McDaniel D O, Alarcón G S, Pratt P W, Reveille J D
University of Alabama at Birmingham, USA.
Ann Intern Med. 1995 Aug 1;123(3):181-7. doi: 10.7326/0003-4819-123-3-199508010-00004.
To evaluate the relation between the presence of the "rheumatoid epitope," defined by a sequence motif in the HLA-DRB1 alleles, and disease severity in African-American patients with rheumatoid arthritis.
Cross-sectional study.
Rheumatology outpatient clinics at two university medical centers.
86 African-American patients with rheumatoid arthritis (66 seropositive and 20 seronegative for the rheumatoid factor) attending the clinics and 88 healthy African-American persons.
HLA-DRB1 alleles were determined by restriction fragment length polymorphism and by allele-specific oligonucleotide typing of polymerase chain reaction-amplified HLA-DRB1 second exons.
With the exception of an increased frequency of HLA-DRB1*04 alleles in seropositive patients with rheumatoid arthritis (27.3%) compared with controls (13.1%) (P = 0.02), the frequencies of HLA-DRB1 alleles were similar in patients and controls. Most seropositive (48 of 66) and seronegative (15 of 20) patients were HLA-DR4 negative, but some (7 of 48 seropositive patients and 3 of 15 seronegative persons) inherited the rheumatoid epitope on a non-DR4 allele. Disease features, including severity, were similar for patients without the epitope and for those with either a single or a double dose of an epitope-positive allele. Positivity for rheumatoid factor, but not for the rheumatoid epitope, was weakly associated with severity in these patients.
Most African-American patients with rheumatoid arthritis did not express the rheumatoid epitope. The predisposition to and severity of rheumatoid arthritis in African-Americans appears to be independent of the presence and dose of the shared rheumatoid epitope.
评估由HLA - DRB1等位基因中的序列基序所定义的“类风湿表位”的存在与非裔美国类风湿关节炎患者疾病严重程度之间的关系。
横断面研究。
两所大学医学中心的风湿病门诊。
86名就诊于门诊的非裔美国类风湿关节炎患者（66名类风湿因子血清阳性和20名血清阴性）以及88名健康非裔美国人。
通过限制性片段长度多态性以及聚合酶链反应扩增的HLA - DRB1第二外显子的等位基因特异性寡核苷酸分型来确定HLA - DRB1等位基因。
与对照组（13.1%）相比，类风湿关节炎血清阳性患者中HLA - DRB1*04等位基因频率增加（27.3%）（P = 0.02），患者和对照组中HLA - DRB1等位基因频率相似。大多数血清阳性（66名中的48名）和血清阴性（20名中的15名）患者为HLA - DR4阴性，但一些（48名血清阳性患者中的7名和15名血清阴性患者中的3名）在非DR4等位基因上继承了类风湿表位。没有该表位的患者以及具有单剂量或双剂量表位阳性等位基因的患者，其疾病特征（包括严重程度）相似。在这些患者中，类风湿因子阳性而非类风湿表位阳性与疾病严重程度弱相关。
大多数非裔美国类风湿关节炎患者不表达类风湿表位。非裔美国人患类风湿关节炎的易感性和严重程度似乎与共享类风湿表位的存在和剂量无关。
