Pub Date : 2026-02-06DOI: 10.1038/s41591-026-04205-z
Nerys Astbury, Elizabeth Morris
Data suggest that primary care practices could help deliver effective weight management — but only with robust implementation strategies that acknowledge the realities and pressures of primary care settings.
{"title":"Practical solutions to weight management in primary care","authors":"Nerys Astbury, Elizabeth Morris","doi":"10.1038/s41591-026-04205-z","DOIUrl":"10.1038/s41591-026-04205-z","url":null,"abstract":"Data suggest that primary care practices could help deliver effective weight management — but only with robust implementation strategies that acknowledge the realities and pressures of primary care settings.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"32 2","pages":"418-419"},"PeriodicalIF":50.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132401","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}
Pub Date : 2026-02-06DOI: 10.1038/s41591-025-04197-2
Petronela Weisová, Susanne Scheiblauer, Jacqueline Ecker, Martina Schneider, Romana Hochreiter, Annegret Bitzer, Karin Kosulin, Petra Schoengrundner, Ulrike Fuchs, Luz Rodeles, Sonia Mazara, Yeycy Donastorg, Silvia Rivera, Nina Wressnigg, Katrin Dubischar, Vera Buerger, Susanne Eder-Lingelbach, Juan Carlos Jaramillo
Currently, no licensed vaccine is available against chikungunya virus (CHIKV) in children aged less than 12 years. In this phase 2, observer-blind, randomized, dose–response trial we evaluated the tolerability (solicited adverse events (AEs)), safety (unsolicited AEs) and immunogenicity of a live-attenuated CHIKV vaccine (VLA1553) in healthy children aged 1–11 years in endemic countries. Here we provide a prespecified interim analysis to 28 days after vaccination. Participants (n = 304) received either a half dose (n = 119) or a full dose (n = 124) of VLA1553, or active control meningococcal vaccine (Nimenrix) (n = 61). The primary endpoint was the incidence and severity of solicited AEs within 14 days after vaccination. Secondary endpoints included unsolicited AEs, medically attended AEs, serious AEs, AEs of special interest and immunogenicity through 28 days after vaccination. For the primary endpoint, there were no statistically significant differences between the VLA1553 groups and control for each age group nor between age groups (1–2, 3–6 and 7–11 years). Overall, the most frequently reported solicited injection site AEs were tenderness (10.9%) and pain (8.6% of participants); the most frequently reported solicited systemic AEs were fever (12.5%) and headache (11.5%; participants aged 7–11 years and 3–6 years only, (headache was not solicited in participants aged 1–2 years)). For the secondary safety endpoints, the most common unsolicited AEs were infections and infestations (10.0–20.5%) and the most common medically attended AE overall was fever (2.6%), with no differences for unsolicited AEs or medically attended AEs regardless of vaccine and age group (serious AEs and AEs of special interest were too infrequent for meaningful comparisons). Anti-CHIKV neutralizing antibody titers were higher in the full-dose than the half-dose group at days 14 and 28 after vaccination. The trial met its prespecified endpoints and supported the selection of full-dose VLA1553 in future clinical trials in this population, addressing a critical unmet medical need. ClinicalTrials.gov registration: NCT06106581 . In a phase 2 randomized, controlled, dose–response trial, the live-attenuated chikungunya vaccine (VLA1553) was given in full and half doses to children under the age of 12 in Honduras and the Dominican Republic and was found to be safe and immunogenic, with the results supporting selection of the full-dose VLA1553 in future clinical trials in this population.
