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Deep phenotyping of health–disease continuum in the Human Phenotype Project 人类表型计划中健康-疾病连续体的深度表型
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-15 DOI: 10.1038/s41591-025-03790-9
Lee Reicher, Smadar Shilo, Anastasia Godneva, Guy Lutsker, Liron Zahavi, Saar Shoer, David Krongauz, Michal Rein, Sarah Kohn, Tomer Segev, Yishay Schlesinger, Daniel Barak, Zachary Levine, Ayya Keshet, Rotem Shaulitch, Maya Lotan-Pompan, Matan Elkan, Yeela Talmor-Barkan, Yaron Aviv, Maya Dadiani, Yonatan Tsodyks, Einav Nili Gal-Yam, Haim Leibovitzh, Lael Werner, Roie Tzadok, Nitsan Maharshak, Shin Koga, Yulia Glick-Gorman, Chani Stossel, Maria Raitses-Gurevich, Talia Golan, Raja Dhir, Yotam Reisner, Adina Weinberger, Hagai Rossman, Le Song, Eric P. Xing, Eran Segal
{"title":"Deep phenotyping of health–disease continuum in the Human Phenotype Project","authors":"Lee Reicher, Smadar Shilo, Anastasia Godneva, Guy Lutsker, Liron Zahavi, Saar Shoer, David Krongauz, Michal Rein, Sarah Kohn, Tomer Segev, Yishay Schlesinger, Daniel Barak, Zachary Levine, Ayya Keshet, Rotem Shaulitch, Maya Lotan-Pompan, Matan Elkan, Yeela Talmor-Barkan, Yaron Aviv, Maya Dadiani, Yonatan Tsodyks, Einav Nili Gal-Yam, Haim Leibovitzh, Lael Werner, Roie Tzadok, Nitsan Maharshak, Shin Koga, Yulia Glick-Gorman, Chani Stossel, Maria Raitses-Gurevich, Talia Golan, Raja Dhir, Yotam Reisner, Adina Weinberger, Hagai Rossman, Le Song, Eric P. Xing, Eran Segal","doi":"10.1038/s41591-025-03790-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03790-9","url":null,"abstract":"<p>The Human Phenotype Project (HPP) is a large-scale deep-phenotype prospective cohort. To date, approximately 28,000 participants have enrolled, with more than 13,000 completing their initial visit. The project is aimed at identifying novel molecular signatures with diagnostic, prognostic and therapeutic value, and at developing artificial intelligence (AI)-based predictive models for disease onset and progression. The HPP includes longitudinal profiling encompassing medical history, lifestyle and nutrition, anthropometrics, blood tests, continuous glucose and sleep monitoring, imaging and multi-omics data, including genetics, transcriptomics, microbiome (gut, vaginal and oral), metabolomics and immune profiling. Analysis of these data highlights the variation of phenotypes with age and ethnicity and unravels molecular signatures of disease by comparison with matched healthy controls. Leveraging extensive dietary and lifestyle data, we identify associations between lifestyle factors and health outcomes. Finally, we present a multi-modal foundation AI model, trained using self-supervised learning on diet and continuous-glucose-monitoring data, that outperforms existing methods in predicting disease onset. This framework can be extended to integrate other modalities and act as a personalized digital twin. In summary, we present a deeply phenotyped cohort that serves as a platform for advancing biomarker discovery, enabling the development of multi-modal AI models and personalized medicine approaches.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"200 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629651","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}
引用次数: 0
A tipping point for kidney xenotransplantation 异种肾脏移植的转折点
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-14 DOI: 10.1038/s41591-025-03855-9
{"title":"A tipping point for kidney xenotransplantation","authors":"","doi":"10.1038/s41591-025-03855-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03855-9","url":null,"abstract":"Transplantation of pig kidneys into patients is entering clinical trials, but important scientific questions need to be addressed before kidney xenotransplantation can become an everyday clinical reality.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"7 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622350","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}
引用次数: 0
The exposome of healthy and accelerated aging across 40 countries 健康和加速老龄化在40个国家的暴露
