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Hiwa R, Ikari K, Ohmura K, Nakabo S, Matsuo K, Saji H, Yurugi K, Miura Y, Maekawa T, Taniguchi A, Yamanaka H, Matsuda F, Mimori T, Terao C. HLA-DRB1 Analysis Identified a Genetically Unique Subset within Rheumatoid Arthritis and Distinct Genetic Background of Rheumatoid Factor Levels from Anticyclic Citrullinated Peptide Antibodies. J Rheumatol 2018; 45:470-480. [PMID: 29419463 DOI: 10.3899/jrheum.170363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE HLA-DRB1 is the most important locus associated with rheumatoid arthritis (RA) and anticitrullinated protein antibodies (ACPA). However, fluctuations of rheumatoid factor (RF) over the disease course have made it difficult to define fine subgroups according to consistent RF positivity for the analyses of genetic background and the levels of RF. METHODS A total of 2873 patients with RA and 2008 healthy controls were recruited. We genotyped HLA-DRB1 alleles for the participants and collected consecutive data of RF in the case subjects. In addition to RF+ and RF- subsets, we classified the RF+ subjects into group 1 (constant RF+) and group 2 (seroconversion). We compared HLA-DRB1 alleles between the RA subsets and controls and performed linear regression analysis to identify HLA-DRB1 alleles associated with maximal RF levels. Omnibus tests were conducted to assess important amino acid positions. RESULTS RF positivity was 88%, and 1372 and 970 RF+ subjects were classified into groups 1 and 2, respectively. RF+ and RF- showed similar genetic associations to ACPA+ and ACPA- RA, respectively. We found that shared epitope (SE) was more enriched in group 2 than 1, p = 2.0 × 10-5, and that amino acid position 11 showed a significant association between 1 and 2, p = 2.7 × 10-5. These associations were independent of ACPA positivity. SE showed a tendency to be negatively correlated with RF titer (p = 0.012). HLA-DRB1*09:01, which reduces ACPA titer, was not associated with RF levels (p = 0.70). CONCLUSION The seroconversion group was shown to have distinct genetic characteristics. The genetic architecture of RF levels is different from that of ACPA.
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Affiliation(s)
- Ryosuke Hiwa
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Katsunori Ikari
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Koichiro Ohmura
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Shuichiro Nakabo
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Keitaro Matsuo
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Hiroh Saji
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Kimiko Yurugi
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Yasuo Miura
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Taira Maekawa
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Atsuo Taniguchi
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Hisashi Yamanaka
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Fumihiko Matsuda
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Tsuneyo Mimori
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Chikashi Terao
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA. .,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute.
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