BMC Medicine最新文献

{"title":"Neoadjuvant camrelizumab plus chemotherapy or apatinib for resectable stage IIA-IIIA NSCLC: a multicenter, two-arm, phase II exploratory trial.","authors":"Shuyu Ji, Zhenxin Sheng, Dongliang Bian, Minwei Bao, Kaiqi Jin, Wentian Zhang, Xinsheng Zhu, Fenghuan Sun, Haoran Xia, Han Zhang, Ziyun Shen, Huansha Yu, Lele Zhang, Jie Huang, Zhang Peng, Nan Song, Haifeng Wang, Biyun Qian, Yuming Zhu","doi":"10.1186/s12916-025-04250-4","DOIUrl":"https://doi.org/10.1186/s12916-025-04250-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy and safety of camrelizumab, an anti-PD-1 antibody, combined with either chemotherapy or apatinib, a VEGFR-2 inhibitor, as neoadjuvant treatment for stage IIA-IIIA NSCLC.</p><p><strong>Methods: </strong>This prospective, multicenter, dual-arm, non-randomized phase II trial enrolled participants from four hospitals in China between September 2020 and March 2022. Patients received 2-4 cycles of neoadjuvant treatment followed by surgery. Arm-AR (n = 28) included patients treated with camrelizumab (200 mg every 3 weeks) plus platinum-based chemotherapy, regardless of PD-L1 status. Arm-BR (n = 10) included PD-L1-positive patients treated with camrelizumab (200 mg every 3 weeks) plus apatinib (250 mg daily). The primary endpoint was the major pathological response (MPR) rate. Secondary endpoints included pathological complete response (pCR) rate, objective response rate (ORR), disease control rate (DCR), event-free survival (EFS), overall survival (OS), and safety profiles.</p><p><strong>Results: </strong>In the ITT population, MPR rates were 25.0% (95% CI 10.7-44.9) in arm-AR and 60.0% (95% CI 26.2-87.8) in arm-BR. The 24-month EFS rates were 53.6% and 70.0%, respectively, after a median follow-up of 30.5 months. Grade 3 or higher treatment-related adverse events (TRAEs) occurred in 25% of arm-AR patients and 10% of arm-BR patients.</p><p><strong>Conclusions: </strong>Camrelizumab combined with platinum-based chemotherapy demonstrated promising efficacy and tolerability for resectable IIA-IIIA NSCLC, regardless of PD-L1 status. In PD-L1-positive patients, camrelizumab plus apatinib showed improved safety and effectiveness, highlighting a potential treatment option for this subgroup.</p><p><strong>Trial registration: </strong>NCT04379739, initiated on July 26, 2020.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"429"},"PeriodicalIF":7.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667169","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":"Long-term clinical sequelae among Sudan ebolavirus disease survivors 2 years post-infection: a matched cohort study.","authors":"Haruna Muwonge, Carolyne Nasimiyu, Barnabas Bakamutumaho, Peter Elyanu, Moses L Joloba, Silvia Situma, John Schieffelin, Bronwyn Gunn, Shuangyi Bai, Robert F Breiman, Isaac Ssewanyana, Susan Nabadda, Julius Lutwama, Yonas Tegen, Allan Muruta, Bruce Kirenga, Charles Olaro, Jane Ruth Aceng, Henry Kyobe Bosa, M Kariuki Njenga","doi":"10.1186/s12916-025-04271-z","DOIUrl":"https://doi.org/10.1186/s12916-025-04271-z","url":null,"abstract":"<p><strong>Background: </strong>The long-term health effects of ebolavirus disease (EVD) caused by the Sudan ebolavirus (SUDV) strain remain poorly characterized. Here, we assessed the nature, frequency, and persistence of post-EVD clinical symptoms among SUDV survivors 2 years after infection by comparing them with matched community controls.</p><p><strong>Methods: </strong>The primary objective was determining the prevalence of clinical symptoms over the 24-month period. Using a prospective matched cohort approach, 87 laboratory-confirmed SUDV survivors from the 2022-2023 Ugandan outbreak and 176 age-, sex- and village-matched controls were followed at 3, 9, 12, 15 and 24 months. Symptom data were collected through structured interviews and targeted clinical examinations. A secondary objective was investigating the duration of viral RNA shedding in semen and breast milk of survivors collected during follow-up, using the PCR test.</p><p><strong>Results: </strong>Of the 87 SUDV survivors, 57.5% reported significantly higher frequencies of clinical symptoms involving musculoskeletal (45.0%, P < 0.001), central nervous system (36.3%, p < 0.001), ophthalmologic (20%, P < 0.001), and respiratory (10%, P < 0.001) systems than those observed among controls. The risk ratio of occurrence was highest for ophthalmologic (20% vs 3.4%, RR = 5.9; p < 0.001) and central nervous systems symptoms (36.3% vs 6.8%, RR = 5.3, p < 0.001), and lowest for reproductive system (13.8% vs 8.5%; RR = 1.6; p > 0.005). Importantly, 50% of the survivors reported persistent multi-systemic symptoms, including low back pain, hand and feet numbness, confusion, and diarrhoea that resulted in an inability to perform basic activities of living. Viral RNA was detected in semen for up to 210 post-infection (median = 131 days, range: 111-210 days) and in breast milk for up to 199 days (median = 149 days, range: 111-199 days).