1
|
Howarth S, Sneddon G, Allinson KR, Razvi S, Mitchell AL, Pearce SHS. Replication of association at the LPP and UBASH3A loci in a UK autoimmune Addison's disease cohort. Eur J Endocrinol 2023; 188:lvac010. [PMID: 36651163 DOI: 10.1093/ejendo/lvac010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/21/2022] [Accepted: 11/30/2022] [Indexed: 01/13/2023]
Abstract
Autoimmune Addison's disease (AAD) arises from a complex interplay between multiple genetic susceptibility polymorphisms and environmental factors. The first genome wide association study (GWAS) with patients from Scandinavian Addison's registries has identified association signals at four novel loci in the genes LPP, SH2B3, SIGLEC5, and UBASH3A. To verify these novel risk loci, we performed a case-control association study in our independent cohort of 420 patients with AAD from the across the UK. We report significant association of alleles of the LPP and UBASH3A genes [odds ratio (95% confidence intervals), 1.46 (1.21-1.75)and 1.40 (1.16-1.68), respectively] with AAD in our UK cohort. In addition, we report nominal association of AAD with SH2B3 [OR 1.18 (1.02-1.35)]. We confirm that variants at the LPP and UBASH3A loci confer susceptibility to AAD in a UK population. Further studies with larger patient cohorts are required to robustly confirm the association of SH2B3 and SIGLEC5/SPACA6 alleles.
Collapse
Affiliation(s)
- Sophie Howarth
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
| | - Georgina Sneddon
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
| | - Kathleen R Allinson
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
| | - Salman Razvi
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
| | - Anna L Mitchell
- Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK
| | - Simon H S Pearce
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
- Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK
| |
Collapse
|
2
|
Harsini S, Rezaei N. Autoimmune diseases. Clin Immunol 2023. [DOI: 10.1016/b978-0-12-818006-8.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
3
|
Røyrvik EC, Husebye ES. The genetics of autoimmune Addison disease: past, present and future. Nat Rev Endocrinol 2022; 18:399-412. [PMID: 35411072 DOI: 10.1038/s41574-022-00653-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 12/23/2022]
Abstract
Autoimmune Addison disease is an endocrinopathy that is fatal if not diagnosed and treated in a timely manner. Its rarity has hampered unbiased studies of the predisposing genetic factors. A 2021 genome-wide association study, explaining up to 40% of the genetic susceptibility, has revealed new disease loci and reproduced some of the previously reported associations, while failing to reproduce others. Credible risk loci from both candidate gene and genome-wide studies indicate that, like one of its most common comorbidities, type 1 diabetes mellitus, Addison disease is primarily caused by aberrant T cell behaviour. Here, we review the current understanding of the genetics of autoimmune Addison disease and its position in the wider field of autoimmune disorders. The mechanisms that could underlie the effects on the adrenal cortex are also discussed.
Collapse
Affiliation(s)
- Ellen C Røyrvik
- Department of Clinical Science, University of Bergen, Bergen, Norway.
- K.G. Jebsen Center for Autoimmune Diseases, University of Bergen, Bergen, Norway.
| | - Eystein S Husebye
- Department of Clinical Science, University of Bergen, Bergen, Norway
- K.G. Jebsen Center for Autoimmune Diseases, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
4
|
Silajdzija E, Bliddal S, Borgwardt L, Rossing M, Jarløv A, Nielsen CH, Feldt-Rasmussen U. Severe weight loss in a hypothyroid patient as an acute presentation of autoimmune polyglandular syndrome type II. Hormones (Athens) 2022; 21:317-322. [PMID: 35182386 PMCID: PMC9130185 DOI: 10.1007/s42000-021-00344-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/14/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Autoimmune disease, including autoimmune thyroid disease, with uncharacteristic symptoms can be due to additional severe disease. We report a life-threatening debut of autoimmune polyglandular syndrome type II (APS II) defined as Addison's disease combined with autoimmune diabetes and/or thyroid disease. PATIENT FINDINGS A 33-year-old male with newly diagnosed hypothyroidism was referred to a tertiary center due to fatigue and 20-kg rapid weight loss. Malignancy was excluded. After a gastroscopy, he developed Addison's crisis; he was admitted to our hospital and stabilized. Final diagnoses included Hashimoto's thyroiditis, Addison's disease, vitiligo, and pernicious anemia. Whole genome sequencing found no genetic variants associated with component diseases. Human leukocyte antigen typing revealed DR3/DR4 and DQ8/DQ2 heterozygosity associated with APS II. A patient with Hashimoto's thyroiditis and weight loss presented with Addison's crisis and was diagnosed with APS II. CONCLUSIONS Awareness of potential polyautoimmunity in clinical evaluation of patients with thyroid disease improves diagnosis and can be lifesaving.
Collapse
Affiliation(s)
- Elvira Silajdzija
- Faculty of Health and Medical Research, Copenhagen University, Copenhagen, Denmark
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Sofie Bliddal
- Faculty of Health and Medical Research, Copenhagen University, Copenhagen, Denmark
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
- Institute of Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Line Borgwardt
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Anne Jarløv
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Claus Henrik Nielsen
- Faculty of Health and Medical Research, Copenhagen University, Copenhagen, Denmark
- Institute of Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Faculty of Health and Medical Research, Copenhagen University, Copenhagen, Denmark
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| |
Collapse
|
5
|
Fichna M, Żurawek M, Słomiński B, Sumińska M, Czarnywojtek A, Rozwadowska N, Fichna P, Myśliwiec M, Ruchała M. Polymorphism in BACH2 gene is a marker of polyglandular autoimmunity. Endocrine 2021; 74:72-79. [PMID: 33966174 PMCID: PMC8440266 DOI: 10.1007/s12020-021-02743-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/23/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE Genetically predisposed individuals may develop several autoimmune diseases-autoimmune polyendocrine syndromes (APS). APS types 2-4, are complex disorders, which combine various organ-specific autoimmune conditions. Recent reports support the considerable role of the BACH2 gene in immune cell differentiation and shifting the T-cell balance towards regulatory T-cells. BACH2 polymorphisms are associated with autoimmune disorders, including Addison's disease (AD), Graves' disease (GD), and probably type 1 diabetes (T1D). Our study was aimed to investigate the BACH2 variant, rs3757247, in endocrine autoimmunity in the Polish population. METHODS The analysis comprised 346 individuals with APS, 387 with T1D only, and 568 controls. Genotyping was performed using TaqMan chemistry. RESULTS APS type 2 was found in 219 individuals, type 3 in 102, and type 4 in 25 subjects. Overall, AD was diagnosed in 244 subjects, Hashimoto's thyroiditis-in 238, T1D-in 127, GD-in 58, vitiligo and chronic gastritis each in 40 patients, celiac disease-in 28, premature menopause in 18, and alopecia in 4 patients. Minor T allele at rs3757247 was found in 56.4% APS vs. 44.1% control alleles (OR 1.59; 95%CI: 1.30-1.95, p < 0.0001). The distribution of genotypes revealed excess TT homozygotes in the APS cohort (33.2 vs. 20.1% in controls, p < 0.0001). The frequencies of rs3757247 alleles and genotypes in T1D patients did not present significant differences vs. controls (p-values > 0.05). CONCLUSIONS These results provide evidence of the association between BACH2 polymorphism and polyglandular autoimmunity. Since carriers of rs3757247 display increased risk for additional autoimmune conditions, this variant could identify individuals prone to develop APS.
