Category: 8. Health

  • Higher plasma AFB1 concentration is associated with increased risk of HPV 16 and HPV 18 detection and persistence among Ugandan women | Environmental Health

    Higher plasma AFB1 concentration is associated with increased risk of HPV 16 and HPV 18 detection and persistence among Ugandan women | Environmental Health

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  • Over Half of Middle-Aged Adults With HIV Experience Physical Function Decline

    Over Half of Middle-Aged Adults With HIV Experience Physical Function Decline

    Grace Kulik (née Ditzenberger), PT, DPT

    Image credits: LinkedIn

    Kristine M Erlandson, MD, MS

    Image credits: LinkedIn

    A new analysis from the PREPARE (Pitavastatin to REduce Physical Function Impairment and FRailty in HIV) trial found that 52% of middle-aged adults with HIV experienced measurable declines in physical function over time. Published in the June 2025 issue of Open Forum Infectious Diseases, the study highlights the importance of identifying individuals at risk for functional decline to support aging with HIV and prevent disability.

    The analysis included 569 participants with HIV (median age 51 years; interquartile range, 47–55), 81% of whom were male and 52% White. Physical function was assessed annually using gait speed, chair rise rate, grip strength, and a modified Short Physical Performance Battery (SPPB), which also included balance time. Decline was defined as falling below the 20th percentile on at least one measure. While overall declines were modest, variability among individuals was considerable.

    Demographic and clinical risk factors for decline included female sex (RR, 1.32; 95% CI, 1.12–1.55), non-White race (RR, 1.23; 95% CI, 1.05–1.45), and older age. In multivariable analyses adjusting for age, sex, and race, additional independent predictors included history of depression treatment, elevated body mass index (BMI), baseline frailty, and elevated inflammatory markers such as high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6).

    To contextualize these findings, Contagion spoke with study authors Grace Kulik, PT, DPT, PhD candidate at the University of Colorado (UCD) Anschutz Medical Campus, and Kristine M Erlandson, MD, MS, professor of infectious diseases at UCD Anschutz about the clinical implications of functional decline in people with HIV (PWH), including the roles of inflammation, ART exposure, and screening in mitigating long-term impairment.

    Contagion: How do systemic inflammatory markers such as high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) specifically contribute to physical function decline in people with HIV, given the immune dysregulation associated with the infection?

    Kulik: Higher levels of inflammatory markers are thought to contribute to muscle wasting, which in turn is thought to reduce physical function. Chronic inflammation has also been linked with reduced levels of overall physical activity, and low physical activity is strongly associated with poor physical function.

    Contagion: Which infectious complications or HIV-related comorbidities most significantly exacerbate functional impairment, and what early monitoring strategies do you recommend?

    What You need To Know

    The PREPARE trial found that 52% of adults with HIV showed measurable declines in physical function, based on standard mobility and strength assessments.

    Risk factors for decline included elevated hsCRP and IL-6, higher BMI, prior depression treatment, female sex, and non-White race.

    Routine clinical screening using chair rise or gait speed tests can help identify early functional decline and guide timely interventions.

    Kulik: Prior studies by Dr. Erlandson have demonstrated that physical function is negatively associated with the immune response to cytomegalovirus, which is a common co-infection among people with HIV, even if they have a suppressed viral load. HIV is associated with a greater risk for other comorbidities, such as cardiovascular disease and diabetes, which have also been linked to physical function impairment. Performing annual or semi-annual tests such as 4-meter gait speed, time to complete 5 or 10 chair rises, and grip strength tests are the most commonly used strategies to screen for physical function impairment. Personally, I think that the 4-meter gait speed or chair rise assessments are the most feasible to incorporate for clinical screening because grip strength requires additional equipment and calibration.

    Contagion: From your clinical experience, how do antiretroviral therapy (ART) regimens impact physical function trajectories in aging individuals with HIV?

