Category: 8. Health

  • Lung cells generated from mouse embryonic fibroblasts in just 7 to 10 days

    Lung cells generated from mouse embryonic fibroblasts in just 7 to 10 days

    Researchers in Japan have successfully generated lung cells similar to alveolar epithelial type 2 (AT2) cells from mouse embryonic fibroblasts without using stem cell technology. The AT2-like cells were generated in just 7 to 10 days-a significant reduction compared to the approximately one month typically required by conventional stem cell-based differentiation methods.

    This approach may pave the way for treating serious respiratory diseases, such as interstitial pneumonia and chronic obstructive pulmonary disease, which currently lack effective treatments. The study was published in npj Regenerative Medicine.

    AT2 cells are essential for maintaining lung homeostasis. They produce surfactant and serve as progenitor cells for alveolar repair. In patients with severe lung diseases, such as interstitial pneumonia, these cells are often reduced in number or functionally impaired, which highlights the therapeutic potential of regenerating AT2 cells.

    The advent of the induced pluripotent stem cell (iPSC) technology in 2006 has enabled the generation of AT2 cells in approximately one month, but this method is costly and carries risks of tumor formation and immune rejection. To overcome these disadvantages, we focused on direct reprogramming instead. The direct reprogramming approach produces AT2-like cells in just 7 to 10 days, with lower tumor risk and potential for autologous use.”


    Professor Makoto Ishii of Nagoya University Graduate School of Medicine

    Professor Ishii and colleagues, including Professor Koichi Fukunaga, Assistant Professor Takanori Asakura, and Joint Researcher Atsuho Morita from Keio University School of Medicine, conducted a study to generate AT2-like cells from fibroblasts in mice through direct reprogramming, which had never been accomplished before.

    First, the researchers selected 14 candidate genes associated with lung development. Then, they investigated the expression levels of the AT2 cell marker, surfactant protein-C (Sftpc), to determine the gene combination with the highest reprogramming efficiency. They found that a combination of four genes-Nkx2-1, Foxa1, Foxa2, and Gata6-was the most effective for reprogramming AT2 cells.

    The four genes were introduced into a three-dimensional culture made from mouse embryonic fibroblasts that express green fluorescent protein (GFP) in response to Sftpc. As a result, approximately 4% of the cells became Sftpc/GFP-positive in 7 to 10 days, showing their success in inducing AT2-like cells, called induced pulmonary epithelial-like cells (iPULs).

    The researchers analyzed iPULs after isolating GFP-positive cells by flow cytometry. These purified iPULs exhibited lamellar body-like structures, which are organelles characteristic of normal AT2 cells. In addition, transcriptomic analysis revealed that their gene expression profiles were highly similar to those of native AT2 cells.

    Next, they transplanted purified iPULs into mouse lungs with interstitial pneumonia. Forty-two days later, the transplanted cells had successfully engrafted in the alveolar region. Notably, some of the cells had differentiated into alveolar epithelial type 1 (AT1)-like cells, which are essential for lung tissue regeneration.

    Ishii concluded: “In this study, we succeeded in direct reprogramming of fibroblasts into AT2-like cells in mice. We now aim to explore the application of this technology to human cells, with the ultimate goal of developing a safe regenerative therapy using a patient’s own fibroblasts.”

    This study was funded by JSPS KAKENHI Grant Numbers JP24K02113, JP24K23468, JP22KJ2672, JP21J21344, JP21H02926, JP19K17682, JP18K19566, JP18H02821, JP15K19945, and AMED Grant Numbers JP21bm0404053, JP23wm0325031, and JP24ym0126807.

    Source:

    Journal reference:

    Morita, A., et al. (2025). Direct reprogramming of mouse fibroblasts into self-renewable alveolar epithelial-like cells. npj Regenerative Medicine. doi.org/10.1038/s41536-025-00411-4.

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  • Plant-Based Diet May Improve Stress-Related Metrics in Rheumatoid Arthritis

    Plant-Based Diet May Improve Stress-Related Metrics in Rheumatoid Arthritis

    A plant-based lifestyle program that previously showed benefits for joint pain and inflammation in rheumatoid arthritis may also help ease stress, according to a secondary analysis of the Plants for Joints (PFJ) randomized controlled trial.1 However, researchers did not see the same stress-related effects in participants with metabolic syndrome–associated osteoarthritis (MSOA).

