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George MF, Holingue CB, Briggs FBS, Shao X, Bellesis KH, Whitmer RA, Schaefer C, Benedict RH, Barcellos LF. Feasibility study for remote assessment of cognitive function in multiple sclerosis. ACTA ACUST UNITED AC 2016; 1:10-18. [PMID: 28255581 DOI: 10.29245/2572.942x/2016/8.1084] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. OBJECTIVE To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. METHODS The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. RESULTS 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). CONCLUSIONS Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures.
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Affiliation(s)
- Michaela F George
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA
| | - Calliope B Holingue
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA
| | - Farren B S Briggs
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Xiaorong Shao
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA
| | | | | | | | | | - Lisa F Barcellos
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA; Kaiser Permanente Division of Research, Oakland, CA, USA
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Pan G, Simpson S, van der Mei I, Charlesworth JC, Lucas R, Ponsonby AL, Zhou Y, Wu F, Taylor BV. Role of genetic susceptibility variants in predicting clinical course in multiple sclerosis: a cohort study. J Neurol Neurosurg Psychiatry 2016; 87:1204-1211. [PMID: 27559181 DOI: 10.1136/jnnp-2016-313722] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/01/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND The genetic drivers of multiple sclerosis (MS) clinical course are essentially unknown with limited data arising from severity and clinical phenotype analyses in genome-wide association studies. METHODS Prospective cohort study of 127 first demyelinating events with genotype data, where 116 MS risk-associated single nucleotide polymorphisms (SNPs) were assessed as predictors of conversion to MS, relapse and annualised disability progression (Expanded Disability Status Scale, EDSS) up to 5-year review (ΔEDSS). Survival analysis was used to test for predictors of MS and relapse, and linear regression for disability progression. The top 7 SNPs predicting MS/relapse and disability progression were evaluated as a cumulative genetic risk score (CGRS). RESULTS We identified 2 non-human leucocyte antigen (HLA; rs12599600 and rs1021156) and 1 HLA (rs9266773) SNP predicting both MS and relapse risk. Additionally, 3 non-HLA SNPs predicted only conversion to MS; 1 HLA and 2 non-HLA SNPs predicted only relapse; and 7 non-HLA SNPs predicted ΔEDSS. The CGRS significantly predicted MS and relapse in a significant, dose-dependent manner: those having ≥5 risk genotypes had a 6-fold greater risk of converting to MS and relapse compared with those with ≤2. The CGRS for ΔEDSS was also significant: those carrying ≥6 risk genotypes progressed at 0.48 EDSS points per year faster compared with those with ≤2, and the CGRS model explained 32% of the variance in disability in this study cohort. CONCLUSIONS These data strongly suggest that MS genetic risk variants significantly influence MS clinical course and that this effect is polygenic.
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Affiliation(s)
- Gongbu Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Steve Simpson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jac C Charlesworth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Robyn Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
| | - Yuan Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Rhead B, Bäärnhielm M, Gianfrancesco M, Mok A, Shao X, Quach H, Shen L, Schaefer C, Link J, Gyllenberg A, Hedström AK, Olsson T, Hillert J, Kockum I, Glymour MM, Alfredsson L, Barcellos LF. Mendelian randomization shows a causal effect of low vitamin D on multiple sclerosis risk. NEUROLOGY-GENETICS 2016; 2:e97. [PMID: 27652346 PMCID: PMC5022843 DOI: 10.1212/nxg.0000000000000097] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/12/2016] [Indexed: 01/02/2023]
Abstract
Objective: We sought to estimate the causal effect of low serum 25(OH)D on multiple sclerosis (MS) susceptibility that is not confounded by environmental or lifestyle factors or subject to reverse causality. Methods: We conducted mendelian randomization (MR) analyses using an instrumental variable (IV) comprising 3 single nucleotide polymorphisms found to be associated with serum 25(OH)D levels at genome-wide significance. We analyzed the effect of the IV on MS risk and both age at onset and disease severity in 2 separate populations using logistic regression models that controlled for sex, year of birth, smoking, education, genetic ancestry, body mass index at age 18–20 years or in 20s, a weighted genetic risk score for 110 known MS-associated variants, and the presence of one or more HLA-DRB1*15:01 alleles. Results: Findings from MR analyses using the IV showed increasing levels of 25(OH)D are associated with a decreased risk of MS in both populations. In white, non-Hispanic members of Kaiser Permanente Northern California (1,056 MS cases and 9,015 controls), the odds ratio (OR) was 0.79 (p = 0.04, 95% confidence interval (CI): 0.64–0.99). In members of a Swedish population from the Epidemiological Investigation of Multiple Sclerosis and Genes and Environment in Multiple Sclerosis MS case-control studies (6,335 cases and 5,762 controls), the OR was 0.86 (p = 0.03, 95% CI: 0.76–0.98). A meta-analysis of the 2 populations gave a combined OR of 0.85 (p = 0.003, 95% CI: 0.76–0.94). No association was observed for age at onset or disease severity. Conclusions: These results provide strong evidence that low serum 25(OH)D concentration is a cause of MS, independent of established risk factors.
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Affiliation(s)
- Brooke Rhead
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Maria Bäärnhielm
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Milena Gianfrancesco
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Amanda Mok
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Xiaorong Shao
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Hong Quach
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Ling Shen
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Catherine Schaefer
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Jenny Link
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Alexandra Gyllenberg
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Anna Karin Hedström
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Tomas Olsson
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Jan Hillert
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Ingrid Kockum
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - M Maria Glymour
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Lars Alfredsson
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
| | - Lisa F Barcellos
- Computational Biology Graduate Group (B.R.), Division of Epidemiology (M.G., A.M., X.S., H.Q., L.F.B.), School of Public Health, University of California, Berkeley; Institute of Environmental Medicine (M.B., A.K.H., L.A.), Karolinska Institutet, Stockholm, Sweden; Kaiser Permanente Division of Research (L.S., C.S., L.F.B.), Research Program on Genes, Environment, and Health (C.S.), Kaiser Permanente, Oakland, CA; Department of Clinical Neuroscience and Center for Molecular Medicine (J.L., A.G., T.O., J.H., I.K.), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Biostatistics (M.M.G.), University of California, San Francisco; and Centre for Occupational and Environmental Medicine (L.A.), Stockholm County Council, Sweden
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Werneck LC, Lorenzoni PJ, Arndt RC, Kay CSK, Scola RH. The immunogenetics of multiple sclerosis. The frequency of HLA-alleles class 1 and 2 is lower in Southern Brazil than in the European population. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:607-16. [DOI: 10.1590/0004-282x20160100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 05/25/2016] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To study the HLA of class 1and 2 in a multiple sclerosis (MS) population to verify the susceptibility for the disease in the Southern Brazil. Methods We analyzed patients with MS and controls, by direct sequencing of the genes related to HLA DRB1, DQB1, DPB1, A, B and C alleles with high resolution techniques. Results We found a lower frequency of all HLA alleles class 1 and 2 in MS and controls comparing to the European population. Several alleles had statistical correlation, but after Bonferroni correction, the only allele with significance was the HLA-DQB1*02:03, which has a positive association with MS. Conclusions Our data have different frequency of HLA-alleles than the previous published papers in the Southeast Brazil and European population, possible due to several ethnic backgrounds.
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George MF, Briggs FBS, Shao X, Gianfrancesco MA, Kockum I, Harbo HF, Celius EG, Bos SD, Hedström A, Shen L, Bernstein A, Alfredsson L, Hillert J, Olsson T, Patsopoulos NA, De Jager PL, Oturai AB, Søndergaard HB, Sellebjerg F, Sorensen PS, Gomez R, Caillier SJ, Cree BAC, Oksenberg JR, Hauser SL, D'Alfonso S, Leone MA, Martinelli Boneschi F, Sorosina M, van der Mei I, Taylor BV, Zhou Y, Schaefer C, Barcellos LF. Multiple sclerosis risk loci and disease severity in 7,125 individuals from 10 studies. Neurol Genet 2016; 2:e87. [PMID: 27540591 PMCID: PMC4974846 DOI: 10.1212/nxg.0000000000000087] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 06/16/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE We investigated the association between 52 risk variants identified through genome-wide association studies and disease severity in multiple sclerosis (MS). METHODS Ten unique MS case data sets were analyzed. The Multiple Sclerosis Severity Score (MSSS) was calculated using the Expanded Disability Status Scale at study entry and disease duration. MSSS was considered as a continuous variable and as 2 dichotomous variables (median and extreme ends; MSSS of ≤5 vs >5 and MSSS of <2.5 vs ≥7.5, respectively). Single nucleotide polymorphisms (SNPs) were examined individually and as both combined weighted genetic risk score (wGRS) and unweighted genetic risk score (GRS) for association with disease severity. Random-effects meta-analyses were conducted and adjusted for cohort, sex, age at onset, and HLA-DRB1*15:01. RESULTS A total of 7,125 MS cases were analyzed. The wGRS and GRS were not strongly associated with disease severity after accounting for cohort, sex, age at onset, and HLA-DRB1*15:01. After restricting analyses to cases with disease duration ≥10 years, associations were null (p value ≥0.05). No SNP was associated with disease severity after adjusting for multiple testing. CONCLUSIONS The largest meta-analysis of established MS genetic risk variants and disease severity, to date, was performed. Results suggest that the investigated MS genetic risk variants are not associated with MSSS, even after controlling for potential confounders. Further research in large cohorts is needed to identify genetic determinants of disease severity using sensitive clinical and MRI measures, which are critical to understanding disease mechanisms and guiding development of effective treatments.
