The HLA alleles DRB1*13 and DQB1*06 are associated to Whipple's disease.
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.
Martinetti
Miryam
M
Immunohematology and Transfusion Centre, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Biagi
Federico
F
Badulli
Carla
C
Feurle
Gerhard E
GE
Müller
Christian
C
Moos
Verena
V
Schneider
Thomas
T
Marth
Thomas
T
Marchese
Alessandra
A
Trotta
Lucia
L
Sachetto
Sara
S
Pasi
Annamaria
A
De Silvestri
Annalisa
A
Salvaneschi
Laura
L
Corazza
Gino R
GR
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*
D005819:Genetic Markers; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains