Multiple sclerosis in the Japanese population
Multiple sclerosis in the Japanese population
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DOI：
10.1016/s1474-4422(03)00308-9
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发表时间：
2003-02-01
期刊：
影响因子：
48
通讯作者：
Kira, J
中科院分区：
文献类型：
--
作者：
Kira, J
亚洲人群中多发性硬化症（MS）的特点是视神经和脊髓选择性且严重受累，且患病率较低。日本 15-40% 的多发性硬化症病例属于这种“视脊髓”类型。与传统多发性硬化症相比，这种形式的多发性硬化症通常发病年龄较高，女性与男性的比例也较高。视脊髓多发性硬化症的特征还包括频繁复发、严重残疾、MRI 上可见的脑部病变很少、脊髓 MRI 上可见的延伸到多个椎段的长病变、脑脊液中细胞增多和寡克隆带的缺失，以及在整个复发和缓解阶段 T-helper-1 和 T-细胞毒性-1 细胞反应的显着变化。日本人的传统多发性硬化症与白人多发性硬化症一样，与 HLA-DRB1*1501 相关，而视神经脊髓多发性硬化症与 HLA-DPB1*0501 相关。在 20 世纪 60 年代现代化后出生的日本人中，传统 MS 与视神经 MS 的比例迅速增加。视脊髓多发性硬化症可能具有独特的免疫介导机制，而该机制在传统多发性硬化症中不起作用。
Multiple sclerosis (MS) in Asian populations is characterised by the selective and severe involvement of the optic nerve and spinal cord as well as low prevalence rates. 15-40% of cases of MS in Japan are of this "opticospinal" type. This form of MS generally has a higher age at onset and a higher female to male ratio than conventional MS. Opticospinal MS is also characterised by frequent relapses, severe disability, few brain lesions visible on MRI, long lesions extending over many vertebral segments visible on spinal-cord MRI, pleocytosis and an absence of oligoclonal bands in the CSF, and a pronounced shift in the responses of T-helper-1 and T-cytotoxic-1 cells throughout relapse and remission phases. Conventional MS in Japanese people is, like MS in white people, associated with HLA-DRB1*1501, whereas optico-spinal MS is associated with HLA-DPB1*0501. In Japanese people born after modernisation in the 1960s, the ratio of conventional to opticospinal MS has increased rapidly. Opticospinal MS is likely to have a distinct immune-mediated mechanism, which is not operative in conventional MS.