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Cassia FDF, Cardoso JF, Porto LC, Ramos-E-Silva M, Carneiro S. Association of HLA Alleles and HLA Haplotypes with Psoriasis, Psoriatic Arthritis and Disease Severity in a Miscegenated Population. PSORIASIS-TARGETS AND THERAPY 2021; 11:41-51. [PMID: 34007822 PMCID: PMC8121669 DOI: 10.2147/ptt.s258050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/31/2020] [Indexed: 11/23/2022]
Abstract
Background The study of HLA classes I and II in Brazilian psoriasis patients may contribute to a better understanding of their association with the disease. Objective To describe HLA classes I and II of Brazilian patients with psoriasis, with or without arthritis, compare them to controls and correlate HLA markers with epidemiological and evolutional aspects of psoriasis. Methods A total of 55 patients with more than 5 years of psoriasis, with or without arthritis, answered a questionnaire on ethnic background and disease severity. A total of 134 bone marrow donors were controls. HLA class I and II genotyping was determined by PCR-SSP. Results Mean age was 42.4 years; 23 women and 32 men. HLA-B*57 was present in 23.6% patients and in 7.5% controls (p=0.00200, OR= 3.8381), and HLA-C*06 in 29.1% patients and in 16.4% controls (p= 0.04832, OR=2.0886). HLA-B*57 and HLA-C*18 were significantly present in patients with arthritis (p=0.00104, OR=6.6769 and p=0.00269, OR=16.50, respectively). HLA-B*57 was significantly present in patients with history of erythroderma (p=0.00548, OR= 5.1059), as was HLA-C*06 (p=0.02158, OR=3.0545). HLA-B*57 was also frequent in patients with history of hospital internment due to psoriasis (p= 0.00094, OR=7.8909) and in the ones with history of systemic treatment for psoriasis (p= 0.00011, OR= 5.3733). Haplotype HLA-A*02 B*57 C*06 DRB1*07DQB1*03 was the most common among the patients (p= 0.00069, OR= 3.528). Conclusion HLA-B*57 and HLA-C*06 were significantly increased in the patients indicating risk for psoriasis. HLA-B*57 remained high in patients with history of erythroderma, hospital internment, systemic treatment, and psoriatic arthritis, showing association with disease severity. HLA-C*18 was significantly high only in patients with psoriatic arthritis. HLA-B*57 and HLA-C*06 and haplotype HLA-A*02B*57Cw*06DRB1*07 DQB1*03 seen in this study were already described before, associated with psoriasis. HLA-Cw*18 was not described in other populations in association with psoriasis.
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Affiliation(s)
- Flavia de Freire Cassia
- Sector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana Fernandes Cardoso
- Histocompatibility Section, Special Techniques Laboratory, Albert Einstein Israelite Hospital- HIAE, São Paulo, Brazil
| | - Luiz Cristovao Porto
- Histocompatibility and Cryopreservation Laboratory, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sueli Carneiro
- Sector of Dermatology, University Hospital and School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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The HLA-Cw6 Dilemma: Is It Really an Outcome Predictor in Psoriasis Patients under Biologic Therapy? A Monocentric Retrospective Analysis. J Clin Med 2020; 9:jcm9103140. [PMID: 32998429 PMCID: PMC7600180 DOI: 10.3390/jcm9103140] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023] Open
Abstract
HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. Data regarding correlation between HLA-Cw6 status and biologic treatment outcomes are divergent. The aim of our study in our cohort of psoriatic patients was to explore if the HLA-Cw6 status influences the response rate to biologic therapies at 16 and 48 weeks. One hundred and one psoriatic patients eligible for biologic therapies were enrolled. HLA-C*06 alleles were detected from their blood samples. The effectiveness of antipsoriatic treatments was reported as 90% Psoriasis Area and Severity Index reduction (PASI90). All biologics showed efficacy at week 16, without significant differences between one another. HLA-Cw6 status did not seem to affect baseline characteristics, or treatment response at week 16. At week 48, IL-12/23 and IL-17 targeting drugs were more effective on Cw6-positive patients than on Cw6-negative patients. Conversely, TNF-targeting drugs seemed to be more effective on Cw6- negative patients than on Cw6-positive patients. The HLA-Cw6 test could well deserve to be integrated into the clinical laboratory work-up supporting the choice of the correct biologic.
