{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:04:21Z","timestamp":1792760661019,"version":"4.5.0"},"reference-count":104,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Immunopharmacology"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.intimp.2026.116885","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T19:35:23Z","timestamp":1779219323000},"page":"116885","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Immune dysregulation in immune thrombocytopenia: impaired establishment of exhaustion-associated regulatory programming"],"prefix":"10.1016","volume":"183","author":[{"given":"Tingfang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"12","key":"10.1016\/j.intimp.2026.116885_bb0005","doi-asserted-by":"crossref","DOI":"10.1016\/j.autrev.2024.103677","article-title":"Autoimmune effector mechanisms associated with a defective immunosuppressive axis in immune thrombocytopenia (ITP)","volume":"23","author":"Li","year":"2024","journal-title":"Autoimmun. Rev."},{"key":"10.1016\/j.intimp.2026.116885_bb0010","doi-asserted-by":"crossref","first-page":"1499014","DOI":"10.3389\/fimmu.2025.1499014","article-title":"The function of T cells in immune thrombocytopenia","volume":"16","author":"Bu","year":"2025","journal-title":"Front. Immunol."},{"key":"10.1016\/j.intimp.2026.116885_bb0015","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.979116","article-title":"Tumor accomplice: T cell exhaustion induced by chronic inflammation","volume":"13","author":"Fang","year":"2022","journal-title":"Front. Immunol."},{"issue":"670","key":"10.1016\/j.intimp.2026.116885_bb0020","doi-asserted-by":"crossref","first-page":"eabo4997","DOI":"10.1126\/scitranslmed.abo4997","article-title":"Advancing beyond the twists and turns of T cell exhaustion in cancer","volume":"14","author":"van der Heide","year":"2022","journal-title":"Sci. Transl. Med."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0025","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41568-025-00883-y","article-title":"Epigenetic regulation of T cell exhaustion in cancer","volume":"26","author":"Kang","year":"2026","journal-title":"Nat. Rev. Cancer"},{"issue":"5","key":"10.1016\/j.intimp.2026.116885_bb0030","doi-asserted-by":"crossref","DOI":"10.1016\/j.bbcan.2024.189162","article-title":"T cell exhaustion in human cancers","volume":"1879","author":"Kang","year":"2024","journal-title":"Biochim. Biophys. Acta Rev. Cancer"},{"key":"10.1016\/j.intimp.2026.116885_bb0035","doi-asserted-by":"crossref","DOI":"10.1016\/j.phrs.2024.107161","article-title":"Molecular insight into T cell exhaustion in hepatocellular carcinoma","volume":"203","author":"Zhu","year":"2024","journal-title":"Pharmacol. Res."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0040","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1146\/annurev-immunol-090222-110914","article-title":"T cell exhaustion","volume":"42","author":"Baessler","year":"2024","journal-title":"Annu. Rev. Immunol."},{"issue":"6","key":"10.1016\/j.intimp.2026.116885_bb0045","doi-asserted-by":"crossref","DOI":"10.1016\/j.celrep.2022.111606","article-title":"Single-cell transcriptome profiling and chromatin accessibility reveal an exhausted regulatory CD4+ T cell subset in systemic lupus erythematosus","volume":"41","author":"Guo","year":"2022","journal-title":"Cell Rep."},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0050","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/imm.13881","article-title":"Transient anti-TCR\u03b2 mAb treatment induces CD4 (+) T cell exhaustion and prolongs survival in a mouse model of systemic lupus erythematosus","volume":"174","author":"Gonzalez","year":"2025","journal-title":"Immunology"},{"key":"10.1016\/j.intimp.2026.116885_bb0055","doi-asserted-by":"crossref","first-page":"1476575","DOI":"10.3389\/fimmu.2025.1476575","article-title":"Identification and immunoassay of biomarkers associated with T cell exhaustion in systemic lupus erythematosus","volume":"16","author":"Zheng","year":"2025","journal-title":"Front. Immunol."