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Laaribi AB, Mehri A, Yahia HB, Chaouch H, Babay W, Letaief A, Ouzari HI, Hannachi N, Boukadida J, Zidi I. Association of HLA-G 3'UTR polymorphisms with hepatitis B virus infection in Tunisian population. Immunol Res 2024:10.1007/s12026-024-09516-2. [PMID: 38970627 DOI: 10.1007/s12026-024-09516-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
Hepatitis B virus (HBV) infection is a major public health burden. The mechanisms of immune evasion during chronic HBV (CHB) infection are poorly understood. Human leukocyte antigen (HLA)-G, an immune checkpoint molecule, plays a crucial role in the tolerance mechanisms of various infectious diseases. The 3' untranslated region (3'UTR), including the HLA-G + 3142 C > G polymorphism (rs1063320) and the 14-pb Ins/Del (rs66554220) has been strongly suggested to influence HLA-G expression. This study conducted a case-control analysis to evaluate the potential correlation between the HLA-G + 3142 C > G polymorphism and HBV infection outcome in a Tunisian cohort. The HLA-G + 3142 C > G polymorphism was analysed by PCR-RFLP in 242 patients with chronic HBV infection (116 males and 126 females), 241 healthy controls (116 males and 125 females), and 100 spontaneously resolved subjects (52 males and 48 females). Patients with chronic HBV infection showed a higher frequency of the + 3142G allele compared to healthy controls and spontaneously resolved subjects (p = 0.001 and p = 0.002, respectively). An association between the + 3142G allele and high HBV DNA levels was observed when HBV patients were stratified based on their HBV DNA levels (p = 0.016). Furthermore, the dominant model (GG + GC vs CC) was associated with liver function parameters, including AST, ALT, and high HBV DNA levels (p = 0.04, p < 0.001 and p = 0.002, respectively). However, there was no significant association found between this polymorphism and the fibrosis stage (p = 0.32). The haplotype analysis, using a subset of previously published data on the HLA-G 14-pb Ins/Del polymorphism, revealed an association between the Ins/G haplotype and chronic HBV infection (H1: InsG, p < 0.001). Our findings suggest that the + 3142G allele is a risk factor for the persistence and progression of HBV infection, while the + 3142C allele serves as a protective allele associated with the spontaneous resolution of the infection. Additionally, the HLA-G 3'UTR haplotype Ins/G is associated with chronic HBV infection in the Tunisian population.
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Affiliation(s)
- Ahmed Baligh Laaribi
- Laboratory of Microorganisms and Active Biomolecules (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Asma Mehri
- Laboratory of Microorganisms and Active Biomolecules (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Hamza Ben Yahia
- Laboratory of Microorganisms and Active Biomolecules (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Houda Chaouch
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - Wafa Babay
- Laboratory of Microorganisms and Active Biomolecules (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Amel Letaief
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - Hadda-Imene Ouzari
- Laboratory of Microorganisms and Active Biomolecules (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Naila Hannachi
- Laboratory of Microbiology (UR12SP34), Faculty of Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Jalel Boukadida
- Laboratory of Microbiology (UR12SP34), Faculty of Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Ines Zidi
- Laboratory of Microorganisms and Active Biomolecules (LR03ES03), Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Oliveira Correa JD, Zambra FMB, Michita RT, Álvares-da-Silva MR, Simon D, Chies JAB. HLA-G 3'UTR haplotype analyses in HCV infection and HCV-derived cirrhosis, hepatocellular carcinoma and fibrosis. Int J Immunogenet 2023; 50:249-255. [PMID: 37658479 DOI: 10.1111/iji.12636] [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: 06/05/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/03/2023]
Abstract
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic HCV infection is also an important cause of hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC). HCV has the capacity to evade immune surveillance by altering the host immune response. Moreover, variations in immune-related genes can lead to differential susceptibility to HCV infection as well as interfere on the susceptibility to the development of hepatic fibrosis, cirrhosis and HCC. The human leucocyte antigen G (HLA-G) gene codes for an immunomodulatory protein known to be expressed in the maternal-foetal interface and in immune-privileged tissues. The HLA-G 3' untranslated region (3'UTR) is important for mRNA stability, and variants in this region are known to impact gene expression. Studies, mainly focusing in a 14 bp insertion/deletion polymorphism, have correlated HLA-G 3'UTR with susceptibility to viral infections, but other polymorphic variants in the HLA-G 3'UTR might also affect HCV infection as they are inherited as haplotypes. The present study evaluated HLA-G 3'UTR polymorphisms and performed linkage disequilibrium test and haplotype assembly in 286 HCV infected patients who have developed fibrosis, cirrhosis or HCC, as well as in 129 healthy control subjects. Haplotypes UTR-1, UTR-2 and UTR-3 were the most observed in HCV+ patients, in the frequencies of 0.276, 0.255 and 0.121, respectively. No statistically significant difference was observed between HCV+ and control subjects, even when patients were grouped according to outcome (HCC, cirrhosis or fibrosis). Despite that, some trends in the results were observed, and therefore, we cannot rule out the possibility that variants associated to high HLA-G expression can be involved in HCV infection susceptibility.
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Affiliation(s)
- Julio Daimar Oliveira Correa
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Rafael Tomoya Michita
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Daniel Simon
- Laboratório de Genética Molecular Humana, Universidade Luterana do Brasil (ULBRA), Canoas, Brazil
| | - José Artur Bogo Chies
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Okumura T, Joshita S, Yamazaki T, Iwadare T, Wakabayashi SI, Kobayashi H, Yamashita Y, Sugiura A, Kimura T, Ota M, Umemura T. HLA-G susceptibility to hepatitis B infection and related hepatocellular carcinoma in the Japanese population. Hum Immunol 2023:S0198-8859(23)00071-X. [PMID: 37271588 DOI: 10.1016/j.humimm.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/24/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023]
Abstract
AIMS Human leukocyte antigen (HLA)-G plays a role in various physiological immunomodulatory functions. Aberrant HLA-G expression is observed in various disease states, including tumors, autoimmune disorders, and viral infections. The present study investigated the association between HLA-G functional gene polymorphisms (rs1736933 [-486 C > A], rs1049033 [+2018 C > T], 14 bp Insertion [Ins]/Deletion [Del] [+2961 Del > Ins], and rs1063320 [+3142 C > G]) and disease susceptibility, hepatocellular carcinoma (HCC) development, and hepatitis B surface antigen (HBsAg) clearance. METHODS Allele discrimination of the 3 SNPs (-486 C > A, +2018 C > T, +3142 C > G) was determined by a TaqMan 5' exonuclease assay, while the 14 bp Ins/Del polymorphism was typed by fragment analysis using Genetic Analyzer and GeneMapper software. The above polymorphisms were analyzed for 325 Japanese hepatitis B virus (HBV) patients, 355 Japanese healthy subjects (Controls) as healthy controls, and 799 Japanese hepatitis C virus (HCV) patients as disease controls, respectively. RESULTS The 14 bp Insertion allele was significantly more frequent in HBV patients than Controls (27.1 % vs 20.6 %, odds ratio [OR] 1.43, P = 0.005) but did not differ between HCV patients and Controls. Similar results were found for the rs1063320 G allele (38.9 % vs 26.3 %, OR 1.78, P < 0.001) and the rs1736933 T allele (32.2 % vs 26.9 %, OR 1.29, P = 0.034) between HBV and Controls. The rs1049033 T allele showed a weak but significant association with HCC development in the dominant model (OR 1.95, P = 0.04). Regarding HBsAg clearance, the A allele at rs1736933 was significantly correlated in the recessive model (OR 3.23, P = 0.003). CONCLUSIONS This study revealed significant associations of HLA-G gene polymorphisms with disease susceptibility, HCC development, and HBsAg clearance in HBV patients.
