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Front Mol Biosci:寻常型银屑病的个性化干预:用代谢组学方法对患者进行分子分型

2022-08-17 医路坦克 MedSci原创

寻常型银屑病(PV)是一种复杂的自身免疫性疾病,我们利用血清代谢组学对PV根据脂代谢改变进行亚型的分子证据进行了探索,并验证这种亚型是否可能有助于个性化治疗的发展。

寻常型银屑病(PV)是一种复杂的自身免疫性疾病,以皮肤红斑为特征,缺乏有效的治疗方法。PV与代谢综合征和心血管疾病的风险增加有关,这两者都是由全身炎症和异常代谢之间的相互作用所介导的。然而,不同严重程度的PV在脂代谢方面是否存在差异仍不清楚。因此,我们利用血清代谢组学对PV根据脂代谢改变进行亚型的分子证据进行了探索,并验证这种亚型是否可能有助于个性化治疗的发展。

从2019年1月至2019年11月,皮肤科诊所招募了PV患者,并根据是否存在代谢合并症及其银屑病面积和严重程度指数(PASI)对患者进行了分类。我们对血清样本进行了有针对性的代谢组学分析,并确定了代谢物成分与PASI评分之间的相关性。

本研究共123名受试者,88名PV患者和35名健康受试者。将PV患者分为“PVM组”(合并代谢合并症的PV)和“PV组”(无代谢合并症的PV),并进一步分为“轻度PV”(MP,PASI<10)和“重度PV”(SP,PASI≥10)组。与匹配的健康对照组相比,MP亚组的27种代谢物和SP亚组的28种代谢物的水平发生了变化。在MP亚组中,SM(D16:0/17:1)和SM(D19:1/20:0)与PASI呈正相关,而在SP亚组中,Cer(D18:1/18:0)、PC(18:0/22:4)和PC(20:0/22:4)与PASI呈正相关。PVM组17种代谢物水平明显高于PV组,尤其是神经酰胺和磷脂酰胆碱。相关分析表明,Cer(D18:1/18:0)和SM(D16:1/16:1)不仅与PASI相关,而且与生化指标呈显著正相关。

火山图说明了不同的代谢物。(A)MP和HC-MP亚组之间差异代谢物的火山图。(B)SP和HC-SP亚组之间差异代谢物的火山图。(C)MP和SP亚组之间差异代谢物的火山图。(D)PVM组和PV组之间的差异代谢物的火山图。HC-MP,寻常型银屑病轻度组;HC-SP,寻常型银屑病重度组;MP,寻常型银屑病轻度组;SP,重度寻常型银屑病;PV,寻常型银屑病无代谢性疾病组;PVM,寻常型银屑病伴代谢性疾病组。

热图显示了斯皮尔曼改变的代谢物之间的相互关系。(A)MP亚组中改变的代谢物(MP与HC-MP)的相关热图。(B)SP亚组中改变的代谢物(SP与HC-SP)的相关热图。(C)MP亚组中改变代谢物(MP与SP)的相关热图。(D)SP亚组中改变的代谢物(MP与SP)的相关热图。(E)PVM组中改变的代谢物(PVM与PV)的相关热图。用Spearman相关系数进行相关分析,*p<0.001,**p<0.01,*p<0.001。HC-MP,寻常型银屑病轻度组;HC-SP,寻常型银屑病重度组;MP,寻常型银屑病轻度组;SP,重度寻常型银屑病;PV,寻常型银屑病无代谢性疾病组;PVM,寻常型银屑病伴代谢性疾病组。

Spearman的代谢物改变与PASI的相关性。(A)PASI与MP亚组改变代谢产物(MP与HC-MP)的相关分析:SM(D16:1/17:0):r=0.37,p=0.041;SM(D19:1/20:0):r=0.39,p=0.032。(B)PASI与改变的代谢物(SP)vs PC(18:0/22:4):r=0.45,p=0.015;PC(20:0/22:4):r=0.39,p=0.029。PASI,银屑病面积和严重程度指数;HC-MP,健康对照组与轻度寻常型银屑病组匹配;HC-SP,健康对照组与重度寻常型银屑病组匹配;MP,轻度寻常型银屑病;SP,重度寻常型银屑病组。

这项研究的结果表明,不同严重程度的PV患者具有不同的代谢特征,代谢紊乱使疾病的发展复杂化。这些发现将有助于我们了解PV的病理进展,并为PV的精确治疗制定策略。

文献来源:Dai D,  He C,  Wang S, Toward Personalized Interventions for Psoriasis Vulgaris: Molecular Subtyping of Patients by Using a Metabolomics Approach.Front Mol Biosci 2022;9

 

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    2022-10-16 sunylz
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    2022-08-31 cenghis
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