Inflammatory human leucocyte antigen genotypes are not a risk factor in chronic subdural hematoma development

Acta Neurochir (Wien). 2023 Sep;165(9):2399-2405. doi: 10.1007/s00701-023-05745-w. Epub 2023 Aug 8.

Abstract

Background: Chronic subdural hematoma (CSDH) pathophysiology has undergone a paradigm shift from being regarded as solely traumatic to be driven mainly by inflammation. Human leucocyte antigen (HLA) is a gene complex involved in antigen processing and presentation to T lymphocytes, thereby mediating the adaptive immune responses. As specific HLA profiles are associated with inflammatory diseases, patients with a specific HLA profile may have a lower threshold for subdural inflammation, and therefore are predisposed for CSDH development. We hypothesized that (1) CSDH patients have a specific HLA profile compared to a Danish background population, and (2) patients with recurrent CSDH have a specific HLA profile compared to CSDH patients without recurrent CSDH.

Methods: Three specific HLA class II haplotypes known to drive inflammatory-mediated diseases were determined in 68 patients with CSDH. The distribution of these three haplotypes in our CSDH population was compared to a Danish population of blood donors using Monte Carlo Pearson's chi-square test. Furthermore, the distribution of the haplotypes was compared between CSDH patients with and without recurrent CSDH.

Results: We found no significant association between either of the haplotypes and the risk of CSDH, and neither of the haplotypes were associated with increased risk of CSDH recurrence.

Conclusion: This study did not show an association between selected HLA class II haplotypes and the risk of CSDH or recurrence of CSDH compared with a healthy background population.

Keywords: Chronic subdural hematoma; Genetic disposition; Human leucocyte antigen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Genotype
  • Hematoma, Subdural, Chronic* / epidemiology
  • Hematoma, Subdural, Chronic* / genetics
  • Humans
  • Inflammation
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Subdural Space