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Liu J, Liu X, Liu Y, Deng S, Huang H, Chen Q, Liu W, Huang Z. Association of EVI5 rs11808092, CD58 rs2300747, and CIITA rs3087456 polymorphisms with multiple sclerosis risk: A meta-analysis. Meta Gene 2016; 9:97-103. [PMID: 27331013 PMCID: PMC4908284 DOI: 10.1016/j.mgene.2016.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/19/2016] [Accepted: 04/22/2016] [Indexed: 11/15/2022] Open
Abstract
Purpose Multiple sclerosis (MS) is a major demyelinating disease of the central nervous system with a strong genetic component. Previous studies have reported that the association of EVI5 rs11808092, CD58 rs2300747, and CIITA rs3087456 polymorphisms with the susceptibility to MS. However, the results were inconsistent. Thus, we conducted this meta-analysis to provide a more accurate estimation of the association between any of these polymorphisms and MS risk. Methods The PubMed, Embase, Chinese National Knowledge Infrastructure, Wan Fang databases and MSGene were used to search all potentially relevant studies. The odds ratio (OR) with 95% confidence interval (CI) was used to investigate the associations between these three polymorphisms and MS risk. Results 16 independent case–control studies from 12 publications were finally included into this meta-analysis. The results showed that EVI5 rs11808092 polymorphism was related with increasing the development of MS under five genetic models (allelic: OR = 1.17, 95% CI = 1.10–1.24, P < 0.01; homozygous: OR = 1.37, 95% CI = 1.18–1.59, P < 0.01; heterozygous: OR = 1.16, 95% CI = 1.07–1.26, P < 0.01; recessive: OR = 1.28, 95% CI = 1.11–1.48, P < 0.01; and dominant: OR = 1.19, 95% CI = 1.11–1.48, P < 0.01). CD58 rs2300747 polymorphism was found to be associated with decreasing MS risk in three genetic models (allelic: OR = 0.86, 95% CI = 0.78–0.94, P < 0.01; heterozygous: OR = 0.85, 95% CI = 0.76–0.94, P < 0.01, and dominant: OR = 0.84, 95% CI = 0.76–0.93, P < 0.01). However, this meta-analysis indicated that CIITA rs3087456 polymorphism was not related to multiple sclerosis. Conclusions The mutant alleles of EVI5 rs11808092 polymorphism may increase the susceptibility to MS while those of CD58 rs2300747 polymorphism may decrease MS risk. In addition, CIITA rs3087456 polymorphism might not be associated with MS.
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Affiliation(s)
- Jiahe Liu
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Xu Liu
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Yong Liu
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; School of Pharmacy, Guangdong Medical University, Dongguan, Guangdong 523808, China; Key Laboratory for Research and Development of Natural Drugs of Guangdong Province, Zhanjiang, Guangdong 524023, China
| | - Shimin Deng
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; School of Pharmacy, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Hongbin Huang
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Qicong Chen
- School of Preclinical Medicine, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Weidong Liu
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; School of Pharmacy, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Zunnan Huang
- Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Dongguan Scientific Research Center, Guangdong Medical University, Dongguan, Guangdong 523808, China; School of Pharmacy, Guangdong Medical University, Dongguan, Guangdong 523808, China; Key Laboratory for Research and Development of Natural Drugs of Guangdong Province, Zhanjiang, Guangdong 524023, China
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Yaldizli Ö, Sethi V, Pardini M, Tur C, Mok KY, Muhlert N, Liu Z, Samson RS, Wheeler-Kingshott CAM, Yousry TA, Houlden H, Hardy J, Miller DH, Chard DT. HLA-DRB*1501 associations with magnetic resonance imaging measures of grey matter pathology in multiple sclerosis. Mult Scler Relat Disord 2016; 7:47-52. [PMID: 27237756 DOI: 10.1016/j.msard.2016.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/04/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The HLA-DRB*1501 haplotype influences the risk of developing multiple sclerosis (MS), but it is not known how it affects grey matter pathology. AIM To assess HLA-DRB(*)1501 effects on magnetic resonance imaging (MRI) cortical grey matter pathology. METHODS Whole and lesional cortical grey matter volumes, lesional and normal-appearing grey matter magnetization transfer ratio were measured in 85 people with MS and 36 healthy control subjects. HLA-DRB(*)1501 haplotype was determined by genotyping (rs3135388). RESULTS No significant differences were observed in MRI measures between the HLA-DRB(*)1501 subgroups. CONCLUSIONS The HLA-DRB(*)1501 haplotype is not strongly associated with MRI-visible grey matter pathology.
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Affiliation(s)
- Özgür Yaldizli
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; Department of Neurology, University Hospital Basel, Basel, Switzerland.
| | - Varun Sethi
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - Matteo Pardini
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Carmen Tur
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; MS Centre of Catalonia (Cemcat), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Kin Y Mok
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK; Division of Life Science, Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Nils Muhlert
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; School of Psychology and Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK; School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Zheng Liu
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Rebecca S Samson
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | | | - Tarek A Yousry
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK; Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - John Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - David H Miller
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Declan T Chard
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
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Dubey D, Kieseier BC, Hartung HP, Hemmer B, Warnke C, Menge T, Miller-Little WA, Stuve O. Dimethyl fumarate in relapsing-remitting multiple sclerosis: rationale, mechanisms of action, pharmacokinetics, efficacy and safety. Expert Rev Neurother 2015; 15:339-46. [PMID: 25800129 DOI: 10.1586/14737175.2015.1025755] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Dimethyl fumarate (DMF), a fumaric acid ester, is a new orally available disease-modifying agent that was recently approved by the US FDA and the EMA for the management of relapsing forms of multiple sclerosis (MS). Fumaric acid has been used for the management of psoriasis, for more than 50 years. Because of the known anti-inflammatory properties of fumaric acid ester, DMF was brought into clinical development in MS. More recently, neuroprotective and myelin-protective mechanism actions have been proposed, making it a possible candidate for MS treatment. Two Phase III clinical trials (DEFINE, CONFIRM) have evaluated the safety and efficacy of DMF in patients with relapsing-remitting MS. Being an orally available agent with a favorable safety profile, it has become one of the most commonly prescribed disease-modifying agents in the USA and Europe.
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54
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Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav 2015; 5:e00362. [PMID: 26445701 PMCID: PMC4589809 DOI: 10.1002/brb3.362] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/13/2015] [Accepted: 05/04/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Multiple sclerosis is an acquired demyelinating disease of the central nervous system. It is the second most common cause of disability in adults in United States after head trauma. DISCUSSION The etiology of MS is probably multifactorial, related to genetic, environmental, and several other factors. The pathogenesis is not fully understood but is believed to involve T-cell-mediated inflammation directed against myelin and other related proteins with a possible role for B cells. The McDonald criteria have been proposed and revised over the years to guide the diagnosis of MS and are based on clinical presentation and magnetic resonance imaging (MRI) of the brain and spinal cord to establish dissemination in time and space. The treatment of MS includes disease modification with immunomodulator drugs and symptom management to address the specific symptoms such as fatigue, spasticity, and pain. CONCLUSION An update on etiology, pathogenesis, diagnosis, and immunomodulatory treatment of MS is presented.
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Affiliation(s)
- Neeta Garg
- Department of Neurology, University of Massachusetts Medical School Worcester, Massachusetts, 01655
| | - Thomas W Smith
- Department of Pathology, University of Massachusetts Medical School Worcester, Massachusetts, 01655
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55
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Atmaca MM, Altiokka Uzun G, Shugaiv E, Kürtüncü M, Eraksoy M. Association of Demyelinating and Inflammatory Bowel Diseases: A Case Series and Overview of the Literature. Noro Psikiyatr Ars 2015; 52:315-318. [PMID: 28360731 DOI: 10.5152/npa.2015.8725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 08/05/2014] [Indexed: 01/10/2023] Open
Abstract
Neurological complications of inflammatory bowel diseases (i.e., ulcerative colitis and Crohn's disease) can be summarized as a combination of neuromuscular manifestations, cerebrovascular and demyelinating diseases that can be seen in approximately 3% of patients. In addition, asymptomatic cerebral white matter lesions may be detected in these patients. Clustering of diseases within families may be explained by the exposure to similar environmental factors, shared genes, or complex interactions between genetic and environmental factors. Here we report an epileptic patient with Crohn's disease and cerebral white matter lesions, a family with ulcerative colitis and multiple sclerosis and two patients who have both multiple sclerosis and Crohn's disease.
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Affiliation(s)
- Murat Mert Atmaca
- Department of Neurology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Güneş Altiokka Uzun
- Department of Neurology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | | | - Murat Kürtüncü
- Department of Neurology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Mefküre Eraksoy
- Department of Neurology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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56
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Hollenbach JA, Oksenberg JR. The immunogenetics of multiple sclerosis: A comprehensive review. J Autoimmun 2015; 64:13-25. [PMID: 26142251 DOI: 10.1016/j.jaut.2015.06.010] [Citation(s) in RCA: 210] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 06/23/2015] [Indexed: 12/21/2022]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system and common cause of non-traumatic neurological disability in young adults. The likelihood for an individual to develop MS is strongly influenced by her or his ethnic background and family history of disease, suggesting that genetic susceptibility is a key determinant of risk. Over 100 loci have been firmly associated with susceptibility, whereas the main signal genome-wide maps to the class II region of the human leukocyte antigen (HLA) gene cluster and explains up to 10.5% of the genetic variance underlying risk. HLA-DRB1*15:01 has the strongest effect with an average odds ratio of 3.08. However, complex allelic hierarchical lineages, cis/trans haplotypic effects, and independent protective signals in the class I region of the locus have been described as well. Despite the remarkable molecular dissection of the HLA region in MS, further studies are needed to generate unifying models to account for the role of the MHC in disease pathogenesis. Driven by the discovery of combinatorial associations of Killer-cell Immunoglobulin-like Receptor (KIR) and HLA alleles with infectious, autoimmune diseases, transplantation outcome and pregnancy, multi-locus immunogenomic research is now thriving. Central to immunity and critically important for human health, KIR molecules and their HLA ligands are encoded by complex genetic systems with extraordinarily high levels of sequence and structural variation and complex expression patterns. However, studies to-date of KIR in MS have been few and limited to very low resolution genotyping. Application of modern sequencing methodologies coupled with state of the art bioinformatics and analytical approaches will permit us to fully appreciate the impact of HLA and KIR variation in MS.
