Immunity, Inflammation and Disease最新文献

Systemic inflammation markers independently associated with increased mortality in individuals with hyperuricemia: Results from the NHANES prospective cohort study. 全身炎症标志物与高尿酸血症患者死亡率升高密切相关：NHANES前瞻性队列研究的结果。

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-10-01 DOI: 10.1002/iid3.70032

Tian Ren, Erye Zhou, Jian Wu, Chao Wang, Yufeng Yin

Background: Hyperuricemia is associated with increased systemic inflammation. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are novel systemic inflammation markers and prognostic markers. However, no studies have evaluated the association between the SII/SIRI and mortality risk in individuals with hyperuricemia. This study aimed to investigate the predictive value of the SII and SIRI for all-cause and cardiovascular mortality in a large cohort of hyperuricemia patients.

Methods: We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2020. Hyperuricemia was defined as serum uric acid (SUA) levels of ≥7 mg/dL in men and ≥6 mg/dL in women. The SII and SIRI were calculated based on complete blood count parameters. Associations with all-cause and cardiovascular mortality were analyzed using Cox proportional hazards models. Nonlinearity and effect modification were assessed using restricted cubic splines (RCS) and interaction analysis.

Results: Among the 6181 participants with hyperuricemia aged 20 years and older, over a total 181 months of follow-up, there were 936 all-cause deaths, of which 195 were cardiovascular mortality. In the fully adjusted models, the hazard ratios (HRs) were 1.73 (95% CI 1.42-2.13) for the SII and 2.18 (95% CI 1.82-2.62) for the SIRI with all-cause mortality. The adjusted HRs were 2.08 (95% CI 1.37-3.14) for the SII and 2.32 (95% CI 1.56-3.45) for the SIRI with cardiovascular mortality. Spline models identified nonlinear U-shaped (SII) and J-shaped (SIRI) relationships of inflammation markers with mortality.

Conclusions: Elevated SII and SIRI are independent predictors of mortality in hyperuricemia patients. These inflammatory biomarkers may improve risk stratification in this high-risk population. Further research should evaluate utility in guiding preventive interventions.

背景：高尿酸血症与全身炎症加剧有关。全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）是新型的全身炎症标志物和预后标志物。然而，还没有研究评估过 SII/SIRI 与高尿酸血症患者死亡风险之间的关联。本研究旨在调查 SII 和 SIRI 对一大批高尿酸血症患者的全因死亡率和心血管死亡率的预测价值：我们利用美国国家健康与营养调查（NHANES）2001-2020 年的数据开展了一项前瞻性队列研究。高尿酸血症的定义是男性血清尿酸（SUA）水平≥7 mg/dL，女性≥6 mg/dL。SII和SIRI是根据全血细胞计数参数计算得出的。与全因死亡率和心血管死亡率的关系采用 Cox 比例危险模型进行分析。使用限制性立方样条（RCS）和交互分析评估了非线性和效应修正：在 6181 名年龄在 20 岁及以上的高尿酸血症患者中，在长达 181 个月的随访中，共有 936 人死于各种原因，其中 195 人死于心血管疾病。在完全调整模型中，SII 和 SIRI 与全因死亡率的危险比分别为 1.73（95% CI 1.42-2.13）和 2.18（95% CI 1.82-2.62）。SII和SIRI与心血管死亡率的调整HR分别为2.08（95% CI 1.37-3.14）和2.32（95% CI 1.56-3.45）。样条模型确定了炎症指标与死亡率之间的非线性U形（SII）和J形（SIRI）关系：结论：SII 和 SIRI 升高是高尿酸血症患者死亡率的独立预测指标。这些炎症生物标志物可改善这类高危人群的风险分层。进一步的研究应评估其在指导预防性干预措施方面的效用。

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引用次数: 0

Biomarkers for systemic lupus erythematosus: A scoping review. 系统性红斑狼疮的生物标志物：范围综述。

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-10-01 DOI: 10.1002/iid3.70022

Su-Jie Zhang, Rui-Yang Xu, Long-Li Kang

Background: In recent years, newly discovered potential biomarkers have great research potential in the diagnosis, disease activity prediction, and treatment of systemic lupus erythematosus (SLE).

Objective: In this study, a scoping review of potential biomarkers for SLE over several years has identified the extent to which studies on biomarkers for SLE have been conducted, the specificity, sensitivity, and diagnostic value of potential biomarkers of SLE, the research potential of these biomarkers in disease diagnosis, and activity detection is discussed.

Methods: In PubMed and Google Scholar databases, "SLE," "biomarkers," "predictor," "autoimmune diseases," "lupus nephritis," "neuropsychiatric SLE," "diagnosis," "monitoring," and "disease activity" were used as keywords to systematically search for SLE molecular biomarkers published from 2020 to 2024. Analyze and summarize the literature that can guide the article.

Conclusions: Recent findings suggest that some potential biomarkers may have clinical application prospects. However, to date, many of these biomarkers have not been subjected to repeated clinical validation. And no single biomarker has sufficient sensitivity and specificity for SLE. It is not scientific to choose only one or several biomarkers to judge the complex disease of SLE. It may be a good direction to carry out a meta-analysis of various biomarkers to find SLE biomarkers suitable for clinical use, or to evaluate SLE by combining multiple biomarkers through mathematical models. At the same time, advanced computational methods are needed to analyze large data sets and discover new biomarkers, and strive to find biomarkers that are sensitive and specific enough to SLE and can be used in clinical practice, rather than only staying in experimental research and data analysis.

