The COVID-19 pandemic may be over, but our immune systems are still feeling the impact. After years of battling constant viral threats, from COVID-19 to seasonal flu and other infections, our body’s defense system is exhausted. Many people continue to experience lingering inflammation, frequent illnesses, and slower recovery times. This extended state of immune stress has compromised us further to chronic illness, including autoimmune diseases and even neurodegenerative diseases such as Parkinson's. So why is our immune system still in trouble? And how do we give it its power back? Understanding immune exhaustion is the beginning of rebuilding our body's natural immunity.
A weakened immune system makes people more susceptible to disease, mental illnesses, and even sleep disorders. Now, new research indicates that immune system depletion may play an important role in the onset of Parkinson's disease, a degenerative neurologic disorder that compromises movement and cognition.
Dysfunctional immune response is a leading cause of long-standing inflammation within the body, that has been found to contribute towards a multitude of conditions, including cardiovascular conditions, diabetes, depression, and neurodegenerative diseases such as Alzheimer's.
As people age, their immune system naturally becomes less effective. This deterioration, referred to as immune exhaustion, may be a key contributor to the onset and progression of Parkinson’s disease. Rebecca Wallings, a Parkinson’s Foundation Launch Award grant recipient and senior postdoctoral fellow at the University of Florida, believes that an accumulation of exhausted immune cells could be driving neurodegeneration in Parkinson’s patients.
Parkinson's disease is most commonly linked with the degeneration and loss of dopaminergic neurons—motor nerve cells that produce dopamine, an essential neurotransmitter for movement. While researchers have long suspected inflammation is involved in this neurodegeneration, the mechanisms are not yet well understood.
Wallings' study is on immune cell exhaustion, a process by which aging immune cells fail to control immune responses effectively. Her research indicates that instead of dampening inflammation in Parkinson's patients, attempts should be made to rejuvenate the immune system to regain its functionality.
One of the major findings of Wallings' work is the function of mitochondrial impairment in immune cell exhaustion. Mitochondria are commonly called the powerhouses of cells, as they are vital for generating energy. As mitochondria age and become inefficient, immune cells fail to function well, potentially accelerating neurodegeneration in Parkinson's disease.
Wallings has found that mutations in the LRRK2 gene, a recognized genetic risk factor for Parkinson's disease, are linked with defective mitochondrial function and immune cell exhaustion. Her current work includes testing various therapeutic approaches to restore mitochondrial function in immune cells with the potential to enhance the immune system and potentially prevent or treat Parkinson's disease.
For decades, the standard practice in treating Parkinson's has been to suppress brain inflammation. Yet Wallings' work indicates that instead of slowing down immune responses, restoring the immune system could be a more successful strategy. By addressing mitochondrial impairment and immune resilience, researchers can potentially reverse or slow down Parkinson's disease.
Wallings is now looking into how to rejuvenate immune cells by fixing mitochondria. She studies immune cells from patients with Parkinson's as well as from healthy subjects and performs experiments on animal models to determine if rejuvenation of the immune system could result in improved disease outcomes.
While there is no cure for Parkinson's disease, some lifestyle adjustments may decrease the chances of developing the illness. Since neurodegenerative diseases are associated with chronic inflammation and immune dysfunction, developing habits that enhance immune function might prove helpful.
Diet: There is evidence to suggest that eating in accordance with the Mediterranean or MIND diets, both high in antioxidants, healthy fats, and anti-inflammatory foods, can encourage brain wellness and reduce Parkinson's risk.
Avoiding Dangerous Substances: Restricting alcohol and nicotine use can maintain a robust immune system and suppress inflammation.
Reducing Stress: Chronic stress weakens immune function, so methods such as meditation, exercise, and sufficient sleep can lead to improved overall well-being.
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Why looking beyond the obvious can save lives.
A 50-year-old woman recently came to my clinic seeking a second opinion.
For weeks, she had been treated for asthma. She was using inhalers regularly, yet her cough persisted, and her breathlessness continued to worsen, even while resting. Something about her story didn't add up.
A simple chest X-ray revealed the real problem: a massive pleural effusion, a large collection of fluid surrounding the lung and preventing it from expanding normally. Further evaluation confirmed the underlying cause, lung cancer that had spread to the pleura, the thin membrane lining the lungs.
