tailieunhanh - Báo cáo y học: "The contribution of genetic variation and infection to the pathogenesis of ANCA-associated systemic vasculitis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: The contribution of genetic variation and infection to the pathogenesis of ANCA-associated systemic vasculitis. | Willcocks et al. Arthritis Research Therapy 2010 12 202 http content 12 1 202 REVIEW The contribution of genetic variation and infection to the pathogenesis of ANCA-associated systemic vasculitis Lisa C Willcocks1 Paul A Lyons1 Andrew J Rees2-3 and Kenneth GC Smith 1 Abstract The aetiology of anti-neutrophil cytoplasmic antibody ANCA -associated systemic vasculitis has not been well defined. Here we review two factors which may play a role in the pathogenesis of the disease genetics and infection. In particular we discuss the role of autoantibodies to LAMP-2 which may arise following infection with Gram-negative bacteria and may contribute to the development of ANCA-associated systemic vasculitis in genetically susceptible individuals. Introduction Primary systemic vasculitis is characterised by inflammation and necrosis of blood vessel walls. The disease is broadly classified according to the size of the vessels involved as proposed by the Chapel Hill Consensus Conference 1 . Further categorisation relies on clinical and histological findings as well as the detection of autoantibodies. Three of the small vessel vasculitides -Wegener s Granulomatosis WG microscopic polyangiitis MPA and Churg-Strauss syndrome CSS - are typified by vasculitic lesions with little or no immune complex deposition and by anti-neutrophil cytoplasmic antibodies ANCA . These diseases are collectively known as ANCA-associated systemic vasculitis AAV . Many clinical features are common to all types of AAV including nonspecific inflammatory symptoms such as malaise fever anaemia and weight loss. Multiple organ systems may be affected for example vasculitic lesions may manifest as a rash arthralgia pulmonary haemorrhage and necrotising glomerulonephritis. There are however phenotypic differences between types of AAV Correspondence kgcs2@ Cambridge Institute for Medical Research and Department of Medicine University of Cambridge School of Clinical Medicine .

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