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Exploring the role of gut microbiome in autoimmune diseases: A comprehensive review 探索肠道微生物组在自身免疫性疾病中的作用:综述。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.autrev.2024.103654
As the industrialized society advances, there has been a gradual increase in the prevalence of autoimmune disorders. A probe into the fundamental causes has disclosed several factors in modern society that have an influence on the gut microbiome. These dramatic shifts in the gut microbiome are likely to be one of the reasons for the disarray in the immune system, and the relationship between the immune system and the gut microbiome emerging as a perennial hot topic of research. This review enumerates the findings from sequencing studies of gut microbiota on seven autoimmune diseases (ADs): Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE), Ankylosing Spondylitis (AS), Systemic Sclerosis (SSc), Sjögren's Syndrome (SjS), Juvenile Idiopathic Arthritis (JIA), and Behçet's Disease (BD). It aims to identify commonalities in changes in the gut microbiome within the autoimmune disease cohort and characteristics specific to each disease. The dysregulation of the gut microbiome involves a disruption of the internal balance and the balance between the external environment and the host. This dysregulation impacts the host's immune system, potentially playing a role in the development of ADs. Damage to the gut epithelial barrier allows potential pathogens to translocate to the mucosal layer, contacting epithelial cells, disrupting tight junctions, and being recognized by antigen-presenting cells, which triggers an immune response. Primed T-cells assist B-cells in producing antibodies against pathogens; if antigen mimicry occurs, an immune response is generated in extraintestinal organs during immune cell circulation, clinically manifesting as ADs. However, current research is limited; advancements in sequencing technology, large-scale cohort studies, and fecal microbiota transplantation (FMT) research are expected to propel this field to new peaks.
随着工业化社会的发展,自身免疫性疾病的发病率逐渐上升。对其根本原因的调查显示,现代社会中有几个因素对肠道微生物组产生了影响。肠道微生物组的这些剧烈变化很可能是导致免疫系统混乱的原因之一,而免疫系统与肠道微生物组之间的关系也成为一个长期的研究热点。本综述列举了有关七种自身免疫性疾病(ADs)的肠道微生物群测序研究结果:类风湿关节炎(RA)、系统性红斑狼疮(SLE)、强直性脊柱炎(AS)、系统性硬化症(SSc)、斯约格伦综合征(SjS)、幼年特发性关节炎(JIA)和白塞氏病(BD)。该研究旨在确定自身免疫性疾病队列中肠道微生物组变化的共性以及每种疾病的特性。肠道微生物组的失调会破坏内部平衡以及外部环境与宿主之间的平衡。这种失调会影响宿主的免疫系统,有可能导致急性肠道疾病的发生。肠道上皮屏障受损会使潜在病原体转移到粘膜层,接触上皮细胞,破坏紧密连接,并被抗原递呈细胞识别,从而引发免疫反应。被激活的 T 细胞协助 B 细胞产生针对病原体的抗体;如果发生抗原模仿,则在免疫细胞循环过程中,肠外器官会产生免疫反应,在临床上表现为 ADs。然而,目前的研究还很有限;测序技术、大规模队列研究和粪便微生物群移植(FMT)研究的进步有望将这一领域推向新的高峰。
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引用次数: 0
Prevention of rheumatoid arthritis using a familial predictive medicine approach 利用家族预测医学方法预防类风湿关节炎。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.autrev.2024.103653
Most of the chronic-degenerative diseases deserve a very early recognition of symptoms and signs for the earliest secondary prevention, which could be also very useful in many cases for the most precocious clinical approach. The periodic monitoring of a subject at risk of a specific disease, because of genomic predisposition by predictive medicine approach, may help to earlier detection of onset and/or the progression of the pathology itself, through intra-individual monitoring. This is particularly the case of rheumatoid arthritis (RA) for which an early diagnosis is undoubtedly the first step to ensure the most proper therapy for the patient. Thus, the earlier identification of individuals at high risk of RA could lead to ultra-preventive strategies to start for the best lifestyle performances and/or for any other effective therapeutic interventions to contrast the onset, and/or the evolution of the putative RA. This will also optimize both costs and medical resources, according to the health care policies of many countries.
大多数慢性退行性疾病都需要及早发现症状和体征,以便尽早进行二级预防,这在许多情况下也非常有助于采取最早熟的临床方法。通过预测医学的方法,定期监测因基因组易感性而面临特定疾病风险的受试者,有助于通过个体内部监测,更早地发现疾病的发病和/或进展。类风湿性关节炎(RA)的情况尤其如此,早期诊断无疑是确保为患者提供最适当治疗的第一步。因此,及早发现类风湿性关节炎的高危人群,可以采取超强预防策略,开始最佳的生活方式和/或任何其他有效的治疗干预措施,以对比类风湿性关节炎的发病和/或演变。根据许多国家的医疗保健政策,这还将优化成本和医疗资源。
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引用次数: 0
Impact of non-immunosuppressive medical therapy on disease progression and complications of Takayasu arteritis: A narrative review 非免疫抑制药物疗法对高安动脉炎疾病进展和并发症的影响:叙述性综述。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.autrev.2024.103656
Takayasu's arteritis is a rare large vessel vasculitis typically affecting young Asian women. It causes inflammation of the aorta and its major branches, leading to stenosis and aneurysmal dilations, and increasing cardiovascular morbidity due to accelerated atherosclerosis. Although glucocorticoids are effective for acute disease control and preliminary data on immunosuppressive drugs are promising, standardized treatment protocols are lacking. The use of prophylactic treatments with antihypertensives, antiplatelets, anticoagulants, and lipid-lowering drugs to prevent thrombotic and ischemic complications remains debated. This study reviews the evidence on the effectiveness of non-immunosuppressive medical therapy in Takayasu's arteritis. A search of the PubMed database identified eleven studies involving 204 patients. Antiplatelets: data on 68 patients were mixed, in fact low-dose aspirin did not prevent major cardiovascular events in 36 patients, but higher doses reduced ischemic complications in 24 patients. Anticoagulants: no data on new oral anticoagulants were available, and vitamin K antagonists in 9 patients did not alter cardiovascular complications. Antihypertensives: ACE-inhibitors controlled blood pressure in patients with renovascular hypertension but increased the risk of acute renal function decline, while β-blockers reduced the symptoms and the progression of myocardial hypertrophy in patients with heart failure and aortic regurgitation. Statins: data from two cohorts showed that while statins reduced the recurrence rate of arteritis in 30 patients, they did not affect recurrence rates or cardiovascular complications in 13 patients. Overall, current evidence, although not definitive, supports the use of non-immunosuppressive medical treatments to prevent long-term complications and damage in Takayasu's arteritis, considering the disease's pathophysiological mechanisms and increased cardiovascular risk. Further research is strongly encouraged.
高安氏动脉炎是一种罕见的大血管炎,主要影响亚洲年轻女性。它会引起主动脉及其主要分支的炎症,导致主动脉狭窄和动脉瘤扩张,并因动脉粥样硬化加速而增加心血管疾病的发病率。虽然糖皮质激素能有效控制急性疾病,免疫抑制剂的初步数据也很有希望,但目前还缺乏标准化的治疗方案。使用降压药、抗血小板药、抗凝药和降脂药预防性治疗以防止血栓和缺血性并发症的问题仍存在争议。本研究回顾了非免疫抑制药物疗法对高安动脉炎疗效的证据。在PubMed数据库中搜索到了11项研究,涉及204名患者。抗血小板药物:68名患者的数据参差不齐,事实上低剂量阿司匹林不能预防36名患者的主要心血管事件,但高剂量阿司匹林可减少24名患者的缺血性并发症。抗凝剂:没有关于新型口服抗凝剂的数据,9 名患者服用维生素 K 拮抗剂没有改变心血管并发症。降压药:ACE 抑制剂可控制新血管性高血压患者的血压,但会增加急性肾功能衰退的风险,而 β 受体阻滞剂可减轻心力衰竭和主动脉瓣反流患者的症状和心肌肥厚的进展。他汀类药物:来自两个队列的数据显示,虽然他汀类药物降低了 30 名患者的动脉炎复发率,但对 13 名患者的复发率或心血管并发症没有影响。总之,考虑到高安氏动脉炎的病理生理机制和心血管风险的增加,目前的证据虽然并不确定,但支持使用非免疫抑制药物治疗来预防该病的长期并发症和损害。我们强烈鼓励开展进一步的研究。
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引用次数: 0
Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019 炎症性肠病的全球患病率、残疾调整寿命年数和趋势及其与社会人口指数的相关性分析:1990 年至 2019 年的数据。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-02 DOI: 10.1016/j.autrev.2024.103655

