TyG Index Potential Marker for evaluating kidney function and Diabetic Kidney Disease: Study

A new study published in the Journal of Diabetes & Metabolic Disorders found TyG Index as an indicator for diabetic kidney disease (DKD) in individuals with type 2 diabetes (T2D), highlighting its potential clinical use in evaluating renal function deterioration.

Diabetes continues to have an unacceptably high incidence worldwide, with a steady upward trend. The mortality of diabetes patients and the frequency of cardiovascular events are significantly impacted by end-stage renal disease (ESRD). A higher percentage of people with type 2 diabetes experience DKD than those with type 1 diabetes.

Numerous cardiovascular conditions, including atherosclerosis, acute coronary syndrome, and heart failure, have been discovered to be strongly correlated with the TyG index, a new measure generated from triglycerides (TG) and fasting plasma glucose (FPG). TyG Index is a straightforward indicator of insulin resistance. It is unknown how it affects the development of diabetic kidney disease (DKD) in people with type 2 diabetes. Thus, this study examined the relationship between the TyG index and the advancement of DKD in T2D.

This study included 428 T2D patients with and without DKD. According to the Kidney Disease Improving Global Outcomes (KDIGO) criteria, the progression of DKD was determined. The TyG index was used to separate patient demographic data into quartiles. The relationship between the TyG Index and metabolic markers was examined using multiple regression.

According to the findings, 257 individuals (60.0%) experienced DKD. The TyG index was considerably higher in the DKD group than in the non-DKD group (9.9 ± 0.7 vs. 9.4 ± 0.6, P < 0.001). Age, systolic blood pressure, glycated hemoglobin, triglycerides, urea, total cholesterol, uric acid, LDH, creatinine, albumin creatinine ratio, and TyG index (P < 0.05 for each), glycated hemoglobin, triglycerides, and eGFR were all lower in the DKD group.

An elevated TyG index was identified as an independent risk factor for DKD. Overall, the TyG Index may be an indication of DKD in T2D patients. This data confirms the clinical value of TyG index in evaluating renal function worsening in DKD patients.

Source:

Siddiqui, K., Nawaz, S. S., George, T. P., David, S. K., Alfadda, A. A., & Rafiullah, M. (2025). Association of triglyceride-glucose index with diabetic kidney disease in patients with type 2 diabetes. Journal of Diabetes and Metabolic Disorders, 24(2), 171. https://doi.org/10.1007/s40200-025-01680-y

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FDA approves first cream for treating chronic hand eczema

The U.S. Food and Drug Administration (FDA) has signed off on the first-ever cream specifically approved for treating chronic hand eczema (CHE).

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Research findings could improve outcomes for critically ill patients on ventilators, study finds

A seven-year international, multi-center clinical trial led by London Health Sciences Centre Research Institute (LHSCRI) and St. Michael’s Hospital, a site of Unity Health Toronto, has found that a new ventilation mode called proportional assist ventilation (PAV+) could improve outcomes for patients in the intensive care unit (ICU) who require help breathing. The study is published in the New England Journal of Medicine.

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Tezepelumab effective as Add-On Therapy in Both T2-High and T2-Low Severe Asthma: Study

According to a real-world study, tezepelumab is an effective add-on biologic with a rapid onset of action for patients with both T2-high and T2-low severe asthma. The study was published in International Immunopharmacology by Pelaia and colleagues.

The trial involved 30 patients who had been diagnosed with either T2-high or T2-low severe asthma. Patients were evaluated at baseline and subsequently after 4 weeks of tezepelumab add-on therapy. The clinical symptom control, asthma-related quality of life, lung function, inflammatory biomarkers, and use of oral corticosteroid (OCS) were among the assessments. The participants were recruited from a single centre and comprised those who had and had not received prior treatment with other biologic drugs.