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Affiliation(s)
- Taiki Okumura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoru Joshita
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan; Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
| | - Tomoo Yamazaki
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takanobu Iwadare
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shun-Ichi Wakabayashi
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Kobayashi
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan; Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuki Yamashita
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ayumi Sugiura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takefumi Kimura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masao Ota
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan; Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
| | - Takeji Umemura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan; Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Department of Advanced Endoscopic Therapy, Shinshu University School of Medicine, Matsumoto, Japan; Consultation Center for Liver Diseases, Shinshu University Hospital, Matsumoto, Japan
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Peripheral HLA-G/ILT-2 immune checkpoint axis in acute and convalescent COVID-19 patients. Hum Immunol 2023:S0198-8859(23)00043-5. [PMID: 36925435 PMCID: PMC10011044 DOI: 10.1016/j.humimm.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
The immunosuppressive non-classical human leukocyte antigen-G (HLA-G) can elicits pro-viral activities by down-modulating immune responses. We analysed soluble forms of HLA-G, IL-6 and IL-10 as well as on immune effector cell expression of HLA-G and its cognate ILT-2 receptor in peripheral blood obtained from hospitalised and convalescent COVID-19 patients. Compared with convalescents (N = 202), circulating soluble HLA-G levels (total and vesicular-bound molecules) were significantly increased in hospitalised patients (N = 93) irrespective of the disease severity. During COVID-19, IL-6 and IL-10 levels were also elevated. Regarding the immune checkpoint expression of HLA-G/ILT-2 on peripheral immune effector cells, the frequencies of membrane-bound HLA-G on CD3+ and CD14+ cells were almost identical in patients during and post COVID-19, while the frequency of ILT-2 receptor on CD3+ and CD14+ cells was increased during acute infection. A multi-parametric correlation analysis of soluble HLA-G forms with IL-6, IL-10, activation markers CD25 and CD154, HLA-G, and ILT-2 expression on immune cells revealed a strong positive correlation of soluble HLA-G forms with membrane-bound HLA-G molecules on CD3+/CD14+ cells only in convalescents. During COVID-19, only vesicular-bound HLA-G were positively correlated with the activation marker CD25 on T cells. Thus, our data suggest that the elevated levels of soluble HLA-G in COVID-19 are due to increased expression in organ tissues other than circulating immune effector cells. The concomitant increased expression of soluble HLA-G and ILT-2 receptor frequencies supports the concept that the immune checkpoint HLA-G/ILT-2 plays a role in the immune-pathogenesis of COVID-19.
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Akhlaghipour I, Bina AR, Mogharrabi MR, Fanoodi A, Ebrahimian AR, Khojasteh Kaffash S, Babazadeh Baghan A, Khorashadizadeh ME, Taghehchian N, Moghbeli M. Single-nucleotide polymorphisms as important risk factors of diabetes among Middle East population. Hum Genomics 2022; 16:11. [PMID: 35366956 PMCID: PMC8976361 DOI: 10.1186/s40246-022-00383-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/23/2022] [Indexed: 12/16/2022] Open
Abstract
Diabetes is a chronic metabolic disorder that leads to the dysfunction of various tissues and organs, including eyes, kidneys, and cardiovascular system. According to the World Health Organization, diabetes prevalence is 8.8% globally among whom about 90% of cases are type 2 diabetes. There are not any significant clinical manifestations in the primary stages of diabetes. Therefore, screening can be an efficient way to reduce the diabetic complications. Over the recent decades, the prevalence of diabetes has increased alarmingly among the Middle East population, which has imposed exorbitant costs on the health care system in this region. Given that the genetic changes are among the important risk factors associated with predisposing people to diabetes, we examined the role of single-nucleotide polymorphisms (SNPs) in the pathogenesis of diabetes among Middle East population. In the present review, we assessed the molecular pathology of diabetes in the Middle East population that paves the way for introducing an efficient SNP-based diagnostic panel for diabetes screening among the Middle East population. Since, the Middle East has a population of 370 million people; the current review can be a reliable model for the introduction of SNP-based diagnostic panels in other populations and countries around the world.
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Negrini S, Contini P, Murdaca G, Puppo F. HLA-G in Allergy: Does It Play an Immunoregulatory Role? Front Immunol 2022; 12:789684. [PMID: 35082780 PMCID: PMC8784385 DOI: 10.3389/fimmu.2021.789684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
Allergy is an inflammatory process determined by a cascade of immune events characterized by T-helper 2 lymphocytes polarization leading to interleukin-4 upregulation, IgE secretion, and mast cell and eosinophil activation. HLA-G molecules, both in membrane-bound and in soluble forms, are known to play a key immunoregulatory role and their involvement in allergic diseases is supported by increasing literature data. HLA-G expression and secretion is specifically induced in peripheral blood mononuclear cells of allergic patients after in vitro incubation with the causal allergen. Elevated levels of soluble HLA-G molecules are detected in serum of patients with allergic rhinitis correlating with allergen-specific IgE levels, clinical severity, drug consumption and response to allergen-specific immunotherapy. HLA-G genetic polymorphisms confer susceptibility to allergic asthma development and high levels of soluble HLA-G molecules are found in plasma and bronchoalveolar lavage fluid of patients with allergic asthma correlating with allergen-specific IgE levels. Interestingly, allergic pregnant women have lower plasma sHLA-G levels than non-allergic women during the 3rd trimester of pregnancy and at delivery. Finally, in allergic patients with atopic dermatitis HLA-G molecules are expressed by T cells, monocytes-macrophages and Langerhans cells infiltrating the dermis. Although at present is difficult to completely define the role of HLA-G molecules in allergic diseases, it may be suggested that they are specifically expressed and secreted by immune cells during the allergic reaction in an attempt to suppress allergic inflammation.