背景：近年来，新发现的潜在生物标志物在系统性红斑狼疮（SLE）的诊断、疾病活动预测和治疗方面具有巨大的研究潜力：近年来，新发现的潜在生物标志物在系统性红斑狼疮（SLE）的诊断、疾病活动预测和治疗方面具有巨大的研究潜力：本研究对几年来系统性红斑狼疮的潜在生物标志物进行了范围性回顾，确定了系统性红斑狼疮生物标志物研究的开展程度，系统性红斑狼疮潜在生物标志物的特异性、敏感性和诊断价值，讨论了这些生物标志物在疾病诊断和活动检测方面的研究潜力：在PubMed和谷歌学术数据库中，以 "系统性红斑狼疮"、"生物标志物"、"预测因子"、"自身免疫性疾病"、"狼疮肾炎"、"神经精神系统性红斑狼疮"、"诊断"、"监测 "和 "疾病活动 "为关键词，系统检索2020年至2024年发表的系统性红斑狼疮分子生物标志物。分析并总结文献，为文章提供指导。结论：最新研究结果表明，一些潜在的生物标志物可能具有临床应用前景。然而，迄今为止，其中许多生物标志物尚未经过反复的临床验证。而且没有一种生物标志物对系统性红斑狼疮具有足够的敏感性和特异性。仅选择一种或几种生物标志物来判断系统性红斑狼疮这种复杂的疾病是不科学的。对各种生物标志物进行荟萃分析，寻找适合临床使用的系统性红斑狼疮生物标志物，或者通过数学模型将多种生物标志物结合起来对系统性红斑狼疮进行评估，也许是一个不错的方向。同时，还需要先进的计算方法来分析大型数据集和发现新的生物标志物，并努力寻找对系统性红斑狼疮足够敏感和特异的、可用于临床实践的生物标志物，而不是仅仅停留在实验研究和数据分析上。

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引用次数: 0

Exercise preconditioning mitigates brain injury after cerebral ischemia-reperfusion injury in rats by restraining TIMP1. 运动预处理通过抑制 TIMP1 减轻大鼠脑缺血再灌注损伤后的脑损伤

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-10-01 DOI: 10.1002/iid3.70008

Xiangbo Meng, Hui Yang, Feifeng Chen, Baohua Li, Yan Wu, Rong Wang

Background: Cerebral ischemic disease is a common cerebrovascular disease, especially ischemic stroke. Exercise has protective functions on brain tissues following cerebral ischemia-reperfusion injury (CIRI), but its preventive effects and mechanisms in CIRI remain unclear. We aimed to investigate the effects and mechanisms of exercise preconditioning on CIRI.

Methods: The middle cerebral artery occlusion (MCAO) operation was prepared to establish CIRI rats. All rats were randomized into the MCAO, exercise (exercise preconditioning plus MCAO operation), vector (exercise preconditioning, MCAO operation plus intraventricular injection of empty vector), and tissue inhibitor of metalloprotease 1 overexpression (OE-TIMP1, exercise preconditioning, MCAO operation plus intraventricular injection of OE-TIMP1) groups.

Results: The results indicated that exercise preconditioning suppressed approximately 66.67% of neurological deficit scores and 73.79% of TIMP1 mRNA expression in MCAO rats, which were partially offset by OE-TIMP1. The protective effects of exercise against neuron death status and cerebral infarction size in MCAO rats were reversed by OE-TIMP1. It also confirmed that exercise weakened apoptosis and oxidative stress damage, with notable increases of B-cell lymphoma-2, superoxide dismutase, and glutathione peroxidase production, and evident decreases of BCL2-associated X, caspase 3, and malondialdehyde in MCAO rats, while these effects were partially reversed by OE-TIMP1. Additionally, the inhibitory effects of exercise on the protein levels of TIMP1, hypoxia-inducible factor-alpha, vascular endothelial growth factor receptor 2, vascular endothelial growth factor, and neurogenic locus notch homolog protein 1 in MCAO rats were partially reversed by OE-TIMP1.

Conclusion: Altogether, exercise preconditioning had protective effects on CIRI by restraining TIMP1, which provided new therapeutic strategies for preventing CIRI.

背景：脑缺血疾病是一种常见的脑血管疾病，尤其是缺血性脑卒中。运动对脑缺血再灌注损伤（CIRI）后的脑组织有保护作用，但其对CIRI的预防作用和机制尚不清楚。我们旨在研究运动预处理对 CIRI 的影响和机制：方法：准备大脑中动脉闭塞（MCAO）手术，建立 CIRI 大鼠。所有大鼠随机分为MCAO组、运动组（运动预处理加MCAO手术）、载体组（运动预处理、MCAO手术加脑室内注射空载体）和组织金属蛋白酶1抑制剂过表达组（OE-TIMP1、运动预处理、MCAO手术加脑室内注射OE-TIMP1）：结果表明，运动预处理抑制了 MCAO 大鼠约 66.67% 的神经功能缺损评分和 73.79% 的 TIMP1 mRNA 表达，而 OE-TIMP1 则部分抵消了这一作用。运动对 MCAO 大鼠神经元死亡状态和脑梗塞面积的保护作用被 OE-TIMP1 逆转。研究还证实，运动削弱了 MCAO 大鼠的细胞凋亡和氧化应激损伤，B 细胞淋巴瘤-2、超氧化物歧化酶和谷胱甘肽过氧化物酶的生成明显增加，BCL2 相关 X、Caspase 3 和丙二醛的生成明显减少，而这些效应被 OE-TIMP1 部分逆转。此外，OE-TIMP1 还能部分逆转运动对 MCAO 大鼠体内 TIMP1、缺氧诱导因子-α、血管内皮生长因子受体 2、血管内皮生长因子和神经原位点缺口同源蛋白 1 蛋白水平的抑制作用：总之，运动预处理通过抑制 TIMP1 对 CIRI 具有保护作用，为预防 CIRI 提供了新的治疗策略。