{"title":"Live-attenuated chikungunya vaccine in children: a randomized phase 2 trial","authors":"Petronela Weisová, Susanne Scheiblauer, Jacqueline Ecker, Martina Schneider, Romana Hochreiter, Annegret Bitzer, Karin Kosulin, Petra Schoengrundner, Ulrike Fuchs, Luz Rodeles, Sonia Mazara, Yeycy Donastorg, Silvia Rivera, Nina Wressnigg, Katrin Dubischar, Vera Buerger, Susanne Eder-Lingelbach, Juan Carlos Jaramillo","doi":"10.1038/s41591-025-04197-2","DOIUrl":"10.1038/s41591-025-04197-2","url":null,"abstract":"Currently, no licensed vaccine is available against chikungunya virus (CHIKV) in children aged less than 12 years. In this phase 2, observer-blind, randomized, dose–response trial we evaluated the tolerability (solicited adverse events (AEs)), safety (unsolicited AEs) and immunogenicity of a live-attenuated CHIKV vaccine (VLA1553) in healthy children aged 1–11 years in endemic countries. Here we provide a prespecified interim analysis to 28 days after vaccination. Participants (n = 304) received either a half dose (n = 119) or a full dose (n = 124) of VLA1553, or active control meningococcal vaccine (Nimenrix) (n = 61). The primary endpoint was the incidence and severity of solicited AEs within 14 days after vaccination. Secondary endpoints included unsolicited AEs, medically attended AEs, serious AEs, AEs of special interest and immunogenicity through 28 days after vaccination. For the primary endpoint, there were no statistically significant differences between the VLA1553 groups and control for each age group nor between age groups (1–2, 3–6 and 7–11 years). Overall, the most frequently reported solicited injection site AEs were tenderness (10.9%) and pain (8.6% of participants); the most frequently reported solicited systemic AEs were fever (12.5%) and headache (11.5%; participants aged 7–11 years and 3–6 years only, (headache was not solicited in participants aged 1–2 years)). For the secondary safety endpoints, the most common unsolicited AEs were infections and infestations (10.0–20.5%) and the most common medically attended AE overall was fever (2.6%), with no differences for unsolicited AEs or medically attended AEs regardless of vaccine and age group (serious AEs and AEs of special interest were too infrequent for meaningful comparisons). Anti-CHIKV neutralizing antibody titers were higher in the full-dose than the half-dose group at days 14 and 28 after vaccination. The trial met its prespecified endpoints and supported the selection of full-dose VLA1553 in future clinical trials in this population, addressing a critical unmet medical need. ClinicalTrials.gov registration: NCT06106581 . In a phase 2 randomized, controlled, dose–response trial, the live-attenuated chikungunya vaccine (VLA1553) was given in full and half doses to children under the age of 12 in Honduras and the Dominican Republic and was found to be safe and immunogenic, with the results supporting selection of the full-dose VLA1553 in future clinical trials in this population.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"32 2","pages":"561-571"},"PeriodicalIF":50.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132417","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}
Pub Date : 2026-02-06DOI: 10.1038/s41591-025-04194-5
Joshua S. Siegel, Conor Liston, Ginger E. Nicol, Robin L. Carhart-Harris, Michael P. Bogenschutz
Classic psychedelics typically act at the serotonin 5-HT2A receptor to profoundly alter brain function and consciousness. Research on these compounds has accelerated. Major strides have been made in understanding their unique mechanisms of action and clinical potential. This Review outlines the state of psychedelic science, spanning cellular mechanisms, systems neuroscience and clinical investigation. We show that preclinical and human research findings converge on two complementary processes: acute neural desynchronization, which destabilizes entrenched network patterns, and subacute neuroplasticity, which opens a window for psychological and behavioral change. We review evidence of therapeutic response across neuropsychiatric indications and consider how this integrates with mechanistic findings. We also explore challenges and opportunities, including discrepancies between preclinical evidence that non-hallucinogenic psychedelic analogs engage putative therapeutic mechanisms, and clinical evidence linking the subjective experience to therapeutic response; the risks inherent to enhanced neuroplasticity; and questions surrounding trial design, scalability and regulatory approval. The growth of psychedelic science and medicine may compel a fundamental rethinking of the relationship between subjective experience and biological change in psychiatry. This Review outlines the science behind psychedelic medicine and integrates mechanistic knowledge with clinical evidence across neuropsychiatric indications, highlighting challenges, controversies and opportunities.
