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Fischer JC, Schmidt AG, Bölke E, Uhrberg M, Keitel V, Feldt T, Jensen B, Häussinger D, Adams O, Schneider EM, Balz V, Enczmann J, Rox J, Hermsen D, Schulze-Bosse K, Kindgen-Milles D, Knoefel WT, van Griensven M, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Pedoto A, Maas K, Schmidt L, Grebe O, Esposito I, Ehrhardt A, Peiper M, Buhren BA, Calles C, Stöhr A, Lichtenberg A, Freise NF, Lutterbeck M, Rezazadeh A, Budach W, Matuschek C. Association of HLA genotypes, AB0 blood type and chemokine receptor 5 mutant CD195 with the clinical course of COVID-19. Eur J Med Res 2021; 26:107. [PMID: 34530915 PMCID: PMC8444184 DOI: 10.1186/s40001-021-00560-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19, the pandemic disease caused by infection with SARS-CoV-2, may take highly variable clinical courses, ranging from symptom-free and pauci-symptomatic to fatal disease. The goal of the current study was to assess the association of COVID-19 clinical courses controlled by patients' adaptive immune responses without progression to severe disease with patients' Human Leukocyte Antigen (HLA) genetics, AB0 blood group antigens, and the presence or absence of near-loss-of-function delta 32 deletion mutant of the C-C chemokine receptor type 5 (CCR5). PATIENT AND METHODS An exploratory observational study including 157 adult COVID-19 convalescent patients was performed with a median follow-up of 250 days. The impact of different HLA genotypes, AB0 blood group antigens, and the CCR5 mutant CD195 were investigated for their role in the clinical course of COVID-19. In addition, this study addressed levels of severity and morbidity of COVID-19. The association of the immunogenetic background parameters were further related to patients' humoral antiviral immune response patterns by longitudinal observation. RESULTS Univariate HLA analyses identified putatively protective HLA alleles (HLA class II DRB1*01:01 and HLA class I B*35:01, with a trend for DRB1*03:01). They were associated with reduced durations of disease instead decreased (rather than increased) total anti-S IgG levels. They had a higher virus neutralizing capacity compared to non-carriers. Conversely, analyses also identified HLA alleles (HLA class II DQB1*03:02 und HLA class I B*15:01) not associated with such benefit in the patient cohort of this study. Hierarchical testing by Cox regression analyses confirmed the significance of the protective effect of the HLA alleles identified (when assessed in composite) in terms of disease duration, whereas AB0 blood group antigen heterozygosity was found to be significantly associated with disease severity (rather than duration) in our cohort. A suggestive association of a heterozygous CCR5 delta 32 mutation status with prolonged disease duration was implied by univariate analyses but could not be confirmed by hierarchical multivariate testing. CONCLUSION The current study shows that the presence of HLA class II DRB1*01:01 and HLA class I B*35:01 is of even stronger association with reduced disease duration in mild and moderate COVID-19 than age or any other potential risk factor assessed. Prospective studies in larger patient populations also including novel SARS-CoV-2 variants will be required to assess the impact of HLA genetics on the capacity of mounting protective vaccination responses in the future.