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引用次数: 0

The mediating role of insulin resistance in the association between inflammatory score and MAFLD: NHANES 2017-2018. 胰岛素抵抗在炎症评分与 MAFLD 关联中的中介作用：NHANES 2017-2018。

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-10-01 DOI: 10.1002/iid3.70035

Yan Chen, Xin Zhao

Background: The association between inflammatory score, insulin resistance (IR), and metabolic-associated fatty liver disease (MAFLD) is inconclusive.

Objective: The objective of this study was to examine the relationship between the inflammatory score and MAFLD and investigate the potential mediating effect of IR (evaluated by triglyceride-glucose index) in this association.

Methods: Calculating inflammatory score was performed based on white blood cells and high-sensitivity C-reactive protein. The association between the inflammatory score and MAFLD was evaluated based on the weighted multifactor logistic regression model. Restricted cubic splines (RCS) were used to visualize the dose-response relationship between the inflammatory score and MAFLD. We also conducted a mediation analysis to assess the extent to which IR mediates this association.

Results: Among the 1090 participants, 563 were ultimately diagnosed with MAFLD. Multivariate logistic regression results indicated a close positive association between inflammatory score and MAFLD (odds ratio = 1.235, 95% confidence interval 1.069-1.427, p = .007). The RCS results indicated a linear dose-response relationship between the inflammatory score and the risk of MAFLD after adjusting for potential confounding factors. Furthermore, the mediation analysis results showed that IR partially mediated the association between the inflammatory score and MAFLD (percent mediation = 33%).

Conclusion: Our research results indicate that the inflammatory score is positively associated with the risk of MAFLD, and IR plays a partial mediating effect in this association.

背景：炎症评分、胰岛素抵抗（IR）和代谢相关性脂肪肝（MAFLD）之间的关系尚无定论：本研究旨在探讨炎症评分与 MAFLD 之间的关系，并研究 IR（通过甘油三酯-葡萄糖指数评估）在这一关联中的潜在中介作用：方法：根据白细胞和高敏 C 反应蛋白计算炎症评分。根据加权多因素逻辑回归模型评估炎症评分与 MAFLD 之间的关联。限制性立方样条曲线（RCS）用于显示炎症评分与 MAFLD 之间的剂量-反应关系。我们还进行了中介分析，以评估 IR 在多大程度上中介了这种关联：结果：在 1090 名参与者中，有 563 人最终被诊断为 MAFLD。多变量逻辑回归结果表明，炎症评分与 MAFLD 之间存在密切的正相关关系（几率比 = 1.235，95% 置信区间 1.069-1.427，p = .007）。RCS 结果表明，在调整潜在混杂因素后，炎症评分与 MAFLD 风险之间存在线性剂量反应关系。此外，中介分析结果显示，IR 部分中介了炎症评分与 MAFLD 之间的关系（中介百分比 = 33%）：我们的研究结果表明，炎症评分与罹患 MAFLD 的风险呈正相关，而 IR 在这一关联中起着部分中介作用。

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引用次数: 0

Combined proteomics and metabolomics analysis reveal the effect of a training course on the immune function of Chinese elite short-track speed skaters. 蛋白质组学和代谢组学联合分析揭示了训练课程对中国短道速滑精英运动员免疫功能的影响。

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-10-01 DOI: 10.1002/iid3.70030

Tieying Li, Jing Shao, Nan An, Yashan Chang, Yishi Xia, Qi Han, Fenglin Zhu

<p><strong>Introduction: </strong>The aim of this study was to combine proteomics and metabolomics to evaluate the immune system of short-track speed skaters (STSS) before and after a training course. Our research focused on changes in urinary proteins and metabolites that have the potential to serve as indicators for training load.</p><p><strong>Methods: </strong>Urine samples were collected from 21 elite STSS (13 male and 8 female) of the China National Team before and immediately after one training course. First-beat sports sensor was used to monitor the training load. Proteomic detection was performed using a Thermo UltiMate 3000 ultra high performence chromatography nano liquid chromatograph and an Orbitrap Exploris 480 mass spectrometer. MSstats (R package) was used for the statistical evaluation of significant differences in proteins from the samples. Two filtration criteria (fold change [FC] > 2 and p < 0.05) were used to identify the differential expressed proteins. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis for differential proteins was performed to identify the pathways involved. Nontargeted metabolomic detection was performed using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS_) with an ACQUITY 2D UPLC plus Q Exactive (QE) hybrid Quadrupole-Orbitrap mass spectrometer. Differential metabolites were identified using non-parametric statistical methods (Wilcox's rank test). Two filtration criteria (FC > 1.2 and p < 0.05) were used to identify differential metabolites. Combined analysis of proteomic and metabolomics were performed on the "Wu Kong" platform. Correlation analysis was performed using Spearman's rank correlation coefficient.</p><p><strong>Results: </strong>(1) The most upregulated proteins were immune-related proteins, including complement proteins (C9, C4-B, and C9) and immunoglobulins (IgA, IgM, and IgG). The most downregulated proteins were osteopontin (OPN) and CD44 in urine. The correlation analysis showed that the content of OPN and CD44 (the receptor for OPN) in urine were significantly negatively correlated with the upregulated immune-related proteins. The content of OPN and CD44 is sex-dependent and negatively correlated with the training load. (2) The most upregulated metabolites included lactate, cortisol, inosine, glutamine, argininosuccinate (the precursor for arginine synthesis), 3-methyl-2-oxobutyrate (the catabolite of valine), 3-methyl-2-oxovalerate (the catabolite of isoleucine), and 4-methyl-2-oxopentanoate (the catabolite of leucine), which is sex-dependent and negatively correlated with OPN and CD44. (3) The joint analysis revealed five main related pathways, including the immune and innate immune systems. The enriched immune-related proteins included complements, immunoglobulins, and protein catabolism-related proteins. The enriched immune-related metabolites included cAMP, N-acetylgalactosamine, and glutamate. (4) There is a significant negative correla