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Shen M, Lim SWD, Tan ES, Oon HH, Ren EC. HLA Correlations with Clinical Phenotypes and Risk of Metabolic Comorbidities in Singapore Chinese Psoriasis Patients. Mol Diagn Ther 2020; 23:751-760. [PMID: 31473973 DOI: 10.1007/s40291-019-00423-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Psoriasis is a systemic, chronic inflammatory disease that not only afflicts the skin but is also associated with cardiovascular disease and metabolic syndrome. The strongest susceptibility loci for the disease is within the human leukocyte antigen (HLA) complex, though specific HLA allelic associations vary between populations. OBJECTIVE Our objective was to investigate HLA associations with clinical phenotypes of psoriasis and metabolic syndrome in Chinese psoriasis cases. METHODS We conducted an observational case-control study in Singapore with a cohort of psoriasis cases consecutively recruited from an outpatient specialist dermatological center (n = 120) compared with 130 healthy controls. RESULTS Significant HLA associations with psoriasis were observed with HLA-A*02:07, B*46:01, C*01:02, and C*06:02. The three-locus haplotype of A*02:07-C*01:02-B*46:01 was also significant (odds ratio [OR] 3.07; p = 9.47 × 10-5). We also observed an association between nail psoriasis and HLA-A*02:07 carriers (OR 4.50; p = 0.002), whereas C*06:02 carriers were less prone to have nail involvement (OR 0.16; p = 0.004). HLA-A*02:07 was also identified as a possible risk allele for hypertension (OR 2.90; p < 0.05), and C*01:02 was a possible risk allele for dyslipidemia (OR 3.36; p < 0.05), both known to be common comorbidities in patients with psoriasis. CONCLUSION Our results demonstrate the growing importance of discerning population-specific clinical phenotypes and their association with certain HLA alleles in psoriasis.
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Affiliation(s)
- Meixin Shen
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, #03-06, Immunos Building, Singapore, 138648, Singapore
| | - Soon Wei Daniel Lim
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
| | - Eugene S Tan
- National Skin Centre (S) Pte Ltd, 1 Mandalay Rd, Singapore, 308205, Singapore
| | - Hazel H Oon
- National Skin Centre (S) Pte Ltd, 1 Mandalay Rd, Singapore, 308205, Singapore.
| | - Ee Chee Ren
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, #03-06, Immunos Building, Singapore, 138648, Singapore. .,Department of Microbiology and Immunology, National University of Singapore, 5 Science Drive 2, MD4, Level 3, Singapore, 117545, Singapore.
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Guarene M, Pasi A, Bolcato V, Cananzi R, Piccolo A, Sbarsi I, Klersy C, Cacciatore R, Brazzelli V. The Presence of HLA-A Bw4-80I KIR Ligands Could Predict “Difficult-to-Treat” Psoriasis and Poor Response to Etanercept. Mol Diagn Ther 2018; 22:471-474. [DOI: 10.1007/s40291-018-0345-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Abstract
Psoriasis is a multifactorial disease with a strong genetic background. HLA-Cw6 is one of the most strongly associated psoriasis susceptibility alleles. It is repeatedly observed to affect disease course, phenotypic features, severity, comorbidities and treatment outcomes. To the best of our knowledge, the roles of HLA-Cw6 in psoriasis have not yet been thoroughly reviewed. The worldwide frequency of the HLA-Cw6 allele varies greatly, with it being generally higher in white people than in Asians. The allele is associated with type I early-onset psoriasis. Stress, obesity and streptococcal pharyngitis are commonly observed in HLA-Cw6-positive patients. Phenotypically, HLA-Cw6 has been found to be associated with guttate psoriasis. In addition, patients carrying the allele are more likely to have arm, leg and trunk involvement, and the Koebner phenomenon. Patients with psoriatic arthritis with HLA-Cw6 more often have early onset and tend to show cutaneous symptoms before musculoskeletal symptoms. HLA-Cw6-positive patients have been shown in several studies to be more responsive to methotrexate and ustekinumab. However, this difference in ustekinumab efficacy was only moderate in a post-hoc analysis of a pivotal phase III study. HLA-Cw6 positivity also tends to be less frequent in high-need patients who fail conventional therapy. Small studies have also investigated the role of HLA-Cw6 in remission of psoriasis during pregnancy, and with the comorbidities of photosensitivity and atherosclerosis. Given the diverse nature of psoriasis pathogenesis, as well as the difference of HLA-Cw6 positivity in different ethnic groups, more studies are needed to confirm the role of HLA-Cw6 in psoriasis.
