Search Results (5,337)

Cancer immunotherapy via targeting immune checkpoint proteins (ICPs) has transformed the treatment of multiple malignancies, offering improved clinical outcomes over conventional therapies. Immune checkpoint inhibitors (ICIs), including FDA-approved monoclonal antibodies against CTLA-4, PD-1, and PD-L1, as well as emerging agents targeting novel ICPs, have demonstrated strong therapeutic efficacy by restoring antitumor immune responses. In parallel, RNA interference (RNAi)-based approaches involving microRNAs (miRNAs) and small interfering RNAs (siRNAs) have emerged as promising alternative strategies for modulating ICP expression at the posttranscriptional level, enabling selective and simultaneous regulation of multiple immune checkpoint pathways. Preclinical and early clinical studies have indicated effective downregulation of target ICP expression and enhanced antitumor immunity across diverse cancer models. Due to the inherent instability of RNA molecules, the development of RNAi therapeutics has been accompanied by advances in delivery platforms. In this review, we discuss the biological functions of established and novel ICPs, along with immunotherapeutics approved by the FDA and under Phase III clinical development. We also provide an overview of the RNAi mechanism of miRNAs and siRNAs, highlight endogenous miRNAs that regulate immune checkpoint pathways, and summarize ICP-targeting RNAi agents and their corresponding delivery systems under preclinical and clinical development. Collectively, these advances underscore the potential of RNAi-based immune checkpoint modulation, complementing existing ICIs and expanding the next generation of cancer immunotherapy. Full article

Background: Nirsevimab, a long-acting monoclonal antibody targeting respiratory syncytial virus (RSV), has recently been introduced as universal prophylaxis in newborns and infants. Although clinical trials have shown high efficacy and a favorable safety profile, real-world evidence remains limited. Objectives: Our Italian multicenter observational study included newborns eligible for nirsevimab prophylaxis during the 2025–2026 season and aimed to assess nirsevimab coverage, timing of administration, and short-term safety in routine clinical practice. The association between perinatal and environmental factors and neonatal intensive care unit (NICU) admission was also investigated, while RSV occurrence was evaluated as a descriptive and exploratory outcome. Methods: Eligible newborns were from four Italian hospitals during the 2025–2026 RSV season. We assessed nirsevimab coverage, timing of administration, RSV incidence, adverse events, and selected neonatal, perinatal, and maternal risk factors. Results: Among 1554 eligible newborns, 1462 received nirsevimab, corresponding to a coverage rate of 94.0%. The median age at administration was 3.0 days (IQR 2-6 days), with significantly delayed prophylaxis in preterm compared with term infants. During the observation period, two laboratory-confirmed RSV-associated bronchiolitis cases occurred, corresponding to a cumulative incidence of 0.13%. One case occurred in the immunized group and one in the non-immunized group. No adverse events following immunization were recorded. Conclusions: Nirsevimab prophylaxis achieved high coverage and showed a reassuring short-term safety profile in this real-world multicenter cohort. RSV infections were uncommon, and their very limited number prevents definitive conclusions regarding comparative effectiveness between immunized and non-immunized newborns. Prematurity was associated with delayed administration and greater need for intensive care, underscoring the importance of timely prophylaxis in vulnerable newborns. Full article

Chronic spontaneous urticaria (CSU) is a mast cell-driven disorder defined by recurrent wheals, angioedema, or both, persisting for longer than six weeks without an identifiable external trigger. Second-generation H1-antihistamines remain first-line therapy, yet a large share of patients stay symptomatic after the dose is raised up to fourfold, and for more than a decade, omalizumab was the only targeted option for those who failed antihistamines. This began to change in 2025, when the interleukin-4 receptor alpha (IL-4Rα) antagonist dupilumab and the oral, covalent Bruton tyrosine kinase (BTK) inhibitor remibrutinib were approved for antihistamine-refractory CSU within months of one another, while the anti-KIT monoclonal antibody barzolvolimab, which depletes mast cells, advanced into the largest phase 3 program the disease has seen. This narrative review outlines the guideline framework that still anchors CSU care, appraises the pivotal efficacy and safety data for omalizumab, dupilumab, remibrutinib, and barzolvolimab, and considers how these mechanistically distinct agents might be positioned and sequenced. The widening choice makes individualized, mechanism-informed treatment a realistic goal, but it also sharpens unresolved questions about patient selection, optimal treatment duration in a naturally remitting disease, and the long-term safety of newer oral and mast cell-depleting approaches. Full article

