Communications medicine最新文献

{"title":"Early cardio-oncology intervention in thoracic radiotherapy: prospective single-arm pilot study.","authors":"Samuel C Zhang, Jordan O Gasho, Celeste Eno, Katrina D Silos, Felicity Pendergast, Wenjuan Zhang, Eric Vail, Mitchell Kamrava, Behrooz Hakimian, Amin Mirhadi, Raymond H Mak, Andriana P Nikolova, Katelyn M Atkins","doi":"10.1038/s43856-025-00761-6","DOIUrl":"https://doi.org/10.1038/s43856-025-00761-6","url":null,"abstract":"<p><strong>Background: </strong>While there is increasing recognition of the morbidity of cardiovascular disease in cancer survivors, including accelerated atherosclerosis following thoracic radiotherapy, patients are frequently under-optimized for cardiovascular risk.</p><p><strong>Methods: </strong>In this prospective single-arm cohort pilot study, patients were treated with high-dose thoracic radiotherapy and had early consultation with cardio-oncology. Twenty patients were enrolled. The primary endpoint was adherence to cardio-oncology consultation. Secondary endpoints were cardiovascular medication intervention rate and patient-reported intervention perspectives. Clonal hematopoiesis of indeterminate potential, a major cardiovascular risk marker enriched in patients with cancer and induced by radiation exposure, was measured as an exploratory endpoint.</p><p><strong>Results: </strong>The cohort median age is 71 years. Most patients are female (13/20), have primary lung or esophageal carcinoma (16/20), and 7/20 have pre-existing cardiovascular disease. We show that cardio-oncology consultation adherence is high (19/20) and results in cardiovascular medication optimization changes in most patients (12/19), most commonly to initiate or intensify statin therapy (8/12). 8/12 patients with a primary cardiologist prior to enrollment have medication changes recommended. Most (12/17) participants are glad to learn about their heart health during cancer treatment. Clonal hematopoiesis is detectable prior to treatment in 8/20 patients and three develop new variants after treatment (1/3 de novo).</p><p><strong>Conclusions: </strong>We observe that early cardio-oncology consultation is feasible, leads to cardiovascular medication optimization in the majority (>60%) of participants, most commonly to initiate or intensify statin therapy. New clonal hematopoiesis variants are detectable early after radiotherapy and the impact on post-treatment cardiovascular risk is worthy of further study.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"43"},"PeriodicalIF":5.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities.","authors":"John Friesen, Stefanos Georganos, Jan Haas","doi":"10.1038/s43856-025-00746-5","DOIUrl":"10.1038/s43856-025-00746-5","url":null,"abstract":"<p><strong>Background: </strong>Spatial accessibility to healthcare is a critical factor in ensuring equitable health outcomes. While studies on a global, continental, and national level exist, our understanding of intra-urban differences, particularly between formal and informal areas within cities in sub-Saharan Africa, remains limited.</p><p><strong>Methods: </strong>This study integrates openly available datasets on land use in 19 sub-Saharan cities, healthcare facilities in the region, and street networks from OpenStreetMap. Using these datasets, we calculate service areas around hospitals, considering travel times ranging from 1 to 120 minutes with walking as the mode of travel. The resulting service areas are then merged with population data from WorldPop, allowing us to assess the proportion of the population with specific travel times to healthcare facilities from informal and formal residential areas.</p><p><strong>Results: </strong>Our analysis reveals that 33% of the urban population can reach hospitals within 15 minutes, 58% within 30 minutes, and 78% within 60 minutes. Importantly, for some cities, we observe significant differences between formal and informal areas, with informal areas experiencing a disadvantage in terms of spatial accessibility to healthcare facilities. The population in informal areas is particularly disadvantaged in medium-sized cities.</p><p><strong>Conclusions: </strong>This study sheds light on the spatial accessibility of healthcare facilities in sub-Saharan African cities, emphasizing the need to consider intra-urban disparities, particularly in informal areas. The findings underscore the importance of targeted interventions and urban planning strategies to address these disparities and ensure that healthcare services are accessible to all segments of the urban population.