Markers of inflammation also showed significant reductions. Fractional exhaled nitric oxide (FeNO), the eosinophilic airway inflammation biomarker, declined significantly. Counts of blood basophils, another indicator of allergic and inflammatory reaction, also decreased. In cytokines, serum levels of interleukin-2 (IL-2) and vascular endothelial growth factor (VEGF) were significantly decreased, evidencing the extensive immunomodulatory actions of tezepelumab.

Key Findings

 • 30 patients with severe asthma were assessed

• Substantial symptom improvement quantified by ACT score and AQLQ

• Improved lung function: FEV1, FEF25–75, and Rtot

• Reduced inflammatory markers: FeNO, basophil count

• Decreased cytokines: IL-2, VEGF

• Effects observed in both T2-high and T2-low patients

• Beneficial regardless of previous biologic use

Efficacy Across Asthma Phenotypes

Significantly, the study confirmed that the benefits of tezepelumab extended to both T2-high and T2-low phenotypes of severe asthma. In addition, the drug’s efficacy was unaffected in patients whether they had been exposed to prior use of other biologic medicines or not. This highlights tezepelumab’s sole strength: it neither depends on eosinophilic nor allergic biomarkers to act on patients with severe asthma. Hence, it is a therapy universally applicable across all cases of severe asthma.

In this real-world investigation, tezepelumab demonstrated rapid and robust improvements in asthma control, lung function, and inflammatory markers for both T2-high and T2-low phenotypes. Its efficacy, irrespective of previous biologic exposure, attests to its utility as a useful add-on treatment with widespread use in severe asthma. Future long-term research may further confirm such encouraging initial findings and optimize its placement within asthma treatment guidelines.

Reference:

Pelaia, C., Greco, M., Iaccino, E., Crimi, C., Biafora, M., Dragone, F., Vatrella, A., & Pelaia, G. (2025). Short-term therapeutic effectiveness of tezepelumab in patients with severe asthma: A real-world study. International Immunopharmacology, 162(115185), 115185. https://doi.org/10.1016/j.intimp.2025.115185

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Doppler Ultrasound-Based Approach Reduces Complications in Pregnancies With Reduced Fetal Movements: Lancet Study

Netherlands: A new international study has found that using a cerebroplacental ratio (CPR)-based management approach in pregnancies at term—where women report reduced fetal movements—can help lower the risk of adverse perinatal outcomes, even in fetuses that are not classified as small-for-gestational-age (non-SGA). The findings, published in The Lancet Obstetrics, Gynaecology & Women’s Health, were led by Dr. Laura Lens and her team from the University Medical Centre Groningen, Netherlands.

The cerebroplacental ratio is a Doppler ultrasound measurement that compares blood flow in the fetal brain and the umbilical cord. A low CPR suggests that the fetus may be redirecting blood flow to the brain due to placental dysfunction, an indication that the baby might be under stress despite appearing normally grown.

The CEPRA trial (Cerebroplacental Ratio-based Management) is the first randomized study to evaluate whether using this ratio to guide clinical decisions could improve outcomes in pregnancies where mothers feel reduced fetal movement, but the fetus is not underweight.

The study enrolled 1,815 pregnant women across 23 hospitals—22 in the Netherlands and one in Australia—between July 2020 and September 2024. All participants were carrying singleton pregnancies in a cephalic presentation at term and had reported reduced fetal movement. Women were eligible only if their estimated fetal weight was above the 10th percentile and there was no immediate reason for inducing labor.

Hospitals were randomly assigned to two groups: one where CPR results were disclosed and used to guide clinical management (revealed group), and the other where care proceeded according to usual hospital protocols without disclosing CPR values (concealed group). In the revealed group, women with a CPR below 1.1 were advised expedited delivery, while those with higher ratios continued with routine monitoring.

