Study links overthinking to 'constant communication' between brain's fear-centre, social behaviour

Overthinking could be related to the constant back-and-forth between the brain's fear-processing centre or amygdala and the region governing social behaviour, according to a new study.

Reasoning about another person's thoughts and intentions is a core aspect of social cognition and relies on one's social cognitive network. It connects brain regions working together to support a person's ability to understand and interact with others.

"Previous studies have found co-activation of the amygdala and social cognitive network, but our study is novel because it shows the communication is always happening," senior author Rodrigo Braga, an assistant professor of neurology at Northwestern University, US, said.

The constant back-and-forth is possibly why moments after leaving a party, one is suddenly filled with intrusive thoughts such as ‘Did they think I talked too much?’ or ‘Did my joke offend them?’, the researchers said.

To better understand how humans evolved to become so skilled at thinking about what's happening in other peoples' minds, the team looked at functional magnetic resonance imaging (fMRI) brain scans of six people. The fMRI measures brain activity by detecting changes in blood oxygen levels.

"The results suggest that social cognitive functions emerge through coordinated activity between internal circuits of the amygdala and a broader distributed association network and indicate the medial nucleus (located within the amygdala) may play an important role in social cognition in humans," authors wrote in the study published in the journal Science Advances.

This link to the amygdala helps shape the function of the social cognitive network by giving it access to the amygdala's role in processing emotionally important content, the researchers said.

The findings could have implications for treating psychiatric conditions, such as anxiety and depression, they said. Both anxiety and depression involve amygdala hyperactivity, which can contribute to producing excessively emotional responses and impaired emotional regulation, author Donnisa Edmonds, a PhD candidate of neuroscience at Northwestern University, said.

The researchers explained that currently, someone with either condition could receive deep brain stimulation for treatment, but since the amygdala is located deep within the brain — directly behind the eyes — it means having an invasive surgical procedure.

Transcranial magnetic stimulation (TMS), which uses magnetic fields to arouse neurons in the brain, is a much less-invasive procedure and could benefit from the study's findings to improve treatment, they said.

"Through this knowledge that the amygdala is connected to other brain regions — potentially some that are closer to the skull, which is an easier region to target — that means people who do TMS could target the amygdala instead by targeting these other regions," Edmonds said.

https://www.tribuneindia.com/news/health/study-links-overthinking-to-constant-communication-between-brains-fear-centre-social-behaviour/

Can developing type 2 diabetes before age 50 raise dementia risk?

Scientists have linked an earlier diabetes diagnosis to increased dementia risk. 

Previous research shows that more adults are developing type 2 diabetes before the age of 45, and type 2 diabetes is a known risk factor for dementia.

Researchers have found that adults diagnosed with type 2 diabetes before the age of 50 have a higher chance of developing dementia than those who receive a type 2 diabetes diagnosis later in life.

Scientists also found that participants with obesity who received a type 2 diabetes diagnosis before age 50 had the highest dementia risk.

Although type 2 diabetes — a condition where the body is not able to properly use or produce insulin — is normally seen in adults ages 45 and older,Trusted Source research shows a higher rate of younger adults are now developing the condition earlier in life.

Past studies show that type 2 diabetes is a risk factor for developing dementia.

Now, researchers from the NYU Rory Meyers College of Nursing have found that adults diagnosed with type 2 diabetes before the age of 50 — especially those who also have obesity — have a higher chance of developing dementia than those who receive a type 2 diabetes diagnosis later in life.

The study was recently published in the journal PLOS ONETrusted Source.

The link between earlier-diagnosed diabetes and dementia

For this study, researchers analyzed data for about 1,200 U.S. adults ages 50 and over from the Health and Retirement StudyTrusted Source conducted by the University of Michigan Institute for Social Research.

At the time of the Health and Retirement Study, all participants had type 2 diabetes and no dementia diagnosis.

Type 2 diabetes ages for participants were grouped by before age 50, between ages 50-59, 60-69, and 70 years or above.

“While we’ve known that diabetes increases dementia risk, an emerging trend has caught our attention — type 2 diabetes is occurring at much younger ages than before,” Bei Wu, PhD, FAAN, FGSA, the Dean’s Professor in Global Health and vice dean for Research at NYU Rory Meyers College of Nursing and senior author told Medical News Today.

Wu said that globally, the number of people being diagnosed with diabetes before age 40 was rising.

“This shift raised an important question that hadn’t been fully addressed: Does developing diabetes earlier in life impact dementia risk differently than developing it later? Previous research has shown that people diagnosed with diabetes at younger ages often have worse health outcomes, including poorer blood sugar control and more cardiovascular problemsTrusted Source,” Wu continued.

“We hypothesized that a longer duration of exposure to diabetes-related complications might also increase dementia risk. What’s particularly concerning is that few studies have examined this relationship specifically among people with type 2 diabetes. Most previous research has compared individuals with diabetes to those without diabetes, but we wanted to understand the risk patterns within this group itself. Understanding this could help healthcare providers better identify high-risk individuals and develop more targeted prevention strategies,” he said.

