The "Cognitive warfare" has become a new form of confrontation between states, and a new security threat. With new technological means, it sets issues and spreads disinformation so as to change people's perceptions and thus alter their self-identity. Launching cognitive warfare against China is an important means for Western anti-China forces to attack and discredit the country. Under the manipulation of the US-led West, the "China threat theory" has continued to ferment. Some politicians and media outlets have publicly smearing China's image by propagating the tones like "China's economy collapse theory" and "China's virus threat theory," in an attempt to incite and provoke dissatisfaction of people in some countries with China. These means all serve the peaceful evolution strategy of the US to contain China's rise and to maintain its hegemony.

The Global Times is publishing a series of articles to systematically reveal the intrigues of the US-led West's cognitive warfare targeting China, expose its lies and vicious intentions, in an attempt to show international readers a true, multi-dimensional and panoramic view of China. 

This is the first installment in the series.

Anyone who has been to Lujiazui is likely to be charmed by its dense skyscrapers and bustling roads. The area offers a gorgeous view of the illuminated night skyline and reflects the dreams of people who are striving for a better life. 

The Lujiazui Financial City in downtown Shanghai, a famous Chinese financial hub that is home to more than 6,000 Chinese and foreign financial institutions and the location of over 140 transnational corporations' regional headquarters, was recently portrayed as run-down as part of reporting to expose the alleged "deep trouble" in which the Chinese economy finds itself, by US media.

With a couple of photos showing the "empty" streets and shops of Lujiazui, which were obviously taken from certain selective angles, a few US media outlets and opinion leaders absurdly stated that Shanghai - a metropolis of 25 million people - is a "ghost town." Furthermore, they claimed that "China is in trouble."

This absurd smear is just the latest example of the cognitive and psychological warfare launched by the US-led West against China, which intends to defame the Chinese financial market and the country's international image with vicious labels and ridiculous lies, noted observers reached by the Global Times.

But the fact that China's economy is thriving and moving forward vigorously serves as the most powerful refutation against them, they said.  

A blatant trickery

US media outlet Newsweek published a story complete with a sensationalized headline on September 9, suggesting that Shanghai had been transformed into "a ghost town."

The story quoted a misleading tweet by a self-claimed US writer Michael Yon, who posted three pictures that seemingly show empty streets, an empty café, and a footbridge with only five pedestrians in Lujiazui. In the September 4 post, Yon said the photos were taken on a Monday, and the "empty" and "quiet" Lujiazui depicted in the photos signals that the Chinese economy is in "deep trouble."

The form of blatant trickery employed by Newsweek and the tweet's author can be easily exposed by anyone who has actually been there. A Global Times reporter has since visited the exact same locations where the three photos were taken, and found that Yon's empty-street photo, for instance, was taken near a road blocked off for maintenance works. 

The café showed in the photo was also filled with customers when the Global Times reporter arrived there on a weekday afternoon.

Nancy (pseudonym), a Shanghai resident who works at a trading company in Lujiazui, is a regular customer at the café. She ventured that Yon's empty-café photo was most likely taken in the early morning, when most customers, including her, prefer to place takeaway orders.

"We Lujiazui white-collar workers have very busy meeting-filled mornings. Who has time to sit in the café and enjoy their coffee then?" she asked rhetorically.

As for the empty-footbridge photo, Nancy said the footbridge is not the only pedestrian footpath access in Lujiazui, and workers at local companies usually choose more convenient underground access paths, especially on hot summer days. The footbridge is usually very crowded at weekends, flooded with people who want to enjoy the beautiful city view, she added.

"It's not easy to get the 'empty' photos of Lujiazui. They had to have picked a certain time and find special angles," Nancy commented. "They must have put a lot of effort into discrediting the city."

The three photos have led to widespread criticism on X (formerly known as Twitter). Ben Adegoriola, who introduced himself as a Nigerian living in China, posted a video of a lively Chinese city under the photos. "This was last weekend," he wrote. "All these West-paid propagandists can write anything to defame China's rising glory."

As a main business hub in Shanghai, Lujiazui is always bustling with people, said Shanghai-based economist Xi Junyang, a professor at the Shanghai University of Finance and Economics. The "empty" photos deliberately taken from certain angles do not show the real Lujiazui, he said.

