Original Paper Vox Sang 1992;63:282-284
E. A rocker-Mettinger" W. R. Muyrb V; Huber-Spitzya
L. Steurer-Georgiewa G. GrabneP a
Do HLA Antigens Play a Role in Intermediate Uveitis?
2. Department of Ophthalmology, University of Vienna, Austria; Institute for Transfusion Medicine, RWTH, Aachen, FRG
................................................................................................. Abstract A total of 52 nonrelated Caucasian patients (21 male, 31 female, age at onset of the disease: 7-74 years, average: 31.6 years) suffering from intermediate uveitis were tissue typed for 56 different HLA-A, -B, -C and -DR-antigens. No significant association between any specific HLA-antigen and the disease, both when comparing the total patient group with a large, healthy control population, or any of the different subgroups (male vs. female, early vs. late onset, mild vs. severe course) could be demonstrated.
...........
Introduction
Intermediate uveitis is a chronic, recurrent inflammation of the extreme periphery of the fundus, frequently causing distinct vitreous and macular involvement [l]. It usually affects otherwise healthy individuals with no preference of a gender; in some studies the age at onset seems to show 2peaks, 1 in the younger, and the other in the more advanced age group [2]. The etiology of the disease still remains an enigma [3]. Major vision-threatening complications comprise cystoid macular edema, edema of the optic disc, vascular proliferation with vitreous hemorrhage, retinal detachment, complicated cataract, phthisis bulbi. Evidence has been presented that intermediate uveitis may be a form of an autoimmune disease [3]. In a classical paper Dausset [4] has outlined the characteristic findings of diseases that are commonly found to be associated with the HLA-system: (1) they all have an unknown etiology; (2) no infectious organism has been proven to be causative beyond any doubt (although viral agents have been frequently implicated; (3) immunological disturbances are frequently ob-
served (such as lymphocytic infiltrates in target organs, antiviral antibodies, autoantibodies); (4) they generally do not infer any selective pressure on the population of affected patients, as they generally become apparent only later in life; ( 5 ) they frequently show a subacute or chronic course, and (6) the pattern of inheritance (if any is detected) points to a multifactorial or polygenetic disease. As only few, mostly conflicting reports (either no association or a linkage with HLA-DR3 or HLA-B17) on a possible association between intermediate uveitis and the HLA system have been published, the following investigation was undertaken [5-81.
Patients and Methods Patients A totalof 52consecutivepatients that had beendiagnosedas being affected by intermediate uveitis at their first referral to the Uveitis Clinic of the 2nd Department of Ophtahlmology, University of Vienna, Austria, were included in this study. The clinical data pertinent for the investigation are given in table 1. As it was felt from the analysis of the patient records that there were 2 clearly distinct peaks of onset of
Dr. Elisabeth Arocker-Mettinger 2. Department of Ophthalmology Alserstrasse 4, AKH A-1090 Wien (Austria)
1992 S. Karger AG. Basel 00112-~~7/92/n~34-02~2 $2.7.5/0
Q
the disease (1, in the early and 1in the more advanced age group), an arbitrary limit was set at 30 years and the data of the ‘early’ and ‘late’ onset groups were subjected to statistical analysis as well. Furthermore, male versus female patients, as well as patients with a mild versus severe course of the disease (that is with or without cystoid macular edema, papilledema or/and neovascularization) were compared.
Methods Using the standard microlymphocytotoxicity assay, the frequencies of the following 56 human leukocyte antigens (HLA-A1, -A2, -A3, -A23, -A24, -A25, -A26, -All, -A28, -A29, -A30, -A31, -A32, -A33, -A34; HLA-B57, -B7, -B8, -B12, -B13, -B14, -B15, -B17, -B18, -B22, -B27, -B35, -B37, -B38, -B39, -B40, -B41, -B47, -B49, -B50, , W -~C, W ~- C , W~, -B53, -B70, -B73: HLA-Cwl,-Cw2, - C W -~C, W ~- C -CW8; HLA-DR1, -DR2, -DR3, -DR4, -DR5, -DR6, -DR7, -DR8, -DR9, -DR10) were studied in the above-mentioned patients and in a large control population (n = 1,081,1,066,1,053and 963 for HLA-A, -B, -Cand-DR, respectively). Bloodfrompatients and healthy blood donors, serving as controls, was obtained with full informed consent. For statistical analysis the x2 test and the corrected p value (= pc) were used.
