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Does HLA-DQA1*05 carriage have a greater impact on the outcome of infliximab therapy for isolated small-bowel Crohn's disease? HLA-DQA1*05携带是否会对英夫利西单抗治疗孤立性小肠克罗恩病的结果产生更大影响?
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-10-10 DOI: 10.1111/iji.12696
Juan Wu, Nannan Zhu, Jing Hu, Chenyu Zhang, Yuanyuan Fang, Yumei Wu, Yongrong Shi, Qiuyuan Liu, Hao Ding, Qiao Mei, Bingqing Bai, Wei Han

Carriage of HLA-DQA1*05 is thought to increase the formation of anti-tumour necrosis factor alpha (TNF-α) antibodies, reducing the drug efficacy in Crohn's disease (CD) patients. However, little data are currently available for small-bowel Crohn's disease (SB-CD). A specific assessment of the impact of HLA-DQA1*05 on the clinical response to treatment with infliximab (IFX), a TNF-α antagonists, in SB-CD patients is necessary. We conducted a single-center retrospective study that included 106 SB-CD patients treated with IFX. The serum samples were collected for antibodies to infliximab (ATI) testing and HLA-DQA1*05 genotyping. Double-balloon enteroscopy (DBE) was performed following the IFX treatment, with endoscopic outcomes evaluated using the partial simple endoscopic score for CD (pSES-CD), whereas the clinical response was assessed with the Crohn's disease activity index (CDAI). Multivariate logistic regression and multivariate COX regression analyses were employed to analyze the correlation of the HLA-DQA1*05 genotypes with other clinical variables. In this study, 30.2% of SB-CD patients carried the HLA-DQA1*05 allele, which significantly increased their risk of ATI generation (odds ratio [OR] = 2.337, p = .043), but it was not associated with the clinical response to IFX and drug persistence (OR = 2.356, p = .145; OR = 0.457, p = .249). The endoscopic remission rates were 40.6% (13/32) and 55.4% (41/74) in HLA-DQA1*05 carriers and non-carriers, respectively. HLA-DQA1*05 was not associated with endoscopic remission (OR = 0.684, p = .414). The HLA-DQA1*05 variant is identified as a significant risk factor of ATI formation in Chinese patients with SB-CD, but is not associated with the clinical response of IFX treatment and endoscopic remission of SB lesions.

HLA-DQA1*05携带者被认为会增加抗肿瘤坏死因子α(TNF-α)抗体的形成,从而降低克罗恩病(CD)患者的药物疗效。然而,目前几乎没有关于小肠克罗恩病(SB-CD)的数据。有必要具体评估HLA-DQA1*05对SB-CD患者使用TNF-α拮抗剂英夫利昔单抗(IFX)治疗的临床反应的影响。我们开展了一项单中心回顾性研究,纳入了106名接受IFX治疗的SB-CD患者。采集的血清样本用于英夫利西单抗(ATI)抗体检测和 HLA-DQA1*05 基因分型。IFX治疗后进行了双气囊肠镜(DBE)检查,内镜结果采用CD部分简单内镜评分(pSES-CD)进行评估,临床反应则采用克罗恩病活动指数(CDAI)进行评估。多变量逻辑回归和多变量 COX 回归分析用于分析 HLA-DQA1*05 基因型与其他临床变量的相关性。在这项研究中,30.2%的SB-CD患者携带HLA-DQA1*05等位基因,这显著增加了他们产生ATI的风险(几率比[OR] = 2.337,p = .043),但与IFX的临床反应和药物持续性无关(OR = 2.356,p = .145;OR = 0.457,p = .249)。HLA-DQA1*05携带者和非携带者的内镜缓解率分别为40.6%(13/32)和55.4%(41/74)。HLA-DQA1*05与内镜缓解无关(OR = 0.684,p = .414)。HLA-DQA1*05变异被认为是中国SB-CD患者形成ATI的重要危险因素,但与IFX治疗的临床反应和SB病变的内镜缓解无关。
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引用次数: 0
Investigations of associations between TNF-α promoter polymorphisms and genetic susceptibility to type 2 diabetes mellitus: A cross-sectional study in Chinese Han population. TNF-α启动子多态性与2型糖尿病遗传易感性的关联调查:中国汉族人群横断面研究。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-10-10 DOI: 10.1111/iji.12698
Wenyu Tao, Xiaoling Wang, Man Yang, Xing Zhou, Mingliu Yin, Ying Yang, Yiping Li

