HLA class II alleles are not a general susceptibility factor in Guillain-Barre syndrome

Objective: To assess whether human leukocyte antigen (HLA)-DRB1 and HLA-DQB1 alleles confer susceptibility to Guillain-Barre syndrome (GBS) or are related to specific clinical or serologic subgroups of GBS. Methods: The HLA-DRB1 and HLA-DQB1 loci were genotyped by PCR amplification with sequence-specific primers in 164 well-documented Dutch patients with GBS and 207 healthy Dutch controlsubjects. Patients with GBS were divided into subgroups based on clinical features, severity of disease, antecedent infection,a nd anti-ganglioside antibodies. Data were compared with those of all case-control HLA studies in GBS performed previously. Results: In this case-control study, HLA-DRB1 and HLA-DQB1 alleles did not differ between GBS pateints and control subjects. The frequencyof HLA-DRB1*01 was increased in patients who needed mechanical ventilation (odds ratio 4.2; 95% CI 1.9 to 9.6; p(c)=0.02). Multivariate logistic regression analysis showed that this association was independent of the severity of paresis and the presence of cranial nerve involvement (all p < 0.05). There was a tendency toward an association between certain HLA alleles and several anti-ganglioside antibodies. Conclusions: Human leukocyte antigen (HLA) class II antigens are not a general susceptibility factor in Guillain-Barre (GBS).However, HLA class II alleles may be a determinant in distinct subgroups of GBS, indicating the need for further exploration in large-scale studies.