自身抗体的流行揭示了HIV感染和已感染儿童中主要的sma和anca-pr3 / mpo模式

L.M. Navarta, C. Espul, N. Acosta-Rivero
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引用次数: 2

摘要

甲型肝炎病毒(HAV)和人类免疫缺陷病毒(HIV)与儿童自身抗体和自身免疫表现的发展有关。自身免疫性肝炎(AIH)在儿童/青少年中尤其具有侵袭性,其后果更为严重。因此,研究儿童病毒相关自身免疫性疾病的机制是一个相关的研究课题。我们的目的是研究与健康儿童相比,感染HAV或HIV的儿童血浆中自身抗体的患病率。研究了自身抗体的存在与肝损伤生化指标之间的关系。自身抗体(SMA)检测与甲型肝炎感染相关,患病率为35%。与无自身抗体的患者相比,在对自身抗原有反应性的甲型肝炎患者血清中观察到相似的肝酶水平。另一方面,HIV感染表现出比hav感染患者更广泛的抗体反应性,并且与SMA(18%)、ANCA(20%)、ANCA- pr3(15%)和ANCA- mpo(13%)相关。此外,在8%的艾滋病毒感染儿童中检测到RF或ANA。自身抗体的流行与感染儿童的性别或年龄无关。在HAV和hiv感染患者中观察到SMA的高患病率。由于HAV和SMA可能在某些患者中持续存在,而AIH可能在易感儿童中发展,因此建议对病毒感染患者进行随访。由于ANCA-PR3和ANCA-MPO已被证明具有致病性、促炎性并与症状性HIV感染相关,因此需要进一步研究确定这些自身抗体在儿童病毒感染相关发病机制中的作用。
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PREVALENCE OF AUTOANTIBODIES REVEALS A PREDOMINANT SMA AND ANCA-PR3/MPO PATTERN IN HIV INFECTION AND SMA IN HAV-INFECTED CHILDREN
Hepatitis A Virus (HAV) and Human Immunodeficiency Virus (HIV) have been associated with development of autoantibodies and autoimmune manifestations in children. Autoimmune Hepatitis (AIH) is particularly aggressive in children/adolescents with a more severe outcome. Thus, studying the mechanisms of virus-related autoimmune disorders in children is a relevant topic of research. We aimed to study the prevalence of autoantibodies in plasma of children infected with either HAV or HIV comparing to healthy children. The relationship bet ween the presence of autoantibodies and biochemical markers of hepatic damage was also investigated. De tection of autoantibodies (SMA) was associated with HAV infection with a prevalence of 35%. Similar levels of hepatic enzymes were observed in sera of HAV-infected patients with reactivity against autoa ntigens as compared to those without autoantibodies . On the other hand, HIV infection showed broader aut oantibodies reactivities than HAV-infected patients and was associated with SMA (18%), ANCA (20%), ANCA-PR3 (15%) and ANCA-MPO (13%). Moreover, either RF or ANA was detected in 8% of HIV-infected children. Prevalence of autoantibodies was not associated with either gender or age of inf ected children. A high prevalence of SMA was observed in HAV- and HIV-infected patients. As HAV and SMA may persit in some patients and AIH can develop in susceptible children, it is recommen ded a follow up of virus infected patients. Since ANCA-PR3 and ANCA-MPO have been shown to be pathogenic, proinflammatory and associated with symptomatic HIV infection, further studies are requ ired to determine the role of these autoantibodies in the pathogenesis associated with viral infection in children.
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