Myrthe Pareyn, Fabiana Alves, Sakib Burza, Jaya Chakravarty, Jorge Alvar, Ermias Diro, Paul M Kaye, Johan van Griensven
{"title":"Leishmaniasis.","authors":"Myrthe Pareyn, Fabiana Alves, Sakib Burza, Jaya Chakravarty, Jorge Alvar, Ermias Diro, Paul M Kaye, Johan van Griensven","doi":"10.1038/s41572-025-00663-w","DOIUrl":"https://doi.org/10.1038/s41572-025-00663-w","url":null,"abstract":"<p><p>Leishmaniasis is an endemic disease in Asia, Africa, the Americas and Southern Europe caused by Leishmania parasites and transmitted through the bite of female sandflies, resulting in Leishmania replication in macrophages. The condition manifests either as visceral leishmaniasis, a potentially fatal systemic disease that causes persistent fever, enlargement of the liver and spleen (hepatosplenomegaly), and a reduction in almost all blood cells (pancytopenia), or as cutaneous leishmaniasis, characterized by ulcerative or non-ulcerative skin lesions. Disease manifestation and severity are determined by parasite, host and vector characteristics, with a complex immunological interplay. The rK39 rapid diagnostic test is the primary diagnostic method for visceral leishmaniasis, while cutaneous leishmaniasis is commonly diagnosed by microscopy of skin samples. Visceral leishmaniasis and severe forms of cutaneous leishmaniasis are managed by systemic treatment. For localized cutaneous leishmaniasis, treatment involves topical therapies, including cryotherapy, thermotherapy and/or intralesional injections with antimonials. The WHO 2021-2030 roadmap of neglected tropical diseases aims to eliminate visceral leishmaniasis as a public health problem and to achieve enhanced control of cutaneous leishmaniasis. In South Asia, a regional visceral leishmaniasis programme has dramatically reduced the caseload. Eastern Africa has recently launched a similar initiative. Sustainable progress in the control and elimination of leishmaniasis will require better diagnostics, treatment and vector control interventions as well as progress in vaccine development, political commitment, improved surveillance and healthcare services.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"81"},"PeriodicalIF":76.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564683","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}
Paulina Salminen, Jussi Haijanen, Peter C Minneci, Giana Hystad Davidson, Marja A Boermeester, Ed Livingston, Roland E Andersson, Kyoung Ho Lee, David Flum
{"title":"Appendicitis.","authors":"Paulina Salminen, Jussi Haijanen, Peter C Minneci, Giana Hystad Davidson, Marja A Boermeester, Ed Livingston, Roland E Andersson, Kyoung Ho Lee, David Flum","doi":"10.1038/s41572-025-00659-6","DOIUrl":"https://doi.org/10.1038/s41572-025-00659-6","url":null,"abstract":"<p><p>The appendix is a small, worm-like diverticulum of the caecum, potentially having a role in regulating intestinal microbiota and immunology. Inflammation of the appendix, acute appendicitis, is one of the most common reasons for acute abdominal pain in children and adults and surgical emergency visits worldwide. The pathophysiology of appendicitis is still poorly understood. During the past decade, evidence has overturned the long-lasting dogma that all appendicitis cases have a clinical course inevitably progressing to perforation and life-threatening peritonitis unless operated upon in a timely manner. Instead, this natural course occurs only in a smaller proportion of patients, for whom emergency appendectomy remains mandatory. Advances in diagnostic accuracy following utilization of clinical scoring systems and imaging has enabled more accurate pre-interventional assessment of appendicitis disease severity. While some patients still require urgent surgery, the majority can be treated successfully with antibiotics, and in some the disease has even been shown to resolve spontaneously. This has confirmed the notion of at least two different forms of appendicitis: non-perforating and perforating, often referred to as uncomplicated and complicated appendicitis. Unified definitions of these forms are still undergoing rigorous research and debate, hampering both comparison of different studies and the establishment of unified treatment guidelines. The current knowledge on the safe and effective outcomes of non-operative treatment alternatives has further underlined the need for standardized uniform definitions of appendicitis severity and assessment of the success of two fundamentally different treatment options.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"79"},"PeriodicalIF":76.9,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513484","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}
Benjamin Ungar, Yael Renert-Yuval, Ncoza C Dlova, Ali Jabbari, Brett King, Natasha A Mesinkovska, Lidia Rudnicka, Rodney Sinclair, Emma Guttman-Yassky
{"title":"Alopecia areata.","authors":"Benjamin Ungar, Yael Renert-Yuval, Ncoza C Dlova, Ali Jabbari, Brett King, Natasha A Mesinkovska, Lidia Rudnicka, Rodney Sinclair, Emma Guttman-Yassky","doi":"10.1038/s41572-025-00664-9","DOIUrl":"https://doi.org/10.1038/s41572-025-00664-9","url":null,"abstract":"<p><p>Alopecia areata is a common cause of non-scaring autoimmune hair loss, associated with substantial psychosocial burden. Alopecia areata is an autoimmune disease in which loss of immune privilege in hair follicles leads to local hair follicle-associated inflammation. A chronic disease with uncertain course that is estimated to affect 2% of people over their lifetime, alopecia areata can present with a range of clinical features, from a single small round patch of hair loss to full scalp and body hair loss, and is associated with atopic, autoimmune and psychological comorbidities. Alopecia areata also has a major negative impact on quality of life, with a greater mental burden than physical burden. Since the 2010s, advances in understanding of disease pathogenesis have led to the identification of inflammatory pathways that can be successfully inhibited to produce substantial clinical responses. The therapeutic landscape has been transformed, with FDA approval of the first treatment for adults with severe alopecia areata in 2022 and for adolescents with severe alopecia areata in 2023, with multiple investigational treatments currently in phase II and phase III clinical trials.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"77"},"PeriodicalIF":76.9,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459258","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}
Amy C Sherman, Glenda E Gray, Bin Cao, Kelvin K W To, Nadine Rouphael, Ana Maria Henao-Restrepo, Anthony C Gordon, Lindsey R Baden
{"title":"Acute SARS-CoV-2 infection.","authors":"Amy C Sherman, Glenda E Gray, Bin Cao, Kelvin K W To, Nadine Rouphael, Ana Maria Henao-Restrepo, Anthony C Gordon, Lindsey R Baden","doi":"10.1038/s41572-025-00662-x","DOIUrl":"10.1038/s41572-025-00662-x","url":null,"abstract":"<p><p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory pathogen that emerged in December 2019 and caused a global pandemic by March 2020, with >7 million deaths due to coronavirus disease 2019 (COVID-19) globally as of September 2025. The clinical syndrome of COVID-19 ranges from asymptomatic infection to severe disease with pneumonia and death. SARS-CoV-2 variant type, inoculum, previous exposure and host factors influence the clinical trajectory. Identification of key structural proteins of SARS-CoV-2 and insights into the pathophysiology of the immune response to infection led to the development of effective preventive (vaccines and monoclonal antibodies) and therapeutic (antivirals and immunomodulatory agents) agents. Antiviral agents, such as remdesivir and nirmatrelvir-ritonavir, inhibit viral replication and immunomodulatory agents, such as tocilizumab and baricitinib, act to reduce a dysregulated immune response to SARS-CoV-2. The pandemic had economic and socio-cultural consequences that affected the quality of life and overall life expectancy of individuals. As the emergency phase of the pandemic concludes, robust monitoring and surveillance systems must be sustained and research to improve vaccines and therapeutics must continue to maintain control of SARS-CoV-2 in the population and be prepared for emerging pathogens with pandemic potential.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"11 1","pages":"75"},"PeriodicalIF":76.9,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368386","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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