HLA and autoimmune digestive disease: a clinically oriented review for gastroenterologists.
OBJECTIVE
The human leukocyte antigen (HLA) system includes genes involved in graft-vs-host rejection and in immune response. The discovery that HLAs are associated with several diseases led to appealing developments both in basic biomedical research and in clinical medicine, and offered the opportunity to improve the understanding of pathogenesis and classification of diseases, as well as to provide diagnostic and prognostic indicators. The aim of this article is to review the association between HLA alleles and autoimmune digestive disease and its current relationship with modern HLA nomenclature and clinical practice.


METHODS
Articles dealing with the association between HLAs and autoimmune digestive disease (including celiac disease, inflammatory bowel disease, autoimmune hepatitis, sclerosing cholangitis and primary biliary cirrhosis) were searched for using Pubmed and SCOPUS databases from earliest records to January 2008.


RESULTS
The review has provided two sections. In the first, we explain the basic principles of HLA structure, function, and nomenclature, as an introduction to the second section, which describes current associations between HLA alleles and digestive diseases. The clinical implications of each HLA association are critically discussed. Actually, a clinical role for HLA typing is suggested for only a few conditions, e.g., celiac disease.


CONCLUSIONS
The knowledge of current HLA nomenclature and of its association with some digestive diseases such as celiac disease can be useful in clinical practice for diagnostic and prognostic purposes. This can avoid improper HLA typing as well as stressing the need for further studies on other possible clinical applications.
Cassinotti
Andrea
A
Department of Clinical Science, Division of Gastroenterology, L. Sacco University Hospital, via G.B.Grassi 74, Milan, Italy. andreacassinotti@libero.it
Birindelli
Sarah
S
Clerici
Mario
M
Trabattoni
Daria
D
Lazzaroni
Marco
M
Ardizzone
Sandro
S
Colombo
Riccardo
R
Rossi
Edoardo
E
Porro
Gabriele Bianchi
GB
D001327:Autoimmune Diseases / Q000235:genetics / Q000276:immunology*; D002446:Celiac Disease / Q000235:genetics / Q000276:immunology; D015209:Cholangitis, Sclerosing / Q000235:genetics / Q000276:immunology; D004066:Digestive System Diseases / Q000235:genetics / Q000276:immunology*; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D019693:Hepatitis, Autoimmune / Q000235:genetics / Q000276:immunology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000235:genetics / Q000276:immunology; D008105:Liver Cirrhosis, Biliary / Q000235:genetics / Q000276:immunology
D006680:HLA Antigens