Ukucatshangelwa kwezakhi zofuzo kanye nomcimbi oshukumisayo kucatshangwa ukuthi kubangela izinhlobo ezithile ze-arthritis. Ngokwesibonelo, abacwaningi baye bathola ukuthi cishe amaphesenti angu-40 abantu abanesifo se-psoriasis noma i- psoriatic arthritis banomlando womndeni wezifo ezibandakanya izihlobo zokuqala. Ucwaningo lwemikhaya lubonise ukuthi i-psoriatic arthritis inamathuba angama-55 okukhuphuka ngezihlobo zokuqala zabantu abaphethe lesi sifo uma kuqhathaniswa nokulawula okungahambisani.
Ezifundweni zezofuzo, igama elithi concordance libhekisela ekulinganiseni kwefana lamawele mayelana nokukhona noma ukungabikho kwesifo noma isici. Isilinganiso se-concordance se-psoriatic arthritis (amaphesenti angu-30) sikhulu kakhulu kune-psoriasis (amaphesenti angu-7). Ucwaningo lwe-twwin ku-psoriasis luye lwabonisa izinga eliphezulu le-concordance phakathi kwamawele afana nama-twins abafowabo.
Ukubona izakhi zofuzo ezihlotshaniswa nokutholakala kwesifo esithile akuyona into encane. Kungabandakanya:
- Ucwaningo lwama-aggregation: Ukufuna ukuqoqa isifo phakathi kwemindeni.
- Ukuhlaziywa kobuhlanga: Ukunquma ukuthi isakhi segciwane elikhulu lixhunywe yini ekusakazeni uhlobo oluthile lwe-phenotypic (okungukuthi, isici esibonakalayo).
- Ukuhlaziywa kokuxhumanisa: Ukukhomba ukuhlanganiswa kokufaneleka phakathi kwezakhi zofuzo ngokusekelwe endaweni yabo ku-chromosome.
- Ukuhlaziywa kobudlelwane: Ukuthola ubudlelwano obuvela kudatha, kulokhu, ukuthola izakhi zofuzo zomzimba noma izifunda ze-genome ezifaka isifo esithile.
- Izifundo ezisebenzayo ukuveza izakhi zofuzo: Ukufunda ukuhlukahluka kwemvelo noma ukuphazamiseka kokusebenza okuthinta amagciwane, ama-chromosomes, nokuningi.
Umsindo unzima futhi udidekile? Kungukuthi, njengoba kungaba nomenclature . Kodwa, ake sihlole lokho okutholiwe.
I-HLA (i-Human Leukocyte Antigen)
Ukutholakala kwe-MHC (eyinkimbinkimbi ye-hertocompatibility complex) kwi-chromosome 6 kwakubaluleke kakhulu ekutadisheni izici zofuzo ku-arthritis ye-psoriatic.
Kunezici eziningana zezakhi zofuzo ezitholakale. Kukhona inhlangano eyaziwa kakhulu phakathi kwesifunda se-HLA (isifo se-leukocyte antigen) se-MHC esaziwa njenge-HLA-C, futhi ikakhulukazi i-HLA-Cw6, futhi ikwazi ukuthola i-psoriasis. Ukubambisana ne-HLA-Cw6 kuncipha kancane ku-psoriatic arthritis, lapho i-HLA-B27 ihlotshaniswa kakhulu (ikakhulukazi kubantu abanezinambuzane ze-psoriatic arthritis), njenge-HLA-B38 ne-HLA-B39. I-HLA-Cw6 ihlotshaniswa nokuqala kokuqala kwe-psoriasis (engaphansi kweminyaka engama-40 ubudala) kanye nesifo esibi kakhulu. Kwamanye ama-antigen a-HLA, kwaziwa ukuthi i-HLA-B13, i-HLA-B17, i-HLA-B57, ne-HLA-Cw * 0602 yenzeke njalo kubantu abane-arthritis ye-psoriatic uma kuqhathaniswa nomphakathi jikelele.
Izintambo ezilandelayo (enye yezinye izinhlobo ezimbili noma ngaphezulu zegesi ezithuthukiswa ngokuguqulwa kwamatshe, ezitholakala endaweni efanayo kwi-chromosome) zitholakale zihlotshaniswa kakhulu ne-psoriatic arthritis uma kuqhathaniswa ne-psoriasis: B * 8, B * 27, B * 38, no-C * 06. Kukhona futhi i-HLA haplotypes (iqoqo lezakhi zofuzo ezazuzwa ndawonye kumzali oyedwa) ezihambisana ne-psoriatic arthritis: B * 18, C * 07, B * 27, B38, no-B * 8.
