{"title":"C1 inhibitor: from complement system to bradykinin angioedema","authors":"Federica Defendi , Axelle Amen , Giovanna Clavarino , Chantal Dumestre-Pérard","doi":"10.1016/j.coi.2025.102653","DOIUrl":"10.1016/j.coi.2025.102653","url":null,"abstract":"<div><div>C1 Inhibitor (C1INH) is a crucial regulator of multiple plasmatic pathways, including complement, coagulation, kallikrein-kinin systems, and fibrinolysis. C1INH deficiency results in the downstream overproduction of the vasoactive peptide bradykinin (BK), the primary mediator of angioedema (AE), a rare disease characterized by unpredictable attacks of swelling in various locations of the body. C1INH deficiency can be hereditary (caused by a mutation in SERPING1 gene) or acquired (frequently underlying lymphoproliferative disease); C1INH level and functional assays are the golden standard for biological diagnosis of C1INH deficiency.</div><div>Other forms of hereditary angioedema with normal C1INH activity are emerged in recent years. The most recent guidelines have issue recommendations for classification, clinical and laboratory diagnosis, and management of AE with and without C1INH deficiency. Current axes of research aim to discover new diagnostic and/or prognostic markers of BK-mediated angioedema as well as emphasize the link between C1INH deficiency and chronic comorbidity.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102653"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933311","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":"Layers of defense: protection from respiratory viruses by epithelial-intrinsic immunity","authors":"Ellen F Foxman","doi":"10.1016/j.coi.2025.102677","DOIUrl":"10.1016/j.coi.2025.102677","url":null,"abstract":"<div><div>A central challenge in defending mucosal barriers is protecting against pathogens while also limiting excessive inflammation. Respiratory viruses are a prime example — respiratory viruses present a threat to their target cells, the epithelial cells that line the airways, but excessive leukocyte recruitment to fight the infection can lead to inflammation and respiratory distress. This review focuses on how epithelial-intrinsic defenses contribute to achieving a balanced antiviral response by adding ‘layers of defense’ that engage in sequence to control infections. Layers include: (1) secreting a defensive extracellular barrier, (2) directly blocking viral replication through cell-intrinsic effector mechanisms, (3) amplifying cell-intrinsic defenses within the epithelium through Type III interferons and other epithelial-specific mechanisms, and (4) coordinating leukocyte recruitment and activation. Recent findings in humans and organoid models support the idea that the ‘layers of defense’ created by epithelial-intrinsic mechanisms frequently and successfully counteract respiratory virus infections and limit their health impact.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102677"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262437","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}
Simone A Minnie , Melissa M Berrien-Elliott , Melody Smith , Melinda A Biernacki , Marie Bleakley
{"title":"Optimizing post-transplantation cell therapies to enhance graft-versus-leukemia effects in hematological malignancies","authors":"Simone A Minnie , Melissa M Berrien-Elliott , Melody Smith , Melinda A Biernacki , Marie Bleakley","doi":"10.1016/j.coi.2025.102675","DOIUrl":"10.1016/j.coi.2025.102675","url":null,"abstract":"<div><div>Allogeneic hematopoietic cell transplantation (HCT) can cure patients with high-risk hematologic malignancies. Donor T and natural killer (NK) cells contribute to graft-versus-leukemia (GVL) effects that provide relapse protection. Post-HCT relapses often represent inadequate GVL, but alloreactive lymphocytes that confer GVL may also cause graft-versus-host-disease (GVHD). Here, we review recent developments to selectively augment GVL while minimizing GVHD. Insights into the unique mechanisms of post-HCT T cell dysfunction highlight interventions to enhance GVL-mediating T cells. Early clinical data suggest that adoptive transfer of engineered donor T cells, expressing either transgenic T cell receptors specific for minor histocompatibility antigens presented exclusively on recipient hematopoietic cells or chimeric antigen receptors binding surface proteins on malignant cells, can mitigate post-HCT relapse. NK cells, key GVL mediators after haploidentical HCT, can be induced into a highly functional memory-like state and administered to HCT recipients to enhance GVL. These innovations promise much-needed improvements in post-HCT outcomes.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102675"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262436","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}
Lucio Verdoni , Angelo Mazza , Laura Martelli , Annalisa Gervasoni , Angela Amoroso , Simona Anna Marcora , Paolo Brambilla , Ezio Bonanomi , Greta Carioli , Lorenzo D’Antiga
