J Luis Espinoza, Do Tung Dac, Nguyen Hoang Thao Giang, Akiyoshi Takami
{"title":"Interleukin-17 and transplant immunology: clinical evidence from hematopoietic cell transplantation.","authors":"J Luis Espinoza, Do Tung Dac, Nguyen Hoang Thao Giang, Akiyoshi Takami","doi":"10.1080/1744666X.2025.2575450","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2575450","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin-17 (IL-17), a proinflammatory cytokine primarily produced by Th17 cells, plays a complex role in transplant immunology. Its involvement in graft-versus-host disease (GvHD) and immune regulation following hematopoietic cell transplantation (HCT) has garnered significant clinical interest, though findings remain inconsistent.</p><p><strong>Areas covered: </strong>This narrative review summarizes clinical studies in human HCT recipients investigating IL-17 cytokine levels, Th17 cell activity, and IL-17 gene polymorphisms associated with transplant outcomes. While several studies report associations between elevated IL-17 or Th17 levels and increased GvHD risk, results vary widely due to differences in study design, patient populations, and measurement methods.</p><p><strong>Expert opinion: </strong>IL-17 is a promising, though context-dependent, biomarker and therapeutic target in HCT. Its dual roles in promoting inflammation and supporting antimicrobial defense complicate therapeutic modulation. Future studies should focus on standardized assays, multi-omics approaches, and longitudinal designs to clarify its clinical utility. Tailored strategies that modulate IL-17 without impairing immune reconstitution or graft-versus-leukemia effects are likely to guide future interventions.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"IgG4-related kidney disease: from renal histopathology and immunopathogenesis to novel pharmacological interventions.","authors":"Eva Baier, Augusto Vaglio","doi":"10.1080/1744666X.2025.2575448","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2575448","url":null,"abstract":"<p><strong>Introduction: </strong>Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a rare and chronic fibroinflammatory condition hallmarked by tumefactive lesions that can affect nearly any organ of the body and lead to fibrotic organ destruction. Parenchymal and non-parenchymal affection of the kidney and urogenital tract are subsumed under the umbrella term IgG4-related kidney disease (IgG4-RKD), which is a severe and quite common organ manifestation in IgG4-RD. The immunopathogenesis in IgG4-RD is depicted by a complex interplay of distinct B and T-cell subsets, excessive antibody production, a unique cytokine environment and the development of exuberant fibrosis. Scientific advancements over the last two decades have fostered to explore a broad repertoire of pharmacological interventions starting from B-cell depleting agents and extending to modulators of T-cell co-stimulation.</p><p><strong>Areas covered: </strong>The aim of this review is to a) provide an overview of the current knowledge on IgG4-RKD with an emphasis on the unique properties of renal histopathology and immunopathogenesis and b) overview novel pharmacological interventions targeting B cells, T cells and beyond.</p><p><strong>Expert opinion: </strong>Speculating on a potential scenario that dominates IgG4-RD's treatment reality in five years, the advent of integrative treatment strategies combining both B- and T-cell targeting agents is conceivable.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hui-Jun Lai, Zhi-Ming Ye, Si-Qi Chen, Kevin J McElwee, Hong-Wei Guo
{"title":"Immune therapies for alopecia areata: evidence and new perspectives.","authors":"Hui-Jun Lai, Zhi-Ming Ye, Si-Qi Chen, Kevin J McElwee, Hong-Wei Guo","doi":"10.1080/1744666X.2025.2575365","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2575365","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata (AA) is an autoimmune non-scarring hair loss that involves collapse of hair follicle immune privilege. Genetic susceptibility, environmental stressors, and aberrant interaction between dendritic cells, CD4<sup>+</sup> and CD8<sup>+</sup> lymphocytes, drives follicular destruction and disrupts hair cycling. Proinflammatory cytokines, including IL-15 and IFNγ, and downstream JAK-STAT pathway activation, are central to disease progression.