A drug that stops the body’s overactive immune system could be key to treating lupus. This would be only the second new drug for the autoimmune condition in 60 years.

Around 5 million people around the world are affected by lupus, a condition that causes the body’s immune system to attack healthy organs and results in skin rashes, joint and muscle pain, fatigue and early death.

There is no cure, and doctors often rely on therapies from the 1950s to treat symptoms, says Eric Morand of Monash University, Australia. One in 10 people diagnosed with the disease, typically young women, will die within a decade after diagnosis.

A growing body of evidence suggests that lupus is linked to producing too many molecules called type 1 interferons, which are involved in regulating the body’s immune system. This prompted Morand and his colleagues to study the effects of anifrolumab, a drug that binds to type 1 interferon receptors and stops the molecule from overstimulating the immune system.

They randomly assigned 362 people with moderate to severe symptoms of lupus to receive a 300-milligram injection of either a placebo or anifrolumab every four weeks for almost a year.

The benchmark for success was if all of a participant’s organs that displayed signs of the disease at the beginning of the study improved and there were no flare-ups over the year. They found that 48 per cent of participants taking the drug achieved this, compared with 32 per cent taking the placebo.

In addition, 52 per cent of those who were taking steroids for the condition were able to reduce the dose, compared with 30 per cent in the control group. This is important because the steroids commonly have side effects such as weight gain, osteoporosis, skin fragility and infections.

“In lupus patients there is an additional complication,” says Morand. “With long-term use, the harmful effects of lupus itself appear to be amplified by exposure to steroids – so it’s a real double-edged sword.”

Sean O’Neill at the University of Sydney in Australia says the findings are a “great achievement for a disease that desperately needs some progress”.

However, there are still negative side-effects of the anifrolumab to overcome. The drug was associated with an increase in upper respiratory tract infections, such as the common cold, and herpes zoster, also known as shingles. One person taking the drug died of pneumonia.

Interferon’s role in the immune system is chiefly to defend against viruses, so these effects are expected from a drug that blocks the protein from working, says Morand.

They hope that vaccinating people against herpes zoster, for example, will help reduce these risks.

Smoke from the bushfires raging near Sydney in Australia has been blanketing the city in recent weeks, reaching a crisis point on Tuesday when air pollution in parts of the city rose to over 10 times the level deemed hazardous.

Health authorities are warning the public to be careful. Children have been forced to stay indoors during lunchtime at school, ferries were cancelled and office workers were evacuated from buildings as the smoke triggered fire alarms.

These unprecedented conditions have prompted questions over what effect they could have on the population’s long-term health.

Bushfires are so dangerous because they billow fine particulate matter, known as PM2.5, into the air. When this is inhaled, it can go deep into the lungs, where it causes inflammation, and enter the bloodstream to affect other parts of the body.

The link between several hours or days of poor air quality and health problems is well-established. Such exposure can worsen asthma and lung conditions, such as chronic bronchitis, and lead to heart attacks in people with heart disease.

People who are hospitalised or die as a result of poor air tend to have pre-existing respiratory and cardiovascular diseases. Last week, health authorities recorded a roughly 30 per cent increase in ambulance call outs across New South Wales, and hospitalisations for respiratory issues in the area rose by 25 per cent.

Less severe but longer-term exposure, such as the circumstances in Beijing or New Delhi, has been linked to heart, lung and kidney disease, strokes, type 2 diabetes, sepsis and urinary tract infections. It is also associated with smaller babies, miscarriage and stillbirth.

But this isn’t necessarily true of people in Sydney, who typically enjoy relatively unpolluted air.

Fay Johnston at the University of Tasmania, Australia, says that in the south-east of the country in 2014 may shed some light on what to expect.

A community near the mine was exposed to levels of smoke similar to those experienced by the worst-affected parts of Sydney for six weeks. In the years since, Johnston and her colleagues found that children who were more exposed to the smoke while in the womb or in their first two years of life had more respiratory tract infections than those who were less exposed.

Those exposed to more smoke before the age of 2 had stiffer lungs than those who were less exposed, they found.

“But it was a subtle change,” says Johnston. “If there was a kid who was already at high risk – because they had a family history of asthma, or they also lived with smoker, or they had other risk factors – then it might be what tips the balance in getting symptoms.”

of infant rhesus macaque monkeys living near the 2008 California wildfires found something similar: those who were exposed to the smoke had worse lung and immune health at 3 years of age than those who weren’t exposed.

Neither study found much evidence that the smoke exposure had lasting effects on the respiratory health of adults, which backs up research suggesting air pollution is worse for developing children.

