Category: 8. Health

  • Between politicisation and securitization – Middle East Monitor

    Between politicisation and securitization – Middle East Monitor

    During humanitarian crises and armed conflicts, children are the most vulnerable to the devastating consequences, such as the outbreak and resurgence of diseases like polio. Mainly children under the age of five are affected by polio, with prevention proving the only effective strategy to confront it, as there are no proven curative approaches yet. Some Arab countries are at great risk of witnessing a polio outbreak, with protracted crises and ongoing instability, and the subsequent paralysis in health systems, making the region more prone to such epidemics. For instance, over half of the attacks reported during armed conflicts in 2024 on health care took place in the Middle East, revealing the extreme vulnerability of public health—especially the health of children—in the region. 

    As a result, armed crises and humanitarian disasters led to declined national and subnational polio vaccination coverage, putting the lives of children at grave risk in the Arab world. With the recent conflicts, a wave of new polio cases has emerged in the Arab region, raising critical concerns about the effectiveness and applicability of standard strategies for enhancing immunisation against polio in complex and crisis-prone settings.

    Contextualizing polio in the Arab world 

    The ongoing securitisation and politicisation of polio immunisation in the Arab world undermined the health systems’ capacities to develop and implement prevention strategies. This further marginalised vulnerable populations and resulted in cycles of disease and health injustice. 

    Internationally, the Global Polio Eradication Initiative (GPEI) has contributed significantly to decreasing polio cases by 99.9 per cent. However, certain factors lead to the repeated failure of GPEI in crisis-affected contexts in the Arab world. These obstacles include limited access to healthcare institutions, deliberate targeting of hospitals and ambulances, weaponising medical aid and lack of safety and security for health workers to operate. 

    READ: Gaza’s Health Ministry warns of ‘health disaster’ amid Israeli ban on polio vaccines

    In light of chronic conflicts, massive refugee crises and the collapse of health systems in the Arab world, new polio cases have been reported in the past decades. For instance, with the outbreak of the crisis in Gaza in 2023, a confirmed case of polio was detected in August, 2024, the first case in 25 years. However, the Israeli aid blockade and policies aimed at controlling what is going in Gaza played a critical role in undermining the effectiveness of response or prevention mechanisms to polio risks in Gaza. Syria is another prominent example of how political instability and security threats weaken health responses to polio crisis. The country experienced two polio outbreaks in 2013 and 2017, highlighting the fragility of Syria’s immunisation strategies, after which the outbreaks were controlled through intensive polio vaccination campaigns and surveillance. Other crisis-affected Arab countries, such as Yemen and Iraq, have also been affected by polio in the last decade. Thus, wars and humanitarian crises are the most significant drivers for the polio outbreaks and the inability of health systems to effectively face and contain such health crises.

    Severe implications for the future generations

    Ineffective polio immunisation poses a severe threat to future generations in the already deteriorated Arab world. Given the unprecedented cross-border displacement in the region and the cross-border poliovirus transmission, this underlines the urgency of the issue for the whole region. Millions of people are fleeing Syria, Iraq, Yemen and Palestine, carrying the risk of transmitting poliovirus to refugee-hosting countries, such as Lebanon and Jordan, that already struggle with responding to the increasing health needs of refugees. This not only puts the lives of millions of children in the region and the wider Global South, with a long history of conflicts and health inequity, at severe risk, but also raises concerns about the potential of polio becoming a global pandemic.

    Recognising these and failing to act upon them forms an intentional killing of future generations, particularly children who are vulnerable among already marginalised populations, such as refugees and stateless children. The region has for decades been prone to intrastate and interstate conflicts. Thus, the absence of context-specific mechanisms to prevent the outbreak of diseases like polio is either a deliberate failure or an example of the ineffectiveness of global health governance. In the long run, overlooking the future of these children’s health damages trust in public health in conflict settings. Moreover, the hierarchical structure in the international order, where the Global North monopolises the essential health-related financial and technical resources, also plays a key role in depriving children of the right to polio immunisation.

    The power of context-sensitive immunisation action plans for healthier generations

    Due to the unique context of the Arab World, effective polio response and prevention necessitates strategies that are deeply attuned to local realities, driven by community-based health initiatives, and leverage diplomacy as a vital instrument.

    There needs to be a medical focus, led by local health workers and medical humanitarian institutions, on pre-crisis polio prevention. Given the unique context of the conflict-prone Arab world, it is important to start with raising awareness about polio resistance through prevention and strengthening the immunisation infrastructure. These strategies are central in both peacetime and wartime, urging local medical mobilisation to fight polio in the Arab region. Moreover, in contexts affected by complex crises, local actors are situated as the most decisive actors to take on the role and alleviate the polio risks caused by armed conflicts. Thus, community-level and mobile vaccination campaigns, using inactivated polio vaccine (IPV) and oral polio vaccine (OPV), emerge as critical tools, leveraging the profound knowledge of local context and easier access to isolated areas. 

