临床特征和免疫机制与风湿性关节炎患者的肝功能变化直接相关
I Arias-de la Rosa1, M Ruiz-Ponce1, L Cuesta-López1
1Rheumatology service/Department of Medical and Surgical Sciences, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/ /University of Cordoba/ Reina Sofia University Hospital, Córdoba, Spain.
European journal of internal medicine
|August 6, 2023
概括
风湿性关节炎 (RA) 患者面临更高的肝病风险,与肥胖或糖尿病无关. 这种风险与炎症,自身抗体和胰岛素耐药性有关,在特定情况下可能会产生甲状腺素的影响.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 类风湿性关节炎 (RA) 与各种关节外表现有关.
- 关节炎对肝功能的影响,独立于代谢因素,需要进一步阐明.
研究的目的:
- 为了研究类风湿性关节炎对肝功能的影响.
- 探索关节炎引起的肝脏异常背后的体内和体外机制.
主要方法:
- 在330名受试者 (RA患者,NAFLD非RA患者,健康捐赠者) 的横截面研究.
- 对50名接受甲多特雷克萨特治疗的RA患者进行了纵向研究.
- 在体内 (原诱导性关节炎小鼠模型) 和体内 (肝细胞) 机械学研究.
主要成果:
- RA 患者表现出肝病风险增加,独立于肥胖/T2DM,与胰岛素抵抗,自身抗体,炎症和C3.3相关.
- 甲托雷克萨特治疗RA患者的心血管风险因素与肝脏异常相关.
- 反素蛋白抗体 (ACPAs) 损害了肝细胞功能,促进了胰岛素抵抗和炎症.
- 在小鼠中诱导关节炎导致免疫细胞透,炎症,肝脏亡和纤维化.
结论:
- 由于免疫细胞的透和ACPA活动,RA患者可能会因肝炎而发病,这与肥胖/糖尿病无关.
- 肝功能影响与全身炎症和疾病活动有关.
- 甲状腺素对肝脏的不良影响可能仅限于患有并发性心血管风险因素的患者.
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