I-genetic predisposition kunye nesiganeko eshukumisayo kucatshangelwa ukuba kubangele iintlobo ezithile ze-arthritis. Ngokomzekelo, abaphandi baye bafumanisa ukuba malunga nama-40 ekhulwini abantu abane psoriasis okanye i- psoriatic arthritis baneenkcukacha zentsapho yezifo ezibandakanya izihlobo ezide. Izifundo zentsapho zibonise ukuba i-psoriatic arthritis ingamaxesha angama-55 amathuba okuhlakulela kwizihlobo zokuqala zabantu abaphethe isifo xa kuthelekiswa nokulawula okungahambelani.
Kwizifundo zofuzo, igama elithi concordance libhekisela kwisilinganiselo sokufana kwiseti lamawele malunga nokufumaneka okanye ukungabikho kwesi sifo okanye isifo. Isilinganiso se-concordance ye-psoriatic arthritis (iipesenti ezingama-30) iphezulu kakhulu kune-psoriasis (iipesenti ezi-7). Izifundo ze-twwin kwi-psoriasis ziye zabonisa izinga eliphezulu le-concordance phakathi kwamawele afana nama-twins.
Ukuchonga izakhi zegciwane ezidibene nokukhusela kwisifo esithile akusona msebenzi omncinci. Kungabandakanya:
- Izifundo zobudlelwane ngokubanzi: Ukujonga ukuqoqa isifo kwiintsapho.
- Uhlalutyo localulo: Ukugqiba ukuba i-gene enkulu idibeneyo ekuhanjisweni kwendlela ethile ye-phenotypic (oko kukuthi, into ephawulekayo).
- Uhlalutyo lokuxhunywa: Ukuchonga umbutho wokulungelelanisa phakathi kweentlobo zeejethi ezixhomekeke kwindawo yazo kwi-chromosome.
- Uhlalutyo lombutho: Ukufumanisa ubudlelwane obuvela kwiinkcukacha, kulo mzekelo, ukufumana iigleji ezikhethiweyo okanye imimandla ye-genome enegalelo kwisifo esithile.
- Izifundo ezisebenzayo ukubonisa iinjengezifo: Ukufunda ukutshintsha kwendalo okanye ukuphazamiseka kokusebenza okuchaphazela i-gene, i-chromosomes, kunye nokunye.
Isandi siyanzima kwaye sidideka? Kuye, njengokuba kunokuba yi- nomenclature . Kodwa, masijongise oko kufunyenwe.
I-HLA (i-Human Leukocyte Antigen)
Ukufunyanwa kwe-MHC (ubuninzi bezinto ezihamba phambili kwi-chromosome) kwi-chromosome 6 kwakubaluleke kakhulu ekufundeni iziganeko zofuzo kwi-psoriatic arthritis.
Kuye kwachongwa iziganeko ezininzi zofuzo. Kukhona umbutho owaziwayo phakathi kwe-HLA (indawo ye-leukocyte antigen) yommandla we-MHC ohlonishwa njenge-HLA-C, kunye ne-HLA-Cw6 ngokukhethekileyo, kunye ne-psoriasis. Ukubambisana ne-HLA-Cw6 kunobuthakathaka kwi-psoriatic arthritis, apho i-HLA-B27 inxulumene kakhulu (ikakhulukazi kubantu abaneempawu zomgogodla we-psoriatic arthritis), njenge-HLA-B38 ne-HLA-B39. I-HLA-Cw6 idibene nokuqala kwangaphambili kwe-psoriasis (engaphantsi kweminyaka engama-40 ubudala) kunye nezifo ezibi kakhulu. Kwamanye ama-antigens e-HLA, kwaziwa ukuba i-HLA-B13, i-HLA-B17, i-HLA-B57, kunye ne-HLA-Cw * 0602 ivela rhoqo rhoqo kubantu abane-arthritis ye-psoriatic xa kuthelekiswa nomphakathi jikelele.
Ezi zilandelayo zilandelayo (enye yeendlela ezimbini okanye ngaphezulu ze-gene eziphuhliswa ngutshintsho, ezifunyenwe kwindawo efanayo kwi-chromosome) zifunyanisiwe zihambelana kakhulu ne-psoriatic arthritis kuthelekiswa ne-psoriasis: B * 8, B * 27, B * 38, kunye neC * 06. Kukho kwakhona i-HLA haplotypes (iqela leendiza ezizuze kunye kunye nomzali omnye) ezinxulumene ne-psoriatic arthritis: B * 18, C * 07, B * 27, B38, kunye ne-B * 8.
