Evaluation of HLA Class II Alleles in Cases with Chronic Spontaneous Urticaria

Abstract

Objectives: Autoantibodies against high-affinity IgE receptor or IgE on the surface of mast cells and basophils are held responsible for etiopathogenesis in some cases with chronic spontaneous urticaria. Factors causing the development of autoimmunity are unknown. Genetic factors are known to play a role in autoimmunity and human leukocyte antigen (HLA) alleles are associated with many autoimmune diseases. Our study aimed to investigate the frequency of HLA class II alleles in patients with chronic spontaneous urticaria. Materials and Methods: In this cross-sectional study, HLA class II alleles were evaluated in the 80 cases with chronic spontaneous urticaria and in the control group consisting of 100 renal transplant donors. The case group was divided into subgroups by applying autologous serum skin test (ASST). HLA class II alleles were determined in chronic spontaneous urticaria cases with positive and negative ASST and the control group by molecular analysis method (Olerup SSP DQ-DR Combi tray, Genovision, Vienna, Austria). Results: ASST was found positive in 57.5% of the patients. The frequency of HLA DRB1*04 and HLA DQB1*08 alleles was found to be significantly higher in patients with chronic spontaneous urticaria compared to the control group. In contrast, the frequency of HLA DRB1*07 and HLA DQB1*09 alleles was significantly lower (p<0.05). When the ASST positive and negative case groups and the control group were compared, HLA DRB1*04 and HLA DQB1*08 alleles were higher in the ASST positive patient group (p<0.05). In the ASST negative patient group, HLA DRB1*01 and HLA DRB1*07 alleles were found in low frequency (p<0.05). Conclusion: The fact that there is a significantly higher frequency of HLA DRB1*04 and DQB1*08 alleles in cases with positive ASST and these alleles do not differ significantly from the control group in cases with negative ASST support the idea that autoimmune mechanisms are responsible for pathogenesis in some of the patients.

Keywords

• Genetic Predisposition
• HLA Class II Alleles
• Chronic Spontaneous Urticaria
• Autologous Serum Skin Test
• Autoimmunity

Kronik Spontan Ürtikerli Olgularda HLA Klas II Alellerinin Değerlendirilmesi

Abstract

Amaç: Kronik spontan ürtikerli olguların bir kısmında etiyopatogenezden mast hücreleri ve bazofillerin yüzeyindeki yüksek afiniteli IgE reseptörüne veya IgE’ye karşı oluşan otoantikorlar sorumlu tutulmaktadır. Otoimmünitenin gelişmesine neden olan faktörler bilinmemektedir. Genetik faktörlerin otoimmünitede rol oynadığı bilinmektedir ve insan lökosit antijeni (HLA) alellerinin birçok otoimmün hastalıkla ilişkili olduğu gösterilmiştir. Çalışmamızda kronik spontan ürtikerli hastalarda HLA klas II alellerinin sıklığının araştırılması amaçlanmıştır. Gereç ve Yöntem: Kesitsel tipteki bu çalışmada, 80 kronik spontan ürtikerli olguda ve 100 renal transplant donöründen oluşan kontrol grubunda HLA klas II alelleri değerlendirildi. Olgu grubu otolog serum deri testi (OSDT) uygulanarak alt gruplara ayrıldı. HLA klas II alelleri, OSDT testi pozitif ve negatif olan kronik spontan ürtiker olgularında ve kontrol grubunda moleküler analiz yöntemiyle (Olerup SSP DQ-DR Combi tray, Genovision, Viyana, Avusturya) belirlendi. Bulgular: OSDT hastaların %57,5’inde pozitif bulundu. Kronik spontan ürtikerli hastalarda HLA DRB1*04 ve HLA DQB1*08 alellerinin sıklığı, kontrol grubuna göre anlamlı olarak daha yüksek tespit edildi. HLA DRB1*07 ve HLA DQB1*09 alellerinin sıklığı ise anlamlı derecede daha düşüktü (p<0,05). OSDT pozitif ve negatif olgu grupları ile kontrol grubu karşılaştırıldığında; HLA DRB1*04 ve HLA DQB1*08 alelleri OSDT pozitif hasta grubunda daha sık bulundu (p<0,05). OSDT negatif hasta grubunda ise HLA DRB1*01 ve HLA DRB1*07 alelleri düşük sıklıkta saptandı (p<0,05). Sonuç: OSDT pozitif olan olgularda HLA DRB1*04 ve DQB1*08 alellerinin anlamlı derecede daha sık görülmesi ve bu alellerin OSDT negatif olan olgularda kontrol grubundan anlamlı bir farklılık göstermemesi, hastaların bir kısmında patogenezden otoimmün mekanizmaların sorumlu olduğu fikrini desteklemektedir

Keywords

• Genetik Yatkınlık
• HLA Klas II Alelleri
• Kronik Spontan Ürtiker
• Otolog Serum Deri Testi
• Otoimmünite

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