HLA-DRB1 and DQB1 allele distribution in the Muong population exposed to malaria in Vietnam.

The distribution of 30 HLA-DRB1 alleles in 85 individuals and of 10 HLA-DQB1 alleles in 91 individuals of the Viet Muong population was studied and compared with those of nine other Asian populations, including 103 Viet Kinh belonging to the major ethnic group in Vietnam. In terms of genetic distance, our data are consistent with a close ethnogeographic relationship between Viet Muong, Buyi and Dai Lue, two Southern Chinese ethnic groups. Conversely, these three populations are distant from the Northern Chinese population. The Viet Kinh belong to an intermediate group, together with North-eastern Thais, Thais and present day Thais. The striking presence of the HLA-DQ1*0502 allele (48% frequency) in the Viet Muongs is possibly anthropological or environmental in origin: the Viet Muongs have been submitted to endemic malaria for centuries, and the survivors carry the protective trait of glucose-6-phosphate dehydrogenase deficiency. This raises the hypothesis of a possible resistance to lethal or severe forms of the disease, where the association with a specific HLA-DQB1 allele may play a role.

Multicenter trial of one HLA-DR-matched or mismatched blood transfusion prior to cadaveric renal transplantation.

BACKGROUND: The beneficial effect of blood transfusions before cadaveric renal transplantation on allograft survival, although previously well documented, has become controversial in light of their adverse effects. Recently, it has been suggested that their clinical benefits are due to HLA-DR sharing between the blood donor and recipient. METHODS: In this prospective study, 144 naive patients were randomly assigned to receive one unit of blood matched for one-HLA-DR antigen (N = 49), or one unit of mismatched blood (N = 48), or to remain untransfused (N = 47). Graft survival and acute rejection rate were analyzed in 106 cadaveric renal allograft recipients receiving the same immunosuppressive protocol. RESULTS: Graft survival was similar in the three groups at one and five years: 91.7 and 80% in untransfused patients, 90.3 and 79.3% in patients transfused with one DR-antigen-matched unit, and 92.3 and 83.7% in patients transfused with HLA-mismatched blood. The difference in the incidence of six-month post-transplant acute rejections was not statistically significant in the three groups: 12 out of 36, 33.3% in nontransfused patients; 6 out of 31, 19.4% in patients transfused with one DR-matched blood; and 13 out of 39, 33.3% in patients transfused with mismatched blood. CONCLUSION: The results of our prospective randomized trial showed that in a population of naive patients, one transfusion mismatched or matched for one HLA-DR antigen given prior to renal transplantation had no significant effect on the incidence and severity of acute rejection, and did not influence overall long-term graft outcome. Considering the potentially deleterious adverse effects of blood transfusions, the costs, and the considerable logistical efforts required to select and type blood donors, such a procedure cannot be recommended in a routine practice for patients awaiting cadaveric kidney transplantation.