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"41"},"PeriodicalIF":5.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple long-term conditions as the next transition in the global diabetes epidemic.","authors":"Edward W Gregg, Naomi Holman, Marisa Sophiea, Shivani Misra, Jonathan Pearson-Stuttard, Jonathan Valabhji, Kamlesh Khunti","doi":"10.1038/s43856-025-00742-9","DOIUrl":"10.1038/s43856-025-00742-9","url":null,"abstract":"<p><p>Several transitions, or new patterns and dynamics in the contributors and health outcomes, have altered the character and burden of the multi-decade, worldwide growth in prevalence of type 2 diabetes (T2DM). These changes have led to different needs for prevention and care. These dynamics have been driven by diverse demographic, socio-economic, behavioural, and health system response factors. In this Perspective, we describe these transitions and how their attributes have set the stage for multimorbidity, or multiple long-term conditions (MLTCs), to be the next major challenge in the diabetes epidemic. We also describe how the timing and character of these stages differ in high-, middle-, and low-income countries. These challenges call for innovation and a stronger focus on MLTCs across the spectrum of cause, effectiveness, and implementation studies to guide prevention and treatment priorities.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"42"},"PeriodicalIF":5.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model.","authors":"Yuanjia Zhu, Annabel M Imbrie-Moore, Matthew H Park, Tyler E Cork, Shin Yajima, Robert J Wilkerson, Nicholas A Tran, Mateo Marin-Cuartas, Danielle M Mullis, Sam W Baker, Yuko Tada, Tsuyoshi Ueyama, Matthew Leipzig, Vicky Y Wang, Sidarth Ethiraj, Sarah Madira, Shreya Anilkumar, Sabrina K Walsh, Haley J Lucian, Chris Huynh, Kimberly Morris, Ok S Kim, Jack Mulligan, Hanjay Wang, Yasuhiro Shudo, Daniel B Ennis, Y Joseph Woo","doi":"10.1038/s43856-025-00753-6","DOIUrl":"10.1038/s43856-025-00753-6","url":null,"abstract":"<p><strong>Introduction: </strong>Current mitral annuloplasty rings fail to restrict the anteroposterior distance while allowing dynamic mitral annular changes. We designed and manufactured a mitral annuloplasty ring that demonstrated axis-specific, selective flexibility to meet this clinical need. The objectives were to evaluate ex vivo biomechanics of this ring and to validate the annular dynamics and safety after ring implantation in vivo.</p><p><strong>Methods: </strong>Healthy human mitral annuli (n = 3) were tracked, and motions were isolated. Using the imaging data, we designed and manufactured our axis-specific mitral annuloplasty ring. An ex vivo annular dilation model was used to compare hemodynamics and chordal forces after repair using the axis-specific, rigid, and flexible rings in five porcine mitral valves. In vivo, axis-specific (n = 6), rigid (n = 6), or flexible rings (n = 6) were implanted into male Dorset sheep for annular motion analyses. Five additional animals receiving axis-specific rings survived for up to 6 months.</p><p><strong>Results: </strong>Here we show the axis-specific, rigid, and flexible rings reduced regurgitation fraction to 4.7 ± 2.7%, 2.4 ± 3.2%, and 17.8 ± 10.0%, respectively. The axis-specific ring demonstrated lower average forces compared to the rigid ring (p = 0.046). Five animals receiving axis-specific rings survived for up to 6 months, with mitral annular motion preserved in vivo. Mature neoendocardial tissue coverage over the device was found to be complete with full endothelialization in all animals.</p><p><strong>Conclusions: </strong>The axis-specific mitral annuloplasty ring we designed demonstrates excellent capability to repair mitral regurgitation while facilitating dynamic mitral annular motion. This ring has tremendous potential for clinical translatability, representing a promising surgical solution for mitral regurgitation.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"40"},"PeriodicalIF":5.