Collapse
Affiliation(s)
- Marta Fichna
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
| | - Magdalena Żurawek
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Bartosz Słomiński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marta Sumińska
- Department of Paediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Czarnywojtek
- Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Piotr Fichna
- Department of Paediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Myśliwiec
- Department of Paediatrics, Diabetology and Endocrinology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
6
|
GWAS for autoimmune Addison's disease identifies multiple risk loci and highlights AIRE in disease susceptibility. Nat Commun 2021; 12:959. [PMID: 33574239 PMCID: PMC7878795 DOI: 10.1038/s41467-021-21015-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023] Open
Abstract
Autoimmune Addison's disease (AAD) is characterized by the autoimmune destruction of the adrenal cortex. Low prevalence and complex inheritance have long hindered successful genetic studies. We here report the first genome-wide association study on AAD, which identifies nine independent risk loci (P < 5 × 10-8). In addition to loci implicated in lymphocyte function and development shared with other autoimmune diseases such as HLA, BACH2, PTPN22 and CTLA4, we associate two protein-coding alterations in Autoimmune Regulator (AIRE) with AAD. The strongest, p.R471C (rs74203920, OR = 3.4 (2.7-4.3), P = 9.0 × 10-25) introduces an additional cysteine residue in the zinc-finger motif of the second PHD domain of the AIRE protein. This unbiased elucidation of the genetic contribution to development of AAD points to the importance of central immunological tolerance, and explains 35-41% of heritability (h2).
Collapse
|
7
|
Zamanpoor M. The genetic pathogenesis, diagnosis and therapeutic insight of rheumatoid arthritis. Clin Genet 2019; 95:547-557. [PMID: 30578544 DOI: 10.1111/cge.13498] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022]
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease that causes chronic inflammation of the joints. RA is a heterogeneous disorder caused by an abnormal autoimmune response triggered by the complex interactions of genetic and environmental factors that contribute to RA etiology. However, its underlying pathogenic mechanisms are yet to be fully understood. In this review, I provide an overview of the pathogenesis, diagnosis and therapeutic insight in the clinical management of RA in light of the recent updates to classification criteria and recent discoveries of genetic loci associated with susceptibility for RA.
Collapse
Affiliation(s)
- Mansour Zamanpoor
- Department of Biochemistry, University of Otago, Dunedin, New Zealand.,Wellington Regional Genetics Laboratory, Genetic Health Service New Zealand, Wellington Regional Hospital, Wellington, New Zealand
| |
Collapse
|
8
|
Eriksson D, Bianchi M, Landegren N, Dalin F, Skov J, Hultin-Rosenberg L, Mathioudaki A, Nordin J, Hallgren Å, Andersson G, Tandre K, Rantapää Dahlqvist S, Söderkvist P, Rönnblom L, Hulting AL, Wahlberg J, Dahlqvist P, Ekwall O, Meadows JRS, Lindblad-Toh K, Bensing S, Rosengren Pielberg G, Kämpe O. Common genetic variation in the autoimmune regulator (AIRE) locus is associated with autoimmune Addison's disease in Sweden. Sci Rep 2018; 8:8395. [PMID: 29849176 PMCID: PMC5976627 DOI: 10.1038/s41598-018-26842-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/18/2018] [Indexed: 12/23/2022] Open
Abstract
Autoimmune Addison's disease (AAD) is the predominating cause of primary adrenal failure. Despite its high heritability, the rarity of disease has long made candidate-gene studies the only feasible methodology for genetic studies. Here we conducted a comprehensive reinvestigation of suggested AAD risk loci and more than 1800 candidate genes with associated regulatory elements in 479 patients with AAD and 2394 controls. Our analysis enabled us to replicate many risk variants, but several other previously suggested risk variants failed confirmation. By exploring the full set of 1800 candidate genes, we further identified common variation in the autoimmune regulator (AIRE) as a novel risk locus associated to sporadic AAD in our study. Our findings not only confirm that multiple loci are associated with disease risk, but also show to what extent the multiple risk loci jointly associate to AAD. In total, risk loci discovered to date only explain about 7% of variance in liability to AAD in our study population.
Collapse
Affiliation(s)
- Daniel Eriksson
- Department of Medicine (Solna), Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
- Department of Endocrinology, Metabolism and Diabetes Karolinska University Hospital, Stockholm, Sweden.
| | - Matteo Bianchi
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Nils Landegren
- Department of Medicine (Solna), Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Frida Dalin
- Department of Medicine (Solna), Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jakob Skov
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Lina Hultin-Rosenberg
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Argyri Mathioudaki
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Jessika Nordin
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Åsa Hallgren
- Department of Medicine (Solna), Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Andersson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Karolina Tandre
- Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Peter Söderkvist
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Lars Rönnblom
- Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Anna-Lena Hulting
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jeanette Wahlberg
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Department of Endocrinology, Linköping University, Linköping, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Per Dahlqvist
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Olov Ekwall
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennifer R S Meadows
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Kerstin Lindblad-Toh
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Sophie Bensing
- Department of Endocrinology, Metabolism and Diabetes Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Gerli Rosengren Pielberg
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Olle Kämpe
- Department of Medicine (Solna), Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Endocrinology, Metabolism and Diabetes Karolinska University Hospital, Stockholm, Sweden
- K.G. Jebsen Center for Autoimmune Diseases, Bergen, Norway
| |
Collapse
|
9
|
Hellesen A, Bratland E, Husebye ES. Autoimmune Addison's disease - An update on pathogenesis. ANNALES D'ENDOCRINOLOGIE 2018; 79:157-163. [PMID: 29631795 DOI: 10.1016/j.ando.2018.03.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Autoimmunity against the adrenal cortex is the leading cause of Addison's disease in industrialized countries, with prevalence estimates ranging from 93-220 per million in Europe. The immune-mediated attack on adrenocortical cells cripples their ability to synthesize vital steroid hormones and necessitates life-long hormone replacement therapy. The autoimmune disease etiology is multifactorial involving variants in immune genes and environmental factors. Recently, we have come to appreciate that the adrenocortical cell itself is an active player in the autoimmune process. Here we summarize the complex interplay between the immune system and the adrenal cortex and highlight unanswered questions and gaps in our current understanding of the disease.
