Categories : Mental Health Obstetrics & GynaecologyTags : Leave a comment

Postpartum Psychosis Found to Have a Substantial Genetic Component

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Study finds postpartum psychosis is strongly influenced by genetics and reveals links to cholesterol metabolism, immune biology, and psychiatric disorders

Photo by Alina Matveycheva

Researchers at the Icahn School of Medicine at Mount Sinai have uncovered a substantial genetic component to postpartum psychosis, a rare but severe psychiatric illness that occurs in the days to weeks after childbirth. The findings, published May 14 in Molecular Psychiatry, provide new evidence that the condition has a substantial biological and genetic basis and may help guide future research into prediction, prevention, and treatment. 

The study, which combined whole genome sequencing with population-level family data, identified rare damaging mutations in the gene HMGCR as associated with increased risk for postpartum psychosis. The researchers also found significant genetic overlap between postpartum psychosis and bipolar disorder, schizophrenia, and several autoimmune diseases, including rheumatoid arthritis, Sjögren’s syndrome, myasthenia gravis, and Crohn’s disease. 

Postpartum psychosis affects approximately 1 in 1000 mothers and is considered a psychiatric emergency because of the elevated risk of suicide and infanticide. Symptoms can include delusions, hallucinations, severe mood changes, confusion, and disorganised behaviour. 

“Our findings show that postpartum psychosis is a biological illness with a substantial genetic basis,” said Behrang Mahjani, PhD, Assistant Professor in the Departments of Psychiatry, Genetics and Genomic Sciences and Artificial Intelligence and Human Health at the Icahn School of Medicine and senior author of the paper. “It is not a parenting failure or a personal weakness, and women affected by it deserve the same medical seriousness afforded to other severe illnesses.”  

This condition has historically been understudied, particularly at the genetic level, and we hope these results help move the field toward a more mechanistic understanding of why some women become vulnerable during the postpartum period.” 

The study estimated that approximately 55 percent of risk for postpartum psychosis is attributable to inherited genetic factors based on family data, while whole genome sequencing analyses estimated heritability from common genetic variants at approximately 46 percent. 

Researchers were particularly surprised by the identification of HMGCR, which encodes the rate-limiting enzyme in cholesterol biosynthesis. The study also revealed broader-than-expected overlap between postpartum psychosis and immune-related conditions. Researchers say the findings are consistent with longstanding clinical observations that autoimmune disease activity often changes during the postpartum period and suggest that immune biology may play a role in the illness. 

“Cholesterol biosynthesis was not a pathway we had anticipated, but once HMGCR emerged, the biology became highly coherent in light of the changing dynamics of cholesterol during and after pregnancy, because cholesterol serves as the precursor for steroid hormone synthesis and prior reports linking low serum cholesterol to first episode psychosis and suicidal behaviour,” said Dr Mahjani. “The postpartum period is marked by dramatic hormonal and metabolic shifts, and this gene sits directly within pathways affected during that transition.” 

The research, with analyses performed by Seulgi Jung, PhD, a postdoctoral fellow in the Mahjani Lab at Mount Sinai, is the first study to apply whole genome sequencing to postpartum psychosis, allowing investigators to examine rare damaging mutations across the genome rather than focusing solely on common genetic risk variants. The team combined data from Swedish national health registers with genomic information from the National Institutes of Health’s All of Us Research Program, enabling researchers to study one of psychiatry’s rarest and least understood conditions at an unprecedented scale. 

“It is important to understand that multiple genes are involved in postpartum psychosis and that HMGCR can be used as a research tool for further scientific discovery,” said Veerle Bergink, MD, PhD, Director of the Women’s Mental Health Research Center at Mount Sinai and an author of the paper.  

Future work will focus on expanding sample sizes and improving ancestral diversity. The team is now pursuing functional studies of HMGCR and other candidate genes in neuronal and immune cell models relevant to pregnancy and the postpartum period. Researchers also plan to integrate genetic findings with hormonal and immunological changes associated with childbirth to better understand why the illness emerges during such a tightly defined window. 

“In the long term, our goal is to understand postpartum psychosis well enough to predict it, prevent it where possible, and develop treatments that target the underlying biology rather than symptoms alone,” said Dr Bergink. 

The investigators also emphasized the importance of large-scale collaborative research infrastructure in enabling discoveries for rare conditions. 

