Dreyfus P, Geay D, Cambon H, Daupleix D
Rev Rhum Mal Osteoartic. 1984 Apr;51(4):197-202.
Cross reactions are very frequently observed when HLA A and B antigens are determined by a routine lymphocytotoxicity method. Such cross reactions are probably due to biochemical structural similarities shared by several HLA antigens. In this work, we studied the cross reactions which occurred during HLA A and B typing of 63 patients with classical or definite rheumatoid arthritis (RA) according to the ARA criteria. No association was found between RA and any single HLA A or B antigen. In contrast, when cross reactions were taken into account, the B8 B14 cross reactant group frequency was increased in RA patients (34,9 p. cent) as compared to controls (20 p. cent, p less than 0,004) and was even more clearly elevated in the 42 seropositive RA patients (40,5 p. cent, p less than 0,002). No relation was found between HLA phenotype and Sjögren's syndrome even when cross reactions were considered. The B8 DR3 haplotype has been shown to be associated with drug intolerance . The B8 B14 cross reactant group was present in 22 out of our 63 RA patients, 16 of whom were B8+. Among the latter, 6 patients exhibited poor tolerance to gold salts and 6 other patients did not respond to gold therapy, suggesting that the B8 antigen could predict not only a poor tolerance but also a poor response to disease modifying drugs.
当通过常规淋巴细胞毒性方法测定HLA A和B抗原时,经常会观察到交叉反应。这种交叉反应可能是由于几种HLA抗原共有的生化结构相似性。在这项研究中,我们根据ARA标准,对63例典型或确诊类风湿关节炎(RA)患者进行HLA A和B分型时发生的交叉反应进行了研究。未发现RA与任何单一HLA A或B抗原之间存在关联。相反,当考虑交叉反应时,RA患者中B8 B14交叉反应组频率(34.9%)高于对照组(20%,p<0.004),在42例血清阳性RA患者中更为明显升高(40.5%,p<0.002)。即使考虑交叉反应,也未发现HLA表型与干燥综合征之间存在关联。已证明B8 DR3单倍型与药物不耐受有关。在我们的63例RA患者中,有22例存在B8 B14交叉反应组,其中16例为B8阳性。在后者中,6例患者对金盐耐受性差,另外6例患者对金治疗无反应,这表明B8抗原不仅可以预测耐受性差,还可以预测对改善病情药物的反应差。