Volume 28 Issue 11, November 2022

Nature Medicine explores the latest translational and clinical research news

Nature Medicine explores the latest translational and clinical research news

99% of clinical trials for Alzheimer’s disease fail to show positive results, but researchers remain optimistic that new disease-modifying treatments are on the horizon

Most health systems struggled to obtain and analyze real-time data during the COVID-19 pandemic, but places that succeeded can be studied to provide a model for data-enabled responses to future epidemics and pandemics.

The ethical impact of AI algorithms in healthcare should be assessed at each phase, from data creation to model deployment, so that their use narrows rather than widens inequalities.

Clinical research often excludes people with disabilities who have impaired decisional capacity, but they can be included through supported decision-making, where their decisions can be assisted by designated supporters of their choosing. This will promote equitable access to research.

Use of AI-driven care for patients with type 1 diabetes has freed up clinicians’ time to focus on patients’ quality of life and provide more empathic, patient-centered care.

Circulating tumor DNA (ctDNA) informs predictive biomarkers in non–small-cell lung cancer, but the presence of ctDNA itself could also be a prognostic indicator.

Emerging evidence shows that boosting with updated mRNA vaccines that target SARS-CoV-2 variants stimulates better neutralizing antibody responses than homologous boosters.

In a clinical trial, non-nutritive sweeteners — which are supposedly inert — were shown to disrupt the gut microbiome of healthy people and impair glucose tolerance.

Impaired glucose tolerance (IGT) is a common condition that affects glucose control after sugar consumption. Isolated IGT is undetected by screening and diagnostic strategies, leaving affected individuals at high risk of developing diabetes. Here, a machine-learning framework identifies a three-protein signature for detecting isolated IGT from a single blood sample.

Using electronic health records data from the All of Us Research Program, we show that higher daily step counts in data collected over several years of Fitbit fitness tracker use were associated with lower risk of common, chronic diseases, including diabetes, hypertension, gastroesophageal reflux disease, depression, obesity and sleep apnea.

Early identification of at-risk people is critical in disease prevention, but current screening approaches are resource intensive and are often restricted to one disease at a time. We show how nuclear magnetic resonance (NMR) spectroscopy–derived metabolomics profiles can be used to predict multi-disease risk for the onset of 24 common conditions.

Evidence — provided by a combination of amyloid-β and tau PET examinations — of advanced Alzheimer’s disease pathological changes in the brain in cognitively unimpaired individuals is strongly associated with short-term (3–5 years) cognitive decline. Thus, amyloid-β and tau PET have high clinical relevance.

We show that patients who survive the first 30 days of acute SARS-CoV-2 infection have an increased risk of various post-acute neurological disorders after 1 year compared with uninfected contemporaries. The burden of these sequelae (aspects of ‘long COVID’) has serious implications for patients as well as society.

We used a global mathematical model simulating different scenarios to study the effects of increased COVID-19 vaccine equity during 2021. Our results indicate that vaccine nationalism leads to increased infections and mortality worldwide, and by favoring the emergence of new viral variants, in the long term it may adversely affect all countries.

The COVID-19 mRNA vaccines have transformed the field of mRNA nanomedicine, but this new class of therapeutics has the potential to treat many other diseases. This Review profiles the latest advances and challenges.

Findings of unrecognized or asymptomatic monkeypox virus (MPXV) infections with replication-competent virus in humans suggest that a lack of recognized, clinical symptoms could play a role in virus transmission and the magnitude of the 2022 MPXV outbreak.

A new study combines large-scale proteomics and machine learning to identify proteins that can be used to identify individuals with isolated impaired glucose tolerance, who would otherwise only be detectable with oral glucose tolerance tests.

Step count monitoring with Fitbit devices in the All of Us Research Program enabled quantification of the benefits of physical activity across a wide range of chronic diseases over the course of an extended time frame—a median of 4 years.

In a study involving more than 100,000 individuals in the UK Biobank, a neural network model trained on metabolomic data can predict disease risk for over 20 conditions and adds predictive information over clinical variables for eight common diseases.

Analyses of the genetic architecture of the human plasma metabolome in two large population-based cohorts identify associations between genetically determined metabolite levels and health.

The influence of an individual’s genetics, diet and gut microbiome on their plasma metabolome was studied in 1,368 individuals and Mendelian randomization and mediation analyses were used to unveil causal relationships between diet, the gut microbiome and the metabolome.

A prospective analysis of gut microbiome signatures in patients treated with neoadjuvant immunocheckpoint blockade for high risk resectable metastatic melanoma identifies new links between microbiota signatures, dietary intake and systemic inflammation in shaping the response and toxicity to immunotherapy.

In a prospective international cohort of 1,127 patients with non-small-cell lung cancer and ctDNA-guided therapy, ctDNA detection was associated with shorter survival, independently of clinicopathologic features and metabolic tumor volume.

In a multicenter, single-arm, open-label phase 2 study of patients with previously treated metastatic uveal melanoma, treatment with tebentafusp, a soluble TCR bispecific (gp100xCD3) showed promising clinical activity with an acceptable safety profile.

Results from EMPOWER-Lung 3 demonstrate increased overall survival with cemiplimab plus platinum-doublet chemotherapy compared to cemiplimab as first-line treatment in patients with advanced non-small cell lung cancer, irrespective of PD-L1 expression.

Abnormal amyloid and tau PET in cognitively unimpaired individuals is strongly associated with short-term cognitive decline and subsequent development of dementia.

A bivalent vaccine encoding the ancestral and Beta variant SARS-CoV-2 spike proteins boosts neutralizing antibody responses against multiple viral variants, suggesting that a bivalent approach is an effective strategy to broadly enhance protection against COVID-19.

A new analysis using US Department of Veterans Affairs databases showed that reinfection is associated with increased risk of all-cause mortality, hospitalization and a wide range of long COVID complications in individuals who have had SARS-CoV-2 compared to those with no reinfection.

Individuals with COVID-19 are at an increased risk for an array of neurologic disorders at 12 months, even in those who were not hospitalized during the acute phase of the infection.

Retrospective simulation of several global COVID-19 distribution scenarios shows that equitable and altruistic vaccine sharing strategies could have substantially reduced the global burden of SARS-CoV-2 infections and associated mortality.

Coupling cure interventions with ART during early HIV infection may accelerate virus clearance and enhance T cell responses, supporting tailoring of monoclonal antibodies to sensitive viruses to improve their effects.