Autoimmunity reviews最新文献

{"title":"The FOXO1-SIRT1 axis in ankylosing spondylitis: A cross-platform regulator linking immunometabolism, oxidative stress, and bone remodeling","authors":"Xuhong Zhang,&nbsp;Lu Jia,&nbsp;Xueni Lin,&nbsp;Lamei Zhou","doi":"10.1016/j.autrev.2025.103878","DOIUrl":"10.1016/j.autrev.2025.103878","url":null,"abstract":"<div><div>Ankylosing spondylitis (AS) is a chronic immune-mediated disorder defined by the paradoxical coupling of inflammatory bone erosion and ectopic new bone formation. Recent studies implicate the Forkhead box O1 (FOXO1)-Sirtuin 1 (SIRT1) signaling axis as a systems-level regulator integrating immune metabolism, redox balance, and skeletal remodeling. FOXO1 and SIRT1 cooperatively regulate immune tolerance, redox balance, and skeletal homeostasis via transcriptional, epigenetic, and metabolic pathways.</div><div>This review delineates the cross-platform roles of the FOXO1-SIRT1 axis across three interrelated modules: regulation of immune cell metabolism and polarization; redox sensing and organelle quality control via autophagy and mitophagy; and coordination of osteoblast – osteoclast dynamics in inflammatory microenvironments. Dysregulation of this axis disrupts immuno-metabolic equilibrium and promotes pathological ossification, contributing to the dual pathology of AS.</div><div>We further discuss emerging therapeutic strategies – ranging from SIRT1 activators and anti -Interleukin-17 A (IL-17 A) biologics to histone deacetylase inhibitors – that converge mechanistically on FOXO1-SIRT1 signaling. These translational approaches underscore the axis's potential as a cross-domain integrator of immune and skeletal homeostasis, and as a promising target for precision intervention in AS.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103878"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Proportion of circulating T follicular helper cells in peripheral blood of systemic lupus erythematosus patients: A systematic review and meta-analysis” [Autoimmunity Reviews Volume 24, Issue 10, 24 September 2025, 103874]","authors":"Futai Feng ,&nbsp;Ziyan Wu ,&nbsp;Honglin Xu ,&nbsp;Yongzhe Li ,&nbsp;Shulan Zhang","doi":"10.1016/j.autrev.2025.103881","DOIUrl":"10.1016/j.autrev.2025.103881","url":null,"abstract":"","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103881"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring vaccine safety and adverse events in major autoimmune diseases","authors":"Shabnam Sodagari ,&nbsp;Nassim Sodagari","doi":"10.1016/j.autrev.2025.103857","DOIUrl":"10.1016/j.autrev.2025.103857","url":null,"abstract":"<div><div>This study evaluates post-vaccination adverse events by analyzing a large dataset of patients with major autoimmune diseases, including Hashimoto’s <span><math><mrow><mi>n</mi><mo>=</mo><mn>26</mn><mo>,</mo><mn>330</mn></mrow></math></span>; Rheumatoid Arthritis <span><math><mrow><mi>n</mi><mo>=</mo><mn>9</mn><mo>,</mo><mn>251</mn></mrow></math></span>; psoriasis <span><math><mrow><mi>n</mi><mo>=</mo><mn>5</mn><mo>,</mo><mn>589</mn></mrow></math></span>; Systemic Lupus Erythematosus <span><math><mrow><mi>n</mi><mo>=</mo><mn>4</mn><mo>,</mo><mn>208</mn></mrow></math></span>; Inflammatory Bowel Disease <span><math><mrow><mi>n</mi><mo>=</mo><mn>5</mn><mo>,</mo><mn>831</mn></mrow></math></span>; type 1 diabetes <span><math><mrow><mi>n</mi><mo>=</mo><mn>2</mn><mo>,</mo><mn>235</mn></mrow></math></span>; vasculitis <span><math><mrow><mi>n</mi><mo>=</mo><mn>466</mn></mrow></math></span>; Guillain-Barré Syndrome <span><math><mrow><mi>n</mi><mo>=</mo><mn>185</mn></mrow></math></span>; Immune Thrombocytopenic Purpura <span><math><mrow><mi>n</mi><mo>=</mo><mn>623</mn></mrow></math></span>; ankylosing spondylitis <span><math><mrow><mi>n</mi><mo>=</mo><mn>926</mn></mrow></math></span>; Sjögren’s syndrome <span><math><mrow><mi>n</mi><mo>=</mo><mn>269</mn></mrow></math></span>; psoriatic arthritis <span><math><mrow><mi>n</mi><mo>=</mo><mn>2</mn><mo>,</mo><mn>355</mn></mrow></math></span>; polymyositis <span><math><mrow><mi>n</mi><mo>=</mo><mn>169</mn></mrow></math></span>; dermatomyositis <span><math><mrow><mi>n</mi><mo>=</mo><mn>130</mn></mrow></math></span>. Our objective is not to refute the importance of