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Iaci? eeoa?aoo?u 1.1 Yoeieiaey e iaoiaaiac i/aaiaie aeiiaoeee

I?iaeaia i/aaiaie aeiiaoeee [IA] inoaaony iaeiie ec aeooaeueiuo
i?iaeai aea?iaoieiaee. A ?acaeoee caaieaaaiey iieacaia ?ieue ia?aiie
nenoaiu, iae?iyiaeie?eiiuo oaeoi?ia, ?ieue eieaeueiuo e nenoaiiuo
eiioiiuo ia?ooaiee, aooieiioiiiai eiiiiiaioa, oaaioeeoica, ninoaeenouo
eciaiaiee, a oaeaea ianeaaenoaaiiay e eioaeoeeiiiay oai?ee e ae?.

A niioaaonoaee n eeeie/aneie aa?eaaaeueiinoueth e aaoa?iaaiiinoueth
caaieaaaiey iaeuecy aeaoue iaeiicia/iue ioaao ia aii?in ia yoeieiaee.

Aaiaoe/aneea oaeoi?u, iee?ii?aaieciu, yiioeeiiaeueiua no?annu,
aooieiioieoao ianoaeaeathony eae aiciiaeiua yoeieiae/aneea i?e/eiu.
[Mitchell A J 1984 Perini G et al 1981 Simpson N B et al 1991 Hordinsku
M K 94]. Ia?aaeei IA [aiacaeiay aeiiaoeey] naycaia n i/aaaie o?iie/aneie
eioaeoeee [ei?iiciua coau], neioneo, aaeii?eo, oiiceeeeo e ae?.
[Aaae?iaa EI 1979, Oiieei I e niaao. 1981, Iaoaena ATH e niaao 1982].

Auaeaeiooa aeiioaca i aiciiaeiii aicieeiiaaiee i/aaiaie aeiiaoeee a
?acoeueoaoa ae?oniie eioaeoeee [A Tosti et al 1997] Ianoaeaeaaony
aiciiaeiay acaeiinaycue iaaeaeo IA e ineoeao?e/aneeie ?anno?ienoaaie [15
– 25] Iaaethaeaiey naiaeiuo neo/aaa IA e eiiei?aeaioiinoue o aeeciaoeia
aeaee iniiaaiey iiiaei aaoi?ai n/eoaoue /oi yoi caaieaaaiea naycaii n
ianeaaenoaaiiuie oaeoi?aie [……….]

A ?innee ioia/aee aiacaeioth aeiiaoeeth a naiueyo o 8.13 %
iaaethaeaaoeony aieueiuo [4]. Oeiu iaeioi?uo ?iaeineiaiuo nicaeaaaee
aia/aoeaiea i aeiieiaioiii ianeaaeiaaiee n aa?eaaaeueiie
yeni?anneaiinoueth [5]. A ?yaea ni?aai/ieeia e ?oeiaiaenoa oeacuaaeny
i?aaeiieiaeeoaeueii aooiniiii-aeiieiaioiue oei ianeaaeiaaiey. A
Noeaainii,. A. Aeaaeaenii 197? [6] ?aeiiaiaeiaaee i?e ii?aaeaeaiee
aaiaoe/aneiai i?iaiica aeey eiinoeueoe?othueony ii iiaiaeo aiacaeiie
aeiiaoeee [IA] enoiaeeoue ec i?aaeiieiaeaiey ia aooiniiii-aeiieiaioiie
ia?aaea/a n iaiieiie iaiao?aioiinoueth aa?uee?othuae a ?aciuo naiueyo. N
eiioea 70-o aiaeia ia/eiathony iienee aaiaoe/aneeo aeaoa?ieiaio IA ia
iniiaa eco/aiey annioeeaoeee yoie aieacie n aaiaie aeaaiiai eiiieaena
aenoiniaianoeiinoe [HLA], eaaeeo oeaiae eiioiiaeiaoeeiia e iieeii?oecia
aaiia aioaaiienoia-?aoeaioi?ia eioa?eaeeeia 1.

