{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:34:41Z","timestamp":1792427681642,"version":"4.5.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and triglyceride-glucose (TyG) index are used to evaluate the risk of coronary artery disease (CAD) or chronic kidney disease (CKD). However, there are limited reports on their role in CKD risk assessment among CAD patients. This study focuses on their linear\/nonlinear correlations, threshold effects, and mediating effects with CKD risk strata (classified by KDIGO) among CAD patients to explore their interrelationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study enrolled 1,091 patients with chronic coronary syndrome (CCS), 166 patients with acute coronary syndrome (ACS), and 431 healthy controls (HC). Their complete blood count indices and glucose\/lipid metabolism parameters were used to calculate the NLR\/PLR (reflecting immuno-inflammation) and TyG index (reflecting insulin resistance), and their kidney biomarkers were used to evaluate the CKD risk strata based on KDIGO classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No significant differences were found between acute and chronic CAD patients in any observational indicators except urea (all P&amp;gt;0.05). As CKD risk strata increased, NLR (z=17.813, P&amp;lt;0.001), PLR (z=8.699, P&amp;lt;0.001), TyG (z=11.213, P&amp;lt;0.001), and insulin resistance (\u03b3=0.471, P&amp;lt;0.001) rose progressively. After adjusting for sex, age, and disease, the NLR and PLR showed linear correlations with potential CKD (P for nonlinear=0.094 and 0.152), with no threshold effects (P for likelihood=0.113 and 0.890); in contrast, TyG showed a nonlinear correlation (P for nonlinear=0.003; Reference threshold=8.62) and a threshold-dependent effect (P for likelihood test&amp;lt;0.001; Inflection point=8.67). Among the three indicators, only the NLR and TyG significantly predicted all four CKD risk strata (NLR OR\u00a0=\u00a02.30, 2.34, 2.70, and 2.73; TyG OR\u00a0=\u00a03.80, 3.27, 3.48, and 11.98; all P&amp;lt;0.01). Finally, the NLR and TyG demonstrated a reciprocal mediating role in potential CKD, with their effects strengthening as risk strata increased (NLR Mediation=14.52%~30.16%; TyG Mediation=6.54%~27.07%; all P&amp;lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The NLR and TyG index may serve as potential inflammation-metabolism markers for predicting potential CKD in CAD patients. The reciprocal mediation of NLR and TyG index across CKD risk strata suggests that immuno-inflammation and insulin resistance are overlapping correlates of higher CKD likelihood, rather than fully independent predictors. Combining both indices may improve early identification of high-risk CKD patients and enable early intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1937248","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:43:12Z","timestamp":1788928992000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Reciprocal mediation of immuno-inflammation and insulin resistance in the risk of chronic kidney disease among patients with coronary artery disease: insights from neutrophil-to-lymphocyte ratio and triglyceride-glucose index"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaohong","family":"Chen","sequence":"first","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bitao","family":"Wu","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqiang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Yang","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Tang","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Yang","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Mianyang, China"]},{"name":"NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital)","place":["Mianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2624-5607","article-title":"The history of coronary artery disease","volume":"34","author":"Gorton","year":"2025","journal-title":"Int J Angiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s11883-025-01309-8","article-title":"Global perspectives on coronary artery disease: The emerging role of miRNAs","volume":"27","author":"Mansour","year":"2025","journal-title":"Curr Atheroscler Rep"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/9715114","article-title":"Role of matrix metalloproteinase-2 in the development of atherosclerosis among patients with coronary artery disease","volume":"2023","author":"Samah","year":"2023","journal-title":"Mediators Inflammation"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf958","article-title":"Non-ST-segment elevation acute coronary syndrome: Understanding the full spectrum to guide management","volume":"47","author":"Savonitto","year":"2026","journal-title":"Eur Heart J"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.2931","article-title":"7 takeaways for primary care clinicians from the updated acute coronary syndromes guideline","volume":"333","author":"Rodgers","year":"2025","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2026.01.075","article-title":"Chronic kidney disease screening in patients with coronary heart disease: The multinational INTERASPIRE study","volume":"87","author":"Al-Azzawy","year":"2026","journal-title":"J Am Coll Cardiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-020-00842-w","article-title":"Renal dysfunction in cardiovascular diseases and its consequences","volume":"34","author":"Deferrari","year":"2021","journal-title":"J Nephrol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/epidemiologia7030087","article-title":"10-year change in the laboratory-based prevalence of chronic kidney disease in patients from a Brazilian cardiologic center","volume":"7","author":"Samaan","year":"2026","journal-title":"Epidemiologia (Basel)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000001054","article-title":"Chronic inflammation as an overlooked link between cardiovascular and kidney disease: A focus on IL-6 and C-reactive