Autoimmunity reviews最新文献

Autoantibodies, hallmark mediators of autoimmune diseases, drive pathogenesis through Fc receptors (FcRs) engagement. Among human FcRs, FcγRIIa is the most abundantly expressed subtype and plays a pivotal role in regulating both innate and adaptive immune responses. Genetic polymorphisms and dysregulated FcγRIIa signaling are increasingly implicated in autoimmune pathogenesis. By governing immune cell activation, differentiation, and effector functions, FcγRIIa emerges as a central orchestrator of immune responses. Recent clinical studies have identified FcγRIIa as a promising therapeutic target in patients with autoimmune diseases, as well as in murine autoimmune models. This review outlines the structure and cellular expression profile of FcγRIIa and elucidates its role in immune regulation. Furthermore, we discuss its association with autoimmune pathogenesis and highlight FcγRIIa targeted therapeutics evaluated in past and ongoing clinical trials for autoimmune disease treatment.

Metabolomics has significantly advanced our understanding of connective tissue diseases (CTDs) in recent years by revealing the complex metabolic alterations that underlie these autoimmune disorders. This comprehensive review synthesizes current knowledge on how metabolomics elucidates CTDs pathogenesis, enhances diagnostic precision, and guides therapeutic interventions. Central to this discussion are pivotal metabolic pathways-including those of amino acids, lipids, and carbohydrates-which exhibit distinct dysregulation patterns across different CTDs. These metabolic shifts not only reflect disease activity and severity but also offer potential biomarkers for early detection and monitoring. Advanced metabolomic technologies have facilitated the identification of novel therapeutic targets by uncovering the metabolic networks that govern immune responses and inflammation. Furthermore, metabolomics bridges the gap between host metabolism and gut microbiota, shedding light on how microbial metabolites influence immune homeostasis and disease progression. The integration of metabolomics with other omics disciplines promises a more holistic understanding of CTDs, paving the way for personalized medicine. This review highlights the transformative potential of metabolomics in CTDs research, underscoring its role in uncovering the molecular mechanisms driving these diseases and inspiring innovative management and treatment strategies.

Recent years have seen a considerable increase in knowledge pertaining to Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). Nevertheless, a noteworthy degree of uncertainty remains within the neurological community, primarily due to the often highly heterogeneous nature of the disease and the absence of approved long-term treatment options. In this article, we undertake a comprehensive review of the various treatment strategies and drug options available for the pharmacological treatment of acute attacks and relapses in MOGAD.

Cell-free DNA (cf-DNA) refers to extracellular DNA fragments released during cell death, which have been observed to accumulate with advancing age. Elevated cf-DNA concentrations have been detected in the plasma and disease-affected tissues of patients with multiple disorders, particularly age-related autoimmune diseases such as rheumatoid arthritis (RA). Growing evidence supports the potential of cf-DNA as a biomarker for a broad spectrum of autoimmune and age-associated conditions, including cancer, systemic lupus erythematosus (SLE), and psoriasis. Fluctuations in cf-DNA levels and characteristics appear to be closely associated with disease onset, progression, severity, and prognosis. Importantly, emerging studies indicate that cf-DNA may not merely act as a passive biomarker but could also function as an active mediator contributing to RA pathogenesis through distinct immunological pathways. These insights suggest that cf-DNA represents a promising target for the development of innovative diagnostic, preventive, and therapeutic strategies. In this review, we summarize the current understanding of age-related cf-DNA in RA, highlight its potential immunopathological roles, and discuss recent advances in cf-DNA-based diagnostic tools, preventive approaches, and therapeutic interventions with possible clinical translational value.

Multiple Sclerosis (MS) is an autoimmunity-related disorder that mainly affects young adults. The high prevalence of the disease and its impact on patients' quality of life led researchers to investigate the etiopathogenesis of the disease to identify possible modifiable factors and consequent effective intervention strategies. Recent hypotheses suggest that the etiopathogenesis of MS is multifactorial and includes factors related to the immune system, neuroinflammation and neurodegeneration. In this scenario, sleep seems to have a close indirect relationship with MS, through its relationship with each of those factors and given the high incidence of sleep disorders in the MS population. Furthermore, given the growing interest of research in the mechanisms underlying MS and therapies able to alleviate MS-related symptoms at all stages of the disease, a more in-depth study of the role of sleep and its loss and disturbances and the factors intrinsically related to sleep and MS could be useful both to investigate the etiopathogenetic factors of MS and to develop non-invasive intervention strategies for MS treatment.

