1
|
Tur C, Ramagopalan S, Altmann DR, Bodini B, Cercignani M, Khaleeli Z, Miller DH, Thompson AJ, Ciccarelli O. HLA-DRB1*15 influences the development of brain tissue damage in early PPMS. Neurology 2014; 83:1712-8. [PMID: 25298310 DOI: 10.1212/wnl.0000000000000959] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To investigate whether (1) there were differences between HLA-DRB1*15-positive and -negative patients at baseline, and (2) HLA-DRB1*15-positive patients showed a greater development of brain and spinal cord damage, as assessed by MRI, and greater progression of disability, during a 5-year follow-up, compared with HLA-DRB1*15-negative patients. METHODS HLA-DRB1*15 typing was performed in 41 patients with primary progressive multiple sclerosis (PPMS) who were recruited within 5 years of symptom onset. All patients and 18 healthy controls were studied clinically and with MRI at baseline, and every 6 months for 3 years, and then at 5 years. Magnetization transfer ratio parameters and volumes for brain gray matter and normal-appearing white matter, brain T2 lesion load, and spinal cord cross-sectional area were obtained. Patient disability was assessed at each visit using the Expanded Disability Status Scale and Multiple Sclerosis Functional Composite subscores. RESULTS There were no significant differences between HLA-DRB1*15-positive and -negative patients at baseline. HLA-DRB1*15-positive patients showed a greater decline in brain magnetization transfer ratio for gray matter and normal-appearing white matter (both p = 0.005) than HLA-DRB1*15-negative patients over 5 years, while the same parameters did not change over time in healthy controls. HLA-DRB1*15-positive patients also showed a trend toward a faster increase in brain T2 lesion load than HLA-DRB1*15-negative patients (0.29 [95% confidence interval 0.20-0.38] vs 0.21 [0.13-0.30] mL/mo, p = 0.085) and higher T2 lesion volumes at all time points (average difference [95% confidence interval]: 10.58 mL [7.09-14.07], p < 0.001) during the follow-up, after adjusting for disease duration. CONCLUSIONS These findings suggest that HLA-DRB1*15 influences the progression of brain pathology in PPMS.
Collapse
Affiliation(s)
- Carmen Tur
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Sreeram Ramagopalan
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Daniel R Altmann
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Benedetta Bodini
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Mara Cercignani
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Zhaleh Khaleeli
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - David H Miller
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Alan J Thompson
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Olga Ciccarelli
- From the Departments of Brain Repair and Rehabilitation (C.T., B.B., Z.K., A.J.T., O.C.) and Neuroinflammation (D.R.A., D.H.M.), University College of London Institute of Neurology, UK; Multiple Sclerosis Centre of Catalonia (Cemcat) (C.T.), Neurology-Neuroimmunology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Blizard Institute (S.R.), Queen Mary University of London; Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, University of London; Clinical Imaging Sciences Centre (M.C.), Brighton and Sussex Medical School, Falmer, East Sussex; and National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, UK.
| |
Collapse
|
2
|
Kellar-Wood HF, Wood NW, Holmans P, Clayton D, Robertson N, Compston DA. Multiple sclerosis and the HLA-D region: linkage and association studies. J Neuroimmunol 1995; 58:183-90. [PMID: 7759607 DOI: 10.1016/0165-5728(95)00015-t] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Inheritance patterns of multiple sclerosis (MS) in multiplex families suggest a complex aetiology involving environmental and genetically determined components. The association between the HLA class II DR15, DQ6, Dw2 haplotype and MS has been well documented in patients with ancestral origins in Northern Europe. Conversely, linkage analysis of this region in multiplex families, derived from a population base, has generated negative results. Thus, given the Dw2 specificity association, evidence implicating this locus in disease susceptibility appears contradictory. We have collected and determined the HLA-DR and -DQ haplotypes of 115 sibling pairs with multiple sclerosis, and confirm a significant association with the Dw2-associated haplotype, both in index cases and their affected siblings compared with controls. However, using a sibling pair linkage analysis that restricts haplotype sharing probabilities to defined genetic models, we have not observed linkage of this region to susceptibility in MS. We discuss the basis for association and linkage and conclude that the DR15, DQ6, Dw2 haplotype does represent a susceptibility locus but its contribution to the pathogenesis is small; although it may interact epistatically with other susceptibility genes, this haplotype is not necessary for disease expression.
Collapse
Affiliation(s)
- H F Kellar-Wood
- University of Cambridge Neurology unit, Addenbrooke's Hospital, Cambridge, UK
| | | | | | | | | | | |
Collapse
|
5
|
Govaerts A, Gony J, Martin-Mondiére C, Poirier JC, Schmid M, Schuller E, Degos JD, Dausset J. HLA and multiple sclerosis: population and families study. TISSUE ANTIGENS 1985; 25:187-99. [PMID: 3874450 DOI: 10.1111/j.1399-0039.1985.tb00436.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Association between HLA and multiple sclerosis (MS) was investigated at the population level on 100 MS patients genotyped for HLA-A, B, C, DR and Bf, Glo, and on 155 patients phenotyped for the same HLA antigens. Association between MS and DR2 was clearly confirmed, although its strength is rather weak. No other genetic marker could be related to the disease, no haplotype nor any allelic combination could be recognized as MS specific, and antigen genotype frequencies among the diseased could not ascertain the mode of inheritance, although dominance is very likely. Computer analysis between HLA, Bf, Glo and age of the patient, sex, age of onset and evolution of MS, impairment indexes, titres of anti-DNA and anti-measles antibodies in CSF did not show any interaction. Twenty sib pairs and two trios of MS were also studied; they showed no significant distortion with the random distribution of haplotypes. DR2 gene frequency, however, was significantly higher in sib pairs showing one or two haplotypes than in HLA different affected siblings. Three crossing-overs were identified which suggest where the HLA-linked MS susceptibility (MSS) gene could be located within the HLA segment, while other epistatic MSS genes or environmental factors are likely to be important.
Collapse
|