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Fidalgo M, Faria R, Carvalho C, Carvalheiras G, Mendonça D, Farinha F, da Silva BM, Vasconcelos C. Multiple autoimmune syndrome: Clinical, immunological and genotypic characterization. Eur J Intern Med 2023; 116:119-130. [PMID: 37385917 DOI: 10.1016/j.ejim.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION The existence of subphenotypes common to several autoimmune diseases (AIDs) suggests a shared physiopathology - autoimmune tautology. Multiple Autoimmune Syndrome (MAS) - the coexistence of three or more AIDs in one person-, best illustrates that polyautoimmunity is more than a coincidence. OBJECTIVES Characterize and compare the monoautoimmune and MAS patients. Understand if clustering of AIDs leads to differences in disease severity, autoantibodies expression or genetic polymorphisms that could be markers for polyautoimmunity. METHODS Currently adult patients were selected from unit cohort. MAS was assumed when ≥3 AIDs were present. 343 patients were included after exclusion criteria: having two AIDs or undetermined diagnosis. Clinical and immunological data were collected from medical files. HLA-DRB1 was genotyped by PCR-SSP methodology and PTPN22(rs2476601) polymorphisms by TaqMan Real Time PCR. Data were analysed using Chi-Square, Fisher's exact tests and logistic regression. Odds ratios (OR) and 95% confidence intervals were calculated. RESULTS In comparison with control population: ELEVATED FREQUENCIES: HLA-DRB1*03 in study cohort (OR=3.68,p<0.001) and in monoautoimmune SLE (OR=2.79,p<0.001) and SjS (OR=8.27,p<0.001); HLA-DRB1*15 in monoautoimmune SjS (OR=2.39,p = 0.011); HLA-DRB1*16 in MAS SLE (OR=2.67,p = 0.031); PTPN22_T in all groups except monoautoimmune SjS and triple positive systemic MAS. DIMINISHED FREQUENCIES HLA-DRB1*11 in study cohort (OR=0.57,p = 0.013), in MAS SLE (OR=0.39,p = 0.031) and monoautoimmune SjS (OR=0.10,p = 0.005); HLA-DRB1*13 in study cohort (OR=0.52,p = 0.001) and in monoautoimmune SLE (OR=0.53,p = 0.009) and SjS (OR=0.38,p = 0.031); HLA-DRB1*14 in study cohort (OR=0.32,p = 0.013) and monoautoimmune SLE (OR=0.21,p = 0.021); SLE group: HLA-DRB1*07 frequency was higher in monoautoimmune patients (OR=0.43,p = 0.023). MAS patients had significantly more NPSLE (OR=2.99,p<0.001), subacute cutaneous lesions (OR=2.30,p = 0.037), muscle&tendon (OR=2.00,p = 0.045), and haematological (OR=3.18,p = 0.006) involvement and Raynaud's (OR=2.94,p<0.001). SjS group: MAS patients had more frequently cryoglobulins (OR=2.96,p = 0.030), low complement (OR=2.43,p = 0.030) and Raynaud's (OR=4.38,p<0.001); monoautoimmune patients had more parotid enlargement (OR=0.12,p<0.001). APS group: MAS patients had more non-thrombotic manifestations (OR=4.69,p = 0.020) and Raynaud's (OR=9.12,p<0.001). Triple positive systemic MAS (SLE+SjS+APS) had more frequently severe kidney involvement (OR=11.67,p = 0.021) and CNS thrombosis (OR=4.44,p = 0.009). Anti-U1RNP increased frequency was transversally attributable to MAS. CONCLUSIONS The coexistence of AIDs contributes to a more severe disease course. We confirmed previously established genetic risk and protection factors and suggest a new protective one - HLA-DRB1*14. HLA-DRB1*07 and anti-U1RNP could be markers for mono and polyautoimmunity, respectively; HLA-DRB1*13 could be a predictor for vascular risk in patients with multiple AIDs. PTPN22(rs2476601) polymorphism could be associated with less severe disease.
