title: HLA and tumour necrosis factor (TNF) polymorphisms in ocular Behçet's disease.
abstract: The role of HLA-B*51 and other major histocompatibility complex (MHC) genes in Behçet's disease (BD) remains unknown. We have performed HLA and tumour necrosis factor (TNF) polymorphism analysis in BD and evaluated their contribution to ocular disease. In this study, 102 patients and 115 controls of Middle Eastern descent were investigated by HLA and B*51 subtyping using novel primers, and by LT alpha NCo 1 and TNF 308 promoter polymorphism analysis. The frequency of the HLA-B*51 family of alleles was raised in patients compared to controls (66% vs. 15%, Pc=2.5x10(-12), OR=10.9). The odds ratio (OR) of this group of alleles for subgroups of patients was as follows: non-ocular patients 7.8, all ocular patients 12.6, blind patients >22. HLA-B*51 subtyping detected B*5101, 07, 08 and 09 alleles, with a similar frequency among patients and controls. HLA-Cw*1602 was associated with B*5108, but was not an independent risk factor for disease. The LT alpha (TNFB*2) allele was associated with HLA-B*51 among patients and the frequency of this allele was significantly higher among completely blind patients compared to both non-ocular patients (P=0.048, OR >3.6) and to healthy controls (P=0.022, OR >4.3). The rare TNF-2 polymorphism at the TNF -308 promoter position was associated with HLA-B*50 (not B*51), and was not associated with BD. Thus, in this population the HLA*B51 family of alleles is a strong risk factor for BD, and in particular the development of ocular disease. HLA-B*51 subtyping did not define new markers for BD. A primary role for TNF gne polymorphisms in BD was not identified, but co-expression of the TNFB*2 allele with HLA-B*51 may contribute to severity of ocular disease.
authors.affiliation: St Thomas' Hospital, King's College, London, UK. dverity@rayne.umds.c.uk
authors.forename: D H
authors.initials: DH
authors.lastname: Verity
authors.forename: G R
authors.initials: GR
authors.lastname: Wallace
authors.forename: R W
authors.initials: RW
authors.lastname: Vaughan
authors.forename: E
authors.initials: E
authors.lastname: Kondeatis
authors.forename: W
authors.initials: W
authors.lastname: Madanat
authors.forename: H
authors.initials: H
authors.lastname: Zureikat
authors.forename: F
authors.initials: F
authors.lastname: Fayyad
authors.forename: J E
authors.initials: JE
authors.lastname: Marr
authors.forename: C A
authors.initials: CA
authors.lastname: Kanawati
authors.forename: M R
authors.initials: MR
authors.lastname: Stanford
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001528:Behcet Syndrome / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics*; D015235:HLA-B Antigens / Q000235:genetics; D059949:HLA-B51 Antigen; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D000949:Histocompatibility Antigens Class II / Q000235:genetics; D006650:Histocompatibility Testing; D006801:Humans; D007597:Jordan; D008297:Male; D008875:Middle Aged; D008877:Middle East; D011110:Polymorphism, Genetic / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length; D011401:Promoter Regions, Genetic / Q000235:genetics; D012307:Risk Factors; D012737:Sex Factors; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
chemical_list: D006680:HLA Antigens; D015235:HLA-B Antigens; D059949:HLA-B51 Antigen; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D014409:Tumor Necrosis Factor-alpha