Disease by association

Abstract

HLA in Health and Disease (2nd edn)edited by Robert Lechler and Anthony WarrensAcademic Press, 2000. £99.95 (hdbk) (xvii+472 pages) ISBN 0 12 440315 8Given the biological importance of the HLA system (the human MHC and its gene products) it is surprising how few books are devoted to this topic. HLA in Health and Disease fills this gap in an approachable and well-structured way. Significantly expanded from the first edition, the new edition of HLA in Health and Disease addresses the subject in three major sections, on the biology of the HLA system, HLA and disease association, and methods of HLA typing.The first section of the book introduces the HLA system, with chapters covering the evolution and molecular genetics of the HLA region, the generation and selection of polymorphism in HLA genes, structure and function of HLA molecules and mechanisms of association between HLA and disease. In the first chapter, a history of the discovery of HLA, Jon van Rood tells the story of a voyage of scientific discovery that I would make compulsory reading for all aspiring immunologists. In addition, there are chapters of practical use on the statistical analysis of disease susceptibility and on nomenclature for factors of the HLA system. These subjects are often overlooked (I am regularly surprised at the poor understanding of HLA nomenclature and genetic organization of immunologists), but are essential for the proper understanding of HLA and disease association. Given their topical nature, I would have liked to have seen greater discussion in this section of some of the more recent advances in our understanding of the MHC, such as the role of certain MHC molecules as ligands for natural killer cell receptors and the development and use of HLA tetramers. However, these are relatively minor criticisms.The second, and largest, section of the book deals with HLA and disease, and is structured in a ‘systems-based’ way (HLA associations with diseases being related to a broad range of end-organ groups). I was drawn particularly to the chapter on HLA and psychiatric disease, a novel idea to me, but slightly disappointed by the conclusion that there is as yet no conclusive evidence of HLA association with any psychiatric disorder. The range and scope of this section was broad, covering most of the body's organ systems, although I was disappointed that there were no chapters on the association between HLA and cancer or HLA and hematological disease.Finally, to understand the significance of HLA and disease association requires an appreciation of the different methodologies used in HLA typing and their limitations. The last section of the book, therefore, describes the techniques that are used to define the factors of the HLA system, from serological and cellular techniques through to the newer molecular approaches to HLA typing.Robert Lechler and Anthony Warrens have collated contributions from an impressive cast of contributors to provide a broad and timely review of this important topic. Each chapter includes a comprehensive bibliography, making the book a valuable reference source. The content is such that this book should appeal to a broad readership, from students of immunology, through interested clinicians, to those with a specialist interest in HLA. It is certainly a book that I shall return to as a source of information. HLA in Health and Disease provides an excellent overview of the subject. But, given the rate of advances in this field, how long will it be before we need a third edition?