IgG4 相关疾病研究进展
关键词:
IgG4 相关疾病；发病机制；临床特点；综述摘要
IgG4 相关疾病( IgG4- Ｒ D) 是一类由免疫介导的，同时累及多脏器的慢性纤维炎性疾病，伴或不伴有IgG4 水平升高，可累及胰腺、肾脏、涎腺和泪腺、腹膜后组织，临床表现各异。目前发病原因不清，部分相关研究数据表明与遗传因素、慢性感染、肠道菌群紊乱、过敏反应等均有关。近年对其发病机制的研究不断深入，包括T 细胞亚群、B 细胞等因素可能参与疾病的发展。目前IgG4-RD 首选药物为糖皮质激素，对于难治及复发的病例，利妥昔单抗逐渐受到重视，成为二线用药。为进一步提高对IgG4 相关疾病的认识，本文主要从病因、发病机制、临床表现、诊断、治疗等方面的最新研究作一综述。
参考
[1]Wallace ZS, Miles G, Smolkina E, et al. Incidence, prevalence and mortality of IgG4-related disease in the USA: a claims-based analysis of commercially insured adults[J]. Annals of the Rheumatic Diseases, 2023, 82(7): 957-962.
[2]Wallace ZS, Zhang Y, Perugino CA, et al. Clinical phenotypes of IgG4-related disease: an analysis of two international cross-sectional cohorts[J]. Annals of the rheumatic diseases, 2019, 78(3): 406-412.
[3]Rispens T, Huijbers MG. The unique properties of IgG4 and its roles in health and disease[J]. Nature Reviews. Immunology, 2023, 23(11): 763-778.
[4]Pillai S. Is it bad, is it good, or is IgG4 just misunderstood?[J]. Science Immunology, 2023, 8(81): eadg7327.
[5]Kawa S, Ota M, Yoshizawa, et al. HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population[J]. Gastroenterology, 2002, 122(5): 1264-1269.
[6]Liu Q, Zheng Y, Sturmlechner I, et al. IKZF1 and UBR4 gene variants drive autoimmunity and Th2 polarization in IgG4-related disease[J]. The Journal of Clinical Investigation, 134(16): e178692.
[7]Guarneri F, Guarneri C, Benvenga S. Helicobacter pylori and autoimmune pancreatitis: role of carbonic anhydrase via molecular mimicry?[J]. Journal of Cellular and Molecular Medicine, 2005, 9(3): 741-744.
[8]Frulloni L, Lunardi C, Simone R, et al. Identification of a novel antibody associated with autoimmune pancreatitis[J]. The New England Journal of Medicine, 2009, 361(22): 2135-2142.
[9]Kawano M, Yamada K, Kakuchi Y, et al. A case of immunoglobulin G4-related chronic sclerosing sialadenitis and dacryoadenitis associated with tuberculosis[J]. Modern Rheumatology, 2009, 19(1): 87-90.
[10]Yanagisawa N, Haruta I, Shimizu K, et al. Identification of commensal flora-associated antigen as a pathogenetic factor of autoimmune pancreatitis[J]. Pancreatology: official journal of the International Association of Pancreatology (IAP) ... [et al.], 2014, 14(2): 100-106.
[11]Liu Q, Li B, Li Y, et al. Altered faecal microbiome and metabolome in IgG4-related sclerosing cholangitis and primary sclerosing cholangitis[J]. Gut, 2022, 71(5): 899-909.
[12]Saeki T, Kobayashi D, Ito T, et al. Comparison of clinical and laboratory features of patients with and without allergic conditions in IgG4-related disease: A single-center experience in Japan[J]. Modern Rheumatology, 2018, 28(5): 845-848.
[13] 张霞. PD-1/PD-Ls 在IgG4-RD 中作用的研究及过敏/ 嗜酸性粒细胞升高在IgG4-RD 中的意义[D]. 北京协和医学院,2019.
[14]Zhao Z, Liu Y, Bai M, et al. Clinical profiles differ in IgG4-related disease with and without allergy: a large case-control study in China[J]. Clinical and Experimental Rheumatology, 2023, 41(9): 1808-1814.
