systemic immunity

全身免疫
  • 文章类型: Journal Article
    进行了两项试验,以绘制不同年龄(71至130d,和211至270d)。使鸟类适应以下条件60d:恒定的最佳环境温度在24°C,高环境温度在34°C持续8h/d(10:00-18:00)。每10天进行一次数据收集和生化测量。在这两个年龄范围内,高温有利于先天免疫(P<0.01)在一个给定的时期的性能(P<0.05)的成本,包括B和T辅助淋巴细胞的相对丰度,淋巴细胞增殖率(B和T淋巴细胞),和外周血中的血清免疫球蛋白含量(IgG和IgM),以及炎症相关基因的脾表达(iNOS,TLR-4,TNF-α,IL-6和INF-γ)。与蛋鸡相比,生长的小母鸡在热攻击后显示出免疫反应的时间延迟激活,并且在暴露结束时没有免疫抑制。总的来说,蛋鸡的免疫系统在炎热的环境中与生产组织有权衡,并表现出明显的年龄范围特异性适应反应。
    Two trials were conducted to draw the phase-response curve of productive and immunological variables in heat-exposed layer chickens at different ages (71 to 130 d, and 211 to 270 d). Birds were acclimated to the following conditions for 60 d: constant optimal ambient temperature at 24°C and high ambient temperature at 34°C for 8 h/d (10:00-18:00). Data collection and biochemical measurements were performed every 10 d. In both age ranges, high temperature favored the innate immunity (P < 0.01) at the cost of performance (P < 0.05) during a given period, including the relative abundance of B and T-helper lymphocytes, lymphocyte proliferation ratio (B and T lymphocytes), and serum immunoglobulin contents (IgG and IgM) in the peripheral blood, as well as splenic expression of inflammation-related genes (iNOS, TLR-4, TNF-α, IL-6, and INF-γ). Compared with laying hens, growing pullets showed a time-delayed activation of immune response following heat challenge, and had no immunosuppression up to the end of exposure. Overall, the immune system of layer birds has a trade-off with production tissues in a hot environment, and exhibits distinct age-range-specific responses of acclimatization.
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  • 文章类型: Journal Article
    背景:本研究旨在对足月孕妇的口腔微生物群与母亲的局部胎盘免疫和全身免疫系统之间的相关性进行初步探索。
    方法:共有26名孕妇参加了这项研究,从口腔拭子收集的样本,胎盘组织,和外周静脉血。高通量测序用于检查口腔微生物群落。采用流式细胞术评估胎盘组织和外周静脉血中的免疫细胞。采用ELISA和Luminex液珠芯片技术检测胎盘组织和外周静脉血中的细胞因子。
    结果:在胎盘组织中,口腔微生物群落主要与胎盘CD3+CD4+CD8+T细胞呈负相关,与胎盘IL-5呈正相关。在外周血中,口腔微生物群落主要与母体全身免疫参数呈正相关,包括CD3+CD4+T细胞和CD4+/CD8+比值,以及与外周IL-18呈正相关。
    结论:足月孕妇口腔菌群参与母体免疫系统的调节功能。同时,口腔微生物群落也可能是介导胎盘局部免疫调节的重要因素。
    BACKGROUND: This study aims to conduct a preliminary exploration of the correlation between the oral microbiota of full-term pregnant women and both local placental immunity and the systemic immune system of the mother.
    METHODS: A total of 26 pregnant women participated in this study, with samples collected from oral swabs, placental tissue, and peripheral venous blood. High-throughput sequencing was used to examine the oral microbial community. Flow cytometry was employed to assess immune cells in placental tissue and peripheral venous blood. ELISA and Luminex liquid bead chip technology were utilized to detect cytokines in both placental tissue and peripheral venous blood.
    RESULTS: In placental tissue, The oral microbial community is primarily negatively correlated with placental CD3+CD4+CD8+T cells and positively correlated with placental IL-5. In the peripheral blood, The oral microbial community is primarily positively correlated with maternal systemic immune parameters, including CD3+CD4+ T cells and the CD4+/CD8+ ratio, as well as positively correlated with peripheral IL-18.
    CONCLUSIONS: The oral microbiota of full-term pregnant women participates in the regulatory function of the maternal immune system. Meanwhile, the oral microbial community may also be an important factor mediating local immune regulation in the placenta.
