Pemphigus and HLA in Morocco.

PURPOSE OF STUDY: Pemphigus is a group of autoimmune bullous dermatosis diseases characterized by autoantibodies against keratinocyte adhesion molecule. A significant association with HLA class II genes, particularly DR4 and DR14 has been described in many ethnic groups and countries. We have investigated, for the first time in Morocco the relationship between different pemphigus subtypes and HLA genes.

PATIENTS AND

METHODS

Fifty-two unrelated patients were compared to 178 healthy controls matched by age, sex and ethnic origin. HLA typing was performed by standard complement dependent microlymphocytotoxic method for class I and by sequence-specific primer amplification method for class II.

RESULTS

No significant association was observed with any of the HLA-A or -B antigens. Generic typing showed a significant increase of DRB1*04 (p=0.002), DRB1*14 (p=0.003) and DQB1*03 (p=0.02) allele frequencies and significant decrease of DRB1*15 (p<0.0001) and DQB1*06 (p=0.01) allele frequencies. HLA-DRB1*15-DQB1*06 haplotype seems to confer a protective effect in our population while DRB1*04-DQB1*03 and DRB1*14-DQB1*05 haplotypes induced susceptibility to the disease.

CONCLUSION

Taken together, our results confirmed the genetic predisposition to pemphigus. However, genetic factors are not sufficient to explain the high prevalence of pemphigus observed in the Moroccan population since alleles of susceptibility were similar to those commonly described in other populations throughout the world.