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Achiron A, Falb R, Menascu S, Magalashvili D, Mandel M, Sonis P, Gurevich M. Deciphering the shift from benign to active relapsing-remitting multiple sclerosis: Insights into T regulatory cell dysfunction and apoptosis regulation. Neurobiol Dis 2024; 194:106475. [PMID: 38521093 DOI: 10.1016/j.nbd.2024.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/05/2024] [Accepted: 03/17/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Relapsing-remitting multiple sclerosis (RRMS), a common demyelinating disease among young adults, follows a benign course in 10-15% of cases, where patients experience minimal neurological disability for a decade following disease onset. However, there is potential for these benign cases to transition into a clinically active, relapsing state. OBJECTIVE To elucidate the biological mechanisms underlying the transition from benign to active RRMS using gene expression analysis. METHODS We employed complementary-DNA microarrays to examine peripheral-blood gene expression patterns in patients with benign MS, defined as having a disease duration exceeding 10 years and an Expanded Disability Status Scale (EDSS) score of ≤3.0. We compared the gene expression pattern between patients who switched to active disease (Switching BMS) with those who maintained a benign state (Permanent-BMS) during an additional 5-year follow-up. RESULTS We identified two primary mechanisms linked to the transition from benign MS to clinically active disease. The first involves the suppression of regulatory T cell activity, and the second pertains to the dysfunction of nuclear receptor 4 A family-dependent apoptosis. These mechanisms collectively contribute to an augmented autoimmune response and increased disease activity. CONCLUSIONS The intricate gene regulatory networks that operate in switching-BMS are related to suppression of immune tolerance and aberrant apoptosis. These findings may lead to new therapeutic targets to prevent the escalation to active disease.
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Affiliation(s)
- Anat Achiron
- Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Rina Falb
- Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel
| | - Shay Menascu
- Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Mathilda Mandel
- Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel
| | - Polina Sonis
- Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel
| | - Michael Gurevich
- Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Beecham AH, Amezcua L, Chinea A, Manrique CP, Gomez L, Martinez A, Beecham GW, Patsopoulos NA, Chitnis T, Weiner HL, De Jager PL, Burchard EG, Lund BT, Fitzgerald KC, Calabresi PA, Delgado SR, Oksenberg JR, McCauley JL. Ancestral risk modification for multiple sclerosis susceptibility detected across the Major Histocompatibility Complex in a multi-ethnic population. PLoS One 2022; 17:e0279132. [PMID: 36548255 PMCID: PMC9778564 DOI: 10.1371/journal.pone.0279132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
The Major Histocompatibility Complex (MHC) makes the largest genetic contribution to multiple sclerosis (MS) susceptibility, with 32 independent effects across the region explaining 20% of the heritability in European populations. Variation is high across populations with allele frequency differences and population-specific risk alleles identified. We sought to identify MHC-specific MS susceptibility variants and assess the effect of ancestral risk modification within 2652 Latinx and Hispanic individuals as well as 2435 Black and African American individuals. We have identified several novel susceptibility alleles which are rare in European populations including HLA-B*53:01, and we have utilized the differing linkage disequilibrium patterns inherent to these populations to identify an independent role for HLA-DRB1*15:01 and HLA-DQB1*06:02 on MS risk. We found a decrease in Native American ancestry in MS cases vs controls across the MHC, peaking near the previously identified MICB locus with a decrease of ~5.5% in Hispanics and ~0.4% in African Americans. We have identified several susceptibility variants, including within the MICB gene region, which show global ancestry risk modification and indicate ancestral differences which may be due in part to correlated environmental factors. We have also identified several susceptibility variants for which MS risk is modified by local ancestry and indicate true ancestral genetic differences; including HLA-DQB1*06:02 for which MS risk for European allele carriers is almost two times the risk for African allele carriers. These results validate the importance of investigating MS susceptibility at an ancestral level and offer insight into the epidemiology of MS phenotypic diversity.
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Affiliation(s)
- Ashley H. Beecham
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Dr. John T. Macdonald Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Lilyana Amezcua
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Angel Chinea
- San Juan MS Center, Guaynabo, Puerto Rico, United States of America
| | - Clara P. Manrique
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Lissette Gomez
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Andrea Martinez
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Gary W. Beecham
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Dr. John T. Macdonald Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Nikolaos A. Patsopoulos
- Ann Romney Center for Neurological Diseases, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Tanuja Chitnis
- Ann Romney Center for Neurological Diseases, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Howard L. Weiner
- Ann Romney Center for Neurological Diseases, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Philip L. De Jager
- Center For Translational & Computational Neuroimmunology and the Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Esteban G. Burchard
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Brett T. Lund
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Kathryn C. Fitzgerald
- Department of Neurology and The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Peter A. Calabresi
- Department of Neurology and The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Silvia R. Delgado
- Multiple Sclerosis Division, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Jorge R. Oksenberg
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States of America
| | - Jacob L. McCauley
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Dr. John T. Macdonald Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL, United States of America
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Santos E, Bettencourt A, Duarte S, Gabriel D, Oliveira V, da Silva AM, Costa PP, Lopes C, Gonçalves G, da Silva BM, Leite MI. Refractory myasthenia gravis: Characteristics of a portuguese cohort. Muscle Nerve 2019; 60:188-191. [DOI: 10.1002/mus.26507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Ernestina Santos
- Neurology Department, Centro Hospitalar Universitário do PortoHospital de Santo António Largo Prof Abel Salazar, 4099‐001 Porto Portugal
- Unit for Multidisciplinary Research in BiomedicineInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
| | - Andreia Bettencourt
- Unit for Multidisciplinary Research in BiomedicineInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
- Immunogenetics LaboratoryInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
| | - Sara Duarte
- Neurology Department, Centro Hospitalar Universitário do PortoHospital de Santo António Largo Prof Abel Salazar, 4099‐001 Porto Portugal
| | - Denis Gabriel
- Neurology Department, Centro Hospitalar Universitário do PortoHospital de Santo António Largo Prof Abel Salazar, 4099‐001 Porto Portugal
| | - Vanessa Oliveira
- Neurology Department, Centro Hospitalar Universitário do PortoHospital de Santo António Largo Prof Abel Salazar, 4099‐001 Porto Portugal
| | - Ana Martins da Silva
- Neurology Department, Centro Hospitalar Universitário do PortoHospital de Santo António Largo Prof Abel Salazar, 4099‐001 Porto Portugal
- Unit for Multidisciplinary Research in BiomedicineInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
| | - Paulo Pinho Costa
- Unit for Multidisciplinary Research in BiomedicineInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