Background

Inflammatory bowel disease (IBD) is a kind of chronic inflammatory disorders of the gastrointestinal tract with diverse prevalence rates and patterns globally. Accurate comprehension of the disease's epidemiological characteristics is imperative for disease control and prevention all over the world.

Objective

To provide the most updated estimates on the global burden of IBD using the 2019 Global Burden of Disease (GBD) study data, to systematically analyze the IBD epidemiological characteristics at the global, regional, and national levels including the prevalence, incidence, and disability-adjusted life years (DALY) rates, and to analyze the correlations of the socioeconomic development level with IBD epidemiological characteristics.

Methods

We conducted an overall analysis of the global, regional, and national burden of IBD from 1990 to 2019, data from the 2019 GBD study. The GBD's classification of the world into 21 regions and 204 countries and territories facilitated a thorough examination. Age-standardized estimated annual percentage changes (EAPCs) were computed to assess the temporal trends in IBD age-standardized rates (ASRs), with age standardization employed to mitigate potential confounding effects from age structure. The sociodemographic Index (SDI) was used to correlate the socioeconomic development level with the epidemiological characteristics of IBD.

Results

From 1990 to 2019, the global age-standardized prevalence, incidence, and DALY rates of IBD remained high. There was a slight downward trend in the global age-standardized incidence and DALY rates of IBD and men exhibited higher DALY rates than women. In 2019, high-income North America recorded the highest age-standardized prevalence, incidence, and DALY rates, while Oceania had the lowest age-standardized prevalence and incidence rates. South Asia had the lowest age-standardized DALY rates. The age-standardized mortality and DALY rates decreased as SDI values increased and remained higher than the expected levels over the past three decades. A negative correlation was observed between age-standardized DALY rates and SDI at the national level.

