Vašků Vladimír, Vašků Anna
1st Department of Dermatology, St. Ann's Faculty Hospital, Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic.
Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic.
Genes (Basel). 2025 Jun 12;16(6):703. doi: 10.3390/genes16060703.
BACKGROUND: The etiopathogenesis of atopic dermatitis is complicated, and it includes aspects such as dysfunction of the skin barrier, changes in immune responses, IgE-mediated hypersensitivity, and many characteristics of the environment. Regarding skin barrier dysfunction, a number of genetic changes have been described. This genetic predisposition could be related to the phenotypes of atopic dermatitis. AIM: In this study, several polymorphisms in five proinflammatory genes were associated with certain phenotypes of AD patients (genotype-phenotype study). METHODS: In total, 89 unrelated AD Czech (Caucasian) patients were genotyped regarding five proinflammatory gene polymorphisms (angiotensinogen AGT M235T, AGT-6 G/A, TNF-α-238 G/A, TNF-β Fok1, IL-6-174 C/G and IL-6-596 G/A). Genotyping was performed using PCR and restriction analysis. For phenotypes, patients' sex, age and personal and family history of atopy, aero- and food allergies and other complex diseases were evaluated. RESULTS: A significant association with transepidermal water loss (TEWL) measured on the forearm was found with the AGT M235T polymorphism ( = 0.02). For the AG genotype of TNF-α-238 G/A, a six-times higher risk for a family history of diabetes mellitus compared to other examined aspects of family history was found ( = 0.02). A family history of thyreopathy was associated with the IL-6-174 G/C polymorphism when compared to a family history of other complex diseases. The GG genotype had a ten-times higher risk for a family history of thyreopathy compared to the other genotypes ( = 0.004). This result was highly specific (0.914). The GG genotype of IL-6-596 G/A was associated with a family history of thyreopathy, with the same result ( = 0.004). Moreover, the G allele of IL-6-174 G/C was associated with a family history of thyreopathy compared to AD patients without a positive family history of complex diseases ( = 0.03). In AD men, the MM genotype of the AGT M235T gene was found to be associated with food allergies ( = 0.004). This result was highly sensitive (0.833). A family history of cardiovascular disease in AD men was associated with AGT-6 G/A variability. The A allele was found to be six times more frequent in patients with a positive family history of cardiovascular disease ( = 0.02, with high sensitivity and specificity (0.700 and 0.735, respectively)). A family history of diabetes mellitus was associated with the TNF-β Fok1 polymorphism, where the B1 allele was almost six times more frequent in AD men with a positive family history of diabetes mellitus ( = 0.02), with high sensitivity (0.85). A significant association between TEWL measured on the forearm and the AGT M235T polymorphism was found when AD women were carriers of the MM genotype, with a median of 25 and range 4-61; those patients with the MT genotype had a median of 10 and range of 0.3-39; and patients with the TT genotype had a median of 5 and range of 3-40, = 0.003. The polymorphism AGT-6 G/A was associated with different ages of eczema onset. The AG genotype was almost nine times more risky for the youngest group (0-7 years) compared to the oldest group (more than 18 years) ( = 0.02), with high specificity for this result. CONCLUSIONS: Our results in the field of cytokine signaling in the immune system in patients with atopic dermatitis are in agreement with those of GWASs. We suggest that cost-effective and simple PCR tests may be the best approach for the rapid and optimal collection of valid genetic information in clinical practice.
背景:特应性皮炎的发病机制复杂,包括皮肤屏障功能障碍、免疫反应变化、IgE介导的超敏反应以及许多环境因素。关于皮肤屏障功能障碍,已有多项基因变化被描述。这种遗传易感性可能与特应性皮炎的表型有关。 目的:在本研究中,五个促炎基因中的几个多态性与AD患者的某些表型相关(基因型-表型研究)。 方法:总共对89名无亲缘关系的捷克(高加索)AD患者进行了五个促炎基因多态性(血管紧张素原AGT M235T、AGT -6 G/A、TNF-α -238 G/A、TNF-β Fok1、IL-6 -174 C/G和IL-6 -596 G/A)的基因分型。基因分型采用PCR和限制性分析进行。对于表型,评估了患者的性别、年龄以及个人和家族的特应性病史、空气和食物过敏史以及其他复杂疾病史。 结果:发现AGT M235T多态性与在前臂测量的经表皮水分流失(TEWL)显著相关(P = 0.02)。对于TNF-α -238 G/A的AG基因型,与家族病史的其他检查方面相比,糖尿病家族史的风险高六倍(P = 0.02)。与其他复杂疾病家族史相比,甲状腺疾病家族史与IL-6 -174 G/C多态性相关。与其他基因型相比,GG基因型的甲状腺疾病家族史风险高十倍(P = 0.004)。该结果具有高度特异性(0.914)。IL-6 -596 G/A的GG基因型与甲状腺疾病家族史相关,结果相同(P = 0.004)。此外,与无复杂疾病阳性家族史的AD患者相比,IL-6 -174 G/C的G等位基因与甲状腺疾病家族史相关(P = 0.03)。在AD男性中,发现AGT M235T基因的MM基因型与食物过敏相关(P = 0.004)。该结果具有高度敏感性(0.833)。AD男性的心血管疾病家族史与AGT -6 G/A变异相关。在心血管疾病阳性家族史的患者中,A等位基因的频率几乎是六倍(P = 0.02),具有高敏感性和特异性(分别为0.700和0.735)。糖尿病家族史与TNF-β Fok1多态性相关,其中B1等位基因在有糖尿病阳性家族史的AD男性中频率几乎高六倍(P = 0.02),具有高敏感性(0.85)。当AD女性为MM基因型携带者时,发现前臂测量的TEWL与AGT M235T多态性之间存在显著关联,MM基因型携带者的中位数为25,范围为4 - 61;MT基因型患者的中位数为10,范围为0.3 - 39;TT基因型患者的中位数为5,范围为3 - 40,P = 0.003。AGT -6 G/A多态性与湿疹发病的不同年龄相关。与最年长组(超过18岁)相比,AG基因型在最年幼组(0 - 7岁)中患湿疹的风险几乎高九倍(P = 0.02),该结果具有高特异性。 结论:我们在特应性皮炎患者免疫系统细胞因子信号传导领域的结果与全基因组关联研究(GWASs)的结果一致。我们建议,具有成本效益且简单的PCR检测可能是临床实践中快速、最佳收集有效遗传信息的最佳方法。
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