免疫球蛋白A血管炎病因及发病机制的研究进展

Research advances in the etiology and pathogenesis of immunoglobulin A vasculitis

免疫球蛋白A血管炎(immunoglobulin A vasculitis,IgAV),也称过敏性紫癜,病因及发病机制较为复杂,目前尚未完全阐明。最新研究表明,新型冠状病毒及相关疫苗、人乳头瘤疫苗及其他生物制剂等也可以诱发IgAV。大多研究认为,半乳糖缺陷型IgA1(galactose-deficient IgA1,Gd-IgA1)及含Gd-IgA1的免疫复合物形成在IgAV发病机制中起至关重要的作用。也有假设提出IgAV的发生与IgA1和抗内皮细胞抗体的结合有关。此外,遗传学也是IgAV研究的重点。该文综述IgAV病因的新进展,并总结Gd-IgA1、含Gd-IgA1的免疫复合物、抗内皮细胞抗体和IgA1的结合物、T细胞免疫及遗传因素在IgAV发病机制中的作用。

Immunoglobulin A vasculitis(IgAV),also known as Henoch-Schönlein purpura,has complex etiology and pathogenesis which have not been fully clarified.The latest research shows that SARS-CoV-2 and related vaccines,human papilloma vaccine,and certain biological agents can also induce IgAV.Most studies believe that the formation of galactose-deficient IgA1(Gd-IgA1)and Gd-IgA1-containing immune complex plays a crucial role in the pathogenesis of IgAV.It is hypothesized that the pathogenesis of IgAV is associated with the binding of IgA1 to anti-endothelial cell antibodies.In addition,genetics also constitutes a major focus of IgAV research.This article reviews the new advances in the etiology of IgAV and summarizes the role of Gd-IgA1,Gd-IgA1-containing immune complex,anti-endothelial antibody,IgA1 conjugates,T lymphocyte immunity,and genetic factors in the pathogenesis of IgAV.