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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Mumbaikars are currently being forced to wade through waterlogged streets, as the city has been receiving heavy rainfall for the last few days.
Floodwater often gets mixed with harmful contaminants like animal waste, animal feces, waste from human settlements, industrial pollutants, and harmful microorganisms, which can lead to serious monsoon infections.
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Here’s how one can stay safe after getting exposed to floodwater:
HealthandMe spoke to Dr. Murtaza S Bagwala, Head of Emergency Medical Services, Saifee Hospital, Mumbai, about how to keep infections at bay after coming in contact with filthy floodwater.
When you are in floodwater, there may be sharp objects like broken glass, nails, stones and metal debris around you. You are more likely to come in contact with these objects unintentionally.
Dr. Bagwala recommends, “Small cuts, blisters, or punctures may not be noticed but can lead to infection if bacteria get into the skin. If you see any injury, clean it well, brush on antiseptics and consult a doctor for advice if the wound is deep or dirty.”
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As the risk of contracting infections is high during monsoon, do not neglect if you develop flu-like symptoms after coming in contact with contaminated floodwater. The expert warns against dangerous monsoon infections like leptospirosis.
He says, “After contact with water contaminated with the urine of an infected animal (usually a rodent), the early symptoms of leptospirosis may include fever, severe muscle pain, headache, vomiting, chills, or redness of the eyes. The symptoms are very similar to those of a viral disease, so prompt medical evaluation is crucial to avoid complications, such as kidney, liver, or lung involvement.”
The doctor also says that if your skin’s colour or texture changes after getting exposed to floodwater, do not ignore it. He says that if the area around the feet or legs becomes red, swollen, painful, warm, discharges pus or the itching persists, it should be treated immediately.
These can be signs of bacterial or fungal infections that need to be treated, especially in individuals with diabetes, poor blood flow, or impaired immune function.
Also read: Leptospirosis In Monsoon: Expert Explains Why Early Detection & Prevention Is A Must
As you can get cuts and bruises after walking through floodwater, it is important to stay on top of your tetanus shots.
The expert advises, “Seek health care advice if you have a cut or puncture wound, particularly from a sharp object that was submerged in the water, while walking through the water. Early management of wounds can help avoid complications."
You are also at risk of contracting gastrointestinal infections after coming in contact with floodwater. Contaminated water may enter your mouth and lead to stomach and intestinal infections or may contact food and lead to food poisoning.
Prevent diarrhoea, vomiting and dehydration by drinking only clean, safe water, eating only freshly prepared food and practicing good hand hygiene before eating.
Credit: iStock
India has approximately 101 million people living with diabetes, one of the largest such populations in the world. Blood sugar levels, HbA1c targets, and medication compliance tend to dominate the clinical conversation around the condition. What receives considerably less attention, from both doctors and patients, is what diabetes does to the feet, and what the consequences of that neglect look like over time.
Diabetic foot ulcers develop when nerve damage caused by prolonged high blood sugar, referred to as diabetic neuropathy, reduces sensation in the feet. A small cut, blister, or pressure sore that a person without neuropathy would notice and address goes unfelt. In the absence of pain as a warning signal, the injury progresses. Infection sets in. By the time the patient presents for medical attention, the wound has often reached a stage where conservative management is no longer sufficient.
The clinical outcomes associated with delayed presentation are sobering. A 2024 study published in Diabetes and Metabolic Syndrome, drawing on real-world data from a tertiary care facility in India, found that amputation was required in 43.4 percent of diabetic foot ulcer patients. Ten-year mortality among those who underwent amputation reached 30.9 percent, compared to 24.5 percent among those who achieved primary healing.
A 2025 cross-sectional study published in Cureus found a significant disparity in mortality rates between individuals with diabetic foot ulcers and those with diabetes alone, at 231 deaths per 1,000 person-years compared to 182. Globally, 18.6 million individuals develop diabetic foot ulcers annually.
The gap between the clinical evidence on diabetic foot complications and the attention the condition receives in routine diabetes management is where the preventable harm accumulates. Most patients presenting with advanced diabetic foot disease describe a history of minor symptoms that were attributed to something else, ignored, or left unaddressed because they were painless.
Regular foot inspection, appropriate footwear, avoidance of barefoot walking, and early medical review of even minor foot injuries are the practices that interrupt this progression before it reaches the point of irreversibility. Dedicated foot care clinics are built around exactly this philosophy, bringing together the multidisciplinary expertise needed to catch complications early and treat them before the window for limb salvage closes.
Eastern India carries a significant share of this burden, with patients across West Bengal, Bihar, Odisha, Jharkhand, and the Northeast frequently facing limited access to the multidisciplinary care that diabetic foot management requires. Diabetologists, vascular specialists, wound care experts, reconstructive surgeons, and rehabilitation teams working in coordination produce outcomes that sequential, single-specialty care cannot consistently achieve. Where such integrated care is available and accessed early, limb salvage rates improve, and amputations are reduced.
The Ministry of Health and Family Welfare’s recent advisory on diabetic foot care reinforces that foot health in diabetes management warrants systematic attention, not as an afterthought to glycemic control, but alongside it.
(Dr. Anupam Golash, Consultant - Plastic Reconstructive Surgery, CK Birla Hospitals, CMRI)
Credit: Washington University
A small implanted device that stimulates the vagus nerve may offer substantial and lasting relief for people with severe treatment-resistant depression, according to a large multicenter clinical trial.
The findings, published in the International Journal of Neuropsychopharmacology, showed that improvements in depressive symptoms, quality of life, and daily functioning were sustained for at least two years in most patients who responded to treatment.
Notably, more than 20% of treated participants (39 patients) were in remission after two years, meaning their depressive symptoms had improved enough for them to function normally in daily life.
"We were shocked that one in five patients was effectively without depressive symptoms at the end of two years," said lead author Charles Conway, professor of psychiatry and director of Washington University's Treatment Resistant Mood Disorders Center.
Earlier this week, Republican Tom Kean Jr. revealed that he had been diagnosed with depression, explaining his absence from public life for more than 100 days.
He is far from alone. About 20% of U.S. adults experience major depression during their lifetime. While most people improve after antidepressants or psychotherapy, up to one-third develop treatment-resistant depression, in which standard treatments fail to provide adequate relief.
The RECOVER trial, led by researchers at Washington University School of Medicine in St. Louis, enrolled nearly 500 patients across 84 sites in the US. On average, participants had:
"We believe the sample in this trial represents the sickest treatment-resistant depressed patient sample ever studied in a clinical trial," Conway said.
"There is a dire need to find effective treatments for these patients, who often have no other options. With this kind of chronic, disabling illness, even a partial response to treatment is life-altering, and with vagus nerve stimulation, we're seeing that benefit is lasting," he added.
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The VNS Therapy System, manufactured by LivaNova USA, Inc., involves implanting a small device beneath the skin of the chest. The device delivers carefully calibrated electrical pulses to the left vagus nerve, which serves as a major communication pathway between the brain and internal organs.
Although every participant received an implant, only half had their devices activated during the first year, allowing researchers to compare outcomes.
The latest analysis focused on 214 patients whose devices were activated from the beginning of the study.
Among them:
Conway noted that even a 30% improvement can dramatically change the lives of patients with severe depression, who often struggle to carry out basic daily activities and face a higher risk of hospitalization or early death.
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The study also found that recovery may take longer for some people.
Nearly one-third of participants who had not responded after the first year reported meaningful improvements by the end of the second year, suggesting prolonged stimulation may continue to produce benefits.
Researchers also observed consistently low relapse rates among patients who improved, particularly among those with the strongest responses.
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