The histocompatibility antigen in asbestos related disease

Our plain-English summary of The histocompatibility antigen in asbestos related disease, by N. Al Jarad, S. Uthayakumar, E.J. Buckland, et al (British Journal of Industrial Medicine, 1992).

The study

• Authors: N. Al Jarad, S. Uthayakumar, E.J. Buckland, T.S. Green, J. Ord, A.C. Newland, R.M. Rudd
• Journal: British Journal of Industrial Medicine
• Published: 1992;49(12):826-31
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Thirty nine phenotypes of human leucocyte antigens (HLA)-A-B-DR and DQ were obtained from 99 asbestos workers (one woman and 98 men). Presence or absence of antinuclear antibodies and rheumatoid factor was determined in 91 of them. Workers were divided into five groups: asbestos workers with no apparent disease (AW; n = 17), diffuse benign pleural disease (PD; n = 31), asbestosis (AS; n = 24), asbestosis with lung cancer (AS-CA; n = 14), and mesothelioma (M; n = 13). Compared with AW, several trends of differences of HLA antigen prevalence were found in patients with asbestos related disease, but these did not achieve statistical significance when p was corrected (pcorr) by number of analyses undertaken. Analysis of the results obtained in previous studies together with the results of this study showed that compared with AW, AS patients had decreased prevalence of HLA-DR5 (pcorr < 0.02). Reasons for the differences in results of previous studies and statistical methods commonly used to compare prevalences of HLA antigen are discussed.

In plain English

Authors at The London Chest Hospital tested blood from 99 asbestos-exposed people (98 white men and one white woman, mean age 59). They asked whether inherited immune markers called HLA antigens differed in asbestos-related disease. They typed 39 HLA types (class I and class II). They compared 17 workers with no apparent disease against groups with benign pleural disease (31), asbestosis (24), asbestosis with lung cancer (14) and mesothelioma (13). Exposure came mainly from lagging, stripping asbestos, dock work, the building trade and lorry driving. No HLA type differed significantly between the unaffected workers and any disease group. HLA types also did not differ by antinuclear antibody or rheumatoid factor status. When the authors combined their data with five earlier studies, they found no difference in HLA-A or HLA-B types between unaffected workers and people with asbestosis. They also combined their HLA-DR data with one other study. In that analysis, people with asbestosis had a lower prevalence of HLA-DR5 than unaffected workers (corrected p less than 0.02). The authors concluded that this suggests a possible protective effect of HLA-DR5 against asbestosis. They noted that some workers classed as unaffected might develop disease later.

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: Cross-sectional comparison of HLA antigen types between groups of asbestos-exposed people, plus combined analyses with previously published studies
• Who was studied: 99 asbestos-exposed people (98 white men, one white woman; mean age 59, range 35 to 79). Groups: no apparent disease (AW, n = 17), benign pleural disease (n = 31), asbestosis (n = 24), asbestosis with lung cancer (n = 14), mesothelioma (n = 13)
• Exposure: Occupational asbestos exposure through lagging (35), stripping asbestos (16), loading and unloading asbestos in shipyards (21), building trade (17) and driving lorries occasionally loaded with asbestos (6). Domestic exposure in 4. Fiber types not stated.
• Main results:
  • No significant differences in the frequency of any HLA type between the workers without disease (AW) and any of the disease groups
  • Among the 91 people tested, HLA prevalence did not differ between those with antinuclear antibodies (n = 19) and those without (n = 72)
  • HLA prevalence did not differ between those with rheumatoid factor (n = 6) and those without (n = 85)
  • The authors combined HLA-A and HLA-B data from this study and five earlier studies (Matej, Evans, Gregor, Huuskonen, Vergnaud), totalling 355 workers without disease and 289 asbestosis patients. This combined analysis showed no difference between the asbestosis and AW groups apart from the HLA-DR5 finding.
  • In the combined HLA-DR data from this study and Begin et al (49 AW, 64 asbestosis patients), the asbestosis group had a decreased prevalence of HLA-DR5 compared with the AW group. Corrected p was less than 0.02.
  • The reported statistics for the HLA-DR5 comparison were a relative risk of 2.6 and a chi-squared value of 16.8
  • Duration of asbestos exposure and time since first exposure did not differ significantly between groups
  • Pack-years of smoking were higher in the asbestosis with lung cancer group than in the AW group (p less than 0.02) and the pleural disease group (p less than 0.0001). They were also higher in the asbestosis group than in the pleural disease group (p less than 0.009).
• The authors' conclusion: The authors concluded that their own data showed no significant associations between HLA types and types of asbestos-related disease. They also concluded that the combined data from this and one previous study suggest a possible protective effect of HLA-DR5 against asbestosis.
• Limitations the authors state:
  • Some workers classed as having no disease may later develop asbestosis, cancer or mesothelioma, so that classification may be correct only at the time of assessment

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Statistical Significance.

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