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  • 文章类型: Journal Article
    扩大免疫检查点阻断(ICB)在结直肠癌(CRC)中的功效,有助于全面了解治疗反应性。这里,我们分析了22例接受PD-1阻断的患者的多个序贯单细胞样本,以绘制CRC患者局部和全身免疫的演变图.在肿瘤中,我们确定了显示不同反应关联的协调细胞程序。具体来说,耗竭T(Tex)或肿瘤反应样CD8+T(Ttr样)细胞与治疗疗效密切相关,和Tex细胞在PD-1阻断后显示与多种其他肿瘤富集细胞类型的相关比例变化。此外,我们揭示了肿瘤中血液相关Ttr样细胞较少耗尽的表型,并发现其较高的丰度表明更好的治疗结局.最后,基线时循环CD8+T细胞中更高的主要组织相容性复合物(MHC)II相关特征与优异的应答相关.我们的研究提供了对CRC新辅助PD-1阻断后时空细胞动力学的见解。
    Expanding the efficacy of immune checkpoint blockade (ICB) in colorectal cancer (CRC) presses for a comprehensive understanding of treatment responsiveness. Here, we analyze multiple sequential single-cell samples from 22 patients undergoing PD-1 blockade to map the evolution of local and systemic immunity of CRC patients. In tumors, we identify coordinated cellular programs exhibiting distinct response associations. Specifically, exhausted T (Tex) or tumor-reactive-like CD8+ T (Ttr-like) cells are closely related to treatment efficacy, and Tex cells show correlated proportion changes with multiple other tumor-enriched cell types following PD-1 blockade. In addition, we reveal the less-exhausted phenotype of blood-associated Ttr-like cells in tumors and find that their higher abundance suggests better treatment outcomes. Finally, a higher major histocompatibility complex (MHC) II-related signature in circulating CD8+ T cells at baseline is linked to superior responses. Our study provides insights into the spatiotemporal cellular dynamics following neoadjuvant PD-1 blockade in CRC.
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  • 文章类型: Journal Article
    背景:已经报道了全身免疫的季节性变化。本研究旨在评估季节性是否影响抗癌免疫疗法的疗效。
    方法:从两个前瞻性观察队列中筛选了总共604名接受单一抗程序性细胞死亡(配体)1(抗PD-[L]1)抑制剂的肺癌患者。主要结果是无进展生存期(PFS)和总生存期(OS)。根据治疗开始的季节将患者分为两组:冬季(11月至2月)和其他季节(3月至10月)。Kaplan-Meier分析和Cox比例风险模型被拟合以评估季节性对生存的影响。对于验证,进行倾向评分匹配.
    结果:共纳入484例晚期非小细胞肺癌患者。在无与伦比的人口中,多变量分析表明,冬季组(n=173)的免疫疗法进展或死亡风险明显低于其他组(n=311)(PFS:风险比[HR],0.77[95%置信区间(CI),0.62-0.96];p=.018;OS:HR,0.77[95%CI,0.1-0.98];p=0.032)。在倾向得分匹配的人群中,冬季组(n=162)的中位PFS明显更长(2.8个月[95%CI,1.9-4.1个月]与2.0个月[95%CI,1.4-2.7个月];p=.009)比另一组(n=162)。冬季组的中位OS也明显长于另一组(13.4个月[95%CI,10.2-18.0个月]vs.8.0个月[95%CI,3.6-8.7个月];p=0.012)。在亚组分析中,冬季组的生存期更长的趋势仍在继续。
    结论:与其他季节相比,在冬季开始使用抗PD-(L)1抑制剂与肺癌患者更好的治疗结果相关。
    BACKGROUND: Seasonal variations in systemic immunity have been reported. This study aimed to evaluate whether seasonality affects the efficacy of anticancer immunotherapy.
    METHODS: A total of 604 patients with lung cancer receiving single anti-programmed cell death (ligand) 1 (anti-PD-[L]1) inhibitors from two prospective observational cohorts were screened. Primary outcomes were progression-free survival (PFS) and overall survival (OS). Patients were classified into two groups according to the season when the treatment started: winter (November-February) and other seasons (March-October). Kaplan-Meier analysis and Cox proportional hazards models were fitted to evaluate the impact of seasonality on survival. For validation, propensity score matching was performed.
