Autoimmunity reviews最新文献_第3页

Advances in RNA therapy for the treatment of autoimmune diseases

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-20 DOI: 10.1016/j.autrev.2025.103753

Ying Zhang , Chenyang Zang , Manyun Mao , Mi Zhang , Zhenwei Tang , Wangqing Chen , Wu Zhu

Autoimmune diseases (ADs) are a group of complex, chronic conditions characterized by disturbance of immune tolerance, with examples including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, and psoriasis. These diseases have unclear pathogenesis, and traditional therapeutic approaches remain limited. However, advances in high-throughput histology technology and scientific discoveries have led to the identification of various pathogenic factors contributing to ADs. Coupled with improvements in RNA nucleic acid-based drug synthesis, design, and delivery, RNA-based therapies have been extensively investigated for their potential in treating ADs. This paper reviews the progress in the use of miRNAs, lncRNAs, circRNAs, siRNAs, antisense oligonucleotides (ASOs), aptamers, mRNAs, and other RNA-based therapies in ADs, focusing on their therapeutic potential and application prospects, providing insights for future research and clinical treatment of autoimmune diseases.

引用次数: 0

Endometriosis and autoimmunity 子宫内膜异位症与自身免疫。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-17 DOI: 10.1016/j.autrev.2025.103752

Luz P. Blanco , Noemi Salmeri , Sarah M. Temkin , Victoria K. Shanmugam , Pamela Stratton

Endometriosis is a female-specific chronic condition that affects 1 in 10 women and other individuals with a uterus worldwide with common symptoms that include pelvic pain and infertility. Reliable and effective non-invasive biomarkers for endometriosis do not exist, and therefore currently a diagnosis of endometriosis requires direct visualization of lesions at surgery. Similarly, few safe and effective management strategies exist for endometriosis, with hormonal interventions and surgery only providing temporary symptom control. The development of endometriosis involves the implantation and proliferation of ectopic endometrial cells which triggers local and systemic inflammation and fibrosis. While multiple genetic, environmental, and lifestyle factors appear to influence the natural history of endometriosis, chronic inflammation is a hallmark feature associated with development and progression of the disease. Data further shows that endometriosis commonly co-occurs with autoimmune diseases, adding evidence that immune dysfunction likely contributes to the pathogenesis of this disorder. Specific innate and adaptive immune system drivers of endometriosis remain to be identified and additional research is needed to elucidate the mechanistic underpinnings of this debilitating disease. In this narrative review, we discuss the shared biological mechanisms and plausible immune-related connections between endometriosis and autoimmunity.

子宫内膜异位症是一种女性特有的慢性疾病，全世界有十分之一的女性和其他有子宫的人受到影响，常见症状包括盆腔疼痛和不孕。子宫内膜异位症的可靠和有效的非侵入性生物标志物尚不存在，因此目前子宫内膜异位症的诊断需要在手术中直接观察病变。同样，对于子宫内膜异位症也没有安全有效的治疗策略，激素干预和手术只能暂时控制症状。子宫内膜异位症的发展涉及异位子宫内膜细胞的植入和增殖，引发局部和全身炎症和纤维化。虽然多种遗传、环境和生活方式因素似乎影响子宫内膜异位症的自然史，但慢性炎症是与该疾病的发生和进展相关的一个标志性特征。数据进一步表明，子宫内膜异位症通常与自身免疫性疾病共同发生，增加了免疫功能障碍可能导致这种疾病发病的证据。子宫内膜异位症的特异性先天和适应性免疫系统驱动因素仍有待确定，需要进一步的研究来阐明这种使人衰弱的疾病的机制基础。在这篇叙述性综述中，我们讨论了子宫内膜异位症和自身免疫之间的共同生物学机制和可能的免疫相关联系。

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引用次数: 0

Maternal and fetal outcomes in Latin American SLE pregnancies: A systematic review and meta-analysis 拉丁美洲SLE妊娠的母胎结局：系统回顾和荟萃分析。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-12 DOI: 10.1016/j.autrev.2025.103744

Jairo Cajamarca-Baron , Catalina Sanmiguel-Reyes , Juan Esteban Bedoya-Loaiza , Juan Pablo Castañeda-Gonzalez , Gabriel E. Acelas-Gonzalez , Saulo Molina-Giraldo , Diana Guavita-Navarro , Claudia Ibáñez , Alejandro Escobar , Adriana Rojas-Villarraga

Introduction

Systemic lupus erythematosus (SLE) predominantly affects women, especially during their reproductive years, leading to increased risks during pregnancy. Latina women develop SLE at a younger age, which increases their susceptibility to pregnancy complications such as pre-eclampsia, preterm birth and fetal growth restriction.