    In the face of politicisation and securitisation of polio vaccination efforts, a strong political and diplomatic commitment is essential to ensure effective and timely response and prevention mechanisms. Thus, the role of public health diplomacy must me highlighted, since it lies at the heart of effective immunisation strategies by engaging key stakeholders—including key states, World Health Organizations, and United Nations—towards one aim, that is protecting children from polio to build stronger generations in future. This is fundamental for both the response phase during or after crises and preparedness in crisis-prone settings to prevent any occurrence of polio case. More importantly, vaccine diplomacy—utilising polio vaccine development, distribution and safe access as a tool of diplomacy and foreign policy—emerges as a key policy and advocacy strategic approach not only to confront but also to put an end to polio.

    OPINION: Trump’s move to lift sanctions against Syria: A humanitarian move or carrot-and-stick politics?

    The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.

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  • Cohort profile of the Heidelberg study on diabetes and complications HEIST-DiC

    Cohort profile of the Heidelberg study on diabetes and complications HEIST-DiC

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  • Long COVID linked to lasting financial hardship and work disruption

    Long COVID linked to lasting financial hardship and work disruption

    While the economic impact of the COVID-19 pandemic continues to be widely studied and debated, the financial toll of the COVID-19 pandemic for individual patients is less understood. To address this gap, Rush University Medical Center analyzed self-reported data from more than 3,600 participants in the INSPIRE (Innovative Support for Patients with SARS-CoV-2 Infections Registry) to assess return-to-work, work productivity, and financial toxicity.

    The INSPIRE study found that individuals with long COVID-19 experienced worse financial and employment outcomes – lasting up to three years after their initial infection. Notably, vaccination against COVID-19 was associated with strikingly improved work and financial outcomes. The study, “Work Impairment and Financial Impact among Adults With vs. Without Long COVID“, was published Aug. 12 in JAMA Network Open.

    INSPIRE is a CDC-funded multi-center collaboration including eight academic medical centers seeking to better understand the long-term effects of COVID-19. 

    “While much of the focus in Long COVID research has been on the medical impact, we must also consider the sustained financial burden faced by those whose symptoms persist,” said lead author Michael Gottlieb, MD, an emergency medicine physician and vice chair of research at Rush University Medical Center Gottlieb and co-authors suggest that better understanding of the economic challenges millions of Americans face can lead to better workplace policies, disability support systems, and health care strategies. 

    Of the more than 777 million reported cases of COVID-19 worldwide, data compiled by the Agency for Healthcare Research and Quality suggest that approximately 13% of patients experience persistent symptoms lasting three months or longer, a condition which is commonly referred to as long COVID.

    Gottlieb and colleagues working on the INSPIRE research already have contributed valuable scientific data about the medical nature of Long COVID, such as identifying that it is not a single condition but rather four distinct symptom patterns, called phenotypes, which can help guide treatments. INSPIRE’s unique, long-standing self-reported survey structure also helps researchers better understand and measure the financial burdens associated with the illness and, importantly, the beneficial effect of prior vaccination. Researchers used survey responses to track the degree of missed work and work impairment and a tool long used by cancer researchers to calculate “financial toxicity,” which estimates the negative consequences experienced by patients due to the cost of medical care. 

    Three years of study data revealed that those with Long COVID continue to experience significantly higher odds of missing more work per week than those who did not have Long COVID. Nearly half of participants currently experiencing Long COVID had not returned to full-time work within three years of their initial infection. 

    Financial toxicity scores also showed that those with Long COVID had more than three-times higher odds of moderate-to-high financial toxicity compared to those whose Long COVID symptoms had resolved, and more than five-times higher odds compared to those who never experienced Long COVID.

    Authors noted that this financial strain could be caused by medical expenses, job loss, reduced work-hours due to limited work capacity, or lower work productivity resulting in reduced bonuses or raises. 

    Gottlieb emphasized that vaccination status had a clear impact on rates of work impairment and financial toxicity scores with markedly better outcomes in the vaccinated patients compared with the unvaccinated patients. This is consistent with other recent research from their team which also identified improved physical and mental health outcomes among those who were vaccinated against COVID.

    “Throughout all or our research, whether someone was vaccinated was shown to be strongly associated with more symptom reduction and measurably better quality of life. The COVID-19 vaccine kept us healthier – both physically and financially.” 

    Source:

    Rush University Medical Center

    Journal reference:

    Gottlieb, M., et al. (2025). Work Impairment and Financial Outcomes Among Adults With vs Without Long COVID. JAMA Network Open. doi.org/10.1001/jamanetworkopen.2025.26310,

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  • Women with Down syndrome show more advanced Alzheimer’s signs at diagnosis

    Women with Down syndrome show more advanced Alzheimer’s signs at diagnosis

    According to research by the University of California, Irvine, women with Down syndrome have more advanced signs of Alzheimer’s disease than men do at the average age of diagnosis, which is the same for both sexes. The findings, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, can shape how we understand and approach treatments for Alzheimer’s in this population and beyond. The National Institutes of Health supported the study.

