HLA-A and B antigen frequencies and mesothelioma in relation to asbestos exposure

Our plain-English summary of HLA-A and B antigen frequencies and mesothelioma in relation to asbestos exposure, by M.M. Wagner, C. Darke, R.M. Coles, et al (British Journal of Cancer, 1983).

The study

• Authors: M.M. Wagner, C. Darke, R.M. Coles, C.C. Evans
• Journal: British Journal of Cancer
• Published: 1983;48(5):727-30
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004263).

Summary of the article

This short communication asked whether HLA-A and HLA-B tissue types are associated with mesothelioma in relation to asbestos exposure. The authors HLA typed 71 mesothelioma patients from 7 UK centres (Belfast, Cardiff, Carlisle, Derby, Liverpool, London and Plymouth). Diagnosis was confirmed by post-mortem histology in 54 cases and by biopsy in 11, with agreement required between at least two pathologists; in 6 cases only pleural effusion cytology was available. Asbestos exposure was graded with an exposure rating (exposure code x years in job). Patients were compared with pooled random unexposed control populations (5,863 individuals). The 27 Plymouth (Devonport Dockyard) patients were also compared with five local asbestos-exposed groups, including a 135-person case-control group and 230 dockyard workers with radiographic abnormalities, and with 298 unexposed people from South West England. The 18 Liverpool patients were compared with 616 local blood donors. Typing covered 14 HLA-A and 30 HLA-B antigens. Using uncorrected P<0.05, the total mesothelioma group showed a slight decrease in HLA-A11 (2.8% vs 12.1%) and an increase in BW21 (9.9% vs 3.8%). HLA-B12 was associated with the occupationally exposed group (59.1% vs 29.8%). Plymouth patients showed increased HLA-A2 (74.1%) and decreased HLA-B8 (7.4%) compared with the exposed and unexposed local groups. The Liverpool patients showed no differences. All differences became non-significant after correction for the number of antigens tested. The authors suggested that HLA may be associated with variations in the 'walling up' of fibres in the pleural cavity, and noted that the differences were clearly associated with the Devonport population.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short communication reported HLA tissue typing (inherited immune-system markers) in 71 people with mesothelioma from seven UK centres, 27 of them from Plymouth, home of the Devonport Dockyard. Asbestos exposure was graded from job type and years in the job. HLA-A and B antigen frequencies were compared with unexposed random populations and, for Plymouth patients, with five groups of asbestos-exposed dockyard workers. Five antigens differed at P less than 0.05 before correction for the number of antigens tested. Among all mesothelioma patients, HLA-A11 was found in 2.8% versus 12.1% of unexposed controls, and BW21 in 9.9% versus 3.8%. HLA-B12 was found in 59.1% of occupationally exposed patients versus 30.8% of those with light or no exposure. Plymouth patients had more HLA-A2 and less HLA-B8 than the comparison groups. No statistically significant differences were found between the 18 Liverpool patients and local controls. All differences were non-significant after correction. The authors suggested HLA may be associated with how efficiently fibres are "walled up" in the pleural cavity, and said the differences were associated with the Devonport Dockyard population.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Short communication: HLA typing study comparing mesothelioma patients with asbestos-exposed and unexposed comparison groups
• Who was studied: 71 mesothelioma patients from 7 UK centres (Belfast, Cardiff, Carlisle, Derby, Liverpool, London and Plymouth). Diagnosis was confirmed by post-mortem histology in 54, by biopsy in 11, and by pleural effusion cytology only in 6. Of these, 27 were from Plymouth (Devonport Dockyard) and 18 from Liverpool. Comparison groups were pooled random unexposed UK populations (5863), 298 unexposed people from Bristol and Exeter, 616 Liverpool blood donors, and five Plymouth asbestos-exposed groups: a 135-person matched case control group, 75 retired workers aged 75 or over, 230 workers with radiographic abnormalities, 78 with pulmonary fibrosis and 61 with pleural calcification. Study dates are not given.
• Exposure: Asbestos exposure (fibre type not specified), graded by an exposure rating (exposure code times years in job). The exposure codes ranged from 1 (dockyard office work) to 25 (asbestos sprayer, lagger afloat). Patients were grouped as light or no exposure (0-100), intermittent occupational (100-399) and heavy occupational (400+).
• Main results:
  • Across sixteen intergroup comparisons, 5 HLA antigens showed frequency differences at P less than 0.05, uncorrected for the number of antigens tested.
  • In all 71 mesothelioma patients compared with the random unexposed control group (5863), HLA-A11 was 2.8% versus 12.1% (P less than 0.05) and BW21 was 9.9% versus 3.8% (P less than 0.01).
  • HLA-B12 was found in 59.1% of the 22 occupationally exposed mesothelioma patients, compared with 30.8% of the 39 with light or no exposure (P less than 0.05) and 29.8% of the unexposed control group (P less than 0.01). The authors noted that Plymouth patients made a major contribution to this finding.
  • The 27 Plymouth mesothelioma patients had more HLA-A2 and less HLA-B8 than the Plymouth asbestos-exposed groups and the unexposed South West England group. Compared with the unexposed South West England group, A2 was 74.1% versus 47.0% (P less than 0.01) and B8 was 7.4% versus 29.9% (P less than 0.05).
  • No statistically significant differences were found between the 18 Liverpool mesothelioma patients and 616 local blood donors.
  • All frequency differences became non-significant after correction for the number of HLA antigens tested.
  • Plymouth patients were divided by survival after diagnosis (more or less than one year). The authors found no evidence that mesotheliomas resemble leukaemias, in which HLA types have been linked with survival.
• The authors' conclusion: The authors suggested that the low B8 frequency and the A2 and B12 differences in Devonport mesothelioma patients mean HLA may be associated with variations in how efficiently fibres are "walled up" in the pleural cavity. They said the lack of HLA association in patients with low exposure probably indicates that exceptional susceptibility to mesothelioma is unassociated with the HLA-related immune response. They stated the differences found were associated with the Devonport Dockyard population.
• Limitations the authors state:
  • Accurate histological diagnosis of mesothelioma is difficult. Agreement of at least two pathologists was required.
  • For 6 cases, only material from pleural effusions was available.
  • Groups from areas other than Plymouth and Liverpool were too small for separate comparisons.
  • Survival after treatment cannot be measured for mesothelioma, which limits comparison with leukaemia survival findings.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Histology, Biopsy, Pleural Effusion, Cytology, Pleural Cavity.

Related studies

• HLA-A and B antigen frequencies in an asbestos exposed population with normal and abnormal chest radiographs — C. Darke, M.M. Wagner, et al. (1979)
• Frequency of HLA antigen in asbestos workers with and without pulmonary fibrosis — C.C. Evans, H.C. Lewinsöhn, et al. (1977)
• The relationship between HLA-A, B, DQ, and DR antigens and asbestos-induced lung disease — J.F. Shih, G.W. Hunninghake, et al. (1993)
• Recognition of pleural mesothelioma by mucin-1(950-958)/human leukocyte antigen A*0201-specific CD8+ T-cells — D. Roulois, V. Vignard, et al. (2011)
• Human T cell responses to endogenously presented HLA-A*0201 restricted peptides of Simian virus 40 large T antigen — M.P. Velders, M.F. Macedo, et al. (2001)
• Elevated micronucleus frequencies in patients with pleural plaque secondary to environmental exposure to asbestos — M. Gövercin, A.G. Tomatır, et al. (2014)

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