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From the Health Research Board, Dublin, Ireland (G.D.); Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (T.W.Y., A.G., S.S., D.A.S.C.); Section for Experimental Neurology, Katholieke Universiteit Leuven, Leuven, Belgium (A.G.); Tissue Typing Laboratory, Addenbrooke’s Hospital, Cambridge, UK (C.J.T., R.S.G.); Central Middlesex Hospital, London, UK (M.E.); St. Luke’s Hospital, Guardamangia, MSD09, Malta (A.G.-D., M.V.); Maltese Blood Transfusion Service, Guardamangia, MSD09, Malta (A.A.); and Laboratory of Molecular Genetics, Department of Physiology and Biochemistry, Biomedical Sciences Building, University of Malta, Msida, MSD06, Malta (A.F.).
* To whom correspondence should be addressed. E-mail: hrb{at}hrb.ie.
ABSTRACT
Background: By comparison with the neighboring island of Sicily, the frequency of multiple sclerosis (MS) in Malta is remarkably low.
Methods: To explore whether the relative rarity of MS in Malta might be the result of lower population frequencies of major histocompatibility complex susceptibility alleles, we genotyped the HLA-DRB1 locus in 77 Maltese-born patients (97% of the prevalent unrelated native cases) and 206 Maltese controls. We made comparisons with previously published data for Sicily and other European countries.
Results: The anticipated association with HLA-DRB1*15, the main susceptibility allele in most other populations, was confirmed (pc = 0.009) but, in addition, we also observed an equally strong, and apparently protective, effect of the HLA-DRB1*11 allele (pc = 0.016). In comparison with previously published data from Sicily, we found that all HLA-DRB1 risk alleles were more common in Malta, whereas HLA-DRB1*11 was slightly less common.
Conclusions: The difference in prevalence seen between the neighboring islands of Malta and Sicily cannot be explained by differences in background HLA-DRB1 population allele frequencies, which if anything would predict a higher rate of disease in Malta than in Sicily.
This article has been cited by other articles:
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  S. V. Ramagopalan, D. A. Dyment, A. D. Sadovnick, and G. C. Ebers HLA-DRB1 AND MULTIPLE SCLEROSIS IN MALTA Neurology, October 21, 2008; 71(17): 1379 - 1379. [Full Text] [PDF]
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B. Fontaine and L. F. Barcellos Evidence for a complex interaction between HLA-DRB1 and environmental factors in MS Neurology, January 8, 2008; 70(2): 97 - 98. [Full Text] [PDF]
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Read all Correspondence
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