HLA-DRB1 alleles associated with polymyalgia rheumatica in northern Italy: correlation with disease severity
HLA-DRB1 alleles associated with polymyalgia rheumatica in northern Italy: correlation with disease severity
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DOI：
10.1136/ard.58.5.303
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发表时间：
1999-05-01
影响因子：
27.4
通讯作者：
Macchioni, P
中科院分区：
文献类型：
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作者：
Salvarani, C;Boiardi, L;Macchioni, P
研究协会的HLA-DRB 1等位基因与风湿性多肌痛（PMR）在地中海国家，并探讨HLA-DRB 1基因在确定疾病severity. Methods的作用，一个五年的前瞻性随访研究92例连续PMR患者诊断的二级转诊中心的风湿病的雷焦艾米利亚，意大利进行。应用聚合酶链反应扩增和寡核苷酸杂交技术，对92例类风湿关节炎（RA）患者、29例DR 4阳性RA患者和148名来自同一地区的对照者进行了HLA-DRB 1等位基因检测。具有双倍剂量表位的患者的频率较低，并且在PMR和对照中没有显著差异。DR 4 + PMR、DR+ RA和DR 4+对照组之间的HLA-DR 4亚型分布无显著差异。单因素分析结果显示，诊断时血沉> 72 mm，HLA-DR 1、DR 10、类风湿抗原表位和类风湿抗原表位类型是复发/再发的重要危险因素。考克斯比例风险模型确定了两个变量，独立增加复发/复发的风险：ESR在诊断> 72毫米第1小时（RR=1.5）和2型（由非DR 4等位基因编码）类风湿抗原表位（RR=2.7）。结论这些数据来自地中海国家显示，类风湿抗原表位与PMR在北方意大利患者没有关联。诊断时的高ESR和由非DR 4等位基因编码的类风湿表位的存在是疾病严重程度的独立有价值的标志物。
Objective-To examine the association of HLA-DRB1 alleles with polymyalgia rheumatica (PMR) in a Mediterranean country and to explore the role of HLA-DRB1 genes in determining disease severity.Methods-A five year prospective follow up study of 92 consecutive PMR patients diagnosed by the secondary referral centre of rheumatology of Reggio Emilia, Italy was conducted. HLA-DRB1 alleles were determined in the 92 patients, in 29 DR4 positive rheumatoid arthritis (RA) patients, and in 148 controls from the same geographical area by polymerase chain reaction amplification and oligonucleotide hybridisation.Results-No significant differences were observed in the frequencies of HLA-DRB1 types and in the expression of HLA-DRB 70-74 shared motif between PMR and controls. The frequency of the patients with double dose of epitope was low and not significantly different in PMR and in controls. No significant differences in the distribution of HLA-DR4 subtypes were observed between DR4+ PMR, DR+ RA, and DR4+ controls. Results of the univariate analysis indicated that an erythrocyte sedimentation rate (ESR) at diagnosis > 72 mm 1st h, the presence of HLA-DR1, DR10, rheumatoid epitope, and the type of rheumatoid epitope were significant risk factors associated with relapse/ recurrence. Cox proportional hazards modelling identified two variables that independently increased the risk of relapse/recurrence: ESR at diagnosis > 72 mm 1st h (RR=1.5) and type 2 (encoded by a non-DR4 allele) rheumatoid epitope (RR=2.7).Conclusion-These data from a Mediterranean country showed no association of rheumatoid epitope with PMR in northern Italian patients. A high ESR at diagnosis and the presence of rheumatoid epitope encoded by a non-DR4 allele are independent valuable markers of disease severity.