Expert Review of Clinical Immunology最新文献_第10页

All-cause and cause-specific mortality in atopic dermatitis patients: a systematic review and meta-analysis. 特应性皮炎患者的全因和病因特异性死亡率：一项系统回顾和荟萃分析。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2026-01-01 Epub Date: 2026-01-22 DOI: 10.1080/1744666X.2026.2618271

Yi Yang, Qin Zhang, Jinpeng Zhao, Anning Huang, Jianren Yang, Lulu Wang, Yuan Zeng, Guomei Xu

{"title":"All-cause and cause-specific mortality in atopic dermatitis patients: a systematic review and meta-analysis.","authors":"Yi Yang, Qin Zhang, Jinpeng Zhao, Anning Huang, Jianren Yang, Lulu Wang, Yuan Zeng, Guomei Xu","doi":"10.1080/1744666X.2026.2618271","DOIUrl":"10.1080/1744666X.2026.2618271","url":null,"abstract":"Introduction: This meta-analysis evaluates the risk of all-cause and cause-specific mortality in patients with atopic dermatitis (AD).Methods: A systematic search of PubMed, EMBASE, and the Cochrane Library (from inception to April 2025) was conducted for cohort studies comparing mortality risks in AD patients versus controls, in accordance with PRISMA guidelines. Two reviewers screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Hazard ratios (HRs) were calculated using random-effects models in Stata 14.0, with sensitivity analyses, subgroup analyses, and publication bias assessments.Results: Nine cohort studies were included. AD patients had significantly increased risks of all-cause mortality [HR = 1.222, 95% CI (1.117-1.336)], as well as mortality due to infectious diseases [HR = 1.606, CI (1.087-2.372)], cancer [HR = 1.129, CI (1.015-1.256)], respiratory diseases [HR = 1.381, CI (1.044-1.825)], and gastrointestinal diseases [HR = 1.658, CI (1.002-2.743)]. Subgroup analyses revealed a higher risk of all-cause mortality in prospective studies compared to retrospective studies, with significantly higher risks in studies from Europe and Asia.Conclusions: AD is associated with an elevated risk of all-cause and cause-specific mortality, underscoring the need for improved monitoring and targeted interventions. Future research should incorporate more diverse populations and study designs.Prospero identifier: CRD420251038553.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"135-143"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009502","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}

引用次数: 0

Old and new autoantibodies in systemic lupus erythematosus. 系统性红斑狼疮的新旧自身抗体。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2026-01-01 Epub Date: 2026-02-08 DOI: 10.1080/1744666X.2026.2625964

Ioannis Parodis, Dionysis Nikolopoulos, André Brylid, Olof Hultgren, Marta E Alarcón-Riquelme, Christopher Sjöwall

{"title":"Old and new autoantibodies in systemic lupus erythematosus.","authors":"Ioannis Parodis, Dionysis Nikolopoulos, André Brylid, Olof Hultgren, Marta E Alarcón-Riquelme, Christopher Sjöwall","doi":"10.1080/1744666X.2026.2625964","DOIUrl":"10.1080/1744666X.2026.2625964","url":null,"abstract":"Introduction: Systemic lupus erythematosus (SLE) is a prototypical autoimmune disorder characterized by production of autoantibodies targeting self-antigens. These autoantibodies form immune-complexes that deposit in various tissues, leading to complement activation, inflammation, and, ultimately, organ damage. The detection of specific autoantibodies is crucial for diagnosing SLE and for assessing disease activity.Areas covered: A variety of autoantibodies are employed in clinical practice to assess the risk of different SLE manifestations and other systemic inflammatory diseases. These autoantibody specificities are integral to clinical decision-making procedures. Herein, we examine the most commonly evaluated autoantibodies and their associations with disease phenotypes. In addition, we discuss recent findings of novel autoantibodies in SLE and their clinical relevance and potential utility.Expert opinion: In addition to the well-established autoantibody specificities routinely assessed in clinical practice for patients with a diagnosis of - or clinically suspected - SLE, recent studies have identified several new autoantibodies with potential clinical relevance. If these findings are validated through further research and accessible diagnostic assays are developed, these emerging autoantibodies could narrow the gap between first symptoms and classifiable disease and significantly enhance patient management by providing critical insights into the risk of specific SLE manifestations, thereby facilitating more timely and personalized interventions.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"19-29"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118320","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}

