{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:08:47Z","timestamp":1792188527811,"version":"4.4.0"},"reference-count":145,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The publication of the 2023 Global Definition of ARDS has further unveiled the clinical heterogeneity of sepsis-induced acute respiratory distress syndrome (ARDS), rendering traditional systemic biomarkers insufficient for precisely characterizing lung-specific pathological changes. Cell-specific exosomes, owing to their high stability and high fidelity to the molecular signatures of their parent cells, have emerged as a highly promising tool for liquid biopsy. This review aims to elucidate how exosomes construct a multidimensional communication network within the compromised alveolar-capillary barrier. Beyond exploring the traditional function of exosomes as inflammatory vectors, we provide an in-depth analysis of the mechanisms by which alveolar epithelial exosomes propagate ferroptosis and mitochondrial damage in a wave-like manner, and how macrophage exosomes drive immunometabolic reprogramming via glycolysis and histone lactylation to sustain the inflammatory state. Furthermore, we elaborate on the central role of endothelial exosomes in vascular leakage and immunothrombosis, proposing a novel hypothesis that they may serve as mediators propagating cuproptosis within the vascular bed. Finally, by integrating advances in single-cell omics and analyzing technical barriers such as isolation specificity and timeliness, we propose a precision medicine framework based on exosomal molecular fingerprints. This strategy aims to utilize exosomes for ARDS subphenotyping, thereby promoting a paradigm shift in clinical practice from syndrome management to mechanism-driven theranostics.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1799086","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:19:22Z","timestamp":1774588762000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Cell-specific exosomes in sepsis-associated ARDS: from immunometabolic reprogramming to precision medicine"],"prefix":"10.3389","volume":"17","author":[{"given":"Yihan","family":"Dang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caifeng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Rui","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxi","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaobo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaorong","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries","volume":"315","author":"Bellani","year":"2016","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.5669","article-title":"Acute respiratory distress syndrome: the berlin definition","volume":"307","author":"Ranieri","year":"2012","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1164\/rccm.202303-0558WS","article-title":"A new global definition of acute respiratory distress syndrome","volume":"209","author":"Matthay","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202308-1369ED","article-title":"The global definition of acute respiratory distress syndrome: ready for prime time","volume":"209","author":"Smit","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/MCC.0000000000000786","article-title":"Biomarkers in acute respiratory distress syndrome","volume":"27","author":"Jabaudon","year":"2021","journal-title":"Curr Opin Crit Care"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e12404","DOI":"10.1002\/jev2.12404","article-title":"Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches","volume":"13","author":"Welsh","year":"2024","journal-title":"J Extracell Vesicles"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2021.108118","article-title":"Extracellular vesicles in acute respiratory distress syndrome: Recent developments from bench to bedside","volume":"100","author":"Quan","year":"2021","journal-title":"Int Immunopharmacol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/cas.14563","article-title":"Biology and therapeutic potential of mesenchymal stem cell-derived exosomes","volume":"111","author":"Xunian","year":"2020","journal-title":"Cancer Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e70853","DOI":"10.1002\/hsr2.70853","article-title":"The use of extracellular vesicles as a promising therapeutic approach for pulmonary diseases","volume":"8","author":"Chaleshtori","year":"2025","journal-title":"Health Sci Rep"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1615264","article-title":"Molecular mechanisms and potential implications of ferroptosis, cuproptosis, and disulfidptosis in septic lung injury","volume":"12","author":"Li","year":"2025","journal-title":"Front Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1038\/s41418-021-00841-9","article-title":"Lactate promotes macrophage HMGB1 lactylation, acetylation, and exosomal release in polymicrobial sepsis","volume":"29","author":"Yang","year":"2022","journal-title":"Cell Death Differ"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.646546","article-title":"Exosomes derived from alveolar epithelial cells promote alveolar macrophage activation mediated by miR-92a-3p in sepsis-induced acute lung injury","volume":"11","author":"Liu","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymthe.2019.07.003","article-title":"Peripheral