A na-eche na mkpụrụ ndụ ihe nketa na ihe na-akpali akpali na-akpata ụfọdụ ụdị ogbu na nkwonkwo. Dịka ọmụmaatụ, ndị nyocha achọpụtawo na ihe dị ka pasent 40 nke ndị nwere psoriasis ma ọ bụ ọrịa arthritis nwere akụkọ ihe mere eme nke ezinụlọ nke ọrịa ndị metụtara ndị ikwu nke mbụ. Ihe ọmụmụ ezinụlọ egosiwo na arthritis psoriatic dị ugboro 55 na-enwe ike ịmalite na ndị ikwu nke mbụ nke ndị nwere ọrịa ahụ ma e jiri ya tụnyere njikwa ndị na-enweghị njikọ.
Na ọmụmụ ihe ọmụmụ, okwu ọnụ na-ezo aka n'ókè nke nha na otu ejima banyere njide ma ọ bụ enweghị ọrịa ma ọ bụ àgwà. Ọnụ ọnụ ọnụ maka ọrịa arthritis (pasent 30) dị elu karịa psoriasis (pasent 7). Nnyocha abụọ ejiri na psoriasis gosipụtara ọnụ ọgụgụ dị elu nke nkwekọrịta n'etiti ụmụ ejima yiri ya na ejima abụọ.
Ịmata mkpụrụ ndụ ihe nketa ndị metụtara ọrịa na-arịa ọrịa a abụghị obere ọrụ. O nwere ike ịgụnye:
- Ọmụmụ ihe ọmụmụ ezinụlọ: Na-achọ ka ịmalite ịrịa ọrịa n'ime ezinụlọ.
- Nchịkọta dị iche iche: Ịchọpụta ma njikọta mkpụrụ ndụ dị na nkesa nke ọdịdị phenotypic (nke bụ, àgwà a na-ahụ anya).
- Nyocha ntinye: Nyochaa ihe jikọrọ mkpụrụ ndụ n'etiti mkpụrụ ndụ ihe nketa nke dabeere na ọnọdụ ha na chromosome.
- Nchịkọta mkpakọrịta: Ịmeghe mmekọrịta sitere na data, na nke a, ịchọta mkpụrụ ndụ ndị na-eto eto ma ọ bụ mpaghara genome nke na-enye aka na ọrịa.
- Ihe omumu nke oma bu ihe omuma: Iche ihe di iche iche ma obu ihe ndi ozo nke na - emetuta genes, chromosomes, na ndi ozo.
Ụda mgbagwoju anya na mgbagwoju anya? Ọ bụ, dịka ọ pụrụ ịbụ nomenclature . Ma, ka anyị lee anya na ihe a chọtara.
HLA (Human Leukocyte Antigen)
Nchọpụta nke MHC (isi akụkọ mgbagwoju anya) na chromosome 6 bụ ihe dị mkpa n'ịmụ ihe banyere mkpụrụ ndụ ihe nketa na arthritis psoria.
Achọpụtara ọtụtụ mkpụrụ ndụ ihe nketa. E nwere otu a maara nke ọma n'etiti mpaghara HLA (mpaghara mmadụ nke leukocyte antigen) nke MHC a maara dị ka HLA-C, yana kpọmkwem HLA-Cw6, na ịmalite psoriasis. Njikọ ya na HLA-Cw6 dị ntakịrị ike n'ọrịa ọrịa psoria, ebe HLA-B27 na-ejikọta ya na ya (karịsịa ndị nwere ihe omimi nke ọrịa arthritis), dị ka HLA-B38 na HLA-B39. HLA-Cw6 jikọtara na mmalite nke psoriasis (ihe na-erughị afọ 40) yana ọrịa siri ike. N'ime ndị antigens HLA ndị ọzọ, a maara na HLA-B13, HLA-B17, HLA-B57, na HLA-Cw * 0602 na-emekarị ugboro ugboro na ndị nwere ọrịa ogbu na nkwonkwo psoriatic ma e jiri ya tụnyere ọha mmadụ.
Ihe omuma atu ndia (otu n'ime uzo abuo ma obu karia nke uzo nke meghariri site na ngbanwe, nke achotara n'otu ebe na chromosome) choputara ka enwere ya na arthritis psoriatic ma e jiri ya tụnyere psoriasis: B * 8, B * 27, B * 38, na C * 06. E nwekwara HLA haplotypes (otu mkpụrụ ndụ nke e ketara n'aka otu nne ma ọ bụ nna) nke metụtara ọrịa arthritis psoria: B * 18, C * 07, B * 27, B38, na B * 8.