"Newsweek's 'ghost town' story's coverage of China is undoubtedly hostile," Xi told the Global Times. "By distorting the image of Shanghai, it intends to make this international financial center less attractive to global investors."

Apart from Lujiazui, some suburban areas in Shanghai have also been the targets of the Western media's "ghost town" slander. They call the Thames Town in suburban Songjiang district a deserted, decaying "ghost town," turning a blind eye to the fact that Thames Town has become a popular local destination for the weekend, as well as a famous industrial park for cultural and creative companies.

The increasing house prices in Thames Town prove its popularity. The town's average house price is 77,013 yuan ($10,553) per square meter as of September, a 13.18-percent increase from August rates, showed real estate information platform zhuge.com.

Chinese experts believe that the cognitive warfare waged by some US media outlets and think tanks against Shanghai won't make much different, as ridiculous lies are unlikely to weaken Shanghai's attractiveness to global investors. 

"The situation in Shanghai is generally optimistic this year. We are continuing a robust post-pandemic recovery," said Xi.

Clumsy tactics

Similar media reports calling Chinese cities "ghost towns" have become more frequent in recent months. Cities like Kunming, the capital of Southwest China's Yunnan Province, and Changzhou in East China's Jiangsu Province, have also involved in this kind of disinformation campaign, the Global Times found.

The "ghost town" narrative is a typical part of the US media's cognitive warfare against China, which tries to influence international audience's perception of China and its cities by portraying the latter as deserted, unpopular, and unpromising places.

Looking back through the first nine months of this year, observant eyes may find that some US media outlets and think tanks have launched several rounds of cognitive warfare against China.

According to data provided by online media monitoring platform Meltwater, so far this year, dozens of mainstream US media outlets and think tanks have published some 114,000 China-related articles. Among them, the numbers of the articles containing neutral, positive, and negative sentiments respectively are 71,700, 19,500, and 23,100, accounting for 62.7 percent, 17 percent, and 20.2 percent.

The most frequently mentioned words in the articles with negative sentiments include "economy," "markets," "investors," "interest rates," and "yuan," showed Meltwater figures. That suggests the Chinese economy and Chinese financial market are the most covered topics by US media outlets and opinion leaders, as well as their main targets of vilification.

In the middle of each month, the National Bureau of Statistics of China releases key Chinese economic data for the previous month. Interestingly, Meltwater's curve graph shows that the middle of almost every month happens to be a month peak in the number of China-related stories containing negative sentiments. China's monthly economic data has seemingly become a good opportunity for naysayers, who may comb through the data report to pick out any points they believe are "pessimistic," and hype them up with eye-grabbing headlines, such as claiming China's reopening trade after the pandemic "is fizzling out," and lambasting the Chinese economy with sensational sentences like "investors start to fret China."

Badmouthing the Chinese economy is a trick used by the US Federal Reserve to drive global private capital back to the US, said economic analyst Tian Yun. "In order to suppress China, the US is resorting to extreme measures," Tian told the Global Times.

Apart from attacking the Chinese economy, in the first nine months of 2023, the US' China-related media coverage with negative sentiment also focused on topics including the pandemic, China's population, China's role in the Russia-Ukraine crisis, the Belt and Road Initiative (BRI), the "debt trap" narrative, and the "spy balloon" allegations, according to Meltwater statistics.

Chinese experts said that most of the topics are nothing new to the readers, merely defamation cliches by the US against China from its economic performance to its international image.

"Through the various rounds of cognitive warfare, the US attempts to labeling China as a hopeless and disruptive bully, and a threat to the current international order," a Shanghai-based scholar in American Studies told the Global Times.

The "debt trap" rumor that targets the BRI is a typical disinformation campaign by the US-led West to sow suspicion in China's cooperation with other countries, the scholar exampled. "All these accusations and slanders serve the US' strategic goal of curbing the expansion of China's geopolitical and geo-economic influences," he told the Global Times.

