Clinical Reviews in Allergy & Immunology最新文献

{"title":"Probiotics in Autoimmune Disease: Strain-specific Mechanisms and Therapeutic Perspectives.","authors":"Junxiong Zhou, Jialu Cao, Shumin Dong, Haonan Li, Shutong Yang, Ze Yan, Chanmin Wang, Yaoshun Pei, Yian Su, Bin Wen, Honglei Zhang, Li Ma, Caihong Wang, Yufeng Fan, Yukai Jing","doi":"10.1007/s12016-026-09190-2","DOIUrl":"10.1007/s12016-026-09190-2","url":null,"abstract":"<p><p>The gut microbiota plays a crucial role in human health and is increasingly recognized as a potential therapeutic target for various diseases. Current standard-of-care treatments for autoimmune diseases often include immunosuppressive agents aimed at controlling immune activation and limiting tissue injury rather than solely suppressing autoantibody production. However, systemic immunosuppression can be associated with dose- and duration-dependent adverse effects, underscoring the need to explore adjunctive and alternative therapeutic strategies. This review summarizes the putative mechanisms of action of seven commonly studied probiotic taxa: Lactobacillus, Bifidobacterium, Propionibacterium, butyrate-producing bacteria, yeasts, Enterococcus, and Bacillus. These taxa are presented as representative examples rather than an exhaustive list. The review further compares their commonalities and differences in immunomodulatory features across major autoimmune diseases, including systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and rheumatoid arthritis (RA). We further discuss evidence for potential synergy among probiotic combinations, contrast probiotic-based interventions with conventional immunosuppressive regimens in terms of their putative advantages and limitations, and examine the prospects for precision probiotic strategies alongside current challenges, including strain specificity, dosing and formulation, host heterogeneity, and reproducibility across cohorts. By integrating existing evidence, this review aims to inform the rational development of probiotic-based interventions for autoimmune diseases and provide a framework for future clinical and translational research.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fucosyltransferases in asthma: regulators of epithelial dysfunction, senescence, and airway inflammation.","authors":"Wenjing Gu, Snehalakshmi Kavacheri Subramaniam, Minxuan Hu, Chuangli Hao, Peisong Gao","doi":"10.1007/s12016-026-09192-0","DOIUrl":"10.1007/s12016-026-09192-0","url":null,"abstract":"<p><p>Glycosylation is a critical post-translational modification that regulates protein folding, stability, and cellular communication. Among glycan modifications, fucosylation, catalyzed by fucosyltransferases (FUTs), plays important roles in immune regulation, epithelial homeostasis, and host-pathogen interactions. Increasing evidence suggests that dysregulated fucosylation contributes to chronic inflammatory airway diseases, including asthma. Asthma is characterized by chronic airway inflammation, epithelial barrier dysfunction, mucus hypersecretion, and airway remodeling, processes that are increasingly associated with altered glycosylation patterns. Recent studies indicate that specific FUT isoforms regulate epithelial integrity, mucin glycosylation, immune-cell recruitment, and inflammatory signaling in asthma. Emerging evidence also suggests that FUT-mediated fucosylation may contribute to airway remodeling and cellular senescence; however, direct evidence for these mechanisms in asthma remains limited, and many insights are derived from related respiratory diseases and experimental models. This review summarizes current knowledge of the FUT family and critically evaluates the evidence linking aberrant fucosylation to asthma pathogenesis. We discuss the roles of FUTs in epithelial dysfunction, mucus secretion, immune regulation, airway remodeling, and cellular senescence, while distinguishing established asthma-specific findings from emerging mechanistic hypotheses. Finally, we highlight current challenges, future research directions, and the potential of FUT-targeted strategies for biomarker discovery and precision therapies in asthma.