The Genetic and Bacteriological Aspects of Peyronie's Disease

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Abstract
Peyronie's disease has been associated with HLA tissue types, including HLA-A1, DR3, DQw2 and HLA-B7 cross-reactive group antigens which include HLA-B27. This association was tested as was the process of molecular mimicry where the host HLA surface antigen cross-reacts with a microorganism. HLA tissue typing was performed on 51 white patients with Peyronie's disease, of whom 15 also had Dupuytren's contracture of the hand. Fecal, urine and urethral samples were taken from patients with Peyronie's disease who had proved penile inflammation on biopsy. The samples were cultured for species of Campylobacter, Shigella, Salmonella, Yersinia, Chlamydia and gonococcus, all known to cross-react with the HLA-B27 surface antigen. Antibodies to Klebsiella species, Proteus species and Escherichia coli were also assessed in the sera of 65 patients with Peyronie's disease. A significant association between Peyronie's disease and HLA-B27 was found (p = 0.02). The remaining antigens of the HLA-B7 group were not significantly associated with the disease individually (HLA-B7 p >0.2, HLA-B22 p >0.6, HLA-B40 p >0.7) or as a group (p = 0.69). The previously found associations did not reach significance in this study (HLA-A1 p >0.5, HLA-B8 p >0.2, HLA-Cw7 p = 0.1, HLA-DR3 p >0.4, HLA-DQ2 p >0.4). Cultures for all enteric and urethral organisms were negative, and patients with Peyronie's disease did not have elevated serum titers of anti Klebsiella, anti Proteus or anti E. coli antibodies. Although there is an association between Peyronie's disease and HLA-B27, molecular mimicry does not occur with the organisms tested, and an infectious agent has not been found in this study.