HLA-DR predicts the prognosis in Scandinavian patients with pulmonary sarcoidosis

Although most patients with sarcoidosis have a good prognosis, a significant proportion runs a more severe and prolonged disease course. There is no marker to distinguish these subpopulations of patients, however. To investigate the relationship between HLA haplotype and clinical course, 122 Scandin...

Full description

Saved in:
Bibliographic Details
Published in:American journal of respiratory and critical care medicine 1997-11, Vol.156 (5), p.1601-1605
Main Authors: BERLIN, M, FOGDELL-HAHN, A, OLERUP, O, EKLUND, A, GRUNEWALD, J
Format: Article
Language:English
Subjects:
Adult
Alleles
Biological and medical sciences
Chronic Disease
Female
Forced Expiratory Volume
HLA-DQ Antigens - analysis
HLA-DR Antigens - analysis
Humans
Male
Medical sciences
Medicin och hälsovetenskap
Middle Aged
Phenotype
Polymerase Chain Reaction
Prognosis
Sarcoidosis, Pulmonary - immunology
Sarcoidosis, Pulmonary - physiopathology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Sweden
Vital Capacity
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Although most patients with sarcoidosis have a good prognosis, a significant proportion runs a more severe and prolonged disease course. There is no marker to distinguish these subpopulations of patients, however. To investigate the relationship between HLA haplotype and clinical course, 122 Scandinavian patients with sarcoidosis were genomically typed for HLA-DR, -DQA1 and -DQB1 alleles using PCR amplification with sequence-specific primers. Control subjects were 250 healthy Swedish volunteers. Patients were carefully clinically monitored for up to 10 yr. We found that HLA-DR17(3) was overrepresented among sarcoidosis patients (33%) compared with control subjects (17%, p < 0.001). Ninety-one patients were followed for more than 2 yr and classified into chronic or nonchronic patients, according to disease outcome. Among the 34 patients with a nonchronic form of sarcoidosis, 65% were DR17(3)-positive (p < 10(-5) versus control subjects). On the other hand, DR14(6) and DR15(2) were significantly associated with chronic disease. Even in patients with clinical manifestations that are normally associated with good prognosis, HLA typing enabled a subgrouping into two categories with significantly different clinical courses. Therefore, HLA class II typing is a valuable tool in predicting the outcome of the disease in Scandinavian sarcoidosis patients.
ISSN:1073-449X
1535-4970
DOI:10.1164/ajrccm.156.5.9704069