The impact of rheumatoid arthritis and immunotherapy on outcomes following cervical fusion.

Introduction: One of the difficult problems remains the role of herpes viruses in the development of chronic abacterial prostatitis, since their etiological role in the dynamics of this disease remains difficult to prove and insufficiently studied. Purpose of the study: to assess the informativity of mass spectrometry of microbial markers in the diagnosis and antiviral therapy of patients with chronic abacterial prostatitis category III associated with herpes viruses. Materials and Methods: 61 patients with chronic abacterial prostatitis associated with herpes viruses who applied for examination and treatment aged 25 to 50 years were examined. In addition, 70 volunteers who applied for a screening study were examined. The prostate secretion study was carried out using the Maestro gas chromatograph (Interlab LLC, Russia) using the mass spectrometry of microbial markers method. Serum levels of SPR-06 antigen autoantibodies and IgM and IgG immunoglobulins were tested. All patients underwent a course of antiviral therapy and immunomodulators, as well as antioxidants and alpha-1-blockers for 2 months. Results: The data we obtained showed that in patients with chronic abacterial prostatitis with clinical symptoms, the level of herpesviruses in the prostate secretion is significantly higher compared to healthy ones. Our antiviral therapy with immunomodulators showed high efficacy, since along with the disappearance or reduction of clinical symptoms, there was a significant decrease in the level of herpesviruses in the RLS from 3 to 5 times (p < 0.0001), normalization of the level of immunoglobulins of autoantibodies to SPR-06 antigen in the blood serum. Conclusion: The mass spectrometry of microbial markers study of prostate secretion made it possible to identify and quantify herpes viruses in patients with chronic abacterial prostatitis associated with herpes viruses (in the presence of characteristic symptoms) and to conduct effective antiviral and immunomodulatory therapy. Keywords: herpesviruses, prostate secretion, microbial marker mass spectrometry, antiviral therapy, immunomodulatory therapy.

Hybrid membrane-camouflaged photothermal immunomodulatory nanoparticle inhibits colorectal cancer growth and metastasis.

Even though immune checkpoint inhibitors (ICI) remain effective treatments for an increasing number of cancers, they are also liable to cause immune-related adverse events (irAE). Rheumatologic manifestations occur in 5-10 % of patients. The most common rheumatologic irAEs are immune checkpoint-induced inflammatory arthritis (ICI-IA) and immune checkpoint-induced polymyalgia rheumatica (ICI-PMR). While ICI-IA can mimic rheumatoid arthritis (RA), it is predominantly immuno-negative (absence of rheumatoid factor and anti-citrullinated peptide antibodies) and can persist subsequent to r ICI cessation. ICI-PMR is usually reversible. First-line treatments consist of corticosteroids at the lowest effective doses and are given for short periods. They are aimed at reducing symptoms such as joint swelling, with minimal (if any) disruption of ICI therapy. In patients with corticoid dependence at a dose > 10 mg/day, second-line treatments include methotrexate and biologic therapy: anti-IL6 and TNF inhibitors (TNFi). Management of these manifestations requires balancing the opposed perspectives of effective arthritis control and possible cancer progression. When possible, ICI cessation should be avoided, and immunomodulating therapies are to be applied cautiously. Co-management by patients, oncologists, and rheumatologists is of crucial importance when balancing the risks and benefits of treatment.

This review provides a summary of the evolving landscape of pediatric lung transplantation highlighting current trends, short and long-term outcomes, ongoing challenges in posttransplant survival, and unique considerations in pediatric populations. The annual volume of pediatric lung transplantation has declined over the past decade due to a decreased need among children with cystic fibrosis. Improvement in survival has paralleled advancements in bridge to transplant strategies, expanding what were once considered contraindications. Despite the ongoing shortage of donor organs, innovations in policy changes, surgical and immunologic strategies, and organ preservation technologies have expanded the donor lung pool. Chronic lung allograft dysfunction (CLAD) remains the primary limitation to long-term survival, with limited management strategies and emerging immunomodulatory therapies offering promise. As survival in pediatric lung transplantation improves, emphasis should shift to long-term outcomes including quality of life and equitable care, development of effective CLAD prevention strategies and pediatric-specific guidelines to optimize long-term survival.