简介本研究旨在结合蛋白质组学和代谢组学来评估短道速滑运动员（STSS）在训练前后的免疫系统。我们的研究重点是尿液蛋白质和代谢物的变化，它们有可能成为训练负荷的指标：收集了中国国家队 21 名精英短道速滑运动员（13 男 8 女）在一次训练课前后的尿液样本。使用第一跳运动传感器监测训练负荷。使用 Thermo UltiMate 3000 超高效色谱纳米液相色谱仪和 Orbitrap Exploris 480 质谱仪进行蛋白质组检测。MSstats（R 软件包）用于统计评估样本中蛋白质的显著差异。两个过滤标准（折叠变化[FC]>2 和 p 1.2 和 p 结果：(1) 上调最多的蛋白质是免疫相关蛋白质，包括补体蛋白（C9、C4-B 和 C9）和免疫球蛋白（IgA、IgM 和 IgG）。尿液中下调最多的蛋白质是骨生成素（OPN）和 CD44。相关分析表明，尿液中 OPN 和 CD44（OPN 的受体）的含量与上调的免疫相关蛋白呈显著负相关。OPN和CD44的含量与性别有关，并与训练负荷呈负相关。(2）上调最多的代谢物包括乳酸盐、皮质醇、肌苷、谷氨酰胺、精氨酸琥珀酸盐（精氨酸合成的前体）、3-甲基-2-氧代丁酸盐（缬氨酸的分解物）、3-甲基-2-氧代戊酸盐（异亮氨酸的分解物）和 4-甲基-2-氧代戊酸盐（亮氨酸的分解物），这些代谢物与 OPN 和 CD44 呈负相关。(3）联合分析发现了五条主要的相关途径，包括免疫系统和先天免疫系统。富集的免疫相关蛋白包括补体、免疫球蛋白和蛋白质分解代谢相关蛋白。富集的免疫相关代谢物包括 cAMP、N-乙酰半乳糖胺和谷氨酸。(4）尿液中 OPN 和 CD44 的含量与训练负荷呈显著负相关：结论：一个训练课程可导致免疫系统的激活，以及 OPN 和 CD44 含量的下降与性别有关。训练负荷与 OPN 和 CD44 的含量呈明显负相关，表明 OPN 和 CD44 可能是训练负荷的潜在指标。

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引用次数: 0

Development and validation of a nomogram to predict severe influenza 开发和验证预测严重流感的提名图。

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-09-28 DOI: 10.1002/iid3.70026

Mingzhen Zhao, Bo Zhang, Mingjun Yan, Zhiwei Zhao

Background

Influenza is an acute respiratory disease posing significant harm to human health. Early prediction and intervention in patients at risk of developing severe influenza can significantly decrease mortality.

Method

A comprehensive analysis of 146 patients with influenza was conducted using the Gene Expression Omnibus (GEO) database. We assessed the relationship between severe influenza and patients' clinical information and molecular characteristics. First, the variables of differentially expressed genes were selected using R software. Least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis were performed to investigate the association between clinical information and molecular characteristics and severe influenza. A nomogram was developed to predict the presence of severe influenza. At the same time, the concordance index (C-index) is adopted area under the receiver operating characteristic (ROC), area under the curve (AUC), decision curve analysis (DCA), and calibration curve to evaluate the predictive ability of the model and its clinical application.

Results

Severe influenza was identified in 47 of 146 patients (32.20%) and was significantly related to age and duration of illness. Multivariate logistic regression demonstrated significant correlations between severe influenza and myloperoxidase (MPO) level, haptoglobin (HP) level, and duration of illness. A nomogram was formulated based on MPO level, HP level, and duration of illness. This model produced a C-index of 0.904 and AUC of 0.904.

Conclusions

A nomogram based on the expression levels of MPO, HP, and duration of illness is an efficient model for the early identification of patients with severe influenza. These results will be useful in guiding prevention and treatment for severe influenza disease.

