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Rosi-Schumacher M, Baker J, Waris J, Seiffert-Sinha K, Sinha AA. Worldwide epidemiologic factors in pemphigus vulgaris and bullous pemphigoid. Front Immunol 2023; 14:1159351. [PMID: 37180132 PMCID: PMC10166872 DOI: 10.3389/fimmu.2023.1159351] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
Autoimmune blistering diseases such as bullous pemphigoid (BP) and pemphigus vulgaris (PV) are complex, multifactorial, and polygenic diseases, whose exact pathogenesis is difficult to pinpoint. Research aimed at elucidating the associated epidemiologic risk factors of these two diseases has been hampered by their rare disease status. Further, a lack of centralization and standardization of available data makes the practical application of this information challenging. In order to collate and clarify the available literature we comprehensively reviewed 61 PV articles from 37 different countries and 35 BP articles from 16 different countries addressing a range of disease relevant clinical parameters including age of onset, sex, incidence, prevalence, and HLA allele association. The reported incidence of PV ranged from 0.098 to 5 patients per 100,000 people, while BP ranged from 0.21 to 7.63 patients per 100,000. Prevalence of PV ranged from 0.38 to 30 per 100,000 people and BP ranged from 1.46 to 47.99 per 100,000. The mean age of onset in patients ranged from 36.5 to 71 years for PV and 64 to 82.6 years for BP. Female-to-male ratios ranged from 0.46 to 4.4 in PV and 1.01 to 5.1 in BP. Our analysis provides support for the reported linkage disequilibrium of HLA DRB1*0402 (an allele previously shown to be associated with PV) and DQB1*0302 alleles in Europe, North America, and South America. Our data also highlight that HLA DQB1*0503 (also known to be associated with PV) appears in linkage disequilibrium with DRB1*1404 and DRB1*1401, mainly in Europe, the Middle East, and Asian countries. The HLA DRB1*0804 allele was only associated with PV in patients of Brazilian and Egyptian descent. Only two HLA alleles were reported as associated with BP more than twice in our review, DQB1*0301 and DQA1*0505. Collectively, our findings provide detailed insights into the variation of disease parameters relevant to PV and BP that can be expected to inform future work aimed at unraveling the complex pathogenesis of these conditions across the globe.
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Affiliation(s)
| | | | | | | | - Animesh A. Sinha
- Department of Dermatology, University at Buffalo, Buffalo, NY, United States
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Panhuber A, Lamorte G, Bruno V, Cetin H, Bauer W, Höftberger R, Erber AC, Frommlet F, Koneczny I. A systematic review and meta-analysis of HLA class II associations in patients with IgG4 autoimmunity. Sci Rep 2022; 12:9229. [PMID: 35654912 PMCID: PMC9163138 DOI: 10.1038/s41598-022-13042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/13/2022] [Indexed: 11/22/2022] Open
Abstract
Autoimmune diseases caused by pathogenic IgG4 subclass autoantibodies (IgG4-AID) include diseases like MuSK myasthenia gravis, pemphigus vulgaris or thrombotic thrombocytopenic purpura. Their etiology is still unknown. Polymorphisms in the human leukocyte antigen (HLA) gene locus, particularly in HLA-DRB1, are known genetic susceptibility factors for autoimmune diseases. We hypothesized a similar role for HLA polymorphisms in IgG4-AID and conducted a systematic review and meta-analysis with case-control studies on IgG4-AID based on MOOSE/ HuGENet guidelines. Genotype (G) and allele (A) frequencies of HLA-DQB1*05 (G: OR 3.8; 95% CI 2.44-5.9; p < 0.00001; A: OR 2.54; 95% CI 1.82-3.55; p < 0.00001) and HLA-DRB1*14 (G: OR 4.31; 95% CI 2.82-6.59; p < 0.00001; A: OR 4.78; 95% CI 3.52-6.49; p < 0.00001) and the HLA-DRB1*14-DQB1*05 haplotype (OR 6.3; 95% CI 3.28-12.09; p < 0.00001/OR 4.98; 95% CI 3.8-6.53; p < 0.00001) were increased while HLA-DRB1*13 (G: OR 0.48; 95% CI 0.34-0.68; p < 0.0001; A: OR 0.46; 95% CI 0.34-0.62; p < 0.00001) was decreased in IgG4-AID patients. In conclusion, the HLA-DQB1*05, HLA-DRB1*14 alleles and the HLA-DQB1*05-DRB1*14 haplotype could be genetic risk factors that predispose for the production of pathogenic IgG4 autoantibodies and the HLA-DRB1*13 allele may protect from IgG4 autoimmunity.
