Immunology Laboratory, Facultad de Estudios Superiores-Cuautitlán, Universidad Nacional Autónoma de México, State of Mexico, Mexico.
Virology Laboratory, Facultad de Estudios Superiores-Cuautitlán, Universidad Nacional Autónoma de México, State of Mexico, Mexico.
Gac Med Mex. 2023;159(2):154-160. doi: 10.24875/GMM.M23000760.
Anti-cytokine autoantibodies (ACAA) have been reported to be an important cause of secondary immunodeficiencies. High titers of neutralizing autoantibodies may cause susceptibility to different life-threatening infectious diseases. For example, neutralizing autoantibodies against IFNg have been reported to be correlated with susceptibility to mycobacterial infections and intracellular fungal pathogens. Autoantibodies against IL-6 were detected in patients with subcutaneous abscesses and recurrent staphylococcal cellulitis; on the other hand, patients with cryptococcosis, nocardiosis, and pulmonary alveolar proteinosis were positive for autoantibodies to GM-CSF. A relationship has also been established between autoantibodies against IL-17 and IL-22 and chronic mucosal Candida infections, which have been identified in patients with APECED or thymoma. Autoantibodies against type-I IFN have been recently reported during the onset of acute COVID-19. These ACAAs resemble genetic defects in cytokines or their signaling pathways. Therefore, they may be considered to be primary immunodeficiencies phenocopies. Consequently, the detection of ACAA could be important in the diagnosis of patients, particularly in the case of late-onset diseases, in order to decide appropriate treatments. This review presents an overview of current understanding of ACAA-associated secondary immunodeficiencies.
抗细胞因子自身抗体 (ACAA) 已被报道是继发性免疫缺陷的一个重要原因。高滴度的中和自身抗体可能导致易患不同危及生命的传染病。例如，针对 IFNg 的中和自身抗体已被报道与分枝杆菌感染和细胞内真菌病原体易感性相关。在患有皮下脓肿和复发性葡萄球菌蜂窝织炎的患者中检测到针对 IL-6 的自身抗体；另一方面，患有隐球菌病、奴卡菌病和肺泡蛋白沉积症的患者对 GM-CSF 的自身抗体呈阳性。自身抗体针对 IL-17 和 IL-22 与慢性黏膜念珠菌感染之间也建立了关系，这些在 APECED 或胸腺瘤患者中已被确定。在急性 COVID-19 发作期间最近报道了针对 I 型 IFN 的自身抗体。这些 ACAAs 类似于细胞因子或其信号通路的遗传缺陷。因此，它们可能被认为是原发性免疫缺陷的表型。因此，ACAA 的检测对于患者的诊断可能很重要，特别是对于迟发性疾病，以便决定适当的治疗。这篇综述介绍了目前对与 ACAA 相关的继发性免疫缺陷的理解概述。