},{"issue":"8","key":"10.1016\/j.intimp.2026.116885_bb0060","doi-asserted-by":"crossref","DOI":"10.1002\/mco2.70311","article-title":"Nanoparticle-delivered siRNA targeting NSUN4 relieves systemic lupus erythematosus through declining Mitophagy-mediated CD8+T cell exhaustion","volume":"6","author":"Ren","year":"2025","journal-title":"MedComm"},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0065","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.jaci.2016.04.013","article-title":"CD4(+) T cells in patients with chronic inflammatory rheumatic disorders show distinct levels of exhaustion","volume":"138","author":"Frenz","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"10.1016\/j.intimp.2026.116885_bb0070","doi-asserted-by":"crossref","first-page":"1383110","DOI":"10.3389\/fimmu.2024.1383110","article-title":"Abatacept increases T cell exhaustion in early RA individuals who carry HLA risk alleles","volume":"15","author":"Long","year":"2024","journal-title":"Front. Immunol."},{"issue":"3","key":"10.1016\/j.intimp.2026.116885_bb0075","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1177\/1076029614562952","article-title":"Soluble programmed death 1 (PD-1) is decreased in patients with immune thrombocytopenia (ITP): potential involvement of PD-1 pathway in ITP Immunopathogenesis","volume":"22","author":"Birtas Atesoglu","year":"2016","journal-title":"Clin. Appl. Thromb. Hemost."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0080","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1080\/21645515.2017.1342913","article-title":"Percentages of PD-1(+)CD4(+)T cells and PD-L1(+)DCs are increased and sPD-1 level is elevated in patients with immune thrombocytopenia","volume":"14","author":"Wang","year":"2018","journal-title":"Hum. Vaccin. Immunother."},{"issue":"5","key":"10.1016\/j.intimp.2026.116885_bb0085","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1055\/s-0039-1679909","article-title":"PD-1\/PD-L pathway potentially involved in ITP Immunopathogenesis","volume":"119","author":"Nie","year":"2019","journal-title":"Thromb. Haemost."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0090","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.thromres.2015.07.017","article-title":"Decreased level of cytotoxic T lymphocyte antigen-4 (CTLA-4) in patients with acute immune thrombocytopenia (ITP)","volume":"136","author":"Zhu","year":"2015","journal-title":"Thromb. Res."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0095","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/21645515.2015.1059975","article-title":"The effect of single course high dose dexamethasone on CD28\/CTLA-4 balance in the treatment of patients with newly diagnosed primary immune thrombocytopenia","volume":"12","author":"Guo","year":"2016","journal-title":"Hum. Vaccin. Immunother."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0100","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.thromres.2013.10.029","article-title":"Decreased Tim-3 and its correlation with Th1 cells in patients with immune thrombocytopenia","volume":"133","author":"Shan","year":"2014","journal-title":"Thromb. Res."},{"key":"10.1016\/j.intimp.2026.116885_bb0105","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2023.110597","article-title":"Mitochondrial ROS-dependent CD4(+)PD-1(+)T cells are pathological expansion in patients with primary immune thrombocytopenia","volume":"122","author":"Li","year":"2023","journal-title":"Int. Immunopharmacol."},{"key":"10.1016\/j.intimp.2026.116885_bb0110","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2021.630693","article-title":"Low-dose Decitabine inhibits cytotoxic T lymphocytes-mediated platelet destruction via modulating PD-1 methylation in immune thrombocytopenia","volume":"12","author":"Han","year":"2021","journal-title":"Front. Immunol."},{"issue":"7","key":"10.1016\/j.intimp.2026.116885_bb0115","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1182\/blood-2018-05-847624","article-title":"Low-dose chidamide restores immune tolerance in ITP in mice and humans","volume":"133","author":"Zhao","year":"2019","journal-title":"Blood"},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0120","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/j.1600-0609.2006.00780.x","article-title":"Abnormality of CD4(+)CD25(+) regulatory T cells in idiopathic thrombocytopenic purpura","volume":"78","author":"Liu","year":"2007","journal-title":"Eur. J. Haematol."},{"key":"10.1016\/j.intimp.2026.116885_bb0125","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s13045-014-0072-6","article-title":"T cell immune abnormalities in immune thrombocytopenia","volume":"7","author":"Ji","year":"2014","journal-title":"J. Hematol. Oncol."