Antigen-Antibody Complex

抗原 - 抗体复合物
  • 文章类型: Journal Article
    通过传统技术优化治疗性抗体,例如通过杂交瘤或噬菌体展示进行候选筛选,是资源密集型和耗时的。近年来,基于计算和人工智能的方法已经被积极开发,以加速和改进治疗性抗体的开发。在这项研究中,我们开发了一个基于端到端序列的深度学习模型,称为AttABseq,用于预测与抗体突变相关的抗原-抗体结合亲和力变化。AttABseq是一种高效且通用的基于注意力的模型,通过利用不同的抗原-抗体复合物序列作为输入来预测残基突变的结合亲和力变化。对三个基准数据集的评估表明,就预测的和实验的结合亲和力变化之间的皮尔逊相关系数而言,AttABseq比其他基于序列的模型更准确120%。此外,AttABseq也优于或与基于结构的方法竞争。此外,AttABseq始终如一地展示了在各种条件下的强大预测能力,强调了其在广泛的抗原-抗体复合物中的显着泛化能力。它对改变的残留物的数量没有限制,使其在晶体学结构仍然不可用的情况下特别适用。基于注意力的可解释性分析表明,点突变对抗体-抗原结合亲和力变化的因果影响可以在残基水平上可视化,这可能有助于自动抗体序列优化。我们相信AttABseq为治疗性抗体优化提供了一个竞争激烈的答案。
    The optimization of therapeutic antibodies through traditional techniques, such as candidate screening via hybridoma or phage display, is resource-intensive and time-consuming. In recent years, computational and artificial intelligence-based methods have been actively developed to accelerate and improve the development of therapeutic antibodies. In this study, we developed an end-to-end sequence-based deep learning model, termed AttABseq, for the predictions of the antigen-antibody binding affinity changes connected with antibody mutations. AttABseq is a highly efficient and generic attention-based model by utilizing diverse antigen-antibody complex sequences as the input to predict the binding affinity changes of residue mutations. The assessment on the three benchmark datasets illustrates that AttABseq is 120% more accurate than other sequence-based models in terms of the Pearson correlation coefficient between the predicted and experimental binding affinity changes. Moreover, AttABseq also either outperforms or competes favorably with the structure-based approaches. Furthermore, AttABseq consistently demonstrates robust predictive capabilities across a diverse array of conditions, underscoring its remarkable capacity for generalization across a wide spectrum of antigen-antibody complexes. It imposes no constraints on the quantity of altered residues, rendering it particularly applicable in scenarios where crystallographic structures remain unavailable. The attention-based interpretability analysis indicates that the causal effects of point mutations on antibody-antigen binding affinity changes can be visualized at the residue level, which might assist automated antibody sequence optimization. We believe that AttABseq provides a fiercely competitive answer to therapeutic antibody optimization.
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  • 文章类型: Journal Article
    固定化技术在增强酶的稳定性和环境适应性方面发挥着重要作用。尽管发展迅速,这项技术仍然面临许多挑战,如酶泄漏,大规模实施的困难,和有限的可重用性。从天然配对分子中汲取灵感,本研究旨在建立一种利用人工抗体-抗原相互作用固定化α-葡萄糖苷酶的方法。所提出的方法包括三个主要部分:合成人工抗体,人工抗原的合成,和人工抗体-抗原复合物的组装。该方法中的关键步骤包括选择一对结构相似的化合物:邻苯二酚作为制备人工抗体的模板和原儿茶醛用于修饰酶以产生人工抗原。通过在这些化合物中使用相同的官能团,可以实现人工抗体对抗原的特异性识别,从而固定酶。结果表明,固定化量,具体活动,固定化α-葡萄糖苷酶的酶活为25.09±0.10mg/g,5.71±0.17U/mgprotein和143.25±1.71U/gcarrier,分别。固定化的α-葡萄糖苷酶不仅表现出优异的可重用性,而且在催化4-甲基伞形酰基-α-D-吡喃葡萄糖苷的水解方面也表现出卓越的性能。
    Immobilization technology plays an important role in enhancing enzyme stability and environmental adaptability. Despite its rapid development, this technology still encounters many challenges such as enzyme leakage, difficulties in large-scale implementation, and limited reusability. Drawing inspiration from natural paired molecules, this study aimed to establish a method for immobilized α-glucosidase using artificial antibody-antigen interaction. The proposed method consists of three main parts: synthesis of artificial antibodies, synthesis of artificial antigens, and assembly of the artificial antibody-antigen complex. The critical step in this method involves selecting a pair of structurally similar compounds: catechol as a template for preparing artificial antibodies and protocatechualdehyde for modifying the enzyme to create the artificial antigens. By utilizing the same functional groups in these compounds, specific recognition of the antigen by the artificial antibody can be achieved, thereby immobilizing the enzymes. The results demonstrated that the immobilization amount, specific activity, and enzyme activity of the immobilized α-glucosidase were 25.09 ± 0.10 mg/g, 5.71 ± 0.17 U/mgprotein and 143.25 ± 1.71 U/gcarrier, respectively. The immobilized α-glucosidase not only exhibited excellent reusability but also demonstrated remarkable performance in catalyzing the hydrolysis of 4-methylumbelliferyl-α-D-glucopyranoside.
