Stastny P, Gao X J, Fernandez-Viña M
Department of Internal Medicine, University of Texas, Southwestern Medical Center, Dallas.
Recenti Prog Med. 1991 Jul-Aug;82(7-8):409-16.
Starting with the historical background and ending with the most recent data obtained by DNA typing, using PCR and oligonucleotide probes, the role of HLA antigens in rheumatoid arthritis (RA) and in several forms of juvenile arthritis (JA) is reviewed. RA is thought to be associated with an epitope of the third hypervariable region of DRB1 which is shared by several alleles including DR4-Dw4, Dw14, Dw15, DR1, DRw14.2, and DRw10. Rheumatoid factor-positive JA is also associated with DR4, but in rheumatoid factor-negative JA DR4 is absent, or markedly decreased, suggesting that it has a protective effect. Typing for the HLA-DP alleles has confirmed the association of pauciarticular JA with DPBI0201. Recent studies in the author's laboratory have shown that DPB10301 is the main susceptibility factor for rheumatoid factor-negative polyarticular onset JA. It is of interest that also adult rheumatoid factor-negative RA patients have an increase of DPB1*0301, suggesting that these two clinical subsets may represent related diseases.
本文从历史背景入手，以通过聚合酶链反应（PCR）和寡核苷酸探针进行DNA分型获得的最新数据为结尾，综述了人类白细胞抗原（HLA）抗原在类风湿关节炎（RA）和几种幼年型关节炎（JA）中的作用。RA被认为与DRB1第三高变区的一个表位相关，该表位由多个等位基因共享，包括DR4-Dw4、Dw14、Dw15、DR1、DRw14.2和DRw10。类风湿因子阳性的JA也与DR4相关，但在类风湿因子阴性的JA中，DR4缺失或显著减少，提示其具有保护作用。HLA-DP等位基因分型已证实少关节型JA与DPB10201相关。作者实验室最近的研究表明，DPB10301是类风湿因子阴性多关节起病型JA的主要易感因素。有趣的是，成年类风湿因子阴性的RA患者中DPB1*0301也增加，提示这两个临床亚组可能代表相关疾病。
