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Anti-U1RNP antibodies are associated with a distinct clinical phenotype and a worse survival in patients with systemic sclerosis 抗 U1RNP 抗体与系统性硬化症患者独特的临床表型和较差的存活率有关
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-04-19 DOI: 10.1016/j.jaut.2024.103220
Kevin Chevalier , Guillaume Chassagnon , Sarah Leonard-Louis , Pascal Cohen , Bertrand Dunogue , Alexis Regent , Benjamin Thoreau , Luc Mouthon , Benjamin Chaigne

Objectives

To clarify the impact of anti-U1RNP antibodies on the clinical features and prognosis of patients with SSc.

Methods

We conducted a monocentric case-control, retrospective, longitudinal study. For each patient with SSc and anti-U1RNP antibodies (SSc-RNP+), one patient with mixed connective tissue disease (MCTD) and 2 SSc patients without anti-U1RNP antibodies (SSc-RNP-) were matched for age, sex, and date of inclusion.

Results

Sixty-four SSc-RNP+ patients were compared to 128 SSc-RNP- and 64 MCTD patients. Compared to SSc-RNP-, SSc-RNP+ patients were more often of Afro-Caribbean origin (31.3% vs. 11%, p < 0.01), and more often had an overlap syndrome than SSc-RNP- patients (53.1 % vs. 22.7%, p < 0.0001), overlapping with Sjögren's syndrome (n = 23, 35.9%) and/or systemic lupus erythematosus (n = 19, 29.7%). SSc-RNP+ patients were distinctly different from MCTD patients but less often had joint involvement (p < 0.01). SSc-RNP+ patients more frequently developed interstitial lung disease (ILD) (73.4% vs. 55.5% vs. 31.3%, p < 0.05), pulmonary fibrosis (PF) (60.9% vs. 37.5% vs. 10.9%, p < 0.0001), SSc associated myopathy (29.7% vs. 6.3% vs. 7.8%, p < 0.0001), and kidney involvement (10.9% vs. 2.3% vs. 1.6%, p < 0.05). Over a 200-month follow-up period, SSc-RNP+ patients had worse overall survival (p < 0.05), worse survival without PF occurrence (p < 0.01), ILD or PF progression (p < 0.01 and p < 0.0001).

Conclusions

In SSc patients, anti-U1RNP antibodies are associated with a higher incidence of overlap syndrome, a distinct clinical phenotype, and poorer survival compared to SSc-RNP- and MCTD patients. Our study suggests that SSc-RNP+ patients should be separated from MCTD patients and may constitute an enriched population for progressive lung disease.

方法 我们开展了一项单中心病例对照、回顾性纵向研究。结果64名SSc-RNP+患者与128名SSc-RNP-患者和64名MCTD患者进行了比较。与SSc-RNP-患者相比,SSc-RNP+患者多为非洲裔加勒比海人(31.3% vs. 11%,p <0.01),与SSc-RNP-患者相比,SSc-RNP+患者多有重叠综合征(53.1% vs. 22.7%,p <0.0001),与Sjögren综合征(n = 23,35.9%)和/或系统性红斑狼疮(n = 19,29.7%)重叠。SSc-RNP+ 患者与 MCTD 患者明显不同,但较少出现关节受累(p < 0.01)。SSc-RNP+患者更常出现间质性肺病(ILD)(73.4% vs. 55.5% vs. 31.3%,P < 0.05)、肺纤维化(PF)(60.9% vs. 37.5% vs. 10.9%,p <0.0001)、SSc 相关肌病(29.7% vs. 6.3% vs. 7.8%,p <0.0001)和肾脏受累(10.9% vs. 2.3% vs. 1.6%,p <0.05)。在200个月的随访期间,SSc-RNP+患者的总生存率较差(p <0.05),无PF发生(p <0.01)、ILD或PF进展(p <0.01和p <0.0001)的生存率较差。结论在SSc患者中,与SSc-RNP-和MCTD患者相比,抗U1RNP抗体与较高的重叠综合征发生率、独特的临床表型和较差的生存率相关。我们的研究表明,SSc-RNP+患者应与MCTD患者分开,并可能构成进展性肺病的富集人群。
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引用次数: 0
Interleukin-15 is a hair follicle immune privilege guardian 白细胞介素-15 是毛囊免疫特权的守护者
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-04-05 DOI: 10.1016/j.jaut.2024.103217
Takahiro Suzuki , Jérémy Chéret , Fernanda S. Dinelli , Ali Rajabi-Estarabadi , Aysun Akhundlu , Dana-Lee Demetrius , Jennifer Gherardini , Aviad Keren , Matthew Harries , Jose Rodriguez-Feliz , Gorana Epstein-Kuka , Wendy Lee , Talveen Purba , Amos Gilhar , Ralf Paus