    Erlandson: Some of the older therapies (AZT, DDI, D4T) can have a negative impact on skeletal muscle, mitochondrial function (in fat or skeletal muscle), and/or contribute to neuropathy. Efavirenz has also been linked to greater physical function decline, possibly through some of the neurocognitive or weight-suppressive effects. Obesity contributes to physical function decline, so we ultimately may see greater physical function declines in people with greater weight gain, regardless of the regimen.

    Contagion: What role do you see for infectious disease specialists in multidisciplinary interventions aimed at preventing or mitigating physical decline in this population?

    Erlandson: Many infectious disease specialists serve as the primary care providers for patients living with HIV. Infectious disease providers may see people with HIV frequently—especially older adults or those with more comorbidities—and have the opportunity to recognize early declines and to provide counseling on preventive measures to mitigate physical function declines. Infectious disease specialists may also recognize important side effects or drug interactions with HIV medications that might contribute to physical function impairments, such as protease inhibitors with some statins.

    Reference
    Kulik GL, Umbleja T, Brown TT, et al. Prognostic factors of physical function decline among middle-aged adults with HIV. Open Forum Infect Dis. 2025;12(6):ofaf311. doi:10.1093/ofid/ofaf311

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  • 7 Sneaky Signs You Could Have Cognitive Decline

    7 Sneaky Signs You Could Have Cognitive Decline

    • Cognitive lapses aren’t always linked to aging or dementia. Factors like stress, anxiety, and multitasking can mimic or contribute. 
    • Incorporating brain-healthy foods, staying physically active and engaging in mentally stimulating activities are ways to slow cognitive decline. 
    • Early consultation with a healthcare professional is crucial for proper diagnosis and intervention.

    It happens from time to time: You start telling a story, only to lose your train of thought halfway through. Or you walk into a room and can’t remember what you went in there to do. Mental glitches like these happen to everyone and are understandably scary, but aren’t necessarily a sign of cognitive decline. “The feeling of your brain short-circuiting is often more likely due to psychological processes,” says Sarah Garcia-Beaumier, Ph.D. Increases in stress, distractions, multitasking, anxiety or depression can be contributors. “A common consideration we have to make clinically is whether cognitive symptoms are due to early dementia, or rather due to a depressive or anxiety disorder,” Garcia-Beaumier says.

    Cognitive Lapses vs. Cognitive Decline 

    Cognitive decline typically involves a worsening of performance in areas such as memory, attention or language. Common signs include forgetting to call someone or struggling to recall the right word. When those symptoms appear much more than they did previously, so much so that others are starting to notice, “that’s typically an early red flag for cognitive decline beyond what we expect for the normal aging process,” says Garcia-Beaumier. Normal aging may cause minor delays in memory retrieval, like struggling to remember a name but recalling it later. These are not signs of dementia or cognitive impairment, per Thomas Hammond, M.D. “Forgetting conversations or important appointments, or feeling lost in familiar places, are more worrisome and concerning for significant early cognitive impairment,” Hammond explained.

    Garcia-Beaumier notes that some individuals with mild cognitive impairment may stabilize or improve over time. Still, unresolved psychological distress or untreated health issues could increase the risk of dementia, making it crucial to address potential warning signs early.

    Common Signs of Cognitive Decline 

    1. You struggle to stay on top of things. 

    The corticolimbic system of the brain modulates the experience of anxiety. “It also happens to be the same area of the brain that helps with processing speed, attention, planning, judgment, organization and lots of thinking skills,” says Garcia-Beaumier. “So if there’s a change in this area of the brain due to stress or anxiety, these cognitive skills are also affected.”

    This overlap in brain pathways, along with the larger amount of resources devoted to modulating your stress and anxiety due to your body constantly shifting between survival and recuperation mode, will lead to a varying array of cognitive deficits.

    These pathways are also crucial in processing information—if you can no longer pay attention to things, your brain isn’t going to be able to encode them and retain them for later memory.

