CD8-positive T-lymphocytes

CD8 阳性 T 淋巴细胞
  • 文章类型: Journal Article
    细胞毒性T淋巴细胞(CTL),也被称为CD8+T细胞,通过识别与肿瘤细胞相关的特异性抗原和I类主要组织相容性复合物分子后分泌各种细胞因子参与免疫功能,因此在抗肿瘤免疫中起关键作用。然而,某些CD8+T细胞显示低反应性,因此不能有效去除肿瘤细胞或病毒抗原。由于这种异质性,需要代表CD8+细胞中这些差异的有效生物标志物。合适的生物标志物的鉴定也将增强癌症治疗的管理。最近的研究提高了对肿瘤微环境和循环系统中CD8T淋巴细胞的认识。治疗效果直接受到CTL的致病反应的影响,因此,使用辅助疗法来解决这些病理变化,例如,刺激反应性T细胞比例的增加或抑制终末耗尽T细胞的比例,将是有利的。
    Cytotoxic T lymphocytes (CTLs), also known as CD8+ T cells, participate in immune function by secreting various cytokines after recognizing specific antigens and class I major histocompatibility complex molecules associated with tumor cells, and thus have a key role in antitumor immunity. However, certain CD8+ T cells show low reactivity and thus cannot effectively remove tumor cells or viral antigens. Due to this heterogeneity, effective biomarkers representing these differences in CD8+ cells are needed. The identification of suitable biomarkers will also enhance the management of cancer treatment. Recent research has improved the understanding of CD8+ T lymphocytes in the tumor microenvironment and circulatory system. Treatment efficacy is impacted directly by the pathogenic response of CTLs, and thus, the use of adjuvant therapies to address these pathological changes, e.g., stimulating the increase in the proportion of reactive T cells or suppressing the proportion of terminally exhausted T cells, would be advantageous.
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  • 文章类型: Case Reports
    我们报告了一例罕见的多发性孤立性浆细胞瘤(MSP)老年患者的自发性消退(SR)病例。通过手术切除左鼻腔肿块和随后的右肱骨活检证实了MSP的诊断。由于表现状况不佳,该患者被认为不适合接受化疗。诊断后3个月,随着骨病变的恶化和新的血清单克隆蛋白的出现,患者的病情恶化。然而,这些临床发现在6个月时完全消失,1年时正电子发射断层扫描-计算机断层扫描证实代谢完全缓解。值得注意的是,外周血淋巴细胞计数与肿瘤进展和缓解呈负相关。初始活检标本的病理重新评估显示,肿瘤浸润性CD8T细胞中的程序性细胞死亡蛋白1(PD-1)表达。此外,肿瘤细胞感染EB病毒(EBV),但程序性细胞死亡配体1(PD-L1)表达阴性,这是肿瘤细胞中最有效的免疫逃逸机制。虽然SR的潜在机制尚不清楚,我们的研究结果表明,宿主免疫反应以及EBV感染可能与SR有关。需要进一步的研究来阐明浆细胞肿瘤肿瘤消退的临床病理机制。
    We report a rare case of spontaneous regression (SR) in an elderly untreated patient with multiple solitary plasmacytoma (MSP). Diagnosis of MSP was confirmed through surgical resection of the left nasal cavity mass and subsequent biopsy of the right humerus. The patient was considered ineligible for chemotherapy due to poor performance status. At 3-month post-diagnosis, the patient\'s condition worsened with deteriorating bone lesions and emergence of a new serum monoclonal protein. However, these clinical findings completely disappeared at 6 months, and positron emission tomography-computed tomography at 1 year confirmed complete metabolic remission. Notably, peripheral blood lymphocyte counts were inversely correlated with tumor progression and remission. Pathological re-evaluation of the initial biopsy specimens revealed programmed cell death protein 1 (PD-1) expression in tumor-infiltrating CD8+ T cells. In addition, tumor cells were infected with Epstein-Barr virus (EBV) but were negative for programmed cell death ligand 1 (PD-L1) expression, which is the most potent immune escape mechanism in tumor cells. While the mechanism underlying SR remains unclear, our findings suggest that host immune response as well as EBV infection may contribute to SR. Further studies are needed to elucidate the clinicopathologic mechanisms of tumor regression in plasma cell neoplasms.