The study revealed the following findings:

  • A total of 1,684 women were in the modified intention-to-treat analysis.
  • Adverse perinatal outcomes occurred in 12% of women who received CPR-based management.
  • In the standard care group, adverse outcomes were in 15% of women; corresponding to a relative risk reduction of 24% in the CPR-guided group.
  • There were no stillbirths in either group.
  • One neonatal death occurred in each group.
  • The adverse outcomes included neonatal mortality, low five-minute Apgar scores, low umbilical artery pH, emergency births due to fetal distress, and severe neonatal morbidity.
  • Serious adverse events were slightly more common in the standard care group.
  • None of the serious adverse events were related to the study protocol.

The research offers a new perspective on managing pregnancies where reduced fetal movements are reported but fetal growth appears normal. “These findings suggest that CPR can help distinguish between cases that require early intervention and those that do not,” said co-author Dr. Sanne Gordijn. “This ensures that both mother and baby receive the care best suited to their situation.”

The authors concluded, “The study reinforces the value of Doppler-based screening in identifying hidden risks in term pregnancies. It provides a foundation for updating clinical guidelines in managing reduced fetal movements in non-SGA fetuses.”

Reference:

Lens, L. A., Posthuma, S., Damhuis, S. E., Burger, R. J., Groen, H., Duijnhoven, R. G., Kumar, S., Heazell, A. E. P., Khalil, A., Ganzevoort, W., & Gordijn, S. J. (2025). Cerebroplacental ratio-based management versus care as usual in non-small-for-gestational-age fetuses at term with maternal perceived reduced fetal movements (CEPRA): A multicentre, cluster-randomised controlled trial. The Lancet Obstetrics, Gynaecology, & Women’s Health, 100002. https://doi.org/10.1016/j.lanogw.2025.100002

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Low neighborhood walkability is associated with increased risk of cardiovascular disease: Study

Low neighbourhood walkability is associated with increased risk of cardiovascular disease (CVD), according to research presented today at ESC Preventive Cardiology 2025,1 a scientific congress of the European Society of Cardiology (ESC).

The health benefits of physical activity are well established and yet more than a quarter of adults do not meet the recommended guideline of 150 minutes of moderate-intensity physical activity per week. “Neighbourhoods designed to be walkable may help residents to choose active transportation, such as commute walking, rather than sedentary modes of travel like driving, and allow increased physical activity to be incorporated into daily life,” said presenter Dr. Erik Timmermans of University Medical Center Utrecht, Utrecht, Netherlands. Neighbourhood walkability can be defined as a composite measure of built environment characteristics that facilitate walking, with consideration of factors including land use mix, population density and green space density. “Evidence on the relationship between walkability and CVD is scarce and largely relies on cross-sectional studies. We conducted a longitudinal study to capture changes in walkability over time and relate them to CVD incidence in later years,” noted Dr. Timmermans.

The analysis included data from Statistics Netherlands for all 3,019,069 Dutch residents aged 40 years or older at baseline (2009), without a history of CVD and who did not move house after baseline. A nationwide, objectively measured walkability index was calculated for 500 m areas around their residential addresses. In this study, the walkability index consisted of six components: population density, retail and service density, land use mix, intersection density, green space density and sidewalk density, with geographical data provided by the Geoscience and Health Cohort Consortium. Latent class trajectory modelling was used to assess walkability changes over a 13-year period, from 1996 to 2008.

Data on the incidence of CVD from 2009 to 2019 was collected from the Dutch Hospital Discharge Register and the National Cause of Death Register. Cox proportional hazards modelling was used to analyse associations between walkability trajectories and subsequent CVD incidence, adjusted for individual- and area-level sociodemographic characteristics.

The median age of the study population at baseline was 57 years (interquartile range, 49 to 65 years). Four distinct trajectories of neighbourhood walkability were observed: a stable but relatively low walkability trajectory (91.1%), a stable but relatively higher walkability trajectory (0.6%), a relatively higher initial neighbourhood walkability that decreased over time (1.7%), and a relatively lower initial neighbourhood walkability that increased over time (6.5%). During a median follow-up of 11.0 years, 21.4% of individuals developed CVD. Among CVD outcomes, there were 81,600 deaths due to any CVD (2.7%).

