Volume 9 Issue 4 (2025)

Chronic wounds in older adults are a growing concern due to impaired immunity, delayed epithelialization, and prolonged inflammation. These wounds lead to significant morbidity, increased healthcare costs, and reduced quality of life. Immunotherapies and adjunctive interventions show promise but remain insufficiently validated in geriatric populations. This study aimed to synthesize and map current evidence on immune-based strategies and supportive approaches for chronic wound management in the elderly, focusing on mechanisms, outcomes, and delivery challenges. A scoping review was conducted following the Arksey and O’Malley framework and PRISMA-ScR guidelines. Searches in PubMed, Scopus, and Web of Science, complemented by manual screening, identified eligible studies using the PCC (Population–Concept–Context) framework. Data extracted included therapeutic class, mechanism, wound type, and outcomes. Of 1,142 records, 89 met inclusion. Key immunotherapies included NLRP3 inflammasome inhibitors, regulatory T-cell modulators, and mTOR-targeted agents, which improved re-epithelialization and reduced cytokines in preclinical models. However, evidence in elderly human cohorts was scarce. Adjunctive strategies—such as protein supplementation, senescence-targeted agents, and engineered biomaterials—enhanced immunotherapy effects. Major barriers were the lack of wound-specific formulations, limited geriatric trial representation, and underdeveloped topical delivery systems. While immunotherapy shows mechanistic potential to correct immune dysregulation in chronic wounds, most data remain preclinical. Multi-modal strategies integrating immunotherapy, nutrition, and bioengineered scaffolds, tailored to aging physiology, are needed to improve outcomes and require rigorous clinical validation.

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Asthma and allergies both cause similar signs and symptoms and often occur together. Evidence for the effectiveness of immunotherapy has rapidly increased in recent years. Several well-designed studies have demonstrated that allergen immunotherapy may prevent the development of asthma in people with allergic rhinitis. The present study aimed to assess the effect of subcutaneous immunotherapy with specific allergens on clinical symptoms, immunological factors, and cytokines in patients with allergic rhinitis and allergic asthma from the Kyrgyz Republic. This retrospective cohort study was conducted on patients with a slight to moderate level of persistent asthma and moderate to severe allergic rhinitis who had been referred to Osh State Clinic in Osh city, Kyrgyz Republic, from March 2000 to February 2025. About 160 atopic patients with allergic rhinitis and asthma were included in the study; confirmed by history, physical examination, and SPT, irrespective of gender. In patients with allergic asthma, 23 (58.97%) patients showed complete symptom improvement, 11 (28.2%) patients showed complete improvement, and 5 (12.82%) patients showed no response to treatment. Compared to previous treatment in the allergic rhinitis group, the cytokine TGFβ was significantly increased (p < 0.001), while the levels of IFN-γ (p = 0.047) and FOXP3 (p = 0.013) were also insignificantly decreased after immunotherapy. This study examined the impact of standard subcutaneous immunotherapy on patients with allergic respiratory diseases.  The study also shows that immunotherapy stands as the most effective treatment for asthma and nasal allergies in patients who meet selection criteria, especially when medications do not work.

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The majority of people today would suffer and pass away from the hepatitis C virus (HCV); there is little knowledge of the illness in the world. Although many individuals have HCV characteristics and are affected, several individuals do not genuinely believe that this is a major issue. They are simply visiting the hospital to get short-term relief from symptoms like fatigue, nausea, jaundice; in long-term situations, they may experience fluid accumulation in the belly and easily bruise. Later on, it will develop into a chronic illness that causes liver cancer, liver failure, and scarring of the liver (cirrhosis). Since HCV continues to be a major cause of death among the populations, we established a compartmental framework for the nationwide outbreak in the current research, classifying those infected into two sections with the most effective control. To get the fundamental reproduction number, first, we employed the Next-Generation Matrix method to identify the model's endemic and disease-free equilibrium point. Using infected and disease-free equilibrium points with reproduction number coordination, as well as MATLAB software to simulate the model's numerical equations, the local and global stability were analysed.

