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IgA 缺乏症的早期遗传预测因素概述。

An overview of early genetic predictors of IgA deficiency.

机构信息

Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

出版信息

Expert Rev Mol Diagn. 2024 Aug;24(8):715-727. doi: 10.1080/14737159.2024.2385521. Epub 2024 Aug 1.

Abstract

INTRODUCTION

Inborn errors of immunity (IEIs) refer to a heterogeneous category of diseases with defects in the number and/or function of components of the immune system. Immunoglobulin A (IgA) deficiency is the most prevalent IEI characterized by low serum level of IgA and normal serum levels of IgG and/or IgM. Most of the individuals with IgA deficiency are asymptomatic and are only identified through routine laboratory tests. Others may experience a wide range of clinical features including mucosal infections, allergies, and malignancies as the most important features. IgA deficiency is a multi-complex disease, and the exact pathogenesis of it is still unknown.

AREAS COVERED

This review compiles recent research on genetic and epigenetic factors that may contribute to the development of IgA deficiency. These factors include defects in B-cell development, IgA class switch recombination, synthesis, secretion, and the long-term survival of IgA switched memory B cells and plasma cells.

EXPERT OPINION

A better and more comprehensive understanding of the cellular pathways involved in IgA deficiency could lead to personalized surveillance and potentially curative strategies for affected patients, especially those with severe symptoms.

摘要

简介

先天性免疫缺陷(IEI)是指一组免疫系统组成成分数量和/或功能异常的异质性疾病。免疫球蛋白 A(IgA)缺乏症是最常见的 IEI,其特征为血清 IgA 水平降低,而 IgG 和/或 IgM 血清水平正常。大多数 IgA 缺乏症患者无症状,仅通过常规实验室检查发现。其他患者可能表现出广泛的临床特征,包括黏膜感染、过敏和恶性肿瘤等重要特征。IgA 缺乏症是一种多因素复杂疾病,其确切发病机制尚不清楚。

涵盖领域

本综述汇集了近期关于可能导致 IgA 缺乏症发生的遗传和表观遗传因素的研究。这些因素包括 B 细胞发育缺陷、IgA 类别转换重组、合成、分泌以及 IgA 转换记忆 B 细胞和浆细胞的长期存活。

专家意见

更好地全面了解 IgA 缺乏症相关的细胞通路,可能为受影响的患者,尤其是有严重症状的患者,提供个体化监测和潜在的治疗策略。

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