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Evaluation of SLE Susceptibility Genes in Malaysians. 马来西亚人SLE易感基因的评估。
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-02-18 DOI: 10.1155/2014/305436
Julio E Molineros, Kek Heng Chua, Celi Sun, Lay Hoong Lian, Prasenjeet Motghare, Xana Kim-Howard, Swapan K Nath

Systemic Lupus Erythematosus (SLE) is a clinically heterogeneous autoimmune disease with strong genetic and environmental components. Our objective was to replicate 25 recently identified SLE susceptibility genes in two distinct populations (Chinese (CH) and Malays (MA)) from Malaysia. We genotyped 347 SLE cases and 356 controls (CH and MA) using the ImmunoChip array and performed an admixture corrected case-control association analysis. Associated genes were grouped into five immune-related pathways. While CH were largely homogenous, MA had three ancestry components (average 82.3% Asian, 14.5% European, and 3.2% African). Ancestry proportions were significantly different between cases and controls in MA. We identified 22 genes with at least one associated SNP (P < 0.05). The strongest signal was at HLA-DRA (P Meta = 9.96 × 10(-9); P CH = 6.57 × 10(-8), P MA = 6.73 × 10(-3)); the strongest non-HLA signal occurred at STAT4 (P Meta = 1.67 × 10(-7); P CH = 2.88 × 10(-6), P MA = 2.99 × 10(-3)). Most of these genes were associated with B- and T-cell function and signaling pathways. Our exploratory study using high-density fine-mapping suggests that most of the established SLE genes are also associated in the major ethnicities of Malaysia. However, these novel SNPs showed stronger association in these Asian populations than with the SNPs reported in previous studies.

系统性红斑狼疮(SLE)是一种临床异质性自身免疫性疾病,具有很强的遗传和环境因素。我们的目标是在马来西亚两个不同的人群(华人(CH)和马来人(MA))中复制25个最近发现的SLE易感基因。我们使用免疫芯片阵列对347例SLE病例和356例对照(CH和MA)进行了基因分型,并进行了混合校正的病例-对照关联分析。将相关基因分为5种免疫相关通路。虽然CH在很大程度上是同质的,但MA有三种血统组成(平均82.3%的亚洲人,14.5%的欧洲人和3.2%的非洲人)。MA病例和对照组的血统比例有显著差异。我们发现22个基因至少有一个相关SNP (P < 0.05)。HLA-DRA信号最强(P Meta = 9.96 × 10(-9);pch = 6.57 × 10(-8), pma = 6.73 × 10(-3));最强的非hla信号发生在STAT4 (P Meta = 1.67 × 10(-7);pch = 2.88 × 10(-6), pma = 2.99 × 10(-3))。这些基因大多与B细胞和t细胞功能和信号通路有关。我们使用高密度精细定位的探索性研究表明,大多数已建立的SLE基因也与马来西亚的主要种族相关。然而,这些新的snp在这些亚洲人群中显示出比以往研究中报道的snp更强的相关性。
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引用次数: 8
Differential immunotoxicity induced by two different windows of developmental trichloroethylene exposure. 发育期接触三氯乙烯的两个不同窗口诱发的不同免疫毒性。
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-02-20 DOI: 10.1155/2014/982073
Kathleen M Gilbert, William Woodruff, Sarah J Blossom

Developmental exposure to environmental toxicants may induce immune system alterations that contribute to adult stage autoimmune disease. We have shown that continuous exposure of MRL+/+ mice to trichloroethylene (TCE) from gestational day (GD) 0 to postnatal day (PND) 49 alters several aspects of CD4(+) T cell function. This window of exposure corresponds to conception-adolescence/young adulthood in humans. More narrowly defining the window of TCE developmental exposure causes immunotoxicity that would establish the stage at which avoidance and/or intervention would be most effective. The current study divided continuous TCE exposure into two separate windows, namely, gestation only (GD0 to birth (PND0)) and early-life only (PND0-PND49). The mice were examined for specific alterations in CD4(+) T cell function at PND49. One potentially long-lasting effect of developmental exposure, alterations in retrotransposon expression indicative of epigenetic alterations, was found in peripheral CD4(+) T cells from both sets of developmentally exposed mice. Interestingly, certain other effects, such as alterations in thymus cellularity, were only found in mice exposed to TCE during gestation. In contrast, expansion of memory/activation cell subset of peripheral CD4(+) T cells were only found in mice exposed to TCE during early life. Different windows of developmental TCE exposure can have different functional consequences.

