| Popis: |
Background: In the last years it has been shown a subgroup of patients with hypersensitivity pneumonitis (HP) that develop autoantibodies with or without clinical manifestations of autoimmune disease. Factors involved in this process, and the effect of these autoantibodies on clinical course and mortality are unknown. Aim: To evaluate association between HLA class II alleles and HP patients with and without autoantibodies. Methods: 170 patients with confirmed diagnosis of HP were included. Autoimmune laboratory profile included ANA, RF, anti-SSA/Ro, anti-SSB/La, anti-Scl70 and anti-CCP. HLA typing was performed by PCR-SSP in a high-resolution modality, including HLA-DRB1 and HLA-DQB1 loci. Statistical analysis was performed employing EPI-info v7 and SPSSv20. Results: Sixty HP patients developed sera autoantibodies (HPAb+; 50 females; 53.4±9.3 years) and 110 HP patients did not (HP; 84 females; 52.5±11.8 years). The frequency of the allele HLA-DRB1*03 was remarkably increased in the HPAb+ group (10.8% vs. 0.45%; OR=26.6, CI95% 3.0-206.8 p=8.26E-06). Likewise, the loci HLA-DQB1*02:01 and DQB1*06:01 frequencies were almost three-fold higher in the HPAb+ group [(15.0% versus 6.4%, OR=2.59, CI95% 1.24-5.42; p=7.7E-03) and (12.5% vs. 4.5%, OR=3.33, CI95% 1.30-6.90 p=6.8E-03)]. Regarding the haplotypes, DRB1*03-DQB1*02:01 showed a significant difference (OR=17.75, CI95% 2.22-141.9 p=0.0004). Mortality was associated to the HLA-DRB1*03 allele (p=0.004, β=0.225, CI95% 0.098-0.505). Conclusions: A subset of HP patients present circulating autoantibodies which is associated, at least partially, to some variants of the HLA, increasing the risk for death. |