    If women with Down syndrome are further along in disease progression at the time of diagnosis, it could change how we time interventions and interpret outcomes in clinical trials. This research could help tailor therapies more effectively, not just for people with Down syndrome, but for the broader Alzheimer’s population as well.”


    Elizabeth Head, corresponding author, UC Irvine professor of pathology

    Alzheimer’s disease is the primary cause of death for individuals with Down syndrome, who are genetically predisposed to develop the condition earlier in life. While previous studies observed that women with Down syndrome may live longer with dementia than men who have Down syndrome, few have looked closely at whether the underlying brain pathology differs by sex. In this study, the researchers examined postmortem brain samples from the UC Irvine Alzheimer’s Disease Research Center Brain Tissue Repository and the NIH NeuroBioBank, measuring levels of two hallmark Alzheimer’s proteins: beta amyloid and phosphorylated tau.

    The results suggest that women with Down syndrome may carry a higher burden of these disease-related proteins than men, particularly in the occipital lobe, which is an area typically affected later in disease both for people with Down syndrome and for women with sporadic Alzheimer disease – the more common, late-onset form of Alzheimer’s that occurs without a clear genetic cause.

    This insight points to the need for more sex-specific approaches in both Alzheimer’s research and treatment planning, especially in the design of clinical trials.

    “Understanding selective vulnerabilities within the brain and how these differ in women versus men will help us to better navigate treatment outcomes. We’re learning the importance of modifiable risk factors, which includes accounting for sex-specific risk,” said the study’s lead author, Elizabeth Andrews, a Ph.D. candidate in Head’s lab group.

    The research team will next investigate whether sex-based differences extend to other types of pathology – such as blood vessel integrity, white matter connectivity and additional contributors to dementia – and how those findings correlate with biomarker data collected during life. These efforts will help advance the field of precision medicine and offer more personalized strategies for Alzheimer’s care and prevention.

    Source:

    University of California – Irvine

    Journal reference:

    Andrews, E. J., et al. (2025). Age and sex are associated with Alzheimer’s disease neuropathology in Down syndrome. Alzheimer’s & Dementia. doi.org/10.1002/alz.70408.

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  • Mount Sinai receives major grant for new initiative dedicated to reducing cancer care disparities

    Mount Sinai receives major grant for new initiative dedicated to reducing cancer care disparities

    The American Cancer Society (ACS) has awarded The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai a $4.08 million grant to establish the Cancer Health Research Center at Mount Sinai, a new initiative dedicated to reducing cancer-related health inequities across New York City.

    The Center aims to become a leading model for community-driven research that addresses disparities across the cancer care continuum, from prevention to end-of-life support. The primary goal of the Center is to conduct research focused on community-engaged navigation to address multi-level social determinants of health.

    The center will collaborate closely with its community advisory board and its expanding network of trained Community Scientists to ensure that every research initiative is shaped by the lived experiences and needs of local residents.

    We would like to thank the American Cancer Society for this grant, which allows us to conduct community-engaged research that addresses the social determinants of health and delivers solutions that reflect the priorities of the communities we serve.”


    Melissa Mazor, PhD, MS, RN, Co-Associate Director for Community Outreach and Engagement at The Tisch Cancer Institute

    “It was an honor to shape the vision for the Cancer Health Research Center at Mount Sinai,” said Cardinale B. Smith, MD, PhD, Principal Investigator of the initiative and current Chief Medical Officer, Memorial Sloan Kettering Cancer Center (MSK). “Although I remain at MSK, I am proud to continue collaborating with Dr. Mazor, who is taking a leadership role as the site lead. Her deep commitment to community engagement and health equity ensures that the Center’s mission will thrive and make a lasting impact.”

    Among the goals of the Center will be to develop and implement innovative models of cancer care delivery that are community-delivered, culturally and linguistically concordant, and designed to address structural barriers to care. The Center will identify, develop, and propel new and/or established postdoctoral and faculty investigators committed to cancer health research. It will also expand and empower community scientists to translate research into actionable outcomes that reduce disparities and improve cancer care for all New Yorkers.

    “This grant from the American Cancer Society is a powerful endorsement of the work we’re doing at Mount Sinai to confront cancer disparities head-on,” said Ramon Parsons, MD, PhD, Director of The Tisch Cancer Institute. “The Cancer Health Research Center will not only generate groundbreaking research; it will help reimagine how cancer care is delivered in communities that have long been underserved. We’re proud to lead this national effort to create more just, equitable outcomes for every patient, everywhere.”

    The Center will begin work immediately, with the launch of three integrated research projects led by Jamilia Sly, PhD, Deborah Doroshow, MD, PhD, and Chris Woodrell, MD, MHS, with its full program expected to roll out over the next several months.

    Source:

    Mount Sinai Health System

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  • Powerful optical technique can analyze the biochemical fingerprints of vaginal fluid

    Powerful optical technique can analyze the biochemical fingerprints of vaginal fluid

    Vaginal health is tightly linked to the balance of bacteria in the microbiome, especially certain species of Lactobacillus. When this balance is disturbed-a condition known as dysbiosis-it can lead to increased risk of infections, complications during pregnancy, and other long-term health concerns. Despite this risk, existing diagnostic methods often fall short, especially in detecting Lactobacillus iners, an important vaginal bacterium, which doesn’t always show up under a microscope or in lab cultures. Researchers at Vanderbilt University are working to change that by using a powerful optical technique known as surface-enhanced Raman spectroscopy (SERS) to analyze the biochemical fingerprints of vaginal fluid.

