Your Genes' Hidden Battle: Mother vs Father DNA Shapes Everything From Height to Diabetes Risk

The genes you inherit from your mother and father may be locked in a hidden evolutionary battle inside your cells, with profound effects on your health, growth, and metabolism. A landmark study analyzing DNA from nearly 237,000 people has uncovered over 30 examples of this genetic conflict, where the same gene variant produces dramatically different sometimes completely opposite effects depending on which parent it came from.

"We found compelling evidence for an evolutionary phenomenon that's been theorized for decades but rarely observed at this scale," says Robin Hofmeister at the University of Lausanne in Switzerland, who led the research published in Nature. "Your maternal and paternal genes are essentially competing over resource allocation, and this competition shapes traits from your height to your risk of diabetes."

Scientists have long suspected that some genes behave differently depending on their parental origin, a phenomenon called parent-of-origin effects (POEs). According to evolutionary theory, this genetic conflict arises because fathers' genes benefit from offspring that extract maximum resources from mothers, promoting growth and energy consumption. Meanwhile, mothers' genes favor more conservative resource use, preserving the mother's health for future pregnancies.

But studying these effects has been challenging because it typically requires genetic data from both parents, which is rarely available in large-scale studies. Hofmeister's team developed an innovative workaround, using patterns of DNA sharing between relatives, along with sex chromosomes and mitochondrial DNA, to infer which genes came from which parent without needing parental genomes.

Applying this method to the UK Biobank, Estonian Biobank, and a Norwegian cohort, the researchers identified over 30 POEs affecting mainly traits linked to resource allocation, such as growth and metabolism. More than one third of these showed opposite parental influences.

One striking example involves a variant near genes called KLF14 and MEST at chromosome location 7q32.2. When inherited from the father, this variant decreased triglyceride levels, but when inherited from the mother, it increased them. The researchers believe this occurs because the variant affects different genes depending on its parent of origin, influencing the maternally expressed KLF14 when inherited from mother, but the paternally-expressed MEST when from father.

Even more dramatically, a variant at chromosome 11p15.5 showed a bipolar effect on type 2 diabetes risk. The paternal version increased diabetes risk by 14%, while the maternal version was protective, reducing risk by 9%. This locus had been identified over 15 years ago but never successfully replicated until now, highlighting the power of the new approach.

The effects of this genetic conflict begin early. When the team examined height and body mass index (BMI) measurements in over 42,000 Norwegian children from birth to age 8, they found that parent-of-origin effects present in infancy persisted into adulthood.

A variant affecting BMI showed a particularly intriguing pattern: when inherited from the mother, it increased BMI in infancy but decreased BMI and hip circumference in adulthood, with the effect gradually reversing over time.

"These findings suggest that parental genetic conflicts influence our entire developmental trajectory, not just single time points," notes Hofmeister.

The discovery validates 87% of the testable associations when replicated in independent cohorts, demonstrating the robustness of these effects. This hidden layer of genetic complexity could explain why some people respond differently to treatments or have varying disease risks despite carrying the same genetic variants.

"We've been missing half the story by not considering parent of origin," says Hofmeister. "For precision medicine to truly deliver on its promise, we need to know not just what genetic variants people carry, but which parent they came from."

The findings could be particularly relevant for metabolic conditions like diabetes and obesity, where multiple POEs converge on related biological pathways. As genetic testing becomes more sophisticated, incorporating parent-of-origin information could improve disease risk prediction and treatment selection.

This evolutionary battle in our genomes, fought between maternal and paternal genes over millions of years, continues to shape human health today, a reminder that our bodies are still influenced by ancient biological conflicts we're only beginning to understand.

Your Genes' Hidden Battle: Mother vs Father DNA Shapes Everything From Height to Diabetes Risk

The genes you inherit from your mother and father may be locked in a hidden evolutionary battle inside your cells, with profound effects on your health, growth, and metabolism. A landmark study analyzing DNA from nearly 237,000 people has uncovered over 30 examples of this genetic conflict, where the same gene variant produces dramatically different sometimes completely opposite effects depending on which parent it came from.

"We found compelling evidence for an evolutionary phenomenon that's been theorized for decades but rarely observed at this scale," says Robin Hofmeister at the University of Lausanne in Switzerland, who led the research published in Nature. "Your maternal and paternal genes are essentially competing over resource allocation, and this competition shapes traits from your height to your risk of diabetes."

Scientists have long suspected that some genes behave differently depending on their parental origin, a phenomenon called parent-of-origin effects (POEs). According to evolutionary theory, this genetic conflict arises because fathers' genes benefit from offspring that extract maximum resources from mothers, promoting growth and energy consumption. Meanwhile, mothers' genes favor more conservative resource use, preserving the mother's health for future pregnancies.

But studying these effects has been challenging because it typically requires genetic data from both parents, which is rarely available in large-scale studies. Hofmeister's team developed an innovative workaround, using patterns of DNA sharing between relatives, along with sex chromosomes and mitochondrial DNA, to infer which genes came from which parent without needing parental genomes.

Applying this method to the UK Biobank, Estonian Biobank, and a Norwegian cohort, the researchers identified over 30 POEs affecting mainly traits linked to resource allocation, such as growth and metabolism. More than one third of these showed opposite parental influences.

One striking example involves a variant near genes called KLF14 and MEST at chromosome location 7q32.2. When inherited from the father, this variant decreased triglyceride levels, but when inherited from the mother, it increased them. The researchers believe this occurs because the variant affects different genes depending on its parent of origin, influencing the maternally expressed KLF14 when inherited from mother, but the paternally-expressed MEST when from father.

Even more dramatically, a variant at chromosome 11p15.5 showed a bipolar effect on type 2 diabetes risk. The paternal version increased diabetes risk by 14%, while the maternal version was protective, reducing risk by 9%. This locus had been identified over 15 years ago but never successfully replicated until now, highlighting the power of the new approach.

