A&R:滑膜炎症通路是抗TNF应答RA患者的特征

2022-07-30 紫菀款冬 MedSci原创

探究抗肿瘤坏死因子(TNF)治疗反应的机制基础,并确定滑膜中的转录组变化是否反映在外周蛋白标记物中。

目的:探究抗肿瘤坏死因子(TNF)治疗反应的机制基础,并确定滑膜中的转录组变化是否反映在外周蛋白标记物中。

方法: 抗TNF治疗前和治疗12周后,对46例RA患者的滑膜组织进行RNA测序。对滑膜活检的RNA表达谱进行通路和基因特征分析,以确定区分EULAR良好、中度和无反应者的机制。在同一患者中测量由不同EULAR反应组之间差异表达的滑膜基因编码的血清蛋白。

结果:基因特征预测了反应良好的患者,通路分析确定了包括趋化因子信号、Th1/Th2细胞分化和Toll样受体信号在内的升高的免疫通路。只有在反应良好的患者中,抗TNF治疗才相应下调这些炎症通路

根据细胞特征分析,与无反应者相比,反应良好者的淋巴细胞、髓样细胞和成纤维细胞数量增加,这与炎症通路增上调一致。抗TNF治疗后减少的细胞特征主要与淋巴细胞有关,较少与髓系和成纤维细胞群有关。

在抗TNF治疗后,仅在反应良好的患者中,几种外周炎性蛋白下降,与相应的滑膜基因变化一致

结论:对抗TNF治疗有强烈反应的RA患者在基线时具有免疫通路激活的特征,在抗TNF治疗后免疫通路激活减少。了解特定患者对抗TNF反应性的机制可能有助于开发患者反应的预测标志物早期治疗选择

文献来源:

Wang J, Conlon D, Rivellese F, et al. Synovial inflammatory pathways characterize anti-TNF-responsive rheumatoid arthritis patients [published online ahead of print, 2022 Jul 19]. Arthritis Rheumatol. 2022;10.1002/art.42295. doi:10.1002/art.42295

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    2023-02-21 ms2000000074172228 来自湖南省

    学习了

    0

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    2022-11-17 mfx808
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    2022-07-30 pcw106
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    2022-07-30 snowpeakxu

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