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Goodin DS, Khankhanian P, Gourraud PA, Vince N. Multiple sclerosis: Exploring the limits and implications of genetic and environmental susceptibility. PLoS One 2023; 18:e0285599. [PMID: 37379505 DOI: 10.1371/journal.pone.0285599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/27/2023] [Indexed: 06/30/2023] Open
Abstract
OBJECTIVE To explore and describe the basis and implications of genetic and environmental susceptibility to multiple sclerosis (MS) using the Canadian population-based data. BACKGROUND Certain parameters of MS-epidemiology are directly observable (e.g., the recurrence-risk of MS in siblings and twins, the proportion of women among MS patients, the population-prevalence of MS, and the time-dependent changes in the sex-ratio). By contrast, other parameters can only be inferred from the observed parameters (e.g., the proportion of the population that is "genetically susceptible", the proportion of women among susceptible individuals, the probability that a susceptible individual will experience an environment "sufficient" to cause MS, and if they do, the probability that they will develop the disease). DESIGN/METHODS The "genetically susceptible" subset (G) of the population (Z) is defined to include everyone with any non-zero life-time chance of developing MS under some environmental conditions. The value for each observed and non-observed epidemiological parameter is assigned a "plausible" range. Using both a Cross-sectional Model and a Longitudinal Model, together with established parameter relationships, we explore, iteratively, trillions of potential parameter combinations and determine those combinations (i.e., solutions) that fall within the acceptable range for both the observed and non-observed parameters. RESULTS Both Models and all analyses intersect and converge to demonstrate that probability of genetic-susceptibitly, P(G), is limited to only a fraction of the population {i.e., P(G) ≤ 0.52)} and an even smaller fraction of women {i.e., P(G│F) < 0.32)}. Consequently, most individuals (particularly women) have no chance whatsoever of developing MS, regardless of their environmental exposure. However, for any susceptible individual to develop MS, requires that they also experience a "sufficient" environment. We use the Canadian data to derive, separately, the exponential response-curves for men and women that relate the increasing likelihood of developing MS to an increasing probability that a susceptible individual experiences an environment "sufficient" to cause MS. As the probability of a "sufficient" exposure increases, we define, separately, the limiting probability of developing MS in men (c) and women (d). These Canadian data strongly suggest that: (c < d ≤ 1). If so, this observation establishes both that there must be a "truly" random factor involved in MS pathogenesis and that it is this difference, rather than any difference in genetic or environmental factors, which primarily accounts for the penetrance difference between women and men. CONCLUSIONS The development of MS (in an individual) requires both that they have an appropriate genotype (which is uncommon in the population) and that they have an environmental exposure "sufficient" to cause MS given their genotype. Nevertheless, the two principal findings of this study are that: P(G) ≤ 0.52)} and: (c < d ≤ 1). Threfore, even when the necessary genetic and environmental factors, "sufficient" for MS pathogenesis, co-occur for an individual, they still may or may not develop MS. Consequently, disease pathogenesis, even in this circumstance, seems to involve an important element of chance. Moreover, the conclusion that the macroscopic process of disease development for MS includes a "truly" random element, if replicated (either for MS or for other complex diseases), provides empiric evidence that our universe is non-deterministic.
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Affiliation(s)
- Douglas S Goodin
- Department of Neurology, San Francisco & the San Francisco VA Medical Center, University of California, San Francisco, San Francisco, California, United States of Ameirca
| | - Pouya Khankhanian
- Kaiser Permanente, Walnut Creek Medical Center, Dublin, California, United States of Ameirca
| | - Pierre-Antoine Gourraud
- Center for Neuro-Engineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of Ameirca
| | - Nicolas Vince
- INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, Nantes, France
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Alsharidah MM, Uzair M, Alseneidi SS, Alkharan AA, Bunyan RF, Bashir S. The Role of Transcranial Magnetic Stimulation as a Surrogate Marker of Disease Activity in Patients with Multiple Sclerosis: A Literature Review. INNOVATIONS IN CLINICAL NEUROSCIENCE 2022; 19:8-14. [PMID: 35382066 PMCID: PMC8970240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Multiple sclerosis (MS) is a chronic, immune-mediated inflammatory disease of the central nervous system (CNS) characterized by demyelination, axonal degeneration, and cognitive impairment. It also has an important impact on the quality of life of patients and their family members. We sought to determine if transcranial magnetic stimulation (TMS) is a valid instrument for determining disease progression activity in patients with MS. METHODS A literature search of the PubMed database was conducted using the terms "multiple sclerosis," "transcranial magnetic stimulation," and "neurophysiological parameters." RESULTS Neurophysiological parameters, such as sensitivity to demyelination and the strength of excitatory and inhibitory synaptic interactions in the cerebral cortex, can be identified through TMS in patients affected by MS. These objective parameters can be correlated with the progression of disease and provide reliable indices for the severity of illness and the efficacy of drugs used to treat MS in clinical trials. CONCLUSION The discovery of specific and detailed neurophysiological parameters as surrogate endpoints for disease activity could represent an important step in clinical trials. Changes in cortical connectivity have already been demonstrated in MS, but in clinical practice, other measures are typically used to evaluate disease activity. We speculate that TMS might be more effective in identifying disease progression that leads to long-term disability, compared to standard surrogate markers, since it represents a direct measure of synaptic transmission(s) in MS.
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Affiliation(s)
- Muhannad M Alsharidah
- Drs. Alsharidah and Alseneidi are with the College of Medicine, King Saud University in Riyadh, Saudi Arabia
- Mr. Uzair is with the Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University in Islamabad, Pakistan
- Dr. Alkharan is with the College of Medicine, Princess Nourah Bint Abdulrahman University in Riyadh, Saudi Arabia
- Drs. Bunyan and Bashir are with the Neuroscience Center, King Fahad Specialist Hospital in Dammam, Saudi Arabia
| | - Mohammad Uzair
- Drs. Alsharidah and Alseneidi are with the College of Medicine, King Saud University in Riyadh, Saudi Arabia
- Mr. Uzair is with the Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University in Islamabad, Pakistan
- Dr. Alkharan is with the College of Medicine, Princess Nourah Bint Abdulrahman University in Riyadh, Saudi Arabia
- Drs. Bunyan and Bashir are with the Neuroscience Center, King Fahad Specialist Hospital in Dammam, Saudi Arabia
| | - Sarah S Alseneidi
- Drs. Alsharidah and Alseneidi are with the College of Medicine, King Saud University in Riyadh, Saudi Arabia
- Mr. Uzair is with the Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University in Islamabad, Pakistan
- Dr. Alkharan is with the College of Medicine, Princess Nourah Bint Abdulrahman University in Riyadh, Saudi Arabia
- Drs. Bunyan and Bashir are with the Neuroscience Center, King Fahad Specialist Hospital in Dammam, Saudi Arabia
| | - Afnan A Alkharan
- Drs. Alsharidah and Alseneidi are with the College of Medicine, King Saud University in Riyadh, Saudi Arabia
- Mr. Uzair is with the Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University in Islamabad, Pakistan
- Dr. Alkharan is with the College of Medicine, Princess Nourah Bint Abdulrahman University in Riyadh, Saudi Arabia
- Drs. Bunyan and Bashir are with the Neuroscience Center, King Fahad Specialist Hospital in Dammam, Saudi Arabia
| | - Reem Fahd Bunyan
- Drs. Alsharidah and Alseneidi are with the College of Medicine, King Saud University in Riyadh, Saudi Arabia
- Mr. Uzair is with the Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University in Islamabad, Pakistan
- Dr. Alkharan is with the College of Medicine, Princess Nourah Bint Abdulrahman University in Riyadh, Saudi Arabia
- Drs. Bunyan and Bashir are with the Neuroscience Center, King Fahad Specialist Hospital in Dammam, Saudi Arabia
| | - Shahid Bashir
- Drs. Alsharidah and Alseneidi are with the College of Medicine, King Saud University in Riyadh, Saudi Arabia
- Mr. Uzair is with the Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University in Islamabad, Pakistan
- Dr. Alkharan is with the College of Medicine, Princess Nourah Bint Abdulrahman University in Riyadh, Saudi Arabia
- Drs. Bunyan and Bashir are with the Neuroscience Center, King Fahad Specialist Hospital in Dammam, Saudi Arabia
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The HLA-G Immune Checkpoint Plays a Pivotal Role in the Regulation of Immune Response in Autoimmune Diseases. Int J Mol Sci 2021; 22:ijms222413348. [PMID: 34948145 PMCID: PMC8706866 DOI: 10.3390/ijms222413348] [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: 10/31/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 12/11/2022] Open
Abstract
The human G-leukocyte antigen (HLA-G) molecule is a non-classical major histocompatibility complex (MHC) class I molecule. The pertinence of HLA-G has been investigated in numerous studies which have sought to elucidate the relevance of HLA-G in pathologic conditions, such as autoimmune diseases, cancers, and hematologic malignancies. One of the main goals of the current research on HLA-G is to use this molecule in clinical practice, either in diagnostics or as a therapeutic target. Since HLA-G antigens are currently considered as immunomodulatory molecules that are involved in reducing inflammatory and immune responses, in this review, we decided to focus on this group of antigens as potential determinants of progression in autoimmune diseases. This article highlights what we consider as recent pivotal findings on the immunomodulatory function of HLA-G, not only to establish the role of HLA-G in the human body, but also to explain how these proteins mediate the immune response.