The effects of this genetic conflict begin early. When the team examined height and body mass index (BMI) measurements in over 42,000 Norwegian children from birth to age 8, they found that parent-of-origin effects present in infancy persisted into adulthood.

A variant affecting BMI showed a particularly intriguing pattern: when inherited from the mother, it increased BMI in infancy but decreased BMI and hip circumference in adulthood, with the effect gradually reversing over time.

"These findings suggest that parental genetic conflicts influence our entire developmental trajectory, not just single time points," notes Hofmeister.

The discovery validates 87% of the testable associations when replicated in independent cohorts, demonstrating the robustness of these effects. This hidden layer of genetic complexity could explain why some people respond differently to treatments or have varying disease risks despite carrying the same genetic variants.

"We've been missing half the story by not considering parent of origin," says Hofmeister. "For precision medicine to truly deliver on its promise, we need to know not just what genetic variants people carry, but which parent they came from."

The findings could be particularly relevant for metabolic conditions like diabetes and obesity, where multiple POEs converge on related biological pathways. As genetic testing becomes more sophisticated, incorporating parent-of-origin information could improve disease risk prediction and treatment selection.

This evolutionary battle in our genomes, fought between maternal and paternal genes over millions of years, continues to shape human health today, a reminder that our bodies are still influenced by ancient biological conflicts we're only beginning to understand.

Your Genes' Hidden Battle: Mother vs Father DNA Shapes Everything From Height to Diabetes Risk

The genes you inherit from your mother and father may be locked in a hidden evolutionary battle inside your cells, with profound effects on your health, growth, and metabolism. A landmark study analyzing DNA from nearly 237,000 people has uncovered over 30 examples of this genetic conflict, where the same gene variant produces dramatically different sometimes completely opposite effects depending on which parent it came from.

"We found compelling evidence for an evolutionary phenomenon that's been theorized for decades but rarely observed at this scale," says Robin Hofmeister at the University of Lausanne in Switzerland, who led the research published in Nature. "Your maternal and paternal genes are essentially competing over resource allocation, and this competition shapes traits from your height to your risk of diabetes."

Scientists have long suspected that some genes behave differently depending on their parental origin, a phenomenon called parent-of-origin effects (POEs). According to evolutionary theory, this genetic conflict arises because fathers' genes benefit from offspring that extract maximum resources from mothers, promoting growth and energy consumption. Meanwhile, mothers' genes favor more conservative resource use, preserving the mother's health for future pregnancies.

But studying these effects has been challenging because it typically requires genetic data from both parents, which is rarely available in large-scale studies. Hofmeister's team developed an innovative workaround, using patterns of DNA sharing between relatives, along with sex chromosomes and mitochondrial DNA, to infer which genes came from which parent without needing parental genomes.

Applying this method to the UK Biobank, Estonian Biobank, and a Norwegian cohort, the researchers identified over 30 POEs affecting mainly traits linked to resource allocation, such as growth and metabolism. More than one third of these showed opposite parental influences.

One striking example involves a variant near genes called KLF14 and MEST at chromosome location 7q32.2. When inherited from the father, this variant decreased triglyceride levels, but when inherited from the mother, it increased them. The researchers believe this occurs because the variant affects different genes depending on its parent of origin, influencing the maternally expressed KLF14 when inherited from mother, but the paternally-expressed MEST when from father.

Even more dramatically, a variant at chromosome 11p15.5 showed a bipolar effect on type 2 diabetes risk. The paternal version increased diabetes risk by 14%, while the maternal version was protective, reducing risk by 9%. This locus had been identified over 15 years ago but never successfully replicated until now, highlighting the power of the new approach.

The effects of this genetic conflict begin early. When the team examined height and body mass index (BMI) measurements in over 42,000 Norwegian children from birth to age 8, they found that parent-of-origin effects present in infancy persisted into adulthood.

A variant affecting BMI showed a particularly intriguing pattern: when inherited from the mother, it increased BMI in infancy but decreased BMI and hip circumference in adulthood, with the effect gradually reversing over time.

"These findings suggest that parental genetic conflicts influence our entire developmental trajectory, not just single time points," notes Hofmeister.

The discovery validates 87% of the testable associations when replicated in independent cohorts, demonstrating the robustness of these effects. This hidden layer of genetic complexity could explain why some people respond differently to treatments or have varying disease risks despite carrying the same genetic variants.

"We've been missing half the story by not considering parent of origin," says Hofmeister. "For precision medicine to truly deliver on its promise, we need to know not just what genetic variants people carry, but which parent they came from."

The findings could be particularly relevant for metabolic conditions like diabetes and obesity, where multiple POEs converge on related biological pathways. As genetic testing becomes more sophisticated, incorporating parent-of-origin information could improve disease risk prediction and treatment selection.

This evolutionary battle in our genomes, fought between maternal and paternal genes over millions of years, continues to shape human health today, a reminder that our bodies are still influenced by ancient biological conflicts we're only beginning to understand.

Aug 13, 2025

3 min read

First Alzheimer's Agitation Drug Shows Promising Real World Safety Profile

The first drug specifically approved to treat agitation in Alzheimer's patients appears to be safer than feared, according to a major analysis of Medicare data tracking over 40,000 dementia patients. The findings could ease concerns about brexpiprazole, which carries a stark FDA warning about increased death risk in elderly dementia patients.

Agitation affects up to 90% of people with Alzheimer's disease during their illness, causing distress for both patients and caregivers. Until 2023, doctors had no FDA-approved options and relied on off-label use of antipsychotic medications all of which carry "black box" warnings about potentially fatal risks in dementia patients.

"We're seeing real-world evidence that contradicts some of our worst fears about this medication," Says the research team from the University of Southern California.

Who analyzed nine years of Medicare claims data. Their study found that dementia patients starting brexpiprazole had roughly half the mortality risk compared to those starting aripiprazole, a similar antipsychotic commonly prescribed off-label.