Type 2 diabetes (T2DM) is characterised by insulin resistance and a relative shortage of insulin secretion. Tumour necrosis factor-α (TNF-α) plays an important role in insulin resistance by impairing insulin signal transduction. The variants of the TNF-α promoter region are considered to influence its transcription and are associated with the TNF-α level. Therefore, it is worth detecting the association of the variants in the TNF-α gene with the development of T2DM. The aim of this study was to investigate the association of five variants (rs1799964, rs1800630, rs1799724, rs1800629 and rs361525) in the TNF-α gene promoter region with T2DM in a Chinese Han population. A total of 713 subjects with T2DM and 751 nondiabetic subjects were genotyped using the TaqMan method. The associations of the five variants with the development of T2DM were evaluated. The associations of the five variant genotypes with metabolic traits in nondiabetic subjects were analysed. Our data showed that the A allele of rs1800629 could increase the risk of developing T2DM (p = .002, OR = 1.563; 95% CI: 1.18-2.08). According to inheritance mode analysis, compared with the G/G genotype, the G/A+2A/A genotype of rs1800629 showed a risk effect on T2DM in the log-additive mode (p = .002, OR = 1.56; 95% CI: 1.17-2.07). The haplotypes analysis identified that the rs1799724-rs1800629CA was associated with high risk of the development of T2DM (p = .002, OR = 1.559, 95% CI: 1.173-2.072). Conversely, the rs1799724-rs1800629CG was a protective haplotype of T2DM (p = .001, OR = 0.732, 95% CI: 0.607-0.884). Moreover, compared with the rs1799964 (T/T+C/T) genotype, the rs1799964 C/C genotype was associated with higher glycosylated haemoglobin (HbA1c) levels in nondiabetic subjects (p = .017). Our results revealed that the rs1800629 in the TNF-α gene promoter region was associated with T2DM in a Chinese Han population.

2 型糖尿病(T2DM)的特点是胰岛素抵抗和胰岛素分泌相对不足。肿瘤坏死因子-α(TNF-α)通过损害胰岛素信号转导,在胰岛素抵抗中发挥着重要作用。TNF-α 启动子区域的变异被认为会影响其转录,并与 TNF-α 水平相关。因此,值得检测 TNF-α 基因变异与 T2DM 发病的关联。本研究旨在调查中国汉族人群中TNF-α基因启动子区5个变异(rs1799964、rs1800630、rs1799724、rs1800629和rs361525)与T2DM的相关性。采用 TaqMan 方法对 713 名 T2DM 受试者和 751 名非糖尿病受试者进行了基因分型。评估了五个变异基因与 T2DM 发病的相关性。分析了五个变异基因型与非糖尿病受试者代谢特征的关系。我们的数据显示,rs1800629 的 A 等位基因会增加患 T2DM 的风险(p = .002,OR = 1.563;95% CI:1.18-2.08)。根据遗传模式分析,与 G/G 基因型相比,rs1800629 的 G/A+2A/A 基因型在对数加成模式下对 T2DM 有风险影响(p = .002,OR = 1.56;95% CI:1.17-2.07)。单倍型分析发现,rs1799724-rs1800629CA 与 T2DM 的高发病风险相关(p = .002,OR = 1.559,95% CI:1.173-2.072)。相反,rs1799724-rs1800629CG 是 T2DM 的保护性单倍型(p = .001,OR = 0.732,95% CI:0.607-0.884)。此外,与 rs1799964 (T/T+C/T) 基因型相比,rs1799964 C/C 基因型与非糖尿病受试者较高的糖化血红蛋白(HbA1c)水平相关(p = .017)。我们的研究结果表明,在中国汉族人群中,TNF-α基因启动子区的rs1800629与T2DM有关。
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引用次数: 0
Association between a single-nucleotide polymorphism of the angiotensin-converting enzyme gene and susceptibility to systemic lupus erythematosus in the Hainanese population of China 中国海南人血管紧张素转换酶基因单核苷酸多态性与系统性红斑狼疮易感性之间的关系
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-07-23 DOI: 10.1111/iji.12690
Qi Zhang, Yanping Zhuang, Xuan Zhang, Guiling Lin, Huitao Wu, Ziman He, Zhe Wang, Wenlu Xu, Xiyu Yin, Linglan Su, Xiaokang Jia, Aimin Gong

