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Relapsing/remitting multiple sclerosis: A speculative model and its implications for a novel treatment 复发/缓解多发性硬化症:一个推测模型及其对一种新治疗方法的影响
4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-08-21 DOI: 10.1111/sji.13325
Peter Bretscher
Abstract The clinical pattern in relapsing/remitting multiple sclerosis may be accounted for if an autoreactive immune response can transition back and forth between inflammatory, pathogenic, and non‐inflammatory, non‐pathogenic modes. Such ‘back‐and‐forth’ immune responses are rare. I speculate how such back‐and‐forth immune responses may arise. Understanding the nature of these different modes, and what controls their mutual transition, may help in designing strategies to favour the nonpathogenic mode, thus constituting treatment. Antigen dose is known to be critical in determining the class/subclass of primary immune responses. Observations have led us to suggest the level of antigen also similarly influences the class/subclass of on‐going immune responses. I propose the relapsing, inflammatory and the remitting modes are respectively sustained by relatively low and high amounts of the responsible autoantigens, as is the case, for example, for Th1 and Th2 responses to foreign antigens. In addition, I propose more self‐antigens are released during an inflammatory than during a remitting mode. The decrease in the amount of antigen released, as the response transitions from an inflammatory to a remitting mode, results in time in a decreased level of antigen and so the response again evolves towards the inflammatory mode. The inflammatory mode then leads to an increased release of antigen and so, in time, to remission. This model thus explains the transition between different modes. I outline non‐invasive, testable predictions of the hypothesis. If confirmed, it may be ethical to examine whether the non‐inflammatory mode can be sustained by administering myelin antigens during the remitting phase.
如果自身反应性免疫反应能够在炎性、致病性和非炎性、非致病性模式之间来回转换,那么复发/缓解型多发性硬化症的临床模式可能得到解释。这种“来回”的免疫反应是罕见的。我推测这种来回的免疫反应是如何产生的。了解这些不同模式的本质,以及控制它们相互转换的因素,可能有助于设计有利于非致病性模式的策略,从而构成治疗。抗原剂量是决定原发性免疫反应类别/亚类别的关键因素。观察结果表明,抗原水平也同样影响正在进行的免疫反应的类别/亚类别。我认为复发,炎症和缓解模式分别由相对低和高的负责自身抗原维持,例如,对于Th1和Th2对外来抗原的反应。此外,我提出在炎症期间比缓解模式释放更多的自身抗原。当反应从炎症模式转变为缓解模式时,抗原释放量的减少导致抗原水平的下降,因此反应再次向炎症模式发展。然后,炎症模式导致抗原释放增加,从而及时缓解。因此,这个模型解释了不同模式之间的转换。我概述了该假设的非侵入性、可测试的预测。如果得到证实,检验在缓解期给予髓鞘抗原是否能维持非炎症模式可能是合乎伦理的。
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引用次数: 0
TGF-β levels significantly increases in patients with stage III and IV breast cancer and can be explored as a target for tumour diagnosis and staging. TGF-β水平在III期和IV期乳腺癌患者中显著升高,可作为肿瘤诊断和分期的靶点。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-08-01 Epub Date: 2023-05-10 DOI: 10.1111/sji.13280
Joshua M Mutiso, Ciriaka M Gitonga, Michael M Gicheru
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引用次数: 0
How the initial discovery of modified RNA enabled evasion of innate immune responses and facilitated the development of RNA therapeutics. 修饰RNA的最初发现如何使先天免疫反应得以逃避,并促进了RNA疗法的发展。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-07-01 DOI: 10.1111/sji.13282
Mouldy Sioud

Besides being the physical link between DNA and proteins, RNAs play several other key roles, including RNA catalysis and gene regulation. Recent advances in the design of lipid nanoparticles have facilitated the development of RNA-based therapeutics. However, chemically and in vitro transcribed RNAs can activate innate immunity, leading to the production of proinflammatory cytokines and interferons, a response similar to the one induced by viral infections. Since these responses are undesirable for certain therapeutic applications, it is important to develop ways to block the sensing of exogenous RNAs by immune cells, such as monocytes, macrophages and dendritic cells. Fortunately, RNA sensing can be blocked by chemical modifications of certain nucleotides, particularly uridine, a finding that has facilitated the development of RNA-based therapeutics such as small interfering RNAs and mRNA vaccines. Here, I provide a backstory on how improved understanding of RNA sensing by innate immunity can be applied to develop more effective RNA therapeutics.