Her symptoms were genuine. The diagnosis, however, was not asthma.
Cough and breathlessness are among the most frequent reasons people visit a doctor. In most cases, the cause is something common, such as asthma, allergies, or a respiratory infection.
But common symptoms do not always point to common diseases. The key is recognizing when the clinical picture no longer fits.
If symptoms:
Then it is time to pause, reassess, and investigate further rather than simply changing medications.
In this patient's case, inhalers could never have relieved the pressure caused by fluid around the lung. Nor could they have treated an underlying tumor. The delay didn't change the diagnosis, but it delayed the answers, appropriate treatment, and the opportunity to plan the next steps.
For decades, lung cancer was largely associated with older men who smoked heavily. That picture has changed.
In our practice, we diagnose approximately two to three new cases of primary lung cancer every three months, and nearly 40% of these patients are women or individuals who have never smoked.
Increasingly, we are seeing:
If we continue to associate lung cancer only with smoking, we risk missing a significant proportion of patients who need timely diagnosis.
Asthma should not become a permanent label simply because someone has a cough or wheeze.
When symptoms fail to improve within a few weeks of appropriate treatment, it is important to step back, reconsider the diagnosis, and investigate further.
A chest X-ray remains one of the most valuable first-line investigations.
In just a few minutes, it can identify pneumonia, tuberculosis, heart failure, pleural effusion, lung masses, and many other conditions that require an entirely different treatment approach.
Even in an era of advanced imaging and artificial intelligence, the fundamentals of clinical medicine remain indispensable.
When detected early, lung cancer is often more treatable and offers significantly better outcomes.
Even in advanced disease, timely diagnosis can make an enormous difference. Procedures such as draining pleural fluid, initiating targeted therapy, immunotherapy, or palliative treatment can greatly improve both symptoms and quality of life.
Seek medical evaluation if you experience:
I often remind my patients that the body rarely sends repeated signals without a reason.
A persistent cough or unexplained breathlessness should never be dismissed simply because it resembles asthma. While asthma is common, it is only one of many possible causes.
Artificial intelligence can generate a list of potential diagnoses within seconds. But medicine is about more than identifying possibilities. It requires listening carefully, examining thoughtfully, choosing the right investigations, and connecting the clinical clues.
The woman who came to me was looking for reassurance.
Instead, she received something far more important: a correct diagnosis, a clear treatment plan, and the opportunity to move forward with certainty.
Because every cough is not asthma. And every breath deserves an explanation.
(By Dr. Sachin Kumar, Director – Pulmonology & Critical Care Medicine, Sakra World Hospital, Bengaluru)
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Tadalafil, a widely used drug for erectile dysfunction and enlarged prostate symptoms, may increase the risk of glaucoma, the leading cause of blindness, in men with lower urinary tract symptoms (LUTS), according to a new study.
Although the study identified a significant association, the researchers emphasized that it was observational and does not prove that tadalafil directly causes glaucoma.
However, they suggested that men taking tadalafil long-term for LUTS may benefit from regular eye examinations, particularly those with existing glaucoma risk factors such as a family history of the disease or ocular hypertension.
Researchers from the National Taiwan University Hospital in Taipei, Taiwan, found that men taking tadalafil for LUTS were:
The findings were published in the British Journal of Ophthalmology.
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The researchers analyzed health data from 73,854 men aged 40 years and older with a history of lower urinary tract symptoms.
Half of the participants had been prescribed tadalafil or another phosphodiesterase type 5 inhibitor (PDE5i) for up to five years, while the remaining participants received other treatments.
The increased glaucoma risk remained consistent, particularly among men aged over 50 years.
Tadalafil works by relaxing smooth muscles and improving blood flow. Besides treating erectile dysfunction, it is also prescribed to relieve urinary symptoms caused by an enlarged prostate, such as frequent urination and urgency.
Previous studies have linked PDE5 inhibitors to several eye-related side effects, and the new findings add to concerns about their long-term effects on eye health.
"Tadalafil use for lower urinary tract symptoms was associated with a significant increase in the risk of glaucoma, ocular hypertension, primary open-angle glaucoma and initiation of glaucoma treatment in a large, multinational, real-world cohort," the researchers concluded.
