The Role of Clinical Immunology in Non-Communicable Chronic Diseases: Pathophysiological Insights and Immunotherapeutic Perspectives

Common NCDs, such as type 2 diabetes, cardiovascular disease, cancer and obesity have become increasingly prevalent in populations worldwide. These are complex issues in relation to the underlying mechanisms of public health and involvement of immune system. The relevance of clinical immunity in the development and/or course of these diseases appears to be even more evident when considering shared inflammatory and immune pathways, including those involved in renal failure or removal; recently developed immunotherapies. This review emphasizes three main concepts: the impact of the immune system on clinical physiology, how immune dysregulation leads to a select set of chronic diseases and extrinsic factors (foods, pollutants, lifestyle habits-of-mind) that modulate immunity. It also reviews new immunotherapeutic strategies such as anti-cytokine development, checkpoint inhibitor therapy, regulatory-cell-based approaches and nanotechnology-based interventions, and microbiota-targeted therapies. The studies highlight the importance of transitioning from traditional treatment approaches to one that is immune-focused, precision-based and personalized—to be guided by a comprehensive understanding of the immune interactions in individual patients' diseases. The paper ends with suggestions for pragmatic steps, including promoting interdisciplinary research, stimulants for therapeutic innovation and identifying immune biomarkers for early detection, that could optimally improve the patient's outcome.