• 文章类型: Journal Article
    本研究的目的是探讨异位脑胺的保护作用和潜在机制,一种天然的渗透保护剂,干眼症眼表粘蛋白的产生。
    在暴露于干燥应激(DS)的C57BL/6小鼠中建立干眼模型,未处理(UT)小鼠作为对照。DS小鼠用2.0%艾克托因或PBS载体局部处理。通过俄勒冈绿葡聚糖(OGD)荧光染色评估角膜上皮缺损。结膜杯状细胞,眼粘蛋白,和T帮助(Th)细胞因子通过免疫荧光染色或ELISA进行评估,和RT-qPCR。
    与UT小鼠相比,角膜上皮缺损被检测为强点OGD荧光染色DS小鼠与载体,而ectoine治疗将OGD染色大大降低至接近正常水平。DS小鼠结膜杯状细胞密度和细胞大小明显下降,但通过艾克托因治疗显着恢复。两种凝胶分泌型MUC5AC和MUC2的蛋白质产生和mRNA表达,以及4种跨膜粘蛋白,MUC1,MUC4,MUC16和MUC15在DS小鼠中大幅下降,但是被ectoine修复了。此外,Th2细胞因子IL-13被抑制,而Th1细胞因子IFN-γ在DS小鼠的结膜和引流颈淋巴结(CLN)中的蛋白质和mRNA水平受到刺激,导致IL-13/IFN-γ比值降低。有趣的是,2.0%的埃托因逆转了它们的交替,并恢复了IL-13/IFN-γ平衡。
    我们的研究结果表明,外用外用能显著减少角膜损伤,并通过恢复小鼠干眼模型中不平衡的IL-13/IFN-γ信号传导来增强杯状细胞密度和粘蛋白产生。这表明天然渗透保护剂艾托因治疗干眼病的潜力。
    UNASSIGNED: This study aimed to explore protective effects and potential mechanism of ectoine, a natural osmoprotectant, on ocular surface mucin production in dry eye disease.
    UNASSIGNED: A dry eye model was established in C57BL/6 mice exposed to desiccating stress (DS) with untreated (UT) mice as controls. DS mice were topically treated with 2.0% ectoine or PBS vehicle. Corneal epithelial defects were assessed by Oregon Green Dextran (OGD) fluorescent staining. Conjunctival goblet cells, ocular mucins, and T help (Th) cytokines were evaluated by immunofluorescent staining or ELISA, and RT-qPCR.
    UNASSIGNED: Compared with UT mice, corneal epithelial defects were detected as strong punctate OGD fluorescent staining in DS mice with vehicle, whereas ectoine treatment largely reduced OGD staining to near-normal levels. Conjunctival goblet cell density and cell size decreased markedly in DS mice, but was significantly recovered by ectoine treatment. The protein production and mRNA expression of two gel-forming secreted MUC5AC and MUC2, and 4 transmembrane mucins, MUC1, MUC4, MUC16, and MUC15, largely decreased in DS mice, but was restored by ectoine. Furthermore, Th2 cytokine IL-13 was inhibited, whereas Th1 cytokine IFN-γ was stimulated at protein and mRNA levels in conjunctiva and draining cervical lymph nodes (CLNs) of DS mice, leading to decreased IL-13/IFN-γ ratio. Interestingly, 2.0% ectoine reversed their alternations and restored IL-13/IFN-γ balance.
    UNASSIGNED: Our findings demonstrate that topical ectoine significantly reduces corneal damage, and enhances goblet cell density and mucin production through restoring imbalanced IL-13/IFN-γ signaling in murine dry eye model. This suggests therapeutic potential of natural osmoprotectant ectoine for dry eye disease.
