title: HLA class 1 associations in Henoch Schonlein purpura: increased and decreased frequencies.
abstract: Henoch Schonlein purpura (HSP) is the most common vasculitis of childhood. Susceptibility to HSP and associated clinical heterogeneity in HSP may be conferred by a number of genetic loci, including the major histocompatibility complex. We aimed to investigate the implications of the human leukocyte antigen (HLA) class 1 alleles in susceptibility to HSP and determine the possible associations with renal, gastrointestinal (GI), and joint manifestations of the disease. 110 children with HSP (66 boys, 44 girls) and 250 unrelated healthy controls were enrolled in the study. The mean age was 8.65 +/- 3.59 years. HSP was diagnosed on the basis of clinical and laboratory data according to the American College of Rheumatology classification. The diagnosis was supported with skin and/or kidney in most of the patients. Clinical and laboratory findings revealed: skin involvement in 110 (100%), joint manifestations in 82 (74.5%), GI symptoms in 58 (52.7%), and hematuria and/or proteinuria in 36 (32.7%) patients. HLA class 1 alleles were identified by DNA amplification, hybridized with specific primer sequences. Comparison of frequencies between patients and controls were made by using the Fisher's exact test. Odds ratio (OR) was used as the measure of association. HLA A2, A11, and B35 antigens showed an increased risk for predisposition to HSP (OR = 1.714, 95%CI = 1.088-2.700, p = 0.020; OR = 2.185, 95%CI = 1.289-3.703, p = 0.003; and OR = 2.292, 95%CI = 1.451-3.619, p = 0.000, respectively), while HLA A1, B49, and B50 antigens revealed decreased risk for predisposition to HSP (OR = 4.739, 95%CI = 1.828-12.345, p = 0.001; OR = 3.268, 95%CI = 0.955-11.236, p = 0.047; and OR = 7.462, 95%CI = 0.975-55.555, p = 0.024, respectively). Considering the renal involvement and severity of proteinuria, there was no association with HLA class 1 alleles. Our results suggest that the increased frequency of HLA A2, A11, and B35 alleles in unselected pediatric HSP patient population and miscarrying of HLA A1, B49, and B50 could be considered as a risk factor for susceptibility to HSP.
authors.affiliation: Department of Pediatric Nephrology, Gazi University Hospital, Besevler, Ankara, Turkey, 06540. peruharun@yahoo.com
authors.forename: Harun
authors.initials: H
authors.lastname: Peru
authors.forename: Oguz
authors.initials: O
authors.lastname: Soylemezoglu
authors.forename: Sevim
authors.initials: S
authors.lastname: Gonen
authors.forename: Aysun
authors.initials: A
authors.lastname: Cetinyurek
authors.forename: Sevcan Azime
authors.initials: SA
authors.lastname: Bakkaloğlu
authors.forename: Necla
authors.initials: N
authors.lastname: Buyan
authors.forename: Enver
authors.initials: E
authors.lastname: Hasanoglu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000235:genetics / Q000276:immunology; D005787:Gene Frequency; D005805:Genes, MHC Class I; D020022:Genetic Predisposition to Disease; D015235:HLA-B Antigens / Q000097:blood / Q000235:genetics; D015395:Histocompatibility Antigens Class I / Q000097:blood / Q000235:genetics*; D006650:Histocompatibility Testing; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000235:genetics* / Q000276:immunology; D007592:Joint Diseases / Q000209:etiology / Q000235:genetics / Q000276:immunology; D007674:Kidney Diseases / Q000209:etiology / Q000235:genetics / Q000276:immunology; D008297:Male; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D011507:Proteinuria / Q000209:etiology / Q000235:genetics / Q000276:immunology
chemical_list: D015235:HLA-B Antigens; D015395:Histocompatibility Antigens Class I