- Immunogenetics LaboratoryInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
- Instituto Nacional de Saúde Dr. Ricardo Jorge Porto Portugal
| | - Carlos Lopes
- Unit for Multidisciplinary Research in BiomedicineInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
| | - Guilherme Gonçalves
- Unit for Multidisciplinary Research in BiomedicineInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
| | - Berta Martins da Silva
- Immunogenetics LaboratoryInstituto de Ciências Biomédicas Abel Salazar–Universidade do Porto Porto Portugal
| | - Maria Isabel Leite
- Nuffield Department of Clinical NeurosciencesOxford University Hospitals and University of Oxford Oxford UK
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Anti-Myelin Oligodendrocyte Glycoprotein and Human Leukocyte Antigens as Markers in Pediatric and Adolescent Multiple Sclerosis: on Diagnosis, Clinical Phenotypes, and Therapeutic Responses. Mult Scler Int 2018; 2018:8487471. [PMID: 30595920 PMCID: PMC6282147 DOI: 10.1155/2018/8487471] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/19/2018] [Accepted: 11/07/2018] [Indexed: 12/17/2022] Open
Abstract
Early-onset (pediatric and adolescent) multiple sclerosis (MS) is a well-established demyelinating disease that accounts for approximately 3-5% of all MS cases. Thus, identifying potential biomarkers that can reflect the pathogenic mechanisms, disease course and prognosis, and therapeutic response in such patients is of paramount importance. Myelin oligodendrocyte glycoprotein (MOG) has been regarded as a putative autoantigen and autoantibody target in patients with demyelinating diseases for almost three decades. However, recent studies have suggested that antibodies against MOG represent a distinct clinical entity of dominantly humoral profile, with a range of clinical phenotypes closely related to the age of onset, specific patterns of disease course, and responses to treatment. Furthermore, the major histocompatibility complex (MHC)—which has been regarded as the “gold standard” for attributing genetic burden in adult MS since the early 1970s—has also emerged as the primary genetic locus in early-onset MS, particularly with regard to the human leukocyte antigen (HLA) alleles DRB1⁎1501 and DRB1⁎0401. Recent studies have investigated the potential interactions among HLA, MOG, and environmental factors, demonstrating that early-onset MS is characterized by genetic, immunogenetic, immunological, and familial trait correlations. In this paper, we review recent evidence regarding HLA-genotyping and MOG antibodies—the two most important candidate biomarkers for early-onset MS—as well as their potential application in the diagnosis and treatment of MS.
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Čierny D, Lehotský J, Kantorová E, Sivák Š, Javor J, Kurča E, Dobrota D, Michalik J. The HLA-DRB1 and HLA-DQB1 alleles are associated with multiple sclerosis disability progression in Slovak population. Neurol Res 2018; 40:607-614. [PMID: 29619906 DOI: 10.1080/01616412.2018.1456711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of our present study was to analyse the association of HLA-DRB1 and -DQB1 alleles and genotypes with Multiple Sclerosis (MS) disability progression in a cohort of Central European Slovak population. METHODS The allele and genotype variants were analyzed in 282 non-related MS patients. Rate of disease disability progression was evaluated using EDSS score in the 5th, 7th, 10th, and 15th year of disease duration, time to reach EDSS score 3 and 5, and MSSS score. Genotyping was performed by polymerase chain reaction with sequence-specific primers. RESULTS We found that carriers of homozygous genotype for alleles DRB1*15 and DQB1*03 reached EDSS score 3 significantly earlier than non-carriers of these alleles (p = 0.0172; p = 0.00183, respectively). Genotype DQB1*03/03 carriage was also associated with significantly reduced time to reach EDSS score 5 (p = 0.00316). Lower EDSS score in the 5th year of disease duration was found in carriers of DRB1*07 allele (p cor = 0.028). When MSSS score was used, genotype DRB1*15/15 was found to be less frequent in slow progressing MS patients, when compared to MS patients with mid-rate and rapid disease disability progression (p cor = 0.0305). DISCUSSION We showed for the first time that HLA-DRB1 and -DQB1 genotypes are genetic markers associated with disability progression in Slovak MS patients. Genotypes DRB1*15/15 and DQB1*03/*03 were identified as short-term clinical negative prognostic factors, while allele DRB1*07 carriage appeared to be a positive prognostic marker of better MS outcome.
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Affiliation(s)
- Daniel Čierny
- a Jessenius Faculty of Medicine, Department of Clinical Biochemistry , Comenius University in Bratislava and University Hospital Martin , Martin , Slovak Republic
| | - Ján Lehotský
- b Jessenius Faculty of Medicine in Martin, Department of Medical Biochemistry and BioMed , Comenius University in Bratislava , Martin , Slovak Republic
| | - Ema Kantorová
- c Jessenius Faculty of Medicine, Clinic of Neurology , Comenius University in Bratislava and University Hospital Martin , Martin , Slovak Republic
| | - Štefan Sivák
- c Jessenius Faculty of Medicine, Clinic of Neurology , Comenius University in Bratislava and University Hospital Martin , Martin , Slovak Republic
| | - Juraj Javor
- d Faculty of Medicine, Institute of Immunology , Comenius University in Bratislava , Bratislava , Slovak Republic
| | - Egon Kurča
- c Jessenius Faculty of Medicine, Clinic of Neurology , Comenius University in Bratislava and University Hospital Martin , Martin , Slovak Republic
| | - Dušan Dobrota
- a Jessenius Faculty of Medicine, Department of Clinical Biochemistry , Comenius University in Bratislava and University Hospital Martin , Martin , Slovak Republic.,b Jessenius Faculty of Medicine in Martin, Department of Medical Biochemistry and BioMed , Comenius University in Bratislava , Martin , Slovak Republic
| | - Jozef Michalik
- c Jessenius Faculty of Medicine, Clinic of Neurology , Comenius University in Bratislava and University Hospital Martin , Martin , Slovak Republic
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6
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Fabis-Pedrini MJ, James I, Seewann A, Yau WY, van de Bovenkamp AA, Sanders FRK, Qiu W, Burton J, Mastaglia FL, Carroll WM, Kermode AG. Natural history of benign multiple sclerosis: Clinical and HLA correlates in a Western Australian cohort. J Neurol Sci 2018; 388:12-18. [PMID: 29627005 DOI: 10.1016/j.jns.2018.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Benign multiple sclerosis (BMS) is a controversial term that has been used for MS patients with minimal disability decades after disease onset. Herein, we evaluated disease status after 20 years in a Western Australian cohort defined as BMS based on an Expanded Disability Status Scale (EDSS) score ≤ 3.0 at 10 years from onset. METHODS MS patients with an EDSS score ≤ 3.0 at 10 years from onset and minimum of 20 years follow up were included in the study. The 20-year EDSS score was considered the primary outcome. Associations with demographic and clinical characteristics and HLA-DRB1 genotype were investigated. RESULTS Among 120 patients with a benign course at 10 years, 78 (65%) remained benign at the 20-year follow up, but patients with an EDSS ≥ 2.5 were more likely to go on to develop more severe disability in the next decade. When considering factors associated with an increase in EDSS score ≤ 1 from 10 to 20 years, indicating limited progression, apart from the EDSS score at 10 years, poly-symptomatic presentation (p = 0.004) and cerebellar/brainstem mono-symptomatic presentation (p = 0.016) were independently associated with more rapid progression compared with other mono-symptomatic presentations. Carriage of the high risk HLA-DRB1*1501 allele was marginally associated with slower progression. CONCLUSIONS In this geographically isolated MS cohort of predominantly Anglo-Celtic origin clinical progression in the benign MS group was similar to that in other published series from Western countries. These results are in keeping with the view that patients labeled as benign MS are part of a heterogeneous continuum of disease progression and do not possess unique clinical characteristics. Possible genetic determinants of a benign course warrant further investigation.
