Ellen V Stadler, Alison Holmes, Danny O'Hare, Timothy M Rawson
{"title":"Towards individualised treatment of urinary tract infections.","authors":"Ellen V Stadler, Alison Holmes, Danny O'Hare, Timothy M Rawson","doi":"10.1038/s43856-025-00962-z","DOIUrl":"10.1038/s43856-025-00962-z","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"263"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546398","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}
Richard Novak, Tiffany Lin, Shruti Kaushal, Megan Sperry, Frederic Vigneault, Erica Gardner, Sahil Loomba, Kostyantyn Shcherbina, Vishal Keshari, Alexandre Dinis, Anish Vasan, Vasanth Chandrasekhar, Takako Takeda, Rahul Nihalani, Sevgi Umur, Jerrold R Turner, Michael Levin, Donald E Ingber
{"title":"AI-enabled drug prediction and gene network analysis reveal therapeutic use of vorinostat for Rett Syndrome in preclinical models.","authors":"Richard Novak, Tiffany Lin, Shruti Kaushal, Megan Sperry, Frederic Vigneault, Erica Gardner, Sahil Loomba, Kostyantyn Shcherbina, Vishal Keshari, Alexandre Dinis, Anish Vasan, Vasanth Chandrasekhar, Takako Takeda, Rahul Nihalani, Sevgi Umur, Jerrold R Turner, Michael Levin, Donald E Ingber","doi":"10.1038/s43856-025-00975-8","DOIUrl":"10.1038/s43856-025-00975-8","url":null,"abstract":"<p><strong>Background: </strong>Many neurodevelopmental genetic disorders, such as Rett syndrome, are caused by a single gene mutation but trigger changes in expression of numerous genes. This impairs functions of multiple organs beyond the central nervous system (CNS), making it difficult to develop broadly effective treatments based on a single drug target. This is further complicated by the lack of sufficiently broad and biologically relevant drug screens, and the inherent complexity in identifying clinically relevant targets responsible for diverse phenotypes that involve multiple organs.</p><p><strong>Methods: </strong>Here, we use computational drug prediction that combines artificial intelligence, human gene regulatory network analysis, and in vivo screening in a CRISPR-edited, Xenopus laevis tadpole model of Rett syndrome to carry out target-agnostic drug discovery. Four-week-old MeCP2-null male mice expressing the Rett phenotype are used to validate the therapeutic efficacy.</p><p><strong>Results: </strong>This approach identifies the FDA-approved drug, vorinostat, which broadly improves both CNS and non-CNS (e.g., gastrointestinal, respiratory, inflammatory) abnormalities in X. laevis and MeCP2-null mice. To our knowledge, this is the first Rett syndrome treatment to demonstrate pre-clinical efficacy across multiple organ systems when dosed after the onset of symptoms. Gene network analysis also reveals a putative therapeutic mechanism for the cross-organ normalizing effects of vorinostat based on its impact on acetylation metabolism and post-translational modifications of microtubules.</p><p><strong>Conclusions: </strong>Although vorinostat is an inhibitor of histone deacetylases (HDAC), it unexpectedly reverses the Rett phenotype by restoring protein acetylation across hypo- and hyperacetylated tissues, suggesting its activity is based on a previously unknown therapeutic mechanism.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"249"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546340","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}
Stephanie S R Souza, Kathryn R Piper, Odion O Ikhimiukor, Michael M Marcovici, Nicole I Zac Soligno, Ashley J Harmon, Elissa M Eckhardt, Nisalda Carreiro, Adrienne A Workman, Isabella W Martin, Cheryl P Andam
{"title":"Variants of β-lactamase-encoding genes are disseminated by multiple genetically distinct lineages of bloodstream Escherichia coli.","authors":"Stephanie S R Souza, Kathryn R Piper, Odion O Ikhimiukor, Michael M Marcovici, Nicole I Zac Soligno, Ashley J Harmon, Elissa M Eckhardt, Nisalda Carreiro, Adrienne A Workman, Isabella W Martin, Cheryl P Andam","doi":"10.1038/s43856-025-00972-x","DOIUrl":"10.1038/s43856-025-00972-x","url":null,"abstract":"<p><strong>Background: </strong>Escherichia coli is a major cause of bloodstream infections (BSI), which can lead to life-threatening organ dysfunction. We determined the genomic characteristics of E. coli implicated in BSI and the spread of antimicrobial resistance (AMR).</p><p><strong>Methods: </strong>We carried out in vitro antimicrobial susceptibility testing and whole genome sequencing of 557 E. coli isolates recovered from BSI at Dartmouth-Hitchcock Medical Center, USA.