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-14 DOI: 10.1038/s41591-025-03808-2
Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilner, Francesca R. Farina, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Raul Gonzalez-Gomez, Joaquín Migeot, Carlos Coronel-Oliveros, Enzo Tagliazucchi, Marcelo Adrián Maito, María E. Godoy, Josephine Cruzat, Ahmed Shaheen, Temitope Farombi, Daniel Salazar, Lucas Uglione Da Ros, Wyllians V. Borelli, Eduardo R. Zimmer, Alfred K. Njamnshi, Swati Bajpai, A. B. Dey, Cyprian Mostert, Zul Merali, Mohamed Salama, Sara A. Moustafa, Sol Fittipaldi, Florencia Altschuler, Vicente Medel, David Huepe, Kristine Yaffe, Chinedu Momoh, Harris A. Eyre, Pawel Swieboda, Brian Lawlor, J. Jaime Miranda, Claudia Duran-Aniotz, Sandra Baez, Agustin Ibanez
{"title":"The exposome of healthy and accelerated aging across 40 countries","authors":"Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilner, Francesca R. Farina, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Raul Gonzalez-Gomez, Joaquín Migeot, Carlos Coronel-Oliveros, Enzo Tagliazucchi, Marcelo Adrián Maito, María E. Godoy, Josephine Cruzat, Ahmed Shaheen, Temitope Farombi, Daniel Salazar, Lucas Uglione Da Ros, Wyllians V. Borelli, Eduardo R. Zimmer, Alfred K. Njamnshi, Swati Bajpai, A. B. Dey, Cyprian Mostert, Zul Merali, Mohamed Salama, Sara A. Moustafa, Sol Fittipaldi, Florencia Altschuler, Vicente Medel, David Huepe, Kristine Yaffe, Chinedu Momoh, Harris A. Eyre, Pawel Swieboda, Brian Lawlor, J. Jaime Miranda, Claudia Duran-Aniotz, Sandra Baez, Agustin Ibanez","doi":"10.1038/s41591-025-03808-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03808-2","url":null,"abstract":"<p>Protective and risk factors can drive healthy or accelerated aging, with distinct environments modulating their effects. The impact of the exposome—the combined physical and social exposures experienced throughout life—on accelerated aging remains unknown. We assessed delayed and accelerated aging in 161,981 participants from 40 countries (45.09% female; mean age, 67.06; s.d., 9.85) by measuring biobehavioral age gaps (BBAGs), defined as the difference between estimated age from protective and risk factors and chronological age, in cross-sectional and longitudinal designs. BBAGs predicted chronological age, followed by regional and exposomal factor analyses, linked to accelerated aging. Europe led in healthy aging, while Egypt and South Africa showed the greatest acceleration; Asia and Latin America fell in between (Cliff’s delta (δ<i>d</i>) = 0.15–0.52; all <i>P</i> &lt; 0.0001). Accelerated aging was more evident in eastern and southern Europe; globally, it was also associated with lower income (δ<i>d</i> = 0.48–0.56, <i>P</i> &lt; 1 × 10<sup>−15</sup>). Exposomal factors of accelerated aging include physical (air quality), social (socioeconomic and gender inequality, migration) and sociopolitical (representation, party freedom, suffrage, elections and democracy) determinants (all Cohen’s <i>d</i> (<i>d</i>) &gt; 0.37, <i>P</i> &lt; 0.0001). BBAGs predicted future functional (<i>r</i> (Pearson correlation) = −0.33, <i>P</i> &lt; 1 × 10<sup>−15</sup>, <i>d</i> = 0.70) and cognitive declines (<i>r</i> = −0.22, <i>P</i> &lt; 1 × 10<sup>−15</sup>, <i>d</i> = 0.44), and larger BBAGs (<i>P</i> &lt; 0.0001, <i>d</i> = 1.55). Healthy and accelerated aging are influenced by physical, social and sociopolitical exposomes, with considerable disparities across nations.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"7 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629655","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}
引用次数: 0
Reshaping transplantation with AI, emerging technologies and xenotransplantation 用人工智能、新兴技术和异种移植重塑移植
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-14 DOI: 10.1038/s41591-025-03801-9
Alexandre Loupy, Evgenia Preka, Xiangmei Chen, Haibo Wang, Jianxing He, Kang Zhang
