扩张型心肌病与HLA—B^＊基因的多态性关系

目的探讨北方汉族人扩张型心肌病（dilated cardiomyopathy，DCM）遗传易感性与人类主要组织相容性复合体（HLA—B^＊）基因多态性的关系。方法采用聚合酶链反应和顺序特异性引物（PCR—SSP）基因多态性分析方法，对31例扩张型心肌病患者及29例无血缘关系健康人的HLA—B^＊各等位基因及亚基因进行检测分析。结果HLA—B^＊35基因与DCM呈正相关（相对危险度RR=3．9375，P〈0．05）．其他HLA—B^＊各等位基因未见异常，差异均无统计学意义（P〉0．05）。结论HLA—B^＊35基因可能是北方地区汉族人DCM的致病易感基因之一，为揭示DCM的发病机制中免疫遗传学所起的作用提供了重要信息和依据。     

扩张型心肌病与MHC-DQ基因多态性的关联分析

目的　探讨扩张型心肌病 ( DCM)易感的分子机制和确立一种较为实用的 MHC- 类基因的检测方法。方法　采用聚合酶链式反应和顺序特异性引物 ( PCR- SSP)基因分析方法 ,对 31例扩张型心肌病患者及 30例无血缘关系的健康人的人类主要组织相容性复合体 ( MHC- 类 ) DQ各等位基因及亚基因进行了检测分析 ,并将该方法与其它检测 MHC- 类基因的方法进行对比。结果　结果表明 ,MHC- DQB1* 0 30 1基因与 DCM呈正相关 ( P <0 .0 1) ,其它 MHC- DQB1*其它各等位基因未见异常。结论　 MHC- DQB1* 0 30 1基因可能为北方汉族人 DCM的致病易感基因。尽管目前 MHC- 类基因分型方法已有多种 ,但所采用的方法 ( PCR- SSP)具有快速、简便、敏感、准确和可靠等优点。     

肿瘤坏死因子的基因型与扩张型心肌病的相关性研究

目的探讨中国北方地区汉族人肿瘤坏死因子鄄α(TNF鄄α)基因型别的多态性与扩张型心肌病(DCM)的相关性。方法对26例DCM患者采用放射免疫分析法(RIA)测定TNF鄄α,应用顺序特异性引物聚合酶链反应(PCR鄄SSP)方法检测TNF鄄α基因型别的多态性变化,并与31名健康献血者对比。结果DCM组TNF鄄α(1.986±0.101)显著高于对照组(1.06±0.061),P<0.01;DCM组TNF鄄α(308A)等位基因频率(39.26%)显著高于对照组(11.76%),P<0.01。提示该等位基因频率增高与DCM相关。结论北方地区汉族人TNF鄄α基因308位点的多态性与DCM的易感性相关联。     

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目的研究扩张型心肌病(DCM)与血管紧张素转换酶(ACE)基因多态性及β肌球蛋白重链(βMHC)基因的关系。方法选择中国医科大学附属第二医院2000-01-2002-1043例DCM病人及53例健康对照者,用PCR法检测ACE基因型,并扩增心脏βMHC基因第13、14外显子,用DdeⅠ、NIAⅢ限制性内切酶酶解βMHC基因扩增产物,分析有无8848位及9124位点突变。结果DCM组ACE基因DD型及D等位基因频率显著高于正常对照组(P<0.01),比值比分别为4.16,2.65。1例DCM病人出现βMHC基因8848位点突变应产生的394bp片段。结论ACE基因I/D多态性可能与扩张型心肌病有关,DD基N型可能是DCM发病的危险因子。βMHC基因可能是DCM遗传易感性的基因标志之一。     

扩张型心肌病患者HLA-DQB1基因的多态性

目的 :探讨扩张型心肌病 (DCM)的遗传背景及免疫学发病机制。方法 :借助聚合酶链式反应 /序列特异性引物 (PCR/ SSP)技术对 84例 DCM患者和 143例正常人进行了 HL A- DQB1 基因型别分析。结果 :与正常对照组相比 ,HL A- DQB1 * 0 30 3等位基因频率降低 ,其 RR值为 0 .41,P <0 .0 1。结论 :研究进一步证实免疫遗传学在部分 DCM发病机制中具有重要意义。携带 HL A- DQB1 * 0 30 3等位基因的个体可能对 DCM具有抗性。     