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Affiliation(s)
- Anja Panhuber
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Giovanni Lamorte
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Veronica Bruno
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Hakan Cetin
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Bauer
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Romana Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Astrid C Erber
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Florian Frommlet
- Center for Medical Statistics Informatics and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Inga Koneczny
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.
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Epidemiology and genetics of granulomatosis with polyangiitis. Rheumatol Int 2021; 41:2069-2089. [PMID: 34635927 DOI: 10.1007/s00296-021-05011-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/20/2021] [Indexed: 01/09/2023]
Abstract
Granulomatosis with polyangiitis (GPA) previously known as Wegener's granulomatosis (WG) is a rare rheumatic disease affecting subjects of all ages. Prevalence and incidence of this systemic disease greatly varies across different ethnic groups. GPA is the commonest form of ANCA-associated vasculitis (AAV) with PR3 positivity among 85-95% of the cases. Scientific investigations of GPA is warranted because its severity, clinical heterogeneity, fast disease manifestation and end-organ damage. The etiology of GPA is still unknown. Major role of HLA and non-HLA genes with immune functions were identified, however, very limited replication was observed in different ethnic populations. In the present review, we have discussed the updates on the global epidemiology and contribution of HLA and major non-HLA genes/loci in GPA. We have also highlighted the cross disease association of GPA associated genes that may help in better disease management and predictive medicine. We proposed that high-resolution HLA typing and development of genetic risk model would help in early disease diagnosis and understanding the prognosis.
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Scarsella L, Pollmann R, Amber KT. Autoreactive T cells in pemphigus: perpetrator and target. Ital J Dermatol Venerol 2020; 156:124-133. [PMID: 33179878 DOI: 10.23736/s2784-8671.20.06706-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pemphigus vulgaris (PV) is an autoimmune blistering disease, in which autoantibodies against epidermal cadherins, such as desmoglein (Dsg)1 and Dsg3, lead to the development of blisters and erosions on the skin and mucous membranes. Autoreactive CD4+ T cells are essential for the induction and perpetuation of the disease by interaction with B cells producing autoantibodies. PV has a strong genetic association with certain human leucocyte antigen (HLA) alleles with HLA-DRB1*04:02 and LA-DQB1*05:03 being the most prevalent in patients. Recently, genome-wide association studies have provided a new approach to identify single nucleotide polymorphisms, alongside the known association with HLA alleles. Loss of tolerance against Dsgs and other autoantigens is a critical event in the pathogenesis of PV. Epitope spreading contributes to the progression of PV, leading to an extension of the Dsg-specific autoimmune response to other molecular epitopes of autoantigens, such as desmocollins or muscarinic receptors. Alterations in CD4+CD25+ FoxP3+ regulatory T cells are thought to contribute to the development of PV representing a suitable target for therapeutic interventions. Several CD4+ T-cell subsets and cytokines are involved in the pathogenesis of PV, while Th2 cells are the extensively studied population. Recently, other T cell subsets like T follicular helper cells and Th17 have gained attention as new potential players in PV pathogenesis. The involvement of local autoantibody production in the lesional skin of PV patients in tertiary lymphoid organs is currently discussed but not yet clarified. In this study, we reviewed the current knowledge about the development, characteristics and function of autoreactive T cells in pemphigus and present current new T cell-targeted therapeutic approaches.
