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Pediatric autoimmune diseases in the light of COVID-19 pandemic, A retrospective observational big data study 新冠肺炎大流行背景下儿童自身免疫性疾病的回顾性观察性大数据研究
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-03-06 DOI: 10.1016/j.jtauto.2025.100281
Rim Kasem Ali Sliman , Hilla Cohen , Shereen Shehadeh , Reut Batcir , Yigal Elenberg Alter , Keren Cohen , Ilana Koren , Inbal Halabi , Hussein Sliman , Mohamad Hamad Saied

Background

The COVID-19 pandemic has raised concerns about potential links between SARS-CoV-2 infection and autoimmune diseases. This study investigated changes in the incidence rate (IR) of autoimmune diseases among children following the pandemic's onset.

Methods

A retrospective cross-sectional study analyzed data from Clalit Health Services, Israel's largest healthcare provider, examining the IR of different autoimmune diseases in children aged 0–18. The study compared pre-pandemic (2019) with pandemic/post-pandemic periods (2020–2023), encompassing a cohort of over 1.5 million children.

Results

Significant IR increases were observed across multiple autoimmune diseases. Rheumatic diseases (Juvenile Idiopathic Arthritis, Systemic Lupus Erythematosus, Henoch Schoenlein Purpura (HSP)) showed consistent increases, with HSP demonstrating the most pronounced trend. Endocrine disorders exhibited diverse patterns, with autoimmune thyroid diseases and Type 1 diabetes showing overall increases, while diabetic ketoacidosis exhibited an initial spike followed by a decline. Gastrointestinal diseases displayed heterogeneous patterns; Celiac disease and Ulcerative colitis showed general increases, Crohn's disease showed a downward trend, and autoimmune hepatitis exhibited an initial significant decrease followed by a significant increase. Dermatological conditions, including Psoriasis and Vitiligo, demonstrated consistent elevations throughout 2020–2023. Immune Thrombocytopenia Purpura showed initial decreases followed by significant increases in 2022–2023.

Conclusions

This comprehensive analysis reveals significant changes in pediatric autoimmune disease incidence following the COVID-19 pandemic, suggesting potential associations between SARS-CoV-2 infection and autoimmune dysregulation. The diverse patterns observed across different conditions highlight the complex interplay between viral infection and autoimmunity, emphasizing the need for continued surveillance and investigation of long-term immunological consequences of COVID-19 in pediatric populations.
COVID-19大流行引发了人们对SARS-CoV-2感染与自身免疫性疾病之间潜在联系的担忧。本研究调查了大流行爆发后儿童自身免疫性疾病发病率(IR)的变化。方法一项回顾性横断面研究分析了以色列最大的医疗保健提供商Clalit Health Services的数据,检查了0-18岁儿童不同自身免疫性疾病的IR。该研究将大流行前(2019年)与大流行/大流行后(2020-2023年)进行了比较,涉及150多万名儿童。结果在多种自身免疫性疾病中观察到显著的IR升高。风湿病(幼年特发性关节炎、系统性红斑狼疮、过敏性紫癜(HSP))持续增加,其中HSP的趋势最为明显。内分泌失调表现出不同的模式,自身免疫性甲状腺疾病和1型糖尿病总体增加,而糖尿病酮症酸中毒表现出最初的高峰,然后下降。胃肠道疾病表现出异质性;乳糜泻和溃疡性结肠炎总体呈上升趋势,克罗恩病呈下降趋势,自身免疫性肝炎呈初始显著下降后显著上升趋势。皮肤病,包括牛皮癣和白癜风,在2020-2023年期间持续升高。免疫性血小板减少性紫癜在2022-2023年表现出最初的下降,随后显著上升。结论这项综合分析揭示了COVID-19大流行后儿童自身免疫性疾病发病率的显著变化,提示SARS-CoV-2感染与自身免疫性失调之间存在潜在关联。在不同情况下观察到的不同模式突出了病毒感染与自身免疫之间复杂的相互作用,强调需要继续监测和调查COVID-19在儿科人群中的长期免疫后果。
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引用次数: 0
NETosis: A key player in autoimmunity, COVID-19, and long COVID NETosis:自身免疫、COVID-19和长COVID的关键参与者
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-02-21 DOI: 10.1016/j.jtauto.2025.100280
Diana M. Monsalve , Yeny Acosta-Ampudia , Nicolás Guerrero Acosta , Mariana Celis-Andrade , Ali Şahin , Ahsen Morva Yilmaz , Yehuda Shoenfeld , Carolina Ramírez-Santana
NETosis, the process through which neutrophils release neutrophil extracellular traps (NETs), has emerged as a crucial mechanism in host defense and the pathogenesis of autoimmune responses. During the SARS-CoV-2 pandemic, this process received significant attention due to the central role of neutrophil recruitment and activation in infection control. However, elevated neutrophil levels and dysregulated NET formation have been linked to coagulopathy and endothelial damage, correlating with disease severity and poor prognosis in COVID-19. Moreover, it is known that SARS-CoV-2 can induce persistent low-grade systemic inflammation, known as long COVID, although the underlying causes remain unclear. It has been increasingly acknowledged that excessive NETosis and NET generation contribute to further pathophysiological abnormalities following SARS-CoV-2 infection. This review provides an updated overview of the role of NETosis in autoimmune diseases, but also the relationship between COVID-19 and long COVID with autoimmunity (e.g., latent and overt autoimmunity, molecular mimicry, epitope spreading) and NETosis (e.g., immune responses, NET markers). Finally, we discuss potential therapeutic strategies targeting dysregulated NETosis to mitigate the severe complications of COVID-19 and long COVID.
NETosis是中性粒细胞释放中性粒细胞胞外陷阱(NETs)的过程,已成为宿主防御和自身免疫反应发病机制的重要机制。在SARS-CoV-2大流行期间,由于中性粒细胞募集和激活在感染控制中的核心作用,这一过程受到了极大的关注。然而,中性粒细胞水平升高和NET形成失调与凝血功能障碍和内皮损伤有关,与COVID-19的疾病严重程度和不良预后相关。此外,众所周知,SARS-CoV-2可以诱导持续的低度全身性炎症,即长冠状病毒,尽管根本原因尚不清楚。人们越来越多地认识到,过度的NETosis和NET生成有助于SARS-CoV-2感染后进一步的病理生理异常。本文综述了NETosis在自身免疫性疾病中的作用,以及COVID-19和长型COVID与自身免疫(如潜伏性和显性自身免疫、分子模仿、表位扩散)和NETosis(如免疫反应、NET标记物)之间的关系。最后,我们讨论了针对NETosis失调的潜在治疗策略,以减轻COVID-19和长期COVID的严重并发症。
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引用次数: 0
Understanding the role of immune-mediated inflammatory disease related cytokines interleukin 17 and 23 in pregnancy: A systematic review 了解免疫介导炎性疾病相关细胞因子白介素17和23在妊娠中的作用:一项系统综述
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-02-07 DOI: 10.1016/j.jtauto.2025.100279
Aniek Plug , Liana Barenbrug , Bart G.J. Moerings , Elke M.G. de Jong , Renate G. van der Molen

