Annals of medicine最新文献

{"title":"Clinical impact of disease stability on exacerbation and mortality in COPD: a retrospective cohort study.","authors":"Sang Hyuk Kim, Jung-Kyu Lee, Kyung Hoon Min, Deog Kyeom Kim, Hyun Woo Lee","doi":"10.1080/07853890.2025.2611466","DOIUrl":"10.1080/07853890.2025.2611466","url":null,"abstract":"<p><strong>Background: </strong>Disease stability is an achievable goal in chronic obstructive pulmonary disease (COPD) management. However, the clinical implications of disease stability in patients with COPD remain unclear.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study using the electronic medical records of treated patients with symptomatic COPD. Patients who had newly initiated inhaler therapy with long-acting β2-agonist/long-acting muscarinic antagonist (LABA/LAMA) or inhaled corticosteroid/LABA/LAMA combinations were included. Disease stability was defined over a one-year assessment period as meeting all of the following criteria: (1) symptom stability; (2) no moderate or severe exacerbations; and (3) no rapid decline in lung function. The outcomes included acute exacerbations and all-cause mortality.</p><p><strong>Results: </strong>Of the 725 screened patients, 405 were eligible for inclusion in the study. Among them, 158 (39.0%) achieved disease stability. The proportions of patients who met each criterion were 70.4% for symptom stability, 63.7% for no exacerbations, and 71.4% for a non-rapid lung function decline. Only 5.9% met none of these criteria. During the follow up duration of median 62 (interquartile ranges, 30-90) months, disease stability was significantly associated with a reduced risk of moderate-to-severe (adjusted hazard ratio [aHR] 0.521, 95% confidence interval [CI] 0.392-0.692) and severe (aHR 0.393, 95% CI 0.279-0.553) exacerbations after adjusting for confounders. It was also associated with a decreased mortality risk (aHR 0.345, 95% CI 0.135-0.883).</p><p><strong>Conclusion: </strong>Disease stability was associated with a lower risk of exacerbation and mortality, suggesting its potential role as a treatment target and outcome measure for COPD.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2611466"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12778000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906774","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":"Comparison of liposomal bupivacaine and bupivacaine hydrochloride intercostal nerve blocks for postoperative analgesia after thoracic surgery: a multicenter, randomized, three arms trial protocol.","authors":"Junyi Huang, Lihua Wang, Shiyou Wei, Yuxuan Xin, Rui Chang, Hang Liu, Yiming Yang, Jiong Song, Xin Lv","doi":"10.1080/07853890.2025.2612384","DOIUrl":"10.1080/07853890.2025.2612384","url":null,"abstract":"<p><strong>Introduction: </strong>Whether intercostal nerve block can fully realize the prolonged analgesic potential of liposomal bupivacaine remains uncertain. This study aims to evaluate whether liposomal bupivacaine administered <i>via</i> intercostal nerve block confers a long-acting analgesic advantage over bupivacaine hydrochloride and no block within the postoperative 25-72 h window.</p><p><strong>Patients and methods: </strong>This is a multicenter, randomized, parallel, three-arm controlled trial planning to enroll 210 patients undergoing elective unilateral video-assisted thoracoscopic surgery. Using center-stratified block randomization (1:1:1), patients will be allocated at the end of surgery to receive an intercostal nerve block with liposomal bupivacaine, bupivacaine hydrochloride, or no block. All patients will follow a standardized general anesthesia and multimodal analgesia protocol. The primary outcome is the area under the curve for pain scores during the postoperative 25-72 h. Other outcomes include pain verbal response scale at predefined time points, cumulative postoperative morphine milligram equivalent consumption, sensory block recovery time, 15-item quality of recovery scale, postoperative nausea and vomiting, postoperative pulmonary complications, length of hospital stay.</p><p><strong>Discussion: </strong>This study prospectively evaluates the central question of whether liposomal bupivacaine confers a clinically meaningful long-acting analgesic advantage when used in the context of nerve block. By focusing on the area under the curve of pain scores and incorporating patient-centered outcomes such as opioid consumption and quality of recovery, the study aims to generate high-quality, translatable evidence to define the role of liposomal bupivacaine in thoracic surgery.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.org, NCT07134660.