The angiotensin-converting enzyme (ACE) gene plays a significant role in regulating immune responses and inflammatory processes, thus impacting the susceptibility to systemic lupus erythematosus (SLE). Understanding how single-nucleotide polymorphisms (SNPs) within the ACE gene contribute to the genetic susceptibility to SLE is essential for comprehending the disease's aetiology. Therefore, exploring this relationship in the Hainan region of China is crucial for gaining insights into the pathogenesis of SLE. This study comprised 428 participants, including 214 SLE patients and 214 healthy controls. Clinical data were gathered, and blood samples were collected. Genotyping of three SNPs (rs4459609, rs4309, rs1987692) within the ACE gene was performed using SNaPshot technology. The frequencies of alleles and genotypes of these three SNPs were compared between the SLE and control groups. Combining different genetic models and haplotype analysis, the correlation between ACE gene polymorphisms and SLE was investigated. Both study groups exhibited conformity with the Hardy–Weinberg genetic equilibrium (p > .05). Significant differences were observed in the genotype frequency distributions of ACE genes rs4459609, rs4309 and rs1987692 between the SLE and control groups (p = .009, .008, .032, respectively). The frequency of allele T at rs4309 was significantly higher in the SLE group than in the control group, correlating significantly with increased SLE risk (odds ratio [OR] = 1.527, 95% confidence interval [CI] = 1.147–2.035). Associations among ACE rs4459609, rs4309 and rs1987692 polymorphisms and increased susceptibility to SLE were found under co-dominant and dominant models (p < .05, with OR values and 95% CI greater than 1). Linkage disequilibrium was observed among rs4459609, rs4309 and rs1987692, and haplotype analysis revealed a significantly higher frequency of the CCA haplotype in the control group compared to the SLE group (p < .001). The ACA and ATA haplotypes showed significantly higher frequencies in the SLE group than in the control group (p = .014, p = .013, respectively). ACE gene polymorphisms are associated with the genetic susceptibility to SLE. The AC and AA genotypes at the rs4459609 locus, the TT genotype and T allele at the rs4309 locus and the AC and CC genotypes at the rs1987692 locus may serve as risk factors for the development of SLE.

