Pathogenesis of immunoglobulin G4-related hepatobiliary and pancreatic diseases
-
摘要: IgG4相关性疾病(IgG4-RD)是一种可累及全身的多系统的慢性进行性自身免疫性疾病,IgG4相关性肝胆胰疾病为IgG4-RD受累肝胆胰腺系统表现,其主要特征为血清IgG4水平升高和IgG4阳性淋巴浆细胞浸润,可模仿各种炎症及肿瘤疾病,临床易漏诊误诊。从基因遗传、感染与分子模拟、免疫因素等方面阐述IgG4相关性肝胆胰疾病的发病机制,从而提高对该病的认识。Abstract: Immunoglobulin G4 (IgG4) -related disease is a chronic progressive autoimmune disease involving multiple systems throughout the body. IgG4-related hepatobiliary and pancreatic diseases are the manifestation of IgG4-related disease involving the hepatobiliary and pancreatic systems, with the main features of an increased serum IgG4 level and IgG4-positive lymphoplasmacytic infiltration. IgG4-related hepatobiliary and pancreatic diseases can mimic various inflammations and tumor diseases, which may lead to missed diagnosis and misdiagnosis in clinical practice. This article elaborates on the pathogenesis of IgG4-related hepatobiliary and pancreatic diseases from the perspectives of genetic inheritance, infection and molecular mimicry, and immune factors, so as to improve the understanding of such diseases.
-
Key words:
- immunoglobulin G /
- autoimmune diseases /
- pancreatitis /
- cholangitis, sclerosing /
- liver diseases /
- review
-
[1]KIM YR, LEE YH, CHOI KH, et al.Imaging findings of IgG4-related hepatopathy:A rare case presenting as a hepatic mass[J].Clin Imaging, 2018, 51:248-251. [2]KAWA S, OTA M, YOSHIZAWA K, et al.HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population[J].Gastroenterology, 2002, 122 (5) :1264-1269. [3]PARK DH, KIM MH, OH HB, et al.Substitution of aspartic acid at position 57 of the DQbeta1 affects relapse of autoimmune pancreatitis[J].Gastroenterology, 2008, 134 (2) :440-446. [4]CULVER EL, CHAPMAN RW.IgG4-related hepatobiliary disease:An overview[J].Nat Rev Gastroenterol Hepatol, 2016, 13 (10) :601-612. [5]CHANG MC, CHANG YT, TIEN YW, et al.T-cell regulatory gene CTLA-4 polymorphism/haplotype association with autoimmune pancreatitis[J].Clin Chem, 2007, 53 (9) :1700-1705. [6]KOCHI Y, YAMADA R, SUZUKI A, et al.A functional variant in FCRL3, encoding Fc receptor-like 3, is associated with rheumatoid arthritis and several autoimmunities[J].Nat Genet, 2005, 37 (5) :478-485. [7]UMEMURA T, OTA M, HAMANO H, et al.Genetic association of Fc receptor-like 3 polymorphisms with autoimmune pancreatitis in Japanese patients[J].Gut, 2006, 55 (9) :1367-1368. [8]OGUCHI T, OTA M, ITO T, et al.Investigation of susceptibility genes triggering lachrymal/salivary gland lesion complications in Japanese patients with type 1 autoimmune pancreatitis[J].PLo S One, 2015, 10 (5) :e127078. [9]OTA M, UMEMURA T, KAWA S.Immunogenetics of IgG4-Related AIP[J].Curr Top Microbiol Immunol, 2017, 401:35-44. [10]OGUCHI T, OTA M, ITO T, et al.Correction:Investigation of susceptibility genes triggering lachrymal/salivary gland lesion complications in Japanese patients with type 1 autoimmune pancreatitis[J].PLo S One, 2016, 11 (1) :e146738. [11]GUARNERI F, GUARNERI C, BENVENGA S.Helicobacter pylori and autoimmune pancreatitis:Role of carbonic anhydrase via molecular mimicry?