对抗TNFα治疗的不充分反应与患有牛皮关节炎的患者的TNFR2-R多态变异功能获取相关
James K Sullivan1, Vandana Rai2, Jennifer Harvey2
1Cleveland Clinic Lerner College of Medicine of Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Annals of the rheumatic diseases
|November 8, 2025
概括
瘤坏死因子受体2 (TNFR2) 的特定遗传变异与牛皮关节炎患者对瘤坏死因子α抑制 (TNFi) 治疗的反应不佳有关. 这种TNFR2-R变体显示出独立于TNFα的增强的促炎活性,表明治疗失败的机制.
科学领域:
- 免疫遗传学 免疫遗传学
- 类风湿病学 类风湿病学
- 分子生物学分子生物学
背景情况:
- 牛皮关节炎 (PsA) 治疗经常使用瘤亡因子α抑制 (TNFi) 疗法.
- 超过40%的PsA患者对TNFi表现出不充分的反应,目前没有预测生物标志物.
- 瘤亡因子受体2 (TNFR2) 是炎症途径的关键调解者.
研究的目的:
- 调查TNFR2 rs1061622多态变体 (TNFR2-M和TNFR2-R) 与牛皮关节炎患者TNFi治疗反应之间的关联.
- 探索TNFR2-M和TNFR2-R变体之间的细胞信号和基因表达的机制差异.
主要方法:
- 在164名PsA患者中使用限制片段长度多态分析对TNFR2rs1061622多态的基因定型.
- 评估TNFi在12个月内因疗效不足而停止使用作为主要结局.
- 使用表达TNFR2变异的内皮细胞和Jurkat T细胞进行体外研究,以分析细胞信号和基因表达.
主要成果:
- 与TNFR2-M载体相比,患有TNFR2-R变异的患者在12个月内TNFi中止的可能性增加了约5倍.
- 表达TNFR2-R的细胞表现出独立于TNFα刺激的增高的促炎基因表达.
- TNFR2-R的促炎活性对TNFα中和不敏感,但被特定的Rho激酶 (ROCK) 抑制剂抑制.
结论:
- TNFR2 rs1061622多态性显著影响了牛皮关节炎中TNFi治疗反应.
- 这种TNFR2-R变体具有TNFα独立的,ROCK活动依赖的功能增益.
- 这种功能增益机制可能解释了PsA患者的一个子集的TNFi反应不足.
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