Type 2 diabetes diagnosis before 50 increases dementia risk 1.9 times

After a follow-up of about 10 years, almost 18% of the study’s participants developed dementia.

Upon analysis, Wu and her team found that participants who received a type 2 diabetes diagnosis at younger ages increased their dementia risk, compared to those diagnosed at age 70 and older.

Participants diagnosed with type 2 diabetes before age 50 were 1.9 times more likely to develop dementia. Receiving a diagnosis between ages 50 to 59 increased dementia risk 1.72 times, and between ages 60 to 69 by 1.7 times.

“Most strikingly, we found that the earlier someone develops type 2 diabetes, the higher their dementia risk — with those diagnosed before age 50 having nearly twice the risk compared to those diagnosed at 70 or older,” Xiang Qi, PhD, RN, assistant professor at NYU Rory Meyers College of Nursing and first author told MNT. “This wasn’t just a slight increase; we saw a clear ‘dose-response’ pattern where younger age at diagnosis consistently linked to higher dementia risk.”

“What makes this particularly concerning is that we’re seeing a rapid rise in early-onset type 2 diabetes globally,” Qi continued. “Our findings suggest this trend could lead to a larger wave of dementia cases in the future, as these individuals age. This aligns with the 2024 Lancet CommissionTrusted Source‘s emphasis that ‘the earlier, the better’ for risk reduction.”

Highest dementia risk among people with obesity

The researchers also found that obesity seemed to play a role in the link between type 2 diabetes and dementia. They found that participants with obesity who received a type 2 diabetes diagnosis before age 50 had the highest dementia risk in the study.

“The findings become even more significant when we consider obesity,” Qi said. He said they discovered that individuals who had obesity and who were diagnosed with diabetes before age 50 had the highest dementia risk, which was equivalent to three times the risk of individuals who did not have obesity and were diagnosed with diabetes after age 50.

“This interaction between early diabetes and obesity suggests we have multiple intervention points for prevention. These results aren’t just academic — they have immediate clinical implications. They tell us we need to be especially vigilant about cognitive health in younger diabetes patients, particularly those with obesity,” Qi said.

“Our research has highlighted a particularly concerning trend: younger individuals developing type 2 diabetes face a significantly higher risk of dementia, especially if they are also living with obesity. This is troubling, as diabetes and obesity are both increasing at younger ages and affecting a growing number of individuals,” Wu added.

“The most important aspect of our findings is that the risk factors we identified — obesity and early-onset diabetes — are potentially modifiable. This means that there are steps individuals and healthcare providers can take to reduce dementia risk. The goal of our research goes beyond understanding the disease; it’s about finding practical ways to prevent it. Each new risk factor we uncover offers an opportunity to intervene early and potentially prevent cognitive declineTrusted Source, ultimately improving quality of life for millions of individuals and their families.” — Bei Wu, PhD, FAAN, FGSA

More research on type 2 diabetes and the brain needed

MNT also spoke with Clifford Segil, DO, neurologist at Providence Saint John’s Health Center in Santa Monica, CA, about this study.

“Increased blood sugars increase a person’s risk of having a heart attack or strokeTrusted Source, and therefore, increase the risk of type 2 diabetic patients having vascular dementia but not Alzheimer’s dementia. Vascular or multi-infarct dementia is a subcortical dementia in which people become slower (than) forgetful,” Segil said.

“Early onset diabetes (increases) cardiovascular risk with an increased risk for a heart attack and stroke. There are many diabetic patients who never get Alzheimer’s dementia or vascular dementia if they can control their blood sugars.” — Clifford Segil, DO

“I would like to see MRIs of these (study) participants’ brains and a screening cognitive test to determine if early diabetes causes worsening cognition in addition to the expected worsening brain chronic ischemic white matter disease,” Segil added.

https://www.medicalnewstoday.com/articles/can-developing-type-2-diabetes-before-age-50-raise-dementia-risk

Biologic therapies show promise for severe asthma, but barriers remain: Report

Biologic therapies are revolutionising severe asthma management, showcasing potential for remission, but cost and equitable access are the major barriers, according to a report on Tuesday.

Biologic therapy, also known as immunotherapy, is a type of treatment that uses substances derived from living organisms to treat disease.

The report by GlobalData, a data and analytics company, showed that the new Biologics target specific inflammatory pathways, shifting care from symptom control to potential remission.

Biologic treatments like dupilumab interleukin-4 receptor alpha and tezepelumab (anti-thymic stromal lymphopoietin (TSLP)) show potential for wider application. They also offer benefits to patients with various inflammatory profiles.

As per real-world evidence, these therapies have proved their efficacy across diverse patient profiles, including those with complex asthma cases.

However, the report cited barriers such as cost and accessibility. It stressed the urgent need for equitable healthcare solutions to ensure the widespread adoption of these transformative treatments.

“Biologics have fundamentally changed our approach to severe asthma by enabling targeted, personalised treatment, but expanding access is crucial to realising their full potential,” Sravani Meka, Senior Pharmaceutical Analyst at GlobalData.