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Genetic susceptibility to multiple sclerosis in African Americans. PLoS One 2021; 16:e0254945. [PMID: 34370753 PMCID: PMC8352072 DOI: 10.1371/journal.pone.0254945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/06/2021] [Indexed: 12/26/2022] Open
Abstract
Objective To explore the nature of genetic-susceptibility to multiple sclerosis (MS) in African-Americans. Background Recently, the number of genetic-associations with MS has exploded although the MS-associations of specific haplotypes within the major histocompatibility complex (MHC) have been known for decades. For example, the haplotypes HLA-DRB1*15:01~HLA-DQB1*06:02, and HLA-DRB1*03:01~ HLA-DQB1*02:01 have odds ratios (ORs) for an MS-association orders of magnitude stronger than many of these newly-discovered associations. Nevertheless, all these haplotypes are part of much larger conserved extended haplotypes (CEHs), which span both the Class I and Class II MHC regions. African-Americans are at greater risk of developing MS compared to a native Africans but at lesser risk compared to Europeans. It is the purpose of this manuscript to explore the relationship between MS-susceptibility and the CEH make-up of our African-American cohort. Design/methods The African-American (AA) cohort consisted of 1,305 patients with MS and 1,155 controls, who self-identified as being African-American. For comparison, we used the 18,492 controls and 11,144 MS-cases from the predominantly European Wellcome Trust Case Control Consortium (WTCCC) and the 28,557 phased native Africans from the multinational “Be the Match” registry. The WTCCC and the African-Americans were phased at each of five HLA loci (HLA-A, HLA-C, HLA-B, HLA-DRB1 and HLA-DQB1) and the at 11 SNPs (10 of which were in non-coding regions) surrounding the Class II region of the DRB1 gene using previously-published probabilistic phasing algorithms. Results Of the 32 most frequent CEHs, 18 (56%) occurred either more frequently or exclusively in Africans) whereas 9 (28%) occurred more frequently or exclusively in Europeans. The remaining 5 CEHs occurred in neither control group although, likely, these were African in origin. Eight of these CEHs carried the DRB1*15:03~DQB1*06:02~a36 haplotype and three carried the DRB1*15:01~DQB1*06:02~a1 haplotype. In African Americans, a single-copy of the European CEH (03:01_07:02_07:02_15:01_06:02_a1) was associated with considerable MS-risk (OR = 3.30; p = 0.0001)–similar to that observed in the WTCCC (OR = 3.25; p<10−168). By contrast, the MS-risk for the European CEH (02:01_07:02_07:02_15:01_06:02_a1) was less (OR = 1.49; ns)–again, similar to the WTCCC (OR = 2.2; p<10−38). Moreover, four African haplotypes were “protective” relative to a neutral reference, to three European CEHs, and also to the five other African CEHs. Conclusions The common CEHs in African Americans are divisible into those that are either African or European in origin, which are derived without modification from their source population. European CEHs, linked to MS-risk, in general, had similar impacts in African-Americans as they did in Europeans. By contrast, African CEHs had mixed MS-risks. For a few, the MS-risk exceeded that in a neutral-reference group whereas, for many others, these CEHs were “protective”–perhaps providing a partial rationale for the lower MS-risk in African-Americans compared to European-Americans.
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Genetic susceptibility to multiple sclerosis: interactions between conserved extended haplotypes of the MHC and other susceptibility regions. BMC Med Genomics 2021; 14:183. [PMID: 34246256 PMCID: PMC8272333 DOI: 10.1186/s12920-021-01018-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background To study the accumulation of MS-risk resulting from different combinations of MS-associated conserved-extended-haplotypes (CEHs) of the MHC and three non-MHC “risk-haplotypes” nearby genes EOMES, ZFP36L1, and CLEC16A. Many haplotypes are MS-associated despite having population-frequencies exceeding the percentage of genetically-susceptible individuals. The basis of this frequency-disparity requires explanation. Methods The SNP-data from the WTCCC was phased at the MHC and three non-MHC susceptibility-regions. CEHs at the MHC were classified into five haplotype-groups: (HLA-DRB1*15:01 ~ DQB1*06:02 ~ a1)-containing (H +); extended-risk (ER); all-protective (AP); neutral (0); and the single-CEH (c1). MS-associations for different “risk-combinations” at the MHC and other non-MHC “risk-loci” and the appropriateness of additive and multiplicative risk-accumulation models were assessed. Results Different combinations of “risk-haplotypes” produce a final MS-risk closer to additive rather than multiplicative risk-models but neither model was consistent. Thus, (H +)-haplotypes had greater impact when combined with (0)-haplotypes than with (H +)-haplotypes, whereas, (H +)-haplotypes had greater impact when combined with a (c1)-haplotypes than with (0)-haplotypes. Similarly, risk-genotypes (0,H +), (c1,H +), (H + ,H +) and (0,c1) were additive with risks from non-MHC risk-loci, whereas risk-genotypes (ER,H +) and (AP,c1) were unaffected. Conclusions Genetic-susceptibility to MS is essential for MS to develop but actually developing MS depends heavily upon both an individual’s particular combination of “risk-haplotypes” and how these loci interact. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-01018-6.
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Goodin DS, Khankhanian P, Gourraud PA, Vince N. The nature of genetic and environmental susceptibility to multiple sclerosis. PLoS One 2021; 16:e0246157. [PMID: 33750973 PMCID: PMC7984655 DOI: 10.1371/journal.pone.0246157] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 01/15/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To understand the nature of genetic and environmental susceptibility to multiple sclerosis (MS) and, by extension, susceptibility to other complex genetic diseases. BACKGROUND Certain basic epidemiological parameters of MS (e.g., population-prevalence of MS, recurrence-risks for MS in siblings and twins, proportion of women among MS patients, and the time-dependent changes in the sex-ratio) are well-established. In addition, more than 233 genetic-loci have now been identified as being unequivocally MS-associated, including 32 loci within the major histocompatibility complex (MHC), and one locus on the X chromosome. Despite this recent explosion in genetic associations, however, the association of MS with the HLA-DRB1*15:01~HLA-DQB1*06:02~a1 (H+) haplotype has been known for decades. DESIGN/METHODS We define the "genetically-susceptible" subset (G) to include everyone with any non-zero life-time chance of developing MS. Individuals who have no chance of developing MS, regardless of their environmental experiences, belong to the mutually exclusive "non-susceptible" subset (G-). Using these well-established epidemiological parameters, we analyze, mathematically, the implications that these observations have regarding the genetic-susceptibility to MS. In addition, we use the sex-ratio change (observed over a 35-year interval in Canada), to derive the relationship between MS-probability and an increasing likelihood of a sufficient environmental exposure. RESULTS We demonstrate that genetic-susceptibitly is confined to less than 7.3% of populations throughout Europe and North America. Consequently, more than 92.7% of individuals in these populations have no chance whatsoever of developing MS, regardless of their environmental experiences. Even among carriers of the HLA-DRB1*15:01~HLA-DQB1*06:02~a1 haplotype, far fewer than 32% can possibly be members the (G) subset. Also, despite the current preponderance of women among MS patients, women are less likely to be in the susceptible (G) subset and have a higher environmental threshold for developing MS compared to men. Nevertheless, the penetrance of MS in susceptible women is considerably greater than it is in men. Moreover, the response-curves for MS-probability in susceptible individuals increases with an increasing likelihood of a sufficient environmental exposure, especially among women. However, these environmental response-curves plateau at under 50% for women and at a significantly lower level for men. CONCLUSIONS The pathogenesis of MS requires both a genetic predisposition and a suitable environmental exposure. Nevertheless, genetic-susceptibility is rare in the population (< 7.3%) and requires specific combinations of non-additive genetic risk-factors. For example, only a minority of carriers of the HLA-DRB1*15:01~HLA-DQB1*06:02~a1 haplotype are even in the (G) subset and, thus, genetic-susceptibility to MS in these carriers must result from the combined effect this haplotype together with the effects of certain other (as yet, unidentified) genetic factors. By itself, this haplotype poses no MS-risk. By contrast, a sufficient environmental exposure (however many events are involved, whenever these events need to act, and whatever these events might be) is common, currently occurring in, at least, 76% of susceptible individuals. In addition, the fact that environmental response-curves plateau well below 50% (especially in men), indicates that disease pathogenesis is partly stochastic. By extension, other diseases, for which monozygotic-twin recurrence-risks greatly exceed the disease-prevalence (e.g., rheumatoid arthritis, diabetes, and celiac disease), must have a similar genetic basis.
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Affiliation(s)
- Douglas S. Goodin
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States of America
| | - Pouya Khankhanian
- Center for Neuro-Engineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Pierre-Antoine Gourraud
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States of America
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Nicolas Vince
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
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Gröger V, Emmer A, Staege MS, Cynis H. Endogenous Retroviruses in Nervous System Disorders. Pharmaceuticals (Basel) 2021; 14:ph14010070. [PMID: 33467098 PMCID: PMC7829834 DOI: 10.3390/ph14010070] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
Human endogenous retroviruses (HERV) have been implicated in the pathogenesis of several nervous system disorders including multiple sclerosis and amyotrophic lateral sclerosis. The toxicity of HERV-derived RNAs and proteins for neuronal cells has been demonstrated. The involvement of HERV in the pathogenesis of currently incurable diseases might offer new treatment strategies based on the inhibition of HERV activities by small molecules or therapeutic antibodies.
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Affiliation(s)
- Victoria Gröger
- Department of Drug Design and Target Validation, Fraunhofer Institute for Cell Therapy and Immunology, 06120 Halle (Saale), Germany;
| | - Alexander Emmer
- Department of Neurology, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany;
| | - Martin S. Staege
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
- Correspondence: (M.S.S.); (H.C.); Tel.: +49-345-557-7280 (M.S.S.); +49-345-13142835 (H.C.)
| | - Holger Cynis
- Department of Drug Design and Target Validation, Fraunhofer Institute for Cell Therapy and Immunology, 06120 Halle (Saale), Germany;
- Correspondence: (M.S.S.); (H.C.); Tel.: +49-345-557-7280 (M.S.S.); +49-345-13142835 (H.C.)
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Urbaneja P, Hurtado-Guerrero I, Hernández MÁ, Oliver-Martos B, Oreja-Guevara C, Ortega-Pinazo J, Alonso A, Barón-López FJ, Leyva L, Fernández Ó, Pinto-Medel MJ. Skin Phototype Could Be a Risk Factor for Multiple Sclerosis. J Clin Med 2020; 9:jcm9082384. [PMID: 32722577 PMCID: PMC7464407 DOI: 10.3390/jcm9082384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022] Open
Abstract
Environmental and genetic factors are assumed to be necessary for the development of multiple sclerosis (MS), however its interactions are still unclear. For this reason here, we have not only analyzed the impact on increased risk of MS of the best known factors (HLA-DRB1*15:01 allele, sun exposure, vitamin D levels, smoking habit), but we have included another factor (skin phototype) that has not been analyzed in depth until now. This study included 149 MS patients and 147 controls. A multivariate logistic regression (LR) model was carried out to determine the impact of each of the factors on the increased risk of MS. Receiver Operating Characteristics (ROC) analysis was performed to evaluate predictive value of the models. Our multifactorial LR model of susceptibility showed that females with light brown skin (LBS), smokers and who had HLA-DRB1*15:01 allele had a higher MS risk (LBS: OR = 5.90, IC95% = 2.39–15.45; smoker: OR = 4.52, IC95% = 2.69–7.72; presence of HLA-DRB1*15:01: OR = 2.39, IC95% = 1.30–4.50; female: OR = 1.88, IC95% = 1.08–3.30). This model had an acceptable discriminant value with an Area Under a Curve AUC of 0.76 (0.69–0.82). Our study indicates that MS risk is determined by complex interactions between sex, environmental factors, and genotype where the milieu could provide the enabling proinflammatory environment that drives an autoimmune attack against myelin by self-reactive lymphocytes.
