巴西人群中的未分化脊柱关节病：HLA - B27和B7 - CREG等位基因在疾病特征及进展中的重要性

Undifferentiated spondyloarthropathies in Brazilians: importance of HLA-B27 and the B7-CREG alleles in characterization and disease progression.

作者信息

Sampaio-Barros Percival D, Conde Roseneide A, Donadi Eduardo A, Kraemer Maria Helena S, Persoli Ligia, Coimbra Ibsen B, Costallat Lilian Teresa L, Samara Adil M, Bértolo Manoel B

机构信息

Rheumatology Unit, Department of Internal Medicine, State University of Campinas, Barao Geraldo, Campinas SP, CEP 13081-970, Brazil.

出版信息

J Rheumatol. 2003 Dec;30(12):2632-7.

PMID:14719206

Abstract

OBJECTIVE

To analyze the profile of the HLA-B27 and B7 cross-reactive group (CREG) alleles and the role of these markers in disease characterization and progression in patients with undifferentiated spondyloarthropathies (uSpA).

METHODS

A total of 80 patients with a diagnosis of uSpA (40 HLA-B27 positive and 40 HLA-B27 negative) were prospectively studied for 2 years. The control group consisted of 66 HLA-B27 positive and 112 HLA-B27 negative individuals without a history of seronegative SpA. HLA-B alleles were typed at low (B7-CREG alleles, i.e., B7, B54, B55, B56, B40, B42) or high resolution (B*27 alleles) using polymerase chain reaction-amplified DNA hybridized with sequence-specific oligonucleotide probes.

RESULTS

HLA-B2705 was the most frequent allele, observed in 92.5% of the patients and in 77% of the controls, followed by the HLA-B2702, observed in 5% of the patients and in 12% of the controls. HLA-B2704 was observed in only one patient (2.5%), and was absent in the control population. HLA-B2703 (6%) and HLA-B2707 (5%) alleles were observed only in controls. No associations between HLA-B27 alleles or B7-CREG alleles and any specific manifestation of uSpA were observed. HLA-B27 positive patients more frequently presented juvenile onset SpA (p = 0.002) and progression to ankylosing spondylitis (AS) (p = 0.03) than did HLA-B27 negative patients. The B7-CREG alleles were observed in 5% of the HLA-B27 positive uSpA group, in 25% of the HLA-B27 negative uSpA group, in 7% of the HLA-B27 positive controls, and in 13% of the HLA-B27 negative controls; a significant association was observed between the presence of the B7-CREG and the HLA-B27 negative uSpA group (p = 0.012).

CONCLUSION

The frequency of the HLA-B2705 allele among the B27 positive uSpA patients of this series was closely similar to that reported for patients with ankylosing spondylitis (AS). The presence of HLA-B27 alleles was associated with the progression to AS, and the presence of B7-CREG was associated with uSpA in the HLA-B27 negative group.

摘要

目的

分析HLA - B27和B7交叉反应组（CREG）等位基因特征，以及这些标志物在未分化脊柱关节病（uSpA）患者疾病特征和病情进展中的作用。

方法

对80例诊断为uSpA的患者（40例HLA - B27阳性和40例HLA - B27阴性）进行了为期2年的前瞻性研究。对照组由66例HLA - B27阳性和112例HLA - B27阴性且无血清阴性脊柱关节病病史的个体组成。使用与序列特异性寡核苷酸探针杂交的聚合酶链反应扩增DNA，以低分辨率（B7 - CREG等位基因，即B7、B54、B55、B56、B40、B42）或高分辨率（B*27等位基因）对HLA - B等位基因进行分型。

结果

HLA - B2705是最常见的等位基因，在92.5%的患者和77%的对照中观察到；其次是HLA - B2702，在5%的患者和12%的对照中观察到。仅在1例患者（2.5%）中观察到HLA - B2704，对照组中未出现。仅在对照组中观察到HLA - B2703（6%）和HLA - B2707（5%）等位基因。未观察到HLA - B27等位基因或B7 - CREG等位基因与uSpA的任何特定表现之间存在关联。与HLA - B27阴性患者相比，HLA - B27阳性患者更常出现幼年起病的脊柱关节病（p = 0.002）和进展为强直性脊柱炎（AS）（p = 0.03）。在HLA - B27阳性uSpA组中5%的患者、HLA - B27阴性uSpA组中25%的患者、HLA - B27阳性对照组中7%的患者以及HLA - B27阴性对照组中13%的患者中观察到B7 - CREG等位基因；在B7 - CREG的存在与HLA - B27阴性uSpA组之间观察到显著关联（p = 0.