    RESULTS: A total of 484 patients with advanced non-small cell lung cancer were included. In an unmatched population, multivariable analysis demonstrated that the winter group (n = 173) had a significantly lower risk of progression or death from immunotherapy than the other group (n = 311) (PFS: hazard ratio [HR], 0.77 [95% confidence interval (CI), 0.62-0.96]; p = .018; OS: HR, 0.77 [95% CI, 0.1-0.98]; p = .032). In a propensity score-matched population, the winter group (n = 162) showed significantly longer median PFS (2.8 months [95% CI, 1.9-4.1 months] vs. 2.0 months [95% CI, 1.4-2.7 months]; p = .009) than the other group (n = 162). The winter group\'s median OS was also significantly longer than that of the other group (13.4 months [95% CI, 10.2-18.0 months] vs. 8.0 months [95% CI, 3.6-8.7 months]; p = .012). The trend toward longer survival in the winter group continued in subgroup analyses.
    CONCLUSIONS: Starting an anti-PD-(L)1 inhibitor in winter was associated with better treatment outcomes in patients with lung cancer compared to other seasons.
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  • 文章类型: Journal Article
    目前的mRNA疫苗主要通过肌肉注射给药,诱导良好的全身免疫,但粘膜免疫有限。通过mRNA疫苗接种实现粘膜免疫可以减少病原体在进入位点的复制并减少人与人之间的传播。然而,向粘膜递送mRNA疫苗面临着mRNA降解等挑战,进入细胞不良,和反应原性。将mRNA封装在细胞外囊泡中可以保护mRNA并降低反应原性,使粘膜mRNA疫苗成为可能。已经研究了来自可食用水果的植物来源的细胞外囊泡作为mRNA载体。动物研究表明,通过口服给药时,橙色衍生的细胞外囊泡中的mRNA可以引起全身和粘膜免疫反应,鼻部,或肌内途径。一旦冻干,这些产品表现出显著的稳定性。优化mRNA,提高翻译效率,免疫原性,反应原性,可以通过调整5'上限区域来获得稳定性,poly-A尾巴,密码子选择,以及核苷类似物的使用。最近的研究还提出了含有RNA聚合酶以及环状mRNA构建体的自扩增RNA疫苗。来自肠胃外灌注动物的数据证明了用非佐剂蛋白进行鼻免疫的功效,在人类中的研究表明,肠胃外疫苗与粘膜自然暴露于相同抗原的组合提供了保护并减少了传播。因此,粘膜mRNA疫苗接种至少在用肠胃外疫苗预处理的生物体中是有益的。这种做法可以广泛应用于传染病的治疗。
    Current mRNA vaccines are mainly administered via intramuscular injection, which induces good systemic immunity but limited mucosal immunity. Achieving mucosal immunity through mRNA vaccination could diminish pathogen replication at the entry site and reduce interhuman transmission. However, delivering mRNA vaccines to mucosae faces challenges like mRNA degradation, poor entry into cells, and reactogenicity. Encapsulating mRNA in extracellular vesicles may protect the mRNA and reduce reactogenicity, making mucosal mRNA vaccines possible. Plant-derived extracellular vesicles from edible fruits have been investigated as mRNA carriers. Studies in animals show that mRNA vehiculated in orange-derived extracellular vesicles can elicit both systemic and mucosal immune responses when administered by the oral, nasal, or intramuscular routes. Once lyophilized, these products show remarkable stability. The optimization of mRNA to improve translation efficiency, immunogenicity, reactogenicity, and stability can be obtained through adjustments of the 5\'cap region, poly-A tail, codons selection, and the use of nucleoside analogues. Recent studies have also proposed self-amplifying RNA vaccines containing an RNA polymerase as well as circular mRNA constructs. Data from parenterally primed animals demonstrate the efficacy of nasal immunization with non-adjuvanted protein, and studies in humans indicate that the combination of a parenteral vaccine with the natural exposure of mucosae to the same antigen provides protection and reduces transmission. Hence, mucosal mRNA vaccination would be beneficial at least in organisms pre-treated with parenteral vaccines. This practice could have wide applications for the treatment of infectious diseases.