Collapse
Affiliation(s)
- Alexander Hellesen
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; K.G. Jebsen Senter for Autoimmune Sykdommer, University of Bergen, 5021 Bergen, Norway
| | - Eirik Bratland
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; K.G. Jebsen Senter for Autoimmune Sykdommer, University of Bergen, 5021 Bergen, Norway
| | - Eystein S Husebye
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; K.G. Jebsen Senter for Autoimmune Sykdommer, University of Bergen, 5021 Bergen, Norway; Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Medicine (Solna), Karolinska Institutet, 17176 Stockholm, Sweden.
| |
Collapse
|
10
|
Pazderska A, Fichna M, Mitchell AL, Napier CM, Gan E, Ruchała M, Santibanez-Koref M, Pearce SH. Impact of Month of Birth on the Risk of Development of Autoimmune Addison's Disease. J Clin Endocrinol Metab 2016; 101:4214-4218. [PMID: 27575942 PMCID: PMC5095257 DOI: 10.1210/jc.2016-2392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
CONTEXT The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease. OBJECTIVE Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects. DESIGN, SETTING, AND PATIENTS The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births. MAIN OUTCOME MEASURES Association between month of birth and the susceptibility to AAD. RESULTS In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively. CONCLUSION For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD.
Collapse
Affiliation(s)
- Agnieszka Pazderska
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Marta Fichna
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Anna L Mitchell
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Catherine M Napier
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Earn Gan
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Marek Ruchała
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Mauro Santibanez-Koref
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Simon H Pearce
- Institute of Genetic Medicine (A.P., A.L.M., C.M.N., E.G., M..S-K., S.H.P.), Newcastle University, Newcastle upon Tyne, NE1 3BZ United Kingdom; Institute of Human Genetics (M.F.), Polish Academy of Sciences, 60-479, Poznan, Poland; and Department of Endocrinology, Metabolism and Internal Medicine (M.F., M.R.), Poznan University of Medical Sciences, 60-355 Poznan, Poland
| |
Collapse
|
11
|
Brorsson CA, Pociot F. Shared Genetic Basis for Type 1 Diabetes, Islet Autoantibodies, and Autoantibodies Associated With Other Immune-Mediated Diseases in Families With Type 1 Diabetes. Diabetes Care 2015; 38 Suppl 2:S8-13. [PMID: 26405073 PMCID: PMC4582910 DOI: 10.2337/dcs15-2003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Type 1 diabetes (T1D) is a polygenic autoimmune disease that is often present with autoantibodies directed against pancreatic islet proteins. Many genetic susceptibility loci are shared with other autoimmune or immune-mediated diseases that also cosegregate in families with T1D. The aim of this study was to investigate whether susceptibility loci identified in genome-wide association studies (GWAS) of T1D were also associated with autoantibody positivity in individuals with diabetes. Fifty single nucleotide polymorphisms (SNPs) were genotyped in 6,556 multiethnic cases collected by the Type 1 Diabetes Genetics Consortium (T1DGC). These were tested for association with three islet autoantibodies-against autoantibodies to GAD (GADA), IA-2 (IA-2A), and zinc transporter 8 (ZnT8A)-and autoantibodies against thyroid peroxidase (TPOA) in autoimmune thyroid disease, gastric parietal cells (PCA) in autoimmune gastritis, transglutaminase (TGA) in celiac disease, and 21-hydroxylase (21-OHA) in autoimmune hypoadrenalism. In addition to the MHC region, we identify SNPs in five susceptibility loci (IFIH1, PTPN22, SH2B3, BACH2, and CTLA4) as significantly associated with more than one autoantibody at a false discovery rate less than 5%. IFIH1/2q24 demonstrated the most unrestricted association, as significant association was demonstrated for PCA, TPOA, GADA, 21-OHA, and IA-2A. In addition, 11 loci were significantly associated with a single autoantibody.
Collapse
Affiliation(s)
- Caroline A Brorsson
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark Copenhagen Diabetes Research Center, Department of Pediatrics E, Herlev University Hospital, Herlev, Denmark
| | - Flemming Pociot
- Copenhagen Diabetes Research Center, Department of Pediatrics E, Herlev University Hospital, Herlev, Denmark
| | | |
Collapse
|
12
|
Mitchell AL, Bøe Wolff A, MacArthur K, Weaver JU, Vaidya B, Erichsen MM, Darlay R, Husebye ES, Cordell HJ, Pearce SHS. Linkage Analysis in Autoimmune Addison's Disease: NFATC1 as a Potential Novel Susceptibility Locus. PLoS One 2015; 10:e0123550. [PMID: 26042420 PMCID: PMC4456164 DOI: 10.1371/journal.pone.0123550] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 03/04/2015] [Indexed: 11/20/2022] Open
Abstract
Background Autoimmune Addison’s disease (AAD) is a rare, highly heritable autoimmune endocrinopathy. It is possible that there may be some highly penetrant variants which confer disease susceptibility that have yet to be discovered. Methods DNA samples from 23 multiplex AAD pedigrees from the UK and Norway (50 cases, 67 controls) were genotyped on the Affymetrix SNP 6.0 array. Linkage analysis was performed using Merlin. EMMAX was used to carry out a genome-wide association analysis comparing the familial AAD cases to 2706 UK WTCCC controls. To explore some of the linkage findings further, a replication study was performed by genotyping 64 SNPs in two of the four linked regions (chromosomes 7 and 18), on the Sequenom iPlex platform in three European AAD case-control cohorts (1097 cases, 1117 controls). The data were analysed using a meta-analysis approach. Results In a parametric analysis, applying a rare dominant model, loci on chromosomes 7, 9 and 18 had LOD scores >2.8. In a non-parametric analysis, a locus corresponding to the HLA region on chromosome 6, known to be associated with AAD, had a LOD score >3.0. In the genome-wide association analysis, a SNP cluster on chromosome 2 and a pair of SNPs on chromosome 6 were associated with AAD (P <5x10-7). A meta-analysis of the replication study data demonstrated that three chromosome 18 SNPs were associated with AAD, including a non-synonymous variant in the NFATC1 gene. Conclusion This linkage study has implicated a number of novel chromosomal regions in the pathogenesis of AAD in multiplex AAD families and adds further support to the role of HLA in AAD. The genome-wide association analysis has also identified a region of interest on chromosome 2. A replication study has demonstrated that the NFATC1 gene is worthy of future investigation, however each of the regions identified require further, systematic analysis.
Collapse
Affiliation(s)
- Anna L. Mitchell
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Anette Bøe Wolff
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Katie MacArthur
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jolanta U. Weaver
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Bijay Vaidya
- Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | | | | | - Rebecca Darlay
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Eystein S. Husebye
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Heather J. Cordell
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Simon H. S. Pearce
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
13
|
Edvardsen K, Bjånesøy T, Hellesen A, Breivik L, Bakke M, Husebye ES, Bratland E. Peripheral Blood Cells from Patients with Autoimmune Addison's Disease Poorly Respond to Interferons In Vitro, Despite Elevated Serum Levels of Interferon-Inducible Chemokines. J Interferon Cytokine Res 2015; 35:759-70. [PMID: 25978633 PMCID: PMC4589105 DOI: 10.1089/jir.2014.0171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10.
