Meta-Analysis and Systematic Review of HLA DQ2/DQ8 in Adults with Celiac Disease

Sara Aboulaghras, Daniela Piancatelli, Khalid Taghzouti, Abdelaali Balahbib, Mohammed Merae Alshahrani, Ahmed Abdullah Al Awadh, Khang Wen Goh, Long Chiau Ming, Abdelhakim Bouyahya, Khadija Oumhani, Sara Aboulaghras, Daniela Piancatelli, Khalid Taghzouti, Abdelaali Balahbib, Mohammed Merae Alshahrani, Ahmed Abdullah Al Awadh, Khang Wen Goh, Long Chiau Ming, Abdelhakim Bouyahya, Khadija Oumhani

Abstract

Although people with human leukocyte antigens (HLA) DQ2 and/or DQ8 are more likely to develop celiac disease (CD), the condition cannot be fully explained by this genetic predisposition alone. Multiple, as yet unidentified, factors contribute to the genesis of CD, including genetics, the environment, and the immune system. In order to provide insight into a prospective possibility and an expanded screening technique, we aim to undertake a comprehensive and meta-analytical study of the assessment and distribution of HLA class II (HLA-DQ2/DQ8) in adult CD patients. A systematic review was conducted using an electronic search of databases (PubMed, Google Scholar, Embase, and Direct Science) from January 2004 to February 2022. DQ2/DQ2 homozygotes have the highest risk of developing CD. DQ2/DQ8 typing is an effective test to exclude CD from the differential diagnosis of a patient with CD symptoms. Although other non-HLA genes have been associated with CD, they are rarely considered at diagnosis because they account for only a small proportion of the heritability of CD. This finding, together with the information gathered previously, may be useful in considering widely available and economically feasible screening options for celiac disease in young people.

Keywords: HLA DQ2; HLA DQ8; adult; celiac disease; systematic review.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study following the PRISMA statement.
Figure 2
Figure 2
Forest plot of CD risk analysis in adult patients with the HLADQ2 allele. Abbreviations: CI, confidence interval. Data sources are shown in Table 2. In the forest plot the contribution of each study to the meta-analysis (its weight) is represented by the area of a box whose centre represents the size of the odds ratio (OR) estimated from that study (point estimate). The 95% confidence interval (CI) for the OR from each study is also shown. The summary OR is shown by the middle of a diamond whose left and right extremes represent the corresponding CI.
Figure 3
Figure 3
Forest plot of CD risk analysis in adult patients with the HLADQ8 allele. Abbreviations: CI, confidence interval. Data sources are shown in Table 2. In the forest plot the contribution of each study to the meta-analysis (its weight) is represented by the area of a box whose center represents the size of the odds ratio (OR) estimated from that study (point estimate). The 95% confidence interval (CI) for the OR from each study is also shown. The summary OR is shown by the middle of a diamond whose left and right extremes represent the corresponding CI.
Figure 4
Figure 4
Forest plot of CD risk analysis in adult patients with HLADQ2/DQ8 allele. Abbreviations: CI, confidence interval. Data sources are shown in Table 2. In the forest plot the contribution of each study to the meta-analysis (its weight) is represented by the area of a box whose center represents the size of the odds ratio (OR) estimated from that study (point estimate). The 95% confidence interval (CI) for the OR from each study is also shown. The summary OR is shown by the middle of a diamond whose left and right extremes represent the corresponding CI.
Figure 5
Figure 5
Forest plot of CD risk analysis in adult patients with the homozygous HLADQ2 allele. Abbreviations: CI, confidence interval. Data sources are shown in Table 2. In the forest plot the contribution of each study to the meta-analysis (its weight) is represented by the area of a box whose center represents the size of the odds ratio (OR) estimated from that study (point estimate). The 95% confidence interval (CI) for the OR from each study is also shown. The summary OR is shown by the middle of a diamond whose left and right extremes represent the corresponding CI.
Figure 6
Figure 6
Forest plot of CD risk analysis in adult patients with heterozygous HLADQ2 allele. Abbreviations: CI, confidence interval. Data sources are shown in Table 2. In the forest plot the contribution of each study to the meta-analysis (its weight) is represented by the area of a box whose center represents the size of the odds ratio (OR) estimated from that study (point estimate). The 95% confidence interval (CI) for the OR from each study is also shown. The summary OR is shown by the middle of a diamond whose left and right extremes represent the corresponding CI.
Figure 7
Figure 7
Forest plot of CD risk analysis in adult patients with heterozygous HLADQ8 allele. Abbreviations: CI, confidence interval. Data sources are shown in Table 2. In the forest plot the contribution of each study to the meta-analysis (its weight) is represented by the area of a box whose center represents the size of the odds ratio (OR) estimated from that study (point estimate). The 95% confidence interval (CI) for the OR from each study is also shown. The summary OR is shown by the middle of a diamond whose left and right extremes represent the corresponding CI.

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Source: PubMed

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