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Autoantibody and biomarker detection in the follow-up of autoimmune diseases: state of the art and future perspectives 自身免疫疾病随访中的自身抗体和生物标志物检测:现状和未来展望
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-20 DOI: 10.1016/j.jtauto.2025.100346
Jan Damoiseaux , Yves Renaudineau
Originally developed for the diagnosis of autoimmune diseases, the application of autoantibodies and related biomarkers has been extended in certain cases to monitor therapeutic efficacy and to predict disease recurrence and/or severity. Several critical considerations must be addressed prior to employing autoantibodies for monitoring purposes: (i) whether the autoantibody is pathogenic, as exemplified by anti-glomerular basement membrane and anti-acetylcholine receptor autoantibodies; (ii) whether the autoantibody level is essential for tracking disease activity, which may necessitate establishing prognostic thresholds and/or adapting detection methodologies; (iii) whether there is added value in combining autoantibodies, as demonstrated with anti-dsDNA and anti-chromatin antibodies in systemic lupus erythematosus; (iv) which immunoglobulin isotype is optimal for monitoring; and (v) whether alternative biomarkers exist that provide greater accuracy for patient follow-up. Additional issues remain unresolved, including appropriate intervals between measurements, intra- and inter-laboratory reproducibility, inter-assay variations, and ethnic variability, among others. To address these challenges, the European Autoimmunity Standardization Initiative (EASI) has proposed adapted strategies for utilizing autoantibodies in the longitudinal assessment of selected autoimmune diseases, as presented in this special issue.
自身抗体和相关生物标志物的应用最初是为自身免疫性疾病的诊断而开发的,在某些情况下已扩展到监测治疗效果和预测疾病复发和/或严重程度。在使用自身抗体进行监测之前,必须考虑几个关键因素:(i)自身抗体是否具有致病性,例如抗肾小球基底膜和抗乙酰胆碱受体自身抗体;(ii)自身抗体水平是否对追踪疾病活动至关重要,这可能需要建立预后阈值和/或调整检测方法;(iii)结合自身抗体是否有附加价值,如在系统性红斑狼疮中使用抗dsdna和抗染色质抗体;哪种免疫球蛋白同型最适合监测;(v)是否存在可替代的生物标志物,为患者随访提供更高的准确性。其他问题仍未解决,包括测量之间的适当间隔、实验室内和实验室间的可重复性、测定间的差异和种族差异等。为了应对这些挑战,欧洲自身免疫标准化倡议(EASI)提出了在选定自身免疫疾病的纵向评估中利用自身抗体的适应性策略,如本期特刊所述。
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引用次数: 0
T cell proliferative response to a homocitrullinated peptide correlates with joint pathology in collagen induced arthritis 在胶原诱导的关节炎中,T细胞对一种均酰化肽的增殖反应与关节病理相关
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-18 DOI: 10.1016/j.jtauto.2025.100345
Jaspreet Kaur , Sofya Ulanova , Ewa Cairns , Lillian Barra
Rheumatoid arthritis (RA) is characterized by autoimmune responses against citrullinated and homocitrullinated proteins/peptides (CitP and HomoCitP respectively), resulting in joint pain, inflammation, and damage. Although the collagen induced arthritis (CIA) model shares pathological features with RA, it remains unclear whether this model is suitable for studying RA-specific immune responses. Therefore, we investigated whether immune responses to CitP and HomoCitP influence arthritis severity in CIA.
Male DBA/1J mice were immunized with bovine type II collagen (CII) (N = 58) or PBS (N = 14) in adjuvant. Arthritis was assessed by clinical arthritis score, caliper measurements of joint swelling, von Frey pain testing, micro-CT, histopathology, and immunofluorescence. Splenocyte proliferation was measured using flow cytometry and serum antibodies via ELISAs.
Although anti-bovine and anti-mouse CII IgG developed in all bovine CII-immunized mice, only 31 % developed clinical arthritis. Arthritis closely resembled RA pathology, including joint pain, reduced bone mineral density, and histopathological damage. Immunofluorescence showed higher CitP and HomoCitP in joints from arthritic vs. PBS-injected mice. At day 49 post primary immunization, HomoCitP, but not CitP, stimulation induced higher proliferation in splenic T cells from arthritic mice compared to controls and strongly correlated with joint swelling, pain, and histopathology, as well as with serum anti-CII IgG. Anti-HomoCitP IgG were rare, and anti-CitP IgG were undetected, in arthritic mice.
This study identifies RA-specific antigens and immune responses to HomoCitP as potentially relevant in CIA. These results support the use of CIA to study RA-specific immunopathogenic mechanisms and highlight HomoCitP-specific T cells as potential contributors to disease.
类风湿性关节炎(RA)的特点是自身免疫反应对瓜氨酸化和同源瓜氨酸化蛋白/肽(分别为CitP和HomoCitP),导致关节疼痛,炎症和损伤。尽管胶原诱导关节炎(CIA)模型与RA具有相同的病理特征,但该模型是否适合研究RA特异性免疫反应尚不清楚。因此,我们研究了对CitP和HomoCitP的免疫反应是否影响CIA关节炎的严重程度。用牛II型胶原(CII) (N = 58)或PBS (N = 14)作为佐剂免疫雄性DBA/1J小鼠。通过临床关节炎评分、关节肿胀卡尺测量、von Frey疼痛测试、显微ct、组织病理学和免疫荧光来评估关节炎。流式细胞术检测脾细胞增殖,elisa检测血清抗体。虽然抗牛和抗小鼠的CII IgG在所有牛CII免疫小鼠中产生,但只有31%的小鼠发生临床关节炎。关节炎的病理与类风湿性关节炎非常相似,包括关节疼痛、骨密度降低和组织病理学损伤。免疫荧光显示,与注射pbs的小鼠相比,关节炎小鼠关节的CitP和HomoCitP更高。在初次免疫后第49天,与对照组相比,HomoCitP(而非CitP)刺激诱导关节炎小鼠脾T细胞增殖增加,并与关节肿胀、疼痛、组织病理学以及血清抗cii IgG密切相关。抗同源citp IgG在关节炎小鼠中少见,且未检测到抗citp IgG。本研究确定了ra特异性抗原和对HomoCitP的免疫反应可能与CIA相关。这些结果支持使用CIA来研究ra特异性免疫致病机制,并强调homocitp特异性T细胞是疾病的潜在贡献者。
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引用次数: 0
Autoantibodies reactive with glomerular endothelial cells and podocytes in patients with membranous nephropathy 膜性肾病患者肾小球内皮细胞和足细胞的自身抗体反应
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-09 DOI: 10.1016/j.jtauto.2025.100342
Vojtech Petr , Shrey Purohit , Felix Poppelaars , Brandon Renner , Jennifer Laskowski , Russell Whelan , Liudmila Kulik , Jessica Kendrick , Ashley Frazer-Abel , Diana Jalal , Barbara Marcolin , Isabelle Schmelzer , Hanna Debiec , Pierre Ronco , Moin A. Saleem , Simon C. Satchell , Joshua M. Thurman