vaccines, but to raise awareness about potential risks observed in autoimmune patients by analyzing CDC (Centers for Disease Control and Prevention) data. The sex distribution analysis in vaccine adverse events highlights a consistent female predominance across most autoimmune conditions. We designed machine learning predictive classification models by identifying key predictors to predict severe adverse events (hospitalization or death) following vaccination based on clinical and demographic predictors including age, sex, vaccine type, dose series, and vaccine route. Our models identified distinct risk profiles for severe events across diseases. Example AUC values ranged from 0.90 for dermatomyositis and GBS to 0.98 for Psoriatic Arthritis with accuracy 96% observed for ankylosing spondylitis. Vasculitis and Sjögren’s showed peak precision scores, while polymyositis showed peak recall (97%). Moreover, the reported adverse events in the first week and after the 6th week of vaccine administration are one order of magnitude larger than reported incidents in other time intervals for all diseases. Understanding these differences can inform safer vaccination strategies. We recognize the essential public health role of vaccines and underscore the importance of vigilant post-vaccination monitoring in autoimmune populations.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103857"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination targeted therapy with two biologic/targeted synthetic DMARDs in 1200 patients with immune mediated inflammatory diseases. A systematic literature review for current landscape in safety and efficacy","authors":"Angeliki Zoi Lignou ,&nbsp;Konstantinos D. Vassilakis ,&nbsp;Xenofon Baraliakos ,&nbsp;Petros P. Sfikakis ,&nbsp;Jacques-Eric Gottenberg ,&nbsp;George E. Fragoulis","doi":"10.1016/j.autrev.2025.103865","DOIUrl":"10.1016/j.autrev.2025.103865","url":null,"abstract":"<div><h3>Background</h3><div>Immune-mediated inflammatory diseases (IMID) include rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), Crohn's disease (CD), ulcerative colitis (UC), and psoriasis (PsO). While biologic (b) and targeted synthetic (ts) DMARDs are effective, nearly 60 % of patients fail to achieve low disease activity status. Combination targeted therapy (CTT) using concomitantly two different b- or ts-DMARDs has been explored, but results on safety and efficacy are unclear.</div></div><div><h3>Objective</h3><div>To systematically review the literature on CTT in IMID.</div></div><div><h3>Methods</h3><div>Following the PICO framework, we included literature of adult patients (≥18 years) with IMID receiving CTT. Three databases (PubMed, Scopus, Epistemonikos) were searched up to June 2024. Studies in non-English, pediatric populations, and non-approved treatments were excluded. Risk of bias was assessed using approved tools.</div></div><div><h3>Results</h3><div>Of 2038 records, 70 studies (6 RCTs, 11 cohorts, 22 case series, 31 case reports) involving 1200 patients were analyzed. About 75 % of them demonstrated low risk of bias. The most studied combinations were TNFi+IL/23i, JAKi+bDMARDs, and vedolizumab+TNFi. Approximately 40-60 % of patients with PsA, axSpA, and IBD with refractory disease improved with TNFi+IL/23i CTT. About half of patients with inflammatory arthritis and up to 80 % of IBD cases benefited with JAKi+bDMARD CTT, whereas favorable outcomes were observed in 30-50 % of IBD patients following Vedolizumab+TNFi CTT. Safety profiles were generally acceptable, without emerging signals so far.</div></div><div><h3>Conclusion</h3><div>CTT benefits about half of refractory IMID patients, particularly TNFi/IL-23i, JAKi/bDMARD, and vedolizumab/TNFi combinations, without raising significant safety issues. Further research is needed to clarify safety and efficacy across diseases.