The autoimmunity-promoting cytokine, Interleukin-15 (IL-15), is often claimed to be a key pathogenic cytokine in alopecia areata (AA). Yet, rhIL-15 promotes human hair follicle (HF) growth ex vivo. We have asked whether the expression of IL-15 and its receptor (IL-15R) isoforms is altered in human AA and how IL-15 impacts on human HF immune privilege (HF-IP) in the presence/absence of interferon-γ (IFNγ), the well-documented key AA-pathogenic cytokine, and on hair regrowth after experimental AA induction in vivo. Quantitative immunohistomorphometry showed the number of perifollicular IL-15+ T cells in AA skin biopsies to be significantly increased compared to healthy control skin, while IL-15, IL-15R-α, and IL-15R-γ protein expression within the hair bulb were significantly down-regulated in AA HFs. In organ-cultured human scalp HFs, rhIL-15 significantly reduced hair bulb expression of MICA, the key “danger” signal in AA pathogenesis, and increased production of the HF-IP guardian, α-MSH. Crucially, ex vivo, rhIL-15 prevented IFNγ-induced HF-IP collapse, restored a collapsed HF-IP by IL-15Rα-dependent signaling (as documented by IL-15Rα−silencing), and protected AA-preventive immunoinhibitory iNKT10 cells from IFNγ-induced apoptosis. rhIL-15 even promoted hair regrowth after experimental AA induction in human scalp skin xenotransplants on SCID/beige mice in vivo. Our data introduce IL-15 as a novel, functionally important HF-IP guardian whose signaling is constitutively defective in AA patients. Our data suggest that selective stimulation of intrafollicular IL-15Rα signaling could become a novel therapeutic approach in AA management, while blocking it pharmacologically may hinder both HF-IP restoration and hair re-growth and may thus make HFs more vulnerable to AA relapse.

白细胞介素-15(IL-15)这种促进自身免疫的细胞因子通常被认为是斑秃(AA)的主要致病细胞因子。然而,rhIL-15 能促进人体毛囊(HF)的体内外生长。我们想知道 IL-15 及其受体(IL-15R)异构体的表达在人类 AA 中是否发生了改变,以及 IL-15 在存在/不存在干扰素-γ(IFNγ)(已被证实为 AA 的关键致病细胞因子)的情况下对人类 HF 免疫特权(HF-IP)以及在体内实验性 AA 诱导后对毛发再生有何影响。免疫组织形态定量测定显示,与健康对照组皮肤相比,AA 皮肤活检组织中毛囊周围 IL-15+ T 细胞数量明显增加,而在 AA HFs 中,毛球内 IL-15、IL-15R-α 和 IL-15R-γ 蛋白表达明显下调。在器官培养的人类头皮HFs中,rhIL-15能显著降低毛球中MICA(AA发病机制中的关键 "危险 "信号)的表达,并增加HF-IP监护因子α-MSH的产生。最重要的是,在体内外,rhIL-15 能防止 IFNγ 诱导的 HF-IP 崩溃,通过 IL-15Rα 依赖性信号(IL-15Rα-silencing 证明了这一点)恢复崩溃的 HF-IP,并保护 AA 预防性免疫抑制 iNKT10 细胞免于 IFNγ 诱导的细胞凋亡。rhIL-15 甚至能促进体内 SCID/beige 小鼠头皮皮肤异种移植实验性 AA 诱导后的毛发再生。我们的数据将 IL-15 介绍为一种新型的、功能上重要的高频-IP 监护因子,在 AA 患者中,它的信号传导存在组成性缺陷。我们的数据表明,选择性刺激毛囊内 IL-15Rα 信号传导可能成为 AA 治疗的一种新的治疗方法,而药物阻断 IL-15Rα 信号传导可能会阻碍 HF-IP 恢复和毛发再生长,从而使 HF 患者更容易复发 AA。
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引用次数: 0
Peripheral helper T cells in human diseases 人类疾病中的外周辅助性 T 细胞
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-04-04 DOI: 10.1016/j.jaut.2024.103218
Xueyang Zou , Feifei Huo , Lulu Sun , Jing Huang

