类风湿关节炎患者中HLA - DRB1*15与继发性干燥综合征之间的关联。

Association between HLA-DRB1*15 and secondary Sjögren's syndrome in patients with rheumatoid arthritis.

作者信息

Mattey D L, González-Gay M A, Hajeer A H, Dababneh A, Thomson W, García-Porrúa C, Ollier W E

机构信息

Staffordshire Rheumatology Centre, Stoke-on-Trent, England.

出版信息

J Rheumatol. 2000 Nov;27(11):2611-6.

PMID:11093441

Abstract

OBJECTIVE

To examine the relationship between HLA-DRB1 alleles and the clinical expression of the secondary form of Sjogren's syndrome (SS) in patients with rheumatoid arthritis (RA).

METHODS

Typing of HLA-DRB1 alleles was carried out by molecular based techniques on DNA obtained from a population of patients with RA from Lugo in northwestern Spain. Patients were diagnosed according to the 1987 American College of Rheumatology criteria for RA, and comprised 137 seropositive and 42 seronegative individuals. Secondary SS was defined by xerostomia and keratoconjunctivitis sicca, supported by ophthalmologic examination. Patients were compared with 145 ethnically matched controls.

RESULTS

Twenty-two (12.3%) of the patients with RA also had secondary SS. The majority of these (19/22) were rheumatoid factor positive. Eleven (57.9%) of the seropositive patients with secondary SS carried an HLA-DRB115 allele compared with 28 (23.7%) seropositive patients without secondary SS (OR 4.4, 95% CI 1.5-13.6, pc = 0.014). In contrast, the frequency of DRB104 was reduced in seropositive patients with secondary SS compared to those without secondary SS, although this did not achieve significance after correction for multiple testing (OR 0.28, 95% CI 0.09-0.88, pc = 0.08). Of note, in individuals lacking the RA shared epitope (SE), DRB115 was found to be associated (OR 2.3, 95% CI 1.0-5.1, pc = 0.03) with RA in the absence of secondary SS. No differences were found between DRB115 positive and negative patients in terms of erosive disease, nodules, or rheumatoid factor positivity.

CONCLUSION

Secondary SS is associated with an increased frequency of HLA-DRB115 in seropositive patients with RA from northwestern Spain. HLA-DRB115 is also associated with RA in SE negative individuals without secondary SS, although the possibility that such patients will later develop SS cannot be ruled out. Further studies are needed to confirm whether the HLA-DRB1*15 association with secondary SS in RA is common to Spanish and other ethnic populations.

摘要

目的

研究类风湿关节炎（RA）患者中人类白细胞抗原-DRB1（HLA-DRB1）等位基因与继发性干燥综合征（SS）临床表型之间的关系。

方法

采用分子技术对来自西班牙西北部卢戈的RA患者群体的DNA进行HLA-DRB1等位基因分型。患者根据1987年美国风湿病学会RA标准进行诊断，包括137例血清阳性和42例血清阴性个体。继发性SS由口干症和干燥性角结膜炎定义，并经眼科检查证实。将患者与145名种族匹配的对照进行比较。

结果

22例（12.3%）RA患者同时患有继发性SS。其中大多数（19/22）类风湿因子呈阳性。11例（57.9%）血清阳性的继发性SS患者携带HLA-DRB115等位基因，而28例（23.7%）无继发性SS的血清阳性患者携带该等位基因（比值比4.4，95%可信区间1.5 - 13.6，校正P值 = 0.014）。相比之下，血清阳性的继发性SS患者中DRB104的频率低于无继发性SS的患者，尽管在多重检验校正后未达到显著差异（比值比0.28，95%可信区间0.09 - 0.88，校正P值 = 0.08）。值得注意的是，在缺乏RA共享表位（SE）的个体中，发现DRB115与无继发性SS的RA相关（比值比2.3，95%可信区间1.0 - 5.1，校正P值 = 0.03）。在侵蚀性疾病、结节或类风湿因子阳性方面，DRB115阳性和阴性患者之间未发现差异。