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Affiliation(s)
- Jill A Hollenbach
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158, USA.
| | - Jorge R Oksenberg
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158, USA
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57
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Homo-β-amino acid containing MBP(85-99) analogs alleviate experimental autoimmune encephalomyelitis. Sci Rep 2015; 5:8205. [PMID: 25644378 PMCID: PMC4314633 DOI: 10.1038/srep08205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/13/2015] [Indexed: 11/20/2022] Open
Abstract
MBP(85–99), an immuno-dominant epitope of myelin basic protein which binds to the major histocompatibility complex haplotype HLA-DR2 is widely implicated in the pathogenesis of multiple sclerosis. J5, an antagonist of MBP(85–99), that blocks the binding of MBP(85–99) to soluble HLA-DR2b much more efficiently than glatiramer acetate (a random copolymer comprising major MHC and T-cell receptor contact residues), was transformed into analogs with superior biological half-lives and antagonistic-activities by substitution of some of its residues with homo-β-amino acids. S18, the best analog obtained ameliorated symptoms of experimental autoimmune encephalomyelitis at least twice more effectively than glatiramer acetate or J5. S18 displayed marked resistance to proteolysis in-vitro; biological impact of which was evident in the form of delayed clinical onset of disease and prolonged therapeutic-benefits. Besides active suppression of MBP(85–99)-reactive CD4+ T-cells in-vitro and in-vivo S18 treatment also generated IL-4 producing CD4+ T-cell clones, through which protective effect could be transferred passively.
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58
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Abstract
Hypoadrenocorticism is an uncommon disease in dogs and rare in humans, where it is known as Addison disease (ADD). The disease is characterized by a deficiency in corticosteroid production from the adrenal cortex, requiring lifelong hormone replacement therapy. When compared with humans, the pathogenesis of hypoadrenocorticism in dogs is not well established, although the evidence supports a similar autoimmune etiology of adrenocortical pathology. Several immune response genes have been implicated in determining susceptibility to Addison disease in humans, some of which are shared with other autoimmune syndromes. Indeed, other types of autoimmune disease are common (approximately 50%) in patients affected with ADD. Several lines of evidence suggest a genetic component to the etiology of canine hypoadrenocorticism. Certain dog breeds are overrepresented in epidemiologic studies, reflecting a likely genetic influence, supported by data from pedigree analysis. Molecular genetic studies have identified similar genes and signaling pathways, involved in ADD in humans, to be also associated with susceptibility to canine hypoadrenocorticism. Immune response genes such as the dog leukocyte antigen (DLA) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) genes seem to be particularly important. It is clear that there are genetic factors involved in determining susceptibility to canine hypoadrenocorticism, although similar to the situation in humans, this is likely to represent a complex genetic disorder.
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Affiliation(s)
- Alisdair M Boag
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, Scotland.
| | - Brian Catchpole
- Department of Pathology and Pathogen Biology, Royal Veterinary College, University of London, Hatfield, UK
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59
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Abstract
One of the most consistent findings in multiple sclerosis (MS) is that development of MS is linked with carriage of the class II human leucocyte antigen (HLA) molecule HLA-DRB1*15:01; around 60 % of Caucasian MS patients carry this allele compared to 25-30 % of ethnically matched healthy individuals. However, other HLA molecules have also been linked to the development of MS. In this chapter, the association between different HLA types and susceptibility to MS will be reviewed, and other linkages between the carriage of specific HLA molecules and clinical and experimental findings in MS will be considered.
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Affiliation(s)
- Judith M Greer
- The University of Queensland, UQ Centre for Clinical Research, Building 71/918 Riyal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia.
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60
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Bloch EM, Reed WF, Lee TH, Montalvo L, Shiboski S, Custer B, Barcellos L. Male microchimerism in peripheral blood leukocytes from women with multiple sclerosis. CHIMERISM 2014. [DOI: 10.4161/chim.15151] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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61
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Current Developments in Pharmacogenomics of Multiple Sclerosis. Cell Mol Neurobiol 2014; 34:1081-5. [DOI: 10.1007/s10571-014-0095-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
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62
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Hedström AK, Lima Bomfim I, Barcellos L, Gianfrancesco M, Schaefer C, Kockum I, Olsson T, Alfredsson L. Interaction between adolescent obesity and HLA risk genes in the etiology of multiple sclerosis. Neurology 2014; 82:865-72. [PMID: 24500647 PMCID: PMC3959752 DOI: 10.1212/wnl.0000000000000203] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 11/01/2013] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE We investigated potential interactions between human leukocyte antigen (HLA) genotype and body mass index (BMI) status in relation to the risk of developing multiple sclerosis (MS). METHODS We used 2 case-control studies, one with incident cases (1,510 cases, 2,017 controls) and one with prevalent cases (937 cases, 609 controls). Subjects with different genotypes and BMI were compared with regard to incidence of MS by calculating odds ratios (ORs) with 95% confidence intervals (CIs) employing logistic regression. Potential interactions between genotypes and BMI were evaluated by calculating the attributable proportion due to interaction. RESULTS In both cohorts, a significant interaction was observed between HLA-DRB1*15 and obesity, regardless of HLA-A*02 status. Similarly, there was a significant interaction between absence of A*02 and obesity, regardless of DRB1*15 status. In the incident cohort, obese subjects with the most susceptible genotype (carriage of DRB1*15 and absence of A*02) had an OR of 16.2 (95% CI 7.5-35.2) compared to nonobese subjects without the genetic risk factors. The corresponding OR in the prevalent study was 13.8 (95% CI 4.1-46.8). CONCLUSIONS We observed striking interactions between BMI status and HLA genotype with regard to MS risk. Hypothetically, a low-grade inflammatory response inherent to obesity synergizes with the adaptive, HLA molecule-restricted arm of the immune system, causing MS. Prevention of adolescent obesity may thus lower the risk of developing MS, predominantly among people with a genetic susceptibility to the disease.
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Affiliation(s)
- Anna Karin Hedström
- From the Institute of Environmental Medicine (A.K.H.), Neuroimmunology Unit, Department of Clinical Neuroscience (I.L.B., I.K.), and the Institute of Environmental Medicine (L.A.), Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology and Genomics Lab (L.B., M.G.), Division of Epidemiology, School of Public Health, University of California, Berkeley; Kaiser Permanente Division of Research (C.S.), Oakland, CA; Center for Molecular Medicine (I.K.) and Neuroimmunology Unit, Department of Clinical Neuroscience and Center for Molecular Medicine (T.O.), Karolinska Institutet at Karolinska University Hospital, Solna; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
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Ahram M, Zaza R, Ibayyan L, Dahbour S, Bahou Y, El-Omar A, Samhouri B, El-Khateeb M. Towards establishing a multiple sclerosis biobank in Jordan. Int J Neurosci 2014; 124:812-7. [DOI: 10.3109/00207454.2014.886204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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64
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Stüve O, Cravens PD, Eagar TN. DNA-based vaccines: the future of multiple sclerosis therapy? Expert Rev Neurother 2014; 8:351-60. [DOI: 10.1586/14737175.8.3.351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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65
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Dobson R, Ramagopalan SV, Giovannoni G. Genome-wide association studies: will we ever predict susceptibility to multiple sclerosis through genetics? Expert Rev Neurother 2014; 13:235-7. [DOI: 10.1586/ern.13.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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66
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Abstract
Familial aggregation and the studies of twins indicate that heredity contributes to multiple sclerosis (MS) risk. Immunologic studies of leukocyte antigens subsequently followed by gene-mapping techniques identified the primary MS susceptibility locus to be within the major histocompatibility complex (MHC). The primary risk allele is HLA-DRB1*15, although other alleles of this gene also influence MS susceptibility. Other genes within the MHC also contribute to MS susceptibility. Genome-wide association studies have identified over 50 additional common variants of genes across the genome. Estimates suggest that there may be as many as 200 genes involved in MS susceptibility. In addition to these common polymorphisms, studies have identified several rare risk alleles in some families. Interestingly, the majority of the genes identified have known immunologic functions and many contribute to the risk of inheriting other autoimmune diseases. Genetic variants in the vitamin D metabolic pathway have also been identified. That vitamin D contributes to MS susceptibility as both an environmental as well as genetic risk factor underscores the importance of this metabolic pathway in disease pathogenesis. Current efforts are focused on understanding how the myriad of genetic risk alleles interact within networks to influence MS risk at family level as well as within populations.
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Affiliation(s)
- Bruce A C Cree
- Department of Neurology, University of California, San Francisco, USA.
