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HLA‐DR6 association confers increased resistance to T. rubrum onychomycosis in Mexican Mestizos
Author(s) -
AszSigall Daniel,
LópezGarcía Lirio,
VegaMemije María Elisa,
LacyNiebla Rosa María,
GarcíaCorona Cristina,
RamírezRentería Claudia,
Granados Julio,
Villa Antonio,
Ameen Mahreen,
Arenas Roberto
Publication year - 2010
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2010.04550.x
Subject(s) - odds ratio , medicine , human leukocyte antigen , population , confidence interval , case control study , relative risk , polymerase chain reaction , immunology , genetics , antigen , biology , environmental health , gene
Background Onychomycosis is multifactorial in origin. Studies have suggested an autosomal dominant pattern of inheritance and human leukocyte antigen DR4 (HLA‐DR4) has been shown to protect against onychomycosis in an Ashkenazi Jewish population. Aim This study investigates HLA class II association in a Mexican Mestizo population with Trichophyton rubrum onychomycosis. Methods This was a prospective case–control study. Mexican Mestizos with a clinical diagnosis of onychomycosis and culture positive for T. rubrum were recruited, together with age‐ and sex‐matched controls. First‐degree relatives were also investigated for onychomycosis. Case–control samples were HLA typed by polymerase chain reaction sequence‐specific primer based analysis. Results Twenty‐one cases and 42 controls were recruited with a mean age of 40 years (range: 18–58 years). HLA‐DR6 was found in seven (33%) cases and 19 (45%) controls [ P < 0.023, odds ratio (OR) = 0.088, 95% confidence interval (CI): 0.01–0.71]. Six (29%) cases and three (7%) controls had an affected child ( P < 0.043, OR = 9.15, 95% CI: 1.07–78.31), and 13 (62%) cases and 12 (29%) controls had an affected first‐degree relative ( P < 0.02, OR = 4.0, 95% CI: 1.1–14.3). Conclusions These results suggest that HLA‐DR6 confers protection against the development of onychomycosis in a Mexican Mestizo population. Having an affected first‐degree relative significantly increases the risk of onychomycosis, suggesting genetic susceptibility.