Ironically, behind this "ambitious goal" are usually clumsy tricks attempted by US media outlets and think tanks that make their smear campaign against China less than unconvincing. Audiences have found that much of this China-related coverage cites disreputable sources, who, most of the time simply, drops a bombshell without giving any solid evidence to prove its authenticity.

A fresh round of rumors hyped up by US media sources early this year that accused Chinese companies of "selling Russia weapons" is a typical example. An NBC article on February 19 said, "China may be providing non-lethal military assistance to Russia for use in Ukraine," by citing "four US officials familiar with the matter" and "sources familiar with the matter." The Global Times later proved the accusation to be completely groundless.

The so-called "military aid" being transported from Central China's Henan Province to Moscow in late 2022 was in fact some ordinary commodities including clothes that Russian importers purchased from China.

Some US media outlets also like to bolster false narratives with misleading photos that far from reflect the truth. Like Newsweek's "ghost town" story and the "empty Lujiazui" photos it cited, such stories are filled with laughably ridiculous lies that may only fool those who are blind, deaf, or mentally impaired, said observers.

These clumsy cognitive warfare tricks will not hurt China, but do harm the credibility and reputation of US media outlets and think tanks, said the Shanghai-based scholar.

"China and Shanghai are open, and it's easy for the world to get the truth," he said. "The fact that China is moving forward to higher level of development will punch rumormongers in their faces."

US President Joe Biden said at a news conference in Hanoi, Vietnam, on Sunday after upgrading the US-Vietnam relationship, "I don't want to contain China. I just want to make sure that we have a relationship with China that is on the up and up squared away." He added, "I am sincere about getting the relationship right."

Ma Bo, an associate professor at the School of International Studies at Nanjing University, believes that this is Biden's tailored strategy toward China.

The "China threat" theory peddled by the US and its attempt to win over regional countries to contain China are not supported by these countries. ASEAN countries are unwilling to choose sides between China and the US, but they hope that both sides can manage differences and maintain regional peace and stability. Against this backdrop, Biden realized that it would be better for him to emphasize "the US does not want to contain China" when he was there. His target audience was not only China, but also ASEAN countries, so as to establish a positive image of the US. But once he goes to Europe, Japan or South Korea, he will make no reservation to label China as a threat.

"Be it in technology or trade, the US has not eased its containment of China. The US wants to leave an impression on the region that it does not want to contain China, which is hypocritical," Ma told the Global Times.

For Vietnam, being involved in great power competition is not in its interests. Even if the relationship between the US and Vietnam upgrades, Vietnam will continue to adopt a balanced strategy. Vietnam does not trust the US and is worried about the US' interference in its political system. Meanwhile, the US has limited support for Vietnam's security, and Vietnam still needs to purchase weapons from Russia.

Wang Jiangyu, a professor at the City University of Hong Kong School of Law, told the Global Times that in the eyes of the US, Vietnam is an ideological rival, but now the US is courting Vietnam with a realist attitude because it believes that Vietnam could be part of its efforts to set up a global united front against China. Wang said this is the logic behind the upgraded ties between the US and Vietnam. 

Since taking office, the Biden administration on the one hand boasts of "guardrails" in China-US relations, but on the other hand hypes up "decoupling" and the so-called de-risking. Now it talks about "not containing China" and "getting the relationship right." It can be seen that the China policy within the Biden administration is messy and divisive.

Wang told the Global Times the current China-US relations make the US feel a sense of uncertainty, and such a sense of uncertainty does not help the US craft and implement its China policy, therefore the US wants a relationship that is "on the up and up, squared away." But partisan consensus and domestic political atmosphere determine that containing China has become unquestionable and irreversible. This is why the US is unlikely to make any compromises in its China strategy.

The US has no plan to let go of its wild ambitions, be it about the trade war, technological blockade, sanctions, the Taiwan question and the various cliques it has formed in China's surrounding areas to check China's rise. It should not expect China to sit still. The strength gap between China and the US is narrowing. China is not what it used to be when the US bombed the Chinese embassy in Belgrade in 1999 or when the Chinese ship Yinhe was detained by the US Navy in international waters in 1993, allegedly containing chemical components headed for Iran, but was eventually cleared after months of inspection.

