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Harley ITW, Sawalha AH. Systemic lupus erythematosus as a genetic disease. Clin Immunol 2022; 236:108953. [PMID: 35149194 PMCID: PMC9167620 DOI: 10.1016/j.clim.2022.108953] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022]
Abstract
Systemic lupus erythematosus is the prototypical systemic autoimmune disease, as it is characterized both by protean multi-organ system manifestations and by the uniform presence of pathogenic autoantibodies directed against components of the nucleus. Prior to the modern genetic era, the diverse clinical manifestations of SLE suggested to many that SLE patients were unlikely to share a common genetic risk basis. However, modern genetic studies have revealed that SLE usually arises when an environmental exposure occurs in an individual with a collection of genetic risk variants passing a liability threshold. Here, we summarize the current state of the field aimed at: (1) understanding the genetic architecture of this complex disease, (2) synthesizing how this genetic risk architecture impacts cellular and molecular disease pathophysiology, (3) providing illustrative examples that highlight the rich complexity of the pathobiology of this prototypical autoimmune disease and (4) communicating this complex etiopathogenesis to patients.
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Affiliation(s)
- Isaac T W Harley
- Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; Human Immunology and Immunotherapy Initiative (HI(3)), Department of Immunology, University of Colorado School of Medicine, Aurora, CO, USA; Rocky Mountain Regional Veteran's Administration Medical Center (VAMC), Medicine Service, Rheumatology Section, Aurora, CO, USA.
| | - Amr H Sawalha
- Division of Rheumatology, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA; Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Lupus Center of Excellence, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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2
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Pharmacogenetic Predictors of Response to Interferon Beta Therapy in Multiple Sclerosis. Mol Neurobiol 2021; 58:4716-4726. [PMID: 34169444 DOI: 10.1007/s12035-021-02454-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/16/2021] [Indexed: 01/22/2023]
Abstract
First-line therapy with interferon beta (IFN-β), involved in gene expression modulation in immune response, is widely used for multiple sclerosis. However, 30-50% of patients do not respond optimally. Variants in CBLB, CTSS, GRIA3, OAS1 and TNFRSF10A genes have been proposed to contribute to the variation in the individual response. The purpose of this study was to evaluate the influence of gene polymorphisms on the IFN-β response in relapsing-remitting multiple sclerosis (RRMS) patients. CBLB (rs12487066), GRIA3 (rs12557782), CTSS (rs1136774), OAS1 (rs10774671) and TNFRSF10A (rs20576) polymorphisms were analysed by Taqman in 137 RRMS patients. Response to IFN-β and change in the Expanded Disability Status Scale (EDSS) after 24 months were evaluated using multivariable logistic regression analysis. Carriers of at least one copy of the C allele of CTSS-rs1136774 had a better response to IFN-β (p = 0.0423; OR = 2.94; CI95% = 1.03, 8.40). Carriers of TT genotype of TNFRSF10A-rs20576 had a higher probability of maintaining their EDSS stable after 24 months of IFN-β treatment (p = 0.0251; OR = 5.71; CI95% = 1.39, 31.75). No influence of CBLB (rs12487066), OAS1 (rs10774671) and GRIA3 (rs12557782) gene polymorphisms in the variation of the individual response to IFN-β was shown. Our results suggest that the TNFRSF10A-rs20576 and CTSS-rs1136774 gene polymorphisms influence the response to IFN-β after 24 months, while the CBLB (rs12487066), OAS1 (rs10774671) or GRIA3 (rs12557782) gene polymorphisms had no effect on the variation of the individual response to IFN-β.
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3
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Martínez-Aguilar L, Pérez-Ramírez C, Maldonado-Montoro MDM, Carrasco-Campos MI, Membrive-Jiménez C, Martínez-Martínez F, García-Collado C, Calleja-Hernández MÁ, Ramírez-Tortosa MC, Jiménez-Morales A. Effect of genetic polymorphisms on therapeutic response in multiple sclerosis relapsing-remitting patients treated with interferon-beta. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2020; 785:108322. [PMID: 32800273 DOI: 10.1016/j.mrrev.2020.108322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 11/30/2022]
Abstract
Treatment with interferon beta (IFNβ) is one of the first-line treatments for multiple sclerosis. In clinical practice, however, many patients present suboptimal response to IFNβ, with the proportion of non-responders ranging from 20 to 50%. This variable response can be affected by genetic factors, such as polymorphisms in the genes involved in the disease state, pharmacodynamics, metabolism or in the action mechanism of IFNβ, which can affect the efficacy of this drug. This review assesses the impact of pharmacogenetics studies on response to IFNβ treatment among patients diagnosed with relapsing-remitting multiple sclerosis (RRMS). The results suggest that the detection of polymorphisms in several genes (CD46, CD58, FHIT, IRF5, GAPVD1, GPC5, GRBRB3, MxA, PELI3 and ZNF697) could be used in the future as predictive markers of response to IFNβ treatment in patients diagnosed with RRMS. However, few studies have been carried out and they have been performed on small sample sizes, which makes it difficult to generalize the role of these genes in IFNβ treatment. Studies on large sample sizes with longer term follow-up are therefore required to confirm these results.
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Affiliation(s)
- Laura Martínez-Aguilar
- Department of Pharmacy and Pharmaceutical Technology. Social and Legal Assistance Pharmacy Section, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071 Granada, Spain.
| | - Cristina Pérez-Ramírez
- Pharmacy Service. Pharmacogenetics Unit, University Hospital Virgen Macarena, Dr. Fedriani, 3, 41009 Sevilla, Spain.
| | | | - María Isabel Carrasco-Campos
- Pharmacy Service. Pharmacogenetics Unit, University Hospital Virgen de las Nieves, UGC Provincial de Farmacia de Granada, Avda. Fuerzas Armadas, 2, Spain.
| | - Cristina Membrive-Jiménez
- Pharmacy Service. Pharmacogenetics Unit, University Hospital Virgen de las Nieves, UGC Provincial de Farmacia de Granada, Avda. Fuerzas Armadas, 2, Spain.
| | - Fernando Martínez-Martínez
- Department of Pharmacy and Pharmaceutical Technology. Social and Legal Assistance Pharmacy Section, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n, 18071 Granada, Spain.
| | - Carlos García-Collado
- Pharmacy Service. Pharmacogenetics Unit, University Hospital Virgen de las Nieves, UGC Provincial de Farmacia de Granada, Avda. Fuerzas Armadas, 2, Spain.
| | | | - María Carmen Ramírez-Tortosa
- Department of Biochemistry, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, s/n 18071 Granada, Spain.
| | - Alberto Jiménez-Morales
- Pharmacy Service. Pharmacogenetics Unit, University Hospital Virgen de las Nieves, UGC Provincial de Farmacia de Granada, Avda. Fuerzas Armadas, 2, Spain.
