Two amino acid substitutions at residues 63 and 67 between HLA-B51 and HLA-Bw52 form multiple epitopes recognized by allogeneic T cells.
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Clone Cells↗
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Hereditary factors of Takayasu arteritis.
Takayasu arteritis is a chronic vasculitis characterized by a clinical pulseless condition and is predominant in young female patients. Its loci is found mainly in Asian countries, and its etiology is still unknown. Our experiences of cases of twin sisters with Takayasu arteritis led us to suppose that hereditary factors participate in the pathophysiology of this disease. Population and family-incidence studies employing HLA analysis in Japan have focused on an complotype Aw24-DW52-C4A2-C4BQ0-Dw12 which was in disequilibrium with Takayasu arteritis. Clinical features and clinical courses were found to be intimately related to this complotype. Recent studies on HLA typing in other countries have also suggested the important roles of hereditary factors in this morbid condition and international collaborative studies on these hereditary factors are now under way.
Adolescent↗
Comparative studies between Japanese and Korean patients: comparison of the findings of angiography, HLA-Bw52, and clinical manifestations.
A Japan-Korea cooperative survey on Takayasu arteritis has shown some differences in the features between Japanese and Korean patients with this disease. In angiographic findings, Japanese patients more frequently had lesions at the aortic arch and/or its branches (58% of 75 cases), while, in Korean patients, the abdominal aorta is the site of relatively frequent lesions (30% of 112 cases). Higher occurrence of HLA-Bw52 was found in Japanese patients in comparison with Korean patients (46% vs 15%). The presence of HLA-Bw52, however, might have a close association with Takayasu arteritis in Korea as well as in Japan. The complications in 126 Japanese and 88 Korean patients were also compared. The complications occurring with higher frequency in Japanese patients were aortic regurgitation, ischemic heart disease, and visual disturbances, while, in Korean patients, the more frequent complications were renovascular hypertension as well as hypertension of some other etiology.
Adolescent↗
Left ventricular dysfunction and HLA Bw52 antigen in Takayasu arteritis.
Heart disease is the main cause of death in patients with Takayasu arteritis. It has been reported that this disease is closely related to the presence of HLA Bw52 antigen. To assess the correlation between this antigen and left ventricular involvement, we studied 40 patients with Takayasu arteritis, 21 with and 19 without Bw52, using Tl-201 stress myocardial scintigraphy and echocardiography. Those with Bw52 had a significantly higher incidence of abnormal electrocardiographic findings (67% vs 26%; P < 0.05) and of aortic regurgitation (52% vs 11%; P < 0.05). The echocardiographically determined interventricular septal wall thickness plus left ventricular posterior wall thickness (25 +/- 8 vs 17 +/- 3 mm; P < 0.01) and the left ventricular mass (257 +/- 132 vs 142 +/- 51 g; P < 0.01) were significantly increased in the patients with Bw52. Scintigraphically determined perfusion abnormalities were significantly more frequent in those with Bw52 (76% vs 32%; P < 0.05). These observations indicate that patients with Takayasu arteritis and Bw52 antigen have a more severe left ventricular involvement than the patients without that antigen. The left ventricular impairment may account for the poor prognosis of Takayasu patients with Bw52.
Adult↗
Pregnancy in Takayasu arteritis from the view of internal medicine.
To evaluate the influence of pregnancy on the morbid condition of Takayasu arteritis, we summarized the clinical data and pregnant courses of 18 patients with Takayasu arteritis and a total of 22 deliveries. We followed C-reactive protein (CRP) scores in 16 of 18 patients (20 of 22 deliveries) to ascertain the inflammatory condition inherent in Takayasu arteritis 1 year prior to, during, and 1 year after pregnancy. We also evaluated digital plethysmograms (pulse amplitude, pulse wave, crest time) to follow the hemodynamical condition of patients before, during, and after pregnancy. CRP scores improved significantly during pregnancy and 1 year after delivery. In the digital plethysmograms, pulse amplitude and wave also exhibited improvement after delivery, but crest time remained unchanged. This indicated that pregnancy is a state favorable to this disease. Some factors, such as the sex hormone progesterone, may induce this condition, but the details are still unknown. In conclusion, inflammatory activity and the hemodynamic state improve with pregnancy in patients with Takayasu arteritis. The physiologic aspects which cause this improvement should be maintained even after pregnancy.
Adult↗
Takayasu arteritis: follow-up studies for 20 years.
