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Zhang Z, Hu Q, Yang C, Chen M, Han B. Comparison of human leukocyte antigen in patients with paroxysmal nocturnal hemoglobinuria of different clone sizes. Ann Hematol 2024; 103:1897-1907. [PMID: 38616191 DOI: 10.1007/s00277-024-05740-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
Glycosylphosphatidylinositol-anchored protein-deficient hematopoietic stem and progenitor cell development caused by PIGA mutations cannot fully explain the pathogenesis of paroxysmal nocturnal hemoglobinuria (PNH). Herein, patients newly diagnosed with PNH at our hospital between April 2019 and April 2021 were recruited. The human leukocyte antigen (HLA) class I and II loci were analyzed, and patients were stratified by PNH clone sizes: small (< 50%) and large (≥ 50%). In 40 patients (29 males; 72.5%), the median PNH clone size was 72%. Thirteen (32.5%) and twenty-seven (67.5%) patients harbored small and large PNH clones, respectively. DRB1*15:01 and DQB1*06:02 had higher frequencies in patients with PNH than in healthy controls (adjusted P-value = 4.10 × 10-4 and 4.10 × 10-4, respectively). Whole HLA class I and II allele contributions differed (P = 0.046 and 0.065, not significant difference) when comparing patients with small and large PNH clones. B*13:01 and C*04:01 allelic frequencies were significantly higher in patients with small clones (P = 0.032 and P = 0.032, respectively). Patients with small clones had higher class II HLA evolutionary divergence (HED) (P = 0.041) and global class I and II HED (P = 0.019). In the entire cohort, 17 HLA aberrations were found in 11 (27.5%) patients. No significant differences in HLA aberrations were found between patients with small or large clones. In conclusion, patients with small clones tended to have a higher frequency of immune attack-associated alleles. A higher HED in patients with small clones may reflect a propensity for T cell-mediated autoimmunity. HLA aberrations were similar between patients with small and large clones.
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Affiliation(s)
- Zhuxin Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Qinglin Hu
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Chen Yang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Miao Chen
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Bing Han
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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2
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Li YM, Li YX, Li DY, Zhou Y, An L, Yuan ZY, Du KM, Zheng ZZ. Investigation of HLA susceptibility alleles and genotypes with hematological disease among Chinese Han population. PLoS One 2024; 19:e0281698. [PMID: 38593173 PMCID: PMC11003630 DOI: 10.1371/journal.pone.0281698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/10/2024] [Indexed: 04/11/2024] Open
Abstract
Several genes involved in the pathogenesis have been identified, with the human leukocyte antigen (HLA) system playing an essential role. However, the relationship between HLA and a cluster of hematological diseases has received little attention in China. Blood samples (n = 123913) from 43568 patients and 80345 individuals without known pathology were genotyped for HLA class I and II using sequencing-based typing. We discovered that HLA-A*11:01, B*40:01, C*01:02, DQB1*03:01, and DRB1*09:01 were prevalent in China. Furthermore, three high-frequency alleles (DQB1*03:01, DQB1*06:02, and DRB1*15:01) were found to be hazardous in malignant hematologic diseases when compared to controls. In addition, for benign hematologic disorders, 7 high-frequency risk alleles (A*01:01, B*46:01, C*01:02, DQB1*03:03, DQB1*05:02, DRB1*09:01, and DRB1*14:54) and 8 high-frequency susceptible genotypes (A*11:01-A*11:01, B*46:01-B*58:01, B*46:01-B*46:01, C*01:02-C*03:04, DQB1*03:01-DQB1*05:02, DQB1*03:03-DQB1*06:01, DRB1*09:01-DRB1*15:01, and DRB1*14:54-DRB1*15:01) were observed. To summarize, our findings indicate the association between HLA alleles/genotypes and a variety of hematological disorders, which is critical for disease surveillance.