},{"issue":"8","key":"10.1016\/j.intimp.2026.116885_bb0130","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1182\/blood.2020008477","article-title":"Low-dose decitabine modulates T-cell homeostasis and restores immune tolerance in immune thrombocytopenia","volume":"138","author":"Han","year":"2021","journal-title":"Blood"},{"issue":"7","key":"10.1016\/j.intimp.2026.116885_bb0135","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1182\/blood-2003-07-2268","article-title":"Adult chronic idiopathic thrombocytopenic purpura (ITP) is the manifestation of a type-1 polarized immune response","volume":"103","author":"Panitsas","year":"2004","journal-title":"Blood"},{"key":"10.1016\/j.intimp.2026.116885_bb0140","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.thromres.2020.04.004","article-title":"Dexamethasone suppresses the Th17\/1 cell polarization in the CD4(+) T cells from patients with primary immune thrombocytopenia","volume":"190","author":"Li","year":"2020","journal-title":"Thromb. Res."},{"issue":"14","key":"10.1016\/j.intimp.2026.116885_bb0145","doi-asserted-by":"crossref","first-page":"3710","DOI":"10.1182\/bloodadvances.2023009949","article-title":"Deciphering the genetic basis of immune thrombocytopenia: current evidence for genetic predisposition in adult ITP","volume":"7","author":"Georgi","year":"2023","journal-title":"Blood Adv."},{"issue":"9","key":"10.1016\/j.intimp.2026.116885_bb0150","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1038\/nm921","article-title":"T-cell-mediated cytotoxicity toward platelets in chronic idiopathic thrombocytopenic purpura","volume":"9","author":"Olsson","year":"2003","journal-title":"Nat. Med."},{"issue":"5","key":"10.1016\/j.intimp.2026.116885_bb0155","doi-asserted-by":"crossref","DOI":"10.1016\/j.rpth.2025.102977","article-title":"Natural killer cell granule protein 7 contributes to CD8(+) T cell-mediated platelet apoptosis in immune thrombocytopenia","volume":"9","author":"Wang","year":"2025","journal-title":"Res. Pract. Thromb. Haemost."},{"issue":"6","key":"10.1016\/j.intimp.2026.116885_bb0160","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1038\/ni.2035","article-title":"T cell exhaustion","volume":"12","author":"Wherry","year":"2011","journal-title":"Nat. Immunol."},{"issue":"8","key":"10.1016\/j.intimp.2026.116885_bb0165","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1038\/nri3862","article-title":"Molecular and cellular insights into T cell exhaustion","volume":"15","author":"Wherry","year":"2015","journal-title":"Nat. Rev. Immunol."},{"issue":"19","key":"10.1016\/j.intimp.2026.116885_bb0170","doi-asserted-by":"crossref","DOI":"10.3390\/ijms21197357","article-title":"Cellular and molecular mechanisms of CD8(+) T cell differentiation, dysfunction and exhaustion","volume":"21","author":"Verdon","year":"2020","journal-title":"Int. J. Mol. Sci."},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0175","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1038\/s41577-019-0221-9","article-title":"Defining \u2018T cell exhaustion\u2019","volume":"19","author":"Blank","year":"2019","journal-title":"Nat. Rev. Immunol."},{"key":"10.1016\/j.intimp.2026.116885_bb0180","article-title":"T Cell exhaustion in cancer immunotherapy: heterogeneity, mechanisms, and therapeutic opportunities","author":"Yu","year":"2026","journal-title":"Adv. Sci. (Weinheim, Baden-Wurttemberg, Germany)"},{"key":"10.1016\/j.intimp.2026.116885_bb0185","doi-asserted-by":"crossref","first-page":"1646292","DOI":"10.3389\/fimmu.2025.1646292","article-title":"Dissecting the role of T cell exhaustion in cancer progression: a multifaceted approach","volume":"16","author":"Li","year":"2025","journal-title":"Front. Immunol."},{"key":"10.1016\/j.intimp.2026.116885_bb0190","doi-asserted-by":"crossref","first-page":"1198551","DOI":"10.3389\/fimmu.2023.1198551","article-title":"Hierarchical transcriptional network governing heterogeneous T cell exhaustion and its implications for immune checkpoint blockade","volume":"14","author":"Tian","year":"2023","journal-title":"Front. Immunol."},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0195","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1038\/s41590-022-01337-5","article-title":"Divergent clonal differentiation trajectories of T cell exhaustion","volume":"23","author":"Daniel","year":"2022","journal-title":"Nat. Immunol."