M. G. Hammond

HLA-A, B, DR, and DQ antigens in black patients with severe chronic rheumatic heart disease.

To determine whether genetic factors could be involved in the pathogenesis of rheumatic heart disease, we performed HLA-A and HLA-B typing in 120 black patients with severe chronic rheumatic heart disease requiring cardiac surgery, and HLA-DR and HLA-DQ typing in 103 and 97 of these patients, respectively. The HLA typing was done by a standard microlymphocytotoxicity method. Patients were 12 to 60 years old (mean 27.6 +/- 14.5). No differences in HLA-A, HLA-B, and HLA-DQ frequencies between patients and controls were noted. HLA-DR 1 antigen was present in 12.6% of patients compared with 2.7% of normal control subjects (corrected p less than .045; relative risk = 5.2) and the HLA-DRw6 antigen was present in 31.1% of patients compared with 15% of control subjects (corrected p less than .045; relative risk = 2.6). These findings suggest that genetically determined immune-response factors may play a role in the pathogenesis of severe chronic rheumatic heart disease.

Pemphigus in South Africa

Abstract

HLA-A, B, C and DR antigens in young South African blacks with Type 1 (insulin-dependent) diabetes mellitus

SummaryThe HLA status of South African black Type 1 (insulin-dependent) diabetic patients with age of onset under 35 years was compared with that of healthy black control subjects. HLA-A, B and C antigens were determined in 94 patients and 995 control subjects, while DR typing was carried out on 56 patients and 195 control subjects. There was a significant increase in the frequency of DR4 in patients as compared with control subjects (P < 0.01; relative risk 3.4). DR3/DR4 heterozygosity was associated with a greater relative risk for developing Type 1 diabetes mellitus (3.7) than the presence of DR3 alone (relative risk 1.6). A significant negative association was observed between the presence of BW42 and Type 1 diabetes in this population sample (P < 0.04; relative risk 0.3). A similar trend was observed with regard to DR2, the corrected p value just attaining statistical significance (p < 0.05; relative risk 0.1).

Associations between HLA Antigens and Nephrotic Syndrome in African and Indian Children in South Africa

The nephrotic syndrome (NS) reported from Southern Africa is distinguished by unusual characteristics in African children and typical features among Indian children. A genetic basis for these differences is explored in 44 African and 33 Indian children with NS in this paper. HLA associations were detected in the 20 Indian children with minimal change NS (MCNS) and 12 African children with membranous NS. Previous studies of HLA antigens, which have all been performed on Caucasian children with MCNS or steroid-responsive NS (SRNS), have detected associations with HLAB and DR locus genes. In this report HLA Bw44, which is part of HLA B12, was found to be significantly more frequent in Indian children with MCNS or SRNS than in controls (45 and 12%, respectively, p less than 0.04; relative risk 5.8). In contrast, African children with membranous nephropathy had a significantly increased frequency of HLA Bw21 (15% in patients and 1% in controls, p less than 0.04; relative risk 22.1). HBsAg was positive in 9 of 11 patients tested in the latter group. We conclude that the interaction between heredity and environmental factors is central to the pathogenesis of membranous nephropathy and similar considerations may be important in the development of MCNS.

HLA and insulin-dependent diabetes in South African negroes

SummaryThe HLA antigens of 57 South African negroes with juvenile-onset, insulin-dependent diabetes were determined. The frequency of B8 was increased (29.8% vs 13.9%) as was the frequency of B14 (17.5% vs 6.1%). The frequency of patients with either one of these cross-reactive antigens was significantly increased after correction for the number of antigens tested (45.6% vs 19.2%, P (corrected) <0.005).

Human leucocyte antigen status in African women with eclampsia

Summary. Investigation of the HLA system in 53 African eclamptic or imminently eclamptic women showed that they were significantly more likely to be heterozygous at the B locus than were normal controls. This did not apply to the A or D related loci.

