A growing body of research has shown that autoimmunity influences certain psychiatric disorders. A new study by Nemani et al., currently in preprint, has shown that schizophrenia is strongly associated with an elevated level of autoantibodies that target the central nervous system. Using Rapid Extracellular Antigen Profiling (REAP) to screen 352 patients against 971 controls, the researchers found that schizophrenia is marked by an increased autoantibody burden that tracks with disease severity and duration, nearly doubling in the most chronic cases.
These immune responses are present near the start of the illness and tend to increase as the disease progresses, particularly targeting neuronal ion channels and synaptic proteins. Notably, certain autoantibodies appear to compromise the blood–brain barrier, which may further expose the brain to peripheral immune attacks.
The study also discovered that patients with a higher autoantibody burden respond less effectively to standard antipsychotic treatments like risperidone. However, clinical trials showed that these antibody levels significantly declined during successful treatment courses. These findings suggest that humoral autoimmunity is a core component of the disorder, potentially offering new pathways for immune-based therapies.
A landmark international clinical trial, led in the UK by University College London researchers, has identified the optimal antibiotics for staph blood infection, a breakthrough that is set to reshape treatment for the life-threatening condition.
The SNAP trial found that a little used antibiotic, cefazolin, is as effective as and safer than the current UK standard therapy, flucloxacillin, for treating life-threatening staph blood infections. More than half of staph blood infections lead to sepsis and 15% to 25% of those who get these infections die within three months.
The researchers also found that a commonly used antibiotic, penicillin, can be used when the staph is treatable with this in the laboratory. And that similarly this is probably as effective as flucloxacillin, and safer.
The findings from the SNAP trial, published in the New England Journal of Medicine(NEJM) and The Lancet, challenge the long-held assumption that flucloxacillin should remain the default treatment and provide important new evidence to guide treatment strategy.
Staph (Staphylococcus aureus) is a leading cause of deadly blood infection, associated with over 1 million deaths worldwide each year. While effective antibiotic treatments exist, there has been no clear agreement about which antibiotic leads to the best outcomes for patients.
The NEJM results – Comparing cefazolin and flucloxacillin
In the trial published in the NEJM, researchers compared antibiotics used to treat meticillin-susceptible Staphylococcus aureus (MSSA) infections (i.e. blood infections that are not resistant to the meticillin antibiotic). It found cefazolin is at least as good as flucloxacillin for helping people to survive this infection, and associated with fewer side effects and a lower risk of kidney injury. It compared cefazolin and flucloxacillin in 1341 adults with staph blood infections across eight countries taking part in this part of the trial.
In patients who received cefazolin there were fewer cases of changes in how the kidneys are working (as measured by blood tests). Such kidney changes can cause long-term health problems and occurred in fewer of those given cefazolin compared to those given flucloxacillin.
The Lancet results – Comparing benzylpenicillin and flucloxacillin
In the paper published in The Lancet, the trial evaluated whether penicillin could be used to treat penicillin-susceptible Staphylococcus aureus (PSSA) infections where laboratory testing confirmed the susceptibility to penicillin.
This trial compared penicillin and flucloxacillin in 281 adults with staph blood infections. Penicillin was found to be likely to be at least as good for helping people to live with this infection as flucloxacillin.
In patients who received penicillin there were similarly fewer cases of changes in how the kidneys are working (as measured by blood tests). These occurred in 11% of those given penicillin compared to 22% of those given flucloxacillin. Mortality was also 14% in the penicillin group compared with 22% in the flucloxacillin group.
Professor Anna Goodman, UK lead of the SNAP trial at the UCL Innovative Clinical Trials, said: “This trial fills a major research gap. Our results strongly support cefazolin as the new first treatment for most adults with these infections. They also show a role for penicillin in some cases. It’s been helpful to deliver it in collaboration with researchers around the world and patients who have been affected by the condition, who we found via the UK Sepsis Trust.
“The results represent huge progress in the management of this disease with the first change in our approach to antibiotics in decades. Not only are cefazolin and penicillin as effective as flucloxacillin at treating penicillin- and meticillin-susceptible staph blood infection, but they also lead to significantly fewer abnormal blood tests.”
Staph infections are caused by bacteria called Staphylococcus aureus. They most often affect the skin and cause relatively minor problems. However, if the bacteria enter the bloodstream or other parts of the body, they can cause serious infections such as blood poisoning, blood infection or sepsis.
These more serious infections can affect anyone, but individuals at higher risk include people with catheters in their veins (as happens when people receive renal replacement therapy also called haemodialysis) or implanted devices (such as pacemakers), and people with diabetes. Those living with cancer and on immune suppressing medication, those who cannot get out of bed, and those who inject drugs are also more vulnerable to these infections.