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Affiliation(s)
- Luca Scarsella
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Robert Pollmann
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany -
| | - Kyle T Amber
- Department of Dermatology, University of Illinois, Chicago, IL, USA
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Dere G, Yavuz IH, Ozaydın Yavuz G, Bayram Y, Gunes Bilgili S, Ozturk M. Assessment of HLA-A, HLA-DR, and HLA-DQ alleles in patients with pemphigus vulgaris from eastern of Turkey. J Cosmet Dermatol 2020; 19:2432-2437. [PMID: 31944522 DOI: 10.1111/jocd.13298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/11/2019] [Accepted: 01/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pemphigus vulgaris (PV) is a chronic progressive autoimmune bullous disease caused by the interaction of pathogenic factors, genetic, and environmental factors. HLA alleles, which are considered as protective factors against disease or predisposing factors, may be different in various populations and ethnic groups. AIMS The purpose of this study is to examine the HLA-A, HLA-DR, and HLA-DQ alleles in patients that are diagnosed with PV in and around eastern of Turkey and to determine the alleles that create predisposition to disease or protect against the disease. PATIENTS/METHODS Thirty patients diagnosed as PV with clinical, histopathological, and immunofluorescence findings and 30 healthy subjects were included in this study. The HLA-A, HLA-DR, and HLA-DQ typology in the DNA samples that were obtained from the blood samples of the groups was performed by using the PCR-SSP low-resolution gene panels. RESULTS The HLA-A*03 allele was found to be significantly higher in patient group than the control group (P-value: .020). HLA-DRB1*04 and HLA-DRB1*14 alleles in PV patients were found to be significantly higher than the control group (P-value = .000). CONCLUSION It was concluded that the HLA-DRB1*03, HLADQB1*02, and HLA-DQB1*06 alleles in and around eastern of Turkey showed protective effects against pemphigus vulgaris. It was also concluded that the HLA-A*03, HLA-DRB1*04, HLA-DRB1*14, HLA-DRB4, HLA-DQB1*03, and HLA-DQB1*05 alleles could cause predisposition to the disease.
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Affiliation(s)
- Gokturk Dere
- Department of Dermatology, Ordu State Hospital, Ordu, Turkey
| | - Ibrahım Halil Yavuz
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Goknur Ozaydın Yavuz
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Yasemin Bayram
- Department of Medical Microbiology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Serap Gunes Bilgili
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Murat Ozturk
- Department of Dermatology, Van Training and Research Hospital, Health Sciences Universty, Van, Turkey
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Li S, Zhang Q, Wang P, Li J, Ni J, Wu J, Liang Y, Leng RX, Pan HF, Ye DQ. Association between HLA-DQB1 polymorphisms and pemphigus vulgaris: A meta-analysis. Immunol Invest 2017; 47:101-112. [PMID: 29182409 DOI: 10.1080/08820139.2017.1385622] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study was performed to systematically summarize the results on the association of HLA-DQB1 polymorphisms with pemphigus vulgaris (PV) and other related factors. METHODS A comprehensive literature search of PubMed, The Cochrane Library, Embase, and Google Scholar database was conducted to identify relevant articles in English, with the last report up to November 1, 2016. Heterogeneity test was performed, and publication bias was evaluated. Stata software 12.0 was used to perform the meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CI) were used to describe the correlation by random-effects model. RESULTS 18 studies were obtained after searching databases: 10 studies were about Caucasian, and 8 articles were about non-Caucasian. Meta-analysis revealed that the allele and phenotype frequencies of DQB1*05 were markedly higher in PV patients than in controls [P < 0.001, OR: 2.640, 95%CI: 1.570-4.441; P = 0.030, OR 3.688, 95%CI: 1.138-11.946]. In addition, DQB1*03 was significantly increased at the allele level [P < 0.001, OR: 2.080, 95%CI: 1.507-2.869], and DQB1*02 was significantly decreased in PV at the allele and phenotype levels [P = 0.002, OR: 0.450, 95%CI: 0.289-0.702; P = 0.001, OR: 0.293, 95%CI: 0.146-0.587]. When based on each subtype of HLA-DQB1, DQB1*05:03 and DQB1*03:02 may play susceptibility roles in PV, and DQB1*03:03, DQB1*05:01 and DQB1*06:01 are negatively associated with PV. CONCLUSION In summary, our study suggests that alleles from the groups DQB1*05 and DQB1*03, concretely DQB1*05:03 and DQB1*03:02, respectively, may be the susceptibility factors for PV at allele and phenotype levels, whereas DQB1*05:01, DQB1*02, DQB1*06:01, and DQB1*03:03 are negatively associated with PV.
