Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment of various hematological malignancies. Recently, CAR-T has been used in refractory auto-immune diseases with initial encouraging results. In this systematic review, we examined the safety and efficacy of CAR-T in patients with refractory auto-immune diseases. PubMed/Medline, EMBASE, Web of Science, and Scopus search revealed 1552 articles, of which 24 were included for the final analysis. 80 patients with autoimmune diseases received CAR-T cell therapy, of which 52 patients had systemic lupus erythematosus, 16 patients had systemic sclerosis, 7 patients had idiopathic inflammatory myopathies, 2 patient had anti-phospholipid antibody syndrome, 2 patients had rheumatoid arthritis, and 1 patient had Sjogren's disease. 44 patients got CD-19 CAR-T and 36 patients got BCMA/CD-19 compound CAR-T. All the patients achieved an immunosuppression-free state at the last follow-up. Of the 47 patients with follow-up data, 79 patients developed cytokine release syndrome (CRS) and 4 patients developed neurotoxicity. None of the patients had fatal adverse events with CAR-T cell therapy. CAR-T appears to be safe and effective in patients with refractory autoimmune diseases. Future studies are crucial to further validate these findings, explore long-term outcomes, and refine the treatment protocols to enhance efficacy and safety.

Conventional therapies for systemic lupus erythematosus (SLE) often fail to achieve lasting remission. CAR T cell therapy, which depletes autoreactive B cells, offers a novel approach for refractory cases. We aim to consolidate the current evidence on CAR T cell therapy in the treatment of SLE. PubMed, Scopus, Web of Science, the Cochrane Library, and Clinical trials.gov were searched up to November 18, 2024, for SLE patients receiving CAR T cell therapy. Data on efficacy, safety, and treatment responses were analyzed. Ten studies involving 47 SLE patients were identified. Among those patients, 81% achieved lupus low disease activity state (LLDAS) with improvements in disease activity and serologic markers. B cell depletion was consistent, with immune recovery over time. Cytokine release syndrome (CRS) occurred in 87% but was mostly mild (grades 1-2). Immune effector cell-associated neurotoxicity syndrome (ICANS) occurred only in one patient and was mild (grade 1). CAR T cell therapy shows promise in refractory SLE, achieving durable remission with manageable toxicity. Further trials are needed to confirm long-term outcomes.

It is known that in less than a third of patients presenting sudden hearing loss, the disorder can be attributed to viral infection, trauma, neoplasms, and vascular and autoimmune diseases. However, the role of the HIV in the onset of this disease has not yet been well described. A 46-year-old female, in an immunosuppression state induced by HIV infection, presented with sudden bilateral hearing loss, with no improvement despite treatment. Several mechanisms were reported by which the virus could induce damage to the auditory pathway. However, little is known regarding the prevention and treatment of this morbidity.

anti-rejection measure and in patients with an overactive immune system, such as in autoimmune diseases. Some people are born with intrinsic defects in their Immunodeficiency, also known as immunocompromise, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that affect the patient's immune system. Examples of these extrinsic factors include HIV infection and environmental factors, such as nutrition. Immunocompromisatio Immunodeficiency, also known as immunocompromise, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that affect the patient's immune system. Examples of these extrinsic factors include HIV infection and environmental factors, such as nutrition. Immunocompromisation may also be due to genetic diseases/flaws such as SCID. In clinical settings, immunosuppression by some drugs, such as steroids, can either be an adverse effect or the intended purpose of the treatment. Examples of such use include organ transplant surgery as an anti-rejection measure and in patients with an overactive immune system, such as in autoimmune diseases. Some people are born with intrinsic defects in their immune system, or primary immunodeficiency. A person who has an immunodeficiency of any kind is said to be immunocompromised. An immunocompromised individual may be particularly vulnerable to opportunistic infections, in addition to normal infections that could affect anyone. It also decreases cancer immunosurveillance, in which the immune system scans the body's cells and kills neoplastic ones. They are also more susceptible to infectious diseases owing to the reduced protection afforded by vaccines.

<h4>Objective</h4>Chimeric antigen receptor (CAR)-T cell and natural killer cell therapies are emerging as treatments for autoimmune diseases (AIDs), capable of inducing immune reprogramming and drug-free remission. However, their efficacy, safety, and durability across AIDs remain incompletely defined.<h4>Methods</h4>We performed a systematic review and meta-analysis of proportions to evaluate the efficacy and safety of CAR-based therapies in AIDs. PubMed, Embase, and CENTRAL were searched from January 1, 2010, to October 20, 2025. The primary outcome was medication-free remission (MFR); secondary outcomes included disease-specific remission indices, incidence of adverse events and their severity. Subgroup and meta-regression analyses were conducted.<h4>Results</h4>Of 3367 records screened, 56 studies met the inclusion criteria (15 eligible for meta-analysis; 41 synthesized qualitatively). For CAR-T cell therapies, among SLE patients, pooled MFR was 0·76 and DORIS remission 0·75. Subgroup analyses revealed a longer disease duration was associated with lower remission rates. From the qualitative analysis, CAR-T cell therapies demonstrated promising clinical efficacy and seroconversion rates in other AIDs, such as systemic sclerosis, myositis and myasthenia gravis. Across all AIDs, CRS of any grade occurred in 0·63, but grade ≥ 3 CRS and any grade of ICANS were negligible (both 0·00). Hypogammaglobulinaemia of any grade occurred in 0·47, while grade ≥ 3 events were rare. Cytopenias were common: neutropenia and anemia of any grade were most frequent. Severe cytopenias occurred in ≤0·3. Infection within 3 months occurred in 0·29.<h4>Conclusion</h4>CAR-T cell therapies targeting CD19 or BCMA appear highly effective in inducing remission in refractory autoimmune diseases, with predominantly mild CRS and negligible neurotoxicity.

