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Breast Milk, Best Sleep According to Japanese Study

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Japanese study of more than 82 000 children finds that breastfed infants are less likely to have short sleep at age one

Photo by William Fortunato on Pexels

In contrast to the misconception that breastfed babies sleep less as breastmilk is easily digested, a new study of 82 918 infants found that children who received breast milk during the first six months of life were less likely to experience short sleep duration at one year of age than those who were exclusively fed formula. Using data from the Japan Environment and Children’s Study, the researchers proposed biological mechanisms that may help explain this association.

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life because of its many proven benefits, including protection against infections and support for healthy long-term development. However, perceptions that breastfed infants sleep less or require more frequent feeding than formula-fed infants remain common among parents and caregivers. Short sleep duration during infancy has also been linked to obesity, behavioural problems, and poorer cognitive performance later in life. Therefore, adequate sleep during this period is considered important for healthy physical and psychological development. Although infants are known to gradually develop longer and consolidated sleep periods, some caregivers choose formula feeding partly based on concerns about their child’s sleep.

To better understand the relationship between infant feeding and sleep, Ms. Yuri Nakagawa, a doctoral researcher at the University of Toyama, Japan, and colleagues analysed data from the nationwide Japan Environment and Children’s Study (JECS), one of the world’s largest birth cohort studies. The study examined 82 918 mother–infant pairs to investigate whether feeding practices during the first six months of life were associated with sleep duration at one year of age. The findings were published in the European Journal of Clinical Nutrition on March 31, 2026.

“WHO widely promotes breastfeeding, and most people are aware of the multiple health benefits it provides. Nevertheless, perceptions that breastfed infants sleep less, or that formula-fed infants sleep for longer periods, remain common. We wanted to provide solid evidence to bust this misconception,” says Ms Nakagawa, the study’s first author.

The mothers were given questionnaires at 6 months asking about the feeding practices they followed during the first six months for their babies. The children were then divided into four groups according to their feeding method. The first group consisted of infants fed exclusively with formula. The second group included infants who were breastfed for less than six months. The third group included infants who were breastfed throughout the six-month period while also receiving formula supplementation. The fourth group consisted of infants who were exclusively breastfed for six months. When the children reached one year of age, parents completed another questionnaire reporting their child’s sleep duration. Children sleeping less than 11 hours per day were considered to have insufficient sleep, based on the US National Sleep Foundation recommendations.

All groups that received breastmilk showed lesser chance of insufficient sleep compared to exclusively formula-fed infants. While infants who received only formula for the first six months had a 12.2% chance of having short sleep, the risk in infants breastfed for less than 6 months was only 10.2%. When breastfed for the entire six months and supplemented with formula, the risk further fell to 9.7%. The least risk of insufficient sleep at age one was for babies exclusively breastfed for the first six months, at 8.8%. After adjusting for a wide range of maternal, infant, and environmental factors, infants who were exclusively breastfed for six months had a 23% lower likelihood of short sleep duration compared with those fed only formula. The findings also showed a graded association, with longer breastfeeding duration associated with a progressively lower likelihood of short sleep.

“This study provides reassurance against the common perception that breastfed babies sleep less because breast milk is digested more rapidly,” says Ms Nakagawa. “Our findings suggest that such concerns should not discourage parents from considering breastfeeding and its many well-established benefits,” she adds.

The researchers proposed several possible explanations. While the nutritional composition of formula remains relatively constant, that of breast milk adapts to the changing needs of the infant. To help establish and regulate the baby’s internal clock and sleep–wake cycle, melatonin – a hormone that promotes sleep onset and improves sleep quality—is secreted into breast milk at night. Because newborns produce only small amounts of their own melatonin, breast milk-derived melatonin may help support the development of healthy sleep rhythms. In addition, breast milk contains tryptophan, an amino acid used to produce melatonin. Interestingly, tryptophan concentrations in breast milk have also been found to be higher at night.

Furthermore, growing evidence supports the gut–brain axis, a communication network linking intestinal bacteria and brain function. Breastfeeding is known to positively influence the development of a healthy infant gut microbiome. Differences in gut microbiota between breastfed and formula-fed infants may also contribute to the development of healthy sleep–wake patterns and sleep quality.

Source: University of Toyama

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New Shingles Vaccine to Be Launched in SA Private Sector, but Affordability May Limit Access

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A more effective vaccine against shingles – an often painful and debilitating condition caused by the same virus that causes chickenpox – will soon be available in South Africa’s private sector. Photo by Mufid Majnun on Unsplash

By Marcus Low and Catherine Tomlinson

Ten years after its launch in the United States, a new, more effective shingles vaccine is finally set to hit the market in South Africa. While the vaccine, called Shingrix, should soon be available at private sector pharmacies, it seems unlikely that it will be provided in the country’s public healthcare system any time soon.

A more effective shingles vaccine is finally set to hit the market in South Africa. Shingles is a common and painful condition that mostly affects the elderly and people with weakened immune systems. It generally appears with a telltale red rash and cluster of red blisters on one side of one’s body, often in a band-like pattern.

“Shingles is pretty awful to get – it’s extremely painful, and some people can get strokes, vision loss, deafness and other horrible manifestations as complications,” infectious disease specialist Professor Jeremy Nel previously told Spotlight. “Shingles really is something to avoid, if at all possible.”