Objective

The purpose of this study is to systematically review maternal and fetal outcomes in pregnant Latina women with SLE and to perform a meta-analysis to assess specific risks associated with the disease.

Materials and methods

A systematic review according to PRISMA guidelines was performed (PubMed and SciELO), including studies on SLE and pregnancy in Latin America through December 2022. Eligible studies included case reports, cohort studies and clinical trials in pregnant women with SLE. The meta-analysis focused on key outcomes, including pre-eclampsia and lupus nephritis, with relative risk (RR) calculations.

Results

Forty-four studies with 2190 pregnancies were included. High rates of pre-eclampsia (11–52 %), preterm delivery (18.6–70.8 %), and fetal loss were reported. A decades-long analysis of pregnancy outcomes in SLE in Latin America shows increased research and improved care, with fetal loss rates decreasing from 35 % (1980–1999) to lower intrauterine (28 %) and neonatal (10 %) death rates in 2020–2023. Meta-analysis showed that lupus nephritis almost doubled the risk of pre-eclampsia (RR = 1.89, 95 % CI:1.40–2.55) compared to women without nephritis.

Conclusion

Latina women with SLE are at increased risk for adverse pregnancy outcomes, particularly pre-eclampsia and preterm delivery. Lupus nephritis and disease activity are major risk factors, highlighting the need for tailored care and early intervention to improve maternal and fetal outcomes in this population.

系统性红斑狼疮（SLE）主要影响女性，特别是育龄期，导致怀孕期间风险增加。拉丁裔妇女在较年轻时就会患上SLE，这增加了她们对妊娠并发症的易感性，如先兆子痫、早产和胎儿生长受限。目的：本研究的目的是系统地回顾拉丁裔SLE孕妇的母胎结局，并进行荟萃分析以评估与该疾病相关的特定风险。材料和方法：根据PRISMA指南（PubMed和SciELO）进行系统评价，包括截至2022年12月拉丁美洲SLE和妊娠的研究。符合条件的研究包括SLE孕妇的病例报告、队列研究和临床试验。荟萃分析的重点是关键结局，包括先兆子痫和狼疮性肾炎，以及相对风险（RR）计算。结果：纳入44项研究，共2190例妊娠。先兆子痫（11-52 %）、早产（18.6-70.8 %）和胎儿丢失的发生率较高。一项对拉丁美洲SLE妊娠结局长达数十年的分析表明，研究的增加和护理的改善，胎儿损失率从1980-1999年的35% %下降到2020-2023年的更低的宫内死亡率（28% %）和新生儿死亡率（10% %）。荟萃分析显示，与没有肾炎的女性相比，狼疮肾炎的先兆子痫风险几乎增加了一倍（RR = 1.89,95 % CI:1.40-2.55）。结论：患有SLE的拉丁裔女性发生不良妊娠结局的风险增加，尤其是先兆子痫和早产。狼疮肾炎和疾病活动性是主要的危险因素，强调需要量身定制的护理和早期干预，以改善这一人群的母婴结局。

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引用次数: 0

Diagnostic approach in giant cell arteritis 巨细胞动脉炎的诊断方法。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-08 DOI: 10.1016/j.autrev.2025.103743

Chiara Marvisi , Federica Macaluso , Caterina Ricordi , Alberto Cavazza , Francesco Muratore , Carlo Salvarani

Giant cell arteritis (GCA), also known as temporal arteritis, is the most common form of vasculitis in the elderly. While initially described as involving the temporal arteries, GCA can also affect the aorta and its major branches.

Despite the increased use of imaging modalities and the availability of temporal artery biopsy, diagnosing GCA remains challenging.

GCA should be considered a spectrum, with diagnostic methodologies tailored to the prevalent symptoms. The sensitivity and specificity of different diagnostic approaches can vary depending on the clinical setting.

Timing in diagnosing GCA is crucial to prevent serious complications, such as blindness and cerebrovascular ischemic events. While the prompt initiation of glucocorticoids (GCs) has reduced the incidence of major ischemic events, an uncertain diagnosis may expose the patient to unnecessary harm, such as complications from overtreatment or organ damage due to inadequate control of vasculitis.

This narrative review will summarize the most widely available diagnostic techniques for GCA and outline our approach for cases where the diagnosis may be uncertain.