{"title":"The outcome of severe MIS-C managed at the Italian epicenter of the SARS-CoV-2 epidemic: a follow-up study of 50 consecutive patients","authors":"Lucio Verdoni , Angelo Mazza , Laura Martelli , Annalisa Gervasoni , Angela Amoroso , Simona Anna Marcora , Paolo Brambilla , Ezio Bonanomi , Greta Carioli , Lorenzo D’Antiga","doi":"10.1016/j.coi.2025.102659","DOIUrl":"10.1016/j.coi.2025.102659","url":null,"abstract":"<div><h3>Background</h3><div>During the SARS-CoV-2 pandemic, we described a peak of a Kawasaki-like disease in children, later renamed multisystem inflammatory syndrome in children (MIS-C). We report the long-term outcomes of MIS-C patients who presented to our center.</div></div><div><h3>Methods</h3><div>We recorded clinical features and outcomes in patients with MIS-C admitted to our institution (February 2020–February 2022), focusing on the long-term outcome of those with a severe course.</div></div><div><h3>Results</h3><div>A total of 50 MIS-C patients (mean age 8.8 ± 4.3 years, 16 females) were admitted. In univariate analysis, the predictors of high-risk disease were older age; high CRP, neutrophils, ferritin, D-dimer, and transaminases; and low white blood cells, lymphocytes, platelets, albumin, and sodium. In multivariate analysis, a more severe course of the disease was associated with sodium ≤133 or ferritin >684. In two months, the symptoms disappeared. No relapses occurred during four years of surveillance.</div></div><div><h3>Conclusion</h3><div>The prognosis of MIS-C is favorable, even in severe cases. MIS-C resolves completely as early as eight weeks from onset and is not associated with other events over four years of observation. In our experience, careful and correct stratification in the initial phases has proven essential in setting up the correct treatment, with full recovery in all cases.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"97 ","pages":"Article 102659"},"PeriodicalIF":5.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118483","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}
Carson E Moseley , Joseph J Sabatino Jr , Scott S Zamvil
{"title":"B-cell antigen presentation in central nervous system autoimmunity","authors":"Carson E Moseley , Joseph J Sabatino Jr , Scott S Zamvil","doi":"10.1016/j.coi.2025.102647","DOIUrl":"10.1016/j.coi.2025.102647","url":null,"abstract":"<div><div>The role of B cells in central nervous system (CNS) autoimmunity was initially highlighted by successful clinical trials of anti-CD20 monoclonal antibodies in multiple sclerosis (MS). Research in MS as well as in aquaporin 4 (AQP4)-IgG<sup>+</sup> neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorder (MOGAD) has expanded our appreciation of the contribution of B cells in multiple CNS autoimmune diseases. B cells have multiple functions in the initiation and propagation of CNS autoimmunity that extend beyond autoantibody production, including bidirectional interactions with T cells via B-cell antigen presentation. A deeper understanding of the cooperation between B cells and T cells in MS, NMO, and MOGAD should permit the development of more effective therapies across CNS autoimmune disorders.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"96 ","pages":"Article 102647"},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893287","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":"Intracellular complement in monocytes and macrophages: emerging roles","authors":"Valentin Baverel , Carmen Garrido , Evelyne Kohli","doi":"10.1016/j.coi.2025.102629","DOIUrl":"10.1016/j.coi.2025.102629","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"96 ","pages":"Article 102629"},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779524","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":"Complement in antiphospholipid syndrome, time to target?","authors":"Marie-Agnès Dragon Durey , Houcine Hamidi , Luc Darnige","doi":"10.1016/j.coi.2025.102628","DOIUrl":"10.1016/j.coi.2025.102628","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"96 ","pages":"Article 102628"},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779523","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":"Microbial regulation of serotonin and neuroimmune interactions","authors":"Lewis W Yu , Elaine Y Hsiao","doi":"10.1016/j.coi.2025.102639","DOIUrl":"10.1016/j.coi.2025.102639","url":null,"abstract":"<div><div>Bidirectional communication between the gut microbiota and neuroimmune system is essential during host–microbiome interactions. Recent research has begun to unravel microbiome–neuroimmune crosstalk and suggest classical neurochemicals as key molecular players. Serotonin, a tryptophan-derived neurochemical found across the kingdom of life, is increasingly recognized as an important effector molecule central to interkingdom communication. Here, we focus on serotonin as a key factor for microbiome–neuroimmune interaction. We briefly summarize the serotonergic system and the role of the gut microbiome in regulating serotonin bioavailability, which leads to downstream effects on neuroimmune responses and microbial fitness.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"96 ","pages":"Article 102639"},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866547","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}
James K Sullivan , Audrey Kwun , Trine N Jørgensen
{"title":"Neuropsychiatric lupus: a myriad of symptoms requires a myriad of models","authors":"James K Sullivan , Audrey Kwun , Trine N Jørgensen","doi":"10.1016/j.coi.2025.102631","DOIUrl":"10.1016/j.coi.2025.102631","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"96 ","pages":"Article 102631"},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779613","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":"SARS-CoV-2 and chronic kidney disease: challenges and future directions","authors":"Giannini Olivier , Elzi Luigia","doi":"10.1016/j.coi.2025.102642","DOIUrl":"10.1016/j.coi.2025.102642","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":11361,"journal":{"name":"Current Opinion in Immunology","volume":"96 ","pages":"Article 102642"},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866546","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}