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Affiliation(s)
| | | | - Xiaorong Shao
- Author affiliations are listed at the end of the article
| | | | - Ingrid Kockum
- Author affiliations are listed at the end of the article
| | - Hanne F Harbo
- Author affiliations are listed at the end of the article
| | | | - Steffan D Bos
- Author affiliations are listed at the end of the article
| | - Anna Hedström
- Author affiliations are listed at the end of the article
| | - Ling Shen
- Author affiliations are listed at the end of the article
| | | | | | - Jan Hillert
- Author affiliations are listed at the end of the article
| | - Tomas Olsson
- Author affiliations are listed at the end of the article
| | | | | | | | | | | | - Per S Sorensen
- Author affiliations are listed at the end of the article
| | - Refujia Gomez
- Author affiliations are listed at the end of the article
| | | | - Bruce A C Cree
- Author affiliations are listed at the end of the article
| | | | | | | | | | | | | | | | - Bruce V Taylor
- Author affiliations are listed at the end of the article
| | - Yuan Zhou
- Author affiliations are listed at the end of the article
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Longbrake EE, Hafler DA. Linking Genotype to Clinical Phenotype in Multiple Sclerosis: In Search of the Holy Grail. JAMA Neurol 2016; 73:777-8. [PMID: 27244583 PMCID: PMC5198230 DOI: 10.1001/jamaneurol.2016.1227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Erin E Longbrake
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut2Department of Neurology, Washington University in St Louis, St Louis, Missouri
| | - David A Hafler
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut3Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut
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Hussman JP, Beecham AH, Schmidt M, Martin ER, McCauley JL, Vance JM, Haines JL, Pericak-Vance MA. GWAS analysis implicates NF-κB-mediated induction of inflammatory T cells in multiple sclerosis. Genes Immun 2016; 17:305-12. [PMID: 27278126 PMCID: PMC4956564 DOI: 10.1038/gene.2016.23] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/22/2016] [Accepted: 04/29/2016] [Indexed: 12/13/2022]
Abstract
To identify genes and biologically relevant pathways associated with risk to develop multiple sclerosis (MS), the Genome-Wide Association Studies noise reduction method (GWAS-NR) was applied to MS genotyping data. Regions of association were defined based on the significance of linkage disequilibrium blocks. Candidate genes were cross-referenced based on a review of current literature, with attention to molecular function and directly interacting proteins. Supplementary annotations and pathway enrichment scores were generated using The Database for Annotation, Visualization and Integrated Discovery. The candidate set of 220 MS susceptibility genes prioritized by GWAS-NR was highly enriched with genes involved in biological pathways related to positive regulation of cell, lymphocyte and leukocyte activation (P=6.1E-15, 1.2E-14 and 5.0E-14, respectively). Novel gene candidates include key regulators of NF-κB signaling and CD4+ T helper type 1 (Th1) and T helper type 17 (Th17) lineages. A large subset of MS candidate genes prioritized by GWAS-NR were found to interact in a tractable pathway regulating the NF-κB-mediated induction and infiltration of pro-inflammatory Th1/Th17 T-cell lineages, and maintenance of immune tolerance by T-regulatory cells. This mechanism provides a biological context that potentially links clinical observations in MS to the underlying genetic landscape that may confer susceptibility.
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Affiliation(s)
| | - A H Beecham
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - M Schmidt
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - E R Martin
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA.,Dr John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - J L McCauley
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA.,Dr John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - J M Vance
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA.,Dr John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - J L Haines
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - M A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL, USA.,Dr John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
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58
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Mescheriakova JY, Broer L, Wahedi S, Uitterlinden AG, van Duijn CM, Hintzen RQ. Burden of genetic risk variants in multiple sclerosis families in the Netherlands. Mult Scler J Exp Transl Clin 2016; 2:2055217316648721. [PMID: 28607725 PMCID: PMC5433503 DOI: 10.1177/2055217316648721] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/08/2016] [Indexed: 01/22/2023] Open
Abstract
Background Approximately 20% of multiple sclerosis patients have a family history of multiple sclerosis. Studies of multiple sclerosis aggregation in families are inconclusive. Objective To investigate the genetic burden based on currently discovered genetic variants for multiple sclerosis risk in patients from Dutch multiple sclerosis multiplex families versus sporadic multiple sclerosis cases, and to study its influence on clinical phenotype and disease prediction. Methods Our study population consisted of 283 sporadic multiple sclerosis cases, 169 probands from multiplex families and 2028 controls. A weighted genetic risk score based on 102 non-human leukocyte antigen loci and HLA-DRB1*1501 was calculated. Results The weighted genetic risk score based on all loci was significantly higher in familial than in sporadic cases. The HLA-DRB1*1501 contributed significantly to the difference in genetic burden between the groups. A high weighted genetic risk score was significantly associated with a low age of disease onset in all multiple sclerosis patients, but not in the familial cases separately. The genetic risk score was significantly but modestly better in discriminating familial versus sporadic multiple sclerosis from controls. Conclusion Familial multiple sclerosis patients are more loaded with the common genetic variants than sporadic cases. The difference is mainly driven by HLA-DRB1*1501. The predictive capacity of genetic loci is poor and unlikely to be useful in clinical settings.
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Affiliation(s)
| | - Linda Broer
- Department of Neurology, Erasmus Medical Centre, the Netherlands
| | - Simin Wahedi
- Department of Neurology, Erasmus Medical Centre, the Netherlands
| | | | | | - Rogier Q Hintzen
- Department of Neurology, Erasmus Medical Centre, the Netherlands
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59
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Jiang T, Li L, Wang Y, Zhao C, Yang J, Ma D, Guan Y, Zhao D, Bao Y, Wang Y, Yang J. The Association Between Genetic Polymorphism rs703842 in CYP27B1 and Multiple Sclerosis: A Meta-Analysis. Medicine (Baltimore) 2016; 95:e3612. [PMID: 27175669 PMCID: PMC4902511 DOI: 10.1097/md.0000000000003612] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Multiple sclerosis (MS) is the most frequent nontraumatic disabling neurological disease among young adults. Previous studies have examined the association of rs703842 in CYP27B1 with MS susceptibility, with inconsistent results reported.The objective of this study is to conduct a systematic literature search and perform meta-analyses to examine whether rs703842 is associated with MS risk.We searched potential literature in PubMed, Cochrane Library, Embase, Google Scholar, Web of Science, and HuGE by using the following inclusion criteria: studies were on human subjects; the studies were case-control studies; studies included subjects who had MS and those who did not have MS; and the studies provided genotype data for rs703842 for subjects who had and did not have MS, or provided odds ratios (ORs) and the 95% confidence intervals (CIs) for assessing the association of rs703842 with MS, or provided sufficient data for the calculation of OR and the 95% CI. We used random-effects models to calculate the OR as a measure of association. We used I to assess between-study heterogeneity, and a funnel plot and Egger test to assess publication bias.Seven studies published since 2008 met the eligibility criteria and were included in the meta-analyses. We found that the C allele was significantly associated with reduced MS susceptibility (OR = 0.88, 95% CI: 0.80-0.89; P < 0.0001). We also found significant association of rs703842 with MS risk using a dominant and a recessive model (both P < 0.0002). Our results remain unchanged if our meta-analysis was limited to studies that included only Caucasian participants (OR = 0.85, 95% CI: 0.80-0.90; P < 0.0001).Our study has several limitations: The sample size is limited; We were unable to control for some important confounding factors as data for individual participant were not available; and Most of the included studies focus on MS risk in Caucasian. As a result, we could not perform meta-analysis for assessing the relationship in other ethnic groups.In summary, we found that the genetic variant rs703842 in CYP27B1 is associated with MS risk in Caucasians. More studies with larger sample size that control for important confounding factors are needed to validate the findings from this study.
