Metformin: A Potential Therapy for Periodontal Tissue Repair following periodontitis

Researchers have found in a new research that Metformin shows promise in promoting periodontal tissue repair following periodontitis. It is attained by controlling inflammation and enhancing cellular activity essential for tissue restoration.

Periodontitis is a destructive disease that affects periodontal tissue. While current research focuses on disease management, research on tissue repair remains limited. Metformin, a first-line medication for diabetes treatment, has positive effects on bone health in nondiabetic patients. However, its potential for repairing periodontal tissue remains unclear. Therefore, this study aimed to evaluate the reparative effects of metformin on periodontitis-damaged periodontal tissue in mice.

A mouse model of periodontal repair was used, in which silk ligatures were removed from the molars after inducing periodontitis, followed by metformin administration. Histomorphometric and histological analyses were conducted to assess comprehensive repair of the periodontium. Additional in vitro studies were conducted to determine the effect of metformin on the function of the individual cells that comprise the periodontium.

RESULTS: Metformin treatment promoted the repair of periodontal ligament, alveolar bone, and cementum affected by periodontitis, as evaluated using microcomputed tomography based morphometric and histologic analyses. The therapeutic effect was linked to mitigating persistent inflammatory activity during periodontitis resolution, primarily attributed to the sustained presence of interleukin-1 beta (IL-1β), which may delay tissue repair. In vitro studies simulating this pathological condition showed that AMP-activated protein kinase (AMPK) activation by metformin counteracted the effect of IL-1β, inhibited osteoclast differentiation and restored the osteogenic differentiation capacity of periodontal ligament cells and cementoblasts.

These findings suggest that metformin holds promise for repairing periodontal tissue following periodontitis, potentially through modulating inflammatory responses and regulating cellular differentiation processes.

Reference:

Wang, Zhao, et al. “Metformin Reverses Periodontal Destruction Caused By Experimental Periodontitis By Inhibiting Interleukin-1β Activity.” Journal of Periodontology, 2025.

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Omicron Reinfections in Children Linked to Increased Risk of Long COVID: Study

Children and teenagers were found by researchers to have an exponentially increased chance of acquiring long-term sequelae following a secondary infection with SARS-CoV-2 within the time period of the Omicron variant, according to a new study.The research identifies the additive risks for reinfection, involving several organ systems and raising the risk for diseases like myocarditis, thrombophlebitis, heart illness, and cognitive impairment. The study was conducted by Bingyu Z. and colleagues published in medRxiv.

This retrospective cohort study used data from the RECOVER consortium, consisting of medical records from 40 children’s hospitals and health centers in the U.S. The study duration was January 2022 to October 2023, a period when the Omicron variant was prevalent.

The participants were children and adolescents aged less than 21 years (mean age: 8.17 years, 52% male). For a child to be defined as having a reinfection, they had to have tested positive for SARS-CoV-2 by PCR or antigen tests at least 60 days after a previous infection.

Researchers thereafter contrasted health outcomes after first and second infection.

Two methods were utilized to identify PASC:

• ICD-10-CM diagnosis code U09.9 (clinical diagnosis of long COVID).

• A definition of 24 physician-identified symptoms and conditions related to PASC was used.

Absolute risks were estimated, and relative risks (RRs) were computed using a modified Poisson regression model, which controlled for demographic, clinical, and healthcare utilization factors via exact matching and propensity score matching.

Key Findings: Elevated Risk of PASC Following Reinfection

The research found that SARS-CoV-2 reinfection greatly elevates the risk of PASC. A subsequent infection was compared to the initial infection and was found to be associated with:

•2.08-fold increased risk of a composite diagnosis of PASC (RR: 2.08; 95% CI, 1.68-2.59).

• 3.6-fold increased risk of myocarditis (RR: 3.60; 95% CI, 1.46-8.86).

• 2.83-fold increased risk of taste and smell abnormalities (RR: 2.83; 95% CI, 1.41-5.67).