The Royal Melbourne Hospital’s Professor Steven Tong, an infectious diseases physician at the Doherty Institute in Australia and global co-lead investigator of the SNAP Trial, said the results provide clear evidence that cefazolin should be considered the first-line option to treat MSSA blood infections.
“In the treatment of MSSA blood infections, there is an 89% probability that cefazolin is associated with lower mortality,” said Professor Tong.
“Patients treated with cefazolin fare better, with fewer deaths within 90 days (15% compared to 17% for those who received flucloxacillin). Cefazolin was also associated with fewer cases of acute kidney injury, at 14%, compared to 20% with flucloxacillin.
“The results are sufficiently compelling that I immediately made the switch in my own clinical practice.”
A shift away from flucloxacillin
Researchers said these results mark a turning point in the treatment of MSSA and PSSA blood infections, signalling a shift in clinical practice.
Penicillin was once widely used to treat Staphylococcus aureus, but antibiotic resistance of staph led clinicians to adopt flucloxacillin as the standard treatment for MSSA and PSSA blood infections. The findings support moving away from flucloxacillin as the default treatment for MSSA and PSSA blood infections, given safer alternatives are available.
The new results mark the first major finding from the ongoing SNAP trial, which aims to improve treatment for Staphylococcus aureus infections around the world. These parts of the trial took place in Australia, Canada, Israel, the Netherlands, New Zealand, Singapore, South Africa and the UK – each supported by regional funders working together to form one global network.
Global leadership was provided by the University of Melbourne trial team led by Professor Steven Tong and Professor Josh Davis.
So far, over 6000 participants have been enrolled in over 150 sites in those countries stated, and more recently in Germany and Sweden, Germany, Japan, Malaysia, and the United States. The trial will continue testing new approaches to improve outcomes for patients facing this serious infection.
Translating the findings
Researchers say the next challenge will be translating the findings into routine clinical practice.
While cefazolin availability may need to increase in some countries, researchers say implementation will ultimately depend on hospitals, laboratories and guideline groups incorporating the findings into clinical care.
Professor Goodman said: “Sepsis and staph blood infections are devastating for those affected and those who care for them. We are grateful to all those who took part and supported these two trials which will change practice. The platform trial continues as we ask further important questions in this area.”
When 12-year-old Eugene underwent a highly specialised facial reanimation procedure earlier this year, the surgery represented something profoundly human, the possibility of smiling for the first time.
Born with Moebius syndrome, a rare neurological condition that affects facial movement and expression, Eugene had spent his life unable to smile, blink properly or express emotion through facial movement. And while his story is emotionally powerful, it also shines a light on a far broader healthcare reality, the growing importance of highly specialised reconstructive surgery in restoring not only appearance but movement, function, dignity and quality of life.
At Wits Donald Gordon Medical Centre (WDGMC), reconstructive microsurgery is helping redefine what is possible for patients facing some of the most complex medical challenges, from congenital conditions and cancer to severe trauma and tissue loss.
Often misunderstood as a field focused primarily on cosmetic procedures, reconstructive microsurgery sits at the intersection of surgical precision, innovation and long-term patient rehabilitation. These procedures frequently involve transplanting tissue, muscle and nerves from one part of the body to another and reconnecting blood vessels, often measuring less than two millimetres in diameter, under microscopic magnification.
Leading this work at WDGMC is Dr Dimitri Liakos, a plastic and reconstructive surgeon with fellowship training in reconstructive microsurgery and super microsurgery.
Dr Dimitri Liakos, a plastic and reconstructive surgeon with fellowship training in reconstructive microsurgery and super microsurgery.
“These procedures are not simply about appearance,” says Dr Liakos. “They are about restoring function, movement and ultimately helping patients regain parts of their lives that were lost or that they were born without.” In Eugene’s case, surgeons transferred functioning muscle together with its blood and nerve supply into the face, reconnecting these delicate structures under a microscope so movement could gradually return over time.
Eugene’s procedure was facilitated through the support of the Smile Foundation, which works to improve access to reconstructive surgery for children requiring specialised care.
“We are deeply grateful to Wits Donald Gordon Medical Centre and Dr Dimitri Liakos for their dedication in supporting Eugene on his journey,” says Tarri Parfitt, CEO of Smile Foundation. “It is truly remarkable to open a world-class facility to this family and provide care at the highest level of expertise. Facial reanimation surgery is profoundly life-changing. For Eugene, it represents the possibility of expression, connection and a future he may never have imagined before. For Smile, it was also an invaluable opportunity for other surgeons to learn from such a rare and complex case, turning one surgery into the potential to help many more children like Eugene. We highly value the opportunity to work alongside Wits Donald Gordon Medical Centre on cases such as this and look forward to helping many more children together.”
