HLA-DRB1基因多态性与慢性肾小球肾炎相关性

Relationship between chronic glomerulonephritis and the human leukocyte antigen DRB1

目的探讨慢性肾小球肾炎(CGN)与人类白细胞抗原(HLA)DRB1等位基因的相关性。方法以山东省3大省级医院近十年汉族CGN尿毒症患者1073例为病例组,选择中国造血干细胞捐献者资料库山东分库汉族人7 418名汉族健康志愿捐献者为对照组,对两组的HLA-Ⅱ类DRB1基因多态性进行分析比较,探讨HLA-DRB1基因多态性与CGN的关系;并随访了部分携有易感基因的患者,评价其预后。结果病例组中HLA-DRB1*18基因频率高于对照组(P<0.001),可能是CGN尿毒症的易感基因,且随访发现携有该类基因的患者预后较差。病例组中HLA-DRB1*16基因频率低于对照组(P<0.001),可能是CGN尿毒症的保护基因。结论山东汉族人群CGN与HLA-DRB1关联,且携有可能易感基因的患者预后较差。

Objective To explore the association between chronic glomerulonephritis（CGN） and the human leukocyte antigen （ HLA）-DRB1 on DNA levels and to find susceptibility genes and protective genes, so as to further explain the possible pathogenesis of CGN. Methods 1 073 Han renal transplantation patients were included in this study. All patients were recruited from three provincial Hospitals during the past ten years. The control group contained 7 418 healthy Han volunteer donors from the Shandong Hematopoietic Stem Cell Data Bank of China. We collected data about the polymorphism of HLA-DRB1. Gene frequency （GF）, relative risk （RR） and correlation test were analyzed by using statistical software. Some patients carrying the suscepti- bility genes were followed up 1, 3 and 5 years, and their survival rates were compared. Results The frequency of the HLA- DRB1＊18 allele increased more significantly in the CGN patients than in controls. They might be the suspicious susceptibility genes of CGN. After the follow-up, the prognosis of patients with the susceptibility genes was worse than that of the controls. However, the frequency of the HLA- DRB1＊16 alleles decreased more significantly in the CGN patients than that in the controis. They might be the protective genes of CGN. Conclusion There might be corresponding susceptibility and protective genes of CGN in the Shandong Han population, and interestingly, the prognosis of patients with the susceptibility genes is worse than that of the controls.