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4
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Islam MA, Kundu S, Hassan R. Gene Therapy Approaches in an Autoimmune Demyelinating Disease: Multiple Sclerosis. Curr Gene Ther 2020; 19:376-385. [PMID: 32141417 DOI: 10.2174/1566523220666200306092556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/19/2020] [Accepted: 03/02/2020] [Indexed: 01/08/2023]
Abstract
Multiple Sclerosis (MS) is the most common autoimmune demyelinating disease of the Central Nervous System (CNS). It is a multifactorial disease which develops in an immune-mediated way under the influences of both genetic and environmental factors. Demyelination is observed in the brain and spinal cord leading to neuro-axonal damage in patients with MS. Due to the infiltration of different immune cells such as T-cells, B-cells, monocytes and macrophages, focal lesions are observed in MS. Currently available medications treating MS are mainly based on two strategies; i) to ease specific symptoms or ii) to reduce disease progression. However, these medications tend to induce different adverse effects with limited therapeutic efficacy due to the protective function of the blood-brain barrier. Therefore, researchers have been working for the last four decades to discover better solutions by introducing gene therapy approaches in treating MS generally by following three strategies, i) prevention of specific symptoms, ii) halt or reverse disease progression and iii) heal CNS damage by promoting remyelination and axonal repair. In last two decades, there have been some remarkable successes of gene therapy approaches on the experimental mice model of MS - experimental autoimmune encephalomyelitis (EAE) which suggests that it is not far that the gene therapy approaches would start in human subjects ensuring the highest levels of safety and efficacy. In this review, we summarised the gene therapy approaches attempted in different animal models towards treating MS.
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Affiliation(s)
- Md. Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Shoumik Kundu
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Rosline Hassan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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5
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Tsareva EY, Favorova OO, Boyko AN, Kulakova OG. Genetic Markers for Personalized Therapy of Polygenic Diseases: Pharmacogenetics of Multiple Sclerosis. Mol Biol 2019. [DOI: 10.1134/s0026893319040149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hočevar K, Ristić S, Peterlin B. Pharmacogenomics of Multiple Sclerosis: A Systematic Review. Front Neurol 2019; 10:134. [PMID: 30863357 PMCID: PMC6399303 DOI: 10.3389/fneur.2019.00134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 02/01/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Over the past two decades, various novel disease-modifying drugs for multiple sclerosis (MS) have been approved. However, there is high variability in the patient response to the available medications, which is hypothesized to be partly attributed to genetics. Objectives: To conduct a systematic review of the current literature on the pharmacogenomics of MS therapy. Methods: A systematic literature search was conducted using PubMed/MEDLINE database searching for articles investigating a role of genetic variation in response to disease-modifying MS treatments, published in the English language up to October 9th, 2018. PRISMA guidelines for systematic reviews were applied. Studies were included if they investigated response or nonresponse to MS treatment defined as relapse rate, by expanded disability status scale score or based on magnetic resonance imaging. The following data were extracted: first author's last name, year of publication, PMID number, sample size, ethnicity of patients, method, genes, and polymorphisms tested, outcome, significant associations with corresponding P-values and confidence intervals, response criteria, and duration of the follow-up period. Results: Overall, 48 articles published up to October 2018, evaluating response to interferon-beta, glatiramer acetate, mitoxantrone, and natalizumab, met our inclusion criteria and were included in this review. Among those, we identified 42 (87.5%) candidate gene studies and 6 (12.5%) genome-wide association studies. Existing pharmacogenomic evidence is mainly based on the results of individual studies, or on results of multiple studies, which often lack consistency. In recent years, hypothesis-free approaches identified novel candidate genes that remain to be validated. Various study designs, including the definition of clinical response, duration of the follow-up period, and methodology as well as moderate sample sizes, likely contributed to discordances between studies. However, some of the significant associations were identified in the same genes, or in the genes involved in the same biological pathways. Conclusions: At the moment, there is no available clinically actionable pharmacogenomic biomarker that would enable more personalized treatment of MS. More large-scale studies with uniform design are needed to identify novel and validate existing pharmacogenomics findings. Furthermore, studies investigating associations between rare variants and treatment response in MS patients, using next-generation sequencing technologies are warranted.
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Affiliation(s)
- Keli Hočevar
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Smiljana Ristić
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Esmaeili Reykande S, Rezaei A, Sadr M, Shabani M, Najmi Varzaneh F, Ziaee V, Rezaei N. Association of interferon regulatory factor 5 (IRF5) gene polymorphisms with juvenile idiopathic arthritis. Clin Rheumatol 2018; 37:2661-2665. [PMID: 29423720 DOI: 10.1007/s10067-018-4010-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/18/2018] [Accepted: 01/29/2018] [Indexed: 11/24/2022]
Abstract
Interferon regulatory factor 5 (IRF5) is a member of IRF family which induce signaling pathways and are involved in modulation of cell growth, differentiation, apoptosis, and immune system activity. Juvenile idiopathic arthritis (JIA) is an auto-inflammatory syndrome where the inflammatory markers are believed to play a fundamental role in its pathogenesis. In this study, we aimed to assess the association of IRF5 gene polymorphisms with susceptibility of JIA in Iranian population. Three IRF5 single-nucleotide polymorphisms (rs10954213 A/G, rs2004640 G/T, and rs3807306 G/T) were genotyped using TaqMan assays in 55 patients with JIA and 63 matched healthy individuals. The frequency of the IRF5 rs2004640 T allele was significantly higher (69 vs 45%, P value = 0.0013) in JIA group as compared to control. The frequency of the IRF5 rs 2004640 G allele was significantly higher in the control group in comparison to JIA group (54 vs 32%, P value = 0.001). Allele and genotype frequencies of the rs10954213 and rs3807306 did not show any significant difference between JIA and control group. IRF5 rs 2004640 T allele can be considered as a risk factor for the development of JIA and presence of rs 2004640 G may be act as protective factor.