circulating exosome-mediated delivery of miR-155 as a novel mechanism for acute lung inflammation","volume":"27","author":"Jiang","year":"2019","journal-title":"Mol Ther"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.00001.2016","article-title":"Macrophage micro-RNA-155 promotes lipopolysaccharide-induced acute lung injury in mice and rats","volume":"311","author":"Wang","year":"2016","journal-title":"Am J Physiol-Lung Cell Mol Physiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e1006308","DOI":"10.1371\/journal.pgen.1006308","article-title":"MiR-155 enhances insulin sensitivity by coordinated regulation of multiple genes in mice","volume":"12","author":"Lin","year":"2016","journal-title":"PloS Genet"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.677902","article-title":"Tissue factor-enriched neutrophil extracellular traps promote immunothrombosis and disease progression in sepsis-induced lung injury","volume":"11","author":"Zhang","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26136114","article-title":"Immunothrombosis in sepsis: cellular crosstalk, molecular triggers, and therapeutic opportunities\u2014A review","volume":"26","author":"Aklilu","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25094898","article-title":"Unveiling the role of exosomes in the pathophysiology of sepsis: insights into organ dysfunction and potential biomarkers","volume":"25","author":"Gebeyehu","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/cells12020280","article-title":"Extracellular vesicles biogenesis, cargo sorting and implications in disease conditions","volume":"12","author":"Fonseka","year":"2023","journal-title":"Cells"},{"key":"B20","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s13054-024-04885-4","article-title":"Unraveling the role of HIF-1\u03b1 in sepsis: from pathophysiology to potential therapeutics\u2014a narrative review","volume":"28","author":"Ruan","year":"2024","journal-title":"Crit Care"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1410041111","article-title":"Hypoxia-inducible factors and RAB22A mediate formation of microvesicles that stimulate breast cancer invasion and metastasis","volume":"111","author":"Wang","year":"2014","journal-title":"Proc Natl Acad Sci"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1220998110","article-title":"Exosomes reflect the hypoxic status of glioma cells and mediate hypoxia-dependent activation of vascular cells during tumor development","volume":"110","author":"Kucharzewska","year":"2013","journal-title":"Proc Natl Acad Sci"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.853840","article-title":"Extracellular vesicles, new players in sepsis and acute respiratory distress syndrome","volume":"12","author":"Jing","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2014.00403","article-title":"Exosomes and autophagy: coordinated mechanisms for the maintenance of cellular fitness","volume":"5","author":"Baixauli","year":"2014","journal-title":"Front Immunol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.896353","article-title":"Activation and regulation of NLRP3 by sterile and infectious insults","volume":"13","author":"Banerjee","year":"2022","journal-title":"Front Immunol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.24158","article-title":"Endoplasmic reticulum stress stimulates the release of extracellular vesicles carrying danger-associated molecular pattern (DAMP) molecules","volume":"9","author":"Collett","year":"2018","journal-title":"Oncotarget"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201802675R","article-title":"Exosomes from activated hepatic stellate cells contain GLUT1 and PKM2: a role for exosomes in metabolic switch of liver nonparenchymal cells","volume":"33","author":"Wan","year":"2019","journal-title":"FASEB J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S403778","article-title":"Metabolic reprogramming and its regulatory mechanism in sepsis-mediated inflammation","volume":"16","author":"Liu","year":"2023","journal-title":"J Inflammation Res"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkaf056","article-title":"Histone lactylation exacerbates acute lung injury in septic mice by promoting ferroptosis in pulmonary microvascular endothelial cells","volume":"13","author":"Fang","year":"2025","journal-title":"Burns Trauma"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.physiol.65.092101.142446","article-title":"Alveolar type I cells: molecular phenotype and development","volume":"65","author":"Williams","year":"2003","journal-title":"Annu Rev Physiol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2006.00800.x","article-title":"Biology of alveolar type II cells","volume":"11","author":"Mason","year":"2006","journal-title":"Respirology"},{"key":"B32","doi-asserted-by":"publisher","first-page":"20750","DOI":"10.1038\/s41598-020-77448-6","article-title":"Salidroside regulates inflammatory pathway of alveolar macrophages by influencing the secretion of miRNA-146a exosomes by lung epithelial cells","volume":"10","author":"Zheng","year":"2020","journal-title":"Sci Rep"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13092299","article-title":"Alveolar epithelial cell dysfunction in acute respiratory distress syndrome: mechanistic