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Mepolizumab versus benralizumab for eosinophilic granulomatosis with polyangiitis (EGPA): A European real-life retrospective comparative study Mepolizumab与benralizumab治疗嗜酸性肉芽肿病合并多血管炎(EGPA):一项欧洲现实回顾性比较研究
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-26 DOI: 10.1016/j.jaut.2025.103398
Irene Mattioli , Maria Letizia Urban , Roberto Padoan , Aladdin J. Mohammad , Carlo Salvarani , Chiara Baldini , Alvise Berti , Paolo Cameli , Marco Caminati , Pascal Cathébras , Fulvia Chieco Bianchi , Francesco Cinetto , Jan Willem Cohen Tervaert , Angelo Coppola , Giulia Costanzo , Vincent Cottin , Claudia Crimi , Stefano Del Giacco , Charlene Desaintjean , Allyson Egan , Barbara Trezzi

Background

Following the results of the MANDARA trial, this real-life study aimed at comparing the effectiveness and safety profile of mepolizumab versus benralizumab in a European EGPA cohort.

Methods

We conducted a retrospective observational comparative study including EGPA patients, who received mepolizumab or benralizumab at the asthma dose. Patients were matched 1:1 by sex, age, BVAS and oral corticosteroid (OCS) dosage at the treatment initiation (T0). Complete response (CR) and partial response (PR), disease activity, OCS, pulmonary parameters, eosinophil count, relapses, and safety outcomes were also compared at 3, 6 and 12 months.

Results

Patients treated with mepolizumab or benralizumab (n = 88 each) were matched: 57 % were females, median age was 54 years (IQR 45–60), median OCS dose 10 (7.5–12.5) and 10 (7–13) mg/day, median BVAS 4 (2–7) and 3 (2–8), respectively. 45.4 % of patients in the mepolizumab group and 51.1 % in the benralizumab group achieved CR or PR at T3, with CR steadily increasing during follow-up for both treatments. At T12, a higher CR rate was found in the benralizumab group (48.1 % vs 32.4 %, p = 0.005). No differences in BVAS, OCS, and respiratory parameters were observed between groups at the different timepoints. Throughout the follow-up, both treatments reduced eosinophil count, although a deeper reduction was found in the benralizumab group at all timepoints (p < 0.0001). Safety profile was comparable between patient groups.

Conclusion

Mepolizumab and benralizumab showed comparable overall effectiveness and safety in EGPA. However, benralizumab achieved a higher CR rate at T12, and a deeper peripheral eosinophil reduction.
在MANDARA试验结果之后,这项现实生活中的研究旨在比较mepolizumab与benralizumab在欧洲EGPA队列中的有效性和安全性。方法我们进行了一项回顾性观察性比较研究,纳入EGPA患者,接受mepolizumab或benralizumab的哮喘剂量。患者按性别、年龄、BVAS和治疗开始时口服皮质类固醇(OCS)剂量(T0)进行1:1匹配。完全缓解(CR)和部分缓解(PR)、疾病活动性、OCS、肺参数、嗜酸性粒细胞计数、复发和安全性结果也在3、6和12个月时进行了比较。结果mepolizumab或benralizumab治疗的患者(各88例)匹配:57%为女性,中位年龄为54岁(IQR 45-60),中位OCS剂量为10(7.5-12.5)和10 (7-13)mg/天,中位BVAS分别为4(2-7)和3(2-8)。45.4%的mepolizumab组患者和51.1%的benralizumab组患者在T3达到CR或PR,在两种治疗的随访期间CR稳步增加。在T12时,benralizumab组的CR率更高(48.1% vs 32.4%, p = 0.005)。各组在不同时间点的BVAS、OCS和呼吸参数均无差异。在整个随访过程中,两种治疗均降低了嗜酸性粒细胞计数,尽管贝纳利珠单抗组在所有时间点均有更深程度的降低(p <;0.0001)。患者组间的安全性具有可比性。结论mepolizumab和benralizumab在EGPA治疗中具有相当的总体有效性和安全性。然而,贝纳利珠单抗在T12时实现了更高的CR率,以及更深的外周嗜酸性粒细胞减少。
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引用次数: 0
Treatment of uveitis in Blau syndrome: A systematic review and meta-analysis Blau综合征葡萄膜炎的治疗:系统回顾和荟萃分析
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-26 DOI: 10.1016/j.jaut.2025.103401
Ilaria Maccora , Carine Wouters , Carlos D. Rosè , Valerio Maniscalco , Salvatore de Masi , Maria Vincenza Mastrolia , Edoardo Marrani , Ilaria Pagnini , Gabriele Simonini

