银屑病和银屑病关节炎的地理流行病学及环境因素。
Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis.
机构信息
Division of Rheumatology, Toronto Western Hospital, University of Toronto, Canada.
出版信息
J Autoimmun. 2010 May;34(3):J314-21. doi: 10.1016/j.jaut.2009.12.001. Epub 2009 Dec 24.
Psoriasis and Psoriatic Arthritis (PsA) are chronic inflammatory diseases that have a major impact on health. The prevalence and incidence estimates of these two closely related diseases show ethnic and geographic variations, being generally more common in the colder north than in the tropics. In Europe the prevalence of psoriasis varies anywhere from 0.6 to 6.5%. In the USA, the estimated prevalence of diagnosed psoriasis is 3.15%. The prevalence in Africa varies depending on geographic location, being lowest in West Africa. Psoriasis is less prevalent in China and Japan than in Europe, and is entirely absent in natives of the Andean region of South America. There are fewer reports on the incidence of psoriasis, but a recent study from Rochester, USA showed an increasing trend over the last 2 decades. The prevalence of PsA also shows similar variation, being highest in people of European descent and lowest in the Japanese. Although, study methodology and case definition may explain some of the variations, genetic and environmental factors are important. Genetic epidemiologic studies have shown that both diseases have a strong genetic component. The strongest association is with HLA-Cw*06. Associations with a number of genes including IL12B and IL23R have recently been confirmed. Environmental risk factors including streptococcal pharyngitis, stressful life events, low humidity, drugs, HIV infection, trauma, smoking and obesity have been associated with psoriasis and PsA. Here we have reviewed the current literature on the epidemiology and genetics of psoriasis and PsA.
银屑病和银屑病关节炎(PsA)是两种慢性炎症性疾病,对健康有重大影响。这两种密切相关的疾病的患病率和发病率估计值存在种族和地域差异,在较冷的北方比在热带地区更为常见。在欧洲,银屑病的患病率在 0.6%至 6.5%之间不等。在美国,诊断为银屑病的患病率估计为 3.15%。非洲的患病率因地理位置而异,在西非最低。银屑病在中国和日本的发病率低于欧洲,在南美洲安第斯地区的原住民中则完全不存在。关于银屑病发病率的报告较少,但美国罗切斯特的一项最近研究显示,过去 20 年来呈上升趋势。PsA 的患病率也存在类似的变化,在欧洲裔人群中最高,在日本人中最低。尽管研究方法和病例定义可能解释了部分差异,但遗传和环境因素很重要。遗传流行病学研究表明,这两种疾病都具有很强的遗传成分。与 HLA-Cw*06 的关联最强。最近已经证实与包括 IL12B 和 IL23R 在内的许多基因的关联。包括链球菌性咽炎、生活压力事件、低湿度、药物、HIV 感染、创伤、吸烟和肥胖在内的环境危险因素与银屑病和 PsA 相关。在这里,我们回顾了关于银屑病和 PsA 的流行病学和遗传学的当前文献。