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Affiliation(s)
- Ye-Mo Li
- Shenzhen Tissuebank Precision Medicine Co., Ltd, Shenzhen, China
| | - Yu-Xia Li
- Shanghai Tissuebank Biotechnology Co., Ltd, Shanghai, China
| | - Dai-Yang Li
- Shenzhen Tissuebank Precision Medicine Co., Ltd, Shenzhen, China
| | - Ying Zhou
- Shenzhen Tissuebank Precision Medicine Co., Ltd, Shenzhen, China
| | - Lin An
- Shanghai Tissuebank Biotechnology Co., Ltd, Shanghai, China
| | - Zhi-Yang Yuan
- Shenzhen Tissuebank Precision Medicine Co., Ltd, Shenzhen, China
| | - Ke-Ming Du
- Shenzhen Tissuebank Precision Medicine Co., Ltd, Shenzhen, China
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3
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Gurnari C, Pagliuca S, Maciejewski JP. Clonal evolution in aplastic anemia: failed tumor surveillance or maladaptive recovery? Leuk Lymphoma 2023; 64:1389-1399. [PMID: 37356012 PMCID: PMC11104022 DOI: 10.1080/10428194.2023.2215614] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/10/2023] [Accepted: 05/13/2023] [Indexed: 06/27/2023]
Abstract
Clonal evolution to secondary paroxysmal nocturnal hemoglobinuria (PNH) or myeloid neoplasia (MN) represents one of the long-term complications of patients with aplastic anemia (AA). The recent evidence in the field of immunology and the application of next-generation sequencing have shed light on the molecular underpinnings of these clonal complications, revealing clinical and molecular risk factors as well as potential immunological players. Particularly, whether MN evolution represents a failed tumor surveillance or a maladaptive recovery is still a matter of controversy in the field of bone marrow failure syndromes. However, recent studies have explored the precise dynamics of the immune-molecular forces governing such processes over time, generating knowledge useful for potential early therapeutic strategies. In this review, we will discuss the immune pathophysiology of AA and the emergence of clonal hematopoiesis with regard to the adaptive and maladaptive mechanisms at the basis of secondary evolution trajectories operating under the immune pressure.
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Affiliation(s)
- Carmelo Gurnari
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Simona Pagliuca
- Sérvice d‘hématologie Clinique, ChRu de Nancy, Nancy, France
- CNRS UMR 7365 IMoPa, Biopôle de l‘Université de Lorraine, France Vandœuvre-lès-Nancy
| | - Jaroslaw P. Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
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4
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Liang L, Li N, Wang Y, Luo S, Song Y, Fang B. Human leukocyte antigen-DRB1 gene polymorphism and aplastic anemia: A meta-analysis. Medicine (Baltimore) 2023; 102:e33513. [PMID: 37335708 DOI: 10.1097/md.0000000000033513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND The human leukocyte antigen-DRB1 (HLA-DRB1) gene plays key roles in mediating immune response and activating autoreactive T-cells during aplastic anemia (AA) etiology. However, inconsistency appeared in the associations between HLA-DRB1 polymorphism and AA. We aimed to comprehensively clarify their associations in the meta-analysis. METHODS PubMed, Embase, Web of Science, Science Direct, SinoMed, WanFang Data, China National Knowledge Infrastructure, and Chongqing VIP Chinese Science Database were searched from January 2000 to June 2022. Statistical analysis was performed in STATA 15.0 and Comprehensive Meta-analysis Software 3.0. RESULTS A total of 16 studies with 4428 patients were eventually analyzed. The results of the meta-analysis suggested that HLA-DRB1*0301 could decrease the risk of AA (odd ratio (OR) = 0.600, 95% CI: 0.427, 0.843). Besides, HLA-DRB1*0901 and HLA-DRB1*1501 were risk factors of AA (OR = 1.591, 95% CI: 1.045, 2.424; OR = 2.145, 95% CI: 1.501, 3.063; respectively). Sensitivity analysis showed heterogeneity among included studies. CONCLUSION HLA-DRB1 polymorphisms could play roles in the occurrence of AA, however more population-based studies with larger sample sizes are required to certify our findings.
