Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Mod Rheumatol. 2020 Jul;30(4):708-714. doi: 10.1080/14397595.2019.1649103. Epub 2019 Aug 6.
To scrutinize the influence of HLA-B51 to each clinical manifestation of patients with Behçet's disease (BD) using a database of the Ministry of Health, Labour and Welfare of Japan. The database of newly registered patients with BD was obtained from the Japanese Ministry of Health, Labour and Welfare. Patients who met International Criteria for Behçet's Disease (ICBD) and had data for HLA-B51 were selected and analyzed. Among the 3044 analyzable cases, 1334 (43.8%) were men and 1710 (56.2%) were women; the median age was 38 years (IQR 29-48). HLA-B51 was positive for 1334 (44.5%). Prevalence of selected manifestations was 98.5% for oral ulceration, 85.5% for skin lesion, 42.1% for ocular lesion, 69.1% for genital ulceration, and 29.0% for gastrointestinal symptom. HLA-B51-positive patients had higher risk for ocular lesion (OR 1.59, 95%CI: 1.37-1.84; < .001) and lower risk for genital ulceration (OR 0.72, 95%CI: 0.62-0.84; < .001) and gastrointestinal symptom (OR 0.65, 95%CI: 0.55-0.77; < .001). No significant difference was observed for other organ involvement; oral ulceration, skin lesion, positive pathergy test, arthritis, epididymitis, vascular lesion, or neurological manifestation. Subgroup analyses revealed that HLA-B51 was not related to genital ulceration in the cases with an ICBD score of 6 or higher and that HLA-B51 tended to more largely affect the risk of three manifestations for men compared to that for women. HLA-B51 positive is a risk factor for ocular lesion and vice versa for genital ulceration and gastrointestinal symptoms in patients with Japanese BD.
利用日本厚生劳动省的数据库，深入研究 HLA-B51 对 Behçet 病（BD）患者各临床表现的影响。该数据库是从日本厚生劳动省新登记的 BD 患者数据库中获得的。选择并分析了符合 Behçet 病国际标准（ICBD）且具有 HLA-B51 数据的患者。在可分析的 3044 例患者中，男性 1334 例（43.8%），女性 1710 例（56.2%）；中位年龄为 38 岁（IQR 29-48）。HLA-B51 阳性者 1334 例（44.5%）。口腔溃疡、皮肤损害、眼部病变、生殖器溃疡和胃肠道症状的发生率分别为 98.5%、85.5%、42.1%、69.1%和 29.0%。HLA-B51 阳性患者眼部病变风险较高（OR 1.59，95%CI：1.37-1.84；<0.001），生殖器溃疡（OR 0.72，95%CI：0.62-0.84；<0.001）和胃肠道症状（OR 0.65，95%CI：0.55-0.77；<0.001）的风险较低。其他器官受累、口腔溃疡、皮肤损害、阳性 PAT 试验、关节炎、附睾炎、血管病变或神经表现无显著差异。亚组分析显示，HLA-B51 与 ICBD 评分≥6 分的生殖器溃疡无关，与女性相比，HLA-B51 更倾向于增加男性三种表现的风险。HLA-B51 阳性是日本 BD 患者眼部病变的危险因素，反之则是生殖器溃疡和胃肠道症状的危险因素。