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Affiliation(s)
- Patricia Urbaneja
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Isaac Hurtado-Guerrero
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Miguel Ángel Hernández
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
- Unit of Multiple Sclerosis, Department of Neurology, Hospital Universitario Ntra. Sra. de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Begoña Oliver-Martos
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Celia Oreja-Guevara
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
- Department of Neurology, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid (UCM), IdISSC, 28040 Madrid, Spain
| | - Jesús Ortega-Pinazo
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Ana Alonso
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Francisco J Barón-López
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- Unit of Biostatistics, Deparment of Public Health, Faculty of Medicine, University of Malaga, 29010 Málaga, Spain
- Department of Nursing, Faculty of Health Sciences, University of Malaga, 29010 Málaga, Spain
| | - Laura Leyva
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Óscar Fernández
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- Department of Pharmacology, Faculty of Medicine, University of Malaga, 29010 Málaga, Spain
- Correspondence: (Ó.F.); (M.J.P.-M.)
| | - María Jesús Pinto-Medel
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
- Correspondence: (Ó.F.); (M.J.P.-M.)
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9
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Maghbooli Z, Sahraian MA, Naser Moghadasi A. Multiple sclerosis and human leukocyte antigen genotypes: Focus on the Middle East and North Africa region. Mult Scler J Exp Transl Clin 2020; 6:2055217319881775. [PMID: 31976083 PMCID: PMC6956601 DOI: 10.1177/2055217319881775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/05/2019] [Accepted: 09/18/2019] [Indexed: 01/13/2023] Open
Abstract
Recent reports have demonstrated that the prevalence of multiple sclerosis (MS) is increasing in the Middle East and North Africa region. There is also emerging evidence regarding the genetic components of MS risk. This review provides an overview of the role of genetic factors in MS susceptibility by examining human leukocyte antigen loci in patients within the Middle East and North Africa region. Most of the genetic studies conducted in the Middle East and North Africa region have been based on case–control designs, which cannot confirm direct causality of genetic variants on MS susceptibility. Moreover, there are very limited and inconsistent studies on human leukocyte antigen class I and II (DQA and DQB) in MS patients of the Middle East and North Africa region. To identify common risk haplotypes in the Middle East and North Africa region or its sub-populations, further longitudinal studies will be required.
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Affiliation(s)
| | | | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Iran
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10
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Nordin J, Ameur A, Lindblad-Toh K, Gyllensten U, Meadows JRS. SweHLA: the high confidence HLA typing bio-resource drawn from 1000 Swedish genomes. Eur J Hum Genet 2019; 28:627-635. [PMID: 31844174 PMCID: PMC7170882 DOI: 10.1038/s41431-019-0559-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/12/2019] [Accepted: 11/26/2019] [Indexed: 11/10/2022] Open
Abstract
There is a need to accurately call human leukocyte antigen (HLA) genes from existing short-read sequencing data, however there is no single solution that matches the gold standard of Sanger sequenced lab typing. Here we aimed to combine results from available software programs, minimizing the biases of applied algorithm and HLA reference. The result is a robust HLA population resource for the published 1000 Swedish genomes, and a framework for future HLA interrogation. HLA 2nd-field alleles were called using four imputation and inference methods for the classical eight genes (class I: HLA-A, HLA-B, HLA-C; class II: HLA-DPA1, HLA-DPB1, HLA-DQA1, HLA-DQB1, HLA-DRB1). A high confidence population set (SweHLA) was determined using an n−1 concordance rule for class I (four software) and class II (three software) alleles. Results were compared across populations and individual programs benchmarked to SweHLA. Per gene, 875 to 988 of the 1000 samples were genotyped in SweHLA; 920 samples had at least seven loci called. While a small fraction of reference alleles were common to all software (class I = 1.9% and class II = 4.1%), this did not affect the overall call rate. Gene-level concordance was high compared to European populations (>0.83%), with COX and PGF the dominant SweHLA haplotypes. We noted that 15/18 discordant alleles (delta allele frequency >2) were previously reported as disease-associated. These differences could in part explain across-study genetic replication failures, reinforcing the need to use multiple software solutions. SweHLA demonstrates a way to use existing NGS data to generate a population resource agnostic to individual HLA software biases.
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Affiliation(s)
- Jessika Nordin
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
| | - Adam Ameur
- Science for Life Laboratory, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kerstin Lindblad-Toh
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ulf Gyllensten
- Science for Life Laboratory, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Jennifer R S Meadows
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
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11
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Abstract
OBJECTIVE In a previous pilot monocentric study, we investigated the relation between human leukocyte antigen (HLA) genotype and multiple sclerosis (MS) disease progression over 2 years. HLA-A*02 allele was correlated with better outcomes, whereas HLA-B*07 and HLA-B*44 were correlated with worse outcomes. The objective of this extension study was to further investigate the possible association of HLA genotype with disease status and progression in MS as measured by sensitive and complex clinical and imaging parameters. METHODS Hundred and forty-six MS patients underwent HLA typing. Over a 4-year period of follow-up, we performed three clinical and magnetic resonance imaging (MRI) assessments per patient, which respectively included Expanded Disability Status Scale, Multiple Sclerosis Severity Scale, Timed-25-Foot-Walk, 9-Hole Peg Test, Symbol Digit Modalities Test, Brief Visual Memory Test, California Verbal Learning Test-II, and whole-brain atrophy, fluid-attenuated inversion recovery (FLAIR) lesion volume change and number of new FLAIR lesions using icobrain. We then compared the clinical and MRI outcomes between predefined HLA patient groups. RESULTS Results of this larger study with a longer follow-up are in line with what we have previously shown. HLA-A*02 allele is associated with potentially better MS outcomes, whereas HLA-B*07, HLA-B*44, HLA-B*08, and HLA-DQB1*06 with a potential negative effect. Results for HLA-DRB1*15 are inconclusive. CONCLUSION In the era of MS treatment abundance, HLA genotype might serve as an early biomarker for MS outcomes to inform individualized treatment decisions.
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12
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Terao C, Brynedal B, Chen Z, Jiang X, Westerlind H, Hansson M, Jakobsson PJ, Lundberg K, Skriner K, Serre G, Rönnelid J, Mathsson-Alm L, Brink M, Dahlqvist SR, Padyukov L, Gregersen PK, Barton A, Alfredsson L, Klareskog L, Raychaudhuri S. Distinct HLA Associations with Rheumatoid Arthritis Subsets Defined by Serological Subphenotype. Am J Hum Genet 2019; 105:616-624. [PMID: 31474319 PMCID: PMC6731376 DOI: 10.1016/j.ajhg.2019.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 07/29/2019] [Indexed: 01/12/2023] Open
Abstract
Rheumatoid arthritis (RA) is the most common immune-mediated arthritis. Anti-citrullinated peptide antibodies (ACPA) are highly specific to RA and assayed with the commercial CCP2 assay. Genetic drivers of RA within the MHC are different for CCP2-positive and -negative subsets of RA, particularly at HLA-DRB1. However, aspartic acid at amino acid position 9 in HLA-B (Bpos-9) increases risk to both RA subsets. Here we explore how individual serologies associated with RA drive associations within the MHC. To define MHC differences for specific ACPA serologies, we quantified a total of 19 separate ACPAs in RA-affected case subjects from four cohorts (n = 6,805). We found a cluster of tightly co-occurring antibodies (canonical serologies, containing CCP2), along with several independently expressed antibodies (non-canonical serologies). After imputing HLA variants into 6,805 case subjects and 13,467 control subjects, we tested associations between the HLA region and RA subgroups based on the presence of canonical and/or non-canonical serologies. We examined CCP2(+) and CCP2(−) RA-affected case subjects separately. In CCP2(−) RA, we observed that the association between CCP2(−) RA and Bpos-9 was derived from individuals who were positive for non-canonical serologies (omnibus_p = 9.2 × 10−17). Similarly, we observed in CCP2(+) RA that associations between subsets of CCP2(+) RA and Bpos-9 were negatively correlated with the number of positive canonical serologies (p = 0.0096). These findings suggest unique genetic characteristics underlying fine-specific ACPAs, suggesting that RA may be further subdivided beyond simply seropositive and seronegative.
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13
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Extracellular vesicle fibrinogen induces encephalitogenic CD8+ T cells in a mouse model of multiple sclerosis. Proc Natl Acad Sci U S A 2019; 116:10488-10493. [PMID: 31068461 PMCID: PMC6535008 DOI: 10.1073/pnas.1816911116] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In this report, we show that fibrinogen, identified by proteomics to be present in blood plasma extracellular vesicles (EVs), is sufficient and required for autoimmune-mediated spontaneous relapsing disease activity in a murine model of multiple sclerosis (MS). Unique to this model is that plasma EVs induced CD8-mediated disease. Analysis of human plasma EVs identified fibrinogen in MS patient samples, thereby providing a compelling translational association between our experimental findings and the perpetuation of CD8-mediated autoimmunity in human MS. Hence, these findings provide evidence for EVs as means by which to model an important aspect of spontaneous CD8+ T cell development related to autoimmunity in MS. Extracellular vesicles (EVs) are emerging as potent mediators of intercellular communication with roles in inflammation and disease. In this study, we examined the role of EVs from blood plasma (pEVs) in an experimental autoimmune encephalomyelitis mouse model of central nervous system demyelination. We determined that pEVs induced a spontaneous relapsing−remitting disease phenotype in MOG35–55-immunized C57BL/6 mice. This modified disease phenotype was found to be driven by CD8+ T cells and required fibrinogen in pEVs. Analysis of pEVs from relapsing−remitting multiple sclerosis patients also identified fibrinogen as a significant portion of pEV cargo. Together, these data suggest that fibrinogen in pEVs contributes to the perpetuation of neuroinflammation and relapses in disease.
