Peculiarities of HLA-phenotypes in patients with pyelonephritis

Анотація

Introduction. Of great interest are the studies on the role of human leucocyte antigens (HLA) in pathogenesis of a disease. The kidneys is vulnerable to injury in the context of inflammatory responses, with the potential involvement of a number of different inflammatory processes. There are shown the associative links of the HLA antigens which stipulate the relative and attributive risks of some autoimmune diseases, with immune disorder and high production of pro-inflammatory cytokines, that confirms their important role in immunopathogenesis. The aim was to determine the value of some HLA in the development of such important desease as pyelo- and glomerulonephritis.

Material and Methods. The distribution of HLA-A, B, DR antigens in 364 patients with kidney diseases (120 – pyelonephritis and 244 - glomerulonephritis) was analyzed. HLA antigens were defined using a standard microlymphocytotoxic test on the Terasakiґs planchette with special panels of anti-HLA serums (20 antigens of locus A, 31 – B and 9 – DR). The control group consisted of 350 healthy donors – students from Kiev. The HLA antigen frequencies in normal and deseased subjects were compared taking each antigen separately, using χ²  test. The etiologic fraction (attributive risk s>0.1) was counted using the formula: s = (x - y)/(I- y), where x is frequency of antigen in patients and y – frequency in healthy. The s  reading was considered reliable when it exceeded 0.1. Results and discussion. It is advisable to associate PN are А10, А11, В14, В16 и В17 (RR > 2); the causal role (σ > 0.1) was determined for А10, А11, В14, В16; antigens-protectors - А2, В21, В35, В40. Associated with CGN, NS (RR > 2) are with antigens HLA- A23, 24, 28; B8, 38, 44 in patients; the causal role (σ > 0.1) was determined for A24, 28; B8; antigens-protectors – B12, B16. The analysis of the associative features of HLA-phenotype and identified pathogens in patients with PN is carried out. HLA-А2 і В35 as protectors of PN associate  with smaller frequency of  presence the E. Cоli in urine of patients. Conclusion. The article analyzes the peculiarities of HLA-phenotypes in patients with pyelo- and glomerulonephritis, which allowed to establish a correlation between certain genes of histocompatibility complex and susceptibility to develop some diseases of the kidneys in humans. The HLA-phenotype analysis and infection activators for PN allows to take into account the additional prognostic markers not only of disease but also of its course, that provokes more individualized approach to the therapy of patients.