Molekulare Pathomechanismen von HLA-B27 und anderen Genen bei Spondyloarthritiden

Zusammenfassung

Der Oberflächenrezeptor HLA-B27 wird bei 85 - 95 % aller Patienten mit ankylosierender Spondylitis (AS) nachgewiesen und ist damit das MHC-Klasse-I-Molekül mit der höchsten Krankheitsassoziation beim Menschen. Es besteht eine starke Korrelation zwischen dem Auftreten von HLA-B27, der Prävalenz von ankylosierender Spondylitis und den anderen Spondyloarthritiden. Es wird ferner vermutet, dass zusätzliche Umweltfaktoren eine Rolle bei der Krankheitsentstehung spielen. Hierbei scheinen vor allem Bakterien und deren Interaktion mit HLA-B27 von großer Bedeutung zu sein. Obwohl bereits zahlreiche Krankheitsmodelle zur Rolle von HLA-B27 und Mikroben bei der AS vorgestellt worden sind, bleibt die Pathogenese dieser Erkrankung ungeklärt. HLA-B27 ist zwar das Gen mit der höchsten bisher dargelegten Assoziation mit AS, es gibt aber daneben noch eine sehr große Anzahl weiterer Gene, die auch mit der AS und den anderen Spondyloarthritiden assoziiert zu sein scheinen. Die Bedeutung von HLA-B27 und der anderen bisher bekannten assoziierten Gene werden in dieser Arbeit vorgestellt und bewertet.

Abstract

The surface receptor HLA-B27 is found in 85 - 95 % of patients with ankylosing spondylitis (AS), which is one of the strongest associations between MHC class I molecules and human disease. There is a high correlation between the overall HLA-B27 prevalence in a population and the prevalence of ankylosing spondylitis and other spondyloarthropathies, suggesting that additional environmental factors play an important role in the development of the disease. Among these, bacteria and their interaction with HLA-B27 appear to be the most important factors. To date, numerous models have been proposed, attempting to explain the association of AS with HLA-B27 and bacteria. The pathogenetic mechanisms, however remain unsolved. Although HLA-B27 is the major gene involved in susceptibility to AS, several other genes appear to be linked to AS and the spondyloarthritic group of diseases. In this paper, the significance of HLA-B27 and other known associated genes is presented and discussed.

Schlüsselwörter

HLA-B27 - Spondyloarthritis - Gene

Key words

HLA-B27 - Gens - Spondyloarthritis

Literatur

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