    2. You can’t find the words you’re looking for. 

    Cognitive decline manifests itself in almost all aspects of complex daily tasks, especially our language. “Even a simple undertaking, like naming a kitchen appliance, engages our brain networks extensively, making it a sensitive indicator of early decline,” says Aubry Alvarez-Bakker, Ph.D..

    A strong sign can be found in moments when you might forget a simple, specific word you’re looking for, so you try to describe it instead. Over time, you might also start having difficulty keeping up with conversations, which can lead to anxiety in social situations.

    The specific mechanism behind why this happens isn’t fully known, but research shows that language decline often originates in the left side of the brain. “We also know that low BDNF production (a protein produced by our nervous system that’s crucial for the production of new brain cells) means fewer new cells to help us carry on activity across our brain,” says Alvarez-Bakker.

    As we age, production of this protein naturally declines, so our body relies heavily on our environment to create BDNF to “fertilize” our brain and allow new cells to form. “Among the best foods to consume to boost BDNF in our body—and subsequently ward off cognitive decline—are blueberries, turmeric, green tea and dark chocolate,” says Alvarez-Bakker.

    3. You feel blasé about things you used to enjoy. 

    Because apathy is a common symptom of severe burnout, it’s easy to pay no mind that it can also be a symptom of cognitive decline. “It’s actually the most common symptom and perhaps the most overlooked,” says Alvarez-Bakker.

    A sudden loss of interest in activities you used to love, or a willingness to throw in the towel easily, is a common symptom of dementia. You might lose interest in reading books, gardening or many other activities you used to enjoy. You might also find things that used to be easy for you to accomplish are now overwhelming, or that you avoid complex tasks or projects entirely.

    “This is unfortunate because withdrawing from stimulation is known to speed up the decline process,” says Alvarez-Bakker. “Luckily, our lifestyle can help counteract this symptom to an extent.” When apathy creeps in, the best step to take is to get personal by integrating things you deeply enjoy—music, art, sports, reminiscing—into daily activities that will boost your participation in life, and in turn, stimulation.

    4. You’ve been acting out of character. 

    Subtle personality changes are an often-missed sign of cognitive decline, primarily because of how easily they can be blamed on chronic stress (say, becoming easily angered or swearing when that isn’t a regular part of your vocabulary).

    You might also find yourself withdrawing from social interactions and activities—and when you are around others, you may not participate in discussions, but instead stay quiet. “These are symptoms which are often written off as an individual being shy,” says Hammond. “However, the person who was once talkative and garrulous will often become quiet and a wallflower as an early sign of developing cognitive decline.”

    Regardless if stress is the cause or a variable that’s augmenting the cognitive decline, “any treatment hoping to prevent or reduce cognitive decline needs to incorporate stress management,” says, Isaac Tourgeman, Ph.D.

    5. You’re always ruminating and worrying. 

    Incessantly ruminating and worrying keeps your fight-or-flight response in overdrive, and symptoms of chronic stress can mimic cognitive decline, such as forgetfulness and inattention.

    “Uncontrolled, toxic thinking has the potential to create a state of low-grade inflammation across the brain and body over time, which can impact our cognitive health and ability to remember or recall information,” says Caroline Leaf, Ph.D. “If left unmanaged, this kind of chronic cognitive upset can progress into varying levels of cognitive decline.”

    Resolution of the underlying causes of your rumination and worry is paramount to improving current and preventing future symptoms of cognitive decline.

    6. You’ve recently been sick or have a chronic condition. 

    “Cognitive dulling is a common feature associated with general medical illnesses, such as the flu, urinary tract infection and gastroenteritis,” says Hammond. “Metabolic stress caused by minor infection will often lead to a transient cognitive decline,” Hammond added.

    Other conditions can also lead to cognitive decline, including sleep disorders (such as sleep apnea). “Similar to psychological distress, sometimes symptoms can be resolved if it’s due to one of these conditions,” says Garcia-Beaumier. “But if left untreated, it does increase a person’s risk of dementia down the line.”

