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临床特征及预测因素分析:干扰素-γ 自身抗体阳性在非结核分枝杆菌或马尔尼菲青霉菌感染患者中的表现:一项多中心前瞻性队列研究。

Clinical findings and predictive factors for positive anti-interferon-γ autoantibodies in patients suffering from a non-tuberculosis mycobacteria or Talaromyces marneffei infection: a multicenter prospective cohort study.

机构信息

Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China.

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.

出版信息

Sci Rep. 2022 May 31;12(1):9069. doi: 10.1038/s41598-022-13160-x.

Abstract

We investigated the clinical features and screened for predictive factors of anti-interferon-γ autoantibody (AIGA) positivity. We enrolled 63 AIGA-positive (group 1) and 29 AIGA-negative (group 2) HIV-negative patients. White blood cell (WBC) and neutrophil counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), globulin, immunoglobulin (Ig) G, and IgM levels were higher, whereas CD4T cell count and hemoglobin level were lower in group 1 than in group 2. Co-infections, multiple infections, and disseminated infections were significantly higher in group 1 than in group 2. Prognosis was worse in group 1 than in group 2, especially for relapse and persistent infections. The number of infecting pathogens and sites involved; WBC and neutrophil counts; globulin, IgG, IgM, and CRP levels; and ESR were significantly positively correlated with AIGA titers; however, CD4T cell count was significantly negatively correlated with AIGA titers. Therefore, IgG, globulin, and CRP levels; CD4T cell and WBC counts; the number of infecting pathogens and sites involved; and ESR were considered potential predictors for AIGA positivity. For HIV-negative hosts with double or multiple opportunistic, disseminated infections and high serum IgG and globulin levels, low CD4T cell count, and an increase in inflammatory marker levels, positive AIGA-associated immunodeficiency should be considered.

摘要

我们研究了抗干扰素-γ自身抗体(AIGA)阳性的临床特征并对其预测因素进行了筛查。共纳入 63 例 AIGA 阳性(第 1 组)和 29 例 AIGA 阴性(第 2 组)HIV 阴性患者。第 1 组的白细胞(WBC)和中性粒细胞计数、红细胞沉降率(ESR)和 C 反应蛋白(CRP)、球蛋白、免疫球蛋白(Ig)G 和 IgM 水平较高,而 CD4+T 细胞计数和血红蛋白水平较低。第 1 组合并感染、多重感染和播散性感染的比例显著高于第 2 组。第 1 组的预后较第 2 组差,尤其是复发和持续性感染。感染病原体的数量和部位、WBC 和中性粒细胞计数、球蛋白、IgG、IgM 和 CRP 水平以及 ESR 与 AIGA 滴度呈显著正相关;而 CD4+T 细胞计数与 AIGA 滴度呈显著负相关。因此,IgG、球蛋白和 CRP 水平;CD4+T 细胞和 WBC 计数;感染病原体的数量和部位;以及 ESR 被认为是 AIGA 阳性的潜在预测因素。对于 HIV 阴性宿主出现双重或多重机会性、播散性感染,以及血清 IgG 和球蛋白水平升高、CD4+T 细胞计数降低和炎症标志物水平升高,应考虑存在与 AIGA 相关的免疫缺陷。

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