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0200","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.it.2023.02.006","article-title":"Exhausted CD8(+) T cells face a developmental fork in the road","volume":"44","author":"Zander","year":"2023","journal-title":"Trends Immunol."},{"key":"10.1016\/j.intimp.2026.116885_bb0205","doi-asserted-by":"crossref","first-page":"1204363","DOI":"10.3389\/fimmu.2023.1204363","article-title":"Strategies to reinvigorate exhausted CD8(+) T cells in tumor microenvironment","volume":"14","author":"Guan","year":"2023","journal-title":"Front. Immunol."},{"issue":"3","key":"10.1016\/j.intimp.2026.116885_bb0210","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1002\/JLB.5MR1120-778R","article-title":"TCF-1 maintains CD8(+) T cell stemness in tumor microenvironment","volume":"110","author":"Wen","year":"2021","journal-title":"J. Leukoc. Biol."},{"issue":"12","key":"10.1016\/j.intimp.2026.116885_bb0215","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/s41571-022-00689-z","article-title":"Clinical implications of T cell exhaustion for cancer immunotherapy","volume":"19","author":"Chow","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"10.1016\/j.intimp.2026.116885_bb0220","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.926714","article-title":"The road less taken: less appreciated pathways for manipulating CD8(+) T cell exhaustion","volume":"13","author":"Pichler","year":"2022","journal-title":"Front. Immunol."},{"key":"10.1016\/j.intimp.2026.116885_bb0225","doi-asserted-by":"crossref","DOI":"10.1016\/j.trac.2021.116505","article-title":"Analytical methods for the detection of PD-1\/PD-L1 and other molecules related to immune checkpoints","volume":"146","author":"Wang","year":"2022","journal-title":"TrAC Trends Anal. Chem."},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0230","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/jcp.27172","article-title":"PD-1\/PD-L1 immune checkpoint: potential target for cancer therapy","volume":"234","author":"Dermani","year":"2019","journal-title":"J. Cell. Physiol."},{"issue":"9","key":"10.1016\/j.intimp.2026.116885_bb0235","doi-asserted-by":"crossref","DOI":"10.3390\/pharmaceutics16091181","article-title":"Alternative strategies for delivering Immunotherapeutics targeting the PD-1\/PD-L1 immune checkpoint in Cancer","volume":"16","author":"Hoshi","year":"2024","journal-title":"Pharmaceutics"},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0240","doi-asserted-by":"crossref","DOI":"10.1084\/jem.20182232","article-title":"PD-1 restraint of regulatory T cell suppressive activity is critical for immune tolerance","volume":"218","author":"Tan","year":"2021","journal-title":"J. Exp. Med."},{"issue":"16","key":"10.1016\/j.intimp.2026.116885_bb0245","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13164040","article-title":"PI3K\/Akt pathway: the indestructible role of a vintage target as a support to the Most recent immunotherapeutic approaches","volume":"13","author":"Caforio","year":"2021","journal-title":"Cancers"},{"key":"10.1016\/j.intimp.2026.116885_bb0250","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/978-981-15-3266-5_3","article-title":"Roles of PD-1\/PD-L1 pathway: signaling, Cancer, and beyond","volume":"1248","author":"Ai","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"issue":"9","key":"10.1016\/j.intimp.2026.116885_bb0255","first-page":"552","article-title":"Lower expression of PD-1 and PD-L1 in peripheral blood from patients with chronic ITP","volume":"21","author":"Zhong","year":"2016","journal-title":"Hematology (Amsterdam, Netherlands)"},{"issue":"3","key":"10.1016\/j.intimp.2026.116885_bb0260","doi-asserted-by":"crossref","first-page":"127","DOI":"10.3345\/cep.2022.00920","article-title":"Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-\u03b3 in pediatric immune thrombocytopenia","volume":"66","author":"El-Gendy","year":"2023","journal-title":"Clin. Exp. Pediatr."},{"key":"10.1016\/j.intimp.2026.116885_bb0265","doi-asserted-by":"crossref","first-page":"1198365","DOI":"10.3389\/fimmu.2023.1198365","article-title":"Current understanding of CTLA-4: from mechanism to autoimmune diseases","volume":"14","author":"Hossen","year":"2023","journal-title":"Front. Immunol."