首页 > 最新文献

Journal of autoimmunity最新文献

英文 中文
Optimizing the tapering scheme of corticosteroid treatment for acute onset of autoimmune hepatitis 优化自身免疫性肝炎急性发作的皮质类固醇治疗的逐渐减少方案
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-02-26 DOI: 10.1016/j.jaut.2025.103387
Rui Wang , Qiuxiang Lin , Li Sheng , Yan Zhang , Haoyu Wen , You Li , Mingxia Shi , Xiao Xiao , Li Yan , Canjie Guo , Qi Miao , Jing Hua , Zuxiong Huang , Hai Li , M. Eric Gershwin , Qixia Wang , Xiong Ma , Min Lian

Background

Uncertainties persist regarding the optimal management of acute onset of autoimmune hepatitis, including the use of corticosteroids. This study aimed to compare the effectiveness and safety of rapid versus slow corticosteroid tapering in acute onset of AIH.

Methods

A multicenter study involving patients with acute AIH was conducted. We defined acute AIH as an acute presentation (<30 days) with AIH and exhibiting no evidence of pre-existing liver diseases. Initially, corticosteroid treatment and overall outcomes were reported. Subsequently, the role of corticosteroid tapering rate in modifying outcomes across subgroups was investigated. For patients with an initial corticosteroid dose of 20 mg/day or higher, we further classified patients into rapid tapering group (duration until dose of prednisone <20 mg/day <3 weeks) and slow tapering group (duration until dose of prednisone <20 mg/day ≥3 weeks). Adverse events were defined as any of the following events, progression (e.g., acute icteric AIH progression to AS-AIH or AIH-ALF, AS-AIH progression to AIH-ALF, non-cirrhotic progression to cirrhosis, compensated cirrhosis progression to decompensation), LT, and liver-related death.

Results

This retrospective cohort study enrolled 237 patients, with 109 presenting acute icteric AIH, 97 with acute-severe AIH (AS-AIH), and 31 with AIH-acute liver failure (ALF). Among patients with acute icteric AIH, slow tapering significantly improved adverse outcome-free survival compared to rapid tapering (99 % vs. 71 %, P < 0.0001). Similarly, in AS-AIH patients, slow tapering resulted in notably higher adverse outcome-free survival rates compared to rapid tapering (92 % vs. 54 %, P < 0.001). Slow tapering independently predicted fewer adverse events (OR 0.144; 95 % CI 0.037–0.562; P = 0.005). However, in AIH-acute liver failure (ALF) patients, tapering rate did not significantly affect adverse outcome-free survival (38 % vs. 50 %, P = 0.590). Overall, there were no significant differences in osteoporosis or infection occurrence between tapering groups in the entire acute AIH cohort.

