Biomedical subjects
Publications and source records attributed to M Minev.
Sixty patients with psoriatic arthritis were examined for the rate of demonstration of A, B and DR loci of the HLA system. As compared to the control group, the patients manifested an increase of the rate of demonstration of A24, B27 antigens as well as of DR4 and DR7, which may serve an adjuvant criterion for the disease diagnosis. The highest rate of B27 antigen demonstration was seen in patients with spondylitis.
In 79 diabetic patients, 37 patients with diabetes mellitus type I and 42 patients with diabetes mellitus type II, the HLA-A, B and DR antigens were examined. An association of diabetes mellitus type I with HLA-B8, DR3 and DR4 was found. For the first time a relation between diabetes mellitus type I and HLA-B21 antigen was established. The early onset of the disease and the exhaustion of the endogenic insulin secretion are linked with B8 and DR3 carrier state while the late manifestations of diabetes mellitus and the preservation of one's own insulin production correlate with antigen B21. In the patients with diabetes mellitus Type II the frequency of antigen B21 and DR1 is increased and the carriers of B21 develop in the course of the disease relative insulin insufficiency and a secondary resistance toward sulfanilurea drugs.
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For an 8 year period 45 patients with Bechterew's disease were found who had no antigen HLA-B27. 35 of the patients were tested for HLA--A, -B or -C. In 12 patients antigens of the cross-reacting group B27 (B7, Bw22 and B40) were found. In patients without psoriasis antigens B13, B16, B17 which are known to be related to psoriasis vulgaris were found. 9 patients were antigen Cw2 carriers which is in unbalanced linkage with B27. The B27 negative forms present several clinical features: late onset of the disease, slow and favourable course, development of spinal forms only, lack of iridocyclitis and heart lesions.
A statistically significant, after correction of P value, increased incidence of the antigen HLA-DR4 chi 2 = 32.81, p less than 0.001, was established in the comparison of the antigen incidence of HLA-A, B, C and DR antigens in 59 patients with classical and positive rheumatoid arthritis and control healthy subjects. No essential difference in the distribution of DR4 was established that depended on sex, age of occurrence of the disease, presence of rheumatoid factor and the form of the disease.
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In 192 patients with psoriasis an increased frequency of the antigens HLA-B13 (19.79%, X2 = 32.79, p less than 0.001), HLA-B17 (24.47%, X2 = 64,84, p less than 0.001), and HLA-B27 (19.27%, X2 = 11.07, p less than 0.001) in comparison with the control group of 1,085 clinically healthy persons, was established. After 4 weeks of thalassotherapy 3 groups of patients could be distinguished: (1) those with full clinical remission - 50 (26.8%), (2) those with great or moderate improvement - 116 (60.4%), and (3) those with no improvement - 26 patients (13.6%). In the first two groups there is a statistically significant association with the HLA antigens B13 and B17. In the third group (no improvement) there is no such association with HLA-B13 (p less than 0.01). Consequently, patients in whom psoriasis is associated with HLA-B13 were better influenced by the thalassotherapy. The variability in the therapeutic efficiency means that perhaps there is a genetic heterogenicity in the group of common psoriasis.
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In 200 patients with myocardial infarction, 35 of them with concomitant insulin-independent diabetes mellitus, 91 - with hypertension and 91 - without diabetes and hypertension, it was established that the patients with diabetes and hypertension manifected an association with HLA-BW, whereas sucr association was not observed in infarction group without hypertension and diabetes.
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Fifty two patients, 29 males and 23 females, with seronegative polyarthritis, carriers of tissue-compatible antigen HLA--B27 manifested characteristic clinical signs: the disease started at young age--29; it progresses, most frequently, with attacks--acute or subacute as monoarthritis (gonitis) or oligoarthritis, the lower limb joints predominantly involved. The periarticular structures are very often involved in the process--achillitis, styloiditis, talagia and sarcoiliac joints--sarcoiliitis clinically and scintigraphically confirmed. With the family examinations of the patients' relatives the following cases were established: 9 cases with Bechterew's disease, four cases with sacroiliitis, one--with iridocyclitis, two patients with rheumatoid arthritis and 18 healthy carriers of HLA--B27 antigen. The dynamics of the development of typical ankylozing spondylitus was a favourable prognosis and the treatment, most often, covers--nonsteroid anti-inflammatory drugs or low doses of corticosteroids--generally or locally.
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With the investigation of HL A phenotypes of 133 patients with an akylozing spondylarthritis, 110 males and 23 females, confirmed incidence of antigen B 27 was established in 87.96 per cent versus 10.78 per cent of 1085 control healthy subjects. The families of 24 patients were also examined with a total of 27 subjects HLA-B27 positive relations, among them 11 cases of SA with a latent course so far. The results from those exminations reveal that HLA-B27 antigen investigations could aid making the diagnosis in cases, suspected of SA, together with the other diagnostic methods.
Balkan endemic nephropathy, a fatal family disease with unknown aetiology and pathogenesis is typical for three neighbouring regions in Bulgaria, Yugoslavia and Rumania. HLA typing of 180 patients from the endemic area in Bulgaria was done and the antigen frequencies were compared with 1264 healthy controls. An increased frequency (P less than 0.001) of the antigen HLA-B18 in the patients was demonstrated.
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Association of juvenile diabetes with antigen B8 and B15 was established with the comparison of the phenotype incidence of 28 HLA antigens from locus A and B among 1085 healthy control subjects and 200 patients with diabetes mellitus (74 with juvenile insulin-dependent type and 126 with insulin-independent diabetes in adults). Only the incidence of antigens B15 and Bw 21 was established to be increased in the cases of insulin-dependent type of diabetes in adults. That raises a new interest in the further study of the problem.