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Human sperm RNA in male infertility 男性不育症中的人类精子 RNA
IF 15.3 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-09-10 DOI: 10.1038/s41585-024-00920-9
Rossella Cannarella, Andrea Crafa, Roberto Curto, Laura M. Mongioì, Vincenzo Garofalo, Vittorio Cannarella, Rosita A. Condorelli, Sandro La Vignera, Aldo E. Calogero

The function and value of specific sperm RNAs in apparently idiopathic male infertility are currently poorly understood. Whether differences exist in the sperm RNA profile between patients with infertility and fertile men needs clarification. Similarly, the utility of sperm RNAs in predicting successful sperm retrieval and assisted reproductive technique (ART) outcome is unknown. Patients with infertility and fertile individuals seem to have differences in the expression of non-coding RNAs that regulate genes controlling spermatogenesis. Several RNAs seem to influence embryo quality and development. Also, RNA types seem to predict successful sperm retrieval in patients with azoospermia. These findings suggest that sperm RNAs could influence decision-making during the management of patients with infertility. This evidence might help to identify possible therapeutic approaches aimed at modulating the expression of dysregulated genes in patients with infertility. Performing prospective studies with large sample sizes is necessary to investigate cost-effective panels consisting of proven molecular targets to ensure that this evidence can be translated to clinical practice.

目前,人们对特定精子 RNA 在明显特发性男性不育症中的功能和价值还知之甚少。不育症患者和育龄男性的精子 RNA 特征是否存在差异需要澄清。同样,精子 RNA 在预测成功取精和辅助生殖技术(ART)结果方面的效用也不得而知。不育症患者和生育能力强的人在调控精子发生基因的非编码 RNA 表达上似乎存在差异。有几种 RNA 似乎会影响胚胎的质量和发育。此外,RNA 类型似乎还能预测无精子症患者能否成功取精。这些发现表明,精子 RNA 可影响不育症患者的治疗决策。这些证据可能有助于确定可能的治疗方法,以调节不育症患者体内失调基因的表达。有必要进行大样本量的前瞻性研究,以调查由已证实的分子靶点组成的成本效益面板,确保这些证据能转化为临床实践。
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引用次数: 0
PIONEER big data platform for prostate cancer: lessons for advancing future real-world evidence research 前列腺癌 PIONEER 大数据平台:推进未来真实世界证据研究的经验教训
IF 15.3 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-09-09 DOI: 10.1038/s41585-024-00925-4
Ailbhe Lawlor, Katharina Beyer, Beth Russell, Carl Steinbeisser, Anders Bjartell, Bertrand De Meulder, Muhammad Imran Omar, Tim Hulsen, John Butler, James N’Dow, Juan Gómez Rivas, Giorgio Gandaglia, Rossella Nicoletti, Vasileios Sakalis, Emma Jane Smith, Monika Maass, Jihong Zong, Louise Fullwood, Thomas Abbott, Azadeh Tafreshiha, Kishore Papineni, Robert Snijder, Denis Horgan, Sarah Seager, Susan Evans-Axelsson, Maria J. Ribal, Monique J. Roobol, Mieke Van Hemelrijck

Prostate Cancer Diagnosis and Treatment Enhancement through the Power of Big Data in Europe (PIONEER) is a European network of excellence for big data in prostate cancer. PIONEER brings together 34 private and public stakeholders from 9 countries in one multidisciplinary research consortium with the aim of positively transforming the field of prostate cancer clinical care by answering pressing questions related to prostate cancer screening, diagnosis and treatment. PIONEER has developed a unique state-of-the-art big data analytic platform by integrating existing data sources from patients with prostate cancer. PIONEER leveraged this platform to address prioritized research questions, filling knowledge gaps in the characterization, management and core outcomes of prostate cancer across the different disease stages. The network has benefited from sustained patient and stakeholder involvement and engagement, but many challenges remain when using real-world data for big data projects. To continue to advance prostate cancer care, data need to be available, suitable methodologies should be selected and mechanisms for knowledge sharing must be in place. Now acting as the prostate cancer arm of the European Association of Urology’s new endeavour, UroEvidenceHub, PIONEER maintains its goal of maximizing the potential of big data to improve prostate cancer care.

通过欧洲大数据的力量加强前列腺癌诊断和治疗(PIONEER)是欧洲前列腺癌大数据卓越网络。PIONEER 将来自 9 个国家的 34 个私营和公共利益相关者聚集在一个多学科研究联盟中,旨在通过回答与前列腺癌筛查、诊断和治疗相关的迫切问题,积极改变前列腺癌临床治疗领域。PIONEER 通过整合前列腺癌患者的现有数据源,开发了一个独特的先进大数据分析平台。PIONEER 利用这一平台解决优先研究的问题,填补了前列腺癌不同疾病阶段的特征描述、管理和核心结果方面的知识空白。该网络得益于患者和利益相关者的持续参与和介入,但在将真实世界的数据用于大数据项目时仍面临许多挑战。为了继续推进前列腺癌治疗,需要提供数据,选择合适的方法,并建立知识共享机制。现在,PIONEER作为欧洲泌尿外科协会新项目UroEvidenceHub的前列腺癌分支,继续坚持其目标,即最大限度地发挥大数据的潜力,改善前列腺癌治疗。
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引用次数: 0
Non-coding transcriptome profiles in clear-cell renal cell carcinoma 透明细胞肾细胞癌的非编码转录组图谱
IF 15.3 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-09-06 DOI: 10.1038/s41585-024-00926-3
Tereza Tesarova, Ondrej Fiala, Milan Hora, Radka Vaclavikova