Conclusions

This analysis of the GBD 2019 database demonstrates that the overall global burden of IBD is still high. Meanwhile, an increasing disease burden is observed in the middle and low SDI locations.
背景:炎症性肠病(IBD炎症性肠病(IBD)是一种慢性胃肠道炎症性疾病,在全球的发病率和发病模式各不相同。准确了解该疾病的流行病学特征对全世界的疾病控制和预防工作至关重要:利用 2019 年全球疾病负担(GBD)研究数据对 IBD 的全球负担进行最新估算,系统分析全球、地区和国家层面的 IBD 流行病学特征,包括流行率、发病率和残疾调整生命年(DALY)率,并分析社会经济发展水平与 IBD 流行病学特征的相关性:我们对 1990 年至 2019 年全球、地区和国家 IBD 负担进行了总体分析,数据来自 2019 年 GBD 研究。GBD 将全球划分为 21 个地区和 204 个国家和地区,这为全面分析提供了便利。通过计算年龄标准化估计年百分比变化(EAPCs)来评估 IBD 年龄标准化比率(ASRs)的时间趋势,同时采用年龄标准化来减轻年龄结构可能带来的混杂效应。社会人口指数(SDI)用于将社会经济发展水平与IBD的流行病学特征相关联:结果:从 1990 年到 2019 年,全球 IBD 的年龄标准化患病率、发病率和残疾调整寿命年率仍然居高不下。全球 IBD 年龄标准化发病率和残疾调整寿命率略有下降趋势,男性的残疾调整寿命率高于女性。2019年,高收入的北美洲的年龄标准化患病率、发病率和残疾调整寿命率最高,而大洋洲的年龄标准化患病率和发病率最低。南亚的年龄标准化残疾调整寿命年数率最低。年龄标准化死亡率和残疾调整寿命率随着 SDI 值的增加而下降,在过去三十年中一直高于预期水平。在国家层面,年龄标准化残疾调整寿命率与 SDI 之间呈负相关:对 GBD 2019 数据库的分析表明,全球 IBD 的总体负担仍然很高。结论:GBD 2019 数据库的分析表明,全球 IBD 的总体负担仍然很高。
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引用次数: 0
Intima media thickness of the carotid artery in primary antiphospholipid syndrome: A systematic review and meta-analysis 原发性抗磷脂综合征的颈动脉内膜厚度:系统回顾和荟萃分析。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-02 DOI: 10.1016/j.autrev.2024.103657

Background

Primary antiphospholipid syndrome (PAPS) has been associated with an increase in clinical events associated with atherosclerotic vascular disease. Intima media thickness (IMT) of carotid arteries is a surrogate marker of atherosclerotic vascular disease.

Objectives

To conduct a systematic review and meta-analysis of studies evaluating IMT and their clinical correlates in PAPS.

Methods

Systematic search of EMBASE and PubMed databases from January 2000 to December 2023; we employed random effect meta-analyses for continuous outcomes and Peto's odds ratio for rare events.

Results

The meta-analysis included 21 studies (20 case control and 1 cohort) showing that PAPS patients (n = 1103) had thicker IM than controls (n = 832) (p < 0.0001) with wide heterogeneity (I2 = 86.9 %); PAPS patients (n = 782) also had a greater pooled prevalence of carotid plaques than controls (n = 537) (13.1 % vs 2.97 %, p < 0.0001). A sensitivity analysis by meta-regression indicated that mean age, gender, disease duration, lipid profile, blood pressures, smoking and statin use all explained the heterogeneity variance; a sensitivity analysis by subgroups confirmed smoking status and statin use as explanatory variables with the addition of ethnicity.

