Susanne Roth, Minoti Apte, Vinod P Balachandran, Giulia Biffi, Thierry Conroy, Edna Cukierman, Efrat Dotan, Irene Esposito, Barbara T Grünwald, Miriam Klauß, Alison P Klein, Núria Malats, Eileen M O Reilly, Mike J Pishvaian, Francisco X Real, Dieter Saur, Jens T Siveke, Christoph W Michalski
{"title":"Pancreatic cancer.","authors":"Susanne Roth, Minoti Apte, Vinod P Balachandran, Giulia Biffi, Thierry Conroy, Edna Cukierman, Efrat Dotan, Irene Esposito, Barbara T Grünwald, Miriam Klauß, Alison P Klein, Núria Malats, Eileen M O Reilly, Mike J Pishvaian, Francisco X Real, Dieter Saur, Jens T Siveke, Christoph W Michalski","doi":"10.1038/s41572-026-00699-6","DOIUrl":"https://doi.org/10.1038/s41572-026-00699-6","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma remains one of the deadliest malignancies, characterized by late diagnosis, aggressive biology and limited therapeutic success. Advances in multiagent chemotherapy have improved outcomes across disease stages, whereas precision medicine approaches are reshaping treatment paradigms. Personalized RNA vaccines and oncogenic KRAS-directed agents represent emerging immunological and molecular frontiers. Multimodal treatment regimens and surgical innovations, including vessel-oriented and minimally invasive techniques, have enhanced complete resection rates and enabled conversion of initially unresectable locally advanced pancreatic cancer into resectable disease. Increasingly, multidisciplinary, biology-guided strategies define resectability and the sequence of systemic and local therapies. The tumour microenvironment's complex stromal and immune ecology remains central to therapeutic resistance but also offers opportunities for rational combination therapy. Early detection and risk-adapted surveillance for high-risk individuals are advancing, as are artificial intelligence-assisted imaging and liquid biopsy approaches. Despite persistent challenges, the convergence of mechanistic insights, precision therapeutics and supportive care provides a framework for transforming pancreatic ductal adenocarcinoma from an inevitably lethal disease towards a better manageable condition.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":76.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David J Hackam, Neena Modi, Jan Hulscher, Elisabeth M W Kooi, Asuka Ishiyama
{"title":"Necrotizing enterocolitis.","authors":"David J Hackam, Neena Modi, Jan Hulscher, Elisabeth M W Kooi, Asuka Ishiyama","doi":"10.1038/s41572-026-00698-7","DOIUrl":"https://doi.org/10.1038/s41572-026-00698-7","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is a devastating condition that affects premature infants and remains one of the leading causes of death in neonatal intensive care units worldwide. Current approaches to the diagnosis and treatment of NEC have changed minimally in the past 30 years, in part due to an incomplete understanding of the biological mechanisms of the disease, and a lack of treatment options. Importantly however, recent research advances have improved our understanding of the pathogenesis of NEC, resulting in a broader approach to diagnosis, prevention and treatment. In parallel, an increased understanding of the long-term complications of NEC has shed light on the importance of early decision-making for patients with this disease. This Primer includes insights from an international team of clinician-investigators from Europe, Asia and North America, which now seeks to answer some of the key questions in the NEC field, with a focus on understanding epidemiology, pathogenesis and optimal management, including the fact that many infants with NEC require surgery, and to understand the morbidity that survivors experience. We also highlight how the future care of patients with NEC is likely to include a sophisticated diagnostic approach that includes novel molecular and imaging analyses, leading to the precise delivery of targeted molecular and cellular therapies, so as to improve outcomes in infants with this disease.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":76.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Franc Strle, Klemen Strle, Adriana Marques, Anna J Henningsson, Randi Eikeland, Jacob E Lemieux, Jean I Tsao, Paul S Mead, Gary P Wormser