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Affiliation(s)
- Tao Jiang
- From the Department of Neurology (TJ, JY), Laizhou People's Hospital, Laizhou, Shandong; Department of Critical Care and Emergency Medicine (LL), The Affiliated Hospital of Hainan Medical University, Haikou, Hainan; Emergency Department (LL), Shengjing Hospital of China Medical University, Shenyang, Liaoning; Department of Neurosurgery (YW, DM), Huashan Hospital, Fudan University, Shanghai, China; Brain Tumor Center (CZ), Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Neurosurgery (YG, DZ, YB, YW), The First Hospital of China Medical University, Shenyang, Liaoning; Rush Alzheimer's Disease Center (JY); and Department of Neurological Sciences (JY), Rush University Medical Center, Chicago, IL, USA
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60
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Michalik J, Čierny D, Kantorová E, Kantárová D, Juraj J, Párnická Z, Kurča E, Dobrota D, Lehotský J. The association of HLA-DRB1 and HLA-DQB1 alleles with genetic susceptibility to multiple sclerosis in the Slovak population. Neurol Res 2016; 37:1060-7. [DOI: 10.1080/01616412.2015.1115212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Jozef Michalik
- Clinic of Neurology, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Daniel Čierny
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ema Kantorová
- Clinic of Neurology, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Daniela Kantárová
- I. internal clinic, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Javor Juraj
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Zuzana Párnická
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Egon Kurča
- Clinic of Neurology, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Dušan Dobrota
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ján Lehotský
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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61
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Associations of HLA DRB1 alleles with IgG oligoclonal bands and their influence on multiple sclerosis course and disability status. Medicina (B Aires) 2016; 52:217-222. [PMID: 27515835 DOI: 10.1016/j.medici.2016.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 01/24/2023] Open
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62
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Xiao D, Ye X, Zhang N, Ou M, Guo C, Zhang B, Liu Y, Wang M, Yang G, Jing C. A meta-analysis of interaction between Epstein-Barr virus and HLA-DRB1*1501 on risk of multiple sclerosis. Sci Rep 2015; 5:18083. [PMID: 26656273 PMCID: PMC4676020 DOI: 10.1038/srep18083] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/11/2015] [Indexed: 11/09/2022] Open
Abstract
Infection with Epstein-Barr virus (EBV) and HLA-DRB1*1501-positivity is a risk factor for multiple sclerosis (MS), but whether an interaction between these two factors causes MS is unclear. We therefore conducted a meta-analysis on the effect of the interaction between HLA-DRB1*1501 and EBV infection on MS. Searches of PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and the Wanfan databases through February 2015 yielded 5 studies that met the criteria for inclusion in the meta-analysis. EBV infection and HLA-DRB1*1501-positivity were dichotomized. The additive (S) and multiplicative interaction indexes (OR) between EBV infection and HLA-DRB1*1501 and their 95% confidence intervals (95%CI) were calculated for each study and then combined in a meta-analysis. EBV infection was significantly associated with MS (OR = 2.60; 95%CI, 1.48–4.59). HLA-DRB1*1501 was associated with a significantly increased risk of MS (OR, 3.06; 95%CI, 2.30–4.08). An interaction effect between EBV infection and HLA-DRB1*1501 on MS was observed on the additive scale (S, 1.43; 95%CI, 1.05–1.95, P = 0.023), but no interaction effect was observed on the multiplicative scale (OR, 0.86, 95%CI, 0.59–1.26). This meta-analysis provides strong evidence that EBV alone, HLA-DRB1*1501 alone or their interaction is associated with an elevated risks of MS.
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Affiliation(s)
- Di Xiao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Xingguang Ye
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Na Zhang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Meiling Ou
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Congcong Guo
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Baohuan Zhang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Yang Liu
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Man Wang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Guang Yang
- Department of Parasitology, School of Medicine, Jinan University, No.601, Huangpu Avenue West, Guangzhou, Guangdong, China.,Key Laboratory of environmental exposure and health in Guangzhou, Jinan University, Guangzhou, Guangdong, China
| | - Chunxia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China.,Key Laboratory of environmental exposure and health in Guangzhou, Jinan University, Guangzhou, Guangdong, China
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63
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Moutsianas L, Jostins L, Beecham AH, Dilthey AT, Xifara DK, Ban M, Shah TS, Patsopoulos NA, Alfredsson L, Anderson CA, Attfield KE, Baranzini SE, Barrett J, Binder TMC, Booth D, Buck D, Celius EG, Cotsapas C, D'Alfonso S, Dendrou CA, Donnelly P, Dubois B, Fontaine B, Fugger L, Goris A, Gourraud PA, Graetz C, Hemmer B, Hillert J, Kockum I, Leslie S, Lill CM, Martinelli-Boneschi F, Oksenberg JR, Olsson T, Oturai A, Saarela J, Søndergaard HB, Spurkland A, Taylor B, Winkelmann J, Zipp F, Haines JL, Pericak-Vance MA, Spencer CCA, Stewart G, Hafler DA, Ivinson AJ, Harbo HF, Hauser SL, De Jager PL, Compston A, McCauley JL, Sawcer S, McVean G. Class II HLA interactions modulate genetic risk for multiple sclerosis. Nat Genet 2015; 47:1107-1113. [PMID: 26343388 PMCID: PMC4874245 DOI: 10.1038/ng.3395] [Citation(s) in RCA: 227] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/12/2015] [Indexed: 01/01/2023]
Abstract
Association studies have greatly refined the understanding of how variation within the human leukocyte antigen (HLA) genes influences risk of multiple sclerosis. However, the extent to which major effects are modulated by interactions is poorly characterized. We analyzed high-density SNP data on 17,465 cases and 30,385 controls from 11 cohorts of European ancestry, in combination with imputation of classical HLA alleles, to build a high-resolution map of HLA genetic risk and assess the evidence for interactions involving classical HLA alleles. Among new and previously identified class II risk alleles (HLA-DRB1*15:01, HLA-DRB1*13:03, HLA-DRB1*03:01, HLA-DRB1*08:01 and HLA-DQB1*03:02) and class I protective alleles (HLA-A*02:01, HLA-B*44:02, HLA-B*38:01 and HLA-B*55:01), we find evidence for two interactions involving pairs of class II alleles: HLA-DQA1*01:01-HLA-DRB1*15:01 and HLA-DQB1*03:01-HLA-DQB1*03:02. We find no evidence for interactions between classical HLA alleles and non-HLA risk-associated variants and estimate a minimal effect of polygenic epistasis in modulating major risk alleles.
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Affiliation(s)
- Loukas Moutsianas
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Luke Jostins
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Ashley H Beecham
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | | | - Dionysia K Xifara
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Maria Ban
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Tejas S Shah
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Nikolaos A Patsopoulos
- Program in Translational NeuroPsychiatric Genomics, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard University and MIT, Cambridge, Massachusetts, USA
| | - Lars Alfredsson
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
| | - Carl A Anderson
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Katherine E Attfield
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Sergio E Baranzini
- Department of Neurology, University of California, San Francisco, Sandler Neurosciences Center, San Francisco, California, USA
| | - Jeffrey Barrett
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Thomas M C Binder
- HLA Laboratory, Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - David Booth
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Dorothea Buck
- Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Elisabeth G Celius
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Chris Cotsapas
- Program in Medical and Population Genetics, Broad Institute of Harvard University and MIT, Cambridge, Massachusetts, USA
- Department of Neurology and Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sandra D'Alfonso
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Calliope A Dendrou
- Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Peter Donnelly
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Bénédicte Dubois
- Department of Neurosciences, Laboratory for Neuroimmunology, KU Leuven, Leuven, Belgium
| | - Bertrand Fontaine
- INSERM, Université Pierre et Marie Curie, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Département des Maladies du Système Nerveux and UMRS 1127-7225, Institut Cerveau Moelle Spinal Cord and Brain Institute, Pitié-Salpêtrière, Paris, France
| | - Lars Fugger
- Medical Research Council (MRC) Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - An Goris
- Department of Neurosciences, Laboratory for Neuroimmunology, KU Leuven, Leuven, Belgium
| | - Pierre-Antoine Gourraud
- Department of Neurology, University of California, San Francisco, Sandler Neurosciences Center, San Francisco, California, USA
| | - Christiane Graetz
- Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), Johannes Gutenberg University-Medical Center, Mainz, Germany
| | - Bernhard Hemmer
- Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Competence Network Multiple Sclerosis (KKNMS), Munich, Germany
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Stephen Leslie
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia
- Department of Mathematics and Statistics, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Christina M Lill
- Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), Johannes Gutenberg University-Medical Center, Mainz, Germany
- Platform for Genome Analytics, Institutes of Neurogenetics and Integrative and Experimental Genomics, University of Lübeck, Lübeck, Germany
| | - Filippo Martinelli-Boneschi
- Laboratory of Genetics of Neurological Complex Disorders, Institute of Experimental Neurology (INSPE), Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Department of Neurology, Institute of Experimental Neurology (INSPE), Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Jorge R Oksenberg
- Department of Neurology, University of California, San Francisco, Sandler Neurosciences Center, San Francisco, California, USA
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Annette Oturai
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janna Saarela
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Helle Bach Søndergaard
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Spurkland
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Bruce Taylor
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Juliane Winkelmann
- Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institut für Humangenetik, Technische Universität München, Munich, Germany
- Institut für Humangenetik, Helmholtz Zentrum München, Munich, Germany
- Department of Neurology and Neurological Sciences, Center for Sleep Sciences and Medicine, Stanford University, Stanford, California, USA
| | - Frauke Zipp
- Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), Johannes Gutenberg University-Medical Center, Mainz, Germany
| | - Jonathan L Haines
- Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Chris C A Spencer
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Graeme Stewart
- Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia
| | - David A Hafler
- Program in Medical and Population Genetics, Broad Institute of Harvard University and MIT, Cambridge, Massachusetts, USA
- Department of Neurology and Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
- Broad Institute of Harvard University and MIT, Cambridge, Massachusetts, USA
| | - Adrian J Ivinson
- Harvard NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Hanne F Harbo
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- University of Oslo, Oslo, Norway
| | - Stephen L Hauser
- Department of Neurology, University of California, San Francisco, Sandler Neurosciences Center, San Francisco, California, USA
| | - Philip L De Jager
- Program in Translational NeuroPsychiatric Genomics, Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard University and MIT, Cambridge, Massachusetts, USA
| | - Alastair Compston
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Jacob L McCauley
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Stephen Sawcer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Gil McVean
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
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64
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Affiliation(s)
- Kelly Hilven
- Laboratory for Neuroimmunology, Department of Neurosciences, KU Leuven - University of Leuven, Belgium
| | - An Goris
- Laboratory for Neuroimmunology, Department of Neurosciences, KU Leuven - University of Leuven, Belgium
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65
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Esposito F, Guaschino C, Sorosina M, Clarelli F, Ferre' L, Mascia E, Santoro S, Pagnesi M, Radaelli M, Colombo B, Moiola L, Rodegher M, Stupka E, Martinelli V, Comi G, Martinelli Boneschi F. Impact of MS genetic loci on familial aggregation, clinical phenotype, and disease prediction. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2015; 2:e129. [PMID: 26185776 PMCID: PMC4503410 DOI: 10.1212/nxi.0000000000000129] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 05/25/2015] [Indexed: 11/15/2022]
Abstract
Objective: To investigate the role of known multiple sclerosis (MS)-associated genetic variants in MS familial aggregation, clinical expression, and accuracy of disease prediction in sporadic and familial cases. Methods: A total of 1,443 consecutive patients were screened for MS and familial autoimmune history in a hospital-based Italian cohort. Among them, 461 sporadic and 93 familial probands were genotyped for 107 MS-associated polymorphisms. Their effect sizes were combined to calculate the weighted genetic risk score (wGRS). Results: Family history of MS was reported by 17.2% of probands, and 33.8% reported a familial autoimmune disorder, with autoimmune thyroiditis and psoriasis being the most frequent. No difference in wGRS was observed between sporadic and familial MS cases. In contrast, a lower wGRS was observed in probands with greater familial aggregation (>1 first-degree relative or >2 relatives with MS) (p = 0.03). Also, female probands of familial cases with greater familial aggregation had a lower wGRS than sporadic cases (p = 0.0009) and male probands of familial cases (p = 0.04). An inverse correlation between wGRS and age at onset was observed (p = 0.05). The predictive performance of the genetic model including all known MS variants was modest but greater in sporadic vs familial cases (area under the curve = 0.63 and 0.57). Conclusions: Additional variants outside the known MS-associated loci, rare variants, and/or environmental factors may explain disease occurrence within families; in females, hormonal and epigenetic factors probably have a predominant role in explaining familial aggregation. The inclusion of these additional factors in future versions of aggregated genetic measures could improve their predictive ability.