</p><p><strong>Conclusions: </strong>This study demonstrates that SUDV survivors develop long-term clinical sequelae characterized by persistent multi-systemic clinical symptoms. Detection of viral RNA in semen and breastmilk for up to 7 months post-infection suggests prolonged persistence, opening the possibility of latency and reactivation of the virus.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"432"},"PeriodicalIF":7.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667148","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":"Early prediction of gestational diabetes mellitus based on systematically selected multi-panel biomarkers and clinical accessibility-a longitudinal study of a multi-racial pregnant cohort.","authors":"Jiaxi Yang, Yaqi Cao, Fang Qian, Jagteshwar Grewal, David B Sacks, Zhen Chen, Michael Y Tsai, Jinbo Chen, Cuilin Zhang","doi":"10.1186/s12916-025-04258-w","DOIUrl":"https://doi.org/10.1186/s12916-025-04258-w","url":null,"abstract":"<p><strong>Background: </strong>Early identification of high-risk women is critical for preventing gestational diabetes mellitus (GDM). We aimed to improve early prediction of GDM using multiple panels of cardiometabolic biomarkers assessed in early and mid-pregnancy, considering clinical accessibility.</p><p><strong>Methods: </strong>In a US study of 2802 pregnant individuals, we assessed 91 cardiometabolic biomarkers at 10-14 (random blood) and 15-26 (fasting) gestational weeks (GW) in 107 GDM cases and 214 controls. Candidate biomarkers were categorized by clinical accessibility from high to low: group I (clinically accessible tests like HbA1c, lipids), group II (clinically accessible biomarkers upon request like insulin-like growth factor (IGF) axis markers, adipokines), and group III (specialty lab-required targeted metabolomics: amino acids (AAs) and phospholipid fatty acids (FAs)). At each visit, we constructed a full model incorporating all candidate biomarkers and conventional predictors. We built alternative models utilizing different groups of biomarkers considering clinical accessibility. Variable selection was performed to retain variables with a p value < 0.10 for a parsimonious model. Model performance was evaluated by area under receiver operating characteristics curve (AUC), proportion of cases followed (PCF, %) and proportion needed to follow (PNF, %), and decision curve analysis.</p><p><strong>Results: </strong>A full model comprising conventional predictors, clinical and non-clinical cardiometabolic biomarkers, and metabolomic markers achieved the highest discriminative accuracy (AUC: 0.842 at 10-14 GW, 0.829 at 15-26 GW). The addition of novel biomarkers increased PCF and decreased PNF, suggesting increased clinical utility. For example, at 10-14 GW, 69.5% of GDM cases are expected to be detected from women whose risk is above the 80% percentile estimated by the full model vs. 49.1% by the conventional model. Additionally, 46.1% of women identified as being at the highest risk by the full model are expected to account for 90.0% of GDM cases vs. 71.1% by the conventional model. Decision curve analysis showed that models incorporating novel biomarkers performed better than the conventional model including glucose, and the full model at 10-14 GW had the highest net benefit, overall.</p><p><strong>Conclusions: </strong>This study suggested that a selected panel of cardiometabolic biomarkers using early-pregnancy random plasma samples predicted GDM comparably to those using mid-pregnancy fasting samples.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"430"},"PeriodicalIF":7.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667147","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":"Association of specific microbiota taxa in the amniotic fluid at birth with severe acute and longer-term outcomes of very preterm infants: a prospective observational study.","authors":"Birte Staude, Silvia Gschwendtner, Tina Frodermann, Frank Oehmke, Thomas Kohl, Susanne Walch, Michael Schloter, Harald Ehrhardt","doi":"10.1186/s12916-025-04259-9","DOIUrl":"https://doi.org/10.1186/s12916-025-04259-9","url":null,"abstract":"<p><strong>Background: </strong>Dysbiotic microbial colonization predisposes to severe outcomes of prematurity, including mortality and severe morbidities like necrotizing enterocolitis (NEC), late-onset infection (LOI) and bronchopulmonary dysplasia (BPD). Here, we studied the variations in the bacterial signatures in the amniotic fluid (AF) of very preterm deliveries < 32 weeks with severe acute and longer-term outcomes within a prospective cohort study.