The Associations of Human Leukocyte Antigen Class I and Class II Alleles in Bullous Pemphigoid - European Medical Journal

The Associations of Human Leukocyte Antigen Class I and Class II Alleles in Bullous Pemphigoid

1 Mins
Dermatology
Authors:
Hui Fang,1 Xiaodong Zheng,2 Liangdan Sun,2 *Gang Wang1
Disclosure:

The authors have declared no conflicts of interest.

Acknowledgements:

This study was supported by a grant from the National Natural Science Foundation of China (81220108016).

Citation:
EMJ Dermatol. ;5[1]:53-54. Abstract Review No. AR1.
Keywords:
Bullous pemphigoid (BP), human leukocyte antigen (HLA) Class I, human leukocyte antigen (HLA) Class II, haplotypes

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

Bullous pemphigoid (BP) is a complex, multifactorial autoimmune disease characterised by the presence of autoantibodies against BP autoantigens, leading to dermal-epidermal separation with consequent blister formation.1 Genetic, environmental, and stochastic factors contribute to susceptibility to most autoimmune diseases.2 Associations of genes, especially human leukocyte antigen (HLA)-DQ and HLA-DR alleles, with BP indicate that genetic predisposition contributes to the disease. Population studies have revealed that HLA Class II alleles are associated with BP in diverse ethnic groups, including British,3 German,4 Japanese,5 Chinese,6 and Iranian7 populations. However, BP has previously been found not to have HLA Class I associations. The objective of our study was to evaluate the association of HLA Class I and HLA Class II alleles with susceptibility to BP in the northern Chinese Han population.

We performed genotype investigations for HLA-A, HLA-B, HLA-C, HLA-G, HLA-DPA1, HLA-DPB1, HLA-DQA1, HLA-DQB1, and HLA-DRB1 loci in 105 patients with BP by using the Sanger sequence-based typing method. These data were compared with a local control cohort of 1,000 cases. Among the HLA alleles described herein, the susceptibility alleles associated with a high prevalence of BP were HLA-A*01:01 and 11:01, HLA-B*37:01, HLA-G*01:01 and 01:06, HLA-DQA1*01:05 and 05:05, HLA-DQB1*05:01, and HLA-DRB1*10:01 and 11:04. On the contrary, HLA-DQA1*01:02 and 01:03, HLA-DQB1*02:02, and HLA-DRB1*07:01 had significant associations with protection against BP. In addition, the frequencies of haplotypes HLA-DRB1*13/HLA-DQA1*05/HLA-DQB1*03 and HLA-DRB1*15/HLA-DQA1*01/HLA-DQB1*05 in BP patients were significantly higher than those in controls.

Susceptibility to BP is caused by a combination of genetic and environmental factors.1,8,9 Current thought postulates that a collection of common risk alleles mediates the development of an autoimmune-prone immune system which, when coupled with poorly defined environmental triggers, becomes dysregulated, leading to the development of autoantibodies and the initiation of disease pathologies.10 Major histocompatibility complex (MHC) Class I and II alleles are often the strongest risk factors associated with autoantibody-mediated diseases. In BP, the activation of antigen-specific B cells and secretion of autoantibodies depends on the interaction between the T cell receptor and classical MHC Class II molecules. Our HLA Class I and Class II profiles of Chinese BP patients, together with the previous reports on populations with BP worldwide, suggest that the alleles and haplotypes reported in this study may play crucial roles in autoimmune responses to BP antigens. In addition, our data indicate that genetic susceptibility differences in ethnic groups are maintained in patients living away from their countries of ethnic origin, underlining the importance of genetic risk factors in this disease. Furthermore, the relationships between the HLA alleles/haplotypes and autoimmune responses to BP antigens remain to be clarified.

References
Schmidt E, Zillikens D. Pemphigoid diseases. Lancet. 2013;381(9863):320-32. Tsai S, Santamaria P. MHC class II polymorphisms, autoreactive T-cells, and autoimmunity. Front Immunol. 2013;4:321. Banfield CC et al. The association of HLA-DQ7 with bullous pemphigoid is restricted to men. Br J Dermatol. 1998;138(6):1085-90. Büdinger L et al. Identification and characterization of autoreactive T cell responses to bullous pemphigoid antigen 2 in patients and healthy controls. J Clin Invest. 1998;102(12):2082-9. Okazaki A et al. Polymorphisms of HLA-DR and -DQ genes in Japanese patients with bullous pemphigoid. J Dermatol. 2000;27(3):149-56. Gao XH et al. HLA-DR and DQ polymorphisms in bullous pemphigoid from northern China. Clin Exp Dermatol. 2002;27(4):319-21. Esmaili N et al. Association between HLA-DQB1*03:01 and bullous pemphigoid in Iranian patients. Iran J Immunol. 2013;10(1):1-9. Zakka LR et al. Role of MHC class II genes in the pathogenesis of pemphigoid. Autoimmun Rev. 2011;11(1):40-7. Lo Schiavo A et al. Bullous pemphigoid: Etiology, pathogenesis, and inducing factors: facts and controversies. Clin Dermatol. 2013;31(4):391-9. Raj P et al. Regulatory polymorphisms modulate the expression of HLA class II molecules and promote autoimmunity. eLife. 2016;5:e12089.

Rate this content's potential impact on patient outcomes

Average rating / 5. Vote count:

No votes so far! Be the first to rate this content.