RESUMO
The paper presents the All-Russian consensus on the diagnosis and treatment of celiac disease in children and adults, which has been elaborated by leading experts, such as gastroenterologists and pediatricians of Russia on the basis of the existing Russian and international guidelines. The consensus approved at the 42nd Annual Scientific Session of the Central Research Institute of Gastroenterology on Principles of Evidence-Based Medicine into Clinical Practice (March 2-3, 2016). The consensus is intended for practitioners engaged in the management and treatment of patients with celiac disease. Evidence for the main provisions of the consensus was sought in electronic databases. In making recommendations, the main source was the publications included in the Cochrane Library, EMBASE, MEDLINE, and PubMed. The search depth was 10 years. Recommendations in the preliminary version were reviewed by independent experts. Voting was done by the Delphic polling system.
Assuntos
Doença Celíaca , Gerenciamento Clínico , Adulto , Doença Celíaca/classificação , Doença Celíaca/diagnóstico , Doença Celíaca/terapia , Criança , Medicina Baseada em Evidências , Humanos , Federação RussaRESUMO
The multitude of carried out population studies resulted in confirmation of association of HLA-antigens with human diseases. The ulcerative colitis is belongs to the group of chronic inflammatory diseases of intestine. The etiology and pathogenesis of ulcerative colitis is still quite contradictory. The article considers actual approach to pathogenesis of development of ulcerative colitis. The material demonstrates impact of individual immunogenotypic factors on origin and development of disease and specifically relationship with particular profile of HLA-system.
Assuntos
Colite Ulcerativa/imunologia , Antígenos HLA , Colite Ulcerativa/diagnóstico , HumanosRESUMO
Immunology has grown beyond the classic doctrine of immunity to infectious diseases, and gradually covered the problems of general physiology and pathology, genetics, embryology, transplantation, oncology and many other disciplines. A new direction has appeared--immunogenetics, which should help to answer questions the disposition and/or resistance to disease, as well as influence of environmental factors on implementation of predisposition to the development of pathology. Much attention is paid to investigation of HLA in IBD. These data indicate a significant polymorphism of major histocompatibility complex antigens in this disease in different countries. The aim of our study was to investigate the immunogenetic susceptibility and resistance to the development of ulcerative colitis (UC), and Crohn's disease (CD), the character of their flow, as well as the associated extraintestinal manifestations, in particular predisposition development of bronchial obstruction (BO) in patients with inflammatory bowel disease (IBD). A study of DNA frozen blood samples of 75 patients with IBD of both sexes has been conducted. The obtained results have been compared with the results of the study 1700 of samples of umbilical cord blood of newborns (apparently healthy children), born at 37-41 weeks' gestation in Moscow (control). The group of patients with UC revealed a positive association of HLA specificities-B*38, HLA-Cw*12 and HLA-DRV1*15, which can be regarded as potentially high risk of developing the disease. The presence of the specificity of HLA-DQV1*02 can be considered as a factor in resistance to the development of UC. High risk of developing Crohn's disease among residents of Moscow associated with groups of alleles of HLA B*41, HLA-B*56, HLA-Cw*05, HLA-Cw*08, HLA-DRV1*01, HLA-DRV1*11, HLA-DQV1*04, and the presence of specificity of HLA-DQV1*05 can be considered as a factor of resistance to the development of BC. High risk of developing BO in patients with IBD is associated with specificities HLA-DQB1*02, DQB1*03, DRB1*15.
Assuntos
Colite Ulcerativa/imunologia , Doença de Crohn/imunologia , Predisposição Genética para Doença , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe I/genética , Adulto , Broncopatias/genética , Broncopatias/imunologia , Estudos de Casos e Controles , Doença Crônica , Colite Ulcerativa/complicações , Colite Ulcerativa/genética , Doença de Crohn/complicações , Doença de Crohn/genética , DNA/genética , Feminino , Frequência do Gene , Testes Genéticos , Humanos , Masculino , Polimorfismo GenéticoRESUMO
The study examined the genetic predisposition to the development of glutensensitive celiac disease (CD). Were analyzed samples of peripheral blood of 17 adult patients diagnosed with CD, as well as samples of umbilical cord blood of 1700 newborns of healthy children. HLA-typing was performed using two basic methods of molecular typing--SSO and SSP. The studies revealed the specificity of HLA-B*08; HLA-DRB1*2003; HLA-DRB1*07 and HLA-DQB1*02, which are the genetic markers of CD. Was identified a combination of HLA-markers of CD, each of which is a genetic marker for CD: HLA-B*08; HLA-DRB1*2003; HLA-DQB1*02 and HLA-DRB1*2007; HLA-DQB1*02/HLADQB1*03. In addition, negative associations were identified with CD specificity of HLA-DQB1*05. Thus, the results indicate the possibility of individual risk predicting of CD developing in a healthy population and in families of patients with CD.