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On antigen-specific signals, immune class regulation and energetics: Report III from the workshops on foundational concepts of immune regulation. 关于抗原特异性信号、免疫类调节和能量学:免疫调节基础概念研讨会报告III
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-09-01 Epub Date: 2023-07-11 DOI: 10.1111/sji.13311
Colin C Anderson, Elizabeth A Bonney, Thomas F Mueller, Alexandre Corthay, Calliopi Havele, Nevil J Singh, Inger Øynebråten, Peter A Bretscher

This is a report from a one-week workshop held in Athens, Greece in July of 2022. The workshop aimed to identify emerging concepts relevant to the fundamentals of immune regulation and areas for future research. Theories of immune regulation emphasize the role of T cell help or co-stimulation (signal 2). The workshop participants considered how new data on the characteristics of agonist antigens, the role of the antigen receptor signals (signal 1) in driving fate decisions, the effect of energetics on immunity and a better understanding of class-control in the immune response, may impact theories of immune regulation. These ideas were discussed in the context of tumour immunology, autoimmunity, pregnancy and transplantation. Here we present the discussions as a narrative of different viewpoints to allow the reader to join the conversation. These discussions highlight the evolving understanding of the nature of specific antigen recognition and how both antigen-specific and non-specific mechanisms impact immune responses.

这是2022年7月在希腊雅典举行的为期一周的研讨会的报告。该研讨会旨在确定与免疫调节基本原理相关的新概念以及未来研究的领域。免疫调节理论强调T细胞帮助或共同刺激的作用(信号2)。研讨会参与者考虑了激动剂抗原的特性、抗原受体信号(信号1)在驱动命运决定中的作用、能量学对免疫的影响以及对免疫反应中类别控制的更好理解等方面的新数据如何影响免疫调节理论。这些观点在肿瘤免疫学、自身免疫、妊娠和移植的背景下进行了讨论。在这里,我们将讨论作为不同观点的叙述,让读者加入对话。这些讨论强调了对特异性抗原识别性质的不断发展的理解,以及抗原特异性和非特异性机制如何影响免疫反应。
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引用次数: 0
Immune modulation by nutritional intervention in malnourished children: Identifying the phenotypic distribution and functional responses of peripheral blood mononuclear cells. 营养干预对营养不良儿童的免疫调节:确定外周血单核细胞的表型分布和功能反应
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-09-01 Epub Date: 2023-06-07 DOI: 10.1111/sji.13302
Zannatun Noor, Md Mehedi Hasan, Md Amran Gazi, Farzana Hossaini, Nur Muhammad Shahedul Haque, Parag Palit, Shah Mohammad Fahim, Subhasish Das, Mustafa Mahfuz, Chelsea Marie, William A Petri, Rashidul Haque, Tahmeed Ahmed

Malnourished children are susceptible to an increased risk of mortality owing to impaired immune functions. However, the underlying mechanism of altered immune functions and its interaction with malnutrition is poorly understood. This study investigates the immune function and evaluates the effect of a particular nutritional intervention on the immune cells of undernourished children. Stunted (LAZ <-2) and at-risk of being stunted (length-for-age Z-scores, LAZ <-1 to -2) children aged between 12 and 18 months were enrolled and were provided with the daily nutritional intervention of one egg and 150 mL cow's milk for 90 days. Peripheral blood mononuclear cells (PBMCs) were isolated at enrolment and upon completion of the intervention. Phenotypic profiles for CD3+ cells, CD4+ cells, CD8+ cells, NKT cells, and B cells were similar in both cohorts, both before and after the intervention. However, activated B cells (CD25+) were increased after nutritional intervention in the at-risk of being stunted cohort. Several pro-inflammatory cytokines, IL-6, IFN-γ, and TNF-α, were elevated in the stunted children following the nutritional intervention. The results of the study indicate that nutritional intervention may have a role on activated B cells (CD25+) s in children who are at-risk of being stunted and may alter the capacity of PBMC to produce inflammatory cytokines in stunted children.

