title: Different distribution of HLA class II and tumor necrosis factor alleles (TNF-308.2, TNFa2 microsatellite) in anti-topoisomerase I responders among scleroderma patients with and without exposure to quartz/metal dust.
abstract: OBJECTIVE
  To investigate the influence of quartz/ metal dust exposure on the pathogenesis of systemic sclerosis (SSc; scleroderma), by an immunogenetic comparison of HLA class II and tumor necrosis factor (TNF) alleles in patients with and without exposure.
  
  
  METHODS
  A retrospective study of 30 SSc patients exposed to quartz/metal dust (qSSc) and 50 patients with idiopathic SSc (iSSc) was conducted by DNA-based typing of HLA, TNF-308, and TNFa/b microsatellite alleles.
  
  
  RESULTS
  A neutral or protective haplotype in iSSc anti-topoisomerase I (anti-topo I) responders was found to be a susceptibility haplotype in qSSc patients. HLA-DRB1*0301 (DR3), a component of the extended haplotype HLA-DQA1*0501;B1*0201;DRB1*0301; TNF-308.2;TNFa2/b3, had a decreased frequency in iSSc anti-topo I responders compared with non-responders (P = 0.03, odds ratio [OR] 0.11, 95% confidence interval [95% CI] 0.00-0.95), but a significantly increased frequency in qSSc anti-topo I responders compared with controls and with iSSc anti-topo I responders (P = 0.00004, Pcorr = 0.006, OR 11.38, 95% CI 3.17-44.35 and P = 0.0002, Pcorr = 0.02, OR 30.0, 95% CI 2.05-986, respectively). In contrast, DRB1*1104 (DR5) and DRB1*11/15 (DR5/DR2) with no TNF-308.2 and TNFa2 alleles were prevalent in only the iSSc anti-topo I responders compared with controls (P = 0.0005, Pcorr = 0.04, OR 11.0; 95% CI 2.68-45.93 and P = 0.0002, Pcorr = 0.02, OR 12.43, 95% CI 3.65-40.04, respectively).
  
  
  CONCLUSIONS
  The mechanisms that lead to the development of anti-topo I in qSSc and iSSc patients are suggested to be distinct, although it is not clear that the two diseases themselves are different.
authors.affiliation: Technical University, Dresden, Germany.
authors.forename: K H
authors.initials: KH
authors.lastname: Frank
authors.forename: M
authors.initials: M
authors.lastname: Füssel
authors.forename: K
authors.initials: K
authors.lastname: Conrad
authors.forename: H P
authors.initials: HP
authors.lastname: Rihs
authors.forename: R
authors.initials: R
authors.lastname: Koch
authors.forename: B
authors.initials: B
authors.lastname: Gebhardt
authors.forename: J
authors.initials: J
authors.lastname: Mehlhorn
mesh_terms: D001323:Autoantibodies / Q000032:analysis; D004264:DNA Topoisomerases, Type I / Q000276:immunology*; D004391:Dust / Q000009:adverse effects; D005260:Female; D005802:Genes, MHC Class II / Q000235:genetics*; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects; D018895:Microsatellite Repeats; D011401:Promoter Regions, Genetic; D011791:Quartz / Q000009:adverse effects; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000209:etiology / Q000235:genetics* / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
chemical_list: D001323:Autoantibodies; D004391:Dust; D008670:Metals; D014409:Tumor Necrosis Factor-alpha; D011791:Quartz; D004264:DNA Topoisomerases, Type I