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Affiliation(s)
- Simone Negrini
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Paola Contini
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Francesco Puppo
- Department of Internal Medicine, University of Genoa, Genoa, Italy
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7
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Immunomodulatory Potential of Non-Classical HLA-G in Infections including COVID-19 and Parasitic Diseases. Biomolecules 2022; 12:biom12020257. [PMID: 35204759 PMCID: PMC8961671 DOI: 10.3390/biom12020257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 02/04/2023] Open
Abstract
Human Leukocyte Antigen-G (HLA-G), a polymorphic non-classical HLA (HLA-Ib) with immune-regulatory properties in cancers and infectious diseases, presents both membrane-bound and soluble (sHLA-G) isoforms. Polymorphism has implications in host responses to pathogen infections and in pathogenesis. Differential expression patterns of HLA-G/sHLA-G or its polymorphism seem to be related to different pathological conditions, potentially acting as a disease progression biomarker. Pathogen antigens might be involved in the regulation of both membrane-bound and sHLA-G levels and impact immune responses during co-infections. The upregulation of HLA-G in viral and bacterial infections induce tolerance to infection. Recently, sHLA-G was found useful to identify the prognosis of Coronavirus disease 2019 (COVID-19) among patients and it was observed that the high levels of sHLA-G are associated with worse prognosis. The use of pathogens, such as Plasmodium falciparum, as immune modulators for other infections could be extended for the modulation of membrane-bound HLA-G in COVID-19-infected tissues. Overall, such information might open new avenues concerning the effect of some pathogens such as parasites in decreasing the expression level of HLA-G to restrict pathogenesis in some infections or to influence the immune responses after vaccination among others.
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Suominen NT, Jaakola AJ, Roger M, Faucher MC, Syrjänen KJ, Grénman SE, Syrjänen SM, Louvanto K. The association of HLA-G polymorphism with oral and genital HPV infection in men. Eur J Clin Microbiol Infect Dis 2021; 41:219-226. [PMID: 34697671 PMCID: PMC8770419 DOI: 10.1007/s10096-021-04362-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/04/2021] [Indexed: 12/24/2022]
Abstract
The host genetic factors that influence the natural history of human papillomavirus (HPV) infection in men are not well known. Our aim was to evaluate the role of human leukocyte antigen (HLA)-G polymorphism in oral and genital HPV infection in men. Altogether, 130 men from the Finnish Family HPV Study, with a 6-year follow-up, were included in the analyses. HLA-G alleles were tested by direct sequencing. Oral, urethral, and semen samples were collected and analyzed for 24 different HPV genotypes. Unconditional logistic regression was used to determine associations between HLA-G alleles and genotypes with HPV infection and its outcomes. Overall, eight different HLA-G alleles were identified with 15 different HLA-G genotype combinations. The most common HLA-G allele among the men was G*01:01:01 (86.2%, n = 112) followed by G*01:01:02 (36.2%, n = 47). Allele G*01:01:02 showed to be protective against any- and high-risk (HR) oral HPV (OR range of 0.20–0.24, 95% CI range of 0.06–0.85). Men having allele G*01:01:01 showed a reduced risk for incident (OR 0.30, 95% CI 0.11–0.84) and persistent (OR 0.24, 95% CI 0.08–0.69) oral infections. Allele G*01:01:03 was associated with increased risk for urethral HR-HPV infections (OR 4.94, 95% CI 1.34–18.27). Among self-reported demographic data, genotype G*01:01:01/01:01:03 was associated with an increased risk for oral warts (OR 8.00, 95% CI 1.23–51.89) and allele G*01:03:01 increased the risk of pollen and/or animal allergy (OR 13.59, 95% CI 1.57–117.25). To conclude, HLA-G polymorphism in men largely impacts the outcome of an oral HPV infection and seems to associate with self-reported allergies.
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Affiliation(s)
- Nelli T Suominen
- Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Anna J Jaakola
- Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.,Department of Obstetrics and Gynecology, Kymenlaakso Central Hospital, Kotkantie 41, 48210, Kotka, Finland
| | - Michel Roger
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, 900, rue Saint-Denis, Pavillon R, Montréal, Québec, H2X 0A9, Canada.,Département de Microbiologie, Infectiologie, Immunologie, Université de Montréal, Roger-Gaudry Building, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada
| | - Marie-Claude Faucher
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, 900, rue Saint-Denis, Pavillon R, Montréal, Québec, H2X 0A9, Canada
| | - Kari J Syrjänen
- Department of Clinical Research, Biohit Oyj, Laippatie 1, 00880, Helsinki, Finland
| | - Seija E Grénman
- Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Stina M Syrjänen
- Department of Oral Pathology and Radiology, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - Karolina Louvanto
- Department of Oral Pathology and Radiology, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.,Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere University, Finn-Medi 1, Biokatu 6, 33100, Tampere, Finland
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Rashidi S, Farhadi L, Ghasemi F, Sheikhesmaeili F, Mohammadi A. The potential role of HLA-G in the pathogenesis of HBV infection: Immunosuppressive or immunoprotective? INFECTION GENETICS AND EVOLUTION 2020; 85:104580. [PMID: 33022425 DOI: 10.1016/j.meegid.2020.104580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/20/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023]
Abstract
The non-classical human leukocyte antigens (HLA)-G could be generally considered as a potent tolerogenic molecule, which modulates immune responses. HLA-G due to the immunosuppressive properties may play an important role in the pathogenesis of infections related to the liver. HLA-G may display two distinct activities in the pathological conditions so that it could be protective in the autoimmune and inflammatory diseases or could be suppressive of the immune system in the infections or cancers. HLA-G might be used as a novel therapeutic target for liver diseases in the future. Indeed, new therapeutic agents targeting HLA-G expression or antibodies which block HLA-G activity are being developed and tested. However, further consideration of the HLA-G function in liver disease is required. This review aims to summarize the role of HLA-G in the liver of patients with HBV infection.
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Affiliation(s)
- Saadyeh Rashidi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Leila Farhadi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Faezeh Ghasemi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Farshad Sheikhesmaeili
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asadollah Mohammadi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Arnaiz-Villena A, Juarez I, Suarez-Trujillo F, López-Nares A, Vaquero C, Palacio-Gruber J, Martin-Villa JM. HLA-G: Function, polymorphisms and pathology. Int J Immunogenet 2020; 48:172-192. [PMID: 33001562 DOI: 10.1111/iji.12513] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/04/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
HLA-G immune modulatory genes and molecules are presently being studied by a widespread number of research groups. In the present study, we do not aim to be exhaustive since the number of manuscripts published every year is overwhelming. Instead, our aim is pointing out facts about HLA-G function, polymorphism and pathology that have been confirmed by several different researchers, together with exposing aspects that may have been overlooked or not sufficiently remarked in this productive field of study. On the other hand, we question whether performing mainly studies on HLA-G and disease associations is going to give a clear answer in the future, since 40 years of study of classical HLA molecules association with disease has still given no definite answer on this issue.
