Human leucocyte antigen determinants of susceptibility to Barrett's oesophagus in Asians – a preliminary study

• Published in: Alimentary pharmacology & therapeutics Vol. 21; no. 11; pp. 1377 - 1383
• Main Authors: Rajendra, S., Ackroyd, R., Murad, S., Mohan, C., Ho, J. J., Goh, K. L., Azrena, A., Too, C. L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-06-2005; Blackwell
• Subjects: Asian Continental Ancestry Group - genetics; Barrett Esophagus - genetics; Barrett Esophagus - immunology; Biological and medical sciences; Cohort Studies; Digestive system; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - genetics; Gene Frequency; Genetic Predisposition to Disease - genetics; Histocompatibility Antigens Class I - genetics; Histocompatibility Antigens Class II - genetics; Histocompatibility Testing; Humans; Malaysia; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prospective Studies; Malaysia; Antigen; Human; Sensitivity; Leukocyte; Esophageal disease; Digestive diseases; Barrett esophagus
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2005.02496.x

Summary
Background : Characteristic immune profiles have been demonstrated in gastro‐oesophageal reflux disease. However, the genetic basis of gastro‐oesophageal reflux disease remains unclear.
Aim : To investigate whether certain human leucocyte antigen genes are associated with Barrett's oesophagus.
Methods : Asian patients of Malay, Chinese and Indian descent with Barrett's oesophagus (n = 59) and those without reflux symptoms and a normal oesophagus (n =60) were recruited prospectively using endoscopic and histopathological criteria. Human leucocyte antigen class I and II typing was performed using a polymerase chain reaction sequence‐specific primers method.
Results : The HLA‐B7 allele was present in 17% (10 of 59) of patients with Barrett's oesophagus when compared with 0% (zero of 60) of controls [P = 0.0006, corrected P = 0.0171, OR = 25.67]. Subgroup analysis revealed that the HLA‐B7 allele was confined almost exclusively to Indians with Barrett's oesophagus, 43% (nine of 21) vs. 0% (zero of 19) Indian controls (P = 0.0014, corrected P = 0.0406, OR = 29.64). No class II associations, protective human leucocyte antigens or extended haplotypes for disease susceptibility were identified.
Conclusions : Barrett's oesophagus in Asians, particularly Indians, is strongly positively associated with HLA‐B7; reinforcing a genetic component to gastro‐oesophageal reflux disease. A larger sample size and different ethnic populations should be genotyped to further confirm this association and identify possible additional risk factors in the human leucocyte antigen locus.