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HLA‐B*39:06, HLA‐B*39:01, and HLA‐B*38:01 are closely related HLA allotypes differentially associated with type 1 diabetes (T1D) risk and progression. B*39:06 is highly predisposing, while B*39:01 and B*38:01 are weakly predisposing and protective allotypes, respectively. Here, we aimed to decipher molecular mechanisms underlying the differential association of these allotypes with T1D pathogenesis. We addressed peptide binding and conformational stability of HLA‐B allotypes using computational and experimental approaches. Computationally, we found that B*39:06 and B*39:01 allotypes had more rigid peptide‐binding grooves and were more promiscuous in binding peptides than B*38:01. Peptidomes of B*39:06 and B*39:01 contained fewer strong binders and were of lower affinity than that of B*38:01. Experimentally, we demonstrated that B*39:06 and B*39:01 had a higher capacity to bind peptides and exit to the cell surface but lower surface levels and were degraded faster than B*38:01. In summary, we propose that promiscuous B*39:06 and B*39:01 may bind suboptimal peptides and transport them the cell surface, where such unstable complexes may contribute to the pathogenesis of T1D. [ABSTRACT FROM AUTHOR]

A 19-year-old woman with a history of recurrent aphthous stomatitis and genital ulceration was diagnosed with Behçet disease. She was treated with steroids and immunosuppressive agents for more than 30 years, but multiple complications manifested including ileocecal ulcer, aortic valve regurgitation, renal failure, ischemic enterocolitis, and arteriosclerotic obliterans until her death at the age of 56 from pneumonia. An autopsy examination demonstrated an entirely calcified aorta and major aortic branches. The ascending aorta was dilatated 55 mm in diameter and branches were all stenosed. Microscopically, the aortic arch and its branches showed collagenous fibrosis of the outer media and adventitia, whereas coronary and abdominal aortic branches showed conventional atherosclerosis. Although the ante-mortem diagnosis was angio-Behçet disease, its pathophysiology along with her clinical history, morphology of the lead pipe-like aorta, predominant destruction of the outer arteries, and a human leukocyte antigen ( HLA) haplotype of B39 were all suggestive of Takayasu arteritis. Thus, this case implies that HLA- B39 may be associated with the pathogenesis of arteritis like Takayasu arteritis, even if the primary disease is Behçet disease. [ABSTRACT FROM AUTHOR]

Post-streptococcal reactive arthritis (PSRA) is a temporary arthritis following pharyngeal and/or tonsillar infection with Group A, β-haemolytic streptococci. We investigated the clinical manifestations of adult patients with reactive arthritis (ReA) induced by tonsillitis. All patients were diagnosed and treated at Juntendo Hospital. Patients were 9 male and 12 female aged from 20 to 55 years old. Episode of recurrent arthritis ranged from 2 weeks to 10 years (median: 24 months). Elevated ASO/ASK was revealed in 13 of 21 patients (62.0%) and Group A Streptococcus was isolated in 12 patients (57.1%). Pseudomonas and other bacteria were identified from resected tonsillar abscess. Asymmetrical oligoarthritis of large joints and enthesitis were demonstrated. Non-specific abdominal pain and erythema were noted in a few patients. No patient revealed carditis during the course of illness and follow-up period of at least 2 years. Rheumatoid factor was positive in 9.5%. HLA-B39 and BW61(B40) were demonstrated in 33.3 and 46.7% (p<0.005, p<0.01, respectively). Eight patients underwent tonsillectomy. Resected tonsils revealed presence of cryptic abscess. Tonsillectomy was especially effective for patients with recurrent tonsillitis and ReA associated with tonsillar abscess. [Copyright &y& Elsevier]

HLA-B*3909 has only been found among South Amerindians, and presumably arose locally in these populations. It differs from B*3901 by a single Tyr to Ser change at position 99. To analyze the influence of this polymorphism on peptide specificity, pool sequence analysis and sequencing of multiple individual ligands from B*3901 and B*3909 were carried out. Both allotypes bind peptides with Arg2 or His2 and nonpolar C-terminal residues. However, whereas His2 is the predominant B*3901 motif, a majority of the B*3909-bound peptides have Arg2. In addition, B*3909 binds peptides with Pro2, and also shows an increased preference for Pro3. In spite of their differences, both subtypes bind overlapping peptide repertoires, as indicated by the identification of several identical ligands from their respective peptide pools. B*3909 is significantly more similar in its peptide specificity to HLA-B27 than B*3901. This is due to the increased preference of B*3909 for Arg2 and to low suitability of HLA-B27 for His2. The similarity between HLA-B27 and B*3909 was confirmed by identification of a natural ligand common to both allotypes. In addition, multiple HLA-B27 ligands bound efficiently B*3909 in vitro. The results indicate that, among the HLA class I allotypes of known peptide specificity, B*3909 is the most similar in its peptide binding properties to HLA-B27, which is absent in South Amerindians. This may have implications for the susceptibility of individuals in these populations to spondyloarthropathies. [ABSTRACT FROM AUTHOR]