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Published ahead of print on February 14, 2003, doi:10.1165/rcmb.2003-0007OC

Am. J. Respir. Cell Mol. Biol., Volume 29, Number 2, August 2003, 225-231

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Submitted on January 9, 2003
Revised on February 14, 2003

HLA-DR alleles influence the clinical course of pulmonary sarcoidosis in Asian Indians

Surendra K. Sharma1*, Arumugam Balamurugan2, Ravindra M. Pandey3, Pradip K. Saha1, and Narinder K. Mehra2

1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India, 2 Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, Delhi, India, 3 Department of Biostatistics, All India Institute of Medical Sciences, NewDelhi, Delhi, India

* To whom correspondence should be addressed. E-mail: surensk{at}hotmail.com.

Host genetic factors are known to contribute to disease susceptibility and course in sarcoidosis. They may also be important in defining the pattern of disease presentation, progression as well as its overall prognosis. We have studied HLA class I (n=31) and class II alleles (n = 56) in a cohort of Indian patients with sarcoidosis and 275 healthy controls from north India. Although no specific HLA class I allele association was found among sarcoidosis, the functional classification of HLA-A, -B and -Cw alleles into supertypes revealed an increased frequency of group 2 ligands (Cw2, Cw4, Cw5) for the Killer cell Ig-like receptors (KIR2DL1) in the patient group as compared to controls. Among class II alleles, positive association of DRB1*11, DRB1*14, DQA1*0101/4 and DQB1*0503 alleles with the disease was noticed. Clinical follow-up of the patient cohort up to 5 yr period showed a predominant occurrence of DRB1*14 and its linked DQ alleles in patients with insidious onset, advanced disease on chest radiographs and chronic course with frequent relapses on tapering off the prednisolone treatment. Further, multivariate logistic regression analysis revealed that the presence of DRB1*11(OR 9) and DRB1*14 (OR 7) and absence of DRB1*07 [Odds Ratio (OR) 63], DQB1*0201(OR 3) alleles were independent predictors of sarcoidosis. The present findings imply that HLA associated genetic factors influence the risk for the development of sarcoidosis and disease progression.




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