血管紧张素转换酶(ACE)基因在调节免疫反应和炎症过程中发挥着重要作用,从而影响着系统性红斑狼疮(SLE)的易感性。了解 ACE 基因中的单核苷酸多态性(SNPs)如何导致系统性红斑狼疮的遗传易感性,对于理解该疾病的病因至关重要。因此,在中国海南地区探索这种关系对于深入了解系统性红斑狼疮的发病机制至关重要。本研究共有 428 名参与者,包括 214 名系统性红斑狼疮患者和 214 名健康对照者。研究人员收集了临床数据,并采集了血液样本。采用 SNaPshot 技术对 ACE 基因中的三个 SNPs(rs4459609、rs4309 和 rs1987692)进行了基因分型。比较了系统性红斑狼疮组和对照组这三个 SNP 的等位基因频率和基因型。结合不同的遗传模型和单倍型分析,研究了 ACE 基因多态性与系统性红斑狼疮之间的相关性。两个研究组均符合哈代-温伯格遗传平衡(P > .05)。在系统性红斑狼疮组和对照组之间,ACE 基因 rs4459609、rs4309 和 rs1987692 的基因型频率分布存在显著差异(p = .009、.008、.032)。在系统性红斑狼疮组中,rs4309等位基因T的频率明显高于对照组,与系统性红斑狼疮风险增加有显著相关性(几率比[OR] = 1.527,95%置信区间[CI] = 1.147-2.035)。在共显性和显性模型下,发现 ACE rs4459609、rs4309 和 rs1987692 多态性与系统性红斑狼疮易感性增加之间存在关联(P<0.05)。
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引用次数: 0
Nomenclature for factors of the HLA system, update April, May and June 2024 HLA 系统因子命名法,2024 年 4 月、5 月和 6 月更新。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-07-22 DOI: 10.1111/iji.12691
Steven G. E. Marsh, for the WHO Nomenclature Committee for Factors of the HLA System
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引用次数: 0
High-resolution HLA sequencing and hypocretin receptor 2 autoantibodies in narcolepsy type 1 and type 2 1型和2型嗜睡症患者的高分辨率HLA测序和下视素受体2自身抗体。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-06-19 DOI: 10.1111/iji.12688
Samia Hamdan, Pontus Wasling, Alexander Lind

Narcolepsy is a sleep disorder caused by an apparent degeneration of orexin/hypocretin neurons in the lateral hypothalamic area and a subsequent decrease in orexin/hypocretin levels in the cerebrospinal fluid. Narcolepsy is classified into type 1 (NT1) and type 2 (NT2). While genetic associations in the human leukocyte antigen (HLA) region and candidate autoantibodies have been investigated in NT1 to imply an autoimmune origin, less is known about the pathogenesis in NT2. Twenty-six NT1 and 15 NT2 patients were included, together with control groups of 24 idiopathic hypersomnia (IH) patients and 778 general population participants. High-resolution sequencing was used to determine the alleles, the extended haplotypes, and the genotypes of HLA-DRB3, -DRB4, -DRB5, -DRB1, -DQA1, -DQB1, -DPA1, and -DPB1. Radiobinding assay was used to determine autoantibodies against hypocretin receptor 2 (anti-HCRTR2 autoantibodies). NT1 was associated with HLA-DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01, -DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01 (odds ratio [OR]: 9.15; p = 8.31 × 10−4) and HLA-DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01, -DRB4*01:03:01, -DRB1*04:01:01, -DQA1*03:02//03:03:01, -DQB1*03:01:01 (OR: 23.61; p = 1.58 × 10−4) genotypes. Lower orexin/hypocretin levels were reported in the NT2 subgroup (n = 5) that was associated with the extended HLA-DQB1*06:02:01 haplotype (p = .001). Anti-HCRTR2 autoantibody levels were not different between study groups (p = .8524). We confirmed the previous association of NT1 with HLA-DQB1*06:02:01 extended genotypes. A subgroup of NT2 patients with intermediate orexin/hypocretin levels and association with HLA-DQB1*06:02:01 was identified, indicating a possible overlap between the two distinct narcolepsy subtypes, NT1 and NT2. Low anti-HCRTR2 autoantibody levels suggest that these receptors might not function as autoimmune targets in either NT1 or NT2.