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Affiliation(s)
- Antonio Arnaiz-Villena
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Ignacio Juarez
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Fabio Suarez-Trujillo
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Adrián López-Nares
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Christian Vaquero
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Jose Palacio-Gruber
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Jose M Martin-Villa
- Departamento de Inmunología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
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Ben Selma W, Laribi AB, Alibi S, Saad A, Boukadida J. Interaction analysis of IL-12A and IL-12B gene variants with chronic hepatitis B infection in Tunisian patients. Immunol Lett 2020; 225:50-56. [PMID: 32554051 DOI: 10.1016/j.imlet.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/09/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022]
Abstract
Given the key role of interleukin-12 (IL-12) in the control of HBV, we investigated the possible correlation between IL-12A rs568408 and IL-12B rs3212227 polymorphisms and the risk of chronic HBV infection in Tunisian population. Two hundred patients with chronic HBV infection and two hundred healthy controls were genotyped using PCR-RFLP. A allele, AA and AG genotypes of IL-12A rs568408 were more represented in the chronic HBV infection group compared to the control group, and they were associated with 1.65-, 2.58- and 3.13-fold risks of developing this infection, respectively. Gene-gene interaction analysis showed that subjects carrying the IL-12A rs568408AA/AG and IL-12B rs3212227AA genotypes had a 3.16-fold increased risk of chronic HBV infection. This study suggested that IL-12A rs568408 and gene-gene interactions of IL-12A rs568408 and IL-12B rs3212227 contributed to the outcome of chronic HBV infection, meanwhile indicating their usefulness as a predictive and diagnostic biomarker of chronic HBV infection.
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Affiliation(s)
- Walid Ben Selma
- Laboratory of Microbiology, Genetic Characterization of Infectious Diseases, UR12SP34 University Hospital Farhat Hached, Sousse, Tunisia; Laboratory of Studying Biological and Genetic Markers for Early Diagnosis and Follow-Up of Neurological Diseases, LR18ES47, Faculty of Medicine, Sousse, Tunisia; High Institute of Applied Sciences and Technology, Mahdia, Tunisia.
| | - Ahmed Baligh Laribi
- Laboratory of Microbiology, Genetic Characterization of Infectious Diseases, UR12SP34 University Hospital Farhat Hached, Sousse, Tunisia
| | - Sana Alibi
- Laboratory of Microbiology, Genetic Characterization of Infectious Diseases, UR12SP34 University Hospital Farhat Hached, Sousse, Tunisia
| | - Afef Saad
- Department of Microbiology, Faculty of Medicine, Sousse, Tunisia
| | - Jalel Boukadida
- Laboratory of Microbiology, Genetic Characterization of Infectious Diseases, UR12SP34 University Hospital Farhat Hached, Sousse, Tunisia; Department of Microbiology, Faculty of Medicine, Sousse, Tunisia
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Rodrigues JKF, Crovella S, Celerino da Silva R. The HLA-G 14 bp allele frequency in different populations: A global meta-analysis. Meta Gene 2020. [DOI: 10.1016/j.mgene.2019.100624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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13
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The HLA-G 14-bp insertion/deletion polymorphism is associated with chronic hepatitis B in Southern Brazil: A case-control study. Hum Immunol 2020; 81:79-84. [PMID: 31955869 DOI: 10.1016/j.humimm.2020.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/08/2019] [Accepted: 01/07/2020] [Indexed: 12/14/2022]
Abstract
There is growing evidence that the non-classical HLA-G has a role in the process of the immune response against pathogens, including HBV and HIV. Previous studies demonstrated that a 14-bp insertion/deletion (indel) polymorphism at 3'-untranslated region of HLA-G gene interferes in the mRNA stability and expression. The present study aimed to evaluate the association of the 14-bp indel polymorphism (rs371194629) with HBV infection in chronic hepatitis B (CHB) mono-infected and HBV/HIV co-infected patients from Southern Brazil. A total of 817 individuals were analyzed, including 357 CHB patients, 134 HBV/HIV co-infected patients and 326 healthy controls. The 14-bp indel polymorphism was analyzed by DNA amplification using PCR. Logistic regression models were performed to compute adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs). To control for multiple comparisons, the Bonferroni correction was applied to the p-values. The 14-bp Ins allele was observed in 47.6% of the CHB mono-infected patients and in 41.6% of the controls (aOR = 1.33; 95% CI: 1.05-1.60; p = 0.02; pcorrected = 0.08). The results also showed that the 14-bp Ins/Ins genotype was present in 21.8% of the CHB mono-infected patients and in 12.9% of the controls (aOR = 1.91; 95% CI: 1.21-3.01; p < 0.01; pcorrected = 0.02). There was significant association between the 14-bp indel and CHB monoinfection, but not in HBV/HIV co-infection. In conclusion, the 14-bp indel polymorphism was associated with CHB in this specific population.
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14
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Rohn H, Schwich E, Tomoya Michita R, Schramm S, Dolff S, Gäckler A, Korth J, Heinemann FM, Wilde B, Trilling M, Horn PA, Kribben A, Witzke O, Rebmann V. HLA-G 3' untranslated region gene variants are promising prognostic factors for BK polyomavirus replication and acute rejection after living-donor kidney transplant. Hum Immunol 2019; 81:141-146. [PMID: 31679637 DOI: 10.1016/j.humimm.2019.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/19/2019] [Accepted: 09/30/2019] [Indexed: 01/26/2023]
Abstract
The immunosuppressive non-classical human leukocyte antigen-G (HLA-G) promotes transplant tolerance as well as viral immune escape. HLA-G expression is associated with regulatory elements targeting certain single nucleotide polymorphisms (SNPs) in the HLA-G 3' untranslated region (UTR). Thus, we evaluated the impact of HLA-G 3'UTR polymorphisms as surrogate markers for BK polyomavirus (BKPyV) replication or nephropathy (PyVAN) and acute cellular and antibody mediated rejection (ACR/AMR) in 251 living-donor kidney-transplant recipient pairs. After sequencing of the HLA-G 3'UTR, fourteen SNPs between +2960 and +3227 and the 14 bp insertion/deletion polymorphism, which arrange as UTR haplotypes, were identified. The UTR-4 haplotype in donors and recipients was associated with occurrence of BKPyV/PyVAN compared to the other UTR haplotypes. While the UTR-4 recipient haplotype provided protection against AMR, the UTR-2 donor haplotype was deleteriously associated with ACR/AMR. Deduction of the UTR-2/4 haplotypes to specific SNPs revealed that the +3003C variant (unique for UTR-4) in donors as well as in recipients is responsible for BKPyV/PyVAN and also provides protection against AMR; whereas the +3196G variant (unique for UTR-2) promotes allograft rejection. Thus, HLA-G 3'UTR variants are promising genetic predisposition markers both in donors and recipients that may help to predict susceptibility to either viral infectious complication of BKPyV or allograft rejection.
