Current Opinion in Immunology最新文献_第5页

Challenges in diagnosis of sarcoidosis 结节病诊断的挑战

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-09-01 DOI: 10.1016/j.coi.2025.102652

Karol Bączek , Wojciech J Piotrowski , Francesco Bonella

{"title":"Challenges in diagnosis of sarcoidosis","authors":"Karol Bączek , Wojciech J Piotrowski , Francesco Bonella","doi":"10.1016/j.coi.2025.102652","DOIUrl":"10.1016/j.coi.2025.102652","url":null,"abstract":"<div><h3>Purpose of review</h3><div>Diagnosing sarcoidosis remains challenging. Histology findings and a variable clinical presentation can mimic other infectious, malignant, and autoimmune diseases. This review synthesizes current evidence on histopathology, sampling techniques, imaging modalities, and biomarkers and explores how emerging ‘omics’ and artificial intelligence tools may sharpen diagnostic accuracy.</div></div><div><h3>Recent findings</h3><div>Within the typical granulomatous lesions, limited or ‘burned-out’ necrosis is an ancillary finding, which can be present in up to one-third of sarcoid biopsies, and demands a careful differential diagnostic work-up. Endobronchial ultrasound–guided transbronchial needle aspiration of lymph nodes has replaced mediastinoscopy as first-line sampling tool, while cryobiopsy is still under validation. Volumetric PET metrics such as total lung glycolysis and somatostatin-receptor tracers refine activity assessment; combined FDG PET/MRI improves detection of occult cardiac disease. Advanced bronchoalveolar lavage (BAL) immunophenotyping via flow cytometry and serum, BAL, and genetic biomarkers show to correlate with inflammatory burden but have low diagnostic value. Multi-omics signatures and Positron Emission Tomography with Computer Tomography radiomics, supported by deep-learning algorithms, show promising results for noninvasive diagnostic confirmation, phenotyping, and disease monitoring.</div></div><div><h3>Summary</h3><div>No single test is conclusive for diagnosing sarcoidosis. An integrated, multidisciplinary strategy is needed. Large, multicenter, and multiethnic studies are essential to translate and validate data from emerging AI tools and -omics research into clinical routine.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102652"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926252","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}

引用次数: 0

Approved and emerging therapies for glucocorticoid-refractory chronic graft-versus-host disease 经批准和新兴的治疗糖皮质激素难治性慢性移植物抗宿主病的方法

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-09-09 DOI: 10.1016/j.coi.2025.102654

Xinwen Zhang , Yuxin Ren , Ruihao Huang , Xiaoqi Wang , Xi Zhang

{"title":"Approved and emerging therapies for glucocorticoid-refractory chronic graft-versus-host disease","authors":"Xinwen Zhang , Yuxin Ren , Ruihao Huang , Xiaoqi Wang , Xi Zhang","doi":"10.1016/j.coi.2025.102654","DOIUrl":"10.1016/j.coi.2025.102654","url":null,"abstract":"<div><div>Glucocorticoid-refractory chronic graft-versus-host disease (glucocorticoid-refractory cGVHD) remains a major barrier to long-term survival and quality of life following allogeneic hematopoietic stem cell transplantation (allo-HSCT), affecting 30–70% to half of patients with chronic GVHD who fail corticosteroid therapy. In recent years, the Food and Drug Administration (FDA) has approved four agents — ibrutinib, ruxolitinib, belumosudil, and axatilimab — each targeting distinct immune and fibrotic pathways. This review systematically evaluates their mechanisms of action, efficacy across organ systems, and safety profiles while highlighting persistent limitations. We further summarize emerging therapies in clinical and preclinical development, including kinase inhibitors, monoclonal antibodies, cellular approaches, and tissue-specific interventions. A dual-axis framework — distinguishing inflammatory versus fibrotic phenotypes and organ-specific manifestations — is proposed to support biomarker-guided, individualized treatment. In addition, combination regimens and AI-assisted strategies offer new opportunities to optimize outcomes and reduce treatment burden. Despite these advances, challenges remain, including irreversible fibrosis, disease heterogeneity, lack of standardized diagnostic criteria, and balanced GVHD and graft versus tumor effect. Greater incorporation of patient-reported outcomes and long-term functional assessments into clinical trials and practice is urgently needed. Collectively, this review offers a roadmap for optimizing glucocorticoid-refractory cGVHD management, and evolving strategies hold promise for transforming glucocorticoid-refractory cGVHD from a life-limiting condition into a manageable chronic disease.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102654"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020396","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}