</p><p><strong>Methods: </strong>One hundred twenty-six AF samples were available for 16S rRNA gene metabarcoding to describe bacterial community structure and diversity in connection to intraventricular haemorrhage (IVH), LOI, focal intestinal perforation (FIP), NEC, retinopathy of prematurity (ROP) and the 2-year cognitive (MDI) and motor (PDI) outcome.</p><p><strong>Results: </strong>Diversity and overall bacterial community composition did not differ between the studied outcomes. But disparities in sequences assigned to single bacterial taxa were observed for the acute outcomes LOI and ROP and the longer-term impairments of MDI and PDI. Enrichments associated with a poor acute outcome were particularly detected in the Escherichia-Shigella cluster, while the predominance of Ureaplasma and Enterococcus species was associated with unrestricted acute and longer-term outcomes. Analysis for FIP did not reach any significance. IVH and NEC constituted rare events, prohibiting the analyses.</p><p><strong>Conclusions: </strong>Our data provide evidence that microbiota patterns at birth might allow the early identification of infants at risk for the severe outcomes of prematurity and argue against morbidity-specific associations. The data support the early origins hypothesis and relevant contribution of prenatal factors. The partly existing disparities between acute and longer-term outcomes might be traced back to the relevant impact of the diverse longitudinal exposures and socioeconomic factors.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"431"},"PeriodicalIF":7.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667146","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":"Age-targeted vaccination for reducing Clostridioides difficile infection in England: a coupled mathematical-economic modelling analysis.","authors":"Laith Yakob, Kasim Allel, Aiman Elragig, Tim Planche, Tendai Mugwagwa, Jennifer C Moïsi, Holly Yu","doi":"10.1186/s12916-025-04265-x","DOIUrl":"10.1186/s12916-025-04265-x","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infection (CDI) is associated with high morbidity and mortality, emphasising the need for prophylaxis. The lead vaccine candidate recently demonstrated promising reductions in medically attended cases.</p><p><strong>Methods: </strong>Key risk factors for CDI were incorporated into a hospital-level mathematical model used to simulate the impact of the vaccine on reducing disease burden in England. Model outputs of interest included medically attended cases, intensive care admissions and deaths associated with CDI, as well as costs and quality-adjusted life years (QALYs). Hospital costs and costs of years of life lost due to premature mortality averted per vaccine course were computed for a 10-year time horizon.</p><p><strong>Results: </strong>The epidemiological model demonstrated considerable benefits to targeting older age groups whereby vaccinating only those over the age of 74 years old (i.e. 9% of England's population) more than halved CDI cases and intensive care unit (ICU) admissions. Simulations also showed that this could be expected to reduce deaths by almost two-thirds and that around 20% of lives saved would be achieved through indirect benefits, i.e. due to reduced transmission to unvaccinated as well as vaccinated individuals. Issuing around 5 million vaccine courses in both the first and second year to protect the eldest, and 0.4 million annual courses thereafter to maintain effective coverage of all those over 64 years old, can be expected to avert £378 in costs (2023£) and gain 0.046 QALYs per vaccine course by the fourth year of rollout.</p><p><strong>Conclusions: </strong>Should a safe and efficacious C. difficile vaccine be licensed, it could be positioned very well for providing considerable economical and health benefits. This work guides how these gains could be maximised for England's population.