One way to prevent the viral infection, is to get vaccinated against it. Unfortunately, getting hold of shingles vaccines have been a challenge in South Africa.

A vaccine called Zostavax, from the pharmaceutical company MSD, was approved by South Africa’s medicines regulator in 2011, but taken off the market here in 2024. It was only around 50% effective at preventing shingles.

A more effective vaccine, called Shingrix, was introduced by GlaxoSmithKline (GSK) in the United States in 2016. Shingrix is estimated to be around 90% effective in preventing shingles.

But, as Spotlight reported last year, access to Shingrix in South Africa has been severely constrained. That was partly because the vaccine had not been registered by the South African Health Products Regulatory Authority (SAHPRA). Because of this, the only way to get the vaccine in the country was via a Section 21 application – a mechanism in the Medicines Act that allows for the limited importation of unregistered medicines.

That situation changed earlier this month when Shingrix was registered by SAHPRA, thus opening the door for the jab to be imported at scale and sold at pharmacies.

“GSK’s vaccine against shingles (herpes zoster) is expected to be available in South Africa by the end of June 2026,” a GSK spokesperson told Spotlight this week.

It will be launched at a price of R2 783 per dose, including VAT. The total price charged by pharmacies will be slightly higher due to extras like the cost of administration.

Shingrix vaccination requires two doses administered two to six months apart. Since Shingrix is a schedule 4 product, you will need a prescription from a doctor to get it. (You can see more technical details about the vaccine as released by SAHPRA here.)

What about public sector access? 

After a vaccine is registered by SAHPRA, the next step on the road to potential public sector access is typically for that vaccine to be considered by the National Advisory Group on Immunisation (NAGI). NAGI then makes a recommendation to the National Department of Health on whether or not the vaccine should be procured for the public sector.

“The decision for the public health sector to offer any vaccine, including Shingrix, is based on the recommendations by NAGI, which considers a number of factors, including availability of [the] registered health product, effectiveness and safety, operational feasibility, alignment with public health priorities, and whether sufficient funding is available,” Foster Mohale, spokesperson for the National Department of Health, told Spotlight.

He said the department has not yet received NAGI’s assessment outcomes and recommendations regarding Shingrix.

It seems likely that an asking price of over R2 000 per dose will be considered unaffordable for the public sector. That said, the price will have to be weighed up against the savings that will result from fewer people developing shingles and requiring treatment.

Spotlight asked GSK whether the company has engaged with the health department regarding the potential supply of Shingrix to the public sector and what price they might offer the government (the department of health often procures medicines at lower prices than what is asked in the private sector).

A GSK spokesperson responded: “As Shingrix is expected to become available in South Africa by the end of June 2026, we anticipate its initial introduction within the private sector. GSK is open to relevant discussions regarding the availability of this vaccine in the public sector.”

What about medical scheme coverage?

For now, it is unclear to what extent medical schemes in South Africa will cover the jab.

“For a vaccine to be considered for funding by the medical scheme, it must be registered with SAHPRA, have a valid NAPPI code, and be commercially available in South Africa,” Dr  Noluthando Nematswerani, Chief Clinical Officer at Discovery Health, told Spotlight.

Nematswerani pointed out that Shingrix is not yet commercially available in the country. Spotlight received her comments on 25 June 2026.

When Shingrix does become commercially available, that is to say when it’s available in pharmacies, it seems likely that at least some medical scheme members will be able to access it using their medical savings accounts.

“Discovery Health Medical Scheme funds vaccines that are registered with SAHPRA from the member’s available Medical Savings Account (MSA) on plans that include an MSA benefit,” said Nematswerani.

“Until Shingrix becomes commercially available locally, Discovery Health Medical Scheme members can only access Shingrix via a Section 21 authorisation process. Medicines accessed under Section 21 are treated as a general scheme exclusion and are therefore not funded from scheme benefits,” she said.

Who should get the vaccine?

As we previously reported, South Africa does not have guidelines regarding who should receive the shingles vaccine and when they should receive it. The US Centers for Disease Control and Prevention recommends that all adults over 50 receive the two-dose Shingrix vaccine. They also recommend that people whose immune systems can’t defend their body as effectively as it should, like those living with HIV, should get the vaccine starting from age 19.

In March 2025, the World Health Organization (WHO) recommended that countries where shingles is an important public health problem consider the two-dose shingles vaccine for older adults and people with chronic conditions.

“The vaccine is highly effective and licensed for adults aged 50 years and older, even if they’ve had shingles before,” according to the WHO. It advised countries to look at how much the vaccine costs compared to the benefits before deciding to use it.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

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Not All Children with Early Puberty Need the Same Level of Testing or Treatment

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Endocrine Society guideline addresses different subgroups of central precocious puberty

Photo by Ben Wicks on Unsplash

Some subgroups of children with precocious puberty – such as older girls with slowly progressing puberty – may not need the same level of testing or treatment, according to a new Endocrine Society Clinical Practice Guideline.

“Children who start puberty earlier than usual should be carefully evaluated so they receive the right care at the right time – without unnecessary tests or treatment,” said the guideline’s writing group chair, Ana Claudia Latronico, MD, PhD, of the University of São Paulo. “The Endocrine Society’s guideline gives clinicians evidence-based suggestions to identify central precocious puberty, understand its causes and decide when and what treatment is appropriate.”