Objectives

Blau syndrome (BS) is a rare autoinflammatory disease caused by gain of function variants in NOD2. Uveitis is one of the triad features with arthritis and dermatitis. Management of uveitis is challenging, and uncontrolled uveitis may lead to blindness. We aim to evaluate the evidence regarding effectiveness of systemic treatments, including conventional Disease Modifying anti-Rheumatic drugs(cDMARDs) and biologic DMARDs(bDMARDs), for the management of uveitis in BS.

Methods

A systematic literature review and meta-analysis was performed according to PRISMA guidelines. Papers were selected if they reported patients with BS and uveitis who received systemic treatment. Papers were selected if reporting efficacy according to Standardization of Uveitis Nomenclature (SUN) criteria.

Results

We identified 1205 papers with 11 selected for systematic review and meta-analysis. Among the 11 selected papers, we identified 88 treatments. Among these, 53 were cDMARDs (36 methotrexate, 7 azathioprine, 5 mycophenolate, 3 thalidomide, 1 tacrolimus and 1 cyclosporine) and 35 bDMARDs (23 adalimumab, 6 infliximab, 4 etanercept, 1 golimumab and 1 canakinumab). The proportion of children showing improvement of uveitis was 20 % (95 % CI 2–46) and 22 % (95 % CI3-47) for cDMARDs and bDMARDs respectively (χ20.23, p = 0.631). No differences were observed among the administered drugs (χ27.21, p = 0.706).

