Broadening the translational immunology landscape

Authors

  • M. Peakman

    Corresponding author
    1. NIHR Comprehensive Biomedical Research Centre, Guy's and St Thomas’ NHS Foundation Trust and King's College London, London, UK
    • Department of Immunobiology, King's College London
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Correspondence: M. Peakman, Department of Immunobiology, King's College London School of Medicine, 2nd Floor, Borough Wing, Guy's Hospital, London SE1 9RT, UK.

E-mail: mark.peakman@kcl.ac.uk

Summary

It is just over 5 years since Clinical and Experimental Immunology came under the direction of a new team of Editors and made a concerted effort to refresh its approach to promoting clinical and applied immunology through its pages. There were two major objectives: to foster papers in a field which, at the time, we loosely termed ‘translational immunology’; and to create a forum for the presentation and discussion of immunology that is relevant to clinicians operating in this space. So, how are we doing with these endeavours? This brief paper aims to summarize some of the key learning points and successes and highlight areas in which translational gaps remain.

Gathering opinions

One of the better ways to serve the clinical and experimental immunology community has proved to be in asking it to provide reviews, opinion pieces, disease guidelines and high-level, ‘best-practice’ essays aimed at postgraduate training and beyond. These latter have proved a considerable success, and we have now published more than 13 of these papers in a series describing the approach to patients with different immune-mediated conditions [1-3]. These papers have also become a publicly accessible resource through the British Society for Immunology website [4]. This concept has spawned a further wave of recent review papers focusing similarly on ‘immunology in the clinic’, which have also proved to be of major interest to readers, attracting thousands of downloads [5-22]. Papers that provide guidelines and disease classifications to practising clinical immunologists and rheumatologists are an important part of this dissemination process, and here we have particularly promoted areas such as the vasculitides [3, 23-29] and primary immunodeficiency [30-33].

Clinical immunology in practice

The journal has also welcomed regular research papers that have addressed important topics in the translational pathway. Various aspects of clinical care in primary immunodeficiency have been highlighted, including patient and research databases, patient-centric screening protocols, clinical uses of immunoglobulin replacement and health economics [34-42]. The journal is striving to become a key forum for these issues, especially in disease settings that are niche areas for clinical immunologists, such as immunodeficiency, and therefore do not otherwise have clear publishing outlets. We have also highlighted emerging fields, including tumour immunotherapy [14-17, 43, 44] and the autoinflammatory diseases [11-13], as well as the more traditional domains of the translational immunologist, such as allergy [18, 22, 45]. Clinically relevant advances in cell separation technology and the identification of pathogenic T cells in autoimmunity and inflammation have also been featured [46-48].

New insights into immunopathology

One of the strengths of the journal is the prevailing interest in underlying cellular and molecular pathways of disease. In recent years we have published numerous review papers highlighting current understanding in this area. We were among the first to capture the importance of T helper type 17 (Th17) cells in human disease [49], and recently highlighted their continued importance in immunobiology and disease settings in a mini-review series [50-55]. A further strength has been a widespread focus on the integration of environmental influences (e.g. infectious agents) and immune function to influence complex polygenic diseases. This included an entire issue of the journal devoted to different aspects of the hygiene hypothesis [56-75], as well as papers on viruses and type 1 diabetes [5-10] and other aspects of host–pathogen and host–environment interactions that affect inflammatory diseases [19, 76-81]. Other notable review papers on disease pathogenesis included several focusing on isolated molecular/disease pathways such as CD23, immunoglobulin (Ig)G-mediated effects, CD46, gut hormones, Toll-like and related receptors (TLRs), the inflammasome, ectosomes, RNA/DNA sensors and natural killer (NK) T cells [21, 82-90], as well as on disease mechanisms including T cells and chemokines in autoimmune and inflammatory diseases [91-93], cytokines in lupus nephritis [94], TLRs in IgA nephropathy [95] and anti-proteinase 3 antibodies in vasculitis [96].

Novel therapeutics

We have highlighted several promising new therapeutic avenues, including dendritic cell-based therapies for autoimmunity, allergy and cancer [97], the potential of mesenchymal stem cell therapies [98] and the mechanistic pathways that new drug regimes can expose; for example, in breast cancer therapy with zoledronate [99]. Several novel and existing therapeutic modalities have been featured [100-106], as well as treatment challenges [107], including the complications of tumour necrosis factor (TNF)-α blockade [108] and the hurdles faced when considering novel combination immunotherapies for autoimmune diseases such as type 1 diabetes [109]. Pharmacogenomics is an allied and emerging concept in therapeutics [110]. Natural immune modulators based on parasites are the focus of many groups’ research [111].

In summary, the Journal has come some considerable distance in addressing the stated goal of becoming ‘The’ Journal of Translational Immunology.

Acknowledgements

The author's research is funded/supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health.

Disclosure

The author has no conflicts of interest to disclose.