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Affiliation(s)
- Marzena J Fabis-Pedrini
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Ian James
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia
| | - Alexandra Seewann
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Wai Y Yau
- Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Arnold A van de Bovenkamp
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Fay R K Sanders
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Wei Qiu
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Jason Burton
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - William M Carroll
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Allan G Kermode
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia; Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia.
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Bjelobaba I, Begovic-Kupresanin V, Pekovic S, Lavrnja I. Animal models of multiple sclerosis: Focus on experimental autoimmune encephalomyelitis. J Neurosci Res 2018; 96:1021-1042. [PMID: 29446144 DOI: 10.1002/jnr.24224] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/15/2018] [Accepted: 01/25/2018] [Indexed: 12/15/2022]
Abstract
Multiple sclerosis (MS) is a chronic, progressive disorder of the central nervous system (CNS) that affects more than two million people worldwide. Several animal models resemble MS pathology; the most employed are experimental autoimmune encephalomyelitis (EAE) and toxin- and/or virus-induced demyelination. In this review we will summarize our knowledge on the utility of different animal models in MS research. Although animal models cannot replicate the complexity and heterogeneity of the MS pathology, they have proved to be useful for the development of several drugs approved for treatment of MS patients. This review focuses on EAE because it represents both clinical and pathological features of MS. During the past decades, EAE has been effective in illuminating various pathological processes that occur during MS, including inflammation, CNS penetration, demyelination, axonopathy, and neuron loss mediated by immune cells.
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Affiliation(s)
- Ivana Bjelobaba
- Institute for Biological Research "Sinisa Stankovic," Department of Neurobiology, University of Belgrade, Belgrade, Serbia
| | | | - Sanja Pekovic
- Institute for Biological Research "Sinisa Stankovic," Department of Neurobiology, University of Belgrade, Belgrade, Serbia
| | - Irena Lavrnja
- Institute for Biological Research "Sinisa Stankovic," Department of Neurobiology, University of Belgrade, Belgrade, Serbia
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Bettencourt A, Boleixa D, Guimarães AL, Leal B, Carvalho C, Brás S, Samões R, Santos E, Costa PP, Silva B, da Silva AM. The vitamin D receptor gene FokI polymorphism and Multiple Sclerosis in a Northern Portuguese population. J Neuroimmunol 2017; 309:34-37. [DOI: 10.1016/j.jneuroim.2017.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/04/2017] [Accepted: 05/10/2017] [Indexed: 02/07/2023]
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9
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Amezcua L. MS in self-identified Hispanic/Latino individuals living in the US. Mult Scler J Exp Transl Clin 2017; 3:2055217317725103. [PMID: 28979795 PMCID: PMC5617095 DOI: 10.1177/2055217317725103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/07/2017] [Indexed: 12/26/2022] Open
Abstract
Self-identified Hispanic/Latino individuals living with multiple sclerosis (MS) in the continental United States (US) are a diverse group that represents different cultural and ancestral backgrounds. A marked variability in the way MS affects various subgroups of Hispanics in the US has been observed. We reviewed and synthesized available data about MS in Hispanics in the US. There are likely a host of multifactorial elements contributing to these observations that could be explained by genetic, environmental, and social underpinnings. Barriers to adequate MS care in Hispanics are likely to include delivery of culturally competent care and social and economic disadvantages. Considerable efforts, including the formation of a national consortium known as the Alliance for Research in Hispanic Multiple Sclerosis (ARHMS), are underway to help further explore these various factors.
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Affiliation(s)
- Lilyana Amezcua
- Department of Neurology, University of Southern California, Keck School of Medicine, USA
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11
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Yaldizli Ö, Sethi V, Pardini M, Tur C, Mok KY, Muhlert N, Liu Z, Samson RS, Wheeler-Kingshott CAM, Yousry TA, Houlden H, Hardy J, Miller DH, Chard DT. HLA-DRB*1501 associations with magnetic resonance imaging measures of grey matter pathology in multiple sclerosis. Mult Scler Relat Disord 2016; 7:47-52. [PMID: 27237756 DOI: 10.1016/j.msard.2016.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/04/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The HLA-DRB*1501 haplotype influences the risk of developing multiple sclerosis (MS), but it is not known how it affects grey matter pathology. AIM To assess HLA-DRB(*)1501 effects on magnetic resonance imaging (MRI) cortical grey matter pathology. METHODS Whole and lesional cortical grey matter volumes, lesional and normal-appearing grey matter magnetization transfer ratio were measured in 85 people with MS and 36 healthy control subjects. HLA-DRB(*)1501 haplotype was determined by genotyping (rs3135388). RESULTS No significant differences were observed in MRI measures between the HLA-DRB(*)1501 subgroups. CONCLUSIONS The HLA-DRB(*)1501 haplotype is not strongly associated with MRI-visible grey matter pathology.