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Affiliation(s)
- Si Li
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Qin Zhang
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Peng Wang
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Jun Li
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Jing Ni
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Jun Wu
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Yan Liang
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Rui-Xue Leng
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Hai-Feng Pan
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
| | - Dong-Qing Ye
- a Department of Epidemiology and Biostatistics , School of Public Health, Anhui Medical University , Hefei , Anhui , China.,b The Key Laboratory of Major Autoimmune Disease, Anhui Province , Anhui Medical University , Hefei , Anhui , China
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Gil JM, Weber R, Rosales CB, Rodrigues H, Sennes LU, Kalil J, Chagury A, Miziara ID. Study of the association between human leukocyte antigens (HLA) and pemphigus vulgaris in Brazilian patients. Int J Dermatol 2017; 56:557-562. [PMID: 28197992 DOI: 10.1111/ijd.13577] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/15/2016] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies. METHODS The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil. DNA was extracted from peripheral blood, and HLA A, B, C, DR, and DQ typing was performed. The control group was composed of a database of 297 deceased donors from the city of São Paulo typed with the same method. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA A, HLA B, HLA C, HLA DRB1, DQA1, and HLA DQB1. RESULTS The alleles HLA-B*57, HLA-C*15, HLA-DRB1*04:02, HLA-DRB1*08:04, HLA-DRB1*14:01, DQA1*03:01, DQB1*03:02, and DQB1*05:03 were associated with susceptibility. Alleles HLA DRB1*04:02 and HLA-DRB1*14:01 and their respective haplotypes DRB1*04-DQA1*03:01-DQB1*03:02, and DRB1*14-DQA1*01:01-DQB1*05:03 conferred a risk of the disease. CONCLUSIONS The DRB1*04:02 and DQB1*05:03 alleles are associated with pemphigus vulgaris in our study as well as in various populations. The association with HLA-DRB1*08:04 in our study was confirmed to be specific to this allele and not to linkage disequilibrium to any adjacent gene. The association between HLA-B*57 and pemphigus vulgaris is reported for the first time in the present study.
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Affiliation(s)
- Julio M Gil
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Raimar Weber
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Claudia B Rosales
- Transplant Immunology and Immunogenetics Laboratory, Heart Institute (INCOR), School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Helcio Rodrigues
- Transplant Immunology and Immunogenetics Laboratory, Heart Institute (INCOR), School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Luiz U Sennes
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Jorge Kalil
- Transplant Immunology and Immunogenetics Laboratory, Heart Institute (INCOR), School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Azis Chagury
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Ivan D Miziara
- ENT Department of School of Medicine, Sao Paulo University, Sao Paulo, Brazil
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Zivanovic D, Bojic S, Medenica L, Andric Z, Popadic D. Human leukocyte antigen class II (DRB1 and DQB1) alleles and haplotypes frequencies in patients with pemphigus vulgaris among the Serbian population. HLA 2016; 87:367-74. [DOI: 10.1111/tan.12796] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/13/2016] [Accepted: 03/16/2016] [Indexed: 12/13/2022]