“The long-term impact of these therapies could shift asthma management from simply controlling symptoms to achieving remission, like advances seen in fields like rheumatoid arthritis,” Meka added.

While biologics have shown great promise, barriers such as cost, access, and insurance coverage limit their availability, particularly in underserved communities.

This is further complicated by environmental and social factors. Many patients in high-risk areas are disproportionately exposed to pollutants that worsen symptoms.

“Tezepelumab’s broad efficacy, even for patients with low eosinophil (a type of white blood cell that helps fight infections) counts, highlights the potential of biologics to address asthma across diverse profiles and patient demographics,” Meka said.

Systemic changes to improve healthcare equity and accessibility are crucial even as efforts to expand access to biologics in severe asthma treatment are underway,

Meka called for “sustained attention to cost and accessibility issues”. She noted that this will ensure that biologics are available to all needy patients.

https://www.newkerala.com/news/2024/74410.htm

Here is how cancer cells fend off starvation, death from chemotherapy, finds study

Laboratory experiments with cancer cells reveal two ways in which tumors evade drugs designed to starve and kill them, a new study shows. While chemotherapy successfully treats tumours and extends patients' lives, it is known that they do not work for everyone for long, since cancer cells rewire the mechanism by which they transform fuel into energy (metabolism) in order to avoid the treatments' effects. Many of these medications are so-called antimetabolics, which disrupt cell processes necessary for tumour growth and survival.

Led by researchers at NYU Langone Health and its Perlmutter Cancer Center, the new study shows how cancer cells survive in an environment made hostile by the persistent shortage of the energy from glucose (the chemical term for blood sugar) needed to drive tumor growth. This better understanding of how cancer cells evade the drugs' attempts to kill them in a low-glucose environment, the researchers say, could lead to the design of better or more effective combination therapies.

Three such drugs used in the study -- raltitrexed, N-(phosphonacetyl)-l-aspartate (PALA), and brequinar -- work to prevent cancer cells from making pyrimidines, molecules that are an essential component to genetic letter codes, or nucleotides, that make up RNA and DNA. Cancer cells must have access to pyrimidine supplies to produce more cancer cells and to produce uridine nucleotides, a primary fuel source for cancer cells as they rapidly reproduce, grow, and die. Disrupting the fast-paced but fragile pyrimidine synthesis pathways, as some chemotherapies are designed to do, can rapidly starve cancer cells and spontaneously lead to them dying (apoptosis).

Study results showed that the low-glucose environment inhabited by cancer cells, or tumor microenvironment, stalls cancer cell consumption of existing uridine nucleotide stores, making the chemotherapies less effective.

Normally, uridine nucleotides would be made and consumed to help make the genetic letter codes and fuel cell metabolism. But when DNA and RNA construction is blocked by these chemotherapies, so too is the consumption of uridine nucleotide pools, the researchers found, as glucose is needed to change one form of uridine, UTP, into another usable form, UDP-glucose. The irony, researchers say, is that a low-glucose tumor microenvironment is in turn slowing down cellular consumption of uridine nucleotides and presumably slowing down rates of cell death. Researchers say cancer cells need to run out of pyrimidine building blocks, including uridine nucleotides, before the cells will self-destruct.

In other experiments, low-glucose tumor microenvironments were also unable to activate two proteins, BAX and BAK, sitting on the surface of mitochondria, a cell's fuel generator. Activation of these trigger proteins disintegrates the mitochondria, and instantly sets off a series of caspase enzymes that help initiate apoptosis (cell death).

"Our study shows how cancer cells manage to offset the impact of low-glucose tumor microenvironments, and how these changes in cancer cell metabolism minimize chemotherapy's effectiveness," said study lead investigator Minwoo Nam, PhD, a postdoctoral fellow in the Department of Pathology at NYU Grossman School of Medicine and Perlmutter Cancer Center.

"Our results explain what has until now been unclear about how the altered metabolism of the tumor microenvironment impacts chemotherapy: low glucose slows down the consumption and exhaustion of uridine nucleotides needed to fuel cancer cell growth and hinders resulting apoptosis, or death, in cancer cells," said senior study investigator Richard Possemato, PhD. Possemato is an associate professor in the Department of Pathology at NYU Grossman School of Medicine and also a member of Perlmutter Cancer Center.

Possemato, who is also coleader of the Cancer Cell Biology Program at Perlmutter, says his team's study results could one day be used to develop chemotherapies or combination therapies that would change or trick cancer cells into responding the same way in a low-glucose microenvironment as they would in an otherwise stable glucose microenvironment.

He also says that diagnostic tests could be developed to measure how a patient's cancer cells would most likely respond to low-glucose microenvironments and to predict how well a patient might respond to a particular chemotherapy.

Possemato says his team has plans to investigate how blocking other cancer cell pathways might trigger apoptosis in response to these chemotherapies. Some experimental drugs, such as Chk-1 and ATR inhibitors, already exist that might accomplish this, he notes, but more need to be investigated because Chk-1 and ATR inhibitors are not well tolerated by patients.