Central precocious puberty happens when a child’s brain activates puberty-related hormones too early – before age 8 years in girls and before age 9 years in boys. This early hormone signalling triggers physical changes such as breast development in girls, testicular enlargement in boys, rapid growth, and, in some cases, early menstruation.

Early puberty can affect a child’s adult height and is associated with long-term physical and emotional health risks, including psychosocial stress, heart disease, and some cancers later in life.

According to the guideline authors, puberty-pausing medication, which temporarily pauses the brain signals that start puberty, can be an effective treatment and has the potential to increase adult height as well as improve psychosocial and long-term health outcomes among children with early puberty.

“Some subgroups of children may not need the same level of testing or treatment. For example, older girls with slowly progressing precocious puberty often have normal adult height without intervention,” said the guideline’s writing group co-chair Stephanie Roberts, MD, of Boston Children’s Hospital in Boston, Mass. “We give clinicians suggestions that avoid unnecessary or invasive testing and treatment, such as sometimes initially using a period of observation by their health care provider, using simpler testing methods and individualising treatment when indicated.”

Suggestions from the guideline include:

  • Monitoring girls with early breast development with physical exams every 4-6 months before initiating diagnostic testing
  • Observing girls under 7 years old for 4-6 months to distinguish slowly vs. rapidly progressing puberty, since slow progression often results in normal adult height without treatment.
  • Using simple first-line testing with a basal luteinising hormone (LH) blood test rather than GnRH agonist stimulation testing.
  • Avoiding routine brain MRIs in older children (> 6 years in girls and > 7 years in boys) without neurological symptoms.
  • Not routinely doing genetic testing, especially for cases without a family history of early puberty.
  • Starting treatment with longer-acting puberty-delaying medications (rather than shorter-acting medications) whenever it is expected that longer-acting medications will be used for long-term therapy.
  • Not routinely using growth hormone therapy.
  • Not routinely doing frequent lab monitoring during treatment unless treatment failure is suspected.
  • Discontinuing therapy by early adolescence (about 10-11 years in girls, 11-12 years in boys).

The new guideline is available online.

Source: Endocrine Society

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An Unusual Antibiotic Pairing Is a New Breakthrough in Antimicrobial Resistance

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Pseudomonas bacteria. Source: Wikimedia CCO

A Monash University-led study has found that an unusual pairing of two commonly used antibiotics can kill and stop the spread of resistance in a highly drug-resistant bacterium, Pseudomonas aeruginosa, which can cause life-threatening bloodstream infections, pneumonia and meningitis.

Published in The Lancet Microbe, Monash Institute of Pharmaceutical Sciences (MIPS) researchers used a validated laboratory infection system in which they were able to expose bacterial samples from infected patients to simulated antibiotic dosing regimens, as would actually occur in hospitalised patients.

The discovery of the combination regimen of two so-called β-lactam antibiotics – the most commonly used antibiotics class against serious infections – comes in the context of the World Health Organization’s designation of Pseudomonas aeruginosa as a high-priority pathogen requiring rapid and sustained action.

Antimicrobial resistance (AMR) is one of the top global public health threats and was directly responsible for 1.14 million deaths in 2021. The impact of AMR puts many of the gains of modern medicine at risk, including jeopardising procedures and treatments such as surgery, caesarean sections and cancer chemotherapy.

AMR occurs when bacteria change over time and no longer respond to previously successful antibiotic treatments. Bacteria that develop AMR to several of the commonly used antibiotics can cause infections that are harder to treat, increasing the risk of disease spread, severe illness and death.

The development of new antibiotics has not kept pace with the rapid rise in AMR, which means some bacteria, such as Pseudomonas aeruginosa, have become resistant to essentially all available antibiotics.

Co-lead author, Associate Professor Cornelia Landersdorfer from MIPS, said their method was applied to the combination regimen of two β-lactam antibiotics, as well as treatments with each of the antibiotics alone. The combination regimen was very successful, as it resulted in much faster and generally substantially greater killing of bacteria than each antibiotic alone. In addition, the combination regimen very substantially suppressed resistance to both antibiotics.

Subsequently, a mathematical model, utilising quantitative systems pharmacology (QSP), was developed to describe the data from the infection system, and predict likely outcomes in patients. QSP models incorporate biological information, such as genetic information, to describe and predict how medicines work against disease in the human body.

“The QSP modelling approach coupled with genomic analysis performed in hospitals could represent a step towards optimising and personalising antibiotic regimens against life-threatening infections caused by Pseudomonas aeruginosa,” Associate Professor Landersdorfer said.

“This research is important because previous approaches to selecting an antibiotic regimen do not account for important pre-existing bacterial characteristics, including mutations, that can influence resistance emergence in bacterial patient isolates of important pathogens such as Pseudomonas aeruginosa.”

The QSP model in the current study is the first to incorporate information on the various resistance mechanisms present in bacterial samples from infected patients before treatment, and those which emerge during therapy with an antibiotic.

The developed QSP model describes the full time-course of bacterial growth, bacterial killing and emergent antibiotic resistance across multiple Pseudomonas aeruginosa strains isolated from patients. Importantly, the model also incorporates the contributions of various resistance mechanisms, including resistance mutations, to the emergent resistance.

The predictive potential of the novel QSP model developed in the study offers the future possibility of tailoring an antibiotic regimen to the specific resistance and other characteristics of the bacterial strain causing a serious infection in a patient.

