Fischbein L, Sachs R N, Geay D, Baudelot J, Coste T, Lanfranchi J
Service de médecine interne et cardiovasculaire, hôpital, Avicenne, Bobigny.
Arch Mal Coeur Vaiss. 1987 Jun;80(7):1171-5.
It has been hypothesized that dilated cardiomyopathy (DCM) is of dysimmune origin. Conventional immunological studies have provided no evidence that a primary disregulation of immune mechanisms is involved. In the present study, the possibility of an individual predisposition to DCM resting on a preferential distribution of HLA system antigens has been investigated. Typing of the HLA system antigens A and B was performed in a group of 38 DCM patients who were heavy drinkers. The results were compared with those obtained in: (a) 57 alcoholic patients without cardiopathy, and (b) a population of 306 healthy subjects. All subjects were caucasians. Compared with alcoholic patients without cardiac disease, DCM patients had a prevalence of B8 allele. The relative risk of developing DCM was 2.83 in the presence of the B8 antigen. This result suggests a genetic predisposition to DCM: the B8 allele, prevalent among our patients, is associated with the phenotype of numerous autoimmune diseases. This study therefore supports the theory that DCM is of dysimmune origin, but this must be confirmed by further investigations conducted on a larger number of cases.
有人提出扩张型心肌病（DCM）起源于免疫失调。传统免疫学研究并未提供证据表明免疫机制存在原发性失调。在本研究中，研究了基于HLA系统抗原的优先分布，个体易患DCM的可能性。对一组38名酗酒的DCM患者进行了HLA系统抗原A和B的分型。将结果与以下两组的结果进行比较：（a）57名无心脏病的酒精性患者，以及（b）306名健康受试者组成的人群。所有受试者均为白种人。与无心脏病的酒精性患者相比，DCM患者中B8等位基因的患病率较高。存在B8抗原时发生DCM的相对风险为2.83。这一结果表明DCM存在遗传易感性：我们的患者中普遍存在的B8等位基因与多种自身免疫性疾病的表型相关。因此，本研究支持DCM起源于免疫失调的理论，但这必须通过对更多病例进行进一步研究来证实。