While these procedures are performed in highly specialised centres globally, access to this level of care remains limited in South Africa due to the advanced infrastructure, multidisciplinary expertise and years of specialised training required to perform them successfully.
For WDGMC, however, the ability to perform these surgeries forms part of a broader commitment to advancing highly specialised care within South Africa’s healthcare system while simultaneously strengthening academic medicine and specialist training.
As an academic hospital affiliated with the University of the Witwatersrand, WDGMC has become an important training environment for complex reconstructive microsurgery in South Africa. The hospital recently established the country’s first reconstructive microsurgery fellowship programme for qualified plastic surgeons, helping expand the number of specialists capable of performing these highly technical procedures.
“We have a responsibility not only to perform these surgeries, but to transfer the skill,” says Dr Liakos. “If we do not train future microsurgeons, access to this level of specialised care will remain limited.”
According to Dr Liakos, successful reconstructive microsurgery depends not only on surgical expertise but on building the right multidisciplinary environment around patients.
“To do these cases successfully, you need a dedicated team and an environment that functions seamlessly,” he explains. “Microsurgery is never a one-person effort. It is the nursing staff, anaesthetists, theatre teams and systems around you that make these outcomes possible.”
For surgeons working in the field, the impact of reconstructive microsurgery extends far beyond the operating theatre.
“These surgeries can take 10 or 12 hours. They are physically and emotionally demanding,” says Dr Liakos. “But when you step back and realise that what you are doing may change the course of a person’s life forever, it gives meaning to every moment spent in theatre.”
As WDGMC continues to build on its reconstructive microsurgery programme and the country’s first fellowship of its kind, the hospital is helping shape a future in which South African patients can access world-class reconstructive care close to home and in which the specialists capable of providing that care are trained locally.
Emotional eating increased when women were taking hormone-containing birth control pills compared to the hormone-free pills taken at the end of each monthly cycle
Photo by Reproductive Health Supplies Coalition on Unsplash
Birth control pills are safe and effective for millions of women, but researchers are still working to understand how the hormones they contain may influence eating behaviour.
A new study in JAMA Network Open followed 422 women who were already using combined oral contraceptives, tracking their eating patterns daily for 49 consecutive days. The goal: to examine whether binge-related eating changes depending on whether women are taking hormone-containing pills or hormone-free pills within the same cycle.
In a typical birth control pack, women take about three weeks of “active” pills that contain hormones, followed by about a week of “inactive” pills that contain no hormones.
“Because we tracked the same women day to day, we could see how eating changed with hormone exposure,” said Dr. Shaunna Clark, a co-author and associate professor of psychiatry and behavioral sciences at Texas A&M University’s Naresh K. Vashisht College of Medicine.
How birth control hormones may increase binge-eating risk
The study used a within-person design, meaning each participant served as her own comparison. Researchers measured emotional eating (overeating in response to negative emotions) while tracking whether each day corresponded to an active or inactive pill.
They found a consistent pattern:
Emotional eating was significantly higher during active pill days than during inactive pill days.
This pattern appeared:
across two full pill cycles
in the full sample of 422 women
and in a subset of women with diagnosed binge eating
Clark says the findings held even after accounting for negative mood, suggesting the change was not fully explained by emotional distress.
“That tells us the hormones themselves may be playing a role, rather than those changes being driven by mood or other factors,” she said.
Why birth control may increase binge-eating risk for some women, but not others
The analysis focused on average changes across the group, but the study emphasizes that not all women experience these shifts in the same way.
“Participants ranged in age from late adolescence to young adulthood and were all using the same type of pill, monophasic combined oral contraceptives, which provide a consistent dose of hormones during active pill days,” said Clark, part of the research team led by Dr Kelly Klump at Michigan State University.
Because the study examined within-person changes, it shows that eating behavior can shift alongside hormone exposure, even if the magnitude of that shift differs between individuals.
“These findings show a pattern at the group level,” she said, “but individual responses can vary.”
Birth control pills linked to binge eating, but not mood or body image
The study does not establish that birth control pills cause binge eating. Instead, it identifies a specific association between hormone exposure and increased emotional eating within individuals.
