Immunogenetics of uveitis in leprosy

Purpose: To identify any possible determinants in the development of uveiti s in leprosy patients. Methods: Human leukocyte antigen (HLA) class I and II antigen, and HLA clas s II genotypings were analyzed among Japanese leprosy patients. Ninety-thre e unrelated Japanese leprosy patients (46 patients with a history of uveiti s and 47 patients without uveitis) and 114 healthy control subjects were in vestigated. Results: The occurrence of HLA-DR2 was significantly higher in patients wit h uveitis (78.3%) than in those without uveitis (57.4%; odds ratio = 2.7, P < .05) and in the controls (33.3%; odds ratio = 7.2, P < .0000005, Pc < .0 0005). The occurrence of HLA-DR4 was significantly lower in patients with u veitis (15.2%) than in those without it (38.3%; odds ratio = 0.29, P < .05) and in the controls (46.5%; odds ratio = 0.21, P < .0005, Pc < .05). Furth ermore, the frequencies of DR2-positive and DR4-negative genotypes were sig nificantly higher in patients with uveitis (69.6%) than in those without it (38.3%; odds ratio = 3.7, P < .005) and in the controls (21.9%; odds ratio = 8.1, P < .00000005). At the genomic level, the occurrence of HLA-DQB1*03 02 was significantly lower in the patients with uveitis (8.7%) than in thos e without it (25.5%; odds ratio = 0.28, P < .05). The distribution of HLA-D RB1 and DQA1 alleles was not significantly different between the patients w ith and those without uveitis. However, the frequencies of DRB1*1501-positi ve, as well as DRB1*0405- and DQB1*0302-negative genotypes were significant ly higher in the patients with uveitis (47.8%) than in those without it (25 .5%; odds ratio = 2.7, P < .05) and in the controls (8.8%; odds ratio = 9.5 , P < .00000005). Conclusions: Our results suggest that HLA Class II genes confer susceptibil ity to or protection from leprous uveitis. (C) 1999 Japanese Ophthalmologic al Society.