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Association of Propionibacterium acnes endophthalmitis with HLA-DQw5
J L Davis1, K R Winward, E C Lonardo
1University of Miami School of Medicine, Department of Ophthalmology, Miami, FL.
Background:
An HLA-DQ1 association has been suspected in patients who develop Propionibacterium acnes endophthalmitis following cataract surgery. New techniques exist which may help to define this association.
Materials And Methods:
Patients with culture-proven P. acnes endophthalmitis following cataract surgery were HLA-typed with new sera able to detect fine specificities in the HLA-DQ1 region and compared to a large number of racially-matched controls. Sequence-specific oligonucleotide typing with probes and primers designed to amplify and define the HLA-DQ1 region was then performed. P. acnes patients were compared to HLA-DQ1-matched controls who had undergone cataract surgery but had no evidence of chronic post-operative inflammation.
Results:
Thirteen of 15 P. acnes patients (87%) were serologically defined as carrying a split of DQw1 (DQw5 or DQ26). HLA DQw5 was increased to a statistically significant degree (p < 0.014) with an odds ratio of 3.72 (95% confidence interval 1.34 to 10.31). Sequence-specific oligonucleotide typing confirmed the DQw5 predominance: Seventy-three percent of P. acnes patients had DQB1 (*)0501 or DQB1 (*)0503 vs. 33% of DQw1-matched cataract patients without inflammation (not significant).
Conclusion:
HLA-DQ2w5 is associated with the development of P. acnes endophthalmitis following cataract surgery. The molecular mechanism of this association is unknown.
Insights
A specific human leukocyte antigen (HLA) type, HLA-DQ2w5, is linked to developing Propionibacterium acnes endophthalmitis after cataract surgery. This finding may help identify at-risk patients for this post-operative complication.
Area of Science:
- Ophthalmology
- Immunogenetics
Background:
- A link between HLA-DQ1 and Propionibacterium acnes endophthalmitis post-cataract surgery has been suggested.
- Advanced typing techniques can now better define this association.
Purpose of the Study:
- To investigate the association between HLA-DQ1 and P. acnes endophthalmitis following cataract surgery.
- To utilize new HLA typing methods to confirm or refute this suspected link.
Main Methods:
- Patients with culture-proven P. acnes endophthalmitis underwent HLA typing using new sera for HLA-DQ1 fine specificities.
- Sequence-specific oligonucleotide typing was performed to define the HLA-DQ1 region.
- P. acnes patients were compared to ethnically-matched controls who had cataract surgery without inflammation.
Main Results:
- 87% of P. acnes patients carried a DQw1 split (DQw5 or DQ26).
- HLA DQw5 was significantly increased (p < 0.014) with an odds ratio of 3.72.
- DQB1 (*)0501 or DQB1 (*)0503 was present in 73% of P. acnes patients versus 33% of controls.
Conclusions:
- HLA-DQ2w5 is associated with P. acnes endophthalmitis after cataract surgery.
- The precise molecular mechanism underlying this association remains undetermined.
