Rheumatology and Immunology Center, China Medical University Hospital, and School of Medicine, China Medical University, Taichung, Taiwan.
School of Medicine, Chung Shan Medical University, and Department of Pediatrics, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung City, 40201, Taiwan.
BMC Immunol. 2023 Sep 26;24(1):33. doi: 10.1186/s12865-023-00569-w.
Patients with idiopathic inflammatory myopathy (IIM) often express a different type of myositis-specific autoantibodies (MSAs), each associated with different clinical symptoms. Understanding the immunopathogenesis of various IIM subgroups can help improve the diagnosis and prognosis of IIM patients with different MSAs. However, the immune cell profiles of these IIM patients with anti-aminoacyl tRNA synthetase (ARS) or anti-melanoma differentiation-associated gene 5 (MDA5) autoantibodies remain unclear. We focused on the immune cell profiles of IIM patients with anti-ARS or anti-MDA5 autoantibodies.
The peripheral blood from IIM patients with anti-MDA5 autoantibody (MDA5 + group, n = 24) or one of the anti-ARS autoantibodies (ARS + group, n = 40) autoantibodies, and healthy controls (HC group, n = 60) were collected and examined. We found that IIM patients had a lower CD3 T cell population compared to the HC group. IIM patients showed a significantly lower T cell population and a higher T cell population. Higher Th17 and Treg cell populations were found in these IIM patients than in the HC group. In these IIM patients, the MDA5 + group exhibited the higher percentages of Th17 and Treg cells than the ARS + group. It is noteworthy that the percentage of Th1 cells in the survival subgroup was higher than in the death subgroup in IIM patients with ARS + or MDA5 + . Furthermore, in the MDA5 + group, the percentage of Treg cells was higher in the survival subgroup compared to the death subgroup.
Our study demonstrated that elevated Th1 may be a good prognostic indicator in IIM patients with ARS + or MDA5 + . Elevated Treg may also help predict a good prognosis in MDA5 + IIM patients. However, more large-scale studies and clinical samples are needed to verify the significance of Th1 and Treg cell subsets in clinical outcomes for these IIM patients with ARS + or MDA5 + . These data may help design a therapeutic approach that specifically targets the pathogenic immune molecular responsible for autoimmune attacks in IIM.
特发性炎性肌病（IIM）患者常表达不同类型的肌炎特异性自身抗体（MSA），每种自身抗体与不同的临床症状相关。了解各种 IIM 亚组的免疫发病机制有助于改善不同 MSA 的 IIM 患者的诊断和预后。然而，抗氨酰基-tRNA 合成酶（ARS）或抗黑色素瘤分化相关基因 5（MDA5）自身抗体的这些 IIM 患者的免疫细胞谱仍不清楚。我们专注于具有抗-ARS 或抗-MDA5 自身抗体的 IIM 患者的免疫细胞谱。
收集了抗 MDA5 自身抗体（MDA5+组，n=24）或一种抗 ARS 自身抗体（ARS+组，n=40）的 IIM 患者和健康对照者（HC 组，n=60）的外周血，并进行了检查。我们发现，与 HC 组相比，IIM 患者的 CD3 T 细胞群体较低。与 HC 组相比，IIM 患者的 T 细胞群体明显较低，而 Th17 和 Treg 细胞群体较高。在这些 IIM 患者中，MDA5+组的 Th17 和 Treg 细胞群体百分比高于 ARS+组。值得注意的是，在 ARS+或 MDA5+的 IIM 患者中，存活亚组的 Th1 细胞百分比高于死亡亚组。此外，在 MDA5+组中，与死亡亚组相比，存活亚组的 Treg 细胞百分比较高。
我们的研究表明，在 ARS+或 MDA5+的 IIM 患者中，升高的 Th1 可能是一个良好的预后指标。升高的 Treg 也可能有助于预测 MDA5+IIM 患者的良好预后。然而，需要更多的大规模研究和临床样本来验证 ARS+或 MDA5+的这些 IIM 患者中 Th1 和 Treg 细胞亚群在临床结局中的意义。这些数据可能有助于设计一种专门针对导致 IIM 自身免疫攻击的致病免疫分子的治疗方法。
