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Inflammatory human leucocyte antigen genotypes are not a risk factor in chronic subdural hematoma development

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Abstract

Background

Chronic subdural hematoma (CSDH) pathophysiology has undergone a paradigm shift from being regarded as solely traumatic to be driven mainly by inflammation. Human leucocyte antigen (HLA) is a gene complex involved in antigen processing and presentation to T lymphocytes, thereby mediating the adaptive immune responses. As specific HLA profiles are associated with inflammatory diseases, patients with a specific HLA profile may have a lower threshold for subdural inflammation, and therefore are predisposed for CSDH development.

We hypothesized that (1) CSDH patients have a specific HLA profile compared to a Danish background population, and (2) patients with recurrent CSDH have a specific HLA profile compared to CSDH patients without recurrent CSDH.

Methods

Three specific HLA class II haplotypes known to drive inflammatory-mediated diseases were determined in 68 patients with CSDH. The distribution of these three haplotypes in our CSDH population was compared to a Danish population of blood donors using Monte Carlo Pearson’s chi-square test. Furthermore, the distribution of the haplotypes was compared between CSDH patients with and without recurrent CSDH.

Results

We found no significant association between either of the haplotypes and the risk of CSDH, and neither of the haplotypes were associated with increased risk of CSDH recurrence.

Conclusion

This study did not show an association between selected HLA class II haplotypes and the risk of CSDH or recurrence of CSDH compared with a healthy background population.

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Data availability

The datasets generated and/or analyzed during the study are available from the corresponding author on reasonable request.

Code availability

Not applicable

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Funding

This study was funded by the Research Fund at the Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet.

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Authors and Affiliations

  1. Department of Neurosurgery, The Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 6, 2100, Copenhagen Ø, Denmark

    Thorbjørn Søren Rønn Jensen & Kåre Fugleholm

  2. Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Claus Thorn Ekstrøm

  3. Department of Clinical Immunology 7631, University Hospital of Copenhagen – Rigshospitalet and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Helle Bruunsgaard

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  1. Thorbjørn Søren Rønn Jensen
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Contributions

Thorbjørn Søren Rønn Jensen: original draft preparation, conceptualization, sample collection, analysis, validation, and data curation.

Kåre Fugleholm: conceptualization, analysis, validation, data curation, supervision and writing, reviewing and editing.

Claus Ekstrøm: statistical analysis and writing, reviewing and editing.

Helle Bruunsgaard: conceptualization, supervision, methodology, writing, reviewing and editing, and data curation.

Corresponding author

Correspondence to Thorbjørn Søren Rønn Jensen.

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The study was approved by the Scientific Ethical Committee (Journal no. H-20051073).

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Jensen, T.S.R., Fugleholm, K., Ekstrøm, C.T. et al. Inflammatory human leucocyte antigen genotypes are not a risk factor in chronic subdural hematoma development. Acta Neurochir 165, 2399–2405 (2023). https://doi.org/10.1007/s00701-023-05745-w

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