Clear-cell renal cell carcinoma (ccRCC) is a common urological malignancy with an increasing incidence. The development of molecular biomarkers that can predict the response to treatment and guide personalized therapy selection would substantially improve patient outcomes. Dysregulation of non-coding RNA (ncRNA) has been shown to have a role in the pathogenesis of ccRCC. Thus, an increasing number of studies are being carried out with a focus on the identification of ncRNA biomarkers in ccRCC tissue samples and the connection of these markers with patients’ prognosis, pathological stage and grade (including metastatic potential), and therapy outcome. RNA sequencing analysis led to the identification of several ncRNA biomarkers that are dysregulated in ccRCC and might have a role in ccRCC development. These ncRNAs have the potential to be prognostic and predictive biomarkers for ccRCC, with prospective applications in personalized treatment selection. Research on ncRNA biomarkers in ccRCC is advancing, but clinical implementation remains preliminary owing to challenges in validation, standardization and reproducibility. Comprehensive studies and integration of ncRNAs into clinical trials are essential to accelerate the clinical use of these biomarkers.

透明细胞肾细胞癌(ccRCC)是一种常见的泌尿系统恶性肿瘤,发病率不断上升。开发可预测治疗反应并指导个性化治疗选择的分子生物标志物将大大改善患者的预后。非编码 RNA(ncRNA)的失调已被证明在 ccRCC 的发病机制中发挥作用。因此,越来越多的研究正在进行,重点是鉴定 ccRCC 组织样本中的 ncRNA 生物标志物,以及这些标志物与患者预后、病理分期和分级(包括转移潜力)以及治疗效果之间的联系。通过 RNA 测序分析,我们发现了一些在 ccRCC 中失调的 ncRNA 生物标志物,它们可能在 ccRCC 的发展过程中发挥作用。这些 ncRNA 有可能成为 ccRCC 的预后和预测生物标志物,有望应用于个性化治疗选择。有关 ccRCC 中 ncRNA 生物标志物的研究正在取得进展,但由于在验证、标准化和可重复性方面存在挑战,临床应用仍处于初步阶段。全面研究 ncRNA 并将其纳入临床试验对于加快这些生物标志物的临床应用至关重要。
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引用次数: 0
Artificial intelligence in the management of prostate cancer. 人工智能在前列腺癌治疗中的应用。
IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-09-04 DOI: 10.1038/s41585-024-00938-z
Raghav Khanna, Alejandro Granados Martinez, Nicholas Raison, Sebastien Ourselin, Alberto Briganti, Francesco Montorsi, Prokar Dasgupta
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引用次数: 0
Videourodynamics — role, benefits and optimal practice Videourodynamics - 作用、益处和最佳实践
IF 15.3 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-08-29 DOI: 10.1038/s41585-024-00923-6
Mikolaj Przydacz, Howard B. Goldman

Videourodynamics (VUDS) is an advanced diagnostic procedure that simultaneously combines functional and anatomical evaluation of the lower urinary tract. The goal of this synchronous assessment is to promote accurate diagnosis of the aetiology responsible for patient symptoms, improving therapeutic decision-making. Overall, high-quality VUDS is advocated when other tests such as traditional urodynamics might not provide sufficient data to guide therapy, particularly in patients with complex, persistent or recurrent dysfunctions of the lower urinary tract. Additionally, VUDS is often crucial in the follow-up monitoring of many patients with these dysfunctions. A VUDS study is frequently considered a gold standard in patients with neurogenic lower urinary tract dysfunction, female bladder outlet obstruction or congenital anomalies of the lower urinary tract. Nevertheless, this specialized test should be limited to patients in whom VUDS data add value. Particularly, reliable studies comparing the effect of diagnosis with and without imaging on management outcomes are lacking, and no standardized procedures for undertaking VUDS are available. Additionally, patients should be carefully selected for VUDS evaluation, considering the increased cost and risks associated with radiological imaging. In routine practice, clinicians should balance the additional value of synchronous imaging and the enhanced diagnostic precision of VUDS against the limitations of this approach, which mainly include an uncertain effect of VUDS on final treatment outcomes.

