セルリアック病は,自己免疫性心筋炎と関連しています
Andrea Frustaci1, Lucio Cuoco, Cristina Chimenti
1Department of Cardiology, Catholic University, Rome, Italy. biocard@rm.unicatt.it
Circulation
|June 5, 2002
まとめ
セリアック疾患 (CD) と心筋梗塞は,自己免疫的なつながりを共有しています. 筋炎患者の4%以上がCDを発症し,免疫抑制とグルテンフリーダイエットに良好な反応を示した.
科学分野:
- 心臓病学 心臓病学
- 胃腸内科 胃腸内科
- 免疫学 免疫学とは
背景:
- セリアック疾患 (CD) と心筋梗塞は,全身性自己免疫疾患と関連しています.
- CDと心筋梗塞の同時発生は,以前調査されていません.
- この関連性を調査することは,重要な臨床的影響を及ぼす可能性があります.
研究 の 目的:
- セリアック病 (CD) と心筋梗塞の共存を調査する.
- 筋炎の患者におけるCDマーカーの有病率を決定する.
- 自己免疫プロセスが心臓と小腸の両方に与える影響を評価する.
主な方法:
- 187人の心筋梗塞患者の血清スクリーニングで,心臓の自己抗体,抗組織トランスグルタミンゼ (IgA-tTG),および抗エンドミジア抗体 (AEA) を検出した.
- IgA-tTGおよびAEA陽性患者に対する十二指管内視鏡検査,生検,およびHLA分析.
- 306人の正常な個人からなる対照群と比較.
主要な成果:
- 187人中9人 (4.4%) の心筋炎患者は,AEA検査で陽性となり,CDの証拠を示した.
- CDの罹患率は,対照群 (4.4%対0.3%,P<0.003) よりも,筋炎患者において有意に高かった.
- CDを患った心筋梗塞の患者は心不全または心室不律を経験しました; 免疫抑制および/またはグルテンフリーダイエットによる治療は回復または改善をもたらしました.
結論:
- 心筋と小腸に影響する共通の自己免疫プロセスは,心筋炎患者の4%以上に存在します.
- 免疫抑制とグルテンフリーダイエットは,これらの患者にとって効果的な治療戦略です.
- この研究は,CDと心筋梗塞の間の潜在的自己免疫的リンクを強調しています.
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