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The Association Between HLA-DRB1 Alleles Polymorphism, ANCA and Susceptibility To Antithyroid Drug Induced Leucocytopenia in Patients with Graves Disease

Author: ZhangPing
Tutor: PanTianRong
School: Anhui Medical University,
Course: Internal Medicine
Keywords: Graves' disease Anti - thyroid drugs Leukopenia Allele Anti-neutrophil cytoplasmic antibody Polymerase chain reaction Indirect immunofluorescence
CLC: R581.1
Type: Master's thesis
Year: 2010
Downloads: 41
Quote: 1
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Abstract


Objective To study the the Anhui Han Graves' disease (GD) in patients with anti-thyroid drugs (ATD) induced leukocyte reduced susceptibility allele HLA-DRB1 polymorphism and anti-neutrophil cytoplasmic antibody (ANCA). Method (1) using the polymerase chain reaction - sequence specific primers (PCR-SSP) method detected 76 cases of ATD induced neutropenia patients, 98 cases using the ATD white blood cells of normal patients and 230 healthy control group of HLA-DRB1 * 08032, DRB1 * 1501, DRB1 * 0901 allele frequency. (2) using indirect immunofluorescence (IIF) to detect 76 cases of ATD induced neutropenia patients, 98 cases of ATD white blood cells in patients with normal serum ANCA. Positive further measured by speckle anti-myeloperoxidase (MPO) antibody and anti-proteinase 3 (PR3) antibody. Results (1) with the healthy control group, leukopenia group DRB1 * 08032, DRB1 * 1501 frequency increased significantly (p = 0.00, OR = 3.06; p = 0.042, OR = 1.77), the frequency of DRB1 * 0901 was significantly lower (p = 0.01 , OR = 0.33). (2) and white blood cells, normal group, the leukopenia group DRB1 * 08032 and DRB1 * 1501 frequency increased significantly (p = 0.001, OR = 4.03; p = 0.016, OR = 2.28), the frequency of DRB1 * 0901 was significantly lower (p = 0.023, OR = 0.43). (3) with the healthy control group, normal white blood group alleles DRB1 * 08032, DRB1 * 1501, DRB1 * 0901 frequency was no significant difference (P gt; 0.05). (4) with the use of methimazole normal white blood cells group and methimazole induced leukopenia group ANCA positive rate was significantly increased (x2 = 4.878, p = 0.027); taking propylthiouracil WBC normal group, taking propylthiouracil leukocyte Reduce ANCA positive rate increased, but no significant difference (p = 0.404); either in the leukopenia group or group of normal white blood cells, and taking methimazole compared to patients taking propylthiouracil in patients with ANCA-positive rate, but no significant difference (x to 2 = 0.287, p = 0.592; x 2 = 0.141, p = 0.707). ⑤ in terms of the leukopenia group or in the normal group of white blood cells, and do not carry the allele DRB1 * 08032 and DRB1 * 1501 patients, carriers serum ANCA positive rate was significantly increased (P lt; 0.05); and do not carry the allele DRB1 * 0910 compared to patients, carriers serum ANCA positive rate reduced, but no significant difference (p gt; 0.05). ⑥ leukopenia group thyroid function and normal white blood group comparison, FT3, FT4, TSH level was no significant difference (p gt; 0.05); the leukopenia group thyroid antibodies compared with normal white blood cells, the the TRAb, TGAb,, TMAb positive rate statistically significant difference (p gt; 0.05). Conclusion (1) HLA-DRB1 * 08032, HLA-DRB1 * 1501 allele may be the Anhui Han ATD induced leukopenia susceptibility genes; HLA-DRB1 * 0901 allele may ATD induced leukopenia protective genes or resistance gene . (2) immune response may be involved in the occurrence to ATD caused by leukopenia. (3) serum ANCA positive and carry certain DRB1 alleles may be related to the immune response there may be a genetic predisposition. (4) ATD induced neutropenia incidence of thyroid hormone levels and thyroid antibodies may be irrelevant.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Thyroid disease > Hyperthyroidism
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