RESUMO Objetivo Este estudo tem como objetivo descrever a distribuição dos principais alelos de risco da doença celíaca relacionados ao complexo antígeno leucocitário humano e sua associação com a gravidade da lesão intestinal, resultados de testes sorológicos, doenças associadas à doença celíaca e sintomatologia. Métodos Foi analisado o DNA de 140 pacientes com doença celíaca e identificada a distribuição dos três alelos de risco mais importantes para o desenvolvimento de doença celíaca (DQA1*05:01, DQB1*02:01 e DRB1*04, sendo este o último um marcador para o aplótipo de risco DQB1*03:02/DQA1*03/DRB1*04). Os dados de exames sorológicos, resultados de biópsia, sintomatologia e incidência de doenças associadas à doença celíaca foram coletados por meio de questionário previamente validado. Resultados Verificou-se que 98% dos pacientes apresentavam pelo menos uma cópia dos alelos estudados. Pacientes portadores simultaneamente de ambos os alelos de risco HLA-DQ2 foram altamente prevalentes (75.0%), e 20,7% dos pacientes carregavam o haplótipo HLA-DQ8. Pacientes positivos para ambos os alelos de risco HLA-DQ2 apresentaram associação positiva aos testes sorológicos anti-gliadina (p=0,037), anti-endomísio (p=0,001) e anti-transglutaminase (p=0,032), e maior prevalência de osteoporose e hipotireoidismo. Pacientes portadores de um ou nenhum desses alelos frequentemente apresentavam resultados sorológicos negativos. Além disso, foi encontrada associação entre gravidade da lesão intestinal e perfil genético (p<0,001). Conclusão Os resultados sugerem que a genotipagem do HLA-DQ está associada aos testes sorológicos e à gravidade do dano intestinal em pacientes com doença celíaca. 14 DQA1*0501, DQA10501 DQA DQA1*05 01, DQA1 05 01 (DQA1*05:01 DQB1*0201 DQB10201 DQB DQB1*02 DQB1 02 DQB1*02:0 DRB104 DRB DRB1 04 DRB1*04 DQB1*0302/DQA1*03/DRB1*04. DQB10302DQA103DRB104 DQBDQADRB DQB1*03 02/DQA1*03/DRB1*04 . 03 DQB1*03:02/DQA1*03/DRB1*04) biópsia validado Verificouse Verificou se 98 estudados HLADQ2 HLADQ HLA DQ2 DQ 75.0%, 750 75.0% , 75 0 (75.0%) 207 20 7 20,7 HLADQ8. HLADQ8 DQ8. DQ8 HLA-DQ8 antigliadina anti gliadina p=0,037, p0037 p p=0,037 037 (p=0,037) antiendomísio endomísio p=0,001 p0001 001 (p=0,001 antitransglutaminase transglutaminase p=0,032, p0032 p=0,032 032 (p=0,032) hipotireoidismo negativos disso p<0,001. p<0,001 (p<0,001) 1 0501 DQA1*0501 DQA1050 DQA105 DQA1*0 (DQA1*05:0 0201 DQB1*020 DQB1020 DQB102 DQB1*0 DQB1*02: DRB10 DRB1*0 0302 DQB1*0302/DQA1*03/DRB1*04 DQB10302DQA103DRB10 DQB103 02DQA103DRB104 DQADRB 02/DQA1*03/DRB1*0 DQB1*03:02/DQA1*03/DRB1*04 9 75.0 (75.0% 2 20, p003 p=0,03 (p=0,037 p=0,00 p000 00 (p=0,00 (p=0,032 p<0,00 (p<0,001 050 DQA1*050 DQA10 DQA1* (DQA1*05: 020 DQB10 DQB1* DRB1* 030 DQB1*0302/DQA1*03/DRB1*0 DQB10302DQA103DRB1 02DQA103DRB10 02/DQA1*03/DRB1* DQB1*03:02/DQA1*03/DRB1*0 75. (75.0 p00 p=0,0 (p=0,03 (p=0,0 p<0,0 (p<0,00 (DQA1*05 DQB1*0302/DQA1*03/DRB1* DQB10302DQA103DRB 02DQA103DRB1 02/DQA1*03/DRB1 DQB1*03:02/DQA1*03/DRB1* (75. p0 p=0, (p=0, p<0, (p<0,0 (DQA1*0 DQB1*0302/DQA1*03/DRB1 02DQA103DRB 02/DQA1*03/DRB DQB1*03:02/DQA1*03/DRB1 (75 p=0 (p=0 p<0 (p<0, (DQA1* DQB1*0302/DQA1*03/DRB DQB1*03:02/DQA1*03/DRB (7 p= (p= p< (p<0 (DQA1 ( (p (p< (DQA