扩张型心肌病与血管紧张素转换酶基因、chymase基因多态性的研究

目的 :探讨血管紧张素转换酶 (ACE)基因插入 /缺失 (I/D)多态性及chymase(CMA)基因B种A/G多态性是否是扩张型心肌病 (DCM )的易感性标志。 方法 :采用聚合酶链反应 (PCR)和限制性片段长度多态性方法 (RFLP)检测 4 3例DCM患者和 6 3例健康者中ACE基因I/D多态性和CMA/B基因A/G多态性的频率分布 ,同时超声心动图测量左心室内径 (LVDd、LVDs)大小 ,计算射血分数 (EF)值 ,测量心胸比、血压和心率等临床指标。结果 :①ACE基因II、ID、DD基因型及I、D等位基因频率在DCM组与对照组的分布差异无显著性意义。②CMA基因AA、AG、GG基因型及A、G等位基因频率在DCM组与对照组的分布差异无显著性意义。③ACE、CMA基因型间年龄、患病史、NYHA心功能分级、LVDd、LVDs、EF值、心胸比、心率、收缩压、舒张压差异无显著性意义。④ACE、CMA基因型与LVDd、LVDs、EF值不相关。结论 :ACE基因I/D多态性及CMA/B基因A/G多态性与DCM患者心脏大小及收缩功能不相关。     

特发性扩张型心肌病与HLA-A*基因的关联研究

目的探讨特发性扩张型心肌病（idiopathic dilated cardiomyopathy，IDC）易感的分子机制和确立一种人类主要组织相容性复合体（HLA—A＊）基因的检测方法。方法采用聚合酶链式反应和顺序特异性引物（PCR—SSP）基因分析方法，对31例特发性扩张型心肌病患者及29例无血缘关系的健康人的HIA—A＊各等位基因及亚基因进行检测分析，并将该方法与其他检测HIA等位基因的方法进行对比。结果HIA—A＊ 03基因与IDC呈正相关（RR=4．697，P〈0．05），其他HIA—A＊各等位基因未见异常。结论HIA—A＊03基因可能是北方汉族人IDC的致病易感基因之一。采用的方法（PCR—SSP）具有快速、简便、敏感、准确和可靠等优点，值得推广。     

扩张型心肌病与δ-肌聚糖基因关系的研究

目的探讨中国人扩张型心肌病患者中δ肌聚糖基因的突变情况。方法通过聚合酶链反应单链构象多态性分析,结合脱氧核糖核酸测序,对扩张型心肌病患者60例和对照者60例进行δ肌聚糖基因所有9个外显子的分析。结果该基因外显子3发现3种类型单链构象多态性图谱;脱氧核糖核酸测序证实为T84C单核苷酸多态性,所编码氨基酸未发生改变;其等位基因频率在扩张型心肌病组和对照组中差异无显著性（P>0.05）;但在亚组分析中,扩张型心肌病伴传导阻滞亚组T等位基因频率显著高于对照组（P<0.01）。结论中国人群中存在δ肌聚糖基因T84C单核苷酸多态性;该多态性T等位基因是扩张型心肌病伴传导阻滞的易患基因或与心脏传导系统疾病有关。     

血管紧张素转换酶基因多态性与扩张型心肌病关系的meta分析

目的:探索血管紧张素转换酶基因多态性与扩张型心肌病的关系。方法:检索PubMed、Web of Sci、EMBASE、CNKI与万方数据库,查找建库至2019-01-01发表的有关血管紧张素转换酶基因多态性与扩张型心肌病的关系的文献。应用STATA 15.1进行meta分析。结果:共纳入18篇文献,共包括1 815例扩张型心肌病患者和2 893例正常对照。将东亚国家与非东亚国家进行亚组分析后发现,东亚国家研究之间异质性较小(P0.05,4个模型的I~2依次为47.6%、47.8%、25.9%、49.7%),且等位基因频率(D:I)(OR=1.47,95%CI:1.17～1.85)以及加性模型(DD:DI)(OR=1.91,95%CI:1.40～2.60)、显性模型(DD+DI:II)(OR=1.33,95%CI:1.00～1.78)与隐性模型(DD:DI+II)(OR=1.97,95%CI:1.48～2.64)均显示ACE基因多态性与DCM有关。非东亚国家的ACE基因多态性与DCM的关系均没有统计学差异。所有模型的漏斗图呈现对称性。Egger检验显示,所有模型均显示没有发表偏倚。结论:东亚国家人群血管紧张素转换酶基因多态性与扩张型心肌病有关,等位基因D频率高更有可能患有扩张型心肌病。     

