性结肠炎的精确分子亚型揭示了免疫异质性,并预测了临床药物反应
Shaocong Mo1,2, Bryan Jin1, Yujen Tseng1
1Department of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Journal of translational medicine
|July 13, 2023
概括
研究人员确定了三种独特的性结肠炎 (UC) 分子亚型,具有独特的免疫模式. 一个新的亚型系统可以预测患者对生物疗法的反应,从而实现个性化的UC治疗策略.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 分子生物学分子生物学
背景情况:
- 性结肠炎 (UC) 是一种具有异质临床表现的慢性炎症性肠病.
- 目前对UC的治疗策略缺乏精度,导致患者的治疗结果不足.
- 识别分子亚型对于开发向疗法至关重要.
研究的目的:
- 使用大规模患者队列发现性结肠炎 (UC) 的新型分子亚型.
- 建立一个临床上适用的分类系统,用于UC的精密治疗.
- 为了将分子亚型与免疫透模式和对生物剂的反应相关联.
主要方法:
- 分析了357名UC患者的8个微阵列资料.
- 基于表达异质性的稳定分子亚型的识别.
- 免疫透和生物制剂对亚型的反应的比较.
- 关键基因 (PRLR,TNFSF13B) 和通路 (CXCL1-NF-κB) 的功能验证.
主要成果:
- 确定了三种稳定的UC分子亚型:先天性免疫激活UC (IIA),全免疫激活UC (WIA) 和像UC这样的免疫恒常 (IHL).
- WIA患者对生物药物 (infliximab/vedolizumab) 的反应最低 (<10%),而IHL患者的反应最高 (42-60%).
- 一个基于PRLR/TNFSF13B基因比例的分类器准确地预测了IHL亚型 (AUC:0.961-0.986).
- 在上皮细胞中的PRLR被证明可以通过CXCL1-NF-κB通路在巨细胞中抑制TNFSF13B的表达.
结论:
- 首次识别了三个稳定的UC亚型,具有不同的免疫特征和对生物疗法的差异反应.
- 建立精确的分子亚型系统和分类器,用于预测UC的药物反应.
- 基于分子亚型的UC患者个性化治疗策略的潜力.
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