Renauer Paul, Sawalha Amr H
University of Michigan, department of internal medicine, division of rheumatology, Ann Arbor, MI, USA.
University of Michigan, department of internal medicine, division of rheumatology, Ann Arbor, MI, USA; University of Michigan, center for computational medicine and bioinformatics, Ann Arbor, MI, USA.
Presse Med. 2017 Jul-Aug;46(7-8 Pt 2):e179-e187. doi: 10.1016/j.lpm.2016.11.031. Epub 2017 Jul 26.
Takayasu arteritis (TAK) is a rare systemic vasculitis that is characterized by granulomatous inflammation of the aorta and its major branches. The cellular and biochemical processes involved in the pathogenesis of TAK are beginning to be elucidated, and implicate both cell and antibody-mediated autoimmune mechanisms. In addition, the underlying etiology to TAK may be explained, at least in part, by a complex genetic contribution. The most well-recognized genetic susceptibility locus for the disease is the classical HLA allele, HLA-B52, which has been confirmed in several ethnicities. The genetic susceptibility with HLA-B52, as well as additional classical alleles and loci, implicate both HLA class I and class II involvement in TAK. Furthermore, genetic associations with genes encoding immune response regulators, pro-inflammatory cytokines and mediators of humoral immunity may directly relate to disease mechanisms. Non-HLA susceptibility loci that have been recently established for TAK with a genome-wide level of significance include FCGR2A/FCGR3A, IL12B, IL6, RPS9/LILRB3, and a locus on chromosome 21 near PSMG1. In this review, we present the complex genetic predisposition to TAK and discuss how recent findings identified potential targets in the pathogenesis and treatment of the disease.
高安动脉炎(TAK)是一种罕见的系统性血管炎,其特征是主动脉及其主要分支发生肉芽肿性炎症。TAK发病机制中涉及的细胞和生化过程正逐渐被阐明,涉及细胞介导和抗体介导的自身免疫机制。此外,TAK的潜在病因至少部分可以用复杂的遗传因素来解释。该疾病最广为人知的遗传易感性位点是经典的HLA等位基因HLA-B52,已在多个种族中得到证实。HLA-B52以及其他经典等位基因和位点的遗传易感性表明HLA I类和II类均参与TAK。此外,与编码免疫反应调节因子、促炎细胞因子和体液免疫介质的基因的遗传关联可能直接与疾病机制相关。最近在全基因组水平上确定的与TAK相关的非HLA易感性位点包括FCGR2A/FCGR3A、IL12B、IL6、RPS9/LILRB3以及21号染色体上靠近PSMG1的一个位点。在本综述中,我们阐述了TAK复杂的遗传易感性,并讨论了最近的研究结果如何确定了该疾病发病机制和治疗中的潜在靶点。