The stakes couldn't be higher. Approximately 250,000 people die annually from severe dementia-related agitation, and behavioral symptoms are a leading cause of nursing home placement. Yet the very drugs used to manage these symptoms have been linked to increased mortality, creating an agonizing treatment dilemma for physicians and families.

Brexpiprazole works as a dopamine modulator in the brain, with a mechanism similar to other atypical antipsychotics but with potentially milder side effects. In clinical trials leading to its approval, the drug showed modest improvements in agitation scores. However, those trials included only 345 patients followed for 12 weeks too small and brief to assess real mortality risks.

The new study examined 1,337 dementia patients who started brexpiprazole between 2015 and 2023, comparing them to 40,534 similar patients starting aripiprazole. After six months, only 4% of brexpiprazole users had died, compared to 11% of aripiprazole users.

"What's particularly interesting is that when we dug deeper with sophisticated statistical methods to account for hidden differences between patient groups, the mortality advantage disappeared,"

Explains the research team. This suggests that brexpiprazole users might have been healthier to begin with, but crucially, the drug doesn't appear to increase death risk compared to existing treatments.

The study also found no differences in hospitalization rates or emergency department visits between the two drugs, further supporting brexpiprazole's safety profile in real-world use.

Dr. Julie Zissimopoulos, lead author of the study, emphasizes the importance of having options:

"Even if brexpiprazole proves merely equivalent to existing drugs, that's valuable. We know there's tremendous variability in how individual patients respond to these medications."

While these findings are reassuring, researchers caution that the study has limitations. The Medicare data doesn't capture dementia severity or the intensity of behavioral symptoms, factors that could influence both drug choice and outcomes. Additionally, the relatively small number of brexpiprazole users reflects its recent approval and higher cost as a brand-name medication.

The research arrives at a critical moment. As the population ages and dementia cases rise, the need for safe, effective treatments for behavioral symptoms becomes increasingly urgent. The International Psychogeriatric Association recently published guidelines emphasizing integrated approaches combining psychosocial interventions with medications when necessary.

"This isn't about medicating away behavioral symptoms," notes the research team. "It's about having tools that can help when non-drug approaches aren't enough, without adding unacceptable risks."

For the millions of families grappling with dementia's behavioral challenges, this real-world evidence offers a measure of hope. While brexpiprazole isn't a miracle cure and still requires careful monitoring it appears to provide another option in the limited arsenal against one of dementia's most distressing aspects.

The findings underscore a broader principle in medicine: real-world evidence from diverse patient populations often tells a different story than controlled clinical trials. As more patients use brexpiprazole and data accumulates, the true risk-benefit profile will become clearer. For now, families and physicians have reason for cautious optimism about this new tool in dementia care.

Jul 6, 2025

3 min read

Dual-drug combo shows promise for hard-to-treat cancers

The combination of pembrolizumab, an immune checkpoint inhibitor, with vorinostat, a drug that modifies gene expression, achieved response rates of up to 39 per cent in some cancer types during a phase 2 clinical trial. The findings suggest that priming the immune system with epigenetic modifications could overcome resistance to immunotherapy alone.

Squamous cell carcinomas affect various parts of the body including the cervix, anus, head and neck, and genital regions. While immunotherapy has revolutionized cancer treatment, only a minority of patients - typically 15 to 24 per cent - respond when these drugs are used alone.

"The combination strategy addresses a critical challenge in cancer immunotherapy," says Christophe Le Tourneau at Institut Curie in Paris, who led the international study. "By using vorinostat to modify the epigenetic landscape, we're essentially making tumors more visible to the immune system."

The PEVOsq trial enrolled 112 patients with advanced cancers that had returned or spread despite previous treatments. The researchers used a "basket trial" design, simultaneously testing the drug combination across multiple cancer types rather than focusing on a single disease.

The results varied significantly by cancer type. Cervical cancer patients showed the highest response rate at 39 per cent, followed by anal cancer at 31 per cent. However, the combination was less effective for head and neck cancers (19 per cent) and penile cancer (18 per cent).

"What's particularly intriguing is how the same drug combination can have such different effects depending on the cancer's origin," says Le Tourneau. This variability likely reflects the distinct molecular characteristics of squamous cell carcinomas from different body sites.

The treatment wasn't without challenges. Two-thirds of patients required dose reductions or treatment interruptions due to side effects from vorinostat, including nausea, fatigue, and blood abnormalities. Despite these issues, the side effects were generally manageable and no treatment-related deaths occurred.

Beyond testing the drug combination's effectiveness, the researchers conducted extensive genetic analyses to identify biomarkers that could predict which patients would benefit most. They discovered that patients with mutations in genes like B2M, RAD51, and NOTCH1 showed longer progression-free survival.

Patients with high tumor mutational burden - meaning their cancers had accumulated many genetic changes - were particularly likely to respond, with 58 per cent showing tumor shrinkage compared to just 20 per cent in those with fewer mutations.

HPV status also emerged as an important factor. Patients whose cancers were linked to human papillomavirus infection had better response rates (34 per cent) compared to HPV-negative cancers (16 per cent).

The findings open new avenues for combination therapies in cancer treatment. Vorinostat works by inhibiting enzymes called histone deacetylases, which can alter how genes are expressed without changing the DNA sequence itself. This epigenetic reprogramming appears to enhance the immune system's ability to recognize and attack cancer cells.

"We're moving beyond the one-size-fits-all approach to cancer treatment," notes Le Tourneau. "Understanding why certain cancers respond better to this combination could help us design more personalized treatment strategies."

The research team is now planning larger studies to validate these findings and explore whether the genetic biomarkers they identified can reliably guide treatment decisions. They're also investigating ways to reduce vorinostat-related side effects while maintaining the drug's cancer-fighting benefits.