Ngoxa i-HLA-B27 kuthiwa inexabiso eliphezulu lokuqikelela i-psoriatic arthritis versus psoriasis, akuqinisekanga.
Ubume be-HLA-B27 buphakamileyo kwi- spondylitis e-ankylosing kunye ne-arthritis esebenzayo xa kuthelekiswa ne-psoriatic arthritis. Kukwafanelekile ukukhankanya ukuba abantu abaninzi abane-psoriasis kunye nenye ye- spondyloarthropathies ayinayo i-HLA-B27. Kwakhona, abaninzi abantu abane-storiatic arthritis abanomdla kwi-HLA-B27 ababonisi ukubandakanya umgudu.
Ezinye izifundo zibonise ubudlelwane phakathi kwe-psoriatic arthritis kunye ne- HLA-DR4 , i-antigen eyaziwayo ukuba idibene ne- rheumatoid arthritis . Ama-allele ahluke phakathi kweemeko ezimbini, nangona kunjalo, kunye ne-HLA-DRB1 * 0401 ingaqhelekanga rhoqo kubantu abane-psoriatic arthritis abanomdla kwi-HLA-DRB1 * 04 kunabantu abane-arthritis ye-rheumatoid.
I-reverse iyinyaniso kwi-HLA-DRB1 * 0402, edla rhoqo kwi-psoriatic arthritis kune-arthritis ye-rheumatoid. Ezinye izakhi zofuzo ngaphakathi kwinqanaba le-MHC ziye zafundiswa ngokunjalo.
I-GWAS (iGenesome-Wide Association Scans)
I-Genome-wide scale scans (GWAS) ihlalutya ukuhlukahluka kofuzo oluqhelekileyo phakathi kwabantu abahlukeneyo ngenzame yokuqinisekisa ukuba nayiphi na into eyahlukileyo ihambelana nomlinganiselo. Ngokomsebenzi ogqwesileyo noPhando: i-Clinical Rheumatology (ngo-2014), iijethi ezingama-36 ziye zafikelela ngokubaluleka kwe-geneome kwaye zibhala malunga ne-22% ye-psoriasis heritability. Iimpawu zeGenesis ezibonwe yi-GWAS ezibonwa zivelele kwi-psoriasis ziquka 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. I-Genesesi echazwe yi-GWAS evelele kwi-psoriatic arthritis iquka i-HLA-B / C, i-HLA-B, i-IL-12B, i-IL-23R, i-TNIP1, i-TRAF3IP2, i-FBXL19 kunye ne-REL.
Okukwintsusa
Ukuba unelungu lentsapho elinesifo sesifo se-psoriatic, ukufunda ukuba izifundo zibonise amaxesha angama-55 aphezulu ekuphuhliseni imeko leyo, ngokuqondakalayo, iya kuba yinkxalabo. Zibophe ngolwazi oluchanekileyo-mhlawumbi unemibono engalunganga malunga nemeko yokuba inyaniso inokukunceda ukubeka ngqo, ukunciphisa ukukhathazeka kwakho. Kwaye, ke, qhubeka unxibelelwano oluvulekileyo kunye noqeqesho lwakho lwezempilo.
Imithombo:
Uhlalutyo lwee-familyal aggregation studies kunye nezicwangciso zokuqhelanisa. Matthews AG et al. I-Med Med. 2008 Oktobha 30; 27 (24): 5076-5092.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562890/
I-Genetics ye-Psoriatic Arthritis. Ukusebenza ngokugqibeleleyo kunye nophando: i-Rheumatology yeeKlinikhi. O'Reilly DD et al. 2014 Oct; 28 (5): 673-85.
http://www.ncbi.nlm.nih.gov/pubmed/25488777
I-Pathogenesis ye-Psoriatic Arthritis. Isemgangathweno. Gladman noRitchlin. Uhlaziywe ngoMeyi 2016.
https://www.uptodate.com/contents/pathogenesis-of-psoriatic-arthritis
I-Genetics ye-Psoriasis ne-Psoriatic Arthritis. Indian Journal of Dermatology. V. Chandran. 2010 kuMbasa-Juni.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887520/
I-Psoriatic Arthritis. Pathogenesis. Izinto zobomi. I-Kelley's Bookbook yeRheumatology. Isahluko 77. Inkcazelo yesithoba. Elsevier.