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103865"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proportion of circulating T follicular helper cells in peripheral blood of systemic lupus erythematosus patients: A systematic review and meta-analysis","authors":"Futai Feng ,&nbsp;Ziyan Wu ,&nbsp;Honglin Xu ,&nbsp;Yongzhe Li ,&nbsp;Shulan Zhang","doi":"10.1016/j.autrev.2025.103874","DOIUrl":"10.1016/j.autrev.2025.103874","url":null,"abstract":"<div><h3>Objectives</h3><div>Dysregulation of circulating follicular helper T (cTfh) cells plays a key role in the breakdown of immune tolerance and the pathogenesis of antibody-mediated autoimmune diseases, including systemic lupus erythematosus (SLE). This study aims to evaluate the proportions of cTfh cells and their potential pathogenic mechanisms in the peripheral blood of SLE patients through a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Systematic search and review were conducted across PubMed, Cochrane Library, EMBASE, and Web of Science to identify relevant studies. A meta-analysis was performed to compare the proportions of cTfh cells and their subsets between SLE patients and healthy controls (HC). Subgroup analyses were conducted based on the markers used for defining cTfh cells and geographical regions.</div></div><div><h3>Results</h3><div>The meta-analysis revealed a significantly higher proportion of cTfh cells in SLE patients compared to HC (SMD 0.904, [0.620, 1.188], <em>p</em> &lt; 0.01). Subgroup analyses showed a consistent increase in cTfh cells in SLE across different markers. Geographically, both Asian (SMD 1.005, [0.608, 1.402], <em>p</em> &lt; 0.01) and non-Asian populations (SMD 0.708, [0.428, 0.988], <em>p</em> &lt; 0.01) demonstrated elevated cTfh cell proportions in SLE. A trend toward a decrease in Tfh1 cells and an increase in Tfh17 cells was observed, though neither reached statistical significance.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that cTfh cells proportions are significantly elevated in SLE patients, supporting their role in the pathogenesis of SLE. These findings suggest that cTfh cells could serve as potential biomarkers for SLE and therapeutic targets for treatment.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103874"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic evaluation of the associations between schizophrenia and autoimmune diseases: An umbrella review","authors":"Zhouyang Sun,&nbsp;Beibei Han,&nbsp;Qianlu Ding,&nbsp;Yuan Feng,&nbsp;Tingyi Jia,&nbsp;Yixin Ouyang,&nbsp;Xinru Guo,&nbsp;Jingyi Liang,&nbsp;Qianlong Huang,&nbsp;Changgui Kou ,&nbsp;Wei Bai","doi":"10.1016/j.autrev.2025.103854","DOIUrl":"10.1016/j.autrev.2025.103854","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess research trends in the association between schizophrenia and autoimmune diseases, systematically review their relationship, and evaluate the credibility of existing evidence.</div></div><div><h3>Methods</h3><div>Bibliometric analysis was conducted using the bibliometrix package in R, along with VOSviewer and CiteSpace. Relevant systematic reviews and meta-analyses were retrieved from six databases: PubMed, Web of Science, Embase, CINAHL, PsycINFO, and the Cochrane Library. Summary risk estimates were recalculated using the DerSimonian and Laird method under a random-effects model, and the credibility of the evidence was assessed.</div></div><div><h3>Results</h3><div>The bibliometric analysis found that “meta-analysis” has become a frequently used keyword and may be a focal point for future research. The umbrella review included 17 articles, containing 24 report data points from 12 quantitative reviews. Results indicated that 9 reports assessed the relationship between schizophrenia and autoimmune diseases. Schizophrenia was significantly associated with autoimmune neurological disorders <em>(RR</em> = 1.42; 95 % <em>CI</em> = 1.18–1.72), providing suggestive evidence. Seven reports evaluated the impact of schizophrenia on autoimmune diseases, showing highly suggestive evidence that schizophrenia patients had a pooled relative risk of 2.22 (95 % <em>CI</em> = 1.95–2.52) for psoriasis. Eight reports assessed the impact of autoimmune diseases on schizophrenia, with bullous pemphigoid patients showing significantly higher schizophrenia prevalence (<em>OR</em> = 2.63; 95 % <em>CI</em> = 2.03–3.39).</div></div><div><h3>Conclusions</h3><div>This study synthesizes evidence of varying levels, highlighting the association between schizophrenia and autoimmune diseases. It offers new insights for future exploration, fosters interdisciplinary collaboration, and provides valuable implications for public health policy development.