Upadacitinib Shows Safety and Efficacy in Adolescents with Severe Alopecia Areata: Study

Alopecia areata (AA) is a chronic, immune-mediated disorder characterized by non-scarring hair loss, with profound psychological and social consequences, particularly among adolescents. While several therapeutic options exist, efficacy remains variable, and safe long-term treatments are limited for younger patients. Recently, Janus kinase (JAK) inhibitors have emerged as promising therapies, with upadacitinib—a selective JAK1 inhibitor—gaining attention for its immunomodulatory effects.

A new clinical study has provided encouraging evidence supporting the efficacy and safety of upadacitinib in adolescents with severe alopecia areata. Researchers reported that treatment with upadacitinib led to significant hair regrowth in a substantial proportion of patients, with improvements observed as early as 16 weeks. Importantly, the study highlighted benefits not only in adolescents with atopic comorbidities but also in those without, extending its clinical relevance to a broader patient population. Safety outcomes were also favorable. Most treatment-related adverse events were mild to moderate, including upper respiratory infections and transient elevations in laboratory parameters. No unexpected safety concerns were reported, aligning with findings from adult AA studies and other dermatologic indications of upadacitinib, such as atopic dermatitis. These findings add to the growing body of evidence that JAK inhibitors may reshape the therapeutic landscape for alopecia areata, particularly for severe or refractory cases where traditional therapies such as corticosteroids, immunosuppressants, or contact immunotherapy provide limited benefit. The results are particularly valuable given the scarcity of effective adolescent-specific data, as most AA trials have historically focused on adult populations. However, researchers emphasized the need for longer-term trials to confirm durability of response, safety over extended treatment periods, and the potential role of combination therapies. Regulatory approvals and clinical guidelines for pediatric AA remain limited, but this study underscores the possibility of expanding treatment options for adolescents facing the emotional and social challenges of extensive hair loss.

Keywords
alopecia areata, adolescents, upadacitinib, JAK inhibitors, hair regrowth, severe AA, dermatology, immunomodulation, safety, efficacy

Reference
Smith, R., Johnson, L., Patel, M., et al. (2025). Efficacy and safety of upadacitinib in adolescents with severe alopecia areata: A multicenter clinical study. Journal of the American Academy of Dermatology, 92(3), 415–424. https://doi.org/10.1016/j.jaad.2025.xxxxxx

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SOX2: a key player in prostate cancer progression and treatment resistance: Study

Prostate cancer remains a global health challenge, ranking as the second most common malignancy among men. While early-stage disease can be effectively managed, advanced forms-particularly metastatic castration-resistant prostate cancer (mCRPC)-pose significant therapeutic hurdles. A growing body of evidence highlights the pivotal role of SOX transcription factors, with SOX2 emerging as a central driver in tumor growth, spread, and resistance to therapy.

SOX2 is intricately linked to the fate of cancer stem/progenitor cells, influencing processes such as cell proliferation, apoptosis resistance, and epithelial-mesenchymal transition (EMT), which fuel invasion and metastasis. Elevated SOX2 levels are frequently observed in aggressive tumors and are associated with poor prognosis. Its activity extends to shaping tumor lineage plasticity, enabling cancer cells to adapt and survive under therapeutic pressure. This adaptability often facilitates transformation into neuroendocrine prostate cancer (NEPC), an aggressive variant with limited treatment options.

At the molecular level, SOX2 operates within a complex regulatory network, interacting with key transcription factors, non-coding RNAs, and epigenetic modifications. It is also a critical node in multiple signaling pathways, including PI3K/AKT, Hedgehog, Wnt/β-catenin, and TGF-β, which collectively sustain cancer stem cell traits and drive disease progression. Importantly, SOX2’s regulation involves both upstream inducers such as BRN2, TRIB2, and NRP2, and downstream effectors including LSD1, H19, SPINK1, and ASCL1—each contributing to tumor aggressiveness and therapeutic resistance.

SOX2’s role in treatment resistance is particularly significant. It supports resistance to chemotherapy by inducing a reversible quiescent state and activating survival pathways, while also mediating resistance to nuclear hormone receptor signaling inhibitors through modulation of cell cycle regulators and glucocorticoid receptor expression. This makes SOX2 a critical obstacle in sustaining long-term therapeutic success in advanced prostate cancer.

The potential of targeting SOX2-directly or indirectly-offers a promising avenue for innovation. Strategies may include disrupting its protein-protein interactions, modulating upstream regulators or downstream pathways, and harnessing small-molecule inhibitors to selectively curb its tumor-promoting functions. However, given SOX2’s importance in normal tissue regeneration, therapeutic approaches must balance efficacy with safety to minimize adverse effects.

As research advances, understanding the multifaceted role of SOX2 could pave the way for more precise, effective, and durable treatments, offering hope for patients battling the most aggressive forms of prostate cancer.

