Journal of Vascular Surgery
Volume 30, Issue 5 , Pages 959-960, November 1999

Negative genetic risk factor for abdominal aortic aneurysm: HLA-DQ3, a Japanese study

Department of Cardiovascular Surgery Shin-Tokyo Hospital Nagasaki City, Japan and Columbia University Department of Surgery St Luke’s/Roosevelt Hospital Center New York, NY

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To the Editors: 

Abdominal aortic aneurysms (AAAs) may be related to specific HLA alleles.1, 2 We have reported that HLA-DR2(15) is a positive risk factor for nonspecific infrarenal AAAs in Japan.3 HLA class II antigens are further divided into DR and DQ antigens, which are expressed independently on the antigen presenting cells. Some DQ alleles are reported to be associated with autoimmune diseases, such as Hashimoto’s thyroiditis.4 This study was performed to determine whether specific HLA DQ alleles are associated with AAA.

METHOD 

Peripheral blood samples were obtained from 36 patients with AAAs and from 39 volunteers, most of whom were among the subjects (all Japanese) on whom we have previously reported an association with HLA-DR2(15). The age, sex, and associated medical problems of the two groups were similar (data not shown). DQ antigen typing was performed at the Mitsubishi Biochemical Laboratory (MBC, Tokyo, Japan) with a serologic technique.5 The homozygosity was identified if only one antigen was identified from an individual. The typing tests were repeated to confirm that the results were not simple serologic reagent error. The frequency of antigens of HLA-DQ alleles were compared with the χ2 test.

RESULTS 

The AAA group consisted of 30 men and six women, with an age distribution from 47 to 85 years (mean, 71.8 years). Three AAAs were ruptured, and the others were intact infrarenal AAAs with diameters of 4 cm to 10.0 cm (mean, 5.7 cm). The distributions of HLA-DQ are shown in Table I.

Table I. Frequency of HLA-DQ alleles in patients with abdominal aortic aneurysms and control subjects
HLA DR antigenAAA groupControl groupP value
No. of antigens (no. of patients)No. of antigens (no. of patients)
DQ141 (30)34 (28).102NS
DQ23 (2)0 (0).069NS
DQ316 (16)32 (27).014<.02
DQ412 (11)12 (11).999NS
Total72 (36)78 (39)

AAA, Abdominal aortic aneurysm.

The frequency of HLA-DQ3 antigen was significantly decreased in the AAA group (22.2% in AAAs and 41.0% in controls), with a P value of less than .02. Homozygous DQ3 was observed in five control subjects but was not observed in relation to the AAA group.

DISCUSSION 

These study results suggested that HLA-DQ3 antigen appeared to have a protective effect in relation to AAA. However, the relation of DQ3 and DR2(15) remained unknown. Suppressive effects of certain DQ alleles have been reported in other autoimmune conditions, like Hashimoto’s thyroiditis and insulin-dependent diabetes mellitus.6

When DR status is included in the analysis of these groups of patients with AAA and control subjects, the data further suggest that DR2(15) promotes AAA disease and DQ3 protects. If DR2(15) positive and DQ3 negative are considered to be the high-risk serotypes, then 89% (32 of 36) of the patients with AAA had one of these features as compared with 41% (16 of 39) of the control subjects (P < .0001).

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References 

  1. Tilson MD, Ozsvath KJ, Hirose H, Xia S. Hypothesis: a genetic basis for autoimmune manifestations in the abdominal aortic aneurysm (AAA). N Y Acad Sci. 1996;800:208–217
  2. Rasmussen TE, Hallett JW, Mathieu Metzger RL, Richardson DM, Harmsen WS, Goronzy JJ, et al.  Genetic risk factors in inflammatory abdominal aortic aneurysms: polymorphic residue 70 in the HLA-DR B1 gene as a key genetic element. J Vasc Surg. 1997;25:356–364
  3. Hirose H, Takagi M, Miyagawa N, Hashiyada H, Noguchi M, Tada S, et al.  Genetic risk factor for abdominal aortic aneurysm: HLA-DR2(15), a Japanese study. J Vasc Surg. 1998;27:500–503
  4. Nishimura Y, Thorsby E, Ronningen KS, Nelson LJ, Hansen JA, Bias WB, et al.  General organization and overview of the disease component. In:  Tsuji K,  Aizawa M,  Sasazuki T editor. HLA 1991: proceedings of the eleventh international histocompatibility workshop and conference. Oxford: Oxford University Press; 1992;p. 693–700
  5. Terasaki PI, Bernoco D, Park MS, Ozturk G, Iwaki Y. Microdroplet testing for HLA-A, -B, -C, and -D antigens. Am J Clin Pathol. 1978;69:103–120
  6. Weyand CM, Grononzy JJ. Functional domains on HLA-DR molecules: implications for the linkage of HLA-DR genes to different autoimmune disease. Clin Immunol Immunopathol. 1994;70:91–98

PII: S0741-5214(99)70025-X

Journal of Vascular Surgery
Volume 30, Issue 5 , Pages 959-960, November 1999