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Simultaneous testing of immunological sensitization to multiple antigens in sarcoidosis reveals an association with inorganic antigens specifically related to a fibrotic phenotype.
Clinical & Experimental Immunology ( IF 3.4 ) Pub Date : 2020-09-17 , DOI: 10.1111/cei.13519 E Beijer 1 , R Kraaijvanger 1 , C Roodenburg 1, 2 , J C Grutters 1, 3 , B Meek 2 , M Veltkamp 1, 3
Clinical & Experimental Immunology ( IF 3.4 ) Pub Date : 2020-09-17 , DOI: 10.1111/cei.13519 E Beijer 1 , R Kraaijvanger 1 , C Roodenburg 1, 2 , J C Grutters 1, 3 , B Meek 2 , M Veltkamp 1, 3
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Organic and inorganic antigens were studied simultaneously in the same cohort of sarcoidosis patients to investigate whether correlations between clinical characteristics and immunological sensitization could reveal new phenotypes. Sensitization to antigens of mycobacteria, Propionibacterium acnes catalase and vimentin was investigated in 201 sarcoidosis and 51 obstructive sleep apnoea patients, serving as control group. Sensitization to aluminium, beryllium, silica and zirconium was also studied in 105 of the sarcoidosis patients and in 24 of the controls. A significantly higher percentage of sarcoidosis patients (27·6%) than controls (4·2%) had an immunological response to metals or silica (P = 0·014). A higher percentage of these sarcoidosis patients showed fibrosis on chest X‐ray 5 years after the diagnosis (69·2 versus 30·3%, P = 0·016). No significant differences in mycobacterial or vimentin enzyme‐linked immunospot (ELISPOT) assay results were observed between sarcoidosis and control patients. A significantly lower percentage of sarcoidosis patients (3·5%) than control patients (15·7%) had a positive ELISPOT for P. acnes catalase (P = 0·003). However, sarcoidosis patients sensitized to P. acnes catalase were more likely to have skin involvement, while sarcoidosis patients sensitized to mycobacterial antigens were more likely to have cardiac involvement. Our study suggests a more prominent role for inorganic triggers in sarcoidosis pathogenesis than previously thought. Immunological sensitization to inorganic antigens was associated with development of fibrotic sarcoidosis. No association was found between sensitization to bacterial antigens or vimentin and sarcoidosis in Dutch patients. However, our data suggest that trigger‐related phenotypes can exist in the heterogeneous population of sarcoidosis patients.
中文翻译：
结节病中对多种抗原的免疫敏感性的同时测试揭示了与与纤维化表型特别相关的无机抗原的关联。
在同一组结节病患者中同时研究有机和无机抗原，以研究临床特征和免疫致敏之间的相关性是否可以揭示新的表型。对作为对照组的 201 名结节病和 51 名阻塞性睡眠呼吸暂停患者的分枝杆菌、痤疮丙酸杆菌过氧化氢酶和波形蛋白的抗原致敏进行了研究。还在 105 名结节病患者和 24 名对照组中研究了对铝、铍、二氧化硅和锆的致敏情况。结节病患者 (27·6%) 显着高于对照组 (4·2%) 对金属或二氧化硅有免疫反应的百分比 ( P = 0·014)。诊断 5 年后，这些结节病患者的胸部 X 线显示纤维化的比例更高（69·2对30·3%，P = 0·016）。在结节病患者和对照患者之间未观察到分枝杆菌或波形蛋白酶联免疫斑点 (ELISPOT) 检测结果的显着差异。结节病患者 (3·5%) 的百分比显着低于对照患者 (15·7%) 具有阳性痤疮丙酸杆菌过氧化氢酶ELISPOT ( P = 0·003)。然而，结节病患者对痤疮丙酸杆菌敏感过氧化氢酶更可能有皮肤受累，而对分枝杆菌抗原敏感的结节病患者更可能有心脏受累。我们的研究表明，无机触发因素在结节病发病机制中的作用比以前认为的更重要。对无机抗原的免疫致敏与纤维化结节病的发展有关。在荷兰患者中未发现对细菌抗原或波形蛋白的致敏与结节病之间存在关联。然而，我们的数据表明，在结节病患者的异质人群中可能存在与触发相关的表型。
更新日期：2020-09-17
中文翻译：
结节病中对多种抗原的免疫敏感性的同时测试揭示了与与纤维化表型特别相关的无机抗原的关联。
在同一组结节病患者中同时研究有机和无机抗原，以研究临床特征和免疫致敏之间的相关性是否可以揭示新的表型。对作为对照组的 201 名结节病和 51 名阻塞性睡眠呼吸暂停患者的分枝杆菌、痤疮丙酸杆菌过氧化氢酶和波形蛋白的抗原致敏进行了研究。还在 105 名结节病患者和 24 名对照组中研究了对铝、铍、二氧化硅和锆的致敏情况。结节病患者 (27·6%) 显着高于对照组 (4·2%) 对金属或二氧化硅有免疫反应的百分比 ( P = 0·014)。诊断 5 年后，这些结节病患者的胸部 X 线显示纤维化的比例更高（69·2对30·3%，P = 0·016）。在结节病患者和对照患者之间未观察到分枝杆菌或波形蛋白酶联免疫斑点 (ELISPOT) 检测结果的显着差异。结节病患者 (3·5%) 的百分比显着低于对照患者 (15·7%) 具有阳性痤疮丙酸杆菌过氧化氢酶ELISPOT ( P = 0·003)。然而，结节病患者对痤疮丙酸杆菌敏感过氧化氢酶更可能有皮肤受累，而对分枝杆菌抗原敏感的结节病患者更可能有心脏受累。我们的研究表明，无机触发因素在结节病发病机制中的作用比以前认为的更重要。对无机抗原的免疫致敏与纤维化结节病的发展有关。在荷兰患者中未发现对细菌抗原或波形蛋白的致敏与结节病之间存在关联。然而，我们的数据表明，在结节病患者的异质人群中可能存在与触发相关的表型。
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