营养不良的儿童容易因免疫功能受损而增加死亡风险。然而,人们对免疫功能改变的潜在机制及其与营养不良的相互作用知之甚少。本研究调查了营养不良儿童的免疫功能,并评估了特定营养干预对免疫细胞的影响。年龄在12至18岁之间的发育迟缓(LAZ<−2)和有发育迟缓风险的儿童(长度Z评分,LAZ<-1至−2) 几个月的患者被纳入研究,每天接受一个鸡蛋和150个鸡蛋的营养干预 90毫升牛奶 天。在入组时和干预完成时分离外周血单核细胞(PBMC)。在干预前后,CD3+细胞、CD4+细胞、CD8+细胞、NKT细胞和B细胞的表型特征在两个队列中相似。然而,在发育迟缓的高危队列中,营养干预后活化的B细胞(CD25+)增加。营养干预后,发育迟缓儿童的几种促炎细胞因子IL-6、IFN-γ和TNF-α升高。研究结果表明,营养干预可能对有发育迟缓风险的儿童的活化B细胞(CD25+)起作用,并可能改变发育迟缓儿童PBMC产生炎性细胞因子的能力。
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引用次数: 0
HLA-DR+ mucosal-associated invariant T cells predict poor prognosis in patients with sepsis: A prospective observational study. HLA-DR+粘膜相关不变T细胞可预测败血症患者的不良预后:一项前瞻性观察研究。
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-09-01 Epub Date: 2023-06-27 DOI: 10.1111/sji.13286
Lijun Tian, Junxian Xu, Cong Chen, Jinfeng Lin, Linling Ju, Lin Chen, Yufeng Zhang, Xudong Han, Lijun Liu

Mucosal-associated invariant T (MAIT) cells are important in antibacterial immune responses; however, during sepsis, they are few in number and exhibit highly activated phenotypes. The relationship between MAIT cells in peripheral blood and the prognosis of sepsis is not well understood. Thus, this study aimed to examine the levels and phenotypes of MAIT cells in early sepsis, evaluate their clinical relevance, and investigate their association with patient prognosis. This prospective observational study enrolled 72 septic patients defined according to the Sepsis 3.0 criteria and 21 healthy controls matched for age and sex. Their peripheral blood samples were used to assay the expression of immune activation (CD69 and HLA-DR) and immune checkpoint (PD-1 and PD-L1) markers on MAIT cells. The systemic inflammatory response syndrome, acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment scores were recorded. Subsequently, the association between MAIT cell characteristics and clinical indicators was assessed using Spearman's rank correlation analysis, and binary logistic regression analysis with a forward stepwise approach assessed independent risk factors for 28-day mortality. We noted a decrease in the percentage of MAIT cells in the patients' peripheral blood, which exhibited an activated phenotype. Besides, HLA-DR+ MAIT cell percentage and the APACHE II score were independently associated with the 28-day mortality and, in combination, were the best indicators of mortality. Thus, the percentage of HLA-DR+ MAIT cells in early sepsis serves as a novel prognostic biomarker for predicting mortality and improves the predictive capacity of the APACHE II score.

粘膜相关不变T细胞(MAIT)在抗菌免疫反应中非常重要;然而,在败血症期间,它们的数量很少,并表现出高度活化的表型。外周血中的 MAIT 细胞与败血症预后之间的关系尚不十分清楚。因此,本研究旨在检测脓毒症早期 MAIT 细胞的水平和表型,评估其临床相关性,并研究其与患者预后的关系。这项前瞻性观察研究招募了 72 名根据脓毒症 3.0 标准定义的脓毒症患者和 21 名年龄和性别匹配的健康对照者。他们的外周血样本用于检测 MAIT 细胞上免疫激活(CD69 和 HLA-DR)和免疫检查点(PD-1 和 PD-L1)标记物的表达。此外,还记录了全身炎症反应综合征、急性生理学和慢性健康评估(APACHE)II和序贯器官衰竭评估的评分。随后,使用斯皮尔曼秩相关分析评估了MAIT细胞特征与临床指标之间的关联,并使用前向逐步法的二元逻辑回归分析评估了28天死亡率的独立风险因素。我们注意到,患者外周血中的 MAIT 细胞比例下降,表现出活化表型。此外,HLA-DR+ MAIT 细胞百分比和 APACHE II 评分与 28 天死亡率独立相关,两者结合是死亡率的最佳指标。因此,脓毒症早期HLA-DR+ MAIT细胞的百分比可作为预测死亡率的新型预后生物标志物,并提高了APACHE II评分的预测能力。
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引用次数: 0
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 and Microbiology 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
Virus-infected mast cells activate virus-specific CD8+ T cells. 病毒感染的肥大细胞激活病毒特异性CD8+ T细胞
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-08-01 Epub Date: 2023-05-01 DOI: 10.1111/sji.13272
Yana Hackler, Frank Siebenhaar, Marcus Maurer, Melba Muñoz