“This work would not have been possible without the NIH’s All of Us Research Program and the participants who contributed their data,” said Dr. Mahjani.  “For rare and historically neglected illnesses such as postpartum psychosis, equitable access to large genomic datasets is essential for scientific progress.” 

Source: Mount Sinai

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Indigenous Plant Study Opens New Path in Cancer Treatment Research

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Prof. Chrisna Gouws and her team have been researching cancer bush for five years. Lessertia frutescens, commonly known as cancer bush.

by Phenyo Mokgothu

A plant long used in traditional medicine is now at the centre of research that could shape future cancer treatment options in South Africa and beyond.

Researchers at the North-West University(NWU) are investigating the anti-cancer potential of Lessertia frutescens, commonly known as cancer bush, after laboratory studies showed activity against several forms of cancer, including drug-resistant small cell lung cancer and colorectal cancer.

According to Prof Chrisna Gouws, a research professor in the Centre of Excellence for Pharmaceutical Sciences in the Faculty of Health Sciences, the research team tested extracts from the indigenous plant on cultured human cancer cells and more advanced laboratory-grown “mini-tumours” known as spheroids.

“Lessertia frutescens has shown significant anticancer activity against several different cancer types in our research,” she says.

Targeting cancers considered incurable

She says the findings became more important when the team observed activity in cancers that no longer respond to conventional treatment.

“What is very interesting and exciting is the apparent activity in drug-resistant cancers such as resistant small cell lung cancer where known chemotherapies have limited to no activity,” Prof. Gouws says.

“This provides us with new avenues to investigate for treatment options to treat cancers currently considered incurable.”

The research team said another factor attracting attention is the plant’s longstanding use in traditional medicine and its safety profile.

“An important consideration is that this plant has a long history of use and is considered non-toxic and safe for use,” Prof. Gouws says.

“It’s anticancer activity comes without the significant side-effects known to occur with most standard chemotherapies.”

Other systems in the body may benefit

Researchers also found that the plant may support other systems in the body during treatment.

“Lessertia has known boosting effects for the digestive and immune systems, and it can have mood-enhancing activities as well,” she says.

“It may therefore not only target the cancer but positively impact the patient as a whole at the same time.”

The team is now studying the plant’s phytochemicals to identify the molecules responsible for the anticancer activity and understand how they work.

“Although many molecules have been identified and shown to contribute to the anticancer activity of the plant, the mechanism of action remains mostly unclear,” says Prof. Gouws.

“We are therefore delving deeper now to try and understand how and why this plant works.”

The next phase of the study will include animal model testing later this year to confirm safety and efficacy before future clinical trials can be considered.

At the same time, the researchers are developing a complementary medicine product that may be available in pharmacies by 2027.

Prof. Gouws says the project could also create economic opportunities.

“Chemotherapy can be very expensive and inaccessible in rural areas. A new plant-based treatment will be much more cost-effective and may be more accessible because it can be manufactured locally,” she says. “An increase in demand for the plant material will also create economic opportunities through farming.”

More about Prof Chrisna Gouws

Prof Gouws leads the strategic project for Human-Based New Approach Methodologies for Biomedical Research. She holds a PhD in biochemistry and has more than 15 years’ experience in utilising cell culture-based models for human health and disease research, including developing new complex in vitro models for applications in drug research, including traditional medicinal remedies and plant materials for cancer treatment.

She is the founder and executive committee chair for the Society for Advanced Cell Culture Modelling for Africa, a board member of International Microphysiological Systems Society, and co-editor of the NAM Journal.

Source: North-West University

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Low Vitamin D Levels Linked to More Pain After Breast Cancer Surgery

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Patients with vitamin D deficiency may benefit from supplements before operations

Photo by Tima Miroshnichenko on Pexels

Vitamin D deficiency is associated with more moderate to severe pain following breast cancer surgery and an increased consumption of opioid drugs, finds research published online in the journal Regional Anesthesia & Pain Medicine. Breast cancer patients with low levels of vitamin D (below 30nmol/L) may benefit from taking supplements before undergoing a radical mastectomy, suggest researchers.

There is emerging evidence suggesting that vitamin D helps control how pain is felt and processed by the body. This is likely due to its anti-inflammatory effects and action on the immune system. Vitamin D deficiency is also commonly reported among patients with breast cancer. A team of researchers set out to examine the relationship between vitamin D deficiency and postoperative pain in patients undergoing breast cancer surgery.