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Cancer immunotherapy has emerged as a breakthrough treatment, but access to this therapy is heavily influenced by social, geographic, and economic factors, potentially widening healthcare disparities. This study aimed to analyse global trends in scientific publications related to cancer immunotherapy within the context of social justice, service access, and social determinants of health through a bibliometric approach. Data were collected from the Scopus database (2017–2025) using a defined Boolean search query, and analysis was performed using VOSviewer, Publish or Perish, and Microsoft Excel. The results show a gradual increase in publications, with a significant spike in 2021 and a peak in 2024. The United States was the primary hub for knowledge production, followed by European countries, while developing regions such as Africa, Southeast Asia, and Latin America had minimal representation. International collaboration patterns revealed the dominance of North–North partnerships, with limited involvement from developing countries. Keyword analysis highlighted the importance of interdisciplinary approaches, addressing social determinants, healthcare access, and financing issues, but also revealed underexplored areas such as cultural contexts and social support. The findings emphasise the urgent need for more inclusive research agendas and international collaborations involving low- and middle-income countries. Strengthening capacity building, integrating regional and non-English databases, and prioritising social and cultural dimensions in future research are recommended strategies to ensure that advances in cancer immunotherapy contribute to reducing, rather than exacerbating, global health inequities.

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In this susceptible population, respiratory syncytial virus (RSV) can cause severe lower respiratory tract illness (LRTI), which can result in substantial morbidity and mortality. Adults who have RSV infection face a substantial burden. In this study, a Phase III, randomized, double-blind, placebo-controlled trial evaluated the effectiveness of a liposome-encapsulated perfusion F protein nanoparticle-based RSV vaccine (Nano-RSV) in preventing RSV infection. Adults who were enrolled and 60 years of age or older were given either Nano-RSV or a placebo. The incidence of laboratory-confirmed RSV LRTI exhibiting three or more symptoms (cough, fever, and shortness of breath) was the main outcome. Severity of symptoms and hospitalization rates for RSV LRTI were secondary endpoints. When compared to a placebo, the Nano-RSV vaccine dramatically lowered the risk of RSV LRTI (vaccine efficacy: 82.6%, 95% CI: 74.1–90.2%). RSV LRTI-related hospitalization rates were likewise markedly lower in the immunization group. The safety profile of the Nano-RSV vaccine was comparable to that of a placebo, and it was well-tolerated. These results imply that Nano-RSV may prove to be a secure and reliable prophylactic against RSV infection and its sequelae in the elderly.

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Nipah virus (NiV) is a highly virulent zoonotic pathogen associated with significant mortality rates and limited treatment options, posing a significant public health threat. This review explores the epidemiology, molecular structure, and vaccine development efforts targeting glycoprotein G, a critical component of the virus's entry mechanism. Advances in structural biology and immunogenetics have highlighted the potential of glycoprotein G-based vaccines in preventing NiV infections. Despite promising preclinical results, challenges such as immune evasion, safety concerns, and limited clinical trials persist. Additionally, we examine the benefits of glycoprotein G-based vaccines in enhancing immune responses and preventing viral entry, as well as the limitations posed by genetic diversity and cross-reactivity. This review highlights the critical need for ongoing research to overcome existing challenges and guide future vaccine development efforts against NiV. It further underscores the necessity of innovative approaches in vaccine design to reduce the global burden of NiV infections. Glycoprotein G-based vaccines represent a promising avenue for combating NiV infections. Advances in structural biology, immune system targeting, and delivery system technology are paving the way for more effective vaccines. However, overcoming challenges such as cross-reactivity and safety concerns will require continued innovation and collaboration.