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  • 文章类型: Journal Article
    结直肠癌(CRC)提出了相当大的临床挑战,包括肿瘤扩散到远处的高死亡率。在这个高级阶段,迫切需要更准确地预测预后和治疗结果.癌症免疫在转移性CRC(mCRC)中的作用知之甚少。这里,我们探讨了多器官mCRC患者的细胞免疫细胞状态。我们分析了原发肿瘤切片中的T细胞浸润,调查了肝转移的淋巴细胞景观,并评估循环单核免疫细胞。除了询问免疫细胞是否与疾病这一阶段的生存有关,我们调查了不同组织类型之间的相关性;因为这可能表明显性免疫表型。一起来看,我们的分析证实了之前的观察结果,即更高水平的CD8+T淋巴细胞与更好的生存结局相关.因此,我们的发现扩展了CRC早期阶段的证据,表明即使在转移扩散到多个器官后,癌症免疫在疾病控制中也具有重要作用。这一发现可能有助于改善mCRC患者的预后预测,并提示免疫治疗策略的未来作用。
    Colorectal cancer (CRC) raises considerable clinical challenges, including a high mortality rate once the tumor spreads to distant sites. At this advanced stage, more accurate prediction of prognosis and treatment outcome is urgently needed. The role of cancer immunity in metastatic CRC (mCRC) is poorly understood. Here, we explore cellular immune cell status in patients with multi-organ mCRC. We analyzed T cell infiltration in primary tumor sections, surveyed the lymphocytic landscape of liver metastases, and assessed circulating mononuclear immune cells. Besides asking whether immune cells are associated with survival at this stage of the disease, we investigated correlations between the different tissue types; as this could indicate a dominant immune phenotype. Taken together, our analyses corroborate previous observations that higher levels of CD8+ T lymphocytes link to better survival outcomes. Our findings therefore extend evidence from earlier stages of CRC to indicate an important role for cancer immunity in disease control even after metastatic spreading to multiple organs. This finding may help to improve predicting outcome of patients with mCRC and suggests a future role for immunotherapeutic strategies.
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  • 文章类型: Journal Article
    乳腺癌(BC)是全球女性最常见的恶性肿瘤之一。免疫肿瘤学的大量研究和成功的免疫治疗试验已经证明了免疫系统在癌症发病机理中的因果作用。已知肿瘤与免疫系统之间的相互作用具有双重性质。尽管对转化细胞具有细胞毒性淋巴细胞活性,肿瘤可以逃避免疫监视,并利用慢性炎症来维持自身的发展。抗肿瘤免疫的研究主要集中在肿瘤微环境的作用,而对肿瘤部位以外的全身免疫反应的描述不那么透彻。这里,提供了对乳腺癌患者免疫谱形成的全面审查。描述了作为肿瘤进展的自我维持机制的全身和局部免疫反应之间的相互作用,并讨论了与先天和适应性免疫相关的主要细胞群的功能活性。此外,强调了免疫系统不同功能水平之间的相互作用及其对BC中促肿瘤或抗肿瘤免疫反应发展的贡献。所提供的数据可能为BC患者的治疗提供新的免疫治疗策略的开发。
    Breast cancer (BC) is one of the most common malignancies in women worldwide. Numerous studies in immuno-oncology and successful trials of immunotherapy have demonstrated the causal role of the immune system in cancer pathogenesis. The interaction between the tumor and the immune system is known to have a dual nature. Despite cytotoxic lymphocyte activity against transformed cells, a tumor can escape immune surveillance and leverage chronic inflammation to maintain its own development. Research on antitumor immunity primarily focuses on the role of the tumor microenvironment, whereas the systemic immune response beyond the tumor site is described less thoroughly. Here, a comprehensive review of the formation of the immune profile in breast cancer patients is offered. The interplay between systemic and local immune reactions as self-sustaining mechanism of tumor progression is described and the functional activity of the main cell populations related to innate and adaptive immunity is discussed. Additionally, the interaction between different functional levels of the immune system and their contribution to the development of the pro- or anti-tumor immune response in BC is highlighted. The presented data can potentially inform the development of new immunotherapy strategies in the treatment of patients with BC.
