The Clinical Study Of HLA-DRB1*0405 Gene And Rheumatoid Arthritis

OBJECTIVE: To explore the role of HLA-DRB1*0405 gene in the development of rheumatoid arthritis (RA) and the correlations between HLA-DRB1*0405 gene and clinical manifestations, serological characteristics, diagnosis of patients with RA in the Han Nationality of Shandong area population.METHODS: 108 RA patients and 102 matched healthy control subjects were examined separately with polymerase chain reaction-sequence specific primer (PCR-SSP) to get the gene frequencies of HLA-DRB 1*0405. Rheumatoid factor (RF) was detected by latex agglutination. C-reactive protein (CRP) was determined by immunoturbidimetry. Antikeratin antibody (AKA) was determined by indirect immumofluorescence (â…¡F). The enzyme linked immunosorbent assay (ELISA) was used to test anti-cyclic citrullinated peptide (CCP) autoantibodies.RESULTS: Compared with controls, an increased gene frequency of HLA-DRB1* 0405 (19.4% vs 8.8%, X~2 = 4.833, P = 0.028) was found. There was no significant difference between the HLA-DRB1*0405~+ and HLA-DRB 1*0405~-patients with respect to age, sex, duration of disease, tender joint numbers and swelling joint numbers. But the disease was more severe in females than that in males. Rheumatoid factor (RF) was associated with HLA-DRB1*0405~+ (X~2 =5.434, P = 0.020). According to the X-ray stage, the patients of HLA-DRB1*0405~+ were more severe than those of HLA-DRB 1*0405~- (X~2 = 5.319, P = 0.021). In 59 patients, the positive rate of AKA was 30.5% and that of anti-CCP antibody was 47.5%. HLA-DRB 1*0405 was not associated with AKA (X~2= 0.347, P = 0.556), but had a significant (X~2 = 4.583, P = 0.032) and poor correlation (Pearson contingency coefficient = 0.268) with anti-CCP antibody. HLA- DRB1*0405 did not completely overlap with anti-CCP antibody. The wrist, knee, or elbow joint destructions weresignificantly correlated with HLA-DRB 1*0405 (statistical analysis: wrist: X2= 4.455, P = 0.035; knee: X2 = 4.462, P = 0.035; elbow: X2= 5.852, P = 0.016).CONCLUSION: HLA-DRB 1*0405 is a risk factor of RA in the Han Nationality of Shandong area population. The disease is more severe in females than that in males, and there is no significant sex difference in the gene frequency. HLA-DRBl*0405 is strongly associated with RF in RA. HLA-DRBl*0405 is not associated with AKA, but has a significantly and poor correlation with anti-CCP antibody, furthermore it does not completely overlap with anti-CCP antibody. The wrist, knee, or elbow joint destructions are correlated with HLA-DRB 1*0405. HLA-DRBl*0405 may be a useful marker for disease diagnosis, severity and prognosis in the RA patients.