We reviewed retrospectively 126 (5 male, 121 female) patients suffering from Takayasu arteritis who had been treated in our clinics from 1971 to 1990. The patients' ages ranged from 19 to 80 yrs old (1990) with a mean age of 48.7 +/- 11.8 years. HLA typing analysis in 98 patients revealed that 45 patients (47%) were confirmed as carrying the Bw52 antigen, a high result that is statistically significant as compared with that in healthy Japanese. Arteriograms (performed in 75 patients) revealed that 28 patients (37%) were affected in the aorta and its main branches by this disease (type IV by Nasu's classification) and 23 patients (31%) were affected only in the main branches (type I). The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) improved significantly from 2.55 +/- 0.28(+) and 57.0 +/- 5.69 mm/hr to 0.53 +/- 0.12(+) and 31.2 +/- 3.45 mm/hr, respectively after treatment including steroid and antiplatelet therapy (P < 0.01). Patients with Bw52 exhibited more severe inflammatory conditions than those without Bw52. Lung scintillations performed in 81 patients showed pulmonary arterial lesions in 50 patients (62%). Echocardiograms revealed aortic regurgitation (AR) in 44 patients (35%), with a significant difference noted between the Bw52 positive group and the Bw52 negative group [29/40 (73%) versus 11/47 (23%), respectively, P < 0.001]. Patients with Bw52 were prescribed higher doses of steroids (P < 0.05) for longer periods (P < 0.01) than those without Bw52.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Ventricular arrhythmias in Takayasu arteritis.
We studied the prevalence, severity and clinical significance of ventricular arrhythmias in 78 female patients with Takayasu arteritis by 24-h ambulatory electrocardiography monitoring. Fifty (64%) of 78 patients had no or less than 30 beats/h premature ventricular contractions (Group A). The remaining 28 (36%) patients exhibited frequent or complex premature ventricular contractions (Group B). The frequency of HLA Bw52 which is closely associated with this morbid condition, echocardiographic and thallium-201 stress myocardial scintigraphic findings were then compared between these two groups. The frequency of positive HLA Bw52 was not significantly different between these two groups. Echocardiographically determined left ventricular mass (309 +/- 94 vs. 166 +/- 64 g; P < 0.01), frequency of complicated aortic regurgitation (77% vs. 24%; P < 0.01) and abnormal thallium-201 scintigraphic findings (76% vs. 38%; P < 0.05) were found higher in Group B as compared with those in Group A. These data indicate that frequent or complex ventricular arrhythmias in patients with Takayasu arteritis were associated with the presence of left ventricular hypertrophy, aortic regurgitation and decreased coronary reserve.
Adult↗
Peptide motifs of HLA-B51, -B52 and -B78 molecules, and implications for Behćet's disease.
Here we report peptide motifs of five HLA-B molecules, B*5101, B*5102, B*5103 B*5201 and B*7801. Motifs were obtained by pool sequencing of natural ligands eluted from the respective molecules expressed in C1R cells upon transfection. A number of individual ligands that could be sequenced confirmed the motifs. All five HLA-B molecules belong to the HLA-B5, B35-cross-reactive group and are closely related as indicated by similar sequences. B51 and B52 are associated with Bw4, whereas B78 is associated with Bw6. One of the HLA-B molecules investigated here, HLA-B*5101, is associated with Behçet's disease, a multisystemic inflammatory disease affecting various organs. This disease is especially frequent among the Japanese population. The subtle differences between the peptide motifs of B*5101 as compared with the motifs of the four other closely related but not disease-associated molecules could shed light on the nature of the HLA-association of Behçet's disease.
Amino Acid Sequence↗
Discrimination of HLA-B5 crossreactive group antigens by human allospecific CTL clones.
Human CTL clones discriminating serologically closely related HLA-Bw52, B51, and B35, which belong to HLA-B5 crossreacting group (CREG), were established from peripheral blood lymphocytes by repeated in vitro stimulations. Five HLA-Bw52-specific CTL clones from an individual with HLA-B5 CREG antigens and four CTL clones from another individual with HLA-B51 were generated. The specificity of these CTL clones was ascertained by their lysis of EBV-transformed B cells with HLA-Bw52, but not those with HLA-B51 or B35, and Bw52-transfected Hmy2CIR cells but not HLA-B51 or B35 transfectants. Conversely HLA-B51-specific clones were generated from the HLA-B5 CREG-negative individual, as well as another individual with HLA-Bw52. Their specificity was determined in a similar fashion. Since HLA-B51 differed from HLA-Bw52 only by two amino acid substitutions on the alpha helical region of the alpha 1 domain, these results demonstrated that allospecific CTLs can be produced and discriminate the epitopes formed by the subtle difference in the structure of these HLA class I molecules. Furthermore, three HLA-B35-specific CTL clones were generated from the HLA-B5 CREG-negative individual that discriminated HLA-B35 from HLA-Bw52 and B51. Taken together these results demonstrated that human CTL clones could definitively discriminate the three serologically related HLA-B5 CREG specificities.
