HLA-DRB1 alleles associated with rheumatoid arthritis in Northern Italy: correlation with disease severity.
HLA-DRB1 alleles associated with rheumatoid arthritis in Northern Italy: correlation with disease severity.
复制标题
意大利北部与类风湿性关节炎相关的 HLA-DRB1 等位基因：与疾病严重程度的相关性。
DOI：
10.1093/rheumatology/37.2.165
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
L. Boiardi
中科院分区：
文献类型：
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作者：
C. Salvarani;P. Macchioni;W. Mantovani;M. Bragliani;E. Collina;T. Cremonesi;B. Battistel;L. Boiardi
本研究的目的是评估在意大利北部类风湿关节炎(RA)患者中，由人类白细胞抗原-DRB1等位基因序列基序定义的‘类风湿表位’的存在与类风湿因子和疾病严重程度之间的关系。对29例DR4阳性和57例DR4阴性的RA患者进行了研究。每个DR4阳性患者与两个病程和性别相似的DR4阴性对照相匹配。对同一地区的86例患者和351例对照进行了HL A-DRB1等位基因检测。对患者的关节外特征(EAF)和放射学损伤进行了回顾性评估。45%的患者表达类风湿表位。在无表位、一次表位和二次表位的患者中，类风湿因子、EAF和关节损害的存在没有显著差异。然而，与那些没有该表位的患者相比，有一个HLA-DR4等位基因编码的患者有更多的关节受到侵蚀和更高的Larsen评分。表达HLA-DRB1*01等位基因的患者与缺乏类风湿表位的患者之间无差异。即使在没有类风湿表位表达的情况下，与血清阴性的患者相比，血清阳性的患者也有更多的EAF和更多的侵袭性疾病。即使大多数北意大利RA患者不表达类风湿表位，疾病的放射严重程度也与HLA-DRB1*04等位基因相关。
The aim of the study was to evaluate the relationship between the presence of the 'rheumatoid epitope', defined by a sequence motif in the HLA-DRB1 alleles, rheumatoid factor and disease severity in Northern Italian patients with rheumatoid arthritis (RA). Twenty-nine DR4-positive and 57 DR4-negative RA patients were studied. Each DR4-positive patient was matched with two DR4-negative controls of similar disease duration and sex. HLA-DRB1 alleles were determined in the 86 patients and 351 controls from the same geographical area. The patients were retrospectively evaluated for extra-articular features (EAF) and radiographic damage. The rheumatoid epitope was expressed in 45% of patients. No significant differences in the presence of rheumatoid factor, EAF and articular damage were observed between patients with no, one or two doses of epitope. However, the patients encoding the epitope by an HLA-DR4 allele had a higher number of eroded joints and a higher Larsen score compared to those without the epitope. No differences were present between patients expressing HLA-DRB1*01 alleles and those lacking the rheumatoid epitope. Even in the absence of expression of the rheumatoid epitope, seropositive patients had more EAF and more erosive disease compared to those who were seronegative. Even if most Northern Italian RA patients do not express the rheumatoid epitope, the radiological severity of disease is associated with HLA-DRB1*04 alleles.