Peripheral helper T cells (Tph) are a specialized subset of CD4+ T cells with the ability to help B cells and induce antibody production. Although usually located in ectopic lymphoid-like structures (ELS), inside the peripheral blood, Tph cells can also be identified. The aberrant proliferation and functions of Tph cells are commonly found in the patients with disease. In this review, first we will summarize the biological characteristics of Tph cells, such as the expression of surface molecules, transcription factors and cytokines, and discuss its B cell help functions. Tph cells also have roles in a wide range of human diseases, including autoimmune diseases, infectious diseases, malignancies etc. Therefore, there is a strong interest in targeting Tph cells to improve treat strategies of human diseases.

外周辅助 T 细胞(Tph)是 CD4+ T 细胞的一个特化亚群,具有帮助 B 细胞和诱导抗体产生的能力。虽然 Tph 细胞通常位于外周血中的异位淋巴样结构(ELS)中,但也能在外周血中发现。Tph细胞的异常增殖和功能常见于疾病患者。在这篇综述中,我们将首先总结 Tph 细胞的生物学特征,如表面分子、转录因子和细胞因子的表达,并讨论其 B 细胞帮助功能。Tph 细胞还在多种人类疾病中发挥作用,包括自身免疫性疾病、传染病、恶性肿瘤等。因此,人们对靶向 Tph 细胞以改善人类疾病的治疗策略产生了浓厚的兴趣。
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引用次数: 0
Engineered Treg cells: The heir to the throne of immunotherapy 工程Treg细胞:免疫疗法的王位继承人
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-04-01 DOI: 10.1016/j.jaut.2022.102986
Adriana Stucchi , Federica Maspes , Ely Montee-Rodrigues , Georgia Fousteri

Recently, increased interest in the use of Tregs as adoptive cell therapy for the treatment of autoimmune diseases and transplant rejection had led to several advances in the field. However, Treg cell therapies, while constantly advancing, indiscriminately suppress the immune system without the permanent stabilization of certain diseases. Genetically modified Tregs hold great promise towards solving these problems, but, challenges in identifying the most potent Treg subtype, accompanied by the ambiguity involved in identifying the optimal Treg source, along with its expansion and engineering in a clinical-grade setting remain paramount. This review highlights the recent advances in methodologies for the development of genetically engineered Treg cell-based treatments for autoimmune, inflammatory diseases, and organ rejection. Additionally, it provides a systematized guide to all the recent progress in the field and informs the readers of the feasibility and safety of engineered adoptive Treg cell therapy, with the aim to provide a framework for researchers involved in the development of engineered Tregs.

最近,人们对使用Tregs作为治疗自身免疫性疾病和移植排斥反应的采用性细胞疗法的兴趣日益浓厚,促使该领域取得了一些进展。然而,Treg 细胞疗法虽然在不断进步,但却不加区分地抑制免疫系统,无法永久性地稳定某些疾病。转基因 Tregs 在解决这些问题方面大有可为,但在确定最有效的 Treg 亚型方面存在挑战,同时在确定最佳 Treg 来源方面也存在模糊性,在临床级环境中进行扩增和工程设计仍然至关重要。本综述重点介绍了开发基于基因工程 Treg 细胞治疗自身免疫性疾病、炎症性疾病和器官排斥反应的方法的最新进展。此外,它还为该领域的所有最新进展提供了系统指南,并向读者介绍了工程化收养性 Treg 细胞疗法的可行性和安全性,旨在为参与工程化 Tregs 开发的研究人员提供一个框架。
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引用次数: 0
Characterization of Th17 tissue-resident memory cells in non-inflamed intestinal tissue of Crohn's disease patients 克罗恩病患者非炎症肠组织中 Th17 组织驻留记忆细胞的特征
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-03-29 DOI: 10.1016/j.jaut.2024.103206
Yoonho Lee , Jiwon Baek , Sojung Park , Yongjae Kim , Sung Wook Hwang , Jong Lyul Lee , Sang Hyoung Park , Jihun Kim , Suk-Kyun Yang , Buhm Han , Mi-Na Kweon , Kyuyoung Song , Yong Sik Yoon , Byong Duk Ye , Ho-Su Lee