HBV感染者人类白细胞Ⅰ,Ⅱ类抗原等位基因多态性分析

目的:分析HBV感染者体内病毒持续和清除与HLA-A,B,DRB1各位点等位基因分布频率的关系.方法:采用序列特异性引物-聚合酶链式反应(PCR-SSP)技术,对61例慢性乙型肝炎患者(CHB)、32例HBV感染后病毒清除者(感染恢复组)和40例骨髓移植供者(正常组)的外周血白细胞,进行人类白细胞抗原等位基因(HLA-A,B,DRB1)分型检测.结果:在慢性乙型肝炎组,HLA-DRB1*12等位基因分布频率较正常组(0.230vs0.075,P=0.004,OR=3.674,95%CI:1.445-9.338)和HBV感染恢复组(0.230vs0.063,P=0.004,OR=4.468,95%CI:1.492-13.377)均显著增高,HLA-B*35,DRB1*13则显著降低(0.066vs0.163,P=0.027,OR=0.362,95%CI:0.143-0.918;0.016vs0.008,P=0.017,OR=0.174,95%CI:0.035-0.859);HLA-A*69,B*56也显著降低(均0.000vs0.037,P=0.031).HLA-A*02等位基因分布频率在慢性肝炎组与HBV感染恢复组比较显著降低(P=0.044),HLA-B*51在感染恢复组与正常组比较显著增高(P=0.019).结论:机体对HBV易感性和病毒持续或清除与HLA等位基因多态性相关.HLA-DRB1*12可能既为易感性位点,又能促进病毒的持续感染;HLA-B*51,A*02可能为易感性位点,但感染后易清除病毒;HLA-DRB1*13可能是抗HBV感染的保护性基因;HLA-B*35,B*56和A*69在中国北方汉族人可能也为抗HBV感染的保护性基因.     

Mapping the HLA association in Behçet's disease: a role for tumor necrosis factor polymorphisms?

OBJECTIVE: Experimental evidence suggests that inappropriate regulation of tumor necrosis factor alpha (TNF alpha) may play a role in the pathogenesis of Beh?et's disease (BD). This is supported by recent reports highlighting the efficacy of anti-TNF alpha agents in the treatment of this disease. The TNF gene is encoded in the class III region of the HLA complex adjacent to HLA-B. This genetic proximity to a gene that is already widely implicated in disease susceptibility led us to investigate the association between TNF promoter polymorphisms and susceptibility to BD. METHODS: We studied 133 UK white Caucasoid patients with BD and 354 healthy controls. We attempted to dissect the contribution of individual polymorphisms in this gene-dense region by linkage disequilibrium mapping across 6 adjacent genes. RESULTS: We report a novel association with the TNF promoter allele TNF-1031C. Subsequent analysis identified 2 extended HLA haplotypes associated with BD. One of them contained the previously recognized susceptibility gene HLA-B*51, while the other was defined by HLA-B*5701. Both of these haplotypes contained the TNF promoter polymorphism -1031C, an allele that was associated with disease even in individuals who did not carry either HLA-B*51 or HLA-B*5701. CONCLUSION: The TNF-1031C allele is independently associated with susceptibility to BD in Caucasoid patients. Further studies will be required to determine the functional effects of this polymorphism, its influence in disease pathogenesis, and its role in other ethnic groups.     

