HLA—DRβ1＊04抗原表位与类风湿关节炎的相关性研究

The Relationship between Antigen Epitope of HLA-DRβ1＊04 and Rheumatoid Arthritis

目的:检测HLA-DRβ1* 04抗原表位在类风湿关节炎(RA)患者中的分布情况,探讨HLA-DRβ1* 04抗原表位检测在RA中的意义。方法:用序列特异性引物聚合酶链反应(PCR-SSP)检测140例RA患者和100例正常对照的HLA-DRβ1* 04基因型,比较不同基因型所对应的抗原表位与RA患者临床表现及血清学指标之间的关系。结果:140例RA患者中,HLA-DRβ1* 04阳性率为57.9%,明显高于正常对照组的24.0%,差异具有统计学意义;HLA-DRβ1* 04阳性的RA患者中QK/RRAA序列阳性率为42.9%,高于对照组的13.0%,差异也具有统计学意义。含有QK/RRAA序列的RA患者关节畸形发生率明显增高,晨僵>1 h的患者明显增多,血清CRP值、抗CCP抗体阳性率及RF阳性率明显增高,差异均具有统计学意义。结论:HLA-DRβ1* 04是RA易感基因;携带QK/RRAA序列的RA患者关节受累明显,易发生关节畸形,HLA-DRβ1* 04抗原表位可以作为判断RA活动性及预后的指标之一。

Objective ： To analyze the distribution of antigen epitope of HLA-DRβ1＊04 in the patients with rheumatoid ar- thritis （RA）. And to investigate the significance of antigen epitope of HLA-DRβ1＊04 in rheumatoid arthritis. Methods： One hundred and forty patients with RA and 100 normal controls were recruited in this study. HLA typing was performed using PCR - SSP techniques. The clinical features and serologic markers between different epitopes were analyzed. Results： The positive rate of HLA-DRβ1＊04 in patients with RA was significantly higher than in controls （57.9 % vs 24.0 % ）. The motifs QK/RRAA carried in HLA-DRβ1＊04 were significantly higher in patients with RA than in controls （42.9 % vs 13.0 % ）. Moreover, the incidences of joint malformation and morning stiff 〉 1 h, as well as the serum levels of CRP, anti - CCP and RF were signifi- cantly increased in RA patients with QK/RRAA motifs. Conclusion： HLA-DRβ1＊04 alleles might be associated with RA. QK/RRAA motif in HLA-DRβ1＊04are related to RA. Antigen epitope of HLA-DRβ1＊04 might be one of the most signifi- cant indices in the assessment of RA activity and prognosis.