[J].J Cell Mol Med, 2005, 9 (3) :741-744. [12]FRULLONI L, LUNARDI C, SIMONE R, et al.Identification of a novel antibody associated with autoimmune pancreatitis[J].N Engl J Med, 2009, 361 (22) :2135-2142. [13]FELIX K, HAUCK O, SCHNOLZER M, et al.Identification of novel serum autoantibodies for differential diagnosis of autoimmune pancreatitis and pancreatic ductal adenocarcinoma[J].Pancreas, 2016, 45 (9) :1309-1319. [14]CULVER EL, SMIT WL, EVANS C, et al.No evidence to support a role for helicobacter pylori infection and plasminogen binding protein in autoimmune pancreatitis and IgG4-related disease in a UK cohort[J].Pancreatology, 2017, 17 (3) :395-402. [15]WATANABE T, YAMASHITA K, FUJIKAWA S, et al.Involvement of activation of toll-like receptors and nucleotide-binding oligomerization domain-like receptors in enhanced IgG4responses in autoimmune pancreatitis[J].Arthritis Rheum, 2012, 64 (3) :914-924. [16]MOISINI I, DAVIDSON A.BAFF:A local and systemic target in autoimmune diseases[J].Clin Exp Immunol, 2009, 158 (2) :155-163. [17]NARADIKIAN MS, PERATE AR, CANCRO MP.BAFF receptors and ligands create independent homeostatic niches for Bcell subsets[J].Curr Opin Immunol, 2015, 34:126-129. [18]WATANABE T, YAMASHITA K, SAKURAI T, et al.Toll-like receptor activation in basophils contributes to the development of IgG4-related disease[J].J Gastroenterol, 2013, 48 (2) :247-253. [19]AKITAKE R, WATANABE T, ZAIMA C, et al.Possible involvement of T helper type 2 responses to Toll-like receptor ligands in IgG4-related sclerosing disease[J].Gut, 2010, 59 (4) :542-545. [20]KIYAMA K, KAWABATA D, HOSONO Y, et al.Serum BAFFand APRIL levels in patients with IgG4-related disease and their clinical significance[J].Arthritis Res Ther, 2012, 14 (2) :R86. [21]FURUKAWA S, MORIYAMA M, TANAKA A, et al.Preferential M2 macrophages contribute to fibrosis in IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz's disease[J].Clin Immunol, 2015, 156 (1) :9-18. [22]ZEN Y, FUJII T, HARADA K, et al.Th2 and regulatory immune reactions are increased in immunoglobin G4-related sclerosing pancreatitis and cholangitis[J].Hepatology, 2007, 45 (6) :1538-1546. [23]UMEHARA H, NAKAJIMA A, NAKAMURA T, et al.IgG4-related disease and its pathogenesis-cross-talk between innate and acquired immunity[J].Int Immunol, 2014, 26 (11) :585-595. [24]HEERINGA JJ, KARIM AF, van LAAR J, et al.Expansion of blood IgG4 (+) B, TH2, and regulatory T cells in patients with IgG4-related disease[J].J Allergy Clin Immunol, 2018, 141 (5) :1831-1843. [25]LI YH, XIANG XX.Research advances in immunoglobulin G4-related sclerosing cholangitis[J].J Clin Hepatol, 2017, 33 (11) :2239-2242. (in Chinese) 李雨涵, 向晓星.IgG4相关性硬化性胆管炎的研究现状[J].临床肝胆病杂志, 2017, 33 (11) :2239-2242. [26]DELLA-TORRE E, LANZILLOTTA M, DOGLIONI C.Immunology of IgG4-related disease[J].Clin Exp Immunol, 2015, 181 (2) :191-206. [27]NAKASHIMA H, MIYAKE K, MORIYAMA M, et al.An amplification of IL-10 and TGF-beta in patients with IgG4-related tubulointerstitial nephritis[J].Clin Nephrol, 2010, 73 (5) :385-391. [28]OHTA N, KURAKAMI K, ISHIDA A, et al.Roles of TGF-beta and periostin in fibrosclerosis in patients with IgG4-related diseases[J].Acta Otolaryngol, 2013, 133 (12) :1322-1327. [29]CONWAY SJ, DOETSCHMAN T, AZHAR M.The inter-relationship of periostin, TGF