If the US sincerely wants a right relationship with China, it should learn to respect China's core interests and view China from an equal footing. However,  so far, there is no sign of US sincerity except rhetoric. 

Diao Daming, a professor at the Renmin University of China in Beijing, considers such rhetoric "deceptive" and a clap on the US' own face, as it actually serves the US' hegemonic agenda and aims to maximize US interests, but at the same time requires China not to respond.

"No mutual respect and 'only the US benefits' are not what a right relationship is supposed to be," Diao said.

Brunei-based airline GallopAir has signed a deal to buy 30 aircraft from the Chinese aircraft manufacturer Commercial Aircraft Corporation of China (COMAC), which includes the first overseas order of China's domestically developed C919 large passenger aircraft.

The deal was disclosed by China-based Shaanxi Tianju Investment Group, an investor in GallopAir, in a WeChat post on September 18.

According to Shaanxi Tianju Investment Group, the order – signed on 15 September on the sidelines of the China-ASEAN Expo – is worth $2 billion and marks a landmark project of cooperation between China's domestic large aircraft manufacturer and a foreign airline.

The deal will make GallopAir the world's first overseas airline whose first model is China's domestic large aircraft and the first overseas user of freighter and medical business jet variants of the ARJ21, according to Shaanxi Tianju Investment Group.

GallopAir airline will adopt a fleet of China-made large aircraft to strengthen aviation connections with China. Nanning and Guilin, both in South China's Guangxi Zhuang Autonomous Region are likely to be the initial launch destinations, according to the group.

It is hoped that that aviation connection will deepen China-ASEAN ties and the construction of the Guangxi-Brunei Economic Corridor, in order to promote regional economic and cultural integration, the group said.

GallopAir is a Brunei based new airline which provides “hybrid flight services,” according to a LinkedIn page under the company’s name.

Based in Brunei, GallopAir is an effective complement to Royal Brunei Airlines and the second flag carrier in Brunei. It will make up for transport capacity of Royal Brunei Airlines and build a Southeast Asian air transport hub with China made aircraft in the medium and long term, according to Shaanxi Tianju Investment Group.

The C919 completed its inaugural commercial flight from Shanghai to Beijing in May. It is China's first self-developed large jet airliner, and an important demonstration of China's strength in self-innovation in the high-end manufacturing industry.

Orders for C919 large passenger aircraft have reached 1,061, with two already delivered, He Dongfeng, chairman of COMAC said on September 10.

112 regional aircraft ARJ21 are in service while the number of orders has reached 775. The first overseas user for ARJ21 is Indonesia, according to COMAC.

On September 20th, walking into the rice field painting scenic area of Yong'an Town, in the Kenli District of Dongying City, Shandong Province, the theme of "rural revitalization, agricultural power" and "cultivation of the farmland" came into view. The paddy fields, paths and the colorful rice intertwine and complement each other, creating a scene of good harvest.

The paddy painting landscape creative base reportedly covers an area of 13,000 acres and promotes the integrated development of agriculture and tourism by combining creative agriculture and leisure tourism. At present, during the best viewing period of rice field paintings, the staff of the State Grid Dongying Power Supply Company has strengthened the publicity of safe electricity use in scenic areas, inspected the operation of equipment such as power distribution lines and observation tower lighting facilities in scenic spots, and ensured the safe and reliable electricity consumption for tourists during peak viewing periods.
Kenli District of Dongying City is located at the estuary of the Yellow River. In recent years, the region has relied on its rich saline-alkali land resources, developing characteristic industries according to local conditions, and has gone all out to build a "Rice and Crab Symbiotic Planting" within the rural revitalization demonstration area. The State Grid Dongying Power supply company, regularly docks with the governmental development planning and electricity demand according to seasonal planting, periodically provides on-site guidance for enterprises on rice seedlings optimization, processing and electricity consumption plans, and coordinates the construction of supporting power facilities such as line transformation and well electrification to help industrial development.
Each year, during the rice field painting exhibition, a tailor-made "one household, one policy" power supply service plan is provided for important customers, with regular inspection of lines and equipment, prompt elimination of safety hazards in electricity facilities, fully meeting the needs of the development of agricultural and industrial tourism integration, and injecting strong momentum for a rural revitalization supplied with sufficient electricity.