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Affiliation(s)
- Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Albrecht G Schmidt
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
| | - Markus Uhrberg
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Björn Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Ortwin Adams
- Institute for Virology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Universitaetsstr. 1, 40225, Dusseldorf, Germany
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Vera Balz
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Jürgen Enczmann
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Jutta Rox
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Derik Hermsen
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty Heinrich-Heine University, Dusseldorf, Germany
| | - Karin Schulze-Bosse
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty Heinrich-Heine University, Dusseldorf, Germany
| | - Detlef Kindgen-Milles
- Medical Faculty, Department of Anesthesiology, Heinrich Heine University, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- Medical Faculty, Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Heinrich Heine University, Dusseldorf, Germany
| | - Martijn van Griensven
- Department cBITE, Maastricht University, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, the Netherlands
| | - Jan Haussmann
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christian Plettenberg
- Medical Faculty, Department of Ear, Nose and Throat Disease, Heinrich Heine University, Dusseldorf, Germany
| | - Kathrin Scheckenbach
- Medical Faculty, Department of Ear, Nose and Throat Disease, Heinrich Heine University, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Alessia Pedoto
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kitti Maas
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Irene Esposito
- Institute of Pathology, University of Dusseldorf, Dusseldorf, Germany
| | - Anja Ehrhardt
- Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | - Matthias Peiper
- Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Bettina Alexandra Buhren
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christian Calles
- Medical Faculty, Coordination Center for Clinical Studies, University of Dusseldorf, Dusseldorf, Germany
| | - Andreas Stöhr
- Medical Faculty, Coordination Center for Clinical Studies, University of Dusseldorf, Dusseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Matthias Lutterbeck
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Amir Rezazadeh
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
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Guerra SG, Hamilton-Jones S, Brown CJ, Navarrete CV, Chong W. Next generation sequencing of 11 HLA loci characterises a diverse UK cord blood bank. Hum Immunol 2020; 81:269-279. [PMID: 32305144 DOI: 10.1016/j.humimm.2020.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/16/2022]
Abstract
The introduction of next generation sequencing (NGS) for stem cell donor registry typing has contributed to faster identification of compatible stem cell donors. However, the successful search for a matched unrelated donor for some patient groups is still affected by their ethnicity. In this study, DNA samples from 714 National Health Service (NHS) Cord Blood Bank donors were typed for HLA-A, -B, -C, -DRB1, -DRB345, -DQA1, -DQB1, -DPA1 and -DPB1 by NGS. Analysis of the ethnic diversity showed a high level of diversity, with the cohort comprising of 62.3% European and 37.7% of either multi-ethnic or non-European donors, of which 12.3% were multi-ethnic. The HLA diversity was further confirmed using PyPop analysis, 405 distinct alleles were observed in the overall NHS-CBB cohort, of which 37 alleles are non-CWD, including A*31:14N, B*35:68:02, C*14:23 and DQA1*05:10. Furthermore, HLA-DQA1 and HLA-DPA1 analysis showed 12% and 10%, respectively, of the alleles currently submitted to IMGT, confirming further diversity of the NHS-CBB cohort. The application of 11 HLA loci resolution by NGS revealed a high level of diversity in the NHS-CBB cohort. The incorporation of this data coupled with ethnicity data could lead to improved donor selection, contributing to better clinical outcomes for patients.
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Affiliation(s)
- Sandra G Guerra
- National Histocompatibility & Immunogenetics Service Development Laboratory, National Health Service Blood and Transplant (NHSBT), Colindale, London, UK
| | - Siobhan Hamilton-Jones
- National Histocompatibility & Immunogenetics Service Development Laboratory, National Health Service Blood and Transplant (NHSBT), Colindale, London, UK
| | - Colin J Brown
- Histocompatibility & Immunogenetics Laboratory, National Health Service Blood and Transplant (NHSBT), Colindale, London, UK; Faculty of Life Sciences and Medicine, King College London, UK
| | - Cristina V Navarrete
- National Histocompatibility & Immunogenetics Service Development Laboratory, National Health Service Blood and Transplant (NHSBT), Colindale, London, UK; Division of Infection and Immunity, University College London, London, UK
| | - Winnie Chong
- National Histocompatibility & Immunogenetics Service Development Laboratory, National Health Service Blood and Transplant (NHSBT), Colindale, London, UK.