beta, and BMP in heart valve development and valvular heart diseases[J].Scientific World J, 2011, 11:1509-1524. [30]STONE JH, ZEN Y, DESHPANDE V.IgG4-related disease[J].N Engl J Med, 2012, 366 (6) :539-551. [31]UCHIDA K, KUSUDA T, KOYABU M, et al.Regulatory T cells in type 1 autoimmune pancreatitis[J].Int J Rheumatol, 2012, 2012:795026. [32]KUSUDA T, UCHIDA K, MIYOSHI H, et al.Involvement of inducible costimulator-and interleukin 10-positive regulatory Tcells in the development of IgG4-related autoimmune pancreatitis[J].Pancreas, 2011, 40 (7) :1120-1130. [33]MAEHARA T, MATTOO H, MAHAJAN VS, et al.The expansion in lymphoid organs of IL-4 (+) BATF (+) T follicular helper cells is linked to IgG4 class switching in vivo[J].Life Sci Alliance, 2018, 1 (1) :e201800050. [34]GASCAN H, GAUCHAT JF, RONCAROLO MG, et al.Human B cell clones can be induced to proliferate and to switch to IgEand IgG4 synthesis by interleukin 4 and a signal provided by activated CD4+T cell clones[J].J Exp Med, 1991, 173 (3) :747-750. [35]WALLACE ZS, MATTOO H, CARRUTHERS M, et al.Plasmablasts as a biomarker for IgG4-related disease, independent of serum IgG4 concentrations[J].Ann Rheum Dis, 2015, 74 (1) :190-195. [36]AKIYAMA M, YASUOKAH, YAMAOKA K, et al.Enhanced IgG4 production by follicular helper 2 T cells and the involvement of follicular helper 1 T cells in the pathogenesis of IgG4-related disease[J].Arthritis Res Ther, 2016, 18:167. [37]LIN W, ZHANG P, CHEN H, et al.Circulating plasmablasts/plasma cells:A potential biomarker for IgG4-related disease[J].Arthritis Res Ther, 2017, 19 (1) :25. [38]FOX RI, FOX CM.IgG4 levels and plasmablasts as a marker for IgG4-related disease (IgG4-RD) [J].Ann Rheum Dis, 2015, 74 (1) :1-3. [39]MATTOO H, MAHAJAN VS, DELLA-TORRE E, et al.De novo oligoclonal expansions of circulating plasmablasts in active and relapsing IgG4-related disease[J].J Allergy Clin Immunol, 2014, 134 (3) :679-687. [40]MAJUMDER S, MOHAPATRA S, LENNON R J, et al.Rituximab maintenance therapy reduces rate of relapse of pancreaticobiliary immunoglobulin G4-related disease[J].Clin Gastroenterol Hepatol, 2018, 16 (12) :1947-1953. [41]DELLA-TORRE E, FEENEY E, DESHPANDE V, et al.B-cell depletion attenuates serological biomarkers of fibrosis and myofibroblast activation in IgG4-related disease[J].Ann Rheum Dis, 2015, 74 (12) :2236-2243. [42]XIAO X, LIAN M, ZHANG W, et al.The Immunologic paradoxes of IgG4-related disease[J].Clin Rev Allergy Immunol, 2018, 54 (2) :344-351. [43]MASAKI Y, DONG L, KUROSE N, et al.Proposal for a new clinical entity, IgG4-positive multiorgan lymphoproliferative syndrome:Analysis of 64 cases of IgG4-related disorders[J].Ann Rheum Dis, 2009, 68 (8) :1310-1315. [44]TAKEUCHI M, SATO Y, OHNO K, et al.T helper 2 and regulatory T-cell cytokine production by mast cells:A key factor in the pathogenesis of IgG4-related disease[J].Mod Pathol, 2014, 27 (8) :1126-1136. [45]CULVER EL, SADLER R, BATEMAN AC, et al.Increases in IgE, eosinophils, and mast cells can be used in diagnosis and to predict relapse of IgG4-related disease[J].Clin Gastroenterol Hepatol, 2017, 15 (9) :1444-1452. [46]WALLACE ZS, MATTOO H, MAHAJAN VS, et al.Predictors of disease relapse