Category: 8. Health

Bipolar disorder (BD) is a chronic mental health condition characterized by recurrent episodes of depression and mania. It poses a substantial burden on global health, with an increasing incidence. Despite its prevalence, there exists a significant gap in understanding the underlying neuropathological mechanisms. Although mitochondrial dysfunction has been implicated in BD, the specific brain region damaged is not yet fully understood. A deeper understanding is essential for advancing research efforts and developing better therapeutic strategies.

In an effort to bridge the knowledge gap, a team of researchers in Japan investigated the thalamus and medial temporal regions of the brain-areas involved in mood regulation and cognitive function. The research team, led by Professor Tadafumi Kato from the Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Japan, and Dr. Akito Nagakura from Tokyo Metropolitan Matsuzawa Hospital, Japan, set out with a vision to change the trajectory of BD research. Their findings were published in Psychiatry and Clinical Neurosciences on September 2, 2025.

“Although animal models have pointed to the involvement of the paraventricular thalamic nucleus in the pathophysiology of BD, neuropathological knowledge is limited. In particular, we aimed to investigate whether the accumulation of certain neurodegenerative proteins, previously associated with neurological diseases, might play a role in the pathology of BD,” says Prof. Kato.

The research involved an analysis of postmortem brain tissue, specifically the paraventricular thalamus and medial temporal regions, which were studied in detail. The postmortem tissues were subjected to immunohistochemical analyses using antibodies targeting key neurodegenerative markers, including phosphorylated tau, amyloid β, α-synuclein, and TDP-43. Additionally, markers of granulovacuolar degeneration (GVD), such as CHMP2B and CK-1δ, were investigated. This comprehensive approach enabled an efficient assessment of the expression and distribution of multiple proteins that are commonly associated with neurodegenerative diseases.

The findings revealed significantly higher neurofibrillary tangle (NFT) stages in patients with BD, along with argyrophilic grain pathology. Both are related to tau proteins that accumulate in brain cells and are commonly associated with aging. These findings replicated a greater burden of tau-related pathology in BD, as suggested by previous postmortem brain and neuroimaging studies, possibly linked to the age of onset.

More importantly, the presence of CHMP2B-positive GVD in the paraventricular thalamus in about half of the BD cases was an observation not previously reported.

Together, these insights highlight the potential role of neurodegenerative protein accumulation and dysfunctional paraventricular thalamus in the underlying biology of BD.

Overall, the findings add to a growing body of evidence that suggests that BD is a brain-based disease. By uncovering specific protein pathologies, such as CHMP2B-positive GVD, and tau accumulation in key brain regions, the research strengthens the biological understanding of BD beyond simply clinical symptoms.

As the understanding of underlying brain changes improves, there is a growing need for early detection, personalized treatment strategies, and therapies that address the root mechanisms.

“Our study, by demonstrating the presence of CHMP2B-positive GVD in the paraventricular thalamus and increased NFT stages in patients with BD, may pave the way for the development of new diagnostic tools and targeted therapies,” concludes Prof. Kato.

One dose of a respiratory syncytial virus (RSV) vaccine could provide protection against RSV-associated hospitalization and severe infection for adults aged 60 years and older for 2 consecutive RSV seasons, according to findings from the IVY Network research group. The study authors, who published their findings in JAMA, noted that the results confirm the recommendation that older adults should receive an RSV vaccine while also providing a basis for determining how long a single dose of the vaccine remains effective.^1,2

“These results clearly demonstrate that the RSV vaccines prevent hospitalizations and critical illness due to RSV infection among older Americans,” Wesley Self, MD, MPH, principal investigator for the IVY Network and senior vice president for clinical research at Vanderbilt University Medical Center, said in a news release. “It is exciting to see the public health benefits of this new vaccination program.”²

RSV Incidence and Vaccination Recommendations for Older Adults

Peak RSV season occurs in the fall and winter, with an estimated 110,000 to 180,000 RSV-related hospitalizations among US adults aged 50 years and older, accounting for nearly 4000 to 8000 annual deaths. RSV symptoms are typically mild and cold-like, including a congested or runny nose, dry cough, low-grade fever, sore throat, sneezing, and headache. Symptoms of severe infection include fever, severe cough, wheezing, rapid breathing or difficulty breathing, and bluish skin color. RSV also could worsen conditions like asthma, chronic obstructive pulmonary disease, or heart failure, leading to hospitalization or fatal outcomes.³

