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Jerbi A, Hachicha H, Feki S, Abida O, Bahloul E, Sellami K, Bouzid A, Turki H, Masmoudi A, Masmoudi H. Autoantibodies against Desmoglein 1 and 3 in South Tunisian pemphigus. LA TUNISIE MEDICALE 2021; 99:992-999. [PMID: 35288901 PMCID: PMC8972175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Desmoglein (Dsg) 1 and 3 are the 2 major autoantigens in pemphigus foliaceus (PF) and pemphigus vulgaris (PV). AIM We aimed to determine anti-Dsg1 and 3 Abs'usefulness in the diagnosis of pemphigus and to assess the correlation of these antibodies (Abs) with clinical phenotype and disease activity in south Tunisian patients. METHODS We retrospectively analyzed 131 samples from 82 patients (52 with PF and 30 with PV) during follow-up. Anti-Dsg1 and 3 Abs were measured by ELISA. Consecutive anti-Dsg1 and 3 Abs were correlated with disease activity. Receiver operating characteristics (ROC) curve were calculated to determine anti-Dsg1 and 3 Abs'cut-offs with optimal sensitivity and specificity for disease activity. RESULTS Anti-Dsg1 and 3 levels were associated to in PF and PV patients respectively (p<0,001). Anti-Dsg1 and 3 Ab were associated with skin (95%) and mucosal (60%) lesions, respectively. A significant decrease of anti-Dsg1 Abs was observed in patients with PF in clinical remission (36 ± 62 U/mL; (p=0,04). No correlation was found between anti-Dsg3 Abs and the course of mucosal lesions in PV (p=0,3). During follow-up, anti-Dsg1 Abs correlated with relapses (177 ±60 U/mL ; p=0,04). The 161,5 U/mL cut-off for anti-Dsg1 Abs provided 100% specificity and 86,4% sensitivity in PF disease activity. The 30,7U/mL cut-off for anti-Dsg3 provided 89,5% sensitivity and 100% specificity in PV. CONCLUSIONS High anti-Dsg3 Abs values are not always associated with PV disease activity. Anti-Dsg1 Abs showed a closer relationship with skin activity in PS and should be therefore taken into account in management of pemphigus patients.
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Affiliation(s)
- Ameni Jerbi
- 1-Laboratoire d’Immunologie, CHU Habib Bourguiba Sfax, Tunisie / Faculté de médecine de Sfax
| | - Hend Hachicha
- 1-Laboratoire d’Immunologie, CHU Habib Bourguiba Sfax, Tunisie / Faculté de médecine de Sfax
| | - Sawsan Feki
- 1-Laboratoire d’Immunologie, CHU Habib Bourguiba Sfax, Tunisie / Faculté de médecine de Sfax
| | - Olfa Abida
- 1-Laboratoire d’Immunologie, CHU Habib Bourguiba Sfax, Tunisie / Faculté de médecine de Sfax
| | - Emna Bahloul
- 2-Service de Dermatologie, CHU Hedi CHAKER Sfax, Tunisie / Faculté de médecine de Sfax
| | - Khadija Sellami
- 2-Service de Dermatologie, CHU Hedi CHAKER Sfax, Tunisie / Faculté de médecine de Sfax
| | - Amina Bouzid
- 1-Laboratoire d’Immunologie, CHU Habib Bourguiba Sfax, Tunisie / Faculté de médecine de Sfax
| | - Hamida Turki
- 2-Service de Dermatologie, CHU Hedi CHAKER Sfax, Tunisie / Faculté de médecine de Sfax
| | - Abderrahmen Masmoudi
- 2-Service de Dermatologie, CHU Hedi CHAKER Sfax, Tunisie / Faculté de médecine de Sfax
| | - Hatem Masmoudi
- 1-Laboratoire d’Immunologie, CHU Habib Bourguiba Sfax, Tunisie / Faculté de médecine de Sfax
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Petzl-Erler ML. Beyond the HLA polymorphism: A complex pattern of genetic susceptibility to pemphigus. Genet Mol Biol 2020; 43:e20190369. [PMID: 32639508 PMCID: PMC7341728 DOI: 10.1590/1678-4685-gmb-2019-0369] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/06/2020] [Indexed: 12/16/2022] Open
Abstract
Pemphigus is a group of autoimmune bullous skin diseases that result in
significant morbidity. As for other multifactorial autoimmune disorders,
environmental factors may trigger the disease in genetically susceptible
individuals. The goals of this review are to summarize the state of knowledge
about the genetic variation that may affect the susceptibility and pathogenesis
of pemphigus vulgaris and pemphigus foliaceus – both the endemic and the
sporadic forms –, to compare and discuss the possible meaning of the
associations reported, and to propose recommendations for new research
initiatives. Understanding how genetic variants translate into pathogenic