[15]Munemura R, Maehara T, Murakami Y, et al. Distinct diseasespecific Tfh cell populations in two different fibrotic diseases: IgG4-related disease and Kimura’s disease[J]. The Journal of allergy and clinical immunology, 2022, 150(2): 440-455.e17.
[16]Della-Torre E, Lanzillotta M, Doglioni C. Immunology of IgG4-related disease[J]. Clinical and Experimental Immunology, 2015,181(2): 191-206.
[17]Wallace ZS, Matto H, Carruthers M, et al. Plasmablasts as a biomarker for IgG4-related disease, independent of serum IgG4 concentrations[J]. Annals of the Rheumatic Diseases, 2015, 74(1): 190-195.
[18]Lin W, Zhang P, Chen H, et al. Circulating plasmablasts/plasma cells: a potential biomarker for IgG4-related disease[J]. Arthritis Research & Therapy, 2017, 19(1): 25.
[19]Katayama Y, Katsuyama T, Shidahara K, et al. A case of recurrent IgG4-related disease successfully treated with belimumab after remission of systemic lupus erythematosus[J]. Rheumatology (Oxford, England), 2022, 61(10): e308-e310.
[20]Perugino CA, Walllace ZS, Zack DJ, et al. Evaluation of the safety, efficacy, and mechanism of action of obexelimab for the treatment of patients with IgG4-related disease: an open-label, single-arm, single centre, phase 2 pilot trial[J]. The Lancet. Rheumatology, 2023, 5(8):e442-e450.
[21] 张文, 董凌莉, 朱剑, 等.IgG4 相关性疾病诊治中国专家共识[J]. 中华内科杂志,2021,60(3):192-206.
[22]Zhu L, Xue HD, Zhang W, et al. Pancreaticobiliary involvement in treated type 1 autoimmune pancreatitis: Imaging pattern and risk factors for disease relapse[J]. European Journal of Radiology, 2019, 120: 108673.
[23]Ferry JA, Deshpande V. IgG4-related disease in the head and neck[J]. Seminars in Diagnostic Pathology, 2012, 29(4): 235-244.
[24]Yamamoto M, Harada S, Ohara M, et al. Clinical and pathological differences between Mikulicz’s disease and Sjögren’s syndrome[J]. Rheumatology (Oxford, England), 2005, 44(2): 227-234.
[25]Touzani F, Pozdzik A. New insights into immune cells crosstalk during IgG4-related disease[J]. Clinical Immunology (Orlando, Fla.), 2019, 198: 1-10.
[26]Tsushima K, Tanabe T, Yamamoto H, et al. Pulmonary involvement of autoimmune pancreatitis[J]. European Journal of Clinical Investigation, 2009, 39(8): 714-722.
[27] 费允礼, 刘燕鹰, 董凌莉, 等.IgG4 相关性疾病诊疗规范[J].中华内科杂志,2023,62（10）:1161-1171.
[28]Umehara H, Okazaki K, Kawa S, et al. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD[J]. Modern Rheumatology, 2021, 31(3): 529-533.
[29]Wallace ZS, Naden RP, Chari S, et al. The 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria for IgG4-Related Disease[J]. Arthritis & Rheumatology (Hoboken, N.J.), 2020, 72(1): 7-19.
[30]Zhang W, Stone JH. Management of IgG4-related disease[J]. The Lancet. Rheumatology, 2019, 1(1): e55-e65. .
[31]Orozco-Gálvez O, Fernández-Codina A, Lanzillotta M, et al. Development of an algorithm for IgG4-related disease management[J]. Autoimmunity Reviews, 2023, 22(3): 103273.
[32]Carruthers MN, Topazian MD, Khosroshahi A, et al. Rituximab for IgG4-related disease: a prospective, open-label trial[J]. Annals of the Rheumatic Diseases, 2015, 74(6): 1171-1177.
[33]Campochiaro C, Della-Torre E, Lanzillotta M, et al. Longterm efficacy of maintenance therapy with Rituximab for IgG4-related disease[J]. European Journal of Internal Medicine, 2020, 74: 92-98.
[34]Pinheiro FAG, Pereira IA, De Souza AWS, et al. IgG4-related disease—rare but you should not forget it[J]. Advances in Rheumatology, 2024, 64(1): 35.