First author, Dr Siobhonne Breen from MIPS said, “resistance of Pseudomonas aeruginosa emerges rapidly even to new antibiotics when used as a single therapy. Therefore, it is important to identify optimal antibiotic combination treatments that maximise killing of the bacteria and suppress the development of further resistance”.

Co-lead author Associate Professor Antonio Oliver from the Instituto de Investigación Sanitaria Illes Balears (IdISBa) and Hospital Son Espases, Palma de Mallorca, Spain said the research indicates that “by identifying resistance characteristics through rapid diagnostics, a therapy adapted to the individual pathogen and infected patient is an exciting future prospect”.

Read the research paper: doi.org/10.1016

Source: Monash University

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Youth Lead the Way as South Africa’s New Generation of Blood Donors Steps Up

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Johannesburg, 25 June 2026 – As South Africa concludes Youth Month, the South African National Blood Service (SANBS) is celebrating a new generation of life-savers who are helping to secure the country’s blood supply through regular blood donation.

This year’s World Blood Donor Day was commemorated under the theme, “Give blood, give hope: together we save lives,” highlighting the critical role voluntary blood donors play in strengthening healthcare systems and saving lives. For SANBS, the theme has resonated strongly with a growing number of young South Africans who are choosing to become regular blood donors and make a meaningful contribution to their communities.

Recent SANBS data reveal that 43.27% of its donor panel comprises regular donors aged 16 to 30, reflecting a positive shift in donor demographics and a growing culture of volunteerism among young people.

Historically, blood donation has largely been sustained by older generations. However, SANBS has seen a notable increase in younger people showing interest in donating blood, helping to ensure a sustainable blood supply for future generations.

The organisation has also recorded encouraging growth in donor diversity, including an increase in black blood donors, contributing to a donor base that is increasingly representative of South Africa’s population.

Blood remains an essential resource in healthcare, as a stable blood supply enables hospitals and healthcare facilities to respond swiftly to emergencies and deliver life-saving treatment to patients in need. A reliable blood supply is therefore fundamental to the effective functioning of any healthcare system and the overall wellbeing of communities.

Commenting on the encouraging trend, SANBS Reputation and Communications Manager, Sifiso Khoza, said the growing participation of young people demonstrates the positive impact that youth can have on society.

“Young people have always been at the forefront of driving positive change in South Africa. We are encouraged by the growing number of youth who are choosing to become regular blood donors and embracing the opportunity to make a difference in others’ lives. Their commitment reflects the spirit of compassion, active citizenship, and hope that both World Blood Donor Month and Youth Month seek to celebrate.”

Khoza added that maintaining a stable blood supply depends on the continued support of both existing and first-time donors.

“Blood donation is one of the simplest yet most impactful ways to give back to society. Every donation has the potential to save lives, and we encourage more young South Africans to join this community of life-savers. By donating blood, they are helping to build a healthier, stronger, and more resilient South Africa.”

As Youth Month draws to a close, SANBS is calling on eligible South Africans to become regular blood donors and play their part in ensuring that blood is available for patients whenever and wherever it is needed.

To become a blood donor, individuals must be between the ages of 16 and 75 years, weigh at least 50kg, lead a safe and healthy lifestyle, and be in good general health.

One Drop of Humanity. Give Blood. Save Lives.

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Faster Aging in Younger Generations Linked to Rise in Early-onset Cancer

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Immune system aging linked to earlier lung cancer; adipose tissue aging linked to earlier colorectal cancer

Photo by Malvestida on Unsplash

Cancer is often considered a disease of aging. Older adults are at higher risk because they have had more time to accumulate cellular damage that can trigger tumour formation. But as cancer rates in younger adults rise, with each successive generation facing higher risks than the one before it, researchers are asking whether cellular damage is accumulating faster in recent generations, accelerating their body’s biological aging.

A new study led by researchers at Washington University School of Medicine in St. Louis provides evidence that younger generations are indeed aging faster biologically than their older counterparts. The causes remain under investigation around the world, including global efforts led by research members of Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine, and Cancer Grand Challenges, a global initiative co-founded by the National Cancer Institute and Cancer Research U.K.; but importantly, the new research links this accelerated aging to an increased risk of early-onset cancers in younger generations. In general, early-onset cancers are those diagnosed at age 55 or younger.

The larger the gap between biological age — that is, how old our bodies appear to be — and chronological age — which is how many years we have actually lived — the higher the cancer risk, according to the researchers. They found that people in more recent birth cohorts had larger age gaps than those in older birth cohorts, which may help explain the rise in early-onset cancer in recent generations.

Their study also identified links between faster aging in particular organ systems and increased risks for certain cancers. For instance, an immune system that appears older than its actual age was associated with early-onset lung cancer. Similarly, fat tissue that appears older than its chronological age was associated with early-onset colorectal cancer.

The study, published June 22 in the journal Nature Medicine, suggests that measures of accelerated aging could help identify individuals at higher risk of early-onset cancer and guide new strategies for cancer prevention and early detection.

“Our ultimate goal is to decode how modern environments become biologically embedded to drive cancer risk, transforming prevention from broad recommendations to personalised interventions,” said Yin Cao, ScD, a molecular epidemiologist and an associate professor of surgery and of medicine at WashU Medicine. “This brings us closer to identifying risk earlier and developing prevention strategies that are tailored to an individual’s biology.”

