Common respiratory condition nearly triples the risk of death in adults, new study finds

A major study presented today at ESCMID Global 2025 has revealed that adults with respiratory syncytial virus-associated acute respiratory infection (RSV-ARI) face a 2.7-fold higher risk of death within one year compared to the general population.

The findings underscore the significant, yet often under-recognised, long-term health and economic burden of RSV-ARI in adults, particularly among those with underlying conditions such as chronic obstructive pulmonary disease (COPD) and asthma.

RSV-ARI refers to a group of illnesses caused by respiratory syncytial virus (RSV), a common and highly contagious virus that primarily affects the respiratory tract. While its impact on infants and young children is well-documented, it can also lead to serious complications in adults, including pneumonia and chronic respiratory disease. Despite these risks, the full extent of its burden in adults remains poorly understood.

The Danish nationwide cohort study analysed data from 5,289 adults (≥18 years) diagnosed with RSV-ARI between 2011 and 2022, comparing them to 15,867 matched controls from the general population. Clinical and economic outcomes were assessed up to 365 days following RSV-ARI onset.

In addition to the increased risk of death, the study found that adults with RSV-ARI experienced significantly worse health outcomes. Over the course of the 365-day follow-up period, exacerbations of COPD and asthma were 3.1 and 4.6 times more frequent in RSV-ARI patients, respectively. Hospitalisation rates for RSV-ARI patients were more than double those of the control group (57% versus 28%), and intensive care unit admissions were nearly four times higher (5.3% versus 1.4%).

The economic impact of RSV-ARI was also considerable. Total direct healthcare costs for RSV-ARI patients during the 365-day follow-up amounted to €20,181, more than double the €8,085 spent on healthcare for individuals within the control group.

“One of the most striking findings from this study was the prolonged and significant impact of RSV-ARI”, said lead study author, Maria João Fonseca. “Even after the acute phase, patients continued to experience worse outcomes compared to the general population. This underscores just how serious and enduring the effects of RSV-ARI can be.”

“Exacerbations of COPD and asthma were the most common adverse clinical outcomes. These pre-existing conditions are already challenging in themselves, and RSV-ARI exacerbates their severity. Because of this, it’s crucial that we pay closer attention to patients with these underlying conditions to prevent further, potentially life-threatening complications.”

Commenting on the measures needed to reduce the impact of RSV-ARI, co-author, Stanislava Bratković commented, “Vaccination has proven highly effective in preventing severe outcomes from RSV. Given the significant burden of RSV-ARI highlighted by our study, prioritising vaccination for vulnerable populations is essential to reduce both health complications and associated costs.”

She concluded, “Looking forward, we hope our findings will inspire further research into the broader clinical and societal burden of RSV, particularly in high-risk groups. This will help shape more targeted preventive strategies and ensure timely interventions for those who need it most.”

Reference:

Common respiratory condition nearly triples the risk of death in adults, new study finds, Beyond, Meeting: ESCMID Global.

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Empowering Women’s Heart Health: Innovative App-Based Strategies to Boost Physical Activity After Hypertensive Pregnancy Disorders, suggests study

Recently conducted randomized clinical trial aimed to assess the effectiveness of app-based moderate to vigorous physical activity (MVPA) interventions for women with a history of hypertensive pregnancy disorder (HPD). The study was conducted over an 8-week period and relied on the Integrated Behavior Change (IBC) model and behavior change techniques. Participants were divided into three groups: control, motivation, and action. The primary outcome measured was MVPA using a wearable fitness tracker, and secondary outcomes included variables like resting heart rate and self-reported measures. The interventions incorporated techniques targeting motivational, volitional, and automatic processes.

Intervention Results

The study found that while the action intervention positively impacted motivational and volitional processes, it did not lead to a significant increase in MVPA compared to the control group. Results showed a decline in MVPA over the study period across all groups, with no significant differences between the action and motivation groups. Attrition rates were observed at 27% by week 9, 41% by week 21, and 71% by week 61, diminishing the final sample size.

Subgroup Analyses

Subgroup analyses indicated that the action intervention was more effective for participants with low baseline MVPA levels. However, no differences were found in treatment effects based on educational level subgroups. The study highlighted the challenges of bridging the intention-behavior gap and emphasized the importance of targeting both automatic and deliberative processes for behavior change.

Engagement and Process Limitations

Although engagement rates were relatively high, with positive evaluations from participants, the study suggested that the interventions may have faced challenges due to participants reaching a high baseline level of MVPA. The interventions did not directly encourage increasing MVPA minutes, and the lack of impact on automatic processes raised questions about their role in driving MVPA behavior.