{"title":"Reshaping transplantation with AI, emerging technologies and xenotransplantation","authors":"Alexandre Loupy, Evgenia Preka, Xiangmei Chen, Haibo Wang, Jianxing He, Kang Zhang","doi":"10.1038/s41591-025-03801-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03801-9","url":null,"abstract":"<p>Organ transplantation remains the sole definitive treatment for many forms of end-stage organ failure, yet donor organ shortages impose life-threatening delays for thousands of patients worldwide. Mechanical supports and dialysis provide only temporary respite, while lifelong immunosuppression poses additional risks—including infections, malignancies and considerable healthcare costs. Recent innovations hold promise for overcoming these barriers. Artificial intelligence tools increasingly guide organ allocation decisions by integrating clinical, demographic and immunological data. They also refine rejection monitoring, personalize immunosuppressive regimens and facilitate virtual patient simulations. Meanwhile, xenotransplantation has progressed through multi-gene editing of donor pigs and improved immunosuppressive protocols, edging closer to mitigating hyperacute rejection in kidney, heart and liver grafts. In parallel, regenerative medicine approaches—spanning stem cell therapies, three-dimensional organoids and three-dimensional bioprinting—are poised to create patient-specific tissues that reduce rejection and enhance graft longevity. Biomaterials and cell encapsulation further offer localized immunosuppression, potentially streamlining post-transplant care. Yet widespread clinical adoption requires rigorous validation, ethical frameworks and interdisciplinary collaboration. By combining artificial intelligence-guided diagnostics, innovative organ engineering and advanced immunotherapies, transplant medicine can progress toward a future in which organ scarcity is alleviated, patient outcomes are optimized and healthcare systems operate with greater efficiency.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"151 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622299","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}
引用次数: 0
The UBE3A-ATS antisense oligonucleotide rugonersen in children with Angelman syndrome: a phase 1 trial UBE3A-ATS反义寡核苷酸rugonersen用于Angelman综合征儿童:1期试验
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-11 DOI: 10.1038/s41591-025-03784-7
Jörg F. Hipp, Carlos A. Bacino, Lynne M. Bird, Ina Bruenig-Traebert, Daniel Chan, Marie Claire de Wit, Paulo Fontoura, Gregory Hooper, Ravi Jagasia, Michelle L. Krishnan, Lorraine Murtagh, Alessandro Noci, Ana Roche Martínez, Dietmar Schwab, Mercedes Serrano, Mark D. Shen, Julian Tillmann, Jorrit Tjeertes, Brenda Vincenzi, Elizabeth Berry-Kravis, Azad Bonni
{"title":"The UBE3A-ATS antisense oligonucleotide rugonersen in children with Angelman syndrome: a phase 1 trial","authors":"Jörg F. Hipp, Carlos A. Bacino, Lynne M. Bird, Ina Bruenig-Traebert, Daniel Chan, Marie Claire de Wit, Paulo Fontoura, Gregory Hooper, Ravi Jagasia, Michelle L. Krishnan, Lorraine Murtagh, Alessandro Noci, Ana Roche Martínez, Dietmar Schwab, Mercedes Serrano, Mark D. Shen, Julian Tillmann, Jorrit Tjeertes, Brenda Vincenzi, Elizabeth Berry-Kravis, Azad Bonni","doi":"10.1038/s41591-025-03784-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03784-7","url":null,"abstract":"<p>Angelman syndrome (AS) is a severe genetic neurodevelopmental disorder with no disease-modifying treatments. AS is caused by deletion or mutation of the neuronally imprinted gene encoding the ubiquitin-protein ligase E3A (UBE3A). Rugonersen (RO7248824) is an antisense oligonucleotide that reinstates <i>UBE3A</i> by derepressing the silenced paternal allele. TANGELO was a phase 1, multicenter, open-label, multiple-ascending-dose trial with a long-term extension to investigate the safety and tolerability (primary) and pharmacokinetics (secondary) of rugonersen in children aged 1–12 years with AS (<i>n</i> = 61, F/M: 28/33). Key exploratory endpoints assessing changes following rugonersen treatment were electroencephalogram <i>δ</i>-power (2–4 Hz) and domains of the Bayley Scales of Infant and Toddler Development—Third Edition and Vineland Adaptive Behavior Scales—Third Edition. The primary endpoint was met; rugonersen had an acceptable safety and tolerability profile. Analysis of exploratory endpoints showed that rugonersen led to a dose-dependent partial normalization of the AS-associated electroencephalogram abnormality and revealed signals of clinical improvement in core AS symptom domains beyond expectation from natural history data. The results of the primary study objective support continued development of rugonersen for AS. ClinicalTrials.gov registration: NCT04428281.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"4 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603725","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}
