A RACE-CONTROLLED HUMAN-LEUKOCYTE ANTIGEN FREQUENCY-ANALYSIS IN LUPUS NEPHRITIS
A RACE-CONTROLLED HUMAN-LEUKOCYTE ANTIGEN FREQUENCY-ANALYSIS IN LUPUS NEPHRITIS
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DOI：
10.1016/s0272-6386(12)80264-2
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发表时间：
1993-04-01
影响因子：
13.2
通讯作者：
CANZANELLO, VJ
中科院分区：
文献类型：
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作者：
FREEDMAN, BI;SPRAY, BJ;CANZANELLO, VJ
与白人相比，非裔美国人（黑人）系统性红斑狼疮（SLE）的发病率和死亡率更高，肾病风险也更高。我们分析了1982年至1986年的东南部器官采购基金会（SEOPF）数据库，以确定人类白细胞抗原（HLA）频率的变化，超出了种族之间通常存在的频率，是否与狼疮性肾炎（LN）有关。将271名黑人和230名白色肾移植受者中的HLA抗原频率与4,506名种族匹配的尸体供肾者对照进行比较。计算比值比（OR）和卡方值，以评估每种HLA表型的患病率，分别为黑人和白人的情况下与对照组。与种族匹配的对照组相比，两个种族的病例中HLA-B8和-DR 2频率升高，HLA-DR 4频率降低（种族合并OR分别为1.68，1.46和0.49;均P < 0.01）。种族特异性分析显示，与黑人对照组相比，黑人病例组HLA-DR 6降低（OR，0.48;P< 0.001），而与白色对照组相比，白色病例组HLA-DR 3升高（OR，1.88;P< 0.001）。在两个种族的患者中，HLA-B8和DR 2与LN呈正相关，HLA-DR 4与LN呈负相关。HLA-DR 3和-DR 6在LN中表现出种族特异性，并使白人相对于黑人处于不利地位。非HLA介导的遗传因素和/或环境因素可能导致黑人SLE患者肾炎风险增加。此外，HLA-B和-DR相关性可能是种族特异性、相关的HLA-130多态性的标志物，这些多态性容易导致SLE肾脏受累。
Systemic lupus erythematosus (SLE) has higher incidence and mortality rates in addition to a greater risk for nephropathy in African Americans (blacks), compared with whites. We analyzed the South-Eastern Organ Procurement Foundation (SEOPF) database from 1982 through 1986 to determine if variation in human leukocyte antigen (HLA) frequencies, beyond those normally present between the races, were associated with lupus nephritis (LN). HLA antigen frequencies in 271 black and 230 white renal transplant recipients with LN as the cause of end-stage renal disease (ESRD) were compared with 4,506 race-matched cadaveric kidney donor controls. Odds ratios (ORs) and chi-square values were computed to assess the prevalence of each HLA phenotype among the cases versus the controls separately for blacks and whites. HLA-B8 and -DR2 frequencies were increased, and HLA-DR4 frequency was decreased in cases of both races compared with race-matched controls (race-combined ORs,1.68,1.46, and 0.49, respectively; allP< 0.01). Race-specific analyses showed that HLA-DR6 was decreased in black cases versus black controls (OR, 0.48;P< 0.001) and HLA-DR3 was increased in white cases versus white controls (OR, 1.88;P< 0.001). HLA-B8 and DR2 are positively associated and HLA-DR4 is negatively associated with LN in patients of both races. HLA-DR3 and -DR6 demonstrate race-specificity in LN and place whites at a disadvantage relative to blacks. It is likely that nonHLA-mediated genetic factors and/or environmental factors contribute to the increased risk of nephritis observed in black patients with SLE. In addition, HLA-B and -DR associations are likely to be markers for race-specific, linked HLA-130 polymorphisms that predispose to renal involvement in SLE.