March 2013, Volume 63, Issue 3

Student's Corner

Pemphigus, Study of HLA-Class I

Mohamad Goldust  ( Medical Student, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. )
Shhla Babaei Nejad  ( Department of Dermatology, Tabriz University of Medical Sciences, Tabriz, Iran. )
Efat Khodaeiani  ( Department of Dermatology, Tabriz University of Medical Sciences, Tabriz, Iran. )

Madam, pemphigus is a group of self-immune vesicular diseases and is divided into two vulgaris and foliaceus pemphigus and mainly appears during fifties and sixties.1,2 Its etiology is not exactly known and genetic talent may play a role in its development.3,4 The disease is globally widespread and is more common in some races.5,6 A study was conducted to evaluate the HLA-class I in patients suffering from pemphigus. Patients with skin biopsy of pemphigus were selected and HLA-typing was conducted. Fifty one healthy subjects were selected as members of the control group. HLA antigens were determined by microcytotoxicity method. Gender, kind of disease, disease onset age, lesions onset place, lesions development place, records of the disease in first class relatives, response to treatment, type of treatment, cases of diseases relapse, existence of any accompanying disease, and results of HLA-typing were studied. In this study, mean age of the disease onset was 46.47 years. Out of 51 understudy patients, 28 (54.9%) were men and 23 945.1%) women. 49 (96.1%) patients suffered from pemphigus vulgaris and 2 (3.9%) cases from foliaceus pemphigus. Out of 51 patients with pemphigus who underwent HLA-typing, HLA-BW6 was positive in 49%, BW4 in 39%, A3 in 35%, B5 in 31%, A11 and CW4 in 27%, B44 and B12 in 25%, and B51 and A9 in 24% of the patients. The analysis does not refer to any meaningful relation between the age at disease onset and type of HLA (P>0.05). Special HLAs (BW6, BW4, A3, B5) were obtained which were more prevalent in our region.

References

1. Dhandha MM, Seiffert-Sinha K, Sinha AA. Specific immunoglobulin isotypes correlate with disease activity, morphology, duration and HLA association in Pemphigus vulgaris. Autoimmunity 2012; 45: 516-26.
2. Augusto DG, Lobo-Alves SC, Melo MF, Pereira NF, Petzl-Erler ML. Activating KIR and HLA Bw4 Ligands Are Associated to Decreased Susceptibility to Pemphigus Foliaceus, an autoimmune blistering skin disease. PLoS One 2012; 7: e39991.
3. Yan L, Wang JM, Zeng K. Association between HLA-DRB1 polymorphism and pemphigus vulgaris: a meta-analysis. Br J Dermatol 2012; 167: 768-77.
4. Zakka LR, Reche PA, Ahmed AR. The molecular basis for the presence of two autoimmune diseases occurring simultaneously--preliminary observations based on computer analysis. Autoimmunity 2012; 45: 253-63.
5. Robledo MA. Chronic methyl mercury poisoning may trigger endemic pemphigus foliaceus "fogo selvagem". Med Hypotheses 2012; 78: 60-6.
6. Sinha AA. The genetics of pemphigus. Dermatol Clin 2011; 29: 381-91.

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