Rationale & objective

Membranous nephropathy (MN) is a glomerular disease caused by autoantibodies reactive with podocyte antigens. The most common antigen is the M-type phospholipase A2 receptor (PLA2R), but autoantibodies to other podocyte antigens have also been identified. Investigators have reported elevated levels of complement fragments in plasma. However, most complement fragments generated on podocytes are likely to pass into the urine and not enter the bloodstream. Further, anti-PLA2R antibodies are usually IgG4 subclass and do not activate the classical pathway of complement. To look for additional autoantibodies capable of generating endovascular complement fragments, we examined whether MN patients have antibodies reactive with endothelial cell antigens.

Study design

Retrospective cohort study.

Setting & participants

We analyzed plasma samples from 64 patients with MN, and results were compared to healthy controls and patients with chronic kidney disease.

Exposure

Plasma and urine complement activation fragments, glomerular endothelial cell and podocyte antibody binding assays, anti-cardiolipin antibody enzyme linked immunosorbent assay.

Outcome

Proteinuria, estimated glomerular filtration rate.

Analytical approach

Groups were compared with Wilcoxon, Kruskal-Wallis or chi-square tests. Correlations were performed using Pearson's correlation.

Results

Plasma C3a, C4a, C5a, and sC5b-9 levels were elevated in MN patients. Some patients had IgG reacted with glomerular endothelial cells or with podocytes. These antibodies were seen in distinct subsets of patients and did not correlate with the presence of anti-PLA2R antibodies. Higher titers of anti-glomerular endothelial cell antibodies correlated with systemic complement activation, seen by sC5b-9, and disease severity, determined by proteinuria. Anti-cardiolipin IgG levels associated with proteinuria.

Limitations

Assays used immortalized cell lines, and target antigens have not yet been identified.