    Depression can result in what’s called pseudodementia, where depression essentially masquerades as cognitive impairment. “Symptoms present as forgetfulness, difficulty with attention and lowered energy and motivation,” says Tourgeman. This is when it’s especially important to consult with your doctor to ensure the right diagnosis is made and proper treatment given.

    7. Other people are noticing your mental glitches. 

    “We all experience cognitive glitches to a certain extent when going through the pressures of life, but a good rule of thumb is if anyone who knows you has noticed a consistent increase of these symptoms over time, it may be a sign that you’re experiencing cognitive decline,” says Leaf. Usually the person experiencing symptoms is the last to be aware of the decline, so it’s important to be open to feedback and proactive about taking action.

    How to Help Prevent or Slow Cognitive Decline 

    “While we currently aren’t able to change our genes, we can influence how our environment impacts them,” says Tourgeman. “A healthy lifestyle—eating a brain-healthy diet (like the MIND Diet), exercising regularly, reducing stress and distractions, maintaining a sense of utility and connectedness—can all go a long way.”

    And no healthy lifestyle with the goal of avoiding or improving cognitive decline would be complete without a wide range of activities that keep your brain engaged. “Playing brain games on your phone will only go so far, though, mostly because you’ll only get really good at that one thing,” says Garcia-Beaumier. “Doing lots of activities that you enjoy and that challenge you is best.” Things like reading, playing games, learning new skills and dancing can all contribute to optimal cognitive health when done in conjunction with other healthy habits.

    How to Know When It’s Time to See a Healthcare Provider 

    “Any time someone notices cognitive changes, such as memory not being as good or the brain feeling slower or foggy, they should check in with their doctor,” says Garcia-Beaumier. “But it’s especially important if family or friends are also noticing issues or if the issues make it hard to fulfill daily responsibilities.”

    You can try to work on decreasing stress and improving how you take care of any other health conditions to see if that also clears up any cognitive issues, but there isn’t a definitive way to know whether your symptoms are due to stress, psychological issues, another health condition or cognitive decline without talking to a healthcare provider and possibly seeing specialists for further testing.

    “Even getting some basic tests, early before any issues arise, can allow your doctor to compare your current cognitive performance to possible cognitive issues in the future,” says Garcia-Beaumier.

    Our Expert Take

    The occasional mental lapse, like misplacing your keys or forgetting the name of a person you just met, is a normal part of life and not necessarily a cause for concern. These fleeting moments of forgetfulness are often tied to stress, lack of sleep, or even simply being preoccupied with too many things at once. However, when these cognitive issues become consistent, noticeable to others and begin to interfere with daily life, they may signal something more significant, such as cognitive decline. Taking proactive steps to manage stress, maintain overall health, and engage in stimulating mental and physical activities can help you protect your brain’s function and resilience.

    Understanding the difference between normal cognitive aging and more concerning symptoms is key to addressing issues early on. Consult a healthcare professional if you or those close to you observe persistent changes in memory, attention, or overall behavior. Seeking support and adopting lifestyle habits that prioritize brain health can not only slow potential decline but also improve your quality of life. By staying informed and proactive, you give yourself the best chance at maintaining your cognitive health and vitality for years to come.

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  • ADHD Linked to Higher Risk of PMDD Symptoms

    ADHD Linked to Higher Risk of PMDD Symptoms

    Women with attention deficit hyperactivity disorder (ADHD) may be more likely to experience severe premenstrual symptoms, according to new research from Queen Mary University (QMU) of London.

    Published in The British Journal of Psychiatry, the study found that women with ADHD, diagnosed or not, were more likely to meet criteria for provisional premenstrual dysphoric disorder (PMDD), especially if they also had depression or anxiety.

    Why ADHD and PMDD in women have been overlooked

    ADHD has long been thought of as a childhood condition that mostly affects boys. As a result, many girls and women with ADHD go undiagnosed, often until adulthood. Their symptoms, such as trouble focusing or emotional impulsivity, are usually less disruptive than the hyperactivity seen in boys – and easier to miss.

