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Guan Y, Li F, Li N, Yang P. Decoding Behcet's Uveitis: an In-depth review of pathogenesis and therapeutic advances. J Neuroinflammation 2024; 21:133. [PMID: 38778397 PMCID: PMC11112928 DOI: 10.1186/s12974-024-03123-6] [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: 01/05/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Behcet's disease (BD) is a rare but globally distributed vasculitis that primarily affects populations in the Mediterranean and Asian regions. Behcet's uveitis (BU) is a common manifestation of BD, occurring in over two-thirds of the patients. BU is characterized by bilateral, chronic, recurrent, non-granulomatous uveitis in association with complications such as retinal ischemia and atrophy, optic atrophy, macular ischemia, macular edema, and further neovascular complications (vitreous hemorrhage, neovascular glaucoma). Although the etiology and pathogenesis of BU remain unclear, numerous studies reveal that genetic factors (such as HLA-B51), dysregulated immune responses of both the innate and adaptive immune systems, infections (such as streptococcus), and environmental factors (such as GDP) are all involved in its development. Innate immunity, including hyperactivity of neutrophils and γδT cells and elevated NK1/NK2 ratios, has been shown to play an essential role in this disease. Adaptive immune system disturbance, including homeostatic perturbations, Th1, Th17 overaction, and Treg cell dysfunction, is thought to be involved in BU pathogenesis. Treatment of BU requires a tailored approach based on the location, severity of inflammation, and systemic manifestations. The therapy aims to achieve rapid inflammation suppression, preservation of vision, and prevention of recurrence. Systemic corticosteroids combined with other immunosuppressive agents have been widely used to treat BU, and beneficial effects are observed in most patients. Recently, biologics have been shown to be effective in treating refractory BU cases. Novel therapeutic targets for treating BU include the LCK gene, Th17/Treg balance, JAK pathway inhibition, and cytokines such as IL-17 and RORγt. This article summarizes the recent studies on BU, especially in terms of pathogenesis, diagnostic criteria and classification, auxiliary examination, and treatment options. A better understanding of the significance of microbiome composition, genetic basis, and persistent immune mechanisms, as well as advancements in identifying new biomarkers and implementing objective quantitative detection of BU, may greatly contribute to improving the adequate management of BU patients.
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Affiliation(s)
- Yuxuan Guan
- Department of Ophthalmology, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, 450052, People's Republic of China
- The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450052, People's Republic of China
| | - Fuzhen Li
- Department of Ophthalmology, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, 450052, People's Republic of China
| | - Na Li
- Department of Ophthalmology, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, 450052, People's Republic of China
| | - Peizeng Yang
- Department of Ophthalmology, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, 450052, People's Republic of China.
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Zhong Z, Su G, Yang P. Risk factors, clinical features and treatment of Behçet's disease uveitis. Prog Retin Eye Res 2023; 97:101216. [PMID: 37734442 DOI: 10.1016/j.preteyeres.2023.101216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
Behçet's disease is a systemic vasculitis frequently associated with intraocular inflammation. Recent findings identified independent clinical clusters in Behçet's disease, each involving distinct combinations of affected organs. Ocular Behçet's disease, mainly manifested as uveitis, is characterized as an independent cluster with a low likelihood of association with other system involvements, such as intestinal, cardiovascular, or central nervous system. A prevailing theory suggests that the pathogenesis of the disease is multifactorial, where a variety of genetic and infectious agents may interact with each other to cause the disease. Among sporadic cases, the human leukocyte antigen (HLA) genes, including HLA-B51, HLA-A26, HLA-B15, and HLA-B5701, have been found to be a key component conferring genetic susceptibility. Outside the HLA region, a set of susceptibility variants are identified, closely related to interleukin (IL)-23/IL-17 pathway, tumor necrosis factor (TNF) signaling, and pattern recognition receptor systems. Microbial infections, such as Streptococcus sanguinis, Mycobacterium tuberculosis, and Herpes simplex virus (HSV), are linked to play the triggering of disease in immunogenetically predisposed individuals. Clinically, due to the notable relapsing-remitting course of ocular Behçet's disease, the prevention of recurrent attack would be the primary treatment goal. Combination of corticosteroids and immunomodulatory drugs, such as anti-TNF agents, interferon, and conventional immunosuppressants (e.g. cyclosporine, azathioprine), have been the mainstream regimen for the disease. Future research may focus on comparing the effectiveness of immunomodulatory drugs and identifying the most suitable subgroups for a specific drug on the basis of the knowledge of the molecular heterogeneity of the disease.
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Affiliation(s)
- Zhenyu Zhong
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China.
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Lin S, Xu Z, Lin Z, Xie B, Feng J. Advances in pathogenesis and treatment of ocular involvement in Behcet's disease. Front Immunol 2023; 14:1206959. [PMID: 37841268 PMCID: PMC10570607 DOI: 10.3389/fimmu.2023.1206959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023] Open
Abstract
Behcet's disease (BD) is a chronic multi-systemic disease characterized by relapsing-remitting oral ulcers, genital ulcers, ocular inflammatory involvements, and numerous other systemic features. Ocular involvements are quite common in BD and may cause severe tissue damage and potentially blindness. Even though the pathogenesis of BD remains ambiguous, growing evidences have shown that genetic factors, environmental triggers and immunological abnormalities play significant roles in its development and progression. Novel biotherapies targeting IFN-γ, TNF-α and interleukins have been used in recent years. In this review, we mainly pay attention to the ocular involvement of BD, and discuss the current understanding of mechanisms and advances in therapeutic approaches, especially novel biologics. Finally, we discuss the management in patients with pregnancy.
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Affiliation(s)
- Suibin Lin
- Department of Gynaecology and Obstetrics, Zhangpu Hospital, Zhangzhou, China
| | - Zhirong Xu
- Department of Internal Medicine, Zhangpu Hospital, Zhangzhou, China
| | - Zhiming Lin
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Baozhao Xie
- Department of Rheumatology and Immunology, the Seventh Affiliated Hospital of Guangxi Medical University (Wuzhou Gongren Hospital), Wuzhou, China
| | - Junmei Feng
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Rheumatology and Immunology, Nanfang Hospital of Southern Medical University, Guangzhou, China
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Castaño-Núñez ÁL, Montes-Cano MA, García-Lozano JR, Ortego-Centeno N, García-Hernández FJ, Espinosa G, Graña-Gil G, Sánchez-Bursón J, Juliá MR, Solans R, Blanco R, Barnosi-Marín AC, Gómez de la Torre R, Fanlo P, Rodríguez-Carballeira M, Rodríguez-Rodríguez L, Camps T, Castañeda S, Alegre-Sancho JJ, Martín J, González-Escribano MF. The complex HLA-E-nonapeptide in Behçet disease. Front Immunol 2023; 14:1080047. [PMID: 37638008 PMCID: PMC10449640 DOI: 10.3389/fimmu.2023.1080047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 07/04/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The knowledge of the aetiology of Behçet disease (BD), an immune-mediated vasculitis, is limited. HLA-B, mainly HLA-B51, and HLA-A molecules are associated with disease, but the ultimate cause of this association remains obscure. There is evidence that NK cells participate in the etiopathology of BD. NK cells have activator and inhibitor surface receptors, like the KIR and the NKG2 families. Classical HLA-class I molecules (A, B and C) are keys in the activity control of the NK because they are KIR ligands. Most NKG2 receptors bind HLA-E, which presents only nonapeptides derived from the signal peptide of other class-I molecules. Objective This study investigates the contribution of the pair HLA-E and ligand, nonapeptide derived from the 3-11 sequence of the signal peptides of class I classical molecules, to the susceptibility to BD. Methods We analyzed the frequency of the HLA-derivated nonapeptide forms in 466 BD patients and 444 controls and an HLA-E functional dimorphism in a subgroup of patients and controls. Results: In B51 negative patients, the frequency of VMAPRTLLL was lower (70.4% versus 80.0% in controls; P=0.006, Pc=0.04, OR=0.60, 95%CI 0.41-0.86), and the frequency of VMAPRTLVL was higher (81.6% versus 71.4% in controls; P=0.004, Pc=0.03, OR=1.78, 95%CI 1.20-2.63). In homozygosity, VMAPRTLLL is protective, and VMAPRTLVL confers risk. The heterozygous condition is neutral. There were no significant differences in the distribution of the HLA-E dimorphism. Discussion Our results explain the association of BD with diverse HLA-A molecules, reinforce the hypothesis of the involvement of the NK cells in the disease and do not suggest a significant contribution of the HLA-E polymorphism to disease susceptibility.