},{"issue":"6","key":"10.1016\/j.intimp.2026.116885_bb0270","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13061440","article-title":"CTLA-4 in regulatory T cells for Cancer immunotherapy","volume":"13","author":"Sobhani","year":"2021","journal-title":"Cancers"},{"issue":"8","key":"10.1016\/j.intimp.2026.116885_bb0275","doi-asserted-by":"crossref","first-page":"513","DOI":"10.14348\/molcells.2022.2056","article-title":"Current understanding of cytotoxic T lymphocyte Antigen-4 (CTLA-4) signaling in T-cell biology and disease therapy","volume":"45","author":"Kim","year":"2022","journal-title":"Mol. Cell"},{"issue":"9","key":"10.1016\/j.intimp.2026.116885_bb0280","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/s41590-022-01289-w","article-title":"Differences in CD80 and CD86 transendocytosis reveal CD86 as a key target for CTLA-4 immune regulation","volume":"23","author":"Kennedy","year":"2022","journal-title":"Nat. Immunol."},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0285","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1038\/s41423-025-01348-w","article-title":"Dissection of the trans-endocytosis and signal inhibition functions of CTLA-4 through the study of a disease-associated Y139C mutation","volume":"22","author":"Zhao","year":"2025","journal-title":"Cell. Mol. Immunol."},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0290","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.immuni.2024.01.013","article-title":"The B7:CD28 family and friends: unraveling coinhibitory interactions","volume":"57","author":"Burke","year":"2024","journal-title":"Immunity"},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0295","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1182\/blood-2017-06-741033","article-title":"CTLA-4: a moving target in immunotherapy","volume":"131","author":"Rowshanravan","year":"2018","journal-title":"Blood"},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0300","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s44313-024-00011-z","article-title":"Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) gene polymorphisms in a cohort of Egyptian patients with immune thrombocytopenia (ITP)","volume":"59","author":"El Demerdash","year":"2024","journal-title":"Blood Res."},{"issue":"7865","key":"10.1016\/j.intimp.2026.116885_bb0305","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/s41586-021-03626-9","article-title":"TIM-3 restrains anti-tumour immunity by regulating inflammasome activation","volume":"595","author":"Dixon","year":"2021","journal-title":"Nature"},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0310","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.immuni.2024.01.010","article-title":"LAG-3, TIM-3, and TIGIT: distinct functions in immune regulation","volume":"57","author":"Joller","year":"2024","journal-title":"Immunity"},{"key":"10.1016\/j.intimp.2026.116885_bb0315","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2021.107933","article-title":"TIM-3: An update on immunotherapy","volume":"99","author":"Zhao","year":"2021","journal-title":"Int. Immunopharmacol."},{"issue":"93","key":"10.1016\/j.intimp.2026.116885_bb0320","doi-asserted-by":"crossref","first-page":"eadf2223","DOI":"10.1126\/sciimmunol.adf2223","article-title":"Beyond T cell exhaustion: TIM-3 regulation of myeloid cells","volume":"9","author":"Dixon","year":"2024","journal-title":"Sci. Immunol."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0325","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.intimp.2013.12.025","article-title":"Imbalanced expression of human Tim-1 and Tim-3 in PBMCs from immune thrombocytopenia patients","volume":"19","author":"Zhang","year":"2014","journal-title":"Int. Immunopharmacol."},{"issue":"10","key":"10.1016\/j.intimp.2026.116885_bb0330","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1038\/s42255-020-00280-9","article-title":"Metabolic and epigenetic regulation of T-cell exhaustion","volume":"2","author":"Franco","year":"2020","journal-title":"Nat. Metab."},{"issue":"8","key":"10.1016\/j.intimp.2026.116885_bb0335","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1038\/s41590-024-01896-9","article-title":"T cell dysfunction and therapeutic intervention in cancer","volume":"25","author":"Zebley","year":"2024","journal-title":"Nat. Immunol."},{"issue":"8","key":"10.1016\/j.intimp.2026.116885_bb0340","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1007\/s11427-023-2520-4","article-title":"High dimensional proteomic mapping of bone marrow immune characteristics in immune thrombocytopenia","volume":"67","author":"Liu","year":"2024","journal-title":"Sci. China Life Sci."