The association between cerebrospinal fluid interleukin-6, soluble interleukin-6 receptor, and interleukin-6 trans-signalling binary complex with postoperative delirium: an observational cohort study.

Treg cells as potential therapeutic targets for bullous pemphigoid: A review.

Chronic histiocytic intervillositis: Insights into immunopathogenesis and prospective treatments.

Autoimmune diseases are associated with increased neurodegenerative and cerebrovascular risk, while systemic corticosteroid exposure shows limited neurodegenerative and modest vascular associations.

BackgroundThis study examined the association between social determinants of health (SDOH) and access to first-line therapy, time to treatment (TTT), and overall survival (OS) among patients with metastatic non-small cell lung cancer (mNSCLC).MethodsThis retrospective study used data from the Generating Evidence Excellence research environment, incorporating de-identified U.S. patient-level claims, electronic medical records, and neighborhood-level SDOH data from the American Community Survey. Adults with newly diagnosed mNSCLC were included. Patient characteristics, treatment patterns, and SDOH were analyzed descriptively. Kaplan-Meier methods estimated OS, and multivariable logistic regression evaluated associations between selected SDOH and receipt of first-line treatment.ResultsAmong 869 patients, median follow-up was 11.5 months; median age was 67 years; 53% were female, 83% were White, and 10% were Black. Overall, 77% (n = 665) received systemic first-line treatment. Among treated patients, 44% received immunotherapy (IO) plus chemotherapy, 22% chemotherapy alone, 20% other IO regimens, and 14% other treatments. Black patients were less likely than White patients to receive first-line IO (odds ratio 0.47; P = 0.0346). Median TTT was longer among Black patients (49 days) compared with White patients (40 days). Median OS was numerically shorter among Black patients (11.2 months) than White patients (13.6 months), though differences were not statistically significant.ConclusionsRace was associated with differences in first-line treatment patterns and TTT among patients with mNSCLC. Black patients were less likely to receive IO and experienced longer TTT compared with White patients, highlighting potential disparities in treatment access and timing and supporting continued evaluation of strategies to promote equitable cancer care delivery.

Gain-of-function variants in the TLR7 gene have been associated with a spectrum of clinical manifestations, including systemic lupus erythematosus (SLE)-like disease, neuromyelitis optica, and progressive leukoencephalopathy. The p.(Leu528Ile) variant has previously been shown to underlie this constellation of findings. Here, we report the extended follow-up of a previously described young female patient with TLR7-related interferonopathy, who developed non-paraneoplastic autoimmune retinopathy following a failed attempt to taper her systemic immunomodulatory therapy. This case expands the phenotypic spectrum of TLR7-related disease and highlights a potential link between interferon-driven immune dysregulation and autoimmune retinal pathology.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Uveitis is the most frequent extra-articular manifestation of JIA and a major cause of visual morbidity. Despite advances in immunomodulatory therapy, many patients reach adulthood with active ocular inflammation or vision-threatening complications. The transition from pediatric to adult care represents a vulnerable period. The primary objective of our study is to describe ophthalmologic and rheumatologic disease characteristics at the time of transition from pediatric to adult care. We conducted a retrospective cohort study of patients with JIA and past or present uveitis who transitioned to adult rheumatology at Cochin Hospital between 2016 and 2024. Clinical, ophthalmologic, and therapeutic data were collected from electronic medical records. Descriptive statistics were performed. Comparative analyses were exploratory and intended to describe differences between subgroups rather than to test predefined hypotheses. A total of 46 patients were included. Median age at JIA diagnosis was 7.5 years [IQR 2.0-16.0] and median age at first uveitis was 6.0 years [IQR 3.0-12.2]. Median follow-up after transition was 2.44 years [IQR 1.17-3.94]. Most patients were female (80%, n = 37) and had oligoarticular JIA (59%, n = 27). Chronic uveitis predominated (83%, n = 38). Ocular complications occurred in 46% (n = 17), including cataract (24%, n = 11), glaucoma (20%, n = 9), and keratitis (7%, n = 3). Over half (57%, n = 13/23) experienced ≥ 5 flares since diagnosis. Biologic DMARDs were prescribed in 53% (n = 23/43), predominantly anti-TNF agents. This study highlights the substantial burden of JIA-associated uveitis at the time of transition to adult care, characterized by frequent complications, persistent disease activity, and a high need for biologic therapy. Our findings emphasize the necessity of structured and continuous ophthalmologic follow-up across all JIA subtypes, alongside close multidisciplinary collaboration, to prevent long-term ocular damage and preserve visual function.

