摘要 背景和目的：银屑病关节炎和SAPHO（滑膜炎-痤疮-脓疱疹-骨肥厚-骨炎）综合症有一些共同特征，许多人还把SAPHO列入广义的银屑病关节炎。然而，SAPHO综合症有某些独特的临床特点，另外，也不像脊柱关节病那样与B27抗原有相关性。到目前为止，尚无对这2种疾病免疫遗传学进行对比的研究，本文旨在分析这2种疾病是否有相似的遗传背景。 患者和方法 1985年到2005年在同一所大学医院就诊的所有SAPHO综合症患者（n=25）作为研究对象，并进行标准的随访，以研究其主要特点和HLA谱。把这些患者的HLA-Cw6、DR和B27抗原分布与50例寻常型银屑病、120例银屑病关节炎和170例健康献血者进行对比。根据最近5年疾病演变情况对银屑病关节炎进行分类，计算风险比来评估HLA抗原与疾病的相关性，用双侧Fisher精确检验评价相关性的统计学意义（P<0 .05有统计学意义）。

结果 HLA-Cw6、B27或DR抗原与SAPHO综合症均无相关性。HLA-Cw6与银屑病强烈相关【风险比为12，95%可信区间为5.6-26, p<0 .0001】，并与银屑病关节炎强烈相关【风险比为10，95%可信区间为5.4-19.5, p<0.0001】,但其在三种银屑病关节炎类型中的分布相同。与对照组相比，银屑病关节炎患者的hla-dr4表达较弱【风险比为0.4，95%可信区间为0.2-0.7, p="0.002)，HLA-DR7与银屑病的少关节炎型相关【风险比为9.6，95%可信区间为2.9-28," p<0.0001】, hla-dr8 与银屑病关节炎多关节炎型相关【风险比为6.7，95% 可信区间为2-25, p="0.002】," 而hla-b27与银屑病关节炎脊柱炎型相关【风险比为10，95%可信区间为3.3-25, p<0.0001】。

结论：银屑病/银屑病关节炎与SAPHO综合症具有不同的免疫遗传学背景,但SAPHO综合症的遗传背景仍不清楚。

附原文：BACKGROUND AND OBJECTIVES: Patients with psoriatic arthritis (PsA) as well as those with synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome share some common features, and in fact, for many authors the SAPHO concept fits well into the broader concept of PsA. However, some clinical features are unique to the SAPHO syndrome, and in the other hand, these patients do not show the known association between the HLA-B27 antigen and the spondyloarthropathies. To date, there are no studies comparing the immunogenetic profile of these two conditions, so the main objective of the present report was to analyse whether or not both entities may share the same genetic basis. PATIENTS AND METHODS: All patients with SAPHO syndrome (n=25) seen in a single university hospital from 1985 to 2005 were recruited and followed up in standardised manner in order to study their main characteristics and HLA profile. The HLA-Cw6, DR and B27 antigen distribution of these cases was compared to that of 50 patients with psoriasis vulgaris, 120 with PsA, and 170 healthy blood donors. PsA patients were classified in accordance with their predominant pattern observed in the last 5 years of disease evolution. Odds ratios (OR) values were calculated to measure the strength of the association between HLA antigens and disease, while the statistical significance of the association was assessed with a two-tailed Fisher's exact test. P<0 .05 values were considered significant. results: no association was found between hla-cw6, b27, or dr antigens, and sapho syndrome. hla-cw6 was strongly associated with psoriasis, or 12 (95% ci: 5.6-26, p<0.0001) and psa, or 10 (95% ci: 5.4-19.5, p<0.0001), however this antigen was equally distributed among the three articular categories of psa. hla-dr4 was found under-represented in psa patients compared to controls, or 0.4 (95% ci: 0.2-0.7, p="0.002)." hla-dr7 correlated well with psoriatic oligoarthritis, or 9.6 (95% ci: 2.9-28, p<0.0001), hla-dr8 was found associated with polyarthritis, or 6.7 (95% ci: 2-25, p="0.002)," while hla-b27 was over-represented in psoriatic spondylitis, or 10 (95% ci: 3.3-25, p<0.0001). conclusions: psoriasis/psa and sap-ho syndrome show a different immunogenetic background, however the genetic basis of sapho syndrome remains unknown.

引自：Queiro R, Moreno P, Sarasqueta C,et al. Synovitis-acne-pustulosis-hyperostosis-osteitis syndrome and psoriatic arthritis exhibit a different immunogenetic profile. Clin Exp Rheumatol，2008，26(1):125-8.