title: A strong association between thyrotropin receptor-blocking antibody-positive atrophic autoimmune thyroiditis and HLA-DR8 and HLA-DQB1*0302 in Koreans.
abstract: We investigated whether the associations between HLA alleles of patients with autoimmune hypothyroidism varied according to the presence or absence of TSH receptor-blocking antibody (TRBab). We analyzed the HLA-A, -B, -C, and -DR antigens by serotyping and the DQA1 and DQB1 genes using both enzymatic DNA amplification and sequence-specific oligonucleotide hybridizations. The patient population consisted of 47 Korean patients with atrophic autoimmune thyroiditis and 62 patients with goitrous autoimmune thyroiditis. The antigen frequency of HLA-DR8 was significantly increased in 23 atrophic autoimmune thyroiditis patients that were positive for TSH binding inhibitor immunoglobulin (TBII) compared to 136 controls [52% vs. 16%; chi 2 = 13.1; Pc (corrected P value) = 0.003]. This relative risk was 5.7; the etiological fraction was 0.43. HLA-DQB1*0302 was also increased in patients with TBII-positive atrophic autoimmune thyroiditis (24% vs. 7%; chi 2 = 11.2; Pc = 0.012; relative risk = 4.4; etiological fraction = 0.19). No specific DR antigens or DQB1 alleles were increased in either TBII-negative atrophic autoimmune thyroiditis or goitrous autoimmune thyroiditis. A significant decrease in the frequency of HLA-DR6 antigen was observed in both TBII-positive atrophic autoimmune thyroiditis (0% vs. 32%; chi 2 = 8.4; Pc = 0.03) and goitrous autoimmune thyroiditis (0% vs. 32%; chi 2 = 23.2; Pc < 0.001) patients. The frequency of the HLA-Cw1 antigen was significantly increased in all patient groups. We conclude that TRBab-positive atrophic autoimmune thyroiditis is immunogenetically different from both goitrous autoimmune thyroiditis and TRBab-negative atrophic autoimmune thyroiditis. It is possible that HLA-DR8 and/or DQB1*0302 may be related to the susceptibility genes involved in the production of TRBab in Koreans.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Korea.
authors.forename: B Y
authors.initials: BY
authors.lastname: Cho
authors.forename: J H
authors.initials: JH
authors.lastname: Chung
authors.forename: Y K
authors.initials: YK
authors.lastname: Shong
authors.forename: Y B
authors.initials: YB
authors.lastname: Chang
authors.forename: H
authors.initials: H
authors.lastname: Han
authors.forename: J B
authors.initials: JB
authors.lastname: Lee
authors.forename: H K
authors.initials: HK
authors.lastname: Lee
authors.forename: C S
authors.initials: CS
authors.lastname: Koh
mesh_terms: D000328:Adult; D000483:Alleles; D001323:Autoantibodies / Q000097:blood*; D001483:Base Sequence; D005260:Female; D005787:Gene Frequency; D015236:HLA-C Antigens / Q000032:analysis; D006683:HLA-DQ Antigens / Q000032:analysis* / Q000235:genetics; D059866:HLA-DQ beta-Chains; D006684:HLA-DR Antigens / Q000032:analysis*; D059810:HLA-DR Serological Subtypes; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating; D007723:Korea; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D013967:Thyroiditis, Autoimmune / Q000235:genetics / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015236:HLA-C Antigens; C047431:HLA-Cw1 antigen; D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D006684:HLA-DR Antigens; D059810:HLA-DR Serological Subtypes; C041559:HLA-DR8 antigen; D018828:Immunoglobulins, Thyroid-Stimulating