Conclusions

MN is a disease of autoimmunity directed against podocyte antigens, but some patients may also produce autoantibodies that target antigens on glomerular endothelial cells. The level of these antibodies correlates with adverse clinical findings.
理由与目的膜性肾病(MN)是一种由自身抗体与足细胞抗原反应引起的肾小球疾病。最常见的抗原是m型磷脂酶A2受体(PLA2R),但也发现了针对其他足细胞抗原的自身抗体。研究者报告血浆中补体碎片水平升高。然而,足细胞产生的大多数补体片段很可能进入尿液,而不是进入血液。此外,抗pla2r抗体通常是IgG4亚类,不激活补体的经典途径。为了寻找能够产生血管内补体片段的其他自身抗体,我们检查了MN患者是否有与内皮细胞抗原反应的抗体。研究设计回顾性队列研究。我们分析了64例MN患者的血浆样本,并将结果与健康对照组和慢性肾脏疾病患者进行了比较。暴露:血浆和尿液补体活化片段,肾小球内皮细胞和足细胞抗体结合测定,抗心磷脂抗体酶联免疫吸附测定。结果:蛋白尿,估计肾小球滤过率。各组比较采用Wilcoxon、Kruskal-Wallis或卡方检验。使用Pearson相关进行相关性分析。结果MN患者血浆C3a、C4a、C5a和sC5b-9水平升高。部分患者IgG与肾小球内皮细胞或足细胞反应。这些抗体在不同的患者亚群中可见,与抗pla2r抗体的存在无关。抗肾小球内皮细胞抗体的高滴度与全身补体激活相关,可通过sC5b-9观察到,与疾病严重程度相关,可通过蛋白尿确定。与蛋白尿相关的抗心磷脂IgG水平。局限性:试验使用永生化细胞系,靶抗原尚未确定。结论smn是一种针对足细胞抗原的自身免疫疾病,但部分患者也可能产生针对肾小球内皮细胞抗原的自身抗体。这些抗体的水平与不良临床表现相关。
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引用次数: 0
Decoding ulcerative colitis pathogenesis through transcriptomics: from dysregulated gene networks to targeted intervention strategies 通过转录组学解码溃疡性结肠炎的发病机制:从失调的基因网络到靶向干预策略
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-08 DOI: 10.1016/j.jtauto.2025.100334
Xiang Zhu , Yujie Yang , Yi Zhu
<div><h3>Background</h3><div>Ulcerative colitis (UC) is an immune-mediated chronic inflammatory bowel disease, and with the rising global incidence and the risk of malignant transformation, the treatment of UC is challenged by heterogeneous progression and limited targeted therapies, and its underlying pathogenesis remains unclear. This study aims to identify novel therapeutic targets for UC, elucidate the genetic factors associated with UC development, and advance precision medicine strategies for UC.</div></div><div><h3>Methods</h3><div>Differential expression analysis was performed on three independent UC datasets from the Gene Expression Omnibus (GEO) database, identifying differentially expressed genes (DEGs) associated with UC. An eQTL-MR analysis was conducted to identify UC-related gene expression loci, and the results were intersected with the GEO differential analysis using a Venn diagram. Subsequently, a protein-protein interaction network was constructed based on the 20 intersecting genes identified through both eQTL-MR and differential expression analysis, using STRING. Key hub genes were then identified based on centrality scores calculated in Cytoscape. Additionally, Gene Set Enrichment Analysis (GSEA) and Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to explore the functional roles and pathways of these genes. Finally, the results obtained for the target genes were validated.</div></div><div><h3>Results</h3><div>Twenty intersecting genes were identified, specifically PITPNC1, OLFM1, PARP9, BATF2, PDGFRB, LEF1, CST7, HCLS1, SLC16A6, CCR7, KMO, ITGA4, SLC22A5, ASB13, SLC22A4, DNMBP, PGAP3, FAAH, SLC7A9, and BTNL8. These genes are involved in fundamental biological processes and pathways, including immune response modulation and epithelial barrier regulation. Additionally, CIBERSORT analysis revealed a unique immune cell distribution in UC and highlighted the association between immune cells and the intersecting genes. Gene Set Enrichment Analysis (GSEA) showed that high expression levels of HCLS1, ITGA4, and PDGFRB may collectively contribute to the recruitment and activation of inflammatory cells, as well as the amplification of immune signaling. Conversely, lower expression levels of these genes suggest that the tissue may be in a state of reduced inflammation or repair. The MR analysis was consistent with the results of variance analysis in the validation cohort, further reinforcing the reliability of our MR findings.</div></div><div><h3>Conclusions</h3><div>HCLS1, ITGA4, and PDGFRB may represent core modules involved in T/B cell homing and activation, pro-inflammatory macrophage recruitment, and extracellular matrix responses. These genes interact with upregulated genes to promote the amplification of inflammation, counteracting with downregulated metabolic-related genes. Together, they contribute to the molecular foundation of the inflammatory and metabolic protective phenotype
背景溃疡性结肠炎(UC)是一种免疫介导的慢性炎症性肠病,随着全球发病率和恶性转化风险的上升,UC的治疗受到异质性进展和有限靶向治疗的挑战,其潜在的发病机制尚不清楚。本研究旨在寻找UC的新治疗靶点,阐明UC发展的相关遗传因素,推进UC的精准医疗策略。方法对基因表达综合数据库(GEO)中三个独立的UC数据集进行差异表达分析,鉴定与UC相关的差异表达基因(DEGs)。通过eQTL-MR分析确定uc相关基因表达位点,并使用维恩图将结果与GEO差异分析相交。随后,基于通过eQTL-MR和差异表达分析鉴定的20个交叉基因,使用STRING构建蛋白-蛋白相互作用网络。然后根据在Cytoscape中计算的中心性评分确定关键枢纽基因。此外,通过基因集富集分析(GSEA)和基因本体(GO)/京都基因与基因组百科全书(KEGG)富集分析来探索这些基因的功能作用和途径。最后,对目标基因得到的结果进行验证。结果共鉴定出20个交叉基因,分别为PITPNC1、OLFM1、PARP9、BATF2、PDGFRB、LEF1、CST7、HCLS1、SLC16A6、CCR7、KMO、ITGA4、SLC22A5、ASB13、SLC22A4、DNMBP、PGAP3、FAAH、SLC7A9和BTNL8。这些基因参与了基本的生物过程和途径,包括免疫反应调节和上皮屏障调节。此外,CIBERSORT分析揭示了UC中独特的免疫细胞分布,并强调了免疫细胞与交叉基因之间的关联。基因集富集分析(GSEA)显示,HCLS1、ITGA4和PDGFRB的高表达水平可能共同促进炎症细胞的募集和激活,以及免疫信号的扩增。相反,这些基因的低表达水平表明组织可能处于减少炎症或修复的状态。MR分析与验证队列的方差分析结果一致,进一步加强了MR结果的可靠性。结论shcls1、ITGA4和PDGFRB可能是参与T/B细胞归巢和活化、促炎巨噬细胞募集和细胞外基质反应的核心模块。这些基因与上调的基因相互作用,促进炎症的放大,与下调的代谢相关基因相互抵消。总之,它们有助于在溃疡性结肠炎中观察到的炎症和代谢保护表型的分子基础。
{"title":"Decoding ulcerative colitis pathogenesis through transcriptomics: from dysregulated gene networks to targeted intervention strategies","authors":"Xiang Zhu ,&nbsp;Yujie Yang ,&nbsp;Yi Zhu","doi":"10.1016/j.jtauto.2025.100334","DOIUrl":"10.1016/j.jtauto.2025.100334","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Ulcerative colitis (UC) is an immune-mediated chronic inflammatory bowel disease, and with the rising global incidence and the risk of malignant transformation, the treatment of UC is challenged by heterogeneous progression and limited targeted therapies, and its underlying pathogenesis remains unclear. This study aims to identify novel therapeutic targets for UC, elucidate the genetic factors associated with UC development, and advance precision medicine strategies for UC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Differential expression analysis was performed on three independent UC datasets from the Gene Expression Omnibus (GEO) database, identifying differentially expressed genes (DEGs) associated with UC. An eQTL-MR analysis was conducted to identify UC-related gene expression loci, and the results were intersected with the GEO differential analysis using a Venn diagram. Subsequently, a protein-protein interaction network was constructed based on the 20 intersecting genes identified through both eQTL-MR and differential expression analysis, using STRING. Key hub genes were then identified based on centrality scores calculated in Cytoscape. Additionally, Gene Set Enrichment Analysis (GSEA) and Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to explore the functional roles and pathways of these genes. Finally, the results obtained for the target genes were validated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty intersecting genes were identified, specifically PITPNC1, OLFM1, PARP9, BATF2, PDGFRB, LEF1, CST7, HCLS1, SLC16A6, CCR7, KMO, ITGA4, SLC22A5, ASB13, SLC22A4, DNMBP, PGAP3, FAAH, SLC7A9, and BTNL8. These genes are involved in fundamental biological processes and pathways, including immune response modulation and epithelial barrier regulation. Additionally, CIBERSORT analysis revealed a unique immune cell distribution in UC and highlighted the association between immune cells and the intersecting genes. Gene Set Enrichment Analysis (GSEA) showed that high expression levels of HCLS1, ITGA4, and PDGFRB may collectively contribute to the recruitment and activation of inflammatory cells, as well as the amplification of immune signaling. Conversely, lower expression levels of these genes suggest that the tissue may be in a state of reduced inflammation or repair. The MR analysis was consistent with the results of variance analysis in the validation cohort, further reinforcing the reliability of our MR findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;HCLS1, ITGA4, and PDGFRB may represent core modules involved in T/B cell homing and activation, pro-inflammatory macrophage recruitment, and extracellular matrix responses. These genes interact with upregulated genes to promote the amplification of inflammation, counteracting with downregulated metabolic-related genes. Together, they contribute to the molecular foundation of the inflammatory and metabolic protective phenotype ","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"12 ","pages":"Article 100334"},"PeriodicalIF":3.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the immunomodulatory effects of environmental contaminants on autoimmune patients: An in vitro approach 探索环境污染物对自身免疫性患者的免疫调节作用:体外方法
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-08 DOI: 10.1016/j.jtauto.2025.100341
Yeny Acosta-Ampudia , Diana M. Monsalve , Daniel Galeano-Sánchez , Manuel Rojas , Carolina Ramírez-Santana

