Rheumatic heart disease (RHD) is influenced by genetic factor, microorganism's virulence, and environmental factor. The aim of this study was to determine human leukocyte (HLA)-DRB1 allele among children with RHD in Medan, Indonesia. Methods An observational study was conducted at the Department of Child Health, Haji Adam Malik Hospital Medan from April to June 2017. Inclusion criteria were children aged 5-18 years diagnosed with RHD. Children with concomitant congenital heart disease were excluded. HLA-DRB1 alleles were analyzed using the PCR sequence-specific priming (SSP) technique. Statistical analysis was done using computer software. Results A total of 62 children were enrolled. The mean age of children was 12.6 (SD 3.44) years; 33 (53.2%) were male. The most dominant allele was HLA-DRB1*12, followed by HLA-DRB1*15. Conclusion It is proven in this research that RHD is influenced by genetic factor with HLA-DRB1*12 allele found to be the most common allele in children with RHD in Medan, Indonesia.
Komata T, Tsuchiya N, Hatta Y, Matsushita M, Ogawa A, Mitsui H, et al. HLA-DRB1 alleles encoding the shared epitop associated with rheumatoid arthritis confer additional susceptibility to seronegative spondyloarthropathies in HLA-B27-positive Japanese individuals. Jpn J Rheumatol 1999:55–64.
2
Guilherme L, Kohler K, Postol E, Kalil. Genes, autoimmunity and pathogenesis of rheumatic heart disease. Ann Pediatr Cardiol 2011:13–21.
3
Olmez U, Turgay M, Ozenirler S, Tutkak H, Duzgun N, Duman M, et al. Association of HLA class I and class II antigens with rheumatic fever in a Turkish population. Scand J Rheumatol 1993:49–52.
4
Jhinghan B, Mehra K, Reddy K, Taneja V, Vaidya M, Bhatia M. HLA, blood groups, and secretor status in patients with established rheumatic fever and rheumatic heart disease. Tissue Antigens 1986:172–8.
5
Guilherme L, Kalil J, Cunningham M. Molecular mimicry in the autoimmune pathogenesis of RHD. Autoimmunity 2006:31–9.
6
Bajoria D. The HLA class II associations with rheumatic heart disease in south Indian patients. J Clin Diag Res 2003:302–4.
7
Fae K, Oshiro S, Toubert A, Charron D, Kalil J, Guilherme L. How an autoimmune reaction trigerred by molecular mimicry between streptococcal M protein. J Autoimmun 2005:101–9.
8
Guilherme L, Kalil J. Rheumatic fever and rheumatic heart disease: cellular mechanisms leading autoimmune reactivity and disease. J Clin Immunol 2010:17–23.
9
Steer A, Carapetis J, Nolan T, Shann F. Systematic review of rheumatic heart disease prevalence in children in developing countries: the role of environmental factors. Circulation 2002:229–34.
10
Carapetis J, Donald M, Wilson M, N. Acute rheumatic fever. Lancet 2005:155–68.
11
Bodis G, Toth V, Schwarting A. Role of human leukocyte antigens (HLA) in autoimmune diseases. Rheumatol Ther 2018:5–20.
12
Park M. Paediatric Cardiology for Practitioners: Acute Rheumatic Fever 2008:153–5.
13
Cortez A, Pulit S, Leo P, Pointon J, Robinson P, Weisman M, et al. Major histocompatibility complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1. Nat Commun 2015:7146.
14
Anderson R. Paediatric Cardiology: Rheumatic Fever. 3 2010:222–31.
15
Prajapati D, Sharma D, Regmi P, Khanal H, Baidya S, Rajbhandari S, et al. Epidemiological survey of rheumatic fever, rheumatic heart disease and congenital heart disease among school children in Kathmandu valley of Nepal. Nepalese Heart Journal 2014:1–5.
16
Venugopal P, Gupta P. Identification and diagnosis of risk factors and symptoms for rheumatic heart disease. J Cardiovasc Dis Res 2018:109–14.
17
Okello E, Beaton A, Mondo K, Kruzka P, Kiwanuka N, Adome-Odoi R, et al. Rheumatic heart disease in Uganda: the association between MHC classII HLA DR alleles and disease: a case control study. BMC Cardiovasc Disord 2014:1–5.
18
Bryant P, Robins-Browne R, Carapetis J, Curtis N. Some of the people, some of the time. Circulation 2009:742–53.
19
Beg A, Younas M, Asma T. Rheumatic heart disease: Socio-economic and environmental risk factors for acute rheumatic fever and rheumatic heart disease patients in Pakistan. Professional Med J 2016:324–7.
20
Kumar R, Raizada A, Aggarwal A, Ganguly N. A community-based rheumatic fever/ rheumatic heart disease cohort: twelve-year experience. Indian Heart J 2002:54–8.
21
Carapetis J. Rheumatic heart disease in Asia. Circulation 2008:2748–53.
22
Seckeler M, Hoke T. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 2011:67–84.
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