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"426"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of night light exposure and risk of overweight and obesity: a 15-year longitudinal cohort study of 218,239 Chinese children.","authors":"Xijie Wang, Manman Chen, Din Son Tan, Jie Hu, Bin Dong, Yu Jiang, Wannian Liang","doi":"10.1186/s12916-025-04262-0","DOIUrl":"10.1186/s12916-025-04262-0","url":null,"abstract":"<p><strong>Background: </strong>Light at night (LAN) is found to be associated with elevated overweight and obesity in broad population. However, evidence for the long-term LAN exposure trajectories and its influence to weight gain remained limited, especially to school-aged children who experience critical physical development. We aimed to analyze variations in body weight among children with different LAN exposure profiles, and how varying levels of LAN exposure influenced children's overweight (including obesity) risk overt time.</p><p><strong>Methods: </strong>Children who had ≥ 5 school health examinations between 2005 and 2020 in Zhongshan were recruited in this population-based longitudinal study. LAN data of each child at each survey year were modeled with group-based trajectory model and named as sharp rise (reference; 5.5%), mild rise, high stable (69.7%), and decline. Differences of overweight incidence between groups were analyzed.</p><p><strong>Results: </strong>Among 218,283 children (1,318,542 measurements; 53.1% boys; baseline mean [SE] age, 9.1 [2.5]), 12,050 (5.5%) were categorized in the sharp rise group and 152,030 (69.7%) in the stable high group. In the 189,011 participants categorized as normal or underweight at baseline, the overall incidence of overweight during follow-up was 8.80/1000 person-years (95% CI: 8.69, 8.91). Compared to the sharp rise group, the hazard ratios (HR) for developing overweight were 1.67 (95% CI: 1.28, 2.18) for boys and 1.56 (95% CI: 1.21, 2.01) for girls in stable high group, followed by the mild rise group. The HRs in decline group were non-significant. Overall, the stable high trajectory of LAN exposure accounted for 40.24% (range: 22.14, 54.14) of overweight risk in boys and 36.09% (range: 17.79, 50.31) in girls, while the mild rise group contributed approximately 23% to the overall risk.</p><p><strong>Conclusions: </strong>Higher LAN exposure trajectories, especially at early school age, had persistent effect to overweight and obesity risk in school-aged children. Interventions to reduce LAN exposure during school age may help reduce excessive weight gain in children.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"423"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A population-based observational study using statistical modeling to assess the association between depressive symptom severity and sleep disorders in postmenopausal women.","authors":"Ying Cui, Huimin Du","doi":"10.1186/s12916-025-04248-y","DOIUrl":"10.1186/s12916-025-04248-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between depressive symptom severity and sleep disorders in postmenopausal women.</p><p><strong>Methods: </strong>This observational study included data from 4808 postmenopausal women derived from a nationally representative sample in the USA. Depressive symptom severity was assessed using the Patient Health Questionnaire-9, while sleep disorders were identified based on self-reported physician diagnoses. Weighted multivariable logistic regression models were used to analyze the association between depressive symptom severity and sleep disorders, adjusting for potential confounders. Restricted cubic splines were applied to evaluate possible nonlinear relationships, and subgroup analyses were conducted across key sociodemographic, health, and behavioral factors. Additionally, Lasso regression and logistic regression were used to identify the most influential predictors of sleep disorders. Supplementary and sensitivity analyses were performed using alternative sleep outcomes and modified depressive symptom scales to test robustness and item-level overlap.</p><p><strong>Results: </strong>Depressive symptom severity was positively associated with sleep disorders, demonstrating a dose-response relationship (P for trend < 0.001). Each unit increase in depressive symptom score was associated with a 10% higher risk of sleep disorders (OR = 1.10, 95% CI: 1.07-1.13). RCS analysis confirmed a linear association (P for nonlinear = 0.4696). Subgroup analyses identified CVD as a significant effect modifier (P for interaction = 0.019), with a stronger association in individuals with CVD (OR = 1.11, 95% CI: 1.09-1.13) compared to those without (OR = 1.07, 95% CI: 1.03-1.11). Lasso and logistic regression analyses consistently ranked depressive symptoms as the strongest predictor of sleep disorders. The association remained robust and specific across both supplementary outcomes and sensitivity models using modified depressive symptom scales.