Human leucocyte antigen determinants of susceptibility to Barrett's oesophagus in Asians--a preliminary study.
BACKGROUND
Characteristic immune profiles have been demonstrated in gastro-oesophageal reflux disease. However, the genetic basis of gastro-oesophageal reflux disease remains unclear.


OBJECTIVE
To investigate whether certain human leucocyte antigen genes are associated with Barrett's oesophagus.


METHODS
Asian patients of Malay, Chinese and Indian descent with Barrett's oesophagus (n = 59) and those without reflux symptoms and a normal oesophagus (n =60) were recruited prospectively using endoscopic and histopathological criteria. Human leucocyte antigen class I and II typing was performed using a polymerase chain reaction sequence-specific primers method.


RESULTS
The HLA-B7 allele was present in 17% (10 of 59) of patients with Barrett's oesophagus when compared with 0% (zero of 60) of controls [P = 0.0006, corrected P = 0.0171, OR = 25.67]. Subgroup analysis revealed that the HLA-B7 allele was confined almost exclusively to Indians with Barrett's oesophagus, 43% (nine of 21) vs. 0% (zero of 19) Indian controls (P = 0.0014, corrected P = 0.0406, OR = 29.64). No class II associations, protective human leucocyte antigens or extended haplotypes for disease susceptibility were identified.


CONCLUSIONS
Barrett's oesophagus in Asians, particularly Indians, is strongly positively associated with HLA-B7; reinforcing a genetic component to gastro-oesophageal reflux disease. A larger sample size and different ethnic populations should be genotyped to further confirm this association and identify possible additional risk factors in the human leucocyte antigen locus.
Rajendra
S
S
Division of Gastroenterology, Department of Medicine, Royal Perak College of Medicine, Ipoh, Malaysia. shanraj@pd.jaring.my
Ackroyd
R
R
Murad
S
S
Mohan
C
C
Ho
J J
JJ
Goh
K L
KL
Azrena
A
A
Too
C L
CL
D044466:Asian People / Q000235:genetics*; D001471:Barrett Esophagus / Q000235:genetics* / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000235:genetics; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D000949:Histocompatibility Antigens Class II / Q000235:genetics*; D006650:Histocompatibility Testing; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II