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Affiliation(s)
- Federica Esposito
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Clara Guaschino
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Melissa Sorosina
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Ferdinando Clarelli
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Laura Ferre'
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Mascia
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Santoro
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Pagnesi
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Marta Radaelli
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Bruno Colombo
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Lucia Moiola
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Mariaemma Rodegher
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Elia Stupka
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Vittorio Martinelli
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Filippo Martinelli Boneschi
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
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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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Marro BS, Blanc CA, Loring JF, Cahalan MD, Lane TE. Promoting remyelination: utilizing a viral model of demyelination to assess cell-based therapies. Expert Rev Neurother 2015; 14:1169-79. [PMID: 25245576 DOI: 10.1586/14737175.2014.955854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory disease of the CNS. While a broad range of therapeutics effectively reduce the incidence of focal white matter inflammation and plaque formation for patients with relapse-remitting forms of MS, a challenge within the field is to develop therapies that allow for axonal protection and remyelination. In the last decade, growing interest has focused on utilizing neural precursor cells (NPCs) to promote remyelination. To understand how NPCs function in chronic demyelinating environments, several excellent pre-clinical mouse models have been developed. One well accepted model is infection of susceptible mice with neurotropic variants of mouse hepatitis virus (MHV) that undergo chronic demyelination exhibiting clinical and histopathologic similarities to MS patients. Combined with the possibility that an environmental agent such as a virus could trigger MS, the MHV model of demyelination presents a relevant mouse model to assess the therapeutic potential of NPCs transplanted into an environment in which inflammatory-mediated demyelination is established.
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Affiliation(s)
- Brett S Marro
- Department of Molecular Biology and Biochemistry, University of California, Irvine 92697, USA
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Al-Temaimi R, Alroughani R, Jacob S, Al-Mulla F. Gender influence in EBV antibody response in multiple sclerosis patients from Kuwait. J Neuroimmunol 2015. [PMID: 26198919 DOI: 10.1016/j.jneuroim.2015.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Epstein-Barr virus (EBV) infection is implicated with multiple sclerosis (MS) risk, exacerbation, and progression. The HLA-DRB1*1501 haplotype is a strong MS risk factor consistently documented in MS populations. There are no studies of EBV infections and HLA-DRB1*1501 haplotype associating with MS from Kuwait where MS prevalence has increased significantly. OBJECTIVES To determine the association of EBV infection with MS incidence, and to investigate HLA-DRB1*1501 as a potential genetic risk factor for MS in Kuwait. METHODS This is a case-control study involving 141 MS patients and 40 healthy controls. Antibody titers against EBV antigens' viral capsid antigen (VCA) and Epstein-Barr nuclear antigen 1 (EBNA1) were measured using enzyme-linked immunosorbent assays. HLA-DRB1*1501 haplotype assessment was done using rs3135005 TaqMan genotyping assay. RESULTS Antibody titers against EBV were significantly elevated in MS patients compared to healthy controls (anti-EBNA1, p=0.008; anti-VCA, p=0.028). MS males had higher antibody titers to EBNA1 than healthy male controls (p=0.005) and female MS patients (p=0.03). HLA-DRB1*1501 haplotype genotypes failed to generate a risk association with MS or EBV antibody titers (p=0.6). CONCLUSION An increased immune response to EBV infection is associated with MS incidence influenced by the type of antigen and sex. HLA-DRB1*1501 haplotype is not associated with MS risk in our Kuwaiti MS cohort.
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Affiliation(s)
- Rabeah Al-Temaimi
- Human Genetics Unit, Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait.
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Kuwait, Kuwait; Neurology Clinic, Department of Medicine, Dasman Diabetes Institute, Kuwait
| | - Sindhu Jacob
- Molecular Pathology Unit, Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait
| | - Fahd Al-Mulla
- Molecular Pathology Unit, Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait
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Occasional presence of herpes viruses in synovial fluid and blood from patients with rheumatoid arthritis and axial spondyloarthritis. Clin Rheumatol 2015; 34:1681-6. [PMID: 25980837 PMCID: PMC4575354 DOI: 10.1007/s10067-015-2974-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/07/2015] [Accepted: 05/08/2015] [Indexed: 12/20/2022]
Abstract
Viral agents have been suspected as participants of immune-mediated disorders. In the case of rheumatic diseases, the synovial joint cavity represents a secluded area of inflammation which could harbor etiological agents. We analyzed by polymerase chain reaction the possible presence of DNA from various herpes viruses in blood and synovial fluid from patients with either rheumatoid arthritis (n = 18), axial spondyloarthritis (n = 11), or osteoarthritis (n = 8). Relevant findings were as follows: DNA from varicella zoster virus was found in synovial fluid but not in blood mononuclear cells from 33 % of patients with rheumatoid arthritis and in 45 % of patients with axial spondyloarthritis but not in patients with osteoarthritis. Also, DNA from herpes simplex viruses 1 and 2 was found both in the blood and in the synovial fluid from 33 % of patients with rheumatoid arthritis. Our results indicate the occasional presence of DNA from herpes viruses in patients with rheumatoid arthritis or with axial spondyloarthritis. However, these findings might represent a parallel epiphenomenon of viral activation associated either with immunosuppressive therapy or with primary immune disturbances, rather than the etiological participation of herpes viruses in these disorders.
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Abstract
BACKGROUND Tobacco smoke is an established risk factor for multiple sclerosis (MS). We hypothesized that variation in genes involved in metabolism of tobacco smoke constituents may modify MS risk in smokers. METHODS A three-stage gene-environment investigation was conducted for NAT1, NAT2, and GSTP1 variants. The discovery analysis was conducted among 1588 white MS cases and controls from the Kaiser Permanente Northern California Region HealthPlan (Kaiser). The replication analysis was carried out in 988 white MS cases and controls from Sweden. RESULTS Tobacco smoke exposure at the age of 20 years was associated with greater MS risk in both data sets (in Kaiser, odds ratio [OR] = 1.51 [95% confidence interval (CI) = 1.17-1.93]; in Sweden, OR = 1.35 [1.04-1.74]). A total of 42 NAT1 variants showed evidence for interaction with tobacco smoke exposure (P(corrected) < 0.05). Genotypes for 41 NAT1 single nucleotide polymorphisms (SNPs) were studied in the replication data set. A variant (rs7388368C>A) within a dense transcription factor-binding region showed evidence for interaction (Kaiser, OR for interaction = 1.75 [95% CI = 1.19-2.56]; Sweden, OR = 1.62 [1.05-2.49]). Tobacco smoke exposure was associated with MS risk among rs7388368A carriers only; homozygote individuals had the highest risk (A/A, OR = 5.17 [95% CI = 2.17-12.33]). CONCLUSIONS We conducted a three-stage analysis using two population-based case-control datasets that consisted of a discovery population, a replication population, and a pooled analysis. NAT1 emerged as a genetic effect modifier of tobacco smoke exposure in MS susceptibility.
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Perga S, Montarolo F, Martire S, Berchialla P, Malucchi S, Bertolotto A. Anti-inflammatory genes associated with multiple sclerosis: A gene expression study. J Neuroimmunol 2015; 279:75-8. [DOI: 10.1016/j.jneuroim.2015.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/02/2015] [Accepted: 01/20/2015] [Indexed: 01/25/2023]
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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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Kumar A, Sechi LA, Caboni P, Marrosu MG, Atzori L, Pieroni E. Dynamical insights into the differential characteristics of Mycobacterium avium subsp. paratuberculosis peptide binding to HLA-DRB1 proteins associated with multiple sclerosis. NEW J CHEM 2015. [DOI: 10.1039/c4nj01903b] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Differential properties of MAP binding to HLA proteins in Sardinian MS patients.