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Affiliation(s)
- Özgür Yaldizli
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; Department of Neurology, University Hospital Basel, Basel, Switzerland.
| | - Varun Sethi
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | - Matteo Pardini
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Carmen Tur
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; MS Centre of Catalonia (Cemcat), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Kin Y Mok
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK; Division of Life Science, Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Nils Muhlert
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; School of Psychology and Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK; School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Zheng Liu
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Rebecca S Samson
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
| | | | - Tarek A Yousry
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK; Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - John Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - David H Miller
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Declan T Chard
- Queen Square MS Centre NMR Research Unit, Department of Neuroinflammation, UCL Institute of Neurology, London, UK; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
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12
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The Protective Role of HLA-DRB1(∗)13 in Autoimmune Diseases. J Immunol Res 2015; 2015:948723. [PMID: 26605347 PMCID: PMC4641944 DOI: 10.1155/2015/948723] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 10/20/2015] [Indexed: 12/23/2022] Open
Abstract
Autoimmune diseases (AIDs) are characterized by a multifactorial aetiology and a complex genetic background, with the MHC region playing a major role. We genotyped for HLA-DRB1 locus 1228 patients with AIDs-213 with Systemic Lupus Erythematosus (SLE), 166 with Psoriasis or Psoriatic Arthritis (Ps + PsA), 153 with Rheumatoid Arthritis (RA), 67 with Systemic Sclerosis (SSc), 536 with Multiple Sclerosis (MS), and 93 with Myasthenia Gravis (MG) and 282 unrelated controls. We confirmed previously established associations of HLA-DRB1∗15 (OR = 2.17) and HLA-DRB1∗03 (OR = 1.81) alleles with MS, HLA-DRB1∗03 with SLE (OR = 2.49), HLA-DRB1∗01 (OR = 1.79) and HLA-DRB1∗04 (OR = 2.81) with RA, HLA-DRB1∗07 with Ps + PsA (OR = 1.79), HLA-DRB1∗01 (OR = 2.28) and HLA-DRB1∗08 (OR = 3.01) with SSc, and HLA-DRB1∗03 with MG (OR = 2.98). We further observed a consistent negative association of HLA-DRB1∗13 allele with SLE, Ps + PsA, RA, and SSc (18.3%, 19.3%, 16.3%, and 11.9%, resp., versus 29.8% in controls). HLA-DRB1∗13 frequency in the AIDs group was 20.0% (OR = 0.58). Although different alleles were associated with particular AIDs, the same allele, HLA-DRB1∗13, was underrepresented in all of the six diseases analysed. This observation suggests that this allele may confer protection for AIDs, particularly for systemic and rheumatic disease. The protective effect of HLA-DRB1∗13 could be explained by a more proficient antigen presentation by these molecules, favouring efficient clonal deletion during thymic selection.
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Paradela ER, Alves-Leon SV, Figueiredo ALS, Pereira VCSR, Malfetano F, Mansur LF, Scherpenhuijzen S, Agostinho LA, Rocha CF, Rueda-Lopes F, Gasparetto E, Paiva CLA. The CIITA genetic polymorphism rs4774*C in combination with the HLA-DRB1*15:01 allele as a putative susceptibility factor to multiple sclerosis in Brazilian females. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:283-8. [PMID: 25992516 DOI: 10.1590/0004-282x20150012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/09/2014] [Indexed: 11/21/2022]
Abstract
The objective of this study was to investigate the association between the HLA alleles at the DQA1, DQB1 and DRB1 loci, the CIITA genetic polymorphisms -168A/G and +1614G/C, and susceptibility to multiple sclerosis (MS) in a sample from Rio de Janeiro State, Brazil. Furthermore, we wished to determine whether any of these associations might be more significant in women compared with men. DNA samples from 52 relapsing-remitting MS (RRMS) patients and 126 healthy controls matched for sex and age were analyzed. We identified a significant HLA-DRB1*15:01-MS association that was female-specific (Odds Ratio (OR) = 4.78; p = 0.001). Furthermore, we observed that the +1614G/C mutation in combination with the HLA-DRB1*15:01 allele increased susceptibility to MS in females (OR = 4.55; p = 0.01). Together, these findings highlight the polygenic nature of MS.
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Affiliation(s)
- Eduardo R Paradela
- Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Soniza V Alves-Leon
- Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - André L S Figueiredo
- Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Valéria C S R Pereira
- Centro de Referência em Esclerose Múltipla e outras Doenças Inflamatórias Desmielinizantes do Sistema Nervoso Central,, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Fabíola Malfetano
- Centro de Referência em Esclerose Múltipla e outras Doenças Inflamatórias Desmielinizantes do Sistema Nervoso Central,, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Letícia F Mansur
- Centro de Referência em Esclerose Múltipla e outras Doenças Inflamatórias Desmielinizantes do Sistema Nervoso Central,, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Simone Scherpenhuijzen
- Centro de Referência em Esclerose Múltipla e outras Doenças Inflamatórias Desmielinizantes do Sistema Nervoso Central,, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana A Agostinho
- Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Catielly F Rocha
- Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Fernanda Rueda-Lopes
- Centro de Referência em Esclerose Múltipla e outras Doenças Inflamatórias Desmielinizantes do Sistema Nervoso Central,, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Emerson Gasparetto
- Centro de Referência em Esclerose Múltipla e outras Doenças Inflamatórias Desmielinizantes do Sistema Nervoso Central,, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Carmen L A Paiva
- Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Pandit L, Malli C, Singhal B, Wason J, Malik O, Sawcer S, Ban M, D’Cunha A, Mustafa S. HLA associations in South Asian multiple sclerosis. Mult Scler 2015; 22:19-24. [DOI: 10.1177/1352458515581439] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 03/15/2015] [Indexed: 11/16/2022]
Abstract
Background: Previous efforts to identify Human Leukocyte Antigen (HLA) gene associations with multiple sclerosis (MS) in the South Asian population have been underpowered. Aim: To identify the primary HLA class II alleles associated with MS in Indians. Methods: We typed HLA-DRB1, -DQA1 and -DQB1 in 419 patients and 451 unrelated controls by polymerase chain reaction using sequence specific oligonucleotide probes (PCR-SSOP). Results: At the gene level DRB1 showed significant evidence of association ( p=0.0000012), DQA1 showed only marginal evidence of association ( p=0.04) and there was no evidence for association at DQB1 ( p=0.26). At the DRB1 locus association is confirmed with the *15:01 ( p=0.00002) and the *03 ( p=0.00005) alleles. Conclusion: Our study confirms that the risk effects attributable to the HLA- DRB1*15:01and DRB1*03 alleles seen in Europeans are also seen in Indians. The absence of any evidence of association with DQB1 alleles reflects the lower linkage disequilibrium between DQB1 alleles and DRB1 risk alleles present in this population, and illustrates the potential value of fine mapping signals of association in different ethnic groups.