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Affiliation(s)
- Samira Esmaeili Reykande
- Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Arezou Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, 14194, Iran
| | - Maryam Sadr
- Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahsima Shabani
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, 14194, Iran
| | - Farnaz Najmi Varzaneh
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Baltimore, MD, USA
| | - Vahid Ziaee
- Division of Pediatric Rheumatology, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, 14194, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. .,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Sheffield, UK.
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8
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Kalincik T, Manouchehrinia A, Sobisek L, Jokubaitis V, Spelman T, Horakova D, Havrdova E, Trojano M, Izquierdo G, Lugaresi A, Girard M, Prat A, Duquette P, Grammond P, Sola P, Hupperts R, Grand'Maison F, Pucci E, Boz C, Alroughani R, Van Pesch V, Lechner-Scott J, Terzi M, Bergamaschi R, Iuliano G, Granella F, Spitaleri D, Shaygannejad V, Oreja-Guevara C, Slee M, Ampapa R, Verheul F, McCombe P, Olascoaga J, Amato MP, Vucic S, Hodgkinson S, Ramo-Tello C, Flechter S, Cristiano E, Rozsa C, Moore F, Luis Sanchez-Menoyo J, Laura Saladino M, Barnett M, Hillert J, Butzkueven H. Towards personalized therapy for multiple sclerosis: prediction of individual treatment response. Brain 2017; 140:2426-2443. [PMID: 29050389 DOI: 10.1093/brain/awx185] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/20/2017] [Indexed: 11/14/2022] Open
Abstract
Timely initiation of effective therapy is crucial for preventing disability in multiple sclerosis; however, treatment response varies greatly among patients. Comprehensive predictive models of individual treatment response are lacking. Our aims were: (i) to develop predictive algorithms for individual treatment response using demographic, clinical and paraclinical predictors in patients with multiple sclerosis; and (ii) to evaluate accuracy, and internal and external validity of these algorithms. This study evaluated 27 demographic, clinical and paraclinical predictors of individual response to seven disease-modifying therapies in MSBase, a large global cohort study. Treatment response was analysed separately for disability progression, disability regression, relapse frequency, conversion to secondary progressive disease, change in the cumulative disease burden, and the probability of treatment discontinuation. Multivariable survival and generalized linear models were used, together with the principal component analysis to reduce model dimensionality and prevent overparameterization. Accuracy of the individual prediction was tested and its internal validity was evaluated in a separate, non-overlapping cohort. External validity was evaluated in a geographically distinct cohort, the Swedish Multiple Sclerosis Registry. In the training cohort (n = 8513), the most prominent modifiers of treatment response comprised age, disease duration, disease course, previous relapse activity, disability, predominant relapse phenotype and previous therapy. Importantly, the magnitude and direction of the associations varied among therapies and disease outcomes. Higher probability of disability progression during treatment with injectable therapies was predominantly associated with a greater disability at treatment start and the previous therapy. For fingolimod, natalizumab or mitoxantrone, it was mainly associated with lower pretreatment relapse activity. The probability of disability regression was predominantly associated with pre-baseline disability, therapy and relapse activity. Relapse incidence was associated with pretreatment relapse activity, age and relapsing disease course, with the strength of these associations varying among therapies. Accuracy and internal validity (n = 1196) of the resulting predictive models was high (>80%) for relapse incidence during the first year and for disability outcomes, moderate for relapse incidence in Years 2-4 and for the change in the cumulative disease burden, and low for conversion to secondary progressive disease and treatment discontinuation. External validation showed similar results, demonstrating high external validity for disability and relapse outcomes, moderate external validity for cumulative disease burden and low external validity for conversion to secondary progressive disease and treatment discontinuation. We conclude that demographic, clinical and paraclinical information helps predict individual response to disease-modifying therapies at the time of their commencement.
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Affiliation(s)
- Tomas Kalincik
- CORe, Department of Medicine, University of Melbourne, 300 Grattan St, Melbourne, 3050, Australia.,Department of Neurology, Royal Melbourne Hospital, 300 Grattan St, Melbourne, 3050, Australia
| | - Ali Manouchehrinia
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-17177, Sweden
| | - Lukas Sobisek
- Department of Neurology and Center of Clinical Neuroscience, General University Hospital and Charles University in Prague, Katerinska 30, Prague, 12808, Czech Republic.,Department of Statistics and Probability, University of Economics in Prague, Winston Churchill Sq 1938/4, Prague, 13067, Czech Republic
| | - Vilija Jokubaitis
- Department of Neurology, Royal Melbourne Hospital, 300 Grattan St, Melbourne, 3050, Australia.,Department of Medicine, University of Melbourne, 300 Grattan St, Melbourne, 3050, Australia
| | - Tim Spelman
- Department of Neurology, Royal Melbourne Hospital, 300 Grattan St, Melbourne, 3050, Australia.,Department of Medicine, University of Melbourne, 300 Grattan St, Melbourne, 3050, Australia
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, General University Hospital and Charles University in Prague, Katerinska 30, Prague, 12808, Czech Republic
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience, General University Hospital and Charles University in Prague, Katerinska 30, Prague, 12808, Czech Republic
| | - Maria Trojano
- University of Bari, Via Calefati 53, Bari, 70122, Italy
| | - Guillermo Izquierdo
- Hospital Universitario Virgen Macarena, Amador de los Rios 48-50. 4a, Sevilla, 41003, Spain
| | - Alessandra Lugaresi
- Department of Neuroscience, Imaging and Clinical Sciences, University 'G. d'Annunzio', Via dei Vestini, Chieti, 66100, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Via dei Vestini, Bologna, 66100, Italy
| | - Marc Girard
- Hopital Notre Dame, 1560 Sherbrooke East, Montreal, H2L 4M1, Canada; CHUM and Universite de Montreal, Montreal, Canada
