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HLA DR15 indicates susceptibility to multiple sclerosis (MS) but does not affect its course, Hensiek et al have confirmed. Previous studies have mostly been too small to confirm or refute speculation that HLA type might influence clinical features or course of MS.
In their study Hensiek et al typed 729 patients whose MS was clinically well characterised for HLA DR15 homozygous and heterozygous phenotypes. The patients were all index cases from trio families (affected patient and both parents), white, mean age 38 years, EDSS score 4.3 (range 0–9.3), with clinically definite (89%), laboratory supported definite (6%), or clinically probable (5%) MS. Hensiek et al grouped patients according to whether they had primary progressive MS (no remissions) (69 probands) or bout onset MS (relapsing-remitting and secondary progressive) (660) and opticospinal (61) or diffuse (668) disease.
In all, 59% of the patients had one or more HLA DR15 alleles. MS was diagnosed at an earlier age in patients with HLA DR15 (30.3 v 32.3 years, p=0.001), and more women than men had this phenotype (66% v 55%, p=0.01). HLA DR15 was linked with female sex and age at diagnosis in regression analyses but not with clinical subgroup, history of autoimmune diseases, family history of MS, or disease progression; nor was it linked with disability or laboratory markers for MS.
These results, the authors say, agree with those of one other large study and suggest that HLA DR15 phenotype affects susceptibility to MS, not its course.
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