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Vaginal mesh particles ‘could trigger autoimmune response even after removal'

Vaginal mesh particles ‘could trigger autoimmune response even after removal'

Glasgow Times06-06-2025

Experts suggest allergy testing patients before they are fitted with mesh may help to better understand why complications happen in some cases.
Campaign group Sling the Mesh said the majority of its members have developed a reaction they believe is down to the material, including autoimmune diseases, unexplained rashes and chronic fatigue.
Transvaginal mesh (TVM) implants are made from synthetic materials such as polypropylene, a type of thermoplastic, and have been used to treat pelvic organ prolapse and incontinence after childbirth.
However, they can cause serious harm to some women, with side effects including infection, pelvic pain, and incontinence.
The NHS restricted its use of TVM implants in 2018 and they are now used only as a last resort through a high-vigilance programme of restricted practice.
A new article led by Dr Nicholas Farr, published in the journal Nature Reviews Urology, analysed studies which suggest polypropylene is a material which causes autoimmune/inflammatory syndrome induced by adjuvants (Asia).
Asia arises following exposure to substances that enhance the immune response in the likes of vaccines, silicone implants, or other foreign materials.
Symptoms can vary widely, but include chronic fatigue and chronic pain.
It comes after previous work by Dr Farr, who is a research fellow at the University of Sheffield, showed polypropylene mesh started to degrade within 60 days of being implanted in the pelvis of sheep.
The study also found particles of polypropylene in the tissue surrounding implant sites.
Dr Farr told the PA news agency: 'Our previous studies have shown that polypropylene mesh can degrade and leave behind particles within the surrounding tissues.
'This is important because it raises a key question – what kind of clinical response might these particles trigger?'
'Earlier studies have explored links between mesh implants and systemic symptoms resembling Asia. Patients often reported that symptoms improved after mesh removal, but in some cases, they didn't fully resolve.
'These cases were described as involving 'complete' mesh removal. But our findings challenge that definition.
'We've shown that even after the mesh has been surgically removed, polypropylene particles can persist in the tissue.
'So, it may not be a truly complete removal – and that could help explain why symptoms persist in a subset of patients.
'Our findings offer a new perspective on earlier studies, suggesting that residual particles might be a contributing factor in ongoing immune responses, even after the visible mesh is gone.'
Dr Farr called for 'increased clinical surveillance of mesh patients' to keep track of any autoimmune symptoms, as well as allergy tests to consider suitability before they are implanted.
He added: 'While it is important to recognise that the majority of mesh implants do not result in serious complications, we need to better understand why complications arise in a subset of patients and ensure those experiences are not overlooked.
'It is also essential that we engage with patients who have lived experience of mesh complications, as their insights are vital to improving future care and guiding the responsible development of safer medical devices.'
Reacting to Dr Farr's latest findings, Kath Sansom, founder of campaign group Sling The Mesh, told PA it 'confirms what thousands of mesh injured patients have been reporting for years – that polypropylene mesh can lead to autoimmune disease, fibromyalgia and allergic reactions'.
'For too long, our voices have been dismissed,' she added.
'Now, science is catching up, and it's imperative that regulators and manufacturers take immediate action to prevent further harm.'
Ms Sansom told PA the findings underscore the need for revaluation of the material used in mesh, along with the importance of 'patient-centred approaches'.
'The majority of our group – nearly 12,000 people – have developed some sort of reaction believed to be from the plastic mesh including a wide range of autoimmune diseases, unexplained rashes, IBS, dry eyes and chronic fatigue,' she added.
Sharron Mahoney, 57, claims the vaginal mesh she had implanted in 2010 caused her immune system to go 'into overdrive', with symptoms either easing or disappearing when she had it removed in 2018.
She said: 'After receiving a rectopexy mesh implant, I began suffering from a host of unexplained symptoms – severe fatigue, joint pain, recurring rashes, and food and chemical sensitivities that I had never experienced before.