Conclusion

Atherosclerosis of the carotid artery represents a clinical feature of PAPS in relation to the traditional risk factors and to statin use. Minimising the atherogenic risk with statins could reduce the late arterial atherothrombotic risks of PAPS.
背景:原发性抗磷脂综合征(PAPS原发性抗磷脂综合征(PAPS)与动脉粥样硬化性血管疾病相关的临床事件增加有关。颈动脉内膜厚度(IMT)是动脉粥样硬化性血管疾病的替代标志物:对评估 PAPS 中内膜厚度及其临床相关性的研究进行系统回顾和荟萃分析:方法:对2000年1月至2023年12月的EMBASE和PubMed数据库进行系统检索;对连续结果采用随机效应荟萃分析,对罕见事件采用Peto几率分析:荟萃分析包括21项研究(20项病例对照和1项队列研究),结果显示,PAPS患者(n = 1103)的IM比对照组(n = 832)更厚(p 2 = 86.9%);PAPS患者(n = 782)的颈动脉斑块总发病率也高于对照组(n = 537)(13.1% vs 2.97%,p 结论:PAPS患者的颈动脉斑块总发病率高于对照组(n = 537),PAPS患者的颈动脉斑块总发病率高于对照组(n = 782),PAPS患者的颈动脉斑块总发病率高于对照组(n = 537):颈动脉粥样硬化是 PAPS 的一个临床特征,与传统的风险因素和他汀类药物的使用有关。使用他汀类药物将动脉粥样硬化风险降至最低,可降低 PAPS 的后期动脉粥样硬化血栓风险。
{"title":"Intima media thickness of the carotid artery in primary antiphospholipid syndrome: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.autrev.2024.103657","DOIUrl":"10.1016/j.autrev.2024.103657","url":null,"abstract":"<div><h3>Background</h3><div>Primary antiphospholipid syndrome (PAPS) has been associated with an increase in clinical events associated with atherosclerotic vascular disease. Intima media thickness (IMT) of carotid arteries is a surrogate marker of atherosclerotic vascular disease.</div></div><div><h3>Objectives</h3><div>To conduct a systematic review and meta-analysis of studies evaluating IMT and their clinical correlates in PAPS.</div></div><div><h3>Methods</h3><div>Systematic search of EMBASE and PubMed databases from January 2000 to December 2023; we employed random effect meta-analyses for continuous outcomes and Peto's odds ratio for rare events.</div></div><div><h3>Results</h3><div>The meta-analysis included 21 studies (20 case control and 1 cohort) showing that PAPS patients (<em>n</em> = 1103) had thicker IM than controls (<em>n</em> = 832) (<em>p</em> &lt; 0.0001) with wide heterogeneity (<em>I</em><sup><em>2</em></sup> = 86.9 %); PAPS patients (<em>n</em> = 782) also had a greater pooled prevalence of carotid plaques than controls (<em>n</em> = 537) (13.1 % vs 2.97 %, <em>p</em> &lt; 0.0001). A sensitivity analysis by meta-regression indicated that mean age, gender, disease duration, lipid profile, blood pressures, smoking and statin use all explained the heterogeneity variance; a sensitivity analysis by subgroups confirmed smoking status and statin use as explanatory variables with the addition of ethnicity.</div></div><div><h3>Conclusion</h3><div>Atherosclerosis of the carotid artery represents a clinical feature of PAPS in relation to the traditional risk factors and to statin use. Minimising the atherogenic risk with statins could reduce the late arterial atherothrombotic risks of PAPS.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review 慢性疲劳综合征 (CFS)、纤维肌痛 (FM)、冠状病毒-19 感染性疾病 (COVID) 和长期 COVID 综合征 (PCS)、病态建筑综合征 (SBS)、心动过速后综合征 (PoTS) 以及佐剂诱发的自身免疫/炎症综合征 (ASIA) 中的耳部异常:系统综述。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.autrev.2024.103606
Chronic fatigue syndrome (CFS), fibromyalgia (FM), silicone breast implants (SBI), Coronavirus-19 infectious disease (COVID), COVID-19 vaccination (post-COVIDvac-syndrome), Long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/ inflammatory syndrome induced by adjuvants (ASIA) are a cluster of poorly understood medical conditions that have in common a group of ill-defined symptoms and dysautonomic features. Most of the clinical findings of this group of diseases are unspecific, such as fatigue, diffuse pain, cognitive impairment, paresthesia, tachycardia, anxiety, and depression. Hearing disturbances and vertigo have also been described in this context, the underlying pathophysiologic process for these conditions might rely on autonomic autoimmune dysbalance.
The authors procced a literature review regarding to hearing and labyrinthic disturbances in CSF, FM, SBI, COVID, post-COVIDvac-syndrome, PCS, SBS, POTS, and ASIA. The PRISMA guidelines were followed, and the literature reviewed encompassed papers from January 1990 to January 2024.
After the initial evaluation of the articles found in the search through Pubmed, Scielo and Embase, a total of 172 articles were read and included in this review.
The prevalence of hearing loss, dizziness, vertigo and tinnitus was described and correlated with the diseases investigated in this study. There are great variability in the frequencies of symptoms found, but cochlear complaints are the most frequent in most studies. Vestibular symptoms are less reported.
The main pathophysiological mechanisms are discussed. Direct effects of the virus in the inner ear or nervous pathways, impaired vascular perfusion, cross-reaction or autoimmune immunoreactivity, oxidative stress, DNA methylation, epigenetic modifications and gene activation were implicated in the generation of the investigated symptoms.
In clinical practice, all patients with these autoimmune conditions who have any audiological complaint an ENT consultation followed by an audiometry are needed.
慢性疲劳综合征(CFS)、纤维肌痛(FM)、硅胶乳房植入物(SBI)、冠状病毒-19 感染性疾病(COVID)、COVID-19 疫苗接种(后 COVIDvac-syndrome )、长 COVID 综合征(PCS)、病态建筑综合征(SBS)、这些病症的共同特点是症状不明确,并伴有自主神经功能紊乱。这类疾病的临床表现大多没有特异性,如疲劳、弥漫性疼痛、认知障碍、麻痹、心动过速、焦虑和抑郁。听力障碍和眩晕也有相关描述,这些病症的潜在病理生理过程可能依赖于自主神经自身免疫失调。作者对 CSF、FM、SBI、COVID、后 COVIDvac 综合征、PCS、SBS、POTS 和 ASIA 中的听力和迷宫障碍进行了文献综述。该研究遵循 PRISMA 指南,所查阅的文献包括 1990 年 1 月至 2024 年 1 月期间的论文。在对通过 Pubmed、Scielo 和 Embase 搜索到的文章进行初步评估后,共阅读了 172 篇文章并将其纳入本综述。本研究对听力损失、头晕、眩晕和耳鸣的发病率进行了描述,并将其与所调查的疾病相关联。发现的症状频率差异很大,但在大多数研究中,耳蜗症状最为常见。前庭症状的报告较少。本文讨论了主要的病理生理机制。病毒对内耳或神经通路的直接影响、血管灌注受损、交叉反应或自身免疫反应、氧化应激、DNA 甲基化、表观遗传修饰和基因活化都与所研究症状的产生有关。在临床实践中,所有患有这些自身免疫性疾病并伴有任何听力症状的患者都需要进行耳鼻喉科会诊,然后进行听力测定。
{"title":"Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review","authors":"","doi":"10.1016/j.autrev.2024.103606","DOIUrl":"10.1016/j.autrev.2024.103606","url":null,"abstract":"<div><div>Chronic fatigue syndrome (CFS), fibromyalgia (FM), silicone breast implants (SBI), Coronavirus-19 infectious disease (COVID), COVID-19 vaccination (post-COVIDvac-syndrome), Long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/ inflammatory syndrome induced by adjuvants (ASIA) are a cluster of poorly understood medical conditions that have in common a group of ill-defined symptoms and dysautonomic features. Most of the clinical findings of this group of diseases are unspecific, such as fatigue, diffuse pain, cognitive impairment, paresthesia, tachycardia, anxiety, and depression. Hearing disturbances and vertigo have also been described in this context, the underlying pathophysiologic process for these conditions might rely on autonomic autoimmune dysbalance.</div><div>The authors procced a literature review regarding to hearing and labyrinthic disturbances in CSF, FM, SBI, COVID, post-COVIDvac-syndrome, PCS, SBS, POTS, and ASIA. The PRISMA guidelines were followed, and the literature reviewed encompassed papers from January 1990 to January 2024.</div><div>After the initial evaluation of the articles found in the search through Pubmed, Scielo and Embase, a total of 172 articles were read and included in this review.</div><div>The prevalence of hearing loss, dizziness, vertigo and tinnitus was described and correlated with the diseases investigated in this study. There are great variability in the frequencies of symptoms found, but cochlear complaints are the most frequent in most studies. Vestibular symptoms are less reported.</div><div>The main pathophysiological mechanisms are discussed. Direct effects of the virus in the inner ear or nervous pathways, impaired vascular perfusion, cross-reaction or autoimmune immunoreactivity, oxidative stress, DNA methylation, epigenetic modifications and gene activation were implicated in the generation of the investigated symptoms.</div><div>In clinical practice, all patients with these autoimmune conditions who have any audiological complaint an ENT consultation followed by an audiometry are needed.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
The effects of lifestyle interventions on disease activity and quality of life in patients with systemic lupus erythematosus: A systematic review 生活方式干预对系统性红斑狼疮患者疾病活动和生活质量的影响:系统综述。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.autrev.2024.103609

