Pub Date : 2025-04-07DOI: 10.1038/s41585-025-01026-6
Matthias Walter, Andrei V. Krassioukov, Tom E. Nightingale
Autonomic dysreflexia is a sudden rise in systolic blood pressure observed in individuals with spinal cord injury at or above the sixth thoracic spinal cord segment, often triggered by stimuli from the urinary bladder, bowel or sexual organs. Autonomic dysreflexia can cause severe complications, including stroke or death. Cardiovascular monitoring during urological procedures is crucial, particularly for individuals with cervical spinal cord injury who are at the highest risk of developing autonomic dysreflexia.
{"title":"Managing autonomic dysreflexia during urological care in individuals living with spinal cord injury","authors":"Matthias Walter, Andrei V. Krassioukov, Tom E. Nightingale","doi":"10.1038/s41585-025-01026-6","DOIUrl":"10.1038/s41585-025-01026-6","url":null,"abstract":"Autonomic dysreflexia is a sudden rise in systolic blood pressure observed in individuals with spinal cord injury at or above the sixth thoracic spinal cord segment, often triggered by stimuli from the urinary bladder, bowel or sexual organs. Autonomic dysreflexia can cause severe complications, including stroke or death. Cardiovascular monitoring during urological procedures is crucial, particularly for individuals with cervical spinal cord injury who are at the highest risk of developing autonomic dysreflexia.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 11","pages":"723-724"},"PeriodicalIF":14.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789946","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 : 2025-04-01DOI: 10.1038/s41585-025-01024-8
María P. Herrera, Cristina Dominguez
{"title":"The disruption of circadian rhythm as a potential mechanism of nocturia-like symptoms — a paediatric urology perspective","authors":"María P. Herrera, Cristina Dominguez","doi":"10.1038/s41585-025-01024-8","DOIUrl":"10.1038/s41585-025-01024-8","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 5","pages":"321-321"},"PeriodicalIF":14.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764500","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 : 2025-04-01DOI: 10.1038/s41585-025-01014-w
Cristina Boixareu, Tarek Taha, Varadha Balaji Venkadakrishnan, Johann de Bono, Himisha Beltran
Prostate cancer remains a substantial health challenge, with >375,000 annual deaths amongst men worldwide. Most prostate cancer-related deaths are attributable to the development of resistance to standard-of-care treatments. Characterization of the diverse and complex surfaceome of treatment-resistant prostate cancer, combined with advances in drug development that leverage cell-surface proteins to enhance drug delivery or activate the immune system, have provided novel therapeutic opportunities to target advanced prostate cancer. The prostate cancer surfaceome, including proteins such as prostate-specific membrane antigen (PSMA), B7-H3, six transmembrane epithelial antigen of the prostate 1 (STEAP1), delta-like ligand 3 (DLL3), trophoblastic cell-surface antigen 2 (TROP2), prostate stem cell antigen (PSCA), HER3, CD46 and CD36, can be exploited as therapeutic targets, as regulatory mechanisms might contribute to the heterogeneity of expression of these proteins and subsequently affect treatment response and resistance. Specific treatment strategies targeting the surfaceome are in clinical development, including radionuclides, antibody–drug conjugates, T cell engagers and chimeric antigen receptor (CAR) T cells. Ultimately, biomarker development and clinical implementation of these agents will be informed and refined by further understanding of the biology of various targets; the target specificity and sensitivity of different agents; and off-target and toxic effects associated with these agents. Understanding the dynamic nature of cell-surface targets and non-overlapping expression patterns might also lead to future combinational strategies. This Review provides an overview of the main targetable surface proteins in prostate cancer, defined as the surfaceome, discussing the mechanisms of action and efficacy of currently available drugs targeting surface proteins, as well as future perspectives of integrating these treatments into prostate-cancer management.
{"title":"Targeting the tumour cell surface in advanced prostate cancer","authors":"Cristina Boixareu, Tarek Taha, Varadha Balaji Venkadakrishnan, Johann de Bono, Himisha Beltran","doi":"10.1038/s41585-025-01014-w","DOIUrl":"10.1038/s41585-025-01014-w","url":null,"abstract":"Prostate cancer remains a substantial health challenge, with >375,000 annual deaths amongst men worldwide. Most prostate cancer-related deaths are attributable to the development of resistance to standard-of-care treatments. Characterization of the diverse and complex surfaceome of treatment-resistant prostate cancer, combined with advances in drug development that leverage cell-surface proteins to enhance drug delivery or activate the immune system, have provided novel therapeutic opportunities to target advanced prostate cancer. The prostate cancer surfaceome, including proteins such as prostate-specific membrane antigen (PSMA), B7-H3, six transmembrane epithelial antigen of the prostate 1 (STEAP1), delta-like ligand 3 (DLL3), trophoblastic cell-surface antigen 2 (TROP2), prostate stem cell antigen (PSCA), HER3, CD46 and CD36, can be exploited as therapeutic targets, as regulatory mechanisms might contribute to the heterogeneity of expression of these proteins and subsequently affect treatment response and resistance. Specific treatment strategies targeting the surfaceome are in clinical development, including radionuclides, antibody–drug conjugates, T cell engagers and chimeric antigen receptor (CAR) T cells. Ultimately, biomarker development and clinical implementation of these agents will be informed and refined by further understanding of the biology of various targets; the target specificity and sensitivity of different agents; and off-target and toxic effects associated with these agents. Understanding the dynamic nature of cell-surface targets and non-overlapping expression patterns might also lead to future combinational strategies. This Review provides an overview of the main targetable surface proteins in prostate cancer, defined as the surfaceome, discussing the mechanisms of action and efficacy of currently available drugs targeting surface proteins, as well as future perspectives of integrating these treatments into prostate-cancer management.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 9","pages":"569-589"},"PeriodicalIF":14.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745577","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 : 2025-04-01DOI: 10.1038/s41585-025-01025-7
Qi-Xiang Song, Sylvia Suadicani, Hiromitsu Negoro, Hai-Hong Jiang, Rita Jabr, Christopher Fry, Wei Xue, Margot S. Damaser
{"title":"Reply to ‘The disruption of circadian rhythm as a potential mechanism of nocturia-like symptoms — a paediatric urology perspective’","authors":"Qi-Xiang Song, Sylvia Suadicani, Hiromitsu Negoro, Hai-Hong Jiang, Rita Jabr, Christopher Fry, Wei Xue, Margot S. Damaser","doi":"10.1038/s41585-025-01025-7","DOIUrl":"10.1038/s41585-025-01025-7","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 5","pages":"322-323"},"PeriodicalIF":14.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764481","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 : 2025-03-27DOI: 10.1038/s41585-025-01018-6
Manuela Schmidinger, Irene Huebner-Resch
The first study of personalized cancer vaccines for renal cell carcinoma with breakthrough results in the adjuvant setting has been published, showing a 100% efficacy rate and negligible toxic effects. However, important questions remain concerning long-term effectiveness.
{"title":"Adjuvant personalized cancer vaccine: is this the end of metastatic kidney cancer","authors":"Manuela Schmidinger, Irene Huebner-Resch","doi":"10.1038/s41585-025-01018-6","DOIUrl":"10.1038/s41585-025-01018-6","url":null,"abstract":"The first study of personalized cancer vaccines for renal cell carcinoma with breakthrough results in the adjuvant setting has been published, showing a 100% efficacy rate and negligible toxic effects. However, important questions remain concerning long-term effectiveness.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 9","pages":"567-568"},"PeriodicalIF":14.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723645","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 : 2025-03-26DOI: 10.1038/s41585-025-01013-x
Léa G. Deltourbe, Méline Durand, Ariana Costas, Molly A. Ingersoll
The bladder is a complex organ that can be affected by various pathologies, such as cancer or infection. It has a specific tissue structure composed of many different cell types and layers, including urothelial and endothelial cells but also a muscle layer controlling stretch and contraction to void urine. The bladder has constitutive and induced immune responses to infection or damage and harbours a microbiome. Each of these features can be influenced by factors including age and biological sex, which makes modelling homeostasis and disease in the bladder complex and challenging. To model diseases that affect the bladder, mouse models are an invaluable tool to understand the bladder in situ. However, stark differences exist between mice and humans, and so mouse models of human disease have limitations. Thus, models that more closely approximate human physiology would be expected to contribute to improved understanding of bladder biology. As technology advances, improvements in model development and creation of 3D bladder structures are enabling scientists to recapitulate essential aspects of human bladder physiology to gain increased understanding of bladder homeostasis and diseases. In this Review, the authors present the development, structure and microenvironment, and defence mechanisms of the bladder, which together create a blueprint that can be used to optimize current models or create new approaches.
{"title":"A bladder blueprint to build better models for understanding homeostasis and disease","authors":"Léa G. Deltourbe, Méline Durand, Ariana Costas, Molly A. Ingersoll","doi":"10.1038/s41585-025-01013-x","DOIUrl":"10.1038/s41585-025-01013-x","url":null,"abstract":"The bladder is a complex organ that can be affected by various pathologies, such as cancer or infection. It has a specific tissue structure composed of many different cell types and layers, including urothelial and endothelial cells but also a muscle layer controlling stretch and contraction to void urine. The bladder has constitutive and induced immune responses to infection or damage and harbours a microbiome. Each of these features can be influenced by factors including age and biological sex, which makes modelling homeostasis and disease in the bladder complex and challenging. To model diseases that affect the bladder, mouse models are an invaluable tool to understand the bladder in situ. However, stark differences exist between mice and humans, and so mouse models of human disease have limitations. Thus, models that more closely approximate human physiology would be expected to contribute to improved understanding of bladder biology. As technology advances, improvements in model development and creation of 3D bladder structures are enabling scientists to recapitulate essential aspects of human bladder physiology to gain increased understanding of bladder homeostasis and diseases. In this Review, the authors present the development, structure and microenvironment, and defence mechanisms of the bladder, which together create a blueprint that can be used to optimize current models or create new approaches.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 8","pages":"496-508"},"PeriodicalIF":14.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712851","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 : 2025-03-18DOI: 10.1038/s41585-025-01019-5
Recognizing that human healthcare influences the health of our planet and that our environment affects human health is increasingly important. Thus, in recognition of Earth Day and to support research in this area, Nature Reviews Urology presents articles putting the field of urology into a planetary context.
