SGLT-2 inhibitors effective in treating cirrhosis patients under diuretic therapy: JAMA

A new study published in the Journal of American Medical Association showed that the usage of sodium-glucose cotransporter 2 (SGLT-2) inhibitors was linked to a decreased risk of severe liver outcomes.

There are currently few effective treatment options available to lessen the consequences of cirrhosis. Inhibitors of sodium-glucose cotransporter 2 (SGLT-2), which are mostly used to treat diabetes and heart failure, may also have advantages for the liver. Thus, this study assessed the relationship between the usage of SGLT-2 inhibitors and the risk of severe liver events in cirrhosis patients on spironolactone and furosemide.

Data from more than 120 healthcare institutions on the TriNetX platform were used in this cohort research. Included were the adult cirrhosis patients treated with furosemide and spironolactone between January 2013 and July 2021. Using 1:1 propensity matching, patients taking SGLT-2 inhibitors in addition to furosemide and spironolactone were matched with a control group of patients receiving furosemide and spironolactone alone based on comorbidities, age, and demographics. The 3-year follow-up period for these patient ended on July 11, 2024.

A composite of significant liver outcomes, such as the incidence of ascites, hyponatremia, variceal development, or all-cause death, was the main outcome. The incidence of variceal hemorrhage, paracentesis, hepatic encephalopathy, spontaneous bacterial peritonitis, hypoglycemia, hepatorenal syndrome, hepatocellular cancer, and hospitalizations for all reasons were among the secondary outcomes. The Pearson χ2 test was used to compare categorical variables, while the independent-samples t test was used to analyze continuous variables.

SGLT-2 inhibitor-treated patients exhibited a lower incidence of major liver events than control patients among 10 660 propensity-matched individuals (mean [SD] age, 63.8 [10.7] years; 57.8% male) (hazard ratio [HR], 0.68 [95% CI, 0.66-0.71]; P <.001).

Hepatorenal syndrome (HR, 0.47 [95% CI, 0.40-0.56]), paracentesis (HR, 0.54 [95% CI, 0.50-0.60]), spontaneous bacterial peritonitis (HR, 0.55 [95% CI, 0.46-0.65]), hypoglycemia (HR, 0.75 [95% CI, 0.62-0.91]), variceal bleeding (HR, 0.79 [95% CI, 0.73-0.84]), and all-cause hospitalizations (HR, 0.67 [95% CI, 0.63-0.71]) were secondary outcomes that were linked to a lower risk among those taking SGLT-2 inhibitors.

Overall, cirrhosis patients may benefit from SGLT-2 inhibitors in relation to their liver. To further assess their safety and effectiveness, prospective studies are required. Given that recurrent UTIs, euglycemic diabetic ketoacidosis, and changes in sodium levels after starting an SGLT-2 inhibitor are established side effects of this medication class, future research should explicitly look at these alterations. 

Reference:

Abu-Hammour, M.-N., Abdel-Razeq, R., Vignarajah, A., Khedraki, R., Sims, O. T., Vigneswaramoorthy, N., & Chiang, D. J. (2025). Sodium-glucose cotransporter 2 inhibitors and serious liver events in patients with cirrhosis. JAMA Network Open, 8(6), e2518470. https://doi.org/10.1001/jamanetworkopen.2025.18470

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New study shows link between childhood health and risk of disease in men in later life

New research has shown how boys being overweight in early childhood or having chickenpox or another infectious disease in infancy may increase their risk of having chronic disease in later life.

Scientists from the University of Nottingham’s School of Biosciences have analysed the level of the unique testis hormone biomarker insulin-like peptide 3 (INSL3) in young men at 24 years of age and related this to a range of health and lifestyle factors during their childhood.

The team have previously shown that the biomarker INSL3 in younger men is predictive of chronic disease when they get older. In this new study they found that while most factors had little or no effect, being overweight as a child or young teenager, or having had chickenpox or other infectious disease in early infancy, were significantly associated with a reduction in adult INSL3 by 10 to 15%. This potentially increases the risk of later adult illnesses such as diabetes, cardiovascular disease, bone weakness, or sexual dysfunction.

The study, published today in Andrology is the first to ever examine the impact of childhood diet, health and infections and their long term impact on health across the lifespan.