引用次数: 0

Navigating obstetric antiphospholipid syndrome: pathophysiology, diagnosis, and therapeutic advances. 导航产科抗磷脂综合征：病理生理学，诊断和治疗进展。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2026-01-01 Epub Date: 2026-01-11 DOI: 10.1080/1744666X.2025.2612589

Ghaydaa Aldabie, Ahlam Almarzooqi, Roaa Aljohani, Manar Altawash, Amjad Alkadi, Munther Khamashta

{"title":"Navigating obstetric antiphospholipid syndrome: pathophysiology, diagnosis, and therapeutic advances.","authors":"Ghaydaa Aldabie, Ahlam Almarzooqi, Roaa Aljohani, Manar Altawash, Amjad Alkadi, Munther Khamashta","doi":"10.1080/1744666X.2025.2612589","DOIUrl":"10.1080/1744666X.2025.2612589","url":null,"abstract":"Introduction: Obstetric antiphospholipid syndrome (OAPS) is a complex autoimmune disorder that contributes significantly to pregnancy morbidity. Despite advances in understanding its mechanisms, 20-30% of women, especially those refractory to standard treatments, continue to face adverse outcomes. Emerging therapies, including biologics and immunomodulators, are under investigation; however, data in this field remain limited.Areas covered: This review examines the current understanding of OAPS pathogenesis and risk stratification. It evaluates established management strategies such as aspirin and heparin, and explores adjunctive or investigational therapies, including hydroxychloroquine, corticosteroids, intravenous immunoglobulins, statins, plasma exchange, and biologics. Key knowledge gaps, concerning refractory cases and personalized treatment approaches, are highlighted, emphasizing the importance of multidisciplinary, risk-based care throughout preconception, pregnancy, and postpartum. This review focuses primarily on primary OAPS rather than secondary APS associated with systemic lupus erythematosus.Expert opinion: Innovations in immunotherapy and targeted biologics hold promise for refractory OAPS; however, large trials are needed to confirm their safety and efficacy during pregnancy. Future management is likely to involve biomarker-driven strategies, incorporating machine learning to enhance prediction and individualization of treatment. The development of standardized diagnostic criteria and risk assessment tools, alongside multidisciplinary collaboration, will be crucial in advancing care, ultimately transforming maternal-fetal health outcomes.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"123-134"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911199","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}

引用次数: 0

Myocardial involvement in inflammatory myopathies: from subclinical disease to life-threatening myocarditis. 炎症性肌病的心肌受累：从亚临床疾病到危及生命的心肌炎。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2026-01-01 Epub Date: 2026-02-03 DOI: 10.1080/1744666X.2026.2625281

Albert Gil-Vila, Ernesto Trallero-Araguás, Clara Edo-Fernandez, Iago Pinal-Fernandez, Aitor Uribarri, Hug Cuellar-Calabria, Albert Selva-O'Callaghan

