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抗体介导的免疫反应与非酒精性脂肪性肝病:一项双向孟德尔随机化研究
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作者 陈阮昶 周方正 +1 位作者 章佳瑶 鲁葆春 《临床医学进展》 2024年第11期522-530,共9页
背景:先前的研究已将抗体介导的免疫反应与非酒精性脂肪性肝病(NAFLD)联系起来,但其因果关系仍不明确。目的:进一步明确抗体免疫反应与NAFLD之间的因果关系。方法:抗体介导的免疫反应和NAFLD的汇总统计数据来自欧洲人群的全基因组关联研... 背景:先前的研究已将抗体介导的免疫反应与非酒精性脂肪性肝病(NAFLD)联系起来,但其因果关系仍不明确。目的:进一步明确抗体免疫反应与NAFLD之间的因果关系。方法:抗体介导的免疫反应和NAFLD的汇总统计数据来自欧洲人群的全基因组关联研究(GWAS)。研究采用双向孟德尔随机化分析,主要通过逆方差加权法(IVW)评估46种抗体介导的免疫反应与NAFLD之间的因果关系。潜在的多效性使用MR-Egger和MR-PRESSO法进行评估,异质性通过Cochran’s Q检验进行检测,敏感性分析则采用leave-one-out法进行评估。结果:基于IVW的孟德尔随机化分析结果表明,两种抗体介导的免疫反应可能会增加NAFLD的风险:(沙眼衣原体tarp-D F1抗体水平:OR 1.068, 95% CI: 1.006~1.133, P-value = 0.032和幽门螺杆菌UREA抗体水平:OR 1.084, 95% CI: 1.001~1.174, P-value = 0.047)。反向孟德尔随机化显示,随着NAFLD风险的增加,幽门螺杆菌UREA抗体水平和抗单纯疱疹病毒1型IgG血清阳性也增加。相反,抗沙眼衣原体IgG血清阳性和抗多瘤病毒2 IgG血清阳性则呈下降趋势。结论:这项研究证实了抗体介导的免疫反应与NAFLD之间的因果关系,为免疫反应在NAFLD发展中的作用提供了新的证据,对NAFLD的预防和治疗具有重要意义。Background: Previous studies have linked antibody-mediated immune responses to non-alcoholic fatty liver disease (NAFLD), but the causal relationship remains unclear. Aims: To further understand the causal relationship between immune responses and NAFLD. Methods: Summary statistics for antibody-mediated immune response and NAFLD were derived from GWAS data based on European participants. Bidirectional Mendelian randomization mainly applying Inverse variance weighted (IVW) method was employed to assess the causal relationships between 46 antibody-mediated immune responses and NAFLD. Potential pleiotropy was evaluated using MR-Egger and MR-PRESSO methods, heterogeneity was examined with Cochran’s Q test, and sensitivity was assessed through leave-one-out analysis. Results: Based on IVW method, our Mendelian randomization showed that two antibody-mediated immune responses potentially causally increase NAFLD risk (Chlamydia trachomatis tarp-D F1 antibody levels: OR 1.068, 95% CI: 1.006~1.133, P-value = 0.032 and Helicobacter pylori UREA antibody levels: OR 1.084, 95% CI: 1.001~1.174, P-value = 0.047). Reverse Mendelian randomization revealed increased NAFLD risk causally associated with higher Helicobacter pylori UREA antibody levels and Anti-herpes simplex virus 1 IgG seropositivity. Conversely, Anti-Chlamydia trachomatis IgG and Anti-polyomavirus 2 IgG seropositivity showed a decreasing trend. There was no evidence of heterogeneity or horizontal pleiotropy detected. Conclusions: This study confirms causal relationships between antibody-mediated immune response and NAFLD, offering new evidence for the role of immune responses in NAFLD development and presenting significant implications for its prevention and treatment. 展开更多
关键词 孟德尔随机化 抗体介导免疫反应 非酒精性脂肪性肝病 因果关系
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抗体介导的中枢神经系统自身免疫性疾病患儿207例临床分析
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作者 康庆云 杨理明 +3 位作者 廖红梅 廖彩时 宁泽淑 吴丽文 《中华神经医学杂志》 CAS CSCD 北大核心 2023年第8期808-814,共7页
