Protective effect of HLA-DQB1 alleles against alloimmunization in patients with sickle cell disease

Hum Immunol. 2016 Jan;77(1):35-40. doi: 10.1016/j.humimm.2015.10.010. Epub 2015 Oct 22.

Abstract

Background: Alloimmunization or the development of alloantibodies to Red Blood Cell (RBC) antigens is considered one of the major complications after RBC transfusions in patients with sickle cell disease (SCD) and can lead to both acute and delayed hemolytic reactions. It has been suggested that polymorphisms in HLA genes, may play a role in alloimmunization. We conducted a retrospective study analyzing the influence of HLA-DRB1 and DQB1 genetic diversity on RBC-alloimmunization.

Study design: Two-hundred four multi-transfused SCD patients with and without RBC-alloimmunization were typed at low/medium resolution by PCR-SSO, using IMGT-HLA Database. HLA-DRB1 and DQB1 allele frequencies were analyzed using logistic regression models, and global p-value was calculated using multiple logistic regression.

Results: While only trends towards associations between HLA-DR diversity and alloimmunization were observed, analysis of HLA-DQ showed that HLA-DQ2 (p=0.02), -DQ3 (p=0.02) and -DQ5 (p=0.01) alleles were significantly higher in non-alloimmunized patients, likely behaving as protective alleles. In addition, multiple logistic regression analysis showed both HLA-DQ2/6 (p=0.01) and HLA-DQ5/5 (p=0.03) combinations constitute additional predictor of protective status.

Conclusion: Our data suggest that particular HLA-DQ alleles influence the clinical course of RBC transfusion in patients with SCD, which could pave the way towards predictive strategies.

Keywords: Alloimmunization; HLA-DQB1; HLA-DRB1; Red Blood Cell transfusion; Sickle cell disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / genetics
  • Anemia, Sickle Cell / immunology*
  • Anemia, Sickle Cell / therapy
  • Child
  • Erythrocyte Transfusion*
  • Female
  • Gene Frequency
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • HLA-DQ beta-Chains / genetics*
  • HLA-DRB1 Chains / genetics
  • Humans
  • Immunization
  • Isoantibodies / metabolism
  • Isoantigens / immunology
  • Male
  • Polymorphism, Genetic
  • Retrospective Studies
  • Young Adult

Substances

  • HLA-DQ beta-Chains
  • HLA-DQB1 antigen
  • HLA-DRB1 Chains
  • Isoantibodies
  • Isoantigens