Value of HLA ‐ DR genotype in systemic lupus erythematosus and lupus nephritis: a meta‐analysis

Aim Human leukocyte antigen ( HLA )‐ DRB 1 allele polymorphisms have been reported to be associated with systemic lupus erythematosus ( SLE ) susceptibility, but the results of these previous studies have been inconsistent. The purpose of the present study was to systematically summarize and explore whether specific HLA ‐ DRB 1 alleles confer susceptibility or resistance to SLE and lupus nephritis. Methods This review was guided by the preferred reporting items for systematic reviews and meta‐analyses ( PRISMA ) approach. A comprehensive search was made for articles from PubMed, Medline, Elsevier Science, Springer Link and Cochrane Library database. A total of 25 case–control studies on the relationship between gene polymorphism of HLA ‐ DRB l and SLE were performed and data were analyzed and processed using Review Manager 5.2 and Stata 11.0. Results At the allelic level, HLA ‐ DR 4, DR 11 and DR 14 were identified as protective factors for SLE (0.79 [0.69,0.91], P  <   0.001; 0.72 [0.60, 0.85], P  <   0.0001; 0.47 [0.59, 0.95], P  <   0.05, respectively). HLA ‐ DR 3, DR 9, DR 15 were potent risk factors for SLE (1.88 [1.58, 2.23], P  <   0.001; 1.24 [1.07, 1.45], P  <   0.05; 1.25 [1.10, 1.43], P  <   0.001, respectively). However, HLA ‐ DR 8 was not statistically significant between the SLE group and control group ( OR , 1.11 [0.96, 1.30], P  >   0.05). DR 4 and 11 ( OR , 0.55 [0.39, 0.79], P  <   0.01; 0.60 [0.37, 0.96], P  <   0.05, respectively) conferred a significant protective effect for lupus nephritis. DR 3 and DR 15 ( OR , 2.00 [1.49, 2.70], P  <   0.05; 1.60 [1.21, 2.12], P  <   0.001, respectively) were at a high risk of developing lupus nephritis. HLA ‐ DR 8, DR 9 and DR 14 ( OR , 1.47 [0.9, 2.33], P  >   0.05; 0.90 [0.64, 1.27], P  >   0.05; 0.61 [0.36, 1.03], P  >   0.05, respectively) were not statistically significant between the lupus nephritis and control groups. Conclusions The HLA ‐ DR 4, DR 11, DR 14 alleles might be protective factors for SLE and HLA ‐ DR 3, DR 9, DR 15 were potent risk factors. In addition, HLA ‐ DR 4 and DR 11 alleles might be protective factors for lupus nephritis and DR 3 and DR 15 suggest a risk role. These results proved that HLA ‐ DR 3, DR 15, DR 4 and DR 11 might be identified as predictors for lupus nephritis and SLE .