Pseudomonas aeruginosa is an important opportunistic pathogen associated with diverse healthcare-associated infections and increasing antimicrobial resistance. This systematic review evaluated antimicrobial treatment regimens, clinical outcomes, and pharmacokinetic/pharmacodynamic (PK/PD) considerations in P. aeruginosa infections. A systematic review was conducted according to PRISMA guidelines. PubMed/MEDLINE and the Cochrane Library were searched for studies published between January 2000 and March 2026. Data on antimicrobial therapies, clinical and microbiological outcomes, and PK/PD parameters were extracted. Study quality was assessed using the NHLBI quality assessment tool. Narrative synthesis was performed for all eligible studies, and a quantitative meta-analysis was conducted for studies with standardized outcome data. Of the 982 records identified, 249 studies met the inclusion criteria, and 34 were included in the quantitative meta-analysis. The evidence base was highly heterogeneous regarding study design, patient populations, infection types, and treatment regimens. Respiratory infections, particularly in cystic fibrosis patients, accounted for most studies. Quantitative synthesis showed no consistent superiority of any antimicrobial regimen (or combination of them), while treatment outcomes were influenced by infection characteristics, antimicrobial resistance patterns, and PK/PD factors. No universally superior antimicrobial regimen was identified for Pseudomonas aeruginosa infections. Some novel and promising treatment options have been identified, such as anti-Pseudomonas aeruginosa LPS monoclonal antibody panobacumab and inhaled Clostridium butyricum delivered via oxygen-driven nebulization. Two novel treatment modalities did not yield a clinically relevant effect, namely, the bispecific monoclonal antibody MEDI3902 (gremubamab) and the IC43 Pseudomonas aeruginosa vaccine. Treatment effectiveness appears to depend on clinical context, antimicrobial susceptibility, and PK/PD considerations, highlighting the need for further standardized research. Full article

This study evaluated population immunity against peste des petits ruminants (PPR) in sheep and goats in India following the second annual round of mass vaccination conducted under the National PPR Eradication Programme (PPR EP), launched in 2023 in accordance with the national strategic plan. A cross-sectional post-vaccination evaluation (PVE) was conducted during August 2024 and April 2026 to assess the herd or population immunity under field conditions, in line with the WOAH and FAO Global Control and Eradication Strategy (GCES) of the PPR Global Eradication Programme (PPR GEP) 2030. A total of 52,133 serum samples were collected within 90 days post vaccination from sheep and goats across three age groups, 6–12 months (n = 18,002), 1–2 years (n = 17,316), and >2 years (n = 16,842), representing 1666 epidemiological units across multiple taluks and districts in 20 Indian states and Union Territories. Serum samples were tested for antibodies against PPR virus using in-house IVRI developed hemagglutinin (H) protein monoclonal antibody based competitive ELISA. The study revealed an overall population immunity of 72%, with age-wise PPRV antibody prevalence of 70.8%, 71.8%, and 72.6% in the 6–12-month, 1–2-year, and >2-year age groups, respectively. Statistical analysis showed significant associations (p < 0.005) between PPRV seropositivity and host factors, including species. Population immunity increased markedly from 41% (pre-vaccination sero-prevalence) in 2023 to nearly 72% by 2025-26 following two consecutive rounds of annual vaccination, accompanied by a substantial reduction in confirmed outbreaks from 57 during 2023 to 20 in 2025 in these 20 states/Union Territories. Notably, about 14.5% of epidemiological units remained below 30% seroprevalence, indicating targeted gaps requiring intensified vaccination. Overall animal vaccination coverage exceeded 95% among small ruminants aged above four months, approaching the population immunity threshold of 70 to 80%. These findings highlight the critical role of sustained successive mass vaccination campaigns in achieving and maintaining protective herd/population immunity, thereby supporting national and global PPR eradication goals. Full article

