van Kerckhove C, Luyrink L, Taylor J, Melin-Aldana H, Balakrishnan K, Maksymowych W, Elma M, Lovell D, Choi E, Glass D N
Division of Pediatric Rheumatology, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
J Rheumatol. 1991 Jun;18(6):874-9.
To further investigate a clinical impression that patients with early onset pauciarticular juvenile rheumatoid arthritis (EOPA-JRA) who carry HLA-DQw1 have more severe arthritis, we subtyped HLA-DQw1 in American midwestern patients with EOPA-JRA. The HLA-DQA10101 subtype was present in 10 of 19 patients who developed persistent polyarticular erosive disease compared with 18 of 92 healthy controls (chi 2 = 9.13, p = 0.003, RR = 4.6), and occurred more frequently in this polyarticular group than in patients without polyarticular erosive disease (chi 2 = 4.11, p = 0.040, RR = 3.0). The presence of HLA-DQA10101 was significantly lower in patients with chronic iridocyclitis than in patients without chronic iridocyclitis (chi 2 = 7.07, p = 0.008, RR = 0.21). In HLA-DQA10101 positive patients, DNA sequences of the beta-1 domain of the HLA-DQ alpha and HLA-DQ beta genes (HLA-DQA10101, HLA-DQB10501 and HLA-DQB10503) were identical to those in controls. In this midwestern EOPA-JRA population, HLA-DQA1*0101 or genes in linkage disequilibrium with it, are associated with a cohort of patients with EOPA-JRA with distinct clinical characteristics.
为了进一步研究一种临床印象，即携带HLA - DQw1的早发型少关节型幼年类风湿性关节炎（EOPA - JRA）患者患有关节炎更为严重，我们对美国中西部EOPA - JRA患者的HLA - DQw1进行了亚型分析。19例发生持续性多关节侵蚀性疾病的患者中有10例存在HLA - DQA10101亚型，而92例健康对照者中有18例存在该亚型（χ² = 9.13，p = 0.003，相对危险度 = 4.6），且该亚型在多关节组中比在无多关节侵蚀性疾病的患者中更频繁出现（χ² = 4.11，p = 0.040，相对危险度 = 3.0）。慢性虹膜睫状体炎患者中HLA - DQA10101的存在率显著低于无慢性虹膜睫状体炎的患者（χ² = 7.07，p = 0.008，相对危险度 = 0.21）。在HLA - DQA10101阳性患者中，HLA - DQα和HLA - DQβ基因β - 1结构域的DNA序列（HLA - DQA10101、HLA - DQB10501和HLA - DQB10503）与对照者相同。在这个中西部EOPA - JRA人群中，HLA - DQA1*0101或与之处于连锁不平衡的基因，与一组具有独特临床特征的EOPA - JRA患者相关。
