Ho nahanoa hore ho na le liphatsa tsa tlhaho tsa lefutso le ntho e etsang hore motho a tšoaroe ke ramatiki. Ka mohlala, bafuputsi ba fumane hore hoo e ka bang karolo ea 40 lekholong ea batho ba nang le psoriasis kapa ramoriki ea lefu la psoriatic ba na le pale ea lelapa ea mafu a amanang le boemo ba pele. Liphuputso tsa malapa li bontšitse hore lefu la masapo a psoriatic ka makhetlo a 55 a ka ba le menyetla e mengata ea ho ba le beng ka bona ba batho ba nang le lefu lena ha ba bapisoa le taolo e sa amanang.
Lipatlisisong tsa liphatsa tsa lefutso, lentsoe "concordance" le bolela ho lekanngoa ha leihlo la mafahla mabapi le boteng kapa ho se be teng ha lefu kapa tšobotsi. Tlhōlisano ea concordance ea lefu la psoriatic (karolo ea 30 lekholong) e phahametse haholo ho feta psoriasis (karolo ea 7 lekholong). Liphuputso tse peli tsa lipina tsa psoriasis li bontšitse hore ho na le palo e phahameng ea li-concordane pakeng tsa mafahla a tšoanang le mafahla a morabe.
Ho khetholla liphatsa tsa lefutso tse amanang le ho tšoaroa ke mafu a itseng hase mosebetsi o monyenyane. E ka 'na ea kenyelletsa:
- Liphuputso tse tloaelehileng tsa ho hlophisa batho: Ho batla ho hlophisoa ha boloetse ka hara malapa.
- Tlhahlobo ea khethollo: Ho tseba hore na liphatsa tsa lefutso tse kholo li amahanngoa le ho aroloa ha tšobotsi e itseng ea phenotypic (ke hore, tšobotsi e hlokomelehang).
- Tlhaloso ea likamano: Ho khetholla mokhatlo oa phetoho pakeng tsa liphatsa tsa lefutso tse thehiloeng sebakeng sa bona ka chromosome.
- Tlhahlobo ea mokhatlo: Ho sibolla likamano tse tsoang ho data, tabeng ena, ho fumana liphatsa tsa lefutso tse hlakileng kapa libaka tsa genome tse tlatsetsang lefung le itseng.
- Liphuputso tse sebetsang ho khetholla liphatsa tsa lefutso: Ho ithuta ho fapana ha tlhaho kapa ts'ebetso ea ts'ebetso ea liteko tse amang liphatsa tsa lefutso, li-chromosome le tse ling.
E utloahala e rarahaneng le e ferekanyang? Ho joalo, joalo ka ha e ka ba lebitso la nomenclature . Empa, a re hlahlobeng se fumanoeng.
HLA (Human Leukocyte Antigen)
Ho sibolloa ha MHC (mochine o moholo oa phetoho ea hae) ka chromosome 6 e ne e le ntho ea bohlokoa ho ithuta liphatsa tsa lefutso tse nang le ramatiki ea psoriatic.
Ho 'nile ha khethoa lintho tse' maloa tsa liphatsa tsa lefutso. Ho na le botsoalle bo tummeng pakeng tsa sebaka sa HLA (human leukocyte antigen) sa MHC se tsejoang e le HLA-C, haholo-holo HLA-C6, le ho amoheleha ho psoriasis. Ho kopana le HLA-Cw6 ho fokotseha hanyenyane ho ramoriki ea psoriatic, moo HLA-B27 e amanang haholo (haholo-holo ho batho ba nang le litšoantšo tsa mokokotlo oa ramoriki ea psoriatic), joalo ka HLA-B38 le HLA-B39. HLA-C6 e amahanngoa le ho qala ho psoriasis (e ka tlaase ho lilemo tse 40) hammoho le boloetse bo matla haholo. Ho li-antigen tse ling tsa HLA, ho tsebahala hore HLA-B13, HLA-B17, HLA-B57, le HLA-Cw * 0602 li etsahala khafetsa ho batho ba nang le ramatiki ea psoriatic ha bapisoa le batho ba bangata.
Li-alleles tse latelang (e 'ngoe ea mefuta e' meli kapa e meng e mengata ea liphatsa tsa lefutso e hlahisoang ke phetoho ea lefutso, e fumanehang sebakeng se le seng ka chromosome) e fumanoe e amahanngoa haholo le ramatiki ea psoriatic ha e bapisoa le psoriasis: B * 8, B * 27, B * 38, le C * 06. Hape ho na le HLA haplotypes (sehlopha sa liphatsa tsa lefutso tse futsitsoeng hammoho ho motsoali a le mong) tse amanang le ramatiki ea psoriatic: B * 18, C * 07, B * 27, B38, le B * 8.