mechanisms and phenotypes remains a mystery for most of the polymorphisms that
contribute to disease susceptibility. However, genetic studies provide a strong
foundation for further developments in this field by generating testable
hypotheses. Currently, results still have limited influence on disease
prevention and prognosis, drug development, and clinical practice, although the
perspectives for future applications for the benefit of patients are
encouraging. Recommendations for the continued advancement of our understanding
as to the impact of genetic variation on pemphigus include these partially
overlapping goals: (1) Querying the functional effect of genetic variants on the
regulation of gene expression through their impact on the nucleotide sequence of
cis regulatory DNA elements such as promoters and enhancers, the splicing of
RNA, the structure of regulatory RNAs and proteins, binding of these regulatory
molecules to regulatory DNA elements, and alteration of epigenetic marks; (2)
identifying key cell types and cell states that are implicated in pemphigus
pathogenesis and explore their functional genomes; (3) integrating structural
and functional genomics data; (4) performing disease-progression longitudinal
studies to disclose the causal relationships between genetic and epigenetic
variation and intermediate disease phenotypes; (5) understanding the influence
of genetic and epigenetic variation in the response to treatment and the
severity of the disease; (6) exploring gene-gene and genotype-environment
interactions; (7) developing improved pemphigus-prone and non-prone animal
models that are appropriate for research about the mechanisms that link
genotypes to pemphigus. Achieving these goals will demand larger samples of
patients and controls and multisite collaborations.
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Affiliation(s)
- Maria Luiza Petzl-Erler
- Laboratório de Genética Molecular Humana, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Masmoudi H, Abida O, Masmoudi A, Turki H. Update on immunogenetics of Tunisian endemic pemphigus foliaceus. J Leukoc Biol 2018; 105:257-265. [DOI: 10.1002/jlb.mr0318-132r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/19/2018] [Accepted: 11/13/2018] [Indexed: 01/15/2023] Open
Affiliation(s)
- Hatem Masmoudi
- Department of ImmunologyAutoimmunity and Immunogentics Resaerch UnitHabib Bourguiba HospitalUniversity of Sfax Sfax Tunisia
| | - Olfa Abida
- Department of ImmunologyAutoimmunity and Immunogentics Resaerch UnitHabib Bourguiba HospitalUniversity of Sfax Sfax Tunisia
| | | | - Hamida Turki
- Department of DermatologyHedi Chaker HospitalUniversity of Sfax Sfax Tunisia
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Saha M, Harman K, Mortimer NJ, Binda V, Black MM, Kondeatis E, Vaughan R, Groves RW. Sporadic pemphigus foliaceus and class II human leucocyte antigen allele associations in the white British and Indo-Asian populations in the UK. Clin Exp Dermatol 2018; 44:290-294. [PMID: 30280412 DOI: 10.1111/ced.13774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pemphigus foliaceus (PF) has both genetic and environmental susceptibility factors. Current data on human leucocyte antigen (HLA) in patients with sporadic PF are limited. AIM To better define the distribution of HLA alleles in patients with PF in the UK. METHODS We recruited 36 patients [26 of white British (WB) descent, 10 of Indo-Asian (IA) descent] with PF who were living in the UK and 159 ethnically matched normal controls, and analysed their class II HLA DRB1 and DQB1 allele distribution. RESULTS There was an increased frequency of DRB1*1404 in association with DQB1*0503 in IA patients with PF. The DRB1*04 allele group as a whole had an increased frequency (P < 0.001) in the WB patient group compared with controls. The alleles contributing to this significance were DRB1*0401 (P = 0.03) and DRB1*0404 (P < 0.01). CONCLUSION This is the largest HLA association study in sporadic PF from the UK to date. There appears to be a difference in PF susceptibility alleles between WB and IA patients, highlighting the importance of racial variation in genetic susceptibility to disease development.
