IDIOPATHIC DILATED CARDIOMYOPATHY - LACK OF ASSOCIATION BETWEEN CIRCULATING ORGAN-SPECIFIC CARDIAC ANTIBODIES AND HLA-DR ANTIGENS
IDIOPATHIC DILATED CARDIOMYOPATHY - LACK OF ASSOCIATION BETWEEN CIRCULATING ORGAN-SPECIFIC CARDIAC ANTIBODIES AND HLA-DR ANTIGENS
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DOI：
10.1111/j.1399-0039.1992.tb01941.x
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发表时间：
1992-05-01
期刊：
影响因子：
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通讯作者：
BOTTAZZO, GF
中科院分区：
文献类型：
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作者：
CAFORIO, ALP;MARTINETTI, M;BOTTAZZO, GF
器官特异性心脏抗体是扩张型心肌病（DCM）自身免疫的血清学标志物。HLA-DR 4和可能的DR 5是DCM易感性的免疫遗传学标志物，但尚不清楚它们是否与自身抗体产生相关。我们研究了80例来自北方意大利的扩张型心肌病白人患者的HLA-DR抗原频率和器官特异性心脏抗体的存在。采用血清学方法进行HLA-DR分型，并以同一地区289名健康献血员为对照。DCM中HLA-DR频率也与意大利的第八届国际研讨会对照数据进行了比较。用间接免疫荧光法检测人心脏抗体。使用骨骼肌鉴定交叉反应抗体。DCM患者心脏抗体的患病率为：器官特异性34%，骨骼肌交叉反应性30%。使用来自同一地区（21.25% vs 10.73%，p = 0.02，相对风险= 2.30）或来自整个意大利（21.25% vs 12.3%，p = 0.03）的对照证实了先前报告的DCM与HLA-DR 4之间的阳性关联。HLA-DR 5频率在DCM中略高于来自同一地区的对照组（46.25%vs 31.49%p = 0.02，相对风险为1.87，p校正= NS）或来自所有意大利的对照组（46.25%vs 35.8%p = NS），但无显著性差异。HLA-DR 3频率在DCM中低于来自相同地区的对照组（12.50% vs 29.41% p = 0.003，相对风险为0.36，p校正= 0.03）。使用整个意大利的对照数据未证实这种负相关性（12.50% vs 16.5% p = NS）。 HLA-DR 4与HLA-DR 4之间无显著相关性。DR 5和/或DR 3和心脏抗体状态。年龄性别症状持续时间HLA-DR与心脏抗体之间缺乏相关性可能是由于疾病异质性和/或抗体水平随疾病进展而降低。这是器官特异性自身免疫病症的公认特征。
Organ-specific cardiac antibodies are serological markers of autoimmunity in dilated cardiomyopathy (DCM). HLA-DR4 and possibly DR5 are immunogenetic markers of susceptibility in DCM, but it is not known whether they are associated with autoantibody production. We studied the frequency of HLA-DR antigens and the presence of organ-specific cardiac antibodies in 80 DCM Caucasian patients from Northern Italy. HLA-DR typing was performed by serology; 289 healthy blood donors from the same region were tested as controls. HLA-DR frequencies in DCM were also compared with VIII International Workshop control data for Italy. Cardiac antibodies were detected by indirect immunofluorescence on human heart. Skeletal muscle was used to identify cross-reacting antibodies. The prevalence of cardiac antibodies in DCM was: organ-specific 34% and skeletal muscle cross-reactive 30%. The previously reported positive association between DCM and HLA-DR4 was confirmed using either the controls from the same region (21.25% vs 10.73% p = 0.02, relative risk = 2.30) or from all of Italy (21.25% vs 12.3%, p = 0.03). HLA-DR5 frequency was slightly but not significantly higher in DCM than in controls from the same region (46.25% vs 31.49% p = 0.02, relative risk of 1.87, p corrected = NS) or from all of Italy (46.25% vs 35.8% p = NS). HLA-DR3 frequency was lower in DCM than in controls from the same region (12.50% vs 29.41% p = 0.003, relative risk of 0.36, p corrected = 0.03). This negative association was not confirmed using the control data from the whole of Italy (12.50% vs 16.5% p = NS). No significant association was found between HLA-DR4. DR5 and/or DR3 and cardiac antibody status. age, sex, symptom duration. The lack of association between HLA-DR and the presence of cardiac antibodies may be due to disease heterogeneity and/or reduction of antibody levels with disease progression. which are well-recognised features of organ-specific autoimmune conditions.