A case-control study on the association of human leukocyte antigen-A*9 and -B*15 alleles with generalized aggressive periodontitis in an Indian population

Association of human leukocyte antigens Class I and Class II antigens with chronic periodontitis in East India

CONTEXT

Human leukocyte antigens (HLAs) have an important role in the determination of susceptibility and resistance to periodontal diseases in humans, which may vary from population to population.

AIMS

The aim of this study was to find out the association of HLA Classes I and II genes with chronic periodontitis in East Indian population.

MATERIALS AND METHODS

In a cross-sectional study design, a total of sixty participants of chronic periodontitis (CP) (mean age: 44.12 ± 5.85) and sixty subjects of periodontal disease-free controls (NP) Periodontitis free controls (mean age 41.85 ± 7.71) were analyzed for their various HLA combinations using serologic (microlymphocytotoxicity test) method. The results are further compared with the HLA profile of 100 samples of blood donors for which periodontal status was unknown. All the data were statistically analyzed by applying Chi-square test.

RESULTS

HLA-B7 (P = 0.003), DR7 (P = 0.001), DR53 (P = 0.001), and DQ3 (P = 0.001) were identified as susceptible phenotypes to CP, whereas HLA-A1 (P = 0.010), A3 (P = 0.001), and Cw4 (P = 0.001) phenotypes were identified to be associated with disease resistance.

CONCLUSION

The HLA-B7, DR7, DR53, and DQ3 alleles may represent as risk factors for CP in Eastern Population of India, whereas HLA-A1, A3, and Cw4 may indicate to protective factors for CP of the same.

Association of interleukin-1 α (-889) gene polymorphism in patients with generalized aggressive and chronic periodontitis

BACKGROUND

There is a strong evidence that genetic as well as environmental factors affect the age of onset, severity and lifetime risk of developing periodontitis. The objective of the present study was to compare and to evaluate the association between interleukin (IL)-1α(-889) and gene polymorphisms in patients with generalized aggressive periodontitis, chronic periodontitis and healthy controls.

MATERIALS AND METHODS

A total of 60 Indian patients, with 20 aggressive periodontitis, 20 chronic periodontitis and 20 healthy controls were recruited for this study. From each patient, a volume of 2 ml of blood was collected by venipuncture in the ante-cubital fossa and was stored in sodium EDTA vacutainers and was used for genotyping assays with the polymerase chain reaction restriction fragment length polymorphism technique. Clinical parameters such as oral hygiene index, gingival index and clinical attachment loss (CAL) were evaluated for each patient. Genotype distribution between different groups were analyzed using Chi-square test. A P = 0.05 or less was set for significance.

RESULTS

The mean oral hygiene index was 3.7 ± 0.86 and 3.25 ± 0.30 for chronic and aggressive periodontitis cases respectively. The CAL was 4.29 ± 0.63 mm for chronic periodontitis and 6.44 ± 0.57 mm for aggressive periodontitis. Homozygous genotype 2,2 was more predominant in cases of aggressive periodontitis whereas in chronic periodontitis, heterozygous genotype 1,2 was more predominant when compared with others (P < 0.001). Odds ratio for aggressive versus chronic periodontitis was calculated as 6.2 (95% confidence interval 6.019-7.892).

CONCLUSION

The results of the present study support a positive association between aggressive periodontitis and the presence of the IL-1α-889, allele 2 polymorphism in Indian patients.

Risk factors of periodontal disease: review of the literature

Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: "periodontal disease," "periodontitis," "risk factors," and "causal." This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors.

Generalized aggressive periodontitis and its treatment options: case reports and review of the literature

Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.

Dominant suppression of Addison's disease associated with HLA-B15

CONTEXT

Autoimmune Addison's disease (AD) is the major cause of primary adrenal failure in developed nations. Autoantibodies to 21-hydroxylase (21OH-AA) are associated with increased risk of progression to AD. Highest genetic risk is associated with the Major Histocompatibility region (MHC), specifically human leukocyte antigen (HLA)-DR3 haplotypes (containing HLA-B8) and HLA-DR4.

OBJECTIVE

The objective of the study was the further characterization of AD risk associated with MHC alleles.

DESIGN, SETTING, AND PARTICIPANTS

MHC genotypes were determined for HLA-DRB1, DQA1, DQB1, MICA, HLA-B, and HLA-A in 168 total individuals with 21OH-AA (85 with AD at referral and 83 with positive 21OH-AA but without AD at referral).

MAIN OUTCOME MEASURE(S)

Genotype was evaluated in 21OH-AA-positive individuals. Outcomes were compared with general population controls and type 1 diabetes patients.

RESULTS

In HLA-DR4+ individuals, HLA-B15 was found in only one of 55 (2%) with AD vs. 24 of 63 (40%) 21OH-AA-positive nonprogressors (P = 2 × 10(-7)) and 518 of 1558 (33%) HLA-DR4 patients with type 1 diabetes (P = 1 × 10(-8)). On prospective follow-up, none of the HLA-B15-positive, 21-hydroxylase-positive individuals progressed to AD vs. 25% non-HLA-B15 autoantibody-positive individuals by life table analysis (P = 0.03). Single nucleotide polymorphism analysis revealed the HLA-DR/DQ region associated with risk and HLA-B15 were separated by multiple intervening single-nucleotide polymorphism haplotypes.

