Duration biased distribution of clinical and immunological phenotypes in active SLE.
Duration biased distribution of clinical and immunological phenotypes in active SLE.
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DOI：
10.3389/fimmu.2022.1044184
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
--
作者：
本研究旨在了解不同病程的活动期狼疮患者的临床及免疫学特征。为了进行临床表型分析，我们从仁基狼疮登记中心（一个标准治疗的住院SLE患者的单中心数据库）中丰富了符合条件的SLE活动性医疗记录（SLEDAI-2k≥8），涵盖了全国范围内的患者。在此浓缩中，反复住院记录的患者进行了纵向分析，以验证上述横断面研究。我们丰富了1313例活动性SLE （SLEDAI-2k≥8）的符合条件的记录进行横断面分析。按病程间隔5年分为4组，这些活动性SLE患者的临床表型随病程（升性肾炎、肺动脉高压降热、皮肤症状、关节炎和神经精神表现）发生显著变化，尤其是发病年龄≤45岁的分层。一项对55名因活动性狼疮反复住院的患者的纵向分析显示了类似的趋势。在222份血清学和淋巴细胞亚群信息完整的病历横断面研究中，外周血B细胞比例、抗dsdna抗体和血清IgG/IgM与病程呈负相关，而CD8+ T细胞比例与病程呈正相关（P值，0.029-4.8×10-17），根据发病年龄和近期治疗情况对患者亚组进行敏感性分析支持了这一结论。多元线性回归发现，持续时间是唯一与B细胞和CD8+ T细胞比例相关的显著因素（P值分别为8.9×10-8和7.6×10-5）。这些持续时间偏倚的免疫表型与14例反复住院患者的纵向观察高度一致。活动性SLE的临床和免疫学特征均存在明显的时间偏倚分布，值得进一步研究SLE发病机制的演变。
This study is aimed to map the clinical and immunological features of active lupus patients with different disease duration. For clinical phenotype analysis, we enriched eligible medical records with active SLE (SLEDAI-2k≥8) from the Renji Lupus registry, a single-center database of hospitalized SLE patients with standard care, which covered national-wide patients. Patients with repeated hospitalization records in this enrichment were analyzed longitudinally as validation for the cross-sectional study above. We enriched a total of 1313 eligible records on active SLE (SLEDAI-2k≥8) for cross-sectional analysis. Stratified into four groups by a 5-year interval of disease duration, these active SLE patients showed a significantly shifting clinical phenotype along with the duration (ascending nephritis, pulmonary hypertension and descending fever, cutaneous symptoms, arthritis, and neuropsychiatric manifestations), especially in stratifications with disease onset age ≤ 45 years old. A longitudinal analysis of 55 patients with repeated hospitalizations for active lupus showed a similar trend. In the cross-sectional study of 222 records with full information on serology and lymphocyte subsets, peripheral B cell proportion, anti-dsDNA antibody, and serum IgG/IgM negatively correlated with duration, while CD8+ T cell proportion was positively correlated (P values, 0.029-4.8×10-17), which were supported by the sensitivity analysis in patient subgroups according to disease onset age and recent treatment. Multivariate linear regression identified duration as the only significant associator with both B cell and CD8+ T cell proportion (P values, 8.9×10-8 and 7.6×10-5, respectively). These duration biased immune phenotypes were highly consistent with the longitudinal observation in 14 patients with repeated hospitalizations. Both clinical and immunological features of active SLE are significantly duration biased distributed, which merits further investigations in the evolution of SLE pathogenesis.
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影响因子：
5.5
作者：
Ines, Luis;Duarte, Catia;da Silva, Jose Antonio P.
通讯作者：
da Silva, Jose Antonio P.
影响因子：
13.3
作者：
Aringer, Martin;Costenbader, Karen;Johnson, Sindhu R.
通讯作者：
Johnson, Sindhu R.
影响因子：
2.6
作者：
Furie, Richard;Morand, Eric F.;Tummala, Raj
通讯作者：
Tummala, Raj
DOI：
10.1093/rheumatology/keaa382
发表时间：
2020-12-05
期刊：
Rheumatology (Oxford, England)
影响因子：
--
作者：
Arnaud L;Tektonidou MG
通讯作者：
Tektonidou MG
影响因子：
4.9
作者：
Ichinose, Kunihiro;Kitamura, Mineaki;Kawakami, Atsushi
通讯作者：
Kawakami, Atsushi