目的:探讨抗体介导的中枢神经系统(CNS)自身免疫性疾病患儿的临床特征、治疗及预后。方法:回顾性收集湖南省儿童医院神经内科自2014年6月至2022年5月收治的经血和(或)脑脊液抗神经抗体检测确诊的207例抗体介导的CNS自身免疫性疾病患儿... 目的:探讨抗体介导的中枢神经系统(CNS)自身免疫性疾病患儿的临床特征、治疗及预后。方法:回顾性收集湖南省儿童医院神经内科自2014年6月至2022年5月收治的经血和(或)脑脊液抗神经抗体检测确诊的207例抗体介导的CNS自身免疫性疾病患儿的临床资料,总结分析其临床特征、实验室和影像学资料、治疗方案和预后。结果:207例抗体介导的CNS自身免疫性疾病患儿中抗N-甲基-D-天冬氨酸受体(NMDAR)抗体阳性117例,抗髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性63例,抗胶质纤维酸性蛋白(GFAP)抗体阳性32例,抗接触蛋白相关蛋白-2(CASPR2)抗体阳性6例,抗水通道蛋白4(AQP4)抗体阳性3例,抗γ-氨基丁酸B型受体(GABABR)抗体阳性2例,抗富亮氨酸胶质瘤失活蛋白1(LGI1)抗体阳性1例;最常见的临床表型是急性播散性脑脊髓炎(ADEM),其次为视神经炎(ON);精神行为异常、癫痫发作及不自主运动是抗NMDAR抗体阳性患儿最常见的临床症状,而发热、头痛、意识障碍及视觉障碍是MOG抗体相关疾病(MOGAD)及自身免疫性GFAP星形胶质细胞病(GFAP-A)病程中最常见的临床症状。207例患儿中17例有多重抗神经抗体共阳性,其中抗NMDAR抗体与抗MOG抗体共存10例(1例同时检测到抗GFAP抗体),抗NMDAR抗体与抗GFAP抗体共存3例,抗MOG抗体与抗GFAP抗体共存3例,抗NMDAR抗体与抗CASPR2抗体共存2例,抗GABABR抗体与抗CASPR2抗体共存1例。202例患儿脑脊液检查结果显示154例出现白细胞增多症,27例蛋白水平升高。203例患儿脑电图检查结果显示179例异常,异常脑电图主要表现为局灶性或全面性慢波,部分患儿脑电图提示痫性放电。205例患儿接受了免疫治疗。所有存活患儿均至少随访6个月,164例患儿完全康复,40例存在不同程度后遗症,3例死亡。随访期间共有28例患儿有1次或多次复发。结论:抗体介导的CNS自身免疫性疾病可发生于儿童各年龄段,免疫治疗有效,大部分患儿对免疫治疗反应良好,死亡率低,但部分患儿存在复发风险。 展开更多
关键词 抗体介导的自身免疫性疾病 中枢神经系统 儿童 临床特征 免疫治疗 预后
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结节性多动脉炎一例报告
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作者 郭淑文 《西北国防医学杂志》 CAS 1993年第1期56-56,共1页
结节性多动脉是由抗体介导免疫反应引起的坏死性血管炎的一种,以侵儿犯全身中、小动脉为主,常有严重的纤维素样坏死及血栓形成,累及多个系统,症状有发热、乏力、体重下降并伴有肌痛、关节痛、高血压、肾小球肾炎或腹痛.实验检查为正细... 结节性多动脉是由抗体介导免疫反应引起的坏死性血管炎的一种,以侵儿犯全身中、小动脉为主,常有严重的纤维素样坏死及血栓形成,累及多个系统,症状有发热、乏力、体重下降并伴有肌痛、关节痛、高血压、肾小球肾炎或腹痛.实验检查为正细胞正常色素性贫血,白细胞增高、血沉快,常伴有高球蛋白血症.病理分两型,即曲型型和显微镜型.典型型肾脏大、中、小叶间动脉发生局灶坏型动脉炎.显微镜型70%以上累及肾脏,大多数以肾小球局灶与节段坏死性损害为唯一病理病变.免疫萤光Igc、IgM、C<sub>3</sub>与纤维素沿肾小球毛细血管壁呈颗粒样沉积,现介绍一例: 展开更多
关键词 结节性多动脉炎 高球蛋白血症 小叶间动脉 纤维素样坏死 抗体介导免疫 白细胞增高 肾小球肾炎 色素性 坏死性血管炎 颗粒样
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A Woman with Psychogenic Non-epileptic Seizures and Pelvic Mass
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作者 Teng-da Xu Sheng-yong Xu Jia-yuan Dai 《Chinese Medical Sciences Journal》 CAS CSCD 2016年第3期203-205,206,共4页
MOST cases of encephalitis are caused by viruses but a few have an immunological basis, such as paraneoplastic encephalitis, with specific antibodies identified. One recently characterized encephalitis caused by antib... MOST cases of encephalitis are caused by viruses but a few have an immunological basis, such as paraneoplastic encephalitis, with specific antibodies identified. One recently characterized encephalitis caused by antibodies is anti-N- methyl-D-aspartate (NMDA) receptor encephalitis. It is a form of paraneoplastic limbic encephalitis associated with ovarian teratoma and has recently been described.The NMDA receptor mediates excitatory neurotransmission. It is important for synaptic plasticity, and thus for higher function such as learning and memory. This disorder results in prominent psychiatric symptoms followed by a rapid decline of the level of consciousness, central hypoventilation, seizures, involuntary movements and dysautonomia. 展开更多
关键词 psychogenic seizure limbic encephalitis ovarian teratoma anti-N-methyl-D-aspartate receptor encephalitis emergency treatment
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