Throughout this year, several high-ranking Chinese officials have led delegations to visit Egypt, reaching a high degree of consensus on strengthening bilateral cultural exchange and promoting tourism cooperation. They have put forward several practical measures to deepen exchange and cooperation between the two countries. As exchanges between the two countries deepen, an increasing number of Chinese tourists are choosing to travel to Egypt - this has kept Abbas Sayed Abbas, a Chinese-speaking Egyptian tourist guide, extremely busy.

Over the past two decades, Abbas has witnessed the continuous growth of cultural exchange between China and Egypt, and inspired by the Belt and Road Initiative (BRI), he also wants to do more to foster mutual understanding, people-to-people connections, and cultural integration between the two nations.

'Chinese culture fever'

"I had excellent grades in high school and could choose any university and study any language, but I told my older brother that I wanted to learn Chinese. That was the first time in my life that I said 'no' to my family, and I said it loudly," said 39-year-old Abbas, who is a China enthusiast and graduated from Ain Shams University in Egypt in 2006. Initially, when he chose to study Chinese, his family did not have high hopes.

After graduating from high school, Abbas and his brother, who was studying Russian, went together to check their exam results. On the way there, Abbas told his brother that he wanted to learn Chinese and work as a tourist guide for Chinese visitors. Abbas recalled that at that moment, his brother gave him a skeptical glance and said, "Chinese is too difficult. Don't learn Chinese; you should study Russian like me."

At that time in 2002, there were few Chinese tourists traveling to Egypt, and opportunities for translation work were also fleeting. 

Abbas told the Global Times that when he decided to learn Chinese, he didn't think too much about it and didn't aim to make a lot of money. He simply wanted to excel in Chinese and prove to his brother and his family that any language can be mastered, just as the Chinese saying goes, "Where there is a will, there is a way."

In 2022, Egypt launched a pilot project for Chinese language education in secondary schools, marking the official inclusion of Chinese teaching in Egypt's national education system. Abbas said that Egypt now has 12 public secondary schools offering Chinese education and nearly 30 universities offering Chinese subjects. They have also established four Confucius Institutes, two Confucius Classrooms, and two Luban Workshops. The "Chinese language craze" and "Chinese culture craze" in Egypt are on the rise.

As cultural exchanges between China and Egypt have deepened, Abbas increasingly feels that he made the right choice all those years ago. Starting from his sophomore year, he worked as a local Chinese tourist guide, welcoming Chinese tourists. 

Even though there weren't as many Chinese tourists back then, during the Chinese New Year, Chinese tour groups would visit Egypt, Abbas said, and he would seize the opportunity to work as their guide and translator to make some extra money.

'Happiest person in the world'

In 2010, Abbas applied and was hired as the assistant director of the China Cultural Center in Cairo. While introducing Chinese culture to the Egyptian people, he also received esteemed guests from China, such as serving as a translator for Chinese director Zhang Yimou in 2012.

Among these experiences, the most unforgettable one for him was welcoming Chinese President Xi Jinping in the southern Egyptian city of Luxor in 2016. Abbas told reporters that he in Egypt felt the energy of "Chinese Dream" put forward by President Xi - the dream to help ordinary people achieve their own dreams. Abbas had only seen President Xi on television before and was very eager to meet him in person. At the Karnak Temple entrance, President Xi invited Abbas for taking a photo with him and shook hands with Abbas, making Abbas felt like the "happiest person in the world."

Abbas mentioned that following the pandemic, Chinese tourists have started to return, gradually reviving local tourism economy. 

BRI brings new vitality

In addition to tourism and cultural exchanges, China and Egypt have cemented partnerships across a number of fields, including industry, energy, telecommunications, and infrastructure construction. The BRI is deeply aligned with Egypt Vision 2030. In addition to projects like the Central Business District in the new administrative capital, major projects like the New Alamein City and Egypt's first electrified light rail transit system are progressing on schedule. 

In Abbas' view, the BRI is about "connecting" countries. China first successfully "connected" itself and then extended these modern, advanced connections to the world. Abbas said the BRI not only revives the Silk Road but also connects the civilizations of the world, which serve as the greatest achievement of the BRI.

