Immunogenetic analysis of post-schistosomal liver disease in China

中国血吸虫病后肝纤维化的免疫遗传学分析江西省沿着扬子江及其支流和鄱阳湖的日本血吸虫病患者估计超过30万人。最严重的并发症之一是在感染后几年内发展的后染色体肝病。为探讨影响感染后预后的宿主遗传因素，我们对江西省玉山县北山村244例无亲缘关系的病人进行了分型，包括76名患者（31.1%）无肝脏纤维化改变（O级），168例患者有典型的纤维化改变，包括I级HLA-DRB 1和DQB 1基因型分别为Ⅱ级（91例，37.3%）和Ⅲ级（7例，2.9%）。用超声观察肝纤维化改变，按WHO标准（Cairo 1991）分级，肝纤维化改变组HLA-DRB 1 ^** 1101显著降低（I级），提示该等位基因对肝纤维化具有抵抗力（P校正<0.005，RR=0.29）。相反，HLA-DRB 1 ^**>1202在纤维化组中略有增加，但无统计学显著性。我们还用同样的方法对188例患者进行了HLA-DQB分型（0级64例，I-III级124例）。肝纤维化组中未观察到等位基因的增加或减少，虽然我们应该检测他们的HLA-DQA、DPA和DPB，但强烈提示HLA-DRB 1 ^**>1101主要与肝纤维化的抗性相关。

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.