Importantly, researchers also tested other outcomes:
Weight preoccupation did not change across pill type
Mood changes in response to pill type were smaller and less consistent than the changes in eating
Clark says that suggests the effect is relatively specific to binge-related eating behaviour, rather than a general shift in mood or body image concerns.
How this study changes what we know about birth control and binge eating
Previous research has shown that binge‑related eating tends to increase after ovulation, when both oestrogen and progesterone are elevated.
This study extends that work by showing that synthetic hormones in birth control pills are linked to similar patterns.
By comparing hormone-containing and hormone-free days within the same individuals, the study provides some of the clearest evidence to date that binge-related eating increases during periods of hormone exposure in the birth control cycle.
“Findings like these can help us better understand how different hormone exposures affect eating behaviour,” Clark said. “Over time, that could help clinicians and patients make more informed decisions about care.”
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By Lesley Henton, Texas A&M University Division of Marketing and Communications
Errors and irrelevant details mean physicians may spend more time editing AI-drafted responses than it would take to write them, a large study of an online patient portal shows
Photo by National Cancer Institute on Unsplash
Artificial intelligence is spreading rapidly in health care, with the goal of streamlining critical but onerous clerical tasks such as note-taking and charting so that physicians and nurses can devote more time to patients. But even when AI can free up doctors to correspond with patients, it may fall short in helping them do it by introducing errors and extraneous details into their messages, according to a new Dartmouth study presented at the 2026 Annual Meeting of the Association for Computational Linguistics and published in the conference proceedings.
The result is that physicians may spend more time editing responses than it would’ve taken to write them, the researchers report.
“We find that AIcan sound like a doctor but not think like one,” says Sarah Preum, an assistant professor of computer science and the study’s co-corresponding author with Parker Seegmiller, a graduate researcher in Preum’s PersistLab at Dartmouth.
The researchers conducted the first large-scale study of an online patient portal that uses AI to draft responses from physicians to patients. The team developed a tool that compares AI-generated replies to a dataset of real responses they developed with health care professionals from Dartmouth Health.
They then analysed 146 000 conversations between 10 105 patients and their primary care physicians at the large rural health system, with data anonymised.
The researchers also used their tool to evaluate physician responses drafted by Claude, Gemini, and ChatGPT, as well as the three smaller commercial platforms, Llama, Aloe, and Qwen.
“We find that AI can sound like a doctor but not think like one.”
Sarah Preum, corresponding author and assistant professor of computer science
The team reports that AI-generated answers frequently misalign with what clinicians would actually write. This includes automated responses that are too long, don’t ask follow-up questions, and use irrelevant or inaccurate medical details.
“There are smaller studies that say, ‘Oh, AI is amazing,’ but we realised there is a gap in the existing literature of a large-scale evaluation of this technology,” Preum says. “We didn’t just want to measure a platform’s accuracy, but whether it actually helps with the workload, which in this case is measured by how much editing the physician is doing.”
For example, the portal’s AI suggested telling a 32-year-old woman who is taking an acid reflux drug and was concerned about constant nausea that the medication might take some adjustment in diet. A physician replaced that by asking if there’s any chance she was pregnant.
Even little changes can add up over hundreds or thousands of messages, Preum says. “You don’t want to integrate large language models into the workflow and just shift the bottleneck so that doctors are devoting their cognitive energy to playing AI janitor and fixing mistakes,” Preum says. “But if we’re not careful, that’s a likely outcome.”
The researchers show, however, that adapting AI to how individual physicians communicate can improve accuracy by 33% and reduce editing by 26%.
“If message generation is really efficient and high quality, if it asks the right things, then it really has potential to improve efficiency,” says co-author Tim Burdick, an associate professor of community and family medicine in Dartmouth’s Geisel School of Medicine and a family medicine physician at Dartmouth Health.
“I don’t foresee a time when the portal can respond to a patient without a clinician editing it first. But as we make the models better, we’ll be able to address portal messages much more quickly and with less mental energy,” Burdick says.
The study shows that there are such things as “good” AI responses and provides a framework for implementing them into patient-physician portals, Preum says. These platforms are increasingly common among large health care systems and often customized, she says.
“That took us a long time to figure out, but if you’re trying to measure how effective this technology is, you need to define what a good response is,” she says. “We can only improve what we can measure and objectively evaluate.”
The researchers created a technique called TADPOLE (Thematic Agentic Direct Preference Optimization for Learning Enhancement) that trains AI platforms using the hybrid model they constructed from physician- and AI-generated responses.
They plugged TADPOLE into the six commercial LLMs and found that drafted responses better matched physicians’ standards for precision and information quality. “That could save a busy clinician an hour or two of work a day,” Burdick says.
