Background The clinical and prognostic implications of asymptomatic tuberculosis remain poorly understood. Methods We conducted a multicentre prospective cohort study to evaluate the association between asymptomatic tuberculosis (TB) and treatment outcomes. Individuals with rifampicin-susceptible pulmonary TB were enrolled from the Cohort Study of Pulmonary Tuberculosis. Asymptomatic TB was defined as the absence of any TB-related symptoms at diagnosis. The primary outcome was a favourable outcome, defined as treatment success without recurrence. Multivariable logistic regression models were used to assess associations between asymptomatic TB and favourable outcomes. The Cox proportional hazards model was applied to evaluate effect of asymptomatic TB on failure to complete treatment within 1 year. Stratified analyses by symptom status and mode of detection were performed to examine stratum-specific effects. Results Of 1071 individuals with pulmonary TB, 32.7% were asymptomatic. Compared to symptomatic patients, asymptomatic individuals were younger, less likely to be underweight and more often diagnosed through population health screening rather than clinical presentation or opportunistic testing. Asymptomatic TB was associated with higher likelihood of favourable outcome in multivariable models (adjusted odds ratio (aOR) 1.50, 95% CI 1.04-2.20) and a reduced risk of failing to complete treatment within one year in survival analyses (adjusted hazard ratio 0.66, 95% CI 0.45-0.95). Asymptomatic TB detected through health screening had the most favourable outcomes (aOR 2.41, 95% CI 1.34-4.66). Conclusion Asymptomatic TB was significantly associated with treatment success without recurrence and particularly in patients identified through health screening. Our results support symptom-agnostic screening in TB control programmes.
Abstract Introduction Abnormal uterine bleeding (AUB) is a pathological condition defined by irregularities in the frequency, duration, volume, or regularity of uterine bleeding, affecting 10–30% of reproductive-age women in Korea. Although the role of the microbiome in gynecological health has gained increasing attention, investigations specifically examining vaginal microbiota alterations in AUB remain limited. Objective To characterize the vaginal microbiota in women with abnormal uterine bleeding (AUB) and assess differences according to etiologic subgroups. Methods This prospective observational study included 176 premenopausal women with AUB and 100 healthy controls. The vaginal microbiota was analyzed using 16S rRNA gene sequencing. Main outcome measures included alpha and beta diversity, community state types (CSTs), taxonomic composition, and microbial co-occurrence networks. AUB etiologies were categorized according to the FIGO PALM-COEIN classification system to allow for subgroup analysis (structural-benign, structural-malignant, and non-structural). Results Women with AUB exhibited significantly higher alpha diversity and distinct beta diversity compared to controls (p < 0.01). CST IV, characterized by low Lactobacillus and high anaerobic diversity, was predominant in the AUB group (57.4%), whereas CST I (L. crispatus-dominant) was most common in healthy controls (47.0%). Genera enriched in AUB included Gardnerella, Atopobium, Prevotella, Sneathia, Ralstonia, and Streptococcus. Subgroup analyses showed an enrichment of Prevotella and Mycoplasma_g19 in malignancy-associated AUB, which also had greater microbial diversity compared to benign cases. Microbial co-occurrence networks were sparse in healthy, benign, and malignant AUB groups, but the network for non-structural AUB was denser and more modular. Within this network, Fusobacterium emerged as a central hub taxon. Conclusions AUB is associated with distinct alterations of the vaginal microbiota, including CST IV predominance, reduced Lactobacillus, and an enrichment of anaerobic taxa. Subgroup-specific differences, such as increased diversity in malignancy-associated AUB and a Fusobacterium-centered network in non-structural AUB, were observed. These findings suggest a potential role for microbial dysbiosis in AUB pathogenesis and warrant validation in larger, well-controlled cohorts to determine their clinical significance. Disclosure No
Prurigo nodularis (PN) is a chronic pruritic dermatosis with incompletely defined pathogenesis, and molecular data from East Asian populations are limited. We characterized the transcriptomic signatures of non-atopic PN in Korean patients to identify pathways linked to chronic itch and lesion persistence. RNA sequencing was performed on lesional and non-lesional skin from 17 PN patients and normal skin from 11 controls, followed by differential expression, functional enrichment, and correlation analyses. Lesional PN skin showed distinct transcriptional signatures with upregulation of Th22/IL-22–related genes and IL-22–inducible epidermal stress markers (S100A7/A8/A9, SERPINB4, HRNR), along with keratinization genes (KRT6C, KRT16, KRT17). Itch severity correlated strongly (Spearman’s ρ>0.7) with IL-22–inducible stress genes, IL4R, profibrotic mediators (WNT5A), JAK–STAT regulators (JAK3, SOCS1/3), neuromodulatory/epidermal–neural genes (TRPV3), and senescence markers (CDKN1A, CXCL8, PLAUR). Non-lesional skin showed intermediate expression patterns, consistent with subclinical inflammation. Despite the modest sample size and single-ethnicity design, these findings indicate that non-atopic PN in Korean patients is characterized by IL-22–driven epidermal stress, fibroblast remodelling, neuroimmune signalling, and senescence programsprogrammes, highlighting therapeutic targets including IL-31RA, IL-4Rα/JAK1, antifibrotic and senescence-directed pathways.
