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系统性红斑狼疮中的疾病表现与II类人类白细胞抗原

Disease expression and class II HLA antigens in systemic lupus erythematosus.

作者信息

Gladman D D, Urowitz M B, Darlington G A

机构信息

The University of Toronto, Centre for Prognosis Studies in the Rheumatic Diseases, Ontario, Canada.

出版信息

Lupus. 1999;8(6):466-70. doi: 10.1177/096120339900800610.

Abstract

The aim of this investigation was to examine the relationship between Class II HLA antigens and disease expression in systemic lupus erythematosus (SLE). HLA-DR and DQ antigen frequency was studied serologically in 217 SLE patients followed prospectively and compared to 320 healthy controls. The relationship between HLA antigens and the presence of disease manifestations, as well as death was investigated in 117 SLE patients enrolled within the first year of their disease. A univariate analysis confirmed the association between HLA-DR3 and SLE. HLA antigen DR1, DR6, DR7, DQw1 and DQw3 were decreased in patient group compared to the controls. A logistic regression model showed a significantly negative association with HLA-DR1, DR6 and DR7, and a positive association with HLA-DR3. The reduced frequency of HLA-DQw1 and DQw3 was maintained using a logistic procedure. Cox Proportional Hazards models revealed no association between HLA-Class II antigens and death. Logistic regression models revealed no associations between central nervous system (CNS) disease nor musculoskeletal manifestations with any of the DR antigens. There was a trend towards a lower frequency of HLA-DR6 in patients with renal involvement and lower prevalence of HLA-DR1 and HLA-DR7 in patients with vasculitis.

摘要

本研究的目的是探讨Ⅱ类人类白细胞抗原(HLA)与系统性红斑狼疮(SLE)疾病表现之间的关系。对217例前瞻性随访的SLE患者进行血清学研究,分析HLA-DR和DQ抗原频率,并与320名健康对照者进行比较。对疾病发病第一年内纳入研究的117例SLE患者,研究HLA抗原与疾病表现以及死亡之间的关系。单因素分析证实HLA-DR3与SLE之间存在关联。与对照组相比,患者组中HLA抗原DR1、DR6、DR7、DQw1和DQw3的频率降低。逻辑回归模型显示,HLA-DR1、DR6和DR7呈显著负相关,HLA-DR3呈正相关。采用逻辑回归方法,HLA-DQw1和DQw3频率降低的情况得以维持。Cox比例风险模型显示,Ⅱ类HLA抗原与死亡之间无关联。逻辑回归模型显示,中枢神经系统(CNS)疾病和肌肉骨骼表现与任何DR抗原之间均无关联。肾脏受累患者中HLA-DR6频率有降低趋势,血管炎患者中HLA-DR1和HLA-DR7患病率较低。

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