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Affiliation(s)
- Ángel Luís Castaño-Núñez
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, Spain
| | | | - José-Raúl García-Lozano
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, Spain
| | | | | | - Gerard Espinosa
- Department Autoimmune Diseases, Hospital Universitari Clínic, Barcelona, Spain
| | - Genaro Graña-Gil
- Department of Rheumatology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | | | - María Rosa Juliá
- Department of Immunology, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Roser Solans
- Department of Internal Medicine, Autoimmune Systemic Diseases Unit, Hospital Vall d’Hebron, Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | - Patricia Fanlo
- Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Spain
| | | | | | - Teresa Camps
- Department of Internal Medicine, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital de la Princesa, IIS-Princesa, Madrid, Spain
| | | | - Javier Martín
- Instituto de Parasitología y Biomedicina “López-Neyra”, CSIC, PTS Granada, Granada, Spain
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Bubnova L, Pavlova I, Terentieva M, Glazanova T, Belyaeva E, Sidorkevich S, Bashketova N, Chkhingeria I, Kozhemyakina M, Azarov D, Kuznetsova R, Ramsay ES, Gladkikh A, Sharova A, Dedkov V, Totolian A. HLA Genotypes in Patients with Infection Caused by Different Strains of SARS-CoV-2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14024. [PMID: 36360904 PMCID: PMC9657774 DOI: 10.3390/ijerph192114024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The aggressive infectious nature of SARS-CoV-2, its rapid spread, and the emergence of mutations necessitate investigation of factors contributing to differences in SARS-CoV-2 susceptibility and severity. The role of genetic variations in the human HLA continues to be studied in various populations in terms of both its effect on morbidity and clinical manifestation of illness. The study included 484 COVID-19 convalescents (northwest Russia residents of St. Petersburg). Cases in which the responsible strain was determined were divided in two subgroups: group 1 (n = 231) had illness caused by genovariants unrelated to variant of concern (VOC) strains; and group 2 (n = 80) had illness caused by the delta (B.1.617.2) VOC; and a control group (n = 1456). DNA typing (HLA-A, B, DRB1) was performed at the basic resolution level. HLA-A*02 was associated with protection against infection caused by non-VOC SARS-CoV-2 genetic variants only but not against infection caused by delta strains. HLA-A*03 was associated with protection against infection caused by delta strains; and allele groups associated with infection by delta strains were HLA-A*30, B*49, and B*57. Thus, in northwest Russia, HLA-A*02 was associated with protection against infection caused by non-VOC SARS-CoV-2 genetic variants but not against delta viral strains. HLA-A*03 was associated with a reduced risk of infection by delta SARS-CoV-2 strains. HLA-A*30, HLA-B*49, and HLA-B*57 allele groups were predisposing factors for infection by delta (B.1.617.2) strains.
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Affiliation(s)
- Ludmila Bubnova
- Russian Research Institute of Hematology and Transfusion Science, FMBA, 191024 St. Petersburg, Russia
- Department of immunology, Faculty of medicine, Pavlov First Saint Petersburg State Medical University, Russian Ministry of Health, 197022 St. Petersburg, Russia
| | - Irina Pavlova
- Russian Research Institute of Hematology and Transfusion Science, FMBA, 191024 St. Petersburg, Russia
| | - Maria Terentieva
- Russian Research Institute of Hematology and Transfusion Science, FMBA, 191024 St. Petersburg, Russia
| | - Tatiana Glazanova
- Russian Research Institute of Hematology and Transfusion Science, FMBA, 191024 St. Petersburg, Russia
| | - Elena Belyaeva
- Russian Research Institute of Hematology and Transfusion Science, FMBA, 191024 St. Petersburg, Russia
| | - Sergei Sidorkevich
- Russian Research Institute of Hematology and Transfusion Science, FMBA, 191024 St. Petersburg, Russia
| | - Nataliya Bashketova
- Saint Petersburg Office, Federal Service for Consumer Rights Protection and Human Welfare, 191025 St. Petersburg, Russia
| | - Irina Chkhingeria
- Saint Petersburg Office, Federal Service for Consumer Rights Protection and Human Welfare, 191025 St. Petersburg, Russia
| | | | - Daniil Azarov
- Saint Petersburg Center for Hygiene and Epidemiology, 191023 St. Petersburg, Russia
| | - Raisa Kuznetsova
- Department of immunology, Faculty of medicine, Pavlov First Saint Petersburg State Medical University, Russian Ministry of Health, 197022 St. Petersburg, Russia
- Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, 197101 St. Petersburg, Russia
| | - Edward S. Ramsay
- Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, 197101 St. Petersburg, Russia
| | - Anna Gladkikh
- Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, 197101 St. Petersburg, Russia
| | - Alena Sharova
- Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, 197101 St. Petersburg, Russia
| | - Vladimir Dedkov
- Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, 197101 St. Petersburg, Russia
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, Sechenov First Moscow State Medical University, 119435 Moscow, Russia
| | - Areg Totolian
- Department of immunology, Faculty of medicine, Pavlov First Saint Petersburg State Medical University, Russian Ministry of Health, 197022 St. Petersburg, Russia
- Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, 197101 St. Petersburg, Russia
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The Immunogenetics of Behcet’s Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:335-347. [DOI: 10.1007/978-3-030-92616-8_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Francois J, Moulinet T, Neiter E, Ehrardt A, Conart JB, Angioi-Duprez K. [Behçet's disease : Description and analysis of a French single-center retrospective study of 51 patients]. J Fr Ophtalmol 2021; 44:711-717. [PMID: 33741217 DOI: 10.1016/j.jfo.2020.04.064] [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: 12/09/2019] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate if the presence of uveitis in Behçet's disease (BD) is associated with a particular clinical phenotype and to analyze the prognostic impact of a missed diagnosis of BD at the time the uveitis is diagnosed. MATERIEL AND METHODS Ophthalmologic and systemic clinical features of 51 patients with BD were recorded retrospectively. We compared the clinical phenotype of patients with ocular manifestations with those without ocular manifestations. The patients were divided into two groups depending on the progression of their visual acuity: "decreased visual acuity" versus "stable or improved visual acuity." RESULTS In the group of patients with ocular involvement, there was a mean 2.3 systemic manifestations, vs. 3.2 in the group without ocular manifestations (P=0.004). When BD was diagnosed prior to the onset of uveitis, we counted fewer patients in the "decreased visual acuity" group in comparison with the patients who had no prior diagnosis of BD at the onset of the uveitis (91.3% in the "decreased visual acuity" group, P=0.04). The time before initiation of immunosuppressive treatment or a biological agent was shorter for these patients (4.4 vs. 39.3 months, P=0.007). CONCLUSION It appears that different phenotypes exist according to whether or not the BD patient has ocular involvement. Moreover, the visual prognosis is better if the uveitis occurs in patients who have already been diagnosed with BD, due to earlier initiation of immunosuppressive therapy.
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Affiliation(s)
- Julie Francois
- Département d'ophtalmologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France.
| | - Thomas Moulinet
- Département de médecine interne, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Estelle Neiter
- Département d'ophtalmologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Alix Ehrardt
- Département d'ophtalmologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Jean-Baptiste Conart
- Département d'ophtalmologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Karine Angioi-Duprez
- Département d'ophtalmologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
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Poddighe D, Turganbekova A, Mukusheva Z, Abdirakhmanova A, Assylbekova M, Abdrakhmanova S. HLA-B*51 allelic and carrier frequency in Kazakhstan: insights into Behçet's disease prevalence in Central Asia. Intern Emerg Med 2021; 16:325-331. [PMID: 32472479 DOI: 10.1007/s11739-020-02369-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/06/2020] [Indexed: 12/18/2022]
Abstract
Behçet's disease (BD) is a systemic vasculitis whose prevalence varies according to the ethnicity. HLA-B*51 is a well-known genetic factor predisposing to BD: populations with higher HLA-B*51 allelic frequencies are also those with a greater disease prevalence, as occurs in the Silk Road countries. However, the BD prevalence is unknown in many countries, including Kazakhstan and, in general, Central Asia, despite the location on or near the Silk Road. Due to the lack of clinical studies from this area, we analyzed the bone marrow donors registry in Kazakhstan, in order to assess the HLA-B*51 allelic and carrier frequencies, which resulted to be 8.14 and 15.28%, respectively. Through a comparison with the same parameters in other countries (by performing a data search in the medical literature and in the Allele Frequency Net Database), we might speculate a BD prevalence in Kazakhstan of 10-15/100.000 at least. This result should prompt a greater clinical consideration of this disease in Central Asia, as well as the publication of clinical data from this geographic area.