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14
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Tamouza R, Oliveira J, Etain B, Bengoufa D, Hamdani N, Manier C, Mariaselvam C, Sundaresh A, Bellivier F, Henry C, Kahn JP, Krishnamoorthy R, Charron D, Leboyer M. HLA genetics in bipolar disorder. Acta Psychiatr Scand 2018; 138:464-471. [PMID: 29869414 DOI: 10.1111/acps.12912] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Bipolar Disorder (BD) is characterized by deregulated adaptive immune processes. Recent genome-wide association studies (GWAS) implicate the major histocompatibility complex (MHC) region in BD. The present study investigates the potential influence of variations in human leukocyte antigen (HLA) on BD risk and/or clinical presentations. This may have relevance to the dysregulated inflammatory processes commonly found in BD. METHOD DNAs from 475 BD patients and 195 healthy controls (HC) were genotyped for classical HLA class I and II loci. RESULTS We found that: (i) the HLA-A*02~B*44~DRB1*07 sub-haplotype is less prevalent in BD, vs. HC (pc = 2.4 × 10-2 ); (ii) the 57.1 and the 8.1-derived ancestral haplotypes i.e. HLA-A*02~B*57~Cw*06~DRB1*07~DQB1*09 and HLA-A*02~B*08~Cw*07 are associated with rapid cycling (pc = 1.9 × 10-3 and 1.05 × 10-2 , respectively); (iii) the 8.1AH-derived HLA class II-DRB*03~HLA-DQB1*02 sub-haplotype is more frequent in BD patients with a history of suicidal behaviors (pc = 2.1 × 10-2 ); and (iv) disease onset by an hypomanic episode or by psychotic symptoms are, respectively, more frequent in BD patients bearing the 7.1 AH-derived A*03~B*07~DRB1*15 sub-haplotype (pc = 8.5 × 10-3 ) and the HLA-A*02~B*07~DRB1*15 sub-haplotype (pc = 4.0 × 10-2 ). CONCLUSION Corroborating the established link between these HLA haplotypes/sub haplotypes and common immune disorders, our findings suggest possible HLA-mediated proinflammatory processes operating in BD.
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Affiliation(s)
- R Tamouza
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,FondaMental Foundation, Créteil, France.,Cordons de Vie Association, Monaco and LabEx Transplantex, Strasbourg, France
| | - J Oliveira
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,FondaMental Foundation, Créteil, France
| | - B Etain
- FondaMental Foundation, Créteil, France.,Department of Psychiatry & Addiction Medicine, INSERM UMR-S1144 - VariaPsy, University Paris Diderot, AP-HP, Fernand Widal Hospital, Paris, France
| | - D Bengoufa
- INSERM, U1160, Saint Louis Hospital, Paris, France
| | - N Hamdani
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,FondaMental Foundation, Créteil, France
| | - C Manier
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,INSERM, U1160, Saint Louis Hospital, Paris, France
| | - C Mariaselvam
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,INSERM, U1160, Saint Louis Hospital, Paris, France
| | - A Sundaresh
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,INSERM, U1160, Saint Louis Hospital, Paris, France
| | - F Bellivier
- FondaMental Foundation, Créteil, France.,Department of Psychiatry & Addiction Medicine, INSERM UMR-S1144 - VariaPsy, University Paris Diderot, AP-HP, Fernand Widal Hospital, Paris, France
| | - C Henry
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,FondaMental Foundation, Créteil, France
| | - J-P Kahn
- Department of Psychiatry and Clinical Psychology, CHU of Nancy, Brabois Hospitals, Vandoeuvre Les Nancy, France
| | - R Krishnamoorthy
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,FondaMental Foundation, Créteil, France
| | - D Charron
- FondaMental Foundation, Créteil, France
| | - M Leboyer
- INSERM, U955, Translational Psychiatry, Paris-East University, School of Medicine, AP-HP, DHU PePSY, Pole of Psychiatry, Henri Mondor University Hospital, Créteil, France.,FondaMental Foundation, Créteil, France
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15
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Al-Nashmi M, Taha S, Salem AH, Alsharoqi I, Bakhiet M. Distinct HLA class I and II genotypes and haplotypes are associated with multiple sclerosis in Bahrain. Biomed Rep 2018; 9:531-539. [PMID: 30546882 DOI: 10.3892/br.2018.1164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 10/10/2018] [Indexed: 12/24/2022] Open
Abstract
Multiple sclerosis (MS) has become prevalent in the Arabian Gulf area with high incidence in Bahrain due to environmental influences and genetic susceptibilities, but there is a lack of study into human leukocyte antigen (HLA) types in patients with MS in Bahrain. The present study aimed to study the HLA types expressed in MS patients compared with in control subjects. Blood samples from 50 Bahraini patients with MS and 50 Bahraini control subjects' were subjected to HLA tissue typing by polymerase chain reaction using sequence-specific primers. In comparison with those in control subjects, the allele frequencies of HLA class-I antigens A2, A9, A19, B5, B35 and B40 were higher in MS patients. For class II antigens, the allele frequencies of DR3, DR4 and DR16 were higher in MS patients. The allele frequency of DR15 was lower in MS patients than in control subjects but the difference was not statistically significant (P=0.138). The higher prevalence of the HLA-ABDR allele was common among the female patients with MS, in relapse remission stage, in cases with higher expanded disability status scale scores and with disease duration between 4 and 9 years. Haplotype HLA-A2-B40-DR2 exhibited significantly higher frequency in MS patients compared with in control subjects (P=0.03). In conclusion, the results indicated different alleles associated with MS compared with previous reviews. The present study supports the importance of identifying genetic susceptibilities and targets for therapies in specific populations and individuals, to personalize disease management in terms of prediction, protective measures and treatment.
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Affiliation(s)
- Moudi Al-Nashmi
- Department of Molecular Medicine, Princess Al-Jawhara Center for Genetics and Inherited Diseases, Arabian Gulf University, Manama 329, Bahrain
| | - Safa Taha
- Department of Molecular Medicine, Princess Al-Jawhara Center for Genetics and Inherited Diseases, Arabian Gulf University, Manama 329, Bahrain
| | - Abdel Halim Salem
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Bahrain
| | - Isa Alsharoqi
- Department of Neuroscience, Salmaniya Medical Complex, Manama 12, Bahrain
| | - Moiz Bakhiet
- Department of Molecular Medicine, Princess Al-Jawhara Center for Genetics and Inherited Diseases, Arabian Gulf University, Manama 329, Bahrain
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16
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Portaro S, Naro A, Cimino V, Calabrò RS. What about novel pathogenetic mechanisms in Multiple Sclerosis? The emerging role of mitochondria. Med Hypotheses 2018; 116:42-43. [PMID: 29857908 DOI: 10.1016/j.mehy.2018.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/31/2018] [Accepted: 04/11/2018] [Indexed: 10/17/2022]
Affiliation(s)
| | - Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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17
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Goodin DS, Khankhanian P, Gourraud PA, Vince N. Highly conserved extended haplotypes of the major histocompatibility complex and their relationship to multiple sclerosis susceptibility. PLoS One 2018; 13:e0190043. [PMID: 29438392 PMCID: PMC5810982 DOI: 10.1371/journal.pone.0190043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/07/2017] [Indexed: 12/03/2022] Open
Abstract
Objective To determine the relationship between highly-conserved extended-haplotypes (CEHs) in the major histocompatibility complex (MHC) and MS-susceptibility. Background Among the ~200 MS-susceptibility regions, which are known from genome-wide analyses of single nucleotide polymorphisms (SNPs), the MHC accounts for roughly a third of the currently explained variance and the strongest MS-associations are for certain Class II alleles (e.g., HLA-DRB1*15:01; HLA-DRB1*03:01; and HLA-DRB1*13:03), which frequently reside on CEHs within the MHC. Design/Methods Autosomal SNPs (441,547) from 11,376 MS cases and 18,872 controls in the WTCCC dataset were phased. The most significant MS associated SNP haplotype was composed of 11 SNPs in the MHC Class II region surrounding the HLA-DRB1 gene. We also phased alleles at the HLA-A, HLA-C, HLA-B, HLA-DRB1, and HLA-DQB1 loci. This data was used to probe the relationship between CEHs and MS susceptibility. Results We phased a total of 59,884 extended haplotypes (HLA-A, HLA-C, HLA-B, HLA-DRB1, HLA-DQB1 and SNP haplotypes) from 29,942 individuals. Of these, 10,078 unique extended haplotypes were identified. The 10 most common CEHs accounted for 22% (13,302) of the total. By contrast, the 8,446 least common extended haplotypes also accounted for approximately 20% (12,298) of the total. This extreme frequency-disparity among extended haplotypes necessarily complicates interpretation of reported disease-associations with specific HLA alleles. In particular, the HLA motif HLA-DRB1*15:01~HLA-DQB1*06:02 is strongly associated with MS risk. Nevertheless, although this motif is almost always found on the a1 SNP haplotype, it can rarely be found on others (e.g., a27 and a36), and, in these cases, it seems to have no apparent disease-association (OR = 0.7; CI = 0.3–1.3 and OR = 0.7; CI = 0.2–2.2, respectively). Furthermore, single copy carriers of the a1 SNP-haplotype without this HLA motif still have an increased disease risk (OR = 2.2; CI = 1.2–3.8). In addition, even among the set of CEHs, which carry the Class II motif of HLA-DRB1*15:01~HLA-DQB1*06:02~a1, different CEHs have differing strengths in their MS-associations. Conclusions The MHC in diverse human populations consists, primarily, of a very small collection of very highly-selected CEHs. Our findings suggest that the MS-association with the HLA-DRB1*15:01~HLA-DQB1*06:02 haplotype may be due primarily to the combined attributes of the CEHs on which this particular HLA-motif often resides.
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Affiliation(s)
- Douglas S. Goodin
- Department of Neurology, University of California, San Francisco, CA, United States of America
- * E-mail:
| | - Pouya Khankhanian
- Center for Neuro-engineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Pierre-Antoine Gourraud
- Department of Neurology, University of California, San Francisco, CA, United States of America
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Nicolas Vince
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
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18
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Lorefice L, Fenu G, Sardu C, Frau J, Coghe G, Costa G, Schirru L, Secci MA, Sechi V, Barracciu MA, Marrosu MG, Cocco E. Multiple sclerosis and HLA genotypes: A possible influence on brain atrophy. Mult Scler 2017; 25:23-30. [PMID: 29111883 DOI: 10.1177/1352458517739989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The strongest genetic determinant for multiple sclerosis (MS) is located at the human leukocyte antigen (HLA) class II DRB1 and DQB1 loci. OBJECTIVES To investigate the possible role of predisposing HLA genotypes in determining brain atrophy. METHODS HLA genotypes were categorized as high risk (two predisposing haplotypes) or medium/low risk (one or no predisposing haplotypes). Patients underwent a brain magnetic resonance imaging (MRI) study and volumes of white matter (WM), gray matter (GM), and whole brain (WB) were estimated with SIENAX. Longitudinal atrophy was also assessed with SIENA. RESULTS The study included 240 MS patients. In 51/240 (21%) subjects, a high-risk HLA genotype was observed, while medium- and low-risk HLA genotypes were 109/240 (45%) and 80/240 (34%), respectively. Multiple regression analysis found that the high-risk HLA genotype was associated with significant reduction in WB ( p = 0.02) and GM ( p = 0.03) volumes compared with the medium-/low-risk HLA genotypes, independently from MS clinical features. The longitudinal study included 60 patients and showed a brain volume loss of -0.79% in high-risk HLA genotype group versus -0.56% in low-risk HLA genotype. CONCLUSION Our results suggest an influence of HLA genotype on WB and GM atrophy. Further investigations are necessary to confirm these findings.
