低形态DCLRE1C缺陷从童年到成年期的可变临床表现
Esra Hazar1,2, Mehmet Ali Karaselek1, Hasan Kapakli1
1Division of Pediatric Immunology and Allergy, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
概括
长期对DCLRE1C突变的严重综合免疫缺陷 (SCID) 患者的长期随访显示出可变的临床和免疫学发现. 一个T辅助1主导反应和增加的T卵泡辅助细胞可能会驱动慢性炎症和自免疫性后血造干细胞移植 (HSCT).
科学领域:
- 免疫学 免疫学 免疫学
- 遗传学 遗传学 是一个
- 血液学 血液学 血液学
背景情况:
- 专注于长期跟踪患有DCLRE1C低形态突变导致泄漏性严重联合免疫缺陷 (SCID) 的儿科和成人患者.
- 突出了不同年龄组的临床表现和实验室发现的变化.
研究的目的:
- 报告DCLRE1C突变和泄漏SCID的患者的长期结果.
- 描述血造干细胞移植 (HSCT) 之前和之后的临床和免疫特征.
主要方法:
- 包括18名患者 (13名儿童,5名成年人),年龄为6至29岁,DCLRE1C基因突变.
- 评估了临床和免疫学参数,包括免疫球蛋白水平,T/B细胞,NK细胞,Treg细胞和细胞因子.
- 将HSCT前后数据与健康对照进行比较.
主要成果:
- 常见发现:复发性感染 (78%),皮肤问题 (61%),自身免疫性疾病 (33%),恶性病 (17%).
- 患者表现出低IgA,B/T淋巴缺血,最近的胸腺移民减少,天真的T/B细胞和CD56dimCD16+细胞.
- 观察到T毛囊辅助细胞 (TFH) 和Th1 (IFN-γ) 细胞比率升高,这表明T1主导的免疫反应.
结论:
- 低形态DCLRE1C突变导致不同的临床和实验室表型.
- 一个 Th1 主导的免疫反应,由 IFN-γ 和 TFH细胞的增加证明,可能会导致慢性炎症和自身免疫.
- 在HSCT后进行进一步的长期随访对于了解疾病病理生理学至关重要.
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