引用次数: 0

From genes to granulomas: the genetic blueprint of sarcoidosis 从基因到肉芽肿：结节病的基因蓝图。

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-09-19 DOI: 10.1016/j.coi.2025.102663

Martin Petrek , Natalia V Rivera

引用次数: 0

COVID-19 and inflammatory bowel disease — what to know COVID-19和炎症性肠病——需要了解什么？

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-09-30 DOI: 10.1016/j.coi.2025.102661

Anne Godat , Dimitrios Chistoforidis , Thomas Greuter

{"title":"COVID-19 and inflammatory bowel disease — what to know","authors":"Anne Godat , Dimitrios Chistoforidis , Thomas Greuter","doi":"10.1016/j.coi.2025.102661","DOIUrl":"10.1016/j.coi.2025.102661","url":null,"abstract":"<div><div>Inflammatory bowel disease (IBD) represents a chronic inflammation of the gastrointestinal tract that arises from a complex interplay between a dysregulated immune response in genetically predisposed individuals. IBD can further be classified into its two main subtypes, Crohn’s disease and ulcerative colitis. Both subtypes have shown increasing prevalence and incidence rates worldwide, and IBD is now considered a global epidemic. About three million patients are estimated to suffer from this disease, both in the US and Europe, with most of them requiring maintenance treatment including immunosuppressive agents, putting them at risk for opportunistic infections. In 2020, coronavirus disease 2019 (COVID-19) hit the world with a long pandemic period resulting in dramatic numbers of hospitalizations, Intensive care unit (ICU) admissions, and deaths. Patients with chronic illnesses, such as IBD, were rapidly considered to be at an increased risk for both infection and infection-related complications. For IBD and its treatment, however, evidence over the last few years showed no increased risk for SARS-CoV-2 infection or COVID-related complications. In this review, we will discuss the latest insights about COVID-19 in IBD patients with a particular focus on the disease course of COVID-19 and on IBD-related adverse outcomes.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102661"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208346","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}

引用次数: 0

Deciphering and harnessing gut microbiota–associated immune regulation in acute graft-versus-host disease 在急性移植物抗宿主病中破译和利用肠道微生物群相关的免疫调节

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-10-10 DOI: 10.1016/j.coi.2025.102676

Emmanuelle Godefroy , Frédéric Altare

{"title":"Deciphering and harnessing gut microbiota–associated immune regulation in acute graft-versus-host disease","authors":"Emmanuelle Godefroy , Frédéric Altare","doi":"10.1016/j.coi.2025.102676","DOIUrl":"10.1016/j.coi.2025.102676","url":null,"abstract":"<div><div>Allogeneic hematopoietic stem cell transplantation represents a curative treatment of choice for numerous severe hematological malignancies. While donor-derived transplanted T cells can limit disease relapse (GvT/GvL effect), they also induce, in 30–50% of the patients, acute graft-versus-host disease (aGvHD), a severe condition with elevated mortality and comorbidity rates. Gut microbiota composition has been associated with aGvHD outcome. This observation created a substantial research interest, and individual gut microbiota commensals have been acknowledged for their ability to promote immune regulation, both locally and systemically, and thus limit aGvHD-related inflammation. The mechanisms by which commensals support immune homeostasis are being decrypted at a remarkable rate. However, the trillions of micro-organisms comprising the gut microbiome interact, both directly and indirectly, with local immune cells, which is all the more critical in the context of heavy conditioning regimens these patients undergo, themselves damaging mucosal tissues and prompting inflammation. Commensals can help preserve the gut barrier integrity by actively limiting deleterious inflammation processes. Mechanistically deciphering the intricate crosstalk between gut microbes and gut immune cells, both at the species level and globally, represents a colossal challenge, but holds great promise in predicting and harnessing numerous pathological processes, including aGvHD. This review aims to examine the acquired knowledge concerning immunoregulatory responses driven by gut microbiota in the context of aGvHD. Recent preclinical and clinical studies harnessing such pathways proved to be encouraging, while substantial hurdles subsist regarding how to successfully harness this complex host/microbiota interplay to constrain aGvHD.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102676"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262435","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}

