Indonesian Journal of Clinical Pathology and Medical Laboratory
ISSN 0854-4263
Vol. 18 / No. 3 / Published : 2012-01
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Original Article :
Association hla-drb1* and hla-dqb1* with serum igm-rf with rheumatoid arthritis
Author :
- Joewono Soeroso*1
- Ferdinandus Maria Judajana*2
- Handono Kalim*3
- Divisi Reumatologi, Departemen-SMF Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo, Surabaya
- Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
- Divisi Reumatologi, Departemen-SMF IlmuPenyakit Dalam, Fakultas Kedokteran UniversitasBrawijaya-RSUD Syaiful Anwar, Malang
Abstract :
Rheumatoid arthritis (RA) is a chronic progressive polygenic autoimmune disease with a high socio-economic burden. Genetic polymorphisms expressed as a shared epitope (SE) at hypervariable regions of HLA-DRB1*01/*04/*10/*14 and linkage disequilibriums of HLA-DRB1*-HLA-DQB1* with some microorganisms, increase the risk of RA. Shared epitopes are also related with the increase of serum IgM-RF as well. A cross-sectional study on 48 RA patients diagnosed by ACR Criteria 1987 from 6 hospitals in Java and Bali was done to determinethe associations of HLA-DRB1* and HLA-DQB1* alleles with serum IgM-RF levels. The presence of HLA-DRB1* and HLA-DQB1* alleles were assessed through PCR-SSO. Serum IgM-RF levels (IU/mL) were assessed through ELISA. Man-Whitney U tests were used to measure the associations. Value of p<0.05 is considered to be statistically significant. The results showed that mean ranks IgM-RF levels of subjects who are bearing HLA-DRB1*04 compared to subjects who are not bearing HLA-DRB1*04 were 34.10 IU/ml (n=10) vs 21.97 IU/ml (n=38), p=0.014]. While, the mean ranks of IgM-RF levels of subjects who are bearing haplotype combination of HLA-DRB1*04-HLA-DQB1*03 vs subjects who are not bearing haplotype combination of HLA-DRB1*04- HLA-DQB1*03 were 32.89 IU/mL (n=9)] vs 22.56 IU/mL (n=39) (p=0.046)]. It is concluded that there are association of HLA-DRB1*04, and haplotype combination of HLA-DRB1*04-HLA-DQB1*03 with increased levels of IgM-RF among Indonesians with RA. Artritis reumatoid (RA) merupakan suatu penyakit otoimun kronik progresif dengan dampak sosio-ekonomik yang buruk. Polimorfisme genetik berupa pasangan epitop [shared epitope (SE)] dari alela HLA-DRB1*01/*04*/10*/14 dan gabungan haplotipe HLA-DRB1*-HLA-DQB1*dengan mikroorganisme tertentu meningkatkan kebahayaan timbulnya AR. SE juga terkait dengan peningkatan kadar IgM-RF serum. Sebuah telitian dengan desain potong lintang untuk menentukan pertalian (asosiasi) alela HLA-DRB1* dan HLA-DQB1* dengan kadar IgM-RF serum telah dilaksanakan pada 48 pasien dengan AR yang didiagnosis melalui patokan ACR 1987. Pasien tersebut berasal dari 6 RS di Jawa dan Bali. Alela HLA-DRB1* dan HLA-DQB1* ditentukan melalui PCR-SSO. Kadar IgM-RF (IU/mL) diukur dengan metode ELISA. Uji Man-Whitney U digunakan untuk menganalisis pertalian kadar IgM-RF pada subjek yang membawa SE dibanding yang tidak membawa SE. Nilai p<0.05 dianggap bermakna secara statistik. Hasil analisis menunjukkan rerata peringkat kadar IgM-RF subjek pembawa HLA-DRB1*04 dibanding subjek bukan pembawa HLA-DRB1*04 adalah 34,10 IU/mL (n=10) dibanding 21,97 IU/mL (n=38), p=0,014]. Rerata peringkat kadar IgM-RF pada subjek yang membawa gabungan haplotipe HLA-DRB1*04-HLA-DQB1*03 dibanding subjek yang membawa gabungan haplotipe HLA-DRB1*04-HLA-DQB1*03 adalah 32,89 IU/mL (n=9)] dibanding 22,56 IU/mL (n=39) (p=0,046)]. Kesimpulan dari penelitian ini, terdapat pertalian HLA-DRB1*04 dan gabungan haplotipe HLA-DRB1*04-HLA-DQB1*03 dengan peningkatan kadar IgM-RF pada pasien RA di Indonesia.
Keyword :
Association, HLA-DRB1* , HLA-DQB1* , IgM-RF rheumatoid arthritis,
References :
Gabriel SE, Michaud K,(2009) Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases USA : Arthritis Res & Ther
Silman AJ, Pearson JE,(2002) Epidemiology and genetics of rheumatoid arthritis USA : Arthritis Res Ther
Kalim H,(2000) Masalah penyakit reumatik di Indonesia serta upaya penanggulangannya Jakarta : Naskah Lengkap Temu Ilmiah Reumatologi
4. Milicic A, Lee D, Brown MA, Darke C, Wordsworth P,(2002) HLA-DR/DQ Haplotype in rheumatoid arthritis: novel allelic associations in UK Caucasians UK : J Rheumatol
Zanelli E, Breedveld FC, de Vries RR,(2000) HLA class II association with rheumatoid arthritis: facts and interpretations USA : Hum Immunol
Archive Article
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Volume : 18 / No. : 3 / Pub. : 2012-01 |
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