Conclusion

In conclusion, the study underscored the complexity of behavior change interventions, especially in the context of increasing MVPA among women with HPD. While the interventions positively influenced motivational and volitional processes, translating these effects into significant changes in MVPA proved challenging. The study identified areas for improvement in future interventions, emphasizing the need for a tighter link between intervention activities and the desired outcomes.

Key Points

– The study focused on evaluating the effectiveness of app-based interventions for promoting moderate to vigorous physical activity (MVPA) in women with a history of hypertensive pregnancy disorder (HPD) using the Integrated Behavior Change (IBC) model and behavior change techniques over an 8-week period.

– Participants were divided into control, motivation, and action groups, with the primary outcome being MVPA measured using a fitness tracker, and secondary outcomes included variables like resting heart rate and self-reported measures, targeting motivational, volitional, and automatic processes.

– Findings revealed that while the action intervention positively impacted motivational and volitional processes, there was no significant increase in MVPA compared to the control group, with all groups showing a decline in MVPA over the study period and attrition rates increasing over time.

– Subgroup analyses indicated that the action intervention was more effective for participants with low baseline MVPA levels, emphasizing the challenge of bridging the intention-behavior gap and the importance of targeting automatic and deliberative processes for behavior change.

– Despite relatively high engagement rates and positive participant evaluations, challenges were faced due to participants starting at a high baseline level of MVPA, interventions not directly promoting increased MVPA minutes, and lack of impact on automatic processes potentially hindering the desired behavior change outcomes.

– In conclusion, the study highlighted the complexity of behavior change interventions for increasing MVPA in women with HPD, noting the influence on motivational and volitional processes but the difficulty in translating these effects into substantial changes in MVPA, suggesting areas for improvement in future interventions for a closer link between activities and desired outcomes.

Reference –

Lili L KóKai et al. (2025). App-Based Physical Activity Intervention Among Women With Prior Hypertensive Pregnancy Disorder. *JAMA Network Open*, 8. https://doi.org/10.1001/jamanetworkopen.2025.2656.

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NEET 2025: Check out Top Medical Colleges in Maharashtra to pursue MBBS as per NIRF

Maharashtra- Maharashtra is home to numerous government and private medical colleges. The state has a total of 42 government medical colleges, out of which two colleges are under the central government and the rest are under the state government.

Among these 42 government medical colleges, the top medical colleges in Maharashtra include All India Institute of Medical Sciences (Nagpur), Armed Forces Medical College (Pune), BJ Government Medical College (Pune), Dr. Vaishmpayan Memorial Medical College (Solapur), Dr. Shankarrao Chavan Govt. Medical College (Nanded), Government Medical Colleges in Alibag, Amravati, Baramati, Akola, Ambarnath, Chhatrapati Sambhajinagar, Bhandara, Buldana, Chandrapur, Gadchiroli, Gondia, Hingoli, Jalgaon.

Also Read: DMER begins Recruitment for 792 Faculty posts, 10 dean posts in Maha GMCs

Meanwhile, the private medical colleges of Maharashtra include Bharati Vidyapeeth University Medical College (Pune), Dr D Y Patil Medical College (Kolhapur), Jawaharlal Nehru Medical College (Wardha), Krishna Institute of Medical Sciences (Karad), Maharashtra Institute of Medical Education and Research (Pune), KJ Somaiya Medical College, Symbiosis Medical College for Women (Deemed University), Prakash Institute of Medical Sciences and Research (Sangli) and MGM Medical College and Hospital (Chhatrapati Sambhajinagar), among others.

Moreover, according to the NIRF Rankings 2024 released last year by the Ministry of Education, Dr. D. Y. Patil Vidyapeeth, Pune, Datta Meghe Institute of Higher Education and Research, Wardha and Armed Force Medical College, Pune, medical colleges from the state are ranked among the top 50. Below are details:

S.NO

RANK

INSTITUTE

STATE

SCORE

1

11th

Dr. D. Y. Patil Vidyapeeth

Maharashtra

64.10

2

23rd

Datta Meghe Institute of Higher Education and Research

Maharashtra

60.14

3

30th

Armed Forces Medical College

Maharashtra

57.68

Medical Dialogues has earlier reported regarding the top 10 government medical colleges in India, as per the NIRF Ranking 2024. The National Institutional Ranking Framework (NIRF), launched in November 2015 by the Ministry of Education, was used for this edition as well as for the previous eight editions of India Rankings released for the years 2016 to 2023.