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  • 文章类型: Journal Article
    目的:探讨抗黑色素瘤分化相关基因5(MDA5)阳性的临床肌病性皮肌炎(CADM)和间质性肺病(ILD)患者的预后因素。
    方法:回顾性分析2014年12月至2022年12月华东地区10个分支的125例抗MDA5+CADM-ILD患者的临床资料。预后因素分析采用χ2检验,Log-ranktest,COX和logistic回归分析。
    结果:在此队列中,125名抗MDA5+CADM-ILD患者表现出37.6%的快速进展性间质性肺病(RPILD)发病率,总死亡率为24.8%。一名患者失去了随访。诊断为RPILD后,在3个月内死亡的患者死亡率为53.2%,5.6%出现在存活3个月以上的人中。多因素分析显示,C反应蛋白(CRP)≥10mg/L(p=0.01)和含21(Ro52)(+)(p=0.003)的重组人三方基序与抗MDA5+CADM-ILD患者发生RPILD的风险较高相关;CRP≥10mg/L(p=0.018)和是否存在RPILD(p=0.003)是患者生存时间的影响因素。而关节炎是保护因素(p=0.016)。
    结论:抗MDA5+CADM-ILD患者的死亡率更高,诊断为RPILD后的最初3个月被认为是预后不良的风险窗。CRP≥10mg/L的患者,Ro52(+)和RPILD可能与较短的生存时间有关,而患有关节炎的患者可能会出现相对温和的情况。
    OBJECTIVE: To investigate the prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (MDA5) positive clinically amyopathic dermatomyositis (CADM) and interstitial lung disease (ILD).
    METHODS: A retrospective analysis was conducted on clinical data of 125 patients with anti-MDA5 + CADM-ILD collected from 10 branches in eastern China between December 2014 and December 2022. Prognostic factors were analyzed using χ2 test, Log-rank test, COX and logistic regression analysis.
    RESULTS: In this cohort, 125 anti-MDA5 + CADM-ILD patients exhibited a rapidly progressive interstitial lung disease (RPILD) incidence of 37.6%, and an overall mortality rate of 24.8%. One patient was lost to follow-up. After diagnosis of RPILD, a mortality rate of 53.2% occurred in patients died within 3 months, and that of 5.6% appeared in those who survived for more than 3 months. Multiple factor analysis revealed that C-reactive protein (CRP) ≥ 10 mg/L (p = 0.01) and recombinant human tripartite motif containing 21 (Ro52) (+) (p = 0.003) were associated with a higher risk of RPILD in anti-MDA5 + CADM-ILD patients; CRP ≥ 10 mg/L (p = 0.018) and the presence of RPILD (p = 0.003) were identified as the factors influencing survival time in these patients, while arthritis was the protective factor (p = 0.016).
    CONCLUSIONS: Patients with anti-MDA5 + CADM-ILD will have a higher mortality rate, and the initial 3 months after diagnosis of RPILD is considered the risk window for the dismal prognosis. Patients with CRP ≥ 10 mg/L, Ro52 (+) and RPILD may be related to a shorter survival time, while patients complicated with arthritis may present with relatively mild conditions.
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  • 文章类型: Journal Article
    克罗恩病(CD)和类风湿性关节炎(RA)合并症的发生率,以及受影响的人数,由于它们共同的分子和细胞因子,正在上升。本研究旨在确定CD和RA合并症的潜在治疗靶点和药物。
    我们整合了单细胞RNA测序,孟德尔随机化,和来自公共数据库的共定位分析结果,以分析CD和RA患者的免疫细胞亚群并确定候选治疗靶标。我们使用比较毒性基因组学数据库(CTD)和分子对接和分子动力学模拟进一步筛选了确定的候选靶标的潜在药物。
    在CD和RA患者的外周血单核细胞(PBMC)中,CD8效应记忆T细胞(Tem)的比例始终升高。MYBL1对CD(OR=1.23;95%CI,1.05-1.45;P=0.046)和RA(OR=1.45;95%CI,1.14-1.85;P=0.04)的发作均有因果关系。从CTD数据库中检索到四种潜在的治疗分子,其中维甲酸(对接评分:-6.3kcal/mol)表现出最佳潜力。
    我们的综合分析表明,CD8Tem细胞是RA和CD共病的关键细胞群,MYBL1具有因果效应。维甲酸被确定为潜在的靶向治疗药物,具有重要的临床研究价值。
    UNASSIGNED: The incidence of Crohn\'s disease (CD) and rheumatoid arthritis (RA) co-morbidity, as well as the number of individuals affected, is on the rise due to their shared molecular and cellular factors. This study aimed to identify potential therapeutic targets and medicines for comorbid CD and RA.
    UNASSIGNED: We integrated single-cell RNA sequencing, Mendelian randomization, and colocalization analysis results from public databases to analyse immune cell subgroups in CD and RA patients and identify candidate therapeutic targets. We further screened potential medicines for the identified candidate targets using the Comparative Toxicogenomics Database (CTD) and molecular docking and molecular dynamics simulations.