Results and Discussion
In table 2, the HLA antigens showing a significant difference (without correcting the p value) in various comparisons are listed. All these deviations did not reach the statistically significant value of p
E. A rocker-Mettinger" W. R. Muyrb V; Huber-Spitzya
L. Steurer-Georgiewa G. GrabneP a
Do HLA Antigens Play a Role in Intermediate Uveitis?
2. Department of Ophthalmology, University of Vienna, Austria; Institute for Transfusion Medicine, RWTH, Aachen, FRG
................................................................................................. Abstract A total of 52 nonrelated Caucasian patients (21 male, 31 female, age at onset of the disease: 7-74 years, average: 31.6 years) suffering from intermediate uveitis were tissue typed for 56 different HLA-A, -B, -C and -DR-antigens. No significant association between any specific HLA-antigen and the disease, both when comparing the total patient group with a large, healthy control population, or any of the different subgroups (male vs. female, early vs. late onset, mild vs. severe course) could be demonstrated.
...........
Introduction
Intermediate uveitis is a chronic, recurrent inflammation of the extreme periphery of the fundus, frequently causing distinct vitreous and macular involvement [l]. It usually affects otherwise healthy individuals with no preference of a gender; in some studies the age at onset seems to show 2peaks, 1 in the younger, and the other in the more advanced age group [2]. The etiology of the disease still remains an enigma [3]. Major vision-threatening complications comprise cystoid macular edema, edema of the optic disc, vascular proliferation with vitreous hemorrhage, retinal detachment, complicated cataract, phthisis bulbi. Evidence has been presented that intermediate uveitis may be a form of an autoimmune disease [3]. In a classical paper Dausset [4] has outlined the characteristic findings of diseases that are commonly found to be associated with the HLA-system: (1) they all have an unknown etiology; (2) no infectious organism has been proven to be causative beyond any doubt (although viral agents have been frequently implicated; (3) immunological disturbances are frequently ob-
served (such as lymphocytic infiltrates in target organs, antiviral antibodies, autoantibodies); (4) they generally do not infer any selective pressure on the population of affected patients, as they generally become apparent only later in life; ( 5 ) they frequently show a subacute or chronic course, and (6) the pattern of inheritance (if any is detected) points to a multifactorial or polygenetic disease. As only few, mostly conflicting reports (either no association or a linkage with HLA-DR3 or HLA-B17) on a possible association between intermediate uveitis and the HLA system have been published, the following investigation was undertaken [5-81.
Patients and Methods Patients A totalof 52consecutivepatients that had beendiagnosedas being affected by intermediate uveitis at their first referral to the Uveitis Clinic of the 2nd Department of Ophtahlmology, University of Vienna, Austria, were included in this study. The clinical data pertinent for the investigation are given in table 1. As it was felt from the analysis of the patient records that there were 2 clearly distinct peaks of onset of
Dr. Elisabeth Arocker-Mettinger 2. Department of Ophthalmology Alserstrasse 4, AKH A-1090 Wien (Austria)
1992 S. Karger AG. Basel 00112-~~7/92/n~34-02~2 $2.7.5/0
Q
the disease (1, in the early and 1in the more advanced age group), an arbitrary limit was set at 30 years and the data of the ‘early’ and ‘late’ onset groups were subjected to statistical analysis as well. Furthermore, male versus female patients, as well as patients with a mild versus severe course of the disease (that is with or without cystoid macular edema, papilledema or/and neovascularization) were compared.
Methods Using the standard microlymphocytotoxicity assay, the frequencies of the following 56 human leukocyte antigens (HLA-A1, -A2, -A3, -A23, -A24, -A25, -A26, -All, -A28, -A29, -A30, -A31, -A32, -A33, -A34; HLA-B57, -B7, -B8, -B12, -B13, -B14, -B15, -B17, -B18, -B22, -B27, -B35, -B37, -B38, -B39, -B40, -B41, -B47, -B49, -B50, , W -~C, W ~- C , W~, -B53, -B70, -B73: HLA-Cwl,-Cw2, - C W -~C, W ~- C -CW8; HLA-DR1, -DR2, -DR3, -DR4, -DR5, -DR6, -DR7, -DR8, -DR9, -DR10) were studied in the above-mentioned patients and in a large control population (n = 1,081,1,066,1,053and 963 for HLA-A, -B, -Cand-DR, respectively). Bloodfrompatients and healthy blood donors, serving as controls, was obtained with full informed consent. For statistical analysis the x2 test and the corrected p value (= pc) were used.
Results and Discussion
In table 2, the HLA antigens showing a significant difference (without correcting the p value) in various comparisons are listed. All these deviations did not reach the statistically significant value of p
