部分HLA-DRB1等位基因与抗环瓜氨酸肽抗体及类风湿因子的相关性

Association of HLA-DRB1 alleles with the levels of anti-cyclic citrullinated peptide antibody and rheumatoid factor in rheumatoid arthritis

目的探讨类风湿性关节炎(RA)中人类白细胞抗原(HLA)-DRB1共同表位(SE)与抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)的相关性。方法研究对象包括120例RA患者、146名健康对照者,采用引物特异性聚合酶链反应(PCR-SSP)分析HLA-DRB1*01、*04、*10基因型,酶联免疫吸附试验(ELISA)检测CCP抗体,免疫比浊法测定RF含量。结果在RA组中CCP抗体阳性率(85.8%)与RF(77.5%)差异无统计学意义,但特异性显著高于RF。SE等位基因与CCP抗体一致率为75%,两者间存在相关性,且在CCP抗体阳性的RA中SE阳性者CCP抗体水平[(158.5±147.1)RU/mL]显著高于SE阴性者[(88.2±67.0)RU/mL]。在CCP抗体阳性RA患者中,SE等位基因与RF无显著相关性。结论SE等位基因与增加CCP抗体产生存在显著相关,与RF无相关性,CCP抗体与RF无相关性。

Objective To examine the association between human leucocyte antigen （HLA）-DRB1 shared epitope （SE） and anti-cyclic citrullinated peptide antibody（anti-CCP） and rheumatoid factor （RF） in patients with rheumatoid arthritis （RA）. Methods 120 RA patients and 146 controls were enrolled in this study. HLA-DRB1 ＊ 01, ＊ 04, ＊ 10 subtypes were determined by polymerase chain reaction with sequence-specific primers （PCR-SSP）. Serum anti-CCP levels were measured by enzyme-linked immunosorbent assay （ELISA）, and serum RF levels were measured by turbidimetric immunoassay. Results There was no significant difference between the positive rate of anti-CCP and RF in the patients with RA （85.8% vs 77.5% ）, but the specificity of anti-CCP was significantly higher than RF. Compared to RF, anti-CCP positivity was significantly associated with HLA-DRB1 SE. Consistency of SE alleles and anti-CCP was 75%, and there was significant difference in the titer of anti-CCP between carrier and uncarrier SE （ [ 158.5 ± 147.1 ] RU/mL vs [ 88.2 ± 67. 0] RU/mL）. In contrast, RF positivity was not significantly associated with the presence of anti- CCP under SE independently. And RF positivity was also not significantly associated with the presence of SE under anti- CCP independently. Conclusions SE alleles are associated with the positive rate of anti-CCP in RA patients, but not associated with RF. Anti-CCP is not associated with RF.