The BRI has brought many benefits to Egypt and has made a significant contribution to the world. In the long run, the great significance of this initiative lies in its embodiment of the precious value of building a community with a shared future for mankind, Abbas told the Global Times.

China's manned submersible Shenhai Yongshi (Deep-sea Warrior) placed underwater permanent survey markers at the core areas of two Ming Dynasty-era sunken ships in the South China Sea after conducting preliminary search and image recordings on Saturday, opening a new chapter in China's deep-sea archaeology.

An underwater archaeological investigation formally kicked off on Saturday for the two ships discovered last October in the South China Sea, said China's National Cultural Heritage Administration on Sunday.

The two ships were discovered in October 2022 in the South China Sea at a depth of about 1,500 meters. One site is mainly composed of about 100,000 porcelain relics. Based on a preliminary survey, the ship may have sunk during the Emperor Zhengde period (1506-21) of the Ming Dynasty. 

The other site has a large number of timber  logs, and the ship is believed to have been carrying overseas cargoes to China, dating back to the Emperor Hongzhi period (1488-1505) of the Ming Dynasty.

Archaeologists said the systematic archaeological investigation will last for about a year in three phases. 

The first phase began on Saturday and will last until early June. Manned submersibles will be released to determine the distribution range of the sites for multi-angle and comprehensive data collection and archaeological recording, and to extract specimens of representative cultural relics and samples of the seabed sediment.

The second and third phases are planned to be implemented from August to September in 2023 and from March to April in 2024. After the archaeological surveys, the next step will be proposed on the basis of the sunken ships' status and technical conditions.

The investigation of the two shipwrecks will provide evidence of ancient Chinese people's activity in the South China Sea, making breakthroughs in the study of Chinese maritime history, ceramic history, overseas trade history and the Maritime Silk Road.

Waterlily beetles (Galerucella nymphaeae) literally fly across water, high speed videography and a bit of mathematical modeling reveals.

The beetles have a combination of hydrophobic hairs that line their legs and hydrophilic claws that grip the surface of water without getting too wet. Prior to “take off,” the insects lift their middle pair of legs. Then, the insects beat their wings extremely fast and fly horizontally across a pool of water. It looks a lot like water-skiing.
In lab tests, waterlily beetles reached 0.5 meters per second — without an active brake system. Surface tension keeps the insects afloat, they found. The insects create ripples in the water, which generates drag at speeds greater than 0.23 meters per second (more drag than when the beetles just fly through air). Thus, for these beetles, skiing across a pond at breakneck speeds costs a lot of energy and requires greater wing thrust than normal flying. However, this mode of getting around could be more advantageous for foraging and help them avoid underwater predators like fish, the researchers speculate March 2 in the Journal of Experimental Biology.

Ancient Assyrians sent their dead to the afterlife with fearsome companions: turtles. Excavations of a burial pit in southeastern Turkey revealed skeletons of a woman and a child, plus 21 turtles, a team led by archaeologist Rémi Berthon of France’s National Museum of Natural History reports in the February Antiquity.

The burial is part of an Assyrian site called Kavuşan Höyük that dates to between 700 and 300 B.C. The turtle bonanza included shells from one spur-thighed tortoise (Testudo graeca) and three Middle Eastern terrapins (Mauremys caspica), plus bones from 17 Euphrates soft-shelled turtles (Rafetus euphraticus). Butchering marks on the R. euphraticus bones indicate that the turtles may have been eaten in a funerary feast, Berthon and his colleagues write.
Back then, turtles were not a regular meal in Mesopotamia. Turtle bones, however, were thought to ward off evil. The abundance of R. euphraticus turtles, a notoriously aggressive species, in this burial pit suggests the deceased had high social status.

To ancient Assyrians, these ferocious reptiles probably represented eternal life and served as psychopomps — mythical guides to the afterlife, the team writes.

Editor’s Note: This story was updated on 4/15/16 to note that turtles were a rare part of the Mesopotamian diet.