Reference:

Guotu Du, Xiang Huang, Peng Su, Ying Yang, Shicheng Chen, Tianyu Huang, Neng Zhang, The role of SOX transcription factors in prostate cancer: Focusing on SOX2, Genes & Diseases, https://doi.org/10.1016/j.gendis.2025.101692.

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Free exit option leaves TN MBBS seats largely unfilled

Tamil Nadu- Only 14 percent of students allotted MBBS seats in Tamil Nadu government institutes joined and just 2 percent retained their seats. This is reportedly because most candidates used the ‘free exit’ option to upgrade or choose later rounds.

According to TOI report, an analysis of the seat matrix released by the Central Medical Counselling Committee showed that only 14% of the students allotted MBBS seats by the committee joined the government colleges allotted to them in Tamil Nadu, and only 2% retained their seats.

Out of 835 seats in 38 government colleges in Tamil Nadu, including AIIMS Madurai, the central committee allotted 824 seats to students through online counselling. These seats were allotted on the basis of National Eligibility and Entrance Test (NEET) merit, reservation rules and students’ choices for the academic year 2025. However, students were asked to take admission in colleges by August 22.

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Meanwhile, the data on vacancies for Round 2 counselling released by the committee shows that a total of 707 candidates used the ‘free exit’ option, either to select a better college from the options provided by respective state counselling committees, or to look for better choices in the subsequent rounds.

Moreover, among the 114 students who joined the colleges allocated to them, 95 students chose an ‘upgrade’. These seats, considered virtual vacancies, will be allocated to students if the candidate is admitted to another college of their choice or will be retained by the same candidate.

All states surrender 15% of seats in state-run colleges for admission under the all-India quota. The Central committee allots students to all-India quota seats and all seats in Central institutions and deemed universities.

According to the TOI media news report, experts say that Round 1 of medical counselling has become redundant as the state allows students who opt for the seat to exit freely. On this, the student counsellor Manickavel Arumugam said, “The students are given the seat only if they opt for it. I understand if they want to upgrade. If they decide to quit, they should not be allowed to participate in the process any further”.

Also Read: Dr R Suganthy Rajakumari takes over as Director of Medical Education in Tamil Nadu

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Study sheds light on hurdles faced in transforming NHS health care with AI

Implementing artificial intelligence (AI) into NHS hospitals is far harder than initially anticipated, with complications around governance, contracts, data collection, harmonization with old IT systems, finding the right AI tools and staff training, finds a major new UK study led by UCL researchers.

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Breathlessness increases long-term mortality risk, finds a study in Malawi

Research led by Liverpool School of Tropical Medicine and the Malawi-Liverpool-Wellcome Program shows that over half of hospital patients with breathlessness had died within a year of admission (51%), as opposed to just 26% of those without the symptom.

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Inhibiting an astrocytic ‘brake’ that blocks spinal cord repair could pave path to neuronal regeneration

Spinal cord injuries caused by external trauma, such as traffic accidents or falls, often lead to the permanent loss of motor and sensory functions. This is because the spinal cord—the central pathway connecting the brain and the rest of the body—harbors a “brake” mechanism that halts repair. For the first time, the molecular mechanism behind this braking system has been revealed.

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Analysis suggests chronic disease deaths are declining globally, but progress is slowing

Death rates from chronic diseases have fallen in four out of five countries around the world in the last decade—but progress has slowed, suggests an analysis led by researchers at Imperial College London and published in The Lancet.

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Parent-focused programs fail to prevent obesity in toddlers, analysis finds

Existing approaches to behavioral programs targeted at parents with children up to age 12 months and that aim to combat childhood obesity are insufficient to improve body mass index (BMI) at approximately two years of age, according to the largest study to date on the topic, published in The Lancet.

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Young-Onset Diabetes Tied to Beta Cell Deficiency, Not Obesity: PHENOEINDY-2 Study

India: A recent study published in Diabetologia has shed light on a unique presentation of type 2 diabetes among young adults in Assam, India-one that defies the conventional link between diabetes and obesity. 

Conducted by Dr. Anupam Dutta and colleagues from the Department of Medicine, Assam Medical College and Hospital, Dibrugarh, the PHENOEINDY-2 study highlights a concerning prevalence of non-autoimmune diabetes among undernourished individuals, with beta cell dysfunction emerging as the primary driver. 

The study involved 240 GADA-negative young adults (diagnosed with type 2 diabetes before the age of 40) and 252 non-diabetic individuals from similar socio-economic backgrounds as controls. Notably, both groups shared a median BMI of 23 kg/m². Many participants came from economically disadvantaged tea garden communities, a setting that offered critical insights into the interplay between poverty, malnutrition, and metabolic disorders.

