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Journal of the Korean Society of Pediatric Nephrology 2000;4(1): 33-39.
한국인 IgA 신병증 환아에서 MHC Class II유전자형과 예후와의 관계 분석
김병길, 육진원, 김지홍, 장윤수, 신전수, 최인홍
1연세대학교 의과대학 소아과학교실, 신장질환연구소
2연세대학교 의과대학 신장질환연구소
3연세대학교 의과대학 신장질환연구소
4연세대학교 의과대학 소아과학교실, 미생물학교실
5연세대학교 의과대학 소아과학교실, 미생물학교실
6연세대학교 의과대학 소아과학교실, 미생물학교실
MHC Class II Allele Association in Korean Children With IgA Nephropathy and its Role as a Prognostic Factor
Pyung Kil Kim, Jinwon Yook, Ji Hong Kim, Yoon Soo Jang, Jeon-Soo Shin, In-Hong Choi
1Department of Pediatrics, The Institute of Kidney Disease, Yonsei University, College of Medicine
2The Institute of Kidney Disease, Yonsei University, College of Medicine
3The Institute of Kidney Disease, Yonsei University, College of Medicine
4Department of Pediatrics and Microbiology Yonsei University, College of Medicine
5Department of Pediatrics and Microbiology Yonsei University, College of Medicine
6Department of Pediatrics and Microbiology Yonsei University, College of Medicine
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ABSTRACT
Purpose: Our study was designed to investigate the association of MHC Class II (DR, DQ) allele with IgA nephropathy and its significance as a prognostic factor for progression to ESRD Material and
Methods: 69 children with IgA nephropathy with normal renal function(serum creatinine $leq$ 1.5mg/dL) was classified as group A and 70 patients who received renal transplantation due to IgA nephropathy were selected as group B. The HLA-DQB1 and HLA-DRB1 alleles were studied by polymerase chain reaction using sequence specific primers. We have compared the difference in alleles between these two groups and with normal control and also examined any possible effect of the MHC class II genes on the histopathological severity and prognosis of IgAN.
Results : Mean age was $8.8{pm}2.9$ years in group A and $35.0{pm}15.5$ years in group B. Male to female ratio was 2.8:1 in group A and 2.5:1 in group B. There was a significantly higher frequency of HLA-$DQB1^*03;and;DQB1^*05$ in Group B. The frequency of HLA-$DQB1^*0302;and;^*05031$ allele had increasing tendency in Group B(P<0.05). HLA-$DRB1^*03;and;^*05$ were more common in Group B(P<0.05). HLA-$DRB1^*04$ allele was the most common DR alleles in both group, but there was no statistical significance. There were no significant correlation with MHC class 13 genes on the hjstopathological severity in Group A.
Conclusion : In conclusion, $HLA-DQB1^*0302;and;HLA-DQB1^*05031 $ allele seemed to be more common in transplanted patients compared to group with normal renal function suggesting that this allele is associated with poor prognosis in IgAN. However larger studies and follow up are required to confirm this due to uncharacterized heterogeneity in etiopathogenesis of IgA nephropathy and possibly one or more than one gene may exert influence in determining susceptibility to the diseases.
Key words: IgA nephropathy | Prognostic factor | MHC class II | HLA
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