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Affiliation(s)
- Amit Kumar
- CRS4 Science and Technology Park Polaris
- Biomedicine Dept
- Pula (CA)
- Italy
- Department of Biomedical Sciences
| | - Leonardo A. Sechi
- Department of Biomedical Sciences
- Microbiology and Virology Unit
- University of Sassari
- Sassari
- Italy
| | - Pierluigi Caboni
- Department of Life and Environmental Sciences
- University of Cagliari
- Cagliari
- Italy
| | - Maria Giovanna Marrosu
- Multiple Sclerosis Center
- Department of Public Health and Clinical and Molecular Medicine
- University of Cagliari
- Cagliari
- Italy
| | - Luigi Atzori
- Department of Biomedical Sciences
- Oncology and Molecular Pathology Unit
- University of Cagliari
- Cagliari
- Italy
| | - Enrico Pieroni
- CRS4 Science and Technology Park Polaris
- Biomedicine Dept
- Pula (CA)
- Italy
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Kaushansky N, Ben-Nun A. DQB1*06:02-Associated Pathogenic Anti-Myelin Autoimmunity in Multiple Sclerosis-Like Disease: Potential Function of DQB1*06:02 as a Disease-Predisposing Allele. Front Oncol 2014; 4:280. [PMID: 25360418 PMCID: PMC4199271 DOI: 10.3389/fonc.2014.00280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/29/2014] [Indexed: 12/20/2022] Open
Abstract
Susceptibility to multiple sclerosis (MS) has been linked mainly to the HLA-DRB1 locus, with the HLA-DR15 haplotype (DRB1*1501-DQA1*0102-DQB1*0602-DRB5*0101) dominating MS risk in Caucasians. Although genes in the HLA-II region, particularly DRB1*1501, DQA1*0102-DQB1*0602, are in tight linkage disequilibrium, genome-wide-association, and gene candidate studies identified the DRB1*15:01 allele as the primary risk factor in MS. Many genetic and immune-functional studies have indicated DRB1*15:01 as a primary risk factor in MS, while only some functional studies suggested a disease-modifying role for the DRB5*01 or DQB1*06 alleles. In this respect, the susceptibility of DRB1*15:01-transgenic (Tg) mice to myelin basic protein- or myelin oligodendrocyte glycoprotein-induced MS-like disease is consistent with primary contribution of DRB1*15:01 to HLA-DR15+ MS. The studies summarized here show that susceptibility to MS-like disease, induced in HLA-“humanized” mice by myelin oligodendrocytic basic protein or by the proteolipid protein, one of the most prominent encephalitogenic target antigens implicated in human MS, is determined by DQB1*06:02, rather than by the DRB1*15:01 allele. These findings not only offer a rationale for a potential role for DQB1*06:02 in predisposing susceptibility to MS, but also suggest a more complex and differential functional role for HLA-DR15 alleles, depending on the primary target myelin antigen. However, the conflict between these findings in HLA-Tg mice and the extensive genome-wide-association studies, which could not detect any significant effect from the DQB1*06:02 allele on MS risk, is rather puzzling. Functional analysis of MS PBLs for DQB1*06:02-associated anti-myelin autoimmunity may indicate whether or not DQB1*06:02 is associated with MS pathogenesis.
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Affiliation(s)
- Nathali Kaushansky
- Department of Immunology, The Weizmann Institute of Science , Rehovot , Israel
| | - Avraham Ben-Nun
- Department of Immunology, The Weizmann Institute of Science , Rehovot , Israel
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Hedström AK, Bomfim IL, Barcellos LF, Briggs F, Schaefer C, Kockum I, Olsson T, Alfredsson L. Interaction between passive smoking and two HLA genes with regard to multiple sclerosis risk. Int J Epidemiol 2014; 43:1791-8. [PMID: 25324153 PMCID: PMC4276064 DOI: 10.1093/ije/dyu195] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: The recently described interaction between smoking, human leukocyte antigen (HLA) DRB1*15 and absence of HLA-A*02 with regard to multiple sclerosis (MS) risk shows that the risk conveyed by smoking differs depending on genetic background. We aimed to investigate whether a similar interaction exists between passive smoking and HLA genotype. Methods: We used one case-control study with incident cases of MS (736 cases, 1195 controls) and one with prevalent cases (575 cases, 373 controls). Never-smokers with different genotypes and passive smoking status were compared with regard to occurrence of MS, by calculating odds ratios (ORs) with 95% confidence intervals (CIs). The potential interaction between different genotypes and passive smoking was evaluated by calculating the attributable proportion (AP) due to interaction. Results: An interaction was observed between passive smoking and carriage of HLA-DRB1*15 (AP 0.3, 95% CI 0.02–0.5 in the incident study, and AP 0.4, 95% CI 0.1–0.7 in the prevalent study), as well as between passive smoking and absence of HLA-A*02. Compared with non-smokers without any of these two genetic risk factors, non-exposed subjects with the two risk genotypes displayed an OR of 4.5 (95% CI 3.3–6.1) whereas the same genotype for subjects exposed to passive smoking rendered an OR of 7.7 (95% CI 5.5–10.8). Conclusions: The risk of developing MS associated with different HLA genotypes may be influenced by exposure to passive smoking. The finding supports our hypothesis that priming of the immune response in the lungs may subsequently lead to MS in people with a genetic susceptibility to the disease.
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Affiliation(s)
- Anna Karin Hedström
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Izaura Lima Bomfim
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Lisa F Barcellos
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Farren Briggs
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Catherine Schaefer
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Ingrid Kockum
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Tomas Olsson
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine, and Neuroimmunology Unit, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA, Kaiser Permanente Division of Research, Oakland, CA, USA and Neuroimmunology Unit, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
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Abolfazli R, Samadzadeh S, Sabokbar T, Siroos B, Armaki SA, Aslanbeiki B, Ghelman M, Taheri T, Shakoori A. Relationship between HLA-DRB1* 11/15 genotype and susceptibility to multiple sclerosis in IRAN. J Neurol Sci 2014; 345:92-6. [DOI: 10.1016/j.jns.2014.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 04/30/2014] [Accepted: 07/07/2014] [Indexed: 01/21/2023]
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Abstract
Asparaginase is a therapeutic enzyme used to treat leukemia and lymphoma, with immune responses resulting in suboptimal drug exposure and a greater risk of relapse. To elucidate whether there is a genetic component to the mechanism of asparaginase-induced immune responses, we imputed human leukocyte antigen (HLA) alleles in patients of European ancestry enrolled on leukemia trials at St. Jude Children's Research Hospital (n = 541) and the Children's Oncology Group (n = 1329). We identified a higher incidence of hypersensitivity and anti-asparaginase antibodies in patients with HLA-DRB1*07:01 alleles (P = 7.5 × 10(-5), odds ratio [OR] = 1.64; P = 1.4 × 10(-5), OR = 2.92, respectively). Structural analysis revealed that high-risk amino acids were located within the binding pocket of the HLA protein, possibly affecting the interaction between asparaginase epitopes and the HLA-DRB1 protein. Using a sequence-based consensus approach, we predicted the binding affinity of HLA-DRB1 alleles for asparaginase epitopes, and patients whose HLA genetics predicted high-affinity binding had more allergy (P = 3.3 × 10(-4), OR = 1.38). Our results suggest a mechanism of allergy whereby HLA-DRB1 alleles that confer high-affinity binding to asparaginase epitopes lead to a higher frequency of reactions. These trials were registered at www.clinicaltrials.gov as NCT00137111, NCT00549848, NCT00005603, and NCT00075725.
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Abstract
Genome-wide association studies have revolutionised the genetic analysis of multiple sclerosis. Through international collaborative efforts involving tens of thousands of cases and controls, more than 100 associated common variants have now been identified. These variants consistently implicate genes associated with immunological processes, overwhelmingly lie in regulatory rather than coding regions, and are frequently associated with other autoimmune diseases. The functional implications of these associated variants are mostly unknown; however, early work has shown that several variants have effects on splicing that result in meaningful changes in the balance between different isoforms in relevant tissues. Including the well established risk attributable to variants in genes encoding human leucocyte antigens, only about a quarter of reported heritability can now be accounted for, suggesting that a substantial potential for further discovery remains.
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Affiliation(s)
- Stephen Sawcer
- Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
| | - Robin J M Franklin
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK; Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Maria Ban
- Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
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Gianfrancesco MA, Acuna B, Shen L, Briggs FBS, Quach H, Bellesis KH, Bernstein A, Hedstrom AK, Kockum I, Alfredsson L, Olsson T, Schaefer C, Barcellos LF. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors. Obes Res Clin Pract 2014; 8:e435-47. [PMID: 25263833 DOI: 10.1016/j.orcp.2014.01.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 12/26/2013] [Accepted: 01/01/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors. METHODS Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied. RESULTS In analyses stratified by gender, being overweight at ages 10 and 20 were associated with MS in females (p<0.01). Estimates trended in the same direction for males, but were not significant. BMI in 20s demonstrated a linear relationship with MS (p-trend=9.60×10(-4)), and a twofold risk of MS for females with a BMI≥30kg/m(2) was observed (OR=2.15, 95% CI 1.18, 3.92). Significant associations between BMI in 20s and MS in males were not observed. Multivariate modelling demonstrated that significant associations between BMI or body size with MS in females persisted after adjusting for history of infectious mononucleosis and genetic risk factors, including HLA-DRB1*15:01 and established non-HLA risk alleles. INTERPRETATION Results show that childhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors.
