Autoimmunity reviews最新文献

{"title":"Breast and gynecological cancer risk in systemic lupus erythematosus: A meta-analysis of cohort studies","authors":"Yuejie Lu ,&nbsp;Hejing Pan ,&nbsp;Chengping Wen ,&nbsp;Lin Huang ,&nbsp;Xuanlin Li","doi":"10.1016/j.autrev.2025.103888","DOIUrl":"10.1016/j.autrev.2025.103888","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between systemic lupus erythematosus (SLE) and the risk of breast and gynecological cancers through a systematic review and meta-analysis of cohort studies.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Embase, and the Cochrane Library. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed, with separate analyses for standardized incidence ratios (SIRs) and 95 % confidence intervals (CIs). Sensitivity analyses, publication bias assessment using funnel plots and Egger's regression test, and subgroup analyses were conducted.</div></div><div><h3>Results</h3><div>The meta-analysis found no significant association between SLE and risk of breast cancer (SIR = 0.84, 95 % CI 0.64–1.11), I² = 97.8 %, <em>P</em> = 0.000) or ovarian cancer (SIR = 0.96, 95 % CI 0.72–1.28, I² = 60.9 %, <em>P</em> = 0.003). However, a significant increase in uterine cancer risk was observed (SIR = 1.41, 95 % CI 1.09–1.82, I² = 94.3 %, <em>P</em> = 0.000). The strongest association was found for vaginal/vulvar cancer (SIR = 3.61, 95 % CI 2.41–5.41, I² = 66.6 %, <em>P</em> = 0.006). Subgroup analyses indicated significant regional variations. European patients showed reduced breast cancer risk (SIR = 0.73, 95 % CI 0.57–0.94), while no significant association was observed in Asian or North American populations. Patients from developed countries had lower ovarian cancer risk than those from developing countries (SIR = 0.82, 95 % CI 0.59–1.60).</div></div><div><h3>Conclusion</h3><div>SLE is associated with an increased risk of uterine and vaginal/vulvar cancers, but not with breast or ovarian cancers. Subgroup analyses reveal regional differences in the relationship between SLE and breast/gynecological cancers.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103888"},"PeriodicalIF":9.2,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694787","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":"STING-inflammasome axis in autoimmune diseases and inflammation-related disease","authors":"Shengjun Chai ,&nbsp;Haiming Xu ,&nbsp;Ruixin Liu ,&nbsp;Chunmei Cai","doi":"10.1016/j.autrev.2025.103898","DOIUrl":"10.1016/j.autrev.2025.103898","url":null,"abstract":"<div><div>The STING-inflammasome axis predominantly functions to transmit signals generated from cGAS-STING-mediated cytosolic DNA recognition, thereby inducing and potentiating inflammasome activation and amplifying immune responses. However, under specific circumstances, the inflammasome can reciprocally modulate STING activity. This dynamic relationship comprises a canonical upstream-downstream activation cascade complemented by bidirectional interactions and feedback loops within the intricate immune regulatory network. Accumulating evidence underscores the pivotal involvement of the STING-inflammasome axis in diverse host defense mechanisms and inflammatory disorders, including autoimmune diseases, sterile inflammatory conditions, carcinogenesis, and neurodegenerative diseases. In this comprehensive review, we systematically summarize the current understanding of the contributions and underlying mechanisms of the STING-inflammasome axis in physiological and pathological processes. Additionally, we conduct an in-depth exploration of the translational potential of targeting this axis for preventive and therapeutic interventions, offering novel insights into future research directions and clinical applications.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103898"},"PeriodicalIF":8.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768337","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":"Intersecting paths between autoimmunity and bone marrow fibrosis: the case of autoimmune myelofibrosis.","authors":"Francesco Carubbi ,&nbsp;Alessia Alunno ,&nbsp;Elisa Matone ,&nbsp;Alessandro Lucchesi ,&nbsp;Gerardo Musuraca ,&nbsp;Claudio Ferri","doi":"10.1016/j.autrev.2025.103893","DOIUrl":"10.1016/j.autrev.2025.103893","url":null,"abstract":"<div><div>Bone marrow fibrosis is frequently observed in patients with haematological malignancies including myeloproliferative neoplasm (MPNs). The most common cause of BMF is the BCR-ABL-negative MPN primary myelofibrosis (PMF) however, BMF may also be caused by a variety of non-neoplastic disorders such as infections, endocrine diseases and autoimmune diseases (ADs). Autoimmune myelofibrosis (AIMF) is a type of BMF associated with either a fully blown AD (secondary AIMF) or serological signs of autoimmunity without an overt AD (primary AIMF). Although isolated case reports and case series have been published, AIMF remains a poorly recognized disorder. Therefore, we performed a scoping review and critically appraised the literature on AIMF pathogenesis, diagnosis and treatment with a particular focus on similarities and differences between AIMF and PMF.