HLA Class I and II Antigens in South African Indians With NIDDM

The relationship between the HLA system and non-insulin-dependent diabetes mellitus (NIDDM) in South African Indians, a migrant Indian group, was evaluated by testing HLA-A, -B, and -C antigens in 184 patients and 1444 control subjects and HLA-DR antigens in 104 patients and 330 control subjects. There was a significant increase in the frequency of HLA-Bw61 in patients compared with control subjects (27.7 vs. 18%, P = .00155), although the degree of association was not very strong (relative risk 1.7). A similar association has been noted in Fiji Indians, another migrant Indian group. However, no relationship could be established at the DR locus. It is suggested that the relatively high frequency of the Bw61 allele in South African Indians could, in the presence of some environmental factor like obesity, confer increased susceptibility to NIDDM.

Antigen Society #9 Report (Bw46 and the Subgroups of B15)

The antigen HLA-B15, first described as LND (Thorsby et al. 1970 (29) ) or TE15 (Albert et al. 1970 (1) ), was first recognized to be heterogeneous at the Fourth International Workshop (Thorsby et al. 1970b (30) ). In the following Workshops, a growing number of reports documented the heterogeneity of B15 (Richiardi et al. 1974 (23), Joysey et al. 1975 (18), Dick et al. 1978 (15), Singal et al. 1980 (27), Danilovs and Pollock 1980 (13), Saueracker et al. 1981 (24), Alonso et al. 1983 (2), Zhao and Shiraki 1986 (33) ). It was becoming clear that most of the variants of B15 are found in Southeast Asian populations. During the Ninth International Histocompatibility Workshop, the complexity of B15 was discussed in nine different Newsletter contributions (3,6,9,11,12, 14,17,25,32) and summarized by Chandanayingyong et al. (10) and Cambon-Thomsen et al. (5). From this summary it appears that next to the classical Bw62 antigen there exists a Bw6-associated short Bw62 antigen, which has been observed by several different authors (6,9,11 17,25,34) mostly in Asian populations, and named Bw62.1, TS1, B15short Thai, B15 Kemp, SH7, Bw62S.

AN EVALUATION OF HUMORAL ANTIBODY RESPONSES IN PATIENTS WITH CARCINOMA OF THE CERVIX

Tumour tissue from patients with inoperable cervical carcinoma was studied to determine the significance of humoral antibody involvement. Comparative elution studies using normal and cancerous tissues revealed that various classes of immunoglobulin and complement, either singly or in combination could only be recovered from the cancerous tissues. Some cancer tissue eluates possessed antibodies which sensitized normal lymphocytes by the cytotoxicity test suggesting the hosts recognition of structural modification of the tumour cell. It is possible that the various classes of immunoglobulin found in cancer tissue eluates represent antibodies to cytoplasmic constituents, cell membranes or antigen‐antibody complexes. It was found that the serum from the cancer patients possessed a significantly higher incidence of “non specific” lymphocytotoxic antibodies than the controls. Our inability to associate these antibodies with specificities for normal histocompatibility antigens suggests that this type of antibody may symbolize humoral responses towards a combination of tumour‐related and normal transplantation antigens. It seems apparent that their activity is of an autoimmune nature capable of altering the in vivo functions of the cell‐mediated immune mechanism.

HLA antigens in donovanosis (granuloma inguinale).

OBJECTIVE--To compare the frequencies of HLA antigens in patients with donovanosis and in controls. DESIGN--HLA Class I, Class II and DQ antigens were detected in patients with genital ulceration caused by donovanosis and in a control group. SETTING--City Health STD Clinic, King Edward VIII Hospital, Durban, South Africa. Participants--Sixty (47 men, 13 women) patients with donovanosis. RESULTS--HLA B57 was detected in nine of 60 (15%) with donovanosis and 75 of 1478 (5.1%) controls (RR = 3.3 chi 2 = 11.0, p = 0.001, p corrected = 0.026). CONCLUSIONS--A possible link between donovanosis and HLA B57 could be explained by coexisting alleles or immune response genes in linkage disequilibrium altering disease susceptibility.