Dāvidsone Zane, Eglīte Jeļena, Lazareva Arina, Dzelzīte Sarmīte, Šantere Ruta, Bērziņa Dace, Staņēviča Valda
Departement of Paediatrics, Riga Stradiņš University (RSU), Vienības gatve 45, LV 1004, Riga, Latvia.
Riga Stradiņš University, Joint Laboratory of Clinical Immunology and Immunogenetics, Rātsupītes 5, LV-1067, Riga, Latvia.
Pediatr Rheumatol Online J. 2016 Apr 19;14(1):24. doi: 10.1186/s12969-016-0086-4.
Temporomandibular joint (TMJ) arthritis is seen very often (38-87 %) in children with juvenile idiopathic arthritis (JIA). With contrast enhanced magnetic resonance imaging (MRI) we can detect more cases of TMJ arthritis than ever before. Previous studies show that HLA II class alleles may have protective or risk importance in JIA subtypes. Our objective is to identify HLA II class alleles of risk and protection in JIA patients with TMJ arthritis.
During the period from 2010 to 2015 MRI for TMJ was performed in 85 JIA patients who were genotyped for HLA- DRB1; DQB1 and DQA1 using RT-PCR with sequence-specific primers. As a control group, data of 100 individuals were taken from the genetic bank of RSU Joint Laboratory of Clinical Immunology and Immunogenetics. Associations of DRB1; DQB1; DQA1 alleles in patients were examined individually using the χ (2) test. P-value (<0.05) and odds ratio were calculated using EPI INFO 6.0 software.
Out of 85 JIA patients with mean age of 13.7 ± 3.0 years (range 6.9-17.9 years), 59 (69 %) were girls and 26 (31 %) were boys. The mean duration of the disease was 3.07 ± 2.35 years (range 0.2-11.0 year). JIA subtypes were as follows: seronegative polyarthritis 51 (60 %), seropositive polyarthritis 6(7 %), oligoarthritis extended 7(8 %), oligoarthritis persistent 2 (2 %) arthritis with enthesitis 14 (17 %), undifferentiated 3 (4 %) and 2 (2 %) systemic arthritis. Two groups where separated after TMJ MRI exam: first with at least two signs of active inflammation and/or any structural damage (n = 62); second with no pathologic signs or with slight contrast enhancement (n = 23). We discovered that there are risk alleles that are found in all JIA patient's groups (MRI positive and negative groups) versus controls such as DRB107:01, DQB103:03; DQB105:01. Also some protective alleles as DRB118:01, DQB106:02-8 were found in overall JIA group. Alleles DRB112:01, DQB103:01; DQA105:01 were found to be protective for TMJ arthrits.
In our study there were no convincing risk alleles, but there are alleles that probably are protective for TMJ arthritis like DRB112:01, DQB103:01; DQA1*05:01.
颞下颌关节（TMJ）关节炎在幼年特发性关节炎（JIA）患儿中很常见（38 - 87%）。通过对比增强磁共振成像（MRI），我们能够比以往检测到更多的TMJ关节炎病例。先前的研究表明，HLA II类等位基因在JIA亚型中可能具有保护或风险意义。我们的目的是确定患有TMJ关节炎的JIA患者中HLA II类等位基因的风险和保护作用。
在2010年至2015年期间，对85例JIA患者进行了TMJ的MRI检查，并使用序列特异性引物的RT - PCR对其进行HLA - DRB1、DQB1和DQA1基因分型。作为对照组，从临床免疫学和免疫遗传学RSU联合实验室的基因库中获取了100名个体的数据。使用χ²检验分别检查患者中DRB1、DQB1、DQA1等位基因的关联性。使用EPI INFO 6.0软件计算P值（<0.05）和比值比。
85例JIA患者的平均年龄为13.7±3.0岁（范围6.9 - 17.9岁），其中59例（69%）为女孩，26例（31%）为男孩。疾病的平均病程为3.07±2.35年（范围0.2 - 11.0年）。JIA亚型如下：血清阴性多关节炎51例（60%），血清阳性多关节炎6例（7%），扩展性少关节炎7例（8%），持续性少关节炎2例（2%），附着点炎相关关节炎14例（1%），未分化型3例（4%），全身型关节炎2例（2%）。TMJ MRI检查后分为两组：第一组至少有两个活动性炎症迹象和/或任何结构损伤（n = 62）；第二组无病理迹象或仅有轻微对比增强（n = 23）。我们发现与对照组相比，在所有JIA患者组（MRI阳性和阴性组）中都存在风险等位基因，如DRB107:01、DQB103:03、DQB105:01。在整个JIA组中还发现了一些保护性等位基因，如DRB118:01、DQB106:02 - 8。发现等位基因DRB112:01、DQB103:01、DQA105:01对TMJ关节炎具有保护作用。
在我们的研究中，没有令人信服的风险等位基因，但存在可能对TMJ关节炎具有保护作用的等位基因，如DRB112:01、DQB103:01、DQA1*05:01。