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Affiliation(s)
- Lekha Pandit
- Center for Advanced Neurological Research, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India
| | - Chaithra Malli
- Center for Advanced Neurological Research, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India
| | - Bhim Singhal
- Bombay Hospital and Research Center, Mumbai, India
| | - James Wason
- Medical Research Council Biostatistics Unit, Cambridge, UK
| | - Omar Malik
- Division of Brain Sciences, Imperial College London, UK
| | - Stephen Sawcer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Maria Ban
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anitha D’Cunha
- Center for Advanced Neurological Research, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India
| | - Sharik Mustafa
- Center for Advanced Neurological Research, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India
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15
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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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Bettencourt A, Silva AM, Carvalho C, Leal B, Santos E, Costa PP, Silva BM. The role of KIR2DS1 in multiple sclerosis--KIR in Portuguese MS patients. J Neuroimmunol 2014; 269:52-5. [PMID: 24529855 DOI: 10.1016/j.jneuroim.2014.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 01/16/2014] [Accepted: 01/21/2014] [Indexed: 12/13/2022]
Abstract
Killer Immunoglobulin-like Receptor (KIR) genes may influence both resistance and susceptibility to different autoimmune diseases, but their role in the pathogenesis of Multiple Sclerosis (MS) is still unclear. We investigated the influence of KIR genes on MS susceptibility in 447 MS Portuguese patients, and also whether genetic interactions between specific KIR genes and their HLA class I ligands could contribute to the pathogenesis of MS. We observed a negative association between the activating KIR2DS1 gene and MS (adjusted OR=0.450, p=0.030) independently from the presence of HLA-DRB1*15 allele. The activating KIR2DS1 receptor seems to confer protection against MS most probably through modulation of autoreactive T cells by Natural Killer cells.
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Affiliation(s)
- Andreia Bettencourt
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UPorto), Porto Portugal.
| | - Ana Martins Silva
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UPorto), Porto Portugal; Neurology Department, Centro Hospitalar do Porto - Hospital de Santo António (CHP-HSA), Porto, Portugal
| | - Cláudia Carvalho
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UPorto), Porto Portugal
| | - Bárbara Leal
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UPorto), Porto Portugal
| | - Ernestina Santos
- Neurology Department, Centro Hospitalar do Porto - Hospital de Santo António (CHP-HSA), Porto, Portugal
| | - Paulo P Costa
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UPorto), Porto Portugal; Instituto Nacional de Saúde Dr. Ricardo Jorge (INSA), Porto, Portugal
| | - Berta M Silva
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UPorto), Porto Portugal
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Ouadghiri S, El Alaoui Toussi K, Brick C, Ait Benhaddou E, Benseffaj N, Benomar A, El Yahyaoui M, Essakalli M. Genetic factors and multiple sclerosis in the Moroccan population: A role for HLA class II. ACTA ACUST UNITED AC 2013; 61:259-63. [DOI: 10.1016/j.patbio.2013.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 05/22/2013] [Indexed: 11/12/2022]
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18
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Myelin oligodendrocyte glycoprotein induces aquaporin-4 autoantibodies in mouse experimental autoimmune encephalomyelitis. J Neuroimmunol 2013; 261:1-6. [PMID: 23707078 DOI: 10.1016/j.jneuroim.2013.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 03/18/2013] [Accepted: 03/22/2013] [Indexed: 11/22/2022]
Abstract
To investigate whether AQP4 autoantibodies (AQP4-Ab) are causative for neuromyelitis optica (NMO), the production of AQP4-Ab and clinical experimental autoimmune encephalomyelitis (EAE) was investigated in mice administered with mouse AQP4 antigen or myelin oligodendrocyte glycoprotein (MOG35-55) alone, and in combination. Eight- to twelve-week-old female C57BL/6 mice were randomly immunized with encephalitogenic mixture containing 300 μg of MOG35-55 or AQP4 antigen alone, and in combination in complete Freund's adjuvant supplemented with H37Ra M. tuberculosis. The incidence of EAE, Weaver 15 scores, and body weight was evaluated. ELISA was used to detect serum mouse AQP4-Ab. Mice injected with MOG35-55 and MOG33-35 plus AQP4 antigen began to show EAE symptoms 12 days after immunization. The incidence of EAE was 91.6%, and 62.5%, for MOG35-55 alone and MOG33-35 plus AQP4 antigen groups, respectively, while AQP4 antigen alone didn't develop EAE. In all but the control group, serum AQP4-Ab levels were increased, and correlated positively with Weaver 15 score (rs=0.713, p=0.000) and negatively with body weight changes (rs=-0.415, p=0.011). Injection of human NMO sera positive for AQP4-Ab exacerbated MOG-induced EAE. Our results suggest that AQP4-Ab can be produced in MOG-induced MS model, and itself is not sufficient for the development of EAE, implying that NMO might be a subtype or transition from MS.
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Bettencourt A, Silva AM, Santos E, Gomes S, Mendonça D, Costa PP, Faustino P, Silva BM. HFE gene polymorphisms and severity in Portuguese patients with multiple sclerosis. Eur J Neurol 2011; 18:663-6. [PMID: 20586792 DOI: 10.1111/j.1468-1331.2010.03109.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND High iron concentrations have been reported in oligodendrocytes, myelin and macrophages in multiple sclerosis (MS) lesions. It has been proposed that HFE gene polymorphisms could have a role in MS. METHODS The C282Y and H63D HFE variants frequencies were determined in 373 patients with MS and compared with a normal population. RESULTS No significant association was found between HFE polymorphisms and disease susceptibility. An analysis of the association of genotypes with disease severity was performed, and the C282Y allele was more frequent in the aggressive group. CONCLUSIONS Patients carrying the C282Y variant seem to have a worse prognosis.