Exploring biological aging

Cao’s team has been at the forefront of identifying individual factors that influence cancer risk across the life course, such as obesity, metabolic dysregulation, alcohol consumption, sedentary behaviour, poor diet quality and caesarean delivery. Although these discoveries have revealed important clues to the origins of cancer at younger ages, the contribution of any single factor is modest.

With that in mind, Cao, also a research member of Siteman, and her colleagues have sought ways to capture the influence of multiple risk factors operating together to spur cancer development. With support from Cancer Grand Challenges, Cao, as co-lead of Team PROSPECT, has been able to go after this problem.

For the current study, Cao’s team analysed data from more than 154,000 young adults in the UK Biobank, a large biomedical dataset containing biological, health and lifestyle data, and from more than 10,000 individuals in the U.S. participating in the National Institutes of Health’s (NIH) All of Us Research Program, an effort to build a comprehensive health dataset on more than 1 million people living in the U.S.

To estimate the level of biological aging — or age gap — the researchers, including first author Ruiyi Tian, a doctoral student in the Cao lab, examined aging at two levels: across the body as a whole, known as systemic aging, and within individual organs, known as organ-specific aging. For systemic aging, the researchers used established measures, including clinical biomarker-based measures such as PhenoAge and the Klemera-Doubal Method, as well as a metabolomic age score, which provides a measure of individual metabolism.

PhenoAge, for example, measures nine blood biochemistry markers such as albumin, made by the liver, and creatinine, a waste product removed by the kidneys. For organ-specific aging, the researchers used blood proteomic data, which measure levels of multiple proteins linked to specific organ systems, to estimate biological aging in individual organs.

The researchers calculated the average age gap for each birth cohort and used standard deviation to describe how much each group differed from the study average. Standard deviation is a measure of how spread out data points are around the average.

The researchers found that individuals in the UK born between 1965 and 1974 had systemic aging that was 23% of one standard deviation higher compared with those born between 1950 and 1954, after accounting for chronological age. In other words, people in the younger birth cohort showed a modest shift toward older biological profiles than people in the older birth cohort when at the same chronological age.

The researchers observed a similar pattern in the U.S cohort. Participants born between 1990 and 1999 had systemic aging that was 92% of one standard deviation higher compared with those born between 1965 and 1969.

This increased systemic aging in the younger group was associated with an 8% increased risk of early-onset solid cancers, especially lung, gastrointestinal and uterine cancers. When participants were divided into three groups based on their level of systemic aging, those with the most advanced systemic aging had a 15% increased risk of early-onset solid cancer compared with those with the least advanced systemic aging. According to the analysis, the increased risk persisted even after controlling for inherited genetic risks of cancer and genetic susceptibility to accelerated aging.

By zooming into organ-specific aging, the researchers found that advanced immune system aging was associated with increased risk of early-onset lung cancer, and advanced adipose (fat) tissue aging was associated with increased risk of early-onset colorectal cancer.

“If we can identify younger people with the highest cancer risk when they are still healthy, we can focus on prevention and early-detection strategies for the individuals who will benefit most from early interventions,” Cao said.

By Julia Evangelou Strait

Source: WashU Medicine

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Finding the Lock and Key for the Cryptosporidium Parasite and Its Host

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Cryptosporidium parasites. Credit: Cryptosporidiosis Laboratory. 

The Cryptosporidium parasite lives within cells that line the human intestine, but how does this pathogen find, recognise and then successfully invade these cells without triggering immunity? An international collaboration aims to find out. 

Parasites have lived on and within humans throughout history, co-evolving along with us to adjust to new climates and challenges. In some cases, this relationship has left significant genetic imprints. For example, the prevalence of sickle-cell disease in humans has been driven by selective pressure from the malaria parasite.

Cell biologist Adam Sateriale and his team at the Crick study a close relative of the malaria parasite, known as Cryptosporidium, which infects the intestinal tract of a wide range of animals, including humans. Most human infections are mild and asymptomatic, but Cryptosporidium can be deadly within immunocompromised people or very young children.  

“Certain species of the Cryptosporidium parasite are adapted to specifically invade and then live within the human intestinal lining, or epithelium,” Adam explains. “We’re interested to find out how the parasite recognises, and then successfully invades, these cells within the epithelium.”

Cryptosporidium and the malaria parasite, known as Plasmodium, diverged from one another nearly 500 million years ago, yet many of their features are conserved. Two organelles (or cellular compartments) can be found within both parasites: micronemes, which contain proteins that help parasites move, and rhoptries, which contain proteins that help parasites invade cells.

Micronemes of the malaria parasite are important vaccination targets, as proteins from these organelles are displayed on the surface of the parasite and are critical for infection. While Cryptosporidium has these invasion organelles, very little is known about their function and how they diverge from those of the malaria parasite.  

A recently awarded Wellcome Discovery grant has allowed Adam’s team to join forces with Gavin Wright’s team at the University of York and Amandine Guérin’s team at the University of Geneva to tackle these questions. Together, they will examine the function of micronemes and rhoptries and explore how Cryptosporidium specifically recognises and invades intestinal epithelial cells. To do that, they will harness the power of genetic editing.

“We’re going to use CRISPR gene editing to switch off, one by one, all the genes that code for the proteins in Cryptosporidium’s micronemes and rhoptries,” says Adam. “If the parasites can’t complete their normal functions without a particular protein, we’ll know that it’s a critical part of Cryptosporidium’s offensive strategy.”