insights and targeted interventions","volume":"13","author":"Wang","year":"2025","journal-title":"Biomedicines"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200509-1477OC","article-title":"Receptor for advanced glycation end-products is a marker of type I cell injury in acute lung injury","volume":"173","author":"Uchida","year":"2006","journal-title":"Am J Respir Crit Care Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5327-1","article-title":"Plasma sRAGE is independently associated with increased mortality in ARDS: a meta-analysis of individual patient data","volume":"44","author":"Jabaudon","year":"2018","journal-title":"Intensive Care Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s00011-022-01612-z","article-title":"Type 2 alveolar epithelial cell-derived circulating extracellular vesicle-encapsulated surfactant protein C as a mediator of cardiac inflammation in COVID-19","volume":"71","author":"Rudiansyah","year":"2022","journal-title":"Inflammation Res"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00371","article-title":"Alveolar fluid clearance in pathologically relevant conditions: in vitro and in vivo models of acute respiratory distress syndrome","volume":"8","author":"Huppert","year":"2017","journal-title":"Front Immunol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/s40001-025-02561-z","article-title":"Exosomes and MicroRNAs: key modulators of macrophage polarization in sepsis pathophysiology","volume":"30","author":"Saadh","year":"2025","journal-title":"Eur J Med Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"991","DOI":"10.7150\/thno.82552","article-title":"Exosomal STIMATE derived from type II alveolar epithelial cells controls metabolic reprogramming of tissue-resident alveolar macrophages","volume":"13","author":"Feng","year":"2023","journal-title":"Theranostics"},{"key":"B40","doi-asserted-by":"publisher","first-page":"e00376","DOI":"10.1002\/advs.202500376","article-title":"Type II Alveolar Epithelial Cells Promote Sepsis-Induced Immunosuppression in Alveolar Macrophages via Exosomal lncRNA Rmrp Release","volume":"13","author":"Liu","year":"2026","journal-title":"Adv Sci"},{"key":"B41","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.trsl.2024.04.001","article-title":"Exosomal Tenascin-C primes macrophage pyroptosis amplifying aberrant inflammation during sepsis-induced acute lung injury","volume":"270","author":"Gong","year":"2024","journal-title":"Transl Res"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.66477","article-title":"Caspase-1-mediated extracellular vesicles derived from pyroptotic alveolar macrophages promote inflammation in acute lung injury","volume":"18","author":"Qin","year":"2022","journal-title":"Int J Biol Sci"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1038\/nature18629","article-title":"Inflammasome-activated gasdermin D causes pyroptosis by forming membrane pores","volume":"535","author":"Liu","year":"2016","journal-title":"Nature"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1559659","article-title":"Cell death in acute lung injury: caspase-regulated apoptosis, pyroptosis, necroptosis, and PANoptosis","volume":"16","author":"Xiao","year":"2025","journal-title":"Front Pharmacol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1186\/s12964-023-01369-w","article-title":"Ferroptosis: a promising candidate for exosome-mediated regulation in different diseases","volume":"22","author":"Liu","year":"2024","journal-title":"Cell Commun Signal"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S528482","article-title":"Role of ferroptosis in alveolar epithelial cells in acute respiratory distress syndrome","volume":"18","author":"Sun","year":"2025","journal-title":"J Inflammation Res"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1038\/s41418-023-01198-x","article-title":"Small extracellular vesicles delivering lncRNA WAC-AS1 aggravate renal allograft ischemia\u2013reperfusion injury by inducing ferroptosis propagation","volume":"30","author":"Li","year":"2023","journal-title":"Cell Death Differ"},{"key":"B48","doi-asserted-by":"publisher","first-page":"3411","DOI":"10.1016\/j.celrep.2020.02.049","article-title":"Transferrin receptor is a specific ferroptosis marker","volume":"30","author":"Feng","year":"2020","journal-title":"Cell Rep"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2024.103042","article-title":"Human proximal tubular epithelial cell-derived small extracellular vesicles mediate synchronized tubular ferroptosis in hypoxic kidney injury","volume":"70","author":"Wang","year":"2024","journal-title":"Redox Biol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25137305","article-title":"Mitochondrial quality control processes at the crossroads of cell death and survival: mechanisms and signaling pathways","volume":"25","author":"Marzetti","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B51","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1038\/s41419-021-03961-9","article-title":"Circulating mitochondrial DNA-triggered autophagy dysfunction via STING underlies sepsis-related acute lung injury","volume":"12","author":"Liu","year":"2021","journal-title":"Cell Death Dis"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.973089","article-title":"Role of released