Carrozzo M, Francia Di Celle P, Gandolfo S, Carbone M, Conrotto D, Fasano M E, Roggero S, Rendine S, Ghisetti V
Department of Oral Medicine, School of Medicine and Dentistry, University of Turin, C.so Dogliotti 14, I-10126 Turin, Italy.
Br J Dermatol. 2001 Apr;144(4):803-8. doi: 10.1046/j.1365-2133.2001.04136.x.
Recent controlled studies have confirmed that hepatitis C virus (HCV) is the main correlate of liver disease in patients with lichen planus (LP), mainly in southern Europe and Japan. However, a low prevalence of HCV infection has been found in LP patients in England and northern France, and significant differences in serum HCV RNA levels or HCV genotypes have not been found between LP patients and controls. Thus host rather than viral factors may be prevalent in the pathogenesis of HCV-related LP. The HLA-DR allele may influence both the outcome of HCV infection and the appearance of symptoms outside the liver.
To assess whether major histocompatibility complex class II alleles play a part in the development of HCV-related LP.
Intermediate-resolution DRB typing by hybridization with oligonucleotide probes was performed in 44 consecutive Italian oral LP (OLP) patients with HCV infection (anti-HCV and HCV RNA positive), in an age, sex and clinically comparable disease control group of 60 Italian OLP patients without HCV infection (anti-HCV and HCV RNA negative), and in 145 healthy unrelated Italian bone marrow donors without evidence of liver disease or history of LP and with negative tests for HCV.
Patients with exclusive OLP and HCV infection possessed the HLA-DR6 allele more frequently than patients with exclusive OLP but without HCV infection (52% vs. 18%, respectively; Pc (Pcorrected) = 0.028, relative risk = 4.93). We did not find any relationship between mucocutaneous LP, HCV infection and HLA-DR alleles.
HCV-related OLP therefore appears to be a distinctive subset particularly associated with the HLA class II allele HLA-DR6. This could partially explain the peculiar geographical heterogeneity of the association between HCV and LP.
近期的对照研究证实，丙型肝炎病毒（HCV）是扁平苔藓（LP）患者肝脏疾病的主要相关因素，主要见于南欧和日本。然而，在英国和法国北部的LP患者中，HCV感染的患病率较低，并且LP患者与对照组之间在血清HCV RNA水平或HCV基因型方面未发现显著差异。因此，宿主因素而非病毒因素可能在HCV相关LP的发病机制中起主要作用。HLA-DR等位基因可能既影响HCV感染的结果，也影响肝脏外症状的出现。
评估主要组织相容性复合体II类等位基因是否在HCV相关LP的发生中起作用。
对44例连续的意大利口腔扁平苔藓（OLP）合并HCV感染患者（抗-HCV和HCV RNA阳性）、60例年龄、性别和临床情况相当的未感染HCV的意大利OLP患者（抗-HCV和HCV RNA阴性）以及145例无肝病证据、无LP病史且HCV检测阴性的健康无关意大利骨髓供者，采用与寡核苷酸探针杂交的方法进行中等分辨率DRB分型。
单纯OLP合并HCV感染的患者比单纯OLP但未感染HCV的患者更频繁地携带HLA-DR6等位基因（分别为52%和18%；校正P值（Pc）=0.028，相对风险=4.93）。我们未发现黏膜皮肤型LP、HCV感染与HLA-DR等位基因之间存在任何关系。
因此，HCV相关OLP似乎是一个独特的亚组，尤其与HLA II类等位基因HLA-DR6相关。这可能部分解释了HCV与LP关联的特殊地理异质性。