{"title":"The science of psychedelic medicine","authors":"Joshua S. Siegel, Conor Liston, Ginger E. Nicol, Robin L. Carhart-Harris, Michael P. Bogenschutz","doi":"10.1038/s41591-025-04194-5","DOIUrl":"10.1038/s41591-025-04194-5","url":null,"abstract":"Classic psychedelics typically act at the serotonin 5-HT2A receptor to profoundly alter brain function and consciousness. Research on these compounds has accelerated. Major strides have been made in understanding their unique mechanisms of action and clinical potential. This Review outlines the state of psychedelic science, spanning cellular mechanisms, systems neuroscience and clinical investigation. We show that preclinical and human research findings converge on two complementary processes: acute neural desynchronization, which destabilizes entrenched network patterns, and subacute neuroplasticity, which opens a window for psychological and behavioral change. We review evidence of therapeutic response across neuropsychiatric indications and consider how this integrates with mechanistic findings. We also explore challenges and opportunities, including discrepancies between preclinical evidence that non-hallucinogenic psychedelic analogs engage putative therapeutic mechanisms, and clinical evidence linking the subjective experience to therapeutic response; the risks inherent to enhanced neuroplasticity; and questions surrounding trial design, scalability and regulatory approval. The growth of psychedelic science and medicine may compel a fundamental rethinking of the relationship between subjective experience and biological change in psychiatry. This Review outlines the science behind psychedelic medicine and integrates mechanistic knowledge with clinical evidence across neuropsychiatric indications, highlighting challenges, controversies and opportunities.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"32 2","pages":"449-462"},"PeriodicalIF":50.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132454","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}
Pub Date : 2026-02-06DOI: 10.1038/s41591-025-04192-7
Andy Haines, Ana Bonell, Rosemary Green, Lorna Benton, Zulfiqar Bhutta
{"title":"An urgent need to build climate and health intervention trial capacity.","authors":"Andy Haines, Ana Bonell, Rosemary Green, Lorna Benton, Zulfiqar Bhutta","doi":"10.1038/s41591-025-04192-7","DOIUrl":"https://doi.org/10.1038/s41591-025-04192-7","url":null,"abstract":"","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":" ","pages":""},"PeriodicalIF":50.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132484","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}
Pub Date : 2026-02-06DOI: 10.1038/s41591-025-04190-9
Jack W. O’Sullivan, Anil Palepu, Khaled Saab, Wei-Hung Weng, Daniel K. Amponsah, Evaline Cheng, Yong Cheng, Emily Chu, Yaanik Desai, Aly Elezaby, Muhammad Fazal, Tasmeen Hussain, Sneha S. Jain, Daniel Seung Kim, Roy Lan, Jiwen Li, Wilson Tang, Natalie Tapaskar, Victoria Parikh, Ryan Sandoval, Gabriella Spencer-Bonilla, Bryan Wu, Kavita Kulkarni, Philip Mansfield, Dale Webster, Juraj Gottweis, Joelle Barral, Mike Schaekermann, Ryutaro Tanno, S. Sara Mahdavi, Vivek Natarajan, Alan Karthikesalingam, Euan Ashley, Tao Tu
The scarcity of subspecialist medical expertise poses a considerable challenge for healthcare delivery. This issue is particularly acute in cardiology, where timely, accurate management determines outcomes. We explored the potential of Articulate Medical Intelligence Explorer (AMIE), a large language model-based experimental medical artificial intelligence system, to augment clinical decision-making in this challenging context. We conducted a randomized controlled trial comparing large language model-assisted care with the usual care of complex patients suspected of having a genetic cardiomyopathy, and we curated a real-world dataset of complex cases from a subspecialist cardiology practice. Nine participating general cardiologists were provided with access to both clinical text reports and raw diagnostic data—including electrocardiograms, echocardiograms, cardiac magnetic resonance imaging scans and cardiopulmonary exercise testing—and were randomized to manage these cases, either with or without assistance from AMIE. We developed a ten-domain evaluation rubric used by three blinded subspecialists to evaluate the quality of triage, diagnosis and management. In our randomized controlled trial with retrospective patient data, subspecialists favored large language model-assisted responses overall, and for the management plan and diagnostic testing domains, with the remaining domains considered a tie. Overall, subspecialists preferred AMIE-assisted cardiology assessments 46.7% of the time, compared with 32.7% for cardiologists alone (P = 0.02), with 20.6% rated as a tie. Subspecialists also quantified errors, extra and missing content, reasoning and potential bias. Cardiologists alone had more clinically significant errors (24.3% versus 13.1%, P = 0.033) and more missing content (37.4% versus 17.8%, P = 0.0021) than cardiologists assisted by AMIE. Lastly, cardiologists who used AMIE reported that AMIE helped their assessment more than half the time (57.0%) and saved time in 50.5% of cases. In a randomized study involving 9 general cardiologists and 107 real-world patient cases, assistance from a specifically tailored large language model resulted in preferable responses on complex case management compared to physicians alone, as rated by specialist cardiologists using a multidimensional scoring rubric.