Background

Autoimmune diseases are multifactorial, with environmental contaminants increasingly recognized as risk factors. This pilot study investigated the in vitro effects of particulate matter (PM), silica, and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on peripheral blood mononuclear cells (PBMCs) from healthy donors (HD) and patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE).

Methods

PBMCs were obtained from HD (n = 6), RA patients (n = 5), and SLE patients (n = 5) and stimulated for 24 h with PM (100 μg/mL), silica (30 μg/mL), or TCDD (250 pg/mL). Immunophenotyping by flow cytometry was performed in HD, characterizing T cell subsets, B cells, NK/NKT cells, monocytes, and dendritic cells, including activation markers. Production of 18 cytokines and chemokines was quantified in all groups using Cytometric Bead Array. Activation of intracellular signaling pathways (AKT, NFκB, p38 MAPK, STAT1, STAT3) was assessed by Western blot.

Results

All contaminants induced strong immune activation. In HD, flow cytometry revealed strong activation of monocytes and dendritic cells, with increased co-stimulatory markers (CD40, CD80, CD83) and skewing of T cells toward effector phenotypes. Cytokine analysis showed substantial overlap in inflammatory profiles across HD, RA, and SLE, despite the significant upregulation of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), growth factors (GM-CSF, G-CSF), and regulatory cytokines (IL-10). Western blot confirmed modulation of signaling pathways, with PM notably enhancing p38 MAPK phosphorylation in HD and RA.

