人类白细胞抗原（HLA）-DQ及HLA-DQA1/DQB1等位基因与原田小柳-原田病的关联：一项系统评价和荟萃分析
Association of human leukocyte antigen (HLA)-DQ and HLA-DQA1/DQB1 alleles with Vogt-Koyanagi-Harada disease: A systematic review and meta-analysis.
作者信息
Liu Bing, Deng Tuo, Zhu Linxin, Zhong Jingxiang
机构信息
Department of Ophthalmology, the First Affiliated Hospital of Jinan University Department of Urology, Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Urology, Guangdong Key Laboratory of Urology, Guangzhou, China.
出版信息
Medicine (Baltimore). 2018 Feb;97(7):e9914. doi: 10.1097/MD.0000000000009914.
OBJECTIVE
The aim of this study was to evaluate the association of human leukocyte antigen (HLA)-DQ and HLA-DQA1/DQB1 alleles with Vogt-Koyanagi-Harada (VKH), providing further evidences on the genetic background of this disease.
METHODS
A comprehensive literature search was conducted on the relationship of HLA-DQ and/or HLA-DQA1/DQB1 alleles with VKH through PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and databases for grey literature. The last search was in October 2017. Pooled odds ratio (OR) with 95% confidence interval (95% CI) was calculated from extracted data to access the strength of the association between a genotype and VKH.
RESULTS
HLA-DQ4 was confirmed to increase the risk of VKH significantly (OR = 4.63, 95% CI: 1.74-12.31, P = .002), while HLA-DQ1 seemed to reduce VKH occurrence with OR = 0.32 (95% CI: 0.22-0.47, P < .00001). HLA-DQA10301-(OR = 4.52, 95% CI: 1.42-14.35, P = .01) and HLA-DQB10401-(OR = 23.12, 95% CI: 11.54-46.31, P < .00001) positive patients probably had a rising tendency to suffer from VKH. Alleles including HLA-DQA10103, 0401, 0501 and HLA-DQB10301, 0402, 0601, 0603 were significant protective genetic factors.
CONCLUSION
We concluded that HLA-DQ4 carriers had a higher risk of VKH and HLA-DQ1 seemed to be protective. People with positive HLA-DQA10301 and HLA-DQB10401 demonstrated to be more susceptible to VKH. HLA-DQA10103, 0401, 0501 and HLA-DQB10301, 0402, 0601, 0603 could be potential protectors.
目的
本研究旨在评估人类白细胞抗原（HLA）-DQ及HLA-DQA1/DQB1等位基因与葡萄膜炎-小柳原田综合征（VKH）的关联，为该疾病的遗传背景提供更多证据。
方法
通过PubMed、Embase、Cochrane图书馆、中国知网、维普以及灰色文献数据库，对HLA-DQ和/或HLA-DQA1/DQB1等位基因与VKH的关系进行全面文献检索。末次检索时间为2017年10月。从提取的数据中计算合并比值比（OR）及95%置信区间（95%CI），以评估基因型与VKH之间关联的强度。
结果
证实HLA-DQ4显著增加VKH风险（OR = 4.63，95%CI：1.74 - 12.31，P = 0.002），而HLA-DQ1似乎降低VKH的发生风险，OR = 0.32（95%CI：0.22 - 0.47，P < 0.00001）。HLA-DQA10301阳性患者（OR = 4.52，95%CI：1.42 - 14.35，P = 0.01）及HLA-DQB10401阳性患者（OR = 23.12，95%CI：11.54 - 46.31，P < 0.00001）患VKH的倾向可能增加。包括HLA-DQA10103、0401、0501以及HLA-DQB10301、0402、0601、0603在内的等位基因是显著的保护性遗传因素。
结论
我们得出结论，HLA-DQ4携带者患VKH的风险更高，而HLA-DQ1似乎具有保护作用。HLA-DQA10301和HLA-DQB10401阳性的人对VKH更易感。HLA-DQA10103、0401、0501以及HLA-DQB10301、0402、0601、0603可能是潜在的保护因素。
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