Clone Cells↗
Histocompatibility antigens HLA-A, -B, -DR in Greek patients with Kaposi's sarcoma.
Thirty-two Greek patients with histologically documented Kaposi's sarcoma, aged 46 to 82 years, were typed for HLA-A, B and DR antigens. None of them was homosexual and they had not been subjected to any immunosuppressive therapy. The study revealed a significant increase of HLA-DR5 (53.1% vs. 21.4%, R.R. 4.1) and a decreased frequency of HLA-DR1 (3.3% vs. 16.6%, R.R. 0.16). An increased frequency of HLA-B18 was also noted (43.7% vs. 20.7% R.R. 2.96). These results indicate that the same positive association with HLA-DR5 antigen is observed in Greek patients as in other patients of Mediterranean origin and support the view that HLA linked factor(s) may have a role in the development of the disease.
Aged↗
DNA typing of HLA-B gene in Takayasu's arteritis.
Sixty-four patients with Takayasu's arteritis and 156 healthy individuals in the Japanese population were examined for HLA-B specificity at the DNA level by DNA typing using polymerase chain reaction (PCR)/sequence-specific oligonucleotide probe (SSOP) analysis and by subsequent sequencing analysis. The frequency of epitope combination group-B52 (EC-B52) corresponding precisely to HLA-B52 specificity and that of EC-B39.2 which is a newly-identified subtype of HLA-B39 specificity were increased in the patient group. These two disease-associated HLA-B alleles share an epitope composed of 63Glu and 67Ser. Because two HLA-B alleles, HLA-B51 and B39.1, which are similar but different at the epitope from HLA-B52 and B39.2, respectively, are not associated with Takayasu arteritis, 63Glu and 67Ser are supposed to be involved in the pathogenesis.
Alleles↗
Close association of HLA-B51 and B52 in Israeli patients with Behçet's syndrome.
Epidemiological data, family history, clinical data, and HLA typing were studied in three groups of patients with Behçet's syndrome: six Israeli Ashkenazi Jews, 29 non-Ashkenazi Jews, and three Israeli Arabs. HLA-B51 and B52 were present in 24/38 (63%) and 8/38 (21%), respectively, of the patients compared with 13/151 (9%) of the control group for both cases, a relative risk of 18.2 and 2.8 respectively. The syndrome was found in six of the 34 families. Ninety five per cent of the affected family members were either B51 or B52 positive. Eleven of the 14 families (79%) chosen for study contained a close relative of the proband who had recurrent oral ulcers. All the relatives with ulcers, except for one, were B51 or B52 carriers. Recurrent oral ulcers in the patients with Behçet's syndrome began a few years before other manifestations of the syndrome occurred. Our findings suggest that (a) HLA-B51 and HLA-B52 are primarily associated with Behçet's disease of Israeli patients; (b) the familial occurrence of this syndrome is high and occurs predominantly in the B5 positive group; (c) recurrent oral ulcers may be the first symptom of Behçet's syndrome, appearing early in life; HLA analysis can provide the clue for a correct diagnosis; (d) ulcer recurrence is common among members of a family containing a patient with Behçet's syndrome.
Behcet Syndrome↗
Comparative studies of patients with Takayasu arteritis in Japan, Korea and India--comparison of clinical manifestations, angiography and HLA-B antigen.
Comparative study of Takayasu arteritis in 3 Asian countries (India, Korea and Japan) has revealed some significant differences. In angiographic findings, Japanese patients more frequently have lesions at the aortic arch and/or its branches (99% of 96 cases), while most lesions in Korean (76% of 109 cases) and Indian patients (92% of 50 cases) are at the abdominal aorta. The presence of HLA-Bw52 or B5 is closely associated with Takayasu arteritis in all 3 Asian countries. The complications in 108 Japanese, 101 Korean and 50 Indian patients were also compared. The most frequent complications were aortic regurgitation in Japan and hypertension in the other 2 countries. Death occurred most frequently due to congestive heart failure or sudden death resulting from aortic regurgitation in Japan, but resulting from hypertension in Korea and India.
Adolescent↗
Ulcerative colitis associated with Takayasu's disease.
