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IS HLA-DR TYPE ASSOCIATED WITH BW4 ANTIBODY PRODUCTION?
Danny A. Youngs. Seattle WA, USA, Puget Sound Blood Center, 98104, Immunogenetics Laboratory.

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It has been reported that an individual's class II HLA type may influence the repertoire of HLA antibody specificities the individual is likely to produce. To confirm a reported association between HLA-DR1, DR3, DR4 and Bw4 antibody production, we examined DR antigen frequencies in our renal transplant candidates having Bw4 antibodies. Amongst 3327 patients screened in our lab, 74 patients were identified with well-defined Bw4 antibodies. DR antigen frequencies of the Bw4 antibody producers was compared to that of three control groups: normals, renal patients, and renal patients lacking the Bw4 epitope. Increases were noted in the frequencies of DR3, DR4 and DR8 when compared to normals and renal patients, but not when compared to renal patients lacking the Bw4 epitope, which is the only valid control group. DR3 and DR4 are increased in diabetic renal patients, so normals are not an adequate control group for renal patients. DR3 and DR4 are in linkage disequilibrium with several Bw6-positive B-antigens, so the renal control group must only consist of patients lacking the Bw4 epitope. To examine the issue from another angle, 70 Bw4-epitope-negative patients who received and subsequently lost Bw4-positive kidney grafts were evaluated for Bw4 antibodies after they were relisted for a second transplant. The DR frequencies of patients who made Bw4 antibodies (n=19) and those who did not (n=51) were not significantly different. In conclusion, we find no evidence that patients with certain DR types are more likely to produce antibodies to Bw4 than patients with other DR types.