ASSOCIATION OF PROPIONIBACTERIUM-ACNES ENDOPHTHALMITIS WITH HLA-DQW5

Background: An HLA-DQ1 association has been suspected in patients who develop Propionibacterium acnes endophthalmitis following cataract sur gery. New techniques exist which may help to define this association. Materials and Methods. Patients with culture-proven P. acnes endophtha lmitis following cataract surgery were HLA-typed with new sera able to detect fine specificities in the HLA-DQ1 region and compared to a lar ge number of racially-matched controls. Sequence-specific oligonucleot ide typing with probes and primers designed to amplify and define the HLA-DQ1 region was then performed. P. acnes patients were compared to HLA-DQ1-matched controls who had undergone cataract surgery but had no evidence of chronic post-operative inflammation. Results: Thirteen of 15 P. acnes patients (87%) were serologically defined as carrying a s plit of DQW1 (DQW5 or DQW6). HLA DQW5 was increased to a statistically significant degree (p less than or equal to 0.014) with an odds ratio of 3.72 (95% confidence interval 1.34 to 10.31) Sequence-specific oli gonucleotide typing confirmed the DQW5 predominance: Seventy-three per cent of P. acnes patients had DQB10501 or DQB1*0503 vs. 33% of DQW1-m atched cataract patients without inflammation (not significant). Concl usion: HLA-DQW5 is associated with the development of P. acnes endopht halmitis following cataract surgery. The molecular mechanism of this a ssociation is unknown.