    UNASSIGNED: The proportion of CD8 effector memory T cells (Tem) was consistently elevated in the peripheral blood mononuclear cells (PBMCs) of both CD and RA patients. MYBL1 had a causal effect on the onset of both CD (OR = 1.23; 95 % CI, 1.05-1.45; P = 0.046) and RA (OR = 1.45; 95 % CI, 1.14-1.85; P = 0.04). Four potential therapeutic molecules were retrieved from the CTD database, among which tretinoin (docking score: -6.3 kcal/mol) showed the best potential.
    UNASSIGNED: Our comprehensive analysis suggests that CD8 Tem cells are a key cell group in comorbid RA and CD and that MYBL1 has a causal effect. Tretinoin was identified as a potential targeted therapeutic drug, which is of great clinical research value.
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  • 文章类型: Journal Article
    该研究旨在探讨不同肌肉骨骼超声(MSUS)体征的诊断价值,血清尿酸(SUA),以及它们对痛风性关节炎(GA)的联合检测。
    在这项回顾性研究中,70名患者(62名男性,8名女性;平均年龄:46.1±14.1岁;范围,25至86岁)在2022年8月至2023年3月之间诊断为GA(GA组),有70名患者(54名女性,16名男性;平均年龄:49.0±14.1岁;范围,包括同期(非GA组)诊断为类风湿关节炎和骨关节炎的21至75岁)。记录两组的MSUS体征和SUA阳性率,以比较差异。采用Spearman秩相关分析MSUS征象和SUA与GA的相关性。不同MSUS征象的诊断价值,SUA,并使用接收器工作特性分析了它们对GA的组合检测,曲线下面积(AUC),灵敏度,特异性,和Youden指数。
    双轮廓(DC)符号的阳性率(卡方[χ2]=102.935,p<0.001),高回声斑点(χ2=56.395,p<0.001),骨侵蚀(χ2=10.080,p<0.001),GA组SUA(χ2=41.117,p<0.001)高于非GA组。DC符号的阳性率(rs=0.829,p=0.001),高回声斑点(rs=0.631,p<0.001),骨侵蚀(rs=0.268,p=0.001),SUA与GA呈正相关(rs=0.542,p<0.001)。在单一指标措施中,DC征象表现出最高的诊断价值(AUC=0.907,灵敏度=81.4%,特异性=100%,p<0.001)。在综合指标措施中,DC征象联合SUA表现出最高的诊断价值(AUC=0.929,灵敏度=91.4%,特异性=94.3%,p<0.001),高于单独的DC信号检测。
    与SUA结合的DC符号产生了很高的诊断价值,因此可以为有效和高效地诊断GA提供可靠的依据。
    UNASSIGNED: The study aimed to investigate the diagnostic values of different musculoskeletal ultrasound (MSUS) signs, serum uric acid (SUA), and their combined detection for gouty arthritis (GA).
    UNASSIGNED: In this retrospective study, 70 patients (62 males, 8 females; mean age: 46.1±14.1 years; range, 25 to 86 years) diagnosed with GA (the GA group) between August 2022 and March 2023 and 70 patients (54 females, 16 males; mean age: 49.0±14.1 years; range, 21 to 75 years) diagnosed with rheumatoid arthritis and osteoarthritis during the same period (the non-GA group) were included. The positive rate of MSUS signs and SUA in both groups was recorded to compare the differences. The correlations of MSUS signs and SUA with GA were analyzed using Spearman\'s rank correlation analysis. The diagnostic values of different MSUS signs, SUA, and their combined detection for GA were analyzed using a receiver operating characteristic, the area under the curve (AUC), sensitivity, specificity, and the Youden index.
    UNASSIGNED: The positive rate of the double contour (DC) sign (chi-squared [χ2 ]=102.935, p<0.001), hyperechoic spots (χ2=56.395, p<0.001), bone erosions (χ2 =10.080, p<0.001), and SUA (χ2 =41.117, p <0.001) were higher in the GA group than in the non-GA group. The positive rate of the DC sign (rs=0.829, p=0.001), hyperechoic spots (rs=0.631, p<0.001), bone erosion (rs=0.268, p=0.001), and SUA (rs=0.542, p<0.001) were positively correlated with GA. Among the single-indicator measures, the DC sign exhibited the highest diagnostic value (AUC=0.907, sensitivity=81.4%, specificity=100%, p<0.001). Among the combined-indicator measures, the DC sign combined with SUA exhibited the highest diagnostic value (AUC=0.929, sensitivity=91.4%, specificity=94.3%, p<0.001), higher than DC sign detection alone.
