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Immunology is remaking modern medicine. Engineered cell therapies, vaccine platforms, in vivo gene delivery, precision analytics, artificial intelligence (AI)-driven epitope discovery and protein design, immunoexposomics and microbiome-based therapeutics are turning mechanisms into medicines at pace. Clinicians are moving insights from bench to bedside across cancer, infection, autoimmunity, allergy, neurology, transplantation and more. BMJ Immunology exists to serve this moment.