</p><p><strong>Areas covered: </strong>Though variably effective, conventional treatments including corticosteroids, contact sensitizers, phototherapy, and systemic immunosuppressants remain standard therapeutic approaches for AA in many clinics. However, insights into Th1, Th2, and Th17 cell activity, along with the cytokine signals involved (IFNγ, IL-15, IL-4/13, IL-17/23), and an emerging understanding of immune checkpoints in AA (PD-1/PD-L1, CD28/CD80/CD86/CTLA4, OX40/OX40L), are shaping the clinical investigation of new AA treatments; particularly JAK inhibitors and biologics targeting specific signaling pathways.</p><p><strong>Expert opinion: </strong>Heterogeneity in AA clinical presentation, molecular pathogenesis, and variable treatment responses, suggests a biomarker-driven patient stratification system is needed to optimize drug selection, reduce trial-and-error therapy, and minimize side-effect risk. In the longer term, approaches that couple rapid immunosuppression with strategies to regenerate follicular immune privilege and tolerize autoreactive memory T cells are likely to shift AA therapeutic approaches away from chronic immune suppression toward true disease-modifying or curative interventions.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivan Taietti, Francesca Cenzato, Ilaria Brambilla, Gian Luigi Marseglia, Amelia Licari, Riccardo Castagnoli
{"title":"Inborn errors of immunity with atopic phenotypes: what we know so far.","authors":"Ivan Taietti, Francesca Cenzato, Ilaria Brambilla, Gian Luigi Marseglia, Amelia Licari, Riccardo Castagnoli","doi":"10.1080/1744666X.2025.2575361","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2575361","url":null,"abstract":"<p><strong>Introduction: </strong>Inborn errors of immunity with atopic phenotypes (IEIwA) represent a growing and complex subset of monogenic disorders that manifest primarily through severe and multifaceted allergic symptoms. These conditions bridge the fields of immunodeficiency and atopy, posing significant diagnostic and therapeutic challenges.</p><p><strong>Areas covered: </strong>A literature search was performed via the online database PubMed, including all publication years 2021-2024, with the objective of identifying the most recent advancements in the field of IEIwA. This review provides an updated synthesis of the immunogenetic mechanisms underlying IEIwA, categorizing them by pathophysiological pathways, including impaired T cell receptor signaling, cytokine dysregulation, T cell repertoire restrictions, regulatory T cell dysfunction, metabolic abnormalities, and skin barrier defects. Advances in genomic technologies, especially whole exome/genome sequencing, have refined the classification and recognition of these disorders. Moreover, the review highlights red flags that may aid in differentiating monogenic IEIwA from multifactorial allergic conditions. Emerging targeted therapies, such as monoclonal antibodies and small molecules, offer new avenues for precision medicine, though curative treatments like hematopoietic stem cell transplantation remain essential for many conditions.</p><p><strong>Expert opinion: </strong>This review underscores the need for heightened awareness, early recognition, and tailored management strategies to improve outcomes in patients with IEIwA.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giuseppe Miceli, Anna Maria Ciaccio, Mariagiovanna Cuffaro, Martina Profita, Antonino Tuttolomondo
{"title":"Immunology of atherosclerosis as an inflammatory disease: rethinking the dynamic immunoinflammatory activity beneath stability.","authors":"Giuseppe Miceli, Anna Maria Ciaccio, Mariagiovanna Cuffaro, Martina Profita, Antonino Tuttolomondo","doi":"10.1080/1744666X.2025.2575449","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2575449","url":null,"abstract":"<p><strong>Introduction: </strong>Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of lipids, immune cells, and fibrous components within the arterial wall. While traditionally considered a lipid-driven process, growing evidence suggests that immune mechanisms play a central role in all stages of atherogenesis.</p><p><strong>Areas covered: </strong>This review summarizes the most relevant evidence supporting the immunoinflammatory basis of plaque development, progression, and destabilization. Both innate and adaptive immune responses contribute to endothelial dysfunction, immune cell recruitment, cytokine production, and the activation of inflammasome pathways, which amplify vascular inflammation. Crucially, the interplay between inflammation and thrombosis, termed thromboinflammation, plays a pivotal role in plaque instability and clinical events.