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103893"},"PeriodicalIF":8.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739565","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":"Specialized pro-resolving mediators and autoimmunity: Recent insights and future perspectives","authors":"Marta Vomero ,&nbsp;Ludovica Lamberti ,&nbsp;Erika Corberi ,&nbsp;Damiano Currado ,&nbsp;Annalisa Marino ,&nbsp;Onorina Berardicurti ,&nbsp;Marina Fava ,&nbsp;Alessandro Leuti ,&nbsp;Mauro Maccarrone ,&nbsp;Roberto Giacomelli ,&nbsp;Luca Navarini","doi":"10.1016/j.autrev.2025.103896","DOIUrl":"10.1016/j.autrev.2025.103896","url":null,"abstract":"<div><div>Inflammation is a response to injuries involving multiple cellular and molecular mechanisms. Different stimuli, such as trauma or microbial invasion, trigger an acute inflammatory response consisting, at least in principle, of two phases: initiation and resolution. Although the acute phase of inflammatory response represents a protective and usually self-limited mechanism, it can sometimes persist and evolve into chronic inflammation, a key driver in the development of many rheumatic and autoimmune diseases. The biosynthesis of specialized pro-resolving mediators (SPMs) orchestrates the resolution phase of inflammation, leading to the shutdown of phlogosis, tissue damage repair, and restoration of homeostasis. Dysregulation in SPMs biosynthesis or receptor expression and signalling are related to impaired viruses' clearance and adaptive immune response. Emerging knowledge on the involvement of SPMs in the development and progression of rheumatic diseases is arising. An altered SPM profile has been observed in different rheumatic diseases, including Rheumatoid Arthritis, Systemic Lupus Erythematosus, Adult-onset Still's Disease, Systemic Sclerosis, and Sjögren's Syndrome. Considering the anti-inflammatory and pro-resolving roles of these molecules, the possible use of synthetic SPMs and fish oil supplements, a crucial source of SPMs precursors DHA, DPA and EPA, in patients affected by chronic inflammatory diseases, is emerging.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103896"},"PeriodicalIF":8.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759029","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":"Cardiovascular risk in psoriatic arthritis: How can we manage it?","authors":"Fabiola Atzeni ,&nbsp;Javier Rodríguez-Carrio ,&nbsp;Alessandra Alciati ,&nbsp;Angelo Tropea ,&nbsp;Antonio Marchesoni","doi":"10.1016/j.autrev.2025.103889","DOIUrl":"10.1016/j.autrev.2025.103889","url":null,"abstract":"<div><div>It is now widely recognized that patients with psoriatic arthritis (PsA) have a higher risk of cardiovascular disease (CVD) when compared with the general population. A number of factors contribute to this increased risk. Skin and articular inflammation have been shown to be independently associated with CVD in PsA patients. Metabolic syndrome and all its components are significantly more frequent in PsA patients than in healthy populations. Depression, which is not uncommon in psoriatic subjects, seems to increase the CV risk. Finally, corticosteroids and non-steroidal anti-inflammatory drugs, which are often used for the treatment of PsA, have a well-known pro-atherosclerotic effect.</div><div>Therefore, in PsA patients the CV risk should be regularly estimated, using validated scoring instruments and appropriate techniques of vascular assessment when needed. Instrument choice and usefulness in PsA populations are still under debate. Patients at high risk should be treated addressing all the risk factors and tightly monitored. Abrogation or, at least, reduction of skin and articular inflammation, appropriate treatment of the metabolic abnormalities, and modifications of unhealthy life habits are the measures that can substantially improve the CV outcome of the patients with PsA. Cooperation of different specialists may be needed to optimize the management of the individual patient. Artificial intelligence applications, novel biomarkers and new care approaches, including treatment strategies and decision-making processes, may be considered in the PsA setting.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103889"},"PeriodicalIF":8.