},{"issue":"7749","key":"10.1016\/j.intimp.2026.116885_bb0345","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1038\/s41586-019-0985-x","article-title":"NR4A transcription factors limit CAR T cell function in solid tumours","volume":"567","author":"Chen","year":"2019","journal-title":"Nature"},{"key":"10.1016\/j.intimp.2026.116885_bb0350","doi-asserted-by":"crossref","DOI":"10.1016\/j.prp.2025.156081","article-title":"T cell exhaustion: focus on molecular pathways","volume":"272","author":"Dang","year":"2025","journal-title":"Pathol. Res. Pract."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0355","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1038\/s41467-025-55839-5","article-title":"Nr4a1 and Nr4a3 redundantly control clonal deletion and contribute to an anergy-like transcriptome in auto-reactive thymocytes to impose tolerance in mice","volume":"16","author":"Nielsen","year":"2025","journal-title":"Nat. Commun."},{"issue":"17","key":"10.1016\/j.intimp.2026.116885_bb0360","doi-asserted-by":"crossref","DOI":"10.1172\/jci.insight.151005","article-title":"NR4A family members regulate T cell tolerance to preserve immune homeostasis and suppress autoimmunity","volume":"6","author":"Hiwa","year":"2021","journal-title":"JCI Insight"},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0365","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1080\/15384101.2020.1746485","article-title":"miR-106b-5p induces immune imbalance of Treg\/Th17 in immune thrombocytopenic purpura through NR4A3\/Foxp3 pathway","volume":"19","author":"Li","year":"2020","journal-title":"Cell Cycle (Georgetown, Tex.)"},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0370","doi-asserted-by":"crossref","first-page":"220","DOI":"10.7150\/ijbs.10178","article-title":"Changes in follicular helper T cells in idiopathic thrombocytopenic purpura patients","volume":"11","author":"Xie","year":"2015","journal-title":"Int. J. Biol. Sci."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0375","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1159\/000529963","article-title":"The role of follicular regulatory T cells\/follicular helper T cells in primary immune thrombocytopenia","volume":"146","author":"Sun","year":"2023","journal-title":"Acta Haematol."},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0380","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1177\/15353702231168142","article-title":"Imbalance of follicular regulatory t (Tfr) cells\/follicular helper t (Tfh) cells in adult patients with primary immune thrombocytopenia","volume":"248","author":"Sun","year":"2023","journal-title":"Exp. Biol. Med. (Maywood, N.J.)"},{"key":"10.1016\/j.intimp.2026.116885_bb0385","article-title":"Association of Platelet Desialylation and Circulating Follicular Helper T Cells in patients with thrombocytopenia","volume":"13","author":"Chen","year":"2022","journal-title":"Front. Immunol."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0390","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/bjh.70229","article-title":"Dysfunctional T cells due to the abnormal glucose metabolism in patients with primary immune thrombocytopenia","volume":"208","author":"Tang","year":"2026","journal-title":"Br. J. Haematol."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0395","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s40164-022-00304-y","article-title":"Impaired mitochondria of Tregs decreases OXPHOS-derived ATP in primary immune thrombocytopenia with positive plasma pathogens detected by metagenomic sequencing","volume":"11","author":"Zhan","year":"2022","journal-title":"Exp. Hematol. Oncol."},{"key":"10.1016\/j.intimp.2026.116885_bb0400","doi-asserted-by":"crossref","DOI":"10.1016\/j.phrs.2025.107803","article-title":"The metabolism-immunity axis in immune thrombocytopenia: from energy regulation to targeted therapy","volume":"217","author":"Zhou","year":"2025","journal-title":"Pharmacol. Res."