Le hoja ho thoe HLA-B27 e na le boleng bo phahameng ka ho fetisisa ba phallo ea psoriatic khahlanong le psoriasis, hase nnete.
Maqhubu a HLA-B27 a phahame ka ankylosing spondylitis le ramatiki e sebetsang hantle ha a bapisoa le ramatiki ea psoriatic. Hape ke habohlokoa ho bolela hore batho ba bangata ba nang le psoriasis le e 'ngoe ea li- spondyloarthropathies li mpe ho HLA-B27. Hape, batho ba bangata ba nang le ramatiki ea psoriatic ba nang le tšusumetso bakeng sa HLA-B27 ha ba bontše ho kopana ha mokokotlo.
Liphuputso tse ling li bontšitse botsoalle pakeng tsa ramoriki ea psoriatic le HLA-DR4 , antigen e tsejoang hore e amahanngoa le ramatiki ea lefu la masapo . The alleles e fapana pakeng tsa maemo ana a mabeli, leha ho le joalo, ka HLA-DRB1 * 0401 ho ba bonolo haholo ho batho ba nang le ramatiki ea psoriatic ba nang le tšusumetso bakeng sa HLA-DRB1 * 04 ho feta har'a batho ba nang le ramatiki ea lefuba.
Ntho e fapaneng ke 'nete bakeng sa HLA-DRB1 * 0402, e leng khafetsa tabeng ea ramatiki ea psoriatic ho feta lefu la ramatiki. Liphatsa tse ling tsa lefutso ka hare ho sebaka sa MHC le tsona li ithutile.
GWAS (Genome-Wide Association Scans)
Mokhatlo oa batho ba bangata o hlahloba (GWAS) ho hlahloba mefuta e tloaelehileng ea liphatsa tsa lefutso har'a batho ba fapaneng ka boiteko ba ho netefatsa hore na phapang efe kapa efe e amahanngoa le tšobotsi. Ho ea ka Mekhoa e Metle le Lipatlisiso: Clinical Rheumatology (2014), liphatsa tsa lefutso tse 36 li fihletse bohlokoa ba genome 'me li na le karolo ea 22% ea psoriasis heritability. Litho tsa GWAS tse nkoang li hlaheletse psoriasis li kenyeletsa HLA-C6, IL12B, IL23R, IL23A, TNIP1, TNFAIP3, LCE3B-LCE3C, TRAF3IP2, NFkBIA, FBXL19, TYK2, IFIH1, REL le ERAP1. Liphatsa tsa lefutso tse fumanoang ke GWAS tse tummeng ka ramatiki ea psoriatic li akarelletsa HLA-B / C, HLA-B, IL-12B, IL-23R, TNIP1, TRAF3IP2, FBXL19, le REL.
Ntho e ka tlaase
Haeba u na le setho sa lelapa se nang le ramatiki ea psoriatic, ho ithuta hore lipatlisiso li bontšitse ka makhetlo a 55 monyetla o moholo oa ho ntlafatsa boemo bo ka 'na ba tšoenyeha. Itšireletse ka tsebo e nepahetseng-mohlomong u na le maikutlo a fosahetseng ka boemo boo lintlha li ka u thusang hore li otlolohe, ho fokotsa khatello ea hau. 'Me, ho hlakile, lula u buisana ka bolokolohi le ngaka ea hao ea tlhokomelo ea bophelo.
Lisebelisoa:
Tlhahlobo ea lipatlisiso tsa malapa a ho arolelana le lits'ebeletso tse rarahaneng. Matthews AG le al. Stat Med. 2008 ka la 30 October; 27 (24): 5076-5092.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562890/
Psoriatic Arthritis. Mekhoa e metle le lipatlisiso: Meriana ea Rheumatology. O'Reilly DD et al. 2014 Oct; 28 (5): 673-85.
http://www.ncbi.nlm.nih.gov/pubmed/25488777
Pathogenesis ea Psoriatic Arthritis. E maemong. Gladman le Ritchlin. E hlahlobisitsoe ka May 2016.
https://www.uptodate.com/contents/pathogenesis-of-psoriatic-arthritis
Liphoofolo tsa Psoriasis le Psoriatic Arthritis. Indian Journal of Dermatology. V. Chandran. 2010 ka la 12-jone.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887520/
Psoriatic Arthritis. Pathogenesis. Genetic Factors. Kelley's Textbook ea Rheumatology. Khaolo ea 77. Khatiso ea bone. Elsevier.