Doctors and nurses today are inundated with messages from patients and caregivers who can write them online anytime, he says. An ongoing project between Burdick and the Preum Lab called PortalPal aims to streamline patient portals using AI, including by automating some steps in following up with patients to get more information.
“We’re still nowhere near the point of having clinicians removed from the workflow.”
Tim Burdick, co-author and associate professor of community and family medicine
Physicians who Burdick works with say that AI-generated drafts save about 25% of their time on shorter messages. “It’s easier to make small edits to an LLM-generated message than it is to write it from scratch,” he says. But longer drafts can include information that is not correct or accurate.
“If you have to edit 75% of the message, you may be spending more time and energy on making changes than if you were to just write it from scratch,” Burdick says. “I would guess we need to get to where the physician is editing less than 30% of the content before it has substantial benefit.”
One advantage of AI’s verbosity is that it tends to be more empathetic and thorough than physicians crunched for time, the researchers find. For example, AI is more likely to tell a patient experiencing an upset stomach that it’s sorry to hear they’re feeling nauseated.
This means AI could be used to help “nudge” doctors to show more understanding and care for the patient’s situation, or answer patient’s questions more effectively so that patients feel more heard, Preum says. The team produced sample responses such as showing empathy by praising patients for following a treatment plan (“You’ve been doing a great job with your tapering.”) or planning for changes in symptoms (“If you’re feeling dizzy, please call triage.”).
The researchers also find that 65% of all the portal messages they studied came from people over 55, with patients over 65 generating 24% of all messages. These figures suggest that patient portals in general should be designed to accommodate older people, Preum says.
Future work will study how much actual time doctors spend editing automated drafts. The team also plans to evaluate their training model TADPOLE from the user perspective, studying if and how it lightens a physician’s workload, and how doctors and patients rate its performance.
“This is one of the first studies that uses real patient portal messages to establish a generative AI model. In that regard, it’s innovative and shows us that this is not a simple task,” Burdick says. “We’re still nowhere near the point of having clinicians removed from the workflow.”
Right side heart failure. Credit: Scientific Animations CC4.0
An early clinical study shows that a new oral drug is safe and well-tolerated in patients with chronic heart failure. The study, led by researchers at Karolinska Institutet, has been published in the scientific journal The Lancet.
Heart failure with reduced pumping capacity means that the heart struggles to pump blood effectively around the body. Despite current treatments, many patients’ condition worsens over time, and existing drugs that strengthen the heart’s contractions can cause serious side effects, such as heart rhythm disturbances and changes in blood pressure.
In the study, researchers investigated a new drug, AC01, which targets the body’s ghrelin receptor. Ghrelin is a hormone that influences metabolism and growth hormone release, and its receptor is also found in heart muscle. AC01 is intended to strengthen the heart’s pumping ability through a different biological mechanism from traditional heart‑stimulating drugs, thereby reducing the risk of side effects.
The study was a randomised, placebo‑controlled phase 1b/2a trial involving 58 patients with stable, chronic heart failure with reduced pumping capacity. Participants received different doses of AC01 or placebo for either seven or 28 days. The main aim was to assess safety and tolerability.
The drug was well tolerated
The results show that the drug was well tolerated. No serious side effects linked to AC01 were reported. The researchers also found no signs of harmful effects on heart rhythm or blood pressure. Exploratory analyses additionally indicated signs of improved heart function, such as increased stroke volume and cardiac output.
“This is an early study with a limited number of patients, but the results suggest that AC01 can be administered safely to people with heart failure. The findings now justify further studies to investigate whether the signals of improved heart function that we have observed can lead to clinical benefit in larger and longer studies,” says Lars Lund, first author and professor at the Department of Medicine, Solna, Karolinska Institutet, and senior consultant cardiologist at Karolinska University Hospital.
Students and dermatologists are determined to find how rosemary and rosemary extract can repair damaged skin without leaving scars
Penn undergraduate student Jiayi Pang (left) and Penn PhD candidate Emmanuel Rapp Reyes (right) found that rosemary can help skin wounds heal without causing scars.
The social media trend touting rosemary and rosemary extract as part of skincare routines is now backed by science. A compound found in rosemary leaves may significantly improve the healing of skin wounds and reduce scarring, according to new research published in JCI Insight from the Perelman School of Medicine at the University of Pennsylvania.
“Many skin injuries end in scars, and in some people, it can lead to long-term cosmetic and even functional issues,” said senior author Thomas Leung, MD, PhD, an associate professor of Dermatology at Penn. “Our findings suggest that rosemary extract, and specifically the antioxidant, carnosic acid, can shift the healing process from scarring to healthy skin regeneration. We don’t have proven ways to consistently do that in humans.”