Efficient anti-viral responses of CD8+ T cells require signals that promote their effector cell differentiation, that are mainly provided by dendritic cells (DCs). Mast cells (MCs) are key drivers of DC maturation, but also influence their migration and antigen presenting properties and therefore indirectly mediate CD8+ T cell activation. MCs initiate innate immune responses at pathogen entry sites, promote the development of adaptive immune responses after infection, and release mediators including chemokines that recruit and activate immune cells including T cells during viral infections. However, whether MCs can directly activate virus-specific CD8+ T cells remains largely unknown. Here, we used an in vitro viral infection model with lymphocytic choriomeningitis virus (LCMV)-infected MCs or DCs co-cultured with either LCMV-specific CD8+ T cells or with WT (unspecific) CD8+ T cells. Similar to LCMV-infected DCs, LCMV-infected MCs clustered with virus-specific CD8+ T cells and induced their activation and production of antiviral cytokines. In addition, the co-stimulatory molecules CD86 and OX40L, but not CD80, were upregulated on MCs and an increased production of IL-6 and type I interferons after LCMV infection was shown. Our findings suggest that MCs can promote CD8+ T cell activation during viral infections. MC-mediated CD8+ T cell activation might be especially important within infected tissues where direct cellular interaction can take place. A better understanding of anti-viral functions of MCs may help developing new strategies to better treat viral infections.

CD8+T细胞的有效抗病毒反应需要促进其效应细胞分化的信号,而这些信号主要由树突状细胞(DC)提供。肥大细胞(MC)是DC成熟的关键驱动因素,但也影响其迁移和抗原呈递特性,因此间接介导CD8+T细胞活化。MC在病原体进入位点启动先天免疫反应,促进感染后适应性免疫反应的发展,并释放包括趋化因子在内的介质,在病毒感染期间募集和激活包括T细胞在内的免疫细胞。然而,MCs是否能直接激活病毒特异性CD8+T细胞在很大程度上仍然未知。在这里,我们使用了一种体外病毒感染模型,其中淋巴细胞性脉络膜脑膜炎病毒(LCMV)感染的MC或DC与LCMV特异性CD8+T细胞或WT(非特异性)CD8+T电池共培养。与LCMV感染的DC类似,LCMV感染MC与病毒特异性CD8+T细胞聚集,并诱导其活化和产生抗病毒细胞因子。此外,共刺激分子CD86和OX40L(而不是CD80)在MC上上调,LCMV感染后IL-6和I型干扰素的产生增加。我们的研究结果表明,在病毒感染期间,MC可以促进CD8+T细胞的活化。MC介导的CD8+T细胞活化在可以发生直接细胞相互作用的感染组织中可能特别重要。更好地了解MCs的抗病毒功能可能有助于开发更好地治疗病毒感染的新策略。
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引用次数: 0
Sex-dependent expression levels of VAV1 and P2X7 in PBMC of multiple sclerosis patients. 多发性硬化患者PBMC中VAV1和P2X7的性别依赖性表达水平
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-08-01 Epub Date: 2023-05-25 DOI: 10.1111/sji.13283
Airi Rump, Kristel Ratas, Tuuli Katarina Lepasepp, Jaanus Suurväli, Olli-Pekka Smolander, Katrin Gross-Paju, Toomas Toomsoo, Jean Kanellopoulos, Sirje Rüütel Boudinot

Multiple sclerosis (MS) is an inflammatory autoimmune disorder of the central nervous system and the leading cause of progressive neurological disability in young adults. It decreases the patient's lifespan by about 10 years and affects women more than men. No medication entirely restricts or reverses neurological degradation. However, early diagnosis and treatment increase the possibility of a better outcome. To identify new MS biomarkers, we tested the expression of six potential markers (P2X4, P2X7, CXCR4, RGS1, RGS16 and VAV1) using qPCR in peripheral blood mononuclear cells (PBMC) of MS patients treated with interferon β (IFNβ), with glatiramer acetate (GA) or untreated. We showed that P2X7 and VAV1 are significantly induced in MS patients. In contrast, the expression of P2X4, CXCR4, RGS1 and RGS16 was not significantly modified by MS in PBMC. P2X7 and VAV1 are essentially induced in female patients, suggesting these markers are connected to sex-specific mechanisms. Strikingly, VAV1 expression is higher in healthy women than healthy men and IFNβ treatment of MS reduced VAV1 expression in female MS patients while it up-regulated VAV1 in male MS patients. Our data point to the differential, sex-dependent value of MS markers and treatment effects. Although rgs16 expression in PBMC was not a valid MS marker in patients, the strong upregulation of P2X4 and P2X7 induced in the spinal cord of WT mice by EAE was abrogated in rgs16KO mice suggesting that rgs16 is required for P2X4 and P2X7 induction by neurological diseases.