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67
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Ibayyan L, Zaza R, Dahbour S, El-Omar A, Samhouri B, El-Khateeb M, Ahram M. The Promoter SNP, but not the Alternative Splicing SNP, is Linked to Multiple Sclerosis Among Jordanian Patients. J Mol Neurosci 2013; 52:467-72. [DOI: 10.1007/s12031-013-0151-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 10/14/2013] [Indexed: 11/29/2022]
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68
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Muñoz-Culla M, Irizar H, Otaegui D. The genetics of multiple sclerosis: review of current and emerging candidates. Appl Clin Genet 2013; 6:63-73. [PMID: 24019748 PMCID: PMC3760455 DOI: 10.2147/tacg.s29107] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Multiple sclerosis (MS) is a complex disease in which environmental, genetic, and epigenetic factors determine the risk of developing the disease. The human leukocyte antigen region is the strongest susceptibility locus linked to MS, but it does not explain the whole heritability of the disease. To find other non-human leukocyte antigen loci associated with the disease, high-throughput genotyping, sequencing, and gene-expression studies have been performed, producing a valuable quantity of information. An overview of the genomic and expression studies is provided in this review, as well as microRNA-expression studies, highlighting the importance of combining all the layers of information in order to elucidate the causes or pathological mechanisms occurring in the disease. Genetics in MS is a promising field that is presumably going to be very productive in the next decade understanding the cross talk between all the factors contributing to the development of MS.
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Affiliation(s)
- Maider Muñoz-Culla
- Multiple Sclerosis Unit, Instituto Biodonostia, San Sebastián, Spain
- Red Española de Esclerosis Múltiple (REEM), Barcelona, Spain
| | - Haritz Irizar
- Multiple Sclerosis Unit, Instituto Biodonostia, San Sebastián, Spain
- Red Española de Esclerosis Múltiple (REEM), Barcelona, Spain
| | - David Otaegui
- Multiple Sclerosis Unit, Instituto Biodonostia, San Sebastián, Spain
- Red Española de Esclerosis Múltiple (REEM), Barcelona, Spain
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69
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Mohme M, Hotz C, Stevanovic S, Binder T, Lee JH, Okoniewski M, Eiermann T, Sospedra M, Rammensee HG, Martin R. HLA-DR15-derived self-peptides are involved in increased autologous T cell proliferation in multiple sclerosis. ACTA ACUST UNITED AC 2013; 136:1783-98. [PMID: 23739916 DOI: 10.1093/brain/awt108] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The HLA-DR15 haplotype confers the largest part of the genetic risk to develop multiple sclerosis, a prototypic CD4+ T cell-mediated autoimmune disease. The mechanisms how certain HLA-class II molecules functionally contribute to autoimmune diseases are still poorly understood, but probably involve shaping an autoimmune-prone T cell repertoire during central tolerance in the thymus and subsequently maintaining or even expanding it in the peripheral immune system. Self-peptides that are presented by disease-associated HLA-class II molecules most likely play important roles during both processes. Here, we examined the functional involvement of the HLA-DR15 haplotype in autologous proliferation in multiple sclerosis and the contribution of HLA-DR15 haplotype-derived self-peptides in an in vitro system. We observe increased autologous T cell proliferation in patients with multiple sclerosis in relation to the multiple sclerosis risk-associated HLA-DR15 haplotype. Assuming that the spectrum of self-peptides that is presented by the two HLA-DR15 allelic products is important for sustaining autologous proliferation we performed peptide elution and identification experiments from the multiple sclerosis-associated DR15 molecules and a systematic analysis of a DR15 haplotype-derived self-peptide library. We identify HLA-derived self-peptides as potential mediators of altered autologous proliferation. Our data provide novel insights about perturbed T cell repertoire dynamics and the functional involvement of the major genetic risk factor, the HLA-DR15 haplotype, in multiple sclerosis.
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Affiliation(s)
- Malte Mohme
- Institute for Neuroimmunology and Clinical Multiple Sclerosis Research, Centre for Molecular Neurobiology Hamburg, University Medical Centre Eppendorf, 20251 Hamburg, Germany
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70
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Kalincik T, Guttmann CRG, Krasensky J, Vaneckova M, Lelkova P, Tyblova M, Seidl Z, De Jager PL, Havrdova E, Horakova D. Multiple sclerosis susceptibility loci do not alter clinical and MRI outcomes in clinically isolated syndrome. Genes Immun 2013; 14:244-8. [PMID: 23575354 DOI: 10.1038/gene.2013.17] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It has not yet been established whether genetic predictors of multiple sclerosis (MS) susceptibility also influence disease severity and accumulation of disability. Our aim was to evaluate associations between 16 previously validated genetic susceptibility markers and MS phenotype. Patients with clinically isolated syndrome verified by positive magnetic resonance imaging (MRI) and cerebrospinal fluid findings (n=179) were treated with interferon-β. Disability and volumetric MRI parameters were evaluated regularly for 2 years. Sixteen single-nucleotide polymorphisms (SNPs) previously validated as predictors of MS susceptibility in our cohort and their combined weighted genetic risk score (wGRS) were tested for associations with clinical (conversion to MS, relapses and disability) and MRI disease outcomes (whole brain, grey matter and white matter volumes, corpus callosum cross-sectional area, brain parenchymal fraction, T2 and T1 lesion volumes) 2 years from disease onset using mixed-effect models. We have found no associations between the tested SNPs and the clinical or MRI outcomes. Neither the combined wGRS predicted MS activity and progression over 2-year follow-up period. Power analyses confirmed 90% power to identify clinically relevant changes in all outcome variables. We conclude that the most important MS susceptibility loci do not determine MS phenotype and disease outcomes.
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Affiliation(s)
- T Kalincik
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic.
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71
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McPherson RC, Anderton SM. Adaptive immune responses in CNS autoimmune disease: mechanisms and therapeutic opportunities. J Neuroimmune Pharmacol 2013; 8:774-90. [PMID: 23568718 DOI: 10.1007/s11481-013-9453-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 03/13/2013] [Indexed: 01/20/2023]
Abstract
The processes underlying autoimmune CNS inflammation are complex, but key roles for autoimmune lymphocytes seem inevitable, based on clinical investigations in multiple sclerosis (MS) and related diseases such as neuromyelitis optica, together with the known pathogenic activity of T cells in experimental autoimmune encephalomyelitis (EAE) models. Despite intense investigation, the details of etiopathology in these diseases have been elusive. Here we describe recent advances in the rodent models that begin to allow a map of pathogenic and protective immunity to be drawn. This map might illuminate previous successful and unsuccessful therapeutic strategies targeting particular pathways, whilst also providing better opportunities for the future, leading to tailored intervention based on understanding the quality of each individual's autoimmune response.
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Affiliation(s)
- Rhoanne C McPherson
- Centre for Inflammation Research and Centre for Multiple Sclerosis Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK
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72
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Interaction between HLA-DRB1-DQB1 haplotypes in Sardinian multiple sclerosis population. PLoS One 2013; 8:e59790. [PMID: 23593151 PMCID: PMC3620236 DOI: 10.1371/journal.pone.0059790] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 02/18/2013] [Indexed: 01/24/2023] Open
Abstract
We performed a case-control study in 2,555 multiple sclerosis (MS) Sardinian patients and 1,365 healthy ethnically matched controls, analyzing the interactions between HLA-DRB1-DQB1 haplotypes and defining a rank of genotypes conferring a variable degree of risk to the disease. Four haplotypes were found to confer susceptibility (*13∶03-*03∶01 OR = 3.3, Pc 5.1×10−5, *04∶05-*03∶01 OR = 2.1, Pc 9.7×10−8, *15∶01-*06∶02 OR = 2.0, Pc = 9.1×10−3, *03∶01-*02∶01 OR = 1.7 Pc = 7.9×10−22) and protection (*11, OR = 0.8, Pc = 2.7×10−2, *16∶01-*05∶02 OR = 0.6, Pc = 4.8×10−16, *14∶01-4-*05∶031 = OR = 0.5, Pc = 9.8×10−4 and *15∶02-*06∶01 OR = 0.4, Pc = 5.1×10−4). The relative predispositional effect method confirms all the positively associated haplotypes and showed that also *08 and *04 haplotypes confers susceptibility, while the *11 was excluded as protective haplotype. Genotypic ORs highlighted two typologies of interaction between haplotypes: i) a neutral interaction, in which the global risk is coherent with the sum of the single haplotype risks; ii) a negative interaction, in which the genotypic OR observed is lower than the sum of the OR of the two haplotypes. The phylogenic tree of the MS-associated DRB1 alleles found in Sardinian patients revealed a cluster represented by *14∶01, *04∶05, *13∶03, *08∶01 and *03∶01 alleles. Sequence alignment analysis showed that amino acids near pocket P4 and pocket P9 differentiated protective from predisposing alleles under investigation. Furthermore, molecular dynamics simulation performed on alleles revealed that position 70 is crucial in binding of MBP 85–99 peptide. All together, these data suggest that propensity to MS observed in Sardinian population carried by the various HLA-DRB1-DQB1 molecules can be due to functional peculiarity in the antigen presentation mechanisms.
