Immunological Medicine最新文献

Altered plasma metabolomic profiles in treatment-naïve patients with newly diagnosed rheumatoid arthritis. 新诊断的类风湿性关节炎treatment-naïve患者血浆代谢组学特征的改变

IF 2.3

Immunological Medicine Pub Date : 2026-10-07 DOI: 10.1080/25785826.2026.2739140

Miwa Kanaji, Junko Nishio, Mayuko Oka, Keiko Koshiba, Kaori Motomura, Shotaro Masuoka, Mai Kawazoe, Eri Watanabe, Sei Muraoka, Kaichi Kaneko, Karin Furukawa, Izumi Irita, Zento Yamada, Takehiko Sugihara, Toshihiro Nanki

{"title":"Altered plasma metabolomic profiles in treatment-naïve patients with newly diagnosed rheumatoid arthritis.","authors":"Miwa Kanaji, Junko Nishio, Mayuko Oka, Keiko Koshiba, Kaori Motomura, Shotaro Masuoka, Mai Kawazoe, Eri Watanabe, Sei Muraoka, Kaichi Kaneko, Karin Furukawa, Izumi Irita, Zento Yamada, Takehiko Sugihara, Toshihiro Nanki","doi":"10.1080/25785826.2026.2739140","DOIUrl":"https://doi.org/10.1080/25785826.2026.2739140","url":null,"abstract":"Rheumatoid arthritis (RA) is characterized by chronic inflammatory polyarthritis. Despite recent advances in treatment, a subset of patients remains refractory, highlighting the need for better biomarkers for diagnosis and disease activity monitoring to determine appropriate interventions. Therefore, this study aimed to characterize the plasma metabolic profiles of RA and identify candidate metabolite markers for the disease. Plasma samples from treatment-naïve patients with newly diagnosed RA (n = 48) and healthy controls (HC; n = 45) were analyzed using liquid chromatography-tandem mass spectrometry. Fifty-five metabolites were included in the analysis; carnosine, glutamic acid, dimethylglycine, and taurine were significantly increased in RA, whereas histidine, methionine sulfoxide, tryptophan, and alanine were significantly decreased. Metabolite set enrichment analysis showed altered histidine metabolism in patients with RA, and the carnosine/histidine ratio showed the highest area under the ROC curve among the metabolites tested. Histidine was also inversely associated with disease activity and anti-citrullinated protein antibody (ACPA) production. In addition, decreased citrulline levels were significantly associated with higher ACPA production. This study identified the carnosine/histidine ratio as a candidate marker for RA and implicates an imbalance between carnosine synthesis and degradation in its pathophysiology, based on an analysis of treatment-naïve patients with covariate adjustments.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-16"},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age-dependent myositis-specific autoantibody profiles and CD8⁺ T-cell signatures in juvenile dermatomyositis. 青少年皮肌炎中年龄依赖性肌炎特异性自身抗体谱和CD8+ t细胞特征

IF 2.3

Immunological Medicine Pub Date : 2026-09-29 DOI: 10.1080/25785826.2026.2736348

Sungyeon Park, Motoshi Sonoda, Nobutaka Harada, Shunichi Adachi, Keishiro Kinoshita, Yutaro Yada, Katsuhide Eguchi, Motoko Yamanaka, Yuki Ichimura, Naoko Okiyama, Masataka Ishimura, Shouichi Ohga