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Affiliation(s)
- Mariana Fidalgo
- Internal Medicine Resident, Clinical Internship at Unidade de Imunologia Clínica (2), Portugal.
| | - Raquel Faria
- Unidade de Imunologia Clínica, Centro Hospitalar do Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Portugal
| | - Cláudia Carvalho
- Unit for Multidisciplinary Research in Biomedicine, Portugal; Laboratório de Imunogenética, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal
| | | | - Denisa Mendonça
- Departamento de Estudos de Populações, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal; EpiUnit, Instituto de Saúde Pública, Universidade do Porto, Portugal
| | - Fátima Farinha
- Unidade de Imunologia Clínica, Centro Hospitalar do Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Portugal
| | - Berta Martins da Silva
- Unit for Multidisciplinary Research in Biomedicine, Portugal; Laboratório de Imunogenética, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal
| | - Carlos Vasconcelos
- Unidade de Imunologia Clínica, Centro Hospitalar do Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Portugal
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Elbagir S, Diaz-Gallo LM, Grosso G, Zickert A, Gunnarsson I, Mahler M, Svenungsson E, Rönnelid J. Anti-phosphatidylserine/prothrombin antibodies and thrombosis associate positively with HLA-DRB1*13 and negatively with HLA-DRB1*03 in SLE. Rheumatology (Oxford) 2023; 62:924-933. [PMID: 35642868 PMCID: PMC9891424 DOI: 10.1093/rheumatology/keac327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Emerging evidence demonstrates that aPS-PT associate with thrombotic events. Genetic predisposition, including HLA-DRB1 alleles, is known to contribute to the occurrence of conventional aPL [anti-β2glycoprotein-I (anti-β2GPI) and aCL]. We investigated associations between aPS-PT and HLA-DRB1* alleles and thrombosis in SLE. Conventional aPL were included for comparison. METHODS We included 341 consecutive SLE patients, with information on general cardiovascular risk factors, including blood lipids, LA and thrombotic events. aPS/PT, anti-β2GPI and aCL of IgA/G/M isotypes and LA were quantified. RESULTS aPS/PT antibodies associated positively with HLA-DRB1*13 [odds ratio (OR) 2.7, P = 0.002], whereas anti-β2GPI and aCL antibodies associated primarily with HLA-DRB1*04 (OR 2.5, P = 0.0005). These associations remained after adjustment for age, gender and other HLA-DRB1* alleles. HLA-DRB1*13, but not DRB1*04, remained as an independent risk factor for thrombosis and APS after adjustment for aPL and cardiovascular risk factors. The association between DRB1*13 and thrombosis was mediated by aPS-PT positivity. HLA-DRB1*03, on the other hand, associated negatively with thrombotic events as well as all aPL using both uni- and multivariate analyses. HLA-DRB1*03 had a thrombo-protective effect in aPL-positive patients. Additionally, HLA-DRB1*03 was associated with a favourable lipid profile regarding high-density lipoprotein and triglycerides. CONCLUSIONS HLA-DRB1*13 confers risk for both aPS-PT and thrombotic events in lupus. The association between HLA-DRB1*13 and thrombosis is largely, but not totally, mediated through aPS-PT. HLA-DRB1*03 was negatively associated with aPL and positively with favourable lipid levels. Thus, HLA-DRB1*03 seems to identify a subgroup of SLE patients with reduced vascular risk.
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Affiliation(s)
- Sahwa Elbagir
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala
| | - Lina-Marcela Diaz-Gallo
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Giorgia Grosso
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Zickert
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Iva Gunnarsson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Mahler
- Research and Development, Werfen Autoimmunity, San Diego, USA
| | - Elisabet Svenungsson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala
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Kotyla PJ, Islam MA. MicroRNA (miRNA): A New Dimension in the Pathogenesis of Antiphospholipid Syndrome (APS). Int J Mol Sci 2020; 21:ijms21062076. [PMID: 32197340 PMCID: PMC7139820 DOI: 10.3390/ijms21062076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/11/2022] Open
Abstract
MicroRNAs (miRNAs) are single-stranded, endogenous RNA molecules that play a significant role in the regulation of gene expression as well as cell development, differentiation, and function. Recent data suggest that these small molecules are responsible for the regulation of immune responses. Therefore, they may act as potent modulators of the immune system and play an important role in the development of several autoimmune diseases. Antiphospholipid syndrome (APS) is an autoimmune systemic disease characterized by venous and/or arterial thromboses and/or recurrent fetal losses in the presence of antiphospholipid antibodies (aPLs). Several lines of evidence suggest that like other autoimmune disorders, miRNAs are deeply involved in the pathogenesis of APS, interacting with the function of innate and adaptive immune responses. In this review, we characterize miRNAs in the light of having a functional role in the immune system and autoimmune responses focusing on APS. In addition, we also discuss miRNAs as potential biomarkers and target molecules in treating APS.