</p><p><strong>Results: </strong>We identify at least 119 previously recognized sequence types (ST), of which five STs (ST69, ST73, ST95, ST127, ST131) altogether represent 50% of the bloodstream E. coli population. Of the 142 distinct serotypes detected, the most common are O25:H4 and O1:H7. A total of 62 acquired genes are associated with resistance to at least 13 antimicrobial classes. These include the β-lactamase gene families bla<sub>TEM</sub>, bla<sub>SHV</sub>, bla<sub>OXA</sub>, bla<sub>CTX-M</sub>, and bla<sub>CMY</sub>, which together can be further classified into 15 variants, including seven genes encoding extended-spectrum β-lactamases (ESBL). A total of 210/557 genomes carry at least one bla gene, with bla<sub>TEM-1</sub> being the most prevalent variant. ESBL-related genes are frequently detected in ST131 genomes. Four virulence operons related to iron uptake are differentially distributed among the five dominant STs. The putative IncF-type plasmid is often associated with genes related to AMR and iron uptake. Estimation of core and accessory genome similarity identifies 12 presumptive epidemiological linkages that span anywhere between 2-18 months.</p><p><strong>Conclusions: </strong>Multiple but genetically distinct E. coli lineages similarly cause BSI and shape AMR dissemination, emphasizing the opportunistic nature of E. coli in invasive infections.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"260"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546400","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":"Tuning vision foundation models for rectal cancer segmentation from CT scans.","authors":"Hantao Zhang, Weidong Guo, Shouhong Wan, Bingbing Zou, Wanqin Wang, Chenyang Qiu, Kaige Liu, Peiquan Jin, Jiancheng Yang","doi":"10.1038/s43856-025-00953-0","DOIUrl":"10.1038/s43856-025-00953-0","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer segmentation in CT is crucial for timely diagnosis. Despite promising methods, challenges remain due to the rectum's complex anatomy and the lack of a comprehensive annotated dataset.</p><p><strong>Methods: </strong>A total of 33,024 slice pairs from 398 rectal cancer patients in a new source center are enrolled into our dataset, named CARE Dataset, with pixel-level annotations for both normal and cancerous rectum tissue. We split it into 317 cases for training and 81 for testing. Additionally, we introduce a segmentation model, U-SAM, which, to the best of our knowledge, is a novel approach designed to handle the complex anatomy of the rectum by incorporating prompt information. Segmentation performance for both normal and cancerous rectum was evaluated using Intersection-over-Union (IoU), Dice Coefficient (Dice), and Normalized Surface Distance (NSD). With the assistance of 46 clinical practitioners, an observer study is conducted to benchmark the U-SAM with human performance and evaluate its clinical applicability. The original new source 398 CT scans and our code are openly available for research.</p><p><strong>Results: </strong>Our method achieves Dice of 71.23% for normal rectum and 76.38% for rectal tumor, with IoU of 55.32% and 61.78%, and NSD values of 83.63% and 58.59%, respectively, surpassing state-of-the-art methods. The observer study validates that U-SAM can produce diagnostic results comparable to those of highly experienced doctors in just 3 seconds of inference time (with about 5 minutes for prompt acquisition) in clinical settings.</p><p><strong>Conclusions: </strong>The proposed U-SAM offers an efficient and reliable method for segmenting rectal cancer and normal tissue, significantly reducing time in clinical settings and effectively assisting radiologists. We believe this initial exploration in CT-based rectal cancer segmentation will be instrumental for future diagnosis.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"256"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546399","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}
Samuel P Heilbroner, Curtis Carter, David M Vidmar, Erik T Mueller, Martin C Stumpe, Riccardo Miotto