Identification of previously unrecognized predisposing factors for ankylosing spondylitis from analysis of HLA-B27 extended haplotypes in Sardinia

OBJECTIVE: To define the contribution of HLA genes other than HLA-B27 in conferring susceptibility to ankylosing spondylitis (AS), through analysis of HLA-B27 haplotypes in Sardinian subjects. METHODS: Ninety-eight patients with AS, 133 HLA-B27-positive controls (of whom 33 were positive for HLA-B*2709), and 190 randomly selected controls were genotyped for microsatellites and single-nucleotide polymorphisms (SNPs) spanning the HLA region. RESULTS: Haplotypes carrying either the B*2705 or the B*2709 allele were found to share a conserved region downstream of the HLA-B gene and a functional polymorphism in the HLA-E gene (R128G), while differing in all other markers. Notably, the presence of an A at SNP rs1264457, encoding for Arg-128, was significantly increased in the cohort of patients (P = 6 x 10(-6), corrected P = 3 x 10(-5)) but not in B*2705- or B*2709-positive controls. Comparing the alleles co-occurring at each HLA marker, we identified a region differentiating patients with AS and B*2705-matched controls. In particular, there was a markedly increased prevalence of heterozygosity at rs1264457 among B27-positive controls (74%, versus 47% in patients and 54% in random controls), suggesting a protective role of G128 in AS. Moreover, other markers around the HLA-B gene were also differentially represented. CONCLUSION: These results demonstrate a significant difference in the frequency of some HLA markers between AS patients and B*2705-positive controls, which could be attributed to the opposite chromosome. In particular, the differential distribution of a functional polymorphism in the HLA-E gene suggests a possible role of natural killer function in AS pathogenesis.     

Contribution of MHC class I region to genetic susceptibility for giant cell arteritis

OBJECTIVE: The aim of this study was to assess the potential contribution of HLA-class I MICA and HLA-B gene polymorphisms towards the pathogenesis of giant cell arteritis (GCA). METHODS: Ninety-eight biopsy-proven GCA patients and 225 ethnically matched controls from Lugo, Northwest Spain, were genotyped for the MICA-TM microsatellite polymorphism using a polymerase chain reaction (PCR)-based method. Genotyping of HLA-B was performed using PCR and detection with a reverse sequence-specific oligonucleotide (SSO) probes system. RESULTS: A significant difference in the distribution of the alleles of MICA between patient and control groups (P = 0.005) was found. This was due to an increased frequency of the MICA A5 allele in GCA patients compared with controls (26 vs 13.6%; P = 0.0001; P(C) = 0.0005; OR 2.2, 95% CI 1.4-3.4). In addition, the HLA-B*15 allele showed a higher frequency in GCA patients compared with controls (P = 0.004; P(C) = 0.04; OR 2.7, 95% CI 1.3-5.7). Interestingly, the association observed with the MICA A5 allele seems to be independent of linkage disequilibrium with HLA-B, as well as independent of that previously described with HLA-DRB1*04. Remarkably, simultaneous presence of MICA A5 and HLA-B*15 or HLA-DRB1*04 genetic markers leads to an increase in the OR obtained for each individual genetic marker (MICA A5 + B*15 OR 3.2; MICA A5 + DRB1*04 OR 5.8). CONCLUSIONS: Our results provide the first evidence that the MICA and HLA-B genes are independently associated with the genetic susceptibility to GCA, and suggest that several genes within the MHC might have independent effects in the susceptibility to this systemic vasculitis.     

