HLA-DRB1*12 is associated with protection against complicated typhoid fever, independent of tumour necrosis factor alpha.
We investigated whether HLA-DR2 or -DR12 alleles in 63 Javanese patients with complicated or non-complicated typhoid fever were associated with severity of disease. No association was observed between HLA type and susceptibility to disease. However, in patients we did find a negative association of DR12 (DRB1*12021) with complicated typhoid fever (P = 0.05; OR = 0.3; 95% CI: 0.1-1.0). No effect of DR2 (DRB1*1502) on outcome (P = 0.46; OR = 1.5; 95% CI: 0.5-4.5) was demonstrated. The odds ratio for DR12 remained unchanged after adjusting for DR2. Tumour necrosis factor alpha (TNF-alpha) production capacity in lipopolysaccharide (LPS)-stimulated whole blood culture, as measured by non-equilibrium radioimmunoassay, was significantly lower in complicated than in non-complicated cases (P = 0.02), confirming previous data. No significant correlation of either DR12 (P = 0.47) or DR2 (P = 0.89) was found with TNF-alpha production capacity. Apparently, protection against complications by DR12 is attributable to other mechanisms.
Dharmana
E
E
Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
Joosten
I
I
Tijssen
H J
HJ
Gasem
M H
MH
Indarwidayati
R
R
Keuter
M
M
Dolmans
W M V
WM
Van Der Meer
J W M
JW
D000293:Adolescent; D000328:Adult; D005260:Female; D020022:Genetic Predisposition to Disease; D006684:HLA-DR Antigens / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D014435:Typhoid Fever / Q000150:complications / Q000276:immunology / Q000517:prevention & control*
D006684:HLA-DR Antigens; D014409:Tumor Necrosis Factor-alpha