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In the immunotherapy process, a machine vision algorithm exhibits an efficient next-generation model for navigating the complex tumor microenvironment with CAR-T cells. With the integration of image-based analysis into the real-time processing algorithm, the system is able to compute spatial guidance for the immune cell, enabling it to detect, eliminate, and infiltrate cells. The variation between computational vision and cellular therapy needs to overcome the issues in the physical and biological barriers of tumors. Hence, in this paper, an effective Fejer Kernel Entropy Masked R-Convolutional Neural Network (FEM-R-CNN) was constructed. The proposed FEM-R-CNN model performs pre-processing of the CAR-T cell using the Fejer Kernel, and segmentation is performed with the entropy model. With the estimated segmentation, the Single Shot Detector (SSD) is employed for the CAR-T cell, and classification is computed using the masked R-CNN for the immunotherapy. Experimental results demonstrate that FEM-R-CNN achieves a cancer cell detection accuracy of 96.2%, a segmentation Intersection over Union (IoU) of 0.86, and a classification accuracy of 94.8%, outperforming traditional models such as U-Net and standard Mask R-CNN by over 5% across key metrics. The model improves signal-to-noise ratio by 46.4% and reduces false positive rates by 53.3%, enabling more precise CAR-T cell navigation. Immune response analysis revealed a CAR-T cell density of up to 150 cells/mm², with a 50% proliferation rate and 72% tumor cell apoptosis, indicating effective immune activity monitoring. The inference time remains competitive at approximately 70 ms per image, supporting near real-time applications.

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The tumor microenvironment (TME) is an environment that affects the growth, progression, and resistance of the tumor. AI is already transformational in the process of comprehending and attacking the TME. Using datasets with many more variables and different aspects, AI models can predict tumor behavior with greater precision than conventional techniques. In this work, the polyethylene glycol-poly (lactic-co-glycolic acid) (PEG-PLGA) nanoparticles coated with magnesium fluoride (MgF₂) and loaded with L-arginine have been developed to modulate the immunity in tumors using nitric oxide (NO). Designed to be released near the TME, PLGA-MgF₂ regulates the release of NO, producing an improvement in immune responses against cancer cells. Plasma-polymer coating of PLGA-MgF₂ nanoparticles showed an average size of 150 nm with MgF₂ shell thicknesses of 12–14 nm and L-arginine loads of 72–75%. The concentrations of NO did not change under the acidic tumor-like conditions, and the concentration was between 25 and 30 µM in the first 48 hours. Transmission electron microscopy (TEM) showed 75–120 particles per square micrometer in the tumor, and the immune cell infiltration increased by 35–45%, and the hypoxia in the tumor decreased by 30–36%. The deep neural networks and support vector machines reached 85–95% accuracy in tumor response classification using AI. The therapy led to 60% augmentation of T-cell activation, 85% tumor growth retardation, 4-fold elevation of the M1/M2 ratio, and 45% longer survival.

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This study assessed the effect of probiotic supplementation on immune response in physically active males before and after exhausting exercise. With growing evidence linking gut health to immune function, the aim was to determine whether 12 weeks of probiotics could influence key immune markers in athletes. In this semi-experimental study, 28 male athletes (18–35 years) from sports centers in Osh City, Kyrgyzstan, who engaged in regular training (≥ 3 days/week for ≥ 3 years) were randomly assigned to probiotic or placebo groups. Baseline characteristics included age (20.98 ± 5.9 years), weight (62.3 ± 9.8 kg), height (168.2 ± 7.6 cm), BMI (22.05 ± 2.4 kg/m²), and VO₂ max (59.98 ± 8.8 ml/kg/min), with no significant differences between groups. Immune markers—cell blood count (CBC), C-reactive protein (CRP), and immunoglobulin A (IgA)—were monitored at rest and after exercise. Probiotic supplementation resulted in a significant increase in monocyte levels at rest and during activity compared to placebo. Within the probiotic group, lymphocyte, monocyte, and granulocyte percentages rose significantly during activity (p < 0.001). These results indicate that probiotics may positively modulate immune function in athletes under high physical stress. Given that intense training can suppress immunity and increase susceptibility to illness, probiotic use may enhance gut microbiota, supporting immune resilience. A balanced microbiome not only aids digestion and nutrient absorption but also plays a vital role in regulating inflammation and immune responses. These findings support probiotics as a potential strategy to maintain immune health in physically active populations, warranting further investigation into strain-specific effects and long-term benefits.

