HLA基因多态性与带状疱疹后神经痛关联性的系统评价和Meta分析*

POLYMORPHISMS IN THE HLA GENES AND POSTHERPETIC NEURALGIA:A META-ANALYSIS

摘要:

【】目的 探讨人类白细胞抗原(Human leukocyte antigen,HLA)基因多态性与带状疱疹后神经痛(PHN)的关联性。方法 计算机检索数据库PubMed、Embase、Web of Science、Cochrane Library、中国知网(CNKI)以及中国生物医学文献数据库(CBM),搜集国内外发表的关于HLA基因多态性与PHN相关性的病例对照研究,采用RevMan5.3软件进行统计分析。结果 Meta分析结果显示,和健康人以及未发生PHN的带状疱疹患者(HZ)相比,PHN患者在HLA-A^*33、HLA-B^*44、HLA-DRB1^*13、HLA-A^*02基因型分布的差异均有统计学意义,(OR=2.90,95%CI:1.83-4.60,P<0.01；OR =3.04,95% CI:2.25-4.12,P<0.01；OR=2.54,95% CI:1.83-3.53,P<0.01；OR =0.53,95% CI:0.34-0.81,P<0.01；OR=2.36,95% CI:1.48-3.77,P<0.01；OR =3.79,95% CI:2.17-6.60,P<0.01；OR =1.91,95% CI:1.16-3.14,P<0.01；OR =0.61,95% CI:0.42-0.88,P<0.01),而HZ患者和健康人之间的基因型分布均无统计学差异(OR =0.94,95% CI:0.60-1.46,P>0.05；OR =0.82,95% CI:0.47-1.42,P>0.05；OR =1.28,95% CI:0.79-2.07,P>0.05；OR =1.05,95% CI:0.79-1.39,P>0.05)。具有HLA-A^*33、HLA-B^*44、HLA-DRB1^*13基因型的人群发生PHN的风险升高,而具有HLA-A^*02的人群发病风险降低。结论 HLA-A^*33、HLA-B^*44、HLA-DRB1^*13可能为PHN发病的易感基因型,HLA-A^*02可能为保护基因型,HLA基因多态性可能是PHN发病的危险因素之一。

Abstract:

【】Objective The objective of the this study was to assess associations between polymorphisms in the HLA genes and postherpetic neuralgia by meta-analysis.Methods PubMed, EMbase, Web of Science、Cochrane Library,CNKI and CBM databases were searched for case-control studies. All analyses were performed using the Revman5.3 software.Results The results of meta-analysis indicated that,compared with healthy controls and HZ patients,PHN patients were significantly different in the genotypic distribution of HLA-A^*33、HLA-B^*44、HLA-DRB1^*13、HLA-A^*02 (OR=2.90,95% CI:1.83-4.60,P<0.01；OR=3.04,95% CI:2.25-4.12,P<0.01；OR=2.54,95% CI:1.83-3.53,P<0.01；OR=0.53,95% CI:0.34-0.81,P<0.01；OR=2.36,95% CI:1.48-3.77,P<0.01；OR=3.79,95% CI:2.17-6.60,P<0.01；OR =1.91,95% CI:1.16-3.14,P<0.01；OR =0.61,95% CI:0.42-0.88,P<0.01),whereas there were no differences between HZ patients and healthy controls.HLA-A^*33、HLA-B^*44、HLA-DRB1^*13 were associated with increased risk of PHN, while HLA-A^*02 was associated with lower risk.Conclusion The current meta-analysis suggests that HLA-A^*33、HLA-B^*44、HLA-DRB1^*13 served as benificial factors against PHN while HLA-A^*02 susceptible factors.Polymorphisms in the HLA genes are closely associated with PHN.