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Affiliation(s)
- A Bettencourt
- UMIB - Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UP), Porto, Portugal.
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20
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Abstract
As with susceptibility to disease, it is likely that multiple factors interact to influence the phenotype of multiple sclerosis and long-term disease outcomes. Such factors may include genetic factors, socioeconomic status, comorbid diseases, and health behaviors, as well as environmental exposures. An improved understanding of the influence of these factors on disease course may reap several benefits, such as improved prognostication, allowing us to tailor disease management with respect to intensity of disease-modifying therapies and changes in specific health behaviors, in the broad context of coexisting health issues. Such information can facilitate appropriately adjusted comparisons within and between populations. Elucidation of these factors will require careful study of well-characterized populations in which the roles of multiple factors are considered simultaneously.
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Affiliation(s)
- Ruth Ann Marrie
- University of Manitoba, Health Sciences Center, GF-533, 820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
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Depaz R, Granger B, Cournu-Rebeix I, Bouafia A, Fontaine B. Genetics for understanding and predicting clinical progression in multiple sclerosis. Rev Neurol (Paris) 2011; 167:791-801. [PMID: 21683424 DOI: 10.1016/j.neurol.2011.02.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 01/20/2011] [Accepted: 02/07/2011] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a dys-immune disease of the central nervous system with highly variable and unpredictable long-term outcome. STATE OF THE ART In the early 1970s association between HLA alleles and MS was established. Very recently, the power of Genome Wide Association Studies (GWAS) enabled the identification of several loci involved in immune functions as genetic risk factors in MS. Recent data suggest that common genetic variations might modulate the clinical phenotype of MS through a regulation of key pathophysiological pathways. PERSPECTIVES Identification of modifier genes might offer an opportunity to explore new relevant therapeutic targets and early prognostic markers. To date, studies of modifier genes in MS are numerous but results are still unclear. This research field may now benefit from large cohorts of patients available for association studies. CONCLUSION In this context, we propose a review of epidemiological and association studies of genetic modifying effect in MS.
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Affiliation(s)
- R Depaz
- Inserm, CNRS, Centre de Recherche de l'Institut Cerveau-Moelle, Hôpital Pitié-Salpêtrière, Université Pierre-et-Marie-Curie Paris-6, UMR 975-7225, 47, Boulevard de l'Hôpital 75013 Paris, France.
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Romero-Pinel L, Pujal JM, Martínez-Yélamos S, Gubieras L, Matas E, Bau L, Torrabadella M, Azqueta C, Arbizu T. HLA-DRB1: genetic susceptibility and disability progression in a Spanish multiple sclerosis population. Eur J Neurol 2011; 18:337-342. [PMID: 20629714 DOI: 10.1111/j.1468-1331.2010.03148.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The association of HLA-DRB1*15 with susceptibility to multiple sclerosis (MS) has been consistently reported although its effect on the clinical phenotype is still controversial. The objectives of this study are to investigate the influence of the HLA-DRB1 alleles on the genetic susceptibility to MS and to study their impact on disability progression in a Spanish population. METHODS HLA-DRB1 typing was performed by PCR-SSP in 380 patients with sporadic MS and 1088 unrelated healthy controls. Allelic frequencies were compared between groups. We studied the correlation between the different alleles and the progression of MS. RESULTS The HLA-DRB1*15 allele in patients with MS had a statistically significant higher frequency when compared with controls (18.9% in patients vs. 10.1% in controls, Odds ratio (OR)=2.07, 95% CI=1.64-2.60, P<0.001). In the univariate analysis, the DRB1*01 and DRB1*04 alleles were associated with a worse prognosis when considering the time to reach an EDSS of 6, whereas the DRB1*03 was correlated with a better outcome. In the multivariate analysis, the alleles*01 and *04 were demonstrated to be independent factors to have a worse prognosis. CONCLUSIONS HLA-DRB1*15 is associated with MS when comparing patients with unrelated healthy controls in a Spanish population. The HLA-DRB1*01 and HLA-DRB1*04 alleles are related to a worse prognosis when considering the time taken to reach severe disability.
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Affiliation(s)
- L Romero-Pinel
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
| | - J M Pujal
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
| | - S Martínez-Yélamos
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
| | - L Gubieras
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
| | - E Matas
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
| | - L Bau
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
| | - M Torrabadella
- Banc de cordó umbilical, Banc de sang i teixits, Barcelona, Spain
| | - C Azqueta
- Banc de cordó umbilical, Banc de sang i teixits, Barcelona, Spain
| | - T Arbizu
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL
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Relationship between HLA-DRB1 polymorphism and susceptibility or resistance to multiple sclerosis in Caucasians: a meta-analysis of non-family-based studies. Autoimmun Rev 2011; 10:474-81. [PMID: 21440682 DOI: 10.1016/j.autrev.2011.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 03/16/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify the contribution of HLA-DRB1 alleles to susceptibility or resistance to multiple sclerosis (MS) in Caucasians through a meta-analysis of non-family-based studies. METHODS A systematic review of case-control studies in Caucasians was performed. Studies examining allele or phenotype frequencies were analyzed separately. Odds ratio (OR) and 95% confidence intervals (CIs) were used. We also used the relatively predispositional effect (RPE) method to analyze several allele frequency studies to avoid skewed results due to some strongly associated alleles. RESULTS A total of 5464 cases and 7809 controls from 14 allele frequency studies and a total of 5401 cases and 7538 controls from 23 phenotype frequency studies were analyzed. DRB1*15 was definitely the strongest risk factor for MS (allele group, Pc<0.00013, OR 2.59, 95%CI 2.34-2.87; phenotype group, Pc<0.00013, OR 3.35, 95%CI 2.95-3.80). DRB1*03 frequencies were significantly increased among MS cases in the phenotype group (Pc= 0.0013, OR 1.21, 95%CI 1.09-1.33) but not in the allele group. DRB1*14 and DRB1*07 showed protective effects against MS in both groups (DRB1*14, allele group, Pc<0.00013, OR 0.53, 95%CI 0.42-0.66; phenotype group, Pc<0.00013, OR 0.57, 95%CI 0.45-0.71; DRB1*07, allele group, Pc<0.0026, OR 0.75, 95%CI 0.64-0.87; phenotype group, Pc<0.00013, OR 0.67, 95%CI 0.61-0.73). By RPE method, DRB1*14, and DRB1*07 showed protective effects after excluding DRB1*15 from the analysis. DRB1*03 was significantly higher in MS cases than controls after removing both DRB1*15 and DRB1*14. CONCLUSIONS In Caucasians, we highlighted the definite protective role of HLA-DRB1*14 and DRB1*07 for MS. DRB1*03 is probably the only risk factor for MS besides DRB1*15 and a common genetic foundation for autoimmune disease. Targeting to these alleles may have potential values in prevention or therapy for MS in the specific population.