No primary association of MICA polymorphism with systemic lupus erythematosus

OBJECTIVE: To replicate the described association between MHC class I chain-related A (MICA) gene polymorphism and susceptibility to systemic lupus erythematosus (SLE). METHODS: MICA transmembrane microsatellite polymorphism was genotyped using a polymerase chain reaction (PCR)-based method. Genotyping of HLA-B* and DRB1* was performed using PCR and detection with a reverse sequence-specific oligonucleotide (SSO) probe system. Combined data for these three loci (HLA-B*, DRB1* and MICA) were obtained from a total of 333 patients and 361 healthy controls. RESULTS: Significant association with B*08 [P < 10(-7), odds ratio (OR) 3.17, 95% confidence interval (CI) 2.02-5.00], DRB1*0301 (P < 10(-7), OR 2.07, 95% CI 1.59-2.68) and MICA5.1 (P = 0.01, OR 1.23, 95% CI 1.04-1.46) was observed. The combinations DRB1*0301-MICA5.1-B8 and HLA-DRB1*0301-B*08-positive and MICA5-1-negative were more frequent among SLE patients (11.4 vs 3.3% in healthy controls, P = 3.9 x 10(-5), OR 3.76, 95% CI 1.85-7.73, and 6.9 vs 1.7%, P = 0.0007, OR 4.32, 95% CI 1.68-13.10, respectively). Additionally, individuals who were HLA-DRB1*0301-B*08-negative and MICA5-1-positive were less frequent among patients (22.2 vs 31.3% in healthy controls, P = 0.007, OR 0.63, 95% CI 0.44-0.89) and the magnitude of the OR was similar to that obtained in individuals negative for all the three factors (OR 0.69, 95% CI 050-0.94). Further analysis performed to detect independent association strongly suggested that the association between MICA5.1 and SLE is secondary to the linkage disequilibrium of this allele with B*08. CONCLUSIONS: Our results do not support an independent association of MICA gene polymorphism with susceptibility to SLE.     

HLA-B*39 allele confers susceptibility to osteoarticular complications in human brucellosis

OBJECTIVE: To determine the contribution of HLA gene polymorphism toward susceptibility to osteoarticular focal forms of human brucellosis. METHODS: A total of 57 patients with brucellosis, of whom 23 had osteoarticular complications, and 73 healthy volunteers were genotyped for HLA class I and class II antigens by a polymerase chain reaction-sequence specific primer technique. RESULTS: The HLA-B*39 allele was present in significantly more patients with osteoarticular complications than in the other patients (35% vs 3%; p = 0.0006, OR 15.684, 95% CI 3.453-71.231), or in the controls. CONCLUSION: The increased presence of the HLA-B39 genotype in patients with brucellosis with clinical osteoarticular manifestations suggests that this genotype confers susceptibility to developing severe osteoarticular focal forms of the disease.     

MICA gene triplet repeat polymorphism in patients with HLA-B27 positive and negative ankylosing spondylitis from Sardinia

OBJECTIVE: We investigated the distribution of MICA triplet repeat polymorphism in a random population and in patients with seronegative spondyloarthritis from Sardinia compared to continental Italy. METHODS: We analyzed the distribution of MICA triplet repeat polymorphism in HLA-B*2709 [not associated with ankylosing spondylitis (AS)] and B*2705 (associated with AS) haplotypes, to verify whether the strong association of MICA-A4 with HLA-B27 reported in other populations is maintained in Sardinia, and compared the distribution of MICA-A alleles in HLA-B27 negative versus HLA-B27+ patients with AS. RESULTS: We found that the frequency of MICA-A4 triplet repeat allele in a random Sardinia population is higher (53.2%) than in other Caucasian populations (around 20%); this allele is strongly associated with both HLA-B*2709 and B*2705. No significant difference between HLA-B27+ patients with AS and healthy controls was found: the MICA-A4 allele was present in more than 90% of subjects. MICA-A4 was found in 16 out of 20 HLA-B27 negative Sardinian patients with AS, with a frequency (80%) more similar to that of the HLA-B27+ group of patients than that of controls. CONCLUSION: The high frequency of MICA-A4 allele in HLA-B27 negative patients with AS from Sardinia, suggests the presence within the HLA region of a susceptibility factor other and certainly weaker than B27. This factor is likely to be more easily found by analyzing genetically homogeneous populations like the Sardinian, characterized by a small number of very frequent haplotypes.     

HLA-B*27/HLA-B*07 in combination with D6S273-134 allele is associated with increased susceptibility to juvenile spondyloarthropathies

