Soylemezoglu Oguz, Peru Harun, Gonen Sevim, Cetinyurek Aysun, Buyan Necla
Department of Pediatric Nephrology, Gazi University, School of Medicine, Ankara, Turkey.
J Rheumatol. 2008 Jun;35(6):1165-8. Epub 2008 Apr 15.
The genetic basis of susceptibility to Henoch-Schönlein purpura (HSP) may be conferred by a number of gene loci, including the MHC. Associations between human leukocyte antigen (HLA) and disease can help to establish a basis for susceptibility and assist in the prediction of the outcome and clinical heterogeneity. We aimed to investigate the implications of the HLA-DRB1 locus and the susceptibility to HSP, and to determine if there are associations with joint, gastrointestinal, and renal manifestations of the disease.
We studied 110 Turkish patients (men/women: 66/44) with HSP. Patients and ethnically matched controls with respect to age and sex (n = 250) were HLA-DRB1 genotyped from DNA determined using molecular based methods.
HLA-DRB1 genotype differences between patients with HSP and controls were observed. The frequency of HLA-DRB1 11/14 was higher [odds ratio (OR) 1.97, 95% confidence interval (95% CI) 1.25-3.12, p = 0.003; OR = 1.83, 95% CI = 1.02-3.28, p = 0.035, respectively] and the frequency of HLA-DRB1 10/17 was lower (OR = 1.04, 95% CI = 1.01-1.86, p = 0.035; OR = 3.96, 95% CI = 1.17-13.33, p = 0018, respectively) in patients with HSP compared to controls. No HLA-DRB1 associations with gastrointestinal and renal manifestations were found (p > 0.05). In contrast, HLA-DRB1*11 positivity was increased and HLA-DRB1 14 positivity reduced in HSP patients with joint manifestations (OR = 2.68, 95% CI = 1.09-6.66, p = 0.029; OR = 9.34, 95% CI = 3.38-25.64, p = 0.000, respectively). Also, HLA-DRB1 13 positivity was found to be increased in patients with nephrotic proteinuria (OR = 3.76, 95% CI = 1.25-11.23, p = 0.025).
These results suggest that genetic factors from HLA-DRB1 genotypes might be related to the susceptibility to HSP for Turkish children but not to the severity of this disease. Additional studies are required to confirm the association of alleles encoded in the HLA region with the disease progression and severity.
过敏性紫癜（HSP）易感性的遗传基础可能由多个基因位点决定，包括主要组织相容性复合体（MHC）。人类白细胞抗原（HLA）与疾病之间的关联有助于确定易感性基础，并辅助预测疾病结局和临床异质性。我们旨在研究HLA - DRB1基因座与HSP易感性的关系，并确定其与该疾病的关节、胃肠道和肾脏表现是否存在关联。
我们研究了110例土耳其HSP患者（男/女：66/44）。采用分子生物学方法从DNA中对患者以及年龄和性别相匹配的对照者（n = 250）进行HLA - DRB1基因分型。
观察到HSP患者与对照者之间HLA - DRB1基因型存在差异。HSP患者中HLA - DRB1 11/14的频率较高[优势比（OR）1.97，95%置信区间（95%CI）1.25 - 3.12，p = 0.003；OR = 1.83，95%CI = 1.02 - 3.28，p = 0.035]，而HLA - DRB1 10/17的频率较低（与对照者相比，HSP患者中OR = 1.04，95%CI = 1.01 - 1.86，p = 0.035；OR = 3.96，95%CI = 1.17 - 13.33，p = 0.018）。未发现HLA - DRB1与胃肠道和肾脏表现存在关联（p > 0.05）。相反，有关节表现的HSP患者中HLA - DRB1*11阳性率升高，HLA - DRB1 14阳性率降低（OR = 2.68，95%CI = 1.09 - 6.66，p = 0.029；OR = 9.34，95%CI = 3.38 - 25.64，p = 0.000）。此外，发现肾病性蛋白尿患者中HLA - DRB1 13阳性率升高（OR = 3.76，95%CI = 1.25 - 11.23，p = 0.025）。
这些结果表明，对于土耳其儿童，HLA - DRB1基因型的遗传因素可能与HSP易感性有关，但与该疾病的严重程度无关。需要进一步研究以证实HLA区域编码的等位基因与疾病进展和严重程度之间的关联。
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