Lack of association between HLA and age in an aging population

Immunogenetics of longevity. Is major histocompatibility complex polymorphism relevant to the control of human longevity? A review of literature data

Literature data suggest that human longevity may be directly correlated with optimal functioning of the immune system. Therefore, it is likely that one of the genetic determinants of longevity resides in those polymorphisms for the immune system genes that regulate immune responses. Accordingly, studies performed on mice have suggested that the Major Histocompatibility Complex (MHC), known to control a variety of immune functions, is associated with the life span of the strains. In the last 25 years, a fair number of cross-sectional studies that searched for the role of HLA (the human MHC) genes on human longevity by comparing HLA antigen frequencies between groups of young and elderly persons have been published, but conflicting findings have been obtained. In fact, the same HLA antigens are increased in some studies, decreased in others and unchanged in others. On the whole, that could lead us to hypothesize that the observed age-related differences in the frequency of HLA antigens are due to bias. In our opinion, this hypothesis is real for most studies owing to major methodological problems. However, some studies that do not meet these biases have shown an association between longevity and some HLA-DR alleles or HLA-B8,DR3 haplotype, known to be involved in the antigen non-specific control of immune response. Thus, HLA studies in man may be interpreted to support suggestions derived from the studies on congenic mice on MHC effects on longevity. However, in mice the association may be by way of susceptibility to lymphomas whereas, in human beings, the effect on longevity is likely, via infectious disease susceptibility. Longevity is associated with positive or negative selection of alleles (or haplotypes) that respectively confer resistance or susceptibility to disease(s), via peptide presentation or via antigen non-specific control of the immune response.

HLA, aging, and longevity: a critical reappraisal

Despite a large number of studies, available data do not allow at present to reach definitive and clear conclusions on role of HLA on longevity, owing to major methodological problems, such as serological and molecular typing of different loci, insufficient sample sizes, different inclusion criteria and age cut-off, inappropriate mixing of data referred to people from 58 to over 100 years of age, inappropriate control matching, and neglected consideration of sex-related effects and the different genetic make-up of studied populations. However, within this confused scenario, some data emerge. First, two studies that do not fit the biases above discussed show that some HLA alleles are associated with longevity. However, some of these alleles may confer an increased risk to undergo a variety of diseases. Second, longevity may be associated with an increased homozygosity at HLA loci. Third, an intriguing association between longevity and the 8.1 ancestral haplotype (AH), which has been proven to be associated with a variety of immune dysfunctions and autoimmune diseases, apparently emerges. This association appears to be a sex-specific (males) longevity contributor, and it is particularly interesting, taking into account that a type 2 (early infancy) --> type 1 (adulthood) --> type 2 (aging) shift of cytokine profile occurs lifelong, and that individuals bearing this haplotype show a type 2 immune responsiveness (note that type 1 cytokines mainly enhance cellular responses, whereas type 2 cytokines predominantly enhance humoral responses). On the whole, the (sex specific) association of longevity with alleles or haplotypes of several genes related to risk factors for a variety of diseases (cardiovascular diseases, cancer), including HLA alleles and haplotypes, is not unexpected on the basis of previous studies on the genetics of longevity in centenarians. This association can be interpreted under the perspective of a well known evolutionary theory of aging (antagonistic pleiotropy). This theory predicts that the same gene (or allele or haplotype) can have different roles (positive or negative) in different periods of the life span. Thus, the 8.1 AH should exert a positive effect during the infancy and aging but not in adulthood, when, indeed it is associated to susceptibility to a variety of diseases.

The effect of geographic origin on the frequency of HLA antigens and their association with ageing

The association between HLA antigens and ageing is not clear. Ageing in women was associated with B40 and DR5 in a recent study, but other studies yielded conflicting results. In none of the studies, however, did the young and elderly samples originate from the same homogeneous population. Homogeneity is dependent on geographic origin. The aim of this study was to investigate whether differences in geographic origin between age groups could explain the age-associated differences in the frequencies of B40 and DR5. The authors used the new design of a 'birth-place-restricted comparison' in which the origin of all subjects was ascertained. The total study population comprised 1010 young women aged 25-40 years and 660 elderly women aged 85 years and older. The 'birth-place-restricted comparison' included 66 young and 285 elderly women from one geographic area (Leiden, the Netherlands). Men were not included because ageing in men was not associated with HLA antigens in a recent study. In the total population, the frequency of B40 in young women of different origin varied between 16 and 28%, and the frequency of DR5 between 11 and 23%. Similar differences were observed in the elderly women. In the 'birth-place-restricted comparison', the frequency of B40 was 15% in the young women and 11% in the elderly women (difference 4%, 95% confidence interval, -5 to 13%). The frequency of DR5 was 20% in the young women, and 28% in the elderly women (difference 8%, 95% confidence interval, -4 to 19%). Thus, marked differences in HLA antigen frequency were found between populations of various geographic origins. Definition and ascertainment of the target population are therefore necessary in genetic studies of ageing. In such a 'birth-place-restricted comparison', the authors confirmed that ageing in women was negatively associated with HLA-B40 and positively associated with HLA-DR5.