OBJECTIVE: Juvenile spondylarthropathies (jSpA) are polygenic and the clustering of disease in families is caused mainly by genetic factors. Our aim was to look for possible associations of other HLA-A and B specificities, MICA and D6S273 microsatellite polymorphisms that might play a role in determining the susceptibility to jSpA. PATIENTS AND METHODS: jSpA were diagnosed in 74 Croatian children, and 169 healthy unrelated individuals served as the control group. HLA class I (A, B) typing of all individuals was performed, and HLA-B7 and HLA-B27 positive subjects were subtyped by PCR-SSP method. MICA and D6S273 microsatellites alleles were analyzed by electrophoresis in an automated sequencer. RESULTS: We identified 26 HLA-B*07 and 31 HLA-B*27 positive patients with jSpA. DNA subtyping of HLA-B*27 specificity demonstrated only two subtypes, B*2702 (19.35%) and B*2705 (80.65%), among jSpA patients. Subtyping analysis of HLA-B*07 gene showed presence of only one subtype, B*0702. The OR for HLA-B*07 was 2.61, while the highest OR for a single HLA specificity was found for HLA-B*27 (OR=5.60). The HLA-B*07/B*27 combination found in six children showed higher risk (OR=14.82), but the combination of specificities: HLA-B*07/HLA-B*27, and D6S273-134 allele demonstrated the highest risk (OR=26.83). The association with D6S273-134 allele was not a result of the linkage disequilibrium with HLA-B*27 specificity (LD=-0.5). CONCLUSION: Our findings provide evidence that HLA-B*27/HLA-B*07 in combination with D6S273-134 allele is associated with increased susceptibility to jSpA in Croatian children.     

Predisposition to abacavir hypersensitivity conferred by HLA-B*5701 and a haplotypic Hsp70-Hom variant

Susceptibility to a clinically significant drug hypersensitivity syndrome associated with abacavir use seems to have a strong genetic component. We have previously shown that the presence of HLA-B*5701 strongly predicts abacavir hypersensitivity and have identified a potential susceptibility locus within a 300-kb region between the MEGT1 and C4A6 loci in the central MHC. We now report the results of fine recombinant genetic mapping in an expanded patient population of 248 consecutive, fully ascertained, abacavir-exposed individuals in the Western Australian HIV Cohort Study, in which 18 cases of definite abacavir hypersensitivity (7.3%) and 230 tolerant controls were identified. Haplotype mapping within patients with allelic markers of the 57.1 ancestral haplotype suggests a susceptibility locus within the 14-kb Hsp70 gene cluster. HLA-B*5701 was present in 94.4% of hypersensitive cases compared with 1.7% of controls (odds ratio, 960; P < 0.00001). A haplotypic nonsynonymous polymorphism of Hsp70-Hom (HspA1L, resulting from the substitution of residue M493T in the peptide-binding subunit) was found in combination with HLA-B*5701 in 94.4% of hypersensitive cases and 0.4% of controls (odds ratio, 3,893; P < 0.00001). Individuals with abacavir hypersensitivity demonstrated increased monocyte tumor necrosis factor expression in response to ex vivo abacavir stimulation, which was abrogated with CD8(+) T cell depletion. These data indicate that the concurrence of HLA-B*5701 and Hsp70-Hom M493T alleles is necessary for the development of abacavir hypersensitivity, which is likely to be mediated by an HLA-B*5701-restricted immune response to abacavir.     

山东地区新生儿脐血HLA-A、HLA-B等位基因多态性研究

目的研究山东地区新生儿脐血人类白细胞抗原（HLA—A、HLA—B）等位基因的分布特征．探讨国人用山东脐血供者进行造血干细胞移植的可能性。方法应用PCR—SS0方法对山东地区5844例无血缘关系的汉族健康新生儿脐血进行HLA—A、HLA—B等位基因分布调查。结果检出20种HLA—A等位基因，频率较高的为A＊02（0．3041）、A＊11（0．1443）、A＊24（0．1434）、A＊30（0．0975）和A＊33（0．0859），较低的为A＊34（0．0006）、A＊25（0．0005）、A＊66（0．0005）、A＊74（0．0004）和A＊36（0．0001）。检出46种HLA—B等位基因．频率较高的为B＊13（0．1348）、B＊51（0．0713）、B＊62（0．0712）、B＊61（0．0676）和B＊60（0．0642），较低的为B＊77（0．0001）．B＊76（0．0002）．B＊47（0．0003），B＊42（0．0003）和B＊72（0．0004）。结论山东新生儿脐血HLAI类基因具有多态性，能代表山东汉族人群HLA的分布特征，反映北方汉族HLA的分布规律；国人（尤其是北方汉族人）在山东脐血库中最容易找到HLAI类等位基因相合的异基因脐血供者。