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The genetic and bacteriological aspects of Peyronie's disease
D J Ralph1, G Schwartz, W Moore
1Institute of Urology, St Peter's Hospital, London, England.
Purpose:
Peyronie's disease has been associated with HLA tissue types, including HLA-A1, DR3, DQw2 and HLA-B7 cross-reactive group antigens which include HLA-B27. This association was tested as was the process of molecular mimicry where the host HLA surface antigen cross-reacts with a microorganism.
Materials And Methods:
HLA tissue typing was performed on 51 white patients with Peyronie's disease, of whom 15 also had Dupuytren's contracture of the hand. Fecal, urine and urethral samples were taken from patients with Peyronie's disease who had proved penile inflammation on biopsy. The samples were cultured for species of Campylobacter, Shigella, Salmonella, Yersinia, Chlamydia and gonococcus, all known to cross-react with the HLA-B27 surface antigen. Antibodies to Klebsiella species, Proteus species and Escherichia coli were also assessed in the sera of 65 patients with Peyronie's disease.
Results:
A significant association between Peyronie's disease and HLA-B27 was found (p = 0.02). The remaining antigens of the HLA-B7 group were not significantly associated with the disease individually (HLA-B7 p > 0.2, HLA-B22 p > 0.6, HLA-B40 p > 0.7) or as a group (p = 0.69). The previously found associations did not reach significance in this study (HLA-A1 p > 0.5, HLA-B8 p > 0.2, HLA-Cw7 p = 0.1, HLA-DR3 p > 0.4, HLA-DQ2 p > 0.4). Cultures for all enteric and urethral organisms were negative, and patients with Peyronie's disease did not have elevated serum titers of anti Klebsiella, anti Proteus or anti E. coli antibodies.
Conclusions:
Although there is an association between Peyronie's disease and HLA-B27, molecular mimicry does not occur with the organisms tested, and an infectious agent has not been found in this study.
Insights
Peyronie
Area of Science:
- Urology
- Immunogenetics
Background:
- Peyronie's disease is a connective tissue disorder affecting the penis.
- Previous studies suggested associations between Peyronie's disease and specific Human Leukocyte Antigen (HLA) types, including HLA-B27.
- The theory of molecular mimicry proposes that microbial antigens may trigger autoimmune responses in genetically susceptible individuals.
Purpose of the Study:
- To investigate the association between Peyronie's disease and HLA-B27.
- To explore the role of molecular mimicry by testing for specific microbial infections and antibodies in patients with Peyronie's disease.
Main Methods:
- Human Leukocyte Antigen (HLA) tissue typing was performed on 51 patients with Peyronie's disease.
- Microbiological cultures of fecal, urine, and urethral samples were conducted.
- Antibody titers against specific bacteria (Klebsiella, Proteus, Escherichia coli) were measured in patient sera.
Main Results:
- A statistically significant association was found between Peyronie's disease and HLA-B27 (p = 0.02).
- No significant associations were observed with other HLA-B7 cross-reactive group antigens or previously reported HLA associations.
- Microbial cultures were negative, and no elevated antibody titers against tested bacteria were detected.
Conclusions:
- While an association between Peyronie's disease and HLA-B27 exists, the study did not find evidence supporting molecular mimicry with the tested organisms.
- An infectious agent was not identified as a causative factor in this cohort of patients with Peyronie's disease.