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人工智能在遗传性免疫缺陷病识别与管理中的应用:过去、现在与未来——一项系统综述

Application of Artificial Intelligence in Inborn Errors of Immunity Identification and Management: Past, Present, and Future-A Systematic Review.

作者信息

Taietti Ivan, Votto Martina, Colaneri Marta, Passerini Matteo, Leoni Jessica, Marseglia Gian Luigi, Licari Amelia, Castagnoli Riccardo

机构信息

Pediatric Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.

Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.

出版信息

J Clin Med. 2025 Aug 23;14(17):5958. doi: 10.3390/jcm14175958.

DOI:10.3390/jcm14175958
PMID:40943725
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12429086/
Abstract

: Inborn errors of immunity (IEI) are mainly genetically driven disorders that affect immune function and present with highly heterogeneous clinical manifestations, ranging from severe combined immunodeficiency (SCID) to adult-onset immune dysregulatory diseases. This clinical heterogeneity, coupled with limited awareness and the absence of a universal diagnostic test, makes early and accurate diagnosis challenging. Although genetic testing methods such as whole-exome and genome sequencing have improved detection, they are often expensive, complex, and require functional validation. Recently, artificial intelligence (AI) tools have emerged as promising for enhancing diagnostic accuracy and clinical decision-making for IEI. : We conducted a systematic review of four major databases (PubMed, Scopus, Web of Science, and Embase) to identify peer-reviewed English-published studies focusing on the application of AI techniques in the diagnosis and treatment of IEI across pediatric and adult populations. Twenty-three retrospective/prospective studies and clinical trials were included. : AI methodologies demonstrated high diagnostic accuracy, improved detection of pathogenic mutations, and enhanced prediction of clinical outcomes. AI tools effectively integrated and analyzed electronic health records (EHRs), clinical, immunological, and genetic data, thereby accelerating the diagnostic process and supporting personalized treatment strategies. : AI technologies show significant promise in the early detection and management of IEI by reducing diagnostic delays and healthcare costs. While offering substantial benefits, limitations such as data bias and methodological inconsistencies among studies must be addressed to ensure broader clinical applicability.

摘要

遗传性免疫缺陷(IEI)主要是由基因驱动的疾病,会影响免疫功能,临床表现高度异质,从严重联合免疫缺陷(SCID)到成人期免疫调节异常疾病不等。这种临床异质性,加上认知有限以及缺乏通用诊断测试,使得早期准确诊断具有挑战性。尽管全外显子组测序和基因组测序等基因检测方法提高了检测率,但它们往往成本高昂、操作复杂,且需要功能验证。最近,人工智能(AI)工具在提高IEI的诊断准确性和临床决策方面显示出了前景。

我们对四个主要数据库(PubMed、Scopus、Web of Science和Embase)进行了系统综述,以识别专注于AI技术在儿科和成人人群IEI诊断与治疗中应用的同行评审英文发表研究。纳入了23项回顾性/前瞻性研究和临床试验。

AI方法显示出高诊断准确性、提高了致病突变的检测率,并增强了临床结局预测。AI工具有效地整合和分析了电子健康记录(EHR)、临床、免疫和基因数据,从而加速了诊断过程并支持个性化治疗策略。

AI技术通过减少诊断延迟和医疗成本,在IEI的早期检测和管理中显示出巨大前景。虽然带来了诸多益处,但必须解决数据偏差和研究方法不一致等局限性,以确保更广泛的临床适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed99/12429086/bf89756b87f1/jcm-14-05958-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed99/12429086/4e37598d0bcd/jcm-14-05958-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed99/12429086/bf89756b87f1/jcm-14-05958-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed99/12429086/4e37598d0bcd/jcm-14-05958-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed99/12429086/bf89756b87f1/jcm-14-05958-g002.jpg

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本文引用的文献

1
Inborn errors of immunity with atopic phenotypes in the allergy and immunology clinic: a practical review.过敏与免疫门诊中具有特应性表型的先天性免疫缺陷:实用综述
Curr Opin Allergy Clin Immunol. 2025 Apr 1;25(2):105-114. doi: 10.1097/ACI.0000000000001059. Epub 2025 Feb 13.
2
Artificial Intelligence and Machine Learning for Inborn Errors of Immunity: Current State and Future Promise.人工智能和机器学习在先天性免疫缺陷中的应用:现状与未来前景。
J Allergy Clin Immunol Pract. 2024 Oct;12(10):2695-2704. doi: 10.1016/j.jaip.2024.08.012. Epub 2024 Aug 8.
3
Studying inborn errors of immunity to understand the pathogenic mechanisms underlying highly prevalent immune-mediated diseases.
研究免疫缺陷病以了解高度流行的免疫介导疾病的发病机制。
Minerva Pediatr (Torino). 2025 Feb;77(1):4-6. doi: 10.23736/S2724-5276.24.07668-7. Epub 2024 Jul 8.
4
Electronic health record signatures identify undiagnosed patients with common variable immunodeficiency disease.电子健康记录签名可识别出患有普通可变免疫缺陷病的未确诊患者。
Sci Transl Med. 2024 May;16(745):eade4510. doi: 10.1126/scitranslmed.ade4510. Epub 2024 May 1.
5
Natural language processing of clinical notes enables early inborn error of immunity risk ascertainment.临床记录的自然语言处理能够实现先天性免疫缺陷风险的早期判定。
J Allergy Clin Immunol Glob. 2024 Feb 2;3(2):100224. doi: 10.1016/j.jacig.2024.100224. eCollection 2024 May.
6
Validation of Artificial Intelligence (AI)-Assisted Flow Cytometry Analysis for Immunological Disorders.人工智能辅助流式细胞术分析在免疫紊乱中的验证
Diagnostics (Basel). 2024 Feb 14;14(4):420. doi: 10.3390/diagnostics14040420.
7
Validating inborn error of immunity prevalence and risk with nationally representative electronic health record data.利用具有全国代表性的电子健康记录数据验证先天免疫缺陷的患病率和风险。
J Allergy Clin Immunol. 2024 Jun;153(6):1704-1710. doi: 10.1016/j.jaci.2024.01.011. Epub 2024 Jan 24.
8
Proceedings from the inaugural Artificial Intelligence in Primary Immune Deficiencies (AIPID) conference.首届原发性免疫缺陷病人工智能(AIPID)会议论文集。
J Allergy Clin Immunol. 2024 Mar;153(3):637-642. doi: 10.1016/j.jaci.2024.01.002. Epub 2024 Jan 13.
9
Identifying immunodeficiency status in children with pulmonary tuberculosis: using radiomics approach based on un-enhanced chest computed tomography.识别肺结核患儿的免疫缺陷状态:基于胸部平扫计算机断层扫描的放射组学方法
Transl Pediatr. 2023 Dec 26;12(12):2191-2202. doi: 10.21037/tp-23-309. Epub 2023 Dec 22.
10
Shorter birth length and decreased T-cell production and function predict severe infections in children with non-severe combined immunodeficiency cartilage-hair hypoplasia.较短的出生身长以及T细胞产生和功能降低预示着非严重联合免疫缺陷软骨毛发发育不全患儿会发生严重感染。
J Allergy Clin Immunol Glob. 2023 Nov 22;3(1):100190. doi: 10.1016/j.jacig.2023.100190. eCollection 2024 Feb.