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Affiliation(s)
- Lorena Lorefice
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuseppe Fenu
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Claudia Sardu
- Unit of Epidemiology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Jessica Frau
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Giancarlo Coghe
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Gianna Costa
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Lucia Schirru
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Antonietta Secci
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Vincenzo Sechi
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | | | - Maria Giovanna Marrosu
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Center, Binaghi Hospital, ATS Sardegna, Cagliari, Italy/Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
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19
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Gianfrancesco MA, Stridh P, Shao X, Rhead B, Graves JS, Chitnis T, Waldman A, Lotze T, Schreiner T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema JM, Hart J, Caillier S, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Mar S, Kahn I, Rose J, Roalstad S, Casper TC, Shen L, Quach H, Quach D, Hillert J, Hedstrom A, Olsson T, Kockum I, Alfredsson L, Schaefer C, Barcellos LF, Waubant E. Genetic risk factors for pediatric-onset multiple sclerosis. Mult Scler 2017; 24:1825-1834. [PMID: 28980494 DOI: 10.1177/1352458517733551] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Strong evidence supports the role of both genetic and environmental factors in pediatric-onset multiple sclerosis (POMS) etiology. OBJECTIVE We comprehensively investigated the association between established major histocompatibility complex (MHC) and non-MHC adult multiple sclerosis (MS)-associated variants and susceptibility to POMS. METHODS Cases with onset <18 years (n = 569) and controls (n = 16,251) were included from the United States and Sweden. Adjusted logistic regression and meta-analyses were performed for individual risk variants and a weighted genetic risk score (wGRS) for non-MHC variants. Results were compared to adult MS cases (n = 7588). RESULTS HLA-DRB1*15:01 was strongly associated with POMS (odds ratio (OR)meta = 2.95, p < 2.0 × 10-16). Furthermore, 28 of 104 non-MHC variants studied (23%) were associated (p < 0.05); POMS cases carried, on average, a higher burden of these 28 variants compared to adults (ORavg = 1.24 vs 1.13, respectively), though the difference was not significant. The wGRS was strongly associated with POMS (ORmeta = 2.77, 95% confidence interval: 2.33, 3.32, p < 2.0 × 10-16) and higher, on average, when compared to adult cases. Additional class III risk variants in the MHC region associated with POMS were revealed after accounting for HLA-DRB1*15:01 and HLA-A*02. CONCLUSION Pediatric and adult MS share many genetic variants suggesting similar biological processes are present. MHC variants beyond HLA-DRB1*15:01 and HLA-A*02 are also associated with POMS.
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Affiliation(s)
- Milena A Gianfrancesco
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Pernilla Stridh
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Xiaorong Shao
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Brooke Rhead
- Computational Biology Graduate Group, University of California, Berkeley, Berkeley, CA, USA
| | - Jennifer S Graves
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Tanuja Chitnis
- Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Amy Waldman
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Timothy Lotze
- Blue Bird Circle Multiple Sclerosis Center, Baylor College of Medicine, Houston, TX, USA
| | - Teri Schreiner
- Children's Hospital Colorado, University of Colorado, Denver, CO, USA
| | - Anita Belman
- The Lourie Center for Pediatric MS, Stony Brook Children's Hospital, Stony Brook, NY, USA
| | - Benjamin Greenberg
- Department of Neurology & Neurotherapeutics, University of Texas Southwestern, Dallas, TX, USA
| | - Bianca Weinstock-Guttman
- Pediatric Multiple Sclerosis Center, Jacobs Neurological Institute, SUNY Buffalo, Buffalo, NY, USA
| | - Gregory Aaen
- Pediatric MS Center, Loma Linda University Children's Hospital, Loma Linda, CA, USA
| | - Jan M Tillema
- Pediatric MS Center, Mayo Clinic, Rochester, MN, USA
| | - Janace Hart
- Department of Neurology and Regional Pediatric MS Center, University of California, San Francisco, San Francisco, CA, USA
| | - Stacy Caillier
- Department of Neurology and Regional Pediatric MS Center, University of California, San Francisco, San Francisco, CA, USA
| | - Jayne Ness
- Center for Pediatric Onset Demyelinating Disease, University of Alabama and Children's Hospital of Alabama, Birmingham, AL, USA
| | - Yolanda Harris
- Center for Pediatric Onset Demyelinating Disease, University of Alabama and Children's Hospital of Alabama, Birmingham, AL, USA
| | - Jennifer Rubin
- Division of Neurology, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Meghan Candee
- University of Utah and Primary Children's Hospital, Salt Lake City, UT, USA
| | - Lauren Krupp
- The Lourie Center for Pediatric MS, Stony Brook Children's Hospital, Stony Brook, NY, USA
| | | | | | | | - Soe Mar
- Pediatric-onset Demyelinating Diseases and Autoimmune Encephalitis Center, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
| | - Ilana Kahn
- Children's National Medical Center, Washington, DC, USA
| | - John Rose
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Shelly Roalstad
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - T Charles Casper
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ling Shen
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Hong Quach
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Diana Quach
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Jan Hillert
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
| | - Anna Hedstrom
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
| | - Tomas Olsson
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Kockum
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden/Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Catherine Schaefer
- Division of Research, Kaiser Permanente, Oakland, CA, USA/Research Program on Genes, Environment and Health, Kaiser Permanente, Oakland, CA
| | - Lisa F Barcellos
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA/Computational Biology Graduate Group, University of California, Berkeley, Berkeley, CA, USA; Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Emmanuelle Waubant
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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Lind A, Freyhult E, Ramelius A, Olsson T, Arnheim-Dahlström L, Lamb F, Khademi M, Ambati A, Maeurer M, Lima Bomfim I, Fink K, Fex M, Törn C, Elding Larsson H, Lernmark Å. Antibody Affinity Against 2009 A/H1N1 Influenza and Pandemrix Vaccine Nucleoproteins Differs Between Childhood Narcolepsy Patients and Controls. Viral Immunol 2017; 30:590-600. [PMID: 28796576 DOI: 10.1089/vim.2017.0066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Increased narcolepsy incidence was observed in Sweden following the 2009 influenza vaccination with Pandemrix®. A substitution of the 2009 nucleoprotein for the 1934 variant has been implicated in narcolepsy development. The aims were to determine (a) antibody levels toward wild-type A/H1N1-2009[A/California/04/2009(H1N1)] (NP-CA2009) and Pandemrix-[A/Puerto Rico/8/1934(H1N1)] (NP-PR1934) nucleoproteins in 43 patients and 64 age-matched controls; (b) antibody affinity in reciprocal competitive assays in 11 childhood narcolepsy patients compared with 21 age-matched controls; and (c) antibody levels toward wild-type A/H1N1-2009[A/California/04/2009(H1N1)] (H1N1 NS1), not a component of the Pandemrix vaccine. In vitro transcribed and translated 35S-methionine-labeled H1N1 influenza A virus proteins were used in radiobinding reciprocal competition assays to estimate antibody levels and affinity (Kd). Childhood patients had higher NP-CA2009 (p = 0.0339) and NP-PR1934 (p = 0.0246) antibody levels compared with age-matched controls. These childhood controls had lower NP-CA2009 (p = 0.0221) and NP-PR1934 (p = 0.00619) antibodies compared with controls 13 years or older. In contrast, in patients 13 years or older, the levels of NP-PR1934 (p = 0.279) and NP-CA2009 (p = 0.0644) antibodies did not differ from the older controls. Childhood antibody affinity (Kd) against NP-CA2009 was comparable between controls (68 ng/mL) and patients (74 ng/mL; p = 0.21) with NP-CA2009 and NP-PR1934 displacement (controls: 165 ng/mL; patients: 199 ng/mL; p = 0.48). In contrast, antibody affinity against NP-PR1934 was higher in controls with either NP-PR1934 (controls: 9 ng/mL; patients: 20 ng/mL; p = 0.0031) or NP-CA2009 (controls: 14 ng/mL; patients: 23 ng/mL; p = 0.0048). A/H1N1-NS1 antibodies were detected in 0/43 of the narcolepsy patients compared with 3/64 (4.7%) controls (p = 0.272). Similarly, none (0/11) of the childhood patients and 1/21 (4.8%) of the childhood controls had A/H1N1-NS1 antibodies. The higher antibody affinities against NP-PR1934 in controls suggest better protection against wild-type virus. In contrast, the reduced NP-PR1934 antibody affinities among childhood narcolepsy patients suggest poor protection from the wild-type A/H1N1 virus and possibly increased risk for viral damage.