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Lower urinary tract symptoms (LUTS) are common urinary problems that affect the storage or passage of urine. They are particularly common in elderly men and are often linked to conditions such as an enlarged prostate, an overactive bladder or problems affecting the body's fluid balance.
Common symptoms include:
Glaucoma is a group of eye diseases that can damage the optic nerve, potentially leading to irreversible vision loss and even blindness if left untreated.
It is a chronic disease that affects an estimated 80 million individuals globally, according to the World Glaucoma Association.
A major challenge with glaucoma is its lack of symptoms in the initial stages. As a result, the condition is often diagnosed at an advanced stage, where treatment yields the least results. More than 75 percent of glaucoma cases globally remain undiagnosed.
When to see a doctor for glaucoma:
Credit: AI Generated Image
For years, diet sodas have enjoyed a pretty good reputation. They offered the sweetness without the sugar, the fizz without the guilt, and for many people, they became an easy replacement for regular soft drinks. It is not hard to see why. Whether it is an afternoon craving, something to sip with lunch, or a way to satisfy a craving without reaching for sugar, diet drinks have quietly become part of many people's daily routine. However, a major new study is making people look at those drinks a little differently. Researchers have found that people who regularly consumed higher amounts of artificial sweeteners showed faster declines in memory and thinking skills over time. It does not mean your occasional Diet Coke is suddenly a problem. But if you cannot remember the last day you went without one, the findings are definitely worth knowing.
The study followed 12,772 adults in Brazil over eight years, with the average age of participants being 52. It is the largest and longest study so far looking at how artificial sweeteners may be linked to brain health. Researchers examined seven commonly used low- and no-calorie sweeteners found in ultra-processed products like sodas, flavoured water, sugar-free yoghurt and low-calorie desserts. These included:
Throughout the study, participants completed tests that measured memory, verbal fluency, and processing speed. After taking other health factors into account, researchers noticed a clear pattern. People who consumed the highest amounts of artificial sweeteners experienced cognitive decline 62% faster than those who consumed the least. According to the researchers, that difference was roughly equal to 1.6 years of additional brain ageing.
Even people in the middle consumption group showed a 35% faster decline, equivalent to about 1.3 years of brain ageing. Out of the seven sweeteners studied, six showed an association with faster cognitive decline. The only one that did not was the Tagatose.
One finding stood out more than the rest. Most people tend to think of memory problems as something that only becomes a concern later in life. This study suggested that may not be the full picture. The link between artificial sweeteners and cognitive decline was strongest in adults under the age of 60. Researchers believe this could mean that the habits people build during midlife play a much bigger role in long-term brain health. The association was also stronger among people with diabetes, who are often more likely to choose artificially sweetened foods and drinks instead of sugary ones. Among all the areas tested, memory appeared to take the biggest hit.
This is where the conversation becomes important.
“Our findings do not suggest that drinking an occasional diet soda is harmful,” Claudia Kimie Suemoto of the University of São Paulo said. “Rather, they raise questions about the potential consequences of frequent, long-term consumption of artificial sweeteners.”
The study was observational, which means it identified the link, but it cannot say for sure that the sweeteners themselves caused the decline. That is a big difference. Lead researcher Claudia Kimie Suemoto from the University of São Paulo said: “Based on our study alone, I would not tell someone to stop drinking diet soda because of concerns about cognitive impairment”.
The findings also support earlier research. A 2017 study from the Framingham Heart Study reported a similar association between artificially sweetened beverages and a higher risk of stroke and dementia. Scientists say the evidence is growing, but there is still more to understand before firm conclusions can be made.
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The answer is probably not to swear off diet soda forever. Instead, experts suggest taking a closer look at how often you are reaching for it. If one can has quietly turned into several every day, it may be worth cutting back little by little. Whenever you want a Diet Coke, go for plain water, sparkling water, unsweetened tea, or black coffee. This can help reduce your overall intake without making the change feel overwhelming. The goal is not perfection; it is balance.
There is no reason to panic over a single can. But if sugar-free drinks have become something you rely on every day without really thinking about it, this study is a good reminder that even habits that seem harmless deserve an occasional second look. Sometimes the healthiest changes start with asking a simple question: "Do I really need another one?"
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