It may not just be physical health that is affected. The study of around 4000 people living near the coal mine fire found that air pollution exposure was linked to more symptoms of post-traumatic stress disorder in adults two and a half years later.

Calls to the Australian mental health charity Lifeline also spike on days when the bushfires are worst,

Linda Selvey of the Royal Australasian College of Physicians says that research on quitting cigarette smoking may help reassure Sydney residents worried about short-term exposure to poor air. “For lung cancer, the risk is never completely eliminated – but gradually the risks [of other health conditions] return to similar levels to people who never smoked,” she says.

The World Health Organization recently found that improving air quality can have quick and dramatic health benefits.

Nevertheless, the air quality in Sydney may continue to be poor in the coming weeks or even months, with the Bureau of Meteorology predicting a longer, hotter summer than normal and fire experts fearing the worst is yet to come.

Fossils of several shrew-like mammals that lived some 120 million years ago have revealed  the earliest evidence of the middle ear bones separating from the jaw, a key step in the evolution of hearing.

Three tiny bones in the middle ear, known as the incus, malleus and stapes (or anvil, hammer and stirrup), are responsible for the exceptional hearing found in mammals such as dolphins and bats.

Biologists think that this complex architecture gradually evolved as the bones behind the back teeth of the lower jaw shrank and were pushed back. But fossil evidence of how and when this transition happened is rare.

Now at the American Museum of Natural History and his colleagues have discovered proof of this missing link in several nearly complete skeletons of a previously unknown creature, Origolestes lii, found in the Yixian Formation in Liaoning province, China.

The middle ear bones in this mole-sized creature sit behind and at the base of its jawbone, but like in modern mammals, are completely separate from the jaw.

In particular, O. lii’s middle ear bones weren’t connected to the jaw through a bridge called Meckel’s cartilage – a feature found in a relative that lived around the same time.

Meng says this is “a snapshot of the moment when the two organs separated in evolutionary time”.

The evolution of small and loose bones allowed mammals to hear at higher frequencies, and this may have helped them catch insects, says Meng.

“On the other hand, the selection pressure for eating different food, such as vegetables and meat, require strong jaw movement, which would be constrained if the hearing organ was attached to the lower jaw,” he says.

Once the two were separate, hearing and chewing were both able to evolve rapidly without each impairing the other.

All living mammals have a separate middle ear, but reptiles, birds and frogs don’t – which means they lose hearing when eating. In fact, the middle ear is so advantageous that biologists think that it evolved at least three separate times in mammalian history.

It is possible that these findings represent the precursor to human hearing, because O. lii is part of the lineage that led to all living marsupials and mammals with placentas.

The animals were found curled up in a resting position, and the team believe that they may have been killed by toxic volcanic gas while they slept.

A rodent-like mammal that lived 120 million years ago had a weird ear that may have evolved as a result of its unique chewing style.

Yuanqing Wang of the Institute of Vertebrate Paleontology and Paleoanthropology, China and his colleagues discovered an almost complete skeleton of a previously unknown creature – named Jeholbaatar kielana – in the Jiufotang Formation in the Liaoning province of China.

The rodent-like animal’s lower cheek configuration suggests it had an unusual back and forward chewing style that allowed it to grind up and eat plants. This may have contributed to its success as a species, because other mammals alive at the time could only eat insects and other vertebrates.

J. kielana, which weighed about 50 grams, was also different to some other early mammals because its ear bones were separate to its jaw. Its chewing style may have driven this anatomical development, because it forced parts of the jaw to move up to the skull where they ended up forming a unique hearing apparatus, says Wang.

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Like modern mammals, J. kielana had three middle ear bones – the malleus, incus and stapes (or hammer, anvil and stirrup) – that transform soundwaves into electrical signals. But instead of the incus being interlocked with the malleus, as it is in people and other living mammals, it sat partially on top of the malleus.

This configuration was probably necessary to accommodate the animal’s back and forward chewing style, says Wang. In contrast, cats slice their food by biting up and down and cows grind plants between their teeth with a sideways movement. We don’t know if the unusual configuration caused J. kielana to hear sounds in a different way to other mammals.

The separate three-bone middle ear is a defining feature of today’s mammals, distinguishing them from birds, frogs and reptiles, which have connected jaw and ear bones. Research suggests the ear has separated from the jaw at least three times in mammalian evolutionary history, perhaps because it allowed better hearing, says Wang.

“Due to this unique feature, mammals obtained the capability to hear sound in higher frequencies and in a wider frequency range, which allowed mammals to better sense prey and approaching predators,” he says.