切换至 "中华医学电子期刊资源库"

中华口腔医学研究杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 322 -327. doi: 10.3877/cma.j.issn.1674-1366.2022.05.010

综述

IgG4相关口腔疾病的研究进展
王妮妮1, 周佳佳1, 张尽美2, 吴亚菲2, 杨靖梅2,()   
  1. 1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心,成都 610041
    2. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心,成都 610041;四川大学华西口腔医院牙周病科,成都 610041
  • 收稿日期:2022-05-16 出版日期:2022-10-01
  • 通信作者: 杨靖梅

Research progress on IgG4-related oral disease

Nini Wang1, Jiajia Zhou1, Jinmei Zhang2, Yafei Wu2, Jingmei Yang2,()   

  1. 1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
    2. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China; Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-05-16 Published:2022-10-01
  • Corresponding author: Jingmei Yang
  • Supported by:
    Science and Technology Planning Project of Sichuan Province(2022NSFSC1521); The Research and Development Foundation of West China Hospital of Stomatology, Sichuan University(RD-02-201905)
引用本文:

王妮妮, 周佳佳, 张尽美, 吴亚菲, 杨靖梅. IgG4相关口腔疾病的研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2022, 16(05): 322-327.

Nini Wang, Jiajia Zhou, Jinmei Zhang, Yafei Wu, Jingmei Yang. Research progress on IgG4-related oral disease[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2022, 16(05): 322-327.

IgG4相关性疾病(IgG4-RD)是一种非特异性慢性纤维炎症性疾病,累及全身多个器官和系统,需要结合临床表现、血清学检查和组织病理学等诊断。IgG4-RD发病率低,2018年被纳入我国第一批罕见病名录。目前,口腔相关IgG4-RD包括米库利兹病(MD)、Küttner肿瘤等,可累及硬腭、牙龈等黏膜组织。本文就IgG4-RD可能的发病机制、临床特征、诊断标准、治疗及其在口腔相关表现作一综述,以期为临床工作提供帮助。

IgG4-related disease (IgG4-RD) is a non-specific chronic fibroinflammatory disease involving multiple organs and systems, which requires a combination of clinical manifestations, serological examination, and histopathology for diagnosis. IgG4-RD has a low incidence so that it was included in the first batch of rare diseases in China in 2018. At present, oral related IgG4-RD mainly includes Mikulicz′s disease (MD) , Küttner tumor, et al., and it can also involve hard palate, gingiva and other mucosal tissues. This article reviewed the possible pathogenesis, clinical features, diagnostic criteria, treatment and oral related manifestations of IgG4-RD in order to provide clinical guidance.

