{"title":"Pharmacokinetics, safety and tolerability, and efficacy of hyaluronidase-facilitated subcutaneous immunoglobulin 10% (HyQvia<sup>®</sup>) in Japanese patients with primary immunodeficiency diseases.","authors":"Hirokazu Kanegane, Masataka Ishimura, Eisuke Suganuma, Tomoyuki Imagawa, Takayuki Hoshina, Tomoki Kawai, Hidenori Ohnishi, Satoshi Okada, Chihiro Suzuki, Kentarou Kudou, Sharon Russo-Schwarzbaum, Immanuel Freedman, Barbara McCoy, Zhaoyang Li, Atsushi Kuga","doi":"10.1080/25785826.2025.2607878","DOIUrl":"https://doi.org/10.1080/25785826.2025.2607878","url":null,"abstract":"<p><p>This phase 3 open-label study (jRCT2031210457; NCT05150340; January 2022-August 2023) evaluated pharmacokinetics, safety and tolerability, and efficacy of recombinant hyaluronidase-facilitated subcutaneous immunoglobulin (fSCIG) 10% in Japanese patients with primary immunodeficiency diseases (PID) transitioning from intravenous immunoglobulin (IVIG) or conventional SCIG (cSCIG). Patients received fSCIG 10% (HyQvia<sup>®</sup>) with dose ramp-up (Epoch 1) and 3- or 4-week dosing intervals (Epoch 2; 24 weeks). Assessments included IgG trough levels, infusion-related tolerability, validated acute serious bacterial infections (VASBIs), and treatment-emergent adverse events (TEAEs). Sixteen patients completed the study (median age: 21 years; range: 5-62). Prior treatments included cSCIG (62.5%), IVIG (31.3%), and SCIG (human) 20% solution (Ig20Gly; Cuvitru<sup>®</sup>) (6.3%). Geometric mean IgG trough levels during the evaluation period (Epoch 2) remained stable across all visits (1254-1351 mg/dL, 3-week dosing; 874-937 mg/dL, 4-week dosing). No tolerability events or VASBIs were observed. Annual infection rate was 2.74 per patient-year. TEAEs related to fSCIG 10% occurred in 68.8% of patients, all mild or moderate. No serious TEAEs related to fSCIG 10% or deaths occurred. No TEAEs led to study discontinuation. fSCIG 10% effectively maintained IgG levels, prevented infections, and was well tolerated in Japanese patients with PID transitioning from IVIG or cSCIG.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":2.9,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182864","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}
{"title":"Pulmonary alveolar proteinosis developing during tofacitinib treatment for anti-MDA5 antibody-positive dermatomyositis-associated interstitial lung disease: a case report and review of the literature.","authors":"Shunichi Fujita, Hirotake Nishimura, Kazuhisa Nakano","doi":"10.1080/25785826.2026.2624883","DOIUrl":"https://doi.org/10.1080/25785826.2026.2624883","url":null,"abstract":"<p><p>Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM)-associated interstitial lung disease (ILD) is a rapidly progressive and life-threatening condition that often requires aggressive immunosuppressive therapy, including Janus kinase (JAK) inhibitors, whose safety profile remains incompletely understood. We report an extremely rare case of secondary pulmonary alveolar proteinosis (PAP) that developed during tofacitinib treatment for multidrug-refractory anti-MDA5 antibody-positive DM-associated ILD. A 74-year-old Japanese woman with rapidly progressive DM-associated ILD was treated with high-dose glucocorticoids, intravenous cyclophosphamide, and cyclosporine, followed by tofacitinib due to an insufficient response. Although the ILD initially improved, she later developed progressive elevation of serum KL-6 levels and diffuse ground-glass opacities on chest computed tomography despite only mild respiratory symptoms. Transbronchial lung biopsy revealed periodic acid-Schiff-positive material within the alveolar spaces, and serum anti-granulocyte-macrophage colony-stimulating factor antibodies were negative, leading to a diagnosis of secondary PAP. Discontinuation of tofacitinib alone resulted in rapid clinical and radiological improvement. This case highlights PAP as a rare, potentially reversible complication during JAK inhibitor therapy in anti-MDA5 antibody-positive DM-associated ILD and underscores the importance of considering PAP when elevated KL-6 levels and radiological abnormalities occur despite only mild respiratory symptoms.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133215","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}