嗜睡症是一种睡眠障碍,是由于下丘脑外侧区域的奥曲肽/甲状腺素神经元明显退化,脑脊液中的奥曲肽/甲状腺素水平随之下降所致。嗜睡症分为 1 型(NT1)和 2 型(NT2)。虽然对人类白细胞抗原(HLA)区域的遗传关联和 NT1 的候选自身抗体进行了调查,以暗示自身免疫的起源,但对 NT2 的发病机制却知之甚少。研究对象包括26名NT1和15名NT2患者,以及24名特发性嗜睡症(IH)患者和778名普通人群对照组。通过高分辨率测序确定了 HLA-DRB3、-DRB4、-DRB5、-DRB1、-DQA1、-DQB1、-DPA1 和 -DPB1 的等位基因、扩展单倍型和基因型。放射结合试验用于确定针对降视素受体 2 的自身抗体(抗HCRTR2 自身抗体)。NT1与HLA-DRB5*01:01:01、-DRB1*15:01:01、-DQA1*01:02:01、-DQB1*06:02:01、-DRB5*01:01:01、-DRB1*15:01:01、-DQA1*01:02:01、-DQB1*06:02:01相关(几率比[OR]:9.15;P = 8.31 × 10-4)和 HLA-DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01, -DRB4*01:03:01, -DRB1*04:01:01, -DQA1*03:02//03:03:01, -DQB1*03:01:01(OR:23.61;p = 1.58 × 10-4)基因型。据报道,NT2亚组(n = 5)的奥曲肽/视黄醇水平较低,这与扩展的HLA-DQB1*06:02:01单倍型有关(p = .001)。抗HCRTR2自身抗体水平在研究组之间没有差异(p = .8524)。我们证实了之前发现的 NT1 与 HLA-DQB1*06:02:01 扩展基因型的关联。我们还发现了一个 NT2 患者亚组,其奥曲肽/甲状腺素水平处于中间水平,且与 HLA-DQB1*06:02:01 相关,这表明 NT1 和 NT2 这两种不同的嗜睡症亚型之间可能存在重叠。抗HCRTR2自身抗体水平较低,表明这些受体在NT1和NT2中可能都不是自身免疫靶点。
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引用次数: 0
Forming a new perspective: Post-structural approaches to determination of donor compatibility and post-transplant assessment of allograft health 形成新的视角:确定供体相容性和移植后评估同种异体健康的后结构方法。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-06-10 DOI: 10.1111/iji.12687
Fatima Nadat, Brendan Clark
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引用次数: 0
Molecular investigation of vitamin D receptor (VDR) genetic variants and their impact on VDR mRNA and serum vitamin D levels in allergic rhinitis in an Indian population: A case–control study 维生素 D 受体 (VDR) 遗传变异及其对印度人群过敏性鼻炎中 VDR mRNA 和血清维生素 D 水平影响的分子研究:病例对照研究。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-05-29 DOI: 10.1111/iji.12679
Shahid M Baba, Tabasum Shafi, Roohi Rasool, Afaq Hameed, Saba Shafi, Sheikh F. Ahmad

Vitamin D deficiency is widespread and poses a significant health concern, as emerging research links it to allergic diseases owing to its immunomodulatory functions. The optimal functioning of vitamin D and its activation depend on its nuclear receptor, vitamin D receptor (VDR). Genetic variants of VDR have been explored as potential factors in autoimmune and allergic diseases, with limited studies on their association with allergic rhinitis (AR). The present investigation aims to analyse the role of three VDR genetic variants – TaqI, FokI and BsmI – in AR susceptibility and their impact on VDR mRNA and serum vitamin D levels. A total of 550 subjects, consisting of 250 AR cases and 300 age- and gender-matched controls, underwent genotyping by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). VDR mRNA and vitamin D levels were determined by quantitative real-time PCR and chemiluminescence, respectively. Although TaqI did not exhibit significant differences, FokI demonstrated a noteworthy association with AR, particularly with the CC genotype (odds ratio [OR]: 3.34; confidence interval [CI]: 1.79–6.23). Similarly, BsmI revealed an increased risk for AR, with the GA + AA genotypes showing a 2.2-fold elevated risk (OR: 2.20; CI: 1.53–3.16). VDR mRNA expression was threefold lower in AR patients (p < .0001), accompanied by reduced serum vitamin D levels (p < .0001). In addition, CC (p = .01) and AA (p = .02) genotypes of FokI and BsmI were associated with reduced VDR mRNA levels, whereas TaqI showed no such association. Similarly, heterozygous genotypes of TaqI and FokI, as well as homozygous AA of BsmI, correlated with lower serum vitamin D levels (p < .001). This study emphasizes the intricate relationship among VDR genetic variations, altered VDR activity, immune modulation and vitamin D metabolism in AR. Further research involving diverse populations is crucial for confirming and generalizing these findings, paving the way for personalized therapeutic interventions in vitamin D–related disorders.

