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HLA class II allele polymorphism in Hungarian patients with systemic lupus erythematosus
  1. E Endreffy1,
  2. A Kovács2,
  3. L Kovács2,
  4. G Pokorny2
  1. 1Department of Paediatrics, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Korány fasor 14–15, Szeged, Hungary
  2. 2Department of Rheumatology, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Korány fasor 14–15, Szeged, Hungary
  1. Correspondence to:
    Dr E Endreffy;
    endreffy{at}pedia.szote.u-szeged.hu

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Recently, a comprehensive study was published on HLA class II DNA typing in a large cohort of European patients with SLE.1 Independently of this collaborative study, we have examined similar DRB1, DQA1, and DQB1 allele polymorphisms and clinical features in Hungarian patients with SLE.

Fifty patients with SLE (48 female; mean age at the time of the examinations 41 years (range 21–76)) and 50 healthy blood donors matched for age and sex with the controls were examined. Genotyping of HLA-DRB1 alleles was carried out with the Dynal RELI SSO HLA-DRB kit, and the DRB1*15/16 subtyping by the method of Ota et al.2 DQA1 determination was performed by the method of Ota et al.3 The DQB1 typing was carried out with the INNO-LiPA DQB kit. A χ2 test with Yates’s correction was used for statistical analysis. The significance levels (p<0.05) were adjusted by using Bonferroni’s correction to eliminate chance associations (pc value). Odds ratio (OR) values were also calculated.

The main clinical manifestations were articular involvement (92%), anaemia (72%), leucopenia (54%), pericarditis and/or pleuritis (54%), and nephritis (32%).

The DRB1*1501, DRB1*03, and DRB1*07 alleles occurred more frequently in the patients with SLE than in the controls (12/50 (24%) v 3/50 (6%); 20/50 (40%) v 10/50 (20%) and 17/50 (34%) v 6/50 (2%), respectively; ORs 4.4, 2.25, and 3.2, respectively). The DQA1*0102 and *05011 alleles were also more common in the SLE group than in the controls (25/50 (50%) v 13/50 (26%), and 20/50 (40%) v 9/50 (18%), respectively; ORs 2.23 and 2.3, respectively). Of the DQB1 alleles, *0201 and *0602 were detected more frequently in the patients with SLE than in the controls (20/50 (40%) v 8/50 (16%), and 11/50 (22%) v 2/50 (4%), respectively; ORs 2.87 and 6.05, respectively). After the Bonferroni’s correction the above mentioned differences did not reach significance.

In contrast, the DRB1*04 and DRB1*11/12 alleles were less common in the patients with SLE than in the controls (3/50 (6%) v 16/50 (32%) and 15/50 (30%) v 25/50 (50%)). The *04 allele was linked with resistance to leucopenia (pc=0.01), the *11/12 alleles with resistance to discoid skin lupus (pc=0.001). The 1106 subtype of the DRB1*11 alleles occurred only in the patients with SLE (4/16 (25%) v 0/25 (0%)).

Connections between the genetic and clinical characteristics were as follows: the DRB1*1501 positivity was less frequent in the patients with than in those without lupus nephritis (LN) (3/16 (19%) v 15/34 (44%)). In contrast, the DRB1*03 and DRB1*07 alleles were more frequent in the patients with than in those without LN (8/16 (50%) v 11/34 (32%) and 7/16 (44%) v 8/34 (24%)). In the patients with pleuritis and/or pericarditis, only the DRB1*07 positivity was more frequent than in the patients without serositis (12/27 (44%) v 3/23 (13%)). The *07 allele was detected more frequently in the patients with one or more severe renal, cardiorespiratory manifestations than in the patients without these potentially fatal features of the disease (16/36 (44%) v 0/14 (0%)). In the patients with anti-SSA and anti-SSB positivity the renal and cerebral involvement was more common, but the differences were not significant (4/8 (50%) v 9/33 (27%) and 2/8 (25%) v 3/33 (9%)).

A comparison with the results of the comprehensive European study showed that agreement was complete for the increased prevalence of the DRB1*1501, DRB1*03, DQA1*0102, DQB1*0201, and DQB1*0602 alleles in the patients with SLE. We could not detect increased frequencies of the DQB1*0303 and DQB1*0502 alleles in our patients with SLE, and our patients with DRB1*1501 positivity exhibited a milder clinical course and a negative correlation with LN.

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