自身抗体在非 SARS-CoV-2 呼吸道感染和危重病中高度流行。
Autoantibodies are highly prevalent in non-SARS-CoV-2 respiratory infections and critical illness.
机构信息
Department of Medicine, Division of Immunology and Rheumatology.
Institute for Immunity, Transplantation and Infection.
出版信息
JCI Insight. 2023 Feb 8;8(3):e163150. doi: 10.1172/jci.insight.163150.
The widespread presence of autoantibodies in acute infection with SARS-CoV-2 is increasingly recognized, but the prevalence of autoantibodies in non-SARS-CoV-2 infections and critical illness has not yet been reported. We profiled IgG autoantibodies in 267 patients from 5 independent cohorts with non-SARS-CoV-2 viral, bacterial, and noninfectious critical illness. Serum samples were screened using Luminex arrays that included 58 cytokines and 55 autoantigens, many of which are associated with connective tissue diseases (CTDs). Samples positive for anti-cytokine antibodies were tested for receptor blocking activity using cell-based functional assays. Anti-cytokine antibodies were identified in > 50% of patients across all 5 acutely ill cohorts. In critically ill patients, anti-cytokine antibodies were far more common in infected versus uninfected patients. In cell-based functional assays, 11 of 39 samples positive for select anti-cytokine antibodies displayed receptor blocking activity against surface receptors for Type I IFN, GM-CSF, and IL-6. Autoantibodies against CTD-associated autoantigens were also commonly observed, including newly detected antibodies that emerged in longitudinal samples. These findings demonstrate that anti-cytokine and autoantibodies are common across different viral and nonviral infections and range in severity of illness.
越来越多的证据表明,SARS-CoV-2 急性感染患者体内广泛存在自身抗体,但非 SARS-CoV-2 感染和危重症患者体内自身抗体的流行情况尚未见报道。我们对来自 5 个独立队列的 267 例非 SARS-CoV-2 病毒、细菌和非感染性危重症患者的 IgG 自身抗体进行了分析。这些队列来自于 5 个独立的研究,血清样本使用 Luminex 微球阵列进行了筛选,该阵列包含 58 种细胞因子和 55 种自身抗原,其中许多与结缔组织疾病(CTD)相关。针对细胞因子的抗体阳性样本使用基于细胞的功能测定法进行了受体阻断活性检测。在所有 5 个急性疾病队列中,超过 50%的患者存在针对多种细胞因子的自身抗体。在危重症患者中,感染患者体内针对细胞因子的自身抗体比未感染患者更为常见。在基于细胞的功能测定中,39 份针对选定细胞因子的阳性样本中有 11 份显示出针对 I 型 IFN、GM-CSF 和 IL-6 表面受体的受体阻断活性。还观察到针对 CTD 相关自身抗原的自身抗体,包括在纵向样本中出现的新抗体。这些发现表明,针对细胞因子和自身抗体在不同的病毒和非病毒感染中很常见,且与疾病严重程度相关。