Introduction

Systemic Lupus Erythematosus (SLE) is an autoimmune disease affecting multiple organs, characterized by flares and remission. Treatment aims to reduce flare severity and prevent long-term damage, but remission is often elusive, and patients may still experience flares and a reduced quality of life (QoL). This had led to a growing interest in non-pharmacological therapies to improve patient wellbeing.

Objective

We aimed to assess and summarize the efficacy of lifestyle interventions in SLE patients on disease activity and QoL.

Methods

A systematic search on lifestyle interventions, SLE, disease activity, and QoL was conducted in PubMed/Medline, Embase and Clinicaltrials.gov in August 2024. Included studies were randomized controlled trials on lifestyle interventions in adult SLE patients. Each trial was appraised using Scottish Intercollegiate Guidelines Network (SIGN) criteria, with participant numbers, study duration, intervention type and outcome measures detailed in separate tables.

Results

A total of 3564 articles were screened, resulting in the inclusion of 25 randomized controlled trials with 1521 patients. Study quality varied from high (11 studies) to low (6 studies) with considerable intervention heterogeneity. The interventions fell into five categories: physical activity, psychotherapy, lifestyle coaching, supplements and dietary interventions. Physical activity (2 studies, 116 patients), psychotherapy (5 studies, 507 patients) and coaching (1 study with 30 patients) had no significant effect on disease activity, while fish oil supplementation showed a slight benefit in two studies with a total of 102 patients. Quality of life generally improved with physical activity (4 studies with in total 253 patients) and psychotherapy (9 studies with in total 623 patients), with significant mental health benefits, but coaching (3 studies with in total 186 patients) showed no effect.