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  • 文章类型: Systematic Review
    背景:复发性/转移性鼻咽癌(RM-NPC)仍然难以治疗,并导致相当大的死亡率。RM-NPC的一线治疗是吉西他滨和顺铂,二线治疗方案不同。NPC的地方性变异与EB病毒(EBV)有关。因此,靶向EBV特异性RM-NPC的基于细胞的免疫治疗(CBI)可能是有效的。
    方法:我们系统地搜索了PubMed,Embase和Cochrane图书馆进行随机或观察性研究,研究CBI治疗RM-NPC的疗效和安全性。我们使用随机效应模型进行了所有荟萃分析。研究进一步按地方性分层,我们采用疾病性质和药物类型来调查研究间的潜在异质性,并采用额外的预先指定测试来评估发表偏倚.
    结果:我们筛选了1,671项研究,包括13项研究,包括403名参与者,其中9项研究符合荟萃分析的条件.使用CBI单一疗法作为EBV阳性RM-NPC的第二或后续线治疗显示ORR为10%(95CI=3%-29%),中位PFS为2.37个月(95CI=1.23~3.51),中位OS为10.16个月(95CI=0.67~19.65).对于EBV特异性细胞毒性T淋巴细胞单一疗法,合并PD率为54%(95CI=9%-93%),SD率为22%(95CI=2%-75%),任何级别不良事件的发生率为45%。对于树突状细胞单一疗法,PD率为80%(95%CI=29%-98%),SD率为11%(95%CI=0%-82%),任何级别的不良事件发生率为29%。
    结论:CBI单一疗法在预处理的RM-NPC中显示出一定的活性。需要更多的试验来更好地了解如何将CBI整合到RM-NPC护理中。
    BACKGROUND: Recurrent/Metastatic Nasopharyngeal Carcinoma (RM-NPC) remains difficult to treat and contributes to considerable mortality. The first-line treatment for RM-NPC is Gemcitabine and Cisplatin and second-line treatment options differ. The endemic variant of NPC is associated with Epstein-Barr Virus (EBV). Therefore, Cell-based Immunotherapy (CBI) targeting EBV-specific RM-NPC may be effective.
    METHODS: We systematically searched PubMed, Embase and the Cochrane Library for randomised or observational studies investigating the efficacy and safety of CBI in the treatment of RM-NPC. We performed all meta-analyses using the random-effects model. Studies were further stratified by endemicity, nature of disease and drug type to investigate for potential between-study heterogeneity and additional pre-specified tests were employed to assess for publication bias.
    RESULTS: We screened 1,671 studies and included 13 studies with 403 participants in the systematic review, of which nine studies were eligible for meta-analysis. The use of CBI monotherapy as second or subsequent line treatment for EBV-positive RM-NPC revealed an ORR of 10 % (95 %CI = 3 %-29 %), median PFS of 2.37 months (95 %CI = 1.23-3.51) and median OS of 10.16 months (95 %CI = 0.67-19.65). For EBV-specific Cytotoxic T-Lymphocyte monotherapy, the pooled PD rate was 54 % (95 %CI = 9 %-93 %), SD rate was 22 % (95 %CI = 2 %-75 %) and incidence rate of any grade adverse events was 45 %. For Dendritic Cell monotherapy, a PD rate of 80 % (95 % CI = 29 %-98 %), SD rate of 11 % (95 % CI = 0 %-82 %) and incidence rate of any grade adverse events of 29 % was achieved.
    CONCLUSIONS: CBI monotherapy demonstrates some activity in pre-treated RM-NPC. More trials are needed to better understand how to integrate CBI into RM-NPC care.
