European Journal of Immunology

Background: Patients receiving anti-TNF treatment for chronic inflammatory disease display impaired antibody responses, but it remains unclear how immune memory formation is affected. We evaluated antibody responses and memory B cells (Bmem) after COVID-19 booster vaccination in inflammatory bowel disease (IBD) patients receiving anti-TNF treatment. Methodology: Blood was sampled at baseline, 1, and 6 months after WH1/BA.5 bivalent or XBB.1.5 monovalent vaccination from 27 IBD patients receiving intravenous anti-TNF and 44 controls. Neutralizing antibodies were measured using an infectious virus assay. SARS-CoV-2 spike receptor binding domain (RBD)-specific serum IgG was quantified by ELISA, and RBD-specific Bmem were immunophenotyped by flow cytometry using recombinant proteins from ancestral, Omicron BA.1, BA.5, XBB.1.5, and JN.1 variants. Results: Serum IgG to vaccine RBD and neutralizing antibodies in patients increased pre to 1 month post-vaccination, but were lower than controls. Ancestral-, BA.5- and XBB.1.5-specific Bmem increased after vaccination but were significantly lower in patients than controls. Within RBD-specific Bmem, frequencies of recently activated CD21lo cells were increased after vaccination, and were higher in patients than controls. Fewer antigen-specific Bmem in patients expressed IgG4, and more expressed IgG3 or IgD following vaccination. Following vaccination, more RBD-specific Bmem recognized multiple viral variants. However, patients had fewer Bmem that could bind to subvariants than controls. Conclusion: Antibody and Bmem responses to COVID-19 booster vaccination in anti-TNF-treated IBD patients displayed reduced capacity, durability and cross-reactivity, suggesting impaired immune memory for protection against breakthrough infection. This supports the recommendation for annual booster vaccination to prevent severe disease and viral spread.

Keratin gene mutations are often associated with inflammatory skin disorders, in which the ensuing immunopathology is generally attributed to disrupted barrier integrity and consequent microbial invasion. Here, we challenge this paradigm by demonstrating a role for keratin 76 (Krt76) in thymic central tolerance to skin-targeting autoimmune responses. We show that transfer of Krt76-/- thymic lobes under the kidney capsules of athymic recipients is sufficient to induce expansion of effector T cells in the secondary lymphoid organs, T cell skin infiltration, and autoantibody reactivity to both skin and oral mucosa tissue. Mechanistically, we demonstrate that loss of thymic Krt76 expression disrupts canonical differentiation of the thymic medulla and impacts the development of post-AIRE-expressing keratinocyte-like mimetic medullary epithelial cells (termed CorneoTECs). Notably, Krt76-expressing CorneoTECs differentially express a specific skin and oral mucosa-associated gene signature, including skin-specific tissue self-antigens (TSAs). Importantly, in the absence of Krt76 this skin and oral mucosa TSA signature is almost entirely lost, and T cell negative selection is affected. Collectively, these data highlight a heretofore unanticipated role for Krt76 in thymic central tolerance to skin and oral mucosatargeting T cells and suggest that loss-of-keratin-associated skin disorders could also include autoimmune pathologies.

A subset of untreated primary prostate cancer (PCa) contain substantial focal T-cell infiltrates, but whether these reflect antitumor responses that could potentially be enhanced by immune checkpoint blockade (ICB) remains unclear. We used immunohistochemistry, immunofluorescence, whole-slide spatial analysis, bulk RNA sequencing, and immune-cell deconvolution to characterize immune infiltrates in untreated primary PCa. Absolute CD8 T-cell density generally increased with total CD3 T-cell density, but the CD8/CD3 ratio decreased as overall T-cell density increased, indicating a preferential increase in CD4 T cells. Highly infiltrated tumors also had lower GZMB abundance relative to CD8 T-cell abundance. Multiplex analysis showed trends toward greater TIM3 and LAG3 expression among PD1CD8 T cells and increased regulatory T-cell features in highly infiltrated tumors. TIGIT cell density and the TIGIT/CD3 ratio increased with T-cell infiltration, whereas PD1/CD3 was not associated with overall CD3 T-cell density. Both TIGIT/CD3 and PD1/CD3 ratios were enriched within lymphoid aggregates compared with matched tumor and benign regions, consistent with these structures being checkpoint-rich immune niches. Transcriptomic analyses supported a shift in relative immune composition toward CD4 T cells and selective increases in immune checkpoints. Together these findings suggest that effective immune responses in a subset of primary PCa with increased T-cell infiltration are being repressed by several mechanisms and may respond to therapies targeting specific immunosuppressive mechanisms.

Liver metastases (LM) remain a major cause of death from different cancer types, in particular malignancies of the gastrointestinal tract. Liver metastases predict a poor response to immunotherapy due, among others, to the immunotolerant microenvironment (ME) of the liver and loss of local and systemic cytotoxic T cells. Thus, strategies that can reprogram the immune ME of the liver and restore cytotoxic T cell reactivity are being sought. We previously reported that estrogen signaling blockade impedes the growth of LM by reducing MDSC accumulation and monocyte/macrophage polarization. The aim of this study was to elucidate the underlying mechanism(s) and assess whether estrogen signaling in the myeloid lineage was driving the immunotolerant ME of LM. To this end, we generated mice with conditional myeloid cell-specific deletions of estrogen receptors (ER) or ER{beta} and analyzed in these mice the effect of ER loss on the liver immune ME and the outgrowth of LM. In mice with ER, but not with ER{beta} deletion, we observed a marked reduction in the growth of murine colon carcinoma MC-38 liver metastases as compared to their respective controls. Flow cytometry and immunohistochemistry revealed a decrease in macrophages that were polarized to the pro-tumorigenic M2-like phenotype and a concomitant increase in activated CD8+ T and NK cells relative to controls. Bulk RNAseq analysis performed on hepatic immune cells infiltrating the liver revealed changes in the expression of key cytokines/chemokines mediating immune cell recruitment, activation and polarization, including Ccl5 (upregulated) and Csf1 (downregulated). Taken together, the data suggest that ER signaling in myeloid-derived cells programs the immune landscape and contributes to an immunosuppressive and metastases-growth permissive ME in the liver.

Current approaches for imaging fibrotic remodeling have sensitivity, specificity and cost drawbacks that limit both preclinical research and clinical diagnosis. Here, we show that fast green FCF, a small molecule that binds to fibrillar collagen, enables highly sensitive and specific imaging of fibrosis in lung samples from mice and humans using fluorescence microscopy. We report strategies for using fast green FCF staining to assess fibrotic remodeling using precision-cut lung slice and whole-biopsy preparations. Our findings demonstrate that fluorescence imaging of fast green FCF-stained collagen will be useful for fibrosis research and may help to improve detection of fibrosis in clinical pathology.

Substantial inter-individual variation in susceptibility to viral infection persists despite widespread vaccination, and its immunological basis remains poorly understood. We investigated how innate and adaptive immune responses contribute to susceptibility to SARS-CoV-2 infection during the early COVID-19 pandemic. We compared two groups of vaccinated individuals who either remained uninfected or became infected during the first Omicron wave. Blood samples were collected at baseline and 24 weeks later. Peripheral blood mononuclear cells (PBMCs) and polymorphonuclear neutrophils (PMNs) were isolated and stimulated with the TLR7/8 agonist R848 to assess innate responses. PBMCs were stimulated with SARS-CoV-2 peptide pools and highly purified inactivated viruses (ancestral and Omicron BA.1) to evaluate adaptive immunity. Prior to infection, individuals in the infected group exhibited reduced CD4 and CD8 T cells proliferative responses, alongside with increased TNF production across all stimulation conditions, despite largely comparable immune phenotypes, indicating a pre-existing functional immune deficit. Following infection, T-cell proliferation and IFN-gamma production were partially restored in response to viral antigens, although responses to Omicron BA.1 remained suboptimal. This functional deficit was accompanied by heightened inflammatory activity, including increased TNF and IFN-gamma production, elevated anti-nucleocapsid IgG3 levels, higher frequencies of B cells and myeloid cells, reduced circulating interferon-inducible T-cell Alpha Chemoattractant (I-TAC) concentrations, and a modest impairment in PMN IL-8 responses. Notably, these alterations were detectable prior to infection and persisted thereafter, indicating that they represent determinants rather than consequences of viral infection. Importantly, beyond differences in the magnitude of immune responses, protection was associated with the degree of functional coordination within the humoral compartment, as reflected by the relationship between Spike-binding antibodies and neutralizing activity. Together, these results demonstrate that susceptibility to Omicron infection is linked to a pre-existing and persistent functional immune imbalance affecting both innate and adaptive arms of immunity.

