Li Huan, Xiao Lulu, Wang Liang, Lin Jinfu, Luo Min, Chen Menglong, He Ruojie, Zhu Yuling, Zhang Cheng
Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Tissue Typing Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Front Neurol. 2018 Nov 15;9:970. doi: 10.3389/fneur.2018.00970. eCollection 2018.
Immune-mediated pathology has been thought to be an important factor contributing to Duchenne muscular dystrophy (DMD). Allele frequencies of certain HLA types are known to differ between patients with dystrophinopathies and healthy controls with low-resolution HLA gene typing data in limit reports. Using Polymerase chain reactionsequence based typing (PCR-SBT) to genotype 64 children with DMD in , -B,-C, -DRB1, and locus and 503 healthy controls in , - locus, this study aimed to investigate associations of specific alleles with, and their possible roles in the development and clinical phenotypic severity of DMD. The χ test was used to evaluate the distribution of allele frequencies in , - locus between the patients and healthy controls. A significantly higher frequency of was found in children with DMD compared to that in controls (OR = 16.2, 95%CI = 2.9-89.3, < 0.046). More importantly, significantly higher frequencies of (OR = 77.308, 95%CI = 6.794-879.731, < 0.0160) and 07:05 (OR = 60.240, 95%CI = 9.637-376.535, < 2.4110) was found in patients with mutations ( = 14) compared to controls while no difference of HLA alleles frequency ware indicated between patients with inherited mutation and control. The result indicates that alleles is associated with pathogenesis of DMD especially DMD with mutation. We use Vignos scale to estimate the lower limb motor function of patients. The impact of HLA alleles on score of Vignos scale of DMD children was estimated by multiple linear regression. Our study indicates that 02:01 may have a dampening effect on the clinical phenotypic severity of DMD, evidenced by the presence of 02:01 being associated with lower Vignos score. Our study demonstrates that certain alleles are indeed associated with the pathogenesis and clinical phenotypic severity of DMD.
免疫介导的病理学被认为是导致杜氏肌营养不良症(DMD)的一个重要因素。在有限的报告中,根据低分辨率HLA基因分型数据,已知肌营养不良症患者与健康对照之间某些HLA类型的等位基因频率存在差异。本研究采用基于聚合酶链反应序列分型(PCR-SBT)技术,对64例DMD患儿的A、B、C、DRB1和DQB1基因座以及503例健康对照的A、B基因座进行基因分型,旨在研究特定HLA等位基因与DMD发生发展及其临床表型严重程度的关联,以及它们可能发挥的作用。采用χ²检验评估患者与健康对照在A、B基因座上等位基因频率的分布情况。结果发现,DMD患儿中A02:01的频率显著高于对照组(OR = 16.2,95%CI = 2.9 - 89.3,P < 0.046)。更重要的是,与对照组相比,A03:01(OR = 77.308,95%CI = 6.794 - 879.731,P < 0.0160)和A07:05(OR = 60.240,95%CI = 9.637 - 376.535,P < 2.4110)在携带DMD基因(c.14)突变的患者中频率显著更高,而遗传性突变患者与对照组之间HLA等位基因频率无差异。结果表明,HLA等位基因与DMD的发病机制相关,尤其是与携带DMD基因(c.14)突变的DMD相关。我们使用Vignos量表评估患者的下肢运动功能。通过多元线性回归评估HLA等位基因对DMD患儿Vignos量表评分的影响。我们的研究表明,A02:01可能对DMD的临床表型严重程度有抑制作用,证据是携带A*02:01与较低的Vignos评分相关。我们的研究表明,某些HLA等位基因确实与DMD的发病机制和临床表型严重程度相关。