| | - Alexandre Prat
- Hopital Notre Dame, 1560 Sherbrooke East, Montreal, H2L 4M1, Canada; CHUM and Universite de Montreal, Montreal, Canada
| | - Pierre Duquette
- Hopital Notre Dame, 1560 Sherbrooke East, Montreal, H2L 4M1, Canada; CHUM and Universite de Montreal, Montreal, Canada
| | - Pierre Grammond
- Centre de réadaptation déficience physique Chaudière-Appalache, 9500 blvd Centre-Hospitalier, Levis, G6X 0A1, Canada
| | - Patrizia Sola
- Nuovo Ospedale Civile Sant'Agostino/Estense, via giardini 1355, Modena, 41100, Italy
| | - Raymond Hupperts
- Zuyderland Ziekenhuis, Walramstraat 23, Sittard, 6131 BK, The Netherlands
| | | | - Eugenio Pucci
- Azienda Sanitaria Unica Regionale Marche - AV3, Via Santa Lucia 2, Macerata, 62100, Italy
| | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Karadeniz Technical University, Trabzon, 61080, Turkey
| | - Raed Alroughani
- Amiri Hospital, P.O. Box 1661. Qurtoba, Kuwait, 73767, Kuwait
| | - Vincent Van Pesch
- Cliniques Universitaires Saint-Luc, avenue Hippocrate, 10 UCL10/80, Brussels, 1200 BXL, Belgium
| | | | - Murat Terzi
- Ondokuz Mayis University, Medical Faculty, Kurupelit, Samsun, 55160, Turkey
| | - Roberto Bergamaschi
- C. Mondino National Neurological Institute, via Mondino 2, Pavia, 27100, Italy
| | - Gerardo Iuliano
- Ospedali Riuniti di Salerno, Via s. Leonardo, Salerno, 84100, Italy
| | | | - Daniele Spitaleri
- Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Contrada Amoretta, Avellino, 83100, Italy
| | | | - Celia Oreja-Guevara
- Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid, 28050, Spain
| | - Mark Slee
- Flinders Medical Centre, Flinders Drive, Adelaide, 5042, Australia
| | - Radek Ampapa
- Nemocnice Jihlava, Vrchlickeho 59, Jihlava, 58633, Czech Republic
| | - Freek Verheul
- Groene Hart ziekenhuis, bleulandweg 10, Gouda, 2800 BB, The Netherlands
| | - Pamela McCombe
- Royal Brisbane and Women's Hospital, 33 North Street, Spring Hill, QLD 4000, Australia
| | - Javier Olascoaga
- Hospital Donostia, Paseo de Begiristain, San Sebastián, 20014, Spain
| | - Maria Pia Amato
- University of Florence, Viale Morgagni 85, Florence, 50134, Italy
| | - Steve Vucic
- Westmead Hospital, Hawkesbury Rd, Sydney, 2145, Australia
| | | | | | - Shlomo Flechter
- Assaf Harofeh Medical Center, Zerifin, Beer-Yaakov, 70100, Israel
| | | | - Csilla Rozsa
- Jahn Ferenc Teaching Hospital, Köves u. 1., Budapest, 1101, Hungary
| | - Fraser Moore
- Jewish General Hospital, 3755 Cote-Sainte-Catherine, Montreal, J7A 4T8, Canada
| | | | - Maria Laura Saladino
- INEBA - Institute of Neuroscience Buenos Aires, Guardia Vieja 4435, Buenos Aires, C1192AAW, Argentina
| | - Michael Barnett
- Brain and Mind Centre, University of Sydney, 100 Mallett, Camperdown, 2050, Australia
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-17177, Sweden
| | - Helmut Butzkueven
- Department of Neurology, Royal Melbourne Hospital, 300 Grattan St, Melbourne, 3050, Australia.,Department of Medicine, University of Melbourne, 300 Grattan St, Melbourne, 3050, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
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9
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Coyle PK. Pharmacogenetic Biomarkers to Predict Treatment Response in Multiple Sclerosis: Current and Future Perspectives. Mult Scler Int 2017; 2017:6198530. [PMID: 28804651 PMCID: PMC5540248 DOI: 10.1155/2017/6198530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/13/2017] [Accepted: 04/20/2017] [Indexed: 12/20/2022] Open
Abstract
Disease-modifying therapies (DMTs) have significantly advanced the treatment of relapsing multiple sclerosis (MS), decreasing the frequency of relapses, disability, and magnetic resonance imaging lesion formation. However, patients' responses to and tolerability of DMTs vary considerably, creating an unmet need for biomarkers to identify likely responders and/or those who may have treatment-limiting adverse reactions. Most studies in MS have focused on the identification of pharmacogenetic markers, using either the candidate-gene approach, which requires prior knowledge of the genetic marker and its role in the target disease, or genome-wide association, which examines multiple genetic variants, typically single nucleotide polymorphisms (SNPs). Both approaches have implicated numerous alleles and SNPs in response to selected MS DMTs. None have been validated for use in clinical practice. This review covers pharmacogenetic markers in clinical practice in other diseases and then reviews the current status of MS DMT markers (interferon β, glatiramer acetate, and mitoxantrone). For a complex disease such as MS, multiple biomarkers may need to be evaluated simultaneously to identify potential responders. Efforts to identify relevant biomarkers are underway and will need to be expanded to all MS DMTs. These will require extensive validation in large patient groups before they can be used in clinical practice.
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Affiliation(s)
- Patricia K. Coyle
- Department of Neurology and MS Comprehensive Care Center, Stony Brook University Medical Center, Stony Brook, NY 11794, USA
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10
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Grossman I, Knappertz V, Laifenfeld D, Ross C, Zeskind B, Kolitz S, Ladkani D, Hayardeny L, Loupe P, Laufer R, Hayden M. Pharmacogenomics strategies to optimize treatments for multiple sclerosis: Insights from clinical research. Prog Neurobiol 2017; 152:114-130. [DOI: 10.1016/j.pneurobio.2016.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 02/10/2016] [Accepted: 02/27/2016] [Indexed: 12/13/2022]
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Abstract
Treatments with a range of efficacy and risk of adverse events have become available for the management of multiple sclerosis (MS). However, now the heterogeneity of clinical expression and responses to treatment pose major challenges to improving patient care. Selecting and managing the drug best balancing benefit and risk demands a new focus on the individual patient. Personalised medicine for MS is based on improving the precision of diagnosis for each patient in order to capture prognosis and provide an evidence-based framework for predicting treatment response and personalising patient monitoring. It involves development of predictive models involving the integration of clinical and biological data with an understanding of the impact of disease on the lives of individual patients. Here, we provide a brief, selective review of challenges to personalisation of the management of MS and suggest an agenda for stakeholder engagement and research to address them.