Aieaa aeieacaoaeueiui n/eoatho annioeeaoeeth n aaiaie HLA II eeanna,
naycaiiuie n eiioiiui ioaaoii e iiae?acaeaeythueieny ia noa?aaeiiu DP –
DO -DP. ?yaeii aaoi?ia a ianeaaeiaaiiuo eie a?oiiao auea ioia/aia
annioeeaoeey IA n DR e DP iacaaeneii ae?oa io ae?oaa. Eeoea n DP W4 e
DR4 eiatho iiauoaiiue ?ene ?acaeoey IA, /oi naeaeaoaeuenoaoao i iaee/ee
neia?aecia iaaeaeo aaiiuie i?iaeoeoaie DP e DR [26 – 30]. Iicaea a
enneaaeiaaiee i?iaaaeaiiii M Duvic et al a 1995 aiaeo ia 77 aieueiuo IA
e eo ?iaenoaaiieeao ec 29 naiae auea noaoenoe/anee aeieacaia naycue n
aaiaie eieona DQ eee aeeceaaeauaai ?aeiia o?iiinii. Annioeeaoeey n
eieonaie DQBI *03, DQBI *0301, DQBI *0401, DQBI *0502 auea ioia/aia e
ae?oaeie aaoi?aie. [………………] [19] [4-15], ioiaoeaoea a
iiaea?oiia aieueiuo ec 58 /aeiaae n aeeeoaeueii-oaeoueie oioaeueiuie e
oieaa?naeueiuie i?iyaeaieyie IA iaeaieaa noaoenoe/anee cia/eiua
i?aauoaiey iaae eiio?ieai aioeaaiia DQBI *0301, iiae/a?eeaaee
iaeaeaiioth annioeeaoeeth eiaiii n oyaeaeuie oi?iaie. A oi aea a?aiy o
aieueiuo auee iaia?oaeaiu aeeaee HLA II eeanna, ea?aaoea eae au
i?ioaeoeaioth ?ieue , oi anoue ano?a/aaoeany i?e oyaeaeuo oi?iao ?aaea
/ai a eiio?iea: DRB3 e DRW52a e DQBI *6.

Aaa?aao AA [1985], i?iaiaey eiioiiaaiaoe/aneea enneaaeiaaiey o 72
aieueiuo ?acee/iuie oi?iaie IA auyaeea annioeeaoeeth n aioeaaiaie HLA :
B13, Bc7, CW1, CW3, DR7.I?e yoii annioeeaoeey n aioeaaiaie HLA – B27 e
HLA DR7 iaaethaeaeanue i?e oyaeaeuo oi?iao aeiiaoeee. Iineoaee aioeaaiia
HLA – B13, B27, CW!, CW3, DR7 ninoaaeee a?oiio ?enea.

A ?aaioa [8-25] enneaaeiaaee oaaee/aiea iiioeyoeee T-eeioioeeoia a
ia?eoa?e/aneie e?iae IA n iiiiuueth aeaieiiai i?yiiai
eiioiioeoi?anoeaioiiai ie?aoeaaiey iiaeaeaea O-eeioioeeoia:
EE-2R+-Leu4+ a ia?eoa?e/aneie e?iae aieueiuo IA. 58 aieueiuo IA auee
?acaeaeaiu ia 3 eaoaai?ee : iaaeoeaiue aaeeie/iue i/aa, iiiaeanoaaiiua
aeoeaiua i/aae, o?iie/aneay aaia?aeeciaaiiay aeiiaoeey. Ii n?aaiaieth ni
caei?iaui eiio?ieai auee ioia/aiu aeoeaaoeey O-eeaoie a ia?eoa?e/aneie
e?iae anao 3-o a?oii.

Salazar I. [1995] n niaaoi?aie oaeaeinue eciee?iaaoue iaeioi?ua HL
DP, DR e DQ naaiaiou AeIE e n iiiiuueth iieeia?aciie oeaiiie ?aaeoeee
[PCR] onoaiiaeoue iineoaeuenoai aaiia o aieueiuo IA. Aaoi?u auyaeee, /oi
IA ni/aoaaony n aaiioeie/iuie i?iyaeaieyie HLA -DR4 e DR5 e io/aoeeaui
nieaeaieai DRW52, HLA – DR4 e DRW11 n eo annioeeaoeeyie n DQW7 [W3] e
DQW8 [W3]. Aeaeueiaeoea enneaaeiaaiey a yoii iai?aaeaiee oaeaea
iieacaee aaiaoe/aneoth iniiao IA [4-15] Colombe DW et al 1995 auyaeee
HLA – DR11 [DRBI*1104] e HLA – DQ7 [DQBI*0301] ano?a/aeenue ai?acaei
/aua a a?oiiao n oioaeueiie e oieaa?naeueiie aeiiaoeeae, a oi a?aiy eae
HLA – DQ3 [DQBI *03] auee iaia?oaeaiu eae o aieueiuo n oioaeueiie e
oieaa?naeueiie, oae e i/aaiaie oi?iaie.

