Pre-disease pregnancy complications and systemic sclerosis pathogenic or pre-clinical 英文参考文献.docVIP

Chakravarty Arthritis Research Therapy 2012,14:102 /content/14/1/102 EDITORIAL Pre-disease pregnancy complications and systemic sclerosis: pathogenic or pre-clinical? Eliza Chakravarty* See related research by van Wyk et al., /content/13/6/R183 e current study by van Wyk and colleagues is an Abstract excellent example of a well-performed epidemiologic The fetal microchimerism theory for the pathogenesis of systemic sclerosis (SSc) has compelling biologic support, including the female predominance of the disease, the mean age of onset after childbearing years, similarities between di?use cutaneous SSc and graft-versus-host disease, as well as the detection of microchimeric cells in peripheral blood and skin of SSc patients. The previous issue of Arthritis Research and Therapy presents ?ndings of a positive association between pregnancy complications and future study identifying a positive association between preg- nancy complications (hypertensive disorders of pregnancy (HTN) and intrauterine growth restriction (IUGR)) prior to diagnosis and the future development of SS e authors conducted a case–control study of parous women with SSc compared with healthy women. Repro ductive history was obtained through questionnaires e mean age at enrollment was 57 years, approximately 30 years after the ? rst pregnancy for both groups. Results showed a statistically signi? cant increase of HTN as well as IUGR among women who later developed SSc. Notably, the rates of HTN and IUGR among women in this study who were later diagnosed with SSc were not demonstrably di? erent from the rates reported for women with pre- existing SSc (22.9% HTN [2] and 5 to 20% IUGR [2,3]). Despite the merits of this study, it remains di? cult to interpret the results as directly supportive of fetal micro- diagnosis of SSc in parous women. Before interpreting the results of this epidemiologic study as support for fetal microc