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.

Inspection of Endothelial Nitric Oxide Synthase Gene Polymorphism in Patients With Henoch Schönlein Purpura

“…It has been reported that HLA A2, A11, and B35 antigens showed an increased risk for a predisposition to HSP and HSP patients with nephrotic proteinuria had higher HLA-DRB1*13 positivity. 22,23 Results of Amoli et al 24 supported the role of HLA B35 in the susceptibility for HSP patient with nephritis. In another study, transforming growth factor-beta (TGF-b) gene C509T polymorphism was associated with HSP.…”

HLA-B35, a common genetic trait, in a familial case of Henoch-Schoenlein purpura and Berger's disease

“…HLA-DRB1*01 allele is in linkage disequilibrium with HLA-B35, HLA-B14 and HLA-B27 in Caucasian populations. In particular, the HLA-B35 haplotype was previously described as related to an increased predisposition to HSP (Peru et al, 2008), to HSP recurrent forms (Nathwani et al, 1992) and HSP nephritis. All these clinical features were also associated with HLA-B35 in patient 1.…”

Association between HLA-A and -B polymorphisms and susceptibility to Henoch-Schönlein purpura in Han and Mongolian children from Inner Mongolia

“…We studied the correlation of HLA-A and -B polymorphisms in Mongolian and Han children with HSP and found that the susceptible loci of Mongolian patients were HLA-A*11 and HLA-B*15; HLA-A*11 was also reported to be associated with HSP (Peru et al, 2008). The protecting genes were HLA-B*07 and HLA-B*40, and HLA-B*40 was also the protecting gene for hemorrhagic fever in nephrotic syndrome (Luo et al, 2008).…”