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  • 文章类型: Journal Article
    具有PD-1/PD-L1抑制的免疫检查点阻断(ICB)彻底改变了非小细胞肺癌(NSCLC)的治疗。持久的响应,然而,仅在患者亚群中观察到。有缺陷的抗原呈递和免疫抑制性肿瘤微环境(TME)可导致T细胞募集不足和ICB抗性。我们评估了CXCL9和CXCL10工程化树突状细胞(CXCL9/10-DC)的肿瘤内(IT)疫苗接种作为克服耐药性的策略。ITCXCL9/10-DC导致TME中增强的T细胞浸润和活化以及小鼠NSCLC模型中的肿瘤抑制。ITCXCL9/10-DC的抗肿瘤功效依赖于CD4+和CD8+T细胞,以及CXCR3依赖性T细胞从淋巴结运输。ITCXCL9/10-DC,结合ICB,克服抗性并在鼠模型中建立系统性肿瘤特异性免疫。这些研究提供了对CXCL9/10-DC介导的宿主免疫激活的机制理解,并支持ITCXCL9/10-DC的临床翻译以增强NSCLC中的ICB功效。
    Immune checkpoint blockade (ICB) with PD-1/PD-L1 inhibition has revolutionized the treatment of non-small cell lung cancer (NSCLC). Durable responses, however, are observed only in a subpopulation of patients. Defective antigen presentation and an immunosuppressive tumor microenvironment (TME) can lead to deficient T cell recruitment and ICB resistance. We evaluate intratumoral (IT) vaccination with CXCL9- and CXCL10-engineered dendritic cells (CXCL9/10-DC) as a strategy to overcome resistance. IT CXCL9/10-DC leads to enhanced T cell infiltration and activation in the TME and tumor inhibition in murine NSCLC models. The antitumor efficacy of IT CXCL9/10-DC is dependent on CD4+ and CD8+ T cells, as well as CXCR3-dependent T cell trafficking from the lymph node. IT CXCL9/10-DC, in combination with ICB, overcomes resistance and establishes systemic tumor-specific immunity in murine models. These studies provide a mechanistic understanding of CXCL9/10-DC-mediated host immune activation and support clinical translation of IT CXCL9/10-DC to augment ICB efficacy in NSCLC.
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  • 文章类型: Journal Article
    高风险非肌肉浸润性膀胱癌(NMIBC)的治疗包括用卡介苗(BCG)进行膀胱内免疫治疗;然而,经常发生疾病复发和进展。全身免疫对于成功的癌症免疫疗法至关重要;因此,NMIBC的复发可能是由于局部免疫治疗后抗肿瘤免疫的全身激活不够理想.我们先前报道,在接受BCG治疗的NMIBC患者中,循环单核细胞中的全身性获得的训练免疫(先天免疫记忆的一种形式)与复发时间增加有关。在这里,我们使用NMIBC小鼠模型比较了膀胱内和静脉内(全身)BCG免疫治疗对局部和外周免疫微环境的影响.我们还评估了BCG诱导的训练免疫是否调节抗肿瘤免疫应答。与膀胱内BCG相比,这导致了促进肿瘤的免疫微环境,静脉注射BCG导致抗肿瘤膀胱微环境,其特征是细胞毒性T淋巴细胞(CTL)比例增加,和减少比例的骨髓来源的抑制细胞。在引流淋巴结中发生抗肿瘤免疫的极化,脾,脾静脉与膀胱内BCG治疗后的骨髓。与静脉内BCG预处理相比,膀胱内BCG预处理与肿瘤生长速率增加相关。经过训练的免疫有助于肿瘤免疫微环境的重塑,因为BCG训练的巨噬细胞与表达卵清蛋白的膀胱肿瘤细胞的共滴注增加了肿瘤特异性CTL的比例。此外,BCG训练的树突状细胞表现出增强的抗原摄取和呈递,并促进CTL增殖。我们的数据支持全身免疫激活促进抗肿瘤反应的概念,并且BCG诱导的训练免疫在驱动抗肿瘤适应性免疫中很重要。
    Treatment for higher-risk non-muscle invasive bladder cancer (NMIBC) involves intravesical immunotherapy with Bacillus Calmette Guérin (BCG); however, disease recurrence and progression occur frequently. Systemic immunity is critical for successful cancer immunotherapy; thus, recurrence of NMIBC may be due to suboptimal systemic activation of anti-tumor immunity after local immunotherapy. We previously reported that systemically acquired trained immunity (a form of innate immune memory) in circulating monocytes is associated with increased time-to-recurrence in patients with NMIBC treated with BCG. Herein, we used a mouse model of NMIBC to compare the effects of intravesical versus intravenous (systemic) BCG immunotherapy on the local and peripheral immune microenvironments. We also assessed whether BCG-induced trained immunity modulates anti-tumor immune responses. Compared with intravesical BCG, which led to a tumor-promoting immune microenvironment, intravenous BCG resulted in an anti-tumoral bladder microenvironment characterized by increased proportions of cytotoxic T lymphocytes (CTLs), and decreased proportions of myeloid-derived suppressor cells. Polarization toward anti-tumoral immunity occurred in draining lymph nodes, spleen, and bone marrow following intravenous versus intravesical BCG treatment. Pre-treatment with intravesical BCG was associated with increased rate of tumor growth compared with intravenous BCG pre-treatment. Trained immunity contributed to remodeling of the tumor immune microenvironment, as co-instillation of BCG-trained macrophages with ovalbumin-expressing bladder tumor cells increased the proportion of tumor-specific CTLs. Furthermore, BCG-trained dendritic cells exhibited enhanced antigen uptake and presentation and promoted CTL proliferation. Our data support the concept that systemic immune activation promotes anti-tumor responses, and that BCG-induced trained immunity is important in driving anti-tumor adaptive immunity.