Background

Pregnancy requires a careful immune balance between tolerance for the semi-allogenic fetus and protection against pathogens. Women with immune-mediated inflammatory diseases (IMIDs), where the interleukin (IL)-23/IL-17 axis plays an important role, often experience changes in disease severity during pregnancy. These changes and the association between disease flares and pregnancy complications, suggests a role for IL-17 and IL-23 in pregnancy.

Methods

We systemically searched PubMed, EMBASE, and Web of Science (March 2024), to assess the role of IL-17 and IL-23 in pregnancy-related in vitro assays, animal or human studies.

Results

Eighty articles (8 in vitro, 11 animal and 61 human studies) were included. Seventy-one studies reported on IL-17 and 16 studies on IL-23. In vitro trophoblast proliferation, migration and invasion was increased in the presence of IL-17, but impaired with IL-23. IL-17 levels were increased in animal models for pregnancy complications. In humans, IL-17 levels seemed to be increased in pregnant women versus non-pregnant women. Additionally, elevated IL-17 levels were associated with pregnancy complications. Although similar trends were found for IL-23, data were limited.

Conclusions

We identified a large, but heterogenic, body of evidence for a significant role of IL-17 in all stages of pregnancy: while an excessive increase seemed to be associated with complications. The limited number of studies prevents firm conclusions on the role of IL-23. Future research is needed to find biomarkers for patients with IMIDs to predict the effect of possible disease flares on pregnancy, and the effect of therapeutic inhibition of IL-17 or IL-23.
背景:怀孕需要在对半同种异体胎儿的耐受和对病原体的保护之间保持谨慎的免疫平衡。白细胞介素(IL)-23/IL-17轴起着重要作用,患有免疫介导性炎症性疾病(IMIDs)的妇女在怀孕期间经常经历疾病严重程度的变化。这些变化以及疾病发作和妊娠并发症之间的关联提示IL-17和IL-23在妊娠中的作用。方法系统检索PubMed、EMBASE和Web of Science(2024年3月),评估IL-17和IL-23在妊娠相关体外实验、动物或人体研究中的作用。结果共纳入论文80篇,其中体外研究8篇,动物研究11篇,人体研究61篇。关于IL-17和IL-23的研究分别有71项和16项。IL-17的存在增加了体外滋养细胞的增殖、迁移和侵袭,而IL-23的存在则削弱了滋养细胞的增殖、迁移和侵袭。妊娠并发症动物模型中IL-17水平升高。在人类中,孕妇的IL-17水平似乎比非孕妇高。此外,IL-17水平升高与妊娠并发症有关。虽然IL-23也有类似的趋势,但数据有限。结论:我们发现了大量但异质性的证据,证明IL-17在妊娠的所有阶段都有重要作用,而过度增加似乎与并发症有关。由于研究数量有限,无法对IL-23的作用得出明确的结论。未来的研究需要寻找IMIDs患者的生物标志物,以预测可能的疾病发作对妊娠的影响,以及治疗性抑制IL-17或IL-23的效果。
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引用次数: 0
Enhancement of CD8+T cell cytotoxicity activity by IFN-α implies alternative pathologic role in systemic lupus erythematosus IFN-α增强CD8+T细胞毒性活性提示系统性红斑狼疮的病理作用
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-02-04 DOI: 10.1016/j.jtauto.2025.100276
Chen-xing Zhang , You-ying Mao , Yu-pin Tan , Mei-yu Zhang , Kang Shao , Shu-jun Wang , Ping Ji , Jia-yuan Wang , Lei Yin , Ying Wang

Objective

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease which is affected by the environmental, genetic factors as well as the immune system. Previous reports have implicated IFN-α in the pathogenesis of SLE. Up to date, however, no research has ever investigated the effect of IFN-α on CD8+T cells, which might be implicated in the pathogenesis of SLE. In the present study, we aimed to explore the pathologic role of IFN-α in regard to dysfunction of CD8+T cells in SLE.

Methods

Serum level of IFN-α was detected in SLE and healthy controls (HC). Surface expression of lysosome-associated membrane protein 1 (LAMP-1; CD107a) and secretion of granzyme B of CD8+T cells was measured in SLE and HC with or without IFN-α co-stimulation/PI3K inhibitor.

Results

Our results demonstrated that there was increased surface expression of CD107a of CD8+T cells in SLE patients compared with healthy controls (HC), indicating enhanced cytotoxicity of CD8+T cells in SLE patients. Meanwhile, increased secretion of granzyme B was also detected in CD8+T cells of SLE compared with HC, which correlated with the disease activity (SLEDAI). Furthermore, elevated serum level of IFN-α in SLE was confirmed in our study. In vitro study, granzyme B secretion by CD8+T cells was upregulated upon IFN-α costimulation, which was consistent with enhanced cytotoxicity of CD8+T cells upon IFN-α costimulation, as reflected by elevated surface expression of CD107a. PI3K inhibitor reversed increased granzyme B synthesis upon IFN-α costimulation in a dose-dependent manner.

