Contribution of HLA class II genes to end stage renal disease in Mexican patients with type 2 diabetes mellitus

To analyze the contribution of MHC class II genes in type 2 diabetes mellit us (DM) with end stage renal disease (ESRD), we examined the distribution o f HLA-DRB1, DQA1, DQB1 loci in Mexican Mestizos of General Mexico, using PC R-SSOP and PCR-SSP. Three groups were included: 47 type 2 diabetic ESRD pat ients; 42 patients with ESRD and 50 type 2 DM patients with no kidney compl ication. The results were compared with those of 101 controls of the same a rea. The median since DM was first diagnosed, was 18 years prior to the ons et of ESRD, The frequencies of DRB1*1502 and DQB1*0501 were increased in DM patients with ESRD (p = 0.004; RR = 7.4, CI = 1.5-37; EF = 0.13; P = 0.007 ; RR = 2.9, CI = 2.3-3.5, EF = 0.21, respectively). In contrast, DRB1*0407 was decreased in the same group VI = 0.0008 RR = 0.2; CI = 0.035-0.70 PF = 0.19). Diabetic patients with DRB1*1502 are 8.8 times more likely to develo p ESRD, independently of the duration time of DM. DRB1*1502 contributes to the susceptibility to ESRD while DRB1*0407 is involved in protect ion. The residue at DRB1-74 differs in these alleles: DRB1*0407 has glutamic acid an d DRB1*1502 has an alanine, suggesting that this substitution may be import ant. for both, peptide anchoring and for presentation to the T cells. (C) A merican Society for Histocompatibility and Immunogenetics, 2000, Published by Elsevier Science Inc.