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A new study has determined that increased concentrations of methylglyoxal (MGO), a potent reactive byproduct of glucose metabolism, can independently cause the onset of liver fibrosis among obese individuals. The finding is consistent with mounting evidence indicating that MGO and similar compounds not only initiate inflammation and produce deleterious advanced glycation end products (AGEs), but also are key players in liver injury involved with metabolic dysfunction-associated steatotic liver disease (MASLD).

For most children, influenza (flu) usually means unpleasant symptoms like a fever, sore throat, and achy muscles. But for a small subset of kids, the flu can trigger a rare but serious complication called influenza-associated acute necrotizing encephalopathy (ANE). This form of brain inflammation typically occurs in response to a virus — such as those that cause the flu-and can lead to lasting neurological problems and brain damage. Now, findings of a multicenter study, published today in JAMA, led by Molly Wilson-Murphy, MD, and Rachel Walsh, MD, in Boston Children’s Neuroimmunology Center suggest that ANE is often fatal in these children-despite intensive treatment.

Revealing the risks of influenza-associated ANE

During the 2024-5 U.S. flu season, clinicians at large pediatric centers reported an increased number of children with influenza-associated ANE. This anecdotal rise in cases prompted Wilson-Murphy and her colleagues at Stanford University and elsewhere to collect data on pediatric patients who had been diagnosed with ANE between 2023 and 2025.

After analyzing data on 41 patients from 23 U.S. pediatric hospitals, the team found that influenza-associated ANE carried a high risk of morbidity and mortality. Although most children were previously healthy and didn’t have a significant medical history prior to diagnosis, Wilson-Murphy and her colleagues found that influenza-associated ANE had a 27 percent mortality rate. Those patients died within an average of just three days of exhibiting symptoms, typically from brain herniation.

Of the 30 children who survived influenza-associated ANE, several still experienced neurological difficulties such as epilepsy three months later. Likewise, just 43 percent had regained the ability to walk unassisted.

“While rare, ANE is potentially devastating and can progress very quickly. It is incredibly important for providers to be able to recognize ANE and to act immediately, as rapid treatment may save lives and minimize long-term difficulties,” says Wilson-Murphy. “Vaccination may be important in helping to prevent ANE.”

Vaccination remains key

In addition to shedding light on the severity of influenza-associated ANE, the study highlights the importance of vaccinating children against the flu. Of the 41 patients included in the review, only six had received an age-appropriate flu vaccine for the season during which they developed influenza-associated ANE. Only one of the 11 children who died had received a flu shot. These findings support those from previous research, including a large Japanese epidemiologic study, which showed that mass vaccination of school-aged children significantly reduced death from influenza-associated encephalopathy, likely through decreased community transmission.

Along with the role of flu vaccination in prevention, Wilson-Murphy and her colleagues point to the importance of prompt diagnosis and treatment of influenza-associated ANE. Because death occurred quickly in fatal cases, rapid, intense management of the condition — including neuroprotective critical care and immunotherapy — is key.

“There is still so much we have yet to learn about ANE, but we hope this study has helped raise awareness and pave the way for more surveillance and recognition and, ultimately, to advances in treatment,” says Wilson-Murphy.

Reference:

Influenza-Associated Acute Necrotizing Encephalopathy (IA-ANE) Working Group. Influenza-Associated Acute Necrotizing Encephalopathy in US Children. JAMA. Published online July 30, 2025. doi:10.1001/jama.2025.11534.

A new study published in the Nature Scientific Reports showed that compared to kidney recipients who got preemptive transplants, individuals who experienced dialysis prior to transplantation are at a higher risk of developing long-term visual problems, including dry eye and diabetic retinopathy.

For individuals with end-stage renal disease, kidney transplantation is the only proven therapy option, and its success rate has grown over time. The patient survival has increased and the rejection rate has decreased thanks to improvements in surgical methods, immunosuppressive medications, and excellent postoperative care. Uremia, anemia, and oxidative stress are metabolic variables that might lead to ocular consequences from renal disease.

Furthermore, the link between alterations in the retinal microvasculature and microalbuminuria, a symptom of kidney glomerulus damage, raises the possibility that endothelial dysfunction is happening concurrently in the kidney and retinal blood vessels. Thus, this study evaluated the long-term ocular issues and determine the variables influencing these difficulties in dialysis and preemptive kidney transplant patients.

Nearly, 548 individuals who had a full ophthalmologic examination at least a year following kidney donation were included. Two groups of patients were created: Group 1 consisted of individuals who had previously had dialysis, and Group 2 consisted of those who had not. Hypertension and diabetes mellitus were identified as possible causes of retinopathy. Refractive error, intraocular pressure (IOP), best corrected visual acuity (BCVA), and results from dilated fundus and slit-lamp exams were among the data gathered.

Pterygium, corneal calcification, arcus lipoides, macular drusen, hypertensive retinopathy, central serous chorioretinopathy (CSC), diabetic retinopathy, pinguecula, lens opacity, and refractive error were among the ocular abnormalities that were noted. Every patient was receiving mycophenolate mofetil, calcineurin inhibitors, steroids, and mTOR inhibitors as part of maintenance immunosuppressive treatment.

A total of 291 patients in Group 2 (without dialysis) and 257 in Group 1 (with previous dialysis) were enrolled in the study. The groups’ requirements for myopic and hyperopic correction were comparable. Group 1 had a noticeably higher prevalence of dry eye. There were no discernible variations in the rates of glaucoma, cataract, pterygium, arcus lipoides, or pinguecula.

While other posterior segment findings, such as macular drusen, hypertensive retinopathy, and CSC, were similar between groups, diabetic retinopathy was considerably more prevalent in Group 1. The most common ocular problems were retinopathy, cataracts, and dry eye The patients who had previously had dialysis were much more likely to develop diabetic retinopathy and dry eye.

Overall, patients who had dialysis before transplantation were more likely to acquire and advance diabetic retinopathy than those who received preemptive transplantation.

Source:

Çetinkaya Yaprak, A., Avanaz, A., Erkan Pota, Ç., Arabacı Tur, K. T., & Yaprak, M. (2025). Long-term ocular complications after kidney transplantation. Scientific Reports, 15(1), 15222. https://doi.org/10.1038/s41598-025-99847-3