Compared with stable high walkability, individuals exposed to stable low walkability had a 5.1% higher risk of any CVD (hazard ratio [HR] 1.051; 95% confidence interval [CI] 1.011–1.093). Individuals exposed to increasing walkability had a 4.9% higher risk of any CVD compared with those exposed to stable high walkability (HR 1.049; 95% CI 1.008–1.092). Similar associations were observed for coronary heart disease and stroke but were not statistically significant. No significant associations were found for heart failure and CVD mortality.

Dr. Timmermans summarised the findings: “Adults exposed to low walkability over time – which was most individuals in our study – had a higher risk of CVD compared to those in stable high walkability neighbourhoods. Increasing walkability was also associated with higher CVD risk, which is likely due to the overall lower cumulative walkability during the exposure period that could have led to ingrained activity patterns or cardiometabolic risks that were not immediately reversible, even after walkability improved. Our results highlight the importance of long-term urban planning for cardiovascular health.” 

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Smoking Significantly Increases Psoriasis Relapse Risk, reveals research

Researchers have established that smoking tobacco has a high likelihood of increasing the risk of relapse in patients receiving treatment for psoriasis. The study was recently published in the journal of Psoriasis by Shen F. and fellow researchers. The results indicate that smoking not only influences the severity and onset of psoriasis but also potentially has a central part in reducing the success of long-term treatment, highlighting the extreme significance of giving up smoking in the care of chronic skin disorders.

551 adult psoriasis patients participated in the study, 75.7% of whom were male with a mean age of 45.8 years. A formal observational design was used, with information assessed by standardized questionnaire and physical examination at baseline, week 12, week 24, and week 48. Improvement was quantified by PASI scores. PASI50 and PASI75 indicated 50% and 75% improvement, respectively, and relapse was identified by the loss of at least 50% of this improvement after week 12. 282 out of the total participants were current smokers (51.2%). Researchers took special notice of the presence of smoking behavior and its level, which was measured through daily cigarette consumption and smoking duration.

Results

  • At week 12, the relapse rates among those who had reached PASI50 were 41.2% at week 24 and 61.6% at week 48.

  • In patients who reached PASI75, relapse rates were considerable but lower: 27.6% at week 24 and 51.7% at week 48.

  • Tobacco smokers particularly had very high relapse rates compared with non-smokers, especially in the PASI75 group.

  • Logistic regression analysis revealed that the risk of relapse was over twice as great among smokers than non-smokers, with an odds ratio of 2.10 (95% CI: 1.17–3.78) at week 24 and 1.84 (95% CI: 1.07–3.14) at week 48, even when controlling for other factors of influence.

  • Also, individuals with longer durations of smoking and larger daily cigarette consumption had greatest rates of relapse.

The results of this large observational study strongly suggest tobacco smoking as an important and modifiable risk factor for relapse of psoriasis. The findings highlight the importance of integrating smoking cessation programs in the treatment plan for psoriasis to maximize long-term treatment outcome and minimize risk for relapse. Dermatologists and physicians need to actively advise psoriasis patients on the increased risk of relapse linked with smoking and assist them in quitting cigarette smoking.

Reference:

Shen F, Ding Y, Qiang Y, Duan Z, Xu Q, Gao X, Zhang R, Wang R. Tobacco Smoking Was Positively Associated with Disease Relapse at week 24 and 48 Among Patients with Psoriasis Vulgaris in Shanghai: A Prospective Study. Psoriasis (Auckl). 2025;15:261-272

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Direct pulp capping or partial pulpotomy effective treatment of Carious Pulp Exposure in Reversible Pulpitis: Study

A new study published in the Journal of Endodontics revealed that teeth with reversible pulpitis and carious pulp exposure can be effectively treated using either direct pulp capping or partial pulpotomy, based on the intraoperative evaluation of the exposed pulp.

