老年,B细胞功能和数量是预测免疫抑制自身免疫性风湿性疾病患者感染风险的关键因素:一项队列研究
Jaladhar Prakruthi1, Devaraj Kori1, Shruti Paramshetti1
1ChanRe Rheumatology & Immunology Center & Research, Bengaluru, Karnataka, India.
International journal of rheumatic diseases
|March 24, 2025
概括
在自身免疫性风湿性疾病患者中,年龄较大,低免疫球蛋白G (IgG) 和低B细胞计数预测感染易感性. 高中性粒细胞数量和高中性粒细胞与淋巴细胞比率 (NLR) 是感染风险的关键预测因素.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 传染病流行病学 传染病流行病学
背景情况:
- 自身免疫性类风湿性疾病 (ARDs) 会增加感染风险,特别是在免疫抑制疗法下.
- 识别感染高风险的患者对于优化治疗和预防并发症至关重要.
研究的目的:
- 评估基线免疫参数,预测ARD患者感染风险.
- 根据感染率,识别需要强化免疫抑制治疗的个体.
主要方法:
- 在印度接受免疫抑制治疗的102名成年ARD患者的前性队列研究.
- 基线免疫评估包括完整的血液图,炎症标记物,免疫球蛋白,免疫细胞计数,补体水平和病毒标记物.
- 对感染发作进行一年的随访,使用普通最小平方 (OLS) 回归分析来确定感染风险的预测因素.
主要成果:
- 年龄较小,免疫球蛋白E (IgE),甲状腺素 (MTX) 含量较低,生物使用具有保护性.
- 感染的危险因素包括年龄较大,免疫球蛋白G (IgG) 低,中性粒细胞数量升高,中性粒细胞与淋巴细胞比率 (NLR) 高,血小板数量低以及类固醇使用.
- OLS回归确定了年龄,IgG,CD19淋巴细胞计数,白细胞计数和红细胞沉积率 (ESR) 作为重要的预测因素.
结论:
- 高龄,低IgG和低CD19 B细胞计数预测ARD患者的感染易感性.
- 高中性粒细胞数量,低血小板数量和高的NLR是感染发展的关键预测因素.
- 定制的监测和治疗策略对于减轻这一群体的感染风险至关重要.
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