Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; Doctoral Program in Biomedical Sciences, Universidad del Rosario, Bogota, Colombia.
J Autoimmun. 2019 Mar;98:24-32. doi: 10.1016/j.jaut.2018.11.002. Epub 2018 Nov 17.
Autoimmune diseases (ADs) are a chronic and clinically heterogeneous group of diseases characterized by share common immunopathogenic mechanisms and risk factors (i.e., the autoimmune tautology), which explain the fact that one AD may coexist with others (i.e., polyautoimmunity - PolyA). In the present exploratory study, a mixed-cluster analysis of the most common autoimmune rheumatic diseases (ARDs) was done. A total of 187 consecutive women with established systemic lupus erythematosus (n = 70), rheumatoid arthritis (n = 51), systemic sclerosis (n = 35) and Sjögren's syndrome (n = 31) were included. A comprehensive clinical, autoantibody and cytokine assessment was simultaneously done. Total PolyA was registered in 142 (75.9%) patients. Six clusters were obtained, built mainly on autoantibodies: PolyA-I to -VI. The PolyA-III cluster showed the highest frequency of overt PolyA (p = 0.01), and the PolyA-I, -III, and -IV clusters exhibited the highest positivity for IL-12/23p40 (p = 0.015). These results provide new insights into the pathophysiology of PolyA and warrant prospective validation to enable development of a more accurate taxonomy of ARDs.
自身免疫性疾病 (ADs) 是一组慢性且临床表现多样的疾病，其特征是具有共同的免疫发病机制和风险因素（即自身免疫同义反复），这解释了一种 AD 可能与其他疾病共存的事实（即多自身免疫 - PolyA）。在本探索性研究中，对最常见的自身免疫性风湿病 (ARDs) 进行了混合聚类分析。共纳入 187 例确诊的系统性红斑狼疮 (n=70)、类风湿关节炎 (n=51)、系统性硬化症 (n=35) 和干燥综合征 (n=31) 女性患者。同时进行了全面的临床、自身抗体和细胞因子评估。142 例（75.9%）患者记录了总 PolyA。得到了六个聚类，主要基于自身抗体构建：PolyA-I 到 -VI。PolyA-III 聚类显示出最高的显性 PolyA 频率（p=0.01），PolyA-I、-III 和 -IV 聚类显示出最高的 IL-12/23p40 阳性率（p=0.015）。这些结果为 PolyA 的病理生理学提供了新的见解，并需要前瞻性验证，以实现对 ARD 更准确的分类法的发展。
