Sjögren's syndrome. Influence of multiple HLA-D region alloantigens on clinical and serologic expression.
Sjögren's syndrome. Influence of multiple HLA-D region alloantigens on clinical and serologic expression.
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干燥综合症。
DOI：
10.1002/art.1780271106
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发表时间：
1984
影响因子：
--
通讯作者：
Arnett,FC
中科院分区：
文献类型：
--
作者：
Wilson,RW;Provost,TT;Bias,WB;Alexander,EL;Edlow,DW;Hochberg,MC;Stevens,MB;Arnett,FC
对102例原发性和继发性干燥综合征（SS）患者（86例白人和16例黑人）进行了HLA-DR和较新的DS（第二D位点）B细胞同种抗原（MB和MT）与SS临床和血清学表达的关系研究。尽管与种族匹配的正常对照相比，患有原发性SS的白人（50人中的25人，50%）和黑人（5人中的4人，80%）的HLA-DR 3显着增加，但在患有系统性红斑狼疮（SLE）的人中HLA-DR 3没有明显升高-SS、类风湿性关节炎（RA）-SS或结缔组织病-SS。然而，与种族匹配的正常对照相比，MT 2特异性与原发性SS（86%的白人和100%的黑人）以及SLE-SS和RA-SS更密切相关。此外，与非干燥型SLE和RA对照相比，SLE-SS和RA-SS中的MT 2显著增加。尽管原发性和继发性SS与该DS特异性（MT 2）的相关性最强，但抗Ro（SS-A）和抗La（SS-B）抗体应答与DR抗原更密切相关。与抗Ro阴性患者（分别为38%和31%）相比，抗Ro阳性患者（包括白人和黑人）中的HLA-DR 3增加，原发性SS（74%）和总抗Ro阳性受试者（54%）。在DR 3阴性的患者中，HLA-DR 2与原发性SS（83%）和总SS组（58%）中的抗Ro相关。因此，96%的Ro抗体阳性原发性SS患者有DR 3和/或DR 2，所有类别中80%的抗Ro阳性受试者也有DR 3和/或DR 2。La抗体（SS-B）仅与原发SS和总组中的DR 3相关。这些数据表明，MT 2是最强的主要组织相容性复合物决定因素的原发性和继发性SS。然而，HLA-DR 3和DR 2可能介导Ro/La抗体应答，这是更严重疾病的特征。干燥综合征的临床表现似乎是多种HLA-D区域因子的复杂遗传相互作用的结果。
The relationships of HLA—DR and the newer DS (second D locus) B cell alloantigens (MB and MT) to the clinical and serologic expression of primary and secondary forms of Sjögren's syndrome (SS) were examined in 102 patients (86 whites and 16 blacks). Although HLA-DR3 was significantly increased in whites (25 of 50, 50%) and blacks (4 of 5, 80%) with primary SS compared with race-matched normal controls, it was not appreciably elevated in those with systemic lupus erythematosus (SLE)-SS, rheumatoid arthritis (RA)-SS, or connective tissue disease-SS. The MT2 specificity, however, was more strongly associated with primary SS (86% of whites and 100% of blacks) and also with SLE-SS and RA-SS compared with race-matched normal controls. Furthermore, MT2 was significantly increased in SLE-SS and RA-SS when compared with non-sicca SLE and RA controls. Although primary and secondary SS were most strongly associated with this DS specificity (MT2), the anti-Ro (SS-A) and anti-La (SS-B) antibody responses were more closely allied to DR antigens. HLA-DR3 was increased in anti-Ro positive patients, both whites and blacks, with primary SS (74%) and in total anti-Ro positive subjects (54%) compared with their anti-Ro negative counterparts (38% and 31%, respectively). Among DR3 negative patients, HLA-DR2 correlated with anti-Ro in both primary SS (83%) and in the total SS group (58%). Thus, 96% of Ro antibody positive patients with primary SS had DR3 and/or DR2, as did 80% of anti-Ro positive subjects in all categories. Antibodies to La (SS-B) correlated only with DR3 in primary SS and in the total group. These data suggest that MT2 is the strongest major histocompatibility complex determinant for primary and secondary SS. However, HLA-DR3 and DR2 may mediate the Ro/La antibody responses that are characteristic of more severe disease. The clinical expression of Sjögren's syndrome appears to result from the complex genetic interplay of multiple HLA-D region factors.
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