    In a pilot study published in Biophotonics Discovery, the researchers collected vaginal fluid samples from 19 participants during routine gynecological exams. They used two different devices-a laboratory Raman microscope and a portable Raman spectrometer-to record the SERS spectra of each sample. These spectra reveal the biochemical makeup of the fluid, including the presence of proteins, lipids, organic acids, and sugars. The team then used a molecular technique called quantitative PCR to identify whether key microbes were present, focusing on Lactobacillus iners, Lactobacillus crispatus, Gardnerella vaginalis, and Streptococcus agalactiae.

    By comparing the SERS spectra of samples with different microbial compositions, the researchers found consistent biochemical signatures. The presence of Gardnerella vaginalis (G. vaginalis), a microbe linked to bacterial vaginosis, was marked by increased protein and lipid signals and decreased organic acid content-trends that align with what’s known about its role in disrupting the vaginal environment. In contrast, Lactobacillus iners (L. iners), a protective microbe that can be difficult to detect with current methods, was associated with elevated levels of organic acids and reduced signals from proteins and polysaccharides. These patterns were visible not only with the high-end lab equipment but also with the more accessible portable device.

    Notably, the samples containing G. vaginalis were from participants without any diagnosed infections or symptoms. This suggests that SERS may be able to identify early-stage or subclinical shifts in the microbiome before they become clinically evident-a critical advance for prevention and early intervention.

    The findings also highlight how SERS could be used in routine monitoring of vaginal health, especially if integrated into point-of-care devices. The portable Raman system produced results similar to the benchtop microscope, showing that accurate biochemical readings don’t necessarily require a full laboratory setup.

    While this was a pilot study and only a limited number of bacterial species were evaluated, the study provides proof of concept for using SERS to detect meaningful changes in the vaginal microbiome. Future studies aim to expand the participant pool and use genetic sequencing for broader microbial analysis. But even in its current form, the research demonstrates a promising path forward for better, faster, and less subjective diagnostics in women’s health.

    Source:

    SPIE–International Society for Optics and Photonics

    Journal reference:

    Rourke-Funderburg, A. S., et al. (2025) Investigating microbiota and biochemical changes in vaginal fluid toward point-of-care microbial monitoring using surface-enhanced Raman spectroscopy. Biophotonics Discovery. doi.org/10.1117/1.BIOS.2.4.042102.

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  • No Lyme Disease Vaccine This Year — Vax-Before-Travel

    No Lyme Disease Vaccine This Year — Vax-Before-Travel

    (Vax-Before-Travel News)

    Valneva SE announced today that it continues co-developing VLA15, a Phase 3 vaccine candidate, the only Lyme disease program in late-stage clinical development.

    VLA15 is a multivalent recombinant protein vaccine that targets six serotypes of Borrelia, representing the most common serotypes found in the United States and Europe.

    On August 12, 2025, Valneva confirmed its development partner, Pfizer Inc., is currently executing the randomized, placebo-controlled Phase 3 field efficacy study. The participants will be monitored for the occurrence of Lyme disease cases until the end of the 2025 Lyme disease season in the U.S. (end of October), with topline data expected as soon as all Lyme disease cases are confirmed.

    In a press release, Valneva wrote that Pfizer aims to submit a Biologics License Application to the U.S. Food and Drug Administration and a Marketing Authorization Application to the European Medicines Agency in 2026, subject to positive Phase 3 data.

    Lyme disease is the most common tickborne disease in the United States and Europe.

    Lyme disease remains an expanding health risk in the U.S. It is a bacterial illness transmitted to humans through the bite of infected ticks. These ticks become infected by feeding on animals that carry the bacteria in their blood.

    Over 89,000 cases of Lyme disease were reported to the U.S. CDC by state health departments and the District of Columbia in 2023. Recent estimates using other methods suggest that approximately 476,000 people may be diagnosed and treated for Lyme disease each year in the U.S.

    The incidence of Lyme disease in Europe is highest in the Scandinavian and Baltic states in northern Europe and Austria, the Czech Republic, Germany, and Slovenia in central Europe.

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  • Ultra-Processed Foods Could Sabotage Weight Loss, Even on a ‘Healthy’ Diet : ScienceAlert

    Ultra-Processed Foods Could Sabotage Weight Loss, Even on a ‘Healthy’ Diet : ScienceAlert

    Ultra-processed foods already have a lousy reputation – and now a new study suggests that even ‘healthy’ versions of them can significantly undermine your weight-loss efforts.

    Researchers from the UK and US analyzed data from 50 overweight people who completed two diet programs on separate occasions. Both diets matched in terms of nutrition – with the same amounts of fat (including saturated fats), carbs, fiber, salt, and even fruits and vegetables.