除了作为DNA和蛋白质之间的物理联系外,RNA还发挥着其他几个关键作用,包括RNA催化和基因调控。脂质纳米颗粒设计的最新进展促进了基于rna的治疗方法的发展。然而,化学和体外转录的rna可以激活先天免疫,导致促炎细胞因子和干扰素的产生,这种反应类似于病毒感染引起的反应。由于这些反应在某些治疗应用中是不希望的,因此开发阻断免疫细胞(如单核细胞、巨噬细胞和树突状细胞)对外源rna的感知的方法非常重要。幸运的是,RNA感知可以被某些核苷酸的化学修饰阻断,特别是尿苷,这一发现促进了基于RNA的治疗方法的发展,如小干扰RNA和mRNA疫苗。在这里,我提供了一个关于如何通过先天免疫提高对RNA传感的理解来开发更有效的RNA疗法的背景故事。
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引用次数: 0
Clinical, immunological and molecular findings of patients with DOCK-8 deficiency from India. 印度DOCK-8缺乏症患者的临床、免疫学和分子研究
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-07-01 DOI: 10.1111/sji.13276
Vijaya Gowri, Akshaya Chougule, Maya Gupta, Prasad Taur, Vaishnavi V Iyengar, Meena Sivasankaran, Deenadayalan Munirathnam, Sushma Krishna, Umair A Bargir, Aparna Dalvi, Priyanka Setia, Neha Jodhawat, Shweta Shinde, Shakuntala S Prabhu, Minnie Bodhanwala, Manisha R Madkaikar, Mukesh M Desai

DOCK8 deficiency affects various cell subsets belonging to both the innate and adaptive immune systems. Clinical diagnosis is challenging, as many cases present with severe atopic dermatitis as the only initial manifestation. Though flow cytometry helps in the presumptive diagnosis of DOCK8-deficient patients by evaluating their DOCK8 protein expression, it requires subsequent confirmation by molecular genetic analysis. Currently, haematopoietic stem cell transplantation (HSCT) is the only curative treatment option available for these patients. There is a paucity of data from India on the clinical diversity and molecular spectrum of DOCK8 deficiency. In the present study, we report the clinical, immunological and molecular findings of 17 DOCK8-deficient patients from India diagnosed over the last 5 years.

DOCK8缺陷影响属于先天和适应性免疫系统的各种细胞亚群。临床诊断具有挑战性,因为许多病例以严重的特应性皮炎为唯一的初始表现。虽然流式细胞术通过评估DOCK8蛋白表达有助于对DOCK8缺陷患者的推定诊断,但这需要后续的分子遗传学分析来证实。目前,造血干细胞移植(HSCT)是治疗这些患者的唯一选择。印度缺乏DOCK8缺乏症的临床多样性和分子谱数据。在本研究中,我们报告了过去5年中印度诊断的17例dock8缺陷患者的临床、免疫学和分子检查结果。
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引用次数: 0
DNase analysed by a novel competitive assay in patients with complications after ChAdOx1 nCoV-19 vaccination and in normal unvaccinated blood donors. 在接种 ChAdOx1 nCoV-19 疫苗后出现并发症的患者和未接种疫苗的正常献血者中使用新型竞争性测定法分析 DNase。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-07-01 Epub Date: 2023-05-04 DOI: 10.1111/sji.13274
Magne Kristoffer Fagerhol, Nina Haagenrud Schultz, Mohammad Reza Mirlashari, Markus Karl Hermann Wiedmann, Lise Sofie Haug Nissen-Meyer, Arne Vasli Lund Søraas, Geir Hetland

Increased levels of neutrophil extracellular traps (NETs) have been detected in individuals with vaccine complications after the ChAdOx1 nCov vaccine with a correlation between the severity of vaccine side effects and the level of NETosis. DNases may disrupt NETs by degrading their content of DNA, and a balance has been reported between NETs and DNases. Because of this and since the inflammatory marker NETs may be used as a confirmatory test in diagnosing VITT, it is of interest to monitor levels of DNase in patients with increased NETs levels. The current novel rapid DNase ELISA was tested in blood samples of patients with known increased levels of NETs with or without VITT after ChAdOx1 nCoV-19 vaccination. DNase levels in VITT patients were significantly increased compared with normal unvaccinated blood donors and compared with patients with post-vaccination symptoms but not VITT. However, since EDTA was found to inhibit DNase, serum and not EDTA-plasma samples should be applied for DNase testing. The novel DNase assay may serve as a supplementary test to the NETs test when analysing samples from patients with suspected increased NETs levels.