Affiliation(s)
- D. Zivanovic
- Clinic of Dermatovenereology; Clinical Center of Serbia; Belgrade Serbia
| | - S. Bojic
- Faculty of Biology; University of Belgrade; Belgrade Serbia
| | - L. Medenica
- Clinic of Dermatovenereology; Clinical Center of Serbia; Belgrade Serbia
- Department of Dermatovenereology, School of Medicine; University of Belgrade; Belgrade Serbia
| | - Z. Andric
- Tissue Typing Department; Blood Transfusion Institute of Serbia; Belgrade Serbia
| | - D. Popadic
- Institute of Microbiology and Immunology, School of Medicine; University of Belgrade; Belgrade Serbia
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Di Zenzo G, Amber KT, Sayar BS, Müller EJ, Borradori L. Immune response in pemphigus and beyond: progresses and emerging concepts. Semin Immunopathol 2015; 38:57-74. [DOI: 10.1007/s00281-015-0541-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/30/2015] [Indexed: 12/18/2022]
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Hadley D, Hagopian W, Liu E, She JX, Simell O, Akolkar B, Ziegler AG, Rewers M, Krischer JP, Chen WM, Onengut-Gumuscu S, Bugawan TL, Rich SS, Erlich H, Agardh D. HLA-DPB1*04:01 Protects Genetically Susceptible Children from Celiac Disease Autoimmunity in the TEDDY Study. Am J Gastroenterol 2015; 110:915-20. [PMID: 26010309 PMCID: PMC4487515 DOI: 10.1038/ajg.2015.150] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/13/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Tissue transglutaminase autoantibodies (tTGAs) represent the first evidence of celiac disease (CD) development. Associations of HLA-DR3-DQA1*05:01-DQB1*02:01 (i.e., DR3-DQ2) and, to a lesser extent, DR4-DQA1*03:01-DQB1*03:02 (i.e., DR4-DQ8) with the risk of CD differ by country, consistent with additional genetic heterogeneity that further refines risk. Therefore, we examined human leukocyte antigen (HLA) factors other than DR3-DQ2 for their contribution to developing tTGAs. METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) study enrolled 8,676 infants at an increased HLA-DR-DQ risk for type 1 diabetes and CD into a 15-year prospective surveillance follow-up. Of those followed up, 21% (n=1,813) carried DR3-DQ2/DR3-DQ2, 39% (n=3,359) carried DR3-DQ2/DR4-DQ8, 20% (n=1701) carried DR4-DQ8/DR4-DQ8, and 17% (n=1,493) carried DR4-DQ8/DQ4. Within TEDDY, a nested case-control design of 248 children with CD autoimmunity (CDA) and 248 matched control children were genotyped for HLA-B, -DRB3, -DRB4, -DPA1, and -DPB1 genes, and the entire cohort was genotyped for single-nucleotide polymorphisms (SNPs) using the Illumina ImmunoChip. CDA was defined as a positive tTGA test at two consecutive clinic visits, whereas matching in those with no evidence of tTGAs was based on the presence of HLA-DQ2, country, and sex. RESULTS After adjustment for DR3-DQ2 and restriction to allele frequency (AF) ≥5%, HLA-DPB1*04:01 was inversely associated with CDA by conditional logistic regression (AF=44%, odds ratio=0.71, 95% confidence interval (CI)=0.53-0.96, P=0.025). This association of time to CDA and HLA-DPB1*04:01 was replicated with statistical significance in the remainder of the cohort using imputation for specific HLA alleles based on SNP genotyping (hazard ratio=0.84, 95% CI=0.73-0.96, P=0.013). CONCLUSIONS HLA-DPB1*04:01 may reduce the risk of tTGAs, an early marker of CD, among DR3-DQ2 children, confirming that additional variants in the HLA region influence the risk for CDA.