{"title":"Author Correction: Lyme borreliosis.","authors":"Franc Strle, Klemen Strle, Adriana Marques, Anna J Henningsson, Randi Eikeland, Jacob E Lemieux, Jean I Tsao, Paul S Mead, Gary P Wormser","doi":"10.1038/s41572-026-00704-y","DOIUrl":"https://doi.org/10.1038/s41572-026-00704-y","url":null,"abstract":"","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":76.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catherine Lord, Traolach S Brugha, Tony Charman, James Cusack, Guillaume Dumas, Thomas Frazier, Emily J H Jones, Rebecca M Jones, Andrew Pickles, Matthew W State, Julie Lounds Taylor, Jeremy Veenstra-VanderWeele
{"title":"Author Correction: Autism spectrum disorder.","authors":"Catherine Lord, Traolach S Brugha, Tony Charman, James Cusack, Guillaume Dumas, Thomas Frazier, Emily J H Jones, Rebecca M Jones, Andrew Pickles, Matthew W State, Julie Lounds Taylor, Jeremy Veenstra-VanderWeele","doi":"10.1038/s41572-026-00706-w","DOIUrl":"https://doi.org/10.1038/s41572-026-00706-w","url":null,"abstract":"","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":76.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David B Beck, Sophie Georgin-Lavialle, Yohei Kirino, Bhavisha A Patel, Samuele Ferrari
{"title":"VEXAS syndrome.","authors":"David B Beck, Sophie Georgin-Lavialle, Yohei Kirino, Bhavisha A Patel, Samuele Ferrari","doi":"10.1038/s41572-026-00695-w","DOIUrl":"https://doi.org/10.1038/s41572-026-00695-w","url":null,"abstract":"<p><p>VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a disorder discovered in 2020 that bridges haematology, immunology and genetics. VEXAS syndrome arises from somatic mutations in UBA1, which encodes an E1 ubiquitin-activating enzyme, acquired in haematopoietic stem cells. These mutations disrupt ubiquitin-dependent protein homeostasis, triggering proteotoxic and inflammatory stress that drives systemic inflammation, cytopenias and clonal haematopoiesis. Clinically, VEXAS syndrome presents predominantly in older men with glucocorticoid-dependent inflammation, neutrophilic dermatoses, chondritis and myelodysplastic features. Diagnosis relies on characteristic clinical features and confirmation of UBA1 mutations. Prognosis is dismal in many patients, and treatment remains largely empirical. Glucocorticoids and cytokine blockade are used to provide transient control over inflammation, and hypomethylating agents aim to eradicate the mutant clone and induce disease remission. Allogeneic stem cell transplantation offers a potential cure. VEXAS syndrome exemplifies a new paradigm linking somatic genetics, inflammation and clonal haematopoiesis, reshaping our understanding of adult-onset inflammatory disease.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":76.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kai Spiegelhalder, Chiara Baglioni, Charles M Morin, Christoph Nissen, Laura Palagini, Michael L Perlis, Hannah Scott, Dieter Riemann
{"title":"Insomnia disorder.","authors":"Kai Spiegelhalder, Chiara Baglioni, Charles M Morin, Christoph Nissen, Laura Palagini, Michael L Perlis, Hannah Scott, Dieter Riemann","doi":"10.1038/s41572-026-00693-y","DOIUrl":"https://doi.org/10.1038/s41572-026-00693-y","url":null,"abstract":"<p><p>Insomnia disorder (ID) causes both night-time and daytime symptoms. Night-time symptoms include subjective difficulties initiating and maintaining sleep and early morning awakenings, whereas fatigue, perceived impairments in cognitive functioning, and mood disturbances are common daytime symptoms. The prevalence of ID in adults is high (10-16%) and the condition represents a substantial burden for both patients and society. ID is also an independent risk factor for other mental disorders and physical diseases. Diagnosis relies on self-report, as a biomarker for the disorder has not yet been established. The aetiological and pathophysiological understanding of ID spans from epigenetic and genetic research to cognitive behavioural and psychophysiological approaches. Clinical guidelines recommend cognitive behavioural therapy for insomnia (CBT-I) as the first-line treatment. However, CBT-I still requires widespread implementation, with digital CBT-I offering a scalable solution to improve treatment accessibility. Most available hypnotic agents are recommended solely for short-term use, owing to their limited efficacy and potential adverse effects. Given the considerable proportion of patients who respond insufficiently to medications and the need for further research on CBT-I, the development of novel interventions and the refinement of existing treatments is urgently required.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":76.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
求助内容：
应助结果提醒方式：