发育过程中暴露于环境有毒物质可能会诱发免疫系统的改变,从而导致成年阶段的自身免疫性疾病。我们已经证明,MRL+/+小鼠从妊娠0天到出生后49天持续暴露于三氯乙烯(TCE)会改变CD4(+)T细胞功能的多个方面。这一暴露窗口期相当于人类从受孕到青春期/青年期。更严格地定义三氯乙烯发育期暴露窗口期会导致免疫毒性,从而确定避免和/或干预最有效的阶段。目前的研究将连续接触三氯乙烷分为两个不同的窗口期,即妊娠期(GD0 至出生 (PND0))和生命早期(PND0-PND49)。在PND49时,对小鼠进行CD4(+)T细胞功能特定改变的检测。在两组发育暴露小鼠的外周 CD4(+)T 细胞中都发现了发育暴露的一种潜在持久效应,即逆转录转座子表达的改变,表明存在表观遗传学改变。有趣的是,只有在妊娠期接触三氯乙烷的小鼠中才会发现某些其他影响,如胸腺细胞的改变。相反,外周 CD4(+)T 细胞记忆/激活细胞亚群的扩增只在早期暴露于 TCE 的小鼠中发现。暴露于三氯乙烯的不同发育窗口期会产生不同的功能性后果。
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引用次数: 0
Silent Burdens in Disease: Fatigue and Depression in SLE. 疾病中的隐性负担:SLE患者的疲劳和抑郁。
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-01-28 DOI: 10.1155/2014/790724
R Fonseca, M Bernardes, G Terroso, M de Sousa, M Figueiredo-Braga

At a time when health is being recognized as more than just avoiding death, age and comorbidity are becoming increasingly important aspects of chronic disease. Systemic Lupus Erythematous (SLE) is probably one of the best paradigms of modern chronic disease, sitting at the crossroads of numerous somatic health problems, immune activation, depression, pain, and fatigue. One hundred forty-eight female participants were enrolled in the present study: 50 diagnosed with SLE, 45 with major depressive disorder (MDD), and 53 age-matched controls. Statistically significant lower scores in quality-of-life dimensions related to physical impairment were found in SLE. Patients with MDD presented significant levels of pain, reduced physical summary component (PSC), and general health scores different from healthy controls. Fatigue was reported in 90% of women with SLE and 77.8% of the MDD patients in contrast with 39.6% in the control group. Significant correlations were seen among fatigue severity, age, and educational level in SLE. From our own previous work and more recent work on the association of immune activation and depression, unexplained fatigue in SLE may signify an early sign of immune activation flare-up. The search for cytokine markers should perhaps be extended to fatigue in SLE.

在人们认识到健康不仅仅是避免死亡的时候,年龄和合并症正日益成为慢性病的重要方面。系统性红斑狼疮(SLE)可能是现代慢性疾病的最佳范例之一,处于许多躯体健康问题、免疫激活、抑郁、疼痛和疲劳的十字路口。148名女性参与者参加了本研究:50名诊断为SLE, 45名诊断为重度抑郁症(MDD), 53名年龄匹配的对照组。SLE患者在与身体损害相关的生活质量维度上得分较低。重度抑郁症患者表现出明显的疼痛水平,身体综合成分(PSC)减少,总体健康评分与健康对照组不同。90%的SLE女性和77.8%的重度抑郁症患者报告了疲劳,而对照组为39.6%。SLE患者的疲劳程度、年龄和受教育程度之间存在显著相关性。从我们自己之前的工作和最近关于免疫激活和抑郁关联的工作来看,SLE中不明原因的疲劳可能意味着免疫激活爆发的早期迹象。对细胞因子标志物的研究也许应该扩展到SLE患者的疲劳。
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引用次数: 44
Potential Sources and Roles of Adaptive Immunity in Age-Related Macular Degeneration: Shall We Rename AMD into Autoimmune Macular Disease? 适应性免疫在年龄相关性黄斑变性中的潜在来源和作用:我们是否应该将AMD重新命名为自身免疫性黄斑疾病?
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-04-30 DOI: 10.1155/2014/532487
Serge Camelo

