Labbe P, Flipo R M, Fajardy I, Hachulla E, Houvenagel E, Hatron P Y, Duquesnoy B, Danze P M
Service de rhumatologie, hôpital B, CHU, Lille, France.
Rev Med Interne. 1995;16(10):778-81. doi: 10.1016/0248-8663(96)80789-2.
Some studies have suggested that distribution of HLA DRB1 alleles in polymyalgia rheumatica (PMR) resembles that found in giant cell arteritis (GCA). However these data are controversial. OBJECTIVE--To evaluate in French native patients whether PMR immunogenetically resembles GCA in determining HLA DRB1 alleles. PATIENTS AND METHODS--Fourty-five patients were included in the study. Twenty-one patients with PMR alone (Bird's criteria) and 24 with GCA (ACR criteria). In 11 patients, GCA was associated with PMR. HLA DRB1 genotype was determined by PCR-RFLP analysis. Statistical analysis was performed by the chi 2 test and determination of the odds ratio (OR). Two hundred and thirty-three unselected normal healthy subjects served as controls. RESULTS--A significant increased prevalence of HLA DR1 was observed in patient with PMR alone and an absence of DR7 (0% vs 10.3%, p = 0.02, OR = 0.1). An increased incidence of DR4 and particularly *0401 allele was only found in patients with GCA (OR = 2.4). No patient with isolated PMR had DR7 genotype compared with 25% in GCA (p < 0.001, OR = 0.03). A comparative study between isolated PMR versus GCA showed a significant increased in DR1 and DR3 alleles in isolated PMR and a significant increased prevalence of DR4 and DRB1 *0701 allele in GCA. CONCLUSION--The present study emphasizes the absence of similarity in HLA DRB1 allele distribution between PMR and GCA. The association of DR7 in patient with GCA seems characteristic in French native patients.
一些研究表明，风湿性多肌痛（PMR）中HLA DRB1等位基因的分布与巨细胞动脉炎（GCA）中的相似。然而，这些数据存在争议。目的——评估在法国本土患者中，PMR在确定HLA DRB1等位基因方面在免疫遗传学上是否与GCA相似。患者与方法——45名患者纳入研究。21名单纯PMR患者（根据Bird标准）和24名GCA患者（根据美国风湿病学会标准）。11名患者中，GCA与PMR相关。通过聚合酶链反应-限制性片段长度多态性分析确定HLA DRB1基因型。采用卡方检验和比值比（OR）测定进行统计分析。233名未经挑选的正常健康受试者作为对照。结果——在单纯PMR患者中观察到HLA DR1患病率显著增加，且无DR7（0%对10.3%，p = 0.02，OR = 0.1）。仅在GCA患者中发现DR4尤其是*0401等位基因的发生率增加（OR = 2.4）。与GCA中25%相比，无孤立性PMR患者具有DR7基因型（p < 0.001，OR = 0.03）。孤立性PMR与GCA之间的比较研究显示，孤立性PMR中DR1和DR3等位基因显著增加，GCA中DR4和DRB1 *0701等位基因患病率显著增加。结论——本研究强调PMR和GCA之间HLA DRB1等位基因分布不存在相似性。DR7在GCA患者中的关联在法国本土患者中似乎具有特征性。
