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.

Role of Inflammation in Parkinson's Disease

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.

How a Tired Immune System Might Affect Parkinson's?

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.

Energy Deficiency in Immune Cells

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.

Will Rejuvenating the Immune System Help in Treatment?

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.

Lifestyle Factors That May Affect Parkinson's Risk

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.

Non-healing mouth sores are often brushed off as minor issues, but when they persist for more than two weeks, they can signal something more serious.

Mouth ulcers are common and are often caused by stress, minor injuries, or nutritional deficiencies. Sores that do not heal may indicate underlying health concerns, particularly oral cancer.

"Early-stage oral cancers can present as painless ulcers or patches inside the mouth, making them easy to overlook. Conditions like Oral Cancer, Leukoplakia, or Lichen Planus may initially appear as harmless lesions but can progress if left unchecked," Dr. Mandeep Singh Malhotra, Director – Surgical Oncology at the CK Birla Hospital, Delhi, told HealthandMe.

Dr. Tejinder Kataria, Chairperson - Radiation Oncology, Medanta Hospital, Gurugram, added that mouth sores that don't go away after two to three weeks could be an early sign of oral cancer.

"These sores can be red or white and hurt or bleed easily. This is not the same as regular ulcers," he told HealthandMe.

The experts noted that non-healing sores can also be associated with systemic conditions such as

• vitamin deficiencies (especially B12 and iron),
• weakened immunity,
• chronic infections.

What Is Oral Cancer?

Also read: CDC Delay In Infant Hepatitis B Shots May Surge Infections, Deaths In US: Research

Oral cancer is a wide term for cancer that affects the inside of your mouth, and it typically presents itself as white patches or sores that bleed. It can occur on the:

• Lips.
• Gums.
• Tongue.
• Inner lining of the cheeks.
• Roof of the mouth.
• Floor of the mouth

It is estimated that about 60,000 new cases of oral cancer are reported annually in India, and five people die from the condition every hour. It is the most common cancer in Indian men and the third most common in women, with roughly 20 in 100,000 people affected.

Signs To Watch For

Oral cancer grows slowly, and the first signs usually don't hurt, so a lot of people don't notice them. However, it's important to look out for

• a change in voice,
• a lump in the mouth,
• trouble chewing
• A lip or mouth sore that won't heal.
• A white or reddish patch on the inside of the mouth.
• Loose teeth
• Mouth pain
• Ear pain
• Difficult or painful swallowing.

• Not brushing teeth,
• Tobacco use,
• Alcohol consumption,
• Ill-fitting dental appliances

How To Prevent

Early diagnosis plays a crucial role in effective treatment. If a mouth sore persists, grows, or is accompanied by pain, bleeding, or difficulty swallowing, it is important to consult a healthcare professional promptly. Paying attention to such small signs can make a significant difference in long-term health outcomes.

• Avoid smoking,
• drinking alcohol,
• Eat a lot of fruits and vegetables
• Keep your mouth clean.
• Going to the dentist regularly can help spot changes early.

Knee replacement surgery has witnessed remarkable advancements over the past few years. Traditionally, total knee replacement was performed as a uniform procedure ("one procedure fits all"), where the entire knee joint was replaced regardless of the extent or location of damage.

However, with the evolution of modern orthopedics, the focus has shifted towards precision and personalized treatment. In this direction, an A La Carte or Modular approach towards patients who need knee Replacement has emerged, which customizes or personalizes the surgery according to the patient’s specific condition.

Understanding The “à la carte” Concept

The term “à la carte” refers to selecting individual items from a menu. In knee replacement surgery, it means replacing only the damaged portion of the joint instead of the entire knee.

The knee is anatomically divided into three compartments:

• Medial compartment (inner side)
• Lateral compartment (outer side)
• Patellofemoral compartment (front portion involving the kneecap)

In many patients suffering from osteoarthritis, the disease affects only one or two of these compartments—most commonly the medial compartment. In such cases, replacing the entire knee may not be necessary. Modular implants allow surgeons to selectively treat the affected area while preserving healthy bone and ligaments.

The à la carte technique helps preserve the natural structure of the knee while effectively treating only the damaged portion, resulting in better and more natural functional outcomes for patients.

However, this approach is not suitable for all patients. It is generally not recommended in inflammatory conditions such as rheumatoid arthritis.

How It Differs From Total Knee Replacement

In Total Knee Replacement (TKR), all three compartments of the knee are replaced, making it an effective solution for advanced and widespread arthritis.

In contrast, Modular Knee Replacement offers a more targeted approach:

• Replacement of a single compartment (Partial Knee Replacement)
• Replacement of two compartments (e.g., medial + patellofemoral)

This selective treatment helps maintain the knee’s natural structure and function.

