Nature Medicine最新文献

{"title":"Extreme inequities in access to HIV treatment in Malawi","authors":"","doi":"10.1038/s41591-025-03676-w","DOIUrl":"https://doi.org/10.1038/s41591-025-03676-w","url":null,"abstract":"We identified major geographic inequities in the supply of, and need for, human immunodeficiency virus (HIV) medications in Malawi. These inequities have generated ‘HIV treatment deserts’ — areas with low access to a healthcare facility that provides HIV treatment. Approximately one quarter of people living with HIV in Malawi reside in one of these treatment deserts.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"1 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143832474","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":"Reprogramming the tumor immune microenvironment to treat glioblastoma","authors":"","doi":"10.1038/s41591-025-03636-4","DOIUrl":"https://doi.org/10.1038/s41591-025-03636-4","url":null,"abstract":"Johanna Joyce describes how disrupting tumor-associated macrophages showed the importance of the tumor microenvironment in treating cancer.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"116 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143832483","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":"Gene-edited pig liver successfully transplanted into human","authors":"","doi":"10.1038/d41591-025-00025-9","DOIUrl":"https://doi.org/10.1038/d41591-025-00025-9","url":null,"abstract":"The first pig liver to be transplanted into a human (in this case, a brain-dead recipient) showed sustained function without rejection — marking another step toward xenotransplantation as a viable approach to addressing the organ-shortage crisis.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"39 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827254","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":"Clinical translation of microbiome research","authors":"Jack A. Gilbert, Meghan B. Azad, Fredrik Bäckhed, Martin J. Blaser, Mariana Byndloss, Charles Y. Chiu, Hiutung Chu, Lara R. Dugas, Eran Elinav, Sean M. Gibbons, Katharine E. Gilbert, Matthew R. Henn, Suzanne L. Ishaq, Ruth E. Ley, Susan V. Lynch, Eran Segal, Tim D. Spector, Philip Strandwitz, Jotham Suez, Carolina Tropini, Katrine Whiteson, Rob Knight","doi":"10.1038/s41591-025-03615-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03615-9","url":null,"abstract":"<p>The landscape of clinical microbiome research has dramatically evolved over the past decade. By leveraging in vivo and in vitro experimentation, multiomic approaches and computational biology, we have uncovered mechanisms of action and microbial metrics of association and identified effective ways to modify the microbiome in many diseases and treatment modalities. This Review explores recent advances in the clinical application of microbiome research over the past 5 years, while acknowledging existing barriers and highlighting opportunities. We focus on the translation of microbiome research into clinical practice, spearheaded by Food and Drug Administration (FDA)-approved microbiome therapies for recurrent <i>Clostridioides difficile</i> infections and the emerging fields of microbiome-based diagnostics and therapeutics. We highlight key examples of studies demonstrating how microbiome mechanisms, metrics and modifiers can advance clinical practice. We also discuss forward-looking perspectives on key challenges and opportunities toward integrating microbiome data into routine clinical practice, precision medicine and personalized healthcare and nutrition.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"43 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818938","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":"Author Correction: Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults","authors":"Magda Bosch de Basea, Isabelle Thierry-Chef, Richard Harbron, Michael Hauptmann, Graham Byrnes, Maria-Odile Bernier, Lucian Le Cornet, Jérémie Dabin, Gilles Ferro, Tore S. Istad, Andreas Jahnen, Choonsik Lee, Carlo Maccia, Françoise Malchair, Hilde Olerud, Steven L. Simon, Jordi Figuerola, Anna Peiro, Hilde Engels, Christoffer Johansen, Maria Blettner, Magnus Kaijser, Kristina Kjaerheim, Amy Berrington de Gonzalez, Neige Journy, Johanna M. Meulepas, Monika Moissonnier, Arvid Nordenskjold, Roman Pokora, Cecile Ronckers, Joachim Schüz, Ausrele Kesminiene, Elisabeth Cardis","doi":"10.1038/s41591-025-03689-5","DOIUrl":"https://doi.org/10.1038/s41591-025-03689-5","url":null,"abstract":"<p>Correction to: <i>Nature Medicine</i> https://doi.org/10.1038/s41591-023-02620-0, published online 9 November 2023.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"11 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819464","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":"Impact of the ONCOBIOME network in cancer microbiome research","authors":"Laurence Zitvogel, Lisa Derosa, Bertrand Routy, Sibylle Loibl, Lucie Heinzerling, I. Jolanda M. de Vries, Lars Engstrand, Nicola Segata, Guido Kroemer","doi":"10.1038/s41591-025-03608-8","DOIUrl":"https://doi.org/10.1038/s41591-025-03608-8","url":null,"abstract":"<p>The European Union-sponsored ONCOBIOME network has spurred an international effort to identify and validate relevant gut microbiota-related biomarkers in oncology, generating a unique and publicly available microbiome resource. ONCOBIOME explores the effects of the microbiota on gut permeability and metabolism as well as on antimicrobial and antitumor immune responses. Methods for the diagnosis of gut dysbiosis have been developed based on oncomicrobiome signatures associated with the diagnosis, prognosis and treatment responses in patients with cancer. The mechanisms explaining how dysbiosis compromises natural or therapy-induced immunosurveillance have been explored. Through its integrative approach of leveraging multiple cohorts across populations, cancer types and stages, ONCOBIOME has laid the theoretical and practical foundations for the recognition of microbiota alterations as a hallmark of cancer. ONCOBIOME has launched microbiota-centered interventions and lobbies in favor of official guidelines for avoiding diet-induced or iatrogenic (for example, antibiotic- or proton pump inhibitor-induced) dysbiosis. Here, we review the key advances of the ONCOBIOME network and discuss the progress toward translating these into oncology clinical practice.