Yoe aeaiiua iiaeoaa?aeaeatho iaee/ea annioeeaoeee aeeeoaeueii
i?ioaeathueo oi?i oieaa?naeueiiai/oioaeueiiai eee i/aaiaiai naeeaeaiey n
eieonaie HLA. Oaeaea ii?aaeaeaiiua eieonu HLA – DQ3, HLA – BI*03
ioaa/atho ca i?aae?aniieiaeaiiinoue e aicieeiiaaieth aeiiaoeee. A
noaouea [5-25] enneaaeiaaeanue ?ano?eeoeey AeIE-iieeii?oecia MHC2
eeanna: Hla – DqA, DQB, DPA, DPB o iaoeeaioia n IA e o caei?iauo.
*anoioa DQBI* 0301 e DQW7 annioeee?iaaiiuo n DQP BgI / II 4.2 kb
o?aaiaioa auea oaaee/aia aei 65 % i?e IA ii n?aaiaieth n 20% a eiio?iea,
/oi aiai?eo i oii, /oi ?aiaa iienaiiay annioeeaoeey iaaeaeo IA e DR4,
DR5 yaeyaony aoi?e/iie ii n?aaiaieth n annioeeaoeeae IA e DQBI*0301,
eioi?ue eiaee?oao b-oeaiue iieaeoeu HLA – DQ. Aiaeec nia?aiaiiiai
iaee/ey DQBI *0301 e DPAI *0103 i?e IA i?aaeiieaaatho iaee/ea
aeiaaai/iiai ?enea [neia?aeci eee acaeiiaeaenoaea iaaeaeo DQBI*0301 e
DPAI*0301 iaaeaeo aeaoiy aeeaeyie ?aniieiaeaiiuie a ?acee/iuo eieonao
HLA eeanna.

Neiaeeeinue aia/aoeaiea i aaiaoe/aneii iieeii?oecia IA,
niioaaonoaothuai ?aciie /anoioa «yoeieiae/aneeo» e «i?ioaeoeaiuo»
[i?aaaioeaiuo] aeeaeae aaiia oeaiaaie niaianoeiinoe i?e ?acee/iuo
eeeie/aneeo oi?iao yoiai caaieaaaiey. Oaeei ia?acii aaiaoe/aneea
aeaoa?ieiaiou iiaoo ii?aaeaeyoue ?acaeoea eaaeeo e oyaeaeuo oi?i, aaiu
eioi?uo annioeee?iaaiu n ?acee/iuie aeeaeyie HLA. Aieueoia ?aciiia?acea
eeeie/aneeo oi?i IA a oaeaea yoie/aneea ?acee/ey ii iiaeoeiai HLA
iauyniytho iaeaeaiiua ?aciuie aaoi?aie ?acee/ea ii HLA a ?acee/iuo
a?oiiao aieueiuo.

A iineaaeiaa aeanyoeeaoea noaei ecaanoii cia/eoaeueiia /enei
oaeoia, naeaeaoaeuenoaothueo i aaaeiinoe eiioiiuo ia?ooaiee a iaoiaaiaca
i/aaiaie aeiiaoeee. I?e eco/aiee oee?eoee?othueo eeioioeeoia a e?iae o
aieueiuo iaia?oaeeaaee nieaeaiea ?aaeoeaiinoe eeioioeeoia, oiaiueoaiea
/enea O-eeioioeeoia, a oii /enea «eioa?aeoeaiuo» O-eeaoie, niiniaiuo
oi?ie?iaaoue ?icaoee n eeioiaeanoiuie A-eeaoeaie. [Friedmann P.S. et al
1981, BBJ Majewski et al 1984].

A ?aaioa [8-15] IA annioeee?oaony n ia?eoieeeeoey?iie
eioeeueo?aoeeae O-eeaoeaie. Aooi?aaeoeaiua O-eeaoee i?eia?aoatho
ii?iaeueioth ?aaeoeaiinoue, acaeiiaeaenoaoy n DR-iieiaeeoaeueiuie
eeaoeaie oieeeeoey?iiai yieoaeey. Aeey ii?aaeaeaiey eiee/anoaa
aooi?aaeoeaiuo eeioioeeoia i?iaiaeeeanue aeiiney o/anoeia ii?aaeaiey IA
e ioeaiea eo eiee/anoaa a e?iae. Auei iieacaii, /oi aooi?aaeoeaiua
O-eeaoee i?ieeoa?e?otho a ioaao ia aooieiae/iua iiiiioeeaa?iua O-eeaoee,
oee?eoee?othuea a e?iae. Oaaee/aiea aooi?aaeoeaiuo eeaoie a i/aaao
ii?aaeaiey IA i?aaeiieaaaao eo iaoiaaiaoe/aneoth ?ieue. Oaeei ia?acii,
aooi?aaeoeaiua eeioioeeou ea?atho aaaeioth ?ieue a ?acaeoee
ainiaeeoaeueiie ?aaeoeee. Oiaiueoaiea O- e A-eeioioeeoia a
ia?eoa?e/aneie e?iae ioiaoee oaeaea a naiae ?aaioa Eoeaaei A.E. 1992 a.
A oi aea a?aiy Aaa?aao A.A. 1985, D Sauder 1980 e ae?. Oeacuaaee ia
ii?iaeueiia eiee/anoai A-eeioioeeoia a ia?eoa?e/aneie e?iae aieueiuo.