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  • 文章类型: Journal Article
    自身免疫性脑炎(AIE)是一种免疫反应性脑炎,被认为是最常见的非感染性脑炎。然而,通过活检或尸检进行明确的AIE诊断非常罕见,这是对了解和管理疾病的重大障碍.在这篇文章中,我们介绍了AIE的病理学发现,并根据一例以CD8+T淋巴细胞为主的脑炎表现的AIE病例对文献进行了综述.我们描述了临床进展,诊断成像,实验室数据,以及一名80岁男性患者的尸检结果。患者在死亡前6个月被诊断为肺结核,并接受了适当的药物治疗。入院前一周,患者表现出睡眠倾向等症状,食欲下降,和困惑。尽管患者通过药物治疗包括纠正低钠血症在时间上有所改善,患者进展迅速,在6周内死亡。脑组织显示灰质和白质有淋巴细胞浸润,软脑膜,和以CD8+T淋巴细胞为主的血管周围浸润,暗示了一个AIE的案例。没有检测到病毒感染或潜在肿瘤的证据。尸检显示这个病人也有老年痴呆症,动脉粥样硬化,动脉硬化,和衰老相关的tau星形胶质细胞病。本报告强调病理检查在AIE诊断中的关键作用。特别是当血清学自身抗体检测不可用或当患者被怀疑患有多种疾病时。
    Autoimmune encephalitis (AIE) is a type of immunoreactive encephalitic disorder and is recognized as the most prevalent noninfectious encephalitis. Nevertheless, the rarity of definitive AIE diagnosis through biopsy or autopsy represents a significant hurdle to understanding and managing the disease. In this article, we present the pathological findings of AIE and review the literature based on a distinct case of AIE presenting as CD8+ T-lymphocyte predominant encephalitis. We describe the clinical progression, diagnostic imaging, laboratory data, and autopsy findings of an 80-year-old deceased male patient. The patient was diagnosed with pulmonary tuberculosis 6 months before death and received appropriate medications. A week before admission to the hospital, the patient manifested symptoms such as a tendency to sleep, decreased appetite, and confusion. Although the patient temporally improved with medication including correction of hyponatremia, the patient progressed rapidly and died in 6 weeks. The brain tissue revealed lymphocytic infiltration in the gray and white matter, leptomeninges, and perivascular infiltration with a predominance of CD8+ T lymphocytes, suggesting a case of AIE. There was no detectable evidence of viral infection or underlying neoplasm. The autopsy revealed that this patient also had Alzheimer\'s disease, atherosclerosis, arteriolosclerosis, and aging-related tau astrogliopathy. This report emphasizes the pivotal role of pathological examination in the diagnosis of AIE, especially when serological autoantibody testing is not available or when a patient is suspected of having multiple diseases.
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  • 文章类型: Meta-Analysis
    在艾滋病毒携带者(PLHIV)中,CD4/CD8比值已被提议作为非AIDS事件的有用标志物.然而,它对CD4计数死亡率的预测能力,CD8+T细胞计数的作用仍存在争议。
    我们对1996年至2023年已发表的研究进行了系统评价和荟萃分析,包括抗逆转录病毒治疗的PLHIV,并报告CD4/CD8比值或CD8+计数。主要结果是非艾滋病死亡率或全因死亡率。我们进行了标准的随机效应成对荟萃分析,比较了低和高CD4/CD8比率以及预定义的0.5截止点。(CRD42020170931)。
    我们确定了2,479项筛查研究。20项研究纳入系统评价。七项研究发现,低CD4/CD8比率类别与死亡风险增加之间存在关联。具有0.4-1之间的可变截止点。选择了四项研究进行荟萃分析,包括12,893名参与者和618名报告死亡。与CD4/CD8比值低于0.5的患者相比,具有更高的死亡风险(OR3.65;95%CI3.04-4.35;I2=0.00%)。虽然由于研究之间的方法学差异,CD8+T细胞计数的荟萃分析不可行,系统评价提示长期较高值(>1,138~1,500细胞/uL)对预后有负面影响.
