HLA-DQ and-DR alleles in patients with SLE:A tertiary hospital-based case–control study in Bangladesh

Background:Systemic lupus erythematosus(SLE)is a systemic autoimmune disease characterized by the involvement of multiple organs and autoantibody production.This study aimed to determine the association of human leukocyte antigen(HLA)-DQ and-DR alleles with SLE at a tertiary hospital in Bangladesh.Methods:This case-control study was conducted in the Department of Rheumatology,Bangabandhu Sheikh Mujib Medical University(BSMMU),Dhaka,Bangladesh.The patients who fulfilled the 1997 revised American College of Rheumatology classification criteria for SLE were considered cases(n=41).The controls(n=32)were selected from the hospital staff of BSMMU,including doctors and nurses who did not suffer from any known rheumatic diseases,and there was no such disease in their first-degree relatives.Polymerase chain reaction using a sequence-specific primer(PCRSSP)in a low-resolution typing method was carried out on blood samples collected for HLA-DQ and-DR allele typing.Results:The cases and controls had comparable mean ages(31 vs.32 years),and most cases were female(95.1%vs.34.4%).The most frequent clinical manifestations were mucocutaneous(85.4%),followed by musculoskeletal(70.7%)and constitutional symptoms(58.5%).The cases had a significantly higher frequency of HLA-DR2 allele compared with healthy controls(70.7%vs.43.8%;odds ratio:3.1;95%confidence interval:1.2-8.2).In addition,HLADQ6 allele was found to have a significant association with mucocutaneous manifestations of the cases(88.9%,P=0.03).Conclusions:Bangladeshi adults having HLA-DR2 may be more susceptible to SLE.HLA-DQ6 allele might be associated with mucocutaneous manifestations of SLE.

Associations of autoantibodies and clinical profile of the patients with systemic sclerosis

Background:Systemic sclerosis is characterized by the involvement of organs and the presence of specific antibodies.The objectives of this study were to identify the autoantibodies and to determine their association with the selected clinical features of the disease among Bangladeshi systemic sclerosis patients.Methods:This cross-sectional study was performed at the rheumatology outpatient clinic of Bangabandhu Sheikh Mujib Medical University.Autoantibodies against nine systemic sclerosis-specific antigens were tested using an enzyme-linked immunoassay immunoblot kit.Several clinical features of patients with positive and negative autoantibody were examined by χ^(2) or Fisher's exact tests.Results:A total of 71 patients with systemic sclerosis(66;93.0%female)were included.Their mean age at disease onset was 33.2 years.Fifty-seven(80.3%)patients had diffuse cutaneous subtype.Out of nine autoantibodies,four were positive,anti-topoisomerase-I(57.7%),anti-U1 ribonucleic protein(21.1%),anti-RNA polymerase Ⅲ(18.3%),and anticentromere antibodies(4.2%).Eleven(15.5%)patients were negative for any antibodies and 11 patients were positive for at least two autoantibodies.Anti-U3-RNP,anti-PMScl,anti-Ku,and anti-Th/To auto antibodies were absent in all patients.Anti-RNA polymerase III was associated with raised pulmonary arterial systolic pressure(PASP)and anti-U1-RNP with decreased forced vital capacity(FVC).Conclusions:Anti-topoisomerase-I was the commonest autoantibody in patients with systemic sclerosis in Bangladesh.Anti-RNA polymerase III antibody had significant association with raised PASP and anti-U1-RNP with decreased FVC.