Human Leukocyte Antigen Genotype as a Marker of Multiple Sclerosis Prognosis

Can J Neurol Sci. 2020 Mar;47(2):189-196. doi: 10.1017/cjn.2019.329.

Abstract

Objective: In a previous pilot monocentric study, we investigated the relation between human leukocyte antigen (HLA) genotype and multiple sclerosis (MS) disease progression over 2 years. HLA-A*02 allele was correlated with better outcomes, whereas HLA-B*07 and HLA-B*44 were correlated with worse outcomes. The objective of this extension study was to further investigate the possible association of HLA genotype with disease status and progression in MS as measured by sensitive and complex clinical and imaging parameters.

Methods: Hundred and forty-six MS patients underwent HLA typing. Over a 4-year period of follow-up, we performed three clinical and magnetic resonance imaging (MRI) assessments per patient, which respectively included Expanded Disability Status Scale, Multiple Sclerosis Severity Scale, Timed-25-Foot-Walk, 9-Hole Peg Test, Symbol Digit Modalities Test, Brief Visual Memory Test, California Verbal Learning Test-II, and whole-brain atrophy, fluid-attenuated inversion recovery (FLAIR) lesion volume change and number of new FLAIR lesions using icobrain. We then compared the clinical and MRI outcomes between predefined HLA patient groups.

Results: Results of this larger study with a longer follow-up are in line with what we have previously shown. HLA-A*02 allele is associated with potentially better MS outcomes, whereas HLA-B*07, HLA-B*44, HLA-B*08, and HLA-DQB1*06 with a potential negative effect. Results for HLA-DRB1*15 are inconclusive.

Conclusion: In the era of MS treatment abundance, HLA genotype might serve as an early biomarker for MS outcomes to inform individualized treatment decisions.

Keywords: Clinical score; HLA genotype; Magnetic resonance imaging; Multiple sclerosis; Prognostic.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Disease Progression
  • Female
  • Genotype
  • HLA-A2 Antigen / genetics
  • HLA-B44 Antigen / genetics
  • HLA-B7 Antigen / genetics
  • HLA-B8 Antigen / genetics
  • HLA-DQ beta-Chains / genetics*
  • Histocompatibility Antigens Class I / genetics*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis, Chronic Progressive / diagnostic imaging
  • Multiple Sclerosis, Chronic Progressive / drug therapy
  • Multiple Sclerosis, Chronic Progressive / genetics*
  • Multiple Sclerosis, Chronic Progressive / physiopathology
  • Multiple Sclerosis, Relapsing-Remitting / diagnostic imaging
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting / genetics*
  • Multiple Sclerosis, Relapsing-Remitting / physiopathology
  • Prognosis
  • Young Adult

Substances

  • HLA-A*02 antigen
  • HLA-A2 Antigen
  • HLA-B*07 antigen
  • HLA-B44 Antigen
  • HLA-B7 Antigen
  • HLA-B8 Antigen
  • HLA-DQ beta-Chains
  • HLA-DQB1 antigen
  • Histocompatibility Antigens Class I