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Vorholt SM, Hamker N, Sparka H, Enczmann J, Zeiler T, Reimer T, Fischer J, Balz V. High-Throughput Screening of Blood Donors for Twelve Human Platelet Antigen Systems Using Next-Generation Sequencing Reveals Detection of Rare Polymorphisms and Two Novel Protein-Changing Variants. Transfus Med Hemother 2020; 47:33-44. [PMID: 32110192 DOI: 10.1159/000504894] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/15/2019] [Indexed: 01/19/2023] Open
Abstract
Background Exposure to non-matching human platelet alloantigens (HPA) may result in alloimmunization. Antibodies to HPA can be responsible for post-transfusion purpura, refractoriness to donor platelets, and fetal and neonatal alloimmune thrombocytopenia. For the supply of compatible apheresis platelet concentrates, the HPA genotypes are determined in a routine manner. Methods Here, we describe a novel method for genotyping twelve different HPA systems simultaneously, including HPA-1 to HPA-5, HPA-9w, HPA-10w, HPA-16w, HPA-19w, HPA-27w, and the novel HPA-34w by means of amplicon-based next-generation sequencing (NGS). Blood donor samples of 757 individuals with a migration background and 547 of Western European ancestry were genotyped in a mass-screening setup. An in-house software was developed for fast and automatic analysis. TaqMan assay and Sanger sequencing results served for validation of the NGS workflow. Finally, blood donors were divided in several groups based on their country of origin and the allele frequencies were compared. Results For 1,299 of 1,304 samples (99.6%) NGS was successfully performed. The concordance with TaqMan assay and Sanger sequencing results was 99.8%. Allele-calling dropouts that were observed for two samples with the TaqMan assay caused by rare single nucleotide polymorphisms were resolved by NGS. Additionally, twenty rare and two novel variants in the coding regions of the genes ITGB3, GPB1A, ITGBA2, and CD109 were detected. The determined allele frequencies were similar to those published in the gnomAD database. Conclusions No significant differences were observed in the distribution of allele frequencies of HPA-1 through HPA-5 and HPA-15 throughout the analyzed groups except for a lower allele frequency for the HPA-1b allele in the group of donors with Southern Asian ancestry. In contrast, other nucleotide variants that have not yet been phenotypically characterized occurred three times more often in blood donors with a migration background. High-throughput amplicon-based NGS is a reliable method for screening HPA genotypes in a large sample cohort simultaneously. It is easily upgradeable for genotyping additional targets without changing the setup or the analysis pipeline. Mass-screening methods will help building up blood donor registries to provide matched blood products.
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Affiliation(s)
- Stephanie Maria Vorholt
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Nele Hamker
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Hagen Sparka
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Jürgen Enczmann
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Thomas Zeiler
- German Red Cross Blood Service West, Hagen/Breitscheid/Münster/Bad-Salzuflen, Germany
| | - Tanja Reimer
- German Red Cross Blood Service West, Hagen/Breitscheid/Münster/Bad-Salzuflen, Germany
| | - Johannes Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Vera Balz
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Düsseldorf, Germany
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Geretz A, Ehrenberg PK, Bouckenooghe A, Fernández Viña MA, Michael NL, Chansinghakule D, Limkittikul K, Thomas R. Full-length next-generation sequencing of HLA class I and II genes in a cohort from Thailand. Hum Immunol 2018; 79:773-780. [PMID: 30243890 DOI: 10.1016/j.humimm.2018.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/17/2018] [Accepted: 09/18/2018] [Indexed: 01/02/2023]
Abstract
The human leukocyte antigen (HLA) genes are highly variable and are known to play an important role in disease outcomes, including infectious diseases. Prior knowledge of HLA polymorphisms in a population usually forms the basis for an effective case-control study design. As a prelude to future disease association analyses, we report HLA class I and II diversity in 334 unrelated donors from a Dengue vaccine efficacy trial conducted in Thailand. Long-range PCR amplification of six HLA loci was performed on DNA extracted from saliva samples. HLA-A, -B, -C, -DPB1, -DQB1 and -DRB1 were genotyped using a next-generation sequencing method presented at the 17th International HLA and Immunogenetics Workshop. In total, we identified 201 HLA alleles, including 35 HLA-A, 57 HLA-B, 28 HLA-C, 24 HLA-DPB1, 21 HLA-DQB1 and 36 HLA-DRB1 alleles. Very common HLA alleles with frequencies greater than 10 percent were A∗11:01:01, A∗33:03:01, A∗24:02:01, B∗46:01:01, C∗07:02:01, C∗01:02:01, C∗08:01:01, DPB1∗05:01:01, DPB1∗13:01:01, DPB1∗04:01:01, DPB1∗02:01:02, DQB1∗03:01:01, DQB1∗05:02:01, DQB1∗03:03:02, DRB1∗12:02:01, DRB1∗09:01:02, and DRB1∗15:02:01. A novel HLA allele, B∗15:450, had a non-synonymous substitution and occurred in more than one donor. Population-based full-length NGS HLA typing is more conclusive and provides a sound foundation for exploring disease association in a given population.
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Affiliation(s)
- Aviva Geretz
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Philip K Ehrenberg
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | - Nelson L Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Kriengsak Limkittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rasmi Thomas
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
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