The epidermal growth factor receptor (EGFR) was the first receptor tyrosine kinase identified soon after v-Src was recognized as a tyrosine kinase. EGFR signaling begins when EGF binds to EGFR at the cell surface, inducing receptor dimerization, activation, and autophosphorylation. The resulting phosphotyrosine sites recruit downstream effectors that activate signaling cascades such as the RAS-RAF-MEK-ERK and PI3K-Akt pathways, thereby regulating cell growth, proliferation, and survival. EGF binding also promotes EGFR endocytosis, which can direct the receptor to lysosomal degradation. Aberrant EGFR activity is associated with many cancers, and the receptor has been therapeutically targeted using small-molecule tyrosine kinase inhibitors (TKIs) and monoclonal antibodies (mAbs). Furthermore, EGFR endocytosis has been exploited for the targeted delivery of anticancer agents into EGFR-expressing cancer cells through antibody–drug conjugates (ADCs) and antibody–nanoparticle conjugates (ANCs). Although ADCs and ANCs both utilize mAbs as homing mechanisms to recognize cancer-associated antigens, they further harness EGFR endocytosis to deliver therapeutic payloads directly into target cells. In this review, we briefly discuss EGFR structure, activation, signaling, and endocytosis, as well as the mechanisms underlying EGFR function in cancer development. We then focus on current advances and future perspectives in using EGFR endocytosis pathways to improve targeted cancer drug delivery and therapy, particularly in the context of ANCs. Full article

Vaccination remains the primary strategy for poliomyelitis prevention. The D-antigen of poliovirus is a critical component of inactivated polio vaccines, as it induces the production of neutralizing antibodies and provides protective immunity. Therefore, the development of quantitative immunoassays for monitoring D-antigen content during vaccine production is an important task. In this study, we generated recombinant camelid single-domain antibodies (VHHs) specific for the D-antigen of Sabin poliovirus type 1 and evaluated their antigen specificity. The obtained VHH antibodies demonstrated strong binding to the native D-antigen of Sabin type 1 poliovirus. Furthermore, the use of clone S1-C7 as a capture antibody in combination with Sabin type 1-specific polyclonal antibodies for detection revealed differential recognition of the vaccine-derived Sabin type 1 and homologous wild-type Mahoney strains. Notably, such discrimination was not observed when polyclonal antibodies were used alone, indicating that incorporation of VHH S1-C7 into the assay enhances strain-specific antigen recognition. In a neutralization assay, clone S1-C7 exhibited in vitro neutralizing activity against Sabin type 1 poliovirus. One clone, S1-D9, demonstrated cross-reactivity with all three poliovirus serotypes, suggesting recognition of a conserved epitope in the capsid and potential utility as a universal detection antibody. The generated VHH antibodies represent promising analytical tools for poliovirus antigen characterization. Together with S1-C7, they enable the discrimination of both D- and C-antigen forms as well as vaccine-derived and wild-type strains. Full article

Acinetobacter baumannii, a Gram-negative opportunistic bacterium in the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, A. baumannii, Pseudomonas aeruginosa and Enterobacter spp.), has emerged as a leading cause of nosocomial infections worldwide. It is known to possess diverse virulence traits and antimicrobial resistance, making it a critical priority pathogen on the World Health Organization’s 2024 Bacterial Priority Pathogens List. Carbapenem-resistant A. baumannii (CRAB) is currently endemic across several continents, with global carbapenem resistance exceeding 70% in healthcare settings and multidrug-resistant infections being associated with alarming mortality rates. This review comprehensively discusses the molecular underpinnings of A. baumannii pathogenesis and virulence, detailing the array of factors coordinated by complex regulatory networks. The convergence of this pathogen’s virulence and antimicrobial resistance traits, resulting in multidrug resistance, leaves clinicians with only a handful of therapeutic options. The review also discusses upcoming therapeutic strategies, including phage therapy, antimicrobial peptides, monoclonal antibodies, photodynamic therapy, and vaccine candidates in the pipeline. While emerging therapeutics show promise, several challenges remain, and integrated approaches are warranted to efficiently combat A. baumannii’s virulence and resistance armamentarium. Full article