Working together over the next five years, this multidisciplinary team are each bringing unique expertise: Adam’s team have developed CRISPR screening technology for the parasite, Amandine’s team work on Cryptosporidium invasion in detail and Gavin’s team specialise in identifying and studying cell surface protein interactions.

“Although there are many species of the Cryptosporidium parasite, some can only infect very specific hosts,” says Adam. “For instance, there are human species that can only invade and replicate within humans, suggesting a specific lock and key mechanism between the parasite and host. If we can find the essential parasite proteins that engage and unlock human cells for infection, we can then study these interactions and learn how to block them.”

He’s also excited about the impact this work could have, adding, “Ultimately this will lay the foundation for new treatments and preventions for children living in endemic areas.”

Source: Crick Institute

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South Africa’s Tuberculosis Research Changes Global Medical Practice

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Tuberculosis bacteria. Credit: CDC

A South African clinical study that began in a research unit in Gqeberha (PE), Eastern Cape, has transformed global treatment of drug-resistant tuberculosis. Furthermore, the study’s findings were published this week in the New England Journal of Medicine (NEJM), the highest-ranked medical journal in the world.

The publication recognises that this research study has set the global standard for TB care.

The BEAT Tuberculosis clinical study, conducted at the Clinical Health Research Unit (CHRU) Isango Lethemba TB Research Unit in the Eastern Cape and King Dinizulu Hospital Complex in KwaZulu-Natal, enrolled more than 400 participants over two years during the Covid-19 pandemic.

The study was executed by the University of the Witwatersrand in collaboration with the National Department of Health and funded by the United States Agency for International Development (USAID).

“This project has gone full circle,” says Dr Francesca Conradie, principal investigator of BEAT Tuberculosis and a researcher at the Clinical Health Research Unit (CHRU), University of the Witwatersrand. “The results from this trial have changed international guidelines. Being published in the New England Journal of Medicine is proof that South Africa produces world-class research that improves the lives of patients globally.”

Treatment for the whole family

The primary aim of BEAT Tuberculosis was to evaluate the safety and effectiveness of a novel, shortened treatment regimen for DR-TB compared with the established standard of care. The standard treatment at the time required a seven-drug regimen administered over a minimum of nine months. BEAT Tuberculosis tested a streamlined regimen of four to five medications, including the newer agents bedaquiline and delamanid, administered over six months.

The BEAT Tuberculosis trial enrolled children, pregnant women and breastfeeding mothers alongside adults. These former groups are usually excluded from clinical research. The result is a treatment regimen that can be used across the entire family.

“This is a one-size-fits-all treatment regimen,” explains Conradie. “Adherence is much easier when the three-year-old, the teenager, the mother and the father are all receiving treatment of similar duration and composition. That simplicity saves lives.”

The study enrolled 10 pregnant women. All 10 women gave birth to healthy babies, and nine of them were successfully treated. BEAT Tuberculosis has since been cited internationally as a model for inclusive clinical research methodology, and the findings have influenced World Health Organization policy on the treatment of DR-TB globally, including for pregnant women and children.

South Africa’s National Clinical Advisory Committee already reviews and approves the regimen for pregnant women presenting with Drug-Resistant TB, while other provinces are adopting the treatment, particularly when treating children.

During 2024, South Africa had 249,000 people who were infected with active tuberculosis, and 54 000 died from the disease,” says Professor Norbert Ndjeka, Chief Director: TB Control and Management, National Department of Health. “Not only did BEAT TB produce world-class research, but it is also being implemented progressively across South Africa and globally and is internationally recognised. South Africa has accomplished something exceptional.”

Source: Wits University

Categories : Neurodegenerative DiseasesTags : Leave a comment

Does Iron Accumulation in the Brain Contribute to Neurodegeneration?

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Salk Institute scientists discover chronoferroptosis, a chronic stress pathway in cells that causes neurons to become less resilient over time and more vulnerable to neurodegeneration

Representative neuronal cells are shown after acute iron exposure of six to eight hours (left) and after chronic iron exposure of nine days (right). The brain cell looks entirely different after chronic exposure, with dysregulated processes characteristic of the newly discovered cell stress pathway chronoferroptosis.
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Credit: Salk Institute

Neurodegenerative diseases affect tens of millions of people worldwide. Among these, Alzheimer’s and Parkinson’s diseases are the most common; in the United States alone, the Alzheimer’s Disease Association and Parkinson’s Foundation report roughly 7 million people with Alzheimer’s and another million with Parkinson’s. An intriguing clue lies in the tangled mystery of neurodegeneration that scientists are working to solve: iron accumulation.

Scientists have noticed that iron can slowly build up inside neurons. Early in life, this iron accumulation appears to have little effect on neuronal function. However, later in life, it can contribute to a slow neuronal demise. Salk Institute researchers studied nerve cells to figure out if and how this iron accumulation relates to neurodegenerative diseases. They found that the excess iron stuck in neurons lowers the cells’ defences, making them more vulnerable to stressors and other cellular insults through a process they named chronoferroptosis.

The study, published in Cell Death Discovery on June 18, 2026, points to iron accumulation as a key target in the effort to predict, prevent, and treat neurodegenerative diseases.