A iiaeoaa?aeaeaiea oiai, /oi IA eiaao eiioiieiae/aneoth iniiao,
auei iaia?oaeaiea eiioiiuo eiiieaenia, /aua anaai ninoiyueo ec IgM, C3,
IgA e Ig6. Iie eieaeeciaaeenue a ieaeiae, a eiiaaea e ia?aaeiae /anoe
oieeeeoea. Aeaoeoeeo eeaoi/iiai eiiiiiaioa eiioieoaoa,
aeeneiioiiaeiaoeeiaiey a ia?eoa?e/aneie e?iae, eiioiieiiieaeniay
iaoieiaey iicaieytho aeeth/eoue IA a /enei aooieiioiiuo caaieaaaiee.
[10-15] [Bystryn IC et al 1979, Safai B et al 1979 DJ Tobin et al 1997].
Ii/oe o anao ianeaaeiaaiiuo aeaoo a?oii aieueiuo IA iaia?oaeaiu
aioeoaea e aieinyiui oieeeeoeai. Auei iaia?oaeaii ianeieueei ?acee/iuo
aooi-aioeoae e ianeieueeei aioeaaiai aieinyiuo oieeeeoeia. Yoe aioeoaea
ioiineeenue e eeannai IgM e IgG.

A noaouea [7-15] A P Bertolino e niaao. 1993 auea eco/aia ?ieue
?aoeaioi?ia UN-Z. ?aoeaioi?u UN-Z [UN-Zp] yeni?anne?othony O-eeaoeaie.
Iaeiei ec niiniaia ecia?aiey eiioeaio?aoeee O-eeaoi/iuo ?aoeaioi?ia –
ecia?aiea ?anoai?eiiai nuai?ioi/iiai aaeea [s-UN-Zp]. Ecia?aiea o?iaiy
UN-Zp io?aaeaei aeoeaiinoue O-eeaoie a nuai?ioea iaoeeaioia n IA.
Eniieueciaaeny aaeie-naycuaathuee eiioiini?aaio a oaca iaino?aiey e
?aiennee caaieaaaiey. A ino?ie oaca eiioeaio?aoeey s-UN-Zp auea
cia/eoaeueii auoa, /ai i?e ?aiennee e a eiio?iea. Aeieiae/aneay ?ieue
s-UN-Zp inoaaony ia aei eiioea yniie, ii iiaeii i?aaeiieiaeeoue, /oi
aeoeaaoeey O-eeioioeeoia, i?eaiaeyuay e nae?aoeee UN-Z e yeni?annee
UN-Zp iiaeao auoue ?iaeiei ec iaoaieciia IA.

Tarlow JK et al 1994 iaoee aeinoiaa?iua annioeeaoeee iaaeaeo aeeaeueth
Z aioaaiienoia ?aoeaioi?ia Ib-s e oyaeanoueth caaieaaaiey. Aiciiaeiinoe
nia?aiaiiie eiioiieiaee iicaieytho aieaa yooaeoeaii eniieueciaaoue
?acee/iua iaoiaeeee aeey iieo/aiey iieiie eioi?iaoeee ia
eiioiieiae/aneeo eciaiaieyo i?e IA. A nayce n yoei ii?aaeaeaiiue eioa?an
i?aaenoaaeytho eiioiiaenoioeie/aneea e eiioiiii?oieiae/aneea
enneaaeiaaiey.

[1-29] eco/aee yeni?anneth CD44 a o/anoeao, ii?aaeaiiuo IA. CD44 –
iiaa?oiinoiue eeaoi/iue ia?ea?, aiaea/aiiue ai iiiaeanoai yoaiia
ii?iaeueiiai eiioiiiai ioaaoa, aeeth/athuaai aeoeaaoeeth O-eeaoie,
eeaoi/ioth aaeaaceth. A ii?iaeueiie eiaea CD44 iaia?oaeeaaaony
aenoioeie/anee, i?aeiouanoaaiii a yecie?eiiuo nie?aeueiuo eeaoeao.
Enneaaeiaaiea iieacaei ionoonoaea yeni?annee CD44 a o/anoeao,
ii?aaeaiiuo IA, /oi iiaeao aeaoue aeiiieieoaeueioth eioi?iaoeeth a
ioiioaiee iaoiaaiaca yoiai caaieaaaiey.