Also Read: NEET 2025: Check Out Expected MBBS Cut-Off at Top Govt Medical Colleges

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NEET 2025 score manipulation racket busted! CBI arrests two for cheating aspirants

Maharashtra: For allegedly deceiving NEET 2025 aspirants and their families by claiming they could manipulate scores, and charging Rs 90 lakh per candidate, the Central Bureau of Investigation (CBI) has nabbed 2 individuals.

Speaking to PTI, officials informed, “The CBI arrested two men from Maharashtra for allegedly deceiving NEET UG 2025 aspirants and their families by claiming they could manipulate scores, and charging Rs 90 lakh per candidate.”

Sandeep Shah and Salim Patel, residents of Solapur and Navi Mumbai, respectively, allegedly hoodwinked candidates by posing as middlemen with access to non-existent officials of the National Testing Agency (NTA).

They allegedly demanded up to Rs 90 lakh per candidate, later reducing the amount to Rs 87.5 lakh during negotiations for ensuring ranks in the merit, the police said.

Mr. Shah allegedly held clandestine meetings with anxious parents at the upscale ITC Grand Central hotel in Mumbai’s Parel locality.

During these meetings, he allegedly assured clients that their children’s scores could be inflated and that the revised marks would be disclosed a full six hours before the official announcement of results.

The CBI investigation showed that Mr. Shah was in touch with Mr. Patel, who operates an admission consultancy firm in Navi Mumbai, and another individual who runs a similar consultancy in Pune.

“A forensic examination of the mobile phones of the arrested individuals uncovered incriminating chats containing details of prospective candidates, their roll numbers, admit cards, OMR sheets, and evidence of financial transactions through Hawala networks,” a CBI Spokesperson said in a statement, quotes PTI

Both were presented before a special court earlier this week which sent them to CBI custody till June 16.

“The investigation has not found any involvement of government officials or NTA personnel with the accused persons in the case. The accused misled parents by falsely claiming connections with NTA officials,” the spokesperson added.

Authorities believe the accused cynically misled parents by fabricating connections with examination authorities to give credence to their elaborate scheme.

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NEET PG 2025: MP Doctors urge Health Minister, NMC to extend Internship deadline

Thousands of postgraduate aspirants in Madhya Pradesh may become ineligible to appear in the National Eligibility-Entrance Test Postgraduate (NEET-PG) 2025 examination due to the delay in publication of their results.

While the internship completion deadline for NEET PG 2025 is 31 July, 2025, due to administrative delays, these students will not be able to complete their 12-month compulsory internship within this time limit.

For more information, click on the link below:

NEET PG 2025: Extend Internship Deadline for MP students- Doctors urge Health Minister, NMC

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Assam CM lays foundation stone for Rs 206 crore City Hospital in Dibrugarh

Dibrugarh: In a major step towards strengthening healthcare infrastructure in Assam, Chief Minister Himanta Biswa Sarma on Saturday laid the foundation stone for a state-of-the-art 200-bedded City Hospital at Jail Road in Dibrugarh.

The new facility will serve as an extension of the Assam Medical College and Hospital (AMCH), further enhancing healthcare services in the region.

Also Read: Assam CM inaugurates 100-bedded specialised women and child care hospital

According to the Hub News, the state-of-the-art B+G+6 storied facility is being developed under the World Bank-funded Assam State Secondary Healthcare Initiative for Service Delivery Transformation (ASSIST) Project, with a total financial outlay of ₹206 crore.

The planned structure will be spread across 10 bighas of land, covering a built-up area of 29,087 square metres. Of the 200 beds, 120 will be dedicated to the Maternity Department, while the rest will cater to patients in departments such as Medicine, Surgery, Orthopaedics, Paediatrics, and other specialities.

“This hospital will be a milestone in Assam’s journey towards providing world-class medical facilities. This hospital will complement the existing AMCH infrastructure and create a comprehensive healthcare ecosystem for the people. This project represents our vision of accessible, quality healthcare for all. The strategic location of the hospital will make advanced medical services easily accessible to people from across Dibrugarh district and neighboring areas,” Sarma said, while addressing a public rally at the old high school playground, after laying the foundation stone, reports TOI.

The foundation stone laying ceremony witnessed the presence of several dignitaries, including Union Minister Sarbananda Sonowal, Assam ministers Jogen Mohan, Prasanta Phukan, and  Bimal Borah, along with local MLAs and senior government officials.