• 2.28-fold increased risk of thromboembolism and thrombophlebitis (RR: 2.28; 95% CI, 1.71-3.04).

• 1.96-fold increased risk of heart disease (RR: 1.96; 95% CI, 1.69-2.28).

• 1.9-fold increased risk of acute kidney injury (RR: 1.90; 95% CI, 1.38-2.61).

• 1.89-fold increased risk of fluid and electrolyte disorders (RR: 1.89; 95% CI, 1.62-2.20).

• 1.70-fold increased risk of generalized pain (RR: 1.70; 95% CI, 1.48-1.95).

• 1.59-fold increased risk of arrhythmias (RR: 1.59; 95% CI, 1.45-1.74).

• 1.56-fold increased risk of abnormal liver enzymes (RR: 1.56; 95% CI, 1.24-1.96).

• 1.50-fold increased risk of fatigue and malaise (RR: 1.50; 95% CI, 1.38-1.64).

• 1.45-fold increased risk of musculoskeletal pain (RR: 1.45; 95% CI, 1.37-1.54).

• 1.42-fold increased risk of abdominal pain (RR: 1.42; 95% CI, 1.34-1.50).

• 1.35 times increased risk of postural orthostatic tachycardia syndrome (POTS) / dysautonomia (RR: 1.35; 95% CI, 1.20-1.51).

• 1.32 times increased risk of cognitive dysfunction (RR: 1.32; 95% CI, 1.15-1.50).

• 1.29 times increased risk of respiratory symptoms (RR: 1.29; 95% CI, 1.25-1.33).

This large cohort study reaffirms that reinfection with SARS-CoV-2 during the Omicron era considerably raises the risk of long COVID (PASC) in children and adolescents. As long COVID remains a significant public health concern, preventing children from being infected again is a key priority to minimize long-term health outcomes.

Reference:

Zhang, B., Wu, Q., Jhaveri, R., Zhou, T., Becich, M. J., Bisyuk, Y., Blancero, F., Chrischilles, E. A., Chuang, C. H., Cowell, L. G., Fort, D., Horowitz, C. R., Kim, S., Ladino, N., Liebovitz, D. M., Liu, M., Mosa, A. S. M., Schwenk, H. T., Suresh, S., … Chen, Y. (2025). Reinfection with SARS-CoV-2 in the Omicron era is associated with increased risk of Post-acute sequelae of SARS-CoV-2 infection: A RECOVER-EHR cohort study. In medRxiv.https://doi.org/10.1101/2025.03.28.25324858

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Prednisone Use Linked to Higher Risk of Pericarditis Recurrence in Lupus Patients: Study Finds

USA: In patients with lupus, pericarditis recurrence tends to be higher among those with active disease, recent onset of the initial episode, and those receiving oral prednisone, with a clear dose-dependent link to steroid use. Despite these associations, the overall recurrence rate in lupus patients remains lower than that seen in the general population, as highlighted in data published in JAMA Network Open.

Pericarditis, or inflammation of the pericardium—the protective sac surrounding the heart—is a recognized manifestation of lupus. Although it typically responds well to treatment, a notable proportion of patients experience recurrence, which complicates disease management and affects overall quality of life. Despite its clinical relevance, the prevalence and contributing risk factors for recurrent pericarditis in individuals with systemic lupus erythematosus (SLE) had not been clearly defined.

To address this gap, Yoo Jin Kim from the Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, and colleagues investigated the frequency of pericarditis recurrence in patients with SLE and sought to identify the key factors associated with its occurrence.

For this purpose, the researchers conducted a retrospective analysis using data from a well-defined, single-center prospective cohort of patients with systemic lupus erythematosus (SLE), treated at a tertiary medical center and enrolled between 1988 and 2023. The study focused on patients from the Hopkins Lupus Cohort who had been diagnosed with pericarditis. Data analysis took place between April 2023 and May 2024. To assess recurrence, the team used the SELENA-SLEDAI criteria to define pericarditis and reviewed clinical details from all follow-up visits after the initial episode. Any pericarditis event occurring at least six weeks after the first recorded episode was considered recurrent.