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 9","pages":"Article 103854"},"PeriodicalIF":9.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chimeric antigen receptor cell therapy: A revolutionary approach transforming cancer treatment to autoimmune disease therapy","authors":"Ruifan Wen ,&nbsp;Binbin Li ,&nbsp;Feifeng Wu ,&nbsp;Jueyi Mao ,&nbsp;Tasnim Azad ,&nbsp;Yang Wang ,&nbsp;Junquan Zhu ,&nbsp;Xin Zhou ,&nbsp;Haotian Xie ,&nbsp;Xinying Qiu ,&nbsp;Marady Hun ,&nbsp;Jidong Tian ,&nbsp;Liang Zhang ,&nbsp;Kimsor Hong ,&nbsp;Chuan Wen","doi":"10.1016/j.autrev.2025.103859","DOIUrl":"10.1016/j.autrev.2025.103859","url":null,"abstract":"<div><div>Currently, autoimmune disorders are predominantly managed with broad-spectrum immunosuppressive agents and monoclonal antibodies, which can alleviate disease symptoms but are rarely curative and are frequently associated with significant adverse effects. Autoreactive B cells play a key role in the pathogenesis of many autoimmune diseases; however, B-cell-depleting therapies such as rituximab have shown limited efficacy in certain autoimmune diseases, primarily due to the persistence of autoreactive B cells within lymphoid tissues and sites of inflammation. Consequently, there is an urgent need for more effective and targeted therapies for patients with severe and refractory autoimmune conditions. In this context, recent advancements in genetic engineering have facilitated the application of cell-based therapies, which have transitioned from oncology to treating autoimmune diseases. Therapies utilizing chimeric antigen receptor (CAR) engineered immune cells have emerged as a promising and potentially curative approach. Clinical trials targeting CD19-expressing B cells in B cell–driven autoimmune diseases, such as systemic lupus erythematosus (SLE), have yielded encouraging results, demonstrating durable remissions in otherwise treatment-resistant cases. In addition, novel strategies are being developed to broaden the therapeutic scope of CAR-based therapies in autoimmunity, including chimeric autoantibody receptor (CAAR)-T cells designed to eliminate autoantigen-specific B cells selectively and CAR-engineered regulatory T cells (CAR-Tregs) aimed at achieving antigen-specific immune modulation and restoration of self-tolerance. Despite these advances, several challenges persist, including short and long-term safety concerns, limited in vivo persistence, and the high costs associated with personalized cell manufacturing. Innovations in CAR design, such as logic-gated CARs, inducible suicide switches, and universal CAR constructs, are under active investigation to enhance safety, control, scalability, and clinical accessibility.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 9","pages":"Article 103859"},"PeriodicalIF":9.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological patterns and in-hospital mortality in ANCA-associated vasculitis: Insights from Spain's National Health Data (2016–2022)","authors":"Francisco-Josué Cordero-Pérez ,&nbsp;Pablo Martínez-Rodríguez ,&nbsp;Luis Arribas-Pérez ,&nbsp;David Puertas-Miranda ,&nbsp;Carlos-Rafael Pires-Baltazar ,&nbsp;Leticia Salcedo-Martín ,&nbsp;Juan Antonio Sánchez-Villoria ,&nbsp;Erik Gabriel Díaz-Ávila ,&nbsp;Hugo-Guillermo Ternavasio-De La Vega ,&nbsp;Miguel Marcos ,&nbsp;Antonio-Javier Chamorro","doi":"10.1016/j.autrev.2025.103863","DOIUrl":"10.1016/j.autrev.2025.103863","url":null,"abstract":"<div><h3>Background</h3><div>ANCA-associated vasculitis (AAV), including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), is a systemic autoimmune disease. This study represents the first large-scale analysis of AAV hospitalisation rates and in-hospital mortality trends in Spain.</div></div><div><h3>Methods</h3><div>A retrospective longitudinal analysis of AAV-related hospital admissions between 2016 and 2022 was conducted using the ICD-10 codes from the Minimum Basic Dataset (MBDS) of the Spanish National Health System. Statistical analyses were performed, including odds ratios, Student's <em>t</em>-tests, and Mantel-Haenszel trend tests.