Conclusion

In summary, elevated serum level of IFN-α was responsible for increased secretion of granzyme B and enhanced cytotoxicity of CD8+T cells in SLE and this process may be related to PI3K pathway. Relevant molecules and mechanism remains to be explored in the future.
目的系统性红斑狼疮(SLE)是一种受环境、遗传和免疫系统共同影响的异质自身免疫性疾病。先前的报道暗示IFN-α参与SLE的发病机制。然而,到目前为止,还没有研究研究IFN-α对CD8+T细胞的影响,这可能与SLE的发病机制有关。在本研究中,我们旨在探讨IFN-α在SLE中CD8+T细胞功能障碍中的病理作用。方法检测SLE患者和健康对照组(HC)血清IFN-α水平。溶酶体相关膜蛋白1 (LAMP-1)表面表达;在有或没有IFN-α共刺激/PI3K抑制剂的SLE和HC中检测CD107a)和CD8+T细胞颗粒酶B的分泌。结果与健康对照(HC)相比,SLE患者CD8+T细胞表面CD107a表达增加,表明SLE患者CD8+T细胞的细胞毒性增强。与HC相比,SLE的CD8+T细胞中颗粒酶B的分泌也有所增加,与疾病活动性相关(SLEDAI)。此外,我们的研究证实SLE患者血清中IFN-α水平升高。体外研究发现,IFN-α共刺激后CD8+T细胞颗粒酶B分泌上调,这与IFN-α共刺激后CD8+T细胞的细胞毒性增强一致,表现为CD107a表面表达升高。PI3K抑制剂以剂量依赖的方式逆转IFN-α共刺激下颗粒酶B合成的增加。综上所述,血清IFN-α水平升高导致SLE颗粒酶B分泌增加,CD8+T细胞毒性增强,这一过程可能与PI3K通路有关。相关分子及其作用机制有待进一步研究。
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引用次数: 0
The follow-up of patients with celiac disease 乳糜泻患者的随访
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-01-30 DOI: 10.1016/j.jtauto.2025.100278
Marco Di Tola , Hetty J. Bontkes , Juan Irure-Ventura , Marcos López-Hoyos , Nicola Bizzaro
Celiac disease (CD) is a very common immune-mediated enteropathy resulting from the interaction between dietary gluten and the immune system in genetically predisposed individuals. The immune response leads to intestinal damage, malabsorption and, ultimately, to a broad spectrum of both intestinal and extra-intestinal symptoms. According to current criteria, a proper diagnosis of CD requires an initial phase consisting of clinical case identification and serological screening that, over time, has increased in importance. In most adults and in selected children, the diagnosis is subsequently defined by histological evidence of intestinal damage as a confirmatory test, which usually returns to normal after a suitable period of a gluten-free diet (GFD). The clinical remission and disappearance of circulating antibodies after a GFD further confirm the diagnosis and represent a goal to be achieved to improve the quality of life and reduce the risk of long-term complications. However, although the diagnostic criteria for CD are well defined and described in specific guidelines, the monitoring of CD patients undergoing GFD has been less studied and, consequently, specific guidelines for this phase are still lacking. The aim of this report was to evaluate the classical tools used to monitor the adherence and response to GFD, other non-invasive biomarkers that have been proposed for CD monitoring, and the histological follow-up of CD patients in order to provide a starting point for future discussions on this specific topic.
乳糜泻(CD)是一种非常常见的免疫介导的肠病,是由遗传易感个体的饮食面筋和免疫系统相互作用引起的。免疫反应导致肠道损伤、吸收不良,并最终导致广泛的肠道和肠道外症状。根据目前的标准,乳糜泻的正确诊断需要初始阶段包括临床病例识别和血清学筛查,随着时间的推移,这一点变得越来越重要。在大多数成人和某些儿童中,诊断随后由肠道损伤的组织学证据确定为确认试验,通常在适当时期的无麸质饮食(GFD)后恢复正常。GFD后的临床缓解和循环抗体的消失进一步证实了诊断,并代表了改善生活质量和降低长期并发症风险的目标。然而,尽管CD的诊断标准在具体的指南中有很好的定义和描述,但对行GFD的CD患者的监测研究较少,因此,这一阶段的具体指南仍然缺乏。本报告的目的是评估用于监测GFD依从性和反应的经典工具,其他已提出的用于CD监测的非侵入性生物标志物,以及CD患者的组织学随访,以便为今后关于这一特定主题的讨论提供起点。
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引用次数: 0
The antibody repertoire of autoimmune sensory neuronopathies targets pathways of the innate and adaptive immune system. An autoantigenomic approach 自身免疫性感觉神经病变的抗体库靶向先天性和适应性免疫系统的途径。自体抗基因组方法
