Humoral immunity

体液免疫
  • 文章类型: Journal Article
    自噬是一种受调节的细胞内分解代谢过程,受损的细胞器,聚集的蛋白质,和其他大分子在溶酶体中降解。自噬活动在调节发育中起着重要作用,命运的决定,和免疫系统中细胞的功能,包括B淋巴细胞。自噬包括几种与B细胞稳态和功能相关的不同途径。虽然B细胞向T细胞呈递主要组织相容性复合物(MHC)II类限制性胞质抗原涉及巨自噬和伴侣介导的自噬(CMA),浆细胞和记忆B细胞主要依靠巨自噬生存。新的证据表明,核心自噬因子也参与与经典自噬相关的过程,但与经典自噬明显不同。这些自噬相关途径,称为非规范自噬或ATG8与单膜(CASM)的缀合,有助于B细胞稳态和功能,包括MHCII类限制性抗原呈递给T细胞,生发中心形成,浆细胞分化,和回忆回应。B细胞自噬的失调已经在一些自身免疫和自身炎性疾病如系统性红斑狼疮中被发现,类风湿性关节炎,和炎症性肠病.在这次审查中,我们讨论了在理解规范和非规范自噬在B细胞中的作用方面的最新进展,包括B细胞发育和成熟,抗原加工和呈递,病原体特异性抗体反应,细胞因子分泌,和自身免疫。解开B细胞中规范和非规范自噬的分子机制将提高我们对B细胞生物学的理解。对基于自噬的免疫疗法的发展具有重要意义。
    Autophagy is a regulated intracellular catabolic process by which invading pathogens, damaged organelles, aggregated proteins, and other macromolecules are degraded in lysosomes. It has been widely appreciated that autophagic activity plays an important role in regulating the development, fate determination, and function of cells in the immune system, including B lymphocytes. Autophagy encompasses several distinct pathways that have been linked to B cell homeostasis and function. While B cell presentation of major histocompatibility complex (MHC) class II-restricted cytosolic antigens to T cells involves both macroautophagy and chaperone-mediated autophagy (CMA), plasma cells and memory B cells mainly rely on macroautophagy for their survival. Emerging evidence indicates that core autophagy factors also participate in processes related to yet clearly distinct from classical autophagy. These autophagy-related pathways, referred to as noncanonical autophagy or conjugation of ATG8 to single membranes (CASM), contribute to B cell homeostasis and functions, including MHC class II-restricted antigen presentation to T cells, germinal center formation, plasma cell differentiation, and recall responses. Dysregulation of B cell autophagy has been identified in several autoimmune and autoinflammatory diseases such as systemic lupus erythematosus, rheumatoid arthritis, and inflammatory bowel disease. In this review, we discuss recent advances in understanding the role of canonical and noncanonical autophagy in B cells, including B cell development and maturation, antigen processing and presentation, pathogen-specific antibody responses, cytokine secretion, and autoimmunity. Unraveling the molecular mechanisms of canonical and noncanonical autophagy in B cells will improve our understanding of B cell biology, with implications for the development of autophagy-based immunotherapies.
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  • 文章类型: Journal Article
    随着COVID-19在全球的快速传播和变体的不断涌现,迫切需要开发安全有效的疫苗。这里,我们开发了一种新的mRNA疫苗,HC009,基于QTsome交付平台的新配方。免疫原性结果表明,使用HC009的初免-加强免疫策略能够诱导强大而持久的体液免疫,以及啮齿动物或非人类灵长类动物(NHP)中Th1偏向的细胞反应。在进一步挑战活的SARS-CoV-2病毒后,HC009在hACE2转基因小鼠中提供针对病毒感染的足够保护。因此,HC009对SARS-CoV-2具有显著的免疫保护作用。
    With the rapid global spread of COVID-19 and the continuous emergence of variants, there is an urgent need to develop safe and effective vaccines. Here, we developed a novel mRNA vaccine, HC009, based on new formulation by the QTsome delivery platform. Immunogenicity results showed that the prime-boost immunization strategy with HC009 was able to induce robust and durable humoral immunity, as well as Th1-biased cellular responses in rodents or non-human primates (NHPs). After further challenge with live SARS-CoV-2 virus, HC009 provided adequate protection against virus infection in hACE2 transgenic mice. Therefore, HC009 could provide significant immune protection against SARS-CoV-2.