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Affiliation(s)
- Milena A Gianfrancesco
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States
| | - Brigid Acuna
- Kaiser Permanente Division of Research, Oakland, CA, United States
| | - Ling Shen
- Kaiser Permanente Division of Research, Oakland, CA, United States
| | - Farren B S Briggs
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States
| | - Hong Quach
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States
| | | | | | - Anna K Hedstrom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Kockum
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Tomas Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Lisa F Barcellos
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States; Kaiser Permanente Division of Research, Oakland, CA, United States.
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81
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Isobe N, Oksenberg JR. Genetic studies of multiple sclerosis and neuromyelitis optica: Current status in European, African American and Asian populations. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/cen3.12078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Noriko Isobe
- Department of Neurology; School of Medicine; University of California; San Francisco CA USA
| | - Jorge R. Oksenberg
- Department of Neurology; School of Medicine; University of California; San Francisco CA USA
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82
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Abstract
We recently introduced the concept of the infectome as a means of studying all infectious factors which contribute to the development of autoimmune disease. It forms the infectious part of the exposome, which collates all environmental factors contributing to the development of disease and studies the sum total of burden which leads to the loss of adaptive mechanisms in the body. These studies complement genome-wide association studies, which establish the genetic predisposition to disease. The infectome is a component which spans the whole life and may begin at the earliest stages right up to the time when the first symptoms manifest, and may thus contribute to the understanding of the pathogenesis of autoimmunity at the prodromal/asymptomatic stages. We provide practical examples and research tools as to how we can investigate disease-specific infectomes, using laboratory approaches employed from projects studying the “immunome” and “microbiome”. It is envisioned that an understanding of the infectome and the environmental factors that affect it will allow for earlier patient-specific intervention by clinicians, through the possible treatment of infectious agents as well as other compounding factors, and hence slowing or preventing disease development.
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83
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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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84
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Abstract
Multiple sclerosis (MS) patients are classified as either having relapsing onset or progressive onset disease, also known as primary progressive MS (PPMS). Relative to relapsing onset patients, PPMS patients are older at disease onset, are equally likely to be men or women, and have more rapid accumulation of disability that does not respond well to treatments used in relapsing onset MS. Although estimates vary, 5-15% of all MS patients have a PPMS disease course. Genetic variance is a proposed determinant of MS disease course. If distinct genes associated with PPMS were identified study of these genes might lead to an understanding of the biology underlying disease progression and neural degeneration that are the hallmarks of PPMS. These genes and their biological pathways might also represent therapeutic targets. This chapter systematically reviews the PPMS genetic literature. Despite the intuitively appealing notion that differences between PPMS and relapsing onset MS are due to genetics, definite differences associated with these phenotypes at the major histocompatibility complex or elsewhere in the genome have not been found. Recent large-scale genome wide screens identified multiple genes associated with MS susceptibility outside the MHC. The genetic variants identified thus far make only weak individual contributions to MS susceptibility. If the genetic effects that contribute to the differences between PPMS and relapsing MS are similar in magnitude to those that distinguish MS from healthy controls then, given the relative scarcity of the PPMS phenotype, very large datasets will be needed to identify PPMS associated genes. International collaborative efforts could provide the means to identify such genes. Alternately, it is possible that factors other than genetics underlie the differences between these clinical phenotypes.
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Affiliation(s)
- Bruce A C Cree
- Department of Neurology, University of California, San Francisco, USA.
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85
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Patsopoulos NA, Barcellos LF, Hintzen RQ, Schaefer C, van Duijn CM, Noble JA, Raj T, Gourraud PA, Stranger BE, Oksenberg J, Olsson T, Taylor BV, Sawcer S, Hafler DA, Carrington M, De Jager PL, de Bakker PIW. Fine-mapping the genetic association of the major histocompatibility complex in multiple sclerosis: HLA and non-HLA effects. PLoS Genet 2013; 9:e1003926. [PMID: 24278027 PMCID: PMC3836799 DOI: 10.1371/journal.pgen.1003926] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 09/13/2013] [Indexed: 12/19/2022] Open
Abstract
The major histocompatibility complex (MHC) region is strongly associated with multiple sclerosis (MS) susceptibility. HLA-DRB1*15:01 has the strongest effect, and several other alleles have been reported at different levels of validation. Using SNP data from genome-wide studies, we imputed and tested classical alleles and amino acid polymorphisms in 8 classical human leukocyte antigen (HLA) genes in 5,091 cases and 9,595 controls. We identified 11 statistically independent effects overall: 6 HLA-DRB1 and one DPB1 alleles in class II, one HLA-A and two B alleles in class I, and one signal in a region spanning from MICB to LST1. This genomic segment does not contain any HLA class I or II genes and provides robust evidence for the involvement of a non-HLA risk allele within the MHC. Interestingly, this region contains the TNF gene, the cognate ligand of the well-validated TNFRSF1A MS susceptibility gene. The classical HLA effects can be explained to some extent by polymorphic amino acid positions in the peptide-binding grooves. This study dissects the independent effects in the MHC, a critical region for MS susceptibility that harbors multiple risk alleles.
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Affiliation(s)
- Nikolaos A. Patsopoulos
- Program in Translational NeuroPsychiatric Genomics, Institute for the Neurosciences, Department of Neurology, Brigham & Women's Hospital, Boston, Massachusetts, United States of America
- Division of Genetics, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Lisa F. Barcellos
- Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Kaiser Permanente Division of Research, Oakland, California, United States of America
| | - Rogier Q. Hintzen
- Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands
| | - Catherine Schaefer
- Kaiser Permanente Division of Research, Oakland, California, United States of America
| | - Cornelia M. van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology and Biostatistics and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - Janelle A. Noble
- Children's Hospital Oakland Research Institute, Oakland, California, United States of America
| | - Towfique Raj
- Program in Translational NeuroPsychiatric Genomics, Institute for the Neurosciences, Department of Neurology, Brigham & Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | | | | | - Pierre-Antoine Gourraud
- Department of Neurology, University, of California at San Francisco, San Francisco, California, United States of America
| | - Barbara E. Stranger
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
- Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois, United States of America
| | - Jorge Oksenberg
- Department of Neurology, University, of California at San Francisco, San Francisco, California, United States of America
| | - Tomas Olsson
- Department of Clinical Neuroscience CMM, Karolinska Institutet, Stockholm, Sweden
| | - Bruce V. Taylor
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Stephen Sawcer
- University of Cambridge, Department of Clinical Neuroscience, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - David A. Hafler
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Department of Neurology and Department of Immunobiology, Yale University, School of Medicine, New Haven, Connecticut, United States of America
| | - Mary Carrington
- Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC Frederick, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
- Ragon Institute of MGH, MIT, and Harvard, Charlestown, Massachusetts, United States of America
| | - Philip L. De Jager
- Program in Translational NeuroPsychiatric Genomics, Institute for the Neurosciences, Department of Neurology, Brigham & Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Paul I. W. de Bakker
- Division of Genetics, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Department of Medical Genetics, Division of Biomedical Genetics, University Medical Center, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
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86
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Therapeutic advances in pediatric multiple sclerosis. J Pediatr 2013; 163:631-7. [PMID: 23726542 DOI: 10.1016/j.jpeds.2013.04.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 03/05/2013] [Accepted: 04/11/2013] [Indexed: 11/23/2022]
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87
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Lin R, Taylor BV, Simpson S, Charlesworth J, Ponsonby AL, Pittas F, Dwyer T, van der Mei I. Association between multiple sclerosis risk-associated SNPs and relapse and disability--a prospective cohort study. Mult Scler 2013; 20:313-21. [PMID: 23886828 DOI: 10.1177/1352458513496882] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The modulating effects of the multiple sclerosis (MS) risk-associated single-nucleotide polymorphisms (SNPs) on MS clinical course are not well established. OBJECTIVES The objective of this paper is to investigate whether known MS risk-associated SNPs were associated with clinical course, and whether these SNPs modified the 25(OH)D-relapse association. METHODS Using a prospective cohort of 141 participants with relapsing-remitting MS and genotype data followed between 2002 and 2005, genotype-vitamin D interactions and the genetic predictors of relapse were assessed using survival analysis, and genetic predictors of 25(OH)D and disability progression were evaluated by multilevel mixed-effects linear regression. RESULTS While no SNP reached statistical significance after multiple testing, five SNPs were associated with relapse, with significant cumulative genotype risk effects and two demonstrated significant allele dose-response. Two SNPs altered the 25(OH)D-relapse association with significant allele dose-response. Five SNPs modified levels of 25(OH)D, with significant cumulative genotype 'risk' effect, and three demonstrated significant allele dose-response. We found no consistent evidence for an association between any SNPs and disability. CONCLUSIONS Our study provides evidence for an association between known MS risk-associated SNPs and relapse. Our findings indicate gene-environment interactions may be an important mechanism on MS clinical course, and provide support for the role of vitamin D in MS relapse.
