Abstract:
:We review the aetiology of scleroderma from an epidemiological perspective examining genetic, environmental and stochastic risk factors. The presence of familial clustering (but with low twin concordance) suggests a genetic contribution, and this has been confirmed with recent candidate gene and genome-wide association screening demonstrating both major histocompatibility complex and non-major histocompatibility complex genetic linkage. In contrast, environmental associations are weak or inconsistent. An examination of the age-adjusted incidence curve of scleroderma is consistent with a stochastic process involving five to eight random events. In pathogenesis, scleroderma is best considered as an autoimmune disorder where genetic and environmental factors are both important variables, but random events are also likely to play a pivotal role. We suggest that these random events might result in acquired somatic mutations or epigenetic alterations involving genes coding for immune receptors, tolerogenic gates or proteins involved in immune regulation, inflammation and/or repair that, over time, might summate to form a requisite cassette (of genetic changes), which allows the initiation and progression of the autoimmune process.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Roberts-Thomson PJ,Walker JGdoi
10.1111/j.1445-5994.2011.02706.xsubject
Has Abstractpub_date
2012-03-01 00:00:00pages
235-42issue
3eissn
1444-0903issn
1445-5994journal_volume
42pub_type
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
doi:10.1046/j.1445-5994.2002.00275.x
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更新日期:2012-12-01 00:00:00
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更新日期:2001-12-01 00:00:00
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更新日期:2008-12-01 00:00:00
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更新日期:2008-07-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-08-01 00:00:00
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更新日期:2019-05-01 00:00:00
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abstract:AIM:To prospectively evaluate the efficacy and safety of Selective Internal Radiation (SIR) Spheres (Sirtex Medical, Sydney, NSW, Australia) in patients with unresectable primary or secondary hepatic malignancies. METHODS:We report our experience of SIR sphere therapy at three Australian centres. Patients with previou...
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2005-04-01 00:00:00
abstract::Neuroimaging in dementia has focused on documenting any burden of vascular disease or excluding any reversible intracranial pathology. We review the use of computed tomography to examine for medial temporal lobe atrophy in dementia and compare this with a case series of such measurements from our memory clinic. Measur...
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更新日期:2008-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2006-01-01 00:00:00
abstract:AIMS:The aim of this study was to provide the first population-based descriptions of typical sleep duration and the prevalence of chronic sleep restriction and chronic sleepiness in community-dwelling Australian adults. METHODS:Ten thousand subjects randomly selected from the New South Wales electoral roll, half aged ...
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更新日期:2014-12-01 00:00:00