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  • 文章类型: Journal Article
    大多数宿主-微生物群相互作用发生在肠屏障内,这对于将肠上皮与毒素分离至关重要,微生物,和肠腔中的抗原。肠道炎症使致病菌进入血液,形成可能沉积在器官上的免疫复合物。尽管炎症性肠病(IBD)患者的循环免疫复合物(CIC)增加,并且IBD专家讨论了它们在肠外表现中的潜在致病作用,这一现象被忽视,因为缺乏明确的证据证明在IBD动物模型中CIC诱导的肠外表现.然而,新诊断的CICs升高的临床观察,未经治疗的IBD患者已经重新点燃了对其潜在致病影响的研究。肌肉骨骼症状是最普遍的肠外IBD表现。CICs在各种关节炎形式中是关键的,包括反应性,类风湿,还有莱姆关节炎和系统性红斑狼疮.研究表明,关节炎前期的肠屏障修复可以抑制关节炎的发展。在缺乏支持肠外IBD表现的动物模型的情况下,本文旨在通过多方面分析全面探讨CICs与关节炎发病之间的关系,为进一步研究提供新的视角,并为IBD中CICs与关节炎发病之间的相互作用提供新的见解。
    Most host-microbiota interactions occur within the intestinal barrier, which is essential for separating the intestinal epithelium from toxins, microorganisms, and antigens in the gut lumen. Gut inflammation allows pathogenic bacteria to enter the blood stream, forming immune complexes which may deposit on organs. Despite increased circulating immune complexes (CICs) in patients with inflammatory bowel disease (IBD) and discussions among IBD experts regarding their potential pathogenic role in extra-intestinal manifestations, this phenomenon is overlooked because definitive evidence demonstrating CIC-induced extra-intestinal manifestations in IBD animal models is lacking. However, clinical observations of elevated CICs in newly diagnosed, untreated patients with IBD have reignited research into their potential pathogenic implications. Musculoskeletal symptoms are the most prevalent extra-intestinal IBD manifestations. CICs are pivotal in various arthritis forms, including reactive, rheumatoid, and Lyme arthritis and systemic lupus erythematosus. Research indicates that intestinal barrier restoration during the pre-phase of arthritis could inhibit arthritis development. In the absence of animal models supporting extra-intestinal IBD manifestations, this paper aims to comprehensively explore the relationship between CICs and arthritis onset via a multifaceted analysis to offer a fresh perspective for further investigation and provide novel insights into the interplay between CICs and arthritis development in IBD.
