Abstract
Genetic and environmental factors are responsible for differences in the prevalence of some diseases across countries. Human leukocyte antigen (HLA) allele frequencies in North African populations show some differences in their distribution compared to Europeans, Mediterraneans, and sub-Saharans, and some specific alleles and haplotypes could be clinically relevant. Celiac disease (CD) has been fast increasing in prevalence in North Africa; but few immunogenetic data are available for this area, in which a high prevalence of the disease has been described. In this report, we assess and discuss results of HLA class II (HLA-DQA1/DQB1/DRB1) typing in Moroccan patients with CD and compare them with a control population from Morocco—genetically well characterized—and with other North African, Mediterranean, and European populations. The classical HLA-DQ associations were confirmed in Moroccans with CD. The high frequency of DQ2.5 homozygosity (45.2%) found in Moroccans with CD was noteworthy as compared with other populations (23%–32%). The genetic risk gradient for CD, identified by previous studies, has been confirmed in Moroccans with some differences, mainly concerning DQ8 genotypes. This study provides the immunogenetic framework of CD in Moroccans and confirms the need to learn more about associations with additional HLA and non-HLA genetic factors.
Highlights
Celiac disease (CD) is a multifactorial and autoimmune disease caused by a dysregulated immune response to wheat gliadin, which develops in genetically predisposed individuals
CD shows a prevalence of 0.5%–1% in Caucasian populations from Europe and North America; prevalence is increasing in developing countries, especially in North Africa and the Middle East, and at present it is a common disorder in North Africa [1]
It was hypothesized that genetic factors (i.e., the very high frequency of human leukocyte antigen (HLA) predisposing haplotypes, DQ2 and DQ8) joint with a fast increase of gluten intake are the main reasons for this condition, recently further hypotheses are emerging to explain differences in geographical distribution of the disease
Summary
Celiac disease (CD) is a multifactorial and autoimmune disease caused by a dysregulated immune response to wheat gliadin, which develops in genetically predisposed individuals. CD shows a prevalence of 0.5%–1% in Caucasian populations from Europe and North America; prevalence is increasing in developing countries, especially in North Africa and the Middle East, and at present it is a common disorder in North Africa [1]. It was hypothesized that genetic factors (i.e., the very high frequency of human leukocyte antigen (HLA) predisposing haplotypes, DQ2 and DQ8) joint with a fast increase of gluten intake are the main reasons for this condition, recently further hypotheses are emerging to explain differences in geographical distribution of the disease. HLA allele distribution is different among populations and HLA polymorphism could be a good marker to study disease susceptibility in HLA-associated autoimmune diseases.
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