The research was led by Dr Ravinder Anand-Ivell, Associate Professor in Endocrinology and Reproductive Physiology, who has previously shown how the unique biomarker INSL3, in ageing men is able to predict conditions such as diabetes, cardiovascular disease, or bone weakness, and that low INSL3 in older men has its origins already in younger men.

Dr Anand-Ivell explains: “We know that INSL3 hormone levels in boys and men are a robust biomarker of the testicular capacity to produce the steroid hormone testosterone that is essential not only for reproduction but also for overall healthy well-being. In this new study we have found that there is a clear link between certain health factors in childhood at a time before puberty when the testes are still developing and later men’s health as they age.”

In this new study the researchers analysed data from participants in the “Children of the Nineties” cohort of children (the Avon Longitudinal Study of Parents And Children) established by colleagues at the University of Bristol. These boys had been followed clinically from birth and are now in their twenties.

By correlating the levels of INSL3 in the young men from this cohort with a wide range of clinical and lifestyle parameters throughout their childhood and adolescence, the team identified the factors during childhood which could potentially affect mens health as they aged. Importantly, they also identified many other factors which were less important. The key findings showed that being overweight as a child or young teenager, or having had chickenpox or other infectious disease in early infancy both markedly increase the risk to mens health as they age and moreover emphasize the importance of early vaccination.

Dr Anand-Ivell adds: “By using this new biomarker INSL3 as well as having this childhood health information allows us now to be able to predict those men at risk and thus consider appropriate preventative measures before disease sets in. The next stage of this research is the development of a specialist high-throughput assay which would allow the measurement of INSL3 to be introduced as part of the routine clinical assessment for male healthy ageing.”

Reference:

Richard Ivell, Bilal Tilumcu, Waleed Alhujaili, Ravinder Anand-Ivell, Maternal, childhood and adolescent influences on Leydig cell functional capacity and circulating INSL3 concentration in young adults: Importance of childhood infections and body mass index, Andrology, https://doi.org/10.1111/andr.70091.

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Novel study uncovers the critical role of ADAM10 protein in development of retinal disorders

New research has found that the endothelial cell-specific A disintegrin and metalloproteinase domain-containing protein 10 (ADAM10) regulates abnormal blood vessel growth in the damaged retina, which can cause vision loss or impairment. The findings of the new study in The American Journal of Pathology, published by Elsevier, have significant implications for understanding the pathophysiology of neovascular disorders like retinopathy of prematurity and diabetic retinopathy and provide a potential target for treatment.

ADAM10, a versatile protein involved in a wide range of cellular processes, particularly those related to the regulation of cell surface protein expression and intercellular communication, is known to have a physiological role in normal blood vessel formation. However, its role in proliferative retinopathies, in which abnormal blood vessel formation is the primary cause of vision loss and impairment, remains understudied.

The present study explored the role of endothelial cell-specific ADAM10 and its signaling on pathologic neovascularization within the retina. Using an endothelial-specific ADAM10 knockout mouse model (ADAM10i∆EC), its goal was to uncover the molecular mechanisms underpinning ADAM10 participation in retinal neovascularization to provide fresh insights into potential therapeutic targets for retinal neovascular disorders.

Lead investigator Nikhlesh K. Singh, DVM, PhD, Integrative Biosciences Center and Department of Ophthalmology, Visual and Anatomical Sciences, School of Medicine, Wayne State University, says, “In this study, we discovered that ADAM10 activity was significantly elevated in the injured retina, and reducing ADAM10 levels or its activity notably slowed the growth, spread, movement, and tube formation of human retinal microvascular endothelial cells. Additionally, when we eliminated ADAM10 from the endothelial cells in mice, it substantially alleviated issues associated with retinal diseases, such as blood leakage from vessels, swelling, and the formation of new blood vessels.”

While investigating how ADAM10 influences abnormal blood vessel growth, the researchers found that ADAM10 regulates the levels of the protein Ephrin B2 in endothelial cells, and decreasing Ephrin B2 levels impacts the growth, movement, sprouting, and tube formation of human retinal endothelial cells. Furthermore, a significant increase in Ephrin B2 expression was observed in the damaged retina, and the removal of ADAM10 specifically from endothelial cells drastically reduced Ephrin B2 expression, indicating that ADAM10 plays a crucial role in the development of new blood vessels in the retina by regulating Ephrin B2 levels.