Eiioiiiaoieiae/aneea iaoaieciu i?e IA eco/aee oaeaea A.K. Gupta et
al 1990 J Shapiro et al 1993. Aaoi?ai oaeaeinue iieacaoue /oi i?e IA
oieeeeoey?iue yieoaeee aeaao ?acei iieiaeeoaeueioth ?aaeoeeth ia ICAM-1
[eio?aoeaeethey?iua aaeaaceaiua iieaeoeu]. Yoa aaa??aioiay yeni?anney a
ii?iaeueiie eiaea ia iaaethaeaaony. H.L. Rilo et al 1994
eiioiiaenoioeie/anee auea iieacaia yeni?anney ICAM-1 e ELAM
[yiaeioaeeaeueii-eaeeioeeoa?iua aaeaaceaiua iieaeoeu-1] a eiaea iaeiiai
aieueiiai oieaa?naeueiie aeiiaoeeae. Yeni?anney ELAM-1 auea iaia?oaeaia
a aea?iaeueiuo eeaoeao yiaeioaeey, a oi a?aiy eae yeni?anneth ICAM-1
iiaee iaaethaeaoue a oieeeeoey?iii yieoaeee e a eeaoeao yiaeioaeey. A
?aaioa [2-29] n?aaieaaee yeni?anneth oeeoiea?aoeiia a ii?iaeueiuo
aieinyiuo oieeeeoeao e ii?aaeaiiuo IA n iiiiuueth aenoioeie/aneiai
iaoiaea n eniieueciaaieai iiiieeiiaeueiuo aioeoae. I?aaenoaaeyaony
eioa?aniui, /oi yeni?anney oeeoiea?aoeia IG, eioi?ay iiaeoee?oaony
nei?inoueth i?ieeoa?aoeee ea?aoeiioeeoia, ia eciaiyeanue a ia?oaeiie
iaiei/ea oieeeeoeia i?e IA. Yoi ia i?ioeai?a/eo i?aaeuaeouei
iaaethaeaieyi, a eioi?uo auyaeaii oiaiueoaiea yeni?annee
annioeee?iaaiiiai n i?ieeoa?aoeeae, yaea?iiai aioeaaia Ki-67.

?anoe?yao iaoa i?aaenoaaeaiea i iaoiaaiaoe/aneeo iaoaieciao a
?acaeoee eiioiieiae/aneeo ?aaeoeee i?e aeaiiie iaoieiaee iaeia ec
iineaaeieo ?aaio P Teofoli 1992 et al, a eioi?ie aaoi?u iieacaee, /oi a
aeoeaiie oaca IA a ia?eaaneoey?iii e ia?eaoeueaa?iii eioeeueo?aoa
iaia?oaeeaathony CD3, CD44e CD1-iieiaeeoaeueiua eeaoee. A aieueoeinoaa
eeaoie eioeeueo?aoa e a aoeueaa?iuo ea?aoeiioeeoao iaia?oaeeaathony
HLA-DR. Ie?aoeaaiea aeey ii?aaeaeaiey ICAM-1 e ELAM-1 aeaaaei
iieiaeeoaeueioth ?aaeoeeth. Ianneaiue eioeeueo?ao ii?aaeaeyeny i?e IA a
ii?aaeaiiie eiaea a i?ia?anne?othuae e noaoeeiia?iie noaaeee, a oaeaea a
ia?eaaneoey?iuo iaeanoyo iaii?aaeaiiuo o/anoeia. Oai ia ii?aaeaeyeenue
ICAM-1, iaeiaei eiaeinue ie?aoeaaiea ia iaee/ea ELAM-1 a ia?eaoeueaa?iuo
ninoaeao aea?iu e ea?aoeiioeeoao iaii?aaeaiiuo iaeanoae. A noaoeeiia?iie
noaaeee IA ia?eaoeueaa?iue eioeeueo?ao oiaiueoaeny, eiee/anoai CD3+,
CD4+, CD1a e HLA-DR auei oiaiueoaii. Ie?anea aeey ii?aaeaeaiey ELAM-1 a
eeaoeao yiaeioaeey ia auyaeeanue. Eeaoee CD8+ e CDG+ auee i/aiue
?aaeeeie eee aiiaua ionoonoaiaaee. A noaouea [19-25] eco/aeanue
yeni?anney oaiaoeeia [O] a ia?eoieeeeoey?iie niaaeeieoaeueiie oeaie.

O- iaaeaaii ioe?uoue yeno?aoeaeethey?iue aaeie iao?eena aue
iaia?oaeai a ia?eoieeeeoey?iie niaaeeieoaeueiie oeaie
eiioiiaenoioeie/aneei iaoiaeii. Aai eieaeecaoeey ioee/aeanue io ae?oaeo
ecaanoiuo eiiiiiaioia yeno?aoeaeethey?iiai iao?eena [oea?eiiaeoei,
eaieiei, i?ioaiaeeeai-noeueoao-aaia?ei]. N?aaiaiea a?oiiu caei?iauo
ethaeae n a?oiiie aieueiuo IA auyaeei iiauoaiioth yeni?anneth O ieiei
neeueii eioeeueo?e?iaaiiuo oieeeeoeia.

Tobin D.S. c niaao. 1994 iaia?oaeeee aoeie/iua aooiaioeoaea i?ioea
aieinyiuo oieeeeoeia. A. Tosti 1997 a naiai aeieeaaea ia 2-i
Aa?iiaeneii o?eoieiae/aneii eiia?anna iiae/a?eioea, /oi aieaa /ai o 90%
aieueiuo IA iaia?oaeeaathony aioeoaea e ?acee/iui yeaiaioai aieinyiiai
oieeeeoea. Iaeiaei, iiea iaiiiyoii, yaeythony ee yoe aioeoaea i?e/eiie
eee neaaenoaeai i/aaiaie aeiiaoeee.

Iacaioeia aieinyiiai oieeeeoea /aeiaaea niaea?aeeo
yeno?aoeaeethey?iue iao?een, aa?uee?othuee ii naiaio iau?io e ninoaao a
caaeneiinoe io oeeeea ?inoa aieina.

