New England Journal of Medicine最新文献

{"title":"Survival of Transplanted Allogeneic Beta Cells with No Immunosuppression.","authors":"Per-Ola Carlsson,Xiaomeng Hu,Hanne Scholz,Sofie Ingvast,Torbjörn Lundgren,Tim Scholz,Olof Eriksson,Per Liss,Di Yu,Tobias Deuse,Olle Korsgren,Sonja Schrepfer","doi":"10.1056/nejmoa2503822","DOIUrl":"https://doi.org/10.1056/nejmoa2503822","url":null,"abstract":"The need to suppress a patient's immune system after the transplantation of allogeneic cells is associated with wide-ranging side effects. We report the outcomes of transplantation of genetically modified allogeneic donor islet cells into a man with long-standing type 1 diabetes. We used clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 12b (Cas12b) editing and lentiviral transduction to genetically edit the cells to avoid rejection; the cells were then transplanted into the participant's forearm muscle. He did not receive any immunosuppressive drugs and, at 12 weeks after transplantation, showed no immune response against the gene-edited cells. C-peptide measurements showed stable and glucose-responsive insulin secretion. A total of four adverse events occurred, none of which were serious or related to the study drug. (Funded by the Leona M. and Harry B. Helmsley Charitable Trust; EudraCT number, 2023-507988-19-00; ClinicalTrials.gov number, NCT06239636.).","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"15 1","pages":""},"PeriodicalIF":158.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769820","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 Gilded Age for Patients? The Broken Promises of Profit-Driven Medicine.","authors":"Nancy Tomes","doi":"10.1056/nejmp2415751","DOIUrl":"https://doi.org/10.1056/nejmp2415751","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"57 1","pages":""},"PeriodicalIF":158.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769827","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":"E-Cigarette- or Vaping-Associated Lung Injury.","authors":"Mohd Zulkimi Roslly, Syarifah A A Syed Rozhan","doi":"10.1056/NEJMicm2503172","DOIUrl":"https://doi.org/10.1056/NEJMicm2503172","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":78.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776932","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":"<i>ER</i> and Me.","authors":"Elizabeth Rourke","doi":"10.1056/NEJMp2502606","DOIUrl":"https://doi.org/10.1056/NEJMp2502606","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":78.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776931","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":"Training Health Communicators - The Need for a New Approach.","authors":"Kristen Panthagani,Edward R Melnick,Katelyn Jetelina,Megan L Ranney","doi":"10.1056/nejmp2500320","DOIUrl":"https://doi.org/10.1056/nejmp2500320","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"20 1","pages":""},"PeriodicalIF":158.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769540","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":"Improved Outcomes with Enzalutamide in Biochemically Recurrent Prostate Cancer.","authors":"","doi":"10.1056/NEJMx250003","DOIUrl":"https://doi.org/10.1056/NEJMx250003","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":78.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776933","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":"Resolution of Squamous-Cell Carcinoma by Restoring T-Cell Receptor Signaling.","authors":"Peiying Ye,Jenna R E Bergerson,Isaac Brownell,Gabriel J Starrett,Roshini S Abraham,Megan V Anderson,Triscia Martin,Derek MacMath,Hye Sun Kuehn,Jyothi Padiadpu,Siqi Zhao,Sergio D Rosenzweig,Roxane Tussiwand,Warren J Leonard,Stefania Pittaluga,Mark Raffeld,Danielle E Arnold,Andrea Lisco","doi":"10.1056/nejmoa2502114","DOIUrl":"https://doi.org/10.1056/nejmoa2502114","url":null,"abstract":"Cutaneous squamous-cell carcinoma (SCC) is primarily caused by oncogenesis mediated by ultraviolet radiation, and β-human papillomavirus (β-HPV) is believed to be a mere facilitator that is dispensable for the maintenance of cutaneous SCC. Here, we describe a woman with benign and malignant HPV-related diseases that include a recurrent, unresectable, invasive cutaneous SCC with β-HPV19 genomic integration in the context of germline pathogenic mutations in ZAP70, an adapter required for T-cell receptor (TCR) signal transduction. Restoration of the integrity of TCR signaling by allogeneic hematopoietic-cell transplantation led to the resolution of all HPV-related diseases, thereby revealing a direct role of β-HPV in skin carcinogenesis in hosts with defective adaptive T-cell responses. (Funded by the National Institutes of Health.).","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"1 1","pages":"469-478"},"PeriodicalIF":158.