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Affiliation(s)
- Lijie Liang
- Henan Institute of Hematology, Department of Hematology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Ning Li
- Department of Oncology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yaomei Wang
- Henan Institute of Hematology, Department of Hematology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Suxia Luo
- Department of Oncology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yongping Song
- Henan Institute of Hematology, Department of Hematology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Baijun Fang
- Henan Institute of Hematology, Department of Hematology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
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5
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Pagliuca S, Gurnari C, Awada H, Kishtagari A, Kongkiatkamon S, Terkawi L, Zawit M, Guan Y, LaFramboise T, Jha BK, Patel BJ, Hamilton BK, Majhail NS, Lundgren S, Mustjoki S, Saunthararajah Y, Visconte V, Chan TA, Yang CY, Lenz TL, Maciejewski JP. The similarity of class II HLA genotypes defines patterns of autoreactivity in idiopathic bone marrow failure disorders. Blood 2021; 138:2781-2798. [PMID: 34748628 PMCID: PMC8718627 DOI: 10.1182/blood.2021012900] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/18/2021] [Indexed: 01/01/2023] Open
Abstract
Idiopathic aplastic anemia (IAA) is a rare autoimmune bone marrow failure (BMF) disorder initiated by a human leukocyte antigen (HLA)-restricted T-cell response to unknown antigens. As in other autoimmune disorders, the predilection for certain HLA profiles seems to represent an etiologic factor; however, the structure-function patterns involved in the self-presentation in this disease remain unclear. Herein, we analyzed the molecular landscape of HLA complexes of a cohort of 300 IAA patients and almost 3000 healthy and disease controls by deeply dissecting their genotypic configurations, functional divergence, self-antigen binding capabilities, and T-cell receptor (TCR) repertoire specificities. Specifically, analysis of the evolutionary divergence of HLA genotypes (HED) showed that IAA patients carried class II HLA molecules whose antigen-binding sites were characterized by a high level of structural homology, only partially explained by specific risk allele profiles. This pattern implies reduced HLA binding capabilities, confirmed by binding analysis of hematopoietic stem cell (HSC)-derived self-peptides. IAA phenotype was associated with the enrichment in a few amino acids at specific positions within the peptide-binding groove of DRB1 molecules, affecting the interface HLA-antigen-TCR β and potentially constituting the basis of T-cell dysfunction and autoreactivity. When analyzing associations with clinical outcomes, low HED was associated with risk of malignant progression and worse survival, underlying reduced tumor surveillance in clearing potential neoantigens derived from mechanisms of clonal hematopoiesis. Our data shed light on the immunogenetic risk associated with IAA etiology and clonal evolution and on general pathophysiological mechanisms potentially involved in other autoimmune disorders.
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Affiliation(s)
- Simona Pagliuca
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
- University of Paris, Paris, France
| | - Carmelo Gurnari
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Hassan Awada
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Ashwin Kishtagari
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Sunisa Kongkiatkamon
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Laila Terkawi
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Misam Zawit
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Yihong Guan
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Thomas LaFramboise
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH
| | - Babal K Jha
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Bhumika J Patel
- Leukemia Program, Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH
| | - Betty K Hamilton
- Blood and Marrow Transplant Program, Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH
| | - Navneet S Majhail
- Blood and Marrow Transplant Program, Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH
| | - Sofie Lundgren
- Hematology Research Unit Helsinki, University of Helsinki-Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
- Translational Immunology Research Program and Department of Clinical Chemistry and Hematology, University of Helsinki, Helsinki, Finland
| | - Satu Mustjoki
- Hematology Research Unit Helsinki, University of Helsinki-Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
- Translational Immunology Research Program and Department of Clinical Chemistry and Hematology, University of Helsinki, Helsinki, Finland
- ICAN Digital Precision Cancer Medicine Flagship, Helsinki, Finland
| | - Yogen Saunthararajah
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Valeria Visconte
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
| | - Timothy A Chan
- Center for Immunotherapy and Precision Immuno-Oncology, Cleveland Clinic, Cleveland, OH