The therapeutic monoclonal antibody bevacizumab is typically purified using protein A affinity chromatography, a highly effective but costly method. Affinity-based precipitation for antibody purification is a lower-cost approach. In this work, a precipitation protocol was developed for bevacizumab purification using a branched peptide (Ac-PHQGQHIG-Ahx₃)₂-K-Ahx₃-PHQGQHIG-NH₂, which contains the epitope PHQGQHIG that is responsible for interacting with bevacizumab. The peptide was synthesised by a microwave-assisted solid-phase peptide method, employing LiCl as an additive to prevent aggregation and ensure high purity and yield. Three molecules of 6-aminohexanoic acid were introduced between each epitope branch as spacer arms to promote the formation of cyclic complexes. Bevacizumab purification from cell-free culture broth was achieved through a fractional precipitation process. First, a negative precipitation step using (NH₄)₂SO₄ 1.18 M was performed to remove contaminants. Afterwards, 5 moles of peptide per mol of bevacizumab was added to the supernatant, together with additional (NH₄)₂SO₄, to reach a final concentration of 1.20 M. Under these conditions, bevacizumab was recovered in the precipitate with 98% purity and a yield of 73%. In addition to being recyclable, the peptide’s relatively low production cost could enable the development of a single-use purification process, which would be particularly advantageous for biopharmaceutical manufacturing. Full article

Background/Objectives: Recent advances in immunotherapy have revolutionized cancer treatment, as exemplified by multiple monoclonal antibodies against programmed cell death protein 1 (PD-1) or programmed death-ligand 1 (PD-L1). Nevertheless, immunotherapeutic antibodies exhibit certain limitations, which drives the development of alternative approaches, such as small interfering RNA (siRNA)-based therapeutics. The aim of this study was to design and produce new biological PD-L1 siRNA (BioRNA/PD-L1-siRNA) molecules and further define their immunotherapeutic efficacy against non-small cell lung cancer (NSCLC) in vitro. Methods: A novel RNA molecular bioengineering platform was employed to produce new BioRNA/PD-L1-siRNA agents. The functions of BioRNA/PD-L1-siRNAs were determined by quantitative PCR, Western blot, immunofluorescence confocal imaging, flow cytometry, and PD-1/PD-L1 blockade assays in human NSCLC cells, alone and co-cultured with human peripheral blood mononuclear cells (PBMCs). Results: After heterologous overexpression and purification of five BioRNA molecules, one siRNA named BioRNA/PD-L1-siRNA-1 was identified as the most effective to selectively suppress human PD-L1 mRNA and protein levels in H460 and H1975 cells. Disruption of PD-1/PD-L1 interactions by BioRNA/PD-L1-siRNA-1 was further demonstrated via a PD-1/PD-L1 blockade bioassay. In addition, the immunomodulatory effectiveness of BioRNA/PD-L1-siRNA-1 was established in co-culture models, as indicated by the induction of T-cell and natural killer cell populations and an increase in specific cytokines and cytotoxic granules, and subsequent enhancement of apoptosis and greater inhibition of NSCLC cell viability. Conclusions: Overall, these findings demonstrate the potential of bioengineered PD-L1 siRNA entities for NSCLC immunotherapy. Full article

Background/Objectives: Glycation, a non-enzymatic post-translational modification, can increase structural heterogeneity in therapeutic monoclonal antibodies (mAbs) and is considered a critical quality attribute in biosimilar (BS) development. Despite extensive studies on glycation in individual mAbs, comparative reports on originator (OR) and BS mAbs under forced glycation conditions remain limited. This study aimed to comparatively evaluate the glycation profiles of one OR and three BS anti-tumor necrosis factor-alpha (anti TNF-α) mAb products using integrated mass spectrometry-based methods. Methods: Forced glycation was induced by incubating mAbs with 200 mM D-glucose at 37 °C for 7 days. Intact mass analysis and peptide mapping were used to assess glycation extent and site distribution, respectively. Results: Intact mass analysis revealed a consistent mass increase of approximately 486 Da across all major glycoform species for each mAb product, indicating predominant formation of the tri-glycated mAb population under the applied stress conditions. The overall glycation levels were comparable at the intact level, ranging from 67% to 73% among the OR and BS mAb products. Peptide mapping identified nine glycated lysine (K)-containing peptides, among which three major glycation hotspots (LC:V5 K145/K149, LC:V7 K183, and HC:V7 K250/K252) showed elevated occupancies (~10–16%). These sites collectively accounted for the dominant intact level mass shift. The remaining glycated peptides exhibited only minimal modification levels (<2%). Despite their distinct manufacturing processes, all tested mAb products showed nearly identical site-specific glycation profiles. Conclusions: Forced glycation susceptibility in the studied mAbs was driven by a limited set of structurally preferred K hotspots, leading to highly comparable glycation profiles across OR and BS mAb products. The combined intact mass and peptide mapping strategy provides a robust analytical platform for comparative glycation assessment in BS characterization. Full article