For the study, researchers performed a scan of 3,000 cancer cell genes known to be involved in cell metabolism to determine, by deletion, which were necessary for cancer cell survival after chemotherapy. Most of the genes they found that were essential to cell survival in low-glucose tumor environments were also involved in pyrimidine synthesis, a precise biological pathway targeted by many chemotherapies. This focused their experiments on how different lab-grown clones of cancer cells responded to low-glucose after chemotherapy and what other chemical processes were impacted by depressed sugar levels.

https://www.newkerala.com/news/2024/74490.htm

New vaccine offers high protection against malaria

A small clinical trial of a late-liver-stage attenuated malaria parasite vaccine has shown to be safe and effective against the disease spread by mosquitoes and claims 608,000 lives globally.

The trial, led by researchers at Leiden University Medical Center and Radboud University Medical Center in Netherlands, found that immunisation with a genetically modified Plasmodium falciparum parasite, known as GA2, induced a favorable immune response, while also protecting against infection.

For the trial, the team randomly assigned 25 healthy adult volunteers with no prior malaria exposure to receive immunisation with a genetically modified P. falciparum parasite (GA2) -- designed to continue developing longer in the liver.

While 10 participants were assigned to the GA2 group, another 10 were added to the GA1 group, and five to the placebo group. Each group consisted of both male and female volunteers.

Three immunisation sessions at 28-day intervals involved exposure to 50 mosquitoes infected with the respective parasites or uninfected in the case of the placebo group.

Three weeks after the final immunisation, all participants were exposed to controlled human malaria infection to evaluate protective efficacy.

The results published in the New England Journal of Medicine, showed that protective efficacy was observed in 89 per cent people in the GA2 group. Only 13 per cent in the GA1 group had the prtoective effect whuile those administered the placebo group had none.

Further, the team also found no breakthrough infections occurred after exposure to GA2, indicating a strong safety profile.

The GA2 participants also exhibited a strong proinflammatory response. Both GA2 and GA1 also induced similar antibody titers against the P. falciparum circumsporozoite protein.

This suggests that the enhanced protection with GA2 is associated with cellular immune responses rather than antibody levels alone, the researchers said.

https://www.newkerala.com/news/2024/74475.htm

Southeast Asia sees over 482,000 diabetes-related deaths every year: WHO

Southeast Asia, including India, sees over 482,000 diabetes-related deaths every year, said the World Health Organization (WHO) on Tuesday, while calling for the need to boost the prevention and control measures against the blood sugar condition.

Diabetes is a global health concern and can potentially lead to complications such as blindness, kidney failure, heart attack, stroke, and lower limb amputation.

The WHO noted that the countries in the Southeast Asia Region have made significant progress in provisioning services for the management of diabetes.

Till June, over 60 million people have been placed on protocol-based management for diabetes and hypertension. This is expected to reach 100 million by 2025.

However, despite efforts, challenges remain. More than 260,000 children and adolescents with Type 1 diabetes face limited access to insulin and monitoring. The incidence of type 2 diabetes is also increasing among young people in the Region, the global health body said.

“Bridging the service gaps to ensure timely access to diabetes care can save lives,“ said Saima Wazed, Regional Director, WHO South-East Asia.

Wazed called for making "care services equitable, comprehensive, accessible, and affordable" for all.

She was speaking at the two-day Regional Commemoration of World Diabetes Day 2024 under the theme ‘Breaking Barriers, Bridging Gaps’ in Colombo, Sri Lanka.

To address the growing burden of diabetes, health experts and officials also adopted ‘Colombo Call to Action’.

The Call to Action underlines catalytic actions and collective commitments of Member countries to accelerate efforts to unite, integrate, innovate, treat, track, and educate to reduce the risk of diabetes and ensure that those diagnosed with the disease have access to quality treatment and care.

WHO Director-General Dr Tedros Adhanom Ghebreyesus, in a video message to the gathering, said that more than half of the 800 million people living with diabetes “do not receive treatment".

The WHO chief pressed the need to "intensify efforts to meet global targets and ensure better prevention, diagnosis, and management of diabetes”.

The UN agency suggested measures such as equipping primary healthcare with standard treatment protocols, essential medicines, quality diagnostics, and skilled professionals to meet the growing demand for diabetes care.

Wazed noted that preventing diabetes "is a shared responsibility of governments, healthcare providers, and communities".

https://www.newkerala.com/news/2024/74466.htm

Weight loss, diabetes drugs can also protect kidneys: Study

The popular glucagon-like peptide-1 (GLP-1) receptor agonists known to help in weight loss as well as manage blood sugar can also protect the kidneys, regardless of diabetes status, finds a study led by an Indian-origin researcher.

Originally developed to treat diabetes, GLP-1 receptor agonists have significant benefits in people with and without diabetes, according to the study published in The Lancet Diabetes & Endocrinology.

The drug stimulates insulin production and lowers blood sugar levels by mimicking the action of a hormone called glucagon-like peptide 1. It also slows down digestion, increases feelings of fullness, and reduces hunger to aid in weight loss.