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Affiliation(s)
- Arie Gafson
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Matt J Craner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Paul M Matthews
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK/Centre for Neurotechnology, Imperial College London, London, UK
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Tsareva E, Kulakova O, Boyko A, Favorova O. Pharmacogenetics of multiple sclerosis. Pharmacogenet Genomics 2016; 26:103-15. [DOI: 10.1097/fpc.0000000000000194] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
Interferon regulatory factor 5 (IRF5) has been demonstrated as a key transcription factor of the immune system, playing important roles in modulating inflammatory immune responses in numerous cell types including dendritic cells, macrophages, and B cells. As well as driving the expression of type I interferon in antiviral responses, IRF5 is also crucial for driving macrophages toward a proinflammatory phenotype by regulating cytokine and chemokine expression and modulating B-cell maturity and antibody production. This review highlights the functional importance of IRF5 in a disease setting, by discussing polymorphic mutations at the human Irf5 locus that lead to susceptibility to systemic lupus erythematosus, rheumatoid arthritis, and inflammatory bowel disease. In concordance with this, we also discuss lessons in IRF5 functionality learned from murine in vivo models of autoimmune disease and inflammation and hypothesize that modulation of IRF5 activity and expression could provide potential therapeutic benefits in the clinic.
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Affiliation(s)
- Hayley L Eames
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
| | - Alastair L Corbin
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Irina A Udalova
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
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Sex-specific prediction of interferon beta therapy response in relapsing-remitting multiple sclerosis. J Clin Neurosci 2015; 22:986-9. [DOI: 10.1016/j.jocn.2014.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 11/08/2014] [Indexed: 01/19/2023]
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Corvol JC, Devos D, Hulot JS, Lacomblez L. Clinical implications of neuropharmacogenetics. Rev Neurol (Paris) 2015; 171:482-97. [PMID: 26008819 DOI: 10.1016/j.neurol.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/24/2015] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Pharmacogenetics aims to identify the underlying genetic factors participating in the variability of drug response. Indeed, genetic variability at the DNA or RNA levels can directly or indirectly modify the pharmacokinetic or the pharmacodynamic parameters of a drug. The ultimate aim of pharmacogenetics is to move towards a personalised medicine by predicting responders and non-responders, adjusting the dose of the treatment, and identifying individuals at risk of adverse drug effects. METHODS A literature research was performed in which we reviewed all pharmacogenetic studies in neurological disorders including neurodegenerative diseases, multiple sclerosis, stroke and epilepsy. RESULTS Several pharmacogenetic studies have been performed in neurology, bringing insights into the inter-individual drug response variability and in the pathophysiology of neurological diseases. The principal implications of these studies for the management of patients in clinical practice are discussed. CONCLUSION/DISCUSSION Although several genetic factors have been identified in the modification of drug response in neurological disorders, most of them have a marginal predictive effect at the single gene level, suggesting mutagenic interactions as well as other factors related to drug interaction and disease subtypes. Most pharmacogenetic studies deserve further replication in independent populations and, ideally, in pharmacogenetic clinical trials to demonstrate their relevance in clinical practice.
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Affiliation(s)
- J-C Corvol
- Sorbonne universités, UPMC université Paris 06, 4, place Jussieu, 75005 Paris, France; CIC_1422, département des maladies du système nerveux, hôpital Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Inserm, UMR_S1127, ICM, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France; CNRS, UMR_7225, ICM, 4, place Jussieu, 75005 Paris, France.
| | - D Devos
- Inserm U1171, department of movement disorders and neurology, department of medical pharmacology, university of Lille, CHU Lille, 1, place de Verdun, 59045 Lille cedex, France
| | - J-S Hulot
- Sorbonne universités, UPMC université Paris 06, 4, place Jussieu, 75005 Paris, France; Inserm, UMR_S1166, ICAN, 4, place Jussieu, 75005 Paris, France
| | - L Lacomblez
- Sorbonne universités, UPMC université Paris 06, 4, place Jussieu, 75005 Paris, France; CIC_1422, département des maladies du système nerveux, hôpital Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Inserm, UMR_S1146, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France
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Carlson RJ, Doucette JR, Knox K, Nazarali AJ. Pharmacogenomics of interferon-β in multiple sclerosis: What has been accomplished and how can we ensure future progress? Cytokine Growth Factor Rev 2015; 26:249-61. [DOI: 10.1016/j.cytogfr.2014.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/17/2014] [Indexed: 01/14/2023]
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Sellebjerg F, Søndergaard HB, Koch-Henriksen N, Sørensen PS, Oturai AB. Prediction of response to interferon therapy in multiple sclerosis. Acta Neurol Scand 2014; 130:268-75. [PMID: 24943672 DOI: 10.1111/ane.12269] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Single nucleotide polymorphisms (SNPs) in the genes encoding interferon response factor (IRF)-5, IRF-8 and glypican-5 (GPC5) have been associated with disease activity in multiple sclerosis (MS) patients treated with interferon (IFN)-β. We analysed whether SNPs in the IRF5, IRF8 and GPC5 genes are associated with clinical disease activity in MS patients beginning de novo treatment with IFN-β. METHODS The SNPs rs2004640, rs3807306 and rs4728142 in IRF5, rs13333054 and rs17445836 in IRF8 and rs10492503 in GPC5 were genotyped in 575 patients with relapsing-remitting MS followed prospectively after the initiation of their first treatment with IFN-β. RESULTS 62% of patients experienced relapses during the first 2 years of treatment, and 32% had disability progression during the first 5 years of treatment. Patients with a pretreatment annualized relapse rate >1 had an increased risk of relapse (hazard ratio 1.53, 95% confidence interval 1.24-1.90) and progression (hazard ratio 1.48, 95% confidence interval 1.10-1.99) on treatment and patients with breakthrough relapses in the form of relapses during the first 2 years of treatment had an increased risk of progression during the first 5 years of treatment (hazard ratio 2.04, 95% confidence interval 1.47-2.85).The gene variants in IRF5, IRF8 and GPC5 were not associated with risk of relapse or disease progression. CONCLUSIONS Pretreatment relapse rate and clinical disease activity during the first 2 years of treatment may be associated with disease progression in MS patients treated with IFN-β. Genetic analysis of the studied gene variants do not provide additional information.