    There’s growing awareness that changes in hormone levels throughout the menstrual cycle can affect mental health. PMDD is a severe condition characterized by emotional, cognitive and physical symptoms that appear in the days before menstruation. Its effects are serious, and PMDD has been linked to an increased risk of suicide.

    Recent research is beginning to suggest that women with ADHD might be especially vulnerable during hormonal changes. Studies have found higher rates of depression after starting hormonal contraception, and a higher risk of postpartum depression among women with ADHD.

    One small clinical study also hinted that women with ADHD might be more likely to have PMDD; however, the participants were already receiving care, raising questions about whether this applies more broadly.

    “Because ADHD was historically considered a condition that mainly affected boys, many issues specific to females have been overlooked, including associations between ADHD and times of hormonal change,” said senior author Dr. Jessica Agnew-Blais, a senior lecturer in psychology at QMU.

    The new study set out to examine whether women in the general population who show signs of ADHD, regardless of a formal diagnosis, are at higher risk for PMDD. Unlike earlier studies that focused on women already in clinical care, this research used a broader, population-based sample.

    Higher PMDD risk in women with ADHD symptoms

    The study surveyed 715 women in the UK, aged 18 to 34 years, using the online research platform Prolific. All participants were assigned female at birth and reported having regular menstrual cycles. The researchers deliberately recruited more participants with ADHD to make sure they could look closely at this group.

    Each participant was placed into one of three groups:

    • Had a clinical diagnosis of ADHD.
    • Did not have a formal diagnosis but met criteria for ADHD using a questionnaire, the Adult ADHD Self-Report Scale (ASRS).
    • No diagnosis and did not meet the threshold for ADHD, forming the non-ADHD comparison group.

    The study also asked participants if they had ever been diagnosed with depression or anxiety.

    To assess PMDD, the researchers used the Premenstrual Symptoms Screening Tool (PSST). This tool asks about common PMDD symptoms such as mood swings, fatigue and difficulty concentrating. The PSST is based on recalled symptoms, not daily tracking, meaning it cannot give a formal diagnosis.

    The results showed women with a clinical ADHD diagnosis were over three times more likely to meet criteria for provisional PMDD than those without ADHD. For those who met the ADHD criteria using the ASRS but had no formal diagnosis, the risk was even higher – over four times greater.

    In terms of prevalence, 31% of women with a clinical ADHD diagnosis met criteria for provisional PMDD, compared to just 10% in the non-ADHD group. Among those who met ADHD criteria via the symptom checklist, the rate was 41%.

    The highest risk was among women with ADHD who also reported depression or anxiety.

    While PMDD symptoms looked similar across all groups, insomnia was reported more often by those with ADHD.

    Screening and support for PMDD in women with ADHD

    The findings point to a clear need for PMDD screening in women with ADHD – especially those who also live with depression or anxiety.

    It adds to growing evidence that women with ADHD may be more vulnerable at other times of hormonal change too, such as during pregnancy, postpartum or menopause.

    One explanation is that ADHD is linked to differences in dopamine regulation. Drops in estrogen before menstruation also reduce dopamine availability, which could make women with ADHD more sensitive to these shifts.

    The study was a cross-sectional analysis based on recalled symptoms, which means PMDD and other conditions can’t be fully separated. The design also doesn’t confirm a formal diagnosis, only a provisional one.

    Future research needs to track symptoms daily, over multiple cycles and in more diverse populations. It also needs to explore how medications, both psychiatric and hormonal, interact with these symptoms.

    “Our findings emphasise the need to consider issues affecting adult women with ADHD, and more specifically how females with ADHD may be at higher risk for experiencing PMDD,” said Agnew-Blais.

    “Our findings also suggest that further research is needed to improve understanding of the link between ADHD and times of hormonal change, including the menstrual cycle, and to reduce health inequalities and diagnostic bias in women and girls with ADHD,” said lead author Dr. Thomas Broughton, a postdoctoral research assistant in the School of Biological and Behavioural Sciences at QMU.