Researchers from the George Institute for Global Health explored to understand the impact of GLP-1 receptor agonists on chronic kidney disease (CKD) -- estimated to affect one in 10 people worldwide or about 850 million people.

They conducted a meta-analysis of 11 large-scale clinical trials of GLP-1 receptor agonists involving a total of 85,373 people. This included 67,769 people with Type 2 diabetes, while 17,604 people were overweight or obese and had cardiovascular disease but not diabetes.

The team probed seven different GLP-1 receptor agonists, including semaglutide (also known as Ozempic or Wegovy), dulaglutide (Trulicity), and liraglutide (Victoza).

The team found that GLP-1 receptor agonists decreased the risk of kidney failure by 16 per cent compared to placebo. The estimated glomerular filtration rate -- a measure of how much blood the kidneys filter and reflects the rate of worsening of kidney function also declined by 22 per cent.

Together, the GLP-1 receptor agonists reduced the risk of kidney failure, worsening kidney function, and death due to kidney disease by 19 per cent, the researchers said.

Lead author Professor Sunil Badve, Professorial Fellow at The George Institute for Global Health and UNSW Sydney said that the results show promise for people with chronic kidney disease.

“Chronic kidney disease is a progressive condition eventually leading to kidney failure requiring dialysis or kidney transplantation and is associated with premature death, mostly from heart disease. It has a significant impact on patients’ quality of life and incurs substantial healthcare costs,” Badve said.

https://www.newkerala.com/news/2024/74447.htm

India's healthcare sector grew strongly in Q2 FY25, revenue up by 17.6pc: Report

The Healthcare sector in India grew strongly in Q2 of FY25, with revenue increasing by 17.6 per cent year on year (YoY), according to a report.

The report by Axis Securities showed that the healthcare sector also grew strongly by 10.4 per cent in quarter on quarter (QoQ).

Hospital occupancy rates, which rose by 340 basis points (bps) YoY and 470 bps QoQ were a key driver behind the growth.

Further, insurance payers contributed 33 per cent of total revenues in the hospital segment -- marking a 23 per cent YoY and 12 per cent QoQ growth.

However, the insurance penetration continues to remain low, the report said. It also offers room for expansion as awareness and purchasing power increase.

The report noted that cancer and cardiac care continue to drive double-digit growth. This, in addition to rising occupancy rates and Average Revenue Per Occupied Bed (ARPOB), is expected to sustain future growth in the healthcare sector, it added.

The report also recorded strong growth in the Indian pharma sector in Q2 FY25.

Major pharmaceutical companies in India reported a 10 per cent YoY growth in Q2 of FY25. This has been driven by impressive performance in North America and the domestic market.

The Indian Pharmaceutical Market (IPM) grew by 8 per cent YoY, with chronic therapies seeing a 9 per cent increase. However, acute therapies experienced a modest 4 per cent growth due to a weaker season.

The report highlighted that the pharmaceutical sector under coverage recorded a 10.2 per cent YoY and 1.7 per cent QoQ growth, led by a 10.8 per cent YoY increase in North America and a 9.8 per cent YoY rise in the Indian business.

The outlook for the pharmaceutical sector remains positive over the next three years, with a promising pipeline in biosimilars, GLP-1 (glucagon-like peptide-1), and peptides, all of which are important in treating diabetes and other conditions.

Companies with a significant share of chronic therapy portfolios continue to outperform the broader market.

https://www.newkerala.com/news/2024/74434.htm

Unicef to set up Early Child Development clinics in all Bengal districts

The Unicef has decided to set up Early Child Development (ECD) clinics in all the districts of West Bengal in the coming days, an official said on Monday, adding that the UN body will approach the state government for necessary cooperation in the matter.

"These specialised clinics, currently available at the Centre of Excellence at the SSKM Medical College & Hospital in Kolkata and the District Early Intervention Centres (DEIC) in 17 out of 28 health districts in West Bengal, provide critical medical services to children up to three years. The initiative would convene, converge and catalyse child-centred interventions and initiatives such as the ECD clinics," said Dr Monjur Hossain, chief of Unicef in West Bengal.

It is learnt that in a bid to bring the special care closer to the community, UNICEF, in collaboration with an organisation specialised in developmental paediatrics christened Nanritam, had supported the state health and family welfare and state woman and child development and social welfare departments to run the ECD clinics at two blocks of South 24-Parganas and training the Anganwadi workers, ASHA workers, community nurses and other health department staff.

Now after getting overwhelming response from the parents there, the UN body is planning to spread the ECD network in all the districts of West Bengal.

"In line with our strategic cooperation approaches, this local level knowledge and evidence created would be used for policy advocacy and leveraging of resources with the government. We would approach the state government to scale-up the programme to other blocks too. This will facilitate the government's efforts to reach every child everywhere, and ensure that no one is left behind," Hossain said on Monday following the commemoration of National Newborn Week.

As part of the ECD programme, the frontline workers are being trained to identify the children who need special care and send them to the ECD clinics. They also teach parents to make age-appropriate toys using articles available at home or discarded things like egg trays.