{"title":"Myocardial involvement in inflammatory myopathies: from subclinical disease to life-threatening myocarditis.","authors":"Albert Gil-Vila, Ernesto Trallero-Araguás, Clara Edo-Fernandez, Iago Pinal-Fernandez, Aitor Uribarri, Hug Cuellar-Calabria, Albert Selva-O'Callaghan","doi":"10.1080/1744666X.2026.2625281","DOIUrl":"10.1080/1744666X.2026.2625281","url":null,"abstract":"Introduction: Inflammatory myopathies (IM) are a heterogeneous group of systemic disorders characterized by chronic muscle inflammation. Cardiac involvement has historically been underrecognized, partially because of its subclinical presentation, and is associated with a poor prognosis, underscoring the urgent need for effective diagnostic strategies and therapeutic approaches. Cardiac magnetic resonance and its new mapping techniques appear as one of the most valuable instruments to detect myocardial involvement, thereby limiting the need for an endomyocardial biopsy when the underlying cause of cardiac dysfunction is unclear or when noninvasive imaging is inconclusive. Evidence-based data remains lacking regarding treatment strategies, and nowadays, immunosuppressive therapy constitutes the cornerstone of treatment.Areas covered: In this review, we provide a summary of the current literature on myocarditis in the context of IM, with a focus on clinical manifestations, underlying pathophysiological mechanisms, diagnostic methods, and therapeutic strategies.Expert opinion: We are currently in a privileged moment regarding IM, as there has never been a time with so many ongoing clinical trials. With growing awareness of cardiac involvement in IM, now is the time to focus research efforts on cardiac involvement in IM to address this underrecognized manifestation that carries significant morbidity and prognostic implications in patients with IM.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"93-106"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on: "nociplastic pain in axial spondyloarthritis and psoriatic arthritis: role of JAK kinases in immunopathology and therapeutic impact of JAK inhibitors" by Horbal and Maksymowych. 评论：Horbal和Maksymowych的《轴性脊柱炎和银屑病关节炎的致伤性疼痛：jak激酶在免疫病理中的作用和jak抑制剂的治疗作用》。

IF 3.7 3区医学

Expert Review of Clinical Immunology Pub Date : 2025-12-01 Epub Date: 2025-12-20 DOI: 10.1080/1744666X.2025.2605306

Umut Bakay

引用次数: 0

The intratumor microbiome and cancer immunity: from pathogenesis to therapeutic opportunities through artificial intelligence. 肿瘤内微生物组和癌症免疫：通过人工智能从发病机制到治疗机会。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2025-12-01 Epub Date: 2025-12-16 DOI: 10.1080/1744666X.2025.2602537

Ivanna Honcharyuk, Bruna Caridi, Paola Pinco, Sara Ferri, Alessandra De Giani, Alberto Baeri, Chiara Amoroso, Sara Massironi, Federica Facciotti

{"title":"The intratumor microbiome and cancer immunity: from pathogenesis to therapeutic opportunities through artificial intelligence.","authors":"Ivanna Honcharyuk, Bruna Caridi, Paola Pinco, Sara Ferri, Alessandra De Giani, Alberto Baeri, Chiara Amoroso, Sara Massironi, Federica Facciotti","doi":"10.1080/1744666X.2025.2602537","DOIUrl":"10.1080/1744666X.2025.2602537","url":null,"abstract":"Introduction: The intratumor microbiome is a key component of the tumor microenvironment, influencing oncogenesis, immune modulation, and therapeutic responses. Bacteria, fungi, and viruses infiltrate tumor tissues, modulating local immunity and potentially conditioning the efficacy of immune checkpoint inhibitors. While mucosal-origin tumors exhibit an expected microbial presence, sterile organ tumors, such as brain and breast, reveal less intuitive microbial infiltration.Areas covered: This review evaluated the interplay between the intratumoral microbiota and the immune system across different stages of carcinogenesis, including initiation, progression, and metastasis. Sources included PubMed, Embase, and Google Scholar; searches covered December 2024 to October 2025. We examine microbial metabolites, immune hijacking, and routes of dissemination. We also overview technologies for tumor microbiome characterization, including next-generation sequencing, spatial transcriptomics, and artificial intelligence (AI), with machine learning and deep learning, to support diagnostics, prediction of treatment response, and personalized oncology.Expert opinion: Defining the spatial localization and functions of intratumoral microorganisms is crucial for robust biomarkers and tailored interventions. Integrating AI with spatial and multi-omics data offers major opportunities but faces obstacles - data heterogeneity, model interpretability, and ethical issues. Priorities include standardized protocols, high-resolution spatial profiling, external validation, and expertly annotated datasets to unlock microbiome-informed precision oncology.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1755-1768"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713784","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}

引用次数: 0

Mechanisms of resistance to adoptive cell therapy with tumor-infiltrating lymphocytes. 肿瘤浸润淋巴细胞对过继细胞治疗的耐药性机制。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2025-12-01 Epub Date: 2025-11-17 DOI: 10.1080/1744666X.2025.2588776

