de Serres F J, Blanco I, Fernández-Bustillo E
Center for the Evaluation of Risks to Human Reproduction, Environmental Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709-2233, USA.
Monaldi Arch Chest Dis. 2009 Sep;71(3):96-105. doi: 10.4081/monaldi.2009.354.
AAT deficiency is not a rare disease, but one of the most common congenital disorders increasing susceptibility of individuals with this deficiency to both lung and liver disease as well as other several adverse health effects. Studies to develop accurate estimates of the magnitude of this genetic disorder in any given country is critical for the development of screening programs for detection, diagnosis, and treatment of those individuals and/or families at risk. In the present study, estimates of the prevalence of the two major deficiency alleles PI S and PI Z were estimated for 25 countries in the Caribbean and North, Central, and South America to supplement our previous studies on 69 countries worldwide.
Using data on the prevalence of the two most common deficiency alleles PI S and PIZ in the mother countries that provided the majority of immigrants to these 25 countries, as well as genetic epidemiological studies on various genetic subgroups indigenous to the Caribbean and North, Central and South America it was possible to develop new formulas to estimate the numbers in each of five phenotypic classes, namely PI MS, PI MZ, PI SS, PI SZ and PI ZZ for each country.
When these 25 countries were grouped into six different geographic regions, the present study demonstrated striking differences when comparisons were made in numeric tables, maps and figures. Highly significant numbers of individuals at risk for AAT Deficiency were found in both the European, Mestizo and Mulatto populations for most of the 25 countries studied in the Caribbean and North, Central and South America.
Our studies demonstrated striking differences in the prevalence of both the PIS and PIZ alleles among these 25 countries in the Caribbean and North, Central and South America and significant numbers of individuals at risk for adverse health effects associated with AAT Deficiency in a given country. When these data are added to the results from our earlier studies on 69 countries, we now have data on AAT Deficiency in 94 of the 193 countries worldwide listed in the CIA FactBook.
α1抗胰蛋白酶缺乏症并非罕见疾病,而是最常见的先天性疾病之一,这种缺乏症会增加个体患肺病和肝病以及其他几种不良健康影响的易感性。开展研究以准确估计任何特定国家中这种遗传疾病的规模,对于制定针对有风险的个体和/或家庭的检测、诊断和治疗筛查计划至关重要。在本研究中,估计了加勒比地区以及北美洲、中美洲和南美洲25个国家中两个主要缺乏等位基因PI S和PI Z的患病率,以补充我们之前对全球69个国家的研究。
利用提供了这些25个国家大多数移民的母国中两个最常见缺乏等位基因PI S和PI Z的患病率数据,以及对加勒比地区以及北美洲、中美洲和南美洲本土各种遗传亚组的遗传流行病学研究,得以开发新的公式来估计每个国家五个表型类别(即PI MS、PI MZ、PI SS、PI SZ和PI ZZ)中每类的人数。
当将这25个国家分为六个不同地理区域时,本研究在数字表格、地图和图表比较中显示出显著差异。在加勒比地区以及北美洲、中美洲和南美洲研究的25个国家中的大多数国家,欧洲人、梅斯蒂索人和穆拉托人群中发现有大量有α1抗胰蛋白酶缺乏症风险的个体。
我们的研究表明,在加勒比地区以及北美洲、中美洲和南美洲的这25个国家中,PI S和PI Z等位基因的患病率存在显著差异,且在特定国家中有大量个体有与α1抗胰蛋白酶缺乏症相关的不良健康影响风险。当将这些数据与我们早期对69个国家的研究结果相加时,我们现在拥有了中央情报局《世界概况》列出的全球193个国家中94个国家的α1抗胰蛋白酶缺乏症数据。