{"title":"Considering urology in a planetary context","authors":"","doi":"10.1038/s41585-025-01019-5","DOIUrl":"10.1038/s41585-025-01019-5","url":null,"abstract":"Recognizing that human healthcare influences the health of our planet and that our environment affects human health is increasingly important. Thus, in recognition of Earth Day and to support research in this area, Nature Reviews Urology presents articles putting the field of urology into a planetary context.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 4","pages":"187-187"},"PeriodicalIF":12.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41585-025-01019-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641059","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 : 2025-03-13DOI: 10.1038/s41585-025-01011-z
Seoho Lee, Karen Sfanos, Nirmish Singla
Genitourinary cancers account for 20% of cancer instances globally and pose a substantial burden. The microbiome, defined as the ecosystem of organisms that reside within and on the human body, seems to be closely related to multiple cancers. Research on the gut microbiome has yielded substantial insights into the interactions of this entity with the immune system and cancer therapeutic efficacy, whereas the urinary microbiome has been relatively less well-studied. Advances in next-generation sequencing technologies led to new discoveries in the urinary microbiome, which might aid in early detection, risk stratification and personalized treatment strategies in genitourinary cancers. Mechanistic investigations have also suggested a role for the urinary microbiome in modulating the tumour microenvironment and host immune response. For example, distinct urinary microbial signatures have been linked to bladder cancer occurrence and recurrence risk, with specific taxa associated with cytokine production and inflammation. Urinary microbiome signatures have also been explored as potential biomarkers for non-invasive cancer detection. However, challenges remain in standardizing methodologies, validating findings across studies, and establishing causative mechanisms. As investigations into the urinary microbiome continue to evolve, so does the potential for developing microbiome-modulating therapies and enhancing diagnostic capabilities to improve outcomes in patients with genitourinary cancers. In this Perspective, the authors provide an overview of the current knowledge about a potential role of the urinary microbiome in bladder, prostate and kidney cancers, discussing available studies in which alterations of the urinary microbiome have been associated with genitourinary cancers, also including the potential mechanisms if available. Challenges associated with this body of research as well as future directions in the field are also highlighted.
{"title":"The role of the urinary microbiome in genitourinary cancers","authors":"Seoho Lee, Karen Sfanos, Nirmish Singla","doi":"10.1038/s41585-025-01011-z","DOIUrl":"10.1038/s41585-025-01011-z","url":null,"abstract":"Genitourinary cancers account for 20% of cancer instances globally and pose a substantial burden. The microbiome, defined as the ecosystem of organisms that reside within and on the human body, seems to be closely related to multiple cancers. Research on the gut microbiome has yielded substantial insights into the interactions of this entity with the immune system and cancer therapeutic efficacy, whereas the urinary microbiome has been relatively less well-studied. Advances in next-generation sequencing technologies led to new discoveries in the urinary microbiome, which might aid in early detection, risk stratification and personalized treatment strategies in genitourinary cancers. Mechanistic investigations have also suggested a role for the urinary microbiome in modulating the tumour microenvironment and host immune response. For example, distinct urinary microbial signatures have been linked to bladder cancer occurrence and recurrence risk, with specific taxa associated with cytokine production and inflammation. Urinary microbiome signatures have also been explored as potential biomarkers for non-invasive cancer detection. However, challenges remain in standardizing methodologies, validating findings across studies, and establishing causative mechanisms. As investigations into the urinary microbiome continue to evolve, so does the potential for developing microbiome-modulating therapies and enhancing diagnostic capabilities to improve outcomes in patients with genitourinary cancers. In this Perspective, the authors provide an overview of the current knowledge about a potential role of the urinary microbiome in bladder, prostate and kidney cancers, discussing available studies in which alterations of the urinary microbiome have been associated with genitourinary cancers, also including the potential mechanisms if available. Challenges associated with this body of research as well as future directions in the field are also highlighted.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 8","pages":"544-561"},"PeriodicalIF":14.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143608011","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 : 2025-03-13DOI: 10.1038/s41585-025-01022-w
Annette Fenner
{"title":"A complex association with cadmium","authors":"Annette Fenner","doi":"10.1038/s41585-025-01022-w","DOIUrl":"10.1038/s41585-025-01022-w","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 4","pages":"197-197"},"PeriodicalIF":12.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143608009","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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