Pemphigus in Oxford, UK, and New Delhi, India: A Comparative Study of Disease Characteristics and HLA Antigens

Abstract

A study of pemphigus in New Delhi, India, and Oxford, UK, was undertaken including 20 patients in Oxford and 50 in New Delhi. Data included clinical and histological subtypes and socio-economic data; patients were HLA typed. In New Delhi pemphigus vulgaris predominated, but in Oxford pemphigus vulgaris and pemphigus foliaceus have equal prevalence. Disease distribution with sex was the same, but age at onset was significantly lower in New Delhi (p = 0.0019). HLA typing in pemphigus vulgaris patients revealed a significant reduction in HLA-DR2 in New Delhi (p = 0.0008) and Oxford (p = 0.09). A small increase in HLA-DR1 and -DR4 was found in both groups and, in males only, a subtle increase in HLA-DR6 and reduction in HLA-DR3. No differences were found in the class I antigens. Thus there are striking differences in the types of pemphigus between the two populations, yet the genetic predisposition is the same.

HLA Class II Polymorphism Contributes to Specify Desmoglein Derived Peptides in Pemphigus Vulgaris and Pemphigus Foliaceus

“…Our results confirm previous reports showing a strong association of PV with DQB1*0503 which is in linkage disequilibrium with DR14 alleles [3,4,5,8,10,12,13,14,15,16,17]. Since the DQB1*0503 PV patients had various DRB1*14 related alleles, one alternative The AA residues are shown using the letter code.…”

“…The DRB1*1401 or 1404 alleles were found associated with PV in non-Jewish patients of European ancestry (Italy, Sardinia, Spain, Boston area) [3,4,5,6] and in Asian populations (India, Pakistan, Japan) [12,13,14,15,16,17].…”

Pemphigus in North India

“…7,8 A previous study from New Delhi, India, showed a mean age at onset of 41.2 years. 11 We observed a mean age at onset of 39.27 years for males and 38.57 years for females. Although the exact explanation for the earlier age at onset is not clear, environmental factors may, in some ways, be operative 19,20 because a younger age at onset is observed in Asian, Middle Eastern, and North African regions.…”

“…The usual age at onset of the disease was observed to be between the fifth and sixth decades of life in North American, European, South African, and Mali patients, [9][10][11]13,18 whereas a younger age at onset, predominantly in the third to fourth decades, has been observed from Tunisia and Kuwait. 7,8 A previous study from New Delhi, India, showed a mean age at onset of 41.2 years.…”

Klinik und Immunpathologie bei 48 Patienten mit Pemphigus

“…Einige Untersucher fanden ein geringfügig höheres Auftreten des PV bei Männern [14,25]. Aber auch das gleich häufige Auftreten von Pemphiguserkrankungen bei Frauen und Männern wurde berichtet [4,7,10,13,24,28].…”