'I couldn't grip anything, was losing my vision, had chronic cough, post nasal drip. Dry eyes. Stiff and sore muscles. Rashes on my skin.
'Doctors struggled to find a cause and treated me like a mystery – I later found out they put 'may be psychological' in my notes.
'When I finally had the mesh removed, the change was extraordinary – the allergic reactions instantly eased, my energy slowly returned, and many of the autoimmune symptoms diminished or disappeared entirely.
'My experience has left me in no doubt that the mesh was causing my immune system to go into overdrive.
'Patients need to be heard, and we need robust, long-term research and regulation to prevent others from suffering needlessly.'
A 2024 report by Patient Safety Commissioner Dr Henrietta Hughes highlighted that thousands of women's lives were 'destroyed' because of pelvic mesh.
It called for the Government to create a two-stage financial redress scheme.
However, in February – a year on from the report's publication – campaigners said they have 'faced silence', with no compensation scheme put in place.

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Article continues below Dr Cormack was troubled by videos advertising the company's Gluco Support supplement, priced at £69.95 for 90 pills, which are claimed to help customers "maintain healthy blood sugar levels" using "superfood" ingredients. The videos' characters described health episodes such as collapsing at a wedding because of "spiking" blood sugar, and how the product had changed their lives. Although the footage did not mention the word "diabetes", Dr Cormack feared people could interpret the product as capable of treating diabetes. A "dangerous" example, he felt, was a video that claimed Dr O'Connell had "discovered a way of controlling your blood sugar level without mad exercising, dieting or even painful injections". Dr Cormack felt this could lead to diabetics thinking they could stop taking insulin injections. He was alarmed to see one Facebook user had commented on the video: "Do you quit diabetic medication when using this medicine?" Cardiff GP Dr Paul O'Connell (Image: WalesOnline ) The lawyers representing Dr O'Connell said he had "never made claims around diabetes". They argued that fainting at a wedding could be caused by a "wide range of issues" and that the mention of "painful injections" was actually a reference to the "potentially dangerous practice of using weight loss GLP-1 injections". He would never advise patients to stop taking insulin, the solicitors added. But WalesOnline found an advert with a tagline that described Dr O'Connell as a "leading diabetes expert". The firm's lawyers told us this ad would be removed and that it was a mistake by a marketing employee who had gone against the firm's guidelines, which would be "reiterated" to staff. Next we found wording on the Physical Nutrition website that specifically aimed its blood sugar product at "diabetic" people, telling them "it doesn't have to be this way" and "it couldn't be easier to take back control of your health". Physical Nutrition accepted this "ought never to have been published". Its lawyers told us our enquiries had prompted it to "urgently review its marketing materials", leading to the discovery of ads which "would never have been approved by the senior management". Dr O'Connell's lawyers, meanwhile, said he wasn't aware of the diabetes references and did not endorse them. Secrets of the salamander A range of past scenarios involving Dr O'Connell were used to promote the company's "joint health" supplement, Activ8 Joint Complete. In one video he can be seen wearing black leathers, sprawled on a road after what he describes as a motorbike crash. He tells how the accident left him with chronic joint pain so he carried out research to create Activ8, a 90-capsule bottle of which costs £69.95. In a different video he describes experiencing long-term joint pain after a pedal cycle accident. In another he tells of chronic pain from a "nasty car crash". When we asked Dr O'Connell how many road accidents he had been in, his lawyers responded there had been "a number of significant accidents and numerous more minor accidents". In one video Dr O'Connell was described as a "joint health specialist". When we asked if this was true, the GP's lawyers said he wasn't aware he had been characterised in this way and did not endorse it. But the description, we pointed out, came from his own voiceover. Cardiff GP Dr Paul O'Connell (Image: WalesOnline ) Dr O'Connell said he did not recall using the term "specialist" but did consider himself a joint expert, having previously led teams that gave "electrical stimulation to neurologically impaired patients who suffered from foot drop". His lawyers added that he also carried out an audit on preventing blood clots in joint