HLA-DRB1 alleles in Kuwaiti children with idiopathic nephrotic syndrome

Abstract

We have studied the effect of HLA-DRB1 alleles on the clinical presentation of 61 Kuwaiti Arab children with idiopathic nephrotic syndrome. DR7(*0701) was the most prevalent DR allele, found in 41/61 patients (67%) compared with 10/59 healthy controls (17%) (p<0.001). DR3(*0301-0308) allele was the second most common, found in 25% of patients compared with 26% of controls (not significant). There was no significant difference between DRB1*0701(DR7)-positive and DRB1*0701-negative patients in terms of steroid sensitivity, steroid dependency, or steroid resistance. Nevertheless, the former group had a significantly lower mean age of onset (35 months vs 53 months) and a shorter remission period following treatment with cyclophosphamide or chlorambucil (8 months vs 29 months). Our data highlight the role of the DRB 1*0701 allele in predisposing Kuwaiti Arab children with idiopathic nephrotic syndrome to a more prolonged course of the disease.

HLA-DR, -DQB Typing of Steroid-Sensitive Idiopathic Nephrotic Syndrome Children in Taiwan

“…Several studies have reported specific HLA alleles to be risk factors of nephrotic syndrome [12,13,14,15,16,17,18,19,20,21], but the results are inconsistent. Most of these studies demonstrated that patients with steroid-sensitive nephritic syndrome (SSNS) have strong associations with certain HLA alleles, but the associated alleles vary in different populations.…”

“…Hence, data from the Shanghai and Singapore studies analyzing HLA frequencies in their controls are of special interest. From table 6, we can see that HLA-DR7 was found to be more frequent in INS children in both Shanghai (40 vs. 11.23%, p = 0.00025) and Kuwait (43 vs. 13%, p < 0.001) [12, 16], while HLA-A*11, rather than the HLA-DR or -DQ alleles, was more frequent in Singaporean patients [17]. However, the frequency of HLA-DR7 was low in both patient and control groups in our study (6.8 and 2.3%, respectively, table 1), which indicated the difference in genetic backgrounds.…”

“…In fact, only a few studies have focused on responsiveness to drugs besides steroids [16, 19]. Cyclophosphamide, cyclosporin A and chlorambucil were discussed in a Kuwaiti study [16]; however, only DRB1- 0701 was chosen for analysis of the association with the above drugs in that study, and there no significant difference was found between patients with and without DRB1- 0701.…”

“…Cyclophosphamide, cyclosporin A and chlorambucil were discussed in a Kuwaiti study [16]; however, only DRB1- 0701 was chosen for analysis of the association with the above drugs in that study, and there no significant difference was found between patients with and without DRB1- 0701. In another study in Poland, Krasowska-Kwiecień et al [19] found that the length of time to remission was longer in patients bearing HLA-DR3 as compared with HLA-DR3-negative patients under chlorambucil therapy.…”

Is typing for HLA class II alleles beneficial in Indian children with idiopathic nephrotic syndrome?

“…There have been studies from different parts of the world regarding the HLA class II DR and DQ associations with steroid sensitive nephrotic syndrome in children [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Most of these studies are small and have tested only limited alleles and yielded different associations.…”