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2612384"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013832","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":"Application of artificial intelligence in head and neck squamous cell carcinoma.","authors":"Peipei Wang, Jiaxin Tian, Guowan Zheng, Yunzhao Chen, Xinxin Ren","doi":"10.1080/07853890.2026.2620191","DOIUrl":"10.1080/07853890.2026.2620191","url":null,"abstract":"<p><p><b>Background</b>: Head and neck squamous cell carcinoma (HNSCC) emerges from the mucosal linings of the paranasal sinuses, nasal cavities, oral cavity, nasopharynx, oropharynx, hypopharynx and larynx. Despite significant advances in understanding its epidemiology, pathogenesis and treatment strategies, the survival rate of HNSCC has shown little improvement over the last 40 years, maintaining a 5-year survival outcome of approximately 50%. Although the emergence of immunotherapies, such as pembrolizumab-FDA-approved for first-line HNSCC treatment-has shown promise in enhancing therapeutic outcomes and patient prognosis, merely a limited portion of individuals with HNSCC experience advantages from these therapeutic approaches.</p><p><p><b>Main body</b>: Consequently, the need for novel biomarkers to refine treatment selection is increasingly urgent. The swift progress of artificial intelligence (AI) in medicine has enabled large-scale biomarker screening and the creation of predictive models, which are critical for identifying immunotherapy responders and predicting patient outcomes. This review summarizes current immunotherapeutic approaches in HNSCC and examines the role of AI in advancing immunotherapy strategies.</p><p><p><b>Discussion</b>: Furthermore, it discusses the challenges, opportunities and strategies associated with integrating AI into clinical practice. Finally, the review highlights the transformative potential of AI in HNSCC immunotherapy and offers perspectives on its future applications.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2620191"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069371","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":"Research progress of mesenchymal stem cells/stromal cells and their derivatives against cell senescence in the treatment of osteoarthritis.","authors":"Daihua Deng, Yinlan Wu, Tong Wu, Deying Huang, Xiuping Liang, Chunyu Tan, Yanhong Li, Yi Liu","doi":"10.1080/07853890.2026.2627667","DOIUrl":"10.1080/07853890.2026.2627667","url":null,"abstract":"<p><strong>Background: </strong>Cellular senescence plays a critical role in the pathogenesis and progression of osteoarthritis (OA), contributing to articular cartilage degradation, chronic inflammation, and joint function impairment. Mesenchymal stem cells/stromal cells (MSCs) and their derivatives have emerged as potential targets for novel therapeutic strategies against cell senescence in OA, as they exert anti-aging effects in repairing damaged cartilage through multiple mechanisms-including regulating age-related signaling pathways, reducing the secretion of pro-inflammatory cytokines, and improving mitochondrial function.</p><p><strong>Discussion: </strong>In recent years, a growing body of in-depth studies has focused on various types of MSCsand their derivatives, revealing subtle differences in their anti-cell senescence pathways and therapeutic effects. This review summarizes the latest cutting-edge research, systematically exploring the multi-dimensional roles of these MSCs and their derivatives in ameliorating senescent cell-related pathology in OA, and highlighting their potential clinical application value.</p><p><strong>Conclusions: </strong>Despite the promising anti-aging effects of MSCs and their derivatives in OA treatment, further molecular-level mechanistic studies and large-scale clinical trials are required to verify the efficacy and safety of therapies based on their anti-cell senescence properties. These efforts are expected to provide new breakthroughs in the clinical management of OA, offering more effective treatment options for patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2627667"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596599","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":"Hypertension management in transition: gains, gaps, and growing challenges in a high-altitude multi-ethnic region of China (2019-2024).","authors":"Tingxin Li, Ping Shuai, Maolin Chen, Jing Zhao, Yue Li, Qichuan Qiao, Ruixuan Hou, Zixuan Wang, Xing Chen","doi":"10.1080/07853890.2026.2639162","DOIUrl":"10.1080/07853890.2026.2639162","url":null,"abstract":"<p><strong>Background: </strong>Hypertension remains a major public health challenge in China, particularly in socioeconomically transitioning regions. This study aims to evaluate changes in hypertension prevalence, awareness, treatment, and control rates between 2019 and 2024 in a Tibetan-predominant area of Sichuan Province.