Age-related macular degeneration (AMD) is the leading cause of vision loss in the elderly throughout the industrialized world. Its most prominent pathologic features are lesions involving the retinal pigment epithelium (RPE) the Bruch's membrane, the degeneration of photoreceptors, and, in the most aggressive cases, choroidal neovascularization. Genetic associations between the risk of developing AMD and polymorphism within components of the complement system, as well as chemokine receptors expressed on microglial cells and macrophages, have linked retinal degeneration and choroidal neovascularization to innate immunity (inflammation). In addition to inflammation, players of the adaptive immunity including cytokines, chemokines, antibodies, and T cells have been detected in animal models of AMD and in patients suffering from this pathology. These observations suggest that adaptive immunity might play a role in different processes associated with AMD such as RPE atrophy, neovascularization, and retinal degeneration. To this date however, the exact roles (if any) of autoantibodies and T cells in AMD remain unknown. In this review we discuss the potential effects of adaptive immune responses in AMD pathogenesis.

年龄相关性黄斑变性(AMD)是整个工业化世界中老年人视力丧失的主要原因。其最突出的病理特征是视网膜色素上皮(RPE)、布鲁氏膜的病变、光感受器的变性,在最严重的病例中,脉络膜新生血管。发生AMD的风险与补体系统组分多态性以及小胶质细胞和巨噬细胞上表达的趋化因子受体之间的遗传关联,将视网膜变性和脉络膜新生血管与先天免疫(炎症)联系起来。除了炎症外,适应性免疫的参与者包括细胞因子、趋化因子、抗体和T细胞,已经在AMD动物模型和患有这种病理的患者中被检测到。这些观察结果表明,适应性免疫可能在与AMD相关的不同过程中发挥作用,如RPE萎缩、新生血管形成和视网膜变性。然而,到目前为止,自身抗体和T细胞在AMD中的确切作用(如果有的话)仍然未知。在这篇综述中,我们讨论适应性免疫反应在AMD发病机制中的潜在作用。
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引用次数: 57
Role of hla-B alleles and clinical presentation of b27 negative spondyloarthritis patients from mumbai, Western India. 印度西部孟买b27阴性脊柱炎患者hla-B等位基因的作用和临床表现
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-03-06 DOI: 10.1155/2014/327315
Devaraj J Parasannanavar, Anjali Rajadhyaksha, Kanjaksha Ghosh

Seronegative spondyloarthritis (SpA) are variably associated with HLA-B∗27 antigen. HLA-B∗27 negative SpA has also been reported from different parts of the world. There is paucity of data on this entity from Indian subcontinent. We studied 100 consecutively diagnosed HLA-B27 negative spondyloarthritis patients from a tertiary care center in India. Modified New York Criteria for ankylosing spondylitis (AS) and ESSG criteria for SpA were used for diagnosing patients. HLA-B∗27 typing was done by an in-house PCR-SSP technique in SpA patients to exclude B∗27 positive patients and PCR-SSOP technique was used to type 100 B∗27 negative SpA patients and 100 controls from the same ethnicity. Frequency of B∗07 was significantly increased (B∗07: % PF 54 versus 18; OR 5.348; 95% CI 2.808-10.186; P value 1.14E - 07), whereas frequency of B∗40 was significantly decreased (B∗40: % PF 17 versus 32; OR 0.435; 95% CI 0.222-0.850; P value 0.013) when compared with B∗27 negative controls. Among 100 SpA patients, 47 were undifferentiated spondyloarthritis and 33 patients were reactive arthritis patients. 40% of the patients were suffering from polyarticular arthritis, 35% had pauciarticular arthritis with knee joint, hip joint, ankle joint, and SI joint involvement. We conclude that B∗07 was significantly associated with B27 negative spondyloarthropathy from Western India and majority of B∗27 negative patients were uSpA.