图1 日本医学会IgG4-RD综合诊断标准(2017年)[22]
表1 IgG4相关性疾病诊治中国专家共识推荐意见[24]
序号 推荐意见 证据级别
1 建议由风湿免疫科主导,多学科联合共同完成1gG4-RD的诊断、评估、治疗和随访  
2 建议依据2011年日本制定的1gG4-RD综合诊断标准及2019年美国风湿病学会(ACR)/欧洲抗风湿病联盟(EULAR)制定的IgG4-RD分类标准进行诊断  
3 血清1gG4升高是IgG4-RD诊断和病情评估的重要指标,但其诊断的特异性不高  
4 影像学检查对1gG4-RD受累器官的诊断和评估有重要的辅助作用,应根据患者受累部位选择适当的检查方法  
5 特征性的病理改变是诊断IgG4-D的重要依据,病理检查对鉴别诊断排除模拟疾病亦至关重要,因此建议有条件者应行组织活检  
6 确诊IgG4-RD的患者应行疾病活动度和严重性的评估  
7 有症状目病情活动的IgG4-RD患者应接受治疗,无症状但重要脏器受累并进展的患者亦需及时治疗  
8 糖皮质激素是治疗IgG4-RD的一线药物 同质队列研究的系统评价
9 免疫抑制剂与糖皮质激素联合使用较单用糖皮质激素更有效控制疾病,减少IgG4-RD患者的复发 单个队列研究(包括低质量随机对照试验,如随访率<80%)
10 难治性或复发性IgG4-RD可选用生物制剂 单个队列研究(包括低质量随机对照试验,如随访率<80%)
11 IgG4-RD复发者的治疗方案需根据患者复发器官、既往用药等情况重新制定 基于经验未经严格论证的专家建议
12 IgG4-RD特殊情况时手术治疗是可选择的治疗方法之一 病例系列研究(包括低质量队列和病例对照研究)
[1]
Ishikawa YTerao C. Genetic analysis of IgG4-related disease[J]. Mod Rheumatol202030(1):17-23. DOI:10.1080/14397595.2019.1621000.
[2]
Kawa SOta MYoshizawa K,et al. HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population[J]. Gastroenterology2002122(5):1264-1269. DOI:10.1053/gast.2002.33022.
[3]
Culver ELHurst JMCargill T,et al. Human leucocyte antigen associations in IgG4-related disease and primary sclerosing cholangitis stratified by IgG4 levels,in a Multicenter UK Cohort[J]. J Hepatology201664(2):S646. DOI:10.1016/s0168-8278(16)01205-8.
[4]
Mattoo HMahajan VSDella-Torre E,et al. De novo oligoclonal expansions of circulating plasmablasts in active and relapsing IgG4-related disease[J]. J Allergy Clin Immunol2014134(3):679-687. DOI:10.1016/j.jaci.2014.03.034.
[5]
Lanzillotta MMancuso GDella-Torre E. Advances in the diagnosis and management of IgG4 related disease[J]. BMJ2020369:m1067. DOI:10.1136/bmj.m1067.
[6]
Michailidou DSchwartz DMMustelin T,et al. Allergic aspects of IgG4-related disease:Implications for pathogenesis and therapy[J]. Front Immunol202112:693192. DOI:10.3389/fimmu.2021.693192.
[7]
Kubo SNakayamada SZhao J,et al. Correlation of T follicular helper cells and plasmablasts with the development of organ involvement in patients with IgG4-related disease[J]. Rheumatology(Oxford)201857(3):514-524. DOI:10.1093/rheumatology/kex455.
[8]
Maehara TMattoo HOhta M,et al. Lesional CD4+ IFN-γ+ cytotoxic T lymphocytes in IgG4-related dacryoadenitis and sialoadenitis[J]. Ann Rheum Dis201776(2):377-385. DOI:10.1136/annrheumdis-2016-209139.
[9]
Yoshikawa TWatanabe TMinaga K,et al. Cytokines produced by innate immune cells in IgG4-related disease[J]. Mod Rheumatol201929(2):219-225. DOI:10.1080/14397595.2018.1536364.
[10]
Umehara HOkazaki KKawano M,et al. The front line of research into immunoglobin G4-related disease - Do autoantibodies cause immunoglobin G4-related disease?[J]. Mod Rheumatol201929(2):214-218. DOI:10.1080/14397595.2018.1558519.
[11]
Du HShi LChen P,et al. Prohibitin is involved in patients with IgG4 related disease[J]. PloS One201510(5):e0125331. DOI:10.1371/journal.pone.0125331.
[12]
Hubers LMVos HSchuurman AR,et al. Annexin A11 is targeted by IgG4 and IgG1 autoantibodies in IgG4-related disease[J]. Gut201867(4):728-735. DOI:10.1136/gutjnl-2017-314548.
[13]
Kountouras JZavos CChatzopoulos D. A concept on the role of Helicobacter pylori infection in autoimmune pancreatitis[J]. J Cell Mol Med20059(1):196-207. DOI:10.1111/j.1582-4934.2005.tb00349.x.
[14]
Frulloni LLunardi CSimone R,et al. Identification of a novel antibody associated with autoimmune pancreatitis[J]. N Engl J Med2009361(22):2135-2142. DOI:10.1056/NEJMoa0903068.
[15]