    The key difference is one diet was built around ultra-processed foods (UPFs), and the other focused on minimally processed foods (MPFs). The UPF diet included the likes of breakfast oat bars and lasagne ready meals, while the MPF one featured overnight oats and homemade spaghetti bolognese.

    Related: Ultra-Processed Foods Linked to Early Signs of Parkinson’s Disease

    Both diets resulted in weight loss. But the MPF diet was associated with shedding twice as much weight as the UPF diet, on average. Participants also lost more unhealthy body fat while on the MPF diet and reported better control over unhealthy food cravings.

    “Previous research has linked ultra-processed foods with poor health outcomes,” says clinical scientist Samuel Dicken, from University College London (UCL). “But not all ultra-processed foods are inherently unhealthy based on their nutritional profile.”

    “The main aim of this trial was to fill crucial gaps in our knowledge about the role of food processing in the context of existing dietary guidance, and how it affects health outcomes such as weight, blood pressure, and body composition, as well as experiential factors like food cravings.”

    Greater weight loss was seen with the minimally processed food diet. (Dicken et al., Nat. Med., 2025)

    While the overall reductions in weight were only 2 percent for the MPF diet and 1 percent for the UPF diet, the researchers point out the short timespan of the study: eight weeks for each diet, with a gap of four weeks in between.

    The changes seen here could quickly add up. In combination with other factors that contribute to a healthy and effective diet, avoiding ultra-processed foods could make a noticeable difference over time.

    “Though a 2 percent reduction may not seem very big, that is only over eight weeks and without people trying to actively reduce their intake,” says Dicken.

    “If we scaled these results up over the course of a year, we’d expect to see a 13 percent weight reduction in men and a 9 percent reduction in women on the minimally processed diet, but only a 4 percent weight reduction in men and 5 percent in women after the ultra-processed diet.”

    The trial was relatively small and excluded people with dietary restrictions, but it offers more evidence on how we can tackle our growing obesity crisis – and highlights the difference that following nutritional guidelines in diets can have.

    “The global food system at the moment drives diet-related poor health and obesity, particularly because of the wide availability of cheap, unhealthy food,” says Chris van Tulleken, a global health and infection researcher at UCL.

    “This study highlights the importance of ultra-processing in driving health outcomes in addition to the role of nutrients like fat, salt, and sugar.”

    The research has been published in Nature Medicine.

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  • GLP-1s Linked With Increased Risk of Optic Nerve Disorders

    GLP-1s Linked With Increased Risk of Optic Nerve Disorders

    Semaglutide or tirzepatide treatment among patients with diabetes was associated with an increased risk of optic nerve disorders, such as nonarteritic anterior ischemic optic neuropathy (NAION), according to a study published in JAMA Network Open.1

    “Glucagon-like peptide-1 receptor agonist (GLP-1RA) medications have transformed the treatment of type 2 diabetes (T2D) and obesity, with associated reductions in cardiovascular and nephrological complications,” wrote authors of the study. “Semaglutide and tirzepatide are second-generation GLP-1RA medications approved by the FDA for the treatment of diabetes and obesity.”

    GLP-1s and their ability to transform diabetes care and obesity management have been increasingly noticeable as of late. According to a KFF Health tracking poll, at least 12% of US adults said they’ve taken a GLP-1RA at some point in time. For the sheer recognition of these medications amongst the public, 32% of US adults said they’ve heard “a lot” about GLP-1RAs, which is a 13% increase from 2023 to 2024.2

    Using target trial emulation framework, researchers conducted their study to determine the causal effects of GLP-1s on outcomes of optic nerve disorders. | image credit: PhotoArtHub / stock.adobe.com

    READ MORE: Initiation of Semaglutide Does Not Decrease Health Care Spending

    Despite the notable rise in GLP-1 use in recent history, this drug class is often associated with adverse effects typically related to gastrointestinal outcomes, such as nausea, vomiting, diarrhea, gastroparesis, and constipation.1,3 Recent studies, however, have shown associations between NAION and semaglutide use, leading to concerns of adverse outcomes among diabetes patients outside of the digestive system.

    “Several retrospective studies from 2024 and 2025 reported a potential association of semaglutide with NAION in patients with diabetes and patients with obesity,” they continued.1 “However, a meta-analysis of randomized clinical trials did not detect an association of GLP1-RA therapy, including semaglutide, with NAION.”

    With conflicting evidence reported in the past few years, researchers wanted to better determine the association between NAION and GLP-1 use—namely semaglutide and tirzepatide. They hoped the significant reach of study participants within this new cohort would better inform pharmacist and provider decisions when counseling patients with diabetes, obesity, or a general need for GLP-1RAs.

    “It remains unknown if semaglutide or tirzepatide is associated with other optic nerve and visual pathway disorders,” wrote the authors.1 “This study leveraged a nationwide, multicenter database of electronic health records (EHRs) of more than 118 million US patients to conduct rigorous target trial emulation in patients with T2D to examine associations of semaglutide or tirzepatide with optic nerve and visual pathway disorders, including NAION.”