International travel, especially to areas with higher risk of infection, poses unique risks for infectious and non-infectious issues in patients with history of systemic autoimmune inflammatory diseases. We searched Medline, Scopus, and relevant rheumatology and other professional society guidelines for management of vaccinations and travel medications for immunocompromised travelers. The immune status of travelers with a history of systemic autoimmune inflammatory disease may have an impact on the safety and efficacy of vaccines, especially live-attenuated vaccines. For individuals on immunosuppressive medications, live vaccines are generally contraindicated. However, if safe intervals off immunosuppression are possible, live vaccines may be feasible. Chemoprophylaxis for malaria or acute mountain sickness may be indicated based on travel itinerary. Safe international travel is possible for patients with history of systemic autoimmune inflammatory diseases, including for those receiving immunosuppressive therapy, but may warrant coordination between a patient's rheumatologist and a travel medicine provider.

Progressive multifocal leukoencephalopathy. Progressive multifocal leukoencephalopathy, a demyelinating disease of the central nervous system, is caused by a polyomavirus. This opportunistic virus is demonstrable in affected brain tissue obtained by biopsy or at autopsy. The disease commonly occurs in immunocompromised patients secondary to lymphoproliferative disease, immunosuppressive therapy, autoimmune disorders and acquired immunodeficiency syndrome. The prognosis is poor. Published in American family physician (1988)

Immunocompromised pediatric patients, including hematopoietic cell and solid organ transplant recipients, those undergoing chemotherapy for malignancy, and those receiving biologic response modifiers for autoimmune or inflammatory conditions, are at risk for severe disease from vaccine-preventable respiratory viral infections such as influenza, SARS-CoV-2 (COVID-19), and respiratory syncytial virus (RSV). These children face higher rates of hospitalization, intensive care admissions, and mortality, reflecting contributions from an immature immune system, absence of immunologic memory, and/or increased environmental exposures. Immunization recommendations for immunocompromised children are largely extrapolated from studies conducted among healthy children and/or immunocompromised adults due to a paucity of primary data on immunological responses and vaccine efficacy in immunocompromised children. Trends in vaccine hesitancy in the general population, ongoing transmission of respiratory viral infections in the community, and suboptimal vaccination rates among immunocompromised children and their household contacts further compound the risk for this vulnerable population. As the number of children with immunocompromising conditions expands, it is imperative that primary care practitioners and subspecialists who care for immunocompromised children ensure appropriate immunizations are provided to these patients and their household and community contacts. We will review available data supporting the current guidelines regarding vaccine dosing, scheduling, and formulations to prevent influenza, COVID-19, and RSV infections in immunocompromised children. Furthermore, we highlight key knowledge gaps and areas of current investigation aimed at improving respiratory viral vaccine immunogenicity and optimize protection.

Purpose: This study investigates the impact of varying degrees of immunosuppression on the clinical outcomes of immunocompromised individuals, particularly those with autoimmune diseases or post-solid organ transplant statuses, in the context of COVID-19. By focusing on these highly vulnerable populations, the study underscores the significant health inequalities faced by immunocompromised patients, who experience disproportionately worse outcomes in comparison to the general population. Methods: A retrospective cohort analysis of the K-COV-N dataset was conducted, comparing the effects of immunosuppression in autoimmune and transplant groups with matched control groups. Propensity score matching was employed to minimize inequalities in baseline characteristics, ensuring a more equitable comparison between immunocompromised and non-immunocompromised individuals. Outcomes included COVID-19-related in-hospital mortality, 28-day mortality, ICU admissions, and the need for respiratory support among 323,890 adults in the Republic of Korea. Patients with cancer or other immunosuppressive conditions, such as HIV, were excluded. Subgroup analyses assessed the influence of specific immunosuppressive medications and vaccination extent. Results: Significantly elevated in-hospital mortality was found for patients with autoimmune diseases (adjusted Odds Ratio [aOR] 2.749) and transplant recipients (aOR 7.567), with similar patterns in other outcomes. High-dose steroid use and a greater nu