</p><p><strong>Conclusions: </strong>This study demonstrated a linear dose-response association between depressive symptom severity and sleep disorders in postmenopausal women, which was further amplified among individuals with CVD. Depressive symptoms were identified as the most critical predictor, underscoring the importance of mental health in managing sleep health. These findings highlight the need for integrated interventions combining mental health screening, lifestyle modifications, and community-based care approaches to mitigate the dual burden of depressive symptoms and sleep disorders in this vulnerable population.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"424"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuity of social support among US adults with cognitive impairment before and after the confirmed diagnosis of dementia: a matched ambidirectional cohort study.","authors":"Huanyu Zhang, Benjamin R Underwood, Sabina London, Huitong Zhao, Jiazhou Yu, Da Feng, Shanquan Chen","doi":"10.1186/s12916-025-04264-y","DOIUrl":"10.1186/s12916-025-04264-y","url":null,"abstract":"<p><strong>Background: </strong>Despite increased attention on dementia, much remains unknown about the integration of clinical and non-clinical care, particularly regarding long-term social support, a primary source of non-clinical care. This study uniquely examines the effect of receiving a formal dementia diagnosis on the continuity of social support, an understudied transition point in dementia care pathways.</p><p><strong>Methods: </strong>In this ambidirectional cohort study, we examined ten waves of data from the Health and Retirement Survey(HRS) for US adults over 50 through 2000-2018. Eligibility was limited to participants with cognitive impairment. The exposure group were people with a confirmed dementia diagnosis (N = 1261), and the control group were matched by age, sex, race/ethnicity, and survey wave, but without a confirmed diagnosis (N = 12,604). Unmet social support was defined as reporting physical disability without receiving corresponding social support. Physical disability was assessed using measures of basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). The data were fitted using controlled interrupted time series analysis to explore the continuity of unmet social support before and after a diagnosis.</p><p><strong>Results: </strong>After dementia diagnosis, adults experienced a significant increase in unmet IADL support needs (coef = 0.10, 95% CI [0.07, 0.13]), particularly for making phone calls (coef = 0.74, 95% CI [0.16, 1.33]). By race/ethnicity, Hispanics showed a significant rise in unmet BADL support needs (coef = 0.74, 95% CI [0.03, 1.46]), especially for eating assistance (coef = 1.58, 95% CI [0.17, 2.99]). Blacks experienced increased unmet BADL needs in toileting (coef = 1.52, 95% CI [0.57, 2.47]) and IADL support (coef = 0.09, 95% CI [0.00, 0.17]). Sex disparities were also identified, with females showing decreased unmet BADL support(coef =  - 0.55, 95% CI [- 1.03, - 0.06]) but increased unmet IADL support (coef = 0.08, 95% CI [0.04, 0.11]), while males experienced increased unmet toileting (coef = 0.78, 95% CI [0.03, 1.53]) and IADLs support (coef = 0.14, 95% CI [0.10, 0.18]).</p><p><strong>Conslusions: </strong>Our study identifies a disconnect in the care provided to individuals with dementia before and after their diagnosis. Notably, post-diagnosis, we observed substantial disparities in unmet social support needs across various racial groups. This highlights the need for more cohesive and equitable care strategies in the dementia care continuum.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"428"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faecalibacterium prausnitzii enhances intestinal IgA response by host-microbe derived inecalcitol in colitis.","authors":"Wenfei Qin, Nuoming Yin, Binqiang Xu, Qixiang Mei, Yang Fu, Junjie Fan, Yingying Lu, Guangqiang Wang, Lianzhong Ai, Zhanjun Lu, Yue Zeng, Chunlan Huang","doi":"10.1186/s12916-025-04260-2","DOIUrl":"10.1186/s12916-025-04260-2","url":null,"abstract":"<p><strong>Background: </strong>Faecalibacterium prausnitzii plays a crucial role in ulcerative colitis (UC) remission, but its action mechanism is unknown. Here, we aimed to explore the potential mechanisms focusing on the interaction of F. prausnitzii with host immune response and its potential modulation on gut microbiome.