     

    Reference: Broughton T, Lambert E, Wertz J, Agnew-Blais J. Increased risk of provisional premenstrual dysphoric disorder (PMDD) among females with attention-deficit hyperactivity disorder (ADHD): cross-sectional survey study. The British J Psychiatry. 2025:1-8. doi: 10.1192/bjp.2025.104

     

    This article is a rework of a press release issued by Queen Mary University of London. Material has been edited for length and content. 

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  • Multi-dimensional sleep health and dementia risk: a prospective study in the UK Biobank | BMC Medicine

    Multi-dimensional sleep health and dementia risk: a prospective study in the UK Biobank | BMC Medicine

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  • Do women need a change in dose of prescription drugs with onset of menopause? Time to find out | BMC Medicine

    Do women need a change in dose of prescription drugs with onset of menopause? Time to find out | BMC Medicine

    Literature search identified only very few studies investigating the effects of menopause on pharmacokinetics of different drugs. We here provide some examples to showcase potential effects of menopause.

    Clearance of alfentanil (a short-acting anesthetic) metabolized largely by CYP3A4, was studied in 21 women and found to be more than double as high at premenopausal age compared to menopausal age, with no such effect in age-matched men [3]. Clearance of tirilazad, a neuroprotective steroid, metabolized by CYP3A4, was one third higher in 10 premenopausal women compared to 10 menopausal women [4]. The same study showed a similar difference in the clearance of midazolam (a short acting tranquilizer), which is considered a marker of CYP3A4 activity [4]. Zijp et al. [5] analyzed the effect of menopausal status on metabolism of tacrolimus, an immunosuppressant metabolized by CYP3A4 in 818 patients. Metabolism in women of premenopausal age was 43% higher than in women of menopausal age, while there was a non-significantly (12%) higher metabolism in men of comparable age groups.

    Castberg et al. [6] analyzed age and sex effects in 7626 users of quetiapine, an antipsychotic, metabolized by CYP3A4. They found a sex-by-age interaction and showed that male and female serum concentrations are similar until age 50, after which women develop significantly higher values than men, inducing a 33% sex difference.

    Rosuvastatin, a competitive hydroxymethylglutaryl-coenzyme A inhibitor, partly metabolized by CYP2C9, was studied in 40 women [7]. Three hours after administration of a single dose of 40 mg, more than fourfold higher plasma levels were found in premenopausal women, compared to menopausal women.

    Olanzapine, an antipsychotic drug metabolized by CYP1A2, was studied in 248 patients, finding a sex-by-age interaction, with higher blood levels in young women and lower blood levels in older women [8]. While the dose-corrected concentration (C:D ratio) of olanzapine increased with age in men, it decreased in women; an effect that may be attributable to menopause. Finally, a study including over 3000 men and women using lamotrigine (an anti-epileptic drug metabolized by UGT) demonstrated a significant drop in clearance in women aged 51–55 [9], but not in male peers, again suggesting interaction between menopausal status and pharmacokinetics.

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  • Autoimmune Diseases Almost Double Mental Health Disorder Risk

    Autoimmune Diseases Almost Double Mental Health Disorder Risk

    Twenty-nine percent of autoimmune disease patients also report a mental health condition, compared to 18% of the general population who do not have an autoimmune disorder, according to the results of a recent study published in BMJ Mental Health.

    Specifically, lifetime prevalence rates of autoimmune patients with mental health disorders compared to the general population were 26% vs. 15% for depression, 21% vs. 13% for anxiety and 1% vs. 0.5% for bipolar disorder. These findings are consistent with a previous separate study that found a prevalence of depression (22%), anxiety (13%) and bipolar disorder (7%) in lupus patients, the current study shows.