Introduction Neurodegenerative diseases (NDDs) including Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and non-AD dementias share chronic neuroinflammatory mechanisms that contribute to neuronal injury and disease progression. While anti-inflammatory therapies (AITs) are associated with reduced neurodegenerative disease risk, knowledge regarding the impact of biological sex and treatment duration across multiple NDDs remains limited. Methods We conducted a retrospective cohort analysis using a large propensity-score-matched population ( n = 190,308; 95,154 treated vs. 95,154 untreated) to evaluate associations between long-term AIT exposure and incidence of major NDDs. Disease-specific and combined outcomes were assessed across drug classes (NSAIDs, corticosteroids, immunomodulators), sex, age, and therapy duration. Results AIT exposure was associated with a significantly lower risk of developing any NDD (RR = 0.47, 95% CI 0.43–0.48, p < 0.0001) and was equally effective in both sexes. Risk reduction was observed for each age-associated disease: AD (RR = 0.40), non-AD dementia (RR = 0.51), PD (RR = 0.43), MS (RR = 0.25), and ALS (RR = 0.48). Among drug classes, immunomodulators conferred the greatest reduction (RR = 0.19), followed by corticosteroids (RR = 0.41) and NSAIDs (RR = 0.42). Duration analyses revealed a graded benefit, with RR declining from 0.94 ( < 1 year) to 0.25 ( > 6 years). Risk reduction was greatest in older participants (75–79 years). Discussion Chronic use of anti-inflammatory or immunomodulatory therapies was associated with significantly reduced incidence of multiple neurodegenerative diseases in both sexes. The strongest effects were observed with immunomodulator use and prolonged therapy duration, suggesting that sustained modulation of systemic inflammation confers broad neuroprotective effects in both sexes. These findings highlight the potential of targeting immune-inflammatory pathways for neurodegenerative disease prevention and can inform prospective mechanistic and interventional studies.

Immunomodulatory therapies and emerging drug associations with microscopic colitis: A global pharmacovigilance analysis.

Kidney xenotransplantation has re-emerged as a viable therapeutic strategy to address the global shortage of donor organs, driven by substantial advances in porcine genetic engineering and immunomodulatory therapies. Clinical experiences in brain-dead decedents and, more recently, in living recipients have demonstrated that genetically modified pig kidneys can provide life-sustaining renal function in humans, marking a pivotal milestone in the field. Elimination of major carbohydrate xenoantigens, particularly through GGTA1 deletion, has effectively abrogated hyperacute rejection, enabling short- to intermediate-term xenograft survival. However, emerging data reveal that xenotransplantation elicits a uniquely aggressive and persistent immune response involving both innate and adaptive immunity. Conventional immunosuppressive regimens used in kidney allotransplantation appear insufficient when reduced in intensity and require full-dose application combined with B-cell depletion and costimulation blockade to control pre-existing xenoreactive T-cells and de novo antibody formation. Complement activation remains a central pathogenic mechanism despite extensive donor genetic modification, with emerging evidence suggesting that sustained control of both terminal and proximal complement activation may be beneficial in selected settings. An additional, unexpected challenge is the development of early and often persistent nephrotic-range proteinuria, which may reflect species-specific glomerular barrier incompatibilities, immune-mediated injury or both, and may have important implications for graft survival by promoting urinary loss of biologic immunosuppressive agents. Hyperacute rejection in kidney xenotransplantation has been effectively overcome through targeted genetic modifications of donor pigs. However, xenotransplantation remains characterized by a sustained adaptive and innate immune response and ongoing complement activation, necessitating intensified and multimodal immunosuppression. An additional emerging challenge is early and sometimes persistent nephrotic-range proteinuria, which may compromise graft function and alter the pharmacokinetics of biologic immunosuppressive agents. Future progress will depend on integrated strategies combining genetic engineering, costimulation blockade, and appropriately targeted complement inhibition to achieve long-term xenograft survival.

