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抗因子 H 抗体及其在非典型溶血尿毒综合征中的作用。

Anti-factor H antibody and its role in atypical hemolytic uremic syndrome.

机构信息

Department of Nephrology, Akron Children's Hospital, Akron, OH, United States.

Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, United States.

出版信息

Front Immunol. 2022 Aug 23;13:931210. doi: 10.3389/fimmu.2022.931210. eCollection 2022.

Abstract

Atypical hemolytic uremic syndrome (aHUS) an important form of a thrombotic microangiopathy (TMA) that can frequently lead to acute kidney injury (AKI). An important subset of aHUS is the anti-factor H associated aHUS. This variant of aHUS can occur due to deletion of the complement factor H genes, and , along with the presence of anti-factor H antibodies. However, it is a point of interest to note that not all patients with anti-factor H associated aHUS have a deletion. Factor-H has a vital role in the regulation of the complement system, specifically the alternate pathway. Therefore, dysregulation of the complement system can lead to inflammatory or autoimmune diseases. Patients with this disease respond well to treatment with plasma exchange therapy along with Eculizumab and immunosuppressant therapy. Anti-factor H antibody associated aHUS has a certain genetic predilection therefore there is focus on further advancements in the diagnosis and management of this disease. In this article we discuss the baseline characteristics of patients with anti-factor H associated aHUS, their triggers, various treatment modalities and future perspectives.

摘要

非典型溶血尿毒症综合征(aHUS)是血栓性微血管病(TMA)的一种重要形式,常可导致急性肾损伤(AKI)。aHUS 的一个重要亚组是与补体因子 H 相关的 aHUS。这种 aHUS 变体可能是由于补体因子 H 基因缺失引起的,同时还存在抗因子 H 抗体。然而,值得注意的是,并非所有与抗因子 H 相关的 aHUS 患者都有 缺失。因子-H 在补体系统的调节中具有重要作用,特别是在替代途径中。因此,补体系统的失调可导致炎症或自身免疫性疾病。接受血浆置换治疗、依库珠单抗和免疫抑制剂治疗的患者对此病的治疗反应良好。抗因子 H 抗体相关的 aHUS 具有一定的遗传倾向,因此,人们更加关注该病的诊断和治疗的进一步进展。在本文中,我们讨论了与抗因子 H 相关的 aHUS 患者的基线特征、诱因、各种治疗方法和未来展望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5af/9448717/3bee96f2a158/fimmu-13-931210-g001.jpg

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