Collapse
Affiliation(s)
- Kine Edvardsen
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway
| | - Trine Bjånesøy
- 2 Department of Biomedicine, University of Bergen , Bergen, Norway
| | - Alexander Hellesen
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway .,3 Department of Medicine, Haukeland University Hospital , Bergen, Norway
| | - Lars Breivik
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway
| | - Marit Bakke
- 2 Department of Biomedicine, University of Bergen , Bergen, Norway
| | - Eystein S Husebye
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway .,3 Department of Medicine, Haukeland University Hospital , Bergen, Norway
| | - Eirik Bratland
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway
| |
Collapse
|
14
|
Hansen MP, Matheis N, Kahaly GJ. Type 1 diabetes and polyglandular autoimmune syndrome: A review. World J Diabetes 2015; 6:67-79. [PMID: 25685279 PMCID: PMC4317318 DOI: 10.4239/wjd.v6.i1.67] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 11/11/2014] [Accepted: 12/01/2014] [Indexed: 02/05/2023] Open
Abstract
Type 1 diabetes (T1D) is an autoimmune disorder caused by inflammatory destruction of the pancreatic tissue. The etiopathogenesis and characteristics of the pathologic process of pancreatic destruction are well described. In addition, the putative susceptibility genes for T1D as a monoglandular disease and the relation to polyglandular autoimmune syndrome (PAS) have also been well explored. The incidence of T1D has steadily increased in most parts of the world, especially in industrialized nations. T1D is frequently associated with autoimmune endocrine and non-endocrine diseases and patients with T1D are at a higher risk for developing several glandular autoimmune diseases. Familial clustering is observed, which suggests that there is a genetic predisposition. Various hypotheses pertaining to viral- and bacterial-induced pancreatic autoimmunity have been proposed, however a definitive delineation of the autoimmune pathomechanism is still lacking. In patients with PAS, pancreatic and endocrine autoantigens either colocalize on one antigen-presenting cell or are expressed on two/various target cells sharing a common amino acid, which facilitates binding to and activation of T cells. The most prevalent PAS phenotype is the adult type 3 variant or PAS type III, which encompasses T1D and autoimmune thyroid disease. This review discusses the findings of recent studies showing noticeable differences in the genetic background and clinical phenotype of T1D either as an isolated autoimmune endocrinopathy or within the scope of polyglandular autoimmune syndrome.
Collapse
|
15
|
Abstract
Hypoadrenocorticism is an uncommon disease in dogs and rare in humans, where it is known as Addison disease (ADD). The disease is characterized by a deficiency in corticosteroid production from the adrenal cortex, requiring lifelong hormone replacement therapy. When compared with humans, the pathogenesis of hypoadrenocorticism in dogs is not well established, although the evidence supports a similar autoimmune etiology of adrenocortical pathology. Several immune response genes have been implicated in determining susceptibility to Addison disease in humans, some of which are shared with other autoimmune syndromes. Indeed, other types of autoimmune disease are common (approximately 50%) in patients affected with ADD. Several lines of evidence suggest a genetic component to the etiology of canine hypoadrenocorticism. Certain dog breeds are overrepresented in epidemiologic studies, reflecting a likely genetic influence, supported by data from pedigree analysis. Molecular genetic studies have identified similar genes and signaling pathways, involved in ADD in humans, to be also associated with susceptibility to canine hypoadrenocorticism. Immune response genes such as the dog leukocyte antigen (DLA) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) genes seem to be particularly important. It is clear that there are genetic factors involved in determining susceptibility to canine hypoadrenocorticism, although similar to the situation in humans, this is likely to represent a complex genetic disorder.
Collapse
Affiliation(s)
- Alisdair M Boag
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, Scotland.
| | - Brian Catchpole
- Department of Pathology and Pathogen Biology, Royal Veterinary College, University of London, Hatfield, UK
| |
Collapse
|
16
|
|
17
|
Brønstad I, Skinningsrud B, Bratland E, Løvås K, Undlien D, Sverre Husebye E, Wolff ASB. CYP21A2 polymorphisms in patients with autoimmune Addison's disease, and linkage disequilibrium to HLA risk alleles. Eur J Endocrinol 2014; 171:743-50. [PMID: 25249698 DOI: 10.1530/eje-14-0432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Steroid 21-hydroxylase, encoded by CYP21A2, is the major autoantigen in autoimmune Addison's disease (AAD). CYP21A2 is located in the region of the HLA complex on chromosome 6p21.3, which harbours several risk alleles for AAD. The objective was to investigate whether CYP21A2 gene variants confer risk of AAD independently of other risk alleles in the HLA loci. DESIGN DNA samples from 381 Norwegian patients with AAD and 340 healthy controls (HC) previously genotyped for the HLA-A, -B, -DRB1, and -DQB1 and MICA loci were used for genotyping of CYP21A2. METHODS Genotyping of CYP21A2 was carried out by direct sequencing. Linkage of CYP21A2 to the HLA loci was assessed using UNPHASED version 3.0.10 and PHASE version 2.1. RESULTS Heterozygotes of the single-nucleotide polymorphisms (SNPs) rs397515394, rs6467, rs6474, rs76565726 and rs6473 were detected significantly more frequently in AAD patients compared with HC (P<0.005), but all SNPs were in a linkage disequilibrium (LD) with high-risk HLA-DRB1 haplotypes. rs6472C protected against AAD (odds ratio=0.15, 95% CI (0.08-0.30), P=3.8×10(-10)). This SNP was not in an LD with HLA loci (P=0.02), but did not increase protection when considering the effect of HLA-DRB1 alleles. Mutations causing congenital adrenal hyperplasia were found in heterozygosity in <1.5% of the cases in both groups. CONCLUSION Genetic variants of CYP21A2 associated to AAD are in LD with the main AAD risk locus HLA-DRB1, and CYP21A2 does not constitute an independent susceptibility locus.
Collapse
Affiliation(s)
- Ingeborg Brønstad
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| | - Beate Skinningsrud
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| | - Eirik Bratland
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| | - Kristian Løvås
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| | - Dag Undlien
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| | - Eystein Sverre Husebye
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| | - Anette Susanne Bøe Wolff
- Department of Clinical ScienceUniversity of Bergen, Laboratory building, 8th floor, Bergen 5021, NorwayDepartment of Medical GeneticsOslo University Hospital, Oslo 0407, NorwayDepartment of MedicineHaukeland University Hospital, Bergen 5021, NorwayInstitute of Medical GeneticsUniversity of Oslo, Oslo 0315, Norway
| |
Collapse
|
18
|
Yarwood A, Huizinga TWJ, Worthington J. The genetics of rheumatoid arthritis: risk and protection in different stages of the evolution of RA. Rheumatology (Oxford) 2014; 55:199-209. [PMID: 25239882 DOI: 10.1093/rheumatology/keu323] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Indexed: 11/13/2022] Open
Abstract
There is now a general consensus that RA has a spectrum of disease stages that can begin many years before the onset of clinical symptoms. It is widely thought that understanding the complex interplay between genetics and environment, and their role in pathogenesis, is essential in gaining further insight into the mechanisms that drive disease development and progression. More than 100 genetic susceptibility loci have now been identified for RA through studies that have focused on patients with established RA compared with healthy controls. Studying the early preclinical phases of disease will provide valuable insights into the biological events that precede disease and could potentially identify biomarkers to predict disease onset and future therapeutic targets. In this review we will cover recent advances in the knowledge of genetic and environmental risk factors and speculate on how these factors may influence the transition from one stage of disease to another.
