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Molecular Mechanisms and Therapeutic Targets in Systemic Vasculitis

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Immunology".

Deadline for manuscript submissions: 30 March 2026 | Viewed by 844

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Guest Editor
Internal Service, Hospital Universitario Ramón y Cajal, Irycis, 28034 Madrid, Spain
Interests: systemic lupus erythematosus; autoimmune disease; autoinflammatory disease; Castleman’s disease; vasculitis, IgG4RD
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Special Issue Information

Dear Colleagues, 

Systemic vasculitides represent a heterogeneous group of inflammatory disorders characterized by immune-mediated injury of blood vessels leading to tissue ischemia and organ dysfunction. Recent advances in molecular and cellular research have revealed new insights into the interplay between innate and adaptive immunity, endothelial activation, and effector pathways driving vascular inflammation and damage. Among these, complement activation has emerged as a crucial link between immune complex formation, neutrophil activation, and endothelial injury, contributing to both acute inflammation and chronic vascular remodeling.

This Special Issue aims to gather high-quality original research articles and comprehensive reviews focused on the molecular and immunopathogenic mechanisms underlying systemic vasculitis, including ANCA-associated vasculitides (GPA, MPA, and EGPA), immune complex–mediated and large-vessel vasculitis, as well as other autoinflammatory or clonal forms of vascular inflammation. Topics of interest include genetic susceptibility, cytokine and signaling networks, complement dysregulation, eosinophil-driven inflammation, endothelial dysfunction, biomarkers, and novel therapeutic targets. By integrating translational and clinical perspectives, this Special Issue aims to highlight current challenges and future directions in understanding and managing vasculitis at the molecular level.

Dr. Andrés González-García
Guest Editor

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Keywords

  • vasculitis
  • ANCA-associated vasculitis
  • EGPA
  • complement activation
  • molecular immunopathogenesis
  • endothelial dysfunction
  • cytokine signaling
  • biomarkers
  • therapeutic targets
  • autoimmunity

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Published Papers (1 paper)

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Review

23 pages, 2577 KB  
Review
Molecular Pathogenesis and Targeted Therapies in Eosinophilic Granulomatosis with Polyangiitis: An Updated Review
by María López Paraja, Grisell Starita Fajardo, Ignacio Donate Velasco, David Lucena López, María Pilar Iranzo Alcolea, Francisco José Lirola Sánchez, Mercedes Peña Rodriguez, Andrés González García and Luis Manzano Espinosa
Int. J. Mol. Sci. 2025, 26(22), 11141; https://doi.org/10.3390/ijms262211141 - 18 Nov 2025
Viewed by 736
Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by asthma, eosinophilia, and necrotizing inflammation of small- to medium-sized vessels. Accumulating evidence indicates that EGPA is a polygenic and heterogeneous disorder comprising distinct antineutrophil cytoplasmic antibody (ANCA)–defined endotypes with divergent genetic [...] Read more.
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by asthma, eosinophilia, and necrotizing inflammation of small- to medium-sized vessels. Accumulating evidence indicates that EGPA is a polygenic and heterogeneous disorder comprising distinct antineutrophil cytoplasmic antibody (ANCA)–defined endotypes with divergent genetic backgrounds, immune pathways, and clinical phenotypes. Its pathogenesis reflects the convergence of epithelial–alarmin signaling, type 2 inflammation, eosinophil effector mechanisms, and B-cell/autoantibody responses, with myeloperoxidase (MPO)-ANCA serving as a hallmark of the vasculitic subset. Recent advances in genomics, immunology, and multi-omics profiling have uncovered biomarkers and molecular circuits sustaining disease activity and guiding therapeutic stratification. The identification of the interleukin (IL)-5–eosinophil axis, epithelial-derived alarmins, and B-cell/IgG4 networks as central pathogenic nodes has enabled the development of targeted biologic therapies that are redefining treatment paradigms. Benralizumab (anti-IL-5Rα) has recently been approved for EGPA following the phase 3 head-to-head MANDARA trial, which demonstrated non-inferiority to mepolizumab in achieving remission (BVAS = 0 with ≤4 mg/day prednisone equivalent) at weeks 36 and 48. These results, together with the established efficacy of mepolizumab, inform practical selection between IL-5 and IL-5Rα blockade and support glucocorticoid-sparing approaches. A structured literature search (2015–2025) was conducted in PubMed, Scopus, and Web of Science to identify recent advances in epidemiology, genetics, biomarkers, and targeted therapies for EGPA. This updated review integrates molecular insights, clinical endotypes, and therapeutic innovations to outline current evidence and future precision-medicine strategies aimed at improving long-term patient outcomes. Full article
(This article belongs to the Special Issue Molecular Mechanisms and Therapeutic Targets in Systemic Vasculitis)
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