Das HLA-System in der Vaterschaftsserologie: Praktische Erfahrungen bei 1130 Fällen

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The HLA system which represents the major histocompatibility system of man is governed by a gene complex situated on the short arm of chromosome 6. Out of the cell-bound HLA gene products, only the antigens coded for by the loci HLA -A, B and C fulfil for the moment all the criteria which are necessary in order to be able to use genetically defined markers in cases of disputed paternity: the mode of inheritance must be known with certainty, the techniques of determination must be reliable and simple, the phenotype must reflect the genotype only, and the characteristics must be developed at birth or soon thereafter. Based on the formal genetics of HLA-A,B,C, three classes of exclusion can be distinguished: a man can be excluded if the child possesses an antigen lacked by the mother and the putative father; if the child possesses neither of both antigens coded for by one locus demonstrable in the putative father; or if a child has inherited from his true father two genes which the putative father does not carry on one haplotype. The low frequencies of the HLAA, B,C phenotypes and the tremendous HLA polymorphism are the reason for the extreme usefulness of this system in solving problems of parentage: the investigation of the HLA-A,B,C gene products alone gives a chance of exclusion in false accusations of paternity of 96%. Together with the non-HLA systems routinely used (ABO, MNSs, Rh, P, K, Fy, Jk, Lu, Xg, acP1 AKl ADA, PGM 1 (with subtypes), GPT, EsD, GLO, Hp, Gc (with subtypes), Gm, Km, C3, Bf and Se), the total chanceof exclusion is 99.92%. The results obtained by using the HLA system and most of the above-mentioned non-HLA systems in 1130 affiliation cases with 1452 putative fathers and 1156 children demonstrate the efficiency of the HLA system in paternity testing, especially in cases with more than one putative father, in cases without a mother or with a deceased putative father, and in cases showing a single exclusion with low conclusive force in a non-HLA system. The effects of HLA typing for the plausibility of paternity according to Essen-Moller and for the chance of exclusion are shown and the possible inclusion of the HLA-DR gene products, which could increase the total chance of exclusion to 99.96%, is briefly discussed.