血清阴性脊柱性关节炎(SpA)与HLA-B * 27抗原有不同的相关性。HLA-B * 27阴性SpA在世界各地也有报道。印度次大陆关于这一实体的数据缺乏。我们研究了100名来自印度三级保健中心的连续诊断的HLA-B27阴性脊柱炎患者。强直性脊柱炎(AS)的修正纽约标准和SpA的ESSG标准用于诊断患者。采用内部PCR-SSP技术对SpA患者进行HLA-B∗27分型,以排除B∗27阳性患者,并使用PCR-SSOP技术对100名B∗27阴性SpA患者和100名来自同一种族的对照组进行分型。B∗07的频率显著增加(B∗07:% PF 54 vs 18;或5.348;95% ci 2.808-10.186;P值1.14E - 07),而B∗40的频率显著降低(B∗40:% PF 17 vs . 32;或0.435;95% ci 0.222-0.850;P值0.013),与B * 27阴性对照比较。100例SpA患者中,未分化性脊柱炎47例,反应性关节炎33例。40%的患者患有多关节关节炎,35%的患者患有膝关节、髋关节、踝关节和骶髂关节受累的少关节关节炎。我们得出结论,B∗07与来自西印度的B27阴性脊柱关节病显著相关,并且大多数B∗27阴性患者为uSpA。
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引用次数: 5
Role of autoimmune responses in periodontal disease. 自身免疫反应在牙周病中的作用。
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-05-25 DOI: 10.1155/2014/596824
Soumya Nair, Mohamed Faizuddin, Jayanthi Dharmapalan

Periodontal diseases are characterized by localized infections and inflammatory conditions that directly affect teeth supporting structures which are the major cause of tooth loss. Several studies have demonstrated the involvement of autoimmune responses in periodontal disease. Evidences of involvement of immunopathology have been reported in periodontal disease. Bacteria in the dental plaque induce antibody formation. Autoreactive T cells, natural killer cells, ANCA, heat shock proteins, autoantibodies, and genetic factors are reported to have an important role in the autoimmune component of periodontal disease. The present review describes the involvement of autoimmune responses in periodontal diseases and also the mechanisms underlying these responses. This review is an attempt to throw light on the etiopathogenesis of periodontal disease highlighting the autoimmunity aspect of the etiopathogenesis involved in the initiation and progression of the disease. However, further clinical trials are required to strengthen the role of autoimmunity as a cause of periodontal disease.

牙周病的特点是局部感染和炎症,直接影响牙齿的支撑结构,是牙齿脱落的主要原因。多项研究表明,牙周病与自身免疫反应有关。有报道称牙周病涉及免疫病理学。牙菌斑中的细菌会诱导抗体的形成。据报道,自反应 T 细胞、自然杀伤细胞、ANCA、热休克蛋白、自身抗体和遗传因素在牙周病的自身免疫成分中起着重要作用。本综述介绍了牙周病中自身免疫反应的参与情况以及这些反应的机制。本综述试图揭示牙周病的病因发病机制,强调病因发病机制中的自身免疫参与了牙周病的发生和发展。然而,要加强自身免疫作为牙周病病因的作用,还需要进一步的临床试验。
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引用次数: 0
Neuroantibody biomarkers: links and challenges in environmental neurodegeneration and autoimmunity. 神经抗体生物标志物:环境神经变性和自身免疫的联系和挑战。
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-06-23 DOI: 10.1155/2014/340875
Hassan A N El-Fawal

The majority of neurodegenerative (ND) and autoimmune diseases (AID) remain idiopathic. The contribution of environmental chemicals to the development of these disorders has become of great interest in recent years. A convergence of mechanism between of ND and AID development has also emerged. In the case of ND, including neurotoxicity, the focus of this review, work over the last two decade in the realm of biomarker development, indicates that the immune response provides a venue whereby humoral immunity, in the form of autoantibodies to nervous system specific proteins, or neuroantibodies (NAb), may provide, once validated, a sensitive high throughput surrogate biomarker of effect with the potential of predicting outcome in absence of overt neurotoxicity/neurodegeneration. In addition, NAb may prove to be a contributor to the progression of the nervous system pathology, as well as biomarker of stage and therapeutic efficacy. There is a compelling need for biomarkers of effect in light of the introduction of new chemicals, such as nanoengineered material, where potential neurotoxicity remains to be defined. Furthermore, the convergence of mechanisms associated with ND and AID draws attention to the neglected arena of angiogenesis in defining the link between environment, ND, and AID.