    In this cohort study, researchers included EHR patient data from December 2017 to January 2023. Inclusion criteria called strictly for study participants with T2D, no previous diagnoses of eye disorders, and prescriptions for either semaglutide, tirzepatide, or another antidiabetic drug.

    Using target trial emulation framework, researchers conducted their study to determine the causal effects of GLP-1s on outcomes like NAION.4 With this specific study design, they separated participants into 2 groups: those prescribed the GLP-1RAs semaglutide or tirzepatide and those prescribed alternative antidiabetic medications.1

    Among patients reporting use of semaglutide, tirzepatide, or other antidiabetic medications, the main outcomes researchers explored were any first-time diagnoses of disorders of optic nerve and visual pathways. Some of these disorders included optic neuritis, NAION, optic atrophy, and more.

    The final analysis included a total of 159,398 patients, with an even split of 79,699 participants in the GLP-1RA group (mean age, 56.8 years; 51.7% women) and the other antidiabetic medications group (mean age, 56.2 years; 52.6% women).1

    Including all disorders explored in this study, the main associations between diabetes treatment and optic nerve disorders were only notable for NAION and “other” optic nerve disorders outside of those included in the study. However, among these associations, patients treated with semaglutide or tirzepatide were more likely to develop optic nerve disorders compared with patients on other antidiabetics.

    Indeed, a total of 35 patients (0.04%) on semaglutide or tirzepatide reported NAION diagnoses compared with just 19 (0.02%) from the antidiabetic medication group. Furthermore, 93 participants (0.12%) reported other various optic nerve disorders compared with just 54 patients in the antidiabetic group.

    “In a population of patients with T2D who had no prior diagnosis of eye diseases, this cohort study found that semaglutide or tirzepatide compared with other antidiabetic medications was associated with a differential risk of optic nerve and visual pathways, including increased risk of NAION and other optic nerve disorders, but not optic neuritis, papilledema, optic atrophy, or optic disc orders,” they continued.1

    With the overall risk of developing optic nerve disorder being minimal, the researchers findings are still significant enough to inform future use cases of any antidiabetic drug. Despite aligning with previous findings from 2024 and 2025, researchers believe further investigation is needed to replicate and confirm findings from the current study.

    “Future studies are needed to replicate these findings, explore underlying mechanisms, identify individuals at increased risk for these potential complications, and examine other eye disorders,” concluded the authors.1

    READ MORE: Diabetes Resource Center

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    References
    1. Wang L, Volkow ND, Kaelber DC, Xu R. Semaglutide or tirzepatide and optic nerve and visual pathway disorders in type 2 diabetes. JAMA Netw Open. 2025;8(8):e2526327. doi:10.1001/jamanetworkopen.2025.26327
    2. Montero A, Sparks G, Presiado M, et al. KFF Health tracking poll May 2024: the public’s use and views of GLP-1 drugs. KFF. May 10, 2024. Accessed August 12, 2025. https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-may-2024-the-publics-use-and-views-of-glp-1-drugs/
    3. Catanese L. GLP-1 diabetes and weight-loss drug side effects: “Ozempic face” and more. Harvard Health Publishing. February 5, 2024. Accessed August 12, 2025. https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more
    4. Fu EL. Target trial emulation to improve causal inference from observational data: what, why, and how? J Am Soc Nephrol. 2023 Aug 1;34(8):1305-1314. doi: 10.1681/ASN.0000000000000152.

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  • Genomic and phenotypic characterization of six multidrug-resistant Acinetobacter pittii isolates

    Genomic and phenotypic characterization of six multidrug-resistant Acinetobacter pittii isolates

    Characterization and relatedness of the isolates

    The susceptibility profiles of six clinical A. pittii isolates are presented in Table 1. All isolates were susceptible to aminoglycosides, tetracyclines and fluoroquinolones. All isolates were susceptible to ceftolazone/tazobactam, colistin, ampicillin/sulbactam, trimethoprim/sulfamethoxazole and nitrofurantoin; and resistant to ampicillin, first generation cephalosporin cefazolin, 3rd generation cephalosporins ceftriaxone and cefotaxime and aztreonam. Two isolates (AP290R and AP5092) were intermediate to piperacillin/tazobactam and resistant amoxicillin/clavulanic acid; only one isolate (AP290R) was resistant to all carbapenems tested and had elevated levels of ceftazidime (8 ug/ml).

    Table 1 Resistance profile of the six A. pittii studied isolates. MIC (minimal inhibitory concentration) as determined by sensititre. Abbreviations: AMK (amikacin), AMP (ampicillin), A/S2 (ampicillin/sulbactam 2:1 ratio), AUGC (amoxicillin/clavulanic acid constant 2), CRO (ceftriaxone), ATM (aztreonam), CIP (ciprofloxacin), C/T (ceftolozane/tazobactam 4), CZA (ceftazidime/avibactam), DOR (doripenem), ETP (ertapenem), CZ (cefazolin), FEP (cefepime), CTX (cefotaxime), GEN (gentamicin), IMI (imipenem), LEVO (levofloxacin), MEM (meropenem), MIN (minocycline), NIT (nitrofurantoin), P/T4 (piperacillin/tazobactam constant 4), SXT (trimethoprim/sulfamethoxazole), TAZ (ceftazidime), TET (tetracycline), TGC (tigecycline), and TOB (tobramycin). R, resistant; S, susceptible; I, intermediate. Interpretations are given according to CLSI M100 2025: performance standards for antimicrobial susceptibility testing for acinetobacter species.