The CDC currently recommends a single dose of any of the 3 FDA-approved RSV vaccines—RSVPreF3 (Arexvy; GSK), RSVpreF (Abrysvo; Pfizer), or mRNA-1345 (mRESVIA; Moderna)—for all adults 75 years and older, along with individuals aged 60 to 74 years who are at increased risk of severe illness. Arexvy was the first RSV vaccine approved by the FDA in May 2023 for adults 60 years and older, followed by Abrysvo, also in May 2023, and mRESVIA in May 2024; however, their indications have been updated since their initial approval.⁴

RSV Vaccine Effectiveness in Older Adults Across Seasons

Researchers conducted a test-negative, case-controlled study, including a total of 6958 adults aged 60 years and older who were hospitalized for an acute respiratory illness during 2 RSV seasons: October 1, 2023, to March 31, 2024, and October 1, 2024, to April 30, 2025. Patients were included if they were tested for RSV, COVID-19, or influenza shortly after their illness began and their hospital admission. RSV was also systemically tested from nasal swabs at a central lab. The study authors noted that case patients were those who tested positive for RSV. Control patients were those who tested negative for RSV, COVID-19, and influenza. Patients with COVID-19 or influenza infections were not included in the control group. Using a multivariable logistic regression method, researchers compared the odds of being vaccinated against RSV between those who had RSV and those who did not.^1,2

Among the 6958 individuals, 821 have RSV and 6137 do not. The results demonstrated that RSV vaccination was 58% effective at preventing hospitalization over 2 seasons. However, when given in the same season, its effectiveness was higher at 69% compared to 48% when given in the previous season.^1,2

Further results found that the vaccine was less effective in individuals that were immunocompromised at 30%, compared to 67% among those who were not. It was also 56% effective in individuals with cardiovascular disease compared to 80% in those without.^1,2

“Our data show that the beneficial effects of RSV vaccines appear to wane over time,” Self said in the news release. “Redosing the vaccine at some interval after the initial dose could be a strategy to maintain protection over longer periods of time. It will be important to continue to closely monitor vaccine effectiveness over time to understand how long the benefit lasts after a single dose and if repeat dosing should be considered.”²

REFERENCES

1. Surie D, Self WH, Yuengling KA, et al. RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons. JAMA. Published online August 30, 2025. doi:10.1001/jama.2025.15896

2. One shot of RSV vaccine effective against hospitalization in older adults for two seasons. EurekAlert! News Release. August 30, 2025. Accessed September 4, 2025. https://www.eurekalert.org/news-releases/1096473

3. RSV in Adults. CDC. News release. Updated July 8, 2025. Accessed August 7, 2025. https://www.cdc.gov/rsv/adults/index.html

4. RSV Vaccines. CDC. News release. August 30, 2024. Accessed April 17, 2025. https://www.cdc.gov/rsv/vaccines/index.html

The eye, like most organs, has an intricate plumbing system. Pressure builds when drainage is impaired, and this condition – glaucoma – can cause irreversible vision loss. Certain popular anti-inflammatory eye medications that contain steroids can in some cases compound the problem, although scientists have been at a loss to understand why.

Now, Cornell researchers have identified the signaling mechanism that triggers steroid-induced glaucoma by creating a 3D “eye-on-a-chip” platform that mimics the flow of ocular fluids.

The findings were published Aug. 27 in Nature Cardiovascular Research. The lead author is Renhao Lu, Ph.D. ’24.

Steroid-induced glaucoma is a major clinical challenge. There’s no targeted therapy. We just say you are unlucky. There is a clear, unmet need to better understand, and prevent, this major side effect of the steroid in the clinics.”

Esak (Isaac) Lee, senior author, assistant professor of biomedical engineering at Cornell Engineering

Glaucoma is typically studied in animal models and simple 2D cell cultures, but those approaches often fail to capture the anatomical complexity and responsiveness of the human eye. 

