汽车的影响T细胞在antisynthetase综合症的表现。(一)神经病理学。前,苏木精和伊红染色显示主要围肌肉萎缩和坏死的肌肉纤维。中心,为MHC-1染色显示无处不在的表情肌肉纤维与优势围边界。中心,结缔组织或由酸性磷酸酶染色perimysial分段描述。左下角,C5b9染色显示sarcolemmal装饰肌肉纤维的优势在围边界和一些肌质的染色纤维。右下角,CD3染色显示t细胞浸润人肌内膜隔间和入侵来自perimysial地区。酒吧= 100μm规模。(B)治疗前后肌酐激酶浓度CD19汽车T细胞和前治疗的时机。期待视野行显示正常范围的上限。 (C) Dot plots showing the expression of CD3 and CD19 CAR in circulating CD19 CAR T cells, quantified by FACS on day 2 and day 8 after infusion. (D) Concentration of circulating CD19 CAR T cells over time. (E) Concentration of CD19+ B cells over time. (F) Disease activity assessed using the PGA (left), PtGA (middle), and MMT8 (right) measures. (G) Concentrations of serum creatinine kinase (left) and autoantibodies against Jo-1 (right) over time. Dashed lines show the upper limit of normal range. (H) Disease activity assessed with the EMDA scale. (I) Disease activity assessed with the ACR/EULAR TIS, showing cutoffs for major, moderate, minor, or no improvement. (J) MRI. Top left, baseline coronal axial T2-weighted, fat-suppressed sequence shows the longitudinal extent of the hamstring pathology on both sides (asterisks). Bottom left, the corresponding axial MRI shows diffuse oedematous changes reflecting myositis of almost all thigh muscle groups, but primarily of the quadriceps muscles (asterisk). Marked fasciitis is also seen, particularly in the vastus medialis and semitendinosus muscles (arrows). Top right, complete resolution of muscle and fascial inflammatory alterations 3 months after treatment. Bottom right, corresponding axial MRI confirms that healthy muscle signal has been restored in the quadriceps and the hamstrings. (K) Chest CT scans. Left, baseline coronal reformatted CT scans showing bilateral basal opacities (arrows) and right upper lobe opacities consistent with alveolitis. A reticular abnormality reflecting interstitial lung disease can also be seen. Right, CT scans obtained 3 months after initiation of therapy show complete resolution of right upper lobe findings (asterisk) and alveolitis, and minor residual findings of basal interstitial lung disease (arrows). RTX=rituximab. IVIG=intravenous immunoglobulins. TAC=tacrolimus. CX=cyclophosphamide. CAR=chimeric antigen receptor. FACS=fluorescence-activated cell sorting. VAS=visual analog scale. PGA=physician global assessment. PtGA=patient global assessment. MMT8=manual muscle testing score 8. EMDA=extramuscular disease activity. ACR/EULAR TIS=American College of Rheumatology/European League Against Rheumatism total improvement score. Credit:《柳叶刀》(2023)。DOI: 10.1016 / s0140 - 6736 (23) 00023 - 5