Conclusion

A slow corticosteroid tapering reduced adverse outcomes in acute exacerbation of AIH patients, particularly in acute icteric AIH and AS-AIH.
背景:关于自身免疫性肝炎急性发作的最佳管理,包括皮质类固醇的使用,仍然存在不确定性。本研究旨在比较快速和缓慢皮质类固醇减量治疗急性AIH的有效性和安全性。方法对急性AIH患者进行多中心研究。我们将急性AIH定义为AIH的急性表现(30天),并且没有表现出先前存在肝脏疾病的证据。最初,报告了皮质类固醇治疗和总体结果。随后,研究了皮质类固醇减量率对亚组预后的影响。对于初始皮质类固醇剂量为20mg /天或更高的患者,我们进一步将患者分为快速减量组(持续时间至强的松剂量≤20mg /天≤3周)和缓慢减量组(持续时间至强的松剂量≤20mg /天≤3周)。不良事件被定义为以下任何事件:进展(例如,急性黄疸AIH进展为as -AIH或AIH- alf, as -AIH进展为AIH- alf,非肝硬化进展为肝硬化,代偿性肝硬化进展为失代偿),LT和肝脏相关死亡。这项回顾性队列研究纳入了237例患者,其中109例为急性黄疸AIH, 97例为急性重度AIH (AS-AIH), 31例为AIH急性肝衰竭(ALF)。在急性黄疸AIH患者中,与快速减量相比,缓慢减量显著提高了无不良预后生存率(99% vs 71%, P <;0.0001)。类似地,在AS-AIH患者中,与快速减量相比,缓慢减量导致明显更高的无不良结局生存率(92% vs. 54%, P <;0.001)。缓慢减量独立预测更少的不良事件(OR 0.144;95% ci 0.037-0.562;p = 0.005)。然而,在aih急性肝衰竭(ALF)患者中,减量率对无不良预后生存率没有显著影响(38% vs. 50%, P = 0.590)。总体而言,在整个急性AIH队列中,减量组之间骨质疏松症或感染发生率无显著差异。结论慢性皮质类固醇减量可减少急性加重AIH患者的不良后果,特别是急性黄疸AIH和AS-AIH。
{"title":"Optimizing the tapering scheme of corticosteroid treatment for acute onset of autoimmune hepatitis","authors":"Rui Wang ,&nbsp;Qiuxiang Lin ,&nbsp;Li Sheng ,&nbsp;Yan Zhang ,&nbsp;Haoyu Wen ,&nbsp;You Li ,&nbsp;Mingxia Shi ,&nbsp;Xiao Xiao ,&nbsp;Li Yan ,&nbsp;Canjie Guo ,&nbsp;Qi Miao ,&nbsp;Jing Hua ,&nbsp;Zuxiong Huang ,&nbsp;Hai Li ,&nbsp;M. Eric Gershwin ,&nbsp;Qixia Wang ,&nbsp;Xiong Ma ,&nbsp;Min Lian","doi":"10.1016/j.jaut.2025.103387","DOIUrl":"10.1016/j.jaut.2025.103387","url":null,"abstract":"<div><h3>Background</h3><div>Uncertainties persist regarding the optimal management of acute onset of autoimmune hepatitis, including the use of corticosteroids. This study aimed to compare the effectiveness and safety of rapid versus slow corticosteroid tapering in acute onset of AIH.</div></div><div><h3>Methods</h3><div>A multicenter study involving patients with acute AIH was conducted. We defined acute AIH as an acute presentation (&lt;30 days) with AIH and exhibiting no evidence of pre-existing liver diseases. Initially, corticosteroid treatment and overall outcomes were reported. Subsequently, the role of corticosteroid tapering rate in modifying outcomes across subgroups was investigated. For patients with an initial corticosteroid dose of 20 mg/day or higher, we further classified patients into rapid tapering group (duration until dose of prednisone &lt;20 mg/day &lt;3 weeks) and slow tapering group (duration until dose of prednisone &lt;20 mg/day ≥3 weeks). Adverse events were defined as any of the following events, progression (e.g., acute icteric AIH progression to AS-AIH or AIH-ALF, AS-AIH progression to AIH-ALF, non-cirrhotic progression to cirrhosis, compensated cirrhosis progression to decompensation), LT, and liver-related death.</div></div><div><h3>Results</h3><div>This retrospective cohort study enrolled 237 patients, with 109 presenting acute icteric AIH, 97 with acute-severe AIH (AS-AIH), and 31 with AIH-acute liver failure (ALF). Among patients with acute icteric AIH, slow tapering significantly improved adverse outcome-free survival compared to rapid tapering (99 % <em>vs.</em> 71 %, <em>P</em> &lt; 0.0001). Similarly, in AS-AIH patients, slow tapering resulted in notably higher adverse outcome-free survival rates compared to rapid tapering (92 % <em>vs.</em> 54 %, <em>P</em> &lt; 0.001). Slow tapering independently predicted fewer adverse events (OR 0.144; 95 % CI 0.037–0.562; <em>P</em> = 0.005). However, in AIH-acute liver failure (ALF) patients, tapering rate did not significantly affect adverse outcome-free survival (38 % <em>vs.</em> 50 %, <em>P</em> = 0.590). Overall, there were no significant differences in osteoporosis or infection occurrence between tapering groups in the entire acute AIH cohort.</div></div><div><h3>Conclusion</h3><div>A slow corticosteroid tapering reduced adverse outcomes in acute exacerbation of AIH patients, particularly in acute icteric AIH and AS-AIH.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103387"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Treg fitness signatures as a biomarker for disease activity in Juvenile Idiopathic Arthritis Treg适应度特征作为青少年特发性关节炎疾病活动性的生物标志物
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-02-14 DOI: 10.1016/j.jaut.2025.103379
Meryl H. Attrill , Diana Shinko , Telma Martins Viveiros , Martina Milighetti , Nina M. de Gruijter , Bethany Jebson , Melissa Kartawinata , Elizabeth C. Rosser , Lucy R. Wedderburn , CHARMS Study , JIAP Study , Anne M. Pesenacker
Juvenile Idiopathic Arthritis (JIA) is an autoimmune condition characterised by flares of joint inflammation. However, no reliable biomarker exists to predict the erratic disease course. Normally, regulatory T cells (Tregs) maintain tolerance, with altered Tregs associated with autoimmunity. Treg signatures have shown promise in monitoring other conditions, therefore a Treg gene/protein signature could offer novel biomarker potential for predicting disease activity in JIA.
Machine learning on our nanoString Treg 48-gene signature on peripheral blood (PB) Tregs generated a model to distinguish active JIA (active joint count, AJC≥1) Tregs from healthy controls (HC, AUC = 0.9875 on test data). Biomarker scores from this model successfully differentiated inactive (AJC = 0) from active JIA PB Tregs. Moreover, scores correlated with clinical activity scores (cJADAS), and discriminated subclinical disease (AJC = 0, cJADAS≥0.5) from remission (cJADAS<0.5).
To investigate altered protein expression as a surrogate measure for Treg fitness in JIA, we utilised spectral flow cytometry and unbiased clustering analysis. Three Treg clusters were of interest in active JIA PB, including TIGIThighCD226highCD25low Teff-like Tregs, CD39-TNFR2-Helioshigh, and a 4-1BBlowTIGITlowID2intermediate Treg cluster predominated in inactive JIA PB (AJC = 0). The ratio of these Treg clusters correlated to cJADAS, and higher ratios could potentially predict inactive individuals that flared by 9-month follow-up.
Thus, we demonstrate altered Treg signatures and subsets as an important factor, and useful biomarker, for disease progression versus remission in JIA, revealing genes and proteins contributing to Treg fitness. Ultimately, PB Treg fitness measures could serve as routine biomarkers to guide disease and treatment management to sustain remission in JIA.
幼年特发性关节炎(JIA)是一种以关节炎症为特征的自身免疫性疾病。然而,没有可靠的生物标志物来预测不稳定的病程。正常情况下,调节性T细胞(Tregs)维持耐受性,Tregs的改变与自身免疫有关。Treg标记在监测其他疾病方面已经显示出前景,因此Treg基因/蛋白质标记可能为预测JIA的疾病活性提供新的生物标志物潜力。利用我们在外周血(PB) Tregs上的nanoString Treg 48基因签名进行机器学习,生成了一个区分活跃JIA(活跃关节计数,AJC≥1)Tregs与健康对照(HC,测试数据AUC = 0.9875)的模型。该模型的生物标志物评分成功区分了不活跃(AJC = 0)和活跃的JIA PB Tregs。此外,评分与临床活动评分(cJADAS)相关,并将亚临床疾病(AJC = 0, cJADAS≥0.5)与缓解(cJADAS<0.5)区分开来。为了研究蛋白表达的改变作为JIA中Treg适应度的替代指标,我们使用了光谱流式细胞术和无偏聚类分析。活跃的JIA PB中有3个Treg簇,包括TIGIThighCD226highCD25low Teff-like Treg、cd39 - tnfr2 - heliohigh和4- 1blolowtigitlowid2 intermediate Treg簇(AJC = 0)。这些Treg簇的比例与cJADAS相关,较高的比例可能预示着在9个月的随访中不活跃的个体爆发。因此,我们证明了Treg特征和亚群的改变是JIA疾病进展与缓解的重要因素和有用的生物标志物,揭示了与Treg适应度有关的基因和蛋白质。最终,PB Treg适应度测量可以作为常规生物标志物来指导疾病和治疗管理,以维持JIA的缓解。
{"title":"Treg fitness signatures as a biomarker for disease activity in Juvenile Idiopathic Arthritis","authors":"Meryl H. Attrill ,&nbsp;Diana Shinko ,&nbsp;Telma Martins Viveiros ,&nbsp;Martina Milighetti ,&nbsp;Nina M. de Gruijter ,&nbsp;Bethany Jebson ,&nbsp;Melissa Kartawinata ,&nbsp;Elizabeth C. Rosser ,&nbsp;Lucy R. Wedderburn ,&nbsp;CHARMS Study ,&nbsp;JIAP Study ,&nbsp;Anne M. Pesenacker","doi":"10.1016/j.jaut.2025.103379","DOIUrl":"10.1016/j.jaut.2025.103379","url":null,"abstract":"<div><div>Juvenile Idiopathic Arthritis (JIA) is an autoimmune condition characterised by flares of joint inflammation. However, no reliable biomarker exists to predict the erratic disease course. Normally, regulatory T cells (Tregs) maintain tolerance, with altered Tregs associated with autoimmunity. Treg signatures have shown promise in monitoring other conditions, therefore a Treg gene/protein signature could offer novel biomarker potential for predicting disease activity in JIA.</div><div>Machine learning on our nanoString Treg 48-gene signature on peripheral blood (PB) Tregs generated a model to distinguish active JIA (active joint count, AJC≥1) Tregs from healthy controls (HC, AUC = 0.9875 on test data). Biomarker scores from this model successfully differentiated inactive (AJC = 0) from active JIA PB Tregs. Moreover, scores correlated with clinical activity scores (cJADAS), and discriminated subclinical disease (AJC = 0, cJADAS≥0.5) from remission (cJADAS&lt;0.5).</div><div>To investigate altered protein expression as a surrogate measure for Treg fitness in JIA, we utilised spectral flow cytometry and unbiased clustering analysis. Three Treg clusters were of interest in active JIA PB, including TIGIT<sub>high</sub>CD226<sub>high</sub>CD25<sub>low</sub> Teff-like Tregs, CD39-TNFR2-Helios<sub>high</sub>, and a 4-1BB<sub>low</sub>TIGIT<sub>low</sub>ID2<sub>intermediate</sub> Treg cluster predominated in inactive JIA PB (AJC = 0). The ratio of these Treg clusters correlated to cJADAS, and higher ratios could potentially predict inactive individuals that flared by 9-month follow-up.</div><div>Thus, we demonstrate altered Treg signatures and subsets as an important factor, and useful biomarker, for disease progression versus remission in JIA, revealing genes and proteins contributing to Treg fitness. Ultimately, PB Treg fitness measures could serve as routine biomarkers to guide disease and treatment management to sustain remission in JIA.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103379"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Peripheral immune profiling highlights a dynamic role of low-density granulocytes in myasthenia gravis 外周免疫分析强调了低密度粒细胞在重症肌无力中的动态作用
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-03-04 DOI: 10.1016/j.jaut.2025.103395
Shu Zhang , Qi Wen , Shengyao Su , Yaye Wang, Jingsi Wang, Nairong Xie, Wenjia Zhu, Xinmei Wen, Li Di, Yan Lu, Min Xu, Min Wang, Hai Chen, Jianying Duo, Yue Huang, Dongshan Wan, Zhen Tao, Shufang Zhao, Guoliang Chai, Junwei Hao, Yuwei Da

Background

Myasthenia gravis (MG) is an autoimmune neuromuscular disease marked by dysregulation of several immune cell populations. Here we explored peripheral immune landscape, particularly the role of low-density granulocytes (LDGs).