The solution from Lee’s lab, which studies lymphatic systems in different types of organs, has been to create 3D in-vitro models that can reproduce the systems’ layered structures while isolating biological and biophysical factors, all in a highly reproducible and controlled manner. Lee previously co-designed such a device that revealed a protein that jams up the necessary drainage in human skin lymphatic vessels, causing the painful swelling known as lymphedema.

The eye’s lymphatic vessels are responsible for draining aqueous humor, a clear, water-like fluid that provides oxygen and nutrients but, when not removed, can cause intraocular pressure (IOP) to build, damaging neurons in the retina that are critical for transmitting light signals to the brain.

Lee’s team realized the lymphatics in the eye, known as Schlemm’s canal (SC) cells, are quite different from those in the skin, lungs and other organs. These are surrounded by another cell type: trabecular meshwork (TM). Only with both cell layers working in conjunction can the lymphatic system flush the overproduced aqueous humor back into the bloodstream.

The team built a 3D in-vitro device, known as a microphysiological system (MPS), with a double layer of TM and SC cells, with a curvature that mimicked the conduit structure of lymphatic vessels in the eye. The researchers treated the “eye-on-a-chip” with the anti-inflammatory steroid dexamethasone, which significantly impaired the drainage.

This enabled the researchers to identify the culprit: A key receptor in TM cells, ALK5, responded to the steroid by downregulating a protein, vascular endothelial growth factor C (VEGFC), which normally loosens the endothelial junctions in SC cells, enabling fluid to pass through the endothelial wall. But that function was disrupted by ALK5/VEGFC signaling.

“This communication causes the Schlemm’s canal junction abnormality,” Lee said. “The junctions become really thickened or tightened under the steroid, and that junction change increased the resistance of the outflow, causing this glaucoma.”

The researchers confirmed the role of the mechanism in a mouse model. The finding opens up two paths to treating glaucoma: blocking ALK5 function; or providing additional VEGFC to the eye along with the steroid treatment.

“We are now aiming to study other targets. There are some genes that people know are important for glaucoma, not just steroid-induced, and we could knock them out in these two cell types,” Lee said. “It’s complicated and difficult to target one cell type in conventional animal models, but in this system, we could do any genetic modification of these two cell types separately, and then combine them in the device to get a better understanding of these different mechanisms and different types of glaucoma.”

Co-authors include postdoctoral researcher Anna Kolarzyk, Ph.D. ’25, and W. Daniel Stamer, professor of ophthalmology at Duke University.

The researchers made use of the Cornell NanoScale Science and Technology Facility and was supported by the National Institutes of Health and the BrightFocus Foundation.

The Asbestos Disease Awareness Organization will host its 20th annual Asbestos Awareness and Prevention Conference on September 12 and 13 in New York City at the Westin Grand Central hotel. Global experts will discuss diagnosing, treating and preventing asbestos-related diseases like mesothelioma, as well as policy, advocacy and asbestos law. 

Linda Reinstein, ADAO co-founder and president, tells us this conference is unique. Reinstein shares, “This conference is about using what we know, advancing what we should know and getting to a learned place so we can prevent asbestos exposure.”

The event will start at 4:30 p.m. on Friday, September 12 with a candlelight vigil at the World Trade Center Memorial. Participants will honor those who have died of 9/11-connected asbestos exposure. 

Following the vigil, an awards and recognition ceremony will take place. Public health leaders and dedicated asbestos advocates will receive awards. The evening will also feature a special music performance from Jordan Zevon, a singer and songwriter who advocates for awareness about the dangers of asbestos.

9/11 Ongoing Health Crisis and Dr. Selikoff’s Enduring Legacy

This year’s event begins the day following the 24th anniversary of the September 11 attacks. The conference will focus on the ongoing public health crisis affecting first responders and recovery workers exposed to asbestos at Ground Zero. First responders like firefighters have developed serious illnesses linked to asbestos, including mesothelioma, which can take decades to appear. 

