Nature Medicine最新文献

{"title":"Women twice as likely to develop Alzheimer’s disease as men — but scientists do not know why","authors":"Sofia Moutinho","doi":"10.1038/s41591-025-03564-3","DOIUrl":"10.1038/s41591-025-03564-3","url":null,"abstract":"Changes to the female brain during menopause, together with social and cultural factors, might affect disease risk.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"31 3","pages":"704-707"},"PeriodicalIF":58.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618345","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}

{"title":"The PREPARED Case Study App for deep reflection on research ethics challenges during crises","authors":"Doris Schroeder, Nearchos Paspallis, Nicos Kasenides, Kate Chatfield, Carly Seedall, Michelle Singh","doi":"10.1038/s41591-025-03549-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03549-2","url":null,"abstract":"<p>Allegiance to the Hippocratic Oath was once considered sufficient to ensure ethical conduct in medicine and health care. But in today’s world, healthcare professionals face unprecedented ethical dilemmas¹, from navigating mandatory COVID-19 vaccinations to addressing systemic racism in clinical care². Simultaneously, the systematic practice of medical research has a history that spans only about 300 years³, which has left room for evolution in ethical standards and practices.</p><p>One response to the challenge of new ethical dilemmas is new ethics guidance. For instance, during the COVID-19 pandemic, hundreds of new ethics codes and guidance documents were issued around the world in English alone⁴.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"19 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618346","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}

{"title":"Hospital admissions attributable to reduced air pollution due to clean-air policies in China","authors":"Huimeng Liu, Jian Lei, Yuewei Liu, Tong Zhu, Kahung Chan, Xi Chen, Jing Wei, Furong Deng, Ge Li, Yunxing Jiang, Lijun Bai, Kai Wang, Juan Chen, Yang Lan, Xi Xia, Jinxi Wang, Chen Wei, Yinxiang Li, Renjie Chen, Jicheng Gong, Xiaoli Duan, Kai Zhang, Haidong Kan, Xiaoming Shi, Xinbiao Guo, Shaowei Wu","doi":"10.1038/s41591-025-03515-y","DOIUrl":"https://doi.org/10.1038/s41591-025-03515-y","url":null,"abstract":"<p>The Air Pollution Prevention and Control Action Plan (APPCAP) is considered to be the most stringent air pollution control policy in China implemented since 2013. This policy is a milestone in China to mitigate serious air pollution. However, health benefits attributable to reduced fine-particulate air pollution after the implementation of the APPCAP have not been quantitatively estimated on a PM_2.5 constituent-specific and morbidity cause-specific basis. Here we conducted a nationwide case-crossover study based on hospital admission records in 292 Chinese cities during 2013-2017. Compared with 2013, the annual average concentrations of PM_2.5 and black carbon (BC) in 2017 decreased by 28.61% and 20.35%, respectively. As a result, the average relative reductions in annual attributable fractions of nine major cause-specific hospital admissions associated with PM_2.5 and BC were 30.00% and 21.14%, respectively, among which annual attributable fraction for depression showed the largest reduction. Nationally, cities with higher reductions in PM_2.5 and BC were found to have higher absolute reductions in annual hospital admission attributable fractions associated with PM_2.5 and BC, and geographic inequality in health benefits still existed. Our study highlights the substantial wide-ranging health benefits of reduced PM_2.5 and BC levels following the nationwide implementation of the APPCAP in China.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"10 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618347","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}

{"title":"Immune history shapes human antibody responses to H5N1 influenza viruses","authors":"Tyler A. Garretson, Jiaojiao Liu, Shuk Hang Li, Gabrielle Scher, Jefferson J. S. Santos, Glenn Hogan, Marcos Costa Vieira, Colleen Furey, Reilly K. Atkinson, Naiqing Ye, Jordan T. Ort, Kangchon Kim, Kevin A. Hernandez, Theresa Eilola, David C. Schultz, Sara Cherry, Sarah Cobey, Scott E. Hensley","doi":"10.1038/s41591-025-03599-6","DOIUrl":"https://doi.org/10.1038/s41591-025-03599-6","url":null,"abstract":"<p>Avian H5N1 influenza viruses are circulating widely in cattle and other mammals and pose a risk for a human pandemic. Previous studies suggest that older humans are more resistant to H5N1 infections due to childhood imprinting with other group 1 viruses (H1N1 and H2N2); however, the immunological basis for this is incompletely understood. Here we measured H5N1 antibody responses in sera from 157 individuals born between 1927 and 2016. We show that antibody titers to historical and recent H5N1 strains are highest in older individuals and correlate more strongly with birth year than with age, consistent with immune imprinting. Young children, who were likely not yet exposed to seasonal influenza viruses, had low levels of H5-specific antibodies. We also measured H5N1 antibody responses in sera from 100 individuals before and after receiving an A/Vietnam/1203/2004 H5N1 vaccine. We found that both younger and older humans produced H5-reactive antibodies to the A/Vietnam/1203/2004 vaccine strain and to a contemporary clade 2.3.4.4b strain, with higher seroconversion rates in young children who had lower levels of antibodies before vaccination. These studies suggest that younger individuals might benefit more from vaccination than older individuals in the event of an H5N1 pandemic.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"49 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143608241","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}

