标题：HLA and MuSK-positive myasthenia gravis: A systemic review and meta-analysis
作者：Hong, Y.; Li, H. -F.; Romi, F.; Skeie, G. O.; Gilhus, N. E.
作者机构：[Hong, Y.; Romi, F.; Gilhus, N. E.] Univ Bergen, Dept Clin Med, Bergen, Norway.; [Li, H. -F.] Shandong Univ, Dept Neurol, Qilu Hosp, Jinan, Shandong 更多
通讯作者地址：[Hong, Y]Univ Bergen, Dept Clin Med, Bergen, Norway.
来源：ACTA NEUROLOGICA SCANDINAVICA
关键词：genetic polymorphism; human leucocyte antigen; meta-analysis;; muscle-specific tyrosine kinase; myasthenia gravis
摘要：ObjectivesMyasthenia gravis (MG) represents a spectrum of clinical subtypes with differences in disease mechanisms and treatment response. MG with muscle-specific tyrosine kinase (MuSK) antibodies accounts for 1%-10% of all MG patients. We conducted a meta-analysis to evaluate the association between HLA genes and MuSK-MG susceptibility.; Subjects and methodsStudies were searched in Pubmed, EMBASE database and other sources between 2001 and 2018. Genotype, allele and haplotype frequencies of HLA loci in MuSK-MG patients and healthy controls were extracted from each included study.; ResultsThe meta-analysis showed that HLA DQB1*05, DRB1*14 and DRB1*16 were strongly associated with an increased risk of MuSK-MG (P<.0001), whereas HLA DQB*03 was less frequent in MuSK patients compared with healthy controls (P<.05). Haplotype analysis showed that these DQB1 and DRB1 alleles were closely linked, forming both risk (DQ5-DR14, DQ5-DR16, P<.0001) and protective (DQ3-DR4, DQ3-DR11, P<.05) haplotypes.; ConclusionThe distinct genetic patterns of MuSK-MG indicate that variation in HLA class II genes plays an important role in the pathogenesis of MuSK-MG patients.