Crohn's disease (CD) is a chronic inflammatory disorder affecting the bowel wall. Tissue-resident memory T (Trm) cells are implicated in CD, yet their characteristics remain unclear. We aimed to investigate the transcriptional profiles and functional characteristics of Trm cells in the small bowel of CD and their interactions with immune cells. Seven patients with CD and four with ulcerative colitis as controls were included. Single-cell RNA sequencing and paired T cell receptor sequencing assessed T cell subsets and transcriptional signatures in lamina propria (LP) and submucosa/muscularis propria-enriched fractions (SM/MP) from small bowel tissue samples. We detected 58,123 T cells grouped into 16 populations, including the CD4+ Trm cells with a Th17 signature and CD8+ Trm clusters. In CD, CD4+ Trm cells with a Th17 signature, termed Th17 Trm, showed significantly increased proportions within both the LP and SM/MP areas. The Th17 Trm cluster demonstrated heightened expression of tissue-residency marker genes (ITGAE, ITGA1, and CXCR6) along with elevated levels of IL17A, IL22, CCR6, and CCL20. The clonal expansion of Th17 Trm cells in CD was accompanied by enhanced transmural dynamic potential, as indicated by significantly higher migration scores. CD-prominent Th17 Trm cells displayed an increased interferon gamma (IFNγ)-related signature possibly linked with STAT1 activation, inducing chemokines (i.e., CXCL10, CXCL8, and CXCL9) in myeloid cells. Our findings underscored the elevated Th17 Trm cells throughout the small bowel in CD, contributing to disease pathogenesis through IFNγ induction and subsequent chemokine production in myeloid cells.

克罗恩病(CD)是一种影响肠壁的慢性炎症性疾病。组织驻留记忆 T(Trm)细胞与克罗恩病有关,但其特征仍不清楚。我们的目的是研究 CD 小肠中 Trm 细胞的转录谱和功能特征及其与免疫细胞的相互作用。研究对象包括七名 CD 患者和四名溃疡性结肠炎对照组患者。单细胞 RNA 测序和配对 T 细胞受体测序评估了小肠组织样本中固有层(LP)和粘膜下/肌层富集部分(SM/MP)的 T 细胞亚群和转录特征。我们检测到 58 123 个 T 细胞,分为 16 个群组,包括具有 Th17 特征的 CD4+ Trm 细胞和 CD8+ Trm 群组。在CD中,具有Th17特征的CD4+Trm细胞(被称为Th17 Trm)在LP和SM/MP区域的比例明显增加。Th17 Trm集群表现出组织驻留标记基因(ITGAE、ITGA1和CXCR6)的高表达以及IL17A、IL22、CCR6和CCL20水平的升高。CD 中 Th17 Trm 细胞的克隆扩增伴随着跨膜动态潜能的增强,这表现在迁移评分明显升高。以CD为主的Th17 Trm细胞显示出更多的γ干扰素(IFNγ)相关特征,可能与STAT1激活有关,诱导髓系细胞中的趋化因子(即CXCL10、CXCL8和CXCL9)。我们的研究结果表明,CD患者整个小肠中的Th17 Trm细胞增高,通过IFNγ诱导和随后髓系细胞中趋化因子的产生促进了疾病的发病机制。
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引用次数: 0
Balancing efficacy and safety of complement inhibitors 平衡补体抑制剂的有效性和安全性
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-03-28 DOI: 10.1016/j.jaut.2024.103216
Kanako Watanabe-Kusunoki , Hans-Joachim Anders

Complement inhibitors have been approved for several immune-mediated diseases and they are considered the next paradigm-shifting approach in the treatment of glomerulonephritis. The hierarchical organization of the complement system offers numerous molecular targets for therapeutic intervention. However, complement is an integral element of host defense and therefore complement inhibition can be associated with serious infectious complications. Here we give a closer look to the hierarchical complement system and how interfering with proximal versus distal or selective versus unselective molecular targets could determine efficacy and safety. Furthermore, we propose to consider the type of disease, immunological activity, and patient immunocompetence when stratifying patients, e.g., proximal/unselective targets for highly active and potentially fatal diseases while distal and selective targets may suit more chronic disease conditions with low or moderate disease activity requiring persistent complement blockade in patients with concomitant immunodeficiency. Certainly, there exists substantial promise for anti-complement therapeutics. However, balancing efficacy and safety will be key to establish powerful treatment effects with minimal adverse events, especially when complement blockade is continued over longer periods of time in chronic disorders.

