Tehran University Medical Journal (Dec 2014)
Frequency determination of HLA-DRB1 and HLA-DQB1 alleles in children with primary vesicoureteral reflux
Abstract
Background: Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder into the ureter and toward the kidney. Vesicoureteral reflux is the most com-mon inherited disease in urogenital system. Primary VUR is the most common urologi-cal anomaly in children and it has been reported in 30-50% of those who present with urinary tract infection (UTI). The association of vesicoureteral reflux, urinary tract in-fection and renal damage is well known. Current methods for vesicoureteral reflux di-agnosis are unpleasant. Therefore, human leukocyte antigen system not only might help to detect causative gene but also would assists to establish better prognoses tests of this disease. In this study, the relationship between vesicoureteral reflux and HLA-DRB1 and HLA-DQB1 genes were investigated. Methods: This study applied on forty vesicoureteral reflux confirmed children from Kerman province, Iran. These children have been admitted to the Afzalipour Hospital for UTI and primary VUR for them was proved by voiding cystourethrogram (VCUG). Also, forty children without any VUR sign as control group. DNA was extracted from the whole blood sample and was amplified using sequence-specific priming polymerase chain reaction (PCR-SSP) method. Finally PCR products were evaluated by electropho-resis in 1.5% agarose gel and frequency of alleles and haplotypes were compared by Chi-square test. Significance level was assumed at P< 0.05. Results: Low-resolution HLA typing showed the frequency of the HLA-DR17 antigen was significantly increased in vesicoureteral reflux children compared to control group (P= 0.039). On the other hand HLA-DR16 was significantly decreased in vesicoureteral reflux group. Also, frequency of HLA-DQ2 was significantly higher in patients com-pared to control group (P= 0.002). DRB1 (11, 17) and DQ (2, 7) haplotypes were also higher in vesicoureteral reflux patients (P= 0.027, P= 0.01). Conclusion: The HLA cluster might affect on susceptibility to vesicoureteral reflux es-pecially by locus which located close to HLA-DRB1 and HLA-DQB1 genes. This study demonstrates for the first time in Iran. However, further extensive researches with a large number of samples from different populations and ethnicities are required to val-idate the results obtained in this study.
