Kitamura H, Kobayashi Y, Kimura A, Numano F
Third Department of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, Japan.
Int J Cardiol. 1998 Oct 1;66 Suppl 1:S121-6. doi: 10.1016/s0167-5273(98)00159-4.
HLA-DNA typing using PCR-SSOP and PCR-DCP methods was performed in 85 patients with Takayasu arteritis and 492 healthy controls who had been typed for HLA by serological method. Frequencies of HLA-B52 (B5201) and B39 (B3901 and B3902) were significantly increased in the patients. Frequency of HLA-DRB11502 was also increased but it was suggested to be a reflection of its linkage disequilibrium with B52. Association of HLA-B52 and B39 with seven clinical manifestations--pulmonary infarction, ischemic heart disease, aortic regurgitation, systemic hypertension, renal artery stenosis, cerebrovascular disease, and visual disturbance--in 132 HLA-typed patients with Takayasu arteritis was studied. In HLA-B52 positive TA patients, aortic regurgitation (vs B52(-)-B39(+), OR=3.8, P<0.05, vs B52(-)-B39(-), OR=5.49, P<0.001), ischemic heart disease (vs B52(-)-B39(+), OR=12.05, P<0.05, vs B52(-)-B39(-), OR=2.85, P<0.05), and pulmonary infarction (vs B52(-)-B39(+), OR=5.74, P<0.03) were found to be significantly prevalent. On the other hand, in HLA-B39 positive TA patients, frequency of renal artery stenosis was significantly increased (vs B52(+)-B39(-), OR=12.14, P<0.001, vs B52(-)-B39(-), OR=5.21, P<0.03). These observations have suggested that HLA-B52 molecule and B39 molecule would contribute to different clinical manifestations by binding different antigenic peptides to cause inflammations. Thus HLA-B molecule may play an important role in pathogenesis or determining clinical manifestations of Takayasu arteritis.
采用聚合酶链反应-序列特异性寡核苷酸探针（PCR-SSOP）和聚合酶链反应-序列特异性引物（PCR-DCP）方法，对85例大动脉炎患者及492例已通过血清学方法进行HLA分型的健康对照者进行HLA-DNA分型。患者中HLA-B52（B5201）和B39（B3901及B3902）的频率显著升高。HLA-DRB11502的频率也有所增加，但提示这是其与B52连锁不平衡的反映。研究了132例已进行HLA分型的大动脉炎患者中HLA-B52和B39与七种临床表现（肺梗死、缺血性心脏病、主动脉瓣关闭不全、系统性高血压、肾动脉狭窄、脑血管疾病和视力障碍）的相关性。在HLA-B52阳性的大动脉炎患者中，发现主动脉瓣关闭不全（与B52阴性-B39阳性相比，比值比[OR]=3.8，P<0.05；与B52阴性-B39阴性相比，OR=5.49，P<0.001）、缺血性心脏病（与B52阴性-B39阳性相比，OR=12.05，P<0.05；与B52阴性-B39阴性相比，OR=2.85，P<0.05）和肺梗死（与B52阴性-B39阳性相比，OR=5.74，P<0.03）显著更常见。另一方面，在HLA-B39阳性的大动脉炎患者中，肾动脉狭窄的频率显著增加（与B52阳性-B39阴性相比，OR=12.14，P<0.001；与B52阴性-B39阴性相比，OR=5.21，P<0.03）。这些观察结果提示，HLA-B52分子和B39分子可能通过结合不同的抗原肽引发炎症，从而导致不同的临床表现。因此，HLA-B分子可能在大动脉炎的发病机制或临床表现的决定中起重要作用。
