van Jaarsveld C H, Otten H G, Jacobs J W, Kruize A A, Brus H L, Bijlsma J W
Department of Rheumatology and Clinical Immunology, University Hospital Utrecht, The Netherlands.
Clin Exp Rheumatol. 1998 Jul-Aug;16(4):483-8.
The clinical expression of rheumatoid arthritis (RA) varies considerably among individual patients. Genetic variations in human leucocyte antigen (HLA) may influence susceptibility to RA and the severity of the disease. The literature concerning the association of HLA-DR with the susceptibility to and the clinical expression of RA is reviewed here, taking into account the different populations studied and different typing techniques. An association between the 'shared epitope' and RA susceptibility is present on a group level and may be of some pathophysiological interest. However HLA-DR typing is not useful as a diagnostic test for individuals. The reported associations between HLA-DR and RA severity are various, which might be due to the different typing techniques used. Results from most studies using genomic techniques for HLA-DR typing show an association between HLA-DR4+, DR1+ and a more severe disease course in patient groups. However, this association is too weak to be relevant for individual patients. Therefore, with our current typing techniques, HLA-DR typing is not a useful prognostic test for individual RA patients.
类风湿关节炎（RA）的临床表现在个体患者之间差异很大。人类白细胞抗原（HLA）的基因变异可能影响对RA的易感性以及疾病的严重程度。本文回顾了关于HLA - DR与RA易感性及临床表型之间关联的文献，同时考虑了所研究的不同人群和不同的分型技术。在群体水平上，“共享表位”与RA易感性之间存在关联，这可能具有一定的病理生理学意义。然而，HLA - DR分型对个体而言并非有用的诊断检测方法。报道的HLA - DR与RA严重程度之间的关联各不相同，这可能是由于所使用的分型技术不同所致。大多数采用基因组技术进行HLA - DR分型的研究结果显示，在患者群体中，HLA - DR4 +、DR1 +与更严重的病程之间存在关联。然而，这种关联过于微弱，对个体患者而言并无实际意义。因此，就我们目前的分型技术而言，HLA - DR分型对个体RA患者并非有用的预后检测方法。
