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Tesolin P, Bertinetto FE, Sonaglia A, Cappellani S, Concas MP, Morgan A, Ferrero NM, Zabotti A, Gasparini P, Amoroso A, Quartuccio L, Girotto G. High Throughput Genetic Characterisation of Caucasian Patients Affected by Multi-Drug Resistant Rheumatoid or Psoriatic Arthritis. J Pers Med 2022; 12:jpm12101618. [PMID: 36294757 PMCID: PMC9605087 DOI: 10.3390/jpm12101618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Rheumatoid and psoriatic arthritis (RA and PsA) are inflammatory rheumatic disorders characterised by a multifactorial etiology. To date, the genetic contributions to the disease onset, severity and drug response are not clearly defined, and despite the development of novel targeted therapies, ~10% of patients still display poor treatment responses. We characterised a selected cohort of eleven non-responder patients aiming to define the genetic contribution to drug resistance. An accurate clinical examination of the patients was coupled with several high-throughput genetic testing, including HLA typing, SNPs-array and Whole Exome Sequencing (WES). The analyses revealed that all the subjects carry very rare HLA phenotypes which contain HLA alleles associated with RA development (e.g., HLA-DRB1*04, DRB1*10:01 and DRB1*01). Additionally, six patients also carry PsA risk alleles (e.g., HLA-B*27:02 and B*38:01). WES analysis and SNPs-array revealed 23 damaging variants with 18 novel “drug-resistance” RA/PsA candidate genes. Eight patients carry likely pathogenic variants within common genes (CYP21A2, DVL1, PRKDC, ORAI1, UGT2B17, MSR1). Furthermore, “private” damaging variants were identified within 12 additional genes (WNT10A, ABCB7, SERPING1, GNRHR, NCAPD3, CLCF1, HACE1, NCAPD2, ESR1, SAMHD1, CYP27A1, CCDC88C). This multistep approach highlighted novel RA/PsA candidate genes and genotype-phenotype correlations potentially useful for clinicians in selecting the best therapeutic strategy.
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Affiliation(s)
- Paola Tesolin
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy
| | - Francesca Eleonora Bertinetto
- Department of Medical Sciences, University of Turin, and Immunogenetic and Transplant Biology Service, University Hospital “Città della Salute e della Scienza”, 10124 Turin, Italy
| | - Arianna Sonaglia
- Division of Rheumatology, Department of Medicine (DAME), ASUFC, University of Udine, 33100 Udine, Italy
| | - Stefania Cappellani
- Institute for Maternal and Child Health—IRCCS, Burlo Garofolo, 34137 Trieste, Italy
| | - Maria Pina Concas
- Institute for Maternal and Child Health—IRCCS, Burlo Garofolo, 34137 Trieste, Italy
- Correspondence: ; Tel.: +39-0403785539
| | - Anna Morgan
- Institute for Maternal and Child Health—IRCCS, Burlo Garofolo, 34137 Trieste, Italy
| | - Norma Maria Ferrero
- Department of Medical Sciences, University of Turin, and Immunogenetic and Transplant Biology Service, University Hospital “Città della Salute e della Scienza”, 10124 Turin, Italy
| | - Alen Zabotti
- Division of Rheumatology, Department of Medicine (DAME), ASUFC, University of Udine, 33100 Udine, Italy
| | - Paolo Gasparini
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy
- Institute for Maternal and Child Health—IRCCS, Burlo Garofolo, 34137 Trieste, Italy
| | - Antonio Amoroso
- Department of Medical Sciences, University of Turin, and Immunogenetic and Transplant Biology Service, University Hospital “Città della Salute e della Scienza”, 10124 Turin, Italy
| | - Luca Quartuccio
- Division of Rheumatology, Department of Medicine (DAME), ASUFC, University of Udine, 33100 Udine, Italy
| | - Giorgia Girotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy
- Institute for Maternal and Child Health—IRCCS, Burlo Garofolo, 34137 Trieste, Italy
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