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  • 文章类型: Journal Article
    新变种IBDV(nVarIBDV,基因型A2dB1),以法氏囊萎缩和淋巴细胞减少为特征,自2018年底以来,亚洲(包括中国)已经大规模出现。nVarIBDV是家禽业的新威胁,然而,目前获得许可的商业疫苗,包括活病毒载体疫苗,IBDV免疫复合物疫苗或VP2亚单位疫苗,对nVarIBDV感染无效。在这项研究中,将无特异性病原体(SPF)的鸡和肉鸡分为3组,分别接种活病毒载体疫苗,1日龄的VP2亚单位疫苗或IBDV免疫复合物疫苗,分别。SPF鸡在11天大时接受活B87株疫苗的二次疫苗接种。法氏囊/体重比,法氏囊的组织病理学病变,和通过qRT-PCR区分感染和接种疫苗的动物(DIVA)证实,活病毒载体疫苗或免疫复合物疫苗加上活B87株加强剂可以提供至少80%的保护,以对抗SPF鸡的nVarIBDVFJ2019-01株。肉鸡还在14日龄时接受了使用活W2512G-61菌株疫苗的二次疫苗接种,分析表明,VP2亚单位疫苗或免疫复合物疫苗加上活的W2512G-61株加强剂还对nVarIBDVFJ2019-01株提供了超过80%的保护。不幸的是,活病毒载体疫苗+活W2512G-61菌株加强剂在肉鸡中对FJ2019-01的保护效果较差至中等.这些发现表明,将商业疫苗与合理的加强免疫相结合可以有效地保护鸡免受nVarIBDV攻击。
    The novel variant IBDV (nVarIBDV, genotype A2dB1), characterized by bursal atrophy of fabricius and decreased lymphocytes, has been emerging on a large scale in Asia (including China) since late 2018. nVarIBDV is a new threat to the poultry industry, yet the currently licensed commercial vaccines, including the live viral vector vaccine, IBDV immune complex vaccine or VP2 subunit vaccine, are ineffective against nVarIBDV infection. In this study, specific-pathogen-free (SPF) chickens and broilers divided into 3 groups were vaccinated with the live viral vector vaccine, the VP2 subunit vaccine or the IBDV immune complex vaccine at 1 day-old, respectively. The SPF chickens received a secondary vaccination with the live B87 strain vaccine at 11-day-old. The bursa/body weight ratio, histopathology lesion of the bursa, and the differentiation between infected and vaccinated animals (DIVA) by qRT-PCR confirmed that the live viral vector vaccine or immune complex vaccine plus live B87 strain booster could provide at least 80% protection against the FJ2019-01 strain of nVarIBDV in SPF chickens. The broilers also received a secondary vaccination using a live W2512 G-61 strain vaccine at 14-day-old, and analyses showed that the VP2 subunit vaccine or immune complex vaccine plus the live W2512 G-61 strain booster also provided more than 80% protection against the FJ2019-01 strain of nVarIBDV. Unfortunately, the live viral vector vaccine plus live W2512 G-61 strain booster provided poor to moderate protection against FJ2019-01 in broilers. These findings suggest that combining commercial vaccines with rational booster immunization can effectively protect chickens against an nVarIBDV challenge.
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  • 文章类型: Journal Article
    在患有外分泌胰腺(DP)疾病的患者中,对内分泌胰腺的损害导致血糖恶化减少,最终导致胰腺外分泌型糖尿病(DEP)。本研究旨在探讨DP患者血糖恶化的机制。并确定有用的生物标志物,以提高临床实践意识为最终目标。本研究中DP患者的基因表达谱从基因表达综合数据库获得。原始研究将DP患者定义为以下三类之一:非糖尿病(ND),糖耐量受损(IGT)和DEP,对应于血糖正常,早期和晚期血糖恶化,分别。在确保质量控制后,发现队列包括8ND,20IGT,和12DEP,而验证队列包括27ND,15IGT,20DEP基因集富集分析(GSEA)采用差异表达基因(DEGs),而免疫细胞浸润使用单样品基因组富集分析(ssGSEA)确定。此外,进行相关分析以建立临床特征与免疫细胞浸润之间的联系。最小绝对收缩和选择算子回归和随机森林相结合,以识别指示DP患者血糖恶化的生物标志物。通过独立的队列和动物实验进一步验证了这些生物标志物。随着血糖恶化,在DP患者中,胰岛的生物学过程如营养代谢和复杂的免疫反应被破坏.ACOT4、B2M、ACKR2上调,而CACNA1F的表达下调。胰岛微环境中免疫细胞浸润与年龄呈显著正相关,体重指数(BMI),患者2小时的HbA1c和血糖。这是血糖恶化的关键因素。此外,B2M与免疫细胞浸润和临床特征呈显著正相关。定量实时PCR(qRT-PCR)和蛋白质印迹证实了B2M中的上调。免疫荧光染色提示B2M的改变主要发生在α细胞和β细胞。总的来说,研究表明,逐渐增加的免疫细胞浸润是DP患者血糖恶化的重要原因,它还强调了B2M作为生物标志物。
    The damage to the endocrine pancreas among patients with diseases of the exocrine pancreas (DP) leads to reduced glycemic deterioration, ultimately resulting in diabetes of the exocrine pancreas (DEP). The present research aims to investigate the mechanism responsible for glycemic deterioration in DP patients, and to identify useful biomarkers, with the ultimate goal of enhancing clinical practice awareness. Gene expression profiles of patients with DP in this study were acquired from the Gene Expression Omnibus database. The original study defines DP patients to belong in one of three categories: non-diabetic (ND), impaired glucose tolerance (IGT) and DEP, which correspond to normoglycemia, early and late glycemic deterioration, respectively. After ensuring quality control, the discovery cohort included 8 ND, 20 IGT, and 