Medolago Natália Bronzatto, Ferrasi Adriana Camargo, da Rocha Oswaldo Melo, de Moura Campos Pardini Maria Inês, Tommasini Grotto Rejane Maria, Silva Giovanni Faria
Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, Botucatu, Brazil.
Department of Bioprocess and Biotechnology, College of Agricultural Sciences, Sao Paulo State University, Botucatu, Brazil.
Curr Rheumatol Rev. 2023;19(1):58-63. doi: 10.2174/1573397118666220621151236.
BACKGROUND/AIMS: Hepatitis C has been associated with rheumatologic manifestations (HCV-related RM). Clinically, HCV-related RM may be indistinguishable from the symptoms that occur in diffuse connective tissue diseases (DCTD-related RM), making the differential diagnosis difficult. Host genetic factors, such as the Human Leukocyte Antigens (HLA) polymorphisms were associated with HCV infection, however, there are no studies that discriminate between HCVrelated RM and DCTD-related RM. This study focused on verifying associations between HLADRB1 and RM in patients with chronic hepatitis C, aiming to distinguish between DCTD-related RM and HCV-related RM.
The participants were 152 individuals, of both sexes, aged between 18 and 80 years, and affected by chronic hepatitis C. The patients underwent rheumatologic physical examination and HLA-class II (HLA-DRB1) typing was performed by PCR-SSO (Polymerase Chain Reactionsequence Specific Oligonucleotides).
A significant number of patients with rheumatologic complaints (73%) not attributed to other causes was observed. DRB1*08 allele seems to confer protection against RM in chronic hepatitis C. There is no susceptibility association between HLA-DRB1 alleles and RM.
The absence of association between HLA-DRB1 and the rheumatologic manifestations studied suggests that the pathophysiological pathways of DCTD-related RM and HCV-related RM are distinct.
背景/目的:丙型肝炎与风湿性表现(丙型肝炎病毒相关的风湿性表现)有关。临床上,丙型肝炎病毒相关的风湿性表现可能与弥漫性结缔组织病(弥漫性结缔组织病相关的风湿性表现)出现的症状难以区分,这使得鉴别诊断变得困难。宿主遗传因素,如人类白细胞抗原(HLA)多态性与丙型肝炎病毒感染有关,然而,尚无研究对丙型肝炎病毒相关的风湿性表现和弥漫性结缔组织病相关的风湿性表现进行区分。本研究着重验证慢性丙型肝炎患者中HLA - DRB1与风湿性表现之间的关联,旨在区分弥漫性结缔组织病相关的风湿性表现和丙型肝炎病毒相关的风湿性表现。
研究对象为152名年龄在18至80岁之间的慢性丙型肝炎患者,男女不限。患者接受了风湿科体格检查,并通过聚合酶链反应 - 序列特异性寡核苷酸(PCR - SSO)进行HLA - II类(HLA - DRB1)分型。
观察到大量有风湿性主诉且无其他病因的患者(73%)。DRB1*08等位基因似乎对慢性丙型肝炎患者的风湿性表现具有保护作用。HLA - DRB1等位基因与风湿性表现之间不存在易感性关联。
HLA - DRB1与所研究的风湿性表现之间缺乏关联,这表明弥漫性结缔组织病相关的风湿性表现和丙型肝炎病毒相关的风湿性表现的病理生理途径是不同的。