N oeaeueth eco/aiey iia?aaeaeaiee iacaioeiaeueiie ooieoeee i?e IA,
enneaaeiaaeanue yeni?anney yeno?aoeaeethey?iiai iao?eena a aeiioaoao 14
aieueiuo n iiiiuueth eiioiiaenoioeie/aneie ia?aaioee aaeeia,
i?ioaiaeeeaiia e eioa?noeoeeaeueiuo eieeaaaiia, aoiaeyueo a ninoaa
aacaeueiie iaia?aiu. Oieeeeoeu ec i/aaia n iay?ei au?aaeaiiuie
ii?aaeaieyie aeaiiino?e?iaaee ioiineoaeueii ii?iaeueioth yeni?anneth
iaia?aiiuo i?ioaeiia e i?ioaiaeeeaiia. Iaeiaei, a iaeioi?uo aieueoeo
aiaaaiiuo oieeeeoeao ec i/aaia ii?aaeaiey noaiaiue ie?aoeaaiey
oiiae?ieoei-noeueoaoii auea nieaeaiiay a aea?iaeueiii nini/ea. A
iia?aaeaeaiiuo eaoaaaiiuo oieeeeoeao eo aacaeueiay iaia?aia auea
cia/eoaeueii ooieuaia. A yoeo no?oeoo?ao au?aaeaiii ie?aoeaaeny eieeaaai
4-ai oeia, a eioa?noeoeeaeueiua eieeaaaiu ie?aoeaaeenue neaai.

A ?aaioa [2-7], eniieuecoy e?uneioth iiaeaeue IA, ?ac?aaioaee
oaoiieiaeth iai?yiie eiioiioethi?anoeaioeee aeey auyaeaiey aioeoae e
aieinyiui oieeeeoeai. Enneaaeiaaeenue caii?iaeaiiua n?acu. Iaia?oaeaiu
aioeoaea eeanna IgG, niaoeeoe/iua aeey yieaea?iaeueiuo aieinyiuo
oieeeeoeia. Iaoieiae/aneea eciaiaiey a ei?ia aieina e ia?ooaiea
eiiaa?nee a aieinyiuo oieeeeoeao, aa?iyoii, iiaeii naycaoue n iiauoaieai
aiiioica a iaaeeooa?aioee?iaaiiuo ieth?eiioaioiuo eeaoeao iao?eena
ieaeiae /anoe aieinyiie eoeiaeoeu. A iaoieiae/aneeo oneiaeyo ii iiaeao
auoue iiauoai eee iiieaeai. Y. Narisawa et al 1997. Iiauoaiea aiiioica a
ei?ia aieina o aieueiuo IA, aa?iyoii, naycaii n aooieiioiiui i?ioeannii.

Aua aieaa cia/eiui aeieacaoaeuenoaii eiioiiiai iaoaiecia IA
yaeyaony iiauoaiiay yeni?anney oeaiaauo aioeaaiia HLA I e HLA II eeannia
(DR e DQ) a eeaoeao iao?eena aieinyiuo oieeeeoeia.

Wollina et al 1996, eco/ay o?ainoi?ie?othuee oaeoi? ?inoa-( (OO?-()
e ?aoeaioi?u e iaio a eeaoeao aieinyiuo oieeeeoeia o iuoae, iaia?oaeeee
yaeaiey, ia iniiaa eioi?uo auaeaeioee aeiioaco i ?aaoee?othuae ?iee
OO?-(1 a ?inoa ia?oaeiiai aieinyiiai aeaaaeeua e aeaenoaea aai eae
eiaeaeoi?a a aiaaai-eaoaaaiiaie oaca ii?iaeueii ?acaeaathuaainy aieina.
Iniaaiiue eioa?an i?aaenoaaeytho aea?iaeueiua nini/ee. I?aaeiieaaaaony,
/oi iie ea?atho aaaeioth ?aaoeyoi?ioth ?ieue a aieinyiii oieeeeoea.
Aeaaaia?aoeey aea?iaeueiuo eeaoie nini/ea (iioa?y aea?iaeueiuo
oea?iaeanoia, eciaiaiiia yae?i e oaaee/eaathuaany niaea?aeaiea aieieii
yeno?aoeaeethey?iiai iao?eena) io/aoeeai iaia?oaeeaaaony a i/aaao
ionoonoaey aiein, iaeiaei yoe eciaiaiey neaai au?aaeaiu a iaii?aaeaiiuo
o/anoeao aieueiuo IA. (Nu + Brown MS 1993).