ADAO continues to honor them and push for safer conditions for first responders and the public. Reinstein says, “Our annual conference is a place to exchange life-saving knowledge, honor those we’ve lost, and galvanize our efforts to ban asbestos and prevent exposure.” 

The theme of the 2025 conference is “Building on Dr. Selikoff’s Legacy in Asbestos Science, Prevention and Justice.” During the 1950s, New York physician Dr. Irving Selikoff discovered a pattern of serious illnesses among asbestos workers. By 1964 his work proved the toxic mineral increased the risk of several deadly diseases. 

Dr. Selikoff pioneered and transformed our understanding of asbestos exposure and asbestos-related diseases. Reinstein notes, “Gathering together in New York City is especially meaningful as we reflect on the legacy of Dr. Selikoff and the sacrifices of 9/11 responders.”

Academic Session at Mount Sinai Hospital

The academic session on September 13 will run from 9 a.m. to 5 p.m. at Mount Sinai Hospital. Leading medical professionals, scientists, legal experts and advocates will present information across multiple topics. 

Medical experts will cover new breakthroughs in diagnosis, treatment and prevention strategies. Legal experts and advocates will discuss efforts to hold companies accountable and the push for a global asbestos ban.

2025 ADAO Conference Agenda

• Session 1: From Then to Now, Selikoff’s Vision and Our Journey Forward
• Session 2: Diagnosing and Treating Asbestos-Related Diseases
• Session 3: Prevention Is the Cure, Strategies for Exposure Reduction
• Session 4: Dr. Irving Selikoff, Paul Brodeur and Beyond 
• Session 5: Asbestos and the Law

Tickets are still available for people who want to join. Visit ADAO’s official conference site to register and learn more.

Intense light therapy after surgery can increase a critical protein that protects heart tissue while lowering levels of troponin, a protein indicating heart damage that’s linked to higher mortality in patients undergoing non-cardiac surgery, according to a study by researchers at CU Anschutz.

The study was published this week in the Annals of Translational Medicine.

The results add to a growing body of evidence showing that intense light has a healing effect on the heart and blood vessels, a finding that could help reduce the number of cardiac events that happen after surgery. Myocardial Injuries in Noncardiac Surgeries (MINS) occur in about 20% of patients and significantly increase one year mortality rates.

The risk of myocardial injury goes up after certain surgeries and is significantly higher in patients older than 45. In tests on humans and animal models we found that intense light can significantly reduce troponin release. High levels of troponin following non-cardiac surgery can lead to death. Blocking it could be a very novel therapy for MINS – a disease without therapy.”

Tobias de la Garza Eckle, MD, PhD, FASA, study’s senior author, professor of anesthesiology, CU Anschutz School of Medicine

Eckle’s previous studies using rodent models have shown that bright light can strengthen the endothelium or lining of the blood vessels. The protection comes from a protein called PER2 which works with fellow protein HIF1A to boost levels of yet another protein ANGPTL4, a key player in vascular health.

In this study, the researchers gave some patients having routine spine surgery intense light therapy for 30 minutes at sunrise for five days. The light increased ANGPTL4 levels and lowered troponin levels. Those who didn’t receive the therapy saw troponin levels increase.

Eckle said bright light therapy increases the circadian rhythm amplitude and protects the heart before and after myocardial injury. The protection relies on the presence of the PER2 protein, but Eckle’s team found that ANGPTL4 protein therapy can protect the heart even when PER2 is missing.

“This ANGPTL4 protein therapy could be a promising strategy to reduce myocardial injury to patients one day,” Eckle said. “We have started using intense light therapy in patients and have seen similar pathways are activated in humans as they are in animal models. A clinical trial will be necessary to understand the real impact of intense light therapy on Myocardial Injury in Noncardiac Surgery.”

This study was funded by an R56 from the National Heart, Lung and Blood Institute.

A new study in mice provides insights into why females in their reproductive years appear to be relatively protected from chronic kidney disease, a leading public health concern. The study reports that estrogen-regulated signaling promotes the regeneration of key filtration cells in female kidneys. The study also links pregnancy complications like preeclampsia to failures in this regenerative process. Chronic kidney disease (CKD) – which affects more than 10% of the global population – is a leading public health concern, not only because it can lead to fatal kidney failure, but also because it increases the risk of cardiovascular disease. Within the next 20 years, CKD is expected to become the fifth leading cause of death globally.