{"title":"Clinical relevance of serum lysozyme in sarcoidosis with kidney impairment.","authors":"Shunichiro Hanai, Yoshiaki Kobayashi, Kojiro Ikeda, Soichiro Kubota, Nakako Tanaka-Mabuchi, Mayu Yazaki, Makiko Konishi, Kazuya Takahashi, Daiki Nakagomi","doi":"10.1080/25785826.2026.2624896","DOIUrl":"https://doi.org/10.1080/25785826.2026.2624896","url":null,"abstract":"<p><p>The clinical significance of serum lysozyme in sarcoidosis remains unclear. This study aimed to evaluate the clinical characteristics and kidney function of sarcoidosis patients with elevated serum lysozyme. We retrospectively analyzed 28 patients with sarcoidosis and measured levels of serum lysozyme. Clinical characteristics, laboratory data, and estimated glomerular filtration rate (eGFR) were evaluated. Median age was 57 years (interquartile range, 43-70 years), and 21% were men. High serum lysozyme levels were associated with a greater number of organ involvements (median 4 vs. 2, <i>p</i> = 0.022) and more frequent renal involvement (50 vs. 7%, <i>p</i> = 0.033). Serum lysozyme levels correlated inversely with eGFR (<i>r</i> = -0.814). Median serum lysozyme level was significantly higher in patients with renal sarcoidosis (RS) (30.2 μg/mL) than in non-RS patients (9.5 μg/mL, <i>p</i> = 0.003). Prominent intracytoplasmic lysozyme staining in proximal tubular epithelial cells was observed in the kidney of RS patients. Multiple regression analysis identified serum lysozyme as an independent risk factor for eGFR decline. Elevated serum lysozyme in sarcoidosis was associated with multiorgan involvements and renal impairment. Lysozyme may contribute to tubulointerstitial injury in RS, potentially through tubular reabsorption and cytotoxic effects. Further studies are warranted to clarify the role of lysozyme in the pathogenesis of RS.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126674","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}
Masatomo Yamada, Shunichi Fujita, Masakatsu Ikeda, Yo Mizuta, Sumie Hiramatsu-Asano, Tamaki Sasaki, Hideho Wada, Kazuhisa Nakano
{"title":"A case of concurrent cold agglutinin disease and C3 glomerulonephritis requiring differentiation from other iatrogenic immunodeficiency-associated lymphoproliferative disorder in a patient with rheumatoid arthritis and Sjögren's disease.","authors":"Masatomo Yamada, Shunichi Fujita, Masakatsu Ikeda, Yo Mizuta, Sumie Hiramatsu-Asano, Tamaki Sasaki, Hideho Wada, Kazuhisa Nakano","doi":"10.1080/25785826.2026.2618315","DOIUrl":"https://doi.org/10.1080/25785826.2026.2618315","url":null,"abstract":"<p><p>We report a case of cold agglutinin disease (CAD) considered as other iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD) in a patient with rheumatoid arthritis (RA) and Sjögren's disease. A 69-year-old woman developed hemolytic anemia and renal dysfunction after long-term methotrexate and infliximab therapy. Laboratory findings demonstrated monoclonal IgM-κ paraproteinemia and a high cold agglutinin titer, confirming CAD, while imaging studies and bone marrow evaluation revealed no evidence of overt malignancy. Renal biopsy revealed membranoproliferative glomerulonephritis-like lesions with C3-dominant deposition, consistent with C3 glomerulonephritis (C3GN). These findings suggest that both CAD and C3GN may represent manifestations of OIIA-LPD associated with long-term immunosuppressive therapy. Rituximab combined with glucocorticoids led to a prompt and marked improvement in anemia and renal lesions, resulting in sustained remission of both CAD and C3GN while maintaining RA remission. This case suggests the dual pathogenesis of B-cell dysregulation and complement activation and indicates that B-cell-targeted therapy may contribute to controlling both abnormalities. Accumulation of similar cases will be essential to refine disease classification and to optimize therapeutic strategies for immune-mediated overlap disorders.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012708","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}
{"title":"Immune reconstitution inflammatory syndrome accompanied by transient immune and chromosomal abnormality after azathioprine exposure in utero.","authors":"Ryoko Yokoyama, Yoji Uejima","doi":"10.1080/25785826.2026.2617686","DOIUrl":"10.1080/25785826.2026.2617686","url":null,"abstract":"<p><p>Azathioprine (AZA) is widely used during pregnancy to manage autoimmune diseases; however, concerns regarding fetal immunological vulnerability persist. Although neonatal lymphocytopenia and chromosomal abnormalities have been reported following prenatal AZA exposure, little is known about immune recovery in infants after congenital infections in these infants. Here, we describe an infant with congenital cytomegalovirus (CMV) infection, who was born to a mother treated with azathioprine for systemic lupus erythematosus and developed hemophagocytic lymphohistiocytosis (HLH) during immune reconstitution during lymphocytopenia. The preterm infant presented with lymphocytopenia, anemia, thrombocytopenia, and congenital CMV infection. Despite initiating antiviral therapy, immune reconstitution inflammatory syndrome (IRIS) developed, thus fulfilling the diagnostic criteria for HLH, including increased alanine aminotransferase, ferritin, triglycerides, and soluble interleukin-2 receptor levels. A chromosomal analysis revealed mosaicism with 46,XX and i [18](q10) in the bone marrow cells. In the absence of definitive HLH treatment, such as corticosteroids or other immunosuppressive therapies, fever, splenomegaly, and laboratory abnormalities resolved spontaneously, and the chromosomal alterations normalized. This indicates that prenatal AZA exposure induces transient immunosuppression, leading to the development of IRIS. Our case highlights the necessity of vigilant immunological surveillance in neonates exposed to AZA in utero.