Ann Rheum Dis:遗传风险评分高与系统性红斑狼疮起病早、损伤和生存率降低相关

2019-12-13 xiangting MedSci原创

高GRS与器官损伤、肾功能不全和全因死亡率的风险升高相关。这项研究结果表明,基因分析有助于预测SLE患者的预后。

这项研究旨在探讨系统性红斑狼疮患者(SLE)高遗传疾病风险与疾病严重程度之间的关联。

使用200K免疫芯片单核苷酸多态性阵列对SLE患者(发现队列n=1001,重复队列n=5524)和健康对照(n=2802n=9859)进行基因分型。根据57SLE风险位点对每位个体进行遗传风险评分(GRS)。

GRS低四分位相比,GRS高四分位中的SLE患者更常见(发现队列OR 12.329.53-15.71),p=7.9×10-86;重复队列OR 7.486.73-8.32),p= 2.2×10-304)。在发现队列中,与GRS低四份位患者相比,GRS高四分位患者的平均发病时间提前了6年(HR 1.471.22-1.75),p=4.3×10–5)、损伤(OR 1.471.06-2.04),p=2.0×10-2)、肾病(OR 2.221.50-3.27),p=5.9×10–5)、抗dsDNAOR 1.831.19-2.81),p=6.1×10–3)、终末期肾病(ESRD)(OR 5.581.50-20.79),p= 1.0×10–2)、增殖性肾炎(OR 2.421.30-4.49),p=5.1×10 -3)、抗心磷脂IgGOR 1.891.13-3.18),p=1.6×10-2)、抗β2 -糖蛋白I-IgGOR 2.291.29-4.06),p=4.8×10–3)和狼疮抗凝试验阳性的发生率更高(OR 2.121.16-3.89),p=1.5×10–2)。生存分析表明,与低四分位相比,GRS高四分位患者首个器官损伤(HR 1.511.04-2.25),p=3.7×10–2)、首次心血管事件(HR 1.651.03-2.64),p=2.6×10–2)、肾炎(HR 2.531.72-3.71),p=9.6×10–7)、和ESRD出现时间较早(HR 6.781.78-26.86),p=6.5×10–3),并且总体生存率较低(HR 1.831.02-3.30),p=4.3×10–2)。

GRS与器官损伤、肾功能不全和全因死亡率的风险升高相关。这项研究结果表明,基因分析有助于预测SLE患者的预后。

原始出处:

Sarah Reid. High genetic risk score is associated with early disease onset, damage accrual and decreased survival in systemic lupus erythematosus. Ann Rheum Dis. 11 December 2019.

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    2020-04-04 cmj8wellington
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    2019-12-15 zhouqu_8

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2019年9月,欧洲抗风湿病联盟(EULAR)联合美国风湿病学会(ACR)共同发布了系统性红斑狼疮的分类标准,新的分类标准是在多学科和国际方面的投入下,采用严格的方法制定,具有极好的敏感性和特异性。

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SLICC-FI可以预测偶发性SLE的损害,这进一步支持将SLICC-FI作为SLE的有效健康指标。

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乌司奴单抗在1年内对SLE患者持续有效,其安全性与其他适应症一致。