Ngenkathi i-HLA-B27 kuthiwa inenani eliphakeme kakhulu lokubikezela i-psoriatic arthritis ngokumelene ne-psoriasis, akulona iqiniso.
Imvamisa ye-HLA-B27 iphezulu ku- spondylitis e- ankylosing ne-arthritis esebenzayo uma kuqhathaniswa ne-arthritis ye-psoriatic. Kufanelekile ukuphawula ukuthi abantu abaningi abane psoriasis kanye nenye ye- spondyloarthropathies ayinayo i-HLA-B27. Kanti futhi, abantu abaningi abane-arthritis ye-psoriatic abahle nge-HLA-B27 ababonisi ukubandakanya komgogodla.
Ezinye izifundo zibonise ubudlelwane phakathi kwe-arthritis ye-psoriatic ne- HLA-DR4 , i-antigen eyaziwa ukuthi ihlotshaniswa ne- arthritis ye-rheumatoid . I-alleles ihluke phakathi kwezimo ezimbili, noma kunjalo, nge-HLA-DRB1 * 0401 ukuba ingavamile kakhulu kubantu abane-arthritis ye-psoriatic abangenayo i-HLA-DRB1 * 04 kunabantu abane-arthritis ye-rheumatoid.
I-reverse iyiqiniso nge-HLA-DRB1 * 0402, evame kakhulu ku-arthritis ye-psoriatic kune-arthritis ye-rheumatoid. Ezinye izakhi zofuzo ngaphakathi kwesifunda se-MHC nazo zihlolisisiwe kanye.
I-GWAS (i-Genome-Wide Association Scans)
Inhlangano ye-Genome-wide ihlola (i-GWAS) ihlaziya ukuhlukahluka kofuzo oluphakathi kwabantu abahlukene ngomzamo wokuqinisekisa ukuthi ngabe yikuphi ukuhluka okuhlobene nokuziphatha. Ngokwe-Best Practice & Research: I-Clinical Rheumatology (2014), amajethi angu-36 afike ekufinyeleleni kwe-genome-wide futhi alandisa cishe ngama-22% we-psoriasis heritability. Izidalwa ezibonwe yi-GWAS ezibhekwa njengezivelele kuma-psoriasis zihlanganisa i-HLA-Cw6, i-IL12B, i-IL23R, i-IL23A, i-TNIP1, i-TNFAIP3, i-LCE3B-LCE3C, i-TRAF3IP2, i-NFkBIA, i-FBXL19, i-TYK2, i-IFIH1, i-REL, ne-ERAP1. Izifo ezivezwe yi-GWAS ezivelele ku-arthritis ye-psoriatic zihlanganisa i-HLA-B / C, i-HLA-B, i-IL-12B, i-IL-23R, i-TNIP1, i-TRAF3IP2, i-FBXL19, ne-REL.
Ngaphansi
Uma unamalungu omndeni one-arthritis ye-psoriatic, ukufunda ukuthi izifundo zibonise izikhathi ezingaphezu kuka-55 eziphakeme zokuthuthukisa isimo, ngokuqondakalayo, kufanele zibe nzima. Zivikele ngolwazi olufanele-mhlawumbe unemicabango engafanele mayelana nesimo ukuthi amaqiniso angasiza ukusetha ngqo, ukunciphisa ukukhathazeka kwakho. Futhi-ke, qhubeka ukhulumisana ovulekile nochwepheshe wakho wokunakekelwa kwezempilo.
Imithombo:
Ukuhlaziywa kwezifundo ze-aggregation zohlelo lomndeni nezinhlelo eziyinkimbinkimbi ze-ascertainment schemes. UMathews AG et al. I-Stat Med. 2008 ngo-Okthoba 30; 27 (24): 5076-5092.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562890/
I-genetics ye-Psoriatic Arthritis. Ukusebenza Okuhle Nokucwaninga: I-Rheumatology Clinical. U-O'Reilly DD et al. 2014 Oct; 28 (5): 673-85.
http://www.ncbi.nlm.nih.gov/pubmed/25488777
I-Pathogenesis ye-Psoriatic Arthritis. Kusesikhathini. UGladman noRitchlin. Ibuyekezwe ngoMeyi 2016.
https://www.uptodate.com/contents/pathogenesis-of-psoriatic-arthritis
I-Genetics ye-Psoriasis ne-Psoriatic Arthritis. I-Indian Journal of Dermatology. V. Chandran. 2010 Apr-Jun.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887520/
I-Arthritis Psoriatic. I-Pathogenesis. Izakhi zofuzo. I-Kelley's Bookbook of Rheumatology. Isahluko 77. Umqulu wesishiyagalolunye. Elsevier.