Hirschsprung disease (HSCR) is a severe birth defect where ganglia of the enteric nervous system (ENS) are missing from distal bowel. The aganglionic segment is also characterized by increased epithelial permeability and pro-inflammatory immune activation. These problems may sequentially lead to translocation of gut microbes into the colon wall and systemic circulation, resulting in enterocolitis and sepsis. Current HSCR treatment via surgical resection of the aganglionic segment is lifesaving but not curative, often leaving patients with persistent gastrointestinal complications including recurrent risk of enterocolitis. As alternative, we are developing a regenerative medicine strategy based on in situ stimulation of tissue-resident ENS progenitors via rectal administration of the neurotrophic factor GDNF. Here, we report that GDNF-based therapy has pleiotropic gastrointestinal effects in a mouse model of short-segment HSCR, beyond its role in ENS regeneration. Interestingly, we found that these protective effects are not restricted to the aganglionic distal colon, also positively impacting the ENS-containing proximal colon. GDNF treatment reduces bacterial translocation both locally and in peripheral organs, and this is associated with recovery of the key epithelial junction proteins CLDN3, ZO1 and DSG2. Furthermore, multiparameter flow cytometry-based analysis of 55 lymphoid and 17 myeloid cell subtypes revealed that GDNF treatment has global anti-inflammatory effects, preferentially affecting innate over adaptive immunity. Overall, these findings highlight a critical role for GDNF treatment in reestablishing proper epithelial and immune cell homeostasis, offering promising therapeutic avenues not only for HSCR but also potentially for other intestinal disorders with overlapping pathophysiology.

The cell-intrinsic complement system has emerged as an important orchestrator of a variety of cell-physiological processes, with complement components interacting with intracellular effector systems to regulate cellular responses to pathogens or noxious stimuli. For instance, intracellular C5 signaling through a mitochondrial C5a receptor (C5aR1) controls IL-1{beta} production in human monocytes and macrophages. Here, we investigated whether cell-intrinsic C3 similarly regulates inflammatory responses in macrophages. In LPS-stimulated C3 knockout THP-1-derived macrophages, interferon (IFN)-{beta} production was increased, accompanied by elevated expression of interferon-stimulated genes and enhanced secretion of IFN-induced cytokines and chemokines. C3-deficient cells showed increased phosphorylation of IRF3 at Ser396 and a stabilization of the interaction between IRF3 and TBK1, along with enhanced IRF3 dimerization and nuclear translocation. TBK1 phosphorylation was unaffected, indicating that C3 limits IRF3-TBK1 complex formation rather than upstream TBK1 activation. Small-molecule inhibitors of complement factors B and D restored full-length C3 abundance in LPS-stimulated primary human macrophages, consistent with inhibition of the C3 convertase. It also reduced LPS-induced IFN-{beta} production in primary human macrophages and THP-1 cells, suggesting that full-length, uncleaved C3 suppresses IFN-{beta} production. Collectively, these findings identify cell-intrinsic C3 as a suppressor of IFN-{beta} production in human macrophages, highlighting the importance of the cell-intrinsic complement system in fine-tuning inflammatory responses to pathogens.

Hybridoma screening in semi-solid medium typically employs antigens labeled with visible fluorophores (e.g., FITC, AF488) to enable single-step identification of antibody-secreting clones. However, conventional chemical conjugation via NHS-esters or isothiocyanate groups frequently modifies lysine residues located within epitopes, potentially abrogating antibody recognition of these critical regions. Here, we describe a SpyTag SpyCatcher-based site-specific labeling strategy that circumvents epitope damage during semi-solid medium screening. A 16-amino-acid SpyTag was genetically fused to the C-terminus of the target antigen, enabling covalent conjugation to an sfGFP SpyCatcher fluorescent probe. In semi-solid medium supplemented with SpyTag-antigen and sfGFPSpyCatcher, positive hybridoma clones were readily identified by distinct fluorescent halos, whereas negative clones showed no detectable signal. Notably, the site-specific method yielded a significantly higher frequency of fluorescence-positive clones compared to the conventional AF488-labeled antigen method, suggesting that epitope preservation enhances screening recovery. Furthermore, this approach did not impair hybridoma growth or final clone positivity, offering a simple, rapid, and epitope-compatible method for monoclonal antibody screening.

