| 张二朋,雷秋香,李环,等.HLA-B27基因协同血清 IL-17A对脊柱关节炎易感性的预测价值[J].安徽医药,2025,29(9):1833-1838. |
| HLA-B27基因协同血清 IL-17A对脊柱关节炎易感性的预测价值 |
| Value of HLA-B27 gene in coordination with serum IL-17A in predicting the occurrence of SpA |
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| DOI：10.3969/j.issn.1009-6469.2025.09.028 |
| 中文关键词: 骨关节炎，脊柱 人类白细胞抗原 B27 白细胞介素 -17A 交互作用 易感性 |
| 英文关键词: Osteoarthritis,spine Human leukocyte antigen B27 |
| 基金项目:河北医学科学研究项目( 202001127) |
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| 摘要点击次数: 743 |
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| 中文摘要: |
| 目的分析人类白细胞抗原 B27(HLA-B27)基因、白细胞介素 -17A(IL-17A)水平对脊柱关节炎( SpA)易感性影响交互作用。方法将 2020年 2月至 2022年 3月就诊于邢台市人民医院的 95例 SpA病人纳入病例组，另选同期与 SpA病人的性别、年龄相匹配的 95例健康体检者作为健康组。采集所有受检者血清样本，流式细胞术法测定 HLA-B27抗原表达情况，聚合酶链式反应 -序列特异性引物法( PCR-SSP)测定 HLA-B27基因分型，酶联免疫吸附测定检测血清 IL-17A水平。对比病例组、健康组 HLA-B27基因亚型、血清 IL-17A水平，建立 logistic回归交互作用模型，分析 HLA-B27基因、 IL-17A交互作用。绘制 ROC曲线，分析 HLA-B27基因协同血清 IL-17A预测 SpA发生的价值。结果病例组 HLA-B27阳性率( 76.84%)高于健康组( 9.47%)(P<0.05)病例组HLA-B27基因亚型以 HLA-B*2704、HLA-B*2705为主； AS组、 JSpA组、 PsA组、 ReA组、 USpA组的 HLA-B27阳性率分88.10%、70.00%、60.00%、69.23%、70.00%，且五组 HLA-B27基因亚型均以 HLA-B*2704、HLA-B*2705为主；病例组血别为，清 IL-17A水平为 57.46(11.81，92.85)ng/L，高于对照组的 32.44(5.53，72.02)ng/L(P<0.05)； HLA-B27阳性、阴性组 SpA病人的性别、年龄、病程、发病至确诊时间及晚发型、幼年发病型占比相比，差异无统计学意义( P>0.05)； HLA-B27阳性组血清 IL-17A水平及 SpA家族史占比均高于 HLA-B27阴性组( P<0.05)； logistic回归分析结果显示， SpA家族史［OR=4.90，95%CI:(1.06，22.70)］、 IL-17A水平［OR=5.12，95%CI:(1.19，25.74)］是影响 HLA-B27阳性的危险因素( P<0.05)； logistic回归模型多因素分析显示， HLA-B27基因、血清 IL-17A水平均是 SpA发生的独立危险因素(P<0.05)； logistic回归交互分析显示， HLA-B27基因、血清 IL-17A水平交互项 P<0.05，说明两者之间存在交互作用；绘制 ROC曲线，结果发现， HLA-B27基因、 IL-17A及二者协同预测 SpA发生的 AUC为分别为 0.84，95%CI:(0.78，0.90)； 0.92，95%CI:(0.87，0.96)； 0.98，95%CI:(0.97，1.00)。结论 SpA病人 HLA-B27基因阳性率与血清 IL-17A水平高，基因亚型 HLA-B*2704、HLA-B*2705为主， HLA-B27基因协同血清 IL-17A水平可有效预测 SpA的发生。 |
| 英文摘要: |
| Objective To analyze the interaction between human leukocyte antigen B27 (HLA-B27) gene and interleukin -17A (IL-17A) level and the susceptibility to spinal arthritis (SpA).Methods Ninety-five SpA patients admitted to Xingtai People's Hospitalfrom February 2020 to March 2022 were included in the case group, and another 95 healthy physical examination subjects matchingthe gender and age of SpA patients during the same period were selected as the health group. Serum samples of all subjects were col-lected.The serum samples of all subjects were collected,and HLA-B27 antigen expression was determined by flow cytometry,HLA-B27 genotyping was determined by polymerase chain reaction-sequence-specific primers (PCR-SSP), and serum IL-17A level was deter-mined by enzyme-linked immunosorbent assay.The HLA-B27 gene subtype and serum IL-17A level were compared between the casegroup and the healthy group,and a logistic regression interaction model was established to analyze the interaction between HLA-B27 gene and IL-17A.ROC curve was drawn to analyze the value of HLA-B27 gene in coordination with serum IL-17A in predicting the oc-currence of SpA.Results The positive rate of HLA-B27 in the case group(76.84%) was higher than that in the health group(9.47%)(P<0.05). The subtypes of HLA-B27 gene in the case group were mainly HLA-B*2704 and HLA-B*2705. The positive rates of HLA-B27 in AS, JSpA, PsA, ReA and USpA groups were 88.10%, 70.00%, 60.00%, 69.23% and 70.00%, respectively. The subtypes of HLA-B27 gene in the five groups were mainly HLA-B*2704 and HLA-B*2705. Serum IL-17A level in the case group was 57.46 (11.81,92.85) ng/L, which was higher than that in the control group 32.44 (5.53, 72.02) ng/L (P<0.05). There was no significant difference insex, age, course of disease, time from onset to diagnosis and proportion of late onset and juvenile onset type of SpA patients between theHLA-B27 positive and negative groups (P>0.05). The level of serum IL-17A and the proportion of family history of SpA in the HLA-B27 positive group were higher than those in the HLA-B27 negative group (P<0.05). Logistic regression analysis showed that family his-tory of SpA [OR:4.90 95%CI:(1.06,22.70)] and IL-17A level [OR=5.12,95%CI:(1.19,25.74)] were risk factors for HLA-B27 positivity(P< 0.05). Multivariate analysis of logistic regression model showed that both HLA-B27 gene and serum IL-17A level were independent risk factors for SpA (P<0.05). Logistic regression interaction analysis showed that the P values of interaction terms of HLA-B27 gene and se-rum IL-17A level were P<0.05, indicating the existence of interaction between them. Drawing ROC curve found that the AUC of HLA-B27 gene, IL-17A and their synergistic prediction of SpA occurrence were 0.84,95%CI:(0.78,0.90);0.92,95%CI:(0.87,0.96) and 0.98, 95%CI:(0.97,1.00), respectively.Conclusions The positive rate of HLA-B27 gene and serum IL-17A level in patients with SpA are high.The gene subtypes are mainly HLA-B*2704 and HLA-B*2705. The synergy of HLA-B27 gene and serum IL-17A level can effec-tively predict the occurrence of SpA. |
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