    The 16-week PFJ program combined a whole-food, plant-based diet with physical activity, sleep hygiene, and stress management techniques. In earlier results, the intervention reduced disease activity in rheumatoid arthritis and improved pain and physical function in MSOA.2 Published in Comprehensive Psychoneuroendocrinology, this follow-up analysis looked at whether the program also affected stress markers, including heart rate variability (HRV), cortisol levels, and perceived stress.

    Participants with RA who followed the program showed greater signs of reduced stress compared with those receiving usual care. | Image credit: Prostock-studio – stock.adobe.com

    Evidence Linking Stress Management to Outcomes

    Prior studies have shown that stress management and mindfulness-based interventions can improve psychological well-being and reduce rheumatoid arthritis symptoms like pain, anxiety, and depressive mood, even if they do not always lower disease activity scores such as DAS28. Yoga-based interventions, however, have demonstrated reductions in DAS28, the number of inflamed joints, and inflammatory markers like C-reactive protein and erythrocyte sedimentation rate compared with usual care.3

    Yoga has also been shown to positively influence HRV, cortisol levels, and other markers of autonomic function. Additional evidence suggests practices like deep breathing or electrical vagus nerve stimulation can activate the parasympathetic nervous system, reduce cytokine production, and help modulate immune activity in rheumatoid arthritis.

    Modest But Measurable Stress Reductions in Rheumatoid Arthritis

    Among 77 participants with rheumatoid arthritis, those who followed the PFJ program showed greater signs of reduced stress compared with those receiving usual care.1 One key finding was a significant increase in normalized high-frequency HRV (HFnorm) among those following the program, which signals stronger parasympathetic nervous system activity (between-group difference, 6.6; 95% CI, 0.5-12.6). These patients also saw a trend toward improved root square mean of successive differences, another HRV measure related to stress recovery (between-group difference, 4.3; 95% CI, –1.5 to 10.1).

    Compared with usual care, the lifestyle intervention was also tied to nonsignificant reductions in heart rate (between-group difference, 3.1; 95% CI, –3.9 to 10.1), salivary cortisol (1.3; 95% CI, –0.6 to 3.1), and perceived stress (–2.0; 95% CI, –4.4 to 0.3). Measured via the Perceived Stress Scale-10 (PSS-10), subjective stress declined by 2 points more in the PFJ group than in the control.

    Importantly, participants who reported spending more time on stress-reducing activities like breathing exercises or meditation experienced greater improvements in HFnorm. However, engagement with these activities was short-lived, peaking at 8 weeks and returning to baseline levels by week 16. While this was not reflected in the activity data, the authors said participants may have become more aware of stressors and used techniques that were not quantifiable for the study but still had an effect on their stress levels. According to them, this short-term increase in stress-reducing activity could have longer-term impacts worth investigating. On the other hand, they said the intervention as a whole could have contributed to stress reduction.

    No Observed Effect for Osteoarthritis

    In contrast with the rheumatoid arthritis group, participants with MSOA did not experience any meaningful changes in stress-related measures. This group, which had a higher baseline body mass index and older mean age than the rheumatoid arthritis cohort, showed no differences in heart rate, HRV, cortisol, or perceived stress compared with controls after the intervention.

    Physical activity had a different relationship with stress between groups. Higher activity levels were tied to slightly higher stress levels in rheumatoid arthritis, with a mean of 139 minutes of activity per week (β, 0.022; P = .025), but lower levels in the MSOA group, which averaged 119 minutes a week (β, −0.025; P = .038).

    “While the effects of individual lifestyle components cannot be isolated, the associations suggest that greater engagement in stress-reduction activities and physical activity were most linked to improvements in stress outcomes,” the authors said. “However, these associations should be interpreted with caution, as adherence data was self-reported, the effects were small and potentially clinically insignificant, the sample size was limited, and baseline physical activity levels were already high.”