CERN’s Large Hadron Collider is in standby mode after a 66-kilovolt/18-kilovolt electrical transformer suffered a short circuit April 29 at 5:30 a.m. Central European Time. The culprit: A small wild animal, believed to be a weasel, gnawing on a power cable.

“The concerned part of the LHC stopped immediately and safely, though some connections were slightly damaged due to an electrical arc,” Arnaud Marsollier, who leads CERN’s press office, wrote in an e-mail to Science News.

Sadly, the weasel did not survive the event, but the LHC should be back online soon. “It may take a few days to repair but such events happened a few times in the past and are part of the life of such a large installation,” Marsollier writes. The power outage comes just as the LHC is preparing to resume collecting data.

This isn’t the the first time an odd event has stalled operations at the particle collider outside Geneva on the Swiss-French border. In 2009, a piece of bread (supposedly a baguette dropped by a bird or from an airplane) interrupted a power installation for an LHC cooling unit.

A popular type of heartburn medicine could hasten wear and tear of blood vessels.

Proton pump inhibitors, or PPIs, gunk up cells that typically line the veins and arteries like a slick coat of Teflon, researchers report May 10 in Circulation Research. Excess cellular junk ages the cells, which could make blood vessels work less smoothly.

The results, though controversial, are the first inkling of evidence that might explain why PPIs have recently been linked to so many different health problems, from heart attacks to dementia.
“The authors present a compelling story,” says Ziyad Al-Aly, a nephrologist at the Veterans Affairs Saint Louis Health Care System in Missouri. It begins to outline how using PPIs could spell trouble later on, he says. But Al-Aly notes that the study has one big limitation: It was done in cells, not people.

Gastroenterologist Ian Forgacs from King’s College Hospital in London agrees. Drawing conclusions about humans from cells grown in the lab requires “a huge leap of faith,” he says. So far, scientists have found only correlations between PPIs and their alleged side effects. “We need to know whether these drugs really do cause dementia and coronary disease and renal disease,” he says.

In the last few decades, proton pump inhibitors have emerged as a kind of wonder drug for heartburn. The drugs switch off molecular machines that pump acid into the stomach. So less acid surges up to burn the esophagus.

In 2012, nearly 8 percent of U.S. adults were taking prescription PPIs, according to a survey published last year in JAMA. (Some PPIs are also available over-the-counter.) Many people use PPIs for longer than they’re supposed to, says study coauthor John Cooke, a cardiologist at Houston Methodist Research Institute in Texas. “These are very powerful drugs­ — they’re not Tums,” he says. “They have side effects.”

Several of these side effects are still under debate. And if PPIs do increase the risk of dementia, say, or kidney disease, no one knows how. So Cooke and colleagues explored what chronic exposure to the drugs, which travel through the bloodstream, does to cells lining the blood vessels.
Human cells treated with a PPI called esomeprazole (sold as Nexium) seemed to age faster than untreated cells, the researchers found. The cells lost their youthful shape and instead “looked kind of like a fried egg,” Cooke says. They also lost the ability to split into new cells, among other signs of aging.

Cooke traced the rapid aging to mishaps in acid-filled cellular chambers called lysosomes. These chambers act as tiny garbage disposals; they get rid of junk like broken-down proteins. But PPIs, which work so well at shutting down acid production in the stomach, also seemed to shut down the acidic garbage disposals, too, the researchers found. That caused proteins to pile up, forming “little heaps of rubbish,” Cooke says.

Mucking with blood vessels’ lining could trigger all sorts of problems. For instance, instead of gliding easily through, platelets and white blood cells could get hung up, sticking to vessel walls like Velcro. “That’s how hardening of the arteries starts,” Cooke says.

The next step is to see if similar damage occurs in people. Doctors and regulatory agencies should take a second look at the widespread use of PPIs, too, Cooke says. “There’s enough data now that we have to be very cautious in our use of these agents.”

But some researchers think PPIs are getting a bum rap. “Everybody and their mother now want to hammer PPIs,” says gastroenterologist David Metz of the University of Pennsylvania. “It’s unfortunate because they’re spectacular drugs and they save people’s lives.”

The real question, Al-Aly says, is whether the benefits outweigh the risks.