Nature Reviews Urology最新文献

{"title":"Chemotherapy-induced tumour pyroptosis affects distal haematopoiesis to elevate NLR","authors":"Louise Lloyd","doi":"10.1038/s41585-026-01184-1","DOIUrl":"10.1038/s41585-026-01184-1","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 10","pages":"640-640"},"PeriodicalIF":13.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795723","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":"Unconventional T cells in urological cancers: catch them if you can.","authors":"Amber D Bowler, Sylvain Nguyen, Sonia Domingos-Pereira, Ilaria Lucca, Laurent Derré","doi":"10.1038/s41585-026-01178-z","DOIUrl":"https://doi.org/10.1038/s41585-026-01178-z","url":null,"abstract":"<p><p>Unconventional T cells - including γδ T cells, mucosal-associated invariant T cells, natural killer T cells, double-positive (CD4⁺CD8⁺) and double-negative (CD4^- CD8^-) T lymphocytes - are an underexplored component of immune surveillance in urological cancers. Unlike conventional αβ T cells, these populations recognize mainly non-peptidic antigens independently of classic major histocompatibility complex restriction, enabling rapid responses to cellular stress, microbial cues and metabolic dysregulation within tissues and the tumour microenvironment. Emerging evidence suggests that each subset exhibits context-dependent behaviour across prostate cancer, bladder cancer and renal cell carcinoma, ranging from cytotoxic to immunoregulatory. Together, these unconventional T cell subsets offer a foundation for novel diagnostic and therapeutic strategies. Combination approaches currently in clinical trials that integrate checkpoint blockade, adoptive cell transfer or Bacillus Calmette-Guérin-based immunotherapy could be guided by emerging insights into how these cells recognize or are shaped by tumour cells. Research in mechanistic and translational studies involving unconventional T cells is gaining momentum and could ultimately redefine immune targeting in urological cancers.</p>","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713328","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":"Integrating clinically actionable biomarkers into bladder cancer care - recommendations from the International Bladder Cancer Group.","authors":"Patrick J Hensley, Jeremy Y C Teoh, Roger Li, Shilpa Gupta, Laura Bukavina, Kent W Mouw, Niyati Lobo, Brigida Anna Maiorano, Wei Shen Tan, Piyush Agarwal, Hikmat A Al-Ahmadie, Trinity J Bivalacqua, Liang Cheng, Thomas W Flaig, Charles C Guo, Amir Horowitz, Wassim Kassouf, Max R Kates, Badrinath R Konety, Janet B Kukreja, Yair Lotan, David J McConkey, Laura S Mertens, Maria Carmen Mir, Marco Moschini, Andrea Necchi, Karima Oualla, Vignesh T Packiam, Bogdana Schmidt, Roger J Buckley, Ashish M Kamat","doi":"10.1038/s41585-026-01179-y","DOIUrl":"https://doi.org/10.1038/s41585-026-01179-y","url":null,"abstract":"<p><p>Crucial unmet needs for standardization and clinical integration of actionable biomarkers persist across the bladder cancer disease spectrum. To address these gaps, the International Bladder Cancer Group (IBCG) convened a global multidisciplinary panel to develop evidence-based consensus recommendations on biomarker use in bladder cancer. Recommendations were formulated across the disease spectrum using a modified Delphi process. In patients with asymptomatic microhaematuria, biomarker use should be guided by a risk-stratified approach. For patients with established non-muscle-invasive bladder cancer, no biomarker prospectively validated is available to guide intravesical therapy selection, although approved commercial tests might aid in adjudicating equivocal cytology or cystoscopy findings in patients with high-grade disease. In muscle-invasive bladder cancer, no validated biomarkers exist to guide the choice between bladder preservation and radical cystectomy, or to inform the choice of neoadjuvant therapy. Circulating tumour DNA is prognostic following neoadjuvant therapy and radical cystectomy, and provides predictive value for selecting patients who are most likely to benefit from adjuvant treatment with approved immunotherapy regimens. In addition, circulating tumour DNA has prognostic value in patients with metastatic urothelial carcinoma. The IBCG recommends assessing FGFR3 genomic alterations and HER2 immunohistochemistry in patients with locally advanced and/or metastatic bladder cancer to inform therapeutic selection. The IBCG consensus recommendations provide practical, stage-specific guidance on the use of biomarkers for diagnosis, risk stratification and treatment selection in patients with bladder cancer and define priorities for future validation and trial design.