A 25-year-old Japanese woman had both ulcerative colitis and Takayasu's disease and was positive for HLA-A24, BW52, and DR2. She was found to have thickening of the wall of the carotid artery on contrast-enhanced computerized tomography of the neck and chest. Prednisolone, beraprost, and sulfapyridine achieved rapid remission of both diseases.
Adult↗
Hereditary factors in Takayasu disease. III. Polymorphism of human complements.
Genetic polymorphisms in C2, C4, C6, C7 and BF alleles of human complement were studied in 80 Japanese patients with Takayasu disease, and compared with those of 433 normal Japanese. Statistically significant high frequencies of C4A2 (chi 2: 27.2; p less than 0.01) and C4BQ0 allotype (chi 2: 8.7; p less than 0.01) were found in patients with Takayasu disease. Furthermore, all patients carrying C4A2 were found to be associated with C4BQ0. In addition, patients with HLA Bw52 were strongly associated with C4A2BQ0. In 5 patients homozygous C4BQ0 was found. These data suggest that some genetic factor(s) may contribute to the pathophysiological condition of Takayasu disease, which is strongly associated with the complotype of HLA Bw52-C4A2BQ0.
Adult↗
HLA-B51 and HLA-Bw52 differ by only two amino acids which are in the helical region of the alpha 1 domain.
Genes encoding the serologically cross-reactive HLA-B51 and HLA-Bw52 molecules were isolated and the exons sequenced. HLA-B51 genes obtained from Caucasian and Oriental individuals were identical. HLA-Bw52 differs from HLA-B51 by four nucleotide substitutions in exon 2 encoding the alpha 1 domain. These comprise one isolated silent substitution in codon 23 and a cluster of three coding substitutions in codons 63 and 67. Amino acid substitutions of N----E at position 63 and F----S at position 67 are the only differences between HLA-B51 and HLA-Bw52 and these residues are postulated to form HLA-B51 specific epitopes. HLA-B51 could have been formed from HLA-Bw52 by the combination of a genetic exchange with HLA-B8 and a point mutation. Similarity of HLA-B51 and HLA-Bw52 with HLA-Bw58 suggest they also share a common ancestor.
Amino Acid Sequence↗
CTLs from lymphoid organs recognize an optimal HLA-A2-restricted and HLA-B52-restricted nonapeptide and several epitopes in the C-terminal region of HIV-1 Nef.
In a previous analysis of HIV-1-specific CTLs in lymphoid organs from HIV-seropositive patients, we reported high frequencies of in vivo differentiated CTLs directed against two immunodominant regions in the central and in the C-terminal part of the HIV-1 Nef protein. The present study analyzes the epitopes recognized by CTLs in the carboxyl terminus of Nef (amino acids 182-205). In addition to several epitopes that are recognized in association with different HLA molecules (A1, A2, A25(10), B35, B52), we defined an optimal nonapeptide (190-198). This nonapeptide was recognized by CTLs down to nanomolar concentrations in the context of at least two HLA molecules, HLA-B52 and HLA-A2, including three HLA-A2 subtypes: HLA-A2.1, -A2.2, and -A2.4. We also determined the relative frequencies of effector CTLs directed against peptide 190-198 to be as high as 10(-4), as opposed to lower frequencies ranging between 5 x 10(-5) and 5 x 10(-6) observed for the other peptides recognized in the same region, thus confirming the optimal presentation of this nonapeptide in vivo. Molecular modeling of the interactions between HLA-A2.1 and Nef peptide 190-198 suggests the formation of a stable complex and allowed us to study sequence motifs that are important for the binding of the HIV-1 peptide in the pockets of the HLA-A2.1 molecule.
Base Sequence↗
HLA-DRB1*1502 allele, subtype of DR15, is associated with susceptibility to ulcerative colitis and its progression.
HLA-DRB1 allele typing was performed by the PCR-RFLP method on 59 ulcerative colitis (UC) patients and 136 healthy controls. Phenotypic frequencies of HLA-B52 and DR2 were significantly increased among the UC patients, serologically. DNA typing of HLA-DRB1 revealed that the genotypic frequency of DRB1*1502 was higher in UC than in the controls (49.2% vs 17.6%; P < 0.0001). In the analysis of clinical parameters, 82.8% of patients bearing DRB1*1502 were treated with corticosteroids. DRB1*1501 and DRB1*1502 differ in only one amino acid at residue 86 (valine vs glycine), and 66% of the UC patients carried two glycines at position 86 in the HLA-DR beta-chain (vs 51% of control; P < 0.05). These observations suggest that the presence of Gly-86 in the HLA beta-chain and surrounding amino acid sequence of HLA-DRB1*1502 is strongly associated with susceptibility to UC.
Adolescent↗