多发性硬化症(MS)是一种中枢神经系统炎症性自身免疫性疾病,是年轻人进行性神经残疾的主要原因。它会使患者的寿命缩短约10年 年,对女性的影响大于男性。没有任何药物可以完全限制或逆转神经系统的退化。然而,早期诊断和治疗增加了获得更好结果的可能性。为了鉴定新的多发性硬化症生物标志物,我们使用qPCR检测了接受干扰素治疗的多发症患者外周血单核细胞(PBMC)中六种潜在标志物(P2X4、P2X7、CXCR4、RGS1、RGS16和VAV1)的表达 β (IFNβ)、用醋酸格拉默(GA)或未经处理。我们发现P2X7和VAV1在MS患者中被显著诱导。相反,P2X4、CXCR4、RGS1和RGS16的表达在PBMC中没有被MS显著改变。P2X7和VAV1基本上是在女性患者中诱导的,这表明这些标志物与性别特异性机制有关。引人注目的是,健康女性的VAV1表达高于健康男性,IFNβ治疗MS降低了女性MS患者的VAV1的表达,而上调了男性MS患者的VAV1。我们的数据指出了MS标志物和治疗效果的差异性、性别依赖性价值。尽管rgs16在PBMC中的表达在患者中不是有效的MS标志物,但EAE在WT小鼠脊髓中诱导的P2X4和P2X7的强烈上调在rgs16KO小鼠中被消除,这表明神经疾病诱导P2X4或P2X7需要rgs16。
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引用次数: 0
Anti-SARS-CoV-2 mRNA vaccines, their efficiency, side effects and controversies. 抗严重急性呼吸系统综合征冠状病毒2型信使核糖核酸疫苗及其有效性、副作用和争议
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-08-01 Epub Date: 2023-07-06 DOI: 10.1111/sji.13310
Piotr Kuśnierczyk
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引用次数: 0
The role of bone marrow microenvironment on CAR-T efficacy in haematologic malignancies. 骨髓微环境对血液系统恶性肿瘤CAR-T疗效的影响
IF 4.1 4区 医学 Q2 IMMUNOLOGY Pub Date : 2023-08-01 Epub Date: 2023-05-06 DOI: 10.1111/sji.13273
Dandan Gao, Fei Hong, Aili He

In recent years, chimeric antigen receptor-T (CAR-T) cell therapy has emerged as a novel immunotherapy method. It has shown significant therapeutic efficacy in the treatment of haematological B cell malignancies. In particular, the CAR-T therapy targeting CD19 has yielded unprecedented efficacy for acute B-lymphocytic leukaemia (B-ALL) and non-Hodgkin's lymphoma (NHL). In haematologic malignancies, tumour stem cells are more prone to stay in the regulatory bone marrow (BM) microenvironment (called niches), which provides a protective environment against immune attack. However, how the BM microenvironment affects the anti-tumour efficacy of CAR-T cells and its underlying mechanism is worthy of attention. In this review, we discuss the role of the BM microenvironment on the efficacy of CAR-T in haematological malignancies and propose corresponding strategies to enhance the anti-tumour activity of CAR-T therapy.