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Affiliation(s)
- Alexander Lind
- 1 Department of Clinical Sciences, Lund University/Clinical Research Center (CRC), Skåne University Hospital SUS , Malmö, Sweden
| | - Eva Freyhult
- 2 Department of Medical Sciences, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University , Uppsala, Sweden
| | - Anita Ramelius
- 1 Department of Clinical Sciences, Lund University/Clinical Research Center (CRC), Skåne University Hospital SUS , Malmö, Sweden
| | - Tomas Olsson
- 3 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
| | | | - Favelle Lamb
- 4 Department of Medical Epidemiology and Biostatistics
| | - Mohsen Khademi
- 3 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
| | - Aditya Ambati
- 5 Department of Medicine, Karolinska Institutet , Stockholm, Sweden
| | - Markus Maeurer
- 6 TIM, LabMed, Karolinska Institutet and CAST, Karolinska University Hospital , Stockholm, Sweden
| | - Izaura Lima Bomfim
- 3 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
| | - Katharina Fink
- 3 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden .,7 Department of Neurology, Karolinska University Hospital , Stockholm, Sweden
| | - Malin Fex
- 1 Department of Clinical Sciences, Lund University/Clinical Research Center (CRC), Skåne University Hospital SUS , Malmö, Sweden
| | - Carina Törn
- 1 Department of Clinical Sciences, Lund University/Clinical Research Center (CRC), Skåne University Hospital SUS , Malmö, Sweden
| | - Helena Elding Larsson
- 1 Department of Clinical Sciences, Lund University/Clinical Research Center (CRC), Skåne University Hospital SUS , Malmö, Sweden
| | - Åke Lernmark
- 1 Department of Clinical Sciences, Lund University/Clinical Research Center (CRC), Skåne University Hospital SUS , Malmö, Sweden
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Human leucocyte antigen (HLA) class I and II typing in Belgian multiple sclerosis patients. Acta Neurol Belg 2017; 117:61-65. [PMID: 27797002 DOI: 10.1007/s13760-016-0716-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
This is one of the first studies to compare the frequencies of different human leucocyte antigen (HLA) class I and II alleles and haplotype HLA-DRB1*15-DQB1*06 in a cohort of 119 patients with multiple sclerosis (MS) and a cohort of 124 healthy controls in Belgium. An association with MS was found for the HLA-DRB1*15 (odds ratio [OR] 2.60 [95% confidence interval (CI) 1.51-4.50]) and HLA-DQB1*06 (OR 1.97 [95% CI 1.18-3.29]) alleles, and for haplotype DRB1*15-DQB1*06 (OR 2.63 [95% CI 1.52-4.56]). The HLA-B*07 allele also tended to be more frequent in MS patients (OR 1.46 [95% CI 0.80-2.65]) and more frequent among MS patients with than in those without the HLA-DRB1*15 allele (26/54 [48.1%] versus 6/65 [9.2%]; p value <0.0001). Other alleles were underrepresented in MS patients, such as the HLA-DRB1*07 (OR 0.39 [95% CI 0.21-0.73]) and HLA-A*02 (OR 0.56 [95% CI 0.34-0.94]), showing a protective role against the disease. The HLA-B*44 (OR 0.58 [95% CI 0.31-1.09]) and HLA-DRB1*04 (OR 0.75 [95% CI 0.42-1.34]) alleles tended to be less frequent in MS patients. Altogether, the significant results observed in this population are in line with those from other countries and confirm that propensity to MS can be due to a complex presence of various HLA class I and class II alleles.
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Lysandropoulos AP, Mavroudakis N, Pandolfo M, El Hafsi K, van Hecke W, Maertens A, Billiet T, Ribbens A. HLA genotype as a marker of multiple sclerosis prognosis: A pilot study. J Neurol Sci 2017; 375:348-354. [PMID: 28320165 DOI: 10.1016/j.jns.2017.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/26/2016] [Accepted: 02/07/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The identification of a biomarker with prognostic value is an unmet need in multiple sclerosis (MS). The objective of this study was to investigate a possible association of HLA genotype with disease status and progression in MS, based on comprehensive and sensitive clinical and magnetic resonance imaging (MRI) parameters to measure disease effects. METHOD A total of 118 MS patients (79 females, 39 males) underwent HLA typing. Patient MS status was assessed at two time points in a 2-year interval, based on clinical scores (including EDSS, MSSS, T25FW, 9-HPT, SDMT, BVMT, CVLT-II) and MRI evaluations. Quantitative brain MRI values were obtained for whole brain atrophy, FLAIR lesion volume change and number of new lesions using MSmetrix. Predefined HLA patient groups were compared as of disease status and progression. Global assessment was achieved by an overall t-statistic and assessment per measurement by a Welch test and/or Mann Whitney U test. The effects of multiple covariates, including age, gender and disease duration as well as scan parameters, were also evaluated using a regression analysis. RESULTS The HLA-A*02 allele was associated with better outcomes in terms of MSSS, EDSS and new lesion count (Welch test p-value<0.05). The HLA-B*07 and HLA-B*44 alleles showed a global negative effect on disease status, although none of the measurements reached significance (p-value<0.05). Results for the HLA-DRB1*15, HLA-DQB1*06 and HLA-B*08 alleles were inconclusive. The influence of the confounding variables on the statistical analysis was limited.
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Affiliation(s)
| | - Nicolas Mavroudakis
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Belgium
| | - Massimo Pandolfo
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Belgium
| | - Kaoutar El Hafsi
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Belgium
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Werneck LC, Lorenzoni PJ, Arndt RC, Kay CSK, Scola RH. The immunogenetics of multiple sclerosis. The frequency of HLA-alleles class 1 and 2 is lower in Southern Brazil than in the European population. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:607-16. [DOI: 10.1590/0004-282x20160100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 05/25/2016] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To study the HLA of class 1and 2 in a multiple sclerosis (MS) population to verify the susceptibility for the disease in the Southern Brazil. Methods We analyzed patients with MS and controls, by direct sequencing of the genes related to HLA DRB1, DQB1, DPB1, A, B and C alleles with high resolution techniques. Results We found a lower frequency of all HLA alleles class 1 and 2 in MS and controls comparing to the European population. Several alleles had statistical correlation, but after Bonferroni correction, the only allele with significance was the HLA-DQB1*02:03, which has a positive association with MS. Conclusions Our data have different frequency of HLA-alleles than the previous published papers in the Southeast Brazil and European population, possible due to several ethnic backgrounds.
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Michalik J, Čierny D, Kantorová E, Kantárová D, Juraj J, Párnická Z, Kurča E, Dobrota D, Lehotský J. The association of HLA-DRB1 and HLA-DQB1 alleles with genetic susceptibility to multiple sclerosis in the Slovak population. Neurol Res 2016; 37:1060-7. [DOI: 10.1080/01616412.2015.1115212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Jozef Michalik
- Clinic of Neurology, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Daniel Čierny
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ema Kantorová
- Clinic of Neurology, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Daniela Kantárová
- I. internal clinic, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Javor Juraj
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Zuzana Párnická
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Egon Kurča
- Clinic of Neurology, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Dušan Dobrota
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ján Lehotský
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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Bioinformatics evaluation of the possibility of heat shock proteins as autoantigens in multiple sclerosis based on molecular mimicry hypothesis. J Neuroimmunol 2016; 295-296:100-21. [PMID: 27235356 DOI: 10.1016/j.jneuroim.2016.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/19/2016] [Accepted: 03/29/2016] [Indexed: 01/22/2023]
Abstract
Molecular mimicry is the explanatory link between the heat shock proteins (HSPs) of infectious agents and triggering multiple sclerosis. Considering that there are many similarities between self- and bacterial-HSPs, the goal was to investigate a panel of 60- and 70kDa HSPs from a variety of bacteria in order to predict the role of each microorganism in triggering or progression of the disease under the molecular mimicry hypothesis. By clarifying the peptides meeting criteria for cross-reactivity and elucidating the role of each microorganism in MS pathogenesis, it would be easier to suggest more effective treatment and preventive strategies for this disease.
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Deretzi G, Gavalas E, Boziki M, Tsiptsios D, Polyzos SA, Venizelos I, Zavos C, Koutlas E, Tsiptsios I, Katsinelos P, Kountouras J. Impact of Helicobacter pylori on multiple sclerosis-related clinically isolated syndrome. Acta Neurol Scand 2016; 133:268-75. [PMID: 26079721 DOI: 10.1111/ane.12453] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES There are no data regarding the relationship between Helicobacter pylori infection (Hp-I) and clinically isolated syndrome (CIS) suggestive of multiple sclerosis. The purpose of this pilot study was to investigate the association between active Hp-I, confirmed by histology, and CIS and to evaluate the impact of Hp eradication on the CIS clinical course. MATERIAL AND METHODS We conducted a study on 48 patients with CIS and 20 matched controls. At baseline, apart from histology, serum anti-Hp-specific IgG titer, inflammatory mediators, and HLA-A, HLA-B, HLA-DR genetic polymorphisms were estimated. Hp-positive patients received standard triple eradication regimen, and all patients were followed up for 2 years. RESULTS The prevalence of Hp-I was significantly higher in patients with CIS (43/48, 89.6%) than in control (10/20, 50%) (P < 0.001, OR: 8.6, 95% CI: 2.4-30.8). When compared with controls, patients with CIS also showed significantly higher serum anti-Hp IgG titer and HLA-A26, HLA-A30, and HLA-B57 frequencies. Hp-positive patients also showed higher serum concentrations of inflammatory cytokines and homocysteine. At 2-year clinical endpoint, in the subgroup of CIS patients with successful Hp eradication, the number of patients who presented with a second episode was significantly lower accompanied by significant improvement in mean Expanded Disability Status Scale score. CONCLUSIONS Hp-I seems more frequent in a Greek CIS cohort and its eradication might delay CIS progression, suggesting a possible link between Hp-I and CIS.
