中国麻风皮肤病杂志 ›› 2019, Vol. 35 ›› Issue (6): 321-326.doi: 10.12144/zgmfskin201906321

• 论著 •    下一篇

HLA-Cw6基因对生物制剂治疗银屑病疗效影响的Meta分析

向志  马一平  崔盘根  陈敏   

  1. 中国医学科学院北京协和医学院皮肤病研究所，南京，210042
  • 出版日期:2019-06-15 发布日期:2019-06-06
  • 通讯作者: 陈敏， E-mail：drchenmin@126.com

Effect of HLA-Cw6 allele on the efficacy of biological agents for the treatment of psoriasis

XIANG Zhi, MA Yiping, CUI Pangen, CHEN Min   

  1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China

  • Online:2019-06-15 Published:2019-06-06
  • Contact: CHEN Min, E-mail: drchenmin@126.com

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摘要： 目的：Meta分析评价HLA-Cw6基因阳性对生物制剂治疗银屑病疗效的影响。方法：检索1976年1月至2018年12月Pubmed、Embase、The Cochrane Library、中国生物医学文献数据库、万方数据库及中国知网等数据库中关于HLA-Cw6基因与生物制剂疗效关联的文献，对最终符合入选标准的文献进行Meta分析。结果：符合入选标准的文献共11篇，涉及三种生物制剂，包括：2项关于IL17A拮抗剂Secukinumab研究，3项抗肿瘤坏死因子α(TNF-α)拮抗剂的研究及6项IL-12/IL-23拮抗剂Ustekinumab的研究。对Ustekinumab疗效关联的6项研究Meta分析显示治疗后HLA-Cw6阳性患者中PASI评分下降75%的比例(PASI75)高于HLA-Cw6阴性患者，差异有统计学意义(P<0.05)。Secukinumab的2项研究及TNF-α拮抗剂治疗的3项研究Meta分析显示HLA-Cw6阳性患者中PASI75较HLA-Cw6阴性者无明显增高，差异无统计学意义(P>0.05)。结论：携带HLA-Cw6基因患者对IL-12/IL-23拮抗剂Ustekinumab的疗效优于未携带者，HLA-Cw6对Secukinumab和TNF-α拮抗剂疗效无明显影响。

关键词: 银屑病, HLA-Cw6基因, 生物制剂, Meta分析

Abstract: Objective: To analyze the association of the HLA-Cw6 allele with response to biological agents for the treatment of psoriasis in a Meta analysis. Methods: The relevant studies from MEDLINE, EMBASE, the Cochrane Library, SinoMed, CNKI and Wanfang database from Jan 1, 1974 to Dec 1, 2018 were researched and were analyzed with Meta analysis. Results: Eleven studies were included for analysis. Among these, three kinds of biological agents were contained, including: anti-IL-12/IL-23 antibody Ustekinumab in six studies, anti-TNF-α antagonists in three studies and IL-17/IL-17A receptor antibody Secukinumab in two studies . The analysis of Ustekinumab showed that the score  of PASI decreased by 75% in the patients with HLA-Cw6, which  was higher than that in the patients without HLA-Cw6, with a significant difference (P<0.05). Two Secukinumab and TNF-α antagonist studies showed that there was no significant decrease in PASI score between the patients with and without HLA-Cw6 (P<0.05). Conclusion: HLA-Cw6 positive patients responded better and faster to Ustekinumab than the negative patients. HLA-Cw6 dose not have an impact on the therapeutic efficacy of Secukinumab and TNF-α antagonist. 

Key words: psoriasis, HLA-Cw6, biological agents, Meta-analysis