Their prospective observational study, carried out at Fayoum University Hospital in Egypt between September 2024 and April 2025, included 184 breast cancer patients who were scheduled to undergo surgical removal of one entire breast.

Half of the patients were classified as vitamin D deficient (below 30 nmol/L) and half were classified as vitamin D sufficient (above 30nmol/L). Both groups had similar characteristics with an average age of 44 in the vitamin D deficient group and 42 in the vitamin D sufficient group.

Patients were managed according to the hospital’s routine protocol both during and after surgery. Clinical staff involved in their care were unaware of the patients’ vitamin D levels.

The opioid fentanyl was administered during the operation to manage acute pain. Following surgery, all patients were given paracetamol through a drip every 8 hours. In addition, patients could control how much tramadol (another opioid analgesic) they were given by directly pressing a button.

Patients reported their pain levels at zero, 6 hours, 12 hours, 18 hours and 24 hours after surgery. Nausea and vomiting, sedation score and days in hospital following surgery were also recorded.

Patients with vitamin D deficiency were three times more likely to report moderate to severe postoperative pain at any time point during the first 24 hours than those with sufficient vitamin D levels, the study found.

The researchers noted, however, that no patient in either group reported severe pain (7 or over on a scale of 0 to 10) so the difference was due entirely to a reduction in moderate pain (4-6 on the pain scale).

Vitamin D deficient patients received, on average, 8 μg more fentanyl during surgery, which the researchers described as a modest difference.

However, the study found those in the vitamin D deficient group used substantially more tramadol (112mg) after surgery than those who had sufficient vitamin D levels. This strong opioid was controlled directly by the patient up to a maximum dose of 50mg per hour.

Opioid drugs can cause a number of side effects including nausea, vomiting, drowsiness and confusion, while also carrying risks of dependency and addiction.

Postoperative nausea was more common in the vitamin D deficient group, and vomiting occurred only in that group, although the difference in vomiting was small and not statistically significant.

The study had some limitations. It was observational and conducted at a single centre, so no firm conclusion can be drawn about cause and effect. The researchers also did not assess inflammatory markers so could not explore the mechanisms underlying the relationship between vitamin D and pain. Data was also not collected on anxiety, depression, cancer stage, treatment or sleep disturbance before the surgery was carried out.

Nevertheless, the researchers conclude, “Vitamin D deficiency is associated with a higher occurrence of moderate to severe postoperative pain and increased opioid consumption in patients undergoing unilateral modified radical mastectomy.”

They suggest, “Preoperative vitamin D supplementation in breast cancer patients with vitamin D levels below 30 nmol/L may have a role in modulating postoperative pain.”

Source: The BMJ Group

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SANBS Launches “Be The Lifeline” Campaign to Honour 25 Years of Saving Lives Through Blood Donation this World Blood Donor Day

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Johannesburg, 1 June 2026 – As the world prepares to commemorate World Blood Donor Day on 14 June, the South African National Blood Service (SANBS) is honouring the thousands of South Africans whose selfless blood donations continue to save lives every day.

Recognising June as a globally significant month for blood donor awareness, SANBS is proud to launch its bold new campaign, “Be The Lifeline – Give Blood. Give A Tomorrow.” The campaign forms part of this year’s World Blood Donor Day observance. It marks a dual milestone: celebrating 25 years of SANBS as a trusted lifeline for the nation, while paying tribute to the ordinary South Africans who have become extraordinary lifelines for patients and families across the country.

For SANBS, the campaign is a powerful reminder that behind every unit of blood donated is a future still unfolding.

From mothers safely holding their newborn babies for the first time, to accident victims receiving urgent emergency care, cancer patients continuing treatment, and children overcoming life-threatening illnesses, blood donors are the unseen force helping to protect countless tomorrows.

A tomorrow where a young adult learns to drive and experiences independence for the first time.

A tomorrow where a small business owner opens the doors to their first coffee shop.

A tomorrow where a child nervously walks into their first day of school.

Each moment made possible because someone chose to give blood.

According to SANBS CEO, Ravi Reddy, World Blood Donor Day serves as a powerful reminder of the impact of every donation.

“For 25 years, South Africans have consistently shown extraordinary generosity through blood donation. Every donor who walks through our doors becomes part of someone else’s tomorrow,” says Reddy. SANBS Reputation and Communication Manager, Sifiso Khoza, echoed this sentiment, highlighting the life-saving power of a single donation.

