Scherak O, Smolen J S, Mayr W R, Mayrhofer F, Kolarz G, Thumb N J
J Rheumatol. 1984 Oct;11(5):610-4.
One hundred sixty-eight patients with rheumatoid arthritis treated with chloroquine (n = 87), gold salts (n = 133) and/or penicillamine (n = 77) were investigated for possible associations between HLA antigens and toxic reactions. Patients with 2 or more side effects to gold and/or penicillamine had a significantly increased frequency of antigens HLA-B8 and DR3 compared to patients with one or without adverse reactions. Proteinuria to gold or penicillamine was significantly associated with HLA-B8 (relative risk [RR] 4.2) and DR3 (RR 14.0) whereas nonnephrologic side effects to gold or penicillamine were associated with B7 and DR2 (RR 3.5 and 2.8). Patients with skin reactions to gold had a significantly greater frequency of HLA-B7. We found no correlation between chloroquine side effects and any HLA antigen. The results suggest a genetic predisposition to toxic reactions to gold or penicillamine based on an immunologic dysregulation.
对168例接受氯喹（n = 87）、金盐（n = 133）和/或青霉胺（n = 77）治疗的类风湿性关节炎患者，研究了HLA抗原与毒性反应之间可能存在的关联。与有1种或无不良反应的患者相比，对金盐和/或青霉胺有2种或更多副作用的患者，抗原HLA - B8和DR3的频率显著增加。金盐或青霉胺所致蛋白尿与HLA - B8（相对危险度[RR] 4.2）和DR3（RR 14.0）显著相关，而金盐或青霉胺的非肾脏副作用与B7和DR2相关（RR分别为3.5和2.8）。对金盐有皮肤反应的患者，HLA - B7的频率显著更高。我们未发现氯喹副作用与任何HLA抗原之间存在相关性。结果提示，基于免疫调节异常，对金盐或青霉胺的毒性反应存在遗传易感性。