Key Findings:

  • Out of 2,931 patients in the Hopkins Lupus Cohort, 590 had experienced pericarditis. Among these, 43.6% were under the age of 30 at the time of their first episode, 90.5% were women, 51.4% were Black, and 42.9% were White.
  • In 3.6% of cases (21 patients), the diagnosis was confirmed using ECG or imaging, with complete agreement between clinical findings and database records.
  • Over a median follow-up of 6.7 years, covering a total of 5,277 person-years, 120 patients (20.3%) had recurrent pericarditis.
  • The recurrence rate was 0.053 recurrences per person-year.
  • Among those with recurrence, about half (50.8%) experienced only one episode, while 49.2% had two or more recurrences.
  • Younger patients were more likely to have recurrences, with those aged 60 or older significantly less likely than those under 40 to experience recurrence.
  • Prednisone use of 20 mg or more daily was linked to a higher recurrence risk compared to those not on the medication.
  • Patients with active lupus (SLEDAI ≥3) had a greater chance of recurrence than those without active disease.
  • The risk of recurrence was also higher within the first year after the initial episode, decreasing over time.

This study highlights that recurrent pericarditis in patients with systemic lupus erythematosus is more likely to occur within the first year of the initial episode, particularly among younger individuals, those with active disease, and those receiving oral prednisone therapy. A clear dose-dependent link between corticosteroid use and recurrence was observed, raising concerns about its role in managing pericarditis in this population.

“These findings emphasize the need to reconsider the routine use of oral corticosteroids for pericarditis in SLE and lay the groundwork for future research to identify safer and more effective treatment approaches for this common cardiac complication,” the authors concluded.

Reference:

Kim YJ, Lovell J, Diab A, et al. Incidence and Factors Associated With Recurrent Pericarditis in Lupus. JAMA Netw Open. 2025;8(2): e2461610.doi:10.1001/jamanetworkopen.2024.61610

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Delay of more than 42 days for breast cancer surgery raises death risk for certain subtypes, finds study

Patients with certain subtypes of breast cancer may face a higher risk of death from the cancer if they wait more than 42 days after diagnosis to have surgery, according to newly published research from the University of Oklahoma.

The research team was surprised that the subtypes of breast cancer most affected by delayed surgery were those with the best prognosis: hormone receptor-positive breast cancers, meaning the cancer uses estrogen or progesterone to grow, and HER2-negative cancers, which do not have high levels of the HER2 protein that is associated with more aggressive cancer growth. These subtypes, whose initial treatment is surgery, tend to grow more slowly. But when surgery was delayed in the study, patients’ risk of death from the cancer increased exponentially.

The risk began to increase at 42 days without surgery, and by 60 days, the patient’s risk of death was 21% times higher. By 90 days, the risk was 79% times higher, and by 120 days, the risk was 183% higher.

In contrast, hormone receptor-negative and “triple negative” subtypes, which are aggressive and invasive, changed very little during treatment delays.

“This is an important finding because 42 days can go by very quickly, but it’s also concerning because recent studies show that both the frequency and length of delay are increasing,” said lead author Takemi Tanaka, Ph.D., a professor of pathology in the OU College of Medicine. The study is published in the journal Breast Cancer Research.

Many factors can cause surgery delays, Tanaka said. The diagnosis and pre-operative process can take several days, and patients may have work or family obligations that further delay the surgery date. Some may want a second opinion, and other women of childbearing age may want to pursue egg preservation (if they will undergo chemotherapy after surgery), so they can have a baby in the future. All are important considerations, she said.

“In 2022, the Commission on Cancer recommended that most women with breast cancer undergo surgery within 60 days. That was a major victory, but some women may need to have surgery sooner than 60 days,” Tanaka said. “And while we want people to understand the risk of delaying treatment, we also want them to have time to pursue egg preservation or get a second opinion.”

