Heterogeneity of Genetic Admixture Determines SLE Susceptibility in Mexican

Differential Leukocyte Expression of IFITM1 and IFITM3 in Patients with Severe Pandemic Influenza A(H1N1) and COVID-19

Interferon-induced transmembrane (IFITM) proteins mediate protection against enveloped viruses by blocking membrane fusion at endosomes. IFITM1 and IFITM3 are crucial for protection against influenza, and various single nucleotide polymorphisms altering their function have been linked to disease susceptibility. However, bulk IFITM1 and IFITM3 mRNA expression dynamics and their correlation with clinical outcomes have not been extensively addressed in patients with respiratory infections. In this study, we evaluated the expression of IFITM1 and IFITM3 in peripheral leukocytes from healthy controls and individuals with severe pandemic influenza A(H1N1) or coronavirus disease 2019 (COVID-19). Comparisons between participants grouped according to their clinical characteristics, underlying disease, and outcomes showed that the downregulation of IFITM1 was a distinctive characteristic of severe pandemic influenza A(H1N1) that correlated with outcomes, including mortality. Conversely, increased IFITM3 expression was a common feature of severe pandemic influenza A(H1N1) and COVID-19. Using a high-dose murine model of infection, we confirmed not only the downregulation of IFITM1 but also of IFITM3 in the lungs of mice with severe influenza, as opposed to humans. Analyses in the comparative cohort also indicate the possible participation of IFITM3 in COVID-19. Our results add to the evidence supporting a protective function of IFITM proteins against viral respiratory infections in humans.

Association of HLA-DR1, HLA-DR13, and HLA-DR16 Polymorphisms with Systemic Lupus Erythematosus: A Meta-Analysis

Objectives

The principal purpose of this meta-analysis was to assess the association between HLA-DRB1 (HLA-DR1, HLA-DR13, and HLA-DR16) polymorphisms and SLE susceptibility.

Methods

We searched published case-control studies on the association between HLA-DRB1 polymorphisms and SLE susceptibility from PubMed and Web of Science databases. The pooled ORs with 95% CIs were utilized to estimate the strength of association of HLA-DR1, HLA-DR13, and HLA-DR16 polymorphisms and SLE susceptibility by fixed effect models. We also performed sensitivity analysis, trial sequential analysis, Begg's test, and Egg's test in this meta-analysis.

Results

A total of 18 studies were included in this meta-analysis. Overall analysis showed that HLA-DR1 and HLA-DR13 polymorphisms were associated with a decreased risk of SLE (OR = 0.76, 95% CI: 0.65-0.90, P < 0.01; OR = 0.58, 95% CI: 0.50-0.68, P < 0.01), and HLA-DR16 polymorphism was associated with an increased risk of SLE (OR = 1.70, 95% CI: 1.24-2.33, P < 0.01). In subgroup analysis of ethnicity, the results were as follows: HLA-DR1 polymorphism in Caucasians (OR = 0.76, 95% CI: 0.58-0.98,P = 0.04) and North Americans (OR = 0.64, 95% CI: 0.42-0.96,P = 0.03); HLA-DR13 polymorphism in Caucasians (OR = 0.62, 95% CI: 0.47-0.82,P < 0.01) and East Asians (OR = 0.44, 95% CI: 0.34-0.57,P < 0.01); and HLA-DR16 polymorphism in East Asians (OR = 2.62, 95% CI: 1.71-4.03,P < 0.01).

Conclusions

This meta-analysis showed that HLA-DR1 and HLA-DR13 are protective factors for SLE, and HLA-DR16 is a risk factor. Due to the limitations of this meta-analysis, the association between HLA-DRB1 polymorphisms and SLE susceptibility needs to be further researched before definitive conclusions are proved.

Twenty-year trends in all-cause mortality of patients with systemic lupus erythematosus in Mexico: Results from a nationwide health registry

Objective

Regional variations in systemic lupus erythematosus (SLE) mortality may be due to different spectra of local environmental factors. The aim of this study was to assess mortality trends in adults with SLE using a nationwide health registry.

Methods

Data came from the Dynamic Cubes of the General Direction of Health Information for 1998–2017 for mortality. In patients aged ≥15 years, SLE as the principal cause of death was defined according to ICD-10 code M32 and was classified by sex and age. Joinpoint trend analyses of annual age-standardized mortality rates (ASMR) for SLE patients and non-SLE people were made.

Results

We identified 11 449 SLE deaths and 9,989,874 non-SLE deaths. The SLE ASMR increased more than the non-SLE ASMR, with a 98.2% cumulative increase in the ratio of SLE to non-SLE deaths. Whereas the non-SLE ASMR remained relatively stable throughout the study period (overall and by sex), the SLE ASMR significantly increased between 1998 and 2009, non-significantly decreased between 2009 and 2013 and non-significantly increased thereafter. Both women and men had a large cumulative increase in the SLE ASMR/non-SLE ASMR ratio (73.9 and 191.3%, respectively). The Southeast region had the largest cumulative increases in the ratio of SLE to non-SLE ASMR (108.8%). Of the 11,449 deaths, 445 (3.8%) were in geographical areas where ≥40% of the population is indigenous.

Conclusion

SLE mortality rates have increased since 1998 and remain high compared with non-SLE mortality: significant sex and regional disparities persist.