{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:45:32Z","timestamp":1792644332914,"version":"4.5.0"},"reference-count":115,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but can induce immune-related myocarditis (ICI-MC), a rare yet life-threatening toxicity. This review elucidates the cellular and molecular mechanisms underlying ICI-MC, integrating insights from T-cell dysregulation, innate immunity, and stromal interactions. Pathogenesis involves \u03b1-myosin\u2013driven clonal expansion of cytotoxic CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells, loss of regulatory subsets, and macrophage polarization toward M1 phenotypes via cGAS\u2013STING and STAT1\/NF-\u03baB pathways. Crosstalk among macrophages, fibroblasts, endothelial cells, neutrophils, and B cells amplifies myocardial inflammation through chemokine and complement activation. A five-phase multicellular framework\u2014baseline autoreactivity, checkpoint blockade, clonal expansion, effector execution, and inflammatory amplification\u2014summarizes disease evolution. Candidate biomarkers and targeted therapies offer precision strategies to mitigate cardiotoxicity. Future single-cell and multi-omics studies are essential to refine diagnosis and develop cardioprotective interventions without compromising antitumor efficacy.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1752354","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:35:17Z","timestamp":1780551317000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mechanisms and biomarkers of immune checkpoint inhibitor-associated myocarditis: from T cell imbalance to multicellular crosstalk"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiawang","family":"Huang","sequence":"first","affiliation":[{"name":"The Second Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuli","family":"Xu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yucheng","family":"Jin","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Qiao","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]},{"name":"Department of Cardiology, The Second Hospital of Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Hospital of Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Gao","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School, Lanzhou 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