OLIGOTYPING FOR HLA-DQA, HLA-DQB, AND HLA-DPB IN IDIOPATHIC NEPHROTICSYNDROME

Associations of human leukocyte antigens (HLA) with the idiopathic nep hrotic syndrome (NS) have mainly been described for alleles of the HLA -DR locus. In the present study the polymorphism of HLA-DQ and -DP at the molecular level was investigated in 167 children with NS (129 ster oid-sensitive) using the polymerase chain reaction and sequence-specif ic oligonucleotides in a French and a German cohort. HLA-DR typing was also performed by classical serology. In steroid-sensitive patients w e observed an increased frequency of the alleles HLA-DQA10201 and -DQ B10201 in both populations with relative risks ranging from 3.8 to 8. 5 (P-b < 0.01 to P-b < 0.00001 after Bonferoni's correction). In contr ast, the frequency of HLA-DQA10102 and DQB1*0602 was significantly de creased. In children with frequent relapses the HLA associations were generally more pronounced than in those with infrequent or no relapses . Applying logistic regression analysis, a nephrotic child bearing DQA 10201 or DR7 was five times more likely to be in the steroid-sensitiv e group of patients than in the steroid-resistant group compared with nephrotic children not bearing one of these alleles. These HLA alleles therefore seem to be useful indicators of a steroid-sensitive frequen tly relapsing course of NS. No associations with DPB alleles were obse rved, which narrows the region genetically involved in the disease sus ceptibility to the DR-DQ region. Steroid-resistant NS was not associat ed with HLA.