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抗中性粒细胞胞浆抗体相关性血管炎更新:遗传发病机制。

Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Update: Genetic Pathogenesis.

机构信息

Institute of Dermatology and Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, China.

Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.

出版信息

Front Immunol. 2021 Mar 26;12:624848. doi: 10.3389/fimmu.2021.624848. eCollection 2021.

Abstract

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is characterized by the inflammation of small and medium vessels and presence of proteinase 3-ANCA or myeloperoxidase-ANCA in the circulation. AAV comprises three clinical subtypes: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic GPA (EGPA). Although the pathogenesis of AAV is still unclear, genetic and environmental factors and the immune system are thought to be involved. Genetic factors have been confirmed to play an important role in AAV. Genome-wide association studies have identified numerous genetic variants in MHC and non-MHC regions associated with AAV. The strongest evidence of MHC association in AAV is human leukocyte antigen (HLA)-DP. A significant association between AAV and genetic variations in non-MHC regions, such as , , , , and has also been found. Moreover, different clinical subtypes of AAV have distinct genetic backgrounds. GPA is associated with , MPA with , and EGPA with . These findings could help elucidate the etiology of AAV and develop new biomarkers for diagnosis and targeted therapy. Herein, we briefly summarize the updates on the genetic pathogenesis and biomarkers of AAV.

摘要

抗中性粒细胞胞质抗体(ANCA)相关性血管炎(AAV)的特征是小血管和中等血管的炎症,以及循环中存在蛋白酶 3-ANCA 或髓过氧化物酶-ANCA。AAV 包括三种临床亚型:肉芽肿性多血管炎(GPA)、显微镜下多血管炎(MPA)和嗜酸性粒细胞 GPA(EGPA)。尽管 AAV 的发病机制尚不清楚,但遗传和环境因素以及免疫系统被认为与之相关。遗传因素已被证实在 AAV 中发挥重要作用。全基因组关联研究已经确定了许多与 AAV 相关的 MHC 和非 MHC 区域的遗传变异。在 AAV 中,MHC 关联的最强证据是人类白细胞抗原(HLA)-DP。还发现 AAV 与非 MHC 区域的遗传变异,如 、 、 、 和 之间存在显著关联。此外,不同的 AAV 临床亚型具有不同的遗传背景。GPA 与 相关,MPA 与 相关,EGPA 与 相关。这些发现有助于阐明 AAV 的病因,并为诊断和靶向治疗开发新的生物标志物。在此,我们简要总结了 AAV 的遗传发病机制和生物标志物的最新进展。

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