</p><p><strong>Expert opinion: </strong>We critically examine the limitations of the classic dichotomy between stable and unstable plaques, proposing instead a tripartite classification: active, dormant, and inactive plaques, analogous to the states of volcanic activity. Even clinically 'stable' plaques may exhibit silent yet ongoing immunometabolic and thromboinflammatory activity, contributing to residual cardiovascular risk. Advanced imaging, molecular diagnostics, and inflammation-sensitive biomarkers (e.g. high-sensitivity C-reactive protein, IL-6) can help detect subclinical plaque activity. Finally, the concept of 'thromboinflammaging' emphasizes the impact of age-related immune dysregulation on vascular pathology. This evolving paradigm supports immunomodulation as a cornerstone in precision cardiovascular medicine.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toward precision in psoriatic arthritis: addressing the challenge of difficult-to-treat disease.","authors":"Rubén Queiro, Sara Alonso","doi":"10.1080/1744666X.2025.2575355","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2575355","url":null,"abstract":"<p><strong>Introduction: </strong>Difficult-to-treat psoriatic arthritis (D2T-PsA) is increasingly recognized as a complex clinical entity characterized by persistent disease burden despite multiple targeted therapies. Its identification is essential to improve patient outcomes and to guide the development of new therapeutic strategies.</p><p><strong>Areas covered: </strong>In this perspective article, we discuss the evolving concept of D2T-PsA, including its epidemiology, clinical characterization, and underlying pathophysiological mechanisms. We highlight the role of gender differences, psychosocial comorbidities, and central sensitization in shaping disease persistence and patient-reported impact. We also examine the limitations of current disease activity indices (DAPSA, PsAID, PASDAS) in capturing heterogeneity and the need for multidimensional frameworks. A structured literature search was conducted in PubMed/MEDLINE and Scopus databases (January 2020-June 2025), restricted to English-language publications, using combinations of the terms psoriatic arthritis, difficult-to-treat, refractory, and difficult-to-manage. Additional references were identified from conference abstracts and relevant bibliographies.</p><p><strong>Expert opinion: </strong>Recognizing D2T-PsA as a distinct, multifactorial entity is critical to advancing personalized medicine. Future directions will involve harmonizing EULAR and GRAPPA frameworks, integrating biomarker discovery, digital tools, and adaptive trial designs, and embedding patient perspectives. This multidimensional approach is expected to transform treatment from empirical cycling toward precision care in psoriatic arthritis.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anti-angiotensin 2 receptor 1 antibody (anti-AT1R) and anti-Endothelin receptor type a (anti-ETAR) as biomarkers of endothelial dysfunction in systemic sclerosis (SSc) patients.","authors":"Chiara Pellicano, Annalisa Villa, Gabriella Cusa, Giancarlo D'Ippolito, Valeria Carnazzo, Federica Laterza, Umberto Basile, Edoardo Rosato, Antonietta Gigante","doi":"10.1080/1744666X.2025.2574659","DOIUrl":"https://doi.org/10.1080/1744666X.2025.2574659","url":null,"abstract":"<p><strong>Background: </strong>Aims of this study were to evaluate the serum level of autoantibodies against G-protein-coupled receptors for Angiotensin II type 1 (anti-AT1R) and endothelin receptor type A (anti-ETAR) in systemic sclerosis (SSc) patients and healthy controls (HC) and to evaluate the associations of these antibodies with microvascular complication of SSc, such as digital ulcers (DUs), subclinical renal vasculopathy and early pulmonary vasculopathy.</p><p><strong>Research design and methods: </strong>64 SSc patients and 20 HC were tested for anti-AT1R and anti-ETAR.</p><p><strong>Results: </strong>SSc patients had higher anti-AT1R [7.78 ng/ml (IQR 6.14;12.16) vs 3.25 ng/ml (IQR 2.60;4.70), <i>p</i> < 0.001] and anti-ETAR [0.16 OD (IQR 0.14;0.17) vs 0.10 OD (IQR 0.10;0.12), <i>p</i> < 0.001] than HC. SSc patients with DUs had higher anti-AT1R [10.79 ng/ml (IQR 7.32;14.15) vs 6.76 ng/ml (IQR 5.88;7.88), <i>p</i> < 0.001] and anti-ETAR [0.16 OD (IQR 0.15;0.18) vs 0.15 OD (IQR 0.13;0.16), <i>p</i> < 0.01] than SSc patients without DUs. We found a positive correlation between renal resistive index (RRI) and anti-AT1R (<i>r</i> = 0.357, <i>p</i> < 0.01) or anti-ETAR (<i>r</i> = 0.442, <i>p</i> < 0.001) and a negative correlation between tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure (TAPSE/sPAP) and anti-AT1R (<i>r</i> = - 0.436, <i>p</i> < 0.001) or anti-ETAR (<i>r</i> = - 0.334, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Anti-AT1R and anti-ETAR may play a pathogenic role in endothelial dysfunction.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oluwatomi Ibidapo-Obe, Michael D Rooney, Tony Bruns
