Human leukocyte antigen polymorphism in chronic and aggressive periodontitis among Caucasians: a meta-analysis.

Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.
Journal Of Clinical Periodontology (Impact Factor: 3.61). 04/2008; 35(3):183-92. DOI: 10.1111/j.1600-051X.2007.01189.x
Source: PubMed

ABSTRACT Multiple studies have reported associations between periodontitis and particular human leukocyte antigens (HLA). Because associations are inconsistent, we conducted a systematic literature review and a meta-analysis focusing on Caucasian case-control studies.
A literature search reporting on the distribution of HLA class I and II phenotypes in Caucasian patients with chronic periodontitis (CP) and aggressive periodontitis (AP) was performed. Data sources included electronic databases and bibliographies of published articles. Screening and data abstraction were conducted independently by different reviewers.
Out of 174 publications, 12 studies were considered to be suitable for meta-analysis. In patients with CP, no significant HLA associations were found. Patients with AP showed a positive association with HLA-A9 [odds ratio=2.59 (95% confidence interval 1.36-4.83), p=0.004] and HLA-B15 [1.90 (1.15-3.16), p=0.01] as well as a negative association with HLA-A2 [0.72 (0.56-0.94), p=0.01] and -B5 [0.49 (0.30-0.79), p=0.004]. On grouping all patients into one periodontitis group (AP+CP), the same deviations were confirmed with higher statistical significance. For HLA-A9 and -B15, significant heterogeneity was found between the studies. No significant associations were found with HLA class II antigens.
HLA-A9 and -B15 seem to represent susceptibility factors for AP whereas HLA-A2 and -B5 are potential protective factors against periodontitis among Caucasians.

Download full-text


Available from: Jamal M. Stein, Sep 07, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Periodontal disease, which affects tooth-supporting structures, results from disequilibrium between the oral micro flora and host defense mecha-nisms. It has been classified into chronic (CP) or ag-gressive (AP) periodontitis according to disease onset, localization and progression. Because of their invol-vement in generating immune responses, Human Leukocyte Antigen (HLA) alleles are considered can-didate genetic risk markers for periodontitis. Addi-tionally, periodontitis appears to contribute to the severity of some systemic conditions such as cardio-vascular disease and adverse pregnancy outcome as indicated by elevated levels of C-reactive protein (CRP). Aim: The aims of this study were to deter-mine if there is an HLA-AP association in Lebanese patients, and to determine CRP levels in patients and compare them to those in healthy controls. Materials and methods: The study groups included 26 patients with AP and 39 healthy controls. HLA profiles were determined by DNA typing and CRP levels by ELI-SA. Results: HLA-A*30 (P-value = 0.010), HLA-B*41 (P 1 = 0.012 and P 2 = 0.014), HLA-DRB1*13 (P 1 = 0.031 and P 2 = 0.063) alleles seemed to be associ-ated with protection against AP in Lebanese patients. No linkage disequilibrium existed between alleles associated with AP. Ten of 26 AP patients (38.5%) and 10 of 39 (25.7%) controls had elevated CRP lev-els. Conclusion: In conclusion, protective, but no sus-ceptible HLA alleles were detected in AP. CRP levels were not elevated in the entire AP group, and were not significantly different from controls. No linkage disequilibrium existed between alleles.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to evaluate tumor necrosis factor (TNF)-alpha and interleukin (IL)-4 levels in healthy sites and sites exhibiting signs of moderate and advanced generalized aggressive periodontitis (GAgP) in the same subject. The following sites were selected for crevicular fluid sampling in the same AgP subject (n = 14): Healthy sites (HS): no marginal bleeding or bleeding on probing (BOP) and probing depth (PD) <or= 3 mm; Moderate sites (MS): BOP and PD between 4 and 6 mm; Advanced sites (AS): BOP and PD >or= 7 mm. One site from periodontally healthy subjects (n = 13) was sampled for use as a control. TNF-alpha and IL-4 levels were measured using ELISA. The total amount of TNF-alpha was lower for control sites, while there were no differences among healthy and diseased sites from GAgP subjects (P < 0.05). The concentration of TNF-alpha was higher in HS, in relation to the other sites (P < 0.05). There were no significant differences among the groups regarding total amounts of IL-4 (P > 0.05), while IL-4 concentration was significantly higher in control sites, when compared with sites from GAgP subjects (P < 0.05). In conclusion, high levels of TNF-alpha and low levels of IL-4 were observed in both healthy and diseased sites within the same generalized AgP individuals.
    Oral Diseases 09/2008; 15(1):82-7. DOI:10.1111/j.1601-0825.2008.01491.x
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the correlation of six functional polymorphisms in the MBL gene with MBL plasma levels in relation to periodontitis. Material and A total of 92 periodontitis patients and 70 controls, all of Caucasian origin, were included. Patients and controls were genotyped for the L/H, X/Y, P/Q, A/D, A/B and A/C polymorphisms. Distributions of genotypes, rate of allele carriage and allele frequencies were compared between patients and controls. Patients and controls were subdivided in groups of genotypes. Plasma MBL levels were compared between different genotype groups. On the basis of genotyping, three phenotypes with regard to mannose-binding lectin (MBL) production were distinguished: high-producers, low-producers and deficient subjects. No differences in the genotype frequencies were observed between patients and controls. Within patients and controls, subjects with the high-producing genotypes had significantly higher MBL plasma levels than low-producers and deficient subjects (p<0.001). Plasma MBL was higher in low-producer patients compared with low-producer controls (p(adjusted)=0.021). No association could be observed between MBL gene polymorphisms and susceptibility to periodontitis in Caucasians. However, now that genotyping could distinguish the low producing and deficient subjects from the high-producers, it was observed, for the first time, that MBL acts as a weak acute-phase protein in periodontitis.
    Journal Of Clinical Periodontology 10/2008; 35(11):923-30. DOI:10.1111/j.1600-051X.2008.01311.x