Onishi YNakahara YHirano K,et al. IgG4-related disease in asbestos-related pleural disease[J]. Respirol Case Rep20154(1):22-24. DOI:10.1002/rcr2.142.
[16]
Otsuki TMaeda MMurakami S,et al. Immunological effects of silica and asbestos[J]. Cell Mol Immunol20074(4):261-268.
[17]
Wallace ZSZhang YPerugino CA,et al. Clinical phenotypes of IgG4-related disease:An analysis of two international cross-sectional cohorts[J]. Ann Rheum Dis201978(3):406-412. DOI:10.1136/annrheumdis-2018-214603.
[18]
Carballo IGonzalez-Quintela ASopena B,et al. Immunoglobulin G4-related disease:What an allergist should know[J]. J Investig Allergol Clin Immunol202131(3):212-227. DOI:10.18176/jiaci.0633.
[19]
Berti ADella-Torre EGallivanone F,et al. Quantitative measurement of 18F-FDG PET/CT uptake reflects the expansion of circulating plasmablasts in IgG4-related disease[J]. Rheumatology (Oxford)201756(12):2084-2092. DOI:10.1093/rheumatology/kex234.
[20]
Umehara HOkazaki KMasaki Y,et al. Comprehensive diagnostic criteria for IgG4-related disease(IgG4-RD),2011[J]. Mod Rheumatol201222(1):21-30. DOI:10.1007/s10165-011-0571-z.
[21]
Varghese JLFung AWSMattman A,et al. Clinical utility of serum IgG4 measurement[J]. Clin Chim Acta2020506:228-235. DOI:10.1016/j.cca.2020.04.001.
[22]
Umehara HOkazaki KKawano M,et al. How to diagnose IgG4-related disease[J]. Annals of the rheumatic diseases201776(11):e46. DOI:10.1136/annrheumdis-2017-211330.
[23]
Wallace ZSNaden RPChari S,et al. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease[J]. Ann Rheum Dis202079(1):77-87. DOI:10.1136/annrheumdis-2019-216561.
[24]
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202160(3):192-206. DOI:10.3760/cma.j.cn112138-20200803-00726.
[25]
Yamamoto MHarada SOhara M,et al. Clinical and pathological differences between Mikulicz′s disease and Sjögren′s syndrome[J]. Rheumatology(Oxford)200544(2):227-234. DOI:10.1093/rheumatology/keh447.
[26]
Kamiński BBłochowiak K. Mikulicz′s disease and Küttner′s tumor as manifestations of IgG4-related diseases:A review of the literature[J]. Reumatologia202058(4):243-250. DOI:10.5114/reum.2020.98437.
[27]
Kamiński B. Mikulicz′s disease and Sjögren′s syndrome as the main autoimmune disorders involving salivary glands[J]. Medical Studies/Studia Medyczne202036(3):211-218. DOI:10.5114/ms.2020.99545.
[28]
Baba DSotome KMaeda I,et al. A case report of Kuttner tumor mimicking a malignant tumor,leading to overtreatment[J]. Clin Case Rep20219(5):e04120. DOI:10.1002/ccr3.4120.
[29]
Khurram SAFernando MSmith AT,et al. IgG4-related sclerosing disease clinically mimicking oral squamous cell carcinoma[J]. Oral Surg Oral Med Oral Pathol Oral Radiol2013115(2):e48-e51. DOI:10.1016/j.oooo.2012.04.011.
[30]
Gontarz MWyszyńska-Pawelec GZapała J,et al. IgG4-related disease in the head and neck region:Report of two cases and review of the literature[J]. Pol J Pathol201667(4):370-375. DOI:10.5114/pjp.2016.65871.
[31]
Bukhari AMagnuson BLerman MA. IgG4-related disease mimicking extranodal lymphoma of the hard palatal mucosa:A case report and review of the literature[J]. Oral Surg Oral Med Oral Pathol Oral Radiol2018126(4):e198. DOI:10.1016/j.oooo.2018.05.022.
[32]
Al-Mujaini AAl-Khabori MShenoy K,et al. Immunoglobulin G4-related disease:An update[J]. Oman Med J201833(2):97-103. DOI:10.5001/omj.2018.20.
[33]
Khosroshahi AWallace ZSCrowe JL,et al. International consensus guidance statement on the management and treatment of IgG4-related disease[J]. Arthritis Rheumatol201567(7):1688-1699. DOI:10.1002/art.39132.
[34]
