Organ Specificity in Autoimmune Diseases: Thyroid and Islet Autoimmunity in Alopecia Areata
Organ Specificity in Autoimmune Diseases: Thyroid and Islet Autoimmunity in Alopecia Areata
复制标题
DOI：
10.1210/jc.2014-3985
复制
发表时间：
2015-05-01
影响因子：
5.8
通讯作者：
Ikegami, Hiroshi
中科院分区：
文献类型：
--
作者：
Noso, Shinsuke;Park, Choongyong;Ikegami, Hiroshi
背景：多种自身免疫性疾病，如针对甲状腺和胰岛的自身免疫，经常在单个患者中观察到。虽然斑秃（AA）是最常见的器官特异性自身免疫性疾病之一，但AA与其他自身免疫性疾病的相关性及其遗传基础仍有待分析。目的：探讨AA患者HLA的异同及甲状腺和胰岛自身免疫的临床特点。参与者：新招募的126例AA患者。检测抗胰岛抗体和抗甲状腺抗体，并测定HLA基因型。结果：在与AA相关的自身免疫性疾病中，自身免疫性甲状腺疾病最为常见（10.0%），其次是白癜风（2.7%）和类风湿性关节炎（0.9%），但不包括1型糖尿病（0.0%）。AA患者甲状腺相关自身抗体的患病率明显高于对照组(TSH受体抗体[TRAb]: 42.7% vs 1.2%, P = 1.6 × 10(-46)；甲状腺过氧化物酶抗体：29.1% vs 11.6%；P = 1.7 x 10(-6))，而AA患者与对照组之间胰岛相关自身抗体的患病率具有可比性。trab阳性AA患者DRB1*15:01-DQB1*06:02的保护性单倍型频率（12.8%,P = 0.0028，校正P值[P-c] = 0.02）显著高于对照组（4.5%），而trab阴性AA患者DRB1*15:01-DQB1*06:02的频率（7.1%，无统计学意义）显著高于对照组（4.5%）。1型糖尿病易感单倍型DRB1*04:05-DQB1* 04:01的频率（trab阳性：8.5%，trab阴性：11.9%）显著低于1型糖尿病患者（29.5%,P-c = 0.0003, P-c = 0.0008）。结论：AA与甲状腺自身免疫相关，而与胰岛自身免疫无关，其与ⅱ类HLA单倍型对各种自身免疫性疾病的易感或抗性相关。
Context: Multiple autoimmune diseases, such as autoimmunity against the thyroid gland and pancreatic islets, are often observed in a single patient. Although alopecia areata (AA) is one of the most frequent organ-specific autoimmune diseases, the association of AA with other autoimmune diseases and the genetic basis of the association remain to be analyzed.Objective: The aim of this study was to clarify the similarities and differences in HLA and clinical characteristics of thyroid and islet autoimmunity in patients with AA.Participants: A total of 126 patients with AA were newly recruited. Anti-islet and antithyroid autoantibodies were tested, and genotypes of HLA genes were determined.Results: Among the autoimmune diseases associated with AA, autoimmune thyroid disease was most frequent (10.0%), followed by vitiligo (2.7%) and rheumatoid arthritis (0.9%) but not type 1 diabetes (0.0%). The prevalence of thyroid-related autoantibodies in patients with AA was significantly higher than that in controls (TSH receptor antibody [TRAb]: 42.7% vs 1.2%, P = 1.6 x 10(-46); thyroid peroxidase antibody: 29.1% vs 11.6%; P = 1.7 x 10(-6)), whereas the prevalence of islet-related autoantibodies was comparable between patients with AA and control subjects. The frequency of DRB1*15:01-DQB1*06:02, a protective haplotype for type 1 diabetes, was significantly higher in TRAb-positive (12.8%, P = .0028, corrected P value [P-c] = .02) but not TRAb-negative (7.1%, not significant) patients with AA than in control subjects (4.5%). The frequency of DRB1*04:05-DQB1*04: 01, a susceptible haplotype for type 1 diabetes, was significantly lower in patients with AA (TRAb-positive: 8.5%; TRAb-negative: 11.9%) than in those with type 1 diabetes (29.5%, P-c = .0003 and P-c = .0008, respectively).Conclusion: AA was associated with thyroid autoimmunity but not islet autoimmunity, which correlated with class II HLA haplotypes susceptible or resistant to each autoimmune disease.