},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0405","doi-asserted-by":"crossref","DOI":"10.1016\/j.isci.2025.113792","article-title":"Dysregulation of apolipoprotein o reprograms CCR7(+)CD4(+)T cell fate in primary autoimmune thrombocytopenia","volume":"28","author":"Li","year":"2025","journal-title":"iScience"},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0410","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.immuni.2021.10.011","article-title":"MTHFD2 is a metabolic checkpoint controlling effector and regulatory T cell fate and function","volume":"55","author":"Sugiura","year":"2022","journal-title":"Immunity"},{"issue":"Suppl","key":"10.1016\/j.intimp.2026.116885_bb0415","article-title":"S295: tacrolimus modulates CD4+ t-cell proliferation and function via MTHFD2 in immune thrombocytopenia","volume":"7","author":"Yang","year":"2023","journal-title":"Hemasphere"},{"key":"10.1016\/j.intimp.2026.116885_bb0420","doi-asserted-by":"crossref","DOI":"10.1016\/j.thromres.2025.109475","article-title":"Inhibiting mTORC1 pathway by rapamycin restores the balance of CD8(+) T cell subsets and reduces CD8(+) T cell-mediated platelet destruction in immune thrombocytopenia","volume":"254","author":"Ni","year":"2025","journal-title":"Thromb. Res."},{"issue":"5","key":"10.1016\/j.intimp.2026.116885_bb0425","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1160\/TH14-04-0342","article-title":"Low-dose decitabine promotes megakaryocyte maturation and platelet production in healthy controls and immune thrombocytopenia","volume":"113","author":"Zhou","year":"2015","journal-title":"Thromb. Haemost."},{"issue":"12","key":"10.1016\/j.intimp.2026.116885_bb0430","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1002\/ajh.25646","article-title":"A prospective, multicenter study of low dose decitabine in adult patients with refractory immune thrombocytopenia","volume":"94","author":"Zhou","year":"2019","journal-title":"Am. J. Hematol."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0435","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1038\/s41375-018-0293-8","article-title":"Combination treatment of acute myeloid leukemia cells with DNMT and HDAC inhibitors: predominant synergistic gene downregulation associated with gene body demethylation","volume":"33","author":"Blagitko-Dorfs","year":"2019","journal-title":"Leukemia"},{"key":"10.1016\/j.intimp.2026.116885_bb0440","doi-asserted-by":"crossref","DOI":"10.1016\/j.phrs.2024.107271","article-title":"Dual inhibitors of DNMT and HDAC remodels the immune microenvironment of colorectal cancer and enhances the efficacy of anti-PD-L1 therapy","volume":"206","author":"Yang","year":"2024","journal-title":"Pharmacol. Res."},{"issue":"18","key":"10.1016\/j.intimp.2026.116885_bb0445","doi-asserted-by":"crossref","first-page":"19022","DOI":"10.1021\/acs.jmedchem.5c01092","article-title":"Design, synthesis, and biological evaluation of Quinoline-based Hydroxamic acid derivatives as dual DNMT and HDAC inhibitors with potent anti-breast Cancer activity","volume":"68","author":"Lin","year":"2025","journal-title":"J. Med. Chem."},{"issue":"11","key":"10.1016\/j.intimp.2026.116885_bb0450","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1038\/s41573-020-0077-5","article-title":"Targeting the epigenetic regulation of antitumour immunity","volume":"19","author":"Hogg","year":"2020","journal-title":"Nat. Rev. Drug Discov."},{"key":"10.1016\/j.intimp.2026.116885_bb0455","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.865975","article-title":"Lysine acetylation\/deacetylation modification of immune-related molecules in Cancer immunotherapy","volume":"13","author":"Ding","year":"2022","journal-title":"Front. Immunol."},{"issue":"1","key":"10.1016\/j.intimp.2026.116885_bb0460","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1016\/S2352-3026(18)30175-3","article-title":"Haematological immune-related adverse events induced by anti-PD-1 or anti-PD-L1 immunotherapy: a descriptive observational study","volume":"6","author":"Delanoy","year":"2019","journal-title":"Lancet Haematol."},{"key":"10.1016\/j.intimp.2026.116885_bb0465","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2024.111606","article-title":"PD-1\/PD-L1 inhibitor-induced immune thrombocytopenia: a pharmacovigilance study and systematic review","volume":"129","author":"Moore","year":"2024","journal-title":"Int. Immunopharmacol."},{"key":"10.1016\/j.intimp.2026.116885_bb0470","doi-asserted-by":"crossref","first-page":"1407894","DOI":"10.3389\/fphar.2024.1407894","article-title":"Association of thrombocytopenia with immune checkpoint inhibitors: a large-scale pharmacovigilance analysis based on the data from FDA adverse event reporting system database","volume":"15","author":"Liu","year":"2024","journal-title":"Front. Pharmacol."