抗RA33抗体与幼年特发性关节炎的诊断意义

目的：通过检测幼年特发性关节炎（JIA）患者血清中的抗RA33抗体,了解抗RA33抗体与幼年特发性关节炎的临床诊断价值。方法：采用酶联免疫固相分析检测81例JIA患儿（女19名,男62名,平均年龄8.6岁,平均病程1.4年）血清中抗RA33抗体、RF,同时以55例儿童系统性红斑狼疮（SLE）等其他关节性疾病或病毒感染患者和49例健康儿童作为对照组。阴阳性结果判断均采用试剂盒推荐的临界值。结果：81例JIA患儿中抗RA33抗体阳性率为11.11%（9/81）,RF阳性率为12.35%（10/81）,特异性均为91.35%;JIA组与正常对照组抗RA33抗体阳性率比较有统计学意义（P〈0.05）,与其他关节性疾病对照组比较差异无显著性（P〉0.05）。JIA组中抗RA33抗体的检出与RF无相关性（P〉0.05）;在JIA各亚型中抗RA33抗体主要存在于全身型和多关节型,各占33.3%和25.0%,RF则只出现于多关节型,占62.5%。两者比较有显著性差异（P〈0.05）。81例JIA患儿中共有18例关节出现影像学改变,其中4例抗RA33抗体阳性（22.2%）,与未发生影像学改变的JIA患儿比较无显著性差异（P〉0.05）。结论：抗RA33抗体尚不能作为JIA早期诊断的新的可靠性指标,抗RA33抗体主要见于全身型和多关节型,对JIA的分型有指导意义。     

抗RA33 抗体与幼年特发性关节炎的诊断意义

目的:通过检测幼年特发性关节炎(JIA)患者血清中的抗RA33抗体,了解抗RA33抗体与幼年特发性关节炎的临床诊断价值。方法:采用酶联免疫固相分析检测81例JIA患儿(女19名,男62名,平均年龄8.6岁,平均病程1.4年)血清中抗RA33抗体、RF,同时以55例儿童系统性红斑狼疮(SLE)等其他关节性疾病或病毒感染患者和49例健康儿童作为对照组。阴阳性结果判断均采用试剂盒推荐的临界值。结果:81例JIA患儿中抗RA33抗体阳性率为11.11%(9/81),RF阳性率为12.35%(10/81),特异性均为91.35%;JIA组与正常对照组抗RA33抗体阳性率比较有统计学意义(P<0.05),与其他关节性疾病对照组比较差异无显著性(P>0.05)。JIA组中抗RA33抗体的检出与RF无相关性(P>0.05);在JIA各亚型中抗RA33抗体主要存在于全身型和多关节型,各占33.3%和25.0%,RF则只出现于多关节型,占62.5%。两者比较有显著性差异(P<0.05)。81例JIA患儿中共有18例关节出现影像学改变,其中4例抗RA33抗体阳性(22.2%),与未发生影像学改变的JIA患儿比较无显著性差异(P>0.05)。结论:抗RA33抗体尚不能作为JIA早期诊断的新的可靠性指标,抗RA33抗体主要见于全身型和多关节型,对JIA的分型有指导意义。     

巨噬细胞极化在类风湿关节炎中的作用

类风湿关节炎(rheumatiod arthritis,RA)是侵犯骨和关节为主的多系统炎症的自身免疫性疾病。巨噬细胞具有吞噬?趋化?免疫调节等功能,参与特异性和非特异性免疫应答,其在RA的发生发展中起到至关重要的作用。巨噬细胞不同亚型极化及其作用是近年来RA的致病机制的研究热点。巨噬细胞主要分为经典活化M1型和选择活化M2型。RA患者机体内免疫炎症反应直接影响外周血、滑膜和滑液巨噬细胞的极化,使M1型促炎性巨噬细胞不断增加,从而打破M1/M2平衡状态。现总结巨噬细胞的极化及其在RA发生发展中的作用?     