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  • 文章类型: Journal Article
    尽管抗逆转录病毒治疗(ART),但在HIV感染者(PLWH)中,人类疱疹病毒8型(HHV-8)诱导的卡波西肉瘤(KS)的重新出现提出了临床挑战,因为它们已经具有良好的CD4T细胞数量和不可检测的病毒载量。我们观察到,ART上PLWH的临床表现类似于在未感染HIV的老年患者中发现的经典KS,并假设免疫衰老可能因此在ART上KS的发生中起作用。我们比较了在ART治疗的PLWH(HIVKS)和未感染HIV的经典KS患者(cKS)中与KS发展有关的病毒和免疫因素,与没有KS的对照组相比(艾滋病毒控制,cControlsrespectively).
    等离子,外周血单核细胞,从11名HIVKS和11名cKS患者以及2组年龄匹配的对照组中获得皮肤组织。
    HIVKS参与者比cKS年轻(53岁vs75岁)。HHV-8基因型在组间没有差异。尽管年龄较小,CD4/CD8比率较低,激活,筋疲力尽,HIVKS和cKS之间的衰老T细胞频率相似。与cKS相比,HIVKS中的抗HHV-8免疫球蛋白G水平更高,而循环HHV-8DNA更低。HIVKS中循环血小板衍生生长因子AA-BB和粒细胞集落刺激因子较高我们观察到HIVKS和cKS患者皮肤病变中HHV-8DNA和PD-1表达水平相似。
    总之,在ART治疗的PLWH中,早期免疫衰老可能参与KS的发展。较高的抗HHV-8免疫球蛋白G水平可能与较低的循环病毒载量有关。这些见解应有助于开发治疗策略,以预防发展并治疗PLWHonART中的KS。
    UNASSIGNED: Reemergence of human herpesvirus 8 (HHV-8)-induced Kaposi sarcoma (KS) in people living with HIV (PLWH) despite antiretroviral therapy (ART) poses a clinical challenge because they already have favorable CD4 T-cell numbers and undetectable viral loads. We observed that clinical presentation in PLWH on ART resembled classic KS found in older HIV-uninfected patients and hypothesized that immunosenescence may thus play a role in occurrence of KS on ART. We compared viral and immune factors implicated in the development of KS in ART-treated PLWH (HIV KS) and HIV-uninfected classic KS patients (cKS), compared to controls without KS (HIV Control, cControls respectively).
    UNASSIGNED: Plasma, peripheral blood mononuclear cell, and skin tissues were obtained from 11 HIV KS and 11 cKS patients and 2 groups of age-matched controls.
    UNASSIGNED: HIV KS participants were younger than cKS (aged 53 vs 75 years). HHV-8 genotypes did not differ between groups. Despite the younger age and a lower CD4/CD8 ratio, activated, exhausted, and senescent T-cell frequencies were similar between HIV KS and cKS. Anti-HHV-8 immunoglobulin G levels were higher and circulating HHV-8 DNA lower in HIV KS compared with cKS. Circulating platelet-derived growth factors AA-BB and granulocyte colony-stimulating factors were higher in HIV KS We observed similar levels of HHV-8 DNA and PD-1 expression in skin lesions from HIV KS and cKS patients.
    UNASSIGNED: Altogether, early immune senescence could be involved in the development of KS in ART-treated PLWH. Higher anti-HHV-8 immunoglobulin G levels could be linked with lower circulating viral load. Such insights should help developing therapeutical strategies to prevent development and treat KS in PLWH on ART.