Autoimmune diseases (AIDs) are chronic, systemic disorders marked by aberrant immune responses against self-antigens, leading to widespread inflammation and tissue damage. Cardiovascular diseases (CVDs), the leading cause of mortality in AID patients, share common pathological mechanisms rooted in endothelial dysfunction and chronic inflammation. This comprehensive review explores the intricate relationship among AIDs, CVDs, and endothelial function, emphasizing the role of immune dysregulation and endothelial cell activation in disease progression. The endothelium emerges as both a target and mediator in this interplay, linking systemic inflammation to vascular pathology. The review synthesizes current evidence on the pathophysiology of AIDs, the epidemiology and mechanisms of CVDs, and the pivotal role of endothelial dysfunction. It also presents findings from a metaanalysis highlighting increased cardiovascular risk among AID patients and shared inflammatory and oxidative stress pathways. Novel therapeutic strategies involving endothelial protection and immune modulation are discussed as promising avenues for mitigating the comorbidity burden. The findings underscore the need for integrative research and early intervention strategies to address the shared etiologies and improve outcomes for patients affected by these interrelated conditions

<h4>Background</h4>Stiff-person syndrome spectrum disorder (SPSD) is a rare autoimmune disorder characterized by progressive muscle stiffness and painful spasms. Autoimmune comorbidities are frequently reported in SPSD, contributing to disease burden; however, their pooled frequency has not been systematically quantified. This meta-analysis aimed to estimate the pooled frequency of autoimmune comorbidities in SPSD and to examine differences across clinical subtypes and between GAD65 antibody-positive and -negative patients.<h4>Methods</h4>We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus from inception to August 23, 2025. Two reviewers independently screened studies and extracted data. Studies reporting autoimmune comorbidity frequency in confirmed SPSD were included; reviews, case reports, overlapping cohorts, and studies with fewer than five patients were excluded. Pooled overall and disease-specific frequencies of autoimmune comorbidity were estimated using random- or fixed-effects models, with separate estimates for SPSD subtype and GAD65 antibody-positive and -negative patients.<h4>Results</h4>A total of 38 studies were included, encompassing 1166 patients with SPSD. The pooled frequency of autoimmune comorbidities in this population was 51.2%. The most common were diabetes (including T1D and LADA; 29.0%), autoimmune thyroid disease (25.1%), and hypothyroidism (12.0%), followed by pernicious anemia (10.3%), myasthenia gravis (9.3%), Graves' disease (7.3%), vitiligo (5.8%), and celiac disease (5.0%). Sjögren's syndrome (2.4%), systemic lupus erythematosus (2.1%), and rheumatoid arthritis (1.9%) were relatively uncommon. These frequencies were substantially higher than those in the general population. Frequencies varied across SPSD subtypes: PERM (79.5%), classic SPS (61.9%), and focal or segmental SPS (38.2%). Autoimmune comorbidities were approximately twice as frequent among GAD65-positive patients (63.9%) compared with GAD65-negative patients (34.3%).<h4>Conclusions</h4>Autoimmune comorbidities are highly prevalent in SPSD, particularly in PERM, classic SPS, and GAD65-positive patients. These findings guide screening and management to improve clinical outcomes and provide insights for future research into SPSD pathophysiology.

A woman in her late fifties was admitted to the Family Medicine Inpatient Service directly from Rheumatology clinic for polyarticular pain and erythema with concern for infection. She was taking immunosuppressant medications for a history of multiple autoimmune diseases. Examination showed increasing erythema and tenderness on the upper and lower extremity joints. Histologic evaluation, surgical evaluation, and cultures were consistent with mycobacterium haemophilum infection. Mycobacterium haemophilum is an uncommon opportunistic infection that usually affects immunocompromised patients. The patient was treated with a multi-drug antibiotic regimen for several months due to drug resistance. Although this opportunistic infection is not common it should be considered in the differential of immunocompromised patients with skin and articular symptoms. Treatment outcomes are usually favorable if it caught earlier in the course.

Objective This study aimed to identify the optimal strategy for patients with autoimmune diseases by comparing the immunoreaction and effectiveness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines between healthy individuals and patients.Methods The PubMed, Embase, and Cochrane Library were searched for eligible studies on effectiveness and immunoreaction to SARS-CoV-2 vaccines in patients with autoimmune diseases published until October 07, 2022. The quality of each included study was evaluated by independent reviewers using National Institutes of Health study quality assessment tool, and the STATA 15.0 software was used for all statistical analyses.Results A total of 84 publications were included and analyzed in this meta-analysis, favoring healthy controls regarding serological response (risk ratio, RR=0.88, 95% CI (confidence interval): 0.86–0.91), antibody response (RR=0.90, 95%CI: 0.87–0.94), and incidence of seropositive immunoglobulin G (IgG) (RR=0.74, 95%CI: 0.69–0.80) than patients post-vaccination. Patients with autoimmune diseases developed lower IgG (standard mean difference, SMD=−0.64 95%CI: −0.84 to −0.43) and antibody titer level (SMD=−1.39, 95%CI: −2.30 to −0.49) than healthy individuals in AU/ml. Stratified analyses were conducted further according to various potential factors in full-text studies.Conclusion Patients who are immunocompromised and received more vaccines demonstrated poorer humoral responses and seropositive incidence a

30-50% of AIDS patients with this lymphoma, and in almost 50% of patients with another lymphoma … the nature of the diseases are com- pletely different, autoimmune diseases, like cancers, present … standing how and why autoimmune diseases occur. Some autoimmune diseases primarily occur in