| | - Chao-Yie Yang
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN
| | - Tobias L Lenz
- Research Group for Evolutionary Immunogenomics, Max Planck Institute for Evolutionary Biology, Plön, Germany; and
- Research Unit for Evolutionary Immunogenomics, Department of Biology, University of Hamburg, Hamburg, Germany
| | - Jaroslaw P Maciejewski
- Translational Hematology and Oncology Research Department, Cleveland Clinic, Cleveland, OH
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6
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Qi J, Wang TJ, Li HX, Wu D, Du D, Wu JH, Shang LX, Chen L, Wang MN, Wang XF. Association of HLA class II (-DRB1,-DQB1,-DPB1) alleles and haplotypes on susceptibility to aplastic anemia in northern Chinese Han. Hum Immunol 2020; 81:685-691. [PMID: 32693929 DOI: 10.1016/j.humimm.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/16/2020] [Accepted: 07/05/2020] [Indexed: 11/17/2022]
Abstract
The Human Leukocyte Antigen (HLA) genes, playing key roles in mediating the immune response, especially HLA class II alleles were suggested to play a role in the activation of autoreactive T-cells in aplastic anemia (AA). Previous studies in different ethnic groups have indicated that some of HLA-A,-B,-DRB1 alleles had a protective or susceptive association with the prevalence, pathogenesis and development of AA. HLA class II genes, especially HLA-DQB1 and -DPB1 alleles or haplotypes at high-resolution level associated with AA have not been fully identified in northern Chinese Han populations. The aim of this study was to identify association of the variations in HLA class II region with AA in northern Chinese Han population. A recent case-control study, including 96 AA patients and 824 healthy controls was performed. The high-resolution HLA genotyping was conducted by PCR-SBT, -SSO and NGS-ION S5TM platform. Based on genotypic data of the three loci, haplotype estimation was carried out. HLA-DRB1*15:01 (Pc = 2.87 × 10-3; OR = 2.11, 95% CI = 1.45-3.07) and HLA-DQB1*06:02 (Pc = 1.86 × 10-2; OR = 2.01, 95% CI = 1.32-3.06) were the risk and predisposition alleles to AA in northern Chinese Han after considering multiple testing. Moreover, the HLA-DRB1*15:01-DQB1*06:02 (Pc = 4.90 × 10-3; OR = 2.09, 95% CI = 1.37-3.19) and HLA-DRB1*14:05-DQB1*05:03 (Pc = 2.65 × 10-2; OR = 2.82, 95%CI = 1.45-5.50) haplotypes had direct strong relevance to AA and were the susceptible haplotypes. HLA-DPB1 alleles and 23 polymorphic amino acid residues spanning exon 2 ~ 4 of DPβ1 molecules have showed no statistically significant associations between AA and controls. The present findings establish a novel link between inherited HLA-DRB1,-DQB1,-DPB1 risk alleles and haplotypes in northern Chinese Han with AA, and open new avenues for development of targeted therapies to prevent or redirect immunopathology in AA.
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Affiliation(s)
- Jun Qi
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China.
| | - Tian-Ju Wang
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
| | - Heng-Xin Li
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
| | - Di Wu
- Department of Hematology, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, Shaanxi Province, China
| | - Dan Du
- Department of Tech Service, China Marrow Donor Program, Beijing 100013, China
| | - Jun-Hua Wu
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
| | - Li-Xia Shang
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
| | - Le Chen
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
| | - Man-Ni Wang
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
| | - Xiao-Fang Wang
- HLA Laboratory, Blood Center of Shaanxi Province, Institute of Xi'an Blood Bank, Xi'an, China
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7
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Sayad A, Dehaghi MO, Taheri M, Fallah H, Arsang-Jang S, Shadnoush M, Ghafouri-Fard S, Hamidieh AA. Identification of HLA-A/B/DRB1 alleles in Iranian patients with Fanconi anemia. Hum Antibodies 2020; 28:221-226. [PMID: 32224532 DOI: 10.3233/hab-200410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fanconi anemia includes a number of clinically and genetically diverse disorders all of them being associated with genomic instability. Some previous studies reported higher frequencies of certain HLA alleles in patients with Fanconi anemia. In the current study, we genotyped HLA-A/B/DRB1 alleles in 40 Iranian patients with Fanconi anemia. We also genotyped these alleles in the same number of Iranian sex-matched healthy individuals. The frequency of DRB1*11 was significantly higher in patients compared with controls (OR (95% CI) = 2.143 [1.05, 4.46], P value = 0.036). On the other hand, the frequencies of DRB1*13 and B*13 were lower in patients compared with controls (OR (95% CI) = 0.134 [0.02, 0.55], P value = 0.003 and OR (95% CI) = 0.13 [0.01, 0.89], P value = 0.035, respectively). Assessment of genetic divergence using Fstat test showed complete divergence in HLA-A, -B, -DRB1 alleles and haplotypes between patients and controls. The current study provides evidences for different distribution of HLA alleles between patients with Fanconi anemia and healthy subjects.
