与日本未分类葡萄膜炎患者人类白细胞抗原 DRB1*04 相关的视觉结果和脉络膜厚度。

Visual outcomes and choroidal thickness associated with human leukocyte antigen DRB1*04 in unclassifiable uveitis in Japanese patients.

机构信息

Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka City University, 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.

出版信息

BMC Ophthalmol. 2021 Dec 28;21(1):457. doi: 10.1186/s12886-021-02222-9.

DOI:10.1186/s12886-021-02222-9

PMID:34963463

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8715637/

Abstract

PURPOSE

Human leukocyte antigen (HLA) and immunity are related. Uveitis is also closely related to immunity. For example, the common presence of human leukocyte antigen (HLA)-DRB1*04 in the immune response is well known. The aim of this study was to investigate the relationship between visual prognosis and various HLA alleles before and after therapy in patients with unclassifiable uveitis, excluding those with Vogt-Koyanagi-Harada (VKH) disease.

METHODS

This retrospective case series included 42 eyes from 22 consecutive patients with unclassifiable uveitis, excluding those with VKH disease. Visual acuity (VA), sex, refractive error, central retinal thickness (CRT), central choroidal thickness (CCT), and duration from onset to treatment were measured at initial and 6-month visits. Mean values of parameters were compared at each visit. Genotyping was performed by polymerase chain reaction amplification with sequence-specific primers.

RESULTS

DRB104 showed a dominant change. No significant difference was observed in the other alleles. In DRB104, The mean differences in initial CCT, 6-month CCT, and 6-month VA showed statistically significant difference was found in best-corrected visual acuity (BCVA) between DRB104+ and DRB104- at the first visit. BCVA values at baseline and at the final visit were 0.13 ± 0.29 and 0.20 ± 0.36 in the DRB104+ and 0.00045 ± 0.20 and - 0.058 ± 0.11 in the DRB104- groups(p = 0.00465). Central Choroidal Thickness (CCT) values pretreatment and at the final visit after treatment were (pretreatment:361.00 ± 361.0 μm,after treatment: 286.00 ± 106.53 μm, p = 0.0174) in the DRB104+ group, and (pretreatment:281.3 ± 139.68 μm,after treatment:223.85 ± 99.034 μm, p = 0.0426) in the DRB104- group, respectively, indicating changes between baseline and the final visit. CCT was significantly greater in the DRB104+ group at both the initial visit and at 6 months. Multivariate analysis showed a significant difference between the presence or absence of DRB104 and sex.

CONCLUSION

HLA-DRB1*04 allele may affect visual prognosis and CCT in unclassifiable uveitis.

摘要

目的

人类白细胞抗原（HLA）与免疫有关。葡萄膜炎也与免疫密切相关。例如，众所周知，免疫反应中常见的人类白细胞抗原（HLA）-DRB1*04 存在。本研究旨在探讨排除 Vogt-Koyanagi-Harada（VKH）病后，未经分类的葡萄膜炎患者治疗前后与视觉预后相关的各种 HLA 等位基因之间的关系。

方法

本回顾性病例系列研究纳入了 22 例未经分类的葡萄膜炎连续患者的 42 只眼，排除了 VKH 病患者。在初始和 6 个月就诊时测量视力（VA）、性别、屈光不正、视网膜中央厚度（CRT）、脉络膜中央厚度（CCT）和发病至治疗的时间。在每次就诊时比较参数的平均值。通过聚合酶链反应扩增与序列特异性引物进行基因分型。

结果

DRB104 表现出优势变化。其他等位基因无显著差异。在 DRB104 中，首次就诊时，DRB104+和 DRB104-之间的初始 CCT、6 个月 CCT 和 6 个月 VA 的平均差异存在统计学意义。DRB104+组的基线和最终随访时的最佳矫正视力（BCVA）分别为 0.13±0.29 和 0.20±0.36，DRB104-组分别为 0.00045±0.20 和-0.058±0.11（p=0.00465）。DRB104+组治疗前和治疗后最终随访时的脉络膜中央厚度（CCT）值分别为（治疗前：361.00±361.0μm，治疗后：286.00±106.53μm，p=0.0174），DRB104-组分别为（治疗前：281.3±139.68μm，治疗后：223.85±99.034μm，p=0.0426），表明基线与最终随访之间存在变化。在初次就诊和 6 个月时，DRB104+组的 CCT 均明显更大。多变量分析显示，DRB104 的存在与否与性别之间存在显著差异。