    References

    1. Wagenaar CA, Christiaans J, Hermans V, et al. Effect of a multidisciplinary lifestyle intervention on stress-related parameters in people with rheumatoid arthritis and osteoarthritis: secondary analysis of the “Plants for Joints” randomized controlled trial. Compr Psychoneuroendocrinol. 2025;23:100298. doi:10.1016/j.cpnec.2025.100298
    2. Walrabenstein W, Wagenaar CA, van de Put M, et al. A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial. Osteoarthritis Cartilage. 2023;31(11):1491-1500. doi:10.1016/j.joca.2023.05.014
    3. Slagter L, Demyttenaere K, Verschueren P, De Cock D. The effect of meditation, mindfulness, and yoga in patients with rheumatoid arthritis. J Pers Med. 2022;12(11):1905. doi:10.3390/jpm12111905

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  • Incidence of Symptomatic Gallstone Disease in Bariatric Patients Undergoing Sleeve Gastrectomy, and the Dilemma of Prophylactic Cholecystectomy: A Single-Center Retrospective Study

    Incidence of Symptomatic Gallstone Disease in Bariatric Patients Undergoing Sleeve Gastrectomy, and the Dilemma of Prophylactic Cholecystectomy: A Single-Center Retrospective Study


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  • Unveiling Advances in GU Cancers: Insights from Oncology Decoded

    Unveiling Advances in GU Cancers: Insights from Oncology Decoded

    The Oncology Decoded podcast, co-hosted by Manojkumar Bupathi, MD, MS, executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and medical oncologist with Rocky Mountain Cancer Centers specializing in solid tumors and genitourinary cancers, and Benjamin Garmezy, MD, associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at SCRI and medical oncologist at SCRI Oncology Partners specializing in genitourinary cancers, in a recent live session with US Oncology Network and the Pathways Task Force, delved into significant updates that were set to happen at the 2025 American Society of Clinical Oncology (ASCO), focusing on the genitourinary cancer landscape.

    Bupathi and Garmezy were joined by John M. Burke, MD, a hematologist and medical oncologist at Rocky Mountain Cancer Centers, and Dhaval R. Shah, MBBS, a medical oncologist from Christiana Care.

    A primary focus of the discussion was the phase 3 KEYNOTE-564 trial (NCT03142334), a pivotal trial for patients with renal cell carcinoma (RCC). This study investigated pembrolizumab (Keytruda) as adjuvant therapy for patients with clear cell RCC who had undergone surgical resection and presented with intermediate-high or high-risk features.

    Garmezy highlighted the “clear separation of the curves” in disease-free survival (DFS), with an HR of 0.68, and a compelling 5% difference in long-term overall survival, signifying a benefit for “about 1 in 20 patients”. Despite about 20% of patients discontinuing treatment due to toxicity, the overall safety profile of pembrolizumab was considered well-tolerated, with no statistically significant difference in quality of life compared with placebo.

    Burke provided the panel with his perspective on evaluating such trials. He emphasized the importance of scrutinizing study design flaws, even in “randomized, double-blind, placebo-controlled, phase 3 clinical trials,” which are often seen as the “epitome of great science”. Key questions for consideration include the appropriateness of the control arm (placebo in KEYNOTE-564 was deemed appropriate), the validity of surrogate end points like DFS, and the presence of “informative censoring”—a form of bias that can skew results. Burke noted that informative censoring can occur if patients drop out of a trial due to disappointment with their randomized arm or due to drug toxicity, which can make the treatment arm’s progression-free survival look better than it truly is.

    The discussion also touched upon the consistency of KEYNOTE-564’s findings with other trials. Garmezy noted that while pembrolizumab showed positive results, other adjuvant studies involving atezolizumab (Tecentriq), nivolumab (Opdivo), and nivolumab plus ipilimumab (Yervoy) had no significant difference, potentially due to differences in drug type or duration of therapy (6 vs 12 months). Shah affirmed that despite these nuances, the overall survival benefit seen in KEYNOTE-564 justifies the use of adjuvant pembrolizumab for eligible patients, emphasizing adherence to the exact trial criteria.

    Beyond kidney cancer, the podcast previewed discussions on the phase 3 NIAGARA trial (NCT03732677) for perioperative bladder cancer and the phase 3 TALAPRO-2 trial (NCT03395197) for first-line metastatic castrate-resistant prostate cancer (mCRPC). Bupathi highlighted the ongoing debate within the Pathways Committees regarding the integration of new data vs established practices, particularly concerning the timeline for new drugs to be incorporated into pathways. Burke clarified that while Pathways guides value-driven decisions, physicians retain the autonomy to prescribe off-pathway regimens, though financial implications might arise. The episode concluded with a look ahead to more data releases, underscoring the dynamic nature of oncology practice and the continuous evaluation of therapies for optimal patient care.