    我们的结果支持在临床实践中使用CD4/CD8比率作为预后指标,特别是在值低于0.5的患者中,但在比率计时测量上有共识的标准,截止值,在未来的研究中,需要时间来处理事件,以获得更有力的结论。
    https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42020170931,标识符CRD42020170931。
    In people living with HIV (PLHIV), the CD4/CD8 ratio has been proposed as a useful marker for non-AIDS events. However, its predictive ability on mortality over CD4 counts, and the role of CD8+ T-cell counts remain controversial.
    We conducted a systematic review and meta-analysis of published studies from 1996 to 2023, including PLHIV on antiretroviral treatment, and reporting CD4/CD8 ratio or CD8+ counts. The primary outcome was non-AIDS mortality or all-cause mortality. We performed a standard random-effects pairwise meta-analysis comparing low versus high CD4/CD8 ratio with a predefined cut-off point of 0.5. (CRD42020170931).
    We identified 2,479 studies for screening. 20 studies were included in the systematic review. Seven studies found an association between low CD4/CD8 ratio categories and increased mortality risk, with variable cut-off points between 0.4-1. Four studies were selected for meta-analysis, including 12,893 participants and 618 reported deaths. Patients with values of CD4/CD8 ratio below 0.5 showed a higher mortality risk (OR 3.65; 95% CI 3.04 - 4.35; I2 = 0.00%) compared to those with higher values. While the meta-analysis of CD8+ T-cell counts was not feasible due to methodological differences between studies, the systematic review suggests a negative prognostic impact of higher values (>1,138 to 1,500 cells/uL) in the long term.
    Our results support the use of the CD4/CD8 ratio as a prognostic marker in clinical practice, especially in patients with values below 0.5, but consensus criteria on ratio timing measurement, cut-off values, and time to event are needed in future studies to get more robust conclusions.
    https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020170931, identifier CRD42020170931.
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  • 文章类型: Journal Article
    转录因子,称为碱性亮氨酸拉链ATF样3(BATF3),是常规1型树突状细胞(cDC1)发展的关键因素,这对于引发CD8+T细胞介导的针对细胞内病原体和恶性肿瘤的免疫绝对是必需的。在这方面,依赖BATF3的cDC1可以带来免疫耐受,自身免疫反应,移植免疫,以及对病毒等传染因子的防御,微生物,寄生虫,和真菌。此外,cDC1在刺激CD8+T细胞中的重要功能为开发针对细胞内病原体和疾病的疫苗接种的高效靶标创造了极好的机会。已阐明BATF3可控制CD8α和CD103DCs的发展。肿瘤微环境(TME)中BATF3依赖性cDC1的存在增强了免疫监视并改善了免疫治疗方法,这对癌症免疫疗法是有益的。此外,BATF3通过降低转录因子FOXP3的表达而充当Treg发育的转录抑制剂。然而,当在CD8+T细胞中过度表达时,它可以增强他们的生存,并促进他们过渡到记忆状态。BATF3通过BATF3/IRF4复合物与IL-9启动子结合诱导Th9细胞分化。最新的研究发现之一是BATF3的致癌功能,它已被批准并在增殖和侵袭的多个生物学过程中得到说明。
    The transcription factor, known as basic leucine zipper ATF-like 3 (BATF3), is a crucial contributor to the development of conventional type 1 dendritic cells (cDC1), which is definitely required for priming CD8 + T cell-mediated immunity against intracellular pathogens and malignancies. In this respect, BATF3-dependent cDC1 can bring about immunological tolerance, an autoimmune response, graft immunity, and defense against infectious agents such as viruses, microbes, parasites, and fungi. Moreover, the important function of cDC1 in stimulating CD8 + T cells creates an excellent opportunity to develop a highly effective target for vaccination against intracellular pathogens and diseases. BATF3 has been clarified to control the development of CD8α+ and CD103+ DCs. The presence of BATF3-dependent cDC1 in the tumor microenvironment (TME) reinforces immunosurveillance and improves immunotherapy approaches, which can be beneficial for cancer immunotherapy. Additionally, BATF3 acts as a transcriptional inhibitor of Treg development by decreasing the expression of the transcription factor FOXP3. However, when overexpressed in CD8 + T cells, it can enhance their survival and facilitate their transition to a memory state. BATF3 induces Th9 cell differentiation by binding to the IL-9 promoter through a BATF3/IRF4 complex. One of the latest research findings is the oncogenic function of BATF3, which has been approved and illustrated in several biological processes of proliferation and invasion.
