title: Association of high-altitude pulmonary edema with the major histocompatibility complex.
abstract: BACKGROUND
  A constitutional susceptibility has been suggested in the development of high-altitude pulmonary edema (HAPE) because HAPE generally affects healthy young people, some of whom suffer recurrent episodes. We examined whether immunogenetic susceptibility is present in HAPE-susceptible subjects.
  
  
  RESULTS
  The frequencies of human leukocyte antigen (HLA) alleles in 28 male and 2 female subjects with a history of HAPE were compared with those in 100 healthy volunteers. We assayed the HLA-A, -B, -C, -DR, and -DQ antigens serologically. The pulmonary hemodynamics on admission to the hospital and the ventilatory response to hypoxia and hypercapnia were retrospectively examined in 10 of the HAPE-susceptible subjects. HLA-DR6 was positive in 14 (46.7%) of the subjects with HAPE but only 16.0% of the control subjects (P=.0005), and HLA-DQ4 was positive in 12 (40.0%) of the subjects with HAPE but only 10.0% of the control subjects (P=.0001). HLA-DR6 or HLA-DQ4 was positive in 8 (100%) of the subjects with recurrent HAPE. The pulmonary arterial pressure on admission of the HLA-DR6-positive subjects with HAPE was significantly higher than that of the HLA-DR6-negative subjects with HAPE.
  
  
  CONCLUSIONS
  There were significant associations of HAPE with HLA-DR6 and HLA-DQ4 and of pulmonary hypertension with HLA-DR6. An immunogenetic susceptibility, which is associated with HLA class II alleles located within the major histocompatibility complex, may underlie the development of HAPE, at least in some of its forms.
authors.affiliation: First Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hanaoka
authors.forename: K
authors.initials: K
authors.lastname: Kubo
authors.forename: Y
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: T
authors.initials: T
authors.lastname: Miyahara
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuzawa
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Sekiguchi
authors.forename: M
authors.initials: M
authors.lastname: Ota
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000532:Altitude Sickness / Q000235:genetics* / Q000276:immunology*; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D006935:Hypercapnia / Q000235:genetics / Q000276:immunology; D006976:Hypertension, Pulmonary / Q000235:genetics / Q000276:immunology; D000860:Hypoxia / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D011654:Pulmonary Edema / Q000235:genetics* / Q000276:immunology*; D012129:Respiratory Function Tests; D012189:Retrospective Studies
chemical_list: D006680:HLA Antigens