RESUMEN
HLA-typing was carried out on 122 areca nut chewers who attended hospitals for complaints unrelated to the habit. The subjects were South Africans of Indian extraction. The study did not include haplotypes. Palpable fibrous bands in the mouth indicated oral submucous fibrosis. The subjects were divided into 4 groups based on specific oral symptoms and signs. Groups A and B were without fibrous bands. Group A (47 subjects) included those with one or no symptoms while group B (28 subjects) suffered from 2 to 7 oral symptoms. Group C (17 subjects) had oral symptoms and represented early or mild oral submucous fibrosis and exhibited at least one discrete palpable fibrous band. Group D (30 subjects) were classic oral submucous fibrosis cases with multiple bands. The high occurrence of oral submucous fibrosis in this study group (39%) is similar to the occurrence in comparable age groups reported earlier in South Africa and is conceivably due to the higher age range of the subjects and their relatively long exposure to the areca nut. We were unable to demonstrate a specific pattern of HLA-antigen frequencies in chewers with or without the disease. Furthermore, there were no differences between the study population and the controls. It is concluded that there is not necessarily a HLA-associated susceptibility in oral submucous fibrosis.
Asunto(s)
Areca , Antígenos HLA/genética , Fibrosis de la Submucosa Bucal/inmunología , Plantas Medicinales , Distribución de Chi-Cuadrado , Femenino , Frecuencia de los Genes , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Antígenos HLA-C/genética , Antígenos HLA-D/genética , Humanos , India/etnología , Masculino , Persona de Mediana Edad , Fibrosis de la Submucosa Bucal/epidemiología , Sudáfrica/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/inmunologíaRESUMEN
One hundred seventy-eight couples with positive antisperm antibody titers in serum and genital secretions were offered treatment with prednisone. Of 60 couples who received prednisone only, 43% conceived. Of 25 who had no therapy, 48% conceived. Fifty-four patients treated with prednisone received additional therapy and 31% conceived. Ten of 39 patients not treated with prednisone but receiving other therapies conceived. Cytotoxic antibodies were reduced in 30% to 42% of serum samples and in 24% to 33% of genital secretion samples. In those couples with decreased cytotoxic antibodies pregnancy rates were 40% to 60% compared with 0% to 23% in those with decreased hemagglutinating antibody titers. Our data suggest that prednisone did not improve overall pregnancy rates; pregnancy rates were comparable in both groups treated with other therapies; donor insemination was the most successful of the alternative therapies; reduction of cytotoxic antibody titers after prednisone treatment was associated with increased pregnancy rates.