For patients with advanced squamous cell carcinomas, particularly those with cervical or anal cancers, this combination therapy could offer a new treatment option where few currently exist. As our understanding of the complex interplay between epigenetics and immunotherapy grows, similar combination approaches may prove effective for other hard-to-treat cancers.

Journal reference: Nature Cancer DOI: 10.1038/s43018-025-01004-2

Jul 5, 2025

3 min read

Your Genes' Hidden Battle: Mother vs Father DNA Shapes Everything From Height to Diabetes Risk

The genes you inherit from your mother and father may be locked in a hidden evolutionary battle inside your cells, with profound effects on your health, growth, and metabolism. A landmark study analyzing DNA from nearly 237,000 people has uncovered over 30 examples of this genetic conflict, where the same gene variant produces dramatically different sometimes completely opposite effects depending on which parent it came from.

"We found compelling evidence for an evolutionary phenomenon that's been theorized for decades but rarely observed at this scale," says Robin Hofmeister at the University of Lausanne in Switzerland, who led the research published in Nature. "Your maternal and paternal genes are essentially competing over resource allocation, and this competition shapes traits from your height to your risk of diabetes."

Scientists have long suspected that some genes behave differently depending on their parental origin, a phenomenon called parent-of-origin effects (POEs). According to evolutionary theory, this genetic conflict arises because fathers' genes benefit from offspring that extract maximum resources from mothers, promoting growth and energy consumption. Meanwhile, mothers' genes favor more conservative resource use, preserving the mother's health for future pregnancies.

But studying these effects has been challenging because it typically requires genetic data from both parents, which is rarely available in large-scale studies. Hofmeister's team developed an innovative workaround, using patterns of DNA sharing between relatives, along with sex chromosomes and mitochondrial DNA, to infer which genes came from which parent without needing parental genomes.

Applying this method to the UK Biobank, Estonian Biobank, and a Norwegian cohort, the researchers identified over 30 POEs affecting mainly traits linked to resource allocation, such as growth and metabolism. More than one third of these showed opposite parental influences.

One striking example involves a variant near genes called KLF14 and MEST at chromosome location 7q32.2. When inherited from the father, this variant decreased triglyceride levels, but when inherited from the mother, it increased them. The researchers believe this occurs because the variant affects different genes depending on its parent of origin, influencing the maternally expressed KLF14 when inherited from mother, but the paternally-expressed MEST when from father.

Even more dramatically, a variant at chromosome 11p15.5 showed a bipolar effect on type 2 diabetes risk. The paternal version increased diabetes risk by 14%, while the maternal version was protective, reducing risk by 9%. This locus had been identified over 15 years ago but never successfully replicated until now, highlighting the power of the new approach.

The effects of this genetic conflict begin early. When the team examined height and body mass index (BMI) measurements in over 42,000 Norwegian children from birth to age 8, they found that parent-of-origin effects present in infancy persisted into adulthood.

A variant affecting BMI showed a particularly intriguing pattern: when inherited from the mother, it increased BMI in infancy but decreased BMI and hip circumference in adulthood, with the effect gradually reversing over time.

"These findings suggest that parental genetic conflicts influence our entire developmental trajectory, not just single time points," notes Hofmeister.

The discovery validates 87% of the testable associations when replicated in independent cohorts, demonstrating the robustness of these effects. This hidden layer of genetic complexity could explain why some people respond differently to treatments or have varying disease risks despite carrying the same genetic variants.

"We've been missing half the story by not considering parent of origin," says Hofmeister. "For precision medicine to truly deliver on its promise, we need to know not just what genetic variants people carry, but which parent they came from."

The findings could be particularly relevant for metabolic conditions like diabetes and obesity, where multiple POEs converge on related biological pathways. As genetic testing becomes more sophisticated, incorporating parent-of-origin information could improve disease risk prediction and treatment selection.

This evolutionary battle in our genomes, fought between maternal and paternal genes over millions of years, continues to shape human health today, a reminder that our bodies are still influenced by ancient biological conflicts we're only beginning to understand.

First Alzheimer's Agitation Drug Shows Promising Real World Safety Profile

The first drug specifically approved to treat agitation in Alzheimer's patients appears to be safer than feared, according to a major analysis of Medicare data tracking over 40,000 dementia patients. The findings could ease concerns about brexpiprazole, which carries a stark FDA warning about increased death risk in elderly dementia patients.

Agitation affects up to 90% of people with Alzheimer's disease during their illness, causing distress for both patients and caregivers. Until 2023, doctors had no FDA-approved options and relied on off-label use of antipsychotic medications all of which carry "black box" warnings about potentially fatal risks in dementia patients.

"We're seeing real-world evidence that contradicts some of our worst fears about this medication," Says the research team from the University of Southern California.

Who analyzed nine years of Medicare claims data. Their study found that dementia patients starting brexpiprazole had roughly half the mortality risk compared to those starting aripiprazole, a similar antipsychotic commonly prescribed off-label.

The stakes couldn't be higher. Approximately 250,000 people die annually from severe dementia-related agitation, and behavioral symptoms are a leading cause of nursing home placement. Yet the very drugs used to manage these symptoms have been linked to increased mortality, creating an agonizing treatment dilemma for physicians and families.

Brexpiprazole works as a dopamine modulator in the brain, with a mechanism similar to other atypical antipsychotics but with potentially milder side effects. In clinical trials leading to its approval, the drug showed modest improvements in agitation scores. However, those trials included only 345 patients followed for 12 weeks too small and brief to assess real mortality risks.

The new study examined 1,337 dementia patients who started brexpiprazole between 2015 and 2023, comparing them to 40,534 similar patients starting aripiprazole. After six months, only 4% of brexpiprazole users had died, compared to 11% of aripiprazole users.

"What's particularly interesting is that when we dug deeper with sophisticated statistical methods to account for hidden differences between patient groups, the mortality advantage disappeared,"

Explains the research team. This suggests that brexpiprazole users might have been healthier to begin with, but crucially, the drug doesn't appear to increase death risk compared to existing treatments.