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Affiliation(s)
- G. Deretzi
- Multiple Sclerosis Unit; Department of Neurology; “Papageorgiou” Hospital; Thessaloniki Greece
| | - E. Gavalas
- Department of Medicine; Second Medical Clinic; Aristotle University of Thessaloniki; Ippokration Hospital; Thessaloniki Greece
| | - M. Boziki
- 2nd Department of Neurology; AHEPA University Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - D. Tsiptsios
- Multiple Sclerosis Unit; Department of Neurology; “Papageorgiou” Hospital; Thessaloniki Greece
| | - S. A. Polyzos
- Department of Medicine; Second Medical Clinic; Aristotle University of Thessaloniki; Ippokration Hospital; Thessaloniki Greece
| | - I. Venizelos
- Department of Medicine; Second Medical Clinic; Aristotle University of Thessaloniki; Ippokration Hospital; Thessaloniki Greece
| | - C. Zavos
- Department of Medicine; Second Medical Clinic; Aristotle University of Thessaloniki; Ippokration Hospital; Thessaloniki Greece
| | - E. Koutlas
- Multiple Sclerosis Unit; Department of Neurology; “Papageorgiou” Hospital; Thessaloniki Greece
| | - I. Tsiptsios
- Multiple Sclerosis Unit; Department of Neurology; “Papageorgiou” Hospital; Thessaloniki Greece
| | - P. Katsinelos
- Department of Medicine; Second Medical Clinic; Aristotle University of Thessaloniki; Ippokration Hospital; Thessaloniki Greece
| | - J. Kountouras
- Department of Medicine; Second Medical Clinic; Aristotle University of Thessaloniki; Ippokration Hospital; Thessaloniki Greece
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Peptide motif analysis predicts lymphocytic choriomeningitis virus as trigger for multiple sclerosis. Mol Immunol 2015; 67:625-35. [DOI: 10.1016/j.molimm.2015.07.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/31/2015] [Indexed: 01/08/2023]
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Molecular Dynamics Simulation Reveals the Selective Binding of Human Leukocyte Antigen Alleles Associated with Behçet's Disease. PLoS One 2015; 10:e0135575. [PMID: 26331842 PMCID: PMC4557978 DOI: 10.1371/journal.pone.0135575] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/24/2015] [Indexed: 11/29/2022] Open
Abstract
Behçet’s disease (BD), a multi-organ inflammatory disorder, is associated with the presence of the human leukocyte antigen (HLA) HLA-B*51 allele in many ethnic groups. The possible antigen involvement of the major histocompatibility complex class I chain related gene A transmembrane (MICA-TM) nonapeptide (AAAAAIFVI) has been reported in BD symptomatic patients. This peptide has also been detected in HLA-A*26:01 positive patients. To investigate the link of BD with these two specific HLA alleles, molecular dynamics (MD) simulations were applied on the MICA-TM nonapeptide binding to the two BD-associated HLA alleles in comparison with the two non-BD-associated HLA alleles (B*35:01 and A*11:01). The MD simulations were applied on the four HLA/MICA-TM peptide complexes in aqueous solution. As a result, stabilization for the incoming MICA-TM was found to be predominantly contributed from van der Waals interactions. The P2/P3 residue close to the N-terminal and the P9 residue at the C-terminal of the MICA-TM nonapeptide served as the anchor for the peptide accommodated at the binding groove of the BD associated HLAs. The MM/PBSA free energy calculation predicted a stronger binding of the HLA/peptide complexes for the BD-associated HLA alleles than for the non-BD-associated ones, with a ranked binding strength of B*51:01 > B*35:01 and A*26:01 > A*11:01. Thus, the HLAs associated with BD pathogenesis expose the binding efficiency with the MICA-TM nonapeptide tighter than the non-associated HLA alleles. In addition, the residues 70, 73, 99, 146, 147 and 159 of the two BD-associated HLAs provided the conserved interaction for the MICA-TM peptide binding.
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Khankhanian P, Gourraud PA, Lizee A, Goodin DS. Haplotype-based approach to known MS-associated regions increases the amount of explained risk. J Med Genet 2015; 52:587-94. [PMID: 26185143 PMCID: PMC4552900 DOI: 10.1136/jmedgenet-2015-103071] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/07/2015] [Indexed: 11/18/2022]
Abstract
Genome-wide association studies (GWAS), using single nucleotide polymorphisms (SNPs), have yielded 110 non-human leucocyte antigen genomic regions that are associated with multiple sclerosis (MS). Despite this large number of associations, however, only 28% of MS-heritability can currently be explained. Here we compare the use of multi-SNP-haplotypes to the use of single-SNPs as alternative methods to describe MS genetic risk. SNP-haplotypes (of various lengths from 1 up to 15 contiguous SNPs) were constructed at each of the 110 previously identified, MS-associated, genomic regions. Even after correcting for the larger number of statistical comparisons made when using the haplotype-method, in 32 of the regions, the SNP-haplotype based model was markedly more significant than the single-SNP based model. By contrast, in no region was the single-SNP based model similarly more significant than the SNP-haplotype based model. Moreover, when we included the 932 MS-associated SNP-haplotypes (that we identified from 102 regions) as independent variables into a logistic linear model, the amount of MS-heritability, as assessed by Nagelkerke's R-squared, was 38%, which was considerably better than 29%, which was obtained by using only single-SNPs. This study demonstrates that SNP-haplotypes can be used to fine-map the genetic associations within regions of interest previously identified by single-SNP GWAS. Moreover, the amount of the MS genetic risk explained by the SNP-haplotype associations in the 110 MS-associated genomic regions was considerably greater when using SNP-haplotypes than when using single-SNPs. Also, the use of SNP-haplotypes can lead to the discovery of new regions of interest, which have not been identified by a single-SNP GWAS.
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Affiliation(s)
- Pouya Khankhanian
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA UCSF MS Center, University of California, San Francisco, San Francisco, California, USA
| | - Pierre-Antoine Gourraud
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA UCSF MS Center, University of California, San Francisco, San Francisco, California, USA
| | - Antoine Lizee
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA UCSF MS Center, University of California, San Francisco, San Francisco, California, USA
| | - Douglas S Goodin
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA UCSF MS Center, University of California, San Francisco, San Francisco, California, USA
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30
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Antoniol C, Stankoff B. Immunological Markers for PML Prediction in MS Patients Treated with Natalizumab. Front Immunol 2015; 5:668. [PMID: 25601865 PMCID: PMC4283628 DOI: 10.3389/fimmu.2014.00668] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/11/2014] [Indexed: 12/15/2022] Open
Abstract
Natalizumab (NTZ), a monoclonal antibody recognizing the alpha4 integrin chain, has been approved for the treatment of active multiple sclerosis, but expose to the onset of a rare side effect, progressive multifocal leukoencephalopathy (PML). Estimating the individual risk of PML in NTZ-treated patients is a major challenge, and therapeutic strategies are mainly guided by the overall PML risk assessed by identified risk factors: JC virus (JCV) seropositivity, treatment duration (with peak incidence after 24 months), and the previous use of immunosuppressive therapies. Given that this stratification does not yet allow a precise individual prediction of PML, other predictive markers are needed, and several immunological biomarkers have been described. Quantification of anti-JCV antibody levels may improve individual predictive value, with higher baseline titers indicating increased risk. Other immunological biomarkers such as leukocyte cell membrane markers (CD49d, CD11a, and CD62L), detection of circulating JCV-specific activated T effector memory cells (TEM) or genetic screening have been proposed. In this review, we discuss how recent progress in immunology has paved the way for «new combined monitoring», which will include immunological screening, in NTZ-treated patients.
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Affiliation(s)
- Caroline Antoniol
- AP-HP, Hôpital Saint-Antoine , Paris , France ; Centre Hospitalier Universitaire de Dijon, Université de Bourgogne , Dijon , France
| | - Bruno Stankoff
- AP-HP, Hôpital Saint-Antoine , Paris , France ; Sorbonne Universités, Université Pierre et Marie Curie, UMR S 1127, CNRS UMR 7225, and l'Institut du Cerveau et de la Moelle Épinière (ICM) , Paris , France
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31
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Abstract
One of the most consistent findings in multiple sclerosis (MS) is that development of MS is linked with carriage of the class II human leucocyte antigen (HLA) molecule HLA-DRB1*15:01; around 60 % of Caucasian MS patients carry this allele compared to 25-30 % of ethnically matched healthy individuals. However, other HLA molecules have also been linked to the development of MS. In this chapter, the association between different HLA types and susceptibility to MS will be reviewed, and other linkages between the carriage of specific HLA molecules and clinical and experimental findings in MS will be considered.
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Affiliation(s)
- Judith M Greer
- The University of Queensland, UQ Centre for Clinical Research, Building 71/918 Riyal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia.
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32
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Sundqvist E, Buck D, Warnke C, Albrecht E, Gieger C, Khademi M, Lima Bomfim I, Fogdell-Hahn A, Link J, Alfredsson L, Søndergaard HB, Hillert J, Oturai AB, Hemme B, Kockum I, Olsson T. JC polyomavirus infection is strongly controlled by human leucocyte antigen class II variants. PLoS Pathog 2014; 10:e1004084. [PMID: 24763718 PMCID: PMC3999271 DOI: 10.1371/journal.ppat.1004084] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/03/2014] [Indexed: 01/27/2023] Open
Abstract
JC polyomavirus (JCV) carriers with a compromised immune system, such as in HIV, or subjects on immune-modulating therapies, such as anti VLA-4 therapy may develop progressive multifocal leukoencephalopathy (PML) which is a lytic infection of oligodendrocytes in the brain. Serum antibodies to JCV mark infection occur only in 50–60% of infected individuals, and high JCV-antibody titers seem to increase the risk of developing PML. We here investigated the role of human leukocyte antigen (HLA), instrumental in immune defense in JCV antibody response. Anti-JCV antibody status, as a surrogate for JCV infection, were compared to HLA class I and II alleles in 1621 Scandinavian persons with MS and 1064 population-based Swedish controls and associations were replicated in 718 German persons with MS. HLA-alleles were determined by SNP imputation, sequence specific (SSP) kits and a reverse PCR sequence-specific oligonucleotide (PCR-SSO) method. An initial GWAS screen displayed a strong HLA class II region signal. The HLA-DRB1*15 haplotype was strongly negatively associated to JCV sero-status in Scandinavian MS cases (OR = 0.42, p = 7×10−15) and controls (OR = 0.53, p = 2×10−5). In contrast, the DQB1*06:03 haplotype was positively associated with JCV sero-status, in Scandinavian MS cases (OR = 1.63, p = 0.006), and controls (OR = 2.69, p = 1×10−5). The German dataset confirmed these findings (OR = 0.54, p = 1×10−4 and OR = 1.58, p = 0.03 respectively for these haplotypes). HLA class II restricted immune responses, and hence CD4+ T cell immunity is pivotal for JCV infection control. Alleles within the HLA-DR1*15 haplotype are associated with a protective effect on JCV infection. Alleles within the DQB1*06:03 haplotype show an opposite association. These associations between JC virus antibody response and human leucocyte antigens supports the notion that CD4+ T cells are crucial in the immune defence to JCV and lays the ground for risk stratification for PML and development of therapy and prevention. JC virus infection can lead to progressive multifocal leukoencephalopathy in individuals with a compromised immune system, such as during HIV infections or when treated with immunosuppressive or immunomodulating therapies. Progressive multifocal leukoencephalopathy is a rare but potentially fatal disease characterized by progressive damage of the brain white matter at multiple locations. It is therefore of importance to understand the host genetic control of response to JC virus in order to identify patients that can be treated with immunomodulating therapies, common treatments for autoimmune diseases, without increased risk for progressive multifocal leukoencephalopathy. This may also lead to development of preventative or curative anti-JC virus therapies. We here identify genetic variants being associated with JC virus antibody development; a negative association with the human leucocyte antigen DRB1*15-DQA1*01:02-DQB1*06:02 haplotype and a positive association with the DRB1*13-DQA1*01:03-DQB1*06:03 haplotype among controls and patients with multiple sclerosis from Scandinavia. We confirmed the associations in patients with multiple sclerosis from Germany. These associations between JC virus antibody response and human leucocyte antigens imply that CD4+ T cells are crucial in the immune defence and lay the ground for development of therapy and prevention.