    UNASSIGNED: The DC sign combined with SUA yielded a high diagnostic value and can thus provide a reliable basis for effectively and efficiently diagnosing GA.
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  • 文章类型: Journal Article
    新出现的证据强调了颅骨和椎骨骨髓中的血源性细胞通过骨化的血管通道进入脑膜边界并维持中枢神经系统(CNS)的免疫稳态的能力。与CNS相邻的颅骨和椎骨骨髓包含造血生态位,可以感知CNS损伤并提供专门的免疫细胞以微调炎症反应。这里,我们回顾了我们对颅骨和椎体骨髓来源的免疫细胞在稳态和炎症性中枢神经系统疾病中的最新进展。Further,我们讨论了减轻中枢神经系统炎症及其在神经系统疾病中的有害后遗症的疗法对未来发展的意义。
    Emerging evidence has highlighted the capacity of hematogenous cells in skull and vertebral bone marrow to enter the meningeal borders via ossified vascular channels and maintain immune homeostasis in the central nervous system (CNS). CNS-adjacent skull and vertebral bone marrow comprises hematopoietic niches that can sense CNS injury and supply specialized immune cells to fine-tune inflammatory responses. Here, we review recent advances in our understanding of skull and vertebral bone marrow-derived immune cells in homeostasis and inflammatory CNS diseases. Further, we discuss the implications for future development of therapies to mitigate CNS inflammation and its detrimental sequelae in neurological disorders.
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  • 文章类型: Journal Article
    根据世界卫生组织的全球疾病负担研究,近年来,精神和神经系统疾病占全球疾病的13%,并且正在上升。神经精神病症或神经炎性疾病与外周和中枢神经系统(CNS)中过度的免疫应答的存在有关。认知功能障碍(CD)包括一组复杂的疾病,并且在自身免疫性疾病领域中经常被描述。特别是在多种非中枢神经系统相关的自身免疫性疾病。最近的研究提供了关于自身免疫性疾病中认知障碍的发生的各种假设。包括异常激活的免疫细胞可以破坏血脑屏障(BBB)的完整性,从而引发中枢神经炎症反应。当BBB完好无损时,外周循环中的自身抗体和促炎分子可以进入大脑激活小胶质细胞,诱导CNS炎症和CD。然而,解释免疫系统和神经功能之间的关联及其对疾病的影响的机制尚不确定。在这次审查中,我们使用临床统计数据来说明CD与不直接影响CNS的自身免疫性疾病之间的相关性,总结了自身免疫性疾病引发认知障碍的临床特征和机制,并从神经免疫学领域的角度探讨了有关CD与自身免疫性疾病之间联系的现有知识。
    According to a study from World Health Organization\'s Global Burden of Disease, mental and neurological disorders have accounted for 13% of global diseases in recent years and are on the rise. Neuropsychiatric conditions or neuroinflammatory disorders are linked by the presence of an exaggerated immune response both peripherally and in the central nervous system (CNS). Cognitive dysfunction (CD) encompasses a complex group of diseases and has frequently been described in the field of autoimmune diseases, especially in multiple non-CNS-related autoimmune diseases. Recent studies have provided various hypotheses regarding the occurrence of cognitive impairment in autoimmune diseases, including that abnormally activated immune cells can disrupt the integrity of the blood-brain barrier (BBB) to trigger a central neuroinflammatory response. When the BBB is intact, autoantibodies and pro-inflammatory molecules in peripheral circulation can enter the brain to activate microglia, inducing CNS inflammation and CD. However, the mechanisms explaining the association between the immune system and neural function and their contribution to diseases are uncertain. In this review, we used clinical statistics to illustrate the correlation between CD and autoimmune diseases that do not directly affect the CNS, summarized the clinical features and mechanisms by which autoimmune diseases trigger cognitive impairment, and explored existing knowledge regarding the link between CD and autoimmune diseases from the perspective of the field of neuroimmunology.