Background and Clinical Significance: Anti–myelin-associated glycoprotein (MAG) antibody polyneuropathy is a rare, chronic IgM-mediated demyelinating peripheral neuropathy predominantly affecting sensory nerves in older adults, commonly in association with monoclonal gammopathy of undetermined significance. Reports describing anesthetic management in patients with this condition remain extremely limited, and no specific guidelines currently exist regarding neuromuscular blocking agent (NMBA) use or neuromuscular monitoring in this population. Case Presentation: A 79-year-old man with anti-MAG antibody polyneuropathy (diagnosed in 2007) and IgM monoclonal gammopathy of undetermined significance developed disproportionate progressive lower-extremity weakness and became wheelchair-dependent following COVID-19 infection in 2020. Preoperative evaluation revealed mildly reduced left ventricular function (ejection fraction 49%), mild chronic kidney disease, and marked intrinsic hand muscle atrophy with absent deep tendon reflexes. He was scheduled for robot-assisted radical cystectomy with ileal conduit diversion under combined general and thoracic epidural anesthesia. Before NMBA administration, neuromuscular monitoring was systematically attempted at the ulnar nerve (electromyography and acceleromyography, up to 60 mA/300 μs) and the corrugator supercilii; despite visible muscle contractions following peripheral nerve stimulation, neither modality produced reliable responses at either site. Given the inability to establish reliable monitoring, the administration of NMBAs was considered to carry an unacceptable risk of a prolonged, undetectable blockade. Anesthesia was maintained with deep sevoflurane (2.0–2.5% end-tidal) and remifentanil infusion without NMBAs, titrated to a bispectral index of 40–60. Tracheal intubation was accomplished via video laryngoscopy without NMBA. The 7 h and 30 min surgery was completed without patient movement or surgical compromise. Postoperatively, the patient developed transient upper airway obstruction attributed to glossoptosis, managed successfully with head elevation and nasopharyngeal airway insertion; supplemental oxygen was required until postoperative day 3, and the patient was discharged from the high-dependency unit on postoperative day 5. Conclusions: No measurable quantitative neuromuscular response could be obtained in this patient with advanced anti-MAG antibody neuropathy, despite appropriate application of electromyography- and acceleromyography-based monitoring and the presence of visible muscle contractions following peripheral nerve stimulation. In such circumstances, avoiding NMBA administration in favor of deep volatile or intravenous anesthesia with opioid supplementation may represent a reasonable, hypothesis-generating approach in carefully selected patients; this observation does not establish the general superiority of an NMBA-free strategy, and caution is warranted before generalizing it to procedures such as robotic surgery, in which profound neuromuscular blockade is often considered desirable. Full article

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease with a complex pathogenesis that significantly affects patients’ quality of life. Type 2 inflammation plays a dominant role in its course and is associated with the activation of immune pathways involving interleukins IL-4, IL-5 and IL-13, eosinophils, and immunoglobulin E. Standard treatment methods, including corticosteroids and surgical interventions, despite their proven efficacy, often fail to provide sustained disease control and are associated with a high rate of recurrence. The aim of this review is not only to summarize the available evidence on biological therapies in CRSwNP, but also to critically evaluate their current position within treatment algorithms, with particular emphasis on patient selection, integration with endoscopic sinus surgery, comparison of available biologic mechanisms, and remaining challenges in personalized treatment strategies. The paper discusses available monoclonal antibodies, such as dupilumab, omalizumab, mepolizumab, and benralizumab, which act by selectively inhibiting key mediators of type 2 inflammation. Analysis of clinical trial results indicates that biological therapies lead to a significant reduction in nasal polyp size, improvement in nasal patency, restoration of olfactory function, and enhancement of quality of life as measured by the SNOT-22 scale. Furthermore, they demonstrate a favourable safety profile and may represent an effective therapeutic option for patients with severe, treatment-resistant disease, particularly in cases with coexisting eosinophilic asthma. Biological therapies represent a breakthrough in the treatment of CRSwNP and align with the concept of personalised medicine. Their role in clinical practice continues to expand; however, further research is required to optimise patient selection and assess long-term treatment outcomes. Full article

