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Trained Immunity

Immunology · NLM MeSH · updated 2026-10-29 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

Ability of the innate immunity system to form immunologic memory and provide enhanced defense against subsequent secondary infections.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (791 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

Ability of the innate immunity system to form immunologic memory and provide enhanced defense against subsequent secondary infections. In trained immunity, long-term adaptation of innate immune cells occurs through epigenetic processes and metabolic cellular reprogramming to form long term immunologic memory.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Immunity, Trained; Trained Immunities; Innate Immune Memory; Immune Memories, Innate; Immune Memory, Innate; Innate Immune Memories; Memories, Innate Immune; Memory, Innate Immune.

Where it fits in the MeSH classification

Broader topics
Immunity, Innate

Related concepts

  • Innate Immunity
  • Immunologic Memory
  • Epigenetic Processes
  • Cellular Reprogramming

Research landscape

PubMed indexes 515 records tagged with the MeSH heading “Trained Immunity” (counts retrieved 2026-10-29). 515 of them (100.0%) were published from 2020 onward, and the busiest period so far is 2020 onward with 515 records.

Reviews account for 234 records (45.4%) and meta-analyses for 0. Randomized controlled trials number 5 (1.0%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 0 records; 2000-2009: 0 records; 2010-2019: 0 records; 2020 onward: 515 records0through 199902000-200902010-20195152020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19990
2000-20090
2010-20190
2020 onward515
Share of records by publication typeReviews: 45.4 percent; Meta-analyses: 0.0 percent; Randomized controlled trials: 1.0 percentReviews45.4% (234)Meta-analyses0.0% (0)Randomized controlled trials1.0% (5)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 515 PubMed records
TypeRecordsShare
Reviews23445.4%
Meta-analyses00.0%
Randomized controlled trials51.0%

Method: PubMed query "Trained Immunity"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.

Reading the evidence in immunology

Immune responses are studied in model organisms, in cells from donors and in patients, and the same pathway can behave differently across these settings. Mouse immune systems differ from human ones in important ways, and blood measurements may not reflect what happens in tissues. Clinical conclusions about immune-mediated disease or immunotherapy come mainly from controlled trials and long-term cohorts. Check the species and tissue studied, whether markers were linked to outcomes patients notice, and the follow-up time.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Trained immunity of alveolar macrophages enhances injury resolution via KLF4-MERTK-mediated efferocytosis
Chakraborty S, Singh A, Wang L, Wang X, Sanborn MA, Ye Z, et al.
2023Research article
Design not recorded in structured metadata
78cc by
PMID 37615937 · DOI · PMC10450795
Persistent epigenetic signals propel a senescence-associated secretory phenotype and trained innate immunity in CD34+ hematopoietic stem cells from diabetic patients
Vinci MC, Costantino S, Damiano G, Rurali E, Rinaldi R, Vigorelli V, et al.
2024Research article
Design not recorded in structured metadata
34cc by
PMID 38553774 · DOI · PMC10981360
Fatty acid desaturation and lipoxygenase pathways support trained immunity
Ferreira AV, Alarcon-Barrera JC, Domínguez-Andrés J, Bulut Ö, Kilic G, Debisarun PA, et al.
2023Research article
Design not recorded in structured metadata
34cc by
PMID 37968313 · DOI · PMC10651900
Trained immunity modulators: A new frontier in immunoregulation and disease intervention
Chen J, Wang C, Chen S, Cai H, Wang M, Chang J, et al.
2026Review article
Design not recorded in structured metadata
13cc by
PMID 40975126 · DOI · PMC13227289

Trained immunity of alveolar macrophages enhances injury resolution via KLF4-MERTK-mediated efferocytosis [1]