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  • 文章类型: Journal Article
    背景:用两剂灭活疫苗(CoronaVac)初次接种后,针对SARS-CoV-2的体液免疫动力学和持久性的数据有限。这项研究评估了先前感染的顺序效应,用mRNA-1273(Moderna)进行异源增强,以及此后发生Omicron疫苗突破感染(VBI)。
    方法:我们评估了在两剂CoronaVac引发的印度尼西亚医护人员(2021年8月至2022年8月)中mRNA-1273增强后一年内的抗标IgG(Abbott)和中和(cPASS/GenScript)抗体(nAb)滴度。我们使用线性混合模型来估计抗体水平的变化率,和逻辑回归检查抗体水平和VBI之间的关联。
    结果:在138名参与者中,52(37.7%)曾感染过,78(56.5%)接受了mRNA-1273加强剂。两次注射CoronaVac后,抗体滴度在180天内显著下降,不管以前的感染。mRNA-1273加强后,抗标IgG(1.47%/天下降)和OmicronB.1.1.529/BA.2nAbs在第28-90天之间下降,IgG滴度在第90-360天之间趋于稳定。在BA.1/BA.2浪潮期间(2022年2月至3月),34.6%(27/78)的个体经历了VBI(mRNA-1273后中位181天),虽然没有人患上严重疾病。VBI与低VBI前抗尖峰IgG和B.1.1.529/BA.2nAbs相关,在VBI后恢复。
    结论:两剂CoronaVac后加强mRNA-1273并不能预防BA.1/BA.2VBI。可能需要定期接种疫苗以对抗新出现的SARS-CoV-2变体。
    BACKGROUND: Data on the dynamics and persistence of humoral immunity against SARS-CoV-2 after primary vaccination with two-dose inactivated vaccine (CoronaVac) are limited. This study evaluated the sequential effects of prior infection, heterologous boosting with mRNA-1273 (Moderna), and the occurrence of Omicron vaccine-breakthrough infection (VBI) thereafter.
    METHODS: We evaluated anti-spike IgG (Abbott) and neutralising (cPASS/GenScript) antibody (nAb) titers up to one year after mRNA-1273 boost in two-dose-CoronaVac-primed Indonesian healthcare workers (August 2021-August 2022). We used linear mixed modeling to estimate the rate of change in antibody levels, and logistic regression to examine associations between antibody levels and VBI.
    RESULTS: Of 138 participants, 52 (37.7%) had a prior infection and 78 (56.5%) received an mRNA-1273 booster. After two-dose CoronaVac, antibody titers had significantly declined within 180 days, irrespective of prior infection. After mRNA-1273 booster, anti-spike IgG (1.47% decline/day) and Omicron B.1.1.529/BA.2 nAbs declined between day 28-90, and IgG titers plateaued between day 90-360. During the BA.1/BA.2 wave (February-March 2022), 34.6% (27/78) of individuals experienced a VBI (median 181 days after mRNA-1273), although none developed severe illness. VBI was associated with low pre-VBI anti-spike IgG and B.1.1.529/BA.2 nAbs, which were restored post-VBI.
    CONCLUSIONS: mRNA-1273 booster after two-dose CoronaVac did not prevent BA.1/BA.2 VBI. Periodic vaccine boosters may be warranted against emerging SARS-CoV-2 variants.