“World Blood Donor Day reminds us that behind every successful transfusion is a donor who chose to help someone they may never meet,” says Khoza. “Blood donation is one of the most powerful acts of humanity because a single donation can save multiple lives.”

This year’s campaign places a strong emphasis on trust, gratitude and recognition, honouring long-standing donors who have supported SANBS over the years, while encouraging more South Africans – particularly younger generations – to become regular blood donors.

Through the “Be The Lifeline” campaign, SANBS will spotlight real stories of donors, recipients, and healthcare workers whose lives have been transformed through blood donation, reinforcing the deeply human impact behind every unit collected.

Reddy says the organisation’s 25-year milestone extends beyond reflection, serving as a tribute to the millions of South Africans who have contributed to sustaining a reliable national blood supply. “We are deeply grateful to every donor who continues to choose compassion, kindness, and community through blood donation. Their contributions have helped SANBS remain a trusted lifeline for South Africans for the past 25 years,” he says.

As part of World Blood Donor Day, SANBS is calling on all eligible South Africans to join this life-saving legacy by donating blood and helping secure millions of tomorrows for patients in need.

“Blood cannot be manufactured. It can only come from people willing to give a part of themselves to save another life,” adds Khoza. “This World Blood Donor Day, we encourage South Africans to continue being the lifeline that so many patients depend on every day.”

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Why Africa – and the World – Remain Dangerously Unprepared for the Next Pandemic

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Oyewale Tomori, Nigerian Academy of Science

As the news spread about the outbreak of Ebola in mid-May 2026, the World Health Organization (WHO) released a report about pandemics. The title was: A World on the Edge: Priorities for a Pandemic-Resilient Future.

The document was prepared by the WHO’s Global Preparedness Monitoring Board. It sets out why the world isn’t better prepared for pandemics a decade after Ebola exposed dangerous gaps. And six years after COVID-19 turned those gaps into a global catastrophe.

It adds that investment in pandemic preparedness has not kept pace with the rising risk of pandemics.

The Global Preparedness Monitoring Board is an independent monitoring and accountability body established in 2018 by the WHO and the World Bank. The aim was to strengthen preparedness for global health crises. It is composed of political leaders, agency principals and world-class experts. Its task is to provide assessments of global progress in building and sustaining the capacity to prevent, detect and respond to health emergencies.

The report was released during another Ebola epidemic. This time starting in the Democratic Republic of Congo. On 17 May the WHO declared the outbreak a public health emergency of international concern. This means that it is a risk to many countries through international spread and hence requires global coordinated efforts.

As a virologist and former global health administrator, I believe the monitoring board’s diagnosis and recommendations are vitally important for managing pandemics.

My first observation about the report is that its recommendations remain largely unimplemented by many countries. This is particularly true in Africa, where pandemics thrive and disease epidemics rage and ravage.

Africa needs to specially build trust in its own ability to prepare for and prevent disease outbreaks, and control them when they do occur.

To achieve this, and in line with the recommendations, Africa must sustain:

  • independent pandemic risk monitoring
  • health workforce capability and retention
  • equitable access to countermeasures such as vaccines
  • financing
  • political attention.

Independent pandemic risk monitoring

Using local resources and financing, African countries must own the solution to health through establishing data systems that uphold health sovereignty.

They must also ensure that data derived from surveillance, research and pathogen processing are securely managed and accountable to African institutions rather than foreign entities. Recent agreements with the US have brought this issue to the fore. Some were asking African countries to sign away their health data or prodigally release their precious pathogens in a barter exchange for donor funding.

But health data are an invaluable asset for public health, clinical management and research. They help countries identify diseases and develop vaccines and treatments.

What African countries should be doing instead is mobilising locally sourced counterpart funds. These should be used to create the local environment to support and enhance the capacity of indigenous scientists and researchers to develop innovations from national/natural pathogens for global benefits.

Two African health institutions should be at the centre of these endeavours: the WHO-Africa Region and the Africa Centers for Disease Control, an agency of the African Union. They must not compete, but collaborate and spearhead these efforts through centralised disease control and tracking scorecards.

Health workers

Fostering the well-being of health workforce results in growth, higher productivity, national pride and loyalty.

It also helps in long-term retention of health workers.

African countries need to prioritise capacity retention over capacity building. They must build and sustain a conducive work environment which involves physical workspace and psychological safety.

