Guilherme L, Weidebach W, Kiss M H, Snitcowsky R, Kalil J
Heart Institute, Hospital of Clinics, Faculty of Medicine, University of São Paulo, Brazil.
Circulation. 1991 Jun;83(6):1995-8. doi: 10.1161/01.cir.83.6.1995.
The incidence of rheumatic heart disease is great in Brazil. We analyzed the distribution of human leukocyte (HLA) antigens in a Brazilian population sample with rheumatic fever or rheumatic heart disease, with the aim of better understanding the mechanisms involved.
HLA class I (A, B, and C) and class II (DR and DQ) antigen distribution was studied in 40 patients with diagnosis of rheumatic fever or rheumatic heart disease and compared with a control group of 617 healthy individuals for class I typing, from which 118 were drawn for class II typing. A strong correlation between rheumatic fever and rheumatic heart disease and HLA-DRw53 (72.9% in the disease group versus 39% in the control group: p = 0.00061, relative risk, 4.2; etiologic fraction, 0.43) was found. We also found an increase in the frequency of HLA-DR7 (57.5% in the disease group versus 26.3% in control group: p = 0.00715; relative risk, 3.8; etiologic fraction, 0.56). HLA class I and HLA-DQ typing did not point to any association with these diseases.
HLA-DR7 and HLA-DRw53 are markers for susceptibility to rheumatic fever and rheumatic heart disease in Brazil. These results could be explained by genetic differences resulting from racial or geographical diversity.
风湿性心脏病在巴西的发病率很高。我们分析了患有风湿热或风湿性心脏病的巴西人群样本中人类白细胞（HLA）抗原的分布情况，旨在更好地了解其中涉及的机制。
对40例诊断为风湿热或风湿性心脏病的患者进行了HLAⅠ类（A、B和C）和Ⅱ类（DR和DQ）抗原分布研究，并与617名健康个体的对照组进行Ⅰ类分型比较，从对照组中抽取118人进行Ⅱ类分型。发现风湿热和风湿性心脏病与HLA-DRw53之间存在强相关性（疾病组为72.9%，对照组为39%：p = 0.00061，相对风险为4.2；病因分值为0.43）。我们还发现HLA-DR7的频率有所增加（疾病组为57.5%，对照组为26.3%：p = 0.00715；相对风险为3.8；病因分值为0.56）。HLAⅠ类和HLA-DQ分型未显示与这些疾病有任何关联。
在巴西，HLA-DR7和HLA-DRw53是风湿热和风湿性心脏病易感性的标志物。这些结果可以用种族或地理多样性导致的基因差异来解释。
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