大多数神经退行性疾病(ND)和自身免疫性疾病(AID)仍然是特发性的。近年来,环境化学物质对这些疾病发展的贡献引起了极大的兴趣。新发展与国际援助发展之间也出现了一种趋同机制。在ND的情况下,包括神经毒性,这篇综述的重点,在生物标志物开发领域的工作,在过去的二十年中,表明免疫反应提供了一个场所,体液免疫,以神经系统特异性蛋白质的自身抗体或神经抗体(NAb)的形式,可能提供,一旦验证,一个敏感的高通量替代生物标志物的作用,具有预测结果的潜力,没有明显的神经毒性/神经变性。此外,NAb可能是神经系统病理进展的一个贡献者,也是分期和治疗效果的生物标志物。鉴于新化学物质(如纳米工程材料)的引入,潜在的神经毒性仍有待确定,因此迫切需要有效的生物标志物。此外,与ND和AID相关的机制的趋同使人们注意到在定义环境、ND和AID之间的联系时被忽视的血管生成领域。
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引用次数: 8
Prevalence of thyroid autoimmunity in children with celiac disease compared to healthy 12-year olds. 与12岁健康儿童相比,乳糜泻儿童甲状腺自身免疫患病率
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-01-27 DOI: 10.1155/2014/417356
Maria van der Pals, Anneli Ivarsson, Fredrik Norström, Lotta Högberg, Johan Svensson, Annelie Carlsson

Objectives. Studies have suggested a correlation between untreated celiac disease and risk for other autoimmune diseases. We investigated the prevalence of thyroid autoimmunity in 12-year-old children (i) with symptomatic celiac disease diagnosed and treated with a gluten-free diet, (ii) with screening-detected untreated celiac disease, and (iii) without celiac disease. Methods. Blood samples from 12632 children were collected. All celiac disease cases, previously diagnosed and newly screening-detected, were identified. Per case, 4 referents were matched. Blood samples were analyzed for autoantibodies against thyroid peroxidase (TPOAb). The cut-off value for TPO positivity was set to 100 U/mL. Results. Altogether, 335 celiac disease cases were found. In the entire celiac disease group, 7.2% (24/335) had elevated titers of TPOAb compared to 2.8% (48/1695) of the referents. Among the previously diagnosed celiac disease cases, 7.5% (7/93, OR 2.8, 95% CI 1.2-6.4) was TPOAb positive and among screening-detected cases, 7.0% (17/242, OR 2.6, 95% CI 1.5-4.6) was TPOAb positive. Conclusion. Children with celiac disease showed a higher prevalence of thyroid autoimmunity. We could not confirm the hypothesis that untreated celiac disease is associated with increased risk of developing thyroid autoimmunity. Early initiation of celiac disease treatment might not lower the risk for other autoimmune diseases.

目标。研究表明,未经治疗的乳糜泻与其他自身免疫性疾病的风险之间存在相关性。我们调查了12岁儿童甲状腺自身免疫的患病率(1)诊断并使用无麸质饮食治疗的有症状的乳糜泻,(2)筛查发现的未治疗的乳糜泻,以及(3)没有乳糜泻。方法。收集了12632名儿童的血液样本。所有乳糜泻病例,既往诊断和新筛查发现,被确定。每个病例匹配4个参照物。分析血样中抗甲状腺过氧化物酶(TPOAb)的自身抗体。TPO阳性临界值设为100 U/mL。结果。总共发现了335例乳糜泻病例。在整个乳糜泻组中,7.2%(24/335)的参试者TPOAb滴度升高,而2.8%(48/1695)的参试者TPOAb滴度升高。在先前诊断的乳糜泻病例中,7.5% (7/93,OR 2.8, 95% CI 1.2-6.4)为TPOAb阳性,在筛查检测的病例中,7.0% (17/242,OR 2.6, 95% CI 1.5-4.6)为TPOAb阳性。结论。乳糜泻患儿甲状腺自身免疫的患病率较高。我们不能证实未经治疗的乳糜泻与甲状腺自身免疫风险增加有关的假设。早期开始治疗乳糜泻可能不会降低其他自身免疫性疾病的风险。
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引用次数: 30
Chronic exposure to oral pathogens and autoimmune reactivity in acute coronary atherothrombosis. 慢性暴露于口腔病原体和自身免疫反应急性冠状动脉粥样硬化血栓形成。
IF 4 Q4 IMMUNOLOGY Pub Date : 2014-01-01 Epub Date: 2014-02-25 DOI: 10.1155/2014/613157
Ivana Burazor, Aristo Vojdani