{"title":"Age-dependent myositis-specific autoantibody profiles and CD8+ T-cell signatures in juvenile dermatomyositis.","authors":"Sungyeon Park, Motoshi Sonoda, Nobutaka Harada, Shunichi Adachi, Keishiro Kinoshita, Yutaro Yada, Katsuhide Eguchi, Motoko Yamanaka, Yuki Ichimura, Naoko Okiyama, Masataka Ishimura, Shouichi Ohga","doi":"10.1080/25785826.2026.2736348","DOIUrl":"https://doi.org/10.1080/25785826.2026.2736348","url":null,"abstract":"Juvenile dermatomyositis (JDM) is an autoimmune myopathy with skin manifestations, yet biomarkers reflecting disease activity and organ involvement at presentation remain incompletely defined. This study aimed to identify clinical and immunologic indicators at diagnosis, focusing on myositis-specific autoantibodies (MSAs) and lymphocyte subsets. We retrospectively analyzed 36 patients with JDM treated at a tertiary center in Japan between 2003 and 2024. MSAs (anti-TIF1-γ, anti-MDA5, anti-NXP2, anti-Mi-2, anti-Jo-1, anti-ARS, and anti-SAE) were assessed at diagnosis. Clinical features, laboratory data, and lymphocyte profiles by flow cytometry were compared across MSA subtypes. The cohort (25 females) showed a bimodal age distribution with peaks at 4 and 10 years. Anti-Jo-1 and anti-TIF1-γ antibodies predominated in younger patients, whereas anti-NXP2 was more frequent in older children. Patients with ILD had higher anti-MDA5 positivity (adjusted p = 0.005) and KL-6 levels (adjusted p = 0.007). Both absolute and age-normalized CD8+ T-cell levels were higher in patients with subcutaneous calcinosis (adjusted p = 0.012 for both). Age-dependent MSA profiles characterize JDM. Anti-MDA5 antibodies were associated with ILD, whereas higher age-normalized CD8+ T-cell levels were associated with calcinosis, suggesting their potential utility for risk stratification at diagnosis.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and scintigraphic improvement of mandibular involvement associated with chronic nonbacterial osteitis following an interleukin-23 inhibitor: a case-based literature review. 应用白细胞介素-23抑制剂治疗慢性非细菌性骨炎后下颌受累的临床和影像学改善：一项基于病例的文献综述

IF 2.3

Immunological Medicine Pub Date : 2026-09-25 DOI: 10.1080/25785826.2026.2739130

Koji Suzuki, Mitsuhiro Akiyama, Koichi Saito, Hiroshi Takei, Yuko Kaneko

{"title":"Clinical and scintigraphic improvement of mandibular involvement associated with chronic nonbacterial osteitis following an interleukin-23 inhibitor: a case-based literature review.","authors":"Koji Suzuki, Mitsuhiro Akiyama, Koichi Saito, Hiroshi Takei, Yuko Kaneko","doi":"10.1080/25785826.2026.2739130","DOIUrl":"https://doi.org/10.1080/25785826.2026.2739130","url":null,"abstract":"Chronic nonbacterial osteitis (CNO) occasionally presents with severe and refractory mandibular involvement, conventionally called as diffuse sclerosing osteomyelitis. While conventional treatments such as bisphosphonates and tumor necrosis factor (TNF) inhibitors are utilized, optimal management remains challenging due to heterogeneous responses. Here, we report a 59-year-old male with CNO associated with palmoplantar pustulosis who developed refractory mandibular osteitis. Following recurrent relapses under conventional therapies, he was treated with guselkumab, an interleukin (IL)-23 inhibitor. His clinical symptoms and abnormal tracer uptake on bone scintigraphy markedly improved within three months without any adverse events. Furthermore, we conducted a case-based literature review to evaluate the effectiveness of potential therapies, such as IL-17/IL-23 inhibitors and Janus kinase (JAK) inhibitors, for CNO-associated mandibular involvement. The review identified five additional cases treated with these agents. Clinical improvement was observed across all cases, while radiological progression was noted in two patients treated with JAK inhibitors. Although the precise immunopathogenesis of mandibular CNO requires further elucidation, our findings suggest that IL-23, IL-17, and JAK inhibitors may be potential therapeutic options, particularly for patients experiencing treatment failure or paradoxical reactions to conventional biologic agents.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful combination therapy with ustekinumab and intensive granulocyte and monocyte adsorptive apheresis in highly refractory pediatric ulcerative colitis: pathophysiological rationale and clinical outcome. ustekinumab与强化粒细胞和单核细胞吸附采珠术成功联合治疗高度难治性儿童溃疡性结肠炎：病理生理原理和临床结果

IF 2.3

Immunological Medicine Pub Date : 2026-09-24 DOI: 10.1080/25785826.2026.2737046

Norito Tsutsumi, Shigeo Nishimata, Miki Eto Tanaka, Yu Kamei, Shun Watanabe, Naoko Saito, Yasuyo Kashiwagi, Tadashi Ichimiya, Masakatsu Fukuzawa, Gaku Yamanaka

