Association of HLA B8 with spontaneous resolution in sarcoidosis

ABSTRACT HLA may influence the natural history of some diseases. HLA frequencies have been compared in 164 healthy control subjects, 50 patients with sarcoid lung fibrosis, and 37 patients with sarcoidosis that resolved spontaneously. B8 was increased significantly in the resolved group compared to both healthy control subjects (p <0001) and the fibrotic group (p <0 01). The results support the findings of other investigators, and are consistent with the hypothesis that inherited host factors, perhaps related to immune response, influence the clinical expression of sarcoidosis. Investigation of HLA is of interest in sarcoidosis firstly because of the evidence that inherited factors may influence this disease, ' and secondly because of the involvement of immune mechanisms in its pathophysiology.2 The conflicting results of HLA population studies3-7 and the negative results of a study of 14 families8 show that there is no definite association between HLA and the development of sarcoidosis. However, HLA may influence the natural history of some diseases,9 and an increase in B8 frequency has been reported in patients with acute sarcoidosis presenting with erythema nodosum or arthropathy or both.'0 In this paper we describe a comparison of HLA frequencies in patients with sarcoidosis according to whether the disease resolved spontaneously or progressed to fibrosis. Methods The records of patients with sarcoidosis who had been seen over a period of at least two years at the Brompton Hospital or neighbouring chest clinics were reviewed. Those who satisfied the criteria for each of the following groups were HLA typed. In all cases histological support was obtained from Kveim test, tissue biopsy or both