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Affiliation(s)
- Rui Lin
- Menzies Research Institute Tasmania, University of Tasmania, Australia
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88
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Balnyte R, Rastenyte D, Vaitkus A, Mickeviciene D, Skrodeniene E, Vitkauskiene A, Uloziene I. The importance of HLA DRB1 gene allele to clinical features and disability in patients with multiple sclerosis in Lithuania. BMC Neurol 2013; 13:77. [PMID: 23837503 PMCID: PMC3716946 DOI: 10.1186/1471-2377-13-77] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 06/24/2013] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The association of HLA DRB1 alleles with susceptibility to multiple sclerosis (MS) has been consistently reported although its effect on the clinical features and disability is still unclear probably due to diversity in ethnicity and geographic location of the studied populations. The aim of the present study was to investigate the influence of HLA DRB1 alleles on the clinical features and disability of the patients with MS in Lithuania. METHODS This was a prospective study of 120 patients with MS. HLA DRB1 alleles were genotyped using the polymerase chain reaction. RESULTS The first symptoms of MS in patients with HLA DRB1*15 allele manifested at younger age than in those without this allele (28.32 +/- 5.49 yrs vs. 30.94 +/- 8.43 yrs, respectively, p = 0.043). HLA DRB1*08 allele was more prevalent among relapsing-remitting (RR) MS patients than among patients with progressive course of MS (25.0% vs. 8.3%, respectively, chi^2 = 6.000, p = 0.05). MS patients with this allele had lower relapse rate than those without this allele (1.00 +/- 0.97 and 1.44 +/- 0.85, respectively, p = 0.043). Degree of disability during the last visit was lower among the patients with HLA DRB1*08 allele (EDSS score 3.15 +/- 1.95 vs. 4.49 +/- 1.96, p = 0.006), and higher among those with HLA DRB1*15 allele (EDSS score 4.60 +/- 2.10 vs.4.05 +/- 1.94, p = 0.047) compared to patients without these alleles but there were no significant associations between these alleles and the duration of the disease to disability. HLA DRB1*08 allele (OR = 0.18, 95% CI 0,039-0,8, p = 0.029) was demonstradet to be independent factor to take a longer time to reach an EDSS of 6, while HLA DRB1*01 allele (OR = 5.92, 95% CI 1,30-26,8, p = 0.021) was related in a shorter time to reach and EDSS of 6. Patients with HLA DRB1*08 allele had lower IgG index compared to patients without this allele (0.58 +/- 0.17 and 0.73 +/- 0.31, respectively, p = 0.04), and HLA DRB1*15 allele was more often found among MS patients with oligoclonal bands (OCBs) in cerebrospinal fluid than among those without OCBs (OR 2.3, CI 95% 1.017-5.301; p = 0.043). CONCLUSIONS HLA DRB1*15 allele was related with an earlier manifestation of the first MS symptoms, progressive course of the disease and higher degree of disability. HLA DRB1*08 allele was more prevalent among the RR MS patients and was associated with the lower rate of relapse, degree of disability and IgG index.
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Affiliation(s)
- Renata Balnyte
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Daiva Rastenyte
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Antanas Vaitkus
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Dalia Mickeviciene
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Erika Skrodeniene
- Department of Laboratory Medicine, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Ingrida Uloziene
- Department of Otorinolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
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89
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The Immune Pathogenesis of Multiple Sclerosis. J Neuroimmune Pharmacol 2013; 8:857-66. [DOI: 10.1007/s11481-013-9467-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/23/2013] [Indexed: 12/18/2022]
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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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91
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Huang J, Yoshimura S, Isobe N, Matsushita T, Yonekawa T, Sato S, Yamasaki R, Kira JI. A NOTCH4 missense mutation confers resistance to multiple sclerosis in Japanese. Mult Scler 2013; 19:1696-703. [PMID: 23549433 DOI: 10.1177/1352458513482512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The G allele of NOTCH4 rs422951 is protective against demyelinating disease in Japanese. OBJECTIVES The purpose of this study was to assess the relation of the G allele to neuromyelitis optica (NMO)/NMO spectrum disorder (NMOSD) and multiple sclerosis (MS) and the interaction between the G allele and HLA-DRB1 alleles, and to clarify any association of the G allele with clinical features. METHODS DNA sequencing was used to genotype 106 NMO/NMOSD patients, 118 MS patients and 152 healthy controls (HCs) for rs422951. RESULTS G allele frequency in MS patients, but not that in NMO/NMOSD patients, was lower than that in HCs (8.9% vs 21.7%, p<0.0001, odds ratio (OR)=0.35). HLA-DRB1*0405 was positively associated with MS (OR=2.22, p(corr) =0.0380) while DRB1*0901 was negatively associated (OR=0.32, p(corr) =0.0114). Logistic regression analyses revealed that, after adjusting for gender and either HLA-DRB1*0405 or DRB1*0901, rs422951 was associated with MS in the dominant model (OR=0.37, 95% confidence interval (CI)= 0.20-0.66, p=0.0012). Haplotype analyses identified two susceptible and three resistant haplotypes formed from rs422951 and either HLA-DRB1*0405 or DRB1*0901. There were no statistically significant differences in clinical features between G allele carriers and non-G allele carriers. CONCLUSION This NOTCH4 missense mutation decreased the risk for developing MS in Japanese, but did not affect clinical features of those who had already developed the disease.
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Affiliation(s)
- Jian Huang
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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92
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Toro J, Cárdenas S, Fernando Martínez C, Urrutia J, Díaz C. Multiple sclerosis in Colombia and other Latin American Countries. Mult Scler Relat Disord 2013; 2:80-9. [DOI: 10.1016/j.msard.2012.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 08/30/2012] [Accepted: 09/05/2012] [Indexed: 11/29/2022]
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93
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Kumar A, Cocco E, Atzori L, Marrosu MG, Pieroni E. Structural and dynamical insights on HLA-DR2 complexes that confer susceptibility to multiple sclerosis in Sardinia: a molecular dynamics simulation study. PLoS One 2013; 8:e59711. [PMID: 23555757 PMCID: PMC3608583 DOI: 10.1371/journal.pone.0059711] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 02/17/2013] [Indexed: 12/28/2022] Open
Abstract
Sardinia is a major Island in the Mediterranean with a high incidence of multiple sclerosis, a chronic autoimmune inflammatory disease of the central nervous system. Disease susceptibility in Sardinian population has been associated with five alleles of major histocompatibility complex (MHC) class II DRB1 gene. We performed 120 ns of molecular dynamics simulation on one predisposing and one protective alleles, unbound and in complex with the two relevant peptides: Myelin Basic Protein and Epstein Barr Virus derived peptide. In particular we focused on the MHC peptide binding groove dynamics. The predisposing allele was found to form a stable complex with both the peptides, while the protective allele displayed stability only when bound with myelin peptide. The local flexibility of the MHC was probed dividing the binding groove into four compartments covering the well known peptide anchoring pockets. The predisposing allele in the first half cleft exhibits a narrower and more rigid groove conformation in the presence of myelin peptide. The protective allele shows a similar behavior, while in the second half cleft it displays a narrower and more flexible groove conformation in the presence of viral peptide. We further characterized these dynamical differences by evaluating H-bonds, hydrophobic and stacking interaction networks, finding striking similarities with super-type patterns emerging in other autoimmune diseases. The protective allele shows a defined preferential binding to myelin peptide, as confirmed by binding free energy calculations. All together, we believe the presented molecular analysis could help to design experimental assays, supports the molecular mimicry hypothesis and suggests that propensity to multiple sclerosis in Sardinia could be partly linked to distinct peptide-MHC interaction and binding characteristics of the antigen presentation mechanism.
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Affiliation(s)
- Amit Kumar
- Multiple Sclerosis Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- CRS4 Science and Technology Park Polaris, Bio-Engineering Group, Piscina Manna, Pula (CA) Italy
- Department of Biomedical Sciences, Oncology and Molecular Pathology Unit, University of Cagliari, Cagliari, Italy
- * E-mail: (AK); (EP)
| | - Eleonora Cocco
- Multiple Sclerosis Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Luigi Atzori
- Department of Biomedical Sciences, Oncology and Molecular Pathology Unit, University of Cagliari, Cagliari, Italy
| | - Maria Giovanna Marrosu
- Multiple Sclerosis Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Enrico Pieroni
- CRS4 Science and Technology Park Polaris, Bio-Engineering Group, Piscina Manna, Pula (CA) Italy
- * E-mail: (AK); (EP)
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Mero IL, Gustavsen MW, Sæther HS, Flåm ST, Berg-Hansen P, Søndergaard HB, Jensen PEH, Berge T, Bjølgerud A, Muggerud A, Aarseth JH, Myhr KM, Celius EG, Sellebjerg F, Hillert J, Alfredsson L, Olsson T, Oturai AB, Kockum I, Lie BA, Andreassen BK, Harbo HF. Oligoclonal band status in Scandinavian multiple sclerosis patients is associated with specific genetic risk alleles. PLoS One 2013; 8:e58352. [PMID: 23472185 PMCID: PMC3589422 DOI: 10.1371/journal.pone.0058352] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 02/03/2013] [Indexed: 12/24/2022] Open
Abstract
The presence of oligoclonal bands (OCB) in cerebrospinal fluid (CSF) is a typical finding in multiple sclerosis (MS). We applied data from Norwegian, Swedish and Danish (i.e. Scandinavian) MS patients from a genome-wide association study (GWAS) to search for genetic differences in MS relating to OCB status. GWAS data was compared in 1367 OCB positive and 161 OCB negative Scandinavian MS patients, and nine of the most associated SNPs were genotyped for replication in 3403 Scandinavian MS patients. HLA-DRB1 genotypes were analyzed in a subset of the OCB positive (n = 2781) and OCB negative (n = 292) MS patients and compared to 890 healthy controls. Results from the genome-wide analyses showed that single nucleotide polymorphisms (SNPs) from the HLA complex and six other loci were associated to OCB status. In SNPs selected for replication, combined analyses showed genome-wide significant association for two SNPs in the HLA complex; rs3129871 (p = 5.7×10(-15)) and rs3817963 (p = 5.7×10(-10)) correlating with the HLA-DRB1*15 and the HLA-DRB1*04 alleles, respectively. We also found suggestive association to one SNP in the Calsyntenin-2 gene (p = 8.83×10(-7)). In HLA-DRB1 analyses HLA-DRB1*15∶01 was a stronger risk factor for OCB positive than OCB negative MS, whereas HLA-DRB1*04∶04 was associated with increased risk of OCB negative MS and reduced risk of OCB positive MS. Protective effects of HLA-DRB1*01∶01 and HLA-DRB1*07∶01 were detected in both groups. The groups were different with regard to age at onset (AAO), MS outcome measures and gender. This study confirms both shared and distinct genetic risk for MS subtypes in the Scandinavian population defined by OCB status and indicates different clinical characteristics between the groups. This suggests differences in disease mechanisms between OCB negative and OCB positive MS with implications for patient management, which need to be further studied.
