Immunology, Allergy and Rheumatology Section, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
J Allergy Clin Immunol. 2013 Mar;131(3):675-82. doi: 10.1016/j.jaci.2013.01.012. Epub 2013 Jan 29.
Basic and clinical immunology articles published in the Journal in 2012 were mostly related to the expanding area of primary immunodeficiencies (PIDs). Novel forms of PID were identified by using whole-exome sequencing or after careful examination of flow cytometric data, as in the reports of lymphocyte-specific protein tyrosine kinase, CD27, and CD21 deficiencies. Absent IgG and IgA memory B cells were described in patients with hyper-IgE syndrome, which is consistent with defective antibody response and suggests a potential benefit of immunoglobulin replacement. Impaired production of antibodies to polysaccharide antigens by the human B-cell subset analog to murine B-1 cells was reported in a child with selective polysaccharide antibody deficiency. Increased production of inflammatory cytokines by monocyte-derived cells on Toll-like receptor activation was reported in patients with X-linked agammaglobulinemia, underscoring the important role of Bruton tyrosine kinase in modulation of inflammation. The mechanisms explaining susceptibility to yeast infections and development of chronic mucocutaneous candidiasis were extensively studied. Universal newborn screening for T-cell deficiencies is being implemented in several states, resulting in the diagnosis of a higher number of immunodeficient newborns than previously estimated. The use of laboratory testing to distinguish PIDs from HIV infection was clarified. In the management of PIDs, refinement of indication and strategies to hematopoietic stem cell transplantation resulted in improved outcomes. The use of anti-IL-6 mAbs showed promise as an alternative treatment in patients with Schnitzler syndrome.
2012 年在该杂志上发表的基础和临床免疫学文章主要涉及原发性免疫缺陷病(PID)不断扩大的领域。通过全外显子测序或仔细检查流式细胞术数据,如在淋巴细胞特异性蛋白酪氨酸激酶、CD27 和 CD21 缺陷的报告中,确定了新形式的 PID。高免疫球蛋白 E 综合征患者存在 IgG 和 IgA 记忆 B 细胞缺失,这与抗体反应缺陷一致,表明免疫球蛋白替代治疗可能有效。在选择性多糖抗体缺陷患者中,人类 B 细胞亚群类似鼠 B-1 细胞对多糖抗原产生抗体的能力受损。X 连锁无丙种球蛋白血症患者单核细胞来源细胞在 Toll 样受体激活时产生炎症细胞因子增加,强调 Bruton 酪氨酸激酶在调节炎症中的重要作用。对酵母感染易感性和慢性黏膜皮肤念珠菌病发展机制进行了广泛研究。目前正在几个州实施针对 T 细胞缺陷的新生儿普遍筛查,导致诊断出的免疫缺陷新生儿数量高于之前的估计。实验室检测用于区分 PID 和 HIV 感染的机制得到了澄清。在 PID 的治疗中,造血干细胞移植的适应证和策略的改进导致了更好的结果。抗 IL-6 mAb 的应用显示出作为 Schnitzler 综合征患者替代治疗的潜力。