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Affiliation(s)
- Emilie Sundqvist
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Dorothea Buck
- Department of Neurology, Technische Universität München, Munich, Germany
| | - Clemens Warnke
- The Multiple Sclerosis Research Group, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eva Albrecht
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Christian Gieger
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Mohsen Khademi
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Izaura Lima Bomfim
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anna Fogdell-Hahn
- The Multiple Sclerosis Research Group, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Link
- The Multiple Sclerosis Research Group, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lars Alfredsson
- Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helle Bach Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jan Hillert
- The Multiple Sclerosis Research Group, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Annette B. Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Bernhard Hemme
- Department of Neurology, Technische Universität München, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Ingrid Kockum
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Tomas Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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33
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Lind A, Ramelius A, Olsson T, Arnheim-Dahlström L, Lamb F, Khademi M, Ambati A, Maeurer M, Nilsson AL, Bomfim IL, Fink K, Lernmark Å. A/H1N1 antibodies and TRIB2 autoantibodies in narcolepsy patients diagnosed in conjunction with the Pandemrix vaccination campaign in Sweden 2009-2010. J Autoimmun 2014; 50:99-106. [PMID: 24485154 DOI: 10.1016/j.jaut.2014.01.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 12/19/2022]
Abstract
Narcolepsy is a lifelong sleep disorder related to hypocretin deficiency resulting from a specific loss of hypocretin-producing neurons in the lateral hypothalamic area. The disease is thought to be autoimmune due to a strong association with HLA-DQB1*06:02. In 2009 the World Health Organization (WHO) declared the H1N1 2009 flu pandemic (A/H1N1PDM09). In response to this, the Swedish vaccination campaign began in October of the same year, using the influenza vaccine Pandemrix(®). A few months later an excess of narcolepsy cases was observed. It is still unclear to what extent the vaccination campaign affected humoral autoimmunity associated with narcolepsy. We studied 47 patients with narcolepsy (6-69 years of age) and 80 healthy controls (3-61 years of age) selected after the Pandemrix vaccination campaign. The first aim was to determine antibodies against A/H1N1 and autoantibodies to Tribbles homolog 2 (TRIB2), a narcolepsy autoantigen candidate as well as to GAD65 and IA-2 as disease specificity controls. The second aim was to test if levels and frequencies of these antibodies and autoantibodies were associated with HLA-DQB1*06:02. In vitro transcribed and translated [(35)S]-methionine and -cysteine-labeled influenza A virus (A/California/04/2009/(H1N1)) segment 4 hemagglutinin was used to detect antibodies in a radiobinding assay. Autoantibodies to TRIB2, GAD65 and IA-2 were similarly detected in standard radiobinding assays. The narcolepsy patients had higher median levels of A/H1N1 antibodies than the controls (p = 0.006). A/H1N1 antibody levels were higher among the <13 years old (n = 12) compared to patients who were older than 30 years (n = 12, p = 0.014). Being HLA-DQB1*06:02 positive was associated with higher A/H1N1 antibody levels in both patients and controls (p = 0.026). Serum autoantibody levels to TRIB2 were low overall and high binders did not differ between patients and controls. We observed an association between levels of A/H1N1 antibodies and TRIB2 autoantibody levels particularly among the youngest narcolepsy patients (r = 0.819, p < 0.001). In conclusion, following the 2009 influenza pandemic vaccination, A/H1N1 antibody levels were associated with young age-at-onset narcolepsy patients positive for HLA-DQB1*06:02. The possibility that TRIB2 is an autoantigen in narcolepsy remains to be clarified. We could verify autoantibody responses against TRIB2 which needs to be determined in larger patient cohorts and control populations.
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Affiliation(s)
- Alexander Lind
- Department of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmö, Sweden.
| | - Anita Ramelius
- Department of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmö, Sweden.
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Lisen Arnheim-Dahlström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Favelle Lamb
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Mohsen Khademi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Aditya Ambati
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Markus Maeurer
- TIM, LabMed, Karolinska Institutet and CAST, Karolinska Hospital, Stockholm, Sweden.
| | | | - Izaura Lima Bomfim
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Katharina Fink
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Åke Lernmark
- Department of Clinical Sciences, Lund University/CRC, Skåne University Hospital SUS, Malmö, Sweden.
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34
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Ji N, Somanaboeina A, Dixit A, Kawamura K, Hayward NJ, Self C, Olson GL, Forsthuber T. Small molecule inhibitor of antigen binding and presentation by HLA-DR2b as a therapeutic strategy for the treatment of multiple sclerosis. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2013; 191:5074-84. [PMID: 24123687 PMCID: PMC3891844 DOI: 10.4049/jimmunol.1300407] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The strong association of HLA-DR2b (DRB1*1501) with multiple sclerosis (MS) suggests this molecule as prime target for specific immunotherapy. Inhibition of HLA-DR2b-restricted myelin-specific T cells has the potential to selectively prevent CNS pathology mediated by these MHC molecules without undesired global immunosuppression. In this study, we report development of a highly selective small molecule inhibitor of peptide binding and presentation by HLA-DR2b. PV-267, the candidate molecule used in these studies, inhibited cytokine production and proliferation of myelin-specific HLA-DR2b-restricted T cells. PV-267 had no significant effect on T cell responses mediated by other MHC class II molecules, including HLA-DR1, -DR4, or -DR9. Importantly, PV-267 did not induce nonspecific immune activation of human PBMC. Lastly, PV-267 showed treatment efficacy both in preventing experimental autoimmune encephalomyelitis and in treating established disease. The results suggest that blocking the MS-associated HLA-DR2b allele with small molecule inhibitors may be a promising therapeutic strategy for the treatment of MS.
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Affiliation(s)
- Niannian Ji
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | - Animesh Somanaboeina
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | - Aakanksha Dixit
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | - Kazuyuki Kawamura
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | | | - Christopher Self
- Provid Pharmaceuticals Inc., 7 Deer Park Drive, Monmouth Junction, NJ 08852
| | - Gary L. Olson
- Provid Pharmaceuticals Inc., 7 Deer Park Drive, Monmouth Junction, NJ 08852
| | - Thomas Forsthuber
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
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35
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Abstract
Multiple sclerosis (MS) is universally found to be more prevalent in women than men. This has led to extensive studies of differences in the immune system or nervous system between women and men, which might be caused by the effects of gonadal hormones, genetic differences, and different environmental exposures and modern lifestyle in men and women. We review the effects of sex and gender from a genetic, immunological and clinical point of view. We discuss the effects of sex on the clinical expression of MS and responses to therapy, as well as issues concerning pregnancy.
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Affiliation(s)
- Hanne F Harbo
- Department of Neurology, Oslo University Hospital, Ullevål and University of Oslo, 0407 Oslo, Norway
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36
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Interaction between HLA-DRB1-DQB1 haplotypes in Sardinian multiple sclerosis population. PLoS One 2013; 8:e59790. [PMID: 23593151 PMCID: PMC3620236 DOI: 10.1371/journal.pone.0059790] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 02/18/2013] [Indexed: 01/24/2023] Open
Abstract
We performed a case-control study in 2,555 multiple sclerosis (MS) Sardinian patients and 1,365 healthy ethnically matched controls, analyzing the interactions between HLA-DRB1-DQB1 haplotypes and defining a rank of genotypes conferring a variable degree of risk to the disease. Four haplotypes were found to confer susceptibility (*13∶03-*03∶01 OR = 3.3, Pc 5.1×10−5, *04∶05-*03∶01 OR = 2.1, Pc 9.7×10−8, *15∶01-*06∶02 OR = 2.0, Pc = 9.1×10−3, *03∶01-*02∶01 OR = 1.7 Pc = 7.9×10−22) and protection (*11, OR = 0.8, Pc = 2.7×10−2, *16∶01-*05∶02 OR = 0.6, Pc = 4.8×10−16, *14∶01-4-*05∶031 = OR = 0.5, Pc = 9.8×10−4 and *15∶02-*06∶01 OR = 0.4, Pc = 5.1×10−4). The relative predispositional effect method confirms all the positively associated haplotypes and showed that also *08 and *04 haplotypes confers susceptibility, while the *11 was excluded as protective haplotype. Genotypic ORs highlighted two typologies of interaction between haplotypes: i) a neutral interaction, in which the global risk is coherent with the sum of the single haplotype risks; ii) a negative interaction, in which the genotypic OR observed is lower than the sum of the OR of the two haplotypes. The phylogenic tree of the MS-associated DRB1 alleles found in Sardinian patients revealed a cluster represented by *14∶01, *04∶05, *13∶03, *08∶01 and *03∶01 alleles. Sequence alignment analysis showed that amino acids near pocket P4 and pocket P9 differentiated protective from predisposing alleles under investigation. Furthermore, molecular dynamics simulation performed on alleles revealed that position 70 is crucial in binding of MBP 85–99 peptide. All together, these data suggest that propensity to MS observed in Sardinian population carried by the various HLA-DRB1-DQB1 molecules can be due to functional peculiarity in the antigen presentation mechanisms.
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37
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Steinman L. A Tip leads cytotoxic T cells to the crime scene in neuroinflammation. Nat Immunol 2013; 14:196-7. [PMID: 23416668 DOI: 10.1038/ni.2551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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38
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Harbo HF, Mero IL. From genes to characteristics of multiple sclerosis. Acta Neurol Scand 2012:76-83. [PMID: 23278661 DOI: 10.1111/ane.12027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2012] [Indexed: 02/03/2023]
Abstract
Multiple sclerosis (MS) is an inflammatory, demyelinating heterogeneous disease of the central nervous system, probably caused by an interaction of common genetic and environmental factors. Much progress has been made through the last few years in genetic studies of MS, and a growing list of genetic risk factors is now available. Biobanking and large collaborations have been prerequisites for this research, and detailed genetic and molecular characterizations are underway, with hopes for to translating new knowledge about MS pathogenesis and characteristics of the disease to personalized, better treatment options for each patient with MS.
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Affiliation(s)
- H F Harbo
- Department of Neurology, Oslo University Hospital, Oslo, Norway.
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39
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Waubant E. Improving outcomes in multiple sclerosis through early diagnosis and effective management. Prim Care Companion CNS Disord 2012; 14:11016co2cc. [PMID: 23469314 DOI: 10.4088/pcc.11016co2cc] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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