Malaria vaccines provide waning protection from disease that is correlated with the production of antibodies to the repeat region of the circumsporozoite protein (CSP). CSP-based vaccines display limited durability in malaria-naive individuals yet are even less effective in malaria-experienced individuals, suggesting the generation of non-optimal humoral immunity in response to both infection and vaccination. To address this hypothesis, we performed a cross-species, comprehensive analysis of B cell responses to CSP after Plasmodium infection or immunization, focusing our analysis on the repeat and C-terminus domains included in malaria subunit vaccines. Herein we demonstrate that the repetitive nature of the protective region of the CSP protein independently impacts the differentiation of the CSP-specific B cells, impinging on their ability to recall for multiple subsequent exposures.

IgM is the most ancient antibody isotype, playing an important role in both circulatory and mucosal immune responses across vertebrates, yet structural characterization of its polymeric forms is limited outside of mammals. Here, we report the cryo-electron microscopy structure of mallard duck secretory (S) IgM at 3.37-[A] resolution. The structure revealed a pentameric core globally similar to human SIgM, supporting the view that pentameric IgM is subject to strong evolutionary constraints. However, compared to mammalian structures, we observed species-specific differences at molecular interfaces. Surface plasmon resonance binding assays characterizing secretory component (SC)-IgM interactions supported structural observations and, when compared to IgA binding, revealed isotype-specific contributions from the avian SC N-terminal extension. Together, these findings establish a comparative structural framework for polymeric IgM across vertebrates and provide insight into how avian SIgM-specific features may support mucosal immunity in birds.

BCR and CD40 signals are integrated to shape B cell transcriptional output, but how the two pathways are coordinated at the level of individual signaling nodes is incompletely understood. Using primary mouse B cells stimulated with anti-IgM, anti-CD40, or both (Both), we defined six DEG classes reflecting costimulation-dependence and cross-pathway antagonism. We also connected a CD40-driven, BCR-suppressed B-cell-identity module (Pax5, Aicda, Bcl6, Cd79a/b, Cd19) to an increase in Blimp1 protein at 24 h. Building on our previous work, which showed that cIAP prolongs IKK/ERK activity after single-pathway stimulation (Shinohara et al., 2016), we added an IAP inhibitor 10 min after Both stimulation and generated transcriptomic data. This profiling showed that cIAP is required not only for late canonical NF-{kappa}B-driven genes, as predicted, but also, unexpectedly, for the entire BCR-dominant, CD40-independent negative-feedback module (Cd5, Il10, Nfkbid, Spry1/2) identified in the first dataset. A separate module was instead amplified by IAP inhibition, with kinetics compatible with non-canonical NF-{kappa}B de-repression, directly addressing a question we left open in that study regarding the BCR-side partners of cIAP. Together, these correlative findings converge on a single model: cIAP is not a CD40-restricted adaptor but a hub shared by BCR and CD40, whose feedback simultaneously sustains canonical, fate-instructive signaling and restrains the non-canonical pathway, thereby coupling receptor-proximal signal dynamics to the B cell's downstream transcriptional and fate decisions.