The hypothesis behind the hype
The inspiration for this study stemmed from an unusual place: TikTok and Instagram. After seeing beauty influencers and other social-media users touting the skin-healing benefits of homemade rosemary extract serums and products with rosemary, Penn undergraduate student Jiayi Pang and Penn PhD candidate Emmanuel Rapp Reyes turned to Leung for expertise. Then, they did what all good scientists do: they went to the lab and ran their own tests.
“We hypothesized there was likely something real behind the hype because rosemary contains many antioxidants,” said Pang, co-lead author of the study. “But we knew in order to really uncover its potential, we needed to prove its healing properties and uncover how exactly it was facilitating healing.”
Conducting the research in mice, the researchers made cream with carnosic acid, a naturally occurring antioxidant mostly existing in rosemary, to accelerate wound closure and restore hair follicles, oil glands, and cartilage. They also found that a particular nerve sensor in the skin previously identified as essential to scarless healing, TRPA1, was critical for stimulating the healing in this instance, too. When tested in mice without the TRPA1 sensor, which previous research from Leung showed is responsible for scarless healing, carnosic cream lost its impact.
“We also identified other herbs, such as thyme and oregano, that may activate TRPA1. But rosemary stood out for its potency and safety,” said Rapp Reyes, co-lead author of the study. “Other natural ingredients, such as mustard oil, or the topical medication imiquimod are known to also stimulate the TRPA1 receptor, but unlike rosemary, those can cause irritation and inflammation,”
The researchers also found a localised effect from rosemary; scarless healing only occurred when carnosic acid cream was applied to the site of the injury but not when it was applied to skin far from the wound.
The team at Penn, however, notes that individuals should speak with their doctors before incorporating rosemary skincare products in their daily regimens or mixing up their own rosemary-based concoctions. Nevertheless, given rosemary’s accessibility and low cost, the researchers hope their findings will inspire further investigation into its use in human wound care, especially for patients at risk of excessive scarring.
“If rosemary is part of your skincare regimen and you think it’s working, it likely is,” said Leung. “I’m proud that the young scientists that led this research sought answers to questions in their everyday lives.”
By calming inflammation and reducing excess fat, semaglutide may postpone several molecular signs of aging, pointing to the potential of GLP‑1 receptor agonists to help prevent age‑related diseases.
Semaglutide slowed biological aging across multiple epigenetic clocks in a randomised, double-blind, placebo-controlled clinical trial. The strongest signals were seen in epigenetic measures linked to inflammation, brain, heart, blood, kidney, liver and metabolic health, suggesting that the drug may influence aging-related biology across multiple body systems. The findings offer early clinical evidence that GLP-1 receptor agonists may influence aging biology.
Glucagon-like peptide-1 (GLP-1) receptor agonist medications have gained widespread attention for effectively treating obesity, lowering blood sugar and decreasing the risk of cardiovascular disease. Some researchers have proposed that these drugs may also influence the biology of aging, but direct evidence in humans has remained limited. Now, a new study provides the first randomised, placebo-controlled clinical evidence that semaglutide, a widely used GLP-1 drug, slows down the accumulation of biological aging markers in the DNA of adults with HIV. The study is published in Nature Communications.
Researchers at the University of California San Diego and several partner institutions analysed data from a previously published clinical trial of 108 adults with HIV‑associated lipohypertrophy, a condition in which excess fat builds up around the abdomen. About half of the participants received weekly injections of semaglutide, with the rest receiving placebo injections.
The team used a set of biological “epigenetic clocks” to track cellular aging over the 32-week treatment period. These clocks detect DNA methylation, chemical marks on DNA that help regulate how genes are turned on or off without changing the genetic sequence itself. By measuring changes in these marks, the team could assess whether the treatment was associated with a slower or faster biological aging pattern.
People with HIV often experience accelerated aging, even if it is well-controlled with antiretroviral therapy, according to first author Michael Corley, PhD, associate professor at UC San Diego School of Medicine and the Stein Institute for Research on Aging. However, the study found compared to the placebo group:
Participants treated with semaglutide exhibited a broad pattern of slower biological aging across epigenetic clocks linked to inflammation and blood, brain, heart, kidney, liver and metabolic health.
The drug slowed the pace of biological aging by 9 %, as measured by the DunedinPACE epigenetic clock.
The drug significantly slowed biological processes associated with the risk of all‑cause mortality and age-related disease, as measured by the PCGrimAge epigenetic clock.