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717296","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":"Points to consider in the management of ANCA-associated vasculitis","authors":"Marina Papadopoulou,&nbsp;Anastasios Karamanakos","doi":"10.1016/j.autrev.2025.103894","DOIUrl":"10.1016/j.autrev.2025.103894","url":null,"abstract":"<div><div>Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is characterized by inflammation and necrosis of small to medium blood vessels that frequently present with organ- or life-threatening manifestations. Although significant therapeutic advances have improved outcomes, many areas in the management of AAV remain controversial or insufficiently defined. Key areas of debate include the choice of induction therapy—particularly the potential benefits of combining rituximab and cyclophosphamide—and the role of adjunctive therapies such as avacopan and plasma exchange. Additional challenges involve determining the optimal duration and dosing of maintenance therapy, strategies for relapse prediction and prevention, appropriate glucocorticoid tapering, the use of fixed versus biomarker-guided maintenance regimens, and the potential for withholding maintenance therapy in select patient populations. Despite multiple high-quality randomized controlled trials and international guidelines, clinical practice remains heterogeneous. The emergence of novel therapies is promising in helping to address these gaps and may provide effective treatment options for patients with resistant or refractory disease. This review summarizes current controversies and challenges in the treatment of AAV and provides a practical, evidence-based framework to support clinical decision-making.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103894"},"PeriodicalIF":8.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774599","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":"The role of mTOR signaling pathway in systemic lupus erythematosus and systemic vasculitis","authors":"Despina Michailidou ,&nbsp;Yevgeniya Gartshteyn ,&nbsp;Anca D. Askanase ,&nbsp;Andras Perl","doi":"10.1016/j.autrev.2025.103910","DOIUrl":"10.1016/j.autrev.2025.103910","url":null,"abstract":"<div><div>The mechanistic target of rapamycin (mTOR) is a central regulator of cellular proliferation, metabolism, survival and growth. The mTOR pathway consists of two protein complexes, mTORC1 and mTORC2, which have different sensitivities to rapamycin and cellular functions. mTOR regulates autophagy as well as the function and/or differentiation of many immune cells, including T cells, dendritic cells, natural killer cells, macrophages, neutrophils, and B cells. mTOR signaling is implicated in the pathogenesis of cancer, diabetes and several autoimmune diseases. In this review, we summarize how mTOR pathway may contribute to the pathogenesis of systemic lupus erythematosus (SLE) and systemic vasculitis. In SLE, mTOR activation induces activation of CD4 + T cells, skews differentiation towards Th17 cells resulting in Th17/Treg imbalance, increases production of IL-4 in CD4 − CD8− double-negative (DN) T cells, reduces the number of circulating CD8⁺ memory T cells, promotes B-cell proliferation, increases production of plasmacytes and secretion of autoantibodies, as well as activation of myeloid dendritic cells. In large vessel vasculitis, mTOR overactivity promotes endothelial cell growth, T cell differentiation towards Th1 and Th17 polarization, impairment of Tregs and activation of smooth muscle cell-derived myofibroblasts that contribute to arterial stenosis and ischemia, whereas in anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, reduced activity of the mTOR signaling pathway is observed in neutrophils isolated during the active phase of the disease. Targeting mTOR pathway with rapamycin, rapalogues, or other mTOR inhibitors could be efficacious in the treatment of these complex autoimmune diseases.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 11","pages":"Article 103910"},"PeriodicalIF":8.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841533","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":"Intersection of immune signaling and cell death: The bidirectional regulatory mechanism of STING pathway and Ferroptosis","authors":"Yuxuan Yao ,&nbsp;Xu He ,&nbsp;Yidan Zhu ,&nbsp;Yiru Gong ,&nbsp;Xuchen Song ,&nbsp;Jiali Chen ,&nbsp;Nan Guo ,&nbsp;Yinyu Zhao ,&nbsp;Jing Guo ,&nbsp;Xingxian Luo ,&nbsp;Xiaohong Zhang ,&nbsp;Lin Huang","doi":"10.1016/j.autrev.2025.103877","DOIUrl":"10.1016/j.autrev.2025.103877","url":null,"abstract":"<div><div>The STING signaling pathway is a central component of the innate immune system, primarily responsible for sensing cytosolic DNA and triggering type I interferon responses to regulate innate immune signaling. Recent studies have revealed that, beyond its roles in immune responses, inflammation, and infection, STING can also regulate metabolism and cell death through classical or non-classical signaling pathways. Ferroptosis, a unique iron-dependent form of cell death characterized by intracellular iron accumulation and lipid peroxidation, has been implicated in various diseases, including cancer, autoimmune diseases, neurodegenerative disorders, and infections. Emerging research has demonstrated a correlation between STING and ferroptosis. STING activation induces the production of inflammatory factors and cytokines, which disrupt iron