    A team of researchers, including corresponding author Arish Mudra Rakshasa-Loots, Ph.D., from the Center for Clinical Brain Sciences at the University of Edinburgh in the UK, studied the data of more than 1.5 million UK residents who participated in Our Future Health survey, a British health research project that collects social, demographic, health and lifestyle information. Results were collected from October 2022 to September 2024, and the study was published June 9, 2025. Approximately 37,808 participants reported autoimmune conditions and 1,525,347 did not. Women were more likely to report an autoimmune condition than men (74.5% vs. 56.5%). Additionally, the average age of participants was 53, 90% identified as white and 57% were women. When the researchers adjusted for sociodemographic factors, the risk of depression, anxiety and bipolar disorder was identical in people with autoimmune conditions.

    Survey participants completed the Patient Health Questionnaire (PHQ-9) and the seven-item Generalized Anxiety Disorder Scale (GAD-7) to measure their depression and anxiety symptoms.

    Autoimmune diseases are characterized by the body’s immune system mistakenly attacking healthy cells, causing inflammation and damage that may be life-threatening. Symptoms can include fatigue, muscle aches and digestion problems, ranging from mild to severe, and can come and go. Although there are more than 80 autoimmune diseases recognized by scientists, the researchers in this study focused on six: rheumatoid arthritis, Graves’ syndrome (thyroid hormone disorder), inflammatory bowel disease, lupus, multiple sclerosis and psoriasis.

    The study’s findings also support previous knowledge that autoimmune disorders are more common in women than in men—32% vs. 21%, leading researchers to theorize there is a link between sex hormones and antibodies. In the United States, approximately 50 million people have an autoimmune disease, with women accounting for 80% of diagnoses, according to the National Institutes of Health.

    “Women (but not men) with depression exhibit increased concentrations of circulating cytokines and acute phase reactants compared with non-depressed counterparts,” Rakshasa-Loots and his team write. “It is therefore possible that women may experience the compounding challenges of increased occurrence of autoimmunity and stronger effects of immune responses on mental health, resulting in the substantially higher prevalence of affective disorders observed in this study.”

    Researchers suggest individuals diagnosed with autoimmune disorders should be regularly screened for mental health conditions to establish early detection practices and treatment, especially women.

    “Future studies should seek to determine whether putative biological, psychological, and social factors—for example, chronic pain, fatigue, sleep or circadian disruptions and social isolation—may represent potentially modifiable mechanisms linking autoimmune conditions and affective disorders.”

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  • Factors associated with viral load non-suppression among adults with HIV in Sughd region, Tajikistan: a retrospective cohort study | BMC Infectious Diseases

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  • Epigenetic clues in PCOS embryos reveal new pathways for diagnosis

    Epigenetic clues in PCOS embryos reveal new pathways for diagnosis

    Epigenetic clues in PCOS embryos reveal new pathways for diagnosis | Image Credit: © Toowongsa – © Toowongsa – stock.adobe.com.

    There may be a distinctive “epigenetic memory” in embryos of women with polycystic ovary syndrome (PCOS), explaining the genetic link often observed in the condition, according to a recent study presented at the 41st Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE).1

    Disrupted gene marks observed in early embryo development

    Disrupted genes were identified in the embryos of participants with PCOS, indicating an impact on early developmental programming. This included influences on H3K27me3, H3K4me3, and H3K9me3, which are crucial histone marks for the control of gene expression.

    “Importantly, about half of the abnormal H3K27me3 signatures we saw in Day 3 embryos were already present in the oocyte”, said Qianshu Zhu, PhD, study lead. “This tells us that an epigenetic signal is being passed from mother to embryo before implantation even begins.”

    There were 133 patients with PCOS and 95 infertile women without PCOS receiving fertility treatment included in the final analysis. Gene activity and epigenetic changes were both assessed using ultra-low-input sequencing. Epigenetic changes were defined as chemical tags regulating how genes turn on and off without influencing the underlying DNA sequence.

    Potential therapeutic intervention identified

    Abnormal H3K27me3 levels were decreased using 2 PRC2 inhibitors, EED226 and valemetostat, on affected embryos in vitro. This highlighted a potential method of treating epigenetic imbalances.