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73
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Massey J, Rothwell S, Rusbridge C, Tauro A, Addicott D, Chinoy H, Cooper RG, Ollier WER, Kennedy LJ. Association of an MHC class II haplotype with increased risk of polymyositis in Hungarian Vizsla dogs. PLoS One 2013; 8:e56490. [PMID: 23457575 PMCID: PMC3572995 DOI: 10.1371/journal.pone.0056490] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/10/2013] [Indexed: 12/28/2022] Open
Abstract
A breed-specific polymyositis is frequently observed in the Hungarian Vizsla. Beneficial clinical response to immunosuppressive therapies has been demonstrated which points to an immune-mediated aetiology. Canine inflammatory myopathies share clinical and histological similarities with the human immune-mediated myopathies. As MHC class II associations have been reported in the human conditions we investigated whether an MHC class II association was present in the canine myopathy seen in this breed. 212 Hungarian Vizsla pedigree dogs were stratified both on disease status and degree of relatedness to an affected dog. This generated a group of 29 cases and 183 "graded" controls: 93 unaffected dogs with a first degree affected relative, 44 unaffected dogs with a second degree affected relative, and 46 unaffected dogs with no known affected relatives. Eleven DLA class II haplotypes were identified, of which, DLA-DRB1*02001/DQA1*00401/DQB1*01303, was at significantly raised frequency in cases compared to controls (OR = 1.92, p = 0.032). When only control dogs with no family history of the disease were compared to cases, the association was further strengthened (OR = 4.08, p = 0.00011). Additionally, a single copy of the risk haplotype was sufficient to increase disease risk, with the risk substantially increasing for homozygotes. There was a trend of increasing frequency of this haplotype with degree of relatedness, indicating low disease penetrance. These findings support the hypothesis of an immune-mediated aetiology for this canine myopathy and give credibility to potentially using the Hungarian Vizsla as a genetic model for comparative studies with human myositis.
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Affiliation(s)
- Jonathan Massey
- Centre for Integrated Genomic Medical Research (CIGMR), Institute of Population Health, Faculty of Medical and Human Sciences, The University of Manchester, Manchester, United Kingdom.
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74
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Massey J, Boag A, Short AD, Scholey RA, Henthorn PS, Littman MP, Husebye E, Catchpole B, Pedersen N, Mellersh CS, Ollier WER, Kennedy LJ. MHC class II association study in eight breeds of dog with hypoadrenocorticism. Immunogenetics 2013; 65:291-7. [PMID: 23358933 DOI: 10.1007/s00251-013-0680-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/16/2013] [Indexed: 11/25/2022]
Abstract
Canine hypoadrenocorticism is an endocrine disorder characterised by inadequate secretion of steroid hormones from the adrenal glands. Pathology results from immune-mediated destruction of the adrenal cortex, which is similar to that seen in the human Addison's disease. Both the canine and human diseases have similar clinical presentation, with the diagnosis based on performing a dynamic adrenocorticotropic hormone stimulation test. MHC class II has previously been associated with the human and canine diseases. In the current study, we conducted an MHC class II association study in eight breeds of dog with diagnoses of hypoadrenocorticism. We demonstrated significant differences in dog leukocyte antigen (DLA) haplotype frequencies in six of these breeds: Cocker spaniel, Springer spaniel, Labrador, West Highland white terrier (WHWT), Bearded collie, and Standard poodle. In the Springer spaniel, the DLA-DRB1*015:01--DQA1*006:01--DQB1*023:01 haplotype was significantly associated with disease risk (p = 0.014, odds ratio (OR) = 5.14) and showed a similar trend in the Cocker spaniel. This haplotype is related to one associated with hypoadrenocorticism in the Nova Scotia duck tolling retriever. Similar haplotypes shared between breeds were demonstrated, with DLA-DRB1*001:01--DQA1*001:01--DQB1*002:01 more prevalent in both affected Labrador (p = 0.0002, OR = 3.06) and WHWT (p = 0.01, OR = 2.11). Other haplotypes that have not previously been associated with the disease were identified. The inter-breed differences in DLA haplotypes associated with susceptibility to canine hypoadrenocorticism could represent divergent aetiologies. This could have implications for clinical diagnosis and future comparative studies. Alternatively, it may suggest that the gene of interest is closely linked to the MHC.
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Affiliation(s)
- Jonathan Massey
- Centre for Integrated Genomic Medical Research (CIGMR), School of Medicine, University of Manchester, 2.722 Stopford Building, Oxford Road, Manchester, M13 9PT, UK.
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75
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Lomakin YA, Zakharova MY, Belogurov AA, Bykova NA, Dronina MA, Tupikin AE, Knorre VD, Boyko AN, Favorov AV, Kabilov MR, Ponomarenko NA, Gabibov AG. Polyreactive monoclonal autoantibodies in multiple sclerosis: functional selection from phage display library and characterization by deep sequencing analysis. Acta Naturae 2013; 5:94-104. [PMID: 24455188 PMCID: PMC3890994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system that primarily affects young and middle-aged people. It is widely accepted that B lymphocyte activation is required for MS progression. Despite the fact that the exact triggering mechanisms of MS remain enigmatic, one may suggest that MS can be induced by viral or bacterial infection in combination with specific genetic and environmental factors. Using deep sequencing and functional selection methodologies we characterized clones of poly- and cross-reactive antibodies that are capable of simultaneous recognition of viral proteins and autoantigens. The latter, in turn, possibly may trigger MS progression through molecular mimicry. It was identified that two cross-reactive antigens are probably recognized by light or heavy chains individually. According to the high structural homology between selected autoantibodies and a number of various antiviral IgGs, we suggest that a wide range of pathogens, instead of a single virus, be regarded as possible triggers of MS.
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Affiliation(s)
- Y. A. Lomakin
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - M. Yu. Zakharova
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - A. A. Belogurov
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia,Institute of Gene Biology, Russian Academy of Sciences, 119334, Moscow, Russia
| | - N. A. Bykova
- Kharkevich Institute for Information Transmission Problems, Russian Academy of Sciences, 127994, Moscow, Russia,Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119991, Moscow, Russia
| | - M. A. Dronina
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - A. E. Tupikin
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090, Novosibirsk, Russia,Genomics Core Facility, Siberian Branch, Russian Academy of Sciences, 630090, Novosibirsk, Russia
| | - V. D. Knorre
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - A. N. Boyko
- Moscow Multiple Sclerosis Center at the City Hospital #11, 127018, Moscow, Russia,Pirogov Russian National Research Medical University, Department of Fundamental and Clinical Neurology and Neurosurgery, 117997, Moscow, Russia
| | - A. V. Favorov
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991, Moscow, Russia,Department of Oncology, Division of Biostatistics and Bioinformatics, Johns Hopkins University School of Medicine, 21218, Baltimore, Maryland, USA,State Research Institute of Genetics and Selection of Industrial Microorganisms GosNIIGenetika, 117545, Moscow, Russia
| | - M. R. Kabilov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090, Novosibirsk, Russia,Genomics Core Facility, Siberian Branch, Russian Academy of Sciences, 630090, Novosibirsk, Russia
| | - N. A. Ponomarenko
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - A. G. Gabibov
- Shemyakin–Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia,Institute of Gene Biology, Russian Academy of Sciences, 119334, Moscow, Russia,Faculty of Chemistry, Lomonosov Moscow State University, 119991, Moscow, Russia
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76
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Harbo HF, Mero IL. From genes to characteristics of multiple sclerosis. Acta Neurol Scand 2012:76-83. [PMID: 23278661 DOI: 10.1111/ane.12027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2012] [Indexed: 02/03/2023]
Abstract
Multiple sclerosis (MS) is an inflammatory, demyelinating heterogeneous disease of the central nervous system, probably caused by an interaction of common genetic and environmental factors. Much progress has been made through the last few years in genetic studies of MS, and a growing list of genetic risk factors is now available. Biobanking and large collaborations have been prerequisites for this research, and detailed genetic and molecular characterizations are underway, with hopes for to translating new knowledge about MS pathogenesis and characteristics of the disease to personalized, better treatment options for each patient with MS.
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Affiliation(s)
- H F Harbo
- Department of Neurology, Oslo University Hospital, Oslo, Norway.
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77
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Lindén M, Khademi M, Lima Bomfim I, Piehl F, Jagodic M, Kockum I, Olsson T. Multiple sclerosis risk genotypes correlate with an elevated cerebrospinal fluid level of the suggested prognostic marker CXCL13. Mult Scler 2012; 19:863-70. [DOI: 10.1177/1352458512463482] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: The mechanisms of multiple sclerosis (MS) pathogenesis are still largely unknown. The heterogeneity of disease manifestations make the prediction of prognosis and choice of appropriate treatment protocols challenging. Recently, increased cerebrospinal fluid (CSF) levels of the B-cell chemokine CXCL13 was proposed as a possible marker for a more severe disease course and conversion from clinically isolated syndrome (CIS) to relapsing–remitting MS (RRMS). Objective: To investigate whether there are genetic susceptibility variants in MS that correlate with the levels of CXCL13 present in the CSF of MS patients. Methods: We genotyped the human leukocyte antigens HLA-DRB1 and HLA-A, plus a panel of single nucleotide polymorphisms (SNPs) that have been associated with susceptibility to MS and then correlated the genotypes with the levels of CXCL13, as measured with ELISA in the CSF of a total of 663 patients with MS, CIS, other neurological diseases (OND) or OND with an inflammatory component (iOND). Results: Presence of the HLA-DRB1*15 and the MS risk genotypes for SNPs in the RGS1, IRF5 and OLIG3/TNFAIP3 gene regions correlated significantly with increased levels of CXCL13. Conclusion: Our results pointed towards a genetic predisposition for increased CXCL13 levels, which in MS patients correlates with the severity of the disease course. These findings encourage further investigation and replication, in an independent patient cohort.