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-01-30 DOI: 10.1016/j.jtauto.2025.100277
Christian P. Moritz , Yannick Tholance , Nadia Boutahar , Coralie Borowczyk , Anne-Emmanuelle Berger , Stéphane Paul , Jean-Christophe Antoine , Jean-Philippe Camdessanché
Sensory neuronopathies (SNN) encompass diverse etiologies, with autoimmunity playing a major role through both cellular and humoral responses. To investigate the humoral autoantibody repertoire in autoimmune SNN, we conducted a retrospective cohort study using large Human Proteome-wide protein microarrays (HuProt 3.1, HuProt 4.0, ProtoArrays). We specifically analyzed immune system pathways targeted within the autoantigen repertoire (the autoantigenome). We included 131 participants: 44 patients with non-paraneoplastic autoimmune SNN (12 with anti-FGFR3 and/or anti-AGO antibodies), 8 with paraneoplastic SNN, and 79 controls. Findings were validated in an independent cohort of 16 SNN patients. Overrepresentation of immune-system-related proteins was assessed using the Reactome database, and serum levels of IFN-γ and IL-6 were measured with the Bio-Plex Pro™ Reagent Kit. Autoimmune SNN sera interact with significantly more immune system proteins than healthy controls (ProtoArrays: 271/863 vs. 14/863, HuProt: 112/1694 vs. 39/1694, both p < 0.0001). Overrepresentation was observed across all major immune sub-pathways, including innate and adaptive immune responses as well as cytokine signaling. Anti-FGFR3-positive SNN patients showed more frequent reactivity to immune system proteins than anti-FGFR3-negative ones. The independent SNN cohort validated the overrepresentation of targeted immune system pathways. Validation with dot blot and ELISA confirmed reactivity to TRIM21 and IL-6 and identified anti-IFN-γ-positive SNN patients. IFN-γ levels correlated weakly with levels of anti-IFN-γ antibodies (Pearson's r = 0.22, p = 0.03). We conclude that the antibody repertoire of autoimmune SNN targets pathways of the innate and adaptive immune system, potentially reflecting key disease-related immune pathways and highlighting the systemic role of immune dysregulation in SNN.
感觉神经病变(SNN)包括多种病因,自身免疫通过细胞和体液反应发挥主要作用。为了研究自身免疫性SNN中的体液自身抗体库,我们使用大型人类蛋白质组蛋白微阵列(HuProt 3.1, HuProt 4.0, ProtoArrays)进行了一项回顾性队列研究。我们专门分析了针对自身抗原库(自身抗基因组)的免疫系统途径。我们纳入了131名参与者:44名非副肿瘤自身免疫性SNN患者(12名具有抗fgfr3和/或抗ago抗体),8名副肿瘤SNN患者和79名对照组。研究结果在16例SNN患者的独立队列中得到验证。使用Reactome数据库评估免疫系统相关蛋白的过度表达,使用Bio-Plex Pro™试剂盒测量血清IFN-γ和IL-6水平。自身免疫SNN血清与免疫系统蛋白的相互作用明显多于健康对照组(ProtoArrays: 277 /863 vs. 14/863, HuProt: 112/1694 vs. 39/1694, p <;0.0001)。在所有主要的免疫亚通路中,包括先天和适应性免疫反应以及细胞因子信号传导,都观察到代表性过高。抗fgfr3阳性SNN患者对免疫系统蛋白的反应比抗fgfr3阴性SNN患者更频繁。独立SNN队列验证了靶向免疫系统途径的过度代表性。dot blot和ELISA验证了对TRIM21和IL-6的反应性,并鉴定出抗ifn -γ阳性SNN患者。IFN-γ水平与抗IFN-γ抗体水平呈弱相关(Pearson’s r = 0.22, p = 0.03)。我们得出结论,自身免疫性SNN的抗体库靶向先天性和适应性免疫系统的途径,可能反映了关键的疾病相关免疫途径,并突出了免疫失调在SNN中的全身性作用。
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引用次数: 0
Helicobacter mastomyrinus infection induces autoimmune hepatitis in mice 乳螺杆菌感染诱导小鼠自身免疫性肝炎
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-01-24 DOI: 10.1016/j.jtauto.2025.100275
Liqi Zhu , Yuanyuan Liang , Linghan Yang , Qihui Yang , Jun Yin , Tao Wang , Xiangming Xu , Quan Zhang

