中国汉族类风湿关节炎患者HLA-DR4基因与抗环瓜氨酸肽抗体的相关性研究  

The HLA-DRB1 shared epitope is not associated with antibodies against cyclic citrullinated peptide in Chinese rhemnatoid arthritis patients

作　　者：薛愉[1] 张炯[1] 陈宇明[1] 关明[1] 邹和建[1] 

机构地区：[1]复旦大学风湿、免疫、过敏性疾病研究中心复旦大学附属华山医院风湿科,200040

出　　处：《中华风湿病学杂志》2007年第9期528-531,共4页Chinese Journal of Rheumatology

基　　金：上海市卫生局科研基金资助项目（99428）

摘　　要：目的：探讨中国汉族类风湿关节炎（RA）患者中抗环瓜氨酸肽抗体（ACCP）与人类白细胞抗原（HLA）-DR4基因的相关性。方法：入选RA104例、正常对照122名。ACCP检测采用酶联免疫吸附法（ELISA）,类风湿因子检测采用散色比浊法,HLA-DR4基因采用序列特异性引物-聚合酶链方法（PCR-SSP）检测。结果：RA患者中HLA-DR4基因携带率为34.6%,主要亚型为HLA-DRB1＊0405,正常对照组为17.2%,差异有统计学意义（P=0.01）。RA患者的共同表位（SE）携带率为30.9%,与国内相关研究结果（33.2%,36.8%）相似,但明显低于国外相关研究（78.5%,65.4%,85%,67%）,差异有统计学意义（P〈0.01）。RA患者中ACCP阳性率为76.5%,与国内外报道相符,正常对照组为0,两者差异有统计学意义。SE（＋）患者的ACCP阳性率为84%,SE（-）患者的ACCP阳性率73.2%,两者差异无统计学意义。RA患者中ACCP的滴度与X线分期相关（r=0.233,P〈0.05）。结论：我国汉族RA患者中ACCP与HLA-DR4或SE无明显的相关性。ACCP可能与关节破坏的严重程度相关。Objective Rheumatoid arthritis （RA） is associated with a group of HLA-DRB1 alleles which share a common amino acid sequence at residues 70-74. Anti-cyclic citrullinated peptide （ACCP） anti- bodies have been reported to be associated with HLA-DR4 or shared epitope （SE） in western rheumatoid arthritis patients. This work is aimed to test if there is association between the SE （HLA-DRBl＊0401/04/05/10） and ACCP antibodies in Chinese Han population. Methods One hundred and four RA patients and one hundred and twenty two healthy controls were recruited. HLA-DR4 was detected by PCR-SSP phototyping method. ACCP antibodies and IgM-rheumatoid factor （RF） were measured by ELISA and laser nephelometry, respec- tively. Results 76.5% of Chinese patients with RA exhibited ACCP antibodies, while none in the controls. The prevalence of SE was significantly higher in patients with RA than in controls （P=0.0096, OR=2.42, 95%CI= 1.16-5.07）. Among the HLA-DR4 alleles, the presence of HLA-DRBl＊0401 was significantly higher in RA pa- tients than in controls （P=0.0118, 0R=9.68, 95%CI=1.13-448.8）. In our study the carriership of SE was not associated with production of ACCP antibodies （P=-0.2899, 0R=0.521, 95% CI=0.003-1.935）. Conclusions The prevalence of SE is significantly low in Chinese RA patients,in contrast to the reports from western countries. Our data emphasies the complexity of genetic effects on RA phenotype.

关 键 词：关节炎 类风湿 HLA-DR4抗原 抗环瓜氨酸肽抗体 

分 类 号：R686[医药卫生—骨科学]