Medical Bulletin 04/Jul/2025

NAION is a leading cause of vision loss in adults and the second most common optic neuropathy after glaucoma. It typically presents as sudden, painless, monocular vision loss accompanied by optic disc edema. The vision loss is generally irreversible, and there is currently no effective treatment available.

The EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) reviewed all available data on NAION with semaglutide, including data from non-clinical studies, clinical trials, post-marketing surveillance and the medical literature. PRAC concluded that NAION is a very rare side effect of semaglutide, potentially affecting up to 1 in 10,000 users.

Accordingly, EMA has recommended that the product information for semaglutide medicines be updated to reflect this risk. If patients experience a sudden loss of vision or rapidly worsening eyesight during treatment with semaglutide, they should contact their doctor without delay. If NAION is confirmed, treatment with semaglutide should be stopped.

At its May 2025 meeting, the WHO Advisory Committee on Safety of Medicinal Products also evaluated the evidence and concluded that the Risk Management Plan for semaglutide should be revised to include NAION as a potential risk, including any required additional pharmacovigilance activities.

WHO is issuing this safety alert due to the widespread global use of semaglutide and the serious nature of NAION.

Reference: https://www.who.int/news/item/27-06-2025-27-06-2025-semaglutide-medicines-naion

Sugary Drinks and Fried Food During Pregnancy May Raise Child’s Diabetes Risk

A diet high in inflammatory foods during pregnancy may increase a child’s risk of developing type 1 diabetes, according to new Danish research published online in the Journal of Epidemiology & Community Health. The study found that for every unit increase in a dietary measure of inflammation, there was a 16% higher risk of type 1 diabetes in offspring.

Type 1 diabetes is an autoimmune disease where the immune system destroys insulin-producing cells, requiring lifelong insulin therapy. Its global incidence is rising by 3-4% annually, especially in developed countries, pointing to environmental factors. As the immune system forms early in life, researchers are exploring how maternal diet during pregnancy may influence a child's immune development.

To explore this connection, researchers analyzed data from the Danish National Birth Cohort (DNBC), tracking 67,701 mother-child pairs from 1996 to 2002. At around 25 weeks of pregnancy, women completed a detailed food frequency questionnaire covering 360 items across 38 food groups. From this, researchers calculated an “energy-adjusted dietary inflammatory index” (EDII) to assess the inflammatory potential of their diets.

Foods with pro-inflammatory properties included red and processed meats, sugary drinks, refined grains, deep-fried items, and products high in added sugar or trans fats. Anti-inflammatory foods included garlic, tomatoes, whole grains, leafy greens, fruits, and fish. Over a 17-year follow-up period, 281 children developed type 1 diabetes, with an average age of diagnosis at 10.

“A low-grade inflammatory state secondary to an altered immune cell profile, which triggers pro-inflammatory pathways, is increasingly acknowledged as a critical early-life factor influencing offspring health,” wrote the researchers. Notably, three maternal factors—pro-inflammatory diet, gluten intake, and smoking—were found to independently predict type 1 diabetes risk.

The researchers conclude that “mid-pregnancy may be a critical period during which the fetus is particularly susceptible to maternal lifestyle influences” in shaping the risk of developing type 1 diabetes in childhood or adolescence.

Reference: Noorzae R, Bjerregaard AA, Halldorsson TI, et al

Association between a pro-inflammatory dietary pattern during pregnancy and type 1 diabetes risk in offspring: prospective cohort study

J Epidemiol Community Health Published Online First: 01 July 2025. doi: 10.1136/jech-2024-223320

Microplastics Detected in Human Reproductive Fluids, Raising Fertility Concerns

Microplastics have been found in human reproductive fluids, raising new concerns about their possible impact on fertility, according to research presented at the 41st Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE).

Microplastics are plastic particles smaller than 5 millimeters, formed through the breakdown of larger plastic products such as packaging, synthetic clothing, and personal care items. Even smaller particles, known as nanoplastics, are invisible to the naked eye and can penetrate living tissues. Scientists have previously detected microplastics in various organs, but their presence in reproductive fluids introduces new questions about their effects on human fertility.

To determine whether microplastics had infiltrated human reproductive systems, researchers analyzed follicular fluid from 29 women and seminal fluid from 22 men. Both types of fluids play crucial roles in natural conception and assisted reproduction. What they found was startling: microplastics were present in 69% of the follicular fluid samples and 55% of the semen samples. Commonly detected polymers included polytetrafluoroethylene (PTFE), polypropylene (PP), polyethylene terephthalate (PET), polystyrene (PS), polyamide (PA), and polyurethane (PU).

“Previous studies had already shown that microplastics can be found in various human organs. As a result, we weren’t entirely surprised to find microplastics in fluids of the human reproductive system, but we were struck by how common they were – found in 69% of the women and 55% of the men we studied,” said lead researcher Dr. Emilio Gomez-Sanchez.

While the exact impact of these microplastics on fertility remains unknown, animal studies suggest that accumulated particles may trigger inflammation, DNA damage, and hormone disruption. “It’s possible they could impair egg or sperm quality in humans, but we don’t yet have enough evidence to confirm that,” Gomez-Sanchez added.

Reference: https://www.eshre.eu/