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Affiliation(s)
- Przemysław J. Kotyla
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Faculty in Katowice, Medical University of Silesia, 40-635 Katowice, Poland
- Correspondence: (P.J.K.); (M.A.I.)
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Correspondence: (P.J.K.); (M.A.I.)
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Abstract
PURPOSE OF REVIEW Antiphospholipid syndrome (APS) is a rare heterogenous disorder associated with the presence of antiphospholipid antibodies and can present in a wide variety of clinical manifestations including thrombosis and pregnancy complications. Although the etiology of APS remains poorly understood, there is strong support for considering APS as a complex genetic disease in which multiple genetic risk factors, in conjunction with environmental factors, affect its onset, progression, and severity. Here, we provide a comprehensive review of the current knowledge of the genetic basis of APS, which remains in its infancy. RECENT FINDINGS Most genetic studies to date in APS were performed in small cohorts of patients. As a result, only few genetic associations reported are convincing. Several reports suggested genetic associations with HLA class II alleles in APS, and only two genetic loci outside of the HLA region (STAT4 and C1D) reached the threshold for genome-wide level of significance (P < 5 × 10-8). In this review, we also shed light on the genetic differences among the diverse clinical subsets of APS and briefly discuss the role that DNA methylation changes might play in the pathophysiology of this disease. The genetic basis of APS remains poorly characterized. Larger collaborative multicenter studies using well-characterized patients are needed to comprehensively understand the role of genetic susceptibility in APS.
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HLA DRB1 and HLA DQB1 Alleles in Bulgarian Patients with Primary and Secondary Antiphospholipid Syndrome. ACTA MEDICA BULGARICA 2019. [DOI: 10.2478/amb-2019-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disease with multifactorial and polygenic pathogenesis. Recently, the genetic predisposition in APS has been subjected to wide discussion. The aim of this study is to determine the prevalence of DRB1 and DQB1 loci in Bulgarian population of healthy persons and patients with primary (PAPS) and secondary (SAPS) APS. Patients are divided in 5 groups: I-29 patents with systemic lupus erythematosus (SLE) with SAPS, II-35 patients with PAPS, III-32 women with spontaneous abortions without aPL, IV-15 patients with different thrombosis (deep venous thromboses, pulmonary embolism, mesenterial thrombosis, myocardial infarction, stroke) without laboratory data for APS, and V-16 SLE patients without clinical and laboratory data for APS. SAPS patients have more frequently DRB1*03 and DQB1*02 and more rarely DRB1*11 and DQB1*03 in comparison with healthy subjects and patients with PAPS. Patents with PAPS, those with spontaneous abortions and patients with thrombotic events but without antiphospholipid antibodies (aPL) have DRB1*03, DRB1*11, DQB1*02 and DQB1*03 alleles similar to the general population. There are no differences between group I (SLE+APS) and group V (SLE) in DRB1* and DQB1*alleles.