Pathologic retinal neovascularization is the primary cause of visual loss in diseases such as proliferative diabetic retinopathy, retinopathy of prematurity, central vein occlusion, and age-related macular degeneration. The extracellular matrix breakdown by metalloproteinase leads to vascular complications in various proliferative retinopathies. Most of the current therapeutic approaches for these diseases involve invasive and moderately effective surgical procedures, such as anti-VEGF (Vascular Endothelial Growth Factor) treatment.

Co-investigators Shivantika Bisen, MSc, and Purnima Gogoi, PhD, MVSc, Integrative Biosciences Center and Department of Ophthalmology, Visual and Anatomical Sciences, School of Medicine, Wayne State University, and Department of Medical Genetics, School of Medicine and Public Health, University of Wisconsin (PG), note, “Various clinical and experimental findings report that the use of anti-VEGF agents can result in neuronal damage, hypertension, myocardial infarction, stroke, and diabetes. Additionally, there are many patients who do not respond to anti-VEGF therapies. Our study shows that targeting ADAM10 or its downstream effectors, such as Ephrin B2, could offer novel strategies for managing or preventing retinal diseases characterized by pathologic neovascularization.”

Dr. Singh concludes, “The human body is a sophisticated and autonomous system, and we, as medical researchers, strive to comprehend the intricacies of its existence and functionality, continually fascinated by its self-sufficiency and resilience. Our study has significant implications for understanding the pathophysiology of hypoxic and/or ischemic retinal diseases and highlights potential therapeutic targets, paving the way for novel treatment strategies beyond current anti-VEGF therapies.”

Reference:

Bisen, Shivantika et al., A Disintegrin and Metalloproteinase 10 Regulates Ephrin B2–Mediated Endothelial Cell Sprouting and Ischemic Retinopathy, The American Journal of Pathology, DOI: 10.1016/j.ajpath.2025.03.007 

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Delhi HC Flags Off-Label Use of Diabetes Drugs for Weight Loss, Seeks CDSCO Report

New Delhi: The Delhi High Court has directed the Central Drugs Standard Control Organisation (CDSCO) and the Drug Controller General of India (DCGI) to examine a representation raising serious concerns over the approval and misuse of potent diabetes drugs being repurposed for weight loss. The court’s directive came in response to a public interest litigation (PIL) filed by fitness entrepreneur Jitendra Chouksey, founder of FITTR, seeking urgent regulatory action on drugs such as Ozempic (semaglutide), Mounjaro (tirzepatide), Victoza (liraglutide) and others, originally meant for Type 2 diabetes but now widely being used off-label to lose weight.

The bench, comprising Chief Justice Manmohan and Justice Tushar Rao Gedela, expressed alarm at the uncontrolled promotion and use of these medications. “Drugs with such serious consequences must be regulated,” the bench remarked. Justice Gedela further commented during the hearing that “such instances should be reported to the police” when informed that in some cases gym trainers were recommending or even administering these medications to individuals seeking weight loss.

The petitioner’s counsel, senior advocate Diya Kapur, submitted that the drugs were originally meant for diabetes but were being sold as a “magic formula for weight loss,” with little awareness among users about possible adverse effects. The court was also informed that these drugs were being obtained and used in gyms and wellness clinics without medical supervision, and that they were “being promoted by influencers and wellness platforms that target younger populations without adequate risk disclosure.”

Also Read: Delhi HC Restrains Dr Reddy’s from Selling Semaglutide Drug in India Amid Novo Nordisk Row

Raising further alarm, the PIL contended that these drugs were granted approval “based largely on short-term efficacy trials” and without robust safety evaluations specific to Indian patients. It pointed out that “these drugs were originally developed for the regulation of glycemic levels. However, over time they were repurposed and approved by CDSCO for the treatment of weight loss and obesity in individuals without diabetes, based largely on short-term efficacy trials,” the plea stated as reported by PTI.

The court, noting recent incidents involving unregulated aesthetic or anti-aging treatments, including the death of television actor Shefali Jariwala, remarked, “See what happened two-three days back…it was in the news,” referring to the widespread media coverage of the death. The court said the issue of drug misuse needed to be addressed comprehensively.

Highlighting the potential dangers, the plea cited risks such as pancreatitis, thyroid cancer, pancreatic cancer, cardiovascular and neurological side effects including optic neuropathy. It also referenced a UK report linking 82 deaths to the use of similar GLP-1 receptor agonist drugs. The petition emphasized that despite widespread use, “there is currently no mandatory pharmacovigilance framework to monitor the safety of these drugs in the Indian population.”

The petitioner called for the immediate suspension of approval for non-diabetic use of such drugs and a prohibition on their marketing for weight loss. It also sought that all clinical trial and safety data be made publicly available and that “a public advisory warning should be issued, highlighting the associated risks,” reports LawChakra.

In response, the Delhi High Court disposed of the PIL, but directed the CDSCO to act on the petitioner’s representation. As per the Live Law report, the court said;

“We direct the respondents to take a decision on the petitioner’s representation after consulting experts and stakeholders including manufacturers within three months.” It also permitted the petitioner to “file an additional representation along with all documents relied upon in court within two weeks.”

The Economic Times reports that the PIL had further argued that GLP-1 drugs “should not be administered without adequate medical justification, long-term studies, or medical supervision.” It warned that off-label use had turned into a fitness fad and “must be checked before it becomes a public health hazard.”

The court’s order now places responsibility on the CDSCO and DCGI to review the approvals and safety mechanisms associated with these medications. Their decision is expected within three months, by early October 2025, following stakeholder consultation and submission of supporting data by the petitioner.

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Cervical HPV Linked to Increased Risk of Oral HPV in Women: Study

Researchers have discovered in a new study a strong association between cervical HPV infection and elevated risk of oral HPV. They found that Women with abnormal cervical cytology showed the highest rates of oral HPV presence. As many as 1 in 8 women with cervical HPV had oral HPV, suggesting the need to consider oral HPV screening in this high-risk group.

The human papillomavirus (HPV) is the most common sexually transmitted infection of the 21st century, infecting an estimated 630 million people worldwide and contributing to approximately 4.5% to 5% of all cancers. The incidence of HPV-associated oropharyngeal cancer is increasing. Yet, population screening for oral HPV infection is not recommended by the Food and Drug Administration due to the low prevalence and lack of a universally accepted screening strategy or tool. The study aims to evaluate the link between cervical and oral HPV infection in women and identify high-risk groups. The protocol was registered on PROSPERO (CRD42023477695). The systematic search was performed in 3 databases (PubMed, EMBASE, and CENTRAL) on January 3, 2025. Forty-one analytical observational studies reporting on oral HPV status in women with and without cervical HPV positivity were included. Effect sizes, including proportions and odds ratios with 95% confidence intervals (CIs), were analyzed using a random-effects model. Location, population characteristics, and sampling methods were used to perform the subgroup analyses. The meta-analysis revealed an odds ratio of 2.22 (CI: 1.52-3.25) for oral HPV in women with cervical HPV positivity compared with those without it. The prevalence of oral HPV was significantly higher in cervical HPV-positive women (13%, CI: 8%-20%) than in HPV-negative women (4%, CI: 2%-7%). In addition, the prevalence of oral HPV was even higher in cervical HPV-positive women with positive cytology (17%, CI: 6%-39%). Risk-of-bias assessment indicated low risk among all studies using Quality in Prognosis Studies and moderate to low risk among studies assessed with the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Our findings support the association between cervical HPV positivity and elevated risk for oral HPV infection. Moreover, the highest prevalence of oral HPV carriage was observed in women with positive cytology. As 1 in 8 women with cervical HPV carries oral HPV, screening should be considered for this at-risk population.

Reference:

Mózes AE, Olasz FH, Martineková P, Kiss-Dala S, Bródy A, Végh D, Zsembery Á, Hegyi P, Ács N, Rózsa NK. Cervical HPV Positivity Elevates the Risk for Oral HPV Infection: A Systematic Review with Meta-Analysis. J Dent Res. 2025 Jun 23:220345251337071. doi: 10.1177/00220345251337071. Epub ahead of print. PMID: 40551482.

Keywords:

Cervical, HPV, Linked, Increased, Risk, Oral, HPV, Women, Study, Mózes AE, Olasz FH, Martineková P, Kiss-Dala S, Bródy A, Végh D, Zsembery Á, Hegyi P, Ács N, Rózsa NK, Journal of Dental Research, human papillomavirus viruses; oncogenic virus; oropharyngeal neoplasms; uterine cervical neoplasms; viruses; women.

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Acupuncture significantly reduces stress, pain, and anxiety for patients undergoing IVF, suggests study

A recent study published by researchers at University Hospitals Connor Whole Health and Case Western Reserve University School of Medicine revealed that Whole Systems Traditional Chinese Medicine (WS-TCM), when integrated with in vitro fertilization (IVF), significantly improves patient-reported levels of stress, pain, and anxiety within a single treatment session. The researchers are also among the first to describe the real-world integration of WS-TCM treatments such as acupuncture within a fertility clinic at a U.S. academic medical center.

The retrospective study, conducted at UH Connor Whole Health and the UH Fertility Center, analyzed 1896 WS-TCM treatments provided during 202 embryo transfers for 146 patients from 2019 to 2022. Patients undergoing IVF who received WS-TCM treatments, including acupuncture, lifestyle and dietary guidance, and herbal medicine, experienced measurable symptom relief. The study found clinically meaningful improvements following a single-treatment with average reductions of 2.2 units in anxiety, 2.1 in stress, and 1.4 in pain on a 10-unit numeric rating scale.

Findings support the use of WS-TCM for providing symptom relief for patients navigating the heavy emotional and physical challenges of IVF. Over 25 percent of patients in the study sample had documented mental health diagnoses, with anxiety being the most common. Thus, integrative treatments like WS-TCM may enhance patient experience during IVF treatment. This evidence adds to a growing body of research supporting the efficacy of acupuncture and other WS-TCM modalities for improving IVF success rates.

Researchers found that 88.6 percent of IVF cycles included WS-TCM treatment on the day of embryo transfer. Additionally, 64.9 percent of cycles featured treatments in the weeks leading up to embryo transfer. As WS-TCM practitioners continue to be integrated within U.S. fertility centers, this study provides comprehensive data on when treatments occurred, how many treatments were provided, and what specific acupuncture points were utilized to address the needs of women undergoing IVF.

The UH Fertility Center is among a growing number of academic medical centers nationwide implementing integrative therapies into reproductive health services. This collaborative care model enables personalized, whole-person support for every step throughout fertility treatment.

“During the IVF journey, patients seek the best possible clinical outcomes, but also comprehensive support to help manage the stress and anxiety that often accompany treatment. Our study demonstrates that acupuncture and whole-systems TCM can serve as a valuable tool to decrease pain, stress and anxiety – ultimately contributing to both improved outcomes and a more positive, holistic patient experience,” said Dr. Christine Kaiser, DACM, Lac, Principal Investigator of the Study and the Connor Endowed Director of Reproductive Well-being at UH Connor Whole Health.

“Our patients often ask how complementary therapies impact IVF outcomes, and this study is a critical step toward providing high-quality data to guide those decisions,” added Dr. Rebecca Flyckt, MD, co-author of the study and Division Director of Reproductive Endocrinology and Infertility at UH. “Collaborative research like this helps us to better support patients not only medically, but emotionally and physically throughout their fertility treatments.”

Reference:

Lu R, Rodgers-Melnick SN, Flyckt R, et al. Clinical Delivery of Whole Systems Traditional Chinese Medicine and Impacts Upon Patient Reported Outcomes During IVF. Global Advances in Integrative Medicine and Health. 2025;14. doi:10.1177/27536130251349116

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CO₂ Laser Tonsillotomy Offers Effective, Cost-Efficient Relief for Tonsil Issues: JAMA

Netherlands: In a secondary analysis of a randomized clinical trial, researchers found that CO₂ laser tonsillotomy (TO) and tonsillectomy (TE) under general anesthesia effectively reduced long-term symptoms, with TE showing slightly greater symptom reduction. However, TO had lower costs and similar patient satisfaction, making it a safe, effective, and cost-efficient option for tonsil-related conditions.

The findings were published online in JAMA Network Open on April 29, 2025.

Tonsillectomy, the standard treatment for adult tonsil disease, involves complete removal of the tonsils and is effective, though often associated with significant postoperative pain, extended recovery, and higher costs. In contrast, carbon dioxide (CO₂) laser tonsillotomy, which entails partial removal of tonsillar tissue, offers a less invasive alternative that may lead to a smoother recovery.

Recognizing these differences, Justin Emile Raoul Edouard Wong Chung, Department of Ophthalmology, Maasziekenhuis Pantein, Boxmeer, the Netherlands, and colleagues conducted a secondary analysis of a randomized clinical trial to compare the 1- and 2-year efficacy and cost-effectiveness of TO versus TE.

The researchers conducted a secondary analysis of a randomized clinical trial conducted across five Dutch hospitals and compared tonsillectomy under general anesthesia with CO₂ laser tonsillotomy under local anesthesia in adults with persistent tonsil-related symptoms. The study assessed outcomes at 1 and 2 years, including symptom presence, severity, patient satisfaction, quality-adjusted life-years (QALYs), and cost-effectiveness. Data were analyzed from January to April 2025 to evaluate their long-term benefits and cost-effectiveness.

The key findings were as follows:

  • Ninety-eight patients were assigned to TO and 101 to TE, with 98 analyzed per group.
  • Both groups were similar in terms of gender (70% female in TO vs 68% in TE) and mean age (29 years in TO vs 30 years in TE).
  • The most common symptom was sore throat with fever (34% in both groups), with similar baseline severity scores (57 mm in TO vs 59 mm in TE).
  • At 1 year, 51.8% of TO patients had persistent symptoms, compared to 25.2% of TE patients. At 2 years, 45.2% of TO patients vs 19.7% of TE patients had persistent symptoms.
  • Symptom severity decreased significantly in both groups, but TE had a lower severity at 1 year (14.8 mm vs 23.0 mm) and 2 years (10.8 mm vs 19.6 mm).
  • Patient satisfaction was similar for both groups at 1 year (VAS scores of 79.0 mm for TE vs 69.3 mm for TO) and 2 years (64.1 mm for TE vs 64.4 mm for TO).
  • Similar proportions of participants would recommend the procedure at 1 year (79% TE vs 76% TO) and 2 years (71% for both).
  • Both groups showed high cumulative QALYs at 2 years, with no significant difference (EuroQol 5 Dimension and Visual Analogue Scale scores).
  • Tonsillotomy had lower overall costs ($869 versus $2363 for TE), with societal cost savings of $1925 and a 71% probability of cost-effectiveness at $25,907 per QALY.

This trial highlights that tonsillectomy and CO₂ laser tonsillotomy effectively reduce long-term tonsil-related symptoms, with TE offering slightly greater symptom relief. However, the authors note that CO₂ laser TO stands out as a safe, less invasive, and cost-effective alternative, offering shorter recovery, lower healthcare costs, and comparable patient satisfaction.

While TE may be preferable for those seeking complete symptom resolution and aiming to avoid a potential secondary procedure, the authors suggest that TO is better suited for patients prioritizing quicker recovery, minimal disruption to daily life, or those unfit for general anesthesia. With proper patient selection and counseling, they concluded, that CO₂ laser TO remains a valuable option in managing adult tonsil disease.

Reference:

Wong Chung JERE, van den Hout WB, van Helmond N, van Benthem PPG, Blom HM. Long-Term Efficacy and Cost-Effectiveness of Laser Tonsillotomy vs Tonsillectomy: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025;8(4):e254858. doi:10.1001/jamanetworkopen.2025.4858

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TNF Inhibitor linked to Remission in Early axSpA regardless of Gut Inflammation: Study

A new study published in the journal of Arthritis & Rheumatology showed that early treatment with a TNF inhibitor led to remission in most patients with active axial spondyloarthritis (axSpA), regardless of baseline gut inflammation. Intestinal inflammation did not impact sustained remission rates, and about 75% of patients relapsed after stopping treatment.

The patients with spondyloarthritis experience pauci-articular peripheral arthritis or enthesitis, as well as inflammatory back discomfort. Long-term osteoproliferation and ankylosis of the spine and sacroiliac joint can result from persistent inflammation of the axial skeleton. Remarkably, those with persistent intestinal inflammation were more likely to begin anti-TNFα treatment and had a greater chance of developing ankylosing spondylitis (AS). Thus, to assess the effectiveness of tight-control, quick escalation to TNF suppression in early axial spondyloarthritis in connection to gut inflammation, this study was carried out.

The GO-GUT trial was conducted in treatment-naïve axSpA patients with high disease activity and symptom duration of less than a year. The patients had ileocolonoscopies at baseline, and the gut mucosa was examined histopathologically. After that, each patient got two separate NSAIDs at the recommended dosage for four weeks. Monotherapy with 50 mg golimumab every 4 weeks was started if inactive disease (defined as Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP <1.3) or clinically significant improvement (ΔASDAS-CRP score > 1.1 resulting in low disease activity (ASDAS-CRP <2.1)) could not be obtained.

The patients were monitored until the completion of the experiment or maintained clinical remission (ASDAS-CRP <1.3 at two consecutive visits spaced 12 weeks apart). All medication was stopped after a prolonged clinical remission was achieved, and the prospect of a drug-free remission was assessed.

The trial involved a total of 58 patients. In 28.6% of patients, there was microscopic intestinal inflammation, primarily acute inflammation. It was necessary to escalate treatment to golimumab for 72.7% of patients. Regardless of gut inflammation, 61.8% of patients achieved the primary trial objective of prolonged clinical remission. 78.1% of patients experienced a disease recurrence within a year after stopping treatment.

Overall, regardless of whether microscopic gut inflammation is present or not, a treat-to-target strategy can elicit high percentages of durable clinical remission in treatment-naïve early axSpA.

Reference:

Łukasik, Z., De Craemer, A.-S., Renson, T., Deroo, L., Varkas, G., de Hooge, M., Lenaerts, J., Hoorens, A., Cuvelier, C., Ortega, T. L., Carron, P., Van den Bosch, F., & Elewaut, D. (2025). Efficacy of golimumab in early axial spondyloarthritis in relation to gut inflammation (GO-GUT), an early remission induction study. Arthritis & Rheumatology. https://doi.org/10.1002/art.43283

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Novel brain imaging platform combines upright PET and AR eye tracking to advance cognitive disorder research

A cutting-edge brain imaging platform that integrates upright PET scanning, an augmented reality (AR) headset, and motion tracking enables researchers to study brain function in a more natural and dynamic way. Presented at the Society of Nuclear Medicine and Molecular Imaging 2025 Annual Meeting, the new system-called Motion-tracked Immersive functional PET (MIf-PET)-allows participants to sit upright and interact with immersive tasks during scans. This approach offers a more realistic view of brain activity and holds promise for earlier and more accurate detection of cognitive disorders such as Alzheimer’s and Parkinson’s disease.

Humans naturally interact with and perceive the world in an upright position, which is linked to increased sympathetic nervous system activity-an advantage when performing tasks. Despite this, most neuroscience research relies on functional neuroimaging conducted while participants lie motionless in a supine position, limiting the ecological validity of brain activity measurements.

“To overcome this limitation, my colleagues and I developed MIf-PET-a system designed to assess brain behavior and function in an upright position, allowing task-based neuroimaging to be conducted in a more natural posture without the constraints of head immobilization,” said Zipai Wang, a research associate at Weill Cornell Medicine in New York, New York.

The study tested two types of tasks to measure brain activity: an anti-saccade task, which evaluates eye movement control, and a “face oddball” task, designed to observe how the brain reacts to familiar versus unexpected faces. Participants viewed a mix of standard, target, and novel faces through an AR headset which collected eye-tracking data, At the same time, functional PET imaging was performed to capture detailed brain activity.

Analysis of pupil size and blinking patterns over time showed clear changes related to the tasks. Both novel and target faces triggered pupil dilation, with the most pronounced response occurring during target face presentations. This heightened response reflects increased cognitive load and attentional engagement elicited by novel face presentations.

“This new approach is especially useful for studying how the brain supports thinking, attention, and memory,” said Wang. “It focuses on a small but critical region deep in the brainstem called the locus coeruleus (LC), which is essential for maintaining alertness but is difficult to visualize using traditional imaging methods. Because the LC regulates pupil size, its activity can be inferred through eye movement tracking.”