Antigen presenting cells (APC) can bind HIV-1 and subsequently trans infect CD4+ T cells. In comparison to direct (cis) infection of CD4+ T cells by free virus, APC-mediated HIV-1 trans infection is significantly more efficient and requires lower virus titers. As such, B cell-mediated HIV-1 trans infection of CD4+ T cells, particularly in secondary lymphoid organs (SLO) where B and CD4+ T cells interact frequently in and around B cell follicles, represents an efficient pathway for establishing and maintaining the latent HIV-1 reservoir. The molecular events involved in HIV-1 binding to B cells and transfer to CD4+ T cells are poorly understood. B cells are exposed to various activation signals in SLO including CD40 ligand (CD40L), interleukin-4 (IL-4), interferon-g (IFN-g), and B cell activating factor (BAFF). Here, we treated B cells with these different signals, or combination of signals, to identify those that facilitate HIV-1 binding to B cells and trans-infection of CD4+ T cells, and the mechanisms involved. We found that CD40L/IL-4 stimulated B cells are highly efficient mediators of HIV-1 trans infection of CD4+ T cells due to their enhanced capacity to bind HIV-1. Single cell RNA sequencing of differentially stimulated B cell populations revealed that CD40L/IL-4 stimulation significantly induced expression of the C-type lectin CD205. Confocal microscopy revealed that HIV-1 and CD205 co-localized on CD40L/IL-4 stimulated B cells, and antibody blocking of CD205 on these cells significantly reduced HIV-1 binding. Taken together, this study identifies CD205 as a critical receptor on B cells that facilitates HIV-1 binding and the transfer of virus to CD4+ T cells. Insight into the role of B cell mediated HIV-1 trans infection of CD4+ T cells is critical to optimizing the effectiveness of HIV-1 therapies in SLO.

Background: Immunochemotherapy (ICT) is considered standard in regards to care for small-cell lung cancer (SCLC) in extensive stages, yet reliable biomarkers for treatment response remain elusive. While previous univariate analyses suggest specific peripheral lymphocyte subsets correlate with survival, the systemic immune response involves complex, multivariate interactions that require advanced analytical approaches. Methods: This paper analysed high-dimensional flow cytometry data from 32 patients with stage IV SCLC treated with carboplatin, etoposide, and atezolizumab. Peripheral blood was analysed at baseline (V0) and longitudinally during treatment. To identify potential early predictive biomarkers and mitigate sample attrition in later cycles, we focused on baseline and measurements after two cycles of ICT (V1). We employed a rigorous machine learning framework utilising nested cross-validation, bootstrapping, and permutation-based statistical testing to evaluate eleven different regression and survival models. Results: Under model-appropriate metrics, regressors did not generalise (R2 <0); conversely, censoring-aware Random Survival Forests (RSF) successfully extracted robust prognostic signatures. Baseline immune profiles (V0) achieved a concordance index (C-index) of 0.66 (p= 0.015), while dynamic changes from V0 to V1 ({triangleup}V) achieved a C-index of 0.65 (p= 0.022). Crucially, absolute values measured after two cycles of ICT (V1) yielded no significant signal (p= 0.445). Feature importance analysis confirmed the prognostic value of Th17 normalisation and identified Naive Regulatory T cells and Memory B cells as candidate components. Conclusion: Machine learning validation confirms a predictive signal in the peripheral immune profile of SCLC patients. Early dynamic shifts in the balance between regulatory and effector immune arms are associated with prognosis, contrasting with the lack of signal in absolute counts after two cycles of ICT. These findings establish a proof of concept for multivariate liquid biopsy immune profiling, warranting confirmation in larger cohorts and highlighting the necessity of integrating systemic and tumour-intrinsic data.

Purpose: Clinical response to immune checkpoint blockade (ICB) remains variable. We asked whether immune-cell populations in the tumor microenvironment (TME) are associated with benefit across treatments and tumor types. Experimental Design: We analyzed pretreatment bulk tumor RNA-seq from ICB cohorts and TCGA. Gene-level effects associated with ICB response or TCGA survival were projected onto Human Primary Cell Atlas profiles of 157 cell types. Cox and mixed-effects models accounted for cancer type, cohort, and therapy, as appropriate. After {gamma}{delta} T cells emerged as a leading population, we adjusted their associations for eight CD8 estimators and evaluated them using TRUST4-based TRG/TRD reconstruction and single-cell RNA-seq. Results: {gamma}{delta} T-cell programs were among the signatures consistently associated with ICB response and favorable TCGA survival. Across ICB cohorts, {gamma}{delta} T-cell abundance was associated with response (n=1,356; OR, 1.38; 95% CI, 1.23-1.56) and overall survival (n=1,074; HR, 0.82; 95% CI, 0.76-0.88), with associations persisting after CD8 adjustment. ICB-response-associated cell-type profiles were strongly concordant with chemotherapy response (r=0.92) and moderately concordant with radiation response (r=0.58); targeted and hormone therapy analyses were underpowered. TRUST4 reconstruction and single-cell RNA-seq provided orthogonal support for the {gamma}{delta} signal. Conclusions: Pretreatment {gamma}{delta} T-cell abundance was associated with favorable ICB outcomes and survival across cancers, while related cell-type programs extended to selected non-immunotherapy response settings. Although associative and context dependent, these findings support prospective evaluation of {gamma}{delta} T-cell abundance as a candidate tumor-immune biomarker.

