儿童风湿病的血管内皮功能障碍：系统回顾和荟萃分析。

IF 3.9 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2025-06-01 Epub Date: 2025-05-31 DOI:10.1080/1744666X.2025.2510490

Marieta P Theodorakopoulou, Vasiliki Sgouropoulou, Fotini Iatridi, Artemios G Karagiannidis, Antonios Karpetas, Erasmia Sampani, Panagiota Anyfanti, Theodoros Dimitroulas, Pantelis Sarafidis

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引用次数: 0

摘要

目的：内皮功能障碍与自身免疫性疾病患者心血管风险增加相关。这是一项系统的综述和荟萃分析，用功能方法评估内皮功能，以检查风湿性疾病儿童内皮与对照组的差异。方法：检索PubMed和Scopus数据库自成立至2024年2月的文献，手工检索文献参考文献。通过所有可用的功能方法评估内皮功能的研究都是合格的。通过纽卡斯尔-渥太华量表评估研究质量。结果：24项研究（880例风湿病患儿，784例对照）纳入meta分析。在汇总分析中，与对照组相比，在儿童风湿病患者中观察到明显的内皮功能障碍（SMD: -0.74, 95%CI -1.10至-0.39），但异质性较高（I2 = 91%, p）。结论：儿童风湿病患者内皮功能受损。需要进一步的研究来阐明血管内皮功能障碍是否与风湿性疾病儿童的高心血管风险有关。普洛斯彼罗注册号：CRD42023413799。

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Vascular endothelial dysfunction in pediatric rheumatic diseases: a systematic review and meta-analysis.

Objectives: Endothelial dysfunction is associated with increased cardiovascular risk in individuals with autoimmune diseases. This systematic review and meta-analysis included studies assessing endothelial function with functional methods in children with rheumatic diseases versus controls.

Methods: Literature search involved PubMed and Scopus databases (from inception to February 2024) and manual reference screening. Studies assessing endothelial function by all available functional methods were eligible. Study quality was evaluated via Newcastle-Ottawa scale.

Results: Twenty-four studies (880 children with rheumatic diseases, 784 controls) were included in meta-analysis. Pooled analysis showed significantly impaired endothelial function in patients versus controls (SMD: -0.74, 95%CI -1.10 to -0.39) but with high heterogeneity (I² = 91%, p < 0.001); sensitivity analysis including only high-quality studies confirmed this finding (SMD: -0.83, 95%CI -1.20 to -0.46). In subgroup analyses according to type of rheumatic disease, significantly impaired endothelial function was showed for patients with juvenile idiopathic arthritis (SMD: -1.05, 95%CI -1.84 to -0.25), vasculitis (SMD: -0.74, 95%CI -1.11 to -0.37) and juvenile systemic sclerosis (SMD -2.48, 95%CI -4.34 to -0.61).

Conclusions: Children with rheumatic diseases show impaired endothelial function. Future studies are needed to elucidate whether endothelial dysfunction is involved in high cardiovascular risk of these patients.

Prospero registration number: CRD42023413799.

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.