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Affiliation(s)
- Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine, Kerei-Zhanibek Str. 5/1, 010000, Nur-Sultan, Kazakhstan.
| | - Aida Turganbekova
- RSE on REM Scientific-Production Center of Transfusion Medicine, Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Zaure Mukusheva
- Department of Pediatric Rheumatology, National Research Center for Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Altynay Abdirakhmanova
- Department of Medicine, Nazarbayev University School of Medicine, Kerei-Zhanibek Str. 5/1, 010000, Nur-Sultan, Kazakhstan
| | - Maikesh Assylbekova
- Department of Pediatric Rheumatology, National Research Center for Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Saniya Abdrakhmanova
- RSE on REM Scientific-Production Center of Transfusion Medicine, Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
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Mahmoudi M, Aslani S, Meguro A, Akhtari M, Fatahi Y, Mizuki N, Shahram F. A comprehensive overview on the genetics of Behçet's disease. Int Rev Immunol 2020; 41:84-106. [PMID: 33258398 DOI: 10.1080/08830185.2020.1851372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Behçet's disease (BD) is a systemic and inflammatory disease, characterized mainly by recurrent oral and genital ulcers, eye involvement, and skin lesions. Although the exact etiopathogenesis of BD remains unrevealed, a bulk of studies have implicated the genetic contributing factors as critical players in disease predisposition. In countries along the Silk Road, human leukocyte antigen (HLA)-B51 has been reported as the strongest genetically associated factor for BD. Genome-wide association studies, local genetic polymorphism studies, and meta-analysis of combined data from Turkish, Iranian, and Japanese populations have also identified new genetic associations with BD. Among these, other HLA alleles such as HLA-B*15, HLA-B*27, HLA-B*57, and HLA-A*26 have been found as independent risk factors for BD, whereas HLA-B*49 and HLA-A*03 are independent protective alleles for BD. Moreover, other genes have also reached the genome-wide significance level of association with BD susceptibility, including IL10, IL23R-IL12RB2, IL12A, CCR1-CCR3, STAT4, TNFAIP3, ERAP1, KLRC4, and FUT2. Also, several rare nonsynonymous variants in TLR4, IL23R, NOD2, and MEFV genes have been reported to be involved in BD pathogenesis. According to genetic determinants in the loci outside the MHC region that are contributed to the host defense, immunity, and inflammation pathways, it is suggested that immune responses to the pathogen as an important environmental factor and mucosal immunity contribute to BD susceptibility.
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Affiliation(s)
- Mahdi Mahmoudi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Aslani
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akira Meguro
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Maryam Akhtari
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Fatahi
- Faculty of Pharmacy, Department of Pharmaceutical Nanotechnology, Tehran University of Medical Sciences, Tehran, Iran.,Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Farhad Shahram
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Association between Interleukin-10 Gene Polymorphisms and Behcet's Disease Susceptibility: Evidence from a Meta-Analysis. J Immunol Res 2020; 2020:9382609. [PMID: 32656270 PMCID: PMC7321531 DOI: 10.1155/2020/9382609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022] Open
Abstract
Epidemiological studies have demonstrated that interleukin-10 (IL-10) polymorphisms may be associated with the development of Behcet's disease (BD). However, the published results were inconsistent. Therefore, this meta-analysis was conducted to derive a more precise relationship between IL-10 polymorphisms and BD susceptibility. Online databases (PubMed, Embase, Science Citation Index (SCI), CNKI, and WanFang) were searched to identify eligible studies. Odds ratio (OR) and a 95% confidence interval (CI) were applied to assess the relationship strength between IL-10 -1082A>G (rs1800896), -819T>C (rs1800871), and -592A>C (rs1800872) polymorphisms and BD susceptibility. Publication bias, sensitivity, and cumulative analyses were conducted to measure the robustness of our findings. Finally, fifteen articles (36 independent case-control studies) involving 5,971 patients and 8,913 controls were included. Overall, significant associations between -819T>C polymorphisms and BD risk were observed in the total population (C vs. T: OR = 0.72, 95%CI = 0.67‐0.77, P < 0.01, I2 = 36.6%; TC vs. TT: OR = 0.73, 95%CI = 0.66‐0.80, P < 0.01, I2 = 23.0%; CC vs. TT: OR = 0.52, 95%CI = 0.39‐0.70, P < 0.01, I2 = 53.7%; TC+CC vs. TT: OR = 0.67, 95%CI = 0.61‐0.71, P < 0.01, I2 = 22.1%; and CC vs. TT+TC: OR = 0.66, 95%CI = 0.53‐0.82, P < 0.01, I2 = 57.8%). Moreover, the IL-10 -592 A>C polymorphism and the ACC haplotype exhibited a significant, protective effect against BD susceptibility. In summary, our meta-analysis suggested that IL-10 gene polymorphisms may play a salient role for BD development.
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Muñoz SA, Orden AO, Kostianovsky A, Pisoni CN, Scolnik M, Luissi A, Bottinelli Y, Vijoditz G, Garcia M, Pena C, Pera M, Rillo O, Alvarellos T, Más LM, Trunzo AL, Allievi A. The HLA-B*51 Allele is strongly associated with Behçet Disease in an Argentinean population. ACTA ACUST UNITED AC 2020; 16:282-285. [DOI: 10.1016/j.reuma.2018.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/07/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
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Charles J, Castellino FJ, Ploplis VA. Past and Present Behçet's Disease Animal Models. Curr Drug Targets 2020; 21:1652-1663. [PMID: 32682369 PMCID: PMC7746599 DOI: 10.2174/1389450121666200719010425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/23/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022]
Abstract
Behçet's disease (BD) is presumably an autoinflammatory disease of unknown etiology for which several animal models have been described over the years. Agents and methods used for the development of these models have ranged from the herpes simplex type one virus (hsv-1) pathogen to the use of transgenic mice. Other models have also been used to investigate a possible autoimmune component. Each model possesses its own unique set of benefits and shortcomings, with no one model fully being able to recapitulate the disease phenotype. Here, we review the proposed models and provide commentary on their effectiveness and usefulness in studying the disease.
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Affiliation(s)
- Jermilia Charles
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Francis J. Castellino
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN 46556, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Victoria A. Ploplis
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN 46556, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556, USA
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13
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Shahriyari E, Vahedi L, Roshanipour N, Jafarabadi MA, Khamaneh A, Laleh MG. Exploring the association of IL-10 polymorphisms in Behcet's disease: a systematic review and meta-analysis. JOURNAL OF INFLAMMATION-LONDON 2019; 16:26. [PMID: 31889911 PMCID: PMC6929502 DOI: 10.1186/s12950-019-0230-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/05/2019] [Indexed: 12/21/2022]
Abstract
Background Polymorphisms in the interleukin-10 (IL-10) gene have been studied in various ethnic groups for possible association with Behçet’s disease (BD). This study aimed to perform a meta-analysis of eligible studies to calculate the association of IL-10 polymorphisms with BD. A systematic literature search was carried out in PubMed, Embase, Web of Science, and Scopus databases to identify relevant publications, and extracted the respective results. Pooled odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the power of association with a random-effects model. Results A total of 19 articles, consisting of 10,626 patients and 13,592 controls were included in the meta-analysis. The meta-analysis revealed significant associations in allelic and genotypic test models of − 819 (C vs. T: OR = 0.691, P < 0.001; CC vs. TT: OR = 0.466, P < 0.001; CC + CT vs. TT: OR = 0.692, P < 0.001; and CC vs. CT + TT: OR = 0.557, P < 0.001), − 592 (C vs. A: OR = 0.779, P = 0.002; CC + AA vs. AA: OR = 0.713, P = 0.021; and CA vs. AA: OR = 0.716, P = 0.016), rs1518111 (G vs. A: OR = 0.738, P < 0.001; GG vs. AA: OR = 0.570, P < 0.001; GG + AG vs. AA: OR = 0.697, P < 0.001; GG vs. GA + AA: OR = 0.701, P < 0.001; and AG vs. GG: OR = 0.786, P = 0.004) and rs1554286 (C vs. T: OR = 0.582, P < 0.001; CC vs. TT: OR = 0.508, P < 0.001; CC + CT vs. TT: OR = 0.605, P < 0.001; CC vs. CT + TT: OR = 0.665, P = 0.012; and CT vs. TT: OR = 0.646, P = 0.001). However, we failed to find any association between − 1082 polymorphism and susceptibility of BD. Conclusion This meta-analysis demonstrated that the interleukin-10 -819, − 596, rs1518111 and rs1554286 polymorphisms could be responsible against BD susceptibility, and should probably be regarded as a protective factor for Behçet’s disease.
