IMMUNOGENETICS OF EPISCLERITIS IN LEPROSY

Human leukocyte antigens (HLA) were analyzed among Japanese leprosy pa tients to identify any possible determinants in the development of epi scleritis in leprosy patients. Seventy-nine Japanese leprosy patients (33 patients with history of episcleritis and 36 patients without epis cleritis) and 114 healthy control subjects were investigated. Human le ukocyte antigen-class I and class II specificities were determined ser ologically by the standard microcytotoxicity test. The HLA-DRB1, -DRB. 5, -DQA1, and -DQB1 genotypings were performed by using the polymerase chain reaction (PCR)-single strand conformation polymorphism and PCR- restriction fragment length polymorphism analyses. The frequency of HL A-DR4 was significantly increased among the patients with episcleritis (66.7%) compared to patients without episcleritis (43.5%; odds ratio = 2.6, P < 0.05). The frequency of HLA-DR4 was significantly decreased among the patients with episcleritis (15.2%) compared to patients wit hout episcleritis (39.1%; odds ratio = 0.28, P < 0.05) and the control s (46.5%; odds ratio = 0.21, P < 0.001). At the genomic level, frequen cies of the HLA-DRB10405, -DQB1*0401, and -DQB1*0302 alleles were sig nificantly decreased among the patients with episcleritis (0%, 0%, and 6.1%, respectively) compared to patients without episcleritis (15.2%, 13.0%, and 26.1%, respectively; odds ratio = 0.07, 0.09, and 0.18, P < 0.05). HLA-DRB10405 and -DQB1*0401 were also significantly decrease d among the patients with episcleritis compared to the controls (29.80 /b and 29.5%; odds ratio = 0.041 P < 0.0001). Our results suggest that HLA-Cw3 antigen confers the susceptibility to the development of epis cleritis among Japanese leprosy patients. Concurrently, the DRB1 (the -DBR10305), and/or DQB1 (the -DQB1*0401 and -DQB1*0302) alleles might provide protection against leprous episcleritis. Jpn J Ophthalmol 199 8;42:431-436 (C) 1998 Japanese Ophthalmological Society.