Methods

Single-cell and bulk RNA sequencing analyzed peripheral immune cells from MG patients pre- (n = 4) and after treatment (n = 2), as well as healthy controls (n = 3). Flow cytometry was employed for validating LDG subsets, and various functional assays were conducted to assess their impact on T cell proliferation and differentiation, NET formation, and ROS production.

Results

Single-cell analysis highlighted a shift towards inflammatory Th1/Th17/Tfh subsets, an intense interferon-mediated immune response, and an expansion of immature myeloid subsets in MG. Flow cytometry showed increased LDGs correlated with disease severity. Unlike myeloid-derived suppressor cells, MG LDGs do not restrict T cell proliferation but induce a pro-inflammatory Th1/Th17 response. They also display enhanced spontaneous neutrophil extracellular traps (NETs) formation and basal reactive oxygen species (ROS) production. LDGs decreased after intravenous immunoglobulin and increased after prolonged immunotherapy in minimal manifestation status (MM), with reduced pro-inflammatory activity. Bulk RNA sequencing revealed significant transcriptional differences in LDGs, especially in cell cycle and granule protein genes.

Conclusion

Peripheral immune profiling sheds light on the intricate role of LDGs in MG. These cells, as a distinct subtype of neutrophils with a proinflammatory phenotype, are notable increased in MG, exacerbating chronic inflammation. Furthermore, immunotherapy expanded LDGs but reduced their proinflammatory capacities. The complex interplay of LDGs in MG underscores their potential as biomarkers and therapeutic targets.
背景重症肌无力(MG)是一种自身免疫性神经肌肉疾病,以几种免疫细胞群失调为特征。在这里,我们探讨了外周免疫景观,特别是低密度粒细胞(LDGs)的作用。方法单细胞和大量RNA测序分析了MG患者治疗前(n = 4)和治疗后(n = 2)以及健康对照(n = 3)的外周免疫细胞。流式细胞术用于验证LDG亚群,并进行了各种功能测定以评估其对T细胞增殖和分化,NET形成和ROS产生的影响。结果单细胞分析强调了炎症性Th1/Th17/Tfh亚群的转变,干扰素介导的强烈免疫反应,以及MG中未成熟髓细胞亚群的扩大。流式细胞术显示LDGs升高与疾病严重程度相关。与髓源性抑制细胞不同,MG LDGs不限制T细胞增殖,但诱导促炎Th1/Th17反应。它们还表现出增强的自发中性粒细胞胞外陷阱(NETs)的形成和基础活性氧(ROS)的产生。LDGs在静脉注射免疫球蛋白后降低,在最小表现状态(MM)下延长免疫治疗后升高,促炎活性降低。大量RNA测序显示,LDGs的转录差异显著,特别是在细胞周期和颗粒蛋白基因上。结论外周免疫分析揭示了LDGs在MG中的复杂作用。这些细胞作为嗜中性粒细胞的一种独特亚型,具有促炎表型,在MG中显著增加,加剧慢性炎症。此外,免疫治疗扩大了ldg,但降低了它们的促炎能力。LDGs在MG中的复杂相互作用强调了它们作为生物标志物和治疗靶点的潜力。
{"title":"Peripheral immune profiling highlights a dynamic role of low-density granulocytes in myasthenia gravis","authors":"Shu Zhang ,&nbsp;Qi Wen ,&nbsp;Shengyao Su ,&nbsp;Yaye Wang,&nbsp;Jingsi Wang,&nbsp;Nairong Xie,&nbsp;Wenjia Zhu,&nbsp;Xinmei Wen,&nbsp;Li Di,&nbsp;Yan Lu,&nbsp;Min Xu,&nbsp;Min Wang,&nbsp;Hai Chen,&nbsp;Jianying Duo,&nbsp;Yue Huang,&nbsp;Dongshan Wan,&nbsp;Zhen Tao,&nbsp;Shufang Zhao,&nbsp;Guoliang Chai,&nbsp;Junwei Hao,&nbsp;Yuwei Da","doi":"10.1016/j.jaut.2025.103395","DOIUrl":"10.1016/j.jaut.2025.103395","url":null,"abstract":"<div><h3>Background</h3><div>Myasthenia gravis (MG) is an autoimmune neuromuscular disease marked by dysregulation of several immune cell populations. Here we explored peripheral immune landscape, particularly the role of low-density granulocytes (LDGs).</div></div><div><h3>Methods</h3><div>Single-cell and bulk RNA sequencing analyzed peripheral immune cells from MG patients pre- (n = 4) and after treatment (n = 2), as well as healthy controls (n = 3). Flow cytometry was employed for validating LDG subsets, and various functional assays were conducted to assess their impact on T cell proliferation and differentiation, NET formation, and ROS production.</div></div><div><h3>Results</h3><div>Single-cell analysis highlighted a shift towards inflammatory Th1/Th17/Tfh subsets, an intense interferon-mediated immune response, and an expansion of immature myeloid subsets in MG. Flow cytometry showed increased LDGs correlated with disease severity. Unlike myeloid-derived suppressor cells, MG LDGs do not restrict T cell proliferation but induce a pro-inflammatory Th1/Th17 response. They also display enhanced spontaneous neutrophil extracellular traps (NETs) formation and basal reactive oxygen species (ROS) production. LDGs decreased after intravenous immunoglobulin and increased after prolonged immunotherapy in minimal manifestation status (MM), with reduced pro-inflammatory activity. Bulk RNA sequencing revealed significant transcriptional differences in LDGs, especially in cell cycle and granule protein genes.</div></div><div><h3>Conclusion</h3><div>Peripheral immune profiling sheds light on the intricate role of LDGs in MG. These cells, as a distinct subtype of neutrophils with a proinflammatory phenotype, are notable increased in MG, exacerbating chronic inflammation. Furthermore, immunotherapy expanded LDGs but reduced their proinflammatory capacities. The complex interplay of LDGs in MG underscores their potential as biomarkers and therapeutic targets.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103395"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Glomerular CD68+ macrophages infiltration at initial biopsy predicts response to standard immunosuppression in proliferative lupus nephritis 初始活检时肾小球CD68+巨噬细胞浸润预测增殖性狼疮性肾炎对标准免疫抑制的反应
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 DOI: 10.1016/j.jaut.2025.103392
Cailing Su , Ansheng Cong , Heng Wu , Zhanmei Zhou , Zuoyu Hu , Jiao Luo , Shuang Cui , Dongyan Xu , Zhuoyu Zhou , Zhijie Huang , Manqiu Yang , Guobao Wang , Wei Cao

Objective

Predictive models of kidney response to standard immunosuppression are needed in proliferative lupus nephritis (LN). We tested the kidney macrophage infiltration at initial biopsy.

Methods

The prospective study was performed in 247 patients with newly diagnosed proliferative LN in 2 independent cohorts. Infiltrates of macrophages and lymphocytes in initial biopsies were identified using single-cell RNA sequencing and immunostaining analysis. The outcome was kidney response to standard immunosuppression at 1 year, defined clinically and histologically. Kidney infiltrates were investigated for association with kidney response. Models that combined kidney infiltrates and clinical parameters for predicting kidney response were developed and validated using machine learning algorithms.