巨细胞动脉炎（GCA），也称为颞动脉炎，是老年人最常见的血管炎。虽然最初被描述为累及颞动脉，但GCA也可影响主动脉及其主要分支。尽管越来越多地使用成像方式和颞动脉活检，诊断GCA仍然具有挑战性。GCA应被视为一个谱系，其诊断方法应针对流行症状量身定制。不同诊断方法的敏感性和特异性可能因临床环境而异。诊断GCA的时机对于预防严重并发症（如失明和脑血管缺血事件）至关重要。虽然糖皮质激素（GCs）的迅速启动降低了主要缺血事件的发生率，但不确定的诊断可能使患者遭受不必要的伤害，例如过度治疗引起的并发症或由于血管炎控制不足而导致的器官损害。这篇叙述性综述将总结最广泛可用的GCA诊断技术，并概述我们对诊断可能不确定的病例的方法。

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引用次数: 0

Systemic lupus erythematosus and male reproductive health: A systematic review and meta-analysis 系统性红斑狼疮与男性生殖健康：系统综述和荟萃分析。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-07 DOI: 10.1016/j.autrev.2025.103742

Jie Zhu , Qingmiao Zhu , Xiaolong Li , Tianshu Shen , Xiaowei Shi , Ting Zhao

Objective

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs. Male SLE patients often face reproductive health challenges, but research on male sexual and reproductive health in SLE remains limited. This systematic review and meta-analysis aimed to explore the effects of SLE and its related factors on male sexual function and reproductive health.

Methods

The PubMed, Cochrane library, Embase, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) databases were examined from January 2000 to December 2024. Data extraction and quality assessment were performed by two reviewers. Meta-analysis was carried out using Review Manager 5.3 software, and the risk of bias was assessed using the AHRQ checklist. The following outcomes were evaluated: sexual function, reproductive hormones and fertility.

Results

In the literature search, 5002 articles were identified, of which 9 studies met the inclusion criteria. Meta-analysis showed a significantly higher incidence of erectile dysfunction (ED) in SLE patients (OR = 7.44; 95 % CI = 5.00 to 11.06, p < 0.001). SLE patients also had higher levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) compared to controls (FSH: MD = 4.02; 95 % CI = 1.47 to 6.57; p = 0.002; LH: MD = 2.21; 95 % CI = 1.10 to 3.32; p < 0.001). Semen analysis showed a significant decrease in sperm count in SLE patients (MD = -0.54; 95 % CI = -0.86 to −0.22; p < 0.001).

Conclusions

Male SLE patients are more likely to have problems with sexual function, reproductive hormones and sperm quality. These findings emphasize the need for increased clinical awareness and interventions focused on male sexual and reproductive health in SLE patients.

目的：系统性红斑狼疮（SLE）是一种可累及多脏器的慢性自身免疫性疾病。男性SLE患者经常面临生殖健康方面的挑战，但对SLE患者男性性健康和生殖健康的研究仍然有限。本系统综述和荟萃分析旨在探讨SLE及其相关因素对男性性功能和生殖健康的影响。方法：检索2000年1月至2024年12月的PubMed、Cochrane library、Embase、Web of Science、万方数据和中国知网数据库。数据提取和质量评估由两名审稿人完成。meta分析采用Review Manager 5.3软件进行，偏倚风险采用AHRQ检查表进行评估。评估以下结果：性功能、生殖激素和生育能力。结果：在文献检索中，共检索到5002篇文献，其中9篇符合纳入标准。荟萃分析显示，SLE患者勃起功能障碍（ED）的发生率显著更高(OR = 7.44；95 % CI = 5.00 ~ 11.06，p 结论：男性SLE患者更容易出现性功能、生殖激素和精子质量方面的问题。这些发现强调需要提高对SLE患者男性性健康和生殖健康的临床意识和干预措施。

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引用次数: 0

Cerebral iron accumulation in multiple sclerosis: Pathophysiology and therapeutic implications 多发性硬化症的脑铁积累：病理生理学和治疗意义。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-03 DOI: 10.1016/j.autrev.2025.103741

Geir Bjørklund , David R. Wallace , Tony Hangan , Monica Butnariu , Leonard Gurgas , Massimiliano Peana

Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system characterized by demyelination, neuroinflammation, and neurodegeneration. Recent studies highlight the role of cerebral iron (Fe) accumulation in exacerbating MS pathophysiology. Fe, essential for neural function, contributes to oxidative stress and inflammation when dysregulated, particularly in the brain's gray matter and demyelinated lesions. Advanced imaging techniques, including susceptibility-weighted and quantitative susceptibility mapping, have revealed abnormal Fe deposition patterns in MS patients, suggesting its involvement in disease progression. Iron's interaction with immune cells, such as microglia, releases pro-inflammatory cytokines, further amplifying neuroinflammation and neuronal damage. These findings implicate Fe dysregulation as a significant factor in MS progression, contributing to clinical manifestations like cognitive impairment. Therapeutic strategies targeting Fe metabolism, including Fe chelation therapies, show promise in reducing Fe-related damage, instilling optimism about the future of MS treatment. However, challenges such as crossing the blood-brain barrier and maintaining Fe homeostasis remain. Emerging approaches, such as Fe-targeted nanotherapeutics and biologics, offer new possibilities for personalized treatments. However, the journey is far from over. Continued research into the molecular mechanisms of Fe-induced neuroinflammation and oxidative damage is essential. Through this research, we can develop effective interventions that could slow MS progression and improve patient outcomes.

多发性硬化症（MS）是一种慢性中枢神经系统自身免疫性疾病，以脱髓鞘、神经炎症和神经变性为特征。最近的研究强调了大脑铁（Fe）积累在加重多发性硬化症病理生理学方面的作用。铁是神经功能所必需的物质，一旦失调就会导致氧化应激和炎症，尤其是在大脑灰质和脱髓鞘病变部位。先进的成像技术（包括感度加权和定量感度绘图）揭示了多发性硬化症患者体内异常的铁沉积模式，表明铁参与了疾病的进展。铁与小胶质细胞等免疫细胞的相互作用会释放促炎细胞因子，进一步加剧神经炎症和神经元损伤。这些发现表明，铁失调是多发性硬化症进展的一个重要因素，会导致认知障碍等临床表现。针对铁代谢的治疗策略（包括铁螯合疗法）有望减少与铁有关的损害，这使人们对多发性硬化症治疗的未来充满信心。然而，穿越血脑屏障和维持铁平衡等挑战依然存在。铁靶向纳米疗法和生物制剂等新兴方法为个性化治疗提供了新的可能性。然而，研究之路远未结束。继续研究铁诱导的神经炎症和氧化损伤的分子机制至关重要。通过这项研究，我们可以开发出有效的干预措施，从而减缓多发性硬化症的进展并改善患者的预后。

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引用次数: 0

Chromosome aberrations and autoimmunity: Immune-mediated diseases associated with 18p deletion and other chromosomal aberrations 染色体畸变和自身免疫：与18p缺失和其他染色体畸变相关的免疫介导疾病。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2025-01-02 DOI: 10.1016/j.autrev.2024.103740

Camilla Cirone Papa Giannotti , Renan Rodrigues Neves Ribeiro do Nascimento , Maria Teresa Terreri , Luis Eduardo Coelho Andrade , Sandro Félix Perazzio

Recent advances in genomic methodologies have significantly enhanced our understanding of immune-mediated rheumatic diseases. Specific structural variants (SVs), such as substantial DNA deletions or insertions, including chromosomal aberrations, have been implicated in diseases of immune dysregulation. Regrettably, SVs are frequently overlooked in next-generation sequencing (NGS) targeted-gene panels, whole exome sequencing (WES) and whole genome sequencing (WGS). In view of a case of chromosome 18p deletion syndrome, characterized by hypogammaglobulinemia and an autoinflammatory phenotype, we provide a comprehensive review on chromosome aberrations associated with multiple immune-mediated conditions, highlighting the clinical aspects of the various chromosome aberrations associated with immune-mediated diseases. Further investigations and development of functional tests should contribute to elucidate the mechanistic connection between chromosome aberrations and Primary Immune Regulatory Disorders (PIRD), bringing novel perspectives in the field of autoinflammatory and autoimmune diseases.

