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孟德尔随机化分析揭示自身免疫性疾病与特发性血小板减少性紫癜之间的因果关系以及免疫细胞的中介作用。

Mendelian Randomization Analysis Reveals the Causal Relationships Between Autoimmune Diseases and Idiopathic Thrombocytopenic Purpura and the Mediating Role of Immune Cells.

作者信息

Yan Kaiqing, Sun Lin, Gao Wenyu, Cui Qianqian, Liu Hongxiu, Tian Yun, Gao Siyu, Ma Yanping

机构信息

Second School of Clinical Medicine, Shanxi Medical University, Shanxi, China.

Fifth School of Clinical Medicine, Shanxi Medical University, Shanxi, China.

出版信息

Eur J Rheumatol. 2025 Apr 23;12(1):1-7. doi: 10.5152/eurjrheum.2025.24100.

DOI:10.5152/eurjrheum.2025.24100
PMID:40377429
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12060185/
Abstract

BACKGROUND

Idiopathic thrombocytopenic purpura (ITP) is related to multiple autoimmune diseases clinically, yet the causal relationship remains unclear. This study employed Mendelian randomization (MR) to explore the genetic causal relationship between autoimmune diseases and ITP and potential mediators in the European population.

METHODS

Summary statistics of 10 common autoimmune diseases and ITP were extracted for analysis. Bidirectional two-sample MR and two-step MR were conducted.

RESULTS

Multiple sclerosis (MS, inverse variance weighted [IVW]: odds ratio (OR)=5.840E+16, false discovery rate (FDR)=0.049), celiac disease (CeD, IVW: OR=1.173, FDR=0.023), systemic lupus erythematosus (SLE, IVW: OR=1.068, FDR=0.049), and autoimmune hyperthyroidism (AIH, IVW: OR=1.265, FDR=0.037) are risk factors for ITP. Rheumatoid arthritis (RA, IVW: OR=1.112, FDR=0.055) may be a potential risk factor. Crohn's disease (CD, IVW: OR=0.816, FDR=0.049), ulcerative colitis (UC, IVW: OR=0.709, FDR=0.042), and psoriasis (PsO, IVW: OR=1.690E - 04, FDR=0.042) are protective factors. No clear causal relationship between ankylosing spondylitis (AS, IVW: OR=1.016, FDR=0.553) and type 1 diabetes mellitus (T1DM, IVW: OR=1.035, FDR=0.577) and ITP. Immune cells act as mediators between CeD and ITP and CD and ITP.

CONCLUSION

This study clarified the relationship between some autoimmune diseases and ITP and the mediating role of immune cells.

摘要

背景

特发性血小板减少性紫癜（ITP）在临床上与多种自身免疫性疾病相关，但因果关系仍不明确。本研究采用孟德尔随机化（MR）方法，在欧洲人群中探讨自身免疫性疾病与ITP之间的遗传因果关系以及潜在的中介因素。

方法

提取10种常见自身免疫性疾病和ITP的汇总统计数据进行分析。进行了双向双样本MR和两步MR分析。

结果

多发性硬化症（MS，逆方差加权法[IVW]：比值比[OR]=5.840E+16，错误发现率[FDR]=0.049）、乳糜泻（CeD，IVW：OR=1.173，FDR=0.023）、系统性红斑狼疮（SLE，IVW：OR=1.068，FDR=0.049）和自身免疫性甲状腺功能亢进症（AIH，IVW：OR=1.265，FDR=0.037）是ITP的危险因素。类风湿关节炎（RA，IVW：OR=1.112，FDR=0.055）可能是潜在危险因素。克罗恩病（CD，IVW：OR=0.816，FDR=0.049）、溃疡性结肠炎（UC，IVW：OR=0.709，FDR=0.042）和银屑病（PsO，IVW：OR=1.690E - 04，FDR=0.042）是保护因素。强直性脊柱炎（AS，IVW：OR=1.016，FDR=0.553）和1型糖尿病（T1DM，IVW：OR=1.035，FDR=0.577）与ITP之间无明确因果关系。免疫细胞在CeD与ITP以及CD与ITP之间起中介作用。

结论

本研究阐明了一些自身免疫性疾病与ITP之间的关系以及免疫细胞的中介作用。

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