Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Division of Rheumatology Allergy and Clinical Immunology, University of California Davis School of Medicine, Davis, California, USA.
Curr Opin Gastroenterol. 2019 Mar;35(2):93-98. doi: 10.1097/MOG.0000000000000507.
Primary biliary cholangitis (PBC) is a female predominant chronic autoimmune disease of the intrahepatic bile ducts and with a long latent period. It is crucial to understand how genetics contribute to the disease.
Geo-epidemiological studies in PBC have provided evidence of familial risk; case-control studies and genome wide association studies have identified various human leukocyte antigen (HLA) and non-HLA alleles that are associated with PBC. However, these alleles are non-PBC specific and most of the identified non-HLA loci were also found to be susceptible genes in other autoimmune diseases and different between study populations.
Patients with PBC are often asymptomatic and often left undiagnosed. There are no known HLA and non-HLA alleles specific for PBC. Global effort and novel approaches such as epigenetics directed at identification of genetic risk factors will greatly facilitate accurate and timely diagnosis, which will improve prognosis and increase treatment options.
原发性胆汁性胆管炎(PBC)是一种女性为主的慢性肝内自身免疫性胆管疾病,具有较长的潜伏期。了解遗传因素如何导致该疾病非常重要。
PBC 的地理流行病学研究提供了家族风险的证据;病例对照研究和全基因组关联研究已经确定了与 PBC 相关的各种人类白细胞抗原(HLA)和非 HLA 等位基因。然而,这些等位基因并非 PBC 特异性,并且大多数已确定的非 HLA 基因座也被发现在其他自身免疫性疾病中是易感基因,且在不同的研究人群之间存在差异。
PBC 患者通常无症状,且经常未被诊断出来。目前尚无针对 PBC 的特定 HLA 和非 HLA 等位基因。全球努力和新方法,如针对遗传风险因素的表观遗传学,将极大地促进准确和及时的诊断,从而改善预后并增加治疗选择。