The gut microbiome as a fingerprint of antibiotic use history

Nature Medicine, Published online: 14 April 2026; doi:10.1038/s41591-026-04360-3

Antibiotic use over the past 8 years was associated with alterations in the gut microbiome composition in 14,979 individuals. These analyses integrated data from the Swedish National Prescribed Drug Register and stool metagenomic profiles. Alterations were found even after a single antibiotic course and varied markedly across different antibiotic classes.

Rates of Treatment-Related Blood Cancers Are Increasing in Japan

Research led by Osaka International Cancer Institute in Japan shows that rates of therapy-related acute myeloid leukemia, linked to treatment for an earlier cancer, are going up as the overall number of cancer survivors increases.

As reported in the journal Cancer, the researchers showed the rates of treatment-related acute myeloid leukemia (AML) almost tripled between 1990 and 2020. The share of overall AML cases taken up by these patients has also increased from 4.4% to 8.2% over a similar time period.

With increasing numbers of cancer survivors in the U.S. and elsewhere, understanding the adverse effects of cancer treatment is becoming increasingly more important. Therapy‑related AML is a rare but serious complication of cytotoxic chemotherapy, and different chemotherapy drugs carry different levels of leukemia risk. Radiotherapy can also lead to this condition, but the risk is considered lower than that of chemotherapy.

“Several population‐based studies have analyzed the long‐term trend of therapy-related AML incidence, and the results are controversial,” write lead author Kenji Kishimoto, MD, PhD, a researcher at the Osaka International Cancer Institute, and colleagues.

“A national population‐based study did not demonstrate an increase in the incidence of therapy-related AML in Denmark between 2000 and 2013. In contrast, a significant increase in therapy-related AML incidence between 1997 and 2015 was identified in a Swedish nationwide study.”

As few such studies have been carried out in Asia, Kishimoto and colleagues analyzed how such rates have changed over time and whether the initial cancers leading to therapy-related AML have changed in Japan.

The researchers identified 9841 patients with AML in the Osaka Cancer Registry, 636 (6.5%) of whom had therapy-related AML. These patients were older when diagnosed than other AML patients at a median of 69 versus 66 years. There were also slightly more women with therapy-related AML than standard AML at 45% versus 40%. The time lag between first cancer and resultant AML was between two and 11 years (median five years).

In 1990, the incidence of therapy related AML was 0.13 per 100,000 people, but this had increased to 0.36 per 100,000 people by 2020. The share of all AML cases made up by therapy-related cases almost doubled from 4.4% in 1990 to 8.2% after 2010.

The most common earlier cancers before therapy-related AML were blood cancers (23%), breast cancer (15%), colorectal cancer (12%), and gastric cancer (9%). The mix shifted over time and gastric cancer became less common as the first cancer, while breast, head‑and‑neck, and lung cancers became more prominent.

“The study provides an important step towards better understanding how the nature of therapy-related AML is changing with the increasing number of cancer survivors,” said Kishimoto in a press release.

“Findings from this study lay the foundation for further studies to elucidate the mechanism of the change in therapy-related AML epidemiology,” add the authors.

The post Rates of Treatment-Related Blood Cancers Are Increasing in Japan appeared first on Inside Precision Medicine.

Low Birthweight Increases Risk of Early Stroke

Research led by the University of Gothenburg in Sweden suggests that low birthweight is a risk factor for having a stroke in younger adulthood.

In a study including just under 800,000 people, the investigators found that risk for early stroke events was 18-23% higher in men and women who had a birth weight under the median level than those with a higher birth weight.

Around 795,000 people in the U.S. have a stroke each year. Although it can affect people of any age, it is much more common in older individuals with estimates of prevalence suggesting that 0.9% of 18–44 year olds have strokes versus 3.8% of those in the 45–64 year age group and 7.7% of people aged 65 and over.

Low birth weight has been previously linked to an increased risk for stroke in several studies. Researchers think that low birth weight is an indicator of exposure to an adverse environment in the womb that may adversely affect the cardiovascular system of the fetus in a way that increases stroke risk—for example, by increasing the risk of high blood pressure.

Over the last 10-15 years, stroke prevalence has stayed the same in older adults but has gone up by 14-16% in 18-64 year-olds. Lina Lilja, a doctoral student at the University of Gothenburg, and colleagues aimed to investigate whether low birth weight increased the risk of stroke in younger adults.

They included 420,173 men and 348,758 women from Sweden who were born between 1973 and 1982 and followed up from birth until 2022. The researchers collected data on birth weight, gestational age, and body mass index in young adulthood, as well as information on first stroke and the type of stroke.

Overall, 2252 first stroke events were recorded at an average age of 36 years. Of these, 1624 were ischemic stroke (average age 37 years) and 588 were intracerebral hemorrhage (average age 33 years).

The results, which will be presented at the European Congress on Obesity in Istanbul later this year, showed that birth weight below the median (3.5kg) increased the risk for all stroke by 21%. The rates of stroke were slightly higher in men with a low birthweight at 23% versus women with a low birthweight at 18%.

Notably, gestational age at birth and young adult body mass index were not linked to stroke risk in this study.

The post Low Birthweight Increases Risk of Early Stroke appeared first on Inside Precision Medicine.