title: Western versus Asian types of multiple sclerosis: immunogenetically and clinically distinct disorders.
abstract: The polymorphism of HLA-DRB1, -DRB3, and -DRB5 genes as well as magnetic resonance images of the brain and spinal cord were studied in 57 Japanese patients with multiple sclerosis (MS). Twenty-three patients clinically displayed selective involvement of the optic nerve and spinal cord and were classified as having Asian-type MS. The other 34 patients had disseminated central nervous system involvement and were classified as having Western-type MS. Patients with Asian-type MS had fewer brain lesions shown by magnetic resonance imaging, but more gadolinium-enhanced spinal cord lesions than did patients with Western-type MS (47% vs 17%). Furthermore, the DR2-associated DRB1*1501 allele and DRB5*0101 allele were associated with Western-type MS (41.2%), but not with either Asian-type MS (0%) or healthy control subjects (14.2%). Heterogeneity in the immunogenetic background and in the magnetic resonance imaging features between the two subtypes of MS thus suggests the presence of two etiologically distinct diseases in Asians.
authors.affiliation: Department of Neurology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Kira
authors.forename: T
authors.initials: T
authors.lastname: Kanai
authors.forename: Y
authors.initials: Y
authors.lastname: Nishimura
authors.forename: K
authors.initials: K
authors.lastname: Yamasaki
authors.forename: S
authors.initials: S
authors.lastname: Matsushita
authors.forename: Y
authors.initials: Y
authors.lastname: Kawano
authors.forename: K
authors.initials: K
authors.lastname: Hasuo
authors.forename: S
authors.initials: S
authors.lastname: Tobimatsu
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000483:Alleles; D001921:Brain / Q000503:physiopathology; D005260:Female; D005784:Gene Amplification; D006684:HLA-DR Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008285:Major Histocompatibility Complex; D008297:Male; D009103:Multiple Sclerosis / Q000235:genetics* / Q000276:immunology* / Q000503:physiopathology; D009900:Optic Nerve / Q000503:physiopathology; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology
chemical_list: D006684:HLA-DR Antigens