[Probable association of HLA-DR5 with bullous pemphigoid]

HLA typing was performed in 35 French Caucasoids with bullous pemphigoid and compared with 160 healthy controls. 47 HLA antigens were characterized by a lymphocytotoxicity micromethod. Analysis of the results only reveals one statistically significant difference: an increased incidence of HLA-DR5, which reaches 51.43% in patients versus 22.42% in controls, with P = 0.0007 and Pc = 0.0329. Several bullous dermatosis are associated with various HLA-DR antigens. These data suggest a direct role of HLA-DR molecules in the constitution of these autoimmune disease. An abnormal expression of DR products on some skin cells membrane would permit the presentation of a non self peptide, accumulated in skin cells, to helper T lymphocytes. An heteroimmunization against the non self peptide could lead to lesion of self cells. This peptide perhaps derives from food protein.