12 DEP, while the validation cohort included 27 ND, 15 IGT, and 20 DEP. Gene set enrichment analysis (GSEA) employed differentially expressed genes (DEGs), while immunocyte infiltration was determined using single sample gene set enrichment analysis (ssGSEA). Additionally, correlation analysis was conducted to establish the link between clinical characteristics and immunocyte infiltration. The least absolute shrinkage and selection operator regression and random forest combined to identify biomarkers indicating glycemic deterioration in DP patients. These biomarkers were further validated through independent cohorts and animal experiments. With glycemic deterioration, biological processes in the pancreatic islets such as nutrient metabolism and complex immune responses are disrupted in DP patients. The expression of ACOT4, B2M, and ACKR2 was upregulated, whereas the expression of CACNA1F was downregulated. Immunocyte infiltration in the islet microenvironment showed a significant positive correlation with the age, body mass index (BMI), HbA1c and glycemia at the 2-h of patients. It was a crucial factor in glycemic deterioration. Additionally, B2M demonstrated a significant positive correlation with immunocyte infiltration and clinical features. Quantitative real-time PCR (qRT-PCR) and western blotting confirmed the upregulation in B2M. Immunofluorescent staining suggested the alteration of B2M was mainly in the alpha cells and beta cells. Overall, the study showed that gradually increased immunocyte infiltration was a significant contributor to glycemic deterioration in patients with DP, and it also highlighted B2M as a biomarker.
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  • 文章类型: Journal Article
    准确预测抗体-抗原复合物结构是药物发现的关键,疫苗设计和疾病治疗,可以促进更有效的治疗和诊断的发展。在这项工作中,我们首先回顾了抗体-抗原对接(ABAG对接)数据集.然后,我们介绍了抗体-抗原复合物的综合基准数据集的创建和表征.我们根据对接难度对数据集进行分类,界面特性和结构特征,提供一套多样化的案例进行严格的评估。与对接基准5.5相比,我们增加了112例,包括14例单结构域抗体(sdAb)和98例单克隆抗体(mAb),也增加了疑难案件的比例。我们的数据集包含不同的案例,包括人/人源化抗体,sdAbs,啮齿动物抗体和其他类型,为更好的算法开发打开了大门。此外,我们提供了有关构建基准数据集的过程的详细信息,并引入了用于定期更新的管道以使其保持最新。我们还利用了多种复杂的预测方法,包括ZDOCK,ClusPro,HDOCK和AlphaFold-Multimer用于测试和分析此数据集。该基准是评估和推进抗体-抗原相互作用分析中对接计算方法的宝贵资源,使研究人员能够开发更准确和有效的工具来预测和设计抗体-抗原复合物。非冗余ABAG对接结构基准数据集可在https://github.com/Zhaonan99/抗体-抗原-复合物-结构-基准数据集上获得。
    Accurate prediction of antibody-antigen complex structures is pivotal in drug discovery, vaccine design and disease treatment and can facilitate the development of more effective therapies and diagnostics. In this work, we first review the antibody-antigen docking (ABAG-docking) datasets. Then, we present the creation and characterization of a comprehensive benchmark dataset of antibody-antigen complexes. We categorize the dataset based on docking difficulty, interface properties and structural characteristics, to provide a diverse set of cases for rigorous evaluation. Compared with Docking Benchmark 5.5, we have added 112 cases, including 14 single-domain antibody (sdAb) cases and 98 monoclonal antibody (mAb) cases, and also increased the proportion of Difficult cases. Our dataset contains diverse cases, including human/humanized antibodies, sdAbs, rodent antibodies and other types, opening the door to better algorithm development. Furthermore, we provide details on the process of building the benchmark dataset and introduce a pipeline for periodic updates to keep it up to date. We also utilize multiple complex prediction methods including ZDOCK, ClusPro, HDOCK and AlphaFold-Multimer for testing and analyzing this dataset. This benchmark serves as a valuable resource for evaluating and advancing docking computational methods in the analysis of antibody-antigen interaction, enabling researchers to develop more accurate and effective tools for predicting and designing antibody-antigen complexes. The non-redundant ABAG-docking structure benchmark dataset is available at https://github.com/Zhaonan99/Antibody-antigen-complex-structure-benchmark-dataset.