    Reference

    Choueiri TK, Tomczak P, Park SH, et al; KEYNOTE-564 Investigators. Overall survival with adjuvant pembrolizumab in renal-cell carcinoma. N Engl J Med. 2024;390(15):1359-1371. doi:10.1056/NEJMoa2312695

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  • OMRON Healthcare Issues Urgent Health Message on AFib, Heart Failure Risks in Response to New Research

    OMRON Healthcare Issues Urgent Health Message on AFib, Heart Failure Risks in Response to New Research

    “Progress made in reducing heart attack deaths provides a roadmap to address rising mortality rates from arrythmias, heart failure and hypertensive heart disease”

    HOFFMAN ESTATES, Ill., July 3, 2025 /PRNewswire/ — Heart health leader OMRON Healthcare today issued an urgent health message across the U.S. to raise public awareness of rapidly increasing risks and rising mortality rates associated with arrythmias such as atrial fibrillation (AFib), heart failure, and heart disease from long-term high blood pressure, as identified in new research.

    Published in the Journal of the American Heart Association1, new research focused on age-adjusted mortality rates for a variety of heart disease subtypes among adults 25 years and older in an analysis of Centers of Disease Control and Prevention (CDC) data from 1970 to 2022. 

    The analysis found heart disease accounted for nearly one-third of all deaths over the 52-year period2. During that period, heart attack deaths decreased while deaths from arrhythmias, heart failure, and hypertensive heart disease increased significantly.

    “In this study, researchers noted that public awareness, early diagnosis, and treatment interventions played key roles in reducing the heart attack death rate”, said OMRON Healthcare North America Managing Director Alice Koehler. “That affirms the body of research showing 90 percent of heart disease is preventable3. We must remain diligent in preventing heart attacks and commit to early detection and proper treatment of AFib and heart failure.”

    OMRON is providing the following guidance to reduce rising heart disease risks:

    • Monitor your blood pressure regularly at home. Blood pressure fluctuates over time. Regular blood pressure monitoring at home, daily or weekly, can help with early identification of high blood pressure.
    • Utilize new medical technology for early AFib detection. Early detection of AFib is now widely available for the first time for use at home. OMRON recently introduced blood pressure monitors with AI-powered AFib detection, a medical device first.
    • Tap into a virtual heart health coaching app. Mobile apps, such as OMRON connect, can sync to blood pressure monitors and help flag changes in data, provide reminders, support behavior change, and can be used to send readings to your physician.
    • Talk to your doctor. Ask questions about arrythmias, heart failure, and hypertensive heart disease, especially if these conditions run in your family. Inquire about technology that can be used at home to provide a complete picture of your heart health.

    According to senior author of the research paper Latha Palaniappan, M.D., M.S., FAHA, associate dean for research and a professor of medicine at Stanford University School of Medicine4: “While heart attack deaths are down by 90 percent since 1970, heart disease hasn’t gone away. Now that people are surviving heart attacks, we are seeing a rise in other forms of heart disease like heart failure. The focus now must be on helping people age with strong, healthy hearts by preventing events, and prevention can start as early as childhood.”

    As presented in the research paper:

    In 1970, more than half of all people who died from heart disease (54 percent) died because of a heart attack. The age-adjusted death rate decreased 89 percent by 2022, when less than one-third of all heart disease deaths were caused by a heart attack.

    Conversely, during this time, the age-adjusted death rate from all other types of heart disease (including heart failure, hypertensive heart disease and arrhythmia) increased by 81 percent, accounting for 47 percent of all heart disease deaths in 2022.

    “Over this same 52-year period, OMRON Healthcare began offering blood pressure monitors for home use, sold more than 350 million units, and became the number one doctor and pharmacist recommended blood pressure monitor,” said Koehler. “Regular blood pressure monitoring and acting on that data can make a world of difference.”

    “Our mission is Going for Zero heart attacks and strokes, and our mission calls us to address the most urgent heart health risks,” added Koehler. “The measurable progress made in reducing heart attack deaths provides a roadmap to address rising mortality rates from arrythmias, heart failure and hypertensive heart disease.”