The study also found no differences in hospitalization rates or emergency department visits between the two drugs, further supporting brexpiprazole's safety profile in real-world use.

Dr. Julie Zissimopoulos, lead author of the study, emphasizes the importance of having options:

"Even if brexpiprazole proves merely equivalent to existing drugs, that's valuable. We know there's tremendous variability in how individual patients respond to these medications."

While these findings are reassuring, researchers caution that the study has limitations. The Medicare data doesn't capture dementia severity or the intensity of behavioral symptoms, factors that could influence both drug choice and outcomes. Additionally, the relatively small number of brexpiprazole users reflects its recent approval and higher cost as a brand-name medication.

The research arrives at a critical moment. As the population ages and dementia cases rise, the need for safe, effective treatments for behavioral symptoms becomes increasingly urgent. The International Psychogeriatric Association recently published guidelines emphasizing integrated approaches combining psychosocial interventions with medications when necessary.

"This isn't about medicating away behavioral symptoms," notes the research team. "It's about having tools that can help when non-drug approaches aren't enough, without adding unacceptable risks."

For the millions of families grappling with dementia's behavioral challenges, this real-world evidence offers a measure of hope. While brexpiprazole isn't a miracle cure and still requires careful monitoring it appears to provide another option in the limited arsenal against one of dementia's most distressing aspects.

The findings underscore a broader principle in medicine: real-world evidence from diverse patient populations often tells a different story than controlled clinical trials. As more patients use brexpiprazole and data accumulates, the true risk-benefit profile will become clearer. For now, families and physicians have reason for cautious optimism about this new tool in dementia care.

Dual-drug combo shows promise for hard-to-treat cancers

The combination of pembrolizumab, an immune checkpoint inhibitor, with vorinostat, a drug that modifies gene expression, achieved response rates of up to 39 per cent in some cancer types during a phase 2 clinical trial. The findings suggest that priming the immune system with epigenetic modifications could overcome resistance to immunotherapy alone.

Squamous cell carcinomas affect various parts of the body including the cervix, anus, head and neck, and genital regions. While immunotherapy has revolutionized cancer treatment, only a minority of patients - typically 15 to 24 per cent - respond when these drugs are used alone.

"The combination strategy addresses a critical challenge in cancer immunotherapy," says Christophe Le Tourneau at Institut Curie in Paris, who led the international study. "By using vorinostat to modify the epigenetic landscape, we're essentially making tumors more visible to the immune system."

The PEVOsq trial enrolled 112 patients with advanced cancers that had returned or spread despite previous treatments. The researchers used a "basket trial" design, simultaneously testing the drug combination across multiple cancer types rather than focusing on a single disease.

The results varied significantly by cancer type. Cervical cancer patients showed the highest response rate at 39 per cent, followed by anal cancer at 31 per cent. However, the combination was less effective for head and neck cancers (19 per cent) and penile cancer (18 per cent).

"What's particularly intriguing is how the same drug combination can have such different effects depending on the cancer's origin," says Le Tourneau. This variability likely reflects the distinct molecular characteristics of squamous cell carcinomas from different body sites.

The treatment wasn't without challenges. Two-thirds of patients required dose reductions or treatment interruptions due to side effects from vorinostat, including nausea, fatigue, and blood abnormalities. Despite these issues, the side effects were generally manageable and no treatment-related deaths occurred.

Beyond testing the drug combination's effectiveness, the researchers conducted extensive genetic analyses to identify biomarkers that could predict which patients would benefit most. They discovered that patients with mutations in genes like B2M, RAD51, and NOTCH1 showed longer progression-free survival.

Patients with high tumor mutational burden - meaning their cancers had accumulated many genetic changes - were particularly likely to respond, with 58 per cent showing tumor shrinkage compared to just 20 per cent in those with fewer mutations.

HPV status also emerged as an important factor. Patients whose cancers were linked to human papillomavirus infection had better response rates (34 per cent) compared to HPV-negative cancers (16 per cent).

The findings open new avenues for combination therapies in cancer treatment. Vorinostat works by inhibiting enzymes called histone deacetylases, which can alter how genes are expressed without changing the DNA sequence itself. This epigenetic reprogramming appears to enhance the immune system's ability to recognize and attack cancer cells.

"We're moving beyond the one-size-fits-all approach to cancer treatment," notes Le Tourneau. "Understanding why certain cancers respond better to this combination could help us design more personalized treatment strategies."

The research team is now planning larger studies to validate these findings and explore whether the genetic biomarkers they identified can reliably guide treatment decisions. They're also investigating ways to reduce vorinostat-related side effects while maintaining the drug's cancer-fighting benefits.

For patients with advanced squamous cell carcinomas, particularly those with cervical or anal cancers, this combination therapy could offer a new treatment option where few currently exist. As our understanding of the complex interplay between epigenetics and immunotherapy grows, similar combination approaches may prove effective for other hard-to-treat cancers.

Journal reference: Nature Cancer DOI: 10.1038/s43018-025-01004-2

Scientists Design Artificial Enzymes That Match Nature's Catalytic Prowess

For decades, scientists have dreamed of designing enzymes from scratch – molecular machines that could catalyze any reaction we need, from breaking down plastics to synthesizing new medicines. But there was always a catch: computationally designed enzymes performed dismally compared to their natural counterparts, requiring extensive laboratory optimization to reach even modest activity levels.

Now, researchers at the Weizmann Institute of Science in Israel have shattered this barrier. Their computationally designed enzymes exhibit catalytic rates matching those found in nature – without any laboratory evolution or optimization whatsoever.

"This is really a game-changer," says Sarel Fleishman, who led the research published in Nature. "We can now program enzymes that work efficiently right from the design stage, which opens up enormous possibilities for biotechnology."