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991023","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}
{"title":"Recent advances in immunosuppressive therapy for lupus nephritis.","authors":"Shuhei Takeyama, Michihito Kono","doi":"10.1080/25785826.2025.2610582","DOIUrl":"https://doi.org/10.1080/25785826.2025.2610582","url":null,"abstract":"<p><p>Lupus nephritis (LN) is one of the most important manifestations in patients with systemic lupus erythematosus (SLE). Although LN is associated with increased morbidity, mortality and healthcare costs, the advent of new immunosuppressive drugs and biologics in recent years has led to significant improvements in treatment outcomes. In addition to conventional dual therapy, evidence for triple therapy has been established. Triple therapy, which combines mycophenolate mofetil (MMF) with belimumab (BEL) or calcineurin inhibitors (CNIs, including voclosporin), or intravenous cyclophosphamide with BEL, has been recommended, particularly for active nephritis with poor prognostic factors. Since rapid reductions in proteinuria have been observed with CNIs, triple therapy combining MMF and CNIs have been conditionally recommended for LN patients with preserved renal function and severe proteinuria. In contrast, because BEL reduced disease activity and severe flares in non-renal symptoms, triple therapy including BEL has been conditionally recommended in LN patients with significant extra-renal SLE disease. Furthermore, the latest treatment recommendations from the European League Against Rheumatism had added the combination therapy of MMF plus obinutuzumab as an initial treatment option. In this review, we discuss the latest guidelines and recommendations for LN.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913191","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}
{"title":"Acute changes in indices of cardiac filling and function induced by high-dose intravenous methylprednisolone pulse therapy: a single-center prospective study.","authors":"Takashi Nawata, Kaori Murakawa, Kohei Goda, Chika Kayabe Kuroda, Junya Nawata, Hironori Ishiguchi, Ayumi Omuro, Takeshi Suetomi, Hitoshi Uchinoumi, Shinichi Okuda, Mototsugu Shimokawa, Hiroshi Nakamura, Motoaki Sano","doi":"10.1080/25785826.2025.2608493","DOIUrl":"https://doi.org/10.1080/25785826.2025.2608493","url":null,"abstract":"<p><p>The current study investigated acute circulatory dynamics changes induced by high-dose intravenous methylprednisolone pulse therapy (steroid pulse therapy). Eight patients who underwent steroid pulse therapy were included in the study. After steroid pulse therapy, plasma levels of brain and atrial natriuretic peptides were significantly increased compared with those before steroid pulse therapy (both <i>p</i> < 0.001). Echocardiography revealed that left ventricular end-diastolic diameter (LVDd) tended to increase after steroid pulse therapy (<i>p</i> = 0.055). Left atrial volume index (LAVI) also increased after steroid pulse therapy (<i>p</i> < 0.05). Peak early diastolic transmitral flow velocity (E wave) increased significantly (<i>p</i> < 0.05), and early diastolic mitral annular velocity tended to increase (<i>p</i> = 0.09). These findings indicate that steroid pulse therapy may increase cardiac preload, as suggested by the observed increases in LVDd, LAVI, and E wave velocity. Clinicians should remain mindful of this potential effect when administering steroid pulse therapy.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850996","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}
Immunological MedicinePub Date : 2025-12-01Epub Date: 2025-03-08DOI: 10.1080/25785826.2025.2475626
MengDi Zhang, Jiayu Xu, Wenjia Qu, Jia Gao, Ya Mo