    For more information on blood pressure monitoring and AFib detection, visit OmronHealthcare.com.

    About OMRON Healthcare, Inc.
    OMRON Healthcare, Inc., is the world’s leading manufacturer and distributor of personal heart health products and an innovator in technologies supporting respiratory and pain management care. With over 50 years of medical device category leadership, OMRON is passionate about empowering people to take charge of their health at home through precise technology. Its market-leading products include a full range of home blood pressure monitors, nebulizers and TENS devices. The company’s mission is Going for Zero, the elimination of heart attacks and strokes. With more than 350 million devices sold globally, OMRON provides the world’s most recommended blood pressure monitors by healthcare professionals. OMRON Healthcare strives to improve lives and contribute to a better society by developing innovations that help people prevent, treat, and manage their medical conditions. The company provides products and services in over 130 countries. For more information, visit OmronHealthcare.com.

    SOURCE OMRON Healthcare

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  • Community vaccination program reduces pneumonia deaths among elderly in Japan

    Community vaccination program reduces pneumonia deaths among elderly in Japan

    A research team has evaluated the real-world impact of a community-based pneumococcal vaccination support program for older adults conducted in Sera Town, Hiroshima Prefecture, Japan.

    Their work is published in the Journal of Epidemiology on May 5, 2025.

    Pneumonia is one of the leading causes of death in Japan. Each year about 74,000 people die from pneumonia with 98 percent of these deaths occurring in people aged 65 and older. The bacteria Streptococcus pneumoniae is the primary cause of pneumonia.

    In October 2014, Japan began a nationwide routine vaccination program for the elderly under the National Immunization Program with the 23-valent pneumococcal polysaccharide vaccine (PPSV23). 

    Sera Town, a mountainous municipality in eastern Hiroshima Prefecture, jointly planned and implemented a pneumococcal vaccination support program with a research team at Hiroshima University in October 2010-well before the nationwide rollout. The program, which ran until March 2015, aimed to promote community health and provided PPSV23 vaccination to all residents aged 65 and older. The vaccine used in the project was approved in Japan at the time for elderly individuals. As part of this collaborative initiative, a five-year follow-up survey was conducted to assess the vaccine’s preventive effect against pneumonia. 

    Specifically, we sought to understand the impact of the PPSV23 vaccine on pneumonia incidence and mortality among the elderly population in a rural setting with a high aging rate.”


    Aya Sugiyama, lecturer in the Department of Epidemiology Disease Control and Prevention at the Graduate School of Biomedical and Health Sciences, Hiroshima University

    The Sera Town residents who took part in the project ranged in age from 70 to 114 years old, with a median age of 84.

    To assess changes in mortality following the introduction of the vaccination program, the researchers used aggregated demographic data from Japan’s vital statistics covering the years 2000 to 2016. They applied an interrupted time series analysis to quantify the level and trend changes in mortality rates over time, specifically looking at the mortality rates before and after the vaccination project was introduced in the town. The study aimed to generate real-world evidence on the effectiveness of vaccination support programs in super-aged societies.

    Their analysis of the data showed them that the pneumococcal vaccination support program for older residents in Sera Town was associated with a 25 percent reduction in pneumonia-related mortality. “Notably, it reversed the previously increasing trend in pneumonia mortality in the community,” said Sugiyama.

    The study also provided valuable data on the actual incidence of pneumonia among vaccinated older adults, with an incidence rate of 20.3 cases per 1,000 person-years. Scientists use the person-year method in studies where they follow individuals over a period of time. A person-year is one person being followed for one year.

    “These findings underscore both the public health significance of local vaccination efforts and the burden of pneumonia in aging populations,” said Sugiyama.

    The research team sees the findings as particularly relevant for Japan, which has the most aged population in the world. “With the completion of this evaluation, the next step is to share these findings to inform future discussions on community-based vaccination strategies. While further research is needed, we hope that our results will serve as a reference for regions exploring effective approaches to pneumonia prevention in older adults,” said Sugiyama.

    The research team includes Aya Sugiyama, Kanon Abe, Hirohito Imada, Bunlorn Sun, Golda Ataa Akuffo, Tomoyuki Akita, Shingo Fukuma, Junko Tanaka, and Noboru Hattori from Hiroshima University; Masaaki Kataoka from Sera Central Public Hospital; and Kentaro Tokumo from Sera Central Public Hospital, Hiroshima University, and Hiroshima University Hospital.