</p><p><strong>Methods: </strong>Two cross-sectional surveys were conducted in 2019 (<i>n</i> = 1,880) and 2024 (<i>n</i> = 1,870). Inverse probability of treatment weighting (IPTW) and age-standardization were applied to enhance comparability. Subgroup analyses were performed to examine disparities across gender, residence, age, and education groups.</p><p><strong>Results: </strong>Age-standardized hypertension prevalence decreased significantly from 22.86% to 15.53%. Awareness, treatment, and control rates all improved markedly, from 24.63% to 53.43%, 16.08% to 43.93%, and 3.98% to 17.37%, respectively. Health inequities narrowed substantially between urban and rural areas and between genders. However, absolute control rates remained suboptimal (18.14% in 2024). Rising obesity prevalence (5.11% to 11.44%) and persistent gaps in treatment quality were observed.</p><p><strong>Conclusions: </strong>Substantial progress in hypertension management and health equity was observed in the area between 2019 and 2024. However, persistently low control rates and rising obesity highlight the need to enhance treatment quality and implement integrated cardiovascular risk reduction strategies. These findings provide important insights for chronic disease management in similar transitioning regions.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2639162"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358002","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":"Endoscopic grading of gastric intestinal metaplasia and microvascular pattern for assessing gastric cancer risk: a prospective study.","authors":"Xueling Zhang, Jinxin Shi, Weijia Wang, Haotian Chen, Qian Li, Yixuan Wu, Yue Wu, Guangzhi Shi, Qinsheng Zhang, Wei Wen, Peilin Cui","doi":"10.1080/07853890.2026.2668887","DOIUrl":"10.1080/07853890.2026.2668887","url":null,"abstract":"<p><strong>Background and aims: </strong>The endoscopic grading of gastric intestinal metaplasia (EGGIM) has not been comprehensively validated. Microvascular (MV) pattern abnormalities are critical for diagnosing gastric neoplastic transformation. The present study aims to validate the diagnostic accuracy of EGGIM for identifying high-risk GIM patients and to develop a modified EGGIM model incorporating microvascular pattern, evaluating its diagnostic performance for risk stratification of GC development in GIM patients.</p><p><strong>Methods: </strong>All patients underwent EGGIM scoring and microvascular pattern evaluation. Targeted or random biopsies were performed at the antrum, incisura, and corpus, followed by operative link on gastric intestinal metaplasia assessment (OLGIM). The sensitivity, specificity, positive likelihood ratios (PLR), and positive predictive values (PPV) of both EGGIM and the modified EGGIM model for assessing GC risk in GIM patients were validated.</p><p><strong>Results: </strong>A total of 144 patients were enrolled. The area under curve (AUC) of the receiver operating characteristic of EGGIM for diagnosing OLGIM III-IV was 0.885 (95% CI 0.837-0.943). At the cutoff value ≥4, the sensitivity, specificity, PLR, and PPV were 90.90%, 73%, 3.36, and 50%, respectively. Altered microvascular pattern was identified as a risk factor for high-risk GC development in GIM (<i>p</i> < 0.001; odds ratio [OR] = 4.696; 95% CI 2.792-7.896). The modified EGGIM model achieved an AUC of 0.921 (95% CI 0.873-0.968) for identifying OLGIM III-IV; at the cutoff value ≥ 2.5, the sensitivity, specificity, PLR, and PPV were 97%, 66.70%, 2.91, and 46.4%, respectively. After incorporating MV, the AUC of the EGGIM score increased from 0.885 to 0.921, suggesting improved diagnostic performance.</p><p><strong>Conclusions: </strong>Microvascular pattern serves as a significant independent predictor for OLGIM III-IV. The modified EGGIM demonstrated good diagnostic performance for OLGIM III-IV, suggesting its potential as a non-invasive endoscopic tool for assessing the risk stratification of GC development.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2668887"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870816","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":"Reference ranges and influencing factors of pressure pain threshold in Chinese patients with knee osteoarthritis.","authors":"Zhiheng Hu, Xiaofeng Chang, Shuxin Yao, Feng Ye, Chao Xu, Jianbing Ma","doi":"10.1080/07853890.2026.2664304","DOIUrl":"10.1080/07853890.2026.2664304","url":null,"abstract":"<p><strong>Background: </strong>Pressure pain threshold (PPT) is a reliable objective measure of pain sensitization; however, standardized region-specific reference data for Chinese patients with knee osteoarthritis (KOA) remain scarce. This study aimed to establish preliminary PPT reference ranges for end-stage KOA patients and age- and sex-matched healthy controls in Xi'an, Northwest China, and to identify factors influencing PPT.