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HLA-DRB1*04/*13 alleles are associated with vascular disease and antiphospholipid antibodies in systemic lupus erythematosus
Annals of Rheumatic Diseases, 08/21/2012
Lundstrom E et al. – The HLA–DRB1*04 and HLA–DRB1*13 alleles are associated with vascular events and an aPL positive immune–phenotype in systemic lupus erythematosus. Results demonstrate that a subset of SLE patients is genetically disposed to vascular vulnerability.
Methods- 665 SLE patients of Caucasian origin and 1403 controls were included.
- Previous manifestations of ischaemic heart disease, ischaemic cerebrovascular disease (ICVD) and venous thromboembolism (together referred to as any vascular events (AVE)) were tabulated.
- aPL were measured with ELISA.
- Two–digit HLA–DRB1 typing was performed by sequence–specific primer–PCR.
- HLA–DRB1*04 was more frequent among SLE patients with ICVD compared to unaffected patients.
- This association remained after adjustment for known traditional cardiovascular risk factors.
- HLA–DRB1*13 was associated with AVE.
- All measured specificities of aPL—cardiolipin IgG and IgM, β2–glycoprotein–1 IgG, prothrombin (PT) IgG and a positive lupus anticoagulant test were associated with HLA–DRB1*04—while HLA–DRB1*13 was associated with IgG antibodies (β2–glycoprotein–1, cardiolipin and PT).
- In patients with the combined risk alleles, HLA–DRB1*04/*13, there was a significant additive interaction for the outcomes AVE and ICVD.