Sepúlveda-Delgado J, Rizo-Pinto A, Granados-Arriola J, Mena-Vela B A, Cetina-Díaz J H, García-Silva R, Hernández-Doño S, Cruz-Salvatierra M A, Pérez-Tirado J M, Vázquez-Guzmán C, Dominguez-Arrevillaga S, Trujillo-Vizuet M G, Sanchez-González R A, Zamudio-Castellanos F, Vera-Lastra O L, Jara-Quezada L J
Research and Diagnosis Division, Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Mexico.
Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Tapachula, Chiapas, Mexico.
Clin Rheumatol. 2020 Oct;39(10):2875-2879. doi: 10.1007/s10067-020-05060-0. Epub 2020 Apr 2.
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with an increased prevalence in Mexico. Although its etiology is unknown, its development can be influenced by environmental factors such as smoking and viral infections. But among the factors influencing susceptibility, it is the genetic factors that predominate, mainly the HLA-DRB1 genes, and specifically the alleles that have the shared epitope (SE). A transversal study was performed, in which 31 patients (28 women and 3 men) with RA, treated at the autoimmunity clinic of the High Specialty Hospital Ciudad Salud in Tapachula, Chiapas, southern México, were enrolled. Clinical, biochemical, and demographic data were analyzed; ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), RF (rheumatoid factor), and ACPA (anticitrullinated peptide antibody) were recorded. All patients had at least one positive RA biological marker. For HLA alleles frequencies comparison, we enrolled ethnically matched healthy controls in a ratio of 3:1 for 25 cases and 4:1 for 6 cases in order to guarantee the balance between groups regarding the mean of age and proportion of gender (males vs females). HLA-DRB104 was found to be significantly increased in patients compared with ethnically matched healthy controls (p 0.0007, OR: 2.8, 95% CI 1.5-5.1); contrarily, DRB108 showed a protective effect (p 0.005, OR 0.1). This paper confirmed the involvement of HLA genes on risk determination for RA in a population of Mexican Mestizos from Tapachula, Chiapas. Key Points • HLA-DRB104 confirms the increased risk of rheumatoid arthritis. • HLA-DRB108 showed a more definite protective effect in southern Mexicans mestizos, a population with more Amerindian ancestry.
类风湿关节炎(RA)是一种自身免疫性炎症疾病,在墨西哥的患病率呈上升趋势。尽管其病因不明,但其发展可能受吸烟和病毒感染等环境因素影响。但在影响易感性的因素中,遗传因素占主导,主要是HLA - DRB1基因,特别是具有共同表位(SE)的等位基因。开展了一项横断面研究,纳入了31例在墨西哥恰帕斯州塔帕丘拉市Ciudad Salud高级专科医院自身免疫门诊接受治疗的RA患者(28名女性和3名男性)。分析了临床、生化和人口统计学数据;记录了红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)和抗瓜氨酸化肽抗体(ACPA)。所有患者至少有一项RA生物标志物呈阳性。为比较HLA等位基因频率,我们按照病例数25例时3:1、6例时4:1的比例纳入种族匹配的健康对照,以确保各组在年龄均值和性别比例(男性对女性)方面保持平衡。结果发现,与种族匹配的健康对照相比,患者中HLA - DRB104显著增加(p = 0.0007,OR:2.8,95%CI 1.5 - 5.1);相反,DRB108显示出保护作用(p = 0.005,OR 0.1)。本文证实了HLA基因在恰帕斯州塔帕丘拉市墨西哥梅斯蒂索人群RA风险判定中的作用。要点• HLA - DRB104证实类风湿关节炎风险增加。• HLA - DRB108在具有更多美洲印第安人血统的墨西哥南部梅斯蒂索人群中显示出更明确的保护作用。