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  • 文章类型: Journal Article
    针对干燥综合征(SS)的靶向治疗已成为临床医生的重要关注点。多组学广泛的孟德尔随机化(MR)分析为识别潜在的药物靶标提供了新思路。
    我们进行了基于汇总数据的孟德尔随机化(SMR)分析,以通过整合DNA甲基化来评估与SS相关的治疗靶标,基因表达和蛋白质数量性状基因座(mQTL,eQTL,和pQTL,分别)。与SS的遗传关联来源于FinnGen研究(发现)和GWAS目录(复制)。采用共定位分析来确定两种潜在相关表型在给定区域中是否共享相同的遗传因素。此外,深入研究DNA甲基化之间的潜在调控,基因表达,和蛋白质丰富,我们进行了MR分析,以探讨候选基因甲基化与表达之间的因果关系,以及基因表达和蛋白质丰度之间。进一步采用药物预测和分子对接来验证候选药物靶标的药理活性。
    在整合多组数据后,我们确定了与SS风险相关的三个基因:TNFAIP3,BTN3A1和PLAU.BTN3A1中cg22068371的甲基化与蛋白水平呈正相关,与cg22068371甲基化对SS风险的负面影响一致。此外,PLAU(cg04939496)基因甲基化与表达呈正相关,以及表达和蛋白质水平之间。这种一致性阐明了PLAU在DNA甲基化时对SS风险的促进作用,基因表达,和蛋白质水平。在蛋白质水平,遗传预测的TNFAIP3(OR2.47,95%CI1.56-3.92)与SS风险呈正相关,而BTN3A1(OR2.96E-03,95%CI2.63E-04-3.33E-02)与SS风险呈负相关。分子对接显示候选药物和靶蛋白的稳定结合。
    我们的研究揭示了治疗SS的有希望的治疗目标,为SS的靶向治疗提供有价值的见解。然而,有必要通过未来的实验进一步验证.
    UNASSIGNED: Targeted therapy for Sjögren\'s syndrome (SS) has become an important focus for clinicians. Multi-omics-wide Mendelian randomization (MR) analyses have provided new ideas for identifying potential drug targets.
    UNASSIGNED: We conducted summary-data-based Mendelian randomization (SMR) analysis to evaluate therapeutic targets associated with SS by integrating DNA methylation, gene expression and protein quantitative trait loci (mQTL, eQTL, and pQTL, respectively). Genetic associations with SS were derived from the FinnGen study (discovery) and the GWAS catalog (replication). Colocalization analyses were employed to determine whether two potentially relevant phenotypes share the same genetic factors in a given region. Moreover, to delve deeper into potential regulation among DNA methylation, gene expression, and protein abundance, we conducted MR analysis to explore the causal relationship between candidate gene methylation and expression, as well as between gene expression and protein abundance. Drug prediction and molecular docking were further employed to validate the pharmacological activity of the candidate drug targets.
    UNASSIGNED: Upon integrating the multi-omics data, we identified three genes associated with SS risk: TNFAIP3, BTN3A1, and PLAU. The methylation of cg22068371 in BTN3A1 was positively associated with protein levels, consistent with the negative effect of cg22068371 methylation on the risk of SS. Additionally, positive correlations were observed between the gene methylation of PLAU (cg04939496) and expression, as well as between expression and protein levels. This consistency elucidates the promotional effects of PLAU on SS risk at the DNA methylation, gene expression, and protein levels. At the protein level, genetically predicted TNFAIP3 (OR 2.47, 95% CI 1.56-3.92) was positively associated with SS risk, while BTN3A1 (OR 2.96E-03, 95% CI 2.63E-04-3.33E-02) was negatively associated with SS risk. Molecular docking showed stable binding for candidate drugs and target proteins.
    UNASSIGNED: Our study reveals promising therapeutic targets for the treatment of SS, providing valuable insights into targeted therapy for SS. However, further validation through future experiments is warranted.