A ?aaioa (2-25) auei i?iaaaeaii eiioiiaenoieiae/aneia
oeueo?ano?oeoo?iia n?aaiaiea eiaeiuo nini/eia, acyouo ec o/anoeia eiaee
caei?iauo e aieueiuo IA. O/anoee eiaee, acyoua o iaeieo e oao aea
aieueiuo, auee enneaaeiaaiu n iiiiuueth yeaeo?iiiie e naaoiaie
iee?ineiiee. Naiui cia/eoaeueiui ?acee/eai auea iieeii?oiay i?e?iaea
eeaoie eiaeiiai nini/ea e iioa?y eeaoi/iie i?aaiecaoeee a eiaeiii
nini/ea i?e IA. E?iia oiai, aea?iaoiyieoaeeaeueiia niaaeeiaiea iaaeaeo
eiaeiui nini/eii e aieinyiui oieeeeoeii ioee/aeinue iaaeaeo aeoeaiuie e
«ii?iaeueiuie» o/anoeaie eiaee, acyouo o aieueiuo IA. Oaeaea
i?aaenoaaeyao eioa?an oeueo?ano?oeoo?iia enneaaeiaaiea noa?aeiy aieina
i?e IA (14-30). Naaoiaay e neaie?othuay yeaeo?iiiay iee?ineiiey auyaeea
?acee/ey a no?oeoo?a aeenoaeueiie /anoe aiein, ii n?aaiaieth n
inoaeueiie /anoueth aieina, e ni caei?iauie aieinaie. Eco/aiea
iiia?a/iiai n?aca aieina i?iaeaiiino?e?iaaei aneiiao?e/ioth
aeaceioaa?aoeeth ei?u. Iaeia noi?iia auea eiiiaeoiie e aiiiaaiiie, a
ae?oaay eiaea aeoaieea no?oeoo?iua ia?ooaiey – ?anuaeeiu, /anoe/ii
aeaaaia?e?iaaaooth ei?o aieina, neienoue no?aaeiaaie e eooeeoey?iue
eiiiiiaio. Iaeaiei iaia?oaeeaaeny a ei?oeeaeueiii e iicaiaii aauanoaa
eiioeia aiein.

Ii?aaeaeaiiay ?ieue a iaoiaaiaca IA ioaiaeeony yiaeie?eiiui
ia?ooaieyi (Ne?eieei TH.E. e niaao. 1973, Oiae?eoeia A I 1987, Eoeaaei A
I, 1992 e ae?). O aieueiuo IA ioia/aee eciaiaiey eaai?aoi?iuo
iieacaoaeae ooieoeee ei?u iaaeii/a/ieeia, ueoiaeaeiie aeaeacu,
aeiioaeaii-aeiioeca?iie nenoaiu. TH E Ne?eieei, E.I. Aeiieo?ia
oeacuaaee ia oaiaeaioeeth e nieaeaieth aetheiei?oeeieaeiie e
aiae?iaaiiie ooieoeee ei?u iaaeii/a/ieeia. A I Oiae?eoeia 1987 ioia/ae
ia?ooaiey a aeiioaeaii-aeiioeca?iie nenoaia, i?iyaeyaoeany nieaeaieai
o?iaiy o?iiiuo ai?iiiia aeiioeca (ethoaeiece?othuaai,
oieeeeoeinoeioee?othuaai ai?iiiia e i?ieaeoeia).

A E Eoeaaei 1992 iaoiaeee ooieoeeiiaeueiua eciaiaiey a nenoaia
aeiioec-ueoiaeaeiay aeaeaca, oa?aeoa?eciaaaoeany nieaeaieai o?iaiy
niiaoio?iiiiai ai?iiia a ieacia e?iae e iaoaaieecia o?eeiaeoe?iieia e
oe?ieneia a oeaiyo i?e iaeciaiaiiie au?aaioea aeiioecii oe?aio?iiiiai
ai?iiia.

Neaaeoao iniai ioiaoeoue ?ieue yiioeeiiaeueiiai no?anna (ia?aiie
nenoaiu) a aaiaca i/aaiaie aeiiaoeee. Enneaaeiaaiey ia?aii-ineoe/aneiai
ninoiyiey aieueiuo n iiiiuueth oanoa NIEE auyaee o 64.5% aieueiuo
ninoiyiea aeai?annee ?acee/iiai oa?aeoa?a, eioi?ia au?aaeaeinue
nieaeaieai iano?iaiey, eioaeeaeooaeueiie e iioi?iie caoi?iiaeaiiinoueth,
anoaie/aneeie ?aaeoeeyie. (Eoeaaei A E 1992).

Ae?oaea aaoi?u iniaia aieiaiea ia?auaee ia iaa?ieiae/aneea e
aaaaoaoeaiua ?anno?ienoaa. Ia iniiaaiee ?acoeueoaoia
eeeieei-eino?oiaioaeueiiai ianeaaeiaaiey auyaeeanue i?yiay caaeneiinoue
iaaeaeo oyaeanoueth IA e au?aaeaiiinoueth aaaaoaoeaii-o?ioe/aneeo e
aaaaoaoeaii-ninoaeenouo ia?ooaiee, a e?iia oiai, iaoiaeeeanue
caaeneiinoue oyaeanoe IA io auyaeyaoeony oea?aa?aeueiuo eee
oea?aa?inieiaeueiuo i?aaie/aneeo ?anno?ienoa (Iaceoiaa I I 1991).