Conclusion

Various lifestyle interventions influence quality of life in SLE patients. Consistent with recent guidelines, both exercise and psychotherapy may positively impact the health-related quality of life in these patients. However, some studies were biased due to self-reported outcomes and the Hawthorne effect, where participants' behavior changed from receiving extra attention. Further research with larger patient cohorts is necessary to reduce the influence of heterogeneity across different studies and to better understand the potential of these promising therapies.
导言系统性红斑狼疮(SLE)是一种影响多个器官的自身免疫性疾病,其特点是病情发作和缓解。治疗的目的是减轻疾病发作的严重程度并防止长期损害,但缓解往往难以实现,患者仍可能出现疾病发作和生活质量下降的情况。因此,人们对改善患者生活质量的非药物疗法越来越感兴趣:我们旨在评估和总结生活方式干预对系统性红斑狼疮患者疾病活动和生活质量的影响:2024年8月,我们在PubMed/Medline、Embase和Clinicaltrials.gov上对生活方式干预、系统性红斑狼疮、疾病活动性和QoL进行了系统检索。纳入的研究均为针对成年系统性红斑狼疮患者的生活方式干预随机对照试验。每项试验均采用苏格兰校际指南网络(SIGN)标准进行评估,参与者人数、研究持续时间、干预类型和结果测量详见不同的表格:共筛选了 3564 篇文章,最终纳入了 25 项随机对照试验,涉及 1521 名患者。研究质量从高(11 项研究)到低(6 项研究)不等,干预异质性相当大。干预措施分为五类:体育锻炼、心理治疗、生活方式指导、补充剂和饮食干预。体育锻炼(2 项研究,116 名患者)、心理疗法(5 项研究,507 名患者)和生活方式指导(1 项研究,30 名患者)对疾病活动无显著影响,而鱼油补充剂在两项研究(共 102 名患者)中略有益处。体育锻炼(4 项研究,共 253 名患者)和心理治疗(9 项研究,共 623 名患者)普遍提高了生活质量,对心理健康有明显的益处,但辅导(3 项研究,共 186 名患者)没有效果:结论:各种生活方式干预措施都会影响系统性红斑狼疮患者的生活质量。结论:各种生活方式干预措施都会影响系统性红斑狼疮患者的生活质量。与最新指南一致,运动和心理治疗都会对这些患者的健康相关生活质量产生积极影响。然而,由于自我报告的结果和霍桑效应(即参与者的行为因受到额外关注而发生改变),一些研究存在偏差。有必要对更大的患者群体进行进一步研究,以减少不同研究中异质性的影响,并更好地了解这些前景广阔的疗法的潜力。
{"title":"The effects of lifestyle interventions on disease activity and quality of life in patients with systemic lupus erythematosus: A systematic review","authors":"","doi":"10.1016/j.autrev.2024.103609","DOIUrl":"10.1016/j.autrev.2024.103609","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic Lupus Erythematosus (SLE) is an autoimmune disease affecting multiple organs, characterized by flares and remission. Treatment aims to reduce flare severity and prevent long-term damage, but remission is often elusive, and patients may still experience flares and a reduced quality of life (QoL). This had led to a growing interest in non-pharmacological therapies to improve patient wellbeing.</div></div><div><h3>Objective</h3><div>We aimed to assess and summarize the efficacy of lifestyle interventions in SLE patients on disease activity and QoL.</div></div><div><h3>Methods</h3><div>A systematic search on lifestyle interventions, SLE, disease activity, and QoL was conducted in PubMed/Medline, Embase and <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> in August 2024. Included studies were randomized controlled trials on lifestyle interventions in adult SLE patients. Each trial was appraised using Scottish Intercollegiate Guidelines Network (SIGN) criteria, with participant numbers, study duration, intervention type and outcome measures detailed in separate tables.</div></div><div><h3>Results</h3><div>A total of 3564 articles were screened, resulting in the inclusion of 25 randomized controlled trials with 1521 patients. Study quality varied from high (11 studies) to low (6 studies) with considerable intervention heterogeneity. The interventions fell into five categories: physical activity, psychotherapy, lifestyle coaching, supplements and dietary interventions. Physical activity (2 studies, 116 patients), psychotherapy (5 studies, 507 patients) and coaching (1 study with 30 patients) had no significant effect on disease activity, while fish oil supplementation showed a slight benefit in two studies with a total of 102 patients. Quality of life generally improved with physical activity (4 studies with in total 253 patients) and psychotherapy (9 studies with in total 623 patients), with significant mental health benefits, but coaching (3 studies with in total 186 patients) showed no effect.</div></div><div><h3>Conclusion</h3><div>Various lifestyle interventions influence quality of life in SLE patients. Consistent with recent guidelines, both exercise and psychotherapy may positively impact the health-related quality of life in these patients. However, some studies were biased due to self-reported outcomes and the Hawthorne effect, where participants' behavior changed from receiving extra attention. Further research with larger patient cohorts is necessary to reduce the influence of heterogeneity across different studies and to better understand the potential of these promising therapies.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular disease in connective tissue disease-associated interstitial lung disease: A systematic review and meta-analysis of observational studies 结缔组织病相关间质性肺病的心血管疾病:观察性研究的系统回顾和荟萃分析。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.autrev.2024.103614

Objectives

We performed a systematic review and meta-analysis to assess whether patients with connective tissue disease (CTD)-associated interstitial lung diseases (ILD) have an increased prevalence of cardiovascular (CV) disease and to validate associated risk factors.

Methods

The PRISMA guidelines and PICO model were followed. We searched PubMed, Embase, Cochrane Library databases, Scopus, and Directory of Open Access Journals from inception to April 2024.

Results

Thirteen studies comprising of 12,520 patients were included. Patients with CTD-ILD had a significantly increased risk of CV disease than patients with CTD (relative risk [RR] = 1.65, 95 % confidence interval [CI]: 1.41, 1.93), which are related to the proportion of men (P = 0.001) and the proportion of smokers (P = 0.045). Subgroup analysis found that patients with CTD-ILD had a higher risk of heart failure (RR = 2.84, 95 % CI: 1.50, 5.39), arrhythmia (RR = 1.55, 95 % CI: 1.22, 1.97) than patients with CTD. Another subgroup analysis showed that RA-ILD and SSc-ILD were associated with an increased risk of CV disease, but not IIM-ILD and MCTD-ILD (RA-ILD: RR = 2.19, 95 % CI: 1.27, 3.80; SSc-ILD: RR = 1.53, 95 % CI: 1.29, 1.82). Besides, patients with CTD-ILD had a higher prevalence of pulmonary arterial hypertension (RR = 2.48, 95 % CI: 1.69, 3.63) than patients with CTD.

