Vestibular dysfunction is a clinical syndrome characterized by symptoms such as dizziness or vertigo, abnormal control of eye movements, balance disorders, and autonomic nervous system symptoms. Immune-related vestibular dysfunction is caused by vestibular abnormalities triggered by autoimmune reactions or dysfunctions in the immune system. Some autoimmune diseases can present with vestibular dysfunction as the initial symptom or a typical manifestation. There is still a lack of understanding regarding the immune pathogenic factors of vestibular abnormalities both domestically and internationally. This paper provides a detailed summary of the types, onset, pathological mechanisms, symptoms, signs, and auxiliary examinations of immune-related vestibular dysfunction, aiming to offer new insights for the identification of such diseases.
ObjectivePulmonary infection is commonly seen in patients with rheumatic autoimmune disease (RAD).Sometimes bronchoscopy is used to obtain microorganisms.In order to improve diagnostic yield, the factors affecting diagnostic yield of bronchoscopy in obtaining microorganisms in RAD patients with pulmonary abnormality were analyzed retrospectively. MethodsA retrospective study was performed in RAD patients with lung infiltrates who received bronchoscopy for obtaining microorganisms at the Department of Rheumatology,Peking Union Medical College Hospital from January 2009 to June 2013.Patients characteristics,clinical symptoms,medication history,laboratory parameters,radiographic findings and locations where microorganisms were obtained were recorded. Results87 patients received 91 bronchoscopic exams,including 72 bronchoalveolar lavages,21 bronchial aspirates,and 72 bronchial brushes.The total diagnostic yield was 52.7%.The diagnostic yield was 71.4% with bronchoalveolar lavage,38.9% with bronchial aspirate,and 18.1% with bronchial brush.Diagnostic yield was significantly higher in the patients with clinical symptoms of fever,cough or expectoration compared with the patients without either symptoms (60.0%% vs.34.6%,P=0.028).The patients with CT finding of nodular,massive or consolidation had a higher diagnostic yield compared with those with CT findings of reticular,linear or ground glass opacity (61.8% vs.26.1%,P=0.003).Diagnostic yield was not affected by location of bronchoalveolar lavage (P=0.691). ConclusionRAD patients with fever,cough or sputum,and CT findings of nodular,massive or consolidation would get a higher diagnostic yield by bronchoscopy.
Neuromyelitis optica spectrum disorders (NMOSDs) are a class of immune-mediated inflammatory demyelinating diseases of the central nervous system that mainly involve the optic nerve and spinal cord. As an important environmental factor, the gut microbiota may play an important role in the occurrence and development of NMOSDs. Previous studies have shown that the structure and number of intestinal flora in NMOSDs patients are different from those of normal healthy people. The altered intestinal flora may cross-react with central nervous system autoantigens, induce T cell differentiation, and affect short-chain fatty acids, etc. The metabolite secretion pathway triggers the occurrence of NMOSDs. The summary of the changes of gut microbiota in patients with NMOSDs and the possible underlying mechanisms by summarizing the literature, aim to provide more effective treatments for the prevention and treatment of NMOSDs in the future.
Immunoadsorption with Staphylococcus protein A column is a blood purification therapy that eliminates pathogenic antibodies on the principle that Staphylococcus protein A can specifically bind to human immunoglobin G efficiently. At present, it has been safely applied to a variety of autoimmune diseases and organ transplantation rejection and other fields. It has been reported to have efficacy for a variety of immune diseases, comparable to traditional plasma exchange. This article provides a review of the application progress of this technology in different systemic diseases, providing a reference for selecting blood purification treatment modes for clinical treatment of related diseases.
Objective To explore the association between plasma proteins and the risk of Addison’s disease using the Mendelian randomization (MR) method. Methods Plasma protein quantitative trait loci data from the deCODE cohort, along with genome-wide association study summary statistics for Addison’s disease comprising 1 223 cases and 4 097 controls from Sweden and Norway, were analyzed in a two-sample two-way MR framework. The primary causal inference was performed using inverse variance weighting, with MR-Egger regression, weighted median, and maximum likelihood methods employed as sensitivity analyses to assess the robustness of the findings. To mitigate reverse causality, MR analysis was conducted with Addison’s disease as the exposure factor and plasma proteins as the outcome variables. Results A total of 105 plasma protein closely associated with Addison’s disease were included in the forward study. Among them, sialic acid binding Ig like lectin 5, poly ADP-ribose polymerase, ectonucleotide pyrophosphatase/phosphodiesterase family member 5, butyrophilin subfamily 3 member A3, collagen type Ⅺ alpha 2 chain (COL11A2) and calsyntenin-1 still exhibited certain associations after multiple corrections (P<0.05). In the reverse study, only COL11A2 closely associated with Addison’s disease [odds ratio=0.98, 95% confidence interval (0.96, 1.00), P=0.026]. Conclusions This research discovers that sialic acid binding Ig like lectin 5, poly ADP-ribose polymerase, and ectonucleotide pyrophosphatase/phosphodiesterase family member 5 significantly enhance the risk of Addison’s disease, whereas butyrophilin subfamily 3 member A3, COL11A2, and calsyntenin-1 decrease the risk of Addison’s disease. Moreover, there is a potential reverse causal relationship between Addison’s disease and COL11A2.