{"title":"A self-supervised framework for laboratory data imputation in electronic health records.","authors":"Samuel P Heilbroner, Curtis Carter, David M Vidmar, Erik T Mueller, Martin C Stumpe, Riccardo Miotto","doi":"10.1038/s43856-025-00973-w","DOIUrl":"10.1038/s43856-025-00973-w","url":null,"abstract":"<p><strong>Background: </strong>Laboratory data in electronic health records (EHRs) is an effective source of information to characterize patient populations, inform accurate diagnostics and treatment decisions, and fuel research studies. However, despite their value, laboratory values are underutilized due to high levels of missingness. Existing imputation methods fall short, as they do not fully leverage patient clinical histories and are commonly not scalable to the large number of tests available in real-world data (RWD).</p><p><strong>Methods: </strong>To address these shortcomings, we present Laboratory Imputation Framework for EHRs (LIFE), a self-supervised learning framework based on multi-head attention that is trained to impute any laboratory test value at any point in time in the patient's journey using their complete EHRs. This architecture (1) eliminates the need to train a different model for each laboratory test by jointly modeling all laboratory data of interest; and (2) better clinically contextualizes the predictions by leveraging additional EHR variables, such as diagnosis, medications, and discrete laboratory results.</p><p><strong>Results: </strong>We validate our framework using a large-scale, real-world dataset encompassing over 1 million oncology patients. Our results demonstrate that LIFE obtains superior or equivalent results compared to state-of-the-art baseline methods in 23 out of 25 evaluated laboratory tests and better enhances a downstream adverse event detection task in 7 out of 9 cases.</p><p><strong>Conclusions: </strong>LIFE shows promise in accurately estimating missing laboratory values and enhancing the utilization of large-scale RWD in healthcare. This advancement could lead to better clinical models, more informed decision-making and improved patient outcomes.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"251"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546339","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":"Comparing the metabolomic landscape of polycystic ovary syndrome within urban and rural environments.","authors":"Jalpa Patel, Hiral Chaudhary, Abhishek Chudasama, Jaydeep Panchal, Akanksha Trivedi, Sonal Panchal, Trupti Joshi, Rushikesh Joshi","doi":"10.1038/s43856-025-00985-6","DOIUrl":"10.1038/s43856-025-00985-6","url":null,"abstract":"<p><strong>Background: </strong>Polycystic Ovary Syndrome (PCOS) affects up to 10% of women of reproductive age, characterized by hormonal imbalances and metabolic complications. Environmental factors potentially influence the biochemical expression of this condition. This study aims to examine the impact of urban versus rural environments on metabolite profiles in women with PCOS.</p><p><strong>Methods: </strong>Thirty women aged between 18 and 40, diagnosed with PCOS according to the Rotterdam 2003 criteria, were recruited from June 2022 to May 2023, 16 from urban settings and 14 from rural settings. Serum samples were analyzed using liquid chromatography-tandem mass spectrometry. Principal component analysis and orthogonal partial least squares discriminant analysis were performed to identify metabolic patterns and differences between the two groups.</p><p><strong>Results: </strong>This study reveals significant differences in metabolite profiles between women with PCOS from various environmental backgrounds. Rural participants exhibit higher levels of lipid-related metabolites, especially Palmitone, indicating specific dietary influences. Urban participants show distinct changes in carbohydrate and nucleotide metabolism pathways, likely due to processed food consumption. Multivariate analyses demonstrate a clear separation between the groups, emphasizing the environmental impact on PCOS expression.</p><p><strong>Conclusions: </strong>This research highlights potential environment-related biomarkers for PCOS, emphasizing the importance of developing tailored treatment strategies considering environmental factors. The distinct metabolic profiles observed between urban and rural women provide new insights into the syndrome's complex mechanisms, indicating that environmental influences play a critical role in its biochemical expression and may affect its clinical manifestations.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"253"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546342","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}