Conclusions

Patients with CTD-ILD had a 1.65 times increased risk of CV than patients with CTD-non-ILD, with increased prevalence of heart failure and arrhythmia. The risk of CV disease in SSc-ILD and RA-ILD is increased and we should pay more attention to male smokers. In addition, compared with CTD patients, CTD-ILD patients had a higher risk of pulmonary arterial hypertension.
研究目的我们进行了一项系统综述和荟萃分析,以评估结缔组织病(CTD)相关间质性肺病(ILD)患者是否会增加心血管疾病(CV)的患病率,并验证相关风险因素:方法:研究遵循 PRISMA 指南和 PICO 模型。我们检索了从开始到 2024 年 4 月的 PubMed、Embase、Cochrane Library 数据库、Scopus 和开放获取期刊目录:共纳入13项研究,涉及12520名患者。CTD-ILD患者罹患冠心病的风险明显高于CTD患者(相对风险[RR]=1.65,95%置信区间[CI]:1.41,1.93),这与男性比例(P=0.001)和吸烟者比例(P=0.045)有关。亚组分析发现,CTD-ILD 患者发生心力衰竭(RR = 2.84,95 % CI:1.50,5.39)和心律失常(RR = 1.55,95 % CI:1.22,1.97)的风险高于 CTD 患者。另一项亚组分析显示,RA-ILD 和 SSc-ILD 与心血管疾病风险增加有关,但与 IIM-ILD 和 MCTD-ILD 无关(RA-ILD:RR = 2.19,95 % CI:1.27,3.80;SSc-ILD:RR = 1.53,95 % CI:1.29,1.82)。此外,与 CTD 患者相比,CTD-ILD 患者的肺动脉高压发病率更高(RR = 2.48,95 % CI:1.69, 3.63):CTD-ILD患者的心血管疾病风险比CTD-非ILD患者高1.65倍,其中心力衰竭和心律失常的发病率更高。SSc-ILD和RA-ILD患者罹患心血管疾病的风险增加,我们应更加关注男性吸烟者。此外,与 CTD 患者相比,CTD-ILD 患者发生肺动脉高压的风险更高。
{"title":"Cardiovascular disease in connective tissue disease-associated interstitial lung disease: A systematic review and meta-analysis of observational studies","authors":"","doi":"10.1016/j.autrev.2024.103614","DOIUrl":"10.1016/j.autrev.2024.103614","url":null,"abstract":"<div><h3>Objectives</h3><div>We performed a systematic review and meta-analysis to assess whether patients with connective tissue disease (CTD)-associated interstitial lung diseases (ILD) have an increased prevalence of cardiovascular (CV) disease and to validate associated risk factors.</div></div><div><h3>Methods</h3><div>The PRISMA guidelines and PICO model were followed. We searched PubMed, Embase, Cochrane Library databases, Scopus, and Directory of Open Access Journals from inception to April 2024.</div></div><div><h3>Results</h3><div>Thirteen studies comprising of 12,520 patients were included. Patients with CTD-ILD had a significantly increased risk of CV disease than patients with CTD (relative risk [RR] = 1.65, 95 % confidence interval [CI]: 1.41, 1.93), which are related to the proportion of men (<em>P</em> = 0.001) and the proportion of smokers (<em>P</em> = 0.045). Subgroup analysis found that patients with CTD-ILD had a higher risk of heart failure (RR = 2.84, 95 % CI: 1.50, 5.39), arrhythmia (RR = 1.55, 95 % CI: 1.22, 1.97) than patients with CTD. Another subgroup analysis showed that RA-ILD and SSc-ILD were associated with an increased risk of CV disease, but not IIM-ILD and MCTD-ILD (RA-ILD: RR = 2.19, 95 % CI: 1.27, 3.80; SSc-ILD: RR = 1.53, 95 % CI: 1.29, 1.82). Besides, patients with CTD-ILD had a higher prevalence of pulmonary arterial hypertension (RR = 2.48, 95 % CI: 1.69, 3.63) than patients with CTD.</div></div><div><h3>Conclusions</h3><div>Patients with CTD-ILD had a 1.65 times increased risk of CV than patients with CTD-non-ILD, with increased prevalence of heart failure and arrhythmia. The risk of CV disease in SSc-ILD and RA-ILD is increased and we should pay more attention to male smokers. In addition, compared with CTD patients, CTD-ILD patients had a higher risk of pulmonary arterial hypertension.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Helminth derivative tuftsin-phopshorylcholine to treat autoimmunity 螺旋体衍生物 Tuftsin-phopshorylcholine,用于治疗自身免疫。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.autrev.2024.103601
Autoimmune diseases (AIDs) affect 5 to 10% of the population. There are more than ∼100 different autoimmune diseases. The AIDs are one of the top 10 causes of death in women under 65; 2nd highest cause of chronic illness; top cause of morbidity in women in the US. The NIH estimates annual direct healthcare costs for autoimmune diseases about $100 billion, in comparison, with cancers investment of $57 billion, heart and stroke cost of $200 billion.
The current treatments for autoimmune diseases encompasses: steroids, chemotherapy, immunosuppressants, biological drugs, disease specific drugs (like acethylcholine-estherase for myasthenia gravis). The treatments for autooimmune diseases supress the patient immune network, which leads the patients to be more susceptible to infections. Hence, there is a need to develop immunomodulatory small molecules with minimal side effects to treat autoimmune diseases.