Researchers have several hypotheses as to why treatment delay increases the risk of death in these particular subtypes of breast cancer. One is that, because they are slower-growing, they have more room for change, unlike cancers that are already invasive. Another hypothesis focuses on the biopsy, which appears to cause an inflammatory response that may fuel tumor growth. In a publication last year, Tanaka showed that non-steroidal anti-inflammatory drugs (NSAIDs) can suppress inflammation in a mouse model of breast cancer after biopsy.

Research in this area has been ongoing. In 2020, Canadian researchers analyzed 34 studies on 17 types of cancer and found that treatment delay was a critical contributing factor to risk of death in several types of solid tumors, notably a 6% to 8% increased risk for each four-week delay in treatment.

However, Tanaka’s research is believed to be the first to study whether all breast cancer patients have an equal risk of death, or if the risk differs among subtypes. Importantly, she also measured whether patients died specifically from their breast cancer. Other studies have looked at overall survival, which includes causes of death other than cancer.

Tanaka’s new study also both confirms and builds on her previous study showing that patients with a hormone receptor-positive breast cancer who didn’t receive surgery until 61 to 90 days after diagnosis were 18% more likely to have their tumor size upstaged (changed to a more serious stage) compared to patients who received surgery within the first 30 days after diagnosis. There was a 47% likelihood of tumor upstaging for patients who underwent surgery beyond 90 days.

Reference:

Leslie Salewon, M., Pathak, R., Dooley, W.C. et al. Surgical delay-associated mortality risk varies by subtype in loco-regional breast cancer patients in SEER-Medicare. Breast Cancer Res 26, 191 (2024). https://doi.org/10.1186/s13058-024-01949-9

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Vitamin D Supplementation May Aid in Prevention and Managment of Preeclampsia: Study

A new study published in the journal of Life Sciences found that vitamin D supplementation may help prevent or treat preeclampsia (PE) by supporting placental function, angiogenic balance, and blood pressure regulation.

According to the most recent classification, hypertensive conditions during pregnancy can be divided into three categories: (1) chronic hypertension detected prior to pregnancy or around 20 weeks of gestation, (2) gestational hypertension detected at or after 20 weeks, or (3) preeclampsia, which is defined as gestational hypertension with proteinuria or roughly as gestational hypertension with proteinuria or end-organ dysfunctions in addition to preeclampsia. PE is complicated.

Several pregnancy issues, including poor placental development, are associated with vitamin D deficiency. It has been demonstrated that vitamin D improves prenatal development and reduces the risk of PE. This work investigates the function of vitamin D in placental ischemia and its regulatory effects in the Nitro L-arginine Methyl Ester (L-NAME) animal model of PE in order to get a better understanding of the pathophysiological processes behind the disorder and the therapeutic options utilized to control it.

30 male rats and 50 female rats in the estrous stage were mated. 3 equal groups of 30 pregnant female rats were created: the control group, the Preeclampsia group (PE), the Vit. D group from day seven, and the L-NAME induction group from day ten till the conclusion of the pregnancy. Transmission electron microscopy (TEM), morphometric analysis, histological structure and immunohistochemistry expression of VEGF and Ki67, mean arterial Bp, proteinuria, and oxidative stress indicators were evaluated.

The study’s findings indicated that vitamin D administration may decrease oxidative stress, lower blood pressure, and restore angiogenic equilibrium via interacting with Ki67 and vascular endothelial growth factor (VEGF). This study concludes for the first time that vitamin D administration may help prevent or treat PE by directly affecting blood pressure control, angiogenic hemostasis, and placental function recovery.

Source:

Eissa, H., Abdelsalam, E. M., Mokbel, S. A., Elhadedy, N. H., Khalil, R. M., AbdElfattah, A. A. M., Abdel Ghaffar, D. M., El Nashar, E. M., Hassan, A. H., Al-Zahrani, N. S., Aldahhan, R. A., & Yassin, N. A. E. (2025). Vitamin D supplementation as a prophylactic therapy in the management of pre-eclampsia: Focus on VEGF, Ki67, oxidative stress markers in correlation to placental ultra structure. Life Sciences, 123605. https://doi.org/10.1016/j.lfs.2025.123605

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Early Cardiovascular Health May Offset Genetic Risk for Hypertensive Disorders in Pregnancy: Study

A new study published in the Journal of the American College of Cardiology showed that genetic risk and better cardiovascular health (CVH) in the first trimester were independently and additively linked to a reduced risk of hypertensive disorders of pregnancy (HDP) in first-time mothers. Further favorable early pregnancy CVH may help counterbalance high genetic risk.