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Affiliation(s)
- Elham Shahriyari
- 1Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.,2Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Vahedi
- 2Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Roshanipour
- 3Department of Biology, School of Genetic, Azad University of Tabriz, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- 4Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Khamaneh
- 5Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Ghaffari Laleh
- 1Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.,4Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Gong HB, Wu XJ, Pu XM, Kang XJ. Association of Interleukin-23R Gene Polymorphisms with Behcet’s Disease Susceptibility: A Meta-Analysis of Case-control Studies. Immunol Invest 2019; 49:648-661. [PMID: 31814470 DOI: 10.1080/08820139.2019.1698600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Hai-Bo Gong
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Xiu-Juan Wu
- Department of Dermatology, Shanghai Xuhui Central Hospital, Shanghai, China
| | - Xiong-Ming Pu
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Xiao-Jing Kang
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
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15
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Meta-analysis of associations between interleukin-10 polymorphisms and susceptibility to Behcet’s disease. Immunol Res 2019; 67:424-431. [DOI: 10.1007/s12026-019-09102-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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16
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Characteristics of Behcet's Disease in the American Southwest. Semin Arthritis Rheum 2019; 49:296-302. [DOI: 10.1016/j.semarthrit.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/23/2019] [Accepted: 03/04/2019] [Indexed: 11/23/2022]
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17
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Petrushkin H, Norman PJ, Lougee E, Parham P, Wallace GR, Stanford MR, Fortune F. KIR3DL1/S1 Allotypes Contribute Differentially to the Development of Behçet Disease. THE JOURNAL OF IMMUNOLOGY 2019; 203:1629-1635. [PMID: 31405953 DOI: 10.4049/jimmunol.1801178] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 07/08/2019] [Indexed: 11/19/2022]
Abstract
Behçet disease is a chronic, relapsing-remitting autoinflammatory syndrome with a strong HLA-B*51 association. In this paper, we describe a human cohort of 267 individuals with Behçet disease and 445 matched controls from a tertiary referral center in the U.K. HLA-B*51 was confirmed as a genetic risk factor in this group (p = 0.0006, Bonferroni-Dunn correction for multiple testing [Pc] = 0.0192, odds ratio [OR] 1.92, 95% confidence interval [CI] 1.33-2.76). KIR3DL1/S1 allele-level analysis indicated that low-expressing KIR3DL1/S1 alleles in combination with KIR3DS1 increased the risk of developing Behçet disease (KIR3DL1LOW/KIR3DS1: p = 0.0004, Pc = 0.0040, OR 2.47, 95% CI 1.43-4.25), whereas high-expressing KIR3DL1/S1 alleles in combination with a null-expressing KIR3DL1 reduced the risk of disease (KIR3DL1HIGH/KIR3DL1NULL: p = 0.0035, Pc = 0.0350, OR 0.53, 95% CI 0.33-0.87). Behçet disease can manifest as a purely mucocutaneous disease or can involve other organ systems such as the eyes. In the U.K. cohort studied in this study, KIR3DL1LOW/KIR3DS1 increased the risk of ophthalmic disease (p = 1.2 × 10-5, OR 3.92, 95% CI 2.06-7.47), whereas KIR3DL1HIGH/KIR3DL1NULL reduced the risk of having purely mucocutaneous disease (p = 0.0048, OR 0.45, 95% CI 0.25-0.81). To our knowledge, this is the first analysis of KIR3DL1/S1 allelic variation in Behçet disease and may provide insight into the pathogenic role of HLA-B*51 and its interaction with KIR3DL1/S1.
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Affiliation(s)
- Harry Petrushkin
- Moorfields Eye Hospital National Health Service Foundation Trust, Medical Retina Department, London EC1V 2PD, United Kingdom.,Clinical and Diagnostic Oral Sciences, Queen Mary University of London, Blizard Institute, E1 2AT London, United Kingdom
| | - Paul J Norman
- Division of Biomedical Informatics and Personalized Medicine, Department of Microbiology and Immunology, University of Colorado, Aurora, CO 80045
| | - Emma Lougee
- Viapath, Clinical Transplantation Laboratory, Guy's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London SE1 9RT, United Kingdom
| | - Peter Parham
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA 94305
| | - Graham R Wallace
- Centre for Translational Inflammation Research, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, University of Birmingham, Birmingham B15 2TT, United Kingdom; and
| | - Miles R Stanford
- Medical Eye Unit, St Thomas' Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London SE1 7EH, United Kingdom
| | - Farida Fortune
- Clinical and Diagnostic Oral Sciences, Queen Mary University of London, Blizard Institute, E1 2AT London, United Kingdom;
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18
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Shirvani SS, Nouri M, Sakhinia E, Babaloo Z, Mohammadzaeh A, Alipour S, Jadideslam G, Khabbazi A. The molecular and clinical evidence of vitamin D signaling as a modulator of the immune system: Role in Behçet's disease. Immunol Lett 2019; 210:10-19. [PMID: 30935876 DOI: 10.1016/j.imlet.2019.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/28/2019] [Indexed: 01/07/2023]
Abstract
Various tissues and cell types are the targets of vitamin D. However, the major targets of vitamin D in the immune system are monocytes/macrophages, dendritic cells (DCs), as well as B and T cells. Vitamin D plays an important role in the immune system modulation via regulating the expression of genes that generate pro-inflammatory mediators and inhibiting the proliferation of pro-inflammatory cells, both of which have been implicated in the pathophysiology of the inflammatory diseases. Recent studies have revealed the important relations between vitamin D and Behçet's disease (BD). Vitamin D function and its deficiency have been linked to a wide range of metabolic disorders including malignant, cardiovascular, infectious, neuromuscular, and autoimmune diseases. Here, we provide a brief analysis of the recent literature regarding immune-regulatory effects as well as clinical evidence of vitamin D influence on the molecular level in BD.
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Affiliation(s)
- Sam Seydi Shirvani
- Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Connective Tissue Diseases Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Mohammad Nouri
- Department of Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ebrahim Sakhinia
- Department of Medical Genetics, Faculty of Medicine and Tabriz Genetic Analysis Centre (TGAC), Tabriz University of Medical Sciences, Daneshgah Street, 516661557, Tabriz, Iran
| | - Zohreh Babaloo
- Department of Immunology Medicine faculty, Tabriz University of Medical Sciences, Iran
| | - Adel Mohammadzaeh
- Department of Immunology and Genetic, Urmia University of Medical Sciences, Urmia, Iran
| | - Shahriar Alipour
- Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Connective Tissue Diseases Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Golamreza Jadideslam
- Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Connective Tissue Diseases Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Alireza Khabbazi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Science, Tabriz, Iran.
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19
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Khabbazi A, Vahedi L, Ghojazadeh M, Pashazadeh F, Khameneh A. Association of HLA-B27 and Behcet's disease: a systematic review and meta-analysis. AUTOIMMUNITY HIGHLIGHTS 2019; 10:2. [PMID: 30891643 PMCID: PMC6424999 DOI: 10.1186/s13317-019-0112-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 02/26/2019] [Indexed: 01/01/2023]
Abstract
Background To calculate the genetic impact of the “HLA-B27” allele on the risk of Behcet’s disease (BD) progression using a systematic review and meta-analysis on case control papers. Methods A systematic review search was conducted on the MeSH keywords of Behcet’s disease, HLAB27 and B27 in PubMed, Scopus, ProQuest, EMBASE, SID, Magiran, IranDoc and IranMedex databases from 1975 to Aug 2017. Data underwent meta-analysis (random effect model) in CMA2 software. Pooled odds ratios with 95% confidence intervals were calculated for each study. The heterogeneity of the articles was measured using the I2 index. Results Twenty two articles met the inclusion criteria for 3939 cases and 6077 controls. The pooled OR of “HLA-B27” in BD patients compared with controls was [1.55 (CI 95% 1.01–2.38), P = 0.04]. The OR differ among different countries or geographical areas, focus on domination the European countries. Quality of studies was moderate and heterogeneity was relatively high (I2 = 66.9%). Conclusions There is a significant correlation between HLA-B27 and Behcet’s Disease, but it was weak. Environmental and genetic factors might determine which the “HLA-B27” alleles manifest Behcet’s disease progression. Future researches is required to perform about what factors can do to positively and separately influence Behcet’s disease.
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Affiliation(s)
- Alireza Khabbazi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Vahedi
- Liver and Gastrointestinal Disease Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Morteza Ghojazadeh
- Medical Faculty, Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Pashazadeh
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Khameneh
- Tabriz Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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The association analysis between HLA-A*26 and Behçet's disease. Sci Rep 2019; 9:4426. [PMID: 30872678 PMCID: PMC6418292 DOI: 10.1038/s41598-019-40824-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 02/25/2019] [Indexed: 01/06/2023] Open
Abstract
The strongest genetic risk factor of Behçet’s disease (BD) is HLA-B*51. Our group previously reported that HLA-A*26 is independently associated with the risk of the onset of BD apart from HLA-B*51. Here, we re-evaluated the association between HLA-A*26 and BD in the Japanese population. We also performed a comprehensive literature search and meta-analyzed the extracted published data concerning the relationship between HLA-A*26 and BD to estimate the odds ratio (OR) of HLA-A*26 to BD. In this study, we genotyped 611 Japanese BD patients and 2,955 unrelated ethnically matched healthy controls. Genotyping results showed that the phenotype frequency of HLA-A*26 was higher in BD patients than in controls (OR = 2.12, 95% CI: 1.75–2.56). Furthermore, within the HLA-B*51-negative populations, the phenotype frequency of HLA-A*26 was significantly higher in BD patients than in controls (OR = 3.10, 95% CI: 2.43–3.95). Results obtained from meta-analysis combined with our data showed that the modified OR of HLA-A*26 became 1.80 (95% CI:1.58–2.06), whereas within the HLA-B*51-negative population, the modified OR became 4.02 (95% CI: 2.29–7.05). A subgroup analysis arranged by the geographical regions showed HLA-A*26 is in fact associated with the onset of BD in Northeast Asia (OR = 2.11, 95% CI: 1.75–2.56), but not in the Middle East or in Europe.