mitochondrial DNA in acute lung injury","volume":"13","author":"Long","year":"2022","journal-title":"Front Immunol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1689155","article-title":"Ferroptosis in sepsis induced acute lung injury\/acute respiratory distress syndrome (ALI\/ARDS): a potential therapeutic strategy","volume":"16","author":"Wang","year":"2025","journal-title":"Front Immunol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1186\/s11658-020-00205-0","article-title":"Ferrostatin-1 alleviates lipopolysaccharide-induced acute lung injury via inhibiting ferroptosis","volume":"25","author":"Liu","year":"2020","journal-title":"Cell Mol Biol Lett"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.3390\/biom15081145","article-title":"Mitochondrial extracellular vesicles: A novel approach to mitochondrial quality control","volume":"15","author":"Kong","year":"2025","journal-title":"Biomolecules"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000003129","article-title":"Impact of sepsis on circulating exosomes: pathophysiological mechanisms, biomarker potential, and therapeutic applications","volume":"111","author":"Wu","year":"2025","journal-title":"Int J Surg"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70097-9","article-title":"Latent class analysis of ARDS subphenotypes: analysis of data from two randomized controlled trials","author":"Calfee","year":"2015"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.ijmr_2344_22","article-title":"Emerging role of exosomes as a liquid biopsy tool for diagnosis, prognosis & monitoring treatment response of communicable & non-communicable diseases","volume":"159","author":"Yadav","year":"2024","journal-title":"Indian J Med Res"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.00185.2022","article-title":"Biomarkers of alveolar epithelial injury and endothelial dysfunction are associated with scores of pulmonary edema in invasively ventilated patients","volume":"324","author":"Atmowihardjo","year":"2023","journal-title":"Am J Physiol-Lung Cell Mol Physiol"},{"key":"B60","doi-asserted-by":"publisher","first-page":"200317","DOI":"10.1183\/16000617.0317-2020","article-title":"Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research","volume":"30","author":"Bos","year":"2021","journal-title":"Eur Respir Rev"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbagen.2025.130871","article-title":"Exosome-derived mtDNA disrupts endothelial barrier integrity and accelerates sepsis progression by inducing mitochondrial dysfunction through the PKC\u03b4 gene","volume":"1870","author":"Peng","year":"2026","journal-title":"Biochim Biophys Acta BBA - Gen Subj"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2015.08.010","article-title":"Blockade of exosome generation with GW4869 dampens the sepsis-induced inflammation and cardiac dysfunction","volume":"1852","author":"Essandoh","year":"2015","journal-title":"Biochim Biophys Acta BBA - Mol Basis Dis"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.744141","article-title":"Removal of COVID-19 spike protein, whole virus, exosomes, and exosomal microRNAs by the hemopurifier\u00ae Lectin-affinity cartridge in critically ill patients with COVID-19 infection","volume":"8","author":"Amundson","year":"2021","journal-title":"Front Med"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1109381","article-title":"Engineered NF-\u03baB siRNA-encapsulating exosomes as a modality for therapy of skin lesions","volume":"14","author":"Lu","year":"2023","journal-title":"Front Immunol"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1016\/j.vesic.2022.100002","article-title":"Inhalable exosomes outperform liposomes as mRNA and protein drug carriers to the lung","volume":"1","author":"Popowski","year":"2022","journal-title":"Extracell Vesicle"},{"key":"B66","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1186\/s13287-025-04598-7","article-title":"Magnetic engineered bone mesenchymal stem cells-derived exosomes for targeted acute lung injury therapy","volume":"16","author":"Wang","year":"2025","journal-title":"Stem Cell Res Ther"},{"key":"B67","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/s11658-025-00750-6","article-title":"Targeting alveolar macrophages: a promising intervention for pulmonary infection and acute lung injury","volume":"30","author":"Hou","year":"2025","journal-title":"Cell Mol Biol Lett"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1209438","article-title":"The role of macrophages polarization in sepsis-induced acute lung injury","volume":"14","author":"Wang","year":"2023","journal-title":"Front Immunol"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.3390\/biology14101371","article-title":"Polarized macrophages and their exosomes: implications for autoimmune and immune-mediated diseases","volume":"14","author":"Yuan","year":"2025","journal-title":"Biology"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2024.1271684","article-title":"Exosomes: efficient macrophage-related immunomodulators in chronic lung diseases","volume":"12","author":"Kang","year":"2024","journal-title":"Front Cell Dev Biol"},{"key":"B71","doi-asserted-by":"publisher","first-page":"e70098","DOI":"10.1002\/ctm2.70098","article-title":"The role of the interplay between macrophage