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Affiliation(s)
- F. Sellebjerg
- Danish Multiple Sclerosis Center; Department of Neurology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - H. B. Søndergaard
- Danish Multiple Sclerosis Center; Department of Neurology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - N. Koch-Henriksen
- The Danish MS Registry under the Danish MS Center; Rigshospitalet; University of Copenhagen and Clinical Institute; Copenhagen Denmark
- Department of Clinical Epidemiology; Aarhus University; Aarhus Denmark
| | - P. S. Sørensen
- Danish Multiple Sclerosis Center; Department of Neurology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - A. B. Oturai
- Danish Multiple Sclerosis Center; Department of Neurology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
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Kottyan LC, Zoller EE, Bene J, Lu X, Kelly JA, Rupert AM, Lessard CJ, Vaughn SE, Marion M, Weirauch MT, Namjou B, Adler A, Rasmussen A, Glenn S, Montgomery CG, Hirschfield GM, Xie G, Coltescu C, Amos C, Li H, Ice JA, Nath SK, Mariette X, Bowman S, Rischmueller M, Lester S, Brun JG, Gøransson LG, Harboe E, Omdal R, Cunninghame-Graham DS, Vyse T, Miceli-Richard C, Brennan MT, Lessard JA, Wahren-Herlenius M, Kvarnström M, Illei GG, Witte T, Jonsson R, Eriksson P, Nordmark G, Ng WF, Anaya JM, Rhodus NL, Segal BM, Merrill JT, James JA, Guthridge JM, Scofield RH, Alarcon-Riquelme M, Bae SC, Boackle SA, Criswell LA, Gilkeson G, Kamen DL, Jacob CO, Kimberly R, Brown E, Edberg J, Alarcón GS, Reveille JD, Vilá LM, Petri M, Ramsey-Goldman R, Freedman BI, Niewold T, Stevens AM, Tsao BP, Ying J, Mayes MD, Gorlova OY, Wakeland W, Radstake T, Martin E, Martin J, Siminovitch K, Moser Sivils KL, Gaffney PM, Langefeld CD, Harley JB, Kaufman KM. The IRF5-TNPO3 association with systemic lupus erythematosus has two components that other autoimmune disorders variably share. Hum Mol Genet 2014; 24:582-96. [PMID: 25205108 DOI: 10.1093/hmg/ddu455] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Exploiting genotyping, DNA sequencing, imputation and trans-ancestral mapping, we used Bayesian and frequentist approaches to model the IRF5-TNPO3 locus association, now implicated in two immunotherapies and seven autoimmune diseases. Specifically, in systemic lupus erythematosus (SLE), we resolved separate associations in the IRF5 promoter (all ancestries) and with an extended European haplotype. We captured 3230 IRF5-TNPO3 high-quality, common variants across 5 ethnicities in 8395 SLE cases and 7367 controls. The genetic effect from the IRF5 promoter can be explained by any one of four variants in 5.7 kb (P-valuemeta = 6 × 10(-49); OR = 1.38-1.97). The second genetic effect spanned an 85.5-kb, 24-variant haplotype that included the genes IRF5 and TNPO3 (P-valuesEU = 10(-27)-10(-32), OR = 1.7-1.81). Many variants at the IRF5 locus with previously assigned biological function are not members of either final credible set of potential causal variants identified herein. In addition to the known biologically functional variants, we demonstrated that the risk allele of rs4728142, a variant in the promoter among the lowest frequentist probability and highest Bayesian posterior probability, was correlated with IRF5 expression and differentially binds the transcription factor ZBTB3. Our analytical strategy provides a novel framework for future studies aimed at dissecting etiological genetic effects. Finally, both SLE elements of the statistical model appear to operate in Sjögren's syndrome and systemic sclerosis whereas only the IRF5-TNPO3 gene-spanning haplotype is associated with primary biliary cirrhosis, demonstrating the nuance of similarity and difference in autoimmune disease risk mechanisms at IRF5-TNPO3.
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Affiliation(s)
- Leah C Kottyan
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Erin E Zoller
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and
| | - Jessica Bene
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and
| | - Xiaoming Lu
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and
| | - Jennifer A Kelly
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Andrew M Rupert
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher J Lessard
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA Department of Pathology and
| | - Samuel E Vaughn
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and
| | - Miranda Marion
- Department of Biostatistical Sciences and Center for Public Health Genomics and
| | - Matthew T Weirauch
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Bahram Namjou
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and
| | - Adam Adler
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Astrid Rasmussen
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Stuart Glenn
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Courtney G Montgomery
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | | | - Gang Xie
- Mount Sinai Hospital Samuel Lunenfeld Research Institute, Toronto, ON, Canada
| | | | - Chris Amos
- Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - He Li
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA Department of Pathology and
| | - John A Ice
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Swapan K Nath
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Xavier Mariette
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, INSERM U1012, Le Kremlin Bicêtre, France
| | - Simon Bowman
- Rheumatology Department, University Hospital Birmingham, Birmingham, UK
| | | | | | - Sue Lester
- The Queen Elizabeth Hospital, Adelaide, Australia The University of Adelaide, Adelaide, Australia
| | - Johan G Brun
- Institute of Internal Medicine, University of Bergen, Bergen, Norway Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
| | - Lasse G Gøransson
- Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Erna Harboe
- Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Roald Omdal
- Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
| | | | - Tim Vyse
- Department of Medical and Molecular Genetics, King's College London, London, UK
| | - Corinne Miceli-Richard
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, INSERM U1012, Le Kremlin Bicêtre, France
| | - Michael T Brennan
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | | | | | | | - Gabor G Illei
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | | | - Roland Jonsson
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway Broegelmann Research Laboratory, The Gade Institute, University of Bergen, Bergen, Norway
| | - Per Eriksson
- Department of Rheumatology, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Gunnel Nordmark
- Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden
| | - Wan-Fai Ng
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
| | - Nelson L Rhodus
- Department of Oral Surgery, University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Barbara M Segal
- Division of Rheumatology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Joan T Merrill
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Judith A James
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Joel M Guthridge
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - R Hal Scofield
