摘要
A major susceptibility gene for psoriasis is located in the major histocompatibility complex class I region on chromosome 6 very close to the HLA-Cw6 gene. We collected a cohort of 1,019 patients with chronic plaque psoriasis. The patients were typed for HLA-C and HLA-B. A total of 654 (64.2%) were HLA-Cw*0602 positive but 365 (35.8%) carried other HLA-C alleles. We confirmed that HLA-Cw*0602 positive patients have younger age of onset (17.5 vs 24.3 years, P< 10-10), higher incidence of guttate and the eruptive type of psoriasis (P< 0.0001), more frequent exacerbations with throat infections (P=0.01), higher incidence of the Koebner’s phenomenon (P=0.01), and more extensive disease (P=0.03). A striking new finding was a diverging pattern of disease severity in HLACw*0602 positive and negative patients depending on the age of onset of the disease (P=0.0006). HLA-Cw*0602 positive women also had more frequent remissions during pregnancy (P< 0.0001). All types of nail changes were, however, more common in the Cw*0602 negative patients (P=0.003) and they more often had multiple types of nail lesions (P< 0.0001). The three ancestral haplotypes of Cw*0602 all conferred an increase in odds ratio but showed no difference in any of the clinical features studied. Our findings indicate that the genetic factor on chromosome 6 has a strong influence on the phenotype of the disease, and underline that differences in clinical features of psoriasis may be to a large extent genetically determined.
A major susceptibility gene for psoriasis is located in the major histocompatibility complex class Ⅰ region on chromosome 6 very close to the HLA-Cw6 gene. We collected a cohort of 1,019 patients with chronic plaque psoriasis. The patients were typed for HLA-C and HLA-B. A total of 654 （64.2%） were HLA-Cw ＊ 0602 positive but 365 （35.8%） carried other HLA-C alleles. We confirmed that HLA-Cw ＊ 0602 positive patients have younger age of onset （17.5 vs 24.3 years, P〈 10-10）, higher incidence of guttate and the eruptive type of psoriasis （P〈 0. 0001 ）, more frequent exacerbations with throat infections （P=0. 01）, （P =0. striking severity higher incidence of the Koebner＇s phenomenon 01）, and more extensive disease （P=0. 03） . A new finding was a diverging pattern of disease in HLACw ＊ 0602 positive and negative patients depending on the age of onset of the disease （P = 0. 0006）. HLA-Cw ＊ 0602 positive women also had more frequent remissions during pregnancy （P〈 0. 0001） . All types of nail changes were, however, more common in the Cw ＊ 0602 negative patients （P = 0. 003） and they more often had multiple types of nail lesions （P〈 0. 0001）. The three ancestral haplotypes of Cw ＊ 0602 all conferred an increase in odds ratio but showed no difference in any of the clinical features studied. Our findings indicate that the genetic factor on chromosome 6 has a strong influence on the phenotype of the disease, and underline that differences in clinical features of psoriasis may be to a large extent genetically determined.