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Affiliation(s)
- M Lindén
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - M Khademi
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - I Lima Bomfim
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - F Piehl
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - M Jagodic
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - I Kockum
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - T Olsson
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
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78
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Loma I, Heyman R. Multiple sclerosis: pathogenesis and treatment. Curr Neuropharmacol 2012; 9:409-16. [PMID: 22379455 PMCID: PMC3151595 DOI: 10.2174/157015911796557911] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 10/02/2010] [Accepted: 10/05/2010] [Indexed: 12/20/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease of the central nervous system. It affects approximately 400,000 people in the United States and onset is usually during young adulthood. There are four clinical forms of MS, of which relapsing remitting type is the most common. As the etiology of MS is unknown, finding a cure will remain challenging. The main mechanism of injury appears to be inflammation and 8 agents are now FDA approved to help control MS. These agents for relapsing forms of MS target different parts of the immune system, with the end goal of decreasing and avoiding further inflammation. No agents are FDA approved for the primary progressive version of MS. FDA approved agents include four preparations of interferon β (Avonex, Rebif, Betaseron and Extavia), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), natalizumab (Tysabri) and fingolimod (Gilenya). There are several drug undergoing phase II and III trials. The heterogeneity of the MS disease process, individual patient response, and medication toxicities continue to challenge the treating physician.
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Affiliation(s)
- Ingrid Loma
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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79
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Quandt JA, Huh J, Baig M, Yao K, Ito N, Bryant M, Kawamura K, Pinilla C, McFarland HF, Martin R, Ito K. Myelin basic protein-specific TCR/HLA-DRB5*01:01 transgenic mice support the etiologic role of DRB5*01:01 in multiple sclerosis. THE JOURNAL OF IMMUNOLOGY 2012; 189:2897-908. [PMID: 22888134 DOI: 10.4049/jimmunol.1103087] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Genetic susceptibility to multiple sclerosis (MS) has been linked to the HLA-DR15 haplotype consisting of DRB1*15:01(DR2b) and DRB5*01:01(DR2a) alleles. Given almost complete linkage disequilibrium of the two alleles, recent studies suggested differential roles in susceptibility (DR2b) or protection from MS (DR2a). Our objective was to assess the potential contribution of DR2a to disease etiology in MS using a humanized model of autoimmunity. To assess the potential contribution of DR2a to disease etiology, we created DR2a humanized transgenic (Tg) mice and subsequently crossed them to Tg mice expressing TL3A6, an MS patient-derived myelin basic protein 83-99-specific TCR. In TL3A6/DR2a Tg mice, CD4 Tg T cells escape thymic and peripheral deletion and initiate spontaneous experimental autoimmune encephalomyelitis (EAE) at low rates, depending on the level of DR2a expression. The ability to induce active EAE was also increased in animals expressing higher levels of DR2a. Inflammatory infiltrates and neuronal damage were present throughout the spinal cord, consistent with a classical ascending EAE phenotype with minor involvement of the cerebellum, brainstem, and peripheral nerve roots in spontaneous, as well as actively induced, disease. These studies emphasize the pathologic contribution of the DR2a allele to the development of autoimmunity when expressed as the sole MHC class II molecule, as well as strongly argue for DR2a as a contributor to the CNS autoimmunity in MS.
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Affiliation(s)
- Jacqueline A Quandt
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
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80
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Cocco E, Sardu C, Pieroni E, Valentini M, Murru R, Costa G, Tranquilli S, Frau J, Coghe G, Carboni N, Floris M, Contu P, Marrosu MG. HLA-DRB1-DQB1 haplotypes confer susceptibility and resistance to multiple sclerosis in Sardinia. PLoS One 2012; 7:e33972. [PMID: 22509268 PMCID: PMC3324467 DOI: 10.1371/journal.pone.0033972] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 02/24/2012] [Indexed: 01/28/2023] Open
Abstract
Introduction Genetic predisposition to multiple sclerosis (MS) in Sardinia (Italy) has been associated with five DRB1*-DQB1* haplotypes of the human leukocyte antigen (HLA). Given the complexity of these associations, an in-depth re-analysis was performed with the specific aims of confirming the haplotype associations; establishing the independence of the associated haplotypes; and assessing patients' genotypic risk of developing MS. Methods and Results A transmission disequilibrium test (TDT) of the DRB1*-DQB1* haplotypes in 943 trio families, confirmed a higher than expected transmission rate (over-transmission) of the *13:03-*03:01 (OR = 2.9, P = 7.6×10−3), *04:05-*03:01 (OR = 2.4, P = 4.4×10−6) and *03:01-*02:01 (OR = 2.1, P = 1.0×10−15) haplotype. In contrast, the *16:01-*05:02 (OR = 0.5, P = 5.4×10−11) and the *15:02-*06:01 (OR = 0.3, P = 1.5×10−3) haplotypes exhibited a lower than expected transmission rate (under-transmission). The independence of the transmission of each positively and negatively associated haplotype was confirmed relative to all positively associated haplotypes, and to the negatively associated *16:01-*05:02 haplotype. In patients, carriage of two predisposing haplotypes, or of protective haplotypes, respectively increased or decreased the patient's risk of developing MS. The risk of MS followed a multiplicative model of genotypes, which was, in order of decreasing ORs: *04:05-*0301/*03:01-*02:01 (OR = 4.5); *03:01-*02:01/*03:01-*02:01 (OR = 4.1); and the *16:01-*05:02/*16:01-*0502 (OR = 0.2) genotypes. Analysis of DRB1 and DQB1 protein chain residues showed that the Val/Gly residue at position 86 of the DRB1 chain was the only difference between the protective *16:01- *15:02 alleles and the predisposing *15:01 one. Similarly, the Ala/Val residue at position 38 of the DQB1 chain differentiated the positively associated *06:02 allele and the negatively associated *05:02, *06:01 alleles. Conclusions These findings show that the association of specific, independent DRB1*-DQB1* haplotypes confers susceptibility or resistance to MS in the MS-prone Sardinian population. The data also supports a functional role for specific residues of the DRB1 and DQB1 proteins in predisposing patients to MS.
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Affiliation(s)
- Eleonora Cocco
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Claudia Sardu
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Enrico Pieroni
- CRS4 (Centro di Ricerca, Sviluppo e Studi Superiori in Sardegna), Science and Technology Park Polaris - Piscina Manna, Pula (Cagliari), Italy
| | - Maria Valentini
- CRS4 (Centro di Ricerca, Sviluppo e Studi Superiori in Sardegna), Science and Technology Park Polaris - Piscina Manna, Pula (Cagliari), Italy
| | - Raffaele Murru
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Gianna Costa
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Stefania Tranquilli
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Jessica Frau
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Giancarlo Coghe
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Nicola Carboni
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Matteo Floris
- CRS4 (Centro di Ricerca, Sviluppo e Studi Superiori in Sardegna), Science and Technology Park Polaris - Piscina Manna, Pula (Cagliari), Italy
| | - Paolo Contu
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Maria Giovanna Marrosu
- Department Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- * E-mail:
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81
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Kollaee A, Ghaffarpor M, Ghlichnia HA, Ghaffari SH, Zamani M. The influence of the HLA-DRB1 and HLA-DQB1 allele heterogeneity on disease risk and severity in Iranian patients with multiple sclerosis. Int J Immunogenet 2012; 39:414-22. [PMID: 22404765 DOI: 10.1111/j.1744-313x.2012.01104.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multiple sclerosis (MS) is a common autoimmune disorder of the central nervous system. Recent studies have shown that the HLA-DRB1 and DQB1 alleles are associated with MS susceptibility and severity. However, this is controversial in different population studies. In the present study, the roles of HLA-DRB1 and DQB1 alleles and the amino acids were investigated on disease risk and severity in 120 Iranian patients with MS and 120 controls. Our findings indicate that the DRB1*1501 allele (OR = 3.203 P = 0.001), the DRB1*1501-DQB1*0602 haplotype (OR = 7.792 P = 0.003) and the DRB1*1501/0701- genotype (OR = 3.320 P = 0.006) and amino acid Leu26 (OR = 1.645 P = 0.005) and Phe9 (OR = 1.893 P = 0.009) on the DQβ1 chain are significantly associated with MS susceptibility. DRB1*1001 was the only allele that had a protective effect against MS (P = 0.0004). We also found that the DQB1*0303 allele was significantly associated with disease severity (mean Multiple Sclerosis Severity Score difference = 1.979, P = 0.002). However, protective effect of the DRB1*1001 against MS and also association of DQB1*0303 allele with MS severity need to be confirmed by larger sample size.