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  • 文章类型: Journal Article
    丝绸是中国古代文明的象征,为世界文明的发展做出了不可磨灭的贡献。然而,因为古代文物经常被污染或退化,很难检测到丝的存在,因此,丝绸的真正起源仍然是个谜。因此,这项工作提出了一种柔性压力免疫传感器,该传感器是基于3D聚吡咯(PPy)泡沫设计的,用于在考古现场痕量检测丝素蛋白。最初,将丝素蛋白(SF)与抗体官能化的氧化铜纳米颗粒(CuONP)和羧化磁珠(MBs)缀合以形成夹心免疫复合物。然后,通过磁分离将夹心免疫复合物添加到过氧化氢(H2O2)中以催化产生氧气(O2),将抗原-抗体特异性识别信号转化为气体压力。随着设备内压力的增加,3DPPy泡沫,由于传感层电阻为150Ω,经历挤压和变形。这种变形导致泡沫阻力的改变。柔性压力免疫传感器可以灵敏地监测系统中电阻的变化并定量检测丝素蛋白。随着优化,柔性压力免疫传感器显示出从10ngmL-1到100μgmL-1的动态操作范围,特别是对丝素蛋白的检测极限为10.58ngmL-1。值得注意的是,这种免疫传感器在优越的重现性方面超越了酶联免疫吸附测定(ELISA),特异性,和准确性。因此,本申请为真丝检测提供了新的方法和技术支撑。
    Silk is a symbol of ancient Chinese civilization that has made an indelible contribution to the development of world civilization. However, because ancient artifacts are often contaminated or degraded, it is difficult to detect the presence of silk therein, and the true origin of silk thus remains a mystery. Therefore, this work presents a flexible pressure immunosensor that was designed based on 3D polypyrrole (PPy) foams for the trace detection of silk fibroin at archaeological sites. Initially, silk fibroin (SF) was conjugated with antibody-functionalized copper oxide nanoparticles (CuO NPs) and carboxylated magnetic beads (MBs) to form a sandwich immune complex. Then, the sandwich immune complex was added to hydrogen peroxide (H2O2) by magnetic separation to catalyse the generation of oxygen (O2), which converted the antigen-antibody specific recognition signal to gas pressure. As the pressure within the device increases, the 3D PPy foam, as the sensing layer resistance was 150 Ω, undergoes extrusion and deformation. This deformation leads to alterations in the foam resistance. The flexible pressure immunosensor can sensitively monitor the change in electrical resistance in the system and quantitatively detect silk fibroin. With optimization, the flexible pressure immunosensor demonstrates a dynamic range of operation spanning from 10 ng mL-1 to 100 μg mL-1, exhibiting a remarkable detection limit of 10.58 ng mL-1 specifically for silk fibroin. Notably, this immunosensor surpasses enzyme-linked immunosorbent assay (ELISA) in terms of superior reproducibility, specificity, and accuracy. Therefore, this application provides a new method and technical support for silk detection.