{"title":"A large language model for complex cardiology care","authors":"Jack W. O’Sullivan, Anil Palepu, Khaled Saab, Wei-Hung Weng, Daniel K. Amponsah, Evaline Cheng, Yong Cheng, Emily Chu, Yaanik Desai, Aly Elezaby, Muhammad Fazal, Tasmeen Hussain, Sneha S. Jain, Daniel Seung Kim, Roy Lan, Jiwen Li, Wilson Tang, Natalie Tapaskar, Victoria Parikh, Ryan Sandoval, Gabriella Spencer-Bonilla, Bryan Wu, Kavita Kulkarni, Philip Mansfield, Dale Webster, Juraj Gottweis, Joelle Barral, Mike Schaekermann, Ryutaro Tanno, S. Sara Mahdavi, Vivek Natarajan, Alan Karthikesalingam, Euan Ashley, Tao Tu","doi":"10.1038/s41591-025-04190-9","DOIUrl":"10.1038/s41591-025-04190-9","url":null,"abstract":"The scarcity of subspecialist medical expertise poses a considerable challenge for healthcare delivery. This issue is particularly acute in cardiology, where timely, accurate management determines outcomes. We explored the potential of Articulate Medical Intelligence Explorer (AMIE), a large language model-based experimental medical artificial intelligence system, to augment clinical decision-making in this challenging context. We conducted a randomized controlled trial comparing large language model-assisted care with the usual care of complex patients suspected of having a genetic cardiomyopathy, and we curated a real-world dataset of complex cases from a subspecialist cardiology practice. Nine participating general cardiologists were provided with access to both clinical text reports and raw diagnostic data—including electrocardiograms, echocardiograms, cardiac magnetic resonance imaging scans and cardiopulmonary exercise testing—and were randomized to manage these cases, either with or without assistance from AMIE. We developed a ten-domain evaluation rubric used by three blinded subspecialists to evaluate the quality of triage, diagnosis and management. In our randomized controlled trial with retrospective patient data, subspecialists favored large language model-assisted responses overall, and for the management plan and diagnostic testing domains, with the remaining domains considered a tie. Overall, subspecialists preferred AMIE-assisted cardiology assessments 46.7% of the time, compared with 32.7% for cardiologists alone (P = 0.02), with 20.6% rated as a tie. Subspecialists also quantified errors, extra and missing content, reasoning and potential bias. Cardiologists alone had more clinically significant errors (24.3% versus 13.1%, P = 0.033) and more missing content (37.4% versus 17.8%, P = 0.0021) than cardiologists assisted by AMIE. Lastly, cardiologists who used AMIE reported that AMIE helped their assessment more than half the time (57.0%) and saved time in 50.5% of cases. In a randomized study involving 9 general cardiologists and 107 real-world patient cases, assistance from a specifically tailored large language model resulted in preferable responses on complex case management compared to physicians alone, as rated by specialist cardiologists using a multidimensional scoring rubric.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"32 2","pages":"616-623"},"PeriodicalIF":50.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41591-025-04190-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132314","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}
Pub Date : 2026-02-05DOI: 10.1038/s41591-025-04191-8
Marco Becilli, Markus Metzler, Claudia Bracaglia, Rebecca Nicolai, Tobias Krickau, Francesca Del Bufalo, Chiara Rosignoli, Emiliano Marasco, Nora Naumann-Bartsch, Virginia Messia, Pietro Merli, Daria Pagliara, Mattia Algeri, Aurelio Secinaro, Maria Giuseppina Cefalo, Francesca Diomedi Camassei, Valentina Bertaina, Matilde Sinibaldi, Antonella Insalaco, Michael Aigner, Giovanna Leone, Giuseppina Li Pira, Monica Gunetti, Stefan Berg, Biagio De Angelis, Simon Völkl, Linda Hanssens, Fabian Müller, Andreas Mackensen, Concetta Quintarelli, Georg Schett, Fabrizio De Benedetti, Franco Locatelli
