Abstract
BackgroundMeasurement of soluble HLA in body fluids has a potential role in assessing disease activity in autoimmune disorders.MethodsWe applied a solid phase, enzyme-linked immunoassay to measure soluble HLA class I (sHLA-I) and class II (sHLA-II) molecules in the saliva and cerebrospinal fluid (CSF) in 13 untreated patients with relapsing-remitting form of multiple sclerosis (MS). For comparison purposes, we also studied saliva from 53 healthy subjects.ResultsSaliva from normal controls had detectable sHLA-I levels in 41 of 53 individuals studied, with values ranging from 9–100 ng/ml (mean = 41 ± 2.8 ng/ml). sHLA-I was undetectable in the saliva in 11 of 13 MS patients, and in none of the CSF specimens. In contrast, mean sHLA-II concentration in the saliva of MS patients was significantly increased compared to controls (386 ± 52 unit/ml vs. 222 ± 18.4 unit/ml, t = 8.68, P < 0.005). The mean CSF sHLA-II level (369 ± 16 unit/ml) was equivalent to the mean sHLA-II concentration measured in saliva (mean = 386 ± 52 unit/ml) (P = 0.7). In patients with brain magnetic resonance imaging (MRI) enhancing lesions (n = 5), reflective of more active disease, CSF sHLA-II averaged 356 ± 26 unit/ml compared to 380 ± 51 in saliva. Similarly, in patients with non-enhancing lesions (n = 8), CSF sHLA-II averaged 377 ± 18 unit/ml compared to 390 ± 77 unit/ml in saliva. Thus, the mean sHLA-II concentration in saliva and CSF was essentially equivalent for MS patients with or without enhancing plaques.ConclusionOur data suggest that the measurement of soluble HLA in saliva, specifically sHLA-II, correlates with the level found in the CSF. Therefore, if sHLA correlates with disease activity in MS, as has been proposed, saliva measurements provide a noninvasive correlate of CSF measurement.
Highlights
Measurement of soluble HLA in body fluids has a potential role in assessing disease activity in autoimmune disorders
We have observed no correlation between soluble HLA class I (sHLA-I) and soluble HLA (sHLA)-II levels in the sera of normal individuals [9]. sHLA-I was either non-detectable, or present in very low quantities, in the urine, sweat, saliva and tears of normal individuals. sHLA-I is highly elevated in the saliva of patients with autoimmune rheumatic diseases [2,10]. sHLA-II is routinely detectable in the urine, tears, sweat and saliva of normal individuals, but concentrations of sHLA-II are not observed to be elevated in rheumatological diseases [10,11]
Fainardi et al [15] reported a decrease in sHLA-I concentrations during exacerbations in multiple sclerosis (MS), but an increase in cerebrospinal fluid (CSF) sHLA-I was observed in patients with lesional activity by magnetic resonance imaging (MRI) brain scan
Summary
Measurement of soluble HLA in body fluids has a potential role in assessing disease activity in autoimmune disorders. The human major histocompatibility antigens, HLA, are generally cell bound, but trace amounts exist in soluble form [1,2,3]. SHLA-II is routinely detectable in the urine, tears, sweat and saliva of normal individuals, but concentrations of sHLA-II are not observed to be elevated in rheumatological diseases [10,11]. An elevation of CSF sHLA II and I as well as an increase in serum sHLAI, but not in serum HLA-II levels, in MS has been reported [14]. Fainardi et al [15] reported a decrease in sHLA-I concentrations during exacerbations in MS, but an increase in CSF sHLA-I was observed in patients with lesional activity by MRI brain scan. It appears advantageous to assess sHLA measurements in subjects with a similar racial-ethnic background
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