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Considering what was said about Heat Shock Proteins (HSPs) role in the presentation of tumor antigens, today, before using tumor cell extracts as antigens in vaccine preparation, researchers try to increase the efficiency of antigen presentation by APCs via inducing these proteins; however, since different cell lines express different amounts of HSPs under the influence of different temperatures and different incubation times, discussing the optimal temperature and post-temperature incubation for cancer cell lines that may cause the next stages of the production of cancer cell vaccines, will be very useful. Through systematic search in PubMed/Medline using ("Tumor"[Title/Abstract] OR "Cancer"[Title/Abstract] OR "Neoplasm"[Title/Abstract]) AND ("vaccine"[Title/Abstract] OR "vaccination"[Title/Abstract]) AND ("heat shock protein"[Title/Abstract] OR "HSP"[Title/Abstract]) from 1980 to 2025. Overall, 18 articles were selected from a total of 414. The results of clinical trials confirm the use of HSPs in cancer vaccine therapy. A total of 18 studies, including 1,116 cases with different forms of cancer, were reviewed. These studies spanned different trial phases (I–III) and utilized a range of HSP-based vaccines to evaluate their safety, immunogenicity, and efficacy. HSPPC-96 was the most commonly investigated vaccine. These results indicate that the specific tumor-specific effects of the HSPs' immune response, including cluster of differentiation 4 (CD4+), interferon gamma (IFN-γ), and CD8+, lead to a much stronger vaccination. These outcomes underscore the complexity of the tumor microenvironment and the necessity for tailored approaches to maximize therapeutic success. Advances in vaccine formulation, production, and combination therapies offer promising pathways to address these challenges.

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Periodontitis is a chronic, progressive inflammatory disease characterized by the gradual destruction of the supporting structures of the teeth, including the periodontal ligament and alveolar bone. This condition primarily originates from microbial dysbiosis in the oral cavity, further influenced by the host’s immune responses and a variety of environmental and behavioral factors. As the leading cause of tooth loss and edentulism among adults, periodontitis also has far-reaching systemic consequences. An expanding body of scientific evidence has established strong associations between periodontitis and numerous systemic conditions, including cardiovascular disease, diabetes mellitus, respiratory disorders, thyroid dysfunction, and obstructive sleep apnea (OSA). This review examines the potential biological and clinical connections between periodontitis and these systemic diseases by first providing an overview of the normal physiological functions and pathological changes of each condition. It then explores the shared immunological and pathophysiological pathways, with particular focus on inflammatory mediators, immune system dysregulation, and microbial translocation. By integrating perspectives from disciplines such as microbiology, immunology, and clinical research, this review underscores the integral role of oral health in systemic well-being. It also highlights the necessity of early detection, interdisciplinary cooperation, and preventive strategies—including lifestyle modifications—to manage common risk factors and improve comprehensive patient outcomes.

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This study aims to demonstrate the significance of employing non-invasive dietary intervention to control the diversity and abundance of bacterial communities in feces. The indexing databases Scopus, PubMed/Medline, ISI Web of Science, Embase, Cochrane Central, and CINAHL were extensively searched.  Only 13 of 541 papers found in the initial searches met the criteria. Seven studies involving 210 animals were included in this meta-analysis. The SDPP group showed statistically lower Shannon (SMD: 1.20, 95% CI: 0.22–2.19, I²: 88%, p = 0.02) and Chao1 (SMD: 2.95, 95% CI: 1.99–3.91, I²: 77%, p < 0.00001) indices than the control group.  The SDPP-diet fed group showed notably lower OTU counts compared to the control group (SMD: 2.99, 95% CI: 0.67–5.32, I²: 97%, p = 0.01). The Firmicutes/Bacteroidetes ratio is reliably increased following the SDPP-fed diet (SMD: 0.68, 95% CI: 0.13–1.23, I²: 0%, p = 0.02). While noticeable differences existed between studies and difficulties were encountered in replicating basic ecological measurements, the purpose of this analysis was to identify the consistent characteristics of the gut microbiota's response to the SDPP diet, thereby pinpointing specific areas for further mechanistic research.

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Hair loss still frustrates patients and doctors alike because available treatments yield only modest results; accordingly, researchers are pursuing fresh approaches that target the disorder at its biological roots. The study reported here examined how exosome-based immune tuning affects hair regrowth in mouse models and in ex vivo human follicle cultures. When delivered to skin in the telogen phase, exosomes from adipose stem cells (ADSC-Exo) and from dermal papilla cells (DP-Exo) rewired the local follicular immune environment, and regulatory T cells rose from 2.8 ± 0.5% to 9.1 ± 0.7%, M2 macrophages climbed from 12.4 ± 1.3% to 35.2 ± 2.8%, while potentially harmful CD8 T cells dropped from 28.6 ± 2.4% to 10.2 ± 1.1%. Cytokine profiling revealed a marked decrease in pro-inflammatory signals; hence, TNF-α decreased by 68% and IL-6 by 57%, while simultaneously showing a robust increase in immunoregulatory factors, with IL-10 rising 183% and TGF-β by 156%. The observed changes in immune cell activity appear to have emerged first and closely matched the improved indicators of hair regrowth; in particular, the fraction of regulatory T cells correlated very strongly with hair shaft length (r = 0.84, p < 0.001). Our data indicate that immune reprogramming acts as a central process in exosome-driven hair regrowth, thereby underlining the design of focused immunotherapies for different types of alopecia; however, additional clinical studies are still required.

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Only some primary immunodeficiencies are often found in the population, characterized by a mild clinical phenotype and creating a significant burden on society, so-called primary minor immunodeficiencies (PMD). The study aims to create a clinical and laboratory classification of PMD in humans for basic science and practical medicine. A systematic review of scientific publications in PubMed (MEDLINE) from 1980 to 2025 was conducted using keywords through a sequential two-stage search. The terminology has been clarified and an original clinical and laboratory classification of PMD in humans has been developed according to the following rubrics: origin, affected immune factor, immune system branch and form of immunity, family history, time of debut, frequency in the population, genetic nature, clinical picture, depth of immune factor damage, severity of the patient's condition, duration of the immunological phenotype, evolutionary development scenario, regularity of manifestations, involvement of local and systemic immunity, combinations with each other and with other diseases, curability and some special headings. The significance of the developed classification for fundamental science and clinical practice has been clarified, and promising directions for further research to improve the proposed classification have been indicated. The introduction of a classification will demonstrate the diversity of PMD in humans, enabling both improved clinical diagnosis in individuals with associated immune-dependent pathology and a contribution to the intensification and optimization of clinical research.

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Allergic diseases are thought to be caused by a combination of acquired immune activation, excessive activation of innate immunity, and disruption of epithelial barrier function due to scratching, proteases, and more. The removal and inactivation of allergy-related substances in indoor environments are considered effective for reducing allergic disease symptoms. The typical allergens in Japan are Japanese cedar pollen and house dust mites (HDM), and together with bacteria and fungi, HDM are the main sources of proteases in indoor environments. We investigated the inactivating effects of ozonated water on these substances in vitro in terms of allergenicity, inflammation induction in epithelial and immune cell lines (i.e., HaCaT, A549, and RAW 264 cells), and protease activity. We observed that ozonated water inactivated the Japanese cedar pollen allergen Cry j1 and the HDM allergen Der f1, the innate immune activator lipoteichoic acid from the bacterium Staphylococcus aureus, and proteases from S. aureus, HDM, and the fungus Alternaria in an ozone concentration-dependent manner. In all experiments, ozonated water at 7.5 mg/L significantly inactivated allergy-related substances compared to the untreated group (p < 0.01). The comparison of the effects of ozonated water treatment and thermal treatment at 80 °C revealed that ozonated water treatment is superior to thermal treatment in terms of both effectiveness and reaction time. Together, our findings demonstrate that ozonated water can inactivate allergy-related substances in the indoor environment. The management of indoor environments using ozonated water can thus be expected to contribute to the alleviation of symptoms and suppression of allergic diseases.