背景：流感是一种对人类健康危害极大的急性呼吸道疾病。对有可能患上重症流感的患者进行早期预测和干预可显著降低死亡率：方法：我们利用基因表达总库（GEO）数据库对 146 名流感患者进行了综合分析。我们评估了重症流感与患者临床信息和分子特征之间的关系。首先，使用 R 软件选择差异表达基因的变量。通过最小绝对收缩和选择算子（LASSO）和多变量逻辑回归分析，研究临床信息和分子特征与重症流感之间的关系。研究人员还绘制了预测重症流感的提名图。同时，采用一致性指数（C-index）、接受者操作特征下面积（ROC）、曲线下面积（AUC）、决策曲线分析（DCA）和校准曲线来评估模型的预测能力及其临床应用：146 名患者中有 47 人（32.20%）被确诊为重症流感，且与年龄和病程明显相关。多变量逻辑回归显示，重症流感与甲氧过氧化物酶（MPO）水平、高铁血红蛋白（HP）水平和病程之间存在显著相关性。根据 MPO 水平、HP 水平和病程制定了一个提名图。该模型的 C 指数为 0.904，AUC 为 0.904：基于 MPO、HP 表达水平和病程的提名图是早期识别重症流感患者的有效模型。这些结果将有助于指导重症流感的预防和治疗。

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引用次数: 0

Outpatient use of antibiotics in uncomplicated diverticulitis decreases hospital admissions 无并发症憩室炎患者在门诊使用抗生素可降低住院率

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-09-27 DOI: 10.1002/iid3.70031

Mark Ayoub, Carol Faris, Julton Tomanguillo Chumbe, Nadeem Anwar, Harleen Chela, Ebubekir Daglilar

Introduction

Recently, antibiotics use in uncomplicated acute diverticulitis (AD) has been controversial in Europe. The American Gastroenterological Association (AGA) in their 2015 guidelines recommend their selective use. Our study highlights their role in outpatient management.

Methods

We queried the Diamond Network through TriNetX-Research Network including 92 healthcare organizations. We included large intestine diverticulitis without perforation, abscess or bleeding. Exclusion criteria included any of sepsis criteria, CRP > 15 mg/L, immunodeficiency or HIV, coronary artery disease, chronic kidney disease, history of Crohn's disease or ulcerative colitis, heart failure, hypertension, diabetes or any of the following in the 3 months before study date; clostridium difficile (C. diff) infection, diverticulitis or antibiotics. Patients with AD were divided into two cohorts; patients on antibiotics, and patients not on antibiotics. Cohorts were compared after propensity-score matching (PSM).

Results

214,277 patients met inclusion criteria. 58.9% received antibiotics, and 41% did not. After PSM, both cohorts had 84,320. Rate of hospital admission was lower in the antibiotic group (3.3% vs 4.2%, p < .001). There was a statistical difference between ICU admission (0.1% vs 0.15%, p < .01) and the rate of bowel perforation, peritonitis, abscess formation or bleeding (1.3% vs 1.4%, p = .044). There was no difference in mortality (0.1% vs 0.1%, p = .11), C. diff (0.1% vs 0.1%, p = .9), colectomies (0.2% vs 0.2%, p = .33), or Acute Kidney Injury (AKI) (0.1% vs 0.1%, p = .28).

Conclusion

Outpatient use of antibiotics in patients with uncomplicated AD is associated with lower rates of hospital admissions and complications without changing mortality rate or surgical intervention.

导言：最近，抗生素在无并发症急性憩室炎（AD）中的应用在欧洲引起了争议。美国胃肠病学会（AGA）在其 2015 年指南中建议有选择地使用抗生素。我们的研究强调了药物在门诊治疗中的作用。方法我们通过 TriNetX-Research 网络查询了钻石网络，其中包括 92 家医疗机构。我们纳入了无穿孔、脓肿或出血的大肠憩室炎。排除标准包括任何败血症标准、CRP > 15 mg/L、免疫缺陷或 HIV、冠状动脉疾病、慢性肾脏疾病、克罗恩病或溃疡性结肠炎病史、心力衰竭、高血压、糖尿病或在研究日期前 3 个月内出现过以下情况：艰难梭菌（C. diff）感染、憩室炎或抗生素。AD 患者被分为两组：使用抗生素的患者和未使用抗生素的患者。经过倾向分数匹配（PSM）后，对两组患者进行了比较。结果 214 277 名患者符合纳入标准。58.9%的患者使用了抗生素，41%的患者没有使用。经过倾向分数匹配后，两组共有 84,320 名患者。抗生素组的入院率较低（3.3% vs 4.2%，p <.001）。入住重症监护室（0.1% vs 0.15%，p <.01）与肠穿孔、腹膜炎、脓肿形成或出血率（1.3% vs 1.4%，p = .044）之间存在统计学差异。在死亡率（0.1% vs 0.1%，p = .11）、C. diff（0.1% vs 0.1%，p = .9）、结肠切除术（0.2% vs 0.2%，p = .33）或急性肾损伤（AKI）（0.1% vs 0.1%，p = .28）方面没有差异。结论无并发症的 AD 患者在门诊使用抗生素可降低入院率和并发症发生率，但不会改变死亡率或手术干预。

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引用次数: 0

Prognosis impact of multiple novel lymphocyte-based inflammatory indices in patients with initially diagnosed coronary artery disease 基于淋巴细胞的多种新型炎症指数对初诊冠心病患者预后的影响

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-09-27 DOI: 10.1002/iid3.1340

Yi Gao, Geng Bai, Yuqing Li, Bo Yu, Ziqiang Guo, Xiaolin Chen, Tong Liu, Guangping Li

Background

This study aimed to evaluate six novel lymphocyte-based inflammatory markers (neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, platelet-lymphocyte ratio [PLR], systemic immune inflammation index [SII], systemic inflammatory response index, and systemic immune inflammation response index [SIIRI]) in patients with newly diagnosed coronary artery disease [CAD].