引用次数: 0
Targeting the angiopoietin-like protein 3/8 complex with a monoclonal antibody in patients with mixed hyperlipidemia: a phase 1 trial 针对混合高脂血症患者的血管生成素样蛋白3/8复合物的单克隆抗体:一项1期试验
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-10 DOI: 10.1038/s41591-025-03830-4
Daniel Gaudet, Malgorzata Gonciarz, Xi Shen, Jennifer K. Leohr, Thomas P. Beyer, Jonathan W. Day, Garrett R. Mullins, Eugene Y. Zhen, Maryalice Hartley, Miriam Larouche, Robert J. Konrad, Olivier Benichou, Giacomo Ruotolo
{"title":"Targeting the angiopoietin-like protein 3/8 complex with a monoclonal antibody in patients with mixed hyperlipidemia: a phase 1 trial","authors":"Daniel Gaudet, Malgorzata Gonciarz, Xi Shen, Jennifer K. Leohr, Thomas P. Beyer, Jonathan W. Day, Garrett R. Mullins, Eugene Y. Zhen, Maryalice Hartley, Miriam Larouche, Robert J. Konrad, Olivier Benichou, Giacomo Ruotolo","doi":"10.1038/s41591-025-03830-4","DOIUrl":"https://doi.org/10.1038/s41591-025-03830-4","url":null,"abstract":"<p>The angiopoietin-like protein 3/8 complex (ANGPTL3/8) inhibits lipoprotein lipase (LPL) activity, primarily in oxidative tissues, and does so more potently than ANGPTL3, making ANPTL3/8 an attractive target for treating dyslipidemia. This study enrolled 48 adults (36 men, 12 women) with mixed hyperlipidemia to assess the primary outcome of safety and the secondary outcomes of pharmacokinetics and pharmacodynamics of ascending doses of LY3475766, a human monoclonal antibody that specifically blocks ANGPTL3/8-mediated inhibition of LPL activity. Participants received a single dose of LY3475766 or placebo. LY3475766 was well tolerated with no severe adverse events or adverse event-related discontinuations. Compared with placebo, LY3475766 dose-dependently reduced the concentration of triglycerides (−70%), remnant cholesterol (−86%), low-density lipoprotein cholesterol (−32%), non-high-density lipoprotein cholesterol (non-HDL-C) (−35%) and apolipoprotein B (−29%) while increasing HDL-C (+27%). LY3475766 thus significantly reduced atherogenic lipoprotein levels while increasing HDL-C levels; however, the effects on cardiovascular risk remain to be established. ClinicalTrials.gov registration: NCT04052594.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"65 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593865","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}
引用次数: 0
Mapping circulating hematopoietic stem cells for non-invasive, blood-based diagnostics 为非侵入性血液诊断绘制循环造血干细胞图谱
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-10 DOI: 10.1038/s41591-025-03803-7
{"title":"Mapping circulating hematopoietic stem cells for non-invasive, blood-based diagnostics","authors":"","doi":"10.1038/s41591-025-03803-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03803-7","url":null,"abstract":"A single-cell-resolution reference atlas of circulating hematopoietic stem and progenitor cells from healthy people reveals variations in cell-population frequencies and transcriptional profiles associated with age and sex. This atlas enables non-invasive diagnosis, risk stratification and follow-up of hematological conditions using peripheral blood, offering a potential alternative to bone marrow sampling.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"22 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594197","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}
引用次数: 0
A bispecific antibody–drug conjugate targeting EGFR and HER3 in metastatic esophageal squamous cell carcinoma: a phase 1b trial 一种针对转移性食管鳞状细胞癌中EGFR和HER3的双特异性抗体-药物偶联物:一项1b期试验
