{"title":"Differences of sex development.","authors":"","doi":"10.1038/s41572-025-00644-z","DOIUrl":"https://doi.org/10.1038/s41572-025-00644-z","url":null,"abstract":"","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"55"},"PeriodicalIF":76.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760535","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}
Elton Dajti, Valeria Tripodi, Yayi Hu, Maria Cecilia Estiù, Dan Shan, Giuseppe Mazzella, Francesco Azzaroli
{"title":"Intrahepatic cholestasis of pregnancy.","authors":"Elton Dajti, Valeria Tripodi, Yayi Hu, Maria Cecilia Estiù, Dan Shan, Giuseppe Mazzella, Francesco Azzaroli","doi":"10.1038/s41572-025-00633-2","DOIUrl":"https://doi.org/10.1038/s41572-025-00633-2","url":null,"abstract":"<p><p>Intrahepatic cholestasis of pregnancy is the most common pregnancy-related liver disease, manifesting typically during the third trimester of pregnancy with pruritus and elevated serum bile acids. This condition is associated with increased fetal morbidity and mortality, and its pathogenesis is still incompletely understood, but is most likely multifactorial, involving ethnicity, genetics, hormones and environmental factors. Available evidence covering the pathophysiology of both maternal and fetal manifestations, and potential new areas of interest such as microbiota and the environment, have been reviewed, as well as available biomarkers that can be used particularly with regard to genetics, multiomics and the possible use of machine learning algorithms to predict intrahepatic cholestasis of pregnancy. Ursodeoxycholic acid is still the mainstay of therapy with limited alternative options; however, a new class of drugs inhibiting intestinal bile acid transport might be on the horizon. Intrahepatic cholestasis of pregnancy is still not completely understood, warranting a critical appraisal of its epidemiology, pathogenesis, diagnosis and management.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"51"},"PeriodicalIF":76.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708146","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}
Paola Romagnani, Rajiv Agarwal, Juliana C N Chan, Adeera Levin, Robert Kalyesubula, Sabine Karam, Masaomi Nangaku, Bernardo Rodríguez-Iturbe, Hans-Joachim Anders
{"title":"Author Correction: Chronic kidney disease.","authors":"Paola Romagnani, Rajiv Agarwal, Juliana C N Chan, Adeera Levin, Robert Kalyesubula, Sabine Karam, Masaomi Nangaku, Bernardo Rodríguez-Iturbe, Hans-Joachim Anders","doi":"10.1038/s41572-025-00641-2","DOIUrl":"https://doi.org/10.1038/s41572-025-00641-2","url":null,"abstract":"","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"53"},"PeriodicalIF":76.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682802","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}
Ranjit Unnikrishnan, Jonathan E Shaw, Juliana C N Chan, Sarah H Wild, Anne L Peters, Sharon Orrange, Michael Roden, Viswanathan Mohan
{"title":"Prediabetes.","authors":"Ranjit Unnikrishnan, Jonathan E Shaw, Juliana C N Chan, Sarah H Wild, Anne L Peters, Sharon Orrange, Michael Roden, Viswanathan Mohan","doi":"10.1038/s41572-025-00635-0","DOIUrl":"10.1038/s41572-025-00635-0","url":null,"abstract":"<p><p>Prediabetes or intermediate hyperglycaemia represents a preliminary stage in the development of type 2 diabetes mellitus (T2DM). In addition to an increased likelihood of developing T2DM, individuals with prediabetes have an elevated risk of various vascular and non-vascular complications. No consensus has been achieved on the ideal screening strategy for prediabetes, with fasting plasma glucose concentration, glycated haemoglobin (HbA1c) and the oral glucose tolerance test being the most frequently measured parameters. The two major phenotypes of prediabetes, that is, impaired fasting glucose and impaired glucose tolerance, may represent different pathophysiologies with varying natural history, risk of adverse outcomes and responsiveness to treatment. Most of the evidence for managing prediabetes focuses on lifestyle modification with or without medications in individuals with overweight or obesity and impaired glucose tolerance. Whether these interventions are beneficial in individuals with impaired fasting glucose and those of normal body weight is unclear, as is the cost-effectiveness and sustainability of pharmacotherapy for treating prediabetes. Large-scale national T2DM prevention programmes are currently under way to assess whether the benefits of interventions for prediabetes can be translated to the community setting.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"49"},"PeriodicalIF":76.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659644","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}