Previous research has shown that sex differences play a notable role in disease progression: men are at higher risk for CKD, while women of reproductive age appear to be relatively protected. Although this suggests that female sex hormones, like progesterone and estrogen, may have a protective effect in the development of CKD, the mechanisms underlying the observed sex-based differences in disease susceptibility remain poorly understood.

Through lineage tracing, single-cell RNA sequencing, and an analysis of mouse models and human tissue and urine samples, Carolina Conte and colleagues show that female kidneys possess a greater capacity to regenerate key filtering cells, called podocytes, from renal progenitor cells. The cells are regenerated through estrogen receptor–dependent signaling, which protects against kidney disease and hypertension during reproductive years. What’s more, the authors found that this effect intensified in pregnant mice as kidneys adapted to a higher workload. However, when this regenerative capability is compromised, such as in preeclampsia, mouse mothers face heightened long-term risks of kidney disease and hypertension. At the same time, their offspring are predisposed to poor nephron development, low birth weight, and later-life cardiovascular and renal problems.

According to Conte et al., the findings indicate that preeclampsia may arise from a failure of kidney progenitor cells to supply sufficient podocytes, linking maternal kidney health directly to pregnancy outcomes. This link offers new insights into potential therapeutic opportunities.

Following injury from a heart attack, immune cells called neutrophils release a peptide that punctures stressed heart cells and destabilizes their electrical activity. This triggers life-threatening arrhythmias. These findings offer a novel explanation – and potential therapeutic target – for these deadly cardiac events. Ischemic heart disease – cardiac damage caused by narrowed coronary arteries – is among the leading causes of death worldwide. It can lead to heart attacks and sudden cardiac death. When a coronary artery becomes blocked, cardiomyocytes experience oxygen deprivation, which disrupts their ability to manage ions like sodium and calcium, leading to dangerous electrical instability and life-threatening arrhythmias, for which there are few treatment options beyond defibrillation. Most arrhythmias occur within the first 2 days after a heart attack, which coincides with the characteristic cellular inflammatory response to the cardiac injury. Neutrophils, which are recruited in high numbers during this response, are known to interfere with normal cellular electrical conduction and are implicated in unintended tissue damage. While this highlights neutrophils as a potential target for future therapies, their full role in promoting arrhythmias isn’t fully understood.

Using mouse models of ischemic injury alongside human tissue and cell studies, Nina Kumowski and colleagues identified the peptide resistin-like molecule γ (Retnlg or RELMγ) as a key neutrophil-derived factor that promotes arrhythmias after a heart attack. According to Kumowski et al., RELMy – an antimicrobial pore-forming peptide – destabilizes heart rhythm by binding to and attacking stressed cardiomyocytes. Once bound, the peptide punctures the cardiomyocyte membranes, creating pores that alter cellular ion flux, triggering delayed depolarization, cell death, and the formation of tissue abnormalities that promote arrhythmia. In mouse models, removing RELMγ from neutrophils reduced ventricular arrhythmia 12-fold, supporting findings that the peptide drives electrical instability in the injured heart. Notably, the human homolog of this peptide, resistin (RETN), was detected in infarcted human myocardial tissue samples, and higher circulating RETN levels correlated with worse patient outcomes, highlighting its potential clinical relevance. In a related Perspective, Edward Thorp discusses the study in greater detail.

Researchers from Flinders University have found a severe emotional and physical burden among pregnant women with extreme morning sickness, publishing their findings in PLOS One.¹

The data also indicated significant rates of considering pregnancy termination, alongside 9 in 10 pregnant women with extreme morning sickness considering not having more children. This highlights the debilitating nature of the condition and the inconsistent efficacy of common treatment methods.

“Women are often prescribed multiple medications in an attempt to manage their symptoms, but the reality is that many of these treatments come with their own burdens,” said Luke Grzeskowiak, PhD, associate professor at Flinders University.

