The HLA System: Genetics, Immunology, Clinical Testing, and Clinical Implications

The human major histocompatibility complex HLA is located on the short arm of chromosome 6. It is known to be the most polymorphic genetic system in humans. The biological role of the HLA class I and class II molecules is to present processed peptide antigens. The HLA system is clinically important as transplantation antigens. Molecular HLA allele typing is routinely performed to provide HLA class I and class II allele matching in unrelated donor hematopoietic stem cell transplantation. Prospective lymphocyte crossmatching is critical in solid organ transplantation to prevent allograft rejection. HLA alloimmunization causes various problems in transfusion therapy. The HLA system is associated with certain diseases, but its underlying mechanisms are not yet fully explained.

Immunogenetics of the HLA system

The study of the HLA system was primarily initiated to understand the basis for the histocompatibility between recipients and tissue donors. HLA typing methods are being continuously improved and biochemical and molecular typing, in particular, are expected to provide precise typing of the HLA system. Conventional HLA typing methods can define antigen specificities, while biochemical and molecular methods will provide direct allele typing that is based on the actual sequence polymorphism. The precise tissue typing will definitely improve the outcome of transplantation. Structural studies have revealed the highly polymorphic nature of the HLA system and given insight to understanding the molecular basis of the HLA polymorphism. One big immunological puzzle remaining to be answered is how T-cell receptor molecules recognize peptide antigen in conjunction with the HLA molecule. The crystallization of the T-cell receptor molecule, an experiment currently underway, will eventually reveal the structural basis of the trimolecular interaction.

Bacterial Adherence to Human Buccal Epitheliald Cells and Its Possible Role in Bacterial Colonization in Human Oral Cavity

The ability of several species of streptococcus and staphylococcus to adhere to human buccal epithelial cells was studied in vitro by using bacteria and epithelial cells isolated from human buccal cavity. Viridans streptococci were found adhering in highest numbers(65 +/- 8 bacteria per epithelial cell) to epithelial cells. Streptococcus pyogenes adhered in great numbers (44 +/- 4), whereas Streptococcus pneumoniae (26 +/- 2), Staphylococcus aureus (21 +/- 2), Staphylococcus epidermidis (14 +/- 2) adhered poorly. These data showed that bacteria differed in their ability to adhere to human buccal epithelial cells. This difference in adhesive ability between bacterial species may correlate with the ability of the bacteria to colonize oral surface of human.