Review
Am J Gastroenterol 2009; 104:195–217; doi:10.1038/ajg.2008.10
HLA and Autoimmune Digestive Disease: A Clinically Oriented Review for Gastroenterologists
Andrea Cassinotti MD1, Sarah Birindelli PhD2, Mario Clerici MD3, Daria Trabattoni PhD4, Marco Lazzaroni MD1, Sandro Ardizzone MD1, Riccardo Colombo1, Edoardo Rossi MD2 and Gabriele Bianchi Porro MD1
- 1Department of Clinical Science, Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
- 2Immunohematology and Blood Transfusion Service, "L. Sacco" University Hospital, Milan, Italy
- 3Department of Biomedical Sciences and Technologies, University of Milan, Milano, and Laboratory of Molecular Medicine and Biotechnologies, Don C. Gnocchi Foundation, IRCCS, Milan, Italy
- 4DISP LITA Vialba, University of Milan, Milan, Italy
Correspondence: Andrea Cassinotti, MD, Department of Clinical Science, Division of Gastroenterology, "L. Sacco" University Hospital, via G.B. Grassi 74, 20157 Milan, Italy. E-mail: andreacassinotti@libero.it
Received 29 April 2008; Accepted 8 August 2008.
Abstract
OBJECTIVES:
The human leukocyte antigen (HLA) system includes genes involved in graft-vs-host rejection and in immune response. The discovery that HLAs are associated with several diseases led to appealing developments both in basic biomedical research and in clinical medicine, and offered the opportunity to improve the understanding of pathogenesis and classification of diseases, as well as to provide diagnostic and prognostic indicators. The aim of this article is to review the association between HLA alleles and autoimmune digestive disease and its current relationship with modern HLA nomenclature and clinical practice.
METHODS:
Articles dealing with the association between HLAs and autoimmune digestive disease (including celiac disease, inflammatory bowel disease, autoimmune hepatitis, sclerosing cholangitis and primary biliary cirrhosis) were searched for using Pubmed and SCOPUS databases from earliest records to January 2008.
RESULTS:
The review has provided two sections. In the first, we explain the basic principles of HLA structure, function, and nomenclature, as an introduction to the second section, which describes current associations between HLA alleles and digestive diseases. The clinical implications of each HLA association are critically discussed. Actually, a clinical role for HLA typing is suggested for only a few conditions, e.g., celiac disease.
CONCLUSIONS:
The knowledge of current HLA nomenclature and of its association with some digestive diseases such as celiac disease can be useful in clinical practice for diagnostic and prognostic purposes. This can avoid improper HLA typing as well as stressing the need for further studies on other possible clinical applications.