</p><p><strong>Methods: </strong>A total of 165 patients with end-stage KOA scheduled for total knee arthroplasty and 146 age- and sex-matched healthy controls were enrolled. PPT at the medial knee and dorsal forearm was assessed using standardized PPT assessment. Demographic characteristics, body mass index (BMI), sociological factors and Central Sensitization Inventory (CSI) scores were collected. Nonparametric analyses, Spearman correlation and hierarchical regression were performed.</p><p><strong>Results: </strong>KOA patients exhibited significantly lower median PPTs (forearm: 3.79; knee: 4.21 kg·cm^-2) compared with controls (forearm: 5.53; knee: 6.57 kg·cm^-2; all <i>p</i> < 0.001), with left-shifted and broader 95% reference ranges (KOA: forearm 2.16-6.09; knee 2.07-6.78 kg·cm^-2). CSI scores were moderately negatively correlated with forearm PPT (r = -0.567) and weakly correlated with knee PPT (r = -0.389; all <i>p</i> < 0.001). After adjusting for confounders, CSI remained the strongest independent predictor of PPT (forearm: β = -0.403; knee: β = -0.301; all <i>p</i> < 0.001), explaining greater incremental variance (ΔR² = 0.144 for forearm; ΔR² = 0.080 for knee) than other factors. In healthy controls, PPT was influenced only by sex, age and BMI (all <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>This study is the first to establish preliminary PPT reference ranges for end-stage KOA patients in Xi'an, Northwest China, suggesting generalized pain hypersensitivity as a predominant phenotype in this cohort. The strong correlation between CSI (subjective) and forearm PPT (objective) provides a preliminary basis for future preoperative stratification and potential perioperative analgesic strategies, with potential clinical translational value.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2664304"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13162543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870785","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":"Association between PFAS and renal function indicators in cord blood of newborns: modifying effects of newborn sex and maternal factors.","authors":"Wu Yan, Penghong Xu, Ying Xu, Wentao Yang, Qian Huang, Sabitina Mrisho Mzava, Francis Manyori Bigambo, Dandan Wang, Xu Wang","doi":"10.1080/07853890.2026.2678686","DOIUrl":"10.1080/07853890.2026.2678686","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the associations between per- and polyfluoroalkyl substances (PFAS) exposure and renal function in newborns remains limited, particularly in cord blood studies. This retrospective cross-sectional study aimed to explore the associations between individual and mixed PFAS exposure with renal function indicators in the cord blood and to examine whether these associations were modified by newborn sex and maternal factors.</p><p><strong>Materials and methods: </strong>A total of 403 newborns with available cord blood samples were included. Six PFAS and renal function indicators were measured in cord blood. Multivariable linear regression, quantile-based g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) models were used to evaluate the associations of individual and mixed PFAS exposure with blood urea nitrogen (BUN), creatinine (Cr), the BUN-to-Cr ratio (UCR), and estimated glomerular filtration rate (eGFR).</p><p><strong>Results: </strong>In multivariable linear regression analyses, perfluorobutanoic acid (PFBA) and perfluorononanoic acid (PFNA) were positively associated with BUN; PFBA, perfluorooctanoic acid (PFOA), and PFNA were positively associated with the UCR; and PFBA and perfluorohexanoic acid (PFHxA) were positively associated with eGFR. PFBA and PFHxA were inversely associated with Cr. Mixture analyses further showed that PFAS co-exposure was positively associated with BUN, UCR, and eGFR, but negatively associated with Cr. These associations were more pronounced among male newborns, those delivered vaginally, and those born to mothers aged ≤30 years with a normal pre-pregnancy body mass index.</p><p><strong>Conclusion: </strong>These findings suggest that prenatal co-exposure to PFAS, particularly PFBA, PFNA, PFOA, and PFHxA, may be associated with alterations in renal function indicators in newborns. The associations appeared to differ by newborn sex and maternal characteristics. Prospective longitudinal studies are needed to determine whether these early biomarker differences persist after birth and are related to later kidney outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2678686"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13228176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140142","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":"Parents' willingness to vaccinate their children with special health care needs: a cross-sectional study.","authors":"Lingling Wang, Min Yang, Xuwen Wang, Qing Ye, Xu Yang, Shixin Xiu","doi":"10.1080/07853890.2026.2692729","DOIUrl":"10.1080/07853890.2026.2692729","url":null,"abstract":"<p><strong>Background: </strong>Parents of children with special health care needs (CSHCN) usually hesitate to vaccinate their children, yet limited data on factors influencing parents' willingness to vaccinate their children are available. Our study aimed to reveal parents' willingness to immunize their children with the Expanded Programme on Immunization Vaccines and identify determinants influencing parents' willingness.