Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Curr Opin Rheumatol. 2012 Nov;24(6):642-8. doi: 10.1097/BOR.0b013e328356d9dc.
Racial disparities appear to exist in the susceptibility and severity of systemic sclerosis (SSc, scleroderma) and are responsible for a greater health burden in blacks as compared with whites. Disparities in socioeconomic status and access to healthcare do not sufficiently explain the observed differences in prevalence and mortality. It is important to determine whether there might be a biologic basis for the racial disparities observed in SSc.
We present data to suggest that the increased susceptibility and severity of SSc in blacks may result in part from an imbalance of profibrotic and antifibrotic factors. Racial differences in the expression of transforming growth factor-β1 (TGF-β1) and caveolin-1, as well as differences in the expression of hepatocyte growth factor and PPAR-γ, have been demonstrated in blacks with SSc, as well as in normal black individuals. A genetic predisposition to fibrosis may account for much of the racial disparities between black and white patients with SSc.
A better understanding of the biologic basis for the racial disparities observed in SSc may lead to improved therapies, along with the recognition that different therapies may need to be adapted for different groups of patients.
系统性硬化症（SSc，硬皮病）的易感性和严重程度似乎存在种族差异，与白人相比，黑种人患病的负担更重。社会经济地位和获得医疗保健方面的差异并不能充分解释观察到的患病率和死亡率的差异。重要的是要确定在 SSc 中观察到的种族差异是否可能存在生物学基础。
我们提供的数据表明，黑人 SSc 的易感性和严重程度增加可能部分是由于促纤维化和抗纤维化因子的失衡所致。黑人 SSc 患者以及正常黑人个体中，转化生长因子-β1（TGF-β1）和窖蛋白-1的表达存在差异，以及肝细胞生长因子和 PPAR-γ的表达存在差异。纤维化的遗传易感性可能是 SSc 黑人和白人患者之间种族差异的主要原因。
更好地了解 SSc 中观察到的种族差异的生物学基础可能会导致改善治疗方法，同时认识到不同的治疗方法可能需要针对不同的患者群体进行调整。