This double-blind, parallel randomized trial evaluated 140 mature permanent teeth in patients exhibiting either no symptoms or symptoms consistent with reversible pulpitis. The participants were randomly assigned to receive either direct pulp capping (67 teeth) or partial pulpotomy (73 teeth). All procedures were performed under magnification, with careful intraoperative hemostasis, and the same bioactive material (NeoPUTTY MTA) was used as the pulp capping agent.

Follow-up assessments were scheduled at 6 and 12 months, with both clinical and radiographic examinations performed to assess treatment success. Pre-treatment symptoms were present in roughly half of the cases (74 out of 140 teeth), with no statistical difference between the groups in terms of initial pain levels (p=0.75). Both treatment modalities resulted in significant pain reduction after one week (p<0.001), confirming short-term relief.

At the 6-month follow-up, failure was observed in 10 cases of direct pulp capping and 4 cases of partial pulpotomy. This translated to success rates of 94.4% for partial pulpotomy and 84.4% for direct pulp capping, a difference that approached but did not reach statistical significance (P=0.057).

At the 12-month mark, an additional two failures were reported in each group, yielding final success rates of 91.5% for partial pulpotomy and 81.3% for direct pulp capping. Again, while these findings suggested a trend favoring partial pulpotomy, the difference was not statistically significant (P=0.08).

Multivariate regression analysis revealed no significant prognostic indicators influencing treatment outcomes for either technique, which reinforced that both are viable options depending on case-specific clinical judgment.

The results suggest that partial pulpotomy may offer a marginally higher success rate in treating reversible pulpitis in cariously exposed mature permanent teeth. Both treatments showed excellent pain reduction and high success rates, but the slightly improved durability of partial pulpotomy may guide clinicians when choosing between the two, especially when pulp vitality is confirmed and bleeding is well-controlled.

Overall, the findings underline the importance of intraoperative evaluation and reinforce that, in the absence of firm guidelines, clinical discretion remains key in selecting the appropriate therapy.

Source:

Taha, N. A., Jaradat, H. B., DkmaK, A., & Abidin, I. Z. (2025). Carious pulp exposure in mature teeth with reversible pulpitis: a randomized clinical trial of direct pulp capping and partial pulpotomy. Journal of Endodontics. https://doi.org/10.1016/j.joen.2025.06.019

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A new cell therapy for leukaemia shows high efficacy and safety in the laboratory: Study

T-cell Acute Lymphoblastic Leukaemia (T-ALL) is a highly aggressive form of blood cancer that can occur in both children and adults. It is characterised by failures in the maturation of T-lymphocytes, key immune cells involved in the defence against infections and cancer, which, instead of performing their function, proliferate uncontrollably in the bone marrow. While the cure rate in children exceeds 80%, in adults it remains at around 40% and is associated with a high probability of relapse following chemotherapy.

However, advances in the field of immunotherapy, especially CAR-T cell treatments that show remarkable results in other blood cancers, have not yet reached T-ALL. This is precisely because the cells affected are the same cells used in these therapies, T-lymphocytes. Identifying markers that are in tumour lymphocytes and not in healthy T-lymphocytes, thus avoiding fratricidal attack, is particularly complicated.

Finding a way to distinguish leukaemic T-cells from healthy ones is just what Dr Pablo Menéndez’s team at the Josep Carreras Leukaemia Research Institute has now achieved, with the support of Dr Diego Sánchez, ARAID researcher at the Aragon Health Research Institute, and the biotech company OneChain Immunotherapeutics, a spin-off of the Josep Carreras Institute. Their research has demonstrated that the proteins CD1a and CCR9 are present in the leukaemic cells of most T-ALL patients, but are not appreciably expressed in healthy cells or other parts of the body.

Thanks to this discovery, published in the Journal of Hematology & Oncology, one of the leading journals in the field, the scientific team has been able to develop and test in the laboratory the first dual CAR-T cell therapy targeting T-ALL. Experimental results show that these new CAR-T cells attack cells that express both CD1a and CCR9, as well as those expressing only one of the two, and that they can effectively control the disease in both in vitro and in vivo models.

