title: The HLA alleles DRB1*13 and DQB1*06 are associated to Whipple's disease.
abstract: OBJECTIVE
  Whipple's disease is a systemic, chronic, relapsing disorder caused by a combination of environmental (Tropheryma whipplei) and unknown host factors. Because it is a rare disease, the association between HLA type and Whipple's disease has been studied in only small numbers of patients; these studies have led to conflicting results. We aimed to investigate whether disease phenotype and outcome are associated with HLA type in 122 patients with Whipple's disease.
  
  
  METHODS
  Genomic DNA was collected from 103 German, 11 Italian, and 8 Austrian patients with Whipple's disease, along with 62 healthy Austrian workers exposed to T whipplei (14 stool samples contained the bacterium). HLA class I and II alleles were identified by polymerase chain reaction analysis. Patient genotypes were compared with those of healthy German and Austrian populations; data for Italian controls were obtained from the Pavia HLA bone marrow donors' bank.
  
  
  RESULTS
  HLA-DRB1*13 and DQB1*06 alleles occurred significantly more frequently in patients with Whipple's disease but not in healthy individuals who had been exposed to T Whipplei. The cumulative odds ratios for disease were 2.23 for the DRB1*13 allele (P < .0001) and 2.25 for the DQB1*06 allele (P < .0001).
  
  
  CONCLUSIONS
  DRB1*13 and DQB1*06 alleles were found to be risk factors in the largest HLA study ever performed in patients with Whipple's disease.
authors.affiliation: Immunohematology and Transfusion Centre, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Miryam
authors.initials: M
authors.lastname: Martinetti
authors.forename: Federico
authors.initials: F
authors.lastname: Biagi
authors.forename: Carla
authors.initials: C
authors.lastname: Badulli
authors.forename: Gerhard E
authors.initials: GE
authors.lastname: Feurle
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Verena
authors.initials: V
authors.lastname: Moos
authors.forename: Thomas
authors.initials: T
authors.lastname: Schneider
authors.forename: Thomas
authors.initials: T
authors.lastname: Marth
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marchese
authors.forename: Lucia
authors.initials: L
authors.lastname: Trotta
authors.forename: Sara
authors.initials: S
authors.lastname: Sachetto
authors.forename: Annamaria
authors.initials: A
authors.lastname: Pasi
authors.forename: Annalisa
authors.initials: A
authors.lastname: De Silvestri
authors.forename: Laura
authors.initials: L
authors.lastname: Salvaneschi
authors.forename: Gino R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000483:Alleles; D001317:Austria; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005787:Gene Frequency; D005819:Genetic Markers / Q000235:genetics; D020022:Genetic Predisposition to Disease; D005838:Genotype; D005858:Germany; D006683:HLA-DQ Antigens / Q000235:genetics* / Q000378:metabolism; D006684:HLA-DR Antigens / Q000235:genetics* / Q000378:metabolism; D059811:HLA-DRB1 Chains; D006801:Humans; D007558:Italy; D008297:Male; D016017:Odds Ratio; D016133:Polymerase Chain Reaction; D011336:Probability; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D054851:Tropheryma / Q000302:isolation & purification; D008061:Whipple Disease / Q000175:diagnosis / Q000235:genetics*
chemical_list: D005819:Genetic Markers; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains