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The first study of its kind in white Europeans has suggested that the allelic frequency of histocompatibility genes is linked to susceptibility to pulmonary TB.
The frequency of DBQ1 alleles in a white Polish population showed a significant positive association of DQB1*05 and pulmonary TB, with patients almost three times more likely to have DQB1*05 as controls (odds ratio (OR) 2.84; 95% confidence interval (CI) 1.57 to 5.15). This has been reported in many other ethnic populations.
On the other hand, patients were significantly less likely to have DQB1*02 (OR 0.39; 95% CI 0.21 to 0.71), which has not been noted elsewhere. Other alleles—DQB1*03, DQB1*04, and DQB1*06—had similar frequencies in patients and controls.
This preliminary study included 38 unrelated patients with newly identified active pulmonary TB in one hospital and 58 unrelated controls of similar age. Individuals in both groups were excluded, as necessary, to ensure uniform socioeconomic and ethnic background. All had had BCG immunisation. HLA typing was by low resolution PCR with sequence specific primers (PCR-SSP) of blood samples.
The study provides yet more evidence that variation in the HLA system affects response to infection in pulmonary TB. Only 1 in 10 of infected persons will develop the active disease, and genetic differences in immunological defences, and therefore the HLA system, have been implicated. The frequencies of DQB alleles have been studied in Asian and American ethnic groups, but not in Europe, despite an increasing incidence of TB there.
▴ Thorax 2003;58:890–891.
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