Collapse
Affiliation(s)
- Annie Yarwood
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, Stopford Building, University of Manchester, Manchester, UK
| | - Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands and
| | - Jane Worthington
- Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, Stopford Building, University of Manchester, Manchester, UK, NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
19
|
Short AD, Catchpole B, Boag AM, Kennedy LJ, Massey J, Rothwell S, Henthorn PS, Littman MP, Husebye E, Ollier B. Putative candidate genes for canine hypoadrenocorticism (Addison's disease) in multiple dog breeds. Vet Rec 2014; 175:430. [PMID: 25124887 DOI: 10.1136/vr.102160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A D Short
- Centre for Integrated Genomic Medical Research, The University of Manchester, Manchester, UK
| | - B Catchpole
- Department of Pathology & Infectious Diseases, Royal Veterinary College, Hertfordshire, UK
| | - A M Boag
- Department of Pathology & Infectious Diseases, Royal Veterinary College, Hertfordshire, UK
| | - L J Kennedy
- Centre for Integrated Genomic Medical Research, The University of Manchester, Manchester, UK
| | - J Massey
- Centre for Integrated Genomic Medical Research, The University of Manchester, Manchester, UK
| | - S Rothwell
- Centre for Integrated Genomic Medical Research, The University of Manchester, Manchester, UK
| | - P S Henthorn
- Department of Clinical Studies-Philadelphia, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - M P Littman
- Department of Clinical Studies-Philadelphia, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - E Husebye
- Institute of Medicine, University of Bergen, Bergen, Norway Department of Clinical Science, Haukeland University Hospital, Bergen, Norway
| | - B Ollier
- Centre for Integrated Genomic Medical Research, The University of Manchester, Manchester, UK
| |
Collapse
|
20
|
Abstract
BACKGROUND Many aspects of autoimmune disease are not well understood, including the specificities of autoimmune targets, and patterns of co-morbidity and cross-heritability across diseases. Prior work has provided evidence that somatic mutation caused by gene conversion and deletion at segmentally duplicated loci is relevant to several diseases. Simple tandem repeat (STR) sequence is highly mutable, both somatically and in the germ-line, and somatic STR mutations are observed under inflammation. RESULTS Protein-coding genes spanning STRs having markers of mutability, including germ-line variability, high total length, repeat count and/or repeat similarity, are evaluated in the context of autoimmunity. For the initiation of autoimmune disease, antigens whose autoantibodies are the first observed in a disease, termed primary autoantigens, are informative. Three primary autoantigens, thyroid peroxidase (TPO), phogrin (PTPRN2) and filaggrin (FLG), include STRs that are among the eleven longest STRs spanned by protein-coding genes. This association of primary autoantigens with long STR sequence is highly significant (p<3.0x10(-7)). Long STRs occur within twenty genes that are associated with sixteen common autoimmune diseases and atherosclerosis. The repeat within the TTC34 gene is an outlier in terms of length and a link with systemic lupus erythematosus is proposed. CONCLUSIONS The results support the hypothesis that many autoimmune diseases are triggered by immune responses to proteins whose DNA sequence mutates somatically in a coherent, consistent fashion. Other autoimmune diseases may be caused by coherent somatic mutations in immune cells. The coherent somatic mutation hypothesis has the potential to be a comprehensive explanation for the initiation of many autoimmune diseases.
Collapse
Affiliation(s)
- Kenneth Andrew Ross
- Department of Computer Science, Columbia University, New York, New York, United States of America
| |
Collapse
|
21
|
Short AD, Boag A, Catchpole B, Kennedy LJ, Massey J, Rothwell S, Husebye E, Ollier B. A candidate gene analysis of canine hypoadrenocorticism in 3 dog breeds. J Hered 2013; 104:807-20. [PMID: 23997205 DOI: 10.1093/jhered/est051] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Canine hypoadrenocorticism is believed to be an immune-related condition. It is rare in the overall dog population but shows a breed-related predisposition with Standard poodles and Portuguese water dogs having a greater prevalence of the condition. It shares many similarities with human primary adrenal insufficiency and is believed to be a naturally occurring, spontaneous model for the human condition. Short haplotype blocks and low levels of linkage disequilibrium in the human genome mean that the identification of genetic contributors to the condition requires large sample numbers. Pedigree dogs have high linkage disequilibrium and long haplotypes within a breed, increasing the potential of identifying novel genes that contribute to canine genetic disease. We investigated 222 SNPs from 42 genes that have been associated or may be implicated in human Addison's disease. We conducted case-control analyses in 3 pedigree dog breeds (Labrador retriever: affected n = 30, unaffected = 76; Cocker Spaniel: affected n = 19, unaffected = 53; Springer spaniel: affected n = 26, unaffected = 46) and identified 8 associated alleles in genes COL4A4, OSBPL9, CTLA4, PTPN22, and STXBP5 in 3 pedigree breeds. Association with immune response genes PTPN22 and CTLA4 in certain breeds suggests an underlying immunopathogenesis of the disease. These results suggest that canine hypoadrenocorticism could be a useful model for studying comparative genetics relevant to human Addison's disease.
Collapse
Affiliation(s)
- Andrea D Short
- the Centre for Integrated Genomic Medical Research, The University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK
| | | | | | | | | | | | | | | |
Collapse
|
22
|
The role of PTPN22 C1858T gene polymorphism in diabetes mellitus type 1: first evaluation in Greek children and adolescents. BIOMED RESEARCH INTERNATIONAL 2013; 2013:721604. [PMID: 23936838 PMCID: PMC3727122 DOI: 10.1155/2013/721604] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/27/2013] [Accepted: 06/20/2013] [Indexed: 12/25/2022]
Abstract
Type 1 diabetes mellitus (T1DM) is an autoimmune multifactorial disease. Protein tyrosine phosphatase nonreceptor type 22 (PTPN22) gene encodes lymphoid-specific tyrosine phosphatase (Lyp), an inhibitor of T cell activation. PTPN22 C1858T polymorphism was associated with T1DM in populations of Caucasian origin. The aim of this study was the investigation for the first time of the association of PTPN22 C1858T polymorphism with T1DM in Greek population. We studied 130 children and adolescents with T1DM and 135 healthy individuals of Greek origin. The polymorphism was genotyped using polymerase chain reaction with restriction fragment length polymorphism. C1858T and T1858T genotypes as well as 1858T allele were found more frequently in patients (10.8% and 5.8%, resp.) than in healthy individuals (5.9% and 3.0%, resp.) but at non statistically significant level. There was no statistically significant association found with gender, age at diagnosis, severity of onset, history of Hashimoto thyroiditis or family history of T1DM. Increased frequency of 1858T allele in patients than in controls, implying a probable association, agrees with results of similar studies on other populations. The inability to find a statistically significant difference is probably due to the decreased frequency of minor allele in Greek population, indicating the need for a larger sample.
