García Herola A, Nos P, Hinijosa J, Hoyos M, Molés J R, Carmona E, Puig N, Sánchez-Cuenca J M, Ponce J, Berenguer J
Servicio de Medicina Digestivo. Hospital Universitario La Fe. Valencia. Spain.
Rev Esp Enferm Dig. 2003 Nov;95(11):760-4, 755-9.
the hypothesis of this study is that genes involved in the regulation of the immune system, expressed by HLA antigens and anti-neutrophil cytoplasmic antibodies (ANCA), could be determinants of disease susceptibility and behavior in inflammatory bowel disease (IBD).
seventy patients with a diagnosis of inflammatory bowel disease, 46 with ulcerative colitis and 24 with Crohn"s disease were included. HLA class I (A and B) and II (DR) antigens were studied by serological techniques. Detection of ANCA was carried out in all patients by an indirect immunofluorescence method. The relative frequencies of HLA antigens were compared with a control group made up of 156 blood donors. The control group for the ANCA study was made up of 100 individuals.
we found a significant increased frequency of HLA-DR2 in patients with ulcerative colitis. No significant differences were found between patients with Crohn"s disease and controls regarding HLA typing. We detected a significant increase of HLA-DR3 in extensive forms of ulcerative colitis. Detection of ANCA was positive in 46% of the patients with ulcerative colitis and in 12% of the patients with Crohn"s disease (p <0.05). We observed an increased frequency of ANCA in patients with UC and HLA-DR2 (p = 0.15).
the association found between HLA-DR3 and extensive forms of ulcerative colitis provides evidence of genetic heterogeneity. The relationship between ANCA and HLA phenotype (although not significant) supports this concept.
本研究的假设是，由人类白细胞抗原（HLA）抗原和抗中性粒细胞胞浆抗体（ANCA）所表达的参与免疫系统调节的基因，可能是炎症性肠病（IBD）疾病易感性和病情表现的决定因素。
纳入70例诊断为炎症性肠病的患者，其中46例为溃疡性结肠炎，24例为克罗恩病。采用血清学技术研究HLA I类（A和B）和II类（DR）抗原。通过间接免疫荧光法对所有患者进行ANCA检测。将HLA抗原的相对频率与由156名献血者组成的对照组进行比较。ANCA研究的对照组由100名个体组成。
我们发现溃疡性结肠炎患者中HLA-DR2的频率显著增加。在克罗恩病患者与对照组之间，HLA分型未发现显著差异。我们检测到广泛性溃疡性结肠炎患者中HLA-DR3显著增加。46%的溃疡性结肠炎患者和1 / 2的克罗恩病患者ANCA检测呈阳性（p<0.05）。我们观察到溃疡性结肠炎患者且伴有HLA-DR2时ANCA频率增加（p = 0.15）。
HLA-DR3与广泛性溃疡性结肠炎之间的关联提供了基因异质性的证据。ANCA与HLA表型之间的关系（尽管不显著）支持这一概念。