Availability of adequate resources is needed to function effectively and productively. This includes materials, laboratory facilities, supplies, reagents and consumables for a trained African health workforce and researchers.

Under such enabling conditions, the health workforce can focus on relevant and local health issues and find appropriate solutions to them.

Equitable access to countermeasures

Africa must not compromise on the ratification of international health pacts that guarantee fair technology transfer, intellectual property waivers, and robust regional manufacturing.

Countries must equally expand local production of laboratory diagnostic kits, vaccines and medical supplies as well as non-medical products. Such include gloves, personal protective equipment and masks.

This will reduce reliance on external donation and supply chains in and out of global crises.

Sustainable financing

The greater challenge for many African countries is the waste of available resources and spending on misplaced priorities.

To address this, governments must commit to sustained domestic investment in healthcare. At the same time they must use blended financing (involving both the public and private sectors) to close remaining gaps. Initiatives such as the African Epidemic Fund offer a practical model for building financial reserves for rapid, locally led responses. The fund, launched in 2025, is designed to mobilise funding to support preparedness and response efforts to combat public health threats on the continent. The African Epidemic Fund, though relatively new, must operate at the highest level of accountability. It must provide regular updates on contributions, projects supported and their impact on disease preparedness, prevention and control in Africa.

Sustained political attention

African leaders must keep pandemic preparedness high on the political agenda to ensure continuous resource allocation and accountability. The advocacy for preparedness must go beyond political campaign slogans. It must be driven by regional bodies like the African Union. Countries must then translate commitments into tangible national policies.

There can be no recess or holiday from pandemic preparedness.

African political leaders and elites, at the continental, national and sub-national levels, have crucial roles to play in achieving trusted community engagement and involvement for successful and reliable pandemic preparedness. Above all, there must be active community engagement and involvement.

Oyewale Tomori, Fellow, Nigerian Academy of Science

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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New Research Could Improve Bioluminescence-based Applications in Medicine

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Killer T cells surround a cancer cell. Credit: Alex Ritter, Jennifer Lippincott Schwartz and Gillian Griffiths, National Institutes of Health (CC BY 2.0).

Like fireflies and many deep-sea creatures, certain fungi can naturally emit light through bioluminescence pathways in which specialised enzymes convert chemical energy into visible light. Medical researchers have used fungal light-producing enzymes in the Fungal Bioluminescence Pathway (FBP) to visually track processes like tumour progression and inflammatory responses. New research published in The FEBS Journal provides insights that may help improve and expand such bioluminescence-based tools and applications.

One of the products of the FBP is oxyluciferin, which in fungi is subsequently degraded and recycled back into the pathway, sustaining the bioluminescent process. Previous studies have suggested a role for the caffeylpyruvate hydrolase (CPH), the last of four enzymes involved in the FBP, in breaking down oxyluciferin, but results have been inconclusive. In this latest study, investigators characterised CPH from one of the largest and brightest bioluminescent fungal species described to date, confirming that the enzyme converts oxyluciferin into caffeic and pyruvic acids. Caffeic acid can re-enter the pathway to sustain light emission, while pyruvic acid may be redirected into central metabolism to help generate cellular energy, potentially reducing the energetic cost of bioluminescence. The scientists also developed a new method to monitor CPH activity, thereby providing a useful resource for further studies on bioluminescence.

The findings could be used to develop self-sustained light-emitting systems in other organisms, with potential applications across medicine, agriculture, environmental monitoring, and biotechnology.

“After eight years of work, we were finally able to demonstrate that the breakdown of fungal oxyluciferin by CPH produces caffeic acid and pyruvic acid. This finding helps explain how fungi sustain bioluminescence through metabolite recycling while potentially recovering part of the energy invested in light emission,” said co–corresponding author Cassius V. Stevani, PhD, of the University of São Paulo, in Brazil. “It also provides important insights for the design of engineered cells capable of emitting brighter light in a more efficient and sustainable way.”

Source: Wiley

Categories : Cardiovascular Disease Surgeries & ProceduresTags : Leave a comment

Younger Adults Face Risks With ‘Quick-Fix’ for Heart Valve Surgery

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University of Rochester Medicine researchers urge collaborative decision making

Artificial heart valve. Credit: Scientific Animations CC4.0

Growing demand for a minimally invasive aortic valve replacement by adults under 65 with aortic stenosis may put many at greater risk for potentially more complicated heart surgeries later, according to University of Rochester Medicine research published in The Annals of Thoracic Surgery.

