Terao Chikashi, Yoshifuji Hajime, Mimori Tsuneyo, Matsuda Fumihiko
Center for Genomic Medicine, Kyoto University Graduate School of Medicine.
Nihon Rinsho Meneki Gakkai Kaishi. 2014;37(3):166-70. doi: 10.2177/jsci.37.166.
Takayasu arteritis (TAK) is a systemic vasculitis affecting aorta and its large branches which were firstly reported from Japan. TAK develops mainly in young females and the number of patients with TAK in Japan is estimated about 6,000 to 10,000. This low prevalence has made genetic studies of TAK difficult to elucidate its genetic background. The HLA region, especially HLA-B locus, is the strongest susceptibility locus to TAK. The association between TAK and HLA-B52:01 has been established beyond ethnicity. Recently, two different Japanese research groups identified HLA-B67:01, a relatively rare allele in East Asian population, as a novel susceptibility allele. At the same time, two amino acid variations, namely, histidine at position 171 and phenylalanine at position 67 were reported as susceptibility and protective variations, respectively. Since these positions of amino acid are in the peptide binding grooves of HLA-B protein, changes of peptide-binding in MHC class I seem to play a critical role on susceptibility to TAK. Furthermore, the importance of these two amino acid variations would explain the lack of susceptibility effect of HLA-B51:01 to TAK, which shares most of amino acid sequences with HLA-B*52:01 except for two amino acids including the position 67.
高安动脉炎(TAK)是一种累及主动脉及其主要分支的系统性血管炎,最初由日本报道。TAK主要发生于年轻女性,据估计日本TAK患者数量约为6000至10000人。这种低患病率使得对TAK进行基因研究以阐明其遗传背景变得困难。HLA区域,尤其是HLA - B基因座,是TAK最强的易感基因座。TAK与HLA - B52:01之间的关联已在不同种族中得到证实。最近,两个不同的日本研究小组将HLA - B67:01(东亚人群中相对罕见的等位基因)鉴定为一种新的易感等位基因。同时,分别报道了两个氨基酸变异,即第171位的组氨酸和第67位的苯丙氨酸,分别为易感变异和保护性变异。由于这些氨基酸位置位于HLA - B蛋白的肽结合槽中,MHC I类分子中肽结合的变化似乎在TAK易感性中起关键作用。此外,这两个氨基酸变异的重要性可以解释HLA - B51:01对TAK缺乏易感效应,HLA - B51:01与HLA - B52:01除了包括第67位在内的两个氨基酸外,大部分氨基酸序列相同。