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenchymal Stem/Stromal Cells and Their Derived Extracellular Vesicles: a Promising Therapeutic Strategy for Autoimmune Hepatitis.","authors":"Mai Abdelgawad, Sahar Allam, Amaan Javed, Jia Xian Law, Shing Cheng Tan","doi":"10.1007/s12016-026-09189-9","DOIUrl":"10.1007/s12016-026-09189-9","url":null,"abstract":"<p><p>Autoimmune hepatitis (AIH) is an idiopathic autoimmune disorder characterized by chronic liver inflammation that, if untreated, can lead to liver fibrosis and cirrhosis, hepatic failure, and death. Current treatment options for this potentially life-threatening disorder include either high-dose immunosuppressants or liver transplantation (for late-stage patients). However, these options are risky and can lead to long-term complications. Therefore, there is an urgent need to develop novel treatment strategies for AIH. Therapeutic approaches based on mesenchymal stem/stromal cells (MSCs) and their derived extracellular vesicles (EVs) have emerged as a viable treatment option for AIH because of their potent immunomodulatory and anti-inflammatory properties. This review outlines the recent developments in the use of these therapies for the treatment of AIH. The use of EVs as vehicles for the delivery of therapeutic drugs or miRNAs is also discussed. In addition, we discuss the various efforts that have been made to improve the efficacy of such therapies, including their genetic modification and combination with anti-inflammatory drugs. Finally, we proposed several directions for future research aimed at developing MSCs and MSC-derived EVs for clinical applications.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lanadelumab Use for Hereditary Angioedema Long-Term Prophylaxis Over the Last 7 Years: A Narrative Review of Clinical and Real-World Data.","authors":"Paula Busse, Andrea Zanichelli, Jonathan A Bernstein, John Anderson, Stephen Betschel, Daniel N Castaner, Matthew Otule, Tara Piccolo, William R Lumry","doi":"10.1007/s12016-026-09179-x","DOIUrl":"10.1007/s12016-026-09179-x","url":null,"abstract":"<p><p>Hereditary angioedema (HAE) is a rare genetic disease characterized by unpredictable, painful cutaneous and/or subcutaneous swelling attacks; laryngeal attacks can be fatal. For many patients, long-term prophylaxis (LTP) is critical for disease control and quality of life.Lanadelumab, a plasma kallikrein inhibitor, was approved for HAE LTP for adults and adolescents in 2018 and for children aged ≥ 2 years in 2023; it is currently one of the guideline-recommended, first-line LTP options. By integrating 7 years of cumulative clinical trial and real-world data, this narrative review summarizes lanadelumab long-term effectiveness and safety in adult, adolescent, and pediatric HAE populations. Outcomes in 41 peer-reviewed publications were evaluated, including 5 clinical trials involving 262 lanadelumab-treated patients and 28 real-world studies comprising ~ 700 patients. Across clinical trials, lanadelumab reduced attack rates by up to 100%, with an average of 24.9-27.3 patient-reported attack-free days per 28-day period. These findings were largely corroborated by real-world data, including 2 large observational studies with > 100 patients each. Patient-reported disease control and health-related quality of life improved consistently across both settings. The main treatment-related adverse events across studies were injection site reactions. Treatment persistence was generally high in clinical practice. Unmet needs remain for specific populations, including pregnant or lactating patients and those without access to guideline-recommended LTP. Future research should address real-world outcomes in pediatric patients, extended dosing intervals in well-controlled disease, transitions from other LTP therapies, and cost-effectiveness. Overall, sustained effectiveness, safety, and quality-of-life benefits of lanadelumab reinforce its role as a cornerstone of HAE management.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The OX40-OX40L Co-Stimulatory Pathway as a Shared Driver of Immune Persistence in Skin and Airway Inflammation.","authors":"Francisco José Navarro-Triviño, Tiago Torres, Ricardo Ruiz-Villaverde, José Luis Moreno-Amador, Pedro Mendes-Bastos","doi":"10.1007/s12016-026-09188-w","DOIUrl":"10.1007/s12016-026-09188-w","url":null,"abstract":"","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Pulmonary Involvement in Patients with ANCA-associated Vasculitis: A Systematic Review and Meta-analysis.","authors":"Ze Yang, Yanzuo Wu, Yanhao Chen, Fengyuan Tian, Zexuan Wu, Jie Bao, Yongsheng Fan, Shuo Huang","doi":"10.1007/s12016-026-09186-y","DOIUrl":"10.1007/s12016-026-09186-y","url":null,"abstract":"<p><p>Pulmonary involvement (PI) in ANCA-associated vasculitis (AAV), especially interstitial lung disease (ILD) and diffuse alveolar hemorrhage (DAH), predicts poor outcomes, but a synthesis distinguishing these phenotypes is lacking. We searched seven databases up to April 1, 2026, and included observational studies. Using univariate and multivariate meta-analyses, we calculated pooled odds ratios (OR) or mean differences (MD). Nineteen