Collapse
|
23
|
Gan EH, MacArthur K, Mitchell AL, Pearce SHS. The role of functionally defective rare germline variants of sialic acid acetylesterase in autoimmune Addison's disease. Eur J Endocrinol 2012; 167:825-8. [PMID: 23011869 PMCID: PMC3494867 DOI: 10.1530/eje-12-0579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Autoimmune Addison's disease (AAD) is a rare condition with a complex genetic basis. A panel of rare and functionally defective genetic variants in the sialic acid acetylesterase (SIAE) gene has recently been implicated in several common autoimmune conditions. We performed a case-control study to determine whether these rare variants are associated with a rarer condition, AAD. METHOD We analysed nine SIAE gene variants (W48X, M89V, C196F, C226G, R230W, T312M, Y349C, F404S and R479C) in a United Kingdom cohort of 378 AAD subjects and 387 healthy controls. All samples were genotyped using Sequenom iPlex chemistry to characterise primer extension products. RESULTS A heterozygous rare allele at codon 312 (312*M) was found in one AAD patient (0.13%) but was not detected in the healthy controls. The commoner, functionally recessive variant at codon 89 (89*V) was found to be homozygous in two AAD patients but was only found in the heterozygous state in controls. Taking into account all nine alleles examined, 4/378 (1.06%) AAD patients and 1/387 (0.25%) healthy controls carried the defective SIAE alleles, with a calculated odds ratio of 4.13 (95% CI 0.44-97.45, two-tailed P value 0.212, NS). CONCLUSION We demonstrated the presence of 89*V homozygotes and the 312*M rare allele in the AAD cohort, but overall, our analysis does not support a role for rare variants in SIAE in the pathogenesis of AAD. However, the relatively small collection of AAD patients limits the power to exclude a small effect.
Collapse
Affiliation(s)
- Earn H Gan
- Institute of Genetic Medicine, International Centre for Life, Newcastle University, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.
| | | | | | | |
Collapse
|
24
|
Meta-analysis reveals an association of PTPN22 C1858T with autoimmune diseases, which depends on the localization of the affected tissue. Genes Immun 2012; 13:641-52. [DOI: 10.1038/gene.2012.46] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
25
|
Krupińska J, Urbanowicz W, Kaczmarczyk M, Kulig G, Sowińska-Przepiera E, Andrysiak-Mamos E, Syrenicz A. Association between genetic mutations and the development of autoimmune thyroiditis in patients with chronic hepatitis C treated with interferon alpha. Thyroid Res 2012; 5:10. [PMID: 23072316 PMCID: PMC3579705 DOI: 10.1186/1756-6614-5-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/01/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED BACKGROUND Considerable progress was made by the introduction of interferon to the treatment of chronic hepatitis C virus infection. This treatment, however, is associated with the risk of developing or exacerbating autoimmune diseases, with chronic autoimmune thyroiditis being one of them. The aim of our study was to evaluate the predisposition to autoimmune thyroiditis in patients with chronic hepatitis C virus during IFN-alpha therapy, depending on the presence of polymorphisms in the promoter region of CTLA-4C (-318)T gene and in exon 1 of A49G gene as well as C1858T transition of PTPN22 gene. METHODS The study was conducted in 149 patients aged between 18 and 70 years (mean of 43.9 years), including 82 men and 67 women. Control group for the assessment of the distribution of analyzed polymorphism of genotypes consisted of 200 neonates, from whom umbilical blood was drawn for the tests. The patients were divided into three groups: group 1 consisted of 114 patients without thyroid impairment before and during IFN-alpha therapy, group 2 contained 9 patients with AT with the onset prior to IFN-alpha treatment, and group 3 comprised 26 patients with AT starting after the beginning of IFN-alpha therapy. RESULTS The frequency of C1858Tand C(-318)T genotypes observed in the study group did not differ significantly from control group. A significant difference, however, was found for A49G polymorphism. CONCLUSIONS No association was demonstrated between the occurrence of autoimmune thyroiditis with the onset during IFN-alpha therapy and the presence of polymorphisms within CTLA-4 C(-318)T gene in the promoter region and A49G in exon 1, as well as C1858T transition of PTPN22 gene.
Collapse
Affiliation(s)
- Janina Krupińska
- Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, Szczecin, Poland.
| | | | | | | | | | | | | |
Collapse
|
26
|
Clinical Characteristics and PTPN22 1858C/T Variant Analysis in Jordanian Arab Vitiligo Patients. Mol Diagn Ther 2012; 14:179-84. [DOI: 10.1007/bf03256371] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
27
|
Chew GYJ, Sinha U, Gatenby PA, DeMalmanche T, Adelstein S, Garsia R, Hissaria P, French MA, Wilson A, Whittle B, Kirkpatrick P, Riminton DS, Fulcher DA, Cook MC. Autoimmunity in primary antibody deficiency is associated with protein tyrosine phosphatase nonreceptor type 22 (PTPN22). J Allergy Clin Immunol 2012; 131:1130-5, 1135.e1. [PMID: 22857794 DOI: 10.1016/j.jaci.2012.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 05/07/2012] [Accepted: 06/06/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The 1858T allele of protein tyrosine phosphatase nonreceptor type 22 (PTPN22; R620W) exhibits one of the strongest and most consistent associations with sporadic autoimmune disease. Although autoimmunity is common in patients with primary antibody deficiency (PAD), it remains unknown whether its pathogenesis is similar when it arises in this context compared with in immunocompetent patients. OBJECTIVE We set out to determine whether the 1858T allele of PTPN22 was associated with PAD or with autoimmunity in the context of PAD. METHODS We genotyped rs2476601 (g.1858C>T), a single nucleotide polymorphism encoding substitution of arginine for tryptophan in PTPN22 (R620W), in 193 patients with PAD and 148 control subjects from an Australian cohort. We also performed a subgroup analysis according to the presence of autoimmunity and B-cell phenotypes. RESULTS C/T and T/T PTPN22 genotypes were more common in patients with PAD than in the matched control subjects (C/T, 18.1% vs 9.5%; T/T, 1.04% vs 0.6%). The T allele was associated with an increased risk of PAD relative to control subjects (odds ratio, 2.10; 95% CI, 1.11-4.00). The distribution of genotypes in control subjects was similar to those reported previously and did not deviate significantly from Hardy-Weinberg equilibrium. We found a strong association between the 1858T allele and PAD with coexistent autoimmune diseases. In patients with PAD and autoimmunity, 16 (43.2%) of 37 had at least one T allele of PTPN22 compared with 27 (17.3%) of 156 with the C/C genotype (P=.0014; odds ratio, 3.64; 95% CI, 1.68-7.88). We found no evidence that this effect was mediated by enrichment of CD21low B cells. CONCLUSION The 1858T PTPN22 allele is strongly associated with autoimmunity in patients with PAD.
