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Neurology:自身免疫性疾病史增加肌萎缩侧索硬化发病风险
文章来源:中国医药化工网    添加人:admin    添加时间:2016/12/8 15:45:15
 
多种自身免疫性疾病与ALS相关

研究要点:

自身免疫性疾病与ALS存在相关性。 探索ALS发病机制的进步,证实自身免疫因素可能参与了ALS的发病。 该研究是一项流行病学研究。

自身免疫性疾病病史是否为肌萎缩侧索硬化(ALS)的危险因素尚不清楚。为此,英国牛津大学临床神经科学Nuffield研究所的Martin R. Turner博士等人进行了一项研究,研究结果在线发表在2013年8月14日的Neurology杂志上。研究结果显示:自身免疫性疾病与ALS相关。

该研究是一项流行病学研究。研究人员使用1999-2011年的全英格兰医院记录关联数据库,以该数据库为基础建立各种自身免疫性疾病患者的队列,每个队列的ALS发病率与既往没有自身免疫性疾病住院史的人群的ALS发病率进行比较。

研究结果显示:既往诊断为哮喘、肠病、年轻起病糖尿病(年龄小于30岁)、多发性硬化、重症肌无力、粘液性水肿、多发性肌炎、干燥综合征、系统性红斑狼疮和溃疡性结肠炎的患者ALS的发病率显著高于预期。

该研究发现:自身免疫性疾病与ALS相关。ALS很可能是遗传因素和环境因素共同作用的结果。

研究背景:

了解神经退行性疾病的危险因素有助发现疗效更好的治疗方法。肌萎缩侧索硬化(ALS)是一种快速进展的神经退行性疾病,症状出现后的中位生存时间为3-5年。95%的病例都是散发病例。研究发现ALS的运动外通路与额颞叶痴呆存在共同通路。

患者人群中,大学运动员和职业橄榄球运动员的比例高于总体人群。同时,ALS患者休闲时间体育活动更多、体块指数更低,心血管风险也更低。关于ALS患者合并症的研究很少。一项病例对照研究发现多种疾病(包括内分泌疾病)患者的ALS发病率没有显著性差异。而另一项队列研究发现ALS患者心血管疾病的发生率及心血管疾病危险因素显著低于总体人群。很久之前,人们就怀疑自身免疫因素是ALS的病因或异质性的调节因素,但是没有发现明确的人类淋巴细胞抗原相关性,这一想法一直没有得到有力的证据支持。

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