Results

In Derivation cohort, glomerular infiltration of CD68+ macrophages at initial biopsy was associated with 1-year clinical response. Subjects in the highest tertile of glomerular CD68+ macrophage infiltrate (versus the lowest) had a 7.92-fold increase in probability of clinical response. An intelligent model incorporating infiltration score of glomerular CD68+ macrophage into clinical measures (area under the curve [AUC] 0.82) outperformed traditional clinical measure-based model (AUC 0.76) in predicting clinical response (P = 0.01). This intelligent model performed well in an independent Validation cohort. Furthermore, in 10 patients undergoing repeat kidney biopsy after 1 year of standard immunosuppression, our intelligent model effectively predicted histological response.

Conclusion

Intensity of glomerular CD68+ macrophage infiltration at initial biopsy predicted 1-year kidney response to standard therapy in proliferative LN. The intelligent model, which combines glomerular CD68+ macrophage infiltrates with clinical data at biopsy, could help discriminate responders from non-responders, enabling personalized therapy.
目的探讨增殖性狼疮性肾炎(LN)患者对标准免疫抑制反应的预测模型。我们在初始活检时检测肾巨噬细胞浸润。方法前瞻性研究纳入247例新诊断的增生性LN患者,分为2个独立队列。通过单细胞RNA测序和免疫染色分析,鉴定了初始活检中巨噬细胞和淋巴细胞的浸润。结果是1年时肾脏对标准免疫抑制的反应,临床和组织学定义。研究肾脏浸润与肾脏反应的关系。使用机器学习算法开发并验证了结合肾脏浸润和临床参数预测肾脏反应的模型。结果在衍生队列中,初始活检时肾小球CD68+巨噬细胞浸润与1年临床反应相关。肾小球CD68+巨噬细胞浸润率最高的受试者(与最低的受试者相比)临床反应的可能性增加了7.92倍。将肾小球CD68+巨噬细胞浸润评分纳入临床指标的智能模型(曲线下面积[AUC] 0.82)在预测临床反应方面优于传统的基于临床指标的模型(AUC 0.76) (P = 0.01)。该智能模型在独立验证队列中表现良好。此外,在标准免疫抑制1年后进行重复肾活检的10例患者中,我们的智能模型有效地预测了组织学反应。结论初始活检时肾小球CD68+巨噬细胞浸润强度可预测增生性LN患者1年肾脏对标准治疗的反应。该智能模型结合了肾小球CD68+巨噬细胞浸润和活检的临床数据,可以帮助区分反应者和无反应者,从而实现个性化治疗。
{"title":"Glomerular CD68+ macrophages infiltration at initial biopsy predicts response to standard immunosuppression in proliferative lupus nephritis","authors":"Cailing Su ,&nbsp;Ansheng Cong ,&nbsp;Heng Wu ,&nbsp;Zhanmei Zhou ,&nbsp;Zuoyu Hu ,&nbsp;Jiao Luo ,&nbsp;Shuang Cui ,&nbsp;Dongyan Xu ,&nbsp;Zhuoyu Zhou ,&nbsp;Zhijie Huang ,&nbsp;Manqiu Yang ,&nbsp;Guobao Wang ,&nbsp;Wei Cao","doi":"10.1016/j.jaut.2025.103392","DOIUrl":"10.1016/j.jaut.2025.103392","url":null,"abstract":"<div><h3>Objective</h3><div>Predictive models of kidney response to standard immunosuppression are needed in proliferative lupus nephritis (LN). We tested the kidney macrophage infiltration at initial biopsy.</div></div><div><h3>Methods</h3><div>The prospective study was performed in 247 patients with newly diagnosed proliferative LN in 2 independent cohorts. Infiltrates of macrophages and lymphocytes in initial biopsies were identified using single-cell RNA sequencing and immunostaining analysis. The outcome was kidney response to standard immunosuppression at 1 year, defined clinically and histologically. Kidney infiltrates were investigated for association with kidney response. Models that combined kidney infiltrates and clinical parameters for predicting kidney response were developed and validated using machine learning algorithms.</div></div><div><h3>Results</h3><div>In Derivation cohort, glomerular infiltration of CD68<sup>+</sup> macrophages at initial biopsy was associated with 1-year clinical response. Subjects in the highest tertile of glomerular CD68<sup>+</sup> macrophage infiltrate (<em>versus</em> the lowest) had a 7.92-fold increase in probability of clinical response. An intelligent model incorporating infiltration score of glomerular CD68<sup>+</sup> macrophage into clinical measures (area under the curve [AUC] 0.82) outperformed traditional clinical measure-based model (AUC 0.76) in predicting clinical response (P = 0.01). This intelligent model performed well in an independent Validation cohort. Furthermore, in 10 patients undergoing repeat kidney biopsy after 1 year of standard immunosuppression, our intelligent model effectively predicted histological response.</div></div><div><h3>Conclusion</h3><div>Intensity of glomerular CD68<sup>+</sup> macrophage infiltration at initial biopsy predicted 1-year kidney response to standard therapy in proliferative LN. The intelligent model, which combines glomerular CD68<sup>+</sup> macrophage infiltrates with clinical data at biopsy, could help discriminate responders from non-responders, enabling personalized therapy.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103392"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selective disruption of Traf1/cIAP2 interaction attenuates inflammatory responses and rheumatoid arthritis 选择性破坏Traf1/cIAP2相互作用可减轻炎症反应和类风湿关节炎。
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-02-05 DOI: 10.1016/j.jaut.2025.103377
Yitian Tang , Fatemah Aleithan , Sahib Singh Madahar , Ali Mirzaesmaeili , Sunpreet Saran , Jialing Tang , Safoura Zangiabadi , Robert Inman , Gary Sweeney , Ali A. Abdul-Sater

Objectives

Tumor necrosis factor receptor-associated factor 1 (TRAF1) is an immune signaling adapter protein linked to increased susceptibility to rheumatoid arthritis (RA). TRAF1 has dual roles in regulating NF-κB and MAPK signaling: it promotes signaling through its association with cellular inhibitor of apoptosis 2 (cIAP2) downstream of certain tumor necrosis factor receptor (TNFR) family members but inhibits Toll-like receptor (TLR) signaling by limiting linear ubiquitination of key signaling proteins. In this study, we investigated whether selectively targeting TRAF1/cIAP2 interaction would lower inflammation and reduce severity of RA.

Methods

We employed CRISPR/Cas9-mediated mediated gene editing to modify TRAF1 and specifically abrogate its interaction with cIAP2 in human macrophage cell lines and in mice. Biochemical studies were then employed to assess inflammatory signaling and cytokine production in gene edited macrophages. The collagen antibody-induced arthritis (CAIA) model of RA was used to trigger joint inflammation in mice.

Results

We identify a critical mutation in TRAF1 (V203A in humans, V196A in mice) that disrupts its interaction with cIAP2, leading to a significant reduction in TLR signaling and downstream inflammation in human and murine macrophages. We demonstrate that TRAF1 is recruited to the TLR4 complex and is indispensable for the recruitment of cIAP2, facilitating TAK1 phosphorylation and the activation of NF-κB and MAPK signaling pathways. Remarkably, mice harboring the TRAF1 V196A mutation are protected from LPS-induced septic shock and exhibit markedly reduced joint inflammation and disease severity in the CAIA model of RA.