Chimeric antigen receptor (CAR) T cell therapy was recently proposed as a treatment for adults with B-cell-mediated autoimmune diseases (ADs) refractory to conventional immunomodulatory therapy. We present a case series of eight children with severe/refractory AD (four systemic lupus erythematosus, three dermatomyositis, one systemic sclerosis) treated at Ospedale Pediatrico Bambino Gesù, Rome, and University Hospital Erlangen with a single infusion of 1 × 106 kg-1 point-of-care manufactured autologous CD19 CAR T cells (zorpocabtagene autoleucel), in a hospital exemption (HE) program. In Europe, the HE pathway offers the opportunity to treat patients with life-threatening or seriously debilitating disorders who lack valid therapeutic options, using an advanced therapy medicinal product (ATMP) authorized on a nonroutine, single-patient basis. In contrast to the 'compassionate use' pathway, the ATMP does not necessarily need to have undergone clinical trials or marketing authorization applications. Manufacturing was successful in all patients, yielding several drug product bags. Once infused after lymphodepletion, zorpocabtagene autoleucel cells expanded in vivo, promoting prompt B cell clearance. Grade 1 cytokine release syndrome was reported in six patients, and grade 1 immune effector cell-associated neurotoxicity syndrome was reported in one patient. Late-hematotoxicity was limited to grade 1 in two patients. All these adverse events were manageable and no severe infections occurred. With a median follow-up of 16.5 months (range = 9-24 months), all patients experienced a clinically substantial improvement/resolution of AD, as evidenced by reduction in disease activity scores and signs of reversal of organ damage. This improvement enabled sustained discontinuation of immunomodulators, even after B cell reconstitution. The activation of formal clinical trials enrolling children and adolescents is urgently needed to confirm these preliminary results and to assess the long-term safety of this approach.
嵌合抗原受体（CAR） T细胞疗法最近被提出用于治疗常规免疫调节治疗难治性b细胞介导的自身免疫性疾病（ADs）的成人。我们提出了一个病例系列，8名患有严重/难治性AD的儿童（4名系统性红斑狼疮，3名皮肌炎，1名系统性硬化症）在罗马Ospedale儿科婴儿医院Gesù和埃尔兰根大学医院接受单次输注1 × 106 kg-1护理点制造的自体CD19 CAR - T细胞（zorpocabtagene autoeucel），在医院免免（HE）计划中。在欧洲，HE途径为缺乏有效治疗选择的危及生命或严重衰弱性疾病患者提供了机会，使用非常规、单例患者授权的先进治疗药物（ATMP）。与“同情使用”途径相反，ATMP不一定需要经过临床试验或上市授权申请。所有患者的生产都很成功，生产了几个药品袋。一旦在淋巴细胞消失后输注，zorpocabtagene的自体细胞在体内扩增，促进B细胞的迅速清除。6例患者报告了1级细胞因子释放综合征，1例患者报告了1级免疫效应细胞相关神经毒性综合征。两名患者的晚期血液毒性仅限于1级。所有不良事件均在可控范围内，未发生严重感染。中位随访时间为16.5个月（范围= 9-24个月），所有患者的阿尔茨海默病在临床上均有显著改善/缓解，疾病活动度评分降低，器官损伤出现逆转迹象。即使在B细胞重建后，这种改善也能持续停用免疫调节剂。目前迫切需要启动正式的儿童和青少年临床试验，以确认这些初步结果，并评估这种方法的长期安全性。
{"title":"Anti-CD19 CAR T cells for pediatric patients with treatment-refractory autoimmune diseases.","authors":"Marco Becilli, Markus Metzler, Claudia Bracaglia, Rebecca Nicolai, Tobias Krickau, Francesca Del Bufalo, Chiara Rosignoli, Emiliano Marasco, Nora Naumann-Bartsch, Virginia Messia, Pietro Merli, Daria Pagliara, Mattia Algeri, Aurelio Secinaro, Maria Giuseppina Cefalo, Francesca Diomedi Camassei, Valentina Bertaina, Matilde Sinibaldi, Antonella Insalaco, Michael Aigner, Giovanna Leone, Giuseppina Li Pira, Monica Gunetti, Stefan Berg, Biagio De Angelis, Simon Völkl, Linda Hanssens, Fabian Müller, Andreas Mackensen, Concetta Quintarelli, Georg Schett, Fabrizio De Benedetti, Franco Locatelli","doi":"10.1038/s41591-025-04191-8","DOIUrl":"10.1038/s41591-025-04191-8","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T cell therapy was recently proposed as a treatment for adults with B-cell-mediated autoimmune diseases (ADs) refractory to conventional immunomodulatory therapy. We present a case series of eight children with severe/refractory AD (four systemic lupus erythematosus, three dermatomyositis, one systemic sclerosis) treated at Ospedale Pediatrico Bambino Gesù, Rome, and University Hospital Erlangen with a single infusion of 1 × 10<sup>6</sup> kg<sup>-1</sup> point-of-care manufactured autologous CD19 CAR T cells (zorpocabtagene autoleucel), in a hospital exemption (HE) program. In Europe, the HE pathway offers the opportunity to treat patients with life-threatening