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HLA class II alleles and multiple sclerosis in Tunisian patients. Clin Neurol Neurosurg 2010; 112:849-52. [DOI: 10.1016/j.clineuro.2010.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 03/11/2010] [Accepted: 07/07/2010] [Indexed: 11/19/2022]
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Romero-Pinel L, Pujal JM, Martínez-Yélamos S, Gubieras L, Matas E, Bau L, Torrabadella M, Azqueta C, Arbizu T. Epistasis between HLA-DRB1 parental alleles in a Spanish cohort with multiple sclerosis. J Neurol Sci 2010; 298:96-100. [PMID: 20810130 DOI: 10.1016/j.jns.2010.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 07/26/2010] [Accepted: 07/29/2010] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Multiple sclerosis (MS) has been consistently associated with the HLA-DR2 haplotype and particularly with the HLA-DRB1*15 allele. Epistatic interactions between both parental alleles in the DRB1 loci have been shown to modify the MS susceptibility risk. This study investigated the frequencies of various HLA-DRB1 genotypes, their impact on MS susceptibility and their correlation with the clinical severity in a Spanish population. METHODS A genotype was considered as the combination of the two parental DRB1 alleles. We compared the frequencies of the genotypes in a sporadic MS population (n=380) with those of an unrelated healthy control cohort (n=1088). We correlated the different genotypes with the age at onset, gender distribution, symptoms at onset, course of the disease and progression severity by means of the time to reach the progressive phase and EDSS scores of 3 and 6. RESULTS We found 81 different genotypes. There were four different MS-predisposing genotypes. Three of them contained the DRB1*15 allele (DRB1*03/15, DRB1*04/15, and DRB1*08/15) and the fourth was homozygote for the DRB1*03 allele. The highest odds ratio was found with the genotype DRB1*08/15 (OR=3.88, 95% CI=1.83-8.26, p<0.01), followed by DRB1*03/03 (OR=3.15, 95% CI=1.93-5.14, p<0.01), DRB1*03/15 (OR=2.72, 95% CI=1.88-3.94, p<0.01) and DRB1*04/15 (OR=2.54, 95% CI=1.64-3.98, p<0.01). The DRB1*01/04 and the DRB1*15/15 genotypes were associated with a shorter time to reach an EDSS score of 6. CONCLUSIONS Our results show the importance of epistatic interactions among the HLA-DRB1 alleles, modifying the risk for MS as well as its clinical severity.
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Affiliation(s)
- Lucía Romero-Pinel
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
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Wu XM, Chaodong Wang, Zhang KN, Lin AY, Kira JI, Hu GZ, Qu XH, Xiong YQ, Cao WF, Gong LY. Association of susceptibility to multiple sclerosis in Southern Han Chinese with HLA-DRB1, -DPB1 alleles and DRB1-DPB1 haplotypes: distinct from other populations. Mult Scler 2009; 15:1422-30. [PMID: 19965521 DOI: 10.1177/1352458509345905] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Association of HLA class II with multiple sclerosis (MS) has been widely studied in both Western and Oriental populations. However, such an association is not well documented in Chinese. The objective of this study was to examine the association between the susceptibility to conventional MS in Southern Chinese with HLA-DRB1,-DPB1 alleles and putative DRB1-DPB1 haplotypes. Genotyping of HLA-DRB1 and -DPB1 alleles was performed in 60 patients with conventional MS and 95 controls. Allele frequencies were compared between patients and controls to identify MSassociated alleles. Relative predisposing effect method was used to compare haplotype frequencies in patients and controls and to identify possible predisposing DRB1-DPB1 haplotypes, which were further examined for differences in haplotype carriage rates between the two groups. We found that the allele frequency of DRB1*1501 was not different between patients (18.3%) and controls (21.1%) ( p = 0.837). In contrast, frequency of the DPB1*0501 allele was significantly higher in patients (90%) than in controls (67.4%) (odds ratio = 4.36, p = 0.0013, pcorr = 0.025). DRB1-DPB1 linkage haplotype in patients (8.33%) was significantly higher than in controls (0%) ( p < 0.0001) and the carriage rate of this haplotype was significantly increased in patients (15%) as compared with controls (0%) ( p = 0.00013, pcorr = 0.003). Combined, these results suggest that HLA-DRB1*1501 is not associated with susceptibility to conventional MS in Southern Chinese. Instead, both the DPB1*0501 allele and the DRB1*1602- DPB1*0501 haplotype are strong predisposing factors for conventional MS in this population. Our results establish that the HLA profiles of MS in Southern Chinese are distinct from other populations.
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Affiliation(s)
- Xiao-Mu Wu
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Chaodong Wang
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Kun-Nan Zhang
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Ai-Yu Lin
- Department of Neurology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Jun-ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Guo-Zhu Hu
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Xin-Hui Qu
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Ying-Qiong Xiong
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Wen-Feng Cao
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
| | - Lin-Yun Gong
- Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, PR China
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Patrucco L, Larriba J, Redal MA, Rojas JI, Argibay PF, Cristiano E. HLA-DRB1 and multiple sclerosis in Argentina. Eur J Neurol 2009; 16:427-9. [PMID: 19364369 DOI: 10.1111/j.1468-1331.2008.02523.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The association of multiple sclerosis (MS) with HLA DR subtypes, and particularly human leukocyte antigen (HLA)-DRB1*15 has been a consistent finding across nearly all Caucasian MS populations. In South America, scarce data exist about this issue. As the complete characterization of the HLA association range around the world is important to understand the role of this locus in MS susceptibility, we analyzed the frequency of HLA-DRB1* allelic groups in an MS population in Argentina. METHODS HLA-DRB1 locus was genotyped using PCR and sequence-specific primer amplification in 61 MS patients born in Buenos Aires, Argentina and 1216 healthy controls. Allele frequencies were compared between groups. RESULTS The HLA-DRB1*15 allele frequency significantly differed between controls and patients (13.5% and 33.9% respectively, P < 0.001, OR 2.51, 95% CI: 1.7-3.0). The other allele frequencies did not show significant differences between patients and controls. CONCLUSIONS The present HLA class II population study is in accordance with other Caucasian MS surveys which have found that HLA-DRB1*15 allele is strongly associated with MS disease. In Argentina, this is the first study performed to analyze the association of HLA-DRB1*15 and MS susceptibility in a Caucasian population and therefore contributes with new data to the immunogenomic global MS map.