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  • 文章类型: Journal Article
    Objective.我们旨在报告接受tixagevimab/cilgavimab(T/C)暴露前预防(PrEP)的免疫功能低下个体随时间的实际使用和结果。方法。这项观察性研究包括接受T/CPrEP的参与者,分为三组:(I)无COVID-19(NoC),即,从未患过COVID-19的参与者;(Ii)杂种(H),即,在PrEP之前患有COVID-19的参与者;和(iii)突发性感染(BTIs),即,PrEP后出现COVID-19的参与者。该研究在3(T1)时施用T/C(T0)时测量了几种免疫标志物,6(T2),和9(T3)个月后。这些标志物包括:抗受体结合结构域(RBD)IgG抗体;BA.5中和抗体(nAbs);粘膜IgG;和T细胞免疫。使用泊松回归模型分析了BTIs的发病率比率。结果。共有231名参与者,中位年龄为63岁(IQR54.0-73.0)。包括在内。其中,84%的人患有血液病,平均接种三剂疫苗。N=72名参与者属于NoC组,N=103到H基团,BTI组n=56(24%),大多数BTI是轻度/中度。BTIs的发生率(IR)为4.2/100患者-月(95%CI3.2-5.4),没有发现相关的危险因素。T/C给药后3个月,所有组的抗RBDIgG水平均显着增加,随后在6个月下降,而在同一时间点,所有组的抗BA.5nAb的几何平均滴度(GMT)均较低,且约为或低于检测阈值.在IFN-γ水平中没有观察到显著变化。在PrEP施用后仅3个月观察到粘膜免疫应答。结论。通过全面的病毒学和免疫学研究,我们提供了一个真实世界的经验模型,说明T/CPrEP在O微米波期间预防严重COVID-19的临床疗效。在等待可以有效中和最新变体的新单克隆抗体的到来时,T/CPrEP仍然是当今可用的医疗设备中唯一可行的策略,可以在对COVID-19疫苗免疫反应欠佳的极其脆弱的人群中预防COVID-19并发症。
    Objective. We aimed to report the real-world use and outcomes over time in immunocompromised individuals receiving tixagevimab/cilgavimab (T/C) pre-exposure prophylaxis (PrEP). Methods. This observational study included participants who received T/C PrEP, categorized into three groups: (i) No COVID-19 (NoC), i.e., participants who never had COVID-19; (ii) Hybrids (H), i.e., participants who had COVID-19 before PrEP; and (iii) Break-through Infections (BTIs), i.e., participants who had COVID-19 after PrEP. The study measured several immune markers at the administration of T/C (T0) at 3 (T1), 6 (T2), and 9 (T3) months afterward. These markers included: anti-receptor-binding domain (RBD) IgG antibodies; BA.5-neutralizing antibodies (nAbs); mucosal IgG; and T cell immunity. The incidence rate ratios for BTIs were analyzed using a Poisson regression model. Results. A total of 231 participants with a median age of 63 years (IQR 54.0-73.0). were included. Among these, 84% had hematological diseases and received a median of three vaccine doses. N = 72 participants belonged to the NoC group, N = 103 to the H group, and n = 56 to the BTI group (24%), with most BTIs being mild/moderate. The incidence rate (IR) of BTIs was 4.2 per 100 patient-months (95% CI 3.2-5.4), with no associated risk factors identified. There was a significant increase in anti-RBD IgG levels 3 months after the T/C administration in all groups, followed by a decline at 6 months, whereas at the same time points, geometric mean titers (GMTs) of anti-BA.5 nAbs were low for all groups and were around or below the detection threshold. No significant changes were observed in IFN-γ levels. The mucosal immune response was observed only 3 months after the PrEP administration. Conclusion. We provided a real-world experience model on the clinical efficacy of T/C PrEP in preventing severe COVID-19 during the Omicron wave through a comprehensive virological and immunological study. While waiting for the arrival of new monoclonal antibodies that can effectively neutralize the most recent variants, T/C PrEP remains the only viable strategy in the available armamentarium today to prevent COVID-19 complications in an extremely fragile population with suboptimal immune responses to COVID-19 vaccines.
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  • 文章类型: Journal Article
    稳定的长寿命浆细胞(LLPC)群体的产生是疫苗接种或感染后持久抗体应答的必要条件。我们研究了20名患有2019年冠状病毒感染的个体,并使用骨髓穿刺和血浆样本表征了抗体反应。我们注意到严重急性呼吸综合征冠状病毒2感染后骨髓中尖峰特异性LLPCs的生成不足。此外,而回归模型解释了98%的基于LLPC酶联免疫斑点测定法的抗破伤风免疫球蛋白G水平观察到的方差,我们无法用抗刺药抗体拟合相同的模型,再次指出缺乏LLPC对循环抗尖峰抗体的贡献。
    Generation of a stable long-lived plasma cell (LLPC) population is the sine qua non of durable antibody responses after vaccination or infection. We studied 20 individuals with a prior coronavirus disease 2019 infection and characterized the antibody response using bone marrow aspiration and plasma samples. We noted deficient generation of spike-specific LLPCs in the bone marrow after severe acute respiratory syndrome coronavirus 2 infection. Furthermore, while the regression model explained 98% of the observed variance in anti-tetanus immunoglobulin G levels based on LLPC enzyme-linked immunospot assay, we were unable to fit the same model with anti-spike antibodies, again pointing to the lack of LLPC contribution to circulating anti-spike antibodies.
