Reveille J D, Alarcón G S, Fowler S E, Pillemer S R, Neuner R, Clegg D O, Mikhail I S, Trentham D E, Leisen J C, Bluhm G, Cooper S M, Duncan H, Tuttleman M, Heyse S P, Sharp J T, Tilley B
University of Texas Health Science Center, Houston, USA.
Arthritis Rheum. 1996 Nov;39(11):1802-7. doi: 10.1002/art.1780391105.
To examine the effect of alleles encoding the "shared"/"rheumatoid" epitope on rheumatoid arthritis (RA) disease severity in patients who participated in the minocycline in RA (MIRA) trial.
Of 205 patients with a week-48 visit, blood was available for typing of HLA-DRB1 and HLA-DQB1 in 174 (85%) and successfully completed in 169 (82%). Baseline erosions were used to assess disease severity and new erosions at the last visit served as a proxy for progression.
At baseline, there was no association between the presence of erosive disease or rheumatoid factor status and the dose of rheumatoid epitope (homozygous, heterozygous, none) or the specific alleles identified. At the final visit, a gradient was observed for the 3 allelic subgroups (and their gene doses) in the occurrence of new erosions among the Caucasian placebo-treated, but not the minocycline-treated, patients. A treatment group/HLA-DR4 epitope interaction was demonstrated in multivariate analyses. Approximately two-thirds of African-American patients did not have the rheumatoid epitope.
HLA-DRB1 oligotyping may be useful in predicting the progression of disease in some Caucasian patients. Our study corroborates the infrequency of the epitope among African-American patients with RA.
在参与类风湿关节炎米诺环素治疗（MIRA）试验的患者中，研究编码“共享”/“类风湿”表位的等位基因对类风湿关节炎（RA）疾病严重程度的影响。
在205例进行了48周随访的患者中，174例（85%）有血液可用于HLA-DRB1和HLA-DQB1分型，169例（82%）成功完成分型。以基线期的骨侵蚀情况评估疾病严重程度，末次随访时的新骨侵蚀情况作为疾病进展的替代指标。
在基线期，侵蚀性疾病的存在或类风湿因子状态与类风湿表位的剂量（纯合子、杂合子、无）或所鉴定的特定等位基因之间无关联。在末次随访时，在接受安慰剂治疗的白种人患者中，观察到3个等位基因亚组（及其基因剂量）在新骨侵蚀发生情况上存在梯度差异，但在接受米诺环素治疗的患者中未观察到。多变量分析显示了治疗组/HLA-DR4表位的相互作用。大约三分之二的非裔美国患者没有类风湿表位。
HLA-DRB1寡基因分型可能有助于预测某些白种人患者的疾病进展。我们的研究证实了类风湿表位在非裔美国类风湿关节炎患者中出现频率较低。
