J Neurol Neurosurg Psychiatry 2002
Feb;72(2):184-187
Hensiek AE, Sawcer SJ, Feakes R,
Deans J, Mander A, Akesson E, Roxburgh R, Coraddu F, Smith S, Compston
DA.
University of Cambridge Neurology
Unit, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK MRC Biostatistics
Unit, Institute of Public Health, University Forvie Site, Robinson Way,
Cambridge CB2 2SR, UK Tissue Typing Laboratory, Addenbrooke's Hospital,
Hills Road, Cambridge CB2 2QQ, UK.
Background:
The association between multiple
sclerosis and class II alleles of the major histocompatibiliy complex,
in particular the DRB1*1501-DQB1*0602 haplotype, is well established but
their role in determining specific features of this clinically heterogeneous
disease is unknown as few studies involving large sample sizes have been
performed.
Method:
729 patients with multiple sclerosis
were typed for the HLA DR15 phenotype. All patients underwent clinical
assessment and a detailed evaluation of their clinical records was undertaken.
Results:
The presence of DR15 was associated
with younger age at diagnosis and female sex but there was no association
with disease course (relapsing-remitting or secondary progressive v primary
progressive type), disease outcome, specific clinical features (opticospinal
v disseminated form), diagnostic certainty (clinically and laboratory supported
definite v clinically probable multiple sclerosis), and paraclinical investigations
including the presence of oligoclonal bands in the CSF or characteristic
abnormalities on MRI imaging of the central nervous system.
Conclusion:
Even though DR15 carriers are more
likely to be female and prone to an earlier disease onset, the results
indicate that there is no association with other specific clinical outcomes
or laboratory indices examined here. This suggests that DR15 exerts a susceptibility
rather than disease modifying effect in multiple sclerosis.