</div></div><div><h3>Results</h3><div>Among 5753 AAV episodes, GPA was the most frequent subtype (53.9 %), followed by MPA (31.5 %) and EGPA (14.6 %). AAV episodes were more frequent in older patients (&gt; 65 years) than in other hospital episodes (62.9 % vs. 38.9 %; OR: 2.66, 95 %CI: 2.51–2.80; <em>P</em> &lt; 0.001). Larger hospitals accounted for more AAV episodes, longer hospital stays, and higher costs. MPA had the highest mortality rate (7.2 % vs. 4.9 %; OR: 1.52, 95 % CI: 1.27–1.79; <em>P</em> &lt; 0.001), particularly in patients over 65 years (83.1 % vs. 61.8 %; OR: 3.04, 95 % CI: 2.47–3.75; <em>P</em> &lt; 0.001) compared with the other AAV. In the GPA group, renal involvement significantly increased mortality compared to GPA cases without renal involvement (6.6 % vs. 4.6 %; OR: 1.46, 95 % CI: 1.16–1.83; <em>P</em> = 0.011). Notably, the relative risk of AAV-related deaths increased over the study period (Z = 2.77, <em>P &lt;</em> 0.01).</div></div><div><h3>Conclusion</h3><div>AAV, particularly MPA, is associated with increased hospital mortality, particularly among older adults and patients with renal involvement.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 9","pages":"Article 103863"},"PeriodicalIF":9.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in rheumatoid arthritis among U.S. women aged 20 to 44 years, 2001 to 2023","authors":"Yuhui Zhao ,&nbsp;Weilu Cui ,&nbsp;Yayun Han ,&nbsp;Minjing Chang","doi":"10.1016/j.autrev.2025.103873","DOIUrl":"10.1016/j.autrev.2025.103873","url":null,"abstract":"","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 9","pages":"Article 103873"},"PeriodicalIF":9.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious agents in dilated cardiomyopathy: Genetic interactions, autoimmunity, mechanisms, and therapeutic approaches","authors":"Jingdi Zhang,&nbsp;Haoting Zhan,&nbsp;Honglin Xu,&nbsp;Rongrong Wang,&nbsp;Zhan Li,&nbsp;Futai Feng,&nbsp;Hongzheng Wu,&nbsp;Zhixin Xu,&nbsp;Siyu Wang,&nbsp;Ye Guo,&nbsp;Yongzhe Li","doi":"10.1016/j.autrev.2025.103860","DOIUrl":"10.1016/j.autrev.2025.103860","url":null,"abstract":"<div><div>Dilated cardiomyopathy (DCM) is a heterogeneous myocardial disorder characterized by left ventricular dilation and systolic dysfunction in the absence of ischemic, hypertensive, or valvular heart disease. Although its precise etiology remains unclear, it is widely recognized as a multifactorial disease arising from complex interactions between genetic predisposition and environmental triggers. Among these, infectious agents have been implicated in the pathogenesis of various subtypes, particularly inflammatory and idiopathic DCM. These agents can contribute to disease onset and progression through direct cardiomyocyte injury, immune-mediated chronic inflammation, and other yet-to-be-defined mechanisms. Infection-driven autoimmune activation is another potential key contributor to DCM, potentially linking infectious exposure to sustained myocardial damage. However, the precise role of various infectious agents in DCM initiation and progression, as well as their interactions with genetic predisposition and autoimmune activation, is inadequately understood. Improving understanding of infection-related etiologies could facilitate development of targeted therapeutic strategies; however, significant challenges persist in identifying causative and novel pathogens, and translating this into clinical practice. Therefore, this review explores the complex interactions between infectious agents, genetic predisposition, and autoimmune responses in DCM pathogenesis. We summarize current evidence on the role of infectious agents in DCM and emerging therapeutic strategies aimed at treating infection-related DCM. Finally, we outline future research directions to advance understanding of infection-associated DCM and improve patient outcomes. We reveal that a deeper understanding of host-microbe interactions, immune pathways, and genetic predisposition is essential for advancing DCM research. Furthermore, integrating genomics, metagenomics, and antibody and immunological profiling is crucial for developing personalized therapeutic strategies for this complex disease.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 9","pages":"Article 103860"},"PeriodicalIF":9.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}