Conclusion

Environmental contaminants elicit robust immunomodulatory effects in PBMCs. The overlap in cytokine profiles and signaling responses across HD, RA, and SLE indicates a highly conserved cellular response to environmental stressors, independent of autoimmune disease status.
自身免疫性疾病是多因素的,环境污染物越来越被认为是危险因素。本初步研究探讨了颗粒物(PM)、二氧化硅和2,3,7,8-四氯二苯并-对二恶英(TCDD)对健康供体(HD)和类风湿关节炎(RA)或系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMCs)的体外影响。方法分别从HD (n = 6)、RA (n = 5)和SLE (n = 5)患者中获得spbmcs,分别用PM (100 μg/mL)、二氧化硅(30 μg/mL)或TCDD (250 pg/mL)刺激24 h。流式细胞术对HD患者进行免疫分型,包括T细胞亚群、B细胞、NK/NKT细胞、单核细胞和树突状细胞,包括活化标记。用流式细胞仪定量检测各组18种细胞因子和趋化因子的产生。Western blot检测细胞内信号通路(AKT、NFκB、p38 MAPK、STAT1、STAT3)的激活情况。结果所有污染物均引起强烈的免疫激活。在HD中,流式细胞术显示单核细胞和树突状细胞的强烈活化,共刺激标记物(CD40, CD80, CD83)增加,T细胞向效应表型倾斜。细胞因子分析显示,尽管促炎因子(IL-1β、IL-6、TNF-α)、生长因子(GM-CSF、G-CSF)和调节因子(IL-10)显著上调,但HD、RA和SLE的炎症谱存在显著重叠。Western blot证实了信号通路的调节,PM显著增强了HD和RA中p38 MAPK的磷酸化。结论环境污染物对PBMCs具有较强的免疫调节作用。在HD、RA和SLE中,细胞因子谱和信号反应的重叠表明,细胞对环境应激源的反应高度保守,独立于自身免疫性疾病状态。
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引用次数: 0
“CANDLE syndrome: A closer look at a rare autoinflammatory disorder” “CANDLE综合征:一种罕见的自身炎症性疾病的进一步研究”
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-06 DOI: 10.1016/j.jtauto.2025.100339
Shivam Singh, Ashish Kumar Sharma
A newly identified autoinflammatory condition called CANDLE syndrome (chronic atypical neutrophilic dermatosis with lipodystrophy and increased temperature) is characterized by early onset, recurring fever, skin lesions, and multisystemic inflammatory symptoms. It has been demonstrated that the majority of patients had PSMB8 gene mutations. It leads to dysfunction in the proteasome/immunoproteasome system and subsequent overproduction of type 1 interferons. Patients usually exhibit lipodystrophy, fever, rashes on the skin, and malnutrition in the early stages of infancy. The results of skin biopsies, laboratory tests, and clinical symptoms all support the diagnosis of CANDLE syndrome. Although there isn't a specific treatment for CANDLE syndrome, JAK inhibitors like baricitinib have demonstrated some effectiveness in treating its symptoms. For CANDLE syndrome patients to receive the right therapeutic interventions, early diagnosis and molecular testing are essential. A positive interferon signature has also been found to be a diagnostic indicator for the condition. Although there are no particular treatments for CANDLE syndrome, research is still being done to determine how well immunosuppressive medications, biological agents, and glucocorticoids work in treating the condition. Current research generally aims to improve the quality of life for individuals with CANDLE syndrome through the development of targeted medications, the elucidation of genetic determinants, and the advancement of diagnostic methods.
一种新发现的自身炎症称为CANDLE综合征(慢性非典型中性粒细胞性皮肤病伴脂肪营养不良和体温升高),其特征是早发、反复发热、皮肤病变和多系统炎症症状。研究表明,大多数患者存在PSMB8基因突变。它导致蛋白酶体/免疫蛋白酶体系统功能障碍和随后的1型干扰素过量产生。患者通常在婴儿期早期表现为脂肪营养不良、发热、皮肤皮疹和营养不良。皮肤活检、实验室检查和临床症状的结果都支持CANDLE综合征的诊断。虽然目前还没有针对CANDLE综合征的特殊治疗方法,但像baricitinib这样的JAK抑制剂已经证明在治疗其症状方面有一定的效果。为了使CANDLE综合征患者得到正确的治疗干预,早期诊断和分子检测是必不可少的。干扰素阳性信号也被发现是该病症的诊断指标。尽管目前还没有针对CANDLE综合征的特殊治疗方法,但仍在进行研究,以确定免疫抑制药物、生物制剂和糖皮质激素在治疗这种疾病方面的效果如何。目前的研究一般旨在通过开发靶向药物、阐明遗传决定因素和改进诊断方法来改善CANDLE综合征患者的生活质量。
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引用次数: 0
Data-driven classification of primary Sjögren’s syndrome: From cluster analysis to clinical immune phenotypes and predictive biomarkers 原发性Sjögren综合征的数据驱动分类:从聚类分析到临床免疫表型和预测性生物标志物
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-03 DOI: 10.1016/j.jtauto.2025.100338
Jianbin Li , Suiran Li , Wei Liu

Background

Primary Sjögren’s Syndrome (pSS) exhibits significant clinical heterogeneity, and traditional organ-based classification systems fail to capture the underlying disease mechanisms. This study aims to identify distinct clinical immune phenotypes of pSS through a data-driven approach and explore their predictive biomarkers.