由于维生素 D 具有免疫调节功能,新的研究将其与过敏性疾病联系起来。维生素 D 的最佳功能及其激活取决于其核受体--维生素 D 受体(VDR)。VDR 的遗传变异已被视为自身免疫性疾病和过敏性疾病的潜在因素,但有关其与过敏性鼻炎(AR)关系的研究却很有限。本调查旨在分析三种 VDR 基因变异(TaqI、FokI 和 BsmI)在 AR 易感性中的作用及其对 VDR mRNA 和血清维生素 D 水平的影响。共有 550 名受试者接受了聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)基因分型,其中包括 250 名 AR 病例和 300 名年龄与性别匹配的对照组。VDR mRNA 和维生素 D 水平分别通过实时定量 PCR 和化学发光法测定。虽然 TaqI 没有显示出显著差异,但 FokI 显示出与 AR 的显著关联,尤其是与 CC 基因型的关联(几率比 [OR]:3.34;置信区间 [CI]:1.79-6.23)。同样,BsmI 也显示 AR 风险增加,GA + AA 基因型的风险增加了 2.2 倍(OR:2.20;CI:1.53-3.16)。AR 患者的 VDR mRNA 表达量降低了三倍(p
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引用次数: 0
Commentary on review: Forming new perspective approaches to determination of donor compatibility 对审查的评论:形成确定捐赠者兼容性的新视角方法。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-05-24 DOI: 10.1111/iji.12680
Anat R. Tambur

Clarke and Nadat (2024) provide an overview of techniques currently used to detect HLA antigens and antibodies and describe approaches that attempt to quantify incompatibility between a transplant recipient and her/his donor per their HLA typing. They proceed to mention assays investigating qualities of the antibodies such as affinity and avidity as well as glycosylation state and describe approaches to study T and B lymphocytes’ clonality and receptor repertoires. Lastly, they briefly talk about tests to assess allo-immune memory and mention some assays to assess graft injury.

I applaud the authors for providing a condensed menu of tests available for transplant immunologists. I do, however, fear that if the task was to provide new perspective on evaluating compatibility between recipient and donor, this review misses the forest for the trees.

Immune mechanisms are controlled by thousands of genes that drive much of the variability in immune responses, whether those are to pathogens, susceptibility to autoimmune diseases, or susceptibility to allo-stimulation. Each of these genes had evolved and diverged through mechanisms of essentiality, redundancy, and adaptability to provide diverse routes for the best protection to different populations under their own local threats (Quintana-Murci, 2019). These evolutionary forces also necessitated the generation of pathways for redundancy in immune pathways, such that inhibition of one path would not lead to the demise of the individual/population. This means that testing for one, or even a few, pathways will not necessarily correlate with the overall composite response. We should further consider that beyond the ‘pure’ immune genes, additional variables participate in orchestrating an immune response including factors such as age and gender, and environmental exposures. Thus, the landscape of genes and molecules associated with immune activation is vast and polymorphic. We can opt to develop and validate more and more assays to assess allo-immunity as described in the aforementioned review, or we can direct our attention to the elephant in the room—better understanding of the underlying mechanisms leading to differential immunogenicity.

As Histocompatibility and Immunogenetics (H&I) professionals, we appreciate that much of the adaptive immune response (and at least some of the innate response) is guided by the individual's specific HLA molecules. Those are the molecules that control much of our thymic education, that are instrumental for antigen processing and presentation, and that are involved in the most crucial steps of immune activation. The first step in a decision-making tree is ‘identify the problem’. In the context of allo-stimulation, we must therefore first understand why one's immune system perceives one HLA mismatch as more immunogenic and another mismatch as less immunogenic. With this information, deciphering immune activati