The inflammatory myopathies-including dermatomyositis, immune-mediated necrotizing myopathy, anti-synthetase syndrome, and overlap myositis-are systemic autoimmune diseases characterized by myositis-specific and myositis-associated autoantibodies targeting intracellular antigens. These diseases can be subclassified by autoantibody seropositivity, based on the understanding that each myositis autoantibody is associated with distinct clinical features. Traditionally, given the intracellular nature of their targets, myositis autoantibodies were thought to be non-pathogenic. However, this idea is now being challenged based on data from recent and older studies showing that autoantibodies reach their intracellular targets in vivo and exert functional pathogenic effects. In this review, we summarize experimental evidence supporting a model of pathogenic autoantibody internalization in the skeletal muscle of different inflammatory myopathies. We also address gaps in the evidence for this model, including the lack of a proven mechanism of autoantibody entry, while offering suggestions for future studies to fill these gaps. We discuss possible mechanisms of autoantibody entry, as well as the diagnostic, prognostic, and therapeutic implications of this model. Finally, we propose that autoantibodies targeting intracellular antigens in other autoimmune diseases-including certain autoimmune neurologic disorders, systemic sclerosis, systemic lupus erythematosus, and vasculitis-could potentially play a role in these conditions.

Autoimmune diseases constitute a collection of complex disorders characterized by abnormal immune responses directed against self-tissues. The pathogenesis of these diseases is strongly linked to the interaction of genetic predispositions and environmental influences. Clinically, autoimmune diseases present with heterogeneous manifestations, and their prevalence has been steadily rising, resulting in profound impacts on patients' physical and psychological health and creating a growing challenge for healthcare infrastructures. At present, nonspecific immunosuppressants are the main treatment method, but this method has limitations such as extensive immunosuppression and serious adverse reactions. Therefore, there is an urgent need to develop novel and targeted therapeutic strategies. As crucial mediators of intercellular communication, extracellular vesicles (EVs) have become significant actors in the control of inflammatory and immunological responses, showing great promise in both mechanistic studies and clinical applications. This study offers a comprehensive overview of current developments in EV research for the main autoimmune conditions, including inflammatory bowel disease, systemic lupus erythematosus, and rheumatoid arthritis. It further comprehensively discusses the potential clinical value of EVs from the perspectives of disease pathogenesis and biomarker development, aiming to offer theoretical support and innovative directions for the clinical application of EV-based diagnostics and treatments, as well as for the realization of precision medicine in autoimmune disorders.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by pathological auto-antibody production and severe immune dysregulation. Dysfunction in regulated cell death (RCD) pathways is crucial in SLE development. Abnormal cell death and cell debris clearance disorder within tissues promote the exposure and accumulation of auto-antigens, activate self-reaction B cells, and amplify interferon type I (IFN-I) reaction. Meanwhile, immune microenvironment disorder caused by abnormal RCD of immune cells exacerbate this response. The review systematically expounds the pathogenic mechanisms of both classical and novel RCD pathways in SLE. By comparing shared and disease-specific RCD dysregulation between SLE and other autoimmune diseases, we evaluate innovative RCD-targeted therapies, offering new insights on SLE pathogenesis and precision treatment.

Sporadic Late-Onset Nemaline Myopathy (SLONM) is an acquired myopathy presenting in adulthood with progressive proximal and axial muscle weakness. A substantial proportion of cases are associated with monoclonal gammopathy of undetermined significance (MGUS), referred to as SLONM-MGUS, suggesting a potential immune-mediated pathogenesis. Although the presence of MGUS has clinical and therapeutic implications, its exact role in disease severity and progression remains unclear. We aimed to characterize clinical, pathological, and prognostic differences between SLONM-MGUS and SLONM without MGUS (SLONM-noMGUS). We conducted a systematic review of SLONM case series published over the past 25 years, supplemented by a single-center case series of five additional patients from our institution (Sant'Andrea Hospital, Rome). Eligible subjects included adult patients diagnosed with SLONM based on clinical features and muscle biopsy demonstrating nemaline rods. Data on demographics, laboratory parameters, histopathological findings, treatments and outcomes were extracted and compared between SLONM-MGUS and SLONM-noMGUS cohorts. Of the 144 patients analyzed, 47 % were classified as SLONM-MGUS. These patients exhibited more severe clinical manifestations, including increased respiratory involvement (p = 0.006). Histopathologically, SLONM-MGUS revealed more prominent nemaline rods (p = 0.032), often accompanied by cytoplasmic bodies and lobulated fibers, and frequently required repeat muscle biopsies for diagnosis (p = 0.0285). Inflammatory infiltrates were less frequent in SLONM-MGUS (p = 0.0176). Functional outcomes were significantly worse in this group, with reduced likelihood of full recovery (p = 0.013) and higher rates of non-ambulatory status (p = 0.01). Patients receiving dual or more treatment regimens, particularly those including IVIg and/or autologous stem cell transplantation (ASCT), had more favorable outcomes. These findings indicate that SLONM-MGUS represents a more severe phenotype of SLONM with distinct clinico-pathological features and poorer prognosis. Notably, combined treatment regimens, including IVIg and/or ASCT, were associated with improved outcomes, highlighting the importance of early recognition and aggressive therapeutic strategies in selected patients.