Methods

A total of 959 patients newly diagnosed with CAD and underwent diagnostic coronary angiography were enrolled in this study and followed for major adverse cardiovascular events (MACEs), including cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The best cutoff value was used to compare the six indicators. Cox risk regression analysis evaluated the relationship between novel lymphocyte-based inflammatory markers and MACEs in newly diagnosed CAD patients.

Results

During a mean follow-up period of 33.3 ± 9.9 months, 229 (23.9%) MACEs were identified. Multivariate Cox regression analysis showed that only SIIRI (hazard ratio [HR]: 5.853; 95% confidence interval [CI]: 4.092–8.371; p < .001) and PLR (HR: 1.725; 95% CI: 1.214–2.452; p = .002) were independent predictors of MACEs. Nevertheless, following the adjustment for covariates, only the SIIRI was found to be a significant predictor MACEs and its corresponding specific endpoint occurrences. The predictive ability of the model was improved when six different inflammatory markers were added to the basic model established by traditional risk factors, namely, the C-index increased, and the SIIRI increased most significantly (AUC: 0.778; 95% CI: 0.743–0.812; p < .001). However, among the six novel inflammatory markers, only SIIRI had improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI: 0.187; 95% CI: 0.115–0.259, p < .001. IDI: 0.135; 95% CI: 0.111–0.159, p < .001), which was superior to the basic model established by traditional risk factors.

Conclusions

SIIRI is independent predictor of MACEs in newly diagnosed CAD patients. SIIRI was superior to other measures in predicting MACEs. The combination of SIIRI and traditional risk factors can more accurately predict MACEs.

背景本研究旨在评估新诊断冠状动脉疾病（CAD）患者的六种基于淋巴细胞的新型炎症指标（中性粒细胞-淋巴细胞比值、单核细胞-淋巴细胞比值、血小板-淋巴细胞比值 [PLR]、全身免疫炎症指数 [SII]、全身炎症反应指数和全身免疫炎症反应指数 [SIIRI]）。方法共有 959 名新确诊为 CAD 并接受冠状动脉造影诊断的患者参与了这项研究，并对其主要不良心血管事件（MACE）进行了随访，包括心血管死亡、非致死性心肌梗死和非致死性卒中。比较六项指标时采用了最佳临界值。Cox 风险回归分析评估了新诊断的 CAD 患者中基于淋巴细胞的新型炎症指标与 MACEs 之间的关系。结果在平均 33.3 ± 9.9 个月的随访期间，共发现 229 例（23.9%）MACE。多变量 Cox 回归分析表明，只有 SIIRI（危险比 [HR]：5.853；95% 置信度 [HR]：5.8535.853；95% 置信区间 [CI]：4.092-8.371; p < .001）和 PLR（HR：1.725; 95% CI：1.214-2.452; p = .002）是 MACEs 的独立预测因子。然而，在对协变量进行调整后，发现只有 SIIRI 可显著预测 MACEs 及其相应的特定终点发生率。当在传统风险因素建立的基本模型中加入六种不同的炎症标志物时，模型的预测能力得到了提高，即C指数增加，SIIRI增加最为显著（AUC：0.778；95% CI：0.743-0.812；p <.001）。然而，在六种新型炎症标记物中，只有 SIIRI 的净再分类改进（NRI）和综合判别改进（IDI）有所改善（NRI：0.187；95% CI：0.115-0.259，p <；.001。IDI：0.135；95% CI：0.111-0.159，p <.001），优于由传统风险因素建立的基本模型。结论 SIIRI 是新诊断的 CAD 患者 MACEs 的独立预测指标。在预测 MACE 方面，SIIRI 优于其他指标。SIIRI 和传统风险因素的结合可以更准确地预测 MACE。

{"title":"Prognosis impact of multiple novel lymphocyte-based inflammatory indices in patients with initially diagnosed coronary artery disease","authors":"Yi Gao, Geng Bai, Yuqing Li, Bo Yu, Ziqiang Guo, Xiaolin Chen, Tong Liu, Guangping Li","doi":"10.1002/iid3.1340","DOIUrl":"https://doi.org/10.1002/iid3.1340","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to evaluate six novel lymphocyte-based inflammatory markers (neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, platelet-lymphocyte ratio [PLR], systemic immune inflammation index [SII], systemic inflammatory response index, and systemic immune inflammation response index [SIIRI]) in patients with newly diagnosed coronary artery disease [CAD].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 959 patients newly diagnosed with CAD and underwent diagnostic coronary angiography were enrolled in this study and followed for major adverse cardiovascular events (MACEs), including cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The best cutoff value was used to compare the six indicators. Cox risk regression analysis evaluated the relationship between novel lymphocyte-based inflammatory markers and MACEs in newly diagnosed CAD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean follow-up period of 33.3 ± 9.9 months, 229 (23.9%) MACEs were identified. Multivariate Cox regression analysis showed that only SIIRI (hazard ratio [HR]: 5.853; 95% confidence interval [CI]: 4.092–8.371; <i>p</i> < .001) and PLR (HR: 1.725; 95% CI: 1.214–2.452; <i>p</i> = .002) were independent predictors of MACEs. Nevertheless, following the adjustment for covariates, only the SIIRI was found to be a significant predictor MACEs and its corresponding specific endpoint occurrences. The predictive ability of the model was improved when six different inflammatory markers were added to the basic model established by traditional risk factors, namely, the C-index increased, and the SIIRI increased most significantly (AUC: 0.778; 95% CI: 0.743–0.812; <i>p</i> < .001). However, among the six novel inflammatory markers, only SIIRI had improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI: 0.187; 95% CI: 0.115–0.259, <i>p</i> < .001. IDI: 0.135; 95% CI: 0.111–0.159, <i>p</i> < .001), which was superior to the basic model established by traditional risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SIIRI is independent predictor of MACEs in newly diagnosed CAD patients. SIIRI was superior to other measures in predicting MACEs. The combination of SIIRI and traditional risk factors can more accurately predict MACEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13289,"journal":{"name":"Immunity, Inflammation and Disease","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iid3.1340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of extrathyroidal autoimmune diseases on clinical features and the efficacy of Iodine-131 therapy in patients with differentiated thyroid cancer 甲状腺外自身免疫性疾病对分化型甲状腺癌患者临床特征和碘-131疗法疗效的影响