The team focused on designing enzymes for the Kemp elimination reaction, a model chemical transformation that has served as a benchmark for enzyme designers for over 15 years. Previous computational designs required months of laboratory evolution to achieve respectable activity levels. The best designs without optimization showed catalytic efficiencies around 1-400 M⁻¹s⁻¹ – roughly 1,000 times worse than typical natural enzymes.

The new designs blow these numbers out of the water. The team's best enzyme, dubbed Des27.7, achieved a catalytic efficiency of 12,700 M⁻¹s⁻¹ straight from the computer. With a single strategic mutation, this jumped to an astounding 123,000 M⁻¹s⁻¹ – firmly in the range of natural enzymes.

"We're talking about a 100-fold improvement over any previous computational design," notes Fleishman. "And we achieved this without touching a test tube for optimization."

The secret to their success lay in a counterintuitive insight: don't just focus on the active site where the chemistry happens. Previous design efforts concentrated on perfecting the catalytic machinery while neglecting the rest of the protein. This led to floppy, unstable structures where the carefully positioned catalytic groups would shift out of alignment.

The Israeli team took a holistic approach, using their computational tools to ensure the entire protein structure was rock-solid. They assembled protein backbones from fragments of natural proteins, then systematically optimized every amino acid for stability. Only then did they introduce the catalytic machinery.

"It's like building a precision watch," explains Fleishman. "You need a stable frame before you can install the delicate moving parts."

The approach paid off spectacularly. Their designed enzymes are stable at temperatures above 85°C and show remarkable structural accuracy – crystal structures matched the computational models to within fractions of an ångström.
In a surprising twist, the team discovered that a supposedly essential component of Kemp eliminase design – an aromatic amino acid for binding the substrate – wasn't necessary at all. When they replaced this aromatic residue with a simple leucine, the enzyme's efficiency increased tenfold.

"This really shows how much we still have to learn about enzyme catalysis," says Fleishman. "A design principle we've followed for two decades turned out to be holding us back."

The implications extend far beyond academic interest. Enzymes catalyze virtually every chemical reaction in living organisms and are increasingly used in industry for everything from laundry detergents to pharmaceutical synthesis. But finding or engineering enzymes for new reactions has been laborious and expensive. With this computational approach, researchers could potentially design bespoke enzymes for any reaction on demand. Want an enzyme that breaks down a specific environmental pollutant? Or one that synthesizes a complex drug molecule? The new methods could make such designer enzymes a reality. "We're moving toward truly programmable biocatalysis," says Fleishman. "Instead of spending years optimizing enzymes in the lab, we can now design them correctly from the start." The team has made their computational tools freely available, hoping to accelerate enzyme design efforts worldwide. While the current work focused on a model reaction, they're confident the approach will generalize to more complex and useful transformations. As climate change and sustainability concerns drive demand for greener chemical processes, the ability to rapidly design efficient biological catalysts could prove transformative. These molecular machines work under mild conditions, use renewable resources, and produce minimal waste – a stark contrast to traditional chemical manufacturing. The age of designer enzymes may finally have arrived, no evolution required.

Journal reference: Nature DOI: 10.1038/s41586-025-09136-

Your Genes' Hidden Battle: Mother vs Father DNA Shapes Everything From Height to Diabetes Risk

The genes you inherit from your mother and father may be locked in a hidden evolutionary battle inside your cells, with profound effects on your health, growth, and metabolism. A landmark study analyzing DNA from nearly 237,000 people has uncovered over 30 examples of this genetic conflict, where the same gene variant produces dramatically different sometimes completely opposite effects depending on which parent it came from.

"We found compelling evidence for an evolutionary phenomenon that's been theorized for decades but rarely observed at this scale," says Robin Hofmeister at the University of Lausanne in Switzerland, who led the research published in Nature. "Your maternal and paternal genes are essentially competing over resource allocation, and this competition shapes traits from your height to your risk of diabetes."

Scientists have long suspected that some genes behave differently depending on their parental origin, a phenomenon called parent-of-origin effects (POEs). According to evolutionary theory, this genetic conflict arises because fathers' genes benefit from offspring that extract maximum resources from mothers, promoting growth and energy consumption. Meanwhile, mothers' genes favor more conservative resource use, preserving the mother's health for future pregnancies.

But studying these effects has been challenging because it typically requires genetic data from both parents, which is rarely available in large-scale studies. Hofmeister's team developed an innovative workaround, using patterns of DNA sharing between relatives, along with sex chromosomes and mitochondrial DNA, to infer which genes came from which parent without needing parental genomes.

Applying this method to the UK Biobank, Estonian Biobank, and a Norwegian cohort, the researchers identified over 30 POEs affecting mainly traits linked to resource allocation, such as growth and metabolism. More than one third of these showed opposite parental influences.

One striking example involves a variant near genes called KLF14 and MEST at chromosome location 7q32.2. When inherited from the father, this variant decreased triglyceride levels, but when inherited from the mother, it increased them. The researchers believe this occurs because the variant affects different genes depending on its parent of origin, influencing the maternally expressed KLF14 when inherited from mother, but the paternally-expressed MEST when from father.

Even more dramatically, a variant at chromosome 11p15.5 showed a bipolar effect on type 2 diabetes risk. The paternal version increased diabetes risk by 14%, while the maternal version was protective, reducing risk by 9%. This locus had been identified over 15 years ago but never successfully replicated until now, highlighting the power of the new approach.

The effects of this genetic conflict begin early. When the team examined height and body mass index (BMI) measurements in over 42,000 Norwegian children from birth to age 8, they found that parent-of-origin effects present in infancy persisted into adulthood.

A variant affecting BMI showed a particularly intriguing pattern: when inherited from the mother, it increased BMI in infancy but decreased BMI and hip circumference in adulthood, with the effect gradually reversing over time.

"These findings suggest that parental genetic conflicts influence our entire developmental trajectory, not just single time points," notes Hofmeister.