glycolytic reprogramming and NLRP3 inflammasome activation in acute lung injury\/acute respiratory distress syndrome","volume":"14","author":"Luo","year":"2024","journal-title":"Clin Transl Med"},{"key":"B72","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.cmet.2014.12.005","article-title":"Pyruvate kinase M2 regulates hif-1\u03b1 Activity and IL-1\u03b2 Induction and is a critical determinant of the warburg effect in LPS-activated macrophages","volume":"21","author":"Palsson-McDermott","year":"2015","journal-title":"Cell Metab"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1201516","article-title":"NLRP3 inflammasome activity is negatively controlled by miR-223","volume":"189","author":"Bauernfeind","year":"2012","journal-title":"J Immunol"},{"key":"B74","doi-asserted-by":"publisher","first-page":"e42971","DOI":"10.1371\/journal.pone.0042971","article-title":"Inducible microRNA-223 down-regulation promotes TLR-triggered IL-6 and IL-1\u03b2 Production in macrophages by targeting STAT3","volume":"7","author":"Chen","year":"2012","journal-title":"PloS One"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S547454","article-title":"Macrophage-derived exosomal BMPR2 mediates alveolar epithelial repair and cellular crosstalk in acute lung injury","volume":"18","author":"Yun","year":"2025","journal-title":"J Inflammation Res"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1678-1","article-title":"Metabolic regulation of gene expression by histone lactylation","volume":"574","author":"Zhang","year":"2019","journal-title":"Nature"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.786666","article-title":"Lactylated histone H3K18 as a potential biomarker for the diagnosis and predicting the severity of septic shock","volume":"12","author":"Chu","year":"2022","journal-title":"Front Immunol"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2020-0360OC","article-title":"Lung myofibroblasts promote macrophage profibrotic activity through lactate-induced histone lactylation","volume":"64","author":"Cui","year":"2021","journal-title":"Am J Respir Cell Mol Biol"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms13280","article-title":"PKM2-dependent glycolysis promotes NLRP3 and AIM2 inflammasome activation","volume":"7","author":"Xie","year":"2016","journal-title":"Nat Commun"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2017.05.065","article-title":"SIRT5 desuccinylates and activates pyruvate kinase M2 to block macrophage IL-1\u03b2 Production and to prevent DSS-induced colitis in mice","volume":"19","author":"Wang","year":"2017","journal-title":"Cell Rep"},{"key":"B81","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1186\/s12967-024-05817-0","article-title":"Exosomes as novel biomarkers in sepsis and sepsis related organ failure","volume":"22","author":"Yuan","year":"2024","journal-title":"J Transl Med"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1518008","article-title":"Macrophages in sepsis-induced acute lung injury: exosomal modulation and therapeutic potential","volume":"15","author":"Lv","year":"2025","journal-title":"Front Immunol"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abe0083","article-title":"Metabolically engineered stem cell\u2013derived exosomes to regulate macrophage heterogeneity in rheumatoid arthritis","volume":"7","author":"You","year":"2021","journal-title":"Sci Adv"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1714267114","article-title":"Macrophage-like nanoparticles concurrently absorbing endotoxins and proinflammatory cytokines for sepsis management","volume":"114","author":"Thamphiwatana","year":"2017","journal-title":"Proc Natl Acad Sci"},{"key":"B85","doi-asserted-by":"publisher","first-page":"e957508","DOI":"10.4161\/21688362.2014.957508","article-title":"The angiopoietin-Tie2 signaling axis in the vascular leakage of systemic inflammation","volume":"3","author":"Milam","year":"2015","journal-title":"Tissue Barriers"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.87.7.603","article-title":"Angiopoietin-1 is an antipermeability and anti-inflammatory agent in vitro and targets cell junctions","volume":"87","author":"Gamble","year":"2000","journal-title":"Circ Res"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.1038\/nm1351","article-title":"Angiopoietin-2 sensitizes endothelial cells to TNF-\u03b1 and has a crucial role in the induction of inflammation","volume":"12","author":"Fiedler","year":"2006","journal-title":"Nat Med"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M113.506899","article-title":"Angiopoietin-2 secretion by endothelial cell exosomes","volume":"289","author":"Ju","year":"2014","journal-title":"J Biol Chem"},{"key":"B89","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1038\/ncomms2199","article-title":"Phosphorylation of VE-cadherin is modulated by haemodynamic forces and contributes to the regulation of vascular permeability in vivo","volume":"3","author":"Orsenigo","year":"2012","journal-title":"Nat Commun"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)64887-0","article-title":"Shedding of the matrix metalloproteinases MMP-2, MMP-9, and MT1-MMP as membrane vesicle-associated components by endothelial cells","volume":"160","author":"Taraboletti","year":"2002","journal-title":"Am