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目的 研究经典型吉兰 巴雷综合征 (GBS)———急性炎性脱髓鞘性多神经根神经病(AIDP)和其亚型———急性运动轴索型神经病 (AMAN)易患性与人类白细胞抗原 (HLA) A、B等位基因分型的关系 ,从免疫遗传学角度探讨自身内在因素在GBS不同亚型发病中的可能作用。方法 以改良快速盐析法自静脉血中抽提基因组DNA ,采用聚合酶链反应 顺序特异性引物法 (PCR SSP) ,结合琼脂糖凝胶电泳对 31例AIDP患者、33例AMAN患者和 132名健康对照进行HLA A、B位点等位基因分型。结果 AIDP组HLA A33频率 (2 2 6 %)较对照组 (4 5 %)升高 ,相对危险度 (RR)为 6 1,校正概率值Pc =0 0 11;AMAN组HLA B35、B15频率 (34 5 %,5 1 7%)较对照组 (6 9%,2 0 8%)升高 ,RR分别为7 1、4 1,Pc分别为 0 0 0 0 8、0 0 15。结论 AIDP和AMAN与健康对照比较 ,有着不同的HLA等位基因分布。HLA A33与AIDP易患性相关联 ,HLA B15、B35与AMAN易患性相关联。推测AIDP和AMAN发病机制、病理改变的差异与在免疫应答、调控等各环节有关键作用的HLA的型别有关。
Objective To investigate the association between classical GBS (acute inflammatory demyelinating polyarterotic neuropathy) and its subtype Acute Motor Axon Neuropathy (AMAN) Human Leukocyte Antigen (HLA) A, B allelic genotypes from the perspective of immune genetics to explore their own internal factors in the pathogenesis of GBS subtypes may play a role. Methods Genomic DNA was extracted from venous blood by modified rapid salting-out method. PCR was performed using polymerase chain reaction sequence-specific primers (PCR SSP) and agarose gel electrophoresis on 31 AIDP patients, 33 AMAN patients and 132 Healthy control alleles HLA A, B loci. Results The frequency of HLA A33 (22.6%) in AIDP group was significantly higher than that in control group (45.5%), the relative risk (RR) was 6 1 and the corrected probability Pc = 0 0 11. The frequency of HLA B35 and B15 34 5% and 51 7% respectively) were higher than those in the control group (69%, 208%). The RRs were 7 1, 4 1 and Pc were 0 0 0 0 8 and 0 0 15, respectively. Conclusions AIDP and AMAN have different HLA alleles compared with healthy controls. HLA A33 is associated with AIDP susceptibility, and HLA B15, B35 is associated with AMAN susceptibility. It is speculated that the pathogenesis of AIDP and AMAN, pathological changes in the immune response, regulation and other aspects of the key role of HLA type.