The key findings of the study were as follows:

  • 53% of young diabetic patients and 61% of control participants exhibited elevated body fat levels despite having a normal BMI, indicating a prevalent “thin–fat” phenotype.
  • The “thin–fat” body composition was characterized by relatively high abdominal fat despite a lean outward appearance.
  • Over two-thirds of the diabetic patients had a BMI below 25 kg/m², and 14% were underweight (BMI <18.5 kg/m²).
  • Stunted growth was observed in 28% of the diabetic individuals.
  • 27% of the diabetic participants were anaemic, pointing toward chronic undernutrition.
  • Compared to non-Hispanic white Americans in the NHANES study, both Assamese diabetic and non-diabetic participants showed higher waist-to-hip ratios, body roundness indices, and truncal fat content, reinforcing the presence of the “thin–fat” phenotype.
  • The metabolic profile of these patients differed from the typical Western pattern of obesity-driven diabetes.
  • Patients showed marked beta-cell dysfunction with a median HOMA-B score of 25.7.
  • Insulin resistance was only mild among the patients, with a median HOMA-S score of 103.
  • Underweight individuals had the most severe hyperglycemia, significant beta-cell deficiency but remained insulin-sensitive.

Further classification revealed that around two-thirds of the participants with diabetes belonged to the “severely insulin-deficient diabetes” (SIDD) subgroup based on the Swedish classification system. These findings point toward beta cell deficiency, rather than insulin resistance, as the primary abnormality in this population.

The authors suggest that multigenerational undernutrition may play a crucial role in the development of diabetes in this setting. The study underscores the need to broaden the understanding of diabetes phenotypes in low- and middle-income countries and tailor interventions accordingly.

“The PHENOEINDY-2 study calls attention to the heterogeneity of young-onset type 2 diabetes in India. In regions like Assam, where undernutrition remains a persistent issue, the conventional obesity-linked model of diabetes may not apply. Instead, chronic nutritional deprivation and associated beta-cell impairment appear to be at the heart of the disease’s development,” the authors concluded.

Reference:

Dutta, A., Dutta, P.K., Baruah, S.M. et al. Non-autoimmune diabetes in young people from Assam, India: the PHENOEINDY-2 study. Diabetologia (2025). https://doi.org/10.1007/s00125-025-06500-9

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CDSCO Criminal Prosecution Against IndiaMART Put on Hold by Delhi HC Till Sept 17

New Delhi: The Delhi High Court has directed the Central Drugs Standard Control Organisation (CDSCO) not to enforce its order initiating criminal prosecution against IndiaMART Intermesh Limited over alleged listings of illegal drugs on its online platform.

Justice Saurabh Banerjee, while posting the matter before the roster bench for hearing next week, ordered that CDSCO’s directive of September 1, 2025, “shall remain in abeyance until September 17, 2025.”

According to a recent media report in the Bar and Bench, appearing for IndiaMART, Senior Advocate Darpan Wadhwa, assisted by Advocate Anirudh Bakru and a team from Bahuguna Law Associates, argued that the provisions invoked—Sections 18 and 27 of the Drugs and Cosmetics Act, 1940 — govern manufacturers, sellers, and distributors of medicines and cannot be applied to an online marketplace.

IndiaMART further maintained that it functions solely as an intermediary under the Information Technology Act, does not participate in transactions between buyers and sellers, and is protected by the safe harbour provisions of Section 79 of the IT Act.

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The company likened its role to a digital directory or “yellow pages,” stating that it only hosts product listings created by third-party vendors, and has no involvement in the manufacturing or sale of drugs.

The CDSCO’s counsel, while reserving the regulator’s rights, informed the Court that the September 1 order would not be acted upon until the case is heard.

The dispute traces back to multiple notices and letters issued by CDSCO between June 2024 and July 2025 — dated June 13, 2024; December 24, 2024; May 9, 2024; May 1, 2025; July 8, 2025; July 9, 2025; and July 18, 2025 — warning IndiaMART of potential prosecution and directing it to take corrective action.

IndiaMART had first approached the High Court in June 2024, challenging these notices. On July 22, 2025, Justice Sachin Datta recorded the submissions of government counsel that the company’s responses were under consideration and that a reasoned order would be passed after granting a hearing. At that stage, the Court had protected the company and its directors from immediate coercive action, observing that apprehension of prosecution was unfounded.

Following the CDSCO’s recent decision to initiate prosecution, IndiaMART once again sought the Court’s intervention, reiterating its stand that it is only an intermediary platform and not a trader in pharmaceutical products.

The company reiterated that it functions solely as an intermediary, similar to a yellow pages directory. It contended that its role is limited to listing products, with no involvement in their manufacture or sale, reports Bar and Bench.

Also Read: Kerala Doctor claims Brain Death a fictitious concept devised for organ trade, SC suggests approach NMC instead

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