Clarke 和 Nadat(2024 年)概述了目前用于检测 HLA 抗原和抗体的技术,并介绍了试图根据 HLA 分型量化移植受者和捐献者之间不相容程度的方法。接着,他们提到了研究抗体质量(如亲和力和热敏性以及糖基化状态)的检测方法,并介绍了研究 T 淋巴细胞和 B 淋巴细胞克隆性和受体汇集的方法。最后,他们简要介绍了评估同种免疫记忆的试验,并提到了一些评估移植物损伤的试验。我对作者为移植免疫学家提供了一份浓缩的试验菜单表示赞赏。免疫机制由数千个基因控制,这些基因驱动着免疫反应的许多变异,无论是对病原体、自身免疫性疾病的易感性,还是对同种异体刺激的易感性。这些基因中的每一个都是通过基本性、冗余性和适应性机制进化和分化而来的,为不同人群在各自的局部威胁下提供最佳保护提供了不同的途径(Quintana-Murci,2019)。这些进化力量还要求在免疫途径中产生冗余途径,以便抑制一种途径不会导致个体/种群消亡。这就意味着,对一种甚至几种途径的检测并不一定与整体的综合反应相关。我们应该进一步考虑,除了 "纯 "免疫基因外,还有其他变量参与协调免疫反应,包括年龄、性别和环境暴露等因素。因此,与免疫活化相关的基因和分子是庞大而多态的。作为组织相容性和免疫遗传学(H&amp;I)专业人士,我们知道大部分适应性免疫反应(至少包括部分先天性免疫反应)都是由个体的特异性 HLA 分子引导的。这些分子控制着我们的胸腺教育,对抗原处理和呈递起着重要作用,并参与免疫激活的最关键步骤。决策树的第一步是 "确定问题"。因此,在同种异体刺激的背景下,我们必须首先了解为什么一个人的免疫系统认为一种 HLA 不匹配的免疫原性更高,而另一种不匹配的免疫原性更低。根据这一原理,Rene Duquesnoy 带来的变革性软件--HLA Matchmaker--试图提供一个组织不相容风险分层的数字指标。我们社区的成员匆忙采用了这一方法,屈从于表位一词的口语化用法及其隐含的免疫意义。不幸的是,当我们对这种方法的免疫学基础提出质疑时,却发现它存在很大的局限性(Tambur &amp; Das, 2023)。在分析接受了在特定位点上有两个 HLA 错配的供体的个体患者时(参考示例中为 DQ;Tambur,2019 年),可以明显看出 HLA Matchmaker 原理的基本缺陷。这些患者中的信息队列包括对其中一个 HLA 错配而非另一个错配产生新的供体特异性抗体 (dnDSA) 的受者。这些患者代表了一个独特的队列,其中每个患者都是自己的对照组,所有外部变量(如免疫抑制水平、其他免疫基因、性别、年龄和其他环境暴露)都保持不变,唯一的变量就是 HLA 等位基因错配的质量。其中一个等位基因的免疫原性显然更高,因为它会导致产生 dnDSA,而另一个等位基因的免疫原性显然更低,因为它不会导致 DSA 的形成,尽管患者的免疫系统足够强大,能够对另一个错配产生反应。Tambur(2019)研究的这个队列清楚地表明,根据HLA Matchmaker的统计,免疫原性更强的等位基因并不总是错配率最高的等位基因。后续研究表明,错配等位基因与受者自身HLA背景的进化和功能分化与dnDSA的产生更为一致(Maguire等人,2024年)。
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引用次数: 0
Polymorphisms of HLA genes and hypersensitivity to penicillin among patients in a Taiwanese population 台湾人群中 HLA 基因的多态性与对青霉素过敏的患者。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-05-13 DOI: 10.1111/iji.12678
Chih-Chun Wang, I-Chieh Chen, Guan-Cheng Lin, Yi-Ming Chen, Ching-Hui Shen