“Resilience has become a huge topic of discussion when it comes to Alzheimer’s disease and other neurodegenerative disorders, trying to make the brain more resilient in the face of stressors that contribute to neurodegeneration,” says senior and co-corresponding author Pam Maher, PhD, a research professor at Salk. “Our study reveals that cells lose resilience when iron hits a certain level, making neurons more susceptible to stressors that damage or even kill them.”

What do we already know about how the body uses iron, and is it linked to neurodegeneration?

Iron is an essential mineral for a healthy body. Found in dark leafy greens, starchy cereals, lean meats, seafood, and other common foods, iron helps red blood cells develop, carries oxygen around the body, makes hormones, and so much more, with a hand in everything from the immune system to energy production.

“It’s one of the most important minerals in the body,” says co-corresponding author Nawab John Dar, PhD, a postdoctoral researcher in Maher’s lab. “So, it isn’t the iron itself that is a problem with age. It is this accumulation of iron over time that is the problem.”

While the jury is still out on the exact mechanisms that initiate iron accumulation in neurons, the Salk team suspects the buildup is caused by a failure in the cells’ iron export machinery – iron enters neurons as usual but fails to get removed after use. But this failure doesn’t impact neurons for quite some time. The question is, why?

“People have been doing these experiments looking at iron exposure’s influence on cells over short 24- to 48-hour spans,” explains Dar. “But if neurodegenerative disorders are progressive, shouldn’t we have a cellular model that is progressive, too?”

Is iron accumulation making neurons less resilient?

Using a human-derived nerve cell line, the Salk team created the first progressive model of iron accumulation in neuronal cells. They compared the effects of both acute (between six and eight hours) and chronic (nine days) exposure to iron. What they discovered was an entirely new pathway, which they dubbed chronoferroptosis.

Maher has been studying ferroptosis for decades. Until now, ferroptosis was considered an iron-dependent cell death pathway, with cell death dependent on a process called lipid peroxidation. “It is like the cellular equivalent of when a cooking oil or nut goes bad. The fats in that oil or nut have undergone peroxidation,” explains Maher.

Chronoferroptosis adds the dimension of time to ferroptosis. To the researchers’ surprise, the pathway does not necessarily end in cell death. Instead, the findings reveal that ferroptosis can act as a cellular stress pathway.

In acutely exposed neurons, there was very little biochemical difference pre- and post-exposure to iron. However, in chronically exposed neurons, there were lots of changes: upregulation of some processes and downregulation of others; accumulation of harmful chemicals and depletion of helpful ones; and elevated lipid peroxidation. And when each exposure group was exposed to further stress, acutely exposed neurons could handle the stress, while chronically exposed neurons could not.

“We think these coordinated alterations in iron-handling and antioxidant defence proteins make chronically exposed neurons vulnerable to neurodegenerative pathology,” says Dar. “Entering this state of chronoferroptosis may set neurons up for age-related failure.”

How might chronoferroptosis inform neurodegeneration care?

By creating the first progressive model of iron accumulation in neuronal cells, the researchers were able to reveal surprising new clues in the case to crack neurodegeneration. “It’s not the amount of iron that seals the fate of these cells,” says Dar, “it’s the amount of time they spend under stress.”

Perhaps scientists will one day be able to detect when the brain begins entering this vulnerable state, when iron accumulation starts stressing neurons. They could then develop new interventions to address iron imbalances and keep neurons more resilient for longer.

“It’s not something we worked on in this paper, but our lab has developed several compounds to inhibit this pathway,” says Maher. “This could really be a promising therapeutic route for boosting neuron resilience and staving off neurodegeneration as we grow older.”

Source: Salk Institute

Categories : Substance Use Surgeries & ProceduresTags : Leave a comment

Bariatric Surgery Increases the Risk of Alcohol Problems

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Sleeve gastrectomy. Credit: Scientific Animations CC4.0

The body absorbs alcohol much more rapidly after bariatric surgery, researchers from Norway have found. Patients need to know this when they choose the kind of surgery they will have.

“Bariatric surgery can come with a price. Patients have a significantly higher risk of developing alcohol problems than if they did not undergo surgery,” said Magnus Strømmen, a researcher at the Centre for Obesity Research at St. Olavs Hospital and a PhD research fellow at the Norwegian University of Science and Technology (NTNU).

Between one and two per cent of the population in Norway has undergone bariatric surgery. The most commonly used surgical methods are gastric bypass and gastric sleeve.

Both methods make patients eat less and feel full faster. This is partly due to reduced volume on the stomach, and partly due to hormonal changes. But a person’s changed anatomy also has consequences for what happens when they drink alcohol.

“In a normal stomach, a significant part of the alcohol will be broken down and thus not pass into the bloodstream. This is due to an enzyme that is secreted in the lining of the stomach. It is this protective mechanism that we deprive the patient of when we operate on the stomach. In addition, what you drink passes much faster into the intestine,” says Strømmen.

The small intestine’s big job is absorption. Since the stomach’s ability to break down alcohol more or less stops, significantly more alcohol passes directly into the bloodstream. That’s true even if the patient drinks the same as before the operation.

You get drunk faster

In a new study, Strømmen and his colleagues have had 33 adult patients undergo stress tests with alcohol. The participants consumed measured amounts of vodka mixed with orange juice both before bariatric surgery, and 3, 12 and 36 months after the operation, after which they had their blood alcohol levels measured after they had consumed the alcohol.