Collapse
Affiliation(s)
- Gary Y J Chew
- Department of Immunology and Translational Research, Canberra Hospital, and Department of Immunology, John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
Autoimmune Addison disease is a rare autoimmune disorder with symptoms that typically develop over months or years. Following the development of serum autoantibodies to the key steroidogenic enzyme, 21-hydroxylase, patients have a period of compensated or preclinical disease, characterized by elevations in adrenocortocotropic hormone and renin, before overt, symptomatic adrenal failure develops. We propose that local failure of steroidogenesis, causing breakdown of tolerance to adrenal antigens, might be a key factor in disease progression. The etiology of autoimmune Addison disease has a strong genetic component in man, and several dog breeds are also susceptible. Allelic variants of genes encoding molecules of both the adaptive and innate immune systems have now been implicated, with a focus on the immunological synapse and downstream participants in T lymphocyte antigen-receptor signaling. With the exception of MHC alleles, which contribute to susceptibility in both human and canine Addison disease, no major or highly penetrant disease alleles have been found to date. Future research into autoimmune Addison disease, making use of genome-wide association studies and next-generation sequencing technology, will address the gaps in our understanding of the etiology of this disease.
Collapse
Affiliation(s)
- Anna L Mitchell
- Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK. anna.mitchell@ ncl.ac.uk
| | | |
Collapse
|
29
|
|
30
|
Roque JB, O'Leary CA, Kyaw-Tanner M, Duffy DL, Gharahkhani P, Vogelnest L, Mason K, Shipstone M. PTPN22 polymorphisms may indicate a role for this gene in atopic dermatitis in West Highland white terriers. BMC Res Notes 2011; 4:571. [PMID: 22208456 PMCID: PMC3271996 DOI: 10.1186/1756-0500-4-571] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 12/30/2011] [Indexed: 12/20/2022] Open
Abstract
Background Canine atopic dermatitis is an allergic inflammatory skin disease common in West Highland white terriers. A genome-wide association study for atopic dermatitis in a population of West Highland white terriers identified a 1.3 Mb area of association on CFA17 containing canine protein tyrosine phosphatase non-receptor type 22 (lymphoid) PTPN22. This gene is a potential candidate gene for canine atopic dermatitis as it encodes a lymphoid-specific signalling mediator that regulates T-cell and possibly B-cell activity. Findings Sequencing of PTPN22 in three atopic and three non-atopic West Highland white terriers identified 18 polymorphisms, including five genetic variants with a bioinformatically predicted functional effect. An intronic polymorphic repeat sequence variant was excluded as the cause of the genome-wide association study peak signal, by large-scale genotyping in 72 West Highland white terriers (gene-dropping simulation method, P = 0.01). Conclusions This study identified 18 genetic variants in PTPN22 that might be associated with atopic dermatitis in West Highland white terriers. This preliminary data may direct further study on the role of PTPN22 in this disease. Large scale genotyping and complementary genomic and proteomic assays would be required to assess this possibility.
Collapse
Affiliation(s)
- Joana Barros Roque
- Centre for Companion Animal Health, School of Veterinary Science, The University of Queensland, St Lucia, Queensland, 4069, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Gan EH, Mitchell AL, Macarthur K, Pearce SHS. The role of a nonsynonymous CD226 (DNAX-accessory molecule-1) variant (Gly 307Ser) in isolated Addison's disease and autoimmune polyendocrinopathy type 2 pathogenesis. Clin Endocrinol (Oxf) 2011; 75:165-8. [PMID: 21521299 DOI: 10.1111/j.1365-2265.2011.04030.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT Genome-wide association studies have discovered various susceptibility alleles that are shared among different autoimmune conditions, implicating several biochemical pathways in the pathogenesis of autoimmunity. A nonsynonymous polymorphism in exon 7 of the gene encoding the lymphocyte cell-surface CD226 (DNAM1) receptor, Gly307Ser (rs763361), has recently been identified as conferring risk to many autoimmune disorders. We performed a case-control study to determine if the CD226 307Ser variant is also associated with autoimmune Addison's disease (AAD). PATIENT AND DESIGN: We genotyped rs763361 in a UK cohort of 326 AAD subjects [183 with associated autoimmune conditions - autoimmune polyendocrinopathy syndrome type-2 (APS2)] and 311 healthy controls, using a Taqman genotyping assay. RESULTS The susceptibility 'T' allele at rs763361 was found in 50·5% of patients with AAD compared to 46·5% of controls (P-value 0·16, OR 1·17; 95% CI 0·94-1·46). However, comparing the APS2 subgroup to healthy controls, the T allele was found in 53·8%vs 46·5% in controls (OR 1·34; CI 1·04-1·74, P-value 0·03). In contrast, the T allele frequency was 46·2% in isolated Addison's disease (P-value 0·94 vs healthy controls). CONCLUSION It seems likely that the 307Ser variant of the CD226 receptor is associated with APS2 because of its underlying association with type 1 diabetes and autoimmune thyroid disease. The strength of association in patients with isolated AAD appears to be weak or nonexistent compared to that in APS2.
Collapse
Affiliation(s)
- Earn H Gan
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK.
| | | | | | | |
Collapse
|
32
|
Nonsegmental vitiligo and autoimmune mechanism. Dermatol Res Pract 2011; 2011:518090. [PMID: 21804820 PMCID: PMC3144695 DOI: 10.1155/2011/518090] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 05/30/2011] [Accepted: 06/01/2011] [Indexed: 11/18/2022] Open
Abstract
Nonsegmental vitiligo is a depigmented skin disorder showing acquired, progressive, and depigmented lesions of the skin, mucosa, and hair. It is believed to be caused mainly by the autoimmune loss of melanocytes from the involved areas. It is frequently associated with other autoimmune diseases, particularly autoimmune thyroid diseases including Hashimoto's thyroiditis and Graves' disease, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anemia, systemic lupus erythematosus, Addison's disease, and alopecia areata. This indicates the presence of genetically determined susceptibility to not only vitiligo but also to other autoimmune disorders. Here, we summarize current understanding of autoimmune pathogenesis in non-segmental vitiligo.
Collapse
|
33
|
Examination of candidate genes for hypoadrenocorticism in Nova Scotia Duck Tolling Retrievers. Vet J 2011; 187:212-6. [PMID: 19931476 DOI: 10.1016/j.tvjl.2009.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 09/03/2009] [Accepted: 10/14/2009] [Indexed: 11/20/2022]
Abstract
Inherited hypoadrenocorticism occurs in some dog breeds including the Nova Scotia Duck Tolling Retriever (NSDTR) and is thought to be due to an immune attack on the adrenal glands. The genetic cause of this disorder in dogs has not been identified; however, many genes have been associated with hypoadrenocorticism and other immune-mediated conditions in humans including AIRE, BAFF, Casp10, CD28, CTLA-4, FASL, PTPN22, and TNFRSF6B. Microsatellite marker loci were analysed for linkage with the disease phenotype in a pedigree of NSDTRs and excluded all genes examined, the exception being CTLA-4, which was neither excluded nor shown to be associated by this analysis. Thus, genes associated with hypoadrenocorticism in humans were not linked with the condition in the dog. Further examination is necessary to identify the genetic cause of inherited hypoadrenocorticism in dogs and this may reveal a novel gene not yet implicated with immune-mediated disease.