J Pathol"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.854126","article-title":"Human endothelial cell-derived exosomal microRNA-99a\/b drives a sustained inflammatory response during sepsis by inhibiting mTOR expression","volume":"12","author":"Fitzpatrick","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"B92","article-title":"Serum miR-126-3p level is down-regulated in sepsis patients","author":"Chen","year":""},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0707493105","article-title":"MicroRNA-126 regulates endothelial expression of vascular cell adhesion molecule 1","volume":"105","author":"Harris","year":"2008","journal-title":"Proc Natl Acad Sci"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.1038\/cdd.2011.42","article-title":"miR-200c is upregulated by oxidative stress and induces endothelial cell apoptosis and senescence via ZEB1 inhibition","volume":"18","author":"Magenta","year":"2011","journal-title":"Cell Death Differ"},{"key":"B95","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.826047","article-title":"Cell-crossing functional network driven by microRNA-125a regulates endothelial permeability and monocyte trafficking in acute inflammation","volume":"13","author":"M\u00fcller","year":"2022","journal-title":"Front Immunol"},{"key":"B96","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/SHK.0000000000000509","article-title":"Circulating microparticles, blood cells, and endothelium induce procoagulant activity in sepsis through phosphatidylserine exposure","volume":"45","author":"Zhang","year":"2016","journal-title":"Shock"},{"key":"B97","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1615947","article-title":"A cell-based model of hemostasis","volume":"85","author":"Hoffman","year":"2001","journal-title":"Thromb Haemost"},{"key":"B98","doi-asserted-by":"publisher","DOI":"10.1126\/science.abf0529","article-title":"Copper induces cell death by targeting lipoylated TCA cycle proteins","volume":"375","author":"Tsvetkov","year":"2022","journal-title":"Science"},{"key":"B99","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S533967","article-title":"Deciphering cuproptosis in sepsis: mechanisms, consequences, and therapeutic opportunities","volume":"18","author":"Tan","year":"2025","journal-title":"J Inflammation Res"},{"key":"B100","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2025.111631","article-title":"Cancer-associated fibroblasts promote oral squamous cell carcinoma progression by targeting ATP7A via exosome-mediated paracrine miR-148b-3p","volume":"128","author":"Zhang","year":"2025","journal-title":"Cell Signal"},{"key":"B101","doi-asserted-by":"publisher","DOI":"10.1101\/2025.01.27.634587","article-title":"Endothelial cu uptake transporter CTR1 senses disturbed flow to promote atherosclerosis through cuproptosis","author":"Sudhahar","year":"2025","journal-title":"Cell Biol"},{"key":"B102","doi-asserted-by":"publisher","DOI":"10.17305\/bb.2025.12751","article-title":"Tumor glucose reprogramming suppresses cuproptosis: A review","volume":"26","author":"Song","year":"2025","journal-title":"Biomol Biomed"},{"key":"B103","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2017.00039","article-title":"Pulmonary extracellular vesicles as mediators of local and systemic inflammation","volume":"5","author":"Wahlund","year":"2017","journal-title":"Front Cell Dev Biol"},{"key":"B104","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1161\/ATVBAHA.110.218123","article-title":"The many faces of endothelial microparticles","volume":"31","author":"Dignat-George","year":"2011","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B105","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s40560-018-0340-6","article-title":"Role of extracellular vesicles in the development of sepsis-induced coagulopathy","volume":"6","author":"Iba","year":"2018","journal-title":"J Intensive Care"},{"key":"B106","doi-asserted-by":"publisher","first-page":"e155010","DOI":"10.1172\/jci.insight.155010","article-title":"Glycocalyx heparan sulfate cleavage promotes endothelial cell angiopoietin-2 expression by impairing shear stress\u2013related AMPK\/FoxO1 signaling","volume":"7","author":"Richter","year":"2022","journal-title":"JCI Insight"},{"key":"B107","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/1739615","article-title":"Predictive value of combined LIPS and ANG-2 level in critically ill patients with ARDS risk factors","volume":"2018","author":"Xu","year":"2018","journal-title":"Mediators Inflamm"},{"key":"B108","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.02957","article-title":"Citrullinated histone H3 as a therapeutic target for endotoxic shock in mice","volume":"10","author":"Deng","year":"2020","journal-title":"Front Immunol"},{"key":"B109","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2993-x","article-title":"Microparticles are new biomarkers of septic shock-induced disseminated intravascular coagulopathy","volume":"39","author":"Delabranche","year":"2013","journal-title":"Intensive Care Med"},{"key":"B110","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25031464","article-title":"A narrative review: the role of NETs in acute respiratory distress syndrome\/acute lung