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Affiliation(s)
- L Patrucco
- MS Section, Hospital Italiano Buenos Aires, Argentina
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28
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Silva AM, Bettencourt A, Pereira C, Santos E, Carvalho C, Mendonça D, Costa PP, Monteiro L, Martins B. Protective role of the HLA–A*02 allele in Portuguese patients with multiple sclerosis. Mult Scler 2009; 15:771-4. [DOI: 10.1177/1352458509104588] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Multiple sclerosis (MS) is associated with human leukocyte antigen (HLA) HLA–DRB1*15. Recent evidence that CD8 T cells are implicated in MS suggests that HLA class I may also contribute. An association of HLA–A*02 and A*03 alleles has been described. Objectives We examined the influence of HLA–A*02 and HLA–A*03 in Portuguese patients with MS, independently of HLA–DRB1*15 using a logistic regression model. Conclusions DRB1*15 increased the risk of developing MS and HLA–A*02 decreased the risk. A*03 had no effect. To analyze if HLA–A*02 association was independent from DRB1*15, an interaction between these two alleles was introduced in the model; no significant interaction was found.
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Affiliation(s)
- AM Silva
- Departamento de Neurologia, Centro Hospitalar do Porto – Hospital de Santo António, Porto, Portugal
| | - A Bettencourt
- UMIB – Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UP), Porto, Portugal
| | - C Pereira
- UMIB – Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UP), Porto, Portugal
| | - E Santos
- Departamento de Neurologia, Centro Hospitalar do Porto – Hospital de Santo António, Porto, Portugal
| | - C Carvalho
- Unidade de Investigação, Centro de Genética Médica Jacinto de Magalhães, Porto, Portugal
| | - D Mendonça
- Departamento do estudo de populações, Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UP), Porto, Portugal
| | - PP Costa
- UMIB – Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UP), Porto, Portugal; Unidade de Investigação, Centro de Genética Médica Jacinto de Magalhães, Porto, Portugal
| | - L Monteiro
- Departamento de Neurologia, Centro Hospitalar do Porto – Hospital de Santo António, Porto, Portugal
| | - B Martins
- UMIB – Instituto de Ciências Biomédicas Abel Salazar (ICBAS-UP), Porto, Portugal; Unidade de Investigação, Centro de Genética Médica Jacinto de Magalhães, Porto, Portugal
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29
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Ramagopalan SV, Deluca GC, Degenhardt A, Ebers GC. The genetics of clinical outcome in multiple sclerosis. J Neuroimmunol 2008; 201-202:183-99. [PMID: 18632165 DOI: 10.1016/j.jneuroim.2008.02.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 02/11/2008] [Accepted: 02/11/2008] [Indexed: 11/18/2022]
Abstract
Multiple sclerosis (MS) is a common inflammatory disease of the central nervous system (CNS), the clinical course of which varies considerably between patients. Genetic complexity and interactions with as yet unknown environmental factors have hindered researchers from fully elucidating the aetiology of the disease. In addition to influencing disease susceptibility, epidemiological evidence suggests that genetic factors may affect phenotypic expression of the disease. Genes that affect clinical outcome may be more effective therapeutic targets than those which determine susceptibility. We present in this review a comprehensive survey of the genes (both MHC- and non-MHC-related) that have been investigated for their role in disease outcome in MS. Recent studies implicating the role of the genotype and epistatic interactions in the MHC in determining outcome are highlighted.
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30
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Fernando MMA, Stevens CR, Walsh EC, De Jager PL, Goyette P, Plenge RM, Vyse TJ, Rioux JD. Defining the role of the MHC in autoimmunity: a review and pooled analysis. PLoS Genet 2008; 4:e1000024. [PMID: 18437207 PMCID: PMC2291482 DOI: 10.1371/journal.pgen.1000024] [Citation(s) in RCA: 387] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The major histocompatibility complex (MHC) is one of the most extensively studied regions in the human genome because of the association of variants at this locus with autoimmune, infectious, and inflammatory diseases. However, identification of causal variants within the MHC for the majority of these diseases has remained difficult due to the great variability and extensive linkage disequilibrium (LD) that exists among alleles throughout this locus, coupled with inadequate study design whereby only a limited subset of about 20 from a total of approximately 250 genes have been studied in small cohorts of predominantly European origin. We have performed a review and pooled analysis of the past 30 years of research on the role of the MHC in six genetically complex disease traits - multiple sclerosis (MS), type 1 diabetes (T1D), systemic lupus erythematosus (SLE), ulcerative colitis (UC), Crohn's disease (CD), and rheumatoid arthritis (RA) - in order to consolidate and evaluate the current literature regarding MHC genetics in these common autoimmune and inflammatory diseases. We corroborate established MHC disease associations and identify predisposing variants that previously have not been appreciated. Furthermore, we find a number of interesting commonalities and differences across diseases that implicate both general and disease-specific pathogenetic mechanisms in autoimmunity.
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Affiliation(s)
- Michelle M. A. Fernando
- Section of Molecular Genetics and Rheumatology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Christine R. Stevens
- Program in Medical and Population Genetics, Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
| | - Emily C. Walsh
- Program in Medical and Population Genetics, Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
| | - Philip L. De Jager
- Program in Medical and Population Genetics, Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Department of Neurology, Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Harvard Medical School/Partners Healthcare Center for Genetics and Genomics, Boston, Massachusetts, United States of America
| | - Philippe Goyette
- Université de Montréal, Montréal Heart Institute, Montréal, Québec, Canada
| | - Robert M. Plenge
- Program in Medical and Population Genetics, Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Harvard Medical School, Division of Rheumatology, Allergy and Immunology, Boston, Massachusetts, United States of America
| | - Timothy J. Vyse
- Section of Molecular Genetics and Rheumatology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - John D. Rioux
- Program in Medical and Population Genetics, Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Université de Montréal, Montréal Heart Institute, Montréal, Québec, Canada
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