{"title":"A B7H3-targeting antibody–drug conjugate in advanced solid tumors: a phase 1/1b trial","authors":"Yuxiang Ma, Yunpeng Yang, Yan Huang, Wenfeng Fang, Jinhui Xue, Xiangjiao Meng, Yun Fan, Siqing Fu, Lin Wu, Yulong Zheng, Jian Liu, Zhihua Liu, Wu Zhuang, Seth Rosen, Song Qu, Bihui Li, Mingjun Li, Yanqiu Zhao, Shujun Yang, Yinghua Ji, David Sommerhalder, Suxia Luo, Kunyu Yang, Jingao Li, Dongqing Lv, Peng Zhang, Yuanyuan Zhao, Shaodong Hong, Yang Zhang, Shen Zhao, Steve Chin, Xian Zhang, Wei Lian, Jiaqiang Cai, Tongtong Xue, Li Zhang, Hongyun Zhao","doi":"10.1038/s41591-025-03600-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03600-2","url":null,"abstract":"<p>Antibody–drug conjugates (ADCs) have emerged as a transformative modality in the treatment of solid tumors. YL201, a novel B7H3-targeting ADC, leverages a tumor microenvironment activable linker-payload platform, coupled with a novel topoisomerase 1 inhibitor via a protease-cleavable linker. Here we report the findings from a large-scale, global, multicenter, phase 1 trial evaluating the safety, pharmacokinetics and preliminary efficacy of YL201 in patients with advanced solid tumors refractory to standard therapies. The trial included a dose-escalation part (phase 1) and a dose-expansion part (phase 1b). A total of 312 patients were enrolled across multiple tumor types, including extensive-stage small cell lung cancer (ES-SCLC), nasopharyngeal carcinoma (NPC), non-small cell lung cancer, esophageal squamous cell carcinoma and other solid tumors. The maximum tolerated dose was determined to be 2.8 mg kg⁻¹, and the recommended expansion dose was selected as 2.0 mg kg⁻¹ and 2.4 mg kg⁻¹ every 3 weeks. The most common grade 3 or higher treatment-related adverse events included neutropenia (31.7%), leukopenia (29.5%) and anemia (25.0%). Only 4 cases of interstitial lung disease (1.3%) and 1 case of infusion reactions (0.3%) were observed. Encouraging anti-tumor activity was observed, particularly in patients with ES-SCLC (objective response rate (ORR), 63.9%), NPC (ORR, 48.6%), lung adenocarcinoma (ORR, 28.6%) and lymphoepithelioma-like carcinoma (ORR, 54.2%). No significant correlation between B7H3 membrane expression and the ORR was found. YL201 demonstrated an acceptable safety profile and a promising efficacy in heavily pretreated patients with advanced solid tumors, particularly in those with ES-SCLC, NPC or lymphoepithelioma-like carcinoma. Phase 3 clinical trials for patients with SCLC and NPC have already been initiated. ClinicalTrials.gov identifiers: NCT05434234 and NCT06057922.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"14 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143608242","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}

