CLASS-II MHC TYPING IN PEMPHIGOID GESTATIONIS

Pemphigoid gestationis (PG) is a rare, autoimmune skin disease associa ted with pregnancy or the immediate postpartum period, previously show n to be associated with the HLA class II antigens DR3 and DR4. Advance s in molecular analytical techniques now allow the identification of H LA alleles previously difficult to define by serological assays. Unsus pected polymorphism within the HLA-DR3 and DR4 classes can, therefore, be identified. The aim of our study was to apply these newer techniqu es to the question of genetic predisposition in PG by re-evaluating th e association with DR3 and by studying a possible link with DQ. We hav e investigated by restriction fragment length polymorphism, the DQA, a nd by sequence specified oligonucleotide probing the DQB and DRB1 (HLA DR) specificities of 41 women with immunofluorescence-confirmed PG. T he principal finding of this study is that there is an association bet ween PG and DRB10301 (DR3) and DRB1*0401/040X (DR4). Although there i s also an increase (P = 0.06) in the concurrent presence of both antig ens, this appears to be due to the association with either antigen alo ne. We also found an increase. in the frequency of DQA12 (P=0.016 vs. control) and a decrease in frequency of DQB10201 (P=0.022 vs. contro ls) and DQB10602 (P = 0.026 vs. controls).