"To address any developmental delay, the clinics are equipped with special kits, toys, paediatrician, physiotherapist, special educator, psychologist, speech therapist and occupational therapist," said Dr Nandita Chattopadhyay, a developmental paediatrician and the director of Nanritam.

https://www.newkerala.com/news/2024/74345.htm

Study explains why obesity increases risk of diabetes

The US scientists have decoded why obesity increases the risk of type 2 diabetes by targeting the fat cells.

The study, published in Cell Reports, may advance new treatments for type 2 diabetes and other chronic diseases that work by helping fat stem cells differentiate and make new, smaller fat cells.

In a first, the team from the University of California-Los Angeles (UCLA) showed that obesity can make it difficult for the body to produce key cellular building blocks called ribosomal factors.

Without sufficient ribosomal factors, fat stem cells cannot produce functioning fat cells. Their energy gets trapped and they become enlarged and play a crucial role in diabetes development.

While fat tissue has been blamed for long, it's "actually essential for maintaining normal glucose metabolism," said Dr. Claudio Villanueva, Associate Professor of integrative biology and physiology at the University of California-Los Angeles.

Villanueva explained that people with obesity carry "too much fat tissue which is also not functioning optimally".

Fat tissue stores energy from food. However, when not functioning properly, the excess energy gets rerouted to be stored elsewhere in the body like in the liver -- leading to fatty liver disease; or in the heart -- leading to atherosclerosis or stroke.

The study included obese and diabetic mice. The fat cells of these mice were four to five times larger than those found in lean mice. The team administered them with rosiglitazone.

The results showed that their ribosomal factors increased to normal levels, which triggered their fat stem cells to differentiate to produce new, smaller fat cells. Further, this enabled the mice's fat tissue to function properly in storing energy. These also generate key hormones that regulate metabolism.

However, the scientists found that although the mice remained obese after taking the drug, their "type 2 diabetes essentially disappeared,".

https://www.newkerala.com/news/2024/74204.htm

Short-term menopausal hormone therapy may not affect cognitive function

New research suggests that short-term hormone therapy for menopause symptoms does not have long-term cognitive effects.

• Menopause involves distinct changes in hormone levels and bodily function.
• Using hormone therapy can help with certain symptoms related to menopause. Experts are interested in discovering the full risks and benefits of using hormone replacement therapy.
• Data from a recent trial suggests that short-term hormone therapy for menopause symptoms does not have long-term cognitive effects, whether harmful or beneficial.

Menopause involves the permanent stopping of menstruation. There is a distinct drop in estrogen that occurs in menopause.

Hormone therapy can help minimize certain menopause symptoms like hot flashes and vaginal dryness. Experts are interested in determining the full benefits of menopausal hormone therapy as well as the potential drawbacks.

A paper recently published in PLOS Medicine reported data from the Kronos Early Estrogen Prevention Study (KEEPS) Continuation study.

Researchers found that compared to placebo, women who received hormonal therapy for menopause symptoms did not experience better or worse cognitive outcomes 10 years after treatment.

The results suggest that short-term menopausal hormone therapy is not harmful to cognitive function but also does not appear to offer cognitive benefits.

Short-term hormone therapy and cognitive function

Researchers wanted to learn more about the long-term effects of short-term hormone therapy. They note that this type of therapy is used near the menopausal transition period. The transition time before last menstruation is sometimes called perimenopause.

The research discussed in this paper involved women who had participated in a previous study called the Kronos Early Estrogen Prevention Study (KEEPS). This original research involved healthy, recently postmenopausal women with low cardiovascular disease risk who had intact uteruses.

Women in the original research received a placebo, a transdermal patch of estradiol, or oral conjugated equine estrogens. Participants receiving these hormonal options also received micronized progesterone. The original study continued for 4 years.

The current paper’s results discuss the findings from the KEEPS Continuation study, which followed up with participants around 10 years after the original study ended. In all, 275 participants had data related to cognitive outcomes from the original study and the KEEPS study.

For the KEEPS study, researchers collected data on medical history, mood, and cognitive outcomes. They also conducted several cognitive tests to examine participants’ memory, mental flexibility, and visual and auditory attention.

The KEEPS study also noted which participants had continued or used other menopausal hormone therapy since the end of the original study.

The results of the KEEPS study found similar cognitive outcomes among women who had received a placebo or hormone replacement therapy in the original trial.

Participants’ baseline data in the original study and performance throughout the original study were better indicators of cognitive function at long-term follow-up.

Thus, the results suggest that the use of hormone therapy in early menopause does not affect long-term cognitive function among women who have a low risk for cardiovascular disease.

Overall, the data helps to increase understanding regarding the relationship between short-term menopausal hormone therapy and cognitive function.

G. Thomas Ruiz, MD, a board certified OB-GYN and lead OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in this study, commented on its findings to Medical News Today:

“This study looked at cognitive effects differently than many articles. Most studies approach the question from a standpoint that HRT [hormone replacement therapy] improves cognitive ability. There have been no studies that have definitively demonstrated this. But, it is good to know that there are also no negative cognitive effects when using HRT. It should be noted that long-term HRT is linked with a lower riskTrusted Source of developing Alzheimer’s.”

