Analysis of HLA antigens in Mycobacterium avium-intracellulare pulmonary infection
Analysis of HLA antigens in Mycobacterium avium-intracellulare pulmonary infection
复制标题
DOI：
10.1164/ajrccm.161.4.9906094
复制
发表时间：
2000-04-01
影响因子：
24.7
通讯作者：
Kamijou, Y
中科院分区：
文献类型：
--
作者：
Kubo, K;Yamazaki, Y;Kamijou, Y
肺炎分枝杆菌细胞内(MAI)肺部感染可能发生在没有既往肺部疾病和已知免疫缺陷的受试者中，表现为放射学上的结节状支气管扩张。该病的发病机制仍有一些尚未解决的问题，包括老年妇女的优势和存在。指没有恶化或恶化的疾病。在目前的研究中，我们检查了免疫遗传易感性是否存在于这种疾病中。我们通过症状评估、痰细菌学检查和胸部CT检查，评估了脉病病例，并分析了其短期自然病史。并与100例日本健康受试者的人类白细胞抗原(HL A)等位基因频率进行比较。用血清学方法检测人类白细胞抗原-A、-B、-C、-DR和-DQ。在患者中，37例(35名女性)在间隔30+/-15mo后无恶化，27例(24名女性)出现恶化。两组人群中均无明显的等位基因频率分布。在37例未恶化患者中，DR-6阳性14例(37.8%)，而对照组仅16例(16%)(P=0.0061，OR=3.2)。DQ-4阳性10例(27.0%)，对照组10例(10%)(P=0.0122，OR=3.33)。27例病情恶化患者中，HLAA26阳性14例(51.9%)，对照组21例(21.0%)(P=0.0015，OR=4.05)。MAI肺部感染合并结节状支气管扩张症有两种结局，恶化和未恶化。携带A-26抗原的受试者可能提示MAI感染加重。
Mycobacterium avium-intracellulare (MAI) pulmonary infection may occur in subjects with no preexisting lung disease and no known immunodeficiency, showing radiologically nodular bronchiectasis. There have remained some unresolved problems in the pathogenesis of the disorder, including the predominance in elderly women and the presence. of not deteriorated or deteriorated disease. In the present study, we examined whether immunogenetic susceptibility is present in the disorder. We evaluated 64 cases of MAI disease and analyzed their short-term natural history by assessing symptoms, sputum bacteriology, and chest computed tomographic findings. The frequencies of human leukocyte antigen (HLA) alleles in patients were compared with those in 100 healthy Japanese control subjects. We assayed the HLA-A, -B, -C, -DR, and -DQ antigens serologically. Among 64 patients, 37 (35 females) did not show deterioration, whereas 27 (24 females) showed deterioration after an interval of 30 +/- 15 mo. There was no significant frequency of HLA-B and -C alleles in either group. In 37 not deteriorated patients, DR-6 was positive in 14 (37.8%) patients but in only 16 (16%) control subjects (p = 0.0061, odds ratio [OR] = 3.20). DQ-4 was positive in 10 (27.0%) patients but in only 10 (10%) control subjects (p = 0.0122 OR = 3.33). In 27 deteriorated patients, HLA-A26 was positive in 14 (51.9%) patients but in only 21 (21.0%) control subjects (P = 0.0015, OR = 4.05). MAI pulmonary infection with nodular bronchiectasis shows two types of outcome, deteriorated and not deteriorated. The subjects with A-26 antigen might indicate the deterioration of MAI infection.