Clinical correlates of lifetime and current comorbidity patterns in autoimmune and inflammatory diseases.

Autoimmunity Classification Clustering Comorbidity Epidemiology Inflammation

Journal

Journal of autoimmunity
ISSN: 1095-9157
Titre abrégé: J Autoimmun
Pays: England
ID NLM: 8812164

Informations de publication

Date de publication:
01 Oct 2024
Historique:
received: 23 02 2024
revised: 11 09 2024
accepted: 13 09 2024
medline: 3 10 2024
pubmed: 3 10 2024
entrez: 2 10 2024
Statut: aheadofprint

Résumé

Autoimmune and inflammatory diseases (AIDs) are a heterogeneous group of disorders with diverse etiopathogenic mechanisms. This study explores the potential utility of family history, together with present and past comorbidities, in identifying distinct etiopathogenic subgroups. This approach may facilitate more accurate diagnosis, prognosis and personalized therapy. We performed a multiple correspondence analysis on patients' comorbidities, followed by hierarchical principal component clustering of clinical data from 48 healthy volunteers and 327 patients with at least one of 19 selected AIDs included in the TRANSIMMUNOM cross-sectional study. We identified three distinct clusters characterized by: 1) the absence of comorbidities, 2) polyautoimmunity, and 3) polyinflammation. These clusters were further distinguished by specific comorbidities and biological parameters. Autoantibodies, allergies, and viral infections characterized the polyautoimmunity cluster, while older age, BMI, depression, cancer, hypertension, periodontal disease, and dyslipidemia characterized the polyinflammation cluster. Rheumatoid arthritis patients were distributed across all three clusters. They had higher DAS28 and prevalence of extra-articular manifestations when belonging to the polyinflammation and polyautoimmunity clusters, and also lower ACPA and RF seropositivity and higher pain scores within the polyinflammation cluster. We developed a model allowing to classify AID patients into comorbidity clusters. In this study, we have uncovered three distinct comorbidity profiles among AID patients. These profiles suggest the presence of distinct etiopathogenic mechanisms underlying these subgroups. Validation, longitudinal stability assessment, and exploration of their impact on therapy efficacy are needed for a comprehensive understanding of their potential role in personalized medicine.

Sections du résumé

BACKGROUND BACKGROUND
Autoimmune and inflammatory diseases (AIDs) are a heterogeneous group of disorders with diverse etiopathogenic mechanisms. This study explores the potential utility of family history, together with present and past comorbidities, in identifying distinct etiopathogenic subgroups. This approach may facilitate more accurate diagnosis, prognosis and personalized therapy.
METHODS METHODS
We performed a multiple correspondence analysis on patients' comorbidities, followed by hierarchical principal component clustering of clinical data from 48 healthy volunteers and 327 patients with at least one of 19 selected AIDs included in the TRANSIMMUNOM cross-sectional study.
RESULTS RESULTS
We identified three distinct clusters characterized by: 1) the absence of comorbidities, 2) polyautoimmunity, and 3) polyinflammation. These clusters were further distinguished by specific comorbidities and biological parameters. Autoantibodies, allergies, and viral infections characterized the polyautoimmunity cluster, while older age, BMI, depression, cancer, hypertension, periodontal disease, and dyslipidemia characterized the polyinflammation cluster. Rheumatoid arthritis patients were distributed across all three clusters. They had higher DAS28 and prevalence of extra-articular manifestations when belonging to the polyinflammation and polyautoimmunity clusters, and also lower ACPA and RF seropositivity and higher pain scores within the polyinflammation cluster. We developed a model allowing to classify AID patients into comorbidity clusters.
CONCLUSIONS CONCLUSIONS
In this study, we have uncovered three distinct comorbidity profiles among AID patients. These profiles suggest the presence of distinct etiopathogenic mechanisms underlying these subgroups. Validation, longitudinal stability assessment, and exploration of their impact on therapy efficacy are needed for a comprehensive understanding of their potential role in personalized medicine.

Identifiants

DOI: 10.1016/j.jaut.2024.103318 PMID: 39357469
pubmed: 39357469
pii: S0896-8411(24)00152-5
doi: 10.1016/j.jaut.2024.103318
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103318

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest JS declares honoraria from Roche, Chugai, Pfizer, BMS, MSD, AbbVie, Sandoz, Hospira, Janssen, Novartis, Fresenius Kabi, Sanofi Genzyme, Galapagos. PC declares consultancies, honoraria, advisory board, and speakers’ fees from Alnylam, Innotech, Servier and Vifor. PS declares financial support for scientific works from Biocodex, MSD, Takeda, Janssen, and Sandoz, and consultant fees from Abbvie, Merk, MSD, Gilead, Pfizer, Sandoz, Janssen, and Fresenius Kabi. EV declares consulting fees from Abbott, Coloplast and Boston Scientific.

Auteurs

Signe Hässler (S)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Roberta Lorenzon (R)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Marie Binvignat (M)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, FHU PaCeMM, Sorbonne Université, Paris, 75012, France; Rheumatology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75012, France.

Claire Ribet (C)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Alexandra Roux (A)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Catherine Johanet (C)

Immunology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75012, France.

Chloé Amouyal (C)

Diabetology Department, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Serge Amselem (S)

Sorbonne Université, INSERM, Childhood genetic diseases, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75012, France.

Francis Berenbaum (F)

INSERM UMRS 938, Centre de Recherche Saint-Antoine, FHU PaCeMM, Sorbonne Université, Paris, 75012, France; Rheumatology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75012, France.

Olivier Benveniste (O)

Internal Medicine and Clinical Immunology Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Patrice Cacoub (P)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Internal Medicine and Clinical Immunology Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Gilles Grateau (G)

Internal Medicine Department, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75020, France.

Agnès Hartemann (A)

Diabetology Department, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

David Saadoun (D)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Internal Medicine and Clinical Immunology Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Joe-Elie Salem (JE)

CIC-1901, Pharmacology Department, INSERM, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

Jérémie Sellam (J)

INSERM UMRS 938, Centre de Recherche Saint-Antoine, FHU PaCeMM, Sorbonne Université, Paris, 75012, France; Rheumatology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75012, France.

Philippe Seksik (P)

Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, 75013, France.

Eric Vicaut (E)

Unité de recherche clinique, UMR 942, Saint-Louis Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75010, France.

Encarnita Mariotti-Ferrandiz (E)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France.

Michelle Rosenzwajg (M)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France.

David Klatzmann (D)

Immunology, Immunopathology, Immunotherapy (i3), Sorbonne Université, INSERM, Paris, 75013, France; Biotherapy (CIC-BTi) and Inflammation, Immunopathology, Biotherapy Department (i2B), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France. Electronic address: david.klatzmann@sorbonne-universite.fr.

Classifications MeSH