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Affiliation(s)
- Hana Rohn
- Department of Infectious Diseases, West German Centre for Infectious Diseases (WZI), University Hospital Essen, University Duisburg-Essen, Essen, Germany.
| | - Esther Schwich
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Rafael Tomoya Michita
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Department of Genetics, Institute of Biosciences, Universidade Federal do Rio Grande do Sul (UFRGS), Bento Gonçalves Avenue 9500, Campus do Vale, Porto Alegre, RS CEP 91501970, Brazil
| | - Sabine Schramm
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre for Infectious Diseases (WZI), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Anja Gäckler
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Johannes Korth
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Mirko Trilling
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre for Infectious Diseases (WZI), University Hospital Essen, University Duisburg-Essen, Essen, Germany; Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Vera Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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15
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Rezaei F, Zareei N, Razmi N, Nikeghbalian S, Azarpira N. Genetic Polymorphism of HLA-G 14-bp Insertion/Deletion in Pancreas Transplant Recipients and Its Association With Type 1 Diabetes Mellitus. EXP CLIN TRANSPLANT 2019; 19:154-159. [PMID: 30702046 DOI: 10.6002/ect.2018.0162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Human leukocyte antigen-G is an immuno-modulatory factor that affects acute allograft rejection and autoimmune diseases such as type 1 diabetes mellitus. In this study, possible associations between human leukocyte antigen-G 14-bp insertion/deletion polymorphism and acute pancreas rejection were investigated. MATERIALS AND METHODS Human leukocyte antigen-G genotyping was assessed in 102 Iranian pancreas transplant recipients (including 41 with acute rejection and 61 with nonacute rejection). Results were compared with 100 individuals in a normal control group. RESULTS No significant differences in genotype frequencies of human leukocyte antigen-G 14-bp insertion / deletion were observed in recipients who had acute rejection episodes. On the other hand, the insertion / insertion genotype was a risk factor for susceptibility to type 1 diabetes mellitus (odds ratio = 3.82, 95% confidence interval, 1.37- 11.22; P = .005). CONCLUSIONS Our results provided evidence revealing that the human leukocyte antigen-G insertion / insertion genotype might be involved in the pathogenesis of type 1 diabetes mellitus.
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Affiliation(s)
- Firoozeh Rezaei
- From the Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; and the Department of Biochemistry, Faculty of Basic Sciences, Shiraz Branch, Islamic Azad University, Shiraz, Iran
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16
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Ben Azzouz E, Boumaza A, Mezouar S, Bardou M, Carlini F, Picard C, Raoult D, Mège JL, Desnues B. Tropheryma whipplei Increases Expression of Human Leukocyte Antigen-G on Monocytes to Reduce Tumor Necrosis Factor and Promote Bacterial Replication. Gastroenterology 2018; 155:1553-1563. [PMID: 30076840 DOI: 10.1053/j.gastro.2018.07.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/10/2018] [Accepted: 07/27/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS Infection with Tropheryma whipplei has a range of effects-some patients can be chronic carriers without developing any symptoms, whereas others can develop systemic Whipple disease, characterized by a lack a protective inflammatory immune response. Alterations in HLA-G function have been associated with several diseases. We investigated the role of HLA-G during T whipplei infection. METHODS Sera, total RNA, and genomic DNA were collected from peripheral blood from 22 patients with classic Whipple's disease, 19 patients with localized T whipplei infections, and 21 asymptomatic carriers. Levels of soluble HLA-G in sera were measured by enzyme-linked immuosorbent assay, and expressions of HLA-G and its isoforms were monitored by real-time polymerase chain reaction. HLA-G alleles were identified and compared with a population of voluntary bone marrow donors. Additionally, monocytes from healthy subjects were stimulated with T whipplei, and HLA-G expression was monitored by real-time polymerase chain reaction and flow cytometry. Bacterial replication was assessed by polymerase chain reaction in the presence of HLA-G or inhibitor of tumor necrosis factor (TNF) (etanercept). RESULTS HLA-G mRNAs and levels of soluble HLA-G were significantly increased in sera from patients with chronic T whipplei infection compared with sera from asymptomatic carriers and control individuals. No specific HLA-G haplotypes were associated with disease or T whipplei infection. However, T whipplei infection of monocytes induced expression of HLA-G, which was associated with reduced secretion of TNF compared with noninfected monocytes. A neutralizing antibody against HLA-G increased TNF secretion by monocytes in response to T whipplei, and a TNF inhibitor promoted bacteria replication. CONCLUSIONS Levels of HLA-G are increased in sera from patients with T whipplei tissue infections, associated with reduced production of TNF by monocytes. This might promote bacteria colonization in patients.
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Affiliation(s)
- Eya Ben Azzouz
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France
| | - Asma Boumaza
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France
| | - Soraya Mezouar
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France
| | - Matthieu Bardou
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France
| | | | - Christophe Picard
- Aix-Marseille Univ, CNRS, EFS, ADES UMR 7268, Marseille, France; Laboratoire d'immunogénétique, Établissement Français du Sang Provence Alpes Côte d'Azur Corse, Marseille, France
| | - Didier Raoult
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France
| | - Jean-Louis Mège
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France
| | - Benoit Desnues
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Mediterranee Infection, Marseille, France.
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17
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Lv H, Lv H, Lin Z, Chen L, Zhu M, Hong D. Meta-analysis of correlationship between HLA-G 3'UTR 14-bp Ins/Del polymorphism and virus susceptibility. Medicine (Baltimore) 2018; 97:e12262. [PMID: 30235670 PMCID: PMC6160045 DOI: 10.1097/md.0000000000012262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There is a considerable amount of literature on the potential relationship between human leukocyte antigen-G 14-bp Ins/Del polymorphism and virus infection; however, results from these studies were inconclusive. OBJECTIVES A meta-analysis was carried out to determine whether the 14-bp Ins/Del polymorphism is a susceptible factor for virus infection. METHODS Data were extracted from PubMed and Web of Science databases, and included 10 case-control studies (1835 patients and 2357 controls). RESULTS A total of 177 records from 10 studies were retrieved. Overall, no significant correlation was found between HLA-G 14-bp Ins/Del polymorphism and total viruses under all genetic models (dominant model: OR = 0.93, 95% CI = 0.68-1.29; recessive model: OR = 1.12, 95% CI = 0.84-1.48; deletion/deletion (DD) vs insertion/insertion (II): OR = 1.03, 95% CI = 0.71-1.49; deletion (D) vs insertion (I): OR = 1.01, 95% CI = 0.81-1.25). However, further subgroup analyses by virus type and ethnicity revealed that HLA-G 14-bp Ins/Del polymorphism was significantly associated with HTLV-1 infection in mixed population under the dominant model. CONCLUSIONS Our study demonstrated that HLA-G 14-bp Ins/Del polymorphism may not have any effect on susceptibility to viruses.