injury","volume":"25","author":"Zhou","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B111","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2025.114892","article-title":"Neutrophil-derived exosomes promote sepsis-related multiple organ dysfunction through the induction of neutrophil extracellular trap formation","volume":"159","author":"Xie","year":"2025","journal-title":"Int Immunopharmacol"},{"key":"B112","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.cell.2018.12.002","article-title":"Activated PMN exosomes: pathogenic entities causing matrix destruction and disease in the lung","volume":"176","author":"Genschmer","year":"2019","journal-title":"Cell"},{"key":"B113","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01037","article-title":"Role of neutrophil extracellular traps and vesicles in regulating vascular endothelial permeability","volume":"10","author":"Ma","year":"2019","journal-title":"Front Immunol"},{"key":"B114","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2022.102826","article-title":"Neutrophil-derived extracellular vesicles induce endothelial inflammation and damage through the transfer of miRNAs","volume":"129","author":"Gl\u00e9main","year":"2022","journal-title":"J Autoimmun"},{"key":"B115","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S287256","article-title":"Circulating neutrophil-derived microparticles associated with the prognosis of patients with sepsis","volume":"13","author":"Chen","year":"2020","journal-title":"J Inflammation Res"},{"key":"B116","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.138999","article-title":"Neutrophil extracellular traps in COVID-19","author":"Zuo","year":"2020","journal-title":"JCI Insight"},{"key":"B117","doi-asserted-by":"publisher","DOI":"10.1160\/TH06-06-0313","article-title":"Platelet microparticle membranes have 50- to 100-fold higher specific procoagulant activity than activated platelets","volume":"97","author":"Sinauridze","year":"2007","journal-title":"Thromb Haemost"},{"key":"B118","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-03-1095","article-title":"Tissue-factor\u2013bearing microvesicles arise from lipid rafts and fuse with activated platelets to initiate coagulation","volume":"106","author":"Del Conde","year":"2005","journal-title":"Blood"},{"key":"B119","doi-asserted-by":"publisher","DOI":"10.1172\/JCI32376","article-title":"Protein disulfide isomerase acts as an injury response signal that enhances fibrin generation via tissue factor activation","author":"Reinhardt","year":"2008","journal-title":"J Clin Invest"},{"key":"B120","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12710","article-title":"Activated platelets present high mobility group box 1 to neutrophils, inducing autophagy and promoting the extrusion of neutrophil extracellular traps","volume":"12","author":"Maugeri","year":"2014","journal-title":"J Thromb Haemost"},{"key":"B121","doi-asserted-by":"crossref","DOI":"10.1007\/978-981-99-1443-2_17","article-title":"Platelet-Derived Extracellular Vesicles in Arterial Thrombosis","volume-title":"Extracellular Vesicles in Cardiovascular and Metabolic Diseases","author":"Harper","year":"2023"},{"key":"B122","doi-asserted-by":"publisher","DOI":"10.1038\/nature08780","article-title":"Circulating mitochondrial DAMPs cause inflammatory responses to injury","volume":"464","author":"Zhang","year":"2010","journal-title":"Nature"},{"key":"B123","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0170OC","article-title":"Mesenchymal stromal cells modulate macrophages in clinically relevant lung injury models by extracellular vesicle mitochondrial transfer","volume":"196","author":"Morrison","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"B124","doi-asserted-by":"publisher","DOI":"10.1002\/stem.2372","article-title":"Mitochondrial transfer via tunneling nanotubes is an important mechanism by which mesenchymal stem cells enhance macrophage phagocytosis in the in vitro and in vivo models of ARDS","volume":"34","author":"Jackson","year":"2016","journal-title":"Stem Cells"},{"key":"B125","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12967-015-0642-6","article-title":"LPS-preconditioned mesenchymal stromal cells modify macrophage polarization for resolution of chronic inflammation via exosome-shuttled let-7b","volume":"13","author":"Ti","year":"2015","journal-title":"J Transl Med"},{"key":"B126","doi-asserted-by":"publisher","DOI":"10.21037\/atm-21-3557","article-title":"Mesenchymal stem cell-derived exosomes regulate the polarization and inflammatory response of macrophages via miR-21-5p to promote repair after myocardial reperfusion injury","volume":"9","author":"Shen","year":"2021","journal-title":"Ann Transl Med"},{"key":"B127","doi-asserted-by":"publisher","DOI":"10.1002\/stem.2619","article-title":"Mesenchymal stem cell microvesicles attenuate acute lung injury in mice partly mediated by ang-1 mRNA","volume":"35","author":"Tang","year":"2017","journal-title":"Stem Cells"},{"key":"B128","doi-asserted-by":"publisher","DOI":"10.1186\/s12964-015-0124-8","article-title":"MSC surface markers (CD44, CD73, and CD90) can identify human MSC-derived extracellular vesicles by conventional flow cytometry","volume":"14","author":"Ramos T","year":"2016","journal-title":"Cell Commun