    Additionally, investigators did not expect H3K27me3 to be an inherited driver of PCOS, as the histone mark is commonly used to assess biology in caner. According to Zhu, this provides new opportunities to evaluate embryos and potentially provide intervention.

    Toward improved PCOS diagnosis

    Hormone levels and ovarian morphology are currently analyzed when diagnosing PCOS. Researchers noted epigenetic profiling may be used alongside these tools, especially in the case of H3K27me3. This can lead to earlier risk assessment among the offspring of impacted mothers.

    H3K27me3 patterns may also be utilized among patients undergoing assisted reproductive technology by identifying the best available embryos to use during in vitro fertilization. This may lead to greater success for infertility treatments. However, long-term impacts on children have not yet been observed, as the embryos used in the study were laboratory-grown.

    The team plans to conduct mouse models to knock down the Kdm6a and Kdm6b genes. This will remove H3K27me3, allowing the findings of this trial to be validated by assessing whether mice offspring present with PCOS-like traits.

    A step forward in understanding PCOS

    According to Karen Sermon, MD, PhD, Chair of ESHRE, the molecular origin of PCOS remains largely unknown. Therefore, these findings allow for improved understanding and provide new treatment opportunities. The results have been published in Human Reproduction, a leading journal in reproductive medicine.

    “If we confirm that altering these histone marks changes PCOS traits in the next generation, we’ll have a powerful target for prevention”, said Zhu.

    Supporting evidence from endometrial gene mapping

    This data is supported by a trial evaluating the composition of cells and gene expression in the uterine lining between women with PCOS vs those without PCOS, published in Nature Medicine in March 2025.2 The genes were evaluated using a cell map developed by studying endometrial tissue samples in women.

    Investigators found 7 main cell clusters: stromal cells, smooth muscle cells, epithelial cells, lymphoid and myeloid immune cells, endothelial cells, and lymphatic cells. Epithelial cells were more common in PCOS cases, while stromal and lymphoid cells were less common. This highlighted a map of endometrial alterations among PCOS patients.

    “As we identified changes in gene expression in specific cell types, this study provides crucial guidance for developing more targeted treatments for PCOS-related endometrial dysfunction,” said Elisabet Stener-Victorin, MD, professor of reproductive physiology at Karolinska Institutet.

    References

    1. Dysregulated epigenetic memory in early embryos offers new clues to the inheritance of polycystic ovary syndrome (PCOS). European Society of Human Reproduction and Embryology. June 30 2025. Accessed July 7, 2025. https://www.eurekalert.org/news-releases/1088643.
    2. Krewson C. Study highlights how PCOS alters uterine lining. Contemporary OB/GYN. March 21, 2025. Accessed July 7, 2025. https://www.contemporaryobgyn.net/view/study-highlights-how-pcos-alters-uterine-lining.

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  • Astrocytes influence metabolism and cognitive function in obesity

    Astrocytes influence metabolism and cognitive function in obesity

    Fatty diets and obesity affect the structure and function of astrocytes, the star-shaped brain cells located in the striatum, a brain region involved in the perception of pleasure generated by food consumption. What is even more surprising is that by manipulating these astrocytes in vivo in mice can influence metabolism and correct certain cognitive changes associated with obesity (ability to relearn a task, for example). These results, described by scientists from the CNRS and the Université Paris Cité, are to be published on 7 July in the journal Nature Communication.

    These discoveries reinforce the idea that astrocytes (long neglected in favour of neurons) play a key role in brain function. They also demonstrate, for the first time, the ability of astrocytes to restore cognitive function in the context of obesity, opening up new avenues of research to identify their exact role in energy metabolism.

    These conclusions were reached using a combination of ex vivo and in vivo approaches in rodents, including chemogenetic techniques, brain imaging, locomotion tests, cognitive behavior and measuring the body’s energy metabolism.

    Source:

    Journal reference:

    Montalban, E., et al. (2025). Striatal astrocytes modulate behavioral flexibility and whole-body metabolism in mice. Nature Communications. doi.org/10.1038/s41467-025-60968-y.

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