},{"issue":"3","key":"10.1016\/j.intimp.2026.116885_bb0475","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.4049\/jimmunol.182.3.1421","article-title":"B7RP-1 blockade ameliorates autoimmunity through regulation of follicular helper T cells","volume":"182","author":"Hu","year":"2009","journal-title":"J. Immunol."},{"issue":"5","key":"10.1016\/j.intimp.2026.116885_bb0480","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1097\/BOR.0000000000000412","article-title":"An update on lupus animal models","volume":"29","author":"Li","year":"2017","journal-title":"Curr. Opin. Rheumatol."},{"issue":"5","key":"10.1016\/j.intimp.2026.116885_bb0485","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/09612033251326990","article-title":"Two-year treatment experience with BI 655064, an antagonistic anti-CD40 antibody, in patients with active lupus nephritis: An exploratory, phase II maintenance trial","volume":"34","author":"Furie","year":"2025","journal-title":"Lupus"},{"key":"10.1016\/j.intimp.2026.116885_bb0490","doi-asserted-by":"crossref","first-page":"110","DOI":"10.3389\/fmed.2020.00110","article-title":"Sirolimus as rescue therapy for refractory\/relapsed immune thrombocytopenia: results of a single-center, prospective, single-arm study","volume":"7","author":"Feng","year":"2020","journal-title":"Front. Med."},{"issue":"2","key":"10.1016\/j.intimp.2026.116885_bb0495","doi-asserted-by":"crossref","DOI":"10.1111\/sji.13376","article-title":"Sirolimus is effective and safe in childhood relapsed-refractory autoimmune cytopenias: a multicentre study","volume":"100","author":"Acar","year":"2024","journal-title":"Scand. J. Immunol."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0500","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/MBC.0000000000001303","article-title":"Clinical study reveals the efficacy of sirolimus in treating primary immune thrombocytopenia: findings from a single-center study","volume":"35","author":"Feng","year":"2024","journal-title":"Blood Coagul. Fibrinolysis"},{"issue":"7","key":"10.1016\/j.intimp.2026.116885_bb0505","doi-asserted-by":"crossref","first-page":"E175","DOI":"10.1002\/ajh.25119","article-title":"Sirolimus as a rescue therapy in children with immune thrombocytopenia refractory to mycophenolate mofetil","volume":"93","author":"Miano","year":"2018","journal-title":"Am. J. Hematol."},{"issue":"4","key":"10.1016\/j.intimp.2026.116885_bb0510","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1111\/bjh.18293","article-title":"Empagliflozin modulates CD4(+) T-cell differentiation via metabolic reprogramming in immune thrombocytopenia","volume":"198","author":"Qin","year":"2022","journal-title":"Br. J. Haematol."},{"issue":"18","key":"10.1016\/j.intimp.2026.116885_bb0515","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1182\/blood.2025031332","article-title":"CDK8\/CDK19 inhibition restores T-cell homeostasis in primary immune thrombocytopenia","volume":"147","author":"Wang","year":"2026","journal-title":"Blood"},{"issue":"3","key":"10.1016\/j.intimp.2026.116885_bb0520","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1111\/bjh.17938","article-title":"Atorvastatin restores imbalance of cluster of differentiation 4 (CD4)(+) T cells in immune thrombocytopenia in vivo and in vitro","volume":"201","author":"Xu","year":"2023","journal-title":"Br. J. Haematol."}],"container-title":["International Immunopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1567576926007319?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1567576926007319?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:12:49Z","timestamp":1780290769000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1567576926007319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":104,"alternative-id":["S1567576926007319"],"URL":"https:\/\/doi.org\/10.1016\/j.intimp.2026.116885","relation":{},"ISSN":["1567-5769"],"issn-type":[{"value":"1567-5769","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Immune dysregulation in immune thrombocytopenia: impaired establishment of exhaustion-associated regulatory programming","name":"articletitle","label":"Article Title"},{"value":"International Immunopharmacology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.intimp.2026.116885","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"116885"}}