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21
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Burillo-Sanz S, Montes-Cano MA, García-Lozano JR, Olivas-Martínez I, Ortego-Centeno N, García-Hernández FJ, Espinosa G, Graña-Gil G, Sánchez-Bursón J, Juliá MR, Solans R, Blanco R, Barnosi-Marín AC, Gómez de la Torre R, Fanlo P, Rodríguez-Carballeira M, Rodríguez-Rodríguez L, Camps T, Castañeda S, Alegre-Sancho JJ, Martín J, González-Escribano MF. Behçet's disease and genetic interactions between HLA-B*51 and variants in genes of autoinflammatory syndromes. Sci Rep 2019; 9:2777. [PMID: 30808881 PMCID: PMC6391494 DOI: 10.1038/s41598-019-39113-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/14/2019] [Indexed: 12/16/2022] Open
Abstract
Behçet’s disease (BD) is an immune-mediated systemic disorder with a well-established genetic base. In a previous study, using a next generation sequencing approach, we found many rare variants and some functional polymorphisms in genes related to autoinflammatory syndromes (AID): CECR1, MEFV, MVK, NLRP3, NOD2, PSTPIP1 and TNFRSF1A in our BD cohort. Our strategy did not allow us to establish either number of patients with variants, proportion of individuals accumulating them or relationship with other genetic factors. With the goal to answer these questions, the individual samples were sequenced. Additionally, three functional polymorphisms: NLRP3 p.Gln703Lys, NOD2 p.Arg702Trp and p.Val955Ile were genotyped using TaqMan assays. A total of 98 patients (27.6%) carried at least one rare variant and 13 of them (3.7%) accumulated two or three. Functional regression model analysis suggests epistatic interaction between B51 and MEFV (P = 0.003). A suggestive protective association of the minor allele of NOD2 p.Arg702Trp (P = 0.01) was found in both, B51 positive and negative individuals. Therefore, a high percentage of patients with BD have rare variants in AID genes. Our results suggest that the association of MEFV with BD could be modulated by the HLA molecules; whereas the protective effect of NOD2 p.Arg702Trp would be independent of HLA.
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Affiliation(s)
- Sergio Burillo-Sanz
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | - Marco-Antonio Montes-Cano
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | - José-Raúl García-Lozano
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | - Israel Olivas-Martínez
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | | | | | - Gerard Espinosa
- Department Autoimmune Diseases, Hospital Clinic Universitari, Barcelona, 08036, Spain
| | - Genaro Graña-Gil
- Department of Rheumatology, Complejo Hospitalario Universitario, A Coruña, 15006, Spain
| | - Juan Sánchez-Bursón
- Department of Rheumatology, Hospital Universitario de Valme, Sevilla, 41014, Spain
| | - María Rosa Juliá
- Department of Immunology, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, 07120, Spain
| | - Roser Solans
- Department of Internal Medicine, Autoimmune Systemic Diseases Unit, Hospital Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, 08035, Spain
| | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, 39008, Spain
| | | | | | - Patricia Fanlo
- Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, 31008, Spain
| | | | | | - Teresa Camps
- Department of Internal Medicine, Hospital Regional Universitario, Málaga, 29010, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital de la Princesa, IIS-Princesa, Madrid, 28006, Spain
| | | | - Javier Martín
- Instituto de Parasitología y Biomedicina "López-Neyra", CSIC, PTS, Granada, 18016, Spain
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22
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Elfishawi MM, Elgengehy F, Mossallam G, Elfishawi S, Alfishawy M, Gad A, Mokhtar I. HLA Class I in Egyptian patients with Behçet’s disease: new association with susceptibility, protection, presentation and severity of manifestations. Immunol Invest 2018; 48:121-129. [DOI: 10.1080/08820139.2018.1517364] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Fatema Elgengehy
- Rheumatology and Rehabilitation Department, Cairo University, Cairo, Egypt
| | - Ghada Mossallam
- Clinical Pathology and Immunology Laboratory, National Cancer Institute, Cairo University, Cairo Egypt
| | - Sally Elfishawi
- Clinical Pathology and Immunology Laboratory, National Cancer Institute, Cairo University, Cairo Egypt
| | - Mostafa Alfishawy
- Division of Infectious Disease, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Abdallah Gad
- Department of Internal Medicine, Texas Tech University Health Sciences Center Odessa, Odyessa, Texas, USA
- Department of Biostatistics and Cancer Epidemiology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Imman Mokhtar
- Rheumatology and Rehabilitation Department, Cairo University, Cairo, Egypt
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23
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Deng Y, Zhu W, Zhou X. Immune Regulatory Genes Are Major Genetic Factors to Behcet Disease: Systematic Review. Open Rheumatol J 2018; 12:70-85. [PMID: 30069262 PMCID: PMC6040213 DOI: 10.2174/1874312901812010070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/04/2018] [Accepted: 06/04/2018] [Indexed: 12/15/2022] Open
Abstract
Behcet's disease (BD) is a chronic refractory multi-system autoimmune disorder that occurs in a genetically susceptible host. Multiple genetic factors have been identified that may contribute to the pathogenesis of BD. The major genes with polymorphisms associated with BD include HLA-B and -A, CIITA, ERAP1, MICA, IL10, IL12A, IL12RB2, IL23R, MEFV, IRF8, TNFAIP3, REL, TLR4, NOD1,2, CCR1,CCR3, GIMAP1,2,4, KLRC4, STAT4, NCOA5, FOXP3, PSORS1C1, FUT2, UBAC2, SUMO4, ADO-EGR2, CEBPB-PTPN1, and JPKL-CNTN5. These genes encode proteins involved mainly in immune regulation and inflammation, and some in transcription and post-translational modification. A complete view of these BD-associated genes may provide a clue to this complex disease in terms of its pathogenesis and exploring potentially targeted therapies for BD.
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Affiliation(s)
- Yan Deng
- The Second Affiliated Hospital of Nanchang University, Nanchangine>, China.,Department of Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston McGovern Medical School, USA
| | - Weifeng Zhu
- Department of Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston McGovern Medical School, USA.,College of Basic Medical Sciences, Nanchang University, Nanchang, China
| | - Xiaodong Zhou
- Department of Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston McGovern Medical School, USA
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24
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Wang M, Sun W, Chen Z, Wang X, Lv J, Tan Q, Wang Y, Zhou J. Multiple aneurysms and gastrointestinal involvement in Behcet's disease: A case report. Medicine (Baltimore) 2017; 96:e9131. [PMID: 29245353 PMCID: PMC5728968 DOI: 10.1097/md.0000000000009131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Behcet's disease (BD) is a rare systemic vasculitis disorder that can involve vessels of any size. PATIENT CONCERNS A 60-year-old female had recurrent painful mouth ulcers about 30 years ago and recently presented with abdominal distension, conjunctival congestion, and chest pain in sequence. DIAGNOSES The patient was diagnosed with BD according to the International Criteria for Behcet's Disease (ICBD). INTERVENTIONS A therapy of glucocorticoids and cyclophosphamide was administered. OUTCOMES After a 3-month treatment, follow-up examination showed a depression of the inflammation and a slight decrease of the arterial aneurysms. LESSONS BD patients may get a delayed diagnosis because of the long duration between the first and subsequent manifestations. Suspect patients should be followed-up and the diagnosis of BD should be considered when multiple tissues or organs are involved.