Method

This cross-sectional study included 1087 patients who met the 2016 ACR/EULAR classification criteria for primary Sjögren’s syndrome between 2014 and 2024. Unsupervised K-means clustering analysis was applied to 10 organ involvement variables to identify natural patient subgroups. Network analysis was used to explore the associations between organ involvement and laboratory biomarkers. Multivariable logistic regression was employed to identify independent predictors of subgroup assignment, and restricted cubic spline analysis was conducted to assess the nonlinear relationships between key biomarkers and subtype risk.

Results

Clustering analysis identified two distinct phenotypes: Phenotype 1 (multi-system inflammatory subtype, n = 594) was characterized by widespread musculoskeletal involvement (100 %) and significantly elevated inflammatory markers (RF: 246.41 ± 1177.49 vs 32.75 ± 126.74 IU/mL, P < 0.001); Phenotype 2 (glandular-limited high immunoglobulin subtype, n = 493) was primarily characterized by glandular involvement (40.7 %), higher IgG levels, and less systemic involvement. Network analysis revealed a strong correlation between RF and musculoskeletal involvement (r = 0.32, P < 0.001). Independent predictors of Phenotype 1 included male gender (OR 2.559, 95 % CI 1.109–6.090), elevated potassium (OR 1.607, 95 % CI 1.061–2.433), and elevated RF levels (OR 1.004, 95 % CI 1.002–1.005). A composite clinical prediction score incorporating these biomarkers achieved an AUC of 0.717 (95 % CI: 0.684–0.751) for phenotype discrimination. Nonlinear analysis showed complex U-shaped and inverted U-shaped relationships between key biomarkers and phenotype risk.