Background

Autoimmune hepatitis (AIH) is a chronic progressive liver disease caused by the immune system mistakenly attacking its own hepatocytes. The role of the gut microbiome in the pathogenesis and progression of AIH is of considerable significance. However, the dearth of suitable animal models has significantly constrained advancements in the pathogenesis and the development of therapeutic strategies for AIH. Helicobacter mastomyrinus (H. mastomyrinus, Hm) is a potentially zoonotic pathogenic microorganism capable of causing diseases of the enterohepatic system in rodent laboratory animals. Nevertheless, research on its role and mechanisms in causing liver disease is severely limited.

Methods

In this study, male BALB/c mice were infected with Hm isolate Hm-17, and were sacrificed at 4 w, 8 w, 14 w and 22 w after infection, respectively. The serum was collected for detecting a number of AIH indicators, including the aminotransferases level, IgG content and autoantibody level. Additionally, the liver tissue was examined for pathological analysis, fibrosis, bacterial content, and the distribution of immune cells.

Results

It was observed that the infection initially caused focal necrotizing hepatitis and subsequently progressed to interface hepatitis with lymphocyte/plasma cell infiltration, as well as hypergammaglobulinemia and autoantibody reactions, predominantly to Anti-nuclear and anti-smooth muscle antibodies. Furthermore, as the infection persisted, the mice exhibited a progressive increase in liver fibrosis and mild steatosis. Despite the maintenance of a low level of Hm colonization in the liver, there was a notable infiltrate of macrophages, T and B lymphocytes. In particular, the inflammatory foci in the Hm-infected liver were highly enriched for IL17+ cells.