Also Read: GMCH set to become one of India’s largest hospitals, says Assam CM

As part of the Assam State Secondary Healthcare Initiative for Service Delivery Transformation (ASSIST), construction work is currently in progress. This expansive programme is focused on overhauling the state’s healthcare system, with the twin objectives of enhancing access to quality medical services for every citizen and establishing Assam as a prominent hub for healthcare in the region.

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Waist-to-height ratio outperforms BMI in detecting risk of fatty liver disease and liver cirrhosis: Study

Excess fat mass estimated by waist circumference-to-height ratio predicts the risk of liver damage better than body mass index (BMI) estimated obesity, a new study shows. Waist-to-height ratio is a cheap and universally accessible tool to detect the risk of fatty liver disease both in the young and adult population. The study was conducted at the University of Eastern Finland, and the results were published in the Journal of the Endocrine Society.

In the present study, 6,464 children, adolescents and adults between 12 and 80 years of age were drawn from the United States National Health and Nutrition Examination Survey (NHANES) conducted between 2021 and 2023. Non-invasive liver scans were conducted in all participants by transient elastography, based on which their risk of liver steatosis or fibrosis was classified. The prevalence of significant or advanced liver fibrosis was 7.1%, while 4.9% had liver cirrhosis. More than 1 in 4 (26.1%) participants had suspected liver steatosis, while less than 1% had severe liver steatosis.

Previous studies in adults have shown that BMI-diagnosed obesity is a risk factor for liver steatosis. However, recent clinical consensus statements have recommended that obesity should not be diagnosed with BMI alone but confirmed with another measure such as waist-to-height ratio.

In a recent study, waist-to-height ratio was discovered as a highly sensitive and specific predictor of dual-energy Xray absorptiometry-measured total body fat mass and abdominal fat mass in the pediatric and young adult population. Waist-to-height ratio cutpoints for normal, high and excess fat mass were established and have since been validated to detect the risk of type 2 diabetes and bone fracture. The present study examined if these cutpoints can predict liver steatosis and fibrosis in a multiracial population.

The prevalence of waist-to-height-ratio-estimated normal fat mass (0.40 – <0.50), high fat mass (0.5 – <0.53) and excess fat mass indicating obesity (≥0.53) was 20.3%, 13.6% and 64.5%, respectively. After full adjustments for covariates, normal fat mass had a 48% protective effect against liver steatosis and a 52% protective effect against liver fibrosis or cirrhosis. High fat mass predicted 63% higher odds of liver steatosis and 31% higher odds of liver fibrosis or cirrhosis. Excess fat mass predicted four-fold higher odds of liver steatosis and 61% higher odds of liver fibrosis or cirrhosis.

Waist-to-height-ratio-estimated high fat mass and excess fat mass separately predicted higher odds of liver steatosis nearly two-fold and six-fold, respectively, better than BMI-overweight and BMI-obesity. The study accounted for age, sex, systolic blood pressure, heart rate, educational status, smoking status, race, sedentary time, moderate physical activity, fasting insulin, glucose, total cholesterol and high-sensitivity C-reactive protein.

“Remarkably, the findings were consistent regardless of sex and age. In addition, the findings were similar across the studied White, Black, Mexican-American and Hispanic populations. The simple and universally accessible waist-to-height measurement is useful in clinical and public health practice for liver disease screening, prevention, diagnosis and management globally,” says Andrew Agbaje, physician and associate professor (docent) of Clinical Epidemiology and Child Health at the University of Eastern Finland.

Reference:

Andrew O Agbaje, Novel Pediatric Waist-to-height Ratio Fat Mass Cutoff Predicts Liver Steatosis and Fibrosis Better than Body Mass Index: The NHANES, Journal of the Endocrine Society, Volume 9, Issue 7, July 2025, bvaf079, https://doi.org/10.1210/jendso/bvaf079

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Post-PCI De-escalation of Ticagrelor to Clopidogrel Reduces Bleeding Risk Without Increasing Ischemic Events in CKD Patients: JAMA

A new study published in the Journal of American Medical Association showed that switching from ticagrelor to clopidogrel one month after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) significantly reduced bleeding risk without increasing ischemic events in patients with chronic kidney disease (CKD).

A major risk factor for ischemic and hemorrhagic sequelae after PCI for acute myocardial infarction is chronic kidney disease. Improving clinical results requires optimizing dual antiplatelet treatment (DAPT). Thus, to determine if an 11-month, unguided deescalation approach from ticagrelor to clopidogrel was linked to decreased bleeding without an increase in ischemic events in stable patients with CKD following AMI, Sang Hyun Kim and colleagues carried out this trial.

