The role of human leukocyte antigens as predisposing and/or protective factors in patients with idiopathic thrombotic thrombocytopenic purpura

Ann Hematol. 2012 Apr;91(4):507-10. doi: 10.1007/s00277-011-1384-z. Epub 2011 Dec 28.

Abstract

Fifty-four adult German patients suffering from idiopathic thrombotic thrombocytopenic purpura (TTP) have been examined for HLA class II. All patients presented autoantibodies against ADAMTS13 and ADAMTS13 activity levels <5%. Blood samples have been analyzed for HLA-DRB1 and DQB1 alleles using sequence-specific primer PCR and sequence-specific oligonucleotide PCR. Reference data of German bone marrow and blood donors were obtained from www.allelefrequencies.net. The results were evaluated employing two-sided binomial tests, and p values were corrected using the Benjamini-Hochberg procedure. A significant accumulation for DQB1*02:02 (p < 0.001) and DRB1*11 (p = 0.003) was found within the patient group. Twenty percent (DQB1*02:02) or 48.1% (DRB1*11) of TTP patients were tested positive for the particular HLA antigen compared to 1.2% (DQB1*02:02) or 23.5% (DRB1*11) in the control group. A tendency for a reduced occurrence of HLA-DRB1*04 was revealed (7.4% in patients compared to 24.6% in controls). An association between the HLA antigens DQB1*02:02 and DRB1*11 and disease susceptibility for idiopathic TTP has been found. A higher risk for disease outbreak within persons carrying the mentioned alleles can be assumed. The reduced occurrence of HLA-DRB1*04 in TTP patients indicates a possible protective effect of this HLA allele in disease development.

MeSH terms

  • ADAM Proteins / deficiency
  • ADAM Proteins / genetics
  • ADAM Proteins / immunology
  • ADAMTS13 Protein
  • Adult
  • Alleles
  • Disease Susceptibility*
  • Female
  • Germany
  • HLA Antigens / genetics*
  • HLA-DQ Antigens / genetics
  • HLA-DRB1 Chains / genetics
  • Histocompatibility Antigens Class II / genetics*
  • Humans
  • Male
  • Purpura, Thrombotic Thrombocytopenic / genetics*
  • Purpura, Thrombotic Thrombocytopenic / immunology
  • Purpura, Thrombotic Thrombocytopenic / physiopathology

Substances

  • HLA Antigens
  • HLA-DQ Antigens
  • HLA-DRB1 Chains
  • Histocompatibility Antigens Class II
  • ADAM Proteins
  • ADAMTS13 Protein
  • ADAMTS13 protein, human