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. 2019 Jul;78(7):996-1002.
doi: 10.1136/annrheumdis-2019-215046. Epub 2019 May 28.

Focused HLA analysis in Caucasians with myositis identifies significant associations with autoantibody subgroups

Affiliations

Focused HLA analysis in Caucasians with myositis identifies significant associations with autoantibody subgroups

Simon Rothwell et al. Ann Rheum Dis. 2019 Jul.

Abstract

Objectives: Idiopathic inflammatory myopathies (IIM) are a spectrum of rare autoimmune diseases characterised clinically by muscle weakness and heterogeneous systemic organ involvement. The strongest genetic risk is within the major histocompatibility complex (MHC). Since autoantibody presence defines specific clinical subgroups of IIM, we aimed to correlate serotype and genotype, to identify novel risk variants in the MHC region that co-occur with IIM autoantibodies.

Methods: We collected available autoantibody data in our cohort of 2582 Caucasian patients with IIM. High resolution human leucocyte antigen (HLA) alleles and corresponding amino acid sequences were imputed using SNP2HLA from existing genotyping data and tested for association with 12 autoantibody subgroups.

Results: We report associations with eight autoantibodies reaching our study-wide significance level of p<2.9×10-5. Associations with the 8.1 ancestral haplotype were found with anti-Jo-1 (HLA-B*08:01, p=2.28×10-53 and HLA-DRB1*03:01, p=3.25×10-9), anti-PM/Scl (HLA-DQB1*02:01, p=1.47×10-26) and anti-cN1A autoantibodies (HLA-DRB1*03:01, p=1.40×10-11). Associations independent of this haplotype were found with anti-Mi-2 (HLA-DRB1*07:01, p=4.92×10-13) and anti-HMGCR autoantibodies (HLA-DRB1*11, p=5.09×10-6). Amino acid positions may be more strongly associated than classical HLA associations; for example with anti-Jo-1 autoantibodies and position 74 of HLA-DRB1 (p=3.47×10-64) and position 9 of HLA-B (p=7.03×10-11). We report novel genetic associations with HLA-DQB1 anti-TIF1 autoantibodies and identify haplotypes that may differ between adult-onset and juvenile-onset patients with these autoantibodies.

Conclusions: These findings provide new insights regarding the functional consequences of genetic polymorphisms within the MHC. As autoantibodies in IIM correlate with specific clinical features of disease, understanding genetic risk underlying development of autoantibody profiles has implications for future research.

Keywords: HLA; autoantibody; genetics; idiopathic inflammatory myopathy; myositis.

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Conflict of interest statement

Competing interests: JV reports grants from Ministry of Health in the Czech Republic, grants from European Community’s FP6, AutoCure LSHB CT-2006-01866, grants from European Science Foundation, during the conduct of the study. IEL reports grants from Swedish Research Council, grants from European Science Foundation, grants from Association Francaise Contre Les Myopathies (AFM), grants from Stockholm County Council, grants from The European Union Sixth Framework Programme, during the conduct of the study.

Comment in

  • New insights into myositis genetics.
    Onuora S. Onuora S. Nat Rev Rheumatol. 2019 Aug;15(8):451. doi: 10.1038/s41584-019-0258-y. Nat Rev Rheumatol. 2019. PMID: 31213705 No abstract available.

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