HLA-DR types in rheumatic, congenital and degenerative cardiac valve diseases in Saudi patients

Subjects of Saudi origin were DNA typed for HLA-DR2, DR4 and DRw53 by amplification fragment-length polymorphism and amplification by sequence-specific primer techniques based on polymerase chain reaction. Of these subjects, 125 had sporadic heart valve disease (96 with rheumatic heart disease, 18 with degenerate and 11 with congenital degenerate valve disease) and 77 were healthy Saudi blood donors. While the frequency of individuals typed DR4 was about the same in the rheumatic heart disease as in the control category (30% versus 23%, respectively), it was found to be higher (55%; P<0.02), but below the level of marginal significance after correcting for the number of DR types, in the congenital degenerate valve category. No preferential association of any DR4 subtype could be detected. The incidence of DR2 was lower in the congenital cases compared to that in the controls (9% versus 21%) and remained about the same in the rheumatic heart disease patients as in the controls. The frequency of DRw53 in the degenerate valve categories was slightly lower than that in the controls, but the difference was not significant. The study failed to corroborate the association between HLA-DR4 and rheumatic heart disease shown in previous studies using the serotyping approach.