Conclusion

The present study provides an animal model of immunological liver injury induced by Hm infection that exhibits main characteristics similar to those observed in AIH-1 patients. This model may serve as a novel animal model for the study of the pathogenesis and potential therapeutic strategies for human AIH.
自身免疫性肝炎(AIH)是一种由免疫系统错误攻击自身肝细胞引起的慢性进行性肝病。肠道菌群在AIH发病和进展中的作用具有相当重要的意义。然而,缺乏合适的动物模型极大地限制了AIH发病机制和治疗策略的发展。乳齿幽门螺杆菌(h.m ostomyrinus, Hm)是一种潜在的人畜共患病原微生物,能够引起啮齿动物的肠肝系统疾病。然而,对其在肝脏疾病中的作用和机制的研究严重有限。方法用Hm分离株Hm-17感染BALB/c雄性小鼠,分别于感染后4、8、14、22 w处死。采集血清检测多种AIH指标,包括转氨酶水平、IgG含量和自身抗体水平。此外,对肝组织进行病理分析、纤维化、细菌含量和免疫细胞分布的检查。结果观察到感染最初引起局灶性坏死性肝炎,随后发展为伴有淋巴细胞/浆细胞浸润的界面性肝炎,并伴有高γ球蛋白血症和自身抗体反应,主要是抗核抗体和抗平滑肌抗体。此外,随着感染的持续,小鼠表现出肝纤维化和轻度脂肪变性的进行性增加。尽管Hm在肝脏中的定植维持在低水平,但巨噬细胞、T淋巴细胞和B淋巴细胞的浸润也很明显。特别是,感染hm的肝脏炎症灶高度富集IL17+细胞。结论本研究提供了一种与AIH-1相似的Hm感染引起的免疫性肝损伤动物模型。该模型可作为研究人类AIH发病机制和潜在治疗策略的一种新的动物模型。
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引用次数: 0
Aberrant B cell receptor signaling responses in circulating double-negative 2 B cells from radiographic axial spondyloarthritis patients 轴性脊柱炎x线摄影患者循环双阴性B细胞异常B细胞受体信号反应
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-01-23 DOI: 10.1016/j.jtauto.2025.100270
Rick Wilbrink , Stefan F.H. Neys , Rudi W. Hendriks , Anneke Spoorenberg , Frans G.M. Kroese , Odilia B.J. Corneth , Gwenny M.P.J. Verstappen

Objective

Radiographic axial spondyloarthritis (r-axSpA) is a chronic rheumatic disease in which innate immune cells and T cells are thought to play a major role. However, recent studies also hint at B cell involvement. Here, we performed an in-depth analysis on alterations within the B-cell compartment from r-axSpA patients.

Methods

We performed immune gene expression profiling on total peripheral blood B cells from 8 r-axSpA patients and 8 healthy controls (HCs). Next, we explored B cell subset distribution and B-cell receptor (BCR) signaling responses in circulating B cells from 28 r-axSpA patients and 15 HCs, by measuring spleen tyrosine kinase, phosphoinositide 3-kinase and extracellular signal regulated kinase 1/2 phosphorylation upon α-Ig stimulation using phosphoflow cytometry.

Results

Immune gene expression profiling indicated an elevated pathway score for BCR signaling in total B cells from r-axSpA patients compared with HCs. Flow cytometric analysis revealed an increase in frequency of both total and double-negative 2 (DN2) B cells in r-axSpA patients compared with HCs. In r-axSpA patients, DN2 B cells displayed an isotype shift towards IgA. Remarkably, where DN2 B cells from HCs were hyporesponsive, these cells displayed significant proximal BCR signaling responses in r-axSpA patients. Enhanced BCR signaling responses were also observed in the transitional and naïve B cell population from r-axSpA patients compared with HCs. The enhanced BCR signaling responses in DN2 B cells correlated with clinical disease parameters.

Conclusion

In r-axSpA patients, circulating DN2 B cells are expanded and, together with transitional and naïve B cells, display significantly enhanced BCR signaling responses upon stimulation. Together, our data suggest B cell involvement in the pathogenesis of r-axSpA.
目的影像学中轴性脊柱炎(r-axSpA)是一种慢性风湿性疾病,先天免疫细胞和T细胞被认为在其中起主要作用。然而,最近的研究也暗示了B细胞的参与。在这里,我们对r-axSpA患者的b细胞室内的变化进行了深入分析。方法对8例r-axSpA患者和8例健康对照(hc)外周血总B细胞进行免疫基因表达谱分析。接下来,我们通过使用磷酸流式细胞术检测α-Ig刺激下脾脏酪氨酸激酶、磷酸肌肽3激酶和细胞外信号调节激酶1/2磷酸化,探讨了28例r-axSpA患者和15例hcc患者循环B细胞的B细胞亚群分布和B细胞受体(BCR)信号传导反应。结果免疫基因表达谱显示,与hc相比,r-axSpA患者总B细胞中BCR信号通路评分升高。流式细胞术分析显示,与hc相比,r-axSpA患者的总B细胞和双负2 (DN2) B细胞的频率均有所增加。在r-axSpA患者中,dn2b细胞表现出向IgA的同型转移。值得注意的是,当来自hc的DN2 B细胞反应低下时,这些细胞在r-axSpA患者中表现出显著的近端BCR信号反应。与hc相比,r-axSpA患者的过渡性和naïve B细胞群也观察到增强的BCR信号反应。DN2 B细胞BCR信号反应的增强与临床疾病参数相关。结论在r-axSpA患者中,循环DN2 B细胞扩增,并与过渡性和naïve B细胞一起,在刺激下表现出明显增强的BCR信号反应。总之,我们的数据表明B细胞参与了r-axSpA的发病机制。
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引用次数: 0
Tofacitinib downregulates JAK1 and JAK3 on human intestinal monocytes and macrophages without affecting dendritic cells phenotype or function 托法替尼下调人肠道单核细胞和巨噬细胞的JAK1和JAK3,而不影响树突状细胞的表型或功能
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-01-22 DOI: 10.1016/j.jtauto.2025.100271
Elisa Arribas-Rodríguez , Ángel De Prado , Beatriz de Andrés , Benito Velayos , Jesús Barrio , Alejandro Romero , Francisco Javier García-Alonso , Álvaro Martín-Muñoz , José A. Garrote , Eduardo Arranz , Luis Fernández-Salazar , David Bernardo