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  • 文章类型: Journal Article
    E2F转录因子(E2F)是一组编码转录因子家族的基因。它们已被确定为参与各种癌症类型的肿瘤进展。然而,对表达水平知之甚少,遗传变异,分子机制,HNSCC中不同E2Fs的预后价值和免疫浸润。在这项研究中,我们利用多个数据库来调查mRNA表达水平,遗传改变,HNSCC患者E2Fs的生物学功能。然后,E2Fs表达及其与发生的关系,进展,预后,并评估了HNSCC患者的免疫细胞浸润。我们发现所有八个E2Fs在HNSCC组织中的表达高于正常组织,E2F1/2/3/4/5/6/8的表达水平也与HNSCC的分期和分级有关。E2F1/2/4/8在HNSCC患者中的异常表达与临床转归有关。在HNSCC患者中,E2Fs的表达与免疫细胞浸润呈统计学相关,而B细胞和CD8T细胞的浸润与较好的OS呈正相关。此外,我们在验证实验中验证了组织水平的E2F2.我们的研究可能为HNSCC患者的免疫治疗靶标和潜在预后生物标志物的选择提供新的见解。
    E2F transcription factors (E2Fs) are a group of genes that encode a family of transcription factors. They have been identified as being involved in the tumor progression of various cancer types. However, little is known about the expression level, genetic variation, molecular mechanism, and prognostic value and immune infiltration of different E2Fs in HNSCC.In this study, we utilized multiple databases to investigate the mRNA expression level, genetic alteration, and biological function of E2Fs in HNSCC patients. Then, the relationship between E2Fs expression and its association with the occurrence, progress, prognosis, and immune cell infiltration in patients with HNSCC was evaluated. We found that all eight E2Fs were higher expressed in HNSCC tissues than in normal tissues, and the expression levels of E2F1/2/3/4/5/6/8 were also associated with the stage and grade of HNSCC. The abnormal expression of E2F1/2/4/8 in HNSCC patients is related to the clinical outcome. The expression of E2Fs was statistically correlated with the immune cell infiltration in HNSCC and the infiltration of B cells and CD8+ T cells were positively associated with better OS in HNSCC patients. Furthermore, we verified the E2F2 at the tissue level in the validation experiment. Our study may provide novel insights into the choice of immunotherapy targets and potential prognostic biomarkers in HNSCC patients.
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  • 文章类型: Review
    背景:中间神经痛(NIN)的特征是尖锐的阵发性发作,耳朵深处刺痛。不幸的是,关于这种疼痛综合征的文献中只有少数研究,其病理和术后结果。
    方法:我们对2015年1月至2023年1月在我们中心接受神经外科手术治疗的4例NIN患者进行了回顾性回顾。他们MRI检查的详细信息,获得术中发现和其他临床表现,分离舌咽神经和迷走神经进行免疫组织化学检查。
    结果:本报告共纳入4例NIN患者,这些患者在我院接受了显微外科手术。对所有患者进行NI切片,其中3例接受了微血管减压术。在这4名患者中,1患有伴随的三叉神经痛(TN),和1伴随舌咽神经痛(GPN)。3例接受TN治疗,2例接受GPN治疗。随访评估范围为8至99个月。三名患者在手术后立即报告疼痛完全缓解,直到最后一次随访。而其余患者的术前疼痛在3个月内逐渐缓解。免疫组织化学显示,更大量的CD4和CD8T细胞浸润了舌咽神经和迷走神经。
    结论:NIN是一种非常罕见的疾病,与TN/GPN高度重叠。深入的神经外科干预可以有效地完全缓解NIN疼痛,没有任何严重的并发症。T细胞似乎在CN神经痛的病理生理中起调节作用。
    BACKGROUND: Nervus intermedius neuralgia (NIN) is characterized by paroxysmal episodes of sharp, lancinating pain in the deep ear. Unfortunately, only a few studies exist in the literature on this pain syndrome, its pathology and postoperative outcomes.