Ọ bụ ezie na a na-ekwu na HLA-B27 nwere uru dị oke egwu nke psthiasis psoria na psoriasis, ọ bụghị ihe doro anya.
Ugboro ugboro nke HLA-B27 dị elu na spondylitis ankylosing na arthritis na-arụ ọrụ na-adabere na arthritis psoriatic. O kwesịkwara ịkọwa na ọtụtụ ndị nwere psoriasis na otu n'ime spondyloarthropathies bụ ihe ọjọọ maka HLA-B27. Ọzọkwa, ọtụtụ ndị nwere ọrịa ogbu na nkwonkwo nke na-adabaghị adaba maka HLA-B27 adịghị egosi itinye aka na mkpịsị ụkwụ.
Ufodu omumu ha gosiputara ihe jikota n'agbata oria ogwu psoria na HLA-DR4 , ihe antigen nke a maara na o jikoro ogwu ogbugba ogbugba. Otú ọ dị, okwu ahụ dị iche n'etiti ọnọdụ abụọ, Otú ọ dị, na HLA-DRB1 * 0401 na-abụkarị ndị mmadụ na-enwe ọrịa nkwonkwo psoriatic bụ ndị dị mma maka HLA-DRB1 * 04 karịa ndị nwere ọrịa ogbu na nkwonkwo.
Mgbanwe ahụ bụ eziokwu maka HLA-DRB1 * 0402, bụ nke na-adịkarị na arthritis psoriatic karịa ọrịa ogbu na nkwonkwo. A na-amụkwa mkpụrụ ndụ ndị ọzọ n'ime mpaghara MHC.
GWAS (Genome-Wide Association Scans)
Gọọmenti GWAS na-enyocha ihe niile na-enyocha ụdị ndụ dị iche iche nke mkpụrụ ndụ dị iche iche n'etiti ndị dị iche iche iji gbasie ike ma ọ bụrụ na ụdị ọ bụla dị na njirimara. Dị ka Best Practice & Research: Clinical Rheumatology (2014), mkpụrụ ndụ iri atọ na anọ na-aba uru dị na genome na ha na-akọ banyere ihe dị ka pasent 22 nke psoriasis heritability. Genes nke GWAS mata nke a na-ewere dị ka ndị a ma ama na psoriasis gụnyere HLA-Cw6, IL12B, IL23R, IL23A, TNIP1, TNFAIP3, LCE3B-LCE3C, TRAF3IP2, NFkBIA, FBXL19, TYK2, IFIH1, REL, na ERAP1. Genes nke GWAS mata nke a ma ama na ọrịa arthritis gụnyere HLA-B / C, HLA-B, IL-12B, IL-23R, TNIP1, TRAF3IP2, FBXL19, na REL.
Ndabere ala
Ọ bụrụ na ị nwere onye òtù ezinụlọ nwere ọrịa ogbu na nkwonkwo psoria, na-amụta na ọmụmụ ihe gosipụtara 55 ugboro elu dịka ịmalite ịmalite ọnọdụ ahụ nwere ike, n'ụzọ nghọta, na-echegbu onwe ya. Jiri aka gị mara ihe ọmụma ziri ezi-ikekwe ị nwere echiche na-ezighị ezi banyere ọnọdụ nke eziokwu nwere ike inyere aka dozie, belata nchegbu gị. Ma, n'ezie, na-ekwurịta okwu na nkwonkwo gị na ọkachamara nlekọta ahụike gị.
Isi mmalite:
Nyocha nke ọmụmụ gbasara ọmụmụ ezinụlọ na usoro mgbagwoju anya. Matthews AG et al. Med Med. 2008 October 30; 27 (24): 5076-5092.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562890/
Genetics nke Arthritis Psoriatic. Omume kachasị mma & Nnyocha: Ọrịa Rheumatology. O'Reilly DD et al. 2014 Ọkt; 28 (5): 673-85.
http://www.ncbi.nlm.nih.gov/pubmed/25488777
Pathogenesis nke Arthritis Psoriatic. Kwalitere ruo ugbu a. Gladman na Ritchlin. Nyochaa Mee 2016.
https://www.uptodate.com/contents/pathogenesis-of-psoriatic-arthritis
Genetics nke Psoriasis na Arthritis Psoriatic. Indian Journal of Dermatology. V Chandran. 2010 Apr-Jun.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887520/
Arthritis Psoriatic. Pathogenesis. Ihe ndị dị ndụ. Kelley's Textbook nke Rheumatology. Isi nke 77. mbipụta nke itoolu. Elsevier.