Iguchi TTakaori KMii A,et al. Glucocorticoid receptor expression in resident and hematopoietic cells in IgG4-related disease[J]. Mod Pathol201831(6):890-899. DOI:10.1038/s41379-018-0036-4.
[35]
Wu QChang JChen H,et al. Efficacy between high and medium doses of glucocorticoid therapy in remission induction of IgG4-related diseases:A preliminary randomized controlled trial[J]. Int J Rheum Dis201720(5):639-646. DOI:10.1111/1756-185X.13088.
[36]
Zhao ZHua ZLuo X,et al. Application and pharmacological mechanism of methotrexate in rheumatoid arthritis[J]. Biomed Pharmacother2022150:113074. DOI:10.1016/j.biopha.2022.113074.
[37]
Yunyun FYu CPanpan Z,et al. Efficacy of cyclophosphamide treatment for immunoglobulin G4-related disease with addition of glucocorticoids[J]. Sci Rep20177(1):6195. DOI:10.1038/s41598-017-06520-5.
[38]
Yunyun FYu PPanpan Z,et al. Efficacy and safety of low dose mycophenolate mofetil treatment for immunoglobulin G4-related disease:A randomized clinical trial[J]. Rheumatology (Oxford)201958(1):52-60. DOI:10.1093/rheumatology/key227.
[39]
Carruthers MNTopazian MDKhosroshahi A,et al. Rituximab for IgG4-related disease:A prospective,open-label trial[J]. Ann Rheum Dis201574(6):1171-1177. DOI:10.1136/annrheumdis-2014-206605.
[40]
Omar DChen YCong Y,et al. Glucocorticoids and steroid sparing medications monotherapies or in combination for IgG4-RD:A systematic review and network meta-analysis[J]. Rheumatology(Oxford)202059(4):718-726. DOI:10.1093/rheumatology/kez380.
[41]
张琪,南欣荣,闫星泉,等. IgG4相关疾病21例临床分析[J].口腔疾病防治202230(4):258-265. DOI:10.12016/j.issn.2096-1456.2022.04.005.
[42]
史雨林,郭威孝,商洪涛,等. IgG4相关性疾病1例并文献复习[J].实用口腔医学杂志201834(3):421-423. DOI:10.3969/j.issn.1001-3733.2018.03.032.
[1] 张焱, 刘春媚, 姚瑾, 陈苗苗, 徐雯, 黄品同. 超声O-RADS分类和临床特征对不同病理类型卵巢浆液性肿瘤的诊断价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(03): 268-274.
[2] 顾盼盼, 董传莉, 宋梦瑶, 瞿色华, 杨小迪, 周瑞. 不完全性川崎病患儿临床特征及冠状动脉损害情况分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 446-451.
[3] 张学. 说基因话疾病[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(03): 366-.
[4] 丁科, 张亚琼, 刘杰, 邓莉平, 张永喜, 熊勇. 获得性免疫缺陷综合征相关淋巴瘤患者的临床特征及生存状况的变化趋势[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 278-284.
[5] 曹琮沅, 黄烁金, 何倩婷, 王安训. 平阳霉素复合剂治疗口腔颌面部脉管畸形的有效性和安全性[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 368-374.
[6] 张超, 张珍, 马梁, 穆欢欢, 刘彩玲. 腹腔镜胰十二指肠切除术术后C级胰瘘患者临床特征及影响因素研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 675-678.
[7] 颜晓敏, 崔嵘嵘. 23例乳腺佩吉特病的经验交流[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 353-354.
[8] 王华, 曹素娥, 吴建杰, 狄金明. 膀胱炎性肌纤维母细胞瘤四例诊治报告并文献复习[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 547-552.
[9] 杨柳, 陈佳, 孙雅娟, 陈娇, 谭明超, 龚明福. 抗中性粒细胞胞浆抗体相关性血管炎的胸部CT 及临床特征分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 744-749.
[10] 杨攀, 黄晓寒, 邓才霞, 周利航, 周向东, 罗虎. SMARCA4缺失的胸部未分化肿瘤临床特征及预后分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 529-534.
[11] 何俊, 易淑华, 陈婷婷, 杨玉, 李红雨, 谢飞, 何健. 妊娠并发社区获得性肺炎临床特征及降钙素原和炎症指数对其诊断意义[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 421-425.
[12] 刘郁, 段绍斌, 丁志翔, 史志涛. miR-34a-5p 在结肠癌患者的表达及其与临床特征及预后的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 485-490.
[13] 惠泉, 孙方昱, 赵欣, 许青, 李奕, 陈建雄, 吴立, 郑伟燕. 急性间歇性卟啉病HMBS基因新发缺失突变一例[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 507-511.
[14] 刘昌恩, 李岩, 张其德. 基于内镜筛查发现的自身免疫性胃炎的临床特征分析[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(04): 233-237.
[15] 王宇, 张泽锴, 吴明胜, 王高祥, 孙效辉, 王君, 徐美青, 李田, 徐世斌, 解明然. 术后病理诊断为良性肺结节323例患者临床特征分析[J/OL]. 中华胸部外科电子杂志, 2024, 11(03): 167-174.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?