Genetic control of the susceptibility to psoriasis.

银屑病被认为是一种多因素疾病，其临床表现可能很好地反映了这种异质性病因。为了阐明携带银屑病易感性的不同（或普遍）单倍型，我们对154名无血缘关系的日本银屑病患者进行了血清分型和/或dna寡分型。寻常型银屑病（PV） 62例，银屑病关节炎（PA） 19例，脓疱型银屑病（PP） 73例。73例PP患者中71例的HLA数据引自a . Ohkawara等人（1990）的报告。1)HLA- al - b37 - cw6和B39-Cw7单倍型与pv2相关。2)HLA- a2 - bw46 - cwll - drw8 - dqw6 - dpb2.2（主要相关HLA抗原为HLA- a2）和B27与PA相关。通过Thomson和Bodmer提出的方法，与HLA-A2连锁不平衡的易感基因似乎以显性方式遗传。3)根据HLA-A2基因的RFLP分析，PA患者与健康对照组之间HLA-A2基因的DNA多态性无差异。4)HLA- a2与PP相关。5)HLA- drw13 - dqw6单倍型频率在PA和PV中均降低。6)未发现全球通用的HLA单倍型是银屑病易感性的载体（PV、PA和PP）。HLA单倍型在银屑病中的生物学作用研究结果如下：1)HLA- a2 - bw46 - wll- drw8 - d9。w6-DPB2.2单倍型阳性PA患者与补体成分C4a衍生的血清过敏毒素C4a水平升高相关。4.2)HLA-A1-B37-Cw6单倍型与PV患者血清亚油酸水平低相关。HLAⅰ类抗原和ⅱ类抗原与银屑病的相关性支持了银屑病的某些部分被认为是一种具有免疫遗传性疾病的疾病。为了进一步阐明银屑病的发病机制，有必要利用转基因小鼠引入特定的HLA等位基因进行进一步的研究。

Psoriasis is considered a multifactorial disease, and its clinical manifestations may well reflect this heterogeneous etiology.In order to elucidate distinct (or universal) haplotypes carrying the susceptibility to psoriasis, we performed serotyping and/or DNA-oligotyping of 154 unrelated Japanese patients with psoriasis. Sixty-two out of the 154 were psoriasis vulgaris (PV), 19 were psoriatic arthritis (PA) and 73 were pustular psoriasis (PP). HLA data on 71 out of the 73 PP patients were cited from a report by A. Ohkawara et al. (1990).1)HLA-Al-B37-Cw6 and B39-Cw7 haplotypes had association with PV.2)HLA-A2-Bw46-Cwll-DRw8-DQw6-DPB2.2 (primary associated HLA antigen was HLA-A2) and B27 had association with PA. By using the method proposed by Thomson and Bodmer, the susceptibility gene in linkage disequilibrium with HLA-A2 seems to be inherited in a dominant fashion.3)There was no difference on DNA polymorphism of HLA-A2 gene between patients with PA and healthy controls, according to RFLP analysis of the HLA-A2 gene.4)HLA-A2 had association with PP.5)HLA-DRw13-DQW6 haplotype frequency was decreased both in PA and in PV.6)No globally universal HLA haplotype was identified as the carrier of susceptibility to psoriasis (PV, PA and PP).A study on biological roles of the HLA haplotypes in psoriasis revealed the following findings :1)HLA-A2-Bw46-Cwll-DRw8-D9. w6-DPB2.2 haplotype-positive PA patients had a correlation with increased serum levels of anaphylatoxin C4a derived from complement component C4.2)HLA-A1-B37-Cw6 haplotype showed association with low serum levels of linoleic acid among patients with PV.Association between HLA class I antigens and class II antigens and psoriasis supports that some part of psoriasis is recognized as a disease with immunogenetic disorders. Further investigations by using transgenic mice introduced particular HLA alleles might be necessary to clarify the pathogenesis of psoriasis.