HLA-DQB1/DRB1 Alleles Associate with Traditional Chinese Medicine Syndrome of Chronic Hepatitis B: A Potential Predictor of Progression

Abstract

Background and Aims Traditional Chinese medicine (TCM) has been widely applied in chronic hepatitis B (CHB) supplementary treatment in China. Kidney yang deficiency syndrome (KYDS), one of the most common TCM syndromes of CHB, is more likely to progress to liver cirrhosis or hepatocellular carcinoma than other syndromes. Polymorphisms in the human leucocyte antigen- (HLA-) DQB1 and -DRB1 genes were reported to be associated with hepatitis B virus infection outcomes. Here, we investigated whether HLA-DQB1 and HLA-DRB1 are associated with the classification of CHB TCM syndromes. Methods We genotyped HLA-DQB1 and HLA-DRB1 alleles in a total of 105 subjects, including 74 CHB patients (28 KYDS and 46 non-KYDS) and 31 healthy individuals from Sichuan Province of Southwest China, by polymerase chain reaction sequence-based typing (PCR-SBT). Moreover, a meta-analysis was carried out for further verification. Results The proportion of patients with high HBV DNA load (≥2000 IU/ml) in the KYDS group is higher than that in the non-KYDS group (60.70% [17/28] vs. 28.30% [13/46]); P=0.01). The frequencies of HLA-DQB1∗02:01 (P=0.04) and HLA-DRB1∗03:01 (P=0.04) in the KYDS group were significantly increased compared to the non-KYDS group. The gene test and meta-analysis showed that HLA-DRB1∗08:03 confers susceptibility to CHB (odds ratio = 1.57). Conclusion We found an association between HLA-DRB1/DQB1 polymorphisms and KYDS of CHB. Moreover, KYDS patients of CHB are characteristic with high HBV DNA loads. These findings help to reveal the biological mechanism of KYDS in high risk of CHB progression and suggest a potential prognostic value for disease outcome evaluation.

The Challenges of Ethical Review in Clinical Research of Traditional Chinese Medicine

“…erefore, the performance and treatment protocols in various stages of the same disease are different. However, the diagnosis of "syndrome" is usually subjective, ambiguous, and unrepeatable, and it is difficult to find quantitative indicators even if part of the scientific basis of "syndrome" in TCM has been revealed by related studies with the development and application of genomics and metabonomics in recent years [5][6][7][8]. Meanwhile, it is challenging to format an acknowledged and standard model in syndrome differentiation, and the current methods for diagnosis are not perfect either.…”

Hla-Drb1 Allele Distribution in Healthy Individuals Classified Based on Mizaj (Temperament) of Unani System of Medicine

“…The Eastern Medical Systems of Ayurvedic, Chinese, and Greek Unani medicine had existed for centuries and were based on holistic and vitalistic concepts. Many papers reporting the genetic basis of Prakriti classification, TCM, and Korean system are available however genetic basis of Mizaj concept of Unani system of medicine is unexplored [1,2,12]. In the present work, we assessed if different Mizaj show human leukocyte antigen (HLA)-DRB1 gene polymorphism.…”

“…The present study on Mizaj (temperament) concept of human constitution of Unani system of medicine was inspired by earlier studies on Prakriti concept of Ayurveda as well as constitution classification of TCM [1,2]. Among the traditional systems of medicine practiced all over the world, Unani has a documented history dating back to 460-377 BC and remains highly popular, especially in South Asia [3].…”