    METHODS: We conducted a retrospective review of four cases diagnosed with NIN who underwent a neurosurgical intervention at our center from January 2015 to January 2023. Detailed information on their MRI examinations, intraoperative findings and other clinical presentations were obtained, and the glossopharyngeal and vagus nerves were isolated for immunohistochemistry examination.
    RESULTS: A total of 4 NIN patients who underwent a microsurgical intervention at our institution were included in this report. The NI was sectioned in all patients and 3 of them underwent a microvascular decompression. Of these 4 patients, 1 had a concomitant trigeminal neuralgia (TN), and 1 a concomitant glossopharyngeal neuralgia (GPN). Three patients underwent treatment for TN and 2 for GPN. Follow-up assessments ranged from 8 to 99 months. Three patients reported complete pain relief immediately after the surgery until last follow-up, while in the remaining patient the preoperative pain gradually resolved over the 3 month period. Immunohistochemistry revealed that a greater amount of CD4+ and CD8+ T cells had infiltrated the glossopharyngeal versus vagus nerve.
    CONCLUSIONS: NIN is an extremely rare condition showing a high degree of overlap with TN/GPN. An in depth neurosurgical intervention is effective to completely relieve NIN pain, without any serious complications. It appears that T cells may play regulatory role in the pathophysiology of CN neuralgia.
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  • 文章类型: Journal Article
    恶性腹水(MA)的出现表明卵巢患者预后不良,胃肠,乳房,还有胰腺癌.白细胞介素-10(IL-10)是一种多效细胞因子,在肿瘤微环境中具有免疫调节作用。MA中IL-10的水平因癌症类型和患者而异,影响癌症进展和结果。起源于各种免疫和癌细胞,IL-10有助于MA中的复杂信号传导途径。全身IL-10给药,尽管其对MA疗效的证据有限,仍然是一种有前途的治疗策略,因为它可以增加CD8T细胞的细胞毒性并直接激活耗尽的CD8肿瘤浸润淋巴细胞(TIL)。IL-10信号传导阻断在MA治疗中与其他免疫疗法组合时也显示出巨大的潜力。我们审查了水平,起源,以及IL-10在恶性腹水中的功能,并概述了当前IL-10信号靶向治疗,旨在为MA治疗提供见解。
    The emergence of malignant ascites (MA) indicates poor prognoses in patients with ovarian, gastrointestinal, breast, and pancreatic cancer. Interleukin-10 (IL-10) is a pleiotropic cytokine with immunoregulatory effects in tumor microenvironment. The level of IL-10 in MA varied across cancer types and patients, influencing cancer progression and outcomes. Originating from various immune and cancer cells, IL-10 contributes to complex signaling pathways in MA. Systemic IL-10 administration, although the evidence of its efficacy on MA is limited, still emerges as a promising therapeutic strategy because it can increase CD8+ T cells cytotoxicity and invigorate exhausted CD8+ tumor infiltration lymphocytes (TILs) directly. IL-10 signaling blockade also demonstrates great potential when combined with other immunotherapies in MA treatment. We reviewed the levels, origins, and functions of IL-10 in malignant ascites and overviewed the current IL-10 signaling targeting therapies, aiming to provide insights for MA treatment.