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Affiliation(s)
- David Hadley
- Division of Population Health Sciences and Education, St. George’s, University of London, London, UK
- TransMed Systems, Pleasanton, California, USA
| | - William Hagopian
- Pacific Northwest Diabetes Research Institute, Seattle, Washington, USA
| | - Edwin Liu
- Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
- Barbara Davis Center, University of Colorado Denver, Aurora, Colorado, USA
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine, Georgia Regents University, Augusta, Georgia, USA
| | - Olli Simell
- Department of Pediatrics, University of Turku, Turku, Finland
| | | | - Anette-G. Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, Oberschleissheim, Germany
- Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
- Forschergruppe Diabetes e.V., Neuherberg, Germany
| | - Marian Rewers
- Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jeffrey P. Krischer
- Pediatric Epidemiology Center, University of South Florida, Tampa, Florida, USA
| | - Wei-Min Chen
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA
| | - Suna Onengut-Gumuscu
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA
| | | | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA
| | - Henry Erlich
- Children’s Hospital of Oakland Research Institute, Oakland, California, USA
| | - Daniel Agardh
- Pediatric Epidemiology Center, University of South Florida, Tampa, Florida, USA
- Department of Clinical Sciences, Lund University, Malmo, Sweden
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Alpsoy E, Akman-Karakas A, Uzun S. Geographic variations in epidemiology of two autoimmune bullous diseases: pemphigus and bullous pemphigoid. Arch Dermatol Res 2015; 307:291-8. [PMID: 25589418 DOI: 10.1007/s00403-014-1531-1] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/11/2014] [Accepted: 11/29/2014] [Indexed: 10/24/2022]
Abstract
Autoimmune bullous diseases are rare, organ-specific, a group of blistering disease of skin and mucous membranes. Recent studies suggest that the frequency of the autoimmune bullous diseases has been increasing. Pemphigus vulgaris and bullous pemphigoid are the most frequently reported autoimmune bullous diseases. High incidence of autoimmune bullous diseases in some ethnic groups such as pemphigus in Ashkenazi Jewish, or in some regions such as pemphigus foliaceus in Brazil has been shown to be related to genetic and environmental factors, respectively. Pemphigus has been reported more frequently in the female gender. Although it is most frequently diagnosed between the ages 50 and 60 in European countries, in the remaining countries in the world, it is seen between the ages of 30 and 50. Bullous pemphigoid is generally seen above 70 years of age. Although overall incidence is slightly higher in females, after the age of 80 years it is more frequent in males. Both pemphigus vulgaris and bullous pemphigoid has a chronic course with recurrences. Mortality risk of the patients with bullous pemphigoid was found at least 2 times higher and the mortality risk of the patients with pemphigus was found approximately 3 times higher than that of the general population. In this review, the results obtained from the epidemiological studies were analyzed according to geographic regions, and especially epidemiologic features of two prevalent autoimmune bullous diseases, pemphigus and bullous pemphigoid have been discussed.
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Affiliation(s)
- Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, 07059, Antalya, Turkey,
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Akoğlu G, Metin A, Ceylan GG, Emre S, Akpolat D, Süngü N. Focal epithelial hyperplasia associated with human papillomavirus 13 and common human leukocyte antigen alleles in a Turkish family. Int J Dermatol 2014; 54:174-8. [PMID: 24738569 DOI: 10.1111/ijd.12538] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Focal epithelial hyperplasia (FEH) is a rare and benign papillomatous disease of the oral cavity, which is closely associated with human papillomavirus (HPV) type 13 and 32. Genetic susceptibility to HPV infections are supported by recent studies involving the human leukocyte antigen system (HLA). In this report, we aimed to determine the clinicopathological features of a Turkish family with FEH and to detect the shared HLA DR and DQ types. METHODS HPV DNA typing of tissue samples and HLA determination from blood samples of four family members were performed by polymerase chain reaction. RESULTS Histopathological examination of all patients revealed acanthotic papillomatous epidermis, koilocytes, apoptotic keratinocytes, and mitosoid bodies. HPV13 was detected by polymerase chain reaction. HLA DQA1*0501, HLA DQB1*0302, and HLA DRB1*11 alleles were common in all family members. HLA DRB1*04 was detected in three of them. CONCLUSION This report is the first step for the investigation of involvement of HLA types in the pathogenesis of Turkish patients with FEH.
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Affiliation(s)
- Gülşen Akoğlu
- Dermatology, Atatürk Training and Research Hospital, Ankara, Turkey
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14
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Amber KT, Staropoli P, Shiman MI, Elgart GW, Hertl M. Autoreactive T cells in the immune pathogenesis of pemphigus vulgaris. Exp Dermatol 2013; 22:699-704. [DOI: 10.1111/exd.12229] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2013] [Indexed: 12/18/2022]
Affiliation(s)
- Kyle T. Amber
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL USA
| | - Patrick Staropoli
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL USA
| | - Michael I. Shiman
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL USA
| | - George W. Elgart
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL USA
| | - Michael Hertl
- Department of Dermatology and Allergology; Philipps-Universität; Marburg Germany
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