Autoimmune polyendocrine syndrome Type 1, also known as autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APS‐1/APECED), is a rare monogenic autoimmune disorder with increasing recognition of neurologic manifestations. We report a critically ill adolescent female with APS‐1 and a prior history of autoimmune encephalitis who presented with acute encephalopathy and seizures. Electroencephalography demonstrated focal seizures superimposed on ictal–interictal continuum activity, and brain MRI revealed cytotoxic lesions of the corpus callosum. High‐titer glutamic acid Decarboxylase 65 (GAD65) antibodies supported a relapse of autoimmune encephalitis after other potential etiologies were excluded. The patient demonstrated marked clinical improvement following aggressive immunotherapy, including plasma exchange, high‐dose corticosteroids, and rituximab. This case highlights the diagnostic and management challenges of autoimmune encephalitis in patients with APS‐1, and to our knowledge, represents the first reported case of recurrent autoimmune encephalitis in this population with a favorable response to early immunomodulatory therapy.

Passenger Lymphocyte Syndrome Following Minor ABO-incompatible Liver Transplantation: A Case Report.

The intersection of immunity and mental health: Immunotherapy's role in modulating depression and neuropsychiatric disorders.

Latin American regional diversity of T-cell responses and cytokine immunoregulation in human Trypanosoma cruzi infection.

Approximately 17% of patients with non-small cell lung cancer (NSCLC) have epidermal growth factor receptor mutations (EGFRm). Amivantamab received United States Food and Drug Administration approvals in advanced NSCLC for patients with EGFR exon 20 insertions (exon20ins) who progressed after platinum-based chemotherapy (PBC) on 05/21/2021, for first-line (1L) EGFR exon20ins on 03/01/2024, and for 1L and second-line or later (2L+) EGFR exon 19 deletion and L858R on 08/20/2024 and 09/19/2024, respectively. This claims-based study describes real-world treatment patterns and healthcare resource utilization (HRU) among insured patients with advanced NSCLC initiating amivantamab in 2L or later (2L+). Komodo Research Data closed claims (01/01/2016-10/31/2023) were used to analyze insured adults with a diagnosis of lung cancer who initiated amivantamab on/after 05/21/2021 in 2L+. Treatment patterns, including prior PBC and immunotherapy (IO) use, were described by line of therapy (LOT). All-cause HRU per-patient-per-month (PPPM) was assessed during the amivantamab LOT and all LOTs preceding amivantamab. Time to next treatment or death (TTNT-D) was reported using Kaplan-Meier analysis for each LOT. Overall, 126 patients initiated amivantamab in 2L+ (mean age: 60.2 years, 63.5% female). Amivantamab was initiated in 2L by 51.6% of patients, while 32.5% and 15.9% initiated amivantamab in third-line (3L) and fourth-line or later (4L+), respectively. Most patients initiated amivantamab as monotherapy (2L: 92.3%; 3L: 73.2%; 4L+: 80.0%), had prior PBC use (2L: 83.1%; 3L: 100.0%; 4L+: 100.0%), and prior IO use (2L: 60.0%; 3L: 63.4%; 4L+: 85.0%). Mean outpatient service use was 5.87 days PPPM before amivantamab initiation and 6.79 days PPPM during amivantamab treatment. Mean inpatient admissions PPPM were 0.05 before amivantamab and 0.08 during amivantamab treatment. Among patients initiating amivantamab in 2L, 3L, or 4L+, median TTNT-D was 11.0 months, 5.3 months, and 6.1 months, respectively. Among insured patients with advanced NSCLC receiving amivantamab in 2L+, TTNT-D aligned with results reported in clinical trials. Before initiating amivantamab, most patients received IO, despite IO use being inconsistent with treatment guidelines and limited demonstrated benefit. HRU was similar before and during amivantamab treatment, suggesting that amivantamab does not contribute to an increase in medical services compared to treatment regimens used in earlier LOTs.