Queiro-Silva R, Torre-Alonso J C, Tinturé-Eguren T, López-Lagunas I
Rheumatology Unit, Internal Medicine Service, Hospital San Agustin, Avilés-Asturias, Spain.
Scand J Rheumatol. 2004;33(5):318-22. doi: 10.1080/03009740410005953.
To analyse the relative role of HLA-DR antigens in the susceptibility to, and clinical expression of psoriatic arthritis (PsA).
A retrospective cohort study of 120 patients with PsA who were assessed according to a standard protocol. Patients were classified in accordance with the predominant pattern observed in the last 5 years of disease evolution: polyarthritis (n = 33), oligoarthritis (n = 45), and spondylitis (n = 42). HLA-Cw gene typing was done by the polymerase chain reaction (PCR) sequence-specific oligonucleotide probes (PCR-SSOP) method, while HLA-DR and B27 typing were performed by serological methods. The distribution of HLA-DR and Cw antigens was also analysed in 50 patients with psoriasis alone. One hundred and seventy subjects from our general population served as controls.
No definite association was found between HLA-DR alleles and the risk of psoriasis or PsA. HLA-DR4 was found to be under-represented in arthritic patients [probability (p) = 0.03]. HLA-DR7 showed association with oligoarthritis [odds ratio (OR) 6, 95% confidence interval (CI): 2-16, corrected probability (Pc) = 0.01], whereas HLA-DR8 appeared to be related to the risk of polyarthritis (OR 9.5, 95% CI: 2-42, Pc = 0.02). HLA-Cw*0602 conferred risk for psoriasis (Pc < 0.00001), but not for PsA. As expected, HLA-B27 appeared to be over-represented in patients with spondylitis (p = 0.03).
This is the first report that associates HLA-DR8 with psoriatic polyarthritis. Although HLA-DR antigens have a marginal role in PsA or psoriasis susceptibility, they may be relevant to the modulation of the clinical expression of PsA. These HLA data add support to the classification of PsA into three disease subsets.
分析人类白细胞抗原-DR（HLA-DR）抗原在银屑病关节炎（PsA）易感性及临床表现中的相对作用。
对120例PsA患者进行回顾性队列研究，按照标准方案进行评估。根据疾病演变最后5年观察到的主要模式将患者分类：多关节炎型（n = 33）、少关节炎型（n = 45）和脊柱炎型（n = 42）。采用聚合酶链反应（PCR）序列特异性寡核苷酸探针（PCR-SSOP）法进行HLA-Cw基因分型，采用血清学方法进行HLA-DR和B27分型。还对50例单纯银屑病患者的HLA-DR和Cw抗原分布进行了分析。选取170名普通人群作为对照。
未发现HLA-DR等位基因与银屑病或PsA风险之间存在明确关联。发现HLA-DR4在关节炎患者中表达不足[概率（p）= 0.03]。HLA-DR7与少关节炎相关[比值比（OR）6，95%置信区间（CI）：2 - 16，校正概率（Pc）= 0.01]，而HLA-DR8似乎与多关节炎风险相关（OR 9.5，95% CI：2 - 42，Pc = 0.02）。HLA-Cw*0602增加银屑病风险（Pc < 0.00001），但不增加PsA风险。正如预期的那样，HLA-B27在脊柱炎患者中表达似乎过高（p = 0.03）。
这是首次将HLA-DR8与银屑病性多关节炎相关联的报告。虽然HLA-DR抗原在PsA或银屑病易感性中作用不大，但它们可能与PsA临床表型的调节有关。这些HLA数据为将PsA分为三个疾病亚组提供了支持。