{"title":"Medical progress for all","authors":"","doi":"10.1038/s41591-025-03634-6","DOIUrl":"10.1038/s41591-025-03634-6","url":null,"abstract":"In times of uncertainty, ensuring that medicine continues to evolve for the benefit of all must remain a global, shared priority.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"31 3","pages":"701-701"},"PeriodicalIF":58.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41591-025-03634-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of interactive text communication on neonatal mortality in Kenya: a randomized controlled trial","authors":"Jennifer A. Unger, John Kinuthia, Brenda Wandika, Anna Hedstrom, Erica Wetzler, Jenna I. Udren, Millicent Masinde, Esther M. Choo, Olivia Schultes, Peninah Kithao, June Moraa, Esther Akinyi, Lusi Osborn, Emmaculate Nzove, Barbra A. Richardson, Manasi Kumar, Dalton Wamalwa, Keshet Ronen","doi":"10.1038/s41591-025-03576-z","DOIUrl":"https://doi.org/10.1038/s41591-025-03576-z","url":null,"abstract":"<p>Text communication between newborns’ caregivers and healthcare workers allows for real-time decisional guidance; however, its impact on neonatal health outcomes is unknown. Mobile WACh NEO (MWACh NEO) was a parallel, unblinded and individually randomized controlled trial at six health facilities across Kenya. Pregnant women at 28–36 weeks gestation were randomized (1:1) to the MWACh NEO intervention or standard of care. MWACh NEO delivered automated maternal and neonatal health text messages to participants up to 6 weeks postpartum and allowed free text communication with a nurse. This trial sought to determine if text communication decreased neonatal mortality. The analysis was intention to treat. From September 2020 until June 2022, 5,020 participants were enrolled and randomized. One hundred and thirty-six participants were excluded because of incomplete mortality data, leaving 2,442 participants in each group for the analysis. Eighty-three neonatal deaths occurred for a neonatal mortality rate of 18.8 per 1,000 live births in the intervention group and 15.2 per 1,000 live births in the control group, with a risk ratio of 1.25 (0.81, 1.91), <i>P</i> = 0.31. No adverse events related to the intervention were reported. Text communication did not decrease neonatal mortality compared to standard of care. Most neonates died before discharge from the facility. ClinicalTrials.gov registration: NCT04598165.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"25 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599044","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}

{"title":"Cities, communities and clinics can be testbeds for human exposome and aging research","authors":"Tina Woods, Nic Palmarini, Lynne Corner, Nir Barzilai, Andrea B. Maier, Michael Sagner, Joanna Bensz, Alexey Strygin, Nikhil Yadala, Carina Kern, Peter Ward, Luigi Ferrucci, Evelyne Yehudit Bischof, Richard Barker, Paul G. Shiels, Gerome Guiot, Jennifer Monti, Jamie Justice, Brian K. Kennedy, David Furman","doi":"10.1038/s41591-025-03519-8","DOIUrl":"https://doi.org/10.1038/s41591-025-03519-8","url":null,"abstract":"Understanding the human exposome is now possible with clinics, communities and cities acting as real-world testbeds to understand what drives human healthspan, resilience and flourishing.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"55 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598889","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}

{"title":"Urgent call to close the gap in medical oxygen access","authors":"","doi":"10.1038/d41591-025-00018-8","DOIUrl":"https://doi.org/10.1038/d41591-025-00018-8","url":null,"abstract":"The Lancet Global Health Commission on medical oxygen security highlights catastrophic failures of governments and other stakeholders to provide equitable access to this lifesaving resource, and sets out recommendations to close the gap.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"7 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598926","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}

{"title":"Atlas of genetic and phenotypic associations across 42 female reproductive health diagnoses","authors":"Natàlia Pujol Gualdo, Jelisaveta Džigurski, Valentina Rukins, Fanny-Dhelia Pajuste, Brooke N. Wolford, Mariann Võsa, Mia Golob, Lisette Haug, Maris Alver, Kristi Läll, Maire Peters, Ben M. Brumpton, Priit Palta, Reedik Mägi, Triin Laisk","doi":"10.1038/s41591-025-03543-8","DOIUrl":"https://doi.org/10.1038/s41591-025-03543-8","url":null,"abstract":"<p>The genetic background of many female reproductive health diagnoses remains uncharacterized, compromising our understanding of the underlying biology. Here, we map the genetic architecture across 42 female-specific health conditions using data from up to 293,618 women from two large population-based cohorts, the Estonian Biobank and the FinnGen study. Our study illustrates the utility of genetic analyses in understanding women’s health better. As specific examples, we describe genetic risk factors for ovarian cysts that elucidate the genetic determinants of folliculogenesis and, by leveraging population-specific variants, uncover new candidate genes for uterine fibroids. We find that most female reproductive health diagnoses have a heritable component, with varying degrees of polygenicity and discoverability. Finally, we identify pleiotropic loci and genes that function in genital tract development (<i>WNT4</i>, <i>PAX8</i>, <i>WT1</i>, <i>SALL1</i>), hormonal regulation (<i>FSHB</i>, <i>GREB1</i>, <i>BMPR1B</i>, <i>SYNE1</i>/<i>ESR1</i>) and folliculogenesis (<i>CHEK2</i>), underlining their integral roles in female reproductive health.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"174 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589602","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}