Genetic susceptibility to severe course of nephropathia epidemica caused by Puumala hantavirus
Genetic susceptibility to severe course of nephropathia epidemica caused by Puumala hantavirus
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DOI：
10.1038/ki.1996.29
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发表时间：
1996-01-01
影响因子：
19.6
通讯作者：
Vaheri, A
中科院分区：
文献类型：
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作者：
Mustonen, J;Partanen, J;Vaheri, A
由普马拉汉坦病毒引起的肾综合征出血热（HFRS）是一种常见的肾综合征出血热（HFRS）。NE的临床严重程度存在相当大的变异性。许多感染是亚临床的，但这种疾病甚至可能是致命的。我们通过测定74例成人NE患者的主要组织相容性复合体标志物（MHC），质疑NE的广泛结局是否依赖于宿主相关的免疫因素。病程最严重的患者具有非常高的HLAB 8、C4 A * Q 0和DRB 1 *0301等位基因频率。在所有7例（100%）休克患者和13例（69%）需要透析的患者中发现了HLA B8，而在整个人群中只有25/74（34%）和14/93（15%）对照。此外，发现指向严重形式的NE的各种其他临床发现与这些等位基因相关。有趣的是，相同的MHC等位基因是各种自身免疫性疾病的危险因素。这是第一个研究，其中某一HLA单倍型被发现与急性病毒性疾病或急性肾炎的临床过程。
Nephropathia epidemica (NE) caused by Puumala hantavirus is one type of hemorrhagic fever with renal syndrome (HFRS). There is considerable variability in the clinical severity of NE. Many infections are subclinical but the disease can even be fatal. We questioned whether the wide spectrum in the outcome of NE is dependent on host-related immunological factors by determining the major histocompatibility complex markers (MHC) in 74 adult patients with NE. Patients with the most severe course of the disease had a very high frequency of HLA B8, C4A*Q0, and DRB1*0301 alleles. HLA B8 was found in all 7 (100%) patients with shock and in 9 of the 13 (69%) patients who required dialysis, versus in only 25 of 74 (34%) in the entire population, and in 14 of 93 (15%) controls. In addition, various other clinical findings pointing to a severe form of NE were found to be associated with these alleles. Interestingly, the same MHC alleles are risk factors for various autoimmune diseases. This is the first study where a certain HLA haplotype is found to be associated with the clinical course of an acute viral disease or acute nephritis.