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Belizna C, Stojanovich L, Cohen-Tervaert JW, Fassot C, Henrion D, Loufrani L, Nagy G, Muchardt C, Hasan M, Ungeheuer MN, Arnaud L, Alijotas-Reig J, Esteve-Valverde E, Nicoletti F, Saulnier P, Godon A, Reynier P, Chrétien JM, Damian L, Omarjee L, Mahé G, Pistorius MA, Meroni PL, Devreese K. Primary antiphospholipid syndrome and antiphospholipid syndrome associated to systemic lupus: Are they different entities? Autoimmun Rev 2018; 17:739-745. [PMID: 29885541 DOI: 10.1016/j.autrev.2018.01.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/12/2018] [Indexed: 11/25/2022]
Abstract
Primary antiphospholipid syndrome (PAPS) and antiphospholipid syndrome associated to lupus (SAPS) have several overlapping characteristics. As systemic manifestations are also reported in patients with PAPS, and as a subgroup of PAPS patients could evaluate to a SAPS, the differentiation between the two types of APS could be performed based on the clinical experience of the medical teams and is related to a variety of clinical, biological, histological and genetic features. Several data are available in the literature with respect to the identification of distinctive features between these two entities. However, there are some limitation in the interpretation of results issued from studies performed prior to updated Sydney criteria. Based on recent data, a certain number of features more frequent in one type of APS as compared to the other could be distinguished. The major differentiation between these two entities is genetical. New genetic data allowing the identification of specific subgroups of APS are ongoing.
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Affiliation(s)
- Cristina Belizna
- Vascular and Coagulation Department, University Hospital Angers, 4 rue Larrey, 49000 Angers, France; MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France..
| | - Ljudmila Stojanovich
- Scientific Research Department, Internal Medicine-Rheumatology, Bezhanijska Kosa, University Medical Center, Belgrade University, Belgrade 11080, Serbia
| | - Jan Willem Cohen-Tervaert
- Internal Medicine and Immunology Department, Maastricht University, P Debyelaan 25, 6229 HX Maastricht, The Netherlands; Rheumatology Department, Kaye Edmonton Clinic University of Alberta, 116 St. and 85 Ave., Edmonton, AB T6G 2R3, Canada
| | - Céline Fassot
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France
| | - Daniel Henrion
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France
| | - Laurent Loufrani
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France
| | - Gyorgy Nagy
- 3rd Department of Internal Medicine, Rheumatology Division, Buda Hospital of the Hospitaller Order of Saint John of God, H-1023 Budapest, P.O.B. 98, Hungary; Semmelweis University, Department of Genetics, Cell- and Immunobiology, Buda Hospital of the Hospitalier Order of Saint John of God, 1089 Budapest, Nagyvárad tér 4, Hungary
| | - Christian Muchardt
- Unit of Epigenetic Regulation, Department of Developmental and Stem Cell Biology, UMR3738 CNRS, Institut Pasteur, 28, Rue Doct Roux, 75015 Paris, France
| | - Milena Hasan
- Cytometry and Biomarkers Unit of Technology and Service, Center for Translational Science, Institut Pasteur, 28, Rue Doct Roux, 75015 Paris, France
| | - Marie Noelle Ungeheuer
- Clinical Investigation and Acces to Bioresources Department, Institut Pasteur, 28, Rue Doct Roux, 75015 Paris, France
| | - Laurent Arnaud
- Rheumatology Department, University Hospital Strasbourg, 1, Place de l'Hôpital, 67091 Strasbourg, France
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Department of Medicine, Universitat Autonòma, Plaza Civica, 08193 Barcelona, Spain
| | - Enrique Esteve-Valverde
- Internal Medicine Althaia Healthcare Network of Manresa, Calle Pau 44, 08243 Manresa, Barcelona, Spain
| | - Ferdinando Nicoletti
- Department of Biomedicine and Biotechnology, University of Catania, Universita' Square, 2, 95131 Catania, Italy
| | - Patrick Saulnier
- Research Department Unit University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Alban Godon
- Departement of hematology et immunology University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Pascal Reynier
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France.; Department of Biochemistry and Genetics University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Jean Marie Chrétien
- Research Department Unit University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Laura Damian
- Department of Rheumatology, County Emergency Hospital Cluj-Napoca, Str. Clinicilor nr.3-5, Cod Postal 400006 Cluj-Napoca, Romania
| | - Loukman Omarjee
