title: Strong association of antiepithelial cell antibodies with HLA-DR3 or DR7 phenotype in patients with recurrent oral ulcers.
abstract: BACKGROUND
  Previous studies showed that antiepithelial cell antibodies (anti-ECA) were present in 71% (15/21) of patients with recurrent oral ulcers (ROU) and that there was a strong association of human leukocyte antigen (HLA)-DRw9 with ROU in Chinese patients. In this study, we assessed anti-ECA in a larger group of Chinese patients with ROU (n = 88) in order to further investigate the association of anti-ECA with HLA-DR and -DQ antigens.
  
  
  METHODS
  The anti-ECA in the sera of ROU patients were detected by an indirect immunofluorescence technique with rat esophagus as the substrate, and the HLA-DR and -DQ antigens in ROU patients were typed by a standard microcytotoxicity assay using Terasaki's oriental tray.
  
  
  RESULTS
  The rate of anti-ECA positivity was significantly higher (p < 0.0001) in ROU patients (68%) than in healthy control subjects (0%). Furthermore, the rate of anti-ECA positivity in patients with major or minor oral ulcers (72%) was significantly higher (29%) than that in patients with herpetiform ulcers (p < 0.05). There was a significant increase in the frequency of DR3 or DR7 antigen expression (p < 0.0001, pc [p corrected] < 0.001, relative risk [RR] = 4.3, etiologic fraction = 0.41) in anti-ECA-positive ROU patients compared with the corresponding frequencies in healthy control subjects. There was also a significant increase in the frequency of DR7 or DRw9 antigen expression (p < 0.005, pc < 0.05, RR = 4.7, etiologic fraction = 0.45) compared to healthy controls.
  
  
  CONCLUSIONS
  Because only DR3 or DR7 antigen occurred more frequently in anti-ECA-positive than in anti-ECA-negative ROU patients (p < 0.0007, pc < 0.05, RR = 19.6, etiologic fraction = 0.51), we concluded that the gene coding for DR3 or DR7 antigen may contribute to the presence of anti-ECA in Chinese patients with ROU.
authors.affiliation: School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: A
authors.initials: A
authors.lastname: Sun
authors.forename: R P
authors.initials: RP
authors.lastname: Hsieh
authors.forename: B Y
authors.initials: BY
authors.lastname: Liu
authors.forename: J T
authors.initials: JT
authors.lastname: Wang
authors.forename: J S
authors.initials: JS
authors.lastname: Leu
authors.forename: Y C
authors.initials: YC
authors.lastname: Wu
authors.forename: C P
authors.initials: CP
authors.lastname: Chiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001323:Autoantibodies / Q000032:analysis*; D002648:Child; D004847:Epithelial Cells / Q000276:immunology*; D005260:Female; D006683:HLA-DQ Antigens / Q000032:analysis; D015803:HLA-DR3 Antigen / Q000032:analysis*; D015809:HLA-DR7 Antigen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019226:Oral Ulcer; D010641:Phenotype; D012008:Recurrence
chemical_list: D001323:Autoantibodies; D006683:HLA-DQ Antigens; D015803:HLA-DR3 Antigen; D015809:HLA-DR7 Antigen