</p>","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679467","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":"Routine testosterone screening in military personnel: an opportunity for evidence-based implementation in men's health.","authors":"Mohamed Mubarak, Vaibhav Modgil","doi":"10.1038/s41585-026-01181-4","DOIUrl":"https://doi.org/10.1038/s41585-026-01181-4","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670227","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":"Beyond surgical technique: modifiable risk factors and evolving treatment paradigms in bladder cancer surgery.","authors":"Pietro Scilipoti, Giuseppe Rosiello, Andrea Salonia, Alberto Briganti, Andrea Necchi, Marco Moschini, Francesco Montorsi","doi":"10.1038/s41585-026-01180-5","DOIUrl":"https://doi.org/10.1038/s41585-026-01180-5","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670235","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 urinary microbiome, overactive bladder and bladder pain syndrome/interstitial cystitis - mechanisms, diagnostics and therapeutic opportunities.","authors":"Martina Spazzapan, Nicholas Raison, Claire Steves, Arun Sahai","doi":"10.1038/s41585-026-01174-3","DOIUrl":"https://doi.org/10.1038/s41585-026-01174-3","url":null,"abstract":"<p><p>Overactive bladder and bladder pain syndrome/interstitial cystitis are prevalent, multifactorial disorders with poorly understood pathophysiology. The discovery of the urinary microbiome has overturned the sterile urine paradigm and created new opportunities for mechanistic and translational research. Increasing evidence suggests that bladder microbial communities are associated with urothelial signalling, immune tone and neural pathways that influence urgency, pain and treatment response. In overactive bladder, Lactobacillus-predominant profiles are associated with lower symptom burden and improved response to pharmacotherapy, whereas Gardnerella-enriched and Pseudomonadota-enriched communities positively correlate with refractory disease. In bladder pain syndrome/interstitial cystitis, microbial alterations are not based on a single pathogenic signature but converge on metabolic and immune dysregulation. Multi-omics studies integrating metagenomics, metabolomics and host immune data are beginning to define functional pathways linking microbial metabolites, epithelial barrier function and nociceptor sensitization. Results from emerging clinical trials suggest that urinary microbiome profiling might enable patient stratification and inform treatment selection, whereas interventions, such as probiotics, oestrogen therapy or dietary modulation, hold potential as adjunctive strategies. Together, these advances position the urinary microbiome as a promising contributor to lower urinary tract health and a potential target for precision urology, although the functional importance and causal role of the low-biomass urinary microbiome in disease remain crucial unresolved questions.</p>","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148605693","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":"Mohs micrographic surgery and reconstruction for glans and urethral squamous cell carcinoma.","authors":"Grant Sprow, Hesham Alshaikh, William Phillips, Megan H Trager, Timothy Donahue, Anthony Rossi","doi":"10.1038/s41585-026-01176-1","DOIUrl":"https://doi.org/10.1038/s41585-026-01176-1","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549599","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":"Escaping the matrix: disrupted integrin signalling enables neuroendocrine differentiation.","authors":"Jacob Egelberg,Himisha Beltran","doi":"10.1038/s41585-026-01177-0","DOIUrl":"https://doi.org/10.1038/s41585-026-01177-0","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"37 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522320","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":"Extending a pleasure-based paradigm: reflections on male-centred assumptions in sexual medicine.","authors":"Sam Geuens","doi":"10.1038/s41585-026-01175-2","DOIUrl":"https://doi.org/10.1038/s41585-026-01175-2","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"119 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522394","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":"Neoadjuvant intraprostatic immunotherapy for high-risk localized prostate cancer.","authors":"Sean A Fletcher,Nicholas A Pickersgill,Juan C Osorio,Deaglan J McHugh,Himanshu Nagar,Thomas Kole,James Janopaul-Naylor,Kristine Lacuna,James A Eastham,Karim A Touijer,Jonathan S Fainberg,Howard I Scher,Behfar Ehdaie,Matthew C Dallos,Christopher D Gaffney","doi":"10.1038/s41585-026-01172-5","DOIUrl":"https://doi.org/10.1038/s41585-026-01172-5","url":null,"abstract":"High-risk localized prostate cancer is associated with substantial recurrence rates despite definitive treatment, and no neoadjuvant therapies are currently established. Investigation in this field has largely focused on systemic neoadjuvant androgen deprivation therapy, which is associated with burdensome adverse effects and long-term morbidity. Intraprostatic immunotherapy is an emerging strategy designed to overcome local immune suppression and induce systemic antitumour responses through direct modulation of the tumour microenvironment. Early-phase clinical experience with viral-vector-based gene therapies has shown this approach to be safe, technically feasible and capable of eliciting local and systemic immune activation. Clinical efficacy remains unproven, with results from early-phase studies indicating variable responses in levels of prostate-specific antigen and pathological tumour regression. Nevertheless, these studies establish a proof-of-concept for localized immunomodulation before surgery. Further progress will require standardized biological and clinical end points and rational integration with contemporary treatment modalities.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"378 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148416000","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}