系统性红斑狼疮HLA-DM基因与环境危险因素研究

HLA-DM Genes and Environment Risk Factors in Systemic Lupus Erythematosus

目的 探索ＨＬＡ ＤＭ基因及其与环境危险因素的交互作用对系统性红斑狼疮(ＳＬＥ)发病的影响。方法 采取病例对照研究,用ＰＣＲ ＲＦＬＰ的方法确定ＨＬＡ ＤＭ的基因型,用非条件ｌｏｇｉｓｔｉｃ模型分析ＳＬＥ的危险因素,用广义线性模型分析环境与基因的交互作用。结果 共检测到3种ＤＭＡ与4种ＤＭＢ等位基因,其分布在ＳＬＥ组与正常对照组分布一致。ｌｏｇｉｓｔｉｃ模型分析显示ＳＬＥ的环境危险因素有5个(潮湿、精神刺激、日晒、刀豆、扁桃体感染),女性个人婚育史因素有3个(出生时母亲的年龄、月经初潮年龄、流产次数)。广义线性模型分析提示ＨＬＡ ＤＭＢ 0102与扁桃体感染的交互项效应达到显著水平。结论 有多个环境危险因素与ＳＬＥ的发病有关,ＨＬＡ ＤＭ基因的遗传多态性对ＳＬＥ发病及活动性没有独立作用,但ＨＬＡ ＤＭ基因与某些环境因素存在交互作用。

Objective To explore environmental risk factors and interaction between environmental factors and HLA-DM gene in systemic lupus erythematosus.Methods Case-control study was exerted and genotypes of HLA-DM were determined by PCR-RFLP.The environmental risk factors of SLE was analysed by logistic regression. The interaction between environmental factors and HLA-DM gene in systemic lupus erythematosus was analysed by generalized linear model.Results 7 kinds of allele frequencies of HLA-DM were no significant different between SLEs and controls. 5 environmental risk factors(damp,mind stimulation , sunlight,sword bean,infection of tonsil)were selected to enter the logistic model .The analysis of generalized linear model cued to exist interaction between HLA-DMB*0102 and infection of tonsil.Conclusion These data suggest that neither the DMA nor the DMB genetic polymorphisms determines susceptibility to SLE in Chinese. But there are multi environmental risk factors in SLE and there are the interaction between environmental factors and HLA-DM gene in systemic lupus erythematosus.