Scientists recommend patients work with a multidisciplinary heart care team to assess their short- and long-term needs when facing surgery.

The procedure, transcatheter aortic valve replacement (TAVR), is less invasive than open heart surgery, offering a faster recovery. Since its introduction in 2011, TAVR is the recommended alternative for frail adults over 65 who cannot withstand surgical aortic valve replacement (SAVR) and younger adults whose mortality risk is high.

However, analysis of the Vizient Clinical Database of nearly 14 000 aortic stenosis cases between 2018 and 2023 showed nearly half of the lowest risk patients under 65 underwent TAVR despite the recommendation that they undergo SAVR. And SAVR can be performed using less invasive techniques that can reduce recovery times.

“It’s not surprising that people want a ‘quick fix’ that lets them get back to their normal routine. However, TAVR is not without risks,” said Laurent G. Glance, MD, lead author and professor of Anesthesiology and Perioperative Medicine. “The bioprosthetic valve can wear out or leak and lead to additional complicated surgeries later.” 

Aortic stenosis is diagnosed when the aortic valve gets thick and narrow, restricting blood flow, forcing the heart to work harder. It causes shortness of breath, fatigue, dizziness and can lead to heart failure.

The TAVR technique delivers the new valve through a catheter in the groin and threaded through the femoral artery into the heart. Once inside, it is placed and expanded inside the failing valve.

Researchers reviewed hospital practice data and risk calculations and concluded “the marked use of TAVR among low-risk younger patients…may not represent the optimal long-term strategy for young patients.”

Explanting and replacing a failed TAVR valve requires SAVR, the open surgical approach, which the younger patients initially aimed to avoid. They face potentially slow and painful recovery and face risk of serious complications such as life-threatening stroke.

Co-author and chief of Cardiac Surgery Peter Knight, MD, said the rapid adoption of TAVR for younger adults has outpaced the data to assess durability of the valve and long-term patient outcomes. 

“Careful decision-making is needed and patients should do their homework and talk with their physicians,” Knight said. “You have to look at the short- and long-term needs when making this important choice.”

Source: University of Rochester Medical Center

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How Macrophages Fail Their Jobs in Cystic Fibrosis

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Respiratory tract. Credit: Scientific Animations CC4.0

Researchers have discovered how part of the body’s immune system could better combat a leading cause of death for people with cystic fibrosis (CF). 

A team led by The University of Queensland’s Professor Peter Sly and Dr Abdullah Tarique has identified how macrophages – the white blood cells that fight infection in the body – function differently in people with CF, compared to others.

“Macrophages play a critical role in fighting infection, especially in the lungs,” Professor Sly said.

“They’re the ‘Pac-Man’ cells that find and ‘gobble up’ bacteria and pathogens such as mycobacterium abscessus (MABS). 

“We found people with CF have multiple defects in their macrophages that leave them more vulnerable to infection, even when taking the most effective CF drug treatment available.”

Professor Sly said MABS posed the biggest infection risk for people with CF.  

“MABS is resistant to many antibiotics which makes treatment complex and often unsuccessful,” he said. 

“The infection can exclude a patient from being eligible for a lung transplant and is a leading cause of death for people with CF.

“And because of antibiotic resistance, MABS infections are increasing at alarming rates.”

Professor Sly said in people with CF, macrophages aren’t as efficient at both recognising and killing off bugs in the body.

“CF involves a defect in the CFTR protein, the channel on the cell’s surface responsible for transporting ions and chlorine in and out of cells,” he said.

“That lack of chlorine transport means macrophages don’t activate their killing functions to ‘eat’ the bugs. 

“A second important mechanism in macrophages is also deficient – the zinc transport of proteins. 

“Zinc is a potent antibacterial mechanism used to poison bacteria, but with less zinc and less zinc transporter proteins in CF macrophages, they’re less able to fight the infection.”

Professor Sly said a third defect – in the mitochondria – is perhaps the most significant.

“Mitochondria are the batteries or power packs of cells, and produce things called reactive oxygen species to kill bacteria.

“In CF, not only are macrophages less able to make these reactive oxygen species, but they’re also not able to keep reproducing them to increase their mitochondrial mass when infected.”

The research also examined treatments for CF and found even the most effective drug doesn’t boost macrophage’s ability to kill MABS.