</p><p><strong>Methods: </strong>RNA-seq analysis together with 16S rRNA sequencing and metabolomics were performed in a dextran sodium sulfate (DSS)-induced colitis mouse model followed by F. prausnitzii gavage. To present evidence of sIgA involved in the anti-inflammatory effects of F. prausnitzii, we further applied immunoglobulin A (IgA) knockout mice and secretory IgA (sIgA) depletion mouse models using polymeric immunoglobulin receptor (pIgR) neutralizing antibody. Colonic immune cells were characterized by flow cytometry. The fecal relative abundance of F. prausnitzii, inecalcitol, and colonic IgA expression were assessed in UC patients.</p><p><strong>Results: </strong>F. prausnitzii markedly ameliorated colitis by alleviating intestinal inflammation and barrier dysfunction, with significantly decreased abundance of pro-inflammatory taxa (Enterococcus, Desulfovibrio, Escherichia-Shigella, and Enterorhabdus) and increased abundance of Lachnospiraceae NK4A136_group. Functions related to intestinal immune network for IgA production pathway were up-regulated shown by transcriptomics and KEGG pathway analysis. Increased expression of IgA production associated genes including MHCII-related genes, Aicda, and Tnfrsfl3c were verified, accompanied by up-regulated colonic IgA and pIgR. The IgA knockout mice and sIgA depletion model weakened the anti-inflammation and microbiota-modulation effects of F. prausnitzii, which was further proved by fecal microbiota transplantation (FMT). The shift profile of fecal metabolites after F. prausnitzii supplement was characterized by increased production of inecalcitol, which may account for the enhanced IgA response. In a cohort of UC patients, the relative abundance of F. prausnitzii was decreased and positively correlated with colonic IgA expression and negatively correlated with disease severity.</p><p><strong>Conclusions: </strong>F. prausnitzii effectively alleviated colonic inflammation and modulated dysbiosis via enhancing colonic IgA response, thus showing promise as a UC treatment.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"425"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma carotenoids are inversely correlated with granulocyte counts and soluble inflammatory markers in a middle-aged population: a cross-sectional study with mediation analysis.","authors":"Jan Neelissen, Per Leanderson, Fredrik H Nyström, Lena Jonasson, Rosanna W S Chung","doi":"10.1186/s12916-025-04266-w","DOIUrl":"10.1186/s12916-025-04266-w","url":null,"abstract":"<p><strong>Background: </strong>High intake of fruits and vegetables is generally associated with reduced levels of inflammation. In line with this, plasma levels of carotenoids have shown inverse associations with inflammatory markers, in particular C-reactive protein (CRP) and leukocyte counts. However, it remains unclear to what extent carotenoids are associated with specific leukocyte subsets or other inflammatory markers. This study systematically assessed the inter-relationships among total and individual carotenoids, circulating leukocyte subsets, and soluble inflammatory markers in a middle-aged population.</p><p><strong>Methods: </strong>A subcohort of 1078 subjects, aged 50-64, was recruited from the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort. Leukocyte subsets were determined by whole blood flow cytometry. Five major carotenoids, namely lutein, β-cryptoxanthin, lycopene, α-carotene and β-carotene, and inflammatory markers including CRP, interleukin (IL)-6 and interleukin-18, matrix metalloproteinase (MMP)-9, and myeloperoxidase (MPO), were measured in plasma. Nutrient intake was estimated by validated food frequency questionnaires.</p><p><strong>Results: </strong>Among leukocyte subsets, only granulocytes showed independent and inverse associations with all carotenoids after adjustment. CRP, IL-18, and MMP-9 exhibited similar inverse relationships with most carotenoids. Mediation analysis revealed that the associations of carotenoids with CRP and MMP-9 were mediated by granulocyte counts. Lutein and β-cryptoxanthin remained independently associated with MMP-9 after accounting for the mediation effects of granulocyte counts. No estimated nutrient intake showed comparable associations with leukocyte subsets or inflammatory markers.</p><p><strong>Conclusions: </strong>To our knowledge, this is the largest population-based study investigating relationships between plasma carotenoids, leukocyte subsets, and soluble inflammatory markers. It provides evidence that low levels of carotenoids in plasma are linked to low-grade chronic inflammation and, furthermore, that this relationship is mediated by granulocyte numbers.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"427"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}