Presence of the full-length KIR2DS4 gene reduces the chance of rheumatoid arthritis patients to respond to methotrexate treatment.

Presence of the full-length KIR2DS4 gene reduces the chance of rheumatoid arthritis patients to respond to methotrexate treatment.
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DOI:
10.1186/1471-2474-15-256
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发表时间:
2014-07-28
影响因子:
2.3
通讯作者:
Kuśnierczyk P
Kuśnierczyk P
中科院分区:
医学3区
文献类型:
--
作者:
Majorczyk E;Pawlik A;Gendosz D;Kuśnierczyk P

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编码自然杀伤细胞免疫球蛋白样受体 (KIR) 的 KIR 基因会影响 NK 细胞以及一些 T 淋巴细胞亚群(例如 CD4+CD28-KIR+)的效应和调节功能,具体取决于配体(特别是 HLA-C 分子)的存在。 KIR-KIR 配体相互作用可能导致自身免疫性疾病的发生,包括类风湿性关节炎 (RA)。然而,它们在 RA 患者对甲氨蝶呤治疗反应中的作用尚不清楚。使用 PCR-SSP 方法对 312 名 RA 患者进行 KIR 基因和 KIR 配体(HLA-C C1/C2 同种异型体)基因分型(根据 DAS28 标准,179 名患者被归类为良好反应者,133 名患者被归类为不良反应者)。因此,我们评估了 KIR 基因和 HLA-C 同种异形体与甲氨蝶呤 (MTX) 治疗反应的关联。我们观察到,与 KIR2DS4f 阴性病例相比,拥有全长 KIR2DS4 (KIR2DS4f) 基因的患者出现反应的机会较低。这种现象在糜烂性疾病 (ED) 和类风湿因子 (RF) 阳性以及 ED 和 RF 阴性患者中均观察到。有趣的是,观察到的 KIR2DS4f 基因的影响在红细胞沉降率 (ESR) 中等值 (20-33 mm/h) 的个体中最强。 ESR值高的患者出现MTX反应的概率较低,相反,ESR值低的患者出现MTX反应的概率较高,且KIR2DS4f的存在并不影响其结果。此外,我们表明 KIR2DS4f 效应并不依赖于 C1 或 C2 同质异形体的存在。我们的结果表明,中等 ESR 值的 RA 患者对 MTX 治疗的反应可能取决于全长 KIR2DS4 基因。
KIR genes coding for natural killer cell immunoglobulin-like receptors, KIR, influence the effector and regulatory function of NK cells as well as some subpopulations of T lymphocytes (e.g. CD4+CD28-KIR+) depending on presence of ligands (particularly HLA-C molecules). KIR-KIR ligand interaction may lead to the development of autoimmune disorders, including rheumatoid arthritis (RA). However, their role in the response of RA patients to methotrexate therapy is not known. KIR genes and KIR-ligand (HLA-C C1/C2 allomorphs) genotyping was performed using the PCR-SSP method in 312 RA patients (179 classified as good responders and 133 as poor responders using DAS28 criteria). Thus, we evaluated the association of KIR genes and HLA-C allomorphs with the response to methotrexate (MTX) treatment. We observed that patients possessing the full-length KIR2DS4 (KIR2DS4f) gene had a lower chance of responding in comparison to KIR2DS4f-negative cases. This phenomenon was observed both in erosive disease (ED) and rheumatoid factor (RF) positive and in ED- and RF-negative patients. Interestingly, the observed effect of the KIR2DS4f gene was strongest in individuals possessing medium values (20-33 mm/h) of the erythrocyte sedimentation rate (ESR). Patients with high ESR values had low probability and, in contrast, patients with low ESR had a high probability of MTX response, and the presence of KIR2DS4f did not affect their outcome. Additionally, we show that the KIR2DS4f effect did not depend on the presence of either C1 or C2 allomorphs. Our results suggest that the response of RA patients with medium ESR values to MTX treatment may be dependent on the full-length KIR2DS4 gene.
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