Class II major histocompatibility complex typing across the ethnic barrier in pemphigoid gestationis. A study in Mexicans

Abstract

These results suggest that, in Mexicans, the genetic susceptibility for the development of PG is strongly influenced by the genetic admixture of Caucasian origin, and the role of class II MHC antigens in the pathophysiology of this disease is confirmed.

Polymorphisms of HLA‐DR and ‐DQ Genes in Japanese Patients with Bullous Pemphigoid

“…According to a recent study utilizing DNA typing, more than 85% (35/41) of patients with HG are positive for at least one allele of the HLA-DRB1*0301 or DRB1*04 subtypes (30). It is of note that all 8 reported Mexican patients with HG are heterozygous for HLA-DRB1 *0301/DQA1 *0501/DQB1 *0201 and HLA-DRB1 *04/ DQA1 *03/DQB1*0302 haplotypes (31).…”

A subset of patients with pemphigoid (herpes) gestationis has serological evidence of celiac disease

“…PG is associated immunologically with HLA alleles; HLA‐DR3 is present in 61–80%, HLA‐DR4 in 52%, and both HLA‐DR3/DR4 in 43–50% of patients . HLA‐DR3 and HLA‐DR4 have other autoimmune disease associations, and patients with PG have other autoimmune diseases as do family members .…”

“…An increased incidence of paternal HLA‐DR2 has been associated with maternal development of PG, the greatest in HLA‐DR3/DR4 mothers . Placental tissue derives from paternal genes, and a theory to explain the disease is that an immunological reaction with antibody formation occurs against class II antigens of paternal haplotype at the placental basement membrane zone, and that antibody then cross‐reacts with skin. A related theory is that the placental/skin antibodies cause low‐grade placental insufficiency resulting in preterm delivery and small‐for‐gestational age babies observed in patients with PG.…”

“…[10][11][12] The development of PG is genetically associated with the presence of the human leukocyte antigens (HLA) DR3 and DR4. [13][14][15][16] Celiac disease (CD), an immune-mediated disease triggered by dietary gluten ingestion, is characterized by inflammation of gastrointestinal mucosa with loss of absorptive villi, typically leading to abdominal pain, diarrhea, and malabsorption with nutritional deficiencies. 17 CD is also associated with HLA-DR3 and, more specifically, HLA-DQ2 and, to lesser extent, HLA-DQ8.…”

Pemphigoid Gestationis (Herpes Gestationis)

“…The etiology of PG is unknown, but there is an increased association with other autoimmune diseases [4][5][6] and HLA antigens: B8, DR3, and DR4 [7,8]. The PG antigen in 180 kD antigen (BPAG2) is present in the hemidesmosomes of the basement membrane [9].…”