studies (2,944 patients) were included. For ILD, robust independent risk factors were age > 65 years (OR = 3.60) and male gender (OR = 2.57). MPO-ANCA positivity was more frequent in the ILD group (OR = 2.29). Potential associated factors included smoking, D-dimer, ANA, low C4, and CA199. MPA subtype, cough, and dyspnea were more frequent in the ILD group. Factors associated with lower ILD frequency included GPA subtype, PR3-ANCA positivity, c-ANCA positivity, ENT involvement, gastrointestinal involvement, and a higher BVAS score. For DAH, potential associated factors included proteinuria, high BVAS score, Cr, BUN, PCT, decreased Hb, and low C3. PR3-ANCA positivity and hemoptysis were more frequent in the DAH group. For overall PI, independent risk factors were age (continuous OR = 1.04, > 65 years OR = 4.20), male gender (OR = 3.08), and high BVAS (OR = 3.03). MPO-ANCA positivity (OR = 2.55) was more frequent in the overall PI group, which largely overlapped with those for ILD, suggesting that ILD is the main driver of overall PI. This first meta-analysis combining univariate and multivariate approaches with an evidence-grading framework for ILD demonstrates distinct clinical patterns for ILD versus DAH, offering a clinically actionable tool for risk stratification and personalized management of PI in AAV.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The SP-MrgprX2 Axis in Allergic Rhinitis: a Neuro-immune Paradigm Beyond IgE-mediated Inflammation.","authors":"Biyi Zhang, Yitong Liu, Jun Zhao, Xinpeng Li, Jingyi Deng, Hangyu Li, Yuqia Xie, Dexin Nie, Xinlong Lian, Guochun Huang, Suidong Ouyang","doi":"10.1007/s12016-026-09185-z","DOIUrl":"10.1007/s12016-026-09185-z","url":null,"abstract":"<p><p>Allergic rhinitis (AR) is traditionally defined as an IgE-mediated hypersensitivity disorder; however, this paradigm fails to explain the clinical heterogeneity observed in patients with persistent symptoms and poor therapeutic responsiveness. Emerging evidence indicates that neuro-immune interactions constitute a critical, yet underappreciated, layer of AR pathogenesis. Substance P (SP)-Mas-related G protein-coupled receptor X2 (MrgprX2) axis has recently been recognized as a central mediator of IgE-independent inflammation. Upon sensory neuron activation, SP is rapidly released and directly activates MrgprX2 on mast cells, initiating immediate inflammatory responses independent of FcεRI signaling. This pathway further drives epithelial barrier disruption and neutrophil-dominant inflammation, while sustained activation establishes neuro-immune positive feedback loops and central sensitization along the nose-brain axis, ultimately promoting chronicity and therapeutic refractoriness. Here, we integrate current evidence into a unified neuro-immune framework in which the SP-MrgprX2 axis orchestrates inflammation initiation, amplification, and maintenance beyond the classical IgE-dependent pathway. We further delineate its molecular recognition, signaling dynamics, and neuro-immune synapse organization, and discuss its crosstalk with broader inflammatory networks. On this basis, we propose mechanism-guided therapeutic strategies targeting distinct regulatory layers of this axis. Collectively, this review positions the SP-MrgprX2 axis as a key mechanistic bridge linking neural activation to chronic inflammation, advancing a neuro-immune paradigm that extends beyond IgE-mediated disease and providing a conceptual foundation for precision management of refractory AR.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Inborn Errors of Immunity in China: Discoveries and Treatment Paradigms.","authors":"Yu Shi, Christopher Chang, Kai Guan","doi":"10.1007/s12016-026-09184-0","DOIUrl":"10.1007/s12016-026-09184-0","url":null,"abstract":"<p><p>Inborn errors of immunity (IEI) are monogenic disorders of the immune system that lead to immunodeficiency, autoimmunity, autoinflammation, allergy, and/or cancer. This review provides a comparative review of the epidemiology, clinical manifestations, and management of IEI in China. While individual forms of IEI are generally rare disorders globally, collectively they represent a significant disease burden. China has recently made great strides in the diagnosis and treatment of IEIs with the increasing utility of next-generation sequencing and the availability of hematopoietic stem cell transplantation. Challenges remain in the establishment of national registry databases comparable to the European Society for Immunodeficiencies and The United States Immunodeficiency Network. Also, the absence of a national newborn screening program for severe combined immunodeficiency poses risks regarding live attenuated vaccination in undiagnosed infants. Current access to treatment including subcutaneous immunoglobulin, targeted molecular therapies, and commercialized gene therapy remains limited in China. Nevertheless, the therapeutic landscape is rapidly evolving, marked by an increasing clinical application of precision molecular-targeted treatments and the emergence of AI-empowered gene editing therapies. Ultimately, advancing the field of IEI necessitates global collaboration, integrating the complementary strengths of both regions to establish scientific breakthroughs and clinical innovation.