Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 52621, Israel.
Nat Rev Rheumatol. 2010 Aug;6(8):468-76. doi: 10.1038/nrrheum.2010.86. Epub 2010 Jun 22.
The accumulative global burden of autoimmune and inflammatory rheumatic diseases is substantial. Studying the distribution of these conditions across various global regions and ethnic groups by means of geoepidemiology might readily provide epidemiological data and also advance our understanding of their genetic and environmental underpinnings. In order to depict the geoepidemiology of autoimmune and inflammatory rheumatic diseases, namely rheumatoid arthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, ankylosing spondylitis and Sjögren's syndrome, we present a comprehensive collection of epidemiological reports from various world regions, including the prevalence of each of these conditions. The accumulated data show that the reviewed rheumatic diseases are global phenomena, and, with some variance, seem to be relatively evenly distributed. This finding is in contrast with the obviously uneven distribution of some major nonrheumatic autoimmune conditions. In addition, geoepidemiology demonstrates that ethnogenetic susceptibility interacts with lifestyle and environmental factors, which include socioeconomic status, infectious agents (triggering or protective agents), environmental pollutants, and vitamin D (dependent on sunlight exposure), in determining the risk of developing rheumatic autoimmunity.
自身免疫和炎症性风湿性疾病在全球的累积负担很大。通过地理流行病学研究这些疾病在全球不同地区和种族群体中的分布情况,可以很容易地提供流行病学数据,并深入了解其遗传和环境基础。为了描述自身免疫和炎症性风湿性疾病(即类风湿关节炎、幼年特发性关节炎、系统性红斑狼疮、系统性硬化症、强直性脊柱炎和干燥综合征)的地理流行病学,我们从世界不同地区收集了全面的流行病学报告,包括这些疾病的患病率。积累的数据表明,所审查的风湿性疾病是全球性现象,尽管存在一些差异,但似乎分布相对均匀。这一发现与一些主要的非风湿性自身免疫性疾病明显不均匀的分布形成对比。此外,地理流行病学表明,遗传易感性与生活方式和环境因素相互作用,这些因素包括社会经济地位、感染因子(触发或保护因子)、环境污染物和维生素 D(取决于阳光照射),从而决定了发生风湿性自身免疫的风险。