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Affiliation(s)
- Arezou Sayad
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Ostadali Dehaghi
- Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Hematology, Oncology, and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Fallah
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Arsang-Jang
- Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Mahdi Shadnoush
- Department of Clinical Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Ali Hamidieh
- Pediatric Cell Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran
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8
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Boddu PC, Kadia TM. Molecular pathogenesis of acquired aplastic anemia. Eur J Haematol 2018; 102:103-110. [DOI: 10.1111/ejh.13182] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Prajwal C. Boddu
- Department of Leukemia University of Texas MD Anderson Cancer Center Houston Texas
| | - Tapan M. Kadia
- Department of Leukemia University of Texas MD Anderson Cancer Center Houston Texas
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9
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Deng XZ, Du M, Peng J, Long JX, Zheng CJ, Tan Y, Li LJ, Chen HY, Qing C, Pang YY, Lan Y, Zhang HT. Associations between the HLA-A/B/DRB1 polymorphisms and aplastic anemia: evidence from 17 case-control studies. ACTA ACUST UNITED AC 2017; 23:154-162. [PMID: 28902578 DOI: 10.1080/10245332.2017.1375064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To estimate the associations between HLA-A/B/DRB1 polymorphisms and aplastic anemia (AA), we carried out the meta-analysis. METHODS In this meta-analysis, all publications in English and Chinese were considered up to 30 September 2015. The electronic databases we searched were Pubmed, Science Direct, Embase, Web of Science, CNKI, Wanfang Data and VIP. We conducted all statistical data analyses in the Stata11.0 software. RESULTS A total of 17 studies including 9164 subjects (containing 1372 cases and 7792 controls) were retrieved, which studied the relationship between HLA-A/B/DRB1 and AA. Odds ratios (ORs) with 95% confidence intervals (CIs) for the comparisons between cases and controls were calculated. The result revealed that HLA-A*02 and HLA-DRB1 (*0407, *15 and *1501) polymorphisms might increase the risk of AA. Otherwise, HLA-DRB1 (*0301, *04, *0406, *0802, *1301, *1302 and *14) were protective against AA. But, other sites of HLA-A/B/DRB1 in our study had no correlations with AA (all Pc > 0.05). CONCLUSION In conclusion, HLA-A/B/DRB1 polymorphisms may play an important role in AA, but higher quality and larger sample studies are needed to confirm.
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Affiliation(s)
- Xiao-Zhen Deng
- a Department of Hematology , The First Affiliated Hospital of Guangxi Medical University , Guangxi , China
| | - Meng Du
- a Department of Hematology , The First Affiliated Hospital of Guangxi Medical University , Guangxi , China
| | - Jiao Peng
- b Department of Radiology , The First Affiliated Hospital of Guangxi Medical University , Guangxi , China
| | - Jian-Xiong Long
- c Department of Epidemiology , Guangxi Medical University , Guangxi , China
| | | | - Yuan Tan
- d Guangxi Medical University , Guangxi , China
| | - Li-Juan Li
- d Guangxi Medical University , Guangxi , China
| | | | - Cao Qing
- d Guangxi Medical University , Guangxi , China
| | | | - Yan Lan
- d Guangxi Medical University , Guangxi , China
| | - Hai-Tian Zhang
- e Department of Gastroenterology , The First Affiliated Hospital of Guangxi Medical University , Guangxi , China
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10
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Jeong TD, Mun YC, Chung HS, Seo D, Im J, Huh J. Novel deletion mutation of HLA-B*40:02 gene in acquired aplastic anemia. HLA 2016; 89:47-51. [PMID: 28025876 DOI: 10.1111/tan.12943] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/31/2016] [Accepted: 11/17/2016] [Indexed: 01/03/2023]
Abstract
Despite prevalence of clonal evolution in patients with aplastic anemia (AA), somatic mutation of human leukocyte antigen (HLA) gene is rarely reported. Herein, we reported a case of acquired AA (aAA) harboring a new four-base-pair deletion mutation within exon 4 of HLA-B*40:02 leading to frameshift and premature stop codon. The HLA-B*40:02 mutant allele was detected in the patient's peripheral blood sample not in patient's buccal epithelial cells. The patient received allogenic hematopoietic stem cell transplantation (HSCT) from HLA-matched sibling donor. On day 30 after HSCT, the mutant HLA allele was not detected by high-resolution sequence-based HLA typing. Serial chimerism analyses showed mixed chimeric status indicative of coexisting donor and recipient hematopoietic cells. Our data could provide additional support in view of pathophysiology of aAA that somatic mutation of HLA-B*40:02 allele is one of the possible origin of clonal escape to evade immune attack in patient with aAA.