replacement surgery, and worked with orthopaedic surgeons when he was a foundation doctor. The videos told how Dr O'Connell's "battle with joint pain" led him to remedies derived from "secrets of the salamander", an amphibian which has the ability to regenerate its tail. But last June these videos led to an Advertising Standards Authority ruling against the company, which had failed to engage with the watchdog during its investigation. The ASA found breaches of the advertising code with statements that "a self-healing mechanism can reverse YEARS of arthritis and joint damage" and that cartilage can "regrow just like hair and nails", implying a food supplement could treat human disease. It also found no evidence to support the company's claim that Dr O'Connell was the NHS' "leading joint expert". ‌ Physical Nutrition told us it stood by its claims about Activ8 — pointing to Duke University research suggesting humans have an "inner salamander capacity" — but that nevertheless it agreed to take down the videos. Yet, nearly a year on from the ruling, we found the firm still had videos on its social media suggesting the supplement could help regrow cartilage. When we put this to the business, it said the footage had been "missed in a sweep" after the ruling, and would be removed. We then pointed out there were still claims about "supporting cartilage regrowth" on the website. Again, the firm accepted this "ought not to have remained live" and that "the standards of its marketing team's work fell below those acceptable". It vowed to restrain "sales puff" and bring in "a more robust quality control regimen". The scathing verdict of a rheumatologist We asked award-winning consultant rheumatologist Dr Wendy Holden — who is medical advisor to the Arthritis Action charity — her thoughts on Activ8 itself, which the firm claims to be a "clinically proven" joint health formula. ‌ Dr Holden was damning in her assessment of the pills' ingredients. "Collagen is digested in the gut and metabolised to glucose just as any protein is, so collagen taken by mouth cannot somehow magic itself into the joints, whatever the claims," she said. She also questioned the claim that oral hyaluronic acid could help with joint pain given that, "like collagen, it will be digested and doesn't travel straight to the joints". Dr Holden pointed out that other ingredients, glucosamine and chondroitin, had been assessed by the UK medical body NICE as potential relief for arthritis symptoms — and the latest guidance states: "Do not recommend the use of chondroitin, glucosamine." ‌ She added: "The most worrying implied claim for me, though, is that Activ8 will somehow help with cartilage regeneration. Duke University has shown that humans have molecules similar to those found in salamanders, which may be important in cartilage regeneration, but there is absolutely no evidence that anything in Activ8 can influence these substances, and this whole topic is very much at the basic science stage. "I suspect any benefits from patient testimonials are due to the placebo effect which for pain can be as high as 30 to 40%," she said. The firm's lawyers accepted there was room for "spirited and even heated scientific debate" about the benefits of the ingredients. But they said the product was supported by systematic reviews of studies involving those ingredients, which "carry significantly more weight" than the opinions of any individual. They added: "Our client does not sell medicine, and NICE guidelines are completely irrelevant to it and its products." ‌ Dr Holden acknowledged that eggshell membrane, an ingredient, had appeared in a systematic review of seven studies on easing osteoarthritis pain. But she said all were "low quality for a short duration and with few participants", and that any such benefits "would definitely not agree with conventional medical thinking". Dr O'Connell, meanwhile, denied ever claiming cartilage can be entirely regrown. His lawyers also pointed to a "substantial number of positive reviews" on the website and the offer of a 90-day refund. 'Dangerous' prostate health video Physical Nutrition also sells a "men's health" supplement, 'Protect + Perform', which it says helps "maintain a healthy prostate" at a price of £69.95 for 60 pills. When we showed one of its adverts — which the firm says is no longer in use — to the Prostate Cancer UK charity, it was disturbed. ‌ In the video, Dr O'Connell warns of "record rates of prostate problems" such as loss of bladder control, then another man's voiceover goes on to say: "It's no wonder so few men get checked, but what if there were a way to beat these problems from the comfort of your own home?" Spotting prostate problems too late "can be fatal", adds the voiceover, continuing: "Prostate cancer now kills more people than breast cancer." Prostate Cancer