OPENING
IMAJ | volume 28
Journal 8, August 2026
pages: 481-483
The Ever-evolving Landscape of Inborn Errors of Immunity
1 Lautenberg Center for Immunology and Cancer Research, Institute of Medical Research Israel-Canada (IMRIC), Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
2 Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
3 Department of Pediatrics A, Safra Children's Hospital, Jeffrey Modell Foundation Center, Sheba Medical Center, Tel Hashomer, Israel
4 Pediatric Immunology Services, Safra Children's Hospital, Jeffrey Modell Foundation Center, Sheba Medical Center, Tel Hashomer, Israel
5 Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
6 Israel Association of Allergy and Clinical Immunology, Israel Medical Association, Ramat Gan, Israel
Summary
Inborn errors of immunity (IEI) result from pathogenic germline variants. These disorders are clinically characterized by increased susceptibility to infections and immune dysregulation, often leading to reduced survival [1]. By linking specific monogenic defects to immune phenotypes, IEI serve as experiments of nature that provide powerful models for dissecting human immunology [2]. The International Union of Immunological Societies (IUIS) currently classifies IEI into 10 major categories with overlapping phenotypes [3]: combined T- and B-cell immunodeficiencies, combined immunodeficiencies with syndromic features, predominantly antibody deficiencies, diseases of immune dysregulation, congenital defects of phagocytes, defects in intrinsic and innate immunity, autoinflammatory diseases, complement deficiencies, bone marrow failure, and phenocopies of IEIs. The recent 2024 IUIS update was designed to serve clinicians and researchers and to inform the design of targeted sequencing panels that facilitate the genetic diagnosis of IEI. It lists 508 genes underlying 559 conditions [3]. Of note, molecular, cellular, and clinical investigations of IEI have transformed our understanding of disease pathogenesis and enabled effective targeted therapies.