“Elexacaftor-tezacaftor-ivacaftor (ETI) has been revolutionary in CF treatment by improving lung function in many people, meaning fewer exacerbations and hospitalisations,” Professor Sly said.

“But it doesn’t fix this part of the immune system, which is why people with CF still get these infections.

“Our findings show we now need to accelerate research into different mechanisms of increasing macrophage function, to identify and initiate killing strategies for MABS. 

“This could significantly reduce the impact of these infections for people with CF.”

Read the research in Proceedings of the National Academy of Sciences.

Source: University of Queensland

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Clinical Trials Are Part of UP Professor’s Dream of ‘Making Deafness History’

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University of Pretoria’s Professor Mashudu Tshifularo is leading a groundbreaking clinical trial for 3D-printed ossicles,

Forty-five patients with conductive hearing loss from middle-ear damage are eagerly awaiting the start of clinical trials, led by University of Pretoria’s Professor Mashudu Tshifularo, on a ground-breaking procedure to restore hearing.

The trials, due to begin within weeks at Steve Biko Academic Hospital in Pretoria, come seven long years after Prof Tshifularo successfully performed the world’s first middle-ear transplant using 3D-printed bones made from titanium. The patient was Thabo ***, whose middle-ear bones – the ossicles – had been injured in an accident, causing almost total hearing loss until he had the transplant in March 2019.

In a video screened at a UP Roundtable event held in April this year to announce the launch of the upcoming clinical trials, a beaming Thabo *** confirmed he had regained his hearing after the transplant and had continued to enjoy excellent hearing ever since.

While this procedure was hailed as a surgical breakthrough at the time, its full acceptance by the South African and global ear, nose and throat (ENT) community depends on formal clinical validation. Despite the many obstacles he knew would lie ahead, Prof Tshifularo, joint head of UP’s Department of Otorhinolaryngology, was determined to take his innovation through clinical trials.

“Today is a culmination that I never thought would come. There was a time when I cried, there was a time when I was very depressed, there was a time when I nearly gave up, but something inside me told me to remain steady,” he said at the Roundtable, where the announcement was made that clinical trials could finally move ahead now that all the necessary regulatory, ethical and licensing clearances have been obtained, including from the South African Health Products Regulatory Authority (SAHPRA).

The years since Prof Tshifularo performed that first transplant have also been spent developing, perfecting, testing and patenting a prototype of the titanium material and implants for the clinical trials. UP’s engineering partner on this project, the Council for Scientific and Industrial Research (CSIR), was responsible for the materials and prototype development, while HH Industries manufactures the implants, using 3D printing technology, and Marcus Medical is providing the robotic technology to be used during the surgery. Seed funding was provided by the Motsepe Foundation.

Ready to transform lives

Now that it is all-systems-go for this all-South African collaborative effort, Prof Tshifularo and his team aim to perform this life-changing surgery in the next 12 months on all 45 patients who have expressed interest in participating in the clinical trials.

The team will then focus on publishing their research and training future researchers and medical teams so that the work can be amplified far and wide for the benefit of humanity.

“My dream is to make deafness history,” Prof Tshifularo said, noting that an estimated two billion youth are living with undiagnosed, mostly noise-induced hearing loss, which would become a severe problem in the next 20 to 25 years. Hearing loss is also common among the world’s rapidly ageing population.

The procedure itself takes about three hours and uses advanced robotics to remove the damaged middle-ear bones and replace them with the 3D printed titanium bones. This is minimally invasive, carries significantly less risk than conventional procedures and leaves minimal scarring. The titanium used to manufacture the ossicles is biocompatible, meaning it can be introduced into the ear without causing harmful reactions.

“This innovation will ultimately transform the lives of many people, including newborn babies born with congenital middle-ear defects,” said Prof Themba Mosia, Vice-Principal: Student Life, who gave the opening address at the Roundtable. “It exemplifies the spirit of innovation and collaboration at the university, combined with the deep medical expertise needed to restore hearing.”

UP at the forefront of healthcare advancements

Prof Flavia Senkubuge, Dean of UP’s Faculty of Health Sciences, said innovations such as Prof Tshifularo’s middleear surgical procedure place the university “front and centre” of healthcare advancements on the African continent and the world stage.

She reiterated UP’s commitment to deploying its innovations for the benefit of local communities, such as by establishing a “one-stop shop” – most likely in the form of a private day hospital – where community members could benefit from advanced clinical technologies and the expertise of its researchers.

