Zhang X Y, Wang X M, Hu T S
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing.
Am J Ophthalmol. 1992 May 15;113(5):567-72. doi: 10.1016/s0002-9394(14)74731-2.
Human leukocyte antigen typing was performed in 32 consecutive Chinese patients with Vogt-Koyanagi-Harada syndrome and 52 unrelated healthy Chinese individuals. Results indicated that HLA-DR4 was identified in 24 of the 32 patients with Vogt-Koyanagi-Harada syndrome (75.0%), but only in 12 (23.1%) of the 52 control subjects (P = .0003; relative risk, 10.0). Human leukocyte antigen-DQw7, also correlated with the disease, was identified in 19 (59.4%) patients, and in 19 control subjects (36.5%; P = .0230). The two-haplotype association detection demonstrated that HLA-DR4 and HLA-DQw7 were related through linkage disequilibrium, suggesting that the disease was primarily associated with only one of the antigens. The comparison between HLA-DR4-positive and HLA-DR4-negative patients with Vogt-Koyanagi-Harada syndrome in regard to clinical manifestations has shown that the HLA-DR4-positive group had a lower visual acuity at the first visit than did the HLA-DR4-negative group. However, both groups responded well to corticosteroid treatment. No other significant correlations between HLA-DR4 positivity and ocular features, including complications or systemic features, were found. Therefore, we concluded that the presence of HLA-DR4 may represent susceptibility to Vogt-Koyanagi-Harada syndrome, but may not represent specific tissue involvement or determine the prognosis. A decreased frequency of HLA-DQw1 in the patient group was also noticed. Further studies showed a higher percentage of HLA-DQw1 in HLA-DR4-positive control subjects than in the HLA-DR4-positive patients (P = .0308), which indicated that HLA-DQw1 was negatively associated with the disease. This protective effect from HLA-DQw1 was also studied.
对32例连续性中国Vogt-小柳-原田综合征患者及52名无血缘关系的健康中国个体进行了人类白细胞抗原分型。结果显示，32例Vogt-小柳-原田综合征患者中有24例（75.0%）检测到HLA-DR4，而52名对照个体中仅12例（23.1%）检测到（P = 0.0003；相对风险，10.0）。人类白细胞抗原-DQw7也与该疾病相关，19例（59.4%）患者检测到该抗原，19名对照个体中也有检测到（36.5%；P = 0.0230）。双单倍型关联检测表明，HLA-DR4和HLA-DQw7通过连锁不平衡相关，提示该疾病主要仅与其中一种抗原相关。对Vogt-小柳-原田综合征HLA-DR4阳性和阴性患者的临床表现进行比较，结果显示HLA-DR4阳性组初诊时视力低于HLA-DR4阴性组。然而，两组对皮质类固醇治疗反应均良好。未发现HLA-DR4阳性与眼部特征（包括并发症）或全身特征之间存在其他显著相关性。因此，我们得出结论，HLA-DR4的存在可能代表对Vogt-小柳-原田综合征的易感性，但可能并不代表特定组织受累或决定预后。还注意到患者组中HLA-DQw1频率降低。进一步研究表明，HLA-DR4阳性对照个体中HLA-DQw1的百分比高于HLA-DR4阳性患者（P = 0.0308），这表明HLA-DQw1与该疾病呈负相关。还对HLA-DQw1的这种保护作用进行了研究。