“Our findings show that alcohol uptake almost doubles, both after gastric bypass and gastric sleeve. Perhaps an even more dangerous finding, from a substance-abuse perspective, is that patients reach the maximum blood concentration in only half the time. These effects are lasting, probably lifelong,” Strømmen said.

In other words: The patients were intoxicated faster, and to a much greater extent, by the same amount of alcohol, and it took longer to get sober.

“The effects were more pronounced for people who had gastric bypass surgery. But that does not mean that the sleeve operation is harmless in terms of subsequent alcohol abuse,” Strømmen said.

Gastric bypass (left) and gastric sleeve are the most common forms of bariatric surgery today. In gastric bypass, a corner of the stomach is connected directly to the small intestine, so that both the stomach and one meter of the small intestine are disconnected. In gastric sleeve surgery, part of the stomach is removed so that the volume is reduced, without reconnecting the intestines. Illustration: Kari C Toverud, CMI

Bypass had a 69 per cent higher risk than sleeve

In another study, the researchers compared the risk of getting an alcohol abuse diagnosis after the two bariatric surgeries. The researchers analysed data from the Norwegian Patient Registry linked to the Norwegian Prescription Database for 17,800 patients operated on in the period from 2008 to 2018.

They found that patients who had gastric bypass surgery had a 69 per cent higher risk of being diagnosed with an alcohol-related problem than patients with a gastric sleeve. Bariatric patients who were given an alcohol-related diagnosis also had a higher mortality rate and used specialist health services more than patients who underwent bariatric surgery and who did not receive an alcohol diagnosis.

“It is important that patients, their relatives and health personnel, especially in general medicine, substance abuse and gastro medicine, share this knowledge. These Norwegian studies, based on different data sources and different methodologies, indicate that some of our patients struggle with alcohol problems as a complication from the surgery. Alcohol problems can cost the patient, their relatives, and society a great deal,” Strømmen said.

He likes to tell patients that they need to practice saying no.

“They will suddenly be in social contexts where friends and surroundings expect you to drink as much as before the operation. But your physiology has changed. That means you need to be more careful than before,” he said.

Risk factors for bariatric surgery must be investigated

“We can’t just tell people what to do or not to do,” says Associate Professor Magnus Strømmen. “I believe more that patients need to be educated about the mechanisms behind it. Knowledge can motivate people to be more careful with alcohol. They need to know how altered alcohol absorption can affect their actions while under the influence and that all alcohol intake doubles the stress on their organs. Photo: Aleksander Mjøen

He himself has been involved in building up the obesity outpatient clinic at St. Olavs Hospital in Trondheim. Now he wants to be sure that clinics incorporate this new information into their daily practice. Patients must be assessed individually in relation to the risk of alcohol problems.

“We find that many patients have a clear idea of what type of surgery they want when they are referred. And for a long time, this was given very great importance in the decisionmaking. But obesity is not just a single phenotype. Despite having a large body, patients are very different, also in terms of health,” he said.

Some patients may have type 2 diabetes, others struggle with heartburn. Some may have more extensive obesity and thus desire greater weight loss.

“For a patient like this, gastric bypass may be best. Other conditions may make you want to recommend gastric sleeve. Now we know that the operations result in different risks of alcohol problems. This means we must also investigate the patient’s risk factors for substance abuse before we decide which operation the patient should have. Where patients have several risk factors, gastric sleeve may be a better alternative, but we must also ask whether high-risk patients should be operated on at all,” Strømmen said.

Patients need to know

He wants patients to receive more specific information before the operation.

“It is important that patients make their decision to undergo surgery on a genuinely informed basis. It is not enough to say that their alcohol uptake will change. Patients should be educated about the mechanisms behind increased risk after surgery, and not least how to react differently to alcohol intoxication after surgery as a result of the sudden increase. This information can at best prevent patients from developing alcohol-related problems,” he said.

The patient’s risk factors for substance abuse should be considered before the type of surgery is chosen.

“I think most obesity clinics can get much better at their alcohol history, ie, a thorough conversation about the patient’s alcohol habits and any risk factors. We need to get better at asking the right questions, and make a more precise assessment. But this also requires transparency from the patients. I believe that good patient education can make patients understand why it is important to be honest about these things,” says Strømmen.

Drugs can replace bariatric surgery

In recent years, more effective drugs have been developed against obesity. Strømmen believes these should be considered for everyone before surgery, but especially for those at increased risk of alcohol abuse.

“The current guidelines state that we should not operate on patients with an active substance abuse problem, and that high-risk patients should abstain from alcohol after surgery. However, the guidelines do not provide any guidelines for how patients should be screened.  The lack of specification is a problem because this is information that many clinicians are reluctant to ask for, and which patients may be afraid to share,” he said.

By Ingebjørg Hestvik – Published 25.06.2026

References:

Strømmen, M., Dale, O., Klöckner, C. et al. Ethanol pharmacokinetics before and after sleeve gastrectomy and Roux-en-Y gastric bypass: a 3-year prospective study (the BAR-TRIAL). Int J Obes (2026).https://doi.org/10.1038/s41366-026-02113-3

Strømmen, M., Bakken, I.J., Sandvik, J. et al. Alcohol use disorders and related morbidity and mortality after sleeve gastrectomy and Roux-en-Y gastric bypass: a nation-wide registry study (the BAR-REGISTER). Int J Obes (2026). https://doi.org/10.1038/s41366-026-02123-1

Source: Norwegian SciTech News