More studies on cognitive effects of HRT needed

The data does have some limitations. First, the follow-up study only included a fraction of the women in the original study.

However, researchers were able to include baseline data from these “nonparticipants” to help examine differences between the groups. Researchers acknowledge that there may be a risk for healthy survivor bias regarding participants who chose to participate in both studies.

Researchers of the KEEPS study could not fully examine all the effects of the lower number of participants in the KEEPS study, such as the cause of death for nonparticipants. The KEEPS study also faced struggles related to the COVID-19 pandemic.

Second, the original study had specific inclusion criteria that limited the data’s reach. For example, it excluded women with uncontrolled high blood pressure or who smoked. The average age of participants was also 52, and researchers only included women with low cardiovascular disease risk.

In addition, most of the study population in the KEEPS study was white. Thus, the results cannot be generalized, and more diversity may be helpful for future research.

Some data relied on self-reporting from participants, which is not always reliable. Researchers used the self-report of age rather than age data from the original KEEPS trial. In addition, they did not go into specific details about participants’ use of hormone therapy between the end of the original study and the start of the KEEPS study.

The data for the approximately 10-year follow-up only involved a one-time assessment, so additional long-term follow-up may be helpful. It may also take additional time to realize true cognitive effects.

Researchers noted that there could be several reasons why no cognitive effects were observed. For example, the dose and length of time of hormone therapy used in the original research might not have been big enough to affect cognitive function.

Finally, the current paper focuses on cognitive outcomes, but a future publication will cover the data collected from brain scans.

Despite these limitations, the study does point to the potential safety of short-term menopausal hormone therapy, which could increase its use in the future.

Rikki Baldwin, DO, an OB-GYN with Memorial Hermann, not involved in this research, told MNT:

“I hope this study helps clinicians and patients feel more comfortable in using hormonal therapy to treat menopausal symptoms. There should be a detailed discussion regarding timing, dosage, route, and length of treatment. But using hormonal replacement therapy should be considered first line therapy in appropriate patients.”

Hormone therapy: Benefits and ongoing conversations

Doctors and other experts can offer guidance on menopausal hormone replacement therapy and whether it is appropriate in individual situations. As researchers in this paper note, the timing of menopausal hormone therapy is likely a critical piece of the puzzle.

Baldwin said short-term menopausal hormone replacement therapy has potential benefits, including reduction or resolution of hot flashes, insomnia, and mood shifts.

“It is not FDA approved, but it has been shown to improve bone health,” Baldwin noted. “Anecdotally, hormone therapy was said to improve cognitive health as well. Potential risks, as evidenced in previous studies, are worsening of cardiovascular disease, thromboembolic events, and failure of treatment,” she added.

Ruiz noted the following regarding the benefits of short-term menopausal hormone replacement therapy:

“Short term benefits are resolution of vasomotor symptoms and other symptoms such as insomnia, emotional lability. There may be improvements in libido. The urogenital tract functions better in the presence of estrogen, this includes the bladder and the vaginal mucosa […] Like any therapeutic, not all should use HRT because of medical contraindications to treatment. A woman should discuss HRT with her gynecologist to see if HRT is right for her."

https://www.medicalnewstoday.com/articles/short-term-menopausal-therapy-cognitive-function

Could an innovative nasal spray delay Alzheimer’s by 10 years or more?

Could a nasal spray help delay Alzheimer’s onset in the future?

The number of people with dementia is forecast to almost triple by 2050.

• Around 70% of these cases are likely to be Alzheimer’s disease, the most common form of dementia.
• Current treatments can relieve some of the symptoms, and new disease-modifying treatments are not widely available.
• Now, researchers have developed a nasal spray that, in a mouse model, slows down inflammation and clears protein buildup in Alzheimer’s disease.
• The researchers suggest the spray might delay Alzheimer’s progression by up to 15 years in people.

Population growth and aging mean that the number of people with dementia is forecast to reach almost 152.8 millionTrusted Source by 2050.

There are several forms of dementia, but the most common, Alzheimer’s disease, currently accounts for up to 70%Trusted Source of cases.

Monoclonal antibody treatments, such as lecanemab and donanemab, are the first disease-modifying therapies for Alzheimer’s.

They clear the beta-amyloid plaquesTrusted Source that are a characteristic of Alzheimer’s, potentially delaying the cognitive symptoms. However, the treatments are expensive, and some experts are concerned that the risk of side effects may outweigh their benefits.

In a new study from Texas A & M University College of Medicine, researchers have used a nasal spray to target microglia and astrocytes — cells that cause neuroinflammation (brain inflammation) — delaying the progression of Alzheimer’s disease in a mouse model.

They suggest that, if similar effects are confirmed in people, the spray could delay Alzheimer’s progression by up to 15 years.

The research is published in the Journal of Extracellular VesiclesTrusted Source.