自身炎症性疾病的过去、现在与未来

自身炎症这一概念源于人们对一类单基因疾病的认识,这类疾病似乎在无明显诱因的情况下就会产生炎症,却没有经典自身免疫性疾病中所出现的高滴度的自身抗体或抗原特异性T细胞.在自身炎症领域蓬勃发展的数十年里,自身炎症性疾病与固有免疫系统之间的关系愈发清晰,而多种靶向疗法更为两者之间的关系提供了强有力的支撑.虽然与白细胞介素1β(interleukin-1β, IL-1β)大量产生相关的"炎症小体病"是最早被认识的自身炎症性疾病,但很快人们就发现,自身炎症性疾病可由多种基因变异引起,影响一系列固有免疫信号途径,包括核因子-κB(nuclear factor-κB, NF-κB)通路和Ⅰ型干扰素通路等.这些新发现的疾病、致病基因和信号通路,都离不开下一代测序技术(next-generation sequencing, NGS)、全基因组关联分析(genome-wide association studies, GWAS)等技术的日新月异.在使用多种研究手段和依托丰富的临床病例资源的背景下,中国学者,尤其是协和学者,在儿童自身炎症性疾病领域亦作出了较为突出的贡献.在未来,自身炎症性疾病的疾病谱会进一步扩大,其与自身免疫性疾病等其他疾病的界限也将不断交叉、渗透甚至融合,人们对固有免疫系统的认识也将更加深刻.     

T淋巴细胞与胶原诱导性关节炎

胶原诱导性关节炎是应用较广泛的人类风湿性关节炎动物模型 ,二者在发病机制及病理学改变上极为相似。近年来研究证实激活的某些T细胞在胶原诱导性关节炎的发病过程中起着重要作用 ,尤其在疾病的起始阶段 ,提示胶原诱导性关节炎可能是以T淋巴细胞介导为主的自身免疫性疾病     

白介素-33在疾病中的作用

白介素-33(IL-33)是近年来新发现的IL-1家族的新成员,通过结合其受体ST2诱导Th2型细胞因子的产生。IL-33既可以调节Th2型免疫反应、刺激肥大细胞产生前炎性因子,又可以作为核因子调控基因转录。IL-33在血管性疾病、变态反应性疾病、自身免疫性疾病和炎症性疾病中均发挥重要作用。对IL-33功能及机制的研究将有助于进一步了解这些疾病的致病机制,为疾病治疗提供新的策略。     

利用eQTL构建基因-基因网络挖掘类风湿性关节炎风险基因

目的：类风湿性关节炎是一种全身的慢性炎症型疾病,可能影响许多组织和器官,主要发作于灵活的关节。全世界人群中大约有1％会患有类风湿性关节炎。目前已经证实了一些基因与类风湿性关节炎相关,但是这些基因只能解释一小部分遗传风险,因此我们需要新的策略和方法来解决这个问题。方法：表达数量性状位点（eQTL）是指能够调控基因或蛋白质表达的基因组位点,本文采用了eQTL数据构建基因一基因网络并挖掘候选类风湿性关节炎风险基因。结果：首先,利用eQTL数据,基于基因之间的共调控系数,建立基因-基因网络,我们建立了5个不同阈值（0、O．2、0．4、0．6和0．8）的基因-基因网络;然后,在OMIM和GAD数据库中搜索已经证实的与类风湿性关节炎相关的186个基因;最后我们将已证实与类风湿性关节炎相关的186个基因分别投入到这5个网络中,利用基因与基因之间的相关性来挖掘到一些可能与类风湿性关节炎相关的候选风险基因。结论：本文基于eQTL构建了基因．基因网络,结合已知类风湿性关节炎风险基因,挖掘未知风险基因,得到了较好的结果,证明了本方法的有效性,且对于类风湿性关节炎的发病机制研究具有重要价值。除了类风湿性关节炎外,本方法还可推广到其它复杂疾病中,因此本方法对人类复杂疾病的研究具有很强的学术理论价值和应用价值。     

利用eQTL构建基因-基因网络挖掘类风湿性关节炎风险基因*

摘要目的：类风湿性关节炎是一种全身的慢性炎症型疾病，可能影响许多组织和器官，主要发作于灵活的关节。全世界人群中大 约有1%会患有类风湿性关节炎。目前已经证实了一些基因与类风湿性关节炎相关，但是这些基因只能解释一小部分遗传风险， 因此我们需要新的策略和方法来解决这个问题。方法：表达数量性状位点（eQTL）是指能够调控基因或蛋白质表达的基因组位点， 本文采用了eQTL数据构建基因- 基因网络并挖掘候选类风湿性关节炎风险基因。结果：首先，利用eQTL 数据,基于基因之间的 共调控系数，建立基因- 基因网络，我们建立了5 个不同阈值(0、0.2、0.4、0.6和0.8)的基因-基因网络；然后，在OMIM 和GAD数 据库中搜索已经证实的与类风湿性关节炎相关的186 个基因；最后我们将已证实与类风湿性关节炎相关的186 个基因分别投入 到这5 个网络中，利用基因与基因之间的相关性来挖掘到一些可能与类风湿性关节炎相关的候选风险基因。结论：本文基于 eQTL构建了基因-基因网络，结合已知类风湿性关节炎风险基因，挖掘未知风险基因，得到了较好的结果，证明了本方法的有效 性，且对于类风湿性关节炎的发病机制研究具有重要价值。除了类风湿性关节炎外，本方法还可推广到其它复杂疾病中，因此本 方法对人类复杂疾病的研究具有很强的学术理论价值和应用价值。     

