放射性轴性脊椎关节炎的临床表现及其与欧洲和伊贝罗美洲人群中的HLA-B27相关性
María Ángeles Puche-Larrubia1, Lourdes Ladehesa-Pineda2, Pilar Font-Ugalde3
1M.Á. Puche-Larrubia, MD, PhD, L. Ladehesa-Pineda, MD, PhD, A. Escudero-Contreras, MD, PhD, I. Arias de la Rosa, PhD, C. López-Medina, MD, PhD, Department of Rheumatology, Reina Sofia University Hospital, and GC-05 Group, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), and Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain; mangeles.puche@gmail.com.
The Journal of rheumatology
|January 15, 2025
概括
与欧洲患者相比,患有放射性轴性脊髓关节炎 (r-axSpA) 的伊伯罗美洲患者表现出更多的外周症状,结构损伤和更差的功能. 无论HLA-B27状态如何,这些差异仍然存在,突出了不同的疾病特征.
科学领域:
- 类风湿病学 类风湿病学
- 免疫遗传学 免疫遗传学
- 流行病学 流行病学
背景情况:
- 放射性轴性脊椎关节炎 (r-axSpA) 是一种慢性炎症状况,影响轴性骨架.
- 了解r-axSpA的地理和遗传变异对于定制治疗策略至关重要.
- 在r-axSpA中HLA-B27的作用因人群而异,需要进行比较研究.
研究的目的:
- 为了比较与r-axSpA的伊伯罗美洲和欧洲患者的临床和社会人口统计特征.
- 调查HLA-B27状态对这些特征的影响.
- 确定这些人群之间疾病表现和结果的潜在差异.
主要方法:
- 一项观察性,横截面的多中心研究,涉及2592名被诊断患有r-axSpA.的患者.
- 使用了来自西班牙风湿病学脊柱关节炎注册表 (REGISPONSER) 和北美脊柱关节炎注册表 (RESPONDIA) 的数据.
- 进行了单变量和多变量分析,按HLA-B27状态和种族分层,以比较欧洲和伊贝罗美洲群体.
主要成果:
- 与欧洲人相比,伊伯拉美洲患者 (n=1083) 显示出与csDMARD摄入量,关节炎,肠炎,指甲炎,严重结构损伤 (BASRI) 和功能不良 (BASFI) 的显著关联,特别是当HLA-B27阳性时.
- 即使在HLA-B27阴性患者中,伊比拉美洲身份也与较高的肠炎率,csDMARD使用率和总的BASRI有关.
- 种族分层揭示了外围关节表现的变化,美国印第安人患者患有更多的关节炎和肠炎.
结论:
- 与欧洲同行相比,r-axSpA的伊伯拉美洲患者表现出一个独特的临床形象,其特点是外围参与度更高,结构损伤更大,功能结果更差.
- 这些差异不管HLA-B27阳性程度如何,都会观察到这些差异,这表明还有其他促成因素.
- 这些发现强调了在管理r-axSpA时需要以地理和种族为基础的方法.
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