Korendowych Eleanor, Dixey Jonathan, Cox Beverly, Jones Sharon, McHugh Neil
Royal National Hospital for Rheumatic Diseases and Bath Institute for Rheumatic Diseases, England.
J Rheumatol. 2003 Jan;30(1):96-101.
To investigate the associations of the HLA-DRB1 rheumatoid arthritis shared epitope (SE) with clinical characteristics and radiological outcome in patients with psoriatic arthritis (PsA).
One hundred fifty-eight patients with well documented PsA and 250 controls were typed for HLA-DRB1 alleles including the SE by polymerase chain reaction. Clinical data collected on the patient group included disease subset, swollen and tender joint counts, the psoriasis area severity index (PASI), and the presence of radiological erosions. Clinical and radiological associations with HLA-DRB1 and SE alleles were determined.
There was an increased frequency of HLA-DR7 (41 vs 25%; puncorr = 0.001, OR 2.02, pcorr = 0.01) and a decreased frequency of HLA-DR2 (19 vs 28%; puncorr = 0.03, OR 0.59, pcorr = 0.3) in the patient population compared with controls. There was no significant difference in the frequency of HLA-DR1 and HLA-DR4 between patient and control populations. There was no significant difference in the prevalence of SE alleles between the patient and control populations (48 vs 54%). There was no increase in the prevalence of the SE in the polyarthritis subgroup, but there was a marginal decrease in those who remained in the oligoarthritis subgroup. There were no differences with respect to sex, age of onset of disease, family history, Health Assessment Questionnaire score, joint score, skin score, or nail score between those patients who were SE positive and those who were SE negative. However, significantly more patients who were SE positive developed radiological erosions (60 vs 43%; p = 0.03, OR 2.11).
Overall, the prevalence of the SE in patients with PsA did not differ from our control population. However, it was overrepresented in those who developed radiological erosions. It is possible that the SE does have a role in the clinical severity of PsA.
研究人类白细胞抗原-DRB1类风湿关节炎共享表位（SE）与银屑病关节炎（PsA）患者临床特征及放射学结局之间的关联。
采用聚合酶链反应对158例有详细记录的PsA患者和250例对照者进行HLA-DRB1等位基因分型，包括SE。收集的患者组临床数据包括疾病亚型、肿胀和压痛关节计数、银屑病面积严重程度指数（PASI）以及放射学侵蚀的存在情况。确定与HLA-DRB1和SE等位基因的临床及放射学关联。
与对照组相比，患者群体中HLA-DR7频率增加（41%对25%；校正P值=0.001，比值比2.02，校正P值=0.01），HLA-DR2频率降低（19%对28%；校正P值=0.03，比值比0.59，校正P值=0.3）。患者群体与对照群体之间HLA-DR1和HLA-DR4频率无显著差异。患者群体与对照群体之间SE等位基因患病率无显著差异（48%对54%）。多关节炎亚组中SE患病率未增加，但寡关节炎亚组中SE患病率略有下降。SE阳性患者与SE阴性患者在性别、发病年龄、家族史、健康评估问卷评分、关节评分、皮肤评分或指甲评分方面无差异。然而，SE阳性患者出现放射学侵蚀的比例显著更高（60%对43%；P=0.03，比值比2.11）。
总体而言，PsA患者中SE的患病率与我们的对照人群无差异。然而，在出现放射学侵蚀的患者中其比例过高。SE可能在PsA的临床严重程度中起作用。
