ASSOCIATION BETWEEN VOGT-KOYANAGI-HARADA-SYNDROME AND HLA-DR1 AND HLA-DR4 IN HISPANIC PATIENTS LIVING IN SOUTHERN CALIFORNIA

Background: Vogt-Koyanagi-Harada (VKH) syndrome is associated with hum an leukocyte antigen (HLA)-B54, -DR4, -DR beta 10405, -DQ4, and -DR53 in Japanese patients. Disease-associated HLA specificities may differ among races. This study examined HLA associations with VKH syndrome i n Hispanic patients living in southern California, a racial subgroup a t increased risk for the disease. Methods: Human leukocyte antigen spe cificities were determined on 25 Hispanic patients with VKH syndrome a nd compared with HLA specificities of 217 healthy Hispanic control sub jects, Inclusion criteria for study patients were nontraumatic panuvei tis with exudative retinal detachments, with or without extraocular ma nifestations. Tests were performed using standard cytotoxic assays. Re sults: HLA-DR4 was present in 14 (56%) patients with VKH syndrome and in 62 (29%) control subjects (relative risk = 1.96). HLA-DR1 was prese nt in 9 (36%) patients with VKH syndrome and in 19 (9%) control subjec ts (relative risk = 4.11). HLA-DR1 and DR4 share a common epitope with in the DR beta 1 gene. HLA-DR1 and/or DR4 were present in 21 (84%) pat ients with VKH syndrome and in 76 (35%) control subjects (relative ris k = 2.40). Conclusions: HLA-DR1 and -DR4 were found in a significantly disproportionate number of Hispanic patients with VKH syndrome living in southern California, HLA-DR4, although not HLA-DR1, has been previ ously associated with VKH syndrome in other groups. These associations suggest a common immunogenic predisposition to VKH among different ra cial groups, and suggest that a common epitope shared by DR1 and DR4 m ay be involved in the pathogenesis of the disease.