AIM： To determine the association between the HLADRB1 alleles and perinuclear anti-neutrophil cytoplasmatic antibodies （p-ANCA） positive in Mexican patients with ulcerative colitis （UC）. METHODS： Ninety Mexican ...AIM： To determine the association between the HLADRB1 alleles and perinuclear anti-neutrophil cytoplasmatic antibodies （p-ANCA） positive in Mexican patients with ulcerative colitis （UC）. METHODS： Ninety Mexican mestizo patients （45 females） with UC, confirmed by biopsy, were studied. High resolution HLA typing was performed by PCR-SSO reverse dot blot and PCR-SSP. Molecular typing techniques were applied to define HLA-DRB1 alleles. Enzyme-linked immunosorbent assay and immunofluorescence techniques were used to detect p-ANCA. RESULTS： Forty-eight （53%） UC patients were positive for p-ANCA by ELISA and IF. We found that p-ANCA- positive UC patients had a significantly increased frequency of HLA-DR7 compared with p-ANCA-negative controls （22% vs 5.1%; pC=0.02, OR=5.2, CI 95%： 1.06-37.82）. Disease activity was scored as severe in 20 patients, moderate in 8, mild in 14 and no activity in the remaining 38 patients according to the Truelove and Witts criteria. Subgroup analysis showed a significantly increased frequency of the HLA-DRB1＊07 allele in 15 of 20 UC patients with severe activity of UC and p-ANCA positivity [100% vs 0%; pC=0.0000001; OR=35]. No significant differences were found between p-ANCA positive patients, HLA-DR alleles and other clinical features such as extraintestinal manifestations, proctocolectomy and extension.CONCLUSION： The HLA-DRB1＊07 is associated with p-ANCA positive UC Mexican patients.展开更多
Autoimmune pancreatitis has received considerable attention,especially due to the marked effect of corticosteroid therapy on its clinical course.Knowledge,especially regarding type 1 autoimmune pancreatitis,has signif...Autoimmune pancreatitis has received considerable attention,especially due to the marked effect of corticosteroid therapy on its clinical course.Knowledge,especially regarding type 1 autoimmune pancreatitis,has significantly increased over the last decades,and despite significant differences in pathophysiology and outcomes,both type 1 and 2 autoimmune pancreatitis are still considered different types of the same disease.Some have proposed a different nomenclature reflecting these differences.Although the term steroid-responsive pancreatitides may be interpreted as synonymous to type 1 and 2 autoimmune pancreatitis,these are not the only pancreatic conditions that show a response to steroid therapy.Acute pancreatitis caused by vasculitis and connective tissue diseases and acute pancreatitis secondary to checkpoint inhibitors or programmed cell death receptor antibody-mediated blockage cancer therapy may also benefit from steroid treatment.This review presents current concepts on these disorders,aiming to increase awareness,analyze similarities and differences,and propose a new nomenclature that reflects their specific particularities,clustering them under the term"steroid-responsive pancreatitides".展开更多
基金Supported by Consejo Nacional de Ciencia y Tecnologia CONACYT,NO. 153237
文摘AIM： To determine the association between the HLADRB1 alleles and perinuclear anti-neutrophil cytoplasmatic antibodies （p-ANCA） positive in Mexican patients with ulcerative colitis （UC）. METHODS： Ninety Mexican mestizo patients （45 females） with UC, confirmed by biopsy, were studied. High resolution HLA typing was performed by PCR-SSO reverse dot blot and PCR-SSP. Molecular typing techniques were applied to define HLA-DRB1 alleles. Enzyme-linked immunosorbent assay and immunofluorescence techniques were used to detect p-ANCA. RESULTS： Forty-eight （53%） UC patients were positive for p-ANCA by ELISA and IF. We found that p-ANCA- positive UC patients had a significantly increased frequency of HLA-DR7 compared with p-ANCA-negative controls （22% vs 5.1%; pC=0.02, OR=5.2, CI 95%： 1.06-37.82）. Disease activity was scored as severe in 20 patients, moderate in 8, mild in 14 and no activity in the remaining 38 patients according to the Truelove and Witts criteria. Subgroup analysis showed a significantly increased frequency of the HLA-DRB1＊07 allele in 15 of 20 UC patients with severe activity of UC and p-ANCA positivity [100% vs 0%; pC=0.0000001; OR=35]. No significant differences were found between p-ANCA positive patients, HLA-DR alleles and other clinical features such as extraintestinal manifestations, proctocolectomy and extension.CONCLUSION： The HLA-DRB1＊07 is associated with p-ANCA positive UC Mexican patients.
文摘Autoimmune pancreatitis has received considerable attention,especially due to the marked effect of corticosteroid therapy on its clinical course.Knowledge,especially regarding type 1 autoimmune pancreatitis,has significantly increased over the last decades,and despite significant differences in pathophysiology and outcomes,both type 1 and 2 autoimmune pancreatitis are still considered different types of the same disease.Some have proposed a different nomenclature reflecting these differences.Although the term steroid-responsive pancreatitides may be interpreted as synonymous to type 1 and 2 autoimmune pancreatitis,these are not the only pancreatic conditions that show a response to steroid therapy.Acute pancreatitis caused by vasculitis and connective tissue diseases and acute pancreatitis secondary to checkpoint inhibitors or programmed cell death receptor antibody-mediated blockage cancer therapy may also benefit from steroid treatment.This review presents current concepts on these disorders,aiming to increase awareness,analyze similarities and differences,and propose a new nomenclature that reflects their specific particularities,clustering them under the term"steroid-responsive pancreatitides".