{"title":"Successful combination therapy with ustekinumab and intensive granulocyte and monocyte adsorptive apheresis in highly refractory pediatric ulcerative colitis: pathophysiological rationale and clinical outcome.","authors":"Norito Tsutsumi, Shigeo Nishimata, Miki Eto Tanaka, Yu Kamei, Shun Watanabe, Naoko Saito, Yasuyo Kashiwagi, Tadashi Ichimiya, Masakatsu Fukuzawa, Gaku Yamanaka","doi":"10.1080/25785826.2026.2737046","DOIUrl":"https://doi.org/10.1080/25785826.2026.2737046","url":null,"abstract":"Pediatric-onset ulcerative colitis (UC) is characterized by an aggressive phenotype, with higher rates of pancolitis and more rapid progression to a medically refractory state. After failure of conventional therapies and multiple biologic agents, treatment options are limited and often require surgery. We report the case of a 15-year-old girl with a 5-year history of highly refractory pancolitis-type UC. Previous treatments included mesalazine, salazosulfapyridine, tacrolimus, and three biologic agents (infliximab, vedolizumab, and adalimumab), all of which failed to maintain remission. After ustekinumab initiation, she initially experienced mild improvement but subsequently developed a severe clinical relapse (Pediatric Ulcerative Colitis Activity Index score: 40-50) triggered by Edwardsiella tarda infection. Despite infection resolution and treatment with systemic corticosteroids, her condition remained critical. As adjunctive therapy, intensive granulocyte and monocyte adsorptive apheresis (GMA) was administered twice weekly for 10 sessions, followed by twice monthly for 7 sessions, resulting in rapid symptomatic improvement. Follow-up colonoscopy confirmed complete mucosal healing (Mayo Endoscopic Subscore, 0). Intensive GMA may be a safe and effective adjunct to ustekinumab before its full therapeutic effect is achieved, potentially complementing the anti-inflammatory effects of ustekinumab in refractory pediatric UC and may help avoid colectomy even when multiple drug therapies have failed.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leukopenia and thrombocytopenia in immunoglobulin G4-related disease: frequency, severity, and the association with splenomegaly. 免疫球蛋白g4相关疾病中的白细胞减少和血小板减少：频率、严重程度及其与脾肿大的关系

IF 2.3

Immunological Medicine Pub Date : 2026-09-22 DOI: 10.1080/25785826.2026.2735524

Kojiro Ikeda, Shunichiro Hanai, Soichiro Kubota, Nakako Tanaka-Mabuchi, Mayu Yazaki, Yoshiaki Kobayashi, Daiki Nakagomi

{"title":"Leukopenia and thrombocytopenia in immunoglobulin G4-related disease: frequency, severity, and the association with splenomegaly.","authors":"Kojiro Ikeda, Shunichiro Hanai, Soichiro Kubota, Nakako Tanaka-Mabuchi, Mayu Yazaki, Yoshiaki Kobayashi, Daiki Nakagomi","doi":"10.1080/25785826.2026.2735524","DOIUrl":"https://doi.org/10.1080/25785826.2026.2735524","url":null,"abstract":"Hematological abnormalities are not generally considered characteristic of immunoglobulin (Ig)G4-related disease (IgG4-RD). This study investigated the frequencies of leukopenia and thrombocytopenia in IgG4-RD and the clinical factors associated with their development. We retrospectively analyzed 56 patients diagnosed with IgG4-RD between April 2015 and July 2024 according to the 2020 revised comprehensive diagnostic criteria. Clinical characteristics were compared between patients with and without thrombocytopenia and splenomegaly. Independent factors associated with thrombocytopenia were evaluated using binomial logistic regression. Leukopenia and thrombocytopenia occurred in 6 (10.7%) and 24 (42.8%) patients, respectively. Marked thrombocytopenia (platelet count <10.0 × 104/μL) was observed in 11 patients (19.6%). Patients with thrombocytopenia were older, more often male, and more likely to have splenic and aortic involvements, with significantly higher serum IgG levels. Splenomegaly was associated with increased frequencies of leukopenia and thrombocytopenia, as well as lower platelet and lymphocyte counts. Multivariate analysis identified older age as consistently associated with thrombocytopenia, while splenomegaly was independently associated with thrombocytopenia and marked thrombocytopenia in selected models. Most patients treated with glucocorticoids showed improved blood cell counts within 12 weeks. Thrombocytopenia may be common in IgG4-RD, and splenomegaly and older age are associated with thrombocytopenia.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploratory analysis of IFN-α-high and CXCL9-high cytokine distributions in systemic lupus erythematosus-associated macrophage activation syndrome. 系统性红斑狼疮相关巨噬细胞激活综合征中IFN-α-高和cxcl9 -高细胞因子分布的探索性分析