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  • 文章类型: Journal Article
    背景:系统性红斑狼疮(SLE)是一种复杂的自身免疫性疾病,会影响多个器官系统,在育龄妇女中患病率较高。该疾病的多因素病因涉及遗传,环境,和荷尔蒙成分。最近的研究强调了饮食因素的潜在影响,特别是不饱和脂肪酸,关于SLE的调节,由于它们的抗炎特性。这项荟萃分析旨在评估不饱和脂肪酸消耗与风险之间的关系,programming,和SLE的临床表现,为饮食管理提供循证指导。
    方法:截至2024年1月,我们对主要医学数据库进行了全面搜索,重点是研究不饱和脂肪酸的摄入量以及这种摄入量对SLE的影响。使用PICOS(人口,干预,比较器,结果,研究设计)框架,我们纳入了随机对照试验和病例对照研究,评估结果,如SLE活动,通过SLE疾病活动指数(SLEDAI)或不列颠群岛狼疮评估组(BILAG)指数测量,炎症生物标志物。研究使用基于异质性的固定效应或随机效应模型(I2统计量)进行分析,进行敏感性分析以评估结果的稳健性。
    结果:我们的搜索包括10项研究,涵盖各种各样的设计和人群。荟萃分析显示,富含不饱和脂肪酸的饮食与SLEDAI评分(合并SMD)-0.36,95%CI:-0.61至-0.11,p=0.007显着相关,表明对疾病活动的有益作用。此外,我们发现不饱和脂肪酸的摄入对HDL水平有显著影响,提示对血脂有积极影响。然而,对炎症标志物IL-6或其他脂质成分(LDL和胆固醇)的水平没有观察到显著影响.研究之间的异质性最小(I2≤15%),灵敏度分析证实了这些结果的稳定性和可靠性,强调不饱和脂肪酸在SLE管理中的潜在作用。
    结论:这项荟萃分析表明,饮食摄入不饱和脂肪酸可能在降低SLE活性方面发挥积极作用,并且可能显著影响HDL水平,而对炎症标志物或其他血脂谱没有显著影响。这些发现支持将不饱和脂肪酸纳入SLE患者的饮食管理,尽管需要进一步的研究来完善饮食建议并探索这些关联的潜在机制.
    BACKGROUND: Systemic lupus erythematosus (SLE) is a complex autoimmune disorder that affects multiple organ systems, with a higher prevalence among women in their reproductive years. The disease\'s multifactorial etiology involves genetic, environmental, and hormonal components. Recent studies have highlighted the potential impact of dietary factors, particularly unsaturated fatty acids, on the modulation of SLE due to their anti-inflammatory properties. This meta-analysis aims to evaluate the association between unsaturated fatty acid consumption and the risk, progression, and clinical manifestations of SLE, providing evidence-based guidance for dietary management.
    METHODS: We conducted a comprehensive search across major medical databases up to January 2024, focusing on studies that examined the intake of unsaturated fatty acids and the impact of such intake on SLE. Using the PICOS (population, intervention, comparator, outcomes, study design) framework, we included randomized controlled trials and case-control studies, assessing outcomes such as SLE activity, measured by SLE Disease Activity Index (SLEDAI) or the British Isles Lupus Assessment Group (BILAG) index, inflammation biomarkers. Studies were analyzed using either a fixed- or random-effects model based on heterogeneity (I2 statistic), with sensitivity analyses performed to assess the robustness of the findings.
    RESULTS: Our search included 10 studies, encompassing a wide variety of designs and populations. The meta-analysis showed that a diet rich in unsaturated fatty acids is significantly associated with a reduction in SLEDAI scores (pooled SMD) of -0.36, 95% CI: -0.61 to -0.11, p = 0.007, indicating a beneficial effect on disease activity. Additionally, we found that unsaturated fatty acid intake has a significant impact on HDL levels, suggesting a positive effect on lipid profiles. However, no significant effects were observed on levels of the inflammatory marker IL-6 or other lipid components (LDL and cholesterol). With minimal heterogeneity among studies (I2 ≤ 15%), sensitivity analysis confirmed the stability and reliability of these results, highlighting the potential role of unsaturated fatty acids in SLE management.
    CONCLUSIONS: This meta-analysis suggests that dietary intake of unsaturated fatty acids may play a positive role in reducing SLE activity and may significantly affect HDL levels without having significant effects on inflammation markers or other lipid profiles. These findings support the inclusion of unsaturated fatty acids in the dietary management of SLE patients, although further research is required to refine dietary recommendations and explore the mechanisms underlying these associations.