A total of 32 major cardiac hospitals in South Korea participated in this clinical study Ticagrelor vs. Clopidogrel in Stabilized Patients With Acute Myocardial Infarction (TALOS-AMI), which was the subject of this post hoc secondary analysis. The trial comprised patients with biomarker-positive AMI who were able to tolerate ticagrelor-based DAPT for one month following PCI.

The patients were enrolled between February 2014 and December 2018, and they were followed up with at 30, 3, 6, and 12 months following PCI. The subgroup of CKD patients was the focus of the current investigation. Analysis of the data took place between July 2023 and October 2024. The main outcome was a composite of bleeding (Bleeding Academic Research Consortium [BARC] categories 2, 3, or 5) and myocardial infarction, stroke, and cardiovascular disease mortality.

Of the trial’s 2646 participants, 305 had chronic kidney disease, whereas 2341 did not have CKD. While there was no change in the risk of bleeding, individuals with CKD were more likely to experience ischemic episodes. Deescalation (n = 160) compared to active control (n = 145) was linked to lower chances of the main end point and BARC 2, 3, or 5 bleeding in CKD patients.

After deescalation, there was no discernible rise in the risk of ischemia episodes. Overall, unguided deescalation from ticagrelor- to clopidogrel-based DAPT in patients with AMI and CKD one month after PCI was linked to a lower risk of bleeding complications without an increased risk of ischemic events. 

Reference:

Kim, S. H., Lee, K. Y., Byeon, J., Sa, Y. K., Hwang, B.-H., Kim, C. J., Choo, E.-H., Lim, S., Choi, I. J., Choi, Y. S., Park, C. S., Park, M.-W., Her, S.-H., Lee, M., Chang, K., & TALOS-AMI Investigators. (2025). Deescalation from ticagrelor to clopidogrel for myocardial infarction with chronic kidney disease: A secondary analysis of a randomized clinical trial. JAMA Network Open, 8(5), e2511297. https://doi.org/10.1001/jamanetworkopen.2025.11297

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Adopting healthy diet may have cardiometabolic benefits regardless of weight loss, suggests study

Nearly one-third of people who adopted and adhered to a healthy diet did not lose any weight, but still reaped many health benefits, according to a new study led by researchers at Harvard T.H. Chan School of Public Health and Ben Gurion University, Israel. Independent of weight reduction, study participants showed significant improvements in cardiometabolic markers, including higher HDL cholesterol (the healthy type of cholesterol), lower levels of leptin (the hormone that signals hunger), and less visceral fat (belly fat found deep inside the abdominal cavity, sometimes wrapping around organs).

“We have been conditioned to equate weight loss with health, and weight loss-resistant individuals are often labeled as failures,” said lead author Anat Yaskolka Meir, postdoctoral research fellow in the Department of Epidemiology at Harvard Chan School. “Our findings reframe how we define clinical success. People who do not lose weight can improve their metabolism and reduce their long-term risk for disease. That’s a message of hope, not failure.”

The study will be published June 5 in the European Journal of Preventive Cardiology.

The researchers analyzed changes in weight and health among 761 individuals with abdominal obesity in Israel who participated in three landmark workplace-based nutrition clinical trials (DIRECT, CENTRAL, and DIRECT-PLUS) with high adherence rates and comprehensive metabolic profiling. At each trial, participants were randomly assigned to adopt and adhere to healthy diets-including low-fat, low-carbohydrate, Mediterranean, and green-Mediterranean diets-for between 18 and 24 months.

The study found that, across all of the clinical trials and all of the diets, 36% of participants achieved clinically significant weight loss (defined as losing more than 5% of their initial body weight); 36% achieved moderate weight loss (losing up to 5% of their initial body weight); and 28% were resistant to weight loss, losing no weight or gaining some. Weight loss was associated with a variety of health improvements: The researchers calculated that each kilogram lost was associated with a 1.44% increase in HDL cholesterol, a 1.37% decrease in triglycerides, a 2.46% drop in insulin, a 2.79% drop in leptin, and a 0.49-unit reduction in liver fat, along with reductions in blood pressure and liver enzymes.

The study also found, however, that participants who were resistant to weight change-who tended to be older and/or women-showed many of the same improvements. They had more good cholesterol; lower levels of leptin, leading to less hunger; and less harmful visceral fat.

