Department of Anatomy, Laboratory for Molecular Reproduction & Genetics, New Delhi, India.
Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Med Res. 2022 Feb;155(2):253-263. doi: 10.4103/ijmr.IJMR_3196_20.
BACKGROUND & OBJECTIVES: Human leucocyte antigen (HLA)-G plays a vital role in immunomodulation in rheumatoid arthritis (RA). The mounting evidence suggests a link between HLA-G gene polymorphisms, disease susceptibility and methotrexate treatment response. Various environmental factors influence the onset and progression of RA and its treatment outcomes. The aim is to identify the treatment response of HLA-G 3' untranslated region polymorphisms to yoga-based lifestyle intervention (YBLI).
In this eight-week single-blinded randomized controlled trial (CTRI/2017/05/008589), patients with RA (n=140) were randomized into two groups namely, yoga group or non-yoga group. Baseline genomic DNA was isolated using salting-out method. PCR-based methods were used for genotyping. The levels of soluble (s) HLA-G and disease activity were assessed by ELISA and disease activity score-28-erythrocyte sedimentation rate (DAS28-ESR), respectively, at baseline (day 0) and after eight weeks of intervention.
Low-producing sHLA-G genotypes, i.e. +3142GG and 14 bp ins/ins, showed a significant increase in sHLA-G levels after YBLI. The association analysis between HLA-G polymorphisms and treatment for RA showed no considerable differential treatment remission in either of the groups (P>0.05). The percentages of improvement were higher in the yoga group as compared to the non-yoga group in both the HLA-G +3142G>C and 14 bp ins/del polymorphisms irrespective of their respective genotypes. No significant association was found between sHLA-G levels and disease activity with respect to genotypes.
INTERPRETATION & CONCLUSIONS: Yoga intervention results in improvement and reduced severity of RA in patients irrespective of the HLA-G 14 bp ins/del or +3142G>C polymorphisms. YBLI may be used as an adjunct therapy in RA independent of the genotypes.
人类白细胞抗原（HLA）-G 在类风湿关节炎（RA）的免疫调节中起着至关重要的作用。越来越多的证据表明，HLA-G 基因多态性与疾病易感性和甲氨蝶呤治疗反应之间存在关联。各种环境因素影响 RA 的发病和进展及其治疗结果。目的是确定 HLA-G 3'非翻译区多态性对瑜伽为基础的生活方式干预（YBLI）的治疗反应。
在这项为期八周的单盲随机对照试验（CTRI/2017/05/008589）中，将 140 名 RA 患者随机分为瑜伽组或非瑜伽组。使用盐析法分离基线基因组 DNA。使用基于 PCR 的方法进行基因分型。使用酶联免疫吸附法（ELISA）和疾病活动评分-28-红细胞沉降率（DAS28-ESR）分别在基线（第 0 天）和干预八周后评估可溶性（s）HLA-G 和疾病活动水平。
低表达 sHLA-G 基因型，即+3142GG 和 14 bp ins/ins，在 YBLI 后 sHLA-G 水平显著升高。HLA-G 多态性与 RA 治疗之间的关联分析表明，两组之间均无明显的治疗缓解差异（P>0.05）。在 HLA-G +3142G>C 和 14 bp ins/del 多态性中，瑜伽组的改善率高于非瑜伽组，且不论其各自的基因型如何。sHLA-G 水平与疾病活动之间的基因型无显著相关性。
瑜伽干预可改善 RA 患者的病情并减轻其严重程度，与 HLA-G 14 bp ins/del 或+3142G>C 多态性无关。YBLI 可作为独立于基因型的 RA 辅助治疗。