类风湿关节炎免疫发病机制研究进展

类风湿关节炎(Rheumatoid Arthritis,RA)是以关节滑膜慢性炎症为主的自身免疫性疾病,其病因及发病机制尚未完全明确。本文从T细胞、树突状细胞、肥大细胞等免疫细胞及IL-1家族、结合含γc受体的细胞因子、IL-12家族、IL-17等细胞因子与类风湿关节炎发生发展的关系阐述类风湿关节炎免疫发病机制有关研究进展。     

靶定IL-17 治疗类风湿关节炎研究进展

IL-17作为前炎症因子参与类风湿关节炎,系统性红斑狼疮等自身免疫性疾病的病理过程。它主要由CD4+T细胞的一个亚群--Th17细胞分泌释放。目前,IL-17在类风湿关节炎的病理过程中的作用引起了医学界广泛的关注,抗IL-17A抗体已经生产并进入临床实验,用于治疗类风湿关节炎、银屑病关节炎等疾病。但其在类风湿关节炎病理过程中的作用尚需进一步研究,其有效性亦尚需进一步探讨。本文主要针对IL-17家族的各个亚型的表达、调控、生物学作用及与类风湿关节炎发病的关系进行阐述,为类风湿关节炎的治疗提供新的思路。     

Canakinumab

Canakinumab (ACZ885, Ilaris) is a human anti-IL-1β monoclonal antibody developed by Novartis. Its mode of action is based on the neutralization of IL-1β signaling, resulting in suppression of inflammation in patients with disorders of autoimmune origin. In June 2009 the drug was approved by the US Food and Drug Administration for the treatment of familial cold auto-inflammatory syndrome and Muckle-Wells syndrome, which are inflammatory diseases related to cryopyrin-associated periodic syndromes. The drug is currently being evaluated for its potential in the treatment of rheumatoid arthritis, systemic-onset juvenile idiopathic arthritis, chronic obstructive pulmonary disease, type 1 and 2 diabetes and ocular diseases. Reports from clinical trials suggest that canakinumab is well-tolerated in most patients, and no serious adverse effects have been reported. The drug provides significant advantages over existing competitive therapies, including bimonthly administration and approved use in children.     

Collagen-induced arthritis and related animal models: how much of their pathogenesis is auto-immune, how much is auto-inflammatory?

In this review, we discuss our studies on the pathogenesis of collagen-induced arthritis (CIA) and related mouse models for rheumatoid arthritis. Of note, these models invariably rely on the use of complete Freund's adjuvant (CFA). Our analysis has focused on explaining the dichotomous - either protective or disease-promoting - role of endogenous IFN-γ. Induction of a myelopoietic burst by CFA was identified as an important and underestimated factor in mediating the role of IFN-γ and other cytokines (IL-6, IL-17, GCP-2, RANK-L). Myelopoiesis provides an excess in precursors for joint-infiltrating neutrophils and osteoclasts. We postulate that classical CIA is primarily an auto-inflammatory disease, in part because of a strong innate immune response to the adjuvant. Superimposed on this, collagen-specific auto-immunity reinforces inflammatory reactivity in joints.     

Canakinumab

Canakinumab (ACZ885, Ilaris) is a human anti-IL-1β monoclonal antibody developed by Novartis. its mode of action is based on the neutralization of 1β signaling, resulting in suppression of inflammation in patients with disorders of autoimmune origin. In June 2009 the drug was approved by the US Food and Drug Administration for the treatment of familial cold auto-inflammatory syndrome and Muckle-wells syndrome, which are inflammatory diseases related to cryopyrin-associated periodic syndromes. The drug is currently being evaluated for its potential in the treatment of rheumatoid arthritis, systemic-onset juvenile idiopathic arthritis, chronic obstructive pulmonary disease, type 1 and 2 diabetes and ocular diseases. Reports from clinical trials suggest that canakinumab is well-tolerated in most patients, and no serious adverse effects have been reported. The drug provides significant advantages over existing competitive therapies, including bimonthly administration and approved use in children.Key words: canakinumab, Ilaris, trials, CAPS, rheumatoid arthritis, IL-1β     