Courtney Kloske, PhD, Alzheimer’s Association director of scientific engagement, who was not involved in this study, told Medical News Today that its findings are encouraging but that much more research is needed to confirm them:

“Models are important in helping us understand the basic biology of the disease, but we need human studies in representative populations for ideas to be fully validated. Microglia are an incredibly complex immune cell in the brain and researchers are still working to understand why they respond the way they do at different points in disease. Therefore, while these are intriguing findings, more research is needed to understand the impacts and outcomes of this kind of intervention on people living with, or at risk for, Alzheimer’s.”

Spray targets overactive immune cells in the brain

Microglia and astrocytes play a key role in neuroinflammation in Alzheimer’s disease. In healthy brains, they protect nerve cells and remove damaged nerve tissue, but in Alzheimer’s, after initially clearing beta-amyloid plaques, they become overactive and destroy nerve cells.

Using a mouse model of the early stages of Alzheimer’s disease, the researchers administered a nasal spray containing an anti-inflammatory treatment derived from stem cells in extracellular vesiclesTrusted Source.

The aim was to target these immune cells to decrease inflammation and reduce the buildup of harmful proteins in the brain.

They gave the 3-month old mice — both mice genetically modified to display Alzheimer’s-like symptoms (transgenic mice) and wild-type mice — 2 doses of the nasal spray containing the treatment, or a placebo spray, 1 week apart.

Seventy-two hours after the second dose, they euthanized five mice, to assess the numbers and activity of microglia and astrocytes.

Three weeks after the second treatment, they subjected the rest of the mice to a series of behavioral tests. The researchers repeated these tests regularly over the next month to monitor the mice’s cognitive function following treatment. They then euthanized the mice and analyzed their brains.

Spray treatment leads to lower inflammation, better cognitive function

In this mouse model, untreated transgenic mice usually show characteristic signs of Alzheimer’s such as beta-amyloid plaques, increased microglial activity, and inflammation by the age of 4.5 months.

However, at 4.5 months old, the mice that received the nasal spray treatment in this study had reduced microglial clusters, as well as reduced activation of genes associated with neuroinflammation. In addition, they had fewer beta-amyloid plaques than the untreated mice.

These reduced inflammatory effects were most notable in the hippocampus — the area of the brain that plays a major role in learning and memory — which is severely affected by Alzheimer’s disease.

In behavioral tests, both male and female treated mice showed better cognitive and mood function than the untreated mice.

However, Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in this research, emphasized that this was early days for plaque-removing treatments.

“The authors in the study noted nasal delivered stem cells could decrease the number of plaques in Alzheimer’s dementia patients and there are medications being used around the world right now doing the same thing. Post-marketing surveillance is going to determine if these plaque reducing medicines cause any noticeable cognitive improvements,” he told MNT.

“If the clinical use results in patients with improved memory, unlike the trials which resulted in these medications’ approval, novel and early methods to decrease brain plaques will be extremely desirable,” Segil added.

Brain immune cell regulation clears toxic plaques, but are there side effects?

Reducing the activity of microglia could lead to a reduction in their beneficial effects, but this was not seen when mice were treated with the nasal spray.

In a press release, the study authors said that “an intake of neural stem cell-derived extracellular vesicles significantly changed microglia gene expression and reduced the multiple harmful proinflammatory proteins without affecting the microglia’s ability to continue clearing the protein buildup related to Alzheimer’s.”

Steven Allder, BMedSci, BMBS, FRCP, DM, a consultant neurologist at Re:Cognition Health, also not involved in the stydy, welcomed its findings, noting that:

“The nasal spray appears to regulate microglia activity effectively. By preventing overactivation of microglia, it reduces harmful inflammation while allowing these cells to continue clearing beta-amyloid plaques, which are associated with Alzheimer’s progression. This balance is crucial because excessive inflammation can lead to neuron damage, while clearing plaques is necessary to maintain brain health.”

However, he warned MNT of potential side effects. “While the study shows promising results, possible side effects need to be evaluated,” he cautioned.

“Adverse reactions could arise from altering immune cell behaviour, unexpected impacts on other cell types, or long-term consequences of manipulating the brain’s immune response. Clinical trials would need to monitor any immune-related side effects or unexpected impacts on cognition,” Allder further explained.

Alzheimer’s: ‘Important to consider different mechanisms of drug delivery’

Kloske stressed the need for further research to increase the range of Alzheimer’s treatments available.

“Treatments that target Alzheimer’s from all angles and all stages of the disease are essential, and that’s why strategic research funding that works to diversify the therapies in the pipeline is so important,“ she told us.

“It is also important to consider different mechanisms of drug delivery, such as intranasal delivery as is used in this research study. All evidence-based paths to treatment targets and drug delivery methods of Alzheimer’s and all other dementia should be explored,” added Kloske.

“The Alzheimer’s Association envisions a future where there are many treatments available that address these diseases in multiple ways, and can be combined into powerful combination therapies, most likely in conjunction with brain-healthy lifestyle guidance,” she told MNT.

https://www.medicalnewstoday.com/articles/could-an-innovative-nasal-spray-delay-alzheimers-by-10-years-or-more#Brain-immune-cell-regulation-clears-toxic-plaques-but-are-there-side-effects