Survey characteristics

The cross-sectional online survey study was conducted to evaluate treatment usage and experiences among women with severe nausea and vomiting of pregnancy (NVP) or hyperemesis gravidarum (HG).² Participants included women residing in Australia with prior or current NVP or HG experience.

There were 4 parts to the study survey, which was completed online between July and September 2020. These parts included respondent characteristics, awareness, and perceived safety of treatments, characteristics of HG, and quality of life impact, and personal experiences.

Quality of life impacts were reported on a 5-point Likert scale, with higher scores indicating a greater impact. Additional questions gauged considerations for pregnancy termination, depression and anxiety experiences, and requests for induction or elective cesarean section.

Treatment experiences included treatment methods used, week of pregnancy beginning or stopping treatment, treatment duration, side effects, reasons for termination, and perceived efficacy of treatment on a 5-point Likert scale. Two consumer representatives and 2 clinical experts assessed the survey’s face validity.

Onset and severity of symptoms

There were 289 participants aged a mean of 33 years included in the final analysis. Of these, 38% were currently pregnant, 94% Caucasian, 95% married, and 87% with complete secondary education. One or more prior births were reported in 88% and not smoking in the current or prior pregnancy in 96%.

NVP onset occurred at a median 6 weeks’ gestation, with all cases beginning during the first trimester. Weight loss during pregnancy was reported by 75% of participants, ranging from 1 to 40 kg, and with a median of 7 kg. Moderate NVP was reported in 41% of participants and severe NVP in 59%.

A formal HG diagnosis was given to 76% of respondents, while 72% were admitted to the hospital for IV fluids during pregnancy. Difficulty eating or drinking as normal was reported by 98% and feelings of anxiety or depression because of HG symptoms by 62%. Thirty-seven percent requested labor induction because of their symptoms.

Considering pregnancy termination was reported by 54% of respondents, and not having more children by 90%. Over half of respondents experienced significant impacts of HG on aspects of life, including social life, work, sleep, ability to undertake daily chores, ability to eat or drink, and taking care of pre-existing children.

Complexity of medication use

The use of at least 1 antiemetic during pregnancy was reported by all participants. A mean of 4.2 antiemetics were used, with a range of 1 to 9. Ondansetron was the most common antiemetic used by 91% of participants, followed by pyridoxine in 70%, doxylamine in 70%, metoclopramide in 69%, and ginger in 53%.

Only 7% of respondents used a single antiemetic in pregnancy. Ginger, metoclopramide, ondansetron, and pyridoxine were initiated earlier than other treatments, at a median 6 weeks’ gestation for each antiemetic. The latest median time of initiation at 12 weeks’ gestation was reported for corticosteroids.

The shortest durations of use were reported for ginger, metoclopramide, and prochlorperazine, at 2 to 4 weeks, while doxylamine and ondansetron had the longest median durations of 16 and 20 weeks, respectively.

Side effects were reported in 78% of women taking doxylamine, 73% ondansetron, and 72% promethazine. Thirty-one percent taking metoclopramide ceased treatment because of side effects, vs 24% for ginger and 23% for prochlorperazine. Common side effects included constipation, sedation, and mood disorders.

Implications

Over half of respondents taking corticosteroids, ondansetron, and doxylamine reported the medication to be effective. However, under 10% reported efficacy for pyridoxine or ginger. This highlighted a complex landscape of medication use for severe NVP and HG.

“We need to move away from a one-size-fits-all approach and toward personalized care that recognizes the full impact of HG,” said Caitlin Kay-Smith, study co-author and founder of Hyperemesis Australia.

References

1. Emotional and medical toll of extreme pregnancy nausea, with many women considering ending pregnancies. Flinders University. September 3, 2025. Accessed September 4, 2025. https://www.eurekalert.org/news-releases/1096797.
2. Wills L, Hsiao H, Thomas A, Kay-Smith C, Henry A, Grzeskowiak LE. Assessing the burden of severe nausea and vomiting of pregnancy or hyperemesis gravidarum and the associated use and experiences of medication treatments: An Australian consumer survey. PLOS One. 2025. doi:10.1371/journal.pone.0329687

Researchers from Flinders University have found a severe emotional and physical burden among pregnant women with extreme morning sickness, publishing their findings in PLOS One.¹

The data also indicated significant rates of considering pregnancy termination, alongside 9 in 10 pregnant women with extreme morning sickness considering not having more children. This highlights the debilitating nature of the condition and the inconsistent efficacy of common treatment methods.