Conclusion

These findings reveal a previously unrecognized and crucial role for the TRAF1/cIAP2 axis in promoting inflammation and offer a promising foundation for the development of novel therapeutic strategies for inflammatory conditions, such as RA.
目的:肿瘤坏死因子受体相关因子1 (TRAF1)是一种与类风湿关节炎(RA)易感性增加相关的免疫信号转导蛋白。TRAF1在调节NF-κB和MAPK信号传导中具有双重作用:它通过与某些肿瘤坏死因子受体(TNFR)家族成员下游的细胞凋亡抑制剂2 (cIAP2)关联促进信号传导,但通过限制关键信号蛋白的线性泛素化抑制toll样受体(TLR)信号传导。在这项研究中,我们研究了选择性靶向TRAF1/cIAP2相互作用是否会降低炎症和减轻RA的严重程度。方法:采用CRISPR/ cas9介导的介导基因编辑技术,在人巨噬细胞系和小鼠中修饰TRAF1,特异性地消除其与cIAP2的相互作用。然后采用生化研究来评估基因编辑巨噬细胞的炎症信号传导和细胞因子产生。采用胶原抗体诱导关节炎(CAIA)模型诱发小鼠关节炎症。结果:我们在TRAF1(人类为V203A,小鼠为V196A)中发现了一个关键突变,该突变破坏了其与cIAP2的相互作用,导致人类和小鼠巨噬细胞中TLR信号和下游炎症的显著减少。我们证明TRAF1被招募到TLR4复合体中,并且对于cIAP2的招募是必不可少的,促进TAK1磷酸化和NF-κB和MAPK信号通路的激活。值得注意的是,在RA的CAIA模型中,携带TRAF1 V196A突变的小鼠可以免受lps诱导的脓毒性休克的影响,并显着降低关节炎症和疾病严重程度。结论:这些发现揭示了TRAF1/cIAP2轴在促进炎症中的重要作用,为开发新的炎症治疗策略(如RA)提供了有希望的基础。
{"title":"Selective disruption of Traf1/cIAP2 interaction attenuates inflammatory responses and rheumatoid arthritis","authors":"Yitian Tang ,&nbsp;Fatemah Aleithan ,&nbsp;Sahib Singh Madahar ,&nbsp;Ali Mirzaesmaeili ,&nbsp;Sunpreet Saran ,&nbsp;Jialing Tang ,&nbsp;Safoura Zangiabadi ,&nbsp;Robert Inman ,&nbsp;Gary Sweeney ,&nbsp;Ali A. Abdul-Sater","doi":"10.1016/j.jaut.2025.103377","DOIUrl":"10.1016/j.jaut.2025.103377","url":null,"abstract":"<div><h3>Objectives</h3><div>Tumor necrosis factor receptor-associated factor 1 (TRAF1) is an immune signaling adapter protein linked to increased susceptibility to rheumatoid arthritis (RA). TRAF1 has dual roles in regulating NF-κB and MAPK signaling: it promotes signaling through its association with cellular inhibitor of apoptosis 2 (cIAP2) downstream of certain tumor necrosis factor receptor (TNFR) family members but inhibits Toll-like receptor (TLR) signaling by limiting linear ubiquitination of key signaling proteins. In this study, we investigated whether selectively targeting TRAF1/cIAP2 interaction would lower inflammation and reduce severity of RA.</div></div><div><h3>Methods</h3><div>We employed CRISPR/Cas9-mediated mediated gene editing to modify TRAF1 and specifically abrogate its interaction with cIAP2 in human macrophage cell lines and in mice. Biochemical studies were then employed to assess inflammatory signaling and cytokine production in gene edited macrophages. The collagen antibody-induced arthritis (CAIA) model of RA was used to trigger joint inflammation in mice.</div></div><div><h3>Results</h3><div>We identify a critical mutation in TRAF1 (V203A in humans, V196A in mice) that disrupts its interaction with cIAP2, leading to a significant reduction in TLR signaling and downstream inflammation in human and murine macrophages. We demonstrate that TRAF1 is recruited to the TLR4 complex and is indispensable for the recruitment of cIAP2, facilitating TAK1 phosphorylation and the activation of NF-κB and MAPK signaling pathways. Remarkably, mice harboring the TRAF1 V196A mutation are protected from LPS-induced septic shock and exhibit markedly reduced joint inflammation and disease severity in the CAIA model of RA.</div></div><div><h3>Conclusion</h3><div>These findings reveal a previously unrecognized and crucial role for the TRAF1/cIAP2 axis in promoting inflammation and offer a promising foundation for the development of novel therapeutic strategies for inflammatory conditions, such as RA.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103377"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Autoantibodies against α-synuclein inhibit its aggregation and cytotoxicity 抗α-突触核蛋白的自身抗体抑制其聚集和细胞毒性
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-03-04 DOI: 10.1016/j.jaut.2025.103390
Carmen Noelker , Florian Seitz , Annekathrin Sturn , Frauke Neff , Luminita-Cornelia Andrei-Selmer , Lorenz Rau , Armin Geyer , J. Alexander Ross , Michael Bacher , Richard Dodel
Aggregates of α-synuclein (α-Syn) are the major component of the Lewy bodies associated with Parkinson's disease. Recently, naturally occurring autoantibodies against α-synuclein (α-Syn-nAbs) were detected. Herein we have isolated and further characterized such α-Syn-nAbs. Using an affinity column coated with α-Syn, we have isolated α-Syn-nAbs from a commercially available intravenous Immunoglobulin (IVIg) preparation. A methodological approach based on ELISA, Western blotting and immunoprecipitation as well as surface plasmon resonance, was used to determine binding capacity to α-Syn. The epitope was determined via peptide array membrane and the functionality was tested in vitro using a toxicity and a fibrillation assay. The autoantibodies display strong binding capacity to α-Syn as demonstrated by ELISA, immunoprecipitation and Western blotting analysis. The binding affinities of the purified autoantibodies were analyzed in detail by surface plasmon resonance (Biacore). The epitope on α-Syn that is recognized by the α-Syn nAbs was fully determined. A sequence within the non-amyloid component (NAC)-Region of α-Syn is crucial for the binding of α-Syn-nAbs to α-Syn. Furthermore, the α-Syn-nAbs had an inhibitory effect on α-Syn fibril formation and were also able to specifically reverse the toxicity of α-Syn oligomers species in human neuroblastoma (SH-SY5Y) cells. Our results emphasize the possible importance of naturally occurring autoantibodies for the pathogenesis of Parkinson's disease. Since autoantibodies against α-Syn are detectable in human serum and cerebrospinal fluid and interfere with pathological events associated with α-Syn, they may provide a candidate for the treatment of Parkinson's disease.
α-突触核蛋白(α-Syn)的聚集体是与帕金森病相关的路易体的主要成分。最近,自然产生的抗α-突触核蛋白自身抗体(α- syn - nab)被检测到。在此,我们分离并进一步表征了这种α- syn - nab。利用包被α-Syn的亲和柱,我们从市售的静脉注射免疫球蛋白(IVIg)制剂中分离出α-Syn- nab。采用ELISA、Western blotting、免疫沉淀、表面等离子体共振等方法测定α-Syn的结合能力。通过肽阵列膜确定表位,并使用体外毒性和纤颤试验测试其功能。ELISA、免疫沉淀和Western blotting分析表明,自身抗体对α-Syn具有较强的结合能力。用表面等离子体共振(Biacore)对纯化的自身抗体的结合亲和力进行了详细的分析。完全确定了α-Syn抗体识别的α-Syn表位。α-Syn的非淀粉样成分(NAC)区域内的序列对于α-Syn- nab与α-Syn的结合至关重要。此外,α-Syn- nab对α-Syn纤维的形成具有抑制作用,并且能够特异性逆转α-Syn低聚物物种对人神经母细胞瘤(SH-SY5Y)细胞的毒性。我们的结果强调了自然产生的自身抗体在帕金森病发病机制中的重要性。由于抗α-Syn的自身抗体在人血清和脑脊液中可检测到,并干扰与α-Syn相关的病理事件,因此它们可能为帕金森病的治疗提供候选药物。
{"title":"Autoantibodies against α-synuclein inhibit its aggregation and cytotoxicity","authors":"Carmen Noelker ,&nbsp;Florian Seitz ,&nbsp;Annekathrin Sturn ,&nbsp;Frauke Neff ,&nbsp;Luminita-Cornelia Andrei-Selmer ,&nbsp;Lorenz Rau ,&nbsp;Armin Geyer ,&nbsp;J. Alexander Ross ,&nbsp;Michael Bacher ,&nbsp;Richard Dodel","doi":"10.1016/j.jaut.2025.103390","DOIUrl":"10.1016/j.jaut.2025.103390","url":null,"abstract":"<div><div>Aggregates of α-synuclein (α-Syn) are the major component of the Lewy bodies associated with Parkinson's disease. Recently, naturally occurring autoantibodies against α-synuclein (α-Syn-nAbs) were detected. Herein we have isolated and further characterized such α-Syn-nAbs. Using an affinity column coated with α-Syn, we have isolated α-Syn-nAbs from a commercially available intravenous Immunoglobulin (IVIg) preparation. A methodological approach based on ELISA, Western blotting and immunoprecipitation as well as surface plasmon resonance, was used to determine binding capacity to α-Syn. The epitope was determined via peptide array membrane and the functionality was tested <em>in vitro</em> using a toxicity and a fibrillation assay. The autoantibodies display strong binding capacity to α-Syn as demonstrated by ELISA, immunoprecipitation and Western blotting analysis. The binding affinities of the purified autoantibodies were analyzed in detail by surface plasmon resonance (Biacore). The epitope on α-Syn that is recognized by the α-Syn nAbs was fully determined. A sequence within the non-amyloid component (NAC)-Region of α-Syn is crucial for the binding of α-Syn-nAbs to α-Syn. Furthermore, the α-Syn-nAbs had an inhibitory effect on α-Syn fibril formation and were also able to specifically reverse the toxicity of α-Syn oligomers species in human neuroblastoma (SH-SY5Y) cells. Our results emphasize the possible importance of naturally occurring autoantibodies for the pathogenesis of Parkinson's disease. Since autoantibodies against α-Syn are detectable in human serum and cerebrospinal fluid and interfere with pathological events associated with α-Syn, they may provide a candidate for the treatment of Parkinson's disease.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103390"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Sex differences in biomarkers and biologic mechanisms in psoriatic diseases and spondyloarthritis 银屑病和脊柱关节炎生物标志物和生物机制的性别差异