Michał Waszkiewicz, Katarzyna Wnuk, Jakub Świtalski, Anna Augustynowicz
{"title":"Influenza and pneumococcal vaccines uptake among pharmacists: systematic review and meta-analysis.","authors":"Michał Waszkiewicz, Katarzyna Wnuk, Jakub Świtalski, Anna Augustynowicz","doi":"10.1038/s43856-025-00976-7","DOIUrl":"10.1038/s43856-025-00976-7","url":null,"abstract":"<p><strong>Background: </strong>Influenza virus and pneumococcal infections are associated with serious health risks resulting from complications. Vaccinations are an effective method of preventing them. Pharmacists can play an essential role in promoting and administering vaccines. High vaccination rates among pharmacists could increase their credibility as vaccination advocates. The review aims to discuss the influenza and pneumococcal vaccination coverage among pharmacists and factors influencing the willingness to vaccinate.</p><p><strong>Methods: </strong>The systematic review was performed according to PRISMA guidelines across three medical databases: Medline (via PubMed), Embase (via OVID), and Cochrane Library. The quality assessment of the study was carried out using The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was also conducted to estimate pharmacists' overall influenza vaccination coverage, incorporating an analysis of vaccination trends before and during the COVID-19 pandemic.</p><p><strong>Results: </strong>The meta-analysis of 6194 observations and 3585 events reveals an overall influenza vaccination coverage among pharmacists of 50.78% under a random effects model, with a 95% confidence interval ranging from 36.20% to 65.22%. Only one retrieved study analyzes pharmacists' vaccination coverage against pneumococci. According to the findings, 20.8% of the participants in the study were vaccinated against pneumococci.</p><p><strong>Conclusions: </strong>The current influenza vaccination rate among pharmacists is moderate, and concerted efforts are needed to increase it. This involves implementing continuous education, beginning at the pharmacy degree stage.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"258"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546380","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}
Luiz Felipe C Rezende, Eurico R De Paula, Marcio T A H Muella, Severino L G Dutra, Reinaldo R Rosa, Paulo H N Saldiva, Jean P H B Ometto
{"title":"Influence of geomagnetic disturbances on myocardial infarctions in women and men from Brazil.","authors":"Luiz Felipe C Rezende, Eurico R De Paula, Marcio T A H Muella, Severino L G Dutra, Reinaldo R Rosa, Paulo H N Saldiva, Jean P H B Ometto","doi":"10.1038/s43856-025-00887-7","DOIUrl":"10.1038/s43856-025-00887-7","url":null,"abstract":"<p><strong>Background: </strong>Understanding the role of space weather, specifically Geomagnetic Disturbances (GMDs) caused by solar activity, on health outcomes is unclear. One emerging link includes the impact of space weather on myocardial infarctions (MI). In this study we examined the correlation between MI and GMDs in Brazil.</p><p><strong>Methods: </strong>We used a database from the public health in Brazil, focusing on the city of São José dos Campos (23° 10' 44″ S, 45° 53' 13″ W), located in the state of São Paulo, during the period of 1998-2005. We focused on admissions for MIs, which included a total of 871 men and 469 women. We categorized the MI data into three age groups: age 30 and younger, age 31-60, and age over 60. Additionally, we incorporated Planetary Index (Kp) data as an indicator of variations in the Earth's geomagnetic field resulting from solar disturbances, categorized as quiet, moderate, or disturbed days. In our analysis, we employed two methods: statistical counting and the unsupervised clustering known as K-Means, considering the attributes of age, sex, and geomagnetic condition.</p><p><strong>Results: </strong>Here we show that geomagnetic conditions have an impact on MI cases, particularly for women. The rate of relative frequency of MI cases during disturbed geomagnetic conditions is almost three times greater compared to quiet geomagnetic conditions. Using the unsupervised K-Means algorithm, the results indicate that the group associated with disturbed geomagnetic conditions has a higher incidence of MIs in women.</p><p><strong>Conclusions: </strong>Overall, our results provide evidence that women may exhibit a higher susceptibility to the effects of geomagnetic disturbances caused by solar activity on MI.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"247"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546379","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}