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  • 文章类型: Journal Article
    背景:先前的一项小规模单中心研究表明,乳糜泻(CD)型免疫与难治性颞叶癫痫(TLE)和海马硬化(HS)之间存在关联。本研究在一个大的,特征明确的耐药癫痫(DRE)患者组。这些患者根据CD和谷蛋白敏感性相关抗体的谱进行分组。
    方法:在这项横断面研究中,253名连续的成人癫痫患者(135名女性,118名男性;年龄16-76岁)分为三组:(i)先前诊断为CD或CD特异性TG2/EmA抗体的CD阳性组,(ii)具有抗醇溶蛋白抗体(AGA)但无CD的AGA阳性组,和(iii)无任何谷蛋白敏感性相关抗体或CD的CD/AGA阴性组。然后比较各组的临床和免疫学结果。
    结果:与CD/AGA阴性组相比,CD阳性组合并HS的TLE更为常见(31.8%对11.9%,P=0.019)。自身免疫性疾病在AGA阳性组比CD/AGA阴性组更为常见(P=0.025)。考虑到HS侧化;与CD/AGA阴性组相比,CD阳性组的左侧化更为常见(71.4%对25%,P=0.030)。TG6血清阳性在各组间无差异(P>0.05)。
    结论:这项研究提供了将TLE与HS和CD型自身免疫联系起来的进一步证据,表明对谷蛋白的CD型免疫反应可能是一种潜在的机制,作为导致DRE和HS的疾病调节剂。了解这些免疫因素对于开发可能预防HS进展的DRE的免疫调节或饮食治疗至关重要。
    BACKGROUND: A prior small-scale single center study suggested an association between celiac disease (CD)-type immunity and refractory temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS). The present study addresses this putative association in a large, well-characterized group of drug-resistant epilepsy (DRE) patients. These patients were grouped based on the spectrum of CD and gluten sensitivity-associated antibodies.
    METHODS: In this cross-sectional study, 253 consecutive adult epilepsy patients (135 females, 118 males; age 16-76 years) were categorized into three groups: (i) CD-positive group with either prior diagnosis of CD or CD-specific TG2/EmA antibodies, (ii) AGA-positive group with antigliadin antibodies (AGA) but without CD, and (iii) CD/AGA-negative group without any gluten sensitivity-associated antibodies or CD. Clinical and immunological findings were then compared among the groups.
    RESULTS: TLE with HS was more common in the CD-positive group compared to CD/AGA-negative group (31.8% versus 11.9%, P = 0.019). Autoimmune disorders were more common in the AGA-positive group than in the CD/AGA-negative group (P = 0.025). Considering HS lateralization; left lateralization was more common in CD-positive group compared to CD/AGA-negative group (71.4% versus 25%, P = 0.030). TG6 seropositivity did not differ among the groups (P > 0.05).
    CONCLUSIONS: This study provides further evidence linking TLE with HS and CD-type autoimmunity suggesting that CD-type immune response to gluten can be one potential mechanism as a disease modifier leading to DRE and HS. Understanding these immunological factors is imperative for developing immunomodulatory or dietary treatments for DRE potentially preventing HS progression.
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