Preeclampsia/eclampsia and prenatal hypertension are two examples of HDPs, which are linked to long-term maternal cardiovascular disease and are a major source of morbidity and death in both the mother and the fetus. HDPs are linked to both poor cardiovascular health (CVH) and high genetic risk. However, it is uncertain if early pregnancy CVH status alters genetic risk for HDP. Thus, to examine the independent and combined relationships between genetic risk and first-trimester CVH with the development of HDP, Vineetha Mathew and team conducted this study.

The nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be) was a prospective observational cohort that recruited nulliparous people with singleton pregnancies at 8 clinical locations in the US between 2010 and 2013. This research looked at genotyped participants from this study. A validated genetic risk score for HDP was used to quantify genetic risk. A CVH score for the first trimester was derived using the American Heart Association’s Life’s Essential 8 model. CVH and genetic risk were classified as high (top quintile), moderate (quintile 2-4), or low (lowest quintile). The creation of HDP was the main result. 

The median first-trimester CVH score for 7,499 individuals (mean age 27.0 years) was 77.1 (Q1-Q3: 67.1-85.7). In all, 1,032 individuals (13.8%) experienced an HDP, with 487 [6.5%] experiencing preeclampsia and 545 [7.3%] experiencing gestational hypertension.

HDP was independently and additively correlated with both CVH and genetic risk. Regarding the risk of HDPs, there was no discernible interaction between genetic risk and CVH (Pinteraction > 0.05). From 4.5% (low genetic risk, high CVH) to 25.7% (high genetic risk, low CVH), the incidence of HDP varied.

Across all genetic risk strata, high CVH was linked to a 53%–74% reduced risk of HDP than low CVH. When preeclampsia/eclampsia and gestational hypertension were examined independently, the results were similar. Overall, pregnancy-related genetic risk for hypertensive disorders may be reduced by early cardiovascular health screening. High genetic risk for HDP may be reduced by favorable CVH in the early stages of pregnancy.

Reference:

Mathew, V., Khan, R. R., Jowell, A. R., Yan, Q., Pe’er, I., Truong, B., Natarajan, P., Yee, L. M., Khan, S. S., Sharma, G., Patel, A. P., Cho, S. M. J., Pabon, M. A., McNeil, R. B., Spencer, J., Silver, R. M., Levine, L. D., Grobman, W. A., Catov, J. M., … Honigberg, M. C. (2025). Genetic risk and first-trimester cardiovascular health predict hypertensive disorders of pregnancy in nulliparous women. Journal of the American College of Cardiology, 85(14), 1488–1500. https://doi.org/10.1016/j.jacc.2025.02.015

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AI-guided lung ultrasound marks an advance in tuberculosis diagnosis

A study presented at ESCMID Global 2025 has demonstrated that an AI-powered lung ultrasound outperforms human experts by 9% in diagnosing pulmonary tuberculosis (TB).

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Could changing your diet improve endometriosis pain? A recent study suggests it’s possible

Endometriosis affects around 10% of women of reproductive age. It’s a chronic inflammatory condition that occurs when tissue similar to the lining of the uterus (the endometrium) grows outside the uterus.

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Cancer hijacks your brain and steals your motivation—new research in mice suggests potential avenues for treatment

A cruel consequence of advanced cancer is the profound apathy many patients experience as they lose interest in once-cherished activities. This symptom is part of a syndrome called cachexia, which affects about 80% of late-stage cancer patients, leading to severe muscle wasting and weight loss that leave patients bone thin despite adequate nutrition.

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