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA Division of Veterans Affairs Medical Center, Oklahoma City, OK, USA Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Marta Alarcon-Riquelme
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA de Genómica e Investigación Oncológica (GENYO), Pfizer-Universidad de Granada-Junta de Andalucia, Granada, Spain
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - Susan A Boackle
- Division of Rheumatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Lindsey A Criswell
- Division of Rheumatology, Rosalind Russell Medical Research Center for Arthritis, University of California San Francisco, San Francisco, CA, USA
| | - Gary Gilkeson
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Diane L Kamen
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Chaim O Jacob
- Divison of Gastrointestinal and Liver Diseases, Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Robert Kimberly
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elizabeth Brown
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey Edberg
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Graciela S Alarcón
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John D Reveille
- Division of Rheumatology and Clinical Immunogenetics, The Univeristy of Texas Health Science Center at Houston, Houston, TX, USA
| | - Luis M Vilá
- University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Michelle Petri
- Division of Rheumatology, Johns Hopkins, Baltimore, MD, USA
| | | | | | - Timothy Niewold
- Division of Rheumatology and Immunology, Mayo Clinic, Rochester, MN, USA
| | - Anne M Stevens
- University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | - Betty P Tsao
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jun Ying
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Maureen D Mayes
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Olga Y Gorlova
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Ward Wakeland
- University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Timothy Radstake
- Department of Rheumatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ezequiel Martin
- Instituto de Parasitología y Biomedicina López Neyra Avda, Granada, Spain and
| | - Javier Martin
- Instituto de Parasitología y Biomedicina López Neyra Avda, Granada, Spain and
| | - Katherine Siminovitch
- Mount Sinai Hospital Samuel Lunenfeld Research Institute, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kathy L Moser Sivils
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Patrick M Gaffney
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Carl D Langefeld
- Department of Biostatistical Sciences and Center for Public Health Genomics and
| | - John B Harley
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Kenneth M Kaufman
- Division of Rheumatology, Center for Autoimmune Genomics and Etiology and US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA
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Current Developments in Pharmacogenomics of Multiple Sclerosis. Cell Mol Neurobiol 2014; 34:1081-5. [DOI: 10.1007/s10571-014-0095-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
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Mahurkar S, Suppiah V, O'Doherty C. Pharmacogenomics of interferon beta and glatiramer acetate response: A review of the literature. Autoimmun Rev 2014; 13:178-86. [DOI: 10.1016/j.autrev.2013.10.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 10/24/2013] [Indexed: 02/07/2023]
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Clark DN, Lambert JP, Till RE, Argueta LB, Greenhalgh KE, Henrie B, Bills T, Hawkley TF, Roznik MG, Sloan JM, Mayhew V, Woodland L, Nelson EP, Tsai MH, Poole BD. Molecular effects of autoimmune-risk promoter polymorphisms on expression, exon choice, and translational efficiency of interferon regulatory factor 5. J Interferon Cytokine Res 2013; 34:354-65. [PMID: 24350899 DOI: 10.1089/jir.2012.0105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The rs2004640 single nucleotide polymorphism and the CGGGG copy-number variant (rs77571059) are promoter polymorphisms within interferon regulatory factor 5 (IRF5). They have been implicated as susceptibility factors for several autoimmune diseases. IRF5 uses alternative promoter splicing, where any of 4 first exons begin the mRNA. The CGGGG indel is in exon 1A's promoter; the rs2004640 allele creates a splicing recognition site, enabling usage of exon 1B. This study aimed at characterizing alterations in IRF5 mRNA due to these polymorphisms. Cells with risk polymorphisms exhibited ~2-fold higher levels of IRF5 mRNA and protein, but demonstrated no change in mRNA stability. Quantitative PCR demonstrated decreased usage of exons 1C and 1D in cell lines with the risk polymorphisms. RNA folding analysis revealed a hairpin in exon 1B; mutational analysis showed that the hairpin shape decreased translation 5-fold. Although translation of mRNA that uses exon 1B is low due to a hairpin, increased IRF5 mRNA levels in individuals with the rs2004640 risk allele lead to higher overall protein expression. In addition, several new splice variants of IRF5 were sequenced. IRF5's promoter polymorphisms alter first exon usage and increase transcription levels. High levels of IRF5 may bias the immune system toward autoimmunity.
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Affiliation(s)
- Daniel N Clark
- Department of Microbiology and Molecular Biology, Brigham Young University , Provo, Utah
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Lindén M, Khademi M, Lima Bomfim I, Piehl F, Jagodic M, Kockum I, Olsson T. Multiple sclerosis risk genotypes correlate with an elevated cerebrospinal fluid level of the suggested prognostic marker CXCL13. Mult Scler 2012; 19:863-70. [DOI: 10.1177/1352458512463482] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: The mechanisms of multiple sclerosis (MS) pathogenesis are still largely unknown. The heterogeneity of disease manifestations make the prediction of prognosis and choice of appropriate treatment protocols challenging. Recently, increased cerebrospinal fluid (CSF) levels of the B-cell chemokine CXCL13 was proposed as a possible marker for a more severe disease course and conversion from clinically isolated syndrome (CIS) to relapsing–remitting MS (RRMS). Objective: To investigate whether there are genetic susceptibility variants in MS that correlate with the levels of CXCL13 present in the CSF of MS patients. Methods: We genotyped the human leukocyte antigens HLA-DRB1 and HLA-A, plus a panel of single nucleotide polymorphisms (SNPs) that have been associated with susceptibility to MS and then correlated the genotypes with the levels of CXCL13, as measured with ELISA in the CSF of a total of 663 patients with MS, CIS, other neurological diseases (OND) or OND with an inflammatory component (iOND). Results: Presence of the HLA-DRB1*15 and the MS risk genotypes for SNPs in the RGS1, IRF5 and OLIG3/TNFAIP3 gene regions correlated significantly with increased levels of CXCL13. Conclusion: Our results pointed towards a genetic predisposition for increased CXCL13 levels, which in MS patients correlates with the severity of the disease course. These findings encourage further investigation and replication, in an independent patient cohort.