Collapse
|
34
|
Bratland E, Husebye ES. Cellular immunity and immunopathology in autoimmune Addison's disease. Mol Cell Endocrinol 2011; 336:180-90. [PMID: 21167251 DOI: 10.1016/j.mce.2010.12.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 12/07/2010] [Accepted: 12/08/2010] [Indexed: 12/27/2022]
Abstract
Autoimmune adrenocortical failure, or Addison's disease, is a prototypical organ-specific autoimmune disorder. In common with related autoimmune endocrinopathies, Addison's disease is only manageable to a certain extent with replacement therapy being the only treatment option. Unfortunately, the available therapy does not restore the physiological hormone levels and biorhythm. The key to progress in treating and preventing autoimmune Addison's disease lies in improving our understanding of the predisposing factors, the mechanisms responsible for the progression of the disease, and the interactions between adrenal antigens and effector cells and molecules of the immune system. The aim of the present review is to summarize the current knowledge on the role of T cells and cellular immunity in the pathogenesis of autoimmune Addison's disease.
Collapse
Affiliation(s)
- Eirik Bratland
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
| | | |
Collapse
|
35
|
Abstract
The endocrine system is a frequent target in pathogenic autoimmune responses. Type 1 diabetes and autoimmune thyroid disease are the prevailing examples. When several diseases cluster together in one individual, the phenomenon is called autoimmune polyglandular syndrome. Progress has been made in understanding the genetic factors involved in endocrine autoimmune diseases. Studies on monogenic autoimmune diseases such as autoimmune polyglandular syndrome type 1, immunodysregulation, polyendocrinopathy, enteropathy, X-linked and primary immune deficiencies helped uncover the role of key regulators in the preservation of immune tolerance. Alleles of the major histocompatibility complex have been known to contribute to the susceptibility to most forms of autoimmunity for more than 3 decades. Furthermore, sequencing studies revealed three non-major histocompatibility complex loci and some disease specific loci, which control T lymphocyte activation or signalling. Recent genome-wide association studies (GWAS) have enabled acceleration in the identification of novel (non-HLA) loci and hence other relevant immune response pathways. Interestingly, several loci are shared between autoimmune diseases, and surprisingly some work in opposite direction. This means that the same allele which predisposes to a certain autoimmune disease can be protective in another. Well powered GWAS in type 1 diabetes has led to the uncovering of a significant number of risk variants with modest effect. These studies showed that the innate immune system may also play a role in addition to the adaptive immune system. It is anticipated that next generation sequencing techniques will uncover other (rare) variants. For other autoimmune disease (such as autoimmune thyroid disease) GWAS are clearly needed.
Collapse
Affiliation(s)
- Janneke Wiebolt
- Department of Endocrinology, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | | | | |
Collapse
|
36
|
Fichna M, Żurawek M, Januszkiewicz-Lewandowska D, Fichna P, Nowak J. PTPN22, PDCD1 and CYP27B1 polymorphisms and susceptibility to type 1 diabetes in Polish patients. Int J Immunogenet 2010; 37:367-72. [DOI: 10.1111/j.1744-313x.2010.00935.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
37
|
Zurawek M, Fichna M, Januszkiewicz-Lewandowska D, Gryczyńska M, Fichna P, Nowak J. A coding variant in NLRP1 is associated with autoimmune Addison's disease. Hum Immunol 2010; 71:530-4. [PMID: 20152874 DOI: 10.1016/j.humimm.2010.02.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 01/28/2010] [Accepted: 02/01/2010] [Indexed: 11/18/2022]
Abstract
Autoimmune Addison's disease (AAD) is a complex disorder with several susceptibility loci. Variations in the NLRP1 (previously, NALP1) gene have recently been reported to confer risk for vitiligo and associated autoimmune conditions. We hypothesized that polymorphisms in this gene may affect susceptibility to AAD. The aim of this study was to analyze the associations of six NLRP1 single-nucleotide polymorphisms (SNPs) with AAD within a Polish cohort. The study comprised 101 AAD patients and 254 healthy control individuals. Genotyping was performed by polymerase chain reaction followed by restriction fragment length polymorphism and single strand conformation polymorphism methods. The minor allele of the coding SNP rs12150220 appeared significantly more frequently in AAD compared with healthy individuals (OR = 1.5, 95% CI, 1.08-2.08, p = 0.015). The distribution of genotypes also demonstrated significant differences. The frequency of high-risk genotype AA of rs12150220 SNP was significantly increased among AAD subjects versus controls (p = 0.006 and p = 0.036, respectively; significant after Bonferroni correction), yielding an OR of 2.96 (95% CI, 1.34-6.55). Likewise, the heterozygous genotype TA was observed more frequently in the patient group [OR = 3.09 (95% CI, 1.53-6.24), p = 0.001 and p = 0.006 after Bonferroni correction]. In conclusion, this study confirms an association between the coding polymorphism in NLRP1 and AAD.
Collapse
Affiliation(s)
- Magdalena Zurawek
- Institute of Human Genetics, Polish Academy of Sciences, Poznań, Poland.
| | | | | | | | | | | |
Collapse
|
38
|
Mitchell AL, Cordell HJ, Soemedi R, Owen K, Skinningsrud B, Wolff AB, Ericksen M, Undlien D, Husebye E, Pearce SHS. Programmed death ligand 1 (PD-L1) gene variants contribute to autoimmune Addison's disease and Graves' disease susceptibility. J Clin Endocrinol Metab 2009; 94:5139-45. [PMID: 19850680 DOI: 10.1210/jc.2009-1404] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Despite much investigation, a substantial amount of the genetic susceptibility to autoimmune diseases remains unaccounted for. Recently, a single-nucleotide polymorphism (SNP) in the programmed death ligand 1 (PD-L1) gene has been associated with Graves' disease (GD) in a Japanese patient cohort. Our aim was to determine whether variants in PD-L1 are also associated with autoimmune Addison's disease (AAD) and to replicate the previous association in patients with GD from the United Kingdom. DESIGN AND PATIENTS We analyzed eight SNPs within PD-L1 in a United Kingdom cohort of 315 AAD subjects and 316 healthy controls. We then replicated our experiment in a cohort of 342 Norwegian AAD cases and 379 controls and in 496 United Kingdom GD subjects. RESULTS Three of the eight SNPs studied, part of a haplotype block in the PD-L1 gene, showed modest association with both AAD and GD in the United Kingdom cohort, with maximum evidence at the marker RS1411262 [United Kingdom AAD odds ratio 1.33 (5-95% confidence interval 1.02-1.73), P(genotype) = 0.028; GD odds ratio 1.36 (5-95% confidence interval 1.07-1.72), P(genotype) = 0.033]. Association with genotypes at the same three markers was confirmed in the Norwegian AAD cohort [P(genotype) = 0.011-0.020]. A recessive effect at the most associated alleles was observed in both the AAD and GD cohorts. CONCLUSIONS We confirm the role of PD-L1 variants in GD susceptibility and extend these findings to demonstrate association in two Northern European patient cohorts with AAD. PD-L1 joins the growing number of known susceptibility loci exerting modest effects in these autoimmune disorders.
Collapse
Affiliation(s)
- Anna L Mitchell
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom
| | | | | | | | | | | | | | | | | | | |
Collapse
|