한국인 연소형 당뇨병 환자에 있어서 HLA항원 분포에 관한 연구

Abstract

[한글]1979년 6월부터 1982년 7월까지 연세대학교 세브란스병원에 내원하였던 연소형 당뇨병 환자 31예(남자 14예, 여자 17예)를 대상으로 HLA-A, B 및 C 항원의 빈도에 관하여 조사하고, 아울러 정상 한국인의 HLA 항원분포와 비교분석하였다.

연소형 당뇨병 환자에 있어서 HLA-A 1C(3.2%)은 정상인(20.5%)에 비하여 매우 낮은 빈도를 보였으며, 통계학적으로 의의가 있었다 (P<0.05).

한편 HLA-B 18 (4.8%), HLA-B8(6.5%) 및 HLA-C^^w3(36.4%)은 정상인의 HLA-18(0.0%), HLA-B8(1.4%) 및 HLA-C^^w3(25.0%)에 비하여 높은 빈도를 보였으나, 통계학적으로 의의는 없었다.

또한 HLA-A2(42.2%), HLA-Bw22(0.0%), HLA-Bw35(0.0%) 및 HLA-B15(16.7%)은 정상인의 HLA-A2(61.2%), HLA-Bw22(13.6%), HLA-Bw35(8.9%) 및 HLA-B15(29.9%)에 비하여 낮은 빈도를 보였으나, 통계학적으로 의의는 없었다.

이상의 결과로 보아, 예수가 적어서 확언할 수는 없으나, 한국인 연소형 당뇨병 환자에서는 HLA-A10만이 의의있게 감소되었을뿐, HLA-B 및 C 유전자좌(locus)에서 의미있는 항원은 검출되지 않았으며 이는 백인, 흑인 및 멕시코인의 항원분포와는 물론, 같은 동양민족인 일본인의 항원분포와도 상이한 것으로 생각된다.

[영문]Recently, much evidence has accumulated on an association between HLA antigens and various diseases.

Such associations were mainly observed in those diseases in which immunologic mechanisms are active in their pathogenesis.

Juvenile-onset diabetes mellitus is a genetically determined disorder of metabolism in which inherited susceptibility plays an important role.

Recent investigations have also suggested that viral infection and autoimmune antipancreatic cell-mediated immunity may have a role in the pathogenesis of juvenile-onset diabetes mellitus.

It is well recognized that specific histocompatibility antigens, including HLA-B8, B15, B18, Cw3, D3/DR3, and D4/DR4, are associated with juvenile-onset diabetes in caucasian populations.

In addition, the specific antigen is Bw54, a vatiant of Bw22, in Japanese juvenile-onset diabetics.

These findings support the concept of a race specificity of the HLA system in juvenile-onset diabetes mellitus.

Thirty-one unrelated Korean Juvenile-onset diabetics were tissue-typed with respect to HLA-A, B, and c antigens using the microcytotoxicity test.

A significant decrease in the frequency of HLA-A10 was evident in juvenile-onset diabetics(3.2%) as compared to controls (20.5%).(p<0.05)

The frequencies of HLA-B18, B8, and Cw3 showed a tendency to an increase in juvenile-onset diabetics as compared with controls, but this differences were not statistically significant.

Whereas the frequencies of HLA-A2, Bw22, Bw35, and B15 showed a tendency to a decrease in juvenile-onset diabetics as compared with controls, but this differences were not also statistically significant.

THese findings suggested that there is a race srecificity in the HLA system in Korea juvenile-onset diabetics.