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Affiliation(s)
- Mengdi Wang
- Department of Nephrology and Rheumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Weiwei Sun
- Department of Nephrology and Rheumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Zhenjie Chen
- Department of Nephrology and Rheumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xiaona Wang
- Department of Nephrology and Rheumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Jie Lv
- Department of Nephrology and Rheumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Quanming Tan
- Singapore Thong Chai Medical Institution, Singapore
| | - Yaoxian Wang
- Singapore Thong Chai Medical Institution, Singapore
| | - Jingwei Zhou
- Department of Nephrology and Rheumatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
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25
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ElAoud S, Kamoun A, Mahfoudh N, Charfi A, Snoussi M, Hachicha H, Jerbi A, Dammak C, Frikha F, Hakim F, Gaddour L, Bahloul Z, Makni H. Beyond Human Leukocyte Antigen Class I Antigens: Hereditary Hemochromatosis Gene Mutations in Recurrent Aphthous Oral Ulcers and Behçet Disease in the South of Tunisia. Med Princ Pract 2017; 26:427-432. [PMID: 28950260 PMCID: PMC5757568 DOI: 10.1159/000481782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/26/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this work was to establish human leukocyte antigen (HLA) class I and hereditary hemochromatosis gene (HFE) mutation associations with recurrent aphthous oral ulcers (RAOU) and Behçet disease (BD) in a cohort of Southern Tunisian patients. SUBJECTS AND METHODS A total of 232 patients with RAOU and 123 healthy controls (HCs) were enrolled in this study. The patients were divided into 2 groups based on the presence (BD+: n = 62) or absence of BD (BD-, n = 170). In the BD+ group, 28 patients had severe manifestations of BD. In the BD- group, RAOU was isolated in 81 patients, associated with mucocutaneous manifestations in 58 and with joint symptoms in 25. Complement-dependent microlymphocytotoxicity assay and polymerase chain reaction-restriction fragment length polymorphism were used to study HLA class I polymorphism and HFE mutations, respectively. RESULTS HLA-B51 was positively associated with BD, particularly in those with severe manifestations. No association was detected with HLA class I polymorphism among the BD group. Based on stratification to clinical manifestations, the isolated RAOU was negatively associated with HLA-A1 with a difference close to significance (12 [14.81%] vs. 32 [26.02%] in HCs; p = 0.06). Furthermore, patients with mucocutaneous features had a higher frequency of HLA-B51 (14, 24.14%) than patients without mucocutaneous involvement (11, 11.37%). Considering HFE mutations, patients with isolated RAOU had a higher frequency of H63D when compared with other subgroups, especially after limiting the comparison to 27 patients of at least 5 years of follow-up. CONCLUSION This study showed that, unlike BD, RAOU were not associated with HLA-B51. Moreover, we suggest that H63D mutation was positively associated with isolated RAOU.
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Affiliation(s)
- Sahar ElAoud
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Arwa Kamoun
- Department of Histocompatibility, Hedi Chaker Hospital, Sfax, Tunisia
- *Arwa Kamoun, Histocompatibility Department, Hedi Chaker Hospital, Route El Ain, Sfax 3000 (Tunisia), E-Mail
| | - Nadia Mahfoudh
- Department of Histocompatibility, Hedi Chaker Hospital, Sfax, Tunisia
| | - Aida Charfi
- Department of Histocompatibility, Hedi Chaker Hospital, Sfax, Tunisia
| | - Mouna Snoussi
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Hend Hachicha
- Department of Immunology Department, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Ameni Jerbi
- Department of Immunology Department, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Chifa Dammak
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Feten Frikha
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Faiza Hakim
- Department of Histocompatibility, Hedi Chaker Hospital, Sfax, Tunisia
| | - Lilia Gaddour
- Department of Histocompatibility, Hedi Chaker Hospital, Sfax, Tunisia
| | - Zouheir Bahloul
- Department of Internal Medicine, Hedi Chaker Hospital, Sfax, Tunisia
| | - Hafedh Makni
- Department of Histocompatibility, Hedi Chaker Hospital, Sfax, Tunisia
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Ortiz-Fernández L, Carmona FD, Montes-Cano MA, García-Lozano JR, Conde-Jaldón M, Ortego-Centeno N, Castillo MJ, Espinosa G, Graña-Gil G, Sánchez-Bursón J, Juliá MR, Solans R, Blanco R, Barnosi-Marín AC, Gómez de la Torre R, Fanlo P, Rodríguez-Carballeira M, Rodríguez-Rodríguez L, Camps T, Castañeda S, Alegre-Sancho JJ, Martín J, González-Escribano MF. Genetic Analysis with the Immunochip Platform in Behçet Disease. Identification of Residues Associated in the HLA Class I Region and New Susceptibility Loci. PLoS One 2016; 11:e0161305. [PMID: 27548383 PMCID: PMC4993481 DOI: 10.1371/journal.pone.0161305] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 08/03/2016] [Indexed: 12/15/2022] Open
Abstract
Behcet's disease (BD) is an immuno-mediated vasculitis in which knowledge of its etiology and genetic basis is limited. To improve the current knowledge, a genetic analysis performed with the Immunochip platform was carried out in a population from Spain. A discovery cohort comprising 278 BD cases and 1,517 unaffected controls were genotyped using the Immunochip platform. The validation step was performed on an independent replication cohort composed of 130 BD cases and 600 additional controls. The strongest association signals were observed in the HLA class I region, being HLA-B*51 the highest peak (overall P = 6.82E-32, OR = 3.82). A step-wise conditional logistic regression with classical alleles identified HLA-B*57 and HLA-A*03 as additional independent markers. The amino acid model that best explained the association, includes the position 97 of the HLA-B molecule and the position 66 of the HLA-A. Among the non-HLA loci, the most significant in the discovery analysis were: IL23R (rs10889664: P = 3.81E-12, OR = 2.00), the JRKL/CNTN5 region (rs2848479: P = 5.00E-08, OR = 1.68) and IL12A (rs1874886: P = 6.67E-08, OR = 1.72), which were confirmed in the validation phase (JRKL/CNTN5 rs2848479: P = 3.29E-10, OR = 1.66; IL12A rs1874886: P = 1.62E-08, OR = 1.61). Our results confirm HLA-B*51 as a primary-association marker in predisposition to BD and suggest additional independent signals within the class I region, specifically in the genes HLA-A and HLA-B. Regarding the non-HLA genes, in addition to IL-23R, previously reported in our population; IL12A, described in other populations, was found to be a BD susceptibility factor also in Spaniards; finally, a new associated locus was found in the JRKL/CNTN5 region.
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Affiliation(s)
- Lourdes Ortiz-Fernández
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | - Francisco-David Carmona
- Instituto de Parasitología y Biomedicina “López-Neyra”, CSIC, PTS Granada, Granada, 18016, Spain
| | - Marco-Antonio Montes-Cano
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | - José-Raúl García-Lozano
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | - Marta Conde-Jaldón
- Department of Immunology, Hospital Universitario Virgen del Rocío (IBiS, CSIC, US), Sevilla, 41013, Spain
| | | | - María Jesús Castillo
- Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, 41003, Spain
| | - Gerard Espinosa
- Department Autoimmune Diseases, Hospital Universitari Clínic, Barcelona, 08036, Spain
| | - Genaro Graña-Gil
- Department of Rheumatology, Complejo Hospitalario Universitario A Coruña, A Coruña, 15006, Spain
| | - Juan Sánchez-Bursón
- Department of Rheumatology, Hospital Universitario de Valme, Sevilla, 41014, Spain
| | - María Rosa Juliá
- Department of Immunology, Hospital Universitari Son Espases, Palma de Mallorca, 07120, Spain
| | - Roser Solans
- Department of Internal Medicine, Autoimmune Systemic Diseases Unit, Hospital Vall d’Hebron, Universidad Autonoma de Barcelona, Barcelona, 08035, Spain
| | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, 39008, Spain
| | | | | | - Patricia Fanlo
- Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, 31008, Spain
| | | | | | - Teresa Camps
- Department of Internal Medicine, Hospital Regional Universitario de Málaga, Málaga, 29010, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital de la Princesa, IIS-Princesa, Madrid, 28006, Spain
| | | | - Javier Martín
- Instituto de Parasitología y Biomedicina “López-Neyra”, CSIC, PTS Granada, Granada, 18016, Spain
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Al-Okaily F, Al-Rashidi S, Al-Balawi M, Mustafa M, Arfin M, Al-Asmari A. Genetic Association of HLA-A*26, -A*31, and -B*51 with Behcet's Disease in Saudi Patients. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2016; 9:167-73. [PMID: 27547040 PMCID: PMC4978194 DOI: 10.4137/cmamd.s39879] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND HLA-B*51 has been universally associated with Behcet’s disease (BD) susceptibility, while different alleles of HLA-A have also been identified as independent BD susceptibility loci in various ethnic populations. The objective of this study was to investigate associations of HLA-A and -B alleles with BD in Saudi patients. MATERIALS AND METHODS Genotyping for HLA-A and HLA-B was performed using HLA genotyping kit (Lab type(R) SSO) in 120 Saudi subjects, including 60 BD patients and 60 matched healthy controls. RESULTS Our results revealed that frequencies of HLA-A*26, -A*31, and -B*51 were significantly higher in BD patients than in controls, suggesting that HLA-A*26, -A*31, and -B*51 are associated with BD. The frequency of HLA-B*15 was significantly lower in BD patients than in controls. Stratification of genotyping results into active and nonactive forms of BD revealed that the frequency of HLA-A*31 was significantly higher in the nonactive form than in the active form of BD, while there was no significant difference in the distribution of other alleles between the two forms of BD. CONCLUSION This study suggests that HLA-A*26, -A*31, and -B*51 are associated with susceptibility risk to BD, while HLA-B*15 may be protective in Saudi patients. However, larger scale studies are needed to confirm these findings.