    The six A. pittii isolates and reference strain ATCC19606 were analyzed by FT-IR to determine phenotypic similarity. No clusters (indicating similar isolates) were evident (Fig. 1A). To determine whether FT-IR could distinguish between A. pittii and A. baumannii, we added 11 A. baumannii strains, belonging to different sequence types (STs), to the FT-IR analysis. Still no clusters were identified, and A. pittii isolates were not always more similar to each other than to A. baumannii isolates (Fig. 1B).

    Fig. 1

    FT-IR analysis. (A). A dendrogram representing six A. pittii studied isolates and the reference strain ATCC19606. The automatic cut-off was used. (B). A dendrogram representing six A. pittii isolates, ATCC19606 and 11 randomly chosen A. baumannii strains from different STs. The automatic cut-off was used. Red indicates A. baumannii, black indicates A. pittii. MLST Pasteur type presented in right column.

    All 6 A. pittii strains were sequenced and their genomes were analyzed. The isolates belonged to different STs (Table 2) with different KL types. We constructed a phylogenetic tree based on pangenome analysis (Supplementary Fig. 1). The tree revealed distinct separation, with consistent and even distances observed between each isolate. Next, we conducted core genome alignment of the six A. pittii isolates compared to 64 publicly available complete genomes of A. pittii (Supplementary Table 1) from different countries and different years. The genomes represent a temporal range spanning from 2011 to 2024, allowing for examination of potential genomic changes over nearly three decades. This analysis placed AP5092 and MML4 (isolated in 2023, Hong Kong) on one branch close to each other. Other four isolates were located on a second branch, with AP5047 and AP290R most closely related to each other (Fig. 2). Isolate AP290R most close to isolate HCG18 isolated in Mexico in 2023.

    Table 2 Characteristics of the six A. pittii studied isolates, their ST (Pasteur and Oxford scheme) and KL types. (ST stands for sequence type; KL stands for K locus type).
    Fig. 2
    figure 2

    Phylogenetic tree of six A. pittii isolates together with 64 publicly available genomes of A. pittii.

    Antibiotic resistance genes

    Genomic analysis revealed the presence of several antimicrobial resistance determinants among the isolates (Table 3).

    Table 3 CARD analysis of the six A. pittii studied isolates. Values indicate the percent similarity to the best hit in the CARD database.

    All isolates carried at least two genes conferring β-lactam resistance: a variant of ampC cephalosporinase (ADC) and a variant of OXA-type β-lactamase. Notably, isolate AP290R carried three blaOXA genes – blaOXA−272, blaOXA−255 and blaOXA−72 carbapenemases. Correspondingly, this was the only isolate to display carbapenem resistance.

    In addition, all six study isolates harbored genes conferring quinolone resistance (adeF and abaQ), efflux pump components (abeS, adeF and adaQ), and a gene involved in colistin resistance (lpsB). Three isolates (AP4773, AP4968, and AP5092) contained a single putative aminoglycoside resistance gene, ant(3’’)-IId, with relatively low sequence homology (69%) to the closest match in the Comprehensive Antibiotic Resistance Database (CARD).

    Virulence studies

    In vitro phenotype

    We next evaluated characteristics of the A. pittii isolates which are classically associated with bacterial virulence – growth, motility and biofilm formation. A. baumannii reference strain ATCC19606 served as a reference strain. The growth of all isolates was similar to that of the control strain (p > 0.05; Supplementary Fig. 2). Three A. pittii isolates demonstrated significantly higher motility than the control stain (p < 0.0001) (Fig. 3A), and four isolates produced significantly less biofilm (p < 0.001) (Fig. 3B).

    Fig. 3
    figure 3

    In vitro phenotype of six A. pittii studied isolates. (A) Motility. Columns show average length of tentacle formation for each isolate. (B) Biofilm formation. Quantification of biofilm mass by crystal violet. (*) p-value < 0.001 compared to ATCC19606 values, bar represents standard error mean (SEM). (C) Survival of A. pittii isolates in 80% normal human serum (NHS) and heat inactivated NHS (as a control, strains were grown without serum in BHI medium and their growth was measured). Bar represents standard error mean (SEM). Each isolate is represented in a different color. ATCC19606 used as reference strain.

    All A. pittii isolates were serum sensitive (Fig. 3C), displaying either death (4/6 isolates) or reduced growth (2/6 isolates) after 4 h exposure to NHS. Heat inactivation of the complement system reduced the serum sensitivity of 5/6 isolates (except for AP5091), with one isolate (AP5092) displaying full resistance to the inactivated serum.

