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弥合差距:先天性免疫缺陷中的神经发育障碍风险。

Bridging the gap: neurodevelopmental disorder risks in inborn errors of immunity.

机构信息

Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.

出版信息

Curr Opin Allergy Clin Immunol. 2024 Dec 1;24(6):472-478. doi: 10.1097/ACI.0000000000001036. Epub 2024 Oct 3.

Abstract

PURPOSE OF REVIEW

The aim of this review is to examine published reports of neurodevelopmental phenotypes in patients with inborn errors of immunity (IEI). We briefly discuss potential interactions between the immune and the central nervous system and the implications of this crosstalk for current clinical management guidelines.

RECENT FINDINGS

An increasing number of reports have described neurodevelopmental disorders (NDDs) comorbid with immune-mediated signs. However, the prevalence of this association in IEIs remains unknown.

SUMMARY

IEIs comprise a group of clinically heterogeneous disorders associated with a number of nonimmune comorbidities. Although certain neurological conditions such as microcephaly are recognized as associated features of some IEIs, NDDs are less well described. We reviewed published clinical descriptions of IEIs and found a number of comorbid NDDs in these patients, including autism spectrum disorder (ASD), behavioral deficits, and intellectual disability. Given the lack of uniform assessments for NDDs, we suspect they may be underdiagnosed in IEIs. As NDDs manifest early and can result in life-long cognitive and emotional deficits, which diminish quality of life and increase healthcare utilization, we hope to elucidate relevant pathomechanisms and raise clinician awareness of these comorbidities so appropriate and timely interventions are sought.

摘要

目的综述

本综述旨在研究原发性免疫缺陷(IEI)患者神经发育表型的已发表报告。我们简要讨论了免疫系统和中枢神经系统之间的潜在相互作用,以及这种串扰对当前临床管理指南的影响。

最新发现

越来越多的报告描述了与免疫介导的体征并存的神经发育障碍(NDD)。然而,IEI 中这种关联的患病率尚不清楚。

总结

IEI 是一组临床表现异质性的疾病,与许多非免疫性合并症相关。虽然某些神经疾病,如小头畸形,被认为是某些 IEI 的相关特征,但 NDD 则描述较少。我们回顾了已发表的 IEI 临床描述,并在这些患者中发现了许多合并的 NDD,包括自闭症谱系障碍(ASD)、行为缺陷和智力障碍。鉴于对 NDD 缺乏统一的评估,我们怀疑它们在 IEI 中可能被漏诊。由于 NDD 早期表现,并可能导致终身认知和情感缺陷,降低生活质量并增加医疗保健利用,我们希望阐明相关的发病机制,并提高临床医生对这些合并症的认识,以便寻求适当和及时的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a959/11537469/65217254b6d8/coaci-24-472-g001.jpg

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