“These are deep metabolic shifts with real cardiometabolic consequences,” said Yaskolka Meir. “Our study showed that a healthy diet works, even when weight doesn’t shift.”

The researchers also utilized cutting-edge omics tools and discovered 12 specific DNA methylation sites that strongly predict long-term weight loss.

“This novel finding shows that some people may be biologically wired to respond differently to the same diet,” said corresponding author Iris Shai, principal investigator of the nutrition trials and adjunct professor of nutrition at Harvard Chan School. “This isn’t just about willpower or discipline—it’s about biology. And now we’re getting close to understanding it.”

The study had some limitations, namely that the majority of participants were men. The researchers noted that future similar studies should focus on women.

Reference:

Anat Yaskolka Meir, Gal Tsaban, Ehud Rinott, Hila Zelicha, Dan Schwarzfuchs, Yftach Gepner, Assaf Rudich, Ilan Shelef, Matthias Blüher, Michael Stumvoll, Uta Ceglarek, Berend Isermann, Nora Klöting, Maria Keller, Peter Kovacs, Lu Qi, Dong D Wang, Liming Liang, Frank B Hu, Meir J Stampfer, Iris Shai, Individual response to lifestyle interventions: a pooled analysis of three long-term weight loss trials, European Journal of Preventive Cardiology, 2025;, zwaf308, https://doi.org/10.1093/eurjpc/zwaf308

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Red Blood Cells Linked to Vascular Damage in Type 2 Diabetes: Study

Sweden: A study published in the Journal of Clinical Investigation has revealed that red blood cells (RBCs) in individuals with type 2 diabetes release extracellular vesicles (EVs) loaded with the enzyme arginase-1. These vesicles contribute to oxidative stress and damage to the vascular lining, opening potential pathways for therapeutic intervention to prevent complications commonly associated with diabetes.

Led by Aida Collado Sanchez and her team at the Karolinska Institutet in Stockholm, the research explores how RBCs in type 2 diabetes mellitus (T2DM) contribute to endothelial dysfunction—an early marker for various vascular complications, including heart attacks, strokes, and kidney disease. Despite producing fewer EVs than those from healthy individuals, diabetic RBCs showed increased vesicle uptake by endothelial cells. This uptake impaired the ability of blood vessels to relax, a key feature of healthy vascular function.

The researchers demonstrated that this dysfunction could be significantly reduced by blocking arginase activity or mitigating oxidative stress. Their findings suggest that RBC-derived EVs transfer arginase-1 into the endothelial cells, triggering oxidative mechanisms that disrupt the nitric oxide pathway, which is essential for vascular dilation.

The study challenges the long-held belief that endothelial dysfunction in diabetes is primarily due to intrinsic defects within the endothelial cells. Instead, it positions RBC-derived vesicles as external instigators of vascular injury. A better understanding of the mechanisms involved in EV uptake, particularly changes to proteoglycans like syndecan-4 and CD44 on the EV surface, could help in developing targeted interventions.

Further supporting the findings, proteomic analysis of diabetic RBC-EVs revealed elevated levels of proteins linked to oxidative stress. Treatment with an arginase-1 inhibitor, ABH, prevented the spike in reactive oxygen species and preserved normal vessel relaxation in mouse models, even after exposure to diabetic RBC-EVs.

Genetic studies in mice confirmed that this damaging process stems from externally delivered arginase-1 rather than the endothelial cells’ enzyme. Even when the internal production of arginase-1 was silenced, the vesicle-transferred enzyme was sufficient to provoke oxidative stress.

Beyond vascular damage, the study touches upon broader implications of RBC-EVs in diabetes-related complications. These vesicles carry pro-thrombotic markers like tissue factor and phosphatidylserine, which may contribute to increased clotting risk in heart attack patients. Additionally, EVs containing the protein α-synuclein, which plays a role in neurodegenerative diseases, could pass into the brain and trigger inflammation, possibly explaining the higher risk of dementia in diabetics.

“This study suggests that the problem may not lie within the blood vessels themselves, but rather in the blood,” the authors noted. Their work clarifies the cellular mechanisms behind diabetes-induced vascular damage and paves the way for novel therapies aimed at blocking EV uptake or neutralizing their harmful cargo.

Reference:

Erythrocyte-derived extracellular vesicles induce endothelial dysfunction through arginase-1 and oxidative stress in type 2 diabetes. Aida Collado, … , Zhichao Zhou, John Pernow. Published March 20, 2025. Citation Information: J Clin Invest. 2025;135(10):e180900. https://doi.org/10.1172/JCI180900.

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