基因组方法学的最新进展显著增强了我们对免疫介导的风湿病的理解。特异性结构变异（SVs），如大量DNA缺失或插入，包括染色体畸变，与免疫失调疾病有关。令人遗憾的是，在下一代测序（NGS）靶向基因面板、全外显子组测序（WES）和全基因组测序（WGS）中，SVs经常被忽视。鉴于一例染色体18p缺失综合征，以低γ球蛋白血症和自身炎症表型为特征，我们提供了与多种免疫介导疾病相关的染色体畸变的全面回顾，突出了与免疫介导疾病相关的各种染色体畸变的临床方面。功能测试的进一步研究和发展将有助于阐明染色体畸变与原发性免疫调节障碍（PIRD）之间的机制联系，为自身炎症和自身免疫性疾病领域带来新的视角。

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引用次数: 0

Immunometabolic shifts in autoimmune disease: Mechanisms and pathophysiological implications 自身免疫性疾病的免疫代谢转变：机制和病理生理意义。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2024-12-30 DOI: 10.1016/j.autrev.2024.103738

Yue Chen , Qingqing Lin , Hui Cheng , Qiyu Xiang , Wenxian Zhou , Jinyu Wu , Xiaobing Wang

Autoimmune diseases occur when the immune system abnormally attacks the body's normal tissues, causing inflammation and damage. Each disease has unique immune and metabolic dysfunctions during pathogenesis. In rheumatoid arthritis (RA), immune cells have different metabolic patterns and mitochondrial/lysosomal dysfunctions at different disease stages. In systemic lupus erythematosus (SLE), type I interferon (IFN) causes immune cell metabolic dysregulation, linking activation to metabolic shifts that may worsen the disease. In systemic sclerosis (SSc), mitochondrial changes affect fibroblast metabolism and the immune response. Idiopathic inflammatory myopathies (IIMs) patients have mitochondrial and metabolic issues. In primary Sjögren's syndrome (pSS), immune cell metabolism is imbalanced and mitochondrial damage can lead to cell/tissue damage. Metabolic reprogramming links cellular energy needs and immune dysfunctions, causing inflammation, damage, and symptoms in these diseases. It also affects immune cell functions like differentiation, proliferation, and secretion. This review discusses the potential of targeting metabolic pathways to restore immune balance, offering directions for future autoimmune disease research and treatment.

当免疫系统不正常地攻击身体的正常组织，引起炎症和损伤时，就会发生自身免疫性疾病。每种疾病在发病过程中都有独特的免疫和代谢功能障碍。在类风湿性关节炎（RA）中，免疫细胞在不同的疾病阶段具有不同的代谢模式和线粒体/溶酶体功能障碍。在系统性红斑狼疮（SLE）中，I型干扰素（IFN）引起免疫细胞代谢失调，将激活与可能使疾病恶化的代谢变化联系起来。在系统性硬化症（SSc）中，线粒体变化影响成纤维细胞代谢和免疫反应。特发性炎症性肌病（IIMs）患者有线粒体和代谢问题。在原发性Sjögren综合征（pSS）中，免疫细胞代谢不平衡，线粒体损伤可导致细胞/组织损伤。代谢重编程将细胞能量需求和免疫功能障碍联系起来，导致这些疾病的炎症、损伤和症状。它还影响免疫细胞的功能，如分化、增殖和分泌。本文综述了靶向代谢途径恢复免疫平衡的潜力，为未来自身免疫性疾病的研究和治疗提供方向。

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引用次数: 0

Janus-kinase inhibitor use in immune-mediated inflammatory diseases beyond licensed indications: A scoping review janus -激酶抑制剂在免疫介导的炎症性疾病中的应用：一项范围审查。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2024-12-30 DOI: 10.1016/j.autrev.2024.103736

Dimitris Challoumas , Cameron Simpson , Matthew Arnold , Philip Mease , Robert Moots , Mwidimi Ndosi , Zoe Rutter Locher

Introduction

The use of Janus kinase inhibitors (JAKis) in immune-mediated inflammatory diseases (IMIDs) beyond licence is expanding rapidly. The aim of this scoping review was to identify and present the available evidence on the efficacy of JAKis in all conditions without marketing authorisation.

Methods

Through a systematic literature search we identified studies including 5 or more patients that assessed the use of any JAKi for any efficacy outcome. Quantitative analyses in the form of pairwise meta-analyses were performed for eligible data from randomised controlled trials (RCTs) only.

Results

Eighty-three (n = 83) studies in total were included in our review, assessing efficacy of JAKis in 34 IMIDs. In most conditions, JAKis exhibited generally positive effects, though the majority of evidence came from observational, non-comparative studies. Pairwise meta-analyses were possible for hidradenitis suppurativa and systemic lupus erythematosus (SLE). For hidradenitis suppurativa, we found a clear benefit of treatment with JAKis compared with placebo in achieving clinical response [OR 2.35, 95 % CI (1.24 to 4.46)]. For treatment-resistant SLE, the results were equivocal; JAKi showed some benefit over placebo but statistical significance was only reached for one of the two meta-analysed outcome measures [SLE Responder Index 4, OR 1.41, 95 % CI (1.01 to 1.98); SLE Disease Activity Index 2000; OR 1.36, 95 % CI (0.99 to 1.88)].

