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Potential immune consequences of cold-stored platelet transfusion 冷藏血小板输注的潜在免疫后果
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-19 DOI: 10.1016/j.coi.2025.102645
Kimberly A Thomas , Rachael P Jackman
The rising interest in using cold-stored platelets (CSP) for improving outcomes in patients with active bleeding has led to multiple clinical trials with the goal of determining the in vivo hemostatic efficacy of CSP compared to standard-of-care room temperature–stored platelets. These trials are concentrated predominantly on safety and hemostatic efficacy measurements in response to therapeutic transfusion with CSP, with safety focused on the usual immune-mediated adverse reactions associated with transfusion, such as allergic and alloimmune reactions. However, given the established relationship between thrombosis and inflammation/immune activation as seen in atherosclerosis, autoimmune disease, and infection (to include the recent COVID-19 pandemic), the goal of this review is to highlight additional mechanisms by which CSP may potentiate or dampen immune activity in the context of therapeutic CSP transfusion in actively bleeding patients, thus highlighting areas of future research.
使用冷藏血小板(CSP)改善活动性出血患者预后的兴趣日益增加,导致了多项临床试验,目的是确定与标准护理室温储存血小板相比,冷藏血小板的体内止血效果。这些试验主要集中在CSP治疗性输血的安全性和止血效果测量上,安全性主要集中在与输血相关的通常免疫介导的不良反应上,如过敏反应和同种免疫反应。然而,鉴于血栓形成与炎症/免疫激活之间的既定关系,如动脉粥样硬化、自身免疫性疾病和感染(包括最近的COVID-19大流行),本综述的目的是强调CSP可能增强或抑制活动性出血患者治疗性CSP输血的免疫活性的其他机制,从而强调未来的研究领域。
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引用次数: 0
SARS-CoV-2 and chronic kidney disease: challenges and future directions SARS-CoV-2与慢性肾病:挑战与未来方向
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-18 DOI: 10.1016/j.coi.2025.102642
Giannini Olivier , Elzi Luigia
Patients with chronic kidney disease (CKD), especially those with end-stage kidney disease on dialysis or kidney transplant recipients (KTRs), are highly susceptible to infections, including the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 pandemic disproportionately affected this vulnerable population, leading to increased morbidity and mortality. Immune dysfunction in CKD patients contributes to a suboptimal defense against infections and a reduced response to SARS-CoV-2 vaccinations. Although vaccination has significantly reduced severe outcomes, dialysis patients and KTRs exhibit lower seroconversion rates and faster antibody waning compared to the general population. Recent evidence suggests that booster doses improve immune responses, but vaccine efficacy remains lower in immunosuppressed individuals. This review highlights the epidemiology of COVID-19 in nephropathic patients, the mechanisms underlying their immune dysregulation, and the effectiveness of vaccination strategies. Future directions include optimizing booster regimens, integrating serological and avidity testing to tailor vaccination strategies, and exploring novel immunotherapeutic approaches. A multidisciplinary effort involving nephrologists, immunologists, and public health experts is essential to improve pandemic preparedness and develop targeted strategies to protect nephropathic patients from future viral threats.
