom,” she said. “It’s a place where children can start dreaming of what they want to be in the future.”

The awardee will be invited to PAHO’s Headquarters in Washington, D.C. for meetings with regional experts, participation in strategic AMR discussions, and the opportunity to showcase their work. They will also receive a commemorative plaque.

“AMR threatens lives across the Caribbean, from routine infections to critical treatments like cancer care,” said Pilar Ramon-Pardo, Chief, Antimicrobial Resistance Special Program at PAHO. “This award celebrates Dr. McLennon-Miguel’s legacy by recognizing leaders who are building a healthier future.”

A panel of experts from PAHO and international partners will select the winner based on impact, innovation, collaboration, and sustainable contributions to AMR efforts.

Why AMR matters

Antimicrobial resistance occurs when bacteria, viruses, fungi, or parasites stop responding to the medicines used to treat them. This makes common infections harder—and sometimes impossible—to cure. In the Caribbean, AMR threatens everything from routine infections to surgeries and cancer care, placing decades of public health progress at risk.

PAHO is stepping up its efforts to combat AMR in the Caribbean by strengthening surveillance, expanding laboratory capacity, promoting responsible use of antibiotics, and fostering One Health partnerships. These efforts are supported by the UK Government’s Fleming Fund and new South-South cooperation initiatives.

By honoring leaders like Dr. McLennon-Miguel, this award aims to inspire bold action to curb superbugs and safeguard the region’s health.

Download the nomination form (PDF) and read the full call for nominations (PDF).

For questions or to submit a nomination, please contact Franka Des Vignes at desvigfra@paho.org or Nathalie El Omeiri at elomeirin@paho.org, using the subject line: Suzan McLennon-Miguel Award nomination.

A newly published pair of studies from researchers at the University of Florida, Hokkaido University, and partners in Thailand and Japan has shed light on how Burkholderia pseudomallei—the bacterium responsible for the often-deadly disease melioidosis—can outsmart one of the most important drugs used to treat it.

The work, appearing in Antimicrobial Agents and Chemotherapy and Microbiology Resource Announcements, examined dozens of drug-resistant bacterial samples from patients in northeast Thailand and mapped the entire genome of a particularly important strain. The research uncovers both a brand-new genetic mutation and a structural quirk in the bacterium’s DNA that allow it to survive treatment with ceftazidime (CAZ), a critical antibiotic in many parts of the world.

A New Mutation with Big Consequences

The team discovered a previously unknown genetic change, called A172T, in a gene named penA. This gene produces an enzyme that can break down certain antibiotics before they can work. The A172T mutation alters the enzyme in a way that makes the bacteria up to 16 times more resistant to ceftazidime.

In lab tests, simply adding this mutation to an otherwise drug-sensitive strain was enough to make it highly resistant—strong evidence that A172T is a key driver of treatment failure.

DNA “Copy-and-Paste” Resistance

Beyond single-letter mutations, the studies also revealed another clever survival tactic: gene duplication and amplification. In some resistant strains, the bacteria carried multiple extra copies of the penA gene—sometimes as many as nine. More copies mean more of the antibiotic-destroying enzyme.

Researchers traced this to unusual palindromic GC-rich repeat sequences in the DNA. These repetitive patterns seem to act like “genetic Velcro,” causing the DNA to fold and recombine under drug pressure, effectively copy-pasting penA over and over.

One fully mapped strain, called 490f, carried three penA copies inside a large and complex repeat section of its DNA. Untangling this section required high-tech genome sequencing and painstaking manual assembly.

Other Routes to Resistance

The team also identified changes in the penA promoter region—essentially the gene’s “on/off” switch—that cranked up enzyme production. And in some cases, combinations of mutations subtly altered the enzyme’s shape, allowing it to resist multiple drugs in the same family.

While B. pseudomallei does not typically pick up resistance genes from other bacteria via plasmids (a common route in many pathogens), its ability to mutate and rearrange its own DNA gives it plenty of evolutionary flexibility.

Why It Matters Beyond the Lab

Melioidosis is a serious public health challenge in tropical regions, causing high death rates even with treatment. It’s also considered a Tier 1 select agent in the United States because of its potential misuse as a biothreat. Losing ceftazidime as a reliable treatment option would complicate outbreak control and put both local communities and global health security at greater risk.

For everyday public health, this means that drug resistance in B. pseudomallei is not just an abstract lab problem—it has direct implications for the safety of drinking water, soil contact in rural communities, and medical preparedness for travelers and military personnel in affected areas.

Looking Ahead

The authors suggest several steps:

• Surveillance to spot A172T and similar mutations early.
• Faster diagnostics that can detect known resistance markers right in the clinic.
• Deeper research into the DNA structures that drive gene duplication.
• Lab simulations to see how resistance emerges under incomplete or incorrect dosing.

By understanding how this bacterium develops resistance, scientists and public health agencies can better protect the antibiotics we have—and buy time to develop new ones.

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Sources and Further Reading:

Tuanyok A, Nakajima C, Noll T, et al. Genomic insights into ceftazidime resistance in Burkholderia pseudomallei: discovery of A172T mutation and palindromic GC-rich repeat sequences facilitating penA duplication and amplification. Antimicrobial Agents and Chemotherapy, 21 July 2025.

Khrongsee P, Subramaniam K, Mergia A, Tuanyok A. Complete genome sequence of ceftazidime-resistant Burkholderia pseudomallei strain 490f reveals a complex long repeat region. Antimicrobial Chemotherapy, 11 August 2025

With nearly one in eight people around the world living with obesity in 2022, the disease has more than doubled among adults and quadrupled among adolescents over the past three decades. This complex and chronic condition of excessive body fat increases the risk of non-communicable diseases such as diabetes, heart disease and cancer. Yet despite its surge in industrialized populations, obesity is seldom seen in traditional and farming communities — a contrast commonly attributed to greater physical activity.  

At its root, obesity stems from an imbalance between calories consumed and the energy the body burns. Public health experts often point to two culprits — overeating and insurfficient physical activity. Yet the exact role each factor plays remain debated, since lower activity levels do not always translate into less energy expended over the course of a day. 

The lack of diverse, reliable data on calorie intake, energy expenditure and body composition has further complicated research. Past studies have tried to address the debate, but most focused on nonindustrial populations, lacked body fat measurements, or relied on limited information from country-level consumption data and surveys.   

To close this gap, 68 researchers turned to the IAEA’s Doubly Labelled Water (DLW) Database — a global collection of energy expenditure measurements that have been collected via the DLW stable isotope technique. With datapoints spanning 45 different countries, the database has previously been used by scientists to conduct groundbreaking research on human energy metabolism, develop a predictive equation to assess self-reporting and inform ongoing revisions of human energy requirements.