- Vascular Medicine Department, University Hospital Rennes, 16, Boulevard de Bulgarie, 35203 Rennes, France; University Rennes, CHU Rennes, INSERM, CIC 1414, 2, rue Henri Le Guilloux, 35000 Rennes Cedex 9, France
| | - Guillaume Mahé
- Vascular Medicine Department, University Hospital Rennes, 16, Boulevard de Bulgarie, 35203 Rennes, France; University Rennes, CHU Rennes, INSERM, CIC 1414, 2, rue Henri Le Guilloux, 35000 Rennes Cedex 9, France
| | - Marc Antoine Pistorius
- Vascular Medicine Department, University Hospital Nantes, 1, Place Alexis Ricordeau, 44093 Nantes, France
| | - Pier Luigi Meroni
- Clinical Immunology and Rhumatology Research Department Auxologico Institute Milan, IRCCS, Via G. Spagnoletto, 3, 20149 Milan, Italy
| | - Katrien Devreese
- Coagulation Laboratory, Department of Clinical Biology, Immunology and Microbiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
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Sebastiani GD, Iuliano A, Cantarini L, Galeazzi M. Genetic aspects of the antiphospholipid syndrome: An update. Autoimmun Rev 2016; 15:433-9. [PMID: 26804759 DOI: 10.1016/j.autrev.2016.01.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 01/12/2016] [Indexed: 12/23/2022]
Abstract
Studies on the immunogenetic predisposition to antiphospholipid syndrome (APS) and on other non-genetic and epigenetic factors are summarised and discussed. Family studies suggest a genetic predisposition to APS. It appears that this genetic predisposition is in part accounted for by the HLA system, the most consistent associations being those with DR4 and DRw53. Furthermore, it appears that lupus anticoagulant (LA) and anticardiolipin (aCL) antibodies are both associated with the same HLA antigens. Population studies suggest that HLA genes have a role in conferring susceptibility to develop primary APS, with some differences in different ethnic groups. Other genes, outside the MHC, give their contribution to the development of this autoimmune syndrome, such as IRF5, STAT4 and those related to inherited thrombophilia--factor V Leiden and G20210A prothrombin polymorphisms. Finally, post-transcriptional modifications of anti-beta2GPI antibodies could be implicated too.
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Affiliation(s)
| | | | - Luca Cantarini
- Dip. Di Medicina Clinica e Scienze Immunologiche sez. di Reumatologia, Policlinico Le Scotte, Università di Siena, Siena, Italy.
| | - Mauro Galeazzi
- Dip. Di Medicina Clinica e Scienze Immunologiche sez. di Reumatologia, Policlinico Le Scotte, Università di Siena, Siena, Italy.
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Liang W, Zhou J, Zhou S, Wang T, Yang L, Xu D, Deng G, Huang D, Mei C, He Y, Zhang Z. Val/Leu247 polymorphism of β2-glycoprotein I and thrombosis in Chinese patients with SLE. Int J Lab Hematol 2014; 37:22-8. [PMID: 24661363 DOI: 10.1111/ijlh.12209] [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: 09/17/2013] [Accepted: 01/13/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION To determine the polymorphism at position 247 of the β2-glycoprotein I (β2GPI) gene in patients with systemic lupus erythematosus (SLE) and healthy controls in the Chinese Han Population and elucidate the relationship between β2GPI polymorphisms and anti-β2GPI levels, and furthermore investigate the correlation between β2GPI polymorphisms and thrombosis in patients with SLE. METHODS The β2GPI polymorphisms of 300 patients with SLE and 300 healthy controls were examined by single-specific-primer polymerase chain reaction (SSP-PCR), the efficacy of which was confirmed by sequencing technology. Anti-β2GPI antibodies were tested by enzyme-linked immunosorbent assay. β2GPI polymorphisms associated with thrombosis and the presence of anti-β2GPI antibodies were also statistically evaluated with SPSS software. RESULTS The genotype expressions and the allele frequencies were obtained in both patients with SLE and healthy controls. The SLE patients with thrombosis had significantly higher frequencies of the VV genotype and V allele than those without thrombosis and the controls, and there were no differences in VV genotype and V allele expression between the SLE patients without thrombosis and the controls. In contrast, the presence of anti-β2GPI antibody was related to the VV genotype of β2GPI, and the anti-β2GPI-positive patients had obviously higher frequencies of the VV genotype than the negative ones and the controls. CONCLUSION The study results suggested that the V/V genotype and the V-encoding allele at position 247 of the β2GPI gene had strong correlation with the occurrence of thrombosis and the production of the anti-β2GPI antibodies, showing that the Val(247) β2GPI allele may be one of the genetic risk factors for the development of thrombosis in patients with SLE.