在接种 ChAdOx1 nCov 疫苗后出现疫苗并发症的个体中,发现中性粒细胞胞外捕获物(NET)水平升高,疫苗副作用的严重程度与 NETosis 的水平相关。DNase 可通过降解 NET 中的 DNA 来破坏 NET,有报道称 NET 与 DNase 之间存在平衡。因此,由于炎症标志物 NETs 可作为诊断 VITT 的确证试验,因此监测 NETs 水平升高患者的 DNase 水平很有意义。目前的新型快速 DNase ELISA 在接种 ChAdOx1 nCoV-19 疫苗后出现或未出现 VITT 的已知 NETs 水平升高的患者的血液样本中进行了测试。与未接种疫苗的正常献血者相比,VITT 患者的 DNase 水平明显升高;与接种疫苗后出现症状但未出现 VITT 的患者相比,VITT 患者的 DNase 水平也明显升高。不过,由于乙二胺四乙酸(EDTA)会抑制 DNase,因此在检测 DNase 时应使用血清样本,而不是乙二胺四乙酸(EDTA)血浆样本。在分析疑似 NETs 水平升高的患者样本时,新型 DNase 检测方法可作为 NETs 检测的补充检测方法。
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引用次数: 0
Luminex Crossmatch in kidney transplantation. 肾移植中的Luminex交叉配型。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-07-01 DOI: 10.1111/sji.13279
Radouan Fadi Ameur, Lilya Meriem Berkani, Brahim Belaid, Khadidja Habchi, Messaoud Saidani, Reda Djidjik

The introduction of the Luminex Crossmatch assay (LumXm) which uses Luminex bead technology, consists of extracting the donor's Human Leukocyte Antigen (HLA) molecules from their lymphocytes, and binding them to fluorescent beads that are put in contact with recipient's serum. HLA donor-specific antibodies (DSA) are detected using a fluorescent conjugate. The goal of our study is to determine the benefits of using LumXm in a renal transplantation algorithm. We tested 78 recipients' sera using the LumXm, and the results were compared with the Luminex single antigen bead assay (SAB) for all sera, as well as the Flow Cytometry Crossmatch (FCXM) for 46 sera. We compared our results with those of SAB using 3 cutoffs, the first being the manufacturer's criteria where sensitivity and specificity were at 62.5% and 91.3% respectively for HLA class 1, and 88.5% and 50.0% respectively for HLA class 2. When using the third cutoff criteria (≥2 Adjusted values + MFI [Mean fluorescence intensity] >500 + Neg MFI < 500), the sensitivity increased to 69.0% for HLA class 1 and decreased to 84.0% for HLA class 2, while the specificity increased for HLA class 1 and 2. When comparing with FCXM, the 3 assays agreed in 55.8% of results for class 1 and 2 alike. However, major discrepancies were found for two groups in HLA class 1 and one in HLA class 2. The LumXm when used with other techniques to overcome its' weak points, can provide an interesting insight into the patient's HLA-DSA profile.

Luminex交叉配型试验(LumXm)采用Luminex珠头技术,包括从供体淋巴细胞中提取人类白细胞抗原(HLA)分子,并将其结合到与受体血清接触的荧光珠上。HLA供体特异性抗体(DSA)检测使用荧光偶联物。我们研究的目的是确定在肾移植算法中使用LumXm的益处。我们使用LumXm检测了78例受体血清,并将结果与所有血清的Luminex单抗原珠测定(SAB)和46份血清的流式细胞术交叉匹配(FCXM)进行了比较。我们使用3个截止点将我们的结果与SAB的结果进行比较,第一个是制造商的标准,HLA 1型的敏感性和特异性分别为62.5%和91.3%,HLA 2型的敏感性和特异性分别为88.5%和50.0%。当使用第三个截止标准时(≥2调整值+ MFI[平均荧光强度]>500 +阴性MFI
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引用次数: 0
Monitoring disease activity in antineutrophil antibody-associated vasculitis. 监测抗中性粒细胞抗体相关血管炎的疾病活动性。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-07-01 DOI: 10.1111/sji.13284
Florian G Scurt, Verena Hirschfeld, Leon Schubert, Peter R Mertens, Christos Chatzikyrkou

Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) comprises a group of multisystem disorders with alternating periods of relapse and remission. Beyond that, a smouldering progress during apparently clinically silent phases often develops. AAVs are subgrouped in microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) and renal limited vasculitis (RLV). ANCA are hallmark of this disease entity, although they are not always present. Despite the simplification of treatment, fundamental aspects concerning assessment of its efficacy and its adaptation to encountered complications or to the relapsing/remitting/subclinical disease course remain still unknown. Through the advances in pathogenesis and pathophysiology of AAV a reliable biomarker-based monitoring and treatment algorithm has not been established and disease management follows not infrequently a "trial and error" approach. Here, we overviewed the most interesting biomarkers reported so far.

抗中性粒细胞细胞质抗体(ANCA)相关性血管炎(AAV)包括一组复发和缓解交替的多系统疾病。除此之外,在明显的临床沉默阶段,通常会出现阴燃进展。aav分为显微镜下多血管炎(MPA)、肉芽肿合并多血管炎(GPA)、嗜酸性肉芽肿合并多血管炎(EGPA)和肾局限性血管炎(RLV)。ANCA是这种疾病的标志,尽管它们并不总是存在。尽管简化了治疗,但评估其疗效及其对遇到的并发症或复发/缓解/亚临床病程的适应性的基本方面仍然未知。尽管在AAV的发病机制和病理生理学方面取得了进展,但一种可靠的基于生物标志物的监测和治疗算法尚未建立,疾病管理也经常采用“试错”的方法。在这里,我们概述了迄今为止报道的最有趣的生物标志物。
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引用次数: 2
Simultaneous neutralization of TGF-β and IL-6 attenuates Staphylococcus aureus-induced arthritic inflammation through differential modulation of splenic and synovial macrophages. 同时中和TGF-β和IL-6通过对脾和滑膜巨噬细胞的差异调节减轻金黄色葡萄球菌诱导的关节炎炎症。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-06-01 DOI: 10.1111/sji.13252
Rituparna Ghosh, Rajen Dey, Ritasha Sawoo, Biswadev Bishayi

Septic arthritis is a joint disease caused by Staphylococcus aureus. Different macrophage populations contribute in various ways to control blood-borne infections and induce inflammatory responses. Macrophage tissue-resident niche is necessary for the suppression of chronic inflammation and may contribute to the pathogenesis of septic arthritis. Thus, to obtain a resolution of the disease and restoration of synovial homeostasis, it needs the activation of macrophages that further regulate the inflammatory consequences. The aim of this study was to find out the mechanism by which neutralization of transforming growth factor-beta (TGF-β) and/or interleukin (IL)-6 after induction of septic arthritis could alter the specific macrophage responses in spleen and synovial joints via different cytokines (osteoprotegerin (OPG), osteopontin (OPN), IL-10, IL-12 and CXCL8) cross-talking, and how the response could be modulated by reactive oxygen species vs antioxidant enzyme activities. Dual neutralization of TGF-β and IL-6 is notably effective in eliciting splenic and synovial tissue-resident macrophage responses. Synovial macrophage-derived IL-10 can elicit protection against septic arthritis via regulating receptor-activated nuclear factor Kappa-B ligand (RANKL)/OPG interaction. They also reduced oxidative stress by increasing the activity of antioxidant enzymes including SOD and catalase. Histopathological analysis revealed that dual neutralization of TGF-β and IL-6 prevented bone destruction and osteoclastic activity in septic arthritis by promoting the differential functional response of the splenic and synovial macrophages. Additionally, the macrophage-derived IL-10 can elicit protection against S. aureus-induced septic arthritis via regulating RANKL/OPG interaction. Further studies on STAT3 and STAT4 are needed for the understanding of such cross-talking in resident macrophages of arthritic mice.