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of human microbiome may promote healthier lifestyle and more positive environmental attitudes.","authors":"Olga Rook, Hub Zwart","doi":"10.1038/s43856-025-00747-4","DOIUrl":"10.1038/s43856-025-00747-4","url":null,"abstract":"<p><strong>Background: </strong>The human microbiome is an essential factor of physical and mental health, yet the general population has little knowledge about it. This survey explores public familiarity with the human microbiome and (potential) public preferences related to monitoring and improving one's microbiome health. The study also examines whether recognizing the importance of one's microbiome may promote a more ecosystem-aware perspective towards microorganisms.</p><p><strong>Methods: </strong>We conducted an online survey with nationally representative samples from France, Germany, South Korea, and Taiwan (N = 2860). The results were interpreted using descriptive statistics and network analysis. We also performed a t-test to compare perceptions of microorganisms before and after a short reflection on the role of human microbiome for one's body and health.</p><p><strong>Results: </strong>In our data, most respondents express willingness to monitor the health of their microbiome (especially, in the European countries) and to adjust their lifestyle such as diet and exercise to improve it. A paired samples t-test shows a slight positive shift in perceptions of microorganisms and the microbial world after the reflection exercise compared to baseline.</p><p><strong>Conclusions: </strong>The study shows that the public recognize the essential role of the human microbiome in health and are willing to take care of it, which may have implications for public health policy. Our findings also suggest that stronger awareness of the human microbiome may promote lifestyle change and a more encompassing environmental outlook.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"39"},"PeriodicalIF":5.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swarm learning with weak supervision enables automatic breast cancer detection in magnetic resonance imaging.","authors":"Oliver Lester Saldanha, Jiefu Zhu, Gustav Müller-Franzes, Zunamys I Carrero, Nicholas R Payne, Lorena Escudero Sánchez, Paul Christophe Varoutas, Sreenath Kyathanahally, Narmin Ghaffari Laleh, Kevin Pfeiffer, Marta Ligero, Jakob Behner, Kamarul A Abdullah, Georgios Apostolakos, Chrysafoula Kolofousi, Antri Kleanthous, Michail Kalogeropoulos, Cristina Rossi, Sylwia Nowakowska, Alexandra Athanasiou, Raquel Perez-Lopez, Ritse Mann, Wouter Veldhuis, Julia Camps, Volkmar Schulz, Markus Wenzel, Sergey Morozov, Alexander Ciritsis, Christiane Kuhl, Fiona J Gilbert, Daniel Truhn, Jakob Nikolas Kather","doi":"10.1038/s43856-024-00722-5","DOIUrl":"10.1038/s43856-024-00722-5","url":null,"abstract":"<p><strong>Background: </strong>Over the next 5 years, new breast cancer screening guidelines recommending magnetic resonance imaging (MRI) for certain patients will significantly increase the volume of imaging data to be analyzed. While this increase poses challenges for radiologists, artificial intelligence (AI) offers potential solutions to manage this workload. However, the development of AI models is often hindered by manual annotation requirements and strict data-sharing regulations between institutions.</p><p><strong>Methods: </strong>In this study, we present an integrated pipeline combining weakly supervised learning-reducing the need for detailed annotations-with local AI model training via swarm learning (SL), which circumvents centralized data sharing. We utilized three datasets comprising 1372 female bilateral breast MRI exams from institutions in three countries: the United States (US), Switzerland, and the United Kingdom (UK) to train models. These models were then validated on two external datasets consisting of 649 bilateral breast MRI exams from Germany and Greece.</p><p><strong>Results: </strong>Upon systematically benchmarking various weakly supervised two-dimensional (2D) and three-dimensional (3D) deep learning (DL) methods, we find that the 3D-ResNet-101 demonstrates superior performance. By implementing a real-world SL setup across three international centers, we observe that these collaboratively trained models outperform those trained locally. Even with a smaller dataset, we demonstrate the practical feasibility of deploying SL internationally with on-site data processing, addressing challenges such as data privacy and annotation variability.</p><p><strong>Conclusions: </strong>Combining weakly supervised learning with SL enhances inter-institutional collaboration, improving the utility of distributed datasets for medical AI training without requiring detailed annotations or centralized data sharing.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"38"},"PeriodicalIF":5.