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Affiliation(s)
- L Chen
- Lake Erie College of Osteopathic Medicine, Bradenton, PA, U.S.A
| | - T-F Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan
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Ammar M, Souissi-Bouchlaka C, Gati A, Zaraa I, Bouhaha R, Kouidhi S, Ben Ammar-Gaied A, Doss N, Mokni M, Marrakchi R. [Psoriasis: physiopathology and immunogenetics]. ACTA ACUST UNITED AC 2013; 62:10-23. [PMID: 24589075 DOI: 10.1016/j.patbio.2013.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 07/05/2013] [Indexed: 01/17/2023]
Abstract
Psoriasis is a multifactorial disease that involves genetic, immunological and environmental factors. During the last decade, several studies by genome scan on families or cases/controls helped to highlight more than ten loci "PSORS" located on different chromosomes and containing several candidate genes. Psoriasis appears as a genetic disease that follows the mixed model with the involvement of a major gene (PSORS1) and a set of minor genes with a variable penetrance depending on the locus. Genetic data have focused on the involvement of the immune system in the pathogenesis of psoriasis. It is now accepted that psoriasis is an immunological disease involving the response profiles TH1 and TH17. Much remains to be done to better elucidate the mechanisms involved in the genesis of psoriatic lesions to find new therapeutic targets.
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Affiliation(s)
- M Ammar
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie.
| | - C Souissi-Bouchlaka
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie
| | - A Gati
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie
| | - I Zaraa
- Service de dermatologie, hôpital la Rabta, 1007 Tunis, Tunisie
| | - R Bouhaha
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie
| | - S Kouidhi
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie
| | - A Ben Ammar-Gaied
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie
| | - N Doss
- Service de dermatologie, hôpital militaire de Tunis, rue Raouth Ibnou Hatem, Tunis, Tunisie
| | - M Mokni
- Service de dermatologie, hôpital la Rabta, 1007 Tunis, Tunisie
| | - R Marrakchi
- Laboratoire de génétique, d'immunologie et de pathologies humaines, faculté des sciences de Tunis, université El Manar II, 2092 Tunis, Tunisie
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Liu J, Tang H, Zuo X, Liang B, Wang P, Sun L, Yang S, Zhang X. A single nucleotide polymorphism rs9468925 of MHC region is associated with clinical features of generalized vitiligo in Chinese Han population. J Eur Acad Dermatol Venereol 2011; 26:1137-41. [PMID: 21951294 DOI: 10.1111/j.1468-3083.2011.04259.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vitiligo has been found to be associated with different HLA antigens in different ethnic groups. In our previous genome-wide association study (GWAS), we identified independent association signal of rs9468925 (P = 2.21 × 10(-33), OR = 0.74) within HLA-C-HLA-B region. OBJECTIVES To explore the association between rs9468925 polymorphism within MHC and the clinical features of generalized vitiligo. METHODS The study, using 5566 cases and 6462 controls from previous GWA study investigated the single and combined (GA + GG) genotypic distribution of rs9468925 in subsets of vitiligo patients having different clinical features. We performed a QTL analysis (quantitative trait locus) for age of onset with genotype of rs9468925. RESULTS The GA + GG genotypic distribution of SNP rs9468925 tested with an additive model was found to be significantly different in subgroups of patients of >20 vs. <20 years old (genotypic P = 2.57 × 10(-4), combined P = 3.0 × 10(-3), OR = 0.77, 95% CI: 0.64-0.92), and in patients with different clinical subtypes of vitiligo (genotypic P = 0.03, combined P = 5.0 × 10(-3)). However, there was no statistical significance for familial history, halo nevi involvement and autoimmune disease involvement. CONCLUSIONS Allele G of rs9468925 on HLA-C-HLA-B may be associated with a higher risk of vitiligo. Our study showed a significant genotypic variation between patients with age of onset ≤ 20 years and age of onset >20 years. Obvious clinical differences of generalized vitiligo related to genotypic variation found in the Chinese Han population were confirmed in this study.
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Affiliation(s)
- Jianlan Liu
- Department of Dermatology at No 1 Hospital, Institute of Dermatology, Anhui Medical University, Hefei, Anhui, China
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Wu D, Wu Y, Liu J, Wang B, Zhang X. Association between HLA-Cw*0602 polymorphism and psoriasis risk: a meta-analysis. GENETICS AND MOLECULAR RESEARCH 2011; 10:3109-20. [DOI: 10.4238/2011.december.15.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Zhou J, Sun D, Xu L, Sun L, Fu S, Li Y. ADAM33 as a Psoriasis Susceptibility Gene in the Han Population of Northeastern China. Dermatology 2011; 223:356-62. [DOI: 10.1159/000335417] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 11/30/2011] [Indexed: 11/19/2022] Open
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Kalish RS, Koujak S. Minocycline inhibits antigen processing for presentation to human T cells: additive inhibition with chloroquine at therapeutic concentrations. Clin Immunol 2004; 113:270-7. [PMID: 15507392 DOI: 10.1016/j.clim.2004.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2004] [Accepted: 07/23/2004] [Indexed: 11/26/2022]
Abstract
The ability of minocycline to inhibit processing of tetanus toxoid (TT) for presentation to human T cells was tested. Peripheral blood antigen presenting cells (APC) were incubated with TT before or after addition of test compounds for 4 h. APC were then fixed with paraformaldehyde, and added to autologous TT-responsive T cell lines for a proliferation assay. Minocycline (0.1-0.4 mM) gave significant inhibition of T cell response to TT and was equivalent to chloroquine. Inhibition was not observed when TT was incubated with APC before minocycline, indicating that presentation of preprocessed antigen was not inhibited. Minocycline, doxycycline, and tetracycline all inhibited the proliferation of PBMC to TT. The combination of minocycline and chloroquine resulted in additive inhibition at clinically relevant levels of both drugs (3.7 microM). This study suggests a novel immunosuppressive mechanism for minocycline, as well as possible additive anti-inflammatory effect when combined with chloroquine or hydroxychloroquine.
