265. Mucormycosis.
Mucormycosis is a rapidly progressive, invasive fungal infection that affects patients who are severely immunocompromised, as well as patients with diabetes and persons with immunocompetence who have major trauma. Mucormycosis manifests in several clinical forms, including sino-orbital, rhinocerebral, sinopulmonary, gastrointestinal, cutaneous, musculoskeletal, osteoarticular, and disseminated mucormycosis, as well as single-organ disease. Although mucormycosis is often lethal, early intervention reduces mortality. Successful treatment depends on early detection and staging of the disease, timely initiation of antifungal therapy, surgical resection of infected tissue, reversal of immunodeficiencies, and correction of metabolic abnormalities. Liposomal amphotericin B is the preferred agent for initial antifungal therapy, with oral triazoles as alternative agents. Research on rapid molecular diagnostic strategies, new antifungal agents, host-directed immune augmentation, antivirulence immune therapeutics, and risk-based stratification to inform management of disease may substantially improve outcomes in patients with this highly destructive mycosis.
266. Adenoviral Inciting Antigen and Somatic Hypermutation in VITT.
作者: Jing Jing Wang.;Linda Schönborn.;Theodore E Warkentin.;Luisa Müller.;Thomas Thiele.;Lena Ulm.;Uwe Völker.;Sabine Ameling.;Sören Franzenburg.;Lars Kaderali.;Ana Tzvetkova.;Alex Colella.;Tim Chataway.;Chee Wee Tan.;Bridie Armour.;Alexander Troelnikov.;Lucy Rutten.;James McCluskey.;Roland Zahn.;Tom P Gordon.;Andreas Greinacher.
来源: N Engl J Med. 2026年394卷7期669-683页
Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare prothrombotic complication that occurs after adenoviral vector-based vaccination against coronavirus disease 2019; in rare cases, it can also occur after natural adenovirus infection. VITT is mediated by platelet-activating antibodies against the highly cationic protein platelet factor 4 (PF4). The underlying inciting antigen trigger and immunopathogenesis remain unknown.
267. Dengue Suppression by Male Wolbachia-Infected Mosquitoes.
作者: Jue Tao Lim.;Chee-Seng Chong.;Chia-Chen Chang.;Diyar Mailepessov.;Borame Dickens.;Yee Ling Lai.;Lu Deng.;Caleb Lee.;Li Yun Tan.;Grace Chain.;Muhammad Faizal Zulkifli.;Jonathan Wee Kent Liew.;Kathryn Vasquez.;Man Ling Chau.;Youming Ng.;Vernon Lee.;Judith Chui Ching Wong.;Shuzhen Sim.;Cheong Huat Tan.;Lee Ching Ng.; .
来源: N Engl J Med. 2026年394卷12期1175-1183页
Wild-type female Aedes aegypti mosquitoes that mate with male A. aegypti mosquitoes that have been infected with the wAlbB strain of Wolbachia pipientis bacteria produce nonviable offspring owing to cytoplasmic incompatibility. Repeated releases of wolbachia-infected males can potentially suppress wild-type mosquito populations and reduce the risk of dengue virus infection.
269. AAV9 Gene Therapy in Type II GM1 Gangliosidosis - A Phase 1-2 Trial.
作者: Connor J Lewis.;Precilla D'Souza.;Jean M Johnston.;Maria T Acosta.;Cristan Farmer.;Eva H Baker.;Anna Crowell.;Yoliann Mojica.;Sumaiya Ashraf.;Lisa Joseph.;Gilbert Vézina.;Zenaide Quezado.;Muhammad H Yousef.;Zeynep Vardar.;Mohammed Salman Shazeeb.;Manuela Corti.;Meghan Blackwood.;Kirsten Coleman.;Rita Batista.;Audrey Thurm.;Erika De Boever.;William A Gahl.;Barry J Byrne.;Terence R Flotte.;Xuntian Jiang.;Amanda L Gross.;Allison M Keeler.;Heather Gray-Edwards.;Douglas R Martin.;Miguel Sena-Esteves.;Cynthia J Tifft.
来源: N Engl J Med. 2026年394卷12期1184-1194页
GM1 gangliosidosis, caused by biallelic variants in GLB1, results from deficiency of lysosomal β-galactosidase, which degrades GM1 ganglioside. This fatal neurodegenerative disease currently has no effective therapy.
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