HLA and Mooren's ulceration

Background-Mooren's ulcer is a progressive intractable destructive peripher al ulceration of the cornea, probably of autoimmune aetiology. The disease is rare in the northern hemisphere but is more common in southern and centr al Africa and the Indian subcontinent. Although rape, its predominance in c ertain racial groups and their second generation migrants worldwide indicat es a genetic as well as a geographic predisposition. The highly polymorphic human leucocyte antigens (HLA) confer generic susceptibility to several au toimmune disorders. Therefore, a possible link between Mooren's ulcer and H LA type was investigated. Methods-Patients (n=22) with noninfective destructive peripheral corneal in flammatory disease were recruited worldwide. Differential diagnosis confirm ed Mooren's ulceration in 12 cases. HLA typing (HLA-A, B, C, DRB, DQB) was performed by ser ology and PGR: using sequence specific primers. The patien ts came from varied ethnic backgrounds and their HLA typing results. were c ompared with published data from ethnically matched control populations. Results-Of the 12 patients Mooren's ulcer, 10 (83%) were HLA-DR17(3) positi ve (including all nine patients of Asian, Indonesian, and black African ori gin), and 10 (83%) were HLA-DQ2 positive. The frequency of HLA-DR17(3) and DQ2 was higher in the Mooren's ulcer group compared to published data from ethnically matched control populations, where the expected antigen frequenc ies range between 5% and 40%. Conclusion-These results suggest a possible association between HLA-DR17(3) and/or DQ2 and susceptibility to Mooren's ulcer.