Table of Contents
Definition / general | Terminology | Clinical features | Diagrams / tables | Microscopic (histologic) images | Positive staining - normal | Positive staining - disease | Negative stainingCite this page: Pernick N. HLA-DR. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainshladr.html. Accessed December 26th, 2024.
Definition / general
- HLA-DR is a MHC (major histocompatibility complex) class II cell surface receptor encoded by human leukocyte antigen complex on 6p21.31 (Wikipedia: HLA-DR [Accessed 3 August 2018])
- Antigen presenting cells use HLA-DR molecules to present protein fragments (processed antigen) to T cells, a key event in induction of T cell responses (PLoS One 2012;7:e31483)
Terminology
- Also called HLA-DR (Ia)
Clinical features
- Involved in several autoimmune conditions, disease susceptibility and disease resistance (Scand J Immunol 2011;74:603), including idiopathic dilated cardiomyopathy (Mol Biol Rep 2012;39:221), hepatits B persistence (World J Gastroenterol 2012;18:3119)
- HLA-DR on Tregs is a good marker for HIV1 viral replication and disease progression (Chin Med J (Engl) 2011;124:2340)
- Hypoxia increases membrane and secreted HLA-DR in endothelial cells, rendering them T-cell activators
- May be important in transplants (which have preoperative ischemic periods) and graft rejection (Transpl Int 2011;24:1018)
- HLA-DRB1 mismatches are significant risk factor for kidney transplant rejection, although may be difficult to find matched donors (Arch Surg 2011;146:824)
- Decrease in density of HLA-DR+ cells occurs faster in corneas stored in organ culture than under hypothermic conditions
- Nay prolong graft survival (Ophthalmic Res 2012;47:39)
Microscopic (histologic) images
Positive staining - normal
- Basophils (immature), osteoblasts
- Antigen presenting cells (B cells, dendritic cells, macrophages, monocytes)
- Precursor T cells and CD4+ T cells
- Liver, bile ductules
- Thymus
Positive staining - disease
- AML: M0-M6 (some variability)
- Also AML with myelodysplastic related changes, recurrent genetic abnormalities
- Acute basophilic leukemia, acute panmyelosis with myelofibrosis, transient myeloproliferative disorder of Down syndrome (80%)
- Breast: medullary carcinoma
- Esophagus: Crohn's disease
- Langerhans cell histiocytosis
- Lymphomas:
- Adult T cell leukemia / lymphoma (HTLV1+, frequent)
- B-ALL
- Blastic plasmacytoid dendritic cell neoplasm
- Extranodal NK / T cell lymphoma nasal type
- Primary effusion
- SLL / CLL
- Thyroid: Graves disease (thyrocytes and lymphocytes)
Negative staining
- Acute promyelocytic leukemia (usually, Am J Clin Pathol 2011;135:76)