Immune checkpoint inhibitors targeting the PD-1/PD-L1 axis have shown great promise in treating bladder cancer and are now part of the standard treatment for advanced disease. However, many patients still fail to respond to treatment and at present many biomarkers are assessed but have yet shown only limited results. Therefore, with the advent of combination treatments and the increase of immune related adverse event, the search for reliable predictive biomarkers is paramount. Using a multiplexed enhanced FRET-FLIM based technique (QF-Pro) we quantified the interaction of PD-1/PD-L1, CTLA-4/CD80 and TIGIT/CD155 immune checkpoints in a pre-treatment TMA of 46 patients treated with atezolizumab. The association between higher PD-1/PD-L1 ICP interaction state and treatment efficacy was demonstrated in the male sample cohort, where it identified patients with better PFS. Conversely, patients exhibiting higher CTLA-4/CD80 engagement had a worse response to atezolizumab. Remarkably, the dual assessment of patients with high PD-1/PD-L1 and low CTLA-4/CD80 allowed to identify the best responders. These results indicate that the monitoring of patients immune profile in urothelial carcinoma might be critical in identifying patients who may benefit from combination therapy.

Introduction: C3 glomerulopathy (C3G) is driven by fluid-phase alternative complement pathway dysregulation, with emerging evidence linking glomerular neutrophil infiltration to disease severity. Neutrophil extracellular traps (NETs) are implicated in other forms of glomerulonephritis. However, their participation in the pathogenesis of C3G remains undefined. Methods: Kidney biopsies from 33 patients with C3G (15 with dense deposit disease [DDD] and 18 with C3 glomerulonephritis [C3GN]) were compared with 15 anti-neutrophil cytoplasmic antibody associated vasculitis (AAV) biopsies as a neutrophil-rich disease control in this retrospective cross-sectional study. Glomerular neutrophils and NETs were identified using immunofluorescence, staining for myeloperoxidase, citrullinated histone H3, peptidyl arginine deiminase-4, and DNA. Supervised machine learning was used to quantify glomerular NET formation, and the data were correlated with kidney function at time of biopsy using linear regression. Results: Intraglomerular NETs were abundant and detected in the majority of glomeruli in C3G biopsies. Compared with AAV, C3G showed a significantly higher fraction of neutrophils forming NETs, despite similar neutrophil counts per glomerulus. NET abundance was similar in DDD and C3GN. In exploratory analyses, a greater proportion of glomeruli containing NETs was associated with lower kidney function (estimated glomerular filtration rate) at biopsy, and this association remained significant after adjustment for age, C3G subtype, and interstitial fibrosis. Conclusions: These observations demonstrate that intraglomerular NETs are a common and prominent observation in C3G and are associated with reduced kidney function at biopsy. These findings raise the possibility that NET deposition in glomeruli is a previously unrecognized driver of glomerular injury in C3G.