Jacob Rosenberg, Sarfaraz Baig, David C Chen, Joep Derikx
{"title":"Groin hernia.","authors":"Jacob Rosenberg, Sarfaraz Baig, David C Chen, Joep Derikx","doi":"10.1038/s41572-025-00631-4","DOIUrl":"https://doi.org/10.1038/s41572-025-00631-4","url":null,"abstract":"<p><p>Groin hernias are among the most common indications for surgery worldwide, affecting both men and women, with a significantly higher prevalence in men. These hernias occur when intra-abdominal contents protrude through a weakened area in the groin region, most commonly as inguinal or femoral hernias. The pathogenesis of groin hernias is a complex interplay of genetic predisposition, connective tissue abnormalities and mechanical strain. While watchful waiting is an option for some asymptomatic patients, surgical repair remains the definitive treatment, with both open and minimally invasive techniques available. Tension-free mesh repair has significantly reduced the overall recurrence rates and is now the standard approach in adults in most clinics. However, tissue-based repairs are still preferred in select populations such as children, teenagers and those in resource-limited settings. Advances in laparoscopic and robotic-assisted techniques offer benefits such as reduced postoperative pain and faster recovery. Despite surgical advancements, complications, such as chronic postoperative pain and recurrence, continue to pose challenges. Future research aims to refine surgical techniques, look at mesh-related complications, develop bioengineered meshes and explore the genetic basis of hernia formation.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"47"},"PeriodicalIF":76.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560559","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}
April W Armstrong, Andrew Blauvelt, Kristina Callis Duffin, Yu-Huei Huang, Laura J Savage, Lily Guo, Joseph F Merola
{"title":"Psoriasis.","authors":"April W Armstrong, Andrew Blauvelt, Kristina Callis Duffin, Yu-Huei Huang, Laura J Savage, Lily Guo, Joseph F Merola","doi":"10.1038/s41572-025-00630-5","DOIUrl":"https://doi.org/10.1038/s41572-025-00630-5","url":null,"abstract":"<p><p>Plaque psoriasis is a chronic, immune-mediated inflammatory skin disease that has considerable effects on patients' physical, psychological and social well-being. It is strongly influenced by genetic predisposition, with HLA-C*06:02 showing the strongest association, particularly in those with early-onset disease. Additional susceptibility loci, including IL23A, IL12B and IL17RA, are linked to dysregulation of the IL-23-T helper 17 axis, which contributes to chronic inflammation and keratinocyte hyperproliferation. Plaque psoriasis is frequently associated with psoriatic arthritis and other comorbidities, such as cardiovascular disease, metabolic syndrome and psychiatric disorders, all of which contribute to increased morbidity and mortality. Management strategies are tailored to disease severity and the presence of comorbidities. For mild disease, topical therapies remain the first-line treatment, including corticosteroids, vitamin D analogues and topical calcineurin inhibitors. New non-steroidal agents, such as topical PDE4 and aryl hydrocarbon receptor agonists, offer additional options. In moderate-to-severe disease, oral systemic therapies, such as methotrexate, ciclosporin, acitretin, apremilast and deucravacitinib, provide a range of immunomodulatory effects. Biologic therapies targeting TNF, IL-17, IL-23 and IL-12/23 have demonstrated high efficacy in improving both cutaneous and systemic inflammation. Current research on systemic therapies is focused on the development of additional inhibitors of the Tyk2 pathway and inhibitors to IL-23 receptor, IL-17, and TNF. Early screening for psoriatic arthritis, proactive cardiovascular risk reduction and multidisciplinary care are crucial to optimizing long-term outcomes. Ongoing research continues to advance precision medicine approaches, with the goal of enhancing treatment durability and improving quality of life for individuals living with psoriasis.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"45"},"PeriodicalIF":76.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506867","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}
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