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Affiliation(s)
- M Saha
- Department of Immunodermatology, St John's Institute of Dermatology, Kings College London, London, UK
| | - K Harman
- Department of Dermatology, University Hospitals Leicester, Leicester, UK
| | - N J Mortimer
- Department of Dermatology, University Hospitals Leicester, Leicester, UK
| | - V Binda
- Clinical Transplantation Laboratory, GSTS and MRC Centre for Transplantation, Kings College London, London, UK
| | - M M Black
- Department of Immunodermatology, St John's Institute of Dermatology, Kings College London, London, UK
| | - E Kondeatis
- Clinical Transplantation Laboratory, GSTS and MRC Centre for Transplantation, Kings College London, London, UK
| | - R Vaughan
- Clinical Transplantation Laboratory, GSTS and MRC Centre for Transplantation, Kings College London, London, UK
| | - R W Groves
- Department of Immunodermatology, St John's Institute of Dermatology, Kings College London, London, UK
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Jerbi A, Hachicha H, Feki S, Bahloul E, Sellami K, Abida O, Charfi S, Bouzid A, Sellami Boudawara T, Turki H, Masmoudi A, Masmoudi H. Pemphigus herpetiformis in South Tunisia: a clinical expression of pemphigus foliaceus? Int J Dermatol 2018; 57:1094-1101. [DOI: 10.1111/ijd.14139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 06/08/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Ameni Jerbi
- Immunology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
| | - Hend Hachicha
- Immunology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
| | - Sawsan Feki
- Immunology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
| | - Emna Bahloul
- Dermatology Department; Hedi Chaker Hospital; University of Sfax; Sfax Tunisia
| | - Khadija Sellami
- Dermatology Department; Hedi Chaker Hospital; University of Sfax; Sfax Tunisia
| | - Olfa Abida
- Immunology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
| | - Slim Charfi
- Pathology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
| | - Amina Bouzid
- Immunology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
| | | | - Hamida Turki
- Dermatology Department; Hedi Chaker Hospital; University of Sfax; Sfax Tunisia
| | | | - Hatem Masmoudi
- Immunology Department; Habib Bourguiba Hospital; University of Sfax; Sfax Tunisia
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Beltraminelli H, Kiprono S, Zuriel D, Swai B, Giabbani E, Grossmann H, Masenga J. Dermatopathology in sub-Saharan Africa: a systematic 5-year analysis of all histopathological diagnoses from the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania. J Eur Acad Dermatol Venereol 2014; 29:1370-5. [DOI: 10.1111/jdv.12877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/22/2014] [Indexed: 12/31/2022]
Affiliation(s)
- H. Beltraminelli
- University Clinic for Dermatology; Inselspital - Bern University Hospital; Bern Switzerland
- Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College; Moshi Tanzania
| | - S. Kiprono
- Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College; Moshi Tanzania
- Department of Dermatology; Provincial General Hospital; Kakamega Kenya
| | - D. Zuriel
- Pathology Department; University of Nairobi; Nairobi Kenya
| | - B. Swai
- Pathology Department at the Kilimanjaro Christian Medical University College; Moshi Tanzania
| | - E. Giabbani
- University Clinic for Dermatology; Inselspital - Bern University Hospital; Bern Switzerland
- Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College; Moshi Tanzania
| | - H. Grossmann
- Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College; Moshi Tanzania
| | - J.E. Masenga
- Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College; Moshi Tanzania
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Toumi A, Abida O, Ben Ayed M, Masmoudi A, Turki H, Masmoudi H. Cytokine gene polymorphisms in Tunisian endemic pemphigus foliaceus: a possible role of il-4 variants. Hum Immunol 2013; 74:658-65. [PMID: 23376457 DOI: 10.1016/j.humimm.2013.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 12/19/2012] [Accepted: 01/14/2013] [Indexed: 01/17/2023]
Abstract
Polymorphism in the genes of TH2 cytokines and/or theirs receptors can influence serum cytokine levels in and the switch to the pathologic IgG4 auto-antibodies. In order to underline the role of these genes in the aethiopathogenesis of Pemphigus Foliaceus, we conduct a familial and a case control studies including 80 Tunisian patients, 147 related subjects and 160 matched healthy controls. We investigated, by PCR-RFLP technique, seven nucleotide polymorphisms: rs2243250 in promoter region of IL4 gene, rs47877948, rs3024530 and rs30246223 in the IL4R gene, rs1881457and rs205412 SNPs in IL13 gene and rs535036 in IL13RA2 gene. After Bonferroni adjustment, T allele and the TT genotype of IL4-590 were significantly increased in the PF patients group compared to healthy controls. This association was confirmed by the family study. Interestingly, the serum IL-4 levels were significantly increased in patients with the TT genotype compared to CT or CC genotypes. Interestingly, the IL4/IL13:T-A-C haplotype exhibited a significant effect on PF susceptibility. In addition, a significant gene-gene interaction between the IL4/IL4R (TACA) significantly increases in PF patients as compared to controls. These findings assess the role of the IL4/IL4R axis in the aethiopathogenesis of Tunisian endemic PF by the induction of a high transcriptional activity which could enhance the T-cell balance and inducing immunoglobulin isotype switching.