Advantages Of The Modular Approach

For carefully selected patients, this technique offers several important benefits:

• More natural knee function: Preservation of ligaments and bone provides a more natural feel.
• Faster recovery: Less invasive surgery leads to quicker rehabilitation.
• Reduced pain and blood loss: Minimal surgical trauma results in less discomfort.
• Improved mobility: Patients often achieve a better range of motion.
• Enhanced lifestyle comfort: Activities like sitting cross-legged or squatting may be easier and can be done unrestricted compared to total knee replacement.

Who Is the Ideal Candidate?

Not every patient is suitable for this procedure. Proper patient selection is one of the most critical factors in ensuring the success of this procedure. Ideal candidates typically include people:

• Having arthritis limited to one or two compartments
• Having stable knee ligaments
• Who do not have a severe deformity in the knee

Long-Term Outcomes

When performed in the right patient, modular knee replacement delivers excellent long-term outcomes (90 to 95 per cent survivorship for 15 years). Its success largely depends on accurate patient selection and flawless surgical expertise.

In some cases, if arthritis progresses in the remaining compartments over time, conversion to total knee replacement can still be done. However, this is relatively uncommon when proper indications are followed.

Role Of Robotic Technology

Robotic-assisted surgery has further enhanced the precision of this technique. It enables:

• Millimeter-level accuracy
• Precise implant positioning
• Restoration of patient-specific knee alignment

Conclusion

Ala Carte or Modular Knee Replacement represents a significant shift toward personalized orthopaedic care. Instead of a "one-size-fits-all " approach, surgeons can now tailor treatment based on the patient’s anatomy and disease pattern.

For many patients, this means less invasive surgery, faster recovery, improved function, and a more natural-feeling knee. Individuals experiencing persistent knee pain are advised to consult an orthopaedic specialist early to determine the most appropriate treatment option.

Beyond lung cancers, air pollution fine particulate matter (PM2.5) is increasing mortality for breast as well as liver cancers, according to a global study led by the Union for International Cancer Control (UICC), including researchers from the Indian Council of Medical Research (ICMR).

The important study showed that long-term exposure to PM2.5 increases the overall risk of developing cancer and the chances of dying from it compared with those living in cleaner environments.

For every 10 micrograms per cubic meter (µg/m³) increase in PM2.5 exposure, the overall risk of cancers increases by more than 11 per cent. At the same time, the risk of death also increases by more than 12 per cent for every 10 µg/m³ increase in PM2.5 exposure.

The researchers argued that while other common risk factors like tobacco and alcohol are being targeted with notable progress, air pollution is silently eroding the gains being made.

“We have made huge strides in reducing deaths from cancer, but polluted air is silently undermining that progress. It is a risk people cannot opt out of, and one that disproportionately affects women, children, and people living in poverty,” Cary Adams, CEO, UICC.

“The cancer community continues to make progress in addressing other major risk factors, including tobacco use, alcohol consumption, and viral, bacterial, or parasitic infections such as HPV and HBV that cause cervical and liver cancers. It is increasingly clear that air pollution must also be recognized as a major and preventable factor that increases the risk of developing cancer and of dying from the disease,” added Dr Elisabete Weiderpass, Director, IARC.

Risks of PM2.5: Beyond Lung Cancer

The study, based on data from 42 meta-analyses and systematic reviews published between 2019 and 2024, showed significantly strong associations for liver, colorectal, and breast cancers.

As per recent data from the International Agency for Research on Cancer (IARC), PM₂.₅ exposure contributes to 434,000 lung cancers per year, accounting for more than a quarter of preventable lung cancers in women and nearly one in six in men.

In addition to lung cancer risk, the study noted that the rising levels of PM2.5 are associated with

• a 32 per cent higher incidence of liver cancer
• an 18 per cent increase in the odds of developing colorectal cancer.

• a 12 per cent higher overall risk of dying from cancer,
• a 20 per cent higher risk of death from breast cancer,
• a 14 per cent from liver cancer,
• a 12 per cent from lung cancer.

Who Is At A Higher Risk

According to the researchers, people living in low- and middle-income countries bear the greatest overall burden. These countries frequently lack the resources to reduce pollution at source or to provide timely access to cancer prevention, diagnosis, and treatment.

The challenge is compounded by the projected rise in global cancer cases, expected to increase from 20 million in 2022 to 35 million by 2050. People at risk include:

• Women and children, particularly in settings where solid fuels are used for cooking and heating.
• Women exposed to household air pollution face a 69 per cent higher risk of lung cancer, alongside increased risks of cervical cancer.
• Outdoor workers and communities living near industrial facilities are also at heightened risk, with exposure often concentrated in economically deprived areas.

What Actions Are Required?

The researchers underscored that the evidence presented in the report is already sufficient to justify decisive action to reduce exposure to polluted air. They called upon policymakers to make required changes across energy, transport, industry, and urban planning to reduce the risk of cancer from air pollution.

The study urged the need for properly implementing effective interventions that are well-established. These include:

• Stronger emissions standards and enforcing the WHO air quality Standards
• A transition to clean energy and clean cooking
• Improved urban design by investing more in green infrastructure
• Expanded air-quality monitoring in High-Risk Areas
• Update cancer control plans.