“By combining high-resolution brain imaging with eye tracking and immersive, upright cognitive tasks, the MIf-PET system provides a more direct and dynamic view of this key brain region and its role in cognitive disorders,” added Amirhossein Goldan, PhD, associate professor of electrical engineering in radiology and principal investigator of the project at Weill Cornell Medicine in New York, NY.

This technology is currently being developed under a grant from the National Institute on Aging, part of the National Institutes of Health. Researchers are currently constructing the upright PET scanner and testing the system with healthy volunteers and early-stage Alzheimer’s and Parkinson’s patients. The first prototype is expected to be ready for imaging human subjects in 2027.

Reference:

Zipai Wang, Wanbin Tan, Gloria Chiang and Amirhossein Goldan, Integrating fPET Imaging with AR-Based Eye Tracking: A Novel Platform for Brain Function Assessment, Journal of Nuclear Medicine.

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Adjunctive Hemodialysis may improve Biochemical biomarkers in Adults with DKD Without increasing Short-Term Risks: Study

Researchers have found in a new research that among adults with diabetic kidney disease (DKD), adjunctive hemodialysis improved markers of renal function, inflammation, and glycemic control without raising short-term complication risks. However the researchers emphasized the need for large, multicenter randomized trials to confirm patient-centered outcomes.

Diabetic kidney disease (DKD) progresses inexorably to kidney failure; whether initiating hemodialysis earlier than usual confers additional clinical benefit remains uncertain. The aim of this study is to evaluate the effects of hemodialysis, compared with conventional medical care, on glycemic control, renal function, inflammatory markers, and treatment-related complications in adults with Diabetic kidney disease. They searched eight databases (Chinese Biomedical Database, Wanfang, CNKI, PubMed, EMBASE, ScienceDirect, Cochrane Library and VIP) and conference proceedings from January 2010 to 30 March 2025. Randomized controlled trials comparing hemodialysis plus standard therapy with standard therapy were eligible for inclusion in adult Diabetic kidney disease patients. Two reviewers independently screened records extracted data and assessed risk of bias with the Cochrane Handbook 5.3 tool. Mean differences (MD) and 95% confidence intervals (CI) were pooled with random-effects models. Results: Eight studies (645 participants) met the criteria. Compared with controls, hemodialysis significantly reduced parathyroid hormone (MD =  − 37.30, 95% CI − 43.16 to − 31.43; I2 = 0%), tumour necrosis factor-α (MD =  − 15.29, 95% CI − 25.05 to − 5.53; I2 = 89%), interleukin-4 (MD =  − 20.42, 95% CI − 25.89 to − 14.94; I2 = 42%), and interleukin-8 (MD =  − 13.56, 95% CI − 20.85 to − 6.27; I2 = 76%). Glycemic indices improved (fasting glucose MD =  − 0.80, 95% CI − 1.59 to − 0.02; HbA₁c MD =  − 0.63, 95% CI − 1.34 to 0.08). Serum creatinine (MD =  − 1.03, 95% CI − 1.69 to − 0.36) and blood urea nitrogen (MD =  − 0.94, 95% CI − 1.49 to − 0.39) also fell, despite high heterogeneity (I2 ≥ 99%). Four studies reported complications; pooled analysis showed no significant difference in overall adverse events (risk ratio = 0.91, 95% CI 0.62 to 1.34). Evidence is based on small, single-center studies with unclear allocation concealment, substantial heterogeneity for several outcomes, and no assessment of long-term clinical endpoints. In adults with Diabetic kidney disease, adjunctive hemodialysis improves biochemical surrogates of renal function, inflammation, and glycemic control without increasing short-term complications. Robust multicentre randomised trials powered for patient-important outcomes are warranted.

Reference:

Liu, X., Zhou, J., Liu, C. et al. Efficacy and incidence of complications of hemodialysis in the treatment of diabetic nephropathy: a systematic review and meta-analysis. Syst Rev 14, 129 (2025). https://doi.org/10.1186/s13643-025-02872-6

Keywords:

Adjunctive , Hemodialysis, improve, Biochemical, biomarkers, Adults DKD, Without, increasing, Short-Term Risks, Study , Liu, X., Zhou, J., Liu, C, Hemodialysis, Diabetic nephropathy, Therapeutic effect

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