补体抑制剂已被批准用于多种免疫介导疾病的治疗,它们被认为是治疗肾小球肾炎的下一个范式转变方法。补体系统的分级组织为治疗干预提供了众多分子靶点。然而,补体是宿主防御不可或缺的元素,因此抑制补体可能会引起严重的感染并发症。在此,我们将仔细研究补体系统的层次结构,以及干扰近端分子靶点与远端分子靶点、选择性分子靶点与非选择性分子靶点如何决定疗效和安全性。此外,我们还建议在对患者进行分层时考虑疾病类型、免疫活性和患者的免疫能力,例如,近端/非选择性靶点适用于高活性和潜在致命性疾病,而远端和选择性靶点则可能适用于低度或中度疾病活性的慢性疾病,需要对伴有免疫缺陷的患者进行持续的补体阻断。当然,抗补体疗法大有可为。然而,平衡疗效和安全性将是建立强大治疗效果并将不良反应降至最低的关键,尤其是在慢性疾病患者需要持续较长时间的补体阻断治疗时。
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引用次数: 0
Developmental drugs for sarcoidosis. 开发治疗肉样瘤病的药物。
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-03-28 DOI: 10.1016/j.jaut.2024.103179
Ogugua Ndili Obi, Lesley Ann Saketkoo, Lisa A Maier, Robert P Baughman

Sarcoidosis is a multi-organ granulomatous inflammatory disease of unknown etiology. Over 50% of patients will require treatment at some point in their disease and 10%-30% will develop a chronic progressive disease with pulmonary fibrosis leading to significant morbidity and mortality. Recently published guidelines recommend immunosuppressive therapy for sarcoidosis patients at risk of increased disease-related morbidity and mortality, and in whom disease has negatively impacted quality of life. Prednisone the currently recommended first line therapy is associated with significant toxicity however none of the other guideline recommended steroid sparing therapy is approved by regulatory agencies for use in sarcoidosis, and data in support of their use is weak. For patients with severe refractory disease requiring prolonged therapy, treatment options are limited. The need for expanding treatment options in sarcoidosis has been emphasized. Well conducted large, randomized trials evaluating currently available therapeutic options as well as novel pathways for targeting disease are necessary to better guide treatment decisions. These trials will not be without significant challenges. Sarcoidosis is a rare disease with heterogenous presentation and variable progression and clinical outcome. There are no universally agreed upon biomarkers of disease activity and measurement of outcomes is confounded by the need to balance patient centric measures and objective measures of disease activity. Our paper provides an update on developmental drugs in sarcoidosis and outlines several novel pathways that may be targeted for future drug development. Currently available trials are highlighted and ongoing challenges to drug development and clinical trial design are briefly discussed.

肉样瘤病是一种病因不明的多器官肉芽肿性炎症疾病。50%以上的患者在患病的某个阶段需要接受治疗,10%-30%的患者会发展为慢性进展性疾病,并伴有肺纤维化,从而导致严重的发病率和死亡率。最近发布的指南建议,对于有可能增加疾病相关发病率和死亡率的肉样瘤病患者,以及因疾病对生活质量造成负面影响的患者,应进行免疫抑制治疗。目前推荐的一线疗法泼尼松具有明显的毒性,但指南推荐的其他减少类固醇用量的疗法均未获得监管机构批准用于肉样瘤病,支持使用这些疗法的数据也很薄弱。对于需要长期治疗的严重难治性疾病患者来说,治疗方案十分有限。扩大肉样瘤病治疗方案的必要性已得到强调。为了更好地指导治疗决策,有必要对目前可用的治疗方案以及针对疾病的新途径进行充分的大型随机试验评估。这些试验并非没有重大挑战。肉样瘤病是一种罕见的疾病,表现各异,病情发展和临床结果也各不相同。目前还没有公认的疾病活动性生物标志物,而且由于需要平衡以患者为中心的测量方法和疾病活动性的客观测量方法,结果的测量也受到了干扰。我们的论文介绍了肉样瘤病研发药物的最新情况,并概述了未来药物研发可能针对的几种新途径。本文重点介绍了目前可用的试验,并简要讨论了药物开发和临床试验设计面临的挑战。
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引用次数: 0
A reverse translational approach reveals the protective roles of Mangifera indica in inflammatory bowel disease 逆向转化方法揭示了莽草在炎症性肠病中的保护作用
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-03-23 DOI: 10.1016/j.jaut.2024.103181
Anella Saviano , Anna Schettino , Nunzia Iaccarino , Adel Abo Mansour , Jenefa Begum , Noemi Marigliano , Federica Raucci , Francesca Romano , Gelsomina Riccardi , Emma Mitidieri , Roberta d'Emmanuele di Villa Bianca , Ivana Bello , Elisabetta Panza , Martina Smimmo , Valentina Vellecco , Peter Rimmer , Jonathan Cheesbrough , Zhaogong Zhi , Tariq H. Iqbal , Stefano Pieretti , Francesco Maione

