CLASS-I AND CLASS-II HLA ANTIGENS IN PATI ENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS IN THE SOUTH OF SPAIN

BACKGROUND: To establish the relation between class I and II HLA antig ens, systemic lupus erythematosus (SLE), autoantibodies production, an d clinical manifestations in the south of Spain (Malaga). METHODS: In a regional hospital we undertook a case-control study with a consecuti ve sample of 104 patients with SLE who fulfilled at least 4 criteria o f ARA. Three hundred and twenty-eight local controls with no apparent pathology were included for comparison. We evaluated clinical and anal ytical aspects about multisystem autoimmune disease. HLA typing was se rogically determined. RESULTS: Univariate analysis showed a relation b etween SLE and the specificities 88 (21% of patients vs 10% of control s, p = 0,005; RR = 2,3), DR3 (36% vs 20%, p = 0.0006; RR = 2.5), DRw52 (69% vs 49%, p = 0.001; RR = 2.3), and DQ2 (49% vs 36%, p = 0.0150; R R = 1.7). However, in logistic regression multivariate analysis, there was a confounding effect between DR3 and DRw52, and it could be that only this specificity, HLA-DRw52 (RR = 2.0; 95% CI: 1.1-4.0), and of l esser degree B8 (RR = 1.9; 95% CI:0.94.4), are really associated with SLE. Also, in multivariate analysis, DR6 showed a negative association (5% vs 25%, p = 0.011; RR = 4.2; 95% CI:1.5-17.2) with anti-U1RNP, wh ile DRw52 showed a negative association with IgG-aCL (50% vs 85%, p = 0.019; RR = 0.21; 95% CI:0.06-0.76). Futhermore, DQ2/DQ6 showed positi ve association with anti-SSA/Ro antibodies (50% vs 24%; p = 0.046; RR = 3.0; 95% CI:1.0-9.0). There were also several associations between c linical manifestations and HLA. The specificities DR and DRw53 were al most always risk factors, but only DR5 was a protector for renal lesio n. DRw52 and DQ specificities were always protectors when they were as sociated with some clinical manifestations. Isolated DR3 antigen, is n ot associatted with any of the above-mentioned manifestations. CONCLUS IONS: The previously described relation between SLE and the antigen DR 3 is confirmed, but this association could be a result of the presence of DRw52 specificity in patients, that is in linkage disequilibrium w ith DR3.