视频尿动力学(VUDS)是一种先进的诊断程序,可同时结合下尿路的功能和解剖评估。这种同步评估的目的是促进对患者症状病因的准确诊断,从而改进治疗决策。总之,当传统的尿动力学等其他检查无法提供足够的数据来指导治疗时,尤其是对下尿路功能复杂、持续或反复出现障碍的患者来说,高质量的 VUDS 是值得提倡的。此外,VUDS 往往对许多下尿路功能障碍患者的后续监测至关重要。对于患有神经源性下尿路功能障碍、女性膀胱出口梗阻或先天性下尿路异常的患者,VUDS 常被视为金标准。然而,这种专门的检查应仅限于 VUDS 数据能增加价值的患者。特别是,目前还缺乏可靠的研究来比较有无影像学诊断对治疗效果的影响,也没有进行 VUDS 的标准化程序。此外,考虑到放射成像会增加成本和风险,应谨慎选择患者进行 VUDS 评估。在日常实践中,临床医生应权衡同步成像的额外价值和 VUDS 诊断精确度的提高,以及这种方法的局限性,其中主要包括 VUDS 对最终治疗结果的影响不确定。
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引用次数: 0
Quest for a genetic biomarker for sickle cell disease priapism: rationale, progress and implications. 寻找镰状细胞病早衰的基因生物标志物:原理、进展和影响。
IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-08-27 DOI: 10.1038/s41585-024-00927-2
Oluwafolajimi Adesanya, Arthur L Burnett
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引用次数: 0
The interplay between male fertility, mental health and sexual function 男性生育能力、心理健康和性功能之间的相互作用。
IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-08-27 DOI: 10.1038/s41585-024-00936-1
Vincent J. Straub, Melinda C. Mills
Declining birth rates are drawing attention to male reproductive health, with infertility receiving overdue interest. Alongside genetic and environmental factors, lifestyle behaviours are a key risk factor. Exploring how lifestyle behaviour links to mental health and its interplay with sexual function and fertility can improve understanding of trends in live births and improve men’s health overall.
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引用次数: 0
Immune effects of α and β radionuclides in metastatic prostate cancer α和β放射性核素对转移性前列腺癌的免疫效应
IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-08-27 DOI: 10.1038/s41585-024-00924-5
Sapna Lunj, Tim Andrew Davies Smith, Kimberley Jayne Reeves, Fred Currell, Jamie Honeychurch, Peter Hoskin, Ananya Choudhury
External beam radiotherapy is used for radical treatment of organ-confined prostate cancer and to treat lesions in metastatic disease whereas molecular radiotherapy with labelled prostate-specific membrane antigen ligands and radium-223 (223Ra) is indicated for metastatic prostate cancer and has demonstrated substantial improvements in symptom control and overall survival compared with standard-of-care treatment. Prostate cancer is considered an immunologically cold tumour, so limited studies investigating the treatment-induced effects on the immune response have been completed. However, emerging data support the idea that radiotherapy induces an immune response in prostate cancer, but whether the response is an antitumour or pro-tumour response is dependent on the radiotherapy regime and is also cell-line dependent. In vitro data demonstrate that single-dose radiotherapy regimes induce a greater immune-suppressive profile than fractionated regimes; less is known about the immune response induced by molecular radiotherapy agents, but evidence suggests that these agents might induce an immune-suppressive systemic immune response, indicated by increased expression of inhibitory checkpoint molecules such as programmed cell death 1 ligand 1 and 2, and that these changes could be associated with clinical response. Different radiotherapy modalities can induce distinct immune profiles, which can either activate or suppress immune-mediated tumour killing and the current preclinical models used for prostate cancer research are not yet optimal for studying the complexity of the radiotherapy-induced immune response. This Review focusses on what is known about the interactions between conventional radiotherapy and the immune system. The authors discuss how this knowledge can be applied to investigate gaps regarding the immune interactions of molecular radiotherapies.
体外放射治疗用于器官封闭性前列腺癌的根治性治疗和转移性疾病的病灶治疗,而使用标记的前列腺特异性膜抗原配体和镭-223(223Ra)的分子放射治疗则适用于转移性前列腺癌,与常规治疗相比,该疗法在症状控制和总生存率方面有显著改善。前列腺癌被认为是一种免疫功能低下的肿瘤,因此有关治疗对免疫反应影响的研究十分有限。不过,新出现的数据支持放疗诱导前列腺癌免疫反应的观点,但这种反应是抗肿瘤反应还是促肿瘤反应取决于放疗方案,也取决于细胞系。体外数据表明,单剂量放疗方案比分次放疗方案诱导的免疫抑制作用更大;目前对分子放疗药物诱导的免疫反应了解较少,但有证据表明,这些药物可能会诱导免疫抑制性全身免疫反应,表现为抑制性检查点分子(如程序性细胞死亡 1 配体 1 和 2)的表达增加,这些变化可能与临床反应有关。不同的放疗模式可诱导不同的免疫特征,从而激活或抑制免疫介导的肿瘤杀伤作用,而目前用于前列腺癌研究的临床前模型还不是研究放疗诱导免疫反应复杂性的最佳模型。
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引用次数: 0
Field effect and forerunner genes drive bladder cancer initiation 场效应和先驱基因驱动膀胱癌的发生
IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-08-12 DOI: 10.1038/s41585-024-00929-0
Maria Chiara Masone
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引用次数: 0
AI for drug discovery 人工智能促进药物研发
IF 12.1 1区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-08-09 DOI: 10.1038/s41585-024-00931-6
Louise Lloyd
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引用次数: 0
期刊
Nature Reviews Urology
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