in IgG4-related disease following rituximab[J].Rheumatology (Oxford) , 2016, 55 (6) :1000-1008. [47]JACOBS JF, van der MOLEN RG, KEREN DF.Relatively restricted migration of polyclonal IgG4 may mimic a monoclonal gammopathy in IgG4-related disease[J].Am J Clin Pathol, 2014, 142 (1) :76-81. [48]LIGHAAM LC, RISPENS T.The immunobiology of immunoglobulin G4[J].Semin Liver Dis, 2016, 36 (3) :200-215. [49]TAKEUCHI A, SAITO T.CD4 CTL, a cytotoxic subset of CD4 (+) T Cells, their differentiation and function[J].Front Immunol, 2017, 8:194. [50]LAIDLAW BJ, LU Y, AMEZQUITA RA, et al.Interleukin-10 from CD4 (+) follicular regulatory T cells promotes the germinal center response[J].Sci Immunol, 2017, 2 (16) :eaan4767. [51] MATTOO H, MAHAJAN VS, DELLA-TORRE E, et al.De novo oligoclonal expansions of circulating plasmablasts in active and relapsing IgG4-related disease[J].J Allergy Clin Immunol, 2014, 134 (3) :679-687. [52]MATTOO H, MAHAJAN VS, MAEHARA T, et al.Clonal expansion of CD4 (+) cytotoxic T lymphocytes in patients with IgG4-related disease[J].J Allergy Clin Immunol, 2016, 138 (3) :825-838. [53]MAEHARA T, MATTOO H, OHTA M, et al.Lesional CD4+IFN-gamma+cytotoxic T lymphocytes in IgG4-related dacryoadenitis and sialoadenitis[J].Ann Rheum Dis, 2017, 76 (2) :377-385. [54]MAEHARA T, MORIYAMA M, NAKAMURA S.Pathogenesis of IgG4-related disease:Acritical review[J].Odontology, 2018. [55]KAMEKURA R, TAKAHASHI H, ICHIMIYA S.New insights into IgG4-related disease:emerging new CD4+T-cell subsets[J].Curr Opin Rheumatol, 2019, 31 (1) :9-15. [56]KUBO S, NAKAYAMADA S, ZHAO J, et al.Correlation of Tfollicular helper cells and plasmablasts with the development of organ involvement in patients with IgG4-related disease[J].Rheumatology (Oxford) , 2018, 57 (3) :514-524. [57]CHEN Y, LIN W, YANG H, et al.Aberrant expansion and function of follicular helper T cell subsets in IgG4-related disease[J].Arthritis Rheumatol, 2018, 70 (11) :1853-1865. [58]KAMEKURA R, TAKANO K, YAMAMOTO M, et al.Cutting edge:A critical role of lesional T follicular helper cells in the pathogenesis of IgG4-related disease[J].J Immunol, 2017, 199 (8) :2624-2629. [59]KAMEKURA R, SHIGEHARA K, MIYAJIMA S, et al.Alteration of circulating type 2 follicular helper T cells and regulatory Bcells underlies the comorbid association of allergic rhinitis with bronchial asthma[J].Clin Immunol, 2015, 158 (2) :204-211. [60]AKIYAMA M, SUZUKI K, YAMAOKA K, et al.Number of circulating follicular helper 2 T cells correlates with IgG4 and interleukin-4 levels and plasmablast numbers in IgG4-related disease[J].Arthritis Rheumatol, 2015, 67 (9) :2476-2481. [61]GRAHAM RP, SMYRK TC, CHARI ST, et al.Isolated IgG4-related sclerosing cholangitis:A report of 9 cases[J].Hum Pathol, 2014, 45 (8) :1722-1729. [62]ZEN Y, LIBERAL R, NAKANUMA Y, et al.Possible involvement of CCL1-CCR8 interaction in lymphocytic recruitment in IgG4-related sclerosing cholangitis[J].J Hepatol, 2013, 59 (5) :1059-1064. [63]SELEZNIK GM, REDING T, ROMRIG F, et al.Lymphotoxin beta receptor signaling promotes development of autoimmune pancreatitis[J].Gastroenterology, 2012, 143 (5) :1361-1374.
本文二维码
计量
- 文章访问数: 525
- HTML全文浏览量: 36
- PDF下载量: 224
- 被引次数: 0