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Affiliation(s)
- W Liang
- Institute of Blood Transfusion of Center Blood Station, Ningbo, Zhejiang, China
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Sandrin-Garcia P, Junta CM, Fachin AL, Mello SS, Baião AMT, Rassi DM, Ferreira MCT, Trevisan GL, Sakamoto-Hojo ET, Louzada-Júnior P, Passos GAS, Donadi EA. Shared and unique gene expression in systemic lupus erythematosus depending on disease activity. Ann N Y Acad Sci 2009; 1173:493-500. [PMID: 19758191 DOI: 10.1111/j.1749-6632.2009.04636.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients presenting with active systemic lupus erythematosus (SLE) manifestations may exhibit distinct pathogenetic features in relation to inactive SLE. Also, cDNA microarrays may potentially discriminate the gene expression profile of a disease or disease variant. Therefore, we evaluated the expression profile of 4500 genes in peripheral blood lymphocytes (PBL) of SLE patients. We studied 11 patients with SLE (seven with active SLE and four with inactive SLE) and eight healthy controls. Total RNA was isolated from PBL, reverse transcribed into cDNA, and postlabeled with Cy3 fluorochrome. These probes were then hybridized to a glass slide cDNA microarray containing 4500 human IMAGE cDNA target sequences. An equimolar amount of total RNA from human cell lines served as reference. The microarray images were quantified, normalized, and analyzed using the R environment (ANOVA, significant analysis of microarrays, and cluster-tree view algorithms). Disease activity was assessed by the SLE disease activity index. Compared to the healthy controls, 104 genes in active SLE patients (80 repressed and 24 induced) and 52 genes in nonactive SLE patients (31 induced and 21 repressed) were differentially expressed. The modulation of 12 genes, either induced or repressed, was found in both disease variants; however, each disease variant had differential expression of different genes. Taken together, these results indicate that the two lupus variants studied have common and unique differentially expressed genes. Although the biological significance of the differentially expressed genes discussed above has not been completely understood, they may serve as a platform to further explore the molecular basis of immune deregulation in SLE.
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Affiliation(s)
- Paula Sandrin-Garcia
- Molecular Immunogenetics Group (Department of Genetics), Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Pernambuco-Climaco JM, Brochado MJF, Freitas MVC, Roselino AMF, Louzada-Junior P. Val/Leu247 polymorphism of beta2-glycoprotein I in Brazilian patients with antiphospholipid syndrome--a genetic risk factor? Ann N Y Acad Sci 2009; 1173:509-14. [PMID: 19758193 DOI: 10.1111/j.1749-6632.2009.04655.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A genetic polymorphism of the beta2-glycoprotein I (beta2-GPI) is recognized by antiphospholipid antibodies (aPL) and may even play a role in the development of antiphospholipid syndrome (APS). The objectives of this study were to determine a Val/Leu SNP at position 247 of the beta2-GPI gene in Brazilian patients with APS and to compare these data with clinical and laboratory manifestations. Polymorphism assignment was performed by PCR followed by Rsa I restriction endonuclease. The titration of anti-beta2-GPI antibodies was detected by ELISA. The results showed significantly higher frequencies of the V-encoding allele and the homozygous VV genotype in patients with APS than in control subjects (OR = 1.781, P = 0.0068; and OR = 6.413, P < 0.0001, respectively). The frequency of this genotype was also significantly higher in patients with arterial and venous thrombosis than in the control group (52% and 44%, respectively, versus 13%). Anti-beta2-GPI-positive patients had significantly higher frequencies of the VV genotype than the controls subjects (OR = 8.179, P < 0.0001). These results suggest that the V-encoding allele and the homozygous VV genotype at position 247 of the beta2-GPI gene may play a role in the generation of anomalous beta2-GPI, with consequent auto-antibody production, and in phenotype expression of arterial and venous thrombosis in APS patients.
