HLA and hyperthyroidism in Ireland

Abstract

The distribution of HLA antigens in a group of Irish patients with hyperthyroidism was studied, in an attempt to define whether specific antigens were associated with relapse of the disease following medical therapy. The increase in HLA-B8 and DR3 found by others in this disease was confirmed, but no difference in HLA type was documented in 33 patients who had relapsed compared to 24 who had not relapsed. Forty-six per cent of the relapsed group were DR3 as against 45% of the non-relapsed group.

Immune Mechanisms In Graves' Disease

“…The best example of this type of association is the increased incidence of HLADRw3, a Class II antigen, in Caucasian Graves' disease patients (316). This is a well documented finding with up to 60% of Graves' patients being reported to have this antigen as compared to 11% of the control populations (324)(325)(326)(327)(328)(329)(330)(331)(332)(333)(334). One might postulate that owing to their pivotal role in antigen presentation, a particular Class II antigen might facilitate the development or propagation of an autoimmune respone to thyroid antigens.…”

“…This study (221) has the distinct advantage of apparently being prospective where each patient underwent an identical protocol, but it would have been informative if TSI as well as TBII levels were measured. Although other studies have observed an association between the presence of HLA B8 or DRw3 antigens and Graves' disease (316)(317)(318)(319)(320)(321)(322)(323)(324)(325)(326)(327)(328)(329)(330)(331)(332)(333)(334), some investigators have not noted the propensity for these patients to relapse (316,327,328,334). Allannic et al (329) studied 94 Graves' disease patients and found that 47.8% had B8 (healthy controls 21.5%); 53.2% had DR3 (healthy controls 21.2%); and 42.5% had combined B8 and DR3 antigens (healthy controls 13.3%).…”

“…Several studies have shown that Graves' disease patients having DRw3 antigenic determinants develop the disease earlier and have more recalcitrant disease which is less likely to respond to medical antithyroid therapy (324)(325)(326)(327)(328)(329)(330)(331)(332)(333)(334). Unfortunately, there are also a number of well performed studies which have not been able to confirm this finding (324)(325)(326)(327)(328)(329)(330)(331)(332)(333)(334). Thus, it present at appears that although there is some evidence that DRw3 facilitates the development of Graves' disease, it is prudent to note that the genes responsible for developing Graves' disease are merely associated with the genes for DRw3.…”

Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

“…Moreover, in recent unpublished work, we confirmed the lack of any influence of the presence of these antigens on the prognosis of the disease. Data from others are in keep ing with ours [21,22], At this point, it can therefore be concluded that HLA typing is of no help in selecting patients for medical or ablative therapy. It is likely, however, that this approach warrants further studies using monospecific anti-HLA monoclonal anti bodies allowing discrimination of subtypes of DR antigens.…”

HLA-DR3 and DRw6: prognostic factors for the incidence of hypothyroidism in Graves' disease after radioiodine treatment

“…Whereas the influence of HLA-DR3 on the early course of 131I(Farid et al 1980; Davies et al 1982) or antithyroid drug-treated thyrotoxicosis(Bech et al 1977;McGregor et al 1980; Dahlberg et al 1981;McKenna et al 1982;Allanic et al 1983) has been a subject of several studies, the predic¬ tive value of HLA for the long-term outcome of the treatment remains to be elucidated. Our data show that pre-clinical hypothyroid patients have an elevated frequency of HLA-B8 (P < 0.01) and of DR3 (P < 0.05).…”