“Women are often prescribed multiple medications in an attempt to manage their symptoms, but the reality is that many of these treatments come with their own burdens,” said Luke Grzeskowiak, PhD, associate professor at Flinders University.

Survey characteristics

The cross-sectional online survey study was conducted to evaluate treatment usage and experiences among women with severe nausea and vomiting of pregnancy (NVP) or hyperemesis gravidarum (HG).² Participants included women residing in Australia with prior or current NVP or HG experience.

There were 4 parts to the study survey, which was completed online between July and September 2020. These parts included respondent characteristics, awareness, and perceived safety of treatments, characteristics of HG, and quality of life impact, and personal experiences.

Quality of life impacts were reported on a 5-point Likert scale, with higher scores indicating a greater impact. Additional questions gauged considerations for pregnancy termination, depression and anxiety experiences, and requests for induction or elective cesarean section.

Treatment experiences included treatment methods used, week of pregnancy beginning or stopping treatment, treatment duration, side effects, reasons for termination, and perceived efficacy of treatment on a 5-point Likert scale. Two consumer representatives and 2 clinical experts assessed the survey’s face validity.

Onset and severity of symptoms

There were 289 participants aged a mean of 33 years included in the final analysis. Of these, 38% were currently pregnant, 94% Caucasian, 95% married, and 87% with complete secondary education. One or more prior births were reported in 88% and not smoking in the current or prior pregnancy in 96%.

NVP onset occurred at a median 6 weeks’ gestation, with all cases beginning during the first trimester. Weight loss during pregnancy was reported by 75% of participants, ranging from 1 to 40 kg, and with a median of 7 kg. Moderate NVP was reported in 41% of participants and severe NVP in 59%.

A formal HG diagnosis was given to 76% of respondents, while 72% were admitted to the hospital for IV fluids during pregnancy. Difficulty eating or drinking as normal was reported by 98% and feelings of anxiety or depression because of HG symptoms by 62%. Thirty-seven percent requested labor induction because of their symptoms.

Considering pregnancy termination was reported by 54% of respondents, and not having more children by 90%. Over half of respondents experienced significant impacts of HG on aspects of life, including social life, work, sleep, ability to undertake daily chores, ability to eat or drink, and taking care of pre-existing children.

Complexity of medication use

The use of at least 1 antiemetic during pregnancy was reported by all participants. A mean of 4.2 antiemetics were used, with a range of 1 to 9. Ondansetron was the most common antiemetic used by 91% of participants, followed by pyridoxine in 70%, doxylamine in 70%, metoclopramide in 69%, and ginger in 53%.

Only 7% of respondents used a single antiemetic in pregnancy. Ginger, metoclopramide, ondansetron, and pyridoxine were initiated earlier than other treatments, at a median 6 weeks’ gestation for each antiemetic. The latest median time of initiation at 12 weeks’ gestation was reported for corticosteroids.

The shortest durations of use were reported for ginger, metoclopramide, and prochlorperazine, at 2 to 4 weeks, while doxylamine and ondansetron had the longest median durations of 16 and 20 weeks, respectively.

Side effects were reported in 78% of women taking doxylamine, 73% ondansetron, and 72% promethazine. Thirty-one percent taking metoclopramide ceased treatment because of side effects, vs 24% for ginger and 23% for prochlorperazine. Common side effects included constipation, sedation, and mood disorders.

Implications

Over half of respondents taking corticosteroids, ondansetron, and doxylamine reported the medication to be effective. However, under 10% reported efficacy for pyridoxine or ginger. This highlighted a complex landscape of medication use for severe NVP and HG.

“We need to move away from a one-size-fits-all approach and toward personalized care that recognizes the full impact of HG,” said Caitlin Kay-Smith, study co-author and founder of Hyperemesis Australia.

