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鉴定影响抗药抗体在炎症性肠病中的发展的遗传因素:一个范围审查
Frederikke Bindseil Culmsee-Holm1, Emil Buhl2, Mads Tjørnehøj Kraaer2
1Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.
遗传变异会影响在接受生物疗法治疗炎症性肠病的患者中产生抗药抗体. HLA-DQA1*05和FCGR3A变异是免疫性的主要预测因素,影响治疗的有效性.
科学领域:
- 免疫学 免疫学 免疫学
- 药物基因组学 药物基因组学
- 胃肠病学 胃肠病学
背景情况:
- 生物疗法,如infliximab和adalimumab对于炎症性肠病 (IBD) 管理至关重要.
- 一个重大挑战是抗药抗体 (ADA) 的发展,导致反应丧失.
- 遗传因素与ADA形成有关,影响治疗结果.
研究的目的:
- 系统地审查生物疗法治疗的患者抗药抗体发展的遗传预测因子的文献.
- 为了确定与免疫性和治疗失败相关的特定遗传变异.
主要方法:
- 在Medline,Embase和Cochrane图书馆进行了全面的文献搜索.
- 1944年的记录被选,有27项研究符合分析的纳入标准.
- 提取了基因变异,抗体形成,药物水平和临床结果的数据.
主要成果:
- HLA-DQA1*05携带一直与增加的ADA形成,较低的药物水平和治疗失败有关.
- 其他人类白细胞抗原 (HLA) 等位基因和FCGR3A变体也显示出与更高的免疫性风险的联系.
- 一些遗传单元类型似乎具有保护性,并且根据药物,遗传背景和患者群体而异.
结论:
- HLA-DQA1*05和FCGR3A变种是生物疗法的免疫性可靠预测指标,特别是因弗利西马布.
- 需要进一步的研究,包括大型的多民族前性研究和标准化测量,以确定临床效用.
- 综合的药物基因组方法对于优化IBD的生物疗法至关重要.
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