    The research is funded by the Sera Town municipality.

    Source:

    Journal reference:

    Sugiyama, A., et al. (2024). Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-Based Study. Journal of Epidemiology. doi.org/10.2188/jea.je20240285.

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  • South Africa begins first-ever poultry vaccination to minimize bird flu outbreaks-Xinhua

    JOHANNESBURG, July 3 (Xinhua) — South Africa has commenced its first-ever poultry vaccination campaign, a move expected to play a key role in minimizing the risk of highly pathogenic avian influenza (HPAI) outbreaks.

    Speaking to Xinhua on Thursday, Dipepeneneng Serage, deputy director-general of the Department of Agriculture, said the rollout had already begun at one farm and would be extended to others in the coming days.

    “We just approved one vaccination for the first time. We are still finalizing details for others. So, how it happens is firms apply, a prescription is issued, and only then vaccination starts and other farms will follow,” explained Serage.

    He said the department was finalizing the details for a mass rollout, which would happen in “a week or so.”

    The vaccination drive follows the Department of Agriculture’s recent approval of a vaccination permit issued to Astral Foods Limited, South Africa’s leading poultry producer. The permit allows the company to vaccinate poultry against the HPAI virus at one of its broiler breeder farms.

    According to the department, the vaccination at the farm is starting with 200,000 broiler breeders, representing five percent of the company’s breeding stock.

    Minister of Agriculture John Steenhuisen on Tuesday welcomed the first-ever vaccination campaign, saying it would play a significant role in preventing the effects of bird flu on the poultry industry in the country.

    During one of the worst bird flu outbreaks in South Africa in 2023, millions of poultry birds were culled, resulting in a nationwide shortage of chickens and eggs in the country. ■

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  • Pandemic Surge in IBS, Chronic Idiopathic Constipation

    Pandemic Surge in IBS, Chronic Idiopathic Constipation

    The prevalence of irritable bowel syndrome (IBS) and chronic idiopathic constipation among US adults rose significantly during the COVID-19 pandemic, with a near doubling of the national rate of IBS over 2 years, a study has found.

    The uptick is probably due to not only the direct impact of SARS-CoV-2 infection on the gastrointestinal tract but also to the psychological stress associated with pandemic life, the study team said. 

    “COVID infection itself can definitely cause gastrointestinal symptoms like diarrhea, nausea, and abdominal pain — and for some people, those symptoms can linger and lead to chronic conditions like IBS,” Christopher V. Almario, MD, MSHPM, lead author and gastroenterologist at Cedars-Sinai Medical Center, Los Angeles, California, told Medscape Medical News. 

    “But the stress of living through the pandemic — lockdowns, fear, isolation — also likely played a major role as well in the increased prevalence of digestive disorders. Both the infection itself and the psychological toll of the pandemic can disrupt the gut-brain axis and trigger chronic digestive disorders like IBS,” Almario said. 

    The study was published in Neurogastroenterology & Motility.

    Growing Burden of Gut Disorders 

    Disorders of gut-brain interaction (DGBIs) are a heterogeneous group of conditions in which gastrointestinal symptoms occur without any detectable structural or biochemical abnormalities in the digestive tract. They include IBS, functional dyspepsia, and chronic idiopathic constipation, among others. 

    DGBIs are highly prevalent. Research has shown that nearly 40% of people in the US meet Rome IV criteria for at least one DGBI. 

    Almario and colleagues assessed trends in prevalence of these conditions during the COVID-19 pandemic. Starting in May 2020 through May 2022, they conducted a series of online surveys with more than 160,000 adults aged 18 or older using validated Rome IV diagnostic questionnaires. 

    Results showed that during the pandemic, IBS prevalence rose from 6.1% in May 2020 to 11.0% by May 2022, an increase of 0.188% per month (adjusted P < .001). 

    Chronic idiopathic constipation showed a smaller but statistically significant increase, from 6.0% to 6.4% (0.056% per month; adjusted P < .001). 

    Within the IBS subtypes, mixed-type IBS showed the largest relative increase (0.085% per month), followed by IBS with constipation (0.041% per month) and IBS with diarrhea (0.037% per month). 