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  • 文章类型: Journal Article
    背景和目的:本研究旨在评估患病率,预测因子,狼疮性肾炎(LN)患者肺动脉高压(PH)的转归。材料与方法:回顾性收集2007年至2017年387例LN患者的基线特征和临床结果。PH定义为静息经胸超声心动图评估的肺动脉收缩压≥40mmHg。主要终点是全因死亡率。次要终点是肾脏事件,定义为基线血清肌酐或终末期肾病的两倍。通过Cox回归模型分析PH与结果之间的关联。结果:15.3%(59/387)的LN患者诊断为PH,与eGFR≥30mL/min/1.73m2的患者相比,肾小球滤过率(eGFR)<30mL/min/1.73m2的患者的PH患病率更高(31.5%vs.12.6%)。较高的平均动脉压,低血红蛋白,和较低的甘油三酯水平与患PH的几率更大相关。调整相关混杂变量后,PH与较高的死亡风险(HR:2.01;95%CI:1.01-4.00;p=0.047)和肾脏事件(HR:2.07;95%CI:1.04-4.12;p=0.039)独立相关。结论:PH是LN患者全因死亡和不良肾脏结局的独立危险因素。
    Background and Objectives: This study aimed to assess the prevalence, predictors, and outcomes of pulmonary hypertension (PH) in patients with lupus nephritis (LN). Materials and Methods: Baseline characteristics and clinical outcomes of 387 patients with LN were retrospectively collected from 2007 to 2017. PH was defined as pulmonary artery systolic pressure ≥40 mmHg assessed by resting transthoracic echocardiography. The primary endpoint was all-cause mortality. The secondary endpoint was renal events, defined as the doubling of baseline serum creatinine or end-stage renal disease. Associations between PH and outcomes were analyzed by Cox regression models. Results: A total of 15.3% (59/387) of patients with LN were diagnosed with PH, and the prevalence of PH was higher for patients with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 compared to those with an eGFR ≥ 30 mL/min/1.73 m2 (31.5% vs. 12.6%). Higher mean arterial pressure, lower hemoglobin, and lower triglyceride levels were associated with greater odds of having PH. After adjusting for relevant confounding variables, PH was independently associated with a higher risk for death (HR: 2.01; 95% CI: 1.01-4.00; p = 0.047) and renal events (HR: 2.07; 95% CI: 1.04-4.12; p = 0.039). Conclusions: PH is an independent risk factor for all-cause mortality and adverse renal outcomes in patients with LN.
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  • 文章类型: Journal Article
    类风湿性关节炎(RA)是一种自身免疫性疾病,其通过破坏CD4+T细胞免疫稳态显著影响生活质量。迫切需要鉴定用于RA治疗的低副作用药物。我们先前的研究表明,旋毛虫副肌球蛋白(Ts-Pmy)具有免疫调节作用,但其对RA患者CD4+T细胞应答的潜在影响尚不清楚.在这项研究中,我们使用小鼠模型研究rTs-Pmy在调节胶原诱导性关节炎(CIA)CD4+T细胞分化中的作用.此外,我们评估了rTs-Pmy对CD4+T细胞向Th1和Th17表型分化的影响,这与关节炎的炎症反应有关,使用体外测定。结果表明,rTs-Pmy给药通过抑制Th1和Th17应答同时增强Treg应答来降低关节炎严重程度。与治疗性给药相比,预防性给药Ts-Pmy对CIA的疗效更高。此外,体外实验表明,rTs-Pmy可以抑制CD4+T细胞分化为Th1和Th17,同时诱导Tregs的产生,表明其治疗效果的潜在机制。这项研究表明,Ts-Pmy可能通过恢复CD4T细胞的免疫平衡来改善CIA,并为蠕虫衍生蛋白在自身免疫性疾病中发挥作用的机制提供了新的见解。
    Rheumatoid arthritis (RA) is an autoimmune disease that significantly impacts quality of life by disrupting CD4+ T cell immune homeostasis. The identification of a low-side-effect drug for RA treatment is urgently needed. Our previous study suggests that Trichinella spiralis paramyosin (Ts-Pmy) has immunomodulatory effects, but its potential effect on CD4+ T cell response in RA remains unclear. In this study, we used a murine model to investigate the role of rTs-Pmy in regulating CD4+ T cell differentiation in collagen-induced arthritis (CIA). Additionally, we assessed the impact of rTs-Pmy on CD4+ T cell differentiation towards the Th1 and Th17 phenotypes, which are associated with inflammatory responses in arthritis, using in vitro assays. The results demonstrated that rTs-Pmy administration reduced arthritis severity by inhibiting Th1 and Th17 response while enhancing Treg response. Prophylactic administration of Ts-Pmy showed superior efficacy on CIA compared to therapeutic administration. Furthermore, in vitro assays demonstrated that rTs-Pmy could inhibit the differentiation of CD4+ T cells into Th1 and Th17 while inducing the production of Tregs, suggesting a potential mechanism underlying its therapeutic effects. This study suggests that Ts-Pmy may ameliorate CIA by restoring the immune balance of CD4+ T cells and provides new insights into the mechanism through which helminth-derived proteins exert their effects on autoimmune diseases.
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