台湾人群中人类白细胞抗原亚型与终末期肾病风险的关联：一项回顾性研究。
Association between human leucocyte antigen subtypes and risk of end stage renal disease in Taiwanese: a retrospective study.
作者信息
Dai Ciou-Sia, Chu Chen-Chung, Chen Shin-Fan, Sun Chiao-Yin, Lin Marie, Lee Chin-Chan
机构信息
Department of Internal Medicine, Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
出版信息
BMC Nephrol. 2015 Oct 30;16:177. doi: 10.1186/s12882-015-0165-7.
BACKGROUND
End stage renal disease (ESRD) is prevalent in Taiwan. Human leukocyte antigens (HLA) have been found to be associated with the pathogenesis of autoimmune diseases, allergies and inflammatory bowel diseases, and there are emerging evidences of correlations between HLA genotypes and renal diseases such as diabetic nephropathy, IgA nephropathy, and glomerulonephritis. The aim of this study is to investigate detailed HLA subtypes in a case-control study of Taiwanese individuals.
METHODS
The polymorphisms of HLA class I and II antigens in ESRD patients and a healthy control group were retrospectively analyzed. The information of 141 ESRD patients was obtained from the medical record of the Keelung branch of Chang Gung Memorial Hospital and was compared to the HLA type of a control group comprized of 190 healthy unrelated Taiwanese from one of our previous studies. In order to standardize the HLA designation of prior low-resolution typings with the more advanced DNA based typings, all HLA-A, -B and -DR were analyzed using a low resolution serologic equivalent.
RESULTS
The current work suggests that HLA-DR3 (odds ratio = 1.91, 95 % CI = 1.098-3.324, P = 0.024, Pc = 0.312) and HLA-DR11 (odds ratio = 2.06, 95 % CI = 1.133-3.761, P = 0.021, Pc = 0.273) may represent susceptibility risk factors for the development of ESRD in Taiwanese individuals. On the other hand, HLA-DR8 (odds ratio = 0.47, 95 % CI = 0.236-0.920, p = 0.027. Pc = 0.351) may be a protective factor. HLA-A and -B antigens did not show any contribution of progression to ESRD. However, we note that the significance of all these findings is lost when the results are corrected for multiple comparisons according to Bonferroni. Further investigation with a larger group of patients and control is needed to resolve this issue.
CONCLUSIONS
HLA typing might be a useful clinical method for screening patients with high risk of progression to ESRD.
背景
终末期肾病（ESRD）在台湾地区较为普遍。人类白细胞抗原（HLA）已被发现与自身免疫性疾病、过敏和炎症性肠病的发病机制有关，并且越来越多的证据表明HLA基因型与糖尿病肾病、IgA肾病和肾小球肾炎等肾脏疾病之间存在关联。本研究的目的是在一项针对台湾个体的病例对照研究中调查详细的HLA亚型。
方法
回顾性分析ESRD患者和健康对照组中HLA I类和II类抗原的多态性。141例ESRD患者的信息来自长庚纪念医院基隆分院的病历记录，并与我们之前一项研究中由190名健康、无亲缘关系的台湾人组成的对照组的HLA类型进行比较。为了用更先进的基于DNA的分型方法规范先前低分辨率分型的HLA命名，所有HLA - A、- B和 - DR均使用低分辨率血清学等效物进行分析。
结果
目前的研究表明，HLA - DR3（优势比 = 1.91，95%置信区间 = 1.098 - 3.324，P = 0.024，校正P值 = 0.312）和HLA - DR11（优势比 = 2.06，95%置信区间 = 1.133 - 3.761，P = 0.021，校正P值 = 0.273）可能代表台湾个体发生ESRD的易感性危险因素。另一方面，HLA - DR8（优势比 = 0.47，95%置信区间 = 0.236 - 0.920，P = 0.027，校正P值 = 0.351）可能是一个保护因素。HLA - A和 - B抗原对ESRD的进展没有任何影响。然而，我们注意到，根据Bonferroni方法对结果进行多重比较校正后，所有这些发现的显著性都消失了。需要对更多患者和对照组进行进一步研究来解决这个问题。
结论
HLA分型可能是一种用于筛查有进展为ESRD高风险患者的有用临床方法。
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