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Journal of Neurology, Neurosurgery, and Psychiatry 1983;46:688-693 Matters arising

By Histocompatibility Antigens and Postencephalitic Parkinsonism


Sir: We have read with interest the article on histocompatibility antigens and post-encephalitic Parkinsonism by Lees et all recently published in your joumal. The authors compared the phenotypic frequen-cies of selected histocompatibility antigens in 21. patients with postencephalitic Parkin-sonism and controls, and did not find any differences between the groups. Missing, however, were the ethnic composition of both the patient and control populations, and the antigenic frequency data with resultant p values corrected statistically for total number of antigens tested in each HLA locus. We had previously reported a highly significantly increased frequency of HLA-B14 antigen (corrected p = 0.001) in 18 unrelated American-Jewish patients of Eastem European extraction who had clas-sical postencephalitic (von Economo's) Parkinson's disease, compared with 147 ethnically-matched controls;2 the 17 patients with idiopathic Parkinson's disease concurrently studied did not show any evi-dent differences in HLA frequencies com-pared to the same matched controls. In our paper, we emphasised that we were dealing with a specific, relatively homogeneous, ethnically-defined and matched study population, and that we were well aware of the known wide variations in prevalence of specific HLA antigens in various ethnic groups. The disease association we reported, while not necessarily reflecting genetic susceptibility to the disease, cer-tainly suggests the possibility that a genetic factor may play a role in the pathogenesis of this particular variant of Parkinsonism in certain ethnic groups. The negative study of Lees et al, while of interest, is not com-parable to ours, nor does it negate our con-tentions

Year: 2016
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