{"title":"Advances in understanding the role and mechanism of the cGAS-STING signaling pathway in ocular diseases.","authors":"MengDi Zhang, Jiayu Xu, Wenjia Qu, Jia Gao, Ya Mo","doi":"10.1080/25785826.2025.2475626","DOIUrl":"10.1080/25785826.2025.2475626","url":null,"abstract":"<p><p>The cGAS-STING signaling pathway plays a critical role in the immune defense against DNA viruses and in autoimmunity, coordinating a cascade of events that enhance cytokine production, particularly type I interferons. This review summarizes recent advancements in understanding the pathway's impact on various ocular diseases, including age-related macular degeneration (AMD), diabetic retinopathy, and uveitis. Activation of this pathway by cytoplasmic DNA from either damaged retinal cells or external pathogens induces inflammatory responses that may accelerate disease progression. Moreover, the paper explores new therapeutic approaches that target this pathway, offering insights into how modulation of cGAS-STING signaling could reduce inflammation and improve clinical outcomes. The emerging research in this area suggests potential for innovative treatments in ocular inflammation and degenerative conditions.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"266-280"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587544","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}
{"title":"Bibliometric analysis of systemic lupus erythematosus during pregnancy from 2003 to 2024.","authors":"Xinyan Zou, Xinfu Zou, Qiaoqiao Liu, Bingxin Zhou, Shujie He, Xiulan Liao, Hanqing Zhao","doi":"10.1080/25785826.2025.2483811","DOIUrl":"10.1080/25785826.2025.2483811","url":null,"abstract":"<p><p>Autoimmune diseases such as systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome have a significant impact on pregnancy, potentially exacerbating SLE symptoms and leading to miscarriage, pre-eclampsia and other pregnancy complications. To ensure the safety of SLE patients during pregnancy, experts have conducted in-depth research and provided recommendations. Therefore, it is necessary to provide a thorough summary of the current status, hotspots and emerging trends in this research field. We systematically searched the Web of Science Core Collection database for studies on SLE during pregnancy from 1 January 2003 to 24 March 2024. We then utilized CiteSpace to generate a knowledge visualization map. This analysis included a total of 2239 studies on SLE during pregnancy. The yearly volume of publications exhibits a persistent increasing trend. The United States had the highest number of publications and was the leading country, while the Czech Republic had the highest centrality and influence. The research focused on three main areas: (1) pregnancy outcomes in autoimmune diseases, (2) newborn-related diseases and complications and (3) medication management for patients with SLE during pregnancy. Our study offers both a visual and scientific synopsis of research concerning SLE during pregnancy, furnishing valuable insights and opening up new avenues for researchers.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"318-334"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731955","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}
Immunological MedicinePub Date : 2025-12-01Epub Date: 2025-05-17DOI: 10.1080/25785826.2025.2506260
Yiming Zhao, Qian Liu, Jinmin Zhao, Dezhi Song
{"title":"The roles of natural killer cells in bone and arthritic disease: a narrative review.","authors":"Yiming Zhao, Qian Liu, Jinmin Zhao, Dezhi Song","doi":"10.1080/25785826.2025.2506260","DOIUrl":"10.1080/25785826.2025.2506260","url":null,"abstract":"<p><p>The skeletal system is responsible for the body's support and motor functions, and can be pathologically affected by factors, such as metabolism, autoimmune inflammation, tumors, and infections. Regarding tissue localization and biological function, the immune system is deeply involved in the physiological and pathological processes of the skeletal system. As a regulator and effector cell of the innate immune system, natural killer (NK) cells can exert cytotoxic effects through cell contact and immunomodulatory effects through cytokine secretion. In the past 30 years, many advances have been made regarding the role of NK cells and their derived cytokines on bone and joints. In this review, the role of NK cells in the physiological activities of bone remodeling is summarized first, focusing on osteoclast differentiation and function. Subsequently, the roles of NK cells in osteoarthritis, bone tumors, and bone diseases caused by microbial infections are described, meanwhile, some conflicting research results are discussed. By reviewing the state-of-the-art progress of NK cells in the above-mentioned bone physiological and pathological processes, it is helpful to clarify the blind spots of current research and provide some references for the integrated evaluation of immune factors in the study of skeletal system diseases.</p>","PeriodicalId":37286,"journal":{"name":"Immunological Medicine","volume":" ","pages":"281-294"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095052","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}