David König, Heinz Läubli

{"title":"Mechanisms of resistance to adoptive cell therapy with tumor-infiltrating lymphocytes.","authors":"David König, Heinz Läubli","doi":"10.1080/1744666X.2025.2588776","DOIUrl":"10.1080/1744666X.2025.2588776","url":null,"abstract":"Introduction: Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TIL) has become standard treatment for patients with melanoma after the publication of a phase III trial showing an improvement of progression-free survival of metastatic melanoma patients treated with TIL-ACT compared to patients treated with the immune checkpoint inhibitor ipilimumab. Recent clinical trials also tested TIL-ACT in patients with other immunogenic cancers including non-small cell lung cancer or cervical carcinomas.Areas covered: Some factors were associated with long-term response to TIL-ACT including the number of cells applied to the patient or ratios of CD8+ versus CD4+ T cells. Here, we summarize known factors that are associated with response or resistance to TIL-ACT. We also give an outlook, which factors could be improved to overcome resistance and to enhance long-term outcome of patients.Expert opinion: TIL-ACT shows promise beyond niche use, but its success depends on overcoming resistance driven by patient, tumor, and product factors. Advancing its efficacy will require refined patient selection, TIL optimization, and mechanistic insights to inform new, improved treatment approaches.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1741-1754"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488293","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}

引用次数: 0

State of art and future challenges to early intervention, and management in patients with psoriasis at increased risk of transition to psoriatic arthritis: a review. 银屑病患者向银屑病关节炎过渡风险增加的早期干预和管理的现状和未来挑战：综述

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2025-12-01 Epub Date: 2026-01-11 DOI: 10.1080/1744666X.2025.2608695

Andrea Altomare, Valentina Dini, Enzo Errichetti, Claudia Giofrè, Paolo Gisondi, Alessandro Giunta, Matteo Megna, Alice Ramondetta, Paolo Romita, Anna Levi, Sara Di Fino, Barbara Zucchi, Marina Venturini

{"title":"State of art and future challenges to early intervention, and management in patients with psoriasis at increased risk of transition to psoriatic arthritis: a review.","authors":"Andrea Altomare, Valentina Dini, Enzo Errichetti, Claudia Giofrè, Paolo Gisondi, Alessandro Giunta, Matteo Megna, Alice Ramondetta, Paolo Romita, Anna Levi, Sara Di Fino, Barbara Zucchi, Marina Venturini","doi":"10.1080/1744666X.2025.2608695","DOIUrl":"10.1080/1744666X.2025.2608695","url":null,"abstract":"Introduction: Up to 30% of patients with psoriasis develop psoriatic arthritis (PsA) during their lifetime, which can result in irreversible joint damage. Early identification and interception of PsA could potentially decrease inflammation and progression of structural damage. This review summarizes the state of the art on psoriasis-to-PsA transition and discusses the challenges to prevent and early manage PsA.Areas covered: One primary hurdle clinicians face is their inability to establish an early PsA diagnosis because of the poor specificity of symptoms. Arthralgia, severe psoriasis, a history of uveitis, nail psoriasis, scalp psoriasis, having a first-degree relative with PsA, familial aggregation, genetic factors, specific skin phenotypes, mechanical stress, and obesity confer an increased risk of PsA transition. However, underlying molecular and cellular mechanisms remain poorly defined.Expert opinion: The evolution from cutaneous to synovio-entheseal inflammation in patients with psoriasis presents an opportunity to investigate the critical events linked to arthritis development. Further efforts should be made to clearly define early PsA and identify patients with psoriasis at increased PsA risk. Machine learning and artificial intelligence may analyze and integrate different factors to more objectively estimate the possible risk of psoriasis to PsA transition for each patient.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1699-1708"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932995","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}

引用次数: 0

Immunology of heart failure with preserved ejection fraction. 保留射血分数的心力衰竭的免疫学。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2025-12-01 Epub Date: 2025-11-24 DOI: 10.1080/1744666X.2025.2587180