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Affiliation(s)
- A Kollaee
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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82
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Asgari N, Nielsen C, Stenager E, Kyvik KO, Lillevang ST. HLA, PTPN22 and PD-1 associations as markers of autoimmunity in neuromyelitis optica. Mult Scler 2011; 18:23-30. [DOI: 10.1177/1352458511417480] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Neuromyelitis optica (NMO) is a disease with autoimmune characteristics. A genetic autoimmune dependency for NMO has not been clarified in detail. Objective: To investigate immunogenetic aspects of NMO. Methods: Forty-one patients with NMO and 42 patients with multiple sclerosis (MS) were diagnosed in a population-based Caucasian cohort. HLA DQA1, DQB1, and DRB1 alleles were determined. Polymorphisms in programmed death 1 (PD-1) PD-1.3 G/A and protein tyrosine phosphatase non-receptor 22 (PTPN22) 1858 C/T were genotyped. Results: In the NMO group 15% had other autoimmune disorders and 39% had family occurrence of autoimmunity, comparable to MS. A higher frequency of a family history (17%) of NMO and MS was found in the NMO group ( p < 0.026). The frequency of HLA-DQB1*0402 allele was increased in NMO ( p after Bonferroni correction, cp < 0.035) and the HLA-DRB1*15 and DQB1*06 alleles were increased in MS ( cp < 0.0027, cp < 0.01), compared to controls. No associations of the PTPN22 1858 T were detected. The PD-1.3A allele was increased both in NMO ( p < 0.0023) and in MS patients ( p < 0.028) compared to controls. Conclusion: Patients with NMO had frequent co-existence of autoimmunity and family occurrence of NMO and MS. The PD-1.3A allele was associated with NMO. The data suggest genetic autoimmune dependency of NMO.
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Affiliation(s)
- N Asgari
- The Multiple Sclerosis Clinic of Southern Jutland, (Sonderborg, Vejle, Esbjerg), Denmark
- Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark
| | - C Nielsen
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - E Stenager
- The Multiple Sclerosis Clinic of Southern Jutland, (Sonderborg, Vejle, Esbjerg), Denmark
- Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark
| | - KO Kyvik
- Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark
| | - ST Lillevang
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
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83
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Abstract
Significant progress in multiple sclerosis (MS) treatment has been made over the last two decades, including the emergence of disease-modifying therapy (DMT). However, substantial unmet medical need persists and has stimulated the search for new therapeutics. Teriflunomide, one of the several oral DMTs under investigation, is a selective inhibitor of de novo pyrimidine synthesis which exerts a cytostatic effect on proliferating T- and B lymphocytes in the periphery and thus has both antiproliferative and anti-inflammatory properties. Anti-inflammatory effects have been demonstrated in rodent MS models, with reductions in macrophage and B- and T-cell infiltration in the central nervous system and preservation of myelin and oligodendrocytes. Delays in disease onset, reductions in disease relapses and improvements in clinical symptoms were also observed. A proof-of-concept clinical trial in patients with relapsing MS demonstrated that teriflunomide significantly reduced magnetic resonance imaging (MRI) activity and improved clinical endpoints, with both effects maintained with longer-term treatment. Additional studies have shown that teriflunomide can be safely added to beta interferon or glatiramer acetate therapy, with some evidence of additional improvements in MRI disease burden and clinical signs. Teriflunomide has an acceptable and manageable safety and tolerability profile. A large clinical programme is underway to further elucidate the role of teriflunomide in the treatment of MS.
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Affiliation(s)
- R Gold
- Department of Neurology, St. Josef-Hospital, University of Bochum, Bochum, Germany
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84
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Abstract
As with susceptibility to disease, it is likely that multiple factors interact to influence the phenotype of multiple sclerosis and long-term disease outcomes. Such factors may include genetic factors, socioeconomic status, comorbid diseases, and health behaviors, as well as environmental exposures. An improved understanding of the influence of these factors on disease course may reap several benefits, such as improved prognostication, allowing us to tailor disease management with respect to intensity of disease-modifying therapies and changes in specific health behaviors, in the broad context of coexisting health issues. Such information can facilitate appropriately adjusted comparisons within and between populations. Elucidation of these factors will require careful study of well-characterized populations in which the roles of multiple factors are considered simultaneously.
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Affiliation(s)
- Ruth Ann Marrie
- University of Manitoba, Health Sciences Center, GF-533, 820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
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85
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Abstract
Multiple sclerosis is a heterogeneous disease, and predicting its course is difficult at the individual level. In this article, clinical, demographic, and additional features that are associated with the risk of relapses and of intermediate-term disability are reviewed.
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Affiliation(s)
- Ellen M Mowry
- Multiple Sclerosis Center, University of California, San Francisco, 350 Parnassus Avenue, Suite 908, San Francisco, CA 94117, USA.
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86
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Mowry EM. Vitamin D: evidence for its role as a prognostic factor in multiple sclerosis. J Neurol Sci 2011; 311:19-22. [PMID: 21762931 DOI: 10.1016/j.jns.2011.06.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 06/20/2011] [Indexed: 11/18/2022]
Abstract
Vitamin D insufficiency has been shown to be associated with increased susceptibility to multiple sclerosis (MS), but until recently, it was unclear if vitamin D status also influences the prognosis of the disease. In experimental autoimmune encephalomyelitis, a mouse model of MS, the administration of vitamin D reduces the severity of the disease. Initial reports in MS of inverse associations between vitamin D levels and disability or relapse rate were encouraging, but the cross-sectional or retrospective study designs limited their interpretability. More recently, studies of pediatric-onset and adult MS have demonstrated that among those with established MS, those with lower vitamin D levels are at higher risk for subsequent relapse. These observational data provide strong support for randomized controlled trials of vitamin D supplementation in MS.
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Affiliation(s)
- Ellen M Mowry
- Department of Neurology, Multiple Sclerosis Center, University of California, San Francisco, CA 94117, USA.
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87
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Abstract
Multiple sclerosis (MS) has traditionally been considered to be a T-cell-mediated disease. However, there is an increasing body of evidence for the involvement of B cells and autoantibodies in the pathology of this disease, providing a rationale for treatments directed against B cells. In this paper we summarize evidence for the key role of B cells in the immunopathology of MS and review data supporting the use of a novel B-cell targeted therapy, atacicept, in this condition. Atacicept is a human recombinant fusion protein that comprises the binding portion of a receptor for both BLyS (B-Lymphocyte Stimulator) and APRIL (A PRoliferation-Inducing Ligand), two cytokines that have been identified as important regulators of B-cell maturation, function and survival. Atacicept has shown selective effects on cells of the B-cell lineage, acting on mature B cells and blocking plasma cells and late stages of B-cell development while sparing B-cell progenitors and memory cells. The efficacy of atacicept in animal models of autoimmune disease and the biological activity of atacicept in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) has been demonstrated. Clinical studies were initiated to investigate the safety, tolerability and efficacy of atacicept in patients with MS. An unexpected increase in inflammatory activity in one of the trials, however, led to suspension of all atacicept trials in MS.
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Affiliation(s)
- Hans-Peter Hartung
- Department of Neurology, Heinrich-Heine-University, Moorenstrasse 5, D-40225 Düsseldorf, Germany
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88
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Vandiedonck C, Taylor MS, Lockstone HE, Plant K, Taylor JM, Durrant C, Broxholme J, Fairfax BP, Knight JC. Pervasive haplotypic variation in the spliceo-transcriptome of the human major histocompatibility complex. Genome Res 2011; 21:1042-54. [PMID: 21628452 PMCID: PMC3129247 DOI: 10.1101/gr.116681.110] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 04/15/2011] [Indexed: 12/17/2022]
Abstract
The human major histocompatibility complex (MHC) on chromosome 6p21 is a paradigm for genomics, showing remarkable polymorphism and striking association with immune and non-immune diseases. The complex genomic landscape of the MHC, notably strong linkage disequilibrium, has made resolving causal variants very challenging. A promising approach is to investigate gene expression levels considered as tractable intermediate phenotypes in mapping complex diseases. However, how transcription varies across the MHC, notably relative to specific haplotypes, remains unknown. Here, using an original hybrid tiling and splice junction microarray that includes alternate allele probes, we draw the first high-resolution strand-specific transcription map for three common MHC haplotypes (HLA-A1-B8-Cw7-DR3, HLA-A3-B7-Cw7-DR15, and HLA-A26-B18-Cw5-DR3-DQ2) strongly associated with autoimmune diseases including type 1 diabetes, systemic lupus erythematosus, and multiple sclerosis. We find that haplotype-specific differences in gene expression are common across the MHC, affecting 96 genes (46.4%), most significantly the zing finger protein gene ZFP57. Differentially expressed probes are correlated with polymorphisms between haplotypes, consistent with cis effects that we directly demonstrate for ZFP57 in a cohort of healthy volunteers (P = 1.2 × 10(-14)). We establish that alternative splicing is significantly more frequent in the MHC than genome-wide (72.5% vs. 62.1% of genes, P ≤ 1 × 10(-4)) and shows marked haplotypic differences. We also unmask novel and abundant intergenic transcription involving 31% of transcribed blocks identified. Our study reveals that the renowned MHC polymorphism also manifests as transcript diversity, and our novel haplotype-based approach marks a new step toward identification of regulatory variants involved in the control of MHC-associated phenotypes and diseases.
