原发性硬化性胆管炎(PSC),慢性胆汁淤积性肝病,常与炎症性肠病有关。随着“微生物群”和“肠道淋巴细胞归巢”假说的出现,特异性免疫细胞与PSC发病机理有关,尽管他们的身份仍然存在争议。首次全基因组关联分析利用来自3757个欧洲人的非重叠数据来评估731种免疫表型。包括2871例病例和12,019例对照的全基因组关联分析得出了PSC的汇总统计数据。进行逆方差加权(IVW)分析以确定与PSC因果关系的免疫表型,并使用加权模式对结果进行了验证,MR-Egger,和加权中位数方法。进行了综合敏感性分析,以验证其稳健性,异质性,和结果的水平多效性。IVW分析显示26个免疫性状表现出与PSC的因果关联。HLA-DR+CD4+上的CD3(IVW比值比[OR]:0.904;95%置信区间[CI]:0.828-0.986,P=.023)和分泌Treg上的CD3(IVWOR:0.893;95%CI:0.823-0.969,P=.007)与PSC易感性呈负相关,并且在3种验证方法中表现出高度一致性。此外,其他7种免疫特性,包括CD39+静息Treg绝对细胞(IVWOR=1.083,95%CI:1.013-1.157,P=0.019),分泌CD39+的Treg绝对细胞(IVWOR=1.063,95%CI:1.012-1.118,P=0.015),幼稚CD8br上的CD3(IVWOR=0.907,95%CI:0.835-0.986,P=0.022),CD39+激活的Treg上的CD3(IVWOR=0.927,95%CI:0.864-0.994,P=0.034),CD28对静息Treg(IVWOR=0.724,95%CI:0.630-0.833,P=5.95E-06),CD39+CD4+(IVWOR=1.055,95%CI:1.001-1.112,P=0.044)和CD39在加权中值和加权模式验证方法中表现出一致的结果。此外,在单核苷酸多态性中没有观察到显著的异质性或水平多效性.留一法结果显示,依次消除每个单核苷酸多态性对模型效应估计或定性推断没有显着影响。这项研究评估了731个免疫性状与PSC易感性之间的潜在因果关系。使用IVW方法鉴定了26个免疫性状。跨多种方法的验证揭示了9种免疫性状,与PSC存在似是而非的因果关系。这些发现可能揭示了机械途径和新的治疗方法。
Primary sclerosing cholangitis (PSC), a chronic cholestatic liver condition, is frequently associated with inflammatory bowel disease. Specific immune cells have been implicated in PSC pathogenesis with the emergence of the \"microbiota\" and \"gut lymphocyte homing\" hypotheses, albeit their identities remain controversial. The first genome-wide association analysis leveraged nonoverlapping data from 3757 Europeans to evaluate 731 immunophenotypes. A genome-wide association analysis comprising 2871 cases and 12,019 controls yielded summary statistics for PSC. An inverse-variance weighted (IVW) analysis was performed to identify immunophenotypes causally related to PSC, and the results were validated using weighted mode, MR-Egger, and weighted median methods. Comprehensive sensitivity analyses were performed to verify the robustness, heterogeneity, and horizontal pleiotropy of the results. IVW analysis revealed 26 immune traits exhibiting causal associations with PSC. CD3 on HLA-DR+ CD4+ (IVW odds ratio [OR]: 0.904; 95% confidence interval [CI]: 0.828-0.986, P = .023) and CD3 on secreting Treg (IVW OR: 0.893; 95% CI: 0.823-0.969, P = .007) were negatively associated with PSC susceptibility and demonstrated high consistency across the 3 validation methods. Moreover, 7 other immune traits, including CD39+ resting Treg absolute cell (IVW OR = 1.083, 95% CI: 1.013-1.157, P = .019), CD39+ secreting Treg absolute cell (IVW OR = 1.063, 95% CI: 1.012-1.118, P = .015), CD3 on naive CD8br (IVW OR = 0.907, 95% CI: 0.835-0.986, P = .022), CD3 on CD39+ activated Treg (IVW OR = 0.927, 95% CI: 0.864-0.994, P = .034), CD28 on resting Treg (IVW OR = 0.724, 95% CI: 0.630-0.833, P = 5.95E-06), and CD39 on CD39+ CD4+ (IVW OR = 1.055, 95% CI: 1.001-1.112, P = .044) exhibited consistent results in the Weighted Median and Weighted Mode validation methods. Moreover, no significant heterogeneity or horizontal pleiotropy was observed across the single nucleotide polymorphisms. The leave-one-out results revealed that sequentially eliminating each single nucleotide polymorphism had no significant influence on model effect estimates or qualitative inference. This study evaluated potential causal links between 731 immune traits and PSC susceptibility. Twenty-six immune traits were identified using the IVW method. Verification across multiple methods revealed 9 immune traits with a plausible causal connection to PSC. These findings may uncover mechanistic pathways and novel therapeutic approaches.