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Affiliation(s)
- Richard S Kalish
- Department of Dermatology, State University of New York at Stony Brook, Stony Brook, NY 11794-8165, USA.
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Łuszczek W, Kubicka W, Cislo M, Nockowski P, Mańczak M, Woszczek G, Baran E, Kuśnierczyk P. Strong association of HLA-Cw6 allele with juvenile psoriasis in Polish patients. Immunol Lett 2003; 85:59-64. [PMID: 12505198 DOI: 10.1016/s0165-2478(02)00212-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Association of psoriasis vulgaris with HLA-C is not equally strong in different human populations. It has not yet been studied in Polish patients at DNA level, but only by serology that is inadequate for HLA-C. Therefore, we examined the distribution of HLA-C alleles by means of low resolution PCR-SSP in 102 Polish psoriatics and 123 healthy controls. We have found significantly higher representation of HLA-Cw*06 (odds ratio, 18.73; P(cor)<0.001) and significantly lower representation of HLA-Cw*07 (odds ratio, 0.41; P(cor)<0.038) in patients than in controls. Association of HLA-Cw*06 with psoriasis was even stronger in early age at onset (0-20 years) group: odds ratio, 77.71; P(cor)<0.001. Therefore, our population seems to belong to those with strong association of psoriasis with HLA-Cw*06.
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Affiliation(s)
- Wioleta Łuszczek
- Department of Clinical Immunology, Laboratory of Immunogenetics, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, ul. Rudolfa Weigla 12, PL-53-114, Wroclaw, Poland
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Gilhar A, Ullmann Y, Kerner H, Assy B, Shalaginov R, Serafimovich S, Kalish RS. Psoriasis is mediated by a cutaneous defect triggered by activated immunocytes: induction of psoriasis by cells with natural killer receptors. J Invest Dermatol 2002; 119:384-91. [PMID: 12190861 DOI: 10.1046/j.1523-1747.2002.01812.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study was performed to ask whether psoriasis is a unique pathologic response of epidermis of psoriatic patients, or cells with natural killer receptors can induce psoriatic changes in skin from nonpsoriatic donors. Human nonlesional skin from five psoriatics, as well as from seven nonpsoriatics was grafted on to beige-SCID mice. Lymphocyte lines with natural killer activity, and mixed natural killer, natural killer T cell phenotype, were generated by culture of peripheral blood mononuclear cells from both psoriatic, and normal donors, in 100 U interleukin-2 per ml for 14 d. Natural killer cells were injected into the human skin grafts, and the grafts were harvested after 4 wk. Injection of natural killer cells from psoriatic donors into autologous nonlesional psoriatic skin resulted in classic psoriasis histology with a significant increase in epidermal thickness, and proliferation, as well as expression of epidermal human leukocyte antigen DR, intercellular adhesion molecule-1, CD1d, and K-16. Superantigen stimulation was not necessary. In contrast, injection of natural killer cells from normal donors into autologous normal skin did not induce the histology of psoriasis, but that of psoriasiform dermatitis. This is a nonspecific reaction pattern. These grafts also exhibited a significant increase in epidermal thickness, and proliferation. Differences from psoriasis included mild epidermal edema (spongiosis), hypergranulosis, irregular elongation of rete ridges, and lack of thinning of the suprapapillary plate. Injection of allogeneic natural killer cells into grafts also resulted in psoriasiform dermatitis, regardless of the source of natural killer cells, or skin. Psoriasis induction by cells with natural killer receptors appears to be dependent upon the source of skin. This suggests that psoriasis results from a cutaneous defect that is triggered by an autoimmune activation.
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Affiliation(s)
- Amos Gilhar
- Skin Research Laboratories, Flieman Medical Center and Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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