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"108 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818937","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 cell atlas of human endometrium reveals key molecular and cellular alterations in PCOS","authors":"","doi":"10.1038/s41591-025-03672-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03672-0","url":null,"abstract":"A human cellular and molecular atlas of the proliferative endometrium in polycystic ovary syndrome (PCOS) was generated via single-nucleus RNA sequencing and spatial transcriptomics. This study reveals PCOS-specific alterations in cellular composition and gene expression, and identifies potential therapeutic targets. These findings could advance treatments for PCOS-related endometrial dysfunction and associated health challenges.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"106 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818941","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 WHO aims for financial stability despite US exit","authors":"","doi":"10.1038/s41591-025-03649-z","DOIUrl":"https://doi.org/10.1038/s41591-025-03649-z","url":null,"abstract":"The World Health Organization’s inaugural Investment Round aims to instill stability in the face of global health headwinds and a US exit.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"12 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819398","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":"IVF versus ICSI in patients without severe male factor infertility: a randomized clinical trial","authors":"Sine Berntsen, Anne Zedeler, Bugge Nøhr, Morten Rønn Petersen, Marie Louise Grøndahl, Lars Franch Andersen, Kristine Løssl, Ellen Løkkegaard, Anne Lis Englund, Anette Vestergaard Gabrielsen, Lisbeth Prætorius, Ida Behrendt-Møller, Lea Langhoff Thuesen, Kilian Vomstein, Mette Petri Lauritsen, Aleksandra Ivanoska Trajcevski, Dea Frøding Skipper, David Westergaard, Anja Pinborg, Henriette Svarre Nielsen, Nina la Cour Freiesleben","doi":"10.1038/s41591-025-03621-x","DOIUrl":"https://doi.org/10.1038/s41591-025-03621-x","url":null,"abstract":"<p>Intracytoplasmic sperm injection (ICSI) and conventional in vitro fertilization (c-IVF) are widely used fertilization techniques in assisted reproduction, but their relative effectiveness in patients without severe male factor infertility remains debated. While ICSI’s role in couples with severe male factor infertility is well established, its routine use in cases with normal or nonseverely decreased sperm quality is not evidence-based. Here we conducted the INVICSI study, an open-label, multicenter randomized controlled trial, to compare cumulative live birth rates (CLBR) as the primary outcome between ICSI and c-IVF in patients without severe male factor infertility. Between November 2019 and December 2022, 824 women undergoing their first IVF cycle were randomized to ICSI (<i>n</i> = 414) or c-IVF (<i>n</i> = 410) across six public fertility clinics in Denmark. The CLBR was 43.2% (179/414) in the ICSI group and 47.3% (193/408) in the c-IVF group, yielding a risk ratio of 0.91 (95% confidence interval, 0.79–1.06). These findings demonstrate that ICSI does not improve CLBR compared to c-IVF and support c-IVF as the preferred first-line treatment for patients with normal or nonseverely decreased sperm quality. ICSI should be reserved for severe male factor infertility. ClinicalTrials.gov registration: NCT04128904.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"4 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818940","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":"Sacituzumab tirumotecan in previously treated metastatic triple-negative breast cancer: a randomized phase 3 trial","authors":"Yongmei Yin, Ying Fan, Quchang Ouyang, Lihua Song, Xiaojia Wang, Wei Li, Man Li, Xi Yan, Shusen Wang, Tao Sun, Yuee Teng, Xianjun Tang, Zhongsheng Tong, Zhengkui Sun, Junyou Ge, Xiaoping Jin, Yina Diao, Gesha Liu, Binghe Xu","doi":"10.1038/s41591-025-03630-w","DOIUrl":"https://doi.org/10.1038/s41591-025-03630-w","url":null,"abstract":"<p>Chemotherapy remains a standard treatment option for metastatic triple-negative breast cancer (TNBC) but is associated with limited survival. Although some targeted antibody–drug conjugates have demonstrated clinical benefits and are considered standard therapy, persistent unmet medical needs remain due to varying accessibility. The OptiTROP-Breast01 phase 3 trial assessed sacituzumab tirumotecan (sac-TMT) versus chemotherapy in patients with locally recurrent or metastatic TNBC who had received two or more prior therapies, including at least one for metastatic disease. Patients were randomized to sac-TMT (<i>n</i> = 130) or chemotherapy (<i>n</i> = 133). The primary endpoint of progression-free survival (PFS) by blinded independent central review (BICR) was met based on the protocol-specified interim analysis. At final analysis, the median PFS by BICR was 6.7 (95% confidence interval (CI), 5.5–8.0) months with sac-TMT and 2.5 (95% CI, 1.7–2.7) months with chemotherapy (hazard ratio (HR), 0.32; 95% CI, 0.24–0.44; <i>P</i> &lt; 0.00001). Concurrently, at the protocol-specified interim analysis for overall survival (OS), the median OS was not reached (95% CI, 11.2 months to not estimable (NE)) with sac-TMT and 9.4 (95% CI, 8.5–11.7) months with chemotherapy (HR, 0.53; 95% CI, 0.36–0.78; <i>P</i> = 0.0005). The percentage of patients with an objective response was 45.4% with sac-TMT and 12.0% with chemotherapy. The median duration of response was 7.1 (95% CI, 5.6–NE) months with sac-TMT and 3.0 (95% CI, 2.5–NE) months with chemotherapy. The most common treatment-related adverse event with sac-TMT was hematologic toxicity. Sac-TMT demonstrated statistically significant and clinically meaningful improvements in PFS compared to chemotherapy, with a manageable safety profile. The study findings support sac-TMT as an additional effective treatment option for pretreated metastatic TNBC. ClinicalTrials.gov identifier: NCT05347134.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"23 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818939","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}