Reduced frequency of HLA-DQ6 in individuals with a positive direct antiglobulin test.
BACKGROUND
The association between HLA class II antigens and the production of red cell autoantibodies was investigated in this study.


METHODS
Thirty-one individuals with a positive direct antiglobulin test (DAT) and 85. DAT-negative controls (cadaveric organ donors) were typed using a DNA-based method for class II HLA typing, that is, the polymerase chain reaction with sequence-specific primers. Amplified HLA alleles corresponding to the serologic specificities DR 1-18 and DQ 1-9 were identified.


RESULTS
Analysis of DR and DQ frequencies showed that HLA-DQ6 was less frequent in DAT-positive individuals (19% vs. 53% in the control population), with a p value of 0.0014 and a corrected p value of 0.059, and relative risk of 0.23 (95% Cl = 0.09-0.58). The frequency of HLA-DQ6 was higher in asymptomatic DAT-positive blood donors (n = 8, 38% DQ6 positive, p = 0.48) than in DAT-positive hospital and clinic patients (n = 23, 13% DQ6 positive, corrected p value = 0.030, relative risk = 0.13, 95% Cl = 0.04-0.41), 96 percent of whom had evidence of clinical hemolysis.


CONCLUSIONS
This study demonstrates that HLA-DQ6 may have a negative association with a positive DAT result in patients with evidence for hemolysis, and may be a resistance antigen for clinically relevant red cell autoantibodies.
Wang-Rodriguez
J
J
School of Medicine, University of California, San Diego, La Jolla, USA.
Rearden
A
A
D000328:Adult; D000368:Aged; D000483:Alleles; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000235:genetics* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D003298:Coombs Test; D004198:Disease Susceptibility; D005260:Female; D005787:Gene Frequency; D005802:Genes, MHC Class II; D006683:HLA-DQ Antigens / Q000032:analysis* / Q000235:genetics / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D018807:Polymorphism, Single-Stranded Conformational
D001323:Autoantibodies; D006683:HLA-DQ Antigens; C063831:HLA-DQ6 antigen