    In vivo virulence

    We next evaluated the virulence of the A. pittii isolates in vivo, using killing assay in Z. morio larvae. In this model, AP290R exhibited high virulence potential (Fig. 4), killing 70% of infected Z. morio larvae within 24 h. The other A. pittii strains were less lethal, with a 10%−20% lethality rate 24 h post infection and a 25%−35% lethality rate 7 days post infection.

    Fig. 4
    figure 4

    In vivo virulence of six A. pittii studied isolates. Kaplan- Meier survival curves for Z. morio larvae (30 per group) infected with 1 × 107 CFU of each isolate of A. pittii. G257 – Acinetobacter baumannii clinical strain used as reference.

    Virulence factors

    AP290R possessed the largest number of virulence genes, and AP4773 and AP5092 – the smallest. Nine virulence genes (cpaA, entE, gspDE1E2FINO, bauCDF, pilBCFGHMTU2D, pbpG, lpxABCL, barB, lbsB) were present in all 6 isolates (Fig. 5). These genes are related to various virulence functions, including biofilm formation, adherence, coagulation (cpaA), siderophore biosynthesis (entE), motility, and others. Several differences in genomic content were evident. The cluster of three genes – pilA, pilQ (surface motility) and basI (siderophore biosynthesis) – was missing from AP290R, AP4773, AP4968 and AP5091. However, only pilA was missing in isolate AP5092, and only basI was missing in isolate AP5047. The iron acquisition gene barA was missing in AP5047.

    Fig. 5
    figure 5

    Heatmap of virulome analysis of six A. pittii studied isolates. Comparison of genomes to the virulence factor database (VFDB) was complete, the existence of genes represented by blue color, the absence in white. Hierarchical clustering of the isolates based on the presence or absence of the virulence factors shown at the top. .

    Plasmid content

    Whole genome analysis revealed that two A. pittii isolates carried plasmids. Properties of these plasmids are described in Table 4 and the specific ORFs – in Supplementary Table 3. Plasmid p290R (Fig. 6A) carried ten hypothetical proteins and 4 genes of known function: ydhP (associated with glycosidase and hydrolase activity), azoR1 (azoreductaze), gcvA (regulates the glycine cleavage system, transcriptional activator), and most significantly – the carbapenemase blaOXA−72 gene. The much larger plasmid p5092 (Fig. 6C) carried 119 genes, among them genes involved in different metabolic pathways, transporters and transcriptional regulators, and several insertion sequences (ISAba46, ISAba22, ISAba23, ISAha3, ISAcsp3, ISAba26 and IS1301), and 79 hypothetical proteins.

    Table 4 Properties of the plasmids pAP290R and pAP5092.
    Fig. 6
    figure 6

    Plasmid analysis. Circular maps of plasmid pAP290R from isolate AP290R (A) and pAP5092 from isolate AP5092 (C). The open reading frames are marked along the map in blue. tRNA genes found only in pAP5092 are indicated in pink. The blaOXA-72 gene found in pAP290R is indicated in red. Phylogenetic analysis of A. pittii plasmids pAP290R (B) and pAP5092 (D). Scale indicates branch length (nucleotide substitution per site). Plasmid maps were generated via Proksee.

    BLASTn analysis revealed a significant number of comparable plasmids within the public database, all reported in Acinetobacter spp. From this pool, we selected the ten most closely related plasmids for each of the plasmids (pAP5092 and pAP290R) and constructed a phylogenetic tree (Fig. 6B, D). The plasmid closest to pAP290R was pSU8507_OXA-2 (accession number LC777725.1) isolated from A. pittii in Japan in 2023, followed by 5 closely related plasmids from the US, China and Spain isolated in 2017–2021 (Fig. 6B). The plasmid closest to pAP5092 found in the database was pML4_1 (accession number CP118934.1) isolated from A. pittii in Hong Kong in 2023 (Fig. 6D). Additional information regarding accession numbers, year and country of isolation can be found in Supplementary Table 2.

    Plasmid pAP290R contained the blaOXA−72 gene (an OXA-24 family carbapenemase). To test the inter-species transferability of this plasmid, it was extracted from A. pittii AP290R and electroporated it into AB2142, a carbapenem-susceptible A. baumannii strain. Plasmid pAP290R conferred resistance to beta-lactams and carbapenems (Supplementary Tables 4 and Supplementary Fig. 3). However, resistance to ceftazidime in AP290R seems to be intrinsic; it was not transferred to AB2142 by the pAP290R plasmid.

    Crucially, the plasmid also significantly increased the virulence of AB2142 (Fig. 7), suggesting that it contributes to the virulence of AP290R, raising the possibility that some of the hypothetical genes it carries are in fact virulence factors.

    Fig. 7
    figure 7

    Kaplan- Meier survival curves for Z. morio larvae (30 per group) infected with 1 × 107 CFU of AB2142 – not virulent A. baumannii strain, AP290R -study strain and AB2142 containing plasmid from AP290R.

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