Letter: HL-A and idiopathic optic neuritis.
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Biomedical subjects
Publications and source records attributed to P Platz.
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HL-A and MLC typing in 54 patients with optic neruitis showed increased frequencies of the HL-A3, 7 and LD-7a determinants of approximately the same magnitude as in patients with multiple sclerosis. The frequencies of the same three determinants were not different in the 11 patients who developed multiple sclerosis during the period of follow-up compared to the remaining patients. There was a significant increase in the frequency of the HL-A3 determinant in patients with oligoclonal IgG of the cerebrospinal fluid at the onset of disease. The connection between this determinant and the occurrence of cerebrospinal fluid changes is not clear. The results suggest that optic neuritis and multiple sclerosis represent different aspects of the same disease entity, rather than two distinct diseases. HL-A and MLC typing did not seem to offer prognostic information as to the later development of multiple sclerosis in these patients, but the observation period is still short.
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The relationship between the HLA system and insulin-dependent diabetes mellitus (IDDM) is reviewed. Data compiled by the HLA and Disease Registry reveal that HLA-B8 and/or Dw3 are associated with IDDM in all populations studied so far, but further population studies in non-Caucasian populations should be performed. In Caucasians, HLA-Dw2 renders protection against IDDM while HLA-Dw3 and Dw4 are associated with susceptibility to IDDM. The exact mode of inheritance of susceptibility to IDDM remains to be established. Involvement of at least two genes is likely. Heterogeneity of IDDM is highly possible and should be a matter of major interest in diabetes research.