Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Curr Opin Allergy Clin Immunol. 2010 Dec;10(6):534-41. doi: 10.1097/ACI.0b013e3283402b41.
Anticytokine autoantibodies are an important and emerging mechanism of disease pathogenesis. We will review the clinical and laboratory features of syndromes in which immunodeficiency is caused by or associated with neutralizing anticytokine autoantibodies.
A growing number of patients have been described who demonstrate unique infectious phenotypes associated with neutralizing autoantibodies that target a particular cytokine known to participate in host defense against the offending organism. Examples include antigranulocyte macrophage-colony stimulating factor (GM-CSF) autoantibodies and pulmonary alveolar proteinosis; anti-interferon (IFN)-γ autoantibodies and disseminated nontuberculous mycobacteria (NTM); anti-interleukin-(IL)-6 autoantibodies and severe staphylococcal skin infection; anti-IL-17A, anti-IL-17F, or anti-IL-22 autoantibodies in patients with mucocutaneous candidiasis in the setting of both the autoimmune polyendocrinopathy, candidiasis, ectodermal dystrophy (APECED) syndrome and in cases of thymoma.
Anticytokine autoantibodies have manifestations that are diverse, ranging from asymptomatic to life-threatening. These emerging and fascinating causes of acquired immunodeficiency may explain some previously idiopathic syndromes.
抗细胞因子自身抗体是疾病发病机制中的一个重要且新兴的机制。我们将回顾由中和性抗细胞因子自身抗体引起或与之相关的导致免疫缺陷的综合征的临床和实验室特征。
越来越多的患者被描述为具有独特的感染表型，这些表型与针对特定细胞因子的中和自身抗体有关，这些细胞因子已知参与宿主对病原体的防御。例如，抗粒细胞-巨噬细胞集落刺激因子（GM-CSF）自身抗体与肺泡蛋白沉积症；抗干扰素（IFN）-γ自身抗体与播散性非结核分枝杆菌（NTM）；抗白细胞介素（IL）-6 自身抗体与严重葡萄球菌皮肤感染；自身免疫性多内分泌腺病、念珠菌病、外胚层发育不良（APECED）综合征中的黏膜皮肤念珠菌病患者和胸腺瘤患者中的抗 IL-17A、抗 IL-17F 或抗 IL-22 自身抗体。
抗细胞因子自身抗体的表现多种多样，从无症状到危及生命。这些新出现的、引人入胜的获得性免疫缺陷的原因可能解释了一些以前的特发性综合征。