Conclusions

There is a rapidly increasing use of JAKis beyond current licencing in most IMIDs. Large comparative trials are necessary to confirm efficacy and guide future licencing decisions.

janus激酶抑制剂（JAKi）在免疫介导性炎症（IMIDs）中的应用正在迅速扩大。本次范围审查的目的是确定并提出JAKi在所有条件下未经上市许可的有效性的现有证据。方法：通过详细的文献检索，我们确定了包括5名或更多患者的研究，这些研究评估了使用任何JAKi的任何疗效结果。仅对随机对照试验（rct）的合格数据进行两两荟萃分析形式的定量分析。结果：我们的综述共纳入84项（n = 83）研究，评估了JAKi在34例IMIDs中的疗效。在大多数情况下，JAKi表现出普遍的积极作用，尽管大多数证据来自观察性研究，非比较研究。对化脓性汗腺炎和系统性红斑狼疮（SLE）进行两两荟萃分析是可能的。对于化脓性汗腺炎，我们发现与安慰剂相比，JAKi治疗在获得临床反应方面有明显的益处[OR为2.35(1.24 - 4.46)]。对于治疗抵抗性SLE，结果是模棱两可的；JAKi和安慰剂有利于JAKi，但两项荟萃分析结果测量中只有一项达到统计学显著性[SLE应答指数4，OR 1.41(1.01至1.98)；SLE疾病活动指数2000；OR 1.36(0.99 - 1.88)]。结论：在大多数IMIDs中，JAKi的使用迅速增加，超出了目前的许可范围。为了提供明确的答案，并有助于未来的许可决定，有必要进行大规模的比较试验。

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引用次数: 0

Current state of epigenetics in giant cell arteritis: Focus on microRNA dysregulation 巨细胞动脉炎的表观遗传学现状：关注microRNA失调。

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews

Pub Date : 2024-12-26 DOI: 10.1016/j.autrev.2024.103739

Luka Bolha , Alojzija Hočevar , Vesna Jurčić

Giant cell arteritis (GCA) is a primary systemic vasculitis affecting the elderly, characterized by a granulomatous vessel wall inflammation of large- and medium-sized arteries. The immunopathology of GCA is complex, involving both the innate and adaptive arms of the immune system, where a maladaptive inflammatory-driven vascular repair process ultimately results in vessel wall thickening, intramural vascular smooth muscle cell proliferation, neovascularization and vessel lumen occlusion, which can lead to serious ischemic complications such as visual loss and ischemic stroke. Over the past decade, microRNA (miRNA) dysregulation has been highlighted as an important contributing factor underlying the pathogenesis of GCA. Since current understanding of miRNA involvement in GCA remains largely based on extrapolation of previously determined miRNA functions in vitro or in loss- or gain-of-function studies, an overall insight into the role of miRNA alteration in GCA pathophysiology remains limited. In this narrative review, we summarize the current knowledge on aberrantly expressed miRNAs in GCA and thoroughly discuss the impact of their altered regulatory role in the context of GCA setting. Furthermore, we address challenges and future perspectives in utilization of miRNA-based diagnostic and prognostic biomarkers of GCA in clinical settings.

巨细胞动脉炎（GCA）是一种影响老年人的原发性全身性血管炎，以大中型动脉血管壁肉芽肿性炎症为特征。GCA的免疫病理是复杂的，涉及免疫系统的先天和适应性，炎症驱动的不适应血管修复过程最终导致血管壁增厚，血管内平滑肌细胞增殖，新生血管和血管腔闭塞，可导致严重的缺血性并发症，如视力丧失和缺血性中风。在过去的十年中，microRNA （miRNA）失调已被强调为GCA发病机制的重要促成因素。由于目前对miRNA参与GCA的理解仍然主要基于先前确定的体外miRNA功能或功能丧失或功能获得研究的外推，因此对miRNA改变在GCA病理生理中的作用的全面了解仍然有限。在这篇叙述性综述中，我们总结了目前关于GCA中异常表达的mirna的知识，并深入讨论了它们在GCA设置背景下改变的调节作用的影响。此外，我们讨论了在临床环境中使用基于mirna的GCA诊断和预后生物标志物的挑战和未来前景。

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引用次数: 0