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Fan W, Li Z, Wang Y, Zhang C, Liu H, Wang D, Bai Y, Luo S, Li Y, Qin Q, Chen W, Yong L, Zhen Q, Yu Y, Ge H, Mao Y, Cao L, Zhang R, Hu X, Yu Y, Li B, Sun L. Imputation of the major histocompatibility complex region identifies major independent variants associated with bullous pemphigoid and dermatomyositis in Han Chinese. J Dermatol 2022; 49:998-1004. [PMID: 35751838 DOI: 10.1111/1346-8138.16499] [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: 01/08/2022] [Revised: 04/29/2022] [Accepted: 06/05/2022] [Indexed: 11/27/2022]
Abstract
As autoimmune skin diseases, both bullous pemphigoid (BP) and dermatomyositis (DM) show significant associations with the major histocompatibility complex (MHC) region. In fact, the coexistence of BP and DM has been previously reported. Therefore, we hypothesized that there may be a potential genetic correlation between BP and DM. Based on data for 312 BP patients, 128 DM patients, and 6793 healthy control subjects, in the MHC region, we imputed single-nucleotide polymorphisms (SNP), insertions and deletions (INDEL), and copy number variations (CNV) using the 1KGP phase 3 dataset and amino acids (AA) and SNP using a Han-MHC reference database. An association study revealed the most significant SNP associated with BP, namely, rs580921 (p = 1.06E-08, odds ratio [OR] = 1.61, 95% confidence interval [CI] = 1.37-1.90), which is located in the C6orf10 gene, and the most significant classic human leukocyte antigen (HLA) allele associated with DM, namely, HLA-DPB1*1701 (p = 6.56E-10, OR = 3.61, 95% CI = 2.40-5.42). Further stepwise regression analyses with rs580921 identified a threonine at position 163 of the HLA-B gene as a new independent disease-associated AA, and HLA-DPB1*1701 indicated that no loci were significant. Three-dimensional ribbon models revealed that the HLA-B AA position 163 (p = 3.93E-07, OR = 1.64, 95% CI = 1.35-1.98) located in the α2 domain of the HLA-B molecule was involved in the process of specific antigen presentation. The calculations showed that there was no significant genetic correlation between BP and DM. Our study identified three significant loci in the MHC region, proving that the HLA region was significantly correlated with BP and DM separately. Our research highlights the key role of the MHC region in disease susceptibility.
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Affiliation(s)
- Wencheng Fan
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Zhuo Li
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yirui Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Chang Zhang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Hao Liu
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Daiyue Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yuanming Bai
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Sihan Luo
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yuanyuan Li
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Qin Qin
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Weiwei Chen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Liang Yong
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Qi Zhen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yafen Yu
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Huiyao Ge
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yiwen Mao
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Lu Cao
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Ruixue Zhang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Xia Hu
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yanxia Yu
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Bao Li
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,The Comprehensive Lab, College of Basic Medicine, Anhui Medical University, Hefei, China
| | - Liangdan Sun
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
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Ono R, Kumagae T, Igasaki M, Murata T, Yoshizawa M, Kitagawa I. Anti-transcription intermediary factor 1 gamma (TIF1γ) antibody-positive dermatomyositis associated with ascending colon cancer: a case report and review of the literature. J Med Case Rep 2021; 15:142. [PMID: 33745453 PMCID: PMC7983382 DOI: 10.1186/s13256-021-02664-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/06/2021] [Indexed: 01/15/2023] Open
Abstract
Background Anti-transcriptional intermediary factor 1 gamma (TIF1γ) antibody is a marker for predicting cancer association in patients with dermatomyositis (DM). The overall survival rate in DM patients with cancer was reported to be considerably worse than that in DM patients without cancer. However, the treatment for cancer-associated DM remains controversial, because the treatment priority between surgical resection for the tumor and internal treatments, including glucocorticoids, immunosuppressive agents, and intravenous immune globulin, has not been established. Case presentation We report the case of a 57-year-old Japanese man diagnosed with anti-TIF1γ antibody-positive DM associated with ascending colon cancer. His clinical symptoms included facial and brachial edema, muscle weakness, dysphagia, myalgia, and rash. Physical examination revealed periorbital edema and Gottron's papules over his knuckles with brachial edema, and tenderness and weakness of the proximal limb muscles. The findings of hyperintense muscles in T2-weighted sequences of brachial contrast-enhanced magnetic resonance imaging and the infiltration of lymphocytic cells and CD4-positive lymphocytes from muscle biopsy were compatible with the diagnostic criteria for dermatomyositis. Anti-TIF1γ antibody was positive by immunoprecipitation assay. He first started internal treatment including intravenous immunoglobulin, steroid pulse, prednisolone, and azathioprine, followed by surgical resection for the tumor because of the elevation of creatine kinase and progression of dysphagia. However, clinical symptoms did not improve, and the patient died 6 months later. Conclusions We faced difficulties in determining the treatment priority between surgical resection and internal treatment for our case; therefore, this case would be educational for readers. We searched PubMed to identify English-language case reports of anti-TIF1γ antibody-positive dermatomyositis with malignancy and found 21 reported cases. We herein review and summarize previously reported cases of anti-TIF1γ antibody-positive DM with malignancy. Cancer screening is essential in patients with anti-TIF1γ antibody-positive dermatomyositis because it is associated with a high prevalence of malignancies. Our review revealed that initial surgical treatment should be recommended for better prognosis if the general condition allows.
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Affiliation(s)
- Ryohei Ono
- Department of General Internal Medicine, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan.
| | - Tomohiro Kumagae
- Department of General Internal Medicine, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Mari Igasaki
- Department of General Internal Medicine, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Takaaki Murata
- Department of Surgery, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Masaki Yoshizawa
- Department of Rheumatology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Izumi Kitagawa
- Department of General Internal Medicine, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
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