慢性肾脏疾病(CKD)患者,特别是透析或肾移植患者(KTRs)的终末期肾脏疾病患者,极易受到感染,包括新型严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)。2019冠状病毒病大流行对这一弱势群体的影响尤为严重,导致发病率和死亡率上升。CKD患者的免疫功能障碍导致对感染的防御不理想,对SARS-CoV-2疫苗的反应降低。尽管疫苗接种显著降低了严重后果,但与一般人群相比,透析患者和ktr患者表现出较低的血清转换率和更快的抗体消退。最近的证据表明,加强剂量可改善免疫反应,但疫苗效力在免疫抑制个体中仍然较低。本文综述了COVID-19在肾病患者中的流行病学、其免疫失调的机制以及疫苗接种策略的有效性。未来的方向包括优化加强方案,整合血清学和贪婪测试来定制疫苗接种策略,以及探索新的免疫治疗方法。肾病学家、免疫学家和公共卫生专家参与的多学科努力对于改善大流行防范和制定有针对性的战略以保护肾病患者免受未来病毒威胁至关重要。
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引用次数: 0
Checkpoint agonists — immunoregulatory role and its implications in the treatment of psoriasis and psoriatic arthritis 检查点激动剂-免疫调节作用及其在银屑病和银屑病关节炎治疗中的意义
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-18 DOI: 10.1016/j.coi.2025.102641
Angel Ray Baroz , Debra K Lee , Natalia Maverakis Ramirez , Smriti K Raychaudhuri , Siba P Raychaudhuri
Psoriasis and psoriatic arthritis are chronic autoimmune diseases characterized by dysregulated immune responses, particularly involving Th17 cells. Immune checkpoint molecules such as programmed death-1 (PD-1) and its ligands (PD-L1/PD-L2) are critical for maintaining immune tolerance. Disruptions in these pathways contribute to psoriatic disease pathogenesis. Notably, immune checkpoint inhibitors used in cancer therapy have been linked to the development of psoriasis or its exacerbation. This highlights the complex role of checkpoint pathways in psoriatic diseases. Thus, immune checkpoint agonists could be a therapeutic strategy aimed at restoring immune balance without widespread immunosuppression. Preclinical studies demonstrate that PD-1 agonists can mitigate inflammation by enhancing inhibitory signaling. Additionally, early-phase clinical trials in autoimmune diseases such as rheumatoid arthritis and ulcerative colitis suggest potential benefits of PD-1 modulation in psoriasis. This review explores immune checkpoint agonists in psoriatic disease as a promising alternative to conventional immunosuppressants by selectively suppressing pathogenic T-cell activity.
银屑病和银屑病关节炎是慢性自身免疫性疾病,其特征是免疫反应失调,特别是涉及Th17细胞。免疫检查点分子如程序性死亡-1 (PD-1)及其配体(PD-L1/PD-L2)对维持免疫耐受至关重要。这些通路的破坏有助于银屑病的发病机制。值得注意的是,用于癌症治疗的免疫检查点抑制剂与牛皮癣的发展或其恶化有关。这凸显了检查点通路在银屑病中的复杂作用。因此,免疫检查点激动剂可能是一种治疗策略,旨在恢复免疫平衡而不广泛的免疫抑制。临床前研究表明,PD-1激动剂可以通过增强抑制信号来减轻炎症。此外,自身免疫性疾病(如类风湿关节炎和溃疡性结肠炎)的早期临床试验表明PD-1调节在银屑病中的潜在益处。这篇综述探讨了免疫检查点激动剂在银屑病中作为一种有希望的替代传统免疫抑制剂,通过选择性地抑制致病性t细胞活性。
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引用次数: 0
Implication of epigenetic factors in development and recurrence of psoriasis 表观遗传因素在银屑病发展和复发中的意义
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-14 DOI: 10.1016/j.coi.2025.102636
Jingyi Tang, Erle Dang, Gang Wang
Psoriasis is a chronic autoimmune skin disease characterized by abnormal proliferation and differentiation of keratinocytes, with a complex pathogenesis often linked to environmental and genetic factors. Although many treatments are available, the disease still exhibits a high recurrence rate. Epigenetic regulation appears to bridge external stimuli and genetic abnormalities in the development of psoriasis. Skin-resident cells may contribute to disease recurrence through an ‘inflammatory memory’ formed through epigenetic modifications. This review focuses on skin-resident cells in psoriasis, elucidating their roles in disease progression and recurrence from an epigenetic perspective, providing scientific evidence for targeted therapies.
银屑病是一种慢性自身免疫性皮肤病,以角质形成细胞异常增殖和分化为特征,其发病机制复杂,常与环境和遗传因素有关。虽然有许多治疗方法,但这种疾病仍有很高的复发率。表观遗传调控似乎是银屑病发展过程中外部刺激和遗传异常的桥梁。皮肤驻留细胞可能通过表观遗传修饰形成的“炎症记忆”导致疾病复发。本文综述了银屑病中皮肤驻留细胞的研究进展,从表观遗传学角度阐明其在疾病进展和复发中的作用,为靶向治疗提供科学依据。
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引用次数: 0
Can we cure lupus? 我们能治愈狼疮吗?