Signal"},{"key":"B129","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30418-1","article-title":"Treatment with allogeneic mesenchymal stromal cells for moderate to severe acute respiratory distress syndrome (START study): a randomised phase 2a safety trial","volume":"7","author":"Matthay","year":"2019","journal-title":"Lancet Respir Med"},{"key":"B130","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70097-9","article-title":"Subphenotypes in acute respiratory distress syndrome: latent class analysis of data from two randomised controlled trials","volume":"2","author":"Calfee","year":"2014","journal-title":"Lancet Respir Med"},{"key":"B131","doi-asserted-by":"publisher","first-page":"031502","DOI":"10.1063\/5.0273892","article-title":"Integrated microfluidic platforms for extracellular vesicles: Separation, detection, and clinical translation","volume":"9","author":"Dai","year":"2025","journal-title":"APL Bioeng"},{"key":"B132","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1709210114","article-title":"Isolation of exosomes from whole blood by integrating acoustics and microfluidics","volume":"114","author":"Wu","year":"2017","journal-title":"Proc Natl Acad Sci"},{"key":"B133","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1186\/s12931-025-03326-2","article-title":"The exosomal protein biomarkers auxiliary in diagnosis of interstitial lung disease","volume":"26","author":"Dong","year":"2025","journal-title":"Respir Res"},{"key":"B134","doi-asserted-by":"publisher","DOI":"10.7150\/thno.21358","article-title":"Molecular detection and analysis of exosomes using surface-enhanced raman scattering gold nanorods and a miniaturized device","volume":"8","author":"Kwizera","year":"2018","journal-title":"Theranostics"},{"key":"B135","doi-asserted-by":"publisher","DOI":"10.1002\/smll.202205519","article-title":"Label-free identification of exosomes using raman spectroscopy and machine learning","volume":"19","author":"Parlatan","year":"2023","journal-title":"Small"},{"key":"B136","doi-asserted-by":"publisher","DOI":"10.1007\/s12015-022-10398-w","article-title":"Nebulization therapy with umbilical cord mesenchymal stem cell-derived exosomes for COVID-19 pneumonia","volume":"18","author":"Chu","year":"2022","journal-title":"Stem Cell Rev Rep"},{"key":"B137","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2024.113914","article-title":"ADSCs-derived exosomes suppress macrophage ferroptosis via the SIRT1\/NRF2 signaling axis to alleviate acute lung injury in sepsis","volume":"146","author":"Bai","year":"2025","journal-title":"Int Immunopharmacol"},{"key":"B138","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1605797","article-title":"Alveolar epithelial cells in bacterial sepsis-associated acute lung injury: mechanisms and therapeutic strategies","volume":"16","author":"Jia","year":"2025","journal-title":"Front Immunol"},{"key":"B139","doi-asserted-by":"publisher","DOI":"10.3390\/cells10123473","article-title":"Characterization of extracellular vesicles from bronchoalveolar lavage fluid and plasma of patients with lung lesions using fluorescence nanoparticle tracking analysis","volume":"10","author":"Dlugolecka","year":"2021","journal-title":"Cells"},{"key":"B140","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.309417","article-title":"Methodological guidelines to study extracellular vesicles","volume":"120","author":"Coumans","year":"2017","journal-title":"Circ Res"},{"key":"B141","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1002\/jex2.88","article-title":"Small extracellular vesicles are released ex vivo from platelets into serum and from residual blood cells into stored plasma","volume":"2","author":"Ma\u0142ys","year":"2023","journal-title":"J Extracell Biol"},{"key":"B142","doi-asserted-by":"publisher","first-page":"1801188","DOI":"10.1183\/13993003.01188-2018","article-title":"Increase in circulating ACE-positive endothelial microparticles during acute lung injury","volume":"54","author":"Takei","year":"2019","journal-title":"Eur Respir J"},{"key":"B143","doi-asserted-by":"publisher","DOI":"10.1038\/srep24316","article-title":"Low-density lipoprotein mimics blood plasma-derived exosomes and microvesicles during isolation and detection","volume":"6","author":"S\u00f3dar","year":"2016","journal-title":"Sci Rep"},{"key":"B144","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21186466","article-title":"A review of exosomal isolation methods: is size exclusion chromatography the best option","volume":"21","author":"Sidhom","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B145","doi-asserted-by":"publisher","first-page":"3288","DOI":"10.1038\/s41467-019-11182-0","article-title":"The generation and use of recombinant extracellular vesicles as biological reference material","volume":"10","author":"Geeurickx","year":"2019","journal-title":"Nat Commun"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1799086\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:19:24Z","timestamp":1774588764000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1799086\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":145,"alternative-id":["10.3389\/fimmu.2026.1799086"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1799086","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"article-number":"1799086"}}