</p><p><strong>Methods: </strong>We conducted a cross-sectional, questionnaire-based survey using a stratified sampling approach in Wuxi, China. Description methods were used to describe guardians' willingness to vaccinate their children, and logistic regression analysis was employed to examine the influencing factors of parents' willingness.</p><p><strong>Results: </strong>A total of 904 parents/guardians were collected; 864 (95.58%) were willing to immunize their children. Univariate analysis revealed that parents' knowledge of vaccines and their awareness of vaccination assessment clinics were factors that influenced vaccination willingness. The multivariate logistic regression results indicated that parental education level and awareness of vaccination assessment clinics were significant predictors of parents' willingness to vaccinate their children.</p><p><strong>Conclusion: </strong>Higher parental knowledge and use of vaccination consultation clinic services are associated with greater willingness to vaccinate among parents of children with special health care needs.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2692729"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320856","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":"Integrative profiling of oral fungal communities across <i>Mycobacterium Tuberculosis</i> burden groups in Xpert-positive patients.","authors":"Yilin Wang, Rui Li, Zihan Tang, Zichun Ma, Xiaowei Dong, Wei Shu, Junwei Cui, Mingchong Wei, Zubi Liu, Dan Shen, Liang Li, Yu Pang","doi":"10.1080/07853890.2026.2698284","DOIUrl":"10.1080/07853890.2026.2698284","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB), caused by <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>), remains a major global health burden. A growing body of evidence suggests that mucosal microbial communities may reflect or modulate host responses during infection. However, the oral microbiome in TB patients with different bacterial loads remains poorly characterized. This study aimed to investigate alterations in oral fungal communities among Xpert-positive patients, stratified by <i>Mtb</i> burden based on Xpert MTB/RIF testing.</p><p><strong>Methods: </strong>In this prospective multicenter cohort study (May-August 2024), 278 Xpert-positive TB patients were enrolled across five hospitals in China. Participants were stratified into high, medium, low, and very low <i>Mtb</i> burden groups according to Xpert MTB/RIF cycle threshold values. Paired sputum and tongue swab samples were collected. Oral fungal profiles were characterized <i>via</i> ITS sequencing, followed by taxonomic assignment, diversity analysis, and multivariable association testing (MaAsLin 2) to identify robust biomarkers.</p><p><strong>Results: </strong>Oral fungal community structure varied significantly across <i>Mtb</i> burden strata. Beta-diversity analysis revealed distinct clustering between the very low burden group and higher burden groups (high, medium, low). High-burden patients were enriched with environmental taxa such as <i>Blumeria</i> and <i>Toxicocladosporium</i>, whereas low-burden groups exhibited higher abundances of <i>Candida</i>, <i>Aspergillus</i>, and <i>Penicillium</i>. Notably, MaAsLin 2 analysis confirmed that <i>Penicillium</i> and <i>Podosphaera</i> were independently associated with lower <i>Mtb</i> burden after adjusting for confounders. Neutral model analysis indicated that stochastic processes predominantly drive the assembly of these oral fungal communities. Functional prediction suggested enhanced aerobic respiration and metabolic enzyme activity in high-burden groups.</p><p><strong>Conclusions: </strong>This study analyzed the oral fungal microbiome stratified by <i>Mtb</i> burden strata in Xpert-positive patients, revealing distinct shifts in fungal composition and functional potential. Fungal dysbiosis and altered microbial metabolic capacity may offer insight into host-microbe interactions in pulmonary TB (PTB). These findings underscore the potential value of fungal microbiome profiling for assessing <i>Mtb</i> burden, beyond its application in TB diagnosis alone.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2698284"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407419","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}