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-14 DOI: 10.1016/j.coi.2025.102640
Tessa L Clement, Philip L Cohen
A general understanding of the mechanisms leading to the development of systemic lupus has emerged over recent years, yet treatment of the illness remains largely empiric and unsatisfactory. Targeted therapy with monoclonal antibodies directed against B cells and against cytokines has met limited success, as has therapy with mesenchymal and hematopoietic stem cells. In the last few years, treatment of refractory disease with chimeric-antigen reactive T cells directed against B cells (CAR-T cells) has shown unexpected promise in small patient series, with apparent long-term and complete remission of disease. Rapid progress in this area is likely to result in improved T cell and natural killer (NK) cell treatment of patients with more readily accessible and practical methods. In parallel, increased understanding of systemic lupus erythematosus disease mechanisms using systems biology and single-cell approaches is likely to uncover additional pathways to intervene in the pathogenesis of disease, raising hopes that additional options will be available for long-term treatment or cure of the disease or even prevention of disease in susceptible individuals.
近年来,人们对导致系统性狼疮发展的机制有了普遍的了解,但对这种疾病的治疗仍在很大程度上是经验和不令人满意的。针对B细胞和细胞因子的单克隆抗体靶向治疗取得了有限的成功,间充质干细胞和造血干细胞治疗也取得了有限的成功。在过去的几年里,用靶向B细胞的嵌合抗原反应性T细胞(CAR-T细胞)治疗难治性疾病在小患者系列中显示出意想不到的希望,明显的长期和完全缓解疾病。在这一领域的快速进展可能会导致改善T细胞和自然杀伤(NK)细胞治疗患者更容易获得和实用的方法。同时,利用系统生物学和单细胞方法加深对系统性红斑狼疮疾病机制的了解,可能会发现干预疾病发病机制的其他途径,从而为长期治疗或治愈疾病甚至预防易感个体的疾病提供更多选择的希望。
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引用次数: 0
B cell–targeted therapies in autoimmune skin disease: current advances and challenges 自身免疫性皮肤病的B细胞靶向治疗:目前的进展和挑战
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-14 DOI: 10.1016/j.coi.2025.102643
Zhi Hu , Ming Zhao
Autoimmune skin diseases (AISDs) constitute a group of skin disorders driven by B cell–mediated autoimmunity or dysregulation of other immune cell populations. AISD can be further divided into systemic autoimmune disease with skin involvement, such as systemic lupus erythematosus (SLE), and skin-specific autoimmune disease, such as pemphigus vulgaris (PV). Due to autoreactivity, B cells and autoantibody production play a pivotal role in B cell–driven AISDs. B cell–targeted therapies have become a major focus in research and clinical practice. Recent strategies targeting various B cell have shown promise, whereas several challenges remain in the clinical application. Patient heterogeneity results in variable therapeutic outcomes. Additionally, prolonged B cell suppression increases the risk of infections. Here, this review outlines the B cell–targeted therapeutic approaches in AISDs, explore the implications of their variable efficacy, and discuss future directions for development. We aim to provide broader perspectives for advancing targeted therapies in AISDs.
自身免疫性皮肤病(AISDs)是由B细胞介导的自身免疫或其他免疫细胞群失调驱动的一组皮肤疾病。AISD可进一步分为累及皮肤的系统性自身免疫性疾病,如系统性红斑狼疮(SLE)和皮肤特异性自身免疫性疾病,如寻常型天疱疮(PV)。由于自身反应性,B细胞和自身抗体的产生在B细胞驱动的aids中起关键作用。B细胞靶向治疗已成为研究和临床实践的主要焦点。最近针对各种B细胞的治疗策略显示出了希望,但在临床应用中仍存在一些挑战。患者的异质性导致不同的治疗结果。此外,长期的B细胞抑制会增加感染的风险。在此,本文概述了B细胞靶向治疗aids的方法,探讨了其不同疗效的含义,并讨论了未来的发展方向。我们的目标是为推进aids的靶向治疗提供更广阔的视角。
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引用次数: 0
Can juvenile idiopathic arthritis be cured? 青少年特发性关节炎能治愈吗?
