HLA antigens in Omanis with blinding trachoma: markers for disease susceptibility and resistance
a Transplant Immunology Laboratory,
Department of Surgery, College of Medicine, Sultan Qaboos University,
Muscat, Sultanate of Oman, b Department of Ophthalmology, Sultan
Qaboos University Hospital
Correspondence to: William Leheny, Department of Surgery, College of Medicine, Sultan Qaboos University, PO Box 35 Al Khod, Muscat 123, Sultanate of Oman.
Accepted for publication 13 January
1997
AIM
To determine the presence of HLA antigens in
people with blinding trachoma.
METHODSFifty Omanis with blinding trachoma were
serologically typed for HLA A, B, C, DR, and DQ antigens and DNA typed
for class II DR
and DQ alleles and compared with a population of
100 healthy controls.
RESULTS
2 analysis of serological
reactions did not reveal any significant differences in HLA antigen
frequencies after correction of probability, although DR4, DR7, and
DR53 were completely absent in the patients and all of the patients
were HLA DQ1 positive. In the case of DQ1 the relative risk was 22.6 (95% confidence interval of 20.7-24.7). Class II DNA low resolution
DR typing showed a significant increase in HLA DR16 (pc = 0.036, relative risk = 3.8) and a significant decrease in HLA DR53
(pc = 0.018, relative risk = 0.05 ).
CONCLUSIONThe finding that HLA DR16 (a DR2
subtype) is associated with susceptibility to blinding trachoma, a
disease that is caused by an intracellular micro-organism, is
consistent with reports of an HLA DR2 association with leprosy and
tuberculosis, diseases also caused by an intracellular micro-organism.
Similarly, resistance to leprosy is associated with HLA DR53 as is the
case with blinding trachoma described here. It is postulated that HLA
DR2 or subtypes in association with HLA DQ 1 may enable an
intracellular micro-organism to enter the cell or are involved in
presentation of peptides derived from intracellular micro-organisms to
T lymphocytes initiating a delayed hypersensitivity or autoimmune
reaction. These findings are the first report that genetic factors are
of major importance in the development and protection against blinding trachoma.
* Current address: Eyeclinic, Banegaardsplads 6, 8000 Aarhus C, Denmark
© 1997 by British Journal of Ophthalmology
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