Research suggests there are several mechanisms by which semaglutide may influence biological aging. By reducing inflammation and metabolic stress, GLP-1 drugs decreased chronic immune activation, a primary driver of accelerated aging in people with HIV. They also reduce visceral and ectopic fat that accumulates around the abdomen and organs, which may help curb the inflammatory and metabolic signals that promote aging.
“Emerging data also suggest that GLP-1 drugs may reprogram certain cells in different organs, which could help explain why we see effects across multiple aging clocks,” said Corley.
While the study focused on people with HIV‑associated lipohypertrophy, Corley says it may also offer lessons for the wider population.
“Many of the biological processes we study in HIV are also central to aging in the general population,” he said. “Because these processes can emerge earlier or be more pronounced in people with HIV, this community can help us identify interventions that may improve healthspan more broadly.”
In a related pilot study published in npj Aging, Corley and another team of researchers found that taking semaglutide for 24 weeks:
Reduced the rate of biological aging for 42% of participants with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD) as measured by the DunedinPACE epigenetic clock. Those participants also had a greater reduction in liver fat compared with participants whose pace of aging sped up.
Slowed aging associated with the risk of all‑cause mortality in 34% of participants as measured by the PCGrimAge epigenetic clock.
Increased the length of telomeres in nearly 49 % of participants as measured by the PCDNAmTL epigenetic clock. Those participants also tended to walk faster after treatment, suggesting better physical function.
Together, these studies add to growing evidence that GLP-1 drugs may influence pathways involved in biological aging.
“We are not saying that semaglutide reverses aging or makes people younger. What we are seeing is a signal that it may slow some of the biological processes associated with aging.”
— Michael Corley, PhD
“We are not saying that semaglutide reverses aging or makes people younger,” said Corley. “What we are seeing is a signal that it may slow some of the biological processes associated with aging. With newer GLP-1–based therapies now emerging, the field has an opportunity to test whether different drugs in this class have distinct effects on aging biology and to identify which patients may benefit most.”
Larger clinical trials are needed to confirm the findings, determine how long treatment effects last, and establish optimal dosing and treatment duration for both people with HIV and the broader population. Future studies will also be needed to test whether the effects of GLP-1 effects on aging biology are enhanced when combined with lifestyle interventions such as diet, exercise and sleep optimization.
The Stein Institute for Research on Aging plans to translate these results into individualized “aging dashboards” to track biological aging with epigenetic clocks, enabling clinicians to design personalised therapies that target the underlying mechanisms of aging and help prevent age‑related diseases.
Data from more than 91 000 participants in the UK Biobank who wore activity monitors for seven days revealed an association between prolonged sedentary behaviour and the risk of cancer death
Each additional hour of prolonged, uninterrupted sedentary behaviour in a person’s day is associated with a 9% higher risk of cancer death, according to a study published July 2nd in the open access journal PLOS Medicineby Frederick Ho of the University of Glasgow, UK, and colleagues.
Previous studies have shown that spending more total time on sedentary behaviour, such as sitting, reclining or lying down while awake, is linked to poorer health outcomes. However, most sedentary behaviour guidelines focus on total time spent sedentary, rather than whether that time is accumulated in many short intervals or fewer prolonged intervals.
In the new study, researchers analysed data from 91 292 UK Biobank participants who had worn activity monitors for 7 days and were followed for a median of 12.38 years afterward. Activity was categorised as either prolonged sedentary (bouts of at least 30 minutes with at least 90% of time sedentary), interrupted sedentary behaviour (which lasted less than 30 minutes or was broken up with more than 10% non-sedentary time), or varying degrees of physical activity.
Prolonged sedentary behaviour was associated with a higher risk of cancer mortality (HR 1.09; 95% CI 1.06, 1.11), overall cancer incidence, obesity-related cancers (such as oesophageal, liver, kidney, pancreatic, colorectal, breast, ovarian, and thyroid cancers), and type 2 diabetes-related cancers. Interrupted sedentary behaviour showed the opposite pattern, associated with lower risk across all outcomes. Replacing one hour per day of prolonged sedentary behaviour with light physical activity was associated with a 12% lower risk of cancer death (HR 0.88; 95% CI 0.79, 0.99).
As a single-cohort study of UK Biobank volunteers, who have known health volunteer bias and higher physical activity levels than the general UK population, the findings may not be generalisable and do not prove causality. The researchers also had no data on the context of sedentary behaviour, such as whether it was during work or driving.