Brandon Wang, Stanislovas S Jankauskas, Pasquale Mone, Fahimeh Varzideh, Gaetano Santulli

{"title":"Immunology of heart failure with preserved ejection fraction.","authors":"Brandon Wang, Stanislovas S Jankauskas, Pasquale Mone, Fahimeh Varzideh, Gaetano Santulli","doi":"10.1080/1744666X.2025.2587180","DOIUrl":"10.1080/1744666X.2025.2587180","url":null,"abstract":"Introduction: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by diastolic dysfunction, systemic comorbidities, and chronic low-grade inflammation. Emerging evidence suggests that immune dysregulation plays a central role in its pathophysiology. Both innate and adaptive immune responses contribute to myocardial remodeling, endothelial dysfunction, and comorbidity-driven inflammation that are hallmarks of HFpEF.Areas covered: In this systematic review, we summarize current evidence on the contribution of immunological pathways to HFpEF, including the role of proinflammatory cytokines, immune cell infiltration (particularly macrophages, mast cells, and T cells), and immune - endothelial interactions. We also highlight findings from experimental models linking systemic metabolic inflammation to myocardial fibrosis, coronary microvascular dysfunction, and cardiomyocyte stiffness in HFpEF. Finally, we explore potential immunomodulatory therapeutic approaches currently under investigation and discuss biomarkers of immune activation with potential clinical relevance.Expert opinion: While no immunologically targeted therapy is yet approved for HFpEF, interventions that modulate inflammation - such as IL-1 blockade, mast cell stabilization, or myeloid-targeted therapies - offer promise. Future clinical trials should incorporate immune profiling to enable patient stratification and personalized treatment approaches. A deeper understanding of immune-mediated mechanisms in HFpEF will be essential to advance therapeutic innovation and improve outcomes in this challenging and growing patient population.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1725-1739"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rhupus syndrome: current knowledge and future perspectives. 鲁普斯综合征：目前的认识和未来的观点。

IF 4 3区医学

Expert Review of Clinical Immunology Pub Date : 2025-12-01 Epub Date: 2025-12-28 DOI: 10.1080/1744666X.2025.2605662

Luis M Amezcua-Guerra, Jessica Roldán-Ortega, Mauricio Mora-Ramírez

{"title":"Rhupus syndrome: current knowledge and future perspectives.","authors":"Luis M Amezcua-Guerra, Jessica Roldán-Ortega, Mauricio Mora-Ramírez","doi":"10.1080/1744666X.2025.2605662","DOIUrl":"10.1080/1744666X.2025.2605662","url":null,"abstract":"Introduction: Rhupus syndrome refers to the coexistence of clinical, serological, and imaging features characteristic of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Although recognized for decades, its natural history, immunopathogenesis, and optimal management remain incompletely defined.Areas covered: This narrative review (PICo framework) outlines the historical evolution and current understanding (from inception to 2025) of rhupus, emphasizing its hybrid phenotype: dual autoantibody profiles including rheumatoid factor, anti-citrullinated and anticarbamylated protein antibodies, and antinuclear and extractable nuclear antigen antibodies; RA-like erosive arthropathy demonstrable by radiography, ultrasound, and magnetic resonance imaging; and a variable, frequently milder spectrum of SLE involvement. Genetic studies implicate shared autoimmune susceptibility loci, most notably HLA-DRB1 shared-epitope alleles and PTPN22, while immunophenotyping reveals enrichment of T-helper 1 (Th1)-polarized and CD4+ CD28null T-cell expansion alongside B-cell hyperactivity. Evidence guiding treatment is largely observational; nonetheless, conventional disease-modifying antirheumatic drugs, B-cell depletion, abatacept, and selective use of targeted synthetic agents have demonstrated benefit in subsets of patients.Expert opinion: Progress in rhupus requires standardized classification criteria, prospective international registries, and longitudinal multi-omic and single-cell analyses integrated with advanced imaging. A coordinated research agenda is essential to transition rhupus from a poorly defined clinical overlap to a precision-managed autoimmune entity.","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"1709-1724"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755521","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}

引用次数: 0