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[内分泌疾病中的自身免疫性疾病关联]

[Associations of autoimmune disorders in endocrine diseases].

作者信息

Balázs Csaba, Fehér János

机构信息

Budai Irgalmasrendi Kórház, Belgyógyászati Osztály, Budapest.

出版信息

Orv Hetil. 2009 Aug 23;150(34):1589-97. doi: 10.1556/OH.2009.28706.

Abstract

Increasing data are known for dialogue between neuroendocrine and immune systems recently. Results of molecular genetic studies provided evidences for common languages of these systems by various signals including neurotransmitters, hormones, cytokines. It is proved the immune system is able to produce neurotransmitters and hormones and endocrine organs can even result in cytokines. This new integrative approach allows to investigate the physiologic events and diseases as interactions between the psycho-neuro-endocrine-immune systems. The autoimmune polyendocrine syndromes constitute a heterogeneous group of disorders characterized by loss of immune tolerance to self-antigens. In spite of distinct clinical pictures, molecular genetic studies revealed a common molecular mechanism in the associations of organ-specific diseases. Autoimmune polyendocrine syndrome-1 is characterized by associations at least two out of three cardinal signs: Addison's disease, autoimmune hypoparathyroidism and mucocutaneous candidiasis. This is a rare autosomal recessive syndrome induced by mutations in autoimmune regulator gene. Autoimmune polyendocrine syndrome-2 occurs more frequently and defined as the coexistence of Addison's disease, autoimmune thyroid disease and/or type-1 diabetes mellitus. Autoimmune polyendocrine syndrome-3 is characterized by association of autoimmune thyroid disease and type-1 diabetes mellitus. The HLA and other genes proved to be important in associations of the syndrome-2 and 3 in contrast to autoimmune polyendocrine syndrome-1. Identification of predisposing genetic helps to understand the common mechanisms and provide possibility for early therapy and prevention as well.

摘要

近年来,关于神经内分泌系统与免疫系统之间对话的研究数据越来越多。分子遗传学研究结果通过包括神经递质、激素、细胞因子在内的各种信号,为这些系统存在共同语言提供了证据。已证实免疫系统能够产生神经递质和激素,而内分泌器官甚至能产生细胞因子。这种新的综合方法有助于将生理事件和疾病作为心理 - 神经 - 内分泌 - 免疫 系统之间的相互作用来进行研究。自身免疫性多内分泌综合征是一组异质性疾病,其特征是对自身抗原失去免疫耐受性。尽管临床表现各异,但分子遗传学研究揭示了器官特异性疾病关联中的共同分子机制。自身免疫性多内分泌综合征1型的特征是在三个主要体征中至少有两个同时出现:艾迪生病、自身免疫性甲状旁腺功能减退症和黏膜皮肤念珠菌病。这是一种由自身免疫调节基因发生突变引起的罕见常染色体隐性综合征。自身免疫性多内分泌综合征2型更为常见,定义为艾迪生病、自身免疫性甲状腺疾病和/或1型糖尿病同时存在。自身免疫性多内分泌综合征3型的特征是自身免疫性甲状腺疾病与1型糖尿病相关联。与自身免疫性多内分泌综合征1型不同,HLA及其他基因在综合征2型和3型的关联中被证明具有重要作用。识别易感基因有助于了解其共同机制,也为早期治疗和预防提供了可能。

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