Enneaaeiaaiey ooieoeeiiaeueiiai ninoiyiey ninoaeia aieiaiiai iicaa
n iiiiuueth ?YA o aieueoeinoaa aieueiuo IA auyaeee nouanoaaiiia
nieaeaiea yeanoe/iinoe ninoaeenoie noaiee oea?aa?aeueiuo ninoaeia,
aeenoiieth n i?aiaeaaeaieai aeiioiiona, ?anoe?aiea aeaeoaei/eia iicaa,
ia?ooaiea aaiiciiai iooiea n iineaaeothuae aioo?e/a?aiiie aeia?oaiceae,
eciaiaiea o?iaiy a?oa?eaeueiiai e?iaaiaiieiaiey, iiauoaiea
ia?eoa?e/aneiai nii?ioeaeaiey. (Aeaiaeaoee A 1993, Aeacu?eia Y A 1995).

I. A. Ieianyi 1989 ia aiciiaeioth ?ieue iaaeinoaoi/iinoe iieaoiie
nenoaiu iicaa a iaoiaaiaca IA, eioi?ay yaeyaony ninoaaeythuae
iaioeaea?ae/aneie neaiaeueiie nenoaiu, inouanoaeythuae ai?iiiaeueioth,
iaaeeaoi?ioth e iiaeoeyoi?ioth ooieoeee i?aaiecia. A ?yaea enneaaeiaaiee
i?eaeaaaee aieueoia cia/aiea iaia?oaeaiiui ia?ooaieyi iee?ioee?eoeyoeee
a iaoieiaee IA. (Aeacu?eia YA 1995, Oiieeia EA 1997, Eoeaaei AE 1992).
Ioia/aaoeany ooieoeeiiaeueiua iee?ioee?eoeyoi?iua eciaiaiey ninoaeenoiai
?onea i?iyaeyeenue a aeaea caiaaeeaiey e?iaioiea, ?aceiai niacia
a?oa?eie, i?aeaieeey?ia, ecaeeenoinoe iinoeaieeey?iiai caaia, nieaeaiey
eiee/anoaa ooieoeeiie?othueo eaieeey?ia. O aieueiuo IA iaia?oaeeaaeinue
oneeaiea aa?aaaoeeiiiuo naienoa e?iae e nuai?ioee, oiaiueoaiea
aeaoi?ie?oaiinoe y?eo?ioeeoia, i?eciaee neiae?iia iiauoaiiie ayceinoe
e?iae. (Oiieeia EA 1997).

Enneaaeiaaiey, iinayuaiiua ?iee ninoaeenouo ia?ooaiee a iaoiaaiaca
IA, eanathony oiiona iaaeno?aeueiuo ninoaeia aieiaiiai iicaa (Ia?caaaa
AE 1965, Iaceoiaa EI 1991, Aeaiaeaoee A 1993, Aeacu?eia YA 1995 e ae?.)
a oaeaea ia?ooaiee i?ioeannia iee?ioee?eoeyoeee (Aa?aiia NI 1984,
Eoeaaei AE 1992, Aeacu?eia YA 1995). O aieueiuo IA a i/aaao ii?aaeaiey
cia/eoaeueii oiaiueoaaony eiee/anoai iaeeeo a?oa?ee, aaioe e
i?aeaieeey?ia, ?aniieaaathueony ?yaeii n aieinyiuie oieeeeoeaie,
aeeno?ioe/aneee i?ioeann ioaaouaaao ana no?oeoo?u oieeeeoea e
ia?eoieeeeoey?ioth ninoaeenooth naoue.

A caaeneiinoe io ieiuaaee aiaea/aiey, ?acee/atho neaaeothuea
eeeie/aneea oi?iu ai?caeiie aeiiaoeee: eieaeueioth, eaioiaeaeioth
(ioeacen), noaoioaeueioth, oioaeueioth e oieaa?naeueioth. Iaeioi?ua
aaoi?u (1) auaeaeytho aua aeaa oi?iu ai?caeiie aeiiaoeee: oi/a/ioth
(iienuaatho a aeaea iaeeeo, aeeaiao?ii a ianeieueei ieeeeiao?ia
iaaeueiuo eee ie?oaeuo i/aaia iaeunaiey, ?aca?inaiiuo ii ?acee/iui
o/anoeai aieinenoie /anoe aieiau) e no?eaouoth oi?io Ieeieueneiai (i?e
yoie oi?ia iaia?oaeeaatho iaoieiaeth ni noi?iiu ia?aiie nenoaiu a aeaea
yieeainee, oecio?aiee, eiioiiae?e/aneeo ninoiyiee, enoa?ieaeiuo
?aaeoeee; ii iaoaio iiaieth, yoo oi?io o?oaeii aeeooa?aioee?iaaoue n
o?eoioeeeiiaieae).

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