Immunobiologics or biologics have revolutionized the therapeutic paradigm of autoimmune and inflammatory diseases by selectively targeting and modulating dysregulated immune pathways. Compared with conventional broad-spectrum immunosuppressants, biologics provide a more specific and mechanism-based rational approach, often associated with improved efficacy and reduced adverse events. This review provides a comprehensive overview of the repertoire of therapeutic biologics, their mechanisms of action, pivotal clinical trials, and clinical applications. We discuss biologics targeting T-cell activation, depletion, and adhesion, as well as agents neutralizing pro-inflammatory cytokines, including tumor necrosis factor (TNF), interleukin (IL)-1, IL-6, IL-12, IL-17, IL-22, and IL-23, in addition to B-cell-directed therapies and IgE-modulating agents. Evidence from randomized clinical trials and observational studies highlights the profound therapeutic impact of these agents across a broad spectrum of immune-mediated diseases, including rheumatoid arthritis, psoriasis, systemic lupus erythematosus (SLE), ankylosing spondylitis, chronic spontaneous urticaria, asthma, ulcerative colitis, Crohn’s disease, and other forms of inflammatory bowel disease (IBD). Pharmacodynamic parameters, including receptor-binding affinity and downstream pathway modulation, are critical determinants of therapeutic efficacy, whereas pharmacovigilance remains indispensable for monitoring risks such as immunogenicity, opportunistic infections, and manufacturing-related variability. Continuous regulatory oversight by agencies such as the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA) safeguards standards of safety, efficacy, and quality. In parallel, the expanding development of biosimilars offers a key opportunity to enhance affordability and broaden global access to biologic therapies. Despite substantial clinical progress, important challenges persist, including disease heterogeneity, variability in therapeutic response, long-term safety concerns, and issues of cost-effectiveness. Future directions emphasize precision medicine strategies, including biomarker-guided treatment, rationally designed biologic combinations, next-generation antibody engineering, and the development of high-quality biosimilars to improve therapeutic durability, safety, and accessibility equity. By integrating mechanistic insights with clinical outcomes, this review underscores the transformative role of immunobiologics and delineates strategies to optimize their application in the management of autoimmune and inflammatory diseases. Full article

Mycoplasma bovis (M. bovis) is a major pathogen in cattle, primarily responsible for bovine respiratory disease complex (BRDC). Characterized by high infectivity and morbidity, M. bovis spreads rapidly within herds and is challenging to control and eradicate, underscoring the need for early and accurate diagnosis. To address this, we developed a competitive enzyme-linked immunosorbent assay (cELISA) for detecting M. bovis-specific antibodies in bovine sera. The assay uses recombinant MbovP579 protein (1 μg/mL) as the coating antigen and an HRP-conjugated 1A2 monoclonal antibody against MbovP579 (mAb, 0.35 μg/mL) as the competitor. With a cut-off value of 40.69% (percentage inhibition, PI), the cELISA demonstrated apparent sensitivity (90%; 95% CI: 78.64–95.65%) and specificity (96.15%; 95% CI: 90.53–98.49%) using the known background positive and negative sera. In addition, it yielded 100% positivity (9/9) against sera collected from 21 days post-immunization. The assay showed no cross-reactivity with other Mycoplasma species or two common bovine bacterial pathogens, confirming its high specificity. The intra- and inter-assay coefficients of variation (CVs) were below 10%. In clinical evaluations, this cELISA generated a 55.57% positivity rate for field samples (n = 1069) and exhibited 90.46% overall agreement (967/1069; 95% CI: 88.54–92.15%) with the commercial indirect ELISA kit, demonstrating strong diagnostic consistency. Discrepant specimens were further analyzed by a metabolic inhibition test (MIT), which suggested improved specificity, although further validation is required of this cELISA. Full article