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world smartphone-based point-of-care diagnostics in primary health care to monitor HbA1c levels in people with diabetes.","authors":"Sabrina Rhode, Lisa Rogge, Marthoenis Marthoenis, Till Seuring, Hendra Zufry, Till Bärnighausen, Hizir Sofyan, Jennifer Manne-Goehler, Sebastian Vollmer","doi":"10.1038/s43856-025-00743-8","DOIUrl":"10.1038/s43856-025-00743-8","url":null,"abstract":"<p><strong>Background: </strong>The lack of accurate and affordable monitoring of glycated hemoglobin (HbA1c) is a common issue among patients with diabetes in low- and middle-income countries. We aimed to test a tablet- and smartphone-based point-of-care (TSB POC) device against a local laboratory-based measure of HbA1c for monitoring diabetes under real-world conditions.</p><p><strong>Methods: </strong>For this cross-sectional clinical method applicability study, capillary and venous blood was collected in duplicate and analyzed at local primary health care centers. For a heterogeneity test, the tests were performed by an expert, and by a team of local nurses. The study was conducted in a multicenter design in rural and urban Aceh, Indonesia in 2019, and included a total of 533 adults. We mainly used Bland-Altman plots to assess the number of readings within the 95%-limits of agreement (LoA) and Deming regressions.</p><p><strong>Results: </strong>The results show a mean difference between capillary HbA1c on the test device and the reference method of -0.54 [CI_0.95 = -1.6933; 0.6048] with 5.21% of measurements outside the LoA and a Pearson's r = 0.91 in the Deming Regression. There is no significant difference in test concordance between local nurses and the expert (4.23% versus 5.13% results outside the LoA [CI_0.95 = -0.0331; 0.0511]).</p><p><strong>Conclusions: </strong>TSB POC for analysis of HbA1c is an acceptable alternative for accessible monitoring of diabetes patients under these conditions. This method could provide access to high-quality diagnostic decisions through regular and cost-effective HbA1c monitoring directly in healthcare facilities, thus providing better access to essential health services.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"37"},"PeriodicalIF":5.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 death toll predictions show that triggering counterfactual thinking deteriorates judgmental performance.","authors":"Matthias Seifert, Jeeva Somasundaram","doi":"10.1038/s43856-025-00751-8","DOIUrl":"10.1038/s43856-025-00751-8","url":null,"abstract":"<p><strong>Background: </strong>Effective communication during a health crisis is critical as it directly influences psychological and behavioral responses that will shape the further progression of the crisis. Past research has suggested that one type of cognitive mechanism that is likely to be affected by the framing of public health messages relates to counterfactual thinking.</p><p><strong>Methods: </strong>Based on 6731 incentivized daily forecasts collected over 377 days (from April 2020-May 2021), we investigate the role of triggering counterfactual thinking when interpreting public information regarding the daily US death toll from COVID-19.</p><p><strong>Results: </strong>Here we show that individuals who engaged in thinking about \"interventions that could have led to an alternative evolution of the death toll\" prior to making forecasts exhibit greater judgmental bias in their predictions compared to the control group. Specifically, subjects in the treatment group tend to generate upward counterfactuals and underestimate the death toll, potentially due to anchoring on more favorable scenarios and insensitivity to trend changes. Interestingly, this behavior is also observed among individuals who had recovered from COVID-19 (or someone in their close social circle).</p><p><strong>Conclusions: </strong>Our findings underscore the importance of using debiasing strategies and neutral communication during health crises to mitigate the generation of upward counterfactuals, thus reducing the likelihood of systematic misperceptions and flawed decision-making.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"35"},"PeriodicalIF":5.