近年来,嵌合抗原受体-T(CAR-T)细胞治疗已成为一种新的免疫治疗方法。它在治疗血液系统B细胞恶性肿瘤方面显示出显著的治疗效果。特别是,靶向CD19的CAR-T疗法对急性B淋巴细胞白血病(B-ALL)和非霍奇金淋巴瘤(NHL)产生了前所未有的疗效。在血液系统恶性肿瘤中,肿瘤干细胞更倾向于停留在调节性骨髓(BM)微环境(称为小生境)中,这为抵御免疫攻击提供了保护性环境。然而,骨髓微环境如何影响CAR-T细胞的抗肿瘤疗效及其潜在机制值得关注。在这篇综述中,我们讨论了骨髓微环境对CAR-T在血液系统恶性肿瘤中的疗效的作用,并提出了相应的策略来提高CAR-T治疗的抗肿瘤活性。
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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 and Microbiology Pub Date : 2023-08-01 Epub Date: 2023-05-10 DOI: 10.1111/sji.13280
Joshua M Mutiso, Ciriaka M Gitonga, Michael M Gicheru
{"title":"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.","authors":"Joshua M Mutiso, Ciriaka M Gitonga, Michael M Gicheru","doi":"10.1111/sji.13280","DOIUrl":"10.1111/sji.13280","url":null,"abstract":"","PeriodicalId":21493,"journal":{"name":"Scandinavian Journal of Immunology","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9789273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
APECED and the place of AIRE in the puzzle of the immune network associated with autoimmunity. APECED和AIRE在与自身免疫相关的免疫网络之谜中的地位
IF 3.7 4区 医学 Q2 Immunology and Microbiology Pub Date : 2023-08-01 Epub Date: 2023-06-12 DOI: 10.1111/sji.13299
Elif Soyak Aytekin, Deniz Cagdas

In the last 20 years, discoveries about the autoimmune regulator (AIRE) protein and its critical role in immune tolerance have provided fundamental insights into understanding the molecular basis of autoimmunity. This review provides a comprehensive overview of the effect of AIRE on immunological tolerance and the characteristics of autoimmune diseases in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED), which is caused by biallelic AIRE mutations. A better understanding of the immunological mechanisms of AIRE deficiency may enlighten immune tolerance mechanisms and new diagnostic and treatment strategies for autoimmune diseases. Considering that not all clinical features of APECED are present in a given follow-up period, the diagnosis is not easy in a patient at the first visit. Longer follow-up and a multidisciplinary approach are essential for diagnosis. It is challenging to prevent endocrine and other organ damage compared with other diseases associated with multiple autoimmunities, such as FOXP3, LRBA, and CTLA4 deficiencies. Unfortunately, no curative therapy like haematopoietic stem cell transplantation or specific immunomodulation is present that is successful in the treatment.

最近20 多年来,关于自身免疫调节因子(AIRE)蛋白及其在免疫耐受中的关键作用的发现为理解自身免疫的分子基础提供了基本的见解。这篇综述全面概述了AIRE对免疫耐受的影响,以及由双等位基因AIRE突变引起的自身免疫性多角蛋白病-念珠菌感染-外胚层营养不良(APCED)中自身免疫性疾病的特征。更好地了解AIRE缺乏的免疫机制可能会对自身免疫性疾病的免疫耐受机制和新的诊断和治疗策略有所启发。考虑到并非APCED的所有临床特征都存在于给定的随访期内,患者在第一次就诊时的诊断并不容易。长期随访和多学科方法对诊断至关重要。与其他与多种自身免疫相关的疾病(如FOXP3、LRBA和CTLA4缺乏症)相比,预防内分泌和其他器官损伤具有挑战性。不幸的是,目前还没有像造血干细胞移植或特异性免疫调节这样的治疗方法在治疗中取得成功。
{"title":"APECED and the place of AIRE in the puzzle of the immune network associated with autoimmunity.","authors":"Elif Soyak Aytekin, Deniz Cagdas","doi":"10.1111/sji.13299","DOIUrl":"10.1111/sji.13299","url":null,"abstract":"<p><p>In the last 20 years, discoveries about the autoimmune regulator (AIRE) protein and its critical role in immune tolerance have provided fundamental insights into understanding the molecular basis of autoimmunity. This review provides a comprehensive overview of the effect of AIRE on immunological tolerance and the characteristics of autoimmune diseases in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED), which is caused by biallelic AIRE mutations. A better understanding of the immunological mechanisms of AIRE deficiency may enlighten immune tolerance mechanisms and new diagnostic and treatment strategies for autoimmune diseases. Considering that not all clinical features of APECED are present in a given follow-up period, the diagnosis is not easy in a patient at the first visit. Longer follow-up and a multidisciplinary approach are essential for diagnosis. It is challenging to prevent endocrine and other organ damage compared with other diseases associated with multiple autoimmunities, such as FOXP3, LRBA, and CTLA4 deficiencies. Unfortunately, no curative therapy like haematopoietic stem cell transplantation or specific immunomodulation is present that is successful in the treatment.</p>","PeriodicalId":21493,"journal":{"name":"Scandinavian Journal of Immunology","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48855304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
期刊
Scandinavian Journal of Immunology
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