Alopecia areata and cytomegalovirus infection in twins: Genes versus environment?
Alopecia areata and cytomegalovirus infection in twins: Genes versus environment?
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DOI：
10.1016/s0190-9622(98)70499-2
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发表时间：
1998-03-01
影响因子：
13.8
通讯作者：
Duvic, M
中科院分区：
文献类型：
--
作者：
Jackow, C;Puffer, N;Duvic, M
研究背景：斑秃（Alopecia areata，AA）被认为是一种由T细胞介导的毛囊特异性自身免疫性疾病。遗传易感性可能由HLA赋予，并且怀疑环境触发因素，例如病毒感染。AA在人群中的发病率估计为1.7%，平均四分之一的患者具有阳性家族史。目的：我们的目的是检查AA在同卵与异卵双胞胎之间的一致率以及应激、巨细胞病毒（CMV）感染和疾病之间的相关性。患有AA的家庭是从美国的皮肤科医生那里和通过互联网上的一个网站征集来的。应用聚合酶链反应（PCR）对外周血基因组DNA进行HLA 2型分型和CMV早、晚期基因鉴定。结果：在114个家系中，共鉴定出11对单卵双生子和3对双卵双生子。同卵双胞胎的一致率为55%，异卵双胞胎为0%。大多数同卵双胞胎是男性。AA表型的严重程度各不相同，在第一个受影响的双胞胎中最严重。24对双胞胎中有5对CMV血清学阳性，但在AA发病后研究时，任何受试者的血液淋巴细胞中均未检测到CMV DNA。双胞胎中AA的存在与CMV.Conclusion的证据不相关：55%的一致性罕见的同卵双胞胎和AA发生在家庭支持的遗传成分，以及可能的环境触发器，仍然未知。
Background: Alopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease mediated by T cells directed to the hair follicle. Genetic susceptibility may be conferred by HLA, and an environmental trigger, such as a viral infection, is suspected. The incidence of AA in the population is estimated to be 1.7%, with an average of one in four patients having a positive family history.Objective: Our purpose was to examine the concordance rate of AA among identical versus fraternal twins and the correlation between stress, cytomegalovirus (CMV) infection, and disease.Methods: Families with AA were solicited from dermatologists in the United States and through a Website on the Internet. HLA class 2 typing and identification of CMV early and late genes were performed by polymerase chain reaction (PCR) on genomic peripheral blood DNA. Serum antibodies for CMV were determined by enzyme-linked immunosorbent assay.Results: From 114 families, we identified 11 sets of monozygotic twins and 3 sets of dizygotic twins. The concordance rate was 55% for monozygotic twins and 0% for fraternal twins. Most identical twins were male. The severity of the AA phenotype varied and appeared most severe in the first affected twin. Five of 24 twins were CMV seropositive but CMV DNA was not detected in blood lymphocytes of any of the subjects when studied after the onset of AA. The presence of AA in twins was not correlated with evidence of CMV.Conclusion: A 55% concordance rare in identical twins and AA occurring in families support a genetic component as well as possible environmental triggers that remain unknown.