The helminths developed secreting compounds which modulate the human defense pathways in order to develop tolerance and survive in the host environment.
We have imitated the immunomodulatory activity of the helminth by using a derivative of the helminth secretory molecule.
A bi-functional small molecule –tuftsin (T)-phosphorylcholine (PC), coined as TPC, was constructed. This chimeric molecule showed its immunomodulatory activity in 4 murine models of autoimmune diseases, attenuating the clinical score and the inflammatory response by immunomodutating the host immune system. Ex-vivo in human peripheral blood mononuclear cells (PBMCs) and biopsies originated from arteries of patients with giant cell arteritis. This paper decipher the mode of action of TPC immunomodulatory activity. Our data propose the potential for this small molecule to be a novel therapy for patients with autoimmune diseases.
自身免疫性疾病(AIDs)影响着 5-10% 的人口。有大约 100 多种不同的自身免疫性疾病。自身免疫性疾病是导致 65 岁以下女性死亡的十大原因之一;是导致慢性疾病的第二大原因;也是美国女性发病率最高的原因。据美国国立卫生研究院(NIH)估计,自身免疫性疾病每年的直接医疗费用约为 1000 亿美元,相比之下,癌症的直接医疗费用为 570 亿美元,心脏和中风的直接医疗费用为 2000 亿美元。目前治疗自身免疫性疾病的方法包括:类固醇、化疗、免疫抑制剂、生物药物、特定疾病药物(如治疗重症肌无力的乙酰胆碱乙酰胆碱酯酶)。治疗自身免疫性疾病的方法会抑制患者的免疫网络,导致患者更容易受到感染。因此,有必要开发副作用最小的免疫调节小分子药物来治疗自身免疫性疾病。蠕虫会分泌调节人体防御途径的化合物,以便在宿主环境中产生耐受性并存活下来。我们利用蠕虫分泌分子的衍生物模仿了蠕虫的免疫调节活性。我们构建了一种双功能小分子--头孢菌素(T)-磷酰胆碱(PC),被称为 TPC。这种嵌合分子在 4 种自身免疫性疾病小鼠模型中显示出免疫调节活性,通过对宿主免疫系统进行免疫调节,减轻了临床评分和炎症反应。在人外周血单核细胞(PBMCs)和巨细胞动脉炎患者动脉活检组织中的体内试验也证明了这一点。本文揭示了 TPC 免疫调节活性的作用模式。我们的数据表明,这种小分子有望成为治疗自身免疫性疾病患者的一种新型疗法。
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引用次数: 0
Immunopathogenesis of systemic lupus erythematosus: An update 系统性红斑狼疮的免疫发病机制:最新进展。
IF 9.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.autrev.2024.103648
Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease characterized by dysregulated immune responses leading to widespread inflammation and damage in various organs. Environmental factors such as infections, hormonal influences and exposure to ultraviolet light can trigger the disease in genetically predisposed individuals. Genome-wide association studies have identified over 100 susceptibility loci linked to immune regulation, interferon (IFN) signaling and antigen presentation in SLE. In addition, rare cases of monogenic lupus have been instrumental in understanding critical underlying disease mechanisms. Several immunological abnormalities contribute to the loss of self-tolerance and the perpetuation of autoimmune responses in SLE. In particular, defective clearance of apoptotic cells due to defective phagocytosis and complement activation leads to accumulation of self-antigens. Dysregulated innate immune responses activate the adaptive immune system, amplifying the inflammatory response with an important role for type I IFNs. Abnormalities in B cell development and activation lead to the production of autoreactive antibodies, forming immune complexes that cause tissue damage. Similarly, disturbances in T-cell compartments, altered regulatory T-cell functions and altered cytokine production, particularly IFN-α, contribute to tissue damage. Understanding of the immunopathogenesis of SLE is evolving rapidly, with ongoing research identifying new molecular pathways and potential therapeutic targets. Future classifications of SLE are likely to be based on underlying biological pathways rather than clinical and serological signs alone. This review aims to provide a detailed update on the most recent findings regarding the immunopathogenesis of SLE, focusing on the variability of biological pathways and the implications for future therapeutic strategies, in particular chimeric antigen receptor T (CAR T) cells.
系统性红斑狼疮(SLE)是一种慢性全身性自身免疫性疾病,其特点是免疫反应失调,导致广泛的炎症和各种器官的损伤。感染、激素影响和紫外线照射等环境因素可诱发具有遗传易感性的个体患病。全基因组关联研究发现了 100 多个与系统性红斑狼疮的免疫调节、干扰素(IFN)信号转导和抗原递呈有关的易感基因位点。此外,罕见的单基因狼疮病例也有助于了解关键的潜在疾病机制。系统性红斑狼疮的自身耐受性丧失和自身免疫反应的持续存在是由多种免疫异常造成的。特别是,由于吞噬和补体激活缺陷导致的凋亡细胞清除缺陷会导致自身抗原的积累。失调的先天性免疫反应激活了适应性免疫系统,扩大了炎症反应,其中I型IFNs发挥了重要作用。B 细胞发育和活化异常会导致产生自体反应性抗体,形成免疫复合物,造成组织损伤。同样,T 细胞分区紊乱、调节性 T 细胞功能改变和细胞因子(尤其是 IFN-α)分泌改变也会造成组织损伤。人们对系统性红斑狼疮免疫发病机制的认识正在迅速发展,目前的研究正在确定新的分子途径和潜在的治疗靶点。未来对系统性红斑狼疮的分类可能会基于潜在的生物学途径,而不仅仅是临床和血清学体征。本综述旨在详细介绍有关系统性红斑狼疮免疫发病机制的最新研究成果,重点关注生物通路的可变性以及对未来治疗策略的影响,尤其是嵌合抗原受体T(CAR T)细胞。
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引用次数: 0
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Autoimmunity reviews
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