protein","author":"Pergola","year":"2026","journal-title":"Clin J Am Soc Nephrol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26157440","article-title":"Cardiorenal syndrome: Molecular pathways linking cardiovascular dysfunction and chronic kidney disease progression","volume":"26","author":"Vasquez","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.72443","article-title":"An integrated pathophysiological and clinical perspective of the synergistic effects of obesity, hypertension, and hyperlipidemia on cardiovascular health: A systematic review","volume":"16","author":"Okoh","year":"2024","journal-title":"Cureus"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2026.03.031","article-title":"The kidney in the middle: KDIGO guidelines address multiple key components of cardiovascular-kidney-metabolic syndrome","volume":"110","author":"Levin","year":"2026","journal-title":"Kidney Int"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000001216","article-title":"Do neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio reflect coronary artery disease severity assessed by SYNTAX score?: A meta-analysis","author":"Assayed","year":"2026","journal-title":"Cardiol Rev"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.72173","article-title":"Association of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with three-vessel coronary artery disease: A case-control study","volume":"9","author":"Ayazkhoo","year":"2026","journal-title":"Health Sci Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14196822","article-title":"Neutrophil-to-lymphocyte ratio (NLR)-independent prognostic marker of renal function decline in chronic kidney disease: A systematic review and meta-analysis","volume":"14","author":"Burlacu","year":"2025","journal-title":"J Clin Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12902-024-01564-x","article-title":"Correlation between insulin resistance and the rate of neutrophils-lymphocytes, monocytes-lymphocytes, platelets-lymphocytes in type 2 diabetic patients","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Endocr Disord"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.106772","article-title":"Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and glucose transporter 1 (GLUT-1) as predictors of insulin resistance in patients with rheumatoid arthritis: A cross-sectional study","volume":"18","author":"Upadhyay","year":"2026","journal-title":"Cureus"},{"key":"B19","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/s12933-024-02159-5","article-title":"Insulin resistance and coronary inflammation in patients with coronary artery disease: A cross-sectional study","volume":"23","author":"Yang","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/nu13124349","article-title":"Role and treatment of insulin resistance in patients with chronic kidney disease: A review","volume":"13","author":"Nakashima","year":"2021","journal-title":"Nutrients"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.70162","article-title":"Illuminating glucose: How to unveil organ-specific insulin resistance and guide metabolic strategies in diabetes","volume":"42","author":"Gugliandolo","year":"2026","journal-title":"Diabetes Metab Res Rev"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/life15121845","article-title":"Beyond HOMA-IR: Comparative evaluation of insulin resistance and anthropometric indices across prediabetes and type 2 diabetes mellitus in metabolic syndrome patients","volume":"15","author":"Assani","year":"2025","journal-title":"Life (Basel)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1089\/met.2008.0034","article-title":"The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects","volume":"6","author":"Simental-Mend\u00eda","year":"2008","journal-title":"Metab Syndr Relat Disord"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2022.102581","article-title":"Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and tryglyceride\/glucose index","volume":"16","author":"Tahapary","year":"2022","journal-title":"Diabetes Metab Syndr"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-023-01044-5","article-title":"Baseline and usual triglyceride-glucose index and the risk of chronic kidney disease: A prospective cohort study","volume":"46","author":"Kunutsor","year":"2024","journal-title":"Geroscience"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2750","DOI":"10.1186\/s12889-024-20243-z","article-title":"Evaluating the impact of chronic kidney disease and the triglyceride-glucose index on cardiovascular disease: Mediation analysis in the NHANES","volume":"24","author":"Pei","year":"2024","journal-title":"BMC Public Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1186\/s12933-024-02244-9","article-title":"Joint association of TyG index and high sensitivity C-reactive protein with cardiovascular disease: A national cohort study","volume":"23","author":"Cui","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-024-05241-6","article-title":"The new ESC acute coronary syndrome guideline and its impact in the CPU and emergency department setting","volume":"49","author":"M\u00f6ckel","year":"2024","journal-title":"Herz"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1005-2194.2006.09.012","article-title":"Evaluating and refitting the simplified equation of MDRD to predict glomerular filtration rate in Chinese patients with chronic kidney disease","volume":"26","author":"Shi","year":"2006","journal-title":"Chin J Pract Internal Med (Clinical Edition)"},{"key":"B30","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12933-025-02574-2","article-title":"Triglyceride-glucose index: Carotid intima-media thickness and cardiovascular risk in a European population","volume":"24","author":"Pavanello","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1186\/s12967-024-05524-w","article-title":"Triglyceride-glucose index and glycemic dynamics in pancreatic ductal adenocarcinoma: Implications for disease