Conclusion

pSS consists of distinct clinical phenotypes with varying pathophysiological characteristics. The data-driven classification system complements traditional severity grading and provides new insights into precision medicine approaches. RF is a key biomarker linking musculoskeletal manifestations with the severity of systemic inflammation and may serve as an important indicator for precise subtyping and targeted therapy.
原发性Sjögren综合征(pSS)表现出明显的临床异质性,传统的基于器官的分类系统无法捕捉潜在的疾病机制。本研究旨在通过数据驱动的方法识别pSS不同的临床免疫表型,并探索其预测性生物标志物。方法本横断面研究纳入了2014年至2024年间1087例符合2016年ACR/EULAR原发性Sjögren综合征分类标准的患者。对10个器官受累变量进行无监督k均值聚类分析,以确定自然患者亚组。网络分析用于探索器官受累与实验室生物标志物之间的关系。采用多变量logistic回归确定亚组分配的独立预测因子,并采用限制性三次样条分析评估关键生物标志物与亚型风险之间的非线性关系。结果聚类分析确定了两种不同的表型:表型1(多系统炎症亚型,n = 594)以广泛的肌肉骨骼受累(100%)和显著升高的炎症标志物为特征(RF: 246.41±1177.49 vs 32.75±126.74 IU/mL, P < 0.001);表型2(腺限制性高免疫球蛋白亚型,n = 493)的主要特征是腺体受累(40.7%),IgG水平较高,全身受累较少。网络分析显示射频与肌肉骨骼受累之间有很强的相关性(r = 0.32, P < 0.001)。表型1的独立预测因子包括男性(OR 2.559, 95% CI 1.109-6.090)、钾离子升高(OR 1.607, 95% CI 1.061-2.433)和射频水平升高(OR 1.004, 95% CI 1.002-1.005)。结合这些生物标志物的综合临床预测评分在表型区分方面的AUC为0.717 (95% CI: 0.684-0.751)。非线性分析显示,关键生物标志物与表型风险之间存在复杂的u型和倒u型关系。结论pss具有不同的临床表型和不同的病理生理特征。数据驱动的分类系统补充了传统的严重程度分级,并为精准医学方法提供了新的见解。RF是连接肌肉骨骼表现与全身炎症严重程度的关键生物标志物,可作为精确分型和靶向治疗的重要指标。
{"title":"Data-driven classification of primary Sjögren’s syndrome: From cluster analysis to clinical immune phenotypes and predictive biomarkers","authors":"Jianbin Li ,&nbsp;Suiran Li ,&nbsp;Wei Liu","doi":"10.1016/j.jtauto.2025.100338","DOIUrl":"10.1016/j.jtauto.2025.100338","url":null,"abstract":"<div><h3>Background</h3><div>Primary Sjögren’s Syndrome (pSS) exhibits significant clinical heterogeneity, and traditional organ-based classification systems fail to capture the underlying disease mechanisms. This study aims to identify distinct clinical immune phenotypes of pSS through a data-driven approach and explore their predictive biomarkers.</div></div><div><h3>Method</h3><div>This cross-sectional study included 1087 patients who met the 2016 ACR/EULAR classification criteria for primary Sjögren’s syndrome between 2014 and 2024. Unsupervised K-means clustering analysis was applied to 10 organ involvement variables to identify natural patient subgroups. Network analysis was used to explore the associations between organ involvement and laboratory biomarkers. Multivariable logistic regression was employed to identify independent predictors of subgroup assignment, and restricted cubic spline analysis was conducted to assess the nonlinear relationships between key biomarkers and subtype risk.</div></div><div><h3>Results</h3><div>Clustering analysis identified two distinct phenotypes: Phenotype 1 (multi-system inflammatory subtype, n = 594) was characterized by widespread musculoskeletal involvement (100 %) and significantly elevated inflammatory markers (RF: 246.41 ± 1177.49 vs 32.75 ± 126.74 IU/mL, P &lt; 0.001); Phenotype 2 (glandular-limited high immunoglobulin subtype, n = 493) was primarily characterized by glandular involvement (40.7 %), higher IgG levels, and less systemic involvement. Network analysis revealed a strong correlation between RF and musculoskeletal involvement (r = 0.32, P &lt; 0.001). Independent predictors of Phenotype 1 included male gender (OR 2.559, 95 % CI 1.109–6.090), elevated potassium (OR 1.607, 95 % CI 1.061–2.433), and elevated RF levels (OR 1.004, 95 % CI 1.002–1.005). A composite clinical prediction score incorporating these biomarkers achieved an AUC of 0.717 (95 % CI: 0.684–0.751) for phenotype discrimination. Nonlinear analysis showed complex U-shaped and inverted U-shaped relationships between key biomarkers and phenotype risk.</div></div><div><h3>Conclusion</h3><div>pSS consists of distinct clinical phenotypes with varying pathophysiological characteristics. The data-driven classification system complements traditional severity grading and provides new insights into precision medicine approaches. RF is a key biomarker linking musculoskeletal manifestations with the severity of systemic inflammation and may serve as an important indicator for precise subtyping and targeted therapy.</div></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"12 ","pages":"Article 100338"},"PeriodicalIF":3.6,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to ‘Emerging cell-based and cell-free therapeutic strategies for vitiligo’ [J. Transl. Autoimmun., 11 (2025), 100331] 新出现的基于细胞和无细胞的白癜风治疗策略的勘误[J]。Transl。Autoimmun。农业科学,11 (2025),100331]
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.jtauto.2025.100335
Nasser Gholijani , Effat Noori , Zeinab Zarei-Behjani , Delsuz Rezaee , Maryam Khodaei , Gholamhossien Darya , Kobra Mehdinejadiani , Zeinab Dehghan
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引用次数: 0
Epigenetic advances in rheumatic heart disease 风湿性心脏病的表观遗传学进展
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.jtauto.2025.100336
Wenjie Zhu , Fan Li , Yuchen Zhang , Yuting Chen , Ye Wu , Chengxin Zhang
Rheumatic heart disease (RHD), an autoimmune injury triggered by group A streptococcus (GAS) infection, exerts a significant pathological impact on the human heart. The pathogenesis of RHD is closely associated with abnormal epigenetic regulation, and primarily involves the four core epigenetic mechanisms: DNA methylation, histone modification, non-coding RNAs (ncRNAs), and chromatin remodeling. Currently, researches on RHD have shifted from focusing on late-stage diagnosis and treatment to investigating its multiple etiologies. Therefore, this article presents a systematic literature review aimed at reviewing the latest progress in the epigenetic research of RHD, providing in-depth elucidation of the interactions between RHD and these four core mechanisms, highlighting the value of potential biomarkers for the disease's early diagnosis and treatment, and outlining future research directions, including combined multi-omics analysis, minimally invasive interventional techniques, and gene chip-based approaches. This review aims to address the limitations of single-subject studies and small-sample cross-sectional surveys in epigenetic studies of RHD, thereby providing new strategies for disease prevention, control, and health management.