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  • 文章类型: Journal Article
    马红球菌(R.equi)是一种人畜共患的机会性病原体,主要导致马驹和免疫功能低下的个体致命的肺和肺外脓肿。迄今为止,不存在针对马氏R.的商业疫苗。我们先前使用反向疫苗学方法从R.equi的完整基因组中筛选了所有潜在的疫苗候选物。其中五位候选人,即ABC转运蛋白底物结合蛋白(ABC转运蛋白),青霉素结合蛋白2(PBD2),NlpC/P60家族蛋白(NlpC/P60),酯酶家族蛋白(酯酶),选择和M23家族金属肽酶(M23)用于评估在R.equi攻击的BALB/c小鼠模型中的免疫原性和免疫保护作用。结果表明,所有5只候选疫苗免疫小鼠的脾抗原特异性IFN-γ和TNF-α阳性CD4+和CD8+T淋巴细胞均显著增加,并产生强烈的Th1型和Th2型免疫反应和抗体反应。R.equi挑战两周后,与对照组相比,用五种候选疫苗免疫可减少肺部细菌负荷,并改善肺部和肝脏的病理损伤。NlpC/P60,酯酶,M23比ABC转运体和PBD2更有效地诱导小鼠抵抗R.equi攻击的保护性免疫。此外,这些候选疫苗具有诱导小鼠T淋巴细胞记忆免疫应答的潜力。总之,这些抗原是开发针对马氏杆菌的保护性疫苗的有效候选物。马氏R.equi抗原库得到了扩展,为多价疫苗的开发提供了新思路。
    Rhodococcus equi (R. equi) is a zoonotic opportunistic pathogen that mainly causes fatal lung and extrapulmonary abscesses in foals and immunocompromised individuals. To date, no commercial vaccine against R. equi exists. We previously screened all potential vaccine candidates from the complete genome of R. equi using a reverse vaccinology approach. Five of these candidates, namely ABC transporter substrate-binding protein (ABC transporter), penicillin-binding protein 2 (PBD2), NlpC/P60 family protein (NlpC/P60), esterase family protein (Esterase), and M23 family metallopeptidase (M23) were selected for the evaluation of immunogenicity and immunoprotective effects in BALB/c mice model challenged with R. equi. The results showed that all five vaccine candidate-immunized mice experienced a significant increase in spleen antigen-specific IFN-γ- and TNF-α-positive CD4 + and CD8 + T lymphocytes and generated robust Th1- and Th2-type immune responses and antibody responses. Two weeks after the R. equi challenge, immunization with the five vaccine candidates reduced the bacterial load in the lungs and improved the pathological damage to the lungs and livers compared with those in the control group. NlpC/P60, Esterase, and M23 were more effective than the ABC transporter and PBD2 in inducing protective immunity against R. equi challenge in mice. In addition, these vaccine candidates have the potential to induce T lymphocyte memory immune responses in mice. In summary, these antigens are effective candidates for the development of protective vaccines against R. equi. The R. equi antigen library has been expanded and provides new ideas for the development of multivalent vaccines.