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Affiliation(s)
- T-D Jeong
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Y-C Mun
- Division of Hematology & Oncology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - H-S Chung
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - D Seo
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - J Im
- Research and Development Team, Biowithus Life Science Institute, Seoul, Korea
| | - J Huh
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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11
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Association of Human Leukocyte Antigen DRB1*15 and DRB1*15:01 Polymorphisms with Response to Immunosuppressive Therapy in Patients with Aplastic Anemia: A Meta-Analysis. PLoS One 2016; 11:e0162382. [PMID: 27611583 PMCID: PMC5017877 DOI: 10.1371/journal.pone.0162382] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 08/22/2016] [Indexed: 11/30/2022] Open
Abstract
This study aimed to review and quantitatively analyze (1) the association of aplastic anemia (AA) with human leukocyte antigen (HLA)-DRB1*15 and HLA-DRB1*15:01 polymorphisms and (2) the association of HLA-DRB1*15 and HLA-DRB1*15:01 polymorphisms with response to immunosuppressive therapy (IST) in AA. Published studies have reported conflicting and heterogeneous results regarding the association of HLA-DRB1*15 and HLA-DRB1*15:01 polymorphisms with response to IST in AA. The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wangfang and Chinese Social Sciences Citation Index databases were searched. All relevant publications were searched through December 2015. Odds ratio (OR), risk ratio (RR), and 95% confidence intervals (CI) for the comparison between case–control or cohort studies were evaluated. Finally, 24 articles were identified. For HLA-DRB1*15 and HLA-DRB1*15:01, the OR (95% CI) was 2.24(1.33–3.77), P < 0.01 and 2.50(1.73–3.62), P < 0.01, respectively; and the overall pooled RR was 1.72 (1.30–2.29), P < 0.01 and 1.59 (1.29–1.96), P < 0.01, respectively. Statistical evidence showed no publication bias (P > 0.05). Sensitivity analyses revealed that the results were statistically robust. The meta-analysis suggested that HLA-DRB1*15 and HLA-DRB1*15:01 polymorphisms might be associated with increased AA risk in Asians. IST might be more effective in HLA-DRB1*15+ and HLA-DRB1*15:01+ Asian patients with AA than in HLA-DRB1*15− and HLA-DRB1*15:01− Asian patients with AA. Future studies with adequate methodological quality on gene–gene and gene–environment interactions and gene treatment may yield valid results.
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FU RUTING, XUE HONGMAN, ZHANG BIHONG, WANG JIAN, LIN SHAOFEN, CHEN CHUN. Correlation analysis of severe aplastic anemia immunosuppressive therapy and human leukocyte antigen alleles in pediatric patients. Exp Ther Med 2015; 10:2396-2402. [DOI: 10.3892/etm.2015.2807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 08/20/2015] [Indexed: 11/06/2022] Open
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Zeng Y, Katsanis E. The complex pathophysiology of acquired aplastic anaemia. Clin Exp Immunol 2015; 180:361-70. [PMID: 25683099 DOI: 10.1111/cei.12605] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2015] [Indexed: 12/15/2022] Open
Abstract
Immune-mediated destruction of haematopoietic stem/progenitor cells (HSPCs) plays a central role in the pathophysiology of acquired aplastic anaemia (aAA). Dysregulated CD8(+) cytotoxic T cells, CD4(+) T cells including T helper type 1 (Th1), Th2, regulatory T cells and Th17 cells, natural killer (NK) cells and NK T cells, along with the abnormal production of cytokines including interferon (IFN)-γ, tumour necrosis factor (TNF)-α and transforming growth factor (TGF)-β, induce apoptosis of HSPCs, constituting a consistent and defining feature of severe aAA. Alterations in the polymorphisms of TGF-β, IFN-γ and TNF-α genes, as well as certain human leucocyte antigen (HLA) alleles, may account for the propensity to immune-mediated killing of HSPCs and/or ineffective haematopoiesis. Although the inciting autoantigens remain elusive, autoantibodies are often detected in the serum. In addition, recent studies provide genetic and molecular evidence that intrinsic and/or secondary deficits in HSPCs and bone marrow mesenchymal stem cells may underlie the development of bone marrow failure.
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Affiliation(s)
- Y Zeng
- Department of Pediatrics, Steele Children's Research Center, University of Arizona, Tucson, AZ, USA
| | - E Katsanis
- Department of Pediatrics, Steele Children's Research Center, University of Arizona, Tucson, AZ, USA
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Wang M, Nie N, Feng S, Shi J, Ge M, Li X, Shao Y, Huang J, Zheng Y. The polymorphisms of human leukocyte antigen loci may contribute to the susceptibility and severity of severe aplastic anemia in Chinese patients. Hum Immunol 2014; 75:867-72. [PMID: 24979673 DOI: 10.1016/j.humimm.2014.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 06/19/2014] [Accepted: 06/19/2014] [Indexed: 11/24/2022]
Abstract
The human leukocyte antigen (HLA) system has been reported to be involved in the development of aplastic anemia (AA). We compared and analyzed HLA-A, B, C, DRB1 and DQB1 alleles in 96 Chinese severe AA (SAA) patients to those in 600 healthy people chosen randomly from the China Marrow Donor Program to investigate the association of HLA class I and II allele polymorphisms with disposition of SAA and its severity degree in Chinese population. The DNA of patients was extracted and HLA high-resolution genotyping was conducted using polymerase chain reaction-sequence based typing technique. The gene frequencies of A(∗)02:01, A(∗)02:06, B(∗)13:01, DRB1(∗)07:01, DRB1(∗)09:01, DRB1(∗)15:01 and DQB1(∗)06:02 in SAA patients were significantly higher than in controls (all P<0.05), while the allelic frequencies of A(∗)02:07, A(∗)11:01 and B(∗)40:01 were notably lower in SAA patients than those in the controls (P = 0.001, 0.002, 0.005, respectively). Comparison among different severity of SAA groups exhibited significant increases of DRB1(∗)15:01 (P = 0.027) and DQB1(∗)06:02 (P = 0.013), but obviously lower frequencies of B(∗)46:01 (P = 0.023) and DRB1(∗)09:01 (P = 0.020) in non-VSAA patients than in VSAA patients. Thus, our results identified several risk and protective HLA alleles for Chinese SAA patients. Moreover, DRB1(∗)15:01, DQB1(∗)06:02, B(∗)46:01 and DRB1(∗)09:01 may be associated with severity of SAA.
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Affiliation(s)
- Min Wang
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Neng Nie
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Sizhou Feng
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Jun Shi
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Meili Ge
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Xingxin Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Yingqi Shao
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Jinbo Huang
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China
| | - Yizhou Zheng
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin 300020, PR China.
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Genetic associations in acquired immune-mediated bone marrow failure syndromes: insights in aplastic anemia and chronic idiopathic neutropenia. Clin Dev Immunol 2012; 2012:123789. [PMID: 22956967 PMCID: PMC3432560 DOI: 10.1155/2012/123789] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 08/06/2012] [Indexed: 01/10/2023]
Abstract
Increasing interest on the field of autoimmune diseases has unveiled a plethora of genetic factors that predispose to these diseases. However, in immune-mediated bone marrow failure syndromes, such as acquired aplastic anemia and chronic idiopathic neutropenia, in which the pathophysiology results from a myelosuppressive bone marrow microenvironment mainly due to the presence of activated T lymphocytes, leading to the accelerated apoptotic death of the hematopoietic stem and progenitor cells, such genetic associations have been very limited. Various alleles and haplotypes of human leucocyte antigen (HLA) molecules have been implicated in the predisposition of developing the above diseases, as well as polymorphisms of inhibitory cytokines such as interferon-γ, tumor necrosis factor-α, and transforming growth factor-β1 along with polymorphisms on molecules of the immune system including the T-bet transcription factor and signal transducers and activators of transcription. In some cases, specific polymorphisms have been implicated in the outcome of treatment on those patients.
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Fernández-Torres J, Flores-Jiménez D, Arroyo-Pérez A, Granados J, López-Reyes A. The ancestry of the HLA-DRB1*15 allele predisposes the Mexican mestizo to the development of aplastic anemia. Hum Immunol 2012; 73:840-3. [PMID: 22580214 DOI: 10.1016/j.humimm.2012.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 04/11/2012] [Accepted: 04/16/2012] [Indexed: 11/17/2022]
Abstract
UNLABELLED Aplastic anemia (AA) is a hematological disorder characterized by pancytopenia in peripheral blood and hypoplasia in the bone marrow; the majority of cases have no known etiology, but it is thought that genetic and environmental factors can be involved in its pathogenesis. From the genetic viewpoint, it has been reported a significant increase frequency of the human leukocyte antigen HLA-DRB1(∗)15 in patients with AA as compared to ethnically matched healthy controls, this is true in different populations worldwide, which would suggests that this allele participates in the immune regulation of the disease. OBJECTIVE To determine gene frequencies of HLA-DRB1 alleles in Mexican mestizo patients with AA. METHODS We analyzed and compared the HLA-DRB1 alleles in 36 Mexican mestizo patients (female gender, n=13; male gender, n=23) with AA to those present in 201 umbilical cord blood (UCB) samples as a control group, this was done by means of the polymerase chain reaction-single specific primer (PCR-SSP) technique. RESULTS Analysis of gene frequencies of HLA-DRB1(∗) alleles exhibits a significant increase of HLA-DRB1(∗)15 allele in the group of patients with AA as compared to those present in the control group (15.27% vs. 2.23%, respectively; p=1×10(-5); odds ratio [OR]=9.3; 95% confidence interval [95% CI]=3.2-27.8). CONCLUSIONS Our results showed a positive association of the DRB1(∗)15 allele in Mexican patients with aplastic anemia, which coincides with that reported internationally. In addition, we think that this allele was introduced to the Mexican population structure inherited from European ancestry.
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Affiliation(s)
- Javier Fernández-Torres
- Laboratorio de Sinovioanálisis Molecular, Instituto Nacional de Rehabilitación, Secretaría de Salud, Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, Del. Tlalpan, 14389 México, DF, Mexico.
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Chen C, Lu S, Luo M, Zhang B, Xiao L. Correlations between HLA-A, HLA-B and HLA-DRB1 allele polymorphisms and childhood susceptibility to acquired aplastic anemia. Acta Haematol 2012; 128:23-7. [PMID: 22572536 DOI: 10.1159/000337094] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 02/07/2012] [Indexed: 02/02/2023]
Abstract
To investigate the correlations between polymorphisms of human leukocyte antigen (HLA)-A, HLA-B and HLA-DRB1 alleles and childhood susceptibility to aplastic anemia (AA), 80 children with AA were investigated. Among the 80 children, 74 had severe AA (SAA). Blood samples were collected from 109 healthy children as the controls. High-resolution genotyping of HLA-A, HLA-B and HLA-DRB1 alleles was conducted using polymerase chain reaction amplification with sequence-specific primers and polymerase chain reaction amplification with sequence-based typing. The expression frequencies of HLA-B*48:01 and DRB1*09:01 were significantly higher and the frequencies of HLA-B*51:01, DRB1*03:01 and DRB1*11:01 were significantly lower in the AA group compared with those in the control group. In addition, the frequencies of HLA-B*48:01 and DRB1*09:01 were significantly higher and the frequencies of HLA-B*51:01, DRB1*03:01 and DRB1*11:01 were significantly lower in the SAA group compared with those in the control group. HLA-B*48:01 and DRB1*09:01 were correlated with childhood AA, and thus they may be susceptibility genes for childhood SAA. HLA-B*51:01, DRB1*03:01 and DRB1*11:01 are expressed at low levels in children with AA.
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Affiliation(s)
- Chun Chen
- Pediatrics of Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
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Ioannou S, Hatzis G, Vlahadami I, Voulgarelis M. Aplastic anemia associated with interferon alpha 2a in a patient with chronic hepatitis C virus infection: a case report. J Med Case Rep 2010; 4:268. [PMID: 20704699 PMCID: PMC2925355 DOI: 10.1186/1752-1947-4-268] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Accepted: 08/12/2010] [Indexed: 02/06/2023] Open
Abstract
Introduction Hepatitis-associated aplastic anemia is a common syndrome in patients with bone marrow failure. However, hepatitis-associated aplastic anemia is an immune-mediated disease that does not appear to be caused by any of the known hepatitis viruses including hepatitis C virus. In addition, to the best of our knowledge there are no reported cases of patients with chronic hepatitis C virus infection developing aplastic anemia associated with pegylated interferon alpha 2a treatment. Case presentation We report the case of a 46-year-old Greek man who developed severe aplastic anemia during treatment with pegylated interferon alpha 2a for chronic hepatitis C virus infection. He presented with generalized purpura and bruising, as well as pallor of the skin and mucous membranes. His blood tests showed pancytopenia. He underwent allogeneic bone marrow transplantation after completing two courses of immunosuppressive therapy with antithymocyte globulin and cyclosporin A. Conclusions The combination of a specific environmental precipitant represented by the hepatitis C virus infection, an altered metabolic detoxification pathway due to treatment with pegylated interferon alpha 2a and a facilitating genetic background such as polymorphism in metabolic detoxification pathways and specific human leukocyte antigen genes possibly conspired synergistically in the development of aplastic anemia in this patient. Our case clearly shows that the causative role of pegylated interferon alpha 2a in the development of aplastic anemia must not be ignored.
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Affiliation(s)
- Savvas Ioannou
- Department of Pathophysiology, Medical School, National University of Athens, Athens, Greece.
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