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-11 DOI: 10.1016/j.coi.2025.102632
Shwetha Maharaj, Christopher Chang
Juvenile idiopathic arthritis (JIA) is the most common rheumatological disorder affecting children. It is characterized by chronic synovial inflammation that may lead to permanent joint damage and disability. JIA is an umbrella term for a heterogenous group of subtypes based on specific clinical and serological features. Each subtype has a multifactorial pathogenesis that involves a complex interplay of genetic susceptibility, environmental triggers, and immune dysregulation. Recent advancements in genomic and multi-omics research have elucidated key genetic and epigenetic contributors to JIA, including risk loci within the highly polymorphic human leukocyte antigen region and monogenic mutations in genes, such as LACC1, UNC13D, and NFIL3. Genome-wide association studies have further revealed that many JIA-associated single-nucleotide polymorphisms (SNPs) reside in noncoding regulatory regions, underscoring the significance of chromatin architecture and transcriptional control in disease development.
While current therapies — including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologics, and corticosteroids — offer symptomatic relief, they do not provide a cure, and many patients experience variable treatment responses or adverse effects. Emerging strategies focus on precision medicine approaches, integrating therapeutic biomarkers to predict disease course and optimize treatment. Furthermore, gene therapy using viral and mRNA-based vectors and advanced cell-based therapies — including regulatory T cells (Tregs), CAR-Tregs, and chimeric autoantibody receptor (CAAR)-T cells — are being explored as potential disease-modifying interventions. These innovative approaches aim to restore immune tolerance, reprogram dysregulated immune pathways, and minimize systemic immunosuppression. Although still in experimental stages, these technologies hold promise for achieving durable remission or potential cure in JIA. Continued translational research and clinical trials will be pivotal in realizing the therapeutic potential of these novel interventions.
幼年特发性关节炎(JIA)是影响儿童的最常见的风湿病。它的特点是慢性滑膜炎症,可导致永久性关节损伤和残疾。JIA是基于特定临床和血清学特征的异质性亚型的总称。每个亚型都有一个多因素的发病机制,涉及遗传易感性、环境触发和免疫失调的复杂相互作用。基因组学和多组学研究的最新进展已经阐明了JIA的关键遗传和表观遗传因素,包括高度多态性的人类白细胞抗原区域内的风险位点和基因的单基因突变,如LACC1、UNC13D和NFIL3。全基因组关联研究进一步揭示了许多与jia相关的单核苷酸多态性(snp)存在于非编码调控区域,强调了染色质结构和转录控制在疾病发展中的重要性。虽然目前的治疗方法——包括非甾体抗炎药(NSAIDs)、改善疾病的抗风湿药(DMARDs)、生物制剂和皮质类固醇——可以缓解症状,但它们不能治愈,而且许多患者经历了不同的治疗反应或不良反应。新兴战略侧重于精准医学方法,整合治疗性生物标志物来预测病程和优化治疗。此外,利用病毒和mrna为载体的基因治疗和先进的细胞治疗——包括调节性T细胞(Tregs)、CAR-Tregs和嵌合自身抗体受体(CAAR)-T细胞——正在被探索作为潜在的疾病改善干预措施。这些创新的方法旨在恢复免疫耐受,重新编程失调的免疫途径,并最大限度地减少全身免疫抑制。尽管仍处于实验阶段,但这些技术有望实现JIA的持久缓解或潜在治愈。持续的转化研究和临床试验将是实现这些新干预措施的治疗潜力的关键。
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引用次数: 0
Complement in antiphospholipid syndrome, time to target? 抗磷脂综合征补体,何时达到目标?
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-06 DOI: 10.1016/j.coi.2025.102628
Marie-Agnès Dragon Durey , Houcine Hamidi , Luc Darnige
Antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilia. Complement system, which shares common actors with the coagulation cascade, is nowadays well established to be implicated in APS pathophysiology by different mechanisms. In APS, complement activation assessment is not included in the routine care despite numerous studies showing the presence of activation fragments (C4d, C3d, and C5b9) at a systemic level in sera and blood cells’ surface but also in affected arterial walls, kidneys, placentas, or heart valves. APS patients are treated to prevent thrombosis recurrence by long-term anticoagulation with vitamin K antagonist. Several case reports described the use of an anti-C5 antibody to treat particular forms of APS (recurrent thrombosis, catastrophic APS) but are not sufficient to conclude on its efficacy. There is still a need to identify relevant biomarkers to help establish the role of the various recently developed complement-targeting molecules in the therapeutic approach to APS.
