Kilmartin D J, Finch A, Acheson R W
Institute of Ophthalmology, University College Dublin, Mater Misericordiae Hospital, Ireland.
Br J Ophthalmol. 1997 Aug;81(8):649-53. doi: 10.1136/bjo.81.8.649.
AIMS/BACKGROUND: While a primary association of HLA-B51 with Behçet's disease (BD) in Japanese and Mediterranean patients supports an immunogenetic predisposition, this link is unclear in north western Europe. This study assessed HLA associations with BD, and HLA-B51 with certain clinical characteristics, in the Republic of Ireland, which has an ethnically homogeneous population.
HLA-A, HLA-B, and HLA-DR typing was performed in 24 BD patients, conforming to International Study Group criteria, and in blood donors, as controls. Patient records were retrospectively reviewed and patients reassessed clinically.
A highly significant HLA-B51 association (corrected exact p value = 0.002, relative risk = 6.3) with BD was determined, despite a low B51 prevalence (25%) in patients. No other HLA type was associated. There was a significant B51 link with male sex in BD patients but no association with age at first manifestation/diagnosis, eye involvement, cyclosporin A therapy, or poor visual acuity was determined.
This study supports a HLA-B51 immunogenetic predisposition, similar to Japanese patients, in Irish BD in an ethnically homogeneous population in north western Europe. However, owing to a low prevalence of B51 positivity in BD patients in Ireland, a multifactorial pathogenesis is suggested.
目的/背景:在日本和地中海地区患者中,HLA - B51与白塞病(BD)的主要关联支持了免疫遗传易感性,但在欧洲西北部,这种联系尚不清楚。本研究评估了爱尔兰共和国(其人口种族单一)中HLA与BD的关联,以及HLA - B51与某些临床特征的关联。
对24例符合国际研究组标准的BD患者以及作为对照的献血者进行HLA - A、HLA - B和HLA - DR分型。对患者记录进行回顾性审查,并对患者进行临床重新评估。
尽管患者中B51患病率较低(25%),但仍确定了HLA - B51与BD有高度显著的关联(校正后的精确p值 = 0.002,相对风险 = 6.3)。未发现其他HLA类型存在关联。BD患者中B51与男性有显著关联,但未确定与首次出现症状/诊断时的年龄、眼部受累、环孢素A治疗或视力低下有关联。
本研究支持在欧洲西北部种族单一人群的爱尔兰BD患者中,与日本患者类似,存在HLA - B51免疫遗传易感性。然而,由于爱尔兰BD患者中B51阳性率较低,提示其发病机制为多因素。