Penicillin allergy is a potentially life-threatening condition that is common among patients. However, the genetic associations with penicillin allergy are not yet recognized for prevention or diagnosis, particularly in East Asian populations. We conducted a retrospective case–control study using data from the Taiwan Precision Medicine Initiative and analysing DNA samples to identify eight major MHC Class I and Class II loci. We employed imputation methods for accurate HLA typing and enrolled 17,827 individuals who received penicillin. Logistic regression analyses were utilized to explore associations between HLA genotypes, comorbidities and allergy risk, while simultaneously conducting a subgroup analysis to explore the association between HLA genotypes, comorbidities and the severity of allergic reactions. Our study assigned 496 cases to the penicillin allergy group and 4960 controls to a matched group. The risk of penicillin allergy was significantly higher with HLA-DPB1*05:01 (OR = 1.36, p = .004) and HLA-DQB1*05:01 (OR = 1.54, p = .03), with adjusted p-values of .032 and .24, respectively. Urticaria was identified as a separate risk factor (OR = 1.73, p < .001). However, neither the HLA alleles nor the comorbidities had a significant relationship with the risk of severe penicillin-induced allergy. HLA-DPB1*05:01 was found to be significantly associated with penicillin allergy reactions among the Taiwanese population.

青霉素过敏是一种可能危及生命的疾病,在患者中很常见。然而,人们尚未认识到青霉素过敏与遗传的关联,尤其是在东亚人群中,青霉素过敏的预防或诊断尚不明确。我们利用台湾精准医疗计划(Taiwan Precision Medicine Initiative)的数据开展了一项回顾性病例对照研究,通过分析 DNA 样本确定了八个主要的 MHC I 类和 II 类基因位点。我们采用了估算方法进行准确的 HLA 分型,并招募了 17,827 名接受过青霉素治疗的患者。我们利用逻辑回归分析探讨了 HLA 基因型、合并症和过敏风险之间的关联,同时还进行了亚组分析,以探讨 HLA 基因型、合并症和过敏反应严重程度之间的关联。我们的研究将 496 例病例分配到青霉素过敏组,将 4960 例对照组分配到匹配组。HLA-DPB1*05:01(OR = 1.36,p = .004)和HLA-DQB1*05:01(OR = 1.54,p = .03)的青霉素过敏风险明显更高,调整后的p值分别为0.032和0.24。荨麻疹被确定为一个单独的风险因素(OR = 1.73,p = 0.004),调整后的 p 值分别为 0.032 和 0.24。
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引用次数: 0
Forming a new perspective: Post-structural approaches to determination of donor compatibility and post-transplant assessment of allograft health 形成新的视角:确定供体相容性和移植后评估同种异体健康的后结构方法。
IF 2.3 4区 医学 Q3 GENETICS & HEREDITY Pub Date : 2024-05-06 DOI: 10.1111/iji.12675
Fatima Nadat, Brendan Clark

The purpose of this review is to encourage a new perspective on the question of donor–recipient compatibility and post-transplant assessment of graft health based on functional measures. The premise is that we should be better sighted on what (and how) the immune system responds toward rather than what is merely there. Continuance of the pursuit of further and better definition of antigens and antibodies is not however discouraged but seen as necessary to improved understanding of the structural correlates of functional immunity. There currently exists, in the opinion of the authors, an opportunity for histocompatibility and immunogenetics laboratories to develop and widen their scope of involvement into these new areas of laboratory activity in support and to the benefit of the transplant programmes they serve.

这篇综述的目的是鼓励人们以新的视角来看待供体与受体的兼容性问题,以及移植后根据功能指标对移植物健康状况的评估。前提是我们应该更好地关注免疫系统对什么(以及如何)做出反应,而不是仅仅关注存在什么。不过,我们并不反对继续对抗原和抗体进行进一步和更好的定义,因为这对于更好地理解功能性免疫的结构相关性是必要的。作者认为,组织相容性和免疫遗传学实验室目前有机会发展和扩大其参与这些新领域实验室活动的范围,以支持和造福于他们所服务的移植项目。
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引用次数: 0
期刊
International Journal of Immunogenetics
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