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  • 文章类型: Meta-Analysis
    背景:现有的系统性红斑狼疮(SLE)疗法仅对某些患者有效。开发新的治疗方法迫在眉睫。本荟萃分析旨在评估低剂量IL-2(LD-IL-2)的疗效和安全性。
    方法:根据PubMed发布的数据,WebofScience,Embase,ClinicalTrials.gov,MEDLINE,MEDLINE,WebofKnowledge,科克伦图书馆,和FDA.gov,纳入了8项试验.
    结果:LD-IL-2治疗后,54.8%的患者有明显的临床缓解。SRI-4反应率为0.819(95%置信区间[CI]:0.745-0.894),SELENA-SLEDAI评分显著降低(SMD=-2.109,95%CI:[-3.271,-0.947],p<.001)。此外,CD4+T的比例(SMD=0.614,95%CI:[0.250,0.979],p=.001)和Treg细胞(SMD=1.096,95%CI:[0.544,1.649],p<.001)在LD-IL-2治疗后显著增加,虽然CD8+T细胞的比例没有统计学差异,Th1细胞,Th2细胞,和Th17细胞(p>0.05)。此外,Th17的比例(SMD=1.121,95%CI:[0.709,1.533],p<.001)和Treg(SMD=0.655,95%CI:[0.273,1.038],p=.001)在每天皮下接受0.5百万IU的LD-IL-2治疗5天后显着增加,但是每隔一天皮下接受1百万IU的LD-IL-2治疗后Treg的比例没有统计学差异。注射部位反应和发热是IL-2常见的不良反应,分别占33.1%和14.4%。未报告严重不良事件。
    结论:LD-IL-2在治疗SLE方面是有希望的且耐受性良好,可以促进Treg的增殖和功能恢复。每天注射50万IU的IL-2比每隔一天注射100万IU可以更好地诱导Treg细胞的分化并维持免疫稳态。
    BACKGROUND: Existing therapies of systemic lupus erythematosus (SLE) are efficacious only in certain patients. Developing new treatment methods is urgent. This meta-analysis aimed to evaluate the efficacy and safety of low-dose IL-2 (LD-IL-2).
    METHODS: According to published data from PubMed, Web of Science, Embase, ClinicalTrials.gov, MEDLINE, MEDLINE, Web of Knowledge, Cochrane Library, and FDA.gov, eight trials were included.
    RESULTS: After the LD-IL-2 treatment, 54.8% of patients had distinct clinical remission. The SRI-4 response rates were 0.819 (95% confidence interval [CI]: 0.745-0.894), and the SELENA-SLEDAI scores were significantly decreased (SMD = -2.109, 95% CI: [-3.271, -0.947], p < .001). Besides, the proportions of CD4+ T (SMD = 0.614, 95% CI: [0.250, 0.979], p = .001) and Treg cells (SMD = 1.096, 95% CI: [0.544, 1.649], p < .001) were increased dramatically after LD-IL-2 treatment, while there were no statistical differences in the proportions of CD8+ T cells, Th1 cells, Th2 cells, and Th17 cells (p > .05). Besides, the proportions of Th17 (SMD = 1.121, 95% CI: [0.709, 1.533], p < .001) and Treg (SMD = 0.655, 95% CI: [0.273, 1.038], p = .001) were significantly increased after receiving subcutaneously 0.5 million IU of LD-IL-2 treatment per day for 5 days, but there were no statistical differences in the proportions of Treg after receiving 1 million IU every other day subcutaneously of LD-IL-2 treatment. Injection site reaction and fever were common side effects of IL-2, which occurred in 33.1% and 14.4% of patients. No serious adverse events were reported.
    CONCLUSIONS: LD-IL-2 was promising and well-tolerated in treating SLE, which could promote Treg\'s proliferation and functional recovery. Injecting 0.5 million IU of IL-2 daily can better induce the differentiation of Treg cells and maintain immune homeostasis than injecting 1 million IU every other day.
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