Research article Chakraborty S, Singh A, Wang L, Wang X, Sanborn MA, Ye Z, et al. · · 2023 · cited 78 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Recent studies suggest that training of innate immune cells such as tissue-resident macrophages by repeated noxious stimuli can heighten host defense responses.
Closing excerpt
Thus, our study has identified a subset of tissue-resident trained macrophages that prevent hyperinflammation and restore tissue homeostasis following repeated pathogen challenges.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (170 words)

Recent studies suggest that training of innate immune cells such as tissue-resident macrophages by repeated noxious stimuli can heighten host defense responses. However, it remains unclear whether trained immunity of tissue-resident macrophages also enhances injury resolution to counterbalance the heightened inflammatory responses. Here, we studied lung-resident alveolar macrophages (AMs) prechallenged with either the bacterial endotoxin or with Pseudomonas aeruginosa and observed that these trained AMs showed greater resilience to pathogen-induced cell death. Transcriptomic analysis and functional assays showed greater capacity of trained AMs for efferocytosis of cellular debris and injury resolution. Single-cell high-dimensional mass cytometry analysis and lineage tracing demonstrated that training induces an expansion of a MERTKhiMarcohiCD163+F4/80low lung-resident AM subset with a proresolving phenotype. Reprogrammed AMs upregulated expression of the efferocytosis receptor MERTK mediated by the transcription factor KLF4. Adoptive transfer of these trained AMs restricted inflammatory lung injury in recipient mice exposed to lethal P. aeruginosa. Thus, our study has identified a subset of tissue-resident trained macrophages that prevent hyperinflammation and restore tissue homeostasis following repeated pathogen challenges.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37615937 · DOI · PMC10450795

Persistent epigenetic signals propel a senescence-associated secretory phenotype and trained innate immunity in CD34+ hematopoietic stem cells from diabetic patients [2]

Research article Vinci MC, Costantino S, Damiano G, Rurali E, Rinaldi R, Vigorelli V, et al. · · 2024 · cited 34 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundDiabetes-induced trained immunity contributes to the development of atherosclerosis and its complications.
Closing excerpt
ConclusionsHyperglycemia induces marked chromatin modifications in HSPCs, which, once transmitted to the cell progeny, contributes to persistent and pathogenic changes in immune cell function and composition.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (245 words)

BackgroundDiabetes-induced trained immunity contributes to the development of atherosclerosis and its complications. This study aimed to investigate in humans whether epigenetic signals involved in immune cell activation and inflammation are initiated in hematopoietic stem/progenitor cells (HSPCs) and transferred to differentiated progeny.Methods and resultsHigh glucose (HG)-exposure of cord blood (CB)-derived HSPCs induced a senescent-associated secretory phenotype (SASP) characterized by cell proliferation lowering, ROS production, telomere shortening, up-regulation of p21 and p27genes, upregulation of NFkB-p65 transcription factor and increased secretion of the inflammatory cytokines TNFα and IL6. Chromatin immunoprecipitation assay (ChIP) of p65 promoter revealed that H3K4me1 histone mark accumulation and methyltransferase SetD7 recruitment, along with the reduction of repressive H3K9me3 histone modification, were involved in NFkB-p65 upregulation of HG-HSPCs, as confirmed by increased RNA polymerase II engagement at gene level. The differentiation of HG-HSPCs into myeloid cells generated highly responsive monocytes, mainly composed of intermediate subsets (CD14hiCD16+), that like the cells from which they derive, were characterized by SASP features and similar epigenetic patterns at the p65 promoter. The clinical relevance of our findings was confirmed in sternal BM-derived HSPCs of T2DM patients. In line with our in vitro model, T2DM HSPCs were characterized by SASP profile and SETD7 upregulation. Additionally, they generated, after myeloid differentiation, senescent monocytes mainly composed of proinflammatory intermediates (CD14hiCD16+) characterized by H3K4me1 accumulation at NFkB-p65 promoter.ConclusionsHyperglycemia induces marked chromatin modifications in HSPCs, which, once transmitted to the cell progeny, contributes to persistent and pathogenic changes in immune cell function and composition.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38553774 · DOI · PMC10981360