Paying tribute to Prof Tshifularo, long-time colleague Dr Christian Quitter thanked Prof Tshifularo “for having the guts” to persevere with his innovation, even when it was not always supported by the ENT establishment.

He also thanked the university for supporting researchers who “think out of the box in seeking to improve the lives of all humanity”.

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Updated Colorectal Cancer Guidelines: New Stool Tests, Limited Use of Blood Tests

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Source: CC0

With colorectal cancer a growing concern among younger people, the American Cancer Society has endorsed two new types of stool tests to encourage people to get screened while also recommending a limited role for new blood tests many patients find appealing.

The recommendations are an update to the ACS’s screening guidelines – an update led by Andrew Wolf, MD, a cancer-prevention expert at UVA Health. He and a blue-ribbon panel of cancer experts conducted a systemic review of the available colorectal cancer tests to determine which are most effective. In addition to recommending a next-generation DNA stool test and a new type of RNA stool test, the group is advising doctors to recommend blood tests only to  patients who decline all other options.

The recommendations come with a dose of pragmatism: “The most effective screening test,” the panel concludes, “is the one that the patient completes.”

“The new guidance adds a stool RNA test and an updated stool DNA test to the menu of preferred options for colorectal cancer screening, which currently include colonoscopy and stool tests that detect tiny amounts of blood, among other options,” said Wolf, a professor emeritus at the University of Virginia School of Medicine. “Although the idea of a blood test for colorectal cancer sounds very attractive, they aren’t yet as good as the other tests at detecting precancerous growths and early-stage cancer, so we don’t believe they are as effective as a screening test. That said, we’re very hopeful that broadening the array of options will get more folks screened and reduce the burden of suffering from colorectal cancer.”

About Colorectal Cancer

Colorectal cancer is the second-leading cause of cancer deaths in the United States, killing 55 000 people in 2026. Improvements in detection, screening and treatment have contributed to declining colorectal cancer death rates over the last several decades, but that decline has been accompanied since 2013 by an alarming increase in the cancer among people under the age of 50. Among that age group, colorectal cancer is now the leading cause of cancer death for men and the second-leading cause for women.

In response, the American Cancer Society in 2018 lowered the recommended age for initial colorectal cancer screening from 50 to 45 for people at average risk. It also affirmed the importance of screening tools such as stool-based tests as well as visual exams such as colonoscopies. Since then, however, new, multi-target stool tests and blood-based screening tests have become available. The new blood tests proved popular in a patient survey, with 53% of respondents saying they would prefer blood testing every three years to taking a stool test every year or receiving a colonoscopy every 10.

For the latest guideline update, Wolf and his colleagues examined the effectiveness of the new tests to provide doctors with guidance on if, how and when they should be used. The experts conclude that the DNA and RNA tests had high sensitivity for detecting colorectal cancer and moderate sensitivity for detecting advanced precancerous lesions that are about to turn into cancer. The blood tests, on the other hand, showed lower sensitivity for both advanced precancerous lesions and stage 1 cancers.

“While colorectal screening blood tests may not be as effective as other options, they are certainly better than not screening,” Wolf said. “So if a patient declines a stool test or a visual exam like a colonoscopy, a blood test would be the way to go, as long as the patient understands it is not as effective, and, if it is positive, they will still need to have a colonoscopy.”

Based on their results, the experts endorse the stool tests for patients at average risk but urge doctors to reserve the blood tests for patients who refuse other screening options. And they recommend that anyone who tests positive on any stool or blood test should receive a colonoscopy promptly.

It’s important, they note, that doctors explain to patients the strengths and weaknesses of the available tests so that patients can make informed decisions.

“Currently, almost a third of adults are not up to date with colorectal cancer screening, and among those ages 45 to 49, it’s twice that number,” Wolf said. “We hope these new options will help to close this gap. The most important message is that colorectal cancer is a disease you don’t have to die from, and there’s a screening test out there that’s right for you.”

Better preventing, detecting and treating cancer is the core mission of UVA Comprehensive Cancer Center, one of only 57 cancer centers in the nation to earn the prestigious “comprehensive” designation from the National Cancer Institute. That designation is awarded only to elite cancer centers with the most outstanding cancer care and research programs in the country.

Guidelines Published

The ACS researchers have published the new colorectal cancer guidelines online. 

Source: EurekAlert!