Madigand M, Fauchet R, Oger J, Sabouraud O
Nouv Presse Med. 1981 Jun 27;10(28):2349-52.
The study concerns HLA typing of 261 patients with disseminated sclerosis. All patients were grouped for loci A and B. In addition, 94 were typed in HLA DR and 132 in mixed lymphocytic culture (DW2 only). Analysis of tissue group distribution among patients compared with a control population showed not only over-representation of the B7, DW2, A3 B7 and B7 DR2 types (as previously stressed by several workers), but also of A9 and of B8 DR3 and A1 B8 DR3 associations. Moreover, it would seem that there are two distinct clinical forms of disseminated sclerosis, each form being characterized by a specific antigenic HLA association. Side by side with the conventional and most common "remittent" form, which is partly responsive to treatment, has a relatively favourable course and is frequently associated with B7 and DW2/DR2, there appears to emerge around DR3, B8 DR3 and A1 B8 DR3 a rarer, "progressive" form of rapidly increasing severity and resistant to immuno-suppressants. This, however, is a mere hypothesis which needs to be confirmed by further studies on a larger scale.
该研究涉及261例播散性硬化症患者的HLA分型。所有患者按A和B位点进行分组。此外，94例进行了HLA DR分型，132例进行了混合淋巴细胞培养分型（仅针对DW2）。将患者的组织型分布与对照人群进行比较分析，结果显示不仅B7、DW2、A3 B7和B7 DR2型出现频率过高（此前已有多位研究者强调过），而且A9以及B8 DR3和A1 B8 DR3组合型也出现频率过高。此外，似乎播散性硬化症存在两种不同的临床形式，每种形式都有特定的HLA抗原组合特征。与传统且最常见的“缓解型”并存，这种类型对治疗有部分反应，病程相对较好，且常与B7和DW2/DR2相关，而围绕DR3、B8 DR3和A1 B8 DR3似乎出现了一种较罕见的“进展型”，病情迅速加重且对免疫抑制剂耐药。然而，这仅仅是一个假说，需要通过更大规模的进一步研究来证实。