The discovery validates 87% of the testable associations when replicated in independent cohorts, demonstrating the robustness of these effects. This hidden layer of genetic complexity could explain why some people respond differently to treatments or have varying disease risks despite carrying the same genetic variants.

"We've been missing half the story by not considering parent of origin," says Hofmeister. "For precision medicine to truly deliver on its promise, we need to know not just what genetic variants people carry, but which parent they came from."

The findings could be particularly relevant for metabolic conditions like diabetes and obesity, where multiple POEs converge on related biological pathways. As genetic testing becomes more sophisticated, incorporating parent-of-origin information could improve disease risk prediction and treatment selection.

This evolutionary battle in our genomes, fought between maternal and paternal genes over millions of years, continues to shape human health today, a reminder that our bodies are still influenced by ancient biological conflicts we're only beginning to understand.

First Alzheimer's Agitation Drug Shows Promising Real World Safety Profile

The first drug specifically approved to treat agitation in Alzheimer's patients appears to be safer than feared, according to a major analysis of Medicare data tracking over 40,000 dementia patients. The findings could ease concerns about brexpiprazole, which carries a stark FDA warning about increased death risk in elderly dementia patients.

Agitation affects up to 90% of people with Alzheimer's disease during their illness, causing distress for both patients and caregivers. Until 2023, doctors had no FDA-approved options and relied on off-label use of antipsychotic medications all of which carry "black box" warnings about potentially fatal risks in dementia patients.

"We're seeing real-world evidence that contradicts some of our worst fears about this medication," Says the research team from the University of Southern California.

Who analyzed nine years of Medicare claims data. Their study found that dementia patients starting brexpiprazole had roughly half the mortality risk compared to those starting aripiprazole, a similar antipsychotic commonly prescribed off-label.

The stakes couldn't be higher. Approximately 250,000 people die annually from severe dementia-related agitation, and behavioral symptoms are a leading cause of nursing home placement. Yet the very drugs used to manage these symptoms have been linked to increased mortality, creating an agonizing treatment dilemma for physicians and families.

Brexpiprazole works as a dopamine modulator in the brain, with a mechanism similar to other atypical antipsychotics but with potentially milder side effects. In clinical trials leading to its approval, the drug showed modest improvements in agitation scores. However, those trials included only 345 patients followed for 12 weeks too small and brief to assess real mortality risks.

The new study examined 1,337 dementia patients who started brexpiprazole between 2015 and 2023, comparing them to 40,534 similar patients starting aripiprazole. After six months, only 4% of brexpiprazole users had died, compared to 11% of aripiprazole users.

"What's particularly interesting is that when we dug deeper with sophisticated statistical methods to account for hidden differences between patient groups, the mortality advantage disappeared,"

Explains the research team. This suggests that brexpiprazole users might have been healthier to begin with, but crucially, the drug doesn't appear to increase death risk compared to existing treatments.

The study also found no differences in hospitalization rates or emergency department visits between the two drugs, further supporting brexpiprazole's safety profile in real-world use.

Dr. Julie Zissimopoulos, lead author of the study, emphasizes the importance of having options:

"Even if brexpiprazole proves merely equivalent to existing drugs, that's valuable. We know there's tremendous variability in how individual patients respond to these medications."

While these findings are reassuring, researchers caution that the study has limitations. The Medicare data doesn't capture dementia severity or the intensity of behavioral symptoms, factors that could influence both drug choice and outcomes. Additionally, the relatively small number of brexpiprazole users reflects its recent approval and higher cost as a brand-name medication.

The research arrives at a critical moment. As the population ages and dementia cases rise, the need for safe, effective treatments for behavioral symptoms becomes increasingly urgent. The International Psychogeriatric Association recently published guidelines emphasizing integrated approaches combining psychosocial interventions with medications when necessary.

"This isn't about medicating away behavioral symptoms," notes the research team. "It's about having tools that can help when non-drug approaches aren't enough, without adding unacceptable risks."

For the millions of families grappling with dementia's behavioral challenges, this real-world evidence offers a measure of hope. While brexpiprazole isn't a miracle cure and still requires careful monitoring it appears to provide another option in the limited arsenal against one of dementia's most distressing aspects.

The findings underscore a broader principle in medicine: real-world evidence from diverse patient populations often tells a different story than controlled clinical trials. As more patients use brexpiprazole and data accumulates, the true risk-benefit profile will become clearer. For now, families and physicians have reason for cautious optimism about this new tool in dementia care.

Dual-drug combo shows promise for hard-to-treat cancers

The combination of pembrolizumab, an immune checkpoint inhibitor, with vorinostat, a drug that modifies gene expression, achieved response rates of up to 39 per cent in some cancer types during a phase 2 clinical trial. The findings suggest that priming the immune system with epigenetic modifications could overcome resistance to immunotherapy alone.

Squamous cell carcinomas affect various parts of the body including the cervix, anus, head and neck, and genital regions. While immunotherapy has revolutionized cancer treatment, only a minority of patients - typically 15 to 24 per cent - respond when these drugs are used alone.

"The combination strategy addresses a critical challenge in cancer immunotherapy," says Christophe Le Tourneau at Institut Curie in Paris, who led the international study. "By using vorinostat to modify the epigenetic landscape, we're essentially making tumors more visible to the immune system."

The PEVOsq trial enrolled 112 patients with advanced cancers that had returned or spread despite previous treatments. The researchers used a "basket trial" design, simultaneously testing the drug combination across multiple cancer types rather than focusing on a single disease.

The results varied significantly by cancer type. Cervical cancer patients showed the highest response rate at 39 per cent, followed by anal cancer at 31 per cent. However, the combination was less effective for head and neck cancers (19 per cent) and penile cancer (18 per cent).

"What's particularly intriguing is how the same drug combination can have such different effects depending on the cancer's origin," says Le Tourneau. This variability likely reflects the distinct molecular characteristics of squamous cell carcinomas from different body sites.

