HLA Gm systems and susceptibility to alcoholic cirrhosis: a study of mixed-race subjects.

The fact that only a small percentage of excessive drinkers develop cirrhosis may be due to a genetic susceptibility to the disease. In order to identify possible genetic risk factors for cirrhosis, we studied mixed-race (Negroid-Caucasian) inhabitants of the French West Indies and compared: (1) the frequency of 51 HLA-A, -B, -C and -DR antigens in 41 subjects with alcoholic cirrhosis and in two control groups consisting of 41 excessive drinkers free of liver disease and 51 healthy non-drinkers; and (2) the frequency of Gm and Km haplotypes in the same groups. Analysis of the Gm system also determined the patients' ethnic origins. The frequency of the HLA-A2 antigen was significantly higher in the cirrhotic patients than in the control group of excessive drinkers (chi 2 = 4.47; P less than 0.05), while that of the HLA-B15 antigen was significantly lower (chi 2 = 5.14; P less than 0.05). The frequency of the Cw4 antigen was significantly higher in the cirrhotics than in the non-drinkers (chi 2 = 5.59; P less than 0.05). However, these differences did not persist when the number of comparisons was taken into account. The frequency of Gm and Km haplotypes was not significantly different in the three groups. In conclusion, complementary studies are required to determine the value of the Gm-Km system as a marker of susceptibility to alcoholic cirrhosis. Our results do not identify an association between HLA antigens and cirrhosis specific to a negroid ethnic group and support the notion that such an association is weak.

Blood thiamine and thiamine phosphate concentrations in excessive drinkers with or without peripheral neuropathy.

The aim of our study was to answer the following questions: (1) is thiamine deficient in chronic excessive drinkers; and (2) is peripheral neuropathy associated with thiamine deficiency or with alcohol intake itself? We performed direct assays of blood concentrations of free thiamine and thiamine phosphate in excessive drinkers with or without peripheral neuropathy and in control subjects. We found no difference in free thiamine concentrations between excessive drinkers with and without neuropathy, and no difference in free thiamine concentrations between the two groups of excessive drinkers and the control group. By contrast, a deficiency in thiamine phosphate was observed in each group of excessive drinkers compared to the control group. This was reflected in blood concentrations of total thiamine which were also lower in excessive drinkers than in controls. Finally, the thiamine phosphate: free thiamine ratio was slightly but significantly lower in the two groups of excessive drinkers than in the control group. Both groups of excessive drinkers showed typical moderate liver disease of alcoholic origin. In conclusion, the free thiamine fraction was not diminished in this group of alcoholic hospital inpatients. Thiamine deficiency would not therefore appear to play a determining role in the onset of peripheral neuropathy. In contrast, the phosphorylated fraction was slightly reduced, probably owing to the liver disease in these subjects. Contrary to studies using indirect assay techniques, our results suggest that thiamine deficiency is either slight or absent in chronic drinkers.

Study of HLA antigens in systemic lupus erythematosus in the French West Indies.

As incidence of SLE is high in Blacks, we studied HLA and SLE associations in the French West Indies, whose population is racially mixed. Forty-seven coloured SLE patients have been typed in HLA A,B,C and DR. We observed B8 association in nearly all of the studies. B15 association, more frequent in Caucasians, was found, also B53 association, a Black variant of B5 more frequent in Blacks. We did not find any class II association.

[Human leptospirosis in Martinique]. / Leptospiroses humaines en Martinique

Eco-geographic conditions are good for spread of Leptospiroses in Martinique. Leptospiroses are widespread in all parts of the Island. Many people have animals in inhabitation area. When they are sought, Leptospiroses can be diagnosed. During 3 years, we found many cases confirmed by biological diagnosis (immunological research of antibodies). Icterohaemorrhagiae is the first serogroup encountered and the most frequent. After follow Canicola, Ballum, Cynopteri and Javanica. Actually, Leptospiroses are a disease more frequent than is generally thought in Martinique. But only the severe cases are hospitalized, so diagnosed. Many cases of fever of unknown origin can be Leptospiroses.