Evidence mapPaperPMID 42550263Full record

ReviewCancer immunology, immunotherapy : CII2026

The CREM-IL-15 axis: decoding the persistence-exhaustion paradox in NK cell immunotherapy.

Amr Ali Mohamed Abdelgawwad El-Sehrawy, Mutaz Jamal Al-Khreisat, Jalpa R Patel, Makhfirat Kibriyeva, Lutfullayeva Gulnoza, Khayriddin Qosimov, Lhyb Mohammed Abdul, Navin Kumar Tailor

Abstract readReview
In one paragraph

Review in Cancer immunology, immunotherapy : CII, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Amr Ali Mohamed Abdelgawwad El-SehrawyInternal Medicine, Diabetes, Endocrinology and Metabolism, Mansoura University, Mansoura, Egypt. Elsehrawyamralimohamedabdelgaw@gmail.com.
Mutaz Jamal Al-KhreisatFaculty of Allied Medical Sciences, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.
Jalpa R PatelDepartment of Pharmacy, Faculty of Pharmacy, Gokul Global University, Sidhpur, Gujarat, India.
Makhfirat KibriyevaDepartment of Medicine, Termez University of Economics and Service, Termez, Uzbekistan.
Lutfullayeva GulnozaDepartment of the Faculty of Postgraduate Education of the Samarkand State Medical University, Samarkand, Uzbekistan.
Khayriddin Qosimovof the First Hygiene Department, Bukhara Medical Institute, Bukhara, Uzbekistan.
Lhyb Mohammed AbdulDepartment of Pharmacy, College of Pharmacy, The Islamic University, Najaf, Iraq.
Navin Kumar TailorUniversity Institute of Pharma Sciences, Chandigarh University, Mohali, Punjab, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Natural killer (NK) cells are critical components of the innate immune system, renowned for their ability to recognize and eliminate malignant and infected cells without prior sensitization. NK cell immunotherapy encompasses various approaches, including adoptive transfer of ex vivo expanded NK cells, cytokine stimulation to enhance their activity, and genetic modifications to improve persistence and specificity. CREM is a cAMP-responsive transcription factor that modulates gene expression in response to receptor- and cytokine-driven signaling. Recent evidence now shows that IL-15 and CAR stimulation rapidly induce CREM in activated NK cells. Rafei (Nature 643:1076-1086, 2025) further demonstrated in CAR-NK models that CREM functions as a regulatory checkpoint limiting NK cell cytotoxicity and cytokine production, while its relevance in resting/native NK cells remains to be established. The CREM-IL-15 signaling axis has emerged as a pivotal regulator of NK cell biology, influencing their development, activation, and longevity. IL-15 is a critical cytokine for NK cell survival, proliferation, and functional maturation. Understanding this axis is vital, as it offers insights into mechanisms that sustain NK cell activity and those that lead to functional exhaustion, thereby informing strategies to enhance therapeutic efficacy. A central challenge in NK cell immunotherapy is balancing cellular persistence with functional exhaustion. Persistent NK cell activity is desirable for sustained tumor control; however, prolonged activation often results in cellular exhaustion characterized by diminished cytotoxicity and cytokine production. This paradox hampers the long-term success of NK cell-based treatments. The CREM-IL-15 axis plays a complex role in this dynamic, potentially promoting NK cell survival and persistence while also contributing to exhaustion under certain conditions. Deciphering the molecular underpinnings of this paradox is essential for developing interventions that maintain NK cell functionality over time, thereby improving therapeutic outcomes in cancer patients.

Indexed as

Cyclic AMP Response Element ModulatorImmunotherapyImmunotherapy, AdoptiveInterleukin-15Killer Cells, NaturalNeoplasmsAnimalsHumansSignal TransductionCREM protein, humanCyclic AMP Response Element ModulatorInterleukin-15CancerCREMCytokineIL-15ImmunotherapyNK cell

Identifiers

PMID42550263
PMCPMC13437876

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.