Maximilian Schuessler, Scott Fleming, Shannon Meyer, Tina Seto, Tina Hernandez-Boussard
{"title":"Diagnostic framework to validate clinical machine learning models locally on temporally stamped data.","authors":"Maximilian Schuessler, Scott Fleming, Shannon Meyer, Tina Seto, Tina Hernandez-Boussard","doi":"10.1038/s43856-025-00965-w","DOIUrl":"10.1038/s43856-025-00965-w","url":null,"abstract":"<p><strong>Background: </strong>Real-world medical environments such as oncology are highly dynamic due to rapid changes in medical practice, technologies, and patient characteristics. This variability, if not addressed, can result in data shifts with potentially poor model performance. Presently, there are few easy-to-implement, model-agnostic diagnostic frameworks to vet machine learning models for future applicability and temporal consistency.</p><p><strong>Methods: </strong>We extracted clinical data from EHR for a cohort of over 24,000 patients who received antineoplastic therapy within a distinct year. The label of this study are acute care utilization (ACU) events, i.e., emergency department visits and hospitalizations, within 180 days of treatment initiation. Our cross-sectional data spans treatment initiation points from 2010-2022. We implemented three models within our validation framework: Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), and Extreme Gradient Boosting (XGBoost).</p><p><strong>Results: </strong>Here, we introduce a model-agnostic diagnostic framework to validate clinical machine learning models on time-stamped data, consisting of four stages. First, the framework evaluates performance by partitioning data from multiple years into training and validation cohorts. Second, it characterizes the temporal evolution of patient outcomes and characteristics. Third, model longevity and trade-offs between data quantity and recency are explored. Finally, feature importance and data valuation algorithms are applied for feature reduction and data quality assessment. When applied to predicting ACU in cancer patients, the framework highlights fluctuations in features, labels, and data values over time.</p><p><strong>Conclusions: </strong>The work in this study emphasizes the importance of data timeliness and relevance. The results on ACU in cancer patients show moderate signs of drift and corroborate the relevance of temporal considerations when validating machine learning models for deployment at the point of care.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"261"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546344","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":"Recent advances in CRISPR-based single-nucleotide fidelity diagnostics.","authors":"K A V Kohabir, E A Sistermans, R M F Wolthuis","doi":"10.1038/s43856-025-00933-4","DOIUrl":"10.1038/s43856-025-00933-4","url":null,"abstract":"<p><p>Accurate point-of-care (PoC) detection of single nucleotide variants (SNVs) can support rapid and cost-effective clinical decision-making in tasks such as diagnosing pathogenic genetic variants, identifying pathogen resistance, or tracing viral lineage differentiation. Traditional nucleic acid diagnostics involving PCR and sequencing lack PoC applicability. CRISPR-based diagnostics (CRISPRdx) offer the necessary operational simplicity and ability to integrate specific nucleic acid sequence detection with isothermal amplification. However, achieving single-nucleotide fidelity is not self-evident and often requires empirical optimization. This Review explores recent strategics aimed at refining CRISPRdx specificity for SNV detection including various ways of tactical guide RNA (gRNA) design, fine-tuned effector selection, and improved reaction conditions. While the approaches described here are functional and can be occasionally combined, they often require optimizations to support specific clinical aims. Looking ahead, leveraging computational and AI tools for gRNA design, and harnessing newly discovered CRISPR systems, will broaden applicability and improve precision detection of CRISPRdx in diverse clinical settings.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"252"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546396","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}