IF 2.3

Immunological Medicine Pub Date : 2026-09-22 DOI: 10.1080/25785826.2026.2735585

Shuya Kaneko, Maho Hatano, Asami Shimbo, Futaba Miyaoka, Tomoya Kaneda, Yuko Akutsu, Yuko Hayashi, Tadashi Hosoya, Masae Watanabe, Shotaro Suzuki, Mao Mizuta, Shinsuke Yasuda, Masaaki Mori, Masatoshi Takagi, Masaki Shimizu

{"title":"Exploratory analysis of IFN-α-high and CXCL9-high cytokine distributions in systemic lupus erythematosus-associated macrophage activation syndrome.","authors":"Shuya Kaneko, Maho Hatano, Asami Shimbo, Futaba Miyaoka, Tomoya Kaneda, Yuko Akutsu, Yuko Hayashi, Tadashi Hosoya, Masae Watanabe, Shotaro Suzuki, Mao Mizuta, Shinsuke Yasuda, Masaaki Mori, Masatoshi Takagi, Masaki Shimizu","doi":"10.1080/25785826.2026.2735585","DOIUrl":"https://doi.org/10.1080/25785826.2026.2735585","url":null,"abstract":"Macrophage activation syndrome (MAS) is a life-threatening hyperinflammatory complication of systemic lupus erythematosus (SLE), but its immunopathology remains poorly understood. We investigated cytokine-associated inflammatory heterogeneity in SLE-associated MAS (SLE-MAS). Serum levels of interferon (IFN)-α, C-X-C motif chemokine ligand 9 (CXCL9), interleukin (IL)-6, IL-18 and soluble TNF receptor type II (sTNF-RII) were measured in nine patients with SLE-MAS and compared with patients with systemic juvenile idiopathic arthritis-associated MAS (sJIA-MAS), Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and healthy controls. Exploratory principal component analysis (PCA) was performed to visualize cytokine patterns. Patients with SLE-MAS exhibited elevated IFN-α levels, whereas IL-6 and IL-18 levels were lower than those in sJIA-MAS and EBV-HLH. Exploratory PCA suggested descriptive IFN-α-high and CXCL9-high cytokine distributions. Patients with the IFN-α-high pattern tended to have leukopenia and lupus nephritis, whereas those with the CXCL9-high pattern showed higher LDH levels and HScore values. IFN-α levels were associated with leukopenia but were not significantly correlated with SLEDAI-2K scores. These exploratory findings suggest that SLE-MAS may exhibit heterogeneous IFN-α-high and CXCL9-high cytokine distributions. These observations should be interpreted as descriptive, and hypothesis-generating rather than as validated biological subtypes or a treatment-stratification tool.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complement activation and its pathways in primary immune thrombocytopenia. 原发性免疫性血小板减少症的补体激活及其途径。

IF 2.3

Immunological Medicine Pub Date : 2026-09-11 DOI: 10.1080/25785826.2026.2722492

Risa Shindo, Kenji Oku, Ryohei Abe, Atsushi Ohsaki, Kodai Suzuki, Eri Shishido, Hirotomo Asakura, Kazuma Ino, Yoshiro Kanayama, Yasuhiro Hasegawa, Tomoki Tanaka, Yu Matsueda, Tatsuhiko Wada, Sumiaki Tanaka, Yoshitaka Miyakawa, Kunihiro Yamaoka

{"title":"Complement activation and its pathways in primary immune thrombocytopenia.","authors":"Risa Shindo, Kenji Oku, Ryohei Abe, Atsushi Ohsaki, Kodai Suzuki, Eri Shishido, Hirotomo Asakura, Kazuma Ino, Yoshiro Kanayama, Yasuhiro Hasegawa, Tomoki Tanaka, Yu Matsueda, Tatsuhiko Wada, Sumiaki Tanaka, Yoshitaka Miyakawa, Kunihiro Yamaoka","doi":"10.1080/25785826.2026.2722492","DOIUrl":"https://doi.org/10.1080/25785826.2026.2722492","url":null,"abstract":"Complement activation has been increasingly recognized in immune thrombocytopenia (ITP). However, the involvement of alternative pathways in ITP and relevance of complement activation in refractory ITP remain unclear. This multicenter observational study aimed to characterize complement activation in primary ITP (pITP). C3a des-Arg levels were significantly higher in patients with pITP than in patients with systemic lupus erythematosus/antiphospholipid syndrome and healthy donors (HD). The expression of Bb, an alternative pathway-specific marker, did not differ between groups. sC5b-9 levels were significantly elevated in patients with pITP compared to those in HD patients. Patients with a partial response to pITP who met the criteria for refractory ITP with repeated relapses despite standard treatments exhibited elevated levels of C3a des-Arg and sC5b-9. Complement activation was observed in pITP, whereas involvement of the alternative pathway was limited. These findings highlight the importance of complement assessment in patients with pITP and may guide the optimal use of complement-targeted therapies.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction. 修正。

