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Review
. 2025 May;155(5):1420-1434.
doi: 10.1016/j.jaci.2025.02.018. Epub 2025 Feb 24.

TL1A, a novel alarmin in airway, intestinal, and autoimmune disorders

Affiliations
Review

TL1A, a novel alarmin in airway, intestinal, and autoimmune disorders

Gilda Varricchi et al. J Allergy Clin Immunol. 2025 May.

Abstract

The term alarmin denotes a broad class of molecules rapidly released to alert the immune system through the engagement of specific receptors on immune cells. Three alarmin cytokines-thymic stromal lymphopoietin, IL-33, and IL-25-are released from epithelial and certain stromal cells. TNF-like cytokine 1A (TL1A) is a member of the TNF cytokine superfamily, first identified in human endothelial cells. TL1A is now considered a novel alarmin expressed by human and mouse bronchial and intestinal epithelial cells. TL1A exerts its biological activities by binding to a trimeric receptor DR3 (death receptor 3), expressed on a wide spectrum of immune and structural cells, including lung fibroblasts, endothelial cells, and bronchial epithelial cells. TL1A has been implicated in experimental and human inflammatory bowel diseases as well as in airway inflammation and remodeling in severe asthma. A monoclonal antibody anti-TL1A (tulisokibart) is effective in inducing clinical remission in ulcerative colitis patients. Increasing evidence suggests that TL1A is also involved in certain autoimmune disorders, such as rheumatoid arthritis and psoriasis. These emerging findings broaden the role of TL1A in various human inflammatory conditions. Several clinical trials are currently evaluating the safety and efficacy of monoclonal antibodies targeting TL1A in asthma or inflammatory bowel disease patients.

Keywords: Airway inflammation; alarmins; asthma; autoimmune disorders; inflammation; inflammatory bowel disease; remodelling.

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Conflict of interest statement

Disclosure statement Supported in part by grants from the CISI-Lab Project (University of Naples Federico II), TIMING Project and Campania Bioscience (Regione Campania), to G.M. and G.V. P.N. is supported by the Frederick E. Hargreave Teva Innovation Chair in Airway Diseases. R.P. is a recipient of grants from Associazione Italiana Pneumologi Ospedalieri (AIPO) 2023 and Società Italiana di Medicina Interna (SIMI) 2024. Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.

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