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Affiliation(s)
- Fahda Al-Okaily
- Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Seham Al-Rashidi
- Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Maysoon Al-Balawi
- Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Md Mustafa
- Research Centre, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Research Centre, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Gheita TA, Gheita HA, Kenawy SA. The potential of genetically guided treatment in Behçet's disease. Pharmacogenomics 2016; 17:1165-1174. [DOI: 10.2217/pgs-2015-0004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Continuous identification of specific targets and candidate genes together with novel approaches offers new promises for the future of gene therapy design in Behçet's disease (BD). Personalized medicine based on pharmacogenomics is being developed at the clinical stage to improve treatment response. Screening the whole gene and regulatory regions is important when searching for novel variants associated with such complex diseases. Different host genetic factors play significant roles in susceptibility to BD. Thus, identifying these genes responsible for susceptibility and resistance to BD may offer a notable contribution toward understanding its pathogenesis, and may lead to the development of novel prophylactic and treatment strategies. Evidenced-based treatment strategy is recommended for the management in BD patients. This review sheds light on the immunopathogenesis and pharmacogenetics of BD with special attention to the treatment targeting gene polymorphisms. In conclusion, the potential of genetically guided treatment in BD takes us back to the future for an accurate management strategy of this serious rheumatic disease. The ongoing discovery of pivotal genes related to the susceptibility, manifestations, disease activity and treatment options provide substantial hope to the reduced frequency of BD, effective control and improvement in the prognosis. Targeted gene therapy could be a leading option in the treatment armamentarium of BD.
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Affiliation(s)
- Tamer A Gheita
- Rheumatology & Clinical Immunology, Faculty of Medicine, Cairo University, Egypt
| | - Heba A Gheita
- Pharmacology Department, Atomic Energy Authorization, Cairo, Egypt
| | - Sanaa A Kenawy
- Pharmacology & Toxicology Department, Faculty of Pharmacy, Cairo University
- Pharmacology, Royal College of Surgeons, London University, London, UK
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González Escribano MF, Montes Cano MA. Genética de la enfermedad de Behçet. Med Clin (Barc) 2016; 146:392-3. [DOI: 10.1016/j.medcli.2016.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 10/22/2022]
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Takeuchi M, Kastner DL, Remmers EF. The immunogenetics of Behçet's disease: A comprehensive review. J Autoimmun 2015; 64:137-48. [PMID: 26347074 DOI: 10.1016/j.jaut.2015.08.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 02/08/2023]
Abstract
Behçet's disease is a chronic multisystem inflammatory disorder characterized mainly by recurrent oral ulcers, ocular involvement, genital ulcers, and skin lesions, presenting with remissions and exacerbations. It is thought that both environmental and genetic factors contribute to its onset and development. Although the etiology of Behçet's disease remains unclear, recent immunogenetic findings are providing clues to its pathogenesis. In addition to the positive association of HLA-B*51, which was identified more than four decades ago, and which has since been confirmed in multiple populations, recent studies report additional independent associations in the major histocompatibility complex class I region. HLA-B*15, -B*27, -B*57, and -A*26 are independent risk factors for Behçet's disease, while HLA-B*49 and -A*03 are independent class I alleles that are protective for Behçet's disease. Genome-wide association studies have identified associations with genome-wide significance (P < 5 × 10(-8)) in the IL23R-IL12RB2, IL10, STAT4, CCR1-CCR3, KLRC4, ERAP1, TNFAIP3, and FUT2 loci. In addition, targeted next-generation sequencing has revealed the involvement of rare nonsynonymous variants of IL23R, TLR4, NOD2, and MEFV in Behçet's disease pathogenesis. Significant differences in gene function or mRNA expression associated with the risk alleles of the disease susceptibility loci suggest which genes in a disease-associated locus influence disease pathogenesis. These genes encompass both innate and adaptive immunity and confirm the importance of the predominant polarization towards helper T cell (Th) 1 versus Th2 cells, and the involvement of Th17 cells. In addition, epistasis observed between HLA-B*51 and the risk coding haplotype of the endoplasmic reticulum-associated protease, ERAP1, provides a clue that an HLA class I-peptide presentation-based mechanism contributes to this complex disease.
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Affiliation(s)
- Masaki Takeuchi
- Inflammatory Disease Section, Metabolic, Cardiovascular, and Inflammatory Disease Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA; Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Daniel L Kastner
- Inflammatory Disease Section, Metabolic, Cardiovascular, and Inflammatory Disease Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Elaine F Remmers
- Inflammatory Disease Section, Metabolic, Cardiovascular, and Inflammatory Disease Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Jung JH, Song GG, Lee YH. Meta-Analysis of Associations Between Interleukin-10 Polymorphisms and Susceptibility to Vasculitis. Immunol Invest 2015. [PMID: 26213801 DOI: 10.3109/08820139.2015.1043670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study determined whether interleukin-10 (IL-10) polymorphisms are associated with susceptibility to vasculitis. METHODS A meta-analysis was conducted of the associations between the IL-10 -1082 G/A, -819 C/T, and -592 C/A polymorphisms and the haplotype of the IL-10-1082 G/A, -819 C/T, -592 C/A polymorphisms and vasculitis. RESULTS A total of 21 comparative studies involving 4121 patients and 5504 controls were considered in the meta-analysis. Meta-analysis revealed no association between the IL-10-1082 G allele and vasculitis in all study subjects (OR = 0.927, 95% CI = 0.780-1.102, p = 0.389). However, disease-specific meta-analysis showed an association between Wegener's granulomatosis (WG) and the IL-10-1082 G allele (OR = 0.729, 95% CI = 0.547-0.971, p = 0.031). Meta-analysis revealed an association between vasculitis and the IL-10-819 C allele (OR = 0.804, 95% CI = 0.706-0.916, p = 0.001) in all study subjects and Behcet's disease (BD) (OR = 0.724, 95% CI = 0.679-0.781, p < 1.0 × 10(-9)). Meta-analysis of the IL-10-592 C allele showed an association with vasculitis in all study subjects (OR = 0.805, 95% CI = 0.619-0.938, p = 0.005) and BD (OR = 0.718, 95% CI = 0.661-0.781, p < 1.0 × 10(-9)). Meta-analysis of the IL-10 haplotype revealed an association between the GCC haplotype and vasculitis in Europeans (OR = 1.239, 95% CI = 1.105-1.513, p = 0.035). CONCLUSIONS This meta-analysis showed that IL-10 polymorphisms are associated with vasculitis susceptibility, especially in WG and BD.
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Affiliation(s)
- Jae Hyun Jung
- Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine , Seoul , Korea
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Imperiali C, Alía-Ramos P, Padró-Miquel A. Rapid detection of HLA-B*51 by real-time polymerase chain reaction and high-resolution melting analysis. ACTA ACUST UNITED AC 2015; 86:139-42. [PMID: 26176813 DOI: 10.1111/tan.12603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/30/2015] [Accepted: 06/09/2015] [Indexed: 12/01/2022]
Abstract
HLA-B*51, a class I human leukocyte antigen (HLA) molecule, is the strongest known genetic risk factor for Behçet disease. However, there are only few articles reporting methods to determine the presence or absence of HLA-B51. For this reason, we designed and developed an easy, fast, and inexpensive real-time high-resolution melting (HRM) assay to detect HLA-B*51. We genotyped 61 samples by our HRM assay and by conventional polymerase chain reaction, and no discrepancies were found between results. Besides, a subgroup of 25 samples was also genotyped in a different laboratory, and another subgroup of 16 samples was obtained from the International Histocompatibility Working Group DNA Bank, and a full concordance of results was observed with those obtained by HRM. Regarding the identifying system evaluated, we obtained 100% of specificity, sensibility, and repeatability, and 0% of false positive and false negative rates. Therefore, this HRM analysis is easily applicable to the rapid detection of HLA-B*51, exhibits a high speed, and requires a very low budget.
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Affiliation(s)
- C Imperiali
- Genètica Molecular-Laboratori Clínic, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
| | - P Alía-Ramos
- Genètica Molecular-Laboratori Clínic, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
| | - A Padró-Miquel
- Genètica Molecular-Laboratori Clínic, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
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Petrushkin H, Hasan MS, Stanford MR, Fortune F, Wallace GR. Behçet's Disease: Do Natural Killer Cells Play a Significant Role? Front Immunol 2015; 6:134. [PMID: 25852697 PMCID: PMC4371743 DOI: 10.3389/fimmu.2015.00134] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/10/2015] [Indexed: 11/13/2022] Open
Abstract
Behçet's disease (BD) is a complex inflammatory disease, of unknown etiology. While disease pathogenesis remains unclear, a strong relationship between BD and HLA-B*51 has been established over the last 30 years. A number of theories exist regarding the cause of BD; however, few are able to account for the increased rates of HLA-B*51 positive individuals, particularly around the Mediterranean basin and Middle-East where the prevalence is highest. This review outlines current immunogenetic data on BD and the immunoregulatory role natural killer cells may play. It also describes the interaction of the killer immunoglobulin-like receptor - KIR3DL1 with its ligand Bw4, which is found on HLA-B51. Finally, CD94/NKG2D, MICA, and ERAP are outlined with regard to their potential roles in BD.
