Adverse effect of chronic tonsillitis on clinical course of sarcoidosis in relation to HLA distribution.
We examined the effect of chronic inflammatory foci in the upper respiratory tract and/or HLA class 2 antigens on the clinical course of sarcoidosis. Sarcoidosis resolved spontaneously in 6 of 27 (22 percent) patients with CTL and in 19 of 29 (66 percent) without CTL (p less than 0.01). The clinical course became favorable after TLT in 7 of 14 cases with CTL. Patients with HLA-DR9 and DRw8 showed the highest ratio of patients who had protracted clinical course; those with HLA-DR2, DR5 and DR6 showed the lowest; and those with HLA-DR4, DRw52 and Drw53 were between these levels. A high responsiveness to SCW antigens was seen more frequently in sarcoidosis patients with protracted clinical course. The high responsiveness to SCW antigens was related to HLA-DR4, DRw8, DR9 and DRw53 in sarcoidosis patients. HLA antigens, especially HLA-DR, modulate the immune response to inhaled antigenic agents. Immune response seemed to affect the clinical course of sarcoidosis.
Ikeda
T
T
Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hayashi
S
S
Kamikawaji
N
N
Sasazuki
T
T
Shigematsu
N
N
D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology; D002648:Child; D002908:Chronic Disease; D005260:Female; D006680:HLA Antigens / Q000032:analysis*; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D013291:Streptococcus / Q000276:immunology; D014069:Tonsillitis / Q000150:complications*
D000942:Antigens, Bacterial; D006680:HLA Antigens; D006684:HLA-DR Antigens