Fatty acid desaturation and lipoxygenase pathways support trained immunity [3]

Research article Ferreira AV, Alarcon-Barrera JC, Domínguez-Andrés J, Bulut Ö, Kilic G, Debisarun PA, et al. · · 2023 · cited 34 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Infections and vaccines can induce enhanced long-term responses in innate immune cells, establishing an innate immunological memory termed trained immunity.
Closing excerpt
Grasping the underscoring lipid metabolic pathways contributes to our understanding of trained immunity and may help to identify therapeutic tools and targets for the modulation of innate immune responses.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (123 words)

Infections and vaccines can induce enhanced long-term responses in innate immune cells, establishing an innate immunological memory termed trained immunity. Here, we show that monocytes with a trained immunity phenotype, due to exposure to the Bacillus Calmette-Guérin (BCG) vaccine, are characterized by an increased biosynthesis of different lipid mediators (LM) derived from long-chain polyunsaturated fatty acids (PUFA). Pharmacological and genetic approaches show that long-chain PUFA synthesis and lipoxygenase-derived LM are essential for the BCG-induced trained immunity responses of human monocytes. Furthermore, products of 12-lipoxygenase activity increase in monocytes of healthy individuals after BCG vaccination. Grasping the underscoring lipid metabolic pathways contributes to our understanding of trained immunity and may help to identify therapeutic tools and targets for the modulation of innate immune responses.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37968313 · DOI · PMC10651900

Trained immunity modulators: A new frontier in immunoregulation and disease intervention [4]

Review article Chen J, Wang C, Chen S, Cai H, Wang M, Chang J, et al. · · 2026 · cited 13 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundImmunotherapy has emerged as one of the most revolutionary approaches in disease treatments.
Closing excerpt
Finally, the limitations of current trained immunity modulators and insights into future directions for developing novel therapies targeting trained immunity are proposed.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (253 words)

BackgroundImmunotherapy has emerged as one of the most revolutionary approaches in disease treatments. However, most current and emerging immunotherapeutic strategies primarily target the adaptive immune system. Recent studies have elucidated that innate immune myeloid cells can develop sustained phenotypic modifications upon exposure to specific immunomodulators, mediated through coordinated metabolic alterations and epigenetic reprogramming. These changes lead to either hyperresponsive or hyporesponsive innate immune cells when exposed to secondary stimuli, a phenomenon termed "trained immunity". Over the past decade, trained immunity has garnered increasing attention for its potential to enhance host defense. While numerous studies have investigated trained immunity modulators, comprehensive reviews-especially those focusing on recently identified modulators-are still lacking.Aim of reviewThis review aims to elucidate the molecular mechanisms underlying trained immunity and its dual roles in various pathological conditions. We provide a comprehensive summary of the classifications and mechanisms of trained immunity inducers and suppressors identified in the past decade, emphasizing their therapeutic potential in immune-related diseases. Additionally, we discuss the limitations of these trained immunity modulators and offer insights into future directions for developing novel therapies targeting trained immunity. Key scientific concepts of review: This review first provide an overview of the molecular mechanisms underlying trained immunity, highlighting both its beneficial and detrimental effects on various diseases. Then it focuses on summarizing the classification and mechanisms of trained immunity modulators, including vaccines, polysaccharides, nanobiologics, endogenous mediators and other non-canonical modulators. Finally, the limitations of current trained immunity modulators and insights into future directions for developing novel therapies targeting trained immunity are proposed.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40975126 · DOI · PMC13227289