Inflammatory bowel diseases (IBDs) are chronic intestinal disorders often characterized by a dysregulation of T cells, specifically T helper (Th) 1, 17 and T regulatory (Treg) repertoire. Increasing evidence demonstrates that dietary polyphenols from Mangifera indica L. extract (MIE, commonly known as mango) mitigate intestinal inflammation and splenic Th17/Treg ratio. In this study, we aimed to dissect the immunomodulatory and anti-inflammatory properties of MIE using a reverse translational approach, by initially using blood from an adult IBD inception cohort and then investigating the mechanism of action in a preclinical model of T cell-driven colitis. Of clinical relevance, MIE modulates TNF-α and IL-17 levels in LPS spiked sera from IBD patients as an ex vivo model of intestinal barrier breakdown. Preclinically, therapeutic administration of MIE significantly reduced colitis severity, pathogenic T-cell intestinal infiltrate and intestinal pro-inflammatory mediators (IL-6, IL-17A, TNF-α, IL-2, IL-22). Moreover, MIE reversed colitis-induced gut permeability and restored tight junction functionality and intestinal metabolites. Mechanistic insights revealed MIE had direct effects on blood vascular endothelial cells, blocking TNF-α/IFN-γ-induced up-regulation of COX-2 and the DP2 receptors. Collectively, we demonstrate the therapeutic potential of MIE to reverse the immunological perturbance during the onset of colitis and dampen the systemic inflammatory response, paving the way for its clinical use as nutraceutical and/or functional food.

炎症性肠病(IBD)是一种慢性肠道疾病,通常以 T 细胞(特别是 T 辅助细胞(Th)1、17 和 T 调节细胞(Treg))失调为特征。越来越多的证据表明,从芒果提取物(Mangifera indica L.,俗称芒果)中提取的膳食多酚可减轻肠道炎症和脾脏 Th17/Treg 比率。在这项研究中,我们的目标是采用逆向转化的方法来剖析 MIE 的免疫调节和抗炎特性,首先使用成年 IBD 患者的血液,然后在 T 细胞驱动的结肠炎临床前模型中研究其作用机制。与临床相关的是,MIE能调节IBD患者LPS血清中的TNF-α和IL-17水平,这是一种肠道屏障破坏的体外模型。临床前研究发现,MIE能显著降低结肠炎的严重程度、致病性T细胞肠道浸润和肠道促炎介质(IL-6、IL-17A、TNF-α、IL-2、IL-22)。此外,MIE 还能逆转结肠炎引起的肠道通透性,恢复紧密连接功能和肠道代谢物。机理研究表明,MIE对血管内皮细胞有直接作用,能阻断TNF-α/IFN-γ诱导的COX-2和DP2受体的上调。总之,我们证明了 MIE 在扭转结肠炎发病过程中的免疫紊乱和抑制全身炎症反应方面的治疗潜力,为其作为营养保健品和/或功能食品应用于临床铺平了道路。
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引用次数: 0
Kidney manifestations of sarcoidosis. 肉样瘤病的肾脏表现。
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-03-22 DOI: 10.1016/j.jaut.2024.103207
Francesco Bonella, Adriane Dm Vorselaars, Benjamin Wilde

Renal involvement is a clinically relevant organ manifestation of sarcoidosis, leading to increased morbidity and complications. Although the exact incidence remains unknown, renal disease is likely to occur in up to one third of all sarcoidosis patients. Every patient with newly diagnosed sarcoidosis should receive a renal work-up and screening for disrupted calcium metabolism. Amid various forms of glomerulonephritis, granulomatous interstitial nephritis is the most common one, but it rarely leads to renal impairment. Histologically, granulomas can be absent. Nephrocalcinosis and nephrolithiasis are frequent forms when hypercalcaemia or hypercalciuria occur. Drugs used for treatment of systemic sarcoidosis can also cause renal damage. Due to its high heterogeneity, renal sarcoidosis can be difficult to treat. Glucocorticoids and various immunosuppressive treatments have been proven to be effective based on case series, but clinical trials are lacking. A treatment guideline for renal sarcoidosis is urgently needed. In this review article, we present an overview of the different forms of renal sarcoidosis and the diagnostic steps to confirm renal involvement; in addition, we provide insights on the management and available treatments. A better understanding regarding the pathogenesis of sarcoidosis is the key for the development of more specific, targeted therapies.