homeostasis, lipid metabolism, and oxidative balance, thereby triggering ferroptosis. Meanwhile, key proteins like GPX4 and ACSL4 in ferroptosis along with certain metabolic products can also influence the activity of the STING signaling pathway. The regulatory direction and signaling intensity of these interactions significantly impact disease states. As a result, deciphering their molecular mechanisms is critical for developing precise therapeutic strategies. Here, we provide a comprehensive overview of the latest research advances related to the STING signaling pathway and ferroptosis, with a particular emphasis on the molecular mechanisms underlying their mutual regulation. In addition, we discuss therapeutic strategies targeting STING signaling and ferroptosis in disease pathology, thereby highlighting their prospective clinical significance in conditions such as cancer and autoimmune diseases.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103877"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681925","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":"Managing the clinical heterogeneity of patients with Still's disease, from early diagnosis to timely treatment","authors":"Piero Ruscitti ,&nbsp;Luca Cantarini ,&nbsp;Francesco Ciccia ,&nbsp;Fabrizio Conti ,&nbsp;Lorenzo Dagna ,&nbsp;Florenzo Iannone ,&nbsp;Carlomaurizio Montecucco ,&nbsp;Pistone Giovanni ,&nbsp;Paolo Sfriso ,&nbsp;Roberto Giacomelli","doi":"10.1016/j.autrev.2025.103880","DOIUrl":"10.1016/j.autrev.2025.103880","url":null,"abstract":"<div><div>Still's disease is an inflammatory syndrome affecting patients across all ages, previously known as systemic juvenile idiopathic arthritis (sJIA) in children and adult-onset Still's disease (AOSD) in adults. Multiple lines of evidence reported overlapping clinical features between sJIA and AOSD, commonly manifesting with daily fever, arthritis, evanescent salmon-coloured skin rash. The concomitant various degree of multiorgan involvement may increase the heterogeneity of the patient clinical picture. In active patients, a typical hyperferritinemia is recognized in association with increases of erythrocyte sedimentation rate and C reactive protein. Concerning pathogenesis, also in this case, similar mechanisms are reported in sJIA and AOSD involving both innate and adaptive arms of the immune systems; thus, Still's disease is peculiarly codified at the cross-road of autoinflammatory and autoimmune disorders. Furthermore, life-threatening complications burden the disease course in challenging the management of these patients, mainly macrophage activation syndrome, and worsening the prognosis. Concerning the treatment, glucocorticoids (GCs), conventional synthetic disease-modifying anti rheumatic drugs (csDMARDs) and biologic DMARDs (bDMARDs), mainly IL-1 inhibitors, are administered to treat these patients. Usually, bDMARDs are considered in case of failure of GCs or GC-dependence. However, in some circumstances, bDMARDs may be administered as first-line modifying therapy without GCs, thus avoiding GC predictable side effects and optimizing the long-term outcome.</div><div>In this work, we aimed to synthetize the recent available literature considering the clinical management of patients with Still's disease, reviewing features about early diagnosis, optimal treatment algorithm, clinical therapeutic targets, treatment of complications, and patient monitoring in the follow-up.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103880"},"PeriodicalIF":9.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673875","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":"Rapid radiographic progression in rheumatoid arthritis: Definition, prediction and treatment","authors":"Bo Lv ,&nbsp;Fanshu Li ,&nbsp;Fanlei Hu ,&nbsp;Liling Xu","doi":"10.1016/j.autrev.2025.103913","DOIUrl":"10.1016/j.autrev.2025.103913","url":null,"abstract":"<div><div>Rapid radiographic progression (RRP) in rheumatoid arthritis (RA) is strongly correlated with unfavorable long-term prognostic outcomes. Early identification of RRP is paramount, as prompt intervention and the implementation of intensified therapeutic regimens have the potential to substantially improve clinical outcomes. This review summarized the different definitions and current key predictors of RRP, such as genetic predispositions, body mass index and so on. Furthermore, the existing matrix-based predictive models for RRP were compared. In addition, the potential treatment options for patients with RRP were also outlined. The objective of this review is to improve the early detection of RRP, thereby facilitating timely intervention and the adoption of personalized treatment paradigms that optimize patient prognosis.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 10","pages":"Article 103913"},"PeriodicalIF":8.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881967","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}