Nepom B
Immunology Program, Virginia Mason Research Center, Seattle, Washington.
Rheum Dis Clin North Am. 1991 Nov;17(4):825-42.
Recent major advances in understanding the genetic structure of the human leukocyte antigen (HLA) region and how HLA molecules contribute to immune responses have been paralleled by more precise identification of specific HLA genes conferring susceptibility to the various forms of juvenile rheumatoid arthritis (JRA). This article presents current models for HLA-associated autoimmune disease susceptibility and summarizes the HLA Class II alleles currently known to be associated with JRA: primarily DR8, DR5, DR6, and DPw2.1 in pauciarticular onset JRA; and DR4 in rheumatoid factor-positive polyarticular onset JRA. Rheumatoid factor-negative polyarticular onset JRA and systemic onset JRA are variously associated with several of these same genes. Gene interactions and the clinical utility of HLA typing in this disease are also discussed.
在理解人类白细胞抗原（HLA）区域的遗传结构以及HLA分子如何促进免疫反应方面，近期取得了重大进展，与此同时，对导致各种形式幼年类风湿性关节炎（JRA）易感性的特定HLA基因也有了更精确的识别。本文介绍了目前HLA相关自身免疫性疾病易感性的模型，并总结了目前已知与JRA相关的HLA II类等位基因：在少关节起病型JRA中主要为DR8、DR5、DR6和DPw2.1；在类风湿因子阳性多关节起病型JRA中为DR4。类风湿因子阴性多关节起病型JRA和全身起病型JRA也与这些相同基因中的几个存在不同程度的关联。本文还讨论了基因相互作用以及HLA分型在该疾病中的临床应用。