Background. It has been hypothesized that various infective agents may activate immune reactions as part of the atherosclerotic process. We aimed to investigate the interrelationship between chronic exposure to oral pathogens and immune-inflammatory response in patients with acute coronary atherothrombosis. Patients and Methods. The study included 200 participants from Serbia: 100 patients with acute myocardial infarction (MI), and 100 age- and sex-matched controls. Antibodies to oral anaerobes and aerobes were determined as well as autoantibodies to endothelial cells, beta-2 glycoprotein I, platelet glycoprotein IIb/IIIa and anticardiolipin. Interleukin-6 (IL-6) and C-reactive protein (CRP) were measured. Results. The mean serum antibodies to oral anaerobes tended to be higher among subjects with MI (0.876 ± 0.303 versus 0.685 ± 0.172 OD, P < 0.001). Similarly, antibody levels against oral aerobes in patients were significantly different from controls. Antibodies against endothelial cell, beta-2 glycoprotein I, platelet glycoprotein IIb/IIIa, anticardiolipin along with CRP and IL-6 were highly elevated in patients. The levels of antibodies to oral bacteria showed linear correlation with tissue antibodies, CRP and IL-6. Conclusion. Antibody response to chronic oral bacterial infections and host immune response against them may be responsible for the elevation of tissue antibodies and biomarkers of inflammation which are involved in acute coronary thrombosis development.

背景。据推测,各种感染因子可能激活免疫反应作为动脉粥样硬化过程的一部分。我们的目的是研究慢性暴露于口腔病原体和急性冠状动脉粥样硬化患者免疫炎症反应之间的相互关系。患者和方法。该研究包括来自塞尔维亚的200名参与者:100名急性心肌梗死(MI)患者和100名年龄和性别匹配的对照组。检测对口腔厌氧菌和需氧菌的抗体以及内皮细胞、β -2糖蛋白I、血小板糖蛋白IIb/IIIa和抗心磷脂的自身抗体。检测白细胞介素-6 (IL-6)、c反应蛋白(CRP)水平。结果。心肌梗死患者血清中口腔厌氧菌抗体的平均值较高(0.876±0.303 vs 0.685±0.172 OD, P < 0.001)。同样,患者的口腔需氧菌抗体水平也明显不同于对照组。抗内皮细胞抗体、β -2糖蛋白I、血小板糖蛋白IIb/IIIa、抗心磷脂以及CRP和IL-6在患者中高度升高。口腔细菌抗体水平与组织抗体、CRP、IL-6呈线性相关。结论。慢性口腔细菌感染的抗体反应和宿主对它们的免疫反应可能是导致组织抗体和炎症生物标志物升高的原因,这些炎症生物标志物参与急性冠状动脉血栓形成的发展。
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引用次数: 6
Rheumatoid arthritis. 类风湿性关节炎。
IF 4 Q4 IMMUNOLOGY Pub Date : 2013-01-01 Epub Date: 2013-11-28 DOI: 10.1155/2013/958437
Daniela Melchiorre, Anna Maria Iagnocco, Suchitra Acharya, Guglielmina Pepe, Marco Borderi
Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. The most common signs and symptoms are pain, swelling, and stiffness of the joints. Small joints in the hands and feet are involved most often, although larger joints (such as the shoulders, hips, and knees) may become involved later in the disease. Joints are typically affected in a symmetrical pattern; for example, if joints in the hand are affected, both hands tend to be involved. People with rheumatoid arthritis often report that their joint pain and stiffness is worse when getting out of bed in the morning or after a long rest.
{"title":"Rheumatoid arthritis.","authors":"Daniela Melchiorre,&nbsp;Anna Maria Iagnocco,&nbsp;Suchitra Acharya,&nbsp;Guglielmina Pepe,&nbsp;Marco Borderi","doi":"10.1155/2013/958437","DOIUrl":"https://doi.org/10.1155/2013/958437","url":null,"abstract":"Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. The most common signs and symptoms are pain, swelling, and stiffness of the joints. Small joints in the hands and feet are involved most often, although larger joints (such as the shoulders, hips, and knees) may become involved later in the disease. Joints are typically affected in a symmetrical pattern; for example, if joints in the hand are affected, both hands tend to be involved. People with rheumatoid arthritis often report that their joint pain and stiffness is worse when getting out of bed in the morning or after a long rest.","PeriodicalId":46314,"journal":{"name":"Autoimmune Diseases","volume":"2013 ","pages":"958437"},"PeriodicalIF":4.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/958437","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31981455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Autoimmune Diseases
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