The ability to target two antigens simultaneously makes this therapy significantly more effective than those focusing on only one, as demonstrated in the study. It also broadens its applicability to patients with heterogeneous T-ALL, in which the expression levels of the two targets vary among leukaemic cells.

Moreover, unlike previous attempts, these new dual CAR-T cells targeting CD1a and CCR9 spare both healthy T lymphocytes and themselves, as well as other bone marrow cells, resulting in an excellent safety profile. These findings, combined with previous evidence from the same research team and others internationally, open the door to the clinical development of what could become the first effective cell therapy against T-ALL in the medium term.

Reference:

Tirado, N., Fidyt, K., Mansilla, M.J. et al. CAR-T cells targeting CCR9 and CD1a for the treatment of T cell acute lymphoblastic leukemia. J Hematol Oncol 18, 69 (2025). https://doi.org/10.1186/s13045-025-01715-0.

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Methotrexate Fails to Show Benefit in Knee Osteoarthritis Trial

A new study published in the Journal of American Medical Association showed that methotrexate flops to show benefit in knee osteoarthritis trial. Despite earlier signs of pain relief in hand osteoarthritis, methotrexate did not improve pain or joint inflammation in a placebo-controlled trial for knee OA.

Osteoarthritis (OA) is the leading cause of disability globally due to the population’s rapid aging. Chronic joint pain and functional impairment are hallmarks of OA, which significantly lowers a person’s quality of life. The absence of effective treatments to treat OA symptoms or to halt the disease process and related structural development is one of the main obstacles to lessening the burden of OA on people and society.

According to a recent study, people with inflammatory hand osteoarthritis may experience less joint discomfort while using methotrexate. Whether methotrexate has comparable effects on inflammatory knee OA is yet unclear, though. Thus, to determine if methotrexate has symptom-relieving and disease-modifying effects for individuals with knee OA and effusion-synovitis, this study was carried out.

This clinical study that took place in 11 locations in China from July 18, 2019, until January 15, 2023. The patients with inflammatory knee OA who lived in the community and had effusion-synovitis on magnetic resonance imaging were included. Stratified by trial location, participants were randomly allocated (1:1) to receive either a placebo or methotrexate up to 15 mg weekly using block randomization. Over a 52-week period, the main outcomes for the intention-to-treat group were the change in knee visual analog scale (VAS) pain and the change in effusion-synovitis maximum area.

Out of the 278 individuals who underwent screening, 215 (mean [SD] age, 60.4 [7.4] years; 191 [89%] female) were randomly assigned to one of two groups (108 to receive methotrexate, 107 to receive a placebo), and 175 (81%) finished the experiment.

Over the course of 52 weeks, there was no significant difference in the changes in VAS pain or effusion-synovitis maximum area between the methotrexate and placebo groups (between-group difference: 0.3 mm [95% CI, −6.7 to 7.3 mm] for VAS pain; 0.1 cm2 [95% CI, −0.8 to 1.0 cm2] for effusion-synovitis maximal area).

None of the predetermined secondary outcomes showed any discernible differences between groups. About 32 individuals (29.6%) in the methotrexate group and 26 participants (24.3%) in the placebo group experienced at least one adverse event. Overall, in a placebo-controlled trial for knee OA, methotrexate did not reduce pain or joint inflammation, despite prior indications of pain alleviation in hand osteoarthritis.

Source:

Zhu, Z., Yu, Q., Leng, X., Xu, J., Ren, L., Wang, K., Huang, C., Pan, Y., Zhao, Y., Li, T., Mei, Y., Guan, M., Li, X., Zhang, Z., Wu, J., Chen, Y., Qu, Y., Zhu, X., Liao, Q., … Ding, C. (2025). Low-dose methotrexate for the treatment of inflammatory knee osteoarthritis: A randomized clinical trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.1359

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