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-09-25 DOI: 10.1002/iid3.70018

Ya-hong Long, Na Li, Le Ma, Wan-chun Zhang

Objective

The aim of this study is to assess the impact of extrathyroidal autoimmune diseases (ADs) on the clinical characteristics and efficacy of iodine-131 (¹³¹I) therapy in patients with differentiated thyroid cancer (DTC).

Methods

Patients with DTC who were received ¹³¹I therapy simultaneously were classified into the combination group (n = 35) and noncombination group (n = 146) depending on the presence of ADs. The clinical characteristics, such as gender, age, tumor lesions, lymph node metastasis, distant metastasis, ¹³¹I therapy efficacy, and use of levothyroxine, were compared between the two groups. Statistical analysis was conducted using SPSS 26.0 and R 4.0.3.

Results

There was a statistically significant difference in age between the combination and noncombination groups (t = −2.872, p < .01), and the optimal cutoff value was 50.5 years. Propensity score matching was completed effectively on a total of 121 patients, using age as the matching factor, comprising 32 cases in the combination group and 80 cases in the noncombination group. The baseline demographic features of the two groups were equivalent after matching (p > .05), and there was no significant difference in the therapeutic efficacy of ¹³¹I between the two groups (p > .05). In the subgroup analysis involving patients aged great than 50.5 years, the levothyroxine/weight (µg/kg) was increased in the combination group, and the difference was statistically significant (p < .05).

Conclusion

While extrathyroidal ADs may enhance the detection of DTC among elderly women, they have no impact on the clinical characteristics of thyroid cancer or the efficacy of ¹³¹I therapy. ADs may necessitate higher per-unit dosages of levothyroxine in patients with DTC, regardless of the clinical status. Consequently, it is not essential for nuclear medicine physicians to consider the presence of ADs when designing treatment plans for patients with DTC.

目的本研究旨在评估甲状腺外自身免疫性疾病（AD）对分化型甲状腺癌（DTC）患者的临床特征和碘-131（131I）疗法疗效的影响。方法将同时接受 131I 治疗的 DTC 患者根据是否存在 ADs 分成联合组（35 人）和非联合组（146 人）。比较两组患者的临床特征，如性别、年龄、肿瘤病变、淋巴结转移、远处转移、131I疗效和左甲状腺素的使用情况。统计分析采用 SPSS 26.0 和 R 4.0.3。结果联合组和非联合组之间的年龄差异有统计学意义（t = -2.872，p < .01），最佳临界值为 50.5 岁。以年龄为匹配因子，共对 121 例患者进行了倾向得分匹配，其中联合组 32 例，非联合组 80 例。配对后，两组患者的基线人口学特征相当（p >.05），两组患者的 131I 疗效也无明显差异（p >.05）。在涉及年龄大于 50.5 岁患者的亚组分析中，联合用药组的左甲状腺素/体重（µg/kg）有所增加，差异有统计学意义（p <.05）。结论虽然甲状腺外AD可提高老年妇女DTC的检出率，但对甲状腺癌的临床特征或131I治疗的疗效没有影响。无论DTC患者的临床状况如何，甲状腺外AD可能都需要增加左甲状腺素的单位剂量。因此，核医学医生在为 DTC 患者设计治疗方案时，并不一定要考虑 AD 的存在。

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引用次数: 0

Clinical characteristics and outcomes of patients with antibody-related autoimmune encephalitis presenting with disorders of consciousness: A prospective cohort study 出现意识障碍的抗体相关自身免疫性脑炎患者的临床特征和预后：前瞻性队列研究。

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease

Pub Date : 2024-09-24 DOI: 10.1002/iid3.70019

Dawei Shan, Huimin Zhang, Lili Cui, Shuting Chai, Weibi Chen, Gang Liu, Fei Tian, Linlin Fan, Le Yang, Yan Zhang

Objective

To explore the clinical characteristics, short- and long-term functional outcomes, and risk factors for antibody-related autoimmune encephalitis (AE) in patients with disorders of consciousness (DoC).

Methods

Clinical data were collected from AE patients admitted to Xuanwu Hospital of Capital Medical University from January 2012 to December 2021, and patients were followed up for up to 24 months after immunotherapy.

