Higami K, Hakoda M, Matsuda Y, Ueda H, Kashiwazaki S
Tokyo Women's Medical College, Japan.
Arthritis Rheum. 1997 Dec;40(12):2241-7. doi: 10.1002/art.1780401220.
To evaluate the role of HLA-DRB1 genotypes in the development and progression of the rheumatoid arthritis (RA) disease process.
Patients with polyarthritis of < 1 year in duration were consecutively enrolled in the study. Other inclusion criteria were no diagnosis of inflammatory diseases other than RA, and no history of taking disease-modifying antirheumatic drugs or steroids. Patients were evaluated every 4 weeks, and radiographs of the hands/wrists and feet were taken at presentation and 1 year later. HLA-DRB1 genotypes were determined by polymerase chain reaction and restriction fragment length polymorphism methods.
We enrolled 198 patients (median disease duration 5.0 months) and 150 controls. The frequency of individuals with DRB1*0405 and *0410 was significantly higher in the patients than in the controls. Homozygous states for DRB1 alleles with the RA-related shared epitope (SE) were associated with increased susceptibility for the development of polyarthritis (odds ratio 3.4, 95% confidence interval 1.5-7.7). None of the DRB1 alleles or SE genotypes correlated with the presence of bone erosion at presentation or 1 year later.
DRB1 alleles with SEs were associated with the development of polyarthritis but not with early radiographic progression of the disease process.
评估人类白细胞抗原-DRB1(HLA-DRB1)基因型在类风湿关节炎(RA)疾病发生及进展过程中的作用。
连续纳入病程小于1年的多关节炎患者进行研究。其他纳入标准包括除RA外无炎性疾病诊断,且无服用改善病情抗风湿药物或类固醇的病史。每4周对患者进行评估,并在就诊时及1年后拍摄手部/腕部和足部的X线片。通过聚合酶链反应和限制性片段长度多态性方法确定HLA-DRB1基因型。
我们纳入了198例患者(疾病中位病程5.0个月)和150例对照。患者中携带DRB10405和0410的个体频率显著高于对照。具有RA相关共享表位(SE)的DRB1等位基因纯合状态与多关节炎发生的易感性增加相关(比值比3.4,95%置信区间1.5 - 7.7)。在就诊时或1年后,DRB1等位基因或SE基因型均与骨侵蚀的存在无关。
具有SE的DRB1等位基因与多关节炎的发生相关,但与疾病进程的早期影像学进展无关。