MHC Class II Allele Association in Korean Children With IgA Nephropathy and its Role as a Prognostic Factor

Kim, Pyung Kil; Yook, Jinwon; Kim, Ji Hong; Jang, Yoon Soo; Shin, Jeon-Soo; Choi, In-Hong

J Korean Soc Pediatr Nephrol > Volume 4(1); > Article

한국인 IgA 신병증 환아에서 MHC Class II유전자형과 예후와의 관계 분석

김병길, 육진원, 김지홍, 장윤수, 신전수, 최인홍

¹연세대학교 의과대학 소아과학교실, 신장질환연구소
²연세대학교 의과대학 신장질환연구소
³연세대학교 의과대학 신장질환연구소
⁴연세대학교 의과대학 소아과학교실, 미생물학교실
⁵연세대학교 의과대학 소아과학교실, 미생물학교실
⁶연세대학교 의과대학 소아과학교실, 미생물학교실

MHC Class II Allele Association in Korean Children With IgA Nephropathy and its Role as a Prognostic Factor

Pyung Kil Kim, Jinwon Yook, Ji Hong Kim, Yoon Soo Jang, Jeon-Soo Shin, In-Hong Choi

¹Department of Pediatrics, The Institute of Kidney Disease, Yonsei University, College of Medicine
²The Institute of Kidney Disease, Yonsei University, College of Medicine
³The Institute of Kidney Disease, Yonsei University, College of Medicine
⁴Department of Pediatrics and Microbiology Yonsei University, College of Medicine
⁵Department of Pediatrics and Microbiology Yonsei University, College of Medicine
⁶Department of Pediatrics and Microbiology Yonsei University, College of Medicine

ABSTRACT

Purpose: Our study was designed to investigate the association of MHC Class II (DR, DQ) allele with IgA nephropathy and its significance as a prognostic factor for progression to ESRD.
Material and Methods : 69 children with IgA nephropathy with normal renal function(serum creatinine leq 1.5mg/dL) was classified as group A and 70 patients who received renal transplantation due to IgA nephropathy were selected as group B. The HLA-DQB1 and HLA-DRB1 alleles were studied by polymerase chain reaction using sequence specific primers. We have compared the difference in alleles between these two groups and with normal control and also examined any possible effect of the MHC class II genes on the histopathological severity and prognosis of IgAN.
Results : Mean age was 8.8+/-2.9 years in group A and 35.0+/-15.5 years in group B. Male to female ratio was 2.8:1 in group A and 2.5:1 in group B. There was a significantly higher frequency of HLA-DQB1^*03 and DQB1*05 in Group B. The frequency of HLA-DQB1^*0302 and ^*05031 allele had increasing tendency in Group B(P<0.05). HLA-DRB1^*03 and ^*05 were more common in Group B(P<0.05). HLA-DRB1^*04 allele was the most common DR alleles in both group, but there was no statistical significance. There were no significant correlation with MHC class 13 genes on the hjstopathological severity in Group A.
Conclusion : In conclusion, HLA-DQB1^*0302 and HLA-DQB1^*05031 allele seemed to be more common in transplanted patients compared to group with normal renal function suggesting that this allele is associated with poor prognosis in IgAN. However larger studies and follow up are required to confirm this due to uncharacterized heterogeneity in etiopathogenesis of IgA nephropathy and possibly one or more than one gene may exert influence in determining susceptibility to the diseases.

Key words: IgA nephropathy | Prognostic factor | MHC class II | HLA