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Affiliation(s)
- Claire Vandiedonck
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
- INSERM, UMRS-958, 75010 Paris, France
- Université Paris 7 Denis-Diderot, 75013 Paris, France
| | - Martin S. Taylor
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
- MRC Human Genetics Unit, Edinburgh EH4 2XU, United Kingdom
| | - Helen E. Lockstone
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
| | - Katharine Plant
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
| | - Jennifer M. Taylor
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
| | - Caroline Durrant
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
| | - John Broxholme
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
| | - Benjamin P. Fairfax
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
| | - Julian C. Knight
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford OX3 7BN, United Kingdom
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89
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McElroy JP, Isobe N, Gourraud PA, Caillier SJ, Matsushita T, Kohriyama T, Miyamoto K, Nakatsuji Y, Miki T, Hauser SL, Oksenberg JR, Kira J. SNP-based analysis of the HLA locus in Japanese multiple sclerosis patients. Genes Immun 2011; 12:523-30. [PMID: 21654846 DOI: 10.1038/gene.2011.25] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Although several major histocompatibility complex (MHC)-wide single-nucleotide polymorphism (SNP) studies have been performed in populations of European descent, none have been performed in Asian populations. The objective of this study was to identify human leukocyte antigen (HLA) loci associated with multiple sclerosis (MS) in a Japanese population genotyped for 3534 MHC region SNPs. Using a logistic regression model, two SNPs (MHC Class III SNP rs422951 in the NOTCH4 gene and MHC Class II SNP rs3997849, susceptible alleles A and G, respectively) were independently associated with MS susceptibility (204 patients; 280 controls), two (MHC Class II SNP rs660895 and MHC Class I SNP rs2269704 in the NRM gene, susceptible alleles G and G, respectively) with aquaporin-4- (AQP4-) MS susceptibility (149 patients; 280 controls) and a single SNP (MHC Class II SNP rs1694112, susceptible allele G) was significant when contrasting AQP4+ against AQP4- patients. Haplotype analysis revealed a large susceptible association, likely DRB1*04 or a locus included in the DRB1*04 haplotype, with AQP4- MS, which excluded DRB1*15:01. This study is the largest study of the HLA's contribution to MS in Japanese individuals.
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Affiliation(s)
- J P McElroy
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, CA 94143, USA.
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90
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Role of HLA class II genes in susceptibility and resistance to multiple sclerosis: studies using HLA transgenic mice. J Autoimmun 2011; 37:122-8. [PMID: 21632210 DOI: 10.1016/j.jaut.2011.05.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 05/02/2011] [Indexed: 01/01/2023]
Abstract
Multiple sclerosis (MS), an inflammatory and demyelinating autoimmune disease of CNS has both, a genetic and an environmental predisposition. Among all the genetic factors associated with MS susceptibility, HLA class II haplotypes such as DR2/DQ6, DR3/DQ2, and DR4/DQ8 show the strongest association. Although a direct role of HLA-DR alleles in MS have been confirmed, it has been difficult to understand the contribution of HLA-DQ alleles in disease pathogenesis, due to strong linkage disequilibrium. Population studies have indicated that DQ alleles may play a modulatory role in the progression of MS. To better understand the mechanism by which HLA-DR and -DQ genes contribute to susceptibility and resistance to MS, we utilized single and double transgenic mice expressing HLA class II gene(s) lacking endogenous mouse class II genes. HLA class II transgenic mice have helped us in identifying immunodominant epitopes of PLP in context of various HLA-DR and -DQ molecules. We have shown that HLA-DR3 transgenic mice were susceptible to PLP(91-110) induced experimental autoimmune encephalomyelitis (EAE), while DQ6 (DQB1*0601) and DQ8 (DQB1*0302) transgenic mice were resistant. Surprisingly DQ6/DR3 double transgenic mice were resistant while DQ8/DR3 mice showed higher disease incidence and severity than DR3 mice. The protective effect of DQ6 in DQ6/DR3 mice was mediated by IFNγ, while the disease exacerbating effect of DQ8 molecule was mediated by IL-17. Further, we have observed that myelin-specific antibodies play an important role in PLP(91-110) induced EAE in HLA-DR3DQ8 transgenic mice. Based on these observations, we hypothesize that epistatic interaction between HLA-DR and -DQ genes play an important role in predisposition to MS and our HLA transgenic mouse model provides a novel tool to study the effect of linkage disequilibrium in MS.
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91
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Jurkiewicz E, Kotulska K. [Neuroimaging of multiple sclerosis in children]. Neurol Neurochir Pol 2011; 45:152-60. [PMID: 21574120 DOI: 10.1016/s0028-3843(14)60027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There is an increasing appreciation that multiple sclerosis (MS) can affect children. Up to 10% of MS patients experience their first symptoms before the age of 16. The natural history and magnetic resonance imaging of MS in child-hood differ from those observed in adult patients. The differential diagnosis of MS in children should also encompass some paediatric diseases. Recently, the diagnostic criteria for MS in children were published. Due to the high frequency of relapses and the risk of disability at a young age, early diagnosis and treatment of MS in children is very important. This work presents recent data regarding epidemiology, pathogenesis and diagnosis of MS in children, including the role of neuroimaging in the diagnosis of childhood multiple sclerosis.
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Affiliation(s)
- Elżbieta Jurkiewicz
- Instytut "Pomnik - Centrum Zdrowia Dziecka", Al. Dzieci Polskich 20, 04-730 Warszawa.
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92
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Sombekke MH, van der Voort LF, Kragt JJ, Nielsen JM, Guzel H, Visser A, Oudejans CBM, Crusius JBA, Peña AS, Vrenken H, Polman CH, Killestein J. Relevance of IL7R genotype and mRNA expression in Dutch patients with multiple sclerosis. Mult Scler 2011; 17:922-30. [DOI: 10.1177/1352458511402411] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The interleukin 7 receptor (IL7R) has been recognized as a susceptibility gene for Multiple Sclerosis (MS). Analysis of rs6897932 (the most strongly MS-associated single nucleotide polymorphism (SNP)), showed effects of genotype on the relative expression of membrane-bound to total amount of IL7R mRNA. Objective: We assessed the relevance of IL7R on MS phenotype (including clinical and magnetic resonance imaging (MRI) parameters) at DNA and mRNA level in Dutch patients with MS. Methods: The genotype of rs6897932 was analyzed in 697 patients with MS and 174 healthy controls. The relevance of genotype and carriership of the C allele on MS phenotype (disease activity and severity, using clinical and MRI parameters) was assessed. In addition, relative gene expression of membrane-bound to total IL7R mRNA was analyzed with respect to disease phenotype in a subgroup of 95 patients with early relapsing MS. Results: In particular, homozygosity for the risk allele is a risk factor for MS in our population (ORCC vs CT and TT = 1.65 (95% CI: 1.18–2.30), two-sided p = 0.004). However, no effect of genotype or the relative expression of membrane-bound IL7R (presence of exon 6–7) to total amount of IL7R mRNA (presence of exon 4–5) was found on MS phenotype. Discussion: Homozygosity for the IL7R exon 6 rs6897932 C allele is associated with a higher risk for MS in our Dutch population. No effect was found of genotype or mRNA expression on disease phenotype.
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Affiliation(s)
- MH Sombekke
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - LF van der Voort
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - JJ Kragt
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - JM Nielsen
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - H Guzel
- Image Analysis Center, VU University Medical Center, Amsterdam, The Netherlands
| | - A Visser
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - CBM Oudejans
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - JBA Crusius
- Department of Pathology (Laboratory of Immunogenetics), VU University Medical Center, Amsterdam, The Netherlands
| | - A Salvador Peña
- Department of Pathology (Laboratory of Immunogenetics), VU University Medical Center, Amsterdam, The Netherlands
| | - H Vrenken
- Department of Radiology and Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - CH Polman
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - J Killestein
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
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93
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Amezcua L, Lund BT, Weiner LP, Islam T. Multiple sclerosis in Hispanics: a study of clinical disease expression. Mult Scler 2011; 17:1010-6. [DOI: 10.1177/1352458511403025] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: Hispanics living with multiple sclerosis (MS) in the United States are not well defined. Objective: To describe the clinical characteristics of MS among Hispanic Whites (HW) in Southern California with those of non-Hispanic Whites (NHW). Methods: We performed a medical chart review to identify all cases of HW with MS ( n = 125) who were treated at our institution during a 1-year period. We also identified cases of NHW with MS (100 NHW) treated at those clinics. All HW patients were interviewed to ascertain ancestry including detailed migration history. Disease progression was assessed by ambulatory disability and defined as Expanded Disability Status Scale (EDSS) score ≥6. Results: Compared with NHW, HW were more likely to have a relapsing–remitting form of MS and a younger age of onset (28.4 ± 0.97 years) with presenting symptoms of optic neuritis and transverse myelitis. However, overall ambulatory disability did not differ between HW and NHW. Migration to the US at age >15 years was associated with increased risk of disability in HW. Conclusions: HW living in the USA may be at risk of developing MS at an earlier age compared with NHW. Migration history can play an important role in the management of HW with MS.
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Affiliation(s)
- L Amezcua
- University of Southern California, Keck School of Medicine, Department of Neurology, Los Angeles, California, USA
| | - BT Lund
- University of Southern California, Keck School of Medicine, Department of Neurology, Los Angeles, California, USA
| | - LP Weiner
- University of Southern California, Keck School of Medicine, Department of Neurology, Los Angeles, California, USA
| | - T Islam
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, California, USA
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94
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Sombekke MH, Vellinga MM, Uitdehaag BMJ, Barkhof F, Polman CH, Arteta D, Tejedor D, Martinez A, Crusius JBA, Peña AS, Geurts JJG, Vrenken H. Genetic correlations of brain lesion distribution in multiple sclerosis: an exploratory study. AJNR Am J Neuroradiol 2011; 32:695-703. [PMID: 21436341 DOI: 10.3174/ajnr.a2352] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In MS, the total brain lesion volume and spatial distribution of lesions across the brain vary widely among individual patients. We hypothesized that spatial distribution may be partially driven by genetic predisposition, and we aimed to explore relations among candidate genes and the spatial distribution of white matter brain lesions in MS. MATERIAL AND METHODS Genotypes of 69 SNPs in 208 patients with MS were related to the spatial distribution of T2 brain lesions. Lesions were manually outlined on MR images, and binary lesion masks were produced and registered to a common space. With Randomise software, the lesion masks were related to genotype by using a voxelwise nonparametric GLM approach, followed by clusterwise analysis. We used a DNA chip with SNPs selected from the literature on MS susceptibility, severity, and phenotypes. RESULTS For 11 of these SNPs, 1 of the genotypes expressed significant clusters of increased or decreased lesion probability in varying, predominantly periventricular, brain regions. When we statistically controlled the voxelwise analyses for effects of total brain lesion volume, only 1 SNP remained significant: rs2227139, located within the MHC class II region. This SNP retained its periventricular cluster of significantly increased lesion probability for the heterozygote genotype. CONCLUSIONS Heterozygosity of rs2227139 (MHC class II region) is associated with increased right frontal periventricular lesion probability (P<.01). Ten other SNPs showed associations between genotype and spatial lesion distribution that are partly explained by total lesion volume.