肾脏受累是肉样瘤病的一种临床相关器官表现,会导致发病率和并发症增加。虽然确切的发病率尚不清楚,但多达三分之一的肉样瘤病患者可能会出现肾脏疾病。每位新确诊的肉样瘤病患者都应接受肾脏检查和钙代谢紊乱筛查。在各种形式的肾小球肾炎中,肉芽肿性间质性肾炎是最常见的一种,但它很少导致肾功能损害。在组织学上,肉芽肿可以不存在。当出现高钙血症或高钙尿症时,肾钙化和肾结石是常见的表现形式。用于治疗系统性肉样瘤病的药物也会造成肾损害。由于其高度异质性,肾肉瘤病可能很难治疗。根据病例研究,糖皮质激素和各种免疫抑制治疗被证明是有效的,但缺乏临床试验。肾肉样瘤病的治疗指南亟待制定。在这篇综述文章中,我们概述了不同形式的肾肉样瘤病以及确诊肾脏受累的诊断步骤;此外,我们还提供了有关管理和现有治疗方法的见解。更好地了解肉样瘤病的发病机制是开发更具针对性的靶向疗法的关键。
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引用次数: 0
Quantitative and structural changes of blood platelet cytoskeleton proteins in multiple sclerosis (MS) 多发性硬化症(MS)患者血小板细胞骨架蛋白的数量和结构变化
IF 12.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-03-22 DOI: 10.1016/j.jaut.2024.103204
Angela Dziedzic , Sylwia Michlewska , Piotr Jóźwiak , Janusz Dębski , Michał Seweryn Karbownik , Łukasz Łaczmański , Dorota Kujawa , Sława Glińska , Elżbieta Miller , Marta Niwald , Malgorzata Kloc , Łucja Balcerzak , Joanna Saluk

Epidemiological studies show that cardiovascular events related to platelet hyperactivity remain the leading causes of death among multiple sclerosis (MS) patients. Quantitative or structural changes of platelet cytoskeleton alter their morphology and function. Here, we demonstrated, for the first time, the structural changes in MS platelets that may be related to their hyperactivity. MS platelets were found to form large aggregates compared to control platelets. In contrast to the control, the images of overactivated, irregularly shaped MS platelets show changes in the cytoskeleton architecture, fragmented microtubule rings. Furthermore, MS platelets have long and numerous pseudopodia rich in actin filaments. We showed that MS platelets and megakaryocytes, overexpress β1-tubulin and β-actin mRNAs and proteins and have altered post-translational modification patterns. Moreover, we identified two previously undisclosed mutations in the gene encoding β1-tubulin in MS. We propose that the demonstrated structural changes of platelet cytoskeleton enhance their ability to adhere, aggregate, and degranulate fueling the risk of adverse cardiovascular events in MS.

流行病学研究表明,与血小板过度活跃有关的心血管事件仍然是多发性硬化症(MS)患者死亡的主要原因。血小板细胞骨架的数量或结构变化会改变其形态和功能。在这里,我们首次证明了多发性硬化症血小板的结构变化可能与其过度活跃有关。与对照组血小板相比,多发性硬化症血小板会形成大的聚集体。与对照组相比,过度激活、形状不规则的 MS 血小板图像显示细胞骨架结构发生了变化,微管环支离破碎。此外,MS 小板具有长而多的富含肌动蛋白丝的伪足。我们发现,MS血小板和巨核细胞过度表达β1-tubulin和β-actin mRNA和蛋白质,并且翻译后修饰模式也发生了改变。此外,我们还在多发性硬化症患者的β1-tubulin编码基因中发现了两个之前未公开的突变。我们认为,已证实的血小板细胞骨架结构变化增强了其粘附、聚集和脱颗粒的能力,从而助长了多发性硬化症患者发生不良心血管事件的风险。
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引用次数: 0
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Journal of autoimmunity
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