各种病因的风湿病患者的皮肤纹

M. Nechaeva, V. Kalaev, E. Gosteva, E. Kalaeva, A. Sotnikov, Yulia Elfimova
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引用次数: 0

摘要

由基因组紊乱引起的突变和遗传疾病经常表现在表型水平上,特别是在皮肤印记水平上,这使得使用皮肤印记作为任何遗传疾病的标记成为可能。风湿病是以全身结缔组织损伤为特征的一组疾病,本质上与免疫系统病理有关。结缔组织的全身性进行性解体是整个类风湿疾病的形态学基础。类风湿关节炎和强直性脊柱炎在早期阶段是多因素和难以诊断的疾病,这表明需要识别标志物,以便尽早发现这些疾病。在这些疾病的发病机制中,遗传成分起着特殊的作用,而最近的研究强调了遗传决定在疾病进展中的份额有所不同。本研究的目的是确定类风湿关节炎和强直性脊柱炎患者的皮肤纹样特征。研究了强直性脊柱炎、类风湿关节炎患者的手指纹图,以及一般人群样本的代表。统计数据处理采用非参数Van der Waerden检验。为了建立这些疾病的预测因子,采用ROC分析。与类风湿关节炎患者相比,强直性脊柱炎患者的手指形态与对照组的差异更大。因此,强直性脊柱炎患者的总脊数和左臂纹强度指数均低于对照组。强直性脊柱炎患者比类风湿关节炎患者有更多的病理预测因子。结果分析表明,检查者右臂上没有放射状环和双环可能表明患这些疾病的可能性。类风湿关节炎和强直性脊柱炎的所有预测因子都具有高敏感性和低特异性的特点,这使得类风湿关节炎和强直性脊柱炎成为初步筛选研究和形成这些病理发展的危险群体的方便标记。然而,不建议使用这些预测因子来建立最终诊断,因为它们的低特异性会导致大量的假阳性结果。与类风湿关节炎患者相比,强直性脊柱炎患者的指纹与对照组的差异更大,病理预测指标也更多。可以认为,遗传成分在强直性脊柱炎的发病机制中起着更为显著的作用,而类风湿关节炎的形成更多是由环境因素引起的。我们的研究证实了将皮肤印记作为临床医学中额外的遗传标记的可行性。皮肤印记指标可用于炎性关节疾病一级预防危险人群的形成,解决医学和遗传咨询的诸多问题,预示着该研究领域的前景。
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DERMATOGLYPHS OF PATIENTS SUFFERING FROM RHEUMATIC DISEASES OF VARIOUS ETIOLOGIES
Mutations and genetic diseases, caused by genome disorders, frequently manifest at the phenotypic level and, especially, at the dermatoglyphic level, that makes it possible to use dermatoglyphs as markers of any genetic diseases. Rheumatic diseases is a group of disorders, characterized by systemic conjunctive tissue damage, essentially, connected with immune system pathology. Systemic progressive disorganization of conjunctive tissue is morphological base for the whole group of rheumatic diseases. Rheumatoid arthritis and ankylosing spondylitis are multifactorial and difficult-to-diagnose in the early stages diseases, that indicates the need to identify markers, that allows to detect these diseases as early as possible. A special role in the pathogenesis of these diseases is assigned to the genetic component, while recent studies have highlighted the shares of genetic determination in the disease’s advance are somewhat differ. The goal of this research was to identify the features of dermatoglyphic patterns of patients with rheumatoid arthritis and ankylosing spondylitis. Finger dermatoglyphic drawings of patients suffering from ankylosing spondylitis, rheumatoid arthritis, and representatives of the general population sample were studied. Statistical data processing was performed using non-parametric Van der Waerden test. To establish predictors of these diseases, ROC analysis was used. In persones suffering from ankylosing spondylitis there were found more differences in finger patterns from the control group, than in patients with rheumatoid arthritis. So, the total ridge count and the intensity index of the patterns on the left arm of patients with ankylosing spondylitis were lower than in the control group. Peoples with ankylosing spondylitis had more predictors of pathology than patients with rheumatoid arthritis. The analysis of the results shows that the absence of radial loops on the right arm and double loops in the examined persons may indicate the probability of developing these diseases. All predictors of rheumatoid arthritis and ankylosing spondylitis were characterized by high sensitivity and low specificity, which makes them convenient markers for preliminary screening studies and the formation of risk groups for the development of these pathologies. However, it is not recommended to use these predictors for establishing a final diagnosis, since their low specificity will cause to a large number of false-positive results among the examined persons. Individuals with ankylosing spondylitis have more differences in fingerprints from the control group and more predictors of pathology than patients with rheumatoid arthritis. It can be assumed that the genetic component plays a more significant role in the pathogenesis of ankylosing spondylitis, and the formation of rheumatoid arthritis is more caused by environmental factors. Our study confirms the feasibility of considering dermatoglyphs as an additional genetic marker in clinical medicine. Dermatoglyphic indicators can be used in the formation of risk groups for inflammatory joint diseases for primary prevention, for solving a number of issues of medical and genetic consulting, which indicates the prospects of this research area.
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