系统性硬化症中持续性炎症的表型:与系统性硬化症相关的间歇性肺病:EUSTAR数据库分析
Sabina Guler1,2, Adela-Cristina Sarbu3, Odile Stalder4
1Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland Sabina.Guler@insel.ch.
系统性硬化与持续性炎症显著增加SSc-ILD患者的死亡风险. 早期的免疫抑制治疗在系统性硬化症的炎症表型中稳定了肺功能.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
背景情况:
- 系统性硬化症 (SSc) 是一种复杂的自身免疫性疾病.
- 间歇性肺病 (SSc-ILD) 是SSc的常见和严重并发症.
- 炎症在SSc病原和进展中起着至关重要的作用.
研究的目的:
- 根据炎症水平评估表型化SSc和SSc-ILD患者的预后价值.
- 通过炎症状态和免疫抑制治疗分层的SSc和SSc-ILD中描述疾病轨迹.
主要方法:
- 利用了来自欧洲硬质皮肤病试验和研究 (EUSTAR) 队列的数据.
- 根据C-反应蛋白 (CRP) 水平,将患者分为持续炎症,中间和非炎症表型.
- 在死亡风险分析中采用考克斯回归和在FVC和DLCO轨迹分析中采用混合效应模型.
主要成果:
- 患有SSc-ILD和持久炎症表型的患者与非炎症表型相比,面临5年死亡风险6.7倍.
- 在炎症表型中,强迫生命能力 (FVC) 在没有治疗的情况下下降,但在免疫抑制疗法下稳定.
- 非炎症性表型的FVC下降,在接受免疫抑制治疗的患者中观察到更明显的下降.
结论:
- 通过持久性炎症进行表型化,可以提供SSc和SSc-ILD的显著预后见解,独立于其他临床因素.
- 建议早期免疫抑制治疗SSc-ILD患者表现出持续性炎症.
- 基于炎症的表型可以指导治疗决策并改善SSc-ILD的结果.
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