“Our findings suggest that the health effects of sedentary behaviour may depend not only on total sedentary time, but also on whether that time is accumulated in prolonged bouts or interrupted by activity,” the authors say. “This pattern is biologically plausible: experimental studies have shown that interrupting prolonged sitting with short bouts of activity can improve metabolic responses compared with uninterrupted sitting.”
The authors add, “Current health guidelines focus heavily on moderate or vigorous exercise, but our findings show that light movement shouldn’t be ignored. Moving forward, clinical trials will help us move beyond blanket advice and develop personalised strategies for breaking up sitting time.”
The new implant (to the right) consists of a small ball encased in a larger ball, which gives better stability. Photo: Sandra Gunnarsson. Credit: Queen Mary University of London
A major international clinical trial had found that an emerging type of hip replacement implant dramatically reduces complications in people with pelvic fracture. The study, published in The Lancet, involved 1600 patients across 44 hospitals in the UK and Sweden. The DUALITY trial is the largest clinical trial to compare dual mobility total hip replacements (DM-THR) with standard total hip replacements (THR). The team found that people treated with DM-THR were 70 per cent less likely to experience a dislocation post-surgery – the most common complication after hip replacement for fracture.
A broken hip in older people is one of the most common serious injuries worldwide, affecting more than 14 million individuals each year and accounting for 1.4% of total direct healthcare expenditure in established market economies. The type of hip fracture studied in the DUALITY trial represents approximately half of all hip fractures experienced globally.
A total hip replacement where both the ball and socket of the hip are replaced, is recommended for older, active individuals with some types of hip fracture. For most patients, the procedure improves mobility and quality of life, but dislocation post-surgery can be common and can have serious consequences for those affected. When dislocation occurs, patients often require emergency hospital admission, procedures to reset the joint, and sometimes further surgery. This can lead to longer recovery times, added distress, and increased risk of further health problems.
Dual mobility-THR uses a small ball encased in a much larger plastic ball, and was developed specifically to reduce the risk of dislocation. In the DUALITY trial, the team aimed to establish if DM-THR reduced the risk of dislocation compared to THR. The results showed that the DM-THR implant does improve stability in the hip joint, making it less likely to dislocate after surgery. They found that within one year of surgery, just 1.3 per cent of patients receiving DM-THR experienced a dislocation, compared with 4.2 per cent of those given a standard THR. Importantly, the study found no increase in other risks such as infection or death, and overall complication rates were lower in patients receiving DM-THR.
The researchers conclude that dual mobility implants should be considered the preferred option for suitable older patients undergoing total hip replacement after a broken hip. Crucially, DM-THR requires no new technology or training. Surgeons are already familiar with both implant types, meaning the change could be implemented immediately within existing practice.
Professor Xavier Griffin, study author and Chair of the Centre of Bone and Joint Health at Queen Mary University of London and Honorary Consultant Orthopaedic Surgeon at Barts Health NHS Trust, said:
“Dislocation is the most common major complication following hip replacement for a broken hip. People that experience this painful complication often require further surgery and the recovery following this is usually long, slow and painful. So, it has been an area that I, along with our surgeons around the world, have been wondering if there is any benefit to using these type of hip replacements in people with a broken hip. The fantastic news from DUALITY is that we can make a really substantial reduction in the risk. I hope that this research will make a real difference to many future patents who might avoid this catastrophic problem.
I’ve tried to run similar studies before but never been able to deliver one that is big enough to give us a reliable answer to the question. Meeting the team in Uppsala and making this international collaboration a reality has been a game changer for accelerating how quickly we can discover the answers to these sorts of questions.”
Professor Nils Hailer, study author, Chair of Orthopaedics at Uppsala University and Consultant Orthopaedic Surgeon at Uppsala University Hospital, said:
”After many years of analysing registry data and seeing both advantages and limitations of dual mobility hip replacements, I was eager to obtain solid evidence for or against the concept. Together with colleagues at Queen Mary, we succeeded in delivering a large, pragmatic, orthopaedic randomized trial involving both smaller hospitals and major referral centres across two countries.
“The results provide robust support for the use of dual mobility constructs in hip fracture patients in need of a total hip replacement. Beyond the findings themselves, I believe this collaboration sets a new benchmark for future randomized trials in European orthopaedic research, and we will jointly continue working towards that goal.”
Researchers say that beyond improving outcomes for patients, reducing dislocations could have a significant impact on healthcare systems. Complications such as post-surgery dislocations increase hospital stays, require additional operating time, and drive unplanned readmissions. Although dual mobility implants are currently more expensive than standard implants, researchers believe the reduction in complications could offset the higher upfront cost. A full economic analysis is underway.
