CD43: recent advances and emerging functions

Originally characterized for its roles in T-cell activation and adhesion, CD43 is a prominent mucin-like sialoglycoprotein expressed on hematopoietic cells. CD43 is broadly expressed across leukocyte populations, with its levels, molecular configuration, and ligand interactions varying by cell type, activation state, and differentiation. Growing evidence indicates that CD43 functions as a context-dependent regulator, integrating microenvironmental cues and dynamic glycosylation states with the biophysical organization of the cell surface and intracellular signaling. CD43 simultaneously participates in immune activation, regulation, and dysfunction, depending on the cellular and environmental context. CD43 is associated with distinct, sometimes contrasting, functional outcomes across diverse physiological and pathological settings. For instance, it has been linked to altered leukocyte trafficking and activation, while in infectious diseases, it influences host-pathogen interactions and the balance between protective immunity and immunopathology. Furthermore, in cancer, changes in CD43 signaling, glycosylation, and ligand engagement modulate immune recognition, effector responses, and inflammatory processes, contributing to immune evasion. Here, we review current knowledge on the regulation of CD43 expression, its structural organization, and ligand interactions. We discuss the potential role of CD43 across different disease settings, proposing it as a dynamic, adaptable regulator of immune responses and a potential therapeutic target in immune-mediated diseases.