progression and prognosis","volume":"22","author":"Song","year":"2024","journal-title":"J Transl Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney Int"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10061272","article-title":"The predictive value of NLR, MLR, and PLR in the outcome of end-stage kidney disease patients","volume":"10","author":"Mure\u0219an","year":"2022","journal-title":"Biomedicines"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S496419","article-title":"The predictive value of TyG index and NLR for risk of CHD and the severity of coronary artery lesions in patients with type 2 diabetes mellitus","volume":"17","author":"Li","year":"2024","journal-title":"J Inflammation Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S548327","article-title":"Triglyceride-glucose index and neutrophil-to-lymphocyte ratio: A metabolic-inflammatory signature for mortality prediction in a multicenter retrospective cohort of 1249 dialysis patients with coronary artery disease","volume":"18","author":"Li","year":"2025","journal-title":"J Inflammation Res"},{"key":"B36","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1186\/s12882-025-04363-1","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio for the clinical outcomes of chronic kidney diseases: An update systematic review and meta-analysis","volume":"26","author":"Xu","year":"2025","journal-title":"BMC Nephrol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1017\/S000711452100516X","article-title":"A high neutrophil to lymphocyte ratio is associated with poor nutritional status in chronic kidney disease patients","volume":"128","author":"Han","year":"2022","journal-title":"Br J Nutr"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000035197","article-title":"The relationship between neutrophil lymphocyte ratio, platelet lymphocyte ratio, and depression in dialysis patients","volume":"102","author":"Tutan","year":"2023","journal-title":"Med (Baltimore)"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25168705","article-title":"Hallmarks for thrombotic and hemorrhagic risks in chronic kidney disease patients","volume":"25","author":"Saeed","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3390\/biom11091309","article-title":"Coagulation abnormalities in renal pathology of chronic kidney disease: The interplay between blood cells and soluble factors","volume":"11","author":"Pavlou","year":"2021","journal-title":"Biomolecules"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S465317","article-title":"Relationship of the neutrophil-lymphocyte ratio with all-cause and cardiovascular mortality in patients with diabetic kidney disease: A prospective cohort study of NHANES study","volume":"17","author":"Zeng","year":"2024","journal-title":"J Multidiscip Healthc"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S542136","article-title":"Association of systemic inflammatory biomarkers (NLR, MLR, PLR, SII, SIRI) with preeclampsia-related kidney injury: A retrospective observational study","volume":"18","author":"Gao","year":"2025","journal-title":"J Inflammation Res"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-021-01162-3","article-title":"Neutrophil-to-lymphocyte ratio is a marker for acute kidney injury progression and mortality in critically ill populations: A population-based, multi-institutional study","volume":"35","author":"Chen","year":"2022","journal-title":"J Nephrol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1285509","article-title":"Association between neutrophil-to-lymphocyte ratio and diabetic kidney disease in type 2 diabetes mellitus patients: A cross-sectional study","volume":"14","author":"Li","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B45","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1186\/s12872-024-04407-8","article-title":"Association between triglyceride-glucose index and cardiovascular disease in US adults with chronic kidney disease: A population-based study","volume":"24","author":"Liu","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01577-4","article-title":"Triglyceride-glucose index is a good indicator for early prediction of future chronic kidney disease development in all blood pressure subtypes","volume":"47","author":"Kinguchi","year":"2024","journal-title":"Hypertens Res"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1376166","article-title":"Relationship between the longitudinal trajectory of the triglyceride-glucose index and the development of CKD: An 8-year retrospective longitudinal cohort study","volume":"15","author":"Hou","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1018083","article-title":"The non-linear relationship between triglyceride-glucose index and risk of chronic kidney disease in hypertensive patients with abnormal glucose metabolism: A cohort study","volume":"9","author":"Zhu","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3390\/life16020345","article-title":"The association between the triglyceride-glucose index and the risk of diabetic kidney disease in patients with type 2 diabetes mellitus: A cross-sectional study","volume":"16","author":"Momani","year":"2026","journal-title":"Life (Basel)"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112163","article-title":"The impact of sex-related disparities on the association between triglyceride-glucose index and renal function decline in patients with type 2 diabetes: Insights from the ACCORD trial","volume":"224","author":"Wang","year":"2025","journal-title":"Diabetes Res Clin Pract"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1937248\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:43:23Z","timestamp":1788929003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1937248\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":50,"alternative-id":["10.3389\/fimmu.2026.1937248"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1937248","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1937248"}}