The HLA Region and Autoimmune Disease: Associations and Mechanisms of Action

Thyroid stimulating hormone receptor (TSHR) intron 1 variants are major risk factors for Graves' disease in three European Caucasian cohorts

BACKGROUND

The thyroid stimulating hormone receptor (TSHR) gene is an established susceptibility locus for Graves' disease (GD), with recent studies refining association to two single nucleotide polymorphisms (SNPs), rs179247 and rs12101255, within TSHR intron 1.

METHODOLOGY AND PRINCIPAL FINDINGS

We aimed to validate association of rs179247 and rs12101255 in Polish and UK Caucasian GD case-control subjects, determine the mode of inheritance and to see if association correlates with specific GD clinical manifestations. We investigated three case-control populations; 558 GD patients and 520 controls from Warsaw, Poland, 196 GD patients and 198 controls from Gliwice, Poland and 2504 GD patients from the UK National collection and 2784 controls from the 1958 British Birth cohort. Both rs179247 (P = 1.2×10(-2)-6.2×10(-15), OR = 1.38-1.45) and rs12101255 (P = 1.0×10(-4)-3.68×10(-21), OR = 1.47-1.87) exhibited strong association with GD in all three cohorts. Logistic regression suggested association of rs179247 is secondary to rs12101255 in all cohorts. Inheritance modeling suggested a co-dominant mode of inheritance in all cohorts. Genotype-phenotype correlations provided no clear evidence of association with any specific clinical characteristics.

CONCLUSIONS

We have validated association of TSHR intron 1 SNPs with GD in three independent European cohorts and have demonstrated that the aetiological variant within the TSHR is likely to be in strong linkage disequilibrium with rs12101255. Fine mapping is now required to determine the exact location of the aetiological DNA variants within the TSHR.

Recent advances in the association studies of autoimmune thyroid disease and the functional characterization of AITD-related transcription factor ZFAT

Autoimmune thyroid disease (AITD), including Graves'disease (GD) and Hashimoto's thyroiditis (HT), is caused by immune response to self-thyroid antigens, and affects up to 2-5% of the general population. Twin studies and familial aggregation have clearly indicated the involvement of genetic factors with AITD in addition to environmental factors. Known AITD-susceptibility genes are classified into three categories: HLA genes, non-HLA immune-related genes, and thyroid-specific genes. A comprehensive catalogue of AITD-susceptibility genes with major effects will facilitates elucidating the molecular mechanisms underlying the initiation of AITD. Genome-wide association studies conducted for autoimmune diseases in the last few years have identified a significant number of novel loci contributing disease risk. In this review, we describe the current status of genome-wide association studies for GD and the recent advances in the functional characterization of ZFAT, an AITD-related transcription factor previously identified by our genetic analyses for the Japanese GD population.

Confirmation of association of chromosome 5q31-33 with United Kingdom Caucasian Graves' disease

BACKGROUND

Previous genome-wide microsatellite screening in Graves' disease (GD) has suggested several regions of linkage to disease. Although replication has been inconsistent, some regions such as chromosome 5q31-33 have been associated with several Oriental GD patient cohorts. Recently, two studies have reported association of single-nucleotide polymorphism (SNP) rs31480 in interleukin 3 (IL-3) and the rs1368408 and SNP75 (-623 approximately -622 AG/-T) SNPs in secretoglobulin family 3a member 2 (SCGB3A2) with GD and suggested that this may account for linkage to the 5q31-33 region in Oriental GD datasets. We sought to confirm this association in a large Caucasian U.K. GD cohort.

METHODS

The rs31480 SNP was shown to tag all known common variations in IL-3 and the rs1368408 SNP was shown to tag all common variations in SCGB3A2. The SCGB3A2 SNP75 was found to be rare in the U.K. Caucasian population and, therefore, was not screened. We genotyped rs31480 and rs1368408 and performed a case-control association study in 2504 GD cases and 2688 controls from the U.K.

RESULTS

Association between the SCGB3A2 rs1368408 SNP and GD was detected (p = 0.007, odds ratio = 1.18, 95% confidence intervals = 1.05-1.33). No association between the IL-3 rs31804 SNP and U.K. Caucasian GD patients was observed.

CONCLUSIONS

These data suggest that chromosome 5q31-q33 contains a susceptibility locus for Caucasian GD patients as well as Oriental GD patients. Although association was detected between SCGB3A2 and U.K. Caucasian GD subjects, the size of effect was smaller than that seen in the Oriental population (odds ratio = 1.28-1.73). Fine mapping within this region will be required to determine the exact location of the etiological variants present within this region for both Caucasian and Oriental GD patients.

Chronic obstructive pulmonary disease: towards pharmacogenetics

Chronic obstructive pulmonary disease (COPD) is a common problem worldwide, and it is recognized that the term encompasses overlapping sub-phenotypes of disease. The development of a sub-phenotype may be determined in part by an individual's genetics, which in turn may determine response to treatment. A growing understanding of the genetic factors that predispose to COPD and its sub-phenotypes and the pathophysiology of the condition is now leading to the suggestion of individualized therapy based on the patients' clinical phenotype and genotype. Pharmacogenetics is the study of variations in treatment response according to genotype and is perhaps the next direction for genetic research in COPD. Here, we consider how knowledge of the pathophysiology and genetic risk factors for COPD may inform future management strategies for affected individuals.