Immunogenetic analysis of post-schistosomal liver disease in China

中国血吸虫后肝纤维化的免疫遗传学分析据估计，江西省沿阳苏河及其支流和鄱阳湖地区有30多万日本血吸虫病患者。最严重的并发症之一是在感染后几年内发生的血吸虫后肝脏疾病。这种慢性病患者非常普遍，因此这些地区的生产力多年来一直处于低迷状态。为了确定感染后影响预后的宿主遗传因素，我们对生活在江西省鱼山县北山村的244例无亲缘关系的患者进行了SSOs DNA分型，其中76例（31.1%）无肝纤维化改变（O级），168例典型纤维化改变患者的HLA-DRB1和DQB1分别为I级（70例，28.7%）、II级（91例，37.3%）和III级（7例，2.9%）。用超声观察肝脏的血吸虫纤维化改变，并按世界卫生组织标准确定分级（Cairo1991）。HLA-DRB1^<**>1101在纤维化改变组中显著降低（I级**），表明该等位基因对纤维化具有抗性（p校正<0.005，RR=0.29）。相反，HLA-DRB1^<**>1202在纤维化组略有升高，但无统计学意义。我们也用同样的方法分型了他们的HLA-DQB （n=188, 0级=64，I-III级=124）。纤维化组无等位基因升高或降低。虽然我们应该检查他们的HLA-DQA，DPA和DPB，但我们强烈建议HLA-DRB1^<**>1101主要与血吸虫肝纤维化耐药有关。

Immunogenetic analysis of post-schistosomal liver fibrosis in ChinaOver 300,000 patients have been estimated to be suffering from schistosomiasis japonica in Jiangxi province along Yangsu River, its branches and Poyang lake. One of the most serious complications is post-schistosomal liver disease that develop within several years after the infection. Such chronic patients are very common so that the productivity of those areas has been depressed for many years.To identify the host genetic factors affecting the prognosis after infection, we have typed 244 of unrelated patients who are living in the endemic village named Beishan, Yushan country, Jiangxi, including 76 patients (31.1%) with no fibrotic change in the liver (Grade O) and 168 patients with typical fibrotic change including Grade I (70pts, 28.7%), Grade II (91pts, 37.3%) and Grade III (7pts, 2.9%) for their HLA-DRB1 and DQB1, by DNA typing of SSOs methods. The schistosomal fibrotic changes in the liver were observed by using ultrasound and the grades were determined by the WHO standard (Cairo1991).HLA-DRB1^<**>1101 significantly decreased in the fibrotic change group (Grade I**) indicating that this allele is resistant against fibrosis (Pcorrected<0.005, RR=0.29). On the contrary, HLA-DRB1^<**>1202 was slightly increased in the fibrosis group but it was not statistically significant. We have also typed their HLA-DQB by the same methods (n=188, grade 0=64, grade I-III=124). There observed no allele that increased or decreased in fibrotic group.Although we should examine their HLA-DQA,DPA and DPB,it is strongly suggested that the HLA-DRB1^<**>1101 is primarily associated with resistance to schistosomal liver fibrosis.