    There were no significant changes in the prevalence of other DGBIs, such as functional bloating, functional diarrhea, or functional dyspepsia, during the study period. 

    Almario told Medscape only about 9% of those surveyed reported a positive COVID test at the time of the surveys, but that figure probably underrepresents actual infections, especially in the early months of the pandemic. “Most of the survey responses came in during the earlier phases of the pandemic, and the percentage reporting a positive test increased over time,” he explained. 

    Almario also noted that this study did not directly compare digestive disorder rates between infected and uninfected individuals. However, a separate study by the Cedars-Sinai team currently undergoing peer review addresses that question more directly. “That study, along with several other studies, show that having COVID increases the risk of developing conditions like IBS and functional dyspepsia,” Almario said. 

    Taken together, the findings “underscore the increasing healthcare and economic burden of DGBI in the post-pandemic era, emphasizing the need for targeted efforts to effectively diagnose and manage these complex conditions,” they wrote. 

    “This will be especially challenging for healthcare systems to address, given the existing shortage of primary care physicians and gastroenterologists — clinicians who primarily manage individuals with DGBI,” they noted. 

    Support for this study was received from Ironwood Pharmaceuticals and Salix Pharmaceuticals in the form of institutional research grants to Cedars-Sinai. Almario has consulted for Exact Sciences, Greenspace Labs, Owlstone Medical, Salix Pharmaceuticals, and Universal DX.

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  • Covid-19 impact extends beyond virus with increased deaths from other conditions

    Covid-19 impact extends beyond virus with increased deaths from other conditions

    Disrupted care during the covid-19 pandemic led to sharp increases in other non-covid causes of illness and death, particularly mental health disorders, malaria in young children, and stroke and heart disease in older adults, finds a study published by The BMJ today.

    For example, new cases of depressive disorders rose by 23% in 5-14 year-olds and malaria deaths rose by 14% in children under five years old from 2020-2021.

    The researchers say future responses to potential pandemics or other public health emergencies of international concern “must extend beyond infection control to address long term, syndemic health impacts.”

    Most healthcare services were severely affected during the pandemic, hindering efforts to prevent and control many conditions. Yet an in-depth analysis of the pandemic’s impact on other causes of illness and death is still needed.

    To address this, researchers in China used data from the Global Burden of Disease Study 2021 to simulate the burden of 174 health conditions in 2020 and 2021 across various regions, age groups, and sexes.

    A total of 204 countries and territories were included in the analysis. The main measures of interest were incidence (number of new cases), prevalence (number of people living with a condition), deaths, and disability adjusted life years (DALYs) – a combined measure of quantity and quality of life.

    Depressive and anxiety disorders, along with malaria, were the most notably affected, with a significant rise in disease burden compared with other causes.

    For example, age standardised DALY rates for malaria rose by 12% (to 98 per 100,000). DALY rates for depressive and anxiety disorders also rose by 12% (to 83 per 100,000) and 14% (to 74 per 100,000), respectively, especially among females.

    Age standardised incidence and prevalence rates for depressive disorders rose by 14% (to 618 per 100,000) and 10% (to 414 per 100,000), respectively, while anxiety disorders saw a 15% rise (to 102 and 628 per 100,000).

    Prevalence rates for heart disease also saw notable increases, particularly among individuals aged 70 and above (169 per 100,000 for ischaemic heart disease and 27 per 100,000 for stroke). 

    There was also a significant (12%) increase in the age standardised death rate due to malaria, particularly among children under five years old in the African region.

    The researchers acknowledge that their methods may not fully capture the complexity and variation of pandemic-related disruptions, and say factors such as uneven quality of data across regions, potential underreporting, and delayed diagnoses during the pandemic, may have affected the accuracy of their results.

    However, they say their analysis offers broader scope than previous studies and provides actionable, policy relevant recommendations to improve health system preparedness.

    As such, they conclude: “These findings underscore the urgent need to strengthen health system resilience, enhance integrated surveillance, and adopt syndemic-informed strategies to support equitable preparedness for future public health emergencies.”

    This study highlights how data can guide smarter recovery to ensure that future health crises disrupt lives less and afflict populations more evenly, say researchers in a linked editorial.