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  • 文章类型: Journal Article
    本研究旨在调查羟氯喹(HCQ)处理是否会影响中和抗体的产生,原发性干燥综合征(pSS)计划的17DD-黄热病(YF)初免疫苗(Bio-Manguinhos-FIOCRUZ)时的病毒血症水平和血清可溶性介质动力学。共纳入34名pSS患者和23名健康对照(HC)。pSS组根据HCQ(HCQ和非HCQ)的使用进一步分类。YF-斑块减少中和试验(PRNT≥1:50),在基线和随后的时间点(Day0/Day3-4/Day5-6/Day7/Day14-D28)进行YF病毒血症(RNA贫血)和血清生物标志物分析。pSS组的PRNT滴度和血清阳性率与HC相似(GeoMean=238vs440,p=.11;82%vs96%,p=.13)。然而,与HC相比,HCQ亚组的血清转化率较低(地质平均值=161vs440,p=.04;69%vs96%,p=.02)和非HQC(地质平均值=161vs337,p=.582;69%vs94%,p=.049)。亚组之间未观察到YF病毒血症的差异。血清生物标志物分析表明,HCQ亚组表现出CCL2,CXL10,IL-6,IFN-γ,IL1-Ra,IL-9、IL-10和IL-2在基线处,并且沿着动力学时间线显示出几种生物标志物的一致增加,直到D14-28。这些结果表明,与非HCQ亚组相比,HCQ亚组在由17DD-YF原基接种引发的组装YF特异性免疫应答中表现出缺陷。我们的发现表明,羟氯喹与17DD-YF原始疫苗接种后体液免疫反应的降低有关。
    The present study aimed at investigating whether the hydroxychloroquine (HCQ) treatment would impact the neutralizing antibody production, viremia levels and the kinetics of serum soluble mediators upon planned 17DD-Yellow Fever (YF) primovaccination (Bio-Manguinhos-FIOCRUZ) of primary Sjögren\'s syndrome (pSS). A total of 34 pSS patients and 23 healthy controls (HC) were enrolled. The pSS group was further categorized according to the use of HCQ (HCQ and Non-HCQ). The YF-plaque reduction neutralization test (PRNT ≥1:50), YF viremia (RNAnemia) and serum biomarkers analyses were performed at baseline and subsequent time-points (Day0/Day3-4/Day5-6/Day7/Day14-D28). The pSS group showed PRNT titers and seropositivity rates similar to those observed for HC (GeoMean = 238 vs 440, p = .11; 82% vs 96%, p = .13). However, the HCQ subgroup exhibited lower seroconversion rates as compared to HC (GeoMean = 161 vs 440, p = .04; 69% vs 96%, p = .02) and Non-HQC (GeoMean = 161 vs 337, p = .582; 69% vs 94%, p = .049). No differences in YF viremia were observed amongst subgroups. Serum biomarkers analyses demonstrated that HCQ subgroup exhibited increased levels of CCL2, CXL10, IL-6, IFN-γ, IL1-Ra, IL-9, IL-10, and IL-2 at baseline and displayed a consistent increase of several biomarkers along the kinetics timeline up to D14-28. These results indicated that HCQ subgroup exhibited a deficiency in assembling YF-specific immune response elicited by 17DD-YF primovaccination as compared to Non-HCQ subgroup. Our findings suggested that hydroxychloroquine is associated with a decrease in the humoral immune response after 17DD-YF primovaccination.
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  • 文章类型: Editorial
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  • 文章类型: English Abstract
    确定患有复发性自然流产(RSA)的高龄孕产妇的体液免疫。
    于2022年1月至2023年10月在上海市第一妇婴医院生殖免疫科进行了一项回顾性研究。招募患有RSA的妇女并测试多种自身抗体。多因素logistic回归比较不同年龄组(低龄组20~34岁,高龄组35~45岁)和多种自身抗体之间的关联,在控制三个混杂因素的同时,包括体重指数(BMI),以前的活产史,以及自然流产的数量。然后,我们调查了高龄女性RSA和低龄女性RSA的体液免疫差异.
