Abstract: HLA-DRB1 Alleles and Henoch-Schönlein Purpura: Susceptibility and Severity of Disease

HLA-DRB1 Alleles and Henoch-Schönlein Purpura: Susceptibility and Severity of Disease

OGUZ SOYLEMEZOGLU, HARUN PERU, SEVIM GONEN, AYSUN CETINYUREK, and NECLA BUYAN

ABSTRACT.

Objective. The genetic basis of susceptibility to Henoch-Schönlein purpura (HSP) may be conferred by a number of gene loci, including the MHC. Associations between human leukocyte antigen (HLA) and disease can help to establish a basis for susceptibility and assist in the prediction of the outcome and clinical heterogeneity. We aimed to investigate the implications of the HLA-DRB1 locus and the susceptibility to HSP, and to determine if there are associations with joint, gastrointestinal, and renal manifestations of the disease.

Methods. We studied 110 Turkish patients (men/women: 66/44) with HSP. Patients and ethnically matched controls with respect to age and sex (n = 250) were HLA-DRB1 genotyped from DNA determined using molecular based methods.

Results. HLA-DRB1 genotype differences between patients with HSP and controls were observed. The frequency of HLA-DRB1*11/14 was higher [odds ratio (OR) 1.97, 95% confidence interval (95% CI) 1.25–3.12, p = 0.003; OR = 1.83, 95% CI = 1.02-3.28, p = 0.035, respectively] and the frequency of HLA-DRB1*10/17 was lower (OR = 1.04, 95% CI = 1.01–1.86, p = 0.035; OR = 3.96, 95% CI = 1.17–13.33, p = 0018, respectively) in patients with HSP compared to controls. No HLA-DRB1 associations with gastrointestinal and renal manifestations were found (p > 0.05). In contrast, HLA-DRB1*11 positivity was increased and HLA-DRB1*14 positivity reduced in HSP patients with joint manifestations (OR = 2.68, 95% CI = 1.09–6.66, p = 0.029; OR = 9.34, 95% CI = 3.38–25.64, p = 0.000, respectively). Also, HLA-DRB1*13 positivity was found to be increased in patients with nephrotic proteinuria (OR = 3.76, 95% CI = 1.25–11.23, p = 0.025).

Conclusion. These results suggest that genetic factors from HLA-DRB1 genotypes might be related to the susceptibility to HSP for Turkish children but not to the severity of this disease. Additional studies are required to confirm the association of alleles encoded in the HLA region with the disease progression and severity. (First Release April 15 2008; J Rheumatol 2008;35:1165-8)

Key Indexing Terms:

HENOCH-SCHÖNLEIN PURPURA
HUMAN LEUKOCYTE ANTIGEN
SUSCEPTIBILITY

From the Department of Pediatric Nephrology, Gazi University, School of Medicine, Ankara, Turkey; and the Institute of Mathematics, University of Liege, Liege, Belgium.

O. Soylemezoglu, MD, Professor; H. Peru, MD, Assistant Professor; S. Gonen, MD, Assistant Professor; N. Buyan, MD, Professor, Department of Pediatric Nephrology, Gazi University, School of Medicine; A. Cetinyurek, MD, Researcher, Institute of Mathematics, University of Liege.

Address reprint requests to Dr. H. Peru, Gazi University School of Medicine, Department of Pediatric Nephrology, Besevler, Ankara, Turkey 06540. E-mail: harunperu@gmail.com

Accepted for publication January 2, 2008.