Seki T, Kiyosawa K, Inoko H, Ota M
Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Hepatology. 1990 Dec;12(6):1300-4. doi: 10.1002/hep.1840120609.
Human leukocyte antigen-D region-related alleles (human leukocyte antigen DR and DQ) and human leukocyte antigen class I alleles were typed serologically in 31 Japanese patients with autoimmune hepatitis. These patients had increased serum levels of AST and IgG, high titers of autoantibodies, no history of blood transfusion and were negative for HBsAg and antibodies to HBc. Three hundred eighty-six healthy subjects and 30 patients with cryptogenic chronic hepatitis served as control groups. The frequency of DR4 was significantly higher in autoimmune hepatitis patients (90.3%) than in healthy subjects (38.6%) and in cryptogenic chronic hepatitis patients (30%). The frequency of Bw54 was significantly higher in autoimmune hepatitis patients (45.2%) than in healthy subjects (10.9%). The risk to DR4-positive subjects for autoimmune hepatitis was 14.8 relative to healthy subjects. Two of 31 patients (6.5%) with autoimmune hepatitis were positive for antibody to hepatitis C virus; both clearly satisfied criteria for autoimmune hepatitis and both had Bw54 and DR4. This study revealed a highly significant association of autoimmune hepatitis with human leukocyte antigen Bw54 and DR4 in Japanese patients. Among the DR4-positive patients with autoimmune hepatitis, no significant differences were seen between those positive or negative for Bw54 with regard to clinical or laboratory data, relapse of disease or efficacy of prednisolone. Thus human leukocyte antigen class II alleles contribute to susceptibility and resistance to autoimmune hepatitis in Japanese patients, with distinct racial differences from those in white patients.
对31例日本自身免疫性肝炎患者进行了人类白细胞抗原-D区相关等位基因（人类白细胞抗原DR和DQ）及人类白细胞抗原I类等位基因的血清学分型。这些患者血清AST和IgG水平升高，自身抗体滴度高，无输血史，HBsAg及抗-HBc抗体均为阴性。386名健康受试者和30例隐源性慢性肝炎患者作为对照组。自身免疫性肝炎患者中DR4的频率（90.3%）显著高于健康受试者（38.6%）和隐源性慢性肝炎患者（30%）。自身免疫性肝炎患者中Bw54的频率（45.2%）显著高于健康受试者（10.9%）。相对于健康受试者，DR4阳性受试者患自身免疫性肝炎的风险为14.8。31例自身免疫性肝炎患者中有2例（6.5%）丙型肝炎病毒抗体阳性；二者均明确符合自身免疫性肝炎的诊断标准，且均携带Bw54和DR4。本研究揭示了日本患者自身免疫性肝炎与人类白细胞抗原Bw54和DR4之间存在高度显著的关联。在DR4阳性的自身免疫性肝炎患者中，Bw54阳性和阴性患者在临床或实验室数据、疾病复发或泼尼松龙疗效方面均无显著差异。因此，人类白细胞抗原II类等位基因在日本患者自身免疫性肝炎的易感性和抵抗性方面发挥作用，与白人患者存在明显的种族差异。
