CD94_rs2302489和NKG2A基因多态性与类风湿性关节炎易感性和预后的关系  

Relationship between CD94_rs2302489 and NKG2A gene polymorphism and susceptibility and prognosis of rheumatoid arthritis

作　　者：李静[1] 高鹏[1] 王淑云[1] 刘宇宏[1] 霍爱鑫 LI Jing;GAO Peng;WANG Shu-Yun;LIU Yu-Hong;HUO Ai-Xin(Department of Rheumatology and Immunology,Affiliated Hospital of Yan'an University,Yan'an 716000,China)

机构地区：[1]延安大学附属医院风湿免疫科,延安716000

出　　处：《中国免疫学杂志》2021年第17期2138-2142,共5页Chinese Journal of Immunology

摘　　要：目的:探讨CD94和NKG2A基因多态性与类风湿性关节炎(RA)易感性和抗TNF治疗预后的关系。方法:选取2016年12月至2018年12月我院接受抗TNF治疗的290例RA患者和我院体检中心体检的130例健康受试者,采用PCR LightSNiP分析对CD94(rs2302489)和NKG2A(rs7301582,rs2734440,rs2734414)基因多态性进行分型。抗TNF治疗后第12周和第24周,根据EULAR反应标准评估患者临床反应。结果:RA患者CD94 AA基因型频率明显低于对照组(OR=0.43,95%CI:0.21~0.89,P=0.025)。CD94 AA纯合子在抗CCP抗体阴性患者中更为常见(OR=11.29,95%CI:2.38~52.26,P=0.002);与抗CCP抗体阳性患者相比,等位基因A与抗CCP抗体阴性显著相关(OR=5.01,95%CI:1.87~14.95,P=0.003)。与其他基因型患者相比,CD94 TT基因型患者12周后缓解率较低(OR=3.31,95%CI:0.07~0.89,P=0.020)。此外,与等位基因T或CT/TT相比,携带NKG2A rs7301582 C等位基因(OR=3.67,95%CI:1.13~18.94,P=0.015)或CC基因型(OR=3.59,95%CI:1.02~19.42,P=0.028)的患者在抗TNF治疗12周后无反应频率更高。结论:CD94和NKG2A基因多态性可能导致RA遗传易感性,影响患者抗TNF治疗敏感性。Objective:To investigate relationship between CD94 and NKG2A gene polymorphism and rheumatoid arthritis(RA)susceptibility and anti-TNF treatment prognosis.Methods:290 RA patients who received anti-TNF therapy in our hospital from December 2016 to December 2018 and 130 healthy subjects who participated in physical examination in our physical examination center were selected,CD94(rs2302489)and NKG2A(rs7301582,rs2734440,rs2734414)gene polymorphisms were identified by PCR LightSNiP analysis.Clinical responses were assessed according to EULAR response criteria at 12 and 24 weeks after initiation of TNF therapy.Results:Frequency of CD94 AA genotype in RA patients was significantly lower than that in control group(OR=0.43,95%CI:0.21~0.89,P=0.025).CD94 AA homozygote was more common in patients with negative anti-CCP antibody(OR=11.29,95%CI:2.38~52.26,P=0.002).Compared with patients with positive anti-CCP antibody,allele A was significantly correlated with negative anti-CCP antibody(OR=5.01,95%CI:1.87~14.95,P=0.003).Compared with patients with other genotypes,patients with CD94 TT genotype had a lower response rate after 12 weeks(OR=3.31,95%CI:0.07~0.89,P=0.020).In addition,patients with NKG2A rs7301582 C allele(OR=3.67,95%CI:1.13~18.94,P=0.015)or CC genotype(OR=3.59,95%CI:1.02~19.42,P=0.028)were more frequently unresponsive after 12 weeks of anti-TNF therapy than patients with allele T or CT/TT.Conclusion:Polymorphism of CD94 and NKG2A genes may lead to genetic susceptibility to RA or influence response to TNF therapy.

关 键 词：基因多态性 类风湿性关节炎 预后 

分 类 号：R593.22[医药卫生—内科学]