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Affiliation(s)
- Amina Toumi
- Immunology Department, Habib Bourguiba University Hospital, Sfax, Tunisia.
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MICHENKO AV, ZNAMENSKAYA LF, LVOV AN, VOLKOV IA, FRIGO NV, VOLNUKHIN VA. Pemphigus pathogenesis: problems and prospects. VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Provides the survey of most prospective trends of research of the pathogenesis of the true acantholytic pemphigus. Cites key results of studies of factors of genetic predisposition to the development of this bullous dermatosis. Highlights problems of studies of the role of antiself antibodies and self-antigens in pemphigus pathogenesis. Represents the apoptolyse theory, explaining mechanisms of the loss of link between keratinocytes. Discusses issues of the cellular regulation of autoimmune reactions at acantholytic pemphigus.
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Mejri K, Abida O, Kallel-Sellami M, Haddouk S, Laadhar L, Zarraa IR, Ben Ayed M, Zitouni M, Mokni M, Lahmar H, Fezaa B, Turki H, Tron F, Masmoudi H, Makni S. Spectrum of autoantibodies other than anti-desmoglein in pemphigus patients. J Eur Acad Dermatol Venereol 2010; 25:774-81. [PMID: 21029209 DOI: 10.1111/j.1468-3083.2010.03859.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pemphigus is a life-threatening autoimmune blistering disease mediated by autoantibodies against adhesion molecule of the skin. Its concurrence with systemic and organ-specific autoimmune disease was described in case reports. OBJECTIVES To evaluate the presence of a broad spectrum of organ-specific and non-organ-specific autoantibodies other than anti-desmoglein antibodies in pemphigus patients. PATIENTS AND METHODS Serum samples were obtained from 105 pemphigus foliaceus (PF) patients, 51 pemphigus vulgaris (PV) patients and 50 controls. Both indirect immunofluorescence assay and ELISA were used to assess the presence of autoantibodies related to connective tissue diseases, autoimmune hepatitis, vasculitis, rheumatoid arthritis, coeliac disease, diabetes and thyroiditis. RESULTS Significant difference was observed between the three groups for anti-thyroglobulin antibodies in the pemphigus foliaceus group (18% vs. 4%, P=0.03). A significantly higher occurrence of IgM anti-cardiolipin (P=0.03), IgG anti-reticulin (P=0.01) and IgG anti-gliadin antibodies (P=0.008) were observed in the PV group. Cases with more than four autoantibodies were frequently positives for both anti-desmoglein 1 and anti-desmoglein 3. CONCLUSION Autoantibodies other than anti-desmoglein antibodies are not rare in pemphigus patients. Clinical and serological follow-up of pemphigus patients with positive autoantibodies are needed to clarify their impact in disease evolution.
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Affiliation(s)
- K Mejri
- Immunology Department, La Rabta Hospital, Sfax, Tunisia
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Abida O, Zitouni M, Kallel-Sellami M, Mahfoudh N, Kammoun A, Ben Ayed M, Masmoudi A, Mokni M, Fezzaa B, Ben Osman A, Kammoun M, Turki H, Makni H, Gilbert D, Joly P, Tron F, Makni S, Masmoudi H. Tunisian endemic pemphigus foliaceus is associated with the HLA-DR3 gene: anti-desmoglein 1 antibody-positive healthy subjects bear protective alleles. Br J Dermatol 2009; 161:522-7. [DOI: 10.1111/j.1365-2133.2009.09207.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tron F, Gilbert D, Joly P, Mouquet H, Drouot L, Ayed MB, Sellami M, Masmoudi H, Makni S. Immunogenetics of pemphigus: An update. Autoimmunity 2009; 39:531-9. [PMID: 17101496 DOI: 10.1080/08916930600971497] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pemphigus are rare but informative models of organ-specific autoimmune diseases, resulting from the interplay of environmental, genetic and stochastic factors. There are many arguments to consider that pemphigus have a genetic basis involving, as many other autoimmune diseases, several different genes with additive or synergistic effects. So far, the unique strategy used to identify the contributive loci has been direct analysis of candidate genes through conventional case-control association studies. The major histocompatibility complex in particular the class II locus was demonstrated to be associated with pemphigus with a high rate of replicability. The progresses in the understanding of pemphigus physiopathology and the development of new molecular tools offer new perspectives to unveiled the genetic basis of this group of autoimmune blistering diseases, as shown by recent studies of candidate genes expressed at different levels of the autoimmune process.
