人类白细胞抗原系统在多发性硬化症与传染性单核细胞增多症关联中的作用。

Role of the HLA system in the association between multiple sclerosis and infectious mononucleosis.

作者信息

Ramagopalan Sreeram V, Meier Ute C, Conacher Margaret, Ebers George C, Giovannoni Gavin, Crawford Dorothy H, McAulay Karen A

机构信息

Blizard Institute of Cell and Molecular Science, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, England, UK.

出版信息

Arch Neurol. 2011 Apr;68(4):469-72. doi: 10.1001/archneurol.2011.48.

OBJECTIVE

To determine whether multiple sclerosis (MS) and infectious mononucleosis (IM) share common HLA associations.

DESIGN

A prospective cohort study was conducted from October 1, 1999, through September 30, 2003.

SETTING

University of Edinburgh Richard Verney Health Centre, Edinburgh, Scotland.

PATIENTS

Participants included 179 individuals who underwent asymptomatic Epstein-Barr virus seroconversion and 175 patients who developed IM.

INTERVENTION

Genotyping for 5 classical HLA loci (HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1).

MAIN OUTCOME MEASURE

Diagnosis of IM and allele frequency.

RESULTS

Allelic analysis showed that HLA-DRB101:01 was significantly associated with the development of IM (odds ratio, 3.2; P < .001). Patients with IM and HLA-DRB101:01 had a lower Epstein-Barr virus viral load compared with those without the allele (median, 783 vs 7366 copies/10(6) peripheral blood mononuclear cells; P = .03).

CONCLUSION

HLA-DRB1*01:01 is protective against developing MS; thus, a common genetic basis between IM and MS is not supported.

目的

确定多发性硬化症（MS）和传染性单核细胞增多症（IM）是否具有共同的HLA关联。

设计

1999年10月1日至2003年9月30日进行了一项前瞻性队列研究。

地点

苏格兰爱丁堡大学理查德·弗尼健康中心。

患者

参与者包括179例经历无症状EB病毒血清转化的个体和175例患传染性单核细胞增多症的患者。

干预措施

对5个经典HLA位点（HLA-A、HLA-B、HLA-C、HLA-DRB1和HLA-DQB1）进行基因分型。

主要观察指标

传染性单核细胞增多症的诊断和等位基因频率。

结果

等位基因分析显示，HLA-DRB101:01与传染性单核细胞增多症的发生显著相关（优势比，3.2；P <.001）。与没有该等位基因的患者相比，患有传染性单核细胞增多症和HLA-DRB101:01的患者EB病毒载量较低（中位数，783对7366拷贝/10(6)外周血单个核细胞；P = 0.03）。

结论

HLA-DRB1*01:01对多发性硬化症的发生有保护作用；因此，不支持传染性单核细胞增多症和多发性硬化症之间存在共同的遗传基础。