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-03-02 DOI: 10.1016/j.jaut.2025.103394
Steven Dang , Joan Wither , Igor Jurisica , Vinod Chandran , Lihi Eder
Psoriasis and spondyloarthritis (SpA), including psoriatic arthritis (PsA), are immune-mediated inflammatory conditions that affect the skin and musculoskeletal system. Males and female patients with psoriatic disease and SpA exhibit differences in clinical presentation, disease progression, and treatment response. The underlying biological mechanisms driving these sex differences remain poorly understood. This review explores the current evidence on sex-related differences in biomarkers and biological pathways in psoriasis, PsA, and SpA. While no conclusive sex-specific biomarkers have been validated, this review highlights several sex-related differences in biomarkers and biological pathways, including differences in bone turnover markers, IL-23/IL-17 pathway activity, pro-inflammatory cytokines, and cardio-metabolic profiles that may partially contribute to the clinical differences observed between male and female patients. Sex hormones may contribute to the altered bone metabolism and immune regulation in females. To effectively identify and validate sex-specific biomarkers, there is a need to prioritize sex as a biological variable in future research. Adopting such an approach should enhance more personalized therapeutic strategies and improve management for male and female patients with psoriatic disease and SpA.
银屑病和脊柱炎(SpA),包括银屑病关节炎(PsA),是免疫介导的炎症,影响皮肤和肌肉骨骼系统。男性和女性银屑病和SpA患者在临床表现、疾病进展和治疗反应方面存在差异。导致这些性别差异的潜在生物学机制仍然知之甚少。本文综述了银屑病、PsA和SpA中生物标志物和生物学途径的性别相关差异的现有证据。虽然没有结论性的性别特异性生物标志物得到验证,但这篇综述强调了几种与性别相关的生物标志物和生物学途径的差异,包括骨转换标志物、IL-23/IL-17途径活性、促炎细胞因子和心脏代谢谱的差异,这些差异可能部分促成了男性和女性患者之间观察到的临床差异。性激素可能与女性骨代谢和免疫调节的改变有关。为了有效地识别和验证性别特异性生物标志物,有必要在未来的研究中优先考虑性别作为一个生物学变量。采用这种方法应加强更个性化的治疗策略,并改善对男性和女性银屑病和SpA患者的管理。
{"title":"Sex differences in biomarkers and biologic mechanisms in psoriatic diseases and spondyloarthritis","authors":"Steven Dang ,&nbsp;Joan Wither ,&nbsp;Igor Jurisica ,&nbsp;Vinod Chandran ,&nbsp;Lihi Eder","doi":"10.1016/j.jaut.2025.103394","DOIUrl":"10.1016/j.jaut.2025.103394","url":null,"abstract":"<div><div>Psoriasis and spondyloarthritis (SpA), including psoriatic arthritis (PsA), are immune-mediated inflammatory conditions that affect the skin and musculoskeletal system. Males and female patients with psoriatic disease and SpA exhibit differences in clinical presentation, disease progression, and treatment response. The underlying biological mechanisms driving these sex differences remain poorly understood. This review explores the current evidence on sex-related differences in biomarkers and biological pathways in psoriasis, PsA, and SpA. While no conclusive sex-specific biomarkers have been validated, this review highlights several sex-related differences in biomarkers and biological pathways, including differences in bone turnover markers, IL-23/IL-17 pathway activity, pro-inflammatory cytokines, and cardio-metabolic profiles that may partially contribute to the clinical differences observed between male and female patients. Sex hormones may contribute to the altered bone metabolism and immune regulation in females. To effectively identify and validate sex-specific biomarkers, there is a need to prioritize sex as a biological variable in future research. Adopting such an approach should enhance more personalized therapeutic strategies and improve management for male and female patients with psoriatic disease and SpA.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103394"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Advanced pulmonary sarcoidosis 晚期肺结节病
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI: 10.1016/j.jaut.2025.103397
Florence Jeny , Dominique Valeyre , Elyse E. Lower , Robert P. Baughman
Sarcoidosis affects the lungs in most patients. Manifestations of pulmonary sarcoidosis range from asymptomatic to death. Approximately a quarter of sarcoidosis patients develop chronic pulmonary disease. Advanced pulmonary sarcoidosis patients are those who have progressive disease and are at risk for significant morbidity and mortality. There are several features associated with advanced pulmonary disease: pulmonary fibrosis, pulmonary hypertension, chronic pulmonary inflammation, and/or complications of disease or therapy. Large retrospective studies have identified pulmonary fibrosis and pulmonary hypertension as the major causes of respiratory failure and death in pulmonary sarcoidosis. The high-resolution computer tomography scan (HRCT) and echocardiogram are key methods in screening for pulmonary hypertension and pulmonary fibrosis. Therapy for chronic pulmonary inflammation has been the major focus in chronic disease. However, treatment for pulmonary hypertension has been studied in sarcoidosis. To date, treatment studies for sarcoidosis associated progressive pulmonary fibrosis have been underpowered to demonstrate clear cut benefit of anti-fibrotic agents.
结节病在大多数患者中影响肺部。肺结节病的表现从无症状到死亡不等。大约四分之一的结节病患者会发展成慢性肺部疾病。晚期肺结节病患者是那些病情进展,有显著发病率和死亡率风险的患者。有几个特征与晚期肺部疾病相关:肺纤维化、肺动脉高压、慢性肺部炎症和/或疾病或治疗的并发症。大型回顾性研究已经确定肺纤维化和肺动脉高压是肺结节病患者呼吸衰竭和死亡的主要原因。高分辨率计算机断层扫描(HRCT)和超声心动图是筛查肺动脉高压和肺纤维化的关键方法。慢性肺部炎症的治疗一直是慢性疾病的主要焦点。然而,对结节病的肺动脉高压治疗已经进行了研究。迄今为止,对结节病相关的进行性肺纤维化的治疗研究还不足以证明抗纤维化药物的明确益处。
{"title":"Advanced pulmonary sarcoidosis","authors":"Florence Jeny ,&nbsp;Dominique Valeyre ,&nbsp;Elyse E. Lower ,&nbsp;Robert P. Baughman","doi":"10.1016/j.jaut.2025.103397","DOIUrl":"10.1016/j.jaut.2025.103397","url":null,"abstract":"<div><div>Sarcoidosis affects the lungs in most patients. Manifestations of pulmonary sarcoidosis range from asymptomatic to death. Approximately a quarter of sarcoidosis patients develop chronic pulmonary disease. Advanced pulmonary sarcoidosis patients are those who have progressive disease and are at risk for significant morbidity and mortality. There are several features associated with advanced pulmonary disease: pulmonary fibrosis, pulmonary hypertension, chronic pulmonary inflammation, and/or complications of disease or therapy. Large retrospective studies have identified pulmonary fibrosis and pulmonary hypertension as the major causes of respiratory failure and death in pulmonary sarcoidosis. The high-resolution computer tomography scan (HRCT) and echocardiogram are key methods in screening for pulmonary hypertension and pulmonary fibrosis. Therapy for chronic pulmonary inflammation has been the major focus in chronic disease. However, treatment for pulmonary hypertension has been studied in sarcoidosis. To date, treatment studies for sarcoidosis associated progressive pulmonary fibrosis have been underpowered to demonstrate clear cut benefit of anti-fibrotic agents.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103397"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Total lung capacity is predictive of disease severity and survival in systemic sclerosis: A longitudinal analysis in 2347 patients from the French National Cohort Study 全肺活量可预测系统性硬化症的疾病严重程度和生存:来自法国国家队列研究的2347例患者的纵向分析
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-03-04 DOI: 10.1016/j.jaut.2025.103391
Benjamin Chaigne , Alexandre Bense , Frédérique Aubourg , Christian Agard , Yannick Allanore , Alice Berezne , Grégory Pugnet , Eric Hachulla , Vincent Cottin , Arnaud Hot , Bertrand Dunogue , Anuxcy Kanagaratnam , Sylvain Palat , Alain Lescoat , Sabine Berthier , Emmanuel Chatelus , Sébastien Rivière , David Launay , Marie-Elise Truchetet , Anh Tuan Dinh-Xuan , Perrine Smets