{"title":"Peritoneal immunity in decompensated cirrhosis.","authors":"Oluwatomi Ibidapo-Obe, Michael D Rooney, Tony Bruns","doi":"10.1080/1744666X.2025.2565670","DOIUrl":"10.1080/1744666X.2025.2565670","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with cirrhosis and ascites, failure of intestinal barriers and cirrhosis-associated immune dysfunction contribute to the translocation of bacteria and microbial products to the peritoneal cavity, which promotes infection, perpetuates inflammation and accelerates acute-on-chronic liver failure. Resident peritoneal immune cells are repeatedly exposed to bacterial products, and their activation status is linked to complications of spontaneous bacterial peritonitis.</p><p><strong>Areas covered: </strong>This narrative review summarizes the recent research on human peritoneal immunity in decompensated cirrhosis, focusing on the altered composition and functional states of human peritoneal macrophages, resident and migrating T cells, and neutrophils and their involvement in peritoneal inflammation and infection.</p><p><strong>Expert opinion: </strong>Peritoneal immune cells in decompensated cirrhosis show compartmentalized chronic activation and dysfunction, contributing to inflammation and infection risk. Given the direct accessibility of these cells, targeting peritoneal macrophage priming and differentiation, innate immune memory, inflammatory mediators and intercellular peritoneal cross-talk offer potential strategies to prevent infections and mitigate inflammation. To fine-tune the delicate balance between hyperinflammation and anergy, further research is necessary to translate immunomodulatory approaches into effective clinical interventions.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1-17"},"PeriodicalIF":3.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miho Akabane, Yuki Imaoka, Ghee Rye Lee, Timothy M Pawlik
{"title":"Immunology, immunotherapy, and the tumor microenvironment in hepatocellular carcinoma: a comprehensive review.","authors":"Miho Akabane, Yuki Imaoka, Ghee Rye Lee, Timothy M Pawlik","doi":"10.1080/1744666X.2025.2568904","DOIUrl":"10.1080/1744666X.2025.2568904","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) is a major cause of cancer-related death globally, characterized by an immunosuppressive tumor microenvironment (TME) that impairs immune surveillance. Immunotherapy has emerged as a transformative option; however, durable responses remain limited. The purpose of this review is to synthesize recent advances in HCC immunology, immunotherapy, and the TME.</p><p><strong>Areas covered: </strong>Literature was identified via PubMed and ClinicalTrials.gov (January 2001-May 2025), focusing on clinical and translational studies. We outline the immunological landscape of HCC, emphasizing the roles of T cells, natural killer cells, macrophages, dendritic cells, myeloid-derived suppressor cells, and regulatory T cells in shaping tumor immunity. TME components include cancer-associated fibroblasts, tumor-associated macrophages, suppressive cytokines, angiogenesis, hypoxia, metabolic reprogramming, and the gut-liver axis. Interactions with immunotherapy, mechanisms of resistance, and combination strategies were described. Emerging biomarkers - such as tertiary lymphoid structures, PD-L1, tumor mutational burden, gene signatures, and gut microbiota - are reviewed relative to patient stratification.</p><p><strong>Expert opinion: </strong>Immunotherapy has reshaped HCC management, but resistance, biomarker limitations, and heterogeneity remain major challenges. Advances will require TME reprogramming, multi-parametric biomarkers, and personalized strategies. Integration with targeted and locoregional approaches may achieve durable responses and move toward precision immuno-oncology, transforming HCC into a manageable or curable disease.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1-18"},"PeriodicalIF":3.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reassessing traditional inflammatory biomarkers in spondyloarthritis: time for a paradigm shift?","authors":"Rubén Queiro, Sara Alonso, Mercedes Alperi","doi":"10.1080/1744666X.2025.2568890","DOIUrl":"10.1080/1744666X.2025.2568890","url":null,"abstract":"","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1-5"},"PeriodicalIF":3.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}