The HLA antigens and leprosy in Thailand

Novel HLA Class I Alleles Associated with Indian Leprosy Patients

Convincing results on HLA Class II associations have been reported, however data on HLA class I association are limited and inconsistent from studies in Leprosy. We present here the HLA A, B, and C allele distribution by molecular high resolution PCR-SSOP technique in 32 leprosy patients compared with the 67 controls, from the same ethnic background. The significant results from the present study were a significant increase in frequency of HLA A*0206, A*1102, B*4016, B*5110, Cw*0407, and Cw*0703 was observed when compared to controls. A striking decrease in the frequency of HLA A*0101, Cw*04011, and Cw*0602 leprosy patients was observed when compared to the controls. Further haplotype A*1102-B*4006-Cw*1502 was significantly increased among the lepromatous leprosy patients when compared to the controls. It seems that HLA class I alleles play vital roles in disease association/pathogenesis with leprosy among Indians.

The HLA association of lepromatous leprosy and borderline lepromatous leprosy in Turkey. A preliminary study

Among 50 patients with lepromatous leprosy and borderline lepromatous leprosy in Turkey, the prevalence of HLA-DR2 was 25/50 (50%). The prevalence of the same alleles among 50 healthy controls was 13/50 (26%).

HLA and leprosy in Koreans

HLA antigens in 157 unrelated Koreans with leprosy have been identified and compared with 162 healthy Korean controls. The patient group consisted of 124 with lepromatous leprosy and 33 with tuberculoid leprosy. Although no significant differences were detected between the two patient groups, several antigens were found to be increased in the combined patient group compared to healthy controls. Two Class I antigens were increased: HLA-A11 (22% vs 12%) and Aw33 (27% vs 14%). Four Class II antigens were increased: HLA-DR1 (16% vs 7%), DR2 (39% vs 21%), DRw9 (14% vs 6%) and DQw1 (74% vs 55%). HLA-DR4 (28% vs 48%), DRw53 (46% vs 69%) and DQw3 (50% vs 75%) in contrast were significantly decreased in patients. Interaction of DR1, DR2, DRw9 and DQw1 as risk factors was analyzed. HLA-DR2 appeared to be the strongest risk factor. No evidence for synergy between DR1, DR2 and DRw9 was detected. DQw1 was not significantly increased in patients in the absence of DR1 and DR2, and thus it was not apparent in this study that DQw1 was an independent risk factor.

Association between leprosy and immunoglobulin allotypes: Gm-A2m and Km frequencies in Vietnamese

The relationship between immunoglobulin allotypes and leprosy was studied in 91 unrelated patients and 100 healthy controls from Vietnam. Twenty Vietnamese patients with tuberculosis were also typed for the Gm, A2m and Km allotypes. The results were compared with those from the healthy controls. No significant association was found for the allotypes G1m(z,a,x,f) G2m(n), G3m(g,b), A2m(1,2) and Km(1,3) between the two groups of patients and the controls. Heterogeneity in the distribution of G2m(n), G3m(b), A2m(2) and Km(3) was found when 60 polar-lepromatous (LL) patients and 27 borderline-tuberculoid (BT) patients were separated out of the 91 leprosy patients. In the LL patients there appeared to be a significantly higher frequency of G2m(n), G3m(b) and A2m(2) in comparison with the BT patients (P less than 0.05). A significantly lower frequency of Km(3) was found in the LL patients in comparison with the healthy control group (P less than 0.05). The frequencies of the Gm-A2m haplotypes and of the occurrence of the Km(1) and Km(3) in the Vietnamese population were calculated on the basis of the results in the 100 samples of healthy controls. The main haplotype is Gmaf;n;b (frequency 0.676), occurring with A2m1 (0.200), as well as with A2m2 (0.476).

HLA and disease

This review describes the greater portion of a large number of new studies on HLA and disease association which has appeared in the literature since 1979. The majority of these are concerned with the association of certain diseases with class II major histocompatibility complex antigens. The possible biologic significance of these associations in terms of their probable etiology appears to be the prevailing theme. Current thinking regarding certain heritable diseases is described. It seems that although much has been done to resolve the genetics of insulin-dependent diabetes mellitus, other diseases such a multiple sclerosis still remain a mystery. Doubtlessly, much will be gained from DNA cloning and sequencing studies proposed for the future. A great deal of new information has been obtained relative to HLA itself. New loci have been postulated in the HLA-D/DR region through the use of powerful immunochemical procedures made possibly by the advent of modern technological advances. The impact of these developments on our understanding of the function of the MHC in man and its possible relationship to disease are discussed.

HLA-DR-associated genetic control of the type of leprosy in a population from surinam

The relationship between HLA phenotype and leprosy classification was studied in 73 unrelated patients and 92 healthy controls from a mixed Negroid-Caucasoid population originating from Surinam, South America. Heterogeneity in the distribution of HLA-DR (but not A, B, and C) was detected between tuberculoid (TT* + BT*) leprosy and lepromatous (BL* + LL*) leprosy patients (p = 0.024). This heterogeneity appeared to be caused almost exclusively by DR3. Most significantly, the frequency of DR3 was increased among polar tuberculoid (TT) leprosy patients as compared to the rest of the patients (p = 0.0003). Compared with healthy controls the frequency of DR3 was increased among TT patients (p = 0.006), unchanged in BT patients, and decreased among lepromatous (BL + LL) patients (p = 0.027). These data indicate that in this population an DR3-associated factor controls the type of the disease that develops after infection with Mycobacterium leprae.

Tuberculoid leprosy and HLA in Japanese

HLA phenotypes of 54 patients with tuberculoid leprosy were compared with those of 167 healthy controls. Frequencies of HLA-A, -B and -C antigens did not differ significantly between the leprosy patients and the controls. However, an increase in the frequencies of DR1, DR2, DRW8 and MT1 antigens and a decrease in the frequencies of DR4 and MT3 antigens were observed in the leprosy patients. Statistical evidence was presented that MT1 antigens were primarily associated with tuberculoid leprosy in Japanese patients rather than DR2.

Some recent advances in HLA and skin diseases

During the past 15 years, much has been learned about the human major histocompatibility complex. These new findings have been applied to the whole field of medicine, including transplantation immunology, blood transfusions, association with disease, human genetics, and the mechanism of human immune responses. In clinical medicine, the association between the major histocompatibility complex and various diseases has attracted the greatest interest. In this paper, we summarize the basic information on the human histocompatibility complex and its association with dermatologic disorders. Data from the world literature are reviewed and tabulated. Our own investigations on psoriasis, atopic dermatitis, and epidermolysis bullosa are discussed in detail.