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Affiliation(s)
- François Tron
- Faculté de Médicine et de Pharmacie, INSERM U519, Université de Rouen, Rouen, France
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Mejri K, Kallel-Sellami M, Petit-Teixeira E, Abida O, Mbarek H, Zitouni M, Ben Ayed M, Teixeira VH, Mokni M, Fazza B, Turki H, Tron F, Gilbert D, Masmoudi H, Cornelis F, Makni S. PTPN22 R620W polymorphism is not associated with pemphigus. Br J Dermatol 2007; 157:1068-9. [PMID: 17854359 DOI: 10.1111/j.1365-2133.2007.08170.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Masmoudi A, Cheikhrouhou H, Frigui F, Abida O, Ben Ayed M, Lehyani N, Amouri M, Masmoudi H, Makni H, Zahaf A, Turki H. Dermatoses bulleuses auto-immunes multiples dans une même famille. Ann Dermatol Venereol 2007; 134:572-3. [PMID: 17657188 DOI: 10.1016/s0151-9638(07)89273-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Petzl-Erler ML, Malheiros D. Pemphigus foliaceus and desmoglein 1 gene polymorphism: is there any relationship? J Autoimmun 2005; 25:121-5. [PMID: 16242304 DOI: 10.1016/j.jaut.2005.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2005] [Revised: 08/31/2005] [Accepted: 08/31/2005] [Indexed: 11/23/2022]
Abstract
Transmembrane proteins of the cadherin superfamily, the desmogleins and desmocollins, mediate intercellular adhesion in desmosomes. Autoantibodies to desmoglein 1 (dsg1) are a hallmark of pemphigus foliaceus (PF), a disease characterized by skin blistering resulting from keratinocyte cell detachment. The etiology and pathogenesis of this disease remain poorly understood; however, genetic susceptibility is clearly involved. The aim of this study was to verify if genetic variants of dsg1 influence susceptibility/resistance to endemic PF (fogo selvagem). Two single nucleotide polymorphisms (SNPs) were analyzed: 809 (C,T), a synonymous variation, and 1660 (A,C), a tyrosine<-->serine variation in the fifth extracellular domain. Allelic, haplotypic and genotypic frequencies did not differ significantly between the patient (n=134) and the control (n=227) population samples. Moreover, there is no evidence of interaction between the DSG1 and the HLA-DRB1 and IL6 genes, whose alleles had been found associated with differential susceptibility to PF. The results of this study agree with the described and predicted B- and T-cell epitopes of the dsg1 molecule, which seemingly are not affected by the allelic variation. We conclude that genetic diversity of the autoantigen dsg1 is not a major factor for PF pathogenesis in the Brazilian population.
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Affiliation(s)
- Maria Luiza Petzl-Erler
- Human Molecular Genetics Laboratory, Department of Genetics, Federal University of Paraná, Caixa Postal 19071, 81531-990 Curitiba, Brazil.
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Tron F, Gilbert D, Mouquet H, Joly P, Drouot L, Makni S, Masmoudi H, Charron D, Zitouni M, Loiseau P, Ben Ayed M. Genetic factors in pemphigus. J Autoimmun 2005; 24:319-28. [PMID: 15869862 DOI: 10.1016/j.jaut.2005.03.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2004] [Revised: 02/23/2005] [Accepted: 03/15/2005] [Indexed: 12/20/2022]
Abstract
Epidemiological studies performed in different ethnic populations and family studies, notably based on a partial phenotype of the autoimmune process, indicate that genetic factors are involved in the occurrence of pemphigus. However, the precise heritability remains uncertain in the absence of twin concordance rate studies. Among the different strategies available to identify genetic factors participating in autoimmune disease susceptibility, only population studies based on case-control design have been performed in pemphigus. These studies consistently showed that MHC locus, in particular HLA class II alleles, are associated with pemphigus vulgaris and pemphigus foliaceus. Other genes of the MHC locus may also participate in disease susceptibility as shown by studies using microsatellite markers across different regions of the MHC. It is likely that other non-MHC genes are involved in the pathogenesis of pemphigus. In particular, involvement of a polymorphic variant of desmoglein 1 gene was shown to be associated with pemphigus foliaceus and to interact in an epistatic manner with MHC class II genes to contribute to the autoimmune process. Other candidate genes to which a role can be assigned in the disease pathogenesis should be considered to design case-control or family-based association studies. Genome scan studies which require a large number of multiplex families to reach statistical power, should also be considered in the endemic form of pemphigus foliaceus because of the high number of familial cases.
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Affiliation(s)
- François Tron
- Unité INSERM 519 - IFRMP 23, Hôpital Charles Nicolle, Faculté Mixte de Médecine et de Pharmacie, 22, Boulevard Gambetta, 76183 Rouen Cedex, France.
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