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Affiliation(s)
- M Lindén
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - M Khademi
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - I Lima Bomfim
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - F Piehl
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - M Jagodic
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - I Kockum
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - T Olsson
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
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Kulakova OG, Tsareva EY, Boyko AN, Shchur SG, Gusev EI, Lvovs D, Favorov AV, Vandenbroeck K, Favorova OO. Allelic combinations of immune-response genes as possible composite markers of IFN-β efficacy in multiple sclerosis patients. Pharmacogenomics 2012; 13:1689-700. [DOI: 10.2217/pgs.12.161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: IFN-β is widely used as the first-line disease-modifying treatment for multiple sclerosis. However, 30–50% of multiple sclerosis patients do not respond to this therapy. Identification of genetic variants and their combinations that predict responsiveness to IFN-β could be useful for treatment prognosis. Materials & methods: The combinations of alleles of nine polymorphic loci in immune-response genes were analyzed in 253 Russian multiple sclerosis patients as possible determinants of clinically optimal IFN-β treatment response using APSampler software. Results: Carriage of TGFB1*-509C and CCR5*d was associated with favorable IFN-β response by itself. CCR5*d, IFNAR1*16725G, IFNG*874T and IFNB1*153T/T were the components of the combinations, associated with clinically optimal response to IFN-β. Carriage of composite markers (CCR5*d + IFNAR1*G + IFNB1*T/T) or (CCR5*d + IFNAR1*G + IFNG*T) is beneficial for IFN-β treatment efficacy. Discussion: The data obtained provides evidence of the cumulative effect of immune-response genes on IFN-β treatment efficacy. This joint contribution may reflect the additive effect of independent allelic variants and epistatic interactions between some of them. Original submitted 2 July 2012; Revision submitted 21 September 2012
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Affiliation(s)
- Olga G Kulakova
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ekaterina Yu Tsareva
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Cardiology Research & Production Complex, Moscow, Russia
| | - Alexey N Boyko
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
- Moscow City Multiple Sclerosis Center, Moscow, Russia
| | | | - Evgeny I Gusev
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
| | - Dmitrijs Lvovs
- Research Institute for Genetics & Selection of Industrial Microorganisms, Moscow, Russia
| | - Alexander V Favorov
- Research Institute for Genetics & Selection of Industrial Microorganisms, Moscow, Russia
- VIGG RAS, Moscow, Russia
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Koen Vandenbroeck
- University of the Basque Country (UPV/EHU), Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Olga O Favorova
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Cardiology Research & Production Complex, Moscow, Russia
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Abstract
Multiple sclerosis (MS) is a multifocal demyelinating disease with progressive neurodegeneration caused by an autoimmune response to self-antigens in a genetically susceptible individual. While the formation and persistence of meningeal lymphoid follicles suggest persistence of antigens to drive the continuing inflammatory and humoral response, the identity of an antigen or infectious agent leading to the oligoclonal expansion of B and T cells is unknown. In this review we examine new paradigms for understanding the immunopathology of MS, present recent data defining the common genetic variants underlying disease susceptibility, and explore how improved understanding of immune pathway disruption can inform MS prognosis and treatment decisions.
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Affiliation(s)
- Alyssa Nylander
- Department of Neurology and Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut 06520, USA
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Endogenous, or therapeutically induced, type I interferon responses differentially modulate Th1/Th17-mediated autoimmunity in the CNS. Immunol Cell Biol 2012; 90:505-9. [PMID: 22430251 PMCID: PMC3365287 DOI: 10.1038/icb.2012.8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Different viruses trigger pattern recognition receptor systems, such as Toll-like receptors or cytosolic RIG-I like helicases (RLH), and thus induce early type I interferon (IFN-I) responses. Such responses may confer protection until adaptive immunity is activated to an extent that the pathogen can be eradicated. Interestingly, the same innate immune mechanisms that are relevant for early pathogen defense have a role in ameliorating experimental autoimmune encephalomyelitis (EAE), a rodent model of human multiple sclerosis. We and others found that mice devoid of a component of the IFN-I receptor (Ifnar1−/−) showed significantly enhanced autoimmune disease of the central nervous system (CNS). A detailed analysis revealed that in wild-type mice IFN-I triggering of myeloid cells was instrumental in reducing brain damage. A more recent study indicated that similar to Ifnar1−/− mice, RLH-signaling-deficient mice showed enhanced autoimmune disease of the CNS as well. Moreover, when peripherally treated with synthetic RLH ligands wild-type animals with EAE disease showed reduced clinical scores. Under such conditions, IFN-I receptor triggering of dendritic cells had a crucial role. The therapeutic effect of treatment with RLH ligands was associated with negative regulation of Th1 and Th17 T-cell responses within the CNS. These experiments are consistent with the hypothesis that spatiotemporal conditions of, and cell types involved in, disease-ameliorating IFN-I responses differ significantly, depending on whether they were endogenously induced in the context of EAE pathogenesis within the CNS or upon therapeutic RLH triggering in the periphery. It is attractive to speculate that RLH triggering represents a new strategy to treat multiple sclerosis by stimulating endogenous immunoregulatory IFN-I responses.
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Pharmacogenomics and multiple sclerosis: moving toward individualized medicine. Curr Neurol Neurosci Rep 2012; 11:484-91. [PMID: 21701907 DOI: 10.1007/s11910-011-0211-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Notwithstanding the availability of disease-modifying treatments including interferon-β, glatiramer acetate, and natalizumab, a considerable proportion of multiple sclerosis (MS) patients experience continued progression of disease, clinical relapses, disease activity on MRI, and adverse effects. Application of gene expression, proteomic or genomic approaches is universally accepted as a suitable strategy toward the identification of biomarkers with predictive value for beneficial/poor clinical response to therapy and treatment risks. This review focuses on recent progress in research on the pharmacogenomics of disease-modifying therapies for MS. Although MS drug response biomarkers are not yet routinely implemented in the clinic, the diversity of reported, promising molecular markers is rapidly increasing. Even though most of these markers await further validation, given time, this research is likely to empower neurologists with an enhanced armamentarium to facilitate rational decisions on therapy and patient management.
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