Results

A total of 312 patients with AE were included: 197 (63.1%) with anti-NMDAR encephalitis, 71 (22.8%) with anti-LGI1 encephalitis, 20 (6.4%) with anti-GABAbR encephalitis, 10 (3.2%) with anti-CASPR2 encephalitis, 10 (3.2%) with anti-GAD65 encephalitis, and 4 (1.3%) with anti-AMPAR2 encephalitis. Among these patients, 32.4% (101/312) presented with DoC, and the median (interquartile range, IQR) time to DoC was 16 (7.5, 32) days. DoC patients had higher rates of various clinical features of AE (p < .05). DoC was associated with elevated lumbar puncture cerebrospinal fluid (CSF) pressure, CSF leukocyte count, and specific antibody titer (p < .05). A high percentage of patients in the DoC group had a poor prognosis at discharge and at 6 months after immunotherapy (p < .001), but no significant difference in prognosis was noted between the DoC group and the non-DoC group at 12 and 24 months after immunotherapy. Dyskinesia (OR = 3.266, 95% CI: 1.550–6.925, p = .002), autonomic dysfunction (OR = 5.871, 95% CI: 2.574–14.096, and p < .001), increased CSF pressure (OR = 1.007, 95% CI: 1.001–1.014, p = .046), and modified Rankin scale (mRS) score ≥3 at the initiation of immunotherapy (OR = 7.457, 95% CI: 3.225–18.839, p < .001) were independent risk factors for DoC in AE patients.

Conclusion

DoC is a relatively common clinical symptom in patients with AE, especially critically ill patients. Despite requiring longer hospitalization, DoC mostly improves with treatment of the primary disease and has a good long-term prognosis after aggressive life support and combination immunotherapy.

目的探讨意识障碍（DoC）患者抗体相关自身免疫性脑炎（AE）的临床特征、短期和长期功能预后及风险因素：收集2012年1月至2021年12月首都医科大学宣武医院收治的自身免疫性脑炎患者的临床资料，并对患者进行免疫治疗后长达24个月的随访：结果：共纳入312例AE患者：结果：共纳入312例AE患者：197例（63.1%）抗NMDAR脑炎患者，71例（22.8%）抗LGI1脑炎患者，20例（6.4%）抗GABAbR脑炎患者，10例（3.2%）抗CASPR2脑炎患者，10例（3.2%）抗GAD65脑炎患者，4例（1.3%）抗AMPAR2脑炎患者。在这些患者中，32.4%（101/312）出现 DoC，DoC 的中位时间（四分位数间距，IQR）为 16（7.5，32）天。出现 DoC 的患者出现各种 AE 临床特征的比例较高（P 结论：DoC 是一种相对常见的临床症状：DoC是急性呼吸衰竭患者，尤其是重症患者相对常见的临床症状。尽管住院时间较长，但在治疗原发疾病后，DoC 大多会得到改善，在积极的生命支持和联合免疫疗法后，长期预后良好。

{"title":"Clinical characteristics and outcomes of patients with antibody-related autoimmune encephalitis presenting with disorders of consciousness: A prospective cohort study","authors":"Dawei Shan, Huimin Zhang, Lili Cui, Shuting Chai, Weibi Chen, Gang Liu, Fei Tian, Linlin Fan, Le Yang, Yan Zhang","doi":"10.1002/iid3.70019","DOIUrl":"10.1002/iid3.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the clinical characteristics, short- and long-term functional outcomes, and risk factors for antibody-related autoimmune encephalitis (AE) in patients with disorders of consciousness (DoC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data were collected from AE patients admitted to Xuanwu Hospital of Capital Medical University from January 2012 to December 2021, and patients were followed up for up to 24 months after immunotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 312 patients with AE were included: 197 (63.1%) with anti-NMDAR encephalitis, 71 (22.8%) with anti-LGI1 encephalitis, 20 (6.4%) with anti-GABAbR encephalitis, 10 (3.2%) with anti-CASPR2 encephalitis, 10 (3.2%) with anti-GAD65 encephalitis, and 4 (1.3%) with anti-AMPAR2 encephalitis. Among these patients, 32.4% (101/312) presented with DoC, and the median (interquartile range, IQR) time to DoC was 16 (7.5, 32) days. DoC patients had higher rates of various clinical features of AE (<i>p</i> < .05). DoC was associated with elevated lumbar puncture cerebrospinal fluid (CSF) pressure, CSF leukocyte count, and specific antibody titer (<i>p</i> < .05). A high percentage of patients in the DoC group had a poor prognosis at discharge and at 6 months after immunotherapy (<i>p</i> < .001), but no significant difference in prognosis was noted between the DoC group and the non-DoC group at 12 and 24 months after immunotherapy. Dyskinesia (OR = 3.266, 95% CI: 1.550–6.925, <i>p</i> = .002), autonomic dysfunction (OR = 5.871, 95% CI: 2.574–14.096, and <i>p</i> < .001), increased CSF pressure (OR = 1.007, 95% CI: 1.001–1.014, <i>p</i> = .046), and modified Rankin scale (mRS) score ≥3 at the initiation of immunotherapy (OR = 7.457, 95% CI: 3.225–18.839, <i>p</i> < .001) were independent risk factors for DoC in AE patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DoC is a relatively common clinical symptom in patients with AE, especially critically ill patients. Despite requiring longer hospitalization, DoC mostly improves with treatment of the primary disease and has a good long-term prognosis after aggressive life support and combination immunotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13289,"journal":{"name":"Immunity, Inflammation and Disease","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iid3.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0