The discoveries in the 1970s of strong associations between various diseases and certain human leukocyte antigen (HLA) factors
were a revolution within genetic epidemiology in the last century by demonstrating for the first time how genetic markers
can help unravel the genetics of disorders with complex genetic backgrounds. HLA controls immune response genes and HLA associations
indicate the involvement of autoimmunity. Multiple sclerosis (MS) was one of the first conditions proven to be HLA associated
involving primarily HLA class II factors. We review how HLA studies give fundamental information on the genetics of the susceptibility
to MS, on the importance of linkage disequilibrium in association studies, and on the pathogenesis of MS. The HLA-DRB1*1501
molecule may explain about 50% of MS cases and its role in the pathogenesis is supported by studies of transgenic mice. Studies
of polymorphic non-HLA genetic markers are discussed based on linkage studies and candidate gene approaches including complete
genome scans. No other markers have so far rivaled the importance of HLA in the genetic susceptibility to MS. Recently, large
international collaborations provided strong evidence for the involvement of polymorphism of two cytokine receptor genes in
the pathogenesis of MS: the interleukin 7 receptor α chain gene (IL7RA) on chromosome 5p13 and the interleukin 2 receptor
α chain gene (IL2RA (=CD25)) on chromosome 10p15. It is estimated that the C allele of a single nucleotide polymorphism, rs6897932,
within the alternative spliced exon 6 of IL7RA is involved in about 30% of MS cases.
Keywords Multiple sclerosis - Genetics - HLA - Major histocompatibility complex - Interleukin receptor genes - Linkage - Association