脓毒性关节炎是一种由金黄色葡萄球菌引起的关节疾病。不同的巨噬细胞群体以不同的方式参与控制血源性感染和诱导炎症反应。巨噬细胞组织驻留生态位是抑制慢性炎症所必需的,并可能参与脓毒性关节炎的发病机制。因此,为了获得疾病的解决和滑膜稳态的恢复,它需要巨噬细胞的激活,进一步调节炎症后果。本研究旨在探讨化脓性关节炎诱导后转化生长因子-β (TGF-β)和/或白细胞介素-6 (IL)-6的中和作用通过不同细胞因子(骨保护素(OPG)、骨桥蛋白(OPN)、IL-10、IL-12和CXCL8)的串导改变脾脏和滑膜关节特异性巨噬细胞应答的机制,以及活性氧对抗氧化酶活性的调节作用。TGF-β和IL-6的双重中和在诱导脾和滑膜组织巨噬细胞反应中显着有效。滑膜巨噬细胞来源的IL-10可以通过调节受体活化的核因子κ b配体(RANKL)/OPG相互作用来引起对脓毒性关节炎的保护。它们还通过增加SOD和过氧化氢酶等抗氧化酶的活性来减少氧化应激。组织病理学分析显示,TGF-β和IL-6的双重中和通过促进脾脏和滑膜巨噬细胞的差异功能反应来预防脓毒性关节炎的骨破坏和破骨活性。此外,巨噬细胞来源的IL-10可以通过调节RANKL/OPG相互作用,引发对金黄色葡萄球菌诱导的脓毒性关节炎的保护。需要进一步研究STAT3和STAT4,以了解关节炎小鼠常驻巨噬细胞中的这种串扰。
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引用次数: 2
The value of anti-rods and rings antibodies in Chinese population of Dalian City: A retrospective study. 大连市人群抗棒环抗体水平的回顾性研究。
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-06-01 DOI: 10.1111/sji.13254
Yanan Gu, Si Li, Zhen Wang, Dong Yang

The study aimed to investigate the clinical significance of anti-rods and rings (anti-RR) antibodies in antinuclear antibodies (ANAs) test samples retrospectively. The laboratory data and clinical details of patients with positive anti-RR antibodies were collected and analysed between December 2017 and May 2022 in the First Affiliated Hospital of Dalian Medical University. A total of 72 665 patients were tested for ANAs. There were 45 632 patients discovered with positive ANAs (62.80%), only 131 patients presented with anti-RR antibodies (0.18%), among which only 68 patients were hospitalized patients with a definitive diagnosis. Among the 68 patients with a definitive diagnosis, 8 of 68 (11.8%) had autoimmune diseases, and 19 of 68 (27.9%) had renal diseases. Other diseases included liver disease, pulmonary disease, cerebral ischemia, cerebral infarction, chronic cardiac failure and venous thromboembolism. The detection rate of high titre(≥1:1000) anti-RR antibodies is significantly higher in autoimmune diseases.

本研究旨在回顾性探讨抗核抗体(ANAs)检测样本中抗棒环抗体(anti-RR)的临床意义。收集并分析2017年12月至2022年5月大连医科大学第一附属医院抗- rr抗体阳性患者的实验室数据和临床资料。共有72 665名患者接受了ANAs检测。发现ANAs阳性患者45 632例(62.80%),抗rr抗体仅131例(0.18%),其中确诊住院患者仅68例。在确诊的68例患者中,68例中有8例(11.8%)患有自身免疫性疾病,68例中有19例(27.9%)患有肾脏疾病。其他疾病包括肝病、肺病、脑缺血、脑梗死、慢性心力衰竭和静脉血栓栓塞。在自身免疫性疾病中,高滴度(≥1:1000)抗rr抗体的检出率明显较高。
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引用次数: 0
Abstract 摘要
IF 3.7 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-05-28 DOI: 10.1111/sji.13278
Farhana Jahan, Janne Koski, Diana Schenkwein, Seppo, Ylä-Herttuala, Helka Göös, S. Huuskonen, Markku, Varjosalo, Pilvi Maliniemi, Judith Leitner, Peter, Steinberger, H. Bühring, Kim Vettenranta, Matti Korhonen, A. Luostarinen, Diana, Schenkwein, Hector Monzo, Päivi M. Ojala, Matti, Korhonen
activate the transcriptional
激活转录
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引用次数: 0
期刊
Scandinavian Journal of Immunology
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