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|Title||HLA-DQ2 and DQ8 Haplotypes Frequency and Evaluation of Diagnosed Coeliac Disease Patients in Gaza strip|
|Title in Arabic||مدى انتشار البدائل dq2و dq8qلمستضد كريات الدم البيضاء وتقييم المرضى المشخصين بالداء الزلاقي في قطاع غزة|
Background: Coeliac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of a complex protein, gluten, present in cereals such as wheat barley and rye in genetically predisposed individuals. Genetic susceptibility to CD is strongly associated with HLA- DQA*05-DQB*02 (DQ2 haplotype), and DQA*03-DQB*03:02 (DQ8 haplotype). Coeliac disease diagnosis can be established by serological and histological tests, while HLA-DQ typing mainly excludes the disease when DQ2 and DQ8 haplotypes are absent. Objective: To determine the frequency of HLA-DQ2 and -DQ8 haplotypes and DQA*05, DQB*02 and DQB*03:02 alleles, and to evaluate diagnosed CD patients in Gaza strip. Method: A case control study was performed involving 101 unrelated CD patients attending the two centers of Ard El-Insan Palestinian Benevolent Association and 101 unrelated healthy controls. DQA*05, DQB*02 and DQB*03:02 alleles were typed using Real Time PCR with high resolution melting curve analysis. Clinical data for each patients were obtained from his/her medical record. Data were analyzed using SPSS software. Results: Only nine of the patients had a positive serological and histopathological tests and were positive for DQ2 and/or DQ8 haplotypes. Moreover, when considering patients with at least one positive serological and/or histopathological tests in addition to had DQ2 (and its fractions) and/or DQ8, 70.8% of included patient positive for DQ2 and 15.4% for DQ8, respectively compared with 17.5% and 27.8% of the controls. In the included patients group DQB*02 allele was the most frequently encountered (84.6%) followed by DQA*05 allele (80%) and then DQB*03:02 allele (20%). The DQA*05 allele on the other hand was the most frequently encountered (54.6%) in the control group followed by DQB*02 allele (42.3%) and DQB*03:02 allele (28.9%). The type of infant feeding, the duration of breast feeding, the age of gluten introduction into the diet, the mode of delivery, the season of birth, gastrointestinal infection and surgery were investigated as possible risk factors for CD and none of them exhibited a statistically significant difference between included patients and controls. The age at onset of CD was not significantly reduced with DQA*05, DQB*02 and DQB*03:02 alleles, DQ2 and DQ8 haplotypes, gender, type of breastfeeding, season of birth or previous gastrointestinal infection and surgery. Other accompanying manifestations of CD (anemia, osteoporosis and dermatitis herpatiformus) were significantly more experienced among included patients than controls. Other associated diseases as Rheumatoid and sjogren’s syndrome were significantly higher among included patients in contrast with diabetes mellitus which was not significantly different between the two groups. Conclusion: HLA-DQ2 frequency was higher in included patients than controls and HLA- DQ8 was higher in controls than included patients. DQB*02 allele was the most frequent in included patients compared with DQA*05 in controls. CD diagnosis in Gaza strip was not meeting the diagnostic criteria recommended by international guidelines for diagnosis of CD.
|Publisher||الجامعة الإسلامية - غزة|
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