UK felt the video could lead to men thinking supplements were an adequate alternative to getting tested for prostate cancer. The Essex GP, Dr Cormack, had the same concern. "Research that is about something non-cancerous is presented and conflated with cancer, which is dangerously misleading," Prostate Cancer UK's assistant director of health improvement, Amy Rylance, told us. ‌ Physical Nutrition's lawyers defended the video, saying it warned against the problem of "under-investigating prostate health" and that it "makes no claims that its supplements are a suitable alternative to medical care". They said the footage was used between January 2023 and October 2024 but not since then. Logos used 'without permission' On webpages promoting Physical Nutrition's products, there was a curious positioning of the logos of the Guardian, Independent and Sky News above a picture of Dr O'Connell thoughtfully holding a finger to his head. We repeatedly asked the firm why it displayed those logos, without any answer. It was only when we contacted each news outlet — and each told us they had not licensed their logo for such use — that Physical Nutrition's lawyers responded. ‌ "At all material times our client believed that it was permitted to use the logos of publications/broadcasters with whom it had advertising agreements," said the solicitors, who added that an internal investigation was underway to check this was correct. Even if there had been permission, wouldn't the logos have risked misleading people that there'd been positive coverage from the news outlets, rather than just advertising? Physical Nutrition did not respond to this question. O'Connell denied being aware of the logos' use. What action is being taken? The ASA told us there appeared to be "ongoing problems" with Physical Nutrition's ads. The matter has been passed to the watchdog's compliance team for "follow-up enforcement action", it said. ‌ "Compliance are still actively working with the advertiser in relation to their non-compliant advertising and will decide to take firmer action should that not result in this advertiser making the required amendments," said the ASA's spokesman. "Further action may result in sanctions being applied against this advertiser." The "ongoing problems" are a symptom of regulatory toothlessness, according to Les James, a retired clinical research scientist and a trustee of the HealthSense charity, which campaigns for evidence-based healthcare. "The problem with the ASA is that, although it is by far the most rigorous of the regulators I know, it only operates a voluntary code," he said. "When it says it can apply sanctions, these actually have no legal force, so non-compliant advertisers can take no notice whatsoever. ‌ "The ASA refers to their legal backstop Trading Standards, but at HealthSense we have done research on that and found that there simply are no adequate resources for this to be effective. Trading Standards offices typically have only a handful of people, often as few as three. "The deal that the ASA has with Trading Standards is that, first of all, non-compliant advertisers are placed on the naughty step, but this can take several months or years to happen. Once it does, advertisers can sit on the list for years." Physical Nutrition — whose directors run various other health businesses, including the multimillion-pound Malaberg Ltd — told us through its lawyers that it was unaware of any follow-up enforcement action. ‌ What the NHS says A spokeswoman for Cardiff and Vale health board told us: 'Dr Paul O'Connell is listed as a locum GP on the Cardiff and Vale University Health Board medical performers list. While the concerns raised are in relation to Dr O'Connell's private work, the health board will review and consider the concerns raised in line with our standard procedures.' The lawyers representing Dr O'Connell said: "Our client is clear that he has recently been working as a regular NHS locum GP and fully intends to continue to work as a GP when locum work is available." Asked if he would continue working with Physical Nutrition, his lawyers said the relationship "will be kept under review, as it has been until now (and as with any professional relationship)". Article continues below At the time of writing, Physical Nutrition's Facebook page is not visible because it has been reviewing its marketing since we raised concerns, its lawyers said. A spokesman for Physical Nutrition said: "Gluco Support, Activ8, and Perform + Protect, as with all of our supplements, were formulated off the back of an extensive body of research from world-leading biomedical scientists, academics, and researchers at some of the world's most prestigious institutions." If you know of a story we should be investigating, email us at

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