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-dimensional evidence from the UK Biobank shows the impact of diet and macronutrient intake on aging.","authors":"Chen Zhu, Youfa Wang, Xiaosong Yang, Qiran Zhao, Wenyan Xu, Xiaolu Wang, Yanjun Liang, Qihui Chen, Shenggen Fan","doi":"10.1038/s43856-025-00754-5","DOIUrl":"10.1038/s43856-025-00754-5","url":null,"abstract":"<p><strong>Background: </strong>The role of diet in aging is crucial, yet research findings on how specific diets influence human aging remain inconsistent. Understanding the relationship between dietary factors and aging could inform interventions to promote healthier aging outcomes.</p><p><strong>Methods: </strong>We analyzed data from the UK Biobank baseline survey and a 24-hour dietary assessment survey to investigate the association between diet and aging. The study examined 18 individual food intakes, 6 dietary patterns, 3 macronutrient intakes, and 3 dietary quality scores. High-dimensional Fixed Effects (HDFE) models were used to assess associations between dietary factors and aging measures, including telomere length, phenotypic age, and brain grey/white matter volumes. Multivariable Mendelian Randomization (MVMR) was employed to explore causal links between macronutrient consumption and aging outcomes.</p><p><strong>Results: </strong>Our results show that healthier diets are generally associated with improved aging outcomes from HDFE analyses. Plant-based food consumption correlates with increased telomere length and reduced phenotypic age, while animal-based food intake is linked to adverse aging effects. MVMR results confirm the causal benefits of carbohydrate intake, including reductions in phenotypic age (β = -0.0025; 95% CI = [-0.0047, -0.0003]; p = 0.0253) and increases in whole-brain grey matter volume (β = 0.0262; 95% CI = [0.007, 0.046]; p = 0.0087). The latter association remains significant after multiple testing correction.</p><p><strong>Conclusions: </strong>This study underscores the significant role of diet in biological aging and provides robust evidence for the benefits of carbohydrate intake in promoting healthier aging. These findings highlight the potential of dietary interventions to improve aging-related outcomes.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"36"},"PeriodicalIF":5.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gravity-based microfiltration reveals unexpected prevalence of circulating tumor cell clusters in ovarian and colorectal cancer.","authors":"Anne Meunier, Javier Alejandro Hernández-Castro, Nicholas Chahley, Laudine Communal, Sara Kheireddine, Newsha Koushki, Nadia Davoudvandi, Sara Al Habyan, Benjamin Péant, Anthoula Lazaris, Andy Ng, Teodor Veres, Luke McCaffrey, Diane Provencher, Peter Metrakos, Anne-Marie Mes-Masson, David Juncker","doi":"10.1038/s43856-024-00702-9","DOIUrl":"10.1038/s43856-024-00702-9","url":null,"abstract":"<p><strong>Background: </strong>Circulating tumor cells (CTCs) are rare (a few cells per milliliter of blood) and mostly isolated as single-cell CTCs (scCTCs). CTC clusters (cCTCs), even rarer, are of growing interest, notably because of their higher metastatic potential, but very difficult to isolate.</p><p><strong>Method: </strong>We introduce gravity-based microfiltration (GµF) for facile isolation of cCTCs using in-house fabricated microfilters and 3D printed cartridges. Optimal flow rate and pore size for cCTC isolation are determined by GµF of cultured ovarian single cells and cell clusters spiked in healthy blood. We perform GµF of blood from orthotopic ovarian cancer mouse models and characterize the morphological features of scCTCs and cCTCs, and the expression of molecular markers for aggressiveness. Finally, we analyze blood from 17 epithelial ovarian cancer patients with either localized or metastatic disease, and from 13 colorectal cancer liver metastasis patients.</p><p><strong>Results: </strong>Here, we show that GµF optimized for cell cluster isolation captures cCTCs from blood while minimizing unwanted cluster disaggregation, with ~85% capture efficiency. We detect cCTCs in every patient, with between 2-100+ cells. We find cCTCs represent between 5-30% of all CTC capture events, and 10-80% of the CTCs are clustered; remarkably, in 10 patients, most CTCs are circulating not as scCTCs, but as cCTCs.</p><p><strong>Conclusions: </strong>GµF uncovers the unexpected prevalence and frequency of cCTCs including sometimes very large ones in epithelial ovarian cancer patients, and motivates additional studies to uncover their properties and role in disease progression.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"33"},"PeriodicalIF":5.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}