Background

Total lung capacity (TLC) is seldom assessed in the prediction of systemic sclerosis (SSc) disease severity.

Objective

To describe and analyse TLC in SSc.

Methods

We performed a retrospective multicentre study of SSc patients enrolled in the French national SSc cohort with at least one TLC assessment, described patients based on baseline TLC measurements, modelized TLC trajectories in SSc, and associated TLC measures with disease prognosis.

Results

Two thousand three hundred and forty-seven patients were included in the study. Baseline TLC was associated with disease severity and survival, as well as with the occurrence of interstitial lung disease (ILD), lung fibrosis (LF), and pulmonary arterial hypertension (PAH). Individual TLC trajectories varied among patients. Different models of TLC trajectories were assessed using latent process mixed models. The best model showed that the vast majority of SSc patients had stable TLC trajectories and clustered patients into three groups predictive of SSc survival, ILD, LF, and PAH. Lastly, a 10 % decrease of TLC was found to be predictive of a 5 % decrease in forced vital capacity (FVC), a 10 % decrease in DLCO, and consequently an earlier predictive marker of ILD and LF than FVC.

Limitations

Retrospective study.

Conclusion

TLC is predictive of disease severity and survival in SSc and SSc-ILD. This work suggests TLC as an earlier risk factor for ILD and LF than FVC in SSc.
背景:在预测系统性硬化症(SSc)疾病严重程度时,很少评估总肺活量(TLC)。目的对SSc进行薄层色谱描述和分析。方法:我们对入组法国国家SSc队列的SSc患者进行了一项回顾性多中心研究,至少进行了一次TLC评估,基于基线TLC测量来描述患者,模拟了SSc中的TLC轨迹,并将TLC测量与疾病预后相关联。结果共纳入27347例患者。基线TLC与疾病严重程度和生存,以及间质性肺疾病(ILD)、肺纤维化(LF)和肺动脉高压(PAH)的发生相关。个体TLC轨迹因患者而异。使用潜在过程混合模型评估不同的TLC轨迹模型。最佳模型显示绝大多数SSc患者具有稳定的TLC轨迹,并将患者分为三组,预测SSc生存,ILD, LF和PAH。最后,发现TLC下降10%预示着用力肺活量(FVC)下降5%,DLCO下降10%,因此比FVC更早预测ILD和LF。LimitationsRetrospective研究。结论tlc可预测SSc及SSc- ild的病情严重程度和生存。这项研究表明,在SSc中,TLC比FVC更早成为ILD和LF的危险因素。
{"title":"Total lung capacity is predictive of disease severity and survival in systemic sclerosis: A longitudinal analysis in 2347 patients from the French National Cohort Study","authors":"Benjamin Chaigne ,&nbsp;Alexandre Bense ,&nbsp;Frédérique Aubourg ,&nbsp;Christian Agard ,&nbsp;Yannick Allanore ,&nbsp;Alice Berezne ,&nbsp;Grégory Pugnet ,&nbsp;Eric Hachulla ,&nbsp;Vincent Cottin ,&nbsp;Arnaud Hot ,&nbsp;Bertrand Dunogue ,&nbsp;Anuxcy Kanagaratnam ,&nbsp;Sylvain Palat ,&nbsp;Alain Lescoat ,&nbsp;Sabine Berthier ,&nbsp;Emmanuel Chatelus ,&nbsp;Sébastien Rivière ,&nbsp;David Launay ,&nbsp;Marie-Elise Truchetet ,&nbsp;Anh Tuan Dinh-Xuan ,&nbsp;Perrine Smets","doi":"10.1016/j.jaut.2025.103391","DOIUrl":"10.1016/j.jaut.2025.103391","url":null,"abstract":"<div><h3>Background</h3><div>Total lung capacity (TLC) is seldom assessed in the prediction of systemic sclerosis (SSc) disease severity.</div></div><div><h3>Objective</h3><div>To describe and analyse TLC in SSc.</div></div><div><h3>Methods</h3><div>We performed a retrospective multicentre study of SSc patients enrolled in the French national SSc cohort with at least one TLC assessment, described patients based on baseline TLC measurements, modelized TLC trajectories in SSc, and associated TLC measures with disease prognosis.</div></div><div><h3>Results</h3><div>Two thousand three hundred and forty-seven patients were included in the study. Baseline TLC was associated with disease severity and survival, as well as with the occurrence of interstitial lung disease (ILD), lung fibrosis (LF), and pulmonary arterial hypertension (PAH). Individual TLC trajectories varied among patients. Different models of TLC trajectories were assessed using latent process mixed models. The best model showed that the vast majority of SSc patients had stable TLC trajectories and clustered patients into three groups predictive of SSc survival, ILD, LF, and PAH. Lastly, a 10 % decrease of TLC was found to be predictive of a 5 % decrease in forced vital capacity (FVC), a 10 % decrease in DLCO, and consequently an earlier predictive marker of ILD and LF than FVC.</div></div><div><h3>Limitations</h3><div>Retrospective study.</div></div><div><h3>Conclusion</h3><div>TLC is predictive of disease severity and survival in SSc and SSc-ILD. This work suggests TLC as an earlier risk factor for ILD and LF than FVC in SSc.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103391"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Differences in innate immune cell populations distinguish autoimmune from herpesvirus-associated encephalitis 先天免疫细胞群的差异区分了自身免疫性脑炎和疱疹病毒相关脑炎
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 Epub Date: 2025-03-04 DOI: 10.1016/j.jaut.2025.103396
Saskia Räuber , Andreas Schulte-Mecklenbeck , Kelvin Sarink , Kristin S. Golombeck , Christina B. Schroeter , Alice Willison , Christopher Nelke , Christine Strippel , Andre Dik , Marco Gallus , Stjepana Kovac , Heinz Wiendl , Gerd Meyer zu Hörste , Tobias Ruck , Oliver M. Grauer , Udo Dannlowski , Tim Hahn , Catharina C. Gross , Sven G. Meuth , Nico Melzer