ABSTRACT Objective This study aims to describe the distribution of main celiac disease risk alleles related to human leucocyte antigen complex and their association to the severity of intestinal injury, serological test results, CD-associated diseases and symptomatology. Methods The DNA of 140 celiac disease patients was analyzed, and the distribution of the three most important risk alleles to the celiac disease development was identified (DQA1*05:01, DQB1*02:01 and DRB1*04, the last one as a DQB1*03:02/DQA1*03/DRB1*04 haplotype marker). Data on serological tests, biopsy results, symptomatology and incidence of CD-associated diseases were collected by using a previously validated questionnaire. Results It was found that 98% of patients presented at least one copy of the studied alleles. Patients carrying simultaneously both HLA-DQ2 risk alleles were highly prevalent (75%), and 20.7% patients carried the HLA-DQ8 haplotype. Positive patients for both HLA-DQ2 risk alleles presented positive association to anti-gliadin (p=0.037), anti-endomysium (p=0.001) and anti-transglutaminase (p=0.032) serological tests, and a higher prevalence of osteoporosis and hypothyroidism. Patients carrying one or none of those alleles often presented negative serological results. In addition, it was found an association between intestinal injury severity and genetic profile (No-BreakpNo-Break<0.001). Conclusion Results suggest that the HLA-DQ genotyping are associated to serological tests and the severity of intestinal damage in celiac disease patients. results CDassociated CD 14 analyzed DQA1*0501, DQA10501 DQA DQA1*05 01, DQA1 05 01 (DQA1*05:01 DQB1*0201 DQB10201 DQB DQB1*02 DQB1 02 DQB1*02:0 DRB104 DRB DRB1 04 DRB1*04 DQB1*0302/DQA1*03/DRB1*04 DQB10302DQA103DRB104 DQBDQADRB DQB1*03 02/DQA1*03/DRB1*04 03 DQB1*03:02/DQA1*03/DRB1*0 marker. marker . marker) questionnaire 98 HLADQ2 HLADQ HLA DQ2 DQ 75%, 75 75% , (75%) 207 20 7 20.7 HLADQ8 DQ8 antigliadin anti gliadin p=0.037, p0037 p p=0.037 0 037 (p=0.037) antiendomysium endomysium p=0.001 p0001 001 (p=0.001 antitransglutaminase transglutaminase p=0.032 p0032 032 (p=0.032 hypothyroidism addition NoBreakpNoBreak<0.001. NoBreakpNoBreak0001 NoBreakpNoBreak No BreakpNo Break<0.001 Break (No-BreakpNo-Break<0.001) 1 0501 DQA1*0501 DQA1050 DQA105 DQA1*0 (DQA1*05:0 0201 DQB1*020 DQB1020 DQB102 DQB1*0 DQB1*02: DRB10 DRB1*0 0302 DQB1*0302/DQA1*03/DRB1*0 DQB10302DQA103DRB10 DQB103 02DQA103DRB104 DQADRB 02/DQA1*03/DRB1*0 DQB1*03:02/DQA1*03/DRB1* 9 (75% 2 20. p003 p=0.03 (p=0.037 p=0.00 p000 00 (p=0.00 (p=0.03 NoBreakpNoBreak<0.001 NoBreakpNoBreak000 Break0001 Break<0.00 (No-BreakpNo-Break<0.001 050 DQA1*050 DQA10 DQA1* (DQA1*05: 020 DQB10 DQB1* DRB1* 030 DQB1*0302/DQA1*03/DRB1* DQB10302DQA103DRB1 02DQA103DRB10 02/DQA1*03/DRB1* DQB1*03:02/DQA1*03/DRB1 (75 p00 p=0.0 (p=0.0 NoBreakpNoBreak<0.00 NoBreakpNoBreak00 Break000 Break<0.0 (No-BreakpNo-Break<0.00 (DQA1*05 DQB1*0302/DQA1*03/DRB1 DQB10302DQA103DRB 02DQA103DRB1 02/DQA1*03/DRB1 DQB1*03:02/DQA1*03/DRB (7 p0 p=0. (p=0. NoBreakpNoBreak<0.0 NoBreakpNoBreak0 Break00 Break<0. (No-BreakpNo-Break<0.0 (DQA1*0 DQB1*0302/DQA1*03/DRB 02DQA103DRB 02/DQA1*03/DRB ( p=0 (p=0 NoBreakpNoBreak<0. Break0 Break<0 (No-BreakpNo-Break<0. (DQA1* p= (p= NoBreakpNoBreak<0 Break< (No-BreakpNo-Break<0 (DQA1 (p NoBreakpNoBreak< (No-BreakpNo-Break< (DQA (No-BreakpNo-Break