References

1. Emotional and medical toll of extreme pregnancy nausea, with many women considering ending pregnancies. Flinders University. September 3, 2025. Accessed September 4, 2025. https://www.eurekalert.org/news-releases/1096797.
2. Wills L, Hsiao H, Thomas A, Kay-Smith C, Henry A, Grzeskowiak LE. Assessing the burden of severe nausea and vomiting of pregnancy or hyperemesis gravidarum and the associated use and experiences of medication treatments: An Australian consumer survey. PLOS One. 2025. doi:10.1371/journal.pone.0329687

Polyethylene terephthalate microplastics (PET-MPs) may initiate and exacerbate the progression of idiopathic pulmonary fibrosis (IPF), a new study found.

The findings come as public health officials have raised concerns about the potential health implications of microplastics. The report was published in the journal Ecotoxicology and Environmental Safety.¹

While the underlying mechanisms behind the development of IPF are not yet fully understood, previous research has shown that environmental factors, including cigarette smoke and airborne particles, can contribute to the disease’s initiation and development, explained corresponding author Bing Bai, PhD, of the Fifth Affiliated Hospital of Zhengzhou University in China, and colleagues.²

The potential role of environmental factors is an important research topic, Bai and colleagues said, because the incidence of IPF is rising swiftly. A 2015 study, for instance, found that the global incidence of IPF was rising by approximately 11% per year.³

Bai and colleagues explored the potential role of microplastics in the rising rates of IPF.¹ Defined as plastic particles smaller than 5 mm, microplastics enter the environment via industrial emissions, plastic degradation, and household products. From there, ingestion, inhalation, and dermal contact can all lead to the microplastics entering the human body.

PET-MPs are the most common microplastics encountered in daily life, the authors explained, and there are several reasons why they may play a role in lung diseases like IPF.

“PET-MPs can induce oxidative stress, mitochondrial damage, and inflammatory responses in pulmonary cells, contributing to chronic lung injury,” the authors wrote, adding that PET-MP particles smaller than 10 μm can penetrate the alveolar barrier and accumulate in lung tissue, leading to a fibrosis-like pathology.

Yet, there is “scarce” research examining potential links between PET-MPs and the onset or exacerbation of IPF, the investigators noted. Bai and colleagues said they suspected that PET-MPs might contribute to IPF by modulating certain key molecular targets and signaling pathways.

To test the hypothesis, the investigators used public databases and a toxicity-prediction tool called ProTox 3.0 to identify potential targets and analyze their potential roles in IPF. They used network toxicology, molecular docking, Mendelian randomization, and single-cell sequencing analysis.

In the end, they identified 3 core targets through which they believe PET-MPs might aggravate IPF: AKT1, PIM1, and PIK3CD. The microplastics appear to affect metabolic, lipid, atherosclerosis, and C-type selection receptor signaling pathways, the authors said. They added that the binding affinity of PET-MPs to these core targets was “potent.”

The lung toxicity of PET-MPs may be associated with the proteins AKT1, PIK3CD, and PIM1, the authors said, and they said AT2 and CD8+ T cells are susceptible to the fibrotic effects induced by PET-MPs.

Bai and colleagues said the data show that prolonged exposure to microplastics is linked with the development of pulmonary interstitial fibrosis, and therefore they said it is urgent that regulators adopt better ways to track and restrict microplastics in the environment.

“Furthermore, establishing long-term exposure databases and conducting multi-regional cohort studies will be key to assessing population-level health impacts,” they wrote.

It will also be important to raise public awareness of the dangers of microplastics so that individuals—and their employers—can take steps to mitigate exposure.

The authors cautioned that their work was based on modeling toxicity using publicly available databases, adding that it is very difficult to adequately replicate long-term, low-dose exposure to microplastics. They concluded their hypotheses will require validation through both in vitro and in vivo experiments.

References

1. Zhao W, Yang S, Hu S, Feng Y, Bai B. Polyethylene terephthalate microplastics promote pulmonary fibrosis via AKT1, PIK3CD, and PIM1: A network toxicology and multi-omics analysis. Ecotoxicol Environ Saf. Published online August 27, 2025. doi:10.1016/j.ecoenv.2025.118954

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