    本研究涵盖了4009名患有RSA的女性。其中,1158名妇女为高龄产妇组,2851名妇女为低龄产妇组。抗磷脂综合征的患病率,系统性红斑狼疮,干燥综合征,类风湿性关节炎,未分化结缔组织病分别为15.6%和14.1%,0.0%和0.1%,0.9%和0.9%,0.3%和0.0%,高龄组和低龄组分别为23.7%和22.6%,分别,两组间无统计学差异。抗磷脂抗体(aPL)的阳性率,抗核抗体(ANA),可提取核抗原(ENA)抗体,抗双链DNA(dsDNA)抗体,抗单链DNA(ssDAN)抗体,抗α-fodrin(AAA)的抗体,甲状腺自身免疫(TAI)分别为19.1%和19.5%,6.6%和6.6%,9.2%和10.5%,2.0%和2.0%,2.2%和1.2%,5.1%和4.9%,和17.8%和16.8%,分别。两组间无差异。1.6%的高龄孕妇组狼疮抗凝物(LA)检测呈阳性,而低龄组的女性中有2.7%为LA阳性,差异具有统计学意义(比值比=0.36,95%置信区间:0.17-0.78)。在4008例RSA患者中,3种抗体检测阳性的累计病例为778例,其中抗β2糖蛋白Ⅰ抗体(β2GPⅠAb)-IgG/IgM阳性520例,58为aCL-IgG/IgM阳性,73对洛杉矶呈阳性,105例β2GPⅠAb-IgG/IgM和aCL-IgG/IgM阳性,17例β2GPⅠAb-IgG/IgM和LA均为阳性,2对aCL-IgG/IgM和LA均呈阳性,和3对所有三种抗体均为阳性。
    我们的研究没有发现高龄的RSA女性和低龄的RSA女性之间的体液免疫差异。
    UNASSIGNED: To determine the humoral immunity in advanced maternal-age women with recurrent spontaneous abortion (RSA).
    UNASSIGNED: A retrospective study was performed between January 2022 and October 2023 in the Department of Reproductive Immunity of Shanghai First Maternity and Infant Hospital. Women with RSA were recruited and multiple autoantibodies were tested. Multivariate logistic regression was performed to compare the associations between different age groups (20 to 34 years old in the low maternal-age group and 35 to 45 years in the advanced maternal-age group) and multiple autoantibodies, while controlling for three confounding factors, including body mass index (BMI), previous history of live birth, and the number of spontaneous abortions. Then, we investigated the differences in the humoral immunity of advanced maternal-age RSA women and low maternal-age RSA women.
    UNASSIGNED: A total of 4009 women with RSA were covered in the study. Among them, 1158 women were in the advanced maternal-age group and 2851 women were in the low maternal-age group. The prevalence of antiphospholipid syndrome, systemic lupus erythematosus, Sjogren\'s syndrome, rheumatoid arthritis, and undifferentiated connective tissue disease was 15.6% and 14.1%, 0.0% and 0.1%, 0.9% and 0.9%, 0.3% and 0.0%, and 23.7% and 22.6% in the advanced maternal-age group and low maternal-age group, respectively, showing no statistical difference between the two groups. The positive rates of antiphospholipid antibodies (aPLs), antinuclear antibody (ANA), extractable nuclear antigen (ENA) antibody, anti-double stranded DNA (dsDNA) antibody, anti single-stranded DNA (ssDAN) antibody, antibodies against alpha-fodrin (AAA), and thyroid autoimmunity (TAI) were 19.1% and 19.5%, 6.6% and 6.6%, 9.2% and 10.5%, 2.0% and 2.0%, 2.2% and 1.2%, 5.1% and 4.9%, and 17.8% and 16.8%, respectively. No differences were observed between the two groups. 1.6% of the women in the advanced maternal-age group tested positive for lupus anticoagulant (LA), while 2.7% of the women in the low maternal-age group were LA positive, with the differences being statistically significant (odds ratio=0.36, 95% confidence interval: 0.17-0.78). In the 4008 RSA patients, the cumulative cases tested positive for the three antibodies of the aPLs spectrum were 778, of which 520 cases were positive for anti-β2 glycoprotein Ⅰ antibodies (β2GPⅠ Ab)-IgG/IgM, 58 were positive for aCL-IgG/IgM, 73 were positive for LA, 105 were positive for both β2GPⅠ Ab-IgG/IgM and aCL-IgG/IgM, 17 were positive for both β2GPⅠ Ab-IgG/IgM and LA, 2 were positive for both aCL-IgG/IgM and LA, and 3 were positive for all three antibodies.
    UNASSIGNED: Our study did not find a difference in humoral immunity between RSA women of advanced maternal age and those of low maternal age.
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