Association of class II human histocompatibility leukocyte antigens with rheumatic fever

The association of class I and II HLA antigens with rheumatic fever and its manifestations was examined in 72 patients, including 48 blacks and 24 Caucasians. No significant association was found between class I antigens and rheumatic fever. In contrast, HLA-DR2 and HLA-DR4 phenotypes were encounter...

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Bibliographic Details
Published in:The Journal of clinical investigation 1986-06, Vol.77 (6), p.2019-2026
Main Authors: AYOUB, E. M, BARRETT, D. J, MACLAREN, N. K, KRISCHER, J. P
Format: Article
Language:English
Subjects:
African Continental Ancestry Group
Alleles
Arthritis - immunology
Bacterial diseases
Biological and medical sciences
Chorea - immunology
European Continental Ancestry Group
Histocompatibility Antigens Class II - analysis
HLA Antigens - analysis
HLA-DR2 Antigen
HLA-DR4 Antigen
Human bacterial diseases
Humans
Infectious diseases
Medical sciences
Miscellaneous
Myocarditis - immunology
Phenotype
Rheumatic Fever - immunology
Staphylococcal infections, streptococcal infections, pneumococcal infections
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Summary:The association of class I and II HLA antigens with rheumatic fever and its manifestations was examined in 72 patients, including 48 blacks and 24 Caucasians. No significant association was found between class I antigens and rheumatic fever. In contrast, HLA-DR2 and HLA-DR4 phenotypes were encountered in a significantly higher frequency in black and Caucasian patients with rheumatic fever, respectively, compared with the control populations (P less than 0.005). The most significant association (P less than 0.005) of these DR antigens with a major manifestation of rheumatic fever was found for mitral insufficiency. In addition, a significant association was encountered between persistent elevation of antibody to the group A streptococcal carbohydrate and HLA-DR4 in Caucasian patients (P less than 0.04) or HLA-DR2 in the black patients (P less than 0.001). The frequency of HLA-DR2/4 heterozygotes among patients with rheumatic fever did not differ significantly from controls. These findings support the concept of a genetically determined susceptibility to rheumatic fever and, particularly, to rheumatic heart disease. The association of the clinical manifestations of rheumatic fever and the immune hyperresponsiveness to a streptococcal antigen could be ascribed to a disease-associated immune-response gene which is in linkage disequilibrium with the DR2 and DR4 alleles of HLA-DR locus on chromosome six.
ISSN:0021-9738
1558-8238
DOI:10.1172/JCI112531