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[The HLA system and Coxsackie B viral myocarditis in adults]
Insights
Certain human leukocyte antigen (HLA) types, particularly HLA-A3, are linked to an increased risk of severe Coxsackie B virus myocarditis. This genetic predisposition may influence disease severity.
Area of Science:
- Immunogenetics
- Virology
- Cardiology
Context:
- Human leukocyte antigen (HLA) distribution is crucial in immune responses and disease susceptibility.
- Myocarditis, inflammation of the heart muscle, can be caused by viral infections like Coxsackie B virus or have unknown origins.
- Previous studies suggest a role for genetic factors in the pathogenesis of myocarditis.
Purpose:
- To investigate the association between HLA antigen profiles and the occurrence and severity of Coxsackie B virus myocarditis.
- To compare HLA antigen distribution in myocarditis patients with control groups, including those with myocarditis of unknown origin, coronary disease, and rheumatic heart disease.
Summary:
- A study analyzed HLA-A, B, and C antigen distribution in 152 healthy donors and various patient groups (53 Coxsackie B virus myocarditis, 35 unknown origin myocarditis, 16 coronary, 14 rheumatic).
- Coxsackie B virus myocarditis showed a significant association with increased frequencies of HLA-A3 (severe/medium cases), HLA-B40 (onset before 30), and HLA-Cw2 (high anti-Coxsackie B4 antibody titers).
- HLA antigen distribution in coronary patients resembled controls, while rheumatic patients had increased HLA-Cw2 incidence. HLA-A3 carriers may be genetically predisposed to severe Coxsackie B virus myocarditis.
Impact:
- Suggests a genetic predisposition to severe Coxsackie B virus myocarditis in individuals carrying the HLA-A3 antigen.
- Highlights the potential role of specific HLA types in modulating the immune response to Coxsackie B virus, influencing myocarditis development and severity.
- Provides insights into the immunogenetic basis of viral myocarditis, potentially aiding in risk stratification and understanding disease pathogenesis.
Abstract:
The distribution of HLA antigens A, B and C was studied in 152 normal donors, 53 patients with Coxsackie B virus myocarditis, 35 patients with myocarditis of unknown origin, 16 coronary patients and 14 rheumatic patients with high titres of anti-Coxsackie virus antibodies. Coxsackie virus myocarditis was associated with increased occurrence of HLA antigens A3, B40, Cw2 and A28, the increase being significant (with an adjustment to the number of the tested antigens) for A3 in severe and medium myocarditis, and B40 in patients who had developed myocarditis before age 30. Antigen Cw2 was more common in myocarditis patients with high titres of anti-Coxsackie virus B4 antibodies. The distribution of HLA antigens in coronary patients was similar to that of the controls. Rheumatic patients showed increased incidence of antigen Cw2. It is suggested that carriers of histocompatibility antigen A3 may be predisposed genetically to severe or medium Coxsackie B virus myocarditis.