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Trained immunity - basic concepts and contributions to immunopathology [5]
    Ochando J, Mulder WJM, Madsen JC, Netea MG, Duivenvoorden R · Nat Rev Nephrol · 2023 · cited 392 times (Europe PMC)
  • Research article Innate immune memory in inflammatory arthritis [6]
    Jeljeli MM, Adamopoulos IE · Nat Rev Rheumatol · 2023 · cited 39 times (Europe PMC)
  • Research article The mechanisms and cross-protection of trained innate immunity [7]
    Hu S, Xiang D, Zhang X, Zhang L, Wang S, Jin K, et al. · Virol J · 2022 · cited 22 times (Europe PMC)
  • Research article The Role of NLRP3 Inflammasomes in Trained Immunity [8]
    Lee G, Ahn H, Lee E, Lee GS · Front Biosci (Landmark Ed) · 2023 · cited 10 times (Europe PMC)
  • Research article Trained immunity and epigenetic memory in long-term self-renewing hematopoietic cells [9]
    Johansson A, Lin DS, Mercier FE, Yamashita M, Divangahi M, Sieweke MH · Exp Hematol · 2023 · cited 10 times (Europe PMC)
  • Research article Innate immune memory in chronic HIV and HIV-associated neurocognitive disorders (HAND): potential mechanisms and clinical implications [10]
    Capriotti Z, Klase Z · J Neurovirol · 2024 · cited 9 times (Europe PMC)

References

  1. Chakraborty S, Singh A, Wang L, Wang X, Sanborn MA, Ye Z, et al.. Trained immunity of alveolar macrophages enhances injury resolution via KLF4-MERTK-mediated efferocytosis. . 2023. PMID 37615937 · DOI · PMC10450795
  2. Vinci MC, Costantino S, Damiano G, Rurali E, Rinaldi R, Vigorelli V, et al.. Persistent epigenetic signals propel a senescence-associated secretory phenotype and trained innate immunity in CD34+ hematopoietic stem cells from diabetic patients. . 2024. PMID 38553774 · DOI · PMC10981360
  3. Ferreira AV, Alarcon-Barrera JC, Domínguez-Andrés J, Bulut Ö, Kilic G, Debisarun PA, et al.. Fatty acid desaturation and lipoxygenase pathways support trained immunity. . 2023. PMID 37968313 · DOI · PMC10651900
  4. Chen J, Wang C, Chen S, Cai H, Wang M, Chang J, et al.. Trained immunity modulators: A new frontier in immunoregulation and disease intervention. . 2026. PMID 40975126 · DOI · PMC13227289
  5. Ochando J, Mulder WJM, Madsen JC, Netea MG, Duivenvoorden R. Trained immunity - basic concepts and contributions to immunopathology. Nat Rev Nephrol. 2023. PMID 36253509 · DOI · PMC9575643
  6. Jeljeli MM, Adamopoulos IE. Innate immune memory in inflammatory arthritis. Nat Rev Rheumatol. 2023. PMID 37674048 · DOI · PMC10721491
  7. Hu S, Xiang D, Zhang X, Zhang L, Wang S, Jin K, et al.. The mechanisms and cross-protection of trained innate immunity. Virol J. 2022. PMID 36482472 · DOI · PMC9733056
  8. Lee G, Ahn H, Lee E, Lee GS. The Role of NLRP3 Inflammasomes in Trained Immunity. Front Biosci (Landmark Ed). 2023. PMID 37796716 · DOI
  9. Johansson A, Lin DS, Mercier FE, Yamashita M, Divangahi M, Sieweke MH. Trained immunity and epigenetic memory in long-term self-renewing hematopoietic cells. Exp Hematol. 2023. PMID 36764598 · DOI
  10. Capriotti Z, Klase Z. Innate immune memory in chronic HIV and HIV-associated neurocognitive disorders (HAND): potential mechanisms and clinical implications. J Neurovirol. 2024. PMID 39733092 · DOI · PMC11846772

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-29.

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Related research topics

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All 90 articles in Immunology →

At a glance

515
PubMed records on this heading
100%
published since 2020
234
review articles
5
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-29; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Immunologic MemoryImmunology
  • Disease ResistanceImmunology
  • PhagocytosisImmunology
  • Adaptive ImmunityImmunology
  • ImmunityImmunology

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