CONCLUSIONS

HLA-B15 is not associated with protection from 21OH-AA formation but is associated with protection from progression to AD in 21OH-AA-positive individuals. To our knowledge, this is one of the most dramatic examples of genetic disease suppression in individuals who already have developed autoantibodies and of novel dominant suppression of an autoimmune disease by a class I HLA allele.

Immunogenetics of drug-induced skin blistering disorders. Part II: Synthesis

The overall immunopathogenesis relevant to a large series of disorders caused by a drug or its associated hyperimmune condition is discussed based upon examining the genetics of severe drug-induced bullous skin problems (sporadic idiosyncratic adverse events including Stevens–Johnson syndrome and Toxic epidermal necrolysis). New results from an exemplar study on shared precipitating and perpetuating inner causes with other related disease phenotypes including aphtous stomatitis, Behçets, erythema multiforme, Hashimoto’s thyroiditis, pemphigus, periodic fevers, Sweet’s syndrome and drug-induced multisystem hypersensitivity are presented. A call for a collaborative, wider demographic profiling and deeper immunotyping in suggested future work is made.

Genetic affinities of north and northeastern populations of India: inference from HLA-based study

India is like a microcosm of the world in terms of its diversity; religion, climate and ethnicity which leads to genetic variations in the populations. As a highly polymorphic marker, the human leukocyte antigen (HLA) system plays an important role in the genetic differentiation studies. To assess the genetic diversity of HLA class II loci, we studied a total of 1336 individuals from north India using DNA-based techniques. The study included four endogamous castes (Kayastha, Mathurs, Rastogies and Vaishyas), two inbreeding Muslim populations (Shias and Sunnis) from north India and three northeast Indian populations (Lachung, Mech and Rajbanshi). A total of 36 alleles were observed at DRB1 locus in both Hindu castes and Muslims from north, while 21 alleles were seen in northeast Indians. At the DQA1 locus, the number of alleles ranged from 11 to 17 in the studied populations. The total number of alleles at DQB1 was 19, 12 and 20 in the studied castes, Muslims and northeastern populations, respectively. The most frequent haplotypes observed in all the studied populations were DRB1*0701-DQA1*0201-DQB1*0201 and DRB1*1501-DQA1*0103-DQB1*0601. Upon comparing our results with other world populations, we observed the presence of Caucasoid element in north Indian population. However, differential admixturing among Sunnis and Shias with the other north Indians was evident. Northeastern populations showed genetic affinity with Mongoloids from southeast Asia. When genetic distances were calculated, we found the north Indians and northeastern populations to be markedly unrelated.

Association between lactoferrin gene polymorphisms and aggressive periodontitis among Taiwanese patients

BACKGROUND AND OBJECTIVE

A dramatic difference in the frequencies of the Lys/Arg single nucleotide polymorphism in the lactoferrin genotype between a small population of patients with localized juvenile periodontitis and healthy subjects has been reported. As the single nucleotide polymorphism could be associated with ethnicity, the present study aimed to investigate the association between polymorphisms of the lactoferrin gene and periodontitis.

MATERIAL AND METHODS

Sixty-five patients with aggressive periodontitis, 278 with chronic periodontitis and 88 healthy controls were genotyped for the Lys/Arg polymorphism of the lactoferrin gene at position 29 [reference sequence (rs) 1126478] in the N-terminal alpha-helical region.

RESULTS

The frequencies of the GG genotype and the G allele were highest in the aggressive periodontitis group, followed by the chronic periodontitis group and then the healthy controls. The frequency of the G allele was significantly higher in aggressive periodontitis and chronic periodontitis groups than in healthy controls (p = 0.0037 and 0.0212). Although the difference of the GG genotype distribution between subjects with chronic periodontitis and healthy controls did not reach significance, the distribution of genotypes between aggressive periodontitis and healthy controls was significantly different. The association of the gene polymorphism and aggressive periodontitis still existed, even after adjusting for age, gender and smoking status by logistic regression analysis (GG/AG+AA: odds ratio = 2.16, 95% confidence interval = 1.09-4.35, p = 0.0287). After the study, subjects were further stratified by their smoking status; the GG genotype was still significantly associated with the risk of aggressive periodontitis in the nonsmoking group (odds ratio = 2.69, p = 0.018). However, there were no statistical differences between chronic periodontitis vs. healthy controls and aggressive periodontitis vs. healthy controls in the smoking group.

CONCLUSION

The present study revealed that the A/G polymorphism in the lactoferrin gene might be associated with aggressive periodontitis. The A allele might reduce the risk of development of aggressive periodontitis in a Taiwanese population. Our results also support the hypothesis that lactoferrin genetic polymorphisms could play a role in the risk for periodontitis separate from the smoking factor. The functionality of this gene's polymorphisms has to be further elucidated.