Genetic control of the susceptibility to psoriasis.

银屑病被认为是一种多因素疾病，其临床表现可以很好地反映这种异质性病因。为了阐明携带银屑病易感性的不同(或普遍的)单倍型，我们对154名无关的日本银屑病患者进行了血清分型和/或DNA寡核苷酸分型。其中寻常型银屑病62例，银屑病关节炎19例，脓疱型银屑病73例。73名PP患者中71名的人类白细胞抗原数据引用自A.Ohkawa等人的一份报告。2)HLA-A2-Bw46-Cwll-DRw8-DQw6-DPB2.2(主要相关抗原为HLA-A2)，B27与PA相关。根据Thomson和Bodmer提出的方法，与HLA-A2连锁不平衡的易感基因似乎是以显性方式遗传的。3)通过对HLA-A2基因的RFLP分析，发现PA患者和健康对照组的HL-A2基因DNA多态性没有差异。4)HL A-A2与PP相关。5)PA和PV患者的HLA-DRW13-DQW6单倍型频率均降低。6)未发现全球通用的HLA单倍型携带银屑病(PV，对人类白细胞抗原单倍型在银屑病中的生物学作用的研究发现：1)人类白细胞抗原-A2-Bw46-Cwll-DLu8-D9。W6-DPB2.2单倍型阳性PA患者与血清补体成分C4a过敏毒素C4a水平升高相关；(4)单倍型HLAA1-B37-CW6单倍型与PV患者低亚油酸水平相关，提示部分银屑病患者存在免疫遗传紊乱。为了阐明银屑病的发病机制，可能有必要通过引入特定的HLA等位基因的转基因小鼠进行进一步的研究。

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.