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-10 DOI: 10.1038/s41591-025-03792-7
Chang Liu, Dan Liu, Yinghua Ji, Meili Sun, Shegan Gao, Xuelei Ma, Diansheng Zhong, Ji Zhu, Yanshuo Cao, Changsong Qi, Miao Zhang, Panpan Zhang, Ran Xue, Zhi Peng, Jun Zhou, Sai Ge, Ming Lu, Jiajia Yuan, Yakun Wang, Zhenghang Wang, Jian Li, Xiaotian Zhang, Yi Zhu, Hai Zhu, Sa Xiao, Jifang Gong, Lin Shen, Zhihao Lu
{"title":"A bispecific antibody–drug conjugate targeting EGFR and HER3 in metastatic esophageal squamous cell carcinoma: a phase 1b trial","authors":"Chang Liu, Dan Liu, Yinghua Ji, Meili Sun, Shegan Gao, Xuelei Ma, Diansheng Zhong, Ji Zhu, Yanshuo Cao, Changsong Qi, Miao Zhang, Panpan Zhang, Ran Xue, Zhi Peng, Jun Zhou, Sai Ge, Ming Lu, Jiajia Yuan, Yakun Wang, Zhenghang Wang, Jian Li, Xiaotian Zhang, Yi Zhu, Hai Zhu, Sa Xiao, Jifang Gong, Lin Shen, Zhihao Lu","doi":"10.1038/s41591-025-03792-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03792-7","url":null,"abstract":"<p>Research on patients with advanced esophageal squamous cell carcinoma (ESCC) who have progressed on immunotherapy remains limited. BL-B01D1 is a first-in-class antibody–drug conjugate consisting of an EGFR–HER3 bispecific antibody bound to a topoisomerase I inhibitor (Ed-04) payload via a cleavable linker. Here, we present safety and efficacy data from a phase 1 study of BL-B01D1, in 82 patients previously treated for ESCC. The primary endpoint was the recommended phase 2 dose. Administered doses were 2.0 (<i>n</i> = 22) and 2.5 (<i>n</i> = 60) mg kg<sup>−1</sup> D1D8 infusion every 3 weeks (Q3W). The confirmed objective response rate (cORR) was 29.3% (24 of 82) in all patients and 32.9% (24 of 73) among evaluable patients. For patients dosed at 2.5 mg kg<sup>−1</sup>, cORR was 39.6% (21 of 53) and disease control rate was 79.2% (42 of 53). In the 2.0 mg kg<sup>−1</sup> group, cORR was 15.0% (3 of 20), and the disease control rate was 50.0% (10 of 20). The phase 2 dose was established at 2.5 mg kg<sup>−1</sup> D1D8 Q3W. The incidence of G3 treatment-related adverse events at 2.5 mg kg<sup>−1</sup> was 63.3%; most common adverse events were anemia (28.3%), leukopenia and thrombocytopenia (18.3%, each), and neutropenia (16.7%). Two cases of ≥G3 interstitial lung disease were observed. Overall, BL-B01D1 demonstrated promising efficacy and manageable safety in patients with metastatic ESCC. A further phase 3 clinical trial has already been initiated. ClinicalTrials.gov registration: NCT05262491.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"697 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593864","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}
引用次数: 0
Plasma proteomics links brain and immune system aging with healthspan and longevity 血浆蛋白质组学将大脑和免疫系统老化与健康寿命联系起来
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-09 DOI: 10.1038/s41591-025-03798-1
Hamilton Se-Hwee Oh, Yann Le Guen, Nimrod Rappoport, Deniz Yagmur Urey, Amelia Farinas, Jarod Rutledge, Divya Channappa, Anthony D. Wagner, Elizabeth Mormino, Anne Brunet, Michael D. Greicius, Tony Wyss-Coray
{"title":"Plasma proteomics links brain and immune system aging with healthspan and longevity","authors":"Hamilton Se-Hwee Oh, Yann Le Guen, Nimrod Rappoport, Deniz Yagmur Urey, Amelia Farinas, Jarod Rutledge, Divya Channappa, Anthony D. Wagner, Elizabeth Mormino, Anne Brunet, Michael D. Greicius, Tony Wyss-Coray","doi":"10.1038/s41591-025-03798-1","DOIUrl":"https://doi.org/10.1038/s41591-025-03798-1","url":null,"abstract":"<p>Plasma proteins derived from specific organs can estimate organ age and mortality, but their sensitivity to environmental factors and their robustness in forecasting onset of organ diseases and mortality remain unclear. To address this gap, we estimate the biological age of 11 organs using plasma proteomics data (2,916 proteins) from 44,498 individuals in the UK Biobank. Organ age estimates were sensitive to lifestyle factors and medications and were associated with future onset (within 17 yearsʼ follow-up) of a range of diseases, including heart failure, chronic obstructive pulmonary disease, type 