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Affiliation(s)
- Juliana M Pernambuco-Climaco
- Department of Clinical Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Chapter 6 Genetic Aspects of the Antiphospholipid Syndrome: HLA Associations. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1571-5078(08)00406-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Al Attia HM, Santhosh A. A probe into the HLA-DR and DQ of Arab patients with primary antiphospholipid (Hughes) syndrome. Rheumatol Int 2007; 28:193-5. [PMID: 17609949 DOI: 10.1007/s00296-007-0387-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Accepted: 05/19/2007] [Indexed: 10/23/2022]
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Mackworth-Young C. Primary antiphospholipid syndrome: A distinct entity? Autoimmun Rev 2006; 5:70-5. [PMID: 16338214 DOI: 10.1016/j.autrev.2005.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Accepted: 08/10/2005] [Indexed: 11/29/2022]
Abstract
Although antiphospholipid syndrome (APS) was first fully described in the context of connective tissue diseases such as systemic lupus erythematosus (SLE), it was soon recognised that the condition can exist on its own. APS appears to represent a clinical spectrum, both in terms of APS features and the presence of other autoimmune conditions. The clinical and serological characteristics of "primary" APS (PAPS) are similar to those of secondary APS, although the clinical features are more commonly recognised in the presence of another autoimmune or inflammatory condition. Furthermore, patients with PAPS may subsequently develop SLE. It is important to identify PAPS, since it is likely to be a contributing factor for a significant proportion of patients with a variety of vascular, neurological and other conditions. It may emerge as more common than secondary APS.
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Abstract
Investigation of the clinical epidemiology of the antiphospholipid syndrome (APS) is in its early stages. During the past 20 years, studies of antiphospholipid antibodies (aPL) and APS have been made in many countries and ethno-geographical groups. aPL appear to occur in all populations studied, with some variations noted in their frequency and in the clinical complications. Environmental and genetic factors contribute to ethnic variation and susceptibility to APS and thus inter-ethnic differences in disease patterns may be due to environmental or genetic factors, or both.
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Affiliation(s)
- I Uthman
- American University of Beirut, Medical Centre, PO Box 113-6044, Beirut, Lebanon.
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Abstract
Antiphospholipid syndrome is a hypercoaguable state characterized by recurrent venous and/or arterial thrombosis and/or pregnancy complications of fetal loss, pre-eclampsia, or eclampsia in the presence of antiphospholipid antibodies. It was first described in the setting of systemic lupus erythematosus and subsequently recognized to also exist as an independent condition and in conjunction with a variety of other autoimmune, infectious, and malignant illnesses. These diseases have been called primary antiphospholipid syndrome and secondary antiphospholipid syndrome. However, the two conditions can have significant overlapping features. This paper reviews the similarities and the differences between the two conditions.
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Affiliation(s)
- Jennifer M Grossman
- Division of Rheumatology/ Department of Medicine, Geffen School of Medicine, University of California-Los Angeles, 1000 Veteran Ave. Room 32-59 UCLA, Los Angeles, CA 90095, USA.
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Harris EN, Pierangeli SS. Primary, Secondary, Catastrophic Antiphospholipid Syndrome: is there a difference? Thromb Res 2004; 114:357-61. [PMID: 15507265 DOI: 10.1016/j.thromres.2004.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Revised: 08/02/2004] [Accepted: 08/04/2004] [Indexed: 11/21/2022]
Abstract
Following broad recognition of the disorder called Antiphospholipid Syndrome (APS), it has come to be subcategorized into Primary (PAPS), Secondary (SAPS), and Catastrophic Antiphospholipid Syndrome (CAPS). Primary utilized when there is no associated disorder, secondary with an associated autoimmune disorder such as systemic lupus erythematosus (SLE), and "catastrophic" when thrombosis occurs at multiple sites in a short space of time. Are these entities different? Such differences should be demonstrated in terms of their clinical presentation, disease course, pathogenesis, or management. If no differences exist, is there a basis for continued use of these terms? This manuscript will attempt to explore distinctions between subgroups of the APS and reasons for or against perpetuation of these classifications in the literature.
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Affiliation(s)
- E Nigel Harris
- Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA 30310-1495, USA.
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