or seriously debilitating disorders who lack valid therapeutic options, using an advanced therapy medicinal product (ATMP) authorized on a nonroutine, single-patient basis. In contrast to the 'compassionate use' pathway, the ATMP does not necessarily need to have undergone clinical trials or marketing authorization applications. Manufacturing was successful in all patients, yielding several drug product bags. Once infused after lymphodepletion, zorpocabtagene autoleucel cells expanded in vivo, promoting prompt B cell clearance. Grade 1 cytokine release syndrome was reported in six patients, and grade 1 immune effector cell-associated neurotoxicity syndrome was reported in one patient. Late-hematotoxicity was limited to grade 1 in two patients. All these adverse events were manageable and no severe infections occurred. With a median follow-up of 16.5 months (range = 9-24 months), all patients experienced a clinically substantial improvement/resolution of AD, as evidenced by reduction in disease activity scores and signs of reversal of organ damage. This improvement enabled sustained discontinuation of immunomodulators, even after B cell reconstitution. The activation of formal clinical trials enrolling children and adolescents is urgently needed to confirm these preliminary results and to assess the long-term safety of this approach.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":" ","pages":""},"PeriodicalIF":50.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125961","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}
Pub Date : 2026-02-05DOI: 10.1038/s41591-026-04210-2
John A Batsis, Lorenzo M Donini, Carla M Prado
{"title":"Unintended risks of sarcopenic obesity during weight-loss interventions in older people.","authors":"John A Batsis, Lorenzo M Donini, Carla M Prado","doi":"10.1038/s41591-026-04210-2","DOIUrl":"10.1038/s41591-026-04210-2","url":null,"abstract":"","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":" ","pages":""},"PeriodicalIF":50.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125958","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}
Pub Date : 2026-02-05DOI: 10.1038/d41591-026-00008-4
Natalie Healey
{"title":"Blood tests for Alzheimer's disease could reshape research and care.","authors":"Natalie Healey","doi":"10.1038/d41591-026-00008-4","DOIUrl":"https://doi.org/10.1038/d41591-026-00008-4","url":null,"abstract":"","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":" ","pages":""},"PeriodicalIF":50.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125946","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}
Pub Date : 2026-02-04DOI: 10.1038/d41591-026-00007-5
{"title":"Whose ethics govern global health research?","authors":"","doi":"10.1038/d41591-026-00007-5","DOIUrl":"https://doi.org/10.1038/d41591-026-00007-5","url":null,"abstract":"","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"287 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116012","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}
Pub Date : 2026-02-04DOI: 10.1038/s41591-025-04180-x
Indira Dewi Kantiana, Aprajita Kaushik, Divya Lakhotia, Nima Asgari-Jirhandeh, Margaret Chan, Harvy Joy Liwanag, Angkana Lekagul, Soumya Swaminathan, Kun Tang, Viroj Tangcharoensathien, Yik Ying Teo, Jasper Tromp, Suwit Wibulpolprasert, Kiesha Prem, Afifah Rahman-Shepherd
{"title":"Asia Pacific perspectives on global health architecture reform","authors":"Indira Dewi Kantiana, Aprajita Kaushik, Divya Lakhotia, Nima Asgari-Jirhandeh, Margaret Chan, Harvy Joy Liwanag, Angkana Lekagul, Soumya Swaminathan, Kun Tang, Viroj Tangcharoensathien, Yik Ying Teo, Jasper Tromp, Suwit Wibulpolprasert, Kiesha Prem, Afifah Rahman-Shepherd","doi":"10.1038/s41591-025-04180-x","DOIUrl":"https://doi.org/10.1038/s41591-025-04180-x","url":null,"abstract":"","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"234 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116013","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}
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