2 diabetes and Alzheimer’s disease. Notably, having an especially aged brain posed a risk of Alzheimer’s disease (hazard ratio (HR) = 3.1) that was similar to carrying one copy of <i>APOE4</i>, the strongest genetic risk factor for sporadic Alzheimer’s disease, whereas a youthful brain (HR = 0.26) provided protection that was similar to carrying two copies of <i>APOE2</i>, independent of <i>APOE</i> genotype. Accrual of aged organs progressively increased mortality risk (2–4 aged organs, HR = 2.3; 5–7 aged organs, HR = 4.5; 8+ aged organs, HR = 8.3), whereas youthful brains and immune systems were uniquely associated with longevity (youthful brain, HR = 0.60 for mortality risk; youthful immune system, HR = 0.58; youthful both, HR = 0.44). Altogether, these findings support the use of plasma proteins for monitoring of organ health and point to the brain and immune systems as key targets for longevity interventions.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"91 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586597","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}
引用次数: 0
Real-world deployment of a fine-tuned pathology foundation model for lung cancer biomarker detection 真实世界部署微调病理基础模型肺癌生物标志物检测
IF 82.9 1区 医学
Nature Medicine Pub Date : 2025-07-09 DOI: 10.1038/s41591-025-03780-x
Gabriele Campanella, Neeraj Kumar, Swaraj Nanda, Siddharth Singi, Eugene Fluder, Ricky Kwan, Silke Muehlstedt, Nicole Pfarr, Peter J. Schüffler, Ida Häggström, Noora Neittaanmäki, Levent M. Akyürek, Alina Basnet, Tamara Jamaspishvili, Michel R. Nasr, Matthew M. Croken, Fred R. Hirsch, Arielle Elkrief, Helena Yu, Orly Ardon, Gregory M. Goldgof, Meera Hameed, Jane Houldsworth, Maria Arcila, Thomas J. Fuchs, Chad Vanderbilt
{"title":"Real-world deployment of a fine-tuned pathology foundation model for lung cancer biomarker detection","authors":"Gabriele Campanella, Neeraj Kumar, Swaraj Nanda, Siddharth Singi, Eugene Fluder, Ricky Kwan, Silke Muehlstedt, Nicole Pfarr, Peter J. Schüffler, Ida Häggström, Noora Neittaanmäki, Levent M. Akyürek, Alina Basnet, Tamara Jamaspishvili, Michel R. Nasr, Matthew M. Croken, Fred R. Hirsch, Arielle Elkrief, Helena Yu, Orly Ardon, Gregory M. Goldgof, Meera Hameed, Jane Houldsworth, Maria Arcila, Thomas J. Fuchs, Chad Vanderbilt","doi":"10.1038/s41591-025-03780-x","DOIUrl":"https://doi.org/10.1038/s41591-025-03780-x","url":null,"abstract":"<p>Artificial intelligence models using digital histopathology slides stained with hematoxylin and eosin offer promising, tissue-preserving diagnostic tools for patients with cancer. Despite their advantages, their clinical utility in real-world settings remains unproven. Assessing EGFR mutations in lung adenocarcinoma demands rapid, accurate and cost-effective tests that preserve tissue for genomic sequencing. PCR-based assays provide rapid results but with reduced accuracy compared with next-generation sequencing and require additional tissue. Computational biomarkers leveraging modern foundation models can address these limitations. Here we assembled a large international clinical dataset of digital lung adenocarcinoma slides (<i>N</i> = 8,461) to develop a computational EGFR biomarker. Our model fine-tunes an open-source foundation model, improving task-specific performance with out-of-center generalization and clinical-grade accuracy on primary and metastatic specimens (mean area under the curve: internal 0.847, external 0.870). To evaluate real-world clinical translation, we conducted a prospective silent trial of the biomarker on primary samples, achieving an area under the curve of 0.890. The artificial-intelligence-assisted workflow reduced the number of rapid molecular tests needed by up to 43% while maintaining the current clinical standard performance. Our retrospective and prospective analyses demonstrate the real-world clinical utility of a computational pathology biomarker.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"21 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586599","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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