Cell signalling in macrophages, the principal innate immune effector cells of rheumatoid arthritis

Rheumatoid arthritis is a multisystemic auto-inflammatory disease affecting up to 1% of the population and leading to the destruction of the joints. Evidence exists for the involvement of the innate as well as the adaptive immune systems in the pathology of the disease. The success of anti-tumour necrosis factor-alpha indicates the importance of pro-inflammatory mediators produced by innate immune cells in rheumatoid arthritis progression. Therefore, considerable efforts have been made in elucidating the signalling pathways leading to the expression of those mediators. This review will concentrate on the role of signalling pathways in innate immune cells in the context of rheumatoid arthritis.     

多组学分析在炎症性肠病中的应用与研究进展

炎症性肠病(IBD)是一种累及回肠、直肠和结肠的特发性慢性肠道炎症性疾病,主要包括溃疡性结肠炎和克罗恩病,在临床表现、病程和治疗反应等方面具有高度异质性。目前,关于IBD的发病机制尚未明确,治疗方法相对有限。由遗传、环境、肠道微生态以及宿主免疫失衡在内的多因素共同导致了过度活跃的炎症反应并最终引发患者的肠道粘膜屏障受损和管腔菌群紊乱。单一组学的分析无法全面揭示IBD发病过程中复杂的相互协同作用机制,更无法挖掘潜在的治疗靶点和开发有效的干预策略。因此需要运用多组学关联分析技术以帮助研究者从多个维度解析IBD的发病机制。回顾和分析了多组学技术在IBD相关研究领域中的应用,并且讨论了使用这些方法在IBD分型、早期诊断和个性化医疗等领域的潜力,以期为进一步研究IBD发病机制奠定良好基础。     

Borrelia burgdorferi possesses a collagenolytic activity

Abstract Lyme disease is a multisystemic disorder caused by Borrelia burgdorferi , an invasive spirochete. B. burgdorferi has a predilection for collagenous tissue and one major clinical manifestation of the disease is arthritis. We have identified a collagenolytic activity in B. burgdorferi detergent lysates using iodinated gelatin as well as iodinated pepsinized human collagen types II and IV as protein substrates. In addition, we describe several proteolytic activities in B. burgdorferi with molecular masses greater than 200 kDa on sodium dodecyl sulfate polyacrylamide gels containing copolymerized gelatin. We propose that the collagenolytic activity of B. burgdorferi has a role in invasion, in the pathogenesis of Lyme arthritis, and perhaps also in other manifestations of Lyme borreliosis.     

基于疾病本体的疾病相似性计算方法

疾病相似性研究对于复杂疾病发病机制的理解、诊断、预测和药物研发具有重要意义.最近,研究人员通过集成多种疾病术语库,构建了描述疾病关系的疾病本体(disease ontology,DO),这为从DO角度研究疾病相似性打下了基础.本文综述了基于DO及其注释信息的疾病相似性计算方法,探讨了疾病相似性计算存在的问题和挑战,为疾病相似性进一步的研究提供有益参考.     

Brief Notes on the Natural History of Rheumatoid Arthritis

The natural history of rheumatoid arthritis is the first stage in its scientific study. Existing knowledge of its long-term course is small, and a brief review is made of 250 consecutive unselected patients followed between 1939 and 1963 at the Postgraduate Medical School in London, England. During the course of this study, the clinical signs of digital arteritis were noticed. This appeared to be a systemic manifestation associated with the presence in the plasma of rheumatoid factor. It was a more generalized phenomenon than disease in the joints which is primarily a localized process. We need to know why one joint can remain unaffected and another joint shows active disease over a prolonged period of time.     

The relationship between FV Leiden and pulmonary embolism

A recent review article suggested that idiopathic pulmonary fibrosis (IPF) is a disease that is associated more with abnormal wound healing than with inflammation. Data derived from transgenic and gene transfer rodent models suggest that lung inflammation may be a necessary but insufficient component of IPF, and that at some point in the natural history of the disease IPF becomes no longer dependent on the inflammatory response for propagation. Altered microenvironment and involvement of epithelial cell/mesenchymal cell interaction are the most likely contributors to the pathogenesis of this chronic progressive disorder.