Invernizzi Pietro, Battezzati Pier Maria, Crosignani Andrea, Perego Francesca, Poli Francesca, Morabito Alberto, De Arias Alejandro Espadas, Scalamogna Mario, Zuin Massimo, Podda Mauro
Department of Medicine, San Paolo Hospital Medical School, University of Milan, Via di Rudini; 8, 20142 Milan, Italy.
J Hepatol. 2003 Apr;38(4):401-6. doi: 10.1016/s0168-8278(02)00440-3.
BACKGROUND/AIMS: Primary biliary cirrhosis (PBC) is an autoimmune cholestatic liver disease of unknown etiology with a highly variable progression rate and prevalence among different geographical areas. Data concerning human leukocyte antigen (HLA) polymorphisms in PBC come from a limited number of geographical areas, from which the association with the HLA-DRB1*08 allele has been consistently reported.
To investigate whether HLA polymorphisms contribute toward disease susceptibility, we compared 186 well-defined Italian PBC patients with 558 healthy subjects matched by age, gender and geographical area (Northern, Central and Southern Italy). Patients and controls were HLA typed at low resolution by PCR-sequence specific oligonucleotides for the loci A and B; HLA-DRB1 alleles were typed by reverse line blot assay of PCR-amplified DNA.
HLA-DRB111 was associated with a markedly reduced risk of developing PBC (OR: 0.3; 95% CI: 0.2-0.5). No association was found with HLA-DRB108. The B15 (2.5; 1.3-4.6), B41 (12.0; 2.7-72.1), B55 (2.9; 1.1-7.5) and B58 alleles (6.8; 1.1-46.3) were more frequent in PBC. The frequency of HLA polymorphisms was similar in PBC patients with progressive or non-progressive disease, and in those with or without anti-mitochondrial antibodies.
Our data on a large series of Italian patients suggest that PBC may have a peculiar genetic background in the Mediterranean area.
背景/目的:原发性胆汁性肝硬化(PBC)是一种病因不明的自身免疫性胆汁淤积性肝病,其进展速度和患病率在不同地理区域差异很大。关于PBC中人类白细胞抗原(HLA)多态性的数据来自有限的几个地理区域,其中与HLA - DRB1*08等位基因的关联一直有报道。
为了研究HLA多态性是否与疾病易感性有关,我们将186例明确诊断的意大利PBC患者与558名年龄、性别和地理区域(意大利北部、中部和南部)相匹配的健康受试者进行了比较。通过PCR - 序列特异性寡核苷酸对患者和对照进行低分辨率的HLA分型,检测A和B位点;通过对PCR扩增的DNA进行反向线印迹分析来确定HLA - DRB1等位基因。
HLA - DRB111与发生PBC的风险显著降低相关(比值比:0.3;95%可信区间:0.2 - 0.5)。未发现与HLA - DRB108有关联。B15(2.5;1.3 - 4.6)、B41(12.0;2.7 - 72.1)、B55(2.9;1.1 - 7.5)和B58等位基因(6.8;1.1 - 46.3)在PBC患者中更为常见。在疾病进展或非进展的PBC患者中,以及有或没有抗线粒体抗体的患者中,HLA多态性的频率相似。
我们对大量意大利患者的数据表明,PBC在地中海地区可能具有独特的遗传背景。