Background

Autoimmune encephalitis (AIE) is a disabling inflammatory condition of the brain deemed to be due to a dysregulated immune response. Viral infections and malignancies together with certain genetic polymorphisms are thought to contribute to the pathogenesis of AIE, yet the exact mechanisms remain insufficiently understood. Diagnosis of AIE currently relies on clinical consensus criteria. However, diagnostic workup can be challenging in some cases, potentially delaying treatment initiation associated with poor clinical outcomes.
This study aims to investigate the systemic and intrathecal immune cell profiles of AIE in comparison to viral meningoencephalitis (VME) as a clinically relevant differential diagnosis and evaluate its diagnostic and therapeutic potential.

Methods

97 mainly treatment-naïve AIE patients, 47 patients with VME, and 109 somatic symptom disorder (SD) controls were included. Analysis of peripheral blood (PB) and cerebrospinal fluid (CSF) immune cell profiles was performed using multidimensional flow cytometry (mFC) in combination with novel computational approaches.

Results

We were able to identify alterations in the adaptive B and T cell-mediated immune response in AIE compared to SD controls which correspond to respective changes in the brain parenchyma. AIE and VME exhibit similar patterns of adaptive B and T cell responses and differ in pattern of innate immunity especially NK cells. MFC together with routine CSF parameters can differentiate AIE from VME and SD controls implying diagnostic potential.

Conclusion

AIE is characterized by a B and T cell-mediated systemic and intrathecal immune-cell signature which corresponds to changes reported in the brain parenchyma providing insights into immunopathogenesis. Differences between AIE and VME were most prominent for the innate immune response indicating a potential role of NK cells in the pathogenesis of autoimmunity. Our data provides evidence that mFC could be a novel complementary approach to the diagnosis of AIE with diagnostic, therapeutic, and prognostic implications.
自身免疫性脑炎(AIE)是一种大脑致残性炎症,被认为是由于免疫反应失调所致。病毒感染和恶性肿瘤以及某些遗传多态性被认为与AIE的发病机制有关,但其确切机制尚不清楚。AIE的诊断目前依赖于临床共识标准。然而,在某些情况下,诊断检查可能具有挑战性,可能会延迟与临床结果不佳相关的治疗开始。本研究旨在探讨AIE与病毒性脑膜脑炎(VME)的全身和鞘内免疫细胞谱,作为临床相关的鉴别诊断,并评估其诊断和治疗潜力。方法97例主要为treatment-naïve AIE患者,47例VME患者,109例躯体症状障碍(SD)对照。使用多维流式细胞术(mFC)结合新的计算方法分析外周血(PB)和脑脊液(CSF)免疫细胞谱。结果与SD对照组相比,我们能够识别AIE中适应性B细胞和T细胞介导的免疫反应的改变,这对应于脑实质的各自变化。AIE和VME表现出相似的适应性B细胞和T细胞应答模式,但在先天免疫特别是NK细胞应答模式上存在差异。MFC和常规CSF参数可以区分AIE与VME和SD控制,这意味着诊断潜力。结论aie的特点是B和T细胞介导的全身和鞘内免疫细胞特征,这与脑实质的变化相对应,为免疫发病机制提供了新的认识。AIE和VME之间的差异在先天免疫反应中最为突出,表明NK细胞在自身免疫发病机制中的潜在作用。我们的数据提供了证据,证明mFC可能是AIE诊断的一种新的补充方法,具有诊断、治疗和预后意义。
{"title":"Differences in innate immune cell populations distinguish autoimmune from herpesvirus-associated encephalitis","authors":"Saskia Räuber ,&nbsp;Andreas Schulte-Mecklenbeck ,&nbsp;Kelvin Sarink ,&nbsp;Kristin S. Golombeck ,&nbsp;Christina B. Schroeter ,&nbsp;Alice Willison ,&nbsp;Christopher Nelke ,&nbsp;Christine Strippel ,&nbsp;Andre Dik ,&nbsp;Marco Gallus ,&nbsp;Stjepana Kovac ,&nbsp;Heinz Wiendl ,&nbsp;Gerd Meyer zu Hörste ,&nbsp;Tobias Ruck ,&nbsp;Oliver M. Grauer ,&nbsp;Udo Dannlowski ,&nbsp;Tim Hahn ,&nbsp;Catharina C. Gross ,&nbsp;Sven G. Meuth ,&nbsp;Nico Melzer","doi":"10.1016/j.jaut.2025.103396","DOIUrl":"10.1016/j.jaut.2025.103396","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune encephalitis (AIE) is a disabling inflammatory condition of the brain deemed to be due to a dysregulated immune response. Viral infections and malignancies together with certain genetic polymorphisms are thought to contribute to the pathogenesis of AIE, yet the exact mechanisms remain insufficiently understood. Diagnosis of AIE currently relies on clinical consensus criteria. However, diagnostic workup can be challenging in some cases, potentially delaying treatment initiation associated with poor clinical outcomes.</div><div>This study aims to investigate the systemic and intrathecal immune cell profiles of AIE in comparison to viral meningoencephalitis (VME) as a clinically relevant differential diagnosis and evaluate its diagnostic and therapeutic potential.</div></div><div><h3>Methods</h3><div>97 mainly treatment-naïve AIE patients, 47 patients with VME, and 109 somatic symptom disorder (SD) controls were included. Analysis of peripheral blood (PB) and cerebrospinal fluid (CSF) immune cell profiles was performed using multidimensional flow cytometry (mFC) in combination with novel computational approaches.</div></div><div><h3>Results</h3><div>We were able to identify alterations in the adaptive B and T cell-mediated immune response in AIE compared to SD controls which correspond to respective changes in the brain parenchyma. AIE and VME exhibit similar patterns of adaptive B and T cell responses and differ in pattern of innate immunity especially NK cells. MFC together with routine CSF parameters can differentiate AIE from VME and SD controls implying diagnostic potential.</div></div><div><h3>Conclusion</h3><div>AIE is characterized by a B and T cell-mediated systemic and intrathecal immune-cell signature which corresponds to changes reported in the brain parenchyma providing insights into immunopathogenesis. Differences between AIE and VME were most prominent for the innate immune response indicating a potential role of NK cells in the pathogenesis of autoimmunity. Our data provides evidence that mFC could be a novel complementary approach to the diagnosis of AIE with diagnostic, therapeutic, and prognostic implications.</div></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"152 ","pages":"Article 103396"},"PeriodicalIF":7.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
期刊
Journal of autoimmunity
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1