引用次数: 0

Microglia and myeloperoxidase in neuroinflammatory and neurodegenerative diseases 神经炎症和神经退行性疾病中的小胶质细胞和髓过氧化物酶。

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-09-18 DOI: 10.1016/j.coi.2025.102660

Lorenzo Del Moro , Enrico Brunetta , M. Eric Gershwin , Carlo Selmi

{"title":"Microglia and myeloperoxidase in neuroinflammatory and neurodegenerative diseases","authors":"Lorenzo Del Moro , Enrico Brunetta , M. Eric Gershwin , Carlo Selmi","doi":"10.1016/j.coi.2025.102660","DOIUrl":"10.1016/j.coi.2025.102660","url":null,"abstract":"<div><div>The dogma of an impenetrable blood–brain barrier (BBB) has given way to the view that resident immune cells within the central nervous system respond to a variety of blood-borne soluble factors, particularly cytokines, and play an important functional role. In particular, microglia cells contribute to the regulation of neuroinflammation, with both protective and pathological roles. Specific microglia activation states variably influence the progression of neuroinflammatory and neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and amyotrophic lateral sclerosis. Significant evidence indicates that gut microbiota–derived products regulate microglial function across the lifespan and influence the BBB. Myeloperoxidase (MPO) catalyzes the conversion of hydrogen peroxide and chloride ions into hypochlorous acid, a potent oxidant implicated in oxidative tissue damage and modulation of inflammatory signaling. Elevated MPO levels in the central nervous system have been correlated with human disease and the dysregulation of MPO activity in microglia is particularly detrimental, as it amplifies the oxidative stress, disrupts the BBB integrity, and potentiates the neuroinflammatory cascades through the activation of transcription factors like NF-κB. Targeting MPO activity through selective inhibitors or antioxidant strategies may attenuate microglial activation and reduce neuroinflammation, highlighting its potential as a therapeutic target, but the regulatory mechanisms governing MPO expression in microglia and its interplay with other inflammatory mediators remain poorly understood. New research efforts into the relationship between <u><u>g</u></u>ut microbiota, microglia, MPO, and neuroinflammation are essential to unravel the complexities of neuropathology in a variety of conditions beyond neurodegenerative diseases.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102660"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093281","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}

引用次数: 0

Protective or pathogenic? Tuft cells shape divergent immune outcomes in helminth and viral infections 保护性还是致病性？簇状细胞在蠕虫和病毒感染中形成不同的免疫结果

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-09-12 DOI: 10.1016/j.coi.2025.102657

Miles DW Tyner , Michael R Howitt

引用次数: 0

Antiviral responses in peripheral and brain neurons 外周和脑神经细胞的抗病毒反应。

IF 5.8 2区医学

Current Opinion in Immunology Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.coi.2025.102678

Brian Imbiakha , Hana Janova , Michael S Diamond

引用次数: 0

Human inborn errors of type I interferon–independent intrinsic immunity in nonleukocytic cells 非白细胞细胞I型干扰素非依赖性固有免疫的先天性错误