Background

Ulcerative colitis (UC) is an inflammatory disorder of the gastrointestinal tract. Although Tofacitinib, which inhibits the JAK1 and JAK3 signalling pathway, is approved to treat patients with UC, its specific mechanism of action remain elusive. Given the central role that conventional dendritic cells (cDC) elicit in gut homeostasis, we hypothesised that Tofacitinib acts modulating cDC function in UC.

Methods

Human biopsies were obtained from colon of controls, and patients with UC (active and quiescent). Lamina propria mononuclear cells (LPMC) were ex-vivo cultured in the presence/absence of Tofacitinib. The specific effect elicited over human intestinal cDC, monocytes and macrophages was assessed by flow cytometry. cDC were also enriched following Tofacitinib conditioning in order to assess its effect over naïve T-cells.

Results

Several human intestinal cDC, monocyte and macrophage subsets can be found in the human colon, with these cells being more similar between controls and patients with qUC referred to patients with aUC. Following ex-vivo culture, Tofacitinib downregulated JAK1 expression on intestinal monocytes from patients with both active and quiescent UC. As for macrophages, JAK1 was decreased on patients with active UC while JAK was downregulated on macrophages from patients with quiescent disease. Tofacitinib did not modulate the phenotype or function of human intestinal cDC.

Conclussion

Tofacitinib does not modulate the phenotype and function of human intestinal cDC in UC. On the contrary, it displays a differential capacity to modulate intestinal monocyte and macrophage phenotype. Future studies should address whether it also translates into a differential function of these cells.
背景溃疡性结肠炎(UC)是一种胃肠道炎症性疾病。尽管抑制JAK1和JAK3信号通路的Tofacitinib被批准用于治疗UC患者,但其具体的作用机制尚不清楚。鉴于传统树突状细胞(cDC)在肠道稳态中所起的核心作用,我们假设托法替尼在UC中调节cDC功能。方法对对照组和UC患者(活动性和静止性)进行结肠活检。在有或没有托法替尼的情况下,体外培养固有层单个核细胞(LPMC)。流式细胞术检测其对人肠道cDC、单核细胞和巨噬细胞的特异性作用。cDC也在托法替尼调理后富集,以评估其对naïve t细胞的影响。结果在人类结肠中可发现多种人类肠道cDC、单核细胞和巨噬细胞亚群,且这些细胞在对照组和qUC患者(即aUC患者)之间更为相似。在体外培养后,托法替尼下调了活性和静止UC患者肠道单核细胞中JAK1的表达。在巨噬细胞中,活动性UC患者的JAK1表达降低,而静止性UC患者的巨噬细胞中JAK1表达下调。托法替尼不调节人肠道cDC的表型或功能。结论托法替尼对UC患者肠道cDC的表型和功能无调节作用。相反,它在调节肠道单核细胞和巨噬细胞表型方面表现出不同的能力。未来的研究应该解决它是否也转化为这些细胞的差异功能。
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引用次数: 0
The added value of coupling anti-dsDNA and anti-chromatin antibodies in follow-up monitoring of systemic lupus erythematosus patients 偶联抗dsdna和抗染色质抗体在系统性红斑狼疮患者随访监测中的附加价值
IF 4.7 Q2 IMMUNOLOGY Pub Date : 2025-01-22 DOI: 10.1016/j.jtauto.2025.100274
Caroline Carlé , Françoise Fortenfant , Chloé Bost , Julie Belliere , Stanislas Faguer , Dominique Chauveau , Antoine Huart , David Ribes , Laurent Alric , Gregory Pugnet , Laurent Sailler , Yves Renaudineau

Objective

The autoimmune response to chromatin (Chr) or one of the nucleosome components (double stranded (ds)DNA and histones) is typically associated with the development of systemic lupus erythematosus (SLE). Related autoantibodies (Ab) are heterogeneous and, among them, anti-dsDNA Ab are part of the classification criteria and recommended for monitoring SLE with regards to lupus flares and therapy responses. However, anti-dsDNA Ab biomarker performances are weak; therefore, coupling anti-dsDNA with anti-Chr Ab can be proposed, which is the aim of this study.