抗磷脂综合征(APS)是一种获得性自身免疫性血栓病。补体系统与凝血级联具有共同的作用体,目前已确定补体系统通过不同的机制参与APS的病理生理。在APS中,补体激活评估不包括在常规护理中,尽管大量研究表明激活片段(C4d、C3d和C5b9)在血清和血细胞表面的系统水平上存在,而且在受影响的动脉壁、肾脏、胎盘或心脏瓣膜中也存在。APS患者采用维生素K拮抗剂长期抗凝治疗,预防血栓复发。一些病例报告描述了使用抗c5抗体治疗特殊形式的APS(复发性血栓形成,灾难性APS),但不足以得出其疗效的结论。仍然需要确定相关的生物标志物,以帮助确定各种最近开发的补体靶向分子在APS治疗方法中的作用。
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引用次数: 0
Intracellular complement in monocytes and macrophages: emerging roles 单核细胞和巨噬细胞的细胞内补体:新角色
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-06 DOI: 10.1016/j.coi.2025.102629
Valentin Baverel , Carmen Garrido , Evelyne Kohli
Macrophages and the complement system are fundamental components of innate immunity, emerging early in evolutionary history. The well-established functions of complement in relation to macrophages contribute to both innate and adaptive immunity and are mediated by extracellular components acting systemically or locally within tissues.
A novel compartment, termed intracellular complement or the ‘complosome’, was first identified in 2013 within CD4+ T cells, marking the onset of an active research field. Intracellular complement has been associated with responses to both infectious and noninfectious stimuli, akin to extracellular complement, while also exhibiting significant autocrine functions in cell metabolism and homeostasis.
This review focuses on intracellular complement within monocytes/macrophages. After a brief overview of the complement system and its canonical roles in these cells, we define intracellular complement and discuss current knowledge regarding its expression and functions in monocytes/macrophages, as well as its potential links to human diseases.
巨噬细胞和补体系统是先天免疫的基本组成部分,出现在进化史的早期。补体与巨噬细胞相关的完善功能有助于先天免疫和适应性免疫,并由组织内系统或局部作用的细胞外成分介导。2013年,在CD4+ T细胞中首次发现了一种称为细胞内补体或“合体”的新型隔室,标志着一个活跃研究领域的开始。细胞内补体与对感染性和非感染性刺激的反应有关,类似于细胞外补体,同时在细胞代谢和体内平衡中也表现出显著的自分泌功能。本文综述了单核/巨噬细胞内的细胞内补体。在简要概述了补体系统及其在这些细胞中的典型作用之后,我们定义了细胞内补体,并讨论了目前关于其在单核/巨噬细胞中的表达和功能的知识,以及它与人类疾病的潜在联系。
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引用次数: 0
Neuropsychiatric lupus: a myriad of symptoms requires a myriad of models 神经精神性狼疮:无数的症状需要无数的模型
IF 5.8 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-08-06 DOI: 10.1016/j.coi.2025.102631
James K Sullivan , Audrey Kwun , Trine N Jørgensen
Neuropsychiatric lupus (NPSLE) is believed to manifest in 30–40% of SLE patients, with symptoms spanning from fatigue and anxiety to depression, cognitive impairment, and psychosis. Over the past decades, it has become clear that most animal models of SLE also present with some level of NPSLE-like disease. Similar to the diversity of presentations among NPSLE patients, symptoms of NPSLE differ between animal models, likely due to their fixed genetic background. Therefore, both genetic and therapeutic studies have focused on different mechanisms in different models, making it difficult to translate basic research findings to the clinical realm. Here, we summarize studies of different animal models of NPSLE, specifically focusing on differences and overlaps between identified pathological pathways.
神经精神性狼疮(NPSLE)被认为在30-40%的SLE患者中表现出来,其症状从疲劳、焦虑到抑郁、认知障碍和精神病。在过去的几十年里,很明显,大多数SLE动物模型也表现出一定程度的npsl样疾病。与NPSLE患者表现的多样性类似,NPSLE的症状在动物模型之间也存在差异,可能是由于其固定的遗传背景。因此,无论是基因研究还是治疗研究都侧重于不同模式下的不同机制,这使得基础研究成果难以转化为临床领域。在这里,我们总结了NPSLE不同动物模型的研究,特别关注已确定病理通路之间的差异和重叠。
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引用次数: 0
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Current Opinion in Immunology
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