Conclusion

The data show that there is not enough evidence to establish a preferred treatment for managing uveitis in BS. Considering the rarity, the potential severity and refractoriness to current treatments of the disease, there is a critical need for better understanding of pathophysiology and expert driven treatment guidelines for of BS-uveitis.
目的blau综合征(BS)是一种罕见的由NOD2功能变异获得引起的自身炎症性疾病。葡萄膜炎是关节炎和皮炎的三联征之一。葡萄膜炎的治疗具有挑战性,不受控制的葡萄膜炎可能导致失明。我们的目标是评估系统性治疗的有效性证据,包括传统的疾病修饰抗风湿药物(cDMARDs)和生物DMARDs(bDMARDs),用于治疗BS患者的葡萄膜炎。方法根据PRISMA指南进行系统文献综述和meta分析。报道BS和葡萄膜炎患者接受全身治疗的论文入选。根据葡萄膜炎命名法标准化(SUN)标准选择报告疗效的论文。结果共纳入1205篇论文,其中11篇入选系统评价和荟萃分析。在入选的11篇论文中,我们确定了88种治疗方法。其中,cdmard 53个(甲氨喋呤36个,硫唑嘌呤7个,霉酚酸酯5个,沙利度胺3个,他克莫司1个,环孢素1个),bdmard 35个(阿达木单抗23个,英夫利昔单抗6个,依那西普4个,戈利姆单抗1个,canakinumab 1个)。cDMARDs患儿葡萄膜炎改善的比例为20% (95% CI 2-46), bDMARDs患儿葡萄膜炎改善的比例为22% (95% CI3-47) (χ20.23, p = 0.631)。各给药组间差异无统计学意义(χ27.21, p = 0.706)。结论没有足够的证据来确定治疗BS患者葡萄膜炎的首选治疗方法。考虑到这种疾病的罕见性、潜在的严重性和目前治疗方法的难治性,迫切需要更好地了解bs -葡萄膜炎的病理生理学和专家驱动的治疗指南。
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引用次数: 0
Exploring the correlation between UVB sensitivity and SLE activity: Insights into UVB-driven pathogenesis in lupus erythematosus 探索UVB敏感性与SLE活动的相关性:对UVB驱动的红斑狼疮发病机制的见解
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-26 DOI: 10.1016/j.jaut.2025.103393
Jiayu He , Yuanning Guo , Jiamin Chen , Jinhua Xu , Xiaohua Zhu
Lupus erythematosus (LE) comprises various autoimmune inflammatory diseases, with significant overlap between cutaneous LE (CLE) and systemic LE (SLE). A key feature of both CLE and SLE is UV photosensitivity, particularly in UV-exposure-related skin inflammation. Despite this, reliable and objective UVB photosensitivity indicators closely correlating with LE activity have yet to be identified, and the underlying cellular and molecular mechanisms linking UVB sensitivity with LE onset and progression remain unclear.
We discovered that ultraviolet B minimal erythema dose (UVB-MED), a quantitative photosensitivity measure, is a significant and independent risk factor for SLE activity, demonstrating a negative correlation with SLEDAI (r = −0.58, P < 0.0001). Comprehensive transcriptomic analyses of large-scale CLE and SLE samples (5918 in discovery and 7242 in validation datasets) revealed more pronounced and extensive UVB-response gene dysregulation in skin tissues compared to blood. Additionally, 14 lupus activity-correlated, UVB-response genes (UVBACGs) were identified, including eight type I interferon-stimulated genes (IRF7, ISG20, ISG15, IFI44, IFITM1, MX1, LY6E, OASL) and others (JUN, PTTG1, HLA-F, CAV1, HOPX, RPL3), with dysregulation evident in skin, blood, and affected organs (e.g., kidney and synovium). Immunocytes serve as the primary carriers of this dysregulation. Conventional LE therapies and type I interferon-targeted therapies were found to be associated with these genes and can potentially regulate them, thereby contributing to therapeutic effects.
These findings highlight the role of UVB in triggering autoimmune inflammation in the skin, which may subsequently spread to systemic inflammation via immune cells and factors. UVBACGs play a critical role in this process and may serve as targets for precise therapies, providing insight into the link between UVB photosensitivity and LE pathogenesis.
红斑狼疮(Lupus erythematosus, LE)包括多种自身免疫性炎症性疾病,皮肤性红斑狼疮(CLE)和系统性红斑狼疮(SLE)之间有明显的重叠。CLE和SLE的一个关键特征是紫外线光敏性,特别是与紫外线暴露相关的皮肤炎症。尽管如此,与LE活性密切相关的可靠和客观的UVB光敏指标尚未确定,并且将UVB敏感性与LE发生和进展联系起来的潜在细胞和分子机制仍不清楚。我们发现紫外线B最小红斑剂量(UVB-MED),一种定量光敏测量,是SLE活动的一个重要和独立的危险因素,与SLEDAI呈负相关(r = - 0.58, P <;0.0001)。对大规模CLE和SLE样本(发现5918例,验证数据集7242例)的综合转录组学分析显示,与血液相比,皮肤组织中uvb反应基因失调更为明显和广泛。此外,我们还发现了14个与狼疮活动相关的uhbv应答基因(UVBACGs),包括8个I型干扰素刺激基因(IRF7、ISG20、ISG15、IFI44、IFITM1、MX1、LY6E、OASL)和其他基因(JUN、PTTG1、HLA-F、CAV1、HOPX、RPL3),在皮肤、血液和受影响器官(如肾脏和滑膜)中存在明显的失调。免疫细胞是这种失调的主要载体。常规LE治疗和I型干扰素靶向治疗被发现与这些基因相关,并可能调节它们,从而有助于治疗效果。这些发现强调了UVB在触发皮肤自身免疫性炎症中的作用,这种炎症可能随后通过免疫细胞和因子扩散到全身炎症。UVBACGs在这一过程中发挥着关键作用,可能作为精确治疗的靶点,为了解UVB光敏性与LE发病机制之间的联系提供了线索。
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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 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
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 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 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。
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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 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
Advanced pulmonary sarcoidosis 晚期肺结节病
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2025-03-01 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 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。
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引用次数: 0
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Journal of autoimmunity
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