Background/Objectives: Alcohol Use Disorder (AUD) represents a significant global public health challenge that is associated with cognitive deficits, immune dysfunction, and increased susceptibility to different comorbidities. Recent evidence suggests that neuroimmune signalling, particularly microglial activation and cytokine-mediated pathways, plays a critical role in the development, persistence, and relapse vulnerability of AUD. This narrative review aims to synthesize current evidence on the role of cytokines and interleukins (ILs) in AUD, emphasizing their modulation during alcohol exposure, withdrawal, and abstinence. Methods: A comprehensive narrative review methodology was employed, including a search in PubMed, Scopus, and Web of Science using relevant keywords. Peer-reviewed studies published in English that examined cytokine and interleukin profiles in adults with AUD were included. The main findings were synthesized into thematic domains to identify recurring patterns, inconsistencies, and research gaps. Results: AUD is associated with significant alterations in cytokine profiles. Pro-inflammatory markers such as IL-1β, IL-6, tumour necrosis factor alpha (TNF-α), IL-8, and IL-18 are elevated during active alcohol use and early abstinence, while anti-inflammatory markers like IL-10 show fluctuations. These immune changes are linked to systemic inflammation, neurotoxicity, and AUD severity. Cytokine levels tend to normalize with sustained abstinence, although severe AUD may lead to prolonged immune dysregulation. Associations between inflammatory markers and psychiatric symptoms, including anxiety and depression, were also observed. Conclusions: Immune dysregulation plays a central role in AUD pathophysiology, with cytokines serving as potential biomarkers for disease progression and treatment response. Future research should focus on longitudinal studies, diverse patient populations, and mechanistic investigations to refine biomarker utility and develop targeted immunomodulatory therapies. Addressing inflammation and neuroplasticity may enhance clinical outcomes in AUD management.

Background/Objectives: Alcohol Use Disorder (AUD) represents a significant global public health challenge, associated with cognitive deficits, immune dysfunction, and increased susceptibility to different comorbidities. Recent evidence suggests that neuroimmune signalling, particularly microglial activation and cytokine-mediated pathways, plays a critical role in the development, persistence, and relapse vulnerability of AUD. This narrative review aims to synthesize current evidence on the role of cytokines and interleukins in AUD, emphasizing their modulation during alcohol exposure, withdrawal, and abstinence. Methods: A comprehensive narrative review methodology was employed, including a search in PubMed, Scopus, and Web of Science using relevant keywords. Peer-reviewed studies published in English that examined cytokine and interleukin profiles in adults with AUD were included. The main findings were synthesized into thematic domains to identify recurring patterns, inconsistencies, and research gaps. Results: AUD is associated with significant alterations in cytokine pro-files. Pro-inflammatory markers such as IL-1β, IL-6, tumour necrosis factor alpha (TNF-α), IL-8, and IL-18 are elevated during active alcohol use and early abstinence, while anti-inflammatory markers like IL-10 show fluctuations. These immune changes are linked to systemic inflammation, neurotoxicity, and AUD severity. Cytokine levels tend to normalize with sustained abstinence, although severe AUD may lead to prolonged immune dysregulation. Associations between inflammatory markers and psychiatric symptoms, including anxiety and depression, were also observed. Conclusions: Immune dysregulation plays a central role in AUD pathophysiology, with cytokines serving as potential biomarkers for disease progression and treatment response. Future research should focus on longitudinal studies, diverse patient populations, and mechanistic investigations to refine biomarker utility and develop targeted immunomodulatory therapies. Addressing inflammation and neuroplasticity may enhance clinical outcomes in AUD management.

Background: Non‐pharmacological and complementary therapeutic, notably immersive virtual reality‐based interventions (IVR), could alleviate pain and anxiety associated with gynecologic procedures. Objective: To evaluate the effectiveness of IVR in reducing peri‐ and post‐procedural pain and anxiety in gynecologic procedures. Secondarily, to determine the safety of IVR. Search Strategy: A systematic review with meta‐analysis was conducted, after searching in PubMed/Medline, SCOPUS, Web of Science, CINAHL Complete and PEDro from database inception to September 2025 with no language or publication date restrictions set. Selection Criteria: Inclusion criteria were based on the PICOS framework: Population (patients undergoing gynecologic procedures), Intervention (IVR), Comparison (standard care or other therapeutic approaches), Outcomes (pain, anxiety and adverse events) and Study design (randomized controlled trials [RCTs]). Data Collection and Analysis: Pooled effects were calculated using Cohen's standardized mean difference (SMD) and its 95% confidence intervals (95% CI) in a random‐effects model. Potential adverse events during IVR exposure were also compiled. Main Results: A total of 25 randomized controlled trials (RCTs), comprising data from 2438 women (mean age 35.3 ± 12.6 years), were included. Intraprocedural outcomes indicated that IVR significantly decreased both pain (SMD = −0.46, 95% CI: −0.71 to −0.21, P < 0.001) and anxiety (SMD = −0.33, 95% CI: −0.63 to −0.03, P = 0.031). Post‐procedurally, IVR yielded further reductions in pain (SMD = −0.81, 95% CI: −1.12 to −0.5, P < 0.001) and anxiety (SMD = −0.76, 95% CI: −1.22 to −0.3, P = 0.001). Reported adverse events were minor and infrequent. Conclusion: This meta‐analysis suggests that IVR serves as a highly effective and safe non‐pharmacological adjunct for mitigating peri‐ and post‐procedural pain and anxiety in gynecologic settings. Translating these findings into clinical practice could substantially enhance patient care and overall experience. PROSPERO Registration: CRD420251000835

Chronic neck pain (CNP) is a global health problem characterized by persistent pain, functional disability, and restricted cervical range of motion (ROM). As an adjunct to conventional pharmacotherapy and physiotherapy, immersive virtual reality (IVR) interventions have emerged as a promising clinical tool for CNP management. The aim of this systematic review with meta-analysis (SRMA) was to assess the effectiveness of IVR in improving pain, disability and cervical ROM and joint position sense (JPS) in patients with CNP. Additionally, to evaluate the effectiveness of IVR in combination with physiotherapy programs or when used as a standalone intervention. A systematic literature search was conducted in PubMed Medline, SCOPUS, WOS, CINAHL and PEDro without restrictions from inception up to November 2025. Randomized controlled trials (RCTs) including patients with CNP which a group received IVR and others conventional physiotherapy or usual care were included. Pooled effect was estimated through the Cohen's standardized mean difference in a random-effects model. Nine RCTs were included in this SRMA, providing data from 430 patients with CNP (41 ± 13.7 years old, 67.4% female). Our findings report that IVR is effective in reducing pain (SMD = -0.41; 95% CI -0.76 to -0.07; p = 0.02), disability (SMD = -0.38; 95% CI -0.74 to -0.02; p = 0.037), as well as increasing extension (SMD = 0.34; 95% CI 0.02 to 0.66; p = 0.037) and flexion ROM (SMD = 0.43; 95% CI 0.11 to 0.76; p = 0.01) and JPS during cervical flexion (SMD = -0.56; 95% CI -0.13 to -2.53; p = 0.011). Current evidence suggests that IVR can be effective in improving pain, disability, cervical ROM and JPS in patients with CNP. IVR can be more effective in combination with physiotherapy programs. Limitations related to sample size, performance and detection biases, and heterogeneity between IVR protocols can be considered.