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Affiliation(s)
- Harry Petrushkin
- Clinical and Diagnostic Oral Sciences, Queen Mary University of London , London , UK
| | - Md Samiul Hasan
- Clinical and Diagnostic Oral Sciences, Queen Mary University of London , London , UK
| | - Miles R Stanford
- Academic Unit of Ophthalmology, St Thomas's Hospital , London , UK
| | - Farida Fortune
- Clinical and Diagnostic Oral Sciences, Queen Mary University of London , London , UK
| | - Graham R Wallace
- Centre for Translational Inflammation Research, University of Birmingham , Birmingham , UK
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Xavier JM, Davatchi F, Abade O, Shahram F, Francisco V, Abdollahi BS, Trindade H, Nadji A, Shafiee NM, Ghaderibarmi F, Ligeiro D, Oliveira SA. Characterization of the major histocompatibility complex locus association with Behçet's disease in Iran. Arthritis Res Ther 2015; 17:81. [PMID: 25889189 PMCID: PMC4415285 DOI: 10.1186/s13075-015-0585-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/24/2015] [Indexed: 01/21/2023] Open
Abstract
Introduction The aim of this study was to characterize the association of human leukocyte antigen (HLA) B alleles and major histocompatibility complex (MHC) single nucleotide polymorphisms (SNPs) with Behçet’s disease (BD) in an Iranian dataset. Methods The association of three SNPs in the MHC region previously identified as the most associated in high-density genotyping studies was tested in a case–control study on 973 BD patients and 825 controls from Iran, and the association of HLA-B alleles was tested in a subset of 681 patients and 414 controls. Results We found that HLA-B*51 (P = 4.11 × 10−41, OR [95% CI] = 4.63[3.66-5.85]) and B*15 confer risk for BD (P = 2.83 × 10−2, OR [95% CI] = 1.75[1.08-2.84]) in Iranian, and in B*51 negative individuals, only the B*15 allele is significantly associated with BD (P = 2.51 × 10−3, OR [95% CI] = 2.40[1.37-4.20]). rs76546355, formerly known as rs116799036, located between HLA-B and MICA (MHC class I polypeptide-related sequence A), demonstrated the same level of association with BD as HLA-B*51 (Padj = 1.78 × 10−46, OR [95% CI] = 5.46[4.21-7.09], and Padj = 8.34 × 10−48, OR [95% CI] = 5.44[4.20-7.05], respectively) in the HLA-B allelotyped subset, while rs2848713 was less associated (Padj = 7.14 × 10−35, OR [95% CI] = 3.73[2.97-4.69]) and rs9260997 was not associated (Padj = 1.00 × 10−1). Additionally, we found that B*51 genotype-phenotype correlations do not survive Bonferroni correction, while carriers of the rs76546355 risk allele predominate in BD cases with genital ulcers, positive pathergy test and positive BD family history (2.31 × 10−4 ≤ P ≤ 1.59 × 10−3). Conclusions We found that the HLA-B*51 allele and the rs76546355/rs116799036 MHC SNP are independent genetic risk factors for BD in Iranian, and that positivity for the rs76546355/rs116799036 risk allele, but not for B*51, does correlate with specific demographic characteristics or clinical manifestations in BD patients. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0585-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joana M Xavier
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edifício Egas Moniz, 1649-028, Lisboa, Portugal. .,Instituto Gulbenkian de Ciência, Oeiras, Portugal.
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Olga Abade
- Lisbon Center for Blood and Transplantation, Instituto Português de Sangue e Transplantação, Lisboa, IP, Portugal.
| | - Farhad Shahram
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vânia Francisco
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edifício Egas Moniz, 1649-028, Lisboa, Portugal. .,Instituto Gulbenkian de Ciência, Oeiras, Portugal.
| | | | - Hélder Trindade
- Lisbon Center for Blood and Transplantation, Instituto Português de Sangue e Transplantação, Lisboa, IP, Portugal.
| | - Abdolhadi Nadji
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Fahmida Ghaderibarmi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Dário Ligeiro
- Lisbon Center for Blood and Transplantation, Instituto Português de Sangue e Transplantação, Lisboa, IP, Portugal.
| | - Sofia A Oliveira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Edifício Egas Moniz, 1649-028, Lisboa, Portugal. .,Instituto Gulbenkian de Ciência, Oeiras, Portugal.
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Cytokines Modulate the "Immune-Metabolism" Interactions during Behçet Disease: Effect on Arginine Metabolism. Int J Inflam 2015; 2015:241738. [PMID: 25692069 PMCID: PMC4322663 DOI: 10.1155/2015/241738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/15/2014] [Accepted: 11/04/2014] [Indexed: 11/18/2022] Open
Abstract
Aim and Methods. In this study, we evaluated NOS and arginase activities and their regulation during Behçet disease, a systemic chronic inflammatory disorder with uncertain etiology. The peripheral blood mononuclear cells of 36 patients and 15 control samples (PBMC) were cultured in either RPMI 1640, MEM, or DMEM complemented with 10% of FBS and antibiotics. Cultures were performed with or without the control or patients plasma. Subsequent treatment contained anticytokines (IL-6, TGF-β), a mitogenic effector (PHA), or NOS modulators (L-NMMA, BH4). Culture supernatants were harvested after 24 h of incubation. NO and urea measurements were, respectively, performed by modified Griess and Berthelot methods. Results. Higher urea levels were found in patients' plasma compared to the control's (P < 0.05). NOS modulators induced inverted production profiles for NO and urea (P < 0.05). Their results differed depending on the clinical findings (P < 0.05). It was also found that cytokine neutralization induced different response profiles in patients as opposed to control cultures (P < 0.05). Conclusion. Our results suggest that arginases can compete with NOS2 for L-arginine during Behçet disease. Both enzymes are regulated by environmental cytokines and substrate availability. Furthermore, it seems that NOS/arginase balance is dependent on clinical expression.
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Epistatic interaction of ERAP1 and HLA-B in Behçet disease: a replication study in the Spanish population. PLoS One 2014; 9:e102100. [PMID: 25019531 PMCID: PMC4096596 DOI: 10.1371/journal.pone.0102100] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/14/2014] [Indexed: 11/25/2022] Open
Abstract
Behçet's disease (BD) is a multifactorial disorder associated with the HLA region. Recently, the ERAP1 gene has been proposed as a susceptibility locus with a recessive model and with epistatic interaction with HLA-B51. ERAP1 trims peptides in the endoplasmic reticulum to optimize their length for MHC-I binding. Polymorphisms in this gene have been related with the susceptibility to other immune-mediated diseases associated to HLA class I. Our aim was, the replication in the Spanish population of the association described in the Turkish population between ERAP1 (rs17482078) and BD. Additionally, in order to improve the understanding of this association we analyzed four additional SNPs (rs27044, rs10050860, rs30187 and rs2287987) associated with other diseases related to HLA class I and the haplotype blocks in this gene region. According to our results, frequencies of the homozygous genotypes for the minor alleles of all the SNPs were increased among patients and the OR values were higher in the subgroup of patients with the HLA-B risk factors, although differences were not statistically significant. Moreover, the presence of the same mutation in both chromosomes increased the OR values from 4.51 to 10.72 in individuals carrying the HLA-B risk factors. Therefore, although they were not statistically significant, our data were consistent with an association between ERAP1 and BD as well as with an epistatic interaction between ERAP1 and HLA-B in the Spanish population.
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Ortiz-Fernández L, Conde-Jaldón M, García-Lozano JR, Montes-Cano MA, Ortego-Centeno N, Castillo-Palma MJ, Espinosa G, Graña-Gil G, Sánchez-Bursón J, González-Gay MA, Barnosi-Marín AC, Solans R, Fanlo P, Rodríguez Carballeira M, Camps T, Castañeda S, Martín J, González-Escribano MF. GIMAP and Behçet disease: no association in the European population. Ann Rheum Dis 2014; 73:1433-4. [PMID: 24625627 DOI: 10.1136/annrheumdis-2013-205156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Lourdes Ortiz-Fernández
- Servicio de Inmunología, IBiS, H.U. Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Marta Conde-Jaldón
- Servicio de Inmunología, IBiS, H.U. Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - José Raul García-Lozano
- Servicio de Inmunología, IBiS, H.U. Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | | | | | | | - Gerard Espinosa
- Servicio de Enfermedades Autoinmunes, H. Clinic, Barcelona, Spain
| | | | | | | | | | - Roser Solans
- Servicio de Medicina Interna, H. Vall d'Hebron, Barcelona, Spain
| | - Patricia Fanlo
- Servicio de Medicina Interna, H. Virgen del Camino, Pamplona, Spain
| | - Mónica Rodríguez Carballeira
- Medicina Interna Unitat de Malalties Autoimmunes i Sistèmiques Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Teresa Camps
- Servicio de Medicina Interna, H. Carlos Haya, Málaga, Spain
| | | | - Javier Martín
- Instituto de Parasitología y Biomedicina López Neyra, Granada, Spain
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