Roberts-Thomson R A, Roberts-Thomson P J
University of Adelaide, Department of Immunology, Australia.
Ann Rheum Dis. 1999 May;58(5):266-70. doi: 10.1136/ard.58.5.266.
To document the frequency and disease phenotype of various rheumatic diseases in the Australian Aborigine.
A comprehensive review was performed of the archaeological, ethnohistorical, and contemporary literature relating to rheumatic diseases in these indigenous people.
No evidence was found to suggest that rheumatoid arthritis (RA), ankylosing spondylitis (AS), or gout occurred in Aborigines before or during the early stages of white settlement of Australia. Part of the explanation for the absence of these disorders in this indigenous group may relate to the scarcity of predisposing genetic elements, for example, shared rheumatoid epitope for RA, B27 antigen for AS. In contrast, osteoarthritis appeared to be common particularly involving the temporomandibular joint, right elbow and knees and, most probably, was related to excessive joint loading in their hunter gatherer lifestyle. Since white settlement, high frequency rates for rheumatic fever, systemic lupus erythematosus, and pyogenic arthritis have been observed and there are now scanty reports of the emergence of RA and gout in these original Australians.
The occurrence and phenotype of various rheumatic disorders in Australian Aborigines is distinctive but with recent changes in diet, lifestyle, and continuing genetic admixture may be undergoing change. An examination of rheumatic diseases in Australian Aborigines and its changing phenotype may lead to a greater understanding of the aetiopathogenesis of these disorders.
记录澳大利亚原住民各种风湿性疾病的发病率及疾病表型。
对与这些原住民风湿性疾病相关的考古学、民族历史及当代文献进行全面综述。
未发现证据表明在澳大利亚白人定居之前或早期，原住民中存在类风湿关节炎（RA）、强直性脊柱炎（AS）或痛风。该原住民群体中缺乏这些疾病的部分原因可能与易患基因元素的稀缺有关，例如，RA的共享类风湿表位、AS的B27抗原。相比之下，骨关节炎似乎很常见，尤其累及颞下颌关节、右肘和膝盖，很可能与他们狩猎采集生活方式中关节负荷过重有关。自白人定居以来，已观察到风湿热、系统性红斑狼疮和化脓性关节炎的高发病率，现在也有关于这些澳大利亚原住民中出现RA和痛风的少量报告。
澳大利亚原住民各种风湿性疾病的发生情况及表型具有独特性，但随着近期饮食、生活方式的改变以及持续的基因混合，可能正在发生变化。对澳大利亚原住民风湿性疾病及其不断变化的表型进行研究，可能会加深对这些疾病病因发病机制的理解。