    By integrating these insights into post-pandemic plans, countries can improve resilience, they write. Concrete steps include allocating budgets for essential services in emergencies, reinforcing primary health care, expanding disease surveillance networks, and prioritising universal health coverage with a focus on disadvantaged or marginalised communities.

    “Ultimately, recognising and planning for the pandemic’s indirect toll will save lives and leave health systems stronger and fairer for future public health emergencies,” they conclude.

    Source:

    Journal reference:

    Chen, C., et al. (2025). Global, regional, and national characteristics of the main causes of increased disease burden due to the covid-19 pandemic: time-series modelling analysis of global burden of disease study 2021. BMJ. doi.org/10.1136/bmj-2024-083868.

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  • Alzheimer’s protein found to drive lung cancer spread to the brain

    Alzheimer’s protein found to drive lung cancer spread to the brain

    Researchers at McMaster University, Cleveland Clinic and Case Comprehensive Cancer Center have uncovered how a protein long associated with Alzheimer’s disease helps lung cancer spread to the brain – a discovery that offers hope that existing Alzheimer’s drugs could be repurposed in preventing cancer’s spread.

    The study, published in Science Translational Medicine on July 2, 2025, details how the protein (BACE1) is instrumental in the development of brain metastases – tumours that spread to the brain from cancers originating elsewhere in the body – in people with lung cancer. These tumours occur in up to 40 per cent of patients with non-small cell lung cancer.

    We’ve always associated BACE1 with Alzheimer’s disease, so to find it playing a major role in lung cancer brain metastases is an important discovery. It’s a reminder that cancer can hijack biological pathways in ways we don’t yet fully understand.”


    Sheila Singh, senior author, director of McMaster’s Centre for Discovery in Cancer Research and professor with the Department of Surgery

    To make the discovery, researchers used a cutting-edge gene activation technique known as a genome-wide in vivo CRISPR activation screen. The technique allowed researchers to systematically activate thousands of genes one by one in lung cancer cells and put the modified cells into mice. When BACE1 was switched on, the cancer cells were far more likely to invade the brain.

    BACE1 has long been linked to Alzheimer’s disease, the most common form of dementia. In people with Alzheimer’s, BACE1 cuts a protein called APP, triggering the formation of sticky plaques in the brain.

    Currently, there are limited therapies available once cancer has spread to the brain. However, researchers say the discovery of BACE1 does offer hope as a drug developed for Alzheimer’s could be repurposed.

    The therapy uses a drug called Verubecestat that blocks BACE1 activity. Researchers found that mice given Verubecestat had fewer and smaller tumours, and also lived longer. The drug had shown promise in Alzheimer’s patients but a Phase 3 clinical trial was discontinued in 2018 after a committee determined it was unlikely that positive benefit/risk could be established.

    “The discovery of BACE1 opens the door to repurposing existing treatments like Verubecestat to potentially prevent or slow the spread of lung cancer to the brain, where treatment options are currently very limited,” Singh says.

    The team say more research is needed to better understand the effectiveness of the therapy in preventing the spread of lung cancer to the brain.

    “This study highlights how interdisciplinary partnerships can lead to breakthroughs in understanding and treating devastating diseases like brain metastases,” said Shideng Bao, a researcher in Cleveland Clinic’s Department of Cancer Biology, a corresponding author on the paper. “By identifying BACE1 as a key player in the spread of lung cancer to the brain, we’ve uncovered a promising new avenue for therapeutic intervention that could ultimately improve outcomes for patients.”

    The Sheila Singh Lab collaborated with Cleveland Clinic and Case Comprehensive Cancer Center on the research. Singh and her colleagues are world leaders in brain cancer research, previously discovering a pathway used by cancer cells to infiltrate the brain, as well as new therapeutic approaches.

    The study was supported by funding from the Boris Family Fund for Brain Metastasis Research, the Canadian Cancer Society, the Canadian Institute of Health Research, the Cancer Research UK Lung Cancer Centre of Excellence the Cleveland Clinic Foundation and Lerner Research Institute, and a Sir Henry Wellcome Fellowship.

    Source:

    Journal reference:

    Chafe, S. C., et al. (2025). A genome-wide in vivo CRISPR activation screen identifies BACE1 as a therapeutic vulnerability of lung cancer brain metastasis. Science Translational Medicine. doi.org/10.1126/scitranslmed.adu2459.

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