RESUMO
This preliminary study assessed the association between ossification of the posterior longitudinal ligament (OPLL) and the transforming growth factor ß receptor type 2 (TGFBR2) gene, with autoimmune disease examined as a possible underlying factor. Twenty-one patients diagnosed with OPLL and 42 control patients without OPLL (non-OPLL) were enrolled in the study. The TGFBR2 gene, composed of one promoter and seven exons, including the 5' untranslated region and flanking introns of each exon, was sequenced. Laboratory tests, including indirect immunofluorescence, were performed to detect autoimmune antibodies. The most common types of OPLL were the continuous (n=8, 38.1%) and segmental (n=8, 38.1%) types, with the fifth cervical veterbra (C5) the most common level of cervical spine involvement (n=15, 71.4%). In addition, significant associations between 455-4TâA (p=0.007) and 571GâA (p=0.024) gene variation and OPLL were found. The 95-35CâT variation in intron 1, a previously unreported variation, was also found in all patients with OPLL. Four patients revealed positive results for autoimmune antibodies and exhibited a nucleolar pattern by indirect immunofluorescence. Of these four patients, two were diagnosed with Sjogren's syndrome. The previously reported association of 455-4TâA and 571GâA polymorphisms of the TGFBR2 gene with OPLL was confirmed in this study. In addition, the 95-35CâT polymorphism in intron 1, which to our knowledge is a novel, previously unreported, nucleotide variation, was detected in all patients. Additional functional studies are required to verify the association between OPLL and the genetic variations found in this study.
Assuntos
Predisposição Genética para Doença/genética , Ossificação do Ligamento Longitudinal Posterior/genética , Polimorfismo de Nucleotídeo Único/genética , Proteínas Serina-Treonina Quinases/genética , Receptores de Fatores de Crescimento Transformadores beta/genética , Adulto , Idoso , Autoanticorpos/imunologia , Doenças Autoimunes/complicações , Doenças Autoimunes/genética , Doenças Autoimunes/imunologia , Feminino , Imunofluorescência , Humanos , Íntrons/genética , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior/complicações , Ossificação do Ligamento Longitudinal Posterior/imunologia , Receptor do Fator de Crescimento Transformador beta Tipo II , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
The in vitro response of peripheral blood mononuclear cells or enriched CD4+ T cells from patients with ossification of the posterior longitudinal ligament to anti-CD3 monoclonal antibody has been studied. The response in both was significantly lower in patients with the continuous-type ossification than in patients with the segmental-type ossification and in healthy volunteers, and was inversely correlated with the number of vertebral bodies with ossified ligament. In patients with the segmental-type ossification, the response of peripheral blood mononuclear cells was significantly lower than that in healthy volunteers, but that of the enriched T cells was not. B cell proliferation in response to fixed Staphylococcus aureus cells was significantly lower in patients with the continuous-type ossification than in healthy volunteers but was not correlated with the number of vertebral bodies with ossified ligament. The B cell response in patients with the segmental-type ossification was not lower than that in healthy volunteers. Serum concentrations of transforming growth factor-beta1 and basic fibroblast growth factor also were higher in patients with the continuous-type ossification than in patients with the segmental-type ossification and in healthy volunteers. The findings raise the possibility that continuous-type ossification of posterior longitudinal ligament might develop differently from segmental-type ossification.