The genetic basis for the association of the 8.1 ancestral haplotype (A1, B8, DR3) with multiple immunopathological diseases

An individual's major histocompatibility complex (MHC) ancestral haplotype (AH) is the clearest single determinant of susceptibility to MHC associated immunopathological disease, as it defines the alleles carried at all loci in the MHC. However, the direct effects of any of the 150-200 genes that constitute the MHC are difficult to determine since recombination only occurs at defined hotspots. This review concerns the 8.1 AH (HLA-A1, C7, B8, C4AQ0, C4B1, DR3, DQ2), which is carried by most Caucasians with HLA-B8. It is associated with accelerated human immunodeficiency virus (HIV) disease, and susceptibility to insulin-dependent diabetes mellitus (IDDM), systemic lupus erythematosus, dermatitis herpetiformis, common variable immunodeficiency and IgA deficiency, myasthenia gravis and several other conditions. We have mapped susceptibility genes for HIV, IDDM and myasthenia gravis to the central MHC between HLA-B and the tumour necrosis factor or complement genes. Here we consider which of the remaining 8.1-associated diseases are more closely associated with HLA-DR3 and/or DQ2. Several candidate genes in the central MHC have the potential to modulate immune or inflammatory responses in an antigen-independent manner, as is seen in studies of cultured cells from healthy carriers of the 8.1 AH. Hence these genes may act as a common co-factor in the diverse immunopathological conditions associated with the 8.1 AH.

HLA and longevity or aging among Shanghai Chinese

Twenty-two centenarians and one hundred and seventy-nine nonagenarians (mean age 93 +/- 1.04 years) in the Shanghai Region of China were phenotyped for alleles of A (13 types), B (21 types) and C (6 types) loci of the human leukocyte antigen (HLA). The frequencies of HLA antigens were compared with 211 healthy adults whose ages ranged from 20 to 50 years. It was observed that A9 was highly associated with longevity (frequency in the longevity group is 38%, the control group 24%, P = 0.002). A30 showed marked inverse correlation (frequency in the longevity group is 8%, the control group 17%, P = 0.008). Cw3, Cw6 and Cw7 were also inversely correlated (P = 0.02, 0.04 and 0.02, respectively). Thus, it is likely that A9 may contribute to longevity while A30, Cw3, Cw6 and Cw7 may be associated with aging. The average superoxide dismutase (SOD) contents of erythrocytes in 48 cases with the HLA-A9 (without A30) antigen in the longevity group and in 13 cases with the HLA-A30 (without A9) antigen in the control group were 555 +/- 96 and 593 +/- 58 micrograms/gHb, respectively (t = 1.375, P > 0.05).

The association between human leucocyte antigens (HLA) and mortality in community residents aged 85 and older

OBJECTIVE

The association between Human Leucocyte Antigens (HLA) and aging was investigated. It is possible that HLA antigens are associated with longevity, either indirectly through disease associations or directly through involvement in the aging mechanism.

DESIGN

Community-based follow-up study.

SETTING

Leiden, the Netherlands.

PARTICIPANTS

A total of 919 subjects were HLA typed in this community-based study. All subjects were aged 85 and older and were white. Seventy-two percent of the cohort was female.

MEASUREMENTS

Age- and sex-adjusted Mortality Rate Ratios (MRR) were estimated for 79 antigens by the subject-years method. HLA-A, -B and -C typing was performed with the standard NIH lymphocytotoxicity test, HLA-DR and -DQ typing was performed with the two-color fluorescence test. Homozygosity for HLA-A, -B, and -DR was defined as only one detectable antigen at a locus.

RESULTS

The mean follow-up period (SD) was 5.0 (0.6) years. At the end of the follow-up, 70% of the subjects had died. The MRR (95% CI) for B60 was 0.96 (0.75-1.23), and for DR11 it was 0.82 (0.66-1.01). For A2 and A26 only, the MRR (95% CI) was significantly different from 1: 0.85 (0.73-0.99), P = .04 and 1.45 (1.06-1.99), P = .02, respectively (P values not corrected for the number of antigens tested). Homozygosity was not associated with mortality.

