Analysis of HLA antigens in Mycobacterium avium-intracellulare pulmonary infection

Mycobacterium avium-intracellulare (MAI) pulmonary infection may occur in s ubjects with no preexisting lung disease and no known immunodeficiency, sho wing radiologically nodular bronchiectasis. There have remained some unreso lved problems in the pathogenesis of the disorder, including the predominan ce in elderly women and the presence. of not deteriorated or deteriorated d isease. In the present study, we examined whether immunogenetic susceptibil ity is present in the disorder. We evaluated 64 cases of MAI disease and an alyzed their short-term natural history by assessing symptoms, sputum bacte riology, and chest computed tomographic findings. The frequencies of human leukocyte antigen (HLA) alleles in patients were compared with those in 100 healthy Japanese control subjects. We assayed the HLA-A, -B, -C, -DR, and -DQ antigens serologically. Among 64 patients, 37 (35 females) did not show deterioration, whereas 27 (24 females) showed deterioration after an inter val of 30 +/- 15 mo. There was no significant frequency of HLA-B and -C all eles in either group. In 37 not deteriorated patients, DR-6 was positive in 14 (37.8%) patients but in only 16 (16%) control subjects (p = 0.0061, odd s ratio [OR] = 3.20). DQ-4 was positive in 10 (27.0%) patients but in only 10 (10%) control subjects (p = 0.0122 OR = 3.33). In 27 deteriorated patien ts, HLA-A26 was positive in 14 (51.9%) patients but in only 21 (21.0%) cont rol subjects (P = 0.0015, OR = 4.05). MAI pulmonary infection with nodular bronchiectasis shows two types of outcome, deteriorated and not deteriorate d. The subjects with A-26 antigen might indicate the deterioration of MAI i nfection.