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人类白细胞抗原-DR4和免疫球蛋白重链同种异型Gm(1,3;5,21)与U1-核糖核蛋白抗体阳性结缔组织病相关。

HLA-DR4 and Gm(1,3;5,21) are associated with U1-nRNP antibody positive connective tissue disease.

作者信息

Genth E, Zarnowski H, Mierau R, Wohltmann D, Hartl P W

出版信息

Ann Rheum Dis. 1987 Mar;46(3):189-96. doi: 10.1136/ard.46.3.189.

Abstract

Patients with U1-nRNP antibodies (n = 35, 31 female, four male) were typed for HLA-A, -B, -C, and -DR antigens and IgG heavy chain allotypes G1m(1), -(2), -(3), G3m(5), and -(21). The patient group was clinically heterogeneous. Four met the American Rheumatism Association criteria for systemic lupus erythematosus, six for progressive scleroderma, and 14 for rheumatoid arthritis. Sicca syndrome was present in seven cases. Twenty three had overlapping features compatible with mixed connective tissue disease (MCTD). Healthy blood donors served as controls for HLA typing (n = 64), Gm typing (n = 228), or both (n = 56). Sixty six per cent of the patients with U1-nRNP antibodies were DR4 positive compared with 28% of the controls (relative risk = 4.9, p = 0.00053). The Gm(1,3;5,21) phenotype was found in 46% of the patients and 25% of the controls (relative risk = 2.47, p = 0.0247). Within the patient group Gm(1,3;5,21) was found only in DR4 positive individuals. The coincidence of HLA-DR4 and Gm(1,3;5,21) increases the relative risk values to 8.0 (compared with the group with neither risk factor). DR4 and Gm(1,3;5,21) primarily seem to be related to U1-nRNP antibody formation and not to disease expression. Patients with or without MCTD did not differ with respect to DR4 or Gm(1,3;5,21) frequency. Disease onset was earlier in patients with HLA-DR4/Gm(1,3;5,21) than in patients without both markers (mean 27.9 v 40.1 years; p less than 0.05).

摘要

对35例抗U1 - nRNP抗体阳性患者(31例女性,4例男性)进行了HLA - A、- B、- C和 - DR抗原分型以及IgG重链同种异型G1m(1)、-(2)、-(3)、G3m(5)和 -(21)分型。患者组临床症状各异。4例符合美国风湿病协会系统性红斑狼疮标准,6例符合进行性系统性硬化症标准,14例符合类风湿性关节炎标准。7例有干燥综合征。23例具有与混合性结缔组织病(MCTD)相符的重叠特征。健康献血者作为HLA分型(n = 64)、Gm分型(n = 228)或两者(n = 56)的对照。66%的抗U1 - nRNP抗体阳性患者DR4呈阳性,而对照组为28%(相对风险 = 4.9,p = 0.00053)。46%的患者和25%的对照具有Gm(1,3;5,21)表型(相对风险 = 2.47,p = 0.0247)。在患者组中,仅在DR4阳性个体中发现Gm(1,3;5,21)。HLA - DR4与Gm(1,3;5,21)同时出现会使相对风险值增至8.0(与无任何风险因素的组相比)。DR4和Gm(1,3;5,21)似乎主要与抗U1 - nRNP抗体形成有关,而非与疾病表现相关。有或无MCTD的患者在DR4或Gm(1,3;5,21)频率方面无差异。HLA - DR4/Gm(1,3;5,21)阳性患者的疾病起病早于无这两种标志物的患者(平均27.9岁对40.1岁;p < 0.05)。

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