CONCLUSIONS

HLA was not associated with mortality after the age of 85. Therefore, direct involvement of HLA in aging is unlikely. We suggest that the findings of previous studies are attributable to methodological shortcomings such as small sample size and differences in genetic background of the subjects.

Is the phenotypic combination A1B8Cw7DR3 a marker for male longevity?

OBJECTIVE

To study whether individual Human Leucocyte Antigens (HLA) at the HLA 1 or 11 loci or the phenotypic combination A1B8Cw7DR3 were associated with longevity.

DESIGN

Direct comparison of the > 90-year-old subjects with a control group.

SETTING

Northern Ireland population with little migratory mobility.

SUBJECTS

The > 90-year-old group (79 females, 38 males) was compared with a control group consisting of 150 unrelated blood donors (81 females, 69 males).

MEASUREMENTS

Human Leucocyte Antigen (HLA) Class 1 typing was carried out on 117 nonagenarians (mean age 93.7 years) and 150 younger controls (mean age 33.7 years) using conventional serological methods; HLA DR typing was carried out on 102 of the 117 > 90-year-old subjects, together with the 150 control subjects, and performed using restriction fragment length polymorphisms. The frequency of the phenotypic combination A1B8Cw7DR3 was measured in both groups.

RESULTS

There were no significant differences in the HLA antigen frequencies between the very elderly groups and the younger subjects at the A, B, C, and DR loci. The phenotypic combination A1B8Cw7DR3 was significantly increased (X3) in nonagenarian men compared with young men but not between elderly women and young women. There was a trend for increased representation of this phenotype in elderly men compared with women of the same age.

CONCLUSIONS

The frequency of the supratype A1B8Cw7DR3 was significantly increased in very elderly men but not in elderly women. Since this phenotypic combination has been associated with immune surveillance and/or hyperactivity in Caucasians, there is the suggestion that it could influence longevity through immune mechanisms but that sex differences may exist in its influence and expression.

Longevity and heredity in humans. Association with the human leucocyte antigen phenotype

Several arguments support the idea of a link between longevity and heredity, both in experimental animals and in the human species. In mice, genes in the major histocompatibility complex (MHC) are associated with a significant effect on life span. Results of analogous studies in man are confusing and contradictory. We have therefore investigated the question of an association of the human leucocyte antigen (HLA) and longevity in a large and ethnically homogeneous population. Our study population consisted of all 964 available inhabitants aged 85 years and over in the Dutch community of Leiden (pop. 104,000). Our control group comprised 2444 young inhabitants, aged 20-35 years, with an identical ethnic and demographic background. In addition, control groups of different age-brackets from the same region were used. Two antigens differed in frequency: HLA-B40 was lower and HLA-DR5 was higher in the group of 85 years and over, as compared to the control group, aged 20-35 years. Both differences were more evident in females. No major disease associations with HLA-B40 or HLA-DR5 have been reported. It is unlikely that these results are a chance observation: the overall similarity of the HLA pattern of the old and young age groups is a confirmation of their identical ethnic and demographic background and the changes as observed in the different age-groups were gradual. The biological meaning of these results is still unclear.

Human leucocyte antigens and tardive dyskinesia

HLA status was assessed in matched groups of schizophrenics, 20 with and 20 without tardive dyskinesia. The antigen frequencies were also compared with that in a control sample. The anticipated excess of HLA-B44 was not confirmed. Pooled data displayed a shortfall of HLA-Cw7 and an excess of HLA-B44 in schizophrenics relative to population controls.

Genetic markers in late paraphrenia: a study of HLA antigens

Patients with late paraphrenia were typed for HLA-A, -B and -C. Increased frequencies of BW55 (P = 0.036), B37 (P = 0.008) and CW6 (P = 0.056) were found relative to controls. Unlike findings in paranoid schizophrenia, there was no HLA-A9 association, suggesting that paraphrenics may be genetically distinct from schizophrenics. The primary association seems to be with B37, which has the lowest corrected P value and highest relative risk; if this were replicated, it would make possession of this antigen a strong risk factor for developing the disorder.

HLA-A, B and DR in Caucasians with transitional cell carcinoma of the bladder

When HLA-A, B and DR antigens in Caucasian patients with transitional cell carcinoma of the urinary bladder were compared with controls, no significant alterations in antigen frequencies were found.