风湿性心脏病(RHD)是一种由A群链球菌(GAS)感染引发的自身免疫性损伤,对人类心脏有重要的病理影响。RHD的发病机制与异常的表观遗传调控密切相关,主要涉及DNA甲基化、组蛋白修饰、非编码rna (ncRNAs)和染色质重塑四种核心表观遗传机制。目前,对RHD的研究已经从注重晚期诊断和治疗转向对其多种病因的研究。因此,本文通过系统的文献综述,综述了RHD表观遗传学研究的最新进展,深入阐述了RHD与这四种核心机制之间的相互作用,强调了RHD潜在生物标志物在疾病早期诊断和治疗中的价值,并概述了未来的研究方向,包括联合多组学分析、微创介入技术和基于基因芯片的方法。本文旨在解决RHD表观遗传学研究中单受试者研究和小样本横断面调查的局限性,从而为疾病预防、控制和健康管理提供新的策略。
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引用次数: 0
Rheumatoid factor and anti-citrullinated protein IgA antibodies in the diagnosis, prognosis and monitoring of patients with rheumatoid arthritis 类风湿因子和抗瓜氨酸化蛋白IgA抗体在类风湿关节炎患者诊断、预后和监测中的作用
IF 3.6 Q2 IMMUNOLOGY Pub Date : 2025-11-12 DOI: 10.1016/j.jtauto.2025.100332
Ulrike Steffen , Daniela Sieghart , Günter Steiner
Over the past decades immunoglobulin A (IgA) antibodies have gained increasing attention for their diagnostic and prognostic significance in rheumatoid arthritis (RA), complementing the well-established roles of IgM rheumatoid factor (RF) and IgG anti-citrullinated protein antibodies (ACPA). IgA-RF and IgA-ACPA are found in a subset of RA patients and have been associated with more severe disease phenotypes, including increased joint erosion and extra-articular manifestations, especially cardiovascular disease and lung involvement. Moreover, concerning prediction of therapeutic responses IgA isotypes seem to have potential, as their presence has been shown to be associated with a blunted response to treatment with TNF inhibitors suggesting their usefulness for disease monitoring during follow-up once a diagnosis has been established. Although the diagnostic value of IgA autoantibodies in identifying seronegative RA cases is limited, their presence confirms a diagnosis of RA and may be helpful in the preclinical detection of individuals at risk for developing RA.
Increasing evidence suggests that IgA-RF and IgA-ACPA may contribute to disease pathogenesis. They can activate myeloid cells through engagement with the Fc alpha receptor I, leading to enhanced pro-inflammatory cytokine release, phagocytosis, and the formation of neutrophil extracellular traps that exacerbate tissue damage. Taken together, measuring IgA isotypes may be considered a valuable addition to the serological armamentarium for RA, with potential to improve early diagnosis, risk stratification, and personalized therapeutic approaches.
This review summarizes the current knowledge regarding the value of IgA-RF and IgA-ACPA as diagnostic and prognostic markers for RA. In addition, we discuss how the presence of IgA autoantibodies fits into the mucosal origin theory and describe their potential pathologic effects.
在过去的几十年里,免疫球蛋白A (IgA)抗体因其在类风湿性关节炎(RA)中的诊断和预后意义而受到越来越多的关注,它补充了IgM类风湿性因子(RF)和IgG抗瓜氨酸化蛋白抗体(ACPA)的作用。IgA-RF和IgA-ACPA存在于一部分RA患者中,并与更严重的疾病表型相关,包括关节侵蚀和关节外表现增加,特别是心血管疾病和肺部受累。此外,关于治疗反应的预测,IgA同型似乎具有潜力,因为它们的存在已被证明与对TNF抑制剂治疗的迟钝反应相关,这表明它们在诊断确定后的随访期间对疾病监测有用。尽管IgA自身抗体在识别血清阴性RA病例中的诊断价值有限,但它们的存在证实了RA的诊断,并可能有助于临床前检测有RA发展风险的个体。越来越多的证据表明,IgA-RF和IgA-ACPA可能参与疾病的发病机制。它们可以通过与Fc α受体I结合激活髓细胞,导致促炎细胞因子释放增强、吞噬和中性粒细胞胞外陷阱的形成,从而加剧组织损伤。总之,测量IgA同型可能被认为是类风湿关节炎血清学仪器的一个有价值的补充,具有改善早期诊断、风险分层和个性化治疗方法的潜力。本文综述了IgA-RF和IgA-ACPA作为RA诊断和预后指标的价值。此外,我们讨论了IgA自身抗体的存在如何符合粘膜起源理论,并描述了它们潜在的病理作用。
{"title":"Rheumatoid factor and anti-citrullinated protein IgA antibodies in the diagnosis, prognosis and monitoring of patients with rheumatoid arthritis","authors":"Ulrike Steffen ,&nbsp;Daniela Sieghart ,&nbsp;Günter Steiner","doi":"10.1016/j.jtauto.2025.100332","DOIUrl":"10.1016/j.jtauto.2025.100332","url":null,"abstract":"<div><div>Over the past decades immunoglobulin A (IgA) antibodies have gained increasing attention for their diagnostic and prognostic significance in rheumatoid arthritis (RA), complementing the well-established roles of IgM rheumatoid factor (RF) and IgG anti-citrullinated protein antibodies (ACPA). IgA-RF and IgA-ACPA are found in a subset of RA patients and have been associated with more severe disease phenotypes, including increased joint erosion and extra-articular manifestations, especially cardiovascular disease and lung involvement. Moreover, concerning prediction of therapeutic responses IgA isotypes seem to have potential, as their presence has been shown to be associated with a blunted response to treatment with TNF inhibitors suggesting their usefulness for disease monitoring during follow-up once a diagnosis has been established. Although the diagnostic value of IgA autoantibodies in identifying seronegative RA cases is limited, their presence confirms a diagnosis of RA and may be helpful in the preclinical detection of individuals at risk for developing RA.</div><div>Increasing evidence suggests that IgA-RF and IgA-ACPA may contribute to disease pathogenesis. They can activate myeloid cells through engagement with the Fc alpha receptor I, leading to enhanced pro-inflammatory cytokine release, phagocytosis, and the formation of neutrophil extracellular traps that exacerbate tissue damage. Taken together, measuring IgA isotypes may be considered a valuable addition to the serological armamentarium for RA, with potential to improve early diagnosis, risk stratification, and personalized therapeutic approaches.</div><div>This review summarizes the current knowledge regarding the value of IgA-RF and IgA-ACPA as diagnostic and prognostic markers for RA. In addition, we discuss how the presence of IgA autoantibodies fits into the mucosal origin theory and describe their potential pathologic effects.</div></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"11 ","pages":"Article 100332"},"PeriodicalIF":3.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Translational Autoimmunity
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