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Affiliation(s)
- Inger-Lise Mero
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Department of Medical Genetics, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Marte W. Gustavsen
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hanne S. Sæther
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Department of Medical Genetics, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Siri T. Flåm
- Department of Medical Genetics, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Pål Berg-Hansen
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Helle B. Søndergaard
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Poul Erik H. Jensen
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Tone Berge
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anja Bjølgerud
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Aslaug Muggerud
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jan H. Aarseth
- The Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | | | - Kjell-Morten Myhr
- The Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Centre for MS-research, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Finn Sellebjerg
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institutet, The Multiple Sclerosis Research Group, Center for Molecular Medicine, Stockholm, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, The Neuroimmunology Research Group, Stockholm, Sweden
| | - Annette Bang Oturai
- The Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ingrid Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, The Neuroimmunology Research Group, Stockholm, Sweden
| | - Benedicte A. Lie
- Department of Medical Genetics, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Bettina Kulle Andreassen
- Department of Clinical Molecular Biology and Laboratory Sciences (EpiGen), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Biostiatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Hanne F. Harbo
- Department of Neurology, Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- * E-mail:
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95
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Multiple sclerosis and the blood-central nervous system barrier. Cardiovasc Psychiatry Neurol 2013; 2013:530356. [PMID: 23401746 PMCID: PMC3562587 DOI: 10.1155/2013/530356] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/25/2012] [Accepted: 12/25/2012] [Indexed: 12/23/2022] Open
Abstract
The central nervous system (CNS) is isolated from the blood system by a physical barrier that contains efflux transporters and catabolic enzymes. This blood-CNS barrier (BCNSB) plays a pivotal role in the pathophysiology of multiple sclerosis (MS). It binds and anchors activated leukocytes to permit their movement across the BCNSB and into the CNS. Once there, these immune cells target particular self-epitopes and initiate a cascade of neuroinflammation, which leads to the breakdown of the BCNSB and the formation of perivascular plaques, one of the hallmarks of MS. Immunomodulatory drugs for MS are either biologics or small molecules, with only the latter having the capacity to cross the BCNSB and thus have a propensity to cause CNS side effects. However, BCNSB penetration is a desirable feature of MS drugs that have molecular targets within the CNS. These are nabiximols and dalfampridine, which target cannabinoid receptors and potassium channels, respectively. Vascular cell adhesion molecule-1, present on endothelial cells of the BCNSB, also serves as a drug discovery target since it interacts with α4-β1-integrin on leucocytes. The MS drug natalizumab, a humanized monoclonal antibody against α4-β1-integrin, blocks this interaction and thus reduces the movement of immune cells into the CNS. This paper further elaborates on the role of the BCNSB in the pathophysiology and pharmacotherapy of MS.
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96
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Bogdanos DP, Smyk DS, Invernizzi P, Rigopoulou EI, Blank M, Pouria S, Shoenfeld Y. Infectome: a platform to trace infectious triggers of autoimmunity. Autoimmun Rev 2012; 12:726-40. [PMID: 23266520 PMCID: PMC7105216 DOI: 10.1016/j.autrev.2012.12.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 12/12/2012] [Indexed: 02/06/2023]
Abstract
The "exposome" is a term recently used to describe all environmental factors, both exogenous and endogenous, which we are exposed to in a lifetime. It represents an important tool in the study of autoimmunity, complementing classical immunological research tools and cutting-edge genome wide association studies (GWAS). Recently, environmental wide association studies (EWAS) investigated the effect of environment in the development of diseases. Environmental triggers are largely subdivided into infectious and non-infectious agents. In this review, we introduce the concept of the "infectome", which is the part of the exposome referring to the collection of an individual's exposures to infectious agents. The infectome directly relates to geoepidemiological, serological and molecular evidence of the co-occurrence of several infectious agents associated with autoimmune diseases that may provide hints for the triggering factors responsible for the pathogenesis of autoimmunity. We discuss the implications that the investigation of the infectome may have for the understanding of microbial/host interactions in autoimmune diseases with long, pre-clinical phases. It may also contribute to the concept of the human body as a superorganism where the microbiome is part of the whole organism, as can be seen with mitochondria which existed as microbes prior to becoming organelles in eukaryotic cells of multicellular organisms over time. A similar argument can now be made in regard to normal intestinal flora, living in symbiosis within the host. We also provide practical examples as to how we can characterise and measure the totality of a disease-specific infectome, based on the experimental approaches employed from the "immunome" and "microbiome" projects.
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Affiliation(s)
- Dimitrios P Bogdanos
- Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, Denmark Hill Campus, London, UK.
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97
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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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98
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Rose AM, Bell LCK. Epistasis and immunity: the role of genetic interactions in autoimmune diseases. Immunology 2012; 137:131-8. [PMID: 22804709 DOI: 10.1111/j.1365-2567.2012.03623.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Autoimmune disorders are a complex and varied group of diseases that are caused by breakdown of self-tolerance. The aetiology of autoimmunity is multi-factorial, with both environmental triggers and genetically determined risk factors. In recent years, it has been increasingly recognized that genetic risk factors do not act in isolation, but rather the combination of individual additive effects, gene-gene interactions and gene-environment interactions determine overall risk of autoimmunity. The importance of gene-gene interactions, or epistasis, has been recently brought into focus, with research demonstrating that many autoimmune diseases, including rheumatic arthritis, autoimmune glomerulonephritis, systemic lupus erythematosus and multiple sclerosis, are influenced by epistatic interactions. This review sets out to examine the basic mechanisms of epistasis, how epistasis influences the immune system and the role of epistasis in two major autoimmune conditions, systemic lupus erythematosus and multiple sclerosis.
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Affiliation(s)
- Anna M Rose
- Department of Genetics, UCL Institute of Ophthalmology, London, UK.
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99
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Gourraud PA, Harbo HF, Hauser SL, Baranzini SE. The genetics of multiple sclerosis: an up-to-date review. Immunol Rev 2012. [PMID: 22725956 DOI: 10.1111/j.1600-065x.2012.01134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Multiple sclerosis (MS) is a prevalent inflammatory disease of the central nervous system that often leads to disability in young adults. Treatment options are limited and often only partly effective. The disease is likely caused by a complex interaction between multiple genes and environmental factors, leading to inflammatory-mediated central nervous system deterioration. A series of genomic studies have confirmed a central role for the immune system in the development of MS, including genetic association studies that have now dramatically expanded the roster of MS susceptibility genes beyond the longstanding human leukocyte antigen (HLA) association in MS first identified nearly 40 years ago. Advances in technology together with novel models for collaboration across research groups have enabled the discovery of more than 50 non-HLA genetic risk factors associated with MS. However, with a large proportion of the disease heritability still unaccounted for, current studies are now geared towards identification of causal alleles, associated pathways, epigenetic mechanisms, and gene-environment interactions. This article reviews recent efforts in addressing the genetics of MS and the challenges posed by an ever increasing amount of analyzable data, which is spearheading development of novel statistical methods necessary to cope with such complexity.
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Affiliation(s)
- Pierre-Antoine Gourraud
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143-0435, USA
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100
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Abstract
Multiple sclerosis (MS) is a disease in which genetic, environmental, and stochastic factors interact to trigger an inflammatory disease of the CNS that also has a neurodegenerative component. Over the past 3 years, progress in high-throughput technologies and analysis methods has synergized with the collaborative efforts of investigators studying MS genetics to enable the discovery of more than a dozen genes involved in making individuals susceptible to MS. These genes are beginning to suggest molecular pathways that may be particularly vulnerable to genetic variation in MS. Soon, a comprehensive map of common genetic variants affecting MS susceptibility will be assembled, and communal efforts will need to focus on the more challenging issue of understanding the genetic architecture of disease course and treatment response in MS. Early efforts integrating different dimensions of information, including genomics, imaging, transcriptomics, and proteomics, with precise phenotypic data from clinicians illustrate the way forward for prognostic algorithms in MS and suggest that these approaches will yield a new series of insights in the next decade.
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