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Immune cell engineering is a cutting-edge strategy in modern immunotherapy, enabling precise, personalized treatments using modified immune cells such as CAR-T and NK cells. This paper introduces an Intelligent Optimized Machine Learning (IoML) framework with Sorting Slap Swarm Optimization (SSSO) to enhance immune cell design. The IoML model employs a ranking-based Deep Neural Network (DNN) to predict therapeutic metrics—cytotoxicity, persistence, safety, and antigen specificity—from high-dimensional biological data. Public datasets including GSE120575, ImmPort, and the Single Cell Portal were used for training and validation. The SSSO algorithm efficiently explores the immune cell design space, selecting optimal configurations based on predicted performance. Simulation results highlight the IoML model as an intelligent, low-overhead solution for personalized immunotherapy. It achieved a classification accuracy of 96.8%, precision of 96.1%, recall of 95.9%, and F1-score of 96.0%, outperforming Particle Swarm Optimization, Genetic Algorithm, and Differential Evolution methods. In ranking analysis, the model attained a score of 0.92 within 30 iterations. Experimental validation confirmed optimized CAR-T cells with cytotoxicity of 96.2%, persistence of 93.8%, and apoptosis resistance of 94.3%, while reducing off-target effects to 3.2%. These findings demonstrate that the IoML–SSSO framework surpasses conventional approaches in accuracy, convergence speed, and biological relevance, effectively identifying top-performing immune cell configurations for next-generation immunotherapy platforms.

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Spray-dried plasma (SDP), a byproduct of the meatpacking industry, is commonly used in swine diets to enhance growth and optimize feed utilization. Multiple studies have shown that animals' immune responses can be improved by giving them plasma proteins like SDP orally. This study aims to highlight the importance of non-invasive dietary interventions in stimulating immune responses and enhancing immunological characteristics. A comprehensive search was conducted using the indexing databases Scopus, PubMed/Medline, ISI Web of Science, Embase, Cochrane Central, and CINAHL and out of the 541 publications initially searched, only 13 fit the specified criteria. This meta-analysis incorporated seven trials, including a total of 210 animals. The SDP group had significantly lower IL-10 levels (SMD: −1.79, 95% CI: −2.43, −1.15, I2: 60%, p = 0.04) compared to the control group.  The SDP group showed statistically higher TNF-α (SMD: 2.32, 95% CI: 0.74, 3.89, I²: 92%, p = 0.004) than the control group.  Also, the SDP group showed statistically higher IgG (SMD: 0.59, 95% CI: 0.03, 1.15, I²: 54%, p = 0.04) than the control group. SDP alters cytokine secretion, promoting an anti-inflammatory immune profile. The positive impact of SDP in this model suggests that these supplements may help enhance immune responses.

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Non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-related mortality worldwide, with therapeutic progress often limited by late-stage diagnosis and the variable effectiveness of existing treatments. Immune checkpoint inhibitors (ICIs) have emerged as a promising therapeutic approach, but their clinical success depends critically on accurate biomarker-based patient stratification. Current strategies for integrating biomarkers, however, remain fragmented and lack the robustness needed for reliable prediction of treatment outcomes. To address this gap, we propose a novel multimodal deep learning framework that integrates CT images, PET/CT scans, and curated biomarker profiles to improve prediction of ICI treatment response in NSCLC patients. Our model employs a pre-trained Xception encoder for advanced image feature extraction, an Encoder Attention Network for semantic representation learning, and a DenseNet-inspired metadata processor for structured biomarker data. Multimodal features are fused through a Block Dense Attention Convolutional Module with Self-Attention Multi-Head (BDAC-SAMH) mechanism, enabling richer interactions across modalities. Experimental evaluation demonstrates that our framework achieves 94.3% accuracy, 92.1% sensitivity, and 93.5% specificity, significantly outperforming conventional CNN-based unimodal methods. Importantly, the proposed system improves prediction of key ICI biomarkers, including PD-L1, TMB, and MSI, by 15.6% compared to unimodal baselines while revealing novel biomarker interactions. This highlights its potential to guide personalized immunotherapy strategies in NSCLC.