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  • 文章类型: Journal Article
    青枯病,由青枯雷尔氏菌引起的,最具破坏性的植物病原体之一,导致农作物年产量显著损失。III型效应子(T3Es)主要有助于青枯菌的毒力,通常通过靶向免疫相关蛋白。这里,我们阐明了一种新型E3泛素连接酶(NEL)T3E的作用,RipAW,从青枯菌对病原体相关分子模式(PAMP)触发免疫(PTI)的影响,并进一步探讨其作用机制。在易感寄主拟南芥中,我们监测了PTI标记基因的表达,flg22诱导的ROS爆发,和RipAWC177A转基因植物中的call体沉积。我们的结果表明RipAW以NEL依赖性方式抑制宿主PTI。通过分裂荧光素酶互补,双分子荧光互补,和免疫共沉淀试验,我们进一步表明,RipAW与免疫受体复合物的三个关键成分有关,即FLS2、XLG2和BIK1。此外,RipAW提高了FLS2,XLG2和BIK1的泛素化水平,通过26S蛋白酶体途径加速了它们的降解。此外,FLS2,XLG2或BIK1与RipAW的共表达部分但显着恢复了RipAW抑制的ROS爆发,证实免疫受体复合物参与RipAW调节的PTI。总的来说,我们的结果表明RipAW通过破坏免疫受体复合物损害宿主PTI.我们的发现为青枯菌的毒力机制提供了新的见解。
    Bacterial wilt, caused by Ralstonia solanacearum, one of the most destructive phytopathogens, leads to significant annual crop yield losses. Type III effectors (T3Es) mainly contribute to the virulence of R. solanacearum, usually by targeting immune-related proteins. Here, we clarified the effect of a novel E3 ubiquitin ligase (NEL) T3E, RipAW, from R. solanacearum on pathogen-associated molecular pattern (PAMP)-triggered immunity (PTI) and further explored its action mechanism. In the susceptible host Arabidopsis thaliana, we monitored the expression of PTI marker genes, flg22-induced ROS burst, and callose deposition in RipAW- and RipAWC177A-transgenic plants. Our results demonstrated that RipAW suppressed host PTI in an NEL-dependent manner. By Split-Luciferase Complementation, Bimolecular Fluorescent Complimentary, and Co-Immunoprecipitation assays, we further showed that RipAW associated with three crucial components of the immune receptor complex, namely FLS2, XLG2, and BIK1. Furthermore, RipAW elevated the ubiquitination levels of FLS2, XLG2, and BIK1, accelerating their degradation via the 26S proteasome pathway. Additionally, co-expression of FLS2, XLG2, or BIK1 with RipAW partially but significantly restored the RipAW-suppressed ROS burst, confirming the involvement of the immune receptor complex in RipAW-regulated PTI. Overall, our results indicate that RipAW impairs host PTI by disrupting the immune receptor complex. Our findings provide new insights into the virulence mechanism of R. solanacearum.
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  • 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.
    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。.
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  • 文章类型: Journal Article
    IgA肾病(IgAN),全球最普遍的原发性肾小球肾炎,有相当大的终生肾衰竭风险。IgAN的临床表现从无症状的显微镜下或间歇性肉眼血尿和稳定的肾功能到快速进行性肾小球肾炎不等。IgAN被提议通过“四击”过程来发展,从过量生产和系统性存在低O-糖基化半乳糖缺陷型IgA1(Gd-IgA1)开始,随后通过抗聚糖自身抗体识别Gd-IgA1,Gd-IgA1的聚集和聚合IgA1免疫复合物的形成,最后,这些免疫复合物在肾小球系膜中的沉积,导致肾脏炎症和疤痕。IgAN只能通过肾活检来诊断。广泛,优化支持治疗是IgAN患者治疗的主要手段.对于那些有疾病进展风险的人,2021年KDIGO临床实践指南建议考虑6个月的全身性皮质类固醇治疗疗程;然而,全身性类固醇治疗的疗效存在争议,严重的不良反应很常见。在了解IgAN的病理生理学方面的进展导致了具有可接受的安全性的新型靶向治疗的临床试验。包括SGLT2抑制剂,内皮素受体阻滞剂,靶向释放布地奈德,B细胞增殖和分化抑制剂,以及补体成分的封锁。
    IgA nephropathy (IgAN), the most prevalent primary glomerulonephritis worldwide, carries a considerable lifetime risk of kidney failure. Clinical manifestations of IgAN vary from asymptomatic with microscopic or intermittent macroscopic haematuria and stable kidney function to rapidly progressive glomerulonephritis. IgAN has been proposed to develop through a \'four-hit\' process, commencing with overproduction and increased systemic presence of poorly O-glycosylated galactose-deficient IgA1 (Gd-IgA1), followed by recognition of Gd-IgA1 by antiglycan autoantibodies, aggregation of Gd-IgA1 and formation of polymeric IgA1 immune complexes and, lastly, deposition of these immune complexes in the glomerular mesangium, leading to kidney inflammation and scarring. IgAN can only be diagnosed by kidney biopsy. Extensive, optimized supportive care is the mainstay of therapy for patients with IgAN. For those at high risk of disease progression, the 2021 KDIGO Clinical Practice Guideline suggests considering a 6-month course of systemic corticosteroid therapy; however, the efficacy of systemic steroid treatment is under debate and serious adverse effects are common. Advances in understanding the pathophysiology of IgAN have led to clinical trials of novel targeted therapies with acceptable safety profiles, including SGLT2 inhibitors, endothelin receptor blockers, targeted-release budesonide, B cell proliferation and differentiation inhibitors, as well as blockade of complement components.
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