Methods

In this single center study from 2009 to 2024, 269 SLE patients with follow-up information were retrospectively selected from a population of 646 individuals, including 325 SLE patients, who tested positive for anti-dsDNA and/or anti-Chr Ab (Bioplex 2200™). Bio-clinical information during follow-up were assessed at several time points through medical records in order to explore associations between the anti-dsDNA/Chr Ab profile with disease presentation, and anti-dsDNA/Chr Ab fluctuations with disease activity using clinical SLEDAI-2K, flares requiring specific treatment, and the therapeutic response.

Results

At inclusion in the follow-up analysis, corresponding to diagnosis (116/269, 43.1 %) or flare (153/269, 56.9 %), SLE patients were subdivided into three serological groups: the double positive dsDNA/Chr group (DP+, 190/269: 70.6 %), followed by the single positive Chr group (SP-C+, 42/269: 15.6 %), and the single positive dsDNA group (SP-D+, 37/269: 13.8 %). The DP + group, which presented important anti-dsDNA/Ab variations during follow-up, was at risk to develop lupus nephritis (56.8 % versus 2.4 % in SP-C+ and 29.7 % in SP-D+ groups, p < 0.04) and serositis (30 % versus 9.5 % in SP-C+ group, p = 0.006). During follow-up, anti-dsDNA and Chr Ab levels in the SP-C+ and SP-D+ groups remained stable over time irrespective of disease activity, flares, and therapeutic response. Regarding the DP + group, disease activity was correlated with both anti-dsDNA (RmCorr = 0.46, p = 1.6x110-91) and anti-Chr (RmCorr = 0.38, p = 2.8x10-60) Ab levels, which can be used to predict flares. Following therapy introduction, Ab reduction occurred in all patients from the DP + group with a more pronounced effect reported in complete responders.

Conclusion

coupling anti-dsDNA with anti-Chr Ab detection at disease initiation/flare allows definition of endotypes, which is useful to follow disease activity, predict lupus nephritis/serositis, and anticipate therapeutic response in the DP + group.
目的对染色质(Chr)或核小体成分(双链DNA和组蛋白)的自身免疫反应通常与系统性红斑狼疮(SLE)的发展有关。相关自身抗体(Ab)是异质性的,其中抗dsdna抗体是分类标准的一部分,推荐用于监测狼疮发作和治疗反应。然而,抗dsdna Ab生物标志物的性能较弱;因此,可以提出将抗dsdna与抗chr Ab偶联,这也是本研究的目的。方法在这项2009 - 2024年的单中心研究中,从646名患者中回顾性选择了269例SLE患者并提供随访信息,其中包括325例抗dsdna和/或抗chr Ab (Bioplex 2200™)阳性的SLE患者。随访期间的生物临床信息通过医疗记录在几个时间点进行评估,以探索抗dsdna /Chr Ab谱与疾病表现之间的关系,以及抗dsdna /Chr Ab波动与疾病活动之间的关系,使用临床SLEDAI-2K,需要特异性治疗的耀斑,以及治疗反应。结果在随访分析中,根据诊断(116/269,43.1%)或发作(153/269,56.9%),将SLE患者细分为3个血清学组:dsDNA/Chr双阳性组(DP+, 190/269: 70.6%),其次是单阳性组(SP-C+, 42/269: 15.6%)和单阳性组(SP-D+, 37/269: 13.8%)。DP +组在随访期间出现重要的抗dsdna /Ab变异,有发生狼疮性肾炎的风险(56.8%,SP-C+组为2.4%,SP-D+组为29.7%,p <;0.04)和血清炎(30% vs 9.5% SP-C+组,p = 0.006)。在随访期间,SP-C+和SP-D+组的抗dsdna和Chr Ab水平随着时间的推移保持稳定,而与疾病活动、发作和治疗反应无关。对于DP +组,疾病活动性与抗dsdna (RmCorr = 0.46, p = 1.6x110-91)和抗chr (RmCorr = 0.38, p = 2.8x10-60) Ab水平相关,可用于预测耀斑。在引入治疗后,DP +组的所有患者都出现了Ab减少,完全缓解者报告的效果更为明显。结论:在疾病开始/爆发时,结合抗dsdna和抗chr Ab检测可以确定内源性类型,这有助于跟踪疾病活动,预测狼疮性肾炎/浆膜炎,并预测DP +组的治疗反应。
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引用次数: 0
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Journal of Translational Autoimmunity
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