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The Unresolved Molecular Bases of Major Histocompatibility Complex (MHC) Function with Transplantation and Diseases Linkage

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Immunology".

Deadline for manuscript submissions: 20 June 2026 | Viewed by 161

Special Issue Editor

Special Issue Information

Dear Colleagues,

MHC is a group of genes that encode proteins responsible for the regulation of the immune response. The MHC function of presenting microbial and other peptides to immune-competent cells to start an immune response was mostly discovered with mouse experiments. Most relevant to clinical practice, human MHC (HLA) linkage to disease and transplantation outcomes is still not fully understood regarding their molecular bases. Only hypotheses are available to explain HLA and the particular autoimmune disease statistical association to certain HLA alleles or groups of alleles. These explanations for such associations are highly speculative, mainly used in vitro experiments, and the therapies for these diseases have been somewhat stuck over the years. The molecular physiopathology of HLA and transplantation outcomes and disease linkage needs to be discovered, and research in these fields is urgent since, for example, the statistical linkage of MHC and disease was already discovered more than 50 years ago, and many of the autoimmune-linked diseases are still treated like in the early years with scarce success. Indeed, the role of MHC/HLA extends beyond transplantation into the pathogenesis of numerous immune-mediated diseases.

In addition, there are other puzzling facts regarding MHC (and HLA): In nature, many vertebrates show a very low polymorphism in contrast to humans and laboratory mice, with both having a very high polymorphism. MHC in vertebrates living in nature must be studied to uncover more MHC functions. There are puzzling indications that transplants between spouses have good outcomes regardless of HLA compatibility. This effect must be studied in depth. On the other hand, many drugs have side effects that depend on the existence of certain HLA alleles. Finally, immune modulatory HLA and MHC genes (G, E, and F loci) are now being studied in relation to cancer, autoimmune diseases, and other diseases. This is due to the fact that in autoimmune conditions, like type 1 diabetes, MHC molecules present self-antigens that activate autoreactive T cells, and also tumor cells may downregulate MHC expression as an immune evasion strategy, making them invisible to cytotoxic T cells.

The simple explanation that MHC function presents a peptide to begin adaptive immune response does not explain the molecular bases of some of the MHC- and HLA-linked pathology. In the present Special Issue, we aim to gather research addressing all these points, not only including human and animal (i.e., bird/mouse) pathology but also including phylogeny comparisons between the MHC and evolution of different animals.

Prof. Dr. Antonio Arnaiz-Villena
Guest Editor

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Keywords

  • HLA
  • disease
  • autoimmunity
  • immune deficiency
  • MHC phylogeny
  • HLA pharmacogenomics
  • immune modulatory MHC and HLA genes (G, E, F)
  • transplantation
  • hemochromatosis
  • MHC/HLA epithelial interaction
  • MHC evolution
  • MHC phylogenetics
  • Vertebrate MHC
  • Amimal MHC
  • Veterinary

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Published Papers (1 paper)

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Review

12 pages, 1222 KB  
Review
Enterocyte Autoantibodies (GECAs) and HLA: Their Relationship with HIV Infection Pathogenesis
by Antonio Arnaiz-Villena, Tomas Lledo, Christian Vaquero-Yuste, Ignacio Juarez and Jose Manuel Martin-Villa
Int. J. Mol. Sci. 2026, 27(3), 1254; https://doi.org/10.3390/ijms27031254 - 27 Jan 2026
Abstract
The significance of gut epithelial cell autoantibodies (GECAs), human leukocyte antigen (HLA) alleles, and other scientifically relevant factors has been largely overlooked, despite their potential importance in the medical management of HIV-infected individuals, in understanding the pathogenesis of AIDS, and in improving epidemiological [...] Read more.
The significance of gut epithelial cell autoantibodies (GECAs), human leukocyte antigen (HLA) alleles, and other scientifically relevant factors has been largely overlooked, despite their potential importance in the medical management of HIV-infected individuals, in understanding the pathogenesis of AIDS, and in improving epidemiological and diagnostic approaches. This review may be considered as a hypothesis-driven narrative paper mostly considering GECAs and some easily detectable genetic markers. Thus, the aim is to highlight these neglected medical and scientific issues. Addressing them may contribute to a deeper understanding of HIV pathology at both the individual and population levels. Autoantibodies against enterocytes (GECAs) are present in the majority of HIV-positive patients. These intestinal epithelial cells are crucial for nutrient absorption and because of their role as antigen-presenting cells (APCs) within the immune system. Furthermore, the number of CD4-positive lymphocytes depends largely on daily antigenic stimulation rather than on thymic function, which becomes residual or inactive after puberty. The fall of CD4+ lymphocyte counts observed in HIV-infected patients may therefore be exacerbated by enterocyte dysfunction/damage, as indicated by the presence of GECAs. These autoantibodies either cause or reflect damage to these important antigen-presenting cells, which may impair intestinal antigen presentation by their surface HLA proteins to the clonotypic T-cell receptor of lymphocytes. Additionally, the association between specific HLA alleles and a CCR5 variant affects HIV disease progression or transmission and should be considered in both adults and mother–infant pairs. In particular, HLA-B35 and HLA-B57 allelic groups have been implicated in influencing both the transmission and progression of HIV infection. Moreover, several aspects of the natural history of HIV infection remain unresolved and controversial, and these issues warrant urgent clarification. For instance, diagnostic tests are not yet standardised globally, and viral abundance in HIV-infected individuals or AIDS patients’ cells may be relatively low. In summary, the neglected facets of HIV infection demand renewed investigation, particularly now that an HIV diagnosis is no longer the devastating prognosis it once was. The objective of this work is to emphasise additional factors that may influence the course of AIDS, such as enterocyte injury reflected by presence of GECAs. Ultimately, we propose that GECAs may impair enterocytes’ HLA (MHC II)-mediated antigen presentation by enterocytes to CD4+ T lymphocytes (through T-cell receptors), thereby diminishing T-cell proliferation, reducing CD4+ cell numbers, and impairing immune function. Full article
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