Abstract
The association of coeliac disease (CD) with certain histocompatibility antigens is well documented, but these vary regionally in frequency. Also, differences in annual incidence of CD have been noted in several European nations.
We observed in our clinic an increased incidence of 1:204 live births in 1979, versus an average of 1:438. To determine the phenotype frequencies in our area, and to compare the HLA pattern of 1979 with other years, HLA A,B,C, and DR antigen typing was performed on 125 CD patients, representing 76% of the cases born 1978 to 1984. 997 healthy adults from the general population of the same area served as controls for class I and 667 cases for class II antigen determinations. The HLA distribution pattern of the control group agrees with the literature, as does that of the study group, which revealed relative risks (RR) of 6.12 for DR 3, 3.68 for B 8, and 2.67 for DR 7. The frequency of these three phenotypes was similar in all birth years of the study group, while A 2 occured significantly more often in 1979, with an RR of 2.22. Six study patients born 1979 (19%) were negative for B 8, DR 3, and DR 7, but the difference to other years was not significant. However, all 6 were HLA A 2 positive.
It can be speculated that the HLA A 2 antigen might modulate receptivity for or resistance to viral infections. Taking into considerations Kagnoff's hypothesis, this could explain the increased incidence in 1979.
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Winklhofer Roob, B., Rossipal, E. & Lanzer, G. HLA CLASS I AND II ANTIGENS IN COELlAC DISEASE: A STUBY IN AN AUSTRIAN PEDIATRIC POPULATION. Pediatr Res 26, 271 (1989). https://doi.org/10.1203/00006450-198909000-00046
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DOI: https://doi.org/10.1203/00006450-198909000-00046