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Affiliation(s)
- Haiyan Lv
- Public Laboratory, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai
| | - Huizhi Lv
- Anesthesia Deparment, Sanmen People's Hospital, Sanmen
| | | | - Lihua Chen
- Public Laboratory, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai
| | - Min Zhu
- Public Laboratory, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai
| | - Dun Hong
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, China
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18
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Laaribi AB, Bortolotti D, Hannachi N, Mehri A, Hazgui O, Ben Yahia H, Babay W, Belhadj M, Chaouech H, Yacoub S, Letaief A, Ouzari HI, Boudabous A, Di Luca D, Boukadida J, Rizzo R, Zidi I. Increased levels of soluble HLA-G molecules in Tunisian patients with chronic hepatitis B infection. J Viral Hepat 2017; 24:1016-1022. [PMID: 28429836 DOI: 10.1111/jvh.12718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 04/03/2017] [Indexed: 01/08/2023]
Abstract
Hepatitis B virus (HBV) infection is a global health problem. The mechanisms of immune tolerance in HBV infection are still unclear. The host immune response plays a critical role in determining the outcome of HBV infection. Human leucocyte antigen-G (HLA-G) is involved in immunotolerogenic process and infectious diseases. This study aimed to explore the implication of soluble HLA-G (sHLA-G) and its isoforms in HBV infection. Total sHLA-G (including shedding HLA-G1 and HLA-G5) was analysed by ELISA in 95 chronic HBV patients, 83 spontaneously resolvers and 100 healthy controls (HC). To explore the presence of sHLA-G dimers, we performed an immunoprecipitation and a Western blot analysis on positive samples for sHLA-G in ELISA. The serum levels of sHLA-G were significantly increased in patients with chronic HBV patients compared to spontaneously resolvers and HC (P<.0001). Interestingly, we found an increased level of sHLA-G1 in chronic HBV patients than in spontaneously resolvers and HC (P<.001). In addition, the expression of HLA-G5 seems to be higher in the sera of chronic HBV patients than spontaneously resolvers (P=.026). The analysis of HLA-G dimers showed the presence of homodimers in 93% of chronic HBV patients, 67% in spontaneously resolvers and 60% in HC. These results provide evidence that sHLA-G may have a crucial role in the outcome of HBV infection and could be proposed as a biomarker for infection outcome. Based on its tolerogenic function, HLA-G might be considered as a new promising immunotherapeutic approach to treat the chronic infection with HBV.
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Affiliation(s)
- A B Laaribi
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia.,Sciences Faculty of Bizerte, University of Carthage, Tunis, Tunisia
| | - D Bortolotti
- Section Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - N Hannachi
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - A Mehri
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia.,Sciences Faculty of Bizerte, University of Carthage, Tunis, Tunisia
| | - O Hazgui
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - H Ben Yahia
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - W Babay
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - M Belhadj
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - H Chaouech
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - S Yacoub
- Regional Center of Blood Transfusion, University Hospital Farhat Hached, Sousse, Tunisia
| | - A Letaief
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - H I Ouzari
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - A Boudabous
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - D Di Luca
- Section Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - J Boukadida
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - R Rizzo
- Section Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - I Zidi
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Eskandari E, Dahmardeh T, Safdari V, Khosravi S, Pahlevani E. HLA-G gene 14-bp deletion variant protects Iranian subjects against chronic hepatitis B infection. Int J Immunogenet 2017; 44:322-327. [PMID: 28929613 DOI: 10.1111/iji.12337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 07/02/2017] [Accepted: 08/06/2017] [Indexed: 01/19/2023]
Abstract
To investigate whether 14-bp Ins/Del polymorphism in HLA-G gene is associated with the risk of chronic hepatitis B (CHB) infection. This study was performed on a total of 396 individuals including 199 CHB patients and 197 healthy subjects from a south-east Iranian population. We genotyped 14-bp Ins/Del polymorphism in the HLA-G gene using polymerase chain reaction method. The results of our study revealed that the HLA-G 14-bp deletion polymorphism was associated with a reduced risk of CHB at both allele and genotypic levels. The 14-bp Del allele and Ins/Del genotype were more frequent in control group than in CHB patients (37% vs 28% for Del allele with OR = 0.68 and p-value = .015; 73% vs 52% for Ins/Del genotype with OR = 0.43 and p-value = .001) and both were protective factors against CHB. However, no difference was found in the distribution of HLA-G 14-bp genotypes among subjects with varied levels of HBV DNA or hepatic enzymes (p > .05). Our findings, for the first time, suggest that the HLA-G 14-bp Ins/Del polymorphism may be a marker for genetic susceptibility to CHB infection.
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Affiliation(s)
- E Eskandari
- Genetic of Non-Communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.,Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - T Dahmardeh
- Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | - V Safdari
- Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - S Khosravi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Zahedan, Iran
| | - E Pahlevani
- Infectious Diseases & Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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20
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Lack of relationship between PTEN 32-bp and TP53 16-bp Ins/Del polymorphisms and chronic hepatitis B virus infection. Virusdisease 2017; 28:289-294. [PMID: 29291215 DOI: 10.1007/s13337-017-0391-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/08/2017] [Indexed: 01/04/2023] Open
Abstract
TP53 and phosphate and tension homolog (PTEN) are two tumor suppressor genes that regulate cell proliferation, migration, and death. P53 and PTEN deficiency has been associated with hepatic fibrosis, a prominent pathological feature associated with chronic hepatitis B (CHB). The present study is aimed to assess the association of PTEN 32-bp Ins/Del (rs34421660) and TP53 16-bp Ins/Del polymorphisms with CHB infection susceptibility. A total of 411 subjects were recruited in this case-control study of 213 patients with CHB infection and 198 healthy individuals as controls. PTEN and TP53 deletions were detected by polymerase chain reaction method. We found no significant association between PTEN 32-bp Ins/Del polymorphism and the risk for CHB using either of codominant (Ins/Del vs. Ins/Ins: P = 0.427; Del/Del vs. Ins/Ins: P = 0.235), dominant (Ins/Del + Del/Del vs. Ins/Ins P = 0.343) or recessive genetic model (Del/Del vs. Ins/Ins + Ins/Del: P = 0.516). At allelic level although the PTEN Del variant allele was more common in CHB patients compared to controls (55 vs. 51), but the difference did not reach the statistical significant range (OR 0.87, P = 0.327). Similarly, no association was observed between TP53 16-bp Ins/Del and the risk for CHB infection at both genotype and allele levels (P > 0.05). In summary, our study demonstrated that the PTEN 32-bp and TP53 16-bp Ins/Del polymorphisms did not affect the risk of CHB infection in the Iranian population.