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Affiliation(s)
- M H Sombekke
- VU University Medical Center, Department of Neurology, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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95
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Wijnen PA, Voorter CE, Nelemans PJ, Verschakelen JA, Bekers O, Drent M. Butyrophilin-like 2 in pulmonary sarcoidosis: a factor for susceptibility and progression? Hum Immunol 2011; 72:342-7. [PMID: 21256912 DOI: 10.1016/j.humimm.2011.01.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 12/18/2010] [Accepted: 01/13/2011] [Indexed: 12/19/2022]
Abstract
The aims of this study were to assess the association of BTNL2G16071A with the course of pulmonary sarcoidosis and to verify the association with disease predisposition. In addition, the linkage between BTNL2G16071A and certain human leukocyte antigen (HLA)-DRB1/DQB1 types was investigated. In a retrospective case-control study BTNL2G16071A, HLA-DQB1, and HLA-DRB1 were typed in 632 sarcoidosis patients. These patients were classified into 304 patients with persistent sarcoidosis and 328 patients with nonpersistent sarcoidosis. The BTNL2 16071A variant allele was present significantly more often in patients with persistent disease (92.4%; 281/304) compared with patients demonstrating a nonpersistent course (86.6%; 284/328; odds ratio (OR) = 1.89 with 95% confidence interval (95% CI) 1.11-3.22). Furthermore, BTNL2 16071A variant allele carriers have an increased risk (OR = 1.85, 95% CI 1.19-2.88) of developing sarcoidosis. Moreover, the strong linkage between variant allele and HLA-DRB1*15 presence (OR = 8.43, 95% CI 3.02-23.5) was confirmed. The presence of a BTNL2G16071A variant allele almost doubles the risk of progressing to persistent pulmonary sarcoidosis in addition to increasing the risk of developing sarcoidosis. Presumably, these increased risks are caused by the strong linkage between BTNL2G16071A and DRB1*15. The choice between determining BTNL2G16071A SNP or the HLA-DRB1 type depends on the ability and/or availability to perform either test.
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Affiliation(s)
- Petal A Wijnen
- Department of Clinical Chemistry, Maastricht University Medical Centre, Maastricht, The Netherlands
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96
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Van der Walt A, Stankovich J, Bahlo M, Taylor BV, Van der Mei IAF, Foote SJ, Rubio JP, Kilpatrick TJ, Butzkueven H. Heterogeneity at the HLA-DRB1 allelic variation locus does not influence multiple sclerosis disease severity, brain atrophy or cognition. Mult Scler 2010; 17:344-52. [PMID: 21149397 DOI: 10.1177/1352458510389101] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND HLA-DRB1*1501 (DR15) and other HLA class II alleles increase the risk of developing multiple sclerosis (MS). However, the contribution of genetic heterogeneity to the clinical course of MS remains controversial. We examined the influence of DR15 and other common DRB1 alleles (DRB1*01 (DR1), DRB1*03 (DR3) and DRB1*04 (DR4) on MS severity in a large, Australian, population-based cohort. METHODS We studied the association between common HLA-DRB1 alleles and genotypes and age of onset as well as three clinical disease severity descriptors: Multiple Sclerosis Severity Score, progression index), and the interval between the first and second attack in 978 patients with relapsing remitting MS and secondary progressive MS. We assessed cognition using the Symbol Digit Modalities Test in 811 patients and brain atrophy using the linear magnetic resonance imaging marker, the intercaudate ratio, in 745 patients. RESULTS Carrying DR15 significantly decreased the age of MS onset by 3.2 years in homozygotes and 1.3 years in heterozygotes. Carrying the HLA-DR15, -DR1, -DR3 or -DR4 alone or in combination did not affect clinical disease severity, cognition or cerebral atrophy. CONCLUSIONS This study confirms that heterogeneity of HLA-DRB1 does not influence disease outcome in relapsing MS patients, with the exception of a younger age of onset in HLA-DR15 carriers.
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Affiliation(s)
- Anneke Van der Walt
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia.
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97
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Dyggve H, Kennedy LJ, Meri S, Spillmann T, Lohi H, Speeti M. Association of Doberman hepatitis to canine major histocompatibility complex II. ACTA ACUST UNITED AC 2010; 77:30-5. [PMID: 20946186 DOI: 10.1111/j.1399-0039.2010.01575.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Doberman hepatitis (DH) is a chronic and progressive inflammatory liver disease that mainly affects female dogs. The high incidence of chronic hepatitis in Dobermans is suggestive of a genetic predisposition. DH is characterized by mononuclear cell infiltration and copper accumulation in the liver and major histocompatibility complex (MHC) class II antigen expression in the hepatocytes. In dogs, the MHC is referred to as the dog leukocyte antigen (DLA) system. In this study, the potential role of DLA genes in DH was investigated by sequence-based typing in the exon 2 of DLA-DRB1, -DQA1 and -DQB1. The case group comprised 37 Dobermans with subclinical or clinical DH. The control group consisted of 37 healthy Dobermans, with normal liver enzyme values and without immunosuppressive medication. The control dogs were over 10 years old to include dogs with the lowest genetic risk of DH. Our results indicate that Dobermans with homozygous DLA-DRB1*00601/DQA1*00401/DQB1*01303 [odds ratio (OR) = 14.9, confidence limit (CL) = 3.1-71.7, P < 0.00005], especially with homozygosity for DLA-DRB1*00601 (P < 0.0005), are susceptible to DH. The DQ heterodimer DLA-DQA1*00901/DQB1*00101 and the allele DLA-DRB1*01501 appear to confer protection against DH (P < 0.001). Allele and haplotype frequencies were compared using chi-squared statistics. The disease shows a complex pattern of inheritance, but the observed DLA class II association with DH suggests a role for the immune system in the development of the disease.
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Affiliation(s)
- H Dyggve
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland.
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Romero-Pinel L, Pujal JM, Martínez-Yélamos S, Gubieras L, Matas E, Bau L, Torrabadella M, Azqueta C, Arbizu T. Epistasis between HLA-DRB1 parental alleles in a Spanish cohort with multiple sclerosis. J Neurol Sci 2010; 298:96-100. [PMID: 20810130 DOI: 10.1016/j.jns.2010.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 07/26/2010] [Accepted: 07/29/2010] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Multiple sclerosis (MS) has been consistently associated with the HLA-DR2 haplotype and particularly with the HLA-DRB1*15 allele. Epistatic interactions between both parental alleles in the DRB1 loci have been shown to modify the MS susceptibility risk. This study investigated the frequencies of various HLA-DRB1 genotypes, their impact on MS susceptibility and their correlation with the clinical severity in a Spanish population. METHODS A genotype was considered as the combination of the two parental DRB1 alleles. We compared the frequencies of the genotypes in a sporadic MS population (n=380) with those of an unrelated healthy control cohort (n=1088). We correlated the different genotypes with the age at onset, gender distribution, symptoms at onset, course of the disease and progression severity by means of the time to reach the progressive phase and EDSS scores of 3 and 6. RESULTS We found 81 different genotypes. There were four different MS-predisposing genotypes. Three of them contained the DRB1*15 allele (DRB1*03/15, DRB1*04/15, and DRB1*08/15) and the fourth was homozygote for the DRB1*03 allele. The highest odds ratio was found with the genotype DRB1*08/15 (OR=3.88, 95% CI=1.83-8.26, p<0.01), followed by DRB1*03/03 (OR=3.15, 95% CI=1.93-5.14, p<0.01), DRB1*03/15 (OR=2.72, 95% CI=1.88-3.94, p<0.01) and DRB1*04/15 (OR=2.54, 95% CI=1.64-3.98, p<0.01). The DRB1*01/04 and the DRB1*15/15 genotypes were associated with a shorter time to reach an EDSS score of 6. CONCLUSIONS Our results show the importance of epistatic interactions among the HLA-DRB1 alleles, modifying the risk for MS as well as its clinical severity.
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Affiliation(s)
- Lucía Romero-Pinel
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
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Oksenberg JR, Baranzini SE. Multiple sclerosis genetics—is the glass half full, or half empty? Nat Rev Neurol 2010; 6:429-37. [DOI: 10.1038/nrneurol.2010.91] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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100
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Ramagopalan SV, Dobson R, Meier UC, Giovannoni G. Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol 2010; 9:727-39. [PMID: 20610348 DOI: 10.1016/s1474-4422(10)70094-6] [Citation(s) in RCA: 331] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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