Akiyama Shintaro, Fujii Toshimitsu, Matsuoka Katsuyoshi, Yusuke Ebana, Negi Mariko, Takenaka Kento, Nagahori Masakazu, Ohtsuka Kazuo, Isobe Mitsuaki, Watanabe Mamoru
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
J Gastroenterol Hepatol. 2017 May;32(5):1011-1017. doi: 10.1111/jgh.13640.
Takayasu arteritis (TA) is occasionally complicated with inflammatory bowel disease (IBD). This study assessed the endoscopic and genetic features of IBD complicated with TA (IBD-TA).
This study retrospectively reviewed the clinical charts of 142 TA patients (14 men and 128 women; median age 48.5 years [range, 18-97 years]). Human lymphocyte antigen (HLA) types and a single-nucleotide polymorphism rs6871626 in the IL12B gene were assessed in 101 and 81 patients with TA, respectively.
Inflammatory bowel disease was diagnosed in 13 (9.2%) of the 142 patients. The endoscopic features of IBD-TA at initial diagnosis (n = 8) showed discontinuous and focal mucosal inflammations (n = 7, 87.5%), and only one case was diagnosed as ulcerative colitis (UC) at the first colonoscopy. In the genetic comparison of HLA class I between TA patients with IBD and those without IBD, HLA-B52:01 and C12:02 were more frequent in the IBD-TA group (P = 0.001 and P = 0.009, respectively). Meanwhile, HLA-DRB-115:02, DQA-101:03, DQB-106:01, and DPB-109:01 as HLA class II were positively associated with IBD-TA (P = 0.004, P = 0.019, P = 0.019, and P = 0.002, respectively). IL12B rs6871626 did not show an association with IBD-TA compared with that with TA without IBD.
The endoscopic findings of IBD-TA at initial diagnosis were atypical for UC or Crohn's disease. IBD-TA possessed the HLA haplotype, which had a susceptible effect on UC.
大动脉炎(TA)偶尔会并发炎症性肠病(IBD)。本研究评估了合并TA的IBD(IBD-TA)的内镜和遗传特征。
本研究回顾性分析了142例TA患者(14例男性和128例女性;中位年龄48.5岁[范围18 - 97岁])的临床病历。分别对101例和81例TA患者进行了人类淋巴细胞抗原(HLA)分型及白细胞介素12B(IL12B)基因单核苷酸多态性rs6871626的评估。
142例患者中有13例(9.2%)被诊断为炎症性肠病。IBD-TA初诊时(n = 8)的内镜特征显示为不连续和局灶性黏膜炎症(n = 7,87.5%),首次结肠镜检查时仅1例被诊断为溃疡性结肠炎(UC)。在IBD合并TA患者与未合并IBD的TA患者之间进行的HLA I类基因比较中,HLA-B52:01和C12:02在IBD-TA组中更常见(分别为P = 0.001和P = 0.009)。同时,作为HLA II类的HLA-DRB-115:02、DQA-101:03、DQB-106:01和DPB-109:01与IBD-TA呈正相关(分别为P = 0.004、P = 0.019、P = 0.019和P = 0.002)。与未合并IBD的TA患者相比,IL12B rs6871626与IBD-TA无相关性。
IBD-TA初诊时的内镜表现对于UC或克罗恩病而言不典型。IBD-TA具有对UC有易感性作用的HLA单倍型。