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21
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Ferreira SDC, Chachá SGF, Souza FF, Teixeira AC, Santana RDC, Deghaide NHS, Rodrigues S, Marano LA, Mendes-Junior CT, Ramalho LNZ, Zucoloto S, Donadi EA, Martinelli ADLC. The HLA-G 14-base pair deletion allele and the deletion/deletion genotype are associated with persistent HBe antigenemia in chronic hepatis B infection. Hum Immunol 2016; 78:166-171. [PMID: 28041834 DOI: 10.1016/j.humimm.2016.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 12/15/2016] [Accepted: 12/28/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS HLA-G has well-recognized immunomodulatory properties, and this molecule is frequently expressed in the livers of hepatitis B virus (HBV)-infected patients. Because the HLA-G 14 bp-insertion/deletion polymorphism (rs371194629) has been associated with the magnitude of HLA-G expression, we evaluated this polymorphism in the recognized evolutionary forms of chronic HBV infection. METHODS We studied 196 chronic HBV-infected patients (118 HBeAg-negative chronic hepatitis, 53 HBeAg-positive chronic hepatitis and 25 inactive carriers exhibiting low levels of serum HBVDNA and persistently normal ALT levels), and 202 healthy individuals. Chronic hepatitis HLA-G typing was performed using PCR-amplified DNA hybridized with specific primers. RESULTS The frequencies of the insertion/deletion alleles and genotypes were very similar in patients and controls. After patient stratification according to the evolutionary form of the chronic HBV infection, the frequencies of the deletion allele (P=0.0460; OR=1.26; 95%CI=1.01-1.45) and of the deletion/deletion genotype (P=0.0356; OR=2.08; 95%CI=1.05-4.09) were overrepresented in HBeAg-positive patients when compared to HBeAg-negative patients. No differences were observed when HBV inactive carriers were compared to HBeAg-negative chronic hepatitis patients. CONCLUSIONS Because the 14-bp deletion allele has been associated with increased HLA-G production and because HLA-G may down regulate the cytotoxic activity of TCD8 and NK cells, patients exhibiting the 14-bp deletion allele at single or double doses are at increased risk for developing chronic forms of HBV associated with persistent viremia and worse prognoses.
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Affiliation(s)
- Sandro da Costa Ferreira
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil.
| | - Silvana Gama Florêncio Chachá
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil; Department of Medicine, University Federal of São Carlos (UFSCAR), Brazil
| | - Fernanda Fernandes Souza
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Andreza Corrêa Teixeira
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Rodrigo de Carvalho Santana
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Neifi Hassan Saloun Deghaide
- Division of Clinical Immunology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Sandra Rodrigues
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Leonardo A Marano
- Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | | | | | - Sérgio Zucoloto
- Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Eduardo Antônio Donadi
- Division of Clinical Immunology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
| | - Ana de Lourdes Candolo Martinelli
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Brazil
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22
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Recent Advances in Our Understanding of HLA-G Biology: Lessons from a Wide Spectrum of Human Diseases. J Immunol Res 2016; 2016:4326495. [PMID: 27652273 PMCID: PMC5019910 DOI: 10.1155/2016/4326495] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/23/2016] [Indexed: 12/27/2022] Open
Abstract
HLA-G is a HLA-class Ib molecule with potent immunomodulatory activities, which is expressed in physiological conditions, where modulation of the immune response is required to avoid allograft recognition (i.e., maternal-fetal interface or transplanted patients). However, HLA-G can be expressed de novo at high levels in several pathological conditions, including solid and hematological tumors and during microbial or viral infections, leading to the impairment of the immune response against tumor cells or pathogens, respectively. On the other hand, the loss of HLA-G mediated control of the immune responses may lead to the onset of autoimmune/inflammatory diseases, caused by an uncontrolled activation of the immune effector cells. Here, we have reviewed novel findings on HLA-G functions in different physiological and pathological settings, which have been published in the last two years. These studies further confirmed the important role of this molecule in the modulation of the immune system.
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Genre J, Reginaldo FPS, Andrade JMDL, Lima FP, da Camara AVC, Donadi EA, Crispim JC. HLA-G 14-bp Ins/Ins Genotype in Patients Harbouring Helicobacter pylori Infection: A Potential Risk Factor? Scand J Immunol 2016; 83:52-7. [PMID: 26368842 DOI: 10.1111/sji.12390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/08/2015] [Indexed: 01/04/2023]
Abstract
H. pylori is a potent pathogen due to its capacity to successfully evade host defence mechanisms. Despite inducing immune responses in infected individuals, sometimes these responses fail to clear the infection and the bacterium establishes a persistent infection leading to chronic inflammation. In this context, we hypothesized that human leucocyte antigen G (HLA-G), a non-classical major histocompatibility complex molecule that has the ability to regulate immune responses both in physiological and in pathological conditions, may play an important role in promoting tolerance and helping H. pylori to subvert host defence and consequently establish a chronic infection. Therefore, we evaluated the expression of HLA-G 14-bp Ins/Del polymorphism in patients harbouring H. pylori infection, as well as their relationship with histological and demographic variables, to gain a better understanding of the actual role of HLA-G and its genetic polymorphisms in bacterial infection. Sixty-eight patients with clinical symptoms suggestive of H. pylori infection were enrolled to assess HLA-G 14-bp Ins/Del polymorphism allele and genotype frequencies. After adjustment for covariates (age and gender), the odds of having the genotype Ins/Ins, compared to Del/Del, were 3.77 times greater among HP+ cases than among controls. These findings suggest that the 14-bp Ins/Ins genotype, already associated with inflammatory and autoimmune diseases as well as some viral and parasitic infections, could confer a greater risk of developing H. pylori infection.