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747693","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":"Case 22-2025: A 19-Year-Old Woman with Seizurelike Activity and Odd Behaviors.","authors":"Judith A Restrepo,Amirkasra Mojtahed,Leah W Morelli,Nagagopal Venna,Gulisa Turashvili","doi":"10.1056/nejmcpc2412531","DOIUrl":"https://doi.org/10.1056/nejmcpc2412531","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"3 1","pages":"488-496"},"PeriodicalIF":158.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747744","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 Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery.","authors":"Fabrizio Monaco, Chong Lei, Matteo Aldo Bonizzoni, Sergey Efremov, Federica Morselli, Fabio Guarracino, Giuseppe Giardina, Cristina Arangino, Domenico Pontillo, Michelangelo Vitiello, Alessandro Belletti, Valentina Ajello, Margherita Licheri, Caetano Nigro Neto, Gaia Barucco, Nazar A Bukamal, Carolina Faustini, Lorenzo Filippo Mantovani, Alessandro Oriani, Cristina Santonocito, Marta Mucchetti, Francesco Federici, Chiara Gerli, Sabrina Porta, Anna Mara Scandroglio, Hui Zhang, Marina Pieri, Roman Osinsky, Stefano Lazzari, Elizaveta Leonova, Maria Grazia Calabrò, Daniele Amitrano, Stefano Turi, Paolo Prati, Stefano Fresilli, Filippo D'Amico, Jacopo D'Andria Ursoleo, Rosa Labanca, Marilena Marmiere, Alessandro Pruna, Tommaso Scquizzato, Kaan Kırali, Giacomo Monti, Maria José Carvalho Carmona, Kenichi Tanaka, Valery Likhvantsev, Lian Kah Ti, Tiziana Bove, Gianluca Paternoster, Karen Singh, Mustafa Emre Gürcü, Vladimir Lomivorotov, Giovanni Landoni, Rinaldo Bellomo, Alberto Zangrillo","doi":"10.1056/NEJMoa2504948","DOIUrl":"10.1056/NEJMoa2504948","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing cardiac surgery often receive red-cell transfusions, along with the associated risks and costs. Early intraoperative normovolemic hemodilution (i.e., acute normovolemic hemodilution [ANH]) is a blood-conservation technique that entails autologous blood collection before initiation of cardiopulmonary bypass and reinfusion of the collected blood after bypass weaning. More data are needed on whether ANH reduces the number of patients receiving allogeneic red-cell transfusion.</p><p><strong>Methods: </strong>In a multinational, single-blind trial, we randomly assigned adults from 32 centers and 11 countries who were undergoing cardiac surgery with cardiopulmonary bypass to receive ANH (withdrawal of ≥650 ml of whole blood with crystalloids replacement if needed) or usual care. The primary outcome was the transfusion of at least one unit of allogeneic red cells during the hospital stay. Secondary outcomes were death from any cause within 30 days after surgery or during the hospitalization for surgery, bleeding complications, ischemic complications, and acute kidney injury.</p><p><strong>Results: </strong>A total of 2010 patients underwent randomization; 1010 were assigned to ANH and 1000 to usual care. Among patients with available data, 274 of 1005 (27.3%) in the ANH group and 291 of 997 (29.2%) in the usual-care group received at least one allogeneic red-cell transfusion (relative risk, 0.93; 95% confidence interval, 0.81 to 1.07; P = 0.34). Surgery for postoperative bleeding was performed in 38 of 1004 patients (3.8%) in the ANH group and 26 of 995 patients (2.6%) in the usual-care group. Death within 30 days or during hospitalization occurred in 14 of 1008 patients (1.4%) in the ANH group and 16 of 997 patients (1.6%) in the usual-care group. Safety outcomes were similar in the two groups.</p><p><strong>Conclusions: </strong>Among adults undergoing cardiac surgery, ANH did not reduce the number of patients receiving allogeneic red-cell transfusion. (Funded by the Italian Ministry of Health; ANH ClinicalTrials.gov number, NCT03913481.).</p>","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"450-460"},"PeriodicalIF":78.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276725","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":"Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation.","authors":"Paschalis Karakasis, Nikolaos Fragakis","doi":"10.1056/NEJMc2506666","DOIUrl":"10.1056/NEJMc2506666","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 5","pages":"518-519"},"PeriodicalIF":78.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755146","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}