Salvarani C, Macchioni P L, Mantovani W, Bragliani M, Collina E, Cremonesi T, Battistel B, Boiardi L
Unità Reumatologica, Azienda Ospedaliera Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
Br J Rheumatol. 1998 Feb;37(2):165-9. doi: 10.1093/rheumatology/37.2.165.
The aim of the study was to evaluate the relationship between the presence of the 'rheumatoid epitope', defined by a sequence motif in the HLA-DRB1 alleles, rheumatoid factor and disease severity in Northern Italian patients with rheumatoid arthritis (RA). Twenty-nine DR4-positive and 57 DR4-negative RA patients were studied. Each DR4-positive patient was matched with two DR4-negative controls of similar disease duration and sex. HLA-DRB1 alleles were determined in the 86 patients and 351 controls from the same geographical area. The patients were retrospectively evaluated for extra-articular features (EAF) and radiographic damage. The rheumatoid epitope was expressed in 45% of patients. No significant differences in the presence of rheumatoid factor, EAF and articular damage were observed between patients with no, one or two doses of epitope. However, the patients encoding the epitope by an HLA-DR4 allele had a higher number of eroded joints and a higher Larsen score compared to those without the epitope. No differences were present between patients expressing HLA-DRB101 alleles and those lacking the rheumatoid epitope. Even in the absence of expression of the rheumatoid epitope, seropositive patients had more EAF and more erosive disease compared to those who were seronegative. Even if most Northern Italian RA patients do not express the rheumatoid epitope, the radiological severity of disease is associated with HLA-DRB104 alleles.
本研究的目的是评估在意大利北部类风湿关节炎（RA）患者中，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、类风湿因子与疾病严重程度之间的关系。研究了29例DR4阳性和57例DR4阴性的RA患者。每例DR4阳性患者与两名疾病病程和性别相似的DR4阴性对照进行匹配。对来自同一地理区域的86例患者和351例对照进行了HLA - DRB1等位基因检测。对患者的关节外表现（EAF）和影像学损伤进行回顾性评估。45%的患者表达类风湿表位。在未表达、表达一个或两个剂量表位的患者之间，类风湿因子的存在、EAF和关节损伤方面未观察到显著差异。然而，与未携带该表位的患者相比，由HLA - DR4等位基因编码该表位的患者有更多的侵蚀性关节和更高的 Larsen 评分。表达HLA - DRB101等位基因的患者与缺乏类风湿表位的患者之间没有差异。即使在不表达类风湿表位的情况下，血清阳性患者与血清阴性患者相比仍有更多的EAF和更严重的侵蚀性疾病。即使大多数意大利北部的RA患者不表达类风湿表位，疾病的放射学严重程度仍与HLA - DRB104等位基因相关。