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In recent decades, immunotherapy has revolutionized the landscape of cancer treatment, offering novel therapeutic approaches that harness the body's immune system to combat malignancies effectively. This systematic review explores the pivotal role of immunotherapy in oncology, highlighting its diverse modalities, mechanisms of action, clinical applications, and ongoing challenges. Beginning with an overview of the historical evolution of cancer therapy, emphasis is placed on the emergence of immunotherapy as a cornerstone alongside traditional modalities such as chemotherapy and surgery. The review comprehensively examines various types of immunotherapy, including checkpoint inhibitors, chimeric antigen receptor T cells (CAR T cells) therapy, cytokine therapy, oncolytic viruses, and exosome-based therapies. Mechanisms behind these treatments are clarified, showing how they boost anti-tumor immune system reactions and thus enhance patient outcomes. Recent advancements for each modality are discussed, drawing on seminal studies and clinical trials cited in the literature. Furthermore, the review addresses clinical successes and challenges associated with immunotherapy, including resistance mechanisms and adverse effects, as highlighted in recent research. Technological innovations in drug delivery systems and biotechnology are explored as critical enablers of immunotherapy's efficacy and safety profiles. Finally, the review outlines future directions in the field, proposing strategies to overcome current limitations and optimize treatment efficacy. The synthesis of findings underscores the transformative impact of immunotherapy on cancer care and highlights opportunities for further research and clinical integration.

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This study enrolled 120 patients undergoing elective abdominal or orthopedic surgery (aged 18–75 years, ASA classification I-III) and employed a prospective randomized controlled design to evaluate the effects of regional anesthesia (RA group, n = 60) versus general anesthesia (GA group, n = 60) on perioperative neuro-immune regulation. Through systematic assessment of perioperative cytokine profiles, immune cell subsets, autonomic nervous function, and clinical outcome indicators, we investigated the mechanisms underlying the role of regional anesthesia in inflammation control. The results demonstrated that at 24 h postoperatively, serum IL-6 levels in the RA group were significantly lower than those in the GA group (156.8 ± 35.7 vs 215.3 ± 41.2 pg/ml, p < 0.001), with the IL-6/IL-10 ratio reduced by 46.2% (1.89 ± 0.35 vs 3.51 ± 0.62, p < 0.001), indicating optimized pro-inflammatory/anti-inflammatory balance. Regarding immune cell function, the RA group showed a 56.9% decrease in M1/M2 ratio (0.59 ± 0.15 vs 1.37 ± 0.28, p < 0.001), maintained higher NK cell cytotoxic activity (58.3 ± 9.5% vs 38.7 ± 7.8%, p < 0.001), and exhibited a 213% increase in Treg/Th17 ratio (1.44 ± 0.28 vs 0.46 ± 0.12, p < 0.001). Autonomic nervous function assessment revealed that the RA group had 103.8% higher HRV-HF power (785.3 ± 142.6 vs 385.4 ± 98.7 ms², p < 0.001), 55.1% lower LF/HF ratio (1.28 ± 0.35 vs 2.85 ± 0.62, p < 0.001), and 77.3% elevated plasma acetylcholine levels (32.8 ± 7.5 vs 18.5 ± 5.2 pmol/ml, p < 0.001). Correlation analysis indicated that HRV-HF was positively correlated with IL-10 (r = 0.625, p < 0.001), and the LF/HF ratio was positively correlated with IL-6 (r = 0.512, p < 0.01), suggesting an association between autonomic nervous function and immune status. In terms of clinical outcomes, the RA group demonstrated lower postoperative pain scores, reduced incidence of cognitive dysfunction, and shortened hospital stay. This study suggests that regional anesthesia may improve perioperative inflammatory response by optimizing autonomic nervous balance, regulating cytokine networks, and modulating immune cell function; however, the precise mechanistic pathways require further investigation and validation.

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