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The OX40-OX40L Co-Stimulatory Pathway as a Shared Driver of Immune Persistence in Skin and Airway Inflammation.","authors":"Francisco José Navarro-Triviño, Tiago Torres, Ricardo Ruiz-Villaverde, José Luis Moreno-Amador, Pedro Mendes-Bastos","doi":"10.1007/s12016-026-09187-x","DOIUrl":"10.1007/s12016-026-09187-x","url":null,"abstract":"<p><p>The OX40-OX40L co-stimulatory pathway has emerged as an important regulator of T-cell persistence and immune memory. While traditionally associated with type 2 inflammation, its role extends across multiple barrier tissues, including the skin and respiratory mucosa, where it integrates epithelial signals with adaptive immune responses. To provide a comprehensive and integrative overview of the OX40-OX40L axis as a shared driver of immune persistence across skin and airway inflammatory diseases and to discuss its therapeutic implications. A narrative review was conducted based on a focused literature search of PubMed, Scopus, and Web of Science up to February 2026. Experimental, translational, and clinical studies addressing OX40-OX40L biology and therapeutic targeting were included. OX40 signaling acts as a late co-stimulatory pathway that sustains effector T-cell survival, promotes tissue-resident memory T-cell formation, and modulates regulatory T-cell function. In barrier tissues, epithelial-derived alarmins such as TSLP and IL-33 induce OX40L expression on antigen-presenting cells, reinforcing type 2-polarized immune responses. This axis contributes to chronic inflammation in atopic dermatitis, asthma, allergic rhinitis, and nasal polyposis, supporting the concept of shared mechanisms of immune persistence across type 2 inflammatory diseases. Beyond type 2 immunity, OX40-OX40L signaling also participates in Th1-, Th17-, and Th22-mediated responses, as well as in autoimmune, fibrosing, and lymphoproliferative disorders. Therapeutic targeting of this pathway, particularly with monoclonal antibodies such as amlitelimab, has demonstrated clinically meaningful efficacy and suggests potential for durable disease modification. The OX40-OX40L axis represents an important immunological pathway linking epithelial activation to adaptive immune memory across barrier tissues. Its role in sustaining immune persistence provides a conceptual framework for understanding chronic inflammatory diseases and supports continued investigation of therapies targeting upstream co-stimulatory pathways.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal Infections in Disorders of Inborn Errors of Immunity.","authors":"Manpreet Dhaliwal, Vaishali Thakur, Adilia Warris, Gordon D Brown, Rakesh Kumar Pilania, Ivy M Dambuza","doi":"10.1007/s12016-026-09182-2","DOIUrl":"10.1007/s12016-026-09182-2","url":null,"abstract":"<p><p>Emerging infectious threats continually challenge the adaptability of the human immune system. Inborn errors of immunity (IEIs) provide a unique framework to dissect host-pathogen interactions, revealing how single-gene defects uncover critical pathways in antifungal defence. This review offers an overview of fungal immunity through the lens of IEIs, and integrates recent advances in innate fungal recognition, neutrophil and mononuclear phagocyte effector mechanisms, CARD9/NF-kB signalling, IL-17/IL-23 and IL-12/IFN-gamma cytokine axes, and transcription-factor defects that shape susceptibility to Candida, Aspergillus, Pneumocystis, Cryptococcus, dimorphic fungi and other moulds. We also discuss acquired phenocopies mediated by anti-cytokine autoantibodies, translate these mechanisms into clinical red flags and diagnostic algorithms, and discuss potential therapeutic strategies. Finally, we highlight how genetically defined IEIs can be used to study fungal-bacterial, fungal-mycobacterial and fungal-viral co-infections, revealing the hierarchy and plasticity of host defence in health and disease.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"69 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}