首页|免疫细胞与脓毒症的因果关联:一项基于孟德尔随机化方法的研究

免疫细胞与脓毒症的因果关联:一项基于孟德尔随机化方法的研究

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目的 利用孟德尔随机化(MR)方法,探讨免疫细胞与不同脓毒症亚型之间的因果关联,得出对脓毒症具有单向因果关联的免疫细胞表型。方法 从GWAS catalog数据库中获得各种循环免疫细胞表型的汇总数据(GCST90001391~GCST90002121);从英国生物样本库中获取脓毒症数据。以单核苷酸多态性位点(SNP)作为工具变量,采用P<5×10-6的相关阈值来识别强相关工具变量,并利用代码去除连锁不平衡及F值<10的工具变量。采用逆方差加权法(IVW),用Cochran's Q检验、MR-Egger回归、留一法等评价研究结果的稳定性和可靠性。根据去除水平多效性的免疫表型结果行逆向MR分析,得到具有单向因果关联的免疫细胞表型,利用优势比(OR)和95%可信区间(95%CI)表示结果的效应值。结果 CD16on CD14-CD16+monocyte对脓毒症具有水平多效性(OR=0。965 4,95%CI为0。933 5~0。998 3,P=0。039 6),有5种免疫表型与脓毒症相关亚型有反向因果关联。排除具有水平多效性及反向因果关联的免疫细胞表型后,共42种免疫细胞表型与脓毒症、36种免疫细胞表型与重症监护病房(ICU)28 d死亡脓毒症、32种免疫细胞表型与ICU脓毒症、44种免疫细胞表型与28 d死亡脓毒症、30种免疫细胞表型与75岁以下脓毒症具有潜在因果关联。经错误发现率(FDR)校正后,仅BAFF-R on IgD-CD38br与脓毒症28 d病死率呈负相关,且为强相关(OR=0。737 8,95%CI为0。635 9~0。856 0,P=6。05 × 10-5,PFDR=0。044 2)。结论 多种免疫细胞表型可能对脓毒症具有保护作用,尤其是BAFF-R on IgD-CD38br的表达与脓毒症28 d病死率呈负相关,这为脓毒症免疫调理治疗提供了新思路。
Causal association between immune cells and sepsis:a based on Mendelian randomization method study
Objective To investigate the causal association between immune cell and different types of sepsis by using Mendelian randomization(MR)method,and to find the immune cell phenotypes causally associated with sepsis.Methods Summary data for various circulating immune cell phenotypes were obtained from the GW AS catalog(GCST90001391-GCST90002121).Sepsis data were sourced from the UK Biobank database.Single nucleotide polymorphisms(SNP)were used as instrumental variables.The correlation threshold of P<5×10-6 was used to identify the strongly correlated instrumental variables,and the code was used to remove the linkage disequilibrium and the instrumental variables with F-value<10.Inverse variance weighting(IVW)was used as the main research method to evaluate the stability and reliability of the results,including Cochran's Q test,MR-Egger regression and Leave one out.Reverse MR analysis was performed based on the immunophenotypic results of the removal of horizontal pleiotropy,and the immune cell phenotype with one-way causal association was obtained.Odds ratio(OR)and 95%confidence interval(95%CI)were used to represent the effect value of the results.Results CD 16 on CD 14-CD16+monocyte had horizontal pleiotropy in sepsis(OR=0.965 4,95%CI was 0.933 5-0.998 3,P=0.039 6).There were five immunophenotypes that had reverse causal associations with the types associated with sepsis.After excluding immune cell phenotypes with horizontal pleiotropy and reverse causation,a total of 42 immune cell phenotypes with sepsis,36 immune cell phenotypes with sepsis(28-day death in critical care),32 immune cell phenotypes with sepsis(critical care),44 immune cell phenotypes with sepsis(28-day death),and 30 immune cell phenotypes had potential causal associations with sepsis(under 75 years old).After false discovery rate(FDR)correction,the correlations between BAFF-R on IgD-CD38br and sepsis(28-day death)were negative and strong(OR=0.737 8,95%CI was 0.635 9-0.856 0,P=6.05 × 10-5,PFDR=0.044 2).Conclusion A variety of immune cell phenotypes may have a protective effect on sepsis,especially BAFF-R on IgD-CD38br expression is negatively correlated with sepsis(28-day death),which provides a new idea for immune modulation therapy in sepsis.

Immune cellSepsisMendelian randomizationGenome-wide association study

于秋霜、李凌勖、陶怡娜、张龙强、胡俊锋、汪华学

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蚌埠医科大学第一附属医院重症医学科,安徽蚌埠 233004

蚌埠医科大学第一附属医院呼吸内科,安徽蚌埠 233004

免疫细胞 脓毒症 孟德尔随机化 全基因组关联研究

安徽省临床医学研究转化专项项目

202304295107020073

2024

中华危重病急救医学
中华医学会

中华危重病急救医学

CSTPCD北大核心
影响因子:3.049
ISSN:2095-4352
年,卷(期):2024.36(8)