The treatment wasn't without challenges. Two-thirds of patients required dose reductions or treatment interruptions due to side effects from vorinostat, including nausea, fatigue, and blood abnormalities. Despite these issues, the side effects were generally manageable and no treatment-related deaths occurred.

Beyond testing the drug combination's effectiveness, the researchers conducted extensive genetic analyses to identify biomarkers that could predict which patients would benefit most. They discovered that patients with mutations in genes like B2M, RAD51, and NOTCH1 showed longer progression-free survival.

Patients with high tumor mutational burden - meaning their cancers had accumulated many genetic changes - were particularly likely to respond, with 58 per cent showing tumor shrinkage compared to just 20 per cent in those with fewer mutations.

HPV status also emerged as an important factor. Patients whose cancers were linked to human papillomavirus infection had better response rates (34 per cent) compared to HPV-negative cancers (16 per cent).

The findings open new avenues for combination therapies in cancer treatment. Vorinostat works by inhibiting enzymes called histone deacetylases, which can alter how genes are expressed without changing the DNA sequence itself. This epigenetic reprogramming appears to enhance the immune system's ability to recognize and attack cancer cells.

"We're moving beyond the one-size-fits-all approach to cancer treatment," notes Le Tourneau. "Understanding why certain cancers respond better to this combination could help us design more personalized treatment strategies."

The research team is now planning larger studies to validate these findings and explore whether the genetic biomarkers they identified can reliably guide treatment decisions. They're also investigating ways to reduce vorinostat-related side effects while maintaining the drug's cancer-fighting benefits.

For patients with advanced squamous cell carcinomas, particularly those with cervical or anal cancers, this combination therapy could offer a new treatment option where few currently exist. As our understanding of the complex interplay between epigenetics and immunotherapy grows, similar combination approaches may prove effective for other hard-to-treat cancers.

Journal reference: Nature Cancer DOI: 10.1038/s43018-025-01004-2

Scientists Design Artificial Enzymes That Match Nature's Catalytic Prowess

For decades, scientists have dreamed of designing enzymes from scratch – molecular machines that could catalyze any reaction we need, from breaking down plastics to synthesizing new medicines. But there was always a catch: computationally designed enzymes performed dismally compared to their natural counterparts, requiring extensive laboratory optimization to reach even modest activity levels.

Now, researchers at the Weizmann Institute of Science in Israel have shattered this barrier. Their computationally designed enzymes exhibit catalytic rates matching those found in nature – without any laboratory evolution or optimization whatsoever.

"This is really a game-changer," says Sarel Fleishman, who led the research published in Nature. "We can now program enzymes that work efficiently right from the design stage, which opens up enormous possibilities for biotechnology."

The team focused on designing enzymes for the Kemp elimination reaction, a model chemical transformation that has served as a benchmark for enzyme designers for over 15 years. Previous computational designs required months of laboratory evolution to achieve respectable activity levels. The best designs without optimization showed catalytic efficiencies around 1-400 M⁻¹s⁻¹ – roughly 1,000 times worse than typical natural enzymes.

The new designs blow these numbers out of the water. The team's best enzyme, dubbed Des27.7, achieved a catalytic efficiency of 12,700 M⁻¹s⁻¹ straight from the computer. With a single strategic mutation, this jumped to an astounding 123,000 M⁻¹s⁻¹ – firmly in the range of natural enzymes.

"We're talking about a 100-fold improvement over any previous computational design," notes Fleishman. "And we achieved this without touching a test tube for optimization."

The secret to their success lay in a counterintuitive insight: don't just focus on the active site where the chemistry happens. Previous design efforts concentrated on perfecting the catalytic machinery while neglecting the rest of the protein. This led to floppy, unstable structures where the carefully positioned catalytic groups would shift out of alignment.

The Israeli team took a holistic approach, using their computational tools to ensure the entire protein structure was rock-solid. They assembled protein backbones from fragments of natural proteins, then systematically optimized every amino acid for stability. Only then did they introduce the catalytic machinery.

"It's like building a precision watch," explains Fleishman. "You need a stable frame before you can install the delicate moving parts."

The approach paid off spectacularly. Their designed enzymes are stable at temperatures above 85°C and show remarkable structural accuracy – crystal structures matched the computational models to within fractions of an ångström.
In a surprising twist, the team discovered that a supposedly essential component of Kemp eliminase design – an aromatic amino acid for binding the substrate – wasn't necessary at all. When they replaced this aromatic residue with a simple leucine, the enzyme's efficiency increased tenfold.

"This really shows how much we still have to learn about enzyme catalysis," says Fleishman. "A design principle we've followed for two decades turned out to be holding us back."

The implications extend far beyond academic interest. Enzymes catalyze virtually every chemical reaction in living organisms and are increasingly used in industry for everything from laundry detergents to pharmaceutical synthesis. But finding or engineering enzymes for new reactions has been laborious and expensive. With this computational approach, researchers could potentially design bespoke enzymes for any reaction on demand. Want an enzyme that breaks down a specific environmental pollutant? Or one that synthesizes a complex drug molecule? The new methods could make such designer enzymes a reality. "We're moving toward truly programmable biocatalysis," says Fleishman. "Instead of spending years optimizing enzymes in the lab, we can now design them correctly from the start." The team has made their computational tools freely available, hoping to accelerate enzyme design efforts worldwide. While the current work focused on a model reaction, they're confident the approach will generalize to more complex and useful transformations. As climate change and sustainability concerns drive demand for greener chemical processes, the ability to rapidly design efficient biological catalysts could prove transformative. These molecular machines work under mild conditions, use renewable resources, and produce minimal waste – a stark contrast to traditional chemical manufacturing. The age of designer enzymes may finally have arrived, no evolution required.

Journal reference: Nature DOI: 10.1038/s41586-025-09136-

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