IF 2.3

Immunological Medicine Pub Date : 2026-09-10 DOI: 10.1080/25785826.2026.2732393

引用次数: 0

Pathological perspectives on immune-related adverse events. 免疫相关不良事件的病理学观点。

IF 2.3

Immunological Medicine Pub Date : 2026-09-01 Epub Date: 2026-06-17 DOI: 10.1080/25785826.2026.2689102

Terufumi Kubo, Rena Morita, Kenta Sasaki, Naoki Shijubou, Kenji Murata, Tomohide Tsukahara, Toshihiko Torigoe, Yoshihiko Hirohashi

{"title":"Pathological perspectives on immune-related adverse events.","authors":"Terufumi Kubo, Rena Morita, Kenta Sasaki, Naoki Shijubou, Kenji Murata, Tomohide Tsukahara, Toshihiko Torigoe, Yoshihiko Hirohashi","doi":"10.1080/25785826.2026.2689102","DOIUrl":"10.1080/25785826.2026.2689102","url":null,"abstract":"Over the past decade, immune checkpoint inhibitors (ICIs) have moved from the research setting into routine clinical practice. Their use has expanded from single-agent therapy to combination regimens with cytotoxic chemotherapy, targeted agents, and radiotherapy, and more recently being incorporated into neoadjuvant treatment. Although ICIs have improved the outcomes of a subset of patients, this progress has been accompanied by the occurrence of immune-related adverse events (irAEs), which represent an important challenge in daily clinical care. Ongoing research continues to pursue more effective and durable antitumor immune responses. At the same time, enhanced immune activation is associated with an increased risk of unintended tissue injury, suggesting that irAEs are closely linked to the mechanisms underlying therapeutic immune activation. Therefore, the benefits and disadvantages of ICIs should be considered within the same biological framework. This review does not aim to provide a comprehensive catalog of irAEs; instead, we highlight several representative and clinically relevant topics and discuss them from a pathological perspective. By integrating clinicopathological observations across organ systems, we seek to illustrate how tissue-based findings can contribute to the understanding, recognition, and management of irAEs.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"359-371"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive management of immune-related adverse events: predictive strategies, mechanistic insights, and therapeutic approaches. 免疫相关不良事件的综合管理：预测策略，机制见解和治疗方法。

IF 2.3

Immunological Medicine Pub Date : 2026-09-01 Epub Date: 2026-04-29 DOI: 10.1080/25785826.2026.2664951

Kosaku Murakami

{"title":"Comprehensive management of immune-related adverse events: predictive strategies, mechanistic insights, and therapeutic approaches.","authors":"Kosaku Murakami","doi":"10.1080/25785826.2026.2664951","DOIUrl":"10.1080/25785826.2026.2664951","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) have been game changer in cancer therapy but can trigger diverse immune-related adverse events (irAEs) that impact multiple organs. This review offers a unified perspective on irAE risk assessment, underlying mechanisms, and therapeutic strategies aimed at maintaining anticancer efficacy while safeguarding patient well-being. We explore predictive tools-including baseline profiles of several cytokines, HLA genotype, and markers such as interleukin-6-for identifying high-risk individuals. Key drivers of irAEs were dysregulated T- and B-cell responses, antigenic cross-reactivity, and gut microbiome imbalances. Management follows a graduated approach: initial glucocorticoid intervention, followed by biologics (anti-TNF agents, IL-6 receptor blockers) or small-molecule inhibitors (JAK inhibitors) in refractory cases. Real-world data support cautious ICI use in pre-existing autoimmune disorders under stringent monitoring. We also discuss the emerging notion of \"inverse irAEs,\" where immunosuppression may predispose to secondary malignancies, underscoring the importance of long-term surveillance. Finally, we highlight the urgent need for expansive, multicenter studies to refine irAE management to enhance therapeutic outcomes.","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"275-289"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0