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希腊多发性硬化症队列中的多自身免疫现象

Polyautoimmunity in a Greek cohort of multiple sclerosis.

作者信息

Deretzi G, Kountouras J, Polyzos S A, Koutlas E, Pelidou S-H, Xeromerisiou G, Zavos C, Tsiptsios I

机构信息

Department of Neurology, Multiple Sclerosis Unit, Papageorgiou General Hospital, Thessaloniki, Greece.

出版信息

Acta Neurol Scand. 2015 Apr;131(4):225-30. doi: 10.1111/ane.12308. Epub 2014 Oct 1.

Abstract

OBJECTIVES

The aim of this study was to assess the existence of polyautoimmunity in a Greek cohort of multiple sclerosis (MS), particularly multiple autoimmune syndrome (MAS), i.e., the presence of three or more distinct autoimmune disorders (ADs) in the same individual.

METHODS

Cross-sectional control study.

RESULTS

The overall prevalence of polyautoimmunity in 2140 MS patients (female to male ratio: 2.1:1) was 8.3% (vs 6.07% in 1580 matched control participants, P = 0.008) mainly due to differences in autoimmune thyroid disorders (AITD) and vitiligo. The prevalence of MAS was 1.0%. The most frequent diseases encountered in MS were organ-specific ADs. There was no statistical difference in the total rates of ADs between female and male MS patients. There were higher rates of AITD in women (P = 0.004) and higher rates of iritis (P = 0.039) and ankylosing spondylitis (P = 0.003) in men. MS was diagnosed in the same year with AD in 7.4% of patients with additional ADs, earlier than AD in 42.0% and later than AD in 50.6%.

CONCLUSION

Polyautoimmunity and particularly MAS occur more frequently in MS patients than in control participants indicating that MS may be part of a generalized susceptibility to autoimmunity. Therefore, polyautoimmunity may be implicated in the etiopathogenesis of MS-related ADs, with a potential impact on relative therapeutic strategies.

摘要

目的

本研究旨在评估希腊多发性硬化症(MS)队列中多自身免疫性的存在情况,特别是多重自身免疫综合征(MAS),即在同一个体中存在三种或更多不同的自身免疫性疾病(ADs)。

方法

横断面对照研究。

结果

2140例MS患者(女性与男性比例为2.1:1)中多自身免疫性的总体患病率为8.3%(而1580例匹配对照参与者中的患病率为6.07%,P = 0.008),主要是由于自身免疫性甲状腺疾病(AITD)和白癜风的差异。MAS的患病率为1.0%。MS患者中最常见的疾病是器官特异性ADs。女性和男性MS患者的ADs总发生率无统计学差异。女性的AITD发生率较高(P = 0.004),男性的虹膜炎发生率较高(P = 0.039)和强直性脊柱炎发生率较高(P = 0.003)。在患有额外ADs的患者中,7.4%的患者MS与AD在同一年被诊断,42.0%的患者MS诊断早于AD,50.6%的患者MS诊断晚于AD。

结论

MS患者中多自身免疫性尤其是MAS的发生频率高于对照参与者,表明MS可能是自身免疫性普遍易感性的一部分。因此,多自身免疫性可能与MS相关ADs的发病机制有关,对相关治疗策略可能产生潜在影响。

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