Nipah virus (NiV) is a highly pathogenic zoonotic paramyxovirus with epidemic potential. Despite the threat NiV poses, no therapeutics are licensed to treat infection. Studies have shown that monoclonal antibodies (mAb) can protect animals against NiV and the related Hendra virus (HeV). The best studied mAb, m102.4, has been used to treat infected patients on a compassionate basis, and has entered clinical trials. However, there is a need to define additional mAbs with therapeutic potential, which could be combined with m102.4 to improve neutralising potency and breadth. Here, we isolated five high affinity mAbs from an mRNA immunised pig, which bound the G glycoprotein derived from NiV Malaysia strain (NiV-M), and one of which (mAb A2) also bound HeV G. Aligned with this, all mAbs neutralised NiV-M pseudovirus but only mAb A2 neutralised pseudovirus representing the NiV Bangladesh (NiV-B) strain. mAb A2 and the most potent NiV-M neutralising mAb, C1, showed minimal competition with each other and m102.4, suggesting recognition of non-overlapping epitopes. Single-particle cryogenic electron microscopy of the NiV-M G receptor binding domain complexed to A1 and C2 Fab fragments revealed distinct epitopes that did not overlap with the receptor-binding site, targeted by m102.4, suggesting action through steric impedance of receptor binding or interference downstream of receptor engagement. Inoculation of mAb A2 to hamsters did not provide complete protection against NiV-B challenge (60% survival), however, a split dose of mAb A2 and m102.4 provided the same protection as m102.4 alone (100% survival). Collectively, these data demonstrate the potential of the porcine model for isolation of therapeutic candidate mAbs, which contribute both to our understanding of the NiV G antigenic landscape, and the development of mAb combinations, that exert complementary mechanisms of neutralisation, for therapeutic intervention.

Background VEXAS syndrome is a late onset autoinflammatory disease caused by somatic UBA1 mutations and characterized by heterogeneous systemic and hematologic manifestations. We aimed to describe all identified Belgian cases through a national multicenter cohort. Methods We conducted a retrospective study across four Belgian tertiary centers. Clinical, biological, genetic, therapeutic, and outcome data were collected using standardized anonymized case report forms. Analyses were descriptive. Results Twenty-one male patients were identified between January 2018 and May 2025. General symptoms such as Fatigue, weight loss and sweating occurred in 95% of cases. The most frequent manifestations were cutaneous (85.7%), hematologic (76.2%), articular (66.7%), thromboembolic (57.1%), chondritis (42.9%), ophthalmologic (38.1%), pulmonary (38.1%). Other manifestations also included vasculitis (61.9%). At diagnosis, 95% had anemia, macrocytic in 57%, and 28.6% had thrombocytopenia. Corticosteroids were the main first line therapy. Second line treatments included anti IL 6 agents (46.7%), JAK inhibitors (20%), and azacitidine (14.3%). Complete remission occurred in 50% of patients receiving anti IL 6 therapy and in 33% treated with either JAK inhibitors or azacitidine. Two patients underwent allogeneic stem cell transplantation, one died from infectious complications. Twenty six infectious episodes were recorded, including opportunistic infections. Six patients (28.6%) died during follow-up, four from infectious complications. Conclusion This first Belgian national cohort confirms the clinical heterogeneity of VEXAS syndrome and highlights substantial infectious morbidity and mortality. Access to targeted second-line therapies, particularly anti IL-6 agents and JAK inhibitors, remains challenging despite apparent clinical benefit.

Klebsiella pneumoniae (Kp) is a WHO high-priority pathogen for vaccine development, yet previous efforts failed largely because key protective immune mechanisms remain unclear. Here we show that protective immunity conferred by mucosal mRNA vaccines (but not parenteral) require neither serum IgG nor airway secretory IgA, but instead depends on a previously unrecognized lung-resident CD8IL-17 T-cells (Tc17) that rapidly recruits neutrophils/macrophages to eliminate bacteria. To therapeutically harness this paradigm, we developed INSPIRE, a machine learning-engineered exosome platform incorporating donor-screened, miRNA-bioactive backbones (miR-21-mediated airway barrier penetration and miR-155-associated dendritic-cell activation through SOCS1/Inpp5d axis) and computationally designed peptides that boosts 11.6-fold mRNA encapsulation and 3-fold dendritic-cell cross-presentation. Intranasal INSPIRE-mRNA vaccination confers near-complete protection against clinically relevant Kp strains while intramuscular counterparts fail (below ~30% survival). Leveraging pIgR-/- and IL-17-/- mice coupled with T-cell depletions, we demonstrate the protection is Tc17-dependent. This work overturns the antibody-centric dogma and redefines a non-canonical Tc17-correlate for extracellular bacterial pneumonia.