HLA-DRB1*01:01, but not HLA-DRB1:1503 or HLA-DRB1*11, is associated with decreased inhibitor risk in Iranian hemophilia A patients.

Autor: Hosseini S; Biotechnology, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran. Electronic address: shirinhosseini-1989@yahoo.com., Arabi S; Immunology, Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Electronic address: Shay.arabi@gmail.com., Yari F; Immunology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran. Electronic address: F.Yari@ibto.ir., Pourfatollah A; Immunology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran. Electronic address: pourfa@modares.ac.ir., Rezaie N; Epidemiology, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: rezaei81@yahoo.com., Moazezi S; Iranian Comprehensive Hemophilia Care Center (ICHCC), Iran. Electronic address: S.moazezi@gmail.com., Aghaie A; Immunology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran. Electronic address: aghaie.a@gmail.com.
Jazyk: angličtina
Zdroj: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis [Transfus Apher Sci] 2019 Oct; Vol. 58 (5), pp. 669-673. Date of Electronic Publication: 2019 Sep 16.
DOI: 10.1016/j.transci.2019.08.019
Abstrakt: Background/objective: Hemophilia A is a genetic disorder through which patients suffer from recurrent bleeding. This can be caused by a defect in human plasma coagulation factor VIII. High incidence of FVIII inhibitors in some severe hemophilia A patients after FVIII therapy is a considerable complication. Determination of good predictive factors can improve the safety of this treatment. HLA-II have been shown as a predictive element for inhibitor development. The goal of this study is to determine the association between HLA-DRB1*15:03, HLA-DRB1*11 and HLA-DRB1*01:01 alleles and FVIII inhibitors in severe hemophilia A patients in Iran.
Materials/methods: HLA-DRB1 genotyping was performed using Multiplex sequences Specific Primers (PCR-SSP) in two groups of severe hemophilia A patients comprising 51 and 50 individuals with and without FVIII inhibitors respectively. The levels of inhibitor were determined through Nijmegen-modified Bethesda assay. HLA-DRB1 allele frequencies were compared between groups by using multiple logistic regression models.
Results: HLA-DRB1*01:01 allele frequency was significantly higher in patients without inhibitor OR adj : 2.7 (95%CI: 1.08, 6.97; P = 0.034). There wasn't any statistically significant difference in HLA-DRB1*11 allele frequency between groups OR adj : 0.7 (95%CI: 0.27, 1.82; P = 0.47). There was no connection between HLA-DRB1*15:03 and inhibitor development OR adj : 0.94 (95%CI: 0.38, 2.35; P = 0.94).
Conclusion: An association between HLA-DRB1*01:01 and paucity of FVIII inhibitor showed that this allele has probably a protective effect in severe hemophilia A patients in Iran. Determination of the predictive and protective alleles are beneficial in pre-treatment activities and decrease the risk of unsuccessful therapy with FVIII in each population.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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