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Affiliation(s)
- J Genre
- Programa de Pós-graduação em Ciências da Saúde, Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - F P Santos Reginaldo
- Departamento de Análises Clínicas, Centro de Ciências da Saúde. Faculdade de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - J Marco de Leon Andrade
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade de Brasília, Brasília, Brasil
| | - F P Lima
- Departamento de Patologia, Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - A V Coutinho da Camara
- Hospital universitário Onofre Lopes. Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - E A Donadi
- Departamento de Medicina Clínica, Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo, Ribeirão Preto, Brasil
| | - J C Crispim
- Departamento de Análises Clínicas, Centro de Ciências da Saúde. Faculdade de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, Brasil.,Programa de Pós-graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte, Natal, Brasil
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24
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Huang J, Xiong L, Wang J, Liu Y, Zhu Q, Lei J, Zhou Z. Association between the HLA-DQB1 polymorphisms and the susceptibility of chronic hepatitis B: A comprehensive meta-analysis. Biomed Rep 2016; 4:557-566. [PMID: 27123247 PMCID: PMC4840628 DOI: 10.3892/br.2016.632] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 01/26/2016] [Indexed: 12/14/2022] Open
Abstract
Single-nucleotide polymorphisms in the human leukocyte antigen (HLA)-DQB1 gene are associated with chronic inflammatory and immunological diseases. Host genetic factors have a key role in the development of chronic hepatitis B (CHB). The aim of the present study was to investigate the association between the HLA-DQB1 polymorphisms and the susceptibility to CHB. PubMed, Embase, CNKI and Wanfang databases were searched for the studies that reported the association of the HLA-DQB1 polymorphisms with CHB between January 1, 1966 and July 30, 2015. HLA-DQB1 polymorphism-specific odds ratio (OR) and 95% confidence intervals (95% CI) were pooled and calculated in the fixed effects model using the Mantel-Haenszel method. Q-test and I2 test were performed to examine the heterogeneity. Begg's funnel test and Egger's test were conducted to assess publication bias. All the statistical tests were two-tailed. Subsequent to searching the databases and screening according to the inclusion criteria, 7 case-control studies were available in the present meta-analysis, including 815 CHB patients and 731 control subjects for the HLA-DQB1 polymorphisms. In conclusion, the statistically significant pooled OR of the HLA-DQB1 polymorphisms were obtained for the HLA-DQB1 loci (*0201, case vs. CONTROL I2=36.5%; P-value of heterogeneity=0.15; OR, 1.29; 95% CI, 1.02-1.64; P=0.0301; *0301, case vs. CONTROL I2=0%; P-value of heterogeneity=0.899; OR, 1.37; 95% CI, 1.12-1.69; P=0.002; *0502, case vs. CONTROL I2=24.9%; P-value of heterogeneity=0.239; OR, 1.50; 95% CI, 1.02-2.20; P=0.04), which were associated with an increased risk of CHB. Similar significant results were observed and acquired in the following HLA-DQB1 loci (*0303, case vs. CONTROL I2=0%; P-value of heterogeneity=0.986; OR, 0.77; 95% CI, 0.62-0.95; P=0.017; *0604, case vs. CONTROL I2=0%; P-value of heterogeneity=0.594; OR, 0.38; 95% CI, 0.20-0.74; P=0.003), which were associated with a decreased risk of CHB. No significant association was observed for the other HLA-DQB1 family loci. The present meta-analysis demonstrated that the HLA-DQB1 loci (*0201, *0301 and *0502) polymorphisms were significantly associated with an increased risk of CHB. However, HLA-DQB1 loci polymorphisms (*0303 and *0604) were associated with a decreased risk of CHB. These results support the hypothesis that polymorphisms of the HLA-DQB1 allele families may affect the susceptibility or resistance to CHB.
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Affiliation(s)
- Jinmei Huang
- Department of Infectious Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Liangshi Xiong
- Department of Infectious Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Jin Wang
- Department of Infectious Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Yongfang Liu
- Department of Infectious Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Qirong Zhu
- Department of Infectious Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Jun Lei
- School of Pharmacy, North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Zhonghui Zhou
- Department of Infectious Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
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25
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Zidi I, Laaribi AB, Bortolotti D, Belhadj M, Mehri A, Yahia HB, Babay W, Chaouch H, Zidi N, Letaief A, Yacoub S, Boukadida J, Di Luca D, Hannachi N, Rizzo R. HLA-E polymorphism and soluble HLA-E plasma levels in chronic hepatitis B patients. HLA 2016; 87:153-9. [PMID: 26956431 DOI: 10.1111/tan.12767] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/18/2016] [Accepted: 02/10/2016] [Indexed: 12/11/2022]
Abstract
Chronic hepatitis B virus (HBV) infection occurs in association to a deregulation of immune system. Human leukocyte antigen E (HLA-E) is an immune-tolerant nonclassical HLA class I molecule that could be involved in HBV progression. To measure soluble (s) HLA-E in patients with chronic HBV hepatitis (CHB). We tested the potential association of HLA-E*01:01/01:03 A > G gene polymorphism to CHB. Our cohort consisted of 93 Tunisian CHB patients (stratified in CHB with high HBV DNA levels and CHB with low HBV DNA levels) and 245 healthy donors. Plasma sHLA-E was determined using enzyme-linked immunosorbent assay (ELISA). Genotyping was performed using polymerase chain reaction sequence-specific primer. No association between HLA-E*01:01/01:03 A > G polymorphism and HBV DNA levels in CHB patients was found. G/G genotype is less frequent in CHB patients without significance. sHLA-E is significantly enhanced in CHB patients compared with healthy controls (P = 0.0017). Stratification according to HBV DNA levels showed that CHB patients with low HBV DNA levels have higher sHLA-E levels compared with CHB patients with high HBV DNA levels. CHB patients with G/G genotype have enhanced sHLA-E levels compared with other genotypes (P = 0.037). This significant difference is maintained only for CHB women concerning G/G genotypes (P = 0.042). Finally, we reported enhanced sHLA-E in CHB patients with advanced stages of fibrosis (P = 0.032). We demonstrate, for the first time, the association of sHLA-E to CHB. Owing to the positive correlation of HLA-E*01:01/01:03 A > G polymorphism and the association of sHLA-E to advanced fibrosis stages, HLA-E could be a powerful predictor for CHB progression. Further investigations will be required to substantiate HLA-E role as a putative clinical biomarker of CHB.
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Affiliation(s)
- I Zidi
- Laboratory Microorganismes et Biomolécules Actives, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - A B Laaribi
- Laboratory Microorganismes et Biomolécules Actives, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - D Bortolotti
- Department of Experimental and Diagnostic Medicine, Section Microbiology, University of Ferrara, Ferrara, Italy
| | - M Belhadj
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - A Mehri
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - H B Yahia
- Laboratory Microorganismes et Biomolécules Actives, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - W Babay
- Laboratory Microorganismes et Biomolécules Actives, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - H Chaouch
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - N Zidi
- Faculty of Medicine Ibn Al